Forty years ago, former Mayor Jim Taft was worried about the emerging drug problem in the City of Cranston. He could identify very few supports in the community for individuals struggling with substance abuse, and saw a need.
Today, that idea has grown into CODAC Behavioral Healthcare, which has five branches around the state and treats more than 1,200 Rhode Islanders each year. To date, it is estimated that CODAC has influenced 60,000 people.
“If he didn’t have this vision in 1970, what would substance abuse treatment and behavioral health services be like?” asked Michael Rizzi, president and CEO of CODAC. “The celebration was, in a way, bittersweet.”
Mayor Taft passed away in September of this year, but his contributions to behavioral and mental health care in the Ocean State are not forgotten. His vision and commitment to social services was recognized last Wednesday as CODAC celebrated its 40th anniversary with an event at the Crowne Plaza in Warwick.
Also recognized last week were longtime CODAC supporters and board members Sandra DelSesto and the Regine family of Cranston.
Rizzi joined the CODAC team in 1973. At the time, Craig Stenning was the executive director, a post he served in for 28 years. Stenning has since moved on from the organization, and currently serves as the director of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.
“We would not be standing here today if it was not for Jim Taft…This anniversary is really his celebration. Of all of his achievements as mayor, he always considered CODAC as one of his most important accomplishments,” Stenning said.
The major challenge under Stenning’s leadership was a gap in treatment. Residential treatment facilities were the focus, but outpatient options were scarce.
CODAC stepped in and began expanding from an umbrella organization that connected drug and alcohol users to the appropriate resources, into a treatment option. CODAC offered one of the state’s first outpatient treatment programs.
“CODAC saw itself as an opportunity to provide something that didn’t exist,” Rizzi said.
In the early 1970s, CODAC worked closely with the State of Rhode Island and the former Cranston General Hospital to administer methadone treatment and outpatient detox for opioid addiction.
By 1975, the state wanted out, and CODAC took over their Providence-based methadone program. Two years later, the City of Newport invited CODAC in to provide a similar outpatient service in that community. Over the next two decades, CODAC would open up additional centers in East Providence (1978) and Wakefield (1998).
Stenning thanked the thousands of individuals who began their recovery journey at these CODAC centers statewide.
“Many of you have heard me say what a wonderful field this is to work in – because individuals allow us to join them in this path of recovery,” he said. “They do the really hard work and we provide the tools and improved skills to reach their goals. We now know that treatment is the beginning of the journey – not the end.”
CODAC has developed student assistance and tobacco cessation programs around the state. They also have a contract with the Department of Corrections and work with released inmates.
Between its five centers, CODAC addresses opioid and narcotic addiction, as well as alcohol abuse. Bridging the gap between these types of addiction was something the agency paved the way on.
“The alcohol people didn’t want to deal with the drug people,” Rizzi said.
Offering resources and treatment under one roof allows professionals to work more effectively together, though.
Equally challenging was bringing mental health services into the mix.
“In those days,” Rizzi recalled of the 1970s, “there was a wide chasm between the mental health side and the substance abuse side.”
Often times, there are “co-occurring” disorders that come with addiction. Someone with an addiction to prescription pain pills could also have a mental condition like depression, anxiety or character disorders. Those disorders can, in turn, influence substance abuse.
Today, CODAC professionals treat these co-occurring disorders simultaneously. Patients can access a variety of services easily and begin to heal right away.
“You build, little by little,” Rizzi said. “I think we’re at a place right now where you’re finding more and more mental health centers also having a substance abuse unit.”
CODAC has a staff of 95 that includes physicians, nurses and counselors that specialize in marriage, family or rehabilitation therapies. The 36 employees who have been with the agency for more than five years have a combined service of 420 years in the behavioral healthcare field.
“We have been blessed to have so many dedicated, committed, compassionate, skillful practitioners work for CODAC,” Rizzi said.
Having doctors and nurses close by is crucial. Despite a perception that most drug users have the HIV or AIDS virus, Rizzi says that accounts for less than 3 percent of CODAC patients. An astonishing 85 percent, however, suffer from Hepatitis C.
These individuals continue to be discriminated against, even after years of sobriety. For example, Rizzi has seen many addicts come through treatment successfully but remain at the bottom of donor lists for a new liver because they pose a greater risk of using again.
Outside of the CODAC headquarters on Park Avenue, there is no sign to advertise the business going on inside. Rizzi said that was done as a deliberate choice to see if individuals feel more comfortable turning to CODAC for help when passersby don’t know what services are provided there.
“There is a whole issue of stigma and marginalization that comes with the issues that we’re dealing with here. We know perception, for many folks, is important,” Rizzi said.
In recent years, the individuals seeking treatment or counseling at CODAC have been younger.
“There’s a tendency now to see a younger group of opioid users,” Rizzi said.
Some of that, he said, can be attributed to the availability of drugs, the prevalence of prescription drug abuse as a gateway and the mainstream media.
“There is this incredible exposure to toxic information with not much rebuttal,” Rizzi said, using beer commercials during an afternoon football game as an example. He believes these messages of drinking and drug use as a means to have fun feed into a child’s need for instant gratification.
“There’s this increasing dependence on something external in order to provide excitement,” he said. “Everything is focused on what’s going to make you feel good.”
The recession doesn’t help either.
“We’re also seeing those people who found themselves in a tough economic situation and, as a result, have let their drinking or drug use get out of hand.”
As with any social service agency, CODAC has been forced to do more with less. They are paid through insurance and by state contracts, but budgets are tight and CODAC has seen funding reduced by 20 percent.
Rizzi says the path to recovery is a cost-saving measure in the long run.
Persistent drug use often leads to crime, intervention by DCYF when children are involved, imprisonment and hefty medical bills. Rizzi estimates that for every $1 spent on treatment or recovery efforts, the state avoids $7 in related costs.
“As soon as the door is shut on these folks, the costs go up exponentially. There’s a little bit of short sightedness that goes on here.”
Going forward, all CODAC can do is coordinate care and continue to deliver services in the most effective and cost-efficient way possible.
“It was everybody’s expectation that if we did our jobs really well, our jobs would go away. That hasn’t happened,” Rizzi said. “I think the future of CODAC lies in looking at how we can continually improve services.”
For more information on CODAC services, call 461-5056.