A mother's urgent message on mental health and addiction

Have you ever wondered how deeply intertwined mental health and addiction can be? According to reports published in the Journal of the American Medical Association, around half of those with serious mental health issues also struggle with substance use disorder. Experts say that certain substances can trigger mental health problems, while mental health struggles can lead to alcohol or drug abuse, creating a complex and often devastating cycle.

Stephanie Marquesano knows this cycle all too well. She lost her 19-year-old son to an accidental drug overdose after he battled both substance use disorder and anxiety. In this episode, she shares her regrets about not knowing more about co-occurring disorders. She emphasizes how better treatment and awareness of the connection between mental health and addiction could save lives.

Her organization, The Harris Project, was also involved in an award-winning PSA, which you can watch here.

Transcript

[00:00:00] You Don't Know The Half Of It: Drink to feel something. To feel nothing. Drink if no one even knows.

[00:00:15] Angela Kennecke: Have you ever wondered how deeply entwined mental health and addiction can be? According to reports published in the Journal of the American Medical Association, about half of those suffering from serious mental health issues also struggle with substance use disorder. Experts say certain substances can trigger mental health problems, while mental health struggles can lead to alcohol or drug abuse.

creating a complex and often devastating cycle. 

[00:00:42] Stephanie Marquesano: So much of the work that we do nationally is siloed, like it's either mental health or substance use disorders and not really integrating the two together. 

[00:00:51] Angela Kennecke: In this episode of Grieving Out Loud, hear from a bereaved mother who deeply regrets that her son never received better co occurring disorder 

[00:00:58] Stephanie Marquesano: treatment.

11th grade came. ACTs, SATs, you know, am I playing soccer in college? And the anxiety came back with a vengeance. 

[00:01:08] Angela Kennecke: Join us as Stephanie Marcosano transforms her personal tragedy into a powerful crusade to raise awareness about the critical connection between mental health and addiction. 

[00:01:20] Stephanie Marquesano: The time between the onset of a mental health disorder and the development of a subsequent substance use disorder is a key window of opportunity where co occurring disorders can be prevented.

So if we could make sure that every single young person, family support, adult in their life understands that, that's number one.

[00:01:53] Angela Kennecke: Thank you for joining me for this episode of Gribbing Out Loud. I'm Angela Kenecke. I know the heartache of our nation's opioid epidemic. I lost my daughter to fentanyl when she was just 21 years old. If you or a loved one is struggling, I encourage you to seek help right away. You can find a list of resources on our website, emilyshope.

charity. I posted a link to the show notes in this podcast. Also if you have an idea for a podcast episode, we would love to hear from you. Email us at contact at emilyshope. charity.

Well Stephanie, it is a pleasure to see you again. Welcome to Grieving Out Loud. We were last together. In August, doing advocacy work in Washington, D. C. 

[00:02:43] Stephanie Marquesano: Absolutely. It was International Overdose Awareness Day and an opportunity to once again connect to parents who belong to the club that nobody wants to be part of.

[00:02:53] Angela Kennecke: I know. I always say I'm so glad to know the parents that I've met, and you and so many others, but I wish it weren't under these circumstances. However, you have been working on this advocacy. When you're way ahead of me in this game, several years ahead, I mean, unfortunately, because you lost your son in 2013.

[00:03:09] Stephanie Marquesano: Absolutely. And for me, you know, everybody kind of enters this space if they want to do this education and awareness work with the thing that they're drawn to most. And for me, a non practicing attorney now, but I'm an attorney by training. I was a PTA president and school board member. And when Harris died, the one thing that I kept thinking was, every program he went to said he had this thing called co occurring disorders.

They all said they treated co occurring disorders. And for me, what I needed to figure out was how within a year and a half of entering that first substance treatment program, he was dead. And so co occurring disorders has really become my rallying cry, the call to action. 

[00:03:51] Angela Kennecke: Stephanie says she noticed her son struggled with mental health issues at a very young age.

In fact, At just three years old, Harris was diagnosed with an anxiety disorder. 

[00:04:02] Stephanie Marquesano: Not one professional ever said, good looking social kid like you, but so much anxiety, you need to be really careful around substances. Like that could be a spiral. You go down really quickly. Instead, he had starts and stops and challenges and stopped playing sports and, you know, eighth grade came and he was really struggling and we were seeing a professional.

