By Kevin Shea

SARANAC LAKE—The number of local heroin users admitted to St Joseph’s Addiction Treatment & Recovery Center in Saranac Lake is rising.

According to Zach Randolph, the Inpatient Services director and Veterans Program director, the amount of outpatients from Saranac Lake who list opiate abuse as one of their disorders has risen from thirty-five percent to sixty-six percent in the past two years.

Randolph and Community Services Director Robin Gay believe that the rise is because of an increase in the availability and affordability of heroin, as well as a bump in pain-pill prescriptions. Seventy percent of New York state citizens over the age of 18 have a bottle of opioid pills at home, according to the Heroin and Opioid Task Force Report for New York state in June of 2016.

Aside from the alarming jump in local users, Randolph and Gay noted that the ages of the patients have dropped drastically.

“I think up until about five or six years ago it was not the norm,” Randolph said. “They were the minority.”

In the past, most of the patients coming in averaged 50 years of age. Now it lingers around 20 years of age.

The drop in age can be attributed to how addictive it is compared to other drugs, according to Randolph and Gay. A 2012 survey by The National Center on Addiction and Substance Abuse at Columbia University stated that sixty percent of high school students and thirty-two percent of middle school students reported that students keep, use, or sell drugs on their school grounds.

The shift in age has resulted in a drastic shift in St Joseph’s approach to rehabilitation.

“(Young users) are a much more needy group,” said Gay.

Many lack life and problem solving skills, which need to be taught, explained Randolph. This is a problem when they leave the center and are faced with living on their own, which many have never done, and suffer from anxiety because of it.

These new patients, after having been arrested, are often required by the court to attend a recovery center such as St Joseph’s. Some see the required rehabilitation as unnecessary and are uncooperative, unlike in the past with many older patients who relished the opportunity to start over.

Regardless of the patient’s will to change, St Joseph’s works to alter their thinking and behaviour through evidence-based practices, which Randolph says are mostly cognitive-based therapy.

Randolph simplifies the work they do through two methods.

“If I help you change your thinking, you will change your behaviours. If I can’t help you change your thinking, I will change your behaviours, which will lead you to more positive experiences and hopefully change your thinking,” Randolph said.

It’s easier said than done and takes time, added Randolph. For example, Randolph will send patients out to complete a task, like hiking. At first they may hate it, but the more they do it the better they get and the more they see the positive side effects of completing such tasks.

“It helps them recognize the benefits of engaging in treatment and making different life choices,” Randolph said.

St Joseph’s is also implementing a trauma-informed model of care known as the sanctuary model; the goal of which is to figure out what got them using in the first place. They look at the environment the patient was living in, what their past relationships were like, their job history, and even who their family members are.

The latter is an unfortunate bonus of having such young patients. Five or six years ago when those who sought treatment at St Joseph’s were older, many of the bridges were burnt and family ties cut. Now, many of the family members are still in contact with them. As a result, Randolph and other professionals at St. Joseph’s set up a family session to show the patient the impact his abuse is having on their family.

“A lot of people think, ‘Oh it’s just me, I’m making my own decisions doing what I want. I’m not really hurting anybody with it,’ and when they hear that they’ve actually impacted their mother, their brother, their daughter that can be a very powerful motivator,” Randolph said.  

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