SMART Policy Podcast
Podcast by the UT SMART Initiative. Host Jeremy Kourvelas speaks with experts from across the recovery ecosystem - representing healthcare, prevention, law enforcement and more - about local, state and federal drug policy to find out what is and isn't working to make this fight against addiction a little easier.
SMART Policy Podcast
What's Changing on College Campuses in Tennessee?
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You're listening to the Smart Policy Podcast, a production of the University of Tennessee's Institute for Public Service. If your plan is for one year, plant rice. If your plan is for ten years, plant trees. If your plan is for 100 years, educate children. This quote from Confucius is about 2,500 years old, but it rings true in modern Tennessee. Youth education has been a significant policy focus in the state for several years now, and education reform is one of Bill Lee's biggest targets for his entire tenure as governor. Fortunately, mental health and substance use prevention has become a significant part of this conversation.
SPEAKER_0126% of our young adult population meets the criteria for substance use disorder. And it's a problem that we really can't afford to ignore because this is our next generation.
SPEAKER_00In 2020, the Tennessee Together Student Survey found that the average age for first using a substance was 13 to 14 years old. Identifying and intervening at that age is thus crucial. Most of the time, however, the problem isn't caught until later, usually when the person is about college age.
SPEAKER_01What I've found is that if a student's gonna drop out of college due to substance use, it's most likely gonna be second late in their second term or second year and into their third year. And that to me lends itself to an alcohol use disorder. Because alcohol use can be a insidious and uh slow-growing issue, right?
SPEAKER_00My guest this month is Nathan Payne, Director of Collegiate Recovery at the Tennessee Department of Mental Health and Substance Abuse Services. We discussed how the attitudes on college campuses have changed over the last decade, becoming much more proactive about addressing unhealthy drinking habits and preventing substance use disorders. After all, if we're going to make a dent in this crisis, we have to head the problem off before things spiral out of control. We have to get through to the next generation.
SPEAKER_01Yeah, so my name is Nathan Payne. I'm the director of the Tennessee Collegiate Recovery Initiative. And so what that is, is a program that runs through the Department of Mental Health and Substance Abuse Services. And uh and the primary purpose of that program is to just um bring more conversations to college campuses about recovery and recovery support, uh, raise awareness about students that may be struggling with substance use and uh and mental illness. And what I found is that when I was attending college, that these were conversations that were only had in a few settings. I've always seen that, you know, there's obviously been little pockets on campus of individuals who are passionate about helping those who struggle with substance use and mental health, um, like counseling centers, uh, some individuals in student affairs. And but what I wanted to do was really catalyze a greater movement on college campuses to talk about this because the primary purpose was to support students who are in recovery and uh and to advocate for students who are in recovery. And the way that I saw us going about that in the best way was to start with conversations. Uh, I think that all lasting change has to start with a conversation. If you're not having the conversation and if you're not having open dialogue about something, then you're not gonna see sustainable change, in my opinion.
SPEAKER_00What kind of conversations were lacking, do you think, in the college space?
SPEAKER_01Primarily just being real about the fact that this is an issue that young adults struggle with. So nationwide, uh 24% of young adults meet the criteria for a substance use disorder. And then in Tennessee, it's actually 2% higher. So 26% of our young adult population meets the criteria for a substance use disorder.
SPEAKER_00So that's over one in four.
SPEAKER_01Yeah. And it's a problem that we really can't afford to ignore because this is our next generation. And I think that a lot of this stuff um is perpetuated because of our, and I don't know if if fear would be the right word, but I think that it's it's perpetuated, at least in part, by a aversion that we have to having open dialogue about these things. And so, what I do with the recovery ally training is I come at it from saying, like, hey, I'm a person in long-term recovery, right? And I'm telling you that one of the worst ways that we can talk about this is to not talk about it. So let's start there. And then, you know, we can adjust the way we conversate about these things from that point, but let's start here. Let's just start on the fact that we're not talking about it enough. And then we'll, you know, we can get real specific and technical in our conversations, but that's my job. That's one of the big things that I see is my role as director of the Collegiate Recovery Initiative is just to come in and say, all right, shake things up a little bit and like let's talk about it.
