Ep48 Addiction Treatment Justice-Involved Clients

Ep48 Addiction Treatment Justice Involved Clients

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, Angie Poile from Sioux Falls in South Dakota. Angie is the Director of Outpatient Substance Use Services in Sioux Falls and a representative for the DUI Court.

Welcome to Addiction Recovery Place Podcast, Angie. It's great to have you with us today.

Angie Poile: Thank you so much for having me. Good morning.

Chris Langley: Really appreciate it, and thank you very much for taking the time out of your very busy schedule today to speak to us today. So we're just gonna jump straight in on the first question. Angie, can you tell us about yourself and your journey to becoming the director of outpatient substance use services, please.

Angie Poile: Oh, gosh, that's a long story. my mother actually, struggled with addiction, for most of my life. And when I got to college, and I found, the major, addiction studies at the University of South Dakota. That is, that just easily fit, and, yeah, it just made sense. Then, I struggled with my own addiction in high school and college and, started working in the field, found recovery, actually at the very beginning of working in the field in my internship and, I guess has been history.

Chris Langley: Okay. So what, other roles have you had in between going to college and now obviously with, your very important role as being director of your, services. what other work did you do in between this?

Angie Poile: first, when I was in my internship in college, very many years ago, I worked our state, it was considered our state hospital back then, or our state program. In, in, it was an inpatient adult program, for a few months. then I decided to take a long break for motherhood. I believe it was about. 18 years, like that. I paused my trainee status as a counselor for about 18 years and then got a lot of what I would say practical experience as a mom. then I came back to the field, first part time, worked, actually at a medication assisted treatment center. little bit. So that was a big change to come back to the field after so long and then suddenly there was medication. so that was really a fun learning curve, to come back and was suddenly MAT being, being done. that was about 10 or 12 years ago. then, only did that for about a year. Then worked at a different inpatient treatment center, which was great, excellent, and then to work where I'm currently working, and it was outpatient treatment. then, really enjoyed that, learned all I could, got trained in all the different treatment programs that I could, and just to work my way up, enjoyed doing all the different things. I working with, some specialty stuff with the, more justice involved clients, justice impacted and justice involved clients that are a little, maybe deeper down the path of justice involvement. And fell in love with that, really, that's the area that enjoy most. Now I can't see myself not wanting to work with that population. And, that's, more what we tend to serve now, at, our agency. About, I would say, 95 percent of our clientele is, the justice.

I

Chris Langley: So, what did it feel like when you came back from, from being such a long time on leave with your family and then discovering the mat is now available? That must have been quite a turnaround.

Angie Poile: was so excited. I, I've lost a lot of family members to addiction, including my mother, during that time. And, I love the fact that we can, this is an option now for people that, that we, if there's something more we can do, I think it's a great idea. It

Chris Langley: Most definitely,

Angie Poile: the, it was a really, yeah.

Chris Langley: okay, carry on, sorry.

Angie Poile: Oh, it was a really small clinic. a small agency. and I worked really, I was able to work really hand in hand with the doctor that was the prescriber it, It was done very well, and I saw how it could be done very well. the medication assisted treatment, saw some excellent success and, it was just wonderful to see. The advances.

Chris Langley: Most definitely. So, Angie, can you tell us about your role and who you work with, please?

Angie Poile: My current role, I direct, the majority of our outpatient addiction services right now. that includes right now we have two in, that basically oversee what we call our CGI services, our criminal justice initiative services. quite a few years ago, there was, Legislation to try to keep, many of our justice impacted individuals out of prison. and to try to some treatment with them instead, which obviously is a great, thing. so there was extra, money, legislative stuff that was done to try to Promote that. So two of our counselors do the majority of those special treatments. one of them is, substance abuse treatment.

The other is a criminal thinking, group, it's called MRT. That's a pretty, widely known one. we have the majority of the contract for that. We do a ton of MRT here. We really love that one. One of my favorite things to do, we do a bunch of MRT groups. So two, two of the counselors do that.

