The opioid overdose crisis is as personal as it is professional for many social workers, including Christina Urie (MSW ’09), an outpatient therapist at Pittsburgh Mercy.
“I have known several people who have passed from overdose and had multiple clients who have overdosed and died,” says Urie, a native of Connellsville, Pa.
“I have on multiple occasions needed to be the person to tell my group that a group member has passed and then deal with what this brings up in others. It is hard
not to become numb because you hear of it happening so frequently, especially in helping clients who feel numb due to the sheer number of people they know who overdose. It keeps me aware that this struggle is real and that one bad choice is all it takes.”
Pittsburgh Mercy regularly provides internships for University of Pittsburgh School of Social Work students, and Urie interned there herself from September 2008 to April 2009. The real-world experiences complemented her classroom education, she says, and allowed her to practice what she was learning from professors who are active in the field of social work and who can “better relate the education to how we would use it in the workforce.” Urie joined Pittsburgh Mercy full time one month after graduating and now is part of a new program created to address the opioid epidemic.
“The Substance Use Disorder Team was launched in November 2016 to have an updated approach to delivering care based on population needs rather than site- based services,” says program administrator Kevin Gallagher. Gallagher’s role has been to build and manage an outpatient therapist team that focuses on serving the rising number of people experiencing substance use disorders. Since its inception, the team has served approximately 1,200 people seeking addiction treatment.
“I would say we are seeing about half of our people, at the least, have some history of issues with opioids,” says Gallagher.
Medication-assisted treatment (MAT)—which uses maintenance drugs such as methadone, Suboxone, and naltrexone to ease withdrawal from heroin and prescription drugs that contain other opiates—has become a valuable method of helping individuals to battle opiate addiction, says Gallagher.
“We are trying to come up with procedures and work flows for communicating with the doctors who are prescribing the medications but are not part of Pittsburgh Mercy,” he explains. “That is all piggybacking off of our creation and implementation of an integrated MAT program within Pittsburgh Mercy, where we will be able to induce and maintain people on Suboxone while giving psychotherapeutic treatment all under the same umbrella.”
Gallagher also is coordinating the addition of care management and case management services, along with nurse health navigators and peer support, to best meet the varied needs of clients served. He says that he is excited about the potential benefits of the integrated MAT program, which launched
in September 2017, saying that it promises to more fully serve people on an outpatient basis while reaching other highly vulnerable populations, such as people served on the streets by Pittsburgh Mercy’s Operation Safety Net and Mercy’s Community Support Services teams.
New and effective approaches to addressing the opioid epidemic require social workers, perhaps now more than ever, to facilitate collaboration among stakeholders and to think outside the box.
“We all need to start realizing that we can’t keep our services ‘siloed’ from to coordinate our efforts. So whether you are working specifically in drug and alcohol treatment or you are working in community housing, primary care, or in any number of agencies and companies, everyone needs to work together. Addiction can affect every aspect of a person’s life, so it’s not as simple as just focusing on that one form of treatment.”
Additionally, he says, social workers must stay updated about all resources available to individuals affected by addiction, including programs such as MAT and harm-reduction methods.
Addiction of Body and Mind
Corresponding with the growth of the opioid epidemic is the demand for social workers to serve individuals who have a dual diagnosis of mental health and substance use disorders. This is clear to Associate Dean for Research Gerald Cochran, who has been studying various aspects of the opioid crisis.
“People with preexisting conditions like substance abuse are at higher risk,” Cochran says, adding that often doctors do not screen patients for men- tal or behavioral health issues before prescribing medication containing an opiate.
“To get methadone or one of the other two prime medical treatments, people should also be getting behavioral health counseling,” Cochran says. “So there’s a huge need within the system for providers to meet the needs of this population. And social workers do the lion’s share of that work in most states in the country.”
Urie says that the majority of her clients have a dual diagnosis, and Erin Kelly (MSW ’16) has faced the same reality during her internship at Pittsburgh Mercy and her tenure there since. Kelly says that she feels equipped to meet the challenges.
“I jumped right into doing group and individual psychotherapy as an intern and continued on as a full-time outpatient therapist immediately after graduation,” she says. “If anything, my experiences have strengthened my decision to be a social worker. Going into the field, I had the belief that I wouldn’t really know if I could hack it until I actually experienced being a full-time social worker. The education, self-care, and preparation are important, but the hands-on experience is a whole other level.”
Like Urie, Kelly personally knew people who died from an overdose and has had to deal with that while trying to prevent the same thing from happening to her clients.
“In this day and age, unfortunately, almost everyone is affected by opioid addiction in some way,” says Kelly. “It’s scary, but the more we stigmatize addiction and minimize emotional health, the more we are pushing people away from the help that is out there.”
Both women say that despite the personal challenges of social work and helping people in crisis to navigate choppy waters, they are more committed to the field than ever.
“Having the chance to help others improve themselves has been a wonderful opportunity that I feel social work and being a therapist have brought to me and fuel my desire to stay in the field even when it is difficult,” says Urie.“My education helped to get me thinking and, I feel, has kept me thinking about the roles I can play.”