Countermeasures Season 1 Episode 2 Podcast Transcript: Networks of Support
Amanda Scott [00:00:01] You walk down the street from where you live and where you lived your whole life, and you all of a sudden see that there’s been this whole world of recovery this whole time. It’s been right here where you live. And I think that that gives a reality that I think a lot of people, while using, don’t know that recovery is possible or how common it is. It really gives you that like, “oh dang, again, this has been here like this, you have doing this all the time. I didn’t even know it.”
Narration [00:00:33] This is Countermeasures brought to you by Emergent, maker of NARCAN Nasal Spray. Join us as we explore the shifting complex world of the opioid crisis. In each episode, we’ll hear from makers of Positive Change as they recount personal narratives of loss and perseverance and offer a way forward to a better future. For those struggling with opioid dependency, feelings of loneliness, guilt and isolation can be overwhelming. Bringing awareness to the reality of opioid use disorder is an important part of building empathy and driving education. Resources like community groups, peer mentorship programs and other safe spaces are important tools in addressing the opioid crisis. In this episode, we explore the importance of community connection as a fundamental building block of the path to prevention, treatment and recovery.
Amanda Scott [00:01:35] My name is Amanda Scott. I am the prevention program director at Detroit Recovery Project. I’m also an individual that identifies as being in recovery, so I have been in recovery for 15 years and so it becomes a part of your life to a certain degree.
Narration [00:01:55] The Detroit Recovery Project is a private nonprofit corporation dedicated to supporting recovery, which strengthens, rebuilds and empowers individuals, families and communities who are experiencing co-occurring mental illness and substance use disorders. At Detroit Recovery Project, Amanda and her team work to provide access to integrated networks of effectively and culturally competent holistic health services. Amanda says that one of the biggest initial findings of the initial Detroit Recovery Project team was that this holistic approach was a necessity. People in recovery need support in various ways, from mentorship to writing their resume to finding a ride to their 12 step program.
Amanda Scott [00:02:39] So Detroit Recovery Project started in 2005 as a peer organization. So the idea was that a lot of individuals accessing substance use disorder treatment most often find that they go back to using pretty quickly after returning home from being in treatment or sometimes being incarcerated. There were peers that were using mental health services and that seemed to really help like navigate some of those bonds, like where do I get support? Who do I call at 3 a.m. when I feel like I’m going to crawl out of my skin? So they started that way. It was written by people who had lived experience. It was employed by people who had lived experience to serve, people who wanted to access recovery. But it became really clear pretty quickly that you couldn’t just address the substance use without like acknowledging all the other components of an individual’s life that have that outcome, right? Like if I just stop using drugs, but I still am on house without a phone and that was no support, like, how long am I going to stay off of those substances? And it can be pretty daunting.
Narration [00:03:49] Many people who have been impacted by substance use want to use their lived experience to help others in a similar way. Amanda Lick, director of Community Health Solutions at Emergent, is one such person. While she has never struggled with substance use disorder herself, she grew up watching her mother battle an addiction to prescription opioids.
Amanda Lick [00:04:11] So like my life story with the opioid epidemic or the way that opioids impact the lives of people happens not with my control, not really with my consent and happens in utero. So my parents hit a deer on the backroads of northern Michigan. My mom broke her pelvis in two places and my dad sort of struggled and suffered from brain damage because they were on their way to the hospital due to my dad withdrawing. So or at least that’s the story they’ve been told. So it’s really fascinating because as I have grown, I and learned and unlearned and just, you know, weaved through life, trying to make sense of who I am and how trauma has impacted me and how it’s created beautiful parts of who I am and how it’s created parts of me that I have to, like, dive deeper to understand. I’ve realized that the opioid epidemic was impact me long before I even knew. My mom died in 2007 from an overdose too, with prescription drugs. She died the first year that the CDC had died, like had said, more people in this country was dying from overdose due to prescription drugs than automobile accidents. So prior to that, I was a part of the whole generation of folks who saw their parents maybe take substance use and then become dependent and then become addicted to the substances. And I witnessed just like how damaging that was. And there were just a number of different factors that played into it. What I can do is tell our story, communicate how there are so many people that are just like me that have their own stories that are complicated and beautiful, that likely have been touched by the death or loss of someone that they loved that was also complicated and beautiful and also tell our story, but then also get to do the work that I do every day that makes a difference in so many lives.
