French advocates for SASCC as she steps away from agency after 17 years

By Audrey Posten, Times-Register

Substance Abuse Services for Clayton County (SASCC) has served area residents since 1981, but many people still don’t know the agency exists—or how it can help.

“Many people associate us with, ‘Oh, they’re the people you go to if you have problems with substances.’ I think a lot of people don’t realize most of our work is primarily in prevention of substance misuse,” said Merry French, who stepped down as SASCC Program Director last week after nearly 17 years with the agency.

SASCC is not a Clayton County agency, despite its name. Although the county houses the non-profit and works together on some grant funding, SASCC is governed by a board, explained French. 

Adam Sadewasser is SASCC’s certified prevention specialist, conducting outreach presentations and programming in local schools and communities. As program director, French handled substance evaluations, referrals and after care, in addition to prevention programs and grant writing.

“My role over the years has changed depending on what’s going on with the agency and the world in general,” she said. “When I was hired, and still, the agency is licensed to do substance misuse evaluations and to provide after care for people who have gone through primary treatment. At one time, the agency did treatment, but they let that portion of the licensure lapse.” 

“One of the things that’s always appealed to me, and I hope it’s going to appeal to who’s hired, is the variety,” French added. “On any given day, I might do a substance evaluation and referral to formal treatment, and I might work on putting together a grant application for new services. I might talk with Adam about one of the programs he’s doing in schools. We might work with the coalition. Lots of moving pieces.”

French listed completing substance evaluations and working with individuals in recovery as the most rewarding parts of her job. With her, people found a safe space to open up and answer questions. Since the agency doesn’t currently do treatment, experiences were often more positive.

“I’ve worked with a lot of people over the years who this isn’t their first go around with a substance evaluation, so they’ve had some maybe not so positive experiences with other programs. They say, ‘You’re just going to recommend treatment for me because that’s how you make money.’ It’s always been a pleasure to say, ‘We don’t do treatment. If I recommend it, we’re not going to make a penny off that.’ That has relieved some fears,” French shared. 

When finishing evaluations, she made a point to talk about the positive aspects in the person’s life.

“I’m a firm believer that, even if somebody is abusing substances and needs assistance, there are always positive things going on in their life or things they can draw on,” she explained. “Maybe you have somebody who’s binge drinking, but they still have a job and they still have health insurance and they still have a family who’s supportive. Those are all things that can work in their favor as they look at making some changes.”

French estimated at least 95 percent of the evaluations the agency conducts are court ordered, following a legal charge. Occasionally, health care providers, employers and even schools have contacted SASCC. Rarely do people reach out on their own—but French was always happy when they did.

Evaluations have been done on people ranging in age from 10 or 11 to their late 80s. Substance use and misuse can happen any time in a person’s life. 

“I think that’s important for people to remember,” said French. “Substance misuse and abuse does not discriminate, it doesn’t care how old you are, it doesn’t care whether you are a banker or you’re working a minimum wage job, it doesn’t care if you’re divorced or single, what ethnic or religious background you come from. It’s equal opportunity.”

In Clayton County, alcohol has always been front and center, according to French. 

“We certainly see trends with meth use, marijuana and some prescription medications, but alcohol is always there,” she stated.

That was exacerbated in some ways by the COVID-19 pandemic, as access to methamphetamine, marijuana and other substances was cut off but stores remained open for alcohol sales. Cocktails to go were even allowed. Some people found themselves drinking more at home since social functions were curtailed.

French said alcohol use is often rationalized because it’s legal if you’re 21 or older.

“There are a lot of people who think, ‘Oh, I’d never use those illegal drugs.’ But since alcohol is a legal drug, many of us tend to look at that differently. ‘Yeah, I drink a lot of alcohol, but that’s perfectly legal. I’m paying my taxes on it.’ It’s part of the mind set,” French said.

The pandemic also impacted those in recovery, who dealt with the closure of AA meetings. While some tried to go virtual, French said that sometimes wasn’t comfortable or accessible. 

Even SASCC provided individual appointments via telehealth before people were allowed back into the office with masks.

French hopes the agency, and others like it, consider the option post-pandemic.

