Fighting Substance Abuse by Empowering Incarcerated Women - Podcast Transcript

Have you ever wondered who was doing the research that will impact your future? The research podcast lets you met those people, and learn how the University of Kentucky is exploring and strengthening our understanding of the world through research and discovery. 

Here's Alicia Gregory, director of Research Communications. 

Alicia: Today we’ll meet Michele Staton-Tindall, from the Department of Behavior Science in the UK College of Medicine. She studies drug use and high-risk behaviors in incarcerated women, and she begins by telling us how she got her start in research.

Michele Staton-Tindall: Right out of undergrad, I had the opportunity to work on a multidisciplinary team at the Center on Drug and Alcohol Research, focused on the transition to adulthood for individuals who went through the very first cohort of D.A.R.E. And then, they were 19 to 21 years old at the time. And, I got to be the primary research associate. I got to work in the lab, and I got to do all of the interviews. And, we were really interested in the impact of substance use from an early experimental stage; to abstainers, to individuals who were engaged in heavy use. And, sort of what their transition to adulthood looked like. And, so, I was a new psychology graduate and I loved every minute of it. But I really fell in love with those stories. So, that was probably my favorite part. But that was my first project.

Alicia: So, how did you go from that to deciding you wanted to do this full time? 

Michele Staton-Tindall: I really fell in love with the stories. When I was a psychology student, I got to work in an animal lab. They were exposed to cocaine neonatally, and then we gave an additional drug once they were born. And, then we watched some of their behavior. And, I learned very quickly, that I was really intrigued by the process, and I really liked answering the questions, but I kind of miss that human component. I really miss talking to people, and I miss the stories. So, the job that I had working with students who participated in D.A.R.E. kind of led to another NIH-funded trial where we were interested in substance users' health services utilization. Primarily as they transition from prison to the community. And, I fell in love immediately with the prison population. It was something I didn't know anything about. I'd never been to a prison, I hadn't had that exposure, in any phase of my life; undergrad or anywhere else. And, almost immediately from the first interview, I learned that these are very real people, who have some very real problems. And, who made some tough choices. And, in many cases, some difficult choices.

The focus on rural substance use is very close to my heart. I'm from Appalachia. I'm from an area that used to look very different 15 or 20 years ago. An area where people felt safe, where people didn't lock doors at night, and those kinds of things. And, as an unfortunate consequence of the drug epidemic that now ravages that area of the country, people who didn't used to live in fear, now live in fear. And, drug use is really everywhere. It's hard to talk to anybody there who hasn't been impacted in some way. It's really close to my heart, and I really want to work to make a difference in that area.

And, then secondly, I would say that specific focus on women is also close to me. I've had the opportunity to do a lot of criminal justice types of studies over the years. I've worked in prisons, I've worked in community supervision, probation parole, I've worked in jails. And the women that come in contact with always have very unique vulnerabilities in terms of their health, their transmission of high risk types of infectious diseases; HIV, Hepatitis C; their mental health issues. And in so many ways, those women are usually impacted by these issues as a result of relationships with high-risk people; high-risk partners, high-risk family members. And, so I really want to focus my work in empowering women to make healthier choices, and not just survive the addiction process, but to really thrive in a new and different kind of life. So, if I had to talk about the long-term goals of my research, it would really be to improve the quality of the lives of these women. And, the criminal justice system serves as a wonderful venue for us to outreach and identify and intervene with women who wouldn't otherwise receive treatment, or receive services. 

Alicia: Tell me a little bit about what you're working on right now. 

Michele Staton-Tindall: Probably the most exciting thing I'm working on right now is a study in Appalachia. We are recruiting women from three rural jails. We go into those jails, randomly select women, and do screening for substance use and high-risk behaviors. And, over the course of about two and a half years, we randomly selected and screened 688 women. 97 percent of them met the substance use criteria to enter our study. Which, I knew it would be high, but I think all of us were really surprised at how high it actually was.

Of the 400 who enrolled, 75% of them reported a lifetime history of drug injection. So, not only were they just substance users, they were high-risk substance users. And, so as a follow up to entering the study, doing a baseline interview, we also engage them in brief intervention before they leave the jail. Brief intervention, which primarily utilizes motivational interviewing, to focus on an individual, and that individual's high risk behaviors. Not everybody's a drug injector, so you wouldn't necessarily have to work on things like using clean needles and those kinds of things, but a lot of high-risk, unprotected sexual activity, sexual activity with high-risk partners, and those kinds of things. The intervention allows us to focus on an individual and her high-risk behaviors.