Narration [00:06:20] Like many Americans, Amanda Scott and Amanda Lick both have personal experiences and stories that tie them to the opioid crisis. They have both witnessed firsthand the importance of community and the ability to openly share experiences with others. They have also both channeled their experiences into becoming positive forces, engaging with communities to create a network of support and resources to help. Amanda Scott and the team at Detroit Recovery Project follow the Healing Force Model of Recovery, a concept of the Wellbriety Movement, adapted from Native American teachings. The Healing Forest is a metaphor for the clinical treatment of addiction and follows that if you plant a tree in a sick forest, it will stay sick. But if you plant a tree in a healthy forest, it will heal and eventually thrive. Championing community resources and peer mentors to help those on the path to recovery is one of the first steps to curating a healthy and healing forest.
Amanda Scott [00:07:22] When you go to the bus stop and like wait for the bus in the morning and everyone’s smoking weed and that’s where everyone’s always smoking weed, like that’s like an issue for you. But like down the street, they have live music every day or they’re out on their porch playing music and like it’s not centered around substance use or drinking and it’s in the same neighborhood. But you don’t know because like your area of focus was always like, where can I use, who’s using? How can I use more? So the peer can help, like navigate that. Like, hey, right down the street there’s live music. It’s not centered around using, right? Like, so here’s this other thing you could do that is fun and healing and healthy and community and you just didn’t know. You just didn’t know was there. So that’s one thing a peer can offer. The other thing is, is I think it’s kind of a part of that full circle, which is if you get sober and you have like a criminal background as a result of your using, you are limited in what you can do. There’s only so much employment you can obtain. You’re that you kind of are forever held accountable for those behaviors. Recovery support is an opportunity to do something different where you can really access a level of employment that is maybe levels of employment or like a level of professionalism that you wouldn’t be able to access otherwise because so many, like white collar jobs, require clean criminal backgrounds. So like, it gives you a chance to also grow and to be a part of that healing forest by like being a part of like the community as like a gainful employee, which sounds strange, but it is like so it’s another part of like completing the circle to like giving space for people who are recovering to grow and like kind of level up in their lives.
Narration [00:09:19] The Detroit Recovery Project runs the Recovery Training Institute, where individuals can train to become a certified peer recovery mentor. Peers are paid for their services, and the program provides a new path for people in recovery to help others and also gain important skills that can transfer to other parts of their lives.
Amanda Scott [00:09:37] In the state of Michigan, they have made it so that peer recovery support services are billable services, which is great because that means we have a way to sustain funding for individuals to provide that service. But in order to do that, you have to have certifications. And those certifications have like a whole list of stuff, like you have to have 40 hours of SUD education, 16 hours of SUD ethics, 150 hours of continued education, the other 500 hours of shadowing. It’s kind of a lot. And then there’s an exam and then there’s like certain professionalism, things that some people in recovery might not have acquired the education on throughout their life based on maybe where they grew up or how long they’ve been using. You know, some people start using when they’re 13, 14, so they may have never truly written a professional email like that might not be something they ever did because they were doing other things. So the Recovery Training Institute provides all of that. It’s I think it’s like a month, maybe it’s six weeks and it’s like half day of classes where they kind of go through all those trainings and you do roleplaying and try to really make sure the individual has all the information to access the exam and pass the exam. And then we’re not the sort of fire, but we try to set the individual up to succeed with certification through the state. So we like try to help them set up the account that they’ll need and get everything uploaded, all that good stuff. And then if they want to apprentice with DRP, they can do that. We are recognized. So if you want to go on and do your 500 hours of apprenticeship as as you can and it is paid.
Narration [00:11:28] Amanda Lick’s Mother didn’t access community programing, peer mentorship or have a healing forced around her, but Amanda wishes she had.
Amanda Lick [00:11:36] The program that I wish my mom had had. So one, I guess there’s two programs I wish she would have had. It was she would have had more support as a young mom. So there are certain programs that support women who are pregnant, like early in their pregnancy and do home visits with those families. So I wish my mom had that because, you know, my mom was in the motorcycle accident and she was pregnant with me, broke her pelvis when we went, when she went to deliver me, it was a very stressful delivery. In fact, we almost both didn’t make it. So not only did we survive the motorcycle accident, which we probably shouldn’t have, then we survived the birth in which they actually asked my grandma, like, Which one do you want me to save? Because we don’t know that we can save both of them. And my grandma, of course, said her daughter, because my mom at the time was only 17 and luckily we both made it. But, you know, I look back, I have the birth records of when my mom gave birth to me and she actually was a very dedicated like mom and wanted to attach. And that was like a really beautiful thing to read that and to know that she was committed to being a really good mom in those moments. I just think she could have used some additional support. So now there’s lots of programs like that available for moms and dads and babies and toddlers that offer home visiting. And it’s really wonderful. The second thing I wish that my mom would have had was naloxone. Two things that probably would have made a huge difference in her life, the one having that program, and then the second, having her life saved when she was overdosing.
