Posts by Jano Klimas about the academic career and the long and harrowing journeys of academics.
Posts by Jano Klimas about the academic career and the long and harrowing journeys of academics.
Last days of my INVEST fellowship
Visiting research scholars make new friends quickly and parting is not always easy for them. I said bye in Portland (OR) five times:
First, I said bye to my writing group. This was my second group in the last 15 weeks. The first, 10-week course of prompt-based writing was a birthday gift from my wife. I enjoyed the first course so much that I decided to go for a second round. The new beginnings were difficult, because we had a new group and group dynamics; dynamics matters most in writing groups. By the 3rd-4thmeeting, the group juice started to flow and we shared more and more feedback on our writings. Parting with the second group wasn’t easy, but much smoother thanks to my experience with the first group; I felt I belong there.
My point here – that saying bye slowly makes parting easier – should interest most visiting research scholars. Beyond this limited audience, however, my point should speak to anyone who faces parting with many good friends.
Career in addiction health services research can be daunting. There are moments when people in this career path struggle at work. Have you ever been in that situation yourself? Here’s my story.
The internet was still a toddler and I watched the TV rarely. But when I turned on the box on one of such occasions, a summer afternoon, I was brought into the streets of the Slovakian capital, Bratislava, which was a world far far away for me. Young social work students backpacked those streets with bags full with clean needles and distributed them to drug users and sex workers; they talked about what this exciting and controversial pastime meant for them. They worked for a needle exchange project – Odyseus – and I wanted to do it too. I was excited to help drug users in the same way these women did, but I had to wait a couple of years until I grew up.
After acceptance at the psychology degree, my world changed and the range of my interests expanded. Nevertheless, I never forgot about that documentary. It was in the second year when I saw a poster at our university board, at advertised Needle Exchange as a part time job for students. I picked up a public phone and dialled a number from the poster – following my teenage dream. Nobody picked it up, so I left a message which too remained unanswered, forever. The number on the advert wasn’t for the Needle Exchange which the documentary talked about, but I didn’t know it at that time. By chance, I ended up working for the agency from the documentary movie because they had an email address posted on the internet and were more responsive than the project which advertised on our student board.
Part of my comprehensive exam in the 3rd year of my undergrad was a research project. As most of my friends, I struggled with access to patients. Because of that, almost everyone did a literature review – without having a clue what we were doing. I chose the role of family and drugs as my topic, but it wasn’t an easy choice. At that time, my interest in drugs was drifting away and I felt like researching something else, for example depression or disabilities. I don’t remember how I ended up with drugs again, but my review led to working with Dr Timulak, and eventually, to my MSc and PhD projects.
When we arrived to Ireland in early Autumn 2008, all I had was a small EU grant with a budget of 3000 euros and an unclear host organization. We managed to survive for almost a year with a great help of my wife’s EVS stipend and occasional p/t jobs. The work on my PhD and the EU grant took most of my time, leaving only a couple of hours for finding a more stable position. When I eventually ran out of money, it was late winter and the job market had dried up. I submitted my resume to many advertisements, including a research job on men’s sexual health. I must say that research was not on my list of Top 5 jobs, but when this position came up after 8 hopeless months of job hunt it was a true God-send. The pictured ad initially offered a PhD post in drugs research, but at the interview, my current boss – Prof Walter Cullen – told me about a p/t place on the same project. That’s how I came to research drinking among methadone patients in primary care at UCD.
OK, I know I said that there were 5 key decisions earlier, but there has been a lot going on recently. In July 2011, I have been to a summer school on drugs in Amsterdam, Netherlands – no one could imagine a better place for this adventure. Dr McCarty, lectured for several days on different policy models and evidence based treatments. Two years later, I’m sitting in an office down the hall from Dr McCarty’s office, writing my final report about the INVEST fellowship. Visit this post to read more about how I got here. I did not think that the summer school would lead to a fellowship in Portland, OR and I’m most grateful that it did.
Welcome to my INVESTing log. INVEST is the International Visiting Scientists & Technical Exchange Program for drug abuse research sponsored by NIDA (National Institute on Drug Abuse). From March-August, 2013, I was an INVEST researcher at the Oregon Health& Science University in Portland and this is a log about my experiences.
