Archways' Threads

Narrator 00:02
Welcome to Archways Threads, a show focusing on the threads of family and recovery support services that help make up the tapestry of life in recovery. Join us as we share stories from peers and participants in the field and practice of peer recovery support and family support and strengthening. And now your host, Archway CEO Michelle Lennon.

Michelle Lennon 00:25
Hi, everyone, and welcome back to Episode 3 of our podcast for peer recovery support specialists and family support specialists. We are finishing up our conversation with Cheryle Pacapelli, Project Director for the state supportive recovery centers throughout the state of New Hampshire. We are so excited that you're back with us. Please, if you have missed Episodes 1 and 2, go back so you get the full benefit of the conversation we had with Cheryle. Thank you so much for being with us. Take care.

Michelle Lennon 00:55
Sometimes I wonder about the brain changes. Sometimes substance use is problematic and it's behavioral, and sometimes it's problematic and then the disease of addiction is accompanying the problematic use and so people can't stop without some type of medical support. And we see everything in between on the continuum if we look at it. But I think the abstinence-only mindset has come out of the 12-step tradition, largely because that was the only thing people had to support them for so long.

Cheryle Pacapelli 01:28
Exactly.

Michelle Lennon 01:29
So it's not a bad thing.

Cheryle Pacapelli 01:30
No. What sometimes scares me is that I came in through an abstinence-based recovery. And I have learned over the years to support harm reduction. What gets me scared is when someone enters recovery in an abstinence-based recovery and then they decide, which they can, to do a harm reduction model. It has not always worked out well. So trying to balance those things--and this is for the Recovery Center staff is where I find the biggest, like, early in recovery: "Why am I doing abstinence and helping people who are being successful at harm reduction? Why can't I?" And there's a reason. I would not succeed at a harm reduction model. If I had one drink, I'm going to have 100. But it takes years of brain healing, like you said, to understand that so that I can make the choice every day that I'm just not going to drink today.

Michelle Lennon 02:52
My husband and I have had many conversations about this, because his addiction has been to opiates. Because of the number of surgeries he's had, he's often been prescribed opiates that have led him down to problematic use again. This last time he had hip surgery, he had to make the decision to tell the surgeon: "I cannot go home with opiates." Part of that was basically ultimatums given to him. Because every time it has been done, he hasn't done well, and he had to make that decision. But he has told me but he calls it "the voice of his addiction." What you were talking about harm reduction, the voice of his addiction would say to him: "It worked for him. Maybe it'll work for you." He's like, "But it won't." He discovered that because of the surgeries that he's had. I think it's a tough thing, right? Because each individual really has to answer that for themselves. But when addiction is the voice in your head that--and I know some people hate that idea of giving it human values, right? Because it's the disease, and it's your internal voice talking, but it's influenced by the disease that you carry if you have the disease model going on in your brain. And I firmly believe that's true for my husband, just because of where we've been in the history of his addiction.

Cheryle Pacapelli 04:18
It's amazing how resilient your brain is and also how not forgetful it is, because I was 21 years in recovery and never used an opiate until I was in the hospital for pancreatitis. I was on unlimited opiates for four days. It took me four months for my brain to not want an opiate every single day, every single day. And had they--at 20 years in recovery I hadn't used anything--if they sent me home with 30 of these opiates, I definitely would have used them. But I asked them, "Send me home with one." I knew if the pain came back, I could use it, but I would lay in bed at night and think about that one pill after just four days. People use opiates for years and we want them to get better in 30 days. It's insane.

Michelle Lennon 05:20
It is scary. My daughter had an appendectomy locally, at a local hospital, and she was going to be given opiates after her surgery in the recovery room and I was there when she woke up and her father was there. The nurse was about to give her opiates in the IV and I asked her: "Hold on, what are you doing?" And she looked at me like I was a bad mother. She's like, "She just had major surgery." So I asked my daughter, I said: "Honey, you know what opiates have done to our family? Are you in that much pain that you need it?" And she's like, "I don't think so." And then the doctor, he was drying his hands after washing at the sink, and he comes over and he looks her in the eyes and he's like, "Would you like a little bit of Tylenol to take the edge off?" She's like, "I think I'm good." A little laparoscopic surgery she had. She ended up having Tylenol later, but I think still in certain situations the medical field, dental field--because dental, we've seen unfortunate circumstances in our own community of losing a young person and it started with opiates after a tooth pull--that addiction can take root in the brain very quickly. That's the one thing people don't realize is, we don't choose our physiology and how it's going to react and we don't change, we don't choose how our brain is going to react to these chemicals. 13% of the population will end up addicted due to these substances. We tend to think: Well, I won't be one of those 13." But when you take a group of 100 people--and this is what I used to do, I used to imagine the kids at the high school. Out of the 300 people, that's a whole lot of kids that would be susceptible to this and we're still not providing the education of how dangerous this stuff can be. I had the opportunity to train Headstart workers in the state of Massachusetts, because they were feeling certain types of way about supporting families affected by addiction. So there was a woman in the technical division of Headstart that wanted training, and I was really privileged to work with care and welfare to roll out some training on supporting families affected by substance use. There was a woman who came up to me after her training, saying she had had knee surgery. She remembers in between doses, she couldn't wait to get to the next dose, because she was feeling achy all over her body. She's like: "I am looking back, and I'm looking at the symptoms and oh my goodness, I was getting those sweats."

