Open post covid-19

The New Normal at The GateHouse

WELCOMING THE NEXT PHASE

Although Lancaster County is not currently part of Pennsylvania’s phased reopening plan, today’s news from Governor Tom Wolf and Health Secretary Dr. Rachel Levine brings with it some cause for optimism.

The state is moving in a positive direction and we hope that sometime within the next four weeks, Lancaster County and surrounding areas will begin to open back up on a limited basis. Like you, we here at The GateHouse are ready to emerge from the Commonwealth’s shelter-in-place mandate and get back to some semblance of normalcy!

What that “new normal” looks like, however, remains to be seen. One thing’s for certain, though–the COVID-19 quarantine has permanently changed how some things will operate at The GateHouse.

One question that is on many minds right now is whether we’ve had any outbreaks or positive tests for coronavirus at any of our facilities. We have not. While we’re very happy to make this announcement, we are still proceeding with tremendous caution.

We continue to follow the guidelines issued by The Centers for Disease Control & Prevention (CDC) for keeping our headquarters, our Behavioral Health Facility, and our Residential Treatment centers and Transitional Recovery Housing locations clean and safe. We will continue to follow the Governor’s and the CDC’s guidelines for reopening, as well.

In March, we implemented several changes to our operations at all of our facilities. These included:

  • TEMPERATURE CHECKS: All clients and staff have been required to submit to temperature checks at every location twice a day to ensure any elevations are addressed as quickly as possible.
  • NO-TOUCH POLICIES: We implemented a no-touch policy at all of our locations, as well as our Behavioral Health Programs. Typically, when we close meetings, there are usually hugs, handshakes, and hand-holding during the closing prayer. We asked our clients and attendees to refrain from these behaviors indefinitely.
  • REMOTE 12-STEP MEETINGS: Residents at our Residential Treatment and Transitional Recovery Housing locations were no longer permitted to leave to attend 12-step meetings. Instead, we encouraged them to participate in virtual 12-step meetings.
  • TELE-HEALTH: We implemented Outpatient Tele-Health services from our Behavioral Health Facility on Cherry Street in Lancaster using the Zoom video conferencing program.

We believe that our swift actions in implementing these changes may have saved our residents from contracting the virus and potentially infecting other clients at our facilities.

In the middle of everything and with the help of our dedicated and driven staff, we were able to not only open a brand new recovery facility for men at our Mountville location, but we also were successful in implementing a new Electronic Medical Records program.

Overall, the morale of both our residents and staff has been remarkably positive. At the beginning of the quarantine, things were difficult as everyone adjusted to the new restrictions. Over the past month, however, we’ve discovered that our residents and staff adapted quite well. This was true at all of our facilities from Residential Treatment to the Recovery Houses.

As a result of the COVID-19 pandemic and quarantine, we have learned a lot about what recovery looks like in this new environment. Even after the stay-at-home orders are fully lifted, we anticipate leaving some of these changes in place and we will likely make further adjustments to our day-to-day operations based on what we’ve experienced and what we’ve learned about our recovery community. These may not be dramatic changes, but we believe they’ll be impactful.

For example, prior to the quarantine, we didn’t allow residents to work third shift. Since the shelter-in-place mandate went into effect, however, this was something we had to accommodate to ensure our residents could continue to work and pay their bills.

We also will continue staggering shifts for our staff to ensure social distancing remains in place. The good news, however, is that we anticipate reopening our Family Support program sometime in the near future. We’re currently exploring how this can be done in a responsible way.

While we have no timelines in place for any of our reopening measures, our clinical, administrative, and on-site teams plan to meet regularly to analyze the guidelines form the CDC and the Wolf Administration as we look toward the phased reopening of the state starting this month.

Thanks to everyone for your amazing support!

Open post Partial Hospitalization Program

What is a Partial Hospitalization Program (PHP) for Substance Use Disorder

 


 

What is a Partial Hospitalization Program?

Partial Hospitalization Program, or PHP, is a short-term, comprehensive program of intensive outpatient therapy. At The GateHouse, Individuals attend group sessions four days a week for five hours per day. Patients also meet with their Primary Counselor twice a week as part of their individualized therapy.

Is PHP an evidence-based program?

The curriculum used at The GateHouse for PHP is evidence-based, which means the methods have been rigorously proven effective in the treatment of alcohol and substance use disorders.

What are the benefits of PHP versus solely attending a support group?

PHP provides individualized and specialized group therapies facilitated by professionals and specialists who teach proven strategies for managing specific problems such as trauma, gender-specific issues, and co-occurring disorders.

What classes are provided during PHP?

In addition to meditation, The GateHouse offers a life-skills group, which focuses on:

  • money management
  • budgeting
  • resume writing
  • job search assistance and resources
  • banking
  • other types of access to community resources

Psycho-education classes provide education on issues specific to those struggling with substance use disorders, including trauma, co-occurring disorders, cognitive distortions, and other issues. This includes a discussion with every person in the group to identify how they relate to each topic or how it occurs in their own lives.

What is a typical day of PHP at The GateHouse?

A typical schedule looks like this:

8:30 a.m. – Check-in

9-9:45 a.m. – Meditation and morning meeting –

10 a.m.-12 p.m. – Psycho-education Group

12-12:30 p.m. – Lunch

12:30-1:30 p.m. – Processing Group or Life-Skills Group

1:30-2 p.m. – Closing Group

Fridays include weekly progress updates and weekend prep work to keep clients actively engaged in their treatment program.

How long does PHP typically last?

PHP is a short-term, intensive service. The GateHouse facilitates person-centered therapy, which is guided by the client’s preferences. Most individuals may expect a period of four to six weeks of PHP.

How many people attend the program?

Groups consist of 10 to 12 individuals so that everyone receives the individual attention they need and deserve.

What health care providers or staff are involved in PHP?

The GateHouse has an extensive staff to support the needs of clients, including our Medical Director, Clinical Director, Psychiatrist, Case Managers, Peer Support, Clinicians, and Community Resource Providers as well as members of the recovery community.

Does The GateHouse provide housing for PHP clients?

GateHouse offers housing for those who need it at no additional cost.

What is the philosophy of The GateHouse in treating addiction?

The GateHouse strives to create a community where everyone struggling with addiction is able to pursue and ultimately restore their human spirit.

The GateHouse staff members truly embody the values of our agency.  We walk beside our clients and cultivate a culture that encourages opportunities for growth while supporting them in their journey to overcome addiction. Ultimately, our vision is for our clients to maintain a lifelong lifestyle of recovery.

Why should I entrust my loved one or myself to Gatehouse?

The GateHouse has been providing accredited, community-based recovery care since 1972. Our services are gender-neutral.

Click here to learn more about what makes The GateHouse stand out from other rehabilitation centers as well as our treatment outcomes.

What is the next step for those recovering from addiction after PHP?

One can reasonably expect to be stepped down to a lower level of care, such as Intensive Outpatient Programs (IOP) or other outpatient services. The GateHouse offers IOP and general outpatient treatment. Maintaining support is crucial in sustaining recovery.

Does insurance cover PHP?

The GateHouse works with medical assistance and county assistance as well as some commercial insurance companies to cover PHP.

If you or a loved one are looking for a trusted and effective partial hospitalization program to overcome substance use disorder, our caring staff members at The GateHouse welcome an opportunity to speak with you! Please contact us today by phone or email. All information is 100% confidential.

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Coronavirus Update

To Our Valued Clients, Employees, and Friends

First and foremost, our thoughts and prayers go out to those who have already been directly affected by the Coronavirus and COVID-19. Our hearts also go out to the many people in Lancaster County and beyond who are in the throes of fear and apprehension, especially when it comes to children, older adults, and other vulnerable members of our community.

Please know that the team at The GateHouse has spent considerable time developing and implementing safeguards and guidelines for keeping our clients, residents, and employees safe.

