Merging commerce and care is really, really hard. Health care is a business and it’s often driven by money. I guess I knew that but I have always been more interested in the cause and have found the tedium of the business aspect to be pesky and unethical.
As a part of our series about “Heroes Of The Addiction Crisis” I had the pleasure of interviewing Joe Schrank.
Joe Schrank has more than 20 years experience as a social worker in the addiction and mental health space. As a young man at USC he treated his depression with alcohol and avoidance, but once sober, he returned to academia, studying clinical social work at Iona college and in a Masters program at the University of Illinois where his research was focused on college athletes with depression and alcohol abuse. He is currently serving as program director for The Heavenly Center in Los Angeles.
Thank you so much for doing this with us! Can you tell us a bit of your backstory?
I’m a clinical social worker and person in long term recovery. For me that means, I live my life without any inebriating substance, am compliant with medication protocol and I attend mutual aid meetings. So, main stream, regular sober.
Is there a particular story or incident that inspired you to get involved in your work with opioid and drug addiction?
My work as a social worker led me to understand that the world is a big, diverse place and while MY road to better health is a good one for some people, that’s not true for everyone. We have to respect the inherent worth and value of all people and understand that their recovery may or may not look like mine. I got really interested in the opiate issue after my best friend, Greg Giraldo, who was a semi famous comedian overdosed and died. I really thought we have to do better than we are.
Can you explain what brought us to this place? Where did this epidemic come from?
The opioid epidemic is fairly complex. The truth is, opioid dependence is nothing new, it’s been a problem since forever. What does seem to be new is that the consequences started to leak into communities with more social capital so the awareness became more main stream. That’s not to say we haven’t seen a spike in dependence and overdoses, we have, but there is much more attention paid now then previously. While we like to assign blame to over prescribing and dishonesty from big Pharma, the truth is that’s only part of the story. The issue really indicts all of us for tolerating ineffective drug policy and treatment that doesn’t work.
Can you describe how your work is making an impact battling this epidemic?
“Rehab” in its accepted standard from has been around for decades. It’s a $50 billion a year industry and its largely ineffective. The overdose rate isn’t improving, in fact, it’s worse since covid. San Francisco saw more overdose deaths than covid deaths during covid. Something is wrong. We can do better, we must do better. That means we have to have more diversified roads to health, we have to respect diversity and understand that not everyone in need will get better in the same way. To date, the only “success” in drug treatment is if someone is abstinent for the rest of their life. That’s a nice idea but it’s not realistic. If someone was an opiate user and they eliminated that but they are a medicinal cannabis user, is that success? I think it is, I think that’s a triumph. I think we’re helping people at a micro level but helping the community by giving them permission to redefine success and think about all of this differently. “Abstinence” was supposed to solve the HIV crisis and it didn’t. Harm reduction, safer sex practices, needle exchange, etc is what helped us get a handle on HIV and that’s what we’re trying to do here.
Wow! Without sharing real names, can you tell us a story about a particular individual who was impacted by your initiative?
There are so many! We had a young man who came to us in a severe state with infected injection sites and a severe addiction. Today he’s an apprentice electrician, living independently, has a nice girlfriend. Yes, he isn’t “drug free” because he uses cannabis for sleep but what a tremendous accomplishment to improve his life so vastly. We had an older man who developed an addiction to pain meds after a back issue. Today he’s managing pain with cannabis but also walking for exercise and going to his grandson’s little league games. Improvement matters and we can’t demand perfection and thumb our nose at improvement.
Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?
I always love to see young guys do well. They are a very hard population to engage in mental health treatment. The helping professionals are vastly held by women, which isn’t a bad thing, but talking to young adult men is a specialized thing and they often respond to the style of a man. I’m always so happy when they start to act like humans, go back to school or learn a trade. I’m very happy to see them become independent and healthy. Some days, I’m just happy if they pull up their pants.
Can you share three things that the community and society can do to help you address the root of this problem? Can you give some examples?
All drug policy is successful to the degree to which we will be honest about it. The community can stop living in shame. We lose 80k Americans a year to alcohol use but do we ever read an obituary that says “died after a long struggle with alcohol”? We don’t, and yet, substance issues impact all families. We need to participate more in large scale events. The opiate crisis doesn’t have an “aids quilt”, the NFL doesn’t wear colored cleats for “recovery month”. We need to get politically active. Write your senator and congressional representative and demand to be heard. Demand we reframe our approach to drug policy from law to health. We can change this but not without the political resolve to do so. Civic participation is over ten overlooked but a very powerful tool. Where would the gay community or civil rights be without it. That’s what we need to change this problem in America.
