Filling Gaps in the Healthcare System for Expectant Mothers

Recovery Unscripted banner image for episode 62

Episode #62 | May 23, 2018

Featured Guest: Justin Lanning and Angie Alexander

My guests today are 180 Health Partners’ Justin Lanning and Angie Alexander who serve a critical need: helping pregnant women with addiction by filling the gaps in a healthcare system that’s often not built for meeting their needs on a practical level. But to do this well, 180 builds a health system around each mother by asking for their personal goals and literally meeting them where they are: at their doctor, at their home, even just connecting via text or for 10 minutes at their work during lunch break. And as you’ll hear them explain, reaching mothers-to-be presents a unique opportunity to make a huge impact in two lives in a short window of time, specifically related to neonatal abstinence syndrome and the lasting effect that can have on the life of a child.

Podcast Transcript

David: Hello, and welcome to this episode of recovery unscripted. I’m David Condos and this podcast is powered by foundations recovery network. My guests today are 180 Health Partners Justin Lanning and Angie Alexander, who serve a critical need helping pregnant women who are addicted by filling the gaps in a healthcare system that’s often not built for meeting their needs on a practical level. To do this well 180 builds a support system around each mother by asking for their personal goals and literally meeting them where they are, at their doctor, at their home, even just connecting via text or for 10 minutes during their lunch break.

As you’ll hear them explain, reaching mothers-to-be presents a unique opportunity to make a huge impact in two lives in a short window of time, specifically related to neonatal abstinence syndrome and the lasting effects that can have on the life of a child. Now, here’s Angie and Justin. I’m here with Justin Lanning and Angie Alexander. Thank you guys so much for being here.

Justin: Yes, absolutely.

Angie: Thank you for having us.

David: Let’s start by having you tell us a little bit about your own personal stories and what the journeys were that led you to serving in healthcare and recovery.

Justin: Yes, you bet. My wife and I had spent a very large portion of a couple years really praying about and engaging with family members on both sides who had dealt with addiction, behavioral health, domestic violence, some with the judicial system as well. Then, we had two little cousins that were born with neonatal abstinence syndrome or another way to say that is born dependent on opioids and so, we really did a lot of research and studying and what’s the best way to approach this and really had a front-row seat to what the gaps in the system were and when I was presented with an opportunity with several of the nation’s top thought leaders to say how can we really impact society in the trajectory of society being impacted through the opioid epidemic?

We felt like this was a very important place for us to lean into help mothers, while also helping them make sure that their babies are born healthy and thriving. My background comes from population health wellness, so I’m just somebody who’s extremely passionate about reaching people who are underserved or maybe have some chips down against them but how do you actually engage them with practical solutions that can guide them towards what they believe is improvement not what I might believe this improvement?

David: Yes, and Angie?

Angie: I come at it from just a little different angle, basically. I was one of the moms that we service now but basically, I just grew up in a broken home. I was a child of two people who are addicted to drugs and so grew up in that environment and sort of naturally almost organically just started living that same lifestyle. Around the age of 19, I started going to church and changed my life and went into recovery. I’ve been in recovery for 16 years but really just have a heart for moms in addiction because they don’t really have another place to go to cope and to thrive and feel accepted and good about their lives.

I appreciate the movement of 180 for that reason and I’m glad to be a part of it because I feel like I can offer something a little extra special because I get it. When I meet with moms, they’re always so relieved that they can take off their jackets and just relax with you because you get it, you’ve been there and I cry with them, and I laugh with them because I do get it. I remember what it feels like to be completely stuck with no hope and no support, so that’s why I’m here and that’s my background.

David: As you mentioned, a lot of what 180 does center on neonatal abstinence syndrome, also known as NAS. For people who maybe aren’t familiar, could you give us a brief overview of how that affects newborns? Like what that looks like.

Justin: Sure, you bet. Right now, while we’re doing this podcast, there’s going to be probably close to eight babies born in our nation with NAS. What the implications of that are, these children are starting off into withdrawal, they aren’t addicted. Some people will use the word addicted, they’re dependent on the opioids so now they’re going through withdrawal immediate post birth and generally, that means some are close to 28 days in a hospital environment of some type most of that in the NICU extreme shivering, constant crying and if you’ve ever seen a video of this or seen it in real life, it will take your breath away.

