KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5. Welcome. Later in the broadcast Maryland is considering a statewide ban on single use plastic bags. What does that mean for consumers? But first, Maryland has the third highest number of drug overdose deaths in the country according to the CDC. Hagerstown narcotics officer Kevin Simmers lost his 19-year-old daughter Brooke to heroine overdoes in 2015.

KOJO NNAMDIAfter struggling to get the help she needed to break her addiction, Simmers was determined to create a space for women to recover. Based in Hagerstown, Maryland Brooke's House provides a stable and supportive living environment for adult women in the early stages of substance abuse. But experts say the services provided at Brooke's House are needed on a much larger scale to help curb the addiction crisis in Maryland. Joining me now in studio to discuss this is Kevin Simmers. He is the Founder of Brooke's House in Hagerstown, Maryland. Kevin Simmers, thank you for joining us.

KEVIN SIMMERSThank you. Thank you for having me.

NNAMDITyrone Turner is the Visuals Editors at WAMU who did a story on Brooke's House that you can find a link at our website kojoshow.org. Tyrone, thank you for joining us.

TYRONE TURNERThank you.

NNAMDIAnd Dr. Yngvild Olson is an Addiction Medicine Specialist and the Vice President of the American Society of Addiction Medicine. Dr. Olson, thank you for joining us.

DR. YNGVILD OLSONThanks for having me.

NNAMDIKevin Simmers, you founded Brooke's House after losing your 19-year-old daughter to a heroin overdose as I mentioned earlier. Can you tell us a little bit more about Brooke's struggle with addiction?

SIMMERSYes, sir. She started out with pills in 2013. And she was getting the pills illegally. And she was taking the pills. And at the time we were trying to get in an inpatient treatment program. But the insurance companies wouldn't authorize it at that time. So we tried outpatient treatment and in her case the disease quickly escalated to heroin and IV drug use with heroin.

NNAMDIBrooke faced her addiction and asked for help. How difficult was it to find a treatment facility for her?

SIMMERSA treatment facility that I was happy with, it was impossible. I mean, the treatment facilities that we visited were normally in the inner city in rundown sections of the city. They were overcrowded. I thought they were poorly managed. There wasn't a lot of structure of discipline involved, and it was really nothing that would give a parent peace dropping of their daughter there. I felt like the recovery at the facilities we visited were -- was nearly impossible for an 18-year-old to find recovery in those facilities.

NNAMDIWhat had to make it particularly difficult for you is that you were a narcotics detective and somebody would expect that a narcotics detective might know more about places to get treatment and places to get help, but even with your status there's still nothing there.

SIMMERSYou know, I thought the same thing. I thought being a narcotics officer that I would have the answers and be able to find the resources. Little did I know that insurance companies pretty much dictated where you're going to go for treatment and what level of treatment you were entitled to. In our case they only authorized outpatient treatment at the beginning, and then after outpatient treatment did not work that's when inpatient treatment was then authorized.

NNAMDIIt took four years to raise enough funds and to construct a facility. How did Brooke's House get started initially?

SIMMERSSo initially when Brooke was incarcerated she told me that when she was getting out of jail that her dream was to have a sober living house for women. And she wanted it to be for women only. And she wanted it to be a nice house in a nice section of town. So I told her that I would do my best to deliver that. But in the meantime what she could do is she could pray for it first of all. And secondly she could take classes in drug and alcohol counseling and also stay active in her recovery program through AA or NA once she got out of jail. When she got out of jail, part of her probation was that she was to find a job, stay in recovery, do the right things. But the truth is when someone -- when a female is getting out of jail at age 19 and they have heroine and needles on their criminal record the chances of finding a job are slim to none.

SIMMERSSomeone to take a chance, I mean, here my daughter was 19 years old. She was out of jail less than week. When she would go apply for jobs -- there's not many people willing to take a chance on somebody, who is fresh out of jail with needles on her record. So within two weeks she had relapsed and passed.

SIMMERSAnd after she passed we had seen really an outpouring of support in our community for our family. And we decided that we were going to answer Brooke's prayer and fulfill her dream of having a -- it was originally going to be just a sober living house for women, but as we've seen the amount of support that we had not only through our community, but throughout the entire -- really throughout the entire world, because we got donations from six different countries throughout the world, we decided to go ahead and open an entire rehab facility where we currently do drug and alcohol counseling, mental house counseling, medically assisted treatment.

