Pubdate: Sun, 19 Mar 2006 Source: Daily Reflector (Greenville, NC) Copyright: 2006 Daily Reflector Contact: http://www.reflector.com/ Details: http://www.mapinc.org/media/1456 Author: Paul Dunn SOBRIETY PROVES ELUSIVE, EVEN WHEN HELP Lindsey Harris wears a white, loose-fitting polo shirt with an alligator emblem over the breast. The shirt's horizontal stripes enfold his muscular frame, which in his prime he used to punish opposing high school football players. "You have to be able to accept life on life's terms," he tells four men and one woman lounging on stuffed chairs in a nondescript meeting room. "You always have to have a plan just for today." The listeners are drug addicts and alcoholics. They voluntarily checked into the PORT Human Services Detoxification Center at 203 Government Circle because their lives have crashed headlong onto a rocky bottom. Some will lose their families, jobs and friends if they don't fly right. Others will die: Some overdose, some commit suicide, some are murdered. Others make it. But not many. For the past eight years Harris has been a detox center substance abuse counselor. When he speaks, patients listen: He's been there. As Harris tells it, he would have pursued his gridiron dreams several more years had the chancellor at Elizabeth State University not revoked his football scholarship. Seems a few of Harris' buddies went on an eastern Carolina thieving spree one day 16 years ago and stashed the goods in Harris' car. Though the promising 18-year-old running back professed innocence after local police discovered the theft, the chancellor wanted nothing more to do with him, Harris recalled. So with his sports career fumbled, Harris enrolled in Harbarger Junior College in Raleigh, a business school with no athletic program. But he was soon distraught: Without football he had little initiative, he discovered. So he started drinking, then drugging, dealers scenting the vulnerable kid like sharks do blood. Now 34, the father of three cringes at the memories, but uses the lessons to help others harpoon their sharks, as he once did. The final humiliation| Harris was having a bad day. It was February 1994, 5:30 p.m., nearly dark. Thirty-eight degrees. For a half hour, the eastern North Carolina native and three partners had been treading the frigid asphalt on U.S. 64 near Norfolk, Va. - stark naked. Within minutes, a Virginia state trooper pulled alongside the men, rolled down his window and asked: "What the -- is wrong with you!?" "We just told him what happened," Harris recalled without chagrin. "But we didn't tell him about the drugs or the money." Several hours earlier, a drug dealer had shoved a gun to Harris' temple as he sat in his car with three accomplices. They were in the woods near Norfolk, a perfect spot, they figured, for a cash-for-crack transaction. The streetwise drug runners - all in their early 20s - arrived in Virginia that morning looking to complete a drug deal for their local supplier. They'd never seen this particular Virginia dealer before. Turns out he wasn't as kind as the others had been. The dealer wanted the $20,000 drug money hidden in Harris' white, 1990 Acura Integra, but he didn't want to fork over the crack cocaine the money was supposed to buy. In fact, he had no drugs at all that day, Harris said. When the North Carolina men refused to hand over the money, the angry dealer made the quartet strip and get out of the car. The dealer drove away. The men, meanwhile, trudged out of the woods and finally reached the highway hoping to attract attention. The state trooper carted them to a Norfolk police station, issued them jumpsuits and commanded them to stay put. Three hours later, the police found Harris' abandoned car, and the men were allowed to leave. The money was still there, stashed inside an air vent. The drug dealer had shredded the car's seats and carpet. The incident forced Harris to chuck the drug-and-alcohol lifestyle he'd embraced for four years. The day before the handgun nudged his head, he'd chased a half gallon of gin with $300 of crack cocaine. The day before had been similar, as had the one before that. "I saw myself just down to nothing," Harris recalled. "I had lost everything and didn't have a place to go. It was as low as a person could go." Harris checked himself into the Coastal Plains Substance Abuse Rehabilitation Center in Rocky Mount. He knew he'd made the right decision, but the first week in rehab tested his resolve like nothing he'd ever experienced. "I was very volatile that first week," Harris recalls. "I was violent and wanted to fight because I wanted to drink and get high, but I couldn't." After about five days, his withdrawal-induced sweating and tremors eased; a week or so later so did his depression. On the 29th day at Coastal Plains, Harris walked out clean. He says he's been stone sober ever since. How it happens| Shrieks of laughter