Original Article by Kaya Williams • July 23, 2021
Keir Gallik can draw a straight line between his mental health history and substance use.
“I think that the mental health issues came first. I think they kind of came at a young age where maybe I wasn’t even aware enough to recognize them or put a label on them,” said Gallik, an Aspen Strong board member who is now more than five-and-a-half years sober and living in Aspen. “They just felt as if something wasn’t quite right, and I found, at least in my case, that I had found relief in alcohol and drugs and doing what I was doing — that worked.”
Until it didn’t.
The roots of it — anxiety and accumulating traumas — were still present, and the temporary relief gained from substance use started to diminish, according to Gallik. After a few other go-arounds with in-patient treatment elsewhere, he landed at Jaywalker Lodge, a Carbondale addiction treatment center for men.
That program (which he completed, then stayed on as a staffer for a couple of years) and participation in Alcoholics Anonymous were instrumental in his recovery.
“What it did was just bring me back to a place where I could fully engage in life and, you know, be there for all the ups and the downs,” Gallik said.
The Longevity Project is an annual campaign to drive discussion about what it takes to live a long, fulfilling life in our valley. This year’s project focuses on mental health. The Aspen Times and Glenwood Springs Post-Independent are partnering over the next month and we will explore topics in mental health including resources (Aug. 26), substance use (today), suicide prevention (Sept. 10) and law enforcement (Sept. 17).
Our project culminates with events Sept. 20 in Aspen (6 p.m.) and Rifle (noon) with a panel discussion of local leaders and speaker Kevin Hines. An award-winning global speaker, best-selling author, documentary filmmaker, and suicide prevention and mental health advocate, Hines has reached millions with his story of an unlikely survival. Two years after he was diagnosed with bipolar disorder, he attempted to take his life by jumping from the Golden Gate Bridge. Since the Golden Gate Bridge opened in 1937, thousands of people have tried to kill themselves by leaping. Only 34 have lived and he is one of them. For more information or to register for the local events, go to aspentimes.com/longevity.
Gallik is hardly alone. Far more often than not, substance use is intrinsically intertwined with mental health challenges: the two are “co-occurring” in the majority of clients who turn to recovery resource center A Way Out, said the nonprofit’s executive director, Elizabeth Means.
“They go very much hand in hand, and I think it’s human nature to want to try to fix it, like, ‘OK, I’m not feeling right, what do I need?’” Means said.
Addiction recovery professionals and those in recovery themselves agree that it is rarely if ever a “one or the other” situation.
“It’s kind of like what came first, the chicken or the egg? There’s a major connection,” said MaryMike Haley, the clinical director for Aspire Recovery for Women, a Carbondale-based treatment center.
It is common for someone living with addiction to also have anxiety or depression, according to Haley; they may also be coping with trauma, or living with a “complex mental health issue” like bipolar disorder or attention deficit disorder, she said.
Those mental health conditions don’t go away when a person enters into recovery from addiction — just the opposite, sometimes, Haley said.
“When you take away drugs and alcohol, those things tend to become exacerbated, right?” Haley said. “Because their No. 1 coping mechanism to tamp down the mental health issues that are popping up — you don’t have that anymore.”
Over time, though, and with the right recovery resources, that pendulum starts to swing back to center, said Patrick Shaffer, the chief of admissions and marketing at Jaywalker Lodge.
“We see, in some cases, that (co-occurring mental health condition) be at a diagnostic level where they need continued support, through an entire treatment process, and something that they will continue to live with, and we also see it be linked directly to time away from substance use, so we can see anxiety and depression dissipate over time as somebody has more clean and sober time,” Shaffer said.
“It’s sort of not a chicken-or-an-egg conversation anymore,” added Stefan Bate, Jaywalker’s chief of clinical operations. “It’s the chicken and the egg together.”
Co-occurring conditions are “the expectation now — it’s not the exception,” Bate said, and Jaywalker’s treatment plan takes that into account with integrated treatment.
“Doing really responsible, good mental health work, trauma work and addiction work is essential, because if someone has untreated mental health or trauma, that’s going to be their biggest precipitator to a relapse in substances,” Bate said. “And vice versa: If somebody is really struggling primarily with mental health, but they’re continuing to use substances, their outcomes for their mental health disorder are going to be … pretty poor.”
That line of thinking wasn’t always the norm in recovery, according to Bate and others in the field.
“Historical treatment really separated it: You looked at addiction treatment, you looked at mental health treatment, and you didn’t do them in a co-occurring sort of integrated way,” he said.
When Haley got sober 32 years ago at the age of 18, “there was not an awareness of the connection between trauma, mental health and addiction,” she said. So much so that she was told not to unpack some of her childhood trauma in the early stages of recovery because she was too young and because it might cause a relapse.
That’s not the case now, and certainly not at Aspire, which takes a “whole person” approach to recovery.