Windy and Sandy Jersey shore
Funny looking banknotes in my purse; different scent in my bathroom
With that soulful look on your face
Here’s the opposite – a lot of professionals and not enough patients
A good bye lunch in the park
We don’t own anything; it’s on loan
I lost my voice in Santa Rosa
I feel like I’m swimming upstream
Humans make up stories. Most people are better in the abstract
Please note that your OHSU PC access will expire on 9/2/2013
The goal of writing is to stretch the limits of your thinking
A week of strong decisions
Picnic at Skidmore bluffs
Document the experience
Swimming in the Frog lake under the Hood mountain
A beautiful place where I have time to think and write
The work ethics in US is different
2 Free books in 2 days: paradise
Methamorphosis at Marquam hill
‘If the water is dark, the lake must be deep’
It’s hard to get a credit line
Two writing workshops this week
You are my fountain of knowledge
Great art can emerge from aimless meanderings
Charts reviews started, best time – 4.06 sec
The department is empty these days, the head brought a cake to appreciate staff
I thought I was here to learn more about research, but I’m actually learning a lot about leadership and group interaction
73 new emails after a week out of office
A strange proposal will arrive soon
Everything depends on your determination
at the CPDD conference, visiting San Diego again after 9 years
A complete different time space
First focus group, first night ride through the Terwilliger… feels like on the top of the world
How long have you been using internet for? – 15 years
My first potluck at the OHSU public health
Release from immediacy
Their number will grow, our number will die
The floor is slippery when wet (Really?)
Sometimes you don’t know what’s possible until you’re forced to do it
Where is the sun gone?
The atempt here is creating
sometimes, the most powerful and profound changes can be brought about by the most subttle and innocent moments
Journal of Japanese Gardens
IRB (Institutional Review Board) approval out now!
Working with other writers is good for me
Quote from a song: “Should I stay or should I go now?
If I stay, there will be trouble – If I go, there will be double.”
weeks started to fly by
I said: I’m an office monkey. They said: We are donkeys.
Work, Play, Love, Read
How to spill an oatmeal on the office floor
Two copulating mosquitos sucking blood from my arm
everybody has a different style of working
My first ride to work on the cable car (aerial tram)
My friends at work make their own bread and apple preserves
I’ve been bitten by a writing buy
First day at work in my 10-year old American sandals – the summer’s comming
Learning about my limits and acknowledging my strengths
“A lot of media advertising is based on things that make people insecure and anxious” (the Missrepresentation movie)
Dr. Jan Klimas joined PHPM as an INVEST Fellow beginning March 1. The National Institute on Drug Abuse supports the INVEST Fellows program to accelerate career development for new investigators who are citizens of a country other than the US. Jan will work in the US for six months assessing the value of screening and brief intervention for alcohol use disorders among opioid dependent patients being treated with an opioid agonist medication (i.e., methadone or buprenorphine). He plans to collaborate with Richmond Clinic and CODA to contrast US agonist treatment services with those in Ireland provided through general practitioners.
Jan and his wife Johanka Macekova are Slovakian. Jan is currently working in Ireland where he studies screening and brief intervention for alcohol use disorders among opioid dependent patients receiving agonist medication. The US provides opportunities for comparative research….
For more info, check the Winter 2013 edition of The Liaison, PHPM’s internal newsletter, is published the first week of the month and highlights news and events that took place the previous month, in addition to listing upcoming events as well.
New office, new start
What is the American standard?
First stolen bike saddle
Forging new friendships
Week 6 (April 8-14)
car hand brake is actually a foot brake in new US cars
moving to a new desk next week
restrooms and water fountains are so common in Portland
tatoos and piercings are so tolerated… everywhere
Who uses buses in Portland or US? Discovering Portland Metro area
Changed my location on skype/ twitter to PDX
First fruit of my labour on the INVEST project are here
Beautiful mornings, cycling to work on the hill
Work and life routine, getting used to it
Conference at Washington DC
Getting to know myself better, my expectations
Everything’s so expensive
A photo from the Spring NIDA CTN 2013 conference: INVEST scholar links with Humphrey scholars:
Why does it take so long to get used to this, longer than I expected
Too many things to do at work
I miss Ireland – listening to RTE Lyric.fm
Jet lag, almost all week
My first chai
Everything is so big, different, weird
Arrived safely at OHSU; checking the “Hall of fame” aka Notice board with faculty publications by OHSU Department of Public Health (2011-13):
Jan will speak about his previous and current research in Ireland and plans for future research in Portland, OR at the The Spring 2013 CTN Steering Committee Meeting. It will be held at the Hyatt Regency Bethesda, Bethesda, Maryland, on March 12-15, 2013.