SIMMERSAs well as we have a social enterprise where our ladies work and obtain the job skills and work ethic they need that after they leave our facility in a period of like six to eight months, they're able to kind of hit the ground running. They have the job skills they need. They have their resume. They've been sober for going on six, seven, eight months. And the chances of success are increased greatly, because of those things.

NNAMDIAs I said, it took four years to raise the funds to do it, but the facility has now been open for residence for over a year. What is it that makes Brooke's House different from other treatment facilities apart from some of the things you just mentioned?

SIMMERSThe staff that we have. We have outstanding staff first of all. And, I mean, we really try to treat the ladies with dignity and respect. We think that treating a lady with dignity and respect and love is the answer to this. We're not -- we don't have -- we only have two girls to a room. And we're almost at 9,000 square foot facility. And we have the jobs on property. So our ladies are able to show up. All they have to do is walk out of their bedroom to show up for work on time. And so we have a beauty salon in the house where girls can look towards that curriculum towards cosmetology.

SIMMERSWe have a pet salon in the house where we're teaching ladies how to groom dogs and bath dogs if they want -- when they finish their program at Brooke's House is they want to have a career in grooming and shampooing dogs, they could do that. And the third thing we do, we also have a chocolate making business. So we produce chocolate at Brooke's House and package it for sale. And the proceeds from that then support the operation at Brooke's House.

SIMMERSSo when you first arrive at Brooke's House you may be just washing dishes or preparing chocolate. And as you progress through the program you're then packaging it. You're then handling the distribution of it. You're taking it to retail stores and stocking the shelves. You're handling money. So when you leave after seven to eight months, you've worked at all aspects of the business. So your resume is pretty solid. And also you are a graduate of Brooke's House and you've been sober for nearly seven to eight months. So your chances of finding a job and having a purpose in life go up significantly.

NNAMDIWe're talking with Kevin Simmers. He is the Founder of Brooke's House in Hagerstown, Maryland. Also joining us in studio is Dr. Yngvild Olson, an Addiction Medicine Specialist and Vice President of the American Society of Addiction Medicine. And Tyrone Turner, Visuals Editor at WAMU. Tyrone, you spent some time reporting on a resident, who completed a six month sobriety program at Brooke's House in January. What did you learn?

TURNERUh, yeah. That was Nicole Shuster and she was the first person to enter Brooke's House, and as -- we did a story about Kevin trying to start Brooke's House back in 2017. And I would come back periodically to go, you know, to see how things are going and to see the ribbon cutting. And when things were built and what was happening. But to finally meet the first resident and then to meet other of the women who were coming in. That was pretty extraordinary.

TURNERI'm a photographer. So I'm thinking like, you know, what does a person who's going through addiction recovery, what do they look like? And they look like us. I mean, you just never know. You never know what someone's going through. What's on the inside? You don't know what the challenge is there. What challenges their facing? But you also don't know like what the strengths are on the inside as well. You just don't know. And so I just, you know, talked to Nicole and then started to shoot pictures and document. Especially the last part of her stay when she was -- and she and the other women were graduating from the program.

NNAMDIWhat stood out to you the most about what you observed in your reporting?

TURNERI thought that -- one of the things that impressed me most was how they were relying on each other. The strength that they were taking from each other in this transition from what had become a safe place. You know, they were completing this program six months. They'd been through a 28 day program. They had six months sober. They're now transitioning out of this to a transitional house, but they really had formed this bond. And four of them, Nicole and three others were then traveling to -- were going to be living in this transition house. And you could really see how this bond was supporting them in this effort to be sober.

NNAMDINicole Shuster who you mentioned says she used drugs and alcohol since the age of 12.

TURNERYes.

NNAMDIShe nearly died from an overdose last summer and came to Brooke's House as its first long term resident. We have a clip of Nicole. Can you tell us what she's -- let's hear what she has to say first.

NICOLE SCHUSTERBy thinking back like I don't miss any of it. It was just total torture. It destroyed my life. It destroyed my relationships with anybody that I had in my life. It just did a lot to me mentally emotionally. It broke me down, and I don't want to go back to that ever again. It took me so long to get where I'm at today. I mean, even when I got clean before I've never made it past 90 days. I've never felt as good as I do today.

