'Whatever Works:' Different steps for different needs in opioid recovery

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PITTSFIELD - Every day in Berkshire County, people battling opiate addiction gather to support each other, some walking the 12 steps of Narcotics Anonymous.

But the welcome mat isn't out for everyone.

The internationally known program expects full participants to be "clean," a rule that generally excludes people using substances like methadone and Suboxone to control their addiction.

"For people on Suboxone, they're second-class citizens," said Dr. Ardis Fisch.

Fisch has a second option: Whatever Works Berkshires.

That new group meets Tuesdays in Pittsfield and Thursdays in North Adams. It is designed for people seeking recovery through use of what is known as medication-assisted treatment.

"We're trying to reach out and be accessible to all those people," said Fisch, who is on leave from CleanSlate Addiction Treatment Centers, a national company with a Pittsfield office that provides Suboxone treatment. "We want to make a different kind of support group."

The program arrives as the national opioid crisis intensifies.

More people died of opioid-related overdoses in Berkshire County last year than ever before, new figures show, falling to an epidemic that has hit Massachusetts hard.

President Trump said Aug. 10 he would declare a national emergency on opioid addiction, at a time when an average of 142 people die each day in the U.S. of opioid-related overdoses.

In Berkshire County, 35 people died due to opioid-related overdoses in 2016, according to the state Department of Public Health, compared to 33 in 2015, 29 in 2014 and 22 in 2013.

Across the state, 13,818 people died due to overdose from 2000 to 2016, more than the population of North Adams.

Open to all

Despite her CleanSlate connection, Fisch says the meetings are open to all people using medications to avoid relapse.

In the Berkshires, CleanSlate is one of a number of companies and agencies providing that treatment. Others include Right Choice Health Group LLC, Experience Wellness Center LLC and the nonprofit Brien Center.

Suboxone combines buprenorphine and naloxone and is used to treat opioid addiction. Buprenorphine, a narcotic, relieves symptoms of opiate withdrawal.

Megan Eldridge Wroldson, division director for the Brien Center's adult and family services program, said her agency provides its own support groups for clients using medication-assisted treatment.

She said the Brien Center encourages people to consider all resources available to help them beat addiction, including 12-step programs. "It's a huge resource and it helps people," she said of efforts like Narcotics Anonymous.

But she said that program's rules on abstinence from medication prove a barrier for some.

"I know it's something people come up against," Wroldson said. "It's different for everyone. We support people in every way they create their networks."

Narcotics Anonymous groups meet three to five times a week at the George B. Crane Memorial Center on Linden Street in Pittsfield. For information on dates and times, call 443-4377.

Messages left on a Pittsfield hotline seeking comment on the group's view of medication-assisted treatment were not returned.

In a post online labeled Bulletin #29, Narcotics Anonymous says it does not exclude people on drug-replacement programs from joining meetings and "has no opinion on outside issues, including prescribed medications."

But it notes that members have questioned the presence of people using methadone or Suboxone — and that has led to restrictions.

"While some groups allow such members to share, it is also a common practice for NA groups to encourage these members (or any other addict who is still using), to participate only by listening and by talking with members after the meeting or during the break."

The bulletin, produced in 1996, links medication-assisted treatment to continued drug use.

"When an individual under the influence of a drug attempts to speak on recovery in Narcotics Anonymous, it is our experience that a mixed, or confused message may be given " the bulletin says.

Douglas W. Malins, president of the Crane center, said he is making space available for the new Whatever Works Berkshires group to fill a gap.

"These people have no other option. They cannot attend regular Narcotics Anonymous meetings," said Malins.

"That's why this group is forming. We're here to help people with their addiction problems. We don't care where they come from, they're welcome," Malins said. "It's an option people wouldn't otherwise have. These people also need the peer-to-peer recovery status. They need to be able to talk to the same people suffering the same things they do."

The medication works by bonding to receptors in the brain, Fisch said, to prevent symptoms of withdrawal while also blocking the effect of opiates.

She said use of Suboxone doesn't fundamentally alter people using the drug. "People definitely feel better, but what most people report is that they feel normal. They get their lives back."

New approach

Fisch said she hopes Whatever Works Berkshires can help establish a new approach to peer-supported recovery from addiction. People will be encouraged to look ahead, not back. That means no addiction war stories.

"We're supporting your sobriety, not revisiting the past," she said. "We want to make this a model that can be replicated. When you say the word 'meeting,' people think it's 12-step, because that's the only one around. Everyone we've talked to said, 'This is great. We need this.'"

But she admits the groups have had a slow start. "People don't want to be the first ones on the dance floor at the wedding."

Along with meetings, the group plans to host monthly lectures and occasional life skills fairs for participants.

"We have people ready and willing to do all these things. We have grand plans," Fisch said.

Addiction often robs young people of the opportunity to grow up and learn to be adults.

"It really affects every aspect of your life," she said of addiction. "This isn't a choice. It can happen to anybody."

Reach staff writer Larry Parnass at 413-496-6214 or @larryparnass.


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