he was telling me about the first time he ever used heroin. It was almost like a rite of passage. It was when his father injected him with heroin at the age of 12. The age of 12 and the first time he ever did it was intravenous and that was, he's, at that point, he is great. I'm gonna hang out with dad and daddy likes me. You know, he is 12 years old trying to impress his dad and he had used heroin. until he came in to see me mid thirties, so 20 years later, As an addiction specialist, Trent Carter's passion is to help people struggling with substance use disorder. While working in the ICU, he saw firsthand the gaps in addiction treatment. That experience led the nurse practitioner to build an addiction recovery and mental health practice that is now highly rated. There is a problem with wait list, and I'm a firm believer that you've gotta meet someone where they're at, and if they're reaching out to you right then you need to be available right then but how has he been able to achieve that? What are his recommendations for helping someone struggling with substance use disorder and how can we as a society, turn the tide on the addiction epidemic? Join us as we sit down to talk about an issue impacting millions, some 49 million Americans. You know, sometimes the most powerful change doesn't start in the boardroom or a big city. It starts when one person decides they can't look away anymore, and that's exactly what happened with my guest today. After witnessing the urgent need for compassionate accessible addiction treatment and whose New Mexico community, Trent Carter decided to do something about it. A nurse practitioner with a master's degree from the University of Cincinnati. Trent founded Renew Health, A Recovery Center, built on the idea that everyone deserves hope, healing, and a real chance at recovery. Under his leadership, renew Health has been recognized as the best drug and alcohol rehab center in New Mexico. It continues to grow, reaching more people, removing barriers to care, and redefining what recovery can look like. Trent, I wanna welcome you to Grieving Out Loud. Angela, thank you so much for having me. I'm excited to be here. That's great to have you. You really are reshaping lives, and I think it's quite incredible and I think it could also serve as a model for many other places across the country. But let's start at the beginning. What about addiction treatment, you know, attracted you to this profession? Because, you know, personally, I understand you're not in recovery yourself. Did you have family members who were suffering or, or how did this come about? Yeah, great question. And, and it's one that I get often. So no, I've, I've never personally struggled. I'm not in recovery myself, you know, I don't have any close loved ones or family members or, or good buddies or anything like that, that have ever struggled. It's just something that I was drawn to, which I would, I would say is, you know, it. It's created a passion in me and it's something that I truly care about, and I really had exposure to helping individuals out there. Were struggling with opioid addiction while I was in school to become a nurse practitioner, and that really laid the foundation for me, and as I'm sure we'll get into here in just a little bit, I've really grown up on that. So you decided to open and renew health in New Mexico. What went into that thought process, or what were you trying to accomplish? So you're trying to do something different in a way that hadn't been done before, right. That's exactly right. So honestly, it stemmed just from seeing it a gap in care. So historically, New Mexico as a whole, even just for medical in general, is considered underserved. And so when you look at substance abuse and addiction. Unfortunately those rates get even worse, which probably there's no coincidence there that New Mexico often is ranking among the top of the charts for addiction rates and overdose rates and things like that. So I really saw an opportunity where, hey, I can make a difference in this. Um, I did have some exposure. Honestly, not a ton of exposure to it while I was in school, but I did see some of it in school and learned a little bit about it and thought, you know, I can, I can do this. Um, I wanted to create something that's gold standard that breaks the mold of what folks have come to, I guess expect the way that they get treated, the way that they get, you know, the, the way that treatment is done in general for substance abuse, and that is what led to the start of Renew Health. Well, really, I think part of the problem for everywhere, not just in New Mexico, but everywhere across the country is when somebody says, I need help. Or a family member or a love, you know, a friend convinces them to go into help. There is a waiting game, right? So they have to wait and they have to get on a wait list or there are not enough beds, there aren't enough treatment centers, or they have to have health insurance. Um, state aid or Medicaid is not accepted. So what did you have in mind when you started Renew Health to overcome some of those barriers that happen everywhere. Accessibility for all How, how do you do that? Like, so how do you do that? So at first, I'll be honest, it was not cost effective for opening a new clinic, a new business. Whenever I opened