Marcus Hart (00:00.574)
Dr. Evans, welcome to the TransformU. Let's dive in and unpack this crisis for our warriors, more specifically the veterans. So Dr. Evans, you've seen the numbers recently with rehab calls in states like Wisconsin, where I live at, it hits roughly around 104.1 % of a veteran's income. That's like asking a soldier to scale a financial Everest with no gear.
Can you, for the audience and as well as for myself, paint a picture of this chasm for us, what it means for vet trying to break free from addiction?
Tyler Evans (00:38.028)
Yes, well, I mean, first of all, just thanks for having me. This is really important conversation. And, you know, I'm really glad to be here and shed as much light as I possibly can. know, the reality, Marcus, is it's systematic, right? Like there are so many different layers to this challenge.
You know, I'm an infectious disease and addiction medicine doc. And, you know, we saw this challenge when it came to accessing HIV medications, particularly in places like sub-Saharan Africa from like the 90s to the 2010s. The majority of the folks that needed the care didn't have access to it because they didn't have the purchasing power to access it. Fortunately, because of sort of advocacy and a lot of sort systematic changes in the HIV space, although that's changing as a result of our current administration, we've had sort of a lot of advancement.
Marcus Hart (01:12.915)
Yeah.
Marcus Hart (01:24.712)
Mm-hmm.
Tyler Evans (01:29.166)
And just to start with the positive, and I do think there's been a lot of there's been a lot of positive advancements in terms of addiction medicine. often addiction connotes a sort of negative stigma. So we we tend to use more substance use disorder treatment, SUD. So I might be referencing it as SUD during this talk. But in terms of in terms of in terms of SUD care and prevention,
Marcus Hart (01:51.901)
Yeah, that's
Tyler Evans (01:58.368)
Again, it's a systematic issue and despite the advancements, the big piece is the payers, right? So that's a big one, right? Second, I mean, they're close in terms of sort of the priority of the challenges is the lack of providers out there. And so if we look at these two, and there's a number of other issues, there's the stigma, there's the social determinants of health, which we often talk about in terms of like folks,
Marcus Hart (02:05.182)
Bye.
Tyler Evans (02:26.958)
about at least a third of the country cannot or will not engage in healthcare in the way that it's currently set up. And especially if we have substance use disorder, which co-occurs with mental health disorders as well. And certainly when we're talking about our vets, you know, we know that PTSD, depression is much higher than it is in the general population. So that's gonna impact your ability to access care as well. So lots of sort of lots of components here, right? But just starting from that first layer, from the
from the payers, when you just reference the 104 % of the average salary in order to access that care, the reality is because a lot of those payers out there are only going to be accepting certain insurance. So they're often not going to be accepting veterans, VA insurance. They're often not accepting Medicaid and or Medicare.
Marcus Hart (03:03.847)
Mm-hmm.
Marcus Hart (03:13.032)
Yeah.
Tyler Evans (03:22.798)
And so that's a big challenge. And it's not necessarily the fault of the rehab. It's the fault of the system, right? Like the way Medicaid is set up, you know, I'm based in California, but we have a lot of challenges here. We worked across the country. know, Medicaid only pays a certain amount for certain things. And so for providers that are out there that have their costs or whatnot, often doesn't cut the cost.
So that's a serious sort of challenge. Number two is the lack of trained providers out there. SUD treatment and care for many years was sort of like a peripheral component of your core medical specialties. so,
Marcus Hart (04:08.382)
Mm-hmm.
Tyler Evans (04:14.958)
not a lot of folks were going into that space, but there have been certain boards that have been allowing more people to kind of unconventionally, including myself, unconventionally go into the field of addiction medicine and become board certified without going through sort of your conventional fellowship. So increasingly we are seeing more people that are board certified in addiction medicine. Now those are physicians. You don't necessarily have to be a physician to be providing this treatment. In fact,
We find certainly a lot of advanced practice providers that includes nurse practitioners and physician assistants or associates are very, very well qualified to work in the space. We have a number of mental health professionals, LCSWs, LMFTs, LPCCs, goes on and on, typically with L, because L is licensure. So lots of folks in that space that could be working with it. They're not prescribing, it's all a part of a larger equation.