Really a traumatic beginning of life and when we’ve seen these mothers who care, they’re reaching out into a system for help but it’s an awfully complex system and one that’s not necessarily built today to meet them where they’re at and so that’s where we’re really working on-

Speaker 4: I’m going to jump in here real quick to dive a bit deeper on this. As you heard Justin say, the number of babies born with NAS has risen dramatically in recent years. In fact, over the past 15 years, this number has quadrupled to effect around six out of every thousand babies born nationwide. In areas that are especially hard hit by the opioid crisis, the situation is even more dire. For example, in East Tennessee which is one of the areas that 180 Health Partners currently serves, some counties have reported NAS figures that are up to eight times that national average affecting over 50 babies out of each thousand that are born.

In Johnson City, Northeast Tennessee’s only Children’s Hospital became so overwhelmed that they built a new ward specifically to meet this need. Since 2009, that hospital has served over 1,800 babies with NES and Counting. Here’s Justin with more.

Justin: -that’s the way of life and to give you kind of some numbers on this, not just the volume of babies that are born with this but also the cost. On average in our nation, a baby born with NAS and the first four months of life costs our nation around $66,000 per baby versus a baby that’s born without NAS is generally around $3,500. You’re talking about a $63,000 difference and those are dollars that can be used towards other things and for something that’s completely preventable and avoidable from that standpoint.

David: Looking at the patient journey, how do your patients generally first find out about 180?

Justin: This is something I’m super passionate about, finding that teachable moment and as astonishes me even I was guilty of my own stigmas right when we started this organization but when we saw that 79.2% of babies born within NAS, their moms went to an OB of some type to ask for help in the first or second trimester and another 11% in the third trimester.

David: And they just didn’t get it?

Justin: The system’s not built to help them. An eight-minute doctor’s visit, you can be the most phenomenal caring and we know some of the most amazing doctors on the planet who want to help but their practice is set up for eight-minute 10-minute, 12-minute visits. We looked into the system to say how do we not really compete with any of the systems but take all the viable resources that exist today and amplify them and connect them and then fill in the gaps. In today’s world, if a mom goes in and says, “Hey, I’m using opioids, I didn’t intend on getting pregnant. I’m pregnant. what should I do?”

The doctors, their staff tries to maybe connect them with some people they know other than that that’s kind of what they have. Now, today with 180, they walk in and they say, “You know something, I’d love for you to meet Angie, one of the 180 health partners.” We’re able to meet them at that moment when they’re reaching out for help.

David: Could you describe the process of that journey from finding out through understanding what the program benefits are and then eventually becoming enrolled being a part of the program?

Angie: Ultimately the peer is the one so my job is to go in and I’ll reach the mom first, she’ll go in for her visit and when she’s done with her visit, I’ll go back in the room with her. I just sit down and I just share what 180 is and how we’re coming alongside her to support her. A lot of times moms are afraid that we’re connected with the Department of Children Services sometimes, so sometimes, they’re really standoffish.

David: Yes, and that seems to illustrate another way that the system at large is not really built for helping the needs of that.

Angie: That’s right and ultimately like when you’re in that situation, you get sent through so many systems, there’s so many programs, there’s so many organizations, there’s so many things required of a mom who’s struggling with substance use. She already feels like so much is required of her. These women have- you would not believe it, I don’t know if I could keep all the appointments these women have to make.

David: A lot of waiting rooms, a lot of forums.

Angie: A lot of waiting rooms, a lot of paperwork, a lot of people looking at them like they’re just another number, especially, when moms go to the hospital to deliver. They’re not treated the way maybe Justin’s wife would be treated when she delivers. Anyway, when I meet with them, my number one goal is to just make them feel completely accepted and valued and one of the first things I say is, “I’m a recovering addict and I’ve been clean for 16 years, so I get it and I want you to just be completely honest with me and relax with me and know that I am I am your advocate”, I have a little tag that says peer advocate. I’m here for you and I haven’t had a mom say no thanks. And then at that point, I’ll do an intake with her and get background information and then set up a peer visit and at that point, I go into their homes and visit with them every other week, can’t give them that support that often. Most moms, probably 80% of the moms that I work with don’t really have any support, not from their parents, not from their spouses, or significant others. I can’t even communicate how paramount it is that 180 is involved in their lives and I feel so privileged to be able to be that support when literally they have no one else.

