hi everybody i'm ed baker and it's my pleasure today to welcome you to ark or the addiction recovery channel arc is a channel that's been created for people with subs disorder this channel is devoted to bringing you accurate information vetted accurate current information that pertains to  disease of addiction recovery and treatment it's a channel for anybody who cares about this for anybody who have may have someone in their family with subsidies disorder  alcohol counselors drug counselors social workers medical for riders anybody who wants to really learn accurately about what this disease is all about what we can do about this it's my it's my  live example of hundreds of people walking on church street showing in a very public manner that recovery works that people with addiction recovery recover services and the support of the public in general so i would call your attention to that it was a very very festive day in all those lines i want to introduce my guests today my guest today is jason is the regional director for bart he's been active in this field for over twenty years he serves on boards he's a community member and in his own words he's very interested in just information the f d a recently has released some research findings and the research findings are showing that people who receive what's known as m eight medication assisted treatment for opioid use disorder in other words they receive a medication either viewpoint often or methadone that they're there they cut the death rate their death rate by fifty percent death by all causes is fifty percent less with people who are on medication assisted treatment and i guess my question to you jason is with that kind of information about medication assisted treatment that the death rate for that particular population was with opioid use disorder is cut by fifty percent how is it that the degree of stigma against this population in our in our culture persists i think i think it's a great question and i mean the research is clear that is what we consistently works there are other alternatives absolutely and i'm sure we're going to get into that a little bit more  stigma is the hardest thing for our patient and people in employers as well that work in this field and what i mean by that is people are judged for something that has happened to them this this is this disease it has no barriers it can affect anybody at any time in any place no one usually just wakes up in the morning and says to myself i was going to use heroin it doesn't start that way and you know most of the time in this day and age it starts with prescription pills so what i've been doing a big purpose of what i've been doing is trying to educate the communities trying to educate our patients people that we work with about reducing this stigma i think it's because it's more too but what that means is it takes time you know you look at a person who's battling alcoholism and i think the average person might relapse six or seven times throughout their life the same is true for opioid disorder as well so it takes time and we work with them and again it's a harm reduction model we don't expect and we don't see abstinence overnight it doesn't happen that way but it does happen and we've seen success after success with people that follow our guidelines that we put in front of them stigma is the biggest thing i think it's getting so much better and from obviously i've been making in communities and our community presentations where we've had lots of resistance more recently within the last year i've been going in doing these presentations and we get a lot more praise and people that support us there are still people out there that have questions and challenges but that's great that's the way we get better so i think it we need more people that have  lker this disease to stand up be proud again no barriers mailman school teacher nurse your sister your brother the person that most your lot it can affect anybody at any time that's a  great response yes and it opens up to so many areas that we can we can move in we had this discussion be before we began the show about this just so much information to cover i mean what one of the interesting things that you're mentioning is this idea of relapse or recurrence of use that sometimes people will be deeply powerfully motivated to abstain from psychoactive chemicals it's what they want to do most in life but because the brain has been impaired through the course of the disease they're actually incapable of continuing to abstain when they're put in certain situations maybe they'll see the drug that they used to take maybe someone will call them and want to sell them the drug it could be a very innocent occurrence but that that that that trigger we call it or that cue sets a process off in the person's brain where they're motivated to reengage with that drug and the part of the brain that makes decisions that inhibits impulses is so impaired that against their own will they'll actually have a  recurrence in that self administration on that drug now when you mention alcohol and you mention someone what we call relapsing five or six times that's one case but when we're we get the patient in we have them assessed we ask them a plethora of questions how long they've been using what they've been using for and the research shows that every year a person abuses opiates it takes the brain a year to recover so some people it's going to take longer than others again harm reduction model with we do individualise the truth of the treatment but then it comes down to the counselor and doing therapy so we get them the doctor makes  determination of what kind of medication they're on and then the therapist or the council works with them on a weekly basis a monthly basis again it's case by case some people want to be seen every day some people want to be seen once a month and that's ok it will work around that with them but we want to educate them we want to give them and help them develop coping skills things they can use so when these urges when these opportunities come to them they're able to say that's ok i'm not interested i'm doing ok just fine without that support someone they can call and then we're really starting to look at once we get them stable a little bit they're not actively using or actively trying to use we want to dive into the trauma  what happened why did you start this was it a broken leg and you were given prescription pills and that's what led you down this path was it you were raised this way and you didn't know anything you didn't you didn't you didn't know any  better we see that a lot it's very generational of that if that's the right word but we see families entire flix going through this and so we try to really get at that the root of it what's causing you to do this and then given those skills so when then when they says this when they successfully complete m eighty they're able to go out there and do this on the road but we're always there from regardless if they need that support you know again it's a great response and it just opens up a whole other bunch of avenues but there's this idea of the brain healing this is proven time and time again and research the length of stay