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Heroin: Treating Kitsap’s addiction | Herald series

A North Kitsap Herald series explores the rising use of heroin in Kitsap County.  - Herald graphic
A North Kitsap Herald series explores the rising use of heroin in Kitsap County.
— image credit: Herald graphic

POULSBO — It can be difficult to describe a parent’s experience, watching a child suffer through an opiate addiction, to someone who hasn’t lived through it.

The experience, however, is something to which an increasing number of Kitsap parents can relate.

Misty Snyder has witnessed two of her children fall into a cycle of addiction.

“I’m not afraid to tell my story and more people need to hear it,” Snyder said. “I’m not walking this path by myself.”

Snyder’s daughter and son, ages 25 and 23 respectively, began on the road to heroin like most young addicts today. They began taking prescription pills, such as Oxycontin or oxycodone, recreationally.

“My daughter started out years ago when you could get pills, and she smoked oxy,” Snyder said.

“My daughter probably started around ninth grade (with pills),” she added.

Her son soon followed with his own addiction.

“I don’t think that we had that single-parent, troubled household,” she said. “They played sports, and were very active in sports, and then it all went to hell.”

A younger generation

The experience of Snyder’s children echoes that of a considerable number of teenagers and young adults in the county with opiate addictions, often starting with prescription pain pills and moving on to heroin.

As Scott Lindquist, director of the Kitsap Public Health District, explains, opiate users don’t “sign a registry” claiming to be addicts. Therefore, officials struggle to show firm numbers on the increase. But the signs are there.

In 2012, the health district exchanged 620,582 needles at its facility in Bremerton; more than it ever has in the past.

Monte Levine, who operates a volunteer needle exchange in the county claims that the number of needles he handles has tripled recently.

Treatment facilities have also noticed the trend.

“We’ve seen a tremendous rise with heroin,” said Karen Augustine, clinical operations manager for the Olalla Guest Lodge, a non-profit substance abuse treatment facility.

“I believe much of it starts with old pills of Oxycontin. That seems to be a component,” she said.

Augustine said the population of addicts coming into her facility for opiate abuse is getting younger, ranging between the ages of 19 and 29.

“There are other people that are opiate dependent who are older than that, but there is a trend of the age decreasing,” she said.

Lindquist is also shocked by the young age of opiate users encountered at the health district.

“I’ve been surprised at the young age of people coming in that don’t have a history of drug abuse, that are coming in addicted to heroin,” Lindquist said. “It’s almost normal to do heroin.”

While needle exchanges are a good opportunity to talk to addicts about kicking the habit, Lindquist notes, they are meant for public health, not treatment. Clean needles means cutting down on the spread of diseases. It’s a way of attacking symptoms of a much larger problem.

Detox

As opiate use becomes more common in the region, so has its side effects such as crime, overdoses, and recovery; the first step of which is detox.

Coming off of heroin is perhaps the most intimidating aspect of attempting to kick the addiction, officials say.

“They feel so sick, they feel like they are going to die,” said Victoria Ackerman, a treatment court compliance specialist with the Kitsap County Drug Court.

“It’s so hard to detox,” she said. “You feel like you’ve been hit by a truck, like you have the worst flu you’ve ever had, and you don’t feel like you will get better.”

While it’s painful, it can be overcome.

“They have muscle aches, cramping, nausea, diarrhea, they may have shakes, sweats, inability to sleep,” Augustine said. “It’s a variety of symptoms. They are difficult, but they are not fatal.”

The Olalla Guest Lodge provides sub-acute detox, a method that utilizes medication to manage the symptoms during detox.

Detox is only the first step, however. Treatment takes much longer.

Treatment

Opinions on treatment can be divided. To attack the problem of heroin addiction, some officials say that more adequate treatment is needed in the area.

“The vast majority of resources for any addiction is drug-free out-treatment programs. In some cases they are affective, but not as effective with heroin addiction,” said Steve Freng, a prevention and treatment specialist with the Northwest High Intensity Drug Trafficking Area, or HIDTA. The federally funded agency is charged with reducing drug trafficking through the Northwest region. A quarter of its budget supports prevention and treatment.

Freng pointed to methadone as a treatment method with a proven success rate.

“Methadone outcomes are better than out-treatment,” he said, further noting that there are two philosophies about methadone: Addicts use it to wean off of opiates, or use it long-term as a substitution for the drugs.

“The thing about methadone is that you don’t get high, but you don’t get sick,” Freng said. “It’s not terribly disruptive and doesn’t affect your ability to function if it’s dosed correctly.”

He said methadone clinics are often limited in their capacity to serve addicts. Clinics can also be difficult to come by. Bremerton saw an effort to establish a methadone clinic in 2011 and 2012, however, after a vocal opposition the notion was halted.

“The methadone clinic was shot down in Bremerton,” said Monte Levine, who runs a volunteer needle exchange in the Kitsap region. “The merchants in the area banded together, went to city hall and protested it, and the city put a moratorium into the zoning regulations.”

