Treating Everyone Like They Can Succeed

[Jaunty Guitar Music]

Mike: Welcome everyone. This is Avoiding The Addiction Affliction, a series brought to you by Westwords Consulting. I'm your host, Mike McGowan.

Mike: We wanna have another important conversation today about helping those folks affected by the ongoing opiate epidemic. I'm pleased to have as our guest, Amy Molinski. Amy is a Peer Support Specialist with Community Medical Services. CMS works with clients with substance use issues, and have offices in 11 states with headquarters in my old hometown of Scottsdale, Arizona.

Mike: Welcome, Amy.

Amy: Thank you.

Mike: I'm so glad you could do this with me. You know, we've had a lot of conversations recently about opiates and the epidemic in our state and country. So let's just start this way. Tell us about your work and the philosophy of CMS when working with clients using opiates.

Amy: Sure. So definitely two questions. My, my work is [laugh], I, I guess, are you asking specifically what my work is or [laugh] how much I love it? Because that's immediately what comes to mind.

Mike: Oh, both actually.

Amy: Yeah. I have, I have the best job on the planet, maybe it's just the best job on the planet for me. But what I get to do every day is incredible.

Amy: And what I do get to do is as you said, I'm a peer support specialist for community medical services. But my specific role, I, I don't actually work in a clinic, I work in the community. So I work a few days a week with the Milwaukee Fire Department on their Milwaukee Overdose Response Initiative.

Amy: And that group is designed to follow up in Milwaukee County on non-fatal overdoses. What we do is we go and reach out to individuals who experience a non-fatal overdose and offer them support. Sometimes that support is harm reduction items. Narcan, fentanyl testing strips, resources. Sometimes that's a ride that day to the treatment of their choice.

Amy: So, and everything in between, right? So I get to do that. And then the other days when I'm not with the fire department, I get to work in a program called Medication Assisted Treatment Behind the Walls, and Community Medical Services has a partnership with the Community Reintegration Center, which is formerly the House of Corrections and the Milwaukee County Jail.

Amy: And what we do is we bring medication assisted treatment into the facilities and provide residents. At both of the facilities that have opioid use disorder and are interested in this program we get them started on medication. They meet with a therapist, a case manager, and peer support on a weekly basis to get them engaged and involved and in treatment prior to their release and get them set up for continuation of treatment once they're back into the community.

Mike: Wow, that's fascinating. Let, let's talk about that first and then go back to the work with the fire department. How does somebody who's currently in like the House of Corrections or jail, how do they get access to the program? Do they have to request it?

Amy: No, they can request it. We are very, very fortunate.

Amy: The case manager that works for this program. Her name is Liz Schwartz and she works for Wellpath and she is very diligent. So anyone that gets admitted into, you know, I don't know if you would call it, admit it, but anyone that's incarcerated goes through an initial assessment. So if they indicate opioid use maybe an addiction of some sort, or if they come in and get placed on withdrawal protocol, Liz reaches out to these individuals and, shares with them about the program and sees if it's something they would be interested in. Of course, there are some that don't acknowledge opioid use or addiction or do not get put on withdrawal protocol that still would like assistance, and then they may hear about it from other residents that are there and ask about the program.

Amy: But the case manager Liz, is incredible and she works very hard to offer this to anyone who it might be appropriate for.

Mike: Well, that's actually what I was thinking about because that's a perfect time to offer that right at the beginning of when some of these individuals might be experiencing withdrawal and thinking, now's the time to turn my life around.

Amy: Right. Absolutely. It's, it's a great time. Because for people who have been incarcerated, they know that when you're sitting there and left, I mean, [sigh] I guess so often people that are using substances are trying to escape and oftentimes they're trying to escape themselves, their own thoughts. And when you're incarcerated it's just you and your thoughts so often that.

Amy: They may start to think about the choices that they've made, the circumstances that they're in, and what could possibly be done to try to change that once they go back into the community. And the really cool thing to me is that there are many people that end up in this program that. Didn't either, didn't know that there was help available.

Mike: Right.

Amy: Or just simply had no idea where to start. And so it's just, it's, it's being handed to them. They don't have to look, they don't have to seek out a facility that works for them, that takes their insurance, whatever the case may be. It's, it's right there and it's brought right to them while they're in custody.

