Addiction Professionals in the Pandemic – West

[Chris Budnick did this interview with West. Thanks to both of them!]

Who are you?

My name is Darryl West, and I just go by West. I’m a person in long-term recovery, and I also work in the field treatment.

What do you do professionally?

Professionally, I am a certified substance abuse counselor here in the state of North Carolina. I work for the Department of Public Safety within the Department of Adult Corrections, I work for the Division of Alcohol and Chemical Dependency Programs, and I wanna say as a disclaimer, I do not speak on behalf of the ACDP [the Alcohol and Chemical Dependency Programs]. I’ve been working with them since 2005, so over 15 years. We provide SUD services for offenders within the Adult Corrections.

Do you have any personal interest in addiction and recovery that you’d like to share

Like I said, I’m a person in long term recovery. I’ve been in recovery since January 24, 2001, so that’s 19+ years. Personally, [addiction has] affected my community. I have a brother that has even more time in recovery, some other family, some friends. So yes, I have definitely been personally affected. I’m also fortunate to have found recovery and to have received treatment services that led me to the recovery process.

Tell us about your professional experience in the area of addiction and recovery

I got into the field through my own personal treatment. I guess as a safeguard to continue my treatment, I started working or started working at The Healing Place (now known as Healing Transitions), in the detox and shelter area. At the time, I didn’t realize I was performing some of the core functions of addiction counseling. Later, I went on and got some courses and got deeper into the field, and I think I got certified in 2009.

I’ve worked with women, men, and youth, in detox services, inpatient, outpatient, with different modalities, Minnesota Model, and CBT. I’ve stayed actively involved professionally, as much as I can.

I also worked with Southlight for a while, doing some ADETS [Alcohol Drug Education Traffic School] classes.

Professionally, what are you most proud of?

West: I don’t know who he or she is that I’m most proud of, but I’m sure there is some child or grandchild who has been touched by something that I’ve shared with one of their parents, or relatives, or friends. Something that had a ripple effect, helping them have a more whole life because of it. I think that’s what I’m most proud of–the unknown of who might have been touched by what I was given to give to them.

What keeps you working in addiction and recovery?

What do they say about insanity? Haha.

It’s just fulfilling. Is there anything else to do, but give back? I’m sure there are other forms of service that we can give to our community, to our country, to our families. I just found this is my niche. 

I didn’t plan to do this as a form of service or even a plan of employment, but it’s something that is fulfilling… that you can’t buy it, you can’t find it in headlines. Yeah, I’d like to play in the NBA or be a comedian, or be a music star, but this is where I was meant to be.

I don’t fight it and I don’t force it. It just works naturally.

How has the pandemic affected your work?

First of all, I want to say it has affected my work and me personally, but let’s go with work. 

Nobody was prepared for this… many people have suffered… many people are still dealing with it and trying to cope.

I’m fortunate that I have work, I haven’t lost a minute of work since February, March, whenever this thing was declared… but how has it affected my work? 

I work at a maximum security women’s prison.

At the beginning of the pandemic, we had over 1500 women at the prison. I think we’ve reduced our census greatly, for a lot different reasons. For example, all the pregnant females were released or moved.

I work in an outpatient program, which sounds funny for a prison. We have 102 women, in a four to six month program, where women receive services Monday to Thursday, and we try to give them in a minimum six hours of programming–group, one-on-one, skill building, and recreational.

Since the pandemic started, of the 1500 women that are assigned to the facility, we’ve found over 270 known positive cases among the “inmates” and many of them were in treatment at the time. (We call our clients “clients.”)

In March, we tried some preventive measures and safety measures, of course, but the women weren’t really receptive to the restrictions (or guidelines) that were presented to them–as far as wearing masks, social distancing, hand washing, on and on. It is pretty hard in a facility of that size without the space to provide some of those essential needs to stay safe from the virus. 

We started implementing precautions by making our groups smaller. We normally have 102 women and six counselors, so each counselor should carry a caseload of approximately 17 people. At present, my caseload is down to 5 people. That’s from people getting released. I think our total census is down to maybe 34 or 35.

So, in March, we went with some preventive measures, but at the end of June, we went to total lockdown at the prison, which meant there was no movement. Our clients started receiving their food in the dorm. They weren’t allowed out 24 hours a day. They were locked down from, I believe, June 30th until maybe the end of August. There was no movement. They didn’t come out, they didn’t move.

They live in a quad, with 34 or 36 women to a quad. It was repressive. I’m sure that they’re still recovering. They were suffering. There was no air conditioning or fans. They were just locked in there all day–no recreation, no time out, no matter what. 

Of course, that limited treatment services, they couldn’t come to us for services. 

Like I said, we’re an outpatient, but what that means is they live in their quarters, but they come up to our building and we provide the services, groups, and so forth.

