Essentia docs tackle substance use from variety of angles
Editor’s note: This is the first in a two-part series of articles about substance use disorder treatment in Hubbard County.
In March 2022, Essentia Health’s primary care clinics in Park Rapids, Walker and Baxter received a State Opioid Response Grant, totaling over $523,000, to expand their resources for treating substance use disorders (SUD).
A year later, three Essentia health care professionals who have been treating SUDs during the past five years or so shared results.
Dr. Susan Bauer, a physician, and Chasity Phillips, a physician’s assistant (PA), both work out of the Park Rapids clinic, while nurse practitioner Kathy Nevins works out of Walker. All three have the required waiver to treat SUDs, including prescribing medications such as suboxone (used to treat opiate use), naltrexone (for alcohol use), and more.
Among the resources provided by the grant is the addition of a care facilitator at each clinic – including social worker Laurel Hed in Park Rapids and Angie Emmeck in Walker.
“She’s amazing,” Bauer said of Hed, explaining that the care facilitators help their patients resolve stressors in their lives. “They’re helping if somebody needs food stamps, has housing issues and needs to find affordable housing, needs help making appointments (or) coordinating a ride to the appointment, or things like that.”
Bauer called the care facilitators “absolutely invaluable,” helping docs with the kind of tasks they don’t have time or expertise to do.
“It has taken a huge load off of me,” Phillips agreed, “even to the point (of helping) people who are not officially enrolled in our program.”
For example, Phillips recalled an instance when a woman with substance abuse disorder, who was not quite ready to talk about it, was about to go to prison.
“She had a son who was 18 but he hadn’t finished school yet,” she said. “So, he didn’t actually qualify for any sort of foster program. But how is he going to finish school if he’s got to support himself?”
With nowhere else to turn, Essentia staff called Hed. “Laurel made a few phone calls,” said Phillips. “She was able to find some sort of a grant for him, and basically it covered rent and groceries for two years, so that he could finish school.”
She added that Hed also helps patients get information about completing their GEDs, after which the amount of money they can earn goes up.
Each of the doctors has a different reason for getting into treating SUDs.
“I started doing substance abuse treatment when I was in residency in New Mexico,” said Bauer. “It’s a near and dear thing to my heart.”
The reason, she said, is that she adopted her five children out of the foster care system after their father died of a methamphetamine and heroin overdose. Their biological mother was also a substance user.
“My kids were directly impacted by the harms of substance use,” said Bauer. “This is something I feel really strongly about because they obviously mean a lot to me, and I love them, and their life was changed dramatically because of substance use.”
For example, she noticed that her children never cried during tear-jerking movies like “Old Yeller” or “Marley and Me.” She asked them about it and they said it just didn’t compare to seeing their dad die.
“It’s so much in their life that things we normally deal with, to them, are just nothing,” she said. “Like, ‘I’ve already been through so much loss and hardship in my life that this doesn’t register.”
Seeing effects like that on their young lives really pulled on her heart strings, she said.
“I don’t want people’s kids getting taken away if we can stop it,” said Bauer. “I don’t want families broken up, and I don’t want people to die from substance use.”
Phillips said she has a lot of nurses in her family, but also a lot of people who struggle with alcohol, meth and heroin.
She also recalled being influenced by a professor who was a jailhouse doctor with a military background, then “seeing that so many of my patients have military backgrounds and a lot of trauma that has never been addressed. I feel it’s a population that we’ve not historically done well, as a medical community, taking good care of.”
As for Nevins, she previously practiced in Brookings, S.D., a college town that had very quiet summers. This gave her time to take continuing medical education credits toward earning her waiver to treat SUDs. Despite not thinking she would use it, “I got sucked in big-time,” she said.
Making a difference in lives
Nevins described the feeling of seeing her work make a difference in patients’ lives.
“People come in kind of with their tail between their legs,” she said. “Things are pretty rough. They’ve probably lost their children, their partners, their homes, their cars, their jobs and life is not looking very good” by the time they reach out for help.
“To watch the progression, even by the second and third visit when they come in with a smile on their face and their shoulders back, and then over time to watch them regain all those things in their life, is probably the most rewarding thing that I’ve ever done in my career.”
Asked how she can rev up her empathy again and again after seeing so many patients, Bauer recalled wanting to be only one thing all her life, since she was 5 years old: a physician.
“What I do best in life is to look at other people and go, ‘How can I help you? How can I care for you?’” she said. “That’s what I care about.”
One of Nevins’ patients, David Szathmary of Wadena, confirms what a difference treatment can make. A sometime bodybuilder and powerlifter, Szathmary injured his back around 2004 and started taking opiates. “After that, I was continuously needing those pills,” he said. “I was also heavy into drinking, because I suffer from a mental illness.”
Then his primary caregiver, PA Beth Hirt with the Essentia Park Rapids Clinic, introduced him to Nevins, who put him on suboxone.
“It works really well for my pain,” said Szathmary. “Also, it kind of eliminates the need for opiates, (and) I was able to give up the drinking as well.
“This has totally turned my life around. I was always going to the doctor, trying to get prescriptions for pain pills. Because of the opiate crisis, doctors were reluctant to hand out prescriptions, with good reason. (Suboxone) took away my need to go and try to get prescriptions.”
Szathmary said drugs like hydrocodone or oxycodone are hard to control and tend to run out too fast, leaving users with cravings, whereas suboxone is a long-lasting drug. “A couple of pills last you all day long,” he said. “It’s been four years that I’ve been working with Kathy, and I have not taken a single pain pill since starting the program.”
Phillips said she’s ecstatic when her patients wake up a little bit better off than the day before. Some of her patients have gone on to become peer counselors, and despite the potential for their substance use to be triggered by that challenging position, “they’re doing phenomenally. I am so happy for them.”
One of her patients, Phillips said, is now working at the same facility where he did inpatient treatment. “He’s done wonderfully,” she said. “He had no relationship with his family, and now his son lets him babysit. He’ll talk about it, and he gets all tearful.”
Nevins said her patients’ success stories are far more numerous than “the not-yets,” as she calls them. “I’ve only lost one patient in the five-and-a-half years that I’ve been doing this,” she said.