Nzinga Harrison, MD – In Recovery Podcast
Health and Wellness, Science & Technology Interview Series
Welcome to The Not Old Better Show. I’m Paul Vogelzang, and this is episode #451.
As part of our health and wellness series, our guest today is Dr. Nzinga A. Harrison.
Dr. Nzinga A. Harrison is the Chief Medical Officer, at Eleanor Health. Eleanor Health is a new-ish (and pretty groundbreaking) outpatient clinic with a unique payment model and an emphasis on evidence-based care, with an emphasis on a problem-solving, rather than a fit-someone-inside-a-box, approach to treatment.
A well-respected physician and educator, Dr. Harrison is the Chief Medical Officer and Co-Founder of Eleanor Health, a value-based provider of compassionate, comprehensive, outpatient addiction treatment. Approachable and energetic, she has been known to explain medical concepts with an ease and humor that results in her audiences developing understanding of difficult material while having a good time doing it! And, you’ll hear that throughout the interview.
You’ll also hear us talk about Dr. Nzinga A. Harrison’s new podcast, In Recovery, with Dr. Nzinga A. Harrison. The In Recovery podcast will fill the much-needed gap for individuals and their loved ones seeking immediate and long-term support with addiction. Hosted by physician and addiction medicine specialist Dr. Nzinga Harrison, In Recovery will field questions in a radio-style, call-in format from real people struggling with every form of addiction, from drugs and alcohol to work and gambling.
Here is a brief trailer from In Recovery, new from Lemonada Media.
The new trailer from In Recover podcast. In Recovery is also for healthcare providers and anyone committed to a more values-based, comprehensive and compassionate approach to recovery and mental health in America and abroad.
Please join me in welcoming to The Not Old Better Show via internet phone, Dr. Nzinga Harrison.
My thanks to Nzinga Harrison for her generous time today, and my thanks to Lemonada Media for all the arrangements. My thanks to you, my wonderful Not Old Better Show audience. Please keep the emails and show suggestions coming my way at Paul@notold-better.com. Remember, be safe, be well, practice smart social distancing, and let’s talk about Better. The Not Old Better Show. Thanks everybody.
In Recovery Podcast is available on Apple Podcasts, here:
Paul Vogelzang, Host (00:02):
Welcome to The Not Old – Better Show. I’m Paul Vogelzang, and this is episode number 451. As part of our Health and Wellness series, our guest today is Dr. Nzinga Harrison. Dr. Nzinga Harrison is the Chief Medical Officer at Eleanor Health. Eleanor Health is a new and pretty groundbreaking outpatient clinic with a unique payment model and an emphasis on evidence-based care, which we’re going to talk about today, and there is an emphasis on problem-solving rather than a fit-someone-inside-a-box approach to treatment, which is so prevalent in healthcare today.
Paul Vogelzang, Host (00:43):
A well-respected physician and educator, Dr. Harrison is the Chief Medical Officer and co-founder of Eleanor Health, a value-based provider of compassionate, comprehensive outpatient addiction treatment. Approachable and energetic, Dr. Harrison has been known to explain medical concepts with an ease and humor that results in her audiences developing understanding of difficult material while having a good time doing it, and you’ll hear an awful lot of that today throughout the interview. You’ll also hear us talk about Dr. Nzinga Harrison’s new podcast, In Recovery With Dr. Nzinga Harrison. The In Recovery Podcast will fill the much-needed gap for individuals and their loved ones seeking immediate and long-term support with addiction, hosted by physician and addiction medicine specialist, Dr. Nzinga Harrison. In Recovery will field questions in a radio style, call-in format from real people struggling with every form of addiction, from drugs and alcohol to work and gambling. Here’s a brief trailer from the In Recovery Podcast, which is new from Lemonada Media.