Narration [00:13:11] In her position at Emergent, Amanda Lick works with communities to get naloxone into the hands of people who may need it. Building awareness around naloxone and educating the public on how to use it is part of creating a holistic, community based approach to supporting those with opioid dependency.
Amanda Lick [00:13:30] I think the reason my job and other jobs like mine are important is that we are sort of the conduit of, you know, helping share best practices, like how how are others creating innovative ideas that are reaching people when they need it most in areas where they’re seeing high numbers of overdoses. So we kind of like have this really great view of the landscape and then can sort of maybe help accelerate some of the some of the program building by sharing something that’s already been done so that people across the country aren’t just having to start from scratch. And of course, they can find that other ways. But I think our team does a really good job of saying like, Oh, you’re thinking about finding a distribution solution in a high need area. Oh, have you thought about like vending machines or distribution boxes or. I know of this great program in Chicago that’s using libraries. Let me connect you to the person. We’re constantly learning, engaging. I think our team really is focused on, like so many of us, have our own personal story and how we’ve been impacted by the overdose epidemic over the last 20, 30 years that I think that we take that and carry it with us. And so it’s never about the product. It’s about how the product can help others and how can we help build better relationships, help strengthen communication, help improve programs and help people get what they need when they need it.
Narration [00:15:09] Making sure naloxone is widely available to those who may need it is one element of harm reduction, a spectrum of strategies that focus on keeping people who use opioids and other drugs alive and as healthy as possible. Amanda Scott says pushback against harm reduction tactics like syringe services every day and has even struggled with it herself.
Amanda Scott [00:15:30] So harm reduction is really about meeting people where they are. So it’s kind of like that gap of service like this applies as you do. But I think this probably applies to everything, right? Like there is a population of humans that are not currently able or willing to access further services for whatever reasons. So you have this group of people that aren’t ready to do something different. They are actively using. So going to them and providing that service and providing safe using equipment. I know that that’s one that like personally I haven’t struggled with was a little bit at first was like, is this perpetuating using, and I really just like to talk a minute and I thought about it. Like, I like I said, I’m a person on long term using. I personally know that like the last syringe I was using before I got sober, it was so faded, it didn’t have any of the numbers on the side anymore. The needle itself was bent and had rust on it. And I still used like it didn’t matter what the syringe looks like, you know. And I kind of like thought about that and was like, yeah, that never made a difference for me or anyone I knew. Is having syringe services going to make me high today? No, and not at all. And would having syringe services have like, perpetuated me using? No, not at all. The only thing is, is I probably wouldn’t have gotten cellulitis or cotton fever as often as I did.
Narration [00:16:59] Amanda Lick comes up against similar barriers when it comes to ensuring everyone has access to naloxone if and when they need it for an opioid overdose emergency.
Amanda Lick [00:17:09] So we can take a data driven approach. And that is incredibly important, like where we make naloxone available at the upon discharge and the ED, or we make it available upon release for those incarcerated folks for coming back out into the community. Absolutely, important programs need to be done, but other types of programs that make it available to people who are using other forms of drugs that may not realize that opioids are in it or programs that make it available to parents whose children have been given an opioid for surgery or grandparents who’ve been prescribed. I mean, really, at the end of the day, like if you have an opioid in the home or if you are a loved one, or even if you’re someone who doesn’t ever use an opioid, you could be at risk not knowing where these potential drugs are coming from. You know, 16 years ago, my mom died of an overdose. I knew she was using and naloxone wasn’t available the way that it is out in the community now. I wish it was because I would have given her some every time I saw her. She wasn’t injecting drugs. She wasn’t using drugs outside of well, she was using them illicitly in the sense that she was taking them, not how they were prescribed. But she would have said that she wasn’t using drugs, but she still should have had it. And she became a statistic and she became a statistic in the year that more people died of overdose than car accidents. To me, that life, my mom’s life is just as important and should have naloxone available to it as someone else who might be using four to five times a day. And that person should have naloxone available to them every single time that they use. And until that person dies, I don’t think we’re at that point of saturation yet. I don’t want to live in a space of fear where I’m like, Oh my gosh, anybody can be exposed and die at any moment. Like, that’s not I don’t feel like that’s a healthy place but I also we’re seeing record numbers of people who are using cocaine die because opioids are in their cocaine and they had no idea that they were at risk for a death from an opioid. And that’s super scary. Someone could try cocaine once and have no idea that they are at risk of dying and no one has naloxone available because they don’t consider themselves at risk. Just this idea that to a certain extent many people are at risk and we need to have access for those many people, regardless of whether they’re high risk or low risk.
