Contacts: Steven Lee, UT Health San Antonio, (210) 450-3823, lees22@uthscsa.edu
Monica Ramos, Bexar County, (210) 335-2742, Monica.Ramos@bexar.org
Content contributed by Sandra Zaragoza, Andrea Rochat
SAN ANTONIO, Nov. 6, 2024 – Bexar County awarded The University of Texas Health Science Center at San Antonio (UT Health San Antonio) three grants totaling $9.9 million in federal coronavirus relief bill funding to improve access to health care and create a more equitable and resilient community.
Money from the legislation, known as the American Rescue Plan Act (ARPA), locally will support further recovery from the COVID-19 pandemic in addressing addiction from substance use, behavioral health and long COVID.
Bexar County selected UT Health San Antonio’s Be Well Institute on Substance Use and Related Disorders, a statewide system of substance use and mental health services, for two, two-year grants totaling $7.6 million to support local substance use treatment and peer recovery support services. And Health Confianza, a countywide multilevel health literacy initiative of UT Health San Antonio, will receive a two-year, $2.3 million grant to address long COVID and health literacy challenges.
“This funding is a lifeline for individuals in Bexar County who are struggling with homelessness and substance use disorders,” said Jennifer Sharpe Potter, PhD, MPH, vice president for research at UT Health San Antonio and founding director of its Be Well Institute. “Too many people are unable to get the care they need due to limited access, fragmented care and stigma. With this support and the partnership of local organizations, we can bring compassionate, evidence-based services right to our community, ensuring no one is left behind.”
For Health Confianza, the Bexar County grant comes on the heels of the Promising Practice award from the National Association of County and City Health Officials (NACCHO) for its innovative approach to improving health outcomes in underserved, under-resourced communities in San Antonio. Health Confianza collaborates with organizations, health professionals and the community to reduce health inequities using health literacy strategies. A few of the key benefits of health literacy include improved health outcomes, increased ability to navigate the health care system and lower health care costs.
“This grant will enable us to empower community members to take charge of their own physical and mental health through our team of dedicated community health workers, said Jason Rosenfeld, DrPH, MPH, associate professor at UT Health San Antonio and co-director of Health Confianza. “At the same time, Health Confianza’s work will help to increase the efficacy and coordination of services of health and social service agencies in Bexar County. When you improve health literacy, you improve the well-being of people living in Bexar County.”
The effects of the pandemic
Congress passed ARPA in 2021 to address the economic and public health impacts of COVID. More than five years after the start of the pandemic, Americans still are experiencing its broad effects, especially those in vulnerable populations with barriers to health care.
Be Well Institute is using its funding to deliver two critical programs aimed at addressing substance use and recovery support in Bexar County. In collaboration with Corazón San Antonio, Be Well Institute is launching a Mobile Medical Team to meet the urgent need for substance use treatment among individuals experiencing homelessness, led by project director Tara Karns-Wright, PhD, MS.
This initiative combines Be Well Texas’ expertise in addiction care with Corazón’s trusted outreach services, providing in-field care, addiction treatment and comprehensive coordination to enhance access to vital health services for this vulnerable population.
Additionally, the funds will enable the launch of the Bexar County Community Recovery Support Services initiative in collaboration with community partner Unity Recovery, with Potter as project director. This project will establish the county’s first recovery community organization and recovery community center to offer peer-led recovery services for individuals facing substance use and mental health concerns, including those at elevated risk of experiencing an overdose.
Operating seven days a week, the center will provide peer recovery support services to individuals and family members, while also expanding the workforce to increase access to peer support services and improve long-term outcomes across the community.
The pandemic also highlighted the health disparities vulnerable communities face, such as poverty, housing instability and lower health literacy, which lead to higher rates of chronic diseases and worse health outcomes.
With Bexar County’s funding, Health Confianza and its main partners — Southside Collaborative, South Central AHEC (Area Health Education Center), WestCare Foundation and YWCA San Antonio — plan to expand health literacy training and programming into 12 high-priority ZIP codes in Bexar County. In keeping with ARPA goals, Health Confianza will also focus on long COVID, chronic illness, and mental health education and training.
