The Other 90 Percent: Saving People Who Can't Access Treatment

0:00:13 William Moyers
Here we are again, a new season for Let's Talk, the award-winning series of podcasts produced for you by the Hazelden Betty Ford Foundation. I'm your host, William C. Moyers, welcome! We are pleased you have joined us. The Clinton Foundation is renowned for its efforts and its results to improve lives and strengthen communities across America and around the world. Founded by President Bill Clinton and championed by his wife, Secretary of State Hillary Clinton, and their daughter Chelsea, the Foundation's mission includes public health and wellness. The opioid crisis is one focus. To talk more about these efforts, our guests are Chris Thrasher, the Senior Director of Substance Use Disorders and Recovery at the Clinic Foundation. And Ginny Atwood Lovitt, the Executive Director of the Chris Atwood Foundation in Northern Virginia. Welcome to both of you and thank you for being here.

0:01:09 Ginny Atwood Lovitt
Thank you for having us!

0:01:09 Chris Thrasher
Thank you so much!

0:01:11 William Moyers
Chris, how does a guy like you get a—get a title like the title you have at the Clinton Foundation?

0:01:19 Chris Thrasher
Sure. Well thanks again, William, it's a pleasure to be here. And I'm just so happy to have been invited. It's a great question. How does the title Substance Use Disorders and Recovery go together. You know, when the Clinton Foundation approached me with this position, that was not the title. The title was something like Director of Substance Use Disorders. Which was half right. But I knew as a person myself in long-term recovery that recovery needs to be a part of the narrative. And so, I went back to them and said, you know, if I were to accept this position, I would really like the—the opportunity to change the title to Substance Use Disorders and Recovery. Because we know that we have 23 million of us living in long-term recovery. And it is very much a part of everything we do at the Clinton Foundation is talk about all things recovery.

0:02:13 William Moyers
Way to go, Chris! Thanks for being an advocate for the solution part of this dynamic. Ginny, Ginny Atwood Lovitt, you're the Executive Director as I said of the Chris Atwood Foundation, where does your personal passion come from?

0:02:28 Ginny Atwood Lovitt
It comes from tragedy unfortunately. My little brother Christopher passed away from a heroin overdose in 2013. At the young age of 21. And furthermore, I'm the one who came home and found him the day that he overdosed. And I did not have Naloxone. He had been in and out of treatment six times. Some of these treatment centers were supposed to be the best in the country, they cost a thousand dollars a day, and they didn't tell us about Naloxone. So, we realized there's a huge, huge gap here with Naloxone access. And we started The Chris Atwood Foundation with a goal to try to fill that gap and save as many lives as possible by increasing access to this life-saving medication.

0:03:18 William Moyers
Thank you for sharing your personal story and emphasizing what the stakes are when it comes to this illness. Chris, how did the Clinton Foundation decide to tackle the opioid epidemic?

0:03:30 Chris Thrasher
Well William, you know, this was an issue and still is an issue that's very near and dear to the President and Secretary's personal lives. They have lost friends of theirs to this opioid epidemic. And because it is devastating our country, they wanted to do something. That's what the Clinton Foundation is all about is recognizing the struggles, the challenges, many of us have in many different areas. And trying to respond with effective programming. And the opioid epidemic is no different. It's about recognizing that this is taking, you know, 72,000 lives every year and in fact, we're seeing about a 14 percent uptick since COVID, so we expect that number to increase to as many as 80,000 or more lives in the last twelve months. And so, it's something that we can't just stand by and not address.

0:04:25 William Moyers
Ginny, how did you come to be a partner with the Clinton Foundation in this effort?

0:04:31 Ginny Atwood Lovitt
Well actually we were contacted by Ryan Hampton of the VOICES Project. And asked if we would be interested in partnering to get Naloxone out to recovery residences. And it was a perfect partnership because we're already very involved with recovery residences in Virginia. We have a scholarship program where we can provide assistance to people to get into recovery residences. Door-to-door as they're leaving treatment or incarceration. And I think Ryan recognized that it's grassroots organizations like ours who have the ability to push Naloxone out in the most agile and effective and rapid way because we are already engrained in the community in which we serve. And we're also now mailing it. Our mailing program has been extremely successful. Especially in light of COVID, we've really done a lot of that. We just mailed 60 kits to some houses in the Charlottesville area of Virginia.

