Summer House

Close to a million Americans are treated for alcoholism on a daily basis. For the past 3 decades, the majority of treatments have been empirical and the success of the treatments has never been verified by clinical trials. The numerous methods developed in the treatment of alcohol addiction include the use of medications, psychological, social, behavioral methods and self help groups- all designed to help achieve abstinence from alcohol.

The initial approaches to alcohol treatment were all based on self help and over the years the 12-step self help program has become the gold standard. Other treatments include brief interventions by visiting the primary care physician or trained nurses. Behavioral and psychosocial support therapies have evolved over years and generally involve long term therapy. Over the last 2 decades, motivational enhancement therapy and involvement of the non-drinking spouse have evolved and produced good results.
Of course, over the past 4 decades, pharmacological approaches to alcoholism treatment have made some progress, but the ideal drug still remains to be discovered.

Alcoholism Treatment

The majority of individuals with alcohol dependence initially always deny that they have a problem and are reluctant to undergo therapy. Agreeing to undergo alcohol treatment usually occurs after the individual encounters health, family, employment or legal problems. Depending on the situation of the individual, various treatments are available to help with alcohol dependence. The initial part of the treatment involves evaluation, a brief intervention and either an in/outpatient program or counseling.

Principles of Alcohol Dependence Treatment

Before alcohol treatment can begin, one has to determine if the individual is alcohol dependent. For some who drink socially and are in control over their drinking, treatment may simply require reduction of drinking<. For those who have no control over their drinking, the best treatment is abstinence.

To maintain abstinence, the best approach is to be included with alcohol abuse therapists. These specialists can help develop specific-tailor made treatment plans, which may include objectives, behavioral modification skills, use of self-help manuals, counseling and follow-up care at a treatment center.

Non Drug Residential treatment programs

There are numerous non-drug residential alcoholism treatment institutions and include therapy to maintain abstinence, individual and group therapy, participation in alcoholism support groups (such as Alcoholics Anonymous), educational seminars, spousal involvement, work assignments, physical and non physical activity therapy. Most of these residential programs have professional counselors and staff involved in the treatment of alcohol dependence.

All individuals undergo a complete physical and medical assessment prior to therapy. The essence of all residential programs is to commence detoxification and treatment of withdrawal symptoms that may occur. Hard-hitting psychological counseling and psychiatric treatment is offered to individuals, couples and their families. The principal emphasis of all residential programs is on recognition of the problem and motivation for abstinence. Individuals who are unable to fulfill this basic criteria usually do not succeed with therapy.

Psychological, Behavioural and Social therapy

Numerous behavioral approaches to alcohol dependence treatment include psychological therapy. The primary component of these therapies is motivational enhancement therapy. This therapy is designed to help the individual become more responsible and develop a change in his lifestyle.

Various forms of counseling are available and may involve cognitive behavior therapy to help cope with distorted/abnormal thoughts and help develop a sense of control over these thoughts and feelings.

The majority of pychological therapies often involve the non-alcoholic spouse as most studies show that couple participation increases the likelihood of abstinence from alcohol. Behavioral –marital therapy is a combination of an approach to drinking treatment while strengthening the marital relationship through sharing, teaching and communication skills

Self-Help Programs

The most common self help group in the treatment of alcohol dependence is Alcoholics Anonymous (AA). This is one of the most common and easily available group in any community.

Alcoholics usually get involved with AA before seeking professional help, as a part of it, or as aftercare following professional treatment. Although anecdotal data on the success of AA are plentiful, results indicate that inpatient treatment, a combination of professional treatment and AA, will achieve better results for more people than AA alone. The reason why AA has been beneficial as a treatment for alcohol addiction includes isolating the individual from his social network of alcoholic friends, providing psychological/social support, teaching coping skills and structured behavior treatment.

Physician intervention

Some indivuals receive counseling from primary care physicians and trained nursing professionals. This consists of numerous office visits and counseling. The majority of these brief interventions help those with acute alcoholic crises. Following the brief intervention, all individuals are recommended to enter specialized treatment programs if the alcohol consumption continues.

Drug Treatments

Disulfiram (Antabuse) is an alcohol-sensitizing drug which has been around for at least 40 years. It was the first drug used for aversion therapy. It provides a strong deterrent to alcohol. It is not a cure and does not decrease the craving for alcohol. If taken before an alcoholic drink, it causes a severe reaction that includes nausea, vomiting, facial flushing and headaches. The drug is rarely used today as the severe reaction is not tolerated and most alcoholics are reluctant to take it.

