The Front Porch: Who's to Blame for Appalachia's Drug Addiction?

West Virginia has the nation's worst rate of drug overdose deaths. It started with prescription painkillers, and now is increasingly fueled by heroin.On…

West Virginia has the nation’s worst rate of drug overdose deaths. It started with prescription painkillers, and now is increasingly fueled by heroin.

On this week’s “The Front Porch,” we debate what’s causing the epidemic, and what might actually work in curbing it.

We speak with Ashley, a recovering heroin addict about why she began using, how she got clean, and the struggles to remain sober for her three kids.

We also ask whether society is ready to treat addiction as a health issue, or whether we are still quick to make moral judgments about people with drug addictions.

Finally, we debate what’s at fault:

– An unwillingness by state and federal officials to pay for treatment, even if it is less expensive and more effective than jailing addicts

– Prescription drug companies, for marketing painkillers heavily in the region (West Virginia consumes more prescription painkillers per capita than any other state)

– Workers Comp, for only paying for cheaper drugs and not expensive physical therapy for injured workers

– Drug dealers, who profit from peddling misery

– People who give drugs to people who then overdose (and should they be charged with felony murder?)

– People with addiction (what about personal responsibility?)

– A general sense of hopelessness in our region that leads to more drug abuse

Click here to see West Virginia Public Broadcasting’s series on heroin.

Subscribe to “The Front Porch” podcast on iTunes or however you listen to podcasts.

An edited version of “The Front Porch” airs Fridays at 4:50 p.m. on West Virginia Public Broadcasting’s radio network, and the full version is available above.

Share your opinions with us about these issues, and let us know what you’d like us to discuss in the future. Send a tweet to @radiofinn or @wvpublicnews, or e-mail Scott at sfinn @ wvpublic.org

Delegate to Host Substance Abuse Forum

A panel of law enforcement, health and substance abuse specialists will discuss what's next in West Virginia's fight against substance abuse at the West…

A panel of law enforcement, health and substance abuse specialists will discuss what’s next in West Virginia’s fight against substance abuse at the West Virginia Addiction Summit in Charleston Monday.

Hosted by Del. Chris Stansbury of Kanawha County, the panel includes:

  • House Speaker Tim Armstead
  • Supreme Court Justice Brent Benjamin
  • DOC Commissioner Jim Rubenstein
  • Joseph Garcia, Gov. Tomblin’s Director of Legislative Affairs
  • Kanawha County Judge Jennifer Bailey
  • WVSP Captain Timothy Bledsoe
  • BHHF Commissioner Vickie Jones
  • President & CEO of Union Mission Rex Whiteman
  • Attorney General Patrick Morrisey
  • Dr. Rachel Sowards

The forum will begin with brief comments by the panelists followed by a Q&A session where audience members are encouraged to participate in the dicussion.
The panel will be held Monday, June 1 at 5:30p.m. in the Culture Center Theater on the Capitol Complex in Charleston.

Stansbury will be joined by West Virginia Public Broadcasting’s Ashton Marra as hosts and moderators of the discussion. 

From the Front Lines of West Virginia's Heroin Epidemic: The Perspective of First Responders

While law enforcement officials, lawmakers and medical professionals are all scrambling to find solutions to West Virginia’s heroin epidemic, EMTs and paramedics across the state are receiving calls almost daily, rushing to the homes of those who’ve made it to the very edge with their addiction.

“Most people, they hear about the problem with heroin. But, I don’t know that they fully understand and can fathom how much of an epidemic it truly is and how many lives are affected by it so adversely,” said Captain Chad Jones, a paramedic and shift supervisor for the Charleston Fire Department.

Jones said the heroin overdose calls he and the other paramedics at the fire department  go on prove that addiction shows no prejudice when it comes to age, background, or socio-economic status.

“I think everybody knows somebody that’s been affected–one way or another–with the heroin epidemic currently,” he said.

Jones estimates the Charleston Fire Department runs one heroin overdose call a day. Sometimes there are none. But, when shipments of the drug come to town, Jones said it’s not uncommon to respond to multiple overdose calls in a short period of time.

