October 17, 2023 • 32 mins
Breaking the Silence is a raw and honest look into addiction treatment. This episode features personal stories from Tony Luke and his family's tragic loss to the disease of addiction. Hosted by Loraine Ballard Morrill and industry-leading clinical experts in addiction treatment from Recovery Centers of America, this podcast aims to break down stigmas and provide real conversations about addiction and recovery.
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This podcast episode and others are available to watch in video format here www.RCARecovery360.com
Any views or comments provided by individuals other than RCA employees are their own and do not represent the official views of Recovery Centers of America.
844-25-RECOVERY
This podcast episode and others are available to watch in video format here www.RCARecovery360.com
Any views or comments provided by individuals other than RCA employees are their own and do not represent the official views of Recovery Centers of America.
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Episode Transcript
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(00:00):
Hello, and welcome to Recovery throughsixty, the podcast dedicated to exploring the
pathways to treatment and recovery, broughtto you by Recovery Centers of America.
I'm Lorraine Ballard Morral, director ofNews and Community Affairs for iHeartMedia, Philadelphia.
I am so pleased to introduce myfriend, my colleague, Tony Luke
(00:20):
Junior. Tony, you have hadsuch a powerful voice when it comes to
talking about recovery, and I wonderif you could just briefly tell us a
little bit about your connection with thewhole field of recovery, because you have
a very personal mission. Yes.So in twenty seventeen, I lost my
son, Tony on March twenty seventhto an overduse. And I'm old school.
(00:46):
You know. When I was akid, I would use a lot
of drugs and I just stopped becauseI wasn't self medicating an issue. And
I had trouble with my son understandingwhy he couldn't just stop, which is
a lot of paying parents. Theydon't understand the self medicating of addiction.
And I was kind of thrust intothis when a gentleman had said to me,
(01:10):
I heard about your son that hepassed from cancer, and I said
no, it was an overdose,and he got very upset as if my
son did something wrong to me,And I realized that my lane was to
really do whatever I could to makepeople understand addiction and to get rid of
the stigma. Teaming up with youand doing this show and having all these
(01:34):
amazing guests on, I'm hoping Ican reach people and you can reach people,
and together we can reach people ina way where we're like sitting in
their home and let them know thatwe've been through it. I know it,
I feel it. Whatever I canshare to help bring some hope or
some relief to someone that is suffering, I think this show has a great
(01:57):
chance of doing that well. Inevery episode, we're going to be sitting
down with experts, survivors, andadvocates in the field of treatment and recovery.
We'll be talking about the riddle ofaddiction, the complexities mental health and
physical wellness, while shedding light onthe diverse range of therapies, interventions,
and approaches available. In today's episode, we'll talk about the circle of recovery.
(02:21):
People enter addiction treatment at different pointsin their lives, right their recovery
journey is very specific to each individual. Some people seek help at the very
beginning, recognizing the substance use problemand wanting to address it proactively. Others
may enter treatment after experiencing severe consequencesor hitting rock bottom realizing the urgent need
(02:42):
for change. Every person's journey isunique, but almost always a loved one
or family member is also affected bytheir substance use. Addiction is a disease
that affects the entire family, andyou could not be more on point when
you say that. In many individuals, they go through multiple cycles of treatment
and relapse, but you hope witheach relapse serving as a potential turning point
(03:08):
leaning them back into treatment. Additionally, some may enter treatment as part of
a court mandate or due to familyinterventions. Regardless of the entry point,
addiction treatment provides vital support and resourcesto help individuals regain control of their lives
and move forward towards lifelong, lastingrecovery. Yeah, we're very excited to
(03:34):
be joined by doctor Peter Vernik,who is Vice President of Mental Health Services,
and doctor Hung Un, chief MedicalOfficer, both from Recovery Centers of
America. Well share different viewpoints whenpatients enter recovery centers, three pathways and
what does the life cycle of recoveryjourney, what does it look like peep
(03:59):
Sure, So when we think aboutpeople who are coming into treatment, really
we're thinking about them not as allbeing the same. I think that that's
a place where a lot of timesyou do a great disservice to people who
are in recovery and who are startingtheir recovery journeys by just looking at sort
of a one size fits all wayof providing people with care. So when
we are assessing, when we areworking out a plan of care for patients,
(04:21):
what we look at is people whoare in treatment for the first time.
You know, you had kind ofbrought up, Tony the idea about
people cycling through treatment or having beenin treatment for multiple episodes. And I
think that because we sometimes will focuson that, we'll forget about the person
who's in treatment for the first time. And this is something, you know,
the fear, the stigma, thedifficulty just of not knowing what to
(04:44):
expect, the uncertainty is amazing forthese individuals and for their families. So
being able to tailor their treatment totheir specific needs, to learn about their
illness, learn about how it affectsthem and their families versus folks who have
been in treatment before, and youknow, they maybe don't need that initial
learning, they've already gone through that, but we have amazing opportunities with them
to look at what has worked andwhat hasn't worked in the past. You
(05:08):
know, every experience of treatment thatsomebody has, they got something from that
that was helpful, and they probablywere things that didn't help them and that
were even counterproductive. So let's learnfrom that and help that to tailor their
treatment going forward. And then finally, you know, you brought up also
the idea of trauma and mental healthand how for so many people that's behind
their substance use disorder. So welook at folks who come into to see
(05:30):
us who have a major mental illness, or have a history of trauma,
or even have a physical illness,you know, a pain disorder or something
else that is driving their substance use, and what can we do to treat
the entire person, not just theirsubstance use disorder, but treat what's going
on underneath that so that we're trulynot just putting a band aid on the
surface, but we're addressing what's goingon underneath that. Yeah, doctor Ewan.
(05:53):
As Pete says, people come into treatment in different points. Some
people have been in treatment before,people for the first time. Some people
need to get to rock bottom rightbefore they are ready, and other people
recognize that this is something that theyneed to address and they may not have
hit rock bottom, but they knowthat that is their point. Let's talk
(06:15):
about those different entry points that peoplehave a little bit more so. First
of all, my hope is thatpeople don't have to hit rock bottom to
get treated. Oh thank god,you said. You have no idea how
much that means to me hearing yousay that. Yeah, it's really important
that we try to capture people intheir journey. They're going to be people
who are ready first time. Theywill get better, they'll make recovery,
(06:40):
sustain recovery, and lead a normallife. And as Pete says, there
are people who are having recurrent episodes, and then there are people would behavioral
disorders and they need different types ofinterventions, and the families need different types
of supports. For the first time, you're frightened, you're scared, you
don't know where to go, andyou don't know what to do. Maybe
(07:00):
on the recurrent episode you're frustrated withthat family member, and then with psychiatric
disorders, you know, you maynot even know what to do, and
do I go for the mental healthforce? Do I tree substitutes first?