Naltrexone (ReVia), is an antagonist of morphine and has been found to decrease the urge to drink. As is the case with all addiction disorders, however, naltrexone is only effective if taken on a regular basis.

Acamprosate (Campral) is a drug that decreases alcohol cravings and helps maintain abstinence from alcohol. Unlike disulfiram, naltrexone and acamprosate have fewer side effects and do not produce serious nausea and vomiting if alcohol is consumed.

Recently, the Food and Drug Administration (FDA) approved the first injectable drug to treat alcohol dependence. Vivitrol, a drug similar to naltrexone is administered by an intramuscular injection in the buttocks monthly. It has been shown to decrease the urge to drink by blocking neuro receptors/transmitters that may be coupled with alcohol dependence. Vivitrol has no effect on the withdrawal symptoms due to alcohol. The drug is recommended for use by alcoholics who are undergoing psychosocial therapy and have not consumed any alcohol in the recent past. The drug is also available as a pill, but it has been found that the injectable formulation is easier for individuals recovering from alcohol dependence and only has to be administered once a month.

Even though some drugs may reduce alcohol drinking, it is highly recommended that individuals enter in aftercare programs and prop up groups to help prevent relapse and encourage motivational behavioral and life style changes.

Conclusion

Research supports the idea of using drugs as an adjunct to the psychosocial/behavioral therapy for alcohol abuse and dependence. However, additional clinical trials are needed to identify those patients who will most likely benefit from such an approach, to determine the most appropriate medications for different individuals, to develop optimal dosing formulas, and to develop strategies for improving patient compliance with medication protocols.

With continued research on the effect of alcohol on the brain and behavior, hopefully this will lead to the magic pill. Drugs to decrease alcohol craving are around but specific medications are still missing. In the meantime, the combination of drug therapy and the use of behavioral therapies are the best hope for recovery of the individual -and the lives of loved ones-who suffer from alcohol abuse and dependence.

Miami Herald — Most everybody in this neighborhood coffee haunt has been hooked on something. The high school dropout with beauty-pageant looks has been fending off a heroin habit for two decades. The former football player says he is clean now after years of popping pain pills. Santa Claus succumbed to alcohol.

Nineteen of the fallen are here tonight for therapy and healing, for a second — or a third or fourth — chance, hoping to reclaim a piece of their lives. They form a circle in the pebble garden behind KoffeeOkee, which is owned by Harold and Dawn Jonas, former users who now help others kick drug and alcohol habits and answer the question: What now?

A resort on the Atlantic in Palm Beach County, Delray Beach has another, less obvious civic profile: Florida’s sobriety capital. Like Hazelden in Minnesota and Utah’s Cirque Lodge and the communities that surround them, it is a place to dry out, clean up. Its recovery community is spirited and multilayered, a dense mesh of dozens of treatment facilities, counseling centers and residential housing that gives addicts a wide-reaching chance for recovery and permanent lifestyle change.

This is where people start over. And sometimes stay.

”You want to be here if you are struggling with an addiction,” says Anna O’Connell, 43, who has been in and out of detox for crack cocaine, heroin and alcohol over the past 20 years and attends therapy sessions at KoffeeOkee. “This is the closest thing to family; this is where you feel safe.”

Treatment for addictions that the medical community now accepts as chronic diseases ranges from private $10,000-a-month treatment centers to free coffee, counseling and karaoke at java houses such as this one, which hosts formal therapy sessions twice a week and informal gatherings even more often.

MANY, FROM ALL OVER

The size of South Florida’s recovery community is difficult to estimate because only one layer — facilities with residential treatment beds — is licensed by the state. Delray Beach alone offers more than 1,200 beds in transitional houses — a second layer — according to the South County Recovery Residence Association in Delray, which monitors halfway residences.

Every week in Delray, about 5,000 addicts attend 12-step meetings that stretch from 7 a.m. to 11 p.m. At Crossroads Club, a squat stucco complex off Lake Ida Road, about 700 people walk through the doors every day to attend 120 meetings aimed at a swath of needs, from treatment for cocaine addiction to obsessive cluttering, says Susan Miller, executive director, a recovering alcoholic.

Addicts arrive from as far away as Oregon and Rhode Island and from as nearby as South Beach. They face daunting odds: Relapse rates range from 40 to 90 percent, depending on the client’s dedication and will power, sustained treatment, and follow-up care, according to the National Institute on Drug Abuse.

