Transcript
Speaker: And welcome to the CCDA podcast.
Speaker: In this episode, Kenny House walks us through beyond the opioid crisis and into communities.
Speaker: This workshop taken from the 2021 National Conference.
Speaker: We join him in his workshop now.
Speaker: Welcome to the workshop focused on the opioid epidemic, which we're actually going to go more broad than that.
Speaker: And my co-presenter here is Lily.
Speaker: So if you have any technical questions, she's got the answers.
Speaker: And she reminded me just a moment ago that somewhere before you leave the workshop, you need to make sure you go onto the app and do your evaluation.
Speaker: They used to have them all like in pieces of paper and we were gathering them up and everything.
Speaker: But so, Lily, make sure as we get towards the end, you remind me about that.
Speaker: OK.
Speaker: Thank you.
Speaker: Thank you.
Speaker: Thank you.
Speaker: And as you can tell, we are co-assigned here to CCDA.
Speaker: And just as a way of introduction, so my background is as a licensed clinical addiction specialist in North Carolina.
Speaker: I've been working in the field of addiction, substance use disorders, mental health for the last 42 years.
Speaker: And I've been coming to CCDA since 1990.
Speaker: So I've been here now.
Speaker: I was one of those ones that kind of stood up when they asked this morning about 30 years because it's just been about 30 years.
Speaker: And in 2008, my wife over here, Yolanda, and I met when CCDA was in Miami.
Speaker: And so we met on my birthday at CCDA in Miami.
Speaker: So kind of anything can happen, right?
Speaker: And part of our love story is that she's from Wilmington, California.
Speaker: I'm from Wilmington, North Carolina.
Speaker: So 2008, we met in CCDA.
Speaker: A year later, we got married and came to CCDA as a newlywed married couple as part of our honeymoon.
Speaker: And a few years later, we had a CCDA baby right here, and that's Lily.
Speaker: So CCDA is where we've cut our teeth in a lot of ways.
Speaker: And in getting things going.
Speaker: So I've got a lot of history here.
Speaker: So I'm always excited to to share with folks the opioid epidemic kind of took us by surprise.
Speaker: I actually was doing workshops on addiction recovery for CCDA a few years before people thought about the opioid epidemic.
Speaker: the opioid epidemic is really much bigger than that.
Speaker: And I wouldn't even call it an opioid epidemic now.
Speaker: So we're going to talk about that a little bit.
Speaker: But it's start.
Speaker: And the other thing that I want to share is, you know, what I have here, this presentation, 88 slides.
Speaker: I mean, it's basically a three hour addiction recovery training.
Speaker: I'm not going to use the presentation.
Speaker: I really want to make sure I'll use pieces of it.
Speaker: But I really want to make sure that I scratch where you itch, meaning I want to know the things that you're seeing and feeling like you need to be equipped.
Speaker: And some of that will be connected to the presentation, but it doesn't have to be.
Speaker: If I don't go to the slides again, I don't care.
Speaker: If you leave feeling that you're better equipped to deal in your community with what's going on, we're calling it an opioid epidemic.
Speaker: Yeah.
Speaker: It became an epidemic because in 2007, the National Drug Use Household Surveys were wondering what's going on.
Speaker: And when you looked at those surveys, we found that a large percentage of people were starting their use of opioids out of doctor prescriptions.
Speaker: So this epidemic really started not on the streets as we declared an epidemic.
Speaker: It started in doctor offices.
Speaker: And this slide has changed a little bit over the years, but I'm just going to... Let me just run up to that slide so you can see what really blew us away in the field and what started the idea of us having an opioid epidemic.
Speaker: And so you go to this slide right here.
Speaker: Right here, what we did is we tried to find out who were using pain relievers.
Speaker: Now, understand that pain relievers in the general field, they were strong pain relievers because they were basically Vicodin and OxyContin.
Speaker: It's not rocket science.
Speaker: They were promised by the makers of those drugs to be safe and relatively non-addictive.
Speaker: But that's the history of drugs in this country.
Speaker: They get promoted by pharmaceutical companies and rubber stamp as relatively safe with mild cautions and precautions, but they're not relatively safe.
Speaker: But...
Speaker: I digress.
Speaker: So when we found out the pain relievers, we thought, well, something's going on here.
Speaker: So it must be what we thought it was going to be.
Speaker: If you look over here, this was like, well, where did you get these pain relievers from?
Speaker: And we expected basically in the field three major culprits.
Speaker: And that was drug dealers, the internet, and doctor shoppers.
Speaker: Now, they're on there, and they surprisingly represented about 8%.
Speaker: And we said, well, wait a second, where did everyone else get it?
Speaker: And all of a sudden, 18% said, well, I got it from my primary doctor.
Speaker: One doctor, not doctor shopping, my primary doc.
Speaker: And then another 14% said, well, I just took it from a friend or from grandma's medicine cabinet.
Speaker: 14%.
Speaker: And then, boom, over here, this represents about 56%.
Speaker: I got it free from a friend or a relative.
Speaker: In other words, the distribution site that led to what we call the opioid epidemic
Speaker: was the family and friends plan, which basically said that family members and friends were giving each other these pain relievers.
Speaker: And people were becoming dependent on them from that.
Speaker: And if you add these three together, 70, this was 56, 70, 88%.
Speaker: So that means that almost nine out of every 10 person who was having problems that stemmed from pain relievers, and then they went on to whatever else happened, which usually was heroin,
Speaker: And that wasn't the overdose and death crisis.
Speaker: We'll get to that in a little bit.
Speaker: Because back in the day, there weren't a lot of people dying from heroin.
Speaker: As a matter of fact, I've worked long enough in the field that the people who were struggling with heroin dependence came back and forth in and out of treatment.
Speaker: They lived.
Speaker: Now, there were people who overdosed on heroin, and there are reasons for that.
Speaker: We're now learning about other complications, medical complications, about using multiple substances, blah, blah, blah.
Speaker: You know what I'm saying?
Speaker: That contributed to that.
Speaker: But tended to be people that I knew that were coming in and out.
Speaker: They were winding up in prison.
Speaker: I'd work with them in prison, then they got out.
Speaker: And if they relapsed, we'd work on that.
Speaker: But they were living through addiction.
Speaker: what we saw that happened after about 2010 where people were dying quickly.
