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Our guest for this episode is Dr. Devona Anderson. Dr. Anderson has a very impressive resume, including being Board Certified in three areas! Family Medicine, Obesity Medicine, and Addiction Medicine. She owns her own private practice and is the Medical Director for our facility.
We dive into discussions on Medication Assisted Treatment (MAT), the evils of Fentanyl, and what the medical director does at our facility.
Aaron Reason:
Welcome to episode six of A Reason to Live. I am your host, Aaron Reason. Really excited about today’s episode. We’ll be taking a look at the medical side of treatment. Our guest is Dr. Devona Anderson. She’s going to touch with us on a medicated assisted treatment, the evils of fentanyl and what it’s doing to our world, and also just about the options that a client has as far as treatment goes. So we’re really excited to bring forth this next episode. Hope you guys enjoy it.
Speaker 2:
Located in Anderson, Indiana, Bridges of Hope is a detox and residential treatment facility assisting those experiencing alcohol and substance abuse addiction. Our treatment philosophy is based on a comprehensive and integrated approach to addressing all issues related to substance abuse disorders and co-occurring mental health issues. Addiction treatment at Bridges of Hope can guide you safely through withdrawal from drugs and alcohol and teach you important skills that help you achieve long-term recovery.
Client care is our highest priority and we offer our clients all-inclusive treatment services. Our ultimate goal is to identify the challenges, concerns, and problems related to substance use and mental health disorders to provide professional clinical treatment to all of our patients. For more information on our services, visit us at bhoperehab.com or call 844-449-6392.
Aaron Reason:
Hey guys, welcome back to another episode of A Reason to Live. I am your host, Aaron Reason. I am here with my producer, Michael Whitlock.
Michael Whitlock:
Hello, friends.
Aaron Reason:
And today we have a special guest, Dr. Devona Anderson. Can you say hi, doctor?
Dr. Devona Anderson:
Hello, everyone.
Aaron Reason:
So Dr. Anderson has a very impressive resume, include being board certified in three different areas, family medicine, obesity medicine, and addiction medicine. She owns her own private practice and is the medical director of our facility and is a wife and mother of two.
Dr. Devona Anderson:
Yep. I stay busy.
Michael Whitlock:
Someone’s an overachiever.
Aaron Reason:
I know, right?
Michael Whitlock:
Have you always been an overachiever?
Dr. Devona Anderson:
Yes.
Michael Whitlock:
I mean, we benefit from it, so I appreciate that.
Dr. Devona Anderson:
I’m always up for a challenge. That’s my thing because I get bored easily, so I like challenges.
Michael Whitlock:
Are you looking for any more specialties?
Dr. Devona Anderson:
I’m going to be quiet on that.
Michael Whitlock:
Uh-oh. Uh-oh. Okay.
Aaron Reason:
Awesome. Well, we appreciate you taking the time to come and see us and come on this podcast. We’re really looking forward to your insight from your point of view of where you’re at with us in our facility. So tell us what being board certified means and why it’s important.
Dr. Devona Anderson:
So board certification, it tells organizations and patients that you have gone through a process in order to get these credentials. The process includes testing, keeping up with the current data in your field educationally, so you don’t lag behind. So you know what’s happening, so it just gives you some validity and that’s basically what board certification means.
Michael Whitlock:
Awesome. It lets people know that you’re serious about your role.
Dr. Devona Anderson:
Right.
Michael Whitlock:
So that’s good.
Dr. Devona Anderson:
Yeah, we put in extra effort to know what you’re talking about throughout the lifetime. People start practicing usually when they’re 30 and you practice for a lifetime, maybe until you’re 80. But what if you never do any kind of education to try to keep up with it? And that’s what board certification makes you keep up with the latest treatments and options.
Michael Whitlock:
So it’s recognized also amongst your peers, that set of standards.
Dr. Devona Anderson:
Right.
Michael Whitlock:
Okay.
Aaron Reason:
And I’m sure the treatment has changed a lot now, too, just with-
Dr. Devona Anderson:
Oh, sure.
Michael Whitlock:
… especially with fentanyl coming on the scene now. So, just tell us a little bit about your role at our company as the medical director. What type of things you do?