We are closely following the guidelines issued by The Centers for Disease Control & Prevention (CDC) for keeping our headquarters, our Behavioral Health Facility, and our Residential Treatment centers and Transitional Recovery Housing locations clean and safe. The welfare of our residents, their families, and our employees and their families is our main concern as we navigate this unprecedented crisis.

At least for now, the risk is low for a majority of people in Lancaster County, but we have taken the following steps, so we can continue serving those in recovery while protecting the health of everyone in our care and community.

coronavirus update

We began doing deep cleans for all of our locations over the weekend. We hired cleaners to come into all of our locations and do a deep clean and sanitization, starting with our Behavioral Health Facility on Cherry Street, then proceeded to our Residential Treatment residences in the City of Lancaster.

This week, we will continue deep cleans of our Lititz and Marietta Locations, as well as all other facilities owned and operated by The GateHouse.

All of our Residential Treatment and Transitional Living locations are on lock-down, meaning no one is permitted to leave unless it is for essential services, work, or doctor’s appointments.

We have also temporarily suspended all visitation to our residences, as well.

coronavirus update

All members of The GateHouse team—both onsite and offsite–have been instructed to adhere to CDC best practices and obey the agency’s guidelines and instructions, which include social distancing, the utilization of hand sanitizing stations we’ve set up, and self-quarantining measures.

Out of an abundance of caution, we’ve also changed our staffing patterns so that shifts are staggered and we have less staff on-site during the day.  We’re doing this not only to reduce exposure risk but also to ensure that if staff members are taken ill for any reason, we will have backup team members available and ready to fill in.

Team members at our administrative offices, which includes centralized intake, will be working remotely for the foreseeable future.

coronavirus update

We are fine-tuning our clinical and outpatient services, such as Partial Hospitalization Treatment and Intensive Outpatient Services to ensure there are no group meetings larger than five people.

We are also encouraging any and all clinical and outpatient clients to avoid attending group meetings or treatment if they feel sick or experience any cold-like or flu-like symptoms.

Our centralized intake interviews will include some additional prescreening questions to protect our existing clients and staff and to ensure prospective clients are aware of our new Coronavirus policies and procedures. Once a new client is admitted, we will be taking extra precautions with them when they arrive, including new sanitizing measures and temperature readings.

We have indefinitely suspended our Family Program until further notice.

coronavirus update

  • TEMPERATURE CHECKS: All clients and staff are being asked to submit to temperature checks at every location twice a day to ensure any elevations are addressed as quickly as possible.
  • NO-TOUCH POLICIES: We’ve implemented a no-touch policy at all of our locations, as well as our Behavioral Health Programs. Typically, when we close meetings, there are usually hugs, handshakes, and hand-holding during the closing prayer. We are asking our clients and attendees to refrain from these behaviors indefinitely.
  • 12-STEP MEETINGS: Residents at our Residential Treatment and Transitional Recovery Housing locations are no longer permitted to leave to attend 12-step meetings. Instead, we’re encouraging them to participate in virtual 12-step meetings.
  • VIRUS CONTINGENCY MEASURES: While no one so far has exhibited Coronavirus symptoms at any of our locations, our plan, if they do test positive for the virus, is to use two of our empty locations to place them under quarantine. Our King Street location would be for women residents and our Mountville location would be for men.
  • TELE-HEALTH: We are currently implementing Outpatient Tele-Health from our Behavioral Health Facility on Cherry Street in Lancaster, and we plan to implement this service to all of our locations as soon as possible. We will be utilizing the video and web conferencing program Zoom to offer this service. To participate, please SIGN UP HERE or give us a call at 717-393-3215 for more information.

coronavirus update

The GateHouse has been in operation since 1972. Now in our 48th year, we value our residents, clients, and the recovery community more than ever.

Thank you for your cooperation, patience, and understanding as we all confront this troubling and unpredictable threat. We appreciate your kindness and generosity during this difficult time, and we know that we will all get through this together.

The recovery community endures!

Open post residential treatment and transitional living

What’s the Difference Between Residential Treatment and Transitional Living at The GateHouse?

One of the most frequently asked questions we get here at The GateHouse concerns the distinction between our Residential Treatment programs and our Transitional Living Housing services.

What’s the difference between them? What does “halfway house” mean? What happens at each of these types of services?

While the confusion is understandable, the main difference between the two is that our Residential Treatment program focuses on continuing recovery treatment while re-learning and developing the life-skills necessary to reintegrate into society. Meanwhile, our Transitional Living services focus on putting those skills into practice while continuing to maintain a recovery mindset.

While neither service offers the kind of medically managed treatment that occurs in the first stages of recovery (detox and rehab), those who are on sustained Medical Assisted Treatment (MAT) are welcome in both our residential treatment programs. Those on MAT can coordinate services with any one of the many local medical providers we partner with.

The best way to differentiate between Residential Treatment and Transitional Living is to start at the beginning.

The Recovery Treatment Journey

The first step for an addict entering treatment is to begin with a stay in rehab, where the initial detoxification of addictive substances takes place. This can last anywhere from 28 to 30 days. While there are rehab facilities that have a shortened detox time of only 5 to 10 days, we recommend a longer detox period before entering one of The GateHouse residential programs.

Upon leaving the detox facility, the recovering addict moves into one of our Residential Treatment centers, also known as a “halfway house.” This is where some of the initial confusion occurs. Very often, people unfamiliar with the recovery process will lump residential and transitional living services together as “halfway houses.” This term, however, has been used solely in accordance with Residential Treatment facilities for many years. According to the American Society of Addiction Medicine, the official definition of a halfway house is “a clinically managed, low-intensity residential service.”

Upon meeting the goals laid out at the Residential Treatment program (which we’ll dive into below), the recovering addict then moves into one of our Transitional Recovery Housing facilities. As the name sounds, this is where residents continue practicing the life-skills they learned in Residential Treatment and actively transition back into the community.

What Happens at a Halfway House?

The average stay in one of our Residential Treatment programs is about three to six months and is for people who have undergone primary detox at a rehab facility. During their stay here, residents will start the process of rebuilding their lives in three phases.

In Phase 1, the new resident will meet with his or her counselor on a regular basis, and any medical treatment that’s necessary will be supervised by licensed professionals in coordination with outside medical providers. Residents have access to recreational facilities, but the days are busy with group counseling, one-on-one therapeutic counseling, daily 12-step meetings, life skills training, health and nutrition education, and developing personal goals to help guide the recovery process. During this initial phase, halfway house residents remain at the facility around the clock and are not permitted to leave unless given permission by the staff for very specific reasons.

Phase 2 of Residential Treatment offers a little more freedom—leaving the facility is permitted with a pass, and attending sober groups, finding 12-step meetings, and connecting with sponsors are all encouraged. There is still a lot of work to do in this phase, however. After meeting their goals from Phase 1, residents start working with The GateHouse team to begin developing a healthy daily lifestyle. This includes developing vocational skills and looking for work, preparing for life outside the facility, and identifying and working toward personal goals and priorities.

To get to Phase 3, the resident has to have obtained a job. Residents have a little more freedom than the previous phases, as well. Nevertheless, they must still demonstrate progress, and are asked to continue to meet with peer groups, remain employed, and attend 12-step meetings. One of the most important parts of completing Phase 3 for our halfway house residents is putting together a recovery support system they can access outside of the facility.

The average stay in our Residential Treatment facilities is usually about 90 days due in part to time restrictions put in place by insurance companies. Under certain circumstances, however, longer stays are permitted and may even be covered. The GateHouse team can help with this process.

Transitioning to Transitional Living

Upon leaving Residential Treatment, recovering addicts are typically ready to reside at one of our Transitional Recovery Houses to continue practicing their recovery skills in the community. While it’s ideal for recovering addicts to have first gone through our Residential Treatment program, it is not a requirement. Nevertheless, the benchmarks identified in Phase 3 of Residential Treatment still extend to anyone interested in residing in our Transitional Living Housing.

The most important requirement for Transitional Living is employment and a desire to continue to remain in recovery. You must either have a job upon entering one of our Transitional Recovery Houses or you must have gotten one within two weeks of staying there.

