Jim Ryser, a 20 year veteran in helping people with Substance Use Disorder discusses challenges faced by patients and providers, and how a holistic and pragmatic approach to recovery has proven beneficial.
Q: What challenges do SUD patients face?
20 years ago the mainstream belief was that SUD was mis-managed pain, not addiction. Some folks were over-medicated, others had a raging addiction but both came with their fair share of personal and medical challenges. On top of that, alcoholism and addiction can mimic an anxiety disorder which can make treatment and diagnosis challenging as well. Ideally have someone clean for some time we so clinicians can understand any underlying psychiatric conditions is helpful. Even with treatments such as taking a reduction-type approach, patients find it challenging to go about day to day, have withdrawal, and anxiety.
Q: How do you approach treatment? What have you seen work well?
Approach each patient uniquely and treat the full person. Depending on the patient, meds can be a great intervention, or can be combined with a 12-step program and mindfulness resources. Essentially, it’s all about providing them a toolbox of resources. What has worked really well is keeping the emphasis on the “we” to avoid isolation. Patients can do this through support groups, connecting with their care network, getting involved with others, listening to each other’s stories, and connecting over the same experience.
Q: What are your thoughts on the peer recovery model?
Peer recovery models can be part of the 12 step process. Consider the 12th step, “carry this awakening to others,” here we can see the clear overlap between a 12 step program and the peer recovery model. Connectivity and shared experiences are a key step in holistic recovery. (step 12 – carry this awakening to others), so taken directly from there
Q: What role do medications play in SUD recovery for patients?
A lot of patients take maintenance medications for chronic diseases. Psychiatric issues are very prevalent for which they need psychotropic meds. At the end of the day, we want the best comprehensive care for patients–and this can often require a delicate balance of medications and other resources.
Q: What made you first consider a mobile app as part of the solution?
Patients are always on their phones in our group sessions and even our 1:1 sessions, so why not give them something that can be on their phones. That is initially why I wanted to work with illuminate.health. The digital tools immediately give people feedback, and the checklist is easy to follow and reinforces healthy habits since everyone wants a pat on the back. Many patients struggle with the overwhelming amount of information when it comes to their treatment plan, so it’s nice to have care guidance one can follow. The app allows patients to maintain a level of serenity to stay sober, exercise, engage with their sponsor, take their meds, and even take a look at motivational readings.
Q: What stood out about the illuminate.health app for you and your patients?
There are so many things in one place and something new to do every day. Patients can go right into the app and see where and when the next meeting takes place making personal engagement more structured and easier with the app. The app also helped people find weak spots in their own recovery. Even just taking one medication a day can be difficult to stay compliant. When treating an addictive disease, you’re talking about meetings, sponsors, working steps, working with others, staying sober in spite of all this, and when we add chronic pain, we’re adding in exercise. So, there are a lot of things one must do to maintain a level of serenity so they can stay sober and the app helps calm this storm.
Q: How would you work with patients who aren’t as compliant to their treatment plan as you would like?
Coaches and patients should work together to review their activity level and dedication to programming. If patient is having a hard time, or dreams about using, are you calling your sponsor, engaging with motivational readings, exercising? One of the main benefits of the illuminate.health app is that it’s hard to lie to yourself about compliance when the data is in front of you.
Q: In what ways has technology enabled and extended your relationship with your patients?
Technology empowers the patient. The first thing the app highlighted to me were daily readings, not a one size fits all approach, but a consideration of all aspects of their illness. It’s a great way to bridge the gap between the fear of talking to the doctor about the potential problem because the stigma is still there. People are still afraid to talk about addiction. People who engaged with the app, engaged with their recovery and hence were consistent and recovered faster.
Q: What is the best way to gauge the effectiveness of mobile digital tools?
Data on patient engagement and convenience. As a coach, digital tools allow us to see how many activities a patient went to in a convenient way. The number 1 reason patients relapse is because they stop going to meetings. That’s data we can track with reports on app engagement, and allow us to review daily and weekly actions and activities which makes a digital tool more effective for recovery.
Q: How do your patients feel about using the illuminate.health app?
One of our patients always said “I love and hate the app at the same time. I always have my nose buried in my phone and then I’ll get an app reminder. It helps me to take pause, slow down and keep me focused on the fact that I need to treat this illness every single day.”
Q: How has the adjustment been for your staff when they started using the app?
“I love this app!”, was something I heard often from my staff. It helped patients find weak spots in their own recovery and kept both the staff and the patients engaged. At the end of the day, the app is reinforcing what we keep telling patients to do. The best benefit as a patient is not being able to lie to yourself when the data is right in front of you, which is equally valuable for the coach/therapist who is trying to work with the patient. It’s enables shared decision-making–realizing you didn’t call your sponsor today, I missed my meeting last week, no wonder I’m feeling off. So, what I saw was that people who really engaged with the app really got engaged in their recovery and were more compliant with all aspects of it much quicker and much more consistently. Even patients new to smart phones, the ones with free government phones, did not need much help onboarding or any ongoing training.
Q: Any lessons learned from this experience?
Having the opportunity to provide input into the app was beneficial for the staff as well as patients. Everyone made it their own, so to speak, it was less love-hate and more of a “this is good for me and I am going to do it!”
Sometimes sobriety can get boring. To be able to have something that gives you a checklist to remind you to do your reading or asks: did you to reach out to your sponsor today or what meeting do you have scheduled today? Then being able to go right into the app to find a meeting in your neighborhood. Now, with all of us living and dealing with COVID, that’s extremely imperative to be able to have resources because we don’t have personal engagement like we used to. Recovery is a program where personal engagement is extremely important. Apart from offering this app and care management platform to addiction clinics and Medicaid, other payers, Primary care physicians would really benefit from this.
Jim Ryser Bio
Jim Ryser, MA, LMHC, LCAC, CADAC II, ICDAC, is the former Director of Pain Services and Chemical Dependence programs at an Indiana Health System. He’s spent the last twenty years of his career integrating a 12 step program to address chronic pain at the Chemical Dependency Center at IUH Methodist. He personally recovered from opioids addiction and has been sober since 1999. We’re honored interview Jim as he reflects on his 20+ years of expertise to share his pragmatic approach to recovery and thoughts on the illuminate.health solution.
Only 12% of US adults have proficient health literacy, and as a result, $528 billion is spent due to non-optimized medication therapies – impacting millions of individuals. Illuminate Health is an AI and machine learning-powered digital health assistant designed to help people live healthier. The platform offers medication management skills to help patients and caregivers safely administer medication at home through personalized scheduling, safety checks and education. Collaboration capabilities help patients and their care teams stay connected through remote monitoring and telehealth, allowing for optimized treatment compliance. Disease-specific capabilities such as health status check-ins, recommended wellness activities and community resource navigation support patients with chronic condition management, substance use disorder and beyond. To learn more, visit: https://illuminate.health/