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The Effects of Addiction Stigma on Recovery

December 4th, 2020
A man thinking about the effects of addiction stigma on his recovery journey

In this episode, Zach is joined by Spencer Metcalf, the Lead Peer Recovery Coach of IU Health’s Virtual Behavioral Health Hub. He has been a Certified Addiction Peer Recovery Coach for 2.5 years and is in school pursuing a nursing degree with hopes of becoming a Nurse Practitioner. The two discuss his own recovery and how stigma affected him directly. Spencer also shares the effects of stigma that he has witnessed in those fighting to get sober.


Welcome to Recovery Radio by Landmark Recovery with your host Zach Crouch. In this program will discuss the root causes and treatments of alcohol and substance addiction, speak with experts in related fields and help navigate the road to recovery. Now here’s the host of Recovery Radio Zack Crouch.


Zach: Hi, I’m Zack Crouch. You’re listening to Landmark Recovery Radio, your source for addiction and recovery news and knowledge. You can find us online wherever you get your podcasts. Don’t forget to subscribe to get the most up to date information from leading experts. We have guest Spencer Metcalf joining us on the show today. Spencer There is the lead your recovery coach for IU Health’s virtual behavioral health hub. He was also named the Indiana Credentialing Association on Alcohol and Drug Addictions 2018’s Recovery Coach of the Year.


Spencer has been a certified addiction peer recovery coach for 2.5 years. Prior to his time in IU Health he worked for a small outpatient clinic in Indianapolis providing peer support services to individuals involved in the criminal justice system. Spencer’s been in long term recovery from substance use disorder, self-harm and eating disorder since April 25, 2017.


Since cheating is on recovery he has made it his goal to work with those of similar collections. Spencer is currently in school pursuing a degree in nursing with the goal of having a psychiatric nurse practitioner in hopes of further influencing change in healthcare regarding the stigma of those with substance use disorder. Spencer, that is very impressive resume. It’s a pleasure to have you on.


Spencer: Well thank you so much Zach. I appreciate the invite having me on.


Zach: Tell us a little bit about yourself. How did you get involved in the field of recovery?


Spencer: My name is Spencer Metcalf, a person in long term recovery. How did I get involved in the recovery field? Well, I have struggled with my own substance use disorder for probably of upwards of 10 years. As young as I can remember I’ve always wanted to be a therapist or work in some type of behavioral health field. About three, four years ago when I heard about peer support in recovery coaching it sounded like a perfect fit because I didn’t have to go to school for close to a decade to get license to do something potentially didn’t know if I actually wanted to do. Recovery coaching was a great entry point for me to take some classes and get certified and work with people and see if I like it. Then I continued down that path of working with others.


Zach: You said that you knew for about 10 years and this is a struggle for you. During that time, walk us through what was that like? I mean that’s a long time, a decade.

Spencer: My story starts off somewhat innocent enough. I grew up in an alcoholic home. My mom drank at an early age. I had that exposure and I remember being really young and being really scared of what watching what alcohol did to my mother and kind of how it changed her into a different person. For a really long time I was scared of drugs and alcohol. Then I got into high school and wanted to fit in and be in with the cool kids and all that fun jazz.


I got involved with some people who started smoking marijuana and drinking. I started partaking in that. I wasn’t a huge fan. Then about six months later I discovered prescription pain pills and I fell in love. I very distinctly remember the first time I took that prescription pain pill and the effects kicked in. From there it was a downward spiral. I did pain pills for a long time. By 19 I was an IV drug user, heroin drug user and had been to detox twice. It just kind of continued to spiral from there.


Zach: I was talking to a guy in recovery earlier today about this. I had a brother in law. If I didn’t lose him to the perils of addiction, he overdosed when he was 27. Can you talk to me a little bit about, he was an opiate guy. He used opioids. Can you talk to me a little bit more about your experience with that first time that you said you took a painkiller? Did you remember that it was able to sort of take you to another place where you were able to forget about life and maybe some of the trauma of seeing your mom use or just whatever? I mean kind of what was that like?


Spencer: The first my took a pain pill and it kicked in I think what most distinctly stands out in my mind is that I just felt whole. I felt like a complete person. I think prior to that I had always felt gone through just riddled with anxiety and always felt like I couldn’t fit in or be myself. I just remember that warm fuzzy feeling and just thinking I have a ride. Like I can do anything and I feel like there all the time.