peel from the detox center's business office during a recent noon hour. Between bites of lunch, regional manager Nicole Brown and her staff regale each other with amusing snippets. The brief respite helps diffuse the day's pressures. Detox is a timeout for alcoholics and drug addicts - temporary sanctuary from the rabid dogs nipping at their heels. It's triage for their spirits, too, many crushed at early ages by trauma, tragedy and simple indifference - or worse. As one detox patient said: "I got put down a lot by my parents and teachers. They said I'd never amount to anything." That statement wouldn't surprise Dr. David Ames, PORT consulting psychiatrist and chairman of the Pitt County Substance Abuse Coalition. From his eastern North Carolina vantage point, Ames has seen ruined lives aplenty. Much of it's drug and alcohol related. "Substance abuse just causes a whole lot of trauma in a zillion and one different ways," he says. "The emotional stress of seeing a loved one falling victim to addiction and becoming dreadfully disabled is heart wrenching." Frequently, families fall apart when the first domino falls. Substance abusers rely on others to take up their slack, Ames explains. It happens at work, home, anywhere and everywhere. "You have all those real-life problems," Ames says. "These people are not performing on their jobs or at home. Add to that that their families frequently have to bail them out of jail and pay lawyers' and medical fees." In American society, risk factors for alcoholism and drug addiction run rampant. Ames points to a couple prominent ones: dysfunctional families and living environment. "Parents who drink excessively or abuse other drugs can't help their children learn coping skills or learn to deal with adverse circumstances," Ames says. "These kids may be emotionally scarred and more liable to get into trouble." Compounding the problem is a society obsessed with advertising - much of it for alcohol, Ames contends. "If your area is saturated with advertising for alcohol, your chances are significantly higher for having problems with alcohol," he says. "Television is probably by far the most invasive. You get bombarded with these messages to drink and smoke, so people think it's cool." The craving for drugs or alcohol hijacks a fundamental biological mechanism in the brain for survival, Ames explains. Use drugs long enough, and the brain changes to adapt to the new situation. Stop using and the deprived brain protests. "Even after withdrawal, the changed brain structures are still in place," Ames says. "They can be triggered by cues, such as taking a drink or seeing a drug dealer." The results are predictable. "The person experiences an overwhelming desire to try the drug again," Ames says. "It's so overwhelming that most people relapse, and that's why addiction is so chronic." Pitt County Memorial Hospital treats 1,200 to 1,500 patients per year addicted to drugs or alcohol, said Cheryl Gentile, a hospital substance abuse counselor. Alcohol is by far the most abused drug, Gentile said. Cocaine, prescription medication, heroin and marijuana abuse, in order, are the next most abused. Though the problems are daunting, Dr. Gary Leonhardt, PORT's medical director, sites an above-average complement of local caregivers and law enforcement personnel and increasing public awareness as causes for optimism. "We have community leaders from all walks who are trying to help, and they are planning a siege to jump-start the movement," Leonhardt said. "These people have been very pro-active." Needs are great, Gentile says, but every victory is momentous. "There is a tremendous need for substance abuse counselors and programs in eastern North Carolina," Gentile says. "We treat people in great need, who are forever impacted by the care that we give to them. A former patient of mine approached me four years after I counseled him, and informed me that our brief intervention gave him the chance to get his life back on track, and in fact, saved him." But the efforts are balanced by what Leonhardt calls "a fairly heavy local drug trade." Patients he treats from areas such as Wilson, Washington, Goldsboro, New Bern and elsewhere tell him they visit Greenville to buy drugs. "So, in some ways we're better off and some ways worse off," he says. Greenville Police Department records for 2004-2005 help illuminate Leonhardt's claim. The department made 38 arrests in 2004 for alcohol-related infractions, 52 in 2005. The department made 1,658 drug-related arrests in 2004, 1,038 in 2005. Decreased arrests, though, don't necessarily reflect decreased drug activity, said Maj. Kevin Smeltzer; the department simply shifted its focus to larger dealers. Smeltzer doesn't expect the drug trade to decline until dealers are put out of business. "You can always remain optimistic, but the situation doesn't seem to be any better," Smeltzer explained, noting