A conversation with Tom Coderre, principal deputy assistant secretary at the federal Substance Abuse and Mental Health Services Administration .
Tom, we will get into your distinguished career …
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A conversation with Tom Coderre, principal deputy assistant secretary at the federal Substance Abuse and Mental Health Services Administration.
Tom, we will get into your distinguished career in a moment. But let’s start with your personal journey. On May 15, you celebrated 21 years in recovery, writing in a post that “it’s a road from a badly broken human being to living a life beyond my wildest dreams.” Can you tell us about that road?
Wayne, first, thanks to you and Salve for the gift of Ocean State Stories and for caring about and covering mental health and addiction recovery as a journalist for decades.
As you know, I went through a vicious battle with alcohol and other drugs.
As my addiction progressed, I started to lose the things that were most important to me. When my family and friends tried to help, I resisted their help and pushed them away. This caused me to lose them. I lost interest in politics. I lost my job and my position as a Senate senator. My health deteriorated. I lost my apartment and became homeless. I lost my spirit. I lost my freedom and was briefly incarcerated. In the end, I lost everything, even my desire to live. My life, which at one time was so full of hope, became hopeless. Fortunately, I was able to get the help I needed. I was privileged to have access to psychiatric services and a long-term intensive substance-use disorder treatment program. As a result, today I’m a person in long-term recovery, which for me means that I haven’t used alcohol or other drugs since May 15th of 2003.
What were the factors, insights or interventions that made you begin recovery?
There were many. The downward spiral of my life and my declining health scared me the most, and fear can be a motivator. However, addiction is brain disorder, which functionally changes the circuits in your brain involved in reward, stress and self-control. It is characterized by compulsivity despite adverse consequences. So, I know it probably sounds unusual, but I’m grateful for my arrest, as it gave me the opportunity to stop and seek treatment. In recovery, we call this a nudge from the judge. However, when I was sitting in that jail cell, I realized the jig was up. My friend, the late Christopher Kennedy Lawford, wrote a book called “Moments of Clarity.” This was mine.
Did you have a coach or sponsor?
There are many pathways to recovery, but mine has been a 12-step recovery program, and I have a sponsor. In recovery we call this peer support – walking this journey alongside people with lived experience. Peer support has been essential for my recovery. Peer support taught me I was not alone. Peer support taught me that treatment is effective and that people do recover. Peer support gave me hope, community, a belief in today and a faith in tomorrow. Peer support provided a resilient and robust infrastructure of people and places, and peer support provided a loving but rigorous cohort of “re-enforcers” – people who understood the pitfalls, the daily struggles, the doubts, the uncertainties, and the rationalizations and who – passing no judgment – did not waver in pointing the way forward for me. These peers are people that a power much greater than myself brought into my life, to give meaning and purpose to my life, and to set me on a path where I too now have the chance to help others in need.
And tell us a bit please about your childhood and education.
I was born and grew up in Pawtucket. Attended local public schools until ninth grade, when I went to St. Raphael Academy. My dad graduated from St. Ray’s and he wanted his kids to do the same. It’s an amazing school and it’s where I received a top-notch education and made lifelong friendships. It’s also where I developed leadership skills and would take that with me after graduation. When I was young, my parents were very involved in a local civic group called the Jaycees, so I followed in their footsteps, joining the local chapter and then working my way through the ranks, eventually being elected national vice president. My mom was elected to the legislature as a state representative in 1984 and I decided to run for the state Senate in 1994 and was elected when I was 25 years old. I went to the Community College of Rhode Island and earned my associate degree and transferred to Rhode Island College, but because of my public duties, I ended up pausing my education. When I got into recovery at RIC, President John Nazarian reached out and helped me get back to finish the credits I needed for my bachelor’s degree.
Editor’s note: Coderre is a lifelong Rhode Islander.
OK, now your career before you were promoted to your current post as principal deputy assistant secretary at the federal Substance Abuse and Mental Health Services Administration, popularly known as SAMHSA. That was in February. Congratulations, by the way! You served in Rhode Island state government and also the federal government. Can you give us a summary?
Thank you. It’s really an honor to serve in this capacity at SAMHSA. I’ve had several roles within the administration, and it’s exciting to continue the progress we’ve made. Before this role, I was SAMHSA’s Region 1 administrator, which includes the six New England states and the 10 federally recognized Native American tribes in that area.
I was in that role at the beginning of the pandemic, and I really prioritized prevention, treatment and recovery services. I also reconvened the Federal Interagency Workgroup on Opioids, and as overdoses spiked throughout 2020, I’m also very proud to have launched the Diversity Inclusion Project Showcase with our team. This was an effort to address structural racism and ensure equity in the distribution of resources across New England by introducing organizations that work in BIPOC communities to funders.
I was also SAMHSA’s chief of staff to the assistant secretary and led the team that produced “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health,” and worked on the 21st Century Cures Act, which reauthorized SAMHSA, contained important mental health reform provisions, and included a $1-billion expansion for treatment to stem the opioid crisis and overdose epidemic.
And in Rhode Island, I served as a senior advisor to Governor Raimondo and co-chaired a task force that coordinated a multi-layered response to the opioid crisis. The state built more treatment capacity, reduced opioid prescribing, scaled prevention efforts, expanded resources for recovery support services as well as harm reduction programs and broadened access to medication-assisted treatment and naloxone. I also was chief of staff to Senate President Teresa Paiva Weed for six legislative sessions and was able to see that institution from the perspective of a staffer and help her advance many of the Senate’s priorities, including behavioral health.