And it's very confusing. So makingsure we meet the person where they are,
whether they're ready or not, andtry to help them start their journey,
(07:24):
because getting them started and getting themsustained in their journey is critically what's
important. You know, Tony,you reacted to what the doctor said about
not having to hit rock bottom.You reacted to that, and I'm sort
of curious as to why you said. Yeah, I'm glad you said that,
because it's there's two ways to lookat rock bottom. What is rock
(07:46):
bottom? Is rock bottom being ina street with nothing and ill and all
alone and just abandoned. Is thatrock bottom? Or is rock bottom a
mental state where people just become tiredof being tired? You know, I'm
(08:09):
sorry. When my son died,my son, Michael, gave eulogy,
and every time Tony would come over, he would he would be very distant,
and you know, he didn't wantto be involved in anything, and
it would get my son mad,my my middle son, Michael, and
(08:33):
he would be like, why doyou come over? If you if you
want to act that way, whydo you want to come over? And
when he died and Michael gave eulogy, he told that story and he said,
I didn't realize till after I learnedthat Tony was just tired, you
(08:54):
know, he was tired of beingtired. You know, people think people
struggling with addiction are weak. They'renot. They're the strongest people you will
ever want to meet in your entirelife because they are battling that and to
be judged every day. And lookat the stairs that you get and the
(09:16):
way people talk about you, andno one is harder than someone in recovery
or an active addiction on themselves thanthemselves and they get to feel hopeless.
So when you said that, itjust hit a nerve with me, because
God, we should have programs inplace. People should understand we shouldn't let
(09:41):
someone get to a point where it'sthem wanting to die, just wanting to
die for us to step in.And I know there'll be people that listen
to the podcast and then turn aroundand go, oh, you don't understand
if they don't want help. Yes, I get it. If someone doesn't
want help, you can put themin recovery. You can to go to
recovery and nothing will change because theydon't want that. But we need to
(10:05):
look at recovery different than we've beenlooking at it. We need to look
at the human the human aspect ofwhy people are self medicating. And you
said something else that just, ohmy god, it blew my mind.
It's like, sometimes we're so focusedon the sobriety that we forget that there's
(10:28):
a reason for this. And whenyou said, sometimes you have to decide
is the mental health aspect the mostimportant thing to start with, or is
it the sobriety? Is it gettinginto detox? And I got to tell
you, honestly, I'm a bigbeliever that we should work on the mental
issue and then slowly get them intothat instead of just throwing them into a
(10:52):
room and detoxing them and going,well, now your body doesn't need it
anymore, go out, have fun, God bless you, and use your
will power because eventually will power break. So when you said that, my
respect level for you went up fivethousand points because that is so important that
(11:13):
he said that in so important toaddress and it just it affected me,
it did. It affected me whenyou said, well, yeah, I'm
sorry. You know, Tony,I think you encapsulated the whole area of
how substance disorder has evolved. So, first of all, hidden rock bottom
is really and then example of stigma, right, it's you have to suffer
(11:37):
to recover kind of thing, andthat's not the case. So stigma tells
us that people have to hit rockbottom, and that was true for mental
health. I mean, it wasn'tthat long ago. Depression was stigmatized and
people had to just pull themselves upby the bootstrap, and that's not the
case. They can get treatment early, just as you can get treatment for
(11:58):
Susan Chooes disorder. The other thingis that it's a disorder of the brain.
It's a disorder that causes impact onyour motivation, impact on your ore,
your ability to think. Actually,that is the rock bottom for the
brain, and once you're at thatstate, you really need help to recover.
And to your point, you needto make sure we heal the brain
the mental illness. Wonderful point.Just to follow up on what's been said
(12:24):
so far about meeting patients where theyare. I think that's something that a
lot of people on the outside orwithin the family have a hard time with.
Just like Tony talked about his sonwasn't really understanding where his other son
was at and thinking why doesn't hedo this or why doesn't he have this
(12:46):
attitude? So how do you tellfamily members and friends how to really approach
someone who's going through that struggle andmeeting them where they are? So in
the field we use the term meetthe patient where they are all the time,
and that kind of is representative ofsome of the developments in the field
over the past ten twenty years.The idea, that confrontation and that sort
(13:09):
of linear approach that you know,starting with rock bottom, then a withdrawal
management or detox program, then aresidential than an outpatient. It's just the
only it's a one size fits all. It's the way that it has to
work. The idea that you canpush somebody into treatment as opposed to getting
them to agree and getting thereby andI mean this is true for all of
(13:30):
us. We are much more likelyto work towards a goal that is our
goal, as opposed to as agoal that somebody else gives to us.
So the idea of meeting someone wherethey are is the fact that if somebody
is not willing to acknowledge that theirdrug use has become a problem for them,
sitting down and trying to force themto admit that is not going to
be productive. You know, whenwe confront someone, when we push somebody,
(13:52):
that only makes them more defensive,That only causes them to you know,
back into a corner and feel likethey're being targeted or cornered, and
you know, that is generally nothelpful. So the idea that we encourage
families and that we as professionals useis we're just going to talk about it.
So, you know, if Isit down with a patient and they're
telling me that their drug use isnot a problem, Okay, that's fine.
(14:13):
Just tell me about your drug use. Then tell me about how it's
not a problem, tell me abouthow it affects you, how it doesn't
affect you. Nine times out often they'll start to tell me how it
actually is a problem for them.But that's because I'm not pushing them for
that. I'm not trying to forcethem into saying something. You know,
it's not a gotcha with the patient, and so I would encourage the exact
same thing with families. Just openthat dialogue with them. It's destigmatizing to
(14:37):
talk about it. It's important toopen up those lines of communication and let
them know. There's no judgment andthere's no agenda. It's simply that you
know. If it's a family member, I love you, I care about
you. Every part of your lifeis important to me, even this part
of it. So I want tohear what's going on with you. It's
very hard, I think for peoplenot to be judgmental, but I love
the language that you use that allowthat open conversation. It's not like you're
(15:03):
wrong, you need to get help, but what's happening with you right now?
