I’ve listened to the words of my friends, family members, and colleagues long enough to know that without the stability of a safe and healthy place to live--and the support of people around you--long term recovery from a substance use disorder can be illusive. With what we know about the changes in brain chemistry in response to alcohol and other drugs, it’s not surprising that when people leave treatment and go back to the same environments where they were using substances, reoccurrence happens more often than not.
The opioid crisis has reached epidemic levels, with nearly half of Americans now reporting they personally know someone who has been addicted to prescription painkillers. Despite growing recognition of the problem and concerted efforts to drive practice and policy solutions, significant challenges remain.
While people often begin using alcohol or other drugs during adolescence and young adulthood, only 10 percent of 12-17 year olds who need substance use treatment actually receive services. When they do, they are much more likely to receive services while in the criminal justice system rather than through other avenues, such as their school or health care provider. These sobering statistics speak to the difficulty of identifying and helping at-risk teens before their substance use becomes a problem.
Security. This is something I’ve been thinking a lot about recently. I grew up in a home marked by addiction, dysfunction, and for a period of time, poverty. While I knew my parents loved me, my father’s alcoholism set the tone for much of my childhood. As I got older, left home, and engaged in my own much healthier relationships, I thought I had escaped unscathed. In many ways, my sibling took away some of the more common traits of being raised by an alcoholic parent, but I didn’t seem to carry these with me.
After many years working on substance use recovery issues, my work has shifted to substance use prevention and early intervention. With a grant from the Conrad N. Hilton Foundation, a team at the Center for Social Innovation is developing and testing Project Amp, a substance use prevention model. Project Amp seeks to delay or prevent substance use among teenagers by enhancing protective factors through brief mentorship with a young adult in recovery.This innovative program applies recovery assets within a prevention framework; explores the effect that brief peer-based relationships have on behavior change; and enhances an integrated health care approach: Screening, Brief Intervention, Referral to Treatment (SBIRT).
Some things that happen in our lives have such a profound impact that you can see their tentacles reaching into every avenue of your life. For me, I can see how living poor as an adolescent, losing my mother to cancer, and meeting my husband at an early age has impacted how I approach the world today.
Then other things happen, and while you know they are significant, you can’t trace their impact. You are at a loss on how to interpret the pain and the grief, so you put it aside and move on. I lost my dad to addiction when I was 21 years old.
I’ve been working under our SAMHSA contract Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS) to organize an annual Policy Academy to help state systems adopt a recovery orientation. Armed with a subcontract, states pull together teams of decision makers to effect a paradigm shift by bringing recovery-oriented care to their mental health and substance use services.
Over a year ago I worked with a research group that had secured NIH funding to better understand the 30-day readmission rates at minority-serving hospitals across the country. I interviewed Chief Quality Officers, Chief Medical Officers, case mangers, and others in public, private, and teaching hospitals with a high minority patient population.
I’ve been thinking about Gloria Dickerson’s Looking for the “Borderline Patient" post on t3Threads, and I can’t seem to get certain phrases out of my head. She describes her recent experience at an ER, and as a result of various preconceived notions and prejudices carried by her providers, she received subpar care. As she waited there, in the midst of her health crisis, she shared that, “All the appropriate words like ‘patient-centered care’ and ‘individualized-treatment’ waft like flimsy bubbles through the air. There is no substance, no actions, and no kindness to transform these words into reality.”
This week the National Center on Family Homelessness released A Report Card on Child Homelessness—America’s Youngest Outcasts. They found that one out of thirty children were homeless in our country in 2013 – one out of every thirty. This number is so large it baffles the mind.