While more attention is being brought to solve the state’s drug problems, proper services have always been hard to get in more remote areas. Detox facilities are not available in many communities like Sitka. And with the use of harder drugs such as heroin and meth on the rise, the absence of those services is making it harder for those who need help to get it.
Jeff Arndt runs a private practice in Sitka and specializes in substance abuse counseling. The treatment system in Alaska is a quagmire. Arndt said addicts have to get assessments from the state before they can be placed in treatment, which is necessary, but can take several months. And after the assessments, it can still take a while to get into an inpatient or outpatient program.
“There’s just this huge pool of people out there who I don’t want to say they don’t have nowhere to go because there are options but in terms of residential treatment they don’t have much of anywhere to go and they can’t get there quickly even if they decide they want to,” Arndt said.
Misconceptions of addiction also hurt the situation. Arndt said in many cases it’s not a matter of willpower or stopping cold turkey. Some addicts cannot stop doing drugs without a major intervention or disruption.
“I think some people truly do have the disease of drug addiction,” Arndt said. “And to scorn or feel contempt for someone like that it’s like ‘Wow, you have cancer, man, you’re pitiful, you shouldn’t have had that happen to you. Even in the medical and counseling profession there is quite a bit of that.”
Detoxing , or the process of coming off a drug, can be scary and dangerous. People can die from the process if they are not closely monitored, like what happened to 24-year-old Kellsie Green, who died from a heroin withdrawal in an Anchorage jail earlier this year. At 80 lbs., her death certificate cites malnutrition, dehydration, renal failure, and heart dysrhythmia.
Marita Bailey is the clinical director of Sitka Counseling and Prevention Services. There is no formal, medical detox program in Sitka. Sitka Counseling does have a low-intensity residential treatment program. Bailey said clients here are often 20 to 30 days sober already before receiving one of the facility’s 12 beds, which means they had to detox and start treatment somewhere else. Southeast Alaska Regional Health Consortium also offers an intensive outpatient program for substance abuse, but wait times are still several days.
“We know in this field in substance use field someone doesn’t want to wait six months to get an assessment and then get treatment if your motivation is high today you want to serve that person as close to today as possible,” Bailey said.
This gap — the lack of acute care for drug addiction — may have cost at least one Sitkan her life, according to Erika Burkhouse. Her sister, Lael Grant, disappeared in 2012. Grant was addicted and deeply connected to Sitka’s drug culture. Her death was ruled a suspected homicide. Burkhouse convinced Grant to seek treatment during an intervention a year before she disappeared, but the window closed quickly.
“There are so many different things that need to be done in order for a person to be successful. It can’t just be detoxing and then you’re done it doesn’t work that way unfortunately,” she said.
And for those who do manage to dry out on their own, the math problem remains: there are more people in need than the twelve beds in Sitka can serve. Marita Bailey said that the uncertainty of the state’s budget could mean even longer waits.
“It’s a challenge, we’re going to have to make accommodations when the budget cuts finally come down and we know what we’re facing but we’re gonna keep providing services at the highest capacity that we can that’s pretty much what all the other providers across the state are looking at,” she said.
The Alaska Legislature did pass a law this session that makes it easier to access Narcan, a drug that reverses heroin overdoses. And the state has created the Alaska Opioid Policy Task Force to come up with better solutions but budget cuts mean there is less money to pay for them. The state recently applied for a federal grant to pay for opioid-specific and medically assisted treatment in Southeast and Anchorage.
While those are steps in the right direction, Erika Burkhouse believes that it’s still not enough. But perhaps nothing can be when you’ve lost a loved one to addiction.
“We still don’t have closure,” she said. “We still don’t know what happened. The investigation is still ongoing but it’s really at a standstill.”
Burkhouse said nobody should have to go through what her family has experienced. She hopes Alaskans keep talking about the addictions friends and neighbors battle every day.