0:05:36 William Moyers
Ginny, why is Naloxone so critical to the dynamic of addiction, particularly addiction to opioid use disorder?

0:05:45 Ginny Atwood Lovitt
There's not very many epidemics for which there is a very safe and very effective medication that can instantly bring somebody back from the brink of death. And that's what Naloxone does. I've seen people go from laying on the floor turning blue, barely breathing, or not breathing at all, to up and walking and talking in thirty seconds to a couple minutes, they—you know, they call it the Lazarus drug because it seemingly can bring people back from the dead. And the truth is that dead people don't recover. You know, we all wanna see people with substance use disorder get the help that they need but they have to live long enough to get it. And, you know, I can speak from experience that people like my brother, you know, they don't always make it that long. And every single life has value and every single life is worth saving. And so we wanna make sure that everybody has access to this medication.

0:06:48 William Moyers
Chris, what is the Clinton Foundation's opioid response network? What does it do?

0:06:52 Chris Thrasher
Well we look at the crisis that we're all facing and we try as I said earlier to respond with effective programming. One of those programs that we have is getting Naloxone into the hands of people in communities that need it most. So the partnership that we have with Ginny Atwood over at the Chris Atwood Foundation is just one example of how, you know, at the Clinton Foundation we always say that one plus one plus one is far greater than three. So when we were approached, by Direct Relief, and asked, you know, listen, we have these doses of Naloxone but we really need to get them into the community, can you help us? Because they were running into problems around regulations for the distribution of Naloxone into states. So we thought about it and reached out to a couple of different organizations. The National Association of Recovery Residences. And the VOICES Project with Ryan Hampton. We said, what would it look like if we were to really try to distribute Naloxone? And so we started out with a pilot project. Five different states, one of them was Virginia, where the Chris Atwood Foundation is located. And we just reached out to them and said, would you help us? Would you be kind of the middle—the middle arm or the broker of this project? If we were to be able to get you Naloxone? And Ginny over at the Chris Atwood Foundation said, you know, we're in. And they have been just an incredible partner. The amount of Naloxone that we've gotten out. You know, William, we've put out more than a hundred and sixty-five thousand doses of Naloxone since this program has began. And you know, it's not because we could have done this on our own. It's because partnerships like the Chris Atwood Foundation and others have made this program successful.

0:08:40 William Moyers
Ginny, you talked earlier about recovery homes. I know that Naloxone is a critical component of this fight, but what are recovery homes and what role do they play?

0:08:50 Ginny Atwood Lovitt
Recovery homes for many people are the beginning of recovery and a foundation on which to build. So we see a lot of people they lose everything in their active addiction and they may be getting out of incarceration or out of treatment or for whatever reason, they're looking to get into recovery. And recovery residences are a place where they can have structure, they can live in communities with other people who are in recovery who support one another. And—and it provides so many things. Some of the recovery residences also have a little bit of a treatment component so it just depends on what program they're in. But they are shown to increase rates of recovery. And a lot of that has to do with acceptance and support and community, and these things are incredibly important for people in early recovery.

0:09:47 William Moyers
Chris, what other efforts beyond Naloxone and beyond recovery homes, what is it that really matters in terms of the Clinton Foundation's involvement here?

0:09:57 Chris Thrasher
Sure. Well, we know that the greatest barrier perhaps around substance use disorders and certainly with opioid use disorder it's no different is stigma, right? It's people's attitudes. People's knowledge around what it means for someone to have a substance use disorder. And so we are tackling stigma directly. One of the ways obviously is getting Naloxone out. Can you imagine if we told a diabetic because they had an extra piece of candy we're not gonna give you your insulin? It would be crazy to think that we would do that. Or withhold, you know, life-saving medication to someone. And the same thing holds true for substance use disorder. You know, we have to as Ginny said, we can't help someone who is dead. So, you know, Naloxone is not treatment. But Naloxone will keep them alive in order to get them the help that they so desperately need. We estimate that there's about 20 million people living with a substance use disorder. Only ten percent of them are gonna get the treatment they need. Leaving a 90 percent treatment gap. That's unacceptable. So we're at the Clinton Foundation trying to close that gap. One of the ways that we do it is with our faith-based community. And so, you know, looking at different communities of people that can strategically address substance use disorders talk about it, you know, reduce stigma, and really have people understand that we're not talking about just numbers. We're talking about your mom and your dad. Your brother, your sister. Your husband, your wife. Your son or your daughter. These are all real people with real stories and too often, these stories are cut short. Because of overdose.

