What is the Reality of Recovery?

Substance use and addiction are more than what you expect, and so is the path to recovery. 

In this episode we are exploring what addiction means and what recovery looks like behind the scenes. Eric Martin, Pawnee Mental Health’s Recovery Services Manager, helps us navigate this conversation by expanding expectations and showing us the reality of recovery. We will touch on topics such as relapse, the impact of your community, and getting to the root of addiction.

Have questions, thoughts, or stories you want to share? We would love to hear from you! Shoot us an email at brightminds@pawnee.org

Your mental health matters. While this podcast is meant to foster connection, understanding, and hope, we know that some conversations may bring up difficult or emotional moments. If you need support, help is available and you don’t have to navigate it alone.

If you or someone you know is in crisis or experiencing emotional distress, call or text 988 to reach the Suicide & Crisis Lifeline. Free, confidential support is available at any time.

To learn more about Pawnee Mental Health, visit us at https://www.pawnee.org

Transcript

SPEAKER_00 0:03

Welcome back. I'm Jonathan Saypal.

SPEAKER_03 0:05

And I'm Michelle Nalio, and this is Bright Minds and Brighter Days Podcast.

SPEAKER_00 0:09

Where every episode our goal is to bring you real conversations that meet real care.

SPEAKER_03 0:16

Welcome back. Today we are going to talk about substance use and what is substance use. And today we have Eric Martin, who is, I will actually just let you go ahead and introduce yourself.

SPEAKER_02 0:25

Yeah, hey everyone, I'm Eric Martin, the recovery services manager for Pony Mental Health.

SPEAKER_03 0:30

Okay, thank you so much for being here.

SPEAKER_02 0:32

Absolutely.

SPEAKER_03 0:33

So what is substance use? I think oftentimes what I hear people say is, oh, it's just an alcohol problem. But it's a lot more than alcohol, isn't it?

SPEAKER_01 0:40

Yeah, I mean, such a a a long definition here I can give you, but I mean in simple terms, I mean substance use is it's a problem, it's a struggle uh that not only includes the individual, uh, but you know, the family and friends that are kind of uh in the in the the line of sight of the addiction. Um and yeah, it's not just alcohol. I mean uh obviously there's substances that we know of uh, you know, with uh opiates and methamphetamine and uh you know tobacco, but you know, even on a larger scale, you know, there's there's addictions to gambling, to food, to people, you know. So I mean it's uh you know, specifically our program, you know, addresses more the substance related addictions, but um we certainly can address uh you know addiction uh at a greater level when it impacts you know their emotional health, their physical health. So uh Yeah, that's substance use.

SPEAKER_00 1:34

All right. So what do you do when somebody comes to you and say they're in the throes of addiction, whether they're coming voluntarily or they're being assigned to you uh by somebody else? You know, w what are those first steps?

