Lucy Gellman Photo
Valerie Goodkin told her daughter’s story.
When Lauren Goodkin opened her parents’ medicine cabinet, she was trying to soothe a raging case of strep throat. She found some Percocet left over from her dad’s tooth surgery months before.
Then in her freshman year at University of New Haven, Lauren didn’t feel like she could afford to miss classes this early in the semester. A few Percocet, the strep would be soothed, and classes could go on as planned.
For the 17-year-old, that Percocet became the gateway drug to OxyContin and other opiates, eventually including heroin, a far cheaper option to prescription drugs.
Ten years later, she is still struggling to break the cycle of opioid addiction, working through new methadone maintenance therapies to wean herself off of the drugs that almost killed her, and focusing on a new soap-making business for the immediate future.
Lauren is one of a growing number of people caught up in a heroin epidemic. Her story was told Monday night at the New Haven Free Public Library, where U.S. Rep. Rosa DeLauro hosted a screening of Heroin: Cape Cod, USA, a new HBO documentary on the East Coast’s exploding heroin epidemic. In addition to DeLauro, Pam Mautte, director of the Valley Substance Abuse Action Council, and Steve Merz, vice president and executive director of behavioral health at Yale-New Haven Hospital, spoke to a group of around 25, offering an overview and critique of current treatment options in the state. The two zeroed in on opiate use in and around New Haven, a stop along the “opiate highway” to much of New England.
Many of the evening’s narratives came directly out of the film, which follows eight heroin-addicted adults through detox and rehab, recovery in sober housing, and relapse. The most powerful one was delivered afterwards in person by Lauren’s mom Valerie.
An Embattled Path To Recovery
In bringing her daughter’s story into the open, Valerie Goodkin, who lives and works in North Haven, said during a post-documentary talkback, she wanted to shed light on the barriers that addicts and their respective support networks face in getting adequate and sustained treatment. It’s that limit on care, she said, in fact a constellation of limits, that still poses the biggest single barrier to recovery.
“I am the mother of an addict, and this this was a difficult film to watch tonight,” she said as attendees and panelists listened intently, DeLauro letting the occasional Jesus escape under her breath. “We’ve been fighting it [in North Haven] since 2007 … I was probably the first parent to come out in town and admit [that there was a heroin problem] because back then, really no one was talking about it, no one was putting a face to it. It was very difficult, but I felt very strongly.”
That was a little less than 10 years ago. Since then heroin overdoses have exploded into public view and pushed politicians like DeLauro to fight more aggressively for solutions. In the Naugatuck Valley, a recent rash of overdoses and heroin-linked deaths has pushed advocates like Mautte to advocate for more resources. North Haven has instituted preventive programs like the North Haven Substance Action Council, which sends parents and current and recovering addicts into schools to speak openly about opiate abuse, treatment and prevention. In 2010, the town started a pill and medical waste disposal program for the safe disposal of expired and unused painkillers. (New Haven’s Police Capt. Julie Johnson started one here, too .) A chapter of the research-and-recovery-focused APT Foundation has moved into North Haven, as have chapters of the Connecticut Region of Narcotics Anonymous and parent support groups like My Bottom Line.
Goodkin, too, has fought for recovery for her daughter and other children struggling with the same cycles of addiction.
After recognizing that Lauren needed help in 2007, Valerie recalled, she tried to find a health and treatment program for her daughter. She wanted to find someone who understood addiction as an illness.
She nearly lost hope when center after center told her to take Lauren to the emergency room instead.
Finally, she found a detox and rehab center in Connecticut that would see Lauren. Lauren attended a program there. After her release, she relapsed.
Lauren next went to a detox center in in Florida.
Back home now in Connecticut, Lauren has started her soap company and remains in recovering, using methadone maintenance therapy. That’s “saving her life,” Valerie Goodkin told DeLauro.
But the battle to proper care, as Goodkin sees it, is far from over.
