Podcast Episode 1: Addiction and Substance Use Disorder

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PODCAST Episode 1: Addiction and Substance Use Disorder with Greg Powers

Clinical Director Greg Powers and host Noelle Carmen discuss the topic of addiction and substance use disorder, along with levels of care and dual diagnosis treatment.

Today we are going to delve into the difficult topic of addiction and substance use disorder. I’m Noelle Karmen, and with me today is the clinical director for Discovery Point Retreat. Greg Powers. Greg, welcome to the show.

Thank you.

So before we move into our conversation about substance use disorder, I just want to mention to our audience, if you already know you or someone dear to you is living with addiction – be it alcohol, prescription meds or any other narcotics – please don’t hesitate to call right now to ask questions and get answers. The number is 855-306-8054. OK. So now to the conversation. Greg, you serve as clinical director for Discovery Point Retreat, both in Waxahachie and in Dallas. And a lot of people are familiar with the term rehab, but don’t necessarily understand what the full continuum of treatment looks like. Can you kind of talk us through that?

Sure. So rehab is a combination of a lot of different programs. Initially, when somebody comes into rehab, they’re typically starting with a detox level of care. When somebody is currently drinking or using and needs to come off of substances, that’s actually medical.

When they initially start, they’re going to come through detox. They’re going to be seen by a physician. They’re going to be monitored by nursing staff. And we’re going to start talking about what it looks like for recovery.

So let me stop you here and ask. Because in detox, there are certain things that you detox off that actually pose a life threat. There is a life-threatening issue there versus things that you’re detoxing off of that you could detox at home. Talk us through what some of that looks like as well.

Sure. So one of the biggest dangers or substances that’s dangerous to come off of is alcohol. People will have seizures and can die from withdrawal from alcohol. So that’s one of those that’s not something that you want to do at home. So, you know, a lot of people think, OK, well, I can put the bottle down, I can stop drinking and I’ll just stop.

If you’ve been drinking for a significant amount of time and you notice that when you don’t drink, you start having shakes or you’re starting to sweat a lot or have shakes and stuff. Those are the individuals that we’re most concerned about and want to make sure that you do a medical detox, that you’re being monitored both a physician and nursing staff throughout that process just to make sure that you’re staying safe.

That is actually maybe a new bit of information for some of our listeners. So do you find that in the community in general, people think that they can just detox on their own?

Right. A lot of people feel that, you know, I can stop it any time. I can just put the bottle down. I can just stop doing the drugs, the opiates or whatever. It was easy enough to start. Obviously, I can just stop at any time. That’s not always the case. A lot of people find that when they’ve been drinking for a period of time, putting that bottle down becomes more and more difficult the longer they’ve been doing that.

So it’s not as easy as just saying I want to stop. And that’s why places like Discovery Point exist because it does take that structured environment, that assistance throughout that whole process to walk you through it, to stay clean and sober.

So in talking about this whole continuum of care, you have the detox portion. But then what happens after that? So how long does detox take?

Typical detox is somewhere between seven to 10 days. Really just depends on the severity of the detox.

If you’re coming off multiple substances, it may take a little bit longer. Once you finish with detox, then we’re done. Then we start looking at what’s the next step? And that would be moving into a residential type level of care.

In terms of residential treatment, how does that look as a patient? What are a client’s needs coming out of detox?

Right. So a client who comes into a residential level of care, that’s really the point the substances are out of their system and they’re trying to figure out, OK, how do I do life without it?

So that’s like when reality sets in and possibly even where you’re starting to see some of the dual diagnosis issues that come about.

Absolutely. Can you talk us through what that might look like?

Sure.

So somebody with a dual diagnosis is somebody with a substance abuse problem as well as maybe a mental health problem. A lot of times what we find are people who may be suffering from, say, depression or anxiety and substance abuse. They’re substituting medication with drugs and alcohol. And so they’ll self-medicate. You’ll hear that term a lot of times if they just self-medicating.

So when you take away that medication, those substances, the depression, the anxiety, the post-traumatic stress, things like that start coming up. And clients have to start to deal with that stuff.

And that becomes very scary. So in residential, you are working with clients and helping them really focus on what may be the root of those problems. We’re trying to figure out, you know, are there other alternatives, obviously healthier alternatives than turning to alcohol or drugs.

And so once we started peeling away those layers, it’s kind of like an onion – you’ll hear that reference a lot of times that this is like an onion – and we’re just kind of peeling away at this stuff. We get to the core of what the problem is and really start working on coping skills and opportunities to really address maybe that trauma that happened as a child or even just recently. And that maybe was the catalyst to start using, you know, in the last few years.

So what it sounds like is Discovery Point Retreat, in the way that your clinical program works is not only are you addressing the underlying trauma, but then also filling in the gaps with actual life skills.

