Amanda Wilde (Host): Welcome to Recovery Unscripted, the Haymarket Center Podcast, where we discuss meaningful conversations focused on the integration of substance use disorder, mental health, and primary care treatment. I'm Amanda Wilde, your host. I'm pleased to introduce Dr. Dan Lustig, President and CEO Haymarket Center. Dr. Lustig, thank you for being here.

Dan Lustig, Psy.D., CAADC, CODPII: Thank you, Amanda. We're really excited to launch this podcast with you. It's going to be, I think, an informative and exciting opportunity for families and friends of Haymarket Center.

Host: This is our inaugural podcast, so we'll focus on what Haymarket Center is and its services and impact for clients, because Haymarket is unique with an encompassing comprehensive scope, and we're going to break that down. So, first of all, Dr. Lustig, what is Haymarket Center?

Dan Lustig, Psy.D., CAADC, CODPII: Thank you. Haymarket Center is truly one of those integrated programs that address three kinds of conditions that patients often present with. We address the substance use disorder, we address the primary care condition, and we address the mental health condition. And we have found over our 50 years that, by addressing those three conditions at the same time, it brings a better relief and more stability and recovery for the patients that we serve.

So, we were founded in 1975 by Father Ignatius McDermott. His goal was really to provide ongoing treatment to individuals that are homeless or low income, and to be a resource for families. And so, starting off in our social setting detox program in 1975 to now over 30 specialized programs, we have grown dramatically to meet the needs of the patients that we serve.

Host: Can you talk further about the services Haymarket Center provides?

Dan Lustig, Psy.D., CAADC, CODPII: Absolutely. Haymarket Center serves all levels of care for patients that come into Haymarket Center. So, we have outpatient, we have intensive outpatient, we have residential treatment. And when people complete treatment, we also have beds for recovery homes, and those beds are designed for people to really begin using their skills that they've learned in outpatient or residential treatment in a structured environment. We have specialized care that starts with medical detox so that individuals do have medication to help with their withdrawal symptoms, all the way to kind of our exciting program, which is our moms and children's program, where women can come in to treatment during any part of their trimester and can with a goal of delivering a healthy and drug-free infant.

And so, moms can bring up to two kids into treatment with them. So, we reduce those barriers to access and care, as well as the importance that Haymarket Center has 24-hour day access. So whether you are in need at 2:00 AM or 2:00 PM, you'll get the same level of service as you would get during working hours. And our goal really there is to meet the needs of the patients of the state of Illinois when they need us the most.

Host: Well, with your unique approach, range of services, your 24/7 access, this makes you rather unique, doesn't it? Can you talk about how Haymarket is different from other substance use and behavioral health treatment centers?

Dan Lustig, Psy.D., CAADC, CODPII: Yeah. Thank you for that question, because it really speaks to the heart of our mission. We are truly a comprehensive program. And so when individuals come in, we are addressing, as I've mentioned before, those three conditions. Early in 2023, we became a Federally Qualified Health Center Look-Alike.

And that goal of becoming a Federally Qualified Health Center was really to expand our primary care operations. So many of our patients lack the continuity of ongoing primary care, which really contributed to the severity of their condition. So, we put a lot of pieces together to make people's recovery stronger, whether that is addressing their primary care issue that often they have gone without. But also, as they go through treatment, we've looked at kind of addressing the barriers that they have when they come in. So, we also have part of our expansion into primary care. We have a pharmacy on site, so patients are able to get their medications within 24 hours. And the benefit of that program is that, once a patient completes treatment here, we can mail them their medications ongoing.

The last kind of piece besides the treatment piece and the primary care piece is we also focus very hard on job training. And the importance because job training and people getting employment or education really addresses those social determinants of health that keep people in recovery longer. So also, in late 2024, we also opened up a deli as a collaboration between us and Vienna Beef. That program was designed to get people back into the workforce to be productive citizens again.

