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Breaking The Chains: Overcoming Substance Use Disorders With Trauma-Informed Care With Evita Morin

RTB - DFY  Evita Morin | Substance Use Disorders

 

Addiction doesn’t discriminate. It’s a battle faced by individuals, families, and communities alike. Let’s break the stigma, offer support, and light the path to recovery together. In this eye-opening episode, we dive deep into the heart of substance use disorders and teen addiction with special guest Evita Morin, LMSW. As the CEO of Rise Recovery, a non-profit organization dedicated to helping young people overcome addiction, Evita uncovers the hidden world of addiction. From the impact of trauma and the rise of dangerous new drugs to the importance of early intervention and family support, Evita sheds light on the intricacies of addiction in a relatable and compassionate way. She also emphasizes the importance of trauma-informed care in the healing work.  Join us as we navigate the complexities of substance use disorders, empower families, and explore the role of compassion and innovation in healing.

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Breaking The Chains: Overcoming Substance Use Disorders With Trauma-Informed Care With Evita Morin

In this episode, it is my pleasure to have Evita Morin, the CEO of Rise Recovery, a friend of mine, and a fellow Board Member from The Blood & Tissue Foundation with us. Evita, thank you for joining me.

Thank you so much for having me.

I have quite a list for you and we might be here all day, but I want to start with your professional hat. I want to talk about substance abuse for young people, teenagers specifically, how a person moves forward with substance abuse because you live with that forever but your life can go on, and how an employer navigate having an employee who has a substance abuse issue.

Those are great questions and things that we explore in my field all the time. I am the CEO of Rise Recovery. We have been a nonprofit behavioral health support in the San Antonio Bexar County area for many years. We primarily focus on youth, young adults, and their families. I stress families because it is such a pervasive issue that bleeds through not just the person but all the loved ones around them.

This issue may be in a workplace, not just as the person using, but maybe a parent who’s struggling with their work because of a loved one who’s using. We deal with the whole gamut. We really work hard to ensure that when our folks are young people and our adults finally find sobriety, they are in a stable place and that they learn how to advocate for themselves, and how to work again. We hire a lot of the folks that we end up finding recovery with.

 

RTB - DFY  Evita Morin | Substance Use Disorders

 

A good question that you asked was about employers and how to handle when you recognize that someone has a substance use issue. The first thing I want to say is we have legal counsel on our staff. One hundred percent of our frontline staff are in recovery. This is a reality for us every day. I don’t think employers recognize how many of their employees are in a recovery state of mind or recovery from substance use disorder in the same way that they don’t know how many have recovered from cancer or other ailments that they may be struggling with silently.

In the case where someone has raised their hand and said, “I need help,” that is an opportunity as employers to help that person in the same way we would have been in any other disease and get the care that they need, especially while they are still employed and insured with us. That is a compassionate response to the fact that someone is diagnosed with the disorder that needs help. That’s traditionally how we respond. It’s important to recognize that this group of folks with substance use disorders is a protected class and that there is a risk to treating them any differently. You have to be mindful. It would be great to consult with a lawyer about what best practices you should put in place, and what policies you should put in place should this happen.

Depending on the workplace, being under the influence is something that is absolutely not something that you can accept and is something acceptable. That is the case for Rise Recovery. We are a safe space for kids and families who are seeking recovery. We cannot have our employees misuse alcohol or drugs on our campus. That is a hard line for us, and it can be a hard line for another employer if they have that need. It’s also important to recognize that not everyone’s in recovery. Not everyone has a diagnosis and drinking, alcohol, and drugs might be something, especially in other states that are being in recreational use. How to navigate that is a whole other conversation for another episode.

Would you just touch on that a little bit? Different substances are legal in different parts of the country, and that is incredibly challenging for employers.

It is. In fact, when Colorado first started pioneering the legalization of drugs, at first, they treated it differently. They tried to create boundaries specifically around drug use and marijuana use and drug testing and ultimately where a lot of employers have gone especially in Colorado, but I think others are mimicking it in legalizing states. They are treating it no differently than they would alcohol.

