For Monica Forbes, 46, it took hitting rock bottom to turn her life around.
“It just happened by accident,” the Boise woman said in a phone interview. “. . . And nobody ever said, ‘Hey, you might have a problem, Monica.’ ”
Rock bottom was an Idaho state prison during her struggle with opioid addiction in 2003.
“I remember going back one time into a pain clinic and telling them, ‘I’m sorry. I went through the 30-day supply in 10 days,’ ” Forbes said. “I had come up with what I thought were creative stories — I left them in the hotel, or they fell down the sink in the bathroom.
“They sort of slapped me on the hand and wrote me a new prescription.”
Forbes is among millions of people in the United States affected by nonmedical prescription drug use. According to the 2013 National Survey on Drug Use and Health, 6.5 million people recorded nonmedical use of prescription drugs. Of those people, 4.5 million recorded nonmedical use of prescription pain relievers.
According to the Centers for Disease Control and Prevention, 44 people die from prescription opioid overdose every day in the United States.
In Idaho, opioid abuse has been a rising concern, particularly among youths.
Between 2010 and 2011, the state ranked fourth in nonmedical use of prescription opioids in people ages 12 and older, according to a national survey by the Substance Abuse and Mental Health Services Administration.
And in 2013, 16 percent of Idaho high school students took a prescription drug without a prescription, according to the Idaho Office of Drug Policy’s website.
Painkillers such as hydrocodone and oxycodone are examples of prescription opioids.
It’s not a law enforcement issue, it’s not a health care issue, it’s not a legislative issue. It’s really an issue for all of us.
Elisha Figueroa, director of the Idaho Office of Drug Policy
SPOTLIGHTING THE PROBLEM
Advocates in the state are trying to draw more attention to the issue and recently visited with Republican Idaho Sen. Jim Risch to talk about policy changes on substance abuse that would focus more on health care and recovery.
In the meeting, the advocates asked for better implementation of the 2008 Mental Health Parity and Addiction Equity Act, which required that health insurance providers not put more restrictions on mental health and substance use disorders than they would on any other coverage. Advocates say the law hasn’t been properly upheld.
One of the attendees, Michele McTiernan-Gleason, director of recovery wellness at the Boise advocacy organization Connect the Pieces, said she left disappointed.
Attendees were told that money and politics would inhibit action, said McTiernan-Gleason, who has a family member recovering from opioid addiction.
“He said (it was) because of money,” she said in a phone interview. “It became a political conversation. He just really didn’t hear us.”
Risch said that the advocates gave strong testimony at the meeting during an interview at the U.S. Capitol.
“They obviously bring a face to the problem,” he said. “That always helps you understand the situation better.”
However, he said, he would want to read the fine print before supporting possible legislation addressing the problem. “The devil’s always in the details,” Risch said. “I’d want to see the language before I commit to it.”
16 percent Share of Idaho high school students who took a prescription drug without a prescription in 2013, according to the Idaho Office of Drug Policy
PROGRESS AT THE STATE LEVEL
Despite the disappointment with federal officials, advocates said the state government has worked in several ways to help end opioid addiction in Idaho.
“We have received so much support from the Idaho Office of Drug Policy,” McTiernan-Gleason said. “We see movement.”
Collaboration is key when tackling issues of opioid addiction, said Elisha Figueroa, the director of the Idaho Office of Drug Policy.
She also leads Idaho’s Prescription Drug Abuse Prevention Workgroup — a coalition of advocates, health care providers, law enforcement and state legislative officials who discuss how to address the issue.
“We’ve really tried to be inclusive with the group of people that’s at the table so that we can look at the issue from all different angles,” Figueroa said.
“It’s not a law enforcement issue, it’s not a health care issue, it’s not a legislative issue. It’s really an issue for all of us. So we’ve tried very hard to ensure that the group of people that are at the table represent all of those various backgrounds,” she said.
Two years ago, the office launched the “Lock Your Meds Idaho” campaign. Bus signs and billboards as well as TV and radio public service announcements were made to raise awareness on nonmedical opioid use.
“It was all about bringing awareness to the issue,” Figueroa said. “Lock your meds. Get rid of them when you’re done with them.”
On July 1, state House Bill 108 was implemented into law, allowing the drug naloxone – which can stop a fatal opioid overdose – to be prescribed to friends and family members of addicts.
Idaho police stations in 28 counties also have drop boxes to dispose of unwanted medications, according to the office’s website.
Beginning this past summer, the state gave grants to help start peer-based recovery centers in the community.
Forbes has been working directly in this process.
Halfway through her five-year sentence for committing financial crimes and breaking sobriety treatment, she asked to be put into a treatment program for a second time. She made it her goal to become a substance abuse counselor.
She was released in 2008. Now she’s about 25 college credits away from being a certified drug and alcohol counselor, she said. She’s making her dream into a reality as the director of the PEER Wellness Center in Boise.
As an advocate in recovery, Forbes is proud of her journey — and progress in Idaho. “I’m not ashamed,” Forbes said. “I think we are in the process of seeing change,” she said.
Tori Whitley, 202-383-6131; firstname.lastname@example.org
The PEER Wellness Center opened in Boise June 25 as one of Idaho’s first recovery community centers where peers provide non-clinical services.
The four recovery community centers were initially funded by Millennium Fund grants. These grants came from settlements between large tobacco manufacturers and 46 states in 1998. Manufacturers were required to pay the state of Idaho about $790 million over the first 25 years.
Each recovery community center received $123,000 to get started, Monica Forbes said. Services are free and the work is 95 percent volunteer-driven, she said. If someone seeks treatment, they are asked to volunteer afterward.
These centers reach out to help people before it’s too late, Forbes said. “There are small windows of opportunity where that person can realize, ‘I do need help,’” she said. “If help is not available, we’ll keep losing more.”
Within the first month, the PEER Wellness Center served 386 people. In September, Forbes said the numbers reached up to 800, and that she hopes to open seven additional offices.
The hope is to receive state funding for new recovery community centers in Idaho Falls, Coeur d’Alene, Lewiston and Pocatello and satellite offices in more rural counties, where video and telephone conferences could reach people who otherwise couldn’t get help.