Wo­man vol­un­teers af­ter sis­ter’s opi­oid death

Baltimore Sun Sunday - - NEWS - By Kelly O'Con­nor

To­day is my first visit to an out­pa­tient ad­dic­tion treat­ment cen­ter. On my way to Bal­ti­more’s Con­certed Care Group (CCG), my Uber driver warns me, “This is a danger­ous neigh­bor­hood.” It’s lunchtime on a cold Fri­day af­ter­noon in March, and I’ve taken a va­ca­tion day from work to come in from Wash­ing­ton, D.C., where I live.

My driver drops me at the gas sta­tion next door to CCG. I walk to­ward the en­trance and am greeted by a friendly, armed guard en­ter­ing the build­ing. Just past the re­cep­tion and guard desks that flank the front door is a large wait­ing room with sev­eral empty chairs. It’s bright and clean. A bank of win­dows lines the right wall with peo­ple sit­ting be­hind glass like bank tell­ers but with big cur­tains at each win­dow. I check in and have seat against the back wall. I try not to stare, but I won­der about the cur­tains.

The opi­oid cri­sis has dev­as­tated my fam­ily, but I’m not here for treat­ment. I’m vol­un­teer­ing. My sis­ter, Jenny, died last year from cir­rho­sis of the liver from al­co­holism and opi­oids. She was 44 — a col­lege-ed­u­cated, mid­dle-class sub­ur­ban mom. I ex­pe­ri­enced the en­tirety of her ad­dic­tion, strug­gle and death in six days last July. Our fam­ily was close and saw each other of­ten, but we didn’t know Jenny had sub­stance use dis­or­der.

Ev­ery day since her death I feel an over­whelm­ing sad­ness and al­most de­bil­i­tat­ing re­gret that I did noth­ing to help her. I’m so ashamed of my­self.

I look around the wait­ing room at pa­tients com­ing and go­ing, but no one is wait­ing; ev­ery­one who comes in is served im­me­di­ately. I as­sume they are low­in­come Med­i­caid re­cip­i­ents based on their cloth­ing — and I’m sure my own un­con­scious bias. A few have bat­tered sweat jack­ets with hoods up and their heads down, so I can’t see their faces. A young wo­man check­ing in has the skin­ni­est legs I’ve ever seen, like two pen­cils in col­or­ful, leop­ard-pat­terned leg­gings. She wears big hoop ear­rings and dark lip­stick and has friendly ban­ter with the armed guard. I am sud­denly self-con­scious about my Stella McCart­ney bag and warm cash­mere coat. I feel like a jerk.

My fam­ily’s story feels dif­fer­ent from this, no worse or bet­ter, just dif­fer­ent. I don’t know this world of sub­stance use dis­or­der since I only ex­pe­ri­enced it for six grue­some days in a hos­pi­tal watch­ing my sis­ter die while moan­ing for Di­lau­did (a syn­thetic opi­oid).

I’m here to­day to run a work­shop about man­age­ment meth­ods I’ve learned while work­ing at the United States Dig­i­tal Ser­vice. Us­ing ma­te­ri­als from a class I teach at Ge­orge­town, I’ve planned a 2-hour ses­sion with the CEO, Dr. An­drey Ostro­vsky, for his 15-per­son CCG man­age­ment team.

An­drey greets me with a huge smile and gives me a tour. I learn the cur­tains are for pri­vacy while pa­tients take their med­i­ca­tion at the win­dow. An­drey ex­plains they have plans for a bet­ter set-up, but for now it’s a fast, ef­fec­tive way to serve more than 800 pa­tients a day. As we walk through the halls, there are graphs taped up on walls plot­ting data with per­for­mance met­rics. The place feels more like a Mid­west tech startup than an in­ner-city health care clinic.

I learn that CCG of­fers ad­dic­tion treat­ment (with no wait times), be­hav­ioral health, pri­mary care and other wrap­around pro­grams like GED classes all in one lo­ca­tion. This seems like com­mon sense: What’s the point of get­ting off drugs if I don’t have a job, place to live or the men­tal health ser­vices I need?

Our work­shop is in the CCG build­ing next door. The con­fer­ence room has glass doors and a large TV mon­i­tor I hook up to my com­puter. The walls are cov­ered with stick­ies, like a team from Ap­ple or Google has just fin­ished a work­ing ses­sion here.

The work­shop is great. We work in rapid, it­er­a­tive cy­cles, and ev­ery­one is en­gaged as we go through team ex­er­cises on ag­ile de­liv­ery, de­sign think­ing and min­i­mum vi­able prod­ucts. They are a tal­ented and ded­i­cated team, and I am grate­ful they let me be a small part of their work.

We fin­ish the work­shop, and as An­drey walks me back to the wait­ing room, he tells me about his daily neigh­bor­hood “walka­rounds.” Yes­ter­day was a good one, be­cause one of his clients was in­volved in a “jacket-only” stab­bing, so no one was hurt. His op­ti­mism is gen­uine and con­ta­gious, and for the first time since I started re­search­ing the opi­oid cri­sis last year I am not hope­less about our na­tional re­sponse, be­cause small groups of thought­ful com­mit­ted cit­i­zens like An­drey and his team are go­ing to fix it.

If we ap­ply an in­no­va­tive and pa­tient­cen­tered ap­proach like CCG’s at a na­tional level to im­prove treat­ment and re­cov­ery, we can do a lot with the $3.3 bil­lion re­cently ap­proved in the om­nibus for the opi­oid cri­sis (which is es­ti­mated to be a $504 bil­lion prob­lem by the White House Coun­cil of Eco­nomic Ad­vi­sors).

But treat­ment and re­cov­ery is just one swim lane of this cri­sis. Our na­tional plan needs to pro­vide lead­er­ship and re­sources for all the lanes: health pol­icy, ed­u­ca­tion, preven­tion, treat­ment for crim­i­nal jus­tice pop­u­la­tions, harm re­duc­tion, med­i­cal school cur­ricu­lum up­dates, train­ing for nurses and phar­ma­cists, law en­force­ment re­form, and mon­i­tor­ing and sur­veil­lance.

As I’m wait­ing for my Uber home in the CCG lobby, I notice a sign next to me in dif­fer­ent color mark­ers with big artsy let­ters advertising a pro­gram for “Women Who Want to Change Your Life” on Satur­days from 9 a.m. to 10 a.m. I won­der if the skinny-legged girl will be there. The sign is so pos­i­tive and invit­ing. I want to go. I want more than any­thing to go with my sis­ter.

And then I re­al­ize my fam­ily’s story isn’t dif­fer­ent at all.

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