”My parents sent me here to try to turn my life around,” Rani Canosa, 21, a pretty, petite college dropout offers one Monday night at KoffeeOkee. “Alcohol made me feel good. I would be really, really happy, then really, really sad, then just miserable.”

Canosa, from a Baltimore suburb, started drinking seriously as an 18-year-old freshman in college. Soon she could consume a 12-pack of beer and a half-bottle of vodka in a two-hour stretch.

She had tried treatment centers in Maryland and Pennsylvania but returned home only to relapse once she was back among friends and familiar haunts.

Canosa has been in Delray Beach since Aug. 29, out of treatment at the Wellness Resource Center in nearby Boca Raton since Feb. 5. She lives in a halfway house and works as a barista at KoffeeOkee.

”The truth is, if I was home, I would be drunk or looking to get drunk,” she says softly, never making eye contact. “I actually want to be here.”

COLLECTIVE STRUGGLE

But what distinguishes this vibrant recovery community from similar places elsewhere, is a growing sober social infrastructure, an informal network of places for people to mingle without the colossal temptations of drugs and alcohol.

”Delray Beach is a microcosm of the various layers of the recovery process,” says Howard Lerner, clinical director of the Addiction Treatment Program at South Miami Hospital. “Those struggling belong to a fraternity.”

Here, even in the midst of fighting for sobriety, addicts can go dancing at popular clubs that hold sober nights, sing karaoke at a sober coffee house, listen to live music at a sober juke joint, call in to recovery radio shows, roar into the sunset with a sober motorcycle club and pray at a Bible study just for them.

”The struggle with an addiction can be forever,” says Harold Jonas, a mental health counselor. “So all we really want is for people to be healthy and to laugh and have hope and be part of the world, not just the recovery community.”

The collective sobriety struggle here is no longer anonymous. Recovering addicts live among ”normies” and often work on Atlantic Avenue, the city’s glittering ribbon of sidewalk cafes and boutiques and galleries.

”When you are on this journey, it’s incredibly important to feel like you are not alone, to see and be around people just like you,” says nattily-dressed Jonah Yolman, now 22 months on the clean side of a wicked crack-cocaine addiction.

Yolman, 29, sitting in a Starbucks on Atlantic Avenue, quietly acknowledges two people ordering coffee who are in one of the dozens of 12-step anonymous programs. He talks casually about the familiar identifying signs of people in recovery: the relentless smoking and coffee drinking, the trails of cigarette butts and empty coffee cups and candy wrappers. And the most obvious sign: people tightly clutching books with dark covers, their 12-step guides.

”We are everywhere, living and working in this city,” says Yolman, a counselor at a local treatment facility who promotes two sober nights at area clubs. He and a partner are also launching a similar sober club night in August at a South Beach club (sobernightlife.com).

“People come here and enjoy the weather, the beaches, low-key atmosphere and try to start over.”

NATIONAL REPUTATION

In some ways, Delray’s recovery community draws its inspiration from a small, rural town in Minnesota that over the years became a magnet for recovering addicts, from marquee rock stars like Eric Clapton to the anonymous souls who came looking for peace and order.

Since 1949, addicts have famously flocked to Hazelden, which started as a farmhouse retreat in Center City for men working their way through programs based on the 12-step principles.

Over the years, teams of doctors, counselors and chaplains developed a holistic approach to rehab now emulated worldwide.

More than three decades ago, Delray’s first sober houses opened for people making the transition from residential care to independent living. The houses — a yellow clapboard with a sweeping porch on one street, a peach bungalow with a white-picket fence on another — are sprinkled within neighborhoods, around public squares, near churches.

Rents range from $125 to $175 weekly for a room and access to kitchens and family areas. Most landlords require random drug tests, and some perform bed checks or monitor whether their clients have reported to work.

Two years ago, Crossroads Centre in Antigua, a drug-treatment program founded by Eric Clapton, opened in the city. And in February, Lecreshia Hall, a Boca Raton psychiatrist, started Hallway of Life Recovery Center, a faith-based, 28-bed transitional facility for women, on a quiet residential street near downtown.

”When I did the research to find the best place to open, Delray Beach kept coming up,” says Hall, who leads Bible study on Tuesdays. “The idea of our center is to teach our clients how they can use the Bible to help in recovery.”

But Delray Beach’s national reputation as a recovery community has been unsettling for some residents.

