Home Posts tagged Substance abuse
COVID-19

Glass Half Full

By Mark Morris

many people with a history of alcohol abuse have relapsed

Edna Rodriguez says many people with a history of alcohol abuse have relapsed during the pandemic due partly to boredom and disconnection.

Each October, as the weather becomes colder and the days get shorter, it’s not unusual to see an increase in demand for substance-abuse services due to seasonal depression. This fall, however, counselors are expecting an even larger spike in the need for their services because of COVID-19.

Since the beginning of the pandemic, treatment centers in Massachusetts have seen an increase in opioid-related overdoses in the patients they treat — a problem exacerbated by the fact that the drugs have become more dangerous, said Steve Winn, president and CEO of Behavioral Health Network (BHN).

Health professionals believe the problem stems from interruptions in the worldwide supply chain of illegal drugs, making it harder to get heroin and synthetic opioids like fentanyl. As a result, what is being sold as pure heroin is often mixed with a more lethal type of fentanyl, causing the increase in overdoses and deaths.

“We don’t know if use is up, but we know the repercussions of use are more serious now than they were a year ago,” Winn told BusinessWest. “In 2018 and 2019, Massachusetts had begun to flatten the curve on opioid overdoses, but now that curve has accelerated up.”

It’s not a regional problem, he added, as the most recent data shows opioid deaths up in every county in the state.

People with substance-use disorders often have a co-occurring mental-health diagnosis, a situation that may increase their COVID-19 risk, said Millie Rivas, clinical supervisor for Outpatient Behavioral Health at Center for Human Development (CHD), adding that several factors can make people with substance-use disorders more vulnerable to coronavirus.

“Patients with a co-occurring diagnosis usually have a history of poor healthcare and poor nutrition,” she noted. “Add substance use to that, and they become a magnet for COVID-19.”

In short, the stress and anxiety caused by the pandemic — and the economic turmoil that has followed in its wake — aren’t the only COVID-related factors making things tougher for those struggling with substance abuse and those striving to help them. Not by a longshot.

 

From a Distance

Even treating people with substance-use issues became more complicated when the pandemic first hit. By following CDC guidelines to keep everyone safe, one-on-one support was severely reduced, resulting in more isolation for vulnerable people who needed help.

While support has largely shifted to virtual appointments, Rivas and her staff have had to provide technical guidance, as well as their normal counsel to their clients.

“We’re doing things we aren’t accustomed to, such as training people how to use Zoom platforms and how to use their phone beyond Facebook so they can reach services and telehealth,” she said.

Working on virtual platforms allows CHD staff to interact in a more normal way with clients and observe their behavior. Rivas noted that meeting one-on-one would require clients to wear masks, making it more difficult to hear them or see their facial expressions. When clients use virtual platforms, they are also able to increase their engagement in the world.

Steven Winn

“We don’t know if use is up, but we know the repercussions of use are more serious now than they were a year ago. In 2018 and 2019, Massachusetts had begun to flatten the curve on opioid overdoses, but now that curve has accelerated up.”

“At times, going virtual has been frustrating for the client, but overall, it’s nice to have them experience an achievement like that,” Rivas said, adding that clients can now more easily connect with healthcare providers as well as family and friends, and hopefully become more engaged and feel less isolated.

While it’s not surprising that those with a history of substance abuse would be more vulnerable during a pandemic, Rivas has observed an increase in substance use among people with no diagnosed substance-use disorders. The myriad factors include health concerns, increased isolation from not going out and socializing, and anxiety about finances. “It’s not unusual for people to manage stress with one too many beers or one too many glasses of wine.”

Winn noted that clinicians at BHN have observed an increase in people coming in to talk about alcohol use and overuse. “They are self-medicating because they feel more stressed, more unhappy, and more isolated.”

Edna Rodriguez, director of Clinical Assessment and Clinical Ambulatory Programs at Providence Behavioral Health Hospital, has noticed a trend during the pandemic of people having relapses and abusing alcohol after years of being clean and sober. She cited one example of a person who relapsed after five years of sobriety. Clients tell her they start drinking again out of boredom and being stuck at home.

