SALT LAKE CITY — As hard as it is to stay sober year-round for recovered addicts, Brett Fabert says, the holiday season makes that already uphill battle an even steeper climb.
Fabert speaks from experience, having relapsed at Thanksgiving time after six months completely sober and 2 1/2 years without injecting drugs. He says that "within days" of having a drink on Thanksgiving Day, "I woke up on a toilet, just hunched over, drugs on the ground."
"You'd like to be able to really pinpoint — this is (exactly) why it happened. You can't really do that," Fabert told reporters Tuesday at Odyssey House, a Salt Lake addiction treatment center. "What that (drink) did, for me, was give me permission to do it again."
It's with Fabert and others like him in mind that Odyssey House is pairing each of its almost 200 outpatient and transitional housing clients with naloxone injection kits over Christmas; a time when many of them are away from their usual environments and visiting relatives.
"The holidays are stressful for all of us," said Misty McIntyre Goodsell, a licensed clinical social worker at Odyssey House. "If you're in recovery, the holidays can be especially difficult because the therapeutic issues they're working with (are often family related), such as childhood trauma, things like that."
Naloxone is a nonaddictive, legal substance that has been shown to rapidly cancel out the effects of life-threatening opioid overdoses. Depending on the kit it comes with, it can be administered via a needle injection or a nasal spray.
Goodsell said that for a recovering addict, working through family issues around Christmastime combined with the financial pressures of the season can make for "kind of a perfect storm" in which conditions are ripe for a relapse. The holiday season "can act as a huge trigger because people are feeling down and depressed," she said.
Fabert, who lives in an apartment complex that is part of Odyssey House's Sober Housing program, views increased temptation to rationalize drinking socially like others do, as well as an increased sense of loneliness as major contributors to recovering addicts' holiday season relapses.
"When it gets to the holidays ... 'I don't have family to be with' is what they say to themselves," he said, or alternatively, "'I wish I was normal and could have a couple drinks and be fine.'"
"Next thing you know, you have a needle in your arm."
All kits going to Odyssey House clients were either purchased with the help of a state grant or directly contributed by an organization called Utah Naloxone, the treatment center said. Naloxone kits are also kept at Odyssey House's residential treatment locations and administrative offices as an additional safety measure.
Goodsell said the distribution of naloxone kits could end up saving lives if family members of Odyssey House clients are properly instructed on where the kit is being kept and how to use it. She said people should know that the kits — even the needle-administered ones being distributed by Odyssey House for Christmas — are easy to use in an emergency.
"I think there probably is a fear factor for a lot of people" about treating someone with naloxone, Goodsell said, but "it would be no different than injecting someone with an Epi-Pen."
There is no risk of damaging side effects when treating someone with naloxone even if it turns out they are unconscious for another reason, she added.
"There (are) a lot of safety factors built-in," she said.
Odyssey House clients themselves have training in how to save someone by administering naloxone. Goodsell noted that, in the addiction treatment industry, the need for naloxone is so ubiquitous that "we all know someone whose life has been saved" by it.
Odyssey House workers don't have to reach far back to find an example. Rachel Santizo, an outreach specialist for the organization, saved a man's life Dec. 18 after spotting him lying unresponsive on the ground while handing out naloxone kits at Pioneer Park.
"He was absolutely blue," Santizo said. "He was gone. To actually experience it personally and see it for myself, it is a miracle — a complete miracle. ... I was in the right place at the right time."
Santizo gave a demonstration to reporters Tuesday, showing how she would fill the naloxone needles and where she would inject them (the shoulder and thigh). She explained that while some people may revive after a single ejection, others may need to receive multiple in order to be saved. Kits being sent out contain enough for four injections.
Santizo recommended waiting three minutes between injections if a person remains unresponsive, and said CPR should be administered during those intervals. She also reminded that 911 should be called.
Fabert said some families of recovering addicts may not like the idea of getting trained in using naloxone because it assumes there will be a relapse and they don't want to treat that as a possibility.
"But that's not reality," he said. "Reality is, they can overdose at any time."8 comments on this story
Fabert added that many times a person is most susceptible to a dangerous overdose when they've become sober for a period of time and then use a dose of drugs that their body is no longer accustomed to. For that reason, he said, people who are making real progress in their recovery are frequently those who don't survive an overdose.
Naloxone gives them another chance, he said, to live another day and continue fighting their addiction.
That fight is one that rages every day for Fabert, through sober times and through relapses.
"A lot of people give up," he said, conquered by hopelessness, shame and isolation.
"But thank God I know what to do," Fabert said, crediting both Odyssey House programs and his family for helping to right the ship in recent weeks. "I got through that shame period."