Nzinga Harrison, MD (01:53):
I always say I want us to get to the place where you could be in a bar and say, “I’m not having a drink because I have alcoholism,” and that engender the same kind of understanding and support that it would be if you said, “I’m not going to eat this piece of cake because I have diabetes,” or even to take it the next step if somebody said, “I’m not going to go in that smoky place because I’m a breast cancer survivor.” Right? Like immediately, everybody would rally around that person and be like, “Oh my gosh, breast cancer is such a scary illness,” like, “Great for you for fighting it. So happy that you’re in recovery. What can I do to support you?”
Nzinga Harrison, MD (02:38):
We don’t have that same orientation for people that have addictions, especially substance addictions, but this is true. Like you couldn’t say, “I’m not going to go pass that movie theater because it triggers my sex addiction.” Right? Like the eyeballs that will fall on you would just be heavy and immediately burst you into flames, and so when we can get to the point where our knee-jerk reaction is the same as, “I’m not going to do that because I’m in recovery,” or, “I’m in treatment for breast cancer,” then I think we will have made so much progress in the right direction.
Paul Vogelzang, Host (03:17):
The new trailer from In Recovery Podcast. In Recovery is also for healthcare providers and anyone committed to a more values-based, comprehensive and compassionate approach to recovery and mental health in America and abroad. Please join me in welcoming to The Not Old – Better Show via internet phone Dr. Nzinga Harrison. Nzinga Harrison, welcome to the program.
Nzinga Harrison, MD (03:39):
Thank you so much, Paul. Amazing to be here.
Paul Vogelzang, Host (03:41):
It’s amazing to talk to you, and you are doing some amazing things. I really want to get into this with you, but I’d like to know a little bit about you, who you are. First, how are you and your family doing during this quarantine time or social distancing, but tell us a little bit about you and how things are going.
Nzinga Harrison, MD (03:58):
Oh, yeah. Thank you so much for asking. I continue to be grateful every day about how me and my family are doing during social distancing. To let the listeners in, I am a wife and a mom. My two sons are 13 and 14. My 20-year old niece lives with us.
Nzinga Harrison, MD (04:22):
We have three dogs, German Shepherd. My niece’s dog is a Pit Bull, and then the queen of the pack, who is our little Chihuahua/Schnauzer mix. She’s like-
Paul Vogelzang, Host (04:30):
Nzinga Harrison, MD (04:32):
Yeah, [acts 00:04:33] clearly napoleonicly in charge, and so I’m on video all day with my colleagues and I see folks who are really adhering to social distancing and they live by themselvesm, and I’m like, “Oh, man. That would be so difficult for me if I didn’t have other people and other four-leggers in the house.” Then, thinking about the people that we take care of, and I’m sure we’ll get into it later, but Chief Medical Officer and co-founder of Eleanor Health. We provide addiction treatment, and it’s like seeing how the pandemic has just really ripped the rug out from under the feet of people with less, just really shines a light on not taking for granted the ability to shelter in place at home, or the ability to send my 20-year old niece to the grocery store because she’s dying to get out of the house and I’m not, right? We’ve been doing really well.
Nzinga Harrison, MD (05:39):
We’ve definitely … People that I love have lost people to COVID. I’ve definitely lost a couple of friends, which is really hard because we’re young and nobody thinks about going this young, but despite that, I would say that we’re doing well and I’m so grateful for that.
Paul Vogelzang, Host (05:57):
Well, you refer to Eleanor Health, and I have to tell you, I love that name. Many of my audience, of course, are going to be thrilled perhaps to hear the, kind of the behind the scenes on that name, of course, tied to Eleanor Roosevelt, but something else is important in this too, and I wonder if you could tell us the two meanings, and as I understand it too, four of the Eleanor Health units are open, or more are on the way. Based in High Point, North Carolina, this is all great stuff, but, yeah, tell us about the name because that’s very creative.
Nzinga Harrison, MD (06:31):
Yeah. This is actually one of my favorite things to talk about as it relates to Eleanor Health. Interestingly, we’re a brand new company. We just hit our one-year anniversary. Like our CEO started May 1st as co-founder and CEO and employee number one, May 1st, 2019, and that’s Corbin Petro.
