May 1, 2025 • 50 mins
In this episode of Beyond Substance, hosts Dean Babcock and Jodi Miller explore the critical intersection of research, personal experience, and community support in addressing substance use and recovery. They engage with experts Dr. Brad Ray and Dr. Katrina "Kat" Thomas, who share insights on drug trends, the impact of overdose data, and the importance of empathy and education in combating stigma. The conversation emphasizes the need for harm reduction strategies, the role of naloxone, and the power of personal stories in fostering hope and resilience within communities.
Segment 1
Dr. Brad Ray is a Senior Researcher at RTI International with a PhD in Sociology and Anthropology who conducts research at the intersection of public health and public safety that is aimed at overdose prevention. His training includes multiple quantitative and qualitative methodologies, and he has been the principal investigator on grants from the National Institutes on Health, Centers for Disease Control and Prevention, the National Science Foundation, and the National Institute of Justice. He has conducted numerous randomized trials, integrated large statewide datasets to identify overdose touchpoints, and studied the implementation of multiple harm reduction strategies. Dr. Ray also oversees technical assistance to state governments to implement programming at the intersection of public health and public safety systems.
Segment 2
In this conversation, Dr. Katrina "Kat" Thomas shares her personal journey through substance use and recovery, highlighting the impact of trauma and the importance of seeking help. She discusses her transition from personal struggles to a professional career in counseling and advocacy, emphasizing the evolving landscape of substance use and the need for community support. Dr. Kat addresses the stigma surrounding addiction and the misconceptions that persist, ultimately encouraging listeners to seek reliable resources and never give up hope.
Takeaways
Chapters
00:00 Opening
01:55 Understanding Drug Trends and Overdose Data
04:58 The Role of Research in Public Health
10:03 The Impact of Drug Seizures on Overdoses
14:51 Innovative Approaches to Harm Reduction
19:55 Dispelling Myths About Substance Use
25:06 The Journey of Recovery and Resilience
30:07 Advocacy and the Power of Personal Experience
35:13 The Importance of Community Support
40:01 Looking Ahead: Future Conversations on Recovery
Hosted by Dean Babcock and Jodi Miller
Interview Segment Producer: Angela Shamblin
Personal Story Producer: Shawn P Neal
Executive Producer: Shawn P Neal
Mixed at AvoCast Studio236
#BeyondSubstance #SubstanceUseRecovery #HarmReduction #OpioidCrisis #NaloxoneSavesLives #FentanylAwareness #AddictionRecoveryStories #TraumaInformedCare #DrugPolicyReform #MentalHealthMatters #RecoveryIsPossible #PeerSupport #OverdosePrevention #RadicalEmpathy #StigmaFreeRecovery #PublicHealthResearch #CriminalJusticeReform #LivedExperienceMatters #IndianaRecovery #CommunityHealing #ShawnPNeal #AdvoCast
Segment 1
Dr. Brad Ray is a Senior Researcher at RTI International with a PhD in Sociology and Anthropology who conducts research at the intersection of public health and public safety that is aimed at overdose prevention. His training includes multiple quantitative and qualitative methodologies, and he has been the principal investigator on grants from the National Institutes on Health, Centers for Disease Control and Prevention, the National Science Foundation, and the National Institute of Justice. He has conducted numerous randomized trials, integrated large statewide datasets to identify overdose touchpoints, and studied the implementation of multiple harm reduction strategies. Dr. Ray also oversees technical assistance to state governments to implement programming at the intersection of public health and public safety systems.
Segment 2
In this conversation, Dr. Katrina "Kat" Thomas shares her personal journey through substance use and recovery, highlighting the impact of trauma and the importance of seeking help. She discusses her transition from personal struggles to a professional career in counseling and advocacy, emphasizing the evolving landscape of substance use and the need for community support. Dr. Kat addresses the stigma surrounding addiction and the misconceptions that persist, ultimately encouraging listeners to seek reliable resources and never give up hope.
Takeaways
- Fentanyl has taken over the illegal opioid market.
- The transition from heroin to fentanyl has changed drug use dynamics.
- Drug seizures can lead to increased overdose risks.
- Naloxone distribution is crucial for overdose prevention.
- Listening to people with lived experience is vital for effective interventions.
- Stigma surrounding substance use continues to be a major barrier.
- Radical empathy is essential in service work.
Chapters
00:00 Opening
01:55 Understanding Drug Trends and Overdose Data
04:58 The Role of Research in Public Health
10:03 The Impact of Drug Seizures on Overdoses
14:51 Innovative Approaches to Harm Reduction
19:55 Dispelling Myths About Substance Use
25:06 The Journey of Recovery and Resilience
30:07 Advocacy and the Power of Personal Experience
35:13 The Importance of Community Support
40:01 Looking Ahead: Future Conversations on Recovery
Hosted by Dean Babcock and Jodi Miller
Interview Segment Producer: Angela Shamblin
Personal Story Producer: Shawn P Neal
Executive Producer: Shawn P Neal
Mixed at AvoCast Studio236
#BeyondSubstance #SubstanceUseRecovery #HarmReduction #OpioidCrisis #NaloxoneSavesLives #FentanylAwareness #AddictionRecoveryStories #TraumaInformedCare #DrugPolicyReform #MentalHealthMatters #RecoveryIsPossible #PeerSupport #OverdosePrevention #RadicalEmpathy #StigmaFreeRecovery #PublicHealthResearch #CriminalJusticeReform #LivedExperienceMatters #IndianaRecovery #CommunityHealing #ShawnPNeal #AdvoCast
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
[Music]
(00:04):
Stories connect human beings to human beings.
[Music]
As we realize that our experiences are uniquely our own.
And yet somehow, a part of the bigger picture.
These are the stories from a community that is building hope through recovery by going beyond substance.
(00:28):
Hello, I'm Dean Babcock.
And I'm Jodi Miller. We're the hosts here on the Beyond Substance podcast.
In today's episode, we're diving into the vital role that research about drug trends, overdose data and lived experience can play in shaping how we understand and respond to substance use in our communities.
(00:51):
That's right, Dean. We're bringing together two powerful voices, one from the research world and one from the recovery journey to shine a light on the importance of empathy, education and community support.
I'll be speaking with Dr. Bradley Ray, a public health researcher who witnessed a friend's overdose who was saved with naloxone.
(01:13):
This life-changing event inspired a career focused on overdose prevention and harm reduction.
His insights into the opioid epidemic, drug policy and the importance of radical empathy are must hear for anyone interested in effective compassionate service work.
And I'll be introducing Dr. Katrina Thomas, also known as Dr. Kat, who shares her remarkable story of overcoming trauma and substance use to become a doctorate level counselor and advocate.
(01:47):
Her journey from personal struggle to professional service highlights the power of recovery, resilience and hope.
Together these conversations explore how evidence and experience can work hand in hand to break down stigma, address misconception and overall save lives.
Whether you're here to learn more about public health, support someone in recovery or find inspiration on your own path, we believe this episode offers perspective, insight and hope.
(02:18):
Let's begin as always with Angela Shamblin, taking a look at the numbers.
Thanks, Jodi. Today on our data segment, we're looking at the last DEA Intelligence Report from September 2024 focused on drug trends here in Indiana.
Drug Enforcement Administration, or DEA, has five field offices across Indiana, plus a special enforcement group called the Indiana High Intensity Drug Trafficking Area, or HIDF for short.
(02:49):
According to the report, fentanyl has almost completely taken over the illegal opioid market in our state. Between 2018 and 2023, the average price of a kilogram of fentanyl dropped from $90,000 to just $30,000, that's a 67% decrease in just five years.
With the drug becoming cheaper and easier to get, fentanyl use has spread rapidly across Indiana.
(03:13):
What's more concerning is how these drugs are being packaged. Increasingly, fentanyl is being made into pills. These pills are often produced using pill presses, they're both inexpensive and easy to buy online.
The DEA found that seven out of ten fake fentanyl pills they seized contained a dose strong enough to potentially be deadly.
They also warned that some people may not realize you can't legally buy prescription pills through social media.
(03:38):
If you see something online, it's likely counterfeit and dangerous. Most of these illegal drugs are coming from Mexico. Indiana's network of highways, railways, mail, and packaged delivery systems make it a prime location for moving drugs from the southern border throughout the Midwest.
Methamphetamine is ranked as the second biggest drug threat in Indiana, though in parts of southern Indiana is actually the number one threat. While law enforcement has seen fewer meth labs being busted in recent years, Indiana still ranks second in the country for the number of illegal labs that are discovered and processed.
(04:13):
As for marijuana, it remains most widely used illegal drug in the state. Indiana is bordered by three states, Illinois, Michigan, and Ohio, that have legalized marijuana, which makes it easier for the drug to be brought across state lines.
The report didn't say how much of each drug was seized, but according to DEA lab data from 2022, there were 519 cases in Indiana where evidence was submitted for analysis.
(04:39):
Of those, 120 cases involved fentanyl and 296 involved meth amphetamines. marijuana was not part of these investigations. Back to you, Dean.