“That format within the addiction recovery community has completely changed, right, that we really need to address mental health stuff, that we really need to address trauma,” Haley said, “because the symptoms of dealing with those issues — I think one of the symptoms is addiction.”
Maggie Seldeen, founder and executive director of High Rockies Harm Reduction in Carbondale, shares that view. It isn’t just mental health itself; stressors including housing and job insecurity are compounding challenges for those seeking recovery.
“My belief is that substance use is a symptom and not the cause,” Seldeen said. “I believe that it is, more often than not, the symptom of underlying mental health issues that have not been effectively taken care of, and so I think that if we can help people achieve stability in their housing, in their profession, in their families, and help them address these really mental health issues, then we can start seeing behavioral change.”
Seldeen’s work with High Rockies Harm Reduction focuses on alleviating harm rather than exclusively seeking sobriety; initiatives include syringe access services, peer support and training on how to administer Narcan, a life-saving nasal spray that can treat opioid overdoses in emergency situations.
The goal is to keep people safe, one of many components to what Seldeen sees as a layered approach to substance use and mental health resources.
“When you have something to live for, then you have a reason to address your needs and your issues. … If we can give people the support and mental health services that they need, and that are going to be relevant to them, I think that that can really help with these substance use issues or addiction issues,” Seldeen said.
Aspen has an outsized reputation for substance use. And the atmosphere of a play-hard, then play-even-harder culture in Aspen goes well beyond the roundabout, according to Seldeen.
“There’s a trickle-down effect from the party culture,” Seldeen said.
Seldeen observed that the normalization of substance use in Aspen — especially in the restaurant industry, where the use of drugs and alcohol are particularly prevalent, she said — can flow downvalley to Carbondale or Rifle or Parachute when workers head home at the end of the day.
But an abundance of recovery and harm-reduction resources in Pitkin County doesn’t flow with it, Seldeen said.
“(In Aspen), it’s viewed as not having consequences because the people using (substances) have resources, and that’s a really important point right there is that, just because you’re a millionaire doesn’t mean you’re not using heroin or cocaine, right?” Seldeen said. “It means you have the resources to do it in a safe environment.”
That “trickle down effect” doesn’t necessarily mean that usage is the same throughout the valley, though.
The Roaring Fork Valley is no monolith. The culture surrounding substance use — and what substances are used — can vary from Aspen to Parachute or even between neighboring towns like Aspen and Snowmass Village or Rifle and Silt, according to Seldeen.
“I see how some of our communities have resources that the others don’t and vice versa, and so there’s a lot of traveling that goes on to access the right services, right?” Seldeen said.
Means, whose work with A Way Out focuses in part on filling the financial gaps in mental health and recovery access throughout the valley, said she sees a greater need for resources down in Garfield County than she sees in Pitkin County.
“There’s more (people) needing resources the further downvalley we move,” Means said. “Mental illness is a pretty equitable disease that affects everybody no matter where you live, but definitely, they need more financial resources (downvalley).”
Financial challenges can complicate matters for people seeking clinical recovery resources, too. Programs like Alcoholics Anonymous and other support groups are free, but clinical inpatient treatment and some outpatient therapy doesn’t come cheap.
Insurance providers and Medicaid don’t always cover every program, including those specialized programs that might be the best fit for the individual, Means said.
Even then, the long approval process for those on Medicaid can lead to precious recovery time spent in limbo, waiting for the green light to get help, according to Means.
“It can take months to get into it,” Means said. “And a lot of times, people don’t have a month, right?”
‘The fight is all the same’
Money and insurance aren’t the only — or even the primary — barriers standing between people and the mental health and substance use support they need. A fear of judgment can be a major hurdle to clear, said Jenny Lyons, a mental health program administrator with Pitkin County Public Health.
“The sum total of it is that what we call stigma is keeping people from getting the help that they need,” Lyons said in an interview with Chelsea Carnoali, a Pitkin County mental health analyst.
Regional public health groups are working to counter that by developing messaging campaigns that focus on normalizing getting help for mental health concerns, Lyons and Carnoali said.
“It’s so interesting how our little Aspen bubble culture does fit into what our version of stigma looks like,” Carnoali said.
A lot of the work lies in reminding people that it’s OK to not be OK in a place where so many others come to escape; belonging and community in a resort town are part of the equation for places like Aspen, too.
“People (are) coming to our area, (saying it’s) so beautiful, and we should all be happy, alongside the very clear gap in income and a very clear gap of privilege or availability of resources and what that also does to mental health and sense of belonging,” Carnoali said.
The fact is that mental health struggles and substance use can happen to anyone, said Gabe Cohen, who runs the Discovery Cafe resource center in Rifle and has been in recovery from addiction since 2018.