SPEAKER_01 1:48

On a like administrative uh answer, you know, we have to do an initial assessment. We have to ask them a handful of questions about what's bringing you in, um, you know, what's what's going on, right? And so we ask them all, it's called a biopsychosocial, right? So we ask about their family history, we ask about their mental health, their physical health, uh, we ask about uh substance use history, mental health history, um, all those things. And so from that assessment, um our our clinicians, uh qualified clinicians, uh make a determination on on what to do next, right? So for a lot of folks, the answer is outpatient therapy, outpatient services. So that'll include uh outpatient uh individual therapy, it can include outpatient group therapy, it could include uh case management, uh, and then what's called peer support, which is more uh one-on-one support with with uh a staff member who is also in recovery themselves. So that's a whole topic for another day. But yeah, so we can make that assessment, recommend outpatient services, but we can also recommend inpatient services, which is more of a dramatic recommendation, especially for those really struggling. So with the inpatient, you know, you're spending 21 to 30 days in an inpatient rehab facility, right? Um kind of doors locked, you're not you're not you're not leaving, uh, you're here for for a good while addressing uh addressing your addiction and everything else that comes with it. So those are really kind of what we do at at at at that base layer, but obviously a lot goes on in therapy, a lot goes on with peer support and case management, with dissecting kind of like everything that's like beneath the addiction, because that's like what the root of the problem is. Yeah, what the root of the problem is, you know. So, you know, when someone comes in and they say, you know, I'm I'm addicted to meth, you know, okay, thank you. Like I appreciate you sharing that. Um I appreciate you being honest with me. But what what it what what I see is is someone who's coming in with with baggages of of trauma, baggages of emotional struggles, uh, you know, failed relationships, shame, guilt. So like so our goal is not to say, all right, like no more meth, like knock it off. It's like, all right, yes, ideally, let's not do any more meth uh because it's killing you, but you know, let's let's really get to the root of of of what is at the center of the addiction. Uh and and that's rural really where the the work begins and it's continuous. It's not just a give me two weeks, we'll we'll knock this trauma out of your life, and then you'll be good. No, it's it's it's a lot of work um on both sides, for both both for the clinician and and the client. But um but yeah, that's what I would say majority of what my team does is get to the root of the addiction. Because a lot of people just say, Oh, it's so easy, just stop. Just stop.

SPEAKER_03 4:35

When it's a coping mechanism, it's a habit.

SPEAKER_01 4:37

Absolutely, you know, and that's that's that's why you know so many people struggle with with with substances, you know, because it works, right? I when I hear when a client comes in and says, you know, I've been drinking daily for the past you know 20 years, here's my life story, and they tell me everything they've been through, you know, I in my mind I'm like, yeah, I don't you know blame you for turning to alcohol because it it works, right? Uh, you know, overused term is it it kind of enums the emotions, but yeah, I mean in a sense it I I get it. I mean So there's kind of that like pain pleasure aspect of it. Exactly, exactly. So I obviously I'm not gonna say, well, yeah, you've had a hard life, like keep keep keep drinking. But it it does I kind of normalize, like I I understand, you know, you're not just this uh, you know, this person who just one day decide, hey, you know what, I'm bored, let's just let's just pick up the bottle and not and not put it down, right? There I understand it. I'm with them in in this struggle, kind of uh helping them to breathe a little bit in the sense that there is uh you know a reason for this, uh, and it's not just stop. There's a reason, you know, that we've already talked about with the emotional health and physical health. So um yeah, and I think that's just a misunderstanding a lot with with addiction, just stop. Stop. And that's why so many still struggle because that's not that's not the answer.

SPEAKER_03 5:56

So how does someone, whether it's an individual, themselves, a family member, a friend, how does somebody know when substance use is becoming a problem?

SPEAKER_01 6:04

The physical side of things, you know, depending on what drug you're or substance you're abusing, you're gonna you're gonna see some you know severe weight loss or weight gain, you're gonna see some, you know, um your blood pressure is gonna be off. I mean all all those those like doctor things, uh, you know, uh physical health is is is pretty obvious to to kind of just the the common bystander, but more like internally, you're gonna see, you know, struggles with income, struggles with job stability, struggles in relationships, right? I mean, uh depending on on the addiction, uh your your personality can change dramatically. And so if you have a family, a kid, spouse, you know, they're gonna see it, they're gonna be impacted by your behavior. Um, you know, you may be gone a lot. You may start coming up with excuses to be gone, you know. Hey, I'm gonna be late from work, you know. I usually get home at five, but today I'm gonna be home at seven, and then the next week it's not, it's eight, and not and so relationships start to crumble, um, your emotional health starts to crumble. Maybe you notice the person's, you know, more you know, more introverted or or more extroverted uh than usual. So family and friends are gonna notice those behavioral changes and um they're gonna know something's off, right? So I would look for those things.

SPEAKER_03 7:15

So it's not just a time frame. No, no, they're maybe drink three beers a day for the past seven weeks, now it's a problem. Like it's just when you physically see major changes in somebody's and their behaviors.

