As a case manager for Bartow County’s Division of Family and Children Services (DFCS), Shawna Lewis knows firsthand just how deeply substance abuse has impacted the local community.
Yet she is flabbergasted by just how many people within Bartow remain oblivious to the issue.
“It’s always been evident, but when you have so many people in Bartow that just are not even aware of how bad it is, they don’t know how to help this,” she said. “For DFCS workers in the state, we had to go through mandatory training for substance abuse, every worker did. Because when you don’t have that addiction … you can’t understand.”
A steady drumbeat of research demonstrates just how severe the community’s substance abuse problem has gotten.
According to Georgia Department of Public Health (DPH) data, Bartow County had the third most overdose-related emergency department visits in the state last month.
In a 2016 DPH opioid overdose surveillance report, Bartow ranked fourth in the state for both opioid-involved overdoses and opioid overdose-related hospitalizations, among the state’s counties with fewer than 15 deaths.
And according to data presented by Cartersville Medical Center emergency medicine physician Dr. Garrett Gore, more than 100 people died from fatal overdoses in Bartow County between 2010-2015 alone.
Despite those cold, hard numbers, Bartow Give a Kid a Chance Director Barbara Hoffman said that many members of the community still consider discussion of substance abuse as taboo.
“For hundreds of years, it’s basically been believed that someone with an addiction problem is morally depraved, that they have character flaws,” she said. “Somehow, they’ve been labeled that they’re unworthy. There has become such a shame attached to addiction, embarrassment, almost.”
That stigma, she said, invariably makes circumstances worse — not just for those with substance abuse issues themselves, but their families as well.
“It’s just not out there, the magnitude of the problem we have in Bartow County,” she said. “And the families isolate themselves. So you’re not only dealing with this son or daughter with this addiction, you’re dealing with it largely alone … who are you going to talk to who understands what you’re going through?”
That’s something a small but dedicated group — comprised primarily of nonprofit representatives and members of social service agencies — is trying to address in the local community through a new grassroots organization, Recovery Bartow.
“There’s about six to eight of us who are a part of the team, I guess you would call us,” Hoffman said. “We’re hoping to bring a recovery community organization (RCO) through or with the Georgia Council on Substance Abuse (GCSA) here to Bartow.”
The RCO, Hoffman continued, would be similar to Rome’s Living Proof Recovery Center.
“We wouldn’t be like an inpatient treatment facility, we don’t do clinical diagnoses or anything like that. It’s more of a resource hub,” she said. “For instance, one of our goals would be to work with employers in the county who would be willing to hire people who are in recovery and working with us at the center and give them a chance at a job.”
The RCO would also make referrals to counselors and physicians and direct individuals to other services, such as halfway houses and sober living facilities.
But the RCO would also seek to provide simpler services to members of the community, such as recruiting people to drive those going through recovery to job interviews and their places of employment.
“You’re broke, you’re probably homeless, you can’t drive,” Hoffman said. “So how are you going to get to work?”
From a service provider perspective, Bartow Collaborative Executive Director Doug Belisle said it’s just as important to prevent agencies from siloing as it is keeping families going through substance abuse problems from isolating themselves.
An RCO program such as the one proposed by Recovery Bartow, he said, would show them how to make referrals — and to whom — and provide access to a directory of assistance groups and programs throughout the community.
“Those families require all sorts of different services, and having something like what we’re talking about would provide wraparound services, so that it’s not just one thing, but it’s connecting people to a variety of resources for the multiple needs that are connected with addiction,” he said. “The emergency room, I think, is the No. 1 referred place for addiction. Which is crazy, because really all they’re going to do is test you — they’re going to do what an emergency room is set up to do, they’re not set up to be an addiction recovery place.”
Donnis Steele, president of Hopewell Family Centers, said that kind of linkage is much needed within the community.
“That connection piece is what makes the difference in those who make it and those who don’t,” he said. “It’s the people helping them along the way to get them through this.”
Hoffman said the problem in Bartow isn’t necessarily a lack of resources, but a lack of connectivity between programs, services and organizations targeting substance abuse issues.
“We have a lot of resources available. The issue is that we’re not real good at communicating those resources among ourselves, among the nonprofits, as well as to the community out there that needs them,” she said. “And that’s something that we would definitely do there.”
That’s why a partnership with the GCSA is so vital, Belisle said.
