By Anna Morgan-Barsamian, MPH, RN, PMP, Senior Manager, Training & Education, NaRCAD
An interview with Lindsey C. Beardsley, Individual in Recovery. This month, we’re looking through the lens of the patient experience, something that all detailers and clinicians work so hard to improve. We’re pivoting to an interview with a person with use disorder, her experience with use and recovery, and the ways in which the patient experience can encourage detailers and clinicians to continue working together to improve outcomes for those who struggle with substance use.
Tags: Harm Reduction, Opioid Safety
Anna: Hi, Lindsey! We’ve never featured a patient’s experience on our DETAILS blog - thank you for sharing space with me and telling a vulnerable story. Let’s dive right in. Can you tell me about your background? When were you first introduced to substances?
Lindsey: I was brought up in Cape Cod, Massachusetts with two loving parents and a lot of friends. I had a typical childhood, but I always knew I was different. I was extremely impulsive. I loved food – that was my first addiction. Then it was dance, then soccer, then horses. I did everything to excess.
I was first prescribed opioids after a knee surgery at 13 years old, and again after a second knee surgery at 14. Something clicked in my brain when I used those medications, and it opened a door that I couldn’t close. I was shut off to all emotion and it felt good to not feel anything.
My use progressed from taking prescribed medications for pain to using heroin and becoming homeless, struggling to meet my most basic needs. Using drugs gave me a false sense of power that I wasn’t like any of my peers and that I could do what I wanted because I was different.
Anna: We hear many stories from patients about substance use starting after pain medications are prescribed during adolescence. Despite the power that you felt when you used, were you ever worried about the health effects of your drug use?
Lindsey: I dated someone in my teenage years, and we often used together. Cape Cod is a small community and within a few weeks of dating him, my mom heard that he had Hepatitis C. My entire family was devastated, but I didn’t care at all – I couldn’t see how it would affect me.
I think back to all the times I shared needles and drug supplies. Even if I tried to use new needles, everything looked the same and would get mixed up in the rush of using with other people.
I would always have a little fear inside of me that I would overdose on my first time using again after being in treatment, but that fear never stopped me.
Anna: We know that substance use disorder is a medical condition and patients need professional support. When you felt ready to address that fear and seek treatment, were there healthcare resources or community supports that helped guide you towards recovery?
Lindsey: I’m lucky to be in a state like Massachusetts where we have a lot of resources that the rest of the country doesn’t have. I was a frequent flyer at our detox facilities. When I was admitted, I was always paired with a peer that was in recovery. I often knew the peer; it gave me hope to hear the stories of recovery from people I knew and previously used drugs with.
I was assigned a counselor, and we would discuss my treatment goals and next steps. The counselor would walk through every community resource within several miles of me, like partial hospitalization programs, sober homes, Narcotics Anonymous (NA) meetings, 12-step programs, and syringe exchange programs.
We also have a mobile harm reduction center in my community. Before it existed, a woman in recovery started a needle exchange program out of her home. She sparked a need and desire for our community to learn more about harm reduction.
Anna: Many people don’t have access to substance use resources in their community, especially harm reduction services. Here at NaRCAD, we’re trying to encourage primary care clinicians to be able to provide those linkages to care and harm reduction services. What does harm reduction mean to you?
Lindsey: I was against harm reduction for a long time because I was very involved in a 12-step fellowship where the primary purpose was complete abstinence from drugs. Harm reduction was a shift in mindset for me, but it’s pretty cut and dried. We’re reducing harm, saving lives, and preserving a sense of family and community.
When we reduce harm, we allow a mom to be a part of her family again, we allow her to get a job, we allow her to get off the street and out of harm’s way. Harm reduction can allow people to return home.
Anna: It’s valuable to know that a 12-step program and harm reduction can co-exist. What message about harm reduction would you want to share with members of your community?
Lindsey: Harm reduction doesn’t enable drug use – use is going to continue until the person is ready to seek treatment. A simple approach to harm reduction, like syringe exchange, prevents the spread of infectious diseases and reduces needles in public and community spaces. It prevents someone from contracting Hepatitis C when they use drugs.
Anna: We know that harm reduction plays a huge role in preventing drug-related deaths and offering access to services. There are many approaches to harm reduction and even using just one approach reduces so much harm. Let’s transition to talking about patient care. How would you want your care to look, or not look, when seeking help for substance use from a clinician?
Lindsey: I’d want to seek care in a safe space where I could share what drugs I use and how I use them without being punished, judged, or arrested. I would also want a space to discuss what’s going on in my life with someone who is educated enough to help me.
I honestly wouldn’t want to listen to a clinician tell me about treatment options while I can sense that they’re judging me. A lot of clinicians have been through at least one training on substance use, but those trainings don’t change core beliefs and morals. Those trainings don’t change the way a clinician looks at you when you tell them you use substances.
Anna: That’s true – having a trusting relationship with a clinician where you can share openly and not be judged is critical to effective care. How could clinicians have meaningful conversations with patients about substance use, especially if they have preconceived notions?
Lindsey: Clinicians need to learn to have open, non-judgmental, inclusive discussions. That starts with asking all patients about their mental health and substance use history. Educators can provide clinicians with scripting tools if they feel uncomfortable having these conversations.
Also, including peer support in the plan of care can help take some of the stress off of the clinician. This can include reviewing community resources and continuing the conversation with patients, while also educating the clinician on substance use through sharing personal experiences. We need to support patients, peers, and clinicians in doing this work and doing it as a team.
Anna: I’m hearing you talk about so many elements that clinicians can use to improve patient care, like scripting tools and peer support. We’re continuing to work on ways to support educators and clinicians – your ideas will certainly help guide us. Thank you again for sharing your insights and being open to this conversation. We look forward to connecting with you again in the future!
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Biography. Lindsey C. Beardsley, an individual in long-term recovery, was born and raised in Cape Cod, Massachusetts. She was involved in many different sports growing up – gymnastics, soccer, and dance – but riding and working with horses quickly won over her time and heart from a young age. After many years of struggling with addiction, Lindsey walked into a treatment facility in August of 2018 and made the decision to stop using drugs one day at a time. Lindsey has been in recovery since September 21, 2018.
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