Annually, the Acadia Family Center treats between 100 and 120 clients for addictions and related mental health disorders at its outpatient facility in Southwest Harbor.
On top of that, the center’s clinical staff also provides prevention and education services for more than 1,300 students in Mount Desert Island schools, on the outer islands, and in Hancock County and beyond.
The numbers, said the center’s executive director, Ed Oechslie, are likely a fraction of those who need help.
“The disease statistically affects seven out of 10 people, whether directly or in relationships,” he said. “That’s a pretty high number. It’s important to get the word out, so people know that there’s help available.”
The Acadia Family Center is a nonprofit agency that was founded by the MDI Alcohol and Drug Abuse Group in 1988.
MDI Group, as it was commonly called, was itself formed in 1978, when a group of citizens on MDI became concerned about increased drug and alcohol use and wanted to do something about it, said Oechslie.
MDI Group initially managed the Chemical Dependency Treatment Unit at the MDI Hospital in Bar Harbor. The Acadia Family Center was set up in Southwest Harbor to provide similar access to outpatient substance use and addiction treatment on the west ide of the island.
In 2010, MDI Group and the Acadia Family Center merged in order to streamline administration and provide comprehensive services without duplication. The resultant agency retained the name of Acadia Family Center.
Oechslie was hired as the center’s second director in 2006. Under his administration, the center bought the former Heron House bed-and-breakfast on Fernald Point Road and created a facility that was designed to be warm and inviting, said Oechslie. The center also expanded its treatment and education programs. The staff went from three to seven full-time employees, and the clientele increased by nearly 400 percent.
Relying solely on local donations for what it does, the center has collaborative relationships with local health care providers, the MDI Regional School System, addiction and mental health treatment agencies and island nonprofits.
“It can be difficult to tell who suffers from the disease of drug addiction and alcoholism; its victims are often adept at hiding it for a long time,” said Oechslie. And yet, he said, they could be friends, neighbors, relatives and acquaintances; they could be passerby on the sidewalk, people at a local business, retirees or students. In short, he said, it could be anyone and, mostly, those people are overwhelmed by the burdens of addiction and secrecy, by the constant need to find more of the addictive substance, by the underlying emotional trauma or physical pain that led to substance use in the first place, and by their own undesirable behavior and physical deterioration, spiraling out of control.
“At some point, their lives become so unmanageable that they have to seek help,” said Oechslie. “For everyone, it’s different. Someone may find it too difficult to recover from using to get to work the next day; it can become so difficult, or they need to have just a little bit of their substance just to got to work, to make themselves right. At that point, someone might say, ‘This is getting out of control. If I feel like I need to have a little bit of pain medication or a drink before I go to work, something’s wrong.’ People can lose relationships, can lose jobs, can be faced with legal problems, arrest, OUIs.
“And I call that a window of opportunity. When one of those events happens, I think it’s an opportunity to say, ‘Wait a minute, maybe this is out of control, maybe I do need to get some help.’”
Many sufferers may not realize that addiction is a disease, he said: They think it’s a failing of moral character, a lack of will, a shameful weakness in who they are. This sense of self, coupled with the stigma around the disease that permeates society in general, may prevent them from seeking treatment, he said.
But counselors at the Acadia Family Center, he said, believe that each person has the resilience to bounce back from adversity. Treatment, as well as prevention and education, are based on what is called “The Resiliency Initiative.”
“Everything that we do is based on the idea of resiliency – that the human spirit has the ability to bounce back and right itself from any trouble it might have,” said Oechslie. “We try to latch onto that by working with social involvement and high expectations – those things that ‘resiliency work’ tell you are important. We work on instilling this in the kids at the schools, so they have the strength to make better decisions. And we do that with our clients here.”
When entering the program, he said, each client is assessed for strengths and needs, and an individualized program is developed that utilizes inherent strengths and resiliency to move the client toward her or his treatment goals. Sessions may be individual or one of the center’s specialized groups. Counselors are trained annually in the latest treatment modalities, such as motivational interviewing, art therapy and cognitive behavior therapy.
The word “family” in Acadia Family Center is an essential ingredient, Oechslie said. Counselors consider addiction to be a community disease that affects not just the person addicted but loved ones directly connected to the addict, as well as the larger network of health care, emergency and law enforcement services.
