Di Nguyen and the Conversations with Practitioners Working Group
Disclaimer: This blog post contains the experiences of those who lived with, and/or working to support those living with addiction and substance use disorder (A-SUD). These experiences may not be universal. If you or someone you know are seeking support, please consider reaching out to either SAMHSA’s National Helpline (if you are in the US) or a local helpline. The “988” dialing code is currently the US national three-digit phone number for all mental health, substance use, and suicide crises. If you are a Clemson student, you may wish to reach out to CAIR.
Clemson All-In Recovery (CAIR), formerly Clemson & Sober, is a student organization aiming to support anyone affected by addiction, allies of recovery and students interested in recovery. The organization, led by Gretchen Schober, Benjamin Martin, and Kelly Bollinger, aims to create a safe and healthy peer support environment to discuss problems and find solutions.
Gretchen Schober came to Clemson University in 2015 to pursue a doctoral degree in chemistry, after receiving a Bachelor of Science in biochemistry from the University of New Mexico, and recently successfully defended her dissertation. She has been the president of CAIR since 2018.
Ben Martin is a fifth-year doctoral student at Clemson in the Public Health Sciences department studying biomedical data science and informatics. His research focuses on hypertension control and cardiovascular disease prevention. He grew up in Clemson, South Carolina and attended the university for undergraduate study in health science. He now works with the American Medical Association in Greenville, South Carolina and is aiming to graduate this December.
Kelly Bollinger graduated from Clemson University with both her undergraduate degree in psychology and then her master’s degree in education with focus on community mental health counseling. She is a Licensed Professional Counselor and a Licensed Addictions Counselor. After graduation, she worked six years at Anderson/Oconee Behavioral Health Services as the Child and Adolescent Service Coordinator. In 2012, she came to work at Clemson University in the Counseling and Psychological Services department, where she is currently Interim Assistant Director and coordinates the ACTT Program, Clemson’s addictive behaviors and substance use disorder program. She provides assessment, consultation, individual counseling, and group counseling for Clemson students. She is also the staff advisor for CAIR and is passionate about seeing students enter recovery while in college.
Prevalence of A-SUD in the College-Age Population
External influences play a role in accelerating the A-SUD development. Kelly pointed out that — from her experiences working with students — besides the cultural aspect and a person’s core social circle, social media definitely plays a role. “If you’re at home Friday night and you’re scrolling through social media and everybody’s out and having a great time, then you feel that pressure, that inclination,” Kelly said. Coupled with easy access to fake IDs, underage drinking is still rampant, despite the laws aimed at cracking it down.
“I would say about 20% of students and college students at least will meet criteria for alcohol use disorder at some point in their college career.” [Kelly]
Ben recalled that he was very excited about exploring the party scenes that came with college football. Many colleges in the Southeast have great football programs. It was not hard for him to find others who shared the same excitement but did not quite have the same “problem” as he did. Drinking and doing drugs, something that was very important to Ben, became the most important thing. To many others, including his parents, he was just being a regular college kid.
Listening to Ben and Kelly, Gretchen contemplated on her own experiences. Not everyone she knew who used drugs and alcohol struggled with A-SUD, but being surrounded by people who liked drinking and using drugs made it easier for her to justify her own consumption and accelerated her trajectory to developing A-SUD.
Clemson All-In Recovery (CAIR) and Other Support Groups
Clemson All-In Recovery hosts meetings and activities, maintaining a support network and community for students with A-SUD. When Gretchen and Ben got involved with CAIR, there were official meetings similar to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Eventually, they adopted an “all recovery” approach for these meetings to be more welcoming and inclusive to students who struggle with varying types of addictions. CAIR is also working towards establishing a local Collegiate Recovery Program at Clemson. Collegiate Recovery Programs (or Collegiate Recovery Communities) designate a staff member to support students and liaise with the university to create an environment that is conducive to students’ recovery. Many universities and colleges in the Southeast region, including Louisiana State University, University of Arkansas, University of Florida, Georgia Tech, and neighboring colleges such as Coastal Carolina, University of South Carolina, College of Charleston, are members of Collegiate Recovery Programs. Unfortunately, CAIR’s efforts have largely been ignored by university officials.
While accessible and affordable healthcare has gained more attention from the public in recent years, it is certainly not a reality for many. On-campus organizations like CAIR, run by students for students, become a source of free and accessible support networks for the population on campus. Many of CAIR members were referred by the university’s counseling and psychological services. Other times, family and friends of those who struggle with A-SUD that reached out to CAIR via emails and calls, looking for help and guidance. While group meetings both in local communities and on campus provide the support networks to help with recovery, students seem to be more willing to attend CAIR all-recovery meetings.