SPEAKER_00What do you think was contributing to the hesitancy? Uh, because I think in general, Americans have a problem with opening up about difficult topics. I mean, death, for example, a lot of the times we don't like to talk about that. But what do you what do you think was contributing to this in general?
SPEAKER_01I I think it's really interesting that you you bring up uh, you know, having a difficult time talking about death as well. Um, you know, I've done this training a bunch, and uh, and I've been in this position officially for almost a year now. Um, I've been working with college campuses for over two years now. So I think that substance use, substance use disorder, um, and a lot of mental illness and and some of the things that unfortunately often go along with this, such as suicide and suicidal ideations, they're hard to explain, right? And I I think that's part of what it is with death as well. Um, these things are difficult to really define. And I think that when we can't define something, I used to have this like sociology professor, anyways. He was talking about how um we are so uncomfortable with what we don't understand to the extent to which we've you know created names for it, right? We've even labeled that which we don't understand, such as phenomena and you know, different labels that we give to things that we can't quite define. And I think that that's that's uh one of the reasons that we don't talk about substance uses. It's it's very complex. Uh what we find when we look into the research is some of the things that contribute to it. And this is what I talk about in the recovery ally training is it's a myriad of things, right? It can be genetic, it can be environmental, you know, literally just wrong place, wrong time for some individuals, right? Um, that's what we saw with the opiate epidemic. We saw individuals who were receiving a legitimate prescription and ended up developing an addiction. And so uh it's not something that we can uh, especially when you talk about like trying to understand things from a medical perspective, right? Um, it's not something that we can lay out in black and white and be like, okay, this happens, this mutation happens here, and then this is what you know, this is the course of events that comes after that, right? This is how it's gonna progress, this is what we can do, we can cut it out, or we can do this kind of therapy, this radiation, you know, it's not like that. And so the more complex something is, I think the less likely we are to tackle it as something to uh to advocate for and to raise awareness about.
SPEAKER_00Probably certainly not in casual conversation.
SPEAKER_01Yeah, exactly.
SPEAKER_00And and considering those environmental factors, I personally I can't help but notice I I as you said, it's really difficult to describe. I guess I should I I should let you try to tackle this. How is the college environment itself contributing to this? I mean, there are a number of cultural factors. Uh there are um advertisements, there are just this uh this cultural sense of the way college should be. Um is college inherently conducive, at least the way we culturally approach it.
SPEAKER_01So one of the things that's really interesting, um, when you look at the numbers uh as far as social norms and things like that go on college campuses, there's certainly a large group of college students that just simply don't participate in partying and the behaviors that would lend themselves to someone who struggles with a substance use disorder. I do think that the narrative on college campus is that it's uh sort of a rite of passage, right? Right. To at least uh, you know, and and some of the incoming freshmen and some of the students that I talk to uh talk about it in a way as it's it's just part of the college experience, right? To get a fake ID and to go out and drink. And now obviously uh colleges aren't, you know, they're not printing fake IDs up, but I do believe, and this is something where you just kind of have to be willing to step on some toes or hurt some feelings if that's what happens. Um, I do believe that colleges could do more to put the appropriate measures in place for what happens when a student can't seem to get that partying lifestyle under control. So in that way, um, I'm always hesitant to say, like, this is your fault. I I don't like to point fingers at anybody, right? I just like to point out a problem and say, hey, we have the, you know, we have the necessary means, we have the tools in place. Colleges certainly have the appropriate infrastructure to implement greater support for their students in recovery, because the collegiate recovery movement as a whole is something that's only recently began to grow rapidly, right? So uh there's a point, there's an element of this where it's just like, well, this is just partly because it's something that colleges have never done before. So it's something that colleges have to catch up with, right? Um, you know, over the last 10 years, um, collegiate recovery programs have grown like tenfold.
