His mother and sister would find him dead from an overdose in the room he was renting at a sober-living house. Two-thirds of addicts drop out or get kicked out of his program, he said. Greenwell underlined his point. As the broader war on drugs is being reconsidered — even in conservative states like Kentucky — officials have concluded that an incarceration-first strategy is not only costly but also bad policy.

Drug courts that shuttle defendants to rehabilitation facilities instead of locking them up are now ubiquitous. But a reforming justice system is feeding addicts into an unreformed treatment system, one that still carries vestiges of inhumane practices — and prejudices — from more than half a century ago.

John Peterson got hooked on heroin in the mids, soon after returning home to Los Angeles from a stint in the Army. He struggled to stay in college and to kick the drug. He tried to detox at home with codeine-laced cough syrup. He made regular visits to a clinic on West Pico Boulevard where he was injected with a mysterious brown liquid that he was told could cure him. The infusions were nothing but a painful hoax.

It was an impossibility. A decade later, Camarillo was still the closest approximation of drug treatment available.

Peterson decided he could do it like Bird. He entered the Spanish Mission-style facility, located 60 miles north of Los Angeles, under the wrenching spell of heroin withdrawal. In the room Peterson shared with 50 other patients, he was the only drug addict. Not once did a doctor treat him, a nurse attend to him or a psychiatrist hear his story. In the eyes of the staff, he recalled, all that distinguished him was that he was a little more sane than the rest of the patients.

Instead of receiving treatment, Peterson was recruited for staff duties. He was ordered to help restrain other patients during electroshock therapy. Patients were forced to strip naked before bed and to leave their clothes in a pile outside the dormitory. After lights out, Peterson said, some residents would rape the weaker and more vulnerable. His best friend was an alleged murderer who had been deemed mentally incompetent to stand trial. As he had to do with others, Peterson was made to hold his friend down for shock treatments.

At the time, addicts were lucky to find a hospital bed to detox in. A hundred years ago, the federal government began the drug war with the Harrison Act, which effectively criminalized heroin and other narcotics.

Doctors were soon barred from addiction maintenance, until then a common practice, and hounded as dope peddlers. They largely vacated the field of treatment, leaving addicts in the care of law enforcement or hucksters hawking magical cures. Jails and prisons filled with heroin addicts. They became so despised by wardens that early in the Depression, the federal government established two model facilities just for addicts.

One of the two was built in Lexington. These so-called hospitals still bore all the marks of a prison, and at least 90 percent of the residents relapsed after leaving. To this day, getting locked up is the de facto treatment for a large percentage of addicts. The philosophy of AA co-founder Bill Wilson, also known as Bill W. This was considerably less frightening and more affordable than electroshock therapy. The Big Book, first published in , was the size of a hymnal. With its passionate appeals to faith made in the rat-a-tat cadence of a door-to-door salesman, it helped spawn other step-based institutions, including Hazelden, founded in in Minnesota.

Hazelden, in turn, would become a model for facilities across the country. In ways that may be familiar to reformers today, government officials began to rethink incarceration policies toward addicts. Mandatory sentences fell out of favor, and a new federal law, the Narcotic Addict Rehabilitation Act, gave judges the discretion to divert a defendant into treatment. The law also laid the groundwork for our current system by encouraging local communities to open their own treatment facilities.

Faith-based and step programs, despite the fact that they had little experience with drug addicts in the late s and early s. The number of drug treatment facilities boomed with federal funding and the steady expansion of private insurance coverage for addiction, going from a mere handful in the s to thousands a few decades later. The new facilities modeled themselves after the ones that had long been treating alcoholics, which were generally based on the step methodology.

Recovering addicts provided the cheap labor to staff them and the evangelism to shape curricula. Treatment facilities were designed for discipline. From the start, Wilson intended AA to work with, not against or instead of, the latest and best medical science to treat addiction.

In , he recruited Dr. Along with Dr. Marie Nyswander and Dr. Kreek, Dole pioneered methadone treatment for heroin addicts. But they found that methadone treatment worked. Charles Dederich, a gravel-voiced salesman and an alcoholic, built an empire on this harsh sentiment.

After attending AA meetings in Southern California in the late s, he grew to believe that they were not tough enough. The addict needed more than brotherhood. Dederich held that addicts lacked maturity or the ability to handle freedom responsibly.

They must be broken down to be built back up. John Peterson was one of the first to move into Synanon, as the commune was called. It worked for him, though not for many others. At Synanon, sobriety was achieved not just with mutual support but through mob-directed brainwashing.

