A Better Road? In 2012 Matt Eacott hit rock bottom . . . again. The Avon native in his early thirtie s had spent the previous decade in and out of rehab facilities, trying unsuccessfully to kick his addiction—first to prescription painkillers and later to heroin. He had gone to more than a dozen in-patient treatment centers, some of them long-term. Along the way he carried with him the usual addiction baggage: problems with his family, brief periods of sobriety followed by relapses and frequent drug-related run-ins with the law—including about nine arrests, one of which resulted in a year-long sentence in the Cheshire Correctional Facility. Aft er his latest relapse, it looked as though he was heading back to prison, possibly for a whole lot longer. Eacott had violated his parole and was facing a five-year sentence. At this point, Eacott had all but lost hope. In a meeting with a longtime therapist, he recalls throwing his arms up in the air and asking, “What am I going to try this time?” His therapist had an unexpected answer and said, “You know what? I have a very good friend and he’s started something that’s different, and I think really could work for you.” That something different was a radical addiction recovery program developed by Aware Recovery Care, a Madison-based company that had recently formed. Eacott was intrigued by the program but was not overly optimistic. “I didn’t believe in myself, I was hopeless,” he recalls. Yet, he figured he had nothing to lose and decided to try it. For those with long-term addictions like Eacott, the statistics are pretty grim. More than half of those who attend a recovery program relapse. That’s part of the reason there are so many addiction treatment centers, better than 14,500 nationally and more than 100 in Connecticut alone. Steve Randazzo, founder of Aware Recovery Care, had worked in recovery for 20 years and was painfully aware of the mixed results following addiction treatment. “ I was witnessing the difficulty people were having with maintaining any type of long-term recovery,” he says. “There was a very high relapse rate and a relatively low success rate. I had an entrepreneurial itch and I really wanted to see if something could be done to improve outcomes.” Many people with addictions, whether to drugs or alcohol, relapse in particular when they return to their homes. Randazzo wondered if he could create a recovery program designed to work within the home, which could help avoid the necessity of a post-rehab readjustment. Using this basic concept and inspired by the visiting nurse home care model, Randazzo, with the help of psychiatrist Charles Riordan and other experts, set out to design a rehab program that he hoped would work better than previous ones. During their research, Randazzo and his team met with professionals from the home-care nursing field, and experts from places including Dartmouth-Hitchcock, New York University and Columbia University. The program that emerged from these efforts is an intensive year-long, home-based treatment plan. It treats addiction as a chronic condition and employs a team of healthcare professionals, including an addiction psychiatrist, registered nurse and certified recovery adviser, who all help patients adjust to life without the substance they’ve come to depend on. Patients are also monitored through frequent random drug and alcohol tests as well as voluntary continuous GPS monitoring. In some ways, the program brings the intensive level of care of an in-patient rehab setting to a participant’s home and everyday life; it also lasts longer than most inpatient programs, even the long-term ones. The company launched a proof-of-concept pilot study beginning in December 2012. Because it’s a year long process, only a few participants have already finished the whole program, but initial results based on a small number of participants have been good, in some ways stunningly so. Five people enrolled in the program in the first year, and four, or 80 percent, successfully refrained from drug use. Dr. Ellen Edens, a psychiatrist at Yale School of Medicine, co-authored a paper in the journal Connecticut Medicine that is based on the proof-of-concept study. She has no official affiliation with the company but was impressed with the treatment approach. The abstract for her paper states that “addiction is increasingly conceptualized as a chronic disease, yet the current addiction treatment system is largely based upon an acute illness model.” Edens says the Aware Recovery Care program remedies this situation by using a chronic care treatment model. “With diabetes, if someone has a relapse, they don’t just get sent home, they have tons of patient education or are called frequently,” she says. “A lot of times they’ll be sent home with ways to check their sugars and then they’ll report in on a daily basis. This is how we’re dealing with chronic conditions now, but it hasn’t yet come to the addiction world.” The year-long program at Aware Recovery Care costs about $38,000—expensive, but comparable to in-patient treatment centers, which often start at about $30,000 for 28-day programs. If the program is successful, the ultimate savings are hard to tally. As a self-described “kid from suburbia,” there’s a sense of incredulity in Eacott’s voice as he talks about how he became addicted to heroin. He started using marijuana at around 13. In college, he moved on to recreational pain killer use. He would buy OxyContin on the streets and was arrested for the first time after trying to buy it with a fake prescription. Eacott’s case was transferred to Hartford and that’s when his addiction worsened. “That’s where my use went from OxyContin to what I was told was a cheaper, more effective, more available option, which was heroin,” he says. His chronicle of addiction is tragically familiar. Heroin use in Connecticut and across the nation is on the rise. In 2013, Connecticut had more than 180 deaths from heroin; in just the first six months of 2014 the New Haven Register reported at least 151 people had died from accidental opiate overuse. Many of those who use heroin today are like Eacott—young and from suburban areas not traditionally associated with illegal narcotic use. They are also often drawn to the drug through what starts as medically prescribed use of OxyContin or other opiates. Eacott says that the road from OxyContin to heroin is one that is increasingly traveled, and as a result, heroin is even more available today than it was when he started using. Eacott didn’t try heroin until college; now he says it’s readily available to most high school kids. Edens explains that when conventional addiction treatment stints end, a return home is often problematic. “You send them back home where there’s a lot of frustration, etc. You tell them, ‘You need to call your insurance company and try to access a primary care doctor, and, by the way, you need to find a second therapist, and you need to find a psychiatrist,’” she says. “It’s hard enough for me to contact my insurance company and get through when I’m sober, but when you’re in immediate recovery you don’t have a normal brain, your brain has been rewired to depend on the substance that you now don’t have, so usually in new sobriety you’re less capable of dealing with a lot of these frustrations and problem solving, so it’s helpful having someone right there that can say, ‘Let me help you, let’s sit down and call the insurance company together.’” This return home from rehab was Eacott’s Achilles’ heel. “I was always able to go away and do pretty well at the treatment center but my issue would be that I eventually had to come back home,” he says. “It wasn’t that my parents’ house was such an unhealthy environment, it was just where I was used to doing all the things that I was doing.” That’s part of the reason he was intrigued with the Aware Recovery Care program. As he was undergoing rehab he wanted to be able to try and rebuild his life. “I wanted to show up for work every day. I wanted to be a productive member of society. I wanted to have a relationship. I wanted to make friends,” he says. Thanks to the constant monitoring and extensive support provided by the program, he was able to refrain from drug use, hold a steady job and regain the trust of family members. “It was the perfect combination of structure, support and reality,” he recalls. “When I had to go away to an in-patient setting it’s not really a reality. It’s a controlled environment.” While in the program Eacott began a relationship as he had hoped to do and he is now engaged. After working for a time at his family’s construction business, he decided to help others who had experienced similar issues, and now works as a recovery adviser at Aware Recovery Care. He also helps with the company’s business planning and marketing. Though Eacott and others who completed the program have been successful, Edens cautions that five people is a small sample size and scientific conclusions can’t yet be made. Perhaps just participating in a pilot program, or its cost, influenced the outcomes of those involved, she says. She’d like to raise funds for a full-scale study because she suspects the program’s early successes will be duplicated. “It’s taking many things that we do know are effective and kind of combining them into one,” she says. “The hypothesis is quite plausible. In my opinion, it’s going to be the way that we handle addiction in the future.” (203) 779-5799, awarerecoverycare.com.