Supporting College Students in Recovery

Rich Lucey:  Hi, folks. This is Rich Lucey, Senior Prevention Program Manager in the Drug Enforcement Administration's Community Outreach and Prevention Support Section, and welcome to this episode of Prevention Profiles: Take Five. I'm going to preface this episode with a little bit of information for our listeners.

So National Recovery Month, which started in 1989, is a national observance held every September to promote and support new evidence-based treatment and recovery practices, the nation's strong and proud recovery community and the dedication of service providers and communities who make recovery in all its forms possible. In recognition of Recovery Month, we're focusing this episode on issues related to supporting college students in recovery or who may be having problems with alcohol or other drugs. 

And I'm thrilled to have on this episode, two folks from UMass Amherst. One is a repeat guest, a longtime friend and colleague, Diane Fedorchak, being joined by her colleague, I've met virtually now for the first time, Tommy Claire.

Let me tell you a little bit about Di and Tommy before we get into the interview. So Diana Fedorchak has worked in alcohol and other drug misuse prevention and intervention for more than 20 years at UMass Amherst. She was part of the original team that implemented the Basics program in 2005 and has served as the program director until now. Diane established the Fresh and Sober program in 2003, supporting students in or seeking recovery, which is now UMass Recovery. Diane is an experienced trainer and facilitator specializing in Basics SBIRT, otherwise known as screening, brief intervention, referral to treatment, motivational interviewing and recovery.

Tommy Claire currently serves as a health promotion specialist at the University of Massachusetts Amherst. He has worked in alcohol, cannabis and other drug education for more than 10 years and has engaged various communities to learn from Canada's dispensaries, state regulatory bodies, parents and consumers of all ages and backgrounds. He has consulted for the Centre for Addiction and Recovery, Smith Colleges Summer Excellence Program and Amherst Regional high School's cross-country team. Tommy has presented at national conferences for higher education, being recognized for his cutting-edge program design in the field of college help.

And with that, Diana and Tommy welcome to the podcast.

Diane Fedorchak:  Thanks.

Tommy Claire:  Thank you, Rich, glad to be here.

Rich Lucey:  Glad to have both of you here to...yeah, absolutely, and talk about a really important issue. It's an important part of the whole continuum of, you know, starting with health promotion and prevention right on through to treatment and ultimately, recovery. So in honor of Recovery Month, I'm really pleased to have the both of you here to talk about, you know, what this recovery movement and stance and just place looks like on college campuses and even in their surrounding communities. 

So, Diana, I am going to start with you. I think the last time you were on the podcast was at least three years ago, and we certainly know a lot has happened in those three years. We're actually going to get a little bit into that.

But let me start. You are very open about being a person in long term recovery from addiction and what that means to you. Over the past few years, the recovery movement really has seemed to take hold on college campuses, certainly with collegiate recovery programs, collegiate recovery communities. Why do you think that is?

Diane Fedorchak:  Rich, thanks so much for having us both on, and that's such a great question and I know it has been -- it has been a minute, hasn't it? And a lot's happened in those couple, in just those couple of years, which seems like a lifetime crammed into three years. You know, yeah, the momentum for recovery programs and collegiate recovery programs has really been building for quite some time. I mean, we got to really, you know, pay homage and thanks to the Lisa Lightman's and the Kitty Harris's and the Patrice Salmeri's, I mean, they've really paved the way and were at it way, way before the 2000's, and, you know, were really, were really doing the work.

And somebody that's not really known on the national scene but is really known in this area here, who is also doing that work a long time, along with Lisa, Kitty, and Patrice's is Susan McCarthy, who is doing the work here at Mount Holyoke College and was supporting students in recovery and really built a strong, strong program there.

And those are the people that I learned from. And what I found was that, you know, I got into the field and then, like a long time, like professionally, in 2003 and there was there was some of this work was taking place, but that momentum was just starting to kind of grab hold. And really, it wasn't being spoken a lot at the national level and at our conferences and stuff.

It was like tiny and underground a little bit and I got to tell you, Rich, I really felt the momentum, I cannot remember what meeting it was and it might have been one of the last national meetings that we had and it was the Obama era and tried searching to see who it was. But we had a speaker at the national meeting who stood up at the podium and said that they were a person in long term recovery and they were a President Obama appointee. And I got to tell you, from that moment on, I watched people in that audience straighten up and sit up taller in their chairs and from then, it was, I started seeing, hearing people at that conference be like wait, I'm in long term recovery.