If an addict broke the rules, he faced public humiliation, such as being forced to wear a sign around his neck or shave his head. A centerpiece of the treatment was a confrontational form of group therapy that became known as the Game. The Game was a primitive court-like spectacle where addicts sat in a circle and leveled indictments against their peers, screaming at each other in the hope of a breakthrough. At one point, the verbal shock therapy went on three days a week, an hour or so at a time.

The Game would evolve into longer versions that played out over the course of several uninterrupted days.

Sleep deprivation was supposed to act as its own mind-altering drug. treatment system and particularly in prisons. By the early s, former members and others began branching out across the country forming their own versions of the Synanon model. He went on to work there and became a regional director. The program also developed marathon versions of the Game.

In its early years, if an addict threatened to leave Daytop, the staff put him in a coffin and staged a funeral. The orders are coming from ex-addicts who are role models for them. True believers were promoted in the ranks and, when left unchecked, terrorized the more skeptical addicts. Official outrage soon dissipated, however, and widespread policy change is still slow in coming. Anne Fletcher, the author of Inside Rehab , a thorough study of the U. Zachary Smith, a Northern Kentucky resident, attended a South Carolina boarding school for issues with pills and marijuana in His mother, Sharon, remembered that he had to earn the right to sit in a chair, to drink anything other than milk or water, and to make phone calls.

To move up in the ranks, he had to offer a series of confessions, but he was not considered convincing enough. Government Accountability Office published an examination of the deaths of several teens attending programs in which endurance tests were part of their treatment.

Youth are stripped mentally and physically of material facades and all manipulatory tools. McLellan, of the Treatment Research Institute, recalled a prominent facility he encountered in that made addicts wear diapers if they violated its rules. It was not a shocking find — he knew others that use diapers as a form of punishment. Maia Szalavitz, a journalist who covers the treatment industry — most notably with her book, Help At Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids — said that coercive techniques are still seen as treatment.

According to Deitch, the Synanon-style approach continues to be particularly popular among administrators of prison treatment programs. Years earlier, Brown had suffered a traumatic brain injury in a car accident. His short-term memory was shot, and he crumbled at the slightest sign of stress. Inmates in the program played a version of the Synanon Game. This adaptation of the Game went on all day. His mother, panicked that he would be penalized, contacted Deitch, who helped her make her case to prison administrators.

The officials compromised, and Brown was permitted to take a different class to gain an early release. Central to drug treatment in Kentucky is the idea that addicts must not just confront their addictions, but confront each other. On a Monday morning in late March, the confronted was a reticent year-old man.

He sat in the far corner of a second-floor room at the Grateful Life Center, dressed in jean shorts and a T-shirt, looking isolated and forlorn. Around him sat a few dozen fellow addicts—a jury of much younger peers—keen to let him have it. He was accused of leaving his coffee cup unattended. This disciplinary proceeding drew from the spirit of the Synanon Game, and it fed off the mutual suspicion and instinct for punishment that have become ingrained in drug treatment.

Each session can last as long as two hours. For all but the newly admitted, attendance is mandatory. On this day, the men took seats along a wall in mismatched chairs.

The clock on the wall looked like it had been cadged from an elementary school sometime around This was followed by a recitation of the Serenity Prayer. By the last line, it had become a chant. The younger residents, dressed in baggy jeans and sweatshirts, appeared restless and as yet unscarred from their addictions.

The older ones, with rounded shoulders and last-call faces, rested their hands on their knees, as if bracing themselves for the onslaught. Hamm was the first heroin addict the Grateful Life staff had introduced me to two months earlier, and for good reason. He was as close to a true believer as the program produces. It was a warning sign of underlying dysfunction and inner turmoil.

The man confessed that he knew better than to leave a dirty cup in a common area, but it had slipped his mind. He said he regretted having lied about it when caught. Hamm went in for the kill. The pile-on began. Some years before, Hamm had won a partial baseball scholarship to a small Kentucky college but had dropped out after a few semesters because of his addiction.

He slept under a bridge and at a homeless drop-in center and tried killing himself several times with an overdose of heroin and Xanax. He began thinking of himself as a ghost. There were attempts at treatment, as well, all ending in relapse. He attended classes in light blue surgical scrubs, a public humbling that all newbies were subjected to. Later, if he failed to show up for class or violated some other rule, he could be forced to wear the scrubs again as punishment.