What Happens in Transitional Living?

The first phase of Transitional Living is a two-week orientation period, where your ability to come and go will be restricted. New residents have a 5 o’clock curfew and, as part of the acclimation process, are asked to attend at least one meeting with a housemate.

After the orientation period, The GateHouse team will help you refine the life skills you learned in Residential Treatment. This means putting those life skills into practice, having accountability, and paying rent. This last item is actually very important, because it not only empowers the resident to pay for his or her own recovery process, it also allows them to break free from the insurance safety net. Insurance may still cover other elements of recovery, such as outpatient services, but the goal is to become self-supporting and self-sustaining for the majority of the stay in Transitional Living.

Because insurance is no longer providing financial compensation for recovery housing, Transitional Living residents are encouraged to stay in the program for at least a year. Sometimes residents will earn the privilege of becoming a house manager, and in those cases, they’re allowed to stay in Transitional Recovery Housing for up to 18 months.

Throughout their stay in Transitional Living, residents continue to build a strong foundation for the rest of their lives. They have the time and assistance to work on their recovery support system, and they receive help from staff in developing and working toward short- and long-term goals.

Not only does The GateHouse team help with life skills, coping mechanisms, trigger recognition, and recovery, they also provide assistance with developing a household budget, working through financial challenges and obligations, and rebuilding credit. Residents will set up bank accounts, save money, and even start pursuing a career.

Understanding the Differences

Verlina Velazquez-Millings

Verlina Velazquez-Millings, our Director of Programs here at The GateHouse, says the dynamic between Residential Treatment and Transitional Living is very complementary. Residential Treatment, she says, is highly structured and more intense than Transitional Living, because residents there are under 24-hour care as they work toward rebuilding their mental and emotional outlook and meeting a set of clearly defined character-building benchmarks.

“The requirement for completion is to work with a sponsor, have a job, develop an aftercare plan, and demonstrate the ability to manage all this while still maintaining a focus on recovery,” she says. “Sustaining ongoing recovery is the absolute priority.”

entering recovery: lori fallon
Lori Fallon

Lori Fallon, who coordinates our Transitional Recovery Housing program, says the goals in Transitional Living are geared toward maintaining a healthy lifestyle and staying focused on recovery, while also living on their own in a structured environment.

“People in Transitional Living have a lot of freedom,” she says. “Some folks don’t take that well; others do. Either way, we’re here to help them through this important transition as they continue to work toward recovery and building a new life for themselves.”

Exiting the Program

One of the most important things to understand about Transitional Living is that clients need to buy into the program and have a stake in their own success. Counselors and case managers may encourage residents to stay or leave the program depending on their level of readiness.

For the most part, however, the time will come to leave our programs, and when that happens it is often bittersweet, but necessary.

If you’re interested in learning more about programs and services offered by The GateHouse, please click here. Or, if you need help now, reach out to us or give us a call at 717-393-3215.

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2019: A Historic Year for The GateHouse

By any measure, 2019 was one of the most eventful years in the 47-year history of The GateHouse.

The GateHouse 2019
Executive Director Jodi Holland

Not only did we open a brand-new transitional living location, with the grand opening of The GateHouse at Riverview Tower in Marietta, we interviewed numerous local and statewide leaders about the status of the opioid crisis and hosted a roundtable discussion with U.S. Labor Secretary Eugene Scalia, who also toured our Mountville location and announced a $20 million grant to help fight the opioid epidemic in Pennsylvania.

If that were all, that would certainly be enough, but there was even more. In early 2019, we launched our brand-new website, and in the fall, we raised more than $35,000 through the Extraordinary Give (thank you for your generous support). We also added Partial Hospitalization Treatment (PHP) to our list of non-residential treatment services and participated in a public service announcement video that was aired locally.

The best part, of course, is that we accomplished all of it while continuing to achieve extraordinary outcomes for the men and women we serve.

Executive Director Jodi Holland said she can’t really recall a year quite like it.

“Not historically, no,” Jodi said. “Not since I’ve been here in my little over three years as executive director. And even before that—I mean, I’ve been around the culture of The GateHouse for many more years than that, and I don’t think we’ve ever had as much movement as we’ve had in 2019. It’s really exciting.”

A Grand Opening with Meaning

The GateHouse at Riverview TowerThe grand opening of Riverview Tower was especially sweet, Jodi said because it was the culmination of many months and even years of hard work, commitment, and unwavering dedication.

“It was exhilarating and exhausting, but also a time of excitement,” she said. “I think it’s also a time of a little bit of uncertainty. We have embarked on a whole new vision and strategic plan for the growth of The GateHouse. The building itself is magnificent, and I really think it’s a notch above anything we’ve had or done in the past.”

With all the progress and momentum that The GateHouse has experienced over the last year, however, there’s bound to be some concerns and uncertainty.

“I think it might have been a little nervewracking for some people at first,” Jodi said. “It’s like, ‘Is The GateHouse changing?’ ‘Is it sticking to its mission?’ But overall, I think all of that has all come to a head, and now the culture is, ‘We’re ready to go! We’re really excited, and we’re on to a new chapter!’ I think now, all of that uncertainty and confusion is behind us, and we’re ready to move forward and see what’s next for us.”

A Healthy Transition Forward

The GateHouse 2019Before an organization starts to grow, people naturally tend to be comfortable with the status quo, Jodi said. So, when new blood comes in and changes start happening, “it can be a lot like a snow globe,” she said.

“Everything is normal, and then you shake everything up, and it gets cloudy and confusing, and people can’t really see clearly, and then it all settles back down to the status quo, and you get to once again see this beautiful picture inside,” she said. “I think that when people see that we can do it and that, while there is a lot of work behind it, the outcome is so tremendous and empowering, people eventually come together, and I think now people are ready to shake that snow globe again.”

For those who might still have concerns or reservations about the direction The GateHouse is headed and what that might mean for the mission, vision, and values of the organization, Jodi offers a reassuring message.

“The GateHouse has been in this community for more than 47 years,” she said. “We have a model that has consistently produced successful people. When you look at that, why would you not replicate a model that has historically worked for decades? We’re very clear about what we do, and we’re committed to maintaining it.”

The leaders of The GateHouse are all on the same page, Jodi said.

“We want to continue to replicate the model, and just provide more of the same services for more people,” she said. “What it really comes down to is the bigger you get, the more processes and procedures you have to have and the better the communication has to be. Those things only make you better as an organization.”

National Recognition

The GateHouse 2019The GateHouse’s banner year reached its crescendo in October with a visit from the U.S. Labor Secretary Scalia. While Jodi said no official reason was given as to why The GateHouse was chosen to host the visit, she said Secretary Scalia’s team told her he “had heard good things about our programs and the really good work we’ve been doing in our community.”

Jodi said she asked Secretary Scalia’s people point-blank how the organization’s name had made it all the way to the U.S. Department of Labor.

“They said typically it comes from people in the upper echelons of government noticing what you’re doing, whether that’s someone working with the White House or in some other high cabinet-level position,” she said. “So somehow or other, our name has moved up and people are noticing.”

Jodi believes that has a lot to do with The GateHouse’s consistency and its immersion in the community.

“Again, we’re 47 years old and operating in an environment that has consistently changed over the years,” she said. “And yet we’re still here doing the same kind of work. That in itself, I think, speaks volumes.”

While government is often accused of moving slowly, Secretary Scalia’s visit came together very quickly, Jodi said.

“I got a call the week prior saying that the Secretary wanted to come for a visit the following Thursday,” she said. “Within 24 hours, we were working with his team and it didn’t stop until the roundtable.”

Jodi said she’s always cautious with these kinds of things, but she has seen more of a commitment from the federal government in recent years to help the recovery community fight the opioid crisis.

“You really can’t say something like this is not exciting and gratifying,” she said. “I just hope that it continues. It’s just nice that addiction, mental health, and recovery are at the top of the list when it comes to conversations with the federal government about money. Typically, we’re always the ones being cut. We’re always at the bottom.”

