The Behavioral Corner 

The Behavioral Corner  Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a while.

Steve Martorano 

Yeah, one of the great things about, you know, making a living more or less hanging on the street corner, is that I get to run into all kinds of really interesting people. So I hope you've found us and you can spend some time on the Behavioral Corner. Today's guest is no different. Bill Stauffer has been a lifelong advocate for substance abuse sufferers. I spent the better part of say his adult life as an activist with a capital "A." And he's the kind of fella that hasn't let anything like a pandemic stand in the way of that bill is the Executive Director of a Pennsylvania statewide organization called the Pennsylvania Recovery Organization Alliance. He's been doing that since 2012. He is an addition of a 25-year clinician and administrative expertise in both those areas. And he himself as in long term, very successful sobriety, which began at the age of 21. So we welcome Bill Stauffer to the Behavioral Corner. Hi, Bill, thanks for your time.

Bill Stauffer 

Thank you for having me. It's an honor to be on your show and really appreciate the opportunity to talk about these kinds of things that they're they're things that are near and dear to my heart.

Steve Martorano 

Yeah. I never more important than during this pandemic, which we're going to get deep into, because it has affected everything. Now said at the beginning, I want to get into what the organization does, of course, as well. But you know, I'm guessing that if you got sober at 21, you have been in long term successful recovery for better than half your life. Correct?

Bill Stauffer 

I celebrated 34 years of recovery, actually, last week. And so the majority of my life has been in recovery. And for most of that time, I've done this work, I would say more than full time, it's more of a calling than a job. And this is incredible work to help other people get into recovery. And it's also could be very difficult. I mean, you know, that I think, you know, for me personally, that if there is a curse of long-term recovery, it's seeing sort of the slow-motion train wreck of what can happen in people's lives. And knowing that it doesn't have to be that way that you know, I've seen some really amazing, talented people that we've lost, because we haven't provided the kind of things that they need to get on for recovery. So this is a, this is what I've done with my life. I wouldn't have it any other way.

Steve Martorano 

Yeah, well, we're all better for folks like you, I'll tell you that, you know, 34 years sober is a remarkable achievement. And it's worth just people hearing that because as you know, there are people who can't imagine 34, you know, days, or 34 minutes, without using. So that's always helpful. But you know, it's a great point you make about just...

Bill Stauffer 

I was one of those people just so you know, I mean, I had never envisioned that this would be that I would, I couldn't think of myself being 90 days in recovery. So this wasn't what I thought I would do. But I'm grateful I have.

Steve Martorano 

Well, that's how you string out 34 years. Just before we get into your story about your substance abuse, and how you manage that remarkable change. You mentioned something just embarrassing how difficult it can be because you are surrounded by the stories and the people who suffered the way you did. Sometimes you're successful, many times you're successful in helping them but as you pointed out, you lose, do lose people. I just question just occurred to me, I don't think I've ever asked anybody in your position about this. How do you avoid hearing those stories and seeing those people and what they're going through? How do you avoid that trigger you? Has that ever occurred in your life that it just got too much?

Bill Stauffer 

It's a really good question. And I think anybody doing this work, but you know, there's something called vicarious trauma. And so I have seen in experience, things that are also traumatizing and doing the work. And you know, it's very interesting, because there are corollaries to the other things that we're talking about here today. So, you know, there's actually something called post-traumatic growth. And if you look at, for example, we're undergoing this, this pandemic, and people who go through crisis One of the things that can happen is it allows them a chance to reevaluate things that are important to them. And so trauma is something to be addressed, but it doesn't mean it's not fate, it doesn't mean that it will harm you. And so, for me personally, to stay vital doing this work, I have to practice my own recovery. I think you know, continuing to be a person that is my attitude. Do I have much more to learn, and to stay vital, and there's no experience in life that I can't learn from? I've learned as much from the people that I've worked with, I suspect that they've learned from me. And so it's really a great honor, even though it has exposed me to some difficult things. It's a great honor to spend time with people and watch their growth process. And I even say, you know, sometimes, when I didn't think that people did well, you know, it's more than occasional that I've run into people, eight or 10 years after I work with them on the street. And they, they repeat back to me things that I'd said to them a decade before. And I recognize even though at the time, I didn't think that what I had said, had made a difference that it had stuck with them. So it's not over till it's over. Keeping that mentality is important to me.

