The following feature story was written for VUMC Voice. View the original story here.
Schuyler Clayton graduated high school in 2003. It was also the year he buried five friends, all of whom died as a result of substance use.
“Growing up in Appalachia, there was drug use everywhere,” said Clayton, a native of Johnson City, Tennessee. “From the kids who didn’t go to school to the athletes to everyone in between, no one really batted an eye at it. It was predominant in most of my friends’ families.”
Clayton, now an addiction recovery coach at Vanderbilt University Medical Center, wasn’t immune. He began experimenting with drugs at 18, and watching the consequences play out for his friends only fueled what quickly became a full-blown addiction to opioids.
“Their deaths didn’t stop my use. They only propelled it. I had an excuse to use the drugs because of the way I felt,” said Clayton.
He was 19 the first time he sought help from a six-week program at a local Suboxone (buprenorphine-naloxone) clinic. When the program ended, he was offered no plan for follow-up care, and he relapsed shortly after.
Over the next decade, he went through five more treatment programs, most of which were residential. Each time he was discharged, he was sent back home to Johnson City, distanced from the recovery community he’d been building and with few referrals for subsequent care. His longest period of sobriety was 10 months.
While his 20s are tough to recall, Clayton made a conscious decision at 26 to try quitting for good. He threw all his drugs away, including medications he was supposed to be taking, and within two days, the detox caused him to have a transient ischemic attack, or a brief lack of blood flow to the brain. He was hospitalized and entered his fifth attempt at treatment shortly after.
“That was the first time I took treatment seriously, because I thought, ‘Wow, I’m really going to die,’” said Clayton. “They tell you that all the time. I tell my patients, ‘You’re flirting with death,’ but it’s hard to internalize that. I think often people who suffer from addiction think, ‘I’m going to be different,’ until something happens.”
Clayton spent the next two years stabilized on Suboxone. For the first time, he could pay off a house, hold a steady job and pay his bills, but the emotional challenges of grappling with addiction only worsened, leading to depression and isolation.
“I wasn’t going to counseling or sobriety meetings. When you’re on Suboxone, it’s hard to feel like you’ll be accepted at meetings,” said Clayton, explaining that many programs are abstinence-based and biased against medications for addiction treatment.
Clayton talked his mom into attending a support program designed for family members. She stopped at his house after one of the meetings and asked about his Suboxone use, withdrawal symptoms, whether he was attending meetings and what he needed. What she didn’t know was that Clayton was actively planning suicide — a plan halted by her support.
His parents found an alternative recovery center for addiction located in Dickson, Tennessee, and Clayton embarked on his sixth treatment program — a program he credits with saving his life.
“The thing that was different about this program was that there was a plan in place for what happens after you leave. Thirty days is a small blip of time to change behavior. It’s not enough time to develop a habit,” said Clayton.
The program offered extended care after residential treatment, and once patients finished their 30 days, they were invited to stay in the community through a volunteer role, leading groups and helping other patients. Clayton spent six months volunteering before being offered a paid position, which he held for a year and a half.
“The program is community-based. We didn’t read medical charts to see what was going on. We just talked. That’s where I found my passion,” said Clayton. “On my worst days internally, I was still able to show up for patients. I realized it was something I needed to do.”
Clayton left his job at the program to start a career in addiction counseling at a recovery center in Knoxville. There, he was trained on motivational interviewing and communication techniques, learned about the stages of disease and underwent training in suicide and overdose prevention and CPR.
He stopped thinking about drugs and has been sober the full three years since.
When he saw an open job opportunity at Vanderbilt to join a new addiction “bridge clinic” for patients who are caught in the hospital system without a safe or timely discharge option, he thought the approach sounded too good to be true.
He interviewed with David Marcovitz, MD, medical director of the Bridge Clinic, to become VUMC’s first-ever recovery coach.
“Recovery coaches can play a vital link between health care systems, siloed addiction treatment agencies and community recovery supports. There is also emerging evidence they can improve addiction outcomes,” said Marcovitz, who noted he had hoped to fill the role with someone who had both training and personal experience with substance addiction.
“Lived experience helps us bridge that divide between professional treatment and the recovery community and between patients and providers. It also allows the coaches to empathize and counsel patients in a truly unique way that can be effective at times when medical professionals may not be.”
On Clayton’s first day at VUMC, Marcovitz took him straight into the hospital to meet with patients. By revealing his own recovery story, Clayton made instant connections.
“I immediately felt comfortable because I was seeing what I’d been seeing for a long time in myself and in my friends. I think patients are comforted when they see that I’m not affected by what’s going on. I talk to them on a human level, and I try to motivate them for change while also meeting them where they’re at,” said Clayton.
“I don’t go in there carrying a self-help book and saying, ‘Read this, it’s time to get sober.’ Instead, I say, ‘What are you going to do that’s going to keep you alive, reduce your harm and increase your quality of life, and how can I help get you there?’”
Part of the Bridge Clinic’s mission is to make addiction care synonymous with medical care, eliminating the shame associated with seeking help.
“Our patients live with a disease they don’t get help for out of fear of blame,” said Clayton. “That’s why it’s important for me to say, ‘I’m living with the same thing, and I’m not ashamed.’”
“Schuyler brings a passion and dedication to his work, no question, but also an understanding of our complex treatment system and the role of medication for addiction treatment that is pretty unique in the recovery community,” said Marcovitz.
When he’s not helping patients plan for discharge, he’s making sure referrals go through so no patient facing addiction leaves the hospital without follow-up care.
While his work days are dedicated to helping others, his priority when he clocks out is taking care of himself.
“It’s very important to counterbalance my own recovery with my work life,” said Clayton. “I call my sponsor on my drive home. At night, I attend meetings and sponsor other men.”
When it comes to getting sober, Clayton stresses that recovery is something no person should face alone.
“I had every reason to quit a thousand times,” said Clayton. “It wasn’t until I developed an internal drive and someone else showed me how that I was able to do it. They accepted me where I was and inspired me to be who I would eventually become.”