His behaviors were becoming more and more unpredictable as the year went. I was on the school board. I ended up resigning. Everybody in my community thought, he's just trying to get away with stuff because you're important. My husband and I were like, we think he's losing his mind. We went to what would be the last appointment with the therapist he was seeing who said, Harris has become more than I could manage.

And by the way, he's been smoking marijuana. I thought he was just experimenting, but I think he might have a problem. 

[00:04:55] Angela Kennecke: You must have felt so alone and isolated and confused and, I mean, just you're searching for answers and you're basically getting blamed, right? Or people don't understand. And I just can't imagine, I mean, I can imagine a little bit because I went through some of this with Emily, taking her to counselor after counselor, she had all these outrageous behaviors that started in high school and trying to get help seemed impossible.

Exactly. 

[00:05:20] Stephanie Marquesano: And so here I was thinking, you know, my husband and I were going, we're like hoping that this is all going to work out. And then, We recalibrated, we kind of pulled ourselves together, we homeschooled him for the end of 8th grade. Harris was very committed to going to our local high school. He got fully evaluated, he picked up the ADHD diagnosis, he went on medication for the first time, and he started doing really well.

He went back to playing sports, he was all league and all section in soccer, and we kind of thought, this is like rear view mirror, like we're living the typical suburban life. And he was seeing a therapist and he said, you know, I'm so busy and the medication is working like I'm good. And we went to see her with him and she said, yeah, he's good.

Like, you know, you're done. We can move on. And what I think should have happened was, He should have been told, your brain is always changing, you might hit a bump in the road, you're doing well right now, but I want you to know, like, the door is always open to come back.

[00:06:24] Angela Kennecke: Unfortunately, Harris would need to come back. Anxiety hit him hard during his junior year of high school, bringing back the Those difficult struggles all over 

[00:06:33] Stephanie Marquesano: again. Acts, SATs, you know, am I playing soccer in college? It overwhelmed the medication and he really didn't wanna tell anybody because we had gone through so much trauma when he was in eighth grade, he went to a party in my town.

Prescription pills were available, took those pills, and that's when I could say for us, the game was over. 

[00:06:57] Angela Kennecke: Over the next year and a half, Harris sought help for substance use disorder. through four inpatient centers, along with two outpatient programs. 

[00:07:07] Stephanie Marquesano: Everybody's saying Harris has co occurring disorders and saying that they treated it.

He had been in a program in Florida. It was a program that promised going to college, social emotional, psych work, community like life skills, and substance use treatment. They completely failed on the mental health piece. In fact, while he was in the program, everything was fine and the program was actually on the college campus, but I'll never forget when they said that the sober living environment, you had to take sort of a train to get to campus and Harris was so incredibly anxious about the thought of getting on that train that he derailed the experience.

He ended up finding his own path to a treatment program and a sober living environment where the person he was living with ended up bringing pills in and you know the story and they said, well, he needs to like go to a motel and he'll be fine, you know, we're just going to keep an eye on him and he's still going to school and in under 48 hours of being in that motel, he had reached out to people because a 19 year old with an anxiety disorder could not really be on his own.

Like, we should have been encouraged to fly down. We shouldn't have been told he'll pull himself together and either that or we'll send her to detox. We've got our eyes on him. And so my biggest regret is that we didn't go down is that we didn't say, you know, Harris, we really don't want you on your own.

Like we want to be there. 

[00:08:38] Angela Kennecke: Within two days of staying at that motel, Harris bought prescription pills off the streets and suffered a deadly opioid overdose. 

[00:08:47] Stephanie Marquesano: They had his computer and the police looked at his history. and the pills that the person brought in, Harris was actually looking to see how much he could safely take of that.

So, you know, we knew that it was an accidental overdose. His clothes were laid out for an interview he had that morning and, you know, for me it was such an incredibly overwhelming and challenging time, but it was like the silence was deafening for me. And the one thing that just kept ringing out was co occurring disorders.

You need to figure this out. And you need to tell people that the time of shaming and blaming is over. You know, at these programs, they put them in the middle of the circle, the shaming, the blaming, the language, the stigmatizing experience. But nobody ever actually getting to the mental health piece and that's what drove each recurrence of use for him 

[00:09:45] Angela Kennecke: Have you lost a loved one to overdose or fentanyl poisoning?

