Written by Lauren Farley, Business Development Coordinator at PYA and member of the LHC Marketing and Communications Cohort
Recently, members of Leadership Healthcare (LHC) attended a lunch and learn with Dr. Stephen Loyd, the Medical Director of JourneyPure’s services in Middle Tennessee. The discussion, moderated by Justin Lanning, CEO of 180 Health Partners, began with Dr. Loyd’s personal story, covered the physiological facts and social stigma around substance abuse, and ended with a discussion on reimbursement issues in the addiction recovery space.
Dr. Loyd was wrapping up his medical school training and serving as chief resident when he became addicted to prescription drugs. While driving home from work one day, he flipped opened the glove compartment and saw a bottle of prescription drugs from a dentist appointment a few months prior. He decided to take half a pill. By the time he arrived home, Dr. Loyd felt like he had found a cure for my anxiety, depression, and PTSD from past physical and sexual abuse. Within 3 years, he was taking 500 mg of Oxycontin a day (equivalent to 100 Vicodin). Reality stuck him hard one day as he was treating a patient who had over dosed. Dr. Loyd was actually taking more milligrams of acetaminophen every day than his patient had over dosed on. A couple months after this patient encounter, Loyd stated, “My dad noticed a big change in me and intervened,” and Loyd was able to receive excellent treatment for his addiction.
Dr. Loyd’s personal addiction recovery process birthed a passion for helping others with similar problems. Today, Dr. Loyd is using his personal experience to “I’m grateful for it, don’t want to repeat it, but want to learn from it and teach you as a result of it.”
Here are a few key takeaways from the event:
- Loyd questioned why we don’t feel comfortable talking about addiction. “The reason is stigma—you don’t want anyone to know.” He said, “As long as stigma associated with addiction stays where it is, we’ll continue to lose people, we’ll continue to lose young lives. It’s a very treatable disease, but we have to change our perspective on how we view addiction.”
- Lanning transitioned the conversation to how our bodies are engineered when it comes to addiction. “Our bodies have their own natural endogenous reward system—we make our own endorphins, so when we do things that bring us pleasure and lead to our species going forward in time—we will repeat those things and the human race can go on. That’s how we’re wired.”
- Loyd shared how addicts continue to use something despite their consequences. “When we take medication from the outside, it suppresses our bodies ability to make endorphins on its own. When someone takes opioids, they no longer need things that bring them pleasure—such as relationships, our partner, significant other, our kids—You don’t need them anymore because our opioid receptors are being occupied by the drug your taking from the outside. Therefore, one of the key components of recovery is providing a supportive community.”
- Loyd shared how a person with an addiction has diminished access to their frontal lobe which provides insight and judgement. These individuals are driven solely by their reward system. “In a detox, we keep them off drugs long enough to give them insight and judgement and balance their reward system, but the process takes 90 days for your frontal lobe to begin working again.”
- Lanning shifted the discussion to what leads people to addiction—coping mechanisms. “At some point there has been a trigger or trauma that has caused an individual to have a higher likelihood to needing the support of and access to external coping mechanisms. Those can range from mentoring, counseling, drinking, smoking, shopping, binge watching, eating disorders, many many other outlets and yes…self-medicating,” said Lanning. Dr. Loyd shared information around the ACEs Study: Adverse childhood experiences study. “I think it’s the single most important study done in the history of medicine. There’s nothing more wide range impacting than the ACE’s Study and how it relates to addiction.” The ACE study demonstrates an association of adverse childhood experiences (childhood trauma) with health and social problems across the lifespan. Researchers discovered that a person’s cumulative ACEs score has a strong, graded relationship to numerous health, social, and behavioral problems throughout their lifespan, including substance abuse disorders.
- Loyd then gave us insight into the payer’s role within the addiction recovery space. “The kicker is, insurance companies pay the most for 10-12 days of in-patient detox treatment, which leads to low success rates.” As Loyd mentioned previously, “If I can keep a patient in treatment for 90 days, they will start to have insight and judgement. If I can provide them with a supportive community for 2 years, their success rate will be around 40%. And after 5 years of aftercare, they will have 78-95% success rate.” Lanning added, “He’s describing to you a program that works and has outstanding outcomes but is constructed opposite to how our recovery system is reimbursed and paid for today.”
- Lastly, Dr. Loyd ended with a book recommendation: In the Realm of Hungry Ghost. He said, “I highly recommend this book, because you start to get a feel for the grips of these drugs on the brain and the trauma that led people there in the first place.”
Dr. Loyd and Justin Lanning brought insightful discussion around addiction treatment for the LHC luncheon attendees. The recent trends of our country’s growing problem with opioid addiction requires that we take notice of the epidemic and become more knowledgeable of this disease. Treatment plans and reimbursement programs must be better designed and aligned with proven outcomes if we are going to reverse course.