Despite the deprivations, Grateful Life beat jail and it gave addicts time to think. Many took the place and its staff as inspiration. They spent their nights filling notebooks with diary entries, essays on passages from the Big Book, drawings of skulls and heroin-is-the-devil poetry.

Hamm rose up the ranks, graduating from barracks-style accommodations with bunk beds and communal showers to semi-private quarters. He lived on the third floor in a spartan room he shared with another addict.

His room was nearly spotless, with a brown comforter smoothed on his small bed and nothing on its pale blue walls but a painting of a horse, which had been salvaged from a Louisville hotel and donated to the facility. Horse prints seemed to be everywhere at Grateful Life.

He filled notebooks with class work based on the step program. During one rehab class in early February focused on vulnerability, another student leader boasted about the strength of his own righteousness in the face of future temptation. He interrupted the man and began to talk about the limitations of his own faith.

We all have these behaviors. By then, Hamm had earned the right to attend Narcotics Anonymous meetings off campus. I want to know how he feels, if he feels like he can do it. That spring, a few weeks before Hamm graduated, he seemed relaxed, if tired from long days that now included mentoring new residents.

Hamm shed his haunted demeanor. He cut his bangs so they no longer shielded his eyes, and his manner became more direct. Late one evening, in the second-floor library, Hamm gave a new resident a pep talk. The newbie had detoxed at a separate facility, but during his three-week wait to enter Grateful Life he had relapsed. He was still in an early phase of the program, sleeping in a bunk bed in a communal room, and declaring that being in treatment was the greatest thing ever.

Hamm told the young man that he might not get it yet, but he would eventually. Without his realizing it, the program would suddenly click. And the feeling, Hamm promised, would be worth it. And just, like I said, sit on your hands, man, and watch — watch this. When he finished the Grateful Life program, Hamm could have stayed on as an employee, but he chose not to. He had already started a landscaping job and lined up a room to share in a sober-living house in nearby Covington.

He felt good. On his first night out of rehab, he stayed up late, too excited to sleep. He kept up with his meetings and the Grateful Life aftercare program. But less than three months into his living on his own, his phone buzzed. An old friend asked if Hamm wanted to get high. Hamm later blamed his relapse on a bad day at work, among other reasons. Later that night, he attended a Narcotics Anonymous meeting.

The next day he shot up the remaining heroin. Hamm took a drug test that weekend, knowing he would fail. A week later, he delivered himself to his probation officer and soon after he was booked into the Campbell County jail. Hamm had begged to be allowed back into the program. Greenwell had turned him down. He tried to call me personally many times. Unfortunately, I told him he was no longer in our program. He has to call his probation officer.

You have to be true to the process. You just have to take accountability for yourself. The bottom line is you got to become a man at some point. Hamm might be able to come back eventually and participate in a shortened version of the program, Greenwell said. But there was a three-month waiting list. Are you the One? In late September, Hamm was transferred back to Grateful Life for another try. Six years ago, Jason Merrick was one of the first addicts treated by the newly opened Grateful Life facility.

After completing the program, he became an employee, and he now works weekend nights. On a Saturday in late March, the stocky year-old sat at the front desk, keeping an eye out for trouble.

As residents filtered in after attending off-site NA and AA meetings, the lobby was a blur of faces and not-so-hidden scars. Merrick was like a bouncer, but instead of checking IDs he was checking for any sign of a relapse. With each attempt, there was only a flicker on the digital readout, maybe just part of a 5, maybe half of a 0.

Merrick spoke soothingly to a year-old man who approached the front desk feeling guilt over not being there for his younger brother. He reprimanded a resident who had recently failed to wake up on time for his morning classes, and ordered him to change into scrubs as punishment.

During the week, he will stop by the facility on his days off. Merrick seems to know the names and backgrounds of all the more than addicts who call Grateful Life home. And he knows how many have failed. photos and newspaper obituaries. In his photo, taken at the facility, he is beaming.

He fatally overdosed the day after Merrick expelled him from the program, for doctoring a medical form and showing up high. Grateful Life was originally set up to treat addicts like Merrick, older guys who did most of their self-destruction with alcohol. The majority of addicts coming through now are a lot more like Kenny Hamm and Patrick Cagey. As chairman of the Northern Kentucky chapter of People Advocating Recovery, Merrick has advocated for greater access to naloxone, the drug that can revive a heroin overdose victim, tirelessly passed out free naloxone kits, and pressed the medical establishment to start treating addicts with Suboxone.

Such official endorsements are not winning policy debates. None of it is being used on medically assisted treatment. Bartlett thinks one solution to the heroin epidemic might be a mandatory stint in a detox facility.