Speaker: So, so it changed our whole concept of what was going on.
Speaker: But basically we found out that 88% got it from one doc.
Speaker: And when you, when you,
Speaker: Shift it over here, and you find out those who got it free from a friend or relative, we confirmed it because 80% of them said it came from their primary doc.
Speaker: I mean, if you go back, you guys aren't old enough to remember this, but the old TV shows like Dr. Marcus Welby, MD, and all these kind of things, they got it from Marcus Welby, MD.
Speaker: They didn't get it from some unscrupulous doc working out on the cut and just making money off people.
Speaker: Now, that's happened, but that's not where the large...
Speaker: percentage of people who this opioid epidemic was created.
Speaker: Now, you got to understand, I think, a little bit too about this, and that is that our culture is a drug culture, and America has always been a drug culture.
Speaker: So in the 80s, when I was, since I'm old enough, brother, I was there in the 80s when people weren't talking about heroin, they were talking about cocaine.
Speaker: That was the crack epidemic, which we wound up with legislation to try to solve it, which actually made it worse, a different issue.
Speaker: But the crack epidemic of the 80s.
Speaker: So when I would talk to people, I'd say in the 90s and 2000, I'd say, remember when we had the cocaine epidemic in the 80s?
Speaker: And everyone would say, yeah.
Speaker: I said, which 80s are you referring to?
Speaker: And they said, well, the 1980s.
Speaker: I said, no.
Speaker: We had a cocaine epidemic in the 1880s in this country.
Speaker: In other words, this is not new.
Speaker: Back in the 1880s, it's estimated that at least half of women were addicted to either a cocaine-related product or an opioid-related product.
Speaker: Opium.
Speaker: Because back then, before we had all the pharmaceutical stuff going on, people would travel and the medicines that were available for women were basically either had opium or cocaine in them.
Speaker: So women were highly addicted in this country a long time ago.
Speaker: It wasn't until 1914 when the Harrison Act came in to make that illegal that things started to change a little bit with that, and then it started becoming an underground.
Speaker: But our system has always tried to create new medications for women to addict them.
Speaker: And they've always promised, oh, you can look in the 70s with Valium.
Speaker: Safe.
Speaker: Look at the ads for them.
Speaker: Relatively safe in the 70s.
Speaker: And we addicted a whole generation of women then.
Speaker: So we have a history of this.
Speaker: Now people say, why are you saying women in the 1880s?
Speaker: Because the men were at the saloons.
Speaker: So the same percentage of women that were getting their relief from the medicine man with opium and cocaine in it, their men were getting their relief from alcohol.
Speaker: And so we had alcohol-dependent men
Speaker: And that carried over generations.
Speaker: And we had opium and cocaine-dependent women coming into the 19th century, end of the 19th century.
Speaker: So this is not new.
Speaker: And to understand that, now, when you look at what happens in certain communities where it devastates communities, it's not that addiction is new in devastating communities.
Speaker: We've always had that in American culture.
Speaker: It's the other factors combined with that that tend to produce that devastation.
Speaker: And we can get to that in a little bit, but this is what revolutionized our concept in the last 10 to 15 years of what was going on.
Speaker: This is the opioid epidemic that then became a heroin crisis, but overdoses and deaths...
Speaker: I'm going to stop for a minute about that.
Speaker: That came in not with heroin.
Speaker: That came in basically with two factors.
Speaker: Number one, the underground market discovered that they could use a very cheap and powerful substance to put into the heroin.
Speaker: That would be, and here's the thing, people who struggle with addiction and have that disorder,
Speaker: when you hear that there's a dangerous drug on the street, those who are not in recovery, I mean, those who are not in the addiction mindset run from it.
Speaker: But those who are struggling with addiction tend to run to it.
Speaker: It's like if you're trying to quit chocolate and I got the best chocolate on the table, you're going to, forgive me, run to it.
Speaker: And all of us understand addiction already at a fundamental level, whether you've ever had a problem, quote, unquote, with it or not.
Speaker: I mean, if I just took chocolate and coffee and stripped it away from you, you all would be miserable and wouldn't even be fun to talk to in the morning.
Speaker: I mean, that's just the way it is.
Speaker: We are a chemical positive society.
Speaker: Look at how much socializing has to have alcohol involved with it.
Speaker: We are so attuned to our chemicals and our right to our chemicals, whether it be alcohol or caffeine or nicotine or chocolate, the xanthine that's inside of chocolate that makes us want more.
Speaker: And then you can even go further on the health cycle with sugar and all that stuff.
Speaker: So I guess what I'm saying is we're a society that is prone to addiction, number one, and is supportive of chemicals that alter the way we feel or think.
Speaker: It's a norm for American culture and has been for a long time.
Speaker: This is not new.
Speaker: What came new was this additive of fentanyl into the heroin,
Speaker: Fentanyl, which is spelled F-E-N-T-A-N-Y-L.
Speaker: So fentanyl added.
Speaker: Now fentanyl has typically been used in surgeries and on the operating table because it's very strong.
Speaker: And when people are having surgeries, they need very intense pain relief for a period of time.
Speaker: Usually that period of time is short, but it allows a person to recover without being in extreme pain.
Speaker: Now, fentanyl is about, you know, depending on the way you get it, it can be in a patch, it can be oral, but depending on the way you get it, it can be 50 times or more stronger than even the heroin on the street.
Speaker: So you add a little bit of fentanyl into that heroin, and for many people, it produces and contributes to an overdose, meaning that it
Speaker: it attacks the central nervous system in such a way that it slows by overdose.
Speaker: What it means is it slows the heartbeat down to a dangerous level.
Speaker: So just to kind of get that in your mind, so heroin and other opioids are all central nervous system depressants.
Speaker: That means they slow things down.
Speaker: If you get too slow, you're at risk then of what we would call an overdose.
Speaker: The second thing that contributes to the overdose is other drugs that people are using.
Speaker: Multiple things.
Speaker: They're drinking.
Speaker: Another central nervous system depressant.
Speaker: You put two depressants together, you create more potential for fatal reactions because it does something that we would call
Speaker: it has an effect that we would call synergistic.
Speaker: You've heard that word synergy.
Speaker: It's when you put two things together and it gets great energy from it, right?
