How Steve Carleton Of Gallus Medical Detox Centers Is Helping To Battle One of Our Most Serious Epidemics
“Leave it at the office” is not realistic or necessary. Coming up I was told falsely that if I thought about something outside of work it was a sign I was getting burned out. I wish someone had explained that it is healthy to be sad and disappointed. Developing outlets to safely and without judgment vent about things that happen is critical.
As a part of our series about “Heroes Of The Addiction Crisis” I had the pleasure of interviewing Steve Carleton.
Steve Carleton is a Licensed Clinical Social Worker and Certified Addictions Specialist. He has been practicing in the field of substance use, trauma, and mental health for 16 years. Steve worked in the Department of Veterans Affairs for 10 year and is a professor at the University of Denver Graduate School of Social Work. Currently, he is the Executive Clinical Director of a cutting edge medical drug and alcohol detox facility, Gallus Medical Detox.
Thank you so much for doing this with us! Can you tell us a bit of your backstory?
I have been coaching and helping people since my first job at the YMCA at age 12. In my late adolescence I had personal struggles with mental health that led me to get involved with Outward Bound. It was in my early 20s that I interned and became an instructor there. Having grown up in Dallas I had minimal exposure to the outdoors and this outlet was transformative to my development and growth. Honestly, I haven’t looked back since to my calling as a listener and helper.
Is there a particular story or incident that inspired you to get involved in your work with opioid and drug addiction?
Many of the people I love most in the world have struggled with addiction. Both of my grandfathers had severe gambling addictions and substance use disorders runs on both sides of my family. It is something that I experienced and learned about from a young age. My parents fortunately were always open and willing to speak about it. My work at the VA was really what solidified my interest in opiates and addiction. When I started treating veterans with substance use disorder and PTSD I realized that substance use more often than not is a symptom. The reality is that substances do provide relief and benefits for people struggling. Sadly that answer has diminishing returns over time but once I realized people are doing their best it inspired more compassion.
Can you explain what brought us to this place? Where did this epidemic come from?
Drugs have consistently gotten more efficient and powerful over time. We see trends in every drug class — cannabis, sedatives, stimulants, and obviously opiates — of more concentrated products. Culturally, we want things to work better and faster and unfortunately that has also shown up in how people medicate themselves legally and illegally.
The criminalization of substance use disorders has also not helped. We’ve driven a normal human behavior into the underground over the last hundred or more years. While I think drugs should be illegal, the overemphasis on law enforcement has only deepened the secrets and made the path towards recovery more challenging. If you have felony drug charges and have served time in jail or prison you are left with extraordinary challenges to recover.
The Covid Epidemic has also led to significant stress and isolation for many. Many addictions experts hold the opinion that the opposite of addiction is connection. In an instant people lost connections, at least in person connections. Again, substances are a normal and natural way humans have coped throughout our history. In an age of uncertainty and fear about our global future people started to use more.
Can you describe how your work is making an impact battling this epidemic?
Perhaps the single largest driver to continued use of opiates is fear of withdrawal and the cravings that are standard in opioid use disorder. At Gallus we are pioneering a better and more compassionate way to detox people and get them connected to next levels of care. We have a proactive approach to detox where we get ahead and stay ahead of withdrawal symptoms. In doing this people’s anxiety and fear are reduced. That creates the space for meaningful conversations with our patients and their family about recovery and support they will need after Gallus to stay on the path.
Through our work and data collection at Gallus we are also trying to help insurance companies understand why what we do is so critical and cost effective. Over time we hope to establish our model of detox as the industry standard.
Wow! Without sharing real names, can you tell us a story about a particular individual who was impacted by your initiative?
Last year we had a gentlemen that was forced into treatment by his family. He had been to countless detox and treatment facilities but had never been able to get over the hump. He was understandably angry and depressed when he arrived. After a few days he was astonished at how well we managed his symptoms. He had never had the experience of being comfortable and well cared for in detox. He conveyed stories about having to beg providers for medication and help with symptoms. This patient went on to a 90 day residential treatment program and returned back home to the family business. What happened next was the best part. He later sponsored an employee and friend in our program and then on to a residential program. It was the paying it forward and recovering out loud that stuck with me. We need more of that.
Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?
At the end of the day we are only as effective as our people. We have amazing nurses, behavioral techs, therapists, and doctors. Our average length of stay is 4.5 days but we so often get letters, emails, voicemails, texts from our former patients saying how appreciative they were for the care we provided them. Every week our content manager puts out testimonials from our patients satisfaction surveys and I am blown away by the overwhelming praise we receive. Here was a recent on, “It was honestly the best experience I have ever had with a treatment facility. The staff truly cared for me and made me feel so comfortable and safe” In this vein our patient satisfaction and NPS (net promoter score) is consistently above 90% which is unheard of in addictions treatment.
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?