Steve Martorano 

Sure. I guess I guess it also your life's work, can in a real sense, help you maintain your sobriety, right?

Bill Stauffer 

I think so. I think it also involves extra work, I wouldn't suggest that somebody get into this field, to improve their own recovery, because it can work the other way as well. It also changes what you can do with your support, you know, think about going to meetings with people that you're serving. So you have to be careful. But I do think that that overall the work has been fundamental. And in my own process.

Steve Martorano 

Bill, can I ask you about your experience with substance abuse? How did it start? When did it accelerate? And how did you get finally sober?

Bill Stauffer 

So I started using drugs and alcohol when I was 11 years old. And, you know, people might hear that and think, well, what was wrong with his family that he started at such a young age and I, my family was a pretty average family, my dad worked for the Bethlehem Steel Company, which is a, in the Lehigh Valley, there is a time that I started, there was a lot of problems with the industry. And so there, his focus was on keeping his job. And a lot of the families around me that their parents were the same way so that our parents were distracted. And I was hanging out with kids that were older than me. And I think, you know, one of the things that happened, when I started is, the older kids didn't want the little kid telling on them. So when they were experimenting with pot, and I was 15, or they were 15, and I was 11. You know, they made a decision to share it with me with a 15-year-old brain. And I made the decision to accept it with an 11-year-old brain. And, you know, I do have some of the genetics around addiction and some other things. And we know that that addiction can run in families, it doesn't always mean, I'm short, I got a tall brother, it doesn't mean if it runs in your family that everybody gets it. And we also know that the younger person experimented with drugs, the higher the risk factor, so I had those things going against me. And so I was pretty much off to the races, I had a very high tolerance to drugs fairly quickly. There were around some people who were into some pretty, you know, significant drug use. And so I became addicted really early, I would actually function for a number of years as a team before it really started to get bad, where I wasn't able to function, having blackouts, and just not simply being able to maintain any normal functioning. And I, without getting into a lot of detail, I had a moment of clarity. Because I've seen addiction around me in my life. Even before that, I recognized that I was worse than some of the other people that that were around me. And that if I didn't, if I didn't do something about it, I was going to die really quickly, actually went to a 12 step recovery meeting. And there was nobody in my age group around me. But I listened to what they had to say. And I actually went to some therapy. And I got into recovery 21 it was very hard because there wasn't anybody in my age group. So I had to hang out with older people. And I got involved with service work in the community. And so I kind of fell into doing things. And I think one of the things for me was I had this recognition that I was a failure. But the reason I was a failure was that I had actually failed to try of all the things that hurt the recognition that I had no idea what I could do if I tried because I only had done so like sort of half-heartedly was something that I was determined to see what I could do with my life. I don't want to simplify it, you know, those are sort of the building blocks that I worked on. So you know, I barely graduated high school, but you know, now, I run a nonprofit, I'm a professor at a university. And all those things took a lot of time and effort and energy. But, you know, I think that that's actually the story of recovery. And we could talk about that. The majority. The thing I would say to listeners out there is that the only thing remarkable about my story is it's really unremarkable in the recovery community. I mean, I've seen homeless people get PhDs. I've seen people who never had an honest job in their life end up running successful businesses. When we get into recovery. We take care of ourselves, our families, and we actually get very involved in the community. So we're, we're amazing members of the community in recovery. And so getting more people in the recovery helps our whole society.

Steve Martorano 

You know, it's critical to remind people who may not know that millions of people are doing just that millions. I'm not exaggerating, wind up in long term sobriety. But many, many, many others do not. They do not because they continue using or they do not because they never even get help. So that's why your organization is incredibly important. I want to get into what PRO-A does but be just one moment on this, this notion of a clear moment. And I've heard that a million times, of course, that moment of clarity, you arrived at your very young age at 21. Was there any, any events outside you or people outside you that helped you get to that? Or did you just come to the realization that this wasn't working?

Bill Stauffer 

So events outside of me are that I was just fully unable to function I was, I would start using, and that there was no predictability. I could drink a single drink or two, occasionally, but other times that I would wake up in a different place, and be out of money and have a lot of people upset at me, or I had no idea what would happen when I would start to use and it was really scary and dangerous. I did get arrested. And that was right around the time, I was contemplating, hey, maybe this isn't going to work out for me, I ended up getting arrested. And it was right around the time that I was trying to see if I might be able to just have one or two and be okay. And I just right there in front of me that I couldn't. And like I said, I had been watching people close to me who were suffering from addiction. So I kind of knew, from looking at them what was going to happen to me. So it wasn't a good clarity. It wasn't like, it wasn't fun, clarity. It was more like I could see really bad things about the path that was on and what I was becoming. And I just, I wanted to try to see if there was another outcome.