If it’s not impeding the work, if it’s not evident in the day-to-day engagement with your employee, and if it’s not causing a problem, they treat it no differently than someone who likes to have a glass of wine after work or to responsibly use it. That seems to be the way that folks are gravitating. There’s a great consultation from folks. My sister is one of the leads in the marijuana legalization and lawmaking in Colorado in the state and has pioneered a lot of the laws that now exist in that state as a result of the legalization. I’ve learned so much through her.

I didn’t know that. I imagine you have.

I said she needed to write a book because of what history she was making.

Can you talk a little bit about how an employer should or maybe should not respond in a general way if they suspect that an employee has a substance abuse problem?

It depends on why they suspect. It’s important to know in your policies and procedures whether random drug tests are something that you should employ in your work environment. At Rise Recovery, we do for instance. That is an expectation at employment and randomly throughout your career here. That might be something that you would want as evidence of an issue.

It's important to know in your policies and procedures whether drug tests are random, drug tests are something that you should employ in your work environment. Share on X

It being a protected class, you have to be very careful how you approach that. Coming from a place of concern and focusing on work behavior and performance is a great way to start. If there is an issue approaching it as much professionally as possible would be how I would have approached it, unless you have those policies that mandate those kinds of drug testing and things. It’s a very careful line that you have to walk in the same way you would with other disabilities.

I’m going to throw in there another plug for a very good policies and procedures manual. Everybody hates them, but they are the rules of the road.

They will save you in a risk. We have been so grateful to have legal counsel on staff. If you don’t have that having a legal review of your policies and procedures, I highly recommend that. It’s so important. I know there are a lot of templates online that you can pull from or friends you can borrow from, but there’s nothing like that legal review.

We don’t work so much in policies and procedures, but we do deal with risk quite a lot. We like the documents in order. Whatever they’re going to say, they’re going to say, but they all need to be saying the same thing.

Exactly. You need your employees to sign them.

Yes, you do. You went through a capital campaign. As I look at all of that gorgeous light coming into your office, you told me that you have a trauma-informed building, which is fascinating.

I’m a social worker by trade. That’s my degree. That’s how I got into the role I am in now. Trauma-informed care is such an important part of the healing work of health and successful outcomes, especially in behavioral health. A lot of our participants are used to very stigmatizing, sterile, and institutional environments, even schools but also juvenile justice systems, the adult justice system, and hospitals. There are so many inpatient programs that don’t really treat an individual with trauma-informed care because, unfortunately, a lot of the reason people become this way is due to unaddressed trauma.

It’s important at Rise Recovery. It is our mission that everyone is a worthy individual and is capable of healing. Part of how we represent that is when you walk into our doors, there is a lot of natural light. I’ve worked in cinder block jails in prison settings before and even in schools, where I was assigned a broom closet to do my counseling. What kind of message does that send to a participant when that’s the experience they’re getting?

This is a very beautiful environment. We are a peer-based program. Again, 100% of our program staff are in recovery. A lot of our work is done more over a coffee table or a ping pong table than it is over an executive table because a lot of the work is about developing relationships and rapport and teaching people how to be in healthy relationships with themselves and with others so that they’re not going back to those old people, places, and things. It’s a beautiful place. We have a coffee shop on campus and an amphitheater. We have a recovery high school on our campus that is a trauma-informed school. It’s a beautiful space.

Would you explain what trauma-informed means?

It is about taking the person and their centeredness and choice into the work. We recognize that people don’t choose to go into these jail environments or these hospitals and they have to. We want to create a space that is not triggering to our participants and that is not just figuratively but literally warm in its colors and the way that it was designed.

There is a lot of casual seating for instance. There’s a lot of natural light instead of fluorescent light. There is a variety of places that you can go for privacy and semi-privacy. Things like that make an enormous difference, even the soothing colors you choose as opposed to harsh ones. Things like that make such a big difference in someone’s willingness to relax in an environment and to seek the support that they need.

