“I know I’m going to make it,” says CODAC member Abe B.
Bill discusses his career and the myths about medications for addiction.
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Providing Care from Sea to Sonoran Desert
Bill Reynolds completed 30 years of service in the United States Navy as an enlisted psychiatric technician, submarine medic, and then later, a Physician Assistant in family medicine. While in the service, Bill travelled to many different continents, and even spent seven years serving on submarines! Bill has received 11 Navy and Marine Corps Commendation and Achievement Medals for his superior performance. After three decades of service, he retired as a Navy commander and sought a career in Tucson where his wife’s family lives.
Bill’s years of experience in family medicine make him an asset to CODAC’s Medication Assisted Addiction Treatment team where he is now a Supervising Behavioral Health Medical Provider.
What sparked your interest in the behavioral health field?
While in the Navy, I was exposed to psychiatry and mental health and I always liked the sense of being able to help people and make a difference in their lives. I have a genuine interest in wanting to help others and now, as a provider, I can make a stronger contribution.
At what point did you become a Physician’s Assistant?
After achieving the rank of Chief Petty Officer ( E-7), I was selected for the Physician’s Assistant program offered through the Navy and received my Masters of Physician Assistant Studies in Family Medicine from the University of Nebraska.
Describe a day at the office.
My work day starts at 5:00 in the morning. During that time, I am responsible for the medication management of everyone with a psychiatric illness who is on methadone medication. I see many individuals with co-occurring disorders like depression, PTSD, bipolar disorder, and anxiety, among others.
I also complete intakes and physical examinations for everyone who is starting methadone. Throughout the day, I frequently see people for dosing adjustments based on their symptoms.
What should people know about Medication Assisted Addiction Treatment?
Opiate dependence is a chronic brain disease. When people use opiates, they are re-wiring their brains. It’s difficult to simply quit. Methadone is a very safe and very effective medication that, when given in a stabilizing dose, results in less risky behaviors (like sharing needles or hustling for money) and gives people a chance to stabilize their life.
What are common misconceptions about methadone and Medication Assisted Treatment?
Some of the myths about methadone are that you are trading one addiction for another. This is untrue because when you are using opiates, like heroin, you are getting intoxicated from it. You don’t get high on methadone since it is medically supervised. Sometimes, people who use methadone are perceived as weak and using methadone as a crutch.
What changes to you hope to see regarding these myths?
There needs to be a huge amount of education, especially with medical providers who don’t specialize in substance abuse. Opioid dependence is an epidemic that you hear about everywhere. We are even seeing kids who used pain pills and then begin using heroin because it is cheaper. They find themselves engaging in behaviors they never thought they would to prevent withdrawal symptoms.
What is the best part of your job?
I get to see people grow in recovery. I see a lot of people come in here when they are at a low point in their lives and I get to see them improve their lives and get stabilized on medications. It’s nice to see them truly grasp recovery.
What are some of the challenges?
Many of the people that I see have experienced a lot of trauma in their lives, whether it’s from their childhood, prison, or other things. I’ve deployed all over the world in combat and peacetime settings and have seen the people who suffered the invisible emotional wounds of war. Though most [members at CODAC] haven’t seen war, they are fighting different battles.
What do you think about the transitions and expansions taking place at CODAC?
CODAC is ahead of the curve with responding to the needs of the population, especially with integrated care. It makes me feel good as an employee to know that CODAC is invested in the future.
Fran Buss’ experience in helping women to heal and share their stories spans far beyond the seven years she dedicated as a CODAC volunteer. For nearly forty years, she has worked tirelessly as an advocate for women living in poverty, abuse, and trauma. She has been a shoulder to lean on, an ear to listen, and the voice for a population that often goes unheard.
Up until this past December, Fran facilitated a support group at Mothers Caring About Self (MCAS), CODAC’s intensive outpatient program for women with substance use disorders within Serafina Women’s Services. Her group, called ‘Meaning of Life,’ offered a safe space for women to creatively share their experiences through writing, art and discussion.