Renew Health, I did not have a patient list. I didn't have a wait list. People weren't beating down my doors to come in because it was brand new. I had the idea, I acted on it and within three months we opened the doors. And so I didn't have a substantial amount of time to do boots on the ground and, and have this huge grand opening and everything. And so at first it honestly was a slow ramp up, I understood from the beginning. There is a problem with wait list, and I'm a firm believer that you've gotta meet someone where they're at, and if they're reaching out to you right then you need to be available right then and to say, okay, yeah, we got you. Uh, it's looking like six weeks, you know, and we'll get you in. They're never gonna make it to that. so right off the bat, I started a twenty four seven call center to where when someone calls Renew Health, they will get a live answer no matter what day or what time it is now. I'll be honest, at three in the morning we're, we're not seeing them, but we're answering that call. We're talking with them, we're getting them on the schedule to where that next day they can be seen or at least get something started for their treatment. And I truly think that that's made a difference because nobody else is doing that, at least not How, right. How do you fund that? Is that something that it's gonna take a guy, federal money, state money? I mean, how, how do you fund something like that? I think that's probably one of the biggest barriers, right? There's not money in addiction care. You're right. So it is a private practice. And Hmm. off, it was all on me. I did reach out to find other resources to try to tap into grants to find state money and federal money that's available, and there is money that's out there. Well, opioid settlement money, right? exactly right. Yep. Yeah. them. Absolutely. And there's so many different that can benefit from the opioid settlement money. I mean, you know, detention facilities, jail systems, it's county level. There's so many that can benefit from that, and it really is unfortunate that so few of those dollars are utilized. Right. These numbers aren't gonna be exact, but there's something like 840 million give or take. And that that number's not correct, but it's, it's in the ballpark was appropriated for the state of New Mexico and something like 117 million has been used. So there's $700 million that's just sitting there. And the state's now being faced with, what do we do with the money? Do we turn it back? Which is really sad because it should be used for the purpose it was intended for. Exactly. I think every state is wrestling with that. Right? Just a fraction. Some places or just some states like Iowa, just deciding how to spend it right now. Um, where it's been available for a while. Um, so I think there's a lot of controversy over. How the money, is the money being used, is it, is it being used correctly? And, and you know how to use it. But yeah, access to immediate care should be top of the list and, and you've been covering that access to immediate care. And then what model of care do you find that, what I've heard is that no two addictions are the same and that what works for one person may not work for another person. So do you have a certain model you follow for everybody when it comes to treatment? We have a playbook. you can operate off of. Again, it's kind of your foundation to get started, but then I think it's very important to tailor that treatment to that individual because you're exactly right. No two individuals are just alike. That being said, it is okay to have a, a playbook that you can pull from. Right. And that's exactly what we do. So we're medication based. Um, we're not a 12 step. Or anything like that. We're not faith-based either. I do encourage it for individuals that are okay with that. I actually strongly encourage that, but I made a very, I guess, strategic decision to not go that route because I did not want to turn anybody away, and that's why we're not faith-based or have something such as 12 step approach because look, if someone's reaching out for help, I want to help them, and I wanted to remove any barrier that I possibly and logically could remove. And so that's why we went that route. Are you ready to protect the next generation from the dangers of substance use? Emily's Hope has created a comprehensive K through 12 substance use prevention curriculum designed to educate, empower, and equip students with the tools they need to make healthy choices are age appropriate lessons, starting kindergarten and build through high school using science, real stories and interactive learning to help kids understand their bodies, brains, and risk of drug use. We're already reaching thousands of students across multiple states, and we're just getting started. Visit emily's hope edu.org to learn more and share our curriculum with your school administrators and counselors. At Emily's Hope, we believe prevention begins with education. Let's work together to keep our kids safe. So medications for opioid use disorder, MOUD is something also known as medically Assisted treatment, uh, is something that we've talked a lot about at Emily's Hope, and there are barriers to that as well for people, even though. All the scientific, all evidence, all the data shows it's, you