And then we have three other counselors right now. We do have a couple or we do have, an open position also, but. Then the other three counselors that I supervise, like a lot of substance use evaluations. We do a lot of those. And then, of our other outpatient service services, which is like intensive outpatient group and a lot of aftercare groups.

Chris Langley: So,

what other, agencies do you work with in the community?

Angie Poile: oh, all sorts of stuff. probation and parole, we work hand in hand with probation and parole. I know those guys, those people well, I have those guys on speed dial, and the attorneys, public defender's office, all sorts of. All sorts of people in the community, the residential, living facilities to, all different, resources for our clients. when, because we do. a lot of substance use evaluations to get people into all sorts of treatment. here we have level 1. 0 and, level 2. 1. We, of course, do lots of evaluations to get people into inpatient treatment, 3. 7 and residential and, and we do plenty of just coordinating care.

Of course, it ends up being a fair amount of like case management type stuff just because we care enough about the clients that we put in. extra, we do the extra stuff that just, you know, and referring to, if they need mental health, because focus on addiction here. we do have some in house, mental health services, but they're pretty, busy with other stuff. so they're not always able to take our referrals. sometimes we, yeah, just so much coordinating of care with other agencies,

what. our clients need.

Chris Langley: Yeah. I bet it must be a real weight off the shoulders of the probation staff having your resources, as you say, on speed dial as well.

Angie Poile: Yeah, yeah, they're generally happy with us because we try so hard to just get the client's needs met and get, try to get them the help they need so they can be successful.

Chris Langley: It's just about getting a support network together, isn't it, with the same goal? Yeah,

Angie Poile: exactly.

Chris Langley: absolutely. So what would you say are some of the biggest challenges when working in this field, do you think, Angie?

Angie Poile: Oh, yeah, I was thinking about this one. I would say the two biggest challenges are When, resources are limited, if we know, a client needs housing, and, that is limited, or, they need some residential treatment, and it's maybe backed up till, months, and they just have no place to go, and, right now, it's nine degrees out. And, or, transportation right now. It's a struggle in Sioux Falls. it's still just them getting to and from treatment when they need to. or else they might be in trouble with their probation. yeah, just some of those barriers. or knowing that really need some mental health. therapy, or else maybe their substance abuse treatment, they maybe won't be successful in recovery if they don't address some of those issues, but maybe they really just don't have that access, or the finances to do that, that's a real struggle to see that or know that's their barrier. Yeah, and then another one would just be for us, like us, as counselors, myself and my staff to, to see, or to have the emotional, to see what's happening emotionally and to have our, people, a lot of our clientele are having, just major struggles and to see some of the really bad things happen to have the loss of clients, and we have good, I think we take good care of ourselves, good self care and all that, but just still it's, tough when we have, worked with clients for many months, or maybe even a year or two and they still maybe pass away or, something terrible still happens.

still not easy, and in October and November we had a tough month where a couple pretty bad things happened and that wasn't easy.

Chris Langley: So I guess it's, I guess it's about supporting each other in the workplace as well with going through, like you said, self care for your, for yourself, obviously, and looking after your colleagues as well to make sure that they're looked after and their welfare is acknowledged.

It's very important in this field.

Angie Poile: Yeah.

Chris Langley: Yeah. you mentioned something quite sensitive earlier about some of your clients perhaps have sadly passed away. how, is your state coping with the opioid crisis and what harm reduction services are available in South Dakota?

Angie Poile: yeah, for, a few years now, there's been some great progress in dealing with the opioid crisis. they, there's been a lot of, Narcan, use. even distribution of Narcan to the public and, lots of people are using Narcan all over the place. There's all sorts of, good Samaritan laws where people can be using it all over. And there's even some, more and more grants and, I know there was like What is it with the, I think there's some settlement dollars that just came through. just a bunch of that just came through with, lots more, stuff that's starting to happen, especially with Narcan. use being so much Narcan is being distributed, but a lot of that stuff is just taking off. There's some, great, agencies that have really taken off with that, and some grassroots organizations that have been starting to do some stuff with that. And then there also been, for a few years now, also been starting to distribute the fentanyl test strips to, like, clientele and, or, clients and to anybody who wants those kind of things. And then some also, some great ads that are, going on. there, some marketing and stuff to just educate the public a little more about it. They've also been doing those, for a few years now, at least like 10 years. There's been the, exactly what it's called, the prescription drug, like reporting, I can't think of the exact name, the prescription drug reporting like list, so like doctors can check it, and it's like a data, collection

Area so that, all doctors and pharmacists can check to see who is getting what opioids from where, so that if people are getting it from multiple places, that will, they, they can check that and it'll pop up.

