Ep27 Addiction Treatment Live, Work, Recovery in the Community

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[00:00:00] Boom, boom, boom, boom, boom.

Chris Langley: Hi, welcome to the Addiction Recovery Place Podcast. The podcast championing addiction treatment professionals around the world. I'm your host, Chris Langley, and I'm very pleased to introduce today's guest, Aaron Bitter. Aaron is a Licensed Master Social Worker, Licensed Chemical Dependency Counselor, Jurist Doctor, and Program Director at Symmetria Louisville Outpatient Rehab and Suboxone Clinic in Texas. Welcome to the Addiction Recovery Place Podcast, Aaron. It's great to have you join me today.

Aaron Bitter: Thank you very much for having me, Chris.

Chris Langley: No, really appreciate your time.

I know you're incredibly busy. just going to start at the first question. Can you tell us about yourself and how you became the Program Director at Symetria Recovery?

Aaron Bitter: Absolutely. Thank you. I am, I'm a person in long term recovery myself from addiction. I've been in long term recovery since March 7th, 2012 and what that means is after about 21, 20-21 years of active [00:01:00] substance use, I've made changes in my life and found a way to live that's allowed me to be a productive member of society today.

I went back to school in my mid-thirties. I had previously been a lawyer prior to working in this field. And, unfortunately part of what addiction took from me was the practice of law. And fortunately in recovery, I was able to go back to school, become a Licensed Chemical Dependency Counselor, become a Licensed Master Social Worker,

become a father, which is most important. I've got a six and a half year old boy who's, everything in my life today and 10 years to the day of starting recovery, so March 7th, 2022, 10 years after my recovery date, I took the job here as the Program Director of Symetria Recovery in Lewisville, Texas.

Chris Langley: Goodness me. Well first of all, congratulations, on everything you've achieved in quite a short [00:02:00] space of time as well. And you've certainly been on a journey from being a lawyer and now you're, now the, the Program Director as well. So big, congratulations to you.

Thank you for telling us that story. That's just amazing. We're going to talk about your service. So can you tell us about the team that you have and some of their roles, please? And

Aaron Bitter: Yeah, we've got a great team. One of the things I like about Symetria is it really, truly is a holistic approach, and I feel like that is a term that sometimes is bandied about. And what does that mean? Here, what that looks like, we've got physicians. So we've got, doctor on staff, both in house doctor as well as, doctors that we work with in a virtual setting if necessary. We've got nurses on staff and our nurses here, we're really fortunate to have a pair of nurses that have worked in this field behavioral health. For a long, quite a while with extensive experience. [00:03:00] We've got a administrative person who's like the face of our clinic.

The first person you see in someone that is really is an indispensable part of making that connection. With people the first time they walk through the door. Of course, we have counselors in Texas, requires to do this sort of work, a license to do chemical dependency counseling, and we have three, full time counselors on our staff.

All bring in various backgrounds, but quite a bit of experience between the three of them, collective experience in addiction and behavioral health, and then myself as Program Director, I do some counseling as well, but as we grow, my role is more oversight of the clinic at large.

We also have, we offer psychotherapy. We do that [00:04:00] through virtual at this point. We've got psychiatrists that we work with, trained in addiction, who are able to work with any of our patients. So they might not be physically in the clinic, but they're available to serve our patients.

Chris Langley: How long has the service been running for?

Aaron Bitter: So we've been open in Texas since 2018, at least at our clinic here in Louisville, and our clinic is one of seven in Texas. There's four in the Dallas Fort Worth area, Lewisville, Arlington, Fort Worth, and Hearst. Then there's one in College Station, where Texas A&M University is. Then two in the Houston area.

We also have six clinics in Illinois, and those have been around a little longer. Those actually were originally part of an entity called Soft Landings, and they've been around [00:05:00] about 15 years, right at 15 years. So the Illinois clinics are a little more established in terms of time in operation.

Chris Langley: Okay. What programs do you run at your service, and how do they work? How does someone get referred to you?

Aaron Bitter: Yeah. We are an outpatient medication assisted treatment clinic and what that means would be that we treat people for opioid use disorder and alcohol use disorder primarily, although we do treat other substances. We utilize methadone, suboxone, primarily medications that we work with for individuals with opioid use disorder.

