Taking Healthcare by Storm: Industry Insights with Brandi Edwards Farmer

In this episode of Taking Healthcare by Storm, Quality Insights Medical Director Dr. Jean Storm speaks with Brandi Edwards Farmer, BSW, ADC, PRSS, CTTS, Director of the COMAT (Community Outreach MAT) program at Southern Highlands Community Mental Health Center (SHCMHC).

Brandi shares her journey from addiction in rural West Virginia to long-term recovery and leadership at Southern Highlands, where she uses outreach models to connect people and their families to treatment and support. She discusses a nearly 49% decline in fatal overdoses, ongoing rural barriers and stigma, and her work with WVCBAPP to expand credentials and professional pathways, including efforts to create licensure for advanced addiction counselors and reduce the criminalization of substance use disorder.

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

The views and opinions expressed by the host and guests are their own and do not necessarily reflect the views, positions, or policies of Quality Insights. Publication number QI-060326-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.

Hi, everyone. Welcome to another episode of Taking Healthcare by Storm. I am Dr. Jean Storm, the medical director here at Quality Insights. Today, I'm joined by Brandi Farmer, BSW, ADC, PRSS, CTTS. She is a leader in addiction recovery services and a passionate advocate for peer-driven recovery support in West Virginia. Brandi is the director of COMAT, an outpatient substance use disorder treatment program at Southern Highlands Community Mental Health Center, and she's going to be telling us all about that organization. She began her career there as a peer recovery support specialist and has advanced her leadership while staying deeply connected to the peer recovery model, a model that we know works so well. Brandi is a person in long-term recovery herself and holds credentials as both a peer recovery support specialist and an alcohol and drug counselor through the West Virginia Certification Board for Addiction and Prevention Professionals. That's WVCBAPP. She is currently the president-elect of that organization and is working to expand professional pathways for the peer recovery workforce across the state. She also graduated summa cum laude with her Bachelor of Social Work from Concord University and is currently completing her Master of Social Work. Brandi's work focuses on strengthening recovery-oriented systems of care and bridging the gap between peer recovery and clinical treatment. Brandi, thank you so much for joining us today. Thank you for having me. I just wanna jump in. Talk about your personal journey. As I said, you are a person in long-term recovery, and now a leader in the addiction treatment field. Can you share a little bit about your personal journey and what led you to dedicate your career to helping others recover from substance use disorder? Yes, I would love to do that. I was born in a very rural county, Barbour County, in West Virginia. I was born into addiction and, alcoholism and all the things that comes with that. So, uh, unfortunately, I, from a very young age, I followed in those footsteps. And so from 11 to 25 um, I struggled with substance use alcohol and drugs. And, as a child to follow in those footsteps and, be addicted to those substances so long naturally when I became an adult, I continued to do that. And, I, I really never saw another way of life. I didn't see other people live different ways of life. That's just, you know, what was in my family and what was around me. And so when I became an adult, when I became 18, uh, I started getting in trouble as a result with the police and, you know, I was charged with different various drug charges. Finally, when I was 25, I got the opportunity to come do treatment actually here at Southern Highlands, where I'm now a director of one of our programs. And whenever I came to treatment here for the first time in my life, I felt people loved me and cared about me, and guided me, and for the first time, I felt like I was that people cared enough to lead me in a good direction. And so even then, at that point, uh, I never, ever dreamed that my life would be where it is today any part of it. But even at that point, I knew that I wanted to, I wished, I hoped I could be that for somebody else. And luckily, the stars aligned and here I am, you know, being able to be that for somebody else. Yeah. And I, and I love that. I, I love meeting people who, you know, have been there, and then they've, uh, had help from individuals, and they strive to do the same for others. I mean, that's what makes the world go round, right? That kind of- It is. Yes ... thing. Yeah. So you started at Southern Highlands as a peer recovery support specialist and now serve as the director of COMAT, C-O-M-A-T, and maybe you can tell us what that is. So what was that transition like for you, and, and how has your lived experience shaped the way you lead treatment programs today? Yeah. So, like I said, I came down to our, residential treatment center for women, which is called WAVES. And when I was two years into my recovery, I was able to come back and work there at WAVES as a peer recovery support specialist. And, I was there for about two years, and then I moved into the SUD Reintegration Specialist, which kinda worked with, the individuals who were getting ready to graduate the residential treatment. And from there I became the assistant director of COMAT, and then now the director of COMAT. And COMAT stands for Community Outreach MAT, Medication Assisted Treatment. So, course we wanna connect people to treatment, whatever that looks like. But one of the big components of my program is that we actually go out