The number of unintentional drug overdose deaths in Stark County, Ohio in 2009 was 21. In 2016, that number climbed to 97. That data, which can be found in the 2019 Stark County Community Health Assessment Report, demonstrates the increasing problem of substance abuse in the area. To combat this problem, various institutions provide treatment in order to prevent drug and alcohol offenders from re-offending.
The Stark County Jail offers a substance abuse counseling program called the IARP (International Association of Rehabilitation Professionals) Program. This program provides case management services and aftercare and is facilitated by certified chemical dependency counselors. In addition to the IARP Program, Stark County Jail also offers Alcoholics Anonymous and Narcotics Anonymous sessions; however, these are limited to inmates who were either court ordered or were deemed as non-violent.
Kelleen Weber, the director of the Alcohol, Drug, and Wellness Education department at the University of Mount Union, worked for Townhall II from 1997 to 2007. Townhall II is a Portage County-based organization which features various services related to addiction prevention and treatment. During her time there, Weber ran a jail group. Some of the concepts she worked with the inmates on included time management, recovery skills and where to find self-help groups. One of the biggest challenges Weber faced while working with the jail groups was the schedule.
“You’re there, ready to start your group, like at 9:00 A.M., but because something else is going on at the jail, your inmates might not show up until 9:30. And then, they have to stay on schedule, so working in a jail system is not the priority, but it’s offered.”
Weber discusses how many inmates would come to the group sessions as an excuse to get out of their cell and do something. Because of this, she believes many of the people who came to these meetings went back to their prior lifestyle upon being released from jail.
“In there [jail], they’re away from their environment. They’re away from their using-people, their using-places, their using-friends. So, they get to think clear. But then upon release, when they get back out, they go right back into that environment.” Weber continues, “It’s hard, you know? I mean, how do you say no, no, no? It’s like putting me in a chocolate factory. I mean, I’m not going to be able to say no. I’m gonna eat the chocolate.”
Aside from running jail groups, Weber performed numerous tasks during her tenure at Townhall II. Some of these included co-dependency counseling, adolescent treatment, DUI school, individual and group counseling and many other tasks. However, although Townhall II offers a plethora of services to help those with substance abuse disorders, Weber would argue the programs are only as effective as the individual allows them to be.
“We can provide a service. And we can offer all the tools in the world…We can give you our time, our sweat, our blood, our tears, but a person who has a severe substance-use disorder has to want to get better. So, I can say we effectively provide the tools and resources, but the person on the other side has to be in a place where they are ready.”
Weber also talks about how there are many other areas that individuals suffering from substance abuse issues need help with, in addition to getting clean. “Let’s say if you got clean, you’re not selling drugs, and selling drugs is how you made your living. And now, you have no skills and no job to go back to.” She goes on to describe the other services individuals dealing with substance abuse disorders often need. These include career counseling and resumé building, but also involve teaching them social and family skills.
In addition to the challenges involved with helping the individuals dealing with their substance abuse disorders recover, another barrier involved in treatment revolves around the insurance companies.
“The insurance company will come in and say, ‘We’ll authorize payment for five weeks of service,’” Weber states, “Oh, so we have to give you five weeks of service, and we’re supposed to get you sober in five weeks. It’s a lifetime journey. Once you have a substance abuse disorder, you have it for life. Five weeks isn’t gonna cut it.”
Regarding the circumstances that often lead individuals to develop substance abuse disorders, Weber believes that although there are many specific reasons concerning each individual, the primary reasons for people turning to drugs and alcohol is to either create a feeling or get rid of a feeling.
Weber explains, “Nine times out of ten—almost a hundred percent I would say—the person’s broken. I mean something’s wrong. If you had a perfect life, why would you go use drugs?”
In Weber’s opinion, the root of the problem that causes people to turn to drugs and alcohol to cope is society. “Society sucks. I mean, society reinforces our world and our culture. We reinforce those hurts instead of supporting and lifting people up and letting them be who they are and helping them. If I saw my brother in pain, why would I beat him down anymore? I would want to lift him up, but our society is notorious for beating down those who are already at a disadvantage or hurt.”
