About this series
The heroin-fentanyl epidemic has lead to a spike in the number of Clark County residents who have died from unintentional drug deaths. Tom Stafford spoke to several recovering addicts and leaders at McKinley Hall treatment center to dig into new treatment options. Next Sunday, the Springfield News-Sun will look at how Springfield is beginning to reap some benefits from a program that weens pregnant addicts off of heroin so that babies can avoid going through withdrawal in their first days out of the womb.
By the time they’re ready to endure a withdraw from heroin, addicts have lost so many possessions, burned so many bridges and spent so many endless days sacrificing everything to the altar of addiction that they’ve grown uncomfortably numb.
Then during and right after withdrawal, things turn painful, said recovering addict Erin Conwell
Conwell, who is 28 and whose 10-year slide culminated in 2½ years of heroin use, said that although “the trauma happens when you’re in active addiction,” it’s “once you get clean (that) the wreckage of your past crashes in on you.”
As McKinley Hall CEO Wendy Doolittle puts it: “By the time people get to us, they’re so broken.”
Feeling again
Once opiates clear the body, “you can actually feel things and realize the severity of the situation,” Conwell said.
In her case, a situation in which she and her peers had grown comfortable calling themselves prostitutes and junkies.
At McKinley Hall, recovery begins by moving most users to Suboxone, a so-called opioid agonist, meaning that it contains opioids in a form that ease the symptoms of heroin withdrawal.
Addicts are then weaned from Suboxone on “a very, very slow taper,” Mental health therapist Kathy Maddy said, that lasts an average of six months but can differ depending on individual circumstances.
In an inpatient setting, where the environment is more controlled, things can progress more quickly, she said, because patients feel more stable.
In an outpatient setting — “when they still have to live and work and care for their children” — she said it can take longer because those daily stresses can be threats to stability and sobriety.
Other issues can assert themselves in the process.
Conwell, for instance, said her bipolar disorder made her final withdrawal from Suboxone “just as hard as coming off heroin. I didn’t sleep for a week, and I was just crazy, very crazy.”
She then transitioned to monthly injections of Vivitrol, a drug that prevent opiate addicts from experiencing a high even if they use the drugs.
Hurting again
When people do finally leave Suboxone behind, Maddy said the physical pain it and heroin mask emerges.
Lost in addiction, “they haven’t been to a doctor or dentist for years,” she said, and the wear and tear on joints and untended teeth, “all that comes out.”
While depression is common among recovering heroin addicts, Maddy said, “it’s pretty common for our folks (who were IV drug users) to have Hepatitis C,” which adds an extra burden of fatigue.
It’s in this state that they begin to re-enter life off the streets with the help not only of medications but therapists.
Therapists teach recovering addicts how to deal with normal things, in addition to their supportive role, recovering addict Jody Arnold said.
“Some people don‘t even have a birth certificate, a Social Security card,” Maddy said, a reality that suggests parallels between the long room-by-room process of rehabilitating a home and the process of rehabilitating a life.
Arnold said that early in the process, it’s important to focus on short-term goals in order to build momentum while avoiding stress overloads that might lead to a relapse.
Both Arnold and Conwell said their therapists have been crucial to their recovery.
Conwell said that an hour after a group meeting she attended, Maddy set up an appointment for her to get into the Suboxone program.
“If she wouldn’t have shown up, I’d have been (stuck) where I was,” Conwell said.
Conwell also was reassured in knowing that “if I were having any sort of situation, I could come up here and there were four people I could talk to.”
Although she recently completed a 22-month course of Vivitrol, classes in social work at Clark State and is on her way to becoming a chemical dependency counsellor’s assistant — all signs of her progress — Arnold still harbors some worries about formally ending end her counselling relationship with McKinley Hall’s Sarah Collinsworth.
“I don’t want to be a (McKinley Hall) client,” which would disqualify her from being a counsellor’s assistant, Arnold said, but she’d prefer to be able to see Collinsworth in the setting of a private practice.
In the long run, however, it’s also important for recovering addicts to build social support systems of their own.
Finding new friends
Like other aspects of recovery, that can be harder than it seems.
During their periods of active use, addicts become estranged from their family and former friends, sometimes to the point that they feel estranged from non-users.
“I don’t know if I could date anybody who’s not an addict,” Conwell said. “There’s so much they wouldn’t understand.”
Arnold — who has become close friends with Conwell in treatment — understands what her friend means but also has experienced the hazards involved in pairing up with men who are in recovery and slipping into relapse.
She calls it “one of my downfalls.”
Doolittle said that recovering addicts’ families can pose a risk to sobriety, particularly if there is a history of enabling or when efforts at being supportive turn controlling.
After the need for supportive friendships emerged toward the top of a client survey, McKinley Hall established its Many Pathways clubhouse, Doolittle said, which opened last September at Selma Road and Linden Avenues.
Open from noon to 9 p.m. Monday through Saturday, the house hosts not only 12-step meetings but a continuing series of social events and serves as a gathering place for what the agency calls a diverse group of people, including people in recovery and those who advocate for it.
A difficult road
Like the housing McKinley Hall offers to recovering addicts, the clubhouse is an attempt to help people who are putting their houses in order and continuing on the road to sobriety.
But that road is still a difficult one.
Dr. Narinder Saini, medical director of the Medication Assisted Treatment program at McKinley Hall, said relapse rates for long term users of Suboxone, the drug used to wean addicts from heroin, run 60 to 80 percent.
Although the 20 to 40 percent rates for those using Vivitrol represent an improvement, he cautioned that Vivitrol isn’t a magic bullet and worries that because of the medication’s ability to control cravings, “patients may start believing that their sobriety is more solid than it is” and fail to follow through with the rest of their recovery work.
Calling addiction a complex disease that “remains a black box for science,” Saini concluded an email response to questions posed for this story by noting that in the hour it took him to research and write his response, four to five people in the United States had died of overdoses.
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