The Way Forward

With all the changes, achievements, and recognition The GateHouse received in 2019, it might seem like 2020 may be the right time for the organization to take a breather, right?

Nope.

“We’re very excited about the future,” Jodi said. “Many more good things are coming for our organization. We’ve got some amazing things in the works, and we look forward to another year of progress and commitment to the men and women in our community who have chosen to recover.”

So, stay tuned. 2020 looks to be another banner year for The GateHouse.

Open post Rachel Levine

Opioid Crisis Q&A with Dr. Rachel Levine, Secretary of the Pennsylvania Department of Health

Recently, The GateHouse had the good fortune to sit down with Dr. Rachel Levine, Secretary of the Pennsylvania Department of Health, for a wide-ranging discussion about the opioid crisis in the Commonwealth. Our goal was to learn more about how Dr. Levine, Gov. Tom Wolf, and the rest of the administration are approaching this crisis and what Pennsylvanians can expect from the future efforts of state government.

TGH: Thank you so much for taking the time to speak with us today. To start, can you please tell us the role that the Pennsylvania Department of Health plays in combatting the opioid crisis and how this issue has affected you personally?

Secretary Levine: The opioid crisis really remains the biggest public health crisis that we face in Pennsylvania and the nation. It’s natural for the Department of Health to be very involved in collaboration with all the other departments in terms of this effort. If you actually look across the country, many public health departments—in fact most—have been very involved in this.

I am the president-elect of ASTHO, the Association of State and Territorial Health Officials, and this is one of the issues that we talk about at our meetings all the time. The only thing from a professional point of view is that my field is adolescent and adult medicine, so I trained in pediatrics with a fellowship in adolescent and young adult medicine, and so my whole career has been involved with the intersection of medical issues and behavioral health issues. So, the opioid crisis, from a professional point of view, is right up my alley.

I started and ran the adolescent medicine and eating disorder program at Penn State Hershey, and we saw lots of patients with substance abuse issues even though it wasn’t a substance abuse program.  Again, professionally, that intersection of medical issues and mental health issues has really been the focus of my whole career.

TGH: Not too long ago, Gov. Wolf declared the opioid crisis a disaster emergency. How has that changed the approach the Commonwealth has taken to the opioid crisis?

Secretary Levine: It has changed it completely. Gov. Wolf’s Opioid Disaster Declaration was announced in January 2018, so we’re actually approaching the second anniversary of this. These are 90-day disaster declarations, and actually, this week (Dec. 3, 2019), the governor renewed that declaration for the eighth time. This declaration has allowed us to form the Opioid Command Center, which meets weekly at the Pennsylvania Emergency Management Association. It’s this unique collaboration of 16 or 17 different state agencies, including the state Attorney General’s office and the High Intensity Drug Trafficking Association, which is through the federal government, all meeting every week to look at the opioid crisis from all of our different perspectives. That includes the health and human service agencies, the Department of Health, the Department of Human Services, the Department of Drug and Alcohol Programs, the Department of Aging, and then you have the perspectives of public safety and law enforcement, including the Pennsylvania State Police, the Pennsylvania Department of Corrections, the Pennsylvania Commission for Crime and Delinquency, the AG’s office as I said, and then other agencies—for instance, Education, Military and Veterans affairs, Labor and Industry—who are all looking at the opioid crisis and collaborating our responses. So, I think that that has been a game changer, in terms of the state’s addressing the opioid crisis.

TGH: As early as 2016, when you were the Commonwealth’s Physician General, you had called for an “all-hands-on-deck” response from state government to combatting the opioid crisis. How do you think the government—both the Wolf Administration and the state Legislature—has responded since then in your opinion?

Secretary Levine: This has been a priority of Gov. Wolf’s since the beginning of his first term. Our term started in 2015. The inauguration was on a Tuesday and that Wednesday was the first meeting at the Governor’s policy office on the opioid crisis. This has always been a priority for Gov. Wolf, and his leadership has been absolutely key. The Department of Health has been collaborating with other agencies since the very beginning, but it focused on health and human service agencies. The disaster declaration broadened this to help foster collaboration with public safety, law enforcement and other agencies. The “all-hands-on-deck” approach has absolutely been key.

We also collaborate with the Legislature. This a completely non-partisan issue and the Governor has always been working with the Legislature. We also collaborate with counties and communities, with other states, as I mentioned ASTHO, and then of course, the federal government. We might have many disagreements in terms of federal policy, but actually in terms of the opioid crisis, we have had very good collaboration with the U.S. Department of Health and Human Services, particularly SAMHSA (Substance Abuse and Mental Health Services Administration), and of course the Centers for Disease Contro (CDC), and then robust funding from the federal government as well.

TGH: Lancaster County District Attorney Craig Stedman recently told us that he believes one of the answers to the opioid crisis isn’t just recovery, but long-term recovery. He told us, “Short-term recovery just doesn’t give the brain of a heavy heroin user the time it needs to recover from acute addiction.” Do you agree with him, and if so, are there any initiatives or legislative proposals that would make the path to long-term recovery clearer for opioid addicts?

Secretary Levine: I like the comments in terms of the issues with the brain. The Surgeon General of the United States has called addiction “a chronic relapsing neurological disorder.” I think that that is a very good description. As you know, there are particular brain changes, circuit changes that occur with substance use. I think that, from my perspective, we need to view addiction as a medical condition, and certainly not as a moral failing, and even more so as a chronic medical condition, and particularly as a chronic, potentially, relapsing medical condition. Long term recovery needs to be viewed in that context.

We’re certainly in favor of all forms of treatment, and the treatment needs to be individualized to the specific patient.  For many, if not most patients with opioid use disorder, we’ve been devoting our resources—and this is in full agreement with the federal government, SAMHSA and the CDC—on emphasizing medication-assisted treatment. Those medications can include methadone or buprenorphine medications, such as Suboxone, although there are other brands. And then, long-acting Naltrexone or Vivitrol, which works in a different way. I think you’ll find that most patients with opioid use disorder are going to do best with medication-assisted treatment, and we have expanded that availability through the Centers of Excellence, through the department of Human Services for patients predominantly on Medicaid, as well as through another program the Department of Health has sponsored called PAC-MAT, which stands for Pennsylvania Coordinated Medication Assisted Treatment. And so, I think the idea is that the medication allows the brain the time it needs to heal and to try to prevent that type of relapse.

There are a lot of unanswered questions in terms of medication-assisted treatment. One of them, of course, is how long should the medication be continued. There are a lot of different responses to that. Unfortunately, we don’t really know. There aren’t biological markers about which patients can be weaned off the medication and which patients can’t. So, that’s a decision between the patient and his or her physician.

TGH: Do you think enough is being done by the General Assembly to combat the opioid crisis? What more could be done by Pennsylvania lawmakers, in your opinion, to combat opioid use disorder?

Secretary Levine: We have been in very close collaboration with the Legislature on this issue. In 2014, the Legislature enacted Act 139, which authorized third-party prescriptions for Naloxone. Then, at the Department of Health, first as Physician General, and then as Secretary of Health, I wrote two standing order prescriptions. One was for first responders to have access to Naloxone, and the other is for the general public to have access to Naloxone. So, we have pushed out thousands and thousands of doses of Naloxone, which has resulted in saving thousands of lives. That was a collaboration with the Legislature that began even before the Wolf administration started. Another bill in 2014 was the Prescription Drug Monitoring Program (PDMP). That program started in August 2016, and over the last three years, through many measures, including the PDMP, we have effectively decreased the rate of opioid prescriptions by 30%. As a prevention method, I think that that has been key. One bill that we worked on with the Legislature was requiring continuing medical education for physicians. So, there has been lots of different collaboration with the Legislature on the opioid crisis.

TGH: What would you like to see done in the short-term to alleviate some of the bigger problems that are still outstanding with the opioid crisis?