At the end of the day, Weber believes the most important thing is that these individuals are able to find recovery in whatever way works best for them. “When it comes down to it—how you get to your recovery—if it works, do it,” Weber explains, “If it’s church, praying, AA, celebrate recovery. I mean, you do what you gotta do. Whatever a person believes in is what’s gonna work for them.”
Another local organization that helps individuals suffering from substance abuse disorders is CommQuest. In 2015, CommQuest merged with Quest Recovery & Prevention Services to add many new substance abuse programs ranging from detox to outpatient counseling. Their detox program is designed to begin the recovery process by using a combination of counseling, medication and case management. Kylee Crislip, a site coordinator at CommQuest, explains that many inpatient clients who graduate out of the detox program return for outpatient counseling to receive additional support. She adds that even those who do not relapse often see the benefits of receiving extra counseling.
Crislip agrees with Weber that various traumas often lead individuals to begin their substance abuse problems. In addition, Crislip points out that peer pressure is also a contributing factor that can lead to a substance abuse disorder. However, she primarily emphasizes the importance of mental health as it relates to substance abuse. For this reason, CommQuest integrates their mental health and substance abuse services to ensure the best treatment for their clients.
According to Crislip, providing the best accommodations for the client is the priority at CommQuest. For example, Crislip states that if their residential bedding is full at their facility, CommQuest would accommodate by partnering with another local institution to provide housing.
Weber pointed out that those who benefit the most from treatment are the individuals who seek it; however, Crislip doesn’t entirely agree. There are numerous cases at CommQuest where individuals battling with substance abuse are mandated by the courts to seek treatment. During these instances, Crislip notes that some of these individuals have still seen success with CommQuest’s treatment methods. Regardless, Crislip echoes Weber’s sentiment that repeated treatment and therapy are key to resolving substance abuse disorders. Some of the treatment methods Crislip describes that CommQuest uses include the Matrix Model, Cognitive-Behavioral Therapy and Motivational Enhancement Therapy.
The Matrix Model
According to the National Institute on Drug Abuse, the Matrix Model is primarily used to treat individuals who abuse stimulants. Examples of stimulants include methamphetamine and cocaine. In the Matrix Model, the therapist plays the roles of both teacher and coach. Their goal is to foster a positive relationship with the patient in a way that’s authentic and direct without being too confrontational. The therapist teaches the patient about issues related to addiction and relapse, as well as providing the patient with guidance and support along the way. Using the Matrix Model, patients are monitored throughout the treatment through urine testing.
The Matrix Model also incorporates elements of other treatment methods. Some of these include relapse prevention, group therapy, family therapy, drug education and self-help group participation. In addition, the Matrix Model uses worksheets for individual sessions, combined group sessions, 12-step programs, relapse analysis and social support groups. Therapists using the Matrix Model conduct sessions in a way that promotes the patient’s self-esteem, dignity and self-worth.
The National Institute on Drug Abuse explains that Cognitive-Behavioral Therapy relies on the theory that when a person develops self-destructive behaviors including substance abuse, learning processes play a major role. Because of this, Cognitive-Behavioral Therapy involves learning to identify and correct problematic behaviors by implementing various skills to stop substance abuse, as well as addressing the other problems that often occur alongside it. Cognitive-Behavioral Therapy, according to the National Institute on Drug Abuse, is used for various substances ranging from alcohol to methamphetamine.
Because a central element of Cognitive-Behavioral Therapy revolves around learning problematic behaviors, one goal of the therapy is to teach patients how to anticipate likely problems. Another goal of Cognitive-Behavioral Therapy is to develop the patients’ self-control and teach them new and healthier coping mechanisms. One technique therapists use is exploring with the patient both the positive and negative impacts of continued substance use. Therapists also teach patients self-monitoring skills to recognize cravings and identify situations that could put them at risk of using. The therapist also helps the patient to develop individual strategies to avoid high-risk situations and cope with cravings.
Motivational Enhancement Therapy
According to the National Institute on Drug Abuse, Motivational Enhancement Therapy is a counseling approach to help individuals who suffer from substance abuse disorders develop intrinsic motivations to stop their usage. The goal of this method is to evoke rapid change in an individual, as opposed from guiding them through a step-by-step process. This technique is most often used for individuals dealing with abuse issues involving alcohol, marijuana and nicotine.