his 21 years on the job. "As long as there's a market for it (drugs), somebody is going to provide that service. You have to dry up the market." Recovery's first steps The PORT Human Services Detoxification Center does not rehabilitate drug addicts and alcoholics. That's left to other facilities, such as The Walter B. Jones Alcohol and Drug Abuse Treatment Center in Greenville, a 76-bed, short-term, residential treatment center. Detox center patients graduate to Walter B. Jones, but first they must endure five to seven days of hideous, body-and-mind-wracking withdrawal. For many, headaches, vomiting, stomach cramps, depression, anxiety and stark terror scar just about every moment of their detox. Detox center counselors, nurses and contracted doctors help ease the process, but the onus clearly is on the patients themselves to change. By the time they leave the center, most will have conquered the worst of their physical trauma. "We hope to see people no longer in acute medical distress as a result of withdrawal," said Brown the regional manager. "Our goal is to provide a place for a safe withdrawal process." Because patients only stay an average of five days, new and distinct challenges greet detox staff almost every day. "We have clients come in who are angry and depressed, with just a full array of emotional issues," said Brown, 35. "Sometimes they come in and cuss everybody out on the staff and on the second day they apologize." Most patients leave the facility with a renewed outlook on life, vowing never to return to the center or to the way of life that propelled them there in the first place. But good intentions often fall by the wayside once patients leave the center's encouraging embrace. "We see people return to the detox center pretty frequently," Brown said. "They may do well for a little while, but they relapse and are back." Staff members give patients little time to wallow in self-pity. Days begin at 6 a.m. when nurses check vital signs: pulse, blood pressure, temperature. Vitals are monitored every four hours the first 24 hours of a patient's stay and thereafter every eight hours. Patients receive multivitamins to help gain strength and medication to help ease withdrawal symptoms. Breakfast, lunch and dinner are provided through a contract with Cypress Glen Retirement Community. Counselors typically fill patients' days with addiction education lectures on goal setting, health and stress. They periodically offer "pot luck" activities, too: nature walks, fishing, bingo and "detox feud," among them. Patients also are encouraged to attend nightly 12-step meetings outside the detox center. Vital signs are checked a last time at 11 p.m.; lights go out 15 minutes later. Each day, about four people inquire about the facility's services, Leonhardt said. But not everybody gets in. Potential patients must meet American Society of Addiction Medicine criteria that determine the appropriateness of treatment for individual cases. If they fall in the right range on the ASAM scale, and there's a bed open, they're in. If not, counselors help them find treatment alternatives. Doctors turn away patients less than 10 percent of the time, Leonhardt said. "Patients may not have problems deemed appropriate to require the level of services at the detox center," Leonhardt explained. "On the other hand, patients may have such severe medical and psychiatric problems that we can't provide the level of services they need, and they may need to go to a psychiatric hospital." About a third of the center's patients enter the facility involuntarily, Leonhardt estimated. They're admitted under a legal document called an "involuntary substance abuse petition." To be admitted involuntarily, caregivers or doctors must determine that people are dangers to themselves or others, and that medical treatment is the best option. "A family member may realize that the person will have an extremely bad outcome if they don't seek treatment," Leonhardt said. "A magistrate swears out a petition for the person and the local law enforcement transports the person to the center." Patients typically suffer from depression, anxiety and some psychosis, Leonhardt said. In many cases, alcohol has compromised liver function and added to other health problems, such as tooth decay. Many patients indulge in what Leonhardt calls "poly-drug use." "Mostly we see patients who have a primary substance that they really like, like cocaine or opiates or alcohol," he said. "Most of the folks, though, do more than one drug, and they are very good at what they do. They have the capacity to continue to have access to what they like and use regularly despite losing their home, jobs and family." Hustle and bustle Most days, the PORT center thrums with activity. Eight of 10 facility beds are occupied year-round, Brown said. Admissions usually peak as the weather cools, though totals for