Taking Healthcare by Storm: Industry Insights with Mary Beth O'Connor

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Mary Beth O'Connor, J.D., Recovery Advocate, Author, and former judge.

From Junkie to Judge: One Woman's Triumph over Trauma and Addiction

If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. 

This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-ARPA-010325-GK

Transcript

Welcome to "Taking Healthcare by Storm: Industry Insights," the podcast that delves into the captivating intersection of innovation, science, compassion, and care. 

In each episode, Quality Insights’ Medical Director Dr. Jean Storm will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists, and brave patients navigating their own healthcare journeys. 

Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.

Subscribe now, and together, we can take healthcare by storm.

Hello everyone and welcome to Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director at Quality Insights and today we have a truly inspiring guest, Mary Beth O'Connor. After facing profound challenges of childhood abuse and addiction, she turned her life around and has been sober since 1994.

Mary Beth crafted a unique Secular recovery plan that helped her overcome substance use disorder, and she now advocates for multiple paths to recovery as a board member for life ring, secular recovery, and she recovers foundation and accomplished author, her award winning memoir. From junkie to judge, one woman's triumph over trauma and addiction has garnered widespread acclaim and her essays have appeared in major publications like the Wall Street Journal and the New York Times.

If those things weren't big enough. Mary Beth has a successful legal career culminating in her role as a federal administrative law judge. She's retired in 2020. Today we're going to discuss her remarkable journey and explore the intersection of trauma recovery and advocacy. Mary Beth, thank you so much for joining us today.

Well, thanks for having me. I'm looking forward to it. 

Wonderful. So let's just jump in. Can you share more about your journey from experiencing childhood trauma to developing a substance use disorder? And what were some pivotal moments along the way? 

Yeah, and I, you know, it'd be nice if I could say that that part of my story was unique, but it's actually a very common pathway into addiction, which today we do call substance use disorder.

And so for me, my mother, you know, she wasn't really bonded or connected to me. And she could be violent, but she married my stepfather when I was nine and things got much worse. I mean, he was very violent with her, which is traumatic in and of itself to watch one parent, you know, beat another. There's Transcribed Physically sexually violent with me.

It was just, you know, such a high stress household that sort of primed me to, um, to focus on seeking relief in whatever way I could. And for me, what worked best from when I was 12 and first exposed to it was alcohol and other drugs. And so it just sort of. It made me feel like the pain was more at bay, I could keep it more distant, and I actually felt sort of happy and had fun.

I mean, the reality is in the beginning, the drugs work. Um, but when you develop a problem, you know, then, then it just adds to your difficulties. 

Yeah, and I think that's fairly common, um, for individuals with substance use disorder. You are very unique in that you created a secular recovery plan. So what specific strategies or techniques did you incorporate that you found particularly effective in your recovery?

Yeah, and I mean, I was more unusual when I did it in 94, but unique. So not quite unique. I mean, there are definitely a lot of people who do recovery without the sort of the higher power or God focus. Um, even a lot of religious people prefer some of the self empowerment programs because they like the approach.

And so some sort of. key concepts I used was really, first of all, viewing myself as the decision maker in my recovery. You know, I felt like it was sort of my, my job to listen, you know, to look for strategies and ideas and techniques that others successfully used. And, you know, when I read all of the 12 step Books and the, um, women for sobriety and smarts parent and life brings parent.

And I'd even listen during the smoke break. Cause I did some of a meeting. Did somebody say something useful, but I always viewed myself as the decider, like which of these ideas and techniques do I think will help me. And so that was really sort of a key idea for me today. We call that a self empowered recovery.

Um, And then also I, I really focused on prioritizing because when I got sober, I was 32 and, and I was shooting meth by 17 and didn't get sober for 15, you know, more years. And so by the time I got sober, I had broken so much of my life, but I couldn't possibly fix it all at once. Like there was just too many things to work on.

And so even though I hated it, Because I was 32 and felt like I, you know, I needed to catch up, right. I need to catch up on all my losses and what I could have had that I didn't. Um, I, I was actually relatively patient and part of that was making a list of what I needed to work on and then just picking five priorities and just focusing on those, because that's all I could handle, you know, at one time.