Justin: That’s right and just to highlight, really how important Angie’s role and all of our peer’s role is, when we look at the healthcare system as it is today and it’s a phenomenal healthcare system if you can participate in it. Today, we may all may read an academic article that says the medical best practice for somebody like this is to check into a detox center or is to participate in something known as IOP. The challenge is we think okay IOP is something where you need to go in at least three hours, three days a week. If I’m a mother and I’m barely paying my bills, I don’t have dependable childcare, I don’t have dependable transportation and I’m asked to somehow find a way to get there which is going to take me time in addition to the other appointments I’m supposed to keep. I’m likely to go, “I just can’t”.

A lot of our mothers aren’t quite ready for that step and that’s where Angie and our entire team engage so we provide both that personalized and professional behavioral health. We have licensed counselors, social workers, 60% to 70% of our engagement staff our peers and we always say number one and Angie is phenomenal at this but relationship always trumps process in science. If you don’t have relationship, you’ll never gain permission to begin to build up their confidence, their resilience, their validity in life so that they can begin to take that ownership towards best practices in science, if you never have relationship.

David: Yes, and I love that you say you’ll meet them wherever they are in their journey. I think a lot of people in this industry say that and a lot of people I think mean it in their context, but you guys are literally going to their home, going through their doctor-

Angie: Getting bit by their dogs, and peed on by their kids.


David: But that’s what it takes? That’s incredible.

Justin: Yes, when a mom says, hey all I’ve got is the ability to meet you at McDonald’s across the street from my work from during my 15-minute break, got it, we’re there. Hey, I’m running out of minutes on my phone, I need to move to text even though we may know the outcomes will be better if we can get in person or that if she needs to move to text for a week or two, we’ll go there and that relationship and that trust and we’re being tested because they’ve had a lot of relationships that have gone sideways on them.

In the beginning of the relationship, they’re going to test us on will we really be there? I want to give credit where credit’s due here is for anybody listening if you haven’t read bridges out of poverty or a framework of poverty by Ruby Payne and give this example because I became highly convicted of this. If we were to take some of my family members and if we were to grade some of my family members on how they’re doing in life, we might give them a D or an F in some of the areas of life but if their peers were to grade them or they were to agree themselves, they may be getting an A or a B.

What Ruby does in her work helps unveil for us that we may be living in a middle-class framework or an upper-class framework and we tend to judge people on our frameworks. Well, why don’t you just act this way? Why don’t you just fit in this framework? This is what’s best. Out of your best intentions, you don’t mean to be pushing that person away but I’m here to help because clearly, you need to be in my framework that is not how we exist.

We want to meet those people where they’re at emotionally, physically, all those areas of their life and not bring our judgments of here’s what’s good but rather our guidance of here’s some options and see where they want to go on that. We get them to those best practices, we get them to the stabilization, we just don’t come in yielding that sword out of the gates.


David: When we were talking that before the interview you said there’s a lot of emphasis on patient choice for reasons like you’re saying and making each patient’s personal goals the foundation. What are some ways that you put that into practice and how do you see that affect the progress?

Justin: We are in an interesting cycle here of the pendulum where we weren’t awake in our nation to this opioid epidemic. Suddenly, now we’re full-on awake. We are there but the pendulum can swing too far to where even when we hear each other speak, we will say no you can only follow this practice and I find that maybe a little bit concerning because we’re almost saying to people who are dealing with behavioral health or addiction, you don’t really have the ability to make a wise decision. I would say, these are some of the most powerful inspirational people you will ever meet in your life.

Things that are being overcome. It’s just that you’re dealing with one thing and maybe my coping mechanism through a series of circumstances in life has become this. Doesn’t mean I’m incapable of making a decision, in fact, I make a lot of very complicated decisions every day. When I talk about patient choice that’s when somebody comes in the door and says, “Hey, I believe this is the best thing for my care because guess who knows me the best, I know me the best.” We listen to that.

David: Yes, and coming back to asking for their personal goals too because one patient might come to you and say I want to be here, another patient might come to you to say I want to be up here and so if you can’t come to them and say okay everybody needs to to get to this place.

Justin: Yes, and meeting them where they’re at is super important. If I ask you or if I ask myself- I write down regularly, here’s my goals and guess what happens a year later when I write now my goals, I have new goals. Asking somebody to try to get to the endpoint with their goals today is really irrational because none of us really operate that way, so how can we help people with bite-size chunks and begin the momentum of achieving goals, guess what happens when we achieve goals in our lives. Opioids are released in our bodies.

