For heroin users, the spiral into addiction is fast and deep.
The users are young, with some beginning to use as early as high school. Few have ever had a job or any training that would help them find one. And they have already lost most of their support systems, such as family and friends, and have no idea where to go in their community to get help.
And if they do relapse after getting treatment, they are significantly more likely to overdose, experts said.
As heroin use has grown in communities across the state and nation, including Johnson County, local treatment centers saw the damage the drug was doing. More of their clients were dying from overdoses, and others were struggling to find a way to live in their community without the drug. They know the challenges they were facing: heroin is cheap, easy to get and highly addictive.
They needed a new treatment plan, which focused on the needs of those specific users, who were often younger, with less experience before they began using drugs and who needed more resources.
They needed to help recovering addicts build a new life, without drugs, often starting from the most basic necessities of housing and transportation, they said.
“The individual has fallen so far, so fast, they don’t have the ability to generate any hope,” said Mike Denton, clinical supervisor at Tara Treatment Center.
Other addictions, such as alcoholism, often have a gradual decline, allowing the person to build some sort of life before they hit rock bottom. So they often have a job, a home and a car to go back to after treatment, he said.
With heroin, the decline isn’t gradual, he said.
“These people have nothing,” Denton said.
Part of their recovery is helping them build their life, including basic skills they never learned, such as addressing an envelope or applying for jobs, he said.
They need to develop those skills as part of their recovery, requiring treatment centers to have much more of a focus on social work, Denton said.
At Centerstone, which partnered recently with Valle Vista in Greenwood, counselors and treatment centers learned that recovery meant taking a more involved approach in the person’s community, project manager Jennifer Fillmore said.
That’s why they started using recovery coaches, who are connected with people as they go through treatment and recovery.
They visit the person at home, take them to apply for jobs or public assistance and make sure they have all they need at home, such as food and clothing, she said.
Being in their community is important since so many people need to find a new way to live in their home without using drugs.
And often, someone who is addicted to heroin has depleted any resources they had, such as by stealing from family, so they need to start over, she said.
And, if someone is struggling, they have to get into some sort of treatment immediately, said Linda Grove-Paul, vice president for recovery and innovation at Centerstone.
Too often, when a heroin or opiate user relapses and wants to get high again, they want to take as much of the drug as they did when they were using, but their tolerance has fallen, and they overdose, she said.
“We want to make sure we have something that is more responsive, and meets people where they are,” she said.
“The black and white treatment does not work.”
In some cases, that means that patients receive medication-assisted treatment, such as Vivitrol, Methadone or Suboxone, an option that has been considered controversial, said Sarah Barham, a Centerstone recovery coach.
For some patients, that course of treatment is a big help to them, but also needs to come with a support system and accountability, she said.
In her job as a recovery coach, Barham focuses on first establishing a rapport and trust with her patients. She needs to know everything about them — good, bad and ugly — in order to help them, she said.
That level of honesty allows the coaches into the person’s world, where they can truly see their barriers and help them, whether that means finding a place to stay, or getting food, seeking mental health treatment or leaving an abusive relationship, she said.
“We help with barriers they don’t normally get help with,” Barham said.