Amanda Kinsolving had been in and out of jail for years.
The 31-year-old Port Charlotte resident experienced her first arrest in Charlotte County when she was 16, with a list of charges growing as she became more dependent on opioids.
Last year, she was held in Charlotte County Jail for grand theft auto.
And the court system gave her a choice: Kinsolving could either complete 11 months in jail, or undergo a specialized court program where she would receive treatment for her mental health and substance abuse issues.
“I finally got to that point,” she said. “I was tired of (jail) being my safe place, being tired of not having my family around, missing out on my son. I was just tired of the way I was living. And I didn’t know how to do it on my own.”
Kinsolving is now 6 months sober.
She is one of 25,498 people in a 14-county region, including Charlotte and Sarasota, who sought outpatient treatment for her addiction in 2018. This is almost 4,000 more people than in 2017, according to Central Florida Health Network data.
The data doesn’t distinguish what addiction people are suffering from, whether it be opioids or another substance.
However, opioids were among the most common drug of choice with those seeking treatment between July 2014 and June 2018.
Since Kinsolving was a teenager, she always partied.
“You start doing it because you’re just having fun,” she said.
But at 23, she started injecting opiates, and her drug addiction took off.
“Then it stops being fun,” she said. Kinsolving lost custody of her son when he was 6-years old, making her angry and causing the relationships with her parents to crumble. She lost her job, and spent years either homeless or in jail for various convictions. “All those things will just push you further and further down.”
At the peak of her addiction, she would use any kind of opiate, and shot up anything.
“I just had to be high,” she said.
Eventually she couldn’t go six hours without using due to the intense withdrawal symptoms. Her skin was sensitive, her body ached. She would sweat and shake uncontrollably all while trying to stick a needle in her arm.
“It consumes you completely. You get to such a low point that you feel like there’s no coming out of it. You cannot see the light, you feel stuck. You trap yourself in that mental prison and you don’t realize that you have that choice to get out of it,” she said. “You are a prisoner to your own body.”
Her mom could see it in her eyes. “You’re just not there,” her mother would tell her.
There’s a point for some suffering from addiction when everything clicks.
It’s not a sudden, overnight change in behavior, but more of a change of mind. A moment where they realize they want to be sober.
The most common epiphanies have to do with fear or loss, according to Andrea Mann, a mental health clinician for Southwest Florida Counseling Center and a certified facilitator for SMART Recovery, a nonprofit organization that assists people in seeking abstinence from addictions. Loss of family, friends, health, financial status, career and independence are strong motivators that elicit positive changes.
Kinsolving described it as a spiritual awakening.
“It was knowing that I could get out (of jail) and knowing that I’d probably just go right back to the same (stuff),” she said. “Then I’d come back worse off than I was before, or not come back at all.”
It’s different for every person, said Sarah Stanley, the chief operating officer for Charlotte Behavioral Healthcare. “When a person’s ready, they’re ready.”
Sometimes it can be the indirect impacts addiction has on their child, or a traumatic event. It can happen early on, or after 20 years of substance use.
“They have to get to a point where they really want it,” Kinsolving said. And “have to completely surrender to it all.”
Over 6,500 adults in the region entered treatment for their opiate use in fiscal year 2017/2018.
Between July 2014 and June 2018, there was a 93.8 percent increase of people describing heroin as their drug of choice, according to Central Florida Behavioral Health Network data.
Kinsolving was evaluated by Glenda Steffenhagen, the substance abuse program manager at Charlotte Behavioral Health Care, and accepted into the mental health court program at the facility.
When Kinsolving first walked into group therapy for her outpatient treatment, she had no idea what she was doing.
“I had no idea how to recover,” she said.
Her social skills, she felt, abandoned her while sober. She was guarded, anxious, uncomfortable and suspicious of all those around her.
But in order to be successful in treatment, she had to force herself out of her comfort zone, and learn to trust Steffenhagen and her case manager, Chris Oester.
She attended group therapy three times a week, with a small group of under 15. They started to build a camaraderie, sharing their experiences and learning together how to recover.
While recovering at Charlotte Behavioral Health Care’s inpatient programs, patients meet with a doctor, nurse and clinician, and are offered individual and group therapy. They are also linked to outpatient services when they are discharged, with options including medication assisted treatment, such as Suboxone or Vivitrol, therapy, groups and case management.