“Seems like, you know when there’s a good batch or a bad batch — however you want to refer to it — a pure batch, I guess, you’ll run. Those are the days when we have numerous overdoses that we’ll run. So, you know that somebody’s brought in some pure stuff that’s giving everybody a loop.”

He said those batches come in as frequently as every other week.

Credit Dave Mistich / West Virginia Public Broadcasting
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West Virginia Public Broadcasting

Is Naloxone the Answer?

One of the tools EMTs and paramedics use to fight the effects of an overdose is the opioid antagonist Naloxone. Data from the state Department of Health and Human Resources shows that in 2014 alone, Kanawha County EMTs administered more than 200 doses of the medication. After taking a look at data, Jones argues those numbers are likely inaccurate.  He says that number is “grossly underestimated” and human error is likely the cause.

Jones says sometimes they administer more than one dose. But addicts rarely end up footing the bill and the the drug has essentially doubled in recent years.

“If you want to look at it from the financial standpoint, some of them people we give three or four of them to. If we give you three of them that’s $115 dollars. We’re not getting that back. Most of the people don’t have insurance, typically.”

"I think everybody knows somebody that's been affected–one way or another–with the heroin epidemic currently."

As far as stopping–or at least slowing–overdoses on heroin, Jones says he thinks showing people the harsh reality is the way to educate those who are struggling.

“You know, seeing it? If everybody could see it, it’d be better. As morbid as it sounds, there’s been a couple times, one guy he said, ‘I would have the family video of the patient on their cell phone to show them that when they woke up they could say ‘This is you. This is you just about dead. And you need to come clean and get off of heroin.’”

 

What's Next in W.Va.'s Fight Against Heroin Abuse?

In some counties in the state, deaths from heroin overdoses have tripled in the past three years, drawing the attention of both lawmakers and law…

In some counties in the state, deaths from heroin overdoses have tripled in the past three years, drawing the attention of both lawmakers and law enforcement looking for ways to combat the problem.

At the statehouse, lawmakers approved the Opioid Antagonist Act during the 2015 Legislative session. The bill expands access to the overdose reversing drug Naloxone, allowing police officers to carry it and also family members and friends of addicts to seek a prescription for the medication.

Naloxone, if followed by more intense medical treatment, can save a person’s life giving them a second chance, according to Joseph Garcia, Gov. Tomblin’s legislative affairs director. Tomblin backed the bill.

But members of both the House and Senate leadership say the new law alone will not decrease the number of heroin overdose fatalities. Senate Majority Leader Mitch Carmichael said that ‘more’ should include a focus on rehabilitative services and a program to drug test those on public assistance.

“Now, it’s not a punitive measure, it’s a compassionate response to identify those who are using illegal drugs and channelthem into some kind of a counseling program,” he said.  

Carmichael introduced a bill during the 2015 session to create a pilot program, but the bill didn’t pass out of committee.

House Speaker Tim Armstead agreed rehabilitative services are important, but he would like to see the Legislature focus on increased penalties for people selling drugs and bringing them across state lines.

“That’s not going to be an easy thing to do, but it’s something we may need to do because if you are making money on a drug trade, you need to be in jail,” he said.

Gary Tennis, Secretary of Pennsylvania’s Department of Drug and Alcohol Programs, said he believes both Carmichael and Armstead can be right.

“I think that we need strong treatment, strong prevention and strong law enforcement,” Tennis said. “I don’t think there’s a conflict.”

Tennis cautioned, however, when Pennsylvania raised the mandatory minimum sentences for drug crimes, a bill he wrote while working as a lobbyist for the state’s District Attorney Association, Pennsylvania saw a drastic increase in its prison population, a problem West Virginia is already working to address.

Andrea Boxill, Deputy Director of the Governor’s Cabinet Level Opiate Action Team in Ohio, has watched the problem grow in her state as well. She urged West Virginia lawmakers to approach  solutions to substance abuse and drug deaths from a regional stand point, working with other states to combat the problem. 

