As Grace Spence crossed the street on an overcast day this summer, her sister-in-law watched in horror.

Spence had started her day by downing a fistful of painkillers. By noon she was losing control over her body.

“In my mind I was walking normal. In everyone else’s eyes, I was stumbling across the street, falling down,” she said. “It was kind of too early for somebody to be hammered.” 

Her sister-in-law told Spence she needed to get help. Then her relative took an unexpected next step. She called the St. Bernard Parish Sheriff’s Office. Two hours later, a man pulled up on her street with a mission — not to arrest her but to get her help. Within days she was in a residential detox program.

Spence was one of the first clients of a new program launched by the Sheriff’s Office in June to offer addiction treatment resources. It follows similar initiatives around the country that use the long arm of the law to extend a helping hand.

Behind it is a lawman who is passionate about offering better care to people with substance abuse disorders: Sheriff James Pohlmann. Last year his son died of a heroin overdose in New Orleans' Upper 9th Ward.

Pohlmann said the program is not a reaction to his son’s death but a continuation of his longstanding commitment to offering more addiction resources. Still, he said, his son’s struggles gave him a new appreciation for the country’s opioid crisis.

“I’ve seen both sides of it,” Pohlmann said. “I know how it affects the families. And it’s not just the addict that goes through these things. The families go through the same things when they’re dealing with addiction.”

The program is one of several offering treatment referrals for St. Bernard and other area residents, including the state-sanctioned Metropolitan Human Services District.

Pohlmann said St. Bernard residents have come to him for years seeking help with loved ones suffering from addiction.

“I think they were comfortable talking to me not only as sheriff, (but) knowing that I’ve also had a family member that battled addiction. I used to always leave them with some advice, with options, and told them I would keep them in my thoughts and prayers and told them good luck,” Pohlmann said. “But when I left that person, I just felt that I didn’t do enough. I said I needed to do more.”

A helping hand

Earlier this year, Pohlmann called Stanley Simeon, an acquaintance who was director at the Adult & Teen Challenge treatment center in New Orleans.

Pohlmann first tasked Simeon with compiling a list of programs available in the New Orleans area. Then he hired Simeon as a civilian employee to spread the word about treatment options. His official title is addiction resource program coordinator.

In June the Sheriff’s Office announced the fruits of their collaboration: a pair of phone numbers that residents can call to get help for any kind of addiction — whether to substances or to gambling. The sheriff promises that participation in the program is kept confidential.

“We realize that people who are fooling with drugs, you would think not likely to call us for help, right? We understand that, so Stanley's a civilian employee who drives a pickup truck,” Pohlmann said.

Simeon said that as he responds to a call in his black Ford F-150, he often speaks with a concerned family member first. Then he sits down with the person suffering from addiction for a one-on-one chat.

Like many in the addiction counseling world, Simeon has his own story with drugs. He ran a successful concrete business for 15 years while supporting a cocaine habit.

“No one knew it, not until crack got ahold of me. They started seeing me lose weight and go through money like water,” Simeon said. “Once I tried crack, that was it — stick a fork in me, I was done. I loved it.”

Simeon attended a lengthy residential treatment program in Pennsylvania in 1999. He said he’s been sober ever since, and the year after he put drugs away he went to work at Teen Challenge in New Orleans.

The program with the Sheriff’s Office is close to home for Simeon, who lives in St. Bernard. So far the Sheriff’s Office has received over 50 calls, and 28 people have been referred to treatment.

Simeon spreads the word in churches and wherever else people will hear him. He also makes a point of visiting homes where he knows people need help: the same addresses where deputies have responded to non-fatal overdoses the day before.

Grace’s story

Grace Spence, 37, is a Poydras native with a skinny frame and a girlish laugh that belies her years of struggle with drugs. Her slide into pain pill misuse began around 2009 when she had surgery for endometriosis, she said.

She had used painkillers before recreationally, she said, but her relationship with the drugs changed after the operation. As years passed, her problem grew worse and worse, she said.

She can rattle off the names for the drugs that she downed by the handful: Norcos (acetaminophen and hydrocodone), Roxys (roxicodone) and Oxys (oxycodone). There were mornings when they left her semi-conscious on the floor, she said.

The drugs also poisoned Spence's relationship with her daughters, who are 2 and 7 years old.

“I didn’t really have a relationship too much with them. I was there, but I wasn’t there. I was just there in body,” she said. “To me it was kind of like, 'I’m just going to hurry up and do this.' And that’s not who I am. I love my kids before everything. They come first.”

Spence had her dramatic stumble crossing the street on June 26. Days later her sister placed a call to the Sheriff’s Office.