Increase access to quality substance use disorder treatment, have compassion through understanding why someone is using, and stop arresting and imprisoning people struggling with addiction. In my home state of Colorado, access to care was the worst in the country in 2021. Only about 10% of people with a substance use disorder go into treatment. I think that stigma drives this parity more than anything. Our dialogs about substance use have improved but people still blame and are judgmental about those that struggle with substance use. We still look at this as a character defect rather that a way people are coping. Addiction does not happen overnight and secrets keep people sick. We need to continue to educate that substance use is a way people adapt, medicate, or cope with life and challenges. This stigma and lack of compassion is what perpetuates the cycle of locking people up and further ostracizes them from healthier communities and paths. We cannot police our way out of this problem, we must get people better access to quality help.
If you had the power to influence legislation, which three laws would you like to see introduced that might help you in your work?
I would eliminate felonies for petty drug possession of any kind to start. It just worsens the problem on a systemic and individual level. People have a hard time engaging in a recovered life with felonies over their heads and it costs $30k or more to incarcerate one person for a year. It just doesn’t make sense.
I would institute drug courts and mandated treatment for people caught using. One of the biggest myths out there is that people must be intrinsically motivated to get better. That’s just not true. Consequences from use are what initially get everyone to want to make a change. No one starts in treatment because things are going well in their lives. Those consequences don’t matter much though in long term recovery. What does matter is helping people identify the benefits of recovery. If you can help someone stop using, even through swift consequences, the potential for them to experience something new and better goes up.
More enforcement of the Mental Health Parity Act. The reality is that people have an extraordinarily challenging time accessing and paying for much needed care. Loopholes and low reimbursements create environments where quality of care plummet. Getting people into treatment will ultimately lower costs systemically and lead to more people recovering and going from strain on the system to contributing members of society.
I know that this is not easy work. What keeps you going?
I agree, it’s not easy work. Some days are easier than others for sure. I have a wife and two young kids at home that I stay involved with coaching their sports, getting outside as much as possible, and doing study hall with. That along with success stories help. It is easy in this work to hold on to the sad stories where former patients have relapsed and even died. I must try consciously to make the time to work through sadness and disappointment while simultaneously celebrating success and patients that have achieved some recovery.
Do you have hope that one day this leading cause of death can be defeated?
Absolutely! Recovery is possible and happens every day. The one thing that is constant in life and the world is that things will change. It’s not all bad news right now. Studies show that kids and adolescents try and use less substances than previous generations. We just all need to continue to talk about this problem and I believe that we will move towards more viable solutions.
How do you define “Leadership”? Can you explain what you mean or give an example?
I think leadership is being an excellent collaborator in driving a vision. I have tried to build a team of clinicians at Gallus that know more than me about something. That diversity in knowledge, experience, and thought is where better solutions come from. I also lead try to lead from the front. In my courses at DU I always demonstrate skills before asking my students to role play. If I ask someone to do something I need to know with confidence that I would be willing to do that thing as well.
What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.
- I wish someone had better explained that the most potent part of therapy is the relationship you build with someone. Techniques are important but not nearly as important as trust and instilling confidence that someone can get better.
- “Leave it at the office” is not realistic or necessary. Coming up I was told falsely that if I thought about something outside of work it was a sign I was getting burned out. I wish someone had explained that it is healthy to be sad and disappointed. Developing outlets to safely and without judgment vent about things that happen is critical.
- The first few years out of graduate school are the most difficult. I wish someone had explained that this is when you typically work with the hardest patients with the least number of skills.
- Your team and co-workers are far more important than your paycheck. Having supportive colleagues is so rewarding. When people interview at organizations ask about the team and supervision. Try to attend a team meeting and see if it’s a dynamic you want to be part of.
- Listen and reflect twice as much as any other skill. Clients and patients respond infinitely better to reflections and validations than they do questions. Questions in therapy are the least important tool we have.
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. 🙂
Recover out loud! I would love it all people that have found success in recovery would talk about it more publicly. We are starting to see this happen more, especially with celebrities. This instills hope and reduces stigma.
I would also love for elementary age kids to all be taught basic CBT. Just the idea that when something happens we tell ourselves a story and that story determines how we feel and what we do. My experience is that this creates more flexible thinking at a younger age. People become less rigid in thinking with this skill and anxiety and depression decrease.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
My wife has a small framed crochet tapestry her grandmother knitted that reads “grow where you are planted.” It always serves as a reminder that life happens in the seemingly mundane moments. Weekday and weeknight morning routines is where we spend most of our time. If I can enjoy and be present in those moments life is most enjoyable.
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. 🙂
I have really enjoyed Dak Shepard’s podcast, Armchair Expert. He is bold and I had tremendous respect for him after going public about a recent relapse he experienced. He had me in tears when he was talking about it. His childhood story and history I relate to on some levels. I don’t always agree with him and would love to discuss his view on Suboxone and MAT in general.
How can our readers follow you on social media?
I try to keep up and current on my LinkedIn profile. Also, our website www.GallusDetox.com has our many blog posts as well as our Pulse. Whenever we identify a new drug trend, we blast out a Pulse article to educate the community about any recent drug trends or dangers.
This was very meaningful, thank you so much!
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