By Carl Mueller
Matt Ganem spends his day on the phone. He has no office, no schedule and no boss. Yet, he works outside the hours of 9-to-5 and never has a day off. Ganem is the outreach coordinator at Wicked Sober Inc., a small company that provides treatment options to addicts in Massachusetts. Part of his job is to take calls from addicts seeking help and connect them with facilities like detoxification centers. However, these facilities are regularly full.
Some call simply to talk as they need support or encouragement to stay clean. Yet, most call because they need more tangible help. That help comes in the form of beds at detoxification centers.
“It’s a chaotic situation, somebody needs help,” Ganem said. “I just got off the phone with a woman. She’s so bad with alcohol right now that she’s drinking Nyquil, just whatever she can get her hands on. She’s scared of kicking into seizures and withdrawals.”
Ganem’s job is to help addicts find the beds they need to prevent possibly fatal overdoses. No beds were available that day, a growing problem, he said. “I get phone calls all the time: ‘I overdosed three times last week.’ I clearly need to get this kid help; he might not make it to his next overdose…” Ganem said. “I don’t say I can’t, I just say keep calling. We have to keep calling and be persistent because that’s what it takes.”
A growing problem
Opiate addiction is growing across the country and especially Massachusetts, one of 11 states with at least 713 clients per 100,000 people over the age of 18 in treatment for opioid addiction, according to a 2013 survey by the National Survey of Substance Abuse Treatment Services.
The road to opiate addiction generally follows a predictable sequence of events, according to the National Institute of Health . Prescription painkillers are used and abused, and the brain loses its ability to create natural endorphins. As painkillers become unattainable due to their high cost or an individual’s inability to receive prescriptions, addicts transition to the cheaper and more potent heroin. This vicious cycle has increased the number of opiate addicts and, with that, overdoses.
The Massachusetts Department of Public Health released statistics reporting that, from 2010 to 2013, the number of reported heroin overdoses grew from 420 to 863 in the Bay State. In the spring of 2014, then-Gov. Deval Patrick declared the opiate epidemic a public health emergency and created an Opiate Task Force to determine a strategy. Its findings resulted in a pledge of $20 million to treatment and recovery services, $10 million of which was appropriated by the state legislature and distributed through 14 prevention, treatment and recovery programs and initiatives.
Funds are spread throughout specific and broader initiatives. The state is being asked to address the issue on all fronts and therefore prioritize spending.
Finding beds at all stages of treatment
Ganem said he believes the priority should be to help those who need help right now. That means more funding for detoxification clinics and the longer-term Clinical Stabilization and Transitional Support Services so they can better handle the influx of clients. He said beds are lacking most in CSS and TSS.
As of now, Ganem calls clinics around the state to hear time and again that no beds are readily available, a shortage that can cost lives. “You have such a small window of opportunity when somebody wants to get help, that you need to seize that, you need to have a bed available right then and there,” Ganem said. Having lost hope in action at the state level, he is taking the matter into his own hands He is a renowned poet and has written a book about his experiences called, “The Shadow of an Addict.”
Ganem, now 30, knows from experience, having used heroin for much of his young adulthood. He spent time in jail, overdosed three times and walked in on his childhood friend hanging from a noose in the bathroom. He has experienced the horrors of addiction first hand and often tried to get help. “Every time I called a detox and heard ‘hey, no beds, call back in the morning,’ I would hang up, I would go and get high, I wouldn’t wake up in the morning in time to find that open bed. I would wake up midday to the afternoon and at that point the beds are taken. Then I say ‘I tried’ and I’m off and running until some other drastic situation takes place,” Ganem explained.
Ashley Rapoza, a recovering addict from Haverhill, said she has been to many different detox centers. She follows a specific procedure to have the best chance of getting a bed. “You are going to call detoxes. If they don’t have a bed they will tell you to call the following morning between 7 a.m. to 9 a.m. Another good time to get a detox bed is the first of the month,” Rapoza said.
What is being done?
Today the state is losing, not gaining, beds. In January of 2015, demolition began on the Long Island Bridge after years of concern regarding its structural integrity. This bridge connected the mainland with one of Massachusetts’ largest recovery centers for addicts. In fact, the shelter on Long Island held 57 percent of the Boston’s treatment beds.
To pick up the volume, at least temporarily, the city is renovating a city-owned brick building on 112 Southampton St. in Roxbury, and the state’s looking into a permanent location for these lost beds, said Dr. Monica Bharel, the Commissioner of the Massachusetts Department of Public Health. “I know that the governor is working closely with the city of Boston to find permanent locations for those beds. It’s a high priority for us,” Bharel said.
And the bed shortage isn’t limited to Boston. Marissa Hebble, director of the Franklin County Opioid Task Force, works with state officials, treatment facilities and medical experts to develop treatment and preventative strategies. She said the problem stems from the ever-increasing number of addicts. “I think the opioid issue has evolved faster than our treatment system has evolved,” Hebble said. The state has not been able to keep up.
Hebble has been director of the program for over a year, during which time she assessed the system.
“We mapped out what we need in a community with just the baseline and what we have. There were a lot of gaps in the what we have. One of the huge gaps was detox and clinical stabilization services. We had none in Franklin County or Hampshire County,” Hebble said.
In the summer of 2014, the state approved $550,000 toward a new Acute Treatment Services Program in Franklin County, the first detoxification center in the county.
Franklin County is just one of many counties across the state where demand is high. Bharel, also a member of the governor’s Opiate Working Group, said that if adding beds were the solution, the state would have already done that. She said we have to look at the entire system.
“Because maybe for some people, that is getting a bed right now and maybe for somebody else that’s being admitted to an inpatient psychiatric and maybe for somebody else its going to outpatient care, maybe for somebody else its home based,” Bharel said. “ It’s really trying to figure out how can we construct a system that works for each individual so there’s enough individuality with it.”
This year’s working group began looking toward solutions in late February and hopes to reach a decision on strategies by the end of May.
Yet, for Ganem, his struggle to find beds for those who need them remains a daily challenge. He’s seen working groups and task forces before and doesn’t think this one will be any different.
“It’s great, you hear a bunch of stories. Some of them are uplifting, some of them are really tragic. But I mean, at the end of these, what’s going to happen? Is there going to be a plan they are going to put in place? Are they going to work on the solution? Or are they just appeasing the public like ‘hey we’re really listening to you guys’. Then when it comes down to it, no change is going to be made. Nothing is going to be different,” Ganem said.
But Hebble remains hopeful. “At the state level, I don’t think they are a PR move either. I can completely understand why it looks like that. And I think it will be that if there isn’t action coming out,” Hebble said, but adding “I do get the impression that action is going to happen.”