Nzinga Harrison, MD (06:52):
She’s like total boss. You should for sure Google her. Then, I started May 6th as co-founder number two and Chief Medical Officer, and at that time, the name of the concept was Recovery NewCo, right? Didn’t even have a name, and so when Eleanor Health got chosen as the name, it was for three reasons. One, you already mentioned the absolute health champion, health equity champion and icon, Eleanor Roosevelt.
Nzinga Harrison, MD (07:26):
She really was like one of the original figures raising her voice to health as a right, and as a human right, and as a civil right, and so we carry that very deeply in our hearts and our identity as a company. Then, second is that Eleanor in Greek means shining light, and so we know so much about the illness of addiction is dark and painful, and so much about the stigma that we’ve created in this country around having the illness of addiction and the way we treat people with addiction. We shove them into the dark, and then blame them for not being able to reach out for help, and so that, the word or the name Eleanor in Greek … We’ll do that over, because my allergy voice. The name Eleanor in Greek stands for shining light, really represents that we want to be a shining light, a beacon of hope for people who have been affected by addiction, so that is whether you are the person who has the addiction or the family or the loved one, whether uses active or whether that illness is in remission and that person is in recovery.
Nzinga Harrison, MD (08:47):
At any point where an individual who’s been affected is on their path, we want them to be able to look up and see the light of Eleanor Health. Then, the last is super simple, which is our foundational belief is that long-term relationships create the opportunity for health and meaningful living, and so we wanted to present ourselves as a relationship with a person, not with a relationship with a company, and so we chose a person’s name.
Paul Vogelzang, Host (09:21):
Brilliant. I really like that. Well thought out too, and meaningful. Great combination with the name. You mentioned recovery, and I want to shine a little light on that subject.
Paul Vogelzang, Host (09:33):
The name of your podcast is In Recovery. We’re going to get into that, but let’s dive into the weeds a little bit because my audience will certainly be very interested in kind of your take on these four levels of care in practice at Eleanor Health, those of the four levels of recovery, so tell us about those first.
Nzinga Harrison, MD (09:49):
Sure. We really strive to care for the whole person that walks in the door, so we say like being affected by addiction is the key that turns the front door to Eleanor Health, but what we know and the reason we call people who join our community, we call them community members, not patients, is because what we know a person with a full set of experiences and a full set of needs, and quite frankly, a full set of things to offer walks in that door, and so when we talk about recovery, the traditional addiction treatment provider is measured really on two measures. Like number one, “What percentage of people in your care have a negative urine drug screen?”, and number two, “How long … What percentage of people ‘Complete your program’?” What we know at Eleanor Health is that a negative urine drug screen does not tell you if a person’s life got better, and whether they completed your program does not tell you if that person is living a life of recovery.
Nzinga Harrison, MD (11:00):
When we think about recovery, it is used interchangeably with complete abstinence from alcohol or other drug use, and we’re using it differently at Eleanor Health. We’re using recovery to be that person has the autonomy and the wherewithal to define what an amazing life is for them, and that may be different from our definition. That may be different from your definition, but once they define like, “This is what an amazing life looks like to me. It’s being socially connected, it’s having my own identity, it’s being independent in this way, it’s doing this hobby, it’s eating this meal, it’s having this freedom,” however they define amazing for their life, recovery is actively working the magic formula that helps remove the barriers to their definition of amazing, and so recovery is not just a negative urine drug screen, it’s physical health. It’s mental health.
Nzinga Harrison, MD (12:06):
It’s emotional health. It’s social health. It’s culture and ethnic identity. It’s age identity. It’s meaningful connectedness. It’s giving back to the community, right?
Nzinga Harrison, MD (12:16):
Like it’s an entire 360-degree concept of what it means to be living a meaningful life despite having a chronic medical illness, and so when we talk about the four phases of care at Eleanor Health, we actually have this hashtag. Probably every single place anybody hears me talk about Eleanor Health, they hear me say, “#Eleanorforlife,” or, “Recovery for life.” Right? What we mean that to be is like we don’t want a temporary relationship with the people that join our community, and so yes, we have four phases of care for the first year that a person is with us, and the idea of that is this idea of a recovery capital. You can think of it like money, right?
