Nurses Have Taught Us That No Crisis Is Too Big to Make a Difference

The Opioid Epidemic Needs You: From an Addiction Treatment Owner.

“Nurses have always been known for taking quick initiatives and using their innovative solutions to make some of the largest contributions to the world’s health related issues. Nurses have changed the course of our country for centuries; from Florence Nightingale who advocated sanitary living conditions in the 1800’s, Clara Barton’s courageous leadership during the civil war that led to a little non-profit called The American Red Cross, to the collaborative work of nurses in the early 20th century that created a system to save children from tuberculosis, one of America’s largest public health crisis to date. Nurses are primed to help the opioid epidemic, the largest public health crisis in a generation.

What if I told you that cancer patients across the board in America had a 90% rate of relapse? Just ponder that notion for a minute, and think about the hysteria that would be taking place in this country. Fortunately, in typical American ingenuity, the majority of cancer treatments have improved over the last decades, thanks in large to the medical and science community, from university research programs to nurses and doctors who help patients on the frontline.

Now what if I told you that another health condition affects 1.5 times as many people in America, often with higher mortality rates, and indeed carries a relapse rate around 90%. And what if I told you that this condition is the number one cause of death amongst our youth? Unfortunately this isn’t another hypothetical question; Substance Use Disorder now kills more people under the age of 50 than any other health condition. We are in the midst of a public health crisis, the likes of which hasn’t been seen in generations. If there could be an even scarier notion, it’s that there seems to be no solutions on the horizon. Possibly the biggest reason for this, is that despite every major health journal and committee labeling drug and alcohol addiction a medical condition (if not a disease), the moral stigma attached to this disorder, has largely kept addiction outside the realm of science and medicine, it is still more often treated as a legal issue, instead of a medical condition.

As the founder and owner of an addiction treatment center, I can attest to the notion that we as an industry are failing at our job, but much of that falls on the way our country has failed to treat addiction like any other health related issue. Don’t get me wrong, I get to see the amazing transformation of those that enter our facility hopeless, and gradually flourish into extraordinary people in recovery — I myself have overcome my drug addiction as a product of treatment, but unfortunately this is much more of the exception than the rule.

While drug and alcohol related fatalities have recently surpassed those of auto accidents and firearms, it seems that no amount of media attention is helping curve this trend. Unfortunately, I have to agree with Jennifer Johns, Director of Government Relations at Cleveland Clinic, when she says:

“Our caregivers have been dealing with the opioid epidemic for years, but we don’t believe it has peaked yet,”

Now that is one scary proposition! As a parent to a child, as a professional on the frontline of this issue, I can only see one solution to stopping this trend that is killing our youth. Former Surgeon General Dr. Vivek Murthy stated it the best in the first ever Surgeon General report on addiction:

“Well-supported scientific evidence shows that the traditional separation of substance use disorder treatment and mental health services from mainstream health care has created obstacles to successful care coordination. Efforts are needed to support integrating screening, assessments, interventions, use of medications, and care coordination between general health systems and specialty substance use disorder treatment programs or services.”

We need the help of mainstream healthcare systems!

As hospitals and emergency rooms all across the country are seeing the massive impact of the opioid epidemic (an increase in opioid related emergency visits of more than 200% since 2004) I see the nurses of this country being one of the most impacted workforces from this crisis, but they also carry the ability to have the greatest impact to help reverse the current trends which have surpassed “alarming levels”.

Nurses in particular make up the single largest group of medical care providers in the United States, and have always been known for taking quick initiatives and using their innovative solutions to make some of the largest contributions to the world’s health related issues. Nurses have changed the course of our country for centuries; from Florence Nightingale who advocated sanitary living conditions in the 1800’s, Clara Barton’s courageous leadership during the civil war that led to a little non-profit called The American Red Cross, to the collaborative work of nurses in the early 20th century that created a system to save children from tuberculosis, one of America’s largest public health crisis to date. Nurses are primed to help the opioid epidemic, the largest public health crisis in a generation.

Of course, the examples that illustrate the power and importance of nursing would be a book in itself. The nursing profession has demonstrated that their impact comes not only from their work at the bedside but also as actors in larger social and political arenas.

I guess I should first reveal my bias regarding my gratitude and hope toward the nurse community. You see, in addition to operating a treatment center for those who are struggling like I did for a portion of my life, and I’m married to my best friend who happens to be an ICU nurse. In fact, it was a combination of both mine and my wife’s paths, our collective experience– hers in the medical field, mine as someone in long term recovery — that spurred us to start Pillars Recovery, the treatment center I started over 3 years ago.

I’m quite proud of the program we’ve built, and the philosophy it’s built upon. Our goal is to connect everyone with a community of support, because we believe that connection is the fundamental starting point for anyone who has ever achieved long term sobriety. At Pillars we believe that those in active addiction are natural problem solvers; they’ve used their minds to maintain their addictions, so why not teach them to use those same skills, in a way that is good for themselves and their community?