As a society, we both underestimate and overestimate the effects of trauma. Many people have been traumatized in some way and they don’t necessarily acknowledge or understand that. I would imagine that a lot of those people arrive at your door.

That is 100% true. I would say the vast majority of the people that we serve have experienced underlying unaddressed traumas. Frankly, now that we’ve all been through a pandemic, all of us have a traumatizing incident whether we want to admit it or not. There are natural environmental traumas and things like that, but then what we see a lot of is harm caused by loved ones, harm caused in the family, different abuses and neglect, and things like that.

Those are very common reasons why people turn to drugs and alcohol. All of us who’ve been through a pandemic and the stresses that it caused can relate to what it’s like to want to numb out after a very stressful period of not knowing what’s going on two feet in front of you as we all did and felt. That is just a glimmer of what these individuals have experienced.

That was a very good way to put that. We’ve all been through something. I served on the Board of the Family Services Association for some time. The executive director’s job was to shock me every time we sat in a meeting. I would just be like, “What?” It was amazing some of the things he told me and the amount of trauma that happens and from people that don’t mean to inflict trauma as well.

That’s very well said. People are doing the best they can with what they know. That’s where generational trauma happens, and we see a lot of that in our work. The neglect that’s caused by being addicted to substances is profound for the kids that they raised, and the cycle goes on and on and on.

People are doing the best they can with what they know. Share on X

You’ve had a lot of astounding growth in the last few years. You went through a capital campaign. You have a new building. Your staff is growing. Let’s talk a little bit about competition. You are in a nonprofit space, yet there is a lot of competition in your segment. How do you manage that?

That’s interesting. A lot of nonprofits like to believe there is no competition, but there’s always the need whether or not we know. I know every day that this work is good work and it’s mission work and that there’s someone we can help. If I am not staying intentionally relevant to the conversations that our public is having and if I am not promoting the work that we’re doing to people and helping de-stigmatize and educate on this issue, then I’m missing an opportunity for this organization to receive the funds that it needs to do the work that is doing.

We provide 100% no-cost services to the people that we serve. We don’t take insurance or a dime unless someone is donating that dime. That is such an important part of the work because the competition is often insurance-provided services. There are a lot of for-profits in my sector. There are many inpatient and intensive outpatient drug and alcohol programs that exist, and there are barriers to that. It’s important to recognize that we at Rise set itself apart is that we work to eliminate those barriers. We provide the transportation. We provide no-cost services. We provide a very central hub of services.

The work we do now goes to not just a lot of these people but competitors in the field. You have to come to them and their center. We go out into the schools. We provide full dedicated staff to those schools, for instance, to provide that support to those students as one of the many services we provide. In San Antonio, we are the only resource for young people. In that way, I would love more competition because there is more work than we can handle dealing with this epidemic and the lack of resources for our teenagers. There’s not an inpatient program for kids in San Antonio.

People are shocked when they hear that. They’re like, “What do you mean?”

It’s hard to understand.

What is the most surprising service that you offer? People think, “I have a substance abuse disorder. I’m going to do this, but it’s not just this. It’s this and this.” What is the most surprising part of that for people?

One, most people aren’t educated in the whole continuum of care, the behavioral health system. They don’t recognize that this is a multi-tier journey. There are multiple steps to recovery depending on how far along the addiction is. You may start with inpatient. After that, you’re not going to be cured like you were saying. This is something that now you need an intensive outpatient. Now, you need community recovery support and an employer who is supportive of your recovery. There are so many components.

One of the very unique things that we do at Rise Recovery is that family wrap-around service. We may have families whose kids are still on the run and who are not yet ready to seek care, yet we will provide that family with the structure and the support that they need to sustain their health, their marriage, and their other children because that family system is all that person who’s struggling has to run up against. We need to keep that unit as healthy as possible. We even serve the siblings and the children of families dealing with this. These are often the most forgotten kids. They’re the ones that are doing okay. They’re the ignored ones because they’re not the ones going through crisis.

