Why Recovery Support Services Matter

David: I’m here with Tom Coderre. Thank you so much for being with us.

Tom: Thank you, David. It’s great to be here in Nashville at the Foundation’s conference.

David: Here we are. All right. To start us off. Could you tell us just a bit about your personal background and how you got started in public work?

Tom: Sure, absolutely. The first thing I should mention is that I’m a person in long-term recovery myself. For me, that means I haven’t used alcohol or drugs since May 15th of 2003.

David: Oh, congratulations.

Tom: Thank you so much. This past May, I celebrated 15 years in recovery. I’ve had an amazing journey over the past 15 years. I’m sure we’ll talk a little bit about it here, but it wasn’t always like that. I grew up in Pawtucket, Rhode Island. I was very involved in my community. I ended up getting addicted to alcohol and other drugs, and my life started this downward spiral. As I started to lose the things that were most important to me, it was very progressive, it got worse and worse and worse.

David: Were you pretty young at that time still?

Tom: Are you saying I’m not young now? [laughs]

David: It’s all relative.

Tom: Thanks, David. No, I was in my 30s, my early 30s at the time. It was a really– but I had drank alcoholic, probably, for a decade through my 20s. I never thought I really had a problem because I wasn’t like the stereotypical person who had a problem. I’ve finished school, I worked, I was an elected member of the Rhode Island State Senate. I got elected to the state Senate when I was 25 years old. I served for eight years.

The excessive use of alcohol, I had this– How would you say? I thought I could control it, basically. I had this feeling I was in control. I drank a little too much, sure. Work hard, play hard kind of thing, but then I was introduced to other drugs and I could not control those. That’s when things really started to become a problem for me. That’s when I started doing the things that I never thought I would do to find ways and means to get more. That was a really traumatic time for me in my life, especially when I got arrested in my home city for possession of a controlled substance. Former lawmaker becomes law breaker. I had been out of the Senate only for four months and ended up losing my position in the Senate.

It was a traumatic period in my life, but it was also the turning point. It’s interesting because people– Christopher Kennedy Lawford talks about these moments of clarity that we have. At that moment, I thought my life was over. What I didn’t realize is it was just beginning.

I think for people who are in recovery, there is that moment of clarity. There is that turning point. There’s something that happens. Getting arrested, going before a judge. I’m not saying I came willingly. There were still claw marks on my addiction when I left it behind. But the fact is those experiences really led me to the beginning of my journey, going back to a residential treatment facility, staying there for five-and-a-half months, then going to a recovery house where my journey continued.

I ended up starting out as a resident of that recovery house. I was a resident for six months, then I became the assistant house manager, then the house manager. That’s when I got involved in recovery advocacy because I was a former legislator, I was always interested in politics and policymaking. I was listening to my peers who were saying, “Hey. There’s not enough beds in detox. There’s not enough treatment slots. There’s not enough money in the system. There’s all these negative public attitudes around addiction and recovery, preventing people from asking for help.”

I said, “Well, what can I do?” They told me about this organization called Rhode Island CARES which is Communities for Addiction Recovery Efforts. I ended up going to one of their meetings one night because I had that interest in the policy thing, but I also heard that they served pizza at their meetings. That was a big draw for me.

David: Whatever it takes to eat at the [unintelligible 00:05:07].

Tom: I know, right? That is the truth. I went to that meeting and raised my hand and said, “I was a former legislator.” They’re like, “You?”

David: Did they know who you were?

Tom: No, they had no idea. I was just another bozo on the bus. I was some guy that was in treatment who ended up going to this meeting. I joined the legislative day committee at that point, and then just got more and more involved as it went on. From there, I ended up becoming the National Field Director for Faces and Voices of Recovery in Washington DC. I did that for two years.

I traveled around the country, helping to build grassroots recovery community organizations that were putting a face and voice on recovery, doing public education and changing public policies providing recovery support services. Really important stuff. I did that for a couple of years. I worked on projects like the HBO Addiction documentary project where we launched that documentary in 30 cities around the country, 30 major cities around the country, we did that project, we joined together in CADCA. I started to get involved with other people who were in the continuum of care, which was very, very cool treatment. Prevention is a big part of recovery, we all know that.

