Restoring Smiles and Lives
One student’s struggles give birth to compassionate care in face of opioid crisis
by Jennifer A. Cline, writer/magazine editor
Published February 26, 2020
Lisa M. Zimmer knows what it’s like to overcome an addiction to opioids. And the recent Pennsylvania College of Technology graduate wants to provide compassionate care to those who are also recovering.
She took the first steps in providing that care through the senior project that concluded her study toward a bachelor’s degree in dental hygiene: health policy and administration.
“There are two things in this world that I really know about: one is teeth, and two is addiction,” Zimmer said.
It turns out, that combination of expertise can serve many. Her senior project has led to a burgeoning nonprofit called smiles4recovery.
“There is a glaring need for a bridge to connect those with opioid use disorder to easily accessible dental care,” Zimmer explained, citing a study published in the Journal of Behavioral Health Sciences & Research that states dental problems are amid the most frequently reported health problems among active opioid users.
Her objective is to educate patients, dentists and the public about the special oral health concerns of people recovering from opioid addiction.
She began with patients. As part of her senior project, she secured an internship with CompleteCare NJ, a network of community health care centers in southern New Jersey (where Zimmer lives).
Zimmer, a registered dental hygienist since 2006, visited with 50 patients who are in a medication-assisted treatment program, educating them about the effects of opioids – including medications used to help in recovery – on their dental health and encouraging them to see a dentist before pain begins.
Opioids can both cause tooth decay and mask the pain associated with it, Zimmer explained. Often, when individuals begin to recover, their mouths begin to hurt.
Studies show that dental pain can be a cause of relapse.
“If you do not have an established dentist, which many recovering addicts do not, you are in a real pickle,” Zimmer said. “If you wake up on a Tuesday morning and have an abscess, you might go to your neighborhood dentist. If a doctor doesn’t know your history and prescribes you a painkiller, that’s very hard to turn down when you’re in real pain.
“You have people who are looking for jobs again for the first time, people who, everything else is going well, but every time they smile they are reminded that they’re a junkie,” she added. “We have enough shame and embarrassment as it is.”
“Lisa went above and beyond course requirements to fulfill her dream of working with her peers, individuals with opioid use disorder, who truly need educational support on oral health and help to find them a dental home,” said Mary Jo Saxe, associate professor of dental hygiene.
Zimmer approached her patients with compassion, explaining that she, too, has experienced addiction.
Zimmer was first prescribed an opioid painkiller when she was 17 and had her wisdom teeth removed.
“I knew right away that I liked it,” she said.
Within a year, she had her tonsils removed and was prescribed the same medication. Opioids make some people feel sick and drowsy. For others, like Zimmer, they cause a different reaction.
“It provided me confidence,” she said. “It reduced my social anxiety. It gave me energy and helped me focus.”
Three years later, a doctor prescribed a daily opioid for jaw pain related to temporomandibular joint dysfunction. A year later, in 2003, the doctor performed extensive surgery, which required a higher initial dose and considerable recovery time.
“An important fact to remember is that the possibility of opioid dependence increases with each additional day of medication, starting with just the third day, and increasing dramatically after the fifth day,” Zimmer wrote in her senior project report. “I was already more than dependent. I was obsessed.”
But she remained functional.
Zimmer enrolled in an associate degree dental hygiene program at another college in 2004. During her final year, between the Fall 2005 and Spring 2006 semesters, when she had planned to attend a review session for the board examination, she instead put herself in rehab.
“I did my 28 days and was out just in time for the spring semester to begin,” she said.
But two weeks before her board exams, she relapsed.
“Opiates gave me the ability to have energy, stay awake and study for boards,” she said.
She did well, received her registered dental hygienist license and began practice.
“Up to that point, I received all my pills through doctors,” she said. They prescribed them to her for various ailments and chronic pain. (She has since been diagnosed with lupus.) Zimmer blames only herself for her opioid use disorder, but notes that, at that time, doctors were generous with prescriptions.
As she began working and making money, and her tolerance increased, she began buying additional painkillers on the street.
Zimmer knew from the time she enrolled in an associate-degree dental hygiene program that she wanted to earn a bachelor’s degree. It would open doors to becoming an educator, which she had learned she had a knack for. She enrolled in Penn College’s online bachelor’s degree in Fall 2007 while working as a dental hygienist.