Speaker: Well, the synergy involved with depressants is if you put multiple depressants together, even though each dose of that depressant might not have been dangerous by itself, when you put them together, it multiplies the effects.
Speaker: So just imagine this for a second.
Speaker: alcohol potency of four and then you add an opioid with a potency of four and you think you're gonna get eight, right?
Speaker: But no, with depressants the synergistic effect is they multiply rather than add.
Speaker: So you're getting four plus four but it's turning into a times so you get a potency of 16.
Speaker: So you think, well, I know how to handle my alcohol, and this is a level of the opioid that my body is tolerant to, not thinking that when you put the two together, you create something different.
Speaker: Not an additive effect, but a multiplied effect.
Speaker: And so...
Speaker: Two major causes.
Speaker: I'm going to add a third cause in a second, but one had to do with fentanyl, which was an underground attempt, started coming out of China and now a couple other places where they're packaging it in such a way so it can be easily inserted into the way heroin is packaged.
Speaker: So basically now nobody knows what they're getting.
Speaker: They might think they're going to.
Speaker: That's why in my program where we provide treatment, someone will test positive for fentanyl.
Speaker: Let's say, no way, I never use fentanyl.
Speaker: And it's like, no, you are positive for fentanyl because something else that you're using has been laced with it.
Speaker: And the reason why it's not an opioid epidemic anymore is because now they're lacing cocaine with it.
Speaker: So guess what?
Speaker: Now a cocaine death is also an opioid death.
Speaker: because of the way it's being packaged.
Speaker: You all with me with it?
Speaker: So I'm trying to just create a picture for you of what's going on.
Speaker: So there really isn't an opioid epidemic now.
Speaker: What we have is almost more a lethal kind of drug epidemic wherever this packaging takes place.
Speaker: So people are dying from fentanyl and they think they're getting high on cocaine or methamphetamine.
Speaker: They just don't know.
Speaker: And that's the other thing that's happened.
Speaker: Now, people always, back in the day when you got cocaine or heroin, people always had some additives in there.
Speaker: And sometimes those additives were dangerous.
Speaker: But none of them were fentanyl.
Speaker: But sometimes, you know, they would put, you know, the evil-minded people
Speaker: Trafficker would put some bad stuff.
Speaker: But you've got to realize the mindset that somebody who's trying to addict a population and spread addiction is not going to put something in there intentionally to kill you because they lose a customer.
Speaker: So this has happened in a way that even surprised the dealing community.
Speaker: This is complicated the way this has happened.
Speaker: I mentioned two things.
Speaker: One was the additive of fentanyl that's created overdose and death.
Speaker: The second is multiple drug use where people were not kind of, I'm going to say not educated, not aware of what that impact would have.
Speaker: And now the third thing with overdose and death, and this is something that's really messed with me over the past few years, is people in recovery.
Speaker: who slip.
Speaker: Now let me say something.
Speaker: That is normal.
Speaker: People in recovery who slip, that is normal.
Speaker: Anytime you try to stop anything or change anything, think about your last January 1 New Year's Eve resolution.
Speaker: You're going to go to the gym, right?
Speaker: You're going to do this.
Speaker: You're not going to cuss out your husband ever again.
Speaker: Three weeks in,
Speaker: There it is.
Speaker: Human behavior is that human behavior change is very difficult.
Speaker: And to sustain behavior change is even more difficult.
Speaker: I have some things in my personal exercise and health plan that I keep failing on.
Speaker: And it's not because I'm a bad person.
Speaker: it's because behavior change is really difficult.
Speaker: And when it has to do with our health, it's even more difficult.
Speaker: So we're all struggling with that.
Speaker: That's why we should all be able to understand the struggle with addiction.
Speaker: It's a health condition that requires extreme behavior change and attention consistently.
Speaker: So what I was dealing with, and I'll just tell you the way it came up.
Speaker: Mothers and fathers coming up to me and telling me about their loved one who died.
Speaker: Overdose death.
Speaker: And they almost always said this to me.
Speaker: She was doing so good.
Speaker: And then sometimes they say, I thought she was doing so good.
Speaker: And I realized the pain in the parent or the brother or the sister.
Speaker: You know what I'm saying?
Speaker: Who said, I thought, meaning the person seemed to be in recovery, working it well.
Speaker: And what I came to realize afterwards was,
Speaker: is they were doing that well.
Speaker: But that the way drug packaging has gone, one slip is not something that you so easily wake up from and correct.
Speaker: Back in the day it was.
Speaker: I can tell you 25 years ago it was.
Speaker: Relapses came back to me.
Speaker: Kenny, I messed up.
Speaker: I had it going.
Speaker: And then this happened and it triggered this.
Speaker: And they lived to talk to me about it.
Speaker: And I always say, that's great.
Speaker: You're back.
Speaker: Don't worry about it.
Speaker: We can start now.
Speaker: You can jump right back on that path now.
Speaker: It was a different environment.
Speaker: These are people who are losing it the first time they slipped.
Speaker: So my heart goes out to people in recovery.
Speaker: And what happens is now people in recovery, we assume they're okay.
Speaker: Okay.
Speaker: And we forget to check in with them because those slips are now fatal.
Speaker: 20 years ago, they weren't.
Speaker: They are now.
Speaker: So we have to kind of have a different mentality now with that.
Speaker: We'll be right back.
Speaker: But first, a word from our sponsor.
Speaker: Hello, I'm Paul Miles, President and CEO of We Raise Foundation.
Speaker: We Raise invests in people and organizations that serve at the intersection of poverty, violence and inequality.
Speaker: We start by acknowledging that change begins with we.
Speaker: We are in this together and it's going to take our love and our compassion and dedication to solve the problems facing communities today.
Speaker: We invite you to be part of that with us.
Speaker: and encourage you to visit WeRaise.org to find out how you can become involved and be a partner with WeRaise.
Speaker: Let's talk about that because it really relates to what I was just sharing and what the question was for the recording was just about people going through rehab or treatment and then the soon relapse.
Speaker: You know, the most, when people are coming out of any institution,
Speaker: the highest rate of relapse is in the first 30 days.
Speaker: It's even higher in the first 72 hours.
Speaker: And so now let me just pull that for a second.
Speaker: All of you are working in some form of community or maybe you're thinking about some form of community development.