David: Then, you were appointed by Obama at some point.

Tom: I did.

David: To SAMHSA.

Tom: I did. I went back to Rhode Island first when a colleague of mine got elected Senate President. I would serve as her chief of staff for six legislative sessions. A friend of mine who was in Washington working in the administration said, “Would you ever come work in the administration?” I never thought anything would come from it. One day I got a call from the White House and asking me if I would apply for this position, this policy position at SAMHSA. I did. I became the senior advisor to the administrator at the Substance Abuse and Mental Health Services Administration. Then, I was elevated to the Chief of Staff at some point. That was an incredible opportunity as well, getting to work in the Federal Agency that supports this work.

David: What did that role entail?

Tom: Well, it was pretty comprehensive. Because I had a legislative background, I did a lot of work with Congress. I helped support our programs and policies and funding before Congress, and I helped the administrator and other members of our team.

David: You actually might be in a room with Congressmen advocating that this is an important thing to care about.

Tom: Exactly, yes. We would do meetings up on the hill. We would get asked to come to some of them and some of them we would initiate ourselves. We would also get called the hearings frequently, which is a scary process, getting called before congressional-

David: Yes, you’re sitting there with the little microphone and your papers, and what would you talk about?

Tom: Exactly. Well, different things depending on what they were concerned about. The opioid crisis started to become front-page news at that point. A lot of members of Congress were hearing from constituents, they were hearing that people in their District were overdosing on opioids, they heard about the prevalence starting to increase. They really wanted to know what they could do about it.

We talked a lot about our prevention treatment and recovery support programs in that space. We also advocated for more funding. We knew that the system did not have the capacity to help all the people that needed help at that time. We really advocated for more of those things. Not that you’re supposed to advocate as a federal employee, but we educated Congress about the need for that stuff.

I think that advocacy became clear to them that this was important. I also got to work with the Surgeon General of the United States on the Surgeon General’s report on alcohol, drugs and health, the very first report that put addiction aside, other public health crises of our time like tobacco use, cancer HIV, AIDS. That was a monumental task when we released that report in the fall of 2016. It was amazing.

David: You help put that together?

Tom: Yes, I was responsible for leading the team that put it together. I’m not a scientist and the Surgeon’s reports are about the best available science. We had a team of scientists that we brought together to write the report. We had over 100 people review the report, but we had a whole federal team that was responsible for coordinating that project. I helped lead that team.

David: Cool, cool.

Tom: It was amazing. Then, I got to represent the agency out in the public, coming to conferences like this, I’m talking about what we were doing, getting input from stakeholder groups, I managed our stakeholder process, which is, there’s a lot of stakeholders in this field.

David: What does that mean for SAMHSA?

Tom: For SAMHSA, it means everybody on the Mental Health and Addiction side, there’s two very separate group of stakeholders that advocate for funding, for research, for programs that will help improve the lives of Americans who suffer with behavioral conditions.

We had groups like NAMI or like Mental Health America on a mental health side, on the addiction recovery side. We had all sorts of stakeholders like ABHW or AAAP or addiction psychiatrists groups, docs, recovery support groups like faces and voices of recovery facing addiction. Those stakeholders are really important to our mission. They are the people also, coincidentally, who talk to Congress and advocate. Because they can advocate to Congress. They say SAMHSA is not doing enough in this State, so they say SAMHSA needs to be doing this. Put some report language in the next budget or change there we were reauthorized during that period that I was at SAMHSA. I worked on the reauthorization bill.

David: What does that mean?

Tom: Federal agencies have authorizations in Congress. They exist in law. That’s how they get created. From time to time, they’re reauthorized. The purpose of your agency can change, the name of your agency can change, the programs within your agency can change, and those reauthorizations ended up in a bill called the 21st Century cures bill, which you may have heard. There was a huge amount of money that was also put in that bill.

The first of the largest expansion since the development of the block man, the subsidies of mental block grants. A billion dollars to fight the opioid crisis were included in that bill. That was really, really important work that we did up on the hill.

David: Yes, just in your view, do you feel like that billion dollars that Bill has that made a difference so far or are we still yet to see it?

