The sober life

“There are lots of Million Dollar Murrays in Reno,” said Deputy Shawn Marston, referencing an article in the New Yorker written by Malcolm Gladwell about an alcoholic homeless man in Reno who managed to rack up about a million dollars in hospital, ER and jail costs over a 10-year period. Murray was a “frequent-flier” who would sometimes be picked up by police or an ambulance several times a day, depending on how drunk he was.

For the past two years, Catholic Charities has been supporting a program through their St. Vincent Residency program aimed at helping alcohol- and drug-addicted homeless people by providing a place to live and a complete treatment program. According to Anna Strub, a social worker assigned to the residence program from Washoe County Social Services, these are people who really want to be sober, but need the basics to help them get there.

“These people need a place to live where they feel safe and they have all the support necessary to get sober and stay sober,” Strub said.

Residents of St. Vincent’s have a specific treatment plan designed around attending Alcoholics Anonymous (A.A.) and Narcotics Anonymous (N.A.) meetings, taking life skills and job skills classes, and getting a GED or high school diploma. Several government agencies and non-profit agencies come together to provide support and services. The program also helps the residents re-establish their identities by helping them locate birth certificates and Social Security cards.

This program is not like some other faith-based programs in Reno where the individual is thrown out of the program for falling off the wagon. The St. Vincent’s Residency program allows for mistakes and slips, only throwing someone out of the program for violence against the staff or residents. Strub says the success rate is quite high, around 70 percent. But because the program allows clients to return, exact figures on how many people continue to do well are a moving target.

“These people really want to be here and we know from experience that relapse is a part of recovery,” Strub said. “Throwing them back on the streets isn’t what they need, so we will forgive them as many times as it takes.”

New uses for old drugs

There haven’t been many drugs on the market that help alcoholics stop drinking. The most common drug prescribed over the years has been Antabuse, a drug that is meant to cause an aversion to alcohol by causing some nasty side effects if alcohol is taken with it.

There is a drug that has been used to help drug addicts stop craving opiates called Naltrexone, which is starting to be used with chronic alcoholics. The drug works by numbing the pleasure center in the brain that craves the continued use of alcohol or drugs. Naltrexone is currently being used by a handful of the residents at St. Vincent’s. It should used under a doctor’s supervision, and doctors are not prescribing it unless the patient is also in a treatment program.

Scott Reid grew up between Winnemucca and Valmy and started drinking when he was 13. After years of working on ranches and doing construction, Reid became homeless by choice.

“I just didn’t care for a long time, but now I’m ready to do the work, and I want to be sober,” he said.

At the age of 50, Reid was one of Reno’s frequent-fliers.

“There wasn’t no one who didn’t know me, no cops, no deputies, no ambulance drivers and no firetruck drivers,” he said. “Everyone knows who Reid is.”

Reid came into the program when it first started in January 2011. The first time, he stayed for eight months. Then he spent time in jail and eventually came back to St. Vincent’s about three months ago. The Washoe Access to Health Care (HAWC) clinic doctors prescribed Naltrexone to Reid, and he has been taking it just a little over a month.

“At first it made me irritable and messed with my sleep, but then it leveled out, and now I don’t really notice it,” Reid said “It also helps with the obsession of thinking about drinking. I usually have trouble staying sober right around three months, so it is helping me.”

Cost benefits

Million Dollar Murray racked up the charges when he would drop over on a sidewalk. Someone would call 911 and along with police and fire, REMSA would show up. According to Marston, those units arriving at the scene costs about $1,000 for every trip. That didn’t include the charges racked up at the hospitals, which could easily run up to five figures or more.

The charge to keep one person in jail per day is approximately $109. Many homeless people end up in jail for days and months, costing thousands of dollars before they are put back on the street. The daily cost for St. Vincent’s Residency program is about $21. Food is provided through several avenues, including the Food Bank of Northern Nevada, Catholic Charities Food Bank, and in some cases, residents have applied for and been given food stamps.

A months’ stay in the Washoe County jail costs taxpayers about $3,270. Naltrexone costs about $48 per month, added to the $630 per month cost of the residence program, come out to about $680 per month.

Not a magic bullet

Naltrexone is not the cure for chronic alcoholics. It is simply another tool in the recovery toolbox. According to Dr. Dan Ahearn, HAWC chief executive officer, the evidence is showing that the drug is good for treating chronic alcoholics. But he warns against anyone taking it on their own.

“A person needs to be under the care of the prescribing physician who will check for liver disease, kidney issues and any other underlying medical problems before the drug is given,” Ahearn said. “That individual also needs to be in some type of treatment program as well, so that they benefit from all possible services.”

Kevin Quint, executive director of Join Together Northern Nevada (JTNN), also said that Naltrexone should be part of a treatment program: “The people who are currently on this drug have been chronic alcoholics who are already willing to try harder to become sober this time around.”

Quint is a big supporter of A.A. because he has seen positive benefits over the years: “Personally, I love it. I’ve had friends and family members who’ve done really well in A.A., and I just love the philosophy.”