the person needs to be in treatment for for a good long while different stages of treatment like you say acute when the conditions are acute they may need medication they mean hospitalization there could be residential treatment where you need to be in a protected environment we're not going to be exposed to q is our neighbors or people with whatever drug you may be tempted to take outpatient therapy you know for weeks sometimes for years nutritional therapy different types of recovery supports in vermont now one of the things that i'm most proud of as a reminder is the network of recovery centers that we have in vermont it's great seven days a week you know meetings in support recovery support services welfare all the time for people whose brains are suffering from impairments who need easy access to support when they're feeling weakened or when they're feeling tempted i do think the general public really understands that and i think this is speaks to one of the sources of stigma that some of the belief in the general public is that addiction is is a choice like causality it's caused by people's choice or the perpetuation of substance use is a choice and in other words people have controllability they can stop when they want but they don't because they just don't want to stop when people believe that then there was sponsor is likely to be punitive but when people see this as a disease their response is more likely to be compassionate can you speak about that a little bit about causality about controllability and your particular patients people with substance use disorder did they choose to develop addiction do they choose to to to to not be in control i think with addiction in general no one ever chooses addiction regardless of what the substance maybe no one chooses that path they might be led down that path before they know what they are addicted with are with a lot of our patients that we see addiction has become something they've either learned or known or something that has come through prescription  and told that these medications are addicting you can't just stop opiate use you can try but the do it medically safe you should be monitored by a doctor or have some interaction them what i mean by that is when you stop using opiates that you've been using consistently for a long time you're going to have withdrawal symptoms like no other people literally describe it as their their skin feel it feels like it's burning or it's literally crawling and moving around on their body aches they sweat their noxious they can't sleep they don't eat they have no appetite these things go on for days and days so to do it safely and to be monitored is the recommendation that i would have and again there's different kinds of treatment and there are different paths to recovery and my answer always is if you don't agree with them eighty that's ok don't block a path of a patient or something that seeking help you know maybe someone just needs therapy with some maybe some medication from a doctor maybe somebody accu detox is a big one now where we're starting to do bring that phone home and say this is what i did a lot of them end up giving it to other patients i don't care what it is whatever works for you were willing to give it a try go down that path you know don't be afraid to fail let yourself  fail pick yourself out and fail the way you would want to fail and then try again because without failure what is what is success anyways i tell our patients i tell a staff the people that i come in contact with you don't have to be fearless of recovery just don't let fear stop you because it takes lots of attempts i always say to someone if you don't know someone that's battling over your use use disorder you will unfortunately we live in a small state we have small communities but we have big hearts so we do we help when we can and we view whatever direction that is that's ok as long as you're getting help for you and i do not think that it's peculiar to vermont but compassion occurring in vermont right now for this particular population and it is wonderful to be a part of it your point about being resilient about not giving up about continuing to try i think is is invaluable because people people with this particular disease become angry with themselves self hate self lo you know the dispair this is why they need like strength and acceptance and compassion from us the hardest thing for anybody the do that's battling this disease is to pick up that phone or walk through that door for that first time and ask for help it's the hardest thing i and that's why it's great that her mom is heading towards a small issue where there right now we're treatment on demand you know there were times where people used to call and they would get put on a waiting list that doesn't exist right now in vermont which is great kudos to vermont you know the hub and spoke model that was created for a lot is being nationally recognized california is adopting our model for many of its counties you know other states are looking at us as well  i go to i go to conferences and things all around the united states and as i go into the conferences and a lot of times up to five ten minutes out i kind of walk out scratching my head and saying we're really is the forefront we are on the front questions but the one thing that i think we really need to do is continue to educate educate our youth we are seeing inning in increase a big increase of people coming in with opioid use disorder at a very young age a very young age late teens early twenty's and they've already been using for years so the more education we can do which is happening i'm hearing some great things in the school system some wonderful things are happening up in the north country of vermont which is very exciting but keep doing more i couldn't be more more with you with that that over the next few generations we will we will do or the next few cans of years if this is going to take a while to deal with we have one population that has addiction those people would need treatment adequate treatment medical psychotherapeutic and recovery supports and we have another population that's that's coming up we have children we have to look at them differently we have to really develop educational inputs that are age appropriate and let kids know throughout their lifespan you know what's dangerous what's not dangerous different types of or a refusal skills one of the i think the promising areas of research right now is childhood resiliency childhood stress resilience  how to get in there with a kid and help their brain to develop in a way that is likely to not respond in this functional ways to exposure to stress this is extremely important it's also it's going to be expensive for our society but i think i think what we've seen i think what we've finally seen is that there's an absolute need to take care of the health of our population in ways that we have never done before hopefully this is the tipping point for our culture now you know i would i would certainly i would want to think that you would be coming back on the show harm reduction sure what is meant by harm reduction because i think again that's an area where the general public really