Heroin addicts find help at their lowest in unique treatment program
Heroin addicts find help at their lowest in unique treatment program

Heroin addicts find help at their lowest in unique treatment program

Toledo paramedics quickly revived Hill, a construction worker and heroin addict, with two injections of naloxone, a drug that abruptly and effectively counteracts deadly overdoses.

September 29, 2016

 

By the time Navarre, a Lucas County deputy assigned to the Drug Abuse Response Team, got to Mercy St. Vincent Medical Center on June 4, 2015, Hill was awake and recovering in the emergency department.

"Are you here to arrest me?" Hill asked.

Navarre assured him he wasn't. He just wanted Hill to get help for his addiction.

"I have nothing more to say to you," Hill told Navarre.

But Hill kept Navarre's business card for reasons he still doesn't fully understand. About five months later, Hill finally hit bottom, with no drugs, money, job, girlfriend or place to live. He pulled Navarre's dog-eared card out of his wallet, grateful that the smeared name and numbers were still readable, and called. An hour later, Navarre pulled up at the hotel where Hill had used his last few dollars to get a room.

Navarre got Hill into a detoxification unit and later into recovery housing at the Zepf Center, a Toledo mental-health and drug-treatment agency, where Hill remains as both a resident and employee today.

Jett Hill received help at the Zepf Center in Toledo and now lives there while trying to help other addicts. This sign, marked with the names of those affected by heroin, is in the Zepf Center lobby. | Doral Chenoweth III/Dispatch

"The window for us to reach out for help is very small," Hill said. "That was my only option. I knew I wouldn't live more than another week or two."

Hill is one of nearly 1,800 contacts that Lucas County Sheriff John Tharp's Drug Abuse Response Team has made in the past 18 months with drug addicts — the majority of them in hospitals after they've suffered potentially fatal overdoses. In two-thirds of the cases, the addict subsequently got into a detox or long-term treatment program, or recovery housing.

Lives were saved. No one knows exactly how many. Likewise, it's not clear how many of the 1,800 got clean and stayed that way.

Tharp's DART is an outside-the-box effort to break the cycle of heroin addiction by throwing a lifeline to addicts when they are most vulnerable, typically in the hospital. If they don't want help then, it's likely they never will.

Tharp, a 44-year law-enforcement veteran who served as a combat medic in Vietnam, shrugs off criticism that DART is "soft on crime" by not putting more drug users behind bars.

"I have personal friends whose children have died," he said. "You belly up and do the right thing, and if people don't like it, they can get rid of me."

Birth of DART

Tharp, 68, started DART in 2014 with two officers. Starting with two deputy sheriffs and begging and borrowing from other Lucas County agencies — the Oregon Police Department, University of Toledo police, Mercy Hospital Police, Toledo Police, Waterville Township Police and Springfield Township fire administrators — Tharp has his team up to 20. Even at that strength, "We're running them ragged," he said.

There's a single job qualification to join DART, the sheriff said. "I want them to have the passion to do the job."

Tharp's team visits addicts at their lowest, in hospitals, homes, homeless shelters, wherever they are needed, offering help to get them through the difficult and painful detoxification process and into long-term treatment. Lt. Robert J. Chromik Jr. supervises DART under Tharp's guidance.

Lt. Robert J. Chromik Jr., left, and Sheriff John Tharp of the Lucas County sheriff's office operate the Drug Abuse Response Team, which tries to rehabilitate drug users instead of incarcerating them. | Doral Chenoweth III/Dispatch

Members of the team wear suits and ties to make them less threatening to police-wary drug users such as Hill.

Hill, 37, was born in Michigan but spent most of his life growing up in Toledo. He said he began partying, drinking and smoking pot at age 13. By 18, he had become a union carpenter, often making good money. But more money afforded Hill access to more and stronger drugs, beginning with cocaine.

When he suffered a work-related injury, Hill was prescribed narcotic pain pills and got hooked. Soon, Hill needed a bigger, less-expensive high. Pain pills cost him up to $160 a day; heroin was $40.

He stayed clean for a few years, but the old habit came back with a vengeance and soon Hill was shooting heroin again.

"Really, on the inside I was dying, but on the outside I looked good. That's all that mattered to me."

Hill has been at the Zepf Center since December 2015 but now helps addicts arriving for treatment.

Joe Navarre, left, a Lucas County deputy sheriff, and drug addict Jett Hill share a lighter moment at the Zepf Center in Toledo. | Doral Chenoweth III/Dispatch

DART operates with an unusual but effective hodgepodge of funding: money from Lucas County commissioners; grants from the attorney general; fundraisers that collect money for radios and other equipment; and contributions from labor unions, community organizations and Whitehouse, a village of just 4,000 people that pitched in $10,000. Cars were donated by auto dealers. Salaries and other expenses total about $650,000 annually.

Tharp said his eyes were opened to the horrors of drug addiction as a Lucas County deputy, when he watched a young man going through painful withdrawal in a jail holding cell. He remembers it vividly, taking a reporter to the cell where it happened.

"Truly, it was one of the ugliest things I had ever seen," Tharp said. "He was swearing and crying and his arms were flailing and legs were flailing. He was vomiting."

