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[00:00:00] Angela Kennecke: This is Grieving Out Loud I'm your host, Angela Kennecke, and today we have a special guest, Dr. Hannah Statz DeVries is a psychiatrist specializing in addiction care. She's also a valued member of our Emily's Hope Board of Directors, and today she's sharing all of her knowledge about substance use disorder with us.

[00:00:24] Dr. Hannah Statz DeVries: it's just challenging because there's so much stigma around it. There's so much choice that people find ingrained into it, like family members saying, this is a decision. Why can't you stop? You just had 28 days of treatment. What was it even worth? And that's so hard when patients don't have that support because it takes more than 28 days for that healing to happen.

[00:00:46] Angela Kennecke: Not only will Dr. Statz DeVries deree share eye-opening issues she encounters in her practice, but she'll also shed light on essential topics that family members of those battling substance use disorder should be aware of. But that's not all. We'll discuss some of the most controversial topics surrounding our nation's drug epidemic and addiction.

[00:01:08] Dr. Hannah Statz DeVries: I won't get started with the legalization also of marijuana, but I have my 

[00:01:12] Angela Kennecke: concerns. You have your concerns about marijuana. So the debate is out there. Is marijuana addictive? 

[00:01:17] Dr. Hannah Statz DeVries: Ah uh, well, we have a cannabis use disorder that we have well documented. So, you know, and there's also intoxication and withdrawal syndrome. So my answer is, yeah. 

[00:01:26] Angela Kennecke: Get ready for a thought provoking conversation. Everyone should hear, especially as our country faces, its deadliest drug epidemic in its history.

Hannah, welcome to Grieving Out Loud. I'm so appreciative 

[00:01:43] Dr. Hannah Statz DeVries: that you're here. Thank you. Thank you for having me. And I'm also 

[00:01:46] Angela Kennecke: super excited that you joined the Emily's Hope 

[00:01:47] Dr. Hannah Statz DeVries: board. Yeah, oh my gosh, absolutely. It's an honor. Yeah. 

[00:01:50] Angela Kennecke: We are so excited to have you. You have such a great background in addiction medicine, and I wanna just dig right into that and talk about. Your background, why you decided to go into this field of medicine and what you're learning along the way. You're relatively new in the field, right? 

[00:02:04] Dr. Hannah Statz DeVries: Yes, I am. I did my psychiatry residency in Chicago and followed that with a fellowship there for addiction, psychiatry through Northwestern Memorial Hospital. And through mentorship that just kind of seemed to be what fit in. My residency training, for some reason, I gravitated toward patients who were suffering from addiction and I think I can. Probably trace that back to college, maybe even high school, honestly from like a nutrition and obesity standpoint actually, and kind of the compulsory behaviors people will have with obesity.

Talking about like food addiction, like food addiction and Nora Volkow, actually the director of NIDA talks about that too. And so yeah, I found it there and I just, I gravitated toward these patients and learned a lot. And um, maybe selfishly feel it's very rewarding when you see people succeed and when you feel like, you've done something and, and can help and you see them in sobriety and, and just really doing so well.

[00:03:04] Angela Kennecke: I would think though, it's also a difficult field to be in because first of all, there's so much stigma around addiction and so much misunderstanding about what it really is, what causes it. 

[00:03:15] Dr. Hannah Statz DeVries: Absolutely. I will say that my husband says this like addiction, like you chose addiction. This is so hard.

And you know, he works in the ER and also a doctor, your husband, also a physician, and he sees addiction at, you know, when people are at their worst withdrawing from. Anything and maybe not wanting help at that point. And, he'll ask me, how do you do this day in and day out?

And I think largely where I'm at, you know, in an outpatient setting, also residential, so a little bit more acute there. I'm seeing people when they say, Hey, I need help and. It's time and sometimes it's family, finally feeling like they were able to effectively reach that person.

You know, when you struggle so much because we see it, right? We can see it from the outside, but when that person isn't ready for it, you just, it's hard to reach them. 

[00:04:05] Angela Kennecke: So you're saying the area of addiction you're working in, you're working with the patients once they decide they do need help. Which I mean before that it can be just so grueling and such an awful experience for everyone involved, the family, friends, the patient themselves, 

[00:04:20] Dr. Hannah Statz DeVries: excruciating.

