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GARY — Walk into the Salvation Army Adult Rehabilitation Center, and you quickly realize you're not at some swanky, beach-side drug rehab.

On a day there last month, a water bucket caught leaks from a hallway ceiling. The boiler had gone out, causing the temperature inside to drop. There were no views of the ocean, or anywhere else, owing to the lack of windows.

But the place is getting people clean nonetheless. Capt. Jason Schaal, who runs the facility, says its success rate is equal to the national inpatient average. About a third of its graduates are still sober a year later.

The center is unique, though, in that it has about 40 open beds at any given time. It also doesn't accept insurance, charging residents little to nothing for their stays. Northwest Indiana, facing an increase in drug overdose deaths, has a dearth of inpatient substance abuse treatment beds, particularly for people without private health coverage.

The Gary rehab has been around for more than 60 years, about half that time at its current location, near a junkyard just west of downtown. It is connected to a Salvation Army Family Store, where the recovering men work — the rehab is only open to men — and the proceeds go to keeping the treatment center open.

The facility hasn't changed its approach to treatment in all those years, either. It uses an abstinence-based, 12-step model. If people need to be medically detoxed, it sends them to the emergency room or the nearby Edgewater Rapid Access Center. It doesn't offer medication-assisted therapy, like Suboxone or Vivitrol (which has shown to be more effective than traditional rehab).

What the place does offer is three meals a day, a clean bed and a chance of sobriety for men who otherwise might not have any of those things.

Learning about effects on family

On the March evening at the center, eight men, some of whom had previously been homeless, congregated in the chapel for a class about addiction's effects on the family.

"Can someone tell me the difference between shame and guilt?" asked Garcina White, a counselor at the center.

"Shame is when I know I'm doing something I shouldn't be doing but I'm doing it anyway," said a guy in a Chicago Bears sweatshirt.

"And how many of you grew up in an addicted family or, I might say, a dysfunctional family?" White asked. She explained that many children of addicts go on to use drugs themselves, because of the anxiety they experienced growing up, how they didn't know what to expect from their parents "from day to day, minute to minute."

"Black families have traditionally been, 'What goes on in this house stays in this house,' " said another man. Most of the men in the class were African-American.

"I was not allowed at most family functions, as far as holidays," said another resident. "They would bring me back a plate but didn't want me there personally. They didn't know how I was going to be from one minute to the next. That was quality time I could have been spending with my cousins, nieces, nephews. I can't get that time back."

After the session, a few of the men sat down to discuss how they ended up at the Salvation Army.

Tim Trinosky, 44, of Hobart, said alcohol had made his life unmanageable.

"May 27th was my last drink," he said. "I remember I woke up in a ditch with the fire department taking me out. I was riding a bike. I don't know how long I was laying there."

He said the program taught him that the core issue isn't substances but what you're using them to cover up.

"It's all from stuff I was burying, that I didn't want to deal with," he said. "Ten percent is the drugs and alcohol; 90 percent is something you've got inside, that you're burying. And I figured that out."

Trinosky is set to graduate soon. He's connected with a local church where he'll get follow-up support.

During his nine months at the facility, he's seen guys cycle in and out, get kicked out for being on drugs. (Residents have to pass a Breathalyzer every time they return to the building and a drug test whenever they come back from an overnight stay.)

"I think a lot of people use this as a shelter when it's cold," he said. "One guy has been here 14 times. When's it going to sink in? Probably never. It's all a choice."

Emphasis on spirituality, work

For Jeff Rose, of Valparaiso, it's his second time at the center. In 2002, he got sober there but slowly drifted back into bad behavior. He eventually found himself holed up in his Utah apartment, drinking all the time.

He thought about the success he had previously at the Salvation Army. He decided to move back to Northwest Indiana, where he still has family, to do the treatment again.

"I came here for the spiritual aspect of the program," said Rose, 48. "I needed to get closer to the Lord. Like the Scripture says, 'You must believe in your heart and confess with your mouth.' The fellowship with like-minded people helps, too. I ran away from fellowship with like-minded people."

Like Alcoholics Anonymous, Salvation Army has a heavy spiritual element. The walls are covered with crosses. "We're a Christ-based program," Schaal said during an interview in his office, clutching a Bible. "There's not a single person God looks at and says, 'You're beyond hope.' I believe everyone deserves that next chance."

The program also prepares participants for the workforce. The second six months of their stay are heavy on job training, resume development and learning interviewing skills. Many of the men go on to work for the Salvation Army, either in the rehab center or as support people for the retail store.

One resident, a 53-year-old Chicago man who asked not to be named, is now the center's kitchen supervisor. He came to the facility in May to get help for his cocaine addiction. (Most of the men are either addicted to alcohol or crack cocaine, though the facility has been seeing an uptick in opioid users.)

"I see so many examples of how this thing works, from the resident manager to the chaplain, all them guys came through this program at one time or another, and they're still standing," he said.

"If it works for them it can definitely work for me. If I apply myself like they applied themselves it'll work for me just as well."

He said his three adult kids are happy to see he's sober. "They got their dad back," he said.

A focus on sobriety

The place isn't totally devoid of amenities. It has a TV room, computer lab, gym, library and barber shop, where residents with a background in cutting hair are put to work. There's also a "man cave" filled with sports memorabilia, like the Joe Montana poster and Scott Podsednik bobblehead.

The main focus, of course, is getting sober. Three substance abuse counselors rotate throughout the day in teaching classes like anger management, relapse prevention and family dynamics.

White, the counselor, is herself a recovering addict. She's been sober for 37 years.

"I find that when you stress abstinence as a new way of life, at first people rebel," she said. "This is all about change. That's one most thing most people resist."

It's also why many of the program's residents are middle-aged, mostly in the 40- to 60-year-old range.

"The younger men don't stay," she said. "It seems to be they think they have a lifetime: 'I've got time. I'm still young. I don't have to do this now.' The older men are faced with physical problems because they're aging. It takes a toll on them."

Sure enough, the class she taught last month in the chapel consisted mostly of grandfatherly types, looking worn-out from years of addiction, their beards and hair graying.

"Anybody can recover from anything if they want to," White told them. "Just because they need to doesn't give them that desire. If you want it bad enough, you'll get it. It takes determination, courage, perseverance. And that want."

The 46 men getting treated at the facility had taken that first step.

But as White reminded them: "It's a lifelong process."


Health Reporter

Giles is the health reporter for The Times, covering the business of health care as well as consumer and public health. He previously wrote about health for the Lawrence (Kansas) Journal-World. He is a graduate of Northern Illinois University.