Treatment in the area remains difficult to obtain, Levine said. He has seen Kitsap addicts travel to Tacoma, Seattle or Kent for treatment. But the distance adds a challenge to overcome toward recovery.

Freng sees a similar situation throughout the Northwest.

“All over the state there is a waiting list for people to get in (to methadone clinics),” he said. “In my mind that is the best way to go.”

But methadone isn’t the only way to go.

Kitsap County has a handful of resources and facilities for addiction recovery such as the Olalla Guest Lodge.

After sub-acute detox, the lodge’s approach, as with many others, is that of abstaining from the drugs.

Augustine said recovery is about more than overcoming withdrawal symptoms.

“I believe that the most critical component in recovery is gaining relapse prevention skills and incorporating into the 12-step community,” she said. “They are not just coming out of treatment and abstaining, they are creating a new lifestyle for themselves.”

She added, “There are triggers that happen for people constantly. Let’s say a young person comes through treatment and then goes back to their old environment. That’s not going to work.”

Snyder can relate through her daughter’s experience.

“I don’t think she was four weeks out and she started using again,” Snyder said. “Like a lot of addicts, they think they’ve got it conquered and they never do. It’s something they have to work out every single day. They think that after they’ve stopped using they can go around with old friends. You got to change yourself completely. It’s not just about not using. You have to change your life.”

Snyder’s daughter went through treatment at private facilities in Washington, outside of Kitsap County, because her health insurance at the time could cover it.

Her son, on the other hand, went through court-ordered treatment.

Drug court

Snyder’s son was not ordered to treat through Kitsap County. If he did, he might have encountered the Kitsap County Drug Court. The court has been catching addicts as they fall into the legal system over the past 14 years. It’s where addicts can end up if their habit requires crime to maintain it.

“I’ve seen so much heroin when I interview our participants,” Ackerman said.

Instead of going through the judicial system, the accused can take part in a monitored treatment program for at least 18 months, but often longer.

“It has to be a crime that is drug driven, even if it’s not a drug crime like possession,” Ackerman said. “We don’t want criminals who use once in a while, we want addicts.”

Not all crimes are apt for drug court, such as violent offenses. The court takes each person on a case-by-case basis. Some go through outpatient treatment, while others may go through inpatient.

“I just had a gal who has been in inpatient treatment for six months, and she’s pregnant,” Ackerman said. “After that she’ll go to outpatient.”

When going through outpatient treatment, participants are subject to weekly court dates, random home searches, drug tests, and regular meetings with case workers.

“They’ve signed up for this,” Ackerman said. “This is what they got into.”

Not everyone goes through the program perfectly. But they don’t give up easily on participants, Ackerman said.

“If they cannot refrain from drugs, alcohol or marijuana, we up the treatment and we sanction them,” she said. “They will slip.”

But they also succeed. The drug court graduates participants from the program every three months. In fact, 16 participants graduated from the drug court on Friday.

Taxpayers save money by freeing up jail cells, and offenders receive support to get their life back on track, Ackerman noted.

“It’s a heavy hammer over them and it’s a guarantee to the community that we save money,” she said. “We try to rehabilitate them.”

“We have a lot of students getting their AA degree, or they get a GED with us,” she said. “They are rebuilding their lives. They have a lot to lose by falling back.”

Timeliness

While opinions on what treatment is best can be diverse — from methadone to abstinence — a common critique of Washington’s approach to the issue is its lack of quick response.

To receive state-funded treatment an addict must complete and assessment with the state’s Department of Social and Health Services. After it is reviewed, they may be referred to a treatment resource that will assess whether they need inpatient or outpatient treatment. It’s not an expedient process, which some officials say is required to adequately tackle the problem.

“My recommendation is that we need to increase easily accessible and timely drug evaluation and treatment programs,” Lindquist said. “When a person is ready to get off heroin, we need to give them the best chance of getting off of IV drugs.”

That perception is echoed in the using community.

“They can go to DSHS and get into a program, but that is a long wait and people change,” Levine said. “It’s really hard to say today ‘I will get off this stuff’ and then get put off for a couple months.”

Snyder has gone through the process with her kids.

“They have to go do their (assessment), get it approved, and get set up for an appointment,” she said.

Snyder said the addict will then go to a treatment center, and make an appointment to decide if they do outpatient or inpatient.

“That’s a long time. By the time that time span is over, I would throw my hands up,” she said. “I don’t think this county has enough resources. If you have a kid that decides tonight that they are ready (to quit), then you need to get ahold of a center, drop them off then, and they can go through their days of detox. The process needs to be a little more streamlined. If they are in detox and they are serious about getting a bed, a representative needs to come to them and get the process going.”

Beyond treatment, Snyder would like to see more support for families going through the experience. She said that in her experience, a lot of support groups are geared more toward spouses or boyfriends and girlfriends, but not families.

“Parents need to get together and share the same heartaches and successes,” she said. “The bond is different than what is shared with your spouse.”

Snyder recommends that parents of addicts start talking to each other.

“There are a lot of parents that think they have failed,” Snyder said. “But we are not alone. There are a lot of us out there."

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