Smokeless treatment facilities test mettle of recovering addicts

SALT LAKE CITY — It's Dusti Benavidez's fifth day at Volunteers of America, Utah's Adult Detoxification Center, and she's craving a smoke — big time.

The facility is smoke-free under the state's Recovery Plus initiative, which requires all substance abuse and mental health treatment facilities that receive public funding to be tobacco-free by March 2013.

Salt Lake County instituted the change ahead of schedule. At VOA's short-term detox center, the change has meant some clients aren't completing the program. Others are shying away completely and that's causing concern among both the clients and those who are there to help them.

"The cigarette thing almost made me walk out," Benavidez said Monday.

"I mean I've been here five days and it's all I'm thinking about. Is there any chance someone can leave a cigarette on the window sill? I'm looking at butts on the ground, even though I don't have any way to light up. I mean, what's wrong with me?"

The impact of the change is significant because the vast majority of clients in the mental health and substance abuse treatment programs are smokers. Three-fourths of those in publicly funded mental health programs smoke, while 66 percent of those in substance abuse programs are smokers, according to the Utah Division of Substance Abuse and Mental Health.

Andrew Johnston, residential service director for VOA Utah, said he's aware of a number of detox clients who have left the program prematurely, which means they do not receive the assessments they need for admission to treatment programs.

"We're waiting to see if our numbers rebound to previous levels. It hasn't fully responded," he said.

Benavidez, who is in her first attempt of overcoming a longtime addiction to "booze, pills and meth," said she hopes that the additional challenge of giving up smoking does not become too onerous.

"I understand we have to climb a mountain to get clean. Can we climb one mountain at a time?" she said.

Rick Hendy, program administrator of adult mental health for the state Division of Substance Abuse and Mental Health, said research shows that people who also give up smoking during substance abuse treatment have a 25 percent greater likelihood of long-term abstinence from alcohol and other drugs. 

While Hendy, a veteran mental health administrator, acknowledges the initiative is a "culture change," he's convinced the long-term benefits are worth the initial discomfort of coping with the new practice.

The initiative has two basic principles: No one will be denied treatment because of their tobacco use. Education and nicotine replacement therapy will be provided to all clients.

The overarching goal of the initiative is to promote health and wellness among Utah clients with mental illness and/or substance abuse, whose average life spans are 29 years shorter than the general population, according to a recent study. 

"When this research came out showing so many people were dying so young, I knew that was true. I'd been to so many funerals. I've spoken at so many funerals of people with mental illness," Hendy said.

Knowing the statistics, treatment providers said they had an obligation to help.

"We're health care providers. We have a responsibility to view ourselves as health care providers," Hendy said.

The initiative has had other benefits. A number of people who work at the affected mental health or substance abuse facilities have also given up smoking.

Johnston said he agrees with objectives of Recovery Plus because the long-term data show smoking cessation helps people maintain their sobriety.