I'd like to invite you to share their story on our new Emily's Hope Memorial website called more than just a number They were our children, siblings, cousins, husbands, wives, aunts, uncles and and friends. So much more than just a number. You can submit a memorial today on MoreThanJustANumber. org.

Right, so really the mental health issue really set him up for addiction, plus he was using substances such as marijuana and then later the opioid pills on a developing brain and a brain that was already troubled. Absolutely. But it was so hard to fit those pieces of the puzzle together because nobody was helping you do that.

[00:10:31] Stephanie Marquesano: Exactly. And here I was, you know, I was the PTA president. We would bring in the programs on mental health or somebody who had struggled with addiction and came in to share their story. But at no point in time did I think these things are really connected, that this inextricable link needs to really be discovered.

How do you prevent something you've never heard of? And how do you demand access to the right kind of treatment if you don't even know what's missing? Like, people who struggle with their mental health and with substance use disorders are not often thought of in terms of like, evidence based practices or what we really need to do to deliver the gold standard care.

Like, we wouldn't accept this level of treatment as far as human beings and then the actual models For any other domain of health, you know, heart disease, cancer, diabetes, you know, you tear your ACL, you find out you have a peanut allergy. Nobody is saying like, what are you doing wrong? People are there to support you.

And I felt like those who are living in my shoes and those who are living the life that Harris lived deserve better and deserve more. 

[00:11:41] Angela Kennecke: You know, and when you talk about we should have, or I wish we would have, I think, We all go through that, would've, should've, could've, right, but you believe that your child is in a program you can trust and you think, you hope everything's going to be okay.

Hindsight is 20 20, right? So it's just so hard what we learn after the fact, after the fact of our children's deaths, the things that I have learned, we wish we knew beforehand. But now you've been doing this work for 10 years. What do you think has changed in those 10 years? 

[00:12:12] Stephanie Marquesano: So I can say that locally, where I am in Westchester County, New York, we are a portion of the nation that is completely committed to co occurring competency.

And by that I mean, you know, it's multi level, and I will say that everything didn't fire all at once, but there was a vision. And so the vision was prevention, and we started CODA, Co Occurring Disorders Awareness. Most recently, we were awarded with Partnership to End Addiction, a significant grant from our county, to create the first evidence based prevention curriculum for high school students about co occurring disorders to really educate and empower.

We're working on developing a 6th grade through 8th grade curriculum, we're doing a curriculum for parents and caregivers, and a curriculum for school personnel, faith leaders, community organizations, and coaches. So that's kind of prevention. We have a logo, a brand, and it's very exciting. Like, that is the piece that I will say, as far as ownership goes, it is truly my baby.

[00:13:12] Angela Kennecke: That's wonderful. We have a curriculum at Emily's Hope, too, and I feel it's our gold star. I feel it's our biggest accomplishment so far, and we continue to develop it. It's a substance use prevention curriculum, but you're talking about co occurring disorders. So what? What do 6th to 8th graders need to know about co occurring disorders?

[00:13:28] Stephanie Marquesano: So the real goal is to really look at pathways to substance misuse and addiction. That, you know, oftentimes there's three ways that you can get co occurring disorders. So, the majority have an existing or an emerging mental health disorder, not looking to party. They want to go to the party feeling comfortable in their own skin.

They're looking to reduce stress, to relieve tension, not really understanding how awfully bad this could go. Then you've kind of got the middle. You've got a predisposition to mental health and substance use disorders. But we also, the third category, so I'm somebody who can have like a thousand young people in an assembly and it's like, you know, by this point they're hearing about Harris, they're interested in the work, but the third category is really the one that impacts everybody.

So we 25. And for our young people, they really need to understand that. Anytime they ingest a substance, alcohol, THC products, nicotine, that they run the risk of changing their brain chemistry, of developing a mental health disorder, even if they weren't on track to. So if you don't give them the knowledge and you don't empower them to be really strong decision makers, we end up in situations and we kind of put our hands up when we're in crisis, but we forget about the fact that.

