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By Dr. Matt Swain & Program Manager Rob Montgomery Traditionally, January is a time for new beginnings, making it the perfect time to take a step toward recovery from drug or alcohol dependence. One of the wisest things I ever heard was from a long-time nurse who worked with substance use disorder (SUD) patients. He said people’s behavior makes so much more sense when you realize we are all treating our own anxieties, just trying to soothe ourselves so we can feel okay. This hit me as a profound truth. Whether people are using drugs and alcohol, watching TikTok, eating potato chips, having sex, or making impulse buys on Amazon Prime, they are all looking for a dopamine hit (dopamine is the brain’s feel-good neurotransmitter). When these behaviors occur in moderation, they’re mostly okay, but when people start using them to avoid the physical or emotional pain of dealing with important situations and relationships, it can signal a disorder. Substance use disorder involves the uncontrolled use of a substance such as drugs or alcohol to the point where a person's relationships suffer and the ability to function in day-to-day life becomes impaired. At MCHC Health Centers, we encourage those who do not feel in control of their drug or alcohol use to seek treatment through our substance use disorder program. This program focuses primarily on opioid addiction, but it also helps people who are misusing benzos (sedatives), alcohol, and other substances such as methamphetamines and cocaine. We focus on opioid addiction because it is so common. Opioids are a class of narcotics often used as pain relievers, including illicit drugs like fentanyl and heroin and prescription pills like hydrocodone and oxycodone. When people hear the term alcoholic or drug addict, they sometimes think of a scruffy-looking homeless person whose life is clearly miserable. The truth is that addiction affects people of all genders, ethnicities, and social classes, including lawyers, doctors, bank tellers, and schoolteachers. Until people understand and accept themselves, it’s hard to heal. To do this, people need to feel safe and supported enough to delve into the causes of their addiction. Otherwise, they can get caught in a vicious cycle of self-loathing. Healing can begin by entering an SUD program. At MCHC we do not judge. We have no use for stigma. We help people leave shame and guilt behind. Whether someone comes with the label of “ex-con” or “mother of three,” it makes no difference to us. We’re here to serve human beings. Substance use disorder is complex, and to truly help people, we need to be available when someone decides they want help, to strike while the iron is hot, so to speak. This is why MCHC is partnering with the Ukiah Recovery Center (Ford Street Program), Mendocino County Behavioral Health and Recovery Services, Mendocino County Sheriff’s Office, Adventist Health, Partnership HealthPlan of California, and others. By working together, we can meet people where they are. There are critical decision points when people choose between recovery and returning to old, unhealthy patterns and relationships. When people are released from jail or discharged from the hospital, if they have a safe place to stay and access to the services they need to gain and maintain sobriety, they are far more likely to choose recovery. Everyone who enters the program does so voluntarily. If they do not have the funds to pay for care, MCHC can help them sign up for public health insurance and other financial aid programs. No one is turned away because they cannot afford care. The biggest barrier to care is the lack of self-compassion and self-love people need to start recovery. In our society, we glorify perfection when in reality, none of us is perfect. If you can accept yourself as an imperfect person–and you have the courage to heal–we can provide you with the tools and support to do so. At first, you may have to make the decision to stay in recovery every five minutes. Then, maybe the decision to stay sober only comes up once a week. Eventually, it gets easier. If you make a mistake, you accept yourself as imperfect and still lovable without falling into a shame spiral. And you get back on course, usually with the help of a community of people who encourage and support you. Anyone can make an appointment to get assessed for the SUD program. If you aren’t comfortable giving the real reason for the appointment, you can give any reason you want: you have a cough, you’re not sleeping well, whatever. Then, when you’re with the medical provider, you can share your desire to overcome your dependence on drugs or alcohol. One of the great things about receiving treatment at a health center like MCHC is that no one knows if you’re coming in for high blood pressure, diabetes, or to get off heroin. We treat people for all sorts of ailments and everything is confidential. Dr. Matt Swain is the chief medical officer and Rob Montgomery is the SUD Program director at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.