And I think the difficult part about that, and that's, that's the crux of treating addictions, you know, you look at interviewing is a cornerstone for treating patients. And as soon as I find myself. Telling a patient what they should be doing, gosh, they shut down. Whether it's they leave, you know, against medical advice, they don't come back for an appointment or you know, I hear it from family or, or others.

And so I think finding from within, where that person's at and, um, meeting them where they're at, and kind of really trying to target. What are your goals? What are your values? And, and how can I help you reach those? Um, And that, that change has to come from within And, and it, it's hard, 

[00:05:04] Angela Kennecke: you know, I did an early podcast in season one with Dr. Matt Stanley, who's a colleague of yours. Yeah. And we talked about how addiction is a disease of the brain. Mm-hmm. And I think that there's just so much misconception about that. Still to this day, the public generally doesn't believe it's a disease. They think it's either a character problem or a matter of willpower.

Can you explain it in a way that people can understand how substances take over the brain? 

[00:05:29] Dr. Hannah Statz DeVries: I can. 

With addiction. Our brain is an organ just like any other organ, and when we start drinking, consuming drugs, using whatever it might be that has a habit forming potential, what happens is what the progression is. It's a bio psychosocial. Pattern or the route that that takes. First and foremost, the drugs or alcohol start to take over your brain, your central nervous system.

Everything else kind of still seems to be going okay. Psychiatrically, mentally, you know, depression hasn't really started to show or manifest and anxiety even insomnia. You're doing okay, well then that psychiatric kind of side of things. You're not sleeping as well or you're maybe feeling anxious cuz you're going in and out of intoxication and withdrawal.

And that drug, that pathway deep in the limbic system really of your brain is starting to take over. Last but not least, friends and family say, Hey Joe or whoever it may be. What's wrong? Like something's wrong. You're not showing up for work. You know, and that's the social piece. So the bio psychosocial, well, the problem or what people don't see with this disease model is, Recovery occurs in the opposite direction, where socially people start to look better.

So people come to my 28 day residential treatment center and you know, I'll say, Hey, you've been here for a couple weeks. You look great, you look awesome. You must feel great too. And patients will look at me like, am I supposed to say yes? And really the answer is no. It can take weeks. I mean, months, years really before someone's back functioning.

Where they were before everything happened years, years, years. And that's, something that we call post-acute or protracted withdrawal. So socially people start to look better. Then kind of comes next, is the psychiatric kind of side of things? Anxiety, maybe depression starts to lift, sleep starts to normalize again.

But then there's your brain. That's the biological side of things where the drugs or the alcohol have so deeply ingrained themselves into your really, your biology that it takes time to heal. 

[00:07:32] Angela Kennecke: I've heard it takes up to 24 months for the brain to heal from drugs like meth or heroin or opioids.

Mm-hmm. And. We only treat people for 30 days. I often say that's dictated by insurance companies. But where did that model come from? and would it be too cost prohibitive to really treat people for like a year and a half to two years? 

[00:07:52] Dr. Hannah Statz DeVries: Gosh, really good questions. I'm not sure. What I can say from my experience is when patients are coming in and say it's a 28 day stay, I'll even get pushback from insurance companies at like two or three weeks sometimes and saying, Hey, I. Does this person really need to be there? And I will think, my goodness, where is this coming from? And you know, maybe it's that they had a good day and it was documented. But again, from my experience, I would think that probably having more intensive treatment might be cost prohibitive. Just, given that experience. 

But the relapse prevention piece, that's, where I think the focus really could, well we focus on it, but can continue to, be robust. And I talk to patients about that piece, like, when you leave here, you're gonna go back into a world that's not protected, , you know, you don't have these supports, these, you know, this, you're waking up and doing a mindfulness or meditation and yoga in the evenings alongside like your peers that are all in recovery.

You're gonna go back to reality at some point. And how are you going to. Work with those triggers because, you know, we say people, places, things, and even just being around those people places, things release, just that tiny bit of dopamine that will put someone back into the place and that can be the trigger 

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[00:09:07] Angela Kennecke:  In fact, research shows that between 40 to 60% of people with substance use disorder experience a relapse at some point. The situation is particularly alarming when it involves alcohol and opioids. Studies indicate that up to 80% of people battling alcohol addiction may experience a relapse. That number rises to 80 to 95% for those struggling with opioids within the first year after treatment. 