[Music]
On this episode, we've had the pleasure of talking with Dr. Bradley Ray. I'm now Dr. Ray for quite some time and working in a number of projects in the Marin County Indiana area.
(05:13):
And so if we could get started today, Dr. Ray, if you could just introduce yourself to our listeners, including your background, and we'll just go from there.
My name is Brad Ray. I'm currently a senior researcher at RTI International. I'm trained as an sociologist. My specialization was medical sociology and criminology.
(05:36):
And I love sociology very much, identify as a sociologist. Bachelor's degree, Bachelor's degree, Ami-PhD-R, all sociology.
And first generation college student, I think that's kind of a big thing I bring with me when I think about doing research too. And I was a professor at Indiana University in Indianaapolis for seven years, 2012 to 2019.
(06:03):
And how did you become interested in research that related to illicit substances and substance use disorder? That's how I met you.
Around 2002, I was living in Chicago and somebody, you know, 2002, this is 22 years ago now, long before there was the term opioid epidemic or overdose epidemic.
(06:24):
Somebody very close to me, overdose, not heroin. And I saw them saved by Naloxo.
I did a pathocall 911. We tried to wake that person up for quite some time. And once EMS came in, they hit him with a needle and he was immediately sitting up and coughing.
And it's still to this day the closest thing I've ever seen to a miracle. And so that really led me on this journey to understand more about how did you save his life? What did you put in there? What is Naloxo?
(06:55):
How come we don't all have Naloxo? And it led me into this research journey. My first ever community partners were a Surin Service program in Chicago that distributed Naloxo to people.
And they taught me everything I know really still today about how to think about Naloxo distribution.
How does research fit into the ecosystem of public health and public welfare, prevention and intervention?
(07:23):
Yeah, so like I said, I'm really proud to call myself a sociologist. And as the older I get in life, the better I feel about that.
And the types of research that I do as a sociologist are vast, which sometimes it's cross-sectional survey data collection.
And we're getting information from the community. Other times we're looking at administrative data sources. And other times we're running experiments.
(07:50):
So really all of those types of research are things that I've done. And I don't know that I would be able to do it if I was kind of more narrow in my focus.
You know, we've done, and I know some of these things you know about, but we've done, you've randomized controlled trials of co-response teams.
We've done longitudinal data collection of people who use drugs in Indiana.
(08:13):
So with that kind of set of tools, I'm able to get into public health, public safety in various systems within there.
So I've been able to do work across the criminal legal system.
So I've done work from policing in courts, jails, reentry, and also in public health spheres, whether that's providing treatment, emergency response, treatment in hospital settings.
(08:42):
I think that that transition from heroin to fentanyl, people don't talk about that enough how much it changed our whole drug use landscape.
Where people could use, we're using heroin not as often. They weren't as immediately going into withdrawal when they stopped using.
With fentanyl, people are immediately within hours, starting to feel the withdrawal symptoms.
(09:04):
People are using much more frequently and they're co-using with stimulants and ways that we've never seen happen before in society.
So that they can get the euphoric effects that they would like from the fentanyl, that's part of the reason that they're co-using.
So I know in one particularly interesting research paper that you shared with our podcast team, you really took a look at the data related to an interrelationship
(09:33):
between law enforcement drug busts and overdoses. Could you share some of that of what you found in that data to help people kind of understand what that relationship might be?
So I will say that this idea that, well, police take drugs from people that's generally referred to as a drug seizure.
(09:55):
Sometimes people call it drug bust. Going back to, I think it was around 2017-2018, Dr. Dano Donald, who's the director of Indianapolis EMS, who I met at the heroin round table many years ago.
And he has been a guest on this program.
There's a brilliant observation, this brilliant, your Indianapolis is so lucky to have him where he is. And he and I would meet and talk about data.
(10:24):
And it was around 2017 that him and the informatics specialist there, Tom Arkins, said that they had noticed that when police sees drugs, that was kind of an indicator to them to purchase more in the locksome.
And the way he described it was, they bust up a house, maybe it was moving drugs, or where people were using drugs, and that they knew overdoses would increase in that community.
(10:50):
And I was kind of like, when he first told me, I kind of thought I knew where he was going, and I'm like, okay, why do you think that's happening? And he said, 'cause they got to go to a new supply. And when they go to the new supply, they have no idea what they're about to do.
And this just hit me as one of the most important research questions I would ever answer in my career.
I'll just back up and say there was already a growing number of studies that were showing that when people left jail, that they were at very high risk of overdose.
(11:20):
Some of the studies say 130 times more likely to die than the general public.
And the fact that they found that Mary and County, for example, at least 25% of the overdose deaths are people who are recently released from incarceration.
And the way opioids work is as you're taking them, you're taking more of them to continue to experience those feelings of euphoria until eventually you develop a dependency.
(11:46):
And once you've developed that dependency and you stop taking opioids, then you feel the withdrawal symptoms.
And then it goes and gets locked up into jail. They spend a couple of days there, most people are only in jail for 48 hours.
And they're there for a couple of days and they go through withdrawal.
And as you're going through withdrawal, your tolerance for opioids decreases.
(12:08):
And people would come out of jail after a couple of days having a horrible experience. Nobody has a good experience in jail.
And they want to use again. And when they want to use again, if they use at the levels they were before,
they're going to overdose because their body has lost that tolerance.
The exact same thing is happening with police drug seizures based on the data and the research that we've done.
(12:32):
That police seize drugs from the community and they're simply as no shortage of fentanyl in any community right now.
And after those drugs are seized, people go find another source of fentanyl.
It could be less potent and it could be not the euphoric effects they're looking for. They take more of it.
(12:53):
It could be more potent where as soon as they take it, they overdose.
But as soon as they go to a new supply, they have no idea what is in that supply that increase their risks of overdose.
So what we've done in Indianapolis with that was we worked with the IMPD several years ago to get their property room management system.
(13:14):
So every single time police take drugs from someone, they log them into a property room where they say here's what we suspect these drugs were.
Here's the time that we are logging them and taking them off the street. Here's where we took them from.
We use that information on where police said they took drugs from.
And we looked and we tried to break their property room data and opioid related seizures and stimulant related seizures.
(13:38):
So you know, math and cocaine versus heroin prescription, fentanyl, things like that opens.
And what we found was that where police seized opioids that fatal overdoses within seven days and 100 meters more than double.
We did not see that same effect when police seized stimulants.
(14:02):
So again, it's the similar hypothesis to people leaving jail that there's this drug market disruption.
This increases their need to go find a new supplier and then this increases their risk of overdose from that new supply.
So what does that data tell us?
For several years when I would present these findings, it would only be to law enforcement.
(14:26):
If I could get a venue in front of police officers, police chiefs, anybody, that's where I would prefer to put this information because then I could maybe fuel some innovation amongst law enforcement to try something different.
Some of the things that have occurred from there, there is a program out of Ohio called the bridge program.
(14:51):
And that individual there that started that he and I met and he saw this research and he was like, I've seen this happen where we see drugs and overdose is increased.
So what he started to do is when they make a big interdiction event, a big seizure, he will communicate to the officers in that location where the drugs were going to go to search the community with the locks known to have quick response teams provide follow-up to try and get it.
(15:20):
To try and engage people in treatment to sort of use that window to help people make decisions that could be safer.
Part of our research was doing a content analysis of news media stories about drug seizures.
We found about 250, you see these all the time that drugs on the table and guns on the table.
We did, we found about 250 of those stories and in only one of them did they tell people where to get treatment.
(15:48):
So the stories are very much like hey look at all the good police work we've done but not recognizing that there could be downstream harm from that.
So in Allen County they've started to put a blanket every drug seizure story.
They have a little text at the bottom here's where you can get services here's where you can get help that has taken off other communities are started to replicate that exact language in their media stories.
(16:10):
So I've seen that happen out there as well but other interventions getting the lock zone is going to always mitigate opioid related overdoses even when there's other substances being co use it will impact that.
And I know you you've looked at data you know really kind of in many low cows across the country and you mentioned that Indiana has been a leader in many ways.
(16:37):
And so when you compare you know the things that we're doing here in Indiana the positive things we're doing here in Indiana other places.
What are the types of things that you you believe we should be replicating doing more of in order to continue to make strides.
So the Naloxone distribution is key can't say enough about that continuing to saturate the community with the lock zone.
(17:05):
And it's I know people that are in Indianapolis doing this work can't experience this the same way that I have since I've moved but when I moved to a new city and I'll ask people to know where to get Naloxone people don't know.
They don't know what website to go to they don't know do I get it online is it free do I have to pay for people in Indiana know that is huge they know where to get Naloxone from they know who to call they know what kind of options are what kind of Naloxone is available from that source.
(17:36):
So you know that's a huge part there's still a lot of misinformation about Naloxone whether or not people think oh if I could become addicted to Naloxone or there's some drugs that.
Opioid in Naloxone doesn't work on or you know if it gets too cold or if it gets too hot or all this all these concerns around Naloxone have been addressed by and large in Indiana.
(18:03):
So I think you know that is one of the biggest things continuing to do that the other thing that Indiana has done really well.