doesn't the stand what that means is that so hard reduction is how we look at as we individual lies our treatment for our patients so we have a patient that comes in that's been using opiates let's say heroin maybe eight bags of heroin every day for the last ten years or our goal right now is to get them off that heroin and get them  that's what that's all to mco but it takes time so maybe in two months they're not testing they're still testing positive maybe for heroin but they're not using as much we really encourage our patients to be open and honest with our counselors so we can adjust one the levels of the medication methadone to buprenorphine a very similar and how it works is we have to find that right level where you're not craving to go get more of these opioids you're not withdrawing you're able to sleep at night you're able to work and have a sustainable life so the harm reduction is we have to get there let's get there and it's different for everybody some people maybe after three months maybe after three weeks we'll have know a licit drugs in their system some people might take longer but people always ask me how long someone have to be in an m eighty program or on methadone or buprenorphine it's different for everybody and it should be that should never change it should be individualized now i will tell you this if i get a gentleman it's fifty five years old that walks in my clinic has been living on the street has no families has no doctor because he's burned all those bridges and in a year or eighteen months has a job has a roof over his has feeding themself taking care of his bills looks physically healthy that might be as good as it gets for him which is great  that's when we take that next step and say ok let's stick reese your medication let's start a taper plant and we slowly reduce that we monitor very closely because we don't want those cravings to come back if we start reducing the levels of methadone or  that they're getting and they say to us i didn't sleep last night i got the shakes whatever the case may be we might hold it right there let's hold it right there for a little while see how you feel in a couple of weeks of them will try again so it seems like in a very non judgmental way and a very very medically based way you join the patient where the patient is right and you begin to reduce the harm right that the patients use is doing to them right you know look for like an abrupt cure or because science tells us out there the way the brain is organized in the way the drug affects the brain that is not going to be a quick cure right so you get in there and help the person to reduce the harm that they're causing to themselves and getting ninety eight ninety nine percent of them back which i think is great because when a person is battling addiction and they want to use it they we'll have a clean needle they're going to use whatever they can find so we're talking about ants we're talking about have a type of seeing a sees a big one right we're talking about a life threatening disease and he might as well harm reduction harm reduction is not all about the medication i have to make that very clear the medication will help us get them stable so they don't have those cravings for those withdrawals but then it's about the counseling giving them the skills to succeed outside of our doors and in society every day so when something does happen an opportunity or they feel like they're going to relapse they know who to call they know what to say and the sooner or later they it gets engraved in there and they can rely on themselves to be strong a be a support and go to the recovery centers that's right best thing that's happened in vermont in the last couple of years is that many great things of have of the treatment but have been journey to recovery up in newport that was one area that didn't have one nice and it's wonderful to have every county need most is hope and where they get hope is from outside themselves as from you it's from me and from margaret from channel seven teens from recovery walks medical doctors education exposure that there's a possibility that they can get better on the just a short vignette on the requiring the recovery walk on on saturday they did a call for a length of recovery so i've been in recovery for a long time and  you know so i was up there on the call for a cover and we went through ten years five years four years down to months and it struck me that the last person in the crowd was at the opposite pole from me was a gentleman was a my my senior by by a few years and he was in recovery for for seven months and i thought to myself wow you know what what i have in common with him w share one hundred percent is hope i have hope for myself he has hope he is he is his borrowing from my hope that is an ageless miss for hope when when i walked on the walk i had my my walk buddy we just kind of you know accidentally kind of joined forces myself and this young man he was maybe twenty five twenty six years old and we told each other our stories and he found hope in his first minutes emerging from a coma and the coma was caused by a lethal  concoction of pharmaceutical pills that he had found on the internet and that he had taken intentionally in and attempt to kill himself because of despair and here he is walking next to me seven months in recovery going to a meeting every day talking the talk using a language full of hope and that is what it's about we were reverberating with the general public about this hope for recovery and  i see that in you i mean i've always admired you i would have admired the programs that you've created in vermont and i was telling jason before the show that one of his treatment centers  specifically in st john's very is on hospital hospital drive and beautiful state of the art facility big beautiful parking lot beautiful waiting room counseling offices for people receiving medication assisted treatment this was not always the case these people were kept in the shadows even though they were saving treatment they suffered a double stigma the stigma of first having addiction to opioids and then the additional statement of needing medication to get better this is what's changing in our culture today because of people like jason and thousands of other people and vermont that are dedicated to doing something about this i would agree ed you know and i know we got to wrap up but i hope you're right we can't give up hope when we have to we have to remember that every single day  these are human beings they are people just like you and i we all make mistakes we all battle some form of addiction whether it is you need to have your coffee every day you need to bite your nails you need to have that cigarette got to have it for you know it or go to work or whatever the case may be sooner or later you wake up in with the help and support of others hopefully you'll beat these addictions opiates a stronger one it's a deadly one but you can't give up hope and you have to work with the patient meet them where they're at help educate them and support them through this and they will they will get through it along those lines i hope you'll come back and join me again i think said absolutely i