Cheryle Pacapelli 08:01
"I was in withdrawal."

Michelle Lennon 08:02
Yeah, starting the withdrawal process. So, the conversation that I had with her is: "You want to be real careful in the future, and make sure you stop as soon as you possibly can." Because once that happens, that addiction has taken root in the brain. There's no turning back from that. I think that's something people don't realize. I think that's one of the reasons why the continuum of care getting recovery-focused is so important, because you look at acute care--and it might be 30 days, 90 days, whatever the length of a program might be--but recovery is the rest of your life. We talked about cancer, you have that five-year checkup, even if you've been in remission for a while. We don't treat addiction the same way when those checkups could be really important to keep people safe. I think about that, this recovery-oriented--and what does that mean? It's really looking at living.

Cheryle Pacapelli 09:01
And what are we doing for people with five years of recovery that want to buy a house or have a real job--not a get-well job--and need to learn how to budget so they can get a car and things like that? How do we teach them about having a retirement plan, things like that? Those are our next phases of this, as we get out of the crisis of the opioid epidemic.

Michelle Lennon 09:31
Yeah, we've been we've been talking a lot about that at our centers, because what we have seen is our peer recovery support workers starting to get caught up and only taking care of the crisis, and discharging people because they haven't been around for six weeks or something. I think to myself: "Hold on," because we tend to work at stabilization. When people come out of treatment, we need to find some type of income to pay for housing, we need to make sure you're not struggling with food insecurity, so hook up to those resources. But still, we don't want people to just survive. And I do think about there was an old slide in the Recovery Coach Academy that CCAR put up that showed people's connection, that when they get into active addiction, their lifepost trajectory takes a dive. Yeah. But if they connect to recovery support services, they don't just get to where they started, they can go even further. We've seen that time and time again, with the people that have stayed connected. But a lot of people drop connection right after the crisis is over.

Cheryle Pacapelli 10:37
You see that a lot, especially when you're serving families, because they have the crisis with their spouse, their child, their uncle, their grandchild. As soon as that person stabilizes, they don't need any more help...when we know they do. Trying to keep them engaged is hard.

Michelle Lennon 10:59
Yeah, we've been talking about that and revamping that recovery support, telephone recovery support system to get to more recovery-oriented long-term check-ins.

Cheryle Pacapelli 11:13
Yeah. I take care about ya. Let's see how you're doing.

Michelle Lennon 11:19
So, one of the things I love to ask guests is if there was one actionable item that you would like people in recovery, people providing recovery support services, family support specialists working with families affected by addiction, if you had one message for them, as a peer in recovery yourself who has been doing this work for a long time, what would you think it would be?

Cheryle Pacapelli 11:42
It would be for me to be patient because I, as someone struggling with substance use, want immediate gratification in things, so I want things to happen quickly. "Everyone agrees, this is a great idea. Why aren't we doing it?" Sometimes you have to step back and work within the system that we have to continue to push that agenda forward, and it takes a lot of patience. You just can't give up. Don't ever give up. Don't ever stop carrying the message, just keep doing it in whatever venue it is that you can do it in. But I never thought that 20-something years from when I started this, we would still be trying to get people to believe in peer recovery support. But they believe more than they did 20 years ago. And one of the things that was told to me early on was when Susan G. Komen started the foundation for breast cancer, when she started it, people didn't say the word "breast" and "cancer" in the same sentence. It took her 25 years to do that. We're on the cusp of 25 years of this movement, and we have made huge progress. There's many more people in recovery today than 25 years ago.

Michelle Lennon 13:22
There are over 27 million people in recovery today.

