The accidental advocate
SMHS grad Melissa Henke discusses her unexpected path toward addiction medicine and helping usher North Dakota through the nation’s ‘addiction crisis’
In 1999, Dr. Melissa Henke was in her second year of medical school at the University of North Dakota (UND). That same year, 12 overdose deaths in North Dakota were reported.
Back then, training in addiction medicine and substance use disorder wasn’t really a thing, according to the award-winning physician known for expanding access to addiction medicine in North Dakota.
“I don’t actually remember having training in medical school for it,” Henke admitted.
Comparatively, North Dakota lost 133 lives to overdose in 2023. Over 106,000 lives were lost nationally to the same cause.
Given that the opioid crisis has made addiction medicine and substance use disorder very much “a thing,” Henke is making it her mission to change lives and minds about what addiction and recovery look like.
A chance meeting
A 2002 graduate of the UND School of Medicine & Health Sciences (SMHS), Henke entered a residency program that combined her two passions from medical school—neither of which included addiction medicine.
“I always loved internal medicine,” she said. “I loved how linear it was – if you had a patient with high blood pressure, give them a medication and see their blood pressure go down. I also loved psychiatry. I truly love to hear people’s stories, learn what makes them tick, and help people reclaim their lives.”
When she found the University of Kansas offered a combined residency for both specialties, Henke knew she found the right fit. But like her time in medical school, the residency didn’t offer much in the way of experience working with or treating patients with addiction.
“We maybe had four hours a year of training in addiction medicine,” she said. “I only saw the ugly side of addiction—those who were in active addiction. We just didn’t have enough time to get to see people come out on the other side.”
So how did Henke go from having an aversion to treating patients with addiction to serving in multiple capacities, both treating and advocating for patients with this exact diagnosis?
“Accidentally,” she said.
Henke completed residency in 2007 and moved back to Bismarck to practice. On an ordinary trip to Target one evening, Henke bumped into one of her former preceptors from medical school who was with her husband, Kurt Snyder, the executive director of the Heartview Foundation. Heartview is an organization offering residential, outpatient, and medication-assisted treatment options for individuals with substance use disorders in the Bismarck-Mandan region.
“The day I ran into them, their medical director had handed in his retirement notice,” Henke said. “Kurt asked me if I would take the job, and I said no on the spot.”
Henke’s experience, to that point, had only been the negative side of addiction treatment. “It just wasn’t my thing,” she repeated.
Eventually, though, Snyder talked Henke into the medical director role by promising just one hour a week providing oversight of policies and procedures—and she didn’t have to see patients. About a year later, Snyder talked Henke into seeing a handful of patients and prescribing medication to help opioid users.
“Again, I said no way. But he had science to back up the fact that medication-assisted treatment was supportive. I read the literature and eventually agreed,” she said.
That pivotal point in Henke’s career set her on a path to impacting the lives of countless people struggling with a difficult disease that not many health professionals were equipped to handle.
“After I started prescribing I saw people’s lives just transform in a way that I’d never experienced in medicine,” Henke said. “I saw the other side of substance abuse, and I saw the hardworking, compassionate, forgiving, tenacious, beautiful side of people. I was hooked.”
Addiction epidemic
From there, she was all-in. Henke left her other job to spend more time seeing patients at Heartview. She was later appointed to Governor Burgum’s Council for Recovery Reinvented and began working as the director of the North Dakota Professional Health Program, an organization offering support and monitoring for physicians, physician assistants, medical students, and residents who are affected by mental illness or substance use disorder in a confidential and non-disciplinary capacity.
Her steadfast work to advocate for patients with addiction and substance use disorders, and her leadership in expanding access to addiction medicine in the state, earned Henke the 2021 Zezula Award, a Governor’s Award for excellence in public service.
With two board certifications under her belt already, a third board certification in addiction medicine was pursued through the work she was already doing with her patients. Typically, adding another board-certification requires the physician to complete a fellowship, meaning several months away from work and family. Because of the growing need for addiction medicine physicians, the American Board of Preventive Medicine has tried to make certification easier by offering a work pathway towards board certification, rather than a traditional on-site fellowship.
“I would not have gone back to do a full fellowship and leave my family, but the work pathway allowed me to achieve board certification status while continuing to see patients,” Henke said.
For his part, Snyder is certainly glad for the Target run-in back in 2007.
“Heartview wouldn’t be where it is today without Dr. Henke,” he smiled. “Her willingness to be open-minded and work on the forefront of addiction research allows us to give patients a chance at a new life. She is much loved by staff and patients alike, and, in return, she is a fierce advocate for her patients.”
With patient care being her first focus, Henke is equally passionate about educating future generations of healthcare professionals and offering experience with addiction medicine that she never received in medical school.
“It doesn’t matter what field of medicine you go into, you will deal with people who use substances,” Henke said. “We are not in an opioid epidemic; we are in an addiction epidemic.”
Just be kind
When training a student, whether it’s a medical student, physician assistant student, or licensed addiction counseling student, Henke goes beyond just having trainees observe her doing her job. She encourages full interaction with her patients and tells her patients to be open and honest with students so they can learn how to treat patients with addiction better.
Stephanie Ziegler is one such student.
A fourth-year UND medical student who has her sights set on rural family medicine, Ziegler spent a week at Heartview in her third year. Having taken so much from the experience, she returned for a full one-month rotation this year. In other clinical rotations, said Ziegler, her interactions with patients who have addiction or substance use disorder often left her feeling helpless.
“I only saw withholding opioids as a response to their disease, not providing help,” she said.
After training with Dr. Henke, though, Ziegler saw that there are ways to help.
“For a lot of patients, Dr. Henke is the first person to really understand them and set them on a path to success,” Ziegler said. “I recently saw a patient who is five-years sober. I want to be like Dr. Henke, I really do.”
Educating the public is another mission for Henke, who believes that helping people understand the disease of addiction can help us all be better neighbors to our fellow North Dakotans. Her message is simple: “just be kind.”
“I tell my patients all the time that if they are sitting in that chair, someone in the medical field has treated them poorly,” she said. “We have to show [new providers] what recovery looks like.”
To that end, Henke notes that because addiction is not something anyone would willingly choose for themselves, individuals and families suffering from a substance use disorder should not be “shunned” as if addiction is their chosen lifestyle.
Henke believes that kindness, not judgement, is something everyone can do.
“What people really need is a champion, so if I can be that voice of compassion, then then I’m happy to do it,” she concludes. “Because what I see, over time, is that my patients are getting more job opportunities, more housing opportunities, and more educational opportunities, and that benefits everybody.”