SPEAKER_00So so that's what I would say to that. Yeah, no, that that's really fascinating. What what do you think spurred this on? Was it the opioid crisis, perhaps?
SPEAKER_01It it seems to correlate with that. Um, just in some, you know, amateur research that I've done, it seems to correlate with I think that the opiate crisis caused us to take a good hard look at at how we were were dealing with substance use disorder as a whole in our society.
SPEAKER_00Yeah, I I think it definitely I think it's a pretty uncontroversial opinion these days to say that it was a reckoning for sure. Uh, but now I I I can't help but wonder, as much as that may have played a factor in opening people up to having these conversations finally. What's interesting, just looking at the aggregate data, I do see that amongst the younger generations who are just now in in college, opioid use is is way down. Uh there's a there's a lot of concern and fear, uh a justifiable fear. They're they're they're listening to the warnings. They know that pills can be contaminated with fentanyl and stuff like that. But at the same time, uh I understand the Collegiate Recovery Ambassador program at UT, and we'll talk about this, found uh in some of their surveys of college students that uh alcohol was seen as a bigger concern among students as opposed to uh what we might call the more traditional hard drugs. Does that line up with what you're seeing more at a statewide level?
SPEAKER_01Oh, absolutely, man. Um the opiate epidemic, what I saw with it was just a greater push to understand substance use disorder in general. What we see is that typically if a student's gonna drop out, and again, this research has been sparse, what I've been able to uncover, but what I've found is that if a student's gonna drop out of college due to substance use, it's most likely gonna be second late in their second term or second year and into their third year. And that to me lends itself to an alcohol use disorder because alcohol use can be a um insidious and uh and slow growing uh issue, right? So if a student has a predisposition to this, alcohol use is one of those things, and I think that that I think it's great to see that our college students um are listening to the warnings about fentanyl lace pills and things like that. Because the reality is when you talk about opiates today or heroin or um, you know, it's it's even been found in some nerve medications. Yeah, one pill literally can kill. Um, but with alcohol use, it it takes a little while for the consequences to really start to pile up, right?
SPEAKER_00Decades sometimes.
SPEAKER_01Yeah, absolutely. So I always say when I try and make space to say when I'm talking, I'm not trying to start a new like, you know, temperance movement or Washingtonian society or anything like that on college campuses. I don't think that's realistic, and I don't want to do that. I'm not trying to be the, you know, the uh drugs are bad guy. Um although sometimes I've been asked to be that guy. Um, that's not my goal. My goal is to have open conversations about these things and at the very minimum plant a seed. And I think that collegiate recovery programs do that as well, right? So when I was in my um active substance use, there were people who tried to intervene that may have walked away from that situation thinking, well, I I did nothing. But I remember every one of those interactions. And it's my belief that those culminated into me reaching a state of crisis of internal crisis to where I was finally willing to where so many people were like, dude, like you got to get it together. Like, I can see this happening. This has happened to so and so, you're headed down this path, and I'm like, oh, one person said it. And then it's like, oh, two, but when, and and I think that this is some of the weight that collegiate recovery programs can carry, you know, when your institution is like, hey, man, like we see you heading down this path, and we want to support you, right? Uh, we want to help you get back on the right track. That could carry um immense amount of weight in an individual's recovery journey.
SPEAKER_00You also mentioned you said the second or third year, that's about the time I'd imagine most of these students are turning 21 and gain that buying ability legally, and then no longer need that fake ID or anything like that.
SPEAKER_01Yeah.
SPEAKER_00So it's another contextual uh factor there.
SPEAKER_01Yeah, absolutely. I would say that that's that certainly has no small part to play in it. Um, I know that for me, of course, I got into recovery when I was 20, so I've never bought a legal drink of alcohol. But uh I know that certainly as you know uh the mile markers, right? The freedom, as the freedom continued to increase, when I turned 16, um, that's when I went from doing opiates recreationally to um you know doing them consistently because I had mobility. Um I could go everywhere that I needed to go to get them. And then when I turned 18, it was just it was nearly game over. Because legally, uh nobody could say anything.
