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Juliana: Welcome to the second episode of They Are Us, where we’ll continue to share stories of resilience and hope from folks in recovery and experts in the field. A big thanks to everyone who tuned into our pilot episode. We really appreciate your feedback and topic suggestions. I’m your host, Juliana and I work with Central City Concern or CCC here in Portland. We’re a nonprofit that provides housing, healthcare, and employment support under one roof. In today’s episode, we’ll dive into what’s happening in our community right now when it comes to the types of substances people are using and how things have changed. I’ll be talking with Bryce who overcame decades of addiction, and we’ll also hear from Dr. Amanda Risser on innovative treatment methods she’s using to get folks on the road to recovery. Let’s get started.
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Juliana: After decades of drug use, Bryce began his recovery journey at CCCs, Hooper Detoxification and Stabilization Center, also known as Hooper, where he was treated for his fentanyl addiction. He then went on to receive primary and mental health care as well as supportive housing. Bryce is now working at CCCs Employment Access Center, helping folks newly in recovery navigate the job market. Welcome to the podcast, Bryce.
Bryce: Thank you. Happy to be here.
Juliana: Alright, well, let’s get started. I’d love for you to first tell me a little bit about yourself, your background, and how you ended up in Portland.
Bryce: Sure. I had a pretty big party background from about the age of 13 until 23 when I decided to move to Portland. I worked as a server, I skipped college. I just went straight into the college parties and had built up some pretty bad habits by the time I was like 22, 23. So when I moved to Portland, I wanted to stop drinking and I wanted to stop doing drugs before I ended up as a 50-year-old coke-addicted waiter in my hometown.
Juliana: Yeah, the restaurant industry is, it’s tough for people who have addictive personalities, right?
Bryce: It is, yeah. But as I learned a geographical move for drug addiction, everywhere you go, there you are. And so it gave me a chance to kind of get a clean start moving to Portland. I came up here also with the dream of being a big city barista. I had worked in a specialty coffee shop in a small town in northern California. I had received a pretty big education in coffee and specialty coffee, and so I would read Barista Magazine and see the baristas in San Francisco and Portland and Oakland that worked for these big single origin coffee providers. And that’s what I wanted to do, and I felt like I had kind of given up on that. So, moving to Portland was my chance to do that. When I got to Portland, I had worked a couple of jobs. By the time I started making money again, I started to meet people. I started to party more. I started drinking again, and it didn’t take very long before I was using again. I started experimenting with pills. I was doing ecstasy and cocaine, smoking weed all the time. By the time I got into my late twenties, my cocaine addiction had gone from something that was something I did casually with friends to something that I did all the time by myself. And then in my early thirties is when I started experimenting with heroin and crystal meth, and that’s when my story got a lot darker. I was starting to lose jobs a little bit here and there. And when I was 31, I’d lose a job. I would pick up another job. When I was 31, I picked up a job downtown, and that is when fentanyl started becoming really prevalent downtown. I had a pretty regular heroin addiction at this point. I was at my dealer’s house and he didn’t have heroin and it didn’t seem like he was going to have heroin anytime soon, but he did have fentanyl. And I remember being really scared. I asked him, I’m like, “I don’t know, is that safe? I don’t know if I can do it.” And he’s just like, “well, I mean, I’m doing it. You can either be sick and not do it, or you can do it and not be sick.” And so it didn’t take very long before I just decided to try it. And I got a huge rush like I had never felt before in my life. We were also mixing it with crystal meth too, which I think amplified that rush. It was the most powerful thing I had ever felt, that first hit of fentanyl. And yeah, that is when I went from thinking that I had it under control to realizing I did not at all.
Juliana: Okay. So you’ve realized that you’re addicted. It’s probably really scary. What got you to take the first step and go to Hooper? Let’s talk about that journey.
Bryce: So the first step for me, I mean, I ran out of money, right? I had exhausted all of my resources and after numbing your body with the most powerful opiate that you can get on the market for a year and then cutting yourself off from it, your body gets really uncomfortable. And so I was in a lot of pain. I was really sick. I was nauseous. My back was aching. I couldn’t sit still. I remember crab walking around my apartment because I couldn’t sit still, and I would just roll. And so after about three days, I reached out to a friend back in California who’s a medical dispatch person, like people call 9-1-1, and she picks up the phone. And I let her know, “Hey, I have a really bad problem here with opiates and I need help. I don’t know what to do.” And she told me that I needed to go to the ER. At that point, I was so sick I couldn’t pull myself out of my basement bedroom to get up my stairs out the front door. So she called a friend for me. That friend came over, he pulled me up over his shoulder. I’m a pretty big dude, and he brought me upstairs. He brought me to the ER. I sat in the ER for about four hours waiting to see a doctor while people were coming in with real ailments, like missing fingers and blood all over their clothes. And I’m going through a withdrawal and I just felt kind of silly, but I couldn’t sit still.
