MADRAS — Behind the nondescript green exterior of the Madras house, a dozen Latino men are working together toward a sober life.

They spend their days together learning, reflecting, cooking, cleaning, eating and sleeping in the state’s only residential substance use disorder treatment facility operated entirely in Spanish.

Instructions are in Spanish. Signs are in Spanish. The Serenity Prayer mural painted in the community dining area is in Spanish.

The treatment facility is run by BestCare Treatment Services, which started the residential program in 2002 for Spanish speakers under the belief that by being culturally appropriate, at least one barrier would be removed as the clients/patients work toward overcoming substance use, said Salvador Amezola, BestCare program director for Latino services.

“It helps them connect with their roots,” Amezola said. “When you walk in here and encounter people who are the same color as you are and it is decorated in a familiar way, it makes you feel welcome.”

The men have come from around the state — some from Medford, others from Central Oregon or Portland — and are undergoing a 90-day to 14-week program that is rooted in evidence-based practices.

Culturally specific programs enhance emotional safety and create a sense of belonging for those experiencing mental health or substance use disorder issues, said Tim Heider, Oregon Health Authority Behavioral Health Services communications officer. By creating a shared cultural experiencing for healing, it boosts recovery, Heider said.

This past legislative session, lawmakers approved more than $200 million for addiction services and behavioral health programs. BestCare will receive $1.5 million toward building a new larger Latino-focused residential facility in Madras that will accommodate 16 men, said Rick Treleaven, BestCare executive director. The existing 10-bed facility in Madras will be used for women.

“The dream for this facility is to convert this for women,” Treleaven said. “There currently are no residential facilities for women needing substance use disorder treatment between the Canadian border and Sacramento.”

BestCare already purchased a 3-acre piece of land in Madras and will need to raise an additional $3 million to build on the site.

“It was a surprise that we got this funding,” Treleaven said. “We’ll be putting together a construction plan with a budget and then go after funding.”

In-patient program

Typically, patients either contact BestCare themselves or they’re referred by other Latino programs, said Amezola. Currently there’s a wait list of up to 25 men seeking residential treatment. On average, the men spend 14 weeks at the Madras house.

According to the National Survey on Drug Use and Health, about 1.1 million Hispanic/Latino youth used illegal drugs in 2018, the most current year data are available.

Substance use disorder and mental health illness increases the risk for poor health outcomes, according to the same report.

Typically in Latino culture, women have not needed substance use disorder treatment, Treleaven said. But a cultural shift is occurring in the female Latino population where it’s more acceptable to see a woman in a bar or taking drugs, Treleaven said. 

The Latino Community Association in Central Oregon praised BestCare’s Latino residential treatment facility and its proposed expansion. The association works in concert with BestCare and other culturally specific behavioral health and substance use intervention community groups, said Daniel Altamirano Hernandez, association interim executive director.

“Mental health and substance abuse intervention services are valuable tools to help better the health of the community,” Altamirano Hernandez said. “We believe offering a culturally based residential program will assist in a successful recovery. Language and cultural identity are important factors to consider in receiving services, but they often pose barriers to receiving equitable care.”

BestCare opened its doors in 1997 as a drug rehabilitation center, and now, nearly 30 years later, it offers residential and outpatient services in five Oregon communities — Bend, Redmond, Madras, Prineville and Klamath Falls.

“Oregon has neglected the Latino population for 20 years,” Treleaven said. “We want to grow the Latino services across the state. “

Residential treatment

The Madras treatment facility is a well-oiled machine. From sunup to sundown, the men who stay there have activities, educational classes, chores and outdoor time inked into a schedule, Amezola said. There’s very little free time and it’s lights out at 10:30 p.m.

“We run a tight schedule here,” Amezola said. “Mental health isn’t about being loco, it’s about issues, especially with immigrants. There’s a lot of trauma that occurs living in the United States and some self-medicate with alcohol and drugs.

“Part of our goal is to get reintegrated into the community.”

Sundays are family days. Some family members drive up from Medford, others across the mountain pass to see a loved one at the treatment facility.

By remaining culturally appropriate, a practice that includes hiring native speakers to work at the treatment facility, the relapse rate lowers, said Perla Orozco Barajas, BestCare Treatment Services bilingual mental health therapist.

“When they come here, it feels like home and it helps them to connect to their roots,” Orozco Barajas said. “Part of what we do here is to provide a road map to living. We help them get housing, get diagnosed with underlying medical conditions.”

Temo Loza, 40, owes his seven years of sobriety to BestCare. The Madras resident is now a licensed painter and owns his own business after battling a substance abuse problem that began when he was 15.

“I was like a majority of the guys there, down on their luck by poor decisions due to drug addiction,” Loza said. “I was given the opportunity to go to BestCare and I took it. I decided then to make a change and set some goals for myself so I could return to my family and society.”

Loza credits the culturally based program with helping him overcome his addiction to drugs and alcohol. Since he left the program, he has not relapsed, Loza said. There have been stresses and temptations, but nothing to set him back, he said.

“It is very structured,” Loza said. “There are rules that you have to abide by and classes on how to cope with triggers and how to do the normal things in life, like dishes and laundry. They try to bring you back to society. I am very grateful to the program.”

In addition to the culture and language, BestCare does not allow cost to be a barrier to the care, Orozco Barajas said. A nurse and doctor oversee medication assistance recovery programs. They too are native Spanish speakers, Treleaven said.

“We also teach life skills and self care,” Orozco Barajas said. “Some of our clients don’t know how to cook or wash clothes.”

“It helps them connect with their roots. When you walk in here and encounter people who are the same color as you are and it is decorated in a familiar way, it makes you feel welcome.”

— Salvador Amezola, BestCare program director for Latino services

“We believe offering a culturally based residential program will assist in a successful recovery. Language and cultural identity are important factors to consider in receiving services, but they often pose barriers to receiving equitable care.”

— Daniel Altamirano Hernandez, interim executive director of the Latino Community Association in Central Oregon