“In my opinion, since COVID hit, we’ve seen an increase in the glorifying of alcohol use,” Rodriguez said, noting social-media memes about people day drinking and taking Zoom calls with a drink in hand. While meant to be humorous, she explained, these messages are dangerous for people with substance-use disorders, especially when so many are feeling less connected to the community.

“Distractions that were healthy, like going to the gym, going to church, or programs that encourage people to live healthy lifestyles, have all been reduced or eliminated,” she said. “We’re in a moment of depleted connections.”

Because the pandemic creates uncertainty for everyone, Winn encourages anyone who has a question about their substance use to reach out to BHN or one of the other local agencies.

“If you’re struggling with something, reach out and ask for help. We’re all doing telehealth, so it’s safe in terms of social distancing.”

 

Heal Thyself

Providers face a dilemma of trying to help people while at the same time feeling their own stress and uncertainty about the coronavirus. Rodriguez said many of her colleagues are experiencing ‘pandemic fatigue.’

“I wish there was a book on my shelf titled ‘How to Treat Substance Use Disorders During a Pandemic,’ but we don’t have that book; we’re all new to this, and we’re still learning.”

Rodriguez and her colleagues are supporting each other by having conversations about how to stay grounded. She mentioned a ‘comfort cart’ that goes around to staff with bottles of water, soda, and treats like chocolate and candy.

“It’s a way of recognizing that everyone is stressed and needs something to comfort themselves,” she said. “The more we take care of each other, the better resource we’re going to be for our patients.”

Rivas said she often reminds her staff about the importance of self-care.

“It’s easy to forget about yourself when you’re trying to take care of someone else,” she noted, adding that, among other changes since COVID-19, staff can no longer use their offices for one-on-one meetings because they are too small to accommodate proper social distancing.

As everyone is still trying to figure out how to stay safe from a virus that just won’t fade away, Rodriguez said her normal work process now includes thinking about how to take care of herself as a provider.

Yet, she remains hopeful the scientific and therapeutic communities will use their creativity to develop new ways for everyone to deal with coronavirus. “These times are calling for an honest and humble review of how we administer treatment, how we approach our patients, and how we approach ourselves as providers.”

Health Care

Recovery Mission

Michael, a three-time resident of Goodwin House

Michael, a three-time resident of Goodwin House, feels he has finally found the strength and resolve to stay on the path to recovery.

Chantal Silloway started using substances at age 12 and eventually battled her way to sobriety at 25; she’s been clean for 32 years. With her background, she knows full well that no two people take the same path to substance use, and likewise, no two take the same path to recovery. This is the mindset, and operating philosophy, she brings to her role as director of the Goodwin House in Chicopee, a place where young men try to piece their lives back together.

Michael (policy allows use of his first name only) remembers that not long after his family moved while he was in middle school, he started “looking up to the wrong people.”

This was a development that would have consequences he says he couldn’t have foreseen.

He told BusinessWest that his descent into substance abuse began when he started drinking with these individuals and smoking some weed, as he put it. Things would only escalate from there.

“I started doing percocets and slowly became addicted to those,” he recalled. “Then I couldn’t afford them anymore, so I was introduced to heroin, and soon developed a real problem … I wasn’t feeling good when I wasn’t using it, and when I was using it, I felt fine.

“I hated life. It was like … I wasn’t even enjoying the fact that I was super young and had so much to look forward to. I didn’t really care anymore, because all I needed was that drug.”

“Eventually, I turned over to the needle, and once I started shooting it, it became a whole different ballgame,” he went on. “It became my life — that became my top priority every day. I eventually spiraled out of control; I dropped out of high school, I started stealing from friends, family … anything I could do to get that fix.”

Michael was offering these flashbacks while sitting down with BusinessWest on the front porch of Goodwin House, a large home on Fairview Avenue in Chicopee. This unique facility, the only one of its kind in the Commonwealth, is a 90-day program providing substance-abuse treatment for males ages 13-17, operated by the Center for Human Development (CHD). Michael says he feels at home here, and he should; this is his third stint here and also his last.