the last quarter of 2005 belie trends. During that time, males outnumbered females about 3-to-1. One-hundred thirty-five people entered the facility with alcohol problems, 36 for opiate addiction and two for other problems. They average 56 years of age. According to Nancy Cleghorn, care management chief for the Pitt Mental Health Local Management Entity - formerly Pitt County Mental Health - 28 people walked into the LME in January seeking substance-abuse counseling. Thirteen of 28 sought admittance to the detox center. LME administrators, who screen potential detox center patients to determine treatment suitability, received 178 telephone calls about substance abuse during the same time period. Pitt County Mental Health operated the center until a 2003 state mandate transformed the agency into an LME and divested its mental health services to private providers. PORT Human Services also operates two other detox centers, a nine-bed unit in Washington, N.C. and a six-bed in Ahoskie. Brown oversees all three. The three centers service residents in 33 counties in eastern North Carolina from Ahoskie to Wilmington. They are funded through the state Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services. The three units use the bulk of their funding to pay salaries, Brown explained. PORT also provides services for Tideland Mental Health and Roanoke/Chowan Mental Health. Counseling punctuates the 24-hour medical care, as did one mid-afternoon, late February. Three men and one woman sit around a table in the detox center kitchen. Lindsey Harris is leading a pot luck session. He passes a roll of white toilet paper, instructing the patients to tear off a few sheets and stack them. He circles the table, asking them to reveal something about themselves as they flip over the sheets. Before long, they've stripped bare the branches of their lives. Harris recites last. "I had just lost all hope," he recalled of his drug days. "I was at the bottom - looking up at the bottom. Everybody was calling me an alcoholic and crack head. "But I made it through. If I can do it, you can, too. "Whatever y'all are going through, you'll come out. You'll come out." Paul Dunn can be reached at and 329-9569. Three patients at PORT Human Services Detoxification Center share their stories in hopes of discouraging others from following their paths. WINE BY THE CARAFE Woody Woodpecker had trapped chipmunks Chip and Dale in the cornice of Doreen Gifford's bedroom. This is just too weird - even for an alcoholic - Gifford thought, mesmerized by the blurry images. "It scared the hell out of me," Gifford said of the hallucination she had six months ago. "It was animated, and that really freaked me out. I got right up and got a 40-ounce bottle of Colt-45." Before the incident, the 39-year-old had gone one and half days without a drink; the drought left her shaking uncontrollably. Every day for the past two years, the single mother had drowned the sorrow of her marital separation six years earlier with two and half six-packs of beer or a 1-liter drink box of zinfandel wine. "My drinking was outrageous," Gifford said. "I had blackouts and didn't remember things." Administrators admitted Gifford at 11:30 p.m., Feb. 20. She'd downed four carafes of wine the day before, but trembled too violently that night to eat. "I was trying to bring the spoon to my mouth, but I couldn't because I was shaking like I had palsy," she said. "I just threw the spoon down." Enough was enough. "I like drinking, but it's time for this stuff to stop," she said the next day, perched in the sun on a detox center picnic table. "I'm too smart, and I have too much to live for." She looked off a moment in mute supplication, took a drag from a cigarette, turned back. Stared. There's a slight yellow tinge to the whites of Gifford's somber brown eyes. Her melancholy's reflected there, as are her memories. Gifford's marriage 13 years ago deteriorated as her husband's crack cocaine habit strengthened. But she still had her job at a mental health facility in Craven County, and in 1998 was pregnant with her first child. The premature girl was born on Gifford's birthday, Sept. 14, 1998. The baby died in her mother's hands 77 minutes later. On the way home from Craven Regional Medical Center, Gifford stopped by work to drop off her resignation. She was inconsolable. "I sat in the house with my head stuck in the pillow, howling," Gifford recalled. Gifford would later conceive a son, now 6, whose welfare, she claims, compels her to get sober. "Amazingly, I'm still optimistic, and I want to go back to school to become a phlebotomist," she said. "I have to get back to the point where I'm self-sufficient. That's really important to me." HOOKED ON PARANOIA When he's high, Dennis can hear a pin drop. It makes him crazy. The detox veteran, who declined to give his last name, has tried to commit suicide five or six times, he