know, the gold standard for treatment, that it works, that it keeps people alive. And we, we talk about this over and over again, but there's so much stigma around having to go on a medication for addiction. And there's stigma by, uh, the patients themselves, people who wanna get into recovery. There's also stigma. From the healthcare profession. So how do you overcome some of the stigmas? And also it only works for opioid use disorder, so we don't have medications for methamphetamines or, or different, we do have medications for alcohol, um, when it comes to, um, treating some for alcoholism, but we don't have it for other drugs. So, but how do you address some of these, some of the stigma that's out there? Great question and a lot to, to unpackage there with that. So I'll say it's a personal mission of mine. Which is why I do a lot of what we're doing right now because I am trying to de-stigmatize, I'm trying to bring education to the community level, the individual level, the state level, the federal level, the national level, everybody that we can. And so I think that it comes with looking at the science. Having people. It's not just me. I have a team, outreach team that's devoted specifically to this, that are peers themself. They've struggled themselves, or it's someone that's very passionate that maybe they haven't struggled but their spouse has or their sister has something like that. it is one of the requirements that I have to fill that position.'cause I need to know that it means something to 'em, right? They're not just collecting a paycheck, they're out there trying to educate. And that's exactly what it is. It's having awareness, bringing education, so. of the points that I love to touch on when someone tries to push back on MOUD, I'll use Suboxone or, or buprenorphine as an example here of, you're just trading one drug for another. Okay? Right. I've had this, I'm sure you've heard it plenty of times. I've argued this with wardens in the jails. I've argued this with emergency room doctors. I've argued this with, uh, legislators, I've, you name it, uh, other patients even, and family members. I view addiction as a chronic disease. I think that that is very commonly accepted here Western medicine. That's the way we view it. So how do we treat other chronic diseases? Well, blood pressure or diabetes or high cholesterol, you name it. I think first and foremost. It starts with lifestyle changes. Start exercising, change your diet and nutrition, right? Change your sleep, stop drinking alcohol, things like that. So after we implement those changes, then follow up with whoever that doctor was or medical provider was, and then you evaluate how it's gone. Hey, have you done these things? No, I haven't. Or, yeah, I kind of have, but we're unsuccessful. Your blood pressure's still high. What's usually the next step? Medication. Okay. Then over time that medication dose may go up because it could worsen, it could remain the same. Or maybe they've actually started to implement some of these lifestyle changes and the medication dose could go down and ultimately they could come off. It's the same thing with MOUD or Suboxone. So right off the bat, I think that we need to look at lifestyle change, that environment, change these habits, change our routines, change our mindset, and if we're not able to, Suboxone is very appropriate. It's very safe. It's very effective. It changes that person's life, it changes their family. It changes the community that they're around. And if they need to remain on it long-term, so be it. Or if they're able to make these changes and then ultimately stop the medication and maintain long-term sobriety. Fantastic. And so I think that that's a way that we need to view this, and I give that argument to anybody that wants to hear it. I think that the idea among so many people who are on medication for opioid use disorder is that they think that they do have to get, they wanna get off of it. I gotta get off of this eventually. I really shouldn't be on this for life. And I think we need to change some of the. Conversation around that, that no, you can be on it for life, just as a diabetic would take insulin for life. I, I, I think that you don't have to be on it for life, but if you need it, it's okay. I think that that is something that we need to change the conversation around. Agreed entirely. So for that topic right there, there's a story that I love to share. It's an active patient of mine. So I started Renew Health four years ago, and he came to me probably within the first six months, and he had been on Suboxone for close to 20 years at that point. So Okay. I was even actively practicing. Right. And this man is mid sixties. And he has been sober abstinent since the day he started Suboxone, so two decades. So do I think that he could successfully come off of that medication, no longer use that medication? Honestly, yeah. I think that he would be successful. doesn't want to, and I'll use his words here because he views it as insurance. He told me, he is like, man, this stuff is insurance if me having to come and see you once a month and take this film, 'cause he is on the strips, he's on the films. Take this once a day and it guarantees that I don't go back to that lifestyle. And living on the street and the way that I was acting and the