And then there's community health workers or community peer support workers. That's absolutely essential in this space. People that often have lived experience, lived experience in terms of addiction. know, there's only, you know, there's only so much that I could speak about and connect with in terms of somebody who's currently struggling with addiction, right? I understand it from a, from a sort of, you know, theoretical and from a sort of, you know, evidence-based model, but I don't have that lived experience. And so, you know, having folks that really have that lived experience will sort of connect.
Marcus Hart (05:21.842)
Yes.
Tyler Evans (05:34.51)
much stronger. So it's changing in a positive way, but we're still far away. And so that compounds the issue of the of the payer piece. And then again, there's all the other kind of access barriers that we had talked about, a lot of which are socially and politically determined.
Marcus Hart (05:51.922)
Yeah, man, a lot of what you said really hits hard and it really resonates with me and from I wouldn't say the entire general population, but, you know, the general population kind of got a sense of, especially when you speak of like the need for more providers, there's, you know, not not enough providers to to accommodate, you know, the the surge that we're that we're seeing, especially with addictions.
I myself been there before PTSD has had me in a dark cave and the delays with VA, it feels like betrayal. for my brothers and sisters who are in the rural areas, you mentioned like, you know, where do they go? Where do they go? They get lost in the sauce, so to speak, you know, and speaking of like ghost networks, know, clinics,
but not actually available. How does these fake networks make it even harder for a veteran struggling with substance use to get help?
Tyler Evans (06:59.66)
Well, just to zoom out on a few other pieces that you just mentioned before I get to that part, in terms of you mentioned the rural and sort of some of the other access barriers and just getting back to again, the payer model. Again, there are increasingly more addiction or substance use disorder treatment providers out there. The problem is a lot of them because of the way the systems are set up, Medicaid, VA not being able to cover it, a lot of them are for profit, right? And so,
Marcus Hart (07:03.934)
Mm-hmm.
Tyler Evans (07:24.43)
And so a lot of those expenses have to come out of pocket, right? And a lot of folks just don't have the funding to do it, which makes a lot of sense. That's again, that gets into the social drivers of health care and access, which is really important that I need to flag that. Those social determinants of health, which we talk about all the time, and this is what I feature in my book, Pandemics, Poverty, and Politics, that really underscores the issue of what we're dealing with. And again,
getting back to kind of the pairs and the lack of providers and whatnot, there's a lot of different layers to it. But that the complexity of access gets worse, the more sort of rural you become, right. And so that's even a bigger, a bigger challenge for folks. And while there's, know, there's some options for like telemedicine and other opportunities, you know, a of folks don't have the digital literacy in order to or the understanding of the access to kind of get to it.
So that's a really, really important sort of piece to flag here. you know, when I was running a lot of COVID operations in the height of the pandemic, and when we saw folks that were coming in to get their COVID vaccine, which was a life-saving vaccine at the time, in the very beginning, Marcus, I used to like describe the folks that, now we were running operations, like 14,000 people coming through these Dodger Stadium every day.
Marcus Hart (08:33.523)
Mm-hmm.
Tyler Evans (08:48.922)
And I used to, I used jokingly describe them as the triple C's Caucasians with cars and computers, right? Because those are the folks who knew how to like access, you know, the system. It was everyone else that didn't. And those were the ones who were actually sort of most at risk for a number of other reasons. And those were the rural folks. Those were the, those were the communities of color and kind of everything else that were not the triple C's folks that don't understand digital literacy. that, that's a really important piece. there.
Marcus Hart (08:53.982)
you
Marcus Hart (08:58.877)
Yeah.
Marcus Hart (09:07.591)
Yeah.