While the pandemic created new constraints that made it difficult to host CAIR meetings, under the leadership of Gretchen and Ben, the group quickly transitioned to online format. The new format allowed CAIR to expand the scale and reach of their meetings, as well as cultivate new relationships and collaborations with neighboring schools like University of South Carolina and University of Georgia. When restrictions loosened, they resumed in-person meetings and needed to find a new meeting location which complied with OSHA standards. CAIR continued using Zoom, allowing flexibility for those who could not attend due to location and personal reasons, and enabling those who recently graduated to continue participating in the program.
Beyond meeting with students from the Clemson area, CAIR works with local groups at University of South Carolina and University of Georgia to host regional retreats. The retreat has become a space for students who share similar experiences to support one another, knowing that they are not alone in the path towards taking charge of their recovery.
Social media can also be a place where some might find support, though this depends on each person. Ben knows that, for him, social media may do more harm than good. Gretchen has been following other Collegiate Recovery Programs in the US and other recovery-related pages on Instagram. Her entire feed is filled with recovery posts that she has personally found useful. Many others have also looked to communities on Reddit for recovery management tools, encouragement, or simply comfort in knowing that they were not the only one fighting this battle. There are also smartphone apps that can assist in managing recovery, such as apps that track days without use or list meetings in the surrounding area.
Living with A-SUD and Living with Someone with A-SUD
Seeing someone you love and care about struggling to live with A-SUD can be challenging, even more so when it feels like there is little you can do to help. Both Gretchen and Ben shared that even though family and friends might have some influence, ultimately, the person with A-SUD themselves must come to accept that they cannot manage it alone. As the visible signs and symptoms of A-SUD are often mistaken for the lack of desire to change or self-destructive tendencies, this can put an enormous strain on relationships with loved ones. It is important for allies, family, and friends to remember that those who struggle with A-SUD are also trying their hardest; sometimes the pressure to help and to fix the issue may create more tension than solutions. Many have found support groups, such as AA and NA meetings for family members, to be helpful.
The path to recovery management is different for everyone. It may take a significant event for some people to acknowledge that they struggle with A-SUD, or that they need help with managing A-SUD. For others, there may be no such single pivotal moment.
Ben described his experiences as a circle. Most of the time, he could convince himself that everything was fine. This would usually be followed by a period of substance use which negatively impacted his personal life and mental health. He would quit, feel better, and convince himself that things were fine. Now and again, there was a tiny window of time during which it was very clear to him that things were not okay.
The last time this clarity resurfaced, Ben reached out to Kelly and began attending CAIR. To Ben, this “last time” was no more special than his previous moments. He has been managing his recovery since.
Gretchen’s experience was similar. The biggest thing for her was being mandated to see Kelly. She recalled a slow escalation of social consequences resulting from drinking during the period leading up to the mandate. At the meeting, Kelly gave her an “Are you an alcoholic?” quiz and Gretchen checked every single box. Even so, it was not easy for her to accept this — Gretchen knew it was something she should stop, but how could she be an alcoholic? She would quit drinking for some time, attend meetings, and go through the checklist of things she needed to do to get back on track. Things could go well for a while before she decided to go out again, but oftentimes that resulted in more consequences.
“It’s crazy because you kind of just forget how bad it was and you think ‘I can just control it now.’” [Gretchen]
“I initially tried to quit drinking without asking for help, because I was trying to take care of the situation myself because, you know, I’m an independent person, I like to solve my own problems, and so I bought a safe made out of hard plastic. You can put cookies and cigarettes in there, put a timer on and say I’m not going to eat this for 20 minutes or two days or up to two weeks. I decided to lock my passport and my ID in there for periods of time. If I felt like I was about to maybe have a craving, want to go drink, or it was about to be the weekend, I would put those things in the safe to prevent myself from being able to go buy alcohol. There was one time, when I looked at the safe and it had three days left on the timer, and there’s no way to circumvent the locking mechanism, I just felt like I cannot wait three days, like, that’s too long. And it was weird because I wasn’t even craving anything before that, until I saw the timer that told me I couldn’t buy alcohol for three days. So then I proceeded to take the safe to my lab and I took the saw and I opened the safe and went and bought beer.” [Gretchen]
A Stigmatized and Misunderstood Population
Kelly explained that the medical community and the general population overall have come to a better understanding and awareness with respect to mental health. Despite ongoing efforts to destigmatize A-SUD, this topic has yet gained the same level of acceptance from the public, which can hinder people from seeking help and getting the right treatments or intervention. There is an ongoing debate within the addiction field, Kelly said. Many people are still holding on to the idea of “tough love,” and that people struggling with A-SUD can only be helped once they have “hit rock bottom.”
