The Reality of Addiction

With illicit drug use on the rise in the U.S., and a large gap in treatment services, addiction is one of this country’s most compelling social problems. But how is this impacting the WilmU community, and what are we doing to prepare students to address addiction issues in their careers? 

addiction2As the door closed behind her at Baylor Women’s Correctional Institution, Jodie Edwards headed to the prison parking lot and jumped into a waiting car. After serving a month-long sentence for her second DUI, she was greeted by a friend who brought along a six-pack and several joints. Prison didn’t change her behavior because she wasn’t ready to change.  Although her life was a downward spiral of getting drunk and high — causing auto accidents while driving under the influence, stealing money from her employer, getting fired from her job and even missing her best friend’s wedding while she was incarcerated — she wasn’t ready to get clean and sober.

It’s a typical story, says Dr. Jim Walsh, a faculty member in Wilmington University’s clinical mental health counseling program in the College of Social and Behavioral Sciences. “The addicted person rarely appears like the stereotype. Until addicted people hit bottom, their friends, loved ones, employer, teachers — even medical caregivers — may not realize the extent of the problem. Addiction requires secrecy, and often the impact of the addiction is hidden well.”

Edwards hadn’t hit bottom yet. She started drinking at the end of high school and using drugs while at college. After graduation, when her college drinking buddies got their acts together and started careers and families, she searched for jobs that wouldn’t interfere with her partying. “Life became really dark,” she says, referring to the drug culture in pockets of Wilmington, Del. At 30, she moved back to her parents’ home in Sussex County. She wasn’t ready to leave the life, so she found new friends to do drugs with and bar hop. Her wake-up call came with her third DUI arrest. She was looking at a six-month prison term and a two-year license suspension. She was sent to Meadowood Hospital in New Castle, Del., to detox for 10 days, but the facility was so crowded, she was placed in the dementia unit.

Following her in-patient stay, Edwards went to outpatient treatment and considers March 15, 2008, her sobriety date. “By 2010, I had done a complete turnaround,” she says. “I went from having the state of Delaware own my license for two years to having them give me the keys to a state car for my job.” Edwards credits her parents and sober friends for keeping her on track. “My life of crazy and chaos is over. Drugs and alcohol are no longer my coping mechanism.”

Her experience in that dementia unit in detox and subsequent job at a state facility influenced her career choice. She hopes to work with seniors when she completes her graduate degree in the administration of human services at WilmU. She’s willing to talk about her experience openly because she never knows who it might help. “By hearing my story,” she says, “it might plant a seed for someone.” She embraces her role as mentor to women who seek her out after hearing her life experience, but tells them that there are no shortcuts. Sobriety takes work.

Edwards is clean and sober now. She uses her hard-learned knowledge to advocate for more long-term treatment in Delaware. “Drug and alcohol abuse is not a seven- to 10-day problem,” she says.  “It’s a lifetime problem.”

Delaware’s Response

Dr. Marc Richman is an adjunct instructor in WilmU’s psychology program in the College of Social and Behavioral Sciences, as well as assistant director for Delaware’s Community Mental Health and Addiction Services and the director of court and special services in the Division of Substance Abuse and Mental Health. Under Cabinet Secretary Rita Landgraf’s direction, Richman is leading the department’s redesign regarding substance use disorders that will allow more providers to offer more services. “The most pressing need is for detox (officially referred to as withdrawal management), especially in downstate Delaware,” says Richman. “Like most states, Delaware is underwater with opiate addiction cases. The much publicized heroin problem, in fact, dwarfs prescription medication addictions.” He points to the need for short-term transitional beds, residential care for women — an underserved group — and programs for young adults, who represent the largest growth population among users.

Contracts with community providers who provide addiction services should also include a mental health focus. “There is co-morbidity of addictions with mental health and trauma issues,” says Richman. “Sometimes it’s cause and effect and sometimes they’re simply correlated, but behavioral health interventions must be trauma informed, comprehensive and provide a better coordination of care for individuals.”