Speaker: If you want to make an impact, you've got to get to returning people.
Speaker: And if you can, get to them right away.
Speaker: Meaning that people coming out of jail...
Speaker: people coming out of prison, people coming out of rehabilitation settings are at their most vulnerable point.
Speaker: Now, the question of why, it's complicated, but we do know that the brain takes a picture of, it's like a Polaroid of high, of being high.
Speaker: And the brain, once a person is suffering from a substance use disorder, that brain is always, I don't know how else to say it, it's almost encouraging the person to go back to that picture.
Speaker: So there's a battle, there's a struggle, it's an okay struggle, it is what it is.
Speaker: And when people are successful in recovery, there's some evidence that their brains actually become more resilient than even non-recovering people.
Speaker: There's some aspect of recovery that actually makes people's brains even stronger in some ways.
Speaker: But they have to get through.
Speaker: That makes sense, right?
Speaker: You go through tough times, you're stronger.
Speaker: Right?
Speaker: But there's that process right there.
Speaker: And I've talked to guys who come out of prison, and I'm talking about five years, ten years.
Speaker: And as soon as they walk out, guess what happens to them?
Speaker: And I'm talking about people who are heroin addicted.
Speaker: They start sweating.
Speaker: all of a sudden, their brain has reinstituted withdrawal symptomology.
Speaker: Sweating, anxiety, heartbeat goes up, all the things that they experience when they used to be sick, what people would call dope sick, they start feeling quote-unquote dope sick, and they haven't even used it.
Speaker: And they're saying, how is that possible?
Speaker: Because the brain took that picture.
Speaker: The brain knows that.
Speaker: And when they walked into that same neighborhood where they used to cop, that same neighborhood where they used to use, that's where they feel it.
Speaker: They didn't feel it when they walked out the door.
Speaker: They felt it.
Speaker: Usually they tell me they felt it when they went into their own neighborhood.
Speaker: It's like the brain took the picture, the brain reminded of the picture, and then the brain just actually replicated the experience.
Speaker: So to think that people are okay is...
Speaker: is to underestimate sometimes the power of addiction and the need for a circle of recovery and support.
Speaker: And I want to lean on that for a second because you are that circle of recovery and support for many people in your community.
Speaker: And so when you hear so-and-so is getting out, you need to assign somebody to be at the door and say, hey, we're going to walk with you.
Speaker: No, I'm good.
Speaker: That's okay.
Speaker: We know you're good.
Speaker: We're going to walk with you.
Speaker: because that's what people need.
Speaker: You know, whether they have people walking with them in a self-help recovery kind of thing, like AA or NA, or whether they have people walking with them in a Celebrate Recovery, a faith-based thing, those are all good.
Speaker: Those are great, because people need people to walk with them.
Speaker: You do better in your exercise plan if you have a walking partner.
Speaker: Isn't that right, Yolanda?
Speaker: Yeah.
Speaker: If she doesn't have a walking partner, like, what am I going to do?
Speaker: You know, so it's like we need partners.
Speaker: We need we are social creatures, even when we're recovering from our own stuff.
Speaker: We need other people to be in that stuff with us.
Speaker: Recovery is just it's it's human.
Speaker: The problem is it's deadly.
Speaker: So the consequences are not that you're just going to gain five pounds.
Speaker: You might not come home at all.
Speaker: So the consequences are more deadly, but the principles are ones we're very familiar with and should be able to embrace without a lot of judgment, without a lot of this and that.
Speaker: That's why...
Speaker: You don't call... Here I'm going to bring something out.
Speaker: So I'm going to get to some of the questions that are there.
Speaker: Language and stigma is a big thing for me because we use language right now that reinforces the stigma for folks.
Speaker: Now let me give you an example.
Speaker: If somebody comes up to me and says, Hi, Kenny, I'm a recovering addict.
Speaker: I'm cool with that.
Speaker: But I'm not going to use the word addict to talk about another person because the concept of an addict...
Speaker: in many people's mind, is going to throw them into a very negative light.
Speaker: And that person will be treated and sometimes even feel.
Speaker: Meaning, you can tell me, and I know sister already, because you shared a little bit with me there in a minute.
Speaker: I know you might call yourself a recovering addict.
Speaker: I'm cool with that.
Speaker: But I'm not going to introduce her as an addict in recovery.
Speaker: I'm going to introduce her as my sister who has a story to tell.
Speaker: And if somebody wants to know her diagnosis, it would be a substance use disorder.
Speaker: I'm not going to call her an addict.
Speaker: Because that's going to trigger something about her in the minds of everybody around.
Speaker: And whether you're aware of it or not, you might treat her differently.
Speaker: So we have to be very careful.
Speaker: In order to increase hope around this whole subject of addiction and recovery, we have to first decrease the stigma attached to it.
Speaker: Decrease stigma, increase hope.
Speaker: If you don't remember anything else from that, this is one of my most important messages to you from my experience.
Speaker: When stigma goes down, hope goes up.
Speaker: You call somebody a drug abuser, what do you think of when you hear abuser?
Speaker: You think of like a guy who beats on a woman, right?
Speaker: You think of somebody who does bad things.
Speaker: Judgment is all over that.
Speaker: And our Jesus didn't come to judge the world.
Speaker: So that judgment, that stigma, we've got to let go of that.
Speaker: So I don't introduce people as addicts.
Speaker: I don't call people drug abusers.
Speaker: Somebody says, you know, this person is a, I get calls all the time, like a doctor from the ER says, I've got a drug abuser here in my, you know, and it's like, well, I already know how that person's going to be treated in the ER.
Speaker: Because if the doctor thinks of them as a drug abuser, they won't be treated with dignity and respect.
Speaker: They're already manipulative.
Speaker: They're already lying.
Speaker: And you know what?
Speaker: There obviously are some behavioral... Everyone who has struggled with somebody, yeah, there's a lot that goes with that.
Speaker: There's denial and there's dishonesty at times.
Speaker: But that's still a person.
Speaker: And it's the same thing you used to lie about when you told people you were clean on chocolate, but you stuck something in.
Speaker: I mean, we all have these struggles to be 100% honest about what's going on.
Speaker: It's only the
Speaker: gravity of the situation with addiction that kind of runs us into this judgment side of things.
Speaker: So I'm concerned about seeing these things in our communities.