Chris Langley: it's great to, it's great to hear that South Dakota isn't running away from the problem.

Angie Poile: oh yeah,

Chris Langley: That's for sure.

And you're, actually the third person I've spoken to in the last two weeks is who's spoken about the opioid resettlement fund.

Angie Poile: yes,

Chris Langley: And, it's nice to hear that South Dakota is actually putting it towards a good, how it's supposed to be,

Angie Poile: right.

Chris Langley: which is,

and

Medication Assisted Therapy, thankfully is increasing.

Yeah, of course.

Angie Poile: yeah, increasing here,

Chris Langley: let's hope those dollars go to, continue to go to the right causes,

Angie Poile: right,

Chris Langley: as it should do, because that was just a travesty, what happened, and quite rightly there should be some, there should be some big compensation for what happened. That was just bad. Really was shocking. that's lovely to hear that South Dakota is actually addressing the problem head on.

That's lovely. Just gonna move on a little bit Angie because you're a long term member of NAADAC can you explain why you joined this organization and what are the benefits to becoming a member? And if there's a message to anyone who's thinking about coming to this very important wide ranging field, why someone should consider becoming a member.

Angie Poile: I think I first joined it because when I first came back to the field, I think I was nervous that I had been out of the field for so long. I went to school, so long ago and I was coming back and I was like, I hope I remember everything. I hope. I hope I'm going to be okay coming back. So I love being a part of it because of all the resources and I want to stay fresh and keep my knowledge current. And I don't know, I guess I'm just a nerd when it comes to, admittedly, I'm a nerd when it comes to addiction and recovery stuff. I just love soaking up all the information that I can. I can never get enough knowledge when it comes to addiction and recovery because I want to always just, Keep gaining more if they're, I can do to help our clients and whatever I can do to be able to teach my staff more so that they can continue to help our clients is better. And NAADAC is such a wealth of knowledge, just constantly putting out more and more information and knowledge. So love it. And they, make all the learning interesting and, in a way that is, easy to want to engage with it.

Chris Langley: So you would recommend someone to look into NAADAC if they're considering it. Yeah,

Angie Poile: And all, of us that need, CEUs, it's the best way.

Chris Langley: yeah, definitely.

Angie Poile: so worth it.

Chris Langley: Yeah, they're an incredible organization. I've loved being a member. It's been a real eye opener for me, a real learning curve for me to join this organization.

Angie Poile: where I let it lapse and, and then I regret it because I'm like, why did I go without it?

Chris Langley: Wonderful. Thank you for that. That's great. One question I always like to ask about is the word stigma. This comes up on all of our podcasts. So I always like to finish our podcasts around this, but why do you think it is in this day and age, we're still having such an issue with stigma, given the crisis of addiction and health that is sweeping across the world now?

Angie Poile: okay, so I was thinking about this one and, I, myself, I'm a person in long term recovery I, guess I was thinking that I don't really, on a personal level, I don't face it. I'm really, I didn't used to be this way for a long time in recovery, but I didn't used to talk about it. And then I do now. I talk about it all the time. I just tell people like I'm in recovery. I'm in recovery. And I don't think I, I face it, but I think that's because, I don't look like it maybe. And people, so people don't stereotype me or anything. In fact, like if I tell a doctor or something. Or when I've had minor surgeries, they just look at me and they're like, You?