Steve Martorano 

Yeah, that's a great way to remind people that these moments of clarity do not occur, as they often do in movies or books, as bright white light, and all you know everything flowing well from it. Sometimes the clarity is a scary picture. And it changes you and put you on a better path. You know, I know you're grateful for that moment. And thanks for sharing that story with us. But let's talk about your work. I'm particularly interested, of course, in your executive directors work with the Pennsylvania Recovery Organization Alliance. Tell us about that organization. How did it come into being and what do you do?

Bill Stauffer 

So we are what's called a recovery community organization and the concept of a recovery community organization comes out of something called the new recovery advocacy movement. And so, you know, for people who are interested in history, you know, there was a recognition in the late 60s that we needed to do things and help people get into recovery, there was really nothing available. I mean, if you go back into the 60s, people were getting frontal lobotomies or getting, you know, brain surgery, to cut out parts of their brain for addiction or being put in jail, or, or old-style electroshock therapy. There wasn't anything around. So two people actually got together then and decided to advocate for services into some of the initial services that are available in America came out of that, what we call the original recovery movement. Now, what happened politically in the 80s is a war on drugs. And so there was increased stigma and an increased focus on incarcerating people. And it sort of drove down or drove out the direction that we were all heading. And in the late 1990s, groups of people got together and started to recognize that we had to get our voices involved and start to get it out there that people can and do recover. And so our organization formed, right around that time, actually, some advocacy in the state of Pennsylvania created some federal grants, focused on networking, the recovery community, very similar to what had happened in the mental health community. And we were formed out of that, to sort of bringing voices together, I will share a few a radical thing back then, was someone publicly acknowledging that they were in recovery. And so the very idea of sharing your story publicly was something that was controversial. And now it's more commonplace because what we want to do is make people understand that we can and do recover. And so our organization was formed out of that. You know, since that federal grant, we've got some other federal grants that there's been some state funding around deliverables that we've done and provided actual products to the state as far as looking at or examining or conducting work. And then we do education and training out in the community for something called peer support services, and through donations, and so you know, I work all around the state and provide education And information. And that's what we wrote down.

Steve Martorano 

You know, it's there's been a sea change, you've seen this, I've seen this, in the public's awareness of substance abuse disorder, and what needs to be done about it and just listening to you, the war on drugs, war being the operative word here, one of the great achievements I think we've made as a society is to recognize that that was horrible as it turns out, a horrible metaphor for what needed to be done. And because you're right, it goes stigma and mass incarceration. And, you know, you can't arrest your way out of this problem. So we mercifully have abandoned that motif. And that, and that is terrific. I know, in reading some of what you've written in this brilliant testimony you made before the Pennsylvania House of Representatives, it's on your website, people should read it. It's a great document, you talk about the importance of community. Why is that important?

Bill Stauffer 

So when we take a look at the building blocks of recovery, and you know, I've had the honor of working with some, some people, like a guy named Bill White, who's the primary writer about this is what we recognize what how do people recover, and in general, there's a connection to the community, humans are social animals. And people generally don't recover in isolation, you need to have people around you and feel supported and have hope, and be connected to others. And so there's a, you know, to reverse it, you know, we could talk about something called deaths of despair, and sociologists are starting to look into this. Why is the opiate overdose epidemic increasing? You know, why is suicide rates going up in America and why actually, alcohol deaths are increasing, and, and they have to do with some of these fundamental concepts of deaths of despair. So the opposite of recovery, the kinds of things that fuel addiction are isolation, loss of hope, and loss of human connectivity, and they're actually sadly some things that are growing in our society.

Steve Martorano 

And they're also being exacerbated by this pandemic. I mean, all of those things, even absent substance abuse disorder, is resulting in broader community isolation, loss of hope, all of that. So it's making everybody's life more difficult, not least of which those people are suffering from this. I want to pause here because I do want to get deeper into this notion of deaths of despair. It's a very big topic, and it's a phrase that I wasn't familiar with until I read some of your stuff. It's, it's fascinating. We're talking to Bill Stauffer. Bill is the executive director of the Pennsylvania Recovery Organization Alliance. He's here to give us chapter and verse on a big, big problem that's been made, like everything else more difficult, maybe in some ways, more damaging. Because of the pandemic. We're on the corner of the Behavioral Corner.