Juliana: Yeah, that’s a note there. That is a real ailment.
Bryce: It is. It is. But in my mind, I felt so ridiculous at the time, and it was one of the first times in my life, and especially in my addiction, where I had to realize that I wasn’t in control of the situation. They gave me something to calm me down when they went in to see me. I was expecting a lot of judgment because I got it from the woman at the reception desk. But the doctor that I talked to, they had seen this before and they were just like, “okay, well, yeah.” And they gave me a piece of paper that had the address for Hooper Detoxification Center on it. And that was my first trying to get to Hooper, my first experience.
Juliana: Alright, let’s talk about your first time and then talk to me about how many times it took and what changed for you between visits that finally made it work.
Bryce: Sure.
Juliana: Alright.
Bryce: So my first time at Hooper, it was really scary for me. I didn’t know how long I was going to be there. There’s a line full of people that are very sick waiting to get in. You fill out your paperwork and hope that you’re going to get in. And fortunately, I had gotten in and when I talked to a doctor, he had asked me how long it had been since I had used fentanyl. And at that point it had been about three, four days since I had used fentanyl. And so he was able to give me medication and I instantly felt a sense of calm. My whole body just calmed down. I kind of smiled. I ate some lunch. I got to go lay in a bed and I just relaxed, fell asleep. It was the first time I had been able to fall asleep in half a week at that point. When I woke up, I had a doctor come talk to me. I remember breaking down in tears as I was telling her what I had been going through. I felt so much shame for something that I really didn’t have any shame about while I was doing. I was just doing what I had to do, but realizing what I had been putting myself through what I had been putting other people through, and the amount of effort it was taking all these people at Hooper to help me. It really made me feel really low. But I was very grateful that they were able to get me in there. I got to get some sleep. I watched some movies, drank some diet lemonade, ate some food.
Juliana: Got some normal stuff, right?
Bryce: Yeah. Had medicated assisted withdrawal basically. And yeah, it kind of restored some peace in my body, in my mind over the next couple of days. I remember going into a men’s group because they would hold groups in there to try and help us figure out what our plan was going to be for when we got out of Hooper. And my counselor asked me, “what is your plan for when you get out of here? “You guys already gave me the pills. I don’t need a plan.” And everybody in the room laughed at me and I realized like, “oh, you guys have all been here before.” This was my first time. He told me that medication wasn’t going to be enough for me to sustain my sobriety and that I was going to need to start going to meetings. I was going to have to get a sponsor. I was going to have to start doing 12-step work. And that all just seemed ridiculous to me. I was just like, “no, I’m not a real addict. I don’t have to do all that. That doesn’t apply to me.” I still had my job downtown and I would walk past the drug dealers every day. And at this point, it was really bad in Portland. There’s still drugs downtown, but it’s nothing like it was in 2022 where it was like the streets were flooded with fentanyl. And so I’d have to walk past these drug dealers and be like, “I’m not going to use drugs today. I’m not going to use drugs today.” And then I would find myself buying drugs and using them before I started my work shift, mixing it with meth to get through the days to stay awake. And so, I went back to Hooper three more times after that. I’ve been to Hooper Detoxification Center as a client four times. The second time I went back in there, I had a relapse, unfortunately, because I had stashed some fentanyl away in my room in a book, and it fell on my chest while I was reading. I was at home trying to be a good kid, and my drugs fell on my chest and I used, and then I continued to use for the next week or so. Um, after my third time in Hooper, I still had some methamphetamine and I wanted to use it to get through my dishwasher shift at work because I was just struggling with really low energy. I didn’t have a lot of motivation, but I had meth. And so, I didn’t want to go through the fentanyl withdrawal anymore either. So I went and bought myself some Xanax off of the street to help myself come down from my methamphetamine high so I could use meth while I was at work. And then I could come home and I could eat Xanax and I would go to sleep, and then the next day I would use more meth and go to work. That was my plan. And what actually ended up happening was I blacked out for about four days, woke up after four days, throwing up and one of my roommates saying, “Bryce is alive.” And I just thought like, “oh, this is not good. And I was like, “is it Tuesday?” They were like, “it’s Thursday.” And I just realized kind of in that moment that I could no longer do drugs and the drugs were not working for me, which was a sad realization for me because I had built my whole life around drugs. My whole identity was around drugs since I was 13 years old. I was the guy that did drugs and that could get you drugs. And drugs were everything that I knew. And so I kind of had to accept that I had gone a little too far down the barrel at this point and that I needed to get myself out.