We also have an intensive outpatient program. so somebody could be in that group regardless of specific substance, so it could be alcohol use disorder, could be opioid use [00:06:00] disorder, but it also could be any substance that they're struggling with for the IOP groups. Services also, we do we do counseling, part of our "Symetria Method" that we call it involves access to unlimited therapy.

It's something we take very seriously, access to psychotherapy. So groups, individuals, psychiatrists, again, trying to really have a well rounded approach.

Chris Langley: It certainly sounds that way. It seems like you're offering such a like you said, holistic approach, and do you work with other agencies as well, say if someone needs help with housing or anything along those lines, you can refer them on to other services?

Aaron Bitter: It's a great question and short, and the answer is yes. And one of the things, just speaking candidly, so I've been here about nearly three years. I've watched the clinic grow to where, our clinic was when I started, it was just, it was myself and a nurse, and then we had a doctor here just a few hours a week.

We were [00:07:00] small, we had a really, small, census at that time, but we knew growth was coming. Various factors, some positive, like taking insurance, some negative, like the fentanyl crisis that's going on. So growth as it's exploded, we've been able to really offer just a lot more breath to what we can do.

Obviously having a full staff. We've got a dedicated team that works for all the clinics, that does nothing other than referrals. I've got a patient that comes in today and they're struggling with housing. Now, I might, I've worked in this community a while, I might have my own resources to link them up with, but if I don't, I've got someone I can go to in real time and say, "this is what I need." His job is to make that happen, whether it be housing, whether it be other healthcare needs, [00:08:00] sometimes there might be a more acute psych need even beyond what our capability is.

Someone with some real intense needs, a lot of our patients, unfortunately, through the addiction might have some issues with, STIs, STDs. So we've got community partners in that area. We know that things like patients who might come to us, they're pregnant, they need resources, or justice involved individuals.

So we definitely, when it comes to referrals, we've got a real good system in place to try to link people with appropriate resources.

Chris Langley: Goodness me. So someone's going through, say, just say the criminal justice system, you can, help refer them to experts to help them through that. Long drawn out, horrible process as well.

Aaron Bitter: Yeah, absolutely. I wish I knew what our data is right now in terms of percentage of patients who have some involvement with the justice system. I would guess though, it's a probably around [00:09:00] 20%. I would, think, maybe a little lower than that, but for some, that is with the impetus for treatment. To answer your question, yeah, absolutely Something that I , really feel strongly about some of the work that we do is in that ability to help someone meet those needs to get people, housing. Housing is, when you reference housing, we know that is the number one need for someone who's going through treatment. What is going to be, statistically number one ancillary housing, it is not even close, but what are the needs beyond that?

Chris Langley: So you said, four years ago, it was just yourself and a of your team members and now you've grown to such an extent that you're offering such a broad range of services and referrals as well. That's really impressive. And [00:10:00] as the, Program Director, that's down to the, great work that you've done and the commitment that you've, got as well. And obviously the organization you work for as well is very keen to get these services moving because there's such a need now the whole approach.

Aaron Bitter: It is, and I appreciate the kind words of positive feedback. We do really have fantastic support. I'm just frankly, I've been really fortunate to work in some really amazing settings. I think part of why I've been able to advance in the field is getting some great experience. That said, I've never been at an agency or with a company with the support at the level that we have here at Symetria. It's allowed us to grow.

On a personal level, this is my community. I grew up here. I went to high school here. My family is in this community. I live, work and recover in this community. And that means a lot [00:11:00] to me.

Chris Langley: Definitely. Most definitely. So how do you receive referrals from outside agencies? Do you ever work with, say, you mentioned the justice system, do you ever speak to parole officers or even the police, or do you get referrals from external agencies?

Aaron Bitter: Yeah. Yeah, absolutely. a couple different ways, so with people that are on probation, specifically like in the county, we're in Denton County, we might get a referral from, the Adult Probation Department, especially as we try to build the relationships with them to let them know that if it's somebody who is struggling with opioid use disorder, we're probably going to be a better option then a clinic, then referring them out somewhere.