And, then we follow them into the community; 3, 6, and 12 months post release from jail. And, we've learned a lot. Almost 60% of our population test positive for Hepatitis C. So, we've done a lot around education around Hepatitis C with this population. And, that's sort of where I see our work moving forward next, in terms of increasing access to and utilization of treatment around Hepatitis C. 

Alicia: What are the most challenging aspects of the work that you do? I'm sure there are several challenging aspects. 

Michele Staton-Tindall: What I love about research, is also what I find challenging about research. We audio tape our intervention sessions for fidelity purposes, and after listening to the first 2 or 3 or 4 of those tapes, these stories are very tough. These women have lived through some very difficult situations. Ranging from just inter-generational substance use, criminal justice involvement, high risk behaviors, victimization, violence. And, through all of that, they're very resilient. But, those stories are tough to listen to. And, I wish we could do more. A brief intervention right before entering the community is somehow just not enough. And that... again, we see lots of opportunities for future research.

So, as a social worker, I think the thing that I'm most interested in is the people. And, I love a good success story. I love getting letters in the mail from the women who said things to us like "nobody ever reached out to me before. I've been through all of these things, but I've never engaged in treatment. And, you guys are the first ones to really encourage me to do that, and to talk to me about some of the problems that I've had."

The other thing that I find really fulfilling, is the partnerships that we've built with people over the last decade. Partnerships like the Department of Corrections. We manage their substance abuse outcome study and they're wonderful to work with. They're very interested in the data, and those kinds of things. Also, had the opportunity to build good partnerships with local agencies, substance abuse treatment providers, people who really... We're all kind of invested in the same problem. And, I find that work just very fulfilling. 

Alicia: How has your research informed the way you work with students here at UK?

Michele Staton-Tindall: First, I'm a little naive in thinking that all students should really love research. I think they should all love it. Even if they don't want to be a researcher long term, I think they should learn to value what the research process can contribute to their work. So, I teach research that way. I teach it as if everybody should love it. But, I also realize that it's my responsibility to make it applicable and transferable to the things that they want to do. So, that's sort of the first part. 

Secondly, I think the content area that I focus in, in substance use and crime in particular. My colleague in sociology, Carrie Oster, and I, started an Inside Out program, where we take students from UK, 14/15 students a semester, and take them into the prison at Blackburn Correctional Complex, and enroll 14/15 students, student inmates from the inside. And, so they have an inside out class. And, we spend the semester in this exciting, and innovative, and transformative learning experience, where they're able to tackle things, and talk about things that you can't really do in a traditional classroom. So, it's one of the most exciting things I do. I really love that, and I think the students love it. On both sides of the fence. So, it's been a really good experience.

Alicia: I know there's a lot of focus here at UK on substance abuse problems in our state. Cause it's a huge problem. Talk about some of your partnerships with people in other disciplines. 

Michele Staton-Tindall:  I think one of the best things for me is to be affiliated with the Center on Drug and Alcohol Research here at UK. It's a multidisciplinary unit focused on the problem of substance use. And the problem from all different angles. And, I learn so much from working with them. People from sociology, who sort of approach group work, and how individuals function through the process of groups, and behavioral pharmacologists, and psychologists, and just all kinds of different disciplines. Again, who come at the problem very differently, but I just learn so much from working with them.

So, I would say, if you're a young substance use investigator out there somewhere, looking for a place to be, Kentucky's going to rise to the top of that list, just by nature of there being some of the best researchers in the nation-- in the world, here at UK. And, there's a way to engage, regardless of what discipline you work from. There's a way to connect there.

And, I would also say that the research infrastructure at the university, is very supportive. And, there's a lot of people here, whether they be colleagues, collaborators across the university, or at the administrative level that really want you to be successful. And, a lot of people are invested in that.

Alicia: What inspires you about working here at the University of Kentucky? 

Michele Staton-Tindall: When you do some of the work that I do, and you go into Appalachia, it's easy to be viewed as an outsider; as one of “them.” But, all you really have to do, is talk about being from the University of Kentucky, and some of those barriers begin to break down a little bit. Because, everybody, regardless of where you are in the state, everybody can connect with UK. Whether it's the basketball team, or UK HealthCare, which has a presence-- a very broad presence across the state. Or whether it be one of UK's satellite campuses, where individuals have the opportunity to take classes, and earn degrees.

So, I think that's probably what I would say. I love being here because I love working out in the community. And, I love the reputation that UK brings with it and, again, everybody can connect with that. Even our partners, when we work in the jails, and we report back to them some of the things that we're doing. Or, we go meet with them to talk about new things. They want to know where their UK stuff is. Like, they love that. And, so that makes me really happy.

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