Many Addicts Seeking Help Offered Waiting List Instead Of An Open Bed

‘Nobody comes into treatment on their own free will. Some kind of crisis has occurred ... something’s kicking them in the ass through the door.’
Richard Lavender
recovering addict and director of New Beginnings

‘‘I truly believe we have a whole generation of young people in Southwest Virginia who wound up being opiate [pain reliever] addicts by accident, by blundering into it ... and did not realize that this thing that the doctor prescribes, when crushed, snorted or shot up, is the same as heroin.’
Dennis Lee
Tazewell County commonwealth’s attorney

‘The people who are the family of an addict go through everything the addict is going through.’
Linda Meadows
pastor of Handsful of Purpose Ministries in Lebanon, Va.

‘I’m amazed at how a little liquid or a little pill can be so powerful in changing somebody’s personality, their entire makeup.’
Lloyd Sheets
director of The Laurels

‘I didn’t want to be no junkie. I wanted to be quarterback of the Oakland Raiders.’
Steve Ray
recovering addict

LEBANON, Va. – Steve Ray never had a favorite drug. He was once what junkies call a “trash can” – he’d gulp down, snort or inject just about anything that came his way.

Today, he’s a street preacher, spreading the gospel of recovery from addiction. For him, much of the 1990s were filled with toxic chemicals, hazy shades of synthetic euphoria and blackouts. There was always more of the same when consciousness returned.

The cycle changed on Jan. 19, 2001, when Ray, then 42, curled up in a bed for several days at a Lebanon drug-and-alcohol detox center – simply because living seemed like a better choice than dying.
The center, called The Laurels, is a state-funded first step to recovery for anyone lacking insurance or a hefty bank account.

“I now have two miracles in my life – I don’t pass out and I don’t come to. I go to bed and I wake up,” smiled Ray, now 49.

Were he to seek a detox bed in Southwest Virginia these days, though, he might be left to die in a drug-induced stupor.

More than half of the 32 detoxification slots that were open when Ray, of Honaker, Va., checked into the center are gone, thanks to stagnant state budgeting. In fact, The Laurel’s 10 remaining beds are the only detox options left for addicts living in the nine counties of Southwest Virginia.

While inflation has increased, annual funding for the center’s detox beds remains at $376,000, roughly what it was in 1989, said Lloyd Sheets, The Laurels director.

So, there are far fewer opportunities to weather, upon request, a painful and possibly lethal withdrawal while surrounded by a trained medical staff.

“I know when I called the treatment center … they had a bed for me, and I feel I was real close to death,” Ray recalled. “I’d been in jail cells, and I’d been to [drug] treatment, and the only thing left for me was death.”

Now, instead of an open bed, a waiting list is offered to many alcoholics and prescription drug addicts who can’t afford immediate help in private centers. An average of 25 names fill that list each day, Sheets said.

The welcome mat

Some addicts on the list will stick with drugs.

Others will choose suicide rather than face the withdrawal that comes with quitting cold turkey on their own.

Pain relievers and tranquilizers are the top drugs of choice in Southwest Virginia.

“This is the area where prescription drug abuse is the worst,” said Lt. Richard Stallard, director of the Southwest Virginia Regional Drug Task Force, which is headquartered in Big Stone Gap, Va.
And the region’s drug use is as deadly as it is rampant.

“On average, we have a higher overdose rate than the rest of the state, many times over,” said Dennis Lee, Tazewell County commonwealth’s attorney.

Withdrawal from alcohol and pain relievers can bring seizures, hallucinations, spiking blood pressure and even death.

“People become desperate. They don’t want to hurt,” said Jane Peay, substance abuse services director for the Cumberland Mountain Community Services Board, which runs The Laurels.

Pain – mental, physical and spiritual – is why many addicts turn to drugs in the first place. They think drugs and alcohol can numb that pain. Instead, it chemically numbs them to their own moral code.

“There’s a lot of people hurting in this world, and we’ve got to help them,” said Lebanon, Va.-based pastor Linda Meadows. Her church, Handsful of Purpose Ministry, is run in a rented skating rink, with temporary walls, a movable pulpit and a bathroom in back of the building painted in gold, from the only paint can found in the building when the church moved in.

Her congregation is filled with current and recovering addicts desperate for a new life. The church doors are open all day on the third Tuesday of each month to any current and recovering addict who needs a few hours away from stress.

“We [society] have nobody to hold them when they get sick and throw up. We have nobody to hold them until they stop shaking,” Meadows said.

From a medical perspective, drugs and alcohol sap away much of a person’s willpower, erodes the ability to understand consequences and renders them incapable of making healthy choices, according to the National Institute on Drug Abuse.

Simply put, they’re hooked on how good the drug feels. They either want to keep that feeling, or need it.

“Most of the pills do seem to take away your problems, and it’s hard to fight feeling good,” Stallard said.

The money trail

In Virginia, drug rehabilitation falls under the Department of Mental Health and Mental Retardation. The department’s local offices, called community service boards (CSBs), offer both outpatient and inpatient treatment programs.

Not all of the state’s 40 CSBs are budgeted for inpatient programs such as detox, which is expensive because of the medical staff and medicine needed to monitor a patient’s health.

