BRUNSWICK, Maine — Kenji Yamauchi woke up in a Portland hospital this summer after overdosing on heroin. It was the second time the 23-year-old had overdosed.
Yamauchi, who grew up in Detroit, started with marijuana at age 13, then tried just about every drug he could find: psychedelic mushrooms, cocaine, LSD, Ecstasy and methamphetamines. He discovered Vicodin at age 16, sold ecstasy and psychedelics, and then at 18 shot heroin for the first time.
“[It] pretty much went downhill from there,” said Yamauchi.
A year later, with Adderall and cocaine in his system, he first overdosed and woke up in a hospital intensive care unit. He has watched friends die from the same drugs he has injected, snorted, smoked or swallowed.
Yamauchi admits to “doing some pretty shady shit” to get money for drugs, and eventually lost touch with his mother and four older brothers and sisters.
At the Portland hospital, Yamauchi told the nurses he wanted to kill himself. When they sent him to a homeless shelter, he instead found the Addiction Resource Center at Mid Coast Hospital in Brunswick.
Sitting at the center on a cool fall afternoon, Yamauchi said, “I’ve been given a second chance I really didn’t deserve.”
Eric Haram, director of the center, has watched for years as his clients immersed themselves in treatment and became healthy.
In September, results of a national study showed Haram and his staff what Yamauchi and dozens of other clients at the center already knew: Patients at the Addiction Resource Center improve at twice to nearly four times the national average rate when compared with 15,000 similar programs around the country. The center’s outpatients improved at more than twice the national average, according to the study, while those in the partial hospitalization program had an improvement rate nearly four times the national average, according to the study by Harvard McLean Hospital.
The National Study on Patient Outcomes is a private study that the center had to pay to obtain.
Six years ago, the center landed a $5,000 grant to implement “medication-assisted treatment” — to prescribe Suboxone, a narcotic medication used to treat opioid dependence by reducing withdrawal symptoms, to help patients combat their addictions.
Suboxone relieves “the intense craving that drives self-destructive behavior and threatens public health and safety,” Haram said. “It removes the desperation and allows a person the dignity and time to get back in their own skin long enough to obtain skills and make needed life changes crucial to supporting ongoing recovery from addiction.”
Fear of becoming “sick” from withdrawal keeps many from seeking treatment in the first place, according to Haram. And lack of health insurance and being too “sick” to work complicates the matter.
Ed Guthro of Phippsburg tried several times to kick his cocaine and oxycodone habit, but the images of those he had watched try to beat their addictions were overwhelming.
“I didn’t want to go through it — that’s why I kept going,” Guthro said. “I didn’t want to get sick.”
While Suboxone “has been pretty vilified,” Haram said — some see it as a substitute drug — he argues that if the individual results he sees every day at the center aren’t proof, the results of the Harvard study clearly show the effectiveness of the treatment.
“It’s as basic as people who aren’t in treatment can’t get [clean], and if treatment is irrelevant and not helpful, people don’t stay,” Haram said. “Bringing medication-assisted therapy on-site provided more relevant care, as medication stops withdrawal and most of the craving, which makes it possible for the person to sit in treatment. It’s hard to stay seated in a group when you’re coming out of your skin.”
The Addiction Resource Center is funded through the Maine Office of Substance Abuse, which provides $400,000 annually, as well as by client fees, Medicaid payments and private insurance. Insurance is not required for treatment, and depending on a patient’s income, a treatment session could cost as little as $5, Haram said.
The $5,000 grant, funded by the Robert Wood Johnson Foundation through the Maine Office of Substance Abuse, allowed the center to begin treating patients with Suboxone to keep them in treatment and get them out successfully.
Keith Amato of Boothbay, who said he has “probably done every drug in the dictionary,” struggled to get clean but, without health insurance, couldn’t get into a rehab program.
Some, such as Bonnie Shippen of Bowdoinham, arrive directly after undergoing medical detoxification. Shippen began taking codeine at age 13 for menstrual cramps and, after a car accident, surgeries and an abusive marriage, found herself on morphine and eventually methadone.
Different programs at the center are focused on specific issues, such as the partial hospitalization program for those with multiple disorders, such as simultaneous psychiatric and substance abuse problems.
The partial hospitalization program, Haram said, “keeps seriously at-risk clients out of inpatient programs. Sixty percent have psychosis, suicidality or other psychiatric disorders, as well as some sort of addiction or ‘chemical coping.’ They are our most fragile. Either they’re going to go to the hospital or they’re going to die. We get them into a program so they don’t have to go to the hospital.”
Suboxone keeps patients such as Shippen, who has been clean since May, in treatment, Haram said.
“I just take the strip once a day and that’s the end of it,” Shippen said. “I don’t have to worry where I’m going to get my high from.”
But she’s still in pain from her injuries, and realizes she’ll have to cope with that pain for the rest of her life — without opiates.
Suboxone “doesn’t get me high, it just makes me feel normal,” Yamauchi said. “It doesn’t give you anything fun about opiates. I’m on it right now and I’m not high — I feel normal. It gets your mind off drugs so you can focus on what’s really going on in your life.”
Other aspects of the grant also dramatically improved the center’s outcomes, Haram said.
In 2003, clients frequently waited about two weeks to enter the program, but today, they frequently are seen within 36 hours.
“When people show up, they’re pretty broken up and … they don’t remember what [we] ask them, they remember if they had to wait, and they remember [the staff] were nice to them. There’s nothing fancy about that,” Haram said.
And he’s quick to credit his staff and relationships with community groups and local law enforcement for the program’s success.
Clients echo Haram’s confidence that the center’s approach leads to success — not for everyone, and perhaps not forever — but success nonetheless.
“I just want people to know, don’t be scared,” Guthro said. “Seek the help, get clean. Clean is good. I’m still early to this, but it’s coming back.”
“This place is a miracle,” said Amato, who has been clean now for about seven months. “Without this place, I’d probably be dead now.”