It’s late on a crisp fall afternoon at the Glenwood Life Counseling Center in Govans. This is typically the quietest time of day, but there is still a small crowd chatting by the front door. One by one, individual clients duck inside, check in with the front desk, and go to one of three booths in the medication room where they receive a dose of Methadone, the synthetic opioid used to treat recovering heroin addicts.
There is a tall, dreadlocked construction worker wearing a bright orange vest, a hard hat tucked under his arm. An elderly woman with oxygen tubes strapped to her nose greets everyone with a broad smile. When a stocky man wearing a hooded sweatshirt approaches the booth, he is instructed to breath into a Breathylizer machine nearby, to make sure he hasn’t been drinking.
Nearby, there is a child-care room where clients leave their kids while meeting with case workers or attending group counseling sessions. There are the rooms, overcrowded with chairs, where the groups meet, and, nearby, a line of offices where case workers conduct the painstaking work of helping addicts put their lives back together.
“People often come here when they’ve lost everything,” says Lillian Donnard, who has worked at Glenwood for 13 years, and been director for five years. “For many of them, for five, 10, 20, 40 years, they’ve been getting sick and chasing drugs every day of their life, every four hours—it’s a full-time job.”
When clients first arrive, often referred by family or other addicts, they receive a medical exam and counseling to help them stabilize their typically out-of-control lives.
“Once they get stable, we start to work on the 50 other things that have become part and parcel of this drug addiction,” says Donnard. “They have no health insurance, no housing, no employment, they didn’t finish school, they have legal issues—it’s all about trying to build this recovery package that is about turning their life around.”
The medication room—where most clients come daily for their dose of Methadone—is the first stop for those entering Glenwood, but it is almost never the last. Most clients stop to talk to their case workers about employment, housing, or personal issues. Many attend support groups and workshops on everything from reading and writing to meditation. Some go to a book-club meeting. Others just sit in the lobby and knit, eat lunch, and chat.
“A lot of people come and stay and don’t really have any place else to go,” Donnard explains. “They live in a shooting gallery.”
Glenwood Life, which marked its 40th anniversary this year, is the second oldest Methadone treatment center in Baltimore. When the center opened in 1971, it had less than 200 clients. Today, it has 560. About half of the clients have been coming here for at least four years and some have been coming a lot longer than that. Because of its age, Glenwood is confronting a new problem for Methadone clinics, which first started cropping up about 45 years ago: treating elderly addicts.
“The thing that’s different now, in 2011, is that some of these people who have been here a long time are getting physically old,” says Donnard. “We have this whole overlay of normal problems of the aged—but also things that have been exacerbated by all those years of drugging and running—that nobody told us about or prepared us for, or that we have the resources to deal with. Our psychiatrist jokes that we look like the VA, with all the amputees that we have from diabetes and gout.”
And while the aging population presents new problems for Glenwood administrators and case workers, it also allows them to become more deeply connected with clients and to see the long-term results of their work.
“You go through this life with them,” says Donnard. “You hear about their children graduating and having their grandchildren.”
When Glenwood Life Counseling Center opened in 1971, it was the second full-service Methadone clinic in Baltimore and lots of people had reservations about it—particularly the center’s new neighbors.
“Forty years ago, everybody was flying by the seat of their pants—people didn’t know a lot about addiction, didn’t know a lot about treatment,” says Frank Satterfield, who started working as a vocational counselor at Glenwood soon after it opened, served as director for many years, and is now the center’s finance officer. “I had to go to 1,000 community meetings trying to explain what Methadone treatment was.”
Early on, the local city councilperson threatened to shut the center down because of the loitering associated with it. But, over time, administrators won over the community. It didn’t hurt that the center’s administrators built a playground across the street that is used by the community, or that they allowed local groups to use the building for meetings. But the most important factor in the détente was the community’s gradual realization that Glenwood’s clients weren’t causing problems. This, more than any community meeting, taught them what Methadone does.
Methadone was first manufactured in Germany in 1937 and introduced in the U.S. a decade later as a pain killer. In a landmark 1965 study, researchers discovered that the drug, which does not offer the same euphoric effect of heroin, could help heroin addicts wean themselves off the drug without debilitating withdrawal symptoms.