We were sending assignments to them… but is that really treatment? Or, is that just sending the assignments? And, we didn’t collect the assignment because of course, we didn’t want cross-contamination from the paperwork or the books.

It has really affected the women. There’s no physical contact within a group… no touching one another… no being in a group setting… not even one-on-ones with the counselors… they can’t do treatment plan updates. 

I haven’t done an assessment on a client since March or April because I haven’t gotten any new clients, so we’re not putting people into treatment. So, the whole program has definitely been shut down.

People are getting released, so it’s not like they’re put on a waiting list or in a holding pattern. 

But, here’s the weird thing, when you’re in a North Carolina prison, and if you’re assigned to certain programs or services, you get what they call gain time. So you can be in treatment for 30 days and you might get, let’s say, four days off your sentence. They’re still receiving this gain time, which is great, but are we setting them up? Will they have the proper tools for when they do return society, and return to their normal situation?

It’s also affected us as counselors and me professionally. We are still receiving virtual clinical supervision from my supervisor. We do monthly trainings. We still have staff meetings, and we still try to staff clients, to go over their needs and preferences, and wants. So now I might see my clients maybe five, six minutes a day. Services like setting up aftercare plans, and home plans, and transitional services for when they do release is limited. 

It has definitely put a burden and a hindrance on the program that I’m in. There are other programs within the prison system that are up and running because they didn’t have the magnitude of virus in their facilities, so it has definitely impacted the services that we can provide.

I know that’s a lot, but there’s a lot that needs to be heard.

What, if any, long-term effects do you anticipate on the field?

It’s weird, we’ve got plans for everything but a pandemic. When you talk about a prison and state government… they have countermeasures for countermeasures for countermeasures. There were no countermeasures for something of this magnitude.

I think we’re definitely gonna have to reduce group sizes. They say a good group is what… maybe 10 to 12 people… we might even have to look at 6 to 8 people as an effective group size. Spacing, of course, is gonna be important.Simple hygiene, and not just HIV and AIDS, but other hygiene training and services and information, that’s gonna need to be passed on the clients and staff. How does the staff [protect themselves]? We’re not immune from contraction.

Also, how are we going to provide services virtually? Is there an effective way to provide virtual treatment services? That’s a hard one, because this is such an insidious disease. Addiction is so weird, that people sometimes need the feeling of feeling… not just touching, but feeling… and sometimes virtual can be sort of cold and… I don’t know… it just seems distant. 

It’s weird, I remember my daughters being in the back seat of the car and texting each other. I would be like, “what in the world?” But maybe that’s the world we’re moving to. I just can’t get it. 

I like to be around people. I like to feel people. I like to hear people. I like to smell people. Some of the dynamics of treatment are definitely going to have to be readjusted. Even, you know, the lights of the room, the color of the room. You know, do I put a false backdrop when I’m doing virtual work from home? Do I put up waterfalls and butterflies? Or, do I keep it real and just have a bare white wall?

I guess there’s a lot of things that we’re gonna have to look at as professionals.

Have you seen any benefits or new opportunities in the pandemic?

Like I said, there are definitely improvements in hygiene. 

A lot of people like to hug in this field… that touch, that feeling of being connected, that heartbeat to heartbeat type thing has sort of diminished. But, I’ve also seen that people care about each other. It also brings out that humanness. How many times do we hear people say, “Now, stay safe, be careful”?

It also brings out the sense of selflessness. I think the pandemic has definitely brought out a sense of caring about somebody. We know that the core of addiction is self-centeredness. I think one of the things that the pandemic has brought about is a momentary lapse of that selfishness. We’re concerned about others, we’re concerned about straightening up or cleaning up behind ourselves a little more. We’re not just assigning it to the janitor. People are more mindful… we are more aware of our surroundings and aware of other people. 

But also, somebody can have a normal sneeze and everybody freaks out.

If you were able to work on a fantasy project to improve treatment and recovery support, what would it be?

Well, I’m gonna go from my experience and my arena of where I work. Women, and men, do well in prison treatment services. We follow it statistically and they have less recidivism. They have fewer infractions while in treatment services. They also say that even once they complete treatment services and are reintroduced to the regular population that their infraction rates go down… definitely, their violent infraction rates go down.

So, they do well in prison and they do well in treatment, but the big gap is transition. 

On the outside, we’re getting all these treatment high schools. One day it’s going to be great when we have Recovery University (you know, like Liberty University) we will have Recovery University.

So, my treatment fantasy would be a do-all treatment facility for criminals, where they serve their time in a dedicated treatment facility. NOT a unit in another facility, but a dedicated treatment facility. Then, during their transition period, sanctioned by the state, they get  treatment services, mental health, social work–throughout that transition period as part of their sentence.

I think that would be my fantasy. That’s the treatment that I would want for a person that has to pay their debt to society, but also has the chance to live in a recovery safe zone–even in prison. That’s what I would try.