Dr. Stephen Loyd’s voice was more timid than usual and trembled when he stood up to speak at the Wilson Chamber of Commerce on Wednesday, June 3. Loyd and a room of community leaders, employers and organizational leaders had just heard Kimberly Redance, a certified peer support specialist for the Wilson County Substance Prevention Coalition, give her testimony of childhood abuse, drug addiction and the people who never gave up on her making it into recovery.

People like Redance, Loyd said, make every effort to help those suffering with addiction worth the battle.

“It’s amazing to me how people can change given the opportunity,” Loyd said. “I’m looking at my story. I was born on third base and thought I hit a triple. I had absolutely every advantage that you can have. You meet someone like Kim, who, just in all honesty, didn’t have a chance — just a little girl with headphones on.”

‘THE PROBLEM IS INTERNAL’

Loyd, vice president of the Tennessee Board of Medical Examiners, has worked as an addiction medicine physician in inpatient and outpatient settings and has been in recovery from opioid and benzodiazepine addiction since July 8, 2004. He inspired a character in the Hulu series “Dopesick.” His visit to Wilson was coordinated through Area L Area Health Education Center as part of Wilson County Department of Social Services’ Behavioral Health Rural Communities Opioid Response Program grant. The grant supports efforts to strengthen prevention, treatment and recovery resources in rural communities affected by substance use disorder. The event at the Wilson Chamber of Commerce was a leadership conversation on substance use stigma and the workplace.

Loyd went off script from his prepared presentation after hearing Redance detail her life story, from sexual abuse at a young age to her escalating drug usage, time spent in jail and prison and her multiple efforts to fight addiction. He said there are two things every human needs: to belong and to matter.

“Kim (Redance) did what she needed to do to get that,” Loyd said. “It almost sounds like she was relieved when she figured it out if I’m not mistaken. That’s what the problem is. Think about how many times in Kim’s life somebody stepped in. I get it. I love where you are. I know the path. I know the path you took. I get all of it, but what if you intervene sometime earlier?”

For many, Loyd said, addiction begins with adverse childhood experiences, or ACEs.

“The doctor that came up with ACEs, he’s a doctor out in California that treated weight issues in women,” Loyd said. “He would treat 400-, 500-pound women. Now, we put them on TV to make fun of them, but back then in the ’80s, he would treat women who were morbidly obese. Some of them would lose the weight and put it back on and others would lose weight and not put it back on. As a doctor, you’d go, ‘What’s the difference between these two cohorts of patients?’”

Loyd said the doctor began to ask questions about the patients’ background and history.

“He thought it had something to do with trauma, just in his experience,” Loyd said. “He came up with a list of 10 questions, which we all know now as the ACEs survey. One of the questions got his attention. The question was, ‘How much did you weigh the first time you had sex?’ And the answer he got back was in the 40- to 50-pound range. You realize he asked the wrong question. He should’ve asked, ‘How old were you?’ These women were all victims of sexual abuse with their own family. Because they were being sexually abused by their fathers, their solution was, ‘I’m going to eat until I make myself physically unattractive to my perpetrator.’ The drug is the answer. It’s not the problem. The drug hasn’t ever been the problem. The problem is internal.”

Loyd pointed to trauma as the root of substance abuse issues.

“As I sit here and listen to Kim’s story, she’s trying her best to connect with anything,” Loyd said. “She’s got this trauma that — I was in the room — nobody in here said a word. Nobody looked at their phones. Nobody looked around and it’s uncomfortable. It rattles you inside. That’s the deal. We’ve got people out there living like that. If you look at the stigma around this for so long, for somebody to come up here and just bear her soul, and she did for 30 minutes, that moves the needle.”

‘WE DON’T UNDERSTAND ADDICTION’

Loyd defined addiction as “continued use despite consequences.”

“How did I know Kim had an addiction? Because she went back to jail.” Loyd asked. “I don’t care how many times you put her in there. You’re going to get the exact same result. It ain’t going to change. She didn’t understand addiction. She had been to treatment, and my guess is in treatment, nobody taught her what addiction is. It would be like somebody coming in, having a heart attack in the hospital and you don’t say anything to him about high cholesterol, hypertension or physical activity.”