We're allowed to say that? Wait, I'm in long term recovery too. And that really shifted things in the mid 2000's and that really continued and built on the past work that was already done.

And then there was some grand money available. So, like Kitty was able to, from Texas Tech, was able to put out a whole curriculum from some national grant funding that she got and was able to like, bring her work more to the forefront and bring it to us practitioners, kind of like, who were kind of figuring out how do we do this? Like, who do I talk to? Who do I, who do I do this from? And then some money started becoming available and I think it was like it's that slow momentum.

And then well, in collegian health and anything, right, it just like takes so long to build that momentum. And I think, because the money has been available and because we've been able to come out of the shadows a little bit and people have been able to more publicly say, hey, I'm in long term recovery and we've been able to identify, hey, we have students in recovery.

How do we support them? We have students who are being completely held back, and their life being impacted by their substance use. And how do we support them and help them find another way and recover? Whatever that means to them.

So I really think all of those factors coming together is really what is bringing this momentum forward. And just that, you know, the balls slowly been rolling and then when you see another university, hey, let me try this and let me see what this program means for me at my school and then we start having conference presentations. Wait, I could do this and I could pick up this piece and I could do that piece and wait, we don't have, we don't have to have like recovery housing for everybody? We could just have a meeting on-campus? That's where we could start? Oh, all of a sudden, we see it becomes more and more accessible as it became more and more destigmatized to say, I'm in long term recovery and hey, let's, we can talk about this on college campuses.

So the stigmas, the de-stigmatation or however you would say that word, if you were to say it, I think it's really perpetuated these programs to the place where they are now, which is still needed to do more work, but momentum growing.

Rich Lucey:  We're definitely going to talk a little bit about stigma later on, but a little bit to unpack on what you talked about. So first of all, it was, you know, great to hear the names that you mentioned, Lisa and Kitty and Patrice, because wow, that just put me on a speed trip down memory lane. You know, it was interesting when I started my career working for the State of New York and back in 1991, you know. 

So I've been in this field 31 years this year. It was interesting, you know, when I was overseeing New York State's collegiate efforts. You know, we used the term "aftercare." I don't even think that that's a term that we use anymore.

But, you know, I was in the Prevention Bureau, but even then, we were concerned, rightfully concerned about the whole spectrum, the continuum, if you will, of prevention, intervention, treatment. We rarely used the word "recovery" then. It was prevention, intervention and treatment.

But it was interesting that, you know, we were concerned about the risks of students who were in treatment, who were returning to campus from treatment. And, you know, what were the aftercare services that, you know, colleges had in place because that created a risky environment, obviously, you know, for students for not having that.

Interesting that you mentioned, though I believe you were probably referring to Michael Botticelli, the former Director of the Office of National Drug Control Policy. Certainly, yeah, he was the director of ONDCP, Michael, very open about his journey in recovery. And yeah, and you know, it's interesting that we get a lot of the firsts, you know, with the high profile, you know names, doesn't have to be in government, can be in sports, can be in business, can be, you know, education, but you know, whenever there's, you know, ground-breaking you know, and he was a groundbreaking individual in that regard. Because I think, as you said, you know, I try not to walk on eggshells when I do these interviews.

But you know, always be careful that we don't want to, you know, use words that are not appropriate, but it was almost as if it was giving people permission, is a word I'm going to use, to be able to talk about their individual stories of, you know, addiction and recovery. So you know, thank you for bringing up, you know, the shoulders of giants, quite honestly, you know, between Rutgers, Le Moyne in New York certainly had substance-free housing. That was a way of talking about, you know, recovery in some regard, although we know there are many reasons people don't want to use and choose not to use alcohol or other drugs. And, you know, so I'm glad we're able to have this conversation.

And so, you know, Tommy, I want to bring you into it because I think this is a nice segue. Diana's kind of brought us up to this point with a little bit of the momentum that the recovery movement has had. And I've, you know, I've referenced this on previous episodes of podcast. We know that alcohol and drug use can tend to increase during stressful times or following a traumatic event. And I kiddingly, but in all seriousness, say when I talk about 2020, you know, you can't find an asterisk in a big enough font type, you know, or size for what 2020 meant. And yes, the pandemic was a big driver, but part of the traumatic trauma and stress people were feeling in 2020, let's not forget the civil unrest due to the reckoning of our nation in social, you know, social justice and racial injustice issues. We had, my characterization, the most contentious presidential election in our history. You know, all of that happened really starting in 2020 and we're feeling the effects of these things now, even two and a half years later. So we know, you know, drug use and alcohol use tends to go up during these types of events and trauma.

