More than 20 years sober from heroin and alcohol, Brian Knight still fights the urge to use every day. His triggers can be a song, a taste, a place, a person.
And 70 days into her sobriety, Melissa Mitchell fights daily triggers, too: Wegmans, Syracuse, old friends.
Coping with addiction isn’t simply a matter of not using a drug, said Knight, 56, and Mitchell, 22: It’s a daily battle of willpower.
“You have to fight it with every ounce of energy you put into using it,” Knight said.
He went cold turkey more than 20 years ago and hasn’t touched an illegal drug since. Individual accountability helps him stay sober and he relies more on his own willpower than community resources.
Mitchell copes with her addiction differently. She now puts a dissolvable strip of suboxone under her tongue daily, medicating herself through a pharmacy prescription rather than shooting up.
She avoids situations that will trigger her to use heroin again and attributes her sobriety to the community resources she uses. Now her focus is her daughter, 3 1/2-year-old Ava, who’s become much more attached to her mother now that she, not heroin, comes first.
Mitchell says she’s more proud of these 70 days clean than she ever was of a six-month sobriety stint before a relapse. This time she is working hard at it.
More addicts, more help
Cortland County offers much more to help opioid and opiate addicts face their addictions than it did two years ago, when all it had was Family Counseling Services and time in the county jail.
Today, three facilities offer outpatient addiction services.
But absent one halfway house and one 10-bed supportive housing unit for people with chemical dependency, the county lacks in-patient programs to help addicts make a plan for sobriety.
Catholic Charities Residential Director Mike Pisa, who oversees those residential options, said the “housing first” model is crucial. It means addicts must first be stabilized in secure living quarters, regardless of their success with staying sober.
He also said rehab stays should be a minimum of 60 days and employment is a crucial component of sobriety, ensuring people will be engaged in some meaningful task when they are released.
He agreed the county desperately needs a detox facility, he said, where addicts can go to ride out the worst withdrawals.
“We probably still are the number one detox center for the county, unfortunately,” said Cortland County Undersheriff Budd Rigg. Beyond detox, the county lacks residential facilities to help addicts make a plan for sobriety. Nor does it have support programs for an addict’s family, said county Public Health Director Catherine Feuerherm.
The addicts are there. Naloxone, the drug that counteracts an opioid overdise, was administered 82 times in 2016 in Cortland County, almost double the year before. Twelve people were hospitalized. Preliminary data showed eight people died of opioid or opiate overdose in 2015, also double the previous year.
It follows a statewide trend that saw a 163 percent increase in heroin-overdose deaths between 2009 and 2013 and a 30 percent increase in deaths from prescription opioid painkillers.
‘You’ll lose everything you love’
Addiction is a twisted path to destruction, Mitchell said, which brings with it everything you care about.
“You’ll lose everything you love. Your family won’t want to talk to you anymore and if they are, most of the time they’re enabling you,” she said. “The pain of addiction is just crazy, you just lose everything.”
Addiction for Knight, a recovering heroin user and alcoholic, was a matter of lack of self awareness, he says.
He got sober more than 20 years ago, while serving a life prison sentence for a homicide that he took part in while in the military. He was sentenced in 1986, first to a military prison then between federal penitentiaries until his release in May 2016.
Now paroled and working, Knight recalled from a downtown cafe on a recent afternoon that moment of awareness, an epiphany he had in prison, when he realized the legacy he was leaving to any future grandchildren.
“I quit everything that day,” said Knight. “It was a moment of truth, a moment of awareness. I could either be an asset or be a debit.”
He chose to be an asset.
Mitchell finally wanted to get sober when she hit rock bottom. She had pawned everything she owned, become homeless and unable to care for or live with her daughter.
Path to sobriety
Mitchell’s success, so far, with staying clean is her fifth attempt. This time her insurer agreed to two-weeks at a rehab center instead of four days, which she says played a large part.
She still doesn’t know why Fidelis allowed her to stay about two weeks at Conifer Park in Schenectady, rather than the four days it previously allowed.
A four-day stay, says Mitchell, is ridiculously short. Addicts are just starting not to feel sick and they’re sent back into the world with one thought: getting high.
She used outpatient services this time, learning coping skills, like how to deal with emotions without using drugs.
“For five years, most of my adult life, I was using drugs,” Mitchell said. “It was hard to learn how to cope with things without drugs. Because when you’re getting high, you don’t feel anything anymore.”
For Knight, who got drugs easily in prison, sobriety was not easy. He was offered no counseling or support and detoxed without help from any medication. People he once used with would belittle his sobriety, encourage him to get high and mock him when he declined.
Knight told of the constant need to feel the same rush that comes from a first high. It’s an inescapable demon for addicts, who must take greater dosages to try to achieve it.
It rarely happens. When it does, the addict has a new goal, Knight said: a deadening cycle that destroys family and life.
How to stay sober
Mitchell’s days are now full. She uses services through Family Counseling Services and the Beacon Center, attends mental health programs and group and individual therapy sessions.
During her last stay in rehab, she made an exit plan, found outpatient services to use, and listed places, situations and people to avoid.
“I had everything set up so when I got out I wasn’t getting out to just sit around thinking about getting high,” she said.
Knight follows a 12-step program and says it is important to acknowledge a higher power, but he stresses the need for an individual to be both responsible and accountable.
“The active user, the pursuer of using, chooses not to be either of these things,” he said.
Knight also practices something he calls: “taking it to the pain,” reminding himself of the family destruction, the money squandered, the trust lost. Staying sober takes energy and hard work, he said.
Mitchell says it ultimately comes down to will.
“If you want it, you will get into treatment,” she said. “You have to want it bad enough to do it. I had to lose everything until I realized I did not want to live that life anymore.”
A new start
Knight now takes in every day with gratitude, happy to be free, happy to be clean.
He works in the trades profession, has a job offer in the building industry pending a drug test and regularly attends 12-step meetings.
Mitchell takes pride in getting up early each morning, and with the help of suboxone, making breakfast for her daughter, attending a therapy session then retrieving Ava to spend the day with her.
She tears up remembering her days lost in pursuit of drugs, trips to and from Syracuse that would keep her away from Ava for hours.
Now she’ll take Ava for a walk or to the park, enjoying time with her and Ava’s father — a family again.
“I’m not neglecting my family. I don’t need to do drugs anymore,” Mitchell said. “I’m so much happier now, it’s the first time I’m living in my own apartment and my family trusts me now again. It’s just so nice.”
Triggers and other challenges
However, Mitchell and Knight will always have to cope with the urge to use.
Mitchell requests urine screenings each time she has an outpatient visit. She doesn’t want to have an excuse to use “just this one time.”
Triggers are everywhere.
Mitchell’s gut will twist over a visit to Syracuse, where she used to get her drugs, so she avoids going there. Also off limits is Wegmans supermarket, where she used to shoot up in the parking lot. She will turn her head the other way if she encounters people she once used drugs with.
Knight has triggers every day. But he does not devote mental energy to them, allowing the urges to pass through him, even as they hit him through a song, a taste, a place, a person.
He reminds himself of the price he’s paid to use: the lost years; the money and trust squandered.
The brain’s immediate reaction to a trigger, says Knight, is to revert to old ways, to use, when memories are sparked.
Instead, he must step outside his comfort zone and do the opposite of what his body tells him to do. It’s a different sort of rush.
So now, despite the triggers he will forever face, he’s regained his chance to leave behind a legacy, determined not to die as a drug addict behind bars.