We've interviewed dozens of people who have relapsed here on grieving out loud, including one man Ed Krumpotich, who was in and out of treatment nearly 50 times.

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[00:09:49] Angela Kennecke: So how do you explain relapse? 

[00:09:50] Edward Krumpotich: Relapse is, it's as simple as this. I'm gonna use diabetes as an example, right? So diabetes is actually really simple. Diabetes is addiction. That's all diabetes is, right? It's a dopaminergic craving and then an attachment to sugar or a A or disposition that gives somebody that right?

Relapse is rather simple. Can you expect a diabetic's blood sugar to stay at around 90 to 120 for the rest of their life? It's naturally cyclical. The difference is, is that the organ that is affected is the pancreas. So the pancreas goes like this, the blood sugar goes up and down and up and down. Let's take addiction.

Addictions disease lives in the brain, so picture that pancreas now is a brain. When your waves go like this, that's like not asking somebody who's eating every day to not have a blood sugar change. The chances of somebody staying sober with that amount of change in a brain. It's in minuscule. So relapse is just decoding those attachments as they come up and they go down.

They come up and they go down. Because when the brain is the diseased organ, it is one of the hardest to detach. 

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[00:10:57] Angela Kennecke: Relapse is not only difficult for those who suffer substance use disorder, but also their friends, family members, even their doctors.

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[00:11:16] Angela Kennecke: that ever frustrate you? The fact that people relapse so frequently and often, multiple times? I

[00:11:22] Dr. Hannah Statz DeVries: think it would be abnormal if it didn't frustrate me. I still will talk with patients that relapsing or even just having a lapse that's part of the illness. I kind of will differentiate this as probably a, a, Hannah ism that It's not part of recovery, it's part of the illness or the disease. 

Recovery is that we're working really hard. You're looking at, are you meeting with your therapist? Are we stepping you down from a 28 day residential to a three times per week meeting, plus the AA meetings, strong family psychosocial support meetings with me, ongoing medication management. It's a combination of it all. 

[00:11:58] Angela Kennecke: I think one thing you could explain from a physician's perspective is we now know about the danger of fentanyl in every illicit drug out there. Yet people continue to do illicit drugs and some people even seek fentanyl. Now how often are you hearing about something like that? Daily. 

[00:12:15] Dr. Hannah Statz DeVries: Daily, yeah. 

[00:12:16] Angela Kennecke: Can you explain it like, you know, something has a chance to kill you and pretty good chance. Can you explain how the brain is working or what is happening with that person?

[00:12:24] Dr. Hannah Statz DeVries: So what I've seen people not even seeking fentanyl. There's fentanyl that's getting laced into just, you know, drugs, whether it be cannabis and others. And, you know, I've seen this even in some of the recent articles that you've written that we know that this is a problem. What the dealers and people who are on the supply side of this know is if they can get someone hooked, then that person is gonna come back for more and they're gonna want it from that dealer.

So sometimes it's an inadvertent, Hey, you know, I, I started using and now this is what I need. And hey, it's actually fentanyl at this point, and that dopamine released that trigger and that disease pathway, it just takes over and it becomes, That's what people want and that's the disease clouding their judgment because the pleasure limbic center in the middle part of their brain has.

Fully taken over that decision making, that judgment, the frontal part of your brain, 

[00:13:16] Angela Kennecke: that's hard for people who don't suffer from substance use disorder to understand it is, it's, it's so 

[00:13:20] Dr. Hannah Statz DeVries: hard to understand and that's that recovery that can take up to two years to really be back to a, a good baseline in mental.

[00:13:27] Angela Kennecke: Have you lost patients to Fentanyl? 

[00:13:29] Dr. Hannah Statz DeVries: I'm sure I have. I don't always, hear about that cuz they don't come back to my clinic. That's right. So I wouldn't be surprised if that has happened. 

[00:13:38] Angela Kennecke: What has been maybe the most rewarding thing? Do you have any patients that have really touched your heart or you've seen such a big difference in working in this field?

[00:13:48] Dr. Hannah Statz DeVries: Yeah, So many come to mind that don't even know where to start from younger to older. I mean patients that have over 10 years of sobriety. And also even in that, I'll say, Hey, don't lose sight of what you've done. With use, if you were to go back, it'll be just like yesterday that you last used. If you go back to this because your, memory is so closely tied with, the addiction from the past.