And that turned out to be a really good key strategy for me. 

So smart. Oh, say. And so you talked a little bit about trauma. So how did addressing your trauma contribute to your recovery from addiction? And what role does trauma informed care play in the recovery process? 

Yeah, so I always knew that the trauma, the violence, and I had like sexual assaults outside the home and a violent boyfriend, just multiple versions of violence.

I always knew it was underneath my drug use. And so when I got, when I got home from rehab, uh, I actually looked for a therapist with expertise in trauma. And in 94, it was a little harder to find than it is today, but I did find someone who had expertise in abuse, but, and some addiction expertise. And so I did individual therapy for three years, mostly CBT, you know, cognitive behavioral therapy, but other techniques too.

Um, and I was on anti anxiety meds for several years. And then I did group therapy for women with trauma histories. And so for me, it was about, um, PTSD, which I didn't even know I had until I got sober because I was, I thought only war vets had PTSD. I didn't understand what it was. And for me, it showed up as very, very severe anxiety.

And it took me years longer to get my mental health under good control than it did to get my substance use disorder under good control, because it was more complicated and it came first. And that is very common. A lot of people with an addiction have a trauma history, which usually means they have other mental health conditions.

Um, and usually today we we call it right dual diagnosis or co occurring disorder. And today we understand you need to tackle both from the beginning to be able to have the best chance of success as to both recoveries. 

Yeah, that makes 100 percent sense. So you're a board member for life ring, secular recovery, and she recovers foundation.

So what are some key messages that you aim to share about alternative paths to recovery? 

I mean, the good news is that all the data shows they work equally well. And so my focus is always about choice, right? Making sure people know that, for example, in peer support, there are multiple choices. And today, So, um, so it's a lot simpler.

And so, um, so it's a lot simpler. But, um, but it's really important to look at the philosophies and also the meeting formats because they can really be different. So, so, for example, life ring. Um, some of our key focuses are that individual nature of a plan that you and I are different. And so our recovery plans are going to be different.

Um, but it's also, um, the meeting formats also different than 12 steps in that it's. It's, um, there's no speaker. It's the whole meeting is the group talking together. And so there's like, they talk to each other and the entire meeting is, um, is individual sharing what's going on last week and the next week.

And so that's a different format than some other programs. And then she recovers foundation. That's not just for substance recovery. It's also trauma recovery, mental health recovery, other behavioral disorders like eating or sex or gambling, overwork, grief. It's everything together because most of the women that have a substance use disorder also have other areas to work on.

And so when she recovers, you can talk about all those things and the interplay of those things. And so those are just two examples of some of the options that are out there for people. 

I think it's important for individuals to understand that there's alternative paths, you know, that maybe the traditional paths don't work for them.

But there's other options available, most definitely. 

Well, and the other thing is you can do more than one. So for example, she recovers about 30 percent of our members also do 12 steps. And so I did multiple programs and, and that's perfectly, you know, perfectly good today. I mean, individual plan means Pick do what you think is right for you and for some people that means I'm going to do AA and I'm going to do life ring or I'm going to do NA and I'm going to do SheRecovers and that's out there too.

You're not, um, you're not bound to an exclusive contract when you find one group that that is giving you some benefits. 

Yeah, self empowerment. So how is important, how important is community support and recovery and what advice would you give to those seeking supportive networks? 

I mean, the data shows that when people have support, they do better.

Now, about 20 percent of the people that actually maintain sobriety don't do peer support, but for a high percentage, they find it useful. And there are a couple reasons. And so I'll just use myself as an example. I mean, when I first got sober, I really, well, when I first went to rehab, I didn't actually think I could get sober.

Like that was. That was beyond my imagination I really thought maybe I could figure out how to do better how to do less drugs Right, like that was as good as I can imagine But in peer support you're exposed to people who have been successful You know ahead of you and you get to know them and you start to see hey, wait a minute She had the same, you know, level of addiction I had.