Speaker: Now, where do we go from there?
Speaker: We have a unique the reason why I do this workshop in Christian Community Development Association session is not
Speaker: because I feel that you wanted to come for a pharmacology workshop on substance use.
Speaker: We could do that.
Speaker: I do that all the time, but that's not it.
Speaker: I think if you have a goal in your ministry or what you're doing to decrease stigma so that hope increases, so when people are less judged and you create the environment where you educate people around that,
Speaker: then there's the room for people to feel, well, then there's hope.
Speaker: I can belong to this group, and I'm not going to be singled out.
Speaker: I'm not going to be pointed out.
Speaker: I'm not going to be distrusted.
Speaker: I'm going to be included as a valuable member of this community.
Speaker: So you have the opportunity in your ministries to actually create some effective strategies that not only work with people in recovery, but actually work good on the prevention side of things as well.
Speaker: And I wanted to get to that a little bit because...
Speaker: You know, addiction is preventable.
Speaker: Now, there are some signs along the way, but it's preventable, it's treatable, and people can find a really meaningful, wonderful recovery.
Speaker: I believe that fundamentally.
Speaker: That's the hope.
Speaker: Yes, it's
Speaker: Well, let's talk with your question about really the nature of recovery.
Speaker: Let me get into that for just a little bit.
Speaker: Not everybody finds the path of recovery the same way or experiences it similarly.
Speaker: So the problem is that we oftentimes, now I've been on panels where there's somebody on the panel who's telling their story, and in order to tell their story, they have to put down somebody's story who's next to them on the panel.
Speaker: Look, this has complications to it.
Speaker: People find recovery different.
Speaker: This is what I say to people.
Speaker: We need all the tools in the toolbox and we need to respect each other's pathway to recovery.
Speaker: Now, what does that really mean in the immediate sense?
Speaker: I've met people who will tell me that they found Jesus and they are recovered.
Speaker: And they are no longer an addict.
Speaker: That's the way they'll term it.
Speaker: And what I usually say to them is, I embrace your experience.
Speaker: I am so happy for you.
Speaker: But there are others.
Speaker: You've got neighbors who don't experience recovery that way.
Speaker: They've been back and forth to Jesus hundreds of times in their life and relapsed every time.
Speaker: And that's not because Jesus is not who he is.
Speaker: It's because their pathway is different.
Speaker: In everyone's pathway, we've got to get to the place where we really don't define the pathway so narrowly that only a few can come in.
Speaker: Like, we're creating this narrow path and this narrow gate.
Speaker: God didn't create it that way.
Speaker: Now, you know, people find their pathway to health a lot of different ways.
Speaker: Allow God to work in many different ways.
Speaker: Look, look.
Speaker: Allow God to work in many different ways, in many different people, at their own pace and in their own way.
Speaker: Now, one way to help with that is because there was a question on here about church leadership roles.
Speaker: Let me tell you the best thing that church leadership can do.
Speaker: And that is be willing to have open conversation in front of the congregation.
Speaker: Now, if you know the history of AA, AA happened because they couldn't have the conversation in the church.
Speaker: So they went to the basement and talked.
Speaker: And that became AA because we could talk real then.
Speaker: I could even cuss if I needed to.
Speaker: Couldn't say it up there.
Speaker: God bless.
Speaker: Yeah, God's good to me.
Speaker: Yeah, everything's good up here.
Speaker: Had to go to the basement, tell you what's really going on.
Speaker: Like, I'm having a problem, you know.
Speaker: And so it was in the basement where the honest conversation took place.
Speaker: But these were all spiritual people, but they needed the basement to talk for real so that their spiritual connection could have some substance to it rather than just the surface to it.
Speaker: So we have to find out how can we create those spaces in our community settings.
Speaker: You know, churches need to talk about it.
Speaker: If a pastor said, what can I do to help my congregation understand addiction and recovery and contribute to this?
Speaker: I'd tell them, I said, you want something practical?
Speaker: Have someone tell their recovery story once a month.
Speaker: Have a recovery day where people can share their stories.
Speaker: You know, I did something on, this is slightly off the path, I did something for the Episcopal Diocese one time, and I talked about addiction, and I also talked about depression.
Speaker: And it amazed me, within a couple minutes, hands started to go up.
Speaker: And a woman stood up and said, I've been suffering from depression.
Speaker: I've never mentioned this anywhere.
Speaker: You just gave me permission to talk about it.
Speaker: Someone else said, me too.
Speaker: It was like this me too thing in an Episcopal convention of people who are struggling with depression and it never was talked about.
Speaker: It wasn't talked about in Bible study, wasn't talked about in Sunday school, wasn't talked about from the pulpit.
Speaker: So nobody said, what do I do with it?
Speaker: So creating safe spaces.
Speaker: So if you want to put this under a category, it's churches and church leaders can create safe spaces for people to talk about their struggle.
Speaker: Without judgment.
Speaker: And then when people tell their struggle, you'll find some good recovery stories.
Speaker: You'll find some people who have found...
Speaker: some success in their journey.
Speaker: You'll find people who will join in with people and say, yeah, that was me too.
Speaker: You know what?
Speaker: You and I will be praying together.
Speaker: You and I will be meeting together.
Speaker: Let's keep each other safe.
Speaker: The opportunities for that come when you open the door for those conversations.
Speaker: Maybe a recovery Sunday or a recovery conversation.
Speaker: Yeah.
Speaker: Let me repeat that for the mic because I really want this in this session.
Speaker: You talked about that the main thing for someone is to be able to forgive yourself.
Speaker: That's the shame piece.
Speaker: That's the shame piece.
Speaker: And the church has really gotten that confused.
Speaker: And rather than giving people opportunity to forgive,
Speaker: to leave their shame behind, they've created a scenario where the shame increases.
Speaker: When you can't talk about something, it means that the shame goes up.
Speaker: The stigma goes up.
Speaker: The shame goes up.
Speaker: And you know the difference between guilt and shame, and we should know that.
Speaker: I mean, guilt says, I screwed up.
Speaker: Shame says, I am a screw-up.
Speaker: And when you struggle with a lifelong, any lifelong struggle, you feel like a screw-up.
Speaker: It's not about, I screwed up.
Speaker: Heck, you did that hundreds of times.