It is estimated that one out of every five people who have COVID can go on to develop long COVID.
“Long COVID is now a recognized chronic illness, and our understanding of it is growing,” said Melanie Stone, DrPH, MEd, assistant professor of family and community medicine at UT Health San Antonio and co-director of Health Confianza. “Research has shown that it can trigger other issues that our communities already struggle with, such as diabetes and heart issues. By making systemic health literacy improvements, such as equipping organizations to provide better access to long COVID and preventive health education and services, we are helping individuals achieve enhanced well-being for themselves and their families.”
The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.
Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.
The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a comprehensive, low-barrier system of care that provides compassionate, evidence-based treatment for substance use and related mental health concerns across Texas. Through its hybrid clinic offering virtual and in-person services, a statewide provider network of more than 140 community partners and wraparound services like peer recovery support, the institute reduces barriers to treatment and supports recovery. It also leads cutting-edge research to advance treatment and conducts workforce training to disseminate best practices. Funded by federal and state sources, the institute is dedicated to expanding access, reducing stigma and improving care for individuals and families affected by substance use disorders. Go to bewelltexas.org.
Founded in 2021, Health Confianza is a collaborative, multilevel public health initiative aimed at creating a more informed, confident and healthier community. Through health literacy programs designed to help people make health decisions, we are increasing access to and utilization of health information and services. In keeping with its mission, Health Confianza, which is housed at UT Health San Antonio, has engaged with thousands of community members and provided support and training to numerous nonprofit agencies and clinics. In 2024, Health Confianza received the Promising Practice award from the National Association of County and City Health Officials (NACCHO) for its innovative approach and the strides it has made in improving health literacy in underserved, under-resourced communities in Bexar County. To learn how to get involved, visit HealthConfianza.org and WellnessCultura.org.
SAN ANTONIO – Recovery is a long road for everyone, but for some, there are extra barriers.
That’s the case with methamphetamine, which affects the brain in a very different way, and is extremely addictive.
The KSAT Solutionaries team found out about a unique treatment being used for both.
Meth use is rampant in our community and across the country.
More than two and a half million Americans are using methamphetamines, which include hundreds of thousands here in Texas, according to the National Institutes of Drug Abuse.
The National Institutes of Health reports that overdose deaths involving methamphetamine nearly tripled from 2015 to 2019 among people ages 18-64 in the United States.
A UT Health San Antonio doctor said he’s seen a tenfold increase in his patients over the last decade.
A local facility, Alpha Home, reports 50% of their clients now come in with meth addiction.
Using meth for a long time or in high quantities physically damages the brain so much that researchers have equated it to a traumatic brain injury.
Relating those together, a lightbulb went off for experts and out came a unique solution: using the same simple therapy for both TBI and meth recovery.
“What led me to my substance use basically was relationship. It was kind of like, ‘If you love me, you’ll use with me.’ And I was really scared but I did it and it was so powerful, like, I had to have it,” said Dana Snider.
Snider was 19 when she tried methamphetamine.
“From there on, it was on and off until I was 35 years old. You know, with losing my kids, destroying relationships, selling drugs because now I have to support my habit. Doing things that I didn’t ever think I was going to ever do,” Snider said.
She didn’t realize how many other young people were just like her, and had such easy and cheap access to meth.
“Around the age of 16 I tried cocaine. But at 17 I tried meth, and that’s what really got me,” said Ashley Criado.
Criado fell into the same darkness, initially finding sobriety, but it didn’t stick
“I ended up relapsing when my youngest at the time was about six months old, and I lost my three children. I was homeless. I experienced a lot in that time. But October 4th, 2018, I came back to Alpha Home. And so my sobriety date is October 5th, 2018,” Criado said.
Both Criado and Snider wound up at Alpha Home, a long-time San Antonio residential treatment center and home for women with substance use disorder.