And this is it's really been at state leadership level I mean the drugs are Doug Huntsinger in Indiana has been phenomenal I can't say enough good things about but the work that he's done.
(18:25):
And in part what he's done is something that was already bubbling underneath the surface.
I think he just gave it the credibility and validity that it needed which was to listen to people of lived experience.
I have made my entire career around that there's so many things that I've studied that I haven't done most of the things I've studied I haven't done.
(18:47):
But I enter into them by partnering and relying on the expertise of people who have.
And in Indiana the peer recovery coach peer recovery specialist movement is very alive it is not just about certification and funding but it's that these folks have made their way into leadership positions.
(19:13):
They're getting the contracting to do this work and listening to people of lived experience is one of the most important things any community can do if they want to reduce overdose and in Indiana's codified that in some ways.
And I think that that's been a major reason why that they've seen some positive changes there.
(19:35):
Are there any you know certain myths about drugs or the substance use disorder that you feel are kind of still kind of out there that you think we really need to continue to dispel.
Well there are so many I feel like it could be its own podcast.
What take one or two I'll take a couple the vast majority of people who use alcohol don't move on to these harder drugs when you look at a prospectively you see that that's just not there.
(20:03):
The other myth I still hear all the time is about the locks on the most dangerous myth I hear about the locks on right now is that we need higher dose of locks on this absolutely inaccurate.
You know that the the argument that people are making is that the opioids are so much more potent that we need to have more potent the locks on.
(20:25):
What happens when you hit people with higher dose of locks on is it immediately precipitates withdrawal they will wake up feeling in pain and in discomfort and I know that some people are kind of apathetic to that and don't care.
But what will happen is it will make people not want to call for services and call for help again and that could increase overdoses in our community.
(20:48):
The other you know myth I hear is about you know no lock zone or harm reduction enabling that's just simply inaccurate as you know there's a trans theoretical model for change when people are ready to change we need to be there and make the change easier.
And there is no concern about enabling and then you know another one I hear fentanyl touching fentanyl you can touch fentanyl.
(21:14):
And then the last thing I'll say the biggest misinformation that's out there is that people who use drugs are bad they're just not that idea that people who use drugs are any any drug that they're somehow less than or that they're somehow evil or they're somehow criminal.
That is the myth that continues to haunt us going forward so more than any that's the one I wish we could address and not continue to perpetuate that.
(21:47):
So what's your thoughts about how do people stay informed about what's really happening and what the truth is.
And there are certain reporters that I follow more than actually specific outlets so like me as salivates within the New York Times does an amazing reporting.
Zach Seagull is another reporter that I'll follow in journalist so it's really about and there's a website that's on you know responsible reporting on addiction and I will sometimes look for other folks there.
(22:14):
So it's about following I think people that you can trust with the types of information that they have you know the other thing people can always interested people can be doing is you know thinking critically we we have been misled about drugs our society has been misled in a lot of ways about drugs critically examining that thinking through what reality looks like and what you've been told.
(22:41):
And then the number one thing you can do is kind of check your own stigma and treat people that have been through this like the experts that they are that their experiences are expert experiences and you know you'll end up finding that just talking to somebody who has a history drug use or active drug use opens up the opens up once thinking about seeing some of these critical misinformation.
(23:10):
Misinformation that we've been given over our life so I think listening to that group is helpful if someone is it would like to you know pursue a smaller path with either doing research about substances research about you know overdoses etc.
What kind of route recommendations that would you have for folks that might be interested who may want to kind of go into this profession or into the field.
(23:36):
Yeah I think for me this is going to go back to being a sociologist was a big decision that I think gives me a purview on this topic that others don't often have so just as an example I have many friends and in colleagues who study policing and when you study kind of policing and you're focused in on policing sometimes you can miss some of what's happening you know negatively.
(24:05):
With policing some of what's happening outside of policing so I think keeping a broad scope as a researcher is necessary I think the other thing and this is something I think I still struggle with and figuring out how to navigate is sometimes the results are not what everybody hopes they would be and you know continuing to get that information out there and a thoughtful way.
(24:34):
It's pretty important so I think that's another another thing I've tried to do and I hesitate to use that term like burn bridges I don't like ever burn bridges but sometimes I've had many times in my career where I've had to provide results back to an agency and say like you know the activity that's happening isn't working or even worse it's having a negative effect or even worse you know there's some systematic body.
(25:03):
It's a systematic bias that's existing in your organization and I definitely know there are people out there who would think I don't want to tell them that that's my bread and butter that's my community partner and I have had to sadly lose partners because the results didn't comport with the way they wanted it to and I often think to myself how many people didn't do that and how much science doesn't get out there because of people.
(25:31):
Self-sensoring themselves but in the long run what I have found is that the people who want to do the rigorous research even if you've had those types of events happen those types of findings they still want to work with you because of that credibility because you're not going to pull a punch and not put something out there.
If you have a family member and you know your family member is using heroin or fentanyl or other kind of drugs having access to an oxygen is absolutely kind of important and that's me is having that access is changing your behavior in order to prevent something bad from happening.
(26:11):
Are there other examples that you'd like to share is kind of a parting thought with our audience.
I can't remember the term for it right now and you should probably look this up but there's a couple like the never use alone hotline but there are these numbers that people can call now before they use.
And I think that those are those are going to increase in use and like how people utilize those.
(26:35):
I think another thing is drug testing drug checking so having you know community based drug checking out there where people can actually check their drugs to see what's going to happen.
And then there's a lot of drug to see what's in them is very beneficial.
Well and even if there's not a hotline to call the whole concept of never use alone is a valuable concept whether you pick up the phone or not so have a friend with you knowing that you know using drugs can be lethal and be very dangerous.
(27:09):
So is a lot of people who love to with other people so they can intervene if it goes too far.
Anything else you'd like to share before we kind of sign off for the afternoon.
I guess the only other thing I would kind of give is a recommendation or a thought that I see as I do this type of work is you know a lot of times I'll see people in service industries who are burnt out and I understand that it's a lot of work.
(27:37):
I'm not authorized and like you said facing potential death.
And I understand that feeling of burnout I think what has surprised me over the past couple of years is the number of people I see getting into the service industry that don't recognize the radical empathy that is going to be required to do that work.
(28:00):
We don't talk about that enough. We don't train people in radical empathy and that is what we need more of we need much more.
So I really think questioning that about oneself before they get into some of this work would help everybody.
Whether you work in healthcare or public health or research or whatever is you've got to find your passion and all that.
(28:23):
If you're a young person and you're going to work in a library right now you're working in a social service setting.
You know this is not a big if you want to just deal in books go to Barnes and Noble.
But if you want to help people that's what people that working at libraries do and I feel like in some of those I don't know if it's just burnout.
I don't know if it's training but yeah just lacking that empathy that radical empathy.
(28:49):
[Music]
Sometimes we meet people whose strength comes not just from the battles they fought but from the way they've chosen to use their pain to help others.
(29:17):
Today's story is about one of those people. Dr. Katrina Thomas. Dr. Kat is known to many.
Has spent decades working in addiction and mental health. But her journey didn't start with professional credentials.
It started with something much more personal.
Well my name is Katrina Thomas. Professionally I'm a licensed clinical social worker, licensed clinical addiction counselor certified at alcohol and drug addiction consultant.
(29:50):
I have a doctorate in clinical counseling with a focus on trauma. I've been in this profession 20-some-odd years. I'm not sure exactly how long.
From an early age, Kat was surrounded by people seeking recovery. Her childhood home was often a haven. People detoxing in the basement. Her parents always ready to help.
(30:15):
But behind the picture of compassion and stability, Kat was holding on to a painful secret. One that would shape the course of her life in ways she couldn't get understand.
I had a cousin. He was 18. I was eight. When he started molesting me and it went on for three years. I never told anybody.
(30:41):
It wasn't a denial thing on my family's part. They didn't know. I'm an expert at acting like everything's fine. I just figured I'd deal with it myself.
Instead of dealing with it the right way, I tried to put it in the bottle.
She never told anyone, not her family, not her friends. Instead, she did what many of us do. She put on a brave face and carried it alone.
(31:10):
But trauma has a way of resurfacing. And when Kat's marriage ended at 21, everything came crashing down.
At the time, I don't think I even realized what I was doing. It was just I started drinking and I liked being drunk. At my worst point, I was up to drinking between two and three fifths of Jack Daniels every night.
(31:36):
As far as work, I was at work every day. It was never late. I paid my bills. All those responsibilities on the outside, everything was fine.
On the inside, obviously, it was not. She was working, paying the bills, showing up for life. But inside, she was unraveling.
(31:57):
And then one morning, she woke up to find a suicide note in her purse. She didn't remember writing it. She still doesn't know exactly what happened.
But in that moment, something shifted. And I don't know what brought that on. I still have no idea what brought that on. But that's when I realized what was behind it and what I was going to have to do.
(32:24):
That was the last time I drank. I just quit. It was like, this is stupid.
It's like, I'm like giving up my entire life because I want to feel sorry for myself. And I am lucky enough that I was able to quit. I didn't I didn't have to deal with withdrawal or anything.
(32:48):
But I did have to deal with the trauma. So my recovery is more about working through the trauma.