She had maybe a trauma history like I had and look, look at her a year or two years down the road. And that can create, um, hope. It can make you start to believe it's an option on the table for you. And I think hope's important because early recovery is hard and it's a lot easier to do it if you think that it could succeed.

Um, but then the other thing is you're exposed to support. You know, you might be. Online support or might be people in your community. You can call up for coffee or, you know, go out and do activities with. It's a great place for suggestions and ideas. And so there's a lot of different benefits that you can get from peer support.

Yeah, 

most definitely. Now, in your, in your memoir, From Junkie to Judge, what message do you hope readers take away regarding the relationship between trauma, addiction, and resilience? 

I mean, a big part of it is I do want to, you know, be a beacon of hope, right? I mean, I had, as I said, multiple forms of violence, a lengthy, you know, addiction.

It was not Um, and yet it's not just that I've been sober now for 30 years, it's that actually with my trauma recovery and my substance recovery, I actually live a happy and productive life. I mean, it's the ultimate goal, right? Is to, is to be in a world where you enjoy the people around you, where you can participate in your community, where you can make forward progress in your profession and where you can just do things that you enjoy.

And I will say. A lot of the, sort of the glory of sobriety for me, um, and my sort of mental health recovery and my better emotional regulation and lack of, you know, catastrophizing. I mean, the, the key underneath fundamental benefit is that I'm not creating more chaos. It's not that life can't be challenging at times.

It's that when it's challenging, I'm not making it worse. Yes. And I'm not creating problems that don't need to exist. And so, um, and I can handle what comes and that's part of recovery is realizing, yeah, life's not always going to be a, you know, a picnic, but I can handle what comes and overall in the long run, I can build a life that I'm really gonna, um, that I'm going to be happy with.

I will say just, you know, you're, you said that your intent was to be a beacon of hope and you've definitely accomplished that. I mean, it's just an, you've had an extraordinary journey. Um, So you speak on a range of topics, including substance use disorder and trauma, which we've been talking about. What reactions or feedback have you received that have impacted you the most?

It's, it's very rewarding when people send me messages through my website, which people can do by the way, junkiesjudge. com. And they'll say that they heard me like on a podcast or they, they read my book or read one of my pieces and that it's making them feel, um, That there's a path forward to them, you know, for them as well, that they can see that if I could have found a way to a healthy, happy life, given my challenges, um, that they start to believe it for themselves.

And that just is always heartwarming. And I'm always happy to, you know, share advice and guidance for people if they have any questions or thoughts, but the goal is also to reduce stigma. And so I talk a lot to people who don't have substance use disorders. And, and a lot of times I will literally start with my trainings with things like, what is a substance use disorder?

How is it defined? And, and I'll even go through like tips about even if you don't have an addiction, you know, maybe you need to look at your alcohol use and things like that. Um, and so part of it is also talking to friends and family. What can friends and family do to help? It's just a wide range of topics where I try to, I try to share information, try to educate, um, and try to help people understand better, whether it's said that they understand what's going on in our society as a whole, or if they're better understand what's happening with someone that they love.

Yeah, that stigma is so pervasive. I feel and people don't really even understand, you know, that they have it themselves. It's almost like a subconscious stigma. So those conversations really help reduce that. So you, I mean, I just, it's extraordinary that you had a career as a federal administrative law judge.

So how did your experiences with addiction and recovery influence your 

Well, I, I will first emphasize that like when I got sober, it wasn't like I thought it was going to be a judge, you know, like it was a progression up there. Um, I, I, I like to share that my first, um, professional goal when I got out of rehab was let's not get fired again.

You know, like that's where I was starting from. Um, but you know, yeah, I did. I went to law school at six and a half years sober. Um, and I worked as a lawyer at a large firm and for the government. And then I was, a federal administrative law judge. And I didn't handle criminal cases, but I did handle disability cases where substance use disorder and other mental health conditions were part of what I had to address and evaluate.