“I’ve been sober for six and a half years,” Snider said.
It was in rehab that they started to learn the biology of what had happened to their brain.
They were surprised to hear all the damage that had been done.
“I remember in class, I was crying. I was like, ‘Am I ever going to, you know, be smart?’” Snider said through tears.
Snider would soon find that her education would extend further than she’d ever thought possible, but what she was learning in the moment was terrifying.
She was taught that meth can destroy brain cells in crucial areas, more so than a lot of other drugs.
That brain injury is usually to the prefrontal cortex, which controls things like personality, decision making, long-term planning.
There is also typically damage to the hippocampus, which controls memory and learning.
“A lot of hallucinations and delusions. I would see things that weren’t there, hear things that others could not hear,” Criado said.
Doctors report about a third of people that use methamphetamines experience psychotic events, and another third of those are going to experience continued psychosis even after they stop using meth.
“One of the biggest things was the jolting. My eyes would jolt. It would be like you see on a TV screen how it kind of goes like into a squiggle,” Snider said.
There were also simple things she just couldn’t seem to manage, even though she was fully committed to recovery.
“It was very irritating to me. I couldn’t pick up on appointments. I was trying to do the things I needed to do, but it was very hard to remember stuff,” Snider said.
“Someone that’s in persistently psychotic state, unfortunately may not have the organization, attention and wherewithal to seek treatment, particularly in a complicated health system,” said Addiction Medicine Physician Dr. Curtis Bone with Be Well Texas.
Be Well Texas is a state-wide, all-encompassing addiction program run through UT Health San Antonio.
Bone said with those intense symptoms in addition to attention problems and planning abilities, patients have trouble retaining treatment, even if they want it.
“When you have a learning disability, whether it’s something you’re born with or something that you’ve damaged because of drug usage, you still need that unique support for whatever it is that you’ve got,” said Alpha Home CEO Liza Jensen.
In her work, Jensen learned something very interesting about these meth-induced brain injuries.
“It is believed to be in some research studies, very similar to somebody who has a traumatic brain injury,” she said.
Traumatic brain injuries cause similar symptoms to those described after meth use: potential for increase in impulsivity, problems with attention and organization, problems with those executive function tasks if the the injury impacts those parts of the brain.
The connection between the two has been researched by the National Library of Medicine and studied by SAMHSA, the Substance Abuse and Mental Health Services Administration.
Jensen mentioned military practices that the VA was using a therapy called contingency management with their traumatic brain injury patients.
Research shows they soon found it also worked for veterans with substance use disorder.
“What they have found that is effective is somebody who gets rewarded immediately to help reinforce the learning of a skill or behavior. And the way we do that is that we constantly give them positive reinforcement for what they’re doing right,” Jensen said.
“There are decades of research, that demonstrate the effectiveness of contingency management,” Bone said.
However until recently, it hadn’t been used in these recovery spaces.
Alpha Home’s Contingency Management program is a level system that rewards clients for hitting weekly treatment goals, like attending classes or meetings.
Rewards are then given out in group settings, in front of peers.
Level 1 is backpack. (Given during a client’s 1st Community Group on week 1)
Level 2. Journal. (Given between Day 14-29)
Level 3. Highlighters. (Given between Day 30-44)
Level 4. Bracelet. (Given after 45+ days)
On the other end, if clients are not successful they fill out a learning experience form and do extra chores. They also continue getting support from their staff and peers.
Jensen said the type of reward isn’t what’s important. It’s the hit of dopamine the brain gets from accomplishing a task and getting encouragement for it.
“30 other people are saying, ‘Yay, way to go!’ That feels good when you’ve got cheerleaders on your side,” Jensen said.
So why does that simple thing work physiologically?
“Methamphetamine is similar to other substances in that it interacts in the reward pathway and cause the release of dopamine. Euphoria makes people feel good,” Bone said.
But when the person stops taking the drug, the brain still needs that reward pathway stimulated, and it’s not easy to match the power of something like methamphetamine.