But yeah, from younger to older patients and, you know, some still in Chicago that I'll occasionally kind of wonder about and. I hope they're doing well. 

[00:14:20] Angela Kennecke: What did they teach you that you needed to learn 

[00:14:22] Dr. Hannah Statz DeVries: I'm a physician and I will tell patients how to get well, what to do. We wanna fix people. That's what physicians do. And I think I learned that the more I tell. The more I kind of say, this is what we have to do in X, Y, or Z. Or if I do that too much, it doesn't work and I have failed. You know, in that sense, whether it be that a patient doesn't show back up and I wonder what did I do? Was it me? I. Or maybe it was the disease, and I'll, I won't know. 

What I think I've learned is patience, compassion, self-compassion, grace that it's not just my medications. My medications are powerful and they can and should be used, and I will emphasize that till I'm blue in the face with my patients. And at the same time we have to focus on therapy too. Maybe it's 50 50. Maybe it's 70 30, maybe it's even 80 20 in terms of percentage for therapy and for medications. But what I do know is it's a combination of both and that's that relapse prevention. When someone's leaving treatment, what are they doing to continue to engage in sobriety and recovery? 

[00:15:30] Angela Kennecke: Let's talk about medically assisted treatment, because we know there isn't enough of it and it's not for enough addictions. Right? So you have Suboxone for opioid addiction And you utilize that?

Yes. Can you talk a little bit about that? 

[00:15:42] Dr. Hannah Statz DeVries: Yeah. I think Suboxone is a great treatment. I have a lot of patients that are on it, and I did a lot of this also in Chicago. Patients have to be ready for it. There's challenges with prescribing it. And challenges in managing it and a lot of education is kind of one of the things that I will kind of go back to with patients, with colleagues to try to kind of get this out there.

And by far, at large, I'll oftentimes find myself having to explain to patients Suboxone is an opioid, and, I'll bring this up to a patient and say, Hey, what about suboxone? Every so often I'll get a, I don't want that one. And I'll say, okay, let's take a step back. Why that reaction? What's your concern with the Suboxone?

And oftentimes it's. Well, I've tried it before. I had that, and gosh, it made me sick, or it didn't work, it did nothing for me. And oftentimes what happens in that case is someone has gotten it from a friend, they've taken it incorrectly, they've precipitated their own withdrawal, and it's very uncomfortable when that happens.

And so I'll go back to step one and say, this is an opioid. When you're ready. Let's do it. I don't want you to whiten knuckle this on your own. That's not fair to you. And so I do a lot and a lot in a lot of education. I put it in their hands. I say, when you're ready, you let me know. And I have had people come back and say, Hey, I think I'm ready.

It happened yesterday. Someone wanted to stop it. They were just on a very low dose. They stopped it and then they said, I don't feel good. I, I don't think I'm ready. I was like, I'm glad you came to that. 

[00:17:16] Angela Kennecke: Can you explain how Suboxone works? 

[00:17:18] Dr. Hannah Statz DeVries: Yeah. Suboxone's a partial opioid agonist. So we're looking at full agonist opioids.

That's things like Norco, the hydrocodone, morphine, fentanyl. Those at 100% will stimulate your opioid receptor. So where I'm thinking, the kind of analogy I'll use is a pedal to the metal, you know, in a car and Suboxone or buprenorphine is a partial opioid agonist. So it's an agonist working at your opioid receptor, but it's more like instead of at a hundred miles per hour, you're like 70 or 80 miles per hour.

So you're stimulating that receptor so that you're not going into withdrawal from an opioid withdrawal management. And it, where it can get you into trouble is if you have a full agonist on board and I give you Suboxone, it's gonna knock that full agonist off because it binds so strongly at the receptor and it's gonna put you into some withdrawal cause it puts you from a hundred.

To 70 or 80. 

[00:18:11] Angela Kennecke: Does it give you a high? 

[00:18:14] Dr. Hannah Statz DeVries: There are ways to misuse abuse medications. 

[00:18:16] Angela Kennecke: So only by misusing or abusing it. 

[00:18:18] Dr. Hannah Statz DeVries: Right. So done under the prescription, you're good. 

[00:18:21] Angela Kennecke: So what about the argument of treating drug addiction with another drug? I mean, that's one of the things that you've been hearing over and over again since this medication came out. 