If you plant those seeds early on, you know, my wish, and I always say this, my fondest wish is that all of our young people are absent from substances until they're 25, right? But is that realistic? Probably not. So we begin to encourage them to think about their why. To take those couple of seconds before any use and think about what the consequences are.

[00:15:10] Angela Kennecke: With the rise of fentanyl, that consequence could be death, even on your first use. In fact, the Drug Enforcement Administration says seven out of every ten fake prescription pills investigators are allowed to use. lab tested, contained a deadly dose of fentanyl. 

[00:15:26] Stephanie Marquesano: You know, a young person can go to a festival, they take a pill, they can be dead on the spot.

But for many of our young people, we kind of reach the point where they understand the risk, but they're struggling and they're in so much pain that that no longer matters. And so really getting them to think about not just the fact that the supply is so risky, but the incredible importance of getting help and support early.

For more UN videos visit www. un. org 

[00:15:53] Angela Kennecke: Right. That's so true. And we hear so often now, especially social media is often blamed, of course, but the horrible epidemic of mental health for young people involving anxiety and depression. And several of my children have suffered from anxiety and depression. And so, I mean, I know how real that is.

And it seems like it's almost the majority of young people versus the minority these days. 

[00:16:17] Stephanie Marquesano: They're saying that 49. 5 percent of U. S. teens have a mental health disorder, 22 percent with significant impact. There's the National Survey for Drug Use and Health. They collect data on only one point related to 12 to 17 year old major depressive episode and co occurring substance use disorder.

A staggering 935, 000 young people fit that definition, but in that space, do you know how many get access to treatment for both? I'm not even talking about the treatment we're doing here in Westchester, which is integrated, and they combined it, but just even getting sent to two places, 9%. 

[00:16:59] Angela Kennecke: Wow. 

[00:17:00] Stephanie Marquesano: It's staggeringly frightening and that's not including anxiety and co occurring substance use disorder, ADHD and co occurring substance use disorder.

That is one tiny sliver, but they say 21 million people in this country have co occurring disorders. Most have never heard of it. 

[00:17:18] Angela Kennecke: Stephanie is trying to change that through her non profit, The Harris Project, which focuses specifically on co occurring disorders. The organization not only supports those dealing with both substance use disorder and mental health issues, but also raises awareness about these challenges.

Here's Stephanie giving a TED Talk in 2023. 

[00:17:40] Stephanie Marquesano: My journey landed me on the cover of the New York Times Sunday Review this past summer. My journey brought me to the White House three times since August. My journey led to my appointment on the New York State Opioid Settlement Fund Advisory Board. My journey started at my kitchen table the day my son Harris died by accidental overdose.

[00:18:05] Angela Kennecke: After sharing her story in the New York Times, Stephanie got the opportunity to raise awareness in another unique way. 

[00:18:12] Stephanie Marquesano: I had outreach from a large media company and advertising agency, Havas, and one of the senior producers knew Harris and knew me and I'm a family friend. And he said, you know, I read the piece in the New York times.

Would you be interested in a campaign to raise awareness about co occurring disorders? And I said, sure. And what happened was almost 11 or 12 months of dialogue about what the campaign would look like. You know, typically in advertising campaign, you're selling a product, even if it's for a good cause, and they were, they needed to wrap their heads around the value of just raising awareness because educated consumers could move to shift the system.

And so we filmed in September. It turns out that the director who is multi award winning himself had his own lived experience with co occurring disorders. He wasn't diagnosed until he was in his 30s. It turns out the lead that was cast also had her own lived experience that she's public about. And actually there had been focus groups with people with lived experience with young people that had gone through INCAPA successfully with parents like us.

The um, campaign launched on October 23rd, which was the 10 year anniversary of Harris death. 

[00:19:31] Angela Kennecke: The PSA is titled, You Don't Know the Half of It. Here's a short segment of it. 

[00:19:37] You Don't Know The Half Of It: Drink if you have a crush on someone that's not your boyfriend. 

[00:19:41] Stephanie Marquesano: You 

[00:19:41] You Don't Know The Half Of It: got an update. Um, drink if you posted a photo I look trash in because you look good in it.

Oh, man. Oh, man. Oh, man. Um, drink if you have to drink to just to be here. Nobody. Yeah, yeah. Yeah, yeah. Yeah, yeah. Yeah, yeah. Drink if you don't know why you just said that.