We’re creating opioid mechanisms and what’s neat about our population that we get to work with is there’s really only two times in life where your body naturally creates the most opioids that’s during pregnancy and during breastfeeding. 180, our belief-

Male Speaker: Here’s a bit more on this, the neurochemical the Justin’s talking about is called Oxytocin. This hormone has been shown to have a variety of effects from relieving pain, calming fear and soothing depression to of course, helping to instigate the physical changes related to childbirth and breastfeeding. In addition to all that, Oxytocin also has a really unique fascinating effect on something else that’s a bit harder to quantify, bonding. In this case between a mother and baby. What research has been able to show us so far is that mothers who show higher levels of Oxytocin during pregnancy, were more likely to engage in bonding activities with their baby such as singing songs to baby, picking baby up, or even just talking baby talk.

And just like how accomplishing goals encourages motivation to reach more goals, Oxytocin can have a snowball effect meaning that the bonding activities that are promoted by Oxytocin, in turn, promote more Oxytocin production. When organizations like 180 can help minimize NAS symptoms, and allow babies to spend less time in the intensive care unit and more time in their mother’s arms, that can create a healthy and adorable cycle for both mom and baby. Now, back to Justin.

Justin: If you’re looking for a window of time to impact and supplement synthetic opioid use with natural opioids, what more beautiful natural time in our lives to take that on?

Angie: A lot of times when we meet our moms in our first interaction, we talk about goals, what are your goals, how do you define success, how will you know that you’ve achieved your goals? Many moms don’t even have goals. What’s a goal? Why do you need a goal? I just do life I’m living in one-hour increments, just last week I asked a mom define success and she said it’s not that I want life to be easy, I’ll just be able to handle the hard. And so for me, I just want to be a part of that process that gives her the confidence to feel like the hard stuff’s not going to go away, everyone has hard stuff.

My hard stuff just looks different than yours, it’s not less hard or more hard, it’s just hard. Being a part of that process and seeing her confidence grow over time, like he said when you achieve, when you actuate your goals, it gives you the confidence to actuate more especially with who we work with because pregnant women you’re not like other people who are dependent on substances. They look down on you because your mother, that’s even worse. You’re not just any Joe off the street. You’re a mother you should know better.

Mothers don’t even have that group, that camaraderie of we can all get-together and smoke dope and shoot up and take pills but moms aren’t even allowed in that circle because they’re looked down on because it should be common sense, a mom should know better. To offer her that acceptance and that love and just helping her recognize this doesn’t have to be your forever or your ending. This can be the beginning. It was something really great.

Justin: That’s cool you brought up about the natural opioid [unintelligible 00:19:42] I remember that from my third birth class I took my wife. [laughs] Yes man, that is– Yes, I didn’t even think of that but that is an amazing timely opportunity. When I talk with some other people who are serving in addiction treatment environments, they often say that they see usually some form of resistance from patients somewhere along the journey. What’s your message to expectant mothers who maybe are unsure about entering the program or about buying into the whole recovery process?

Angie: The cool thing about 180 is that we’re here when you’re ready. We’re not pushy. I have been pushy. We can be pushy because some people need a little swift kick at some points in their life. It’s just about being able to read the mom and I love the fact that it’s individualistic. We don’t have a blanket statement for everyone. It’s how we treat each mom based on their personal individual need but making sure that they’re fully informed, this is what we’re offering. Making sure that’s it’s crystal clear.
If you’re afraid of DCS involvement which usually is the reason why most moms won’t get involved, I’m going to advocate– I just had somebody from DCS call me last week and I advocated for the mom. I try to share that with moms and sharing with them my lived experience and what I needed and what I didn’t have and how that hurt me and how getting what I needed helped me and being to just into their suffering and help them. Some moms don’t even know that they have need, they’re okay with where they are. Even just in that moment planting a seed of “Maybe you have a need.”


Male speaker: Coming up. Angie and Justin explain how they team up with other organizations to surround mothers with support as they transition into the day to day life of being a new mom in recovery. They share 180’s vision for using eight million dollars of new investment to reach exponentially more lives across the country. First, I get to introduce another installment of our trivia segment this week in recovery history.

