Pathways: The road to recovery in St. Helens

Drug and alcohol abuse are not bound by geography, economics or culture – anybody could be affected by addiction, directly or indirectly.

Pathways, a treatment facility in St. Helens, is helping people get clean and sober and hopefully stay that way with the assistance of health local agencies. For decades now, Pathways has offered rehabilitation services. Two years ago, Bridge to Pathways, a detox center in the Pathways facility, was opened to provide a local in-patient setting to treat addiction.

Administrator Kim Krause said Pathways is a residential program under Columbia Community Mental Health (CCMH) in which clients receive daily treatment for addiction as well as mental health issues.

Bridge to Pathways is a nine-bed medical detoxification program in partnership with Oregon Health & Science University (OHSU) that is served by three doctors, two who specialize in alcohol and one specializing in opiates. Clearing the system of alcohol typically takes around five days, and opiates take from five to seven days with the assistance of a suboxone taper to ease withdrawal symptoms.

Once a patient has gotten clean they are referred to a case manager who determines where treatment will take place. With wait lists sometimes running months long, the time between detox and treatment is critical. The closer the facilities and quicker a client can enroll the better, but the system has been strained by increasing numbers of drug and alcohol addicts, an issue that is nationwide.

Krause said detox facilities increase the chance of success for a person who is trying to get clean. Because of the dramatic sickness involved with withdrawal, a trained support staff and proper procedures can provide stability that going solo lacks. While detoxing, a person might suffer flu-like symptoms, diarrhea, vomiting, seizures, body pain and irritability.

“Just think of a really bad, bad case of the flu … and it’s really hard for somebody to complete on their own.” Krause said. She said when the sickness kicks in addicts might turn to drugs and alcohol to alleviate symptoms. A medically managed detoxification process uses certain medications and supplements to aid the struggle.

Leslie Ford, director of clinical innovations for Greater Oregon Behavioral Healthcare, and behavioral health lead at Columbia Pacific CCO, said connecting with detox staff increases the chance that patients will follow up with a recovery program. Those who take on self-detoxing may slip and return to drugs or alcohol after getting clean, Ford said. Even with support, it might take half a dozen tries to kick the habit well enough for treatment to be effective. Some are able to make it on the first try, to be fair, but most will face an uphill battle.

“Contrary to popular wisdom, the more times you try, the better your odds are,” Ford said. Krause added that each attempt leads to more personal insight and progress.

Mental health plays a huge part in the war with addiction. Ford said the two issues are inseparable, and an artificial dichotomy in the medical industry between addiction and mental health is finally being overcome. Ford said cases which are clearly one or the other issue are rare. At the root of both, Ford said she often finds factors of childhood trauma.

Krause agreed, noting patients who began using drugs and alcohol as young as 8 years olds, and stories of people who say their parents put something intoxicating in their baby bottles. Ford said some are suffering from generations of learned behaviors and brain development affected by substance abuse.

Ford explained that recent studies focused on childhood trauma indicate that exposure to adverse conditions at young ages leads to health concerns throughout life. An Adverse Childhood Experiences (ACE) study revealed negative circumstances for young people are associated with increased risk for trauma or toxic stress, particularly when they are cumulative. Extreme stress might lead to addiction, various physiological dysfunctions, disease and death.

Ford said alcohol abuse rates in the region are staggering, but meth use is seeing a rapid increase, and heroin and cocaine are present in the community as well. She added that in terms of fatalities, opiates are the leading cause. Krause said the social acceptance of alcohol means fewer people seek treatment for it.

“There’s not a stigma with alcohol as there is with drugs, so for an alcoholic to hit that bottom where they need to detox or come to residential treatment, something drastic needs to have happened to them,” Krause said. “With drugs, it’s just a matter of time … you’re stealing, buying them off the street, med-seeking … you’re engaging in risky behavior – with alcohol you can just go to the store.”

Originally posted at thechronicleonline.com

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