So in talking about, you know recovery, what has been some of the challenges around supporting students in recovery during the past two and a half years of the pandemic?  I know it's been extremely hard, Tommy.

Tommy Claire:  Yeah, Rich, thank you again for having me on. I feel honored to be here with both of you. Thank you, Di, for including me in this and I think that, you know, wow, you just laid the landscape pretty wide-open there for that question.

I think, you know, several things for me come to mind in terms of thinking about supporting students in recovery through the last several years. You know, it's, as you had already mentioned, you know, the kind of stress and trauma that is chronic and compounding overtime is obviously a huge risk factor for anybody in recovery, in need of recovery, anybody who is, you know, vulnerable in their substance use.

So I think just to not minimize that, which is, you know, what you did in terms of laying out the multiple, multiple layers of that. You know, I know students who families lost their income, and so now you have other layers of financial concern and you have students who are now trying to pick up more, more jobs more than one, you know, more than two, more than three and trying to figure out how to adapt their learning style.

You know, we're talking about people who are now pushed into essentially, online school for a year, who did not sign up to be in school online and so having to, you know, kind of face a whole different layer then of executive functioning to, you know, figure out different, you know, learning management systems.

And how do you navigate, you know, with this professor or that professor? Not to mention, you know, when you add in the social-political context of unpredictable elections, unpredictable violence, you know, I think that I really see the last several years as just really amplifying the cracks that were there in terms of where.

Where did we need more support in terms of guiding folks from, either from institutions back to higher education or for folks who needed to leave, you know, to seek higher levels of care? How were they supported and coming back? Those sorts of things have been just really clear and in technicolor for me in terms of where I see the challenges for students is, you know, take an already sort of complicated, mysterious process, depending on, you know, whether that's navigating, higher ed or navigating, you know, what some of those levels of care might look like.

And then, you know, throw everybody out onto, you know, just uneven territory uneven ground and try and say okay, now figure it out. So for me I've really thought about, you know, how to just stick with the basics, no pun intended, Di.

But to really stick with the importance of that relationship, you know, reaching out to people on purpose, you know, just staying connected even over the summer. You know, we offered recovery support over the summer this year for folks who are in the area and even folks who weren't in the area, just to say we're still here. You know, I think anytime you're offering some kind of grounding for folks, whether that is, you know, they know that they're coming into an institution where their support service is or they're already there and they're navigating the summer and all the transition. You know, I think just being a presence has been something I've been thinking about to meet some of those challenges.

And, you know, another layer, and I'll be brief, is to say that they're, having some attention on helping the helpers.

You know, I think, that folks who are supporting anybody in recovery right now, you know, if you have kids, if you don't, I mean there's just been so much added stress as well to the helpers, that is just another layer of something that I've been thinking about. The importance for me of, you know, not losing track of my self-care. I know that word gets used a lot, but I mean it sincerely that if I don't have something to offer, if I can't be there for somebody, then that there's a real impact there.

Rich Lucey:  Tommy, I'm so glad you brought up the issue of self-care because no matter where you are in the profession, along the continuum, prevention, intervention, treatment, recovery, you know, the helper. I love the way you phrased "to help the helpers." We are no good to the people we are helping to serve if we ourselves are not taking care, doing what we need to do. You know, as nurturers, which is a lot of what we do in prevention. We're nurturers. We want to ensure that, you know, we are at our best and, you know, we do that through self-care.

And I'm sticking with you, Tommy, for a minute. And Diane, please chime in, because I know you and I have talked about this early on in the pandemic. So, for example, early on in the pandemic, when schools were shutting down, workplaces were shutting down, you know, everything was shutting down and people were now, everything was going to happen within the home setting typically. And, you know, we know that for people in recovery, they rely on that interpersonal support network.

And certainly, you know, on a campus any campus, quite honestly, you know, when you have a collegiate recovery program, whether it's formally called that or not, and all of a sudden the students are gone, you know, that support network is really, you know, without being overly dramatic about it, it's ripped out from underneath them. You know, the net, you know, we used to call it the safety net, right, it is kind of gone, you know.

You know, I know there were campuses where professionals were actually calling students at their homes or on their cellphones just to check-in and make sure that they were doing okay. With that, I'll start with you and then, Diane, go to you. Was that your experience with the students that you interacted with regularly at UMass Amherst?