After detox, the defendants would be brought back to his courtroom to discuss further treatment options. But when it was suggested that detoxing without medication can lead to overdoses, Bartlett came up short.

She will not allow Suboxone as part of sentencing options. Thomas is simply following state court policy. For many addicts, the biggest barrier to being prescribed Suboxone is incarceration.

Among the 93 overdose fatalities in Northern Kentucky in , there were a good many who died shortly after leaving jail. Shawn Hopper overdosed three times within three weeks of his release from jail; the third was fatal. Michael Glitz overdosed 10 days after leaving jail. Amanda Sue Watson died of an overdose a week after being transferred from jail to an abstinence-based halfway house.

Henry Lee fatally overdosed one day after being released from the Kenton County jail. Desi Sandlin fatally overdosed the day she was released from jail. Brianna Ballard, 30, was revived by paramedics following a overdose, but was then arrested for the overdose.

Released from the Kenton County jail on Feb. She needed it, and she knew she needed it. Several other heroin addicts who died in were, like Ballard, still dealing with charges stemming from earlier overdoses at the time of their fatal ODs. When the opioid epidemic hit, Mike Townsend, who has managed the Recovery Kentucky system for a decade, said he saw no reason to offer more than the existing step program.

He reasoned that the brain has healed once an addict manages to overcome the physical pain of withdrawal, and that the rest of the recovery is spiritual and psychological. Recovery Kentucky, Townsend said, would never include the use of Suboxone. When asked, he said he was not aware of its success in lowering overdose death rates. Executives at Transitions Inc.

In , on what they described as an extremely limited basis, the company started offering Suboxone in its detox, shorter residential rehabilitation and outpatient programs — which are not part of Recovery Kentucky and therefore not subject to its norms. Transitions Executive Director Mac McArthur agreed. The Hazelden Clinic in Minnesota is perhaps the most influential treatment center in the country, noted not just for its rehabilitation facilities but for its academic publishing arm.

Founded in the late s on a farm, the clinic brought order and professionalism to the step method. Administrators made headlines in early when they integrated buprenorphine into their treatment of opioid addicts. A few years ago, Dr.

Former residents were also dying a few weeks to a few months after leaving the clinic. But he was willing to consider alternatives. He met people just like him who felt the same bottomless craving and the shame that went with it.

Still, he relapsed five days after graduating from the clinic. It would take him another year and a half, along with a platoon of understanding adults, before he found sobriety through another step program. Seppala thought that if he was going to reach these addicts and keep them from relapsing, Hazelden needed to revamp its curriculum and start prescribing buprenorphine and other medications. He spent all of planning to integrate maintenance medications into the program and working to win over staff, some of whom he found avoided treating heroin addicts at all.

Three-quarters of the staff members raised their hands. This is a crisis. We have to base it on science. We have to base it on research. Seppala was well aware of the latest research on treating heroin addicts with buprenorphine. He had worked at an outpatient clinic in Portland, Oregon, that gave addicts both the medication and the step philosophy. He saw how the addicts stuck with that program.

The success in Portland was no anomaly. In November , Stanley Street Treatment and Resources, a nonprofit in Fall River, Massachusetts, introduced Suboxone into its mix of detox, short residential and outpatient therapies.

In , more than addicts were enrolled in the program. Seppala and his staff consulted with a clinic in Washington, D. Seppala also sent a team to study other clinics around the country.

His staff went to facilities in Oregon and Missouri that were offering a mix of medically assisted treatments and step. The team came back optimistic. Current data, which covers between January 1, and July 1, , shows a dropout rate of 7. In the first year, no addict in the new model curriculum died from an overdose. Phoenix House, another giant in the treatment world, started out in the s following the Synanon model. The New York City-based operation had previously used buprenorphine only sporadically for detoxing its opioid-addicted residents.

Now, it is dramatically increasing the use of buprenorphine in its more than programs in multiple states. The shift is taking place under the watch of Dr. At Phoenix House, Kolodny said, they would no longer accept the norm of addicts leaving their short-term abstinence programs only to relapse days later.

Kolodny suggested that the latest opioid epidemic exposes the deficiencies of the U. Now opioid deaths are occurring in the suburbs and rural communities, where methadone clinics are few and far between, making the need for a new medical model that much more apparent.