SPEAKER_00Right.
SPEAKER_01Except for the police. Right. Tried to say a few things.
SPEAKER_00Your story is actually really quite interesting. Um, would you mind sharing what it was the scene that finally began that true uh recovery?
SPEAKER_01Yeah, absolutely, man. So when I do the recovery ally training, and and I've already spoke to this just a little bit, part of what I try and do is I try to bring as much of my own experience in to validate some of what we've already proven and what we already know about helping individuals that struggle with substance use. And one of the things that we know about the initiation of recovery, and I don't think that we've been able to get away from it, um, and I and I don't know that we will just because of the nature of substance use, is that um it's almost recovery is almost always initiated by some kind of crisis, right?
SPEAKER_00Right.
SPEAKER_01And I I personally have not seen anybody embark upon a recovery walk that doesn't go through some kind of crisis, um, in in some extent. And what I like to do is really break down that crisis and talk about what that looks like. Because you may say, well, I got a buddy who, you know, they never went to jail, they never were homeless, they never lost a job, but they just entered recovery, right? And so that's that's amazing when that can happen, and that does happen. Um, but I would argue that that individual experienced some sort of crisis internally. You know, for me in my recovery journey, like I said, when I turned 18, it was really all but game over as far as my substance use went. It was definitely it had stopped being fun for me at that point, right?
unknownRight.
SPEAKER_01I was completely on autopilot. I didn't enjoy living the way that I was living. I'd be remiss if I if I didn't say that there was there were uh brief patches in that time period in my life where I would be using and I experienced you know euphoria or whatever from it, but on on a whole, and and I think that this is something that happens for a lot of people who use substances, uh the good the good or the bad far outweighed the good, right? Um, so I had gotten to that point. Really, I had lost all faith in myself at that point, and uh and in my ability to pull myself up by my bootstraps or anything like that, you know. I did not have any bootstraps really to pull myself up by. Um, I had some worn-out converse. Uh, but uh, but um anyway, so you know, I ended up being uh homeless, mostly couch surfing. For me, I had this uh really cool thing that I would do as your friend, and I would show up at your house, and then I just wouldn't leave until you asked me to, and uh and just kind of like you know, real awkwardly avoid conversations about what I was doing for the rest of the week because I wasn't doing anything. And so I was hopefully sleeping on your couch, but uh so I would couch surf and and I lived out of uh out of a Chevy tracker for a little bit, um, which is a really small vehicle to live in, and um ended up getting you know put in jail for a little bit of time. Uh around Christmas time, I got picked up. I was doing that thing where I was couch surfing and there was a knock on the door, and uh they were like, Yeah, is James Payne here, which is my legal name. Uh Nathan Payne's my alias. And um I uh I'm not real clever when I think of aliases, but uh sounds like you stick to Bible names, so at least it's consistency. Yeah, right. No, and uh, and they they said is James Payne here, and I was like, uh yeah, that's me. I don't know if I thought it was publisher's clearinghouse or what, but it was definitely the sheriff's department, and they were definitely there to take me to jail. And um, you know, they talked about uh, hey, we've got a warrant for your arrest, and I was like, Oh yeah, uh, I was gonna turn myself in after Christmas. And uh he was like, Oh, after Christmas, eh? And uh I was like, Yeah, and I'm thinking in my head, like, oh cool, he's gonna let me go. Let me turn myself in. But they don't do that when they have a warrant for you. They fine you, they're gonna take you. They're not there's no honor system with that, as a you know, uh, which I'm sure has come through uh through experience. Um, and so uh so I spent like I think it was a total of like 45 days in jail, um, which was uh plenty for me to know that I didn't want to go back. Uh that's what I always say. Jail was really good for me. I'm a big proponent of uh reform in our criminal justice system, 100%. Um, but I don't think that it was a bad thing for me to spend a little bit of time in jail just to see uh like okay, this is like gnarly to have all of my. But I will say that after 45 days, what happened is I pretty much just came out of there with better connections. I got you know fattened up and uh three hots in a cot and was ready to kind of rip and roar back at it. So spent a little time in jail, got fired from jobs, man, all kinds of stuff, right? So you could look at my life and see what beyond the shadow of a doubt that you would be looking at my life and think, how is this dude not in a crisis?
