Road to recovery is a long, bumpy one for addicts

Editor's note: This story originally ran on Dec. 5, 2001 as part of the Daily Herald's "Hidden Scourge: Heroin in the Suburbs" series.

Courtney Barkei didn't put much thought into taking her first dose of heroin.

A friend had it, and she tried it.

But recovery has not been that simple.

Much like other addicts, the 20-year-old Batavia woman has been through a series of treatment programs only to relapse again and again since her first dose in 1998.

When she first went through recovery she told herself she never wanted to go through withdrawal again. But she has.

She flew to New Jersey to get a surgical implant to block the high from heroin and vowed to stay clean. But she quickly found herself counting down the days to when the implant would wear off and she could use again.

She's even been near death - twice. The first time she overdosed, she said she would never use again. She overdosed again six months later.

Each time she swore off the drug, Barkei would find a reason to use again - her friends were doing it, she was depressed, one more time wouldn't hurt. Even spending time in the county jail for stealing didn't keep her from using again once she got out.

Much like other recovering addicts, Barkei has been in treatment center after treatment center trying to conquer her addiction. That's because, once addicted it's a lifelong fight to stay clean - like a disease that one can live with if they treat it or die from if they don't, experts say.

"Addiction is a chronic disease," said Arthur Lurigio, chairman of the criminal justice department at Loyola University in Chicago. "There's no such thing as one-shot treatment. Relapses are the rule, not the exception."

Lurigio and other treatment experts compare addiction to chronic diseases such as high blood pressure or diabetes that require extensive monitoring and long-term care. Treatment doesn't fail as long as people follow the plan. Just like a person with high blood pressure can have problems if they stop taking their medication, a person with addiction can become addicted again if they don't follow their treatment plan.

"It's not unusual for a person to require more than one treatment episode," said Carol Falkowski, director of research communication at Hazelden Foundation in Minnesota, "just like it's not unusual for someone with high blood pressure or asthma to require repeated treatments before the chronic disease is effectively managed."

Forty to 60 percent of addicts who complete treatment remained clean for at least one year after treatment, according to research published last year in the Journal of the American Medical Association.

And, drug treatment experts warn that addiction can flare up at any moment - even after several years of sobriety.

Courtney didn't have years of sobriety under her belt when she relapsed. But she quickly learned how easy it could happen.

After her first overdose in May 2000 the fear of dying kept her clean. She and her boyfriend even started going to support group meetings together after he got out of jail in July.

But a trip to the city for dinner one week after his release brought them back to their old habit. They bought one bag that night, thinking it would be a one-time deal.

"We did one bag and it was off to the races again," she said.

It's those kind of relapses that addicts have to be prepared for, experts said.

At Providence House, a residential drug treatment center in Aurora, counselors almost immediately talk to their patients about relapses and how to handle situations that could lead addicts to use again.

Counselors there know the physical grip the drug can have on users. They know that for heroin users, the body has grown accustomed to having the drug and craves it when it's not there.

And even if someone gets past the physical cravings for the drug, counselors know the mental fight will take much longer to beat. They know that seeing an old friend, driving by an old drug spot or seeing a needle can trigger a relapse.

"Recovery is possible," said Carole Arliskas, director of the Community Counseling Center, which runs Providence House. "There are no hopeless cases.

"They just have to have the willingness and realize it's a process and that, sometimes, it takes several attempts."

This time around Barkei is doing all the things she refused to do before. After finishing a 90-day treatment program, she moved to a halfway house in DeKalb. She never wanted to do that before.

She has a sponsor she can call to talk to if she ever feels like using - again, something she refused in the past. Barkei makes sure she goes to meetings for recovering addicts daily and she follows the same 12-step program people in Alcoholics Anonymous use.

She has broken off ties to old friends who still are using heroin. She even broke up with a man she had been seeing. Using heroin is what brought them together. It was during treatment that Barkei realized he, whether he was using or not, was one of those "triggers" counselors talked about. Being with him made her want to use.

All that has helped her stay clean since April 13. It's a record for Barkei.

Six felony counts for crimes including like forgery hanging over her also serve as a motivation to stay clean. She has seen the inside of a county jail, but doesn't want to find out what state prisons are like.

If Barkei uses drugs again and violates her court-ordered treatment program, she could land in one of those prisons.

Barkei says she wants a future. She looks at friends who are in college and wants the same thing.

"I'm young," she says. "I have a future ahead of me. There's no need to waste my life on getting high anymore."

Drug counselors say that kind of desire is key to success.

"People change because it hurts and they can't continue that way," said Mark Graham, clinical supervisor for the Hazelden Foundation in Chicago.

Research also shows that sticking with treatment for an extended time is another key to staying clean. The National Institute on Drug Abuse notes that treatment for less than 90 days is "of limited or no effectiveness." The institute also notes that medical detoxification is only a step in recovery and by itself rarely results in long-term sobriety.

Parents of recovering addicts echo similar sentiments.

"Detox is not the issue," Barkei's mother, Kathy, said. "Anyone can detox if you lock them in a closet, but they're not rehabilitated."

She's watched her daughter come back from treatment centers only to relapse again when she saw an old friend or had the urge to use.

"She has to stay away," Kathy said. "It's that long-term rehabilitation that they need."

At Providence House, the 90-day treatment program involves 25 hours a week of counseling. Group sessions start each morning and continue until lunch. At 1:30, the group session starts again. In the afternoon, patients spend time writing in journals, meeting in one-on-one sessions and attending educational programs.

Recovering addicts also develop a written plan of what to do when they crave heroin. The plan includes the names of people to call and how to handle the craving.

But that kind of treatment doesn't come cheap.

Some parents have spent the equivalent of a college education - and more - on treatment. Because insurance doesn't always cover treatment and state-funded beds at treatment centers are few, the expense of getting their children off drugs often comes out of their own pocket.

Courtney Barkei's latest treatment will come out of her own pocket. Eventually, she'll have to make payments on the $10,000 bill.

"I told her I'm not paying for treatment," her mother said. "She's paying for it."

Kathy Barkei figures this way her daughter is more accountable for her sobriety. Maybe it will help her stay clean if she has to put some cash behind it.

For other parents, paying for treatment isn't the problem. But getting it is.

Parents at a support group in St. Charles often lament how they can get their child into a hospital program for medical detoxification, but then have to wait for a bed at a residential treatment facility. The lag time often provides their child the opportunity to use again.

For parents who can't afford a bed at a treatment center, the wait can be even longer. Beds paid for by the state are often few and far between and the wait for one could take weeks. At Providence House, for example, 15 of the 36 beds are state-funded, but there's always at least a month wait for the subsidized beds.

In a drug rehabilitation court program in Kane County, participants can spend a month or more in jail waiting for a state-funded bed at a treatment center.

Last year, Arliskas ran out of money for state funded beds three months before the end of the year. This year she has spent $80,000 more than what the agency will get reimbursed for.

But no matter how long the program - or how good, parents of addicts know all too well that success rests in the addict's hands.

Barkei's mother holds out hope this will be the time Courtney stays clean. She points to all the right things Courtney is doing - down to when she told a dentist she would have to go through a root canal without any drugs.

"I have a lot of hope for her," Kathy Barkei said.

But Courtney's mom says she still worries. What will happen when Courtney sees her old boyfriend? What if she uses again?

"I think she'll be all right," she said.