Hamden Library Podcast

Substance Abuse Prevention and Recovery

September 05, 2022 Hamden Public Library Episode 12
Substance Abuse Prevention and Recovery
Hamden Library Podcast
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Hamden Library Podcast
Substance Abuse Prevention and Recovery
Sep 05, 2022 Episode 12
Hamden Public Library

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Substance addiction is a pervasive problem that touches everyone in our society. This episode we talk with Dennis Leary of Aware Recovery Care to discuss what addiction is, how to understand it, and how it can be successfully treated. Kara Sepulveda of Quinnipiack Valley Health District also joins us to discuss the overdose epidemic, why the advent of fentanyl has made street drugs even more dangerous, how to recognize an overdose victim and how to help.

CW: Drug use, overdose

More resources:

Substance Abuse & Mental Health Services Administration: https://www.samhsa.gov/
Aware Recovery Care: https://www.awarerecoverycare.com/
ConneCT Without Stigma: https://connectgnh.org/
The Faces of Fentanyl: https://www.FacingFentanylNow.org
Out Of The Darkness Walk : https://supporting.afsp.org/index.cfm?fuseaction=donorDrive.event&eventID=8631
NORAsaves.com: https://www.NORAsaves.com

Show Notes Transcript

Send us a Text Message.

Substance addiction is a pervasive problem that touches everyone in our society. This episode we talk with Dennis Leary of Aware Recovery Care to discuss what addiction is, how to understand it, and how it can be successfully treated. Kara Sepulveda of Quinnipiack Valley Health District also joins us to discuss the overdose epidemic, why the advent of fentanyl has made street drugs even more dangerous, how to recognize an overdose victim and how to help.

CW: Drug use, overdose

More resources:

Substance Abuse & Mental Health Services Administration: https://www.samhsa.gov/
Aware Recovery Care: https://www.awarerecoverycare.com/
ConneCT Without Stigma: https://connectgnh.org/
The Faces of Fentanyl: https://www.FacingFentanylNow.org
Out Of The Darkness Walk : https://supporting.afsp.org/index.cfm?fuseaction=donorDrive.event&eventID=8631
NORAsaves.com: https://www.NORAsaves.com

Michael Pierry  00:07
Hello and welcome to another episode of The Hamden Library Podcast. I'm your host, Michael Pierry, and with me as ever is my co host, Alyssa Bussard. Next month is National Substance Abuse Prevention Month. In recognition, we wanted to dedicate an episode to discussing the ongoing opioid epidemic and the concurrent changes in recovery care that have evolved alongside it. We spoke with Kara Sepulveda, the Quinnipiack Valley Health District, and Dennis Leary -- yes, that's his real name -- of Aware Recovery Care. It is hard to dispel that. The stigma is honestly appalling and pretty ignorant. That's a good place to start. So let's talk about the stigma.

Alyssa Bussard  01:06
Okay, sure. Well, the facts are that there are effective tools in place for opioid and alcohol use disorders that could prevent many deaths, but they aren't sought out by those who would benefit, due to the stigma. Those who suffer from addiction are consistently blamed for their disease. There's a general consensus in the medical profession that addiction is a brain disorder with behavioral components. It is incredibly complex and much like mental health awareness, it seems to be a very taboo and misunderstood topic.

Michael Pierry
So what can we do?

Alyssa Bussard
We have to combat the stigma by educating people about the truth behind substance abuse. By showing that those who suffer from this disease are human beings and thus should be treated the same way you would treat and care for someone else who has an illness.

Michael Pierry  01:37
I read that personalizing those who suffer also reduces the stigma. Some of this is touched upon it in our interview with Dennis Leary from Aware, but the point is that those who suffer from this disease come from all walks of life.

Alyssa Bussard  02:05
They do, yeah. And one in seven Americans reports experiencing a substance use disorder.

Michael Pierry  02:11
Dennis also talked about how addiction is a family disease. I know this is something you have experienced. Can you talk about that at all?

