WINTER 2022
THE PAIN OF DRUG DEPENDENCY radiates through society like a shock wave, starting with the user and working its way outward to family and loved ones, to the community, and beyond. It’s a vast problem, and to fix it requires a major effort aimed at counteracting the social, economic, and public health conditions that lead to addiction.
For those who have been hooked, however, the focus is different. Theirs is an individual agony, and getting unhooked requires an arduous process of self-examination and the will to overcome personal demons. The choice – between the temporary, self-destructive relief of getting high and the positive but at times painful journey of recovery – must be lived every day. Overcoming addiction calls for immense courage and determination.
It also calls for help. Substance dependency is a medical issue with deep psycho-emotional implications. Virtually no one can beat it on their own, and in addressing the problem we can’t afford to hang onto myths – such as the notion that substance abuse is chiefly an urban problem. The opioid explosion of recent years has corrected that stereotype. In suburban and rural areas, far from the urban centers, the sense of isolation for an addict can be crippling, and social services may be hard to find. A remote, idyllic landscape can look hopelessly bleak through the lens of addiction.
In just such a place – the Sullivan County village of Monticello, in the foothills of the Catskill Mountains – the Residential Treatment Program of Catholic Charities of Orange, Sullivan, and Ulster (CCOSU) shines a beacon of hope.
Decades ago, Sullivan County was at the epicenter of a thriving tourism mecca. Dozens of sprawling resorts brought thousands of visitors to the region each summer. In the second half of the 20th century, however, the area’s big resorts began closing one by one; the local economy has never recovered. In Monticello, more than a quarter of the population – and almost half the children – live on incomes below the poverty line. Overdose deaths in the county have increased more than tenfold in the past decade.
The CCOSU campus in Monticello, on a quiet street near the center of town, consists of a modest cluster of wood-frame houses and two-story brick buildings housing administrative offices, a crisis center, a residential treatment unit, a separate “halfway house” for clients re-integrating into the community, and a large outpatient clinic. When the weather is good, a small yard affords clients fresh air and space for outdoor recreation.
At the edge of the alley outside the entry to the main intake building, a chain-link gate, suspended from a horizontal two-by-four and spray-painted blue, is hung with an array of padlocks and blue ribbons. Beside the gate, in black lettering, a plywood sign says:
PLACE A LOCK ON THE GATE
FOR A LOVED ONE LOST
DUE TO OPIOID ADDICTION.
At the bottom of the sign is a stylized cross with a single word written inside: PRAYERS.
This is no posh rehab facility. You won’t be reading about celebrities detoxing here. What you will find is a caring staff providing medical treatment, social and emotional counseling, and post-release support to people afflicted with substance use disorder, regardless of ability to pay, insurance status, or religious affiliation. You’ll also find an abundance of love and respect for the dignity of every individual who comes through the door. In this quiet way, without proselytizing or excluding anyone, CCOSU bears witness to the mercy of Jesus Christ.
Typically, clients enter the Residential Treatment Program via the crisis center. Some simply walk in and ask for help; others come at the suggestion of a friend or acquaintance, or on referral from a hospital emergency room. One of the CCOSU mobile teams may refer (or bring in) someone from the community for care; and some clients arrive with a parole- or probation-related treatment mandate, usually stemming from an arrest for possession or sale of narcotics.
“Somebody might need detox,” says Karen Milazzo, clinical director of residential services for the program, “or somebody might be in crisis, where they feel they might be at risk of relapsing. They don’t have to actually have used recently. They could just be saying, ‘You know, I feel like I’m going to start drinking again, or I’m going to use drugs again.’ That’s a situation where definitely we’re going to take them in. We take people with or without insurance, so there’s no turning anybody away. We’re looking to really help the community.”
On arrival, clients are tested for Covid and then assessed by a clinical team. “We use various assessment instruments to see what level of care we need to put them into,” Milazzo says, “whether there’s any depression or anxiety, what substances they’re using, how severe their use is. This tells us if we need to maintain them at a supervised level or if we can just put them right into our stabilization unit.”
Clients at the supervised level remain in the crisis center, where the medical team helps them through the process of withdrawal. Once withdrawal is complete – or in cases where it’s unnecessary – clients move into stabilization as outpatients or in the Residential Treatment Program.
