In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency.
Today, students, employees and alumni at St. Cloud State University are responding to the crisis by preparing students for the field, working each day to serve people in recovery, and focusing on their own recovery to earn their education and inspire others.
Tayler Waldvogel ’19 works with a treatment court in Morris. Jim Vener ’12 ’17 works with in-patients in Alexandria.
Eleana Lukes ’19 helps sex trafficking victims in St. Cloud.
Krista Tomford ’19 helped launch St. Cloud State’s new Recovery Resource Center as an undergraduate and is now pursuing her rehabilitation and addiction counseling master’s degree while continuing her own recovery from alcohol and opioid addiction.
Dan Pearson lost his son to opioids and is now a driving force in Central Minnesota trying to prevent others from dying from opioids by supporting initiatives at St. Cloud State and throughout the region through his Justin V. Pearson Foundation Fund.
The Centers for Disease Control and Prevention estimate that opioid misuse costs $78.5 billion each year in lost productivity, treatment costs and criminal justice expenses, according to the National Institute on Drug Research.
The current opioid crisis began in the late 1990s when healthcare providers began to prescribe opioid medications at increased rates after pharmaceutical companies assured them users wouldn’t become addicted. The increase in prescriptions led to widespread misuse of both prescription and non-prescription opioids, according to the U.S. Department of Health and Human Services.
New forms of treatment
With the widespread misuse of opioids, new forms of treatment are being developed that are leading to an evolution in the way counselors are treating multiple addictions, said Peter Eischens, St. Cloud State faculty member and coordinator for the chemical dependency and addiction specialist programs.
“They are looking at the opioid crisis and saying ‘how can we approach this problem differently’,” Eischens said.
Harm reduction is becoming embraced and is changing the way counselors view addiction and recovery.
“It’s really individualizing goals for people to help them be as successful as they can in what they have determined to be recovery for themselves,” Eischens said. These methods are being used to treat alcohol and meth addictions, which are also increasing.
Meth is once again growing to an epidemic level in rural Minnesota, Eischens said.
“It’s back and it’s cheaper and it’s stronger,” Eischens said. “We’re seeing a focus on opioids because it’s more of an urban problem and meth is more of a rural problem. We need to know both.”
To prepare students, Eischens incorporates tactics for counseling in both urban and rural areas.
Demand is high for addiction counselors — especially in rural areas, Eischens said.
“What I like about this school is we get a lot of students from Central Minnesota, and they want to stay in Central Minnesota and we have that need right now,” he said.
Most graduates from the program end up in treatment programs in Minnesota in both rural and urban clinics.
Three programs one profession
St. Cloud State University has three programs that prepare students to work with people with addiction disorders.
The chemical dependency program is an undergraduate program that prepares students to work as addiction counselors and earn their Licensed Alcohol and Drug Counselor (LADC) licensing.
The program is changing its name to addiction counseling in the spring. The addiction specialist program is a graduate certificate designed for those seeking LADC licensure. The rehabilitation and addiction counseling (RAC) program is a master’s degree that prepares students to become counselors with both their Licensed Professional Clinical Counselor (LPCC) and LADC licenses providing vocational rehabilitation for clients with addictions and other disabilities.
The RAC program is unique. Launched in 2015, it’s only the second program like it in the United States.
RAC Program Director Dr. Amy Knopf sees the program as a first step toward further professionalizing addictions counseling in the state of Minnesota.
“Addiction is a disability,” Knopf said. “It’s a disabling condition. People still need help to be able to get back to their life, get back to work and be independent and contribute to society.”
“The number of people with addiction diagnosis is on the rise, and counselors are not well-equipped to be able to serve that population,” Knopf said.
The majority of people who don’t fall into addiction after being prescribed opioid pills following an accident or other physical condition have a mental health condition, she said.
Addiction — One disability among many
Lukes earned her bachelor’s and master’s degrees from St. Cloud State. She’s now pursuing an addictions certificate so she can better serve the women at Terebinth Refuge, a shelter for victims of sex trafficking and exploitation.
She works to teach the women she serves how to move from being a victim to being a survivor.
“The women don’t want to be trapped in addiction for the rest of their lives,” she said. “They want to get out of active using.”
In her program Lukes is learning behavior therapy skills such as mindfulness, distress tolerance, interpersonal relationship strategies and emotional regulation that she can teach her clients to help them cope with their addiction, while using her counseling skills to help them address their trauma.
Lukes has worked at Terebinth Refuge since the shelter opened in St. Cloud a year ago.
Many of the women became addicted to substances, including opioids, because they’ve experienced trauma, Lukes said.
In recovering from their addictions, they need to learn new ways to deal with the emotions caused by their trauma and that’s where counseling comes in, she said.
Vener also sees a need for counselors who can work with multiple disabilities. Vener works as a counselor for New Visions in Alexandria and was among the first graduating class of the rehabilitation and addiction counseling program in 2017.
There’s a huge need for counselors who can work with both mental health and chemical dependency because they’re often co-occurring; both carry a stigma, Vener said.
The majority of clients Vener works with have methamphetamine or alcohol addictions, but about 20-30 percent have an opioid addiction — some have more than one addiction, he said.
New Visions, where Vener works with Waldvogel, has been moving more and more toward a person-centered, harm-reduction model of care.
“We can’t expect people who have been in active addiction for years to come into treatment and lose all their addict behavior,” he said.
In the past treatment was regimental, concentrating on client weaknesses or faults. Today it’s more strength-based and person-centered, focused on helping the client on their journey through recovery, he said.
Changing the stigma
Another new focus is efforts to reduce the stigma around addiction and recovery.
Part of the changing way addiction is viewed and treated is the move to treatment courts, which bring together people from the courts, medical profession and counseling to support people through treatment with less stigma and more empathy.
As part of her role as an outpatient counselor for New Visions, Waldvogel works with the treatment court in Stevens County.
“We basically all work together in trying to provide services,” she said.
Treatment courts aren’t new, but they’re spreading to rural counties in Minnesota and are a new way of working for people in criminal justice who interact more with the offenders in treatment court. The work Waldvogel is doing is outside of the regular work done by New Visions, but it’s something she does for her clients because it gives them a second chance, she said.
As one client graduated from treatment court this fall, the judges took off their robes and joined the team and client for ribs and cheesecake to celebrate.
“They get to see them as regular people,” she said. “It’s just a part of trying to get the whole community together to support those in recovery — trying to get the stigma off it.”
Changing the stigma is one goal of the new Recovery Resource Center in the renovated Eastman Hall, said Thaddeus Rybka, Recovery Resource Center director.
“We have students who are very empowered and who really embrace the narrative and going out and putting their face and voice to recovery and that’s helping destigmatize addiction recovery,” Rybka said. “That’s really cool to see the students taking it upon themselves to do advocacy initiatives.”
Students in recovery at St. Cloud State hold Recovery Month events each September to spread the word about recovery and an Opioid Awareness Week each January to share the dangers of opioids with the campus and St. Cloud area communities.
This fall, the Recovery Resource Center co-sponsored the Walk for Recovery at the Capitol in St. Paul.
Its members also visit treatment centers in town and sober high schools throughout Minnesota.
Rybka spreads the word by providing recovery ally trainings to help faculty and staff members better serve students in recovery and understand that it’s a form of mental disorder and not a moral failing, he said.
“We have a lot of partners on campus,” he said. “I’m trying to break those silos and collaborate across campus because there are a lot of students in recovery, and recovery takes a lot of different forms.”