SPEAKER_00Right, right.
SPEAKER_01And uh that was not sufficient enough crisis for me. The uh the crisis came for me. I was homeless still yet. I had just gotten out of treatment 30 days prior. I relapsed immediately. Honestly, I didn't even know what was happening until I already had my my drug of choice in front of me. And I and I don't say that to be dramatic or or sound like a soap opera. Like I swear I almost I swear that you can almost describe it as like I blacked out and I came to at my dealer's house when I got out of treatment. And so I relapsed and um and uh I was homeless and I I talked to my mom. I didn't have anywhere to sleep. It was cold outside, and so she let me stay at her house and uh and I was sleeping on her couch and she had left her uh her laptop out, and I took her laptop and um and I traded that for drugs. And when I came back, she she had known that she forgot to put it in her room with her. So my mom used to have to devil herself in her bedroom at night uh because you couldn't trust me. I was a completely different person. And I don't, you know, particularly enjoy, well, it's never been comfortable for me to share those experiences and that part of who I used to be, but I find it really necessary if we're gonna have open, I find it to be hypocritical if I'm talking about how important it is to have open dialogue about these things and to really get gritty talking about them and me to not share certain elements of myself and my past uh in order to save face, right? Um, so that happened and and um I was a completely different person. Um, I talked to people today that have never seen me in my active substance use, and they don't know they they can't comprehend it. And that's just an attestament to what can happen and the redemption that can happen with an individual in recovery. But anyway, so she I come back and she knew that I had taken it and she had these tears in her eyes, and she was like, Man, I just want my son back. And um and I uh I felt like this wrenching. In my stomach. And so I went to the bathroom and I did my drugs. And for some reason, they didn't uh work, right? They didn't numb out any feelings. And um, and so I got on my knees and I wasn't a particularly religious person at the time. And I got on my knees and uh I asked uh whatever's out there to kill me or help me, and uh, and it felt like that prayer went up and hit the ceiling and came back down and hit me square between the eyes. And um, I called my probation officer the next day and I told him that I needed to go to jail, that it was the only thing that I had ever done. I'd been to treatment at that time three times, and I asked him to send me to jail because I couldn't stop doing what I was doing, and I hated myself and I hated what I was doing to my family, and uh, and I wanted to stop, but I couldn't. I made so many promises to everybody in my life and so many promises myself, and I broke every one of them. So I thought the only solution was to lock me up and throw away the key. I had a 1129 sentence with like nine months left on it. Um, and I was ready to just lay down and do that. Um, but he said uh we should try treatment one more time. And uh I thought, man, I it's not gonna work. And he was like, no, no, no, just come in the office and we're gonna get you in treatment one more time. And uh that uh that is what we did, and I've been in recovery ever since. So the pain and the crisis, you can never know when that's gonna hit, right? You can never underestimate or or really gauge when that's gonna happen. Um, that's why it's always so important to not give up hope.
SPEAKER_00Thank you. Yeah.
SPEAKER_01Yeah, that was a long, drawn-out uh story there, so you're probably gonna have to edit that down. Oh, I've stumped you.
SPEAKER_00No, no, you're fine. I I like you said it it is an uncomfortable thing to open up. And uh uh we live in a culture that just so overvalues you know rise and grind, exceptionalism, flawlessness. We this uh be as perfect as possible, post on social media all your highlights and you know pay no attention to the blooper reel. It's it it it seems to it seems to me almost that the the culture necessary to have these recovery conversations is almost completely counterintuitive to what uh so much of our culture uh desires or at least pushes.
