New Perspective: Internship Opens Eyes to Challenges of Substance Abuse
By Julie Reese, Niagara University
“Ending toxic relationships since ‘08,” could very well be one of Judge David Matia’s most common sayings, ever since his drug court dockets began. Each Thursday there are two dockets that run — one at 9:30 in the morning, and another at 1:30 in the afternoon. On any given day, these sessions include a combination of compliant clients, clients in violation (e.g. not showing for urinalysis, missing probation meetings), and attorneys who are pleading for new clients to be sentenced into this court process.
Focusing on sobriety is what matters the most during this drug court process. Sometimes rehabilitation simply comes down to the removal of “people, places, and things,” as Judge Matia has stated. Sitting in on drug court every Thursday, it is clear that some clients are “falling off the rails,” even though none of them ever intended on living a life that revolves around drug abuse. Many are still ashamed of their past, ashamed of their mishaps and slip-ups, resulting in a “new sober date.” On the other hand, most clients are well on the way to living a healthy, sober life. Recovery is not linear, but nevertheless, it is truly inspiring to hear from each client as they are aiming to live a life with meaning, ultimately making something of themselves.
My internship with the Cuyahoga County Drug Court focused consistently on substance abuse treatments — why individuals become addicted to opioids, and what mental health treatment may help an individual that struggles with both. Going into my internship, I was misled in my prior belief — having an understanding that “substance abuse stems from family genes.” On one hand, this is true, as I have witnessed this with my grandfather and a close friend of mine. However, substance abuse can occur for many other underlying reasons, that may be tied to mental health, trauma, and even through becoming addicted to pills after undergoing a difficult surgery. Additionally, the same can be said for mental health. I know this on a very personal level after struggling with an eating disorder and generalized anxiety. Family members of my own have not experienced this — my struggles occurred for outside reasons, none of which relate to family genes. In short, addiction and mental health challenges can begin anywhere, at any time, for any number of reasons. After hearing from clients within the drug court, and shadowing on assessments in county jail with Larissa Malcolm, a licensed clinical social worker, it was evident that multiple factors play into a person’s battle with addiction.
My understanding of these complexities began June 29, 2018. On that day, I sat in on my very first assessment with a young woman, who was potentially qualified for medically assisted treatment (MAT) with suboxone, through the office of Opioid Safety at MetroHealth — a project that Malcolm had been working on. Suboxone is meant to treat opioid addiction by blocking opioid cravings to the brain. However, this inmate was not interested in this form of treatment, having used it illegally before which resulted in misuse. This assessment proceeded, although we did not push the MAT program. Through the tears, a little bit of laughter, the constant talking and openness, it was clear that this inmate was eager and willing to start changing her life, pleading for a bed in residential treatment, and following that, aftercare. The 24 days spent in jail prior to our visitation were the longest days spent being sober so far. Her biggest motivator for working toward a road to recovery and sobriety was her two children.
Sitting in on this first assessment opened my eyes for the better, as to understanding those other underlying reasons for why individuals fall victim to substance abuse. For this woman, witnessing a family member die in a fire at the young age of nine, being a victim of sexual trauma from a family friend, and domestic violence in three different relationships each contributed to her drug use. Furthermore, a prior partner, who is now out of the picture, got her to use heroin for the first time. Eventually, heroin lead to speedballs and multiple overdoses. Mental health played a significant role in this individual’s story as well. She suffered from depression, anxiety, PTSD, and bipolar disorder. For this woman, drug use was an escape from the many difficult situations she endured.
Talking with this inmate reminded me of my relative and close friends, not because of the opioid use, but because of alcoholism and mental health going hand-in-hand more often than not. Talking with this individual allowed me to see my loved ones in a new light — I saw a little bit of them in her personal story, and these struggles became that much more significant. I also saw myself. For my eating disorder, I admitted myself into intensive outpatient treatment, and aftercare followed that program. I understand what it is like to remove those toxic “people, places, and things.” All options are available to clients who go through the drug court program, some of which feel that “IOP has been the best treatment option for them,” while “getting rid of that significant other worked.” My struggle is not as detrimental as what many clients have been consistently dealing with, that does not make my story any less valid, because this mental health challenge has played a significant role in my own life. Furthermore, I have gathered from a handful of clients, both in drug court, and in county jail, what positivity means to them, and what it means to “keep going,” in their own eyes. This was almost a breakthrough on my end, giving me a sense of encouragement. If others out there that have been through so much more, can still have hope and keep going, I should be able to as well. The individuals I have worked with in the treatment programs and criminal justice system have taught me to not give up on myself.
My internship expanded outside of Judge Matia’s drug court, and further expanded outside of county jail. I was able to visit a needle exchange van where opioid users come between the hours of 9 a.m. to 12 p.m, and again from 1 to 3 p.m. throughout the week to exchange dirty, used needles for clean ones. Some might say that this promotes further use, and in a way it does. However, the bigger picture is that needle exchange vans lessen the chance of sexually transmitted diseases such as hepatitis C and HIV from spreading. I was also able to observe in the Cleveland Treatment Center, a facility that specializes in treating individuals with methadone medication. This opportunity allowed me to gain better insight from someone who had struggled from addiction — learning that while medically assisted treatment programs are in fact tools to recovery, the programs themselves are not substitutions for the actual recovery process. Regular attendance at treatment meetings, finding a sponsor, following through with the twelve-steps, and other measures are all part of recovery.
Each experience during my eight weeks at the Cuyahoga County Justice Center shaped me as an individual, helped to change my perspective on substance abuse and mental health, and solidified my future educational aspirations. This fall, I will be applying to graduate schools for a master’s degree to become a licensed clinical social worker. This decision would not have been possible if Larisssa Malcolm, and Molly Leckler, drug court coordinator, did not take me under their wings this summer.
Julie Reese is a criminal justice major at Niagara University, class of 2019. She was one of 130 students selected for the Shepherd Higher Education Consortium on Poverty’s 2018 Internship Program. Each summer, SHECP interns are placed with nonprofit organizations that work on the front lines of poverty and serve as co-educators to students. The views and opinions expressed in this reflection are those of the author and do not necessarily reflect the official policy or position of the Shepherd Higher Education Consortium on Poverty.