Speaker: It's about I am a, and to be able to have that identity.
Speaker: Now, let me share something from the brother.
Speaker: Let me use this for a second, because this is really important to me.
Speaker: He used another term.
Speaker: He talked about the term addict.
Speaker: He used another term.
Speaker: I don't know if you caught it, but that I welcome him using it for himself, but I will not use it for another person.
Speaker: He said, I've been clean 22 years.
Speaker: So what happens, let me just share this for a second, as to how I'm walking through this change myself.
Speaker: I don't ever refer to somebody as clean anymore.
Speaker: Because now I'm okay with them identifying self, identifying themselves that way.
Speaker: That's cool.
Speaker: That's your language.
Speaker: That's your experience.
Speaker: But if I say you're clean, then when you're not exactly on the path, you're what?
Speaker: You're dirty.
Speaker: And I'm not going to judge that.
Speaker: I mean, if you're struggling with your health and your exercise, are you dirty when you skipped your exercise routine one day?
Speaker: You know what I'm saying?
Speaker: In other words, the judgment needs to come off from our side.
Speaker: I'm okay with it coming from your side because you can define how you're feeling and what that is and the language and the culture that that meant something to you.
Speaker: And I embraced it.
Speaker: I embraced it because it was wonderful, but I'm not going to call him clean.
Speaker: because then if he slips, he's dirty.
Speaker: And I'm not going to call my brother dirty.
Speaker: I'm going to say, my brother is in recovery, and that recovery may include some slips and relapses along the way.
Speaker: It might not.
Speaker: But I'm cool with him either way.
Speaker: We're called alongside to walk with people, not to stand across from them and judge their worth or their status.
Speaker: That's just not our calling.
Speaker: I'm sharing with you, my plead with you is that that shouldn't be our calling.
Speaker: Our calling should be to walk with people.
Speaker: Well, because most people who walk into the recovery journey have to do a level of honesty that many of the rest of us who are not in that don't even understand.
Speaker: We can live and hide things for years and years and years, but people in recovery, they couldn't afford to do that.
Speaker: In order for recovery to happen, honesty had to happen at a much deeper fundamental level.
Speaker: Now, here's the cool thing theologically.
Speaker: You talked about Bible verses.
Speaker: I mean, basically...
Speaker: Is sin an addictive process?
Speaker: Isn't sin an addictive process?
Speaker: Like, there's no person on the face of the earth that doesn't understand addiction.
Speaker: Because what did Paul say in Romans 7?
Speaker: I seek to do the good things and not sin, but I wind up sinning, and then the things I tried.
Speaker: All that was a description of an addictive process.
Speaker: So we fundamentally know from Adam forward in the garden that addiction and sin walked hand in hand.
Speaker: I need to give credits where credit is due.
Speaker: J. Keith Miller wrote a book, The Ultimate Deadly Sin, Addiction.
Speaker: And I read that, and he wrote that out of his journey of addiction and recovery, where he realized he'd been a very famous Bible teacher for years and years back in the 70s, and then he kind of fell out of grace, and addiction destroyed all of that.
Speaker: And then he came back with an understanding about recovery and he tied it to his theology and realized that because sin is an addictive process, and that righteousness also was very much like recovery.
Speaker: So that walking, this whole walk, he said, is really a recovery walk, which means that I have an addictive process.
Speaker: that this relationship with God now allows me to walk free of that process, but that process is always trying to get me to go back into it.
Speaker: He said, so the story of sin and righteousness and walking with God is really a story of addiction and recovery.
Speaker: At the very fundamental level, take chemicals away from it.
Speaker: It's fundamentally our story.
Speaker: Everyone really knows it.
Speaker: Just some are able to confess it and talk about it that way.
Speaker: So when you're sitting in a group room and somebody says, hi, I'm Kenny, I'm an addict.
Speaker: I could do that comfortably now because of my understanding of sin, of what started and what started in the garden is now still in me.
Speaker: And what started in the death and resurrection of Jesus is also in me.
Speaker: And so that's recovery.
Speaker: It was Keith Miller.
Speaker: Keith Miller.
Speaker: It's a fascinating book.
Speaker: It's about 20, 25 years old.
Speaker: And it will walk you through that process.
Speaker: And it's a very good way theologically, not to look up Bible verses about
Speaker: specifically addiction, but to see the whole theology of coming from Scripture as meeting a people.
Speaker: We suffer from addiction.
Speaker: We just call it sin.
Speaker: And we enjoy recovery.
Speaker: We just call it salvation and righteousness.
Speaker: Sanctification.
Speaker: You know, we use these words that nobody else in the world understands.
Speaker: I don't know why we use them so much.
Speaker: It's like private language.
Speaker: You can say something to your family that you can't say outside.
Speaker: It's like that.
Speaker: We do a big disservice to the world when we use our inside language outside.
Speaker: It just doesn't compute.
Speaker: Talk about sanctification.
Speaker: Nobody cares about that in the streets.
Speaker: Right?
Speaker: But they want to know there's hope.
Speaker: They want to know, hey...
Speaker: We can make life better for you, for your family, for your community, for your brothers, your sisters.
Speaker: That's what they want to know.
Speaker: Decrease stigma, increase hope.
Speaker: Hi, my name is Christina Fore.
Speaker: And what I love about CCDA is that our faith is part of communities flourishing.
Speaker: Welcome to the CCDA podcast.
Speaker: Did anybody have a question that they didn't have a chance?
Speaker: I thought I saw your hand.
Speaker: Yeah, let me get some of those.
Speaker: So the question really is about have I seen honest dialogue among people of faith and people struggling?
Speaker: And, you know, Celebrate Recovery can serve that function.
Speaker: And oftentimes they're in suburban settings with larger, more wealthier churches, but Celebrate Recovery doesn't have to be there.
Speaker: You can do that model of honesty anywhere.
Speaker: And you can do it in the hood.
Speaker: You just have to set it up.
Speaker: And so the model that I would encourage is safe spaces, create safe spaces.
Speaker: Now, here's another kind of key thing that we learned in the world of prevention.
Speaker: Hey, sweetheart.
Speaker: In the world of prevention.
Speaker: And that is kids who have meals with adults.
Speaker: at least one time a week, and some studies showed that it needed to be at least two or three times a week, but not every day.