“We’re not the first ever RCO, and to have connections with other RCOs all over the state, with other organizations, is going to be very helpful, because we don’t have to reinvent the wheel, we just have to figure out how to partner better with the services that are here and we have to figure out how to get services here that don’t exist yet,” he said.
When it comes to referrals, Lewis said she often struggles to find places within the community to send families needing assistance.
“With our inpatient, most of those have to go outside of the county, unless they’re able to go to Mercy House,” she said. “If they don’t have families that are pretty wealthy to be able to give them the money to go to these things, then they have to find the resources that people like us are able to say ‘Well, there’s actually some different support through scholarships and things that can be received.’ But most people in the community don’t know that, unless they have linkage through someone like the Bartow Collaborative and other meetings.”
But even for clients who can find such programs, Lewis noted that extensive waiting lists remain a hindrance.
“When they do make that decision and then they say they have two months they have to wait, that’s a long period of time,” she said. “I had two moms on my caseload who died waiting on beds in the past.”
Making things even more arduous, she said many programs refuse to accept patients who haven’t first gone through detox programs.
“A lot of these places, like Mercy House here in Cartersville, in order for you to get there, they’re not just going to let someone come there that just calls and says ‘I’m addicted and I need to come,’” she said. “You have to go through detox, because there’s so many different medical things that can happen when you’re detoxing.”
But as Belisle noted, just going through detox isn't enough to change an individual’s behavior.
“It doesn’t deal with new coping strategies,” he said. “Effective rehab is 12 months or longer, and includes services for the families and aftercare.”
The State, Hoffman said, does have strong peer-support programming.
“Those who are in long-term recovery, which they consider a minimum of two years — ideally five years or more — who want to come alongside someone seeking recovery or in early recovery, they have a 40-hour training program and an extensive interview process,” she said. “If you’ve got somebody coming out of jail and they don’t have anywhere else to go, they could go to the recovery center and hook up with a peer coach who will then walk alongside them for however long.”
Addiction recovery programs, she contends, need to be individually tailored in order to be successful. She said that a diversity of counseling methods — such as motivational interviewing and Self-Management and Recovery Training (SMART) programming — could be employed to help individuals find the best approach for addressing their own personal circumstances.
“Most of your treatment programs are twelve-step based, and it’s kind of a one-size-fits-all deal,” she said.
But as Great Promise Partnership Northwest Regional Coordinator Janet Queen observed, many individuals battling substance abuse in the community never join any recovery programs at all.
“I think in the beginning, everybody thinks ‘I can fix it myself — this is a small little problem and we’re going to keep it right here among the family and we’re going to fix it,’” she said. “Well, it’s already broken by the time it’s apparent you’ve got an addiction problem. And once you’ve got an addiction problem, it is a family problem.”
Yet as Steele noted, there appears to be just one “recovery” option that’s available — 24 hours a day, seven days a week, 365 days a year — to all Bartow County residents.
“They can detox in jail,” he said.
A systemic issue
“We are not going to arrest our way out of this drug crisis,” Hoffman said. “Incarceration seems to have been the default solution. The War on Drugs has become a war on families. It’s not just the individual with the addiction who suffers, it is devastating families.”
Not that incarceration even guarantees those with drug problems will be deprived of such illicit substances, Queen said. “The access,” she said, “does not stop just because the door is shut.”
Hoffman noted that there are recovery centers that have specially trained personnel, who go into jails and set up inmate recovery programs.
“We need that here,” she said. “Our jail is filled with drug-related felons.”
DFCS isn’t without its own structural problems, Lewis added.
“When those parents come in and we are removing their children due to certain situations, a lot of times they don’t want to work with us,” she said. “Most of them don’t have jobs, especially when their kids are removed. They’re having to do so much stuff for us that it gets in the way of a lot of those things.”
Indeed, Belisle said he believes the substance abuse crisis touches virtually every sector of the Bartow community.
“If we can get a handle on this and provide some resources surrounding this, we’d really begin to see the needle move in a lot of other areas that we’re fighting, from poverty to child welfare to education,” he said.
Such is evident, he said, when examining the difficulties numerous employers throughout the county are experiencing when it comes to labor recruitment and retention.
“We’ve all heard employers say ‘If I could just get somebody who would show up and could pass a drug test,'’’ he said. “It’s affecting the business community because they can’t find workers for jobs, so economically, that’s costing our business partners and us as a community.”