Motivational Enhancement Therapy consists of an initial assessment on the patient, followed by two to four individual treatment sessions. The first session involves the therapist providing feedback to the patient regarding the initial assessment. This leads to discussion about personal substance use. The therapist also attempts to elicit self-motivational statements from the patient. The therapist uses motivational interviewing techniques to help build a plan for change that’s centered around the patient’s intrinsic motivations.
In addition to these techniques, the therapist discusses healthy coping mechanisms for instances in which the patient would be at high risk for a relapse. In the sessions that follow, the therapist monitors change and reviews the strategies used by the patient to cease their substance use. The therapist also provides continued encouragement for the patient to commit to these changes. Depending on the circumstance, patients may be encouraged to bring a significant other with them to counseling sessions.
Stark County Law Enforcement
Law enforcement plays a critical role as well in preventing drug and alcohol offenders from re-offending. Sergeant Donald Burns III works in the Patrol Operations Division for the Stark County Sheriff’s Department. During his tenure on the force he has witnessed numerous people get arrested for drug and alcohol offenses. Burns states that often, it’s the same people who are arrested for these crimes. He also reiterates Weber’s point that treatment only works for those who want it.
“The programs only go so far. They’re to help you get clean, but there’s a part of that that you’re personally responsible for,” Burns states, “I mean, it’s just like anything else. For personal health, you go to a doctor. They can’t make you be healthy, but they can get you on the right track and give you advice. But it’s still up to you to actually be healthy.”
Although Burns believes that those who voluntarily seek treatment often get more out of it, he also thinks that law enforcement can heavily factor into a person’s decision to end substance abuse.
“A lot of people get so deep into the rabbit hole that by the time they get arrested or get criminal charges, sometimes coming to jail or getting those charges is a good way to open their eyes,” Burns continues, “But yeah, for the most part, if they are voluntarily seeking the treatment, they probably would get a little more out of it. But hopefully enforcing the laws will open some of their eyes as well.”
Burns also states that law enforcement is working with the courts to create systems that send substance abuse offenders into programs such as CommQuest and Townhall II instead of giving them prison sentences. He believes these programs tend to be more effective in preventing individuals from re-offending than jail or prison.
“Obviously, if you do the crime, you have a debt to society to pay off. But I believe they have more to offer—CommQuest and those other programs—than just institutionalization itself, unless the institution can offer those programs while they are incarcerated,” Burns states.
Burns believes one change that would be effective in helping individuals with substance abuse disorders recover is to provide more financial resources for treatment programs.
“There’s never enough resources. As many grants—federal, state, local—that we can get to offer these programs, it just never seems to be enough,” Burns continues, “Not everyone gets the opportunity to go to these programs just because the resources aren’t there. If they could make more resources available, I think that would assist law enforcement in helping these people get straightened out.”
Burns believes there are multiple reasons why people develop substance abuse disorders. He discusses one reason is that some individuals who experiment with various drugs, eventually try something harder that they become addicted to. He also talks about how individuals who have been on a prescription drug may sometimes turn to the street to find inexpensive substitutes.
“A lot of people in the past decade have sought treatment for pain management, which resulted in Percocet or other opiate pills. At some point, it may have become unavailable to them due to financial issues, and they can find heroin for essentially cheaper on the street and self-medicate,” Burns explains.
Burns and the Stark County Sheriff’s Department recognize the importance of preventing substance abuse issues before people even begin down the path. Because of this, Burns explains how the police reach out to people during their youth in the form of school resource officers who run various drug prevention programs.
“We try to get to them early and explain what can happen if they do get into these drugs. But essentially, educating younger generations would be the best bet,” states Burns.
Burns also stresses the importance of community involvement in preventing individuals with substance abuse issues from re-offending, as well as preventing individuals from offending to begin with.
“It doesn’t just fall on law enforcement. The community helps out. There’s a lot of other programs, and I think we can all just try to do our part and do what we can to get everybody straightened out,” Burns states.