Today question highlights national prevention week. An annual event dedicated to increasing public awareness and action related to mental health and substance use disorders. It was first observed on this very week in which of the following years: 2006, 2009, or 2012? Find out after the interview.


David: In order to offer everything that you guys offer to expectant mothers, it seems like you’ve been able to involve a pretty broad network of outside resources elsewhere in the community. Can you tell us more about some of those resources that you’re able to involve and what they offer patients?

Justin: We’ll look and we’ll help the heath plans know which providers are in their network and also evaluate them, curate them to say, “Here’s who they are and here’s how they fit.” Then, we look at the different things that are not a part of the health system at times. Some of those are nonprofit organizations doing detox or addiction or support groups. Some of those are local NA groups or AA groups. Some of those are food transportations. It’s a series of social needs that we all have and build these relationships and community awareness around this so that as Angie and one of our– and any of our other care team are meeting with that mother and we’re hearing her needs, we’re then reaching out across that network.

We can think, “Should it be nonprofit? Should it not?” If I was sitting strictly in the nonprofit bucket right now, I would still not be doing very much. I may be working with five moms. Instead we’re working with hundred of mother and we’re instead we’re getting ready to launch in multiple states, instea,d we’re able to change a lot of people’s lives. To do this next level thing where we’re engaging these people, what we saw was everybody waiting for somebody else to pay for it or maybe a grant somewhere which isn’t long-term sustainable. What we did is we looked for socially, entrepreneurially minded capital. Organizations that are willing to put their capital at risk in hopes for a return.
Really what that allowed us to do, is we really bring a free workforce into the market, we contract with the health plans and then we go at risk for the outcomes. We’re not paid unless we actually produce positive financial outcomes and they’re very measurable from that standpoint.

David: Yes. Even with all these all resources that you’re mentioning, it’s free of charge to the mothers, right?

Justin: Free to the mothers– which I want to really point out that the health plans are so incredibly passionate and active about this. That’s one of the other things from a business standpoint. I said what you really need to do to when you’re launching something is find one person to pay versus trying to get six or seven or 12 people to pay, you want to move fast. The health plan, since they’re already at risk.

David: Yes. Explain the at-risk part a little bit.

Justin: Let me talk about this because I’ve had to spend a fair amount of time educating legislatures about this. The way this works and in haul for something called MCOs, Managed Care Organizations. They contract and they all manage these 500,000 lives and all manage those for, let’s just say, $425 per member per month.

David: Is that like Medicaid?

Justin: Yes. In Medicaid, that’s the way they– a managed care organization gets paid. What happens is you may have one of those people in the 500,000, if you average out over the year, they may only really cost a hundred dollars per member per month. Another may cost $3,000 per member per month. You have people inside an MCO that just cost more than they’re getting paid.

What we targeted was– these babies cost a whole lot more than they are getting paid.

David: Reducing the cost like you said at the beginning, the 60 something thousand if they’re born with NAS.

Justin: That’s right. They’re highly incented so they look and say, “Well, if you can reduce my cost and improve the long-term health of these babies, by all means, let’s do this.” What’s great about the Medicaid structure is they actually had to put a large majority of those dollars back to work in the underserved community to provide them more and more services that they weren’t getting already.

That’s we need to do. We need to get wise about what is preventable and how can we save dollars there so that they can be reused in other areas.


David: Transitioning into a new life in recovery– I’m not in recovery but I am a parent and so I can understand a little bit of what’s it like to come home with a newborn and to put those together, I can even imagine taking that on. How do you guys approach that phase of the journey? Once the baby comes, setting the mother and baby up for long-term recovery?

Justin: What’s really neat about 180 is because we are engaging during pregnancy, we’ve already gained permission and trust to bridge across to that other side so they look into us. We’re having very, very high rates of babies going home with their moms instead of DCS, needing to separate the family because 180 is involved.

That involvement is home visits, video telehealth conferences, education from our peers, our nurses. We’re engaged for up to one-year post-birth. That care team’s goal after those four months or so is really to make sure that there is a healthy hand-off into a longer-term recovery set of circumstances. Whatever that might be for each mother.

Angie: The important thing too, is to look while we’re working with them. It’s kind of helping them how easy that it– Develop their own ability to shore themselves up. We can’t hold their hand forever. It’s sad to let go and have a less engagement but it’s neat because they’re getting it in ways that are lasting and enduring so they’re making connections in their community, in their– Whether that’s attending a church or just branching out and going to the library and taking their child to the book club and just building relationships that are healthy and not grounded and substance use and just creating for themselves a new community that they can thrive in is so vital and so important and really need to watch.