Secretary Levine: Legislation that we’re going to be pushing in 2020 is the Syringe Service Program (SSP) and traditional harm reduction. Now, I want to draw a distinction between the Syringe Service Program and what Philadelphia was recently discussing, which is safe injection sites. That’s a whole other thing. SSPs have been available in the United States for decades. In fact, Philadelphia and Pittsburgh have had theirs for almost 30 years. Technically, however, SSPs are illegal under Pennsylvania law, and so they’re not able to be formed legally in other parts of the state. So, as strongly supported by the Department of Health and Human Services federally, as well as the CDC, we want to legalize SSPs and traditional harm reduction in Pennsylvania so that syringe service programs can start in other local areas. SSPs have been shown through many studies to be helpful in preventing HIV, preventing hepatitis, as well as serving as an access point to treatment, to getting Naloxone, and as an access point to referring people for treatment, and particularly medication assisted treatment. Our new initiative will be the legalization of syringe service programs.

Editor’s note: According to the CDC, “Syringe services programs … are community-based prevention programs that can provide a range of services, including linkage to substance use disorder treatment; access to and disposal of sterile syringes and injection equipment; and vaccination, testing, and linkage to care and treatment for infectious diseases.”

TGH: What about long-term aftercare programs like those offered by The GateHouse? Where do they fit in?

Secretary Levine: There are three pillars to our response under the disaster declaration. The first is Prevention. That includes school-based prevention, that includes community-based prevention, and then the work that I have done with the medical community, which I call “opioid stewardship.” The second pillar is Rescue. And that, of course, involves the medication Naloxone. And then the third pillar is Treatment and specifically, treatment leading to recovery. Our emphasis with opioid use disorder has been with either what you call “medication assisted treatment,” or “medications for opioid use disorder (or MOUD).” That is obviously where our emphasis has been.

There are other drugs, however, which are threats on the horizon—particularly methamphetamines and cocaine—which require adjustments to our response. It’s an ever-changing landscape in the Opioid Command Center, but under the leadership of Gov. Wolf, we’re going to be right there helping the state address this crisis.

***

Dr. Levine graduated from Harvard College and the Tulane University School of Medicine. She completed her training in Pediatrics and Adolescent Medicine at the Mt. Sinai Medical Center in New York City. She joined the Wolf Administration in 2015 as Physician General, and in 2017 was named Acting Secretary of Health, before being confirmed as Secretary of Health in 2018. She is currently a Professor of Pediatrics and Psychiatry at the Penn State College of Medicine and a Fellow of the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, and the Academy for Eating Disorders. You can learn more about her here.

Open post The GateHouse at Riverview Tower

FAQs About The GateHouse at Riverview Tower

With October 2019’s grand opening celebration of The GateHouse at Riverview Tower firmly in the rear-view mirror, questions still remain about the Riverview Tower estate and its history. Here are the most frequently asked questions we hear about the property and the answers we’ve been able to uncover.

Riverview Tower Under Construction
An early photo of Riverview Tower during its renovation.

When was the home built?

Construction of Riverview Tower began in 1873 and was completed in 1876—the year of the U.S. Centennial.

Who built it and why?

The limestone mansion was built by lawyer and industrialist Henry Miller Watts as a wedding gift for his son, Ethelbert.

Who was Henry Miller Watts?

Henry Miller Watts

Henry, whose grandfathers both served as Revolutionary War generals, was a founding member of the Union League of Philadelphia, which was established to support the Union and the policies of President Abraham Lincoln. After graduating from Dickinson University in 1824, Henry began a career in law, before moving up the ranks of the U.S. government and ultimately serving as the U.S. Ambassador to the Austrian Empire in 1868.

After being recalled from duty by President Harrison in 1869, Henry returned home to Pennsylvania, where he pursued pre-existing business interests in iron and coal. He found his way to Marietta, PA through his company, Henry M. Watts & Sons, which had previously taken ownership of two Marietta iron furnaces bordering the Susquehanna River in 1867.

The mansion is so unusual! What influenced its design?

 

An Early Photo or Riverview Tower
An early photo of Riverview Tower in Marietta, PA

Throughout his lifetime, Henry traveled extensively with his wife and nine children, living in different areas of Pennsylvania as well as in France and Germany. It was Henry’s time in Austria that most influenced the design of Riverview Tower.

From the ornate Mansard roof tower and Italianate design all the way down to the decorative medallions that adorn the ceilings, Riverview Tower blends the best of Italian, French, and Victorian architecture. Measuring more than 9,000 square feet in total, the mansion features 15 rooms and a three-story tower with panoramic views of surrounding mountains that can be seen through stunning glass walls.

Whatever happened to Ethelbert?

Ethelbert Watts

Ethelbert and his wife, Emily, took possession of the mansion five years after they were married in 1871 and lived there with their four children. Emily died in 1885, and when Ethelbert remarried 10 years later, the estate was sold to Colonel James Duffey, the son of a local industrialist. A veteran of the Civil War, Ethelbert entered foreign service in 1896, a year after moving out of the mansion. He would go on to serve as a United States diplomat for over twenty-four years, playing important roles in the Spanish American War, Russo-Japanese War, and World War I.

What happened to the mansion after that?

Riverview remained with the Duffey family until the 1940s, when Dr. William S. Simons, a local dentist, and his wife, Catherine, took ownership of the property. After they passed away, Catherine’s sisters lived in the mansion from the 1960s to the early 1970s. In 1974, the house was sold to Andrew Staubach, a York County resident who never actually lived in the home. Over time, the vacant, once-glorious mansion deteriorated. Fortunately, Riverview Tower was restored to its original grandeur when Joyce and Donald Hershey purchased the property in 1981.

Who were the Hersheys? Were they related to the chocolate family?

Donald Hershey

To the best of our knowledge, Joyce and Donald Hershey were not related to the heirs of the Hershey chocolate fortune. Don founded Hershey Equipment Company in 1968 and served as the president of the Lancaster Farmland Trust for a period of time. Joyce and Don were very committed to their faith, and Don served on the board of directors for a number of faith-based organizations including: Lives Changed By Christ Church in Manheim, Word of Life Church in Schroon Lake, N.Y., and the Old Time Gospel Hour Ministries in Lynchburg, VA.

Lives Changed By Christ? You mean LCBC here in Lancaster? What was their role with them?

Good question! Don and Joyce were among the original founders of LCBC church! In fact, they converted the garage of Riverview Tower into the very first venue for the church!

What improvements did Don and Joyce make to the mansion?

The Hersheys kept many original features during the rigorous remodeling process, including carved wooden doorknobs, gas chandeliers, copper and silver doorknob plates, wooden shutters, and oak and walnut patterned floors. The limestone exterior required re-pointing and the roof was re-slated under Joyce and Donald’s supervision.

The Hersheys also transformed dirt floors into luxurious amenities such as a second kitchen, a game room, a fitness room with a sauna, and a canning cellar.

The first floor, with magnificent 12-foot ceilings, includes a front hall, six fireplaces, a butler’s pantry, and a parlor. The library includes a macabre holdover from the Victorian era—a coffin door that was used to remove people who died in the house. The third floor features a ballroom and a sitting room with a stairway leading to the tower. Once the Hersheys bought Riverview, locals often referred to it as “the old Hershey Mansion.”

When did The GateHouse purchase the property?

The GateHouse purchased the estate in March of 2018, after receiving a grant from the Capitol Area Behavioral Health Collaboration issued in 2017. The inside of Riverview Tower has undergone a number of renovations to accommodate its incoming residents.

The changes will not, however, adversely impact the spirit of the Victorian era the estate represents. The GateHouse recognizes the historical significance of the property, and is committed to preserving its many notable features, including its limestone façade with the daisy motif as well as its arched windows, slate rooftops, and tranquil gardens.

What’s planned for Riverview Tower?

When The GateHouse at Riverview Tower officially opens its doors later this year, it will serve as the new home for women in recovery who are working to rebuild their lives.

More info about the residence:

A blend of Italianate and Victorian styles, the stone home was completed in 1876 under the direction of Henry Miller Watts, an ironmaster in Marietta during the iron boom of the late 19th and early 20th centuries. Watts also served as Pennsylvania deputy attorney general, state representative, U.S. attorney and ambassador to Austria.