What? and that always annoys me because I'm like, What? What do you mean? It can be me. It can be anybody. But, then I started thinking about, my clients of course do face that. and I think the reason is because it is, it's still a little confusing. It really is. Even my clients struggle to accept it because my clients, I don't do a ton of client contact anymore, but I still do have a little bit, I'll do a little bit of individual sessions, maybe with a problem solving court client or something like that, when they're struggling. And I notice people, definitely clients still struggle with, much guilt and shame if they have a lapse or things like that. And I think the reason is it's definitely such, it is a disease. and I'll tell them that myself with, I'll have 29 years of sobriety, by the grace of God, if I make it to the 1st of January, we'll see. I always say, because you never know, right? You just never know. But, it really is one day at a time, but I'll tell people that, still sometimes, I will occasionally have a craving. and that's how I know that it's, truly a brain disease, because it will just, It'll just happen. And I'm like, what? How can that? That's the weirdest thing. but my, the, they will beat themselves up. The clients will really beat themselves up with that guilt and shame. And the reason is because it is a brain disease, but, we do have choices that, first one or two, like me right now, I, have a choice. If I decide to go, and, right now it's totally in my prefrontal cortex, I can go, make those choices right now. And it would be a hundred percent, on me, those decisions right now to go and, get a drink or go use something. I would be to blame if I went and made that decision to go get something right now. But then after that, after those first, that first choice, that's when it's out of control. and that's where it's different. and that's where people don't understand that those choices have been made and once someone is, those coping skills right at first, you can choose. But then after that, it gets out of control and someone doesn't have a choice. they've, once they've lost control and that no one would choose that. No one would choose that. I've even sometimes had staff that is like, why are they doing this? Why are they doing this? And why are they lying to us about it? I've had, I've even had clients that, I know, that have been very honest with me in the past and that we've developed a great rapport and they'll stare at me and look at me right in the eye and they'll be like, Angie, I, don't know why my drug patch is coming back positive, and they'll just lie to me. And my, staff will ask me the same thing. Why are they doing this? And I'm like, it's because they so badly want it to be true themselves. the guilt and shame is so there, but nobody would do that purposely. No one would, or they'll be like, my staff will say, why do they, why are they doing this?

They have everything to lose. I'm, they don't, they're, nobody's choosing that. My mom didn't choose to, do that to her family. she didn't choose to, end up dying. Not, she just couldn't find recovery. Nobody wants that. It just spirals. At that point it's just spiraled out of control and they can't stop at that point.

Chris Langley: Thank you very much for that very personal answer, Angie, by the way, that was really powerful stuff. Last, question. I ask all my guests this because I get some really interesting, varied answers, but can you tell me your opinion of harm reduction, how it can play such a role in recovery?

Angie Poile: I think harm reduction is very important because people's lives matter and I think that we should be willing to. do anything it takes to, help people to survive, to, for another day, to find recovery. Now, and whatever that means, I, not everyone's goal is to be 100%, clean and sober from all substances. And, and that's okay, We should, I think we just need to do our best to help everyone and to, yeah, reduce all harms. And harm reduction means all different things. There's so many different ways to reduce that, the harm. but yeah, some people of course think, oh, it's terrible to do things like provide clean needles and stuff.

But I'm like, you, But if it makes someone healthier, then I think that's, yeah, we should, be doing anything we can to help people. And, while on a personal, do think that probably, in the long run, I don't know that, moderating use usually works very well. probably not, but yeah, sometimes it can. And if it, Again, if we can do to try to get people even doing better, why not? I, yeah, and I don't, I don't about judging that, and yeah, I just think that a great idea if we can help someone.

Chris Langley: most definitely. last question, Angie, do you have a message for anyone who's listening to this podcast, who's going through an addiction? What would you say to them?

Angie Poile: You are worth it. You're worth a better life, and you, have, value and more things to give back to the world. there's a better life out there. it's, it'll be tough, but it's worth it, and you can do this with the help that you'll receive.

Chris Langley: what a perfect end to today's podcast, Angie. Thank you so much for joining me. It's been a real privilege and an honor to hear your journey as well and to hear about the great work that you're doing in the state of South Dakota. thank you very much for your time today. I really appreciate it.

Angie Poile: Thank you so much for having me. I appreciate your time.

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