Sept. 16 2015 02:08 PM

A cautionary tale from the front

Eric Pavona had the world in his hands when he graduated from Okemos High School. He had high college entrance test scores, he’d been working and saving money, he had scholarship offers from numerous universities and colleges, and he owned his own car and paid his own insurance.

His father, Phil Pavona, was proud of his only son. Eric accepted a scholarship at Ferris State University. For the next three years, he seemed to be on track for a bright future.

“As a parent I did the wrong thing,” the elder Pavona, 58, said. “I put a line through my kid and went onto the rest of them. I figuried the kid’s 21 years old, he’s pretty much got the world by the tail.”

Little did Pavona know then, but it was his son whose tail was in grasp of a strong menace. His son’s future was as a statistic in Ingham County’s surge heroin and opioid related overdoses and deaths.

Pavona, 25, was one of nine heroin-related deaths in Ingham County in 2011, according to Elizabeth Reust, forensic pathology supervisor at Sparrow Hospital. That compares to 19 thus far this year, with 47 autopsies pending as of Tuesday. The death totals were 18 in 2012, 17 in 2013 and 28 in 2014.

Eric was 25 when his younger sister, Colleen, found his cold body on the sofa in the basement of the family home. A syringe was on a table near him. He’d overdosed — the third time since he had begun using heroin.

The Pavonas worked with their son and a system the patriarch of the family described as “fractured” to attempt to help their son overcome his addiction. They found a system unable to help the family.

At 21, Pavona decided to change his major and transfer to Michigan State University. He went from studying pre-pharmacy to accounting.

It was at that time that something happened that changed the trajectory of his life.

Somewhere, somehow, Eric was introduced to heroin. His father thinks it happened in student housing in East Lansing.

“He spent a lot of time down there,” Pavona said. “We didn’t really pay any attention.”

Pavona had paid for Eric’s first semester at MSU. Eric, however, had a different idea. He dropped his classes and used the refund cash to buy drugs. His family was unaware of it.

The first inkling Pavona had that his son was in serious trouble was when the young man was arrested. He told his father East Lansing police had gotten him on an alcohol charges.

“His story to us was that he got, you know, picked up with booze at MSU — which is a story almost every parent who has a kid who goes to MSU can tell you,” Pavona said. “He blew it off as no big deal. He was going to take care of it.”

The father went to court and found his son’s name on the court docket. His charge had nothing to do with alcohol — he’d been charged with possession of controlled substances.

“That began our journey,” Pavona said. East Lansing Police had pulled him over when they found Eric driving “kinda weird,” Pavona said. A subsequent search of Eric’s car led to the discovery of heroin.

As Eric’s life spiraled out of control, his family searched frantically to find him help.

“We had no idea what to do,” Pavona said. “It was so foreign to us.”

The senior Pavona worked at a local hospital. Using that position, he was able to open doors for his son more quickly than most parents could. But it wasn’t enough.

“As many connections as I had over those next couple of years, what I found behind those doors was really poor. That doesn’t mean there weren’t good people — there really are good people in each of those systems,” he said. “But it’s fractured, broken, nobody talks to each other, it’s not safe — there’s just a whole wide range of issues that are problematic for the addict and their family.”

The Pavona family’s experience is not uncommon for those struggling with heroin addiction and their friends and loved ones trying to help them. Pavona said the systems were in “silos,” though, he said, that is changing.

From his experience, care providers were not coordinating care. Services were available but not everyone knew where to send a person in recovery for health care needs or housing. And when Phil asked about various ways to link those services, he said he was met with “blank stares.”

He recalled when Eric was released from the Ingham County Jail early in the morning. He came home, and the family was certain they would have time while Eric relished in the freedom of not being locked behind bars. They were wrong. The following day, Phil heard a thump — the sound of something large hitting the floor in the family’s upstairs bathroom. He went to the door and found it locked. Knocks on the door resulted in no answer. He began to break the door down, and saw his son on the floor, unconscious. After beating the door down with a sledgehammer, he got to his son and found he was not breathing. He’d overdosed.