Watts built the home as a wedding gift for his son, Ethelbert, and modeled it after a castle he admired in Austria. The tower features panoramic views of the Susquehanna River and its surrounding mountains through stunning glass walls.

QUICK STATS:

  • 4 acres
  • 3-story tower
  • 15 rooms
  • 6 large bedrooms
  • More than 9,000 total square feet
  • 2 bathhouses (added in 1985 and 2003)

The Grand Opening of The GateHouse at Riverview Tower

The GateHouse celebrated its grand opening of The GateHouse at Riverview Tower on Oct. 24, 2019. Attendees heard from a variety of inspirational speakers and had the opportunity to explore the grounds of the estate. Special thanks to Legacy donor Bob Wummer for his generous and unwavering support and to our Platinum Sponsor C&J Catering, who provided a delicious smorgasbord of delectable food. Thanks also to our Gold, Silver, and Bronze sponsors, as well. We couldn’t have done this without your help!

Follow us on Facebook for updates, and check out our online photo album of the event!

Click here to learn more about The GateHouse, or contact us to speak with someone today. 

Open post The GateHouse at Riverview Tower

The GateHouse at Riverview Tower: A History

When The GateHouse at Riverview Tower opens its doors at the end of this year, the majestic limestone mansion that sits on seven sprawling acres in Marietta will be transformed into a new home for women in recovery who are working to rebuild their lives.

The women living there will be the latest in a long line of residents who have occupied the tower since its final construction in 1876. From the son of an ironmaster, lawyer, and ambassador to a colonel, a dentist, and a family with a deep love of architectural history, the occupants of Riverview Tower have engaged in a tradition of service that stretches back for generations.

Riverview Tower by Thomas Hermansader
Artist Thomas Hermansader memorialized Riverview Tower in one of his paintings.

A Mansion Forged from Iron

Construction of Riverview Tower commenced in 1873 and was completed in 1876—the year of the U.S. Centennial. The estate was  built by lawyer and industrialist Henry Miller Watts as a wedding gift for his son, Ethelbert.

Henry, whose grandfathers both served as Revolutionary War generals, was a founding member of the Union League of Philadelphia, which was established to support the Union and the policies of President Abraham Lincoln.

After graduating from Dickinson University in 1824, Henry began a career in law, before moving up the ranks of the U.S. government and ultimately serving as the U.S. Ambassador to the Austrian Empire in 1868. After being recalled from duty by President Harrison in 1869, Henry returned home to Pennsylvania, where he pursued pre-existing business interests in iron and coal. He found his way to Marietta, PA through his company, Henry M. Watts & Sons, which had previously taken ownership of two Marietta iron furnaces bordering the Susquehanna River in 1867.

Nestled into a corner at the crossroad between routes 23 and 441, the hill upon which Riverview Tower sits is known to this day as “Ironmaster’s Hill.”

Throughout his lifetime, Henry traveled extensively with his wife and nine children, living in different areas of Pennsylvania as well as in France and Germany. It was Henry’s time in Austria that most influenced the design of Riverview Tower.

From the ornate Mansard roof tower and Italianate design all the way down to the decorative medallions that adorn the ceilings, Riverview Tower blends the best of Italian, French, and Victorian architecture. Measuring more than 9,000 square feet in total, the mansion features 15 rooms and a three-story tower with panoramic views of surrounding mountains that can be seen through stunning glass walls.

Riverview Tower Under Construction
Riverview Tower under construction (year unknown).

Ethelbert and his wife, Emily, took possession of the mansion five years after they were married in 1871 and lived there with their four children. Emily died in 1885, and when Ethelbert remarried 10 years later, the estate was sold to Colonel James Duffey, the son of a local industrialist. Riverview remained with the Duffey family until the 1940s, when Dr. William S. Simons, a local dentist, and his wife, Catherine, took ownership of the property. After they passed away, Catherine’s sisters lived in the mansion from the 1960s to the early 1970s.

In 1974, the house was sold to Andrew Staubach, a York County resident who never actually lived in the home. Over time, the vacant, once-glorious mansion deteriorated.

A Return to Victorian Splendor

Fortunately, Riverview Tower was restored to its original grandeur when Joyce and Donald Hershey purchased the property in 1981. The Hersheys kept many original features during the rigorous remodeling process, including carved wooden door knobs, gas chandeliers, copper and silver door knob plates, wooden shutters, and oak and walnut patterned floors. The limestone exterior required re-pointing and the roof was re-slated under Joyce and Donald’s supervision.

An Early Photo or Riverview Tower
An early photo of Riverview Tower in Marietta, PA

The Hersheys also transformed dirt floors into luxurious amenities such as a second kitchen, a game room, a fitness room with a sauna, and a canning cellar.

The first floor, with magnificent 12-foot ceilings, includes a front hall, six fireplaces, a butler’s pantry, and a parlor. The library includes a macabre holdover from the Victorian era—a coffin door that was used to remove people who died in the house.

The third floor features a ballroom and a sitting room with a stairway leading to the tower.

Once the Hersheys bought Riverview, locals often referred to it as “the old Hershey Mansion.” But for the couple, living in the historic estate was about more than just filling it with beautiful objects. They carried on the tradition of service by converting the garage into the very first venue for the Lives Changed by Christ Church (LCBC), which the couple co-founded with several others. After years of joyfully listening to their grandchildren’s laughter filling the great mansion, the couple sold the estate in 2008, after making the difficult decision to downsize.

A New Era, A New Start

Since it was purchased by The GateHouse in 2018, the inside of Riverview Tower has undergone a number of renovations to accommodate its incoming residents. The changes will not, however, adversely impac

Riverview Tower Office Building
Riverview Tower’s newly renovated office building, where residents will meet with their counselors.

t the spirit of the Victorian era the estate represents. The GateHouse recognizes the historical significance of the property, and is committed to preserving its many notable features, including its limestone façade with the daisy motif as well as its arched windows, slate rooftops, and tranquil gardens.

In fact, it’s fitting that Riverview Tower will soon be home to The GateHouse for Women. Once a present from a father to his son and daughter-in-law and later inhabited by many who served their country and community, the mansion now offers a different kind of gift—a new start for women fighting hard to overcome addiction and who ultimately desire to give back to the community themselves.

At the end of 2019, The GateHouse at Riverview Tower will officially open its doors to women eager to start the next phase of their lives. In the meantime, come take a tour of this important piece of Pennsylvania’s past and future at our Grand Opening Celebration on Oct. 24. Together, we will begin to write the next exciting chapter in the history of Riverview Tower.

Interested in sponsoring the Grand Opening event on Oct. 24, 2019?

Download out sponsorship flyer to learn more!

Interested in making a memorial donation to The GateHouse at Riverview Tower?

Download our memorial donor flyer to learn more! 

Open post Ryan Aument

The Opioid Crisis as a Public Policy Issue: The Perspective of Sen. Ryan Aument

Across the country and around the state of Pennsylvania, there are very few lives that are untouched by the effects of the national opioid crisis. It’s true in our small towns, it’s true in our big cities, and it’s true right here in Lancaster County.

In the halls of state government, Pennsylvania lawmakers are actively working to address it.

Senator Ryan Aument, who serves northern Lancaster County’s 36th state Senatorial District, said many of his colleagues in the Pennsylvania Senate have both publicly and privately shared stories about how the opioid epidemic has hit home for them.

“It’s very rare that you engage a family now that doesn’t have a loved one or someone they know touched in some way by the disease of addiction, whether it’s heroin, prescription drug abuse, or something else,” he said. “In my own family, I have a brother-in-law who has struggled for the past number of years with addiction. For him, it started with an opiate prescription for a shoulder surgery. He’s struggled with prescription drug addiction ever since. The sad fact is that nearly every family is impacted by this crisis on some level.”

