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Treatment for addiction is not 'one size fits all,' says Monument founder

Mike Russell is the CEO & Co-Founder of Monument, an online platform to help change your drinking habits.


His story, like so many others, begins with an undetected unhealthy relationship with alcohol. After working in the finance industry after college, he entered what he calls the 'party promotion business,' where drinking and partying became part and parcel of his career success.


He was not a daily drinker.


"You don’t need to 'hit rock bottom' to make the choice to change your relationship with alcohol." -Mike Russell

Rather, he would binge on weekends and nurse 48-hour hangovers. Seven years flew by before he decided to 'settle down.' This involved founding two startups, getting married, and having two children.


“The drinking followed me into the next chapter,” he says.


I would only drink once every week or two, but I would find myself out until the morning and sleeping through the days as my kids stirred asking why their dad was so sleepy,” he says.


So how did Mike Russell change his relationship to alcohol?


He quit - but not without help. It is on this personal journey of self-improvement that he discovered a gap in recovery culture.


“I searched for support only to find myself feeling more adrift and alone than ever,” he says.


“I reached out to outpatient centers and the first one to get back to me took three weeks to respond, only to tell me there was a two month waitlist until they could speak with me,” he says.


Unfortunately, this is all too common - and research has shown time and time again that waiting for treatment provides a barrier to a person not only accessing adequate help when they are ready and willing, but also following through with a treatment plan once they are accepted or admitted.


Redko, et al. discuss a few possible reasons for this linkage between waiting time and treatment success.

  1. People are typically in crisis when they initially reach out for help.

  2. People may have only temporarily overcome internal or external barriers to treatment.

  3. People who experience sobriety during the waiting time may see this as indication that they no longer need treatment.

Russell’s experience is not unique. I have unfortunately seen this firsthand in my family and know how critical the moment of someone asking for help is to their overall outcome.

When seeking help for my brother’s addiction issues*, our family was told there was a several month waitlist for government-funded help. The closest private treatment center was 4 hours away and cost $5,000 per month.


While we were hopeful, my brother was not. The moving away (even for a short while) and the hefty price tag (even though we didn’t expect him to cover the costs) served as life threatening barriers. Those factors, paired with the days it took to find that help, meant the moment of intervention opportunity was lost. For myself, deciding to get sober wasn't a family discussion, but a personal choice prompted by a long history of unhealed trauma, substance use, and an inevitable trip to the ER.


When it comes to getting help, every minute matters.


In Russell's journey, he gave up on his online search for help and group meetings, but he didn’t give up on himself. After talking to a sober friend about their own journey, he learned of additional options for those in need of support.


Today, Russell attributes his sobriety to an FDA-approved prescription medication that helps people moderate or stop drinking, plus therapy and peer support.

From his experience came an idea on how to help others overcome barriers to treatment.

He called it Monument - a digital health platform where people seeking help with their drinking can sign up and access immediate support.


I connected with Russell to learn more about his journey and the way Monument works for those who are looking for help.


Michelle Pugle: You told Medium readers that most people in your life did not know you had a problem with alcohol, but it also does not sound as though you were actively hiding your drinking. Is this true? Can you discuss why you think those closest to you were seemingly unaware of the unhealthy relationship you’d developed with alcohol?

Mike Russell: This is true! In my 20s I worked as a nightlife promoter and successfully scaled the business into a full-time job, working with hotel groups, restaurant groups, clubs, etc. where drinking on the job was part of the gig. I wasn’t hiding my drinking because I didn’t think it was problematic. I didn’t drink every day, and it was ‘for work,’ right? When I left that job and entered the tech world, the binge drinking followed me. I was only drinking every couple of weeks, but once I started I couldn’t stop. I started to understand my drinking was out of control.

I think many people don’t recognize that kind of binge drinking as problematic. Because I wasn’t drinking daily, or during the day, I didn’t fit many people’s definition of a problematic drinker. But that’s what I’m working to dispel at Monument. Just because someone’s alcohol consumption hasn’t entirely disrupted their job, relationships, or health, doesn’t mean it’s not an unhealthy behavior, and one worth addressing. I felt out of control, ashamed, and alone. But because I was ‘high functioning’, my network wasn’t aware.

That’s why I created Monument. Because you don’t need to meet any criteria to make the choice to change your relationship with alcohol. I wanted to provide access to treatment that wasn’t “one size fits all,” and gets you from where you are to wherever you want to be. So many people have reached out to let me know they have a story like mine. Everyone deserves support to get more out of life by drinking less, or stopping altogether.

Pugle: What are some misconceptions about problem drinking you'd like to share with readers that may be preventing them from seeking help?

Russell: A big misconception is that all unhealthy drinking looks the same, or similar. People don’t know there’s a spectrum of unhealthy drinking, and that no matter where you fall on that spectrum, you deserve support. (Alcohol Use Disorder is actually classified as Mild, Moderate, or Severe based on the APA’s DSM-5 criteria.) And as mentioned before, you don’t need to ‘hit rock bottom’ to make the choice to change your relationship with alcohol.

I think people are also surprised to learn that Alcohol Use Disorder is diagnosed as a medical condition, like any other health issue. Statistically speaking, AUD is 50–60% genetically determined. Gene interactions shape how someone ends up developing Alcohol Use Disorder, and to what degree. Recognizing AUD as a medical issue is crucial in providing people with effective support, and reducing the shame and blame associated with it. Realizing this was a game changer for me.

At Monument, we connect members to physicians and therapists specialized in helping people change their drinking to provide the top-quality medical support they deserve. We also provide peer support through our anonymous forum and therapist-moderated support groups.

P: You mentioned 2018 was when you stopped drinking. What do you want people to know about how the recovery process changes as time passes?

