Transcription:
The Opioid Epidemic: A National Crisis; Programs and Services at Riverside

Carl Maronich (Host): And we are joined by Michael Mutterer. Michael is the Senior Vice President and Chief Nursing Officer of Riverside Healthcare. Michael, welcome.

Michael D. Mutterer (Guest): Thank you. Glad to be here.

Carl: Glad you are able to join us on the podcast. And today we are going to be talking about opioids, which has become a real crisis, not only locally, but nationally. It’s really an epidemic. And I want to talk a little bit about how Riverside fits in to hopefully helping with that situation. But let’s start with a little bit about your background. You have a background in addiction.

Michael: I do. I’m actually a board certified and licensed clinical therapist as well as a certified addictions counselor and a registered nurse.

Carl: Oh, so you kind of have a vast background in this. And your role at Riverside as Vice President, Chief Nursing Officer deal with all the nursing situations, a variety of things here at Riverside.

Michael: Yeah, definitely. One of the service lines that actually reports directly up to me in addition to the nursing is the behavioral health services line and part of that service line is our addictions specialty areas as well, so I do still be able to get some touch points with behavioral health and addictions here at Riverside.

Carl: And we are talking about opioids. Tell us exactly what group of drugs that is.

Michael: Sure, so when we talk about opioids and we look at it from a perspective of the national epidemic that we are looking at currently; we really look at it at a couple of different angles. So, one being the heroine piece to this, so the illicit drug. The second being more the prescription drugs opioids which are typically a sort of lead in to potentially getting into heroine use and really both arenas whether it’s illicit or prescription drug use can really cause some issues for people who are not using the prescription drugs as prescribed and certainly anybody who has gotten into use of heroine.

Carl: Sure, now by their nature; is this and especially addictive drug, more so than others?

Michael: You know addiction in and of itself is a disease and I think if somebody is prone to addiction; certainly, opioids are a very dangerous drug to tamper with because they are very addictive so, everyday we see 115+ Americans die from opioid use or opioid overdoses and that’s a number that’s pretty staggering. So, if you think about that, somebody who has started their path down opioid use whether it be from the prescription side or the illicit drug use and using heroine; there is a high propensity for early addiction and a high propensity for sort of escalating their drug use so as we talked about from prescription medications potentially onto the illicit form of opioids which is again heroine.

Carl: Now you have begun, you outlined your career and the things you’ve done with addiction counseling. It seems that every so many years there’s a drug of choice that becomes an issue cocaine, some years back and now opioids. Is there a reason that that happens that way?

Michael: I’m going to say supply and demand. I think that when drug addiction hits it really is about what is an easy source for a high and I think when the demand or the supply outweighs each other; certainly, at this point. It’s sometimes cheaper to get a hold of heroine than it is to find other sources of highs and so I think that definitely plays into this epidemic at this time.

Carl: And right now, it is opioids. And I think 56 deaths in Kankakee County last year in 2017 and you mentioned 115 Americans a day are overdosing and dying, so it is a problem. What is Riverside – how are we positioned. How is Riverside positioned to help the community in the midst of this?

Michael: Absolutely. From a treatment perspective; we opened late 2017 a new department that is adjacent to our emergency department which is our behavioral health central intake department and really a team of specialists that are located here at the hospital in order to do screening assessment and referral and really be able to help people get to the level of treatment that they need based on a full clinical assessment. So, that’s probably our easiest access to treatment and care but we also have a number of different areas that are focused on actual treatment. Our Resolve Center out in Manteno is really focused for that young adolescent boy population so, ages 12-18 and is a residential treatment setting to really work with those young boys who have not made it in outpatient counseling settings or other types of treatment programs as well as a full gamut of outpatient programs that are designated to working with people with all levels of addiction and really from all different addictions as well, so not just looking at opioid addiction, but looking at alcohol, marijuana, any other type of substance dependence that could occur as well.

Carl: And is the treatment similar for any addiction?