And coming to that place where I could forgive people for what they've done to me.
Accepting the fact that it happened can't change it. But what am I going to do with it? Doesn't make me a bad person. It wasn't my fault.
(33:18):
So that was my recovery. Coming to terms with that was then this is now and figuring out how to move forward with that.
A lot of work. A lot of self awareness. A lot of soul searching.
A lot of journaling. And then looking at a journal going, oh my God, that's in my head.
(33:44):
But then realizing, yeah, that's in your head, but not anymore because you just wrote it down. So it's out.
Now it's real. We can deal with it when we make it real. As long as I kept it in my head, I didn't have to deal with it.
But that's the weird way I was thinking. I started reading a lot. I started trying to figure things out of my own.
(34:12):
Once I figured out all this stuff as a kid is what got me to where I was. I knew I had to make that work for me instead of against me.
So now that trauma works for me because I can use my story to say, hey, you can go through hell and come out on the other side.
(34:35):
That moment became her turning point, not just in recovery, but in finding her purpose.
With the encouragement of her husband, she left nursing school and followed her true passion.
Becoming a therapist who could help others, walk through the darkness she had known so well herself.
(34:57):
I started out in nursing school. I had finished all of my classes ready to start my clinicals. And my husband had asked me,
"So why aren't you more excited about this? You're getting ready to graduate in less than a year. Why aren't you more excited?"
He asked me, "What would you do if you could do anything without even thinking?" I said, "It's therapist with addiction and trauma."
(35:23):
He's like, "So why aren't you doing it?" I said, "Because trauma and addiction therapists don't make any money." He said, "It doesn't matter."
I told myself, "If I can go to the dean and switch from the nursing to the counseling program and they will still take all my electives, all I have to do is take the core classes, I am not starting this over.
(35:47):
If they will go for that, then yeah, I'll switch. I went into the dean and told him what I wanted, told him, you know, I just wanted to switch.
I felt I was supposed to be over here in counseling. And we talked for probably about an hour. And he said, "I'm fine with that. Just take the core classes."
(36:12):
He said, "I knew you were coming in here." Sorry, I don't know why this makes me cry.
He said, "I knew you were coming in. I knew what you wanted before you got here and I knew my answer before you walked in."
(36:36):
So it's kind of a confirmation. This is where I belong.
Kat didn't just find healing. She found her calling. Today as a licensed therapist with a doctorate in clinical counseling, she's on the front lines of Indiana's mental health and addiction landscape.
(37:00):
She's seen firsthand how drug trends have evolved, how substances have become more potent, more accessible, and more lethal.
In the beginning, the people I was working with, I worked actually at a work release center, a federal work release.
So they were coming out of federal prison. Some of them had been in for 25 years to see them transition from prison and then going out to work and then they would buy something while they're out.
(37:33):
I saw a lot of overdoses just because drugs had changed so much in those 25 years they were gone. There was a lot of back then, still a lot of opioid use and a lot of marijuana.
Those were the two biggest things that I saw. Math was not a big thing when I first started.
(37:55):
So I think the biggest change since then has been the potency of things. We now is not what we was when I was smoking it.
The way things are being done, there's so many different strains of everything and even the opiates, they're putting fentanyl on everything.
(38:16):
So I think the landscape that I see and what has changed so much is the potency and drug use is more talked about now, which is a good thing as far as getting education out there.
And I've seen that change a lot since I've started.
(38:38):
But even with all the changes, the drugs, the treatments, the systems, some things remain the same, the need for connection, for understanding, for human beings to be seen, not as problems to solve, but as people to love.
The biggest thing for my journey has always been people. I just need people I can talk to. Somebody I can call to vent. It's like, I don't want your advice. I don't want to hear your opinion.
(39:10):
I just need a warm body to hear me throughout my journey. That's what has always been most important.
We didn't have some of the agencies that we have now back then because this was a really long time ago. I think we have tons more resources. There is so much available out there, but there is still sometimes so many barriers to get to those resources.
(39:37):
I think that's what drives me the most crazy. There's still so many barriers.
Of course, I primarily work with criminal justice involved people. So now you've got drug charges. You can't get a job. You can't find place to live. Nobody wants to rent you an apartment or a house. Nobody wants to give you a job.
If you can't work and you don't have shelter, how are you supposed to worry about recovery?
(40:05):
I mean, if I'm homeless and I don't even know where I'm going to get food, recovery is my least priority in that moment.
I think that is one of the biggest barriers that people have trouble getting over.
It's still even as hard as we've worked and it has improved, but there's still so much stigma. It's incredible. I try to understand it because it doesn't matter how old you are. It doesn't matter how much money you have.
(40:36):
It doesn't matter what profession you're in. Your status in society doesn't matter. It hits everywhere. People aren't comfortable reaching out for help.
And then when they do, it's so hard to get it. It's there and people are like, "Here, get help, get help." But then you try to get the help and it's so hard.
(40:59):
But for Dr. Kat, it's not about despair. It's about advocacy. She uses her story and her professional role to fight for people, to break down barriers and to educate anyone willing to listen.
Rather, explaining brain science such as a survival driven lizard brain or challenging the myth that people who use drugs are broken beyond repair, she's on a mission to change hearts and minds.
(41:31):
There's so many myths out there. It means you're a bad person or all you have to do is stop.
Whenever somebody says something like, "Well, all they got to do is quit using." Well, then you quit eating. See how that works out for you? Just quit eating.
But eating is survival, I said, "So are drugs." It's like when you're at that point, it's survival. You're not using to get high anymore. You're using to survive.
(42:01):
What I want to teach everybody in the world is about lizard brain. That's the survival part of your brain that all it cares about is survival. And if we can understand how that works, I think a lot of our myths would go away.
Myths that, once an addict, always an addict, I know where that comes from and I totally get that. But then on the flip side, a lot of people use that against people.
(42:26):
It's like, "Well, you have the problem once. That means you're out. I can't trust you ever, ever again." The myth that recovery is not possible.
I've heard that a lot that full recovery is not possible. I'm like, "How do you figure? I'm standing right here. It is possible."
(42:47):
I think it's just a matter of educating people. People that have never lived it, they have no clue, they don't understand. Educate them.
And for anyone listening who's struggling, who feels alone or ashamed or stuck at a cycle, they can't break. Dr. Kat wants you to know something.
(43:08):
There's always hope. Don't ever give up and don't ever be afraid to ask for help. Talk to people who have been there. Talk to people who work in the field.
Get your information from reliable sources, but don't ever give up.
Today, Dr. Kat is helping lead the charge to expand clinical services at Middle Health America, Indiana.
(43:34):
She's advocating in courts, fighting for better access to care, and most of all showing others that recovery is not only possible, it's worth fighting for.
Her story is a true testament to resilience, to purpose and to the power of using your pain for good.
(43:56):
If you or someone you love needs support, please reach out. There's hope. There's hope. And as Dr. Kat reminded us, there's always a way forward.
One of the things that I took away from that conversation with Dr. Ray, it really has to do with this. If you understand that the trans and drug use change and that the drugs that are out on the street can be so critically dangerous these days,
(44:37):
that when you lose your supplier, it puts you into this unfamiliar territory of not knowing where your drugs are coming from to trust them.
So that risk of overdose can be so high. And so, you know, for me part of that learning is that when you, whether you're a professional working in the field is being aware of that,
(45:03):
you can help teach and guide clients to be very, very careful with their drug use if they're still using.
Yeah. And concepts like, you know, don't use a loan because you don't know what's coming from this new supplier.
You know, that you may have and are making sure that you have fentanyl test strips to test and that you have an arcane on board, how critically those things are.
(45:27):
So I think for me, like if you look at some of the data and you look at some of the science, it should really kind of drive to what's the change in behavior that needs to follow.
Yeah. I really took a lot away from from your interview with Dr. Ray and you know, he talked about how drugs are more available.
There's just more availability to drugs today. They're cheaper and they are more lethal.
(45:53):
So there's just a lot more education involved in what you have to be aware of on the streets.
And I found that very interesting. And I really like the way he talked about, you know, the harm reduction part, like you mentioned.
And, you know, I learned a lot from that too. And really just helping to break that stigma with, you know, people that use drugs are bad, they're evil, they're criminals.
(46:20):
And just how we need to really change the language and how we talk about people in general.
So I really enjoyed that. And then with my interview with Dr. Kat, I just, I really loved connecting with her and hearing some of her story and how that was such a motivator for her to do the work that she's doing today.
(46:42):
And, you know, in how she's been such an advocate for her patients and helping people stay educated because that's really what it takes.
I mean, because it is a whole different world today.
And you know, Jody, in both the interviews and we talk about kind of personal experience and how personal experience informs the field and informs, you know, health care and whatever.
(47:08):
And even Dr. Ray was saying, I go to the people directly and ask questions and that's where I learn from.
Yeah.
It's a very good method for all of us.
If you don't know something or you're curious about something, go and talk with the people who are connected and people who are like affected by the problem.
(47:30):
Yeah.