That is abstinence based. And we know the statistics bear out that medication assisted treatment is more likely to be effective. Now, something that's really cool that we're doing, and it hasn't yet gotten affected our clinic, but some of our other Symetria clinics where we're [00:12:00] actually working with the local jails to provide medication assisted treatment to incarcerated individuals.

That is something that if you had told me, when I started here, that was on the table it would have blown my mind. We have not yet rolled that out officially in our clinic. It's something we're working on, but it is in effect, in real time at some of our other clinics.

And that,

Chris Langley: That's huge.

Aaron Bitter: We know that historically, our incarcerated individuals do not have access typically to a lot of life saving medications, and if we can help continue that treatment, that's something that really matters to me.

Chris Langley: So your service in the future will be maybe going into the jails to actually do this?

Aaron Bitter: Yeah. Transparently, part of what I'm doing is trying to, effectuate something like that [00:13:00] in the local community. It is not, again, it's not yet been implemented, but it is, actively something we're actively seeking to do, and hoping, fingers crossed, that it could be something that, that is rolled out next year.

Chris Langley: Completely. That sounds to me very progressive, and it's nice to hear this. Speaking to a professional like yourself, that's actually engaging with the jails as well to get this in there. Cause it's so badly needed.

Aaron Bitter: Chris, I'm with you, and I've had some conversations with some Individuals in that setting, jail setting, jail health, correctional health, and trying to make that happen. And it's one of the places where, I, in one of those recent conversations where I was there, I went physically, to the jail and having that conversation, chills, really, truly, not exaggeration, just thinking about, if we could help individuals behind these walls, just what that would mean.

Chris Langley: [00:14:00] That's huge. I wish you all the very best for that. And maybe we can have you on again when this, is rolled out, because that's a really exciting program that you're, planning there. And it's much, much needed.

Aaron Bitter: Yeah, I agree. Thank you. Yeah,

Chris Langley: Aaron, with your location in Texas, can you tell us about the opioid crisis within your state and how it's affecting your whole community? This is a big thing.

Aaron Bitter: At this point, the numbers are dire. in terms of overdoses, doubling annually over the past 10 years. We're over 200,000. The numbers are mortifying. What I can say is that

we're in the suburbs, right? What we see, I know if it's as bad as it is here, then, my experience in this field tells me that it's going to [00:15:00] be even that much more worse in an urban and rural areas, underserved areas. And it's bad guys. I said that I live, work and recover in this community. I have a family here, and unfortunately, I've seen in the school district where my son is at recent fatal overdose. If it's happening here, we know where else it's happening, that's happening everywhere. I've seen some data that says that we've hit like, that the numbers for 2024 might actually show where that overdose is maybe had actually hit, whether it be a decrease in 2024 or at least not an increase. But they're still a dire. Now, even if that's the case, these are not going to be pretty numbers that come out, but there is some [00:16:00] optimism that we might have hit it. We might have peaked in terms of looking at the overdose numbers.

Chris Langley: Do you think that's because maybe the message is finally getting out about the, huge risks now involved? My next question is going to be, would you say drug use has become even more of a risk than it was say 10 years ago? And clearly it has, just hearing what you're telling me now.

Aaron Bitter: Yeah, it is. So if you think about it, so one of the areas where is it more recent 10 years ago? Absolutely. If you had me on, and you were just talking about alcohol, we'd be having a different conversation because the data bears out that if I looked at where we're at now, say with teenage adolescent, young adults, the numbers are dramatically reduced in terms of drinking where they were 10 and 20 years ago. That's largely is the efforts that have been made in prevention, recovery, treatment, and really that getting the message out.

Unfortunately, the reality is [00:17:00] though, from a global or a larger perspective, people are still going to use substances. People are going to have maladaptive coping skills. I look at myself and you ask me, if you said, "why did you start using or, why do you use?"

I didn't realize it at the time, but it was the short answer was to tune out the noise, to make that, just that whatever it was, that anxiety, that trouble in my head to stop, just quiet it. I think that to me, that's very normal, very common in talking with other people that started using substances at a young age.