Because of the ongoing state budget crunch, nearly all of Southwest Virginia’s service boards lack a detox program, and so they refer addicts to The Laurels.

The Highlands Community Services Board, which serves the Bristol and Washington County area in Virginia, annually refers roughly 144 addicts to The Laurels, nearly an hour-long drive from the CSB office in Bristol, Va.

As many as half the referrals from Bristol never make it to The Laurels, however.

“Either the wait is too long, or some come in with pressure from family or a court and use this to appease them, or they just decide not to go for whatever reason,” said John Counts, of the Highlands Community Services Board.

Because drug and alcohol addiction is closely associated with the worst of society’s ills, however, legislators prefer funneling money toward mental health services rather than toward programs focused on the junkies responsible for crime, Sheets said.

“The mentally ill has better lobbyists than junkies,” he noted.

Funding for drug treatment, on the other hand, often is reserved for those in jail. The problem, according to a Virginia General Assembly study released in June, is that the best treatments are reserved for the worst offenders. The study, Mitigating the Cost of Substance Abuse in Virginia, focuses on lapses in state-backed treatment programs.

The more severe the crime, the longer the jail sentence. The longer the jail sentence, the more time an inmate has to stay in a treatment program. The longer the treatment program, the better chance there is for a lifelong recovery.

Inmates jailed for less than a year likely will not take part in any intensive treatment programs because such programs tend to last longer than the jail sentence. Instead, they are tossed back to the streets, where their problems are revisited and their addictions fed again, according to the Virginia General Assembly drug study.

Another problem is that many state-funded and private detox programs found outside The Laurels are intended for the mentally ill. To get into many public programs, experts acknowledge, an addict has to suffer a mental illness that requires immediate psychiatric help. Or, the addict claims depression, a recognized mental illness that will get them in the door.

“Our state’s crazy when it comes to this disease [addiction],” said Larry Lavender, a recovering addict and director of the nonprofit drug treatment center New Beginnings, in Dryden, Va.

Lavender’s center is the only long-term, residential drug treatment program in Southwest Virginia that caters to addicts who can’t afford private facilities. New Beginnings, with 40 beds and a three-month waiting list, takes patients from Kentucky and Tennessee as well as Virginia.

On average, a stay at a residential program like Lavender’s would cost $76.13 per day, according to estimates by the federal Substance Abuse and Mental Health Services Administration. That would add up to nearly $6,850 for a 90-day minimum stay at New Beginnings.

It doesn’t have a detox program, which, on its own, rarely cures an addict for life. Detox is merely a waiting period to get rid of all the alcohol, pain relievers and other drugs coursing through the body.

Only when the body is clean can some form of residential or outpatient treatment begin. New Beginnings, for example, is meant to be a life-altering experience, which is why the program lasts at least three months.

From a financial standpoint, an addict’s path to recovery becomes even bleaker when considering that few successfully kick the habit on the first try.

Ray, the street preacher, for example, was 26 when he first entered a detox center. Successful recovery didn’t come until 16 years later.

Experts say it takes roughly eight passes through a substance abuse treatment program before any life-altering headway is made. The cost for recovery could reach as much as $54,800, based on the federal estimate of $76.13 per day.

“You don’t want to bankrupt the family to get someone treatment,” said Sheets, director of The Laurels.

Down the drain?

The problem is not the amount of government money thrown at substance abuse, but where it lands, show national and state studies.

Following the money trail is difficult and rarely done on a large scale. One of the most comprehensive, up-to-date studies on how states fund substance abuse programs focuses on 1998.

The National Center on Addiction and Substance Abuse at Columbia University traced money spent on drug abuse by considering the cost in courts, health care, schools, foster care, welfare, domestic violence, unemployment and other consequences. The study includes only state spending, and does not factor in federal grants or local government money spent on the problem.

Virginia spent $1.8 billion on substance abuse in 1998, or $267.18 for every man, woman and child in the state.

Much of it, $879 million, covered drug-related issues in the courts and jails. Roughly $243 million went to mental health. Treatment programs, near the bottom of the budgeting list, received $23.9 million.

This pattern of financing punishment over treatment in Virginia could change in coming years. Virginia Sen. Emmett Hanger Jr., R-Mount Solon, helped spearhead the General Assembly’s June-released study into state spending on drug treatment.

Initially, Hanger hoped to find a way to cut spending. What he found was that some forms of residential treatment cost less for the state than jail time.

The study, which focused on 2006 budget spending, also found that a successful recovery for addicts both in and out of jail could reap savings for the state.

Addicts who complete long-term recovery programs generally return to work and pay taxes, stay out of the courts, sleep at home instead of in jails and hospitals, and don’t wreck lives.

Hanger’s study estimated a savings of $6.4 million over an 18-month period when the state focuses on treatment.

Reaping even greater savings rests on convincing lawmakers to divert to drug treatment millions of dollars that go to popular budget projects.

“Getting the up-front money is sometimes the issue in getting the ball rolling,” Hanger said. “Whether or not we’ll be successful, to an extent, will remain to be seen.”

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