But here’s the thing — and maybe I’m not supposed to say this, but I’m going to: despite the amazing clinical staff and program we’ve put together, our treatment program isn’t for everyone. I don’t believe in there being a “one size fits all” treatment center. In addition to the clinical reasons that make it difficult to find the right rehab, there is also the economical hurdles that restrict the majority of those who don’t have PPO or HMO insurance from getting in to treatment at all. Most state and medicare plans will only cover treatment centers that most often have waiting lists as long as 3–6 months! And though our center almost always has one or two patients that we have given free scholarships to, the majority of people with substance use disorder will never get the chance at receiving the treatment they need. Having to choose who I can offer free treatment to, is one of the most difficult tasks I have to make, because that means i’m having to reject a dozen others.

This is why we have decided to create a resource line that is designed to help everyone and anyone affected by addiction. Indeed, “in-patient treatment” is not a requirement on the journey map for everyone in recovery.

Meanwhile the “addiction treatment industry” is an industry mixed with great people doing incredible work, as well as dubious-at-best characters, who do whatever they need to in order to get “heads in a bed” and put profit over providing the care and resources needed to give someone a second, third, tenth chance at a new life.

What we’re facing, collectively as a country right now, is a crisis at levels most can’t comprehend. There’s no time for greed or putting profit ahead of patient care. What we need is transparency, honesty, and a diverse selection of treatment options for the diverse population of people that suffer from substance use disorder. Most of all, we need to treat this as a medical condition!

As I began building Pillars and seeing how this epidemic was affecting every type of person in America, my wife had her own experiences as a nurse, helping addicts and alcoholics with whatever limited resources the hospital had available.

Nurses are nothing if not resourceful, and she learned the ins and outs of policies and procedures and possessed a comprehensive understanding of the medical field as it related to drugs and alcohol. I of course saw the front lines through a different lens, but needless to say, we both came to a place of acceptance: that neither of us are going to fix this problem by ourselves.

My experience has taken me on a journey and task that i’ve been working on for nearly two years. I’m trying to implement change in the way communication takes place between general heath care providers, and those who specialize in treating addiction. There is a massive need to learn from each other, and to be able to coordinate a plan in the same way you would with a patient that was suffering from any other disease or condition. For those who have diabetes, cancer, or nearly any other medical issue there is usually an interaction on some level between the primary physician, nurse, and the specialist for that condition.

My quest to make this happen has taken me to hospitals all around the country, finally landing back in my hometown of New Jersey, when a local hospital took notice of my proposal. Still, after months of work with them, this concept fell through, mostly due to the rigid policies and politics of the hospital institutions themselves.

Just as I was running out of ideas, I was again introduced to the resourcefulness and amazing work that nurses do. I found an online community of nurses, running a truly grassroots movement that is doing amazing work. “Show Me Your Stethoscope” (SMYS) started out as a Facebook group, and is now a force to be recon with in the world of medical care. They are a digital community whose 600,000+ nurses, represent over 20% of the workforce in the nursing profession in this country. They too are fed up with the rigid rules and traditions of institutions, that is often rooted in politics before patient care. Unlike any other community SMYS is able to make impactful change at lighting speed. As active members ourselves, my wife and I can attest to some of the amazing work that goes on within this community.

That’s why I’m excited to announce a new partnership between Pillars Recovery and the “Show Me Your Stethoscope” community and it’s administrators. The goal is to help learn from and empower nurses from all over the country who have a stake in the current state of affairs when it comes to the opoiod crisis in America. Together we want to help facilitate a smooth transition for patients from Emergency Rooms and EMT’s to places that can best help set them up for long term sobriety. Nurses are the natural conduit, they are most often the “gate-keepers” of these patients, the first medical professional to make contact with someone suffering from addiction.

We have been working with SMYS for the last few months, trying to come up with a map on how to open the dialogue between the nurses of America and the people who specialize in addiction treatment, and now the time has come to launch our partnership!

It’s important for the nurse community to know, that you are supported in any way we can help. Over the coming weeks we will mostly listen, but we will also provide the resources to any addiction related help you or your patients need, as we build upon this partnership that we see as a way to help attack this epidemic like no one has before. We hope that others will get involved in this partnership as well, other treatment professionals that are doing things the right way, addiction/recovery advocacy groups, and hopefully this will have a domino affect on the way general healthcare providers provide their patients with better assessments and better resources.

My wife and I built a program based upon our own experiences, and like I said, we’ve drawn from the pieces we liked most and Pillars is something we’re extremely proud of. But those are just two experiences. Imagine what we could do if we collectively draw on the experiences of hundreds of thousands of nurses and medical professionals around the country. That’s our goal in partnering with the “Show Me Your Stethoscope” group.

