Pubdate: Tue, 22 Nov 2005 Source: Sudbury Star (CN ON) Copyright: 2005 The Sudbury Star Contact: http://www.thesudburystar.com Details: http://www.mapinc.org/media/608 Author: Laura Stradiotto, The Sudbury Star HELPING ADDICTS HELP THEMSELVES This is the final part of a three-part series to coincide with Drug Awareness Week Nov. 20-26 in Greater Sudbury. Today, The Star examines the work of the Salvation Army Centre's addictions and rehabilitation program. The euphoric pleasure of a crack cocaine or OxyContin high is tough to kick, but easy to replace. Addicts crave some sort of rush long after the drugs have left their system. "They do their drug of choice because they love the intensity," says Perry Kayes, an addictions counsellor. "And if they throw away that crutch, then what's the next best thing? The intensity of a crisis situation. It's like their fix." Clients at the Salvation Army Centre's addictions and rehabilitation program follow a structured day, but at any point that schedule could spin out of order when a "crisis" arises as it did when The Sudbury Star followed Kayes for a day to observe the struggle of both treating and overcoming drug and alcohol addiction. Before his 10 years in addictions, Kayes owned a restaurant in Sudbury and worked in the kitchen. But when the business venture sank, he went back to school to study social work. Kayes has a gentle, been-there-done-that attitude when it comes to his clients. Kicked out of high school for substance abuse, he knows when his clients are trying to con him. But schedule or not, when a crisis arises, dealing with the situation is a priority. The day at the centre begins as any other. One client is assigned to wake the others at 6:30 a.m., make the coffee and select readers for a morning chapel service. At 8:30 a.m., 10 men of all ages -- half of whom have abused the painkiller OxyContin, the program manager tells The Star -- make their way down to the chapel, sing Morning Has Broken and listen to the intention of the day. Today's a new day filled with opportunity and hope. Most clients come from out of town, 70 per cent of whom have a mental health illness as well as an addiction problem, says program manager Kim Bouillon. To be eligible for the program, clients must go through detox for at least 72 hours before admission, and with a mental health illness, they must be "stabilized" three months before admission. "These are chronic addicts," says Bouillon. "These people have lost their jobs, children, wife and respect. Their addiction became their best friend, their lover and confidant." Eleven beds are available at the centre: 10 for addicts in the program, with one bed reserved for clients of Corrections Canada. The intense, three-month program not only helps clients overcome addiction, but a significant focus is to change their behaviour. An alcoholic for 32 years, Les Gyenge says he tried two other treatment programs before coming to Sudbury. Gyenge is the "man on the wall," the subject of an assignment given to him by Kayes. Over a three-week period, clients wrote both Gyenge's positive and negative characteristics on a life-sized figure of him drawn on paper and taped to the wall. The positive comments are used to evoke change, says Kayes. Gyenge marks a black 'X' across words like "stubborn" and "door mat" and uses a green marker to circle words like "intelligent" and "open minded." "You know all these words," Kayes says referring to the words circled in green, "but it's only a two-dimensional piece of paper. The vessel that carries that message has to change." When he first stepped foot in the centre, Gyenge had convinced himself he was "a piece of crap," says Kayes "I came in here with a closed mind," Gyenge admits to his peers."I fought tooth and nail to keep it that way. It took a while to admit I was powerless and my life was unmanageable." The clients become involved in Gyenge's rehabilitation process. "How about the word 'undecided'," says one client. "You're more confident now. When you came in here you didn't want to be here." Gyenge started drinking when he was 18. First it was hard liquor; he would drink until he passed out. He said he turned to beer because he could "control" the effects better. When his fiancee died in 1996, his drinking intensified. "I was spiralling down and slowly killing myself," says Gyenge, an articulate man who also writes for online science and astrology journals on the side. A security guard at General Motors, on his days off Gyenge would lock himself in the house, watch TV and drink. "I'd get roaring drunk every day," he says. But when his boss one day smelled booze on him, he demanded Gyenge seek treatment. Fortunately, Gyenge will have a job to go back to once he completes the program at the end of the month, but many do not, staff said. At the end of the session, the men go for a smoke break or walk, then head downstairs for lunch. Whenever they leave the building, if they have permission, they must use the "buddy system" and never leave their partner's side. During lunch Kayes says he suspects one of the clients, Jake (not his real name), is "using" again. There is zero tolerance for substance use and threats of physical violence during rehabilitation. There is no three-strikes-you're-out policy. If you're caught with drugs, you're out of the program. But counsellors really have no way to test their clients. With no funding to purchase a drug-testing kit, counsellors have to rely on the honesty of the clients and their own observation. That morning, counsellors receive a call informing them that Jake's wife went to pay her bills and discovered there was no money left in the bank account. About $600 was withdrawn in the last few days and one counsellor has noticed Jake's complexion seems pasty and his pupils are pinholes. Another client observed him nodding off during the chapel service. A crack cocaine addict, it's