Tyler Evans (09:15.114)
In terms of these ghost networks and these phony providers, that's health care. There's a lot of that in US health care, and it's super unfortunate, particularly when we're dealing with really vulnerable or historically marginalized populations that don't know where to go, and that they might find somebody and they'll take their money or whatnot, but it turns out that they're not.
they're not legitimate. So it's super unfortunate. Now, having said that, there's a lot of really positive folks out there. There's a lot of mission-driven folks that are out there, but there's just not enough, right? And so trying to work through the workforce, and that's what I do a lot, is working with different sort of fields so that, because again, there's not enough psychiatrists out there, there's not enough addiction medicine specialists out there, so we have to do better in terms of expanding access. So again, the community health workers, community certified peer support workers,
Marcus Hart (09:50.366)
Mm-hmm.
Tyler Evans (10:12.478)
is really essential in order to kind of like, you know, optimize that access.
Marcus Hart (10:18.398)
Yeah, and just kind of going back a little bit, you know, and I appreciate just your response on that. You mentioned like, you know, the ability to train individuals who are not necessarily physicians to be able to administer these medications. And we know there is a lot of addiction counselors out there, a lot of people who may not have like that, you know, the additional medical background, especially in transitional housing, who
would benefit the masses if they were able to access that type of like training to be able to administer these mass in addition to like some of the counseling and or the other services they provide. Is there more of like a push for that that you know of?
Tyler Evans (11:03.756)
Yes, no, there definitely are. are so getting back to the I'm just going to keep flagging it so that the viewers are really tracking this. So CPSW, CHW, Superreport. But those are so those are non-licensed. They do have certification, but they're non-licensed. But there are a lot of licensures that aren't as challenging as like, you know, a physician or whatnot. You've got LSAAs, for example, in certain states like so we do we have some operations in New Mexico. I got a lot of LSAAs there. So Licensed Substance Abuse Associates. You've got LADACs.
licensed alcohol and drug abuse counselors. called in other places called KDAACs or certified drug and alcohol counselors in California, New York. So yes, there are other opportunities and that, you for those folks, I think for LSAAs, in addition to certain sort of certifications, they need like 90 supervised hours.
Marcus Hart (11:55.954)
Mm-hmm.
Tyler Evans (11:56.014)
in New Mexico, for example. It varies sort of state to state. My point is, it's in terms of access for the healthcare professionals, they don't have to mortgage their house or they don't have to spend 15 years kind of going through this process, which makes it a lot more low barrier and it gives more access to the people that...
they're out there. I also wanted to flag too, you when it comes to residential rehab, while that is, it is one version or one form of effective sort of treatment facilities, there's a lot of other opportunities out there that are not as expensive and that can be, you know, very sort of effective as well.
You know, we, my organization, Wellness Equity Alliance, we focus a lot on medication assisted treatment. So that's a lot of that's buprenorphine based regimens. A lot of times the brand name is Suboxone, which is buprenorphine with another formulation on there, Naloxone. And so it's, that's been a game changer, you know, I mean, and so it's, you can't really just use the buprenorphine based regimen alone, right? Like it really needs to be connected to, to that.
Marcus Hart (12:39.72)
Mm-hmm.
Tyler Evans (13:00.918)
sort of substance, alcohol, substance abuse counselor, in addition, potentially a therapist, maybe a psychiatrist, and the peer support workers, right? So it's all a part of a package, but that's a total game changer. And we have not, know, historically back 10 plus years, we did not, increasingly we've seen a lot more buprenorphine. So that's great.
Marcus Hart (13:03.441)
Yeah.
Marcus Hart (13:13.587)
Yeah.
Tyler Evans (13:23.15)
And then there's, you know, then there's outpatient programs as well. We, again, at Wellness Equity Alliance, we focus on a harm reduction. So we don't, we don't, we're not gonna make it really complicated. We're not gonna, if folks are, you know, continue to use sort of intermittently, that's not a, that's, know, lot of programs will throw you out. That's not what we do, right? Like we ultimately, we just wanna reduce harm. So we meet folks where they're at and we really feel like that's the, that's the future.
