Industry Insider - December 2015

Nov/Dec 2015

Vol. 1 No. 2

2016 Presidential Candidates Talk Addiction pg. 2 Industry Trends: CEUs and Conferences pg. 4 Testing Matters pg. 5 Using Data to Improve Outcomes pg. 6 CCAPP Celebrates Year of Firsts pg. 14

Robert Weiss: Sex Addiction 101 & Ashley Madison

Carol McDaid: Lobbying for Recovery pg. 15

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Letter from the Editor October was a heady month for those of us immersed in the treatment and recovery industry; with thirty thousand on the Mall for the UNITE rally and 570 on the Hill the next day for advocacy, including eight major labor unions, the discourse around addiction is palpable in new and unexpected ways. The Surgeon General’s announcement of a commitment to a report on addiction prevention, treatment, and recovery provided a new frontier on which we’ll report in every issue.

It truly is emblematic of what’s happening nationally. As my colleague Gary Seidler writes on page two, the word “recovery” is now embedded in the 2016 presidential campaign and that word has unexpectedly emerged in the vernacular of policy makers. However, history views that boisterous assembly on the National Mall as our moment, crystallized in all of the pending bills in Washington, DC. Congress has never paid so much attention to the disease of addiction. Even Dr. Oz vowed, from a stage full of rockers, to continue devoting his national platform to stories about addiction treatment and recovery—his heroin special was his highest-rated of the year. He’s not the only public figure who’s “all in” on the issue, seeing how UNITE ramped up the opportunities to effect real change.

There are obstacles that we’ll also discern and explore. Parity is assuredly not being fully enforced, even though it’s in statute. But the idea of UNITE, of coming together in a unified way, in communities and nationally, transcends all of the silos of the industry we cover. With headline rockers and powerful testimony from many big names, the UNITE rally was the grand event other health conditions have been accustomed to for a long time, addressing the addiction issue in a broad-based and moving manner.

More than a concert—though Steven Tyler, Sheryl Crow, Joe Walsh, and Jason Isbell added consistent recovery messages to brilliant performances—and more than a rally, it provided a level of shared experience that was quite transcendent and the Industry Insider will continue to capture these galvanizing times.

Sincerely,

Stephen Cooke Editor, Treatment & Recovery Industry Insider

UNITED WE STAND!

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Candidates Weigh-In on Drug-Related Issues Gary Seidler

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ometimes lost in the “Summer of Trump” were statements or comments from candidates of both parties that provided some insights as to where each stands on drug issues, addiction, treatment, and recovery.

While the Obama administration announced a major policy shift in its efforts to combat the nation’s opioid abuse epidemic by removing some of the obstacles that have prevented greater involvement from doctors to treat those addicted to heroin or prescription painkillers, Democratic presidential candidate Hillary Clinton unveiled ten-year, $10 billion dollar, antidrug-abuse treatment plan.

Clinton’s new plan focuses on “prevention, treatment, and recovery; ensuring that first responders have access to naloxone; controlled drug abuse training for prescribers; and criminal justice reform” (DiStaso, 2015). In addition, “such reforms would include ‘alternatives to incarceration for low-level and nonviolent drug offenses,’ and treatment programs that would

policy and Ran Paul’s, stating that he would “treat marijuana as a gateway to harder drugs, rather than decriminalize it or allow medicinal applications” (Nguyen, 2015).

Rand Paul fired back by stating that Bush’s plan would harm patients in need of medical marijuana and target poorer Americans disproportionately.

help those affected to get ‘back on their feet’” (DiStaso, 2015).

Furthermore, Clinton’s plan calls for a directive to the Justice Department to prioritize treatment over incarceration for nonviolent and low-level drug offenders. Clinton believes that the savings coming in as a result of ending “mass incarceration” will help to fund the initiative (DiStaso, 2015).

New Jersey governor Chris Christie quickly joined the fray by reminding the rest of the candidates that his states mandates treatment in lieu of jail time for first-time, nonviolent drug offenders. “I think you need to be prolife for more than just the time in the womb,” he stated (Nguyen, 2015). “It gets tougher when they get out of the womb. And when they’re the sixteen-year-old drug addict in lockup, that life is just as precious as the life in the womb.”

During the same debate, former CEO Carly Fiorina argued that we need to invest more to treat drug addiction, an issue that has sad personal resonance for the candidate as her stepdaughter died from drugs. “We are misleading young people when we tell them that marijuana is just like having beer,” Fiorina said (Nguyen, 2015). “And the marijuana kids are smoking today is not the same as the marijuana that Jeb Bush smoked forty years ago.” ■

CLINTON WEIGHS-IN

Clinton, targeting what her campaign is calling “America’s deadly epidemic of drug and alcohol addiction,” confessed she was surprised to hear “everywhere I went about drug abuse and substance abuse and other such challenges” (DiStaso, 2015).

