Series: 14 Of 16

THE PROFESSIONAL PERSPECTIVE

The key to getting off of drugs is wanting to be off of drugs. Regardless of
the method of rehabilitation, the one thing that drug treatment
professionals agree on is that an addict must truly want to change.

That willingness to get sober is the first step. The next step is finding a
treatment program that works.

The 28-day shuffle

The most prevalent method of treatment for addiction begins with a
detoxification period, usually supervised by a physician, said Kelly Price,
assistant director for prevention at the Agency for Substance Abuse
Prevention in Anniston.

"This depends on the type of drug as well as the severity and duration of
dependency," Price said. "In some cases, withdrawal can be fatal. Opiate
drugs like heroin and morphine - a person can have a seizure. This is true
for alcohol as well."

During this stage, called stabilization, doctors can administer medication
to ensure the patient survives detoxification, Price said.

"They have to get medically stable before they can go into a 28-day
program," Price said. "Then you have what we call residential treatment -
the 28-day type of treatment - also called crisis intervention treatment.

"This involves group therapy throughout the day. They go to support group
meetings in the night time."

The next step would be a halfway house from three to six months.

"Sometimes they stay as long as a year. They work during the day and go to
support groups at night. They still need to live in a strict environment."

During this phase of recovery, Price said, a key factor to success often
involves vocational and educational training.

"The whole idea is for them to become independent," Price said.

The next phase of treatment includes outpatient therapy.

"People recovering from addiction at this stage typically live on their own,
attending three meetings a week for about 12 weeks," Price said.

"The key to the whole thing is how bad the person wants it - how motivated
they are," he said.

The other factor, Price added, is staying away from situations that trigger
cravings.

"Recovering addicts need to stay away from environments that are conducive
to drug and alcohol abuse," he said. "Ninety percent of recovering addicts
who return to those types of environments are going to relapse.

"You have to get a whole new set of friends. You just can't hang with those
people anymore," he said.

Boot camps

Many juveniles' first experience with drug rehabilitation comes through the
court system. Rather than send an adolescent with a drug problem to juvenile
detention centers, Price said, judges will often opt to sentence them to
time in boot camps.

"The biggest difference between adolescent and adult treatment is that they
haven't experienced all the hardships that drug addiction can bring," Price
said.

"They haven't lost a wife or a home.

"They are all good programs for putting discipline in these young kids'
lives," he said. "You try to educate them about the disease process."

As far as the boot-camp program, Price said he had nothing but high regard
for it.

"Counseling is provided in the boot-camp program," he said. "They have a
full-time counselor."

Price said the biggest problem is that once they leave the system they go
back to the same environment.

"The home situation does not provide the adequate supervision these young
kids need," he said.

Faith-based treatment

Another avenue of drug treatment is through faith-based programs such as
Teen Challenge International.

"It's a one-year Christ discipleship program with an emphasis on restoration
for those who have life-controlling addictions such as alcohol, drugs and
gambling," said Alabama Teen Challenge Executive Director Robert Angles.

Teen challenge has four facilities in Alabama and a fifth one on the way,
Angles said.

The treatment program is broken up into two phases.

"Phase one consists of a four-month time frame involving intense Bible
study," Angles said. "Students participate in local church services."

During this period Angles said the program also presents students with an
opportunity to work to get their GED and acquire job skills.

"Phase two is a very intense Bible curriculum. We believe that, as we
introduce Christ to these individuals, then through a personal relationship
with him, students are able to experience a life transformation."

Angles admitted that, for some students, the Christian emphasis was not well
accepted.

"If they don't like that, they have the freedom to leave," he said. "We'll
dismiss a person who won't cooperate."

Angles said that those who complete the program, however, are likely to stay
clean.

"Sixty percent of the people who start the course complete it," he said. "Of
course, we don't make them stay, but if a man or woman will stay with us for
a year, we have a legitimate 85 percent success rate."

The Rev. John Love, pastor of Parkway Assembly of God in Talladega, said his
church strongly supports Teen Challenge and its mission.

"We partner with a program that's already in place," Love said. "Rather than
try to reinvent the wheel, we support Teen Challenge.

"A lot of churches don't know about them," Love said. "They're right down
the road in Sylacauga.

"Their percentage rate for recovery is so high they just blow everybody else
out of the water."

Methadone Treatment

When other treatments have failed, many opiate addicts turn to methadone
clinics to manage their addictions.

Wendy Sprayberry, clinical supervisor and clinic director for the Calhoun
Treatment Center in Anniston, said that rather than heroin, most of her
patients have become addicted to opiate-based prescription pain-killers such
as hydrocodone and oxycodone - the drug in OxyContin.

"We are an opiate-replacement treatment center," Sprayberry said. "We're a
methadone clinic. We specialize in treating people who have opiate
addictions."

Sometimes the clinic treats people with a true medical problem who have
gotten addicted to pain killers, Sprayberry said.

"They're usually prescribed two to four pills a day, but as their tolerance
increases they may take to 'doctor hopping.' "

Sprayberry said doctor hoppers are drug addicts who obtain drugs by seeing
several doctors for the same condition and get multiple prescriptions for
pain-killers such as OxyContin and hydrocodone.

"Addicts may take as many as 20 to 30 hydrocodone a day, or as many as 10
OxyContin in one day," Sprayberry said. "Many people call OxyContin the
hillbilly heroin."

A typical patient has had an opiate addiction of a year or more and cannot
go more than a few hours without taking something, Sprayberry said. They
come here, and we replace the opiate with a long-lasting narcotic that keeps
the withdrawal symptoms away but doesn't get them high.

"Methadone does not cause euphoric effects - if you take a stabilized dose
it doesn't," Sprayberry said. "Research shows that methadone is the most
effective treatment for opiate addiction."

Sprayberry said she measures success in how the treatment improves the lives
of her patients.

"Most of our patients have had the other treatments such as a 28-day
program," she said. "We're kind of a last resort.

"When I get a patient in here whose arms are destroyed from track marks from
shooting OxyContin and three months later they are employed, they're not
breaking the law, they're re-establishing contact with their family, and
they're paying their bills - that to me is a success story," she said.

Like all the other treatments, however, Sprayberry said, the most important
factor is the desire to change.

"They have to come in wanting to stop being high. They have to want things
to be different. They have to be willing to change who they hang out with,"
she said.

The choice is theirs

Marian Phillips, director of outpatient services at Caradale Lodge in
Sylacauga, said that along with a willingness to change, the success of
recovering addicts depends on their continuing treatment and their
willingness to follow recommendations of counselors.

"There's lots of ways to attack this problem," she said. "But recovery is a
process that never ends."