Alyssa Bussard  02:21
Sure, yeah, I try to be very vocal about my loss, because I think talking about it helps bring awareness. My brother died from an overdose over a year ago. Speaking from my own experience, drug addiction affects the family unit as a whole. Much like any illness, if someone is suffering, the entire unit suffers. It's not only the obvious ramifications, the stress of worry, the guilt, and so on. But you see a shift in how conversations are had or how conflict is handled. It's hard to not struggle with how to help and also keep yourself safe unless you're able to view this substance abuse as an illness, which goes against the stigma put forth in society.

Michael Pierry  02:58
So you had a hard time viewing your brother's substance abuse as a disease?

Alyssa Bussard  03:03
You know, I actually think about this a lot. I think I did have a hard time viewing it as a disease. I think at least in the beginning, it's easy to say, you know, "why can't he just choose to be better?" It has taken a lot of time and education to realize that it's not that easy. Anyone can hope to be well but they need the right tools to do that. That’s not to say he didn’t try…trust me there were many different ways in which he tried to be well…but I believe the system failed him. It’s the same as any illness, you need to try different remedies to get better. Some remedies work for some and don’t work for others. This is why I was so interested in the program through AWARE and the harm reduction approach. I wonder - if we had less stigma, if we had more compassion, if these programs were better known and readily available - could that have saved him or others like him?

Michael Pierry  03:49
Yeah. It's hard not to, especially if you lose someone close to you, play that back in your head and try to figure that out. In doing research for this episode I saw that the CDC reported that 107,375 people in the U.S. died of drug overdoses and drug poisonings in the 12-month period ending in January 2022.

Alyssa Bussard  04:15
Yeah, yeah, and 67% of those deaths involve synthetic opioids like fentanyl.

Michael Pierry  04:20
I saw that May 10th has been recognized as National Fentanyl Awareness Day.

Alyssa Bussard  04:25
Yeah, fentanyl is actually said to be 50 times more potent than heroin, and 100 times more potent than morphine. It's less expensive and more addictive. Again, in reading and researching this topic, I found that the CDC reports that fentanyl is involved in more deaths of Americans under 50 than any other cause of death.

Michael Pierry  04:42
And it's involved in more American youth drug deaths than heroin, meth, cocaine, benzos, and prescription drugs combined. How is this happening?

Alyssa Bussard  04:51
Well, as I said, you know, it's less expensive and it's more addictive. Drug traffickers are mixing it with other drugs to drive up the addiction which, of course, leads to repeat customers. Most people who are overdosing don't even know that they're taking fentanyl.

Michael Pierry  05:03
I feel like I'm at a loss here. I mean, how can we - how do we combat this?

Alyssa Bussard  05:09
I guess it all goes back to the stigma and the harm reduction approaches and treating people like humans, you know? Narcan training or simply educating oneself on the statistics usually helps.

Michael Pierry  05:21
I saw the Drug Enforcement Administration created a special exhibit, The Faces of Fentanyl, to commemorate the lives lost from fentanyl poisoning.

Alyssa Bussard  05:30
Yeah, actually, my brother's on that exhibit as well. The hope, you know, is to reduce the stigma by putting a face and a story to these names. FacingFentanylNow.org is a great resource.

Michael Pierry  05:41
We as a society need to remember that addiction is an illness, and it can affect anyone from anywhere. It's a treatable disease and not a character flaw.

Alyssa Bussard  05:51
Exactly. And recovery is so hard, but it's possible. You just have to find the right path to recovery.

Ryan Keeler  06:07
Joining us today is Dennis Leary from Aware Recovery Care. How are you, Dennis?

Dennis Leary  06:12
I'm doing well. Thank you. How are you?

Ryan Keeler  06:14
I'm good. Thank you for joining us.

Dennis Leary  06:17
Thank you for having me.

Ryan Keeler  06:18
We'd like to start out by having you talk about Aware Recovery Care's unique approach to in-home addiction treatment.