“Women would share things about their past, things they remembered about their lives both good and bad,” said Fran as she listed some examples:
“I remember my baby’s first smile…”
“I remember my grandma’s face when she held me in her arms and let me pat her cheeks…”
“I remember the night my husband tried to kill me…”
“The women have had so much pain,” said Fran. However, in sharing their experiences with others who could relate, the women realized they weren’t alone and could move forward from their past.
“Fran inspired women to look at things from various perspectives and to want to learn more,” said Director of Women’s Services, Kelly Irving. “She showed them that they are more than women struggling with addiction and she treated them with positive regard and encouragement.”
Many times, Fran found herself deeply moved by the stories of the women in MCAS. She felt a connection to the women and was reminded of her own personal struggles.
“I came from a poor background, have been on welfare, and was a single mother of three children under the age of five,” she said.
Fran’s personal hardships and those of other women inspired her to start the Women’s Crisis and Information Center in 1971 in Colorado. This was where Fran first began listening to the stories of other women and worked to help them find empowerment and independence.
“Back then, I had all of these stories women were telling me,” said Fran. “They affected my heart deeply and I wanted to share them.” Fran began exploring options to share the stories of the women she had met.
Her first attempts were in poetry, and soon after, she began sharing the stories of impoverished working-class women through oral histories, writing, and photography. Fran’s first published work is titled La Partera: Story of a Midwife, about a Latin-American elderly midwife she met in New Mexico.
Since then, Fran has shared the stories of over one hundred women who have overcome varying struggles in their lives. She has been an advocate for women, racial inequities, and immigrants’ rights. Fran has also worked as a professor of women’s studies and history at the University of Arizona and Pima Community College. Her transcripts and journals have been archived at Harvard University in Cambridge, Massachusetts.
Though she retains comprehensive experience and knowledge of women’s issues, Fran wasn’t looked at as superior to the women of MCAS, but as a motherly and nurturing figure who could provide insight and space for recovery.
“This process has been like a circle for me,” said Fran. “I began my activist life working with women in crisis, and wanted to end my working life working with women in crisis.”
“Fran has brought so much to the program and the lives of the women…She taught creativity, self-love and passion for life. She has been an amazing volunteer and the program is not the same without her,” said Kelly.
Though Fran has ended this chapter as a volunteer at CODAC, she carries the thoughts of the women of MCAS in her heart. She is in now in the process of writing a book about friendship and says all of the women she has worked with will be in her heart when writing.
“I remember when I first started working at CODAC,” recalled Andrea, therapist at Methadone Services. “There was a homeless man on my caseload that had been using cocaine since the 80’s. I was able to work with him to the point where he was able to maintain a year of sobriety, get housing, and continuously progress forward.”
Andrea has worked in many different departments at CODAC. Hired as a Care Manager six years ago, she has spent time working on CODAC’s Criminal Justice Team, Court-Ordered Treatment Team, Intake Team and, now, Methadone Services.
“For me to have that kind of impact in someone’s life is phenomenal.” It is examples like these that reinforce why Andrea chose a career in behavioral health care.
In addition to her diverse experience within the agency, Andrea has kept very busy with a schedule that included pursuit of her Master’s degree in Professional Counseling, an internship at Methadone Services, and a full time job as Care Coordinator.
Most would think 12-hour days in addition to school would wear you down, but Andrea thrives on accomplishing her personal and professional goals. Now that she has her Master’s degree, she is already looking into Doctorate programs.
Andrea initially chose this career because she wanted to better understand a family member who has a diagnosis of manic depressive disorder. “There were points in time where we weren’t getting along so well, and I really wanted to understand her. I thought that this career path might help me to understand.”
“My goal is to be able to relate to members, on their level. I often hear from the Methadone population, that they feel discriminated against because they are addicts. I can relate to them because I have been discriminated against for being African American.” In sharing her experiences with members, Andrea finds that an authentic and trusting rapport develops.
