What I Meant to Say

Have you ever done an interview for a local television station? I had my first experience with it a few weeks ago and really underestimated the difficulty in communicating in that format. They invited me to talk about substance abuse. I knew the discussion topics in advance and had prepared quite a bit of material to talk about.

Maybe it was the light shining directly in my eyes but remembering what I wanted to say proved very difficult. I think I was able to communicate my essential message, just not as smoothly or completely as I would have liked. Considering the amount of time I spend talking during the week, I didn’t expect to have much difficulty with this.

I’ll post the material I had prepared for discussion, followed by the actual interview for comparison. I think there were a few seconds of discussion edited out but otherwise, this was a one shot interview. My first thought was, “do I really look and sound like that”?! Apparently the answer is yes.

For anyone in a similar situation, I would recommend some practice (which I didn’t do) in advance. Have someone else ask you the questions and practice the answers. Take some time to relax and focus your thoughts before starting the interview. If you say anything terribly wrong, I’m sure they can edit it out. Don’t wear plaid or small check patterned clothing…you’ll notice my jacket is a little distorted in the video.

Here is the material I prepared to discuss.

Scope of Problem

• There are around 250 thousand people in Oklahoma that need but don’t receive treatment for alcohol and drug problems, the majority of those, or around 200,000 are alcohol related problems. Around 20,000 people per year receive treatment through state agencies. In Tulsa County, around 3000 were treated in 2012 through state agencies. On average, around 10% of the population has a problem and only around 10% of them will actually get treatment.

Biggest Problems

• When clients come to treatment, we ask them what the primary problem substance is. Based on that information, alcohol is the single biggest problem substance…simply because it’s legal, socially acceptable and widely used. Around 30% of those seeking treatment at our agency report alcohol as their primary problem substance.
• Marijuana is second most common problem at around 25%
• Methamphetamine is the third most common at around 15%. Those numbers are a little off from the rest of the State but the order is the same.
• Opiates, including heroin and prescription pain medication were around 13% last year but it’s growing. We aren’t seeing as many new methamphetamine users as in years past and I think overall, use of meth is on the decline. Opiates appear to be the drug of choice for many of the 18-25 year olds coming into treatment. I really expect opiates to pass methamphetamine in the next year or two.
• In all prescription drugs are responsible for the majority of overdose deaths in the state. They kill many more people than all the street drugs combined.

Current Trends

• I think we’re only seeing the tip of the iceberg on the synthetics. The most common being K2 type products. They are synthetic variations of THC, the active ingredient in marijuana. Many people are drawn to them because they are perceived as safer than many street drugs and of course the biggest attraction is that they aren’t easily detectable by a common drug test. We’re getting better at being able to detect them but the makers are adjusting structure as fast as we’re able to develop tests. We’ve seen some pretty scary results from some users including psychosis, seizures and aggression. There doesn’t seem to be any way to really predict the results so people are really playing roulette when they use these substances.
• Another disturbing trend is the increase in heroin use in the Oklahoma. I’ve seen more heroin users in the past couple of years than in all the previous years I’ve been around this field. We’re getting better at monitoring and regulating the distribution of prescription drugs but we haven’t reduced the demand. Drugs follow the same supply and demand laws as any other commodity so if there’s a demand, someone will come up with a supply.

• The biggest indicator of a problem is a dramatic change in mood or behavior. You really have to know what a person is like and then you can typically spot the change. Another red flag is isolation from friends or family or a sudden change in associations. It’s really tough with kids because adolescence is a pretty chaotic time anyway where behavior change and change of friends are sometimes pretty common. You can’t just ignore those factors because the child a teenager. The most important thing is just to stay involved and don’t be afraid to talk to your kids about these things. If you have suspicions, a drug test is a pretty inexpensive way to see if there’s really a problem or not. It would be well worth it to avoid the heartache of a serious problem later.

Prevention

• Let me start by saying it’s virtually impossible to stop kids from at least experimenting with substances. I’m not saying you shouldn’t try but it’s not an easy task. I can also tell you that the single biggest determinate of who will develop a problem is to look at the environment they grew up in. There’s a study called the Adverse Childhood Experiences study, probably one of the most important studies you’ve never heard of. The results show that abuse, neglect, domestic violence and chaos in the household are some of the biggest predictors of later substance related problems. For kids that have experienced some of those things, the key is to love them and help them heal and to empower them to create a future. All kids need love and support but those kids need all we can give them.

Available Treatment

• Treatment has come a long way in recent years. We have evidence based treatments, things that are proven effective including motivational enhancement therapy, relapse prevention, cognitive behavioral therapy just to name a few.
• One of the keys is that we’re not just treating alcohol and drug problems. Substances are really just a symptom of other problems and once we address the immediate problem of substance use, we’ve got to identify and heal whatever else is wrong.
• The biggest problem is often funding. The state has been trying to make a difference but we still spend a lot more money on incarceration than we do on treatment. There have been dramatic cuts in treatment beds in Oklahoma since the recession started so residential treatment, where you go spend 28 or 30 days at a facility is almost non-existent. That leaves outpatient and intensive outpatient, which is what we do, to fill the gaps.
• Outpatient treatment is where patients will attend some type of counseling session 1, 2 or even 3 times per week for a period of months. Our Drug Court programs, which are prison diversion programs, typically keep people engaged for around 1 year. I think research shows that’s a pretty effective length of treatment.

Actual Interview

Here’s the actual interview: