20 Questions: On The Front Line of A Crisis

SYDNEY SCHAEFER / NNY BUSINESS
Anita Seefried-Brown stands outside the Alliance for Better Communities office.


Anita Seefried-Brown has dedicated 20 years of her career to serving those in the community who struggle with addiction and are seeking help. She talks about how she became involved with the Alliance for Better Communities, how the organization is working hand-in-hand with other agencies and what the future holds for the crisis that is not only sweeping the north country but the nation.


NNYB: The Alliance for Better Communities is a local community coalition comprised of community members who live and work in Jefferson County. To name a few, who are most actively involved and why?

Seefried-Brown: The coalition is comprised of many, many people. Some people are door openers, some people are workers, some people help in writing and passing policy. I would like to say that law enforcement has been absolutely fabulous in their involvement in getting underneath the opiate epidemic. The Family and Recovery Group, which just like the name says, are family members of individuals who are either in recovery or seek recovery and also people who are living their recovery. They have the most to lose, and they have the most to gain. Therefore, they are like pit bulls. They are out, “We need to educate so and so. We need to advocate. This cannot stand. We need immediate access.  We need X, Y and Z.” They’re the people to count on; they drive that locomotive and they run with it. And when they get the steam up, get out of the way.

NNYB: What is the goal of the coalition, both short-term and long-term?

Seefried-Brown: The overall goal of the coalition is, number one, to strengthen the coalition partnerships. That means to make connections with all the twelve sectors within the community, as well as preventing underage drinking and underage substance use. And, over time, adult drinking and adult substance abuse.

NNYB: The Alliance for Better Communities gathers data to create solutions to the addiction epidemic. How is the data gathered?

Seefried-Brown: We are data-gathering fools. We gather archival data, such as the prevention needs assessment survey, which is applied every two years in all eleven school districts to use in grades seven through twelfth. This gives us a really good understanding of what young people are using, what their perception of what risks and harms are, what they think their parents’ perception of what risks and harms are, and there’s sometimes a lot of daylight between those two. That is one of the mainstays of archival data. We also gather data from community agencies, such as how many poundages or tonnages of medications were disposed of, taken back at take-back days, or at the disposal box at the Jefferson County Sheriff’s Department. We gather information from ER admissions, emergency department visits, admissions into the hospital due to substances. From first responders, for example, how many Narcan reversals have been made during the course of the year, through the (medical examiner’s) office how many overdose deaths, unfortunately, that we have. We also gather anecdotal data, such as the opiate health survey, which is an unscientific survey that the people entering treatment providers are asked to fill out.  If they don’t want to fill it out, they don’t have to. And it’s very confidential. It basically asks: Are you male or female? When is the first time you ever used drugs? Are you using any opiates now? Have you ever been in recovery? To date we have about 1,500 surveys gathered, put into an Excel spreadsheet and we use that data to continually educate, not only the alliance membership, but also the community at large.

NNYB: How is the data used to create initiatives and community awareness?

Seefried-Brown: For example, some of the Family and Recovery Committee members started talking about the opiate addiction and sex trafficking in Jefferson County. And I’m like, “Say what?” I had no idea. Talk to me about substances, I can talk until the cows come home. Sex trafficking? Not in my wheelhouse. Human trafficking? Not in my wheelhouse.  But the individuals who brought up that topic, they immediately suggested, “Well, why don’t we get the data, the national data?” Well, I have no idea where you get it from. “Oh, you can get it from the Blue Campaign, you can get it from A21 (Campaign), you can get it from Polaris (Project).” I said, “OK, good. Get it. Get that data.” And we really got into the data-gathering situation, where we got national data, New York state data. Unfortunately, we don’t have really good Jefferson County data because it really is an activity that takes place in the murky waters; it takes place in the shadows. Many of the people who are being sex trafficked while in active addiction, they may not see themselves as victims. They may not understand that being beaten if they don’t want to perform, being beaten if they mouth off and, by having the drug of choice – very often opiates, very often heroin –  withheld (makes them victims.) One of the things that opiate users, particularly IV drug users, fear desperately are withdrawals. Withdrawal is very painful, it is very prolonged. So that is the element of coercion: “If you don’t do X,Y and Z then you’re not going to get the drug.” So that is trafficking.

NNYB: The heroin epidemic in Jefferson, Lewis and St. Lawrence counties is showing no signs of decreasing and, in fact, the ages of those suffering from addiction seems to be becoming younger. How is this younger demographic of addicts being addressed on the front lines?

