 Hi everyone, I'm Ed Baker, and I am your host producer on the Addiction Recovery Channel. Welcome to the show. It's my great privilege today to welcome Dr. Kimberly Blake to our show. Thank you for being on the show, Dr. Thanks, Ed. Thanks for having me. Dr. Blake is a physician. She has been in Vermont since 1990. She came to Vermont in 1990 to complete her residency at the University of Vermont Medical Center. She has since enjoyed a very busy practice in OB-GYN. She's currently with affiliates in OB-GYN right here in Burlington. In addition to that, Dr. Blake recently has expanded her medical role in Vermont as a physician with Howard Safe Recovery. Howard Safe Recovery, for those of you who don't know, is a facility that specializes in harm reduction. Dr. Blake has become the physician there who prescribes medications for addiction treatment. I'd like you to just begin, if you would, with a little bit about your role at Howard Safe Recovery, Dr. Okay, sure. About a year ago, I started a halftime position at affiliates in OB-GYN. It's been planned for many years to have a break of being halftime for about a year and a half. And I found myself with a little bit of feeling a little bit at loss with all my free time. So I looked around for different things to do and it came up in the community that they were looking for a provider to provide buprenorphine treatment. The program at Howard Safe Recovery is a rapid access treatment program. So the people who decide on any given day if they decide they want to, instead of using a substance, they want to start treatment instead, it's aimed for people with opiate use disorder that they can start that same day. And I was very impressed. I mean, had a child who had addiction, the struggle of waiting, you just need to get treatment whenever the person feels that they're ready. And so I was really very pleased to partner with Howard Center, who has such a great reputation in our community for their ability to treat people and take good care of people. Yeah. I want to recognize that work and I want to thank you for that work and recognize how important it is to change around the structure of the way we deliver health care to people with opioid use disorder. It's not business as usual. Motivation comes and goes. We have to be there at that moment where a person is motivated. It's not like you can give a person an appointment card and say, OK, you have opioid use disorder. Your appointment for your first appointment is next Wednesday at 9 a.m. In between that point and next Wednesday at 9 a.m., literally anything could happen. It literally is a matter of life and death. So I want to thank you for your work and I know that that's not easy work. Now, I'd like to begin, I guess, with a little bit of your personal story. I know you have a personal story to tell and I'll just leave it at that if you'd like to go into that. Sure, sure. So my husband and I have two children, our oldest son, Sean. We found out had a substance use disorder when he was in high school. In his senior year, he started having some very erratic behaviors. We weren't sure what the situation was. We brought him to his pediatrician and she did a drug test. Turns out it was marijuana, which we were a little puzzled with. We didn't think that had that degree of mental health change, but it turns out it was the very high dose. Oils that you vape and it had some pretty profound behavioral changes in him. Sean was subsequently diagnosed with bipolar disorder. And we think that his youth precipitated an episode of mania that happened in his senior year in high school. So Sean went into treatment. He went into treatment locally. He did really well. He was able to start college, but then things went downhill again. He went back to treatment at UVMMC at the day one program and again did very well. And when he was not using substances, he was a very capable, he was a very intelligent young man. He was able to do amazing in his life. He was sober for almost a year when he entered the Navy. And so we felt like he had a good, you know, basis in sobriety. He was very involved in 12-step programs. He got through basic training and sub-school training. Really, he was doing very well. But then he started to have a little bit more free time. And during his free time, he was visiting a friend who lived in New York. And again, it just started just with smoking some pot. Didn't seem like anything too serious. But it quickly got out of control. Sean ended up in a psychiatric facility after a suicide attempt. And the Navy questioned their ability to have him stay, given his risk. But they also offered for him to help them find heroin dealers around the base if he would purchase drugs for them and try and find out who the dealers were. And for Sean with the substance use disorder, that went really pretty horribly wrong very quickly. I went down to visit him one time and I noticed that he was showing signs of withdrawal from narcotics. And I, at that point, I was shocked. I had no idea that things had escalated to that degree. So he was discharged from the Navy and we went and got him immediately into treatment. He went into a long-term treatment. Again, he did very well until he had a pretty rough relapse in 2013 or so. He was missing in New York City for several months. We just, we didn't think we'd see him again, to be honest. But he emerged, was treated and diagnosed with a bipolar disorder. Again, went into treatment. This time on some medication-assisted treatment. At that point in time, there was no availability in Vermont for him to go on methadone or continue the methadone he'd been started on in New York. So he went on Vivitrol, which is a different type of medication-assisted treatment. And that worked well for him. He also had a significant alcohol use disorder component to his disease. So the Vivitrol was a good prescription for him. And he flourished and did well again. He started to slip up with alcohol. And then for the next few years, really struggled with the bipolar disorder and alcohol primarily. As a family, we thought the opiate use was a thing of the past. We thought it was something that he had conquered and was never going to use again. Sure. Unfortunately, because of some of his alcohol-related activities, he ended up incarcerated. And it was shortly after release of incarceration that he used an opiate. We don't know if he even knew what he was using, but it turned out to be 100% fentanyl. And he died within instance. And he was brought back with Narcan and