Juliana: Right. Yeah. Alright, well, let’s talk about Hooper the fourth time. Let’s talk about this. This is the part that’s really amazing. So, tell us about the fourth time and what you did after that.
Bryce: Yeah, you’re right. This is the amazing time. This was the time where my life actually got better, um. And so I went into Hooper. This point, I had a pretty good rapport with my counselor. He knew me really well from going to Hooper the three previous times. And I let him know like, “Hey, I’m trying to do this for real this time. I want to get into a sober living program. I want to go to treatment. I want to go to meetings. I want to do whatever it’s going to take for me to actually get sober.” I ended up getting an interview for the Recovery Mentor Program after about a week. I could tell that the mentor who had been interviewing me, had been through a lot. She was asking me, “Are you really going to take this seriously? Are you really going to go to meetings? Do you really want to stay sober?” And I was like, “I do.” And she was like, “yeah, we’ll see.” And I still think about that all the time. I work right around the corner from her now, and I like to go check in with her and be like, “Hey, look, it’s been two years. I’m still doing it.”
Juliana: And I bet she’s so proud of you.
Bryce: She is, is. So, yeah. I got myself into the Recovery Mentor Program. I had a room at the Estate Hotel downtown Portland, a mere three blocks away from where I bought and used all of my drugs in my addiction. I got myself some medical care through Old Town Clinic. I got myself into treatment and all with the help of my mentor. I didn’t do any of this by myself.
Juliana: You had support of somebody who had lived experience, knew what it was like for you. And they helped you do all this navigating.
Bryce: Exactly and from what I understood, the requirement for me to live in this program, it was going to be a five to nine month program where I had to stay sober. I had to take drug tests. I was going to have to do volunteer work. I needed to go to treatment three days a week. I needed to go to meetings every day. And I took it really seriously. I took it like my life depended on it. I knew that if I had failed this program, I was going to get kicked out onto the street. I wasn’t going to have any sort of backup plan, and I would be back on fentanyl and dead in two weeks. More than anything, there was times in my addiction where I didn’t care if I lived or died, but now that I had kind of a grasp on this option that there was a future for me, I knew I didn’t want to die. And what happened by taking the suggestions is my life got better. And yeah, I started to work my 12-step program. I worked on a program through AA. I was probably on my eighth or ninth step by the time I graduated the Recovery Mentor program. I graduated at five months. I had 150 days to the day. And that is how meticulous I treated this program. It turned me into a soldier for recovery, essentially.
Juliana: I love it. Okay. This is the fun part. This is the really fun part. Tell us what you’re doing today and tell us a little bit about your relationship.
Bryce: Yeah, so today I am the trainer for CC Staffing’s Employment Program, our on-call staffing program. We have a fresh class of CC staffing trainees that are coming in either out of recovery, they could be coming in out of prison, they could be coming in off the streets and having either never had worked at all or haven’t had worked in a long time. We hire people that have records. It’s basically a low barrier employment reentry program.
Juliana: Yeah, Okay.
Bryce: And it’s just a real big honor for me, especially coming through as a client of Hooper, coming as a member of the Recovery Mentor Program, going through our treatment and our clinical services. I am honored to be a part of Central City Concern’s team and that I get to set people up kind of on their first step in employment towards a career path.
Juliana: That’s awesome. I love that so much. I love watching people like you and these successful journeys are beautiful. How’s your personal life?
Bryce: My personal life is great. I am newly engaged. I proposed to my partner…
Juliana: Congratulations.
Bryce: Thank you. On Christmas eve. I met her at the Alano Club in one of our 12-step recovery meetings. And she was so cute and had this shiny little gold tooth, and I just saw it sparkle, and I thought she had the cutest voice. And I was like, “wow.” So I asked her out on a date and she avoided me for months, and now we’re getting married next year.