Seefried-Brown: Yes, it is true that people who are opiate users are becoming younger and younger. About four years ago, the Alliance for Better Communities had the opportunity to write a grant through the Office of Alcohol and Substance Abuse Services and the grant’s title is “Partnership for Success.” That grant specifically addresses the issues with people ages 12 to 17 and 18 to 25. So we have created lots of outreach, lots of focus grouping, informational sessions, presentations geared toward that age group. We also survey individuals 18 to 25; the 12 to 17 in the prevention needs assessment. The 18 to 25 are under the young adult survey. So we had to get really creative, and we were quite successful with that, but we want to have at least 500 returns. We are looking into Snap Squares, creating those things, because that is apparently what that particular age group is using more than Foursquares, which is supposed to be for the older crowd. So we are addressing every age group in Jefferson County in bringing community education awareness regarding this topic. In the schools, young people are educated via evidence-based, outcome measurable curricula. That is wonderful and we certainly have a part in helping choose which curriculum is the best way of reaching kids.

NNYB: Heroin addiction appears to cross all age ranges, but is there an age group that is particularly susceptible?

Seefried-Brown: What we have found is that, again the data comes from the prevention needs assessment survey, young people – so the seventh through twelfth graders – but particularly starting in ninth grade they will begin to dabble with prescription medications that were not prescribed to them. Then, we ask in a follow-up anecdotal survey “How do you get these medications that are not prescribed to you?” They say, number one, is from their home; out of the medicine cabinet or from the kitchen counter. The second one is from grandparents and the third one is from friends’ homes. So kids begin to dabble quite early, but it is very, very, very little heroin use and very, very, very little intravenous drug use. However, what we also note is that between ages 18 and 25, that explodes. The individuals most susceptible are really people in their 20s to maybe 40s because, particularly, if they are working maybe construction, which is big in our area, if they’re working in the lumber industry, which we also have, or if they’re working in the paper mill industry, or basically any other industry, where they can get physically hurt and then get prescriptions for opiate-based pain medication. The health care system is really beginning to temper the amounts of prescriptions that they write as well as the number of pills they prescribe per prescription. So I-STOP came around in September 2016, which was a law that helps to prevent two issues. Number one, the overprescribing by physicians, as well as the doctor shopping by patients.  Because now, the physicians’ offices and the pharmacies communicate. If you had your prescription refilled 20 days ago you should still have 10 days’ worth of prescription. And then, of course, we have the elderly. That’s something we often don’t talk about, that the elderly receive prescription medications, opiate-based medications and, of course, often times senior citizens have multiple prescriptions.  If these multiple prescriptions begin to interact with narcotics and with the diminished capacity to metabolize prescription medications, then that can spell real trouble. But the peak of our overdose deaths really is in the 25 to up to 40ish age category.

NNYB: What is the first, or most essential, step in addiction recovery?

Seefried-Brown: To recognize that you have a problem. It is essential for the individual to say that. And how can I arrest this disease I’m suffering from? And, make no mistake; addiction is a chronic and relapsing brain disease. People have various points of entry. They can call the Anchor Recovery Center, they can call Pivot, they can call the alliance, they can go to any AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) meeting. There are numerous ways. People can go online, Google “NA meetings” or “AA meetings” and a whole bunch of different things will come up. But the most essential thing is: “I’m ready. I’m ready; I can’t do this anymore.”

NNYB: Do you ever come across addicts who simply refuse any help?

Seefried-Brown: It is not really refusing help if they are not ready. We meet our clients where they are. So, they’re not ready to go to treatment yet, and oftentimes people in their mind have very logical reasons as to why: “Well, I have kids at home, and who’s going to take care of them? I have a job; I don’t want to lose my job, then I cannot take care of my children.” That is all true and that is very difficult. But in the final analysis, that person could be hit by a car or could have a heart attack and would have to be hospitalized for a certain period of time. That person would go to the hospital and would receive, and hopefully welcome, the help they are about to receive. With addiction, it’s that back door open. And when they’re not ready, it’s “Hey, when you want to come back, you know where I live. Give me a jingle.”

NNYB: Do the success stories outweigh the bad outcomes?

Seefried-Brown: Well, if you talk about individual outcomes, that’s one thing. If you’re talking about the most egregious outcome, which is of course the death, Jefferson County has been extremely successful in lowering the overdose death rate. There are many reasons for that. It is wonderful cooperation and collaboration across agency lines. We have the Anchor Recovery Center   which is an absolute blessing for this county – where, again, people will be met where they are. If they want to go inpatient, we will find them inpatient, or rather the Anchor Recovery Center will find them a bed. If they need to go to an outpatient facility, they will help them. If the waiting list is long, they will “bridge” them during that waiting time. Absolutely it’s a blessing. The wonderful thing about working with the coalition really is the cooperation from all these different sectors. The media, to help us get the word out. The business community, to be vigilant and give people a second chance, or a third, or a fourth or a fifth. The health care system, which is always open to looking at new data. I could go on and on.