Dennis Leary  06:25
Yeah, absolutely. Aware Recovery Care is a dually Joint Commission accredited in-home addiction treatment program. We can be up to a year long. Every client that comes into the program receives a multidisciplinary care team, including a care coordinator, two certified recovery advisors, as well as a family education facilitator that works with the family member of the client. And they also receive an in-home psychotherapist. And what we do is we get together with the client, the care team and any information that we received from any external providers and build a strength, a strength-based treatment plan, and we walk the client through their first year in recovery.

Ryan Keeler  07:11
Okay, and what what is the role of family support? And what does it mean to be, like, a family disease?

Unknown Speaker  07:19
Right. So what we know about addiction is that it impacts everybody that's in the family unit. And by "family unit" I'm referring to - it could be, you know, a loved one, a family member, anybody that has a close and intimate relationship with the person that's living with a substance use disorder, and it really puts the whole family unit in a chokehold. It just regulates, you know, every member from every portion of the whole dynamic. So moms often become nurses, fathers often become, you know, police officers or watchdogs, brothers and sisters become accomplices. So what happens is it has -- addiction has a really strong ripple effect with the client at the center and what they do, what happens is the individual that's sick, you know. Think of when something gets dropped into a puddle, and how those ripples go out. That's kind of like addiction and how it affects everybody within the client's whole circle.

Ryan Keeler  08:31
Why do you think this method works?

Dennis Leary  08:34
Well, it's been shown that people recover better at home, right? When somebody has to go away to treatment, they have to leave their pets, their loved ones, their comfortable things, something as familiar as being able to make food your own way. Being able to still engage with your children, or your dog or your cat or whatever other type of pet you may have, and receiving services right where you live? That's a key metric for success as well as traditional treatment, for some, can often be a bubble, where a person is removed from all temptation and all substances, and then they thrive in a controlled construction environment. With Aware Recovery Care, we are working with the client in real time, helping them navigate real life situations while maintaining sobriety.

Ryan Keeler  09:30
Can you talk a little bit about the peer mentorship?

Dennis Leary  09:34
Right. So, the certified recovery advisors that I mentioned before are a blend different types of recovery support. So there's a blend of certified addictions counselors, recovery support specialists and certified peer recovery support specialists -- certified addictions recovery coaches. And what they do is they work with an individual -- and they are age, gender and story matched to the client to ensure relatability -- and what they do is they work with a client on a peer-to-peer level. And they provide a combination of psychoeducational material around the disease model of addiction, unhealthy coping mechanisms, and things of that nature, combined with adventure based coaching, which can otherwise be known as recovery capital building, and they do things out with the client, in the community, to help promote a recovery oriented lifestyle, and really help that client get assimilated into a life of recovery.

Ryan Keeler  10:36
There may be, like, a stigma or misconception about who is affected by addiction. Who would you say it is?

Dennis Leary  10:45
Everybody from every walk of life judges, lawyers, doctors, nurses, homeless people, business professionals, individuals that work in fast food restaurants. Addiction does not discriminate. I would dare say that everybody walking the face of the earth, to some degree knows somebody, whether it be a loved one, a friend, a friend of a friend, a cousin, somebody that is affected by this disease.

Ryan Keeler  11:12
And can you talk a little bit about the shift from, like, punitive measures to harm reduction?

Dennis Leary  11:20
Right. So the punitive measure is also referred to as the moral model, where they take a look at addiction as being a moral weakness, and that the individual just has a moral failing. And punishment is the treatment modality of choice. Harm reduction takes a broader look at an individual and harm reduction could be, you know. It takes many different forms. An example of a harm reduction approach would be needle exchange, right? So they know that IV drug use is happening, they know that IV drug use promotes the spread of HIV, the spread of Hepatitis C just to name a few, and other pathogens. And so by exchanging needles, allowing individuals to have a clean needle, they're acknowledging the use, acknowledging that it's going to happen, and they're taking steps to mitigate its damages. So what you have is, you have two hands, right? So on this hand, you have a population that's going to inject drugs, regardless of the situation. And then there's a whole host of other sociocultural factors that that go into that. And then you have on this hand, how can we mitigate that? How can we reduce that impact?  Okay, one way is providing a clean syringe exchange program. Some places are even now building safe injection sites, where individuals can go and they can register, and they can actually use their drugs in a controlled environment, and so that's another example. Medication assisted treatment can be considered by some to be a harm reduction model. Personally, I consider it a treatment model. But, you know, some people will say that it's a harm reduction model. What you have is mitigating a factor to otherwise just a problem that would run rampant. And so what's been shown is that quality of life indicators go up if you have somebody that was, you know, I don't know smoking marijuana seven days a week into therapy, combined with, you know, addiction treatment, they reduced that to two times a week. That is improvement.