Nzinga Harrison, MD (13:06):
The more recovery capital a person has, the more likely their illness is to stay in remission, and so people come to us. Recovery capital is stability, connectedness, life meaning, basic needs are met, right? All of that is recovery capital, and so typically, people come to us, and their recovery capital is low, and so we see ourselves in that first phase as lending them a lot of recovery capital, and that comes in seeing us however many times per week they need to see us, talking to us, checking in, drug screens, medication, therapy, nurse care navigation, peer support, all of that. Over the four phases of the first year, as they begin to develop more recovery capital from their community, from their support systems as their illness stabilizes, they need less from us, and so the intensity of our services scales down, but never do we want somebody to finish. We want Eleanor alums, right?
Nzinga Harrison, MD (14:10):
We want people wearing Eleanor T-shirts that say like, “I’m in recovery. Recovery for life.” Right? “Eleanor, you should go there because they actually care about you and love you and want a relationship forever,” and so we really take the concept of recovery. I say put it on steroids to the next level, right?
Nzinga Harrison, MD (14:29):
It’s not just not using, and for some people, there may be recovery even while using something. That’s a little bit controversial. I don’t know how your listeners will feel about that.
Paul Vogelzang, Host (14:42):
I think that’s an important distinction, because I think my audience, I think my listeners are going to really understand this idea that we’re individuals, that we need to look at each other from a 360 perspective. I like the way you refer to the members of Eleanor Health. Not the clients, not the patients, but the members, and so words matter to you, so I think that distinction is an important one, and abstinence and recovery, they are very different, and you might show up one day with a negative urine test, and that might be because you’ve relapsed, but that’s the way … That’s how we are sometimes as individuals.
Nzinga Harrison, MD (15:24):
That’s exactly right, and if you’ll let me tweak your language just a little bit and anybody-
Paul Vogelzang, Host (15:29):
Please, yeah. Yeah. Definitely.
Nzinga Harrison, MD (15:31):
Anybody who talks to me will be like,” Oh my God, she’s the biggest language tweaker of all time.”
Paul Vogelzang, Host (15:35):
No, please. I want to get this right because I think our listeners are going to want this right too.
Nzinga Harrison, MD (15:40):
Yeah. The tweak that I wanted to make was you said, sometimes that’s just how we are as people, and what I really want to do is divorce this idea that people with addiction are fully defined by that, and so the tweak that I would make on that, instead of, “They may have a drug screen show it actually would be positive for drugs in their urine because that’s the way we are as people sometimes,” I would say, “Because that’s how the symptoms of this illness go sometimes.” Right? If we were talking about diabetes and a person’s blood sugar came back high, we wouldn’t say their blood sugar is high because of who they are. We would say their blood sugar is high because that’s a symptom of their illness, and so the same is true for that drug screen that shows whatever it shows, heroin, marijuana, ecstasy, amphetamine, whatever it shows, not because of who that person is, but because of the illness that person has.
Paul Vogelzang, Host (16:44):
Unique, and thanks for pointing out that distinction. I think that that’s important. The other thing that I thought that was really unique about Eleanor Health is this focus on recovery, but this idea that it’s outcomes-based, and so I wonder if you’d talk a little bit about what that means to be positive health outcomes base.
Nzinga Harrison, MD (17:06):
Paul, you are asking all of my favorite questions, okay?
Paul Vogelzang, Host (17:09):
Nzinga Harrison, MD (17:09):
Paul Vogelzang, Host (17:12):
Nzinga Harrison, MD (17:13):
Yes. Yes, yes, yes. Really, in other parts of medicine, for example, your primary care doctor, would not be able to say, “We’ve successfully treated your high blood pressure,” without having an outcome attached to that that actually showed your blood pressure was better, and so in many ways, addiction treatment and substance use disorder treatment has been allowed to lag behind other medical specialties because we’ve not been held to an industry standard for what defines improvement, and so this is a really foundational, just like identity piece for Eleanor Health that you’ll hear many providers say we’re evidence-based. The evidence says for addiction treatment there should be access to medications, and therapy, and counseling, and peer support, and linkage to resources, and all of that is the evidence base. We take that to the next level.
