Treating the Whole Individual at Integrity House
Impakter interviewed Robert Budsock, CEO and President of Integrity House, an organization that helps individuals and families recover from addiction through a system of comprehensive therapeutic community addictions treatments, bringing about positive, long-term lifestyle change. In November of last year, President Obama visited the organization, based in New Jersey, to meet the Integrity House staff and clients and to help shine light on the the relation between addiction and crime.
Integrity House is a nonprofit organization that was founded in 1968. The founder, parole officer Dave Kerr, noticed in the early 1960s that many individuals coming out of prison and assigned to his caseload were relapsing and returning to prison. In 1968, he left his job and started a program that would focus on helping these individuals get the skills they need to stay drug-free out of prison. “Dave Kerr was a man with a vision and a passion, and a pioneer for Integrity House,” says Robert Budsock, the current CEO and President of the organization. He just had the will to help people change their lives.
We exist to provide opportunities for people to reclaim their lives.
Integrity House first served as a long-term residential treatment facility, following the Therapeutic Community Model. This model originated in England in the late 1940s to early 50s, where individuals returning from the war were experiencing PTSD, alcoholism, and drug addiction.
In the 1960s, this community model was introduced in the U.S. The method of therapeutic communities was more democratic and user-led, unlike the more authoritarian practices of many psychiatric establishments of the time. “The central philosophy is that clients are active participants in their own and each other’s mental health treatment, giving feedback to one another, and confronting each other when they feel that they’re not making enough progress, as well as complimenting each other when they are,” tells Budsock.
What sets the organization apart from other rehabilitation centers is the commitment and approach of the center’s community. Budsock explains, “At Integrity House, we believe in treating the whole person. Although they come to us with the primary problem of drug abuse, we recognize that the individual’s drug use is usually just the tip of the iceberg in terms of their problems.”
Integrity House provides a comprehensive treatment, offering care that covers vocational training to ensure patients “relearn appropriate work habits,” become re-employed, can gain a high school diploma, and provide college courses and online courses for those interested in higher education. The patients get help with making their resumes, filling out employment forms, and getting the clothing they need for job interviews.
Integrity House also completes a full medical assessment for their patients, providing appropriate medication for individuals with secondary conditions like diabetes or hypertension, and psychiatric treatment for those who need it. Local medical and dental schools regularly visit to make sure that the patients’ teeth are taken care of, “helping them to be presentable and re-build their self-esteems,” says Budsock.
After recovery, patients can continue using Integrity House’s supportive housing facilities to make sure that they have a safe and sober place to live. “We view addiction as a long-term brain disease, so an acute intervention is not sufficient. There needs to be recognition that it is a chronic disorder, in the same way that diabetes and hypertension are chronic disorders that require lifelong management.”
Robert Budsock’s Story
Budsock describes how he began working with Integrity House in 1984: “As a young person, I had my own struggles, and didn’t always stay on a straight path. I started doing some volunteering for Integrity House. I was 24 years old at the time, and I just wanted to give back to folks who were struggling with addiction.”
Budsock felt so fulfilled by his volunteering that he became interested in making it his vocation. He was certified to become a councilor and over time became interested in the management side of Integrity House. “I wanted to become a program director, and have the ability of having an impact with a large group of members.” He pursued a master’s degree in non-profit management, and today manages 280 staff members and a budget of $20 million a year.
In the Photo: Integrity House. Credit to: Integrity House.
“Back in 1984, I looked forward to going to work every day. That has stayed the same until today,” comments Budsock. “We exist to provide opportunities for people to reclaim their lives.”
For a full mindmap containing additional related articles and photos, visit #integrityhouse .
When discussing stigmas around drug addiction, Budsock explains that, “We see a stigma towards those who are addicted to drugs because they are seen by some as being a bad person and morally failing. What happens is that people addicted to drugs have made poor decisions in their lives. However, the reason they haven’t been able to stop using substances is because it’s a chronic brain disorder.” The misunderstanding of this “prevents individual from raising their hands and saying, ‘Hey I need help,’ because they are looked down on by society.”
Budsock stresses that 89 per cent of individuals who would benefit from addiction treatment are not receiving it.