Dr. Devona Anderson:
So, I have multiple hats. I did more patient care things, which I still do patient care as well, but I do patient care as far as seeing patients in the facility. When they come in to the facility we do an intake appointment and history and physical to just make sure all is well and also to help the patient feel more comfortable and just introduce them to treatment. And so I do that for Bridges of Hope and for ICAN. Also, I do administrative work, so supervising and managerial stuff as well. So those are my basic roles.
Michael Whitlock:
And an integral part of our policy and procedure. And that’s one of the areas where I get to work with you directly is talking about policy, procedure and I think with one of your strengths being research and looking at trends and patterns and data. So, I love that we get to collaborate with regard to what’s going on and I think it’s been a little bit more of what you’ve been doing lately as we’ve grown.
IT’s a great thing to have a business grow. It’s sad why we have to grow because there’s a greater need in this industry for services. So it’s a double-edged sword, but we’ve had to bring in additional staff to take care of our patients. We have some nurse practitioners here now and just a larger medical role. So, what do you think has been your greatest reward as a medical director in this field?
Dr. Devona Anderson:
Well, just seeing people heal. You know, can see from day one, even just looking at their pictures when they come in, from day one, what they look like, how they feel. I mean, you look in their eyes even just from the picture, they’re dead inside.
And then you can see as time goes on at the very end, the light comes back and you can just see them having hope to know that they have a future, they can have a future, things can improve and they can get better. So that is the most rewarding thing to see the transformation in people.
Aaron Reason:
Yeah.
Michael Whitlock:
It’s amazing what a month here will do. Someone, like you said, comes in almost looks like a zombie almost. And it’s so sad and they look like a completely different person the day they leave. Smiling, they’ve been reborn, there’s some hope and you get to be a part of that, and then all the other parts that play into that, it’s just amazing. I’m glad it’s this way and not in reverse, you know?
Dr. Devona Anderson:
Yes.
Michael Whitlock:
There’s some specialties like oncology where you’re seeing the complete opposite and that’s an important medical field obviously, but you get to see rebirth and redemption.
Aaron Reason:
Yeah, they go from lifeless to life again, and you’re right, I mean they come in so broken. I always love when the clients will come to me right before they’re about to leave and they’re like, “Can can the picture of me when I first came in?” And just you’re right, I love that part of it. I love seeing the light come back on in their eyes and just their growth and their health come back and be restored. And they eat so good here that they always gain weight.
Dr. Devona Anderson:
They always gain weight. I warn them at the beginning, you’re going to gain weight.
Aaron Reason:
Yeah, we carb load.
Michael Whitlock:
Well a lot of people aren’t eating. Not only well, but at all they’re using their money on other things so it’s nice to see them and it’s a good kind of weight gain.
Aaron Reason:
Yeah, absolutely. And so we do offer medicated assisted treatment here. Tell us a little bit about that, what it is.
Dr. Devona Anderson:
Okay. So medically assisted treatment is basically what it says. We assist persons who are addicted to substances with medicines to help them to live a normal life. So should I go through some of those treatments?
Michael Whitlock:
Yeah.
Dr. Devona Anderson:
Okay.
Aaron Reason:
Yeah, absolutely.
Dr. Devona Anderson:
So, we only have evidence-based treatment for two types of disorders, opioid use disorder and alcohol use disorder. And so that’s unfortunate because there’s a lot of other things out there. But we do use these two options. So for alcohol use disorder we have Naltrexone which comes in two forms, an oral form and an injectable form. And this medication helps decrease cravings and also it decreases the effects of the substance. So if you try to drink, can’t get tipsy. If you get tipsy, I mean it’ll take a lot more in order to get tipsy, but it just kind of takes that reward away.
And that’s the whole thing with most of these substances is you take it in, you get that dopamine bump and you feel great and then you keep seeking after that. So you take that away. So N is used to treat both alcohol use disorder and opioid use disorder. There’s also other drugs. There’s Acamprosate, which is also approved for alcohol use disorder. And there is one more Disulfiram, which is Antabuse, which is for alcohol use disorder.
Michael Whitlock:
Okay.
Dr. Devona Anderson:
We also use other things off label, but those are the evidence-based ones that we frequently use. On the other side there’s opioid use disorder and we use Suboxone.