Tom: Well, no. It has made a difference. It was $500 million over two years. We’re in the second year of that money right now. Those ended up going out to the states in something called the state targeted response grants for the opioid crisis or STR, as people in the field would know it. The STR grants have been really, really important to put additional resources on that ground. Since the system didn’t have the capacity, a lot of that money has gone to building capacity, and it takes time to build capacity. We have bricks and mortar buildings that people get treatment in and they get services in.

It’s hard to open up new buildings quickly. You can’t do that in the snap of a finger. But what you can do is you can start that process. Congress is so impressed with what’s been happening with the STR grants. They appropriated an additional three billion dollars in the budget for more programs last year. Now, we have a new program on top of STR called SOR, the State Opioid Response grants. You’ve got STR grants, you’ve got SOR grants. Almost every department has grants as well. There’s a grant that Department of Labor just announced, a recovery jobs grant.

Which is when you’re thinking about most people wouldn’t think that the Department of Labor would have anything to do with the opioid crisis, but everyone seeing their role, [coughs] excuse me, the Department of the USDA, US Department of Agriculture sees their role. You know about the health agencies that are involved in this struggle but you often don’t know about what other agencies can do. There’s a huge criminal justice component that goes along with addiction too.

DOJ has been involved in this space for a long time and some of that money is going to Department of Justice to make sure that we’re having diversion programs for people so that they don’t go to jail. Instead they go to treatment. Also people who are in jail, making sure that they get access to treatment and other resources that they need. We shouldn’t waste that time, that moment of clarity that they may have. When I was sitting in that jail cell, when I got when I got arrested, I went to jail first. I was only there for seven days, granted, but seven days is a long time for this guy.

David: That seems like a long time to be in jail, yes.

Tom: For this guy, it was. But there are people who are there for much, much longer. That’s an opportunity moment. That’s a moment when you can engage somebody. You don’t want people going in to prison and having to withdraw from the substances that they are addicted to. You want to get them on medication assisted treatment, which is the gold standard for treatment in this field. You want to make sure that they are sustained on that. You want to make sure that they have good connections so when they get discharged, they don’t just get handed a sheet of okay, here’s some referral sources. You want to do hot hand-offs to agencies so that individual actually goes and continues their treatment. These are the kinds of things that we’re able to do with those resources.

David: Yes. Now you’re serving for Governor Gina Raimondo?

Tom: Correct.

David: Yes, for Governor Gina Raimondo there in Rhode Island.

Tom: That’s true.

David: Why did you choose to serve in that role?

Tom: I think a lot of guys like me Democrats who were working in the previous administration went back to states and recognized that there was a role for us to play to take the knowledge that we had gained and then go put it into use in states. Governor Raimondo is somebody who’s been a leader on these issues. When she came in office in 2015, she issued an executive order, she’s created a overdose prevention and intervention task force. She charged them with coming up with a strategic plan, and they are working that plan very forcefully.

The two task force co-chairs, Dr. Allison Scott, who is the Director of the Department of Health, and Director Becky Boss, who is at the behavioral health department, were leading that effort. The governor really thought that she needed somebody in her office to help coordinate. Just like I mentioned, at the federal level with the US Department of Labor having a role, well, our State Department of Labor in training has a role as well, but who’s coordinating that work? Who’s coordinating the Department of Education and the prevention activities that they could be doing? Who’s bringing the Department of Children Youth and Families to the table? Because we know that a lot of folks that are DCYF involved have issues with addiction. Are we addressing those? Are we making sure that they’re being represented?

The governor said to me, “I’d really like you to come serve in the office and help, number one, find out who is not at the table that needs to be at the table and bring them there, and then find out who is at the table who could be doing more and ask them to do more. Let me know, I’ll ask them. I’ll put some pressure on folks to do a little bit more.”

Then like other people in business and industry, are we missing a community component to this? That’s something I’m really interested in as doing a lot of community organizing in my years in politics and then in the recovery movement. It was something that I was very attracted to to come back and create that community involvement. Our task force named this year, I became a co-chair of the task force and there was three of us. The task force [unintelligible 00:17:11] communities coming together. We have four specific strategies. They’re not going to surprise you, prevention, rescue, treatment, and recovery.