Tommy Claire:  Oh absolutely, I mean, you know, I work with students in a variety of capacities and that was definitely first and foremost on my radar was, you know, we didn't know, there was so much, we didn't know. So half of their semester was interrupted, you know, thrown upside-down so to speak. But for the students who were really kind of, hate to say it, but sort of on the edge of like, they were, they were making do, but were really vulnerable.

And, you know, I, it's actually, you know, it brings up feelings for me to think about some of those students now because I did reach out and some of them had, have ultimately, you know, left the university or were meeting and having some additional care. But also, you know, the institutions were doing the best that they could, absolutely.

But in the early COVID, you know, even just the periods of quarantine and isolation, you know, I talked to students who had just an incredibly hard time in those situations, you know, being in a facility where they were like very literally cut-off. And so unfortunately, at a certain point, you know, lost track of where some of those folks were at, but you couldn't have made it, I mean, I don't think there was any way to be overly dramatic about it. I think it really was ripping the rug out right from under a lot of folks.

Rich Lucey:  And, you know, I just call it the way it is, because, you know, looking in the rearview mirror and hindsight is even keener than 20/20 sometimes, for all of us. I'm just blunt about it. We were making it up as we were going along.

We didn't know how to, you know, go virtual or to provide services and being working from home, and now you have to deal with ring lights and take yourself off mute and the cat's taken a bath behind me and the dogs barking near me and people are walking behind. I mean, we all, we kind of laugh at it now and I'm that way, you know, whenever I've got people on Zoom calls now. I'm like, you know, if I see people and pets, I'm good with it because it's just, you know, we're human, right?

But, you know, Diane, I come to you because, if I remember correctly, I think you were one of those people who also were making phone calls to students and doing the check-in. Is that your recollection from a couple of years ago, early on in this pandemic?

Diane Fedorchak:  Yeah, I mean, we were doing the phone calls, we were doing the emails, it was checking in. We put up some online 12 step meetings and stuff and we like put formats in Google drive and figured out how to do all that and share all that. And, you know, it was hard to get them to show up because like, it was hard enough for me to show up to my couch to work while my kids jumping on top of me and everyone needing attention and stuff.

So it was hard for them to show up. So where some of them needed that 12 set meeting and needed that connection, and they wanted that connection, it was just so hard to show up, you know. So and we did reach out and there was some students I was able to maintain some connection throughout and it was a challenge. And, you know, hopefully, if nothing else, though, students knew we were here, you know, by Tommy's efforts and reaching out, like knowing that, like somebody cared and we can't underestimate what that is.

Rich Lucey:  Exactly.

Diane Fedorchak:  Even if I weren't able, like there were people I couldn't reach back out to. But wow, did it feel good to be like, okay they're there. I'm just going to keep holding on, you know. So it's good to know, like looking in that rearview mirror, like we would do the same, right.

We would do the best we could and reach out and at least let students know we were there and know that we didn't fail if they didn't connect back up with us, right, like having some compassion for what they were going through.

And gosh, those were, they were, they were hard times and some of it was also protective for some of them, right, because they're like home, some of them, you know, and for some of them that was really hopeful to be in that container and for others they found ways to, you know, not getting the support they were used to was detrimental. So it just, you know.

Rich Lucey:  Well, we talk about risk factors. We also know that whether a student was in long term recovery or we know even earlier than that, they're struggling. You know, with the pandemic, if they're going back home into an environment, you know, where alcohol and other drug use is a significant concern, that's, you know, again, one more, you know, school was, as we said it already, school was the safe haven; it was the safety net, if you will, the safe place.

And now, all of a sudden, you know, they no longer had that. And so, you know, we, I know, appreciate all the professionals around the country, on campuses and in the communities, who were doing the work that you both were doing to reach out and stay connected with the students the best that you could.

Again, we always, I think, beat ourselves up, feeling like we're not doing enough and I think we can always say that. But we were doing the best that we could, you know, under the circumstances. You know, I want to shift gears for a little bit, talk a little bit about a programming aspect. And, Diane, I'll, let me ask the question, and you can decide whether you want to start, if you want Tommy to start.

But I'm starting with you just because you're such a proponent of the strategic prevention framework as I am; you live and breathe it in the work that you do. And we know the importance of strategic planning in preventing drug use among college students, such as using the SPF as we call it.