It takes a partnership to make changes. And it’s hard work. Richman’s department advocates a three-pronged approach to address the current epidemic: prevention, treatment and law enforcement. He says that advocacy groups can teach the community that addiction is a public health problem, and that drugs and alcohol change brain chemistry.

“Addiction is not a moral failing,” Richman says. He points to groups like atTAcK addiction, which is credited for being a driving force behind key pieces of legislation. The Good Samaritan 911 law states that if citizens call 911 to report someone experiencing an overdose, they can’t be arrested or prosecuted for a minor drug crime, possession or underage drinking. The group also advocated for legislation that allows law enforcement officers to carry Narcan (naloxone), a prescription drug that counteracts the effects of opioid-related overdoses. It also allows family, friends and community members to buy naloxone after they’ve been trained by the Department of Health and Social Services.

Addiction3

The Salter’s

The tie between addictions and mental health is something that WilmU alumnus and retired Delaware State Trooper Doug Salter knows well. His son was prescribed pain medication for multiple sports injuries and surgeries in high school. The injuries led to feelings of depression, and ultimately the need to self-medicate, which ultimately led to an addiction to prescription pain medication. But they were expensive, so he turned to heroin.

This is a path that many take, and it’s a contributing factor to Delaware’s heroin

“The disease of addiction can be very isolating,” says Salter, who’s also a board member of atTAcK addiction, an advocacy group formed to educate about and bring awareness to the issue of addiction. “It’s isolating for the person in active use, and it’s isolating for the family of those suffering from addiction. We thought we were the only people dealing with this type of issue.”

There was a history of addiction on both sides of the family, so the Salters knew about genetic predisposition. According to the National Council on Alcoholism and Drug Dependence, research has shown conclusively that family history of alcoholism and drug addiction is in part genetic, and not just the result of environment. But as a career law enforcement officer, Salter admits that he hadn’t had much sympathy or understanding of drug users, believing addiction was a lifestyle choice. He knows better now. He wants to work with local police agencies to educate law enforcement about the complex issues surrounding addiction.

Letting the addicted person own the problem is easier said than done. “Enabling him is my biggest regret,” says Salter, whose son is in recovery. “I got him out of things that I probably should have let him experience.” As a parent, Salter wants to be supportive but realizes that it is his son’s recovery and his son needs to make his own path. Dr. Doris Lauckner, chair of WilmU’s graduate clinical mental health counseling program in the College of Social and Behavioral Sciences, agrees. “You can’t just assume that when someone comes for counseling, that they are ready to stop using a substance or change their behavior,” she says. “They may be at a different point in the process of change and we have to meet them where they are at in this process.”

Teaching How and Why

Addiction4Education about addiction is key — not only for law enforcement and the community, but also for students at WilmU who are preparing to work in the social and human services, law enforcement, nursing and education fields.

Lauckner stresses why future counselors should understand addiction. “The problem is very widespread so we are all very much affected by it,” she says. “Our students really need to understand that they’re likely affected in some way, or will be, and all of their future clients will be affected directly or indirectly.”

When WilmU’s counseling program was redeveloped a few years ago,  an addictions course was added. “The topic is extremely relevant,” says Lauckner. “My hope is that our students go through the addictions course — and our program in general — and become more knowledgeable, understanding and compassionate toward people who have addiction problems. Many people with addiction problems have such shame, and there is a need for them to feel cared about and understood.”

David Brumbaugh is a graduate of WilmU’s mental health counseling program and a former patient in and current counselor at Father Martin’s Ashley in Maryland, one of the country’s premier private addiction treatment facilities. He brings the richness of his recovery and treatment experience to the classroom, stressing to students that everyone deserves respect. He also echoes Lauckner’s belief that students can’t be in the counseling field without coming into contact with addictions issues. His passionate teaching style blends his recovery journey, his former career in ministry, and his professional experience as a counselor. Brumbaugh stresses compassion, a key tenet of Ashley’s program, in his Addictions Counseling (MCC 8020) course, and teaches motivational interviewing techniques as part of this new approach to treatment.