“When they come in to the residence, we try to address their needs and help them with whatever struggles they’re having,” Milazzo says. “We get them busy and engaged right away in structured groups, structured programming. On the front end, our groups are geared toward education about the drugs, what it’s doing to their bodies, and motivating them to continue treatment. Mostly it’s the other clients, their peers, that help them feel comfortable so they can start to open up.” Later on, groups and counseling sessions focus on the personal issues that led to substance abuse, and developing habits and attitudes that will help with staying clean in the future.
“We have a complete continuum of care,” says Amy Kolakowski, chief clinical officer for CCOSU – “from medically supervised detox to the situational crisis where a client needs someone to give them a little bit of help and a safe place to work it out.” In addition to the residential program, outpatient options include daytime rehabilitation, which patients attend five days a week, as well as evening care. Mobile teams consist of a clinician and peer advocates who reach out into surrounding communities to offer counseling or help connect people to needed services.
CCOSU also works collaboratively with one of the area hospitals to serve emergency room patients in need of follow-up substance use therapy. “Say someone goes in and they have overdosed,” Kolakowski says. “We can send a mobile team to help them come into our detox unit, or we can set up medication-assisted therapy, where they’re referred to one of our physicians to provide for their medical needs while we work to support the individual or their family in the community.”
The clients at the Residential Treatment Program range in age from young adult to septuagenarian. They represent all races, cultures, and religious backgrounds, but they share the challenge of substance use disorder.
“My drug addiction started when I was 31 years old,” says Joseph P. “I was a business owner in Newburgh. I owned five auto repair shops, and I smoked them all up. Smoking crack. I wound up on the streets of Newburgh using for 10 years.”
Now 70, Joseph has been in and out of jobs between time served for drug possession charges over the past four decades. In the 1990s he opened another car repair business, only to lose it when he succumbed to addiction again.
Most recently, he relapsed in May 2021. “I couldn’t go on anymore the way I was doing. I was using drugs every day after I relapsed,” he says. Fortunately, he had a neighbor who told him about Catholic Charities in Monticello. “He saw how I was living, and he approached me one day. He says Joe, call this number. And when I called the number I spoke to Rodney [in the crisis center], and I packed a bunch of clothes and took a cab up here the same day.”
Joseph feels hopeful now. “I learned a lot about myself in here. A lot of why I was doing what I was doing.” He hopes to stay in the program until March, and after that he plans to look for a part-time job. His dream is to go back into business someday. “But first I have to address my addiction, make sure I’m stable and ready to go out there.”
For now, he’s going to church every week and praying for success finding a network of sober friends. He has applied for housing in Monticello, Newburgh, and Kingston – but he’s hoping he can stay in Monticello, near his supporters at the Residential Treatment Program. “If I stay up in Monticello, it would be good for me,” he says. “Catholic Charities has helped me a lot.”
At the opposite end of the age spectrum, Taylor C. is 24 years old. She grew up in a nearby town and had only been in the program a couple of weeks when we spoke to her. She came in because she was using cocaine and heroin and couldn’t seem to stop on her own.
“My mom is a user,” she says. “She had moved out of my current house. I ended up having to clean everything, and unfortunately I just was not strong enough to say no.” A friend who had been in the program at CCOSU and has now been sober three years recommended the program to Taylor. “So I called here, actually, asking if it was OK if I came, because I needed a little help, and I couldn’t do it on my own. And they were really great. They were very nice.”
After a week in the crisis unit, Taylor was moved into the residential program. At first, she found the counseling and group sessions intimidating. “When I got here I didn’t want to participate, I didn’t want to share anything. A lot of what helped me was the acknowledgment that some staff had also had an issue at one point. They’re not just here saying one thing as a counselor. They’ve experienced it themselves. That encouraged me to actually start sharing. I hate talking about my feelings . . . and I’ve been talking about them quite a lot lately. Feeling things is scary, and I’ve been encouraged to face that.”
One thing that helps give her courage is the genuine concern that the counselors show. “The staff really care. When you’re down on yourself, you gotta knock it off because they’re not going to allow you to beat yourself up. They’re not looking at what you did, they’re looking at where you are now.”