He’ll be aging out of the program soon, but, more importantly, he feels he has, through the help of those at Goodwin House, found the strength and resolve to stay on the path to recovery, with his next stop hopefully being a so-called ‘sober house’ for individuals over 18.

“This is a great success story — we’re very excited for him,” said Chantal Silloway, program director at Goodwin House and someone who can, like many in positions like hers, speak from experience when it comes to substance abuse and recovery.

“I started using substances starting at age 12, and became clean at age 25; I’ve been sober for 32 years,” said Silloway, who has worked for CHD since 2004 in various capacities involving substance-abuse programs. “It’s long been my goal to lead a program like this one.”

With her background, Silloway knows that no two people take the same path to substance use, and, likewise, none take the same path to recovery. Thus, this 90-day residential recovery program focuses on the uniqueness of each young man that arrives at its door, with a view to self-empowerment and the future they choose.

Chantal Silloway says no two people take the same path to substance abuse, or to recovery.

Chantal Silloway says no two people take the same path to substance abuse, or to recovery.

Elaborating, she said that young men are referred to Goodwin House from a variety of sources, including detox facilities, hospitals, the Department of Children & Families, the Department of Youth Services, and parents and guardians themselves. But where they were referred from is not really important, she said. What is, however, is that they arrive with a willingness to help themselves.

Without that, recovery is simply not attainable, she went on, adding that Michael is a good example of this, as we’ll see, and also an example of why many residents make return visits to this facility.

At Goodwin House, a team of clinicians and recovery specialists use evidence-based programs to help residents find and maintain sobriety. Treatment programs include assessment and treatment planning, individual and group therapy, recovery school and/or educational tutoring, vocational and employment-search assistance, recovery meetings, and after-care services and resources.

Often, said Silloway, the path to recovery means getting family members deeply involved in the process, so there is a family-therapy program as well.

Success at this facility is measured in different ways, she went on, adding that while residents do “graduate” from this program and there is a ceremony to commemorate that, there are other milestones, such as ongoing care, accomplishing specific goals that residents have set, and simply becoming ‘stabilized,’ a significant goal in itself.

For this issue, BusinessWest paid a visit to Goodwin House and talked at length with Silloway and Michael. And it is through his eyes, and his thoughts, that we came to understand what happens at this unique facility and how it is helping others change the course of their lives.

Strong Dose of Reality

Flashing back again to those days when heroin was dominating his life, Michael said he needed five to 30 bags of the drug a day, meaning he needed $20 to $80 a day to fuel his habit. And, as he said, he would do anything he had to do to come up with that cash.

Addiction caused him no end of legal problems, and it strained relationships with family and friends to the tipping point and beyond, he went on. But the actual toll was much, much higher.

“I hated life,” he said. “It was like … I wasn’t even enjoying the fact that I was super young and had so much to look forward to. I didn’t really care anymore, because all I needed was that drug.”

Most all of the people who come to Goodwin House are there because they arrived at the same place that Michael did, said Silloway — a place where they probably hated life and didn’t really care anymore. And they needed a way out and a path to a better life.

Helping to provide all that was the motivation for Goodwin House, a facility named after Jim Goodwin, long-time director of CHD. It opened its doors in May 2017.

“Eventually, I turned over to the needle, and once I started shooting it, it became a whole different ballgame. It became my life — that became my top priority every day. I eventually spiraled out of control; I dropped out of high school, I started stealing from friends, family … anything I could do to get that fix.”

The program operated there was created from the ground up by Silloway, and modeled loosely on a similar facility for young girls ages 13-17 in the Worcester area called Highland Grace House.

Residents must have a substance-abuse disorder, and the substances range from marijuana to alcohol to opioids, said Silloway, adding that a resident’s journey there begins with a referral, usually after a stint in detox.

This is a treatment facility and a next step after detox, she told BusinessWest, adding that Goodwin House can accommodate up to 15 young men at a given time. There are a handful there now, and there could and should be more given the state of the opioid crisis in this state and this country, she went on, but there is still a powerful stigma attached to addiction, and this is, unfortunately, keeping many from seeking the help they need.