Narration [00:19:52] While progress is being made, stigma and silence are still barriers to ensuring robust programing and support for prevention, treatment and recovery. Support from the community and peers can help fill this void and create a safe place for people affected by the opioid crisis in all its many forms.
Amanda Lick [00:20:12] I guess the first time I realized I had a problem or that my family had a problem, my family’s different was when I was in elementary school. My mom overdosed in front of me. It was where I knew my family was different. I knew that my mom was different. I knew that things just weren’t quite right necessarily, but I didn’t realize just like, how different. One of the things that people don’t understand about stigma is that it creates an environment of silence. So like me as a child, I was silent and didn’t feel like I could talk to anybody. I didn’t feel like I could talk about my own family. We didn’t talk about it in my own family. My mom would pass out. My other family members would, you know, pass out or do things and nod off or whatever. And it was like, no one talks about it. It just became our norm. I’ve always said this. I truly believe that, like, silence kills and it kills within ourselves. If we’re silent within ourselves, it kills within our families, it kills within our communities. We have to not be silent. But I think the reason we are silent is because the stigma and the shame that is placed on people who have a disease. And it’s just so unfortunate. Even our silence communicates something. And if you take a situation like those who struggle with substance use disorder and in families, for instance, it’s like it by not communicating about it, it becomes the norm. Or by not communicating about it, it it’s saying that we don’t care. By not communicating about it, it says that it doesn’t exist. And if you do see it exist while you don’t know what you’re talking about. It’s dishonoring our reality. It’s dishonoring the lives that matter to all of us, the lives that matter most to us. It’s truly silence kills and it perpetuates this idea that these human lives don’t matter.
Narration [00:22:22] Amanda Scott emphasizes the little things that we don’t talk about also matter.
Amanda Scott [00:22:28] Accessing food. We see a lot of dehydration in the winter. So like preventing deaths or other issues by people just like getting water, gloves and coats in the winter. I can tell you I have multiple like videos of participants being like nobody is talk to me like a human in years. If you’ve ever attempted to go to treatment, it’s not easy. It’s at least a minimum of a two-hour phone call to identify your level of care. And then it could be longer from there and oftentimes there’s waits. So having someone to help navigate that with you is really important, too. Even today, we have one young person who has over three years in recovery, but I was told that she might not be able to work in this space, this this particular grant anymore because she has a larceny from 2019. Mind you, she’s I completed her probation and stayed sober, really done all the things she needs to do. But because she has this, she’s not allowed to bill for services. Even though she’s done all the training and they specifically want a youth who’s in recovery under the age of 25 with lived experience. However, it has to been five years since that criminal charge, which is an insane amount of hoops to jump through. So just like I don’t know, there’s just a lot of like poor decision making. I think poor policy hasn’t really like looked at the truth of an issue and then a lot of like racism, stigma, bias that’s happening that I think in the last few years people have become more willing to look at. But I think that those are the things that hinder us. And as soon as things are an issue anymore there, unless those things get dealt with, they are going to be the things that continue to hinder us.
Narration [00:24:15] Amanda Lick and Amanda Scott are just two voices of the many in the U.S. and around the world who have been impacted by the opioid epidemic. We want to thank them for their willingness to share their stories and help break the silence and their important work cultivating healing forests in their communities. Having conversations about opioid dependency and overdose, supporting harm reduction strategies and championing those with lived experience are all key steps to combating the opioid crisis. We aren’t there yet. We need to have open discussions about community support in order to make an impact. To learn more about the Detroit Recovery Project, please visit the link in the description. Thank you for listening to this episode of Countermeasures. To learn more about what Emergent is doing to address public health threats like the opioid crisis, visit EmergentBioSolutions.com. If this episode resonated with you, consider rating and reviewing Countermeasures on your preferred podcast platform.