Last of an occasional series
Senior Iowa officials sat under a tent in a rural setting near Cambridge last summer, waiting to dig dirt and voice their hopes for a new drug treatment facility.
A handful of young residents from the non-profit youth and home service stood on the outskirts of town and listened. They heard Gov. Kim Reynolds tell the crowd, regarding her own previous arrests for drunk driving and driving prior to her tenure as governor, “Only those who have battled addiction know how excruciating it is.”
They heard Marissa Eyanson, the administrator of community mental health and disability services in the Iowa Department of Human Services, share her story of how she dropped out of high school with untreated issues and went to work at 17.
And they listened to Andrew Allen, CEO and president of Ames-based YSS, which helps youth like you in crisis, how this agency saved his life. He left a senior career at Principal to run it, and on this August day was preparing to break ground on the proposed $20 million rural center Ember. The 53-acre campus on donated land is scheduled to open in February 2024. It is an investment in what Allen calls “the healing power of nature” and will accommodate up to 72 clients, with emergency crisis stabilization accommodation and residences for the long-term treatment of adolescents and 18-23 year olds.
The center is unlocked because, as Allen puts it, “treatment is not punishment.” It accepts private insurance and Medicaid.
About a month after the optimistic groundbreaking, I sat around a table in a Clive office with a group of parents who were tragically connected: through the death of a child, drug poisoning, or an overdose. Everyone had sought help, but many encountered insurmountable obstacles.
“And they were all good kids,” said Lori Steinbach. But four and a half years after she lost her son Matthew and recently lost her husband to illness, Steinbach is so frozen she doesn’t even dream of her boy. And she fears that the way he died could prevent his entry into heaven.
470 Iowans died in 2021 from a drug overdose or fentanyl poisoning. But, as researchers are learning, addiction lies in a network of brain spaces connected by brain fibers that need to be identified and treated individually, regardless of what you’ve done or haven’t done.
“The treatment was so difficult to access,” said Nicci Dean, who lost her 23-year-old son Sam to an overdose. She had even unwillingly enlisted him to protect him, but realized he had to be willing to accept treatment that wasn’t available when he sought it. “You can go downhill quickly and feel like it’s a losing battle.”
More:Rekha Basu: A record 470 Iowa residents died of an overdose last year. Some Iowans helped keep the drugs flowing.
Often only short treatment stays are available; more time is needed
Other parents have shared their struggles to raise $20,000 down payments for private treatment centers or described their children leaving treatment. Since children over 18 and otherwise “healthy” have the legal right to refuse treatment, some families have to have them arrested to have them detoxified at a hospital, only to be released a day or two later because they need another refused treatment.
“At 18, the country says you’re officially an adult,” Allen said in August. “But the brain takes time to develop cognitive thinking.” And after prolonged substance abuse, some addicts are out of their minds.
More:Rekha Basu: A mother’s failed struggle to save her son prompts her to speak more openly about addiction
Diane Armstrong Proffitt’s son, Jordan, died in 2017 from heroin adulterated with carfentanil, a synthetic opioid used to calm elephants. He was 21 years old. He was hospitalized several times, but received only a week of outpatient treatment each time, she said. In the meantime, he kept moving up the ranks to harder drugs.
Lisa Gabriel lost her 25-year-old daughter Alijah Blue Allison to heroin and fentanyl in 2018. Gabriel had tried to get her help. At a Des Moines hospital, she said she was told Aliyah couldn’t be allowed to detox just from heroin because “you can’t die from heroin withdrawal.” But even if she were admitted because she was also a heavy drinker or benzoid user, once her vital signs were normal, she could wait weeks for a bed to be opened at a treatment facility. And Medicaid didn’t cover a stay long enough to treat heroin addiction, and few places would accept it, Gabriel said.
All hospitals provide emergency treatment for overdose patients whose lives are in danger. But each county has a designated court-ordered hospitalization facility. In Polk, this is Broadlawns Public Hospital, which has 44 in-patient psychiatric beds (including addicts) for up to five days for patients who are medically stabilized.
However, Broadlawns does not offer longer inpatient treatment. So admitting someone against their will requires a court order, and a judge must determine that the patient needs additional services before ordering more hospital time, inpatient or outpatient services, according to Broadlawns government liaison Steve Johnson. He said the hospital will keep patients until a bed becomes available elsewhere.
A father who took his child to the hospital during a drug-related medical crisis said a judge then ordered him to take medication and attend intensive rehab at another facility. But the patient, in his 30s, only walked twice for about 20 minutes each time. Neither the establishment nor the judge went any further and he never went back.
More:Rekha Basu: Fentanyl increases drug risks as ‘no way of knowing what you’re taking will kill’
Addiction is a social justice issue: everyone deserves good treatment
Johnson commends two inpatient programs in Des Moines: Prelude Addiction Services on the east side and Bridges of Iowa, which leases space in the Polk County jail. The typical Prelude stay is 30 days, with an option for a stopover afterwards. Bridges partnerships with local businesses and DMACC to enable those in recovery to move to jobs and receive a GED. The program consists of three phases, which extend over a year, the third mostly on an outpatient basis.
The focus in treatment has shifted over the decades, Johnson said, from breaking through the addict’s denial to providing incentive by helping the person envision a better life as a parent or with an education or job skills.
A few parents I spoke to brought their children to the Hazelden facility in Minnesota with good results. Others couldn’t afford it. Most insurance plans don’t cover the full length of treatment, according to Hazelden spokesman Jeremiah Gardner, himself a recovering addict who lost his mother to an overdose.
“Addiction is a social justice issue,” he said. “People with addictions are severely discriminated against.”
Gardner said it’s wonderful “how much people can change” with the motivational enhancement therapy they receive at Hazelden and through the building of camaraderie and community.
After months of research for this series, I see how much of a social justice issue addiction is. As with most things, those who are paid can get good help while the rest have to solve the puzzle of treatment. Only when we stop stigmatizing addiction by treating it as a moral failure, rather than a medical crisis, will more beds free up and insurance companies have to pay for full stays and better treatment.
Some new hope is on the horizon, including brain brain research featured in the June journal Nature Medicine. In response to the many deaths from fentanyl poisoning in Iowa, state Senator Claire Celsi plans to introduce legislation in the next session to legalize fentanyl test strips to help drug users identify the deadly presence of fentanyl in the drugs they buy identify substances. And Ember offers a new opportunity for those who are looking for it.
I started this series months ago, interviewing dozens of struggling or distressed family members, as well as recovering addicts and medical professionals who have generously shared their truths. Unfortunately I cannot introduce all of them as my time in the register is coming to an end. But I sincerely hope that those suffering with an addicted family member will not stop looking – or be urged by politicians, institutions or the media – until they find an approach that works.
And I hope one day to see the young people who gathered at the YSS groundbreaking ceremony in August succeed after being given a chance to start fresh.