And so I think my history made me a little bit more understanding about what was really going on. And for example, understanding that most people Aren't able to be perfectly abstinent from day one when they go, you know, when they start their recovery journey. I wasn't perfectly absent. I used three times in my first five months and now I have 30 years, but also understanding what's underneath it, the mental health challenges and trying to sort of, um, make sure that I, Develop the record in a fair way that I asked the question so that All of the relevant points could get into the record so I can consider them in my decision But also just treating the individual respectfully, you know not making unfounded negative judgments just based on the fact that they have the you know brain disorder of addiction right and that really Can be key to make sure that they're being treated fairly Um rather than using again the stigma as sort of a negative judgment about them just Based on the fact that they have that medical condition.

That's wonderful. 

In a perfect world, we would all operate in that way. So what do you think is the biggest misconception about individuals struggling with substance use disorder? And how can we work to change that perception? 

Well, I think one thing is that we hear a lot of information about how sort of nobody almost, you know, how the percentages of success are so low.

Like I've heard only 5 percent of people succeed or only 15%. And that isn't true. Um, that that data is usually about each effort. When you look at their lifetime. 75 percent of the people who had who qualified under the DSM, you know, the diagnostic manuals test for addiction. 75 percent of them will recover to the point that they no longer qualify under that test.

75%. And the other thing I like to share is that. It at five years of continuous sobriety, people only have a 15 percent chance of ever relapsing. So these are, you know, addiction, substance use disorder is a treatable medical condition. Most people will recover, but there is, I think, this sort of, um, false assumption that, um, that in America, Everybody has access to treatment if they want it.

And that just isn't true. I mean, if you don't have insurance or, um, and you don't have money, you often can't access treatment at all. And even if you have those things, getting evidence based treatment of a net of an appropriate length can still be challenging. And so I feel that sometimes society judges people with the condition under this false paradigm, that there's treatment readily available for everyone, when in fact there really is not.

Yeah, I agree 100 percent with you. Even in underserved areas, rural areas, there's really definitely a lack of of access to treatment. Um, so the COVID 19 pandemic disrupted, I will say, continues to disrupt, created a lot of unexpected challenges for people in recovery, especially How did, do you think the isolation and disruption caused by the pandemic affected those and continue to affect those struggling with addiction and those already in recovery?

I mean, for, um, uh, the lesser percent, um, it actually was beneficial because they weren't sort of going out to their normal activities with other people. And there wasn't sort of that pressure to consume with their friends that they drank with, let's say, but for the bigger group, um, the isolation actually was problematic.

So for example, the rate of alcohol use during the pandemic went up significantly. Um, and we got to remember that, you know, alcohol is drug. So when we talk about drug use, we always need to include alcohol. It's still the most consumed drug in America, although cannabis is catching up and it's still the number one killer, even with the opioid epidemic.

More people still die every year from alcohol than they do from all the other drugs combined. And so alcohol use went up a lot, particularly among women, because women were even more impacted because they're often the primary caregivers at home, the primary parents, and they were trying to juggle a lot of things.

And there are long term ripples from that. The rate of having problems has gone up, but it's also things like, uh, there are, uh, And his historical high of young women having things like serious liver disease in their twenties or early thirties, which doctors haven't seen before. So there are a lot of ramifications that are still ongoing as this all sort of plays out.

And as people are starting to have the, the, the problem with this substance long enough that the consequences are becoming more apparent. 

Yes. Yeah, most definitely. And, and I think we don't include alcohol in all this substance use disorder talk, and we need to most definitely. Yes. So many in-person meetings and recovery programs moved online during the pandemic.

What was your experience with virtual recovery support, both as someone who advocates for multiple recovery paths, and as someone who's walked that journey yourself? 

So, um, a lot of the peer support groups were online before COVID, like Lifering was online for a small number of meetings because, so 12 steps, you know, AA and, and narcotics, anonymous alcoholics, all the anonymous, you can usually at least get AA in every town.

And it was never true for the other groups that you could get them everywhere. All the other groups, the main groups have, have in person meetings and had them before COVID, but not everywhere. And so a lot of the ghost groups did have some online meetings, and I believe 12 steps have online meetings before COVID.

But during COVID, of course, the, um, the in person meetings shut down in most parts of the country for one, all the meetings were online. And that, you know, there's some, there's some benefits to online meetings. For one thing, uh, it's more convenient. Right. And for people, they don't have to travel to go to a meeting, um, during COVID, but even after where people, you know, taking care of young children or a caregiver in other ways, or maybe they're working two jobs.