We provide a support service and a community for them. We also have our recovery high school which I mentioned. This is San Antonio’s first and only recovery high school. We were the only major city in Texas at the time that we opened that hadn’t already begun building a recovery high school, which is a shame that it took us so long.

I want to talk a little bit about the kids that are doing okay. When we were talking earlier, we talked about how children often get left out of the conversation. Children may not know everything, but typically, they’re pretty observant.

They are, very.

What is your best advice for a family in dealing with substance use disorder and managing children if the child is not the person with the disorder?

Making sure that the other children have connection and time with that family member is very important that they have as much dedication and a role in the family that is not just the helper role. Where families go astray is when we start assigning roles that were not intended for children on children. That’s commonly what happens. The health of either the marriage, the relationship, whatever supporting that family of that person, maybe it’s just a single mother or a single father, the health of that person is wholly critical and an absolute priority. Creating the boundaries that are necessary to be able to protect the rest of your family unit from someone who is struggling with substance use when they’re struggling is hard and very important.

There’s an assumption that if you’ve got a loved one who’s using, you must be a bad parent. What I see in Rise Recovery more often than not is the families are deeply invested in these kids. They’re doing everything. They’re turning themselves inside out and upside down. They are remortgaging their houses and doing everything they can to save this kid when, at the end of the day, that kid needs to save themselves. You can love someone to death. You can provide so much runway and let them get away with so much or bail them out of so much that they never feel a consequence of the drug use. It only takes one time to overdose. It only takes one misinterpreted drug without Narcan around to kill yourself.

That’s what’s happening to a lot of our kids these days. With the kind of drugs that are on the market nowadays, they’re not even reaching the point of addiction. They’re experimenting. They’re trying it once. The boundaries aren’t set. Maybe permissive parenting is part of what they were raised with. They’re not here with us anymore because we didn’t have that conversation. I can’t stress enough for parents that for anyone whose brain is still developing, which is in that age range of 0 to 21 to 22, especially for those young boys that last a little bit longer, there’s no permittable time for them to be ingesting drugs that are unregulated that are not supervised by a doctor. It will damage their brain. It will create neuro-pathways that will change the course of their developing brain from the way it should be.

It only takes one wrong, misinterpreted drug to kill yourself, and that's what's happening to a lot of our kids. Share on X

There was a time and a place when it was okay as long as you were watching your kid, but science has shown that it will cause brain damage to developing brains. We have to be mindful that there is never a good time for an underage person to use. The statistics show that, at an inpatient program, if you ask them when they started, over 70% of them will say they started when they were 10, 11, 12, or 13. They started when they were very young.

A lot of people don’t know that the number one cause of developing an addiction in your adult life is how early you start. If you start that kid, depending on those chemicals when they’re 12 or 13, or if they find that and then figure themselves that that’s a solution, it is likely to be a solution for a very long time. If you look at the studies that show people who started when they were 18, 19, and 20, that is significantly lower than those who develop addictions in their lives. Age is the number one factor. It’s not socioeconomic. It’s not genetic. It is age.

That might be the most important thing we’ve learned.

I hope so because I understand the intent and the hope with permissive parenting to be supportive, to develop that relationship with that kid, and to supervise when they’re doing things because you know they’re going to do it anyway, but I can’t stress enough how important it is to set that boundary because you’re risking too much and you’re playing Russian roulette, not just with your child’s brain, but with all the other kids that are potentially engaging in that with them.

Drugs nowadays are much more dangerous than when I was a teenager. Is that accurate?

One hundred percent. They are 50 times more potent than some of the drugs that people were using on the streets before. We’re talking about heroin and morphine. Now, it’s fentanyl. There are drugs that are causing terrible reactions to people. Xylazine is the big one now. It’s called Tranq and it’s on the streets. People don’t know what they’re using anymore.