”We don’t mind taking care of the people living here, but we don’t particularly like people coming from all over the country or the world to recover,” says City Manager David Harden. “But it’s a fact of life, and so we have tried to be supportive of the community.”

Harden says Delray Beach gives money each year to the Drug Abuse Foundation of Palm Beach County, the county’s oldest chemical-dependency treatment and prevention center. The Commission also sold city property to Crossroads Club several years ago, allowing the center to expand.

Over the years, residents have complained to city officials about the lack of security and control at some sober houses. Owners need only a landlord permit to run them, a reality that makes strict regulation difficult.

Jonas, who heads the South County association and runs the coffee shop, says problems stem mostly from unscrupulous landlords who hope to turn quick profits at the expense of fragile tenants and the surrounding neighborhood.

”You got some of these operators who don’t manage the property or the tenants, then they put the people out and leave them homeless,” Jonas says. “There are some operators we would all be better off without.”

FINDING SOLACE

Jonas came to Florida 20 years ago full of reasons to give up. But with the help of his father, who put him in a West Palm Beach treatment center, he cleaned up and stayed put.

A slight guy with a thick mustache and a thicker Philadelphia accent, Jonas sits in the lounge of his coffee shop one afternoon rattling off his story with sobriety’s detachment and confidence.

Pot by 13. Then acid and speed and cocaine. Graduation to alcohol. Bottomed out in the injection world of cocaine and heroin.

Jonas entered rehab in 1987. He married Dawn, a recovering cocaine addict (they met in a 12-step group), and went back to school, earning an online master’s degree in counseling psychology from Antioch University and a doctorate in addiction studies from International University in St. Kitts.

”You come out of a situation like that broken and with very little to hold on to,” Jonas says. ‘You come out of treatment and you say, `Now what?’ ”

So Jonas and his wife — who recently celebrated her 22nd clean year — began working to answer this huge question, working to help define what life after treatment really means.

In 2000, they launched sober.com, a Web clearinghouse for 30,000 recovery programs nationwide. And for 10 years, he operated a recovery residence in Delray Beach. She runs a home for women in recovery.

Two years ago, they opened KoffeeOkee, in many ways ground zero for the recovery community. Inside is a cozy mix of velvet wingback chairs and bistro tables and a small cafe offering every coffee, tea and juice imaginable but absolutely no alcohol. The walls are covered with bulletin boards offering testimonials, treatment and housing ads, and calendars outlining the month’s sober activities.

A piano sits in the corner with a dried white rose on top, a delicate memorial to Valerie, a drug counselor who died a year ago.

Of an overdose.

OrovilleMR.com — Addiction is the double-edged attraction of a feel-good experience that simultaneously suspends anything that is making you feel bad.

We can apply the concept of the double-edge to recovery, which includes the avoidance of a lifestyle that causes problems, and the building of a new life.

The concept of relapse prevention is valid. One needs to be aware of what triggers thoughts of using. As well it helps to have an idea about which triggers are most powerful and thus carry a greater need for avoidance.

Most agree that using buddies, be they friends, family or just using buddies, represent the biggest threat.

Preventing relapse is the first part of creating a new life.

In this phase of recovery we are considering that what went well with addiction may not be compatible with recovery. Casinos, liquor stores, and parties where people are getting intoxicated are examples of things that might not fit in the terrain of recovery.

As important as eliminating relapse hazards is, it is just the beginning of the new life vision. If all you do is remove items that were once important or enjoyable it would be like taking a child’s old toys and asking that they not consider what the new ones might be.

The new life vision must immediately expand to consider what will fill the void.

This is not a call to abandon the wisdom of relapse prevention, but to bring it along as we open the door to recovery promotion. It is helpful if this includes a door to one or more recovery fellowships where we can find the attributes of recovery.

While avoiding those relapse triggers we train ourselves to be ever on the lookout for what will trigger another day clean. We watch for the loving relationships we could not build in addiction. We see people driving legally and responsibly. We hear of children coming home, of amends being made, of self-esteem being repaired, of people getting jobs and going to school. We hear about healthy fun, vacations, sports and hobbies.

We hear it and we see it all around as we are choosing better environments and making a point to watch for those things that motivate recovery.

And as we do this we notice that our new focus is bringing the things that were once only seen and heard to our doorstep, and we become a recovery trigger for others who are seeking to change their life.

We learn again what we have always known, that the best way to lead is to follow the right path, and keep the double-edge of recovery sharp.