Ryan Keeler  13:29
And can you share a story or two of successes that you've witnessed?

Dennis Leary  13:36

Ryan Keeler  13:36
Respecting individual anonymity, of course.

Dennis Leary  13:39
Yeah. Probably the most dramatic and most impactful success story that I can think of is an individual that was enrolled in our program, whose parents had spent over a million dollars on treatment. They had tried everything under the sun to save to save their kid. They even sent their child to Israel, because they thought that their child could not speak the language, that they wouldn't be able to find drugs. Child found drugs. So because we know you can drop somebody off in the middle of, you know, Kalamazoo, they want to find something they're going to find it. However, working with Aware that individual flourished, and that individual was able to not only achieve but maintain sobriety and today is married, has children, is a business owner and a healthy and productive member of society. That's just one of many deeply impactful stories. We've also had clients who've struggled. This is an example of how Aware is nonpunitive. So most treatment modalities will take a look at an individual and say if they render X amount of positive urines, then this level of care isn't working. And they will send them to a what's called a Higher Level of Care. At Aware, any client setback or any client recurrence of use is reviewed by a multidisciplinary team led by a psychiatric nurse practitioner, as well as an addiction psychiatrist, and they review for patient safety. And as long as it's considered to be safe to treat the patient, the individual, if they're still stable enough to participate in outpatient level of care, and we've had clients with episodic use, you know, one or two months in, and then suddenly it clicks. And something -- the seeds that we planted during those first two months -- take hold, and the individuals are then able to grasp the concept, because recovery with -- Change is hard, even positive change. I mean, if change was easy we'd all be walking around here with six packs and you know, muscular arms, so even positive change is difficult. And sometimes, the path from addiction to recovery is not a linear path. I mean, it can look like an EKG chart, but the point is continuously moving in the right direction, and not giving up on those clients.

Ryan Keeler  16:16
Thank you, Dennis. And if people wanted to contact Aware Recovery Care, how should they go about doing that?

Dennis Leary  16:23
They can go to www.awarerecoverycare.com. There is a wealth of information on our program and the admissions process, somebody can reach out to me directly at DLeary@awarerecoverycare.com They can also give me a call at 203-631-2556.

Ryan Keeler  16:44
Dennis, thank you so much for sharing the story and joining us today Absolutely. It's been a pleasure.

Mike Wheatley  16:50
A substance use disorder -- SUD -- is a mental disorder that affects a person's brain and behavior, leading to a person's inability to control their use of substances, such as legal or illegal drugs, alcohol or medications. Symptoms can range from moderate to severe, with addiction, being the most severe form of SUDs. Media is a reflection of a society that deeply stigmatizes people with substance use disorders. Many of them tend to address information related to addictions from a negative, condemnatory, and moralizing approach. This situation does nothing but feed the prejudices around the person with problematic uses of alcohol and other drugs, who is considered a criminal in the social imaginary and accordingly, treated with contempt.

That was from "Stigmatization and Media" on the dianova website. 

What should the responsibility of the entertainment industry be with regards to SUD, substance use disorder? I've been thinking about that question a lot lately. I started asking people the question of the month: what is your favorite SUD movie? And I ask that same question to you. I've been surprised by some of the answers. It's led me to seriously consider that most people are not particularly interested in getting educated by films, and that most media creators already know that. 

