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Health Department connects recovery resources, peers

As law enforcement and prosecutors shift to a model of early intervention and treatment to combat drug addiction, an approach that some say is already paying dividends in Carroll County, access to treatment and recovery services grows even more important. Heroin and opioid addiction is seen as a public health crisis, and the Carroll County Health Department is partnering with law enforcement and other stakeholders to get help for those who might otherwise wind up in prison, or worse.

"It's very coordinated, what we're doing," said Sue Doyle, director of Behavior Health Services with the Health Department.

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At the same time, the Health Department has had to evolve in the way it approaches substance abuse services. Due to restructuring at the state level, local health departments have spent the past year or so moving away from being treatment providers and instead becoming treatment facilitators, Doyle said.

The Health Department used to provide treatment services for approximately 200 people at any given time, according to Doyle, but now workers will assist people with finding a provider in the community.

The changes were made necessary after the Affordable Care Act made more people eligible for programs, according to Doyle.

Additionally, following the merging of the state Alcohol and Drug Abuse Administration and the Mental Hygiene Administration to form the Behavioral Health Administration in October, Doyle said service providers can now bill one administrative agency for services and the department merely coordinates the treatment for the individual.

One function of the department that remains is conducting substance abuse evaluations to determine what kind of treatment individuals need, according to Doyle.

Evaluations are sometimes done based on a court order, according to Doyle, and there is no charge for them. Probation orders may require people to be evaluated and follow all recommendations of the Health Department.

The department conducts about five evaluations each day on a walk-in basis, Doyle said. Evaluations used to be done by appointment, but the department saw a 50 percent to 75 percent no-show rate.

Since changing to a walk-in system, Doyle said the department has gone from 450 evaluations per year to 1,450 evaluations per year over the last three years. People with special needs can still make an appointment.

Doyle said allowing people who believe they have a substance abuse problem to come to the department right away is a better system than asking them to call for an appointment then wait several days.

The value of walk-in or otherwise rapid access to treatment is borne out by the testimony of the people who have used it.

Brittney Sabock, 24, is now living in a sober home, but for several years, beginning when she was 17, she abused heroin and even overdosed several times. She said the key thing to understand about people using heroin is that they have to want to get better, and when they finally come to that conclusion in a moment of clarity, they need to get help right then, before they change their minds.

"Especially for a heroin addict, there is a short window of opportunity," Sabock said. "When I went to my mom and said, 'I need help,' I got into rehab in like, four days."

'No wrong door' approach

When assessing treatment options, Doyle said the department adopted a "no wrong door" approach to avoid having people leave with unmet needs.

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If the Health Department cannot provide the right resources, they will still meet with the person, assess their needs and connect them to the right places, according to Amy Baker, program director of the Recovery Services Unit.

"We will never say to you, 'I'm sorry, I can't help you,' " she said.

There is more to facilitating treatment than finding a care provider, according to Doyle, and the Health Department assists people who need insurance, identification or other documentation before they can even begin treatment.

If an uninsured person comes in, Doyle said, a Health Department worker will sit down with them and determine if they qualify for Medicare or if they need assistance choosing a health care provider.

For people with insurance, the department will help them learn how to advocate for themselves with their provider to get the treatment they need.

"It's teaching people how to do these things and helping them do these things," she said.

Once the client finds a treatment program that's right for them, the department will offer to set them up with a peer counselor who can coach them, especially if there is a waiting period before they enter treatment, according to Doyle.

The Health Department also stays in touch with clients to see that they follow through with treatment and workers attempt to remove as many barriers as possible.

"Sometimes [it's] as basic as riding the Carroll Transit System with them so they can learn how to use the transit system," she said.

Peers assist in recovery process

Certified peer recovery support workers are available to anyone who requests one because of substance abuse or mental health issues, according to Baker.

Peers are assigned to community partners and programs, such as Carroll Hospital, the Safe Haven shelter and the Outpatient Mental Health Center, according to Baker, and more organizations are requesting peers as word of the program spreads.

"We're trying to be everywhere that we can be," she said.

Baker said people with substance abuse or mental health issues light up when they hear about the option of working with a person in long-term recovery who dealt with similar issues, such as addiction co-occurring with mental health issues.

"A lot of people focus on the bad parts … but when we get better, that doesn't get a whole lot of attention," said Heather Coates, a peer worker.

What peers do depends on the person they're working with, according to Coates. It could be sitting and talking or it could be projects like journals and collages.

"It's a great way of giving back," she said.

Workers also help people get their medications and make it to appointments, Baker said.

Greg Hendricks, a peer assigned to the Carroll County Detention Center and the Carroll County Drug Treatment Court, said he does his best to make it clear he is separate from the justice system though that is how people meet him.

After developing a relationship with people, Hendricks said, he makes sure they know he won't report back about what they tell him.

"It's not punitive," Baker said.

The Health Department receives 30 to 40 requests for a peer worker each month, according to Baker, and the caseload for each peer is between 35 and 50 people, though not all of them are met with regularly.

Workers go through hours of training to be certified, Baker said.

Stacia Smith, the peer assigned to the homeless shelters in the county, said she learned about the many ways for people to get treatment, not just the way she came in.

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"The training taught me there were several pathways to recovery," she said.

Peers never start the process suggesting they can fix anyone, Smith said. They make it clear they are just there to support people along the way.

"It's so rewarding, you almost don't feel like you're working," she said.

Jon Kelvey contributed to this article.

More Information

Carroll County Health Department: 410-876-4800

Call for assessment, evaluation and referral information.

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