We have quite the monumental task before us. What is the answer? There isn’t one. There are many. Therefore, it will require the many, to find the solution for the one. And i’m perfectly satisfied if that one, doesn’t end up in our facility, as long as we’re able to be a valued resource, then I see this as a great start. We, as an industry, need to understand this. The epidemic we face is bigger than any one facility, or one program, or one philosophy.

But it’s not bigger than all of us.

Below, I’ll list the general logistics of the start to our partnership, along with our pledge and core values.

With that, I’ll ask that you all join us in this journey, to all of the nurses in SMYS, we’re once again in need of your ability to mobilize and start a new trend, as we have a chance to change the trajectory of what many are calling the largest public health crisis in a generation.


Logistics:

We will spend the time making sure that you are given the resources that you or your patient might need, and we will start this off in two ways:

#1. We have been scouring through the countless posts and comments within your community that are related to substance use, and will begin to address these issues within the group from educators, licensed professionals, advocacy groups, and others that like myself are specialists in the addiction treatment space.

#2. We have started a resource line available for all nurses (or their patients) that need questions answered quickly, or resources to be given on demand. We have spent months putting together the most valuable list of resources available for anyone affected by this crisis. You can quickly reach us at 877–227–1079.

While we have spent the time to staff this with professionals at all levels, If we can’t answer your question, we will directly transfer you to someone who immediately can.

In addition to this resource hotline that is free and confidential, you can see some of the resources we have available and are reasons for sponsoring this partnership at www.pillarsrecovery.com/SMYS

The 877–227–1079 resource line is something we have labored over for months, it’s important to remember that there is help available to everyone, regardless of their economical situation, and we pledge to continue to be an invaluable resource with the following mission statement and core set of values:


“Our mission to engage the largest community of medical professionals in the US, provide the best resources available and learn how we can bridge these to industries to help provide better options and outcomes for the vast majority of those with substance use disorder that don’t get the level of help that they need”

Core Values and Our Pledge to Those in Need of Help:

  • Pillars Recovery believes in full transparency, and runs a top accredited addiction treatment program in California, however we recognize that treatment is not always a necessary step in the journey map of those who obtain long term sobriety.
  • We are committed to staffing our resource line for anyone looking for help on how to manage addiction. We have gained resources for anyone affected by drug addiction (directly or indirectly), and will help direct that person toward where to get the help, support, or community they need, regardless of their economical demographic.
  • Pillars Recovery is sponsoring this partnership as a campaign to help a community (nurses) we believe to be on the front line of the current drug crisis, and can lead to significant changes in how people view, assess, and manage substance use disorder.
  • There is no exchange of money for referrals within the SMYS-Pillars Recovery partnership.
  • We also recognize that the current state of addiction-treatment in this country, as it pertains to treatment centers and sober housing is in peril as it is filled with bad actors that can end up harming those with SUD and their families. We also know the importance of providing a safe community for those in search or recovery, and pledge to continue our work as a treatment center and to hold those practices to the highest of standards.

Why this partnership is so important, in the words of other authority figures:

The following are important outlines taken from the Surgeon General’s report on addiction in America and can also be found here: https://addiction.surgeongeneral.gov/

• Well-supported scientific evidence shows that the traditional separation of substance use disorder treatment and mental health services from mainstream health care has created obstacles to successful care coordination. Efforts are needed to support integrating screening, assessments, interventions, use of medications, and care coordination between general health systems and specialty substance use disorder treatment programs or services.

• Supported scientific evidence indicates that closer integration of substance use-related services in mainstream health care systems will have value to both systems. Substance use disorders are medical conditions and their treatment has impacts on and is impacted by other mental and physical health conditions. Integration can help address health disparities, reduce health care costs for both patients and family members, and improve general health outcomes.

• Supported scientific evidence indicates that individuals with substance use disorders often access the health care system for reasons other than their substance use disorder. Many do not seek specialty treatment but they are over-represented in many general health care settings.

  • Promising scientific evidence suggests that integrating care for substance use disorders into mainstream health care can increase the quality, effectiveness, and efficiency of health care. Many of the health home and chronic care model practices now used by mainstream health care to manage other diseases could be extended to include the management of substance use disorders.
  • Only about 1 in 10 people with a substance use disorder receive any type of specialty treatment. The great majority of treatment has occurred in specialty substance use disorder treatment programs with little involvement by primary or general health care. However, a shift is occurring to mainstream the delivery of early intervention and treatment services into general health care practice.

We thank all of the nurses and stakeholders that have taken the time to read about this new and exciting partnership between the addiction/recovery community and the general medical profession. Once more for anyone with questions please feel free to call or email myself or our resource line

Darren Orloff, Chief Executive Officer at Pillars Recovery:

Darren@pillarsrecovery.com

www.pillarsrecovery.com/SMYS

877–227–1079