things that I was doing and the trouble that I was getting in, and this is all I have to do. One strip once a day and see you once a month. Why would I ever stop it? And I thought that that was a great way to put it, coming from someone that's lived that life and that's actively choosing to stay in treatment. You know, I think a lot about the rise of GLP ones in our society and people accepting that people may need to be on medications for obesity. And they may need to be on them for life and that actually medication is an appropriate treatment. When you talked before about lifestyle changes, there are a lot of parallels and similarities with these, right? Like a food addiction versus a, a drug addiction. And I wonder if maybe the acceptance of GLP ones and medications for food addiction or obesity would, lead to the acceptance of medications for addiction. A greater societal acceptance is what I'm talking about. Yeah, quite possibly, you know, honestly, quite possibly, um, there's a lot of promising hope for these GLP ones, especially when it comes to folks who are struggling with alcohol and things like Yes. Right. Or pathways and yeah, then the added benefits, right? If you could knock off a few pounds and everything else that comes along with that. Yeah. another medication, uh, naltrexone or Vivitrol, the injectable version that is not an opioid like Suboxone, that does help with the cravings and blocks, the euphoric effects and everything else. So it tends to also get stigmatized the same as like methadone or Suboxone or Buprenorphine does, when it's really a very different medication and I think that it's just this. and the way that we view and judge addicts, folks that are struggling with addiction Right. it's really unfortunate. And, and I wanna touch on, so you mentioned about stimulants. So it is off-label, but Vivitrol, I use that paired with, bupropion for my stimulant patients and it works very well. It works very, very well. Tell. Tell me a little bit, gimme a little background on that. For those people that don't know and don't have any medical background, what those drugs are and what they do For somebody who has a stimulant addiction. Sure. So Naltrexone is the pill form. Vivitrol is the exact same medication. It's still Naltrexone, just it's an injection, it's an intramuscular injection, and it's FDA approved for opioid use disorder and alcohol use disorder. So basically folks are. Abusing opioids or they're abusing alcohol. it is not approved for the use of stimulants. So your cocaine, your methamphetamine, or uh, you know, Adderall if you're abusing that, something like that. being said, it is still very effective, and I'm coming from clinical practice here where I've used this on hundreds of patients and it pairs well with Bupropion, which is Wellbutrin. It's actually an antidepressant, and they work synergistically, meaning. One plus one equals three here. So you put the two together and it works better to block those cravings and you know, decrease. If you're not having to think about it a hundred times a day, then it's a lot easier to not make the choice to go un use. Right? And I use it for cocaine, I use it for methamphetamine. Again, Adderall, all of my stimulant patients. And look, no treatment is a hundred percent, but it is very, very effective and works well enough that we continue to do it. So if you yourself are suffering from a stimulant use disorder or you have a loved one who is, you should definitely talk to your practitioner about that because that's not something that I've heard a lot about as I've, um, been in this world and talking about all these things for the last seven years. Um, so I think it's really important for our listeners to really explore that, if that could be an option. Yeah, and I'll even take it a step further. So for folks specifically that are struggling with stimulants, so let's, let's just use methamphetamine for an example here. So, you've got someone that's been using meth for quite a while, uh, you know, daily, not multiple times a day for many years. One of the hardest things about stopping is that crash, they're used to this rush. At this point, they're probably not even getting a rush, but they Yeah. Their dopamine levels are right off the charts. Right. You can't, yeah. Right. So. When you take that away, they crash. And it's hard to even function, much less, maintain a job or be there for your, you know, your young child or you know, the things that hold you accountable, your responsibilities. So I prescribe Modafinil, is a stimulant. It is a controlled substance. So I'm very strict on the way that I do this. But Modafinil is often used for folks that struggle with narcolepsy. So they fall asleep, right? They're having a hard time staying awake. So you take a stimulant, it keeps you awake. I'm very strict on my patients. I prescribe it to, Hey, we're gonna be drug testing you and you have to stop the methamphetamine. In this example, if after next week you're still positive for meth and you're positive for my medication, we're gonna stop this because we're not gonna abuse both. happens is you stop that meth and you take the modafinil. It's a stimulant. While the meth is being excreted, it's wearing off, it's getting out of your system, but there's no crash because I'm giving you a stimulant. So