CPR. His brain did not recover and he became an organ donor two years ago. I want to thank you. I want to thank you for your courage in expressing that so fully and so completely for our audience. Kim, I'm terribly sorry that you experienced that and that he experienced that in your life. Unfortunately, tragically, this story is not only your story. There are tens of thousands of families in America that are experiencing this today. We know today that substance use disorder, opioid use disorder is a chronic brain disease needs treatment and recovery services over the lifespan. It sounds to me that Sean had not only substance use disorder, but also mental health issues. So he had basically three disorders from what you say, mental health issues, issues with alcoholism, and then issues with opioid. So this is a very complicated, a very complex young man. And I'm certain that you and your family did everything, everything in your power to help him. And it's tragic that you lost him. Do you think, I'd like to begin to talk a little bit about stigma. Do you think, I'd like to read a quote. This is from Facing Addiction in America. Facing Addiction in America is Vivek Murthy's Surgeon General's report of 2016. For the viewing audience, if you want to learn about addiction and you want to learn about treatment and you want to learn about brain disease and medications and recovery, read Facing Addiction in America by Vivek Murthy. This is a quote regarding stigma. Surgeon General Murthy says, Stigma has created an added burden of shame that has made people with substance use disorders less likely to come forward and seek help. It has also made it more challenging to marshal the necessary investments in prevention and treatment. He goes on, we must help everyone see that addiction is not a character flaw. It is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes and cancer. Now I would just ask you, did stigma play a role in Sean's illness? I think most definitely. I was explaining to Ed, sometimes I feel like a difficulty within the recovery community in stigmatizing people who are opiate users versus say someone with alcoholism. There's probably even a little bit less stigma for people with a mental health issue. I think for Sean, I think that he did have an opiate use disorder that he was ashamed of. I think that he did not seek treatment even though that was available to him. His primary care doctor was Dr. John Brooklyn who told him at any given point he was happy to prescribe Suboxone to it. He never took him up on that offer. He never made that appointment. He had even seen his psychiatric nurse practitioner just a week before he died. He didn't mention anything to her about potentially using opiates. Though looking back we think that he had been using them since he was released from incarceration. Dr. Murthy in his 2016 report Facing Addiction in America quotes a couple of very shocking statistics. One is that at that time there were 23 million people in America with substance use disorder. Of that 23 million people, 10% are receiving medical treatment. That's 90% or not. And a lot of that has to do with stigma. People with substance use disorder feel ashamed that they have substance use disorder. They hear people talking about them in disparaging terms. This is a weakness. This is a choice. This is criminal behavior. We need to begin to speak about substance use disorder as a disease. There's genetic predisposition towards substance use disorder. There's environmental predisposition towards substance use disorder. There's brain adaptations that occur with continued substance use. It's not a choice. It's a disease. The more the American public can accept that fact and begin to respond to people with substance use disorder, the same way as you would respond to a neighbor down the street that all of a sudden is stricken with cancer. Oh my God, so and so down the street has cancer. What can we do? Can we bring over some dinners that they can freeze to make their life a little bit easier? Can we mow their lawn? Can we express some sort of compassion? This is the way we need to respond to people with addiction. So they feel comfortable saying, I have addiction. Where do I get help? Now, I think one of the most beautiful things about people is that we have the capacity to turn tragedy into motivation and commitment. And I think you have done that. I would like you to talk now a little bit about your event that you're sponsoring in the end of August. So I kind of had ideas bouncing around my head last year around the time of Sean's anniversary of his death. We had a quiet just event with some friends and close family members at Battery Park and we watched the sunset. And that was something that Sean always loved to do. We had some of his favorite foods. And I heard kind of through the grapevine that there was no longer going to be an overdose awareness event in Manchester anymore, which made me sad and we don't have something really here at the end of August to commemorate people lost to overdose. So I wanted to have an event that commemorated people whose lives have been lost to either a mental health disorder or to a substance use disorder. I also wanted to have people who have successfully navigated a substance use disorder and or mental illness, give their recovery stories. For me as a parent, it wasn't until I heard speakers at AA meetings that we went to with my son when I felt the stigma that I carried changed. When I could hear people's success stories, so people who could go on and have an amazing life in recovery, that really turned things around for me to say that, yes, we need to invest in treatment for people. We need to get people the care that they need and that stigma was a barrier not just for the patient but also for family members. So I put together an event. I invited several of my favorite speakers that I've heard, as well as a very, very dear friend of mine who lost her daughter last year. Madeleine Lindsemeyer, Madeleine's mom, Maureen, who I've known for several years, is going to be present. Sharon Lamb, another close friend of mine who lost her son, has written a book about being a mom of a child with a substance use disorder and she's going to be there. She's going to be signing books. We're going to have some refreshments. At the end, after the speakers, we are going to have a tribute to people who've lost their lives. And that is really meaningful to me that we have it balanced in a way that people understand the magnitude of the loss, the number