Nzinga Harrison, MD (18:16):
We’re not just evidence-based, which we absolutely for sure are, we are data-driven, and so we can say what percentage of our members have seen an improvement in their depression since they’ve been with us because we’re using validated evidence-based scales to measure and quantify depression symptoms. We can say that people’s lives … I’ll start that over. It’s allergy season. We can say that people’s lives are getting better when they join our communities because we’re measuring their recovery capital, and we’re getting quantifiable scores that show us, yes, lives are getting better.
Nzinga Harrison, MD (19:04):
We’re measuring quality of life measures that show us lives are getting better. We’re measuring anxiety, gives us a score that shows us anxiety is getting better, and yes, we’re measuring urine drug screens, and so we were just looking at our urine drug screen data today because we review data as a team every single week in some form, and we were looking at drug screen data today, and from the time people come into us that first drug screen to the most recent drug screen, the presence of illicit opioids, so heroin, methadone bought on the street, pain pills like oxycodone, Roxi, all of those is reduced. Like 75% of people that come into us have an illicit opioid in their first drug screen. That’s reduced down to less than 20% in the most recent drug screen, and so, yes, we can say illicit opioid use is getting better as measured by this data. Then, very importantly, when you take care of people, driven by data and outcomes, like people actually getting better, then that undermines what is a negative side effect of the current way our healthcare system is structured, which is called fee for service, right?
Nzinga Harrison, MD (20:23):
Like you get sick, you go see the doctor, they provide a service, you get a bill, you pay that fee, and so there’s an unintentional consequence in that, that you could be providing lots of services and costing lots of money to that individual person, but also to the healthcare system at large, and people still not be getting better, and so when you focus on the outcomes, one of the outcomes we focus on is like we believe we can help people get better. This is the Triple Aim. I would love to claim ownership of this idea, but it’s not mine. It’s the Triple Aim, like we believe we can help people get better because we’re taking care of people longitudinally over every phase of the illness, right? We believe we can do that while giving people an amazing experience, so 98% of people in care with us say that they have felt cared for and respected, and that our team were experts and professional in their presentation.
Nzinga Harrison, MD (21:25):
98%, right? The scale show people’s health getting better. The member satisfaction data shows that they know we really care about them, and we can do it for less than the cost of the traditional healthcare system. That’s the value-based identity that Eleanor has.
Paul Vogelzang, Host (21:45):
Impressive. Definitely. Nzinga Harrison, a physician and co-founder of Eleanor Health is with us today. I get this real sense of energy from you. I’m so impressed to hear about the business expansion. Congratulations on all of that.
Paul Vogelzang, Host (22:02):
I know you’re super busy, and so I really just, I don’t want to leave you though without talking about the new podcast, which is we’re on the eve of the launch of In Recovery. Great title, I think. Especially appropriate for all that you’re doing. I think there’s going to be call-ins with the show and I think there’s going to be some real instances of recovery. I’ve heard you say in research that I’ve done on you, the show’s going to be about all things addiction, so tell us what you mean by all things and tell us about the show, and who’s it for and kind of what you believe is going to kind of come from the show too. What are some of the outcomes that are going to come from the show?
Nzinga Harrison, MD (22:41):
Yeah. I am super busy, you’re right, but just crazy excited about In Recovery. This podcast is produced by Lemonada Media, and some of your listeners may have heard Last Day Podcast, which is really how I came to meet Jess and Steph and the whole team over at Lemonada. I should even take that up a notch and say like came to meet them, and then just came to be an absolute all-out fan.
