Finding detox and rehab — too little, too far
Whether in a medical setting or a bedroom, detoxification is the first step in recovery, it is the several days during which the body gets through the worst of the physical symptoms of withdrawal.
Withdrawal from heroin or opioids is not itself life-threatening. It can be, however, exceptionally taxing and even painful. Detoxification is possible on your own, but specialized facilities help patients manage the pain in a stable environment, with inpatient stays of five to seven days typically covered by insurance, sometimes with some wrangling to prove medical need.
The nearest such facilities are in Springfield, Holyoke and Pittsfield.
Franklin County is lumped in with these cities in the Bureau of Substance Abuse Services’ regional map, so BSAS has not identified a lack of detox beds in Franklin or Hampshire counties as a problem.
Combined, the four facilities in these three cities in Berkshire and Hamden counties have 157 detox beds, according to staff and websites. Staff at the largest, Adcare Hospital in Worcester, reported 76 beds — with none available on a given day in April.
Some question the need for detox beds when weighed against other scarce treatment resources and would prefer to see long-term treatment the first priority, as detox alone is not recovery.
On the other hand, Probation Officer Michael Higgins, co-founder of an eight-year crusade against heroin in Middlesex County — on which the local opioid task force is loosely based — views short-term treatment as a necessary gateway.
“First thing when somebody comes in, we have to have the ability to put a Band-Aid on it,” Higgins said.
For Higgins and cofounder Chief Probation Officer Vincent Piro, short-term care is primarily a way to get people into the system and out of their old surroundings.
Noticing a growing heroin problem in their area in 2005, the two formed a coalition of local police, educated themselves about the problem, then talked their local legislators into securing a $400,000 line-item in the state budget to fund their work. That money, now half a million dollars annually, gave the Heroin Education and Awareness Task Force (HEAT) access to treatment beds for the addicts caught up in probation or brought to the courthouse by their parents.
Stabilization after detox
With a detox already in place, the two persuaded the company operating that facility to transform a floor into a 30-to-45-day stabilization program. With state money following the people they referred to treatment, the wing essentially functioned as an extension of their task force.
The idea of the stabilization program was to provide a bridge between detox and long-term care. Both of these existed to varying degrees, but the short stays in detox covered by insurance did not provide enough breathing room to find an opening at the next stage and move on.
Detox alone doesn’t put much of a dent in addiction, and while detox is available outside Franklin County, the journey from there to the next step can be difficult and dangerous.
It isn’t as easy as checking into a hospital for treatment for any other medical condition.
Those who try, and try again, describe an experience comparable to phoning in reservations at a series of overcrowded hotels for successively longer stays, often with no room at the inn.
After detox Piro cautions about “Superman Syndrome,” when young addicts emerge after a few days or a week, rested, fed, and maybe feeling healthier and stronger than they have in a long time. They may feel and appear cured, but relapse more often than not without a next step in recovery, and may die in doing so.
The idea of the stabilization program i s to offer addicts and their advocates breathing room while they find the long-term help they so badly need.
— CHRIS CURTIS