with QRT, Quick Response Teams, and, you know, while they're focusing on the person who they got a referral on, whether that was overdose or, with the LEAD program interaction with law enforcement and stuff like that, COMAT actually goes out and focuses on implementing the Ring Model. And what that is, is focusing on like the friends, family, neighbors really anybody around because, the idea is that, you know, if somebody is struggling, then probably the people around them are either struggling or at risk of, mental health or substance use issues as well. And so we try to focus on them and offer them support, and connect them as well. So, that transition really was honestly relatively smooth. Like I said, I started as a peer in residential and then I moved to SUD Reintegration, which, I was not housed in residential, but I worked closely with residential, so I got to help them, reintegrate and I ha- of course, had the, experience of doing that myself. And then once I became the assistant director, I was still finishing up my bachelor's degree, but I was able to do some case management, stuff at that point. And then I became the director just this past September. throughout the different positions that I've had, I've got to implement, the things that I've learned in those different positions. And as far as my lived experience, you know, I'm still the same person with the same lived experience. And I think that it does shape the way that I lead programs today, um, just because not only have I been there and done that in a lot of cases with our consumers and stuff, but also I think working with the other directors and stuff really gives them better insight on why the things are or aren't working for the consumers or the community that we're serving Yeah, most definitely. And you're, you know, you're on the ground and so you know that West Virginia is discussed nationally in conversations about the opioid crisis. So from your perspective in actually being there, what does the current state of addiction look like in West Virginia right now? So I mean, it's you know, it's still here and it's still unfortunately in every community, in every family. But it looks better, you know? And the CDC actually just, within the last week or so released some of their numbers, and the latest, number for West Virginia is that we've had a nearly 49% decrease. It was like 48.88% in fatal overdoses, which is incredible. Like, that is nearly half , and so I think, we're definitely making an impact, a positive impact. And there are more programs. Like, we're-- I think we're, , approaching it from a more holistic point of view, and I think that, -- having CCBHC here is also helping that. But we've got more programs and more resources that are addressing, like, the underlying social determinants, of health, which is ultimately leading to better outcomes. I think that we still have a long way to go, and maybe in some cases we've even unfortunately taken a step or two backwards. But compared to whenever I came in seven years ago into recovery I think that it looks a heck of a lot better than it did then. That's great. Yeah. West Virginia has had some of the highest overdose and addiction rates in the country. What do you think are the major factors driving that in the state? Of course, we know that we were targeted with the opioid epidemic, West Virginia and just the Appalachian region as a whole. And so, you know, once the prescribing changed people were addicted. And so they turned to, like, the illicit, substances. And of course, we know, you know when people want it, it's... You know, more and more is gonna come into the area. And so it is, it's a revolving door. But I think that paired with just the rural area in general, there's so many barriers that come with that. You know, transportation lack of workforce, lack of treatment, lack of access to treatment, lack of edu-education, , recreation. Uh, there's still, I think, a lot of stigma in the area, unfortunately. So, I think it's just a revolving door. But again, you know, we're, we're trying to do-- I think a lot of counties in the state's trying to do a lot of good with the opioid settlement funds that we've had. And maybe some, some places are kind of, uh, , expanding resources and just expanding in general So there's a lot of programs out there that help with these barriers exactly, you know, workforce, job training, development and all of that. But I think that, you know-- I think that it's always gonna be here. I think that thinking addiction's gonna go away forever for every single person probably isn't in our lifetime. But I think that, you know, we can all come together and make a very major positive impact, by addressing some of these barriers and underlying issues. Yeah. I wanted to shift a little bit and talk about peer recovery because that's where you've built much of your career around. So for listeners who may not be familiar, what exactly is peer recovery support, and why is it such a powerful tool in helping people recover from opioid and other substance use disorders? Peer recovery is one of my very favorite things in the whole wide world. And, it's just basically lived experience. Whenever I came into treatment, I'd never in my whole entire life had met somebody who had been in addiction and recovered from addiction or been in recovery from addiction. And so whenever I came to treatment I actually met several people who had been in recovery, and those were the people that, you know, I felt connected to and I felt like, "Hey, if they're telling me I can do this, then I probably can do this because they've done this." And so basically peer recovery is, it's not clinical although it comes from, it's the clinical treatment setting. And, you know, with