Substance use disorder. That phrase comes with a backstory. The language we use when discussing those who suffer from the disease of addiction matters. Addict. User. Alcoholic. Junkie. Drug abuse. Drug habit. Is she clean? Is he dirty? These words make no distinction between the person and the disease. They shame, blame, demean and place the fault on the “addict”. They deny the medical nature of the condition and suggest that those with this disorder can simply choose to change their habits.
Substance use disorder. It’s a mouthful, so let’s break it down. “Substance” can refer to one or more of several types of legal or illegal products that cause a release of dopamine in the brain. The dopamine release overstimulates the brain’s “reward circuit”, causing the pleasurable “high” feeling, leading to the substance being overvalued to the point where is becomes a problem. These substances include alcohol; cannabis (marijuana); hallucinogens (LSD, peyote); inhalants; opioids (heroin; oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine); stimulants (cocaine, methamphetamine); and tobacco. Those with this condition may use one or more of these substances, or cycle through them.
“Use” covers a broad spectrum of behavior from mild misuse, to a degree of habituation and psychological dependence, to full-on addiction. Use at any stage along the spectrum can be a problem, and each stage requires a different treatment.
When we label this condition as a disorder, we understand that it is a chronic disease, one that cannot easily be cured. A combination of genetic, environmental, and developmental factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction. Co-occurring disorders, such as trauma and mental health issues, can increase the risk of addiction and make recovery more difficult. The earlier substance use starts, the more likely it will become addiction, and the harder it will be to recover; this makes prevention a key strategy in reducing the instances of SUD. With proper treatment, those with this disorder can recover.
At the League’s April meeting, we learned how substance use disorders (referred to as “SUD”) affect our community, and we heard from two members of our community who have struggled with this condition.
Nicole Keadle coordinates the Community Corrections Partners speakers’ bureau, which is a six-week course for individuals who have had involvement in the criminal justice system. Participants write a speech about their experiences and learn how to be comfortable with public speaking. Nicole started as a participant in the program two years ago; now she runs it. She also works with the Talk About It campaign (http://www.talkaboutitscc.org/), a community partnership that fosters an informed and compassionate county-wide response to substance use disorders and breaks down barriers to treatment of SUD in order to improve health and well-being for all in Santa Cruz County.
Keadle stressed that we must stop talking about addiction as a social issue, or a poor choice someone has made with their life: SUD is a disease like any other. Of the 22,000 people in Santa Cruz County diagnosed with SUD, 94% do not receive treatment. Addiction knows no boundaries: no family, gender, socioeconomic status goes unaffected. No neighborhood or college degree can keep this disease from affecting your family
SUD affects the entire family, “…from the individual suffering from addiction, the parents who have paid that price throughout that entire addiction, the parents themselves that might be facing the addiction, and the children caught in the aftermath.”
Those seeking help with SUD for themselves, a family member, or a friend can call 211 to get connected to the services they need. This service, provided by United Way of Santa Cruz County, is available 24/7, 365 days, in 170 languages, and is free and confidential. The Talk About It website, talkaboutitscc.org, also lists resources for help with SUD. It also has information for those wanting to understand more about this condition or learn how to start a conversation about it.
Keadle related her personal experience with addiction. Because of our county’s unique idea that “it’s treatment over incarceration”, when she found herself in jail, they connected her to service providers and she received the treatment she needed. “Because of that,” she noted, “I’ve been clean now for over four years. It is possible; you just have to give people that chance.”
“We want to live in a thriving, safe place. It starts with opening our minds and our hearts and living in compassion and realizing that this is a treatable, preventable situation.”
Untreated addiction costs our community 208 million dollars a year. Each dollar spent on treatment saves seven. It costs $105 per night to house somebody in jail. On average, it costs $22.50 a night to send somebody to a treatment program. If we could invest that savings into the community, we could work on education, intervention, and preventing SUD in our community’s youth. “We want to live in a thriving, safe place. It starts with opening our minds and our hearts and living in compassion and realizing that this is a treatable, preventable situation.”
Of the 22,000 diagnosed with SUD each year in SCC, only 2,300 ask for help. Of that number, only 1,200 receive the help they need. Whether they are scared or ashamed to ask for help, or just don’t know where to go, those are things we can work to change. “We can live in compassion; we can make it OK to talk about addiction,” Keadle said, “You don't need to feel shamed because you need help. That's something that we can do as individuals. We can make it OK to have this discussion. Talk about it with your family. Talk about it with your co-workers. Talk about it to those that you care about. Let them know that it's OK to ask for help, and that this disease affects everybody. You're not unique, you're not different, you're not something that is shameful. We can help before you hit rock bottom.