we do that for two weeks now. The meth is completely outta their body and outta their system. We stop the modafinil and they never experience an a, a big crash. So they don't have to take that time off of work. They, they can still take their child to school and look, there may not feel a hundred percent, but they're gonna feel pretty dang good and they're not gonna have that big crash. It They're, extremely well. it sounds like they're gonna be able to function, which is all we want. We want people who are suffering from substance use disorder to be functioning members of society. Now, we've covered some medications. What else besides medication is important to recovery counseling. Is there a certain kind of therapy that you think is more effective than others? I know I've talked to people who've gone through EMDR and just different types of therapy. Is there something that you think works or is medication alone enough? So for many people, medication alone is enough. Hmm. I strongly encourage to every single patient that comes in cognitive behavioral therapy, and there's so many different treatment modalities and types of therapy, and it is, like we already said, there's really no one size fits all. But I love CBT Cognitive Behavioral Therapy because those experts are really diving into what's causing this, what's going on, and how can we work through that and how can we, you know. Develop a game plan because we know that life's gonna continue to throw these things at us so that now we've got a new foundation we can fall back on. But we've also got this game plan on how to attack this and how to approach it. And I think it's great. It's not just laying on the couch and talking about your feelings. Like a lot of people, you know, think of therapy or a shrink. That's not what this is, which. I'm not trying to, to hate on that either. Look, if, if that's what someone needs, by all means, I think that's fantastic too. But I love cognitive behavioral therapy, but there's so many things we can go into. I'm a big proponent on structure and having daily routines and weekly routines, and then that and seeing, okay, these are where these wins came from, our successes for the day versus our failures. Or our losses for the day. We can evaluate that and see. Why did we fail at that? What can we do different? Hey, this was a win. Whereas normally I would not have gotten a win out of that. How? How did that happen? We can learn, we can adapt. We can continue to grow from that. I think support systems are huge. Lean on those support systems and. For someone that says, well, I don't have a support system. Okay. I mean, you know, maybe you don't have family or friends that you can lean on, but there's resources in town, there's churches, there's, there's treatment centers, there's something like what Renew Health is, which if you're not in New Mexico, there's other ones out there. There's, there's counselors, there's medical providers that care. There's tons of free groups that you could attend, that you could go to. Um, exercise. I'm a huge proponent of exercise also, and I'm talking any level of fitness. If it's just going for a walk or if it's full on six days a week, an hour a day, anywhere in between. Huge proponent of exercise, the nutrition that you're putting in your body. Sleep, I could go on and on. I'll Well, yeah, we have to treat the whole person. We have to treat the entire person and, um, the social emotional aspect of it. I've been doing a lot of studying lately about trauma and how grief and trauma can really. Lead someone down the path of addiction and how they can stay stuck because of they've never dealt with the traumas, um, that they've experienced in their life. Do you have patients that you've seen that applies to. Absolutely. Unfortunately, it is a very common influencing factor when it comes to substance abuse and then not just the substance abuse, but the mental health that's associated with, you know, the, the anxiety, the depression, the, the whatever else that they may be struggling with. Insomnia, I mean, you name it. And so many times it can be rooted back to childhood trauma. Which it doesn't even have to be childhood, Hm. very, very common. one of my patients, um, he's mid thirties, 35, give or take, and he was telling me about the first time he ever used heroin. It was almost like a rite of passage. It was when his father injected him with heroin at the age of 12. The age of 12 and the first time he ever did it was intravenous and that was, he's, at that point, he is great. I'm gonna hang out with dad and daddy likes me. You know, he is 12 years old trying to impress his dad and he had used heroin. until he came in to see me mid thirties, so 20 years later, he came in and he broke down crying that first visit because he wants to be a better father. He had a young daughter that was, I think she was around the age of six at that time. He was divorced you know, he wanted to be there for, for his daughter. And in two weeks. In two weeks, that man came in with a smile on his face after beginning treatment with a smile on his face, talking about how he's been able to be there for her taking her to the park. They even went by the store and got some toys or something like that. Just the joy that was on his daughter's face and what that brought to him in