Southern W.Va. Just Days Away from Non-Medical, Inpatient Treatment

While other parts of the state are seeing a rapid increase in heroin overdoses, southern West Virginia continues to battle a prescription pill problem. As access to addiction treatment in the state’s larger cities like Charleston and Huntington grows, rural parts of West Virginia are still struggling with a lack of resources. But in Bluefield, a much anticipated alternative for  recovery is just days away from opening, bringing 20 male beds to southern West Virginia. It’s not much, but those involved expect it to make a difference in the community.

The program at the Four Seasons Recovery Place is modeled after the Healing Place in Huntington. A former school in Bluefield was renovated to make room for 20 men looking to recover from addiction.

Credit Jessica Lilly
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A former school in Bluefield is being renovated to accommodate Four Seasons Recovery Place, an inpatient treatment facility for men.

It’s a non-medical detox facility in southern West Virginia. It’s funded by the West Virginia Justice Reinvestment Act, which covers the first three years of cost allowing patients to access treatment for free.

The state plans to double the amount of beds in the second year and provide space for 60 men in year three.

Patients are referred to and qualify for the Four Seasons program after a run in with the law.

“I was dying to get out I just didn’t know how to get out,” said recovering addict Justin Clark.

Clark spent most of the last 18 years of his life addicted to prescription pain pills. After being arrested for the second time for driving under the influence of drugs, Clark decided he wanted to get clean, and the justice system helped him find a way.

He qualified for and recently completed the recovery program at the Healing Place in Huntington.

Credit Jessica Lilly
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After being arrested for the second time for driving under the influence of drugs, Justin Clark decided he wanted to get clean, and the justice system helped him find a way.

Clark is a replication team member at Four Seasons Recovery Center. He helps determine if applicants qualify for the program. He also serves as a mentor to those receiving treatment.

Clark said he believes in this program because it’s peer driven and based on accountability and unity.

“So for me to give back to my own community for so much I’ve took away for so many years is why I took this job,” Clark said.

Director Terry Danielson is also a recovering addict and has been clean since November 2011. So far, Danielson said taking on this new leadership role has been helpful in his own recovery.

“I don’t care to share my story if that’s what it takes to get somebody to relate,” Danielson said.

Danielson was named the director shortly after the expected director was arrested for failing a drug test.  The Four Seasons Recovery Place is expected to open June 1. It’s located on Preston Street in Bluefield.

Some Judges Say There Should be an Alternative to Sending Addicts to Prison

Drug courts are becoming a more and more popular option for judges dealing with minor drug offenders in West Virginia. Instead of being incarcerated,…

Drug courts are becoming a more and more popular option for judges dealing with minor drug offenders in West Virginia. Instead of being incarcerated, offenders go through a highly structured, highly monitored rehabilitative process overseen by a probation officer and counselor.

Judge Wants an Alternative to Sending Addicts to Prison

Three years ago, Michael Aloi became a circuit court judge in Marion County.

In his first year on the bench, Judge Aloi became more and more troubled by the number of people he was sending to prison for drug crimes.

“You know, I became a judge to make matters better. And I couldn’t feel good about looking from the bench at those in front of me and responding in such a way that I couldn’t leave the bench and then say, ‘what have I done today that’s made things better in their lives, and made the community safer?’”

Then he heard about drug courts, which have been in some West Virginia counties since 2006.

Drug Courts are an alternative sentencing program. Instead of sending an addict to prison, a judge can chooses offenders to enroll in the program so they can receive addiction treatment.

Offering Treatment to Addicts

“If we treat the underlying condition and people in recovery, then they’re far less likely to commit the same crime,” said Judge Aloi.

Drug court programs take a minimum of one year to complete, though most participants take at least a year and a half to finish. Participants undergo drug counseling, complete community service, take regular drug tests, and check in with a probation officer every day.

In W.Va. 1 in 4 Released Prisoners Return to Crime

Travis Zimmerman is a probation officer on Judge Aloi’s drug court team. He used to work in prisons, where he saw addicts get released and then come right back, when they either couldn’t or refused to get treatment.

“So if you just want to put somebody in jail and you want to lock them up for 5, 10 or 15 years, and not do anything with them and not change anything about how they act when they get out, then don’t expect them to come out any different that when you put them in,” said Zimmerman.

In West Virginia, about 1 in four of the inmates released from prison fall back into the habits that put them there in the first place. That’s far below the national recidivism average of 43%.