[00:18:30] Dr. Hannah Statz DeVries: It's a treatment that we have. We see people succeed. I see people that get jobs, they get their life back. They go on to be able to do the things that they once loved. Uh, Yeah. It's what are you replacing? You're replacing an opioid and some people can't get past t hat kind of picture of, gosh, I'm just replacing one with the other.

And where I kind of try to counsel patients is, is, hey, we're providing you something that we know what it is. We're helping you, we're getting you through treatment, we're getting you to some sobriety. And in the future, should you wanna try to taper off of this? We can give it a try. I just ask that you're honest with me.

If you're struggling with it. 

[00:19:05] Angela Kennecke: How many people need to be on it like forever? Can you be on it forever? 

[00:19:09] Dr. Hannah Statz DeVries: You know, you can. I've been in practice for less than a year, so I haven't had, as, you know, robust Yeah. An experience with it. Yeah. Uh, what I will say is I have seen people come off it and relapse.

You're a sobriety and they're like, Hey, I wanna stop. I'll say, if you're writing, you wanna do this, just. Please work with me, talk with me, let me know how this goes. And then I've had patients stop it that actually did it on their own, kept continuing to see me and they said, Hey, I'm down to a milligram. I'm like, wait, what? And they just didn't wanna be on it cuz they saw it as a crutch. And so, , close follow up and you know, making sure they've got those other supports can be helpful too. 

[00:19:44] Angela Kennecke: You know, we don't see drugs or diabetes or heart disease In this way. We don't tell people with diabetes or heart disease to off their medication or stop taking it because they shouldn't be doing that.

 You know, is this the same thing? If this is the disease of the brain, And you have Suboxone to treat it, isn't it the same thing as having a drug for diabetes or a drug for heart disease or any other medical condition?

[00:20:06] Dr. Hannah Statz DeVries: I use that example all the time. And I think patients are used to hearing it or not all the time, but sometimes used to hearing that where, hey, if you had diabetes, I would not withhold your insulin from you. , that's against any physician's practice, you know, first, Do no harm.

So it's just challenging because there's so much stigma around it. There's so much choice that people find ingrained into it, like family members saying, this is a decision. Why can't you stop? You just had 28 days of treatment. What was it even worth? And that's so hard when patients don't have that support because it takes more than 28 days for that healing to happen.

Just like when you break an arm, it takes more than a few weeks. Gosh, what was the break? Was it a simple fracture? Was it a compound fracture? It could take months. Your brains no different. Your brain's a much more powerful organ. it takes time. 

[00:20:53] Angela Kennecke: Well, we always think it's about our thoughts or our will.

[00:20:56] Dr. Hannah Statz DeVries: Right. It just comes back to that. Cuz I think it's just a natural human, old fashioned way of Yeah, I think so. . 

[00:21:02] Angela Kennecke: Dated, yeah. Way of thinking of things. So also with Suboxone, Congress recently made it possible for more providers to prescribe it to their patients. I don't know how many medical doctors are stepping up to prescribe it.

There's still some stigma around medical doctors. 

[00:21:18] Dr. Hannah Statz DeVries: Right. And when providers aren't used to seeing, patients with addictions day in and day out, there's some discomfort there. 

[00:21:25] Angela Kennecke: But should there be? 

[00:21:27] Dr. Hannah Statz DeVries: No, is my answer to that.

[00:21:28] Angela Kennecke: Why is there discomfort there? 

[00:21:29] Dr. Hannah Statz DeVries: You know, it's controlled. Right? And we've got this big opioid epidemic that our country is trying, dearly to recover from. And I think It's a scary thing. If you're not familiar with it, it's, it's probably the best perception I could have.

Maybe trying to look from the outside in. I will tell you, when I have conversations with physicians, I'll say, prescribe this. This is helpful. It's not harmful. If anything, you're saving their life because when they go back out and use whatever it is they're using, that will kill them. 

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[00:21:58] Angela Kennecke: Until recently, doctors who wanted to prescribe buprenorphine and opioid medication used to treat opioid use disorder, had to complete an eight to 24 hour training and keep special records. The Drug Enforcement Administration also assigned those clinicians a registration number starting with an X, which many doctors claim, which many doctors claim made them a target for drug enforcement audits.

But thanks to new legislation, any doctor can now prescribe buprenorphine as long as they have a DEA number. Still Dr. Statz DeVries says there's a lot more work that needs to be done to help doctors better understand substance use disorder.