I do some jail work with a women's program and I always say that those, those women are my subject matter experts. I mean, they keep me informed of what's really happening and what's, what's on the street, what's, what's happening out there.
You know, and that in turn, you know, helps me to be an advocate and to help share that information with other people and even just working in the buprenorphine clinic and talking to the doctors and the residents, you know, that education piece of, you know, really.
(48:00):
You know, really, you know, what it takes to know like you had mentioned before, you know, when Dr. Ray talked about when there's a drug bust and then how that changes everybody's supplier.
So they have to be aware of to make sure there's plenty of naloxone in that area because there's a high rate of, you know, overdose is because they don't know what that supplier.
(48:24):
That new supplier is going to be, I never have heard that, but it makes a lot of sense and I know he also talked about and compared it to, you know, when someone leaves the jail and, you know, I work a lot with that too, you know, when someone's leaving the jail, it's so important that, you know, they are connected to, you know, the, a vivitral shot or you just, you know, naloxone and things that they, they will have that support too.
(48:50):
So yeah, we got to know what's happening out there so that we can continue to do the work that that we're doing.
And you know, Jody, you mentioned talking about the jail and so I just wanted to help our listeners understand kind of what's coming up on beyond substance.
So we'll be doing some episodes of connected to how the criminal justice system like jails and community corrections actually interface with the recovery community and help people recover.
(49:16):
And we'll also be talking with a physician here in Indianapolis and talking about stigma, but from a physician's point of view, rather than from a client's point of view.
So I look forward to those episodes.
Yeah, stay tuned everyone. We've got some good stuff coming our way. So yeah, I'm really excited about the jail and the community corrections episodes coming up along with some more talk about stigma.
(49:42):
And I just can't talk about it enough and the more we get, you know, educated and sharing with the medical professionals, that's, that's what's going to make a difference and be a game changer.
So thanks everyone.
We'll see you next time.
If you feel you need assistance, please reach out to a counselor or other healthcare provider, supportive loved one or contact resources in the community such as 211,
(50:08):
where you can be connected to assistance or talk with a peer or counselor.
Beyond Substance is hosted by Dean Batcock and Jodi Miller.
A look at the numbers segment is hosted by Angela Shamblin.
Beyond Substance is produced by Angela Shamblin and the executive producer is Shawn P Neal.
(50:31):
[Music]
#BeyondSubstance #SubstanceUseRecovery #HarmReduction #OpioidCrisis #NaloxoneSavesLives #FentanylAwareness #AddictionRecoveryStories #TraumaInformedCare #DrugPolicyReform #MentalHealthMatters #RecoveryIsPossible #PeerSupport #OverdosePrevention #RadicalEmpathy #StigmaFreeRecovery #PublicHealthResearch #CriminalJusticeReform #LivedExperienceMatters #IndianaRecovery #CommunityHealing #ShawnPNeal #AdvoCast
[Music]
(00:04):
Stories connect human beings to human beings.
[Music]
As we realize that our experiences are uniquely our own.
And yet somehow, a part of the bigger picture.
These are the stories from a community that is building hope through recovery by going beyond substance.
(00:28):
Hello, I'm Dean Babcock.
And I'm Jodi Miller. We're the hosts here on the Beyond Substance podcast.
In today's episode, we're diving into the vital role that research about drug trends, overdose data and lived experience can play in shaping how we understand and respond to substance use in our communities.
(00:51):
That's right, Dean. We're bringing together two powerful voices, one from the research world and one from the recovery journey to shine a light on the importance of empathy, education and community support.
I'll be speaking with Dr. Bradley Ray, a public health researcher who witnessed a friend's overdose who was saved with naloxone.
(01:13):
This life-changing event inspired a career focused on overdose prevention and harm reduction.
His insights into the opioid epidemic, drug policy and the importance of radical empathy are must hear for anyone interested in effective compassionate service work.
And I'll be introducing Dr. Katrina Thomas, also known as Dr. Kat, who shares her remarkable story of overcoming trauma and substance use to become a doctorate level counselor and advocate.
(01:47):
Her journey from personal struggle to professional service highlights the power of recovery, resilience and hope.
Together these conversations explore how evidence and experience can work hand in hand to break down stigma, address misconception and overall save lives.
Whether you're here to learn more about public health, support someone in recovery or find inspiration on your own path, we believe this episode offers perspective, insight and hope.
(02:18):
Let's begin as always with Angela Shamblin, taking a look at the numbers.
Thanks, Jodi. Today on our data segment, we're looking at the last DEA Intelligence Report from September 2024 focused on drug trends here in Indiana.
Drug Enforcement Administration, or DEA, has five field offices across Indiana, plus a special enforcement group called the Indiana High Intensity Drug Trafficking Area, or HIDF for short.
(02:49):
According to the report, fentanyl has almost completely taken over the illegal opioid market in our state. Between 2018 and 2023, the average price of a kilogram of fentanyl dropped from $90,000 to just $30,000, that's a 67% decrease in just five years.
With the drug becoming cheaper and easier to get, fentanyl use has spread rapidly across Indiana.
(03:13):
What's more concerning is how these drugs are being packaged. Increasingly, fentanyl is being made into pills. These pills are often produced using pill presses, they're both inexpensive and easy to buy online.
The DEA found that seven out of ten fake fentanyl pills they seized contained a dose strong enough to potentially be deadly.
They also warned that some people may not realize you can't legally buy prescription pills through social media.
(03:38):
If you see something online, it's likely counterfeit and dangerous. Most of these illegal drugs are coming from Mexico. Indiana's network of highways, railways, mail, and packaged delivery systems make it a prime location for moving drugs from the southern border throughout the Midwest.
Methamphetamine is ranked as the second biggest drug threat in Indiana, though in parts of southern Indiana is actually the number one threat. While law enforcement has seen fewer meth labs being busted in recent years, Indiana still ranks second in the country for the number of illegal labs that are discovered and processed.
(04:13):
As for marijuana, it remains most widely used illegal drug in the state. Indiana is bordered by three states, Illinois, Michigan, and Ohio, that have legalized marijuana, which makes it easier for the drug to be brought across state lines.
The report didn't say how much of each drug was seized, but according to DEA lab data from 2022, there were 519 cases in Indiana where evidence was submitted for analysis.
(04:39):
Of those, 120 cases involved fentanyl and 296 involved meth amphetamines. marijuana was not part of these investigations. Back to you, Dean.
[Music]
On this episode, we've had the pleasure of talking with Dr. Bradley Ray. I'm now Dr. Ray for quite some time and working in a number of projects in the Marin County Indiana area.
(05:13):
And so if we could get started today, Dr. Ray, if you could just introduce yourself to our listeners, including your background, and we'll just go from there.
My name is Brad Ray. I'm currently a senior researcher at RTI International. I'm trained as an sociologist. My specialization was medical sociology and criminology.
(05:36):
And I love sociology very much, identify as a sociologist. Bachelor's degree, Bachelor's degree, Ami-PhD-R, all sociology.
And first generation college student, I think that's kind of a big thing I bring with me when I think about doing research too. And I was a professor at Indiana University in Indianaapolis for seven years, 2012 to 2019.
(06:03):
And how did you become interested in research that related to illicit substances and substance use disorder? That's how I met you.
Around 2002, I was living in Chicago and somebody, you know, 2002, this is 22 years ago now, long before there was the term opioid epidemic or overdose epidemic.
(06:24):
Somebody very close to me, overdose, not heroin. And I saw them saved by Naloxo.
I did a pathocall 911. We tried to wake that person up for quite some time. And once EMS came in, they hit him with a needle and he was immediately sitting up and coughing.
And it's still to this day the closest thing I've ever seen to a miracle. And so that really led me on this journey to understand more about how did you save his life? What did you put in there? What is Naloxo?
(06:55):
How come we don't all have Naloxo? And it led me into this research journey. My first ever community partners were a Surin Service program in Chicago that distributed Naloxo to people.
And they taught me everything I know really still today about how to think about Naloxo distribution.
How does research fit into the ecosystem of public health and public welfare, prevention and intervention?
(07:23):
Yeah, so like I said, I'm really proud to call myself a sociologist. And as the older I get in life, the better I feel about that.
And the types of research that I do as a sociologist are vast, which sometimes it's cross-sectional survey data collection.
And we're getting information from the community. Other times we're looking at administrative data sources. And other times we're running experiments.
(07:50):
So really all of those types of research are things that I've done. And I don't know that I would be able to do it if I was kind of more narrow in my focus.
You know, we've done, and I know some of these things you know about, but we've done, you've randomized controlled trials of co-response teams.
We've done longitudinal data collection of people who use drugs in Indiana.
(08:13):
So with that kind of set of tools, I'm able to get into public health, public safety in various systems within there.
So I've been able to do work across the criminal legal system.
So I've done work from policing in courts, jails, reentry, and also in public health spheres, whether that's providing treatment, emergency response, treatment in hospital settings.
(08:42):
I think that that transition from heroin to fentanyl, people don't talk about that enough how much it changed our whole drug use landscape.
Where people could use, we're using heroin not as often. They weren't as immediately going into withdrawal when they stopped using.
With fentanyl, people are immediately within hours, starting to feel the withdrawal symptoms.