Her current position at Methadone Services includes conducting case management and providing therapy services for new and current members. She has just recently transitioned to her official role as therapist.
“I want to see people get better and improve their quality of life,” Andrea emphasized. Seeing the positive impact she can have in a person’s treatment, propels her desire to help people in the community.
Andrea’s advice for both new and current staff at CODAC is to embrace change. “Change is not always a bad thing”. There have been times in my past here where I have been resistant to it, but now that I reflect back, I see that change is awesome. I have learned so much from being flexible and doing different things around CODAC.”
Erin’s nine year struggle with addiction is why she was motivated to work at CODAC.
She grew up in the small town of Kearney, Arizona, where she was first introduced to the drug that would impact her life for nearly ten years. Her drug use began with marijuana at the age of sixteen and, soon after, escalated to addiction to methamphetamine.
After graduating high school and meeting her Fiancé Daniel, Erin moved to Tucson. The change of scenery did not change Erin’s addiction. Her preoccupation with getting drugs meant leaving her fiancé over and over. “I had left him to use drugs 14 times,” Erin recalled. “It was that last time that I had packed my bags that he told me not to come back unless I went to rehab.”
Those days now seem like a different life to Erin. She recalled working two jobs, going to school, and using meth all at the same time. “I never had any money or food. I lived in the dark and washed clothes out of a tub.” She spent almost everything she had on her addiction.
“I still thought I was being productive. I would use before going to school or work… I needed it to function.”
At her lowest moment, Erin was living alone on the streets with only the comfort of her dog. “I felt worthless,” she said.
Though Erin left rehab a few days shy of completing her program, she managed to completely quit using drugs. She briefly followed up with treatment at CODAC where she was introduced to the organization where she knew she would work one day.
Erin completed her Medical Assistant training program through Pima Community College in January of 2012 and began an internship with CODAC.
It has now been one and a half years since Erin has been a medical assistant at CODAC where she works directly with members who are undergoing similar circumstances she faced.
“When someone is falling towards rock bottom, I can lend them a hand or a shoulder to lean on and tell them that sometimes it takes hitting rock bottom to get to where you need to be,” she said. “For me, living on the streets with my dog was rock bottom and I had burned all the bridges with my family. I had to give up that life to get this new life,” she said.
Erin explained that for every person, rock bottom is different and sometimes, you have to face that place before you realize that something needs to change.
“Sometimes, you need to learn that in order to get something great in your life you have to be willing to give something up. That is exactly what happened with me…It was a long hard struggle but it is well worth it in the end,” she said.
Erin has been sober for the past seven years.
Her family provides her with the support she needs to stay sober. Erin’s husband and her two children are what keep her on the right path.
Erin is in the process of beginning the coursework to become a nurse. Though she lives a busy life, she knows that she can continue to help others in this field. She is proud of her achievements and looks forward to reaching these new goals in the future.
“I feel accomplished that I was able to succeed in my recovery and become the person and mother that I am today,” she concluded.
His childhood experiences with trauma are what fuel his desire to address the subject with youth and their families. For over twenty years, Eddie has been doing just that in the behavioral health field.
After graduating from the University of Arizona with his Bachelor’s degree in Psychology and Child and Family Studies, Eddie decided to pursue a career working with children who, like him, were exposed to trauma.
“I experienced a significant amount of trauma as a child and there was a lot of domestic violence in my home,” said Eddie. “I wanted to help out another child going through that kind of chaos…That’s what really drove me in this field.”
While working for a children’s group home for youth removed from their families, Eddie realized that he wanted to further his education and began pursuing his Master’s degree from the University of Arizona in Counseling and Guidance.
In the early 1990’s he started a doctorate program at Colorado State University. “I wanted to become a psychologist because I wanted to have more say in the matter and the lives of children and families,” Eddie said.
Unexpected life events caused Eddie to put his doctorate on hold. He moved back to Arizona and began working at an internship that connected him with CODAC Behavioral Health Services. In 2006, he officially obtained his doctorate in Psychology.