So when you look at what makes Haymarket Center unique, we just don't address the clinical issues or the primary care issues. We're addressing those social determinants of health. And I think that's what makes Haymarket different. So, it's not just that we have 24-hour access to care. But we really, over the last 50 years, began to look at the needs of our patients and what they need the most. So, that is kind of what I think makes Haymarket unique.

The last piece that we're very excited about is that inside of all of our programs, we have over 19 evidence-based interventions. Those interventions are designed to improve individual outcomes. And that's really important when you're dealing with such complex medical issues as substance use disorders and mental health disorders and their primary care issues. It's really designed to give individuals the biggest and most comprehensive support they need when they gain access to treatment.

Host: Now, I imagine with undertakings like this, obstacles sort of come with the territory. What are the biggest barriers you've found facing substance abuse treatment providers and patients?

Dan Lustig, Psy.D., CAADC, CODPII: i think the largest overarching barrier that we have is stigma. Stigma is feathered throughout this medical condition. So, how we are funded is stigmatized, how people get treated in care is stigmatized. Oftentimes, family members, when they even go into a medical center, like a hospital, they are looked down upon because they have a substance use condition. And so, many people are afraid to get into care until the condition is so severe that they don't have a choice anymore. And we address stigma by educating individuals on the importance of what their disease means. Many people don't understand that their disease takes over every aspect of their life. And I think strongly that by educating individuals about their medical condition helps them to become better advocates for their own healthcare.

I think it's also the fact that our individuals have a lot of chronic healthcare conditions and many of the patients don't get treated properly because most people look at it as a substance use condition as it was their fault. Those barriers prevent people from getting needed care, is this kind of self-shaming, is kind of this, "I did this to myself so I shouldn't have to get any type of care."

So really, when you look back on the National Institute of Drug Abuse, they wrote an article a couple of years ago that said the number one cause of death in this community is stigma because people are too afraid to access care. And at Haymarket Center, we really are trying to be people's North Star. We're trying to give them hope, that their condition can be managed and treatable. But people first have to understand that addiction and substance use disorders is a chronic relapsing condition and needs to be treated that way. But all too often, I think people's barriers that they find with even inside their own families is the fact that people think you go to treatment once and you should be done. When if you treat this as a chronic relapsing condition, you'll understand that people need different dosages of treatment over time in order to get a real firm foundation for recovery. And I think those are the kind of the key things that we try to address while people are here in treatment.

Host: And those concepts and that language really help patients navigate that stigma that you talked about surrounding treatment. How do you help patients transition into the community after treatment?

Dan Lustig, Psy.D., CAADC, CODPII: So, a couple of things that I think make Haymarket Center unique is our Recovery Coach Program. Our Recovery Coach Program is designed to meet individuals when they're in treatment, introduce them introduce them to the individual who's going to reintegrate with them as they go back into the community. So even though an individual might leave treatment, we have staff that will visit them in their homes, will visit them wherever they go, to make sure that they are following their discharge plan.

So when you have a client that is kind of deviating from their discharge plan, we have a program here at Haymarket where we bring people back for a shorter period of time to really kind of address those kind of key pieces that they weren't following. So, you don't need to start treatment again. You just need a different dosage of treatment. And I really think that that Recovery Coach Program has really helped people succeed, both relative to their treatment and, more importantly, as they reemerge into the job environment.

Host: The Recovery Coach Program sounds like such an essential part of treatment. How do you help patients navigate reintegration into the workforce?

Dan Lustig, Psy.D., CAADC, CODPII: Part of our job training program that we have here also have recovery coaches attached to it where they will work with their employer, will work with the patient so that they're not alone as they kind of face those challenges reentering the workforce, because many of the population at Haymarket Center serves doesn't or did not have a kind of coherent workforce history. Some have had no jobs at all. Some haven't had jobs in 10 or 15 years, that could be highly anxiety-provoking.