It used to be that street drugs looked like street drugs. Now, they all look like medication. They all look like pills. You don’t know what’s in them anymore. You don’t know what’s being pressed in them. They all look safe. They all look like maybe what someone took at a party twenty years ago when you could presume it was from a pharmacy and safe. Now, they’re filled with deadly poisonous drugs, and they are causing overdoses left and right for all ages.

It is the second most important thing you’ve said.

I would hope that the third is to carry Narcan. That is an opioid-reversal drug. It is something you can get over the counter. It is something that Rise Recovery distributes for free if you can’t afford it over the counter. Especially if you’re not sure what your children are doing, you never know when that could save a life. It has saved many lives as an opioid-reversal drug. Hopefully, we’ll continue to. We handed out to family members every day.

Through the course of our conversation and through the other conversations that we have had over the course of time, I’m always so interested in how you run Rise Recovery, a nonprofit as a business. That’s very important. I’ve served on several different nonprofit boards. Typically, the more they run like a business, the more people they can serve, and the more stable they are, they’re more impactful in their communities, but that doesn’t happen by itself. You do need business support and business skills for that. Do you invest in any mentorship coaching operational programs to help run your organization more effectively? How has doing that impacted not just you but your staff?

I would certainly recommend it for any leader of an organization, especially if they haven’t been to business school and if they don’t have some significant mentors in their life to engage. There are so many wonderful leadership programs and mentorship programs in San Antonio. I have been on a few of them. There’s been a whole leadership program, which is a mini business school through the San Antonio Area Foundation. I will be applying for Leadership San Antonio at some point and hoping that I get to be a member of that. I have also engaged in executive coaching.

I’ve been a part of a group called C12, which is a Christian-based business executive support system. I am now a member of Vistage, which is another executive group that supports CEOs and small business owners going through all of the different seasons of business together. Ours is focused more on small businesses. We are a $3 million organization. We have about 40 staff. We have grown from 12, several years ago when I got here, up to 40. We’ve grown substantially.

We were about 1.2 million when I first got here. Now, we’ve more than doubled and we’ve had no space for four decades prior. It was handshake deals. There wasn’t even a signed lease. It was very charitable but also very risky. It is not something I felt comfortable doing long-term. I sure am glad that we now have these beautiful walls around us and a property that is ours. It was worth the $8.5 million capital campaign to get where we are now.

I also recommend getting an operating system in place, especially if you don’t have a CEO-type background and you don’t have a real strong skill or grasp for education on project management and analytics because those are so important. They provide the levers that you push and pull on to create change in your organization. They teach you about efficiency. They teach you about outcomes.

I am a very visionary, focused person. I’m a social worker, so I’m very much focused on relationships. I have my strengths, but I also know where I’m not strong. That is on the operational, analytical side. We hired Mission Matters Group at first to help us with EOS or Entrepreneurial Operating System, which is an operating system that helped create support from my team and myself, understanding our strategic plan for four years and our year-end goal, and then breaking that down into bite-size chunks, taking it quarterly, taking it weekly even, and holding us accountable every single meeting that we had with my team on progress toward those goals.

Our meetings stopped putting out fires. Before, I’ve been in organizations like that as well where you end a meeting and you’re like, “What did we say we were going to do there? I feel like we just ran in circles.” Nothing was necessarily accomplished. Great conversation, but I could have done something better with that time. It creates having an operating system in place. There are many to choose from. It creates that structure, direction, map, and dashboard that you need the way that you would for a car. When you’re driving, you need to know how much gas you have, how much oil you have, how far away are you from where you’re trying to go, and your destination. These operating systems are made to provide that for you and to create that with you and your team.

That created massive cohesion instead of me running 500 miles and my team trying to keep up with me, who were all very analytical people because I surrounded myself with people who had strengths that I did not have. I was making them crazy because that is not how they think and work. They were trying to guess what I was envisioning. This forced me to put it on paper, hold myself accountable for it, make it a smart goal, make it measurable, and then break it down into realistic chunks that we could achieve. It gave them a breath of fresh air. It gave them breathing room to do the work and clarity. It is just been pivotal to the success of Rise Recovery over the last few years or so. I wouldn’t do anything different.

