Addiction is a complicated disease, especially for women.
Women’s bodies process medication differently, and they experience a higher incidence of depression and anxiety.
Often, as the primary caregivers for their families, they experience increased emotional and financial distress during treatment.
Those are just some of the reasons The Next Door, a faith-based organization in Nashville, offers a wide range of addiction treatment services designed specifically for women.
Better Tennessee spoke to Chief Clinical Officer Cindy Sneed about the challenges women in recovery face and the current opioid crisis in the state.
Better Tennessee: Why did The Next Door choose to focus on treating women who are addicted to drugs or alcohol?
Cindy Sneed: The women who founded The Next Door were members of a local church congregation. They found an empty building in downtown Nashville that they wanted to put to use in a way that would help others.
After completing a community needs analysis, they looked for gaps where they could make a difference.
They saw that women who were coming out of incarceration faced multiple barriers and often fell through the cracks when rebuilding their lives.
The congregation bought this vacant building on 8th Avenue that became The Next Door’s first home.
Working with women coming out of incarceration, we quickly recognized the majority of them struggled with addiction, mental illness, and trauma, and these challenges impacted the women’s families as well.
Through experience, we learned that clients could do really well when they were in residence, but after they moved out of The Next Door, they continued to struggle with relapse because they had limited to no recovery skills.
We saw the cycle of addiction play out right before our eyes and said, “We can do better.”
As a result, we expanded our original mission to include residential addiction treatment.
BT: How did residency affect recovery?
Sneed: As the residential treatment grew, clients were staying clean and sober longer; as a result, we began to see families coming together in healthier ways.
As we further evaluated our clients’ needs, we realized that effective treatment would involve multiple levels of care over a longer period of time. So we added outpatient services and enhanced our recovery support services.
BT: What do you see as the foundation for success with your clients?
Sneed: Building quality, trusting relationships with our clients.
Working with women requires creating a safe, supportive environment; otherwise, the women we serve cannot begin to make the changes necessary while in treatment.
The collaborative relationship between our clients and our staff is the vehicle for change.
Our clients know that when we say, “We will be here for you,” we mean it.
We understand that addiction is a chronic disease and that at some point in the future, our clients may need our services. If they find themselves in a place where they need help again, we have an established relationship, and they can reconnect with us to get the recovery support they need.
BT: Do women need a different approach in going through recovery?
Sneed: It’s important to recognize that women typically function in multiple roles at the same time.
Many of our clients are the primary caregivers in their home; if they are away receiving treatment, there has to be a strong plan in place for the care of their children.
Otherwise, women attending treatment are more concerned about the welfare and safety of their children than they are about getting the help they need.
Also, by the time women are at the point of asking for our help, they are typically on the verge of losing everything – including a relationship with their children.
They find themselves trapped in a hopeless cycle of addiction where they feel guilt for not being everything their children need.
To manage that guilt, they continue to use drugs or alcohol. This can be crippling to a woman whose desire is only to be the best caregiver possible for her kids.
Addiction is a bio-psycho-social disease, and we have to look at all the facets of a woman’s life to help her move successfully into recovery.
For example:
- Women’s bodies process medication differently
- Women experience a higher incidence of depression and anxiety
- Women report a higher rate of sexual and emotional trauma
- Most of our clients are of childbearing age, so we have to address reproductive health, and
- Many of our clients are dealing with co-morbid conditions such as HIV, hepatitis, and other chronic medical concerns.
BT: Tennessee’s Department of Health says that opioids are now the most abused substance in the state.
Do women face particular stumbling blocks in getting treatment?
Sneed: Yes, they do. In fact, one group has a particularly difficult time getting the services they need: pregnant women.
Many addiction treatment providers exclude pregnant women.
Because The Next Door serves only women, we expect to encounter women who are pregnant, so we felt like we needed to provide healthy, viable options.
Women want to be empowered to make their own decisions about meeting their healthcare needs.
If a client is pregnant, we offer two options for how to begin the process of managing her addiction during pregnancy:
- She can choose to be stabilized on an opioid maintenance drug or
- In collaboration with her OB and our medical team, the client can choose to detox from all substances, if and when it can be done safely for her and her baby.
Much of the concern when talking about pregnant addicted women is about the safety and welfare of the baby, but we have to remember that the original problem was the mother’s addiction.
Regardless of the choice they make, these women will continue to be at high risk for relapse if they do not get the treatment they need.
The Next Door offers multiple levels of care to engage that mother in treatment during pregnancy and after delivering her baby.
KaBOOM!, a nonprofit dedicated to bringing active play into all kids’ lives, built a playground at The Next Door. It is one of 11 playgrounds in the state built from a partnership between KaBOOM! and BlueCross BlueShield of Tennessee.
BT: What happens when a woman comes to The Next Door for help?
Sneed: Addiction is a complex disease, and to recover from addiction, a woman has to learn healthy coping skills and develop a quality support system. That begins when they walk in the door.
Our treatment is tailored to each client’s needs and can include:
- A thorough needs assessment that begins with both medical and psychiatric evaluations
- An integrated clinic that provides medical and psychiatric care
- A fetal doppler monitor for the babies of our pregnant clients
- 24/7 onsite nursing care, and
- Medically-monitored detox.
We offer a holistic approach to treatment that includes individual, group, and family therapy.
Trauma intervention is woven throughout the process, including specialty group sessions that address trauma and grief, which can often be catalysts for drug use.
We also offer beginning 12-Step work, peer recovery support, parenting classes, yoga, art therapy, a clothing boutique, and a cafeteria with a dietician-approved menu.
We provide a lot of education about the brain. I know that sounds boring, but you’d be surprised how popular it is!
Our clients want to know, “Why am I broken?”
Sheryl was in pain. That’s how it started. Working in an ER, she’d seen people overdose, so she knew what addiction looked like, and it wasn’t her. Until it was. Click her photo to read her story.
BT: And what is the answer to that question: “Why am I broken?”
Sneed: Addiction is a disease. It isn’t about choice. It is about compulsion.
During family group sessions, there is always somebody who says that they don’t understand why their loved one keeps using.
They tell them, “If you loved me you would stop.”
The families feel just as powerless as the client does, because they see the drug use as a choice.
Why would a woman leave her child at school, and use drugs for three months? Fundamentally, the brain does not work that way. But when a woman’s brain has been hijacked by the compulsion to use heroin, it pulls her away from logic.
It takes the brain a long time to heal and a woman’s time with us is just the point of getting started. We plan every day for what happens when they leave treatment.
BT: The Next Door is a faith-based treatment center. What does that mean for the women who are being helped?
Sneed: The 12-Step programs begin with the basic position that your life has become unmanageable due to drug or alcohol use, and you need to find a power greater than yourself to support your journey through recovery.
How can you become spiritually, holistically well, if you don’t know that a higher power exists?
We give our clients opportunities to explore their spiritual wellness.
Your higher power is who you lean on when you are alone and frightened, feeling discomfort, or lost and don’t know what to do.
That’s why you can’t leave spirituality out of recovery.
Our goal at The Next Door is for women to find hope, which is essential in the journey to recovery.
We want to care for each woman in all aspects of her life.
A human being is more than just a physical being.
If you don’t have quality mental or spiritual health, you don’t have quality health.
It’s the full life experience.
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