That was my thought. I thought well what’s stopping me. I’m a 16 year old kid why not? I asked my friends shortly thereafter can we get more of these. How do we get more? That was the story of my life for 10 years like I said. I think just that sense of and it just felt like it filled a hole in my heart. I hear people talk about it and that really resonates with me.


Then of course numb some of the trauma and some of my other things. Most importantly for me in that moment it just made me feel like I could be who I felt like I was destined to be in that moment. I think that was really important especially being in high school and wanting to fit and being anxious and stuff like that.


Zach: Did it give you like a confidence maybe you never do you had?


Spencer: Yes. Things that normally I would care about or be concerned about it just didn’t seem to matter. All this stress of doing homework or having go to my part time jobs wasn’t that big a deal and I still did those things eventually they obviously lost priority. I just think like I said I was riddled with anxiety and stress and it just magically took all that away. Then I felt like I could be this gregarious bubbly person that I always wanted to be but was just too nervous or anxious to actually do it. The opioid really allowed for that to occur in that time in my life and through that my perception.


Zach: You did a great interview about stigma for the Indiana Recovery Council or you shared a bit about your story. How did the stigma of addiction impact you directly?


Spencer: It’s a bit of a loaded question because I can think of several different circumstances one of which I shared in that video which it was with the emergency room position but I think overall it kept me in a good place to shame. Even today we’re definitely making positive strides toward and shining more positive light on substance use disorder and also recovery but for a long time I didn’t want to tell people.


People would tell me Hey, I think you have an addiction. I knew deep down inside I did but for a very long time I would not ever verbally agree or even make the notion that I agreed with them just because it was such a horrible stigma and such a horrible perception that society have on folks with substance use disorder. For a while it prevented me from going to treatment.


Then I think once I started going to treatment it kind of became that revolving door of going to treatment a lot. Then it was like oh, Spencer is going to rehab again. People would roll their eyes. I think there’s some big may even involve with that as well.


Zach: It’s interesting you bring up that concept of a revolving door. You’ve been in the field for a while now. What works? I mean because there’s so many success stories and in a lot of respects a lot of unsuccessful stories. What have you found works in your experience in working in this field?


Spencer: I think kind of for me what I share with the folks that I work with is not only do I need, I call it getting the junk out of my system, getting detox, getting the opioids or alcohol or whatever it is out of, physically out of my system but ultimately I recognized that it is a problem in my thinking. I think that if I take a pain pill or do a shot of heroin it is going to fix all my problems.


Not only do I need to detox but I’m a firm believer in residential treatment or intensive IOP where I can get in there with a therapist and maybe even a small group of folks and really figure out what makes Spencer tick and what makes Spencer think the way he does and think that alcohol or drugs going to fix these problems. Then how do we fix that or change that perspective on where I can have enough insight to really understand that it’s not going to fix anything.


For the first 30 seconds absolutely I will feel great but I actually just saw a quote on Facebook this morning that I really like. I could take a drink or drug today to solve my problem but I have plans for Christmas. If I take a drink or drug today I’m not going to make it to Christmas. I might not even be alive much less make it to those plans. I think that’s true for a lot of individuals.


Zach: You mentioned something really important that the shame that you felt when you’re in the yard sort of that feeling. In trauma, I mean listen I grew up in a house where there was a lot of craziness going on. Then I did a little more digging when I went and found out my dad’s history on things. His mom was passed out by the time he got home at five. His siblings got home every day at 3:00. They just kind of fended for themselves.


They learned a lot in that time about what life needs and who can be dependable and counted on. He found out pretty quickly that his caregiver is worst. Tell me in your experience how shame and trauma go together in fueling people’s ongoing addictions?


Spencer: I think in my perspective with working with folks I often think and believe that trauma is kind of the initial, it’s kind of the starting point. That trauma occurs and then myself and others I worked with have shame from that trauma because we internalize it. We don’t want to talk about it. Oftentimes it’s stuff as a society we brush under the rug and don’t talk about it with friends or family.


I think that further perpetuates it. Then you add drugs and alcohol in the mix and sometimes you can get into traumatic situations depending on groups you are running with and things like that and just the shame of using and the stigma in that. It becomes the perfect storm and kind of this perfect hurricane if you will of just chaos. Shame and trauma and substance and several other things get thrown in the mix.


I think it really just like I said creates a lot of chaos. It takes something really kind of I don’t know what the word I’m looking for is but it’s something I guess really kind of pivotal or really I don’t again, I don’t know what the word is that just something really kind of shake that foundation and kind of wake folks up like whoa, this isn’t working. What can I do to address it or change it? I think that’s kind of when the cycle can first be addressed.


