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An Interview with Karen Pietrusinski

by Gordon Nary

Gordon: When did you join Sacred Heart Croatian Parish and how has the parish contributed to your spirituality?

Karen: My family and I moved to the Vet’s Park area in 1980 from South Chicago. My late husband and I were looking for a neighborhood in Chicago in which to raise our 3 children. Sacred Heart Church has a parochial school and we were looking for a school to provide our children with an education based on spiritual values and academics.

The parish is where I receive spiritual grounding with the basic practices of faith such as Sunday Mass and the liturgical celebrations throughout the year. However, there was a need to expand and deepen my spiritual life which was found in The Secular Servants of Mary – our assistant and spiritual mentor and advisor used to tell me that my profession was in keeping with the charism of the order.

Gordon: What interested you in addiction counseling as a profession?

Karen: Initially and ironically that was not my first choice among the helping professions. I really wanted to explore options for mental health therapy or career counseling. My interests always were in the helping professions. There were families in the area who were affected by addiction which is more of a family disease in that it affects families not only the individuals. I was open-minded when I began my career; I am ending with opioid and behavioral addictions.

Gordon: When did you join Family Guidance Centers (FGC) and what are your primary responsibilities?

Karen: I was hired by FGC INC in 2000 who was not my first employer. Initially, I went to work attempting to establish a program for addicted and homeless men as part of FGC. Later that year, the RRP team needed a new member so I applied and received the position. RRP means residential recovery program where the counselors work with a previously incarcerated population, lived at a certain location and received counseling, on two levels of care, at the site where I am currently employed.

The RRP, due to federal and state funding cuts, was closed in 2009. After a layoff of nearly 5 months, I was asked to return to a new challenge; managing an intensive outpatient program in methadone. Eventually, that program ceased (thanks to the ever-changing world of addiction therapy) and I work with methadone patients. I never liked to run groups as a counselor before I completed my MHS. After a challenging course in group dynamics, I was able to manage group counseling with no problem. I guess the challenge is what drives me. The pay is not the greatest but the reward is former clients living their lives drug-free and productively.

Gordon: What are some of the challenges of methadone treatment for substance abuse?

Karen: Methadone is not the only form of medication-assisted therapy. There are individuals who thrive with methadone and others do not. There are also those who want a “vacation from their use”. There are those who are looking for another form of a high. However, methadone maintenance treatment is not meant to be a lifetime commitment for those who are addicted to opiates. One year should be dedicated to adjustment and maintenance along with therapy while the second year might be one of detoxification. However, as always was, many individuals come to treatment due to the residual effects of trauma – they medicate themselves. Those individuals will need extensive treatment in both addictions and mental health simultaneously. FGC actually provides that service. Many who are addicted also have a co-existing mental health problem which can be very challenging. I typically offer an opportunity for the person who has a co-existing mental health disorder for additional therapy.

Another challenge is the ever-present insurance question and what it will cover. For a number of years, our clients have MCO or a type of Medicaid insurance. The clients won’t be turned away if they don’t have MCO. However, if the client has regular Medicaid, there is a possibility, if they need mental health therapy, the insurance won’t cover the costs.

Gordon: What are some of the factors that have contributed to the opioid epidemics in the United States?

Karen: I would have to say that MDs overprescribing opioid medication for pain is a chief cause. The person who has been in an accident has only so many prescriptions that can be filled for some opioids. As one develops a tolerance for opioids, that person will need more to control the pain. Sometimes this goes on for years. So the MD won’t prescribe any more opioids, the person goes in search of a street drug or illegally buying opioids on the streets.

The opioid situation has gone on for years – we often say that in Chicago, the drug that is the worst in terms of addiction is heroin. There has been a crisis as long as I can remember. Only it was never discussed on a national level. When people started dropping dead due to fentanyl being mixed with heroin or maybe bought alone, that occurred as early as say 9-10 years ago. Now that those who do not reside in underprivileged areas are overdosing from prescription opioids, the federal and state governments are beginning to pay attention.

In the past few years, the suburban youth and youth who reside in towns not ordinarily associated with drug trafficking are also part of this crisis. The real tragedy is the increase in younger individuals who become addicted to opioids and overdosing.

Gordon: How are different forms of addiction such as alcohol addiction, pornography addiction, drug addiction, and cell phone addiction interrelated?

Karen: Addictions as a field relates to behavioral health that includes all of what you mention. Anyone can become addicted to anything – not necessarily a substance. Porn as opposed to say, crack addiction, is more a behavioral issue. The founders of a type of therapy called motivational interviewing have written extensively on the more different forms of addiction. Usually, with drugs, gambling and perhaps porn, there is a risk factor involved in all individuals. Environmental factors plus genetics also play a role. If the parent or parents have a chemical addiction, in their children there may be a tendency towards work addiction, porn, and gambling. I have seen this in treatment where a person who has a drug addiction will often have gambling tendencies or have family members who have gambling addictions. Who isn’t addicted to their smartphones? Look around you on a busy city street or ride the CTA. I noticed that many tend to live on their devices.

Regarding your question, the brain chemistry during the process of becoming dependent on a substance or in some cases is similar. The withdrawals from chemical substances such as heroin or alcohol and gambling can have similar characteristics.

Gordon: What can parishes do to address s addiction challenges?

Karen: Parishes can have self-help groups available such as NA, NAR-Anon, and ALANON. Information for 800 self-help numbers can be made available. Also, mental health information should be made available indicated by the increase in suicides. Someone in the parish office or in the deanery can be a resource for those seeking help. A priest can be of great assistance if he can approach the person.

Gordon: Thank you for an exceptional interview.

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