Helping Dental Patients on Recovery Journeys


A conversation with Dental Products Report Contributing Writer Lisa Newburger, LISW-S, and the Founder of Project White Butterfly, Sara Szelagowski, about best practices when caring for patients on recovery journeys.

Video Transcription

Lisa Newburger: One of the things that really concerns the dental industry is that the opioid crisis and taking a look at what are they to do when they get someone coming in who is medication seeking. And you know, they're trying to be responsible, and they just would really like to be able to have some guidelines or some ideas that you might be able to share with us as to what to look for.

Sara Szelagowski: Well, that's interesting that you asked me what they should look for. Because with my ex husband, his dentist was actually one of the first people who asked him if he had any type of, you know, substance use disorder because of the condition of his teeth. But honestly, I think the best thing that anyone can do across the board, and especially anyone in a field where, you know, they may have an encounter with someone and see the signs that they may be using some kind of opioids that they be prepared to have that conversation in a very, as, as compassionate approaches they can take, um, you know, not not to be like, "Oh, my gosh, have you been using?", but to take a stance and maybe say, "Are there any medications in your history?" and maybe start there and get the ball rolling that way.

And then to be equipped with resources and just say, I know a great place, you know, if there's anything that you might want to talk about further with someone else who you may be more comfortable with, here's a great reference for you. And it really is preferable, I guess I could say, to individuals with substance use disorder to speak to someone who has been through the experience. So with the agency that I created, Project White Butterfly, what we try to do is to go to these kind of these agencies that are not directly created to treat individuals with addiction, but who the individuals may frequent at their establishments. So areas such as CSL plasma locations, we have targeted, because from experience, I have friends who have donated plasma to get money for, you know, their habit. And so a dentist, same thing, you know, there's access, they may know the signs, they can see the signs, they can pass along a card or have some information in their office. And so if we can start connecting all of these agencies on the same platform and starting to break down that that stigma, and you know, that judgment that people feel, and just have things be a little more open, and
, what is the word I'm thinking of, a little more holistic, maybe in their approaches, I think that would be a wonderful step for any any facility.

LN: Because we did a Mastermind group earlier this week, and one of the things that came out is that dental hygienists have a different relationship than the dentist that the dentist is in and out or just doing a procedure or checking your teeth and it's not really having that conversation. Whereas a dental hygienist you just like, uh, excuse my pun, like a bartender, it's somebody that you tend to talk more to.

SSz: Exactly.

LN: So and that you trust and that there's more comfort level because of their relationship. But the question that came up is that how do you not offend somebody? Because there's a fear that a the person might react very strongly and then never come back? Or would just be really irate. And they're, you know, there's some professionals who are just a little bit gun shy and uncomfortable and starting those types of conversations.

SSz: I don't know that there's really any, any direct answer for that each person may have a different reaction on any given day, they might have a different reaction, taking into consideration how recently they may have used if they haven't used recently, and they're not feeling well. My addiction had me, you know, sometimes lashing out at the most random comments or anything that I was able to somehow twist in my mind to take as offensive.

So I don't know that there's really a direct answer for that. I think, the most. The most useful tip that I have is try to just hide your face. You know, you may be thinking in your mind, oh, I can't believe this person saying all of this to me if someone does start opening up and just do the best to keep it okay, you know, a neutral and comfortable environment with body language is one of the things that I think puts a lot of us off, and we can take a glance or we can take a tone and twist it the wrong way. So, you know, just remaining as composed and natural as possible, I think is the best approach. And, and like I said, I'm not sure that there's any key phrase or, you know, any words that we can we can give you that, you know, maybe those keywords that can help unlock and open up those conversations. It just kind of depends on the person's mood, I would really, I would really just suggest, let them take the lead. And if they start talking about things, just roll with it, and use open ended questions and just try to get them talking about things. How do you feel about that? You know, questions that might draw out a little more information from them. And I think that really is just the best way to try to deal with that.

