My name is Alexandra and I am a second year medical student. This summer I spent a week in Minnesota learning about addiction medicine, treatment, and recovery, from both a scientific and personal perspective at the Hazelden Betty Ford Foundation Center City campus as part of the SIMS (Summer Institute for Medical Students) program. For so many reasons, this experience was absolutely incredible! The week consisted of lectures and discussions, as well as time with patients, and in particular one “buddy.” By just being present and listening as my buddy and the unit navigated this residential addiction treatment program, I learned more than I ever expected.
Throughout the week, my perspective on addiction and treatment approaches notably shifted. We learned that addiction is a brain disease. There are recognizable symptoms that can be diagnosed. There is a measurable reduction in D2 dopamine receptors, part of the reward pathway, that can lead to the characteristic cycle of addictive behaviors. The brain disease model of addiction is one of many to describe the phenomenon and thinking about addiction in the context of various models in many ways parallels the complexity of the brain. Lectures taught us more than just the neuroscience of addiction. One of the most eye-opening experiences was a discussion led by several healthcare professionals currently in the residential treatment program. Hearing their experiences, and relating to the stress and struggles they faced, felt very close to home. I was struck by the relative ease with which stress and situations relating to the medical profession (and training) can lead anyone toward addiction. I hope that this awareness, early in my career, can help as my colleagues and I embark on increasingly challenging endeavors.
The lectures also provided my first introduction to treatment approaches for patients with addiction(s). And I learned the unfortunate reality that insurance company coverage plays such a large role in treatment plan decisions for patients, sometimes counteracting patient, counselor, or physician advice. We learned about the various treatment options available, including the residential program, day treatment, and the family program. Being on the unit for a week, I was able to speak with patients at various stages in their treatment – a new-comer’s first day, a patient who had been clean for a week, my buddy was beginning his third week, a patient transitioned to day treatment, and a patient transitioned to home. Speaking with the patient who transitioned to day treatment, I realized that completing any amount of time (28 days or any other) in residential treatment does not eliminate the struggle associated with re-introducing aspects of ‘normal life’ back into one’s routine. And for those who do not have the option of going to day treatment, the transition can be particularly challenging.
I especially treasure the time spent on the Tiebout unit. The first thing I noticed when entering the unit was the camaraderie and support. This feeling of togetherness fills the room and persists throughout any and every activity. These men welcomed me kindly to the group, encouraging me to participate in their group activities, discussions, and medallion ceremonies. They were willing to honestly answer my questions and shared with me their journeys, challenges, fears, and progress, oftentimes over lunch or dinner, or out at the ‘smoke pit.’ The Tiebout guys have shown me that when we have the strength to recognize our own shortcomings, there is hope for a better tomorrow.
This week-long journey learning about addiction medicine was extremely valuable to me. I feel that my interactions with patients have improved because of my enhanced understanding of this disease process. Comprehensively, this immersive experience taught me the value of authentic self-expression and to not be afraid of emotion. The people I have met have been utterly inspiring – the patients, counselors, staff, physicians, and fellow colleagues. I hope that I can emulate the strength and perseverance that I learned from these wonderful people in all that I encounter in the future.
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