When he met with jail and probation officials about the incident, he was told he was “lucky” because his son had survived. He was also informed, for the first time, that the first 36 hours after an addict is released from treatment or jail is the time they are most risk for relapse and subsequent overdose.

“I said, "Why didn’t you tell me that?” he said. “They just looked at me with that blank stare. I told them that was information we probably needed to know.”

But the silos that Phil experienced are beginning to break down.

Helping lead that change is Wellness Inx, a treatment and medical case management program for those seeking recovery from drugs and alcohol addictions is located in a nondescript professional office on Holmes Road. It is licensed to provide services to up to 160 people in recovery at a time, delivered in what medical and recovery circles call “wrap around services.” It means that staff work with those in recovery on medical care, housing, food, disability and other issues to create a stable life which will foster recovery. The agency also offers 12-step programs to support those in recovery and one-on-one counseling services.

The Community Mental Health Authority of Clinton, Eaton and Ingham Counties continues to be a part of the solution. Ericanne Spence, director of substance abuse services for Community Mental Health, said beds are available for heroin treatment in the county. Right now, there are at least 75 beds in residential treatment facilities. If those fill up, more are available outside Ingham Country through a network of providers.

There are different components to overcoming a heroin addiction. First a person has to detox. Those addicted to other drugs as well as heroin may need to be medically monitored during their detox process.

Then they need treatment, where they learn to live life without the drug.

Deborah Smith of Wellness Inx acknowledged that a key hurdle is getting the addict to want help, but there remain holes in the system.

Among them is a lack of medical management of detox for those addicted to multiple drugs. While there are local heroin detox programs, there is not a facility in the county which does management for complicated detox situations.

“The detox that we have here can’t do medical monitoring,” Smith said. “They do a wonderful job for people who can fit into their scope of practice. One of the issues with their scope of practice is that many of the clients that out there that are heroin addicted are also using benzodiazepines.”

Stopping benzodiazepines requires medical management because stopping the drugs abruptly can cause the body to shut down.

The only medical monitoring detox facilities are outside the county. A Saginaw-based program is preparing to launch a medical detox — but it will be for women, specifically pregnant women.

Even if a person completes a detox and treatment program, there is another issue that comes into play — transitional housing, said Alina Branscombe, a case manager at Wellness Inx. Without that housing, recovering addicts are returned to the same living conditions they were in before they detoxed — and that is not helpful for recovery, she said.

She said there simply is not enough transitional housing in the area for recovering addicts, and this complicates recovery.

To address that issue, Wellness Inx. brings all the possible players in a recovering person’s life to the table in a holistic approach to addressing the problems. That means the look at housing, and medical care needs and employment needs and try to find solutions as a team. It’s much the same way physicians dealing with a complicated medical issue — say diabetes, heart disease or HIV — coordinate care.

“The client themselves create what their goals are going to be, what they want to get out of case management in nutshell,” said Branscombe. “We create a plan. A plan for each area of your life, and we start going down the list of goals.”

Early on, she said, clients work to identify simple goals — for instance, spending three days a week at Michigan Works trying to find employment. Those simple goals help the client achieve something, which is essential in the process of rebuilding a life from heroin addiction, which is often complicated with run-ins with the law, and sel-festeem issues for the addict themselves.

In addition to working on goal setting and bringing all the care providers together, peer support is important to facilitating recovery, the experts said.

At Wellness Inx, the experts have created peer facilitated and led groups. Group leaders are themselves recovering and act as coaches for other struggling with addictions. Pavona has taken that training and used it and his own experience to help families struggling with loved ones in treatment and recovery.

Despite the ongoing obstacles, Pavona, who started and runs a chapter of Families Against Narcotics, said there have been improvements in the intervening five years since he struggled to get his son care.

“I’m very hopeful of many things that are happening in the community now,” Pavona said. “What used to be absolute roadblocks are now question marks, at the very least. And when they’re question marks, you know, people have an open mind about thinking outside the box. And beginning to do something different than what they were doing before, because what they were doing before didn’t work.”

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