NNAMDINever made it past 90 days before, never felt as good as she did on that day. That was Nicole Schuster talking about her stay at Brooke's House. Yngvild Olson, you are an Addiction Medicine Specialist. Do men and women experience addiction differently?

OLSONThey do. Men and women throughout the lifespan of their lives with addiction actually women face some unique challenges. Even beginning with how women start using substances. So, for example, there's some data now that suggests that young women may start using kind of like Nicole says at the age of 12, but in response to negative emotions so things like depression, things like low self-esteem, low body image. Whereas it seems as if younger boys, men, actually may start using, because of impulsivity. And these are generalizations, of course, but it does actually mean that even at the very beginning we need to think about young women perhaps differently than we do young men.

NNAMDIWhat are some of the barriers that woman face in seeking treatment for addiction?

OLSONSo young women, older women face some unique challenges, when they seek treatment, and that has to do with women where they are in their life cycle. So particularly kind of younger women as they are really thinking about relationships, as they're getting older and they may actually be thinking about pregnancy or they may be pregnant. We know that about 50 percent of pregnancies in the U.S. are unplanned. That certainly is very true for women who have substance use disorders.

OLSONSo one of the things that they find sometimes challenging is really having to decide between, do I seek treatment or do I actually then have to think about my other responsibilities? They may be caretakers of younger children of family members. They may have other responsibilities. And it may be that some of the emotional issues that they're dealing with, for example, significant trauma may also then impede their ability to get into care.

NNAMDIYou treat patients in Baltimore City and you've worked in other parts of Maryland. What does addiction look like on the ground?

OLSONSo you know, addiction is a disease that really has been affecting more and more of our younger populations, older populations. You know, I think as Tyrone mentioned, you can't really tell by looking at someone whether they have a substance use disorder. But we know that particularly with women that between 1999 and 2010 the number of opioid related overdose deaths among women actually increased more than even among men.

OLSONAnd so this is becoming an issue not only for rural areas, suburban areas, but now particularly urban areas where -- and particularly in Baltimore City, you know, heroin, opioids it's not a new thing, but we're seeing increasingly fatalities related to illicitly manufactured Fentanyl, other prescription opioids and other combinations of substances.

NNAMDIAs part of the recovery process at Brooke's House as Tyrone mentioned residents read the autobiography they wrote at the beginning of treatment to see how far they have come. Tyrone, how long was Nicole Schuster's autobiography?

TURNERLet me just make a quick correction. They actually write this at the -- it's part of the end of their stay that they write this. Nicole's was a whole notebook and it took two hours for her to read it. It took two hours. Everybody sat around and sat in the community room at Brooke's House and she read for two hours straight.

NNAMDIThat's amazing. Here's a clip from Tyrone's interview of Nicole Schuster from that event.

SCHUSTERGetting clean, I believe is the easiest part. Finding what makes me tick and fixing that is the hard part, and learning to overcome it. Life is better on the other side of what I was going through.

NNAMDINicole Schuster. Kevin Simmers, can you explain why you incorporated that autobiographical letter into the process and if it's been helpful to the residents?

SIMMERSYes. That was a clinical decision from our drug and alcohol counselors because we have like a three phase program there. An orientation phase and then you go to phase one where you get more freedom. And then you go to phase two, which is the final phase where you have freedom on weekends and you have free visits on the weekends and phone calls and so forth. And also you can work outside the property. And from going from orientation phase to phase one you have to write a short story on why you're ready for the next step. Why you're ready the more freedoms.

SIMMERSAnd then towards the end when we do our autobiography we really want the ladies to kind of own where they are and what got them there. The autobiographies are very personal, so they're discussing the trauma that's taken place their life. If there's a pattern in their life like every time maybe they've relapsed and went back into drugs. They can kind of see the things that they've done that caused that or help push them in that direction.

SIMMERSSo it's really therapeutic. And also sharing it with the other residents because, you know, we have 16 residents there today. But we have -- it's kind of showing to younger residents how people can transform from week one to month one to month three to six months to eventually graduating from our program. So it's very therapeutic not only for the person that wrote the autobiography. But it's also therapeutic for everybody else in the program to hear that and see what other people have come from.

NNAMDITyrone, what did residents tell you about the recovery process?

TURNERThat the interior work -- the internal work of working through their story, of working through what their life is about and how they can fix it in the future is the hardest part. That that's really where they feel like they mess up. And that leads to relapses, but really kind of owning their story and understanding who they are and where are and where they're going is really the most challenging and most critical part of what they're doing.