On the prevention side, we’re going upstream and trying to change prescribing practices for docs. We’re also doing primary prevention and partner with the Truth Campaign in Washington DC, who’s doing this new campaign around opioids now. They’re the same group that had so much success in tobacco prevention.

David: With tobacco, yes.

Tom: Exactly. We’re doing that work on primary prevention. On the rescue side, we’re making sure that naloxone, the lifesaving antidote for a drug overdose, is in the hands of not just with first responders, but anybody who could come into contact with somebody who’s overdosing or anyone who’s at risk for overdose themselves.
We’re getting naloxone out on the street. Our treatment strategy really involves, again, adding capacity to the treatment system, medication assisted treatment, partial hospitalization, outpatient, inpatient, residential, making sure people have access to the services that they need when they need them. We’ve created something called centers of excellence so that people who are receiving medication assisted treatment specifically, not only receive the medication, but they receive the assisted treatment. All too often we’re seeing MAT is really just M.

David: Just a prescription.

Tom: Yes, it’s M. [chuckles] Where is the AT? We need the AT as well. These centers of excellence are really focused on providing the wrap around psycho social and recovery supports that we know have much better outcomes for somebody who is on medications assisted treatment. We also have a program in the prison. I mentioned the work that needs to be done in the Department of Justice. Well, in our state prison, we created a MAT program in the Department of Corrections. So that somebody comes in now, they get access, and we’re using state general revenue dollars to do this because of the governor’s leadership.

But we’re giving people the opportunity to get whatever medication they think will work best for them. There’s three FDA approved medications frequently in criminal justice systems. We’re only seeing people offered one of them. We think it’s important to offer all three, and we’ve noticed that people are much more willing to go on MAT when they’re in the prison as a result. Then as I mentioned, connect them with services afterwards.

Then on the recovery support side, which is the fourth strategy, we’re really focusing on building the peer movement. I know I’m going to talk a little about what I’m presenting on today, and that’s really exciting. Because I think peers are the underutilized resource that we have. We know we have not just a capacity issue in building out the treatment system, but we have a workforce issue. How do you get people to come into this field who may not know about it, who may not have the skills or the training? One of the ways you can help advance the workforce is bring people with lived experience into it and help train them and scale them up so that they can share their lived experience with somebody else.

David: Is that part of what the Department of Labor’s involved with?

Tom: It is. We’re doing two things with the Department of Labor. We have a recovery jobs program, which is building the addiction workforce, but also creating– There’s something called real jobs and real pathways. We’re creating a recovery pathway so people can access whatever career choice that they’re interested in. You want to go into the construction industry, here’s your pathway. You want to go into hospitality, here’s your pathway. You want to go into IT, here’s your pathway. Yes, we want to help build the addiction recovery workforce, but just because you’re in recovery doesn’t mean you have to go work in the treatment center or work in a recovery community center. You might have a different interest.

David: It’s going to help their recovery to have a career afterwards. Yes.

Tom: Oh, my God. What do we know about barriers to people sustaining their recovery? We know there’s three big ones; housing, education, and a job. Somebody doesn’t have those three things, we know that their chances of sustaining their recovery decreased significantly. This is a way to do that.

We’re also with that program creating something called recovery friendly workplaces. We know that people in recovery are people are who are struggling too work amongst us in every different career. What we’re doing is partnering with our friends in New Hampshire, who started this program. Governor Sununu up there got talked to Governor Raimondo and said, “We want to do this. We want to do it together. We know you guys are doing some really innovative things in the recovery space. Let’s do recovery friendly workplaces.” You can help workplaces become more recovery friendly. What does that mean? Well, it means that if people are struggling in the workplace, there’s a culture that helps them come forward and ask for help. There’s policies and procedures and there’s an actual culture that helps somebody come forward and ask for help, knowing that there’s not going to be any retribution.

