This is the final installment of a four-part series on heroin and opiate addiction in Iron County. This report deals with recovery from this life-threatening health condition.
IRON RIVER—In some ways, the journey of the addict is ironic.
What often starts as a way for the addict to feel better – whether physically, emotionally or a few even say spiritually – ends in misery. Narcotics Anonymous, the 12-step based recovery program that has been helping addicts for more than 60 years, gives a stark warning to the still-using addict in its basic text.
“We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions and death.”
One local opiate addict recounts the life trajectory of some former drug-using associates.
“One guy was killed, one guy was hit by a car when he was (high), one girl is badly addicted again, one girl is clean now but lived on the street for a year, and one guy is in prison for rape and attempted murder. I’ve known people who have died from overdose, and I know people whose lives are worse than death.”
So the tragic consequences that stem from heroin and opiate addiction are crystal clear. Even those who are fortunate enough not to end up dead or in jail live lives of quiet, or not-so-quiet, desperation. The pleasures associated with the drug are long gone.
While this all sounds terribly depressing, there is hope for the struggling addict. And it comes in a variety of forms – support groups, counseling services, medication therapy, nutritional therapy and inpatient and outpatient treatment programs, to name a few here in Iron County and the Upper Peninsula.
The first thing the addict must do is obvious, but is usually extraordinarily difficult – she or he must quit ingesting the drug. For the severely addicted, this can mean hospitalization and detoxification. For those who aren’t putting themselves in danger by trying to quit on their own, outpatient treatments are available to help with this initial, crucial stage.
Support groups often play a vital role in the addict’s recovery, not only at the start but throughout a lifetime. Narcotics Anonymous, based on the recovery program started by Alcoholic Anonymous in the mid-1930s, is the most well-known. NA is a nonprofit organization of recovering addicts, “who learn from one another how to live drug-free and recover from the effects of addiction in their lives,” states NA literature.
The program is built around the 12 steps of AA, which include principles such as acceptance of the addiction, spiritual practice and reliance, moral inventory, making amends and service to “the addict who still suffers.”
NA is a philosophy of daily living and subscribes to the disease concept of addiction, meaning among other things that once a chemical is ingested, the addict loses the ability to control subsequent usage.
Social support is the key, one local recovering addict said. “You don’t have to do this alone--that’s the big thing. It gets difficult sometimes because you have to learn a whole new way of dealing with your feelings. But it gets better. The (hard times) don’t last forever.”
A new support group for addicts and their families has just begun in Iron River. It’s called United Prevention Outreach and describes itself as “an active group of recovering addicts, family members and concerned community members that are uniting to promote awareness of, and education about, addiction and recovery.
As important as they are, support groups are just one piece of the recovery puzzle. Many addicts --some would argue most --suffer from what are called dual disorders: a substance abuse problem combined with a mental health issue.
“This stuff starts as self-medication for mental health problems,” said GiGi Polich-Van Doren, who is the administrative director for Samaritan Counseling Center of the Western U.P. in Iron River. “If you don’t go back and look at the mental health issues, then we are really going to revisit
the problem (of addiction) over and over and over again.”
Mental health issues range from clinical depression, anxiety disorders, childhood trauma, unresolved grief, guilt, family of origin problems and post-traumatic stress disorder. Counseling techniques to deal with these difficult issues vary from cognitive and behavioral approaches to more traditional psychodynamic or “talking” therapies to newer approaches like the use of meditation.
Often, heroin and opiate addicts in early recovery are in such a critical state emotionally that they need a more intensive approach. In some areas, addicts can elect or agree to long-term, inpatient treatment, often in the form of halfway houses. But Iron County currently does not have a halfway house, so other options are being explored.
One such version is a proposal for “a four-month pilot alternative intensive treatment model” being initiated by Polich-Van Doren, who is seeking funding for a trial implementation of such a program.
“Many, many people who are severely drug-addicted do not have the option of residential care, even though they may qualify for it,” she said. “So what we don’t have in the community is something more intensive that would help these people.”
Addicts in early recovery are often floundering and have little structure to their lives, Polich-Van Doren said. She hopes her program would help provide that structure, albeit in an outpatient format.
Much of early-stage recovery from heroin or opiate addiction must contend with the high relapse rate associated with these addictions. Because long-term use of these drugs changes brain and body chemistry, any effective treatment regimen needs to address this vital area.
Two approaches to treating these changes caused by opiate addiction are medication-assisted treatment (MAT) and nutrition-based therapies. The former is an approach that “uses FDA-approved pharmacological treatments,” according to the Office of National Drug Control Policy.
These pharmaceutical drugs work by interacting with some of the same receptors in the brain that are triggered by the abused opiate.
“It takes at least a year to stabilize brain chemistry,” said Dr. John Lehtinen, who specializes in addiction medicine at Marquette General Hospital. “And there is a 90 percent relapse rate in the first six months with opiate addicts. The brain becomes conditioned to having the drug, and when it doesn’t have it, it creates all kinds of problems. People hate going through the withdrawal, so they relapse.”
The three main MAT options for opiate addiction are methadone, buprenorphine (Suboxone) and naltrexone (Revia or Vivitrol).
“These are anti-craving drugs, and they work on neurotransmitter rebalancing,” Lehtinen said.
Lehtinen said there are no methadone maintenance clinics in the U.P and a limited number of providers who prescribe Suboxone, which is used for detoxification and relapse prevention according to the National Institute of Health.
Lehtinen is one of those providers, but he also knows there are pitfalls with the drug.
“God, yes, it gets abused. It doesn’t give the high of their drug of choice, but it has abuse potential. And it has a big street value now.”
He said that, in his experience, MAT has been successful.
“The general sense is a lot of my patients are doing better than if I weren’t doing this. Some have 5 to 10 years of sobriety. Before, they had nothing. It was a reoccurring soap opera, in getting and staying sober.”
MAT has its detractors, however. One of those is Mike Beiring, a counselor at North County Counseling Service in Ontonagon. Beiring, who has been in practice for 38 years, is a proponent of nutrition- and supplement-based protocols.
Beiring first came across this approach in 2005, when he began to research the work of Dr. Joan Mathews-Larson, who developed a psychobiological model for treating addictions that combines therapy with intervention at the molecular level to repair the biochemical damage from addiction.
“Neurotransmitter deficiencies are the main cause of addiction,” Beiring said. “That is why we have to visit vitamin deficiencies and amino acid deficiencies to gain neurotransmitter balance. (MAT) doesn’t bring back the balance. They create deficiencies.”
This approach attempts to identify nutritionally-based deficiencies and aims to repair those with a variety of supplements and nutrients.
“I’ve seen success within days,” said Beiring, who estimates the cost of his formulas to be between $50 and $60 per month. “Sixty to 70 percent of the (addicts) I see have an immediate response.”
The aim of these approaches is the same: to help treat the opiate addict who lives with an illness that can kill.
Serious business, but despite the pitfalls and the struggles, there’s hope for better days. The message of Narcotics Anonymous speaks to the struggling addict, his or her loved ones and the community at large: “No addict who seeks recovery has to die.” And once again, the addict can live a fulfilling life without drugs.
“The life energy comes back, hope comes back, laughter comes back, and happiness comes back,”
one local heroin/opiate addict said. “I feel like I’m coming back.”
• NA meetings are held on Tuesdays and Thursdays beginning at 7 p.m. in the basement of the First Presbyterian Church in Iron River.
• The United Prevention Outreach meeting is held at 6:30 p.m. in the Legion Room of the Iron River City Hall. The group also has its own Facebook page.