Marcus Hart (13:49.436)
I love that man, you know, and just to kind of transition a little bit, you know, your book, you know, Pandemics, Poverty and Politics is dropping soon. And it's all about social drivers of disease. You know, I'm a dad of seven. Poverty is very real. Politics are equally messy. You know, how do these forces like poverty, bad policy, feel this veteran addiction crisis right in our own backyards?
Tyler Evans (14:18.818)
Yeah, well, thanks for asking that. I mean, it's super relevant right now. I mean, in the past, ever since, you know, the last election, it's gotten, it's gotten so, unfortunately, we're going backwards in so many ways in terms of like the systems that have existed for folks who really, who are really struggling with access, a lot of which again, are socially and politically determined. Now, the book is really the book, Pandemics, Poverty and Politics, essentially, unpacks
Marcus Hart (14:26.823)
Yeah.
Tyler Evans (14:47.502)
kind of social medicine, social determinants of health, why it matters. Then it looks at pandemics that have existed since 1899 from the third plague to COVID-19. And essentially looks at the sort of the social political drivers for each one of those. And it uses a rubric like a grading tool to determine for the reader, know, did you find, you know, certain sort of components addressing or contributing to these pandemics? And hopefully the answer is yes for most of them. If not, I'm not an effective writer.
But ultimately towards the end, then they get to the third section, which is like, all right, now that I have your attention, hopefully we're on the same page, what do we do about it? And a lot of the book focuses on what's described as syndemics. So I'm talking about infectious disease components, but it all connects to behavioral health pieces and addiction is a big part of it. And that's why I'm flagging it here because...
Marcus Hart (15:32.328)
Mm-hmm.
Tyler Evans (15:43.054)
syndemics is basically looking at a number of different epidemics and they could they don't have to be infectious disease. They could be they could be you know opioid, they could be mental health and I actually talk about we have a carceral health program carceral health and a reentry program in New Mexico and I often talk about a collision of three epidemics taking place. One is mental health, one is addiction and the third is mass incarceration.
Marcus Hart (16:01.917)
Mm-hmm.
Tyler Evans (16:07.478)
And so when you take these three together, the only way that you're going to really kind of break that cycle or disrupt the cycle, if you focus on the social and political drivers, the underlying sort of issues there. So that's a lot of what our sort of work focuses on. And so that's what syndemics are. Basically, it's epidemics that are that are happening in parallel tracks and are not just additive, right? They're working synergistically with one another to basically kind of blow up the sort of the ultimate sort of outcome.
Marcus Hart (16:15.814)
Yes.
Tyler Evans (16:35.83)
So, and behavioral health, addiction's a big part of that. So I focus a lot on street medicine, for example, and a lot of my work is HIV, addiction medicine, street medicine. So we're in the streets providing direct clinical care to the unsheltered, unhoused in Southern California. So we're in the streets of LA, South LA. We're in the desert. And, you know, I'm an HIV doc.
I can't tell somebody to take their HIV meds, right? Unless if they're, if their mental health or if they're currently using, right? If they're currently, you know, if they're currently, when what we see in the streets is often, you know, fentanyl and meth for the most part, if they're currently, you know, if they're currently using their mental health decompositor, there's no way that, that I'm going to have an effective or reasonable conversation with them about, you know, taking their HIV meds. So it's all got to be packaged together. And again, that's that syndemic piece. And until we address the behavioral health pieces, everything else falls apart.
Marcus Hart (17:27.524)
Exactly.
Tyler Evans (17:27.886)
And so and so again now it's getting a lot worse in terms of we just talked about the politics and I'm an optimist But there are certain things that we have to flag. I mean when we're looking at current current stuff last 90 days SAMHSA for example substance abuse Mental Health Services Administration over a billion dollar cut to SAMHSA. That's huge, right? So a lot of these a lot of these, you know certified Behavioral health clinics and other sort of access points or whatnot. That's gonna that's taking a big hit
Marcus Hart (17:46.696)
Yeah.