“So this provides kind of a bridge, you might say, to allow for time to recover, for that prefrontal cortex to get engaged,” Bone said.
Be Well Texas uses contingency management, too, and has the funding to give monetary rewards for small actions.
“Engaging with recovery communities, for example, or reading certain texts, going to appointments, meditating,” Bone said.
The answer both centers have found aligns with the research that medications helping with cravings combined with behavioral therapies, like contingency management, tend to work the best.
“It gets better. There’s light at the end of the tunnel,” Snider said.
Snider and Criado are perfect examples of that.
“I’ve been teaching the Monday morning recovery planning. I’m going to be switching to anger management on Thursdays,” Criado said.
Both women got degrees and have become counselors at Alpha Home, and are using contingency management with their own clients.
“It’s more of a small paper that we call push-ups. It’s like, ‘Hey, good job,’ and we post it on their door,” Snider explained.
She can see first-hand, the reaction.
“They love it. They start taking ownership of what they’re doing. They start getting honest,” Snider said.
They both emphasize brain health, even more so for their clients recovering from meth.
“Giving out crossword puzzles or word search, like ‘Here, exercise your brain a little bit.’ We do math problems sometimes at the beginning of class,” Snider explained.
“Doing anything to challenge your brain because of the neuroplasticity, right? Your brain’s going to be able to heal itself,” Criado said.
That healing has a beautiful ripple effect.
Both women are reunited with their kids and finding true joy in their lives. They say it’s worth every second of the work it took to get there.
They join the researchers and doctors in emphasizing that prevention is key in the form of education and they hope the community will begin spreading this life-saving information.
They also hope more addiction recovery centers and doctors will use contingency management programs for their patients.
However, for someone already using meth, or any drug, it’s never too late to get help.
Be Well Texas has a 24/7 help line, and can connect you or a loved one to almost any type of service. Those services include in person and virtual counseling, statewide treatment, housing and recovery services, distribution of naloxone, and even the ability to cover costs of some treatments.
Reach out, and call 888-85-BEWELL or (888) 852-3935. You can also go to their website.
To watch the full KSAT interview, click here.
SAN ANTONIO – Hope is the one thing no one can live without, and that’s precisely what recovery homes are trying to provide for people battling addiction issues.
In March, UT Health San Antonio announced that its program, Be Well Texas, received a $3.4 million grant for a pilot program to support recovery housing statewide.
UT Health San Antonio said the funds would help expand access to the program for Texans who are housing insecure and battling addiction. KSAT got a look inside one such recovery home in San Antonio, where people suffering from opioid use disorder receive treatment.
Recovery homes provide housing for people who are in long-term care for addiction. Clark Cadwallader, co-founder of New Day Recovery Services, took us inside one of his facilities — a home with multiple bedrooms, living rooms, a meditation room and exercise equipment.
Cadwallader told KSAT this one facility is geared toward people with opioid use disorder, something he battled years ago.
“I’m a person in long-term recovery. I got sober back in 2014,” he said.
“OxyContin was my main thing. [I] was first introduced to opiates through being prescribed [them] by a doctor for an injury,” said Cadwallader.
Now, Cadwallader helps others with the same struggle.
“We’ve seen a big uptick and especially in a lot of our younger population that we serve. Their drug of choice is now fentanyl,” he said.
People in recovery homes get help staying sober and accountable. Eventually, they transition into their regular lives and return to work. Cadwallader told KSAT the average person stays in his recovery home for about eight months.
Cadwallader stayed at a sober living facility when he struggled to stay sober. He said it improved his life and kept him on the right path.
Now that he’s eight years sober, Cadwallader said everyone in recovery needs to believe that things will improve, and recovery homes are a good start.
“There’s a solution that really works to this problem,” he said.
There are more than 40 houses and 440 beds in recovery homes throughout Texas within UT Health San Antonio’s network. The program, Be Well Texas, receives funding from the Texas Health and Human Services Commission.
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