NNYB: How did you first become interested in counseling?

Seefried-Brown: Well, 24 years ago, and this is how long I have worked at Pivot, I needed a job. Okay? Any job. I had small children; I needed a job. Due to a family situation I was dealing with at that time, working in the addiction field was just a perfect fit. I enjoyed prevention education, I enjoyed working with the kids; kids of all ages, kindergarten through twelfth grade. Kindergarten in particular, because I was the puppet show master. Just putting that as an aside. Then, the opportunity arose to work on a community level and I just found my niche. In 2004, we applied for a Drug-Free Communities grant and we were provided the funding. In 2014, we applied again and were provided the funding. I just love, love, what I do. I love to work with the people and I don’t care if it’s a person of the highest standing in the community or a person with track marks running down their arms, or a person who is three hours into recovery. I love to work with individuals because I know that what we as a coalition do saves lives, improves the lives of the individuals and it helps our community to be safe and much more prosperous.

NNYB: What drives your passion for helping addicts?

Seefried-Brown: I have worked in this business for a very, very long time. And I’m kind of hesitant to say my passion has increased since a very personal family tragedy. Because then people might say, “Well, she’s passionate because her son died of an overdose.” And that’s simply not true. I have been passionate about working with people, for people, alongside people for 24 years. Yes, the fact that my own child died certainly has given me an increased understanding of the struggles he had, the struggles we had as a family and I can relate on a very personal level to the individuals who themselves are struggling with addiction, and to the family members of individuals who are struggling with addictions.

NNYB: Do you find that others in the community, those who have not had to deal with addiction firsthand, are as willing to stand and advocate?

Seefried-Brown: I would say, number one, the people most interested in advocating and being outspoken about issues of addiction are people who are directly or indirectly affected by addiction. Having said that, I would like to challenge anybody who doesn’t – even if their family has not struggled with this issue – I challenge anyone, anyone, to point to anybody who does not have a friend whose family hasn’t struggled, who does not know a fellow parishioner of a house of worship who has not struggled, who doesn’t have a colleague whose family has not struggled. With this prevailing epidemic, with all the deaths we’ve had, over the past number of years, there really isn’t anybody who is not affected, be it second-degree, third-degree, fourth-degree, fifth-degree. That is our job, then, to educate the community members who may not have that painful, direct experience. To educate them and say, “Look, when you express a stigma, or when you express a negativity about a family member who is struggling, or a person who is struggling, you really contribute, unknowingly and unwittingly and without malice, but you are contributing to that individual not to seek help as promptly as they could because of shame. You’re contributing in a small part to a family not to reach out because they are ashamed, because they’re guilty, they are afraid of judgment, and you don’t want to be that person.”

NNYB: Do you have a sense of why people start using heroin, or any dangerous drug, in the first place?

Seefried-Brown: It really is a progression of things. We have plenty of data to substantiate it here from Jefferson County. We have plenty of New York state and we have plenty of national data that substantiates that young people who start their drug using period at a very young age (are at greater risk.) It usually is alcohol, it usually is followed perhaps by tobacco.  Nowadays it’s more the e-cigarettes, the vaping, followed perhaps by marijuana use; particularly in this time and day, where marijuana use is looked upon as a risk-free, recreational endeavor.  I’m here to say, it is not. So, young people who are risk friendly, who are kind of adrenaline junkies, who begin to develop very positive relationships with substances at a very early age, are at much higher risk to use the “harder” drugs. One of the things that really continues to drive the opiate epidemic is kind of two- or threefold. Number one, when the I-Stop came in, it curtailed the number of prescriptions and the number of dosages that could be prescribed at any one time. People who never thought of themselves as having an addiction, when they didn’t get the prescription filled when they prematurely ran out – not all but some – learned the hard way that they are, in fact, addicted to a substance. Some of those individuals then went to the illegal market and purchased heroin, which was much, much cheaper on the black market, like 10 bucks, maybe 12 to 15 bucks for a baggie versus 10 dollars per milligram of an oxycodone. You get the same bang for much, much less. It’s a confluence of unfortunate circumstances, really.

NNYB: What is the most challenging aspect of your job personally?

Seefried-Brown: Personally, to keep all the balls in the air. To stay in constant communication with individuals and help, and assist and guide individuals who are not doing this kind of work in doing this kind of work. It is challenging and it’s also a tremendous amount of fun. It is incredibly satisfying. It is challenging, it’s incredibly rewarding and, above all, it is fun.