And one of the SPF's steps is centered around capacity building, which I know your campus has been quite intentional about.

What has UMass Amherst worked on to build capacity in both the prevention and the recovery spaces? We know SPIF can apply to no matter what you're working on, and yeah, it's right in the name, you know, Strategic Prevention Framework, you know. Tell me a little bit about the capacity building you've been doing around recovery there at UMass Amherst.

Diane Fedorchak:  Well, I'll start and I'll toss it to Tommy because Rich, I was really, it really sat with me when, earlier this summer or the end of the fall, at a conference, you had, you were presenting and you asked people in virtual land like I was in the present land, and how many of you like just, substance use, substance use prevention, intervention, wherever you are [inaudible] is your only role, you know. And like, it's so not people's only roles.

And that was, it really stood out to me in the way that you asked that question and, you know, the way that it was affirmed that, wow, we have so much work in this field to do, in capacity. And capacity-building, because it's about like one person is expected to do all of this work.

And, you know, that's a little bit about what happened UMass Amherst and some things I've shifted and changed and what not, and we've gone through some different ebbs and flows where more time and attention has been able to be dedicated towards supporting students in recovery and not beyond the individual support. We always supported students individually.

But then it was like beyond that individual support, around creating that community, around creating visibility and more support and peer support and setting that structure up. We had ebbs and flows and then a recent, a couple of years and then the pandemic happens, right. So you got to like, get back on track there.

What lost, lost some of that and now last year and then now definitely into this year, really being rededicated into like, you know what?  What do we got to be clear off to make this a priority while doing other jobs, right?  Like, and how can we do that? Bring in some help of like some, this grad student work that we have like?  How can we finesse things a little bit to use our time a little bit differently?  You know, because we had some students who had some specialty experience in that area and then Tommy's real great thinking around doing some, doing some work, just having some low level things like let's feed them, you know, once, or...well I said "Tommy, let's have some luncheons once a month and just like throw some sandwiches on and see who comes."

You know, but Tommy's an overachiever, so he was like "sure, Di, I'll get that going. But we're going to do it like every other week and in the off weeks, we're going to have coffee hour."

And I'm like, "awesome," you know.

And that really got the capacity building because and I want to, I would just set Tommy up and then throw it over to him because, just want to just highlight, then Tommy's foresight in seeing like, oh yeah, there's some like undergrads who are, you know, really invested here. How can we like, maybe help get them some credits for doing the work which then really laid the groundwork for the capacity building that he was able to do so that it's not just him and I doing everything. So I'm going to throw that back over, so I'll set that up and let you take it from there, Tommy.

Tommy Claire:  Thanks, Di. I appreciate that. So my background is in public health and community health education and specifically, using models of community organizing. And so I have thought about a lot of this. You know, this idea of capacity building from an organizing perspective and trying to, you know, just basically facilitate opportunity for folks in the community and then utilize the mechanisms that are already in place at UMass.

So Di mentioned, you know, folks having an opportunity to develop professionally through internship credits, through practicum credits, which is more than just attending an event, right. It's actually thinking strategically, marketing, creating outreach material, you know, developing events and following up. And so we were able to use some of what was available through the sort of traditional channels at UMass to create some momentum to build that capacity. Because, you know, I think, capacity, how do you ever measure, you know, this is the sort of classic question right.

How do you measure what doesn't happen? How do you measure the impact you had on somebody who never even showed up to one of the events? But it mattered because they saw the sign. And you know, I will say, we had 32 events last semester, counting everything; lunches, coffees, all recovery meetings, hikes, fires, celebratory lunches to mark milestones. We just went all-in and it was less concerning to me about how many people do we have at each thing, yada, yada, yada, and I will say we average five to 10 at each thing.

So, but it was more about the, you know, at each event we had someone new coming in and someone knew not always at the, in the same relationship with recovery, for example. One person had lost their brother to an overdose, one person wasn't quite sure why they were there. They, you know, were kind of dipping a toe in and other folks who had been in recovery since high school.

But that didn't resonate when they were coming to campus or they didn't see the community yet. So they were lots of different people who were being touched by just having the opportunity. And that, to me, is the real, the potential of capacity building. And now we've been able to scale even more into a paid position. Again, each layer, each level adding more responsibility for those folks, right.

So now we have the opportunity to have a dedicated space for events, whereas before we were kind of, you know, getting a room wherever we could. So that is, it's just really exciting to me. Because of that, like the different layers of capacity, not just the events but also the staffing model, we are able to do personal phone calls, emails, texts, to an ever-growing contact sheet.

