Pam has been trying to stop abusing drugs and alcohol since 1988. Because of her battles with depression, stable housing and chronic stress, she has relapsed many times. Today, she has two years without using opiates, several months without alcohol, a place to live, and healthier ways to cope with depression due to Alameda Health System’s (AHS) PRIME and ambulatory efforts to integrate behavioral health and addiction treatment with primary care.

“If I’m being honest, my motive for going to see Dr. Tian was to try to feed my opioid addiction. He told me he couldn’t prescribe me any medication without running tests first to try and figure out where my pain was coming from. I soon realized I was going to have to be honest with him. I told him about my depression and that I had even had suicidal thoughts. At this point he referred me to Lisa,” said Pam.

Lisa Cooper is a licensed clinical social worker and the behavioral health supervisor of ambulatory services at AHS. Pam admits she was reluctant to reach out at first.

“I’ve worked with social workers in the past and I just didn’t want to make a connection. One issue I faced before was turnover. I would start working with someone and they’d no longer be available. I have abandonment issues,” said Pam.

Pam would set up the appointments and not have consistent attendance. Eventually she came to trust Cooper and the process.
“I consider Lisa a dear friend. She has really supported me this whole time. She doesn’t tell me what to do, she gives me suggestion and she listens. She never made me feel guilty about my drug use, she focused on what was happening with me internally to where I felt I needed to use drugs. She has encouraged me to participate in additional support groups outside of AHS, she even came with me to my first one,” said Pam.

Cooper used a combination of therapeutic techniques and case management to help Pam and says she has actively participated in her recovery throughout the process. Additionally, Pam was enrolled in the Primary Care Addiction Treatment Program (P-CAT) led by David Tian, MD. This program offers medication assisted treatment, case management and group counseling.

“When I first met Pam she was abusing opioids, homeless, stressed out and dealing with major depression. Now she has housing, she’s sober, and she’s even taken a leadership role amongst her peers at our group therapy sessions. She never stops trying and it shows,” said Cooper.

Pam thinks it is important to speak up and speak out at the group meetings because she’s been by herself with negative thoughts that things would never get any better.

AHS patient Pamela R.

“I understand addiction. I understand feeling so low you don’t want to go on. I think it is important to share my story with others to let them know they are not alone. We can support each other. I’ve been where they’ve been and if they keep pushing through they can make it,” said Pam.

Integrated behavioral health in primary care and the P-CAT opioid use program are two initiatives at AHS as part of the system transformation efforts to improve the health outcomes of patients.

“It is great to see our system working. I believe strongly in both of these programs. It is wonderful to see such a tangible example of success,” said Cooper.

“When I finally admitted I needed help it was like a chain reaction. From Dr. Tian, to Monica in my group therapy, to Lisa in our weekly sessions. I felt everyone worked together as a team to help me get to the much better place I am in now.”