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Steve Martorano 

So but let me ask you, this organization is remarkable. They do fantastic work. And you would wonder you would assume every state in the country has an organization like yours, a statewide recovery community. I note from your work again, or you know, research on this, that the only 24 states have an organization like PRO-A. Why is that?

Bill Stauffer 

Well, I mean, I think it's a good question. You celebrated the kinds of things that we do, are, and they're important are things that most people don't necessarily think of. So when you think of like, say behavioral services, most people think of you're going to provide therapy like a group, or a session. And what we recognize about recovery is, again, there's a community-building element of recovery that we see no matter what pathway you use, most people have to have that kind of community. So it's something that may be harder for people to understand that strengthening community is a fundamental aspect or element that we need to do if we're going to expand recovery opportunities in the United States. And so I think that's part of it. It's hard for people initially to get and I think, sadly, stigma plays a role. There is still a stigma against addiction. I think that there are times that people look at recovering individuals in ways They don't necessarily look to us for solutions. When the reality is, you know, if you actually look at the history of all addiction treatment in America, it's been driven by the recovery community.

Steve Martorano 

Well, let me stop you right there and point out something that I think is confusing people. When you talk about community in this context, there are stakeholders in that community that doesn't have substance abuse problems. When you say community, you mean, all of us, not just people, or people's families who are suffering from substance abuse? Correct. 

Bill Stauffer 

We are focused on building the recovery community. But it's also true, as you said, we need to address the community in a larger way in America because the trends that are driving the problems are pretty much a direct result of not having the kinds of things that we need in our society, which include us all being connected to each other, I mean, social media, and other kinds of electronic stuff, we're all more isolated. Most people have fewer connections to people who are close to them. People are not necessarily as hopeful for the next generation as they were in prior generations. And there's a lack of purpose that that people have. So that, you know, these are the trends that we need to build across our society, we focus primarily on recovery communities up.

Steve Martorano 

Okay, let's talk about this phrase that comes up. I said, reading your testimony, "deaths of despair" in the context of substance abuse disorder in general, but I mean, particularly, but also set against the backdrop of COVID-19. What do you mean, what do we mean when we see the phrase "deaths of despair?"

Bill Stauffer 

Yeah, so I don't know if people know this but, you know, it's true, most of my lifetime, I'm 55. Every year, you hear from the government, that our life expectancy was increasing, you know, so, you know, women live longer than men. But you know, they'll say, well, the average life expectancy for men went up to like, I don't know, 85.2, you know, so, or whatever it is. And so, for a long time, our life expectancy was increasing. And then sociologists started to see, statisticians started to see that there was a change. A few years ago, life expectancy in America actually dropped. And we're one of the only major countries in the world experienced this. And so when they took a look at it, they found that there were three main causations of this, and one is the overdose epidemic. And for people, if you don't know, overdoses are the leading cause of death in some age groups do so for people under 25 years old, more people were dying from overdose in America than any other cause, which is rather shocking. And there actually was a lot of focus on that, because those deaths are really right out in front of us. The other two types of deaths that were driving this one is also the suicide rate. The suicide rate in America has actually been increasing over the last 40 years. And it doesn't go up much per year, but over time, it has gone up rather dramatically. So the suicide rate in America and the demographics of people who are taking their own lives are changing. And so how are they also driven that they're getting younger, for example, during the economic downturn of around 2008, to 2010, a lot of men in the 45 to 55 range, were taking their lives. These are productive people who, you know, what we guess is that they were people who couldn't provide for their own families. And so their purpose was gone. And we saw an increase in that age population taking her life at that time. So it isn't just young people that are engaging in suicide. 

Steve Martorano 

Well, in that context, we can hope that somebody in a position of authority, the United States, Congress, for instance, will recognize that economic despair is killing people. So maybe we'll get like a fire under someone, what's the third factor that contributes...