Michael Whitlock:
Thank you.
Dr. Devona Anderson:
Suboxone or buprenorphine. Buprenorphine. We use Suboxone or Sublocade, which is the injectable form of that, and this helps to decrease cravings and any withdrawal symptoms so they don’t have that desire to continue to go out there and try to find the opioids to get again, that dopamine bumps so they feel good.
It just keeps them feeling normal. At some point when you keep using, you have to use to stay normal, to feel normal, your brain chemistry. So this just keeps their brain normal. It doesn’t cause them to feel high or intoxicated, it just normalizes their brain chemistry.
Michael Whitlock:
And they’re getting it in a safe environment where there’s no doctoring going on. They don’t have to worry about fentanyl being added and it’s in a medical facility. I’ve heard the term harm reduction with regard to MAT. Can you explain what that means?
Dr. Devona Anderson:
So harm reduction comes in various forms, but in and itself is like we do what we can as a medical professional to reduce harm for the patient, be it instead of them sharing needles or getting needles from the street, we give them a needle. That reduces the harm to them, decreases the risk of HIV, reduces risk of Hepatitis C.
Sometimes they will give them the little rubber things that go on a pipe that reduces risk of passing diseases. So anything you can do to reduce the harm to the patient is labeled harm reduction. And that’s what the medications are. They’re harm reduction, especially for opioid use disorder, it’s deadly. I mean, you don’t know what’s in it. It used to be heroin and then they started mixing stuff up in it. So it can cause overdoses and death pretty quickly. And it’s unpredictable.
Michael Whitlock:
We talked about this in a previous episode that a lot of people are like, “Yeah, I’m taking heroin.” And there’s a lot of people that never even touch heroin. It’s fentanyl and they just don’t even know what they’re getting.
Aaron Reason:
Yeah, it’s all fentanyl now.
Dr. Devona Anderson:
It is.
Aaron Reason:
You rarely see anybody, I mean from the screens that I see when people come in here now and what’s crazy is people that aren’t even opiate addicts that say that they’re drug of choice is meth, they’re still coming in and testing positive for fentanyl because the drug dealers have seen how addictive it is and they’re putting it in everything now.
Dr. Devona Anderson:
Even Benzos, they buy those pressed pills, they call them Zannies or it’s supposed to be Xanax, they have fentanyl in them as well. So you just never know what you’re going to get.
Michael Whitlock:
And they look like the ones that the pharmacies make. So people have this false sense of security that they’re getting pharmaceutical grade Xanax and they’re not getting anything. It’s amazing and it’s scary.
Dr. Devona Anderson:
Right.
Aaron Reason:
Yeah it is. Well it’s take a quick break and we’ll get a word from our sponsors and we’ll be back with our doctor here.
Speaker 5:
At the Indiana Community Addiction Network. We offer the new standard in medication assisted treatment. So if you’re ready to put substance abuse behind you, we’re here to help. We are a local family owned center who will create an individualized physician-led care plan to help you reach sobriety at ICAN we treat your addiction based on your unique needs and have full addiction treatment programs Get started on recovery today, call ICAN now to speak to an advisor at 888-635-1470 or visit us@addictionsnetwork.com.
Aaron Reason:
Okay. So we want to talk a little bit more about MAT and just real quick, we want to make sure that we address that MAT is something that needs to be discussed with a medical professional just to see if it is a good fit. But like I was talking about during the break, I personally didn’t have… Sublocade wasn’t an option, it was just buprenorphine at that time. So maybe touch a little bit on Sublocade and what that is.
Dr. Devona Anderson:
So Sublocade is a wonderful advancement in the treatment of opioid use disorder. It’s an injectable form of Buprenorphine, just like Suboxone, same medication except it’s a once monthly injection. So it does exactly the same thing. The first two months you get larger doses, 300 milligrams each month and after that it’s a hundred milligrams.
By the second month it’s in your system, steady state. So you don’t have to worry about withdrawal symptoms, you don’t have to worry about any of that. It’s injected in the four quadrants around your belly button, it stays in a little depo, so it’s kind of about the size of an almond around there and the medicine gradually dissolves into your system there every day. And so again, it’s a great option so you don’t have to be worrying about am I going to run out of medication?