of people who are affected, as well as to hear the people who have navigated this and turned things around. It's inspiring. Now, what's the date, what's the time and what's the location? Sure. So it's August 24th. It's a Saturday. The speakers are from five to seven and then afterwards we'll have the tribute. There'll be light refreshments. It's at the Oakledge Park in Burlington. Oakledge is one of Sean's favorite places. There's a really, it's beautiful. There's a beach close by. There's a playground. We have rented the lower pavilion. So it's undercover if there's weather issues. Wonderful. Wonderful. Thank you so much. Yeah, I'm looking forward to it. And for the viewing audience within commutable distance, if you can possibly come, please come. I mean, this is a special event. This is a time to join together and face what's happening, both the tragic part of loss and also the very enthusiastic, hopeful part of commitment to change and moving forward. I think it's interesting that the event is at the end of August in commemoration of those who have gone by and also celebrating recovery. And then September, of course, is recovery month. So it kind of, it fits in beautifully. Now, do you want to talk a little bit also? I mean, you're involved in a lot. There's also your activity with mobilized recovery, which I think is incredibly exciting. Would you talk a little bit about that? Sure. So mobilized recovery is an effort, it's a combined effort between The Voices Project and Facebook. It's a Facebook community public health initiative. Several months ago, I filled out an online application through Facebook to attend a training. The training was paid for, the hotel, food, everything was covered. And it was a two-day event. And the purpose of mobilized recovery is to start a national recovery advocacy group. This group, the training, we learn things like better social media skills, how to talk to an audience. We learned about how to approach politicians, how to talk to a politician and find out exactly what they really feel about a subject, because they can sometimes be a little bit hard to read. And also how to build a community and part of the purpose of my event is to get a group of committed people that want to partner with advocacy, that want to impress upon our communities and our politicians the importance of need for treatment, that people are in dire need. And there are certain things in Burlington, particularly housing, which are really a huge struggle for people, especially early in recovery, trying to navigate. So there are lots of things that we can do. And I was beyond thrilled to be one of only 50 applicants. 50 applicants were chosen out of a thousand, and then they opened it up to another 50, so a total of 100 people from across the nation were... Wow, congratulations. Yeah, it was very impressive. And to meet people who are so much further along in their advocacy than I am was really empowering. Ryan Hampton and Garrett Haid, who are the co-founders of this mobilized recovery, are just an incredibly inspiring gentleman. So that is a plan for a recovery advocacy page through Facebook, which is going to start in September for Recovery Month. And we'll be more about that. All right, so we know about the Our Stories Matter and where to go. How about this? If the viewing audience, if there are people out there that are inspired by that and that are drawn to that, what can they do? In order to find out more about that. Sure. So at the event, I'll be collecting people's contact information, and I'm going to get an email list together. And once the Recovery Advocacy page rolls out, I will communicate that information with people. All right. There's also always ongoing information. My husband and I put together a website to commemorate our son. It's ForKindness.com. F-O-R or the number four? F-O-R dash kindness. And I always post updates on that page. That's a website. It's also on Instagram. ForKindness.com. Thank you. Well, I mean, if get your pencils in paper, ForKindness.com, Our Stories Matter and Mobilized Recovery. Exactly. You are certainly one active person, and I want to appreciate that fully. Thanks. For the viewing audience, I think one of the things that becomes clear here is that here in Vermont, we are very fortunate. You mentioned Dr. John Brooklyn. Dr. Brooklyn, for those of you who don't know, is one of the chief architects of a healthcare delivery model, specifically for people with opioid use disorder, that is the most successful probably in the world. And right here in Vermont, we are leading and rolling out that kind of treatment, making it available. I think in Chittenden County, we have no waiting list, which is really something. We have people like Dr. Blake. We have countless, thousands of people in personal recovery from alcoholism and in AA and NA. We have recovery centers that are, I think we have 12 recovery centers in Vermont. We are leading in our efforts to respond to a tragedy. This really is an all-hands-on-deck situation. We need everyone to participate in any way they can. Exactly. And I would like to mention something called positive messaging. During our talk today, we haven't used the term addict. We haven't used the term substance abuse. We haven't used the term drug abuser. These types of terms tend to perpetuate stigma. They elicit a punitive response. Some of the terms that we have used have been we call person-first language, which I think originated in the mental health movement. Person with schizophrenia rather than schizophrenic. That's carried over into the substance use community. We don't say addict any longer. We say person with addiction. We don't say substance abuser any longer. We say substance use or person with substance use disorder. I just want to emphasize to the viewing audience that mindful choice of language is something that everyone can do every day. And believe it or not, when we engage in this, we become softly spoken advocates. We begin to shape the environment by the way we speak. And you are an excellent example of that. Yeah, it was a process for me, but I feel that our language is important and how we speak about a person. We really need to recognize this as a person first. Yeah, we communicate so much in our language. So, I guess in closing, I want to reiterate my great respect for you, my gratitude, and my camaraderie. We're of one heart, so thank you for being on the show. Thank you. And did you mention that you're going to be at Our Stories Matter? No. One of our speakers. Thank you.