Transcription:

Melanie Cole, MS: Through innovative treatment, education, and research programs, the Grayken Center for Addition at Boston Medical Center is committed to making long term recovery a reality for every patient. My guests today are Michael Botticelli— he’s the executive director of the Grayken Center for Addiction— and Paul Kusiak—he’s the father of two young men who are now in recovery. He’s an advocate for families and a parent coach. Welcome to the show gentlemen. Michael, I’d like to start with you. Set the stage for us a little bit here and tell us what is the state of addiction in this country today?

Michael Botticelli: So, we are really seeing an impressive level of morbidity and mortality associated with drugs and drug overdoses in the United States. Last year, almost 72,000 people died of a drug related overdose. The vast majority of those attributed to opioids like prescription pain medication and heroin. Now illicit drugs like Fentanyl. This is more than car crashes in the United States, more than gun fatalities, and more than HIV deaths in the peak of the AIDs epidemic. So, this has really been an unprecedented health crisis, the likes of which the United States has never seen.

Melanie: Paul tell us your story. Because as Michael discusses the state of addiction in the country, you're kind of ensconced in that. Tell us your story.

Paul Kusiak: So, I'm just a dad who’s worked in high tech most of his life. One day my world changed. My wife and I felt as if we were sitting the bleachers watching our kids playing sports and then one injury led to multiple surgeries and prescribing lots of highly addictive pills. The next thing you know we were living our own private 9/11 spread over about five years. That included learning that my second son was also addicted to prescription pain meds.

So, my oldest son first entered treatment when he was 19 years old, and my youngest son when he was 16 and a half. I'm very fortunate. Today, my oldest son is 34 and he’s been doing well for over eight and a half years. My youngest son is 30, and he’s been doing great for about 11 and a half years. So, my wife and I are very grateful. We’re very proud of our sons, and we’re trying to give back in any ways that we can to help other families.

Melanie: Wow. Well you certainly are and what a story. So, Michael, tell us about the Grayken center. When was it launched, how did it come about, and then we’re going to ask Paul how he is helping other parents.

Michael: So, Boston Medical Center has a very long history of innovation and care for people with substance use disorders. It’s a bit unusual for many hospitals who haven’t really thought about how they treat people with addiction. So, programs started here over 25 years ago to deal with many of the patients who intersect with Boston Medical Center. It’s really been an innovative leader in clinical care, in research in treatment and education. We really realize given the magnitude given the drug crisis before us, really needed to do more work. We’re very fortunate to get an incredible generous gift from the Grayken family to establish the Grayken Center here at Boston Medical Center.

Really, the function of the Grayken Center is to continue to innovate, making sure that we have good clinical models to treat particularly our most vulnerable people. To make sure that we continue to do a good job at educating practitioners around addiction, and to really continue to replicate model programs across the country. So really through the resources of the Grayken center, we really want to continue to innovate and accelerate the great worth that’s happening here, and make sure that that’s a standard of care across the country.

Melanie: Paul, help us understand what it’s like for a parent. Speak about how important support for parents is as you're a parent coach and an advocate for families. I myself am a parent and this is such a heartbreaking story to hear, and hope, in the tunnel there, and hope at the end. Tell us what it’s like and how you were able to get involved.

Paul: Well, it was a long process. There’s no manual for this. At least there wasn’t back in the date when I first learned that my first son was struggling with prescription opiates, like I said, which lead to heroin. What I realized very early on is that you need to move past stigma. You have to just treat this as if it was any other illness and reach out for help early and often. That’s what my wife and I did. We just moved past any blockades that were there. We stayed in our kid’s corners and we advocated for them just like we would if they had any other illness.

This led me to organizations like the Partnership for Drug Free Kids where I've been a volunteer for about eight years. I've recently joined them. In 2014, I became a parent coach when we first started our national parent support network. It’s just been a wonderful organization. We have evidence-based resources that cover everything from awareness to education to prevention, intervention, treatment, and recovery of substance abuse disorders. These are resources that can help any organization throughout any community, but our focus is really helping families in crisis. So, I so wish this was available to me back in the day, but it is available now. We’re so grateful to have this collaboration partnership with the Grayken Center to help families in Massachusetts.

Melanie: Michael, speak a little bit of how the center serves as an umbrella for all of BMC’s work addiction. Explain some of the programs that people might not realize are available.

Michael: So, the way that I like to talk about this is that for people with substance use disorders that they're treated with dignity and respect wherever they intersect with services here at Boston Medical Center. So, whether that is through our emergency department where we have an opioid urgent care center that tries to serve as an intervention point and a gateway to treatment. We have a youth and young adult problem that serves that specialty age group in our pediatric offices. We have a program for pregnant women with opioid use disorders and substance use disorders to give them and their babies good care, not only prior to delivery but also provide them with a level of support services after they deliver.