 

The Frustration for First Responders

 

Even before his brother-in-law’s battles, however, Sen. Aument was hearing about the scourge of addiction and the impact the opioid epidemic was having on Central Pennsylvania.

“About halfway through my first term in the Senate, I did ride-alongs with each of the police departments in the 36th District—at least the ones that had ride-along programs at that time,” he said. “I think I went out with about eight police departments. I typically did a night shift. I would go out on a Friday night from about eight o’clock to about two in the morning. I didn’t do a full shift, but I did a good portion of it.”

Without fail, he said, each and every police officer he talked to cited opioid addiction as their top concern and the top issue that their communities were facing.

“They could even point to certain houses where they had monitored dealing, or where folks had overdosed, or places where they had brought someone back through the administration of Narcan,” he said. “It was eye-opening.”

Several years later, he still hears the frustration from law enforcement. The concern now centers around seeing the same individuals time and time again.

“These officers often feel helpless to get these people the help they need,” Sen. Aument said. “They can hand them off to EMS personnel, but there’s no requirement that they go into treatment. So, of course, this is where you begin to see the bridge to a public policy discussion.”

 

An Issue to Rally Around

 

Sen. Aument said there are a number of people who continue to advocate for involuntary commitments.

“After so many instances of overdose and the administration of Narcan or Naloxone, the question that keeps coming up is, ‘Should there be some sort of rule about when involuntary commitment is required?’” he said. “More importantly, would that even be effective? If somebody is being forced into treatment, that means they’re unwilling to go into treatment, so is it really effective? That’s one issue that the Legislature is still debating.”

And debates in Harrisburg aren’t typically easy. In such a politically polarized environment, even the most rudimentary of discussions can quickly devolve into contentious legislative battles. But when it comes to the opioid crisis, Sen. Aument said Republicans and Democrats seem to have found common ground.

In January 2018, when Gov. Wolf declared the opioid crisis a statewide disaster emergency to, in part, encourage lawmakers to take action, both sides of the aisle rallied around the decision.

“I certainly think he was right to do so, because I think it helps elevate the conversation and shine attention on the issue,” Sen. Aument said. “This is one of those areas where there has been tremendous bipartisan support and agreement. Sen. Gene Yaw, a Republican in our caucus, has been a real leader on these issues and has conducted a number of hearings and has worked closely with the governor. In fact, last year in his budget address, the governor specifically highlighted the work of Sen. Yaw on these issues. It has been good to see such a bipartisan effort, and I do give the governor a lot of credit for bringing attention to these issues and for looking for ways to drive funding out.”

However, Sen. Aument says he doesn’t have a good handle on whether the Commonwealth is being diligent enough in its efforts to follow through on existing policy and program funding.

“We want to make sure that we’re actually taking a look at the return on our investments and measuring outcomes to make sure we’re driving funding to the communities that need it most,” he said. “We also must make sure that those communities are, in turn, using that funding for programs like those at The GateHouse, which are having a real impact, both from an educational standpoint as well as from a treatment and recovery standpoint.”

 

Proposals for Progress

 

This past February, Sen. Aument said, members of the state Senate Republican Caucus held a retreat to discuss legislative priorities.

“The issue of combating the opioid crisis ranked very high among our members,” he said. “It fell just behind economic issues and workforce development, which are always at the top of the list. That should illustrate just how big of a deal this is to lawmakers.”

In mid-June, just as the General Assembly was working to finalize a budget plan for the new fiscal year that began on July 1, Senate Republicans introduced a package of bills aimed at curtailing the opioid crisis through changes in public policy. One of those bills was Sen. Aument’s Opioid Patient Treatment Agreement, Senate Bill 572. The Senator’s cosponsorship memo can be found here.

“One of the areas I believe we need to address is when someone is going to be prescribed an opiate for a protracted length of time,” Sen. Aument said. “In those circumstances, my bill would require an opiate prescription plan that would be agreed to between the physician and the patient. The plan would provide for baseline drug testing to be done, so we know what’s in the patient’s system and we know that that person is not already abusing substances. Then, there would be random drug testing to make sure the plan is being followed.”

Other bills in the package call for limiting opioid prescriptions to seven days unless there is a medical emergency that puts a patient’s health or safety at risk, stiffer penalties for drug dealers, the establishment of a recovery-to-work program to help recovering addicts find occupations through local workforce development boards, and more.

“And these are just some of the specific policy discussions that we’re having,” Sen. Aument said. “There’s no member who’s not hearing from their constituents about this problem and isn’t very much engaged in this issue. We’re looking to provide as much assistance as we can to the folks doing the great work at places like The GateHouse. Legislatively, we want to do as much as we can to give them the tools that they need to help the greatest number of people.”

 

A Problem with Many Perspectives

 

Just about everywhere he goes, Sen. Aument said he hears from people on all sides of the opioid discussion.

“Whether I’m out in the community talking to families or whether I’m talking to law enforcement or taking tours of facilities, it’s on everybody’s minds,” he said. “We are also receiving calls in our offices in Lititz and Harrisburg, as well. In many cases it’s a family member who’s very, very concerned for a loved one and is looking for resources and ultimately an answer. In some cases, the individual may be interested in treatment and we can make a referral or direct them to a resource like The GateHouse.”

In other cases, however, it may be a family member who’s concerned and is trying to get help for a loved one who has yet to show an interest in treatment.

“Obviously, that’s a far more difficult conversation,” Sen. Aument said. “And it once again brings up this discussion of whether you can or should force someone into treatment who doesn’t want to be there. I hear from folks on all sides of this aspect of the issue.”

There are no easy answers, he said.

“I’ve talked to folks—really smart people who know these issues and know the industry really well—and even they have different perspectives and opinions about it,” Sen. Aument said. “And then you have medical personnel and law enforcement officials who are just looking to get some help to stop the repeated overdoses. It’s incredibly demoralizing for EMS and police. They continue to express to me their tremendous frustration just about every time I speak with them.”

Narcan and Naloxone are both effective treatments for overdoses, but they’re also very expensive and can drain public resources. That’s where lawmakers have to draw clear lines and decide when enough is enough.

“It’s a tough one,” Sen. Aument said. “If you back me into a corner, I think there almost has to be a trigger at some point when you’re dealing with the same individual four and five times, over and over. I don’t know what the magic number is, but I do believe there ought to be some sort of requirement to seek treatment when you’ve been revived numerous times. While I recognize that for some of those folks it may not be effective, maybe for one or two it will.”

Open post District Attorney Craig Stedman

Where Drugs and Crime Intersect: District Attorney Craig Stedman’s Perspective

When Craig Stedman began his career as an assistant district attorney 28 years ago, the drug epidemic facing the country was crack cocaine. Heroin or opioids weren’t even a close second.

“You could count on one hand how many heroin cases we had,” he said recently. “Even at the beginning of my term as DA in 2008, we didn’t have as many opioid problems as we do today. In the past five years, we’ve just had an absolute explosion in heroin cases and heroin-related deaths.”

From his position as the county’s top law enforcement official, Stedman sees the impact arrests and convictions are having on the local illicit drug market. Unfortunately, he said, the problem isn’t going away—it’s just going in a different direction.

Just recently, for example, the Lancaster County Drug Task Force captured a long-time heroin dealer who was selling cocaine and methamphetamines. He had no heroin on him.

“We asked him, ‘You’re a heroin dealer! What are you doing with this stuff?’ He said, ‘Look, dude, I’m not catching a body in Lancaster County.’”

Stedman said dealers aren’t giving up, they’re just adapting to changing conditions. Fentanyl-laced heroin is killing people in high numbers, and drug dealers know that if what they sell kills someone, they’re going to jail for a long time.

“And they’re not willing to take that risk,” he said. “So, while we’re definitely making a difference from an enforcement perspective, I’ll be the first to tell you—and I’ve said this a million times—we are not going to arrest our way out of this problem.”

The Bigger Picture

The long-term answer isn’t enforcement, Stedman said. The long-term answer is education, prevention, and treatment.

