[Music] good evening and welcome to this special mental health edition of doctors on call i'm mary morehouse a psychotherapist with insight counseling of duluth and i will be your host for our program tonight on addictions alcohol and drug abuse this is our final mental health episode during this season of doctors on call our program is here to answer your questions about mental health issues that may affect your family or friends please call or email your questions and we will do our best to address them the telephone numbers and email address can be found at the bottom of your screen our expert guests this evening are tanya bednarek a licensed alcohol and drug counselor with the human development center in duluth and jenny rehnquist is a licensed alcohol and drug counselor and the administrator of care in carleton minnesota our phone and email questions are being received this evening by members of the wdse staff who will bring them to me here in the studio now let's begin with a discussion of addictions alcohol and drug abuse thank you both for being here tonight it's great to see you thank you so i'd like to just um start out with just getting a little bit of a background of your of uh in your field so tanya if you could start just give me a little bit of background in your field of addiction yeah um addiction touches my life personally but i've been in the field for four years okay so it's a real passion of mine okay that's great jenny so i have been in the field for about 12 years i started out at a local hospital doing consultations primarily on the inpatient adult psychiatric unit but also throughout the whole medical hospital and for the past three years now i've been site administrator at care carlton which is a state of minnesota treatment facility for women okay great thank you so much um i think a good place to start is really what is the definition of addiction so can you can you give us your definition or the the definition that your agency uses for addiction yeah so um the definition the definition of addiction for um us it's kind of broad it's it rediction affects people in multiple different areas for the program or the group that i'm leading the women's group dr stephanie steffington covington she has a definition that is that that says addiction for women is the chronic neglect of self for some someone else or something else so that one i really resonate with because i work with women okay great and what would your uh definition of of addiction be well the one one thing the first thing is that it's treatable so it's a treatable it's a chronic problem and some people say it's a chronic disease some people don't really resonate with that idea as much but it's a chronic issue nonetheless and when it crosses over into addiction it um it's a compulsion and it's operating in a part of the brain that doesn't think okay so it's not a logic based thing it's you can't outsmart this thing and it compels somebody to do behaviors despite negative consequences so you're losing your family your husband wife might leave you you might lose your job you have embarrassment humiliation that kind of stuff and you still are choosing to engage in that behavior use that substance okay okay and also it's very complex it affects neural circuitry neural pathways and there's an interplay of life experiences genetics environmental factors just very complex okay and very often people it's stemming from trauma there's a trauma history okay okay great and just to to note that we're talking specifically about drug and alcohol addictions tonight we know that there are a lot of other addictions out there um but tonight if we can get the questions just for the alcohol and drug um for for our listeners um so we've all been dealing with covid for the last two years how has covet affected um the way that you uh practice and work with people who are battling addiction well for us we've had to move to telehealth services and one of the biggest factors with with treatment for substance use for substances is the group process it's a really really powerful process to be with a group and sharing that their experiences but with telehealth it takes that away um some people it's found that it's been it's been okay it's been beneficial but then other people have a really hard time with it um so we're still doing the very best we can to treat addiction um but it's it's definitely been an experience yes definitely and what's been your experience with how the covid has you know on and lots of different levels has affected um uh the treatment of addiction for for you and what you've seen um a lot of different impacts um one the the big thing that stands out is the innovations and at um use of technology and the telehealth so some some things are working and some things are not really feeling great so some of the telehealth group feels really disconnected impersonal it's really easy to tune out you can't see everybody in the room from the screen a lot of times so it's just it's not great it's nice to use if you had to if all of the facilitators you know had to quarantine out of the building or something like that and could only tune in via screen that might be helpful maybe doing being able to do comprehensive assessments diagnostic assessments those kind of things over the screen has been really helpful that was a barrier in some cases in the past it wasn't allowed it wasn't billable and so now that's been opened up and i find that to be very very helpful some of the things with kovid just in the residential setting some of the the ppe wearing the mask has been a little bit of an issue especially people who are older hard of hearing not um and people just being uncomfortable wearing the mask the social distancing it's kind of just a little bit frustrating i think for some clients for some staff we're all kind of used to it now it's going on two years but that's been a little bit of