A collection of 52.20 grams of black tar heroin photographed at the Juneau Police Department.

A collection of 52.20 grams of black tar heroin photographed at the Juneau Police Department.

This is what it takes to get into treatment

Editor’s Note: This is one part of a series examining why it’s so hard for heroin and drug addicts to get into treatment in Juneau, and what some in the community are doing about it. For the next installment, click here or see Monday’s newspaper.

When Stacie Arnold went to Rainforest Recovery Center last June, she wanted to get treatment for her meth and heroin addiction.

She had been surrounded by drug addiction her entire life. She was raised by drug addicts in Florida, and had been in and out of foster homes. At 15, she moved to Juneau, where an uncle was stationed in the military.

Soon after she moved here and had settled into a foster home — “a great family,” she said — her mother died.

Although she graduated from Juneau-Douglas High School in 2009, the first person in her family to do so, and received a scholarship to attend the University of Alaska Southeast, she stopped attending classes.

She was having trouble dealing with her mom’s death, and she felt like she was getting teased in school. She was depressed.

She took 99 sleeping pills and a bottle of NyQuil, a suicide attempt. She spent a week in critical care at Bartlett Regional Hospital.

“I’m grateful that I made it through that,” she said by phone last week from a treatment center in Anchorage.

She did meth for the first time on her 22nd birthday. Heroin followed.

She reached Rainforest’s doors at age 23. Her first impression wasn’t good; the person at the front desk was rude to her.

“It was really off-putting,” she said. “I was already having a hard time deciding if I really wanted to do treatment.”

She filled out all the paperwork, anyway. Two months passed. A bed was still not available.

At a 12-step meeting, she overheard someone that they had an easier time getting into Rainforest by saying they were suicidal.

So that’s what she did, too. It seemed to work.

“I ended up using the suicide card to get into the mental health unit, and it helped me get in faster because I got in the next day,” she said. “But the fact that I had to do that, to go to that extreme, it was frustrating.”

 

Frustration

Richard Nault, the new interim director of Rainforest Recovery Center — Juneau’s only residential drug treatment facility — knows the center isn’t the easiest place to get into.

He came on board in mid-October and is already working with several community members on making changes to help fast-track patients through the door.

“We’re definitely trying to be more accommodating,” he said. “We don’t want to be the place that always says no.”

If he wasn’t aware that frustration levels are high, he was on Sunday at a meeting in the Mendenhall Valley public library held by a group of people concerned about Juneau’s heroin problem. He was one of the guest panelists.

Shirlee Bulard, an Anchorage mother formerly of Juneau, flew down from Anchorage just to attend the meeting.

She has triplets in their 20s, all of whom were raised in Juneau and two of whom are now addicted to heroin. She had a pointed question for Nault: How was her son able to get into treatment “so fast it made my head spin” in Ketchikan, but her daughter still lost on the streets of Juneau, unable to find a place to detox or receive treatment?

“I have my daughter on a waiting list for two months in Anchorage, and then last week I was told here at Bartlett hospital that they would just give her an IV and medication (to detox),” she said to him. “And then when I called your office, there was nobody there. So if you can’t admit anybody on the weekends to Rainforest — what’s the purpose of all this? Even if I had a credit card that’s got $25,000 on it, and I’m willing to pay you right then and there, you still can’t take her.”

“It’s true we don’t have —“ Nault began.

“She’ll be basically dead out on the streets,” Bulard said, voice rising. “You’re telling addicts that they can’t get in. It’s ridiculous.”

 

Death toll rising

With limited detox and drug treatment options in Juneau, the demand for more and easily accessible services is growing louder.

It comes amid an alarming and deadly heroin crisis in Alaska’s capital city, a trend that mirrors a nationwide epidemic.

Heroin use has skyrocketed across the country, a direct result of an opioid prescription painkiller that was being overprescribed, OxyContin. When OxyContin pills were reformulated by pharmaceutical companies in 2010 to make them harder to abuse, heroin emerged as a cheaper and easily available alternative.

According to a Centers for Disease Control and Prevention study released Friday, heroin deaths have tripled nationwide since 2013. Drug overdose deaths overall hit record numbers in 2014 — the study found there was over 47,000 deaths last year alone, mostly due to opioid pain relievers and heroin.

In Alaska, the federal Substance Abuse and Mental Health Services Administration estimates that less than 500 people on average used heroin within the past year between 2002 and 2005. That figure quadrupled to 2,000 for 2010-2013.

The heroin death toll in the Last Frontier has quintupled since 2008, according to Alaska Bureau of Vital statistics. There were just 6 heroin drug overdoses in 2008, 7 in 2009 and 4 in 2010. The numbers then began to creep upward: 11 in 2011, 21 in 2012, and 26 in both 2013 and 2014. So far this year, 31 people have died from heroin (either as an underlying or contributing cause) in Alaska.

Juneau has been hit disproportionately hard. There were six heroin related deaths between February and October, four of whom were young men in their 20s. There was also a young woman, and an older male in his late 40s.

