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Spin Dries

August 26, 2015  |  Cathy Finn

There has been a lot of talk in the big wide world these days about drug and alcohol addiction and the treatment available to addicts. Let me give you a boots-on-the-ground perspective.

At least three times a week an addict comes into our case management office asking for detox.  Detox is the process of physically coming off the drug or drink, commonly known on the street as a “spin dry.” It is a time-limited, medically supervised few days where they can come off their addictive substances. There is some medical intervention to try and prevent seizures and ease the shakes, nausea, body pains and emotional difficulties that come along with having the addictive substance fading from the body.

It is not pleasant, but it is better and more effective than detoxing on the streets. I have seen several people detox from heroin on the street. Imagine a very bad flu that lasts for days, no bed to sleep in, the temptation of heroin all around you, and the only friends you have deep into addiction. I have seen several people go back to using heroin during the experience, just to ease their suffering. The suffering is intense.

Our patients know they can come to us for assistance in getting into detox any time, and any number of times. But it simply isn’t easy.

The person comes in and asks for a case manager. I greet them, hear what they want, then settle down at my desk. I pull out my list of detox facilities that take Mass Health. The first catch: the number of facilities that will deal with Mass Health is limited. They are certainly not the exotic and serene venues one sees in the addiction reality shows, although they can be effective.

We start making calls. Some places will not take what are called “dual diagnoses,” people who have addiction and psychological issues, a large number of our patients. That narrows the list down to two or three facilities for some.

We call the first place. “Sorry, we have no beds, call back at 2.”

We call the second place. “Sorry, no beds. Call back tomorrow.”

We call the third place. Guess what they say?

There is no intake, you don’t leave any information. I have to turn and ask a person who has no phone and no place to live to call later in the afternoon. I strongly encourage them to come back and use our phone, our assistance. I escort them to the stairs, with that sinking feeling in my heart that I will not see them at 2… By then, they will have taken a drink or shot up heroin to stop the pain of not having their drug of choice. I am tired of that feeling and of knowing these folks could be walking out the door to their death.

I’ve had people intent enough on drying out that they will come back day after day for a bed in detox, but there still are none available. One man I’ve been helping recently had called one place so much that they said he was a priority. He’s missing right now. I hope he’s in detox, but he could have just given up and be out drinking on the streets.

After a few days most people are back on the streets, where the temptations are intense. Even if they wanted longer term treatment, the cycle starts all over again. There often are no beds in longer term treatment centers, and they are told to keep calling, an unlikely thing to happen once they get off the bus from their spin dry. Even if they do call, after a few tries with no success they give up.

We case managers have seen this happen again and again. We have seen it happen again and again with the same person. We have options to help them here at Duffy: we have the Suboxone and Vivitrol programs, both very effective, but it is a matter of catching them before they get off the bus and veer over to the liquor store or their friendly dealer.

If we and they are very lucky we will see them at our doorstep again, asking for help. We will welcome them, appreciate the fact they are ready to change, and pick up the phone. We will hope and pray there is a bed available, because this is the time, this is the moment, and tomorrow may be too late.

Would you like to see more funds allocated to help people overcome addiction? Contact your elected officials!