(09:04):
People are using much more frequently and they're co-using with stimulants and ways that we've never seen happen before in society.
So that they can get the euphoric effects that they would like from the fentanyl, that's part of the reason that they're co-using.
So I know in one particularly interesting research paper that you shared with our podcast team, you really took a look at the data related to an interrelationship
(09:33):
between law enforcement drug busts and overdoses. Could you share some of that of what you found in that data to help people kind of understand what that relationship might be?
So I will say that this idea that, well, police take drugs from people that's generally referred to as a drug seizure.
(09:55):
Sometimes people call it drug bust. Going back to, I think it was around 2017-2018, Dr. Dano Donald, who's the director of Indianapolis EMS, who I met at the heroin round table many years ago.
And he has been a guest on this program.
There's a brilliant observation, this brilliant, your Indianapolis is so lucky to have him where he is. And he and I would meet and talk about data.
(10:24):
And it was around 2017 that him and the informatics specialist there, Tom Arkins, said that they had noticed that when police sees drugs, that was kind of an indicator to them to purchase more in the locksome.
And the way he described it was, they bust up a house, maybe it was moving drugs, or where people were using drugs, and that they knew overdoses would increase in that community.
(10:50):
And I was kind of like, when he first told me, I kind of thought I knew where he was going, and I'm like, okay, why do you think that's happening? And he said, 'cause they got to go to a new supply. And when they go to the new supply, they have no idea what they're about to do.
And this just hit me as one of the most important research questions I would ever answer in my career.
I'll just back up and say there was already a growing number of studies that were showing that when people left jail, that they were at very high risk of overdose.
(11:20):
Some of the studies say 130 times more likely to die than the general public.
And the fact that they found that Mary and County, for example, at least 25% of the overdose deaths are people who are recently released from incarceration.
And the way opioids work is as you're taking them, you're taking more of them to continue to experience those feelings of euphoria until eventually you develop a dependency.
(11:46):
And once you've developed that dependency and you stop taking opioids, then you feel the withdrawal symptoms.
And then it goes and gets locked up into jail. They spend a couple of days there, most people are only in jail for 48 hours.
And they're there for a couple of days and they go through withdrawal.
And as you're going through withdrawal, your tolerance for opioids decreases.
(12:08):
And people would come out of jail after a couple of days having a horrible experience. Nobody has a good experience in jail.
And they want to use again. And when they want to use again, if they use at the levels they were before,
they're going to overdose because their body has lost that tolerance.
The exact same thing is happening with police drug seizures based on the data and the research that we've done.
(12:32):
That police seize drugs from the community and they're simply as no shortage of fentanyl in any community right now.
And after those drugs are seized, people go find another source of fentanyl.
It could be less potent and it could be not the euphoric effects they're looking for. They take more of it.
(12:53):
It could be more potent where as soon as they take it, they overdose.
But as soon as they go to a new supply, they have no idea what is in that supply that increase their risks of overdose.
So what we've done in Indianapolis with that was we worked with the IMPD several years ago to get their property room management system.
(13:14):
So every single time police take drugs from someone, they log them into a property room where they say here's what we suspect these drugs were.
Here's the time that we are logging them and taking them off the street. Here's where we took them from.
We use that information on where police said they took drugs from.
And we looked and we tried to break their property room data and opioid related seizures and stimulant related seizures.
(13:38):
So you know, math and cocaine versus heroin prescription, fentanyl, things like that opens.
And what we found was that where police seized opioids that fatal overdoses within seven days and 100 meters more than double.
We did not see that same effect when police seized stimulants.
(14:02):
So again, it's the similar hypothesis to people leaving jail that there's this drug market disruption.
This increases their need to go find a new supplier and then this increases their risk of overdose from that new supply.
So what does that data tell us?
For several years when I would present these findings, it would only be to law enforcement.
(14:26):
If I could get a venue in front of police officers, police chiefs, anybody, that's where I would prefer to put this information because then I could maybe fuel some innovation amongst law enforcement to try something different.
Some of the things that have occurred from there, there is a program out of Ohio called the bridge program.
(14:51):
And that individual there that started that he and I met and he saw this research and he was like, I've seen this happen where we see drugs and overdose is increased.
So what he started to do is when they make a big interdiction event, a big seizure, he will communicate to the officers in that location where the drugs were going to go to search the community with the locks known to have quick response teams provide follow-up to try and get it.
(15:20):
To try and engage people in treatment to sort of use that window to help people make decisions that could be safer.
Part of our research was doing a content analysis of news media stories about drug seizures.
We found about 250, you see these all the time that drugs on the table and guns on the table.
We did, we found about 250 of those stories and in only one of them did they tell people where to get treatment.
(15:48):
So the stories are very much like hey look at all the good police work we've done but not recognizing that there could be downstream harm from that.
So in Allen County they've started to put a blanket every drug seizure story.
They have a little text at the bottom here's where you can get services here's where you can get help that has taken off other communities are started to replicate that exact language in their media stories.
(16:10):
So I've seen that happen out there as well but other interventions getting the lock zone is going to always mitigate opioid related overdoses even when there's other substances being co use it will impact that.
And I know you you've looked at data you know really kind of in many low cows across the country and you mentioned that Indiana has been a leader in many ways.
(16:37):
And so when you compare you know the things that we're doing here in Indiana the positive things we're doing here in Indiana other places.
What are the types of things that you you believe we should be replicating doing more of in order to continue to make strides.
So the Naloxone distribution is key can't say enough about that continuing to saturate the community with the lock zone.
(17:05):
And it's I know people that are in Indianapolis doing this work can't experience this the same way that I have since I've moved but when I moved to a new city and I'll ask people to know where to get Naloxone people don't know.
They don't know what website to go to they don't know do I get it online is it free do I have to pay for people in Indiana know that is huge they know where to get Naloxone from they know who to call they know what kind of options are what kind of Naloxone is available from that source.
(17:36):
So you know that's a huge part there's still a lot of misinformation about Naloxone whether or not people think oh if I could become addicted to Naloxone or there's some drugs that.
Opioid in Naloxone doesn't work on or you know if it gets too cold or if it gets too hot or all this all these concerns around Naloxone have been addressed by and large in Indiana.
(18:03):
So I think you know that is one of the biggest things continuing to do that the other thing that Indiana has done really well.
And this is it's really been at state leadership level I mean the drugs are Doug Huntsinger in Indiana has been phenomenal I can't say enough good things about but the work that he's done.
(18:25):
And in part what he's done is something that was already bubbling underneath the surface.
I think he just gave it the credibility and validity that it needed which was to listen to people of lived experience.
I have made my entire career around that there's so many things that I've studied that I haven't done most of the things I've studied I haven't done.
(18:47):
But I enter into them by partnering and relying on the expertise of people who have.
And in Indiana the peer recovery coach peer recovery specialist movement is very alive it is not just about certification and funding but it's that these folks have made their way into leadership positions.
(19:13):
They're getting the contracting to do this work and listening to people of lived experience is one of the most important things any community can do if they want to reduce overdose and in Indiana's codified that in some ways.
And I think that that's been a major reason why that they've seen some positive changes there.
(19:35):
Are there any you know certain myths about drugs or the substance use disorder that you feel are kind of still kind of out there that you think we really need to continue to dispel.
Well there are so many I feel like it could be its own podcast.
What take one or two I'll take a couple the vast majority of people who use alcohol don't move on to these harder drugs when you look at a prospectively you see that that's just not there.
(20:03):
The other myth I still hear all the time is about the locks on the most dangerous myth I hear about the locks on right now is that we need higher dose of locks on this absolutely inaccurate.
You know that the the argument that people are making is that the opioids are so much more potent that we need to have more potent the locks on.
(20:25):
What happens when you hit people with higher dose of locks on is it immediately precipitates withdrawal they will wake up feeling in pain and in discomfort and I know that some people are kind of apathetic to that and don't care.
But what will happen is it will make people not want to call for services and call for help again and that could increase overdoses in our community.
(20:48):
The other you know myth I hear is about you know no lock zone or harm reduction enabling that's just simply inaccurate as you know there's a trans theoretical model for change when people are ready to change we need to be there and make the change easier.
And there is no concern about enabling and then you know another one I hear fentanyl touching fentanyl you can touch fentanyl.
(21:14):
And then the last thing I'll say the biggest misinformation that's out there is that people who use drugs are bad they're just not that idea that people who use drugs are any any drug that they're somehow less than or that they're somehow evil or they're somehow criminal.
That is the myth that continues to haunt us going forward so more than any that's the one I wish we could address and not continue to perpetuate that.
(21:47):
So what's your thoughts about how do people stay informed about what's really happening and what the truth is.
And there are certain reporters that I follow more than actually specific outlets so like me as salivates within the New York Times does an amazing reporting.
Zach Seagull is another reporter that I'll follow in journalist so it's really about and there's a website that's on you know responsible reporting on addiction and I will sometimes look for other folks there.
(22:14):
So it's about following I think people that you can trust with the types of information that they have you know the other thing people can always interested people can be doing is you know thinking critically we we have been misled about drugs our society has been misled in a lot of ways about drugs critically examining that thinking through what reality looks like and what you've been told.