Justin: Then one day see them become future 180 colleagues.

David: Yes. You have some that you’ve hired now as peer advocates?

Justin: Yes.

David: That’s cool, man. I love that.

Justin: Very fun stuff.

David: Yes. As you’ve mentioned, you’ve recently raised a lot of money, a new capital. What is your vision? What do you hope that his new funding will help you accomplish?

Justin: Yes. Thank you for asking. Are partner’s out of New York along with our local partners, First Cressey and Altitude Venture and Resolute and Spring Mountain as well. We raised eight million dollars. 99.999% of that is completely focused on opening new markets. Touching as many lives as we can. We’ll be launching in Florida here very soon. Over the next 18 months, we’re very focused on opening about four to five new markets.

David: Yes. How do you find people that you can trust in those areas because I feel like you’ve just been on Tennessee to this point and I feel like you probably have a pretty good lay of the land as far as who you feel comfortable getting involved in sending a mother to? How do you find new good people in different states?

Justin: There’s quite a bit of process and science behind this of how we go through that vetting process. The other things is we’re a very national company. We didn’t in Tennessee because we live here. We started in Tennessee because there are particular health plans here in Tennessee that operate in several other states. It gave us the ability to make the fastest impact on the nation.

David: Could you explain what that means about the health plans here in Tennessee?

Justin: Yes. You bet. In Tennessee, we have Medicaid contracts with three health plans in Tennessee. United, Amerigroup which is also Anthem, Blue Cross Blue Shield Tennessee which goes under the tag of Blue Care. United is the largest Medicaid MCO across the nation. They, I believe, have somewhere between 26 and 29 states. Amerigroup has about 21, 23 states.

The fact that two of the largest in the nation were right here in Tennessee-

David: Yes. So you’re able to get that experience right here in the same market.

Justin: Now, we do that and it makes it even faster for us to into other states where they also are and say, “Will you please do the same thing- for us over there, over there, over there, over there, over there.” That just– From a strategic standpoint was extremely important about how do we get to as many moms as possible as fast as we can.


David: All right. We’ll just wrap up with this last question. You’ve devoted a lot of your time and your effort to advocate for mothers and babies in our community and now, spreading out national. Could we wrap up by having you tell us — Just to sum up, why helping people start a new life and recovery is so important to you?

Justin: One of the reasons I’ve very specifically focused on moms and babies is you can absolutely start where we get to care for two people, not just one. The other thing that I think is super important that concerns me a little bit as I mentioned before is, how do we respond as a nation to these things? I’m concerned that it’s going to be very difficult. A lot like the crack epidemic that we had in the ’80s to really pinpoint outcomes. It’s very difficult in a short period of time to say what’s really working and what’s not, where are we at.

What we have in within our population is our mothers have a beginning of being pregnant and then an ending. We are able to look at a very short window and show tremendously high impact of this is the way we need to engage with people who are struggling in life. Not just pregnant women. This is how we should engage as communities, as a healthcare system.
To leave with you this if you and the listeners are not aware of a study Bruce Alexander did called Rat Park. They’d put rats in cages, a scientist did. The rat had two bottles, one with water and one that was laced with cocaine actually. In a very high percentage, they went to the cocaine bottle and then in very, very high percentage, they overdosed. Then he created rat park where rats could have community. Could have sex, could play, could get along and what was interesting, same two bottles, very rarely did anybody go to the cocaine bottle and there were zero overdoses.

What’s interesting is in our society, we continue to be getting more and more individualize and more, more separated and we look at these things and we cast stigmas and we cast judgement and our solution today is to separate people from society when this is the time we need to pull closer together than ever.

Angie: I guess for me, the obvious answer is that I’ve tasted it and I’ve lived and it’s bitter and it’s hard. If I can be used as an instrument of hope and acceptance, then what better thing can you do with your life besides being a mother of course because I’m a mother of five. I’m a doula outside of my work for 180 so I’ve helped lots of babies and worked with lots of pregnant women. For the first time, I held a baby who was experiencing not super significant symptoms and– I had never held a baby who had been experiencing some symptoms and-

David: It’s all right. Take your time.

