SUBSTANCE ABUSE AND TREATMENT IN BILLINGS, MONTANA
Billings, Montana is a beautiful city within a beautiful state that incongruously has battled one of the country’s most intense drug issues. Along with those issues have been the direct effect of drug abuse on depression issues and suicides. The battle on all fronts has evened out the numbers of treatment center admissions a bit – numbers have lessened across the board from early 2017 to the present – but as mentioned there is still a long way to go.
The economy is very strong in Billings, though conversely, incomes do not reflect that statistic. The percentage of residents employed, however, does. Employment is plentiful, for both younger and older residents.
Drug trafficking is all-too-common in the region, as is typical in HIDTA strongholds.
Our outlook, though, is one of cautious optimism. Several systems have mobilized to fight the issues – inclusive of politicians and federal organizations- schools are offering educational programs, and the state of Montana is receiving federal assistance to help fight its substance abuse issues.
The drug battle is ongoing. The availability of drugs will continue to be present, and, for many, so will the temptation. But the help is out there.
It is up to you to accept that help. Please feel free to drop us a line with any questions or comments on how we can be of the utmost aid to you.
ABOUT THE CITY
In 2017, Tim Fox, the Montana Attorney General, launched Aid Montana: Addressing the Impact of Drugs, an effort undertaken to combat the state’s growing drug scourge. Billings is a city that has been particularly vulnerable to trafficking, and its most recent statistics mirror the state proper:
- Since 1980, the number of drug offenses in the city has increased nearly 560% since 1980.
- Methamphetamine use, which decreased year-to-year from 2005 to 2010, has increased year-to-year since 2015.
- Statewide in 2017, 57% of all drug-related violations was for marijuana, 31% for meth, and other narcotics at 7%. Related statistics for the city of Billings are nearly identical.
- Heroin use has increased nearly 1600%, both citywide and statewide, from 2010 to 2015.
- Regarding adult felony convictions in general, 40% of all such convictions are for possession or distribution of drugs. Once again, the city and the state figures are nearly identical.
- In the city of Billings, and estimated 25% of all young adults use illicit drugs at least one time per month.
To its credit, the state of Montana has recognized its issues, and is tackling them head-on with efforts such as the above. However, there is a great deal of work still to be done. Unfortunately, for such a beautiful state redolent with nature, its drug problems have infected all of its cities.
Billings is Montana’s largest city, with an estimated population of nearly 111,150 according to the 2018 Census. It is the principal city of the Billings Metropolitan Area, and located within the south-central portion of the state. Billings is the seat of Yellowstone County, and the only city in the entirety of Montana with a population of over 100,000.
Its economy is strong, and the city continues to experience rapid growth. The growth has been notably consistent and fast since 2000, a fact that had enabled the city to avoid both the 2008-2012 national economic downturn, and the subsequent housing bust.
In recent years, the growth has slowed a bit due to recent oil price declines.
In July 1806, Billings claimed its place in world history when William Clark (of Lewis and Clark) traveled through the area. On July 25, he arrived at what would become Pompeys Pillar, and wrote in his journal about the “remarkable rock” of which he ascended. Clark carved his name in the rock, which became the only physical evidence of the Lewis and Clark expedition. In 1965, Pompeys Pillar was designated as a national historic landmark, and in January of 2001 a national monument.
Present median income for a household in the city is under $50,000, below the national average. Racial makeup is the following: 90% Caucasian, 4.5% Native American, 1% African American, 0.5% Asian. Hispanic or Latino of any Race is listed as 5.2% of the population.
The city’s downtown area is rich in arts and culture. Transportation is prevalent by car, rail, and bus. Due in part to the city’s ease of access, Billings is considered a HIDTA (High Intensity Drug Trafficking Area) stronghold by the U.S. Department of Justice (DOJ). The Billings Police Department is the host agency for the Eastern Montana Drug Task Force, a collaborative effort with the Yellowstone County Sheriff’s Office, the U.S. Marshall’s Service, the ATF (Alcohol, Tobacco and Firearms), DEA, FBI, and ICE.
BILLINGS DRUG CULTURE
The combination of Aid Montana and the Eastern Montana Drug Task Force is proving effective in fighting the state’s, and the city’s, drug issues.
There are still, however, gulfs to go:
- Billings’ suicide rate is nearly twice the national average, most successful attempts related to drug abuse;
- By comparison, the statewide suicide average is the highest of any state in the U.S., at nearly 24 incidents per 100,000 people. The rest of the country averages 12.6 incidents yearly, per 100,000 people.
- Opioids use and abuse are slightly above the national average, and are the city’s biggest substance-abuse-related issue behind pot and meth;
- Opioids are the fastest-growing drug issue in Billings, mirroring national trends;
- Hospitalizations and ER visits in Billings are 35% higher for alcohol, than drugs;
- Both the city of Billings and the state of Montana have among the highest drug-related jail incarceration rates in the U.S., and prisons in both entities are near-capacity;
- Like most of the country where opiate abuses are the fastest-growing problem, users frequently turn to heroin when prescription painkillers lose their efficacy.