a peer recovery support specialist on your treatment team, that's-- they're supposed to be like a, a very minimal power imbalance. So it's supposed to be somebody who, is level playing field with the people that they're serving. I think that it's so powerful because again, it's, it-- they do have that lived experience and it's like one of my favorite people, Brené Brown says, "It's when you can say me too that somebody really starts to open up and trust and be there and,, believe the things that you're telling them they can do and ultimately believe in themselves." So, peer recovery, there's just so many studies. Like they're the reason that it's booming now and we're putting them everywhere. We're putting them with police and we're putting them in emergency departments and, there was a actually a bill in the legislature this session for basically protecting the, relationship with like first responders and their peers. So I think that it's just a really amazing thing. You know, there's so many studies out there that show that increased retention starts with that peer relationship. And being able to get the higher, numbers of people getting into treatments are in large part due to peer recovery support specialists being able to reach out and say, "Hey man, I've been there. Like let me help you navigate this. Let me help you call this resource so you can, you know, get your life back together, get your license back, figure this out." It's basically again somebody who, not only has the knowledge but also the experience Yeah, I mean, it makes complete sense. And then, and you're also deeply involved with the West Virginia Certification Board for Addiction and Prevention Professionals, and that's WVCBAPP. And I'm, I'm guessing there's a lot of individuals who, who have been in you know, who are working in peer recovery getting their certification. So can you explain what this organization does and how it helps strengthen the workforce that supports people with addiction? Yes. This actually being part of the board is one of my favorite things too that I get to do. It's just a whole different way of giving back. And everybody on the board is a volunteer, so we do all of that, on our own time. We do have one part-time paid position, an office administrator, Keisha. She's amazing. But anyways, what we do is we are the West Virginia, sector of IC&RC, which is the International Credentialing and Reciprocity Consortium, and they, , create the minimum standards internationally for different credentials such as the PRSS, Peer Recovery Support Specialist the alcohol and drug counselors, the prevention specialists clinical supervisor credential, all of those. So, , they create the minimum standards and we adopt and offer those credentials as well. And so some of the awesome things that we've been able to do the amazing people way before I ever became part of the board, but also since I've become a part of the board, we've actually gotten several of our credentials written into like the BMS and Medicaid manuals, starting with our peer recovery support specialist, for SUD. They actually are reimbursable by Medicaid here, here in West Virginia. We actually created a mental health certification too, so it's, it's pretty close to the same standards as the SUD when they take the same test. But they also have to have like mental health first aid and some additional mental health training to get that. And that's, you know, these credentials are also written into the manual. And then, you know, with us, with, CCBHCs, one of the requirements is to have an AADC or an ADC on staff, so that, you know, we're written in there in that way too. And we're currently working on, and we've been working with OSB and RC in focus groups for the peer supervisor credential, as well as a youth peer and a family peer credential. So we'll be offering those in the near future. , The youth peer is gonna-- it's still a couple of years out. We're developing a whole new curriculum and stuff for that. But the peer supervisor will be probably the next thing. And then the family peer, we're actually partnering with the, National Federation for Families because they already offer one. So we're gonna, kind of use their curriculum and test and stuff to offer it here in West Virginia. The newest thing that we've done is we have a lot of people Jamie Cantley and Jeremy Trimmer specifically on the board, and the people who came before them really worked with Senator Hilton, and other legislators to create and push Senate Bill 897, which just passed and is now on the governor's desk. And so that's actually going to create licensure for the AADC credential. So it'll put them up there with, you know, being able to, offer some of the same services that like LPCs and LCSWs do, but for addictions that are substance specific work. So that is super exciting. , Of course, you know, there's a lot of steps, like it passed the legislation and it's on the governor's desk, and then there's some other things that have to be put into play. But, that's really monumental. I think it's going to change SUD in West Virginia completely, so much exciting stuff. I can see how, why you, why you really love serving on the board. Yes. It is awesome. I'm so grateful that that's something that, Yeah, a friend of mine actually a couple of years ago was like, "Hey, you should do this." And I was like, "I could never. Like, that could never be me." And so I applied, and sure enough, I get to, you know, I meet some amazing people, met some amazing people. I'm learning so much from the people that came before me, and it is, it's really an exciting, super exciting part of my life, yeah. You're in the right place most definitely. So do you feel that there's still stigma in West