When you have a vision, put it on paper, hold yourself accountable for it, make it a smart goal, make it measurable, and then break it down into realistic chunks that you or your team could achieve. Share on X

I would imagine it allows everybody to take a vacation.

Yes. In fact, I took my very first long-term vacation not too long ago, three weeks, which may never happen again, but I sure am glad I did it in Maine and what self-care is. It really did feel like I had just run a marathon, but now, I needed a break. We’re now back at it. I’ve got a great team that’s developing new cohesion because it’s a brand-new team. It’s been hard. I’ll be the first to say. 2022 was a very rough year. Especially post-COVID, so much turnover. Our gallop was around the same range. It’s just the average in the United States. I want to be above average. I don’t want us to be average. We have a lot to do and a lot to achieve. We’re hoping to do that now that we have measurable goals to do it.

Before we wrap up, I want to talk about something near and dear to both of us. We both serve on the Blood & Tissue Foundation, which is the blood-raising arm in Texas. We serve a 47 to 48 county area, where we are the main supplier of blood. You and I had a rather interesting conversation about cord blood. We were also the first entity in Texas to have cord blood storage. Cord blood is way more complicated than either one of us thought.

I never knew. I have learned so much through the Blood & Tissue Foundation and things I wish I had known and now things that I am advocating for as a Board Member for the Blood & Tissue Foundation. I think that more mothers should know. When I first got on board in 2017, I was a brand-new mother to two babies.

I learned that cord blood requires a match for you. If you need the stem cells the cord blood provides, you need to find someone who matches with you. What I did not know at the time was that your genetics played a huge part in that match. What your ethnic background is plays a huge part in that match. You’re more likely to match with people with similar ethnic backgrounds.

In this new world of very commonly interracial marriages and multi-racial babies, it’s important for parents to know when they’re being offered to have their cord blood collected that they say yes because they don’t recognize that if they ever need that in the future and if they’ve got a complexity of ethnicities in their culture and their background and their child, it’s going to be very hard to find a match. I would advocate for every mother to donate their cord blood to the bank. If you can afford to have it frozen, by all means. You don’t need to because there is a bank that will hold it. If ever there is a need and you have that complex background, there’s a chance that you’ll have a match.

Cord blood is one of the many things that the South Texas Blood & Tissue Center does and very important. It was the first cord blood bank in the state of Texas. I know there are, generically for our audience, huge outreaches both to obstetricians to talk to mothers and to new mothers themselves to help them understand what their choices are for cord blood. If anybody has any questions about that, certainly you can reach out to either Evita or me or you can head straight to the South Texas Blood & Tissue Center and they will be very glad to help you. They’ll be glad to take blood too, by the way.

Please.

We will leave it there. We learned some real important things about opioid abuse and substance use disorders. Everybody should have a Narcan. Now, you know where to get one. Thank you so much for joining me.

Thank you so much. It’s been a pleasure talking with you all.

For those of you that have joined us, thank you. I hope you enjoyed the episode. If you liked it, leave us a review and give us a thumbs up. It helps us spread the word. We’ll see you next episode.

 

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About Evita Mori

RTB - DFY  Evita Morin | Substance Use DisordersEvita Morin, LMSW, has been honored to serve Rise Recovery as its CEO since 2016. Her civic and nonprofit career spans the front lines of civil service, housing, education, re-entry, and substance use recovery. A San Antonio native, she grew up throughout urban and rural Texas before attending undergraduate and graduate school at Columbia University in New York. Passionate about her community, she also proudly serves as a board member of Masters Leadership Program of Greater San Antonio, The Blood & Tissue Foundation and her HOA. She is the recipient of recognition by San Antonio Woman Magazine as a “San Antonio Role Model,” the SA Business Journal’s 40 Under 40, and the NASW’s Alamo Region Social Worker of the Year. She has two beautiful children and she loves camping with her family across Texas.

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