Addiction is an illness

Newell Normand
Monday, January 29th
We talk opioid addiction with Dr. Mark Talianich, Clinical Director of Counseling Solutions of Catholic Charities Archdiocese of New Orleans and Dan Foreman of Longbranch Healthcare.

Transcript - Not for consumer use. Robot overlords only. Will not be accurate.

We're going to be talking about a real difficult process and they were talking about and OPO Lloyd. Addiction crisis in this country. And another little. Indication that we're not perfect that we have challenges we have to deal with those challenges. You know where are really came home for me folks and join us in the studio is. Dan Foreman from long branch health care as well as mark tally and see which was a political director of counseling solutions for Catholic Charities archdiocese of New Orleans. But what really started to set this up for me it was several years back the Vermont governor. In his state of the state address. Talked all about OP or detection and heroin addicts. And that that was the hall that was the cornerstone of his speech was scoop about the challenges. Presenting to their community. At that point in time since then we had the president come out and say it's a national health crisis. Yesterday or the day before we're reported that 98 open your prescriptions for every 100 people in Louisiana. And though you know so the statistics keep racking up as it relates to this crisis but I wanted to talk about how we dealing with this crisis. Drug treatment whether it be the creation or drug treatment courts in the court system. The not for profit world the cut Catholic Charities and what they're doing the for profit world is as to. Long branch in what they're doing and working hand in glove with one another so welcome to the show. Thank you thank you so we became the talk about treatment this is not an easy. Path. It takes to support a family friends co worker and a whole lot of folks in order to use to beat back that addictive disorder. Definitely and it certainly also takes awareness of the problem in our communities. And that's the first step right there's not only the community awareness but the individual. Himself for herself that is about to. Cross the torrential into the treatment world that they come to grips with the fact that they have a problem exactly as well as family members and problems. Correct and and I think let's start by defining addiction in the way we look at the long branch. You know we follow the guidelines of the American society of addiction medicine. They're really the thought leaders nationally in addiction treatment. And the definition of addiction is that it's a primary chronic illness of the brain. If there is no salute there is no cure. But it is a highly treatable illness similar to any other chronic disease and requires a lifetime of management. And so the way we view it as something that requires a combination of medication assisted treatment along with traditional counseling. And so we look at it from multiple angles. But they're really as a solution and and yet the idea hopefully today is that will be able to educate. The community that can really there really is a solution for us. And you know a lot of times there at the the detractors of a lot of this wanna say oh there's no cure for their a lot of illnesses out that there's no cure for right for a tough let's put it in its. Proper perspective. Exactly knowing we don't we still treat other. Illnesses and diseases even if we don't have a care. And the treatments can definitely help with decreasing symptoms and help people increase their functionings. You know we we hear the horror stories. Of folks and it disruption of their lives their family and actually the ruining of their lives. And and then we hear the success stories from so many people that have successfully. Been able to maintain sobriety and stay off of whether it be alcohol or drugs and and how much meaning that is brought to their life and would always moves me about that. Is that how holistic it has to be in every aspect of their life. Of that constant reminder that. I have an issue. And I have to address it and it's not hour by hour at second by second of each and every day. That's correct it's it's something that goes on for a lifetime but. You know week we can deal with the symptoms of the illness the key is looking at the underlying causes of the illness and I think it's interesting to point out that. Most people who take appealing to their prescribed opiates by a physician who say they get there an injury of the shoulder to go to the doctor they get a prescription for opiates. Nine out of ten of those people. Will respond to the opiates the way they were intended to they will put the pain will go away. But get relief from the pain the sleep it off they go back to work the next day. One out of ten though when out of hand who have the disease of addiction actually get a different response to the opiates a light bulb goes off when their brain. And for the first time and we hear this all the time from patients for the first time in their lives they feel normal they feel like this is what normal supposed to feel. So when they finish their prescription. And the doctor says when you don't need the pain medication anymore. They say will be soon you're telling me that I am not able to feel normal anymore and that's where the cycle typically begins so. What we know about this on this because one in ten had this response to appeal way it's. We know that is that people are typically born with us on this there are environmental factors to it. But people are born with brain chemistry. Where there there chemicals in the brain are different from 90% of people. And that's who we treat it Margaret we really focus on treating those with the disease of addiction people who report that. People who exhibited early symptoms of addiction before they ever use their first substance. You know an infidel and and that's hard for folks to get their hands around that. Notion right and it's it's a difficult thing where when you say that your in this state of normalcy. When you when Euro on that that drug but it's the same with a lot of other treatments where they there's a drug that's used. Where you feel normal Wear for example you know when you take and diabetes medicine mean you've taken and you feel better you know you feel normally you don't have. Peripheral neuropathy or whatever it may be that presents as a side effect. That illness. And but we never really put it an act contacts. Of those other things because it it does have. And a nasty Condo. Overtone to it you know and and initiating but so to speak that we have to overcome as well. Well we learned