Virginia around seeking treatment for addiction? And if, if you're comfortable sharing, could you tell us about a recovery success story that illustrates what's possible when people get the right support and they kind of get past that stigma? Yeah. So, I definitely, you think, know that there is still stigma in West Virginia, around seeking treatment and, we can see it in different bills in the legislation year after year really that have passed or that are introduced and stuff, and they're really just rooted in like shame and the stigma, and even like doing s- street outreach and handing out Narcan, like the community, you know, isn't always receptive to that. It provides a lot of opportunity to educate though, which is incredible, especially when somebody ends up taking the Narcan afterwards. So that's awesome. But, mean, just a story, uh, mine for one, um, I'm an expert of my life, I feel, so I'll just use mine. But throughout the charges, the different charges that I was charged with, whether it was misdemeanor, or felony charges I was not offered treatment and, you know, there wasn't that in Butler County. There had been like an AA meeting long before but there-- at that time, there was really no help. And again, I'd never seen anybody get help. And so whenever I was able to come down to treatment, it w- was a whole new world. Here in Mercer County, we have, um, AA meetings, NA meetings, a ton of people, you know. There's different rehabs and sober livings and, growing all the time. And, so when I had that around me, I was able to, Yeah, believe in myself, just believe in the next day, because that's something that I couldn't do for a long time. And, you know, unfortunately, Barbour County is still, it's very taboo up there. There actually, there's a treatment center going in, and the majority of the county is absolutely outraged, and it's super sad to see. But, we have a lot of good people who have went there and tried to hold, like, town hall meetings and stuff, and I'm hoping that I can be at one or two too just to be like, "Hey, man, like, if I had this, you know, maybe I could be closer to my family. Like maybe maybe I would have asked for help sooner." But yeah, it all together there definitely is still stigma, and there even is here and in other bigger areas where there's still-- where there's a lot of support, there's still a lot of stigma and sh- shame too associated with, being able to ask for help, so. yeah, and that's something whi- which I wish, you know, I think a lot about stigma, and I wonder why we have it, but I think we just need we need to kind of move beyond it as much as possible to get people the help that they need. Yes, I agree. So last question, and I'm very curious about the answer, or your answer to this question. If you were suddenly put in charge of substance use disorder treatment across the United States, what is the very first change or initiative you would implement to improve outcomes for people struggling with addiction? So that is such a difficult question to answer because so many things run through my mind. But I think that one of the biggest things I would do, honestly, is stop criminalizing addiction. And with that you know, on the front side of it, but also on the back side of it. We have all these people who have the lived experience and have the knowledge and who have went back to school and, you know, or want to go back to school and they want to be the people who have been there, done that that can also help these people, whatever that looks like, whether it's peer recovery or moving up from that like I did. And, you know, I think that if we can build the workforce out without holding the people's pasts against them like background checks and things like that, I think that that would really just make a huge difference in the way that we look at substance use on the front side as well as on the back side. The outcomes would improve if we could put those people in the positions that they deserve and that they've worked hard for. Um, and that goes back kind of to the shame and stigma. Like if we, if we stopped shaming people for the things that they, unfortunately got wrapped up in, whether they started using when they were a kid and didn't have a choice or whether they were 25 when they took their first drink or drug. I think that if we could just move past that, I think it would ... I mean, it would be monumental for so many different reasons. Yeah. I agree, and, and I really hope at one point you are put in charge of substance use disorder treatment across the United States. It would be huge. It would help a lot of people. So if people wanna find out more about you or the organizations you are involved with, how can they do that? So you can go to the board's website at wvcbapp.org, and then Southern Highlands website is shcmhc.com. Um, those organizations also have a Facebook page. , And we try to stay, you know, pretty active on there, so you can find out, you know, things that we're up to. We are posting a lot about the bills and the different credentials on the board site and stuff like that. And if anybody wants to reach me specifically you can reach me at, um, my email brandi, B-R-A-N-D-I, edwards, E-D-W-A-R-D-S, @shcmhc.com. And I'm happy to schedule, schedule a call or whatever whatever anybody would like to do. I'm happy to help in any capacity that I possibly can, so. Wonderful. I'm just, I'm just gonna say, I... this conversation has been inspiring, and I am glad that there are people, uh, like you in the world, Brandi. Brandi Edwards Farmer, thank you so very much for joining me today. Really enjoyed the conversation. Thank you. Thank you for having me. This has been awesome.

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.