The anti-medication approach adopted by the U. sets it apart from the rest of the developed world. Between and , the country reduced overdose deaths by 79 percent as buprenorphine use in treatment became widely accepted. The medication, along with methadone treatment and needle exchange initiatives, also helped cut in half the HIV rate among intravenous drug users. Even in Iranian prisons, addicts can access methadone programs.

In , the World Health Organization added methadone and buprenorphine to its list of essential medicines. France successfully embraced the medical model because there was no entrenched step system, like the one in the U. Marc Auriacombe, a professor of addiction psychiatry at the University of Bordeaux and an addiction psychiatrist at the Charles Perrens Hospital. People were not satisfied, including those that were the most abstinence-oriented.

An article in the May issue of the New England Journal of Medicine called for wider U. use of medication-assisted therapies for addicts, commonly referred to as MATs. It was written by Dr. Nora Volkow, director of the U. National Institute on Drug Abuse — which helped research Suboxone before it earned FDA approval in — along with CDC Director Frieden and two others. Baltimore was held up as an example of progress. Frieden suggested to The Huffington Post that medically assisted treatments are vital.

Many U. states, however, remain as loyal to abstinence-only treatment as Kentucky does, and not enough doctors are willing to prescribe the medications. In a University of Washington study released this month, based on data, researchers found that 30 million Americans lived in counties without a single doctor certified to prescribe Suboxone. The majority of these counties were in rural areas. As of mid-January, in hard-hit West Virginia, there are just doctors who are certified to dispense buprenorphine, according to the Drug Enforcement Administration.

There are in Nevada, 89 in Arkansas and 60 in Iowa. In all of Texas, a state of roughly 27 million people, there are only 1, doctors certified to prescribe the medications. Federal stats presented at a June forum showed that out of , eligible physicians nationwide, only 25, are certified to prescribe buprenorphine.

A mere 2. Carl Levin D-Mich. at the meeting. Primary care physicians who are willing to care for opioid addicts are limited by federal regulations in how many they can treat. Certified doctors can prescribe Suboxone or buprenorphine for only 30 patients at a time during their first year and at a time for each year afterward. Treating a few patients over the cap can mean a visit from the Drug Enforcement Administration. Worried about what might happen to the addicts if they were suddenly cut off from their medication, he went over his patient limit.

A few months later, two plainclothes DEA agents appeared at his office with a letter from the Department of Justice giving them permission to inspect his patient files.

But he was treating 10 addicts more than the law allowed. The agents questioned him for 45 minutes about his practice, and about patient files they had randomly selected. They warned him that he needed to cut off 10 addicts. Gazaway said he has yet to comply. He currently has Suboxone patients. The state has more bupe-certified doctors than many more populous states, such as neighboring Virginia with its certified doctors.

Yet Gazaway said that he still has to turn away between two and five addicts a day who call his office to request the medication. The DEA agents let him off easy. As doctors face scrutiny from the DEA, states have imposed even greater regulations severely limiting access to the medications, according to a report commissioned by the federal agency SAMHSA.

Eleven state Medicaid programs put lifetime treatment limits on how long addicts can be prescribed Suboxone, ranging between one and three years. Multiple state Medicaid programs have placed limits on how much an addict can take per dose.

Such restrictions are based on the mistaken premise that addiction can be cured in a set time frame. In the report, the researchers wrote that the state restrictions seemingly go against established medical practice.

She said Medicaid recipients were cut off at the beginning of from their prescriptions and many relapsed. It drove people back into the street. We definitely saw the effects. Despite the importance Medicaid places on providing access to health care, many states have inconsistent policies toward paying for medications used to treat opiate addiction. The squeeze of regulation has left the door open for more opportunistic forces, such as cash-only clinics and shady doctors.

A vibrant black market has sprung up. In the s, addicts self-treated with illicit methadone because of the severe restrictions on the medication and limited access to clinics. While any illegal trade in a medication should be a concern, there is scant evidence that Suboxone is being used as a gateway to drug use in the U. Addicts say taking the medication just helps them feel normal again. In a U.

study, researchers found that a majority of the addicts they surveyed were buying Suboxone on the black market in an attempt to get sober. One year-old woman addicted to Percocet told researchers in that report that the stigma of medical treatment for addiction motivated her to buy buprenorphine on the black market. The gaping lack of a medical model in the U. People die every year from aspirin. He suggested that in places like West Virginia and Kentucky, where addicts might be hours from the nearest doctor who can prescribe the medication, loosening the regulations may be necessary — as long as the use of the medication is tied to therapy.