in the 1980s that just say no doesn't work. There was gonna work go to work by now we keep hearing the same message over and over again in the community. People should just stop taking drugs you know to say no this is so they know will power issue will not that's true. We treated enough patients were treated hundreds and thousands of patients at this point and we understand that the vast majority of them. Don't have a will power issue is nothing to do book power to affect their brain chemistry is different than others. And they are self medicating. Using substances. And we can help them with that that there's there's a solution for that and to that's what we really specialize in doing. Think you'll play actually different roles in kind of this continuum of care. In mark let's start with you because you all really are more on the education side of this and breaking down the first barriers that we may have as relieved as it relates to. Providing addiction treatment. Rights of Catholic Charities are stars is in New Orleans is teaming up with. A ministry of the arch diocese the substance addiction ministry to provide community education. Over the next year so our goal is to increase awareness for what is OP or addiction. And diction signs and symptoms in general our first one's going to be in March at saint Dominic Catholic Church in lake view. And we're going to have speakers from the addiction treatment community in this area. As well as some clinical topics and and some education on the spiritual side of addiction as well so our goal really is to help. Individuals. And loved ones be able to more readily identify. The signs of addiction. You know what's interesting is that this education component important. It but it's not only important. It's important for another reason is that a lot of folks always think it or not my thing. Right this. Challenge presents itself amongst. All the Scioscia economic groups amongst all of the races it doesn't matter it does not discriminate. And you know week as a community as a whole face this challenge every day. Exactly and that is a pretty pervasive. Idea that it happens to other people. Yeah not to me not to my loved ones and really. Being able to understand. What to look for can help people kind of breakthrough that. Sooner and the sooner you're able to identify and intervene. The better off the individualists. You know I've I kind of stumbled through the words earlier but it's that stigma and that was the word I was looking for a stigma. That's out there that sometimes can be the greatest barrier of them ball. From moving from point a to point B in trying to get onto this road to recovery. Exactly and and we talked earlier about the disease model and how it really is. There are a lot of diseases that we have the can't necessarily be cured that are biological they don't carry the same kind of stigma and being able to view this. In that way. Can help to move people closer to treatment also which is the important part that sooner that we get treatment. The better we all are. And that is the important part because I mean when we think about it from the impact to the to the community. It does have some negative side effects so to speak in and now we have to deal with that we have to fund it and and everything else and we get it. That that doesn't necessarily mean that we. Continue to be insensitive. To. It and yeah we actually build long branch health care in response to stick my that was a big to big piece of it. And the reason why we wanted to open you know one of the big movements we've seen has been in the human resources communities and departments of organizations. And where it used to be when somebody tested positive for drug use he would immediately get fired. But HR departments are really becoming more savvy and understand now that this is a treatable illness there are opportunities out there for help. Where they can actually. Get help for their employees and it cost the organization less to treat than to terminate. That's a big movement we're seeing now among branch. Actually treats that the vast majority of people we treat our professionals. Who are employed you have two cars in the rush to their families who have lost everything yet. As a result of personas. So when we talk about the art treatment worry you know in this not for profit the Catholic Charities approach has been. About providing the information the education necessary in order to kind of break down those barriers and and that dovetails into the actual treatment side and in. On a for profit side there are any number of providers right there you are going to be one correct that I'm familiar with and and there are others in and and then the challenge there is always been financing of the care and and the challenges been whether or not it's going to be government sponsored or. You know private paying a lot of times the private commercial has a cap. So you know all a lot of the providers have been trying to provide this the cheapest. Way that they can go about doing on that bridge yet at the same time be in effect. Yeah unfortunately there's a major disparity. And care for those who have financial resources vs those who don't have financial resources. How long branch healthcare is a facility designed for people with resources who want the very best in innovation and care than includes. Medical intervention and then in psychotherapy and counseling and Tai chi and you have so many wonderful things that we can offer because our patients are willing to pay for that now. That being said. We also our goal is to raise the bottom for patience. On the reason why there are people who can afford to pay for quality care is because we're meeting them before they're losing everything and this is a real trend that we're seeing. It used to be that somebody would have to lose everything as a result of this illness to get better people used to say someone had to pick hit that bottom you know we've all heard the statement. If they hit a bottom to get better he just has in his body just doesn't want it. Well we realize that our job is to meet patients where they are and to know that it's our job to raise the bottom for them so that they don't have to leaves everything. And I think that's important you know because. If you're going to get back onto the road to success and a road to recovery so there are the only road to recovery and hopefully be successful excuse me. You can't have lost. Everything so this sooner that you get in this sooner that you have the recognition issue is Markey pointed out more education. Hopefully it helps with that in minimizing the stigma. That's their recognizing that there's a problem and also realized in