On the spur of the moment, Tharp, a Democrat, called Attorney General Mike DeWine, a Republican, to see whether he would help fund his idea for DART. On the road at the time, DeWine fielded the call and listened to Tharp's request. An hour later, he called Tharp back.

"Send me a proposal," DeWine said.

Eventually, DeWine's office channeled $800,000 to Lucas County for DART and treatment programs.

"It was not what you would normally expect from a sheriff," said DeWine, a former prosecutor. "I thought it made some good sense.

"Things are not perfect in Lucas County," DeWine added, "but that's a model that can be replicated."

Ohio and the nation

Despite the success of the DART program, there is still one serious flaw: a severe shortage of treatment options. In that area, Lucas County, like Ohio and all of the United States, falls woefully short. Resources are simply insufficient to keep up with the burgeoning need for inpatient and outpatient treatment amid a ferocious drug epidemic.

"When an addict comes in and says, 'I'm ready,' you don't want to lose that opportunity. They're more than likely to go right back out and use." — Jennifer Moses, CEO at the Zepf Center, on the need for more treatment centers

In the DART offices, a big whiteboard is updated daily with all Lucas County drug-treatment facilities and how many patients they are able to take. At any given time, the number of available treatment slots ranges from none to a handful.

"We turn people away every day. Our beds are filled by 9 a.m.," said Jennifer Moses, chief executive officer at the Zepf Center, a Lucas County agency that offers adult detoxification and addiction-treatment services and has a large residential facility. The center is in the process of adding four residential beds for women, bringing its total to 120.

"Somebody goes out, someone comes in," Moses said. "There's just not enough resources in the state of Ohio. Period.

"It's very defeating," she said. "When an addict comes in and says, 'I'm ready,' you don't want to lose that opportunity. They're more than likely to go right back out and use. We need to address state policy and federal regulations that would allow us to increase capacity."

Ohio has made progress in providing treatment, both inpatient and outpatient, especially by expanding Medicaid, the federal program for the poor and disabled, pushed by Gov. John Kasich. Nearly 500,000 Ohioans, most previously uninsured, received mental-health and/or addiction treatment because of the expansion.

A huge gap remains for people who want to get treatment but can't because of lack of services, insurance coverage or other reasons. The federal Substance Abuse and Mental Health Services Administration said that in 2014, just 13.9 percent of Ohioans who needed drug treatment received it.

"We are making progress, but we as a state and country are not where we need to be yet," said Tracy Plouck, director of the Ohio Department of Mental Health and Addiction Services. "It's a multifaceted effort, and treatment is a huge part of this. But there also needs to be a focus on prevention."

Even for those who successfully complete treatment, relapse is a real possibility.

"Not until you reach a year of sobriety do you have a 50-50 chance of long-term recovery," said Dr. Mark Hurst, medical director at the Ohio Department of Mental Health and Addiction Services. "Treatment is not one-size-fits-all. Relapse doesn't mean you've lost everything and you need to start all over again."

Steve-O Phillips keeps a journal in his room at the Zepf Center in Toledo. | Doral Chenoweth III/Dispatch

Steve-O Phillips, 30, a Columbus native, has been in and out of drug treatment since he was 18, including stays at Maryhaven. His hangout in Columbus was Parsons Avenue, a hot spot for drug trafficking, where "you don't have to look for it, they will find you," he said of dealers.

Health problems began to develop related to his intravenous drug use. Phillips suffered heart infections and had to undergo open-heart surgery twice. There's a long, vertical scar on Phillips' chest just below a tattoo that says "South Side."

His life on the line, Phillips desperately tried to get into treatment facilities in Dayton and Columbus, but the waiting lists were too long. He eventually turned to the Zepf Center, which made room for him.

Phillips credits a higher power with helping him get through. "I believe alone, by myself, I don't have the power to do it."

Steve-O Phillips shows the tattoo that signifies his Parsons Avenue roots, as well as the scar from a heroin-related heart surgery. | Doral Chenoweth III/Dispatch

A lack of treatment resources is not just an Ohio problem. According to the Substance Abuse and Mental Health Services Administration, less than 12 percent of men, women and children who needed drug or alcohol treatment nationally were able to get it in 2014. Men were slightly more likely than women to get treatment.

It's worth keeping in mind that needing treatment and seeking it often are very different, officials say. Many people think they don't need treatment at all, while others know they need help but resist getting it. Some don't get treatment because it isn't available, they can't afford it or they don't have insurance. Sometimes transportation or family conflicts make it hard to get help.

President Barack Obama has proposed a $1.1 billion drug program, the majority of it earmarked for treatment; Congress has yet to approve funding. Ohio would be eligible for about $45 million over two years under the plan.

Obama also changed the rule that limited physicians who provide Suboxone, a medication used to wean people off opiates, to treating 100 patients, boosting the limit to 275.

Tharp was among a group of law-enforcement officials, representing the 140-member Police Assisted Addiction and Recovery Initiative, who visited the White House in July to "promote treatment, reduce stigma and aid in (fighting the) opioid epidemic rather than to simply arrest and incarcerate."

"Over the last year we have successfully placed thousands of individuals into treatment through our partner police departments. One of the biggest barriers we face in helping people in their battle with addiction is access to treatment," law officers said in a letter to Congress. "We must have more resources if we are going to overcome this epidemic that takes 30,000 lives each year."

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