And so there's, and I, you know, I think that's another way where that person may never get back in touch with us or come to an event.

But again, they know that we're there and that has, what I would think of as an immeasurable impact. And yeah, so I feel really grateful and I want to give a shadow to Aden, who's undergraduate, who came back, who had to withdraw due to substance use disorder, you know, went through a rehab facility and came back and has, you know, spearheaded a lot of the work that we've been able to do, including the Instagram page, shameless plug @UMassRecovery, really great work that he's done there. And that's another layer, right, of capacity, even the folks that we're meeting, meeting and reaching on social media.

Rich Lucey:  And we'll be sure to capture UMassRecovery in the show notes. So it will definitely be part of the transcript and, you know, whenever we talk about capacity building, I know for as long as I've been doing this, I think people go immediately to the money. You know, that money is capacity.

But I think, Tommy, in listening to you, it was much more about another part capacity, which is the people. And, you know, the money can come later. Having, you know, the people connected and helping explain, you know, what their role might be in the efforts that you're doing there or for those who need the services, it's, you know, what services are to provide.

And you touched on something that has been a significant issue in the prevention field for the longest time, which is the struggle we've had to prove, you know, that what we do works. And, you know, I think you said it is that for people who simply know there is a place to go for support. You know, if the, if there's, you know, we talked earlier about, you know, being on the cusp of, you know, just holding on. You know, we know.

Let's not forget that, you know, recovery is a long term process. You know, so, for an individual who may be at peril of a relapse, you know, they need to know that there is a support mechanism, you know, for them and that may be the only time that that person retouches your program or your efforts, your services, right. And that's really kind of an immeasurable count, is like, yeah, I think, Tommy, you had said it. You know, where are we going to include that person in the numbers, right?  I mean, if that's what's so hard sometimes about the work that we do.

And yet that doesn't let us off the hook. We do have to continue to be accountable and continue to strive for showing, you know, that our efforts, you know, are effective.

But I really appreciated what you've said around, you know, it's really the capacity has been more around the people involved in building capacity around people. And let's not forget, food brings people together. So whether it's coffee or whether it's a sandwich, you know.

But of course, I do want to go back to Tommy and ask you the question; you mentioned fires. I wanted to hear what that was all about. You mentioned, I was thinking, I know we're not setting fires. What are we doing here? Are we talking of bonfires? What are we talking here? Let's find out right now.

Tommy Claire:  Think more of like a camp side fire, right, right.

Rich Lucey:  There we go, yeah, yeah, yeah, got it.

Tommy Claire:  Yeah, no, definitely not, yeah, just more informal and actually getting an opportunity to do some events, you know, off-campus as well. So having some camp side fires, and that has been just incredible, even folks informally gathered, you know, at the river over the summer to be together. And so yeah, there's, I think for me my mind set is just get out of the way, like if I can create mechanisms and opportunities and then get out of the way, people know how to, people know how to do this.

They, you know, I remember sitting down and doing some, like you know, planning meetings with Aden and he was like, "oh so you just want me to get in touch with people and plan it "and I was like, "oh yeah."

It's not, I'm making this so much harder than it has to be. I can just set folks up and set them free to go.

And yeah, I just, oh, I also want to give a shout out to Sandy Valentine at UConn for helping us out, thinking about other ways to build capacity. She developed with her students at UConn Allied, Recovery to Allied, Allies in Recovery Training Module.

So we were able to discuss ways of, you know, what does it mean to be a recovery-friendly campus and what does it mean to be an ally to somebody in recovery? And so she did some really pioneering, great work and we're adapting it, you know, to be campus specific here, but the idea is that's another way to build capacity, you know, again through just education and outreach, and but yeah, I really appreciated her time for that.

Rich Lucey:  Great. So I'm going to bring our next question around, let's ring it back to something that was mentioned earlier on. Both of you talked a bit about, a little bit about stigma. So Tommy, I'll stick with you. So first, although substances disorders are chronic and treatable medical conditions, studies do show people with these disorders still face discrimination and stigma that can affect their health and being in a number of ways. We know from research that language and the terms and the words that we use contribute to stigma and discrimination against people with substance use disorders, including by healthcare professionals, which, you know, you would think right.

But it's kind of, you know, both sides of a coin here. I want to ask Tommy and then I'll go to Di. You know, has there been any progress made in reducing stigma and what challenges remain?