Juliana: Awesome.
Bryce: It’s really beautiful. I’ve been living with her for about a year now. So I’m no longer in public housing with CCC anymore, and I’m on my way to living a pretty balanced, resilient life and starting a family of my own, when two years ago, I thought I was knocking on death’s door.
Juliana: Wow. Thank you so much for being here today. Really, really wonderful hearing your story. It’s really going to make a big difference in people’s lives. Thanks for coming.
Bryce: Okay. Thanks for having me.
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Juliana: My next guest is Dr. Amanda Risser, Senior Medical Director of Hooper Detox Center, and is responsible for primary care and substance use disorder services across Central City Concern. We’re going to discuss how her team is using Bupinephrine to treat over 800 folks affected by highly potent drugs currently on Portland’s streets. Hi, Amanda. We just heard from Bryce about his struggles with fentanyl and his journey through Hooper Detox Center. Can you share a few reflections on his story?
Amanda: Absolutely. He’s clearly got a lot to offer our community, and I’m just so glad that we were part of his recovery journey. So that’s just really satisfying to me as somebody who leads that program to know that he had such a good experience. I think a few things stick out to me that are both very, very normal, but also part of the challenges that folks we care for face. Bryce was struggling with opiate use disorder, stimulant use disorder, cocaine, and then ultimately stimulants, methamphetamines. Sounds like alcohol use disorder was something that he was struggling with prior. And so, the methods we apply to those different use disorders are varied, but the research shows that anyone with any kind of use disorder often needs about seven attempts to stop before they’re successful for at least a year.
Juliana: Okay. What else were you thinking about when you were listening to Bryce?
Amanda: Something that has happened in our communities and something that he really highlighted through his story was that after a certain point, heroin is just not available to people. So, heroin is a substance that when you use it either by smoking or injecting, it lasts a few hours. And so, if somebody is feeling really unwell from withdrawal, they can use heroin and it’s, there’s certainly lots of risks with using any opioid, but heroin was a little less potent. People were still absolutely at risk for overdosing, but it was a little less risky than fentanyl. Bryce’s experience where he essentially, in order to feel well, had to use fentanyl, smoke fentanyl every two hours is very normal. So, imagine using a substance that in order to feel well, you essentially had to, because of the way your body metabolizes that substance, you had to use it every one to two hours while you’re awake. It’s very difficult to get anything done and it’s very unsafe and it’s very potent. And his experience of using stimulants along with fentanyl, there has always been kind of a pattern or practice of using stimulants along with opioids for some users, but certainly not at the levels we see now where up to 80 to 90% of folks using fentanyl are also using stimulants.
Juliana: Wow.
Amanda: Yeah.
Juliana: Okay. A lot of folks really get confused between the difference from fentanyl versus P2P Meth.
Amanda: Well, P2P meth has been around a long time. It’s not new. And methamphetamines and any other stimulant like cocaine has always had the potential to cause psychiatric problems. So they did studies back in the seventies where they exposed, I think it was Stanford students to high levels of stimulants. And by the end of the research, everybody was hallucinating. It’s just what happens to people’s brains when they’re exposed to stimulants like methamphetamines, Dexedrine, really, any stimulant has the potential for causing that. So, I think there is this idea that P2P meth is new and it’s permanently scrambling people’s brains. And that’s certainly what has been kind of highlighted in the press. I think those of us who practice addiction medicine do know that people who use methamphetamines regularly in high levels are at risk for having psychiatric problems. And I don’t think it’s necessarily because of new types of meth that are on the market. I think that might be part of it because the drug supply tends to evolve towards more potent and more dangerous, partly because of the pressures we put on it from policing drugs because marketers and manufacturers want to make it smaller, more portable, more easy to transport. And that’s a huge part of why there was this transition from heroin to fentanyl around the pandemic. So, I think it’s a little bit about these more potent and different forms of meth, but I think it’s also unsheltered houselessness with co-use. We know that being unsheltered drives use because when folks are awake or unsheltered in dangerous environments, there’s this sense of needing to be vigilant, needing to be awake in order to stay safe, needing to be awake and busy so that you can do all the things you need to do to survive and hustle for your next dose or whatever you need to do. I think it’s more complicated than just the quote unquote new forms of meth, which P two P has been around for a while.