Paul Vogelzang, Host (23:11):
Nzinga Harrison, MD (23:13):
The Last Day Podcast starts really from the absolutely personal and devastating loss that Jess and Steph both had when their brothers died from opioid overdoses. What’s so brilliant about that podcast is that it created a community of people that could, at the same time, sharing the pain of loss, but look at the potholes in the current system we have and like call them out and not be like make you cry, and make you laugh, and make you wonder, “How can we talk about such a nuanced and difficult topic and want to keep tuning in every single week?”, and so I came on their show as an addiction expert and talked through medications. That series was always meant to be limited, and so as the opioid portion of the Last Day Podcast was coming to an end, it was obvious to the folks over at Lemonada that people need it more and people want it more, and so I was just thrilled when they approached me and asked me to host the follow-on podcast, which is In Recovery With Dr. Nzinga Harrison. That’s my radio voice. I’m working on it.
Paul Vogelzang, Host (24:32):
I love it. I love it. You’re booming.
Nzinga Harrison, MD (24:34):
As you mentioned, it’s designed to be a Q&A show, because what they were finding was that folks were emailing in, and calling in, and leaving voicemails, and tweeting with all of these questions to which people need answers, and so In Recovery is meant to try to stand in that space. Folks can send in their questions, email, voicemail, tweet us, and when I say all things addiction, this is excruciatingly important to me, so substance addictions get a lot of the spotlight because their consequences are like visible, right? The opioid epidemic became so visible to people because your loved one was here today, gone tomorrow. The alcohol epidemic, the cigarette and tobacco epidemic, those are more slower-moving, but people are dying. Then, even outside of substances, so sex addiction, gambling addiction, porn addiction are also consuming people’s lives and people are also struggling, and we heap the same amount of shame, and we try to shove those disorders and the people with those disorders in the dark the same way we do with substance use disorders.
Nzinga Harrison, MD (25:54):
What I found over the last two, three years as the opioid crisis came into the collective consciousness and started to really get some compassionate energy behind it, is that other substances were being left behind in terms of compassion and stigma reduction, but also other addictions were being left even further behind, and so what I want to do with In Recovery is talk about not just those addictions that people immediately see as negative, but even things such as work, right? I, myself struggle with that because I love working, and I will work to the detriment of my family. That is a problem, right, and so we will talk about that on In Recovery. Food, right? Exercise.
Nzinga Harrison, MD (26:46):
Like people are like, “What do you mean exercise?” Yes. There are people who exercise to the point to their physical injury and continue to exercise, even though their physical injury is a result of the exercise, right? That is an addiction, and all of these behaviors share common neurobiological pathways, and so In Recovery is like send in every question that you never had space to ask because you thought you would be judged, because we’re not going to judge you. Like I will answer your question from my medical expertise.
Nzinga Harrison, MD (27:26):
I will answer your question from my personal experience. We will use your personal experience to talk about how we can show up better for people with addiction, how we can start bending this curve to help, as we say, at Eleanor Health, people affected by addiction live amazing lives, and so the podcast is just, people have been saying like, “We’re so glad you’re doing this,” and I’ve been saying, “I’m so glad for the opportunity to do this.”
Paul Vogelzang, Host (27:55):
Yeah. I’m glad to hear about it too, and I just have been moved by your passion and I just get this sense that anyone coming into Eleanor Health is going to have 100% of the tools offered to them to meet their recovery needs. We’ve of course been with Nzinga Harrison, who’s the Chief Medical Officer and co-founder at Eleanor Health, also the host of the new podcast, In Recovery. Nzinga, we’d love to have you come back and talk more with us at some point. What a pleasure it’s been to talk to you, and please, please keep all this up. Congrats on the business going as it’s going, and good luck with this podcast too, because it will mean a lot to people.
Nzinga Harrison, MD (28:35):
Thank you so much, Paul. I really appreciate being here. Just my pleasure.
Paul Vogelzang, Host (28:42):
My thanks to Nzinga Harrison for her generous time today. My thanks to Lemonada Media for all the arrangements. My thanks to you, my wonderful Not Old – Better Show audience. Please keep the emails and show suggestions coming my way at email@example.com. Remember, be safe, be well, practice smart social distancing, and let’s talk about better. The Not Old – Better Show. Thanks, everybody.