Drink if no one likes you anyway.

Drink if you replay every conversation you had that day in your bed at night.

Drink if no one understands what you're so worried about all the time.

Drink if you can't go to class without it.

Drink if you're pretty sure everybody hates you. 

[00:20:51] Angela Kennecke: The PSA is really hitting home for a lot of people, and it's also getting noticed in the advertising world, winning both national and international awards, including the Webby's, Andy's, and Clio Hell, 

[00:21:03] Stephanie Marquesano: just to name a few. We've already won multiple awards.

It's being entered in all of the big advertising awards. The immediate acceptance by the field and the industry of advertising, the pieces were incredible. Like we were listed as a number 24 campaign for 2023 from AdAge. It's really been so exciting. However, I still think that the families, the individuals that need to see this aren't getting to see it as often as they should.

And so, you know, it's a, it's a multi dimensional challenge and there's a multi level approach, you know, consumers, families, parents, teachers, community knowing can kind of demand access to better care. And the system itself can begin to move and look at payment reform and look at the things that they're missing in the work that they're doing to really make this happen.

[00:22:04] Angela Kennecke: If you'd like to see the entire PSA, simply go to our podcast show notes. We've included a link. While you're there, we'd really appreciate it if you'd take a moment to rate and review this episode. It really does help us further our mission. to raise awareness about the opioid epidemic, break down the stigma surrounding substance use disorder, and hopefully, connect people with the help they desperately need.

Recently I was doing some research on another topic and I noticed that Oklahoma has an office of mental health and substance abuse. They've Put the two things together, but you're right. They are in silos. I think in most states, most communities throughout the country, you can go here to get treated for your mental health, but if you're suffering from substance use disorder, you have to go here.

And it seems to me like it's just so integrated that why aren't we combining these? If you could wave a magic wand. What would thorough, comprehensive treatment look like? 

[00:23:03] Stephanie Marquesano: Sure, absolutely. So I can tell you, first at the systems level, my wish would be that the agencies themselves would fully integrate. By that I mean they could bill appropriately for co occurring, their assessment forms would kind of take you down the path of mental health and substance use disorders, and then the actual protocol you use would deliver integrated care.

So we were doing a really good job in prevention. We were doing a really good job in the systems transformation and getting our providers to start self reflect and use some tools to develop competency. But then I started realizing and hearing from the field that if I were a clinician and I had a young person sitting in front of me with co occurring disorders, what exactly would I be doing?

Well, the pandemic hits right after that and we got funded in May of 2020 and we did our first pilot in integrated treatment. We have now gone into our fourth round. We have more than 60 clinicians that are certified and encompassed this once a week. Individual therapy for young people with co occurring disorders.

And our county has now a grant from the Substance Abuse Mental Health Services Administration to amplify all of that work. So right where I live, we have a wraparound coordinator. You make a single phone call. You are navigated to a clinician who can address co occurring disorders. We have support for families and loved ones, and we have sort of this wraparound system of pro social activities and a platform to really support our young people as they look at their pathway to kind of recovery.

[00:24:38] Angela Kennecke: So you have a model for the rest of the nation. 

[00:24:41] Stephanie Marquesano: Actually, we were selected as a commitment to action by the Clinton Global Initiative. They don't fundraise or fund you, but they provide you opportunities to really look at potential funding opportunities nationally. 

[00:24:54] Angela Kennecke: And what do you think it is that most people still don't understand about this?

[00:24:59] Stephanie Marquesano: So we are still in this space of either sequential treatment, like, you know, deal with the substance use first, and then we'll get to the mental health, which is really what Harris got. And Take away the substances and not address the mental health. The only thing you know to go back to is the substances.

Then we're in this world of like simultaneous treatment. Go here for your mental health and there for your substance use. So that's what happened after the first program Harris was in. I was a stay at home mom. I had to take him to the intensive outpatient program, the psychologist, the psychiatrist, the 12 step meeting, and the gym.

And there was a recurrence in use in under two weeks. And so, as much as we're moving the dial, there's definitely a lot of work.

[00:25:46] Angela Kennecke: Stephanie believes a lot of that work also lies in prevention. She would like more awareness and funding focused on preventing co occurring disorders from the start. 

