A Story of Recovery Brandee Izquierdo, Director Office of Consumer Affairs Behavioral Health Administration

My early days… Born and raised in Baltimore, Maryland. My mother and father had me when they were 17 years old and from what I was told, I was a happy child who was energetic and full of life.

I found out later in life that my father was abusive and from my mother’s account, I witnessed that abuse until my father left us at the age of 3. Both my mother and father used drugs and alcohol. My father had many women in his life but at that time, I wasn’t one of them.

ABANDONED UNLOVED I felt abandoned and unloved. I remember having birthday parties when I was young but never payed much attention to the girls. I was obsessed with having one specific boy at my party. I’d say I was in 2nd or 3rd grade at this time. UNLOVED

TRAUMA SHAME My mother remarried and had my sister. I felt like an outsider within my own family. During this time, my sister was being watched by our next door neighbor. I was molested by the next door neighbors husband and I remember a few of my friends in the neighborhood were too. They told their parents but I kept quiet and my mother found out when a police officer came to the door. I remember that officer sitting down on the couch, handed me a doll, and told me to show him where I was touched. I was around 8 years old, I received no therapy and really just thought that I had pushed it to the back of my head. ANXIETY

SHAMEFUL GUILTY Anxiety began to build up inside of me and panic attacks started to surface. I went to a catholic school but my parents could no longer afford it and enrolled me in public school. During the beginning of the new school year, a classmate forced himself on me and I lost my virginity, what I now know to be rape…I was 11. The shame of everything was building up and the guilt sat heavy on me. I remember being in 8th grade and saying to myself, I need to find a boyfriend and keep him so that no one will think I’m dirty. DIRTY

FEELINGS…EMOTIONS…UNDIAGNOSED ABANDONED TRAUMA GUILTY DIRTY SHAME ALONE I found that boyfriend and was pregnant at the age of 14. At this point my mother sent me to live with my grandmother and my grandmother made me get an abortion. TRAUMA I wasn’t aware of this at the time but I was searching for love or what I though was love. At the age of 16, after breaking up with my first “real” boyfriend, I immediately found someone else. I got pregnant by him and when I told him, his response was “If you get rid of this baby, I will not stay with you” and what I heard is “Oh he loves me”. I went on to have that baby and three more children with him. Yet during our marriage there was domestic violence, disloyalty, and a lot of pain. DIFFERENT UNLOVED ANXIETY DEPRESSED

During this time, my disease of addiction was slowly progressing During this time, my disease of addiction was slowly progressing. I started using when I was 11yrs old. At first it began with alcohol to the point of blackouts and marijuana. Later it progressed to illicit drugs and prescriptions. Every time I would use it would take away the pain until I got to the point that I could not function without being high. Jails and Institutions became a part of my story and by the end, I was facing 5 felonies, 11 years in Maryland’s prison system and 4 years in an upstate prison in Pennsylvania. I new nothing about recovery….I didn’t know where to get help or that I even needed help. It wasn’t until I was offered treatment in a Pennsylvania prison that I was given knowledge about the disease of addiction…I was 33 This needs to change!!!!!

What is Recovery? “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” (SAMHSA, 2012)

PEER-SUPPORT SPECIALIST AN INDIVIDUAL WHO… Provides non-medical services Uses his/her lived experience of recovery from mental illness or substance abuse Uses skills learned in formal training to: facilitate support groups, work on a one-on-one basis Has benefitted or is benefitting from mental health or substance use treatment services or supports Performs services only within his or her area of training, expertise, competence, or scope of practice  Peer Support is not just about our lived experience of addiction or mental health. We know what it’s like before we sought help. We have that experience too.

Key Values Trusted, Safe Relationships Person driven and Directed Acceptance, Empathy and Example Honesty and Shared Accountability Hope, Respect and Dignity Power, Choice and Freedom, Human rights Peers hold key values Read the key values

PREVENTION How do we expose individuals to recovery? “We see signs, before they become symptoms” -- Brandee Izquierdo, CPRS, RPS How do we expose individuals to recovery? Child Protective Services Guides within the systems Act as a “Big Brother/Sister” to impacted children School Systems School Nurses Office Prevention Presentations Church Youth Groups Prevention Groups Sober social events Family Services – Domestic Abuse Situations Navigate systems Act as an advocate for people seeking recovery Recovery is not only within the realm of substance use and mental health but other areas including: Trauma Emotional Physical And these are just to name a few. However, I’d like to focus on one particular area of prevention… Chronic Pain Doctors / Pain Management / PCP Offices Work with patients who have concerns about medications Run Peer Led Pain Management groups

AUGUST 2015 FDA approves OxyContin for kids 11 to 16 The FDA does not regulate the practice of medicine, which means drugs such of OxyContin may be prescribed for off-label use to children once a caregiver has provided consent. An FDA representative stressed that the drug’s approval is not intended to expand or change the way it is used for pediatric patients. According to an article in News Week…. Emphasize that while the FDA does not intend harm, there is a need for preventive measures. http://www.newsweek.com/fda-approves-oxycontin-use-children-young-11-363606 http://www.newsweek.com/fda-approves-oxycontin-use-children-young-11-363606

According to the National Institutes of Health, approximately 2 According to the National Institutes of Health, approximately 2.1 million Americans are struggling with an addiction to prescription painkillers. Abusing this class of drugs is often a precursor to heroin addiction. In June of 2015, research presented at the American Headache Society’s annual meeting found that nearly 1 in 6 children who see a specialist for migraines are prescribed opioid medications as a first-line therapy  http://www.newsweek.com/fda-approves-oxycontin-use-children-young-11-363606

How is Maryland addressing the issue? SAMHSA Region III Opioid Overdose Prevention Collaborative Maryland, Delaware, Pennsylvania, Virginia, West Virginia and the District of Columbia $15,000 award by the Patient-Centered Outcomes Research Institute (PCORI) “Engaging Community Partners to Decrease Addiction.”

The purpose of this collaborative is to: Build partnerships that will explore the challenges related to pain management in youth and the risk associated with addiction. Engage communities and create an infrastructure for the improvement of: Doctor-patient/parent communication Care coordination Management of children's pain Methods for proper disposal of leftover medication

According to the Centers for Disease Control: 129 people per day die of drug overdoses Admissions to treatment for prescription opiates has increased 500 percent  http://www.addictionpolicy.org/

What can we do? Find out who the peers are in your community Utilize peer support when going out to schools Introduce peers to people such as the school nurses, principles, etc. Collaborate with peer support during community events Educate and connect families to peer support services

And I want to leave you with this…let’s not wait for individuals to seek treatment… Let’s build a door to create partnerships in preventing the addiction! I hope you all join me tomorrow for the continuation of my story of recovery and how I’ve utilized my experience within the criminal justice system….

Brandee M. Izquierdo-Johnson, CPRS, RPS QUESTIONS? CONTACT INFORMATION Brandee M. Izquierdo-Johnson, CPRS, RPS brandee.Izquierdo@maryland.gov Director, Office of Consumer Affairs Behavioral Health Administration 55 Wade Avenue-Dix Building Catonsville, MD 21228 410.402.8447 Office 443.469.4343 Cell