that you need to get. Treatment and get get you all on that removed. Before. The devastating effects to family in and do your job and and everything else employers have a lot of cost that's tied up there as well. You know I think that's important meaning in in that and then I guess. Part of the problem that I've always have from a government side is ineffective got to Texas says men and ironic sheriff did. That you have these two guys on and you've been. Putting people in jail. Port well it's against what the activity itself is against the law mean I don't get to pick and choose what laws I want to enforce. But I also recognize that it was all about the treatments that we did you know did you drug treatment courts and we actually funded a social detox facility and a super for a number of years because we arrested people that were crying out for help they just had no place to go. So the resource is generally. We're DLC is the state of the treatment. World right now and weigh in and is it healthy is it not help the obviously there's not enough and what can we took what can we expect to see change in the near future due to difference. But we are seeing a growth in as far as the number of people out there who are offering services the key is finding people who really understand this illness. For a lot of people who wanna treat addiction. I'm rich is a ten million dollar investment in abuse springs and in Metairie. And we've got the best resources we've brokered people from hazel than we brought so many people to our community. And we have really seen as over the first comprehensive addiction treatment program in New Orleans. And that's stunning to think that were the first to offer multiple levels of care in the city of New Orleans. For a long time people had to leave New Orleans to get better the other we're just very few options even people with Medicaid usually one or two options and there's a long wait list again. Yeah I mean I think 25 years ago was the Betty Ford clinic right Fran Allen and that was kind of the big name obviously. At the time and it's kind of grown since then but it did. It hasn't reached all of the communities. It and there were a number on the West Coast and number name you know on the East Coast but not really here. And obviously we've had as big a challenge here is anywhere else is Eric constant theme oval of what is the biggest challenge in dealing. Absolutely so we hear it pretty much across the board from patients on opiates their biggest fear about treatment first of all is withdrawal. They're constantly worried about withdrawal people finding out there and withdrawal feeling that pain feeling that discomfort that comes along with. Opiate withdrawal and and why we feel that pain there's a lot of reasons for but the main reason is because our brains are telling us. To take more pills to take more heroin whatever it is that we're using our brains are constantly telling us to use of their creating physical pain symptoms in our bodies. In order to get us two years and and at a holds true in the world that I locals were absolutely. But the great thing is that there're some medications available now on that can really help with withdrawal symptoms. In fact we have a lot of p.s two command and we're able to treat them medically. In addition to the counseling. Where they experienced very little discomfort they can continue to work. Go to school do all the things that they normally doing and people around them don't need to know which actually really impact the stigma as well they have to worry about people finding out what's what's going on. And in what is the biggest challenge that you see through this education component mark that that that for you guys to overcome. A big part of it is simply people don't know. People don't know what to look for and and people don't realize that. How easy it is and we talked earlier about how many opiates are prescribed to individuals and a lot of people don't. Finish those prescriptions. And so. There really easily obtainable. And parents or grandparents. Medicine cabinets. And so it it is and always even necessarily the person who is prescribe the opiates that. Are taking them because they might take a few forget about them and then there's a Coke bottle. In the medicine cabinet that's readily available and so these are things that people just don't think about. You know it up found it interesting. And even as long as I was in law enforcement. And I read this article. About the ninety day prescriptions for every 100 people. Louisiana Louisiana think it is. If this were in fifth place for the most. Per capita word you know the is. Even as good a job as we're doing with the registry. The prescriptions that were given to people. In this state. That we still are having this many numbers and there really hasn't statistically made a real significant dent. Well and what replace it. We have a registry and and good doctors will use that registry to attack but it. The registry requires physicians to use it Bryant doesn't use itself so that's the big issue we see is that people sorry check yet. You know without the information is out there affect. Quite frankly we've had pharmacist catch it before physicians catch it will get calls from pharmacist saying are you sure this is correct and have you look at this record and the answer is yes but. It's the pharmacist and that community is really becoming aware of the record. Now because they see the repeats and they see that the the pattern obviously. It common for multiple positions. Especially those that are used in the registry right correct. So when we. If you predict if you you know in a nutshell give best advice that you got a family out there that has a suspicion. What is it that they should do. They can certainly call professional. In over education educating yourself. Is really important here and one of resource is that is available to everybody across the state. Is that the united way 211. Resource number and they can locate. Professionals that can at least have a meeting and help educate them. To what to look for and how to cope with the parted deal. An approach that individual because how you approach the situation can make a big difference and how that person's career. Yeah and sometimes that first. Sets a course that. May be a very positive one or could be a very negative exact frame. And and I've been working. The patient's treatment and and markets as well from the decade now and in seeing the patterns change over the years has been very interesting used to be that it was mostly families who call for help that was usually the female head of household though the white further. The mother calling about the