Which brings us to your current job as principal deputy assistant secretary at SAMHSA. What are your responsibilities?
Well, a little context first. In January of 2021, I was asked to be the acting assistant secretary and leader of SAMHSA during the Biden/Harris administration transition. I was the first person in recovery to be asked to do that and it was the honor of my lifetime to have that opportunity. My main duties consisted of helping heal and rebuild the agency that had gone through a several difficult years prior. I had to bring together a leadership team, identify strategic priorities and make sure that we were there for people when they needed us the most. I was in this role for six months until Dr. Miriam Delphin-Rittmon was appointed by the president and confirmed by the Senate.
When she arrived, I was prepared to return to my regional role; however, she asked me to stay as the Acting Deputy and eventually, I applied for the permanent role and was selected. In this role, I am the top career official at the agency, and I work closely with the political appointees to advance the administration’s priorities. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. I supervise several members of an executive leadership team who run the centers and offices that deliver grants and other services to the American people. I also represent the assistant secretary across the government and in the community when necessary. I’m now in a position to provide continuity at SAMHSA whenever there is a transition in leadership.
It must be long hours, correct?
Absolutely, but it’s worth it. As someone in recovery, I have a passion for taking on the full spectrum of mental health and substance use challenges, including primary prevention, harm reduction, treatment and recovery supports. And when you’re passionate about something, that makes the hours easier. It’s also heartbreaking to see many people continue to struggle with their mental health and substance use and I know that we need to keep working as hard as we can to engage them and help them find what I’ve found.
How does your own recovery inform your work? Over the last several years, we’ve heard more and more about the role of peers in everything from harm reduction to recovery support and increasing the mental health and substance use workforce. What is being done to make space for peers and increase the legitimacy of lived experience in the eyes of clinical providers and the general public?
We really cannot overstate the importance of peers. All the data we’ve seen shows that when peers are involved with people needing help, outcomes improve. People engaged with peers are less likely to experience or die from an overdose, less likely to have a mental health crisis, more likely to stay engaged with treatment, and more likely to be successful in their recovery.
SAMHSA has done a lot of work to support peers as having valid, effective roles in the behavioral health workforce. Earlier this year, we published a consumer guide, “How Can a Peer Specialist Support My Recovery From Problematic Substance Use?” For People Seeking Recovery, for people with past or current problematic substance to use when exploring of the roles, values and work environments of professional peer specialists. It helps readers understand who professional peer specialists are, what they do in various work settings and how to access and pay for their services.
We have also developed National Model Standards for Peer Support Certification and a guide to Financing Peer Recovery Support.
And finally peers play a critical role given the workforce shortages we have in the behavioral health field; they have bridged an important gap.
In your 21-year post, you also wrote “while I remain imperfect, I persevere and seek humility. It’s all truly a gift so thank you to everyone who’s been a part of this incredible transformation.” Can you expand on that please – and tell us what other gifts recovery has brought you?
As I’ve shared, my life is incredible today, but I know I need to stay humble as I still have work to do. Recovery is a process of change, I need to stay vigilant. And as for other gifts, my family comes to mind first. My dad passed away in 2019 and I will never forget you reaching out to share about when you lost your dad – thank you. We were able to be part of each other’s lives for almost 16 years together thanks to recovery. My mom, my brother and sister, my nieces and other family members have all come back into my life and I’ve come back into theirs. I have relationships with people that are so much deeper, stronger and meaningful than anything I had prior to finding recovery. These are the gifts.
What guidance do you have for people living with substance abuse disorders who are interested in recovery?
Too many people who need help are afraid to seek it. Don’t let fear prevent you from reaching out and talking to someone about what you’re going through. It takes courage and strength but there is no shame or judgment, just help on the other side. My story of recovery is not unique. It’s the story of some 60 million Americans. Recovery is possible for everyone.
For those who want to help someone who is struggling, we must instill hope – the necessary ingredient for someone who is in despair. Only then we can engage them, meet them where they are and help them.
SAMHSA is your partner in this fight. We envision that people with, affected by, or at risk of mental health and substance-use conditions receive care, achieve wellbeing and thrive.
Anyone in immediate danger should call 911.
Other resources:
SAMHSA resources: If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug or alcohol issues, visit FindSupport.gov. If you are ready to locate a treatment facility or provider, you can go directly to FindTreatment.gov or call 800-662-HELP (4357).
BHLink: For confidential support and to get connected to care, call (401) 414-LINK (5465) or visit the BHLink 24-hour/7-day triage center at 975 Waterman Ave., East Providence. Website: bhlink.org
The Samaritans of Rhode Island: (401) 272-4044 or (800) 365-4044. samaritansri.org
Butler Hospital Behavioral Health Services Call Center: Available 24/7 “to guide individuals seeking advice for themselves or others regarding suicide prevention.” (844) 401-0111
Thrive Behavioral Health’s Emergency Services: 24-hour crisis hotline (401) 738-4300.
Prevent Suicide in Rhode Island: a Rhode Island Department of Health resource. If you are in crisis, call (800) 273-8255 or text TALK to 741741. preventsuicideri.org/
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