“We know it’s a family disease, so we try to involve the family as best we can,” he said. “It’s not like somebody has an addiction and they come here for treatment and then go back to their home environment – and everything’s fixed. It’s not like having an appendix out; it’s not surgery. It’s about helping people to make change, and part of that change means that the system they’re from and that they will go back to really needs to change, too.”
Oechslie said the center’s approach identifies the stages of change as pre-contemplation, contemplation, preparation, action and maintenance.
“Someone comes to us and says, ‘I don’t know why I’m here. My wife thinks I need to be here. I’m not sure I need to be here.’ That’s where we call them pre-contemplative: They don’t know that they’re thinking about making a change yet,” Oechslie said. “Our job at that point is to move them into contemplation.”
A counselor, he said, might ask, “’Well, what do you think it is that your wife is seeing that might need to be changed?’ Because if we met them with, ‘Well, you need to stop drinking,’ that’s an action step and they’re not ready to do that. There’s a process to it.”
The center’s counselors, he said, seek to identify the client’s goal in the moment and shape a positive action and accomplishable plan around that – thereby fostering resiliency within the person.
“Take the guy who says, ‘My wife says I drink too much,’” Oechslie said. “That becomes the treatment plan – ‘Well, okay. So that’s your goal, to get your wife off your back.’ He says, ‘Yes, that’s right.’ So we ask them to create their own treatment plan. How are we going to do that? ‘Well, maybe I should cut back a bit on my drinking. Maybe only a 12-pack a day.’ ‘Okay, we’ll write that down. Let’s see how that works.’ And then they get to review their own progress – ‘Here’s what you said was the problem, here’s what you said you were going to do about it. How’d that work?’ ‘Not so good.’ ‘Well, what do you need to do now?’ And we begin to change. We’re moving him toward contemplation, toward action steps. And we listen for that action language, for when they’re ready to make a change. He comes in one day and says, ‘You know, this isn’t working at all. I think maybe the problem isn’t my wife; I think maybe drinking’s the problem.’ ‘Okay, what do you want to do about that?’ ‘Well, I think I need to stop drinking.’ ‘Okay, let’s make a plan and figure out how we make that happen.’ Now he’s moved into the action stage. That’s the way we work here.”
It is also important to engage the people close to the clients, Oechslie said.
“You can’t expect someone to come from a system where they know their role in that system, and that role might be the one who acts out, the one who’s addicted. He goes out and gets taken care of, and he comes back into that same system. You can’t expect him to fit into that without the system changing, too. Or he’s just going to end up back in relapse,” Oechslie said.
Clients arrived at their addiction from a number of directions. There are those who were taking legitimately prescribed opiate medication for pain, but developed tolerance to its benefits and found themselves craving more.
“They’re not just getting rid of the pain, they’re getting high,” he said. “Dependency is that place where the person needs this medication to function. Dependency is being at a crossroads. It can be a person who is on pain medication for chronic pain for long enough that their body has become dependent on this drug in order to be okay. When it goes into addiction, there’s a tolerance change and they need more in order to get the same effect.”
Today’s prescription medications are strong and addictive – in particular, OxyContin, a habit-forming narcotic, he said.
Oechslie recalled one of his first clients, on his return to Maine.
“She was 68 years old, a retired schoolteacher, and she had chronic pain,” he said. “She was prescribed OxyContin, became dependent on it, had a tolerance change, and needed more than what her doctor was willing to prescribe in order to reduce the pain. So now she’s living with the chronic pain again and, by the end of the month, she needed to find more. She was arrested under a trestle where the dealers were, for buying street drugs, at 68. An upstanding member of her community, her whole life. But because of chronic pain, because of the dependency that she had on OxyContin, she was doing things that she would not normally do. And that’s really where the definition of addiction comes in – the behavior changes.”
Many clients are those who were introduced to alcohol or marijuana by friends or family at a young age.
