Melanie Cole, MS (Host): Are you concerned with someone's alcohol or drug use? Addiction can wreak havoc in families, but there is help. Welcome to Bryan Health Podcast. I'm Melanie Cole. And my guest today is Dr. Dave Miers. He's the Senior Director of Behavioral Health Services at the Bryan Medical Center, which includes oversight of the Bryan Independence Center.

Welcome, Dr. Miers. It's always such a pleasure to have you on with us. Can you tell us a little more about alcohol and substance use disorder and addiction? How do you recognize the signs and really, how common is this right now?

Dave Miers, PhD, LIPC: Thanks, and thanks for having me. Substance use addiction, it is, more common than, folks think, and it's important that we recognize the signs and get folks directed to resources. And I always say that the best way to recognize addiction is with the following definition.

So you need to ask, does the use appear compulsive? Does it appear out of control? The third one is the most important. Does the use persist despite negative consequences? Think about it this way. If something bad happens connected to a person's use of whatever product it is that they're using, like alcohol or marijuana, prescription drugs; if a negative thing is connected to that use, and yet the user continues to use and justify the use despite the negative consequences, that's when you begin to think about, okay, this might be an addiction.

Host: That's a really good explanation, Dr. Miers. So what do you do if you notice these things? Is there yelling, screaming, not talking? I mean, we've all known people who have had these fights, tried to get their loved ones some help. What should families do to help their loved ones to take that first step? Because people don't always want the help.

Dave Miers, PhD, LIPC: Well, we really encourage families and loved ones to tell the person the truth. Which is, I don't know what is going on. I don't know if you have an alcohol problem. I don't know if you have a drug problem. I don't know if you have a mental health problem. You know, I don't know if this is just an attitude problem, but would you be willing to go to a professional and let them help us figure out what is going on?

This approach is more of a softer approach. It does not put anyone into a situation of putting your loved one on the defensive. But lets them know that you're concerned and that you want a professional to evaluate what might be going on and make some recommendations. It takes the pressure off both of you and your loved one and puts it on the professional to do an evaluation and make those recommendations.

This approach has helped many more individuals seek help that they need.

Host: But Dr. Miers, what if the person says, I don't need help, I don't want help, I don't feel like there's anything wrong. And if that person is a spouse, or even one of your children, what do we do then if they refuse?

Dave Miers, PhD, LIPC: Well, you know, getting that person into treatment is the goal, which is where they find awareness and understanding and they can take ownership. So the approach I shared will help someone get into treatment. We're not asking them to go see someone for counseling, but rather an evaluation to determine what is going on in their life that's causing the symptoms identified and recommendations for the next steps that's going to be offered.

So let's see what a professional has to say and what options they may provide for you. So counseling is one thing, but an evaluation is basically a one time visit. And you're visiting with your loved one, your spouse, and you can go in with them.

And you can provide some background information. And then your spouse, or your loved one will visit with the evaluator. And what that evaluator is going to do is that they're just going to make recommendations. And it's up to your loved one to determine will I take those recommendations and act on those recommendations? 

Host: Yeah, that's really good advice. So tell us about some of the resources that are available at the Bryan Independence Center.

Dave Miers, PhD, LIPC: Well, the Bryan Independence Center has a continuum of services for substance use treatment. The one I would like to mention first is our walk-in clinic that's available Tuesdays and Thursdays, currently from 8 to 12. So, if you have a loved one who is ready to meet with a professional to take that next step, all you must do is walk in our doors on Tuesday or Thursday morning, and you're going to be eligible to be seen that same day for an evaluation.

You can also call and make an evaluation appointment, where you just call in and just say, Hey, would like to be seen for that evaluation that I was explaining earlier. And, you'll make an appointment and come in and do that. But on Tuesdays and Thursdays, you can just walk in and say, hey, I would like to have an evaluation.

And we have therapists available Tuesdays and Thursday mornings to make that happen. We also have what we call intervention nurses. And they go to all Lincoln hospitals, and so if there's a physician that's treating you in any of the units, in any of the hospitals, and they're concerned about your substance use, they can order an intervention nurse consult, that nurse will come and do a substance use evaluation and make recommendations.

We have detox services. So if somebody would like to detox, at the Independence Center and then get involved in treatment, all they have to do is call and ask us. We also have residential treatment, which is basically like a 28, 30 day length of stay. We have partial care, intensive outpatient, and then traditional outpatient services.

Host: Such a comprehensive approach. Now, where do friends and family come into the picture? Do you involve them in the treatment process? When does this happen?

Dave Miers, PhD, LIPC: Yes, we really recommend family involvement. It's really important for the family to get involved in treatment, but that really is totally up to the client though. If they would like the family involvement, they do sign a release form and then the therapist assigned to your loved one or family member then can arrange for you to come in and then be involved in family sessions that then is integrated into that treatment depending on the level of care that your loved one is involved in. There are many support services too that we recommend, that will be recommended throughout treatment, that we provide as well.

Host: Dr. Miers, what happens after treatment? What support and follow up is available after the fact?

Dave Miers, PhD, LIPC: So we have a really strong, what we call our alumni program. And then, support services afterwards, you know, such as AA, NA, a lot of the traditional support services for individuals involved in substance use treatment. But our alumni program is very strong. And what I mean by that is that anybody who is involved in services at the Independent Center, once they're complete, they're automatically enrolled in one year of alumni services where they sign a form that gives permission for us to contact them.

The alumni services has a board of directors, which is made up of individuals who've been through treatment and they plan events throughout the year, such as our chili feed, that happens once a year. And then they try to do fun events throughout the year, to try to get individuals who have been involved in substance use treatment, to give back and to get involved and to work with other individuals who are in substance use treatment. And it's just a really great program. They come back and they can volunteer and give back and be involved in groups and different things at the Independence Center. It's just a great, great program.

Host: Well, it certainly is, and what a great way to keep them involved in the program, helping other people as they find out how great life can be when you're not suffering from substance use disorder. And Dr. Miers, as we wrap up, what would you say to someone who's out there contemplating treatment? What would you say to that family or friend who's trying to get that person some help?

Dave Miers, PhD, LIPC: Well, it's very important to remember that there's hope, there's help, there's healing. It's never too late to start your journey today and take that first step by obtaining a substance use evaluation. That first step is very, very important. And, there's individuals who've taken that first step and have tried treatment, maybe gone down their journey and then maybe stumbled a little bit. And that's okay. And then you get up and dust yourself off and continue down your treatment. And you might need to ask for help again. And that's what we're here for. And that's what the Independence Center is here for.

And so, coming into the walk-in clinic, calling and setting up that evaluation, if you're in the hospital and you talk to an intervention nurse, whatever it might be, just asking that question, asking for help, and being willing to take that first step and, saying I need help. And asking your loved one, what can I do to get that help and, just calling into the Independence Center and making that appointment is always that first step.

Host: Such an informative episode. Thank you so much. Dr. Miers, you're always just such a great guest. I'd also like to thank our Bryan Foundation partner, Samson Construction. To listen to more podcasts from our experts, you can always visit bryanhealth.org/podcasts. That concludes this episode of Bryan Health Podcast.

I'm Melanie Cole. Thanks so much for joining us today.