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Oregon has funding for addiction recovery programs, but not enough employees

Staci Cowan has been a certified recovery mentor at Bridges to Change for the past three years, most recently working at its drop-in center called Club Hope.
Celeste Noche for NPR
Staci Cowan has been a certified recovery mentor at Bridges to Change for the past three years, most recently working at its drop-in center called Club Hope.

Like many people who work in the field of addiction, Staci Cowan is herself in recovery. She slid into heroin use years ago after she started taking opioids for an injury. The loss of her job and apartment followed. She found herself homeless when her mom was forced to draw a firm boundary. No more sleeping at her house.

"The people on the streets, you think they're there for you," says Cowan. "But you quickly realize that no one is there for you except for yourself."

Now, as a peer mentor at an addiction and recovery facility called Club Hope in the Portland suburb of Gresham, Cowan's job is to be there for other people. She celebrated four years in recovery recently. Listening to people is a big part of her job. She remembers what it was like to feel invisible.

Oregon has recently funded positions for dozens more of these kinds of jobs at facilities across the state, and there are many more jobs coming. It's part of the state's new approach to addressing substance abuse.

In 2020, Oregon voters approved a measure to decriminalize possession of small amounts of drugs like heroin and cocaine and at the same time channel hundreds of millions of dollars from a recreational marijuana tax into helping people battle addiction. The idea is to address substance abuse through public health channels instead of the criminal justice system.

Now, the problem is finding the workforce to staff this effort.

Club Hope in Gresham, Ore., is part of an organization called Bridges to Change, which provides pathways out of addiction.
/ Celeste Noche for NPR
/
Celeste Noche for NPR
Club Hope in Gresham, Ore., is part of an organization called Bridges to Change, which provides pathways out of addiction.

Emotional work has an emotional cost

"Passion is driving people into the field and the flip side of that coin is it's a very emotionally draining position to be in," says Monta Knudson, Executive Director at Bridges to Change. Club Hope is one facility run by the organization. Knudson is himself in recovery. He says the emotional occupational hazards of both participating in this work and contributing to it are high. They often lose clients back to the streets. Some die.

"You feel like 'Did I do enough?'" says Knudson. "There's just all kinds of ways your mind plays tricks on you. And also just the sadness of losing people to a disease that is treatable."

The recent money has made some difference. It's allowed many people at Club Hope to make closer to twenty dollars an hour, raised from sixteen. But it's still difficult both to find people for these jobs and to keep them from burning out, says Knudson.

The recovery workforce will need to expand in the coming years

These staffing challenges are instructive for states across the country as the US will soon make a unique investment in the field of addiction recovery. Settlements with drug companies over their role in the opioid addiction crisis will soon make billions available in order to fund recovery and treatment.

But in Oregon, thirty percent of current jobs in the addiction and recovery workforce are unfilled. That's according to a survey from the Oregon Council for Behavioral Health. "It's the biggest workforce crisis I've seen in my entire 25 year career," says Heather Jefferis, the organization's Executive Director.

The Bridges to Change employee handbook.
/ Celeste Noche for NPR
/
Celeste Noche for NPR
The Bridges to Change employee handbook.

This shortage, she says, has a direct impact on care.

On a recent morning at Club Hope, peer mentor Staci Cowan hands a man a towel and points him to the shower. People can come here to bathe, eat or just watch Netflix and warm up. They can also access social services. The idea is that it allows people a pathway out of addiction.

But this model does not work without peer mentors like Cowan, who offer not only resources but also empathy.

On this morning she talks with a man who has just had a big breakthrough; he's moving from the streets to his own apartment. He's nervous and worried it might not work out. "You've gotta change your thinking," Cowan tells him. "Don't even think about what happens next if this doesn't work."

It's a brief exchange, but it's these kinds of interactions that offer crucial emotional support for people in recovery. The earliest days are some of the hardest.

These are the early days of this recovery funding experiment

Oregon's program is still nascent. During it's first year, an initial $30 million investment has allowed for 16,000 additional people to receive addiction services. Hundreds of millions of dollars are yet to come. Advocates are working to raise pay even more for critical peer mentor positions, as well as make training programs more widely available.

In the meantime, Bridges to Change Executive Director Monta Knudson says his staff are doing what they can to take care of their own mental health.

Knudson says it would be unrealistic to expect this job not to have a high emotional tax. "I've never seen anyone that's not attached in some way," he says. Caring is the work, he says. With caring comes heartache.

Copyright 2022 NPR. To see more, visit https://www.npr.org.