Current and former addicts in the Louisville suburbs, in Lexington and in Northern Kentucky said they bought Suboxone from friends not to get high but to combat withdrawal when they tried to get sober on their own. Inmates in the Kenton County jail have been caught smuggling the medication into the facility.

Warden Terry Carl took it as a constructive hint: he now wants to start treating inmates with legal Suboxone prescriptions. But he has been stymied by budget cuts and overcrowding. As of early August, he had inmates in a facility meant to hold He said one-quarter of them are relapse cases from drug court.

to buprenorphine and Suboxone. Nor must the person making the claim have any special credentials. Seppala of Hazelden. Researchers have found that the far more common overdose risk with Suboxone occurs when an addict shoots up the drug intravenously in combination with a respiratory depressant, such as a benzodiazepine like Xanax. Frieden, the CDC director, said he has been stunned at the level of opposition to the medication from some in the treatment community.

Seppala faced similar treatment. Some step-based halfway houses have even refused to take in Hazelden graduates. But she clarified that because meetings are run autonomously at the local level, there is no uniform policy on how to receive those who are taking Suboxone.

Alcoholics Anonymous takes no position on its members using medications that help them stay sober, according to an AA spokesperson who requested anonymity. The spokesperson said the group welcomes any serious efforts to treat alcoholics — and that includes the efforts of the medical profession. Addicts in Northern Kentucky report facing the stigma in meetings when they begin taking the medication. Phil Lucas, a year-old Suboxone patient, said he tried local NA meetings but no longer attends.

Diana Sholler, 43, another Suboxone patient in Northern Kentucky, attends local AA meetings. She said she is permitted to speak at meetings but that other members are openly critical of her decision to take the medication.

Addicts hear the abstinence message from all corners, and many just stop taking medication because of it. According to Dr. Other studies show that the rate of methadone dropouts can be higher. Michael Fingerhood, an associate professor of medicine at Johns Hopkins University in Baltimore, is the medical director of a primary care practice that treats patients with buprenorphine. In , the practice found that some 40 percent of its patients dropped their Suboxone regimen after a year.

Some transferred to methadone; others left the program after losing their health insurance. Quenton Erpenbeck used heroin for 16 months. For 13 of them he was trying to get off it, his mother, Ann, recalled.

He did a day, step-based residential program and followed up with attending 90 AA or NA meetings in 90 days before relapsing. Toward the end of his life, he started taking Suboxone. Although he was doing well on the medication, he felt tremendous guilt because his parents were paying hundreds of dollars out of pocket for the prescription and clinic visits.

He decided to try abstinence-based treatment. At his graduation from a program in Michigan that lasted 45 days called A Forever Recovery, Quenton told her he was worried about leaving. Chapter 7 The New Drug War: As Northern Kentucky faces a heroin epidemic, the local coroner, a family doctor, is at odds with a county judge over a medical solution to the crisis.

For doctors in Northern Kentucky, treating heroin addicts makes for a lonely career path. Mina Kalfas was certified to prescribe Suboxone soon after it came on the market. When he began having good results with addicts in his private practice, he brought up the idea of using Suboxone at the step rehabilitation facility where he worked as medical director.

His colleagues balked and his superiors declined. Kalfas thought he might have been more successful if he had found more allies. No public outcry. He eventually left his post at the rehabilitation facility in In AA, the definition of insanity is doing the same thing over and over again and expecting a different result.

They should think about that. But Kalfas can serve only so many. Taylor Walters went through a detox, then a three-month outpatient program, and in late December , a day inpatient program. His mother, Sheryl, was desperate for a doctor who would prescribe him Suboxone.

She spent three days working the phones, pleading with doctors. He relapsed the day after he completed the program and died of an overdose two weeks later, in February He was 20 years old. Kalfas estimates there are only a handful of doctors in Northern Kentucky willing to prescribe Suboxone.

One of them is Dr. David Suetholz, who also happens to be the Kenton County coroner. In his private family practice, Suetholz has treated opioid addicts with Suboxone for years. With a base of patients, he said he has a Suboxone dropout rate of only about eight percent over the course of six months and he has never had a patient on the medication die of an overdose. Like Kalfas, he has pushed area doctors and state officials to embrace this medical model.

Because his pleas have gone ignored, he has a waiting list of about addicts hoping to get on the medication. It was a temporary solution. He had to be revived by paramedics. As well as that, he is the 'go to' guy for anything you need to know about Internet dating. He's currently doing his second solo show on the subject which is about how he's been exiled to the darker side of the internet due to becoming undatable since revealing himself as a chronic serial dater in last year's show.

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