SPEAKER_01 7:27

Yeah. And oftentimes it's everyone else that's seeing it but you, right? Which is you know, it's it's it's understandable. But yeah, I mean, oftentimes that's that's the hardest part is hearing the feedback from other people. Hey, we noticed some changes, you're coming to work late, you're missing deadlines, or you know, maybe the person spent all their money on a substance, so they're behind their mortgage. I mean, so all things it starts just to just a snowball, right? So um, and the last person usually to say, okay, let's get some help, is the person struggling.

SPEAKER_00 7:57

Um do you think that like carries over into other addictions too? I mean, you know, like we see addictions and you know, all kinds of things, you know. I mean, kids with video games, social media, things like that. I mean, you know, for anybody listening that, you know, might be wondering, hey, you know, am I addicted to something? Uh I mean, is there like a litness test for it?

SPEAKER_01 8:19

Or yeah, I mean, I think um, you know, again, addiction is really like in simple terms, it's any anything that gets in the way of your normal day-to-day living, right? Um uh that's that's when you're kind of teetering on addiction, right? So yeah, I mean whether it's gaming, whether it's money, whether it's uh relationships, um all that stuff, like gambling, like the all like the the same part of the brain that lights up when you are, you know, you know, smoking meth is the same part of the brain that lights up when someone's like like has a big win on a good gamble, right? Same parts of the brain, right? So yes, or or you have a good, you know, a good piece of cake, right? You know, like all it's it's the it's everything's lighting up in the brain, the same spot like a Christmas tree, right? So um so there really is no there's there's slight differences, yeah, like by like chemically, like biologically, but um obviously um it's gonna show differently outwardly. Uh like a uh a gambling addiction will look a little different than a a drug addiction to the bystander. But uh but yeah, I mean it's crazy how many addictions inner like they're they're intertwined, they overlap uh quite you know uh astoundingly. So um that's why a lot of our clinicians are duly licensed in in in a few different types of of addictions. We have gambling licensures, gambling certifications, we have um, you know, uh tobacco uh cessation, like sp specifically uh certifications for for that substance. And so there's it it's all overlaps frequently. Um so um that's my answer.

SPEAKER_03 9:59

Is addiction hereditary? Maybe not all addictions, but are there addictions that are heredit hereditary?

SPEAKER_01 10:05

Yeah, there the there's a lot of debate and uh uh research that suggests like yes and no. Um so I I mean from from my from my research and knowledge, I do think there is there is a hereditary component. Uh I don't think that it's you know causation or excuse me, uh well, yeah, causation that that oh my dad, you know, is an alcoholic, so therefore I will be an alcoholic.

SPEAKER_03 10:29

And I think that's what a society we hear so often is oh you you know, somebody in your household is, so you're naturally going to be.

SPEAKER_01 10:35

Right. I I I mean I think there's I think there is some concern with that. You know, there is addiction in my family, so I'm well aware of the I guess I I could have a more difficult time if that ever kind of entered my life, uh like like like an an addictive behavior. Um so I'm more aware of that. I'm more aware of my kids being exposed to that. Um so so yeah, I I I I I believe there is absolutely a family, you know, a uh a deep like uh biological re reality to uh addiction. But um but many people don't struggle who you know some people come from a long line of addicts and they come out completely different, you know, completely on the you know, other side of the coin. Uh and vice versa. Some grow up in a wonderful family, you know, zero addiction, and and they find themselves, you know, struggling uh big time uh you know as an adult. So a lot of it is you know nature versus nurture, you know, um, so you um just kinda have to have to watch everything.

SPEAKER_00 11:39

And on that, I mean, you know, what what are some of the things that you uh highly encourage when um uh when you're working with somebody who might be experiencing uh say a craving? Oh goodness, cravings, yeah.