Tyler Evans (17:56.63)
We personally, my organization currently took a personal hit. We already talked about the lack of, know, SUD providers out there. You take more funding away. It takes more funding away to basically improve access for providers who might get like loan repayment and that kind of stuff as well. Number three is methamphetamine treatment. So meth, we're seeing this increasingly, you know, across the country.
Marcus Hart (18:18.451)
Mm-hmm.
Tyler Evans (18:23.158)
aren't a lot of treatment options for meth, unfortunately. There are some medications that have been kind of with some very, very moderate success. It's not nothing, it's something, but it really needs to be coupled with other kind of treatment modalities, particularly psychotherapeutic treatment modalities. And again, once we break away this sort of funding more, that option sort of goes away more.
And finally, there's like the executive orders to the VA, right? Like the fact that I know a lot of folks, a lot of really mission-driven, talented clinicians that have been leaving the VA lately, which is leading to this brain drain, right? Which is leading to the waiting times and all that, that's going to worsen it, right? They're leaving because of just insane executive orders that are existing. I mean, not providing care to people that are registered Democrats, for example. We're still kind of really like...
Marcus Hart (19:04.498)
Mm-hmm.
Tyler Evans (19:19.926)
trying to sort of piece together the evidence there. I mean, that's a lot of us have sort of been trying, a lot of my colleagues have been saying that is actually true. So I can't sort of confirm or deny, but that is what I'm sort of hearing. In addition to other stuff, gender affirming care, for example, and providing care to other folks that are in kind of other sort of like sexual minorities and whatnot, those folks need a lot of care too. And that impact.
Marcus Hart (19:24.744)
Yeah.
Marcus Hart (19:44.318)
Yeah, definitely.
Tyler Evans (19:46.85)
That impacts the mental health, that impacts the substance use treatment. So if they can't get those parts, then everything else kind of falls apart.
Marcus Hart (19:54.524)
man, you're really forward thinking on all of this. you know, when you gave us the picture of the mass incarcerations, know, addictions and also the behavioral health, you know, how all of this really fits in with each other. people, know, the people with the power, they rather separate all of this and make it seem like it's some organic situation, respectively.
Tyler Evans (19:55.15)
You know, it was a picture of...
Marcus Hart (20:22.078)
when that's just not true, it's all interconnected. And your work with Wellness and Equity Alliance, it champions what you was just talking about with health equity, especially for vulnerable folks like veterans with substance use issues who are part of that huge population of homeless people. So what unique barriers do vets face compared to other groups when trying to assess quality behavioral health care?
You can even put this even in a more broader lens too, because I know we're talking about vets here, but we're seeing, even to what you just kind of testify from what you hear from your peers, that there's assaults on people because of what they identify as, to access quality care.
Tyler Evans (21:16.844)
Yeah, man, that's a big one, right? Like the unique barriers to vets is big. I mean, when we look at kind of the number one, when we look at the pipeline of folks that are going to the military, right? Like a lot of folks will go into the military for your GI bills, for kind of opportunities to get out, right? Like to get out of their sort of, could be kind of the poverty sort of networks and whatnot.
You know, you don't see it off as often I'm not saying across the board, but you don't see it as often kind of more privileged or sort of more Wealthier sort of neighborhood. So there's that piece right? So those are the folks that are sort of going in more more sort of More commonly than sort of others right number one number two All the trauma that you're exposed to right all the trauma that you're exposed to if you know folks are actually, you know in the sort of the bad battlefields of you know, extra y Afghanistan Iraq, you know anywhere
All of that sort of exposure is going to lead to obviously much higher risk of PTSD or sort of decompensated or amplifying any sort of baseline, you know, mental health challenges. Now getting back to the first part, when we're dealing with folks that are kind of, you know, living in areas that are kind of lower socioeconomic status or whatnot.
the likelihood of them getting into that access to get into care to begin with, right? So we could have 18, 19 year olds that are suffering from depression, they don't even know it, right? And then they're getting into, they're getting into war, right? And now that is sort of, know, further amplifying sort of this baseline, these baseline challenges. Now then when they're getting out, and then there's all this other stuff, like, you know, if you are from, you know, a sexual minority or something like that, and we know that, you know, that's not the kindest sort of place to sort of be in, you know, if you are kind of dealing with that. that sort of further kind
Marcus Hart (22:37.758)
Yeah.