This support is helping her rediscover her passion for learning. “I love school. I was in college for a few semesters for human resources. I was taking ethics, psychology, sociology. Those things interest me a lot, and I’ve been reading about them a lot here. After 90 days of being sober, the vocational ed counselor is going to help me get access to VR [vocational rehabilitation], and that way I can go back to school. I love learning things, I love knowledge.”
She also draws encouragement from the fact that the staff at CCOSU – and Archways – really believe in the clients’ potential. “When it comes down to it, a lot of us feel like because we’re addicts, we don’t necessarily mean as much as the ones that aren’t. I know I created the label for myself by picking up what I did – but now I’m a grateful, recovering addict. I’m not just what I did. I think it’s cool that you guys are looking at the bright side of it and realizing that we can recover. Not a lot of people have that belief in us.”
The first time Ryan H. came to the CCOSU Residential Treatment Program, in January 2021, his participation was mandated by the terms of his parole. The second time, it was mandated by the loving concern of the staff.
“I started using when I was 11 years old, shooting heroin,” he recalls. “Imagine shooting heroin at 11 years old. I’m 34 now and I’ll be 35 in January 2022. I’ve got a long history under my belt.” That history includes a career as a mason that was on-again off-again due to drug use, and a six-year stint in prison for possession and sale of narcotics. It includes dozens of times in treatment.
“I’ve been to a lot of treatments. At the times it was kind of being forced into treatment, because of parole, probation. . . .
“I was in this program from January to July of [2021], and some negative behaviors got me in trouble.” Once his program ended, Ryan relapsed again quickly.
But this time, it’s different. After his previous release, something unusual happened. He stayed in Monticello, living homeless on the street in a tent, and the staff of CCOSU kept running into him.
“We were seeing him again and again, and begging him to come into treatment,” Karen Milazzo remembers. “We were unbelievably worried about him. To see somebody that we know has so much potential, could be so much in his life, and he’s out there holding a sign – it’s shattering. I don’t know if Ryan knows how much we care about Ryan.”
“I do now,” Ryan says. “When I was here before, I didn’t realize it. But now that I’m here, sober, and on the right path instead of the wrong, I actually see it. Daily.”
Now Ryan works toward the day when he will be ready to leave Monticello and return to his hometown in Pennsylvania. “Once I complete the program, parole is willing to put in my transfer to go back home with my family and my kids. I have everything set up already in Pennsylvania, where I have housing, which I haven’t had in a long time. I have work, too. I haven’t worked since 2014. Then I can gain my life back with my kids and focus on what I need to. I have a lot of friends who are clean many years, like my boss, who I worked for probably 12 years, doing masonry. I’m hoping that he’ll be my [12-step] sponsor.”
Ryan gestures to a window across the room, remembering his days on the street. “I walked past here every day,” he says, looking down at a courtyard with a motel on the far side. “Every day I would see somebody that works here, for probably two and a half months. Now I use that window to remind me of what I was putting myself through.”
While clients are dealing with their substance issues, they may also need assistance with other aspects of their lives. One advantage CCOSU offers its residents is the tie-in to a panoply of Catholic Charities services, including case management offered on-site.
“A person comes in, they’re in need of treatment,” Amy Kolakowski notes. “Maybe their family’s also struggling. Maybe their lights are about to be turned off. Maybe they’re hungry. Maybe they have a child that needs Pampers. Maybe they are undocumented and need help with their immigration status. Our case management services can wrap around the family while we’re meeting the individual’s unique needs in treatment.”
For people struggling with substance use disorder, this “wraparound” integration of services can be life-saving – and it’s inherent to the philosophy of CCOSU. “Everyone here lives our mission,” Milazzo says. “‘Providing help and creating hope.’ When people leave, we make sure they know we’re here to service them whenever they need it. And hopefully with a warm meal in their belly if they’re hungry. We meet people where they’re at.”
For more information on Catholic Charities of Orange, Sullivan, and Ulster’s Residential Treatment Program, visit cccsos.org.
To make a donation, visit cccsos.org/donate-now.
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