Tommy Claire:  I think it's a great question. You know, you can't talk about the work that we're doing and not be addressing stigma in some capacity. And I think one of the other by-products of the capacity building is going right for stigma. You know, that Diane had already mentioned this. The more visible people in recovery are, the more willing folks are, you know, not only willing but that they are actually supported. That does its part to reduce stigma and certainly, were not there by any stretch of the imagination.

I think, you know, one conversation that I've had recently, it was like where, language is tricky and it changes and it's slippery, and then we don't want to be, you know, getting confused about like what is the intention or the essence behind the language. And so we talk about that, you know, there's I'm trying to be succinct, but there's a way that it's not helpful to think of someone as eternally broken, and I think that's a manifestation of stigma. And this is my own thinking about it, that, you know, part of my work, especially with students in recovery, is to really highlight the resilience of people in recovery and that the people who find abstinence, if that's what they want, are the people who keep trying and that is a real resilient characteristic.

So it's, I feel, like there's this like trajectory where there has been, there is more acceptance and people are more cognizant of language. And I think, you know, the opioid crisis itself has really brought into the forefront of people's minds the real impact that substance use disorder has at a different level even. And so I think that the folks in that field have really done a good job of, you know, bringing it into people's consciousness in why language matters, because it affects the way we treat people.

And then going to the next level, at least, you know, maybe it's a little under the surface, is this, you know, that next layer of challenge in my mind is to kind of address this idea of brokenness, that we're not broken and to not proceed as such.

But yeah, I think that the students that I've worked with, it's been really remarkable to be able to highlight and reflect back to them their resilience and to unpack that internalized stigma around it as well.

Rich Lucey:  Diane, where do you land on this?  Where do you think maybe successes have been in addressing stigma, but also what challenges remain?

Diane Fedorchak:  Yeah, Tommy spoke really well about the language and shifting in language and all and how people are treated based on the language that we use. So I'll just let that stay there.

I think too, some of the successes that we've had is around how we do bring SBIRT, Screening, Brief Intervention and Referral to Treatment into our training of our student nurses. And then, you know, through the medical profession. I mean, if somebody is, Rich, if they are our age or older, like, you know, our medical peerage, they haven't had that training and don't know how to really interact necessarily unless they've done some additional work.

But on a general whole, like there, there's been a lack of training in the medical field then and that has been shifting and changing in a really big, big way. So I'm really grateful to have been part of the College of Nursing and the SBIRT grants that we have been A part of for the last, oh, bunch of years now, like over six years or so, and really can, and training our nurses on how to have these conversations and beyond even substances like, how to have these difficult conversations about these big topics that are potentially difficult to have. So that's really excellent in shifting and what happens too, is we're training them for a career, they're also undergraduate college students.

So what happens is they have these skills and then the evaluation shows they're transferrable. They're talking to their roommates, they're talking to their family members, right? Like so the ripple effects of this are wide and whenever I'm doing these trainings, you know, I'm like, I need you out there in the field because like myself and my family are going to run into one of you out there. You know, and the ripple effects are wide. So they really, I feel like that has shifted in the medical profession too.

And really my soapbox that I'm going to get on all the time is about early, early, early, early, early intervention, like having these conversations early, doing the resiliency work early. I mean like pre-K kindergarten, first, second grade, helping our young people have feelings, right. How do we help our young people have appropriate feelings? How do we help them be mad when they are mad without punching each other, without hurting themselves? How do we help them be sad? Right? These are all substance abuse prevention work, right, like this is not to be taken lightly.

And then how do we have these conversations? Because guess what? They're talking about it. They are talking about in the second grade, right? Some of these kids have been impacted by the grown-ups in their lives' substance use. Like, we do them a disservice if we are not talking about that and supporting them in that. So having those conversations, doing that early intervention, doing and having them across our community, you know, so that's just totally my soapbox, that I'm on, which you need to break stigma for, right?

You need, because you need to be able to have those conversations and get rid of that stigma, which in one of, you know, Tommy was taking about capacity building, and some of that was also doing the recovery, coaching, training and doing that work as well that we're going to be doing at UMass as well. And in there, they were really unpacking the word stigma. And what's at the heart of stigma is really prejudice, right?

And you can kind of understand why people do have prejudice against people with a substance use disorder because it's about the behaviors that somebody displays when they're under the influence or trying to get their substance, right.

