Public Health Week: Substance Abuse Treatment

Editor's Note: For National Public Health Week, the Tacoma-Pierce County Health Department is sharing stories of their work with community partners invested in the health of Pierce County. Here's Drug Alcohol Counselor Jan Jepsen.

I was a Montessori educator for 28 years before changing careers, getting a Master’s degree in Counseling and then my Chemical Dependency Professional Certification. I became involved with TPCHD Treatment Services through an internship that eventually led to a position as a Drug/Alcohol Treatment Counselor almost four years ago. In my role, I complete intakes for individuals who wish to join our Methadone program, facilitate a group, and have about 31 clients on my case load who are enrolled in the Methadone program. I see individuals that are often afraid, exhausted, lost and in pain both physically and emotionally. Many have lost everything and it is a big step to ask for help from a complete stranger.

Today I have four individual sessions, one group, and two intakes. My first individual session begins at 5:15 a.m., and then my Healthy Relationships group meets at 6 a.m. The group has eight women this week, and we talk about domestic violence as well as healthy relationships. One woman has recently moved out of her abusive home, another talks about her stress and frustration at allowing someone into her home to “get clean,” only to find this person is using, one lady reports that her landlord gave her an eviction notice, and she believes it is because she is gay. As a group we discuss these issues, and work through solutions to help the group members manage their challenges as they get clean. When I return to my office, I write up group notes for the week.

I have an intake at 7:30 a.m. with a woman in her late thirties. She is well dressed and looks as if she would like to be anywhere else but sitting across from me. She is sitting as small as she can in the chair in my office. I quiet my voice and try to get to know her. She is well-read and articulate. She struggles to answer when I ask, “In the last 12 months have you had significant problems with thinking about ending your life or committing suicide?” She responds, quietly, looking at the floor, “Yes.” We talk about what is going on in her life: her fears, many; her joys, few. She opens up about the abuse she has suffered at the hands of family members. She has a beautiful child, and her significant other is clean.

She never speaks with her family; she has spent much of her life running away from them all. In the past she has been diagnosed with Anxiety Disorder, Severe Depression, Post Traumatic Stress Disorder and Dissociative Disorder. I am not surprised by these diagnoses when I hear about her childhood in an extraordinarily physically and psychologically abusive home and young adult life on the streets. She confides in me all the ways she has tried to kill herself over the years, so we fill out a “No Self Harm” contract. By the time we complete all the paperwork, she has been in my office for two hours. She is signed up for her first dosing appointment the following week.

After lunch, I have an intake with an older man who has never been to treatment before and has spent almost half of his life in prison and dealing with multiple mental health conditions. He tells me about being sexually brutalized as a child, and how as an adult he has difficulty functioning without anxiety around some ethnicities. We talk about the abuse he has suffered and how he has never gotten counseling, just medications. He confides that he is afraid of reliving the abuse through counseling, but that he is willing to think about individual counseling this time. He tells me that he has used almost every substance from early childhood on, and we talk about drug interactions with Methadone and what he must stop using. This man is homeless, he is worried about his grown children and how will he be able to pay for the Methadone. I give him several funding resources to look into before he joins the program and talk about when he can start. After two hours, I am hopeful he will follow through with counseling as it will be instrumental to his putting the pieces of his life back together.

I do ten intakes a week. The stories can often be heart wrenching to hear. Without programs like ours, the cycle of drug abuse, arrest, harm to themselves and others would not change. These are people first, frequently broken and damaged with horrific pasts. Without someone taking the time to hold out an opportunity to help them make life changes, these individuals may not feel any self-worth and the cycle would continue into the next generation. Creating healthy people and healthy communities is what we are all about, and it begins here at 5 a.m., 6 days a week with dedicated counselors, nurses, Doctors, front office staff and supervisors.