Horizons Makes a Difference Helping Individuals Overcome Substance Abuse
by Augusta Sires
The Horizons substance abuse treatment program is a cornerstone of Wheaton Iowa’s many community health initiatives and one of Iowa’s few hospital-based chemical dependency units.
In August, Horizons moved 1.3 miles from its 30-year home in the Kimball Ridge Center to the east wing on Covenant Medical Center’s fifth floor. The relocation eliminated frequent treks to the hospital for medical, mental health and lab services and provided a mental health connection on Covenant’s “behavioral floor.”
“Everything is now centrally located,” said Jena Burch, director of behavioral health for Wheaton Iowa, which oversees Covenant. “The best thing is having physicians readily available to see patients, and the lab and pharmacy services. It took quite a bit of time to get those services over to Kimball Ridge. Now there’s an immediate response.”
“The quality of care will go up because we won’t be shuttling people all over the place,” said Horizons counselor Jim Hoeft. “Sometimes when people are detoxing, they do get sick and need to go into the intensive care unit, which is right here.”A decline in hospital inpatients freed up space for Horizons’ 19 residential beds and four detoxification beds.
“We have a lot of patients who may have neglected their health, so they need medical care here,” Burch said. “We can provide oxygen and medications as well.”
Horizons serves roughly 32 patients from throughout eastern Iowa on a weekly basis.
“We’ve become almost a regional care center, because a lot of folks don’t do detox today,” Hoeft said. “Cedar Rapids has only one inpatient program, so its hospitals may put folks up with us for a week or two.”
Five Horizons counselors — two inpatient, two outpatient and one family — offer individual, group and family therapy sessions, including relapse prevention and a “co-occurring” program for people with mental health and substance abuse issues.
Registered nurses, chemical dependency technicians, recreational therapists and clergy complement the team along with medical director Dr. P.B. Raju and psychiatric hospitalist Dr. Sunita Kantamneni.
The “new Horizons” will add even more focus on “the whole person.”“We have a nutritionist talking about healthy foods,” Burch said. “In chemical dependency, a lot of people neglect their bodies. They are really malnourished.
“And I’m really excited about the new exercise equipment. They’ll learn to replace negative behaviors with positive behaviors. A lot of them are ready to get going and get healthy.”
Hoeft, who has been with Horizons since 1991, supervises evaluations, intakes and admissions.
“A lot of people come in and say, ‘Jim, I have a problem with alcohol and drugs. I need an assessment. Some folks have OWI (operating while intoxicated) violations and need a substance abuse evaluation prior to sentencing. Others may have something going on at work, so they are referred.
“We also have folks who come in to the hospital with a cardiac issue, but test positive for cocaine, so physicians may ask for a consult. And a psychiatrist may order a consult. They’ve stabilized mental health issues with medications, but refer them to the treatment programs for chemical dependency.
“I do those evaluations and determine the level of care — the program they need.”
Horizons offers numerous counseling sessions — day and evening; group, individual and family — often with volunteers from support groups such as Alcoholics Anonymous and Narcotics Anonymous.
“We do a lot more group, because we’ve found it’s the most effective,” Hoeft said.
“A lot of these patients have been through hell. Their lives are rock bottom,” Burch said. “They’re pushing away family, lost jobs and given up hope. This is a safe environment where you can validate, pull out the mistakes you’ve made, and the person next to you has been through something similar. You can make it through this. We can do it together. We can earn sobriety.”
Burch said family counseling is a “unique” element in the Horizons program. A counselor will talk with family members alone about what they’ve experienced, as well as together with the patient.
One family was especially appreciative.
“We had a patient donate a flatscreen TV,” Burch said. “On a Christmas Day, up pops a flatscreen TV. That’s the kind of patients we have.”
“That individual volunteers a lot,” Hoeft said. “The family went through the treatment program. It was successful, and they’ve been very supportive through the years.
“You do see the success stories,” he added, “but at the same time you see other folks dying.”
The key to the success, Hoeft said, is education and application.
“Patients get the education, but they need help figuring out how to implement it. If you’re out there drinking or abusing, you need to match the intensity of the treatment with the intensity of the abusing.
“Unless you understand alcohol or substance abuse as a chemical dependence, it doesn’t make sense because you can’t see what you’re doing to yourself,” he added.
“And if they do see what they’re doing, they don’t know what to do differently. They may get into some bargaining — cutting down on drinking and thinking, ‘I don’t want the bad things to happen any more, but I want to keep drinking.’”
Hoeft said successful treatment requires “reorganization.”
“What am I going to do differently? It’s not just about drinking or using chemicals. I need to make some other changes, too. Behavioral changes or dealing with some other issues, including health, need to be addressed, too.
“No matter what happens, I can never go back to bargaining or saying, ‘I’ve been good for a period of time, maybe I can have another one.’”
The Horizons staff, though, can take pride that its approach is making a difference.
“The biggest thing with our success stories is that they come back, call up and they say have a great relationship with the counselors and the nurses,” Burch said. “They devote themselves to those relationships. The Horizons staff is such a critical part of them turning their lives around that they always remember them.”
Article Written By: Saul Shapiro