“Telehealth as an option on a regular basis has been great for people, especially in rural health. We look at people who need an evaluation because they’ve gotten an OWI and lost their driver’s license. But they live in Guttenberg and to get to us it’s half an hour, and to get to one of the other agencies it’s an hour or more. They don’t have a ride and the people who are supporting them have to take off work,” she said. “If you live in a Cedar Rapids or Des Moines, you’ve got lots of options—there are lots of agencies, cabs, buses, you can walk. In northeast Iowa, that’s not the case.”

In her nearly 17 years at SASCC, French said overcoming stigmas and misconceptions has been one of the biggest efforts. People are often hesitant to ask for help.

“The Midwest mentality is that ‘Someone is always worse off than I am.’ We think, ‘I’ll get through it.’ As agencies, we are continually trying to educate people that there are services available and this is how you access them,” she explained. “With this agency, part of it is the stigma: ‘I don’t want to call those people because that’s where you go if you’re really down and out.’” 

“But we do much more prevention work than we actually see clients,” she continued. “We have people who call every day and ask, ‘Could you tell me where there are AA meetings in Clayton County? If I have a friend who has this problem, where would I go to get help?’” 

Lessening that stigma has come a long way, but there’s still a ways to go, according to French. Many people, at some point in life, develop a picture in their minds of what an alcoholic or substance abuser looks like. But you often can’t identify people by looking at them. 

“A lot of times, people are surprised to learn they’re probably receiving services from somebody who’s misusing substances. It may be somebody at the school, somebody at the convenience store, somebody at the bank, at the church. People who misuse substances are in all walks of life,” she said. “And just because they may be abusing substances doesn’t mean they have a legal charge yet or they’ve lost their job. There are a lot of people who have been able to manage their substance misuse with the rest of their life. Eventually, though, there’s usually a crack.”

One area French has seen improvement is the realization that people can have problems or legal charges related to substances, but that it doesn’t have to define them as a person. 

“We’ve gotten better about it with alcohol because alcohol is legal. There’s still that stigma related to illegal substances, and meth is one of the big ones,” she said. “Most people do not, early on in their life, make the conscious decision that, ‘When I’m 19, I’m going to become a meth addict or I’m going to start misusing prescription medications.’ There are any number of ways where people slide into that. Some people are legitimately prescribed medication for a physical issue and that led into other things.”

“It’s hard to quit using some of those substances because there’s the physical dependence and psychological dependence,” French added. “For many people, they need long term assistance. Most people didn’t become dependent on substances over night. It took years. So to think they can go through a six-week treatment, eight-week treatment, 30-day residential treatment and come out and everything is great is kind of unrealistic. They may need to do several terms of treatment, be in connection with some type of recovery group.”

The profession is also realizing that helping those with substance misuse problems doesn’t necessarily mean an all or nothing approach. Some individuals who come to SASCC are being told to, and they may not be ready to stop using. In cases like this, harm reduction has become an option, said French.

“There’s been talk that it’s enabling them: ‘If they’re only using meth once a week instead of five times a week, you’re OK with that? That doesn’t seem right,” she shared. “We’re looking at a way to help people think about things differently. If you’re someone who’s drinking seven days a week and it’s causing problems for you and you’re not interested in giving up your drinking, what kind of changes would you be willing to make. Instead of drinking seven days a week and driving, maybe drink five days a week and not driving. At least it’s a starting point.”

For French, it’s important to meet people where they are.

“No five people I see in this office are in the same place in their lives. Everybody is different, so we need to treat them differently and work with them differently,” she said.

In her new role with the Iowa Department of Public Health’s (IDPH) Prevention Bureau, French said she will work “from the other side,” so to speak. Currently, SASCC works under prevention grants put out by IDPH.

Although some of what SASCC does is dictated by state and federal requirements, she hopes the board and staff will take her departure as a time to look at what the agency is doing, who’s doing it and how they are doing it. 

“One of the things the agency has been looking at, and I hope will continue to look at, is becoming licensed to provide treatment services again,” French said. “Wouldn’t it be nice if someone who lives in Elkader, Monona, Guttenberg didn’t have to travel to Decorah, Oelwein, Manchester, Dubuque, to actually do their treatment, if they could do that in Clayton County. Or if they didn’t have to travel that distance to do the drinking driver’s school.”

“As an agency, they’re really looking at what can we offer to better serve people within the county. I truly hope they’re going to be able to get somebody hired quickly and they can work with the licensure folks,” she concluded.