LN: Well, the good news is with a pandemic, and as a dental professional, their face is covered. So it's just the eyes and the other parts of the nonverbals. But you do make a very good point, which is that people do. They're able through their body and their tone to be able to sound judgmental, and that even if somebody isn't meaning to do that, sometimes it could be how it's being interpreted, or whatever's going on for individuals. Right. Right. Exactly. Yeah, the dentist had said that one of the things they have seen is when people are coming in saying they have allergies to certain medications that they might be trying to prescribe, and are very specific about what drug and what dose they want, and kind of been a red flag for them. Right. But it really has been something that they said hasn't been as noticeable when it comes to if someone is farther along in their addiction, they're usually not coming to the dentist. Or if they come to the dentist, it's because they're in pain and very true.

SSz: Very true. So yes, and even, I have had friends who even would just go to the emergency room rather than to a dentist if they were in such a dire situation. But it's true. I mean, on it, the personal hygiene takes a backseat when we are actively using it's not at the top of the priority list. And until it's becoming an inconvenience really

LN: So true. And it's just something that people don't really realize that we're not going to stereotype and look at someone and think, oh, no, that person has a problem. Because one of my concerns also is the people who are abusing prescription medication, and alcohol and wine, that, you know, somehow because we're a drinking society, that it's all kind of understood and forgiven. And I really don't understand, just because something might be an illegal drug. You know, when you take a look at for some folks, it started off with a pain issue and a medication and then the medications the doctors wouldn't prescribe. And then they went on to self medicate and be it alcohol or eventually getting to illegal drugs.

SSz: Right. Right. And I think I think that's one of the things that is so sad, you know, like you said, we are drinking society and, and, you know, business drinks and cocktail hours and going out with people after work and all of that as a social activity. And the stigma that surrounds addiction has really just, it has become a barrier for so many people and even even the family members of people with addiction, you know, the shame of that stigma and not wanting to talk about a family member's addiction, really, it ripples through families. And I remember in my own family, when my parents found out I was using, they weren't sure what to do, they weren't sure who to talk to, if they should talk about it, what they should do. And that's one of the things that you know, there's so many there's so many efforts out there trying to help, you know, turn the stigma around and just show people the the root of addiction and where it comes from and how it happens and how it really could be anybody and Project White Butterfly did an event this summer where we tried to take some common common myths that people have these ideas around people with addiction, and and present them in an artistic way.

We did kind of a gallery style art display that just put the facts in front of people's faces and let the truth out on addiction because when when sometimes we get so wrapped up in these ideas that we have in our head, and when we see it presented in a new way, it really makes us open our eyes and think oh wow, was I really? Was I really judging that or how can I not see that there's so many people with addiction around me. And so, to have it to have things so different for people who are wine drinkers or you know, drink alcohol and go out to the bars to people who are with the street drugs. I think really the difference there is just the stigma around it. It's just You know, there's so many words in the stigmatizing language that surrounds addiction as opposed to a cocktail hour or, you know, a business meeting where everybody's drinking, it's just it completely changes how, how we perceive it in our minds.

LN: It really is true. I, we had somebody on our street who the, the adult, or the teenage son had DUI and had hit someone, I'm not sure if the person had died or was just injured. And there was the stigma that we watched the family go through, but then there was this, because it was alcohol, it's kind of viewed a little bit differently, which it's a drug. Right? And then, it just, it's altered many family's lives, not just the individual who got injured, and the person who have the addiction. So absolutely. So I wanted to take a couple of minutes here, just because I didn't properly introduce you. And to give you a chance to just kind of talk a little bit about your background, and more about the project that you're working on.

SSz: Mm hmm. So my name is Sarah Szelagowski. I have a lived experience and actual active addiction. I was addicted to heroin, crack cocaine, pretty much any anything that would take me out of myself, any drug any. I have almost 6 years sober. We don't like to count time ahead, but October 7, will be 6 years sober for me. And I just, life has changed since I got sober. And I know sometimes that sounds really cliche to say, but I have really found myself and found my passion and my people honestly, going through that pain, and that hurt. And the ripple of pain that I created in my addiction has elevated my family and myself to a new level where we do have this compassion. And you know, we're talking about this stigma that exists around drug addiction. And you know, I am just working my butt off to try to reach out to people who are still struggling in active addiction. And let them know that there are so many agencies, so many businesses, so many, so many, so many resources out there for people with addiction to help get them to a healthier place.