(22:41):
And then the number one thing you can do is kind of check your own stigma and treat people that have been through this like the experts that they are that their experiences are expert experiences and you know you'll end up finding that just talking to somebody who has a history drug use or active drug use opens up the opens up once thinking about seeing some of these critical misinformation.
(23:10):
Misinformation that we've been given over our life so I think listening to that group is helpful if someone is it would like to you know pursue a smaller path with either doing research about substances research about you know overdoses etc.
What kind of route recommendations that would you have for folks that might be interested who may want to kind of go into this profession or into the field.
(23:36):
Yeah I think for me this is going to go back to being a sociologist was a big decision that I think gives me a purview on this topic that others don't often have so just as an example I have many friends and in colleagues who study policing and when you study kind of policing and you're focused in on policing sometimes you can miss some of what's happening you know negatively.
(24:05):
With policing some of what's happening outside of policing so I think keeping a broad scope as a researcher is necessary I think the other thing and this is something I think I still struggle with and figuring out how to navigate is sometimes the results are not what everybody hopes they would be and you know continuing to get that information out there and a thoughtful way.
(24:34):
It's pretty important so I think that's another another thing I've tried to do and I hesitate to use that term like burn bridges I don't like ever burn bridges but sometimes I've had many times in my career where I've had to provide results back to an agency and say like you know the activity that's happening isn't working or even worse it's having a negative effect or even worse you know there's some systematic body.
(25:03):
It's a systematic bias that's existing in your organization and I definitely know there are people out there who would think I don't want to tell them that that's my bread and butter that's my community partner and I have had to sadly lose partners because the results didn't comport with the way they wanted it to and I often think to myself how many people didn't do that and how much science doesn't get out there because of people.
(25:31):
Self-sensoring themselves but in the long run what I have found is that the people who want to do the rigorous research even if you've had those types of events happen those types of findings they still want to work with you because of that credibility because you're not going to pull a punch and not put something out there.
If you have a family member and you know your family member is using heroin or fentanyl or other kind of drugs having access to an oxygen is absolutely kind of important and that's me is having that access is changing your behavior in order to prevent something bad from happening.
(26:11):
Are there other examples that you'd like to share is kind of a parting thought with our audience.
I can't remember the term for it right now and you should probably look this up but there's a couple like the never use alone hotline but there are these numbers that people can call now before they use.
And I think that those are those are going to increase in use and like how people utilize those.
(26:35):
I think another thing is drug testing drug checking so having you know community based drug checking out there where people can actually check their drugs to see what's going to happen.
And then there's a lot of drug to see what's in them is very beneficial.
Well and even if there's not a hotline to call the whole concept of never use alone is a valuable concept whether you pick up the phone or not so have a friend with you knowing that you know using drugs can be lethal and be very dangerous.
(27:09):
So is a lot of people who love to with other people so they can intervene if it goes too far.
Anything else you'd like to share before we kind of sign off for the afternoon.
I guess the only other thing I would kind of give is a recommendation or a thought that I see as I do this type of work is you know a lot of times I'll see people in service industries who are burnt out and I understand that it's a lot of work.
(27:37):
I'm not authorized and like you said facing potential death.
And I understand that feeling of burnout I think what has surprised me over the past couple of years is the number of people I see getting into the service industry that don't recognize the radical empathy that is going to be required to do that work.
(28:00):
We don't talk about that enough. We don't train people in radical empathy and that is what we need more of we need much more.
So I really think questioning that about oneself before they get into some of this work would help everybody.
Whether you work in healthcare or public health or research or whatever is you've got to find your passion and all that.
(28:23):
If you're a young person and you're going to work in a library right now you're working in a social service setting.
You know this is not a big if you want to just deal in books go to Barnes and Noble.
But if you want to help people that's what people that working at libraries do and I feel like in some of those I don't know if it's just burnout.
I don't know if it's training but yeah just lacking that empathy that radical empathy.
(28:49):
[Music]
Sometimes we meet people whose strength comes not just from the battles they fought but from the way they've chosen to use their pain to help others.
(29:17):
Today's story is about one of those people. Dr. Katrina Thomas. Dr. Kat is known to many.
Has spent decades working in addiction and mental health. But her journey didn't start with professional credentials.
It started with something much more personal.
Well my name is Katrina Thomas. Professionally I'm a licensed clinical social worker, licensed clinical addiction counselor certified at alcohol and drug addiction consultant.
(29:50):
I have a doctorate in clinical counseling with a focus on trauma. I've been in this profession 20-some-odd years. I'm not sure exactly how long.
From an early age, Kat was surrounded by people seeking recovery. Her childhood home was often a haven. People detoxing in the basement. Her parents always ready to help.
(30:15):
But behind the picture of compassion and stability, Kat was holding on to a painful secret. One that would shape the course of her life in ways she couldn't get understand.
I had a cousin. He was 18. I was eight. When he started molesting me and it went on for three years. I never told anybody.
(30:41):
It wasn't a denial thing on my family's part. They didn't know. I'm an expert at acting like everything's fine. I just figured I'd deal with it myself.
Instead of dealing with it the right way, I tried to put it in the bottle.
She never told anyone, not her family, not her friends. Instead, she did what many of us do. She put on a brave face and carried it alone.
(31:10):
But trauma has a way of resurfacing. And when Kat's marriage ended at 21, everything came crashing down.
At the time, I don't think I even realized what I was doing. It was just I started drinking and I liked being drunk. At my worst point, I was up to drinking between two and three fifths of Jack Daniels every night.
(31:36):
As far as work, I was at work every day. It was never late. I paid my bills. All those responsibilities on the outside, everything was fine.
On the inside, obviously, it was not. She was working, paying the bills, showing up for life. But inside, she was unraveling.
(31:57):
And then one morning, she woke up to find a suicide note in her purse. She didn't remember writing it. She still doesn't know exactly what happened.
But in that moment, something shifted. And I don't know what brought that on. I still have no idea what brought that on. But that's when I realized what was behind it and what I was going to have to do.
(32:24):
That was the last time I drank. I just quit. It was like, this is stupid.
It's like, I'm like giving up my entire life because I want to feel sorry for myself. And I am lucky enough that I was able to quit. I didn't I didn't have to deal with withdrawal or anything.
(32:48):
But I did have to deal with the trauma. So my recovery is more about working through the trauma.
And coming to that place where I could forgive people for what they've done to me.
Accepting the fact that it happened can't change it. But what am I going to do with it? Doesn't make me a bad person. It wasn't my fault.
(33:18):
So that was my recovery. Coming to terms with that was then this is now and figuring out how to move forward with that.
A lot of work. A lot of self awareness. A lot of soul searching.
A lot of journaling. And then looking at a journal going, oh my God, that's in my head.
(33:44):
But then realizing, yeah, that's in your head, but not anymore because you just wrote it down. So it's out.
Now it's real. We can deal with it when we make it real. As long as I kept it in my head, I didn't have to deal with it.
But that's the weird way I was thinking. I started reading a lot. I started trying to figure things out of my own.
(34:12):
Once I figured out all this stuff as a kid is what got me to where I was. I knew I had to make that work for me instead of against me.
So now that trauma works for me because I can use my story to say, hey, you can go through hell and come out on the other side.
(34:35):
That moment became her turning point, not just in recovery, but in finding her purpose.
With the encouragement of her husband, she left nursing school and followed her true passion.
Becoming a therapist who could help others, walk through the darkness she had known so well herself.
(34:57):
I started out in nursing school. I had finished all of my classes ready to start my clinicals. And my husband had asked me,
"So why aren't you more excited about this? You're getting ready to graduate in less than a year. Why aren't you more excited?"
He asked me, "What would you do if you could do anything without even thinking?" I said, "It's therapist with addiction and trauma."
(35:23):
He's like, "So why aren't you doing it?" I said, "Because trauma and addiction therapists don't make any money." He said, "It doesn't matter."
I told myself, "If I can go to the dean and switch from the nursing to the counseling program and they will still take all my electives, all I have to do is take the core classes, I am not starting this over.
(35:47):
If they will go for that, then yeah, I'll switch. I went into the dean and told him what I wanted, told him, you know, I just wanted to switch.
I felt I was supposed to be over here in counseling. And we talked for probably about an hour. And he said, "I'm fine with that. Just take the core classes."
(36:12):
He said, "I knew you were coming in here." Sorry, I don't know why this makes me cry.
He said, "I knew you were coming in. I knew what you wanted before you got here and I knew my answer before you walked in."
(36:36):
So it's kind of a confirmation. This is where I belong.
Kat didn't just find healing. She found her calling. Today as a licensed therapist with a doctorate in clinical counseling, she's on the front lines of Indiana's mental health and addiction landscape.
(37:00):
She's seen firsthand how drug trends have evolved, how substances have become more potent, more accessible, and more lethal.
In the beginning, the people I was working with, I worked actually at a work release center, a federal work release.
So they were coming out of federal prison. Some of them had been in for 25 years to see them transition from prison and then going out to work and then they would buy something while they're out.
