The letter starts out like this:
"None of us, myself included, had any idea where we would go after our inpatient treatment. When Mercy (Recovery Center) asked me what my plan was after release from detox, I responded 'I have no idea, I have no place to go.' The answer was the same for S.G., P.W. and J.A. We just wanted to go to a safe place. We wanted to be around clean and sober people. We wanted the highest odds of success."
Because of a $1 million grant awarded last year to the Recovery Center at Mercy Hospital in Portland, Maine, and its consortium partners, successful recovery is a much stronger possibility for this addict and others like him. The grant provides funding for residential-level treatment services in a safe, sober living environment to those suffering from alcohol and other substance abuse, and engages a collaborative team of social service agencies and providers to help these recovering addicts transition back into the community.
Federal and state governments are cutting budgets for residential addiction services at a time when the need for treatment is increasing. Some treatment facilities have closed because of financial losses. Access to residential beds is very limited in Maine.
"Previously, we found ourselves very frustrated because addicted patients would stay here for three days in detox and then we would have to discharge them," explains Burma Wilkins, director of the division of behavioral health at Mercy Recovery Center at Mercy Hospital.
"We knew that often we were discharging them back into the same environment, be it homelessness or a very unstable home situation. It was dismal — it just seemed like a waste.
"But as a result of this grant, we have client-driven recovery plans in place designed to focus on strengthening the physical, emotional, relational and spiritual health" of the recovering addict, she adds.
Opiate hot spot
Perhaps nowhere in the U.S. is the need greater for addiction recovery help than in Maine. A recent report from the federal Substance Abuse and Mental Health Services Administration shows that over a 10-year period, Maine led the states in the percentage of admissions to substance abuse services for addiction to "non-heroin opiates" — painkillers such as OxyContin, Percocet and Vicodin.
Admissions to licensed or certified substance abuse programs for opiate addiction treatment swelled in Maine to nearly 10 percent in 2008 from 2.2 percent in 1998. The report also states that 386 of every 100,000 residents age 12 or older were admitted for treatment of painkiller addiction in Maine in 2008 — more than eight times the national rate of 45 per 100,000 people.
Wilkins and other health care providers say the state has had a mounting problem with doctors overprescribing pain relievers and with patients getting prescriptions from more than one doctor. In addition, drug smugglers have stepped up their efforts to meet the illicit demand.
Last September, with bipartisan help from the state's U.S. senators, Mercy Hospital, which is a member of Newtown Square, Pa.-based Catholic Health East, received a $1 million earmark grant from the federal substance abuse agency to expand capacity for residential services for recovering addicts. Given the grant stipulations, including that no new facility be built, Mercy contracted with two Portland-area residential treatment centers — Youth Alternatives Ingraham and Crossroads for Women — to develop innovative residential-level treatment services for the area.
The thinking is this: Why use an expensive building with 24-hour round-the-clock staffing for treatment purposes, if patients can be discharged to a safe housing environment and given outpatient substance abuse counseling and life training skills, and have the same or better chances of staying in recovery from drugs and alcohol than in the more costly residential program?
"The use of peers who are in recovery to help clients get transportation, find AA meetings and share their stories provides a level of hope and dignity that is powerful," says Wilkins. "The hope is that through the collective power of this consortium, the current system of care will be transformed into a patient-centric, collaborative and financially sustainable model."
Making a difference
Pat McKenzie is vice president of adult mental health services at Youth Alternatives Ingraham, which runs State Street House for homeless men with co-occurring mental health and addiction disorders. She explains that as a result of the grant, Mercy can refer up to four men to State Street where they typically stay for an average of 30 days as they continue to recover. If need be, these men can stay longer as they look to secure permanent housing and a job.
"One of the commitments we made is that they came to us homeless but we are not discharging them back into that environment," says McKenzie. "We need to get them into stable housing, but they have no money or resources. And there is a waiting list for vouchers."
As part of the grant, Wilkins at Mercy assembled an advisory board that brings together "everyone in the community" who is in a position to help substance abuse addicts and the homeless, says McKenzie.
"Together, our focus is on a structured sober living plan that maintains the momentum of recovery," she says. "We ask these men what it is they want and help them to establish a sense of where they want to go. We look at the different domains in their life — physical health, spiritual health, family, etcetera — and look at their strengths in these areas and their needs.
"Then we have the men set an action plan, where we ask them, 'What steps will you take this week? Next week? The next 30 days?' Sometimes the plans need to be changed, and they are constantly being reevaluated. But the idea is to start with a recovery-oriented, proactive plan that takes into consideration their physical health, their mental health, their spiritual health, their relationships and their working, playing and learning selves. They examine their strengths in those areas and their needs. We build on the body, mind and soul, treating not just the disease but the whole being," McKenzie says.
Crossroads for Women adheres to a similar philosophy. That organization provides outpatient and residential treatment for women with substance abuse issues. Crossroads is where Mercy refers women after they go through detox at the hospital.
Through the grant program, Crossroads made a small cottage on its property available to house four women. They typically stay for up to 30 days and go through Crossroads' intensive outpatient program. Like the men at State Street House, the women at Crossroads are there voluntarily.
Shannon Trainor, clinical director at Crossroads, says what's so advantageous about the grant program is that once the women are released from Mercy, there is a safe place for them to go for help almost immediately.
"Typically, there is a three-to-six week wait for our residential treatment program," she says. "With the grant program, we can provide a sober living option much sooner."
Through the outpatient program, the women receive three hours of intensive therapy a day and participate in life skills groups, working with community providers on issues ranging from domestic violence to substance abuse counseling to vocational training.
While it's too early to determine the success of the grant program, McKenzie and Trainor are encouraged.
McKenzie points to the letter from the State Street House resident as evidence that the program is having a positive effect.
"We feel that we have a real advantage because of this program, that our long-term results will make you all proud of the work you do, and the difference you make," he writes. "I know without a doubt ... our lives will be changed forever for the better because of this opportunity."
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