Tell us about that, and thenit allows that person to open up.
Yeah, and you also said somethingthat hit with me as well.
You said we need to get peoplebetter. And we had this conversation in
our last podcast that I don't likethe term. I just personally am not
(15:28):
fond of the term clean. Idon't like it because it sounds to me
that you're dirty. And I keeptelling people people don't need to get clean,
they need to get well and letme tell you something. Words are
powerful. When you hear them overand over again. You stigmatize yourself as
(15:54):
someone who is struggling with a loss. And make no mistake, someone who
is an active addiction is suffering aloss, a loss of who they were
and who they thought they wanted tobe or what they thought their life would
turn into. I love that youmentioned the fact of the family. The
(16:15):
saddest part is the family is likealways on the back burner, like they're
the least most important thing when unlessyou go through it, you can't imagine
what it is like to watch someonethat you love dying in front of you
(16:37):
and your hands are tied and youdon't know what to do, and you
look for help. That isn't there. When he died, it wasn't there.
No one was speaking like we werespeaking now. No one was talking
about mental health, no one wastalking about trauma. It was just,
you know, people look at mentalhealth as a weakness. They look at
addiction as a choice. And untilwe can change that narrative, until people
(17:03):
understand that these are real people withreal problems that are struggling, my son
said to me, and I willnever forget this, he said, dad,
I just wish I would die soI would stop hurting the people that
I love. And he believed it, like he believed that he believed that
(17:26):
he would be better, everyone inhis life would be better if he died.
So how much pain do you haveto be hidden to feel that way?
And there's very little support for families, and they're afraid. When Tony
first died, everyone said, don'ttell him, don't tell him that he
died. You know, like whywhy? Because this stigma, that's why?
(17:52):
And it has to stop. Doctor. So we're talking about meeting people
where they are, and you've alreadyindicated the two of you that there are
many different strategies. It's not likea one size fit all approach. How
do you begin to decide or tailorto that individual what works best for them?
(18:15):
What are some of the questions thatyou ask them? It's actually relatively
irrelevant what I think. You needto start where the patient is and ask
them what's going with them? Howhas three drug use alcohol use affected them?
And started then craft a solution together. It's called shared decision making.
You know, we do this inrest of medicine when we treat patients with
(18:36):
diabetes we talk about how best totreat diabetes, what's no different with addicption.
Addiction is a chronic disorder the brain. You need to start with the
patient and ask the question, whatwould you like help with what's bothering you
the most? And is this optionan option that's accept the word to you?
If not, how can we tweakit and modify it. That's a
different approach rather than saying you're dirtyand you need to get clean. So
(19:03):
I think it's really listening to thepatient and engaging the patient, and also
the same time also engaging the family. I think you said that families are
just kind of set aside. Addictionis a disorder of the family in some
ways because it impacts the whole familysystem. And so how the patient does,
whether it's diabetes or addiction, alsoinvolves the family. And where's the
(19:23):
family? I mean when you talkabout your other son, Okay, it's
just so moving to hear the strugglethat he's got, and I just wish
that you know, he had theopportunity to have had the information about addiction
and not to blame himself, becauseyou know, there's too much going on
(19:44):
everywhere to be blaming people that's justa disorder of the brain. We don't
blame people with diabetes, right,we should not be blaming people addiction either.
Doctor Vernig. I think that doctorand says something that's so interesting,
and that is that the disease affectsthe whole family. And Tony talks about
it too. And what we've seenis we've seen great strides made in understanding
(20:06):
that and so that when you gointo treatment, it seems like you really
also have to look at how itimpacts the whole family, because it's not
just that person, but it's thatperson in the context of their circle,
right absolutely. And you know,just like every patient to every individual who's
living with a substance huse disorder isdifferent and needs something different. Every family
(20:26):
is different and is in a differentplace. Sometimes what families need is they
just need the support. Sometimes theyneed to heal as a family unit.
Sometimes, you know, if somebody'sbeen struggling for a long time and been
around going through that cycle over andover again, the family needs to learn
that it's not that individual's fault andthey need to learn to forgive the patient.
They need to learn to forgive themselvesas well. So just like with
(20:47):
a patient, you need to notjust dictate what needs to be done and
here's the list of things you haveto go through. It's the same way
with a family. Assess what's goingon, determine what they need, listen
to what they're saying, and thento provide support for them based on that.
Well, we're going to be talkingin future podcasts about all the different
types of modalities that you have tooffer, and there's so many because there's
(21:10):
been so many advances in treatment.But I think, Tony, I think
it'll be interesting for us to askthese guys how they got into this,
why they're committed to this whole fieldof recovery. And Tony, I have
to acknowledge you for your heart andfor your honesty and for your willingness to
share what is clearly still a verypainful, painful thing to lose a child
(21:37):
like that is, and the factthat you're taking that and utilizing it for
your mission to help other people.I just wanted to shout you out for
that because we appreciate you so much. Well, thank you. It's a
club that no one wants to bein. Yeah, you know, and
that was an amazing question that youjust asked me, because I'm always fascinated
(22:04):
by why someone does what they doand what was the mode? Did you
always know this is the field youwanted to do where you always connected in
most people, just you know,you know you want to help people,
like you know that your mission inlife isn't just about making money. And
(22:26):
again, I'm not putting anyone down, and it's the truth that people.
Some people their mission is they wantto be successful, they're entrepreneurs, and
I get it. You know.My youngest son is a nurse, you
know, and he used to bein business and he was like, I
don't I'm not interested in making money, dad, I'm interested in making a
difference, because that's kind of washis calling. So I'm always interested in
(22:52):
asking what brought you to where youare today? Did start as a child?