Zach: I appreciate that. I’m curious to hear from you too because you do a lot of recovery coaching. Are the things that we’re not doing now that we can do or maybe even brought up to engage those people more effectively. I’m talking about the ones especially your opioid folks where there’s a lot of IV drug use going on. They’re just so riddled with shame and the stigma that you brought up that they don’t even ask for help. What can we do differently you think to engage that population?


Spencer: I always think with the disease that’s really kind of centered around shame and trauma like you had mentioned I would think it’s really ironic that we expect folks with shame and trauma to reach out to us for help. I think that there has to be some buy in and some initiative on their part. I think we can do a lot more on in the way of outreach. I really love the idea of a mobile syringe exchange van. We’re meeting people where they’re at in their active use. We’re showing them love and compassion. We’re making sure they’re not transmitting STI then using safely.


A lot of good studies have shown that folks that engage in those types of services versus love and compassion, we’re not here to judge you end up engaging in some type of continued treatment or long term care. Very much so I believe in that harm reduction model because it makes a lot of sense. We’re kind of going out to them. They’re taking one step forward in meeting us and developing g that rapport versus just kind of expecting we open a treatment center and expecting people to show up.


They do. Of course they do and I think as far as further outreach and engagement definitely kind of meeting people on their own terms, in their own neighborhood would prove effective as well.


Zach: What would you say to people who are really kind of not aware of the negative impacts that this stigma has?


Spencer: What would I say to the folks that are not aware of the negative impacts?


Zach: To educate them or engage or whatever, whatever it looks like. I’m thinking of the folks that, I mean I grew up in a family just like this that said you just need to pull yourself up. Come on man, get on with it and stop using, whatever it was but there I was. I had a pretty major injury and got addicted. It wasn’t something that I could plan. It just kind of grabbed me. There my family was just perplexed about like what the hell is wrong with this kid.


Spencer: Oftentimes I think what comes to mind is we wouldn’t tell anybody else with any other type of disorder or mental diagnoses to pull themselves up by their bootstraps and just get better and get over it. I think because the substance use disorder manifests itself in drug use and criminal behavior and things like that. It can be very much perceived oh, just quit doing drugs and just quit doing that but it very much is a medical diagnosis mental health disorder. We would just tell someone with depression just get out of the house and be happy.


They go see a psychiatrist. They go to therapy. That’s also my question with working with medical professionals. I understand too that I’ve been essentially embedded in some form of substance use disorder and it’s chaos and or recovery for the majority of my life. I have a lot of experience with it and cannot necessarily see the trees from the forest. Someone coming from the outside I can totally understand and appreciate how they would have that perspective.


I always like to post it back to them like that. Would you say that to someone with diabetes or heart failure or anything like that? Of course there’s behavior modification needed but it’s so much deeper than that.


Zach: I think the love and compassion piece that you spoke to just makes a ton of sense. Like the whole bit about meeting people where they are. I’m thinking about the young folks 12, 13, 14, 15 year olds maybe even today and pick up their substance for the first time and feel like they arrived. I’m also thinking about parents who deeply love these kids but don’t know how to meet them where they are.


I think that there’s a tremendous amount of work that families can do together to create an atmosphere at home that allows for conversation, for openness and I think that I asked that question earlier what else can we do. I think that the families could benefit a lot from ongoing support and education.


Spencer: Oh absolutely. I totally agree.


Zach: Well Spencer it’s been a pleasure having you on the show. I really appreciate you coming on today. It’s just great to hear about this. Kudos to you, 2018 Recovery Coach of the Year. That’s amazing.


Spencer: Yes sir. Thank you. Thank you so much.


Zach: If you know someone struggling and they have an addiction or they are searching for answers. Maybe you are too. Visit us at LandmarkRecovery.com to learn more about substance abuse programs that are about saving lives and empowering families. Until next week I’m Zach Crouch with Recovery Radio wishing you well.


Thank you for tuning in to Recovery Radio. New content for this program is available every Tuesday at 12 noon eastern time and 9:00 AM Pacific time with all episodes available on demand on the Voice America Health and Wellness Channel and through our content partners iTunes, Stitcher, Tune In and Google Play Podcasts. Please remember to subscribe, rate and review so we can continue to create quality content to help save one million lives in the next 100 years. You don’t need to struggle through addiction alone. Live the life you’ve dreamed on the road to recovery.

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Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.

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