Getting clean: Addiction medicine program sees success in Sheridan County
SHERIDAN — He tried everything to get clean. Chris Evans attended in-patient substance abuse treatment 11 times. He leaned on friends and family for support during bouts of sobriety. He spent time in prison. He underwent multiple surgeries to stay alive.
During one of his stints in the hospital, this time in Seattle, after undergoing another heart surgery and wishing he would die, something clicked. Then, he started setting goals for himself.
Initially the goals were basic but critical. Squeeze the doctor’s fingers three times. Get off the ventilator helping him breathe. Push the button to call the nurse. Say a word. Say a sentence. Raise his head. Sit up in bed.
“I have not stopped making goals since then,” Evans said in April.
After his hospital stay in Seattle, he returned to Sheridan and again asked his family for help staying sober.
“They had heard it all before,” Evans said. “Many times. But, they were willing to give me another chance.”
So Evans returned to things that had helped him in the past. He prayed. He attended Celebrate Recovery meetings. He enrolled with Northern Wyoming Mental Health Center and that’s where he became involved with a program focused on medicinal treatment of addiction.
Now, he not only participates in the program as a patient, but works with NWMHC providing peer support for others.
Sheridan Memorial Hospital’s Dr. Jason Ackerman and NWMHC established the addiction medicine program in August 2017 with $179,284 in funding from the Opioid State Targeted Response Grant.
Since then, the program has received a second round of funding through the grant and program leaders are now considering options for continuing the program that has served several hundred people since its inception.
Jennifer White, clinical director of NWMHC, said it’s unclear how the program will be supported moving forward, as a bulk of the funding has come from the federal government passed through the state.
“If they come out with more opportunities for funding, we’ll certainly apply for it,” White said, adding that funding from other sources, including the state, could be difficult to come by given the budget issues Wyoming currently faces.
The program has proven its worth in the minds of White, Ackerman and, in particular, Evans. White said individuals involved in the addiction medicine program locally have experienced high sobriety success rates. Across the board, addiction recovery patients experience a success rate of 55-60 percent, but with the program, success rates have reached closer to 80 percent.
“Part of what makes it successful is the whole team recovery approach and the collaboration we have,” White said. “The folks coming in know they have the support needed even when they relapse. We don’t give up.
“There is accountability on their end as well, absolutely, but there is a level of support in helping the person get their life — whatever they are looking for — going,” she added. “It’s beyond just being sober.”
Whether an individual calls or walks into NWMHC or the hospital, White said staff will gather a description of the person’s situation and evaluate risk level. If the individual is high risk, staff will work to see the individual immediately.
“There is such a small window of opportunity when somebody is at the point of calling for or seeking help,” White said. “We know we need to jump on that; we can’t wait a month. So we make sure there is a warm handoff between our two clinics and ensure the person knows they have a whole treatment team available.”
Once the person has entered the program, the treatment team delivers a mix of medicinal and therapy treatments.
The medication side of treatment can help reduce cravings and reduce the risk of relapse. The type of medication used depends on the type of addiction, but for those struggling with opiates, Ackerman said, the team will prescribe Suboxone and check in with patients once per week to start, then less frequently as the treatment progresses.
Witnessing the tangible impact of addiction medicine programs while in residency at Yale University prompted Ackerman to start the program here.
“A lot of what we do, especially in internal medicine in terms of reducing risks and improving quality of life — it’s hard to see the impact,” Ackerman said. “I know we may have reduced the risk for stroke, but I don’t necessarily see the direct benefit. For this, getting patients on medications right away and in to see therapists right away, we’ve had people go from being homeless to graduating and getting college degrees. They’ve gotten their families and kids back. We’ve helped them get their lives back.”
Ackerman recalled one patient who, in his mid-20s struggled with heroin and methamphetamine addiction. After getting sober, he earned a job in construction.
“He came in one day super excited because he had paid income tax,” Ackerman laughed. “It’s the funniest success I’ve seen. He was pretty stoked about it. It was amazing to realize how rewarding this is and how much you can help people who feel like they are at the bottom.”
According to White and Ackerman, the addiction medicine clinic went from operating one day a week to two as the demand for treatment grew. The clinic includes Ackerman, a therapist, a case manager and peer support. The “gold standard” of treatment creates simplified access to services, they said.
While insurance often covers addiction treatment, Ackerman said those without insurance shouldn’t shy away from seeking help.
Ackerman said Sheridan Memorial Hospital has worked with individuals to figure out the finances of treatment and has embraced the program as a way to address a community problem.
“I think with this program, it has been an ‘if you build it they will come’ type of thing,” White said. “You don’t really know the full scale of the opioid crisis in the northeast Wyoming region, but as more information comes out and treatment is available, people start coming in and it becomes evident there are a lot of people struggling with all sorts of opioid or poly-substance addiction.”
Those seeking treatment represent a broad swath of Sheridan County’s population, too. Both White and Ackerman said they’ve seen patients from all socioeconomic backgrounds. Currently, White said, about 50 people are active in the program.
“There is this stereotype of people who cannot function or who are homeless and in the gutter,” Ackerman said of people struggling with addiction. “Surely some are approaching that, but there are also people who are employed and drinking or using at work every day. They know that can’t continue. Honestly, you can probably name and profession and I’ve probably had a patient in that profession.”
While some question the use of medicine in addiction treatment — arguing the medication just replaces an existing addiction — both White and Ackerman emphasized success seen in their work and the need to treat addiction for what it is — a medical condition.
While society treats other medical diagnoses with medication and therapy, addiction still carries a stigma.
“The therapy and other things are crucial,” Ackerman said. “But until you can get somebody to a point where they can process and use those, it’s not adequate all by itself.”
Evans had lost everything, more than once, by the time he enrolled in the addiction medicine program with NWMHC and Sheridan Memorial Hospital.
He started using methamphetamines when he was 12 years old. He used to drink codeine cough syrup. It’s what he called a generational curse, as family members also struggled with addiction.
“It was so ingrained in me that drugs equaled happiness,” Evans said. “Even to this day, it’s hard for me to get close to someone if I haven’t used with them.”
Since entering the program, though, he earned an associate degree, became an ordained minister and now serves as peer support for others going through addiction treatment. He worked full time at Volunteers of America Northern Rockies for a few years before landing in his full-time role at NWMHC.
“Getting out of my selfishness and helping others — that is the key to success for me,” Evans said.
His success also serves as inspiration and hope for others going through treatment. When he tells people in the program he understands where they are, the struggles they face as well as the physical and emotional pain, he means it.
He understands the stigmas that accompany addiction, but emphasizes that it’s never too late to seek help.
“I was 42 years old when I got sober,” he said. “It’s never too late to change your life.”
Now he’s 48 years old and will soon complete his bachelor’s degree in addiction counseling, then he intends to pursue a master’s degree with a new goal of living his life in service of others.