“I’ve only been here 90 days, but in the 90 days I’ve been here I’ve done more than I’ve done in the past five years,” says Crystal Connors, a resident of Steppingstone Inc. a substance abuse treatment program in Fall River.

In fact, just two days before Connors sat for an interview in a first-floor common room at Steppingstone’s Transition House program, she had two infected wisdom teeth removed—a procedure the 28-year-old mom acknowledged was about four or five years overdue. Additionally, she’ll soon have an appointment with a neurologist who will treat her for a long-neglected seizure disorder.

That’s because Steppingstone’s approach to substance abuse treatment recognizes that tending to physical and mental health is as important to recovery from addiction as learning to abstain from drugs and alcohol.

“It’s body and soul,” explains Betty Schneider, a clinician and program supervisor at Steppingstone, who joined Connors and a handful of other staff and residents for the interview. “Because drugs don’t only affect the mind they affect the body. So they need to have these services. They need to have their teeth done, they need to have pre-natal checkups, post-natal checkups. All of these things have to be in place and, to me, it contributes to the success of their recovery.”

For many Steppingstone clients, successful recovery from substance abuse often begins with such basics as obtaining health insurance coverage and a primary care physician. Since 2004, Steppingstone’s Project ACCTION (Assistance in Connecting With Care Through Intervention, Outreach and Navigation) has been the mechanism through which clients address a wide array of healthcare issues. The program evaluates residents’ health needs, helps them enroll in MassHealth, Commonwealth Care, and other relevant public and private programs; assists them in choosing an appropriate coverage plan and works with clients to help them keep their scheduled medical and mental health appointments. Under Project ACCTION, Schneider runs educational groups that prepare clients to eventually navigate the state’s healthcare bureaucracy on their own—which can be confusing and intimidating to the unaware consumer. To help sustain the program, in 2008 Project ACCTION received $20,000 through the Blue Cross Blue Shield of Massachusetts Foundation’s Connecting Consumers with Care grant program, which funds organizations that help Massachusetts residents enroll in and utilize coverage under MassHealth, Commonwealth Care, or other programs.

Newly arrived residents to Steppingstone are assigned a primary counselor who provides intensive assistance throughout their stay, including help taking care of their medical needs. “I think when we come in here we have a lot of catching up to do,” explains Nicole Albernaz, a 31-year -old Steppingstone resident. “So it’s really important that we have 45 minutes with a counselor a week, and we come in with a list and they’ll help us go through the list and call doctors, make appointments … and everything gets done because we haven’t been doing it for so long.” Since she arrived at Steppingstone five months ago, Albernaz has faithfully kept her daily appointments at a local methadone clinic, which has resulted in a steady decrease in her required dosage from 90 milligrams a day to its current 25 milligrams.

She has also started seeing a psychotherapist, kept up with her ob-gyn appointments, attends an early intervention program with her six-month-old son, and, like Connors, has finally received some long-overdue dental care.

“Before I came here I wasn’t making appointments,” says Albernaz, as her son sits quietly in her lap. “And if I was making them I wasn’t keeping them so, yeah, I’ve been involved with a lot of medical [care] since I got here.”

Project ACCTION’s emphasis on the importance of physical and mental health to the recovery process is just a piece of Steppingstone’s comprehensive approach to substance abuse treatment. Founded with one program for men in 1972, Steppingstone, Inc. has since grown to encompass 11 programs in Fall River and New Bedford that offer long-term residential and outpatient care to populations that are often turned away from other programs: post-partum mothers, people living with HIV/AIDS, the homeless and those with mental health issues. In addition to Project ACCTION, Steppingstone’s highly-structured programs offer clients intensive case management, individual, group and family counseling, relapse prevention counseling, employment training and job placement assistance, independent living skills training and housing placement assistance, among other services aimed at helping them achieve and maintain a life free from addiction to drugs and alcohol.

“There’s no box for things,” says Mary Cochrane Steppingstone’s Clinical Director. “We try to provide comprehensive care. Medical health, mental health, spiritual health—it is all so connected. To try to address one area, it borders on so many other things that you just can’t tackle, ‘Well you’re going to substance abuse group today.’”

“It’s a little bit of everything,” agrees Richie Serecjzyk, a program supervisor at Steppingstone’s Fall River women’s program. “I mean, Steppingstone over the years, it’s taken on a lot of things other programs haven’t taken on.” He quickly ticks off a list: clients on methadone and suboxone, pregnant women, post-partum women, psychiatric patients. While other substance abuse programs hesitate or refuse to admit people with issues besides substance abuse, the doors to Steppingstone’s programs are almost always open, unless a client presents a safety risk to themselves, staff, or other residents. “Very rarely do we refuse someone,” says Serecjzyk.

Despite its success in helping residents access proper healthcare, there are still barriers. Cochrane bemoaned the lack of coordination between medical providers and Steppingstone staff, which she says can hamper the administration of proper treatment.

“If you work in a hospital … you’ve just got to see the next patient because they’re lining up and there’s not time,” she says. “So they don’t have the time to call over here and say, ‘What do you think?’” Combine that lack of care coordination with hospital personnel who have little training in dealing with substance abusers—quality of care ranges from “all or nothing,” she adds—and it can be hard to manage treatment.

Nonetheless, Cochrane says she is optimistic that Steppingstone residents leave well equipped to deal with such bumps on the road to recovery. The day-to-day routines of Steppingstone programs stress the importance of all the different dimensions of life, she notes. “They learn how to live on a day to day basis and learn how to manage things and what needs to be managed and hopefully from the support they’re given here that’s a foundation for them to go out there and really continue. They’ll know at least know who to go to if they get stuck. We try to get them to a place where they’re independent.”

Says Wendy Carvalho, a 60-year-old Steppingstone residents, “They get you to live a real life, a normal life, which if you don’t know how to live it out there they teach you to live that new life, the real life.”

For Connors, that means passing on the wisdom gleaned from her wisdom tooth extractions. Though she’s still dealing with a little pain and a puffy cheek, not to mention subsequent dental visits to treat some cavities, “It’s worth it,” she says. “I’ve got an eighteen-month-old and she’s got teeth coming and I don’t want her going through, you know, the same thing. It pays off.”