“More often than not, people start using recreationally when they’re young,” he said. “Some clients start drinking at age 12 or 13 and then it escalates into more and stronger recreational drugs….Kids would start stealing out of the medicine cabinets, bring it to a party. They’re orally taking OxyContin, and it’s a short journey from that to crushing it up and snorting it, and it’s a short journey from that to cooking it down and injecting it. And at either the snorting or the injecting place, the discovery that heroin is cheaper can happen.”
Other clients may have endured trauma or tragedy in their lives and were seeking emotional relief.
“Where I got my training and where I first worked was at a treatment center for trauma and addiction,” Oechslie said. “That’s where I learned addiction can be a symptom of trauma. It’s a self-medication for emotional pain, taking a substance for something that’s happened that’s just too horrible to deal with.”
Oechslie brings both professional and personal experience to the field.
Born in Bar Harbor and raised in Maine, he spent 22 years in sales, project management and business development in the state’s construction industry.
“Then I knew I needed to do something different,” he said.
He ended up in New Mexico, where he earned a master’s degree in art therapy from Southwester College in Santa Fe. While there, he began working as a primary therapist at Life Healing Center, a residential treatment center for trauma and addictions in Santa Fe.
“That changed everything for me. I knew then that that was what I needed to be doing,” he said.
The work resonated with him because of his personal experience, he said.
“I grew up with the whole thing in my family,” he said. My father served from December 1941 to September 1945 in World War II and spent some time in – at that time, what they called – ‘R and R’ [rest and recuperation], for shellshock. It was PTSD [post-traumatic stress disorder], so really, I grew up in a family where there was PTSD and also lots of addiction in my extended family. When I started working in the field, I realized that I knew this stuff firsthand from watching it all my life.”
He returned to Maine, where he developed an art therapy program at Mercy Hospital’s Recovery Center in Westbrook and served as program director for SpiralArts, a nonprofit community arts program in Portland, before accepting the top position at the Acadia Family Center.
His own experience, he said, gives him a certain empathy with clients – whether they realize it or not.
“There’s always that kind of question,” he said. “My client comes in and they’ll wonder, ‘Does this counselor really know what it likes to be me?’ I don’t think I have to have experienced everything they’ve experienced, but I at least have to have enough compassion, empathy and understanding for what they’re going through to not judge them. Because I know they’re not making this choice on their own. Nobody sits down in kindergarten, and when the teacher says, ‘What do you want to be when you grow up?’ nobody raises their hand and says, ‘I want to be an addict.’ And I’m not going to judge anybody for making that decision, because they didn’t. It happened. So now, what are we going to do?”
People arrive at the center at all levels of addiction, some at death’s door, Oechslie said.
How do they find the strength to recover?
“I think there’s a moment of desperation, but also – it’s the message of hope,” he said. “When they’re in the darkest place or on death’s door and their life has fallen completely apart because of that substance, to walk into a place where people say, ‘Hey, there’s light, and we can find that light for you, there’s a way through this’ – that hope, I think, is important for people to hear. People we have had the most success with are people who have felt that somebody really cared. I think that’s the success of the 12-step community, too; it’s people caring for each other. That care is what changes people’s lives. Rather than fear this thing, love the person. Rather than fear the disease, love the person, show them that we believe in them, we can help them through this.”
A trend report from the Office of Substance Abuse shows that, between 2003 and 2010, the number of Hancock County clients admitted to treatment centers for OxyContin use more than doubled, from 50 in 2003 to 120 in 2010.
For heroin and morphine, the number of Hancock County clients rose from 35 in 2000 to 101 in 2004, and has been in the 30s since 2006.
At the Acadia Family Center, the breakdown of clients in 2010 is:
• 48 percent female, 52 percent male,
• 13 percent under 18,
• 16 percent age 18-25,
• 26 percent age 26-38,
• 19 percent age 39-52,
• 10 percent 53-65,
• 4 percent over 65,
• 17 percent list Bar Harbor as their place of residence,
• 16 percent Southwest Harbor,
• 11 percent Mount Desert,
• 8 percent Tremont,
• 15 percent Ellsworth,
• 19 percent other Hancock county towns,
• 8 percent Washington County,
• 10 percent elsewhere in Maine.
For more information, visit acadiafamilycenter.org or call 244-4012.
(Published in The Bar Harbor Times, April 13, 2011.)