So they're going to find something. It's more dangerous now, because, okay, alcohol, we got the message out on alcohol. What, kids, good luck, it's not going to be, a 16 year old today is not going to be able to go and buy alcohol. Unfortunately, [00:18:00] what's, scary is they're going to be able to go get fentanyl.

And it's lethal.

Chris Langley: That is heartbreaking to hear when you, speak about it in those terms of young people. So young people are actually overdosing as well with, fentanyl in your state as well. That seems sad.

Aaron Bitter: Oh, yeah, the rates, I wish I had the, I don't have anything right in front of me, but the data on fatal non-accidental overdoses age 12 to 17 is mortifying. It has just gone, if you look at it through, we've charted nationally the overdose data since at least on a national level, since at least 1980,

and say during the peak of the war on drugs in the 1980s, there was an increase, but things started going through just, and on this decade compared to where they were, it's, just, it's very [00:19:00] scary. With the youth while on the one hand, you look and say, okay, teenage drinking is down dramatically.

Well, unfortunately, yeah, they're going to turn to something, and what is the most readily available right now? It's fentanyl.

Chris Langley: Yeah. On these podcasts, Aaron, I've, heard a couple of people telling me that even, cannabis/ marijuana has got fentanyl in it. And that to

just, I couldn't believe what I was hearing. It's

Aaron Bitter: Yeah. , We've not necessarily had an experience in our own community. I've read some stories of other communities of overdoses related to legal, cannabis that was laced with fentanyl. Because then you think, on a global picture, I view, cannabis deregulation as one of the positive steps in, harm reduction and moving away from the war on drugs.[00:20:00]

But if on the other end, if you're telling me that cannabis is going to be laced with fentanyl that is a scary thought. They say it's in everything. I know that just again, if I speak from our community, our clinic, somebody comes in there using illicit drugs that they bought off the streets, the chances are at this point it is laced with fentanyl.

Clinics like this are the front lines in the opioid epidemic, the fentanyl epidemic, fentanyl crisis.

Chris Langley: Most definitely. This is why, one of the reasons why I'm doing this podcast because I feel that people need to hear your side and what is really going on here.

Aaron Bitter: Yeah, I'm glad. It's needed. Things like the more we talk about this, I know working in this field, living in the suburbs, having a kid, and you've got these conversations, "what do you do for a living?" Inevitably when I answer that question, [00:21:00] people have a lot of thoughts.

And I, what I find is there still, while we have got the word out. There's still a lot of misinformation, a lot of lack of information. So having these conversations and getting that word out is, it's vital. I

Chris Langley: Would you say social media has had a big part to play in this as well around false information around possibly propaganda or denial that this is even going on. I've seen many posts about that as well.

Aaron Bitter: I think, on the one hand, social media can obviously be a benefit, and can have a positive sense of, fighting this, but unfortunately the ability to spread misinformation in a rapid manner with a large audience is an aspect of social media.

Chris Langley: Most, most definitely Aaron. My next question is, I asked this of all my guests, [00:22:00] Aaron. Doing these podcasts ,I get very different answers answers to this, which is why I'm asking, what are your views on harm reduction, and why it's so important for the awesome work that you're doing?

Aaron Bitter: So I look at it like this, I very much believe in harm reduction, and I view it from this really bottom line that the term any positive change for far too long. My recovery primarily came through 12-Step or abstinence based. So I believe in, absolutely believe in that. For a lot of people works. It worked for me. But too often because 12-Step has dominated recovery treatment forever, essentially, and so much of treatment is tied with that abstinence based model, we lose sight and we look at anything short of abstinence as failure, and it's not. Any positive change, any reduction in use is a step in the right direction.

[00:23:00] If we can't keep someone alive, how can we treat them?

Chris Langley: That's right.

Aaron Bitter: So when you say harm reduction, you can get me going. I very much believe in it. Our agency, since we're talking about Symetria, how much do we believe in it? We had the author Maia Szalavitz, who's a New York Times bestselling author, I get a little chilly just thinking about her. Last month she did a presentation for all of our clinics, so we had her live at Symetria, where all our staff stopped down to listen to the presentation. Two hours with Maia, and she's done so much work in harm reduction. What is it Symetria believes when it comes to harm reduction, and do they believe in it? If you're going to stop down your whole, your entire company for two hours to meet with one of the real, leading [00:24:00] figures in the harm reduction movement, that is what, where we're at as an organization.