0:11:40 William Moyers
And as we know from Ginny sharing your own personal experience, your family is one that dealt firsthand with the consequences of this use. Ginny, how—how does your work—how does your work—how is it driven by your own family's experience?

0:11:59 Ginny Atwood Lovitt
Well, you know, we started out wanting to fill the gaps in the system of care that we had slipped through. And we found as we began talking about it that we were far from the only people that were experiencing these breaks in the system. And primarily that was lack of access to Naloxone. So everything that we do, we do it and we ask ourselves two questions. Is it A, is it evidence-based? Is this something that we know is actually gonna work? And then B, would it have helped Christopher? You know? And we always ask ourselves what could have been different that might have resulted in Christopher still being here. And there's many, many things I could spend a long time talking about that would have hopefully kept him around. But, you know, we kind of take a—an approach where we triage. We say we can't get people help if they're—if they're dead. So, how do we keep people alive? And a big part of that is Naloxone and harm reduction. People do not just quit immediately because we want them to. That's not how the nature of substance use disorder works. So, it's about meeting people where they are, providing them Naloxone so that they can stay safe, and then working with them in a way that produces real change.

0:13:22 William Moyers
Chris, last question before we wrap it up: does the Clinton Foundation approach other organizations or do those other organizations approach the Clinton Foundation to see if there's a collaboration possible? How does that work?

0:13:36 Chris Thrasher
Well, it's really both, right? So we reach out to partners that we've either worked with in the past, sometimes totally new partners. It really depends on, you know, what aspect of substance use disorders we are tackling. So, with regard to Naloxone distribution, we knew that recovery residences is kinda the—the first line of defense if you will. We have a lot of people—we estimate that there are about 13,000 recovery residences in this country. And unfortunately, the National Association of Recovery Residences only have about 8,000 of those registered. So we're working to try to get those places that are offering these services to people registered so we can follow them and help them. But we reach out to people, you know? We ask, you know? It comes back to that old saying, right? One plus one plus one is far greater than three, William. And that's what we believe at the Clinton Foundation. You know, I have a bumper sticker on my desk that says, 'Collaborate or Die.' And, you know, the truth is, with this opioid epidemic, we must work together. We must break down the silos. Work across sectors. Come together as one. Because we are losing, you know, like I said our moms and our dads and our brothers and our sisters. And it's got to stop. And people like Ginny over at the Chris Atwood Foundation, they're the key to our success.

0:14:57 Ginny Atwood Lovitt
If I can add something, you know, Chris, you mentioned multiple times that these aren't just statistics and numbers, these are real people. There's a story that actually happened not too long ago from our recovery residence Naloxone program. A client of ours named Stevan, he was in his first week in an Oxford House. Which is one of the types of recovery residences in our area. And he went to go show his roommate something that he had just bought at Walmart. He knocked on his door and through the door he could hear, he could recognize, the sounds of gurgling and rasping and gasping and struggling to breathe. Which are very common to overdose. So he broke down the door, he went in, and he used a Naloxone kit that we had provided to that house to revive him. But the story doesn't end there. Because a little while later, Stevan began using again himself. And he—he left the Oxford House and he took the Narcan kit with him. And that kit was then later used to save him multiple times. Before eventually he was able to re-enter recovery, re-enter Oxford House, and now, many months later, he is really doing well. He's employed full-time. He has great relationships with his family. And he's really thriving. And so, it's stories like that that give us hope and really keep us going. And show that this program works and he probably would not be here if it weren't for that.

0:16:36 William Moyers
Ginny Lovitt, Chris Thrasher, thank you so much for not only bringing your personal passion and your professional expertise to this issue but for sharing some of your own journey with us today. Nice to see you both.

0:16:50 Chris Thrasher
Thanks for having us.

0:16:51 Ginny Atwood Lovitt
Thank you, William.

0:16:52 William Moyers
Please join us for another edition of Let's Talk and make sure to tell your family and friends, colleagues and fellow travelers, to check out our podcasts too. On behalf of our Executive Producer, Lisa Stangl, we urge you to remember that together, we are building a healthier, wholesome, and happier tomorrow one day and one life at a time. Take good care.