As heroin use soars, detox centers focus on habits

Chuck has a scraggly beard, deep-set eyes and a heroin addiction.

The 42-year-old New Orleans native checked himself into the Baton Rouge Area Alcohol and Drug Center, also known as the detox center, last week. The average-built man, dressed in dark, loose-fitting clothes, described how he grew up surrounded by heroin, snorting it for the first time as an 8-year-old boy and shooting up only a few years later.

“I just want to do better,” said Chuck, who asked that his last name not be used.

The last time he saw his mother, Chuck said, was more than 20 years ago.

“She was getting shot up twice, once in her neck and once in her arm, by two different guys” at the same time with heroin, he said. “And I just didn’t want to see that.”

He doesn’t know if she’s still alive, but he has seen some of his other family members die from heroin overdoses, a fate that has befallen an increasing number of people in East Baton Rouge Parish in the past year.

The parishwide numbers are troubling: 34 people died from heroin-related overdoses in 2013, up from 5 in 2012. The detox center saw the number of heroin addicts admitted to the facility increase from 74 in 2011 to nearly 300 last year. And it’s not just longtime junkies, experts said, but the young and old, rich and poor, all races — heroin doesn’t discriminate.

Law enforcement agencies have zeroed in on heroin too. Detectives in East Baton Rouge Parish seized more than 8 pounds of heroin last year, 30 times the 2012 total. Authorities recently arrested two men accused of providing heroin to their girlfriends, who died of overdoses on separate occasions. The men’s actions, police say, violated an obscure and rarely cited provision in the state’s second-degree murder statute, which can put dealers in prison for life if prosecutors can prove their actions directly led to the drug user’s death.

Purer doses, sometime cut with various other drugs such as Xanax, have made the drug deadlier than ever, especially for people who have been in recovery or haven’t “used” in a long time.

“If you go to treatment, get out and try to use, it’ll kill you,” said Lael Montgomery, a counselor at the Capital Area Recovery Program for Men, an addiction treatment facility in Baton Rouge.

Locally and nationally, the crackdown on prescription opioid pills has pushed more desperate addicts to heroin over the past several years, said Dr. Rochelle Head-Dunham, medical director for the state’s Office of Behavioral Health. But the reason tighter regulations on pain medications were put in place was to cut down on abuse — the cruel side effect being that heroin moved in to feed a starving market.

Addiction experts, law enforcement officials and doctors offered several suggestions to help reverse — or at least slow down — the disturbing overdose trend, which only a week ago shot into the national spotlight following the death of Oscar-winning actor Philip Seymour Hoffman.

Head-Dunham said possible remedies include increasing addiction treatment services, which are chronically underfunded, and boosting education and prevention efforts.

“The only way to control it is to begin to understand it and to treat it,” which can only be partly accomplished with current funding levels, Head-Dunham said.

Department officials said they could not isolate funding amounts specified for heroin addiction treatment across the state, but Head-Dunham said, “there have never been enough treatment services available for addicts.”

Lisa Bailey, the Baton Rouge detox center’s director, said detox and treatment funding from the state “doesn’t even near touch what we need.”

The center’s waiting list, which includes people suffering from a variety of addictions, hovers around an average of 500 people, and the center has only 24 beds, according to its website. Bailey said pharmaceutical costs alone to treat one heroin addict at the detox center top out around $4,500 a month.

Money from The United Way, private donors, fundraisers and insurance companies helps fill the funding chasm, she said.

In addition to increased funding for treatment, Bailey said, the capture of known dealers would reduce heroin availability. It also could decrease the number of dealers who “back-door” their way into the detox center in an attempt to drum up business by rehooking vulnerable recovering addicts.

Just last week, detox center personnel found a needle, spoon and an empty heroin baggie hidden inside a hole cut into a mattress. Staff members believe a dealer smuggled in the drug and offered it to addicts for free, hoping to lure them as customers once they complete treatment or leave voluntarily, Bailey said.

Dr. Beau Clark, the East Baton Rouge Parish coroner who is pushing for harsher sentences for convicted heroin dealers, said battling the heroin epidemic requires a two-pronged effort.

“No. 1, you handle the dealers,” Clark said. “You want to put people in jail and make it not feasible to sell heroin in Louisiana.”

Typically, heroin dealers don’t use and users don’t deal, he said, meaning addicts need treatment more than they need jail time. So in addition to rounding up dealers, addicts must have adequate treatment services available, he said.

“The tricky part about addictive disorders is that the addict plays a very important role in wanting to get better,” Clark said. “They have to want it.”

Gary Smith, a former drug addict known as “Smitty” who volunteers at the detox center, said even the most well-managed addictions don’t ever disappear completely. Addicts must surround themselves with positive support groups, actively avoiding people, places and ideas that might lead to a relapse, which can erase years of progress instantly, Smith said.

“Ultimately, you’re going to be on your own,” he said.

Reba Casebolt, head counselor at the Cenikor Foundation’s long-term addiction care center in Baton Rouge, said the key to treating addictions involves uncovering the root of each individual’s problem.

“Everyone is running from something,” Casebolt said of addicts, whether it be traumatic memories, fear of abandonment or other issues. “And then they find the wrong coping mechanism. It makes them forget about what’s not going well in their life.”

Chuck, the heroin addict who checked in to the detox center early last week, said his drug use serves as an escape from “a lot of personal issues.” He described his first time shooting up as an out-of-body experience, an euphoria that eclipsed any other. In the three decades he’s spent chasing that high, he’s never once matched it, and he knows he never will.

“You just can’t quit on your own,” he said Wednesday, explaining how he left everything he knew in New Orleans for a fresh start in Baton Rouge, beginning with detox. He said he threw his cellphone in a bayou when he left to ensure he couldn’t reach his old buddies.

“I’m really grateful they took me in and gave me a chance,” Chuck said. “Not many people give me a chance in life.”

Carla Levins, a compliance officer at the detox center, said addicts in rehab need constant self-esteem boosts. When they arrive, many reflect outwardly a stigma heaped upon them by society, Levins said.

“We have to let them know that it’s not hopeless and that they’re not a bad person because they’re addicted to heroin,” she said. “If you’re a bad person, then there’s no point in getting clean.”

About 80 percent of the addicts who begin detox at the Baton Rouge center finish the treatment, which takes on average about five days, sometimes lasting as long as two weeks for severe addicts.

But while completing detox represents an important first step in the cleansing process, both Levins and Bailey agreed it takes at least a year of intense therapy and drug abstinence to provide an addict a real shot at controlling his or her disease. While the detox center rarely keeps patients longer than 28 days, it makes sure to connect treated addicts with other, longer counseling programs once they complete their treatment program.

On Thursday afternoon, Chuck, the heroin addict who a day earlier expressed hope and optimism about managing his addiction, sat on a bench inside the detox center next to several packed duffel bags.

“I had a change of heart,” he said quietly. “I’m a junkie. I belong on the streets.”

Minutes later, partially physically cleansed and clinging to addiction, Chuck hopped in a car with a friend and headed back to New Orleans.