two weeks. This turned around. It's remarkable. And that's MOUD, that's, that's Suboxone. These medications that so often get hated on. So when someone tells me you're just replacing one drug for another, or you're poisoning that person, or it's no good and it's snake oil, it doesn't work, I would say, go talk to that man. Hell go talk to his daughter. You tell me it didn't work. Right, and hopefully he was able to work through some of the issues with having a parent exp. I mean, it seems like such a betrayal, right? To a young person and the rest of their life. To have a abuse really is what it is, and to have to confront that as well. I. So for him, the medication needed to come first before he could open himself to go to therapy. And this is where everyone's different. Oftentimes it's the other way, but for him, he needed to stop the heroin, get to a place where he felt better about himself. the type of parent he wanted to be for his daughter, have a breakdown. I mean, he is a, you know, grown man and he was crying in front of me, which there's no problem with that. But for him it was a very uncomfortable thing.'cause he wasn't used to that. after he was able to achieve those mile markers, he then was at a point where he could go and get therapy and start to unpackage some of those other things. Have you lost a loved one to overdose or fentanyl poisoning? I'd like to invite you to share their story on our new Emily's Hope memorial website called More Than Just a Number. They were our children, siblings, cousins, husbands, wives, aunts, uncles, and friends. So much more than just a number. You can submit a memorial today on more than just a number.org. In addition to running three treatment centers in New Mexico, Trent also offers telehealth services and recently wrote a new book called The Recovery Tool Belt. You'll find details on how to get a copy in our show notes. And while you're there, we'd really appreciate it if you take just a moment to rate and review the podcast. And you probably know someone who needs to hear this. Please share it with your friends and family. Together we can raise awareness and hopefully change lives. The Recovery Tool Belt, it came out this year. Um. Honestly, my audience is anybody, I am clearly trying to help the, the individual that's struggling with substance abuse, I'm also trying to help maybe their loved one. It's if it's a family member or a friend, or even someone that doesn't experience it themselves, but they're seeing it in the community. They're hearing about it on the news. Maybe they're hearing about it in a podcast. even clinicians could benefit from the book that, you know, maybe they're a primary care provider. They don't see individuals that come through struggling with substance abuse often, but occasionally they'll have someone come through and now they'll have a new tool that they can work with. They're a little better prepared for that person. So I, I wrote this to be a very approachable self-help book. It's full of tools. And look, if someone could pick up one tool from the book. It can be life changing. It could be life saving. I don't know how many total tools are in the book. Quite a few. A lot, but it really is just, again, a very approachable self-help book. Um, there's not a lot of big words. It's an easy read. There's no big medical jargon that's in the book. There's some humor that's in there. A lot of patient stories. Several patient testimonials, I wanted to reach the individual that says, oh, well that doesn't apply to me. You know, maybe they read the, they, they hear a story, or they hear about treatment options, they hear about whatever it may be, and they say, yeah, that doesn't work for me. Or, Hey, I've been there, I've tried that and I failed it. Or, that story is not as bad as my story. My story's worse. And so I chose a lot of those stories and a lot of people. That were there, they were in their shoes that are now on the other side of this. And so I had them specifically give patient testimonials to put in the book because I want to reach anybody that's struggling and let you know, Hey, you're not too far gone. You're not W There are options available. why is it so important to give people hope, to give the individuals struggling and their families hope? Well without hope, they may never take that next step. They could be life changing for 'em. I hope that, I think that hope is is very important, and I hope that everyone can know that because there are people that care. Even if you don't know. Look, if you came to me right now and I've never met you before, you think, well, you're a stranger. Why do you care about me? And within just a few minutes, I would like to think that your experience is gonna be. That that changes your mind very quickly. that's a big point at Renew Health is every member, every staff member of Renew Health goes above and beyond to make it known. Hey, you are a brave individual. It takes a big person to come in here right now. It's a scary thing and you've. Realize that this has gotten beyond you. It's out of out of control, and now you're hoping that the experts can help you. And we're glad you're here because we can help you. We will help you. We got you. I think we need a cultural shift, uh, to be able to see the disease of addiction, uh, you know, diseases