One man shares his story of going from High Point patient to program director

John Fortes began smoking marijuana and drinking beer when he was 10.

“I can remember being like 8, 10-years-old and I couldn't sleep at night. I would take the pillow from under my neck and sit there and rock my head back and forth from the left to the right because my mind would be racing and I couldn't sleep,” he said. “Sometimes I would go out of the house and run around the block to tire myself down just because I had all that anxiety.”

By the time he was 16, he was using alcohol, marijuana and cocaine.

“And so when I found that it was like, ‘Oh, that's what did it,’ it helped me to remove all that anxiety I had on the inside. It helped me to get through school. It helped me get my first job," Fortes said.

"It also helped me to get my first arrest,” he said.

In his 20s, he became a patient at High Point Treatment Center in Plymouth and was in and out of treatment for years as he continued to struggle with anxiety.

“I was homeless on the streets, sleeping in abandoned buildings, sleeping under the bridge, parked cars, portajohns, in abandoned buildings in the attics, and that's where the lifestyle had taken me,” he said.

Now, he is the program director at High Point Treatment Center where he uses his experiences to help others overcome addiction.

“I am a person in long-term recovery, which means I haven't used any alcohol or drugs for going on 17 years,” he said.

High Point provides substance use disorder and mental health services across southeastern Massachusetts, including Brockton, Plymouth and Taunton.

Proposed law would bar imprisonment for relapses

Addiction was an important topic at the recent Treatment Over Imprisonment meeting hosted by Rep. Ruth Balser, D-Newton, and Sen. Cindy Friedman, D-Arlington, as part of a series to inform social workers about legislative advocacy. Friedman filed legislation that would prohibit courts from sentencing individuals to imprisonment for relapsing if they are engaged in or actively seeking treatment.

Courts often require people to “stay clean” as a condition of probation. But that view assumes a level of choice that isn’t scientifically based, Balser said.

People do not stigmatize a person who has a heart condition or diabetes. They recognize that the person is ill and needs treatment, she said. Yet addiction is often viewed as a moral failing or criminal act.

The premise behind the bill is that “addiction is an illness and not a crime.” Relapse is a part of the illness.

“It shouldn't be responded to by yanking the person back into jail, incarcerating them again. It should be about re-engaging them in treatment,” Balser said.

“I think at its core, what this bill is saying is that we should be prioritizing keeping people alive instead of prioritizing ending all substance use,” said Abby Kim, the director of public policy at the Association for Behavioral Healthcare.

Treatment decisions should be determined by providers and the people they serve, not the legal system, Kim said.

“Abstinence-based approaches work for plenty of people. It doesn't work for everybody, and relapse, as has been said, should not be seen as a failure and something that breaks down a system of trust between a provider and a person, and might interrupt a person's treatment to be incarcerated,” she said.

What finally turned it around for John Fortes?

Fortes relapsed several times throughout his life before he was ready to commit to recovery. He was pursuing treatment at the Salvation Army in Brockton when he bumped into a man he had been in a treatment program with six years earlier.

When Fortes learned that the man was still sober after all those years from when they were roommates together, he opened up to the possibility of recovery.

“He took me under his wing and brought me through a certain recovery process. And as a result of that process, I have not had a need or desire to use alcohol or drugs for almost 17 years,” Fortes said.

John became a resident supervisor at the Salvation Army and eventually, the clinical director at High Point. He continues to help others struggling with substance use because “that's what we're taught in recovery, is in order to keep it, you need to give it away.”

'Not therapeutic places': Lack of medication-assisted treatment in prisons

High Point has a treatment program in Brockton that offers counseling and methadone treatment for those suffering from opioid use disorder.

Methadone and buprenorphine are evidence-based medications that treat opioid use disorder. Studies have shown that providing medications for opioid dependence in jails and prisons can decrease the likelihood of a person returning to opioid use or overdosing after they are released.

But most prison facilities do not provide these treatments, Kim said. If someone is incarcerated in a place where medications for opioid use disorder are unavailable, detoxing from an illicit substance is “incredibly painful and uncomfortable.”

“So what that means is if you're experiencing withdrawal symptoms, they're not offering a lot of medications to help you feel better. Those symptoms might last for weeks or months,” Kim said. “It includes things like fatigue, cravings, anxiety, depression, insomnia, irritability, heart and breathing difficulty. There's also all of the stress that comes with being incarcerated that contributes [to] and compounds the symptoms.”

The overdose death rate is 120 times higher for people recently released from incarceration compared to the rest of the adult population, according to data from the Department of Corrections.

“Carceral settings are not therapeutic places. They're not the same as the treatment that you'd be receiving in a community,” Kim said.

Breaking through the 'trust barrier': A peer-to-peer approach at High Point

High Point uses a peer-to-peer model where recovery coaches and case managers develop a rapport with clients to provide social and emotional support.

“You got clients that have gone through a lot, in prison and abuse and trauma. And then here we come, ‘Hi, I'm John Fortes, I want to help you, I think you're great!’ And they're like, ‘Hold up, what's the motive here, why you wanna help me? Why do you wanna help me?’” Fortes said.

There's a trust barrier that providers need to break through to reach a person, which often takes time. Sometimes, time is not allowed.

“Are we patient enough? Versus ‘Oh, he's not responded. I'm just going to close him!’ Let's slow that down a little bit,” Fortes said.

He urges providers to reach out a couple more times, give it three weeks, and “be a little more empathetic.”

A man with a purpose: bringing hope

As Fortes works alongside substance use counselors and clients, he shares his recovery story for one purpose.

“And that purpose is for it to bring hope to someone else who has been going through something I've experienced and overcome, [so] that if I share a snippet of my life or personal experience with them, hopefully, they can get some hope out of it. You know, saying like, if he can do it, I can do it,’” Fortes said.

Fortes sees the purpose of his work as similar to the story of a boy walking along a beach filled with starfish. Hundreds of starfish lay drying out on the sand as the boy walks along, picking them up and throwing them back into the ocean one by one.

“And someone says, 'What are you doing? You can't save all of the starfish. What you're doing doesn't matter,' or something like that. Then the kid picked up a starfish and threw it in the ocean and said, ‘It mattered to him.’ The moral is that you can't save them all, nor are you going to. But if you can save one, then that's everything,” Fortes said.

This article originally appeared on The Enterprise: High Point program director talks about his drug addiction, recovery