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“Creating safe places creates a healing culture!”

by Ty LaFountain, Recovery Support Coordinator

January 14, 2025

I started using substances at the age of eleven. Technically, I could argue that I started using substances way before that. I was in second grade the first time that I put grass in a piece of paper and tried to smoke it, emulating what I had watched my father do (of course he wasn’t smoking grass). Then in about third or fourth grade we started stealing my mom’s cigarettes and occasionally stealing them from the Buttrey’s across the street from our house. We learned that if we inhaled these cigarettes, we would get a little buzz. We would inhale the smoke and then try to walk on the curb, lightheaded and off balance. We thought this was the coolest thing in the world. We would also take the cigarette smoke and blow it out against a wall, and it would make these giant smoke rings, once again, this was very cool to us, as that is what the cool guys did in the movies. I guess you could say this is where my true substance use began.

As I got older, seventh grade, my family would go out to my father’s cabin in the Dearborn mountains. He had this plant behind his couch that he would go over and pick something off, put it on a baking sheet and put it in the oven. After a few minutes he would take it out of the oven and roll it up and smoke it. One night, when he went to bed, I snook out there and picked a bunch of leaves off the plant; I took them home and tried to roll them up and smoke them. My older siblings caught me in this process and said, “that’s not how you do it, here we’ll show you how to do it.” And they did. I was already smoking cigarettes at the time and was quickly smoking marijuana daily and drinking alcohol on the weekends. This later led me to harder substances, but this was the beginning of my substance use disorder.

I write this blog for the first annual Substance Use Disorder Treatment Month (Treatment Month). SAMHSA recently announced that January 2025 would be the launch of Treatment Month. According to SAMHSA “this serves to support: people contemplating or seeking help for substance use, practitioners treating or considering treating substance use disorder, friends, family and loved ones of people with substance use conditions; by raising awareness of treatment. SAMHSA seeks to: eliminate stigma surrounding treatment, including medications used to treat substance use disorders, encourage those on their treatment and recovery journey, and promote best practices such as screening, intervention, and treatment of substance use disorders by health care professionals.

First, let’s talk about substance use disorders (SUD). Whether it be alcohol use disorder (AUD), opioid use disorder (OUD), or drug use disorder (DUD), a substance use disorder is a substance use disorder. Of course, I am not saying they are all the exact same and can all be treated the same, however they are all substance use disorders that are manageable and treatable with the right support and treatment and must be acknowledged as such. One thing that our society commonly does is treat them as though one is more socially acceptable than the other.  

 We are all familiar with our drug problems in the United States. We hear about the opioid/fentanyl crisis every day, with over 100,000 individuals losing their lives to overdose last year (last year was the first year in twenty years we saw a decrease in overdose fatalities). We are all familiar with the “war on drugs” sparked by the Raegan administration. There is the “Meth, not even once” movement. Yet, one of the most overlooked drug problems we have in the United States is the excessive use of alcohol. For some reason, when we discuss drugs, alcohol is often put in a separate category. We often say or hear people say, “drugs and alcohol.” The two should not be separated, alcohol is a drug and the most dangerous and abused drug in America. According to recent reports by The Pew Charitable Trusts and the Drug Abuse Warning Network (DAWN), alcohol accounts for America’s worst drug problem and accounted for the most drug related ED visits in the U.S. in 2023.

According to The Pew Charitable Trusts article, “America’s Most Common Drug Problem? Unhealthy Alcohol Use,” “Alcohol is the leading driver of substance use-related fatalities in America: Each year, frequent or excessive drinking causes approximately 178,000 deaths. Excessive alcohol use is common in the United States among people who drink: In 2022, of the 137 million Americans who reported drinking in the last 30 days, 45% reported binge drinking (five or more drinks in a sitting for men; four for women). Such excessive drinking is associated with health problems such as injuries, alcohol poisoning, cardiovascular conditions, mental health problems, and certain cancers. (The Pew Charitable Trusts 2024)”

Alcohol accounted for the most drug-related ED visits in 2023 with 41%, with the nearest substances not even coming close to that number, with cannabis coming in at number two with 11.8% followed by opioids at 11.6%. Yet, we continue to overlook alcohol as a drug and continue to stigmatize the use of other drugs. In 2023 there were approximately 29 million people within the United States who met the criteria for alcohol use disorder, yet less than 1 in 10 received any form of treatment. According to the CDC excessive alcohol use has an annual economic cost of approximately $249 billion nationwide and $871 million annually in Montana.

