An interview with Bill Benham, director of clinical services
Bill Benham oversees the new patient program as well as Evergreen Treatment Services’ counseling services. Along with the medical directors, he also administrates dispensary services so that patients get the medication they need to support recovery. Because this title and job description may seem opaque to someone outside the treatment community, we thought it would be helpful to sit down with Bill to learn how he got involved in this work, and to help our supporters understand how work like Bill’s contributes to ETS’ mission to transform lives.
Bill, we know your name and title, but help us understand what that means – what do you do on an average day?
A lot of my work deals with federal and state regulations. I make sure that our medication-assisted treatment (MAT) for opioid use disorders is provided safely and effectively, in terms of the dispensing of medication, and to ensure our patients have access to their counselors when they need them. I also help to make sure we get reimbursed for the services we provide.
Everything I’ve mentioned is incredibly important, but not all that sexy. So, I’ll switch to the best part of my job. I think the official term is “leadership by walking around.” I walk the halls of the facilities, stopping occasionally to talk to patients as they use our services. I see how they are doing and ask them how we’re doing. I like to ask what they would change if they ran the place, or were “king for a day.” All of this helps us measure our effectiveness, and figure out how we can improve.
What’s the best answer you’ve received for that question?
One person said he wanted a MAT mobile treatment van to come to his house, instead of him having to go to the clinic. This is a great idea, and we just received a grant from King County to fund a MAT van to do something very similar to this – though perhaps not quite as personalized as home visits. The van will move between various locations, making our treatment more accessible to people who do not live close to a clinic.
We understand that regulations are important, but do they ever become a burden? Or create barriers to treatment?
Outside of nuclear power, medicine is the most regulated sector of business in the U.S. economy. This means that our counselors, who see many patients per day due to the tremendous need for treatment in our community, often spend more time filling out paperwork than counseling patients. If counselors do not understand why they’re filling out this information, they may feel resentment for the workload. Our counselors are amazing people who do this job because they care about patients, not because they love paperwork. My job is to ensure that our team understands the value of complete patient records and to help them manage their work effectively.
I also have to make some judgment calls about whether certain regulations ensure consistent care or if they are outdated and over-regulating treatment. If not kept in check, regulations can become like barnacles on a ship – once you get one regulation, it’s difficult to get rid of and often some layering can happen, even if the reason for the bottom layer of regulation no longer exists. In these situations, my role is to advocate for the counselors to get the regulation changed or streamlined if possible.
Overall, it helps me to think in big picture ways. From supporting counselors to better managing the logistics, I focus on what I can do to ensure patients get the best care possible.
Why did you get into this work?
My father struggled with an opioid use disorder for 20 years. He didn’t die of an overdose, but his use disorder definitely shortened his life. He died of complications related to use, and while he was alive, I believe his quality of life would have been much better had he had access to MAT.
I also wanted to help this community. The population we serve is incredibly diverse, and many patients have been dealing with use disorders for a long time, directly and indirectly as addiction is often intergenerational. While we’re currently in an opioid epidemic and opioid overdoses are increasing, particularly in white, middle-class families, people in communities of color have been struggling with addiction for a very long time, as have veterans. ETS has been operating for 45 years. This isn’t a new thing.
What did you do before working for ETS?
Well, speaking of helping veterans, I am one. I was a combat medic in the Army for a long time. I was stationed in Korea, Germany, Kosovo, Turkey, spent some time in Cuba, did one tour in Iraq, Kuwait, and then I retired in 2013. While in conflict zones, I served in combat support as an EMT and ambulance driver.
After retiring, I went to work for the VA. From my time in the military and the VA, opioid use disorders were rampant. For a long time, prescribing opioids was just what the military did to deal with pain. They were convinced by the drug companies that opioids were safe for long-term treatment of chronic pain. From 2001 to 2009 the number of prescriptions written for pain medication by military physicians more than quadrupled. The consequences of this are very clear among the veteran community, particularly those who are also struggling with mental challenges like post-traumatic stress disorder.
Can you share any stories with us about a patient that impacted your life, or made you feel like you’re doing the right work?
So many, but the one that pops into my mind now is a patient down at our Grays Harbor Clinic. She’s in her early 20s and her mom got her to start using heroin. She used for several years until she finally had enough and began treatment when our clinic opened in Hoquiam. She tried to get her mom to go with her, but her mom wasn’t interested.
After a while, her mom couldn’t inject herself anymore because she would shake and couldn’t see very well, so her daughter – who was in recovery – helped her mom use while she herself was trying not to use. You can imagine how challenging this would be, but she kept at it. Finally, she got her mom to start treatment as well. I can’t say that their lives are all sunshine and rainbows now, but they’re better – much better – without needing to use heroin every day to not feel sick. They both take better care of themselves, sleep, and eat well. It’s the little things that improve lives.
I really like this story for a few reasons. One is that it shows how deep heroin use can go, and how much people will put up with in order to continue using. Addiction is a disease. No one would use like this for fun.
Secondly, it’s a story of persistence but it’s not a neat story. These people have flaws. It doesn’t end with this woman going to Harvard and becoming a physician. It’s a real and messy story, but one with hope. People like this woman’s mother will enter treatment when they’re ready – and we need to be here for them when they’re ready. Our patients aren’t perfect, but neither am I, and neither are you. We all deserve the opportunity to live our best lives.
What do you want people to know about addiction and medication-assisted treatment?
We, as a society, are far more likely to forgive and show compassion to a person of means, like the actor Heath Ledger. But “normal” people with use disorders do not get even close to that level of empathy or compassion. No one who walks through our doors is perfect. Just like every other person on the planet. Their lives are hard, and they deserve real human compassion, not judgment.