COVER STORY

Q&A: MEGAN BARRY

On Substance Use Disorder: One Family’s Story

BY AMANDA HAGGARD

At The Contributor’s Spring Breakfast, Megan Barry, Nashville’s former mayor, is slated to speak about substance abuse disorder and its affect on families.

In 2017, two years into her tenure as Nashville’s mayor, Barry’s only child, her 22-year-old son Max, died of a drug overdose. In the aftermath, which included her scandal and resignation, Barry learned more and more about substance abuse disorder and the barriers folks face in getting the help they need.

“Everybody wants their family to be perfect,” she says. “And so we take this kind of suffering as a moral failing and we look at it as a choice.”

In an interview with The Contributor, Barry talked about the stigma families face and the tools needed to move forward in the fight against overdose deaths.

One thing that I’ve heard you talk a lot about is the stigma around addiction and substance abuse and how that can be a barrier for both families and the people who are struggling with addiction to get help?

I think the stigma and the shame component for this is so palpable. And for me the fact that we’re even talking about this is about how we start to take away the stigma and shame so that you can see that people you know either have this in their families or struggle with it themselves. I liken it to this idea that one thing with substance use disorder is that people don’t want to talk about it because they’re ashamed and they’re ashamed because we still treat substance use disorder like a moral failing. And the language we use around it is, ‘if you just tried hard enough, if you just stopped, if you cared enough.’

And we would never say that to somebody who had another kind of disease, right? If you had cancer, nobody would tell you that you just needed to try harder, right? What helps folks is the medical resources that they need to manage a chronic disease like you would anything else. And the lack of those resources can be devastating to communities, cause loss of jobs and homelessness, all those things.

Right, and it’s isolating for the person suffering with substance abuse disorder, but it’s kind of isolating for family too, right?

Oh, absolutely. I personally don’t have substance use disorder, but my son Max did. And the fact of the matter is that Max’s shame killed him because he was so ashamed to even let me know what was going on so we could help him.

The terms that we use to describe the people suffering from substance use disorder are really nasty words: They’re just an addict. They’re not clean. Just everything about it is derogatory and pejorative and nobody would just say someone with breast cancer was unclean.

Everybody wants their family to be perfect. And so we take this kind of suffering as a moral failing and we look at it as a choice, but we know so much more about how the brain works now than ever. Substance abuse fundamentally changes someone’s brain, and I think we’re getting better at taking that into account.

What does this crisis look like on a national scale?

So one thing I really like to talk about is this exact thing. Just look at these numbers from 2020 — there’s a lag — but these are the latest numbers:

• 150,000 people died of COVID

• 38,000 people died in a car accident

• 45,000 people died of suicide

• 42,000 people died of breast cancer

• 45,000 people died of gun violence

• 21,000 people were murdered

• 100,000 people died of a drug overdose

If you look at that list, we throw resources and public service announcements and we’ve got tons of people working on public policy and legislative action. As far as drug overdoses, we are so far behind in that conversation. We haven’t been treating it like the emergency it is.

So let’s talk about some solutions. What do you think helps?

The statistic I saw the other day is that 21 million Americans have substance use disorder and only one in 10 will ever get any treatment. It is heartbreaking.

We have to work on treating this as a chronic condition. If I’d known the capacity for this disease and how it was going to affect Max for the rest of his life, that would’ve helped. We weren’t prepared to understand it and manage it like if he’d had diabetes or another disease. We didn’t have the tools to think he might relapse. Before he died, he had gone to rehab and we thought we had checked that box and he’s great, you know, it’s all good.

What about immediate life-saving interventions like Narcan?

We recognize that people have heart attacks, right? These days you’ll find in all kinds of public places, defibrillators, because if somebody’s having a heart attack, we want to be able to administer first aid right then, to keep them alive. Narcan is the same thing. Anytime where we can use something like this, we should. When someone is on the floor having a heart attack, we’re not making the determination if they had behaviors like eating poorly that would make them ‘less deserving of care.’ And access and training for it should be way more widespread because of this crisis. I have it in my purse. I carry it with me all the time.

But there are many more things that we can be doing and you can look to Oregon as an example. Oregon decriminalized drugs and then bolstered treatment initiatives — it was supported by [around] 58 percent of the voters. But they added this healthcare component, which was making sure the people got into treatment and didn’t have to worry about the potential for being criminalized. And you can look to Portugal that did this in 2000. And, you know, they were all terrified that it was gonna have this huge drug surge. But they saw a 20 percent increase immediately in people who got treatment. There’s a lot of money to be saved by this if we can start to agree that our people are ‘worthy of saving.’ We already spend so much money on this through healthcare costs, criminal justice costs, and loss of productivity.

And so many people go down this road in really mundane ways at the beginning, by getting hurt and getting pain medications from a doctor or having surgery.

Something that we need to do — us and doctors — is to fundamentally rethink how we treat pain. How we treat anxiety. We’ve seen a big reduction in scripts in Tennessee because we are being more conscious, but many, many people

go down this road this way. Of course, some people need these medications and I’m not saying we don’t want them to have them, but we have to think about the long-term consequences of it too.

Max’s journey started with prescription drugs, but it wasn’t an opioid, it was Xanax. It becomes very difficult to ‘just stop’ and we have to begin to reckon with that.

What are some of your favorite things about Max?

One of the most wonderful things about Max was he was fun and he just had this huge sense of adventure.

After he passed, we created at the Oasis Center the Max Barry Travel Fund, where kids who might not have the opportunity to go on trips can do that. They’ve done a mountain biking and camping trip and we’re happy that the funds get to continue his legacy, just a massive legacy of opening your eyes to experiencing new things and that sense of adventure.

That’s one of the things that Max loved. He loved the outdoors. We have this bench at his gravesite because one thing Max’s friend told us he liked to do was if he saw a discarded piece of furniture like a couch on the side of the road, he always had to stop and pick it up. Then he’d make his friends just drag it to some beautiful place and just sit. It makes me the saddest that for as much pain as Max must’ve been in, he never let that ruin his ability to sit and gaze at the stars with a friend. He wasn’t perfect, but he was the sweetest boy who would do anything for anyone.