Jake's first week in the program. The middle-aged man makes a better-than-average wage -- about $90,000 a year working for a car manufacturer -- but came into the program $40,000 in debt, half of which is owed to drug dealers. Jake is also on three 80-mg tablets of OxyContin a day, for a painful knee injury. After lunch, a client is scheduled to give his life story. As part of their rehabilitation, clients are required to write their "stories" about how they came to be in the treatment program. But there's the urgency to look into Kayes' and Bouillon's suspicions about Jake. In certain situations, counsellors will speak to clients one-on-one, but depending on what kind of proof they need to answer their suspicions, the whole group could become involved. This day, they decide to approach the group. Three counsellors enter the classroom; they've been briefed on what to do if a fight breaks out. Counsellors sometimes have to act as security officers -- there's no funding to hire qualified ones. Kayes writes the word "honesty" on the blackboard and leaves the classroom for five minutes. He returns and asks the men whether in the last couple of days "is there anywhere you've been dishonest with yourself." One by one the hands go up; one client admits he watched television after 11 p.m., the mandatory time clients are required to be in their bedrooms, others admit to gossiping. Kayes goes around the table asking everyone the question and finally comes upon Jake. Acting defensive, Jake says people should "try and fix their own problems" before turning on others. "If I look around, everyone's pupils are all nicely fixed," Kayes tells Jake, "and yours are pinholes. We've seen some things and we're worried." When confronted -- or "care-fronted" as the counsellors say -- with leaving his buddy's side and disappearing for hours after a trip to the mall, nodding off during class and the hundreds of dollars in missing money, Jake denies turning back to drugs and retorts that he has about $500 in cash stashed in his pockets. One client has spoken to Bouillon in private about his suspicion that Jake was using again and voices his concern in front of his peers. Others hold the same suspicion but they remain silent that afternoon - -- Jake holds a certain power over them because he can be a bully, the counsellors say. Hoarding money is another addictive behaviour, Kayes tells The Star. Addicts usually keep cash with them in case they need a quick fix. Although they may be off the drugs, the behaviour remains. Kayes leaves the classroom with a warning. "I caution you to be careful," he says to Jake. "I'm not comfortable with your behaviour. You have some things to think about while you're here." The counsellors leave the room and Kayes says he'll leave the issue with the clients to "mull over for a couple of days" to "empower" them to take control of their own behaviour and environment. A sort of "power struggle" is occurring between Jake and his peers, especially the one who confronted him about his suspicions that afternoon. "There's going to be a blow-out," Kayes predicts. "They're like two kids playing in a sand box and they want the same shovel." Moments after Kayes makes the remark, Jake storms into his office saying he wants to show him the money in his pocket. Jake says he's offended by the allegations while Kayes, never raising his voice, tells him he's showing little responsibility and respect towards his partner, leaving her with no money to pay bills. Jake leaves but returns with another client about five minutes later. The tension in the small office escalates as both clients talk over each other. Both are fuming and one, visibly enraged, shakes. No request is made to ask The Star reporter to leave the room. It turns out to be a simple misunderstanding between the two men, but the intensity of the situation evokes a sort of high for them. Gossip runs rampant and culminates with someone blowing up. Conquering drug and alcohol addiction is only the first step. Overcoming negative behaviour accounts for 90 per cent of the treatment process, say Kayes and Bouillon. The staff takes pride in their rehabilitation program. Most programs in the province available to addicts run 28 days; clients at the Salvation Army Centre can stay for up to 17 weeks, or 119 days. Clients who have gone through such a program unsuccessfully tell staff that it's around the 28-day period they begin to feel sober and clean. But behaviour is unchanged, and clients easily fall back into substance abuse once they leave the program. Kayes says funding from the Ontario Ministry of Health has decreased over the years, but the roles staff are required to take on have increased. He says the province is "aiming for out-patient care," rather than residential treatment programs. Drug treatment facilities with long-term care programs, Kayes fears, will become privatized and only those who can afford it will seek help for addiction. With 38 men waiting to enter the Salvation Army Centre's program, there clearly is a lack of beds, he says. Salvation Army executive director Major David Carey is ready to launch a capital campaign in early 2006 to build a new centre. The current one needs a good upgrade -- the sterile building is not wheelchair accessible and quite overcrowded. Clients of the addiction program, shelter and residence are practically living on top of each other. The centre's location in downtown Sudbury, however, is ideal, so plans are to demolish the 50-year-old facility and rebuild. While a new facility is desperately needed, the fear is there won't be enough funding to maintain the building and services. "We have to look to new sustainable funding models," says Carey. And with limited government resources, Carey wishes industry would play a bigger role since the clients who have succeeded in the program return to work more productive. - --- MAP posted-by: Beth Wehrman