of the mind, the same as diseases of the body, right? I mean, we, we readily accept diseases of the body, but we are so slow to accept diseases of the mind, and we think it's a character flaw. Uh, you know, somebody needs to be punished because of this, and it is just really hard to shift the culture in this direction. You're, you're working on doing that. Yeah, yeah, you're exactly right and, and I'm a huge proponent of treatment over incarceration. So rather than just penalizing someone and throwing 'em in jail, I would like to see, hey, there's treatment options and you need to do that. If you don't, then this might be what you're looking at. But yeah, I think that. De-stigmatizing is gonna be huge. And honestly, it needs to come from the top down and the bottom up. It can start at the individual and the community levels. And then I think that we need a nationwide shift too. And I think that they should compliment each other, and that's how we're really gonna see, uh, a change in the landscape here. Otherwise, we're just gonna keep seeing we're ge keep spinning our wheels and we're gonna see five years from now that we're in the exact same spot. Who knows? Maybe it's a different drug. We're in a different wave at that point, Right. We have to stop the demand. That is exactly what has to stop is the demand. because we believe prevention is key. Here at Emily's Hope, we're focused on reaching kids early through our K through 12 substance use prevention curriculum. We're working to stop substance use before it begins. The program is built on evidence-based principles and age appropriate lessons developed by experts. You can find all of the details at emily's hope edu.org. We've also included a link in our show notes. There's been some laws that have come about in New Mexico that could be models for other states. Can you talk about that? Yes. So very proud to say 'cause New Mexico, you know, traditionally is not, I would say not very forward thinking, and they are with this. So, Senate Bill 4 25, it is mandated that these detention centers, so the, the jails that they have to offer mat medication assisted treatment, exactly what we've been talking about here. its detainees, the individuals that are incarcerated there, and it's in a two phase. So the first phase is continuation. So if you're someone that is now going into that jail let's say, but you've been on treatment, you've been on suboxone, they're required to continue that treatment. And then part two of that, will be induction or initiation. So anybody at any point, no matter how long they've been in that facility, can raise their hand and say, Hey. I need help. I would like an evaluation done and if it's deemed to be appropriate, begin medication assisted treatment. And I think that this is absolutely fantastic. I would love for New Mexico to now be a a model for other states to wanna follow.'cause I truly believe that we're gonna see a statistically significant reduction in overdose rates, recidivism. I think it's gonna have an economic impact within the communities. I think it's gonna be great. There's been some concern, and I've heard this from lawmakers, about the potential for Suboxone or the strips to be abused within the prison system. So when you're talking about treating people in prison with medication for opioid use disorder, other disorders are, are you typically doing injections then or what? How, how? How were they administered? I would love to do injections. Um, there can be some logistical challenges there.'cause I mean, let's just face it, the injections are expensive Mm-hmm. these facilities care about bottom dollar and what they can afford. So in many facilities. That is what they're doing. But in many other facilities, they're not. And so my solution there is I'm trying to find funding for them to help offset that, or even where we can bill Medicaid within the first 30 days.'cause oftentimes the length of stay is less than 30 days. Someone may come in for two or three weeks and then they're out. So if we could get them on an injection that covers them for their entire length of stay while they're there, and then they've got coverage going back into the community. Hopefully they would continue with, if this is in New Mexico, let's say with Renew Health or some other provider, and there would be no lapse in care there. Um, yes, diversion is a problem it comes down to supply and demand. So if there's low supply, the demand is high, and depending on where it is, the cost for a of Suboxone could be anywhere from 500 to 1500 dollars. Really? That is crazy. One single eight milligram film can go for a thousand bucks, let's say, that's because the supply is low. So if we actually got everyone on treatment as they should be, because the national average is 85% of detainees, of incarcerated individuals would be eligible for mat. Wow. with substance abuse. 