Juliana: Okay, great. Thank you for that explanation.
Amanda: It might have been too much.
Juliana: I learn something new every single time I hang out with Amanda. It’s amazing. Let’s talk a little bit about stigma. Please give a few examples of the stigmas and systematic barriers that get in the way of interventions.
Amanda: How many hours do we have?
Juliana: I know this is a big question.
Amanda: Okay. So, I’m going to talk from the perspective of an addiction doctor here. So, I’ve been prescribing a medication called Buprenorphine for, since 2003. It just became very clear that methadone and buprenorphine were equivalent in terms of their efficacy for folks with use disorders, opiate use disorders, and were safe in pregnancy. They are some of the most effective medications that you can imagine for opiate use disorder. And there are only 10% of people that have an opiate use disorder are receiving those medications nationwide.
Juliana: Why is that? This just sounds crazy.
Amanda: Stigma period. So, I love my ER colleagues. They do crazy stuff all the time. I just got, that save people’s lives every day. I’m just so grateful. If I have an emergency, I’m going to be grateful for whatever interventions they give me. If I were somebody with an opiate use disorder, there’s not really any emergency departments in the community that regularly provide folks with these lifesaving medications. Somebody comes in and survives a non-fatal opioid overdose, they have a chance of dying in the next month. So what Bryce experienced where he was essentially crab walking and rolling around his floor for three days, that’s the kind of thing that we are seeing at Hooper as the drug supply changed from heroin to fentanyl – is that strategies that we used that were effective and relatively comfortable for folks when they were using heroin or other opioids were ineffective when folks were using fentanyl. So, we had to work really hard to come up with ways to make people comfortable, because even despite our best interventions with that discomfort he was describing, people feel like they’re crawling out of their skin.
Juliana: Wow, I commend you for sticking with it because that’s a real game changer for folks. So Amanda, what inspired you or led you to this type of work?
Amanda: I’ve just always liked these patients the best. My favorite patients have always been patients that I’m helping and supporting through dealing with their use disorders. And because it was just so early in my career, I was prescribing a fair amount of buprenorphine, and I saw how effective it was. I’d offer them this medication that I knew would almost immediately cut their risk of death in half and make them feel better. And they would come into my office uncomfortable, and I would provide them with medication. And I’d be like, “I’ll be back in 10, 15 minutes. I’m gonna see a couple patients.” I’d come back and they would be smiling, they’d be relaxed, they’d be relieved, and they’d be grateful. And that’s just a great moment in any primary care provider’s day. So that was early on, I was just like, “Uh, so satisfying.”
Juliana: So when you are able to have that moment where somebody feels better, which is really important to you, does that make for a better experience in terms of getting them additional care?
Amanda: I hope so. I just really feel like one of the most important things I can do, the medications, of course, are really important in their lifesaving and they’re super effective, is to just see people, hear them, talk to them about their lives. And hopefully, my goal is always to get to the point where, yeah, we talk about their use disorder, but we also talk about their dog and their mom and how they went fishing with their grandpa when they were little, and how their life, even when they’re unsheltered and using, is valuable and they have connections and they have things that are important to them, and they have dreams, and they have – we can just connect on a human level and just care about each other. That is gold to me.
Juliana: Awesome. Alright. Well, if you had three wishes…
Amanda: Yeah.
Juliana: What would you wish for our clients?
Amanda: I want them to feel that they are valued and important. I want them to feel like they deserve high quality evidence-based care that gets them more comfortable and more connected. I want everybody to have a treatment bed. What Bryce described is this kind of process where sometimes folks at Hooper are prioritized for treatment beds because they’re in detox. I want people to have multiple ways to access those services, and I want people to have multiple pathways to recovery. I want folks to have a variety of choices in terms of support, social support, treatment support. I want people to be able to access medication whenever they want to, on demand with very low barriers. That’s more than three wishes.
Juliana: That’s ok. Those are some pretty solid wishes though, and I wish for that too. Thank you so much. As always, I learn something new every time I talk to you. I appreciate you being here today. Thanks for coming.
Amanda: Oh, you’re welcome. That was really fun. Thank you.
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Juliana: Thank you for tuning into They Are Us. Email us at podcast@ccconcern.org with questions and topics you’d like us to address in future episodes. You can also visit central city concern dot org to learn more about what you heard in this episode. Until next time, I’m Juliana.
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