Was it just experiences that you hadin your life? What brought you
here? Sure? So I alwaysknew that I wanted to do things to
help people. That was always importantto me. But actually when I first
was in school and was, youknow, considering careers and what direction my
life would go. Oddly enough,I actually studied engineering and I did that
(23:15):
for a short amount of time,but then realized that what I wanted to
do was be closer to people.And you know, don't get me wrong,
engineers do things, create things,design things that help people, that
serve humanity, that do wonderful things. But I wanted to be closer to
that actual human connection and the helpingprofessions. So I did then, you
know, look into and begin studyingpsychology. You know, after years of
(23:38):
study and working in the field andlearning about, you know, how the
field functions, all of the positivesand all of the negatives too, all
of the difficulties that we've kind oftalked about about stigma and people not getting
the care that they need, realizethat that is what I wanted to dedicate
my life to. So I becamea psychologist, And then also realized that
(23:59):
one of the things that I enjoyis helping people with systems, helping to
build systems that truly help people,that allow people to get the care that
sometimes they're not able to, makingthose systems provide the best care possible.
So I worked on the mental healthside for a long time, mostly in
inpatient hospitals, providing care for someof those most in need of support in
(24:19):
our society. And then you know, obviously, with how prevalent substance use
disorders are among people living with severemental illness, did a lot of work
with substance use and eventually decided toshift a little bit more over towards the
substance use side. But have beenvery involved, obviously in my role in
my current position, integrating mental healthservices and substance use services because that's something
(24:42):
I think that we don't have enoughof in our service delivery system and that
we need more of. We kindof create this false dichotomy, the fake
idea that there are substance use treatmentservices and then there's mental health services,
And of course that's because of theway things are licensed and it's the way
that insurance companies pay for care.But that's a fake dichotomy. The reality
(25:04):
is it's you know, one andthe same substance use disorders are a mental
illness. There's a lot of overlapbetween the two, and the more we
can do to break down those barriers, I mean, the different groups they
struggle with the same issues, stigma, difficulties in the family. They have
this cyclical relationship that makes it reallyhard for people to move forward. Doctor
Wone, what about you so Icome from a family of physicians, actually
(25:26):
a family of psychiatrists, have along standing experience with mental illness and substitute
treatment. One of the areas thatI was really concerned about and frustrated with
is in terms of the pace atwhich we adopt evidence based care. In
the past twenty years, there's beenthis emergence of treatment of psychiatric disorder as
(25:48):
a disorder of the brain, butit was lagging on substitute side, and
there was this emerging literature of nationalistof drug abuse where basically stated that it
was a disorder, chronic disorder ofthe brain that can be helped with therapy
but also with medication, and thatthe treatment needs to be continuous. And
I was frustrated at the level ofthe adoption. So I wanted to really
(26:12):
get into the fear of SUD totry to try to accelerate the adoption of
evidence based care so that people aredying. Your son died, and part
of that is actually our fort insome ways the healthcare delivery, because we
haven't adopted the evidence based care ata pace that is efficient, effective,
(26:33):
and available. That's what got meinto this area. You know, what's
so exciting about doing this podcast isthat I learned something from it. And
I have to admit that even Ihad this preconception that you had to hit
rock bottom before you were ready toseek treatment, because I've known so many
people for whom that was true.But what you're saying is that there's a
(26:56):
continuum and people can jump off thatcontinuum at any point in it, and
it doesn't have to be over here. It can be here or here or
here. And I think that's avery important message for all of our listeners
and viewers to be able to wraptheir heads around. I think that's important.
I learned something from this experience,and I think that's an important important
(27:22):
point to make. You know,it's funny. When I was first approached
about the podcast, you can't imaginehow much tremendous respect I have for you.
I mean, I wouldn't want todo this with anyone. You are
brilliant, brilliant, and I reallywant to applaud both of you doctors.
(27:42):
I did not want to be involvedin a podcast that just gave numbers and
figures and it was the same,the same old rhetoric that I've heard over
and over and over again, thesame cycle to hear someone with your education
and your status to say, youknow what, we dropped the ball for
(28:07):
twenty years, like we need tointegrate. Like this is what I was
praying that this podcast would be realtalk, real people, not people covering
up self, not people not takingresponsibility for anything. But people coming on
and go, look this is thereality. Yeah, things need to change.
We need to get families involved more. We need to educate families more.
(28:30):
We need to let people know thatthey're not useless, and they're not
a waste of life, and they'renot weak, and that they're struggling.
And you hit on a point withdiabetes. But and I agree, but
it's like I've never seen anyone walkinto a hospital with a cancer patient that
(28:51):
is suffering ever and go, well, they should have had a stronger immune
system. No one says that,right, No one says that because people
believe, well, you know cancer, you didn't ask for cancer. Well,
no one asks to go through mentalissues either. There are traumas in
life that are so difficult to dealwith. And I'm telling you firsthand,
(29:14):
I know what it's like to befaced with a trauma that is absolutely unbearable,
where death seems to be the onlyoption that you are given to stop
the pain and to break through that. For me, it was music,
Like I said, it was themusic and to write the music for people
to hear it to help them getthrough it. Everyone is different. We
(29:38):
don't know what everyone else needs,but to be able to have those conversations,
real conversations of car and go.You know what, I don't care
that you're using That's not why we'rehere. I don't care. I want
to know you. I want toknow about you. I'm not judging you.
I'm not looking at you, Fanny. I want to know you.
Talk to me, Just talk tome. That's the first line. We've
(30:03):
just forgot how to speak to eachother. We forgot how to talk in
twenty twenty three. We don't knowhow to sit down and have a genuine
conversation without judgment or trying to forceour opinion or our will and what we
think, you know is morally correcton someone else. It's killing us as
(30:26):
human beings. It's destroying us oneperson at a time. And I am
so proud to be a part ofthis, and I don't even know what
to say. I think we cando real good here and make people really
understand well. I'm excited for thispodcast and I'm excited to have had this
conversation with all of you. DoctorPeter vernek if people want more information about
(30:48):
Recovery Centers of America, how dothey find out more? If you'd like
more information about Recovery Centers of America, you can visit us online at RCA
Recovery three sixty dot com or callus at eight four four two five recovery
Doctor Peter Vernick, Vice President ofMental Health Services, doctor Hyungung, chief
medical Officer, both with the RecoveryCenters of America. Tony, I'm excited
(31:12):
to go on to our next episodewhere we're going to be talking more about
the different modalities and getting down intosome of the state of the art treatments
that are available for people who areready to address their issue with substance use.
I'm excited and I want to thankyou both again for your honesty and
candor. I think what you saidwe'll touch a lot of people and it
(31:36):
will really push them for better understanding. Thank you both so much. I'm
Lorraine Ballard Morrel. I'm Tony LukeJunior. See you next time.
