Part II:
Opioid addiction is a crisis across the nation. Indiana University is leading the way in the battle to fight the epidemic in the Hoosier state. Through its Grand Challenges Program, the university has committed to invest $50 million to collaborate with community partners across the state to prevent and reduce addictions.
The problem brings to light another developing need that needs IU’s attention. With addiction comes the need for addiction professionals. While opioid addiction is a pervasive problem, and the most common reason that people need intervention, addiction is a disease that affects everyone. Preparing a pool of professionals who are experts in treating addiction has become a priority of IU Northwest, which resides in a region that currently has scant resources.
This piece, the second of a two-part series, explores one man’s personal journey and a developing profession, as well as what IU Northwest is doing to address a great need in our Northwest Indiana communities and the state. (Read Part I: Opioid addiction: A Grand Challenge for Indiana, and, it’s universities).
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The journey to recovery for Rodrigo Garcia, a nurse anesthetist who once lost his job for abusing opioid pain relievers, was as difficult as it was enlightening. It involved a relapse, an epiphany, and eventually, a brand-new career.
At the height of his addiction, which started with an innocent prescription for post-surgical pain, Garcia found himself monitored by the state, and when he proved he could stay clean for a year, he went back to work. But monitoring without treatment, he soon learned, meant certain failure. With easy access to the medication, it didn’t take long for him to begin using again.
It wasn’t until the second go-round that things really changed. He went into a treatment program designed for professionals. Studies have shown such programs lead to a higher average rate of maintaining sobriety after treatment, and this was the key to Rodrigo’s recovery.
Turning darkness into light: Rodrigo’s renaissance
Together with his wife, Claudia, an IU Northwest-trained registered nurse, and David Cummins, an addiction physician educated at IU School of Medicine, Garcia opened Parkdale Center for Professionals in Chesterton in 2015. They began building a team with strong IU Northwest connections.
Their goal was to provide the two-pronged treatment approach that Garcia had lacked, and that they felt was lacking in the region overall. Monitoring was state-mandated and provided through the Indiana State Nurses Assistance Program (ISNAP), but treatment options were scant, as Garcia experienced, and also optional. Parkdale aims to address that problem.
Just this year, the state awarded Parkdale Treatment Centers the contract to take over the ISNAP program, since renamed the Indiana Professionals Recovery Program (IPRP). The agency currently monitors nurses and pharmacists and hopes to expand into other professions.
IU Northwest graduates protecting the public, sobriety
Garcia, Garcia and Cummins hired Terry Harman to be the renamed IPRP’s director. Previously, Harman had spent 15 years as an adjunct faculty member at IU Northwest and also ran a private counseling practice.
When Harman was considering the position, he insisted that the clinical case managers hired to work for him be among the best in the field. This fit with Parkdale’s intention to hire only master’s-prepared addictions professionals.
It turns out that the resumes before Harman were all from his former IU Northwest students, professionals he had personally supervised while they were satisfying their internships in the Master of Science in Clinical Counseling (MSCC) program — Brittany Sholtis, Abigail Rosa, Tracy Traut and Michael Barrera. Together with Harman, the team is responsible for holding clients accountable to their treatment, their sobriety, their patients and their careers.
“I had to have people I trust,” Harman said. “From the attorney general’s office, to the boards that govern the licenses of health professionals, there are a lot of eyes on what we do and who we serve. We serve nearly 400 professionals whose careers are on the line, along with the safety of those they treat.”
Based in Valparaiso, the IPRP is tasked with confidentially monitoring health professionals struggling with substance abuse. Either by voluntary admission, or reported by an authority, the clients are referred to treatment and then monitored daily for at least the next three years in order to keep their jobs and the public safe.
Preparing the region’s addiction professionals
As IPRP and its new staff work to hold health professionals accountable to their sobriety, the MSCC program continues to develop to meet the evolving needs of addiction professionals and their clients.
“IU Northwest’s students are practical scholars. They have practical skills and clinical knowledge along with a theoretical base. The instruction and internships combine all of that and by the time they graduate, they are ready to take the state exam for their entry-level license. That is unusual in many programs.” - Terry Harman
The credential they earn is that of Licensed Clinical Addictions Counselor (LCAC), for which the program can boast a 100 percent pass rate.
“They graduate with internships under their belts in places that are primarily doing drug and alcohol treatment,” Harman added. “This makes it easy for them to get jobs. In many cases, they are hired right from their internships.”
Department Chair and Associate Professor of Psychology Mary Ann Fischer says there are plans to expand the program to include a mental health component as those who struggle with addictions frequently have other mental health diagnoses. Adding education in mental health would round out the program and make the graduates more marketable, says Fischer.
Tough love, rare rewards
In the field of addiction, the rewards don’t come easy. An average day for the staff of IPRP is full of difficult moments, setbacks and small successes.
“The job is part investigator, part therapist, part gatekeeper, part probation counselor,” Traut said.
The IPRP is described as a “last line of defense” in both protecting the public from harm and protecting a client’s sobriety – a tall order that doesn’t happen without a lot of really tough questions and accountability, for which the case manager must ask and uphold.
One of the most difficult times, they say, is when they accompany the client to sit before the attorney general and the licensing officials to have the hard conversations about whether their recovery is considered successful, and if they can return to work or must stop working.
The rewards from the profession come largely from bigger-picture accomplishments, as opposed to individual client successes. These folks are working towards things like changing the social stigma of addiction.
This is what drew Sholtis to the profession.
“Substance abuse has a social stigma,” Sholtis said. “I wanted to be the person on the other side of that and work to change society’s views about what substance abuse really is. The face of addiction is not always someone you find weird and are afraid to talk to. They could be a nurse or a doctor — someone who looks like they have it together but they really don’t. Part of the reason I got in to this is because I want to change society’s view of what substance abuse really is.”
Traut pointed out that addiction touches every member of a family and community and recovery is really hard work. But, the disease doesn’t get the support afforded to other afflictions.
“If somebody says, ‘I was just diagnosed with diabetes but I’m having trouble not drinking 32-ounce sodas,’ people rally around you and say, ‘you can do it. We support you.’ It’s not that way with substance abuse. People back off,” Traut said. “I want to help bring others to the table when it comes to fighting addiction.”