A growing concern in communities across America, opiate addictions are impacting us all. These questions, from a panel held at Grace Farms entitled “The Community Impact of Opiates,” are answered by moderator Counselor/Pastor Stuart Knechtle Mdiv, MA, MFT/MHC of Grace Community Church, and participants Rod Khattabi, Grace Farms Foundation’s Director of Safety & Justice Initiative Advisor, Dr. Frank Bartolomeo, PhD, Director of Behavioral Health Services at Southfield Center for Development, Devin McCrossan, an inspiring speaker and leader on the topic of substance abuse, Martin Brault, MS, CAC, LADC, a licensed alcohol and drug abuse counselor, and Ines Cenatiempo, the Victim Witness Coordinator for the United States Attorney’s Office, District of Connecticut.
What is the desired outcome of hosting events educating people about the opiate crisis?
Stuart Knechtle, Mdiv, MA, MFT/MHC: "The opiate crisis is an extremely challenging epidemic that is pervasive throughout our community. Simply by hosting this panel, we are working to eradicate the stigma surrounding addiction by raising awareness. It is our hope and our prayer that events of this nature will continue to shed light on a disease that touches almost everyone—and that it will help those who need to recover physically, mentally, emotionally and spiritually."
What is addiction and how can we think about it rationally?
Frank Bartolomeo, PhD: “Changes occur both in the structure and functioning of the brain when someone becomes addicted. I look for the three Cs to determine the progression: 1) Continued use despite adverse consequences—legally, family-wise, relationally, and academically—that don’t keep them from using, which shows they aren’t learning from errors; 2) Attempts to control their use unsuccessfully; and 3) Evidence of cravings or compulsions to use. Those three things together typically mean you are dealing with someone who has crossed that line over into addiction.”
How does the disease of addiction feel in the mind of an addict?
Devin McCrossan: “Addiction is a vicious cycle. I would always want to be somewhere else, with someone else, doing something else. I would want to use drugs to get out of myself, to feel better. From there I would start obsessing. That’s what it is: The disease of addiction overrides the brain and becomes an obsession to want to use the drugs. Addiction hijacks the brain so that using is the only way you know how to live.”
Why are we seeing such a large spike in heroine use in young people?
Rod Khattabi: “It’s all about the money: one oxy pill on the street goes for about $60 to $100, whereas you can have a fix on heroin for 10 bucks. These pills are so addictive, and once you’re hooked on them it’s very hard to stop. A lot of the kids I arrested in my time in law enforcement became suppliers simply because they ran out of money to finance their habits, or turned to heroin because they didn’t have the money to buy pills.”
How do you broach the subject of addiction with family members?
Martin Brault, MS, CAC, LADC: “When it comes to prevention, start those conversations early and have them often. We call it a family disease because the addict’s behavior shapes the whole family, and their family system starts operating around managing that addict and trying to control his or her use. Family members can be a huge help to prevent things from ever progressing to that point, however. One of the things we tell parents is to begin to set clear expectations with your children early on.”
How do people in relationships with addicts—family or otherwise—have to change to help their loved ones recover?
Frank Bartolomeo, PhD: “If you are in a close relationship with someone who is affected, you are going to have to learn to love differently. We are hardwired to step in, and want to step in and do more when we see someone we love suffering. We want to protect them and bail them out of consequences. Instead, you have to both love them and hold them accountable to the natural consequences of their actions. Sometimes loved ones’ well-intentioned efforts can actually contribute to ongoing use.”
What is the accountability to the doctors to help young people avoid situations in which they increase their risk of being exposed to these highly addictive medications?
Ines Cenatiempo: “Doctors have a responsibility too, and we have prosecuted doctors for illegally prescribing opiates. A lot of doctors are good doctors, but some may not have received the training needed to recognize the signs of addiction. Parents and other family members can play a critical role here advocating for those vulnerable to addiction. ”
Can you point to some effective treatment approaches?
Martin Brault, MS, CAC: “Often insurance companies pay only for what is referred to as medical necessity—the detox phase of treatment—which is somewhere between 5 and 12 days of in-patient treatment. While the patient will be drug-free and may no longer experience horrible withdrawal symptoms, they will be in a prime position to relapse. Insurance may also cover IOP (Intensive Outpatient Programs), but the difficult aspect with IOPs is that at the end of the day they send people back to their home environments with the original influences--friends, dealers, etc.—that originally led them to use. We like the idea of a person being out of their original environment for an extended period of time. The good news is there are some programs being created to make a 60 to 90 day treatment model affordable for families. There are also fantastic stories of recovery going on in communities, in 12 step programs, and other secular and spiritual programs, that addicts can incorporate into their daily lives and take advantage of from home.”
What about for families who can’t afford expensive treatment facilities?
Devin McCrossan: “I wouldn’t necessarily correlate the quality of treatment with the cost of the facility—just because you can’t afford to pay $100,000 dollars doesn’t mean you can’t get quality treatment. There are non-profit organizations —like the Owl’s Nest—where individuals can actually work to help pay for their stay if they don’t have insurance or if they don't have insurance or funds to cover treatment.”
How does community impact people’s chances for recovery?
Frank Bartolomeo, PhD: “Community is so important, especially when we look at addiction as a relational disease where someone develops a primary relationship with a substance. When they have this relationship, they stop turning toward other human beings for comfort and solace, which is one of the reasons why addicts tend to be so isolated. What communities like AA do, is teach people to turn toward people for these relationships rather than toward substances.”
What steps are we taking at the law enforcement level to end this crisis?
Ines Cenatiempo: “We are seeing a spike in numbers across the states in deaths in young kids, between the ages of 18 and 25 from opiate use. Our office is taking a two-pronged approach—both from a prosecution and awareness standpoint—because we know prosecution alone is not enough.”