“I went home and cried my eyes out because I’m like, ‘Oh my gosh, this is really about to happen,’ ” she said. “I was like, ‘I gotta smoke a cigarette first. That’s got to come first.’ ”

Spence kept crying as Simeon began telling her his own story and walking her through different treatment options. Days later, she entered a week-long, residential detox program at River Oaks Hospital in Elmwood.

Then, on July 21, she entered an outpatient program at the ACER treatment center in St. Bernard. She said the friendships she has formed there help her get through the strains of sobriety. She also takes Suboxone, a drug that helps relieve the feelings of withdrawal and craving that many people with substance abuse disorders suffer.

“It helps with the cravings a lot. It makes me normal, to a certain degree. I gotta do a lot of the work myself, but it helps,” Spence said of the drug.

Addiction experts say that medication-assisted treatments, like Suboxone and methadone, are some of the most effective that exist for opioid addiction. Nevertheless, many patients and providers remain leery of them out of fear that they may simply substitute one drug for another.

Simeon came out of the faith-based world of Teen Challenge, an organization that has resisted medication-assisted treatments. Still, he said he tells people about a whole range of options.

“My outlook is this: I don’t like it personally, but that’s what some people need, and if they’re willing to get help, I’m willing to send them there. I don’t want to turn anybody down,” he said.

The effects on Spence’s family life have been dramatic. She now spends her days playing with her children. She is also restoring her relationships with her adult relatives.

“They’ve noticed that I’m different. I’m getting back to the original mom that I knew of, which is pretty cool,” she said.

She hopes to become a drug addiction counselor someday. In the meantime, she remains close to the man who put her on the path to treatment.

“He said he wanted to sit down and share his story with me and hopefully it would help, and it did,” she said. “I grabbed onto it and kept going. I’ve been taking a ride with Mr. Stanley.”

The 'angel' model

St. Bernard’s addiction resource program is one of a growing number operated out of police departments around the country. Advocates say they are one of the most effective ways to reach people in need, although some observers caution that they must be implemented with care.

One recent initiative that has garnered much attention is the Angel Program, a “no-arrest” effort that the Gloucester, Massachusetts, Police Department began operating in 2015.

People could walk into the police station and ask for help without fear of arrest. Researchers said in a letter to the New England Journal of Medicine that 95 percent of the people who walked in the door there wound up getting treatment. The program helped 376 people in its first year.

That level of success has led the “Angel” model to be adopted by 153 other police departments in 28 states, according to the letter. One was launched in St. Tammany Parish last year.

St. Bernard’s program is different from some others in that it relies mostly on telephone calls rather than in-person visits to police stations.

In many communities there is a special authority that comes with law enforcement, said Dr. Arwen Podesta, the medical director at Odyssey House.

“I think having the person with the badge tell you that they’re going to help you is a little more powerful than feeling powerless and helpless, which is part of the feeling of the disease, of addiction,” Podesta said.

There has been little research on how effective the law enforcement referral programs are over time. It’s not clear how many people finish going through detox, and whether they stay sober months later.

Nevertheless, it is encouraging that law enforcement leaders are acknowledging that addiction is not a problem that can be solved by the criminal justice system, said Robert Heimer, a professor of public health at Yale University.

“Throwing people in jail does not cure them of a chronic disease. It wouldn’t cure somebody who has diabetes. It wouldn’t cure somebody who’s got hypertension,” Heimer said.

The head of the state-endorsed agency that provides services to people with addiction problems in St. Bernard Parish emphasized there are services in place in addition to the Sheriff’s Office program.

“If this program helps us move the dial in the direction of these people getting the help they need, or healing, then we absolutely are in support of that,” said Dr. Rochelle Head-Dunham, the executive director of the Metropolitan Human Services District. “We’re already there, and that’s why this is complementary to what we do.”

For Pohlmann, starting the addiction resource program has been one of the greatest satisfactions since he was sworn in as sheriff, with his son at his side, in July 2012.

He is still reluctant to talk about his family’s suffering since Justin Pohlmann was discovered dead inside a car on Sept. 5, 2016.

In an interview, he choked up when asked about his son’s death.

“I don’t like talking about my personal situation. But I was a father before I was a sheriff,” he said.

A few weeks later, however, his face lit up when he met Grace Spence for the first time.

Pohlmann said his dream is to see “universal treatment” for people suffering from addiction.

“If we save one person, to me it’s a success. But the hope is we can help a lot more people than that,” he said.

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How to get help

The St. Bernard Parish Sheriff's Office addiction resource program may be reached by calling Stanley Simeon at (504) 278-7659 or (504) 517-2944.

The Metropolitan Human Services District, which serves Orleans, Plaquemines and St. Bernard parishes, has a 24-hour crisis helpline at (504) 826-2675. Appointments may be made by calling (504) 568-3130.

Follow Matt Sledge on Twitter, @mgsledge.

msledge@theadvocate.com | (504) 636-7432