Mike: You know, I, I've been doing this for a really, really, really long time and I've been battling that, the perception that, oh, if they're not ready for help, it will never help them. You gotta hit rock bottom to get better. And you're mentioning a population that's neither of those places, but yet they may respond and you never know, right, Amy?

Mike: You never know who's going to respond positively to the help that you offer.

Amy: Right. I, I look back, you know, as a person in recovery, I went to treatment 16 times.

Mike: How many times?

Amy: 16 in five years.

Mike: Wow.

Amy: Yep. And I believed at every time that I went into treatment, I believed I was ready. So to me it wasn't a, a mindset of ready or not ready.

Amy: I've always been a pretty firm believer that regardless of what your mental state is, whether you're saying "I want treatment" or somebody's saying, "You get treatment" or "you get this other consequence that is less appealing to you", or as some people like to call forced treatment?

Mike: Yep.

Amy: Either way you get the same information, you get the same service, whether you chose to be there or chose it as a less severe option.

Amy: Either way, you still get all the same stuff. And I believe, and it's been a long time since I've looked into that, but at least at one point, statistics showed that it didn't matter how somebody entered services as long as they got there, they had just as good a chance at what society might call success as anybody else.

Mike: Well, I used to get, [laugh] I actually got fooled a lot. You know, you'd work with somebody and you'd think, "Oh wow, this person's gonna make it. They have all the resources and support, and they know and they're there". And then you hear through the grapevine that they literally started using 10 minutes after they walked out the door, and then somebody else would show up at your office who you wouldn't have given a snowball's chance to.

Mike: And three years later you see 'em in the grocery store and they're so grateful. So you don't know.

Amy: You don't know. There's just so many different directions this could go in, right but.

Mike: Yeah.

Amy: That's, we never as, as just human beings in general. We never know what a person we're walking past.

Amy: We don't know what their circumstances are. We don't know where they're at. We don't know what they're going through. And so treating every person you meet with kindness, or in my case, in the work that I get to do, treating every person as if they are going to succeed in whatever their goals are, is important.

Amy: My personal opinion is irrelevant. I'm not, I'm not here to. To try to put my own beliefs or my own opinions onto somebody I'm here to, to sit with someone and help them achieve their goals, whatever they might be. My personal opinion is irrelevant unless they ask for it.

Mike: Well, it must be helpful then in your job to eventually at some point drop to the person you're working with.

Mike: "Hey, don't tell me I had to go through this 16 times before I got it".

Amy: [laugh] I think sometimes that is helpful. Yeah. So I, I was, one of the people you're talking about, had all the support. I had a great home life. I had a great home life to go back to, you know, all of these things were definitely in the pro column for me, and none of those things mattered when I got out of treatment.

Amy: I. Again, I was trying to escape myself and so I do this because my story is heavy. It's sad and it's, it's truly unfortunate, not only for myself, but my family and everyone that cared about me, the things that they went through. But I also know that a lot of people, most people are not as fortunate as I was. Most people do burn a lot of bridges.

Amy: They, they push a lot of people that care about them away and they end up with very minimal support as a result. So not only do the struggles and the challenges that I faced, maybe give hope to the people that I'm with, but. That's exactly what it is. It motivates me to be hope for somebody. I want, [sigh] I want to love people when others find them unlovable.

Amy: I wanna believe in them when they don't believe in themselves. Because even with all the love and support I had, again, 16 times in treatment, over a five year period. I mean, and that was with the world at [laugh] my feet, you know, and I still couldn't get it. So I know the challenge when you have everything lined up, the challenge is even greater when you don't have those things.

Mike: You know, we had a long time ago, there's a gentleman who had a heart attack right in the middle of group therapy. And no matter what we, we responded immediately and did all of the lifesaving things but couldn't save his life. And he passed away and you're right. When we called home to deliver the news, I, I'm sure that they cared, but they said, do whatever you want.

Mike: So his support was not gonna come from the traditional places. And so organizations like yours are those places sometimes that offer people support who have burned bridges.

Amy: Yeah, absolutely. And [sigh] I'm not faulting any family members or loved ones that have to make that choice to take care of themselves.