As her opioid use continued, her life became unmanageable. In 2009, she was fired.
“It was the best thing that ever happened to me,” she said.
She ran out of money. She felt “dope sick” – a symptom of withdrawal – more and more often. She was suicidal.
It drove her to enter detox and a two-month recovery program. Zimmer has been free from opioid abuse since January 2010.
It took nearly 12 years to earn her walk across the stage at the college’s May 2019 commencement ceremonies, but at no point did she give up.
“If you look at my transcript, you can see times when I didn’t take classes,” she said. “One of the things I like to say is that there are so many times that I stopped, but equally as many times that I started.”
Shawn A. Kiser, director of dental hygiene and Zimmer’s academic adviser, is impressed by her “grit and perseverance.”
In the midst of her senior project, another hurdle emerged. On March 3, 2019, she had a grand mal seizure and was told she could not drive for six months. With the help of her husband, Darren, her internship coordinator and rideshare services, she continued meeting with CompleteCare NJ clients.
“Her determination to complete this capstone was inspiring,” Saxe said.
Recovery for Zimmer has brought her through pain and depression to a position of hope and empowerment that she is using to educate and inspire others. Including her Penn College faculty.
“As a professor, you hope students learn something in your class,” Saxe said. “In this case, I feel I learned more from my student – perseverance, compassion, inclusiveness. Although her life has had obstacles, she didn’t quit, but found new pathways to move forward.”
Zimmer is vice president of the Southern Component of the New Jersey Dental Hygienists’ Association and recently obtained a dental hygiene public health practitioner license, a relatively new credential in Pennsylvania that allows dental hygienists to help underserved populations. And she is a mom.
In August, she began classes toward a master’s degree in dental hygiene with a concentration in education/public health.
“My short-term goal is to start educating dentists and dentists’ offices about opioid use disorder: what to look for but also how to treat patients with compassion,” Zimmer said. “If we don’t do that, we’re not going to help.”
According to the National Institute on Drug Abuse, more than 70,200 individuals died from drug overdoses in 2017. Among them, more than 47,000 involved opioids.
“When I read Facebook posts with people saying, ‘Let them overdose,’ I cry,” Zimmer said. “Because the potential of that person is me. I really want to get the word out there about being compassionate. I want to educate people about real-life addiction.”
College introduces coursework to mitigate crisis
Responding to the chemical dependency crisis, Pennsylvania College of Technology is offering an online chemical dependency credential to enhance the skills of professionals working in fields such as health care, human services, law enforcement and education, as well as the private sector, where employers are finding an increasing need to identify workers who might be struggling with chemical dependency.
“Every day in Pennsylvania, 13 people die from a drug overdose,” said state Sen. Gene Yaw, who also serves as chairman of the Penn College Board of Directors. “Across the nation, over 100 people are dying every day from a drug overdose. This is clearly the greatest public health crisis we face today. No one law or program will solve the problem; but, like weaving a rope, each strand represents one measure to fight the epidemic. Alone, they might not be fully effective, but together they can strengthen the rope and our collective efforts.
“With health care programs being a major part of Penn College’s curriculum, I am happy to see the college use its resources to address this national problem.”
A loving witness
Lisa M. Zimmer is a “daddy’s girl.”
“We were like two peas in a pod,” she said.
When her father developed COPD (chronic obstructive pulmonary disease), Zimmer spent a lot of time taking care of him.
“A lot of my classwork I was doing in the hospital with him,” she said.
He reviewed anatomy and physiology flash cards with her and let her know how proud he was.
He died in 2011, just as Zimmer began dating her husband, Darren. They never got to meet. But when she married, she wanted her father to be part of the ceremony. So she made pins for all her guests that showed a photo of her with her father on the front. As her brothers “gave her away,” her guests flipped their pins to show the other side – a photo of Zimmer with her husband.
“As I looked at everybody, I could see my dad in everyone,” she said.
When commencement came, she decided a physical token of her father needed to be with her again.
“My father was all about education,” she said. “He thought it was super important and was so proud of me going to school. So I took him out and put him right there on my gown so he could see me graduate.”