For this discussion, I am arbitrarily breaking down substance use disorder films into several categories. One, exploitational: drug users and sellers, pushers, have somehow become less than human and deserve whatever bad things happen to them. Two, inspirational: tales or examples to teach us to see the warning signs of drug addiction and offer ways to become healthier. Three, cathartic: screenwriters' and filmmakers' personal journeys expressing their needs, driven either by guilt or artistic inspiration. And four: comic, comedic: sometimes watching someone slip on a banana peel is funny. 

I consider drug films exploitational that create villainous, two dimensional characters as plot device obstacles for the protagonist. Exploitational film is a type of cinema, often cheaply produced, that is designed to create a fast profit by referring to or exploiting contemporary cultural anxieties, such as drug addiction. 

A great example of a cult exploitation film is "Reefer Madness", a 1936 film that, according to Wikipedia, was originally financed by a church group under the title "Tell Your Children". The film was intended to be shown to parents as a morality tale, attempting to teach them about the dangers of cannabis use. Soon after the film was shot, it was purchased by producer Dwain Esper, who recut the film for distribution on the exploitation film circuit, exploiting vulgar interests while escaping censorship under the guise of moral guidance beginning in 1938-1939, through the 1940s and 50s. It was rediscovered in the 60s and 70s as an example, showing the absurd attitude of many about marijuana's supposed addictive power. 

There have been so many plots to films involving drug addicts and dealers that I'm sure we all have an image in our head. For example, a famous black exploitation film was "Coffy", with Pam Grier from 1973 and directed by Jack Hill for American International Pictures, the company founded by Roger Corman. The story is about a black female vigilante played by Pam Grier, who seeks violent revenge against a heroin dealer responsible for her sister's addiction. 

The other well meaning side of drug films is inspirational. They are stories, sometimes mostly true, of addiction and recovery. "Rocket Man", the story of Elton John's descent into drugs, and his recovery is a great example. The word inspirational derives from the Latin root "inspirare", meaning to breathe, or blow into. There are religious overtones to the word inspirational that is appropriate to films about recovery. "When Love is not Enough", and "My Name is Bill W." are about the founding of AA, Alcoholics Anonymous, and by extension NA, Narcotics Anonymous. Movies may inspire us when we need to be uplifted, move us when we least expect it, or cause us to reflect on our own lives when we need a digital mirror to look at ourselves. Be aware that some depictions of alcohol use disorders, AUD, or substance use disorders, SUDs, are graphic, and may cause potential relapse trigger. Some films love to straddle the line between exploitation and catharsis. 

"Trainspotting", an award winning 1996 film from British director Danny Boyle and starring Ewan McGregor, is an exploration into the Edinburgh, Scotland lifestyle of a band of young drug addicts. A tough film to watch, with some deeply disturbing scenes of an addict's life, it is filled with comedy and a musical score that topped the charts. Realistic and gritty, it does offer a warning to those on the same path to destruction, but entertaining all the same. Kind of "The Three Stooges" on heroin. Speaking of the Stooges, then there are those films that seem to play addiction for laughs. One of the more classic 1930s film series and still hugely popular detective series, "The Thin Man" revels in its main character's alcoholism to the extent that William Paul's character is feeding alcohol to their dog, Asta. It would never happen today.

Cheech and Chong have made a career out of living life stoned with films like "Up in Smoke". The films "Dude, Where's My Car" and "Harold and Kumar Go to White Castle" are more current examples. Gateway drugs like ecstasy or the central plot devices in dark comedies, like "Go" from 1999. So what's my favorite? I love the documentary "The Anonymous People" from 2013. It's about the recovery process and concentrates most of its coverage on recovery groups in our region. I also highly recommend the recent movie, "Dan is Back", with a great performance by Julia Roberts, about a son who returns on Christmas Eve. "Half Nelson" with Ryan Gosling and "Brick" with Joseph Gordon Levitt are gritty dramas set in high school that are worth the watch. "Brick"'s dialogue feels straight out of a Bogart film.