SPEAKER_01 11:51

Well I would say uh cravings, so a lot of people don't like cravings, but what I tell clients is a craving is a sign that your body is noticing a shift, is noticing a change, especially if you're let's say like you're a week sober, right? Your cravings for some people are gonna get stronger and stronger and stronger, right? And they come to me, oh my god, I have I have these massive cravings. I'll say, all right, well, first off, cravings while are uncomfortable, it shows that your body's saying something's off, what's going on? So you're you're kind of doing, I guess, the you're you're in the right direction. And secondly, a lot of uh clients will say, I had these these these crazy like dreams where I'm using and I'm just and I wake up in a cold sweat, you know, freaking out. It's like, all right, well that again, that's more your body saying, like, all right, where is this drug? Like, where what's going on? And so so I would say it's it's you know, quote unquote good that those cravings are happening happening, but to address them, uh, well, there's a couple things. One, uh be active, right? Uh in those moments where a craving hits you, depending on what it is, you know, the last thing I want you to do is just to focus on it and just to think about it and say, keep you know, no, no, no, don't do it, stop it. Get up, go for a walk, go for a run, go grab a cup of coffee, do something active to kind of distract yourself from the craving. Um for other people, uh like journaling about it. It sounds cliche. I don't I don't always like journaling, I think for some folks, but writing stuff down, like writing a letter to the drug in that moment, like if you're craving tobacco, whatever, you grab a journal, write out like you know, dear tobacco, I do not want you right now. Love Eric. You know, it's like uh you know, you know, kind of giving your your brain like a different avenue to go down instead of just focusing on the no, no, no, no, no, right. Um, and then you know, thirdly, a lot of folks have you know things like sponsors or or or support people, right? Giving uh your buddy a ring, uh hey, what are you doing right now? You want to go, you know, fishing, whatever. So again, bringing people into your support system, staying active. Um that journal thing is something I've always uh you know utilized for for clients. So those are some some uh things that come off the top of my head. Um but for other people there's there's a lot of things that can work, but uh I think staying active is the top thing for me.

SPEAKER_03 13:58

So we don't really have to change your day-to-day routine.

SPEAKER_01 14:03

Uh sometimes you do. Um sometimes. I mean, depending on the severity of the craving, um, you may have to actually change a lot. You know, for example, someone who you know struggles with uh with alcohol, um sometimes they have to take a different route home from work that you know that that doesn't, you know, drive by the uh the your local local your local liquor store, right? So uh and unfortunately in you know towns like this or even bigger cities, it's almost impossible maybe to find a route home that doesn't involve you passing by a liquor store. Uh but for some people they're they're they go even like a more dramatic route and just you know extend their route by 30 minutes if they have to go really outside of town to avoid you know a liquor store. So um some people have to just drop and their entire social circle and start fresh, you know, because everyone in their social circle drinks or smokes or whatever. And so um and if they're not on the same page as you, you say, you know, listen, I uh you know, I wish the best for you, but I can't break away. I can't do this anymore, right? You know, I'm I'm I'm at I'm at risk of losing too much, right? So um so it's almost like you need that, you need like a positive support system. You need a positive support, a big reset, absolutely. So which is hard too, because I mean for adults, it's hard making new friends as an adult. You know, you mean you've got maybe you got your solid foundation of friends and and changing that midlife is it's can be earth earth shattering, and so um but for some folks, yeah, it may take a minor adjustment here and there, but you know, for a lot of people it's it's major adjustments.

SPEAKER_00 15:40

And then I'm sure for some, you know, that that might even mean staying away from some family members.

SPEAKER_01 15:44

Staying, yeah, absolutely, yeah, exactly. So and you see some, yeah, some some marriages like struggling greatly because like you know, one spouse, like if both spouses are using or you know, and one's ready to turn turn the page and uh and the other's not, I mean it's it just can get really complicated really quickly, but it's in those moments you gotta decide like what's like what's best for me, uh, you know, what do I have control over? And so it's um there's a lot that goes into this. You know, I've had some clients who who uh they've had to you know delete their uh their contacts from their phone, you know, like alright, like the guy usually buy drugs from, like he keeps texting me. I'm like, all right, well, A, let's block them, and then B, let's let's delete them from your contacts. I mean, simple things like that too, right? Or hey, maybe, you know, maybe you need to switch phone numbers altogether. So just to kind of clear your name from the the list of contacts, it it's how dramatic are you willing to go to beat this thing is kind of what it comes down to.