NNAMDIHow did this affect Nicole's relationship with her daughter?

TURNERWell, the addiction almost ended her relationship with her daughter. It was really destroying it. And Nicole talks about how she was, you know, frankly surprised that her daughter stuck with her during those times. And the recovery process has really provided a place for them to heal. Her daughter was very onboard with her going through the treatment process. And then going through Brooke's House and then now being in the transitional house. And you really see them bonding again and healing. And you see that their relationship is strengthening.

NNAMDIHere's what Nicole had to say about that.

CANDICEThere was this thought in the back of my head that I knew something was going to happen. And I couldn't stop it. Like there's nothing in me that I could do to stop it. As much as I wanted to I couldn't. And I think that's the thing that hurt the most, because I was stressed about everything like I wasn't going to school. I wasn't getting good grades. I was slacking. And I was worried about mom more or less and that thing that happened with her and OD and that was even harder, because like it's bad to say, but I knew that was going to happen.

NNAMDIThat was Nicole Schuster talking about her ordeal. Dr. Olson, what are the most important things for treatment facilities to do to make sure women seek and stay in treatment?

OLSONSo that's a great question. You know, we know that women actually will seek care earlier than men. But it's often not for their substance use issues. It's often for depression and anxiety and other -- whether it's pregnancy or other healthcare issues. And so what that means is that we need to have services that actually are able to not only meet those concerns and those symptoms, but then really be able to screen and identify that underlying alcohol and other substance use disorders that may be at the bottom and complicating many of the other health conditions that women present with.

OLSONThe other issue is retention. So women many seek services earlier, but they often have a hard time staying in care. And that has to do with their other outside responsibilities such as childcare, you know, other caregiving responsibilities. And so we need to have services that really are able to actually address the parental responsibilities that women may have, the transportation issues that they may face and also then the trauma that they may have experienced. And so, you know, organizations and facilities like the Brooke's House that actually is able to address all those things are really important.

NNAMDIAnd, Tyrone, I'm reliably informed that that last clip we heard was from Candace, Nicole's daughter.

TURNERThat's right.

NNAMDIAs opposed to Nicole. We got a tweet from Barry who said, "Could you ask Kevin is his experience and training as a law enforcement officer was altered after having a family member who did not need criminalization punishment, but recovery services?"

SIMMERSMy outlook on this whole drug war has changed 180 degrees. In fact, I retired after my daughter passed and started to build the Brooke's House. And now we're in the business of helping women find recovery. And that's what I plan on doing until the day I die is helping women, who are struggling out there who need recovery from this horrible, horrible disease. So what I would say is yes. I mean, during the 80s when I came into law enforcement during the Reagan years, I mean I brought in hook line and sinker that handcuffs and incarceration was the answer to this that we would be able to win this drug war through locking people up.

SIMMERSAnd as time went on even before my daughter was affecting by this I started to think, we're really not doing any good here. You know, we're having the same people. And the people we were arresting -- I like them. I had a personal relationship with most of them. And I was always talking to them. In fact, even my daughter passed at her funeral, a lot of the people that showed up were people I had arrested throughout my career.

SIMMERSAnd then after she passed, you know, when we were struggling with that, the last thing she needed was to be incarcerated. What we needed was we needed drug treatment. We needed, you know, people say we need more jail cells and more space in jails. We need less jails and we need more space in rehab. It's far cheaper for you to send a lady to Brooke's House and far more productive for you to send a lady to Brooke's House than for you to incarcerate her for a year.

NNAMDIKevin Simmers is the Founder of Brooke's House in Hagerstown, Maryland. Thank you so much for joining us.

SIMMERSThank you so for having me here.

NNAMDIDr. Yngvild Olson is an Addiction Medicine Specialist and the Vice President of the American Society of Addiction Medicine. Thank you for joining us.

OLSONThanks for so much.

NNAMDIAnd Tyrone Turner, Visuals Editor at WAMU. You can see Tyrone's story on Brooke's House at our website kojoshow.org. Tyrone, thank you for joining us.

TURNERThank you.

NNAMDIGot to take a break. When we come back, Maryland is considering a statewide ban on single use plastic bags. What does that mean for consumers? I'm Kojo Nnamdi.