Iowa must do more to end the scourge of young people dying from drugs

Last of an occasional series

High-ranking Iowa officials sat under a tent in a rural setting near Cambridge last summer, waiting to shovel dirt and voice their hopes for a new drug treatment facility.

On the outskirts, listening, stood a handful of young residents from the nonprofit Youth and Shelter Services. They heard Gov. Kim Reynolds tell the crowd, in reference to her own past arrests for drinking and driving before she was governor, “Only those who have battled addiction know how agonizing it is.”

They heard Marissa Eyanson, the administrator of Community Mental Health and Disability Services at the Iowa Department of Human Services, share her story of being a high school dropout and going to work at 17 because of untreated issues.

People listen as speakers give remarks during the Ember Recovery Campus groundbreaking ceremony Tuesday, Aug. 9, 2022 in Cambridge.
People listen as speakers give remarks during the Ember Recovery Campus groundbreaking ceremony Tuesday, Aug. 9, 2022 in Cambridge.

And they listened to Andrew Allen, CEO and president of the Ames-based YSS, which serves youth like them in crisis, tell how that agency had saved his life. He left a high-level career at Principal to run it, and on that August day, he prepared to break ground on its planned $20 million rural center, Ember. The 53-acre campus on donated land is due to open in February 2024. It's an investment in what Allen calls "the healing power of nature, housing up to 72 clients, with an emergency shelter for crisis stabilization and residences for long-term treatment of adolescents and 18- to 23-year-olds.

The center will be unlocked because, as Allen puts it, “Treatment is not punishment.” It will accept private insurance and Medicaid.

About a month after the upbeat groundbreaking, I sat around a table in a Clive office with a group of parents connected in the most tragic way: by the death of a child to drug poisoning or overdose. All had sought help, but many found insurmountable hurdles.

"And they were all good kids," said Lori Steinbach. But four and a half years after losing her son, Matthew, and having recently lost her husband to illness, Steinbach is so frozen she doesn't even dream about her boy. And she worries the way he died might prevent his entry to heaven.

Andrew Allen, president and CEO of YSS, speaks during the Ember Recovery Campus groundbreaking ceremony Tuesday, Aug. 9, 2022, in Cambridge.
Andrew Allen, president and CEO of YSS, speaks during the Ember Recovery Campus groundbreaking ceremony Tuesday, Aug. 9, 2022, in Cambridge.

Four hundred and seventy Iowans died of drug overdoses or fentanyl poisoning in 2021. But as researchers are learning, no matter what you did or didn't do to indulge it, addiction resides in a network of cerebral spaces linked by brain fibers that need to be identified and treated individually.

“Treatment was so hard to access,” said Nicci Dean, who lost her 23-year-old son, Sam, to overdose. She'd even had him involuntarily committed to protect him, but recognized he had to be ready to accept treatment, which wasn't available when he sought it. "They can spiral downhill fast into feeling it’s a losing battle."

More:Rekha Basu: A record 470 Iowans died of overdoses last year. Some Iowans helped keep the drugs coming.

Often, only short treatment stays are available; more time is needed

Other parents have shared their struggles to come up with $20,000 down payments for private treatment centers, or described having their children walk out of treatment. Because children over 18 and of otherwise "sound mind" have the legal right to refuse treatment, some families have to get them arrested to have them detoxed in a hospital, only to be released in a day or two because they said no to further treatment.

"At 18, the country says you are now officially an adult," Allen said back in August. "But the brain takes time to develop cognitive thinking." And after persistent drug abuse, some addicts are no longer of sound mind.

More:Rekha Basu: A mother's failed struggle to save her son prompts her to push more open talk about addiction

Diane Armstrong Proffitt’s son, Jordan, died in 2017 of heroin adulterated with Carfentanil, a synthetic opioid used to tranquilize elephants. He was 21. He had been hospitalized multiple times but got only a week of outpatient treatment each time, she said. Meanwhile, he kept moving up to harder drugs.

Lisa Gabriel lost her 25-year-old daughter, Alijah Blue Allison, to heroin and fentanyl in 2018.  Gabriel had tried to get her help. At one Des Moines hospital, she said she was told Alijah couldn’t be admitted to detox from heroin alone because “you can't die from withdrawal from heroin.” But even if she were admitted for also drinking heavily or using Benzoids, once her vitals were normal, she could wait weeks before a bed opened at a treatment facility.  And Medicaid didn't cover a long enough stay to treat heroin addiction, and only a few places would accept it, Gabriel said.

