At SpringBoard, we pride ourselves on having a team that is truly passionate about helping others. In addition to the academic training needed to succeed in treating drug and alcohol addiction, we possess first-hand knowledge of recovery from substance abuse.
Our dedicated team is committed to helping you or your loved one navigate the road to life-long recovery. So we thought that you’d like to meet them! Continuing our series “Getting To Know Our SpringBoard Recovery Staff,” we talk with Bethany Fetzer, DNP, APRN, FNP-C, PMHNP-BC, CARN-AP, our Medical and Psychiatric Provider.
Getting To Know Our SpringBoard Recovery Staff
Bethany began her nursing career as a Certified Nursing Assistant (CNA) in 1985. She soon earned her Licensed Practical Nurse (LPN) certification in 1988 and completed her Registered Nurse (RN) training in 2000 once her children were in school.
Bethany is currently dual certified as a Family Nurse Practitioner (FNP) and an Advanced Practice Psychiatric Mental Health Nurse Practitioner (APRN). Specifically, she earned her Master’s degree in Doctorate in Nurse Practice (DNP) by developing and implementing procedures to reduce missed appointments in an outpatient substance abuse setting.
She has completed additional training and is also certified to provide Medication-Assisted Treatment (MAT) – the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach – with a waiver.
Bethany draws from her extensive nursing experience in the fields of emergency medicine and behavioral health to deliver compassionate and holistic care to patients experiencing psychiatric disorders and substance abuse issues – the simultaneous presence of each in a single patient is known as a co-occurring disorder or dual diagnosis.
Her various areas of interest include:
- Addiction treatment and management
- Developmental disorders
- Acute psychiatric care/ detox in hospital settings and outpatient treatment centers, and
- ADHD, anxiety, depression, bipolar disorder, borderline personality disorder (BPD), obsessive-compulsive disorder (OCD), Post Traumatic Stress Disorder (PTSD), and various other psychiatric conditions in adults
In her free time, Bethany enjoys spending time with her family, listening to music, practicing yoga, participating in spiritual and recovery-based activities, Pilates, and Krav Maga Tactile Defense – an effective, modern self-defense system.
What is your role at SpringBoard Recovery?
I am the Medical and Psychiatric provider at Springboard Recovery.
How long have you been working in the addiction recovery industry?
I have worked in the substance abuse field since 2010, mainly because my own medical experience was itself affected by repercussions of my own alcohol and substance use while working in the stressful environments of ER / Neurology / Burns & Trauma intensive care units (ICUs) since 1999.
In your opinion, what’s the most important aspect of achieving addiction recovery?
I can only speak for myself, but I believe the most important aspects to achieving addiction recovery are:
- Accepting powerlessness over substances (surrendering)
- A strong willingness to live life without substances, and
- Being open-minded to suggestions from those who have maintained emotional, physical, and spiritual recovery from substances/ behaviors.
Tackling addiction is possibly only one component of recovery. How important is it to tackle any co-occurring disorders that may exist?
Research supports that more than 50% of those struggling with substance abuse have a co-occurring mental health disorder, which is recognized in DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders: 5th Edition, produced by the American Psychiatric Association).
In addition, many have overlapping genetic, environmental, and social stress issues, and unresolved traumas which should be addressed to alleviate self-medicating with substances.
How Does Genetics Affect Substance Addiction?
Following years of research, it is now a widely accepted, established medical fact that our genetics – our physical genes and our behavioral traits – can play a significant role in whether we later develop a drug or alcohol addiction, medically termed as a substance use disorder (SUD).
“Genetics” (“gen-” means beginning) can also be defined as the scientific study of how genes and how traits are passed down from one generation to the next, ie. the manner in which parents pass traits onto their children.
So the question regarding genetics is this: Why do some people become addicted while others don’t?
Research studies in substance addiction that have looked specifically at identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup.
Ascertaining a more accurate picture of this risk continues to be an important route of research for scientists who are trying to solve the problem of drug addiction.
Furthermore, in researching all the possible factors that may affect our risk of substance addiction, scientists also established a strong link between addiction likelihood and the environment.
When we discuss “environment” in substance addiction terms, we are discussing a wide range of contributing elements, such as your home life, childhood, school life, friends and peers throughout your early life, any traumatic events, including family bereavement, and your introduction to addictive substances, to name just a few.
Here’s how that works in practice: For example, if you associate on a regular basis with those who excessively use drugs or alcohol, you are more likely to adopt that behavior, and use substances to excess too.
Children whose early home environment included exposure to substance use, e.g. a parent who was a drug abuser, have a higher risk of developing substance use issues themselves later in life.
This is known as “Epigenetics” – the study of where our genes interact with the surrounding environment.
A real-world example of this is identical twins, who are born with the same genetic footprint. Over time, as they are exposed to the differences in their environments, and make their own choices, their DNA becomes marked with genetic information that can affect their behavior, their risk of addiction, and even their response to treatment.