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[00:22:49] Dr. Hannah Statz DeVries: I think there's so many directions we can come from. Training education even from a trainee standpoint. You know, years and years back we've got a lot of, you know, even older physicians that didn't get very robust training really at all.

You know, they're learning this in practice. things that, you know, I'm personally trying to implement is you know, this next academic year, internal medicine residents are gonna be rotating with me. so that I can teach them, Hey, Suboxone, this is how we do it.

 And this is why we do it. And I, think starting small steps like that can be helpful. More physicians trained in addictions more fellowships, you know, things like that. That's an ideal world. Right? I say if I could redo my year in training, it might sound crazy. I would, but it was just the best.

[00:23:32] Angela Kennecke: I wish also we had more screening for patients at every touchpoint among medical systems for addiction or for drug use? For substance use? I think that just like we screen for abuse now, I think most health systems do that kind of thing. I know. There's one more thing you have to screen for and one more thing, the nurse might have to do when the patient comes in. But even in my daughter's case, you know, we knew something was wrong with her and I took her to counselor after counselor and then, and she was picking at her face. She was picking at her face. So she told me it was anxiety. 

And I thought it was more than anxiety, right? I said, okay, well let's go to a dermatologist. , let's go figure this out. And I took her a dermatologist. The dermatologist never once asked if she was use, never sent me. She could have sent me out of the room. I mean, she was an adult at this point, could have sent me out of the room, never once asked a question if she was using substances, prescribed a cream, and an anti-anxiety medication.

And so I think that tells me either that doctor had no clue. I mean, I always think of meth when I think of people and their skin. My daughter wasn't using meth, but I later learned that when people are coming down off of heroin, they pick at their face and I didn't know that.

You know, that was something, in all my research and everything I can research as a journalist, I didn't know that, and wish I would've known it, but I wish the doctor would've asked those questions and I think about when my daughter went into like acute care type, you know, just a CL open clinic when needed something where she had a headache and she was basically shamed by a nurse and a doctor and was sent home and told, oh, you just have to deal with your headaches. You know, obviously they probably could tell that she was using drugs, but they didn't do anything to help her. And that really concerns me, that, that I know that happens to more people than just my daughter. 

[00:25:13] Dr. Hannah Statz DeVries: Well, and what a disservice. You know, you think in your mind like, here is suffering. I'm, I'm showing you suffering. Yes. What is it? Help means addiction is suffering. Yeah. And as an addiction practitioner, when I see someone itching or picking or this or that, I think, hey, I need to get a urine drug screen. But I'm trained to do that. I did it day in and day out, you know, through not only my psychiatric residency, but I do it, in my, addiction practice.

And it's hard because you're looking at someone and saying, Hey, I'm gonna call you out and say, Hey, I'm concerned about drugs, and are you gonna offend that person? But really, you're helping that person. And so where I address that with patients is I'll say, Hey, part of my practice is we're gonna do urine drug screens and we're gonna do breathalyzers, and it's gonna be random.

And I want you to see that as accountability and support. So if physicians say in the dermatology or other settings can say, Hey. This is what we do. You know, when we see these concerns for accountability and support, I'm not saying that this is what you're doing, and this is just one thought, one idea that could be done to maybe address that, to then start that conversation.

Cuz are given a questionnaire. You just write no down the lines. You know how it goes, right? 

[00:26:19] Angela Kennecke: People won't always be honest. That's true. But I often thought just the fact that my daughter was willing to go to the doctor and she hated how her face was looking. You know, what she was picking at. She hated that. And that might have been the point where if someone would've addressed it outright and confronted her with it, maybe she would've admitted it and gotten help. Yes. I don't know. You don't know. But instead it was just like, here's a cream, here's another anti. Mm-hmm. And she'd gone to a psychiatrist before that who prescribed Klonopin.

So, there was just kind of a messy path. Yeah. There wasn't any clear direction. And I, I hear from so many parents. And other people who have a loved one suffering from substance use disorder and they don't know what to do. And that's the hard thing is I don't know what to tell them to do because I tried to do all the things I could for my daughter and reached out to so many different people in the medical profession and none of it helped. So it's, it's a tough thing to tell a loved one. What can you do? 