And you can travel, it gives more freedom and less dependence on that pill popping behavior that some people already have. So I think it’s the best. It’s even great for, I think really good for our correctional system because you know, get in there and then you withdrawal while you’re incarcerated because they’re not going to help you with that.
So if you stop taking it, let’s say you’re due the next month, end of the month for your injection and you’ve already had the first three, it stays in your system for months, it gradually leaves your system so you don’t go through withdrawal symptoms when you come off of it. So if I could offer it up to everybody that qualifies for it versus the tablets or the films, I would definitely do that.
Michael Whitlock:
That sounds like a great opportunity for people. And it seems like it’s been more and more popular as of late. I think people are discovering the benefits of that long-lasting buprenorphine.
Aaron Reason:
Tell me about your observations since you have been in the field with regard to fentanyl. Because we’ve kind of touched on that a little bit.
Dr. Devona Anderson:
So 2019, 2020, I was still seeing heroin in the drug screens. But as 2020 went, you started seeing more fentanyl and still heroin. In 2020 you still see some heroin, but then more fentanyl. Then in 2021 no, by 2021 there was hardly any more heroin seen. It’s all fentanyl.
So patients, like we said earlier, they thought they were getting heroin, which is less potent than fentanyl. So they were getting fentanyl and then they would overdose because they couldn’t test it to see. That’s one part of harm reduction, going back is there are some places where they provide fentanyl test strips for people who are still in active use so they could test the supply and see if there’s fentanyl.
But now the supply is all fentanyl, so it doesn’t really matter. And people, now I used to ask, are you taking heroin or fentanyl? And they were like, “Well, I asked for heroin, but I get fentanyl.” Now, they don’t even ask for heroin anymore for the most part. They just know that it’s going to be fentanyl and that’s just the way it is.
Aaron Reason:
And that’s the world that the addict lives in. And I began as a heroin addict. Well my addiction began with prescription pain pills and it just kept progressing. And honestly, once I found out about fentanyl, I didn’t want anything else. I didn’t want heroin. I was just like, give me that because that was the strongest stuff.
But in that world, when you insert yourself into the world of fentanyl, I knew that when I was doing this to always have Narcan on standby. And honestly we would, and one person would do theirs first, and then that way if they fell out, the other person there could save them. And Narcan became this, oh well we’ll be okay, we’ve got Narcan, we’re not going to die. And it’s just insanity. I mean that’s insane to think like that, that we would have that.
Michael Whitlock:
Well that gets a great segue for something that I’ve been researching and then I’ve talked to Dr. Anderson about, there’s a animal tranquilizer that they’re finding in a lot of fentanyl now. It’s called Xylazine. And what’s scary about Xylazine, first off, it’s not even for human consumption. This is an animal tranquilizer.
They’ve added this to fentanyl to increase the effects, and what’s going on is it’s making Narcan ineffective. And it’s so scary because people have this false sense of security that if they have Narcan, then they overdose, they they’re going to be okay. And it’s killing people. And it’s also I guess making these huge skin ulcerations.
Dr. Devona Anderson:
Yes.
Michael Whitlock:
Just horrible.
Dr. Devona Anderson:
If you Google Xylazine and look at those pictures, they look like zombies.
Michael Whitlock:
Yeah.
Dr. Devona Anderson:
I mean literally you can see all the way down to the bone in some people how bad the ulcerations are from repetitive use of the fentanyl lace with Xylazine.
Michael Whitlock:
The people that are manufacturing this stuff, they don’t care about lives, they care about one thing and that’s making money. The more people they can have hooked on fentanyl and the Xylazine, the better for them. But if people die, they don’t care. And we need the listeners out there that are struggling to know that this is getting scarier and scarier. And I mean it’s not a game.
Aaron Reason:
No, I mean you’re really playing Russian roulette every every time that you use now. And I mean working on the front lines here, I think that’s one of the hardest things about my job in particular is seeing the parents that come in with their 18-year-old kid that was playing PlayStation one minute and the next minute they go in and find their lifeless body. And just to think if the first responders, even if they did get there in time and the Narcan doesn’t work, what then? So it’s sad that that’s the world that we live in. But that’s the face of addiction now is fentanyl in this.