85%. That's everybody. I mean, Mm-hmm. So if it was now available, the supply goes up, the demand goes down, and now it's not a thousand bucks a strip. It's not 500 bucks a strip. It's $5 a strip, let's say, or $10 a strip. So now people are less likely to be bullied into trying, diverting their medication to someone else or getting beaten up because of it. So I think that that problem could potentially sort of work itself out now. There likely would be plenty of wardens that would argue the point that I'm saying, but I think that there's some real merit there. Yeah. What else would you like to see happen within our prison systems? That's not happening today? I would love to see a team that is dedicated to reentry, so. I've been incarcerated, I'm now going to be released. I'm now gonna go back into the community. I would like to see someone bridge that gap, connect those dots. And I'm not even just talking about substance abuse treatment, talking about, Hey, what if they need a driver's license? Right? What if transportation to get to and from? I would love to see them leaving with their medication. Honestly, I'd love to see them leave with the injection just prior to best case scenario. But if that's not feasible, at least. two week supply of their medication and then a ride to wherever they need to be already having their follow up, or even if it's their initial appointment set up prior to release to where all of these things are ironed out for them. And it'd be great if this team stick with them. After they were released, or if there was a team on the outside in the community that they could be handed off to to help with job placement, driver's license, getting on Medicaid, whatever it may be. I think that would be a huge, huge help. And again, it would cut down on recidivism, Yeah. the potential economic impact would be substantial. We need to do so much more than we're doing now because those recidivism rates and people don't know anything different, right? They don't have the support systems in place and it's just, uh, really an epidemic in this country. First of all, the fact that so many people are incarcerated who have substance use disorder is an epidemic by itself. But then also what happens once they get into the system and they can't get out? Um, so many social things that we need to be looking at with substances, often being at the root of them, You're exactly right. And while they're incarcerated, they're there. We've got 'em, we're, we're housing right? Right. care of them. We're providing medical. Why would we not offer them every bit of treatment to the full capacity that we can while we've got them there? right? Yeah, supposed to rehabilitate, but it's not rehabilitating if it's not offering treatment. that's right. Mm-hmm. New Mexico is trying to make a change there, which I'm really, really excited about. And I do think it's gonna be successful, and I do hope that it turns into a model that other states wanna emulate and and follow after. Any closing thoughts about this subject that we haven't talked about that you'd like to leave our audience with? Hmm. So again, a huge. Proponent of treatment over incarceration. But then, you know, also there's, there's the big, beautiful bill too that's coming out that's gonna have such an impact on so many people across the nation. I don't know all the numbers nationwide. I can speak to the numbers within my little state here in New Mexico, and there's potentially a, a massive impact that it's gonna have. Yeah, and we should talk about how just Medicaid itself, that something like, I think an estimated 150,000 people won't be able to get treatment for addiction through Medicaid in 2026 because of the big, beautiful bill. Mm-hmm. Yeah, there's a lot of people that potentially are gonna lose eligibility and right now, so if you're one of those individuals, I think that. Having the awareness of what's going on, educating yourself of what's going on, and then trying to take action that you can right now to get out ahead of that so that you don't turn into a statistic, you don't fall through the cracks and now go without your coverage. And again, not even just for substance abuse, but for other chronic care diseases and, and everything that these individuals may be struggling with, it could be a huge problem. Right, right. We'll have to keep talking about that on this podcast as we move forward because we'll see the impact soon enough. Okay. absolutely. All right. Well, thank you so much, Trent, for joining me. Really appreciate it and your expertise. And I think I know that our viewers and our listeners learn something today. I, Thank you so much for having me on. I really appreciate it. It was a lot of fun. You had great questions, so thank you so much for, for allowing me this time. We invite you to tune in every week for a new episode of Grieving Out Loud. You can also find hundreds of past episodes anytime on our website, Emily's Hope Charity. We've added links in the show notes to just a few episodes we think you may be interested in including one with tiktoks favorite addiction Medicine doctor, Dr. Elizabeth Zona. The number one thing to talk about when we want to prevent, hopefully, drug abuse is feeling. We need to talk about how we feel. We need to process those emotions. Because every time we have something, even if it's small trauma, when you're little, it feels so big. If we're told that's not important or you shouldn't feel that way or stuff it and forget it, we stuff it and forget it. And what we hear is I'm not important. My feelings aren't important. Check out the link in our show notes. Thanks again for listening. Until next time, wishing you faith, hope, and courage. This podcast is produced by Casey Weinberg, king and Kaylee Fitz.