Amy: Everybody's journey is their own, and each individual only knows what they can handle. So I understand why people break away to protect themselves. I, I truly do. But that's why organizations like my own and the, the groups that I get to work with that we partner with are so incredible because, we're not hurt by the choices that they may understand.

Amy: You know, we're, we're emotionally invested from a different angle, and so, and we haven't, we haven't been hurt or disappointed or let down for years. We're, we're coming in and we're like, look, this has been hard for you. Let us try to help now. And I, I think it's not only helpful for the individual that is experiencing the addiction, but for their loved ones as well.

Amy: Because some of that pressure to fix, is relieved.

Mike: Yeah. They don't have to do it. I, you know, I want to get back to the partnerships in a minute, but I, I'd be remiss if I didn't ask you, after 16 times what finally stuck?

Amy: Yeah. [laugh]

Amy: First of all, it's not what finally stuck. It's 16 times in treatment. There was little bits and pieces along the way.

Amy: I don't think any one of them was a failed attempt. It just wasn't my time. I learned something I was cared about in a way that I hadn't been before by strangers. I saw something for the first time that I had never seen in every single treatment. There was something different that I took away. But ultimately I got pregnant.

Amy: I got pregnant with my daughter who will be 13 in September. And the [sigh]. The truth is that before I got pregnant with her I had been using and I lost my job. I had auto title loans on my vehicles. I was hiding in my house with my curtains stapled to the window frames because I couldn't possibly take a chance of the curtains moving and somebody seeing in my house.

Amy: And I was not suicidal, but I was disappointed every day when I woke up.

Mike: Mm-hmm.

Amy: I just didn't want to fight anymore. And at that time that was in 2009. I had, I was living in Oshkosh in the Fox Valley area, and I had called several places looking for assistance with detox. And I was told that none of those places offered detox for opiate use because you didn't die from the withdrawals and previously I had been out in this area in the Milwaukee area and was able to go to places like Rogers. But now here I was up in Oshkosh and nobody offered help. And I, because I was denied, I mean, I didn't make a lot of phone calls. You only have to get turned down once to feel totally defeated when that's your mental state anyways.

Amy: And so I didn't think there was any hope. So I, I honestly spent the next three months just waiting for it to take me out, honestly. And I, I know that's horrible, but that's kind of just where I was at. I didn't have any fight left in me but I found out I was pregnant and.

Amy: It was the best and worst day of my life. I, I wanted to be a mom so bad, but I'm like right now of all, I mean, this is the worst place I've ever been in, in my entire life. But at that point I thought if there was anything that could push me to wanna do this, it's, it's gotta be being a mom. I'm gonna try one more time.

Amy: And I called my family that time and, and told them what was going on and. They said we'll be right there. And my whole family drove two hours up north to come to me and take me somewhere. And they refused to leave an emergency room until they found somewhere for me to go. And you know, again, it's that support that I was talking about.

Amy: Had it not been for them and them demanding that somebody do something I don't know where I would be. And so that's why I wanna do what I do so that I can fight for that for people too. But yeah, I'm. I'm really proud to say that I went into treatment eight weeks pregnant. Like I said, my daughter's gonna be 13.

Amy: She has no idea what it's like to live with a parent who uses substances. And I couldn't be more grateful for that. I do need to at least say that I don't look down, at all, on people who are unable to do that. Right. But it, it's my why. It's not everybody's why. In that it was the perfect storm for me.

Amy: I had given up, I had no hope, and that that was my light. That was the light at the end of the tunnel for me. And because of that, I gave it one last shot and I, I literally gave it everything I had that time And Nova Counseling Services and Oshkosh. I'd like to give them all the credit and they'd tell me that I did it myself.

Amy: But, they gave me one more chance, and I'm grateful.

Mike: Well, and now you don't have to staple the curtain shut anymore.

Amy: I don't [laugh]. I don't even have curtains on my window anymore.

Mike: There you go. Everybody look in [laugh].

Amy: Ya, there's nothing to hide in this house.

Mike: Well, I can, I can see where your passion comes from. And you know, one of the things I like about doing these is, this is stories obviously, but the partnership that you're working with, I think you're, you're one of the organizations part of this is it pronounced MORI, the Milwaukee overdose response initiative.

Mike: Right? Yeah, it's firefighters, it's community, or it's everybody. Right?