Eddie has worked at CODAC for over seven years. Currently, his position encompasses both administrative and clinical supervision for his team working with members who have developmental disabilities (DD).
“We are working with members who have not only been under-served, but the majority have long histories of trauma. At least 90% of our developmentally disabled population has experienced some form of trauma… but multiply that with someone who has autism, epilepsy, or any other cognitive impairment,” he emphasized.
Though the job can be challenging at times, Eddie appreciates that he is allowed room for creativity when it comes to developing individualized treatment and service plans for members.
Eddie’s team must coordinate not only with members themselves, but also their guardians, day program staff, job coaches and more.
Under Eddie’s direction, the implementation of CODAC’s DD Team has proven to be successful with evidence showing positive outcomes for CODAC members.
“We assist [members] with developing the skills they need to avoid a crisis situation,” said Eddie.
“We impact the lives of not only our members, but their children and future generations. It’s amazing to be part of that,” he said.
Eddie’s advice for anyone joining the behavioral health community stems from over twenty years of professional experience: “The work here is both thankless and priceless. If you can be ready for those two pieces you will go far.”
He is referring to the emotional and physical struggles that he has endured and overcome as a result of visual impairments he was born with.
“The impairments led to more than just physical issues but also mental ones, including anxiety and depression,” said Jordan. His first eye surgery took place at the age of five and since then he has had over 20 different ocular procedures. Just last year, Jordan experienced bleeding in his left eye which he feared would result in permanent vision loss.
“I had to really reach out to family, friends, and my faith for support.” Jordan worried that the possibility of having two bad eyes would forever change his life. He became depressed but through the support he found in his friends, family, and faith, he was able to get through it.
These first-hand experiences with physical limitations and mental health issues make it easier for Jordan to relate to CODAC members. “As funny as it sounds, having those hemorrhages has made me a better therapist. I feel like I have more compassion for members who have depression,” said Jordan.
Jordan’s career with CODAC began at First Avenue as a care manager shortly after graduating from Arizona State University with a Master’s of Social Work. “I feel honored to have been a case manager,” said Jordan. “It was extremely tough, and taught me a lot about this field. I learned how to look at the problems a member faces as more than just emotional,” he said. Jordan also learned about how connecting members to community resources is essential to meeting their basic needs so they can have a strong foundation for recovery.
In June of last year, Jordan applied for the position of therapist after much persuasion from a former CODAC therapist. “I had my education but I did not have the experience,” explained Jordan. However, after two years as a care manager, Jordan took the opportunity to apply for the position and was offered the job.
“What I like about being a therapist is that you get to build deeper relationships with members. You get to think outside of the box when it comes to what types of interventions to use,” he explained.
Though he greatly enjoys providing therapy for members, hearing about the struggles and sometimes traumatic pasts can be an emotional weight.
“You can be the most positive person in the world, and every time you hear about terrible things [in members’ lives] it depletes some of your joy and happiness.” For this reason, Jordan makes it a priority to take care of himself.
“I am learning to better take care of myself when I am not at work,” said Jordan. In implementing his own wellness routine, Jordan enjoys taking vacations over the summer to recharge and clear his mind, watching funny television shows such as Family Guy, and even having a good cry while watching Grey’s Anatomy.
Jordan’s motivational character is apparent not only in his personal life, but in how he treats CODAC members.
He has learned that through support, hope, and motivation he has overcome obstacles. His hopes are that members at CODAC are able to do the same.
“I am a firm believer in trying to speak hope into our members’ lives and to encourage them to persevere through anything because it worked for me.”
MORE ABOUT JORDAN:
Jordan will embark on a two week vacation to Japan this summer with his family. Jordan’s grandmother is eager to learn more about her Japanese roots.
Jordan participates in endurance training activities as part of his self-care routine. He rode in El Tour de Tucson and did the Tough Mudder, a 12-mile obstacle course. “Because of my eyes, I wasn’t able to play sports well, so overcoming obstacle courses and endurance challenges mean a lot to me.”