“Three things happen when you start using Methadone,” explains Donnard. “One, people don’t get sick anymore. Two, they don’t feel the effects of street narcotics. And three, they stop craving the drugs.” She stresses that the absence of withdrawal symptoms—during which, she says, “every cell in your body hurts”—is the primary selling point among addicts.
It was the beginning of a major shift from thinking of addicts as weak, flawed individuals to the understanding that addiction is a disease that can be treated medically. But changing the way people think about addicts is a slow process.
“The researchers found this treatment worked, but there was still this moral outrage in the early ’60s about giving a medication to people who are already abusing heroin,” says Donnard.
And still, there are people who doubt Methadone’s effectiveness.
“I sat next to a judge the other day and he asked, ‘Does Methadone really work?’ recalls Donnard. “I said, ‘Well, 100 percent of our clients come in addicted [to heroin], and after a few months, only 20 percent are. So, yeah, I would say it works.’”
In Glenwood’s early days, the heroin problem in Baltimore was relatively small and, in a lot of ways, addicts had an easier time maintaining their lifestyle than they do now.
“Dope was fairly plentiful, and there wasn’t the kind of enforcement there is now—people weren’t getting hassled a lot,” says Satterfield, who worked in the prison system before coming to Glenwood. “Jobs were plentiful—a lot of our folks worked at Sparrows Point or Lever Brothers, or building the highway. They had income, they had health insurance, they had good jobs. And it was easy to find jobs for people once they got into recovery. There was no AIDS, there was no Hepatitis C.”
Over the years, particularly during the 1980s, when AIDS and crack ravaged America’s inner cities, addiction rates soared. The number of people taking Methadone multiplied—it is now the predominant treatment for heroin addicts.
“Methadone is highly reinforcing,” says Donnard. “Once they’re here, people get stable to do the work in their life that they’ve messed up. A pharmacologist likens trying to live your life while addicted to going to class, but it’s right before lunch and you can’t concentrate on anything. Methadone gives you lunch.”
Rodney Jackson first came to Glenwood to treat his heroin addiction in 1995. He stayed with the program for two years, but then fell back into his old habits. In 2000, once he hit rock bottom, he returned.
“I was homeless,” he says. “I walked in without anything but the clothes on my back.”
It was a long way down for Jackson, now 52. For years, he worked as a special- education teacher in city schools and had even worked for a time as an adviser to the Baltimore City Police Department. For 20 years, he managed to conceal his addiction before things unraveled. Jackson, whose father was a drug addict, credits Glenwood’s onetime resident physician Dr. Robert McDaniel—a recovering addict himself who died in 2002—with getting him on the path to recovery.
“He treated me like a human being,” says Jackson. “At the time I came back to Glenwood, it had been a while since someone treated me that way.”
Jackson is one of six long-term clients who have become part-time peer-case managers. While Glenwood’s 14 full-time case managers oversee clients’ cases, they will often refer clients to peer managers to help them navigate the tricky waters of getting housing, employment, and other social services.
“We show them how to get a driver’s license, how to apply for Section 8 housing, how to get food stamps, insurance, things like that,” says Jackson. Like most clients, Jackson still takes Methadone every day. Case workers are very slow to wean clients off the drug, for fear of a relapse. They usually only begin that process after clients have been stable for many years. Few clients ever wean themselves off the drug entirely.
Jackson and the other peer managers work out of a house adjacent to the center and all share a passion for their work.
“We’re only supposed to work four hours at a time, but most of the time, we’ll stay all day,” says Jackson. “We know what it’s like.”
Donnard says one of the biggest rewards of staying at Glenwood for so many years is watching the transformation of peoples’ lives.
“We tend to serve people who have long histories of drug use and who are very disenfranchised,” she says. “And then, one day, you’ll see them at our book club, or celebrating their child’s birthday.”
After 40 years, Glenwood has the history and reputation of an institution, but it still manages to provide surprises almost every day. As Donnard says, “We walk this long life journey with so many of our people.”