Wearing a T-shirt emblazoned with Voices of Hope in a vibrant blue, Ethan Hawes pushes their straight black hair over a shoulder and starts to work making phone calls under the steady gaze of a plush hedgehog on the corner of the desk. "Hi, this is Ethan calling from Voices of Hope. How are you doing today?”
It goes like that for about 30 minutes as Hawes works through a contact list. Some don’t answer. Some just can’t chat.
“Okay, darling. Well, how about just give us a call back when you have a few minutes? Okay. Alright, sounds good.”
Hawes knows some of the folks on the phone, often from a time before they started in recovery.
Some they have met at the non-profit’s Lexington center working as an intern and now a staff member.
Hawes said it’s important to have a person to person contact instead of a text or an email.
“Like, for instance, earlier, I took a call from a client who said that they were recently diagnosed with hepatitis C. We know that's a really tough thing to go through. And so I think it's a lot better to have a voice on one end of the line to talk to you about that,” Hawes said.
Hawes said it’s nice to have a focus on individual paths to recovery.
“So, it's cool to get different perspectives on recovery, and to talk to people who are doing this all different kinds of ways. You know?”
That recognition that there can be multiple paths to recovery is a key tenant of Voices of Hope. The center, which opened in January, represents innovations in the traditional method of treating substance use disorder.
This innovation was recognized in April when Voices of Hope received $1.5 million to create other recovery support services in 16 counties.
That award was part a federal grant pushing $87 million going to the University of Kentucky to research and create recovery efforts. Another Kentucky program, Kentucky Opioid Response Effort, is creating Recovery Community Centers in six rural counties. So far, the has so far the federal government has invested $67 million in the program.
Those programs and others like them represent a significant shift in how substance use disorder is treated.
Dr. Joshua M. Sharfstein, with the Johns Hopkins Bloomberg School of Public Health, is also the author of
He said that a 28-day inpatient treatment program has been the dominate model for decades.
But, he said, “what is very clear with respect to opioids is that there's no 28 day cure, and that it is really a chronic illness, opioid addiction. And treatment requires a whole bunch of different things.”
He said there is a mythology surrounding the 28-day stay,
One false perception is that a person goes into treatment and they are cured. He said treatment for the chronic illness requires support beyond an inpatient stay.
Substance use disorder is also treated differently from other chronic illnesses in other ways. Treatment is usually a response to a crisis, an overdose or an encounter with law enforcement, Because of that it is usually done in secret. If someone goes to the hospital for diabetes, friends and loved ones are aware and supportive. If someone seeks treatment for substance use disorder, it is often on the down low. Families often don’t want to talk about it.
“It really sustains this veil of secrecy around addiction. But if you're going to switch models, you're going to say, ‘we need to help people thrive in their community’,” he said. “You need to overcome that stigma in order to have services that help people really regain their lives. “
That stigma is deeply rooted, Sharfstein said.
“We've had opioid addiction for well over a century. And during that period, when minorities and other socially marginalized groups have had addiction, it's been seen much more as a crime, when more of the majority groups have suffered from addiction, it's been seen more as a disease, and there's been more compassion,” he said. “I think what we have to hope is that the common suffering that many different communities have right now penetrates through that idea, and that everybody is showing compassion, and everybody is given opportunities for treatment and to rebuild their lives.”
That is happening in Kentucky.
Amanda Fallin-Bennett is Co-Founder of Voices of Hope. A nurse by training she first worked in harm reduction programs in San Francisco. She moved back to Kentucky to work with Alex Elswick and his mother, Shellie, to create a different kind of recovery model.
Voices of Hope, she said, hopes to limit stigma and stereotypes about people in recovery by stressing the need for ongoing support for the chronic illness.
“I mentioned I worked in a syringe access program and loved it you know, I love the model. I love working in harm reduction, but it did occur to me sometimes when we're providing services out of a van and an alley in the rain that there's not a lot of other health care in the United States delivered that way,” she said.
Too often, she said, recovery efforts have focused on emergency care for an acute episode. Like Sharfstein she is concerned that treatment stops with graduation from an inpatient program.
“Sometimes when you walk out the door to the treatment facility, that's where your work kind of starts,” she said.
That is where Voices of Hope is there for support. The Lexington community is home to a variety of support meetings, including 12-step programs. There is also peer outreach like the weekly check in phone calls made by Hawes and others.
Fallin-Bennett said so often what you see in the media about addiction focuses on tragedy, DUIs, car accidents, and families torn apart.
“And all those things are true,” she said, “but they're also 23 million Americans living in recovery. It's really unusual that you see them in the media that you see what it is like to live a happy, productive, fulfilled life in recovery. And so we feel like families and people living in active addiction may not see it, may not be able to see you know, the hope that really is there.”
Katie Marks is project director for the Kentucky Opioid Response Effort, or KORE.
KORE is creating six Recovery Community Centers with money from the federal State Opioid Response (SOR) grant program. This is a grant award from the Substance Abuse and Mental Health Services Administration (SAMSHA).
The centers, she said, will “expand beyond treatment and prevention, support long-term recovery, it goes beyond the treatment services and provides support around things like mutual aid and peer support and housing.”
It will, she said, support people as they learn new life skills like filling out an employment applications or signing a lease that weren't part of the routine when they were actively using.
She said the centers will also raise the profile of recovery within communities, in some ways taking it out of the shadows.
That, she said, has several benefits.
“First, we communicate to the community that recovery is possible, and it is happening everywhere. And, so, that forward facing message that recovery is part of our communities, and an amazing asset to our communities is the first part. The second part is that people can engage in the recovery process in their community and access the resources they need, and develop the support that they identify as being critical to their long term recovery.”
She hopes the recovery centers can help educate people on the true nature of the disease and the complexities of recovery.
The centers, she said, will allow us to “talk about hope, and talk about the process of recovery, which talks about a biological recovery, a psychological recovery, and a social recovery. And those three components stand in direct contrast to our misconceptions that promote stigma."
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Contact: Mary Meehan at firstname.lastname@example.org