Amy: Yeah, that's the Milwaukee Fire Department started a program. They have like a mobile integrated health program where they do like community paramedicine.

Amy: They visit people you know, with medical issues that have been long-term that need help. And so off of that, there came this idea that we could help battle the opioid epidemic in, in Milwaukee, which is horrible, and come up with this kind of mobile integrated health idea. So what happened is the fire department started partnering with other agencies in the area.

Amy: My company is, is one of them, and I, I believe, that we were, we were the first to, to sign on and then we were very fortunate to have another agency Clean Slate Centers join us. And then not long after that, another agency was HOPE. So we've got different peers from different agencies throughout Milwaukee County that each one of us has certain days that we're there.

Amy: We have two cars that go out every day, two firefighters and a peer support in each car. And we drive around the city and follow up on any non-fatal overdoses from the day before. We go to their address, their last known location or the address they provided on the EMS run. And we say, "Hey, we're here to follow up and we wanna see if there's anything we can do to help you".

Amy: It's super cool. [laugh]

Mike: I was gonna say, they must just be shaking their head when you say that. Right.

Amy: Yeah, I mean there's a variety of different responses, right? Some people are like, I see a uniform. No thank you.

Mike: Right?

Amy: Some people are like, how did you get my information? Who are you? So and other people are like, [sigh] thank you.

Mike: Mm-hmm.

Amy: I need help. I didn't know where to go. I don't know what to do. Some people lack the trust right away, but they'll listen to what we say. Oftentimes, they'll be willing to take what we call HOPE Kit. We distribute HOPE Kits throughout the city, which contains Narcan, fentanyl testing strips, a CPR face shield, a never use a alone card.

Amy: Narcotics Anonymous, other community resources for harm reduction items or treatment options. We'll leave those behind and it's incredible to me. We've been doing this for four years now and it's incredible to me, how often people call us six months or even a year later say, "Hey, I wasn't ready then, but I am, I am hurting".

Amy: And they remember that we came and we just wanted to help. There was no judgment, there was no pushing. It was just a group of people that wanted to see what they could do, and they remember that, and they call us when they're ready and that's, that's incredible.

Mike: Well, and I think I read somewhere in one of the articles I was reading about this, that you've seen a a, like a 21% reduction in fatal overdoses and the, and the participation in the program.

Amy: Yeah, if, if you read that somewhere, it's probably true. I am not a numbers or statistics girl. It's just not what I do. I, people, people are my thing [laugh], but if it was in print, it is probably accurate and came from [laugh] our data.

Mike: I think. I think what stuck out about that is at a time where the fatal overdoses are actually rising when you follow up and do what you're doing, we've seen a reduction in that. It gives people, I think, a lot of hope.

Amy: I think so.

Mike: Yeah. Let's, we, we'll, we'll let you go back to your work today, cuz I know you're taking a break from your work to just do this, which is great. But what, what have you seen that, that it takes to get people to, well, I'll let you wrap a bow.

Mike: What, what, what does it take for people to turn the corner? Well, like what have you noticed?

Amy: What it takes is understanding, it takes celebrating every positive change. We're not, we're not in a place anymore where we can say abstinence is the only way. We're in a place where harm reduction is incredibly important, and harm reduction, like I said, means any positive change.

Amy: We need to celebrate every single one of them. I, I would be lying if I didn't say that someday I hope everybody has what I have, but that's not everybody's goal. That's not what everybody wants. And so, I wanna help people improve the quality of their life to whatever extent they want.

Mike: Mm-hmm. And to stay alive.

Amy: Well, that's the primary goal.

Mike: Yeah.

Amy: And that's, that's what we tell people every day. We're only here to help keep our community alive.

Mike: Hmm, that's outstanding. Well, you know, this is another one of those great conversations where I go into it thinking we're gonna talk about one thing and end up talking about a bunch of different stuff.

Mike: So I thought this was great. Amy, I wanna thank you so much for joining us today and helping us understand this a little bit better and encouraging more community partnerships.

Mike: For those of you who are listening we of course encourage you to listen again next time when we'll talk about more issues regarding substance use, mental health issues, and people who make a difference in their communities and still, then please stay safe. And if it doesn't work the first time, you got 15 more cracks at it.