Loyd said that in every hospital emergency room, there is a list of names labeled “drug seekers.”

“Do you know what the No. 1 rule of the ER is?” Loyd asked. “It’s GOOMER — get out of my emergency room. You get an ER doctor who’ll be honest with you, that’s the truth. You’ve got to keep the ER clean. Either get them admitted or get them out the door. So you put a sign up that says these patients are drug seekers. We’re going to be mean to them and kick them out. What are we doing? When did we learn that in medical school? I missed that day. I missed the day of criteria that says if they meet these criteria here, kick them out.”

Loyd said addicts are treated poorly because addiction is viewed as a “moral failure.”

“We don’t understand addiction,” Loyd said. “I can sit here for the next 10 years and not do as good of a job as Kim did teaching you about this disease. Why would any rational person want to leave their husband, who they met when they were 15 years old, and their kid? That’s the power of addiction.”

Brains that endure trauma, especially at a young age, Loyd said, turn into survival mode.

“It’s about surviving,” he said. “My desire and my will to live — how strong is your desire and will to live? What would you do to save your own life? Before you get all pious on me, I’m going to tell you that you’re capable of anything. We will eyeball each other to see who’s the weakest because that’s the one who gets eaten first. Then we’re going to go down the line. That’s how strong your will and desire to live is.”

What happens in addiction, he said, is that your will and desire to live are replaced with the object of that addiction.

“That means no longer is my desire to live. My desire is that I have to have this thing or I’m going to die,” Loyd said. “How can a mom who’s getting ready to have a baby stick a needle in her arm? ‘I’m not OK until I have this. I’m going to die unless I have this.’ Am I condoning it? No. Do I understand how it happens? Yes.”

Loyd pointed to his son, who was in attendance for the meeting, and said there was a time in his life where opioids were more important to him than his son.

“I had to have this thing,” Loyd said. “I hate admitting that. There was a time. How is that possible? What happens with addiction? There’s another thing that I saw — it’s shame. It’s still there. It’ll always be there to some degree. When you understand the things that drove you and drove me, then that gets easier. Healthy shame leads to humility. That’s a really good thing. Shame is different than guilt. Shame is, ‘I’ve done something wrong.’ Guilt is, ‘There’s something wrong with me.’ There were multiple times in Kim’s story where she thought something was wrong with her. A lot of that is shame.”

THE SLOT MACHINE METHOD

Loyd said that treating addiction is like pulling a slot machine. It takes all of the right pieces to line up to win. Loyd used the three sevens on the slot machine to symbolize the three things that are needed for success. He said the three sevens are genetics, trauma and opportunity.

“You can ask anybody about their history of addiction,” Loyd said. “Nobody wants to talk about that. The most I’ve had anyone admit to is drinking two drinks. I don’t care how drunk they were. It doesn’t matter. They had two. So I’m not going to get there. Tell me about your family history.”

Loyd said childhood trauma, such as growing up in a house with an alcoholic parent, affect you through adulthood.

“Did anything ever happen when you were growing up that now, as an adult, you know wasn’t right?” Loyd asked. “I don’t have to dig any deeper than that. I’m not a trauma guy, but I can take a history.”

Loyd noted, as a doctor, there is a systemic issue with over prescribing opioids.

“As a doctor or a healthcare provider, how do I know what medication, for how long and what dose?” Loyd asked. “We don’t learn anything about this in medical school — nothing, zero hours. Doctors use something called the SWAG method. You know what that is? It’s scientific wild a** guess. You do what your mentor taught you how to do. I don’t know where patient zero comes in. So if doctors don’t learn about prescribing and they don’t learn about treatment of pain, who teaches them? The pharmaceutical industry teaches them. The pharmaceutical industry says you need to go on this medication, higher doses and you don’t need to worry about addiction because your chance of addiction is less than 1%.”

Loyd said change comes from getting to the doctors and medical schools to educate them on the issue.

“We still don’t do it in 2026,” Loyd said. “In my mind, the opioid crisis started in 1992. We’ve been coming up on 40 years and we still don’t do it.”

‘THAT’S MY COMMITMENT’

Wilson Medical Center CEO Jason L. Kimbrell said that listening to Loyd m...

The Wilson Times Latest News

Message History

Delivery option(s)