(37:33):
I saw a lot of overdoses just because drugs had changed so much in those 25 years they were gone. There was a lot of back then, still a lot of opioid use and a lot of marijuana.
Those were the two biggest things that I saw. Math was not a big thing when I first started.
(37:55):
So I think the biggest change since then has been the potency of things. We now is not what we was when I was smoking it.
The way things are being done, there's so many different strains of everything and even the opiates, they're putting fentanyl on everything.
(38:16):
So I think the landscape that I see and what has changed so much is the potency and drug use is more talked about now, which is a good thing as far as getting education out there.
And I've seen that change a lot since I've started.
(38:38):
But even with all the changes, the drugs, the treatments, the systems, some things remain the same, the need for connection, for understanding, for human beings to be seen, not as problems to solve, but as people to love.
The biggest thing for my journey has always been people. I just need people I can talk to. Somebody I can call to vent. It's like, I don't want your advice. I don't want to hear your opinion.
(39:10):
I just need a warm body to hear me throughout my journey. That's what has always been most important.
We didn't have some of the agencies that we have now back then because this was a really long time ago. I think we have tons more resources. There is so much available out there, but there is still sometimes so many barriers to get to those resources.
(39:37):
I think that's what drives me the most crazy. There's still so many barriers.
Of course, I primarily work with criminal justice involved people. So now you've got drug charges. You can't get a job. You can't find place to live. Nobody wants to rent you an apartment or a house. Nobody wants to give you a job.
If you can't work and you don't have shelter, how are you supposed to worry about recovery?
(40:05):
I mean, if I'm homeless and I don't even know where I'm going to get food, recovery is my least priority in that moment.
I think that is one of the biggest barriers that people have trouble getting over.
It's still even as hard as we've worked and it has improved, but there's still so much stigma. It's incredible. I try to understand it because it doesn't matter how old you are. It doesn't matter how much money you have.
(40:36):
It doesn't matter what profession you're in. Your status in society doesn't matter. It hits everywhere. People aren't comfortable reaching out for help.
And then when they do, it's so hard to get it. It's there and people are like, "Here, get help, get help." But then you try to get the help and it's so hard.
(40:59):
But for Dr. Kat, it's not about despair. It's about advocacy. She uses her story and her professional role to fight for people, to break down barriers and to educate anyone willing to listen.
Rather, explaining brain science such as a survival driven lizard brain or challenging the myth that people who use drugs are broken beyond repair, she's on a mission to change hearts and minds.
(41:31):
There's so many myths out there. It means you're a bad person or all you have to do is stop.
Whenever somebody says something like, "Well, all they got to do is quit using." Well, then you quit eating. See how that works out for you? Just quit eating.
But eating is survival, I said, "So are drugs." It's like when you're at that point, it's survival. You're not using to get high anymore. You're using to survive.
(42:01):
What I want to teach everybody in the world is about lizard brain. That's the survival part of your brain that all it cares about is survival. And if we can understand how that works, I think a lot of our myths would go away.
Myths that, once an addict, always an addict, I know where that comes from and I totally get that. But then on the flip side, a lot of people use that against people.
(42:26):
It's like, "Well, you have the problem once. That means you're out. I can't trust you ever, ever again." The myth that recovery is not possible.
I've heard that a lot that full recovery is not possible. I'm like, "How do you figure? I'm standing right here. It is possible."
(42:47):
I think it's just a matter of educating people. People that have never lived it, they have no clue, they don't understand. Educate them.
And for anyone listening who's struggling, who feels alone or ashamed or stuck at a cycle, they can't break. Dr. Kat wants you to know something.
(43:08):
There's always hope. Don't ever give up and don't ever be afraid to ask for help. Talk to people who have been there. Talk to people who work in the field.
Get your information from reliable sources, but don't ever give up.
Today, Dr. Kat is helping lead the charge to expand clinical services at Middle Health America, Indiana.
(43:34):
She's advocating in courts, fighting for better access to care, and most of all showing others that recovery is not only possible, it's worth fighting for.
Her story is a true testament to resilience, to purpose and to the power of using your pain for good.
(43:56):
If you or someone you love needs support, please reach out. There's hope. There's hope. And as Dr. Kat reminded us, there's always a way forward.
One of the things that I took away from that conversation with Dr. Ray, it really has to do with this. If you understand that the trans and drug use change and that the drugs that are out on the street can be so critically dangerous these days,
(44:37):
that when you lose your supplier, it puts you into this unfamiliar territory of not knowing where your drugs are coming from to trust them.
So that risk of overdose can be so high. And so, you know, for me part of that learning is that when you, whether you're a professional working in the field is being aware of that,
(45:03):
you can help teach and guide clients to be very, very careful with their drug use if they're still using.
Yeah. And concepts like, you know, don't use a loan because you don't know what's coming from this new supplier.
You know, that you may have and are making sure that you have fentanyl test strips to test and that you have an arcane on board, how critically those things are.
(45:27):
So I think for me, like if you look at some of the data and you look at some of the science, it should really kind of drive to what's the change in behavior that needs to follow.
Yeah. I really took a lot away from from your interview with Dr. Ray and you know, he talked about how drugs are more available.
There's just more availability to drugs today. They're cheaper and they are more lethal.
(45:53):
So there's just a lot more education involved in what you have to be aware of on the streets.
And I found that very interesting. And I really like the way he talked about, you know, the harm reduction part, like you mentioned.
And, you know, I learned a lot from that too. And really just helping to break that stigma with, you know, people that use drugs are bad, they're evil, they're criminals.
(46:20):
And just how we need to really change the language and how we talk about people in general.
So I really enjoyed that. And then with my interview with Dr. Kat, I just, I really loved connecting with her and hearing some of her story and how that was such a motivator for her to do the work that she's doing today.
(46:42):
And, you know, in how she's been such an advocate for her patients and helping people stay educated because that's really what it takes.
I mean, because it is a whole different world today.
And you know, Jody, in both the interviews and we talk about kind of personal experience and how personal experience informs the field and informs, you know, health care and whatever.
(47:08):
And even Dr. Ray was saying, I go to the people directly and ask questions and that's where I learn from.
Yeah.
It's a very good method for all of us.
If you don't know something or you're curious about something, go and talk with the people who are connected and people who are like affected by the problem.
(47:30):
Yeah.
I do some jail work with a women's program and I always say that those, those women are my subject matter experts. I mean, they keep me informed of what's really happening and what's, what's on the street, what's, what's happening out there.
You know, and that in turn, you know, helps me to be an advocate and to help share that information with other people and even just working in the buprenorphine clinic and talking to the doctors and the residents, you know, that education piece of, you know, really.
(48:00):
You know, really, you know, what it takes to know like you had mentioned before, you know, when Dr. Ray talked about when there's a drug bust and then how that changes everybody's supplier.
So they have to be aware of to make sure there's plenty of naloxone in that area because there's a high rate of, you know, overdose is because they don't know what that supplier.
(48:24):
That new supplier is going to be, I never have heard that, but it makes a lot of sense and I know he also talked about and compared it to, you know, when someone leaves the jail and, you know, I work a lot with that too, you know, when someone's leaving the jail, it's so important that, you know, they are connected to, you know, the, a vivitral shot or you just, you know, naloxone and things that they, they will have that support too.
(48:50):
So yeah, we got to know what's happening out there so that we can continue to do the work that that we're doing.
And you know, Jody, you mentioned talking about the jail and so I just wanted to help our listeners understand kind of what's coming up on beyond substance.
So we'll be doing some episodes of connected to how the criminal justice system like jails and community corrections actually interface with the recovery community and help people recover.
(49:16):
And we'll also be talking with a physician here in Indianapolis and talking about stigma, but from a physician's point of view, rather than from a client's point of view.
So I look forward to those episodes.
Yeah, stay tuned everyone. We've got some good stuff coming our way. So yeah, I'm really excited about the jail and the community corrections episodes coming up along with some more talk about stigma.
(49:42):
And I just can't talk about it enough and the more we get, you know, educated and sharing with the medical professionals, that's, that's what's going to make a difference and be a game changer.
So thanks everyone.
We'll see you next time.
If you feel you need assistance, please reach out to a counselor or other healthcare provider, supportive loved one or contact resources in the community such as 211,
(50:08):
where you can be connected to assistance or talk with a peer or counselor.
Beyond Substance is hosted by Dean Batcock and Jodi Miller.
A look at the numbers segment is hosted by Angela Shamblin.
Beyond Substance is produced by Angela Shamblin and the executive producer is Shawn P Neal.
(50:31):
[Music]
#BeyondSubstance #SubstanceUseRecovery #HarmReduction #OpioidCrisis #NaloxoneSavesLives #FentanylAwareness #AddictionRecoveryStories #TraumaInformedCare #DrugPolicyReform #MentalHealthMatters #RecoveryIsPossible #PeerSupport #OverdosePrevention #RadicalEmpathy #StigmaFreeRecovery #PublicHealthResearch #CriminalJusticeReform #LivedExperienceMatters #IndianaRecovery #CommunityHealing #ShawnPNeal #AdvoCast
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