an issue also the sickness factor when people are in a residential program if somebody develops symptoms they need to be quarantined into their room and stay in their room for now it's 10 days it was 14 days so there's that isolation just the the practical issues with trying to keep somebody who's struggling with mental health early recovery in our case civilly committed they don't want to be there and to keep them in the room so things like that yeah we were talking so you were talking about you know connection and disconnection and how how um a lot of times addiction is disconnection can you expand on that a little bit so addiction likes to hide in the darkness it really really grows and feeds in in the darkness and oftentimes what we see is people who do use substances and are addicted they they end up isolating themselves and things kind of just get worse with kovid we've we've certainly seen long people that are in long-term recovery they have they have lapsed or relapsed and are now coming in because they're struggling and they lose their their typical coping skills they lose that the connection with their families with the community events that they used to do even even the gyms were closed so it certainly has has impacted it isolation is a tough one so you said the people are now coming in was there a time that when this first started that nobody was able to kind of connect at all physically when when when it first started mm-hmm okay yeah so there was a time that there was a complete disconnection and did you find that that was um a big a big a a big hurdle to overcome certainly certainly yeah yeah and disconnection for you and connection yeah so i'd say one of the biggest factors that leads to relapse it's interesting you bring up that people who have been in long-term recovery this is stress one of the biggest things is stress that's gonna re-trigger and and a lot of people they go to 12-step meetings or the meeting with therapy they've got a lot of events to keep themselves coping with life on life's terms as they say in recovery and i would imagine losing that then that's going to just wake that addiction mindset back up and so connection extremely important and absolutely right that that shame and that addictive behavior hides in the dark and in isolation and that we've created that artificially in our society for people so prime breeding ground for relapse yeah and what about um families families what can families do to help a loved one who is coping with with addiction well i think i i think the biggest thing is compassion um what i think a lot of people may not understand or realize is the the person who's struggling with those substances have so much judgment and shame and guilt for for being addicted for the things that they do when they're addicted um and compassion is huge and i think with society as well we we still there's there's still that that moral failing um belief and um it perpetuates i think that the addiction piece and the stigma okay and what what can what can families do for for you so i think that it's important that family families and support people recognize that this is not just a one-and-done kind of thing it's going to be in for the long haul there's a decent chance a person may relapse so i think it's really important that family members have their own personal boundaries and they keep them and not fall into enabling a lot of people i think with a good heart will enable people who are in addiction they can be really crafty and savvy and and that's the addiction to speaking it's not the person it's the addiction very much so addiction is is this sneaky is the sneaky one the person isn't it's the addiction speaking it's not the person and i think to kind of pull out the addiction from the person it's a person with addiction it's not you know absolutely yeah so having those good boundaries and upholding them even you know if you're going to stick with that person you've got to uphold those boundaries with the person and i would say getting your own support and your own help there are some free services in town and on um it's a good 12-step program but also just psychotherapy working with somebody to help to get your support while you are interacting with that person the best support for the person the loved one of someone who is dealing with addiction is is helping themselves so they don't fall into the enabling trap if you will yep yeah okay great okay so here's a question from the iron range um um how effective is um are the drug courts that people are required to go through and what is the success rate i don't know if either one of you we i don't really i can't really speak to the the statistics on the effectiveness but with my personal experience um i have found that that clients do benefit greatly from it there's a there's a lot of support um they they have accountability um they have phases that they go through so there's there's it's a for it can be up to 14 months long program um i hear good things from clients who go through those core systems same here i hear great things i only would wish that it would be more of a long term because what i hear is that people do it excellent while they're in that 14 month time period and then relapse soon after and as we know this is a lifelong journey that people are on it doesn't just stop but having that accountability that lots of check-ins lots of support very very beneficial for for people okay yeah i just think it needs to continue on maybe at a lesser a lesser some more graduated okay sure um this is a question about um can an alcoholic individual ever get to a point where they can drink in moderation would you like to take that jenny so there are some harm reduction models that um have had some success um there are some medications too that people can take that and i'm not a doctor but i do know that that i've heard anecdotally some people can take these