Lifting a ‘death sentence’

During his first few months in the field of addiction recovery, Dr. Ross Tye treated an alcoholic who had been exposed in utero and born with the disease. Now in his mid-20s, the man has a criminal record including three DUIs, Tye said, and seemed beyond help just a few months ago.

But he has turned a corner: During a court appearance last month, according to Tye, his lawyer didn’t even recognize him.

“He had cleaned up, had good color, had a whole different personality,” Tye said. “It’s just so satisfying seeing people grab their lives back.”

Tye, 75, is medical director of the Student Health Clinic at Butte College, plus works at Premiere Primary Care in Chico and Immediate Care Medical Center in Orland. He’s practiced in the North State for more than 30 years and has a long history of filling service gaps in rural communities, including overseeing medical care at nursing homes in Red Bluff, Williams and Willows.

About six months ago, Tye started seeing a gap in Chico: “It became really obvious that Chico has a need for a rehab—both opioid and alcohol,” Tye said. Around that time, he struck up a working relationship with Mary Ellen Smith, a longtime certified addiction counselor. In February, Tye and Smith launched a new outpatient clinic called Chico Life Restored.

It’s a small operation in north Chico. The only other employee is Tye’s wife, Connie, a certified nursing assistant. Tye handles the clinical aspects, such as prescribing medications—suboxone for opioid addiction and naltrexone for alcoholism—while Smith counsels patients and provides ongoing support.

Chico Life Restored has aided the recovery of about 20 patients and, so far, none have relapsed, Tye said.

Most have been referred from the court system.

“I try to educate attorneys on addiction, how it is possible for people to clean up and improve their lives; get back to work, go to school,” Smith said. “People are stuck in an addiction they don’t know how to get out of. It doesn’t have to be a death sentence.”

Of course, it can be. A couple of high-profile heroin overdoses earlier this year have stayed in the back of Smith’s mind, she said.

On Jan. 17, a city worker found Joseph Maybrun, 29, unresponsive in a public restroom with drug paraphanelia. Medical personnel attempted CPR and transported Maybrun to Enloe Medical Center, where he died of acute heroin poisoning, according to coroner records.

Five days later, 20-year-old Harley Young was found dead from a heroin overdose in the alcove of the front doorway of the Chico Area Recreation and Park District’s office on Vallombrosa Avenue.

It’s difficult to parse how widespread heroin addiction is in Butte County, but data indicates that the greater opioid epidemic is hitting the county hard.

According to the state’s 2016 County Health Status Profiles report, which is based on data from 2012-14, Butte County’s rate of drug overdose deaths (30.7 deaths per 100,000 people) is three times higher than the state average.

Oversaturation of prescription opioids is playing a role. According to the California Department of Public Health, in 2015, there were 1,376 opioid prescriptions for every 1,000 people in Butte County.

In terms of curbing the epidemic, Chico needs more clinics that offer detox and rehab services, Tye said, especially given that several doctors in town who prescribe suboxone are set to retire within the next few years and Chico Life Restored is serving only a small portion of the population.

“We’re pretty selective about who we take in. They have to agree to the counseling,” Tye said. “Quite frankly, we are taking only the people who are motivated to change.”

Smith determines whether patients are right for the program during an initial assessment, which, for opioid addicts, includes a test using the Clinical Opiate Withdrawal Scale: a measure of how severely a patient is withdrawing that runs from 0 to 25. Patients must register at least 13 or 14 to be accepted.

Tye then examines patients for the physical side effects of substance abuse (i.e., liver and heart failure) and prescribes medications to ease withdrawal. Suboxone suppresses withdrawal symptoms and cravings for opioids without the same euphoric high. Naltrexone is another opioid-blocker, but it is also approved by the U.S. Food and Drug Administration for the treatment of alcohol abuse.

Through counseling, Smith aims to address patients’ underlying mental health conditions, encourages reconnecting with family and friends, and generally emphasizes healthy living. “It’s treating the whole patient,” she said. She’s on call 24 hours a day to support patients through the withdrawal process.

Chico Life Restored is not an inpatient facility. Most of the time, people go through withdrawal under supervision at home.

“I’m always in touch with the patients, and we make sure a family member is present,” Smith said. In a handful of cases, patients’ withdrawal symptoms have been severe enough to warrant a hospital stay. “People don’t understand that you can’t just stop; there are certain side effects that are unpleasant and dangerous. If you’ve been drinking hard enough and long enough, you could have a seizure and die.

“We have a serious problem in Butte County,” Smith continued, “and we’re trying to help one patient at a time.”