We launched our recovery friendly workplace event a couple days ago, and we had an employer come forward and say that he had lost one of his most energetic and enthusiastic employees to a drug overdose. He said the thing that surprised him the most is he didn’t even know that the employee was struggling. Imagine that employee who was struggling in silence, going to work every day, being a great employee still, but not feeling like they could ask for the help that they needed. This is a really important initiative. We’re also doing other things. Like we were one of the first states to put peers in the emergency departments because we knew that people who are overdosing, they were getting taken to emergency departments. Then they were being released, and then they were going back to the streets and they were using again.

This was a really important moment to engage with them. Recovery coaches now, all of our emergency departments, you have the ability to get a recovery coach. You’re asked, “Do you want to talk to a recovery coach before you leave?” There’s a whole comprehensive discharge planning process.

David: In the emergency room?

Tom: In the emergency room, that has been implemented. We have what we call levels of care for hospitals now so that you can become a Level 1, Level 2 or Level 3 hospital depending on the kinds of services you offer for people in recovery.

David: In Rhode Island, what are some of the specific challenges you’re seeing related to this? What’s the landscape like up there?

Tom: We’re seeing the same thing everybody else is seeing. The biggest challenge, I think is, is the changing nature of the crisis. We saw initially, obviously, prescription drugs were the problem. People were being prescribed prescription drugs and over-prescribed them for things they really didn’t need them for. Then that fueled this huge surge in the number of prescriptions that were out there.

We clamped down on that through prescription drug monitoring programs and other types of education to docs and putting new regulations in for prescribing so that we limited the number of morphine milligram equivalents per day that could be prescribed in the number of days that could be prescribed. What did that do? It reduced the number of prescriptions that were there, but it didn’t do anything with the people who were getting the prescriptions before.

What happened to those people? They went to the street and started using illicit substances. Either pills they were buying on the black market, or they went to heroin. Then we saw a huge problem there. People going from prescribed substances, which, by the way, we know 75% of people start with a legitimate prescription that they received from a family member, a friend or a doctor, but then they’re going to the street for illicit substances.

Then in the past two years, we’ve seen the introduction of fentanyl into the system and other synthetics, and that’s been a real game changer. Now people who used to be at risk for overdose are now at extreme risk because fentanyl is 100 times more powerful.

David: You’ve seen overdoses go up in that time?

Tom: We have. In fact, over the past 10 years, and what I always seen overdoses steadily increase. 2017 was the first year we saw a slight decrease over 2016, 4% decrease. We’re one of the few states that saw that. We think it’s because of the strategic plan that we have in the work that’s going on there. But with fentanyl, it’s really tricky. We don’t know what 2018 is going to look like. We’re seeing, it’s kind of a roller coaster that we’re on. That substance is coming in through the mail, it’s coming in through all sorts of sources that are harder to track.

David: You need such a little quantity to overdose. It’s not hard to pocket.

Tom: It’s like a grain of salt. It could cause an overdose for somebody. It’s being added to, not just opiates. It’s not just being added to the counterfeit pills, into heroin, but it’s being added to now crystal meth, it’s being added to cocaine. We’re even seeing it in marijuana. This is really scary, and these are new challenges. We’re trying to come up with solutions for that too. Fentanyl test strips are one strategy, I think, that’s being used.

David: That’s where people can have something that they can like it’s touching it to it, taking their drug to the-

Tom: Yes, they can test their drug to see if there’s any fentanyl in it. They then have awareness of what they’re taking. Right now, they think they’re taking crystal meth and they’re actually it’s laced with fentanyl and they’re overdosing without any knowledge. They don’t have Naloxone on them. They’re not using with anybody potentially. They’re really at risk, really high risk. This is a scary time for us.

David: Yes. Here at the conference, you’re giving a presentation about peer recovery support services? Could you start by describing what the concept of peer recovery support entails?

Tom: Sure. We have a continuum of care that is, we call it Recovery Oriented Systems of Care. That’s been a buzz term for, I don’t know, at least six or seven years that people have been talking about Recovery Oriented Systems of Care. We need to become more recovery oriented, because what we found is that we’re investing lots and lots of resources into treatment, which is great, but people are getting out of treatment, they had no recovery support services or had no plan after they got out of treatment to support them. They were having a re-occurrence of symptoms or a relapse, what we frequently call relapse. That’s preventable. I know in my life, having the kinds of things I talked about; going to that recovery house, joining that recovery community organization, having safe and sober social activities, having peers around me who would-

David: You saw how it helped you?