It can be easier to attend online. Many can actually provide additional confidentiality. Because you're not having the meeting in your let's say your small town where everyone knows what you what you say, not that I mean what's said in the meeting should stay in a meeting but you know people are people and that's not always true.

And also online meetings basically you could get meetings 24 hours a day. And so if you need a meeting now you can find. One, you know, some programs meetings right now online. So that's advantages, but the disadvantage is that it's hard to develop community. Um, and people do it online. They absolutely develop community online, but in person, it's a, it's easier to develop those personal one on one relationships, um, and to do activities with your community.

So we sit, you know, the last Two years, a lot of the face to face meetings have come back and people now have the option and a lot of people actually mix and match. They might do, let's say a 12 step meeting online, but I mean in person, but then do life ring online. So the flexibility is good. The options are good, but it is good to have face to face back as an option because for many people they prefer it.

Yeah, 

I would agree. 

So looking ahead, what are some goals or initiatives you're passionate about pursuing to further support individuals in recovery and raise awareness about trauma and addiction? 

Well, I would say that one of the things I do do is I train lawyers and judges. And part of that is trying to make them aware of sort of the problems in the legal system.

So, so for example, there are, you know, there are drug courts around the country and some of them are really. evidence based and they understand habit formation, you know, challenges and all of those things and others aren't others are sort of stuck in 1982 and they have certain beliefs and they haven't evolved and they'll make everyone go to only one program or they or their They're, um, uh, unnecessarily, uh, unrealistic about abstinence perfection from day one that might have really serious consequences for, let's say, not, um, not being sober a hundred percent of the time when the reality is that most people are literally incapable of doing that in the beginning.

And so one of the things I. Talk about and try to educate the lawyers and judges in the system is a more realistic expectation about what people can actually accomplish a deeper understanding of what substance use disorder is and also the tie into other mental health conditions. Drug courts are. Much more commonly today affiliated with mental health courts and so that both can be addressed and that's a positive Um, and then when people ask me, you know What do I think like for example of legalization of cannabis and and I really?

am very open that I support decriminalization of all drugs for personal use and I think Uh, I know people have concerns about that. But you know, the reality is that It costs three to four times as much to incarcerate someone as it does to treat someone. In other words, we could treat three or four people for the price of incarcerating one.

So incarceration is not cost effective if you care about your tax dollars, and it's not effective because it's not usually evidence-based treatment, in addition to which, if substance use disorder is a disease as our own government says it is. then why are we criminalizing it? Um, and we have a very significant racial disparity in how we enforce our drug laws.

People of color are just much more likely to get arrested, much more likely to get, say, a felony instead of a misdemeanor and a longer sentence, even though they use drugs at similar rates to whites. And so those are some of the areas, especially in the legal area that I try to be a voice for and try to do some trainings around.

Those are very exciting things. Um, Mary Beth O'Connor, thank you so much for sharing your inspiring story with us. I mean, it's been a fascinating conversation. I think you talked about your website, um, in the middle of the conversation, but let's say it again in case people want to find out more information.

Sure, and um, my book is from junkie to judge one woman's triumph over trauma and addiction 30 percent of which by the way is about recovery Um, and that's on amazon and all the usual sites and bookstores habit or can get it My website is junkie to judge. com and there's information there as well as you can message me and I answer all messages And I am on x you know, twitter at mary beth o underscore and I do not on Twitter, but I do provide information.

So I'll provide the new studies that come out, articles about, um, addiction and recovery, um, and things, and some of my own recovery thoughts, if anyone's interested in those topics. 

Wonderful. Again, thank you so much for joining us today. Mary Beth O'Connor. 

Thanks for having me.

Thank you for tuning in to Taking Healthcare by Storm: Industry Insights with Quality Insights Medical Director Dr. Jean Storm. We hope that you enjoyed this episode. If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.

If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website. We would love to hear from you.

So, until next time, stay curious, stay compassionate, and keep taking healthcare by storm.