Michael: You know it is. I think certainly the goal is to have abstinence that’s the ultimate goal, but as an addictions therapist and counselor for a number of years; we know that it’s a process and every day is a struggle for people who are dealing with addiction and every day is a new day to wake up and say am I going to use today or not. And really through the counseling process; helping individuals find tools that they can utilize each and every day that help them make that choice to hopefully stay clean and sober. But the basic principle is the same no matter what the chemical is or what the substance is of choice.

Carl: And what do you say to an individual who is in the throws of an addiction and they wake up as you said now you have got a choice today, do you use or not use, and you think, you know, I just don’t see a way out of this. I don’t – it’s not going to be an easy fix so, I’m just going to keep using. It seems like a hopeless situation really.

Michael: We really focus and again, depending upon the treatment program; but there is a focus on that one day at a time philosophy as people go through withdrawal and eventually become the early stages of being clean and sober; it is daunting to think that it’s a lifelong process and so really helping people focus on making that determination or making that decision each day as to whether or not today is a day that you can remain clean and sober and sometimes that day to day might even be minute to minute and really helping them break that down. Because it can be overwhelming thinking about a life of being clean and sober.

Carl: Yeah and when you are at the bottom, it’s tough to see your way out and to see that light at the end of the tunnel, I’m sure.

Michael: It really is, and I think a lot of times people even looking at the disease process itself; there are various different reasons why people start using drugs and alcohol for teens or people that are starting early in life. I mean it can be not fitting in at school. It can be breaking up with a boyfriend or girlfriend. It can be depression. It can be early onset of mental health issues that they’re just compensating for, not wanting to speak to their parents or physicians regarding mental health issues. So, there’s a variety of reasons why people may start using drugs and alcohol and the addiction becomes secondary to that. For adults, very similar. I mean it can be a triggering event that somebody starts using and if that addiction piece is there, they aren’t able to stop. People drink socially, people are able to have one drink, two drinks and walk away from it but that addiction mindset and whether it’s with alcohol or opioids alike; that addiction is the inability to be able to stop that usage.

Carl: If you have someone in your life who you think might be having addiction issues; how do you recognize that?

Michael: There’s a number of ways that you can recognize it. People who are again, unable to stop so if they – first of all if we talk about alcohol, I mean because it’s legal and something that is socially acceptable; a person who doesn’t have that ability to be able to stop so every time they drink, they drink to excess. It may start affecting areas within their life so whether it’s personally, marital issues, issue with their children, certainly we will see employment issues many times. So, not being able to get to work on time because they can’t get up. Needing to leave work early. Some people stash alcohol in their drawers and use that throughout the day. When you’re talking about illicit drugs; I mean certainly you can’t take a break and go shoot up heroin. It’s a little bit different. I mean as you start seeing the use pattern, so if you know somebody is say taking prescription opioids and not following the prescription as the physician ordered, so if they are taking it for a specific pain and that pain to them is not being resolved by the dose that the physician is prescribing to them; they will start taking double the dose or extra pills in order to start to feel what they feel is relief for that.

So, again, using that prescription opioid outside of the parameters of what it was initially prescribed for and when we are talking about heroine. I mean again, that’s an illicit drug. It’s an illegal drug and again, somebody who is using heroin, I don’t believe that there is a recreational use for heroin, myself. So, I think as an addictions counselor; somebody who is willing to go into that level of a substance really puts themselves at risk; is in my opinion, a person that needs to seek help. So, again, if somebody sees issues – issues within that person’s life; the ability to be able to try and get them to a facility for a screening and assessment and then again that determination of what level of treatment they need is critical. They are not always willing to do that, though.

Carl: Sure. I am sure many cases not.

Michael: Many cases not. You know and the one thing about addictions treatment is it is not something that we can force upon somebody. So, if they are interested in wanting to get information and wanting to enter into some type of a treatment program whether inpatient or outpatient; that’s the time to strike. Many times, people will start treatment and leave treatment. People will start outpatient counseling and for whatever reason; if they have hit rock bottom, if they have had an event in their life that has caused them to need to seek out counseling; if they waver in that addiction cycle. Many people go through treatment multiple times in order to conquer that addiction.