Correct. So, you know, one of the things that we do are some kind of weekend retreats, if you will. We call them life skills and life events. What we do is go to simple things like maybe going to a baseball game. You know, a lot of people when they go to sporting events, the first thing they’re doing is going to concession, they’re grabbing their beer before they go sit down. So we try to help them understand that you can go to a baseball game or a football game and you don’t have to go to the bar. You don’t have to drink that beer. It’s fine to drink a Diet Coke and still have a hot dog and still experience that. Same thing with going to movies or going bowling.

A lot of our clients, that’s just how they socialize. That was how they became more comfortable in those social events, by using a substance. We try to teach them, you don’t have to do that. You can still be you and still go and have fun and do these events that everybody else is doing too.

So the whole beautiful point of this, and I wanted to ask you how you addressed this, even as clients are coming into the program, is on the other side there is life, there is hope, there is a way to operate without substance use. In terms of coming out of residential and moving into outpatient, that’s kind of the plan and the goal. So how do you see a client to the end and really create that support system on the other side?

There are a couple of processes that we go through. We kind of look at residential like we’re building the foundation of the house, right? Then it’s giving you the skills that you need to go outside. That would be the outpatient type programs. People hear the term IOP and that stands for intensive outpatient and then just a regular OP or outpatient.

So at an intensive outpatient program, you would still be coming to groups and doing individual sessions, but maybe you’re not doing it in a residential type-setting. Maybe now you’re going home and a lot of people are like, ‘oh my gosh, that’s really scary’ because you’ve kind of been in that bubble when you’ve been in detox in residential and now you’re going back to that environment. Sometimes that environment means that you’re going back to somebody who is still in their addiction or, you know, you’re still dealing with the stress of family and kids and work and school. Well, an IOP program allows you to start getting back into those routines, but then still coming back, talking to your counselor, talking to your peers, going to group sessions and going, ‘wow, you know what? Last night, my kid came home, had, you know, three hours of homework and it really stressed me out. And typically, I would go and drink or I would go take a pill and make it better. I don’t want to do that anymore.’ So coming to IOP and talking to your peers and talking to your counselor allows you to still talk about those things. Talk about what it is that you’re using for a coping skill and not going back to the old habits.

Once you finish with IOP, then you’re then you’re going into the OP program or an outpatient program. That’s probably more where people are used to, as far as counseling. You’re going to schedule with a counselor probably once a week, maybe every other week. And you’re doing check-ins and you’re just going, you know what? ‘Life is really good. And I’m doing X, Y and Z’ or ‘you know what? I’m struggling in this area. I didn’t know that my wife and I were having problems before I went into rehab. But now that stuff is coming out and my gosh, what do I do?’ That gives us that opportunity in outpatient to kind of continue to work through that. Outpatient is like ongoing maintenance.

Gotcha. There’s one other wonderful thing that Discovery Point offers, and that’s Tele-OP and that is really– especially now in light of COVID-19– just offering counseling, offering groups, but doing it online. Can you talk to us a little bit about that?

Sure. So, you know, that’s kind of been in the background a little bit, building up. A lot of people have been talking about the computer aspect and being able to do therapy via computer or phone. And the industry has kind of been slow to get to this. And now with COVID, it’s kind of like everything’s coming to the forefront. One of the programs that we have is our Tele-OP program. That really is a smart approach that we’re taking to outpatient programming. We work with the clients to make sure that they can set up on their computer. They have a webcam and we do everything virtually so you can be sitting at your dining room table, you can dial in to your therapist who may be doing a group with other individuals who are doing Tele-OP, or may just be your individual session is going to be them via the computer or your smartphone.

It’s a lovely option, and right now since we have the whole social isolating and that kind of stuff, it’s becoming more and more of an important aspect of this. As this whole process with COVID-19 evolves people are getting scared and concerned and they don’t necessarily feel comfortable going to their therapist and they’re not wanting to go and be around other people, and that’s understandable. This still gives them that opportunity to continue their treatment and have that support that they need.

Greg Powers, I want to thank you for coming on the show and talking about the fact that you can discover a new you through recovery at Discovery Point Retreat. Thank you for discussing this difficult topic to process. I definitely invite you to come back. We’ve only barely scratched the surface. Any final thoughts in terms of if somebody is listening, if they’re struggling? What kind of message would you like to get out there?

You know, my biggest message that I would have for anybody who is struggling or they have a loved one who has been dealing with this is don’t feel like you’re alone. You’re not, and there are people out there to help. We certainly want to be that catalyst and that support for you. If you have questions or concerns or you feel like a loved one needs help, please give us a call. The number is 855-306-8054.

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