For more info, check the section about International Symposium in the latest issue of the NIDA CTN Bulletin (January 31, 2013, Volume 13 – 02): http://ctndisseminationlibrary.org/ctnbulletin.htm
Jan Klimas, PhD, joins the Western States Node on March 1, 2013, as a NIDA CTN INVEST Fellow. NIDA is National Institute on Drug Abuse, and INVEST is International Visiting Scientists & Technical Exchange Program for drug abuse research, which combines
“postdoctoral research training in the US with professional development activities and grant-writing guidance to form a unique program for drug abuse scientists”(link).
Oregon Health & Sciences University hosts Dr. Klimas’ six months fellowship during which he will assess the use of Screening and Brief Intervention (SBIRT) for alcohol use disorders among patients receiving agonist medication for opioid use disorders.
Professor Dennis McCarty, Co-PI for the Western States Node, will supervise Dr. Klimas during his fellowship. The research examines addiction treatment in primary and specialty care settings with respect to implementation of screening and treatment for unhealthy alcohol use among opioid-dependent patients in methadone or buprenorphine maintenance treatment in Ireland and Oregon. Dr. Klimas’ prior work in Ireland informs the U.S. investigation… read more in the NIDA CTN bulletin, (issue November 15th, 2012): http://ctndisseminationlibrary.org/bulletin/20121115.pdf
Believe me, or not, trust is something that has been emphasized in addiction treatment for many years. One can hardly argue that it has become one of the usual suspects in the life stories of most recovering drug users.
This comes with no surprise – trust is key for building or restoring relationships of all people. No matter if they have drug problems, or not. In this way, my research confirmed what common sense tells us without any special knowledge of research. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and restoration of trust in relationships.
Saying that they are not bothered with relationships or that they’ve no interest in them is too simplistic, and as suggested by this research, not true. Other research showed that people with drug problems do engage in social relationships, pro-social activities, social relationships, raising children – they just don’t do it in a way that ‘we’ are willing to accept. The question that remains to be answered by future research is what would happen if the barriers of engaging in culturally-acceptable social activities were removed? Would ‘they’ be more like ‘us’? The first signals supporting this question come from the opioid agonist treatment. People maintained on pharmaceutical opioids, substituting their illicit drug use, lead more stable lives, commit less crime and have better chances of being employed than people without these substitutes.
Background: interpersonal problems among drug users (DU) are frequent, are related to other problems, and improve during the addiction treatment.
Aims: to better understand changes in relationships which occur in the course of drug use and drug treatment, as well as their subjective appraisal by ex-drug users, using retrospective methodology.
Method: semi-structured interviews with DUs in a therapeutic community (TC) were analysed with descriptive-interpretive method. The coding of interview transcripts into categories was performed in two phases using qualitative software NVivo 7. Five interviews were coded in the pilot phase, followed by an audit by an external psychologist and progressive coding of the rest of the transcripts, with data saturation being reached in the second phase.
Participants: nine male and one female client, aged 18-36 years (mean: 25.9), participated in the study and the length of their stay in the TC was 2-35 months (mean: 9.9). The approximate mean age of drug use onset was 15.6 years (12-28).
Results: the analysis provided 21 categories which were divided into three domains based on chronological order. Changes in relationship priority during active drug use occurred on the basis of barriers (such as the need to obtain drugs and stigma), which restrained active DUs from engaging in and maintaining their social relationships. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and the restoration of trust in relationships.
Conclusions: this study builds on the previous work exploring the broad issue of social consequences of drug use and offers clients’ perspective on this topic.
Cite as: Klimas, J. (2012) Interpersonal relationships during drug use and treatment from the perspective of clients in a therapeutic community. [Interpersonálne vzťahy v priebehu užívania drog a liečby závislosti z pohľadu klientov/iek v terapeutickej komunite.]. Adiktologie (12)1, 36-45
More at: www.adiktologie.cz
|Figure 1. Evolution of relationships during drug use, addiction and treatment|