[00:27:12] Dr. Hannah Statz DeVries: I find families are incredibly important. When I see my patients in, in the outpatient setting, even in the, in the residential center, have them sign releases of information. I request, Hey, I have to talk to your family and your loved ones, cuz if I don't get them involved, we're gonna be back at square one. Potentially when you go, and I know you wanna do this on your own, and I, I know you feel you got this, I just want. People to be there for you and, and I want to be able to kind of incorporate other people within in your support system 

the issue when we're identifying it and how do we do it. I mean, if we're not. Kind of getting from step A to B to C and finding, hey, this is an addiction provider. I'm gonna go to, how are you catching it in, internal medicine? Or maybe the ER where they're doing urine drug screens regularly. Maybe that would be a place to start. Take your loved one there. That's done regularly. And probably one of the more common places that it's, that I see it done regularly. Um, Other than in my. Small addiction practice and you know, one of the addiction providers here that does regularly do that and ask for it. 

[00:28:09] Angela Kennecke: Right. And that, but that could change. I mean, we could change that , as a society, we could, we could, yeah.

Yeah. We could make it easier for people to navigate this and Sure. but there are no real clear steps. I think that's part of the problem I have when people reach out to me is I'm like, well, I don't have all the answers. I often say, if I had all the answers, my daughter would still be alive. Yeah. and unfortunately, so many people are dying now.

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In 2022, the nation witnessed a tragic milestone as drug related deaths reached an all time high. According to the latest data from the Centers for Disease Control and Prevention, the lives of nearly 110,000 Americans were lost due to drug related causes. 

An equal concern is the ongoing issue of excessive alcohol consumption, which continues to claim the lives of more than 140,000 Americans every year. To put it into perspective, that means approximately 380 people lose their lives every day due to alcohol related complications.

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[00:29:14] Dr. Hannah Statz DeVries: I even look at the legality of, of alcohol, you know, what's the number one substance use that we're treating across? The US all covers all kinds of medical conditions. Yeah. Yeah. I won't get started with the legalization also of marijuana, but I have my 

[00:29:27] Angela Kennecke: concerns. You have your concerns about marijuana.  So the debate is out there. Is marijuana addictive? 

[00:29:32] Dr. Hannah Statz DeVries: Ah well, we have a cannabis use disorder. that we have. Well documented. So, you know, and there's also intoxication and withdrawal syndrome. So my answer is, yeah. You know, people don't like to hear that. Yeah. No one likes to hear it cuz it's a, it's a fantasy, it's a cure-all for everything. Yeah. That's what you hear. You 

[00:29:47] Angela Kennecke: know, I always say it's not for the developing brain. I try to stay out of it, the use for adults, but I mean, just worries me that kids are gonna have more access to it now that it's becoming legal.

[00:29:56] Dr. Hannah Statz DeVries: So many places, legalization to commercialization, to advertising, to marketing. Not to say that it may be helpful for certain people in certain instances with the evidence base for it. You know, if you give me the evidence, I'll say, absolutely. Let me help you. It's not regulated. So for me also seeing patients with addictions, it's just not in my repertoire of, treatments, 

[00:30:17] Angela Kennecke: but there is withdrawal. I think people need to know that. 

[00:30:19] Dr. Hannah Statz DeVries: Yes, 

[00:30:20] Angela Kennecke: absolutely. 

Let's talk about withdrawal for a minute because it's a really tough thing, but it I don't, I really think I fully can understand it cuz I've never been through it. But I've heard it's not just a physical thing, that it's a psychological thing and it's just almost like a break.

For people. when I say break, I don't mean like a good break. I mean like they break internally and psychologically. 

[00:30:39] Dr. Hannah Statz DeVries: Yeah, all of the above. This is where, you know, we had kind of the opioid crisis with prescription medications, you know, as being one of the waves of the opioid problem, followed by hey doctors saying we can't give this cuz we have a problem and now patients are left without meds.

going then to things like heroin, fentanyl, and because the withdrawal is so uncomfortable, if my doctor won't prescribe me the copious amounts of opioids that they once were, well, now I feel really crummy. What do I do? Hey. Your, your friend over here says, I can help you. and then the next thing you know, it, it's heroin. And, to kind of speak to your question, with the withdrawal, it's physical. It's mental, and that's that disease piece where the addiction has started to wreak havoc on your dopamine pathways and release abnormally large amounts of dopamine in your brain. And that's your pleasure center. It's your survival center.

If drugs take over your survival center, it goes from. Wanting drugs, just saying, gosh, I don't just want it. I feel like I need it and I, I need it to survive. What a scary thing. 