The number of heroin related deaths in Juneau quietly rose to seven recently. Juneau Police Department Lt. Kris Sell told the Empire that an autopsy came back for a woman in her 30s who died a few months ago. The autopsy showed she died of a multi-drug overdose, and one of the drugs was heroin.

Everyone seems to be looking for answers, including Juneau police.

 

The demand side

Wherever Juneau Police Department Chief Bryce Johnson and Lt. Kris Sell go to talk about heroin—  Chamber of Commerce luncheons, on the radio, to the media — they share the same message: Juneau cannot arrest its way out of the problem.

“We will never arrest enough people or do enough enforcement to eliminate the problem,” Johnson put it during an interview with the Empire last month. “I want to make everyone rest assured, we are still going to go out and do the enforcement that we’re tasked to do, but that’s just not enough. We’ve got to work on the demand side. We’ll keep working on the supply side, which is what JPD does, but we really need to partner with the community and work on the demand side.”

Heroin is a lucrative business in Juneau. Whereas down south a “point” of heroin, or a tenth of a gram, costs around $10, it costs $100 here.

“As soon as we arrest a drug dealer, I guarantee you, another one is coming in to take their place,” Johnson said. “It’s very profitable.”

It’s unknown exactly how many heroin users there are in Juneau. Police say a conservative estimate is 200 but they also say it could be double that. If there truly are 400 users, and if they’re using about four “points” a day on average, that a big profit margin for those trafficking the drug here.

“Even if it cost ten bucks to a get every point of heroin up here, take that off the market and we’re talking about $120,000 day of illegal drug profit in Juneau, a day,” City and Borough of Juneau Assembly member Jesse Kiehl, another panelist at Sunday’s meeting, said, relying on those numbers from police. “We’re not going to interdict it all with that kind of profit to be made bringing it in illegally.”

 

New ideas

The police department has been calling for heroin addiction to be treated primarily as a public health issue rather than a criminal one. JPD is looking at diversionary programs to get addicts into treatment instead of simply arresting them and throwing them behind bars.

“Our goal is not to put people in jail, we know that doesn’t really help anything,” Johnson said. “Our goal is to get people off (the street) and get them into treatment.”

The department is currently looking at how other departments down south operate diversionary programs. The “gold standard,” Johnson said, is the Gloucester, Massachusetts police department, which invites addicts who want help to go to the police station and to ask for it. They won’t be jailed, they won’t be charged with a crime, and the department will provide them with a volunteer “Angel” who can help guide them through the process of getting into treatment. The idea is they get help not in a matter of days or weeks, but immediately.

“You will not be arrested. You will not be charged with a crime. You will not be jailed,” reads a message in bold letters on the Gloucester police department’s website. “All you have to do is come to the police station and ask for help. We are here to do just that.”

It’s a great idea, JPD Chief Bryce Johnson said.  He’s spoken to the police chief there, and the City and Borough of Juneau city manager, Kim Kiefer, recently traveled there to see how they run their program.

“We would like to be able to do that,” Johnson said.

There’s one major hang-up, though.

“We just don’t have the treatment options or facilities here,” Johnson said. “So we’re trying to figure out how to move in that direction.”

 

Nowhere to go

For heroin addicts in Juneau, there’s no place to go receive care immediately. If they decided they wanted to stop using today, they wouldn’t have a place to go to detox, and there wouldn’t be a bed available for them.

Fingers tend to get pointed at Rainforest, the only in-patient residential drug treatment center in town. It has just 16 beds, can only house clients for a 28-day stay, and is not set up to accept people coming in off the streets.

And while Rainforest does offer out-patient services after the 28-day program, there’s no long term residential drug treatment facility to send people to in Juneau.

But already, things are changing.

 

The new normal

Last Wednesday, Kara Nelson and Christina Love helped get someone with a heroin addiction off the streets and into Rainforest within 48 hours.

It was a first, and when word got out (Nelson posted about it on her Facebook page), she was bombarded with about 50 messages from family members of addicts who asked them how they did it.

“She was like, ‘I’ve been trying to get my brother in for months, and here you guys got someone in in 48 hours,’” Nelson said of one woman in particular who messaged her. “And I said, ‘Well, we know this is not normal, but hopefully it is going to be the new normal.’”

The patient’s quick admission was a direct result of Nelson’s and Love’s volunteer efforts as recovery coaches, Rainforest’s willingness to help fast-track the client through, and the client’s desire to seek treatment.

“Rainforest is on board, the director’s on board,” Nelson said. “Some of these polices are what really are the barriers — the policies within the hospital, and we’re all working on that in the background. But up until now, nobody has been able to just seamlessly get into treatment, let alone get into detox within the hospital.”

When the woman was admitted to Rainforest last Friday, Nelson said she cried and hugged Nault. It was cause for celebration.

“When we look back in sixth months — I was telling the girl I brought to treatment yesterday — I said just think you’re going to be able to tell other people when you’re sharing your story, ‘Hey, back in the day, when I tried to get into treatment…’ This is the beginning of that.”

• To learn more about the work Nelson, Love and others are doing to help break down barriers to drug treatment, click here or see Monday’s newspaper.

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