Nell Kelly, one of Brumbaugh’s former students, is completing a yearlong internship in the pain recovery program at Ashley. She’s making a mid-career change into the counseling field. “The community mental health counseling program at WilmU is phenomenal preparation for the field,” she says. “My internship makes book learning 3-D, and the book learning gives the internship a framework.”

Nell Kelly and David Brumbaugh
Nell Kelly and David Brumbaugh

A 2012 National Survey on Drug Use and Health reported grim statistics. More than 20 million Americans have a substance abuse problem. Nearly 44 million Americans have some form of mental illness. And 8.4 million Americans have both. According to a recent article in Counseling Today, a publication of the American Counseling Association, as the counseling field increasingly recognizes these co-occurring disorders, professionals have “largely abandoned the confrontational addiction therapy model previously used for decades and exchanged it for more collaborative and client-centered techniques.”

Help is Here (helpisherede.com), Delaware’s new website, seeks to spread the message to users, family or friends, teens and the larger community that prevention matters and recovery is possible. Words to live by. WU

 


WilmU’s Real World Curriculum

Programs at WilmU are also preparing students for careers in human services, nursing, education and law enforcement. Dr. Adrienne Bey, chair of the administration of human services graduate program, holds an international certification as a Co-Occurring Disorders Professional Diplomate. In the Administering Drug and Alcohol Programs course (AHS 7670), Bey teaches students about the trends and challenges of managing agencies that deal with this population. The course also discusses developing and implementing services, integrating treatment for co-occurring disorders, assessing clients and hiring qualified staff.

“A major current trend in the field is that many substance abuse treatment programs have gone from suggesting to requiring that mental health treatment be incorporated in the services for this population,” says Bey. “This was not the case as early as 10 years ago. The required reading for the course, which has been revised multiple times, ensures that students are abreast of the current state of substance abuse and co-occurring treatment. It shows how rapidly the trends are changing in this field.

The administration of justice program includes Addictions Studies (MAJ 6614) course in its criminal behavior concentration. The education counseling program offers Introduction to Drug/Alcohol Counseling (MEC 6600).

Students at the undergraduate level also have course options to help them understand the challenges of addiction. The nursing program covers the topic of addiction in two of its courses: Global Health Care (NUR 423) and Nurse as Caregiver: Chronic and Palliative Care (NUR 363). The Behavioral Science program offers five courses that in some way address addiction as a social problem, social policy and public health issue through the lens of culture and belief systems, and as a counseling and case management issue for those in the helping professions.  Students in the child advocacy studies certificate program explore the link between addiction and child maltreatment.

In Addictive Behaviors (PSY 483), adjunct instructors Jody Janetta and Stephanie Winfree, who both teach the undergraduate course, agree that students need a broad understanding of addiction beyond drugs and alcohol. Learning about addictive personality, social factors, family history and genetics are important generally to students’ overall self-awareness about addictions. In the course, students often discuss addictions in their families or self-disclose that they are in recovery and are drawn to working in the addictions field. Janetta and Winfree share their experiences and expertise. Winfree works as a psychotherapist at an adult outpatient mental health program and says that co-occurring disorders are more common than people think. Janetta, who worked for years as a psychotherapist in an alternative school, estimates that 85 percent of those juveniles were dealing with substance use and abuse issues. He invites guest speakers — including people in recovery — to his class to underscore the significant challenges to working in the addictions field.

“Students need to be prepared to lose clients and for people to die,” says Janetta, estimating that over the span of his career, he’s lost 40 students to overdoses, gang violence and suicide. “People need to be dually trained in mental health and addictions,” he says. “ A broad mental health background helps professionals to be effective in the addictions field.”

As for their students who are experiencing addictions in their families, Winfree and Janetta advise that there is more than one road to recovery. Families need to let the addict own the problem. WU