Tyler Evans (22:59.946)
amplifies or triggers sort of that piece. Then folks get out and then that gets to kind of what we're talking about right now, right? All of these sort of systematic sort of barriers to access. So the in terms of like the burden of disease is significantly higher here, but the access points are significantly lower. Having, you know, the VA is a really, let's say it has the potential to be an incredible system.
Marcus Hart (23:18.547)
Mm-hmm.
Tyler Evans (23:27.502)
And folks that a lot of the vets that do use it like it for a number of reasons. It's mostly because of the solidarity. It's mostly because of connection to connect with other vets and stuff like that. It's mostly that. did, I did half of my training at the VA and folks loved going to the VA. The problem is it's everything else that we talked about. They're not staffed up appropriately. They don't, and then you get, then you get the executive orders and all that. And that just gets like weirder. So you have, again, this feeder of all these sort of challenges coming into this sort of like this, this
this output and then once they get out, don't have the tools to really connect to these different sort of services. And the final thing I'll say is, and I think it's changing, reaching out for vets to reach out, vets are trained to be warriors, be tough, to be macho, right? And then once they're getting out, to be honest about the fact that they're dealing with
Marcus Hart (24:12.67)
Mm-hmm.
Marcus Hart (24:19.708)
Right.
Tyler Evans (24:25.71)
mental health challenges, to be honest with the fact that they're dealing with addiction or substance use, that's really hard for them to do, right? Because you're trained to be tough, you're trained to be a warrior, and now you're a peer to be vulnerable or weak. I'm not saying it's weak, but it's an appearance and it's perception, and that's really hard for folks to do. So that makes it, that's kind of an issue there. So there's a lot there, Marcus, and I know you're tracking all that.
Marcus Hart (24:32.926)
Mm-hmm.
Marcus Hart (24:53.886)
You're spot on, Tyler, with a lot of stuff. And you're out here transforming healthcare delivery, which is huge. We spoke a lot over this course of this time here, given these deep rooted issues.
and Fentanyl, like very aggressive addictions. What innovative therapies or policy reforms have you seen or we should be pushing for that could actually like close this affordability gap?
Tyler Evans (25:27.244)
Yeah, well, it's the good news. Again, I like to be an optimist. The good news, if you take away all the political disruption that's currently taking place or whatnot, right? Like back, let's go back six months ago. There was a lot of advancement. There have been a lot of advancement in terms of opportunities to optimize access. There's something called 1115 Medicaid waivers that certain states can basically play. Essentially, it's the Medicaid.
Marcus Hart (25:38.674)
Mm-hmm.
Tyler Evans (25:56.002)
The state Medicaid program is essentially asking the Department of Health and Human Services, DHHS, the feds, the secretary of which is, call him the chief pseudoscience officer. So this would be a challenge right now. outside of, if we were in kind of like a normal world.
Marcus Hart (25:59.121)
Yeah.
Marcus Hart (26:04.168)
Yeah.
Tyler Evans (26:15.374)
the state Medicaid program request to focus on some social innovation, something that's important to them, right? So in California, it was homelessness, now it's carceral health. New Mexico is focusing on tribal health and at-risk youth. So it depends on kind of what that, and so then they get it approved, and then they could explore some opportunities to kind of provide community impact for those folks.