Keadle concluded, “We treat other chronic diseases, like cancer or diabetes, and we open our hearts all of the time, we look at them with compassion and say ‘Can we help you?’ We need to look at addiction that way.”
Renee Delisle has been through the first two phases of the speakers’ bureau and is working on phase three, mentoring others. She is now getting her message out to the community.
“The day after my senior prom, (my first Mother’s Day), my own mom passed away from cirrhosis to the liver, the heart, and the throat. I was devastated; I vowed to never drink again, but that didn’t last long.”
“I never in a million years would have imagined that I would become a hopeless drunk, a felon, and an escort who would choose addiction over my own precious child,” Delisle began, “but it happened; not purposely, but it happened.” Delisle took us through her childhood growing up with parents who were “big time partyers and dealers.” At 12, she moved in with her grandparents, but soon she found that weed, alcohol, acid, and crystal meth made her feel alive and accepted, “I finally belonged. My high school years were crazy. I ended up pregnant with my first child, but continued with school. The day after my senior prom, (my first Mother’s Day), my own mom passed away from cirrhosis to the liver, the heart, and the throat. I was devastated; I vowed to never drink again, but that didn’t last long.” Her life spiraled downward, and in spite of many attempts to regain her footing, she “continued to be out of control; I was lost in life.” Her turning point came when her partner, the father of her son, “got belligerently wasted. He punched me in my face while I had the baby in my arms. I had had enough. I called the cops.”
After struggling with alcoholism for the majority of her life, she now has hope, “I’m working my program harder than ever, I work the steps…I go to meetings and have a wonderful sponsor. I’m independent and feel strong.”
Paul Maartense began his story with a grim statistic: “One in four adults suffers from some form of mental illness or substance use disorder. I suspect this statistic to be even higher because of the stigma, shame, and denial associated with mental illness and addiction. It took over 30 years to admit the possibility of mental illness and 40 years before I was finally treated.”
The child of parents who themselves suffered from alcoholism, Maartense’s childhood was marked by homelessness, poverty, bullying, trauma, isolation, and his sense that “I was never enough.” In his teens, Maartense discovered that drugs left him feeling happy and whole, “I couldn’t imagine wanting to feel any other way.” This worked wonderfully, Maartense says, “…up to the point that they decimate everything in my life and I’m sitting in a jail cell trying to make sense of how it all happened.”
“…those visceral feelings of empty coldness were incessant. I was being held hostage in my own mind, thinking thoughts against my will. Thoughts that wanted me dead.”
Over the years, Maartense cycled in and out of addiction. Each time he got his life together, he still felt like a mess inside. “Each time I recovered from drugs, I would put in more effort than the time before, I would attempt new behaviors, methods, and means to make life work right for me.”
Finally, “Afraid of life, but scared to die,” Maartense sought help from a psychologist, who diagnosed him with post-traumatic stress disorder, manic depression, attention deficit disorder, and substance use disorder. At first, Maartense, determined not to use prescription medication, tried many methods of therapy and counseling, but, while he obtained valuable tools, he relapsed and was again placed in rehab. The true breakthrough came when he realized that, despite having many good things in his life, “…those visceral feelings of empty coldness were incessant. I was being held hostage in my own mind, thinking thoughts against my will. Thoughts that wanted me dead.”
Turning back to psychology, a diagnosis of being bi-polar was added to the list, and they found a non-narcotic medication that was right for him. For the first time, he saw his life through clear eyes, “with no inkling of impending doom or inadequacy.” After months of taking the pill, he came to the realization that he no longer needed to take them. Now, having left behind the false beliefs that had limited him, he finds the ups and down of life to be manageable. “Today,” Maartense says, “my disabilities have become my strengths, my experience my greatest asset.”
Those in recovery from substance use disorder have done so through determination and tenacity. They deserve our respect and admiration. We have the means to reduce the impact of substance use disorders on our loved ones and on our community. In order to do so, we must be willing to change how we think about this condition and be willing to commit resources to prevent and treat it.
BY: Pam Newbury, League of Women Voters' VOTER newsletter Editor
To view a video https://youtu.be/wdH5DkqWI8o of this presentation and hear Paul and Renee tell their stories, go to lwvscc.org/videos http://lwvscc.org/videos.html.