SPEAKER_03 16:40

So when somebody doesn't have a support system, yeah, how do you build one? Where like what are resources where can you turn?

SPEAKER_01 16:47

Yeah. Um I mean there's a lot of resources out there. I mean, you know, there's there's the standard AANA support groups, you know, um uh there's other more like spiritual-based groups like celebrate recovery, uh, where you know, um, you know, all those resources you can find on online at your with like the local local meetings and times, but you know, more on like the outpatient setting, I f it's crazy how how quickly clients become friends who are like clients like in our in a in our recovery program, a lot of people have met each other in in group or in in treatment and and they're they become good friends, you know, and they become their support. And it's fascinating to see those relationships develop um rather quickly. Uh some don't end well, some yeah, some you know, some people meet in treatment and it doesn't go well at all. But but a lot of people, you know, it's it they really uh you know uh find themselves uh opening up and and and finding like this newfound like like excitement for life and for treatment and for friendship. So it's it's really cool to see that stuff play out when it does happen.

SPEAKER_00 17:53

Recovery, recovery is kind of you know, I mean it it's definitely a long journey. Yeah. And uh things like relapses do occur. Yeah. Um so when when somebody does go through a relapse and you know they come to you, they're you know, they might there might be, you know, shame. Uh it's a very, very vulnerable state that they might be in. Do you typically uh encourage them to kind of not think about the relapse itself or do you encourage them to you know learn from it?

SPEAKER_01 18:22

Yeah, I mean a little bit of both. I mean I think um I think a relapse you know is expected in recovery. Um it's not often where you see someone who who drops a drug and never touches it again. I mean, often times they'll there'll be those slip-ups, those relapses. So so for one, yeah, I mean, I let's talk about it, but let's not focus on it, right? Let's get you know, kind of the term like let's get back on the horse. Like it happened. Absolutely. I wish it didn't. Um what we focus more on is like what what led up to it, right? Tell me, you know, all right, so this happened last night, like tell me about the last 48 hours, what was going on, and then you can kind of see, connect the dots, say, alright, like so it makes more sense now why the relapse had happened. I'm not saying that it's it's excusable by any means, but in order for us to make change, we need to understand like everything behind it, right? So, so um, and then yeah, I'm not gonna sit there and say, Oh my god, you relapsed again, are you kidding me? You know, like what are you doing? You know, so it's it's it's not guilt, it's not shaming them, but it is challenging them, right, as well, saying, all right, you know, next time, like, you know, we we gotta do something different, especially if they're on probation or if they're on, you know, the throes of having like prison over their head, like, all right, like, you know, probation's not happy with you, you know. So, you know, what are we gonna do this next time? Because I don't know how many more strikes you got left. So for some clients, you need to be more real and honest with them, right? Or hey, you know, you're not, you know, if if they have children and they're in state's custody, it's like, all right, well, I guess you're not gonna see your kids this week because you're gonna test positive on a drug test, right? So sometimes you just gotta let just be real with them and not sugarcoat it, um, which is hard, but I think it's helpful for them just to for for me as the clinician not to sugarcoat or or try to just you know kind of skate around, you know, the issue at hand. But but relapses um is is expected. Not not like I not not that I expect it as in like you will fail, but I just I'm not surprised when it does happen. And I don't say that, hey, you'll you'll probably relapse tomorrow, but like it's a you know, it's just uh um uh I've heard it all, and so I'm not I'm not ever like mad or upset at them. Uh I'm more sympathetic with them and try to get get to the uh root of it.