Bill Stauffer 

The third is alcohol. Alcohol use has been expanding dramatically. And we've been seeing alcohol-related deaths at younger and younger ages. So and then I started seeing people with cirrhosis in their 30s, which is the beginning of my career was not something that you would see, you know, so very, very heavy alcohol use has been increasing and not everybody who drinks alcohol uses alcohol that way, but there is a subgroup of people who are using a lot more alcohol or in life. So these three groups were essentially driving "deaths of despair." And when they looked at the commonality, these are typically people who lived in rural America, these deaths of despair are where the demographics of that change is their accounts were falling apart. The industry wasn't there as it had been in prior generations. And there was a loss of community where the community and particularly small towns were a lot stronger. It had decreased so the sort of social fabric that was holding us together was decreasing. And what people were doing was in engaging in things like drug and alcohol use, which actually is also related to suicide is not all the time, but a fair amount of time.

Steve Martorano 

Yeah, well, it's, it's a very, very graphic, and very spot on a description of the whole broader community. And you know, our culture in this country. Let's take the last couple of minutes here, we've got some time talking to Bill Stauffer about the substance abuse, recovery, and deaths of despair. I know, it's not the happiest topic, but it's critically important to talk about it. But I note that you talk about with regard to the virus and the pandemic, and its effect on your work and all that you mentioned, about stabilizing a fragile treatment and recovery support, service, fragile, in what way?

Bill Stauffer 

I would argue COVID addiction is our largest public health epidemic. I mean, we look at the opioid epidemic alone, it takes 3% of our gross domestic product right off the top. So 3% of everything that's created in America goes away because of the cost of the opioid epidemic. Alcohol is bigger than that. So when you start to add up all the costs, you know, this is our largest public health crisis. However, when you look at the solution, how much are we actually spending on helping people, it's minuscule, it's something like a penny, for every dollar we spent shoveling up so 99 cents to dealing with the match a penny to helping so it's always been a fragile system that was underfunded. And what happened with the covid 19 epidemics is treatment providers ended up not being able to accept patients. And when they did accept patients, and the majority of them are now the costs. So if you're running a residential facility, oftentimes you're cutting your census in half, and you're providing protective material for your staff and your clients. And this is very, very expensive. And reimbursement simply wasn't there for that is created problems. In an already struggling system. And in recovery. You know, we are seeing people, this is very hard on the recovery community because the focal point for many people is connecting to each other. And that has been made more difficult because of COVID-19.

Steve Martorano 

Bill, you're busy, I know, we appreciate the time you've given for us now that we need to get you back more and more. This is not a great picture we have painted, but it is hopeful in one sense that somebody like you and the work you do is out there someone listening to a family member or someone inactive substance abuse to ward off this despair that could lead to death, what do you invite them to do? Who do they reach out to?

Bill Stauffer 

I would actually, at some point love to talk about how the positive elements of recovery because yeah, it's kind of been we're talking about some grim stuff. But you know, we can and do recover. And so I think that we all are part of the solution, I think the government can be part of the solution. But like we can all care about another human being, and reach out and let them know that we care about them. There's a lot of purposes to be had out there. You know, volunteering for a nonprofit, or getting connected or doing something that you love. These actually help people stay well right now. And so we need to stay well for ourselves. And we need to reach out to other people to kind of bring them in. So I don't think we're all powerless. I actually think that there are things that we can do here, that if we actually serve people the way that they needed, we would be able to get millions of more Americans into recovery. And you know, the research is showing us that 85% of the people who hit five years of recovery will stay in recovery for the rest of their lives.

Steve Martorano 

It's an amazing statistic. You know, look, you can't start out with a topic like this and paint a totally rosy picture. And I realized that but you're completely right. I've talked to lots of people over the years I've done the program. And the success stories are abundant. As I said, millions of people in long term recovery and many of them are helping others in the way you have described. So it is it's very hopeful. But as you said, perfectly. We are all in this together. People want more information about pro a what do they do?

Bill Stauffer 

You go to our website, it's www.pro-a.org. So there's information there. And there's an email address. There's a lot of things that could be downloaded, also say just get involved, not necessarily with us or with your local community. I think that's actually how we help ourselves actually get involved. Service to others is very good for people, particularly at times when there's a lot of people being idle. Doing something positive in the local community is a great way to deal with sort of the impending doom that we may get if we think about these things that are outside of our control.

Steve Martorano 

Hey Bill, thanks for joining us. I hope I really do want to have you back more and more because you know, the work goes on. Everything that Bill has mentioned about the organization, Pennsylvania Recovery Organization Alliance will have all those web website addresses and everything on the Corner's website, so you'll be able to find it. Again, thanks so much for hanging with us on the Behavior Corner.

The Behavioral Corner 

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