“And not just treatment—long-term treatment,” he said. “Short-term rehab just doesn’t give the brain of a heavy heroin abuser the time it needs to recover from acute addiction.”

Aftercare is critical, Stedman said.

“As a country and as a county, we need to invest in long-term treatment,” he said. “As a heroin addict, you don’t go into a 15-day rehab and expect everything to be just fine. Heroin addicts are going to struggle with this the rest of their lives. Thankfully, organizations like The GateHouse understand that. They treat the whole person, not just the symptoms of the addiction.”

To truly address the problem, Stedman believes local, state, and national leaders need to make treatment a priority with proper funding.

“So far, unfortunately, I haven’t seen a willingness to do that, so you’re getting this revolving door,” he said. “These people think they’re fine because they’ve been told they’re fine, but they’re not fine. They’re heroin addicts, and their brains are wired that way. It’s science. They need the right tools.”

The Paths to Addiction

Although his focus is on the adjudication of crimes, Stedman said he’s learned a lot about addiction during his time as a prosecutor. He said he sees two typical paths to opioid addiction.

The first is through prescription medication.

“We’re learning that some people are more biologically prone to addiction than others,” he said. “After a surgery, two people might go and get an opioid prescription. One of them might say, ‘I never want to use that stuff ever again.’ The other might say, ‘This is the greatest feeling I’ve ever had. I never want to stop.’ At that point, it’s no longer a choice. It’s an addiction.”

The second path is the “gateway path.”

“That’s the more traditional one, and unfortunately, it’s the one a lot of heroin users take,” he said. “They start with alcohol, or marijuana. They’ve got the biology, they love the high, so they start using or drinking more and more, and they find out they can’t recreate that high they crave. So, they switch to cocaine, and the same thing happens. At first, they’re like, ‘Oh, this is awesome,’ but then they become tolerant to it. Now they’re using cocaine all the time to recreate that high, and it doesn’t work. That’s when they switch to heroin.”

Had they never been exposed to the drug, they would probably be fine living their entire lives never having a concern about it, Stedman said. Once they’re exposed, either through experimentation or prescription, it takes over their lives—and the lives of those around them.

“It doesn’t just damage the person who’s using,” he said. “It destroys everyone who cares about them. It’s this huge wake. The family keeps trying, and they can’t get them to get help. We actually did a public service announcement with a couple of mothers who lost their kids. It’s gut-wrenching stuff. It’s horrible.”

Beyond Arrests and Convictions

Stories like these are why he’s tried to find new and innovative ways to address drug crimes before they start. A few years ago, Stedman hired community outreach coordinator, Sarah Fritz. It was the first hire of its kind in the history of the Lancaster County DA’s office.

“She’s not a lawyer, and she’s not a police officer,” he said. “She’s a civilian. Her whole focus is on building relationships within the county and within the school systems to further the goals of outreach, prevention, and education.”

While she has addressed bullying, pornography, and other social ills affecting the county’s youth, Stedman said Fritz’s primary outreach efforts have centered around drugs.

“Again, we’re not going to enforce our way out of this,” he said. “We need to be much more proactive, and that’s why we’ve really tried to think outside the box—beyond arrests and convictions.”

Speaking of boxes, Stedman’s office also introduced a lock-box initiative using drug money seized from dealers.

“Since one of the key pathways to opioid addiction is prescription drugs, we’ve taken forfeiture money and bought little lock boxes to hand out,” he said. “They have little combinations on them, and they’re designed to encourage people to lock up their prescription medications.”

While the lock boxes aren’t meant to withstand overwhelming force, Stedman said, they’re just sturdy enough to keep dangerous prescriptions out of the wrong hands.

“A lot of people who have surgeries and are prescribed controlled substances don’t even think about it,” he said. “They take them home and put them on the top shelf of their medicine cabinet and forget how dangerous they are.”

The lock boxes are a way for people to make sure these medications are secured.

“This is a tangible way to do something proactive,” Stedman said. “If it saves one life, it’s worth it.”

Diversionary Programs

One of the big issues facing law enforcement is what to do with offenders once they’ve been caught. In Lancaster County, whether to prosecute a case or refer it to a diversionary program is determined on case by case basis, Stedman said.  Sometimes it’s an easy decision, sometimes it’s not.

“The guy who sells heroin for money to people he doesn’t know, and someone dies, he’s going to be treated a whole lot worse than two heroin addicts who were friends and users together and one gives it to the other and that person dies,” Stedman said. “They’re just completely different situations.”

Lancaster County law enforcement reserves its harshest penalties for what Stedman calls “predator dealers.” But not everybody falls into that category. About 22% of the DA’s cases are sent to some sort of diversion or treatment program, whether it’s ARD or a treatment court like drug court, mental health court, or veteran’s court.

“We’ll try to find the right court for the right person,” he said. “Obviously, depending on what the crime is, we have to find the right balance. If a heroin addict broke into someone’s home, for example, there has to be accountability for that.”

It’s tough, because not every case is easily sorted out.

“Many of these people are not bad people,” Stedman said. “They don’t have evil intentions. They’re just addicts. It’s no different than any other disease.”

While Stedman has ultimate authority over how a case is handled in Lancaster County, he doesn’t make the decision himself, he said. Whether a case involving substance abuse is prosecuted or sent to a diversionary program depends on a variety of factors and a variety of input.

“All the programs have teams, so I’ll listen to what the team recommends,” he said. “We also have to talk to the victims. That’s very important. If it’s a victim crime—DUI, personal injury, or something else—we’re going to want to get their input. We also rely a lot on input from the police officers who have often dealt with these people before.”

It is unlikely, for example, that a predator drug dealer would find his way into a treatment court. On the other hand, someone with ties to the community who has slowly descended into criminal behavior as the result of a substance dependence might have the opportunity to enter a diversionary program.

“We’re looking for people who have a chance of success,” Stedman said. “We also look at the drug. Obviously, the marijuana dealer is going to have a better chance of getting more lenient treatment than somebody who’s out there selling fentanyl. With the people selling fentanyl, you know somebody’s probably going to die.”

People who commit sexual offenses are statutorily prohibited from entering diversionary programs, so they’re not even considered, he said.

“We also have a modified track,” Stedman said. “It’s not necessarily a diversionary program, but it’s not a straight guilty plea, either. If you complete the appropriate program, we’ll drop the felony and you’ll just have a misdemeanor on your record. For some of the cases that are in the gray area, a modified track usually works well for everybody involved.”

The Pursuit of Justice

When it comes down to the final decision, however, Stedman said he and the team are asking themselves one very important question: “What should happen here?”

“It’s a complicated question in one way, but in another way, it’s a really simple question,” he said. “What’s the right thing to do? Does this person need to be in jail? Does this person need a second chance? Will this person benefit from a modified track? What is the best thing?”

Stedman said it’s important to treat everyone as an individual.

“They’re not just numbers in a case file,” he said. “The victims are people and the defendants are, too. We’re just tasked with the job of determining what’s going to be the best long-term outcome for the community. If the team can sell me on a case, and they want to take a chance, then I’m not afraid to do that. Sometimes it backfires. Sometimes it doesn’t work.  Unfortunately, nobody gives you a crystal ball.”

While the DA’s drug task force is bringing in more drug-related criminals than ever before, Stedman said more work needs to be done. Drug-related deaths are everywhere—even in places you’d least expect them.

“We just had a case a couple months ago, where we had a death in prison and made arrests,” he said. “A couple of guys who were picking up trash on work release arranged to have someone put heroin out for them. They brought it back to the prison, and one guy died. Another guy almost died.”

Tragedies like these often leave Stedman shaking his head.

“I think we need a stronger word than ‘addiction,’” he said. “I don’t think that word captures it enough. If you put an axe and some heroin on the table in front of some of these addicts and say, ‘If you take the heroin, we’ll chop your hand off,’ they’re not even going to think about it. They’re going to tell you to chop their hand off. They can’t even think straight. It’s just completely taken over their brains. That’s why I really appreciate the work that organizations like The GateHouse are doing to try to help people.”

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