Two-part series: Breaking the chains of opioid addiction
Editor's note: This is the second article in a two part series on opioid addiction in the local area. Click here to read the first.
BEMIDJI—Cody Coyer, an alcohol and drug counselor at Lakes Region Chemical Dependency in Bemidji, said he's seen opioid addiction since he was a teenager in Bagley.
"Somewhere around eight years ago, we started seeing a bit of a switch and a lot of people switched to heroin. Part of that was... it's cheaper to manufacture," Coyer said.
"People don't know they're going to get addicted when they start, though. It's really driven by three areas, biology, psychology and a person's social environment."
As the opioid issue continues to grow locally, programs such as Lakes Region and others in the community have been working to reverse the trends and help people break their addictions.
"As far as the pathway for treatment for opioids any other drug, it's about dealing with the withdrawals first," Lakes Region Treatment Director Amanda Longie said. "We have to make sure these individuals are comfortable so they can distract themselves long enough to stay sober. We've got to get some sobriety under their belt so they can learn some coping skills. The longer they have sobriety, the more the brain can do some healing in terms of calming down. That part of it can take a year at minimum."
Because opioids are so addictive, though, Beltrami County Public Health Director Cynthia Borgen said some treatment includes a smaller dose of a different level opioid. For example, methadone and suboxone are common forms of treatment.
"From the outpatient setting, if we recognize that they can't function without the drug, we usually make a recommendation for them to go to residential treatment so they can be monitored during the detox process," Longie said. "For opioids and heroin, the stays can be longer than the 30 day average, though, with it being closer to 40-to-60 days."
"One of the things about opioids that's so destructive is how ill people get when they're coming down from it. It's like the flu, times a hundred," said Amanda Rohloff, alcohol and drug counselor at Lakes Region. "People get shakes, sweats, aches and they can't sleep. So, it makes it a little more difficult to treat, just because of the stronghold it gets on somebody. It makes your brain believe that you need it."
"Once they do exit out of residential, they can go into outpatient, which is a lot more work," Longie said. "They have all of their life factors along with managing their sobriety. So, we are here to support them and facilitate sober activity for them so they can manage their life."
Face It Together is another Bemidji center where individuals suffering from addiction can find support. They offer offer peer-to-peer management services.
"We pair people with a recovery coach, whether they're in recovery or they are a loved one of someone suffering from this disease," said Margot Kelsey, Face It Together executive director. "We let them create their own recovery or wellness plan."
At Face It Together, Kelsey said many of the people who seek support had their addictions originate from either self-medication for a mental illness and/or from doctors.
"That's what we're seeing here, and then they're not being prescribed opioids anymore," Kelsey said. "Once a person starts to chemically alter their brains, they get stuck in this cycle and they need more of that substance. Nobody starts out saying 'I want to be addicted to something.' It happens because of a progression."
Recovering from that addiction isn't a 'one-size-fits-all' scenario, either, as Kelsey said individuals have many pathways to get better.
"We don't all fit in one box. We're very different with different paths in life, so everyone's recovery path can look different," Kelsey said. "That's why it's important to have as many options available."
Stigma with addiction
Along with navigating through recovery, Kelsey said those trying to get better also have to deal with sometimes harsh perceptions from society. Despite the fact addiction was classified as a disease in 1957 by the American Medical Association, Kelsey said many don't think of it as such.
"This disease is isolating and punishing. That's what it does to you as an individual, and then society isolates and punishes further," Kelsey said. "The antithesis of this disease is connection and community, so, if we can connect people to other people in this community, they have a chance. The majority of people can't do this alone."
Dr. Joseph Corser, who works at Sanford Bemidji Medical Center and who's involved with the First Steps to Healthy Babies program, agrees with Kelsey's notion about the view toward those with addiction.
"We need people to understand that a substance abuse disorder is like having high blood pressure or other routine medical problems," Corser said. "There's an element of people deciding to do something. But on the other hand, once a person has an opioid use disorder, their brains are different. We need to have addiction come into the realm of medical therapy and not just see it as somebody who's just made a bad decision."
Kelsey, who suffered from alcohol addiction herself before recovering, also has fought cancer. As a result, Kelsey learned firsthand people's different types of responses.
"When people find out you have cancer, they show up with casseroles, they want to help and they're worried about you," Kelsey said. "But, you tell people you have addiction and they remove your phone number and judged you, which is unfortunate. Not everyone who suffers from this is a liar and a thief.
"The 'back-alley' perception is false," Kelsey said. "We've found that 58.1 percent of people we support work full time and 70 percent work between full- and half-time."
A point of hope for Kelsey and her program is many who are successful in recovering often turn around and help others.
"It helps them stay in recovery and it helps others," Kelsey said. "Those of us who help, we've been in that hell, that darkness and we want to help people get out of it."
While treatment options are available in the community, though, some barriers still remain. From the county's perspective, for example, Borgen said individuals sometimes have to be transported out of the area to International Falls, Brainerd, St. Cloud or the Twin Cities for some medical-assisted treatment.
Another issue can be the cost.
"For health insurance, it can depend on the individual's plan," Kelsey said. "So, we're penalizing people with money on this disease. The shame and stigma are already huge barriers and the financial parts are another."
Still, Longie said the opioid crisis can be overcome by bringing society together.
"We as an agency see this as a community issue. It's not just opioids but drugs and alcohol in general. Partnering with other agencies is definitely key and we're very fortunate to have great partnerships with others in the area," Longie said. "We do a lot of service coordination. We all have the same, common goal."