[00:25:55] Stephanie Marquesano: One of the first schools I ever went to, the principal said, Well, you know, I kind of like what you're doing, and I kind of could see I can't tell who could be dead a year after graduation, but where's the evidence behind what you do?

And the lawyer in me, I found one study. It said the time between the onset of a mental health disorder and the development of a subsequent substance use disorder is a key window of opportunity.

So if we could make sure that every single young person, family support, adult in their life understands that, that's number one. That is the way to change things right out of the gate. 

[00:26:35] Angela Kennecke: So what should you do if you think your child may be struggling with their mental health? Stephanie suggests, don't wait.

Reach out to an expert right away.

In memory of a bright life cut short, Emily's hope shines a light on the path to recovery. Substance use disorder takes too many too soon, but you can help. Emily's Hope offers education, awareness, and financial aid for treatment, ensuring the cost never stands in the way of recovery. Join us in stopping stigma and saving lives.

Your support could be someone's beacon of hope. Visit emilyshope. charity to learn more. 

[00:27:18] Stephanie Marquesano: So I think first of all is taking mental health challenges seriously because I think everybody says, you know, mental health matters and our IQ around mental health has definitely gone up. However, I think that a lot of times people are eager to help other people who are struggling with their mental health, but when it's happening in their own household, They're not necessarily sure it's either bad enough or if this is really what it is.

And so I think that from the outset, everybody has the right to live as mentally healthy as they can. So it's not a, it's not bad enough. Like we tend to act in crisis and not really be proactive. And so I always say to families now, you know, if you're finally senses are tingling, if you're not really feeling like, you know, something feels off, go see somebody, go talk to somebody.

But even there. Only with mental health, you get like a name scribbles on a piece of paper, you go see the person, you're not feeling better, and then our young people often start just performing in the way that they think, you know, the answer should be, like, it must be me, they're doing what they're supposed to do, like, I must be making the mistake.

And so we really encourage young people to be honest, to say when they're not feeling better, that this might not be the right match, that, you know, it might not be the right protocol. 

[00:28:34] Angela Kennecke: We also have to find the right mental health provider because that is what I found with Emily was that I just could not find.

a mental health provider who could help. Right. It just got worse and worse and worse, and there was a lot of blaming, even among the mental health providers. It's this reason, it's you, or it's this, and just think, it was just so frustrating. 

[00:28:56] Stephanie Marquesano: How could Harris have been in 8th grade, and we're taking him to weekly sessions with a therapist, And they don't think that it's problematic that he's smoking marijuana and that we clearly didn't know if you look at any of the studies, like there is no such thing as experimentation and the impact on anxiety and panic and behaviors.

I mean, it was like. Classic psychosis that was marijuana induced and to me like that is another piece of the work as far as educating the consumer. 

[00:29:27] Angela Kennecke: Right. And we can be so failed by the system and there are, just like in any other sector, there are good people in that line of work and not so good people.

And so weeding that out, especially when it comes to mental health challenges and or addiction issues, is just, extremely difficult because you're sort of at their mercy, especially a family member, a parent doesn't really know what they're doing or what to look for. 

[00:29:49] Stephanie Marquesano: And so that's it. I mean, I always say, you know, our kids don't come with a guidebook and you really rely on professionals and every other aspect of, you know, your life.

And so why would you think that if this is something that's so prevalent, that it wouldn't be easy to access that system? And that I will say was. the magic behind the prevention work here. When I started CODA, it was really, really important that there's a protocol and there are clinicians to refer to who are using this gold standard of treatment.

[00:30:21] Angela Kennecke: Right, right. So, if you're in another part of the country that's not doing it this way, it can be tough. 

[00:30:27] Stephanie Marquesano: And then, if I could wave my wand and get rid of all of the stigma and the shaming and blaming and truly build the integrated treatment model, that would be it. 

[00:30:38] Angela Kennecke: Right, right. All of that stigma and shaming and blaming is so ingrained in our society.

It does sometimes seem insurmountable, right? Like, it's just So ingrained. And I mean, I'm going around and speaking to healthcare providers about stigmatizing people with substance use disorder when they come in to see them, right? Because it happened to my daughter and it happens to many, many people.

