Monroe County's first director of addiction services is working on ways to reach people who she says are traditionally under-served, forgotten, and missing out on treatment.
Tisha Smith was recently appointed to the new position by County Executive Adam Bello.
She's been on the job for about three weeks but Smith is no newcomer to the field of addiction treatment.
She was most recently director of inmate drug and alcohol programs for the county sheriff's office. Before that, she was an addiction therapist supervisor at Unity Hospital.
"I've been doing this for a while now," said Smith, "and we've always had this assumption that our services were adequate in our community."
That may be the case with outpatient services for people with substance use disorder, which Smith calls "quite robust", but she said that's definitely not true when it comes to detox treatment for people who are in crisis.
"Like, if you woke up at 2 o'clock in the morning and you said to your loved one 'I'm struggling and I need assistance, I need a place to go,' at 2 o'clock in the morning they could physically take you to a location such that you can get treatment," she explained. "That's something we sorely need in our community."
This week, Smith is interviewing applicants for an eight member Improving Addiction Coordination team (IMPACT) that includes herself and a project manager.
She envisions a culturally diverse, expert group of clinicians who are familiar with the community, well versed in the available resources, and ready to hit the ground running.
One of their primary jobs will be to reach people who need treatment for addiction but aren't getting it, specifically people of color.
Although fatal overdoses were down overall in Monroe County last year, fatal overdoses among Black people were up 8 percent from 2018.
Even some of those who do enroll in treatment programs aren't staying long enough to get the help they need, according to Smith.
She believes a lack of cultural diversity among local mental health and chemical dependence treatment providers has a lot to do with that.
"It puts the onus on the patient to kind of prove their humanity, prove who they are and it just takes away from the whole entire treatment experience," Smith said. "You go from trying to explain why you're engaging in self-destructive behavior to now trying to educate the person on what it's like to come from your community or what it's like to be your or be in your shoes or navigate the world as you. I have actually witnessed patients actually getting tired of trying to do that and leave treatment as a result."
Smith points to another factor to explain a loss of patient retention, especially for those enrolled in outpatient programs: The switch to telemedicine during the coronavirus pandemic.
"I think it's great that a lot of programs were able to quickly move toward telehealth and do virtual programming for their folks but at the same time," she noted, "that has caused a lot of people to kind of fall off the radar."
While heroin and opioids are still the main culprits in overdoses and deaths, Smith wants people to remember that alcohol and other drugs can make people sick and destroy lives, too.
Another of her goals is to create a comprehensive referral program for patients and their families to ensure that people who are discharged from a hospital following an overdose move immediately into community based treatment programs.
Smith hopes to eventually measure her success not only by counting fewer hospital admissions and overdoses, but also by something that is not data-driven.
"To be approached in Wegmans and someone says 'Thanks for the help,' or 'This is what I'm doing as a result of the help that you've given, or to see a parent just kind of breathe a sigh of relief because their loved one is getting the help they need. That's success to me," she said.