Palm Beach Post — She has a strong grip and broad shoulders and a rage that was so out-of-control she was called The Hulk.

Jen is just 22 and already has suffered years of abuse, from a boyfriend who burned her, beat her and tried to drown her, and from her own self-directed rage.

She believed she found a release and control over her anger and pain by cutting herself.

"It was sick and twisted," she said, curled up in a couch that wrapped its arms around her. "I would have the biggest smile on my face watching the blood run down my leg."

She tried to kill herself nine times, drank and took every kind of drug she could get.

It took courage and knowing that she was hitting bottom, but she finally got the guts to go to her father, who knew little about her abusive and addictive lifestyle, she said. He helped her find The Orchid Recovery Center in Delray Beach.

The staff there, in turn, helped her find a path toward peace through, among other treatments, yoga training.

Enter Angel Lucia, whose mission is to help heal women in recovery through yoga and meditation at her Bindu Yoga Studio in West Palm Beach.

Lucia partners with The Orchid and teaches at the facility and in her own studio.

Jen clearly has a loving addiction to Angel, who nods encouragingly at her while Jen talks about her horrendous experiences.

Nearby are the tranquil-looking yoga mats, candles, books and tapes that are an important part of this lifestyle.

The women in recovery are a close-knit group. They don’t like outsiders watching their yoga, but Jen explains how she is going from an enraged self-mutilator to accepting that life can hold joy for her.

"She winds us all down," Jen, who has been sober a little more than four months, says.

"I can come in angry, jumpy, and the yoga releases all the bad emotions. I like the breathing techniques."

Jen says she is clinically depressed, bi-polar and suffering from short-term memory loss. Yoga and the camaraderie of Angel and the addicted women in recovery at The Orchid have helped her become more centered, she says. She’s starting to like her life.

Angel smiles knowingly. She, herself, had an alcoholic father who threw the family into turmoil. She knows what it’s like to walk on eggshells around a person who can explode at any moment.

She attended family rehabilitation with her parents.

It was yoga and meditation that helped her physically unwind from the effects of a former career as a surgical assistant and a past laden with strained family relations.

"Mentally, I felt more balanced," she says of the yoga she learned and is teaching. "I moved into a more neutral state."

Now, she says, she takes what she knows works for her and tries to transfer it to her students.

"I can’t say I’m floating," she explains. "I can stop and reflect on what is building up in me. What is it and how can I reduce that? If I hold it, it will make me ill."

She watches Jen look at her with a little half-smile. You can almost imagine this powerful young woman she is helping, and whose fists could put Angel on the floor, breathing softly and learning to control her runaway emotions.

"She does have that understanding from having been through something like what we are going through," says Jen.

"When I’m with Angel, I turn off that cellphone, and I am moving and getting that hour of focus."

Angel says some of the women moan and groan and fight off her efforts to help them, not physically, but by withdrawing. She sends them out of the room until they re-engage.

Jen defends that kind of self-protective behavior.

"The feelings are new to us. Any kind of emotion is a shock and completely hard to deal with," she says of women who have learned to numb themselves with drugs and alcohol.

"She helps to keep people sober. She helps with acceptance of a lot of things and letting go. My anger has gone from major to manageable."

Adds Angel, "Yoga helps us to fill a spiritual void. I’m another bridge for them to that. I don’t want to say that I’m better than anyone else this way, but I know what I’ve overcome and know how to apply it to them."

Des Moines Register — Monitoring your teen’s activities is an important deterrent to drug use.
 

Research shows that more teens begin using tobacco, alcohol, and marijuana between spring break and the summer months than any other time.
 

Parents can play an important role in helping their teen stay drug-free by setting clear rules, knowing who their friends are, and by having open and honest discussions about drugs.
 

Q. Why is summer a risky time for teens?
 

A. Summer is a time that often has little structure for teens. This can lead to boredom.

According to a study by the National Center on Addiction and Substance Abuse, teens who report they are "often bored" are 50 percent more likely to smoke, drink, get drunk and use illegal drugs than teens who aren’t.

Another risk factor for teens during summer is having friends who use drugs. Teens are more likely to feel pressured to experiment with drugs if their friends do.

The summer months also have more unsupervised time, which can lead to involvement in risky behavior.

Q. My teen will be unsupervised at home for most of the summer. What can I do to make sure he stays out of trouble?

A. There are steps you can take to ensure your teen stays safe and healthy.

- Lean on other responsible adults in your neighborhood. Network with other adults in your community to build a safe environment for young people.

