Addiction knows no boundaries. It can happen to anybody.

After 35 years in the drug treatment game, Bernie Arnesen can attest to that. He has treated doctors, clergy, rich, poor, black, white.

"We get a wide variety of folks," he said, from his desk at 76 West Humboldt Parkway. "Innercity, poor, addicted families, lots of crime, lots of legal involvement, broken homes. That would be true for some of the population. But there is another part of the population that is not like that at all, some very average folks. There really is no discrimination for addictions."

Arnesen serves as director of Catholic Charities' Chemical Dependency Treatment Program, offered through its Msgr. Carr Institute, which assists adolescents, adults and families struggling with substance abuse and addiction. The facility sees 170 patients come through its doors each week.

The West Humboldt office is an outpatient facility, licensed by the state Office of Alcohol and Substance Abuse Services. Recently, the office began an open-door policy for patients. Anyone who feels the need for help with drug or alcohol addiction can call the central intake at 716-895-1033, then come to the office during one of the daily intake periods.

"All a person has to do is show up," Arnesen said. "The only time we don't accept people into treatment is either, they need none, or they need more than we provide. That could be they need an intensive outpatient treatment where they're going every day for a few hours a day, or that their medical condition is such that they need to be monitored regularly, so they need to be in an inpatient setting."

Once they enter the program, patients might see a psychiatrist or a psychiatric nurse practitioner, then be assigned a counselor. Counselorswill look at all elements of life -chemical dependency, mental health, vocational situations, medical, legal and spiritual concerns, then devise a treatment plan, "which is not unlike what a doctor would do. You would say, I have this complaint, and he would say, well, this is how we need to address it," Arnesen said.

He frequently compares addiction treatment to medical treatment. The clients are patients. Addiction is considered a disease that needs treatment. The patient is "not a bad person trying to be good; it's a sick person trying to get well," he said.

Once in the program, patients are invited to join counseling groups, composed of up to 15 people with similar backgrounds. These may be men's, women's, anger management or stress management groups. Generally, people are recommended to attend two groups a week. As they improve, they may drop to one group and/or be seen only on an individual basis. Joining self-help groups like Alcoholics Anonymous or Narcotics Anonymous is also recomended, as outside support is important to recovery.

"We see addiction as a chronic disease, like diabetes," Arnesen said. "You don't give somebody pills for a year, then they're OK. It's chronic. We recommend that people have support set up."

Patients are required to abstain from using while under treatment.

"That doesn't necessarily mean, from the day they come in, they never use again. But, after not too long a period of time, that they are not using any illicit substances," Arnesen said.

The office has agreements and links with inpatient facilities for those who need more intensive treatment or detoxification.

Someone working at the program can expect to stay involved for a year. Some stay shorter, others longer. The office offers all the aid it can to patients, from nicotine gum to food vouchers.

"The biggest thing is finding their own motivation, why they want to change, why they want to stop, why they don't want to be angry anymore," said Kelly Andol, LMHC, one of six counselors with the Catholic Charities program. "A lot of it is letting go of old things and taking themselves out of the center of it. It's not always about them."

The facility also has a Suboxone program. Suboxone is a mixed agonist-antagonist opioid receptor modulator. It has the qualities of an opiate and the qualities of an opiate blocker. It is used exclusively for opiate addictions - heroin, oxycodone, hydrocodone, codeine - to prevent withdrawal symptoms. Seventy of the Catholic Charities patients use Suboxone to combat their opiate addiction. It's not uncommon for a doctor to put in a 10-hour day at the clinic administering the drug.

During his 35 years in the field, Arnesen has seen the ebb and flow of drug use.

"I can tell you that when I worked in a methadone clinic, the patients did heroin, and that's all they did," he said. "Anybody who did other drugs, they refer to them as a garbagehead. They seem to have some real standards. If they stole, they never stole from family. In many ways they could still be honest, but they still have this problem. Over time, I think the population has become more chronic. They definitely use a wider range of drugs than has been the case in the past."

Prescription pills rank second to marijuana in most abused drugs. New York state's I-STOP law overhauls the way prescription drugs are distributed and tracked, preventing people from getting pills from several different doctors in a short period.

"I think that has made a real considerable impact on the abuse of prescription pain pills," Arnesen said. "But, you know what's happened at the same time? Abuse of heroin has gone up. It's like that old song, 'If you can't be with the one you love, love the one you're with.' If people can't get what it is they want, that doesn't mean that the want goes away. It's just that they have to be a little more clever to find what they want."
Andol cites neurological problems, coping skills and a person's past as reasons for addiction.

"If you took all of the drugs out of the world, they would find sex, gambling, shopping, anything to become addicted to. It's a human disorder that comes from a lot," she said.

"It's not uncommon to see someone move from one addiction to another," said Arnesen. He knows a workaholic who became disabled, and one unable to work, developed a drinking problem.

Arnesen also believes addiction should be seen as a health issue, not a criminal justice issue.

"What I encourage our counselors to do here is to treat people with compassion, understand that they have a problem, and sometimes they have a problem that they don't recognize," he said. "We will never, with our own cleverness, argue them out of their addiction. Usually the addict already feels pretty bad about what they are doing. But they have compassion for the person, look for how they can help them. That doesn't mean being codependent. It doesn't mean not doing things for them or holding them responsible."