Changing the Conversation

Hello old friend. We're here in this most beautiful and familiar place, you and I, sharing a quiet moment together in the yard. For 15 years, we've been sitting with each other, side by side. I've stroked your now fully-greyed head every day, and still it rises in anticipation of each new soft caress of my hand. You're close to leaving, I know. You're preparing me—in the most loving and compassionate ways—and as usual, putting to rest for me any argument about the intelligence of your species. I know you know, and I know you understand all the things I must now do for you to keep you safe, comfortable, and happy until you tell me it's time.

As I sit here with you, I'm taken back to our first meeting. You were a tiny thing, terrified of the noise and bizarre surroundings of the animal shelter. I know this terror, I have spent time in similar places, and our shared lived experience of this trauma bound us instantly. I saw you, your eyes met mine, and instantly, we knew…kindred spirits. Remember when the lady asked us if we needed time to "bond" before you went home with me? Oh, how we silently laughed as I told her, "We've already taken care of that."

Once a person is assigned a stigmatizing label, they are often seen as “less than” and in need of fixing for the remainder of their lives. Members of the larger society often see individual recovery as only partially effective or non-existent. These erroneous conclusions do not go away--no matter how successful or how accomplished the individual may be. These views can be mitigated by the inclusion of peer providers in various key roles.

Peer providers help employers, colleagues, other peers, and services users by example. They use their recovery experiences to make systems of care more focused on the needs of individuals. Peer providers increase the effectiveness of efforts to eliminate stigma in medical and behavioral health care settings.

Why a Public Health Approach? There are many reasons to learn about the impact of trauma and untreated trauma on individuals, families, and communities. Trauma and untreated trauma are common in all socioeconomic groups and are often misunderstood. For example, people experiencing opioid addiction, other substance use conditions, mental illness, and homelessness may shy away from treatment because of stigma in communities and treatment settings.

The symptoms of trauma and its under-treatment are evident more and more everyday. Early childhood and adult trauma are implicated in the onset of addictions and the comorbidity of post-traumatic stress disorders and mood-related psychopathology.

I’ve listened to the words of my friends, family members, and colleagues long enough to know that without the stability of a safe and healthy place to live--and the support of people around you--long term recovery from a substance use disorder can be illusive. With what we know about the changes in brain chemistry in response to alcohol and other drugs, it’s not surprising that when people leave treatment and go back to the same environments where they were using substances, reoccurrence happens more often than not.