Finally, I would like to say that we will never win the so-called drug war with slogans, punishment, and shaming. Media must rise to the medical community's realization that addiction is an illness as real as cancer and heart disease, and support recovery. Dramatic and entertaining as the death of Whitney Houston, or John Belushi, or Heath Ledger is, there are hundreds of thousands of courageous addicts living with recovery that need our support. Where are the telethons? A portion of every film's receipts should go toward recovery. Then, I'll start believing that the industry wants solutions and not profiting on the suffering of others. 

All the films discussed are available through your local library and our surviving local video store Best Video. They are: "Reefer Madness", "Coffy", "Rocket Man", "My Name is Bill W.", "When Love is not Enough", "The Thin Man", "Trainspotting", Cheech and Chong movies, "Dude, Where's My Car?", "Harold and Kumar Go to White Castle", "Half Nelson" "Brick", "The Anonymous People", "Dan is Back". A couple of classic films I didn't mention but deserve to be remembered are "Lost Weekend" with Ray Milland and "Days of Wine and Roses" with Jack Lemmon and Lee Remick. They're both concerned with alcoholics and still resonate today, even though they were made more than 60 years ago.

Ryan Keeler  27:31
Joining us now is Kara Sepulveda from Quinnipiack Valley Health District. Hi, Kara, how you doing today?

Kara Sepulveda  27:38
I'm great. How are you?

Ryan Keeler  27:39
I'm doing very well. Thank you. Um, so the first thing I wanted to ask you about was how did we get to the crisis that we're confronting now?

Kara Sepulveda  27:51
Yeah, no, that's a great question. Especially because a lot of people don't recognize what is happening throughout our community. I think COVID-19 has definitely kind of taken over the last few years in terms of what we're focusing on and responding to, but there's been another epidemic occurring for the last 22 years. And that is the overdose crisis. So, there's a couple of waves that we've gone through, and different substances have contributed to the overdose crisis, but in the 12 month period ending December of 2021, we lost 108,000 people to a drug overdose in the United States. That's a lot of people within a 12 month period. And there's a lot of contributing factors that we're seeing kind of shift as we proceed through this pandemic. So, the first wave of the overdose crisis really began with the overprescribing of prescription opioids in the late 90s. There was little known about the addictive tendencies of opioids and doctors were prescribing, thinking that they were safe and non-addictive, and that really wasn't the case. So that was really the kickstart to this opioid crisis turned overdose crisis. The second wave occurred in 2010, when folks were kind of forced to switch over to heroin instead of prescription opioids, after they were weaned off by doctors once that addictive tendency was recognized, or once they went through their supply too quickly. Heroin is another form of an opioid and it's a lot more accessible and cheaper to buy on the streets as it is illicitly manufactured. The third wave occurred in 2013 with the introduction of synthetic opioids, and that's really fentanyl and other fentanyl analogues that are being illicitly manufactured. And now we're entering our fourth wave. That's, really, poly-substance use. It's not -- people aren't just taking opioids, they're taking a number of substances at one time, and stimulant use is also increasing throughout the community. So there's a lot of intersecting factors, and a lot of this isn't really considered by the average person. It's kind of behind closed doors, there's a lot of stigma surrounding substance use and mental health. So we're really just trying to get ahead of this and show people that it's okay to talk about and it's okay to ask for help.

Ryan Keeler  30:42
What exactly are opioids? And why are they such a problem?