medications that'll lessen the effect of the intoxication and they've been able to drink normally i'd say it's not an experiment somebody should do on themselves and i would say that more often than not if somebody truly is an alcoholic no no okay yeah i would agree with that is that your is that your agreement too yeah i would agree with that and so um so alcohol so this was specifically obviously about alcohol but what about other um other drugs other substances would would you say the same for for those things too no yes okay i think though if we think about opiates and method um methadone suboxone um m-a-t-m-a-t m-a-t medication-assisted treatment um that somebody is still continuing to use chemicals in in a way but they're living a healthier lifestyle and they've got some accountability and they know the drug that they're ingesting and it's measured and things so um i think i would call that being able to function while still taking chemicals so it's a little bit of a gray area almost and i do think that possibly people i don't i think that say if somebody had an addiction to methamphetamines and it was severe and then they used alcohol and didn't have a problem i think that is possible and that's just mine i know there's a lot of controversy about that they think well if you are have that addictive personality then you can't use any substances but i i have seen some kind of anecdotal evidence to say that some people could use other things in a normal way okay what do you think about that absolutely absolutely yep everyone's everyone's journey with addiction um it's it is different and and people have their drug of choice and um it isn't uncommon for from to hear that you know my substance of choices is heroin but i can have a drink every now and then it's not triggering for me so that yeah that does happen okay okay great um and there's a a question um generally about parents and custody and addiction so what sorts of experiences have you had with parents in in custody and and that addiction piece well um i also work with the county we there's a program called north star families and um part of that is working with women who are pregnant or have recently had their baby who struggle with addiction and it's quite common to see cps cases come in with that it's it's complex i think it's complex as well there's so much to speak to that so much to speak to that um all right so another question um a question from hermantown what kind of uh things um do you discuss in the women's group and i know you guys both i know you both work with women so i think you can both answer this but i think you're specifically with the women's group that i should probably be referring to yeah so will the helping women recover curriculum it touches on four main areas that substance use affects for a woman and so we talk about identity their self it touches on relationships so relationships with others relationships with mothers fathers being a mother that sort of thing it touches on sexuality and it also touches on spirituality so those four areas we talk about but i think the the key piece of it is is the trauma we also work with the trauma okay okay great um if you are concerned that a family member has a drinking problem what is a good first step to address the problem how can you get through to them without seeming judgmental you can want to take that jenny it's a tough one it is it is a tough one um i would advise a family member not take that into their own hands by themselves i would i would say consult with maybe an ladc maybe call the county and ask for some assistance on it so that's a service that the county offers is if somebody has a question about a loved one and to to find out whether or not again it rises to that level of addiction which i think which is why i kind of wanted to start the program with what is addiction so to try and figure out what whether that's true or not it that is a service that companies can offer okay great well i mean i wouldn't say that it's a service like that is labeled as something but certainly you could call and speak with the substance use disorder social worker there and kind of they could field some questions and kind of help navigate that a little bit i think that if a family member is attempting to do some type of intervention with with a loved one that there's a good chance that it could backfire the defenses are pretty strong around addiction and the person might be open to it but definitely i'd say get support get support first talk to other people talk to a professional maybe talk to your doctor or their doctor about it first okay is that what you would agree with that too first step okay um and we talked about this a little bit before um we came on from duluth question from duluth can addiction um like alcohol addiction be inherited so research does show that it is about fifty percent um hereditable yep so is that and again not to get into the weeds like like a family culture like a genetic predisposition or a and then the culture of the family too certainly yep because there's there's the the genetic predisposition of a person but addiction also um it it manifests as well from environmental so the nature versus nurture piece if if there's substances with within the home it can travel down to other generations so i mean we see a lot of generational patterns with addiction the generational trauma yep and then it comes out as addictions yeah okay okay um kind of going back to that to the women's group so what sorts of things do you cover in your women's groups uh a wide variety of coping skills so we use a lot of different modalities dbt cbt motivational interviewing eimanr that's enhanced integrated mental health [Laughter] it's a um just a really nice group facilitation covering just nursing mental health um chemical dependency all different topics relapse prevention okay a lot of what we do though is relapse prevention