This initiative calls for “establishing a $7.5 billion fund to support new federal-state partnerships to comprehensively address substance abuse. It also adds $2.5 billion to the existing Substance Abuse Prevention and Treatment Block Grant program” (DiStaso, 2015).

REPUBLICANS SOUND-OFF

One of the most volatile exchanges at the second GOP debate was prompted by a question regarding drug use and several candidates jumped into the fray.

While discussing his drug-reform proposals, Senator Rand Paul “accused Jeb Bush of hypocrisy for having smoked marijuana as a teenager. The former governor quickly admitted that yes, forty years ago, he smoked pot in high school. ‘I’m sure other people did it and didn’t want to admit it in front of twenty-five million people,’ he joked” (Nguyen, 2015).

At that time Jeb Bush began illustrating the differences between his drug

References DiStaso, J. (2015). Clinton unveils $10 billion, ten-year, antidrug abuse, treatment initiative. Retrieved from http:// www.wmur.com/politics/clinton-unveils-10-billion-10yearantidrug-abuse-treatment-initiative/35052262 Nguyen, T. (2015). At GOP debate, Rand Paul, Jeb Bush, and Carly Fiorina spar about marijuana. Vanity Fair.

Retrieved from http://www.vanityfair.com/news/2015/09/ gop-debate-marijuana-rand-bush-fiorina

Nov/Dec 2015

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Robert Weiss: Sex Addiction 101 & Ashley Madison Stephen Cooke

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t was difficult to really process the recent Ashley Madison hacking scandal without running into the televisual expertise of Robert Weiss, LCSW, CSAT-S, the public face of understanding and treating sexual addiction in the United States. Weiss has served as a media specialist for CNN, The Oprah Winfrey Network, the New York Times, the Los Angeles Times, and the Today Show, among many others, and was the expert to turn to as America sought to understand the Jared Fogle and Josh Duggar revelations in addition to the Ashley Madison hack stories.

As easy links to pleasurable sexual content and activity have increased, and so too has the number of people struggling with sex, porn, and love addiction. Unfortunately, very few possess a comprehensive understanding of this incredibly complicated disease.

That accusation cannot be leveled at Weiss, who is the senior vice president of clinical development with Elements Behavioral Health. His newest book, Sex Addiction 101: A Basic Guide to Healing from Sex, Porn, and Love Addiction, covers everything from what sexual addiction is and how it can best be treated, to how it affects various sub-

groups of the population such as women, gays, and teenagers, to how sex addicts can protect themselves from the online sexual onslaught.

Weiss’s work comprehensively covers trauma-based experiences that lead to addiction. His work is at the intersection between digital and social media and human intimacy and the patterns that arise around that, especially related to addiction.

A UCLA graduate who learned his craft under the tutelage of his mentor Dr. Patrick Carnes, Weiss founded the Sexual Recovery Institute in Los Angeles in 1995. He has also developed clinical programs for The Ranch in Nunnelly, TN, and Promises Treatment Centers in Malibu, CA. Weiss states, When I started in ’95, there were two outpatient agencies in the nation for sex addiction. No therapists then, but Dr. Pat Carnes has now trained over 1800 certified CSAT counselors and the “market” has changed from one where just a few Americans looked to California for treatment. In the late 90s, I’d been in the field in a boutique practice for six or seven years, and saw the possibilities. Twenty years in the field is of importance to me because I say to people, how many restaurants, small businesses, and services do you know that’ve stayed open for twenty years?

He has also provided clinical multiaddiction training and behavioral health program development for the US military and numerous other treatment centers throughout the United States, Europe, and Asia.

So another month in the life of America’s foremost and most galvanizing speaker on the topic of sex addiction just began with The Association of Black Sexologists and Clinicians Conference in Philadelphia, PA, and proceeds to Freud Meets Buddha: Mindfulness, Trauma, and Process Addictions, followed

by The Society for the Advancement of Sexual Health (SASH), with his international contributions to the field including imminent trips to South Africa and Singapore.

As more Ashley Madison revelations emerge and spouses and families seek to understand sex addiction, the media continues to seek out the works of Robert Weiss. As he states, “What a great time to be writing and publishing books about online sex addiction and cheating, n’est ce pas?” ■

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Industry Trends Guidelines for Continuing Education Michael Walsh, MS, CAP, BRI-I

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itting around with some colleagues in the field recently, we began discussing the topic of continuing education. A therapist friend, who did not specialize in addiction, asked what she supposed was an innocent, well-meaning question—a question that ignited a spirited and interesting discussion and debate. It soon became apparent that this was a loaded question with a number of different answers depending upon the reason it was asked.

Her question was: What is the best place to continue education in the addiction field?

The answer to this question is dependent on various other questions: • •Why are you interested in addiction training and what do you hope to accomplish? Is this your specialty or something you are trying to add to your primary focus?

• •Is meeting people or learning about available placement important? If not, online or local resources might be an option.