Kara Sepulveda  30:46
Yeah, that's a great question. You'd be surprised how many people come up to me and ask, you know, at an opioid forum, Hey, what are opioids? So opioids are a class of drugs that are found naturally in the opium poppy plant. But they can also be synthetically made in a lab. And they ultimately function to provide physical, mental and emotional relief, so they work to relieve pain. Opioids include both prescription medications that you might receive legally through a doctor and a prescriber at a pharmacy, but they also include illicitly manufactured fentanyl, that is being illegally made, as well as heroin. So opioids are really a problem because they're respiratory depressants. So when taken an excess over time, your body's natural ability to breathe is diminished, and people end up dying due to a lack of oxygen. So while we lost more than 108,000 people, those were only deaths within a 12 month period. There's countless numbers of nonfatal overdoses happening every day. In the greater New Haven area, we have about 30 nonfatal overdoses every single week. So really, just trying to put that in perspective. Opioids are also highly addictive. So people end up having to take more and more over time to receive the same relief. And, you know, people's tolerances vary, and fentanyl -- illicitly manufactured fentanyl is being mixed into the drug supply, which is a very powerful substance, and it only takes a small amount to be a lethal dose if you don't have a high tolerance to opioids. I also think in the United States, we have a tendency to treat pain and, you know, medications are pretty normalized. So I think we need to have more conversations with our youth and saying, you know, "medications are really to be taken as prescribed by the person that they are prescribed for". Medication serves a purpose at the end of the day for a lot of people, but they need to be taken properly and with education.

Ryan Keeler  32:56
Who is being impacted by this, and how does it connect with mental health issues?

Kara Sepulveda  33:01
Yeah, great question. So we're seeing a change in the demographics of folks who are being impacted. So a new analysis from the CDC, using data from 25 states, found that fatal overdoses increased by 44% among Black Americans in 2020 compared to the year prior. So we're seeing more and more drugs -- different drug types -- being contaminated with illicitly manufactured fentanyl. So previously, when I would do outreach in the community, you know, people would hear fentanyl and they would think of heroin, but that's not the case anymore. Fentanyl is being mixed into a lot of different substances like stimulants and cocaine, crack, methamphetamine, so people who are non-opioid users are now being exposed and experiencing overdose. And you've kind of touched on this a little bit in the last two questions, but what are some current trends and issues with overdose and substance abuse? Yeah, so our slogan here at QVHD is, "anyone can overdose and anyone can save a life." So I think it's really important for folks to recognize that if you're not a substance user it doesn't mean that you aren't impacted. There's a saying that everyone knows someone that is impacted by substance use. Substance use, in a way, is very normalized when it comes to substances like alcohol, but other substances like illegal substances don't carry that same weight. So I think it's really important for people to recognize that overdoses occur everywhere. They're happening within every zip code, and they're also happening to an array of people. So it's not just affecting one gender, one race, one ethnicity, one age group. What's interesting is, overdose is a lifespan issue. We're seeing overdoses within every single age group, but at this point in time, overdoses are highest among the 35 to 44 year old age group. We're also seeing other substances entering the drug supply. So there's something called xylazine. It's actually an animal tranquilizer that is now being mixed into fentanyl, and again, it's not designed for human consumption. So it's causing a lot of unfortunate side effects and contributing even further to the overdose crisis.

Ryan Keeler  36:44
How can people identify when someone might be experiencing an overdose and respond?

Kara Sepulveda  36:51
Yeah, that's a great question, because the reality is you never know when you might witness an overdose. So I think the two takeaways is one, overdose is preventable. There's a lot of different ways that people can try to stay safe while using drugs including the buddy system, never using drugs alone, making sure that Naloxone -- the opioid overdose reversal medication, which comes in the form of a nasal spray and is harmless if administered to someone who's not overdosing -- is on hand. And also overdoses reversible, so it doesn't have to end fatally because of this Naloxone that's available. So when people are looking, if they find someone who might be unresponsive, we'd like to say look for your ABCs. So is this person alert? Are they responding to their name being called? Are they nodding out? [B,] Are they breathing normally? Are they taking deep breaths? Are they shallow and they're not getting all of the oxygen that they need? And what is their color, for C? Do they have blue, purple discoloration around their lips or fingertips? Anything that might indicate they're not receiving the oxygen that they need. To respond to an opioid overdoses, you're going to want to try to wake this person, you could give a sternum rub, which is rubbing on their breastbone, and if they don't respond to that you want to call 911 immediately. There's a lot of hesitancy among folks to call 911 in the event of an of an overdose. They're concerned about, you know, what the consequences may be due to them having illegal substances nearby, but Connecticut actually has the Good Samaritan Law. So it protects people who are responding to an overdose, calling 911 and or administering naloxone in response to an overdose from civil liability and prosecution related to drugs that might be found by first responders. So you always want to call 911 because Naloxone, the opioid overdose reversal drug, is actually a short acting medication. So it only works for about 30 to 90 minutes and the person can re-overdose again. It's helping them begin breathing again, but it's not a forever solution. So you'll call 911. You'll try to wake that person. If they aren't responsive, you can say hey, you know, "I'm going to provide Naloxone," you'll put that person on their back, you'll grab your Naloxone, and you'll insert the nasal device and spray. It's very straightforward, and again, it's a safe medication if someone is not actually experiencing an overdose. It will only work if an opioid is in their system. You'll wait about two to three minutes. If the person's not breathing, the 911 operator might recommend rescue breathing and they'll walk you through the steps for conducting that. If the person doesn't respond within two to three minutes, you can go ahead and give a second dose of naloxone. And ideally by that point EMS will be there to take over their care. I recognize that's a lot of information. So there's a great website called NORAsaves.com. It's exactly what you need. In the event of an emergency, it'll walk you step by step through the response process and what you need to do to make sure that person is okay.

