Nearly 150 addicts seek recovery through treatment chain's Rockland office
Rockland — Note: The addicts The Courier-Gazette spoke to for this piece shared their stories on the condition of anonymity. "Jessica" and "Alyssa" are pseudonyms used in place of their real names.
Jessica’s addiction to opioids started in her late 20s, after she was thrown down a flight of stairs by a boyfriend.
“I was probably bed-ridden for about a week,” she said. “It healed wrong because I was embarrassed to get help.”
She ended up with three broken ribs and a chronic spine injury that causes her pain and limits her movement to this day, about 15 years later. Even now, she said, activities like taking a walk on the beach require her to plan for a subsequent day of immobility and pain, and she sometimes needs help with simple things like vacuuming or taking off clothes to shower.
Jessica said she struggled to find a doctor who understood her situation. “You doctor-shop. You do. And it doesn’t start out being for medication, it starts out being: 'listen to me!'” she said. “I know there’s something wrong. Don’t give me another prescription and send me on my way. Fix this!”
She became resigned to the idea that morphine, Vicodin, or other pain pills were the only things that made her close to functional.
However, Jessica was no novice at drug dependence. She said she first used cocaine at the age of 12, while growing up in Hancock County. With abusive parents who were always short on money, she felt free to spend her time partying, drinking and getting high on whatever she could find.
“When you grow up in an abusive – verbally and physically abusive home – I don’t think you’re missed,” she said. “Life was a huge party.”
In her early 20s, Jessica became addicted to crack for a time after learning to freebase cocaine out of a broken lightbulb from her second husband.
She lived all around the country but eventually settled back in Maine after her injury. While large amounts of alcohol and painkillers made her able to work, she reached a point where she simply wanted to stop.
She now lives in Rockland, attends group counseling sessions and receives a Suboxone prescription through Groups: Recover Together, a treatment provider with a chain of offices, including one on Camden Street. Jessica said Suboxone – a brand name for a combination of the opioid buprenorphine and the anti-overdose drug naloxone – helps somewhat with her pain and allows her to get going early in the morning, but doesn’t give her a high.
Her story is similar in many ways to that of Alyssa, another recovering addict who had a history of substance abuse before becoming addicted to opioids later in life.
“My mom died and my sisters raised me, so, trauma and alcoholism, it’s been right from ... since I was 9 years old, so you got all those things piling up,” she explained.
She said kicking alcoholism was nothing compared to the effort it is taking to break her opioid habit. She was first prescribed Vicodin for back pain. A bad break-up with the father of one of her children led to serious addiction.
“Before I knew it, you know, you’re crushin’ ‘em, and snortin’ ‘em, and then, what? Two used to be plenty, now 10,” she said.
She said things can spiral when the threat of brutal withdrawal symptoms makes finding drugs more immediately important than anything else.
“You wake up and the first thing you’re thinking about is, ‘Where am I gonna get it?’” she said. “If you don’t have it, it feels like somebody is literally running you over with a flat roller. It’s just your whole body aches, you get the chills, and you throw up. So you can’t go to work like that!”
She ended up selling drugs to buy them, and has had stints in jail. She said opioids took control of her life in a way nothing else had.
“I look back now and I think all the time, all the time wasted, all the energy, all the money. I don’t know. Life. I wasted life is what I did,” she said.
Alyssa also attends Groups, and said Suboxone brings her a sense of normality. She said it feels nothing like other opioids.
“I don’t have those urges, I don’t have those cravings anymore,” she said. She feels ambitious in the morning, ready to see family, and ready to work.
Previously, she had tried methadone, quitting cold turkey, and other treatment programs, none of which worked for her. “I swear it’s because of my mental state. I really do. I truly believe that. Because if somebody doesn’t want to be sober they’re not going to be. So it all goes in a big package, I think,” she said.
She is well aware of the criticisms of medication-assisted treatment – that as long as one drug is used to replace another, recovery and sobriety are never possible.
“Yes, I see your point, but,” she said, “would you rather have them out here nodding out, or sitting here having a conversation with you?”
“Yes, of course Suboxone can be abused,” she said later. “Any drug can be abused. But the people who are using it to make their lives better, let ‘em be. Let ‘em get it, let ‘em grab onto life again and be themselves, ‘cause that’s all they want, is to be normal. Or feel normal. Not necessarily be normal,” she laughed.
Groups: Recover Together opened its Rockland office in May of last year. It also has locations in Auburn, Biddeford, Ellsworth and Portland, with potential offices coming to Augusta and Calais soon, and more in Indiana, New Hampshire and Ohio.
The program enables more doctors to prescribe Suboxone by taking care of many of the most difficult and time-consuming aspects for them. While Suboxone is not dispensed on the premises, doctor check-ins, urine screens, pill counts and group counseling sessions take place there. Doctors oversee dosage, while a counselor and clinic coordinator check for safe medication use and compliance with the program by testing urine for the presence of prohibited substances and counting pills to check for missing medication. Clients pick up Suboxone at a pharmacy with the prescription they receive through Groups.
According to Maine Clinical Director Donald Kent, the Auburn office is the company’s largest in Maine, with about 250 clients. The Rockland location treats around 150.
He said when the Rockland office first opened, addicts seeking recovery were lined up down the hallway.
“We started at 8 or 9 o’clock in the morning and we worked until 7 o’clock at night and I think we admitted probably 26 people in the first day for treatment here,” he said. “It’s unheard of. We’ve never encountered anything like that at any of the offices we’ve opened.”
Counseling takes place weekly, with consistent groups, and clients must attend the sessions to receive a Suboxone prescription. The company does not take insurance, and clients pay $65 a week for counseling. Kent said avoiding insurance claims allows the company not to hire staff to fight with insurance providers over payments, which helps keep costs low for clients. Suboxone is a separate expense paid for by clients' insurance, if they have it, or out of pocket.
The goal is to begin tapering clients off Suboxone after around 18 months, though the amount of time can vary depending on a client’s specific situation and needs, and according to the prescribing doctor’s judgment. While none of the clients in Maine have yet successfully tapered off their medication, Kent said some in New Hampshire had done so and continued to attend their group counseling sessions. The Rockland office could try beginning its first taper soon.
While the model used by Groups appears to alleviate many of the difficulties inherent in treating addiction, it is by no means simple or easy. In December, the company fired one of the Rockland office's two staff members, the other resigned and replacement staff were hired. Kent said he could not comment on the specifics of either departure, but that the company takes the tasks designed to ensure clients' safety and keep the business open very seriously.
The Groups clients this paper spoke with were not happy with the changes. Still, they said the program continues to work for them right now, and that while getting the money together for treatment can be a challenge, it seems to be the most affordable option.
Reporter Dan Otis Smith can be reached at 594-4401 x123 or by email at firstname.lastname@example.org.