Speaker: But kids who had meals with adults had a lower incidence as adults later with addiction.
Speaker: So I started to say, okay, what does this mean in community?
Speaker: Because you probably work with a lot of kids who don't have that.
Speaker: They don't have the family meal.
Speaker: They're rushing in and getting food, foods made or not made.
Speaker: They got a lot of survival stuff is going on in communities and they don't have that.
Speaker: So community ministries and churches, they need to create mealtimes, safe spaces where adults sit down at the table with kids and talk and listen.
Speaker: Not preaching.
Speaker: I'm not talking about preaching.
Speaker: I'm not talking about, you know, a salvation message and I'll give you a basketball.
Speaker: I'm not talking about that.
Speaker: We've all seen that.
Speaker: And the kids who rack up the basketballs, you know, time after time, but it doesn't.
Speaker: I'm talking about relational development where you have community safe space meals with adults and kids sitting at the table and just talking and listening.
Speaker: That actually has a preventative effect on the outcome of addiction later on in life.
Speaker: It's amazing because it's so simple, but it doesn't happen.
Speaker: So when I think about your question about these places, we need to create those safe spaces where kids can talk and be heard and listened to.
Speaker: That is a prevention.
Speaker: That is Substance Use Disorder Prevention 101.
Speaker: Yes?
Speaker: Yes?
Speaker: So let me jump in on something, because you brought in something that is in my presentation, which is really about pain, just for a minute.
Speaker: And then I want to talk a little bit.
Speaker: In my community program where I work, I worked together with a group of Latinos to develop a Clinica Latina, because there was nothing really for Latinos in our community.
Speaker: and we have to face that issue of documentation as well, and we just don't ask for Social Security numbers.
Speaker: So we just leave that blank so that we can just focus on the individual and focus on what brought them to us.
Speaker: So, you know, I'm familiar with that process, and it can be a difficult process because of a couple things.
Speaker: Number one, Latinos do not want to be seen,
Speaker: because of the documentation issue and what it might bring.
Speaker: So they're fearful of that.
Speaker: And then the other thing is there's no such thing as treating a single Latino or Latina because they all come into our clinic with their families.
Speaker: So if mom comes in, the kids are coming in with them and...
Speaker: So you really have to be prepared to approach the family system, not just the individual.
Speaker: It's a little bit different.
Speaker: You see in the other cultural expressions, people will walk in on their own.
Speaker: But if someone's coming into Clinica Latina, their family comes with them.
Speaker: So there's a lot of unique things.
Speaker: But what you brought up is very...
Speaker: very important, and that is that we have a problem in our country.
Speaker: When I talked about the 1880s, alcohol for men and those medicine man elixirs for women were to eliminate pain.
Speaker: We've always had a problem in our culture with accepting pain as a necessary process.
Speaker: You know, the purpose of pain is to let us know that something's wrong so that we will change something as needed
Speaker: In other words, pain is a message.
Speaker: It's not our enemy, although none of us like pain.
Speaker: It's a message, and we have to learn.
Speaker: And that's why, you know, growing up, what were the commercials?
Speaker: How do you spell relief?
Speaker: And it didn't just have to be relief.
Speaker: It was either Rolaids or bare aspirin when I was growing up, but it was like fast relief.
Speaker: And then the commercial said, what's the fastest relief?
Speaker: And so we're seeking fast relief.
Speaker: And so people want fast relief.
Speaker: The opioid crisis was partly fueled by fast relief demand.
Speaker: And even the Valium crisis with women in the 70s and 80s was often fueled by the doctors wanting to get the women out of their office fast.
Speaker: And the best way to do that was to give them Valium.
Speaker: Of course, the problem was that was highly addictive.
Speaker: and therefore it created a crisis in women around the country.
Speaker: So all of those are tied to our difficulty with dealing with pain.
Speaker: Now, who understands pain theologically?
Speaker: better than the community of faith.
Speaker: We understand it.
Speaker: Because if you look at... There's hardly a scriptural passage that doesn't include death before resurrection or doesn't include pain before joy.
Speaker: You know, for the pain set before Him, the story of the saints is always that they endured something in order to achieve something, in order to realize something.
Speaker: It's the...
Speaker: we understand pain and should be able to contribute to that conversation in a meaningful way.
Speaker: That pain is not our enemy.
Speaker: It's a messenger.
Speaker: And if we listen to it and make the changes that it's telling us we need to make, it will bring us hope and it will bring us freedom in the long run.
Speaker: So this is a very important piece about pain that I'm glad you kind of brought that out with that.
Speaker: Yes, in the back.
Speaker: That's beautiful.
Speaker: Thank you for sharing that.
Speaker: Really appreciate that.
Speaker: And we rejoice in your recovery as well.
Speaker: And let me tell you, I am...
Speaker: I am cool with all different kinds of... I used to be much more dogmatic in my approach a long time ago in my career as an addiction specialist, and now I realize, wow, I need to really just enjoy the fact that so many people find recovery in different ways and just welcome it all.
Speaker: That's why I tell people, we need all the tools in the toolbox, and we need to welcome recovery however somebody finds it.
Speaker: And be welcomers of that recovery, not dogmatic about it.
Speaker: And I'm going to share now a particular issue because it comes up to my sister's one.
Speaker: So people find recovery oftentimes with medications.
Speaker: And here's what I want to say.
Speaker: For some people, you use the term crutch, right?
Speaker: And I got you.
Speaker: Because when you think of a crutch, you think of something that you need to use in order to walk.
Speaker: Fair enough.
Speaker: Chemically, okay, yes.
Speaker: We got 10 more minutes.
Speaker: Thank you.
Speaker: All right.
Speaker: My timekeeper...
Speaker: who I always listen to, has said we've got 10 more minutes.
Speaker: So let me kind of hit on this.
Speaker: It is very important that we do not create second-class recovery pathways.
Speaker: That means that if the sister or brother next to you requires medications and that creates a successful pathway for them, as my wife would say, Dejela.
Speaker: Leave it alone.
Speaker: It's okay.
Speaker: Definition is leave it alone.
Speaker: Yes.
Speaker: Thank you.
Speaker: Confirmed, leave it alone.
Speaker: Basically, basically that some people are going to require medications and it's not important the length of time.
Speaker: What's important is that for them that they're finding a recovery pathway.