She also attended Narcotics Anonymous (NA) meetings. Before she went, she was stuck thinking no one understood what she’d gone through.
“And you go, and everybody’s been through that and everybody understands what you’re going through,” she said. “It’s like coming home again.”
It helped her to see people who had struggled with her same vices remain sober for over a decade.
Fear of Relapse
It’s common for those going through recovery to experience a relapse.
“The urges to use last a long time,” Stanley said, with most people having a few relapses before treatment really sticks.
And unfortunately, brain chemistry is not on their side.
Post-acute withdrawal syndrome is the emotional and psychological withdrawal symptoms that can occur after the initial, more physical, withdrawal.
It takes two years for brain chemistry to stabilize, according to Steffenhagen, so those in recovery can have cravings long after they’ve stopped abusing a substance.
“While there is no guarantee that the brain will heal completely from sustained abstinence,” Mann said, “some of the damage done during substance abuse can be reversed.”
Charlotte Behavioral Health Care had 545 detox patients last year, with a recidivism rate of 7 percent.
“(Relapse) is not a failure,” Mann said. “(It is) a sign that something should be changed in the treatment plan.”
Kinsolving has not relapsed during her six months of treatment.
“Getting up and earning that all back and losing it again was crippling to me,” she said. “But that same fear of failure is what keeps me moving forward now.”
But Kinsolving has faith in the tools she’s learned from treatment.
“If you apply those principles into your life, it reduces that risk. A lot.”
During her six months in treatment, Kinsolving has learned how to identify her emotions, why she’s feeling them and how to deal with them.
“If you understand that, or start to get a grasp on that, you can really work on everything else in your life,” she said. “Being able to understand myself gives me the opportunity to fix it.”
Now Kinsolving is proud she can show up on-time for her commitments, and be reliable.
She has also rebuilt her relationships with her parents, who are taking care of her son while she is focusing on recovery.
“I was not around for a long time,” she said. “I’m so fortunate and grateful for them because without them, my son would be in foster care.” Now she speaks to her parents almost every day, visits her son as often as she can and encourages him to do his homework.
“People literally rebuild their lives in front of my eyes,” said Steffenhagen, who leads Kinsolving’s group therapy sessions.
In recovery, individuals have to assess their values and understand the drive for their continued use.
“It requires frankness and honesty with oneself,” Mann said.
Individuals in recovery also have to understand their triggers and how to manage them in a healthy way.
Kinsolving was an intravenous opiate user for 10 years; a third of her life. “I lived that way for so long and I’m just now learning a new way to live.”
Thankfully, she doesn’t have cravings for the drug today. She’ll sometimes feel tempted, but the urges were a lot worse when she began recovery.
“It’s our go-to coping mechanism,” she said. “If something goes wrong, we use.”
But now she’s afraid of using again.
“My thinking is changing,” she said. Now, if something goes wrong, she goes to her sponsor or her case manager.
And she urges anyone who wants to make a change in their life to do it.
“There is a light at the end of the tunnel. It doesn’t matter what kind of things you’ve done or what you’ve lost or how bad you feel you are, you’re not bad. There’s a way out. There’s coming out alive,” she said. “I never thought I’d come out alive.”
It’s not an easy process, Kinsolving admits, experiencing some bad days.
But “it’s what I do today, and what I do tomorrow. That’s what makes a difference.”
The effects of opioids
Last year, almost 34,000 people sought outpatient treatment for substance abuse in the Central Florida region.
Of those, 8,474 were children.
And opiates have been the most common drug of choice for those seeking treatment for the past three years, according to Central Florida Behavioral Health Network data.
When an opioid is ingested, dopamine, or the chemical in your brain that causes happiness, is released in floods. It tricks the brain into a sense of euphoria, that the brain would otherwise not do naturally.
The brain has to adjust to the abundance of dopamine by slowing down its natural production, creating a chemical imbalance.
Over time, greater amounts of opioids are required for the user to simply feel normal.
“While there is no guarantee that the brain will heal complete(ly) from sustained abstinence, some of the damage done during substance use can be reversed,” said Andrea Mann, a mental health clinician for Southwest Florida Counseling Center.
Originally published in the Charlotte Sun on April 14, 2019.