And then so many healthcare professionals unwilling to prescribe MAT because of their own stigma. 

[00:31:06] Stephanie Marquesano: Yeah. And even medication for opioid use disorder. If you actually look at the guide, it is supposed to be part of an integrated treatment plan. It's not necessarily supposed to stand alone. And I was at a conference this summer and there were a lot of, you know, medical professionals and they were talking about, you know, how do we get people to prescribe?

And I said, you might be approaching this the wrong way. You should be doing ad campaigns about the value of using MOUD and the importance of communities like, you know, demanding access. So if you, again, look at this from the consumer lens. You can actually shift behavior because if I know I need something and the people that I'm going to aren't prescribing it, I'm going to go somewhere else.

And so beginning to create that consumer demand could really change things as well. There are providers even, you know, locally that were not so inclined to want to really change their treatment models. And we're like, well, you know, we're presenting to the schools, we're meeting with pediatrician practices.

We're not recommending your agency if you're not delivering co occurring competent care. So we're not saying you have to do it, but you're certainly going to be obsolete if school based mental health satellites in my county are delivering co occurring competent care and you're not providing that service.

[00:32:26] Angela Kennecke: I wanted to ask you too, because you know, when I met you, I thought here is an extremely bright woman. Who is doing a lot yet, just like me, you are suffering from grief because that never goes away and you're a little bit further along than I am on this grief journey. I have been missing my daughter for nearly, it'll be six years in May, which seems impossible to believe.

And for you, it's been 10 years going on 11, right? So. How much does your grief still impact your daily life, and you're able to do so much and get so much done, that's really impressive. 

[00:33:02] Stephanie Marquesano: It's really something that I think the larger audience needs to understand. For me, and for you, more than likely, getting up and being proactive was the way that we kind of channel our grief.

There are some families and some people who've lived this experience where getting up and brushing their teeth is a win, and so nothing should diminish. Everybody else's way of managing for me. I knew my daughter was the senior in high school when Harris died. My kids were best friends. If I didn't get up and do something, I didn't think she was ever going to go away to college.

My husband went back to work. I. literally took every bit of my energy and channeled it into this, but I cry when I cry, I feel what I feel, Harris is extremely present for me, his poetry is included in my presentations, like he is literally on my shoulder each and every day, like I feel him so profoundly with me, and I will say, and I'm sure you know this to be true as well, There is nobody who is going to fight harder in a room.

There is nobody who is going to be more committed to what they believe in than a parent who has experienced something like this. And so, in the worlds of comparing and contrasting, I value other people's losses and tragedies and I'm there for my friends, but when it comes to this, I'm going to fight harder.

I fight hard, you know, with a smile on our faces sometimes, and with tears in our eyes at other times, but we will always stay true to the mission and to the belief that, you We can and should do better. 

[00:34:39] Angela Kennecke: Fortunately, we cannot change the losses that we experienced, but we can learn from them and we can try to continue to make the world a better place.

And I'm so happy that you're doing that. Right 

[00:34:49] Stephanie Marquesano: back at you. I do. I feel like, you know, Emily, you know, sits behind you. I see her picture and Harris is always with me and they will always be the age they were when they died, which makes us, I think, always. real voices for the space. Like when I speak about Harris, he is forever 19.

When I'm presenting to high school students or college age students, he is always relatable. He is somebody who could be, you know, hanging out with them right now. And I just think how different it could have been had we really understood what was missing in the system. Had we been told ways to better support him.

I think that. By default, the system pits parents against children because it deflects from the fact that what's being delivered is not really meeting the need. 

[00:35:37] Angela Kennecke: That's a really good point. Yeah, that is a great point. And on that, we'll wrap up this podcast, but I just appreciate you sharing all the insight that you have gained, all the work that you're doing.

Good luck with all of the curriculum. We're working hard on advancing our curriculum as well, and it's a big job. So yeah, just really appreciate that. And I appreciate all you do. Thank you for having me on. You're welcome.

And thank you for taking the time to learn more about one of the biggest crises facing our nation, the drug epidemic. If you found this episode helpful, please share it with friends and family. Thanks again for listening. Until next time, wishing you faith, hope, and courage.

This podcast is produced by Casey Wunderberg King and Anna Fye.