To better address this, individuals with substance-use disorders must be identified earlier on. This can be done for example when someone violates the law, or comes into an emergency room and during routine doctor visits. Integrity House encourages that, rather than waiting until the individual is in prison or has lost their home, society needs to look for opportunities to identify those symptoms.
Photo Credit: Integrity House.
Twenty years ago at Integrity House, 70% of the clients admitted were addicted to crack or cocaine. In 2016, 80% of the individuals are addicted to opiates. What is different about opiate addiction is that it has severe withdrawal symptoms. With opiates, the withdrawal symptoms will make the individual very sick with flu-like symptoms for a few days. When these symptoms come, the immediate response is to obtain drugs to seek relief from that sickness and, “They continue to live in fear of experiencing the pain associated with withdrawal. The addiction is sustained because it’s so painful to stop.”
Integrity House also goes beyond stigmas by doing a complete psycho-social analysis of incoming patients. Budsock says that, “While we look at their addiction issue, we also look at their mental health, physical health, education, employment history, and support systems (family/social/spiritual/emotional). It is not as simple as taking someone off of heroin and sending them back into the community. We need to look at all of the other aspects of their life that deteriorated as a result of their drug use, or that weren’t good before that. What’s harder than getting someone off drugs is helping them to learn to stay off drugs.”
Related articles: “AN INTERVIEW WITH BABYLON HEALTH“
America’s War on Drugs
The United States spends $26 billion a year to try to keep drugs from entering the country. Recently, Budsock made a Senate testimony, for Homeland Security and Governmental Affairs. “The focus of that committee hearing was to talk about the supply of drugs and reducing it, and then how to reduce the demand for drugs,” he says.
The border security efforts result in intercepting only 5% of the illegal drugs that are being smuggled into the U.S. “Based upon the increase in the number of individuals using drugs in the US, it is safe to declare that the War on Drugs has not been successful.” Budsock stresses the importance of shifting the focus from supply to demand, saying that, “Our lawmakers recognize that we have an insatiable appetite for drugs in the US and that we must use our resources to reduce demand. The war on drugs was not a good use of resources, and the focus needs to be on reducing the demand, and this will reduce the appetite for illegal drugs coming into our country.”
Prescription drugs are an additional national problem. The US, Canada, and Australia are consuming 80% of all prescription drugs in the world. “There is a real push in developed and sophisticated countries to market drugs and to say that, for any problem, there is a pill to help solve the problem,” describes Budsock. He observes that there seems to be a pharmaceutical solution for everything.
Opiates used as medication have led to the over-prescribing of drugs like OxyContin and Hydrocodone, both of which are very chemically similar to heroin. On this issue, Budsock says that, “Some individuals could safely take prescribed opiates, take the medication for 2-3 days, put the bottle on the shelf, and never touch it again. Other individuals, because their brain is different, will continue taking the drug after their pain stops.”
This leads to asking for more opiates, until their doctor stops. Then, the patient goes ‘doctor shopping’, until another doctor agrees to fill a prescription. Eventually, the person addicted to opiates will quickly switch over to heroin, which is much cheaper and easier to obtain. Budsock adds that, “The purity of the heroin we have in the US, which in some cases is mixed with Fentanyl, a pharmaceutical drug, made in labs in the US or in China, makes the overall combination very potent and sometimes deadly. That’s why this has become an epidemic in the US.”
Accidental death by overdose has surpassed road accidents as the primary cause of death in the US. Approximately 47,000 individuals are dying from accidental overdose each year.
Integrity House and the Medicaid Institution of Mental Diseases Exclusion (IMD)
As described by Budsock, “The IMD was written into our Medicaid laws back in 1965, so it is an antiquated rule, and it was put in place to ensure that states were not warehousing the mentally ill and using federal funds to cover the expenses of this.”
The unintended consequence of this is that individuals today on Medicaid don’t have access to residential treatment. Unfortunately, fixing this by repealing the IMD exclusion would cost anywhere between $200 million to $1 billion a year. So, to this day, it prevents thousands of people from accessing the care they need. This is a major hurdle that will need to be addressed, so that all people who need help actually get it.
To read more about Robert Budsock’s testimony on drugs and Integrity House to the Senate, read the following article.