- Use technology to your advantage. Teens these days use many forms of communication technology including e-mail, cell phones, text messaging and instant messaging, to name a few. Use these forms of technology to check in with your teen each day.

- Get to know your teen’s friends. They can be an important factor in your teen’s decisions about alcohol, tobacco and other drugs.

- Plan regular check-in times throughout the day with your teen.

- Find supervised activities in your community that your teen enjoys. Youth who are involved in constructive, supervised activities during non-school hours are less likely to use drugs. Talk with your child about what she would like to do during the summer and see if you can find a summer program in your community.

Q. How do I start the discussion about drug use with my teen?

A. Teens need to be educated by their parents about drug abuse, expectations in the home, and consequences. This can be a difficult conversation to have but the steps below can help guide you though the process.

1. Talk with your partner to agree on rules and consequences if your teen does use drugs. This information should then be shared with your teen so he knows and understands the expectations.

2. Practice ahead of time what you are going to say to your teen. Be prepared for various reactions from your teen and practice how you will react.

3. Make an agreement with yourself to not get upset or angry. Stay as calm as possible. Remember, you are the parent and you are in charge. Be kind and direct in your statements to your child. Know that you are doing the right thing.

Q. What are some signs to watch for if my teen is using drugs?

A. Look for signs of depression, withdrawal from friends and family, carelessness with grooming, or hostility. Also ask yourself, is your teen doing well in school, getting along with friends, and taking part in regular activities? Some additional signs to look for are:

- Increased secrecy about possessions or activities.

- Increase in borrowing money.

- Unexplained injuries.

- Impaired short-term memory.

- Items or money missing from home.

- Illness, shakiness, or tremors.

Q. What other resources are available?
 

A. A great resource for parents is called "The Anti-Drug," which can be found at www.theantidrug.com. This Web site has a wealth of information for parents about drug education, support from other parents striving to keep their teens drug-free, and helpful articles and advice from experts in the parenting and substance abuse prevention field.

Maryland — The lifestyles of Jean Duley’s clients run the gamut: long-time street drug users, those who were prescribed powerful painkillers after an injury or operation and are now addicted, and middle-class housewives who abuse prescriptions, to name a few.

"Prescription drug abuse is the biggest kept secret," said Duley, program director at Comprehensive Counseling Associates in Frederick. "It’s a lot more prevalent than people can imagine."

In December, Comprehensive Counseling became one of three practices in Frederick County to prescribe suboxone, which Duley calls a "miracle drug" for those addicted to pain medication. The center now prescribes suboxone to about 50 clients.

Suboxone is a partial opioid agonist, containing enough buprenorphine (an opioid) to eliminate cravings and symptoms of withdrawal. The pill also contains naloxone, an opioid antagonist, which blocks the user’s ability to get high on any other drug, Duley said.

Clients usually come to the center for suboxone in the midst of withdrawal, and with regular treatment, clients have gone from "living a nightmare, to feeling like they have a brain for the first time in a long time," said Dr. Allan Levy, a psychiatrist at Comprehensive Counseling.

Duley said while some people lie about the severity of their pain to acquire their abused prescriptions legally, physicians themselves can fuel prescription addiction. Some prescribe increasing strengths of painkillers and then abruptly stop after patients have already become dependent, forcing them to get their fixes from either prescriptions sold on the street or illegal drugs like heroin.

Others prescribe painkillers too loosely. Duley said some of the center’s suboxone clients have Percocet "handed to them like candy for every little ache and pain — it’s a culture of doctors not paying attention. The worst is OxyContin. That drug — is so highly addictive, it’s so difficult to come off of."

Some people can stop taking suboxone after a few months, but most continue for as much as a year before weaning themselves off, Levy said. For others, it becomes a lifelong maintenance drug.

While suboxone addresses the neurological aspect of addiction, Duley said giving medication without regular therapy defeats the drug’s purpose. She facilitates a support group at the center three times a week, and suboxone users are asked to attend at least once a week.

"They usually have all kinds of issues going on at the same time (as the addiction)," Duley said, including problems with employment, family and mental health. "You have to address the whole piece. The drug alone doesn’t work by itself."

And all addiction treatments should revolve around the key factor — a person’s health, Duley said.

"(Beating addiction) is a complicated issue, but it’s very doable," she said. "It’s not a moral issue, it’s not a criminal issue, it’s a health issue."