by Melissa Howell
Upkeep of Firstep men’s recovery center is the responsibility of the residents who cook, clean and maintain the grounds.
Oklahoma ranks second in the nation for substance abuse disorders, including alcohol, at 11.9 percent. State officials estimate between 700,000 and 950,000 adult Oklahomans need services, but most are not receiving the care they need, according to a 2017 study by the Oklahoma Department of Mental Health and Substance Abuse Services.
And the problem appears to be growing.
A 2017 report from the journal JAMA Psychiatry warns that adults in the U.S. are drinking significantly more alcohol than in the past.
“Substantial increases in alcohol use, high-risk drinking, and … alcohol use disorder constitute a public health crisis and portend increases in chronic disease comorbidities in the United States, especially among women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged,” authors of the study wrote.
Oklahoma City-based OKC Metro Alliance, a nonprofit organization, is looking to improve Oklahoma’s substance abuse challenges through two core programs. The programs are designed to address obstacles that often make the struggle with addiction insurmountable.
OKC Metro Alliance’s Firstep initiative offers alcohol and drug recovery assistance through a long-term residential program for men and women. In conjunction with the Oklahoma City Police Department, OKC Metro Alliance also manages the Public Inebriate Alternative program that provides people who are intoxicated in public a place to “sleep it off” instead of being put in jail.
Hurdles to getting help for substance abuse for many focus on a need for employment and a place to live that doesn’t cost thousands of dollars.
OKC Metro Alliance’s Firstep program offers housing, employment, case management, life skills development and a 12-step program. Residency can last from six months to two years.
Dormitories accommodate 56 women and 70 men. In 2016, the program served 558 individuals.
No one is turned away for inability to pay, and residents are free to leave the program if they choose to do so.
“What makes this program successful … is the gentlemen who founded Firstep (in 1987) were probably way ahead of the nation,” said Metro Alliance Executive Director Connie Schlittler, pointing to a recent surgeon general report that touts housing, employment and support as vital components to recovery.
Work is key to the program in that it creates structure, fosters self-esteem and helps keep program costs very low or free to its clients.
“The concept that we have at Firstep allows a person to receive recovery, face the challenges of addiction and at the same time, not have to come up with a lot of money,” said Mike Cody, director of the men’s Firstep program. “In a way, one of the greatest strengths you can give a person is a work ethic. Many of these young men come in, and they’ve never even had a job before. And if they have had a job, it’s not been successful for them because they didn’t know to be respectful to authority. They didn’t know to be punctual. Of course, we all feel like that’s an innate responsibility, but not necessarily if you’ve never been required to do that.”
The program contracts with community businesses to provide entry-level employment. Clients are paid minimum wage and are allowed to keep 5 percent of their earnings to spend. Having money they earn helps with court fees and other expenses or can contribute to savings. The remainder covers income taxes, transportation to and from a work site, housing, meals and insurance, including workers’ compensation.
Self-governance is vital
Perhaps the most motivating aspect of the Firstep program is peer-to-peer self-governance, Cody said.
“The clients really self-govern. The staff facilitate. The staff provide support. But they police each other. That is powerful when a man is found to have violated a rule and he has to go in front of his peers,” Schlittler said.
“One of the clients taught me something that I think is appropriate. The antithesis of addiction is connection. And there’s a lot of truth to that. And that’s what I see happening in this therapeutic community — bonding that occurs between men that develops into relationships beyond Firstep. It’s very interesting to watch an individual go before a community that they care about — that they pledge themselves to — to be accountable,” he said.
“They have a president, vice president and secretary that help the process of governing, but at the same time, they have been voted in by the community to be in those roles. It can be difficult for a man to go before his peers and have to confess that he either relapsed or was rude to the group by not showing up like he was supposed to or he caused the transportation to be late because he slept in. … Any of those kinds of things they have to take responsibility for. It becomes major in their lives and they have to start changing perceptions, changing their lifestyles,” Cody said.
The approach seems to be working. The graduation rate rose from 30 percent in 2016 — the national average for therapeutic community-based programs — to 40 percent in 2017. But challenges remain.
“Unfortunately, we have some of those guys and women who go into the program and they’re not quite ready. They walk before the can (improve),” said Suzanne Graham, chief operating officer at OKC Metro Alliance. “Another big challenge is ensuring that these men have something to do when they leave, and making sure that they have somewhere to go and that they stay connected. I think we have some good ways to do that, but sometimes it’s a challenge.”
Despite that, Schlittler says the staff works continually to advance the program and its outcomes.
“We’re all about improving the program and really making whatever we’re doing impactful,” Schlittler said. “We want to have better outcomes. We want to make sure that people have the greatest chance at success. If they stay those six months, research shows that the likelihood of relapse goes way down. What we’re looking at is how do we make this program attractive enough that they want to stay and complete six months.”
45-year success story
OKC Metro Alliance’s oldest program, the Public Inebriate Alternative, sees between 4,000 and 7,000 come through its doors each year.