Hello, and welcome to Recovery throughsixty, the podcast dedicated to exploring the
pathways to treatment and recovery, broughtto you by Recovery Centers of America.
I'm Lorraine Ballard Morral, director ofNews and Community Affairs for iHeartMedia, Philadelphia.
I am so pleased to introduce myfriend, my colleague, Tony Luke
(00:20):
Junior. Tony, you have hadsuch a powerful voice when it comes to
talking about recovery, and I wonderif you could just briefly tell us a
little bit about your connection with thewhole field of recovery, because you have
a very personal mission. Yes.So in twenty seventeen, I lost my
son, Tony on March twenty seventhto an overduse. And I'm old school.
(00:46):
You know. When I was akid, I would use a lot
of drugs and I just stopped becauseI wasn't self medicating an issue. And
I had trouble with my son understandingwhy he couldn't just stop, which is
a lot of paying parents. Theydon't understand the self medicating of addiction.
And I was kind of thrust intothis when a gentleman had said to me,
(01:10):
I heard about your son that hepassed from cancer, and I said
no, it was an overdose,and he got very upset as if my
son did something wrong to me,And I realized that my lane was to
really do whatever I could to makepeople understand addiction and to get rid of
the stigma. Teaming up with youand doing this show and having all these
(01:34):
amazing guests on, I'm hoping Ican reach people and you can reach people,
and together we can reach people ina way where we're like sitting in
their home and let them know thatwe've been through it. I know it,
I feel it. Whatever I canshare to help bring some hope or
some relief to someone that is suffering, I think this show has a great
(01:57):
chance of doing that well. Inevery episode, we're going to be sitting
down with experts, survivors, andadvocates in the field of treatment and recovery.
We'll be talking about the riddle ofaddiction, the complexities mental health and
physical wellness, while shedding light onthe diverse range of therapies, interventions,
and approaches available. In today's episode, we'll talk about the circle of recovery.
(02:21):
People enter addiction treatment at different pointsin their lives, right their recovery
journey is very specific to each individual. Some people seek help at the very
beginning, recognizing the substance use problemand wanting to address it proactively. Others
may enter treatment after experiencing severe consequencesor hitting rock bottom realizing the urgent need
(02:42):
for change. Every person's journey isunique, but almost always a loved one
or family member is also affected bytheir substance use. Addiction is a disease
that affects the entire family, andyou could not be more on point when
you say that. In many individuals, they go through multiple cycles of treatment
and relapse, but you hope witheach relapse serving as a potential turning point
(03:08):
leaning them back into treatment. Additionally, some may enter treatment as part of
a court mandate or due to familyinterventions. Regardless of the entry point,
addiction treatment provides vital support and resourcesto help individuals regain control of their lives
and move forward towards lifelong, lastingrecovery. Yeah, we're very excited to
(03:34):
be joined by doctor Peter Vernik,who is Vice President of Mental Health Services,
and doctor Hung Un, chief MedicalOfficer, both from Recovery Centers of
America. Well share different viewpoints whenpatients enter recovery centers, three pathways and
what does the life cycle of recoveryjourney, what does it look like peep
(03:59):
Sure, So when we think aboutpeople who are coming into treatment, really
we're thinking about them not as allbeing the same. I think that that's
a place where a lot of timesyou do a great disservice to people who
are in recovery and who are startingtheir recovery journeys by just looking at sort
of a one size fits all wayof providing people with care. So when
we are assessing, when we areworking out a plan of care for patients,
(04:21):
what we look at is people whoare in treatment for the first time.
You know, you had kind ofbrought up, Tony the idea about
people cycling through treatment or having beenin treatment for multiple episodes. And I
think that because we sometimes will focuson that, we'll forget about the person
who's in treatment for the first time. And this is something, you know,
the fear, the stigma, thedifficulty just of not knowing what to
(04:44):
expect, the uncertainty is amazing forthese individuals and for their families. So
being able to tailor their treatment totheir specific needs, to learn about their
illness, learn about how it affectsthem and their families versus folks who have
been in treatment before, and youknow, they maybe don't need that initial
learning, they've already gone through that, but we have amazing opportunities with them
to look at what has worked andwhat hasn't worked in the past. You
(05:08):
know, every experience of treatment thatsomebody has, they got something from that
that was helpful, and they probablywere things that didn't help them and that
were even counterproductive. So let's learnfrom that and help that to tailor their
treatment going forward. And then finally, you know, you brought up also
the idea of trauma and mental healthand how for so many people that's behind
their substance use disorder. So welook at folks who come into to see
(05:30):
us who have a major mental illness, or have a history of trauma,
or even have a physical illness,you know, a pain disorder or something
else that is driving their substance use, and what can we do to treat
the entire person, not just theirsubstance use disorder, but treat what's going
on underneath that so that we're trulynot just putting a band aid on the
surface, but we're addressing what's goingon underneath that. Yeah, doctor Ewan.
(05:53):
As Pete says, people come into treatment in different points. Some
people have been in treatment before,people for the first time. Some people
need to get to rock bottom rightbefore they are ready, and other people
recognize that this is something that theyneed to address and they may not have
hit rock bottom, but they knowthat that is their point. Let's talk
(06:15):
about those different entry points that peoplehave a little bit more so. First
of all, my hope is thatpeople don't have to hit rock bottom to
get treated. Oh thank god,you said. You have no idea how
much that means to me hearing yousay that. Yeah, it's really important
that we try to capture people intheir journey. They're going to be people
who are ready first time. Theywill get better, they'll make recovery,
(06:40):
sustain recovery, and lead a normallife. And as Pete says, there
are people who are having recurrent episodes, and then there are people would behavioral
disorders and they need different types ofinterventions, and the families need different types
of supports. For the first time, you're frightened, you're scared, you
don't know where to go, andyou don't know what to do. Maybe
(07:00):
on the recurrent episode you're frustrated withthat family member, and then with psychiatric
disorders, you know, you maynot even know what to do, and
do I go for the mental healthforce? Do I tree substitutes first?
