There is a new bridge in Soldotna between the emergency room and residential rehab for those seeking to kick their substance addictions.

One of the most dangerous parts of trying to quit using an addictive substance is the withdrawal that follows. People withdrawing from heroin can go through muscle pains, depression, hallucinations and vomiting, among other symptoms. Besides being very painful and unpleasant, people detoxing stand a risk of dying — about 6.6 percent of people in a 2010 study about withdrawal died while attempting to detox without support, according to the Addiction Centers of America.

Central Peninsula Hospital opened a medical detox center, called Care Transitions, on Aug. 2. People seeking to safely detox from substances including alcohol, prescription opiates and heroin, among others, can check themselves into the center to be monitored by medical staff as they withdraw. A doctor on rotation can write prescriptions to help treat the symptoms of withdrawal, making patients more comfortable and making sure they are fed, hydrated and safe.

About 20 people have already gone through the program, said Dr. Kristie Sellers, the director of behavioral health at Central Peninsula Hospital.

“We’ve gotten two patients from Anchorage,” she said. “Everybody else has been local.”

The process to get the center open only formally began last spring. However, the need has been obvious for a long time. Hospital staff members in Central Peninsula Hospital’s emergency room have been seeing an increasing number of patients withdrawing from alcohol, opiates or heroin in recent years, and residential rehabilitation center Serenity House is frequently full. Since Care Transitions opened, the average daily population of patients has been about three or four, Sellers said.

Last year, the Kenai Peninsula Borough’s Healthcare Task Force also specifically identified a detox center as a critical need in the community. In May 2016, community organization Change 4 the Kenai — which Sellers and Serenity House intake coordinator Shari Conner are both involved with — hosted two town hall meetings on how to address heroin addiction on the Kenai that attracted more than 100 people both nights.

Sellers said it was encouraging that so many people supported the center.

Other communities have established centers where users can use drugs safely under observation and eventually wean off them, but that wasn’t the direction the hospital and Change 4 the Kenai wanted to go, Sellers said.

“Shooting facilities feel like giving up a little,” she said. “…What we’ve been doing is aggressively passing out Narcan … and we decided we wanted to make it really easy to stop if people wanted to stop.”

The detox center slides into a gap that brings the medical community on the central peninsula one step closer to a complete continuum of care for substance abuse. Before it opened, people could go to the ER for acute withdrawal or to Serenity House for a 30-day residential program, but there was nothing between. The 30-day program could be daunting for some people and stop them from seeking help, Sellers said- for instance, people with full-time jobs that couldn’t take a month off or single parents with young children.

Care Transitions is typically between a three- and seven-day stay. That means someone can take a three-day weekend from work to complete the program and not risk losing a job, or can find childcare for that time, Sellers said. The paperwork to apply for care is intentionally very simple — a few pages, as opposed to thick applications recipients of public services sometimes have to fill out, she said.

So far, one thing that’s surprised her is the number of people that have expressed interest in going on to the full residential care program at Serenity House, she said.

“I’ve been surprised by the number of people who are interested in going on to Serenity House,” she said.

Central Peninsula Hospital purchased and rehabilitated a building in Soldotna close to the main hospital campus using a grant from the Alaska Department of Health and Social Services, which it received in January 2017. The timing lined up well when the grant became available last year, Sellers said — part of the qualification for the grant was the organizers had to prove they had community support, and the town halls they held last May showed significant public support for a detox center. The grant, part of a set that also included grantees in Fairbanks and Palmer, will be disbursed over three years, with the grantees receiving $500,000 the first year and $1 million for the next two, depending on available state funds.

Sellers said the hospital currently plans to offset the operations at Care Transitions with the grant funds but also intends to keep operations slim, knowing that reimbursement from insurance likely won’t be huge.

Over time, the plans for the detox center will also involved another of the hospital’s substance abuse recovery programs — a planned transitional living house called Diamond Willow. The facility, which is tentatively planned to open this fall pending renovation work, will house graduates of Serenity House’s rehabilitation program as they transition into full independence, teaching them skills like cooking and resume building.

Eventually, one of the intents is to provide basic jobs for the house’s tenants at the detox facility, cooking and cleaning for some pay, Sellers said. That will likely contribute to lowering costs,

“The transitional living facility has a commercial kitchen,” she said. “Hopefully in time the people in the transitional living facility will end up doing all the housekeeping.”

Opioid addiction, particularly heroin, has plagued the Kenai Peninsula’s communities for more than two decades and has noticeably worsened in the last five to 10 yearsm, as it has all across the U.S. One change Sellers said the hospital’s behavioral health department has seen is that more patients addicted to heroin who come in for treatment did not try prescription opiates first — they went immediately to heroin. That’s a shift from the early 2000s, when most heroin users were addicted to prescription pills first, transitioning to heroin when the pills were no longer available. Sellers said many of the users now were exposed to it through their parents or friends using heroin at a young age.

“(Most of the patients so far) are young and using heroin,” she said.

She said the hospital’s behavioral health staff is excited about the center and that the community so far has been very supportive. The hospital hopes to work with other providers and organizations, including the Kenaitze Indian Tribe and the Cook Inlet Council of Addiction and Drug Abuse, to further bulwark the substance abuse recovery services on the peninsula, she said.

“I don’t know that anybody else … was placed to open a detox facility,” she said. “The American Society of Addiction Medicine has a continuum of care … we now have all of those available right here.”

Reach Elizabeth Earl at elizabeth.earl@peninsulaclarion.com.

This Aug. 31, 2017 photograph shows the waiting room in the Care Transitions medical detox facility, operated by Central Peninsula Hospital in Soldotna, Alaska. The hospital obtained a state grant to purchase and renovate the facility, which provides medically supported withdrawal services for people detoxing from addictive substances including alcohol, opiates and heroin. (Photo courtesy Shari Conner/Central Peninsula Hospital Behavioral Health)