THE MULTIPLE STAGES OF ABUSE
The various efforts to curb drug abuse issues in the city in part attempt to educate the public on early warning signs.
The initial stage of substance usage is either experimental, or recreational. For those who choose to experiment with either alcohol or drugs, most either go no further following the first use, or, in the instance of the latter, they use on a controlled basis.
However, that’s a tricky comment and easily misunderstood on its surface. The word most is misleading, as recreational usage frequently leads to heavier usage. Still, the article is highly-informative, and well worth a read, and indeed does go on to explain that those who find their experimentation pleasurable may continue to repeat the rush, and begin to abuse the drug. Continued use is the second state, and tolerance is the third, as the user will look for bigger fixes as old tolerances no longer apply. Abuse is the fourth stage, followed by addiction.
Among the steps that must be taken to support the struggles of an addict, while breaking him or her away from their addiction, include: removing the addict from their negative environment (including the company of dealers and fellow abusers) and placing them within a therapeutic community, the necessity of entering a rehab program and participating in psychological and emotional counseling, and how to spot triggers so as to hedge against relapsing.
To determine the extent and nature of one’s addiction, pre-intake questions may include the following:
- “How long have you been using?”
- “Do you believe you have a problem?”
- “Do you think others who know you believe you have a substance-related problem?”
- “Have others confronted you with questions related to substance abuse?” “Do you ever use alone?”
- “Have you ever substituted one drug for another, thinking one particular drug was the problem?”
- “Does the thought of running out of drugs terrify you?”
- “Have you ever been in a jail, a hospital, or a drug rehabilitation center because of your using?”
You can find pre-intake sample applications online. In this case, as with any other self-diagnostic tool, the questions as asked are exploratory only. You must speak to a trained and licensed professional for any true diagnosis. Still, such online tools such as a pre-intake questionnaire can be extremely useful. If you can honestly answer those questions, you may be validated, or you may dislike your responses. If you were drawn to the tool, likely both will apply. Regardless, consider your results, and then take necessary action.
There are pros and cons with online resources such as these, particularly when it comes to completely basing your treatment decisions on your own responses. That would be a negative, as remember, such questions are guidelines only without a trained professional to analyze your answers. Regardless of whether such questions are based on true-life examples of treatment center queries (they usually are), you may not be the best arbiter of your responses. Most especially if you are under the influence of any drug, or alcoholic drink. On the positive side, if you can be truthful with your answers, such online questions will certainly provide a glimpse into your condition, and the need for help.
Many addicts, or users with a problem whose usage is not yet defined as an addiction, make the mistake of not taking the first step towards sobriety as it regards intake. If you need help in making an informed decision as to what treatment method is right for you, we cannot encourage you strongly enough to, again, speak to family and/or friends who have been there before. Sometimes, a user has a difficult time making such decisions with a clear head.
And once more, if you know of no one who has been through these issues before, please contact one of the centers as listed on this page.
Also, we encourage you to ask yourself a few questions:
- 1) What is holding you back from getting help?
- 2) Do you believe you have a support system? If so, do you feel comfortable contacting them and speaking about your problem? If not, would you feel more comfortable contacting a professional?
- And 3) Do you believe you are capable of making an informed decision as to your treatment? If yes, you are well-advised to take advantage of one or more of the resources here. If no, you are strongly advised to contact one of the phone numbers listed here, and discuss your reservations.
Again, they are there to help.
During the intake application process, you will be required to list your prescription medications and days and times taken (if “none,” you check “none”), an authorization of medical care, a list of allergies or other medical issues, and a waiver of responsibility. Some applications ask more. A physician or treatment center representative will then review your application for the proper steps, and treatment.
The concept and practice of detox is typically broken down into three distinct phases: Evaluation, Stabilization, and Transition to Inpatient Drug Rehab.
Evaluation: As overseen by a doctor, who will determine what drugs are presently being used, how long has the patient been using, and how much and how frequently the patient uses.
Stabilization: As expounded on the site, stabilization differs patient to patient, based on specific substance being abused. This is the end result of the withdrawal phase.
Transition to Inpatient Drug Rehab: Many addicts believe that once they complete withdrawal, they are finished with their treatment. That is a dangerous belief, as withdrawal only releases the immediate physical hold of the substance.
Communication is key. Some users are resistant to treatment, most especially when in a treatment center against their will. In this instance, your communication with your specialists will be at risk. Remember, they are there to help you. You have the freedom to ask questions, and the right to receive answers.
That is one of the benefits of treatment, a better understanding of your illness.
What is withdrawal? How long does it last?
