Cameo with ​Dr. Bernadette Solounias

As a leading addiction treatment center, does Father Martin’s Ashley have a typical patient?
No. We have people from all walks of life. We have 18-year-olds and 80-year-olds, men and women, professionals and college kids, married, divorced, never married, clergy, doctors, lawyers, nurses. The common thread is the addiction. About 50 percent have alcohol dependence as their primary disorder. Another 30 percent have opiate/opioid dependence as their primary disorder, but we treat all the drugs.

Do you use the 12-step program?
The co-founders [Father Joseph Martin and Mae Abraham] wanted to develop a program that would treat people very respectfully, as people having an illness rather than a disgraceful disorder. We are 12-step-based, but we’ve broadened that. We focus on a holistic approach. It looks at their whole life, including their mind, body, spirit and community.

Are there degrees of addiction? Can someone be a minor alcoholic?
Yeah, actually, the new diagnostic criteria have mild, moderate, and severe categories. And it’s not only the amount of drug or alcohol consumed, it’s how far out the negative ripples go in terms of the effect on their lives.

Why does one person become an addict and another doesn’t?
The biggest factor is our genetics. Fifty percent is determined by genetics. It is an illness that is transmitted in families genetically, but also socially; there are learned behaviors.

Are you able to identify who will succeed after treatment?
It’s often hard to predict. Sometimes there are people we think are going to be successful and we’re shocked that they relapse fairly quickly. Other times, we didn’t have confidence in somebody’s ability to stay in recovery and then were totally shocked that they’ve gotten themselves stable. Stable relationships and being able to maintain employment, those are good predictors of success.

Can you think of some improbable success stories you’ve seen?
One young man comes to mind. He came from a professional family and he went off to college and got addicted to heroin. He came to Ashley for treatment and he seemed to do well. Really pleasant young man. We discharged him, and he relapsed. He returned to Ashley for his second treatment and at this treatment he went to a halfway house when he left treatment and he’s done extremely well. He’s gone on to maintain a life of recovery. He’s gotten married. He has a baby. He’s doing well. He’s certainly a success story.

Another man, someone from our pain recovery program, had sustained a very severe injury at his job and was quite disabled. As a result of his injuries, he developed chronic pain, became addicted to his pain medicines, then got addicted to heroin. Then—this was a man who was employed—he ended up living on the street for several years as a heroin addict and was really plagued by the chronic pain as well. It just really didn’t get better. He came into our treatment program. His first admission lasted about 24 hours and he left; he was not happy. He left treatment and about four to six weeks later, he returned [to] our pain recovery program. He did extremely well. We were able to do a detoxification from the opiates. He was not pain-free, but he was far more comfortable. His socialization improved. His mood improved. He went onto a halfway house. We moved him to a climate that was more suitable for his chronic pain and he has done well in that setting and has been an example for other young men in that setting. He was really an inspiration.

How concerning is the rise of opioid addiction?
Opioid addiction is a huge concern because of the heroin-related emergency department visits. In Harford County [where Father Martin’s Ashley is located], heroin-related intoxication deaths have increased by 191 percent between 2007 and 2014. One of the motivations for Father Martin’s Ashley getting involved in our [new] outpatient program was concern in Harford County about the number of overdoses that presented to our local hospitals. There’s also an increase in the number of babies born in opioid withdrawal in the U.S. We also need to talk about alcohol. Alcohol is still a lethal drug. Alcohol-related intoxication deaths have increased by 266 percent in the county.

Really? That doesn’t get nearly as much attention in the media.
No, it doesn’t. There’s not this huge rise in alcohol use disorders that we see in opiates and opioids, but it’s still the most common drug of abuse out there. And it’s associated with so much trauma: traffic accidents, pedestrian accidents, boating accidents, domestic violence.

What’s your position on decriminalization?
Individuals who have a substance-use disorder should be able to get the treatment they need to be able to live a life in recovery. Addiction isn’t a moral failing. After years of research, the medical community has learned that it is a disease of the brain. It’s a public health issue. I don’t know if you remember Kurt Schmoke, but he was our first mayor who said we should be looking at addiction in the City of Baltimore as a public health problem, not as a legal problem.

Yeah, it’s an idea that’s been around, but it has recently gained more mainstream acceptance.
I think there has been a huge push to think about addiction as a chronic illness, a relapsing illness and de-stigmatizing addiction. It can be viewed more as a medical problem than a legal problem.

To that end, Father Martin’s Ashley started a pain recovery program, right?
It’s about three years old, and this is for people who have chronic pain who have become dependent on their prescription medications. Most of them have sustained some injury or have had chronic medical problems resulting in the chronic pain. Our goal for them is to increase their functioning, increase their activity, detox them from their pain medications because often the medicines are no longer effective, and improve their overall quality of life. That program is really quite separate from our main program with a focus on physical therapy, physical activity, really looking at pain and their dependence on drugs.