If you had the power to influence legislation, which three laws would you like to see introduced that might help you in your work?
End no knock warrants. It’s dangerous and in my view, unconstitutional.
Levy a “user tax” on all “intoxicating substances” to fund treatment and recovery services. We pay a fee to make sure our car is safe, in some states we pay for a bag at the grocery store. Why should alcohol cause so much damage to the community and not be responsible in any way? Most states haven’t raised taxes on alcohol in decades but a simple. I would decriminalize simple possession of drugs and issue citations to appear before a a board of a doctor, a social worker, and patient advocate to go over options, all funded by my alcohol tax.
I know that this is not easy work. What keeps you going?
It’s not easy, it’s really hard but I love what I do. I’m very lucky to have work that matters to me and as hard as it is, there’s much joy in it too. I wouldn’t do well selling insurance. I also am good about self care, I work my own program, take care of my health, exercise a lot and try, I really try, to not eat so much junk, though I usually lose that battle. This dad bod doesn’t just happen, it takes a commitment to burritos and Oreos.
Do you have hope that one day this leading cause of death can be defeated?
I have hope and resolve that it can be vastly improved. Humans are humans and there will always be people who don’t make it but we can do so much better than we do. One number I would really like to change is the number of deaths in college campuses. 1800 deaths per year, that’s just unacceptable. Sure, I’d love to see zero but I would be thrilled with a 50% reduction. We could see major declines in opiate overdoses if we have a full throttle campaign to get more marc an out there. We could also save many lives with honesty. We have seen major spikes in overdoses during covid but the death rate from cannabis use is holding steady at zero.
How do you define “Leadership”? Can you explain what you mean or give an example?
Ben Franklin once said “better well done than well said”. People aren’t what they say, they are what they do, humans do some of what you tell them but much more of what they see. I think leadership is a lot about action. It’s also a willingness to be unpopular. With rehab so profitable, it’s not popular to say “it doesn’t work, it has street corner scam odds of working “ but I’m not trying to be prom queen, so I don’t mind the slings and arrows sent my way.
What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.
- People will die. Addiction is powerful and not everyone will make it. I’m covered in tattoos from people I have lost.
- Merging commerce and care is really, really hard. Health care is a business and it’s often driven by money. I guess I knew that but I have always been more interested in the cause and have found the tedium of the business aspect to be pesky and unethical.
- The thing that impacts the most, doesn’t get the most attention. I thought since addiction is roughly 1 in 10 births, America would be up for this fight. We’d all see how important this is and how much we lose when we limp along doing something about it.
- People don’t like change. I thought saying “ hey if we only have a 3–5% success rate, we need to do something else” would be met with “wow, Joe you’re right, what other area of healthcare would rest on that? Cancer? Diabetes? No, nobody should be satisfied with such an abysmal rate of success”. I had no idea I’d be labeled a rabble rousing heretic.
- I wish someone had told me that this kind of work is so hard on people you live. I never know what’s happening, a crisis could hit at any moment. I have missed so many things, asked too much from girlfriends, disappointed my children and that’s really hard because they are asked to be a part of my work too when they didn’t sign on for it.
You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
It would be a movement that takes the social justice of civil rights and gay rights and merges them with the integration of breast cancer. The NFL wears pink cleats, I was in London and half the city was wearing pink bras. The gay community went to banished to certain neighborhoods to being fully integrated into American life in 20 years. Every time I asked a kid who overdoses and he looks like he could have been on one of my boys little league team I think, we can’t let this go on, we need a ground swell movement. I don’t know how breast cancer did it, but they did an incredible job.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I’m a major fan of legendary basketball coach, the Wizard of Westwood, John Wooden (even though I went to rival USC). Coach Wooden said “things work out best for people who make the best of how things work out”. Sounds simple and kind of a coach platitude but I love it, we’re just going to see what tomorrow brings and do the best we can with what we get.
Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂
Without question, Pope Francis. He’s a brilliant man and has done so much to move the church forward. Remember, the church is an institution that moves in centuries. He leads a billion Catholics, his tweets pack a punch and his words could take this issue to the next level. Imagine if he said “Addiction is a mental health issue, one that requires help from many people, we can no longer be at war with our own families and I am inviting world leaders to have massive reform in drug policy”. He is also a Jesuit with a deep commitment to issues of social justice. As a bonus, we’d be in Rime and the food there is just awesome, so, anytime his Holiness is free, I’ll make it work
How can our readers follow you on social media?
This was very meaningful, thank you so much!