“It doesn’t matter what county or town or city you’re in, you know,” he said. “The issues, the trauma, the struggle, the fight is all the same. … it doesn’t really matter whether you are in rural America or, you know, ritzy Aspen, Colorado — addiction’s addiction.”
Cohen sees Discovery Cafe as a “recovery community center” with a broad definition of recovery that extends beyond addiction to include trauma, homelessness, incarceration and other challenges.
“We want everyone to know that they are loved and valued, and we leave any judgment at the door,” he said.
Connecting through lived experience
The sense of community and belonging can be a make-or-break component to recovery, according to resource providers. It’s one that the Roaring Fork Valley is uniquely positioned to provide through outdoor recreation; the connections forged on the trails and slopes of the region can help counter what some addiction treatment professionals consider to be a disease of isolation.
“That is without doubt, I would say, the biggest struggle that people face in early to mid-term recovery is that struggle with finding community without, you know, substances or partying,” said Gallik, the Jaywalker Lodge alumnus.
Here, he has been able to find that, partly because of Jaywalker’s emphasis on outdoor recreation. Gallik, who grew up spending time outside in his hometown of Bozeman, Montana, said Jaywalker reconnected him with the outdoors and placed him in a community of like-minded peers; it was a “game-changer.”
“I was able to see people that I respected and people that I got along with really well who were doing well and who were striving to be better people and get sober and live their life,” Gallik said. “That made me think, ‘Wow, I could do that too, that’s achievable.’ It really kind of put a familiar face on this idea of getting better.”
Lived experience and peer-to-peer connection can make a world of difference in addiction treatment and recovery, High Rockies Harm Reduction’s Seldeen said.
“If we can just build trusting, compassionate relationships with people, that’s how we can get them into the services they need,” she said.
And it can be just as valuable for people who know loved ones who are dealing with addiction, said photographer Cath Adams. Her daughter Emily was in recovery for three years before she died of an accidental fentanyl overdose in 2020.
“You don’t want anybody to ever go through this,” Adams said in a joint interview with her younger daughter Ashley in their backyard in El Jebel. “And you don’t have your last goodbyes. You wake up one morning and your child’s gone, and you just really want to — you become very passionate.”
Cath founded Aperture of Hope about a decade ago as a way to help youth engage with the outdoors and face life’s challenges through what she calls “awareness photography.” It has since evolved into a peer support, recovery coaching and resource hub for those dealing with substance use.
Ashley is involved, too; the Glenwood Springs High School senior organized an Overdose Awareness Day event at Crown Mountain Park on Aug. 31 with speakers who shared their lived experience, music, an honor walk, resource booths and a training led by Seldeen on how to administer Narcan.
Awareness was just one component; the event’s programming and that shared lived experience also countered that notion of a stigma surrounding substance use and mental health.
“I want the message to be known that people are more than their addiction, and everyone has a story,” Ashley said at the event. “Spreading awareness and talking about addiction should not be shameful, and everyone deserves to get the help they need; I want it to be known that you matter, no matter what others think, especially in the society we live in today.”
Ashley and Cath also planted purple flags at several locations throughout the valley this year and last to commemorate those who died of an overdose in Garfield, Eagle and Pitkin counties; there were 52 at each location for the span of 2017-2019 last year and 72 for the span of 2017-2020 this year.
For Ashley, now entering senior year of high school without her older sister, the missed milestones are a reminder of an alternative path; her work over the last year has also strengthened her passion to help others, she said.
“She’s not going to be there when I graduate, so that’s hard, but I know everything she went through, I’m not doing the same, so in a way, she’s helped me, shown me what not to do,” she said.
The two hope their own lived experience can help others navigate the landscape of supporting a loved one with addiction and coping with the grief of losing someone to an overdose.
“I’ve seen it. I’ve been there. … I’ve learned a ton,” Cath said. “It just didn’t start when she took that pill and passed — everything before that, it was just a wealth of knowledge.”
‘Their life has meaning too’
The involvement has also been a way for Cath to find healing and purpose.
“I feel like I have found the meaning of life,” she said. “Now I just want everyone to feel, when they’re suffering, that their life has meaning, too.”
The healing process looks different for everyone: those in recovery, those coping with loss, those who want to support a loved one living with addiction.
It isn’t linear, either; Seldeen wants to emphasize that to those who may feel like a relapse or a misstep along the way puts them right back where they started.
“It’s so much harder to get back on that wagon … it doesn’t have to be this way, but it feels so much like you’re starting at square one, and you feel so powerless, and it can be so difficult to see that reality of sobriety in your own life,” she said.
But the resounding message from Seldeen and others in the recovery — aside from encouragement to seek and accept help — is that there is hope for the future.
“I had no idea how much I was going to love being sober,” said Seldeen, now two-and-a-half years sober. “I just knew how tired I was of being the person I had been, and it was super cool to meet this new person. … Being sober is like its own kind of high to me.”