Cheryle Pacapelli 13:25
Yep. I think when I started it was 21 or 21 and a half million. So, that's an amazing impact.

Michelle Lennon 13:33
It is. And one other question I wanted to ask you: How do you deal with the losses? Because we have lost some amazing friends over the years, you and I both. I was thinking about how for me, I have to box up my feelings and put them on a shelf, and then I take them out and I look at them every once in a while and I have my crying jags at home. Or just recently, I was in the process of packing up one of my offices because I'm moving to a new location right now, and I came across a t-shirt that somebody gave me who's no longer with us, and I came across a little piece of paper that was just a cutout. I was doing a project at one point putting pictures into frames, and he had cut out the frame size that I had with a little note and just seeing his handwriting, I just lost it. Just lost it. I was thinking about how I do have a pretty hardened heart at this point. I think about the difference between open wounds that just scab over and then the scars and I feel like I have a lot of scars that I can look at and appreciate, like the life of Dean LeMire and what his impact on my life was, and I miss him, and sometimes get choked up.

Cheryle Pacapelli 14:50
I know.

Michelle Lennon 14:53
But there are a lot of Deans in my life. There are a lot of people that have had some great impact, guys that lived with me. Before licensing was a thing, my house was like a respite for a little while there. I'm so proud of the guys that have made it. One of the guys that stay with us, he's married, he's got two kids, he's got a job. He's been in recovery I think he said for eight years this week, or a couple of weeks ago. Then I remember the losses, too, because opioid addiction hits a lot of people, over 400 and something people every year. When you think about that. That's like a 9/11 every two days in our country, and we are still, still not really attacking it the way you would want.

Cheryle Pacapelli 15:42
Yeah. I have some pictures on my refrigerator of some of those people, or in my office. I do things like football teams do, I touch Dean LeMire's picture every time I go by it and I say: "I'm gonna do this for you." Or Abi Lizotte's, who's in my office and say: "We're not giving up; we're gonna keep doing this for you." That's how I do it, because it's amazingly hard. You kind of--at least for me--I kind of get callous to it. I don't want to be that, because that's not who I am. But it's the only way to keep doing this work.

Michelle Lennon 16:33
I mean, the burnout rate is very high. I always joke when I see Eric Moran up at Whitehorse; we're the only two originals left now. We recently had a staff member that had been there from the beginning with me move on now, for the same reason, just burnt out, and she moved around positions for a while trying to hang in there, and found it was the best thing, to move on. I'm blessed that she's still a friend of mine; we went to breakfast today. But just thinking about how it's so important for some of us to hang in there because of the history. I was thinking about that, and sharing with you, feeling like some of the history is being lost. But now that we have this Office of Recovery, hopefully a lot of this will be recorded for posterity. I definitely appreciate those that have hung in there, but to completely understand those that have moved on. And that's something else: I think sometimes people get really excited in the trainings that we do about doing peer support. But for some people, this is just a chapter in their story. Once they enter recovery, they should go and live life and thrive and potentially leave it behind them. And that's okay.

Cheryle Pacapelli 17:47
Yeah. Whenever I train, I train it with no expectation, right? Because now I have 30 people who are learning something they didn't learn, they didn't know, they didn't understand about the disease. They didn't understand about how to interact and love someone through it, whether it's their loved one, or themselves.

Michelle Lennon 18:11
To set healthy boundaries. That was one thing my husband and I went through that really helped our family survive was me having support from the recovery community to set those healthy boundaries that protected our family, our house, our finances, things like that, while supporting him to get the help he needed at the same time.

Cheryle Pacapelli 18:32
Yep, yeah.

Michelle Lennon 18:35
So yeah, this was a lot.

Cheryle Pacapelli 18:39
We're in a 100-degree room.

Michelle Lennon 18:43
For New Hampshire, it's an unusual heatwave. Cheryle, thank you so much for being with us and for sharing some of your wisdom. I hope to have you back on the show down the road sometime because, of course, you're a wealth of knowledge, not just in the overall center of stuff, but in all kinds of aspects of peer support. So again, thank you so much for being with us, and we'll see you next time on Archways Threads.

Cheryle Pacapelli 19:10
Bye. Thank you for having me, Michelle.

Michelle Lennon 19:13
Take care. Bye.

Narrator 19:14
Thank you for listening to Archways Threads. If there is a topic you'd like to see us cover, email us at podcast@archwaysnh.org or call us at 603-960-2128. Visit our website at archwaysnh.org to learn more about the Archways family of recovery and family resource centers.