And so again, in California, it's now it's called CalAIM. So it's providing stuff like enhanced care management, community supports, and they're spinning up some potential opportunities for some other programs. So a lot of it's just like sort of wraparound services and whatnot. What it does though is importantly, it provides reimbursement for community health workers, peer support workers or whatnot, folks that sort of historically have been marginalized from like the mainstream workforce.
Marcus Hart (26:57.053)
Yeah.
Tyler Evans (27:09.066)
And in American healthcare, if you can't bill for it, it doesn't exist, right? So now that this social innovation is allowing this alternative workforce to come more into the centralized workflow, which my organization focused a lot on that, there's a lot of advocacy for community health workers, but our work is really like, how do community health workers more effectively work with doctors, general physicians, primary care physicians, psychiatrists?
Marcus Hart (27:13.726)
Right.
Tyler Evans (27:37.026)
behavioral health therapists, how does all kind of work together and how do we demonstrate, you know, sort of effectiveness? And so this 1115 waiver, and again, there's many, it's just not just California, I'm just providing a sort of concrete example, gives us the opportunity to kind of explore these options. And then, you know, there's increasingly a lot more opportunities for us to prescribe.
Buprenorphine. There's also now try I'm just using one example, but there's now Trexone that were used for alcohol as well So increasingly there are more people that are prescribing it there used to be something called an ex waiver that you that was required on DA license So it made it even harder should have been the opposite right? It should be harder to prescribe opioids But they made it more difficult to prescribe addiction medicine medications, which made no sense
Marcus Hart (28:03.187)
Mm-hmm.
Tyler Evans (28:25.996)
So they repealed that, they took that away. So now it's a lot easier for them to do it. Unfortunately, a lot of providers out there, feel a little, sometimes a little sort of reticent, a little hesitant to prescribe, but there's enough champions out there like providers in my organization that are just, just do it, you know, just do it. And the risk benefit is just, is clear. You know, just do it. we, so we're getting increasingly more folks on Buprenorphine and Naltrexone and it's showing like amazing results.
Marcus Hart (28:47.347)
Yeah.
Marcus Hart (28:57.31)
Yeah, man. And that's funny. I'm glad you brought that up, too, about that component of that we have this real big resistance against addiction meds to fix the problem. But we're willing to over-prescribe opioids. And we won't do anything to of reduce that or provide some type of alternative to keep people from.
you know, being a revolving door, so to speak. You know, so I really appreciate that. And, you know, Dr. Evans, our audience, veterans, families, advocates alike, you know, they want to fight back, you know. And this is probably going to be the last question before, you know, we kind of get to a close here, by the way. What immediate steps can they take to push for better addiction care solutions? California, you know, they're doing the best they can and they know what they have.
And there's a lot of what's going on in Southern California, especially that can be kind of duplicated across the nation. really like some of the models that you have over there. But what can we do to kind of push to transform our assets for our brothers and sisters?
Tyler Evans (30:15.8)
Sure, that's a great question. mean, there's always the conventional options, which are basically working with your congressmen, working with local community-based organizations to really get your voice out there, to really advance the problem.
Marcus Hart (30:30.686)
Mm-hmm.
Tyler Evans (30:34.83)
There is a lot of that. I do think the matter is known. But I think we can use more of that. that's a first step, and that's a relatively straightforward one. Other pieces that I think would be really helpful is to work with community-based organizations and to work with of coalitions that really come together on a sort of
national sort of spotlight to really again sort of you know showcase these problems.
Some other opportunities would be to work in the VA system or other systems. If there are opportunities for folks to be a part of clinical trials or a part of research that helps to kind of advance this work, know, go for it. Like we need the patients. We need the evidence because, you know, we're medicine, we're very much evidence-based. We need the evidence to really kind of support the efficacy and the effectiveness to move forward on some of these pieces. So that's really important. I would also say, you know, write about it.
Marcus Hart (31:19.006)
Mm-hmm.