Importantly, some of these changes and adjustments can be passed on to later generations.
Real-World Example: Genetic Influence in Cannabis Use Disorder (CUD)
It is estimated that around 30% of marijuana users have a cannabis use disorder (CUD), representing either problematic use or full-blown addiction. The risk for CUD has been found to have a strong genetic component.
In a recent research study on genomes (the term for a complete set of human genes), scientists tried to identify specific genes that might put people at risk for CUD.
The results identified a certain gene that controls the levels of the protein known as CHRNA2 in the brain. Low levels of this protein in the cerebellum were clearly associated with the development of cannabis use disorder.
Our country is currently under a lot of stress – from the coronavirus pandemic to an unforeseen economic crisis because of it. How does all this affect addiction rates and substance types?
The industry has seen a significant increase in first-time admissions for treatment, as well as readmissions for relapse related to the social consequences of COVID-19.
Clearly, the impact of isolation while working from home, 12-Step meetings being held virtually or canceled altogether, and an inability to surround ourselves with healthy support systems has increased substance relapse, as well as depression and anxiety which can also lead to relapse.
What would you personally say to someone with a drug or alcohol problem (or has a loved one with a problem) who is considering getting help if someone confided that they or someone they love has an issue with substance use?
I would encourage them to do their research and obtain an assessment by a professional. Read reviews, ask questions, join a 12-Step program of either AA / NA / CODA (Co-Dependents Anonymous) / Al-Anon, and obtain a therapist with experience in addiction. I would also say to them, “There is not a panacea for a cure-all, but is what you’re doing currently working?”
When you tell someone you just met that you are in the addiction treatment industry, what are the 3 most common questions you get asked?
The most common reply I hear when someone learns I work in substance abuse treatment is “Isn’t it sad? Hard? Frustrating?” Yes to all, but there’s more. It is also magical, inspiring, and fulfilling.
What are the challenges that you consistently have to overcome when some people say “treatment doesn’t work”?
If someone was adamant that “treatment doesn’t work”, I would acknowledge that some clients do require multiple treatment stays. However, encourage them to be open that maybe the program was a poor fit, or the individual didn’t have necessary support upon discharge, or they hung onto belief they could use or drink unproblematically.
What would you consider to be your top 3 accomplishments while in this industry?
My three top accomplishments while in this industry are my recovery, my family, and authentic care and concern for others.
The Role of Unresolved Trauma in Drug & Alcohol Addiction
Without a doubt, the traumatic events experienced in a person’s life go a long way in shaping the person from then onwards – they invariably change the way the person then looks at themselves and their place in the world around them.
It’s certainly not too unsurprising to hear that someone who has suffered a traumatic experience is now suffering from a substance use disorder (SUD).
Trauma appears to consistently trigger heavy drinking or regular drug use, only for the person to increase their consumption because it’s not providing the “healing” they need.
How Does Trauma Develop?
Trauma can develop from a single traumatic event or a series of traumatic circumstances and can affect a person on a number of levels – mental, emotional, physical, social, and spiritual.
Trauma results in abnormally high levels of stress because the event is seen to be physically or emotionally harmful or even life-threatening.
This stress results in high levels of hormones being released, such as cortisol and adrenaline.
In regular high concentrations, these hormones can actually become toxic, and the body can no longer differentiate between an actual emergency or a memory of the trauma.
Left untreated and unresolved, this can lead to a severe mental health disorder called Post-Traumatic Stress Disorder (PTSD). Most notably seen in military veterans returning from war or combat, the same physiological responses can occur in people who experience childhood trauma.
As previously mentioned, people often turn to drug or alcohol use to self-medicate these feelings.
What are the Most Common Types of Trauma?
There are many types of trauma, the most common being:
While these are just a few common examples, surviving anything where a person believes their life was in serious danger can result in PTSD.
What are the Signs of Trauma?
People who’ve suffered childhood trauma can experience a wide range of side effects, both psychological and behavioral. Symptoms that can be experienced as a result include:
Those who endure a traumatic experience in their childhood are also at an extremely high risk of developing an addiction to drugs or alcohol.
The Link Between Childhood Trauma & Addiction
The link between childhood trauma, such as abuse, and addictive substance abuse later in life is caused by abnormalities in brain structure, where the young brain has not been able to form and develop properly.
The result is often various problems with cognition and behavior. Additionally, high levels of hormones like cortisol and other stress hormones will further negatively impact the normal brain development usualñly seen in children.
What do you do to unwind and relax after a hard day at the office, and did any of this stem from your own addiction recovery, eg. yoga, mindfulness, etc?
Spending time with family, listening to music, and, from my own recovery, keeping fit and healthy through practicing yoga, participating in spiritual and recovery-based activities, Pilates, and Krav Maga Tactile Defense.
– With thanks to Bethany Fetzer for her informative and interesting responses to our questions.