A bill in the House would help people make it to the five-year mark, where chance of relapse drops drastically
Portland was going to be a fresh start for Lor Hiou, 27, and her boyfriend. Hiou had just completed a 30-day inpatient drug treatment program in Tampa, Fla., and the couple planned to reunite after they spent 90 days apart and clean.
The day she arrived in Oregon, she got a phone call letting her know her boyfriend wasn’t coming. He had died from a drug overdose.
Alone in a new city, Hiou said the urge to use again was strong.
“I felt like my whole life just crumbled, and I couldn’t go back to treatment because I had no insurance in the state of Oregon. I couldn’t go back to Tampa because I used all my resources to get here in the first place,” she said.
Over the next week, she filled her days traveling across Portland from one 12-step meeting to another. She was grief stricken and needed support, but wasn’t finding it. She couldn’t relate to the other people in the meetings. They were older; many had kids.
“What I needed was a community,” she said. She felt like she was on the fast-track to relapse.
But that didn’t happen. Her quest for endless meetings that week eventually took her to 4th Dimension Recovery Center, or “4D,” in Northeast Portland. It was different. Everyone there was young, and the meeting she walked into was more like an open mic night than your typical 12-step gathering.
That was 10 months ago, and she credits 4D with keeping her clean.
4D is open to people in Multnomah County ages 18 to 35 who are in recovery from drug and alcohol substance use disorders. It’s a place to hang out and socialize as much as it’s a place to attend meetings, receive one-on-one peer mentorship and find alternative pathways to recovery, such as doing yoga, creating art, dancing or working out.
Any young person in recovery can walk in, get connected with a mentor and participate in activities free of charge. It’s a peer-led recovery community organization, which means it’s a place where people in recovery can find support from other people who have more experience with staying clean. It helps the newcomer to build a more positive social network, and it helps the mentor maintain their own sobriety through helping others.
For Alexandra Morrison, 21, three months of treatment wasn’t enough to give her the foundation she felt she needed. But she’s found spending four days a week at 4D has helped her stay clean and sober for 15 months.
“These people have saved my life,” she said. “It’s not just a meeting hall. It’s an actual family that completely understands every single thing that you’re going through.”
The center’s co-founder and CEO, Tony Vezina, is creating a career ladder at 4D, based on recovery, to keep young people engaged. As early as six months clean, they can become a peer mentor intern and begin learning about what it takes to become certified. From there they could move into a service coordinator position and then to a certified recovery mentor, and on up.
“The idea is to get people employed in a recovery-oriented environment to get them to the five-year mark,” Vezina said.
That’s because after a person is clean and sober for five years, the chance of relapse drops to less than 15%. For comparison, about two-thirds of people with less than one year of sobriety relapse, and after one year, fewer than half relapse, according to the most comprehensive study on the matter, which followed 1,162 people in treatment for eight years.
Numerous studies over the years have also shown that active engagement in peer-support communities is a key predictor of sustained recovery.
In Multnomah County, people in recovery are lucky, said Mike Marshall, co-founder and director of Oregon Recovers . They have 4D for young people and The Alano Club of Portland, another peer recovery center that offers more than 100 weekly meetings and other resources such as meditation classes, aromatherapy, recovery CrossFit and community dinners.
Sober social clubs as comprehensive as these are rare in Oregon, Marshall said. That’s why Oregon Recovers, a coalition formed to revolutionize Oregon’s drug and alcohol treatment system, helped fashion House Bill 2627 , which if passed, would fund the establishment of four recovery community organizations in four counties across the state.
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“The challenge to the current system is that we’ve put all our money into just treatment, and then we release people from outpatient or residential treatment and we don’t provide them any support,” Marshall said. With 11 years of sobriety under his belt, Marshall said having a community of other people in recovery to support his journey was critical.
“We have a society that says go out and drink. Go to a five-course dinner and have wine pairings. Play softball on Saturday morning and drink beer. And we want to do all those things,” he said, “without the alcohol. For too long, 12-step programs have been the only option.”
Marshall said the idea is to model these centers similarly to 4D, but with the addition of 24-hour support. As the bill is written, each center would offer a 24-hour telephone line offering peer support, as well as in-person support services for 12 hours each day. The centers would also be required to offer traditional and non-traditional pathways to support, including mindfulness and medication-assisted treatment.
