New program creates safe space in Floyd County for initial substance withdrawal

StepOne Service, which started at Baptist Health Floyd in early December, creates a safe environment for people in acute withdrawal to get through the uncomfortable and often dangerous or life-threatening side effects of alcohol or opioid withdrawal, under medical supervision.

During the 72-hour stay, patients are monitored and given treatment for symptoms from physicians and nurses trained in the specialty. While there is no direct counseling during the visit, a care coordinator helps get them set up with treatment plans for after the initial and often most-intense period is over.

“What I hope is that people will use this as a first step in changing their lives,” said Debi Bennett, director of the StepOne program at Baptist Health Floyd. “That it will help people with a pretty severe substance disorder to get connected to treatment that can change their lives. This can be the first step in doing that.”

The program is voluntary, and calls for a person who is actively choosing to try to change their situation. Insurance is required.

“It's for people who are ready to do something different,” Bennett said. “People who have the motivation [and say] 'this isn't working for me.'”

She said this can be especially true for those addicted to opioids; they may put off trying to quit because the detox process can be so intense.

“Especially in the latter parts of their addiction, heroin addicts don't enjoy being a heroin addict,” she said. “It's a very difficult, daily grind. They want to stop, they want to change, but what prevents that a lot of times is the physical withdrawal process, so they seek to avoid that at all costs.”

These initial withdrawal symptoms vary based on the substance and the individual. While opioid withdrawal can be much more uncomfortable, severe alcohol withdrawal can be more deadly, and the risk goes up if there are other health conditions.

“With heroin withdrawal, it's like a really severe case of the flu,” she said. “Diarrhea, nausea, vomiting, severe muscle aches, cramping, sweating — you're miserable."

Alcohol can cause some of the same symptoms, with maybe less body aches. But added are the higher blood pressure and the potential for seizures, Bennett said.

Individuals who are interested will first talk with Andrea Trautwein, the patient care coordinator. Preliminary information can be taken over the phone, so when patients arrives, they can quickly get to a bed and start their stabilization process. This can happen in the same day, Trautwein said.

Part of this screening can help identify what the individual's goals are after the hospital stay. The StepOne team is ready to help set up patients with continued addiction treatment if that's what they want — getting appointments set before they even leave the hospital.

“Simply coming in here and withdrawing and leaving is not a good plan,” Bennett said. “They walk out of here with the same life problems and issues that they came in here with.

“That's why treatment is absolutely critical in the healing process.”

And Trautwein said that approach can look different for everyone.

“There are a number of places they can go and it really depends on the style of treatment they're interested in,” she said. These may include residential programs, intensive outpatient therapy, partial hospitalization or therapy sessions and addiction meetings.

“We try to tailor that to their needs, their availability, their locale and their insurance,” Trautwein said. “We just work on what's best for them.”

Dr. Tom Harris, Floyd County health officer, said that from a public health perspective, this is a good thing.

“We're happy to see that and think it's a valuable asset to the community,” he said of the inpatient detox program. “If you talk to people about quitting, withdrawal is one of the things that everybody dreads. Nobody wants to feel bad.

“They get you through the worst of the withdrawal and do it in a medically supervised manner, and if it introduces people to get treatment, that's a good thing, too.”

While Harris sees value in the StepOne program, he'd like to see something similar offered to people without insurance.

“A lot of people with addiction problems don't have insurance,” he said. “There are other treatment options in the community that will treat you without insurance, but in the long run, we would probably benefit if we had more services like this.”

MeriBeth Adams-Wolf, executive director of Our Place Addiction and Education in New Albany, said the program helps fill a hole in addiction treatment services available in the area.

“It's definitely needed,” she said. “There is a need for continuum of care and [this] helps shore up that gap.”

She said the opportunity for a person to get help becoming physically stable, while in a controlled environment, can be a big push toward their recovery success.

“What happens sometimes is you'll get folks who get midway through the withdrawal process and they give up and use again, or they'll reach out to another drug to help calm the withdrawal symptoms,” Adams-Wolf said. “And so they end up kind of defeating the purpose.”

She said the need for insurance does limit the people the new program can help, but it's a step in the right direction.

And the post-withdrawal treatment that StepOne connects individuals to is key to helping them sustain their sobriety, Adams-Wolf said.

“That person still has to take the responsibility for self-care, but at least they've been put on the path," she said. "The connections are made, and so now it's up to you — you've got to follow through.”