Alcohol also has a very close relationship with suicide. Alcohol is considered the heaviest factor involved in suicide. One third of all suicides within the United States involve alcohol.  Montana is among the top three states in the country in suicide rates every year. Montanans consume more alcohol than most of the country, on average: 48.7 gallons per capita compared to the national average of 34 gallons per capita, ranking third among the states. Is this a coincidence? You decide. For people who have suicided, the rate of finding alcohol in their system at the time of death was two times the national average in Montana. In the United States, and more specifically in Montana, drinking seems to be the social norm. Growing up in Montana, I felt like drinking was just the norm and it’s just what everyone did.

I am not here to introduce people to a drug that we all already know exists. My goal is to make people aware that despite having no medicinal purposes when ingested, drinking alcohol is considered socially and culturally acceptable while we dehumanize and shame people who use less socially acceptable substances like methamphetamine, opioids, MDMA and others.

Why do we normalize drinking? Alcohol really needs to be looked at as a key contributing factor to many of our social problems. Why do we see so many ads for alcohol and sell alcohol on every corner, in every grocery store and convenience store and criminalize other substances? It’s time for a change! Perhaps we can stop making one substance use disorder more socially acceptable than another and start to look at them all as substance use disorders, that are manageable and treatable with the right support and treatment.

As a person in long-term recovery I know that recovery is possible. According to SAMHSA, “of the 29 million adults with a substance use problem, 72.2% (20.9 million) considered themselves to be in recovery in 2023.” Based on this statistic, we know that people do recover. Yet, when it comes to drugs like alcohol, a majority are not even being referred to treatment. From 2015 to 2019, while 70% of people with AUD were asked by their primary care provider about their alcohol use, only 12% received any information on reducing their use and only 5% were referred to treatment.

How do we address this? People are being screened and asked about their substance use, but there is no follow up when a person does screen positive. Why? I believe that there continues to be this huge stigma, even amongst our medical providers. They are never really taught how to broach the subject of behavioral health. Therefore, when a person does screen positive for substance use disorder, the provider may not feel comfortable talking about this with the individual. This is where we need to implement more training for teachers, medical providers, law enforcement, court systems, child protective services, and all human service sectors. We really need to take the stigma out of and normalize the talk of substance use disorders.

In the process of creating this blog I spoke to an ex-co-worker and dear friend of mine, Chelsea Solberg. Chelsea is a former labor and delivery nurse, worked alongside me as a community nurse for the Meadowlark Initiative, and is in her final year of her Master of Social Work (MSW) degree. She shared some insight with me about tools that assess risky behaviors, not just frequency of using alcohol. What often happens is that a person may answer yes to using alcohol on a screener but is never followed up with about their consumption. Is their consumption possibly unhealthy or dependent? Chelsea says that appropriate screening and follow up “creates opportunities for early prevention and intervention.”

There are many ways that we can help to promote Treatment Month this January. Screening is a great tool, but it is nothing if we do not use it to open deeper conversations. We must normalize the hard conversation of substance use disorder and help to reduce internal and external stigma that people who have SUD, families and loved ones of people with SUD, and people working within the human service setting experience. We must stop comparing SUD disorders, making one more socially acceptable than the other and stop dehumanizing people that are struggling with substance use disorder. We are all just human beings looking for love, compassion and safety.

I will leave you with one of the last things that Chelsea said to me as we got off the phone, “Creating safe places creates a healing culture.”

A special thank you to my dear friend Chelsea Solberg for taking time out of her busy schedule of being a full-time wife and mother, full time student and completing her hours for her MSW with Child and Family Services yet finding time to talk on the phone with me.

References:

Substance Abuse and Mental Health Services Administration. (2024). Drug Abuse Warning Network (DAWN): National Estimates from Drug-Related Emergency Department Visits, 2023. In dawn-national-estimates-2023.pdf (No. PEP24-07–033). SAMHSA. Retrieved December 23, 2024, from https://www.samhsa.gov/data/sites/default/files/reports/rpt53161/dawn-national-estimates-2023.pdf

The Pew Charitable Trusts. (2024, December 13). America’s most common drug problem? unhealthy alcohol use. America’s Most Common Drug Problem? Unhealthy Alcohol Use | The Pew Charitable Trusts. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2024/12/americas-most-common-drug-problem-unhealthy-alcohol-use

https://www.samhsa.gov/data/report/2021-2022-2023-nsduh-infographic

 

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