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health as it happens

After losing a son, they’re helping people in addiction — and calling for treatment reforms - The Philadelphia Inquirer

A few months after Heather and Larry Arata’s son Brendan died of a heroin overdose in 2017, the Delaware County couple established the Opioid Crisis Action Network.

“Getting very busy on this issue was a way for me to deal with my grief,” Larry said.

“It helped me get through those first few months,” said Heather.

Their organization provides rental and other assistance to residents of recovery homes and seeks to raise awareness about the often fatal consequences of addiction. Opioid overdoses alone claimed a record 93,000 American lives in 2020, including 1,214 in Philadelphia and 5,172 in Pennsylvania.

OCAN also is calling for greater accessibility, transparency, and standardized best practices among Pennsylvania’s 800 treatment facilities and its far more loosely regulated sober living homes, which are estimated to number in the thousands statewide.

The Aratas said they and others who have tried to get help for loved ones often are confounded by a system that’s excruciatingly difficult to navigate. Or makes decisions that are difficult to fathom: Brendan, desperate to avoid relapse, once was turned away from a Philly area treatment center because he was not under the influence of opioids at that very moment, his parents said.

Like other mental illnesses, addiction continues to bear a “they’re doing it to themselves” stigma. And as Spotlight PA has reported, services offered by Pennsylvania treatment centers and sober houses can range from excellent to exploitative.

“With cancer, there’s a continuum of care,” said Heather, 61, a project manager for a local health system. “Your primary care physician refers you to an oncologist, and you’re assigned a navigator to help evaluate your treatment options, and where you should go for treatment. And there’s aftercare.”

Despite the proliferation of outpatient addiction treatment programs — insurance companies cover these far more readily and longer than inpatient treatment — “there’s no real continuum of care for substance use disorder,” said Heather.

“There’s no infrastructure, like there is for other diseases,” she said. “Addiction isn’t treated as a disease. It’s treated as a moral failing.”

Larry, who’s 60 and teaches English at George Washington High School in Northeast Philly, said OCAN “wants to get some transparency around what [providers] can do and how well they do it. There is not a lot of information out there about treatment outcomes — unlike for hip replacements.”

The Aratas spoke to a reporter at Serenity in Recovery, a sober living house for six women in Chester operated by Shonette Parrilla, who lost her mother to an opioid overdose. “Her death taught me how difficult it is for people to fight this disease alone,” Parrilla, 48, said.

Since she opened the house in 2019, OCAN has made grants to pay the $400 monthly rent and provided other assistance for several residents who otherwise would be unable to live there.

Among them is Tyesha Soto, 40, a West Philadelphia mother of six who said she has been free of alcohol and crack cocaine for nearly two months. “Without the girls in this house, I don’t know where I would be,” Soto said. “I’ve finally found a place where I know I’ll be able to make it.”

Said house resident Tashina Wright, 46, a mother of three from Germantown who has been in recovery from crack and alcohol for nine months: “People think there’s no way out. There are possibilities, but they’re not going to come to you. You have to reach out, and grab them.”

Recovery from addiction is often, but not always, characterized by relapse, and treatment is not a cure. The Aratas, Parilla, and OCAN board member Sharon White know this all too well.

Brendan, who at 15 was diagnosed with bipolar disorder, was in several treatment programs and was hospitalized four times for depression before his death, in his family’s home, at age 23. Parilla’s mother kicked cocaine and methamphetamine but years later got hooked on opioids she was prescribed for arthritis pain, dying when she was 52. And White’s son, Lloyd Andrew White, was in and out of rehabs and recovery homes for a decade before he died of an overdose in 2019. He was 26.

Despite the continuing tragedy of fatal overdoses — as well as deaths due to alcoholism, which number 95,000 annually — an estimated 22 million Americans are no longer living in addiction, according to the Recovery Research Institute of Massachusetts General Hospital.

The total abstinence approach of 12-Step programs such as Narcotics Anonymous remains a successful choice for many recovering people. But the rise of harm reduction strategies and the development of Medically Assisted Treatment (MAT) programs using drugs such as buprenorphine and naloxone, along with talk therapy, have broadened the meaning of recovery to include wellness.

“The system needs to meet people where they’re at,” said White, 56, an organizational development consultant who lives in Lansdowne. “All or nothing doesn’t work for some people, like my son. He was an amazing, intelligent, talented person, but abstinence wasn’t for him.”

Said OCAN board member Gene Chollett, a friend of Larry’s from their days at Princeton University: “Addiction is a complex disease with complex paths to wellness.”

The organization’s position is that 30 days of inpatient treatment, followed by 30 days of intensive outpatient treatment, ought to be available at minimum for those seeking recovery. OCAN also would like Pennsylvania to require sober living houses in the state to accept residents who are continuing to undergo medical treatments with drugs, such as buprenorphine. Some do not, but Serenity in Recovery does.

“This is not a partisan issue. This disease has killed Republicans and Democrats,” said Larry, who ran unsuccessfully for Pennsylvania’s Fifth Congressional District seat in 2018 as a Democrat. He said he is no longer interesting in pursuing elective office.

However, the Aratas and their supporters aren’t shy about putting pressure on elected officials. OCAN posted a questionnaire to all Delaware County candidates running for federal, state, or local offices in 2018, asking their position on treatment reforms, including collection and public posting of data on outcomes. The organization’s website also includes statements of support for safe injection sites, including in Philadelphia.

The two-hour-long discussion at the sober house in Chester was lively, and even included a brief poetry reading by the Aratas.

But Brendan was never far from the conversation.

“He was 96 days sober when he died, and had been doing so well,” Larry said.

“He was up every morning, working hard, going to NA meetings every night. We had a wonderful Thanksgiving extended family dinner, and afterwards he was singing at the piano with his cousins.”

Heather brought along a photo of their son, who was a gifted musician and hoped to become a music teacher. Two drumsticks taped to the back of the photo formed a handle.

“We took this to our first recovery walk in 2018,” she said, adding that other families participating in these events also carry images of their lost loved ones.

The Aratas are far from alone in their grief — or their desire to continue the fight in Brendan’s memory.

Their daughter Shelby, 29, said she wants to help people “struggling with the same things my brother went through” and also hopes to “destigmatize” addiction.

“My brother was my best friend,” she said. “And I miss him every day.”