INPATIENT TREATMENT RESOURCES
Inpatient treatment is frequently misunderstood, as there are several options available to the user under that umbrella title. Many people believe the term to refer to only hospital treatment. Or, only highly-restrictive treatment. In reality, it is neither.
Inpatient treatment can either be PHP (a partial hospitalization providing a highly-structured environment, with typically active treatment of 30 hours per week), the less-intensive IOP (intensive outpatient treatment plan, which requires up to three hours daily over 3-5 days, for a total of nine hours weekly; therapy is usually included, but the patient can live either at their own home or a halfway house during the process), and an RTC (residential).
Though you may be the best determinant of the degree of inpatient recovery resources best suited to your needs, frequently one may need the help of family or friends to help you more clearly identify the treatment options that are most prudent for your needs. From there, only your personal commitment will determine your success.
PHPs and RTCs are amazing resources for those with more severe or difficult abuse issues. Both options are highly-structured, especially the former. The importance of structure cannot be understated. You will have a time for medicinal treatment, a time for personal or group therapy, a time to rest, a time for activities …
Frequently, a user has little structure outside of the treatment center. The user is more interested in the high than by scheduling their day via their clock. The structure of PHP treatment, particularly, may be a challenge for some. But, if you allow the treatment to take its course, the end-result can exceed your most optimistic hopes.
So ask yourself: “Do I do well in a structured environment?” “Am I functional in a structured environment, or will I have a better chance to succeed with something less restrictive? As ever, a user if not always the best determinant as to treatment. If a user is high while making the decision, that will be in no one’s best interests. It’s time to commit, with as free a sense of mindfulness as possible.
Should I choose inpatient or outpatient?
OUTPATIENT TREATMENT RESOURCES
Outpatient treatment is a comprehensive approach to wellness, and no less impactful than inpatient services. Please research the importance of outpatient treatment resources on The Recover, or speak to loved ones who have been through the process. Recovery is an ongoing process, which requires a substantive lifestyle change to avoid the ever-present threat of a relapse.
Outpatient treatment allows the patient a certain level of responsibility to remain clean while outside of the treatment center. You will face temptations but will have also learned specific strategies as to how to deal with them. It is up to you to take advantage of those lessons. There is a certain degree of trust on the part of the outpatient treatment administrators that the user will remain clean, and at the same time outpatient treatment allows for the user to remain productive on the outside while still receiving help. If you work, you can schedule your outpatient appointments or check-ins after hours.
One very important point, though, under this or any treatment circumstance: The entirely of your treatment is a commitment. Outpatient or not, if you miss one appointment you will likely miss another.
That is a recipe for failure. What you allow, you encourage.
Remember this as you move forward in your treatment. There are countless reasons why one would fail, in this or any other environment. Laziness, rigidity, intimidation.
But … there are fewer reasons to succeed: Yourself, first of all, then your loved ones (your collective of family and friends). Which means more to you? The pain of the commitment to get well, or the pleasure of using? If you answer the latter question as your affirmative, consider those loved ones who care about you, and worry about you.
On that note, let us elaborate upon the concept of commitment for a moment. Some users resent the term, thinking many of those who do not use, or who are not otherwise plagued by addiction, tend to believe commitment is that much easier than it truly is. How can a user commit to anything at all, one may ask, much less treatment if said user is overwhelmed by their addiction?
It is very difficult. Really, it is. But you can do this. You can reclaim your life, as none of us are defined by our addictions.
More on Inpatient Vs. Outpatient
AFTERCARE AND SOBER LIVING RESOURCES
Sober living may be the final step in your formal treatment plan before returning home, but treatment never really ends. Sober living houses provide the interim environment between rehab and mainstreaming back to your natural environment. The reason for the initial formation of sober houses was simple: a person in recovery frequently needed a safe and supportive place to stay, during the vulnerability of early recovery, prior to returning home.
Sober houses are also highly-structured, and most residents are referred to a sober living environment from a rehab center. Requirements and rules are strict, and they usually include:
- No drugs or alcohol on the premises;
- No violence;
- No overnight or sleepover guests, not even family;
- Commitment to random drug testing;
- Involvement in a community-related program;
- Acceptance by a peer group;
- Acceptance of advice from treatment professionals;
- Respect for the rules of the house;
- Following all directions;
- No swearing;
- No stealing;
- No sexual activity between residents;
- As part of a recovering community, if you see or hear any resident breaking the rules of the community, they must be reported immediately to appropriate staff;
- Anyone on prescribed medication must inform the house manager upon admittance;
- Residents must attend all sober house meetings;
- Residents must submit to drug and/or alcohol tests upon request;
- Rooms must be clean at all times;
- Chores must be completed without argument;
- Curfew must be respected.
Many of the above rules are enforced with a Zero Tolerance Policy. Meaning, if any of these rules are broken even once, you risk being kicked out of your sober living home. If you had experienced structure during your prior treatment to this point, you should be in good shape.
What happens after discharge?