concerns but now with our crisis that we're dealing with right now Ethiopia where it's. We find is mostly patients calling us directly people calling us asking for help. And so there's been a major shift over the years and that. And so my encouragement to people who are listening to this and who are struggling and who are concerned. Is don't wait pick up the phone and ask for help whether it's long branch or Catholic Charities or someone else. Don't wait just just that's for helping it's really our role once we get the call to take it from there. We got a number of questions. On attacks the people wanting to know. About you know his medical oh pure treatment covered by Medicaid in and the Affordable Care Act policies that or a result thereof. Yet so there are very few resources and fortunately for for Medicaid patients. The affordable care policies as long it's just become a commercial the backed policy like a blue cross blue shield policy typically do. Have coverage unfortunately their very few providers who accepted. There are couple of providers in town you offer very low cost treatment. And in general Medicaid and the Obama your policies will. Pay for the medication prescribed so typically the cost of the patients the out of pocket cost to see the position. So when I asked would. You know earlier for the state of those the state of treatment as a relates to these this drug addiction and we know. That we're doing a much better job of having it defined as an illness because. On operating Mazda opinion poll should addiction be treated like a medical conditions 70% of the respondents are saying yes and I see that and I read polls all the time and is an issue and vast majority of Americans are there. But it seems as though the financing is this is not there. Well part of the issues that. Addiction Knology which is a sub specialty under psychiatry but really any physician can get an addiction I'll do background. The they're so few of them in the state of Louisiana. And so. And also there are limited to by the federal government to the number of prescriptions that are able to write for appeal it withdrawal. Which means that you're a limited number physicians who were trained in this in addition to the fact the federal government governments limiting the number of prescriptions. They can write which means the cost to hire one of these physicians by it a treat the company. Is very high because you're so fuel. And so everybody vitamin a vitamin Medicaid reimbursement or just they just don't cover this to step they may. Cover some of the cost of their very few organizations who will actually accept Medicaid as a reimbursements don't cover the cost of the positions so. We're looking at a number of years before this side of the equation. Catches absolutely. But again there are alternatives there are some organizations in town who typically charge or 200 dollars a month. To see a position to get counseling and get a prescription. At that point. Medication should be covered by some of the Mexico and mark is that we're we're gonna see the role of the not for profit world literally cut back filling in the future and getting involved on that side. We certainly hope so it's. It's something that is necessary. And it is going to be a little while before and insurance companies and reimbursements. Catch up with where this field is in terms of treatment. So would almost be fair to say then. That the addiction we're in crisis. And treatment. We're in kind of a crisis as well because we're we're not matching up and you know if we and this is something that we really. Need to focus on. In all aspects where there be the private sector the public sector. Legislatively. And everything else we need to have that perfect storm of everybody's efforts coming together in order to really deal with this so that in the short term this. Problem doesn't exacerbate itself. If no I I agree immunized I think that unfortunately is only so much funding to go around and this just hasn't taken a priority and there's a lot of lip service to a mean Donald Trump for president to declare this a national crisis. Has declared the crisis but one as a result of that declaration. You know and I heard him declared or some declared a Twitter what does that really mean. Right on and so we're at this point now where the there's a lot of people waiting to see. How do we fund more patients how we treat more patients who meet us. Well I think unfortunately right now we're caught in this Obama care. And inertia. In this country about where it what our next step is going to be a long wanna talk to Susan Metairie. What say you Susan. A that I if you we. Was Japan in Massachusetts. It says there is that concerns professional. Chemistry is someone for a windows but they Leah. They can have been committed for Knight and day hot it's with pat on the back side mount harbored. Medical though it has tons of information about but. I just had a relative who. On Saturday. Heatley that it through my they. And it marriage if you are indicating and our time. Letting you know he went back and confidence in died. In this is the kind of thing that we have to. Absolutely distort the tragic stories or one on top of one another Susan thank you so much for Cullen and I was not aware of that a lot to do you know I didn't know about the law about what I have heard about the narc Hannity and locks on the injections at the ambulance drivers are using now and schools are using an. And public officials are using. When when patients are revived with that nine out of ten end up dying anyway in the long term because they relapse in the news again. So with that that really reinforces the importance of treatment. In addition and an active season with like medically but he's patients need treatment. Yeah I mean that's something it's administered obviously and in the heat of a medical crisis and it's not a solution. Obviously. It's also. It's really difficult with the way the laws are currently where commitments. Because he's getting somebody you know is in danger because of substance abuse into. An involuntary. Commitment and hospital. Is nearly impossible. And unless you have evidence that they are immediately endanger absolutely. Well gentlemen thanks so much for spending time with us today you know we're gonna continue to talk about the subject matter as it continues to be. A crisis and we know that there's a significant weight list of folks getting in. To these. Recovery centers and so forth and getting treatment and we know that it continues to be accrue a crisis not only on the addiction side but on the treatment side as well so thank you both of them taking time out of your day today with us I think here.