[00:31:42] Angela Kennecke: Yeah. It's very scary. And I think that's a piece that's very important to point out because someone who is suffering from substance use disorder does think they need the drugs to survive.

Right. And that's so hard. It's good because we see it over and over again in society where people will, you know, they'll lose a job, they'll stop taking care of their children and it's so hard to understand because the brain really has been hijacked. 

[00:32:02] Dr. Hannah Statz DeVries: Hijacked by dopamine. Yep. That's how I actually describe it to my patients.

[00:32:06] Angela Kennecke: Right. So what do you think the future is for addiction medicine? Do you have any high hopes here? Any kind of medically assisted treatment for meth around the corner or anything like that? 

[00:32:14] Dr. Hannah Statz DeVries: I. I think there's a lot of research going into that. , I hope that there's more that's being developed for some of the other, substances. You know, we've got three FDA approved medications for alcohol use disorder. Which is more than we've ever had, more than we've ever had.  And then that naltrexone piece kind of being used for cravings and a lot of other addictive behaviors, we use it. I 

[00:32:31] Angela Kennecke: just heard that Ozempic may help with addictions. I wonder if that's true. You probably have no opinion on that cuz you don't know. But may have been hearing 

[00:32:38] Dr. Hannah Statz DeVries: that I have an unread message in my email right now on just that, so I haven't read it yet. Interesting. But I've heard about it too. 

[00:32:45] Angela Kennecke: Yeah. I don't know. Mm-hmm. I always feel like there's bound to be a price to pay with a drug like that in the long run, but I don't know. I mean, if it would help people, who knows. Right? Who knows. 

I also think, I love to see Emily's Hope Scholarships go to a addiction care center that's affiliated with a medical system. And I think that's what I love to see the most is addiction care affiliated with the medical system. Mm-hmm. Rather than someone just hanging, not that centers that just hang a shingle up or bad and start a center.

They could have good people. They could be good, but I feel like this needs to be treated within a medical system because it is a disease of the brain. 

[00:33:21] Dr. Hannah Statz DeVries: I couldn't agree with you more. There are treatment centers all over the United States and if someone can't go to one for one particular reason that maybe I'm recommending, say please just go somewhere where it's a physician that's overseeing your care.

Right. Cuz my understanding is that if an insurance company is going to allow insurance dollars to pay for a treatment at that point, I can't tell you further unless I know the people that are treating you. If it's just somewhere where you're gonna do groups day in and day out and not have family contact or family sessions while in treatment and, reaching out so that when you leave you're not just, left, empty handed.

Right. 

[00:33:57] Angela Kennecke: Right. Well, I appreciate everything that you're doing. Thank you so much. Thank you for joining me today. I know , you're so busy. You got a baby, you're a mom, and you're working and running this addiction care center and doing all these things. How do you manage it all?

[00:34:12] Dr. Hannah Statz DeVries: You know, I've got a really supportive husband and a really supportive family. And I, I love what I do and until I'm overwhelmed. At that point, I think my husband will know, and Angela. Thank you for your passion for this and for your help. And I know that our, residents at, the Addiction Care Center and receiving your scholarships, it makes a difference.

It, you know, when, patients can't pay for treatment, that should not be what's limiting them. So, thank you. Well, thank 

[00:34:39] Angela Kennecke: you for saying that. I mean, that's why we do it. We wanna take away the barriers. I mean, finances can be a big barrier. Yeah. For people getting treatment.

[00:34:45] Dr. Hannah Statz DeVries: They are. Yeah. Yeah. 

[00:34:46] Angela Kennecke: Thank you. 

[00:34:47] Dr. Hannah Statz DeVries: Thank you. 

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[00:34:48] Angela Kennecke: Thank you for listening to this episode of Grieving Out Loud. If you found it helpful, we'd appreciate you sharing it with friends and family, as well as writing a positive review on Apple Podcasts. It helps to further our mission to raise awareness about our nation's deadly drug epidemic and decrease the stigma surrounding substance use disorder. Hopefully getting more people the help they need. 

You can also find out more information about Emily's Hope, including how you can get involved by checking out our website, Emily's Hope Charity.

Thanks again for listening. Until next time, wishing you faith, hope, and courage. This podcast is produced by Casey Wonnenberg Kind and Anna Fey

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