Substance abuse, he continued, impacts the education system — directly correlating with high school dropout rates — and the local health care system in terms of emergency room overload. And then there’s the burden placed on taxpayers, as incarceration and judicial system costs continue to climb upward.
Distressingly, Lewis said the individuals succumbing to substance abuse are getting younger and younger. She recalled hearing of middle schoolers taking Xanax, and even drinking copious amounts of cough syrup for a cheap high.
“The amount of money that we spend from the child welfare aspect, it would blow your mind,” she said. “When people get addicted, when they get to a certain point … they can’t even give it up to get their own children back.”
So pronounced the local problem, she said there have been times when DFCS has been unable to place a child in the home of a relative, because a family member without a substance abuse problem could not be located.
A proponent of Trust-Based Relational Intervention (TBRI) programming, Lewis said she would like to see service providers place a greater emphasis on addressing traumatic episodes as a root cause of substance dependency.
“Some people, they do it recreationally, but then it usually goes into an addiction that they’re not able to fight,” she said. “It’s about trauma, and how trauma has changed their lives … we see two year olds and three year olds constantly acting out because of the trauma.”
The crisis is even impacting churches and nonprofits. Steele said he’s heard of several food banks being overwhelmed by the demands of families disrupted by substance abuse.
“They’re living in environments where drugs are so plentiful, they just can’t get out of it,” he said. “We’ve got to fix the housing piece.”
And there, Queen said she sees a crucial intervention point for local churches.
“I think that’s where the faith-based community is going to be crucial in this fight against drug addiction,” she said. “Sometimes, the pastor is the first person who knows that there’s a problem in the home.”
That’s a role that some churches are already taking on, Steele said.
“I had a church willing to sponsor a mother into a drug rehab that is a 12-month program, not a three-month program or a nine-month program, because those are just very minimal. They just basically go through detox and then they get out,” he said. “I believe the faith community can actually adopt that.”
Perhaps the most palpable social consequence of the substance abuse epidemic, however, is an uptick in crime throughout the county. Indeed, Cherokee Judicial Circuit District Attorney Rosemary Greene remarked last year that she believed that 85%-90% of all crime throughout the circuit, in some manner, is drug-related.
“I don’t mean that it’s a drug offense, but most of these sex offenses, property crimes, person crimes, have underlying substance abuse issues,” she said. “We see it all the time … you see people breaking into homes in order to sell things, stripping air conditioners down for that — it is a huge problem that just covers everything we do.”
Such is bound to intensify, Lewis said, as long as the community continues to overlook that deep-seated social issue.
“People on Facebook, they’ll be talking about the crime,” she said. “It’s only going to get worse if we don’t look at it and help.”
The next step
On April 25, Bartow Recovery will host a listening session at First Presbyterian Church, 183 West Main St. in Cartersville, at 6 p.m. Representatives from the Georgia Council on Substance Abuse will be on hand for the event.
“It’s about a two-hour presentation,” Hoffman said. “They basically come in to gauge what kind of interest the community has in bringing this to Bartow County. They want to see a broad spectrum of community stakeholders — justice, police, sheriffs, hospitals, EMTs, fire department and DFCS — anybody that’s got anything to do with drugs and addictions, as well as people in recovery, seeking recovery and families that are impacted by alcohol or drug addiction.”
A big turnout, Belisle said, would certainly help Recovery Bartow make some pivotal inroads into the GCSA.
“Having the community show out at this listening session is important, and I think it gives recognition to the fact that we realize that this is an issue that affects all of us, even if I don’t have addiction in my family,” he said.
If there’s enough interest generated by the listening session, Hoffman said the next step is a GCSA-assembled community symposium. “That takes two to four months to plan and pull that together,” she said.
The third step would be a community visioning meeting, at which point the process of establishing an official 501(c)3 organization — as well as the search for a physical center location — would begin.
“It can take anywhere from six months to two years, depending on the community,” Hoffman said.
The RCO, she said, would serve many functions for the community. But one of the most important, she said, would be its role as a "reliever" of sorts for the caretakers of those with substance abuse issues.
“Sometimes, families don’t have the money to get treatment, or they’re just exhausted,” she said. “If a family just can’t handle it anymore, send them to the RCO and let us find somebody else who can walk alongside them.”
More information on the organization and its efforts to bring an RCO to the local community is online at www.recoverybartow.org.