Mario Garcia had always been a social drinker, but when his father died, he said his drinking started spiraling.

“After that, the alcoholism got worse and went on for a couple of years,” Garcia, 42, said.

He lost his job, his wife and access to his kids, he said. That’s when he decided to make a change and enter a rehabilitation facility.

He’s been a patient of Phoenix House in Queens for about 90 days and said interactions with the nurses there can have a big impact on his treatment.

“[A] nurse is actually the first person I see in the morning, and I go off of emotions and stuff like that, so if a person is not in the mood or doesn't want to be here, you kind of vibe off of that and it continues throughout the day,” he said.

Addiction recovery centers and their workers have often felt overlooked within the broader health care industry because of negative stigmas attached to addiction, according to advocates. But while recovery centers, like the overall health care industry, deal with a worsening nursing shortage, they’re also facing record overdose deaths.

The U.S. surpassed 100,000 drug overdose deaths for the first time during the 12-month period ending in April 2021, according to the Centers for Disease Control and Prevention. This was an increase of 28.5% from the 78,056 deaths that occurred in the same period the year before.

And in New York, 2020 was the deadliest year on record for drug overdoses in the city, according to health department officials. From March 2020 to March 2021, 2,245 people died of an opioid overdose, according to CDC data. This was up nearly 40% from the previous year.

In addiction recovery work, nurses play a critical role. Their work involves managing prescription medications and administering psychotherapy. And in health care settings when physicians’ time with patients can be limited, nurses step in to fill in the gaps.

“Nurses are, really, kind of the center of the universe in lots of ways,” said John Coppola, executive director of Alcoholism and Substance Abuse Providers of New York state. 

In 2021, Phoenix House partnered with New York University’s Rory Meyers College of Nursing to place undergraduate nursing students directly in its recovery facilities in New York City and on Long Island.

The launch of the program comes amid the rising nursing shortage across the country, which has long since plagued the health care field and was exacerbated by the COVID-19 pandemic as health care facilities dealt with a surge of patients.  

In New York state, there is a projected shortage of more than 39,000 registered nurses by the year 2030, according to a Department of Health state report from August 2020.

When Shernetta Bailey, the director of nursing at Phoenix House facility in Long Island City, came on board in June 2021, she said the shortage of nurses had a direct impact on care. At the time, there was one nurse to administer medication for all of the more than 100 male patients. 

Patients had to wait in long lines for their medication, which she said led to non-compliance in many cases as people would choose to skip the long lines altogether.

After hiring more nurses and expanding the number of floors for administering medication, there is one nurse who is able to serve about 40 patients each, she said.

“Their behaviors change,” Bailey said. “They're more compliant with their medication regimen. We're able to spend more time with them. We're able to schedule their follow up appointments or medication in a timely manner. We were able to do much more with these clients because we have more nurses on board.”

And in clinics that treat substance abuse like Phoenix House, the issue of recruitment was a problem even before the pandemic, according to advocates.

“Very few people want to come on board when it comes to mental health, and I do think the stigma associated with mental illness — it does play a big part in that,” said Monique Wright, associate director of nursing at Phoenix House.

The Phoenix House nursing program has the potential to alter not only how care is administered, but it can also get more people interested in nursing, advocates say.

“It puts the addiction field on the map,” Coppola said. “It elevates it to the point where now you have people who are teaching you and who are guiding you in the early stages of considering whether nursing is the right profession for you.”

When Stephanie Curtis was a nursing student at New York University, she had no idea that she could work in an addiction recovery center.

She knew she was interested in psychology, but assumed that her clinical rotations would only take place in inpatient hospital settings.

“I don't think most people in nursing programs are aware,” said Stephanie Curtis, nursing supervisor at Phoenix House, an addiction recovery center, in Queens. “I had friends who were going through other programs at the same time as me who were totally shocked that this is where I was doing my clinical rotation.”

Curtis was part of the first year of NYU nursing undergraduate students to be placed at a Phoenix House facility as part of their clinical rotations. 

The Phoenix House facility in Long Island City has 190 beds and treats both women and men.

Patients say the success of a recovery program can hinge on the ability of a nurse to go above and beyond a checklist of medication.

“We're all kind of, like, experiencing some level of irritability because we are recovering addicts, and we have that ‘addict behavior,’ you know what I mean, that we're all trying to get past,” Hansel Hansel, 47, said.

Without the training and access to this patient population as nursing students, however, developing that patience can make it more difficult to break from misconceptions, according to advocates. 

The goal of the expanded partnership with NYU’s undergraduate nursing students is to change that by expanding their experience during clinical rotation outside of traditional hospital settings.

“It's opening their eyes to recognize, ‘Wow, this is like the same patients that I'm treating — though I think of them poorly at times or I may think of them differently at times — because of what's been happening to them,” Justin Shaw, associate medical director at Phoenix Houses, said about the changed perception of the students who have been placed at the center.

The partnership has seen 64 NYU students rotate through since the program started in 2021. It also expanded to the Pace University School of Nursing in January 2022.

Since the partnership, they’ve also been able to bring on nursing students full-time after they graduate, like Curtis.

She thinks that training future nurses in this line of work can make a huge difference in how people treat recovery work.

“Being able to be in front of these people and see they're real people, they're good people struggling,” she said. “It’s really important because people have an idea in their mind that's not maybe reflective of reality, and I think it can bring out some compassion and empathy.”