NNYB: Have you seen any significant changes over your career in the way drug addicts are treated? Has the stigma surrounding drug addicts changed over the last few years?

Seefried-Brown: It is changing and there’s always room for improvement. The more we get out into the community, into various sectors, into business communities, into the school communities, as well as health care, and really talk about, “This is a brain disease.” And we liken it to any other relapsing and chronic disease such as asthma, heart disease and so forth. We don’t want to put stigma on people with heart attacks, we don’t want people to feel compelled to watch an overweight person’s blood pressure and watch how much they eat, what kind of food they put on their plate. Those are personal choices. We don’t want people to feel pilloried about something that is very difficult to manage, such as chronic and relapsing diseases, of which addiction is one.

NNYB: How can the community, or just an average person, help in the battle against addiction?

Seefried-Brown: I’ll be happy to tell. Everybody in this community has gifts and talents. Whether that is writing a newsletter, helping write a blog, maybe transporting an individual from point A to point B, being a volunteer for the alliance, being a member of the alliance, being a volunteer for the Anchor Recovery Center, being a peer coach for the Anchor Recovery Center. Give us a call; I have a whole plethora. You can pick and choose.

NNYB: What changes have you seen in the community since the Alliance for Better Communities was created?

Seefried-Brown: People are becoming much more aware of the opiate epidemic, what that means in terms of the human cost, what that means for everybody’s safety, because where there’s an opiate epidemic there are dealers and there is criminality. In conversations with our district attorney we have learned that the number of pretty serious crimes has significantly increased. People are becoming much more aware. As people become more aware that safety is an issue, they also are becoming much more aware of the connection between drug crises, criminality and being more open-minded, reducing the stigma and helping people to getting people to where they need to go. And also, being very welcoming when individuals are released from rehab facilities or individuals come out of jail or come out of prison. On that one, we still have quite a ways to go. But we’re working on it. It’s a work in progress. This didn’t just happen overnight and we cannot fully address it overnight, either. But we’re making inroads.

NNYB: How do you see the partnerships and battle against addiction developing over the next five years? Where would you like to see things in the next five years?

Seefried-Brown: The Alliance for Better Communities is going to apply for another five-year grant to continue with grant funding. Even if the alliance is not re-funded, we are looking towards sustainability. What do we want to sustain? We have created incredible partnerships. We have gotten the word out that every person who is struggling with addiction is also probably a traumatized person. Probably there was some significant trauma in that person’s childhood  and it should give everyone pause to say, “You know what? I can be a part, in small ways, to contributing to the betterment of each individual.” But back to the sustainability. What do we want to sustain? We want to sustain our partnerships, we want to sustain the capacity of gathering data on an ongoing basis and, eventually, when everything falls into place, become our own 501(c)(3).

NNYB: Do you feel that there are enough resources both medically and non-medically available for those suffering from addiction?

Seefried-Brown: The answer is a cautious: The situation for people looking for treatment has increased significantly. The CREDO Community Center has gotten permission from the Office of Alcohol and Substance Abuse Services to implement its intensive opiate program. It offers suboxone, it offers methadone treatment, which is absolutely fabulous. We have the Anchor Recovery Center, which is of course a blessing. What we’re really struggling with, and is an enormous, enormous barrier, for people with addiction – particularly with opiate addiction – to enter treatment and to stay alive, is the really limited access to detox. And that has to change. That has to change. The sheriff’s department, under the leadership of Sheriff Colleen O’Neill, has been wonderful in getting grants; the latest one a $146,000 from (Senator) Patty Ritchie to provide addiction education and training to the jail population. She has implemented the Rivotril program. Rivotril is a 30-day, injectable substance which basically lowers, or diminishes, the craving for opiates and that medication is made available to inmates who are about to be released back into the community. Because if there is no drive use this drug, if there is no craving to use this drug, and if a coach is immediately available to take this person in the morning, from six o’clock when inmates are released in a timely manner to CREDO and get them hooked up with care through the inpatient or outpatient, either through CREDO or Samaritan Medical’s Behavioral Health Services (there is less chance of relapse.). We can help save lives.

NNYB: How has your involvement with this coalition and the battle against addiction changed you and your perception of the crisis?

Seefried-Brown: The way it has changed me is, and I don’t know if everybody would agree with it, but I feel that I am a much more open-minded, much more compassionate person. My willingness and ability and capacity to meet every person at face value, without judgment, without stigma; that, I truly believe, has been the biggest blessing of working with the alliance.

 

~Interview conducted by Holly C. Boname. Edited for clarity and length to fit this space.