coping skills and trauma not really going into like psychotherapy trauma type stuff but the issues that come out of it and the bringing the women to support each other okay um to to talk about those things okay okay um so what sorts of things um so we have so we had a question about the first steps what are some of the other you know kind of like the bigger steps or kind of some of the other like the like a continuum of of care or like how the program would go in in each like like a uh how long would the process be is it lifelong is it a six month 12 month program are you talking for for like addiction recovery somebody had a problem with addiction they were referred to you what would be a typical what would what could people expect from like an hdc model um well they could expect um integration with family members is is really really lucky likely um we um totally lost my trainer that's all i'm sorry no that's all right we were no we were we're asking about like what can people expect from a uh if somebody was referred to you for um uh for addiction what would kind of the steps be we kind of talked about like that that first step but what would like that a time frame be is it like a weekly meetings or is it group or kind of yep yep so we have group three times a week we're an intensive outpatient treatment program um so we have we have treatments monday wednesdays and thursdays okay yep for three hours at a time okay and how long does that our program is kind of unique um it's we we don't have a set time frame okay um and it's it's hard because in the past you know programs have been like 96 hours for for an intensive outpatient treatment program or like 40 hours for just regular outpatient treatment but because addiction is is a lifelong process and it's a lifelong um something that they live with for life long we we find that the longer person is in treatment the better the outcomes are the least likely they are to relapse or the longer periods in between relapse as well we've had clients that have gone through our program in four months and we have clients that that have been with us for a year year and a half so we we don't have a set certain time okay okay great thank you all right so um is there a difference between men and women in terms of alcohol or drug abuse and would you arrange or have addiction recovery differently between men and women again in your experience so um data from the behavioral health division department human services in minnesota show that about 35 percent of admissions to treatment are women and 65 are men so more men are going to treatment um as far as the services received i think tanya because the covington stuff might you might have a better kind of information about that yeah so we we find that with women they there is definitely differences in why why they use the process of addiction um it it's it's more personal for women it's more of a coping skill in in in terms of like child rearing um just everyday life there is different processes but also to how the the effects of substance is on a woman's body versus a man's immense body so there are certainly differences how women get into addiction there's a lot of sexual abuse a trauma history that it's definitely a big thing that we see okay okay and so are there men's groups available also in the duluth area that are strictly men for alcohol and drug not that i'm aware of you're aware of okay yeah i think center for alcohol treatments they they separate out their houses um by gender yes yes their their um residential treatment residential treatment so some are some are yep some are some are that um okay um so um a little going a little bit back to um kind of the processes that if people are kind of afraid or a little bit nervous um to like that think that they might have a question there's so much information out on google there's so much you know you know when people have symptoms they kind of go on on the internet what would you would you recommend like as a like a first step for someone so we talked about family members what if you know you yourself think that you might have a problem what would you to what would you recommend for a first step um i would recommend that um doing the doing the internet search can be helpful you know you can find good reliable sources that can kind of help navigate whether or not you may have a problem or not otherwise reaching out to professionals i think would be the biggest help okay reaching out to a reaching out to a professional is that what you would recommend to yeah i think the state of minnesota has done a lot starting 2016-17 with substance use disorder reform policies and they are now it's full on direct access you can contact any treatment center and they are obligated to perform a screening or assessment right away and you can um choose so it's really more person driven rather than it used to be an outside authority that would tell you oh here's what you're going to do you're going to go to this program and so just kind of looking up any of those numbers of treatment programs in your area and contacting somebody and they can they can help you kind of tease that out a little bit with the screening process wonderful wonderful thank you both so much i want to thank our panelists tanya bednarik and jenny rehnquist for their time and expertise tonight and to the wdse staff members for answering the phones and for those of you who called in or emailed questions this is our final mental health episode but if you want to continue the conversation attend the let's talk minnesota mental health action concert featuring cloud cult april 20th at the north shore theater the concert will help raise awareness about mental health issues and features a resource fair with representatives from organizations providing mental health services i'm mary morehouse for the guests and crew here at wdse thank you for watching good night [Music] you