Speaker: And it doesn't matter to me
Speaker: Whether it's years, days, doesn't matter.
Speaker: What's important to me is... And some people will say, well, I've been on medications that didn't work for me and I found this and it did work, which is great.
Speaker: Which I'm going to basically rejoice in that.
Speaker: I'm going to rejoice in recovery how people find it.
Speaker: Because when you're dealing with an illness, and I can tell you, addiction is a brain disorder.
Speaker: It is not...
Speaker: Just somebody out of control.
Speaker: It is a brain disorder.
Speaker: Recovery comes in many forms to restore normalcy to the brain.
Speaker: For many people, medications restore normalcy to the brain.
Speaker: Do not make them feel bad because it is.
Speaker: Don't tell them that Jesus will take them off their medications.
Speaker: Unless you're going to say that Jesus is going to all of a sudden make you healthy.
Speaker: It doesn't work that way.
Speaker: So I know people of faith who are on medications for many years.
Speaker: Methadone, buprenorphine, naltrexone.
Speaker: Suboxone is actually a brand name of buprenorphine.
Speaker: It's okay.
Speaker: If they're finding their recovery pathway with those medications, I treat them with the same respect as a person who, when their depression and antidepressant was helpful.
Speaker: Because we're dealing with brain chemistry, you cannot judge people with how their brain chemistry needs to be.
Speaker: Now, that doesn't mean that everyone who's depressed needs an antidepressant.
Speaker: But I leave it to the individual to explore what works for them and then encourage them in that pathway.
Speaker: I also keep the door open that if you ever find that doesn't work, there's no shame in going to another pathway.
Speaker: So, you know, I work in a program where we have hundreds of people in treatment, hundreds of people on medications, some not on medications.
Speaker: Some go from no medications to needing the medications or vice versa.
Speaker: I welcome that.
Speaker: I know people that have great recovery stories, and I just say, let's embrace those recovery stories without having to judge or step on the other's recovery stories.
Speaker: So I was sitting in a panel, and I remember...
Speaker: One guy was telling his recovery story.
Speaker: This is very difficult because I then had to tell him, look, I love your recovery story, but you don't have to step on others who do it differently.
Speaker: And see, the way he told his story, he was stepping on other people's pathway.
Speaker: It's kind of like it worked for me, so it has to work for you that way.
Speaker: And if it works for you another way, it's not really it.
Speaker: So you're second-classing other people.
Speaker: So if you're on medications and that's your pathway for recovery, don't second-class them.
Speaker: Put them in first class.
Speaker: You walk right alongside with me.
Speaker: So that's my... And I could go into a whole class with you guys if we had another day on the chemistry in the brain as to why that is.
Speaker: But you're dealing with brain chemistry...
Speaker: In addiction, the brain depletes certain chemicals, and those medications, for some people, normalize the brain functioning.
Speaker: So they're not getting high.
Speaker: It's not second class.
Speaker: It's like insulin for a person who suffers from diabetes.
Speaker: It's a disease that requires necessary medications, but other people are able to find a pathway to health other ways.
Speaker: Let's rejoice and embrace all of that.
Speaker: As community people, you have to be able to embrace that, or else you'll just welcome some and kick others to the curb, and you'll increase stigma that way.
Speaker: And what did we say from the beginning?
Speaker: Decrease stigma wherever you find it.
Speaker: It increases hope.
Speaker: Yes, ma'am.
Speaker: Learning to forgive.
Speaker: The brother here talked about forgiving yourself.
Speaker: There's a whole other realm.
Speaker: But, you know, until you are in a good space.
Speaker: Now, if I showed you an addiction thing, you'd see that basically what gets hijacked is the reward system in your brain.
Speaker: that basically requires you to stay in survival mode constantly.
Speaker: So when you're in survival mode, you can't deal with trauma.
Speaker: So until the sister and brother here, for example, got into recovery where they got some sense of normalcy, and it takes one to two years before your brain starts to repair itself.
Speaker: And here's the great thing.
Speaker: God made your brain so it'll repair itself.
Speaker: So it's a wonderful thing.
Speaker: The brain is working and wanting to restore.
Speaker: You've got to give it space to restore.
Speaker: So that's the key thing.
Speaker: Once you have that space to restore, you can start dealing with some of these other issues that are forgiveness.
Speaker: And that's why, look at 12 steps.
Speaker: The first three steps are just getting help, getting clean.
Speaker: You get further in the steps, all of a sudden you're making amends, you're going to people you hurt, you're apologizing, you're restoring, but you don't do that right away.
Speaker: You can't do that right away.
Speaker: You are in survival mode.
Speaker: And until that part of your brain gets settled and normalized, whether it's with medications or with time in recovery or whatever, you can't deal with the trauma that's underneath.
Speaker: But once you are there, you can start dealing with those things.
Speaker: And you can forgive yourself.
Speaker: You can forgive others.
Speaker: You can work through those things.
Speaker: Don't expect people to do that right away in recovery.
Speaker: Their brain's already been hijacked.
Speaker: They're in survival mode.
Speaker: Help them survive.
Speaker: Help them get through the day.
Speaker: Don't talk to them about how they have to forgive.
Speaker: They may not be ready for that.
Speaker: A year later, they might.
Speaker: Give them time.
Speaker: And the 12 steps actually helps people with that process in a beautiful way.
Speaker: So work through the steps of survival first.
Speaker: And thank you for listening to the CCDA podcast.
Speaker: And big thanks to Kenny House for his leadership in beyond the opioid crisis and into communities.
Speaker: Hello, I'm Paul Miles, President and CEO of We Raise Foundation.
Speaker: We Raise invests in people and organizations that serve at the intersection of poverty, violence, and inequality.
Speaker: We start by acknowledging that change begins with we.
Speaker: We are in this together.
Speaker: And it's going to take our love and our compassion and dedication to solve the problems facing communities today.
Speaker: We invite you to be part of that with us and encourage you to visit WeRaise.org to find out how you can become involved and be a partner with WeRaise.
Speaker: Thank you for listening to the CCDA podcast.
Speaker: Don't forget to subscribe on Apple Podcasts, Spotify, or wherever you listen to podcasts.
Speaker: This podcast is produced by Dan Portnoy in association with Scott Overpeck.