Carl: Is there value in the family, if we have someone in our family who has got this addiction issue, they’re not willing to seek help; is there help for the family, independently of that individual to try to deal with this and hopefully ultimately get that family member the help they need?

Michael: Yeah, absolutely. You know when you say if you have a family member; I’m going to say most families have some level of addiction within it and unfortunately, addiction crosses all boundaries. So, race, age, sex; so most of us know somebody within our family or close circle who possibly struggles with addiction and I do think that there are avenues for affected others that can help them cope with the addiction itself.

Carl: Affected others, that’s the term for it?

Michael: It is, so I mean if you think of there a number of different groups that are out there that are for adult children of alcoholics or adult teens of alcoholics or spouse of alcoholics, so again, that sort of affected other can be that immediate family, it can be coworkers, it can be friends, but there are support networks out there and typically those support networks are other people who have been affected by people who misuse or abuse drugs or alcohol.

Carl: We started talking about opioids and kind of went into addiction overall but bringing it back to the opioid situation. I know Riverside is involved with a number of organizations throughout the community. How are we partnering with some other organizations and agencies to affect that positive change?

Michael: Sure, we have started a task force here at Riverside that has brought a number of leaders from Riverside to the table to indicate from the area of oversight that they have how opioid dependence or opioid use has affected the areas in which they – that they oversee. And also, to that table, we have brought partners from both the city and county to help us take a look at how we as a organization Riverside, can partner with the local authorities and local agencies to help fight this growing epidemic. And partnering with the police department has been a great avenue that we have found to help at the source. Many times when a 9-1-1 call is made regarding a person who has made and overdose or who has ingested an overdose of an opioid our first responders tend to be the police whether it’s local police or country police and partnering with them to be able to have trained professionals or have the police department themselves trained as administers of Narcan which is the opioid reversal agent.

So, somebody who has ingested the opioids when an injection of the Narcan is given to that patient; it can reverse some of those effects and help that patient until they are able to get stabilized by EMS and brought into the emergency department to again, further stabilize them medically and at that point; we can at least work to hopefully give them some information about the treatment programs that we have here at Riverside to at least impact at some level that addiction cycle that the person is in that has brought them to the emergency department. So, that’s one of the ways that we have partnered. Really looking at the cases that have been unfortunately the individuals who have passed away within our county to really take a look at some of the demographics and figure out how again we, as an organization can start to impact the population and as we look at this; we really see the Caucasian 30s to 50s type male is really the people that are being mostly affected by the opioid crisis here locally.

Carl: Oh, interesting.

Michael: It is.

Carl: So, with the task force you have gotten that demographic information. So now perhaps you can target some messages and some education in that direction?

Michael: Absolutely. We were lucky enough to be able to get a grant that has allowed Riverside to partner again with some of the local agencies and specifically agencies that allow us to do some community education and training regarding addictions and really focusing on again, that opioid epidemic. But to get information out there for parents, for loved ones; to just start to know the warning signs of people that may be utilizing whether it’s illicit drugs like heroin or certainly the misuse of the prescription drugs and really start helping them identify what may be a precipitating event that should provoke them to want to bring them in for an assessment.

Carl: And if they want to reach out to Riverside, make contact and try to get that help, have you got some information of how they can do that?

Michael: Absolutely. So, our behavioral health intake department is available 24 hours a day, seven days a week and we have qualified professionals everyday that can make that referral and assessment and the phone number that they are available at is 24 hours a day is 1-844-442-2551 and again that’s 844-442-2551 or an easier way to remember that is 844-4CALL1, we are just one call away.

Carl: They can get that help. Michael Mutterer, Senior Vice President and Chief Nursing Officer at Riverside Healthcare and addiction counselor as well we appreciate the wealth of information you have shared today. Thanks for being with us.

Michael: Thanks for having me.