Even for those who have A-SUD, understanding their own experiences may not come easy. Reflecting on his journey, Ben noted that he also had his own misconceptions which he had to work through after attending NA and AA groups. Ben’s parents also thought that his experience with A-SUD was a “phase,” that Ben just needed some time to mature, and that it would “go away.” Terms like “lazy,” “absent,” “aloof,” or having a “self-destructive tendency” are often thrown at people struggling with A-SUD. Throughout his undergraduate and graduate studies, Ben needed to explain to professors and advisors what living with A-SUD was like, as his academic performance and everyday life were both influenced by it. A-SUD may look very different from the outside compared to the person’s internal struggle: Ben hopes for people to extend more grace and sympathy towards this community.
“It may not look like it, but at our worst, we were trying our best.” [Ben]
It is easy to stereotype those who struggle with A-SUD. Gretchen said that, from her experience working in CAIR, the spectrum of people living with A-SUD is large, including those who are widely successful and those whom you would never expect.
“I know for me [the stigma associated with addiction and SUD] was one of the reasons I was so in denial about it myself, because I didn’t understand the problem and I had this idea of what an alcoholic look like.” [Gretchen]
Reflecting on her own experiences, Gretchen agreed that the stigma associated with A-SUD had partially kept her from reaching out for support. As the outward manifestation of the condition can be inaccurately perceived and associated as a lack of effort or a portrayal of character, it influences how people, including medical professionals, respond to those who struggle with A-SUD.
“I know that there’s stigma with all mental illnesses and I just I feel like we’re making progress with depression, anxiety and I want that same sort of grace to be extended to people that suffer from addiction, because it is, it is an illness that can be treated and we do recover.” [Gretchen]
Gretchen, who is determined and successful in other aspects of her life, found it especially demoralizing when she could not manage A-SUD by herself.
“It was very miserable. I think something that I wanted the general population to know that […] there’s enough suffering just from the insanity that goes on in our head like this safe story. It’s utterly demoralizing. I have had moments like that many times. You start to lose your complete sense of self and self-esteem and there’s no limit to how miserable you can make yourself.” [Gretchen]
“It can cause enough misery for an alcoholic to show up in a meeting and say, ‘I don’t know what I need to do, but I need to do something.’” [Gretchen]
Kelly recalled a recent conversation with a student client about stigma. The student said that from the outside looking in, university officials would not be able to differentiate a student who is working through their A-SUD with CAIR from any other students on campus. Despite this, addressing A-SUD is not gaining the attention, acceptance, and resources it deserves. Kelly wants people to be able to experience life without A-SUD. She hopes to help students get into recovery earlier so that they do not lose their careers, partners, children, and life because of A-SUD.
Moving Forward
CAIR is working on improving their visibility to be able to reach more students who could benefit from their help.
Students who come to Kelly are either mandated to do so or self-referred (i.e., they have identified that they had a problem and wanted help). She performs an assessment and encourages them to attend at least one meeting. The path to recovery can be incredibly frightening and isolating. Kelly often hears from students that they did not see others like themselves in recovery. She hopes to see the collegiate recovery program expanded and strengthened so it becomes easier for students to connect and meet people like themselves in recovery.
Ben hopes supporting students with A-SUD becomes a higher priority on Clemson campuses. He would like to see greater commitment from the university: having a dedicated space and staff member. This would also lighten the load for Kelly, who has been running the show on her own.
Gretchen hopes that the university will come to acknowledge that A-SUD is a problem on their campuses. She also wants to see a change in attitude and approach to addressing A-SUD that is more constructive and less punishment-oriented. She hopes that the university will permit CAIR to fundraise for a collegiate recovery program which would provide a permanent resource that is not solely contingent on student leadership.
Systemically, there should be more high-level efforts dedicated to lifting barriers to recovery. Governments and universities can help by making funds and grants more accessible. These funds are needed to educate the population and destigmatize A-SUD, which is necessary to shift the perception of the general population and medical community towards those struggling with A-SUD. In doing so, we as a community can create more opportunities to connect people to resources to recovery earlier, such as support groups and treatment programs.