And it's very confusing. So makingsure we meet the person where they are,
whether they're ready or not, andtry to help them start their journey,
(07:24):
because getting them started and getting themsustained in their journey is critically what's
important. You know, Tony,you reacted to what the doctor said about
not having to hit rock bottom.You reacted to that, and I'm sort
of curious as to why you said. Yeah, I'm glad you said that,
because it's there's two ways to lookat rock bottom. What is rock
(07:46):
bottom? Is rock bottom being ina street with nothing and ill and all
alone and just abandoned. Is thatrock bottom? Or is rock bottom a
mental state where people just become tiredof being tired? You know, I'm
(08:09):
sorry. When my son died,my son, Michael, gave eulogy,
and every time Tony would come over, he would he would be very distant,
and you know, he didn't wantto be involved in anything, and
it would get my son mad,my my middle son, Michael, and
(08:33):
he would be like, why doyou come over? If you if you
want to act that way, whydo you want to come over? And
when he died and Michael gave eulogy, he told that story and he said,
I didn't realize till after I learnedthat Tony was just tired, you
(08:54):
know, he was tired of beingtired. You know, people think people
struggling with addiction are weak. They'renot. They're the strongest people you will
ever want to meet in your entirelife because they are battling that and to
be judged every day. And lookat the stairs that you get and the
(09:16):
way people talk about you, andno one is harder than someone in recovery
or an active addiction on themselves thanthemselves and they get to feel hopeless.
So when you said that, itjust hit a nerve with me, because
God, we should have programs inplace. People should understand we shouldn't let
(09:41):
someone get to a point where it'sthem wanting to die, just wanting to
die for us to step in.And I know there'll be people that listen
to the podcast and then turn aroundand go, oh, you don't understand
if they don't want help. Yes, I get it. If someone doesn't
want help, you can put themin recovery. You can to go to
recovery and nothing will change because theydon't want that. But we need to
(10:05):
look at recovery different than we've beenlooking at it. We need to look
at the human the human aspect ofwhy people are self medicating. And you
said something else that just, ohmy god, it blew my mind.
It's like, sometimes we're so focusedon the sobriety that we forget that there's
(10:28):
a reason for this. And whenyou said, sometimes you have to decide
is the mental health aspect the mostimportant thing to start with, or is
it the sobriety? Is it gettinginto detox? And I got to tell
you, honestly, I'm a bigbeliever that we should work on the mental
issue and then slowly get them intothat instead of just throwing them into a
(10:52):
room and detoxing them and going,well, now your body doesn't need it
anymore, go out, have fun, God bless you, and use your
will power because eventually will power break. So when you said that, my
respect level for you went up fivethousand points because that is so important that
(11:13):
he said that in so important toaddress and it just it affected me,
it did. It affected me whenyou said, well, yeah, I'm
sorry. You know, Tony,I think you encapsulated the whole area of
how substance disorder has evolved. So, first of all, hidden rock bottom
is really and then example of stigma, right, it's you have to suffer
(11:37):
to recover kind of thing, andthat's not the case. So stigma tells
us that people have to hit rockbottom, and that was true for mental
health. I mean, it wasn'tthat long ago. Depression was stigmatized and
people had to just pull themselves upby the bootstrap, and that's not the
case. They can get treatment early, just as you can get treatment for
(11:58):
Susan Chooes disorder. The other thingis that it's a disorder of the brain.
It's a disorder that causes impact onyour motivation, impact on your ore,
your ability to think. Actually,that is the rock bottom for the
brain, and once you're at thatstate, you really need help to recover.
And to your point, you needto make sure we heal the brain
the mental illness. Wonderful point.Just to follow up on what's been said
(12:24):
so far about meeting patients where theyare. I think that's something that a
lot of people on the outside orwithin the family have a hard time with.
Just like Tony talked about his sonwasn't really understanding where his other son
was at and thinking why doesn't hedo this or why doesn't he have this
(12:46):
attitude? So how do you tellfamily members and friends how to really approach
someone who's going through that struggle andmeeting them where they are? So in
the field we use the term meetthe patient where they are all the time,
and that kind of is representative ofsome of the developments in the field
over the past ten twenty years.The idea, that confrontation and that sort
(13:09):
of linear approach that you know,starting with rock bottom, then a withdrawal
management or detox program, then aresidential than an outpatient. It's just the
only it's a one size fits all. It's the way that it has to
work. The idea that you canpush somebody into treatment as opposed to getting
them to agree and getting thereby andI mean this is true for all of
(13:30):
us. We are much more likelyto work towards a goal that is our
goal, as opposed to as agoal that somebody else gives to us.
So the idea of meeting someone wherethey are is the fact that if somebody
is not willing to acknowledge that theirdrug use has become a problem for them,
sitting down and trying to force themto admit that is not going to
be productive. You know, whenwe confront someone, when we push somebody,
(13:52):
that only makes them more defensive,That only causes them to you know,
back into a corner and feel likethey're being targeted or cornered, and
you know, that is generally nothelpful. So the idea that we encourage
families and that we as professionals useis we're just going to talk about it.
So, you know, if Isit down with a patient and they're
telling me that their drug use isnot a problem, Okay, that's fine.
(14:13):
Just tell me about your drug use. Then tell me about how it's
not a problem, tell me abouthow it affects you, how it doesn't
affect you. Nine times out often they'll start to tell me how it
actually is a problem for them.But that's because I'm not pushing them for
that. I'm not trying to forcethem into saying something. You know,
it's not a gotcha with the patient, and so I would encourage the exact
same thing with families. Just openthat dialogue with them. It's destigmatizing to
(14:37):
talk about it. It's important toopen up those lines of communication and let
them know. There's no judgment andthere's no agenda. It's simply that you
know. If it's a family member, I love you, I care about
you. Every part of your lifeis important to me, even this part
of it. So I want tohear what's going on with you. It's
very hard, I think for peoplenot to be judgmental, but I love
the language that you use that allowthat open conversation. It's not like you're
(15:03):
wrong, you need to get help, but what's happening with you right now?
Tell us about that, and thenit allows that person to open up.
Yeah, and you also said somethingthat hit with me as well.
You said we need to get peoplebetter. And we had this conversation in
our last podcast that I don't likethe term. I just personally am not
(15:28):
fond of the term clean. Idon't like it because it sounds to me
that you're dirty. And I keeptelling people people don't need to get clean,
they need to get well and letme tell you something. Words are
powerful. When you hear them overand over again. You stigmatize yourself as
(15:54):
someone who is struggling with a loss. And make no mistake, someone who
is an active addiction is suffering aloss, a loss of who they were
and who they thought they wanted tobe or what they thought their life would
turn into. I love that youmentioned the fact of the family. The
(16:15):
saddest part is the family is likealways on the back burner, like they're
the least most important thing when unlessyou go through it, you can't imagine
what it is like to watch someonethat you love dying in front of you
(16:37):
and your hands are tied and youdon't know what to do, and you
look for help. That isn't there. When he died, it wasn't there.
