Rehab, recovery programs absent or overwhelmed
Dorrie Christman, program manager at the 25-bed Watershed Program being set up in a former rest home on Montague City Road in Greenfield, unwraps a chair in one of the double occupancy rooms. The residential rehabilitation program is for women in recovery.
Recorder/Paul Franz Purchase photo reprints »
Program manager Dorrie Christman and staffer Michelle Varady in the kitchen of the newly renovated 25-bed Watershed Program on Montague City Road in Greenfield, a residential rehabilitation program for women in recovery. Recorder/Paul Franz Purchase photo reprints »
The Recover Project community outreach and advocacy coordinator Justin McNary. Recorder/Paul Franz Purchase photo reprints »
“Exquisitely plastic” is how Dr. Ruben Baler, a scientist and lecturer for the National Institute on Drug Abuse, describes the human brain.
The brain can bounce back from a lot, even heroin.
Most of the time.
“You want to give these severely impaired regions of the brain time to re-form because they have been hijacked, handicapped, impaired,” Baler said.
But finding time and a place for help can be tough today.
“There are no inpatient beds when people are ready to go get help,” said Rebecca Bialecki, executive director of the North Quabbin Community Coalition, a nonprofit social service umbrella group in the Orange area. “There’s a long wait for people to get in and often you’ve missed the opportunity to get them in when they’re really open to it.”
The North Quabbin Community Coalition has been around for 30 years, and its mission has changed to suit the times.
Three years ago, the Coalition instituted a substance abuse task force to get what few treatment providers the area has on the same page. It turned out they were a little ahead of the curve. In 2012, opiate troubles skyrocketed. Previously concerned with more familiar alcoholism, now Bialecki and her part-time staff have found themselves trying to help desperate families find treatment for heroin- and opioid-addicted sons and daughters.
Too little help locally
Sometimes they’re lucky and find an opening at a short-term detox elsewhere in the state when the addict has hit bottom and is receptive to the idea. But without the opportunity to continue in a long-term residential rehab program, the affected person comes out of a few days of detox clean, sober and in danger — with a weakened tolerance and no other supports or professional residential care to give them the time they need to change their path — and for their brain to begin recovering physiologically.
Bialecki said she tries to refer people to treatment in Springfield or Worcester, but the beds are limited and need is high.
“When you’re competing with urban populations that have people locally going into those beds, when you’re coming from these rural areas, you can’t even get near them,” she said.
Bialecki believes the best treatment option is a six-month program, but openings in these long-term programs are very scarce.
The Athol-Orange area does have one — the 17-bed Orange Recovery House, run by nonprofit ServiceNet. But while locals have an edge on the waiting list, the men’s home has run at or near capacity for years.
Budget cuts in the mental health and substance abuse fields during the Romney administration closed facilities statewide and left these sectors of the medical field overburdened and underfunded.
Baystate Franklin Medical Center closed its 24-bed detox program, the only such facility in the county, in 2003. The hospital later cut loose its three long-term addiction treatment homes, handing these over to ServiceNet in 2009.
There are currently no detox and no stabilization programs in the county. There are three established long-term recovery homes and one more opened in March, bringing 25 new beds, for a total of 70 this year.
ServiceNet runs the Beacon House for Men and Beacon House for Women in Greenfield and the Orange Recovery House in Orange.
Jay Sacchetti, ServiceNet vice president of Shelter/Housing and Substance Abuse Services, said all three houses added just a single bed last fall in response to new state funding for patients committed through the Section 35 involuntary process, bringing the capacity to 14 in each Beacon house and 17 in Orange.
“We’re at capacity with waiting lists at all three programs,” Sacchetti said. “They kind of ebb and flow, (the lists can hold) anywhere from 10 to 25 people.”
The houses are funded by two separate state Bureau of Substance Abuse Services funding streams, one a general contract covering 70 percent of their costs and another funding Section 35 patients. Section 35 is the legal mechanism through which family members, doctors, police and court officials may force an addicted person into treatment, although it is also sometimes used as a last resort by people who recognize their own addiction and see no other options for help.
The Section 35 money and a third funding stream, Department of Corrections money following addicted parolees, make up the remainder of the state funding — all at a standard $75 per bed per day.
Patients also pay rent if they can, but more often contribute state benefits such as food stamps to the common good.
Insurance does not contribute. Sacchetti said insurers don’t cover long-term care, a topic that might be revisited in future laws.
The houses function on a social model, with patients holding their own support groups and participating in individual and group therapy inside or outside the home, and are not limited to any particular addiction. The recovery homes are not locked or guarded, and the only thing keeping people there is their own desire to recover — and in the case of those on parole or legally committed, the legal complications of leaving.
Sacchetti said they do not discriminate based on what substances are involved — addiction is addiction.
This is the existing system in Franklin County, but it does not involve medical supervision for people in active withdrawal or a safe place to begin recovering while they wait through the waiting lists: detox or stabilization.
Go directly to jail
“The only place I could safely send an addict tonight is to jail,” Dr. Ruth Potee told a forum arranged by the regional Opioid Education and Awareness Task Force in February. Increased access to treatment is a goal of the ad-hoc coalition, spearheaded by regional officials and successful in collecting an audience of legislators and state officials.
“The problem here is no different than the South End, than Quincy. It’s much the same, but we have no resources,” Potee said. “An equivalent problem, fewer resources, greater geography, greater poverty.”
The jail isn’t a detox facility either, even if about 80 percent of the inmates go through withdrawal in their cells. Sheriff Christopher Donelan said the jail has medical staff and a medical unit if necessary to keep an eye on vital signs. Opioid addicts often suffer from dehydration or malnutrition, but there is no weaning the inmate off their drug of choice or even their treatment drugs — Suboxone or methadone — as would take place in an outside detox facility.
Those severely addicted to two other varieties of drug, alcohol and benzodiazepines, may require hospitalization for withdrawal, as their symptoms may be life-threatening.
A fourth facility opened this month.
Last year the Center for Human Development, another nonprofit, won a state Department of Public Health contract to open the first new recovery center in years.
The 25-bed Watershed Program for women opened in mid March, and still had openings in April.