I have lost a lot of friends and a couple relatives to drug overdoses. And it's just, it is a pain that I'm I'm tired of seeing. But I know that it's going to continue, we're never going to completely eradicate addiction. But we can absolutely make the effort to reduce some of these numbers that we have seen rise, especially during COVID. Last year, we had a record setting year for overdose numbers. And it's just, you know, knowing that 93 over 93,000 families are out there in the world without someone that they love because of a preventable death is really just it's unacceptable in our country, you know, with the amount of resources and, and funding and all of this that we have, there's no reason that that those numbers should be so high.

So back in 2019, I started an organization called Project white Butterfly, not at all with the intent to start an organization. But it was a mission that a few friends and I started one night, just in an effort to kind of make ourselves feel better after having lost a few friends over the summer. We went out we wanted to try to reach out to people we started placing cards, with handwritten encouraging messages and some numbers for local resources in them. in neighborhoods where we know people are using where we know some of our friends may have been. And we posted on social media about it. And other people wanted to join in and wanted to help out. And here we are 2 years later, and we have state funding now. And we are working throughout Cuyahoga County directly in the streets providing outreach and resources to individuals with addiction and to community members who want to support individuals with addiction or be of service and carry Narcan to help reverse overdoses should they see them. We send our cards around the country and even a couple out of the country we have sent so that people in other areas can can utilize the same effort and just put a kind word out in the universe and some resources for people to find so that they can find their way to help and you know, we just we do a lot of work educating people about addiction and trying to reduce that stigma and let people know, you know, it can't be overcome. And the best way we can do that is to not judge to not shame to not come down on the person who is using but rather to you know surround them with love and compassion as much as we can, so that they can get rid of they can start moving past that self shame that we have, and and get to a healthier place and start taking those steps to have a better life.

LN: Sarah, you have your work cut out for you. What really strikes me about your project is being out on the streets and passing out Narcan. And I just can't, I can't tell you how much I respect that. And as a previous drug treatment counselor, you know, you're you're fighting the war in the trenches. And so thank you for what you're doing, because you're saving lives.

SSz: It has been an amazing summer, it really has, we've passed out over 1200 boxes of Narcan since the beginning of May. And we, again, it's to, you know, not only individuals who are using, but family members who have someone who may be living with them who's using or just, you know, a family member who is using, we have passed them out to people who know nothing really about addiction or anything, but they've seen it in the headlines, and they know it's an issue. And so they want to carry Narcan to be prepared. And, you know, we tell people it is not, we're handing it out for free on the street. But there, there's footwork that goes behind that, because those you know that it does cost money to have that, that resource available. And so we're doing the work just to try to, you know, make things a little easier for people who are right there on the frontlines.

LN: So true. And I'm just going to say thank you. You were referring to Cuyahoga County that's in Cleveland, Ohio. But I think your point is well taken, which is for the dental professionals to be aware of what resources in their community, whether it's contacting a local drug treatment center and asking their admissions department for referrals as to where to send someone or what to do. But there are, as you said, a lot of resources available and since it goes out nationally to you know, let people know that in their own communities, there are initiatives and things.

SSz: Absolutely. And I think that's the best thing, if, if we know that it's a problem, and we have a concern of how to deal with it, the best thing we can do is educate ourselves about what the resources are. And, again, to have that conversation with someone and to not be shocked, you know, maybe if they open up to you and to be able to say, well, here we have this great resource. You know, we've heard great things about this place, maybe give them a call. And you know, you never know they may not pick up the phone that day. They may not pick up the phone, you know that month, but that seed is planted for them. And when they're ready, they will absolutely I promise they will absolutely remember, oh, this person said this place and maybe I should give them a call.

LN: Well, thank you for joining us tonight. Sara. We really appreciate what you're doing and the information that you're sharing with the dental professionals.

SSz: Thank you very much. This was so fun.

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