So when you look at our job training program, not only do we have recovery coaching as a part of it, but we also have a therapist that is designed to work with the patient and kind of address those insecurities as they emerge back into the workforce. So, it's a very, very, I think, exciting kind of piece to our missing puzzle that we've had over the years, is really helping patients accept their medical disorder and how to advocate for themselves, both in the workforce as well as in the community that they're returning to.

Host: And the job program is a great example of how you have identified and addressed the needs of the community. As a leader in the behavioral health treatment space, how are you looking to continue to expand services for your patients?

Dan Lustig, Psy.D., CAADC, CODPII: I will tell you that's the easiest of all questions, because every single one of the programs at Haymarket Center has built has always been based on the needs of the patients we serve. So, we didn't wake up one day and had 30 specialized programs or job training. Every patient that comes into Haymarket Center, we review their history. and we make sure that we have a program that's designed to help support them and navigate through this kind of disorder that they're having.

So when we look at all of the things that we do, I always make sure that we have a need. And I think the best example of that need was so many of our patients need to get reconnected to services. So, we have a fleet of 13 vans that help to transport clients in and around the city to address those specific needs as they still are in treatment. So, all of these kind of pieces of Haymarket Center programming is really designed and are based upon the client's needs as they've presented here at Haymarket.

Another example that we're really, really excited about was our peer doula program. So, many of our pregnant women who come into treatment, . they're afraid, they're dealing with their disorder. They also have a pregnancy, you know, stressors related to their pregnancy. The peer doula program that we have at Haymarket Center will follow that individual through treatment,. and will advocate, will go to the hospital with the patient, and advocate along with the patient so that they never feel alone. And that's kind of the spirit of Haymarket Center. And the real mission-driven work we do is we don't want our patients to ever feel that they're alone. And that Haymarket will always be a North Star, will always be a resource for them 24 hours a day.

Host: This is very reassuring to know that this service is out there and people are using it. What is the best advice you can provide to the families who are supporting family members with substance use disorders and are unsure of what resources or options they have?

Dan Lustig, Psy.D., CAADC, CODPII: In one word is education. Many families who are going through what is I consider one of the most horrific periods of their life want to do the best for their loved ones. So typically, what families do is they throw a lot of money at the situation trying to send people their loved ones to the best treatment facilities that they could afford or frankly not afford without understanding that it's a chronic, relapsing condition.

Many families really try to do an intervention when an individual might not be appropriate for an intervention. These are opportunities where families should reach out to a program like Al-Anon or could reach out to a program like Haymarket Center where we have a family night and get educated before you do an intervention.

There are support systems out there that can help you navigate without you rushing directly in. But families are so traumatized and want to do something to help their loved one that they react accordingly, when the very first thing that they want to do is try to educate themselves on the disease, educate them on the nature of the disease. Al-Anon does a great job of that, specifically when your loved one is most resistant to ever wanting to go for treatment. That's where I've seen interventions go horribly wrong. So really, the goal is families need to educate themselves on the disease on how to properly and when to properly intervene and always be able to reach out to Haymarket Center as a resource to help them navigate them through this journey.

Host: Well, Dr. Lustig, thank you so much for your compassionate focus on practical ways in which you serve families and the community. Really appreciate your time.

Dan Lustig, Psy.D., CAADC, CODPII: Well, thank you. And I'm really excited as we start this journey of education and information dissemination. I'm hoping that families can reach out and we can share some of our answers that we learn from others. But we've got 50 years of experience that we are really wanting to help educate people on the importance and nature of this disease. So whether it's funding issues and challenges to treatment and clinical issues, we hope to cover all of that on our podcast as we move forward. So, thank you and welcome to this journey.

Host: That was Dr. Dan Lustig, President and CEO, Haymarket Center. For more information, visit hcenter.org. Make sure to visit hcenter.org/recoveryunscripted to subscribe to our podcast, share and connect with us on social media. Thanks for listening to Recovery Unscripted with Haymarket Center.