Residents — that’s the term used to describe those participating in the program — come from across the Commonwealth, noted Silloway. They arrive, as she noted earlier, under different circumstances and with unique backstories.

But the common denominator is that successful recovery must begin with admitting that one has a problem, and possessing a willingness to do something about it — ingredients that are very often missing from the equation.

“We focus on them wanting to be here as opposed to being mandated, and some can be mandated to come,” she explained. “When they get here, they need to have a willingness to work on themselves.”

At Home with the Concept

Indeed, Michael said his first visit to Goodwin House was triggered by his arrest on various charges (he didn’t want to get into any great detail) in November 2017, followed by a stint in detox.

“I was sent here,” he said, putting heavy emphasis on that word ‘sent.’ “I came here for all the wrong reasons; I wasn’t coming here for myself at first, I was coming for the courts.”

With the benefit of hindsight, he believes that first time in detox and his initial visit to Fairview Avenue ultimately saved his life. But he knows now that he when he first arrived, he just wasn’t ready to change — as in change his friends, the places he hung out at, or, most importantly, himself as a person.

This residential treatment program for males ages 13-17 is the only facility of its kind in the Commonwealth.

This residential treatment program for males ages 13-17 is the only facility of its kind in the Commonwealth.

He started using again while he was at Goodwin House, got kicked out of the program, went back to detox, came back to Goodwin House, used again after only a few weeks, and was again kicked out of the program. He went to detox yet again and then to a halfway house in the Boston area, where he was discharged for using. The frustrating cycle continued with one more trip to detox and his third referral to Goodwin House. This time, though, things were different.

Silloway told BusinessWest that those addicted to substances like heroin, other drugs, and even alcohol are essentially in recovery for the rest of their lives. Recovery is a journey, and very often a long and difficult one, she went on, adding that is why it is not considered a failure to relapse and return to Goodwin House a few times, as Michael has.

“As someone’s leaving,” she said, “we say, ‘we hope we don’t see you back here, but if you need us, we’re here.’”

Michael still needed them, and they were there for him when he checked back in over the summer. Only this time, he arrived with a different attitude.

“When I went to detox for the fourth time, I decided I was sick of living that way and knew I needed to make some changes,” he recalled.

And over the course of the past 10 weeks or so, he has made some, and, with the help of the large support network at the Goodwin House, Michael is ready to do something he was never ready to do before — live without drugs.

“I feel like I wanted to make a change — I just didn’t know how,” he said. “But then, I started second-guessing whether I wanted to make that change. I got through that second-guessing, but I’m addict; I’ll always want to use. But now, it’s a matter of what will happen if I use. Am I going to die? Am I going to have more legal issues?

“Now, I’m happy,” he went on. “Before, I didn’t have any emotion — I just got through the day. Now, I can take in the memories that I have; every day, something can happen, and it can turn into a good memory or a bad memory.”

When asked about the long term, Michael said he doesn’t think in such terms. In fact, he doesn’t even take things one day at a time.

“I’m locked in on thought-by thought, minute-by minute,” he explained, “because that last thought can bring you right back to where I was.”

Positive Steps

On Oct. 18, Michael will turn 18. As noted, he will then officially age out of Goodwin House. He’s hoping that his next short-term address will be a sober house, which will be what he called “another stepping stone on the journey to living without drugs.”

He admits to being somewhat nervous, but not scared.

“The way I was brought up was to always want more out of life, to achieve something greater than you’ve already achieved,” he explained. “I want to keep putting one foot in front of the other every day, because I don’t want to take one step forward and two steps back. I did that for such a long time … I don’t want to start this all over again.”

Getting to this point has been a long struggle, but Michael has found the will to change and keep moving forward. The Goodwin House has played a huge role in that, and the goal moving forward is to write more success stories like this.

George O’Brien can be reached at [email protected]

buy ivermectin for humans buy ivermectin online
buy generic cialis buy cialis
payday loans online same day deposit 1 hour payday loans no credit check