So we get confused about that. So there's so much, so much work and so much healing that needs to be done on all sides of the coin on that. So there is still a lot of work that needs to be done and a lot of forward progress motion has been made. So, like most things, I have two totally different answers for the same question on polar opposites.

But that's just what's true right like, yeah.

Rich Lucey:  Yeah. Well, I mean, I totally appreciate both of your perspectives on this very issue and as we wind down the interview, my final question is the question I ask of all the guests on the podcast and Tommy, I'm going to start with you.

So what is it that you want to say to encourage your peers, whether they're in the prevention space primarily, they're in the recovery space, you know, it really doesn't matter, because as Diane said, you know, rarely is the person only working on, in one particular area, but what is it you want to say to your peers who are listening to the podcast?

Tommy Claire:  I think, first and foremost, I would say trust your students, listen to them and keep going, that the work that you're doing matters. And, as is the way with work like this, whether it's education or healthcare, we don't always see the impact that we have, but that it does matter and to keep going and really, really trust the students and lift them up at every opportunity that you can.

Rich Lucey:  Thank you for that. Diane, what about you?

Diane Fedorchak:  Well said. I have a couple of things I'm thinking about. One is that, it's about, like I want to say, about accountability. We need to hold young people, old people, whatever, whatever people, we need to hold each other accountable, right. So how do we do that? And how do we hold our college students accountable with compassion?  Because a lot of our students during recovery, they needed to be held accountable in order to make some, come and work through some decision about where they are now, right. So holding students accountable matters and how we do it matters, and the interventions that we put in place also matters for accountability. So I just want to say that that is something that is really important and it could change the trajectory of a person's life. And it has, and we have hundreds of examples of how that is.

I also want to say that there are many pathways to recovery. There is no one way. So how do we create multiple doors for students to enter into?  How do we create multiple opportunities for students?  And Tommy said it so well too, around, providing different avenues for students to get involved and for some of our students like, like Aden, who Tommy was talking about, is very visible and is out there and is being a face of recovery and talking with his peers.

And what does that mean? And that is fantastic and they're going to be other students for whom that's not going to be their path.

So how do we create other opportunities for them to be as engaged, right, in a way that makes sense? So different paths of engagement and also different paths to recovery. What does that mean for each student? If it's working for them, it's working for them, right. So how do we get our agenda out of the way and support the student's path? And what that means?

And the last thing I think I want to say is that students in recovery, make amazing students. They make amazing human beings, but I mean, they make amazing students, like students in recovery  know how to talk, they know how to talk with each other, they know how to share, they show up for each other, they know how to give back. They know that by giving back like, that's how I'm keeping myself healthy and in check, is by giving back. You know, there's a practice of some mindfulness, there's some self-reflection that has to be done when, whatever path of recover you're taking, there has to be some path of self-reflection right, like all of these things not only make for good students, but good human beings too.

But I just, you know, so if we talk about, we talk about stigma on top of that right, like, let's get that stigma out here, because these students make, make amazing human beings and amazing, amazing, they're students, they're students who we want in our universities and, having heard some stories from other colleagues at other universities where they're challenged around addressing recovery because of, you know, the different stigmas that lie. I want those folks to know that these people make great, great students and great people and great community members.

So that's what I want to say.

Rich Lucey:  Thank you. Thank you both for your perspective, those parting words, you've been great guests. I've enjoyed having this conversation with both of you. Your takeaways, just in that last question that I have, so, you know, Diane, you mentioned many pathways to recovery. The phrase I've heard it put is that there's no wrong door, right? So you know, all doors can ultimately lead, you know, to successful recovery. And Tommy, what you said about trust your students. We know this, whether it's in the prevention space or the recovery space, the student voice is so important.

Let's not also forget, we've kind of been focusing on students, but there are plenty of individuals, whether they're administrators, faculty members, presidents, also are in the recovery space, and so this applies to them as well. And having that kind of support network, you know, on the campus and in the surrounding community is so very, very important. So you know, as part of National Recovery Month, I want to thank again, Di, you and Tommy for joining us on the podcast, sharing your perspective. I think there's some great takeaways for our listeners, so again, thank you very much.

Diane Fedorchak:  Thanks for having us, Rich.

Tommy Claire:  Thank you, Rich.

Rich Lucey:  Absolutely, and to our listeners, of course, we really appreciate you tuning in and listening to this and all of the episodes as part of the Prevention Profiles: Take Five. And with that, I'm going to say thanks for listening and have a great day.