SPEAKER_03 20:30

With substance use, do you guys do a lot of family therapy?

SPEAKER_01 20:34

Uh no no, so we don't do a lot of family therapy. I mean, we um sometimes, you know, spouses or partners will come in for a session or two, uh, but we don't uh a lot of my clinicians aren't licensed in that in that realm. Um so short answer no. But sometimes we we we can do those every now and then sessions if something's really going on. We'll refer out for family therapy or couples therapy if something's really uh you know needs to be solved uh quickly.

SPEAKER_03 21:03

Okay. So before we wrap up, do you have any success stories you want to share?

SPEAKER_01 21:07

Yeah, I mean we man, we have a lot of success stories all the time, uh, thankfully. Um I've been doing this a while, I've been doing this for over over a decade now, but um I've I had one client who who started in treatment um court ordered, right? Had a had a a pretty hefty drug drug conviction and so had to had to come to treatment in order to satisfy probation requirements. Um and she's she she struggled uh in the beginning uh to kind of uh I guess believe that change was possible. Uh and but over time uh she she kind of she she eventually went all in into treatment and she uh she kind of like we talked about, she she gathered a a new network of friends, a new network of support, um finished treatment, outpatient treatment, and I can't remember if she did inpatient, but regardless, she she finished treatment successfully, finished probation successfully. Um Uh and um I hadn't seen her for a while, uh for a couple years, and then and then she kind of popped back in for some treatment just to do some some more like mental health treatment, was still sober. Uh and then shortly after that she got like this crazy great new job in the community, and now she's like a big like uh recovery uh like master in the community around here. Uh she does a lot of great work. She does some work in the prisons now. She does work with with with some other sober living houses in the community. I mean, she's just she's just a rock star. And so uh she uh she is an example of someone who committed to it, uh rode through the waves, um, you know, had her ups and downs, uh, but never took her off the prize, right? And so she she's doing really well now. I'm really, really, really proud of her. And so uh I just I just wish continued success for her. So mm-hmm.

SPEAKER_00 22:52

That's great. Eric, um, I always like to leave the podcast with this last question. Uh, given everything you've seen day in and day out in you know, in your career, what gives you hope? Oh goodness, hope.

SPEAKER_01 23:07

Um I would say um I've I've said this many times in other podcasts and other events, but uh I think seeing people connect the dots in their life, right? Um seeing people kind of have that aha moment, which I see a lot of. Um, and so helping a client not feel so crazy and so you know, just what is wrong with me? And instead saying I can understand myself a little bit more now, uh, which gives them more control over their behaviors and and and their decisions. So that's what gives me hope. And and certainly success stories like I've shared, seeing my staff uh succeed with their clients, seeing the agencies, you know. So I I see it every day, right? That's what keeps me coming back. Uh and I love what I do, and um, you know, we're uh we're a good team and we're ready to serve and help. Well, thank you for being here with us.

SPEAKER_00 23:56

Thank you. We really appreciate your time. Thank you. Thank you. A new day at Pawnee is about care that works with your life, fewer barriers, more access, and a place where support is ready when you need it most. For over 70 years, Pawnee has been a part of our communities, helping people through tough moments, celebrating hope, and always showing up when it matters. If you've ever needed a hand or know someone who has, Pawnee offers therapy, recovery, crisis, and medication services to walk with you every step of the way. Visit Pawnee.org to learn more. Michelle and I would like you to know pain is temporary, but giving up is permanent, and you don't have to face it alone.

SPEAKER_03 24:40

If you or someone you know is in need of care, hope is available. For local listeners, you can call Pawnee's Crisis Hotline at 1-800-609-2002.

SPEAKER_00 24:51

For our national listeners, you can call or text the National Suicide and Crisis Lifeline at 988.

SPEAKER_03 24:57

Other mental health resources can also be located on our website, Pawnee.org.

SPEAKER_00 25:03

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