Angie: I knew in that moment that all of the work that I had done with that mom mattered and the baby didn’t have to stay in the hospital. She was able to go home with the mom and I was so thankful that we were in her life. There’s numbers and the insurance company’s involved and I get all of that but at the end of the day like that mom is home with that baby and they’re safe and they’re happy and that mom doesn’t feel the shame and the guilt and she doesn’t have to live with that for the rest of her life.

My parents were both addicted to drugs when I was born and then I became addicted when I was older. I don’t know what that means. I don’t know if it’s the same for everyone but for me, it’s important for me to be able to reach into a system that didn’t work on my behalf and matter and make the change. That would’ve really benefited me had it been available 16 years ago.

David: Yes, and really make a difference. You’re holding a baby, that baby’s whole life is different now.

Angie: Completely changed. And the way the mother sees herself as a mother now and a human being is changed and shaped and molded in that experience. When I look at my own kids– I have five beautiful kids and I’m raising them in a completely clean home full of love and protection and nourishment and I’m changing five lives. To me, it’s all the same. Just impacting one individual at a time and through 180, I’m allowed to really treat the mom like a person, like an individual.

David: Yes. All right. Angie, Justin, thank you so much for your time today.

Justin: Thank you so much.

Angie: Thank you for having us.


Male Speaker: Thanks again to Angie and Justin for sharing that with us and thank you for sticking around to the end of this episode for another installment of our trivia segment this week in Recovery History.

Today’s question focuses on National Prevention Week which was first observed on May 20th in the year 2012. Put on by the Substance Abuse and Mental Health Services Administration or SAMHSA, Prevention Week aims to bring together communities and organizations to raise awareness about the importance of substance use prevention and positive mental health.

Its timing is intentional. According to SAMHSA research, June and July are the time when it’s most likely for teens and college students to try substances for the first time. Prevention Week’s position in May, allows it to strengthen those community and family bonds as the summer begins.

The purpose of Prevention Week can be broken down into three main goals: Community Involvement, to spread the word and implement strategies; Partner Engagement, to foster collaboration between federal agencies and local organizations; and Resource Sharing, to promote accurate helpful information related to behavioral health. This mission is carried out with free online toolkits and with community events all centered on daily themes such as: Underage drinking or suicide prevention.

That’s National Prevention Week which began this week in the year 2012. Stay tuned for more trivia from Recovery History in future episodes.


This has been the Recovery Unscripted podcast. Today, we’ve heard from Justin Lanning and Angie Alexander of 180 Health Partners. To learn more about their work, visit

Thank you for listening today. If you’ve enjoyed this episode, please pass it along to someone else who might enjoy it as well. We’d love to have your help spreading the word. See you next time.

Unlearning Toxic Masculinity

Episode #105 | January 8, 2020

In a culture that often encourages a toxic version of masculinity, how can treatment providers help men unlearn harmful stereotypes and uncover their own trauma?

We’ll answer this with SCRC clinical director Hedieh Azadmehr on this episode of Recovery Unscripted.

Cultivating an Environment of Innate Listening

Episode #104 | October 2, 2019

As the healthcare industry evolves, how can treatment professionals turn off the noise and really listen – to emerging trends, to their patients and to themselves?

We’ll dive into this with speaker, coach and founder of human connection company BluNovus James Hadlock on this episode of Recovery Unscripted.

The Realities of Self-Harm and Suicide

Episode #103 | August 15, 2019

What can behavioral health providers do to better understand the realities of self-harm and to know how to respond when they spot the signs in their patients?

We’ll discuss this with non-suicide self-injury specialist, author and counselor Lori Vann on this episode of Recovery Unscripted.

For more about Lori’s work, visit

Integrating Buddhism and the 12 Steps

Episode #102 | August 8, 2019

How can ancient principles from Zen and Tibetan Buddhism integrate with modern treatment programs to help more people build lasting recovery?

We’ll discuss this with author Darren Littlejohn on this episode of Recovery Unscripted.

For more about Darren’s book, The 12 Step Buddhist, visit

Can LGBT-Affirmative Therapy Help Re-Write Internalized Messages?

Episode #101 | July 17, 2019

In a heteronormative culture, how can providers use affirmative therapy to help LGBT individuals re-write the false messages they’ve internalized?

We’ll answer this with psychologist, author and activist Dr. Lauren Costine on this episode of Recovery Unscripted.

For more about Dr. Lauren’s work, visit