says. He's usually driving when the mood strikes, but so far hasn't wrecked his cars badly enough to kill himself. The 46-year-old Farmville resident checked into the detox center on Feb. 17. The day after, he's slouched in a stuffed chair absorbing a lecture on goal setting. His head's wrapped in a skintight, black bandanna, a red baseball-style cap atop that. The rotund man's eyes are crescent moons. He's not sleeping well, he says - too much anxiety. The shy giant has been in and out of six or seven detox centers, he says, but the crack cocaine he's hooked on lures him back every time. The highly addictive drug makes him feel "paranoid and stupid," he explains, his honesty sifting through the gravel of his voice. "I hear things and see things that aren't there (when he's high), and I can't be around people." Dennis has used the rock for 15 years, but until recently never believed he was hooked - though he regularly lighted up all night long. His struggles intensified after a divorce and the 1998 death of a son in a car accident. Though he's managed to keep a longtime job, he owes a drug dealer $2,400 and wonders if he'll ever have enough money to pay him. "Sometimes I'd rather be dead than going about doing what I'm doing," he says. "I work all day, and before I even get the check it's already gone to the drug dealers. As long as I ain't got no money in my pocket I'm all right, but if I have $20 in my pocket I have to get the drugs." Dennis was living on easy street at one time, he says. He owned houses in Farmville, Fountain and Texas. Then he started drinking, and drugs soon followed. He was 31 years old. "I was doing pretty well before I started doing this," he explains. "Now I don't have nothin'. People don't even want to be around you when you're doing this." Dennis' latest crack cocaine binge was a nightmarish, surreal straightjacket he wore for four straight days. He didn't eat. He didn't sleep. As far as he was concerned, he didn't exist. "The drug was constantly on my mind," he recalls. "I couldn't think of anything else. People out there who have never done it (drugs) don't know what it's like." Dennis has managed to stay clean for about six months after most of his stints in detox, he said. He's hoping the latest one lasts a lifetime, but the soft-spoken working man knows the odds are against him. "I hope I can get out and stop it and quit it," he says, his head bowed, fingers picking at the nails of his left hand. "I need to find a new place to live." EXACERBATING THE PAIN Kenneth Owens sees body parts in his sleep. Hands, arms, legs, feet ... faces. He stumbled on them in the rubble of New York's Twin Towers several days after the Sept. 11 terrorist attacks. Owens and his buddies had volunteered to accompany the Elizabeth City Fire Department on a mercy mission to New York. They stayed a month. Owens had moved to North Carolina from Virginia at age 12, two years before he started a drug and alcohol habit that would plague him throughout his life. The 43-year-old is an "equal-opportunity drug fiend," as he calls himself. He used what he could get: marijuana, crack cocaine, heroin. "I was just trying to be in with the crowd," he said of his early years. "Now I'm 43 years old and don't have --, no car, no nothin'. It's a dead-end street." Owens, a tree topper until a tumble from a top limb crushed his leg in 1991, figures he's spent $500,000 to $600,000 on drugs in his lifetime. He's been through detox eight to 10 times, he estimated, but has yet to stay clean for more than a year. Drug infractions have landed him in jail 12-13 times, he estimates. "There's a lot of peer pressure to use drugs, mainly from the dealers," he said. "They tempt you by saying, 'Come on, man, I'll give you some for free,' just so you'll get back on it." Owens agreed to chat in the center's kitchen several weeks ago, the day after he'd checked in. Glazed eyes hovered over a thin, black mustache on his unshaven, gaunt face. He wasn't in the best of form: His stomach hurt, he couldn't eat, and he had been unable to sleep, he said. His body craved the heroin he couldn't feed it. "It's rough. I'm going through a lot of withdrawal now, and it's going to get worse," he said. "There's a lot of crazy stuff going through my head right now." Owens' drug use intensified after he returned from New York. The opiates helped blur the horrific images he retained, though they never completely vanished. "It just replays in my head, seeing the body parts," he said. The week before he entered detox, Owens spent $1,500 for 25 caps of heroin, an ounce of marijuana and a quarter ounce of crack cocaine. He paid for the drugs with money from his savings. If he hadn't had the money, he would have stolen to get it. "I would have broke in somewhere to get something to sell," he said. "I've done plenty of that in my life. I'm not proud of it." - --- MAP posted-by: Derek