Tom: I saw how it helped me and it pulled me up when I needed to. The peers were these people who were put in my life to– They were sometimes bullshit meters like, “Tom, you’re full of shit. No, you need to go to your 12-step recovery meeting. You’re not going anymore. You stop going and you’ve got all these excuses. You need to take care of yourself physically and mentally and emotionally.” When you’re off balance in recovery, it’s a really dangerous time for you. Peers are really important in terms of being able to provide you that support that you need.

Today, I’m going to talk a little bit about the importance of that in my own life. Then I’m going to share with them the concepts in the body of evidence that exists now, which is a growing body of evidence that exists now around how peers are really helping people sustain their recovery in the long term and improve treatment outcomes, because I think that’s what people at this conference want to hear. They want to hear, “Okay, we’re doing great treatment and somebody’s doing really well when they’re in our treatment program.” But what happens when they leave? They’re not able to stay in recovery, sustain the recovery. How do you change that?

Well, there’s a role for treatment to play here too in supporting these programs. The models, a lot of the models we have are fee for service models, the payment models. When you move away from fee for service and pay for success and to outcome based bundle services over longer periods of time, this is a chronic condition, we know that. Yet-
David: That’s talking about like the health insurance side of it?

Tom: Correct. Yes. We need to make sure that the health insurance side is matching up with the treatment side, which is matching up with aftercare and recovery support side, and that we need to build communities of recovery. This recovery [unintelligible 00:30:42] organizations that I said I want to run the country helping to build 10 years ago? Those things are still super important because they’re the ones who are going to deliver these peer type services, and they’re non-clinical nonprofessional services. They’re not competing with treatment.

David: There is not a substitute for treatment.

Tom: Not at all. For some people, it might be. Some people might not need to go to treatment or some people, depending on what their diagnosis is and where they fall on the spectrum, recovery support services might be enough for them. But for most people, no. They’ll still need– People with severe substances disorders need to go to treatment.

But what happens after treatment? This is an adjunct to treatment, this is a support for treatment, and so I am excited about the presentation today and looking forward to hearing what people getting feedback from Truman providers on what some of the challenges they’ve had with accessing these kinds of services and what we need to do to really build these up. I think the SOR grant and the STR grant, a lot of states are using those resources to build their recovery coaching academies and giving resources to recovery community organizations because that’s really where that work needs to happen.

David: I know you touched on this earlier and you’ll be highlighting in your presentation some of the research to back this up and says why opioid recovery is so effective. Is there any of that you can share?

Tom: Sure. A lot of this work happened at SAMHSA through a program called BRASS TACs, Bringing Recovery Supports to Scale Technical Assistance Center. Though these technical assistance centers hired some of the researchers that are out there in the field, guys like John Kelly at Harvard, and Bill White, who is a prolific recovery author and researcher, to do a lot of the groundbreaking work on piers. That work is ongoing, but we have some really good research from the effectiveness of recovery community centers, recovery coaching, telephone recovery support, how these have been used in communities to really change the outcomes of clients. That’s why I’m going to be presenting out today.

David: I guess what are some other specific examples that you’ve seen have success as far as pure recovery [unintelligible 00:32:59] way?

Tom: Well, I’m a big fan of the recovery community center model. The reason is, is because recovery community centers are these Oasis’s in the heart of a community, usually on Main Street bringing recovery out of the shadows that it’s existed in previously, and giving people all the kinds of things that they might need. I talked about a lot of this already, but the safe and sober social activities, recovery coaching, or recovery meetings can happen there.

David: This is giving them a space.

Tom: Absolutely. For music, for art, for expression, for fitness. We know that fitness oriented recovery is becoming a thing. I don’t know if you’ve ever interviewed anybody from Phoenix Multi Sport.

David: I have, yes. I’m a big fan of Phoenix.

Tom: Phoenix is amazing, right? Those programs are starting to really materialize all over the country, and all these things can happen in a recovery community center and, or outside of the recovery community center. They can be separate resources that are available in the community. But these are the things that people are reporting back on that are having extremely, extremely incredible outcomes. We need to continue to do that, do those kinds of programs and stand them up in as many places as we can.