Former Addict Talks About Finding Recovery

Officer Zimmerman is in charge of supervising 22 Drug Court participants, including 24 year old Ashley, who was addicted to heroin.

“It destroyed my life. I was put in jail over heroin. I almost lost my children.”

Ashley recently regained custody of her three children. She wants them to have the kind of childhood that she never had.

“My mom is also an addict. And my father. And they are also heroin users. My mother’s on probation now, and my father he’s in prison. And my sister is a heroin addict also, and she is also in prison.”

When she was arrested for heroin possession, Ashley went to a 28 day treatment program. When she was released she moved back in with friends who were also drug addicts. Then she failed a drug test and was sent back to prison.

Judge Aloi wanted to send her to longer-term treatment, but she had to wait in jail for five months before a bed opened up.

Changing Friends, Family, Home In Order to Stay Sober

When she got out of treatment, she decided if she was really going to stay off drugs, then she had to leave her old friends and move to a new town.

“It’s probably one of the hardest decisions I’ve ever made. I get homesick still sometimes,” said Ashley.

Judge Aloi says a lot of the people that come through Drug Court don’t have families who can afford rehab.

“And I can’t feel good as a court that we will treat people who are poor, disenfranchised, do not have certain services available to them, different than others of a different socioeconomic group. I think that’s wrong.”

But treating and supervising addicts can be costly.

William Ihlenfeld is the U.S. Attorney for the Northern District of West Virginia. He says Drug Courts  can be very resource intensive for any county, especially in remote areas.

It’s not as easy as saying that we want to do it – we have to make sure the probation office has the people that can supervise the participants in the program. They need to engage and talk to them every day. They need to call them in the evening to make sure they’re not depressed, not high.”

New Law Makes Drug Courts Mandatory in W.Va. by 2016

Now, there are 21 adult drug courts in 38 counties, with three more in development. A law passed by the West Virginia legislature in 2013 requires every judicial circuit in West Virginia offer an adult drug court by July of next year. The law is known as the Justice Reinvestment Act. It’s aimed at taking on the state’s prison overcrowding problems by lowering the mandatory sentences for minor drug crimes and focusing resources on community-based treatment options.

Ihlenfeld says in the long run, these Drug Courts are worth the cost.

“Because the costs of incarceration are much greater. Not just the dollars, but also the cost on society of incarcerating so many people. If we can keep people out of prison, keep them clean, get them back in the workforce then we’re gonna get them out of this storm that we’re in much quicker.”

According to the National Association of Drug Court Professionals, only one in four offenders who go through a drug court program return to prison. Here in West Virginia, some drug courts are even more successful. Jennifer Bailey is the judge in Kanawha County’s program.

“Certainly when you see the people graduate, and you see what they’re doing now, it makes you want to keep going, doing it,” Judge Bailey said.

Recovery Addict’s Advice: Be Grateful, See That it’s Not Too Late

And Ashley was successful. She got her children back, and now she’s engaged to be married. Still, she says she feels the pull of her old life.

“I mean, it’s not easy at all. Still to this day it’s hard. Like if I see somebody else high, sometimes I’ll get jealous, sometimes I’ll feel sorry for them, and sometimes I’ll get disgusted. You know it depends, day by day. It’s still difficult.”

Still, Ashley says she has hope.

“[In NA] they tell you wait for the miracle. Like it says wait and the miracle will happen. Then you come to realize that you are the miracle. Look what you just went through and you’re alive. There is a purpose for your here on this earth. People just need to step back and look at it. Look how grateful they are for the things they do have still. And that it’s not too late.”

Ashley recently celebrated her first full year of being clean since she was 14 years old. She and her fiancé have a new baby girl on the way. The baby is due just before Ashley graduates from the drug court program.

In the interest of disclosure, Judge Aloi, who was featured in this story, is a close, personal friend of Roxy Todd.

If you want information about where to find help for substance abuse in West Virginia, call 1-866-WV-QUITT, contact your local comprehensive behavioral health center, or visit the The West Virginia Prescription Drug Abuse Solutions Program’s website.

For a list of Narcotics Anonymous meetings in West Virginia, click here.

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