Chris Langley: That must have been very inspiring to have had two hours with her. That's incredible.

Aaron Bitter: Oh Yeah Absolutely. Yeah.

Chris Langley: Definitely. Most definitely. Last couple of questions, Aaron. What plans for the future do you and your team have at your service? Obviously, you mentioned the, the amazing work that you're going to be doing in jails. Is there anything else going on that you maybe got planned for next year or?

Aaron Bitter: One is just to try to continue to. right now is to do what we've been doing and make sure that we are meeting the needs of patients, make sure that our staff grows accordingly. We're always, of course, looking at the possibility of offering more services, like referencing the possibility of jail services, possibility of expansion of hours of

group [00:25:00] programming, things of that nature. Anything we can do to just to decrease barriers to treatment and increase access. But in terms of anything specific, I feel like right now where we're at in our growth, it is just, it really is a matter of just just fine tuning what we're doing and making sure that we've got the capacity to treat the people that are in our clinic versus reinventing the wheel or anything like that.

Chris Langley: Most definitely. Last question, Aaron. Have you a message for anyone who's listened to this podcast today who is going through addiction?

Aaron Bitter: Yeah. It's this, that there is hope. I try, myself as part of why I am very open about my own recovery, I can, say that in my own personal recovery, experienced some real hardships because of the use. Certainly, I was at a point where I felt like, [00:26:00] "I'm not just someone who can, I'm not, I can't just walk into a meeting and get help.

I can't just walk into a treatment center. Like I'm, I've moved past that, I've tried that. That didn't work, and unfortunately now my life's got to where..." that wasn't true. But these are natural things we tell ourselves. Fortunately, the things worked out in my life where, eventually those messages click.

The one thing I would say is to someone who has had some experience in recovery. And maybe it hasn't gone well, or they had a little bit of success and then had a setback. That's a normal part of recovery. I didn't know it at the time. I've been trying to recover for about three, four years at the time where really, I didn't view it that way.

I viewed it differently. We too often view anything again, short of abstinence as failure. So to someone who maybe has had that experience, that there is hope, [00:27:00] support is such a key. To loved ones. you might, you hear this, but how important it is to try to, provide that support, we'll walk that line between, nonjudgmental and nonpunitive, and I understand we don't want to enable people, but we throw that word around like it's a bad thing and sometimes enabling, it's really just loving someone.

and I don't think you can love an addict too much. You could maybe make some poor choices involved in that, but loving them is never going to be a bad thing. , , The message is just hope is out there and to never give up.

Chris Langley: That was beautiful. Thank you, Aaron. Lastly, can you tell our listeners how to best contact you and to find your service online?

Aaron Bitter: Yeah, so couple ways of one, we have a, 800 number. It's 866-583-5844 that connect that's available 24 hours a day. [00:28:00] If someone called that number, they'll get connected with a member of our admissions team. As well if they go online, Symetriarecovery.com. The website's very user friendly.

It's just going to pull up essentially our clinics. You click on essentially the clinic you'd be looking for, and it's very, user friendly. Maybe someone who doesn't want to I get it, like I've been a person that wanted to pick up the phone. You can get everything started through the website as well.

So we try to make it as simple as possible, and we're really good at, in our clinics about getting someone in quick for help. Our admissions team are also just very compassionate individuals. So sometimes look, it might not be that phone call might not end up with you even making that decision for treatment, but it might be the voice at the end of the other line [00:29:00] that you needed to hear just offering support.

Chris Langley: Aaron, thank you so much for your time today, and please send my very best wishes to your awesome team. What, you've built is quite incredible, and it's been a real, honor to have you speak to me today. I look forward to having you on again, because I'd love to hear more about the prison program if that works.

Aaron Bitter: Oh,

Chris Langley: because it's much

needed.

Aaron Bitter: Yeah. I appreciate you having me on. I really liked talking with you and definitely once we get that going, I would love to talk to you about it.

Chris Langley: Awesome. Thanks a lot Aaron.

Aaron Bitter: You're welcome.

Chris Langley: Much appreciated.

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