Ryan Keeler  40:18
Mike, did you have anything you wanted to throw in here?

Michael Pierry  40:21
No, just is there anything else that you think we didn't address or anything else you wanted to say?

Kara Sepulveda  40:26
Yeah, so I just wanted to briefly highlight that, again, I recognize that not everyone has a connection to this cause. And I think one of the most unfortunate realities of our -- of the world we live in, is we have a tendency to really not get involved or care about something until it directly impacts us, and I'm here to say, "let's change that". I hope that you learn something from today's information shared, and that you go on to kind of share that with the people around you. Education and awareness is key. And I think if we kind of take the time to stay informed, normalize these conversations among each other, it could serve a huge role in saving many lives and connecting people to the treatment and resources that they need. Yesterday [August 31, 2022] was International Overdose Awareness Day and we had a huge event on the New Haven Green. I would say more than 500 people came by to learn about the crisis and learn how they can be a part of the solution. So I just wanted to let folks know that Quinnipiack Valley Health District is here to help. We conduct trainings on suicide prevention, overdose response, drug trends, we have harm reduction service providers, and we're really just here to listen to folks, if they aren't really sure where to turn. We're happy to help them kind of navigate what can often be an overwhelming system. I also wanted to invite folks to join the Out of the Darkness Walk. For New Haven County, it's happening at Town Center Park on October 2. Again, the overdose crisis is intersected with the mental health crisis, so we want people to kind of come together and say, "Hey, it's okay not to be okay. Let's talk about it. And let's find something that might help you". So if folks are interested in joining the Out of the Darkness Walk, they could go to afsp.org/hamden. And if you're interested in receiving treatment resources, harm reduction services, getting trained and receive a Naloxone kit for free, they could visit www.ConnectGNH.org. And my contact information is there. And I'd be happy to connect with anyone who might be seeking some guidance at this time.

Ryan Keeler  42:51
Thank you so much for joining us and sharing your expertise.

Kara Sepulveda  42:54
Thank you for having me. I joke that anyone I talk to I try to start these conversations with, so I appreciate you giving me the time of day to kind of share my story and how we can help others. Thank you.

Michael Pierry  43:05
That's it for this month. Thank you for listening. If you found this episode helpful and informative, please consider subscribing to this podcast on whichever app you use and rate and review us on Apple Podcasts, Spotify, or wherever you listen. Next month we will have another special Halloween episode. It's going to be a fun one.

Alyssa Bussard  43:27
If you or someone you know is in immediate danger, call 911 or go to the nearest emergency room. The Substance Abuse and Mental Health Services Administration helpline is a free confidential 24/7 365 day a year treatment referral and Information Service for individuals and families facing mental and or substance use disorders Call 1-800-662-4357 or visit www.samhsa.gov for assistance

Transcribed by https://otter.ai