David: Yes, and just have a place to go. Because if you’ve been an alcoholic for 10, 20 years, you’re used to hanging out at the bar, have no place to go. If you don’t have anywhere to go, then that’s a big gap.

Tom: Exactly. Creating a space in a community. Hopefully, someday, we’ll be set to this part of the community. We see this all the time. Ethnic communities gather together-

David: Yes. just to be around people who understand you.

Tom: Of course. Religious communities gather together. Everyone has that space where they gather. Where’s the space for the recovery community? It’s in these recovery community centers. Super important, that’s what I’m a big fan of.

I think a lot of the peer recovery support services that I’m going to talk about in my presentation today, can be delivered out of those centers in an effective, very comprehensive way where you meet the individual where they’re at.

There’s a Bev [unintelligible 00:35:09] who– I don’t know if you know Bev, but she runs a pro act in Pennsylvania in the Philly area. When you walk into the recovery center in Philly, and a lot of other recovery centers have put this same sign up now, there’s a sign, and it says, ‘How can we help you with your recovery today?’

It puts the onus on the individual to let people know what they need, and that’s what really this is about. It’s about meeting somebody where they’re at and bringing them these kinds of services that they think are going to help them in that moment. When you’re engaging people in using techniques like motivational interviewing or anything and any number of other evidence based practices that people are using in treatment modalities, we use those same types of strategies in recovery engagement as well and in helping somebody identify what their strengths are, and we talk a little bit about this too.

We need to be asking people how to build their recovery capital, what’s right with you. Not what’s wrong with you. Because oftentimes we ask somebody, “What’s wrong with you, I want to help you.” Let’s ask somebody, “What’s right with you” and take a strength approach. Here’s what they have. They’ve got stuff they already can work with-

David: Let’s build on that.

Tom: – let’s build on it. That’s what recovery support’s all about.

David: Oh, yes. For treatment providers, for treatment center, what are some ways that they can they can better partner with peer recovery and integrate that into the whole system?

Tom: It’s a really great question. I think it’s just it’s really basic. It’s reaching out, it’s developing the relationship with your local recovery community organization and sitting at the same table maybe breaking bread, maybe having the conversation about how these two services are complimentary. I think that’s really important. I think when you break down some of those misperceptions that exist between treatment and recovery, I think you see a lot of light bulbs go off. The really good relationships that I’ve seen in the partnerships that I’ve seen, have been because of individuals. It’s not because of a system said you’ve got to go do this. It’s individuals who have stood up and said this is important, this is something we really should do. We need people to speak up and to speak out into make it happen. Be the change you want to see in the world, right?

David: Yes. I finish with this final question. Everyone who serves in this field has their own personal reasons for wanting to get up, get back into this work, do it everyday, that for you you could be working at any part of government, you could be back in the state Senate. But instead, you’re using your knowledge to help fight addiction from that perspective. To close, could you sum up why this mission is so important to you?

Tom: Well, clearly I owe my very life to recovery. I think a lot of people who are in recovery feel this way. There’s this inherent desire to give back, and that’s something I’m getting to do on a daily basis through my work, which is amazing. I’m getting actually paid to do it. I would do it for free, don’t tell anybody. But I would do it for free, but I’m actually getting paid to do something I love and something that also coincidentally sustains my recovery. I’m sitting here today as a man with 15 years in recovery. I don’t know if I’d have that if I wasn’t continuing to do this work. I don’t know if I’d stay connected as connected. Some of it it’s out of fear, quite frankly.

[laughs]

David: Well, because how powerful addiction is.

Tom: I do, and that’s the big point, right? It’s not the individual who’s weak, it’s the drug in the addiction that’s powerful. I think doing this work for me is twofold. It’s something that I’m passionate about, I care about, I think it’s super important, but at the end of the day, I want to see other people get the same opportunities that I’ve had.

David: Yes, all right. Well, Tom, man, thank you so much for your time.

Tom: Thank you.

David: It’s been a pleasure.

Tom: Mine entirely, thank you so much.