“The biggest thing I would say is that the care treatment is not long enough. [The detox center time limit of] 30 days is not enough time. It needs to be much longer. They [addicts] need to come out of this whole environment for more than 30 days — going into sober living is too challenging. Being dismissed after 30 days, the odds are stacked against them.”
“It’s terrible,” she added of trying to get treatment for her daughter. “You could spend a day on the telephone just trying to find a prescriber, just trying to find someone ho will see you to prescribe. I’ve done it with my daughter. I’ve gone through legal pads, calling one [prescriber] after another … No one’s taking in patients. No new patents. No new patients. You’re told to go to the emergency room. How is a person supposed to get help?”
A Multi-Part Solution
Merz.
According to Merz and Mautte, the answer to that question is far from resolved, and speaks to a constellation of issues blocking effective opioid treatment in the state. Among them, Merz said, are a serious shortage of medical, financial, and legislative resources to fight addiction.
“What you said resonated with me, as far as the shortened time frames for treatment,” he said to Goodkin, citing a typical 50 people per day that come into the emergency room at Yale-New Haven Hospital with addiction-related issues. “These require much more than the insurance companies typically offer.”
What that means specifically, he explained, is that federal parity legislation — the Mental Health Parity and Addiction Act of 2008 — “that’s supposed to provide this type of benefits for people with psychiatric or substance abuse needs” isn’t effective in its current iteration. As it stands, the act stipulates that a patient must be actively using drugs or in an intoxicated or drug-induced state in order to receive medical and mental health services.
“That’s like telling a person with a heart condition that they can’t get access to treatment and take the preventative meds until they have a heart attack,” Merz said. “That’s the world we live in.”
He and Mautte also pinpointed proposed budget cuts to Connecticut’s Department of Mental Health and Addiction Services that he claimed would cut the number of state detox beds and virtually eliminate prevention programs at the community and state levels.
“A big part of the prevention piece is early identification and early childhood education,” said Merz. “Last week, if you’re not aware, there were hearings committee talking about closing 20 detox service beds in our state. There’‘s a proposed $15 million cut to private not for profits right now in the state budget … That really hurts the system.”
“There’s a huge opportunity that we have to see,” he added. “We are already as a society experiencing the costs of this — not only the personal costs on people, but the economic costs. 50 patients a day that come to our emergency department, on any given day we have 30 patients or more that are undergoing active detox protocols on our 1,500 beds. Each of those patients are costing anywhere between $10,000 and $30,000 … in contrast it costs between $200 to $300 a day to have a patient in one of those detox programs. We could provide increased access to these services and better outcomes for patients and families with similar resources that we’re currently putting into the system. We just have to find the way to connect those dots.”
Mautte proposed solution: Don’t cut prevention. Those suffering from the epidemic can’t afford it, she argued.
“We need to have addictionologists like we have cardiologists,” added Mautte, who has seen a spike in overdoses in her area. “There’s maybe 10 percent of medical schools in the United States that offer a lot of coursework in addiction medicine and prescribing, so when we go back to the medical profession, we can enhance policy that way. As for health education … going in and doing a one-time talk to a middle or high school is not the best answer. We need to implement evidence-based curricula to build upon, and the sad reality is there’s lack of money for prevention. That’s the first thing that gets cut in our school system, because we need to increase test scores. There are stronger preventative measures that we can take, but it is taking time to implement them.”
Stephanie Moran, Durham-Middlefield prevention coordinator, advocated for more programs at the event.
Some of those changes should be coming on the federal level, DeLauro said, briefly discussing President Obama’s request for 1 billion in emergency funds for to evaluate and enforce opioid research and treatment programs.
“Oftentimes, people think the answer is incarceration, and this is an illness,” she said. “We need to treat this as an illness. That is the approach that we have to take.”
From the back of the room, Goodkin nodded.
“It’s incredibly hard,” she said as people packed up to leave and the room turned dark, shaking hands with DeLauro on her way out “Incredibly hard. It’s not an easy cure. You’re always working at it. Always.”
To listen to an episode of WNHH radio’s “Valley Navel Gazing” about the heroin epidemic, click on or download the audio above.