Under the bill, the centers would be open and operating no later than Jan. 1, 2021. The bill passed out of committee unanimously with a do-pass recommendation and now sits, like so many other bills competing for funding, in the Joint Committee On Ways and Means.
But Marshall said if the Legislature honors the wishes of voters who passed Measure 91 to legalize recreational marijuana in 2014, the funding is already there. Measure 91 dictates that 25% of tax revenue from marijuana sales in Oregon go to pay for mental health, alcohol and drug services. In 2018, that amounted to $18.5 million. But instead of sending additional funds to those areas, the Legislature backfilled existing programs; new money went in, but other money that was already funding those programs was diverted.
This means there was a net-zero gain to those program areas from Measure 91 funds, the Oregon Legislative Fiscal Office confirmed.
The backfilling was made possible by a bill in the 2018 session that’s set to sunset in July. Marshall argues that if it does, then the marijuana tax revenue that would flow into drug and alcohol treatment programs would essentially be new money and could be used to fund the recovery community centers without taking funds away from any existing programming.
If House Bill 2627 becomes law, it’s estimated Oregon Health Authority will distribute about $4.8 million to four peer recovery centers over the next two years.
“The question is, are they going to backfill the budget again with Measure 91 money instead of using it as the voters intended,” Marshall said. If that’s the case, he hopes Ways and Means Committee members will find money for the centers somewhere else.
Regardless of whether the bill passes, at least one new recovery center is slated to open. Washington County intends to award a contract to 4D to open a second center for young people.
When Street Roots visited 4D’s Portland location on May 8, the place was packed. Nearly 100 young people were there for Wednesday night’s Sounds of Recovery meeting, where participants took turns at the mic, playing guitar, singing, dancing, and reading poetry or spoken word.
For C.J. Day, 27, it’s creative outlets like this that he loves most about 4D.
“I’ve been through treatment,” he said, “but this place provided what do you do outside of meetings.”
His peers have suggested he establish his own dance class at the center.
“I didn’t think I had the potential to teach people how to dance or to win a dance battle – but they want to learn, so obviously I have some potential,” he said. Now he thinks he might want to become a dance choreographer.
Megan Casteel, 24, didn’t think sobriety would be much fun, even after struggling with homelessness and addiction for years.
“When I got here, and saw all these faces, it gave me a run for my money because I was like, cool; there’s no excuse for me now,” she said. “If all these people are recovered and they’re my age and they’re doing well and they’re making life for themselves. If they can do it, why can’t I? Today I have a little over a year clean.”
But it’s not just young people who can thrive in recovery with the help of peers.
In Portland, Miracles Club is a peer-led social club supporting sobriety in the African-American community, but there are no peer-support community centers focused on addictions recovery for the LGBTQ+ community, the Latinx community, or any other culturally specific group.
“The dearth of these recovery center is the story,” Marshall said.
In many parts of the state, especially in rural and coastal areas, there are no options at all.
The bill’s proposed 24-hour peer-support phone line and line item for outreach to people living in rural areas might be just what places like Coos County need.
Patty Sanden, who works at a Coos Bay area recovery services provider, Bay Area First Step, said there is concern there are geographic gaps in Coos County, where recovery support is generally not available. The county is currently developing a strategic plan to address those gaps, she said. “So it appears we may be looking at more of a mobile or decentralized structure for recovery support.”
Oregon Recovers worked closely with Rep. Tawna Sanchez (D-Portland) and a workgroup with representatives from 4D, The Alano Club of Portland, Bridges to Change, Central City Concern and Greater Oregon Behavioral Health Inc. to design the peer recovery center bill.
Marshall said the other big priority for his coalition this session is House Bill 3095 , which would bring the reimbursement rate for addictions recovery providers in line with their counterparts in mental health. He said the bill could “profoundly transform the existing system” and make it cost effective to provide treatment. That bill is also under consideration in the Joint Committee On Ways and Means.
Email Senior Staff Reporter Emily Green at emily@streetroots.org . Follow her on Twitter @greenwrites .
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