No one was speaking like we werespeaking now. No one was talking
about mental health, no one wastalking about trauma. It was just,
you know, people look at mentalhealth as a weakness. They look at
addiction as a choice. And untilwe can change that narrative, until people
(17:03):
understand that these are real people withreal problems that are struggling, my son
said to me, and I willnever forget this, he said, dad,
I just wish I would die soI would stop hurting the people that
I love. And he believed it, like he believed that he believed that
(17:26):
he would be better, everyone inhis life would be better if he died.
So how much pain do you haveto be hidden to feel that way?
And there's very little support for families, and they're afraid. When Tony
first died, everyone said, don'ttell him, don't tell him that he
died. You know, like whywhy? Because this stigma, that's why?
(17:52):
And it has to stop. Doctor. So we're talking about meeting people
where they are, and you've alreadyindicated the two of you that there are
many different strategies. It's not likea one size fit all approach. How
do you begin to decide or tailorto that individual what works best for them?
(18:15):
What are some of the questions thatyou ask them? It's actually relatively
irrelevant what I think. You needto start where the patient is and ask
them what's going with them? Howhas three drug use alcohol use affected them?
And started then craft a solution together. It's called shared decision making.
You know, we do this inrest of medicine when we treat patients with
(18:36):
diabetes we talk about how best totreat diabetes, what's no different with addicption.
Addiction is a chronic disorder the brain. You need to start with the
patient and ask the question, whatwould you like help with what's bothering you
the most? And is this optionan option that's accept the word to you?
If not, how can we tweakit and modify it. That's a
different approach rather than saying you're dirtyand you need to get clean. So
(19:03):
I think it's really listening to thepatient and engaging the patient, and also
the same time also engaging the family. I think you said that families are
just kind of set aside. Addictionis a disorder of the family in some
ways because it impacts the whole familysystem. And so how the patient does,
whether it's diabetes or addiction, alsoinvolves the family. And where's the
(19:23):
family? I mean when you talkabout your other son, Okay, it's
just so moving to hear the strugglethat he's got, and I just wish
that you know, he had theopportunity to have had the information about addiction
and not to blame himself, becauseyou know, there's too much going on
(19:44):
everywhere to be blaming people that's justa disorder of the brain. We don't
blame people with diabetes, right,we should not be blaming people addiction either.
Doctor Vernig. I think that doctorand says something that's so interesting,
and that is that the disease affectsthe whole family. And Tony talks about
it too. And what we've seenis we've seen great strides made in understanding
(20:06):
that and so that when you gointo treatment, it seems like you really
also have to look at how itimpacts the whole family, because it's not
just that person, but it's thatperson in the context of their circle,
right absolutely. And you know,just like every patient to every individual who's
living with a substance huse disorder isdifferent and needs something different. Every family
(20:26):
is different and is in a differentplace. Sometimes what families need is they
just need the support. Sometimes theyneed to heal as a family unit.
Sometimes, you know, if somebody'sbeen struggling for a long time and been
around going through that cycle over andover again, the family needs to learn
that it's not that individual's fault andthey need to learn to forgive the patient.
They need to learn to forgive themselvesas well. So just like with
(20:47):
a patient, you need to notjust dictate what needs to be done and
here's the list of things you haveto go through. It's the same way
with a family. Assess what's goingon, determine what they need, listen
to what they're saying, and thento provide support for them based on that.
Well, we're going to be talkingin future podcasts about all the different
types of modalities that you have tooffer, and there's so many because there's
(21:10):
been so many advances in treatment.But I think, Tony, I think
it'll be interesting for us to askthese guys how they got into this,
why they're committed to this whole fieldof recovery. And Tony, I have
to acknowledge you for your heart andfor your honesty and for your willingness to
share what is clearly still a verypainful, painful thing to lose a child
(21:37):
like that is, and the factthat you're taking that and utilizing it for
your mission to help other people.I just wanted to shout you out for
that because we appreciate you so much. Well, thank you. It's a
club that no one wants to bein. Yeah, you know, and
that was an amazing question that youjust asked me, because I'm always fascinated
(22:04):
by why someone does what they doand what was the mode? Did you
always know this is the field youwanted to do where you always connected in
most people, just you know,you know you want to help people,
like you know that your mission inlife isn't just about making money. And
(22:26):
again, I'm not putting anyone down, and it's the truth that people.
Some people their mission is they wantto be successful, they're entrepreneurs, and
I get it. You know.My youngest son is a nurse, you
know, and he used to bein business and he was like, I
don't I'm not interested in making money, dad, I'm interested in making a
difference, because that's kind of washis calling. So I'm always interested in
(22:52):
asking what brought you to where youare today? Did start as a child?
Was it just experiences that you hadin your life? What brought you
here? Sure? So I alwaysknew that I wanted to do things to
help people. That was always importantto me. But actually when I first
was in school and was, youknow, considering careers and what direction my
life would go. Oddly enough,I actually studied engineering and I did that
(23:15):
for a short amount of time,but then realized that what I wanted to
do was be closer to people.And you know, don't get me wrong,
engineers do things, create things,design things that help people, that
serve humanity, that do wonderful things. But I wanted to be closer to
that actual human connection and the helpingprofessions. So I did then, you
know, look into and begin studyingpsychology. You know, after years of
(23:38):
study and working in the field andlearning about, you know, how the
field functions, all of the positivesand all of the negatives too, all
of the difficulties that we've kind oftalked about about stigma and people not getting
the care that they need, realizethat that is what I wanted to dedicate
my life to. So I becamea psychologist, And then also realized that
(23:59):
one of the things that I enjoyis helping people with systems, helping to
build systems that truly help people,that allow people to get the care that
sometimes they're not able to, makingthose systems provide the best care possible.