We also have one of the largest primary care-based treatment programs that provide people integrated treatment care along with their primary medical care. We have over 700 people in that clinic. We also have a program that identifies and intervenes with patients with substance use disorders who might be hospitalized because of their addiction or a related health condition. So, the way that I like to talk about this is that we provide a level of support and intervention wherever people are intersecting with Boston Medical Center’s services. That’s really highly unusual for a hospital or medical center. We like to think that we are delivering overall excellence in substance use care regardless of where our patients are in our healthcare delivery system.

Melanie: Well you certainly are. So, Paul, when you work with families and parents, are these programs for parents, are they intended to learn to cope with their own feelings if their child suffers from addiction? Or are they also helping parents learn the skills to help their child? As you said, programs like this were not available back in the day that you were dealing with this. So, are they teaching parents how to intervene, how to get their children or their loved on into the center? Tell us a little bit about your work with parents.

Paul: Sure. For far too long, I think parents have heard the term “tough love”. Or we’ve been told that we can't help our kids. They need to hit bottom. We need to detach. In some cases, throw them out. We wouldn’t do this if our kids had any other illness. Fortunately, there is another way. As I said earlier, I think by staying engaged parents can help. So today in our parent’s support network, and what we mean by parent is a parent or any significant caregiver in that child’s life. We’re helping kids that are in their teens, their 20s, their 30s, and some are older. The drugs may vary from beer to wine to marijuana to prescription drugs to, as Michael said, heroin or Fentanyl.

Parents can call into our help line and they can talk to a bilingual master’s level specialist. They’ll get one on one guidance on how to develop an action plan for their family that will teach them ways to practice self-care and improve communications with their child and learn ways to encourage and motivate their loved one to realize that they want to change. In other words, to seek treatment, to succeed in treatment, or to embrace recovery. We do that by providing a lot of resources, such as eBooks on intervention, medicine, and assisted treatment are just a couple of examples. Or we may talk to the parents about their self-care. That might include [mind from the space stress ph?] reduction, or the benefit of parent support groups. Or how residential treatment might differ from outpatient care.

So, we really try to help transition the parents from feeling like victims and feeling hopeless to being empowered. I would like parents to know that as part of our support network, they can actually be paired with a parent coach for five or six sessions that are based around community reinforcement and family training. Our coaches have been trained on material covered in the book called A Guide for Families Beyond Addiction: How Science and Kindness Help People Change. There’s a parent 20-minute guide workbook. So, we blend our empathy, our experiences with our own child’s struggles, and we do this to help parents. This is really exactly what parents are looking for.

I really can't do justice in explaining all the cool science and research behind this, but it’s things that compassionate resources and clinicians are really getting excited about today, and parents are too. It’s based on community reinforcement and family training. It blends in cognitive behavioral therapy and motivational interviewing and acceptance and commitment therapy. What this really means to families, like I said earlier, we’re giving you all sorts of tools to let you become your own interventionist. To really encourage and motivate your child to want to get well. Thank you very much.

Melanie: Wow, and you put it so beautifully. Michael, first last word to you, what do you want the listeners to take away from this segment that you're on with Paul as the executive director of the center and to understand how important, as you say, medical communities don’t often partner with an addiction center such as this. So, it’s really early intervention and spotting these things even in the E.R. Wrap it up for us. What would you like us to take away from the importance of addiction in this county and recognizing it in our loved ones.

Michael: So, I think that there’s an overriding belief in this country, and in the state and the city that treatment doesn’t work and there is not effective help out there for either parents of a loved one or someone who’s affected themselves. I think what we really want to promote is that treatment is highly effective, and that recovery is indeed possible. Even if your loved one is affected by this that we can offer you help and hope for these issues. It’s really important that we create a sense of hopefulness. I think too often the media reports on all of the tragic consequences that are related to this epidemic. While that’s important, we also have to make sure that we instill in people that there is effective treatment and that there is hope out there on the other side of addiction.

Melanie: And Paul, last word to you as a parent. We have so appreciated your story, and it certainly is inspiring what you have had to go through and what you see on the other end. Give parents some of that same hope that you have now and tell them what you would like them to know if they have a child that suffers from addiction.

Paul: I would welcome them to reach out to us to try to stay engaged with their loved one and to move past stigma. Take that courageous first step to call our help line, to join some of the wonderful parent support groups that are out there or take advantage of individual counselling. I think that, and I hope that any parent or organization who hears this can agree, that the more we all collaborate and share resources, especially when they're evidence based, the sooner more lives can be saved and more families can heal.

Melanie: The helpline number is 844-319-5999, or you can text HOPE MA to 55753. That’s for the graykenaddictionsupport.org. So, you can learn more as well. Thank you, gentlemen, for being with us and sharing your stories and information today. It’s quite inspiring and really gives hope and information to those out there who love somebody who’s suffering from addiction. This is Boston Med Talks with Boston Medical Center. For more information, you can go to bmc.org. That’s bmc.org. This is Melanie Cole. Thanks so much for listening.