Tyler Evans (31:37.024)
opportunities for op-eds, we need more voices. The fact that our vets, our warriors, the people that are defending us, the fact that they have to go through all of these challenges once they're out, and this has been happening since Time Memorial. mean, there's been so many iterations of that, obviously, with Vietnam and...
way before that, right? And the fact that we're still dealing with this and it's getting worse and then we have these executive orders that's making it worse in terms of access is just so profoundly disturbing. And we need to do better as a nation and then vote, vote, right? Like when it comes to these issues, man, mean, people need to be informed about this kind of stuff and understanding how that vote can really impact their access. So that's key as well.
Marcus Hart (32:01.16)
Yeah.
Marcus Hart (32:27.966)
Exactly. Being informed is so important. I know it's one thing to say vote, but just understanding where it's going to fit the hardest with our vote. So I love the wisdom you gave us today. You truly are the domino that keeps the rest of the domino standing with your contributions. So we really appreciate this. Before we wrap this up, tell us about pandemics, poverty.
Tyler Evans (32:48.494)
Thanks, bye.
Marcus Hart (32:54.268)
policies where folks can grab it and how wellness and equity alliance is changing the game and then how we can kind of support you in both of those avenues.
Tyler Evans (33:04.366)
Sure, okay, well thanks for that opportunity. Yeah, Pandemic's Party in Politics is coming out August 5th, so really excited about that. You can get it on Amazon, you can get it on Barnes and Noble. It's also on the Johns Hopkins University Press, who's the publisher here. So just Google it, you'll find it, but Amazon's your sort of safest bet. You can pre-order it right now.
And, you know, again, it's really just kind of unpacking a lot of the challenges that we just sort of talked about. It's not just about infectious disease, right? It's really about how these other factors, we don't invest in the social and political systems that help to kind of protect our brothers and sisters across the country, across the world, then when it comes to infectious disease outbreaks, all it takes is a little sprinkle of an outbreak here or there.
Marcus Hart (33:34.59)
Yeah.
Tyler Evans (33:51.914)
and it becomes a tinderbox and it blows up, right? So that's really what the book is about. What can we do about it? And Wellness Equity Alliance, look us up online at wellnessequityalliance.com. And essentially we are working in a number of different states, really trying to advance the social medical innovation of healthcare. We need to do better when it comes to a lot of folks that cannot or will not engage in healthcare the way that it's currently set up.
So we're just about meeting folks where they're at. And we're still toddlers. We've only been around four and a half years. So we're going to continue to grow and thrive. But connect with us. Shoot us some notes. And we'd love to continue to cultivate these relationships with you guys. And particularly, if you think that there's interest in your community and your city, county, state, please reach out. And we'll explore further.
Marcus Hart (34:48.158)
Oh yeah, I'm definitely gonna be reaching out again, man. We could have went so many different lanes with this conversation today. I kind of feel bad that we kind of capped it at the time that we are at. So we definitely have to spend a block, so to speak, when the book comes out, maybe come back and visit us if you're open to it, All right, well, thanks, Taylor. Today's episode with Dr. Tyler B. Evans hits me deep and I'm sure it does too.
Tyler Evans (35:07.598)
Sure. Happy to, yeah.
Marcus Hart (35:17.694)
to you guys, Transformers. Addiction is crushing our veterans and others with rehab calls, outpacing incomes in 15 states, 65,000, almost 66,000 in Wyoming alone. But Dr. Evans showed us faith and smart solutions can rewire our lives. Your brain is not broken, it's God's masterpiece ready for a comeback. So if this fire lit you at all, here's what you can do. Check out Dr. Evans' book, Pandemic, Poverty, and Politics at Wellness Equity.
Alliance.org. Grab my free three minute prayer guide at Marcus-Hart.com to start healing the day. Watch the full episode on YouTube or Spraker and hit that like button. Subscribe to the Transform You live show, that's Transform the Letter You live show and comment below what is one step you're taking for a veteran's recovery. Share this with someone who needs help. Join us again. Many blessings, peace and lots of love.