Advice for other CODAC staff:
“As we continue to stick together, we should remind ourselves that we are making a difference in Tucson and to remember for all of us to continue self-care.”
When not in the First Avenue office, you can find Katrina Rodriguez enjoying her favored
physical activities: running and yoga. “Yoga centers me and keeps me out of my head. It focuses me and brings me back to the present moment,” said Katrina.
Yoga, a form of moving meditation, is one of several that Katrina embraces. Meditation and exercise are tools that Katrina utilizes to keep her life in balance outside of work.
Katrina began working for CODAC shortly after graduating from the University of Arizona in May of 2011. She chose to enter the behavioral health field to fuel her compassion towards others. “I like helping people,” said Katrina. “I like feeling like what I do makes a difference and going home each day knowing that what I did is some type of contribution, even if it is small.”
As a Care Manager II, Katrina’s role includes coordination of behavioral health services for members. “I make sure that members get the services that they need, follow up with them on the treatment plans as well as identify ways to reach their goals,” said Katrina. Additionally, Care Managers provide supportive services to enhance the effectiveness of treatment goals whether it is community outreach, education regarding programs and services, or crisis intervention.
The only reported down side to Katrina’s role is the paperwork, she emphasized. “There is a lot of paperwork and it’s actually harder than working with the members,” she joked. “Working with members is the best part.”
Things can certainly get interesting around the office, however, as Katrina recalled one of the most interesting days she’s had. “CPSA put out an alert that we needed to move all of our members out of a board and care ASAP and the supervisors and site director were all at training.” Katrina and one other person were responsible for doing this within a very limited time frame. “It was stressful, but kind of exciting because of the pressure.”
In Katrina’s role, she often times will refer members to resources within the community. However, Katrina’s favorite resource is her co-workers. “They each have an individual wealth of knowledge that they are always more than willing to share,” she explained.
Katrina explained that the reward of her job at CODAC is witnessing the positive changes in members over time. “I see people grow and overcome obstacles. They are able to handle things more independently.” Through her role, she, too, is able to make positive impacts in the lives of CODAC members.
“I fell into the behavioral health field because $11.00 an hour seemed like a lot of money,” giggled Christine Perez, Care Coordinator at CODAC’s Downtown Site. When Christine first entered this field in 1986, she followed the career path of her relatives who also worked in behavioral health.
Christine worked at various facilities while living in Albany, New York, including the first residential facility for the treatment of the “Mentally Ill and Chemically Addicted” (MICA) where she taught living skills and activities of daily living.
In need of a scenery change and enticed by Tucson’s warm winters, Christine decided to make the move to the southwest at the age of 27.
She began her work at CODAC as a case manager at the East site and soon after, transitioned into a supervisor role. She is currently a care coordinator at the Downtown site’s Recovery Bridge where she has been for the past two years. Christine is responsible for the intake assessments, general case management related duties, and runs the intensive outpatient Basic Recovery Group.
“One of the challenges of my job is trying to get people to actually identify that they need assistance,” said Christine. “My goal is to get them to acknowledge they need help without being forced to do so,” she added.
Outside of those challenges, Christine finds heartfelt passion in the behavioral health profession. “This isn’t the type of job where you get a lot of kudos. You have to be dedicated to working with people and be willing to meet them where they are at.” Christine said. “You really have to care.”
It’s the little achievements that make Christine’s career worthwhile. “You need to look at those small steps that members make, like showing up to an appointment, coming to group consistently, and being reunited with their families.”
Christine presented a card that had been sent to her by a member who she had previously worked with. This member is currently at Las Amigas, residential treatment facility for pregnant and postpartum women with substance abuse disorders. The card reads:
“…I am 53 days sober today! Las Amigas is great and I am doing very well. Because of you I am safe and getting the help I so desperately need. I have never been sober this long in my entire life! … Thank you for helping me get the chance to help myself.”
Mementos such as these are why Christine works at CODAC. “This member was extremely challenging,” said Christine. “But now she is doing better and has been reunited with her family.”