Michael Whitlock:
It’s why the justice system is now starting to go after the dealers and manufacturers.
Aaron Reason:
Yeah, that’s a good point.
Michael Whitlock:
They’re going after them with criminal charges and charging them with the deaths of these individuals that are using.
Aaron Reason:
Rightfully so.
Michael Whitlock:
Absolutely.
Dr. Devona Anderson:
I’m hoping that our justice system will continue to evolve to know that treatment is more important than correction.
Michael Whitlock:
Yeah.
Dr. Devona Anderson:
Because the addiction is, if you don’t treat it’s still there, they’re going to go out and do the same thing.
Michael Whitlock:
It’s a disease, and I think we’re starting to see some of these drug courts are getting it right. That they’re helping, instead of just trying to put them away off the streets, they’re helping them get well.
Dr. Devona Anderson:
Right.
Michael Whitlock:
Can we go back to the medication assisted treatment just for a minute. You mentioned that right now it’s good for opioids and it’s good for alcohol. What about the other drugs that are out there? Are there options?
Dr. Devona Anderson:
There are options. Not as good, not as fully based on really good evidence or research, but there has been some evidence and research on some treatments for stimulants. Those stimulants include methamphetamine and Adderall, addictions, cocaine, addictions. We do use some options.
So the best treatment for stimulants is the community of recovery but as far as medications, we use Wellbutrin and Naltrexone, the combination of the two has been shown to help some people with that addiction. Sometimes we use Strattera as well because there’re a subset of people who actually do have ADHD and that led to their addiction or their desire to take something to get things done because they actually were undiagnosed with ADHD.
It’s the same thing. We also use Provigil from time to time. Provigil is a stimulant itself. It is controlled, so we use it sparingly, but for some people it works. I think that the research doesn’t pan out well for everyone because everybody uses it for a different reason, uses the stimulants for a different reason. So that’s why you have to kind of tease which one is better for which person.
Aaron Reason:
Okay.
Michael Whitlock:
Makes sense. Do you think that there are going to be in the future, more options available? Did you see any research that indicates this?
Dr. Devona Anderson:
I haven’t seen anything recently. I want to say I saw research regarding some vaccine for one of these and I can’t remember which one it was, but I’m not going to speak to that, but there is ongoing research. I’ll just say that and then when I see something I’ll come back on the show and let you know.
Michael Whitlock:
Yeah, we’d love it. We would love to have you back. You know what I want to definitely push as important is we talk about all the different treatment modalities that go on at a facility or an outpatient clinic, and we are not pushing any one treatment.
We’re encouraging you to speak to all professionals, both clinical and medical, and arm yourselves with several things. Medication assisted treatment is great, but we think that it’s important to also get therapy and counseling.
Aaron Reason:
Absolutely.
Michael Whitlock:
And to get a sponsor. I mean the more things that you can put in your arsenal to protect against the disease of addiction, the better. And we see that the people that do more work have better success than the people that try and depend on one thing.
Aaron Reason:
Yeah, recovery is really, it’s a new way of life and it’s a beautiful way of life and the more involved you are, the more successful that you’re going to be. So, absolutely. Well Doctor, we really appreciate you taking time out. We know you’re very busy, so thank you so much for coming on the show and sharing your insight and your perspective. I love that. I’m so glad that you came here today.
Michael Whitlock:
Yeah, thank you very much.
Dr. Devona Anderson:
You’re welcome. It was fun, it was lovely. I would be happy to come again.
Michael Whitlock:
Absolutely.
Aaron Reason:
Awesome.
Michael Whitlock:
Have a great day.
Michael Whitlock:
That’s a wrap for episode six of A Reason to Live. Thanks for coming and visiting with us and helping us to spread this encouraging words to the world of addiction and recovery.
I’d like to thank our special guest today, Dr. Devona Anderson, for stopping by and sharing some wisdom with us. And of course, want to thank the sponsors who make all of this possible, Bridges of Hope and Indiana Community Addiction Network work. Be sure to share on social media the information about this podcast so that we can get the word out and make sure to hit follow on all of your favorite platforms. And we just thank you again.
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