R: I will be forever grateful to my friend who told me about medication options to help change your drinking. That’s what really helped me stop drinking in those early days. It’s an incredible tool that so few people know about, and is a huge reason we connect members to physicians on the Monument platform. So, I want people to know about that. Under 9% of people who are good candidates for this medication are currently prescribed it. Also, people should know that it can get harder before it gets easier. The first few months after I stopped drinking were incredibly challenging for me. I was confronted with anger, impulse control issues, and other emotions I had never experienced before. And what I have since learned from the fantastic clinicians we work with, is that this is incredibly common in the early days of changing your drinking. Working with a therapist was instrumental in helping me understand and work through those emotions, and is still part of how I maintain my sobriety today. When building Monument, I knew connecting members to therapists specialized in treating substance use disorders was going to be a core part of our program.

And lastly, be patient with yourself. The first year was particularly challenging. Experiencing each new season and event sober or moderating will feel different -- that first wedding, first winter, etc. But you can and will get through it.

P: Talk to me about the moment you envisioned Monument. What helped you follow through with the goal of creating this platform to help others change their relationship to alcohol?

R: The inspiration behind Monument was a combination of my own experience, my journey as an entrepreneur, and my research into how many people struggle with their drinking. In my journey to change my own drinking, which included trying a few treatment options that didn’t work for me, I learned about evidence-based treatment methods like cognitive behavioral interventions and FDA-approved medication. As an entrepreneur, I keep an ideas log of my favorite business ideas. I continuously prioritize them to see what keeps surfacing to the top, and after several months of sobriety, the idea for Monument remained in the number one spot. Then, I started to research. I learned that 40 million people in the US have unhealthy drinking habits per the CDC. That 15 million people have Alcohol Use Disorder. And under 10% of those people with AUD get treatment in a given year in the current system.

The combination of the influences motivated me to start Monument. And now, hearing all of our members’ stories about how we’re empowering them to live fuller lives, keeps me more motivated than ever.

P: Is Monument a zero-tolerance platform? Why or why not?

R: No, Monument is free of absolutes, labels, and requirements. We support goals for moderation or sobriety. Members work with their Care Team (including a physician and/or therapist depending on their plan) to set achievable goals based on their medical history, needs, and preferences. Some people start moderating with an end goal of sobriety, others quit drinking with aspirations for reintroducing controlled drinking down the road, others decide with their Care Team that sobriety is their only option, and everything in between.

We’re on a mission to increase access to effective treatment, and believe that supporting a range of goals and entry points will get more people the support they deserve.

P: At Monument, you offer a tiered approach to help people seek online treatment. Why did you design the platform in this manner?

R: We recognize that everyone is coming into Monument with different medical histories, needs, preferences, and goals. And because of that, people are seeking and in need of different types of care. Some members prefer to start with physician care, and then introduce therapy after a few months. Others choose to work with a physician and therapist and decide medication isn’t right for them. What’s consistent across our plans is that they’re personalized - your physician and therapist will customize your treatment based on your unique circumstances and aspirations. We designed it this way to decrease members’ barriers to treatment, and increase the likelihood of meeting their goals.

“One of the most useful steps to take during your recovery process is committing to a therapy program that is specifically tailored to you and your needs.” - Laura Diamond, LMHC, EdM, MA.
Laura is the Counseling Supervisor of the dual-diagnosis inpatient detox and rehabilitation unit at The Addiction Institute of Mount Sinai West Hospital.

P: What do you want someone who is thinking about seeking treatment for problem drinking to know about the recovery process? Alternatively, provide a piece of advice to readers who may be questioning their relationship to alcohol.

R: Know this: you are not alone. This can be really hard, and there’s no reason you need to carry this weight by yourself. Whether it’s an encouraging community, professional care, or both, you deserve support. And while it’s taken a while for me to believe this myself: you should be proud of the choice to change your drinking, not ashamed. Taking care of yourself is productive, important, and brave.


P: Is Monument a replacement for traditional methods of treatment such as Alcoholics Anonymous or in-patient care? Please explain.


R: Monument is a new way for people to change their drinking, and we can support anyone who doesn’t require medically assisted detox. Monument is unique in that we operate entirely via telehealth, support goals for moderation or sobriety, and connect members to virtual resources, peer support, and affordable medical care. Our holistic platform is designed to provide members with all of the tools they need to achieve their goals.


We also recognize the value of in-person community, and encourage our members to seek that out in addition to our support if they’re interested. There is no ‘silver bullet’ to treating unhealthy drinking or AUD, and we believe people deserve to know about and have access to as many options as possible.


P: You have said that life shouldn’t have to stop for recovery. Do you think this is true for every problem drinker? Please explain.


R: We avoid asserting that one thing works for everyone, which is why all Monument plans begin with a call with a licensed physician, who can talk members through their options. For example, people requiring medically assisted detox should receive in-person support.


However, many people can receive comprehensive, personalized support entirely via telehealth. And while changing your drinking requires putting in the work, for many, it doesn’t mean you have to check out of your life, or compromise on the quality of care. And a lot of people still don’t know this.


With young kids and a demanding career, checking out of my life didn’t feel like an option for me a couple years ago, and it was a barrier to seeking treatment. At Monument, we provide care on your schedule, and from wherever is most convenient, which has empowered more people to take the leap to get treatment.


For more information about Mike Russell's story or how to find help via Monument, go to https://joinmonument.com/.


Do you have a story about your own alcohol use to share? You can reach others by writing a letter or caption to alcohol and posting under the #dearalcohol hashtag campaign. *My brother has granted me permission to speak about his story in any manner which may be of benefit to others.

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