Sara Carver, director of clinical operations, fist bumps a client at the Southern Rockies Addiction Treatment clinic recently. Since opening in Durango last fall, the clinic has treated some 40 patients suffering from addiction using methadone and other medically assisted therapies. According to the Colorado Health Institute, a nonprofit and nonpartisan group in the health-care industry, drug overdose deaths in Colorado jumped 68 percent from 2002-14./Photo by Jennaye Derge
Breaking the cycle
Local doctor opens only clinic of its kind in Southwest Colorado
by Tracy Chamberlin
For 25 years, Dr. Dan Caplin watched his patients fall victim to drug overdoses in the emergency rooms of New Mexico. Then, he watched as a wave of heroin spread north, into Southwest Colorado.
Caplin called it nothing short of an epidemic. “If it was Ebola or some other virus, people would be in panic mode,” he said.
According to the Colorado Health Institute, a nonprofit and nonpartisan group in the health-care industry, the rate of drug overdose deaths jumped 68 percent statewide from 2002-14.
In that same period, the number of people who died from an overdose doubled in La Plata County. For Archuleta County, that number quadrupled.
“People think they know what an addict looks like,” Caplin said. “But they’re not like that in rural America.”
After years of research on the subjects of treatment and addiction, Caplin opened Southern Rockies Addiction Treatment Services in the fall of last year.
The clinic, located south of downtown Durango, provides medical treatment assistance combined with individual and group counseling to people with addiction. Caplin, the clinic’s founder and medical director, is the only board certified provider of addiction medicine in the region. The clinic already has more than 40 patients.
He called the process of opening the clinic an “administrative marathon.” They’ve received five different permits from local, state and federal authorities and are currently undergoing an additional accreditation program, which will likely be completed this spring.
“This is probably the most regulated field and restricted aspect of health care that exists,” Caplin explained.
Although it’s a marathon, it’s a worthwhile one. Caplin said the experience has been even more rewarding than he thought it would be.
“It’s amazing how many of our patients have thanked me for saving their lives,” he said. They are the same patients who may have ended up in his emergency room.
Finding what works
There is a debate among those who help treat addiction. What works better? Abstinence or assistance?
Some argue that walking away from a drug and never looking back is the only way to get clean. Others contend that for some addictive substances, like heroin, will power isn’t enough to combat the physiological effects.
Heroin actually changes the way the brain works. It essentially turns off areas in the brain’s frontal cortex responsible for making dopamine and serotonin. These two chemicals are key to a person’s mood, appetite, sleep, memory and other aspects of their behavior.
Therefore, when someone no longer takes heroin, they have no way of tapping into the joy of everyday life.
They can’t get up in the morning. Their sleep cycle is disrupted. It’s almost impossible to find happiness or pleasure without the drug because it has taken the place of the chemicals the brain once produced.
The real problem, though, is that it takes time for the brain to start making these chemicals again. This can take years.
Without something to fill that gap, a person cannot feel normal. They can easily slip downward, become depressed and start the search for something to lift them back up. Often that something is the same drug they are fighting to stay away from.
This is where medically assisted treatment comes in. The medicines are used to lift the patients up enough to feel normal while the brain relearns how to make those chemicals on its own. Methadone, buprenorphine and Suboxone are some of the medicines used today for that purpose.
The Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, says methadone “lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.”
For many people struggling with addiction, it’s their only hope. “Nobody wants to be a heroin addict,” Caplin said.
One of his patients said she has tried to get clean hundreds of times. This time, though, it’s working.
“It’s the methadone,” she explained. “That’s the difference.”
In the beginning, Christina (not her real name) wasn’t sure it would work for her. She’d heard stories that others who took methadone suffered from rotting teeth and other ailments. But nothing else worked, so Christina, who’s in her early twenties, tried it in spite of her fears.
It turned out those fears were unfounded. “When I’m stronger I can get off of it,” she explained.
Christina said although she comes to the clinic for the methadone treatments, it’s not just the medicine. It’s the routine, the stability and the support. It all works together.
Since getting medicated assistance treatment at the clinic, she doesn’t wake up and feel like she needs to put a needle in her arm. Instead of the next fix, she’s looking forward to what she can accomplish in life.
She said her family hasn’t seen the person she is today since before she started using heroin. “They haven’t had this (person) since I was 15,” said Christina.
It can happen to anyone
Currently, the clinic is only taking adults. But, the Director of Clinical Operations Sara Carver said they hope to eventually open up the program to 16- to 18-year-olds. That’s the age many patients are when they first take heroin or other drugs.
In the future, Carver said they’d like to expand their program offerings even more because it can happen to anyone.
“Addiction does not discriminate,” she explained.
Regardless of a person’s race, religion, age or gender, anyone can find themselves facing a life of addiction.
Carver said often the pathway begins with an injury. Many common painkillers, like hydrocodone or OxyContin, are highly addictive. The unintended consequence of a legal prescription painkiller can be opening the gates to heroin addiction.
“It can happen to anybody,” she added.
For one young man who is a patient at the clinic, that’s how it all started. After surgery, his doctor prescribed painkillers. Rob (again, not his real name) kept on getting more, until it was no longer enough.
Like Christina, he’d also tried to quit many times. He knew addiction was not the way to live his life, but one way or another he always found his way back to heroin. “I was on the quick road to losing everything in my life,” Rob said. “You’re not even aware of it until it’s all gone.”
He doesn’t want to depend on any substance to live his daily life and with the medicated assistance treatment program at the clinic, he might just be able to do that. Methadone gives him a different mindset, he explained. It gave him his life back.
As one of the clinic’s first patients, he’s been on the road to recovery since late last year. “My mom’s as happy as she’s been in a long time,” he said.
To find out more about Southern Rockies Addiction Treatment Services, go to www.srats.net, call 970-828-3030 or email info@srats.net. n