SPEAKER_01No doubt, man. I I look at things from a couple of perspectives, right? Like I think that uh obviously you have the glass half full, glass half empty, or like, oh, there's just some water in a glass. Um so I think that uh I I always try and look at things with glass half full, but I I do think that um there is an element of this movement on college campuses where they are hesitant to admit that this is a thing that students may struggle with for fear that it may uh make an institution look less than perfect, right? Now, I will say that I've seen exceptional buy-in from tons of administration and faculty on college campuses all across the state, man. So I think that that's completely changing. So, but when we're talking about um part of why this has only just begun to take off and all of those things, I I think that that's been a thing at some points, man.
SPEAKER_00That enough people have finally been affected that no one's really finding it controversial to admit that people need help.
SPEAKER_01Yeah, and and if um if my own recovery has taught me anything, it's that when you can recognize and come to terms with the worst of yourself, uh, you can be the best you uh possible.
SPEAKER_00Um at the policy level, broadly speaking, at the federal, state, or even local level, what what policy changes do you think might be beneficial towards uh encouraging recovery and long-term recovery? I know you mentioned, for example, criminal justice.
SPEAKER_01We don't have to talk about that per se, but criminal justice reform is really important and uh increasing access to treatment or indigent individuals, and and that's something that I've seen great strides in by our legislative body. I think there's always more room for improvement there. Um, but uh, but yeah, I think I could go on and on about this for days. One of the things that I think is interesting is um any any sort of legislation that recognizes okay, you have an individual who has lost control, right? You have an individual that needs that's one of the things I talk about when I talk about the recovery ally training, is that it takes a mess of help just to stand alone, right? I had to come to believe that and I had to come to accept that. And I think that's a fundamental part of the human experience. We need social interaction, we need individuals to some extent. So recognizing then, though, that the important thing is to learn to develop some autonomy and um and to learn to develop a sense of responsibility for your life is important, right? So I I've been always been a huge proponent of recovery courts, and I think that if we've ever seen a failure in a recovery court system, it's just for the fact that it doesn't receive enough funding to really put the appropriate. I worked on a recovery court for a period of time. Um, I saw a lot of success in that. I think um uh which again is another thing that I've seen funding increases for, which is just super rad. Any sort of legislation and policy that recognizes that individuals need help and the help that comes from us is empowering them, is going to be one that I support. Recognizing that these individuals should not be cast out. That's part of again, going back to what I said at the very beginning of this. That's part of why I try to lean into the discomfort of talking about exactly who I used to be and exactly what my life used to look like in every element, right? So how it played out behaviorally, what was going on in my head, all of that. Because I feel very strongly that it would have been super easy to cast me out. Thank God that that probation officer I had that one day was like, No, you need to go to treatment, man. You don't need to go back to jail. It saved my life. So, but it doesn't matter how much funding, how much policy, how much anything we have, if we don't have individuals willing to talk about these things openly. We can't have it if we're not openly talking about the fact that individuals who struggle with substance use, their brain has been hijacked and they are in fact sick. And then on the flip side of that, they do in fact perpetuate or do behaviors that can be harmful to other people. So let's talk about both of those things and let's come to the solution here, right? Um instead of being like, no, like uh lock them away and throw away the key, or no, like uh mitigate all you know, mitigate all consequences and um just give them a cookie. Like we've gotta figure out you know, we've gotta figure out the truth here.
SPEAKER_00I like that very much. And and and I think that's something that we probably need in all areas, is that we probably can solve every issue we're facing these days if we were just able to talk to each other in good faith.
SPEAKER_01Absolutely. Uh in a safe space, you know, like in a in a like a place that is safe for dialogue. Like we have to be able to do that, and that's what I try to cultivate on college camps is around substance use and mental illness.
SPEAKER_00Really well done. Well, thank you, Nathan. I greatly appreciate it. Thank you for having me on here. Always. For more episodes on in-depth discussions on Tennessee policies related to substance use disorder by a range of local experts. Please subscribe to us wherever you get podcasts and visit our website at smart.tennisd.edu. I'm Jeremy Corvellis. Thank you for listening and see you next month.