So I worked on the mental healthside for a long time, mostly in
inpatient hospitals, providing care for someof those most in need of support in
(24:19):
our society. And then you know, obviously, with how prevalent substance use
disorders are among people living with severemental illness, did a lot of work
with substance use and eventually decided toshift a little bit more over towards the
substance use side. But have beenvery involved, obviously in my role in
my current position, integrating mental healthservices and substance use services because that's something
(24:42):
I think that we don't have enoughof in our service delivery system and that
we need more of. We kindof create this false dichotomy, the fake
idea that there are substance use treatmentservices and then there's mental health services,
And of course that's because of theway things are licensed and it's the way
that insurance companies pay for care.But that's a fake dichotomy. The reality
(25:04):
is it's you know, one andthe same substance use disorders are a mental
illness. There's a lot of overlapbetween the two, and the more we
can do to break down those barriers, I mean, the different groups they
struggle with the same issues, stigma, difficulties in the family. They have
this cyclical relationship that makes it reallyhard for people to move forward. Doctor
Wone, what about you so Icome from a family of physicians, actually
(25:26):
a family of psychiatrists, have along standing experience with mental illness and substitute
treatment. One of the areas thatI was really concerned about and frustrated with
is in terms of the pace atwhich we adopt evidence based care. In
the past twenty years, there's beenthis emergence of treatment of psychiatric disorder as
(25:48):
a disorder of the brain, butit was lagging on substitute side, and
there was this emerging literature of nationalistof drug abuse where basically stated that it
was a disorder, chronic disorder ofthe brain that can be helped with therapy
but also with medication, and thatthe treatment needs to be continuous. And
I was frustrated at the level ofthe adoption. So I wanted to really
(26:12):
get into the fear of SUD totry to try to accelerate the adoption of
evidence based care so that people aredying. Your son died, and part
of that is actually our fort insome ways the healthcare delivery, because we
haven't adopted the evidence based care ata pace that is efficient, effective,
(26:33):
and available. That's what got meinto this area. You know, what's
so exciting about doing this podcast isthat I learned something from it. And
I have to admit that even Ihad this preconception that you had to hit
rock bottom before you were ready toseek treatment, because I've known so many
people for whom that was true.But what you're saying is that there's a
(26:56):
continuum and people can jump off thatcontinuum at any point in it, and
it doesn't have to be over here. It can be here or here or
here. And I think that's avery important message for all of our listeners
and viewers to be able to wraptheir heads around. I think that's important.
I learned something from this experience,and I think that's an important important
(27:22):
point to make. You know,it's funny. When I was first approached
about the podcast, you can't imaginehow much tremendous respect I have for you.
I mean, I wouldn't want todo this with anyone. You are
brilliant, brilliant, and I reallywant to applaud both of you doctors.
(27:42):
I did not want to be involvedin a podcast that just gave numbers and
figures and it was the same,the same old rhetoric that I've heard over
and over and over again, thesame cycle to hear someone with your education
and your status to say, youknow what, we dropped the ball for
(28:07):
twenty years, like we need tointegrate. Like this is what I was
praying that this podcast would be realtalk, real people, not people covering
up self, not people not takingresponsibility for anything. But people coming on
and go, look this is thereality. Yeah, things need to change.
We need to get families involved more. We need to educate families more.
(28:30):
We need to let people know thatthey're not useless, and they're not
a waste of life, and they'renot weak, and that they're struggling.
And you hit on a point withdiabetes. But and I agree, but
it's like I've never seen anyone walkinto a hospital with a cancer patient that
(28:51):
is suffering ever and go, well, they should have had a stronger immune
system. No one says that,right, No one says that because people
believe, well, you know cancer, you didn't ask for cancer. Well,
no one asks to go through mentalissues either. There are traumas in
life that are so difficult to dealwith. And I'm telling you firsthand,
(29:14):
I know what it's like to befaced with a trauma that is absolutely unbearable,
where death seems to be the onlyoption that you are given to stop
the pain and to break through that. For me, it was music,
Like I said, it was themusic and to write the music for people
to hear it to help them getthrough it. Everyone is different. We
(29:38):
don't know what everyone else needs,but to be able to have those conversations,
real conversations of car and go.You know what, I don't care
that you're using That's not why we'rehere. I don't care. I want
to know you. I want toknow about you. I'm not judging you.
I'm not looking at you, Fanny. I want to know you.
Talk to me, Just talk tome. That's the first line. We've
(30:03):
just forgot how to speak to eachother. We forgot how to talk in
twenty twenty three. We don't knowhow to sit down and have a genuine
conversation without judgment or trying to forceour opinion or our will and what we
think, you know is morally correcton someone else. It's killing us as
(30:26):
human beings. It's destroying us oneperson at a time. And I am
so proud to be a part ofthis, and I don't even know what
to say. I think we cando real good here and make people really
understand well. I'm excited for thispodcast and I'm excited to have had this
conversation with all of you. DoctorPeter vernek if people want more information about
(30:48):
Recovery Centers of America, how dothey find out more? If you'd like
more information about Recovery Centers of America, you can visit us online at RCA
Recovery three sixty dot com or callus at eight four four two five recovery
Doctor Peter Vernick, Vice President ofMental Health Services, doctor Hyungung, chief
medical Officer, both with the RecoveryCenters of America. Tony, I'm excited
(31:12):
to go on to our next episodewhere we're going to be talking more about
the different modalities and getting down intosome of the state of the art treatments
that are available for people who areready to address their issue with substance use.
I'm excited and I want to thankyou both again for your honesty and
candor. I think what you saidwe'll touch a lot of people and it
(31:36):
will really push them for better understanding. Thank you both so much. I'm
Lorraine Ballard Morrel. I'm Tony LukeJunior. See you next time.
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Decisions, Decisions
Welcome to "Decisions, Decisions," the podcast where boundaries are pushed, and conversations get candid! Join your favorite hosts, Mandii B and WeezyWTF, as they dive deep into the world of non-traditional relationships and explore the often-taboo topics surrounding dating, sex, and love. Every Monday, Mandii and Weezy invite you to unlearn the outdated narratives dictated by traditional patriarchal norms. With a blend of humor, vulnerability, and authenticity, they share their personal journeys navigating their 30s, tackling the complexities of modern relationships, and engaging in thought-provoking discussions that challenge societal expectations. From groundbreaking interviews with diverse guests to relatable stories that resonate with your experiences, "Decisions, Decisions" is your go-to source for open dialogue about what it truly means to love and connect in today's world. Get ready to reshape your understanding of relationships and embrace the freedom of authentic connections—tune in and join the conversation!