Alijah Blue Allison, 25, lost her life to heroin and fentanyl in 2018. Her mother had tried to get her help.
Alijah Blue Allison, 25, lost her life to heroin and fentanyl in 2018. Her mother had tried to get her help.

All hospitals offer emergency treatment for overdose patients whose lives are at risk. But each county has one designated facility for court-ordered hospitalization. In Polk, that’s the public hospital, Broadlawns, which has 44 inpatient mental health beds (including for addiction) for up to five days for patients who are medically stabilized.

But Broadlawns doesn’t provide longer residential treatment. So to admit someone against their will, a court order is required, and a judge must determine the patient needs further services before ordering more hospital time, residential or outpatient services, according to Steve Johnson, Broadlawns' government liaison. He said the hospital will keep patients until a bed opens up elsewhere.

One father who took his kid to the hospital during a drug-induced medical crisis said a judge then ordered that he be on medications and attend intensive rehab at a different facility. But the patient, in his 30s, went only twice for about 20 minutes each time. Neither the facility nor the judge followed up, and he never went back.

More:Rekha Basu: Fentanyl magnifies drug risks with 'no way to know what you're taking is fatal'

Addiction is a social justice issue: Everyone deserves good treatment

Johnson speaks highly of two inpatient programs in Des Moines: Prelude Addiction Services on the east side, and Bridges of Iowa, which rents space at the Polk County Jail. The typical Prelude stay is 30 days, with an option for a halfway house to follow. Bridges partners with local businesses and DMACC, so those in recovery can transition to jobs and get a GED. There are three phases to the program spread over a year, the third mostly outpatient.

The emphasis in treatment has shifted over the decades, Johnson said, from breaking through the addict's denial to creating incentives by helping the person visualize a better life as a parent or with an education or job skills.

Some parents I spoke to took their children to the Hazelden facility in Minnesota with good results. Others couldn't afford it. Most insurance doesn't cover the full length of treatment, according to Hazelden spokesman Jeremiah Gardner, himself a recovering addict who lost his mother to an overdose.

"Addiction is a social justice issue," he said. "People with addictions are very discriminated against."

Gardner said it's miraculous "how much people can change" with the motivational enhancement therapy they get at Hazelden and by building fellowship and community.

After months of research for this series, I see how much addiction is a social justice issue. As with most things, the monied can get the good help, while the rest are left to figure out the jigsaw puzzle of treatment. Only when we stop stigmatizing addiction by treating it as a moral failing, rather than the medical crisis it is, will more beds open up and insurance companies be compelled to pay for full stays and better treatment.

Some new hope is on the horizon, including the brain science research featured in the June "Nature Medicine" journal. Also, in response to the many fentanyl-poisoning deaths in Iowa, state Sen. Claire Celsi plans to introduce legislation next session to legalize fentanyl test strips to help drug users detect the deadly presence of it in substances they buy. And Ember will offer a new chance for those who seek it.

I began this series months ago and have interviewed dozens of stricken or desperate family members, as well as recovering addicts and medical professionals, who generously shared their truths. Sadly, I'm unable to do feature all of them as my time at the Register is ending. But I sincerely hope those suffering with an addicted family member don't stop looking — or pushing policymakers or institutions or media — until you find an approach that works.

And I hope to someday see the young people who gathered at the August YSS groundbreaking thriving, after being given a shot at a new start.

Rekha Basu is an opinion columnist for The Des Moines Register. Contact: rbasu@dmreg.com. Follow her on Twitter @RekhaBasu and at Facebook.com/rekha.basu1106. Her book, "Finding Her Voice: A collection of Des Moines Register columns about women's struggles and triumphs in the Midwest," is available at ShopDMRegister.com/FindingHerVoice.


Want more opinions? Read other perspectives with our free newsletter, follow us on Facebook or visit us at DesMoinesRegister.com/Opinion. Respond to any opinion by submitting a Letter to the Editor at DesMoinesRegister.com/Letters.


Real perspective, brought to you by real Iowans. Subscribe today to support local journalism.

This article originally appeared on Des Moines Register: When addicts are ready for treatment, it should be ready for them