• •What level of training is sought and are there any specific interests or general knowledge on the subject? Are you looking to add a certification, specialty or new modality to your repertoire?

• •What kind of training have you previously had? Some of us have had the luxury of attending many conferences and others are just beginning.

• •How many CEUs do you need? One day,

multiday shows with differing boards offering credits; make sure to check this thoroughly so you don’t waste time and money.

• •I s cost an issue? Prices vary, though scholarships, work study or volunteer opportunities may be available.

These are just some of the questions which came out of the initial discussion. Not too long ago the answer would have been much simpler and the choices far fewer, but in today’s terms there are so many things to consider and so many options available.

OPTIONS

The following are some association conferences: ASAM, NAADAC, NASW, NAATP, AAAP, TASC, and Christian Counselors.

There are conferences for professional groups such as: The Federation of State Physicians Health Programs, Lawyers Assistance Program, Intervention Project for Nurses, and Labor Assistance.

There are CEUs for specific medical specialties: ARNP, family physicians, psychiatric nurse practitioners, pain management physicians, and addictionologists.

I’m sure I’m missing some other medical specialties that previously didn’t offer much in our field, but that have now incorporated these trainings into their conferences.

In addition, there are conferences geared towards specific licensed professionals that include but aren’t specific to substance abuse and dependence like licensed mental health counselors, licensed marriage and family therapists, and licensed social workers.

Furthermore, modality conferences and trainings in specific modalities include but are not limited to trauma, men’s issues, women’s issues, older adults, and more.

There are conferences for nonprofits like C4 and for-profits like Ben Franklin

and treatment providers like Hazelden, Foundations, AAC, and others with large national and regional conferences. Furthermore, other treatment centers run conferences on the local, regional, and national levels. These may also offer workshops for CEUs. In addition, educational institutions such as Rutgers, Harvard, Stanford, and UNC, to name a few, have been running winter and summer schools for some time. In many respects this is long overdue and there are areas in which the topics we discuss are not even being addressed at conferences for medical professionals, mental health, and other related specialists and professionals, who in my opinion, all need education in these topics. I believe that there is no reason any medical professional in the United States should be practicing without an extensive education in one of the world’s primary diseases. But let’s save this tangent for another month’s column.

ONLINE OPTIONS

Online courses present a whole new opportunity—but also a challenge—to the world of continuing education, as they feature some of the same choices as in-person trainings plus the unknown variable of it being somewhat anonymous. If the goal of training is purely to get some CEUs, then online courses are definitely an option. Add to that the convenience of acquiring this training while sitting in your office, at home or even in your pool (what with the new waterproof technology). However, if challenging and intriguing conversations with colleagues, subject matter experts, and others from various fields is part of the experience for you, then choosing an option that offers these added benefits is the way to go.

A PROBLEMATIC ISSUE FOR CEUS AND CONFERENCES

Let me briefly address a pet peeve of mine.

I have recently become aware of an increase in a questionable area of self-proclaimed “experts” who have emerged on the scene. As has been said, “I’m not judging, I’m just saying.” It seems that calling yourself an expert can go a long way in the new age of marketing. Although I am a fan of innovation, I prefer to get my con-

Nov/Dec 2015 tinuing education from actual subject matter experts with a proven pedigree and there are plenty of opportunities to do that without being misled by slick slogans and creative marketing. Experienced speakers with a proven track record are worth every penny, but I have heard horror stories of seasoned professionals paying large amounts of money to questionable companies and people for training that was anything but outstanding.

HOW TO CHOOSE

So after all this information, you may still be asking, “Where, when, and how do I choose?”

I can only tell you how I choose which conferences to attend. It begins with going through the same steps I learned in recovery: assessing options and making an informed decision.

This begins with looking at what I want, why, what are my motives, being honest, and then determining how much it is worth to me. I may do a pros and cons list, assuming I don’t have an unlimited budget and I have a reason for going I will make a list of the potential choices.

Then I will look at logistical issues like where it is, when it is, how to get there, how much is costs, and whether I get this same CEU somewhere else for less.

Do your homework. Come up with a short list of possibilities based on what you hope to accomplish, what fits in the budget, and what meets any other criteria you (or whoever is sending you) decides is important. Next look at the differences, strengths, and weaknesses of the choices left and see if you can find people who have been through any of the possible choices you are considering. I have often been quoted as saying that consumers spend more time picking a pair of shoes or a purse than a treatment center. In this instance you are the consumer; find out about the product and choose something that has value for you.

If you make a choice for the right reasons and have done your homework, you will learn from the experience. Commit to a decision and get the most you can from the experience. ■ Michael Walsh, MS, CAP, BRI-I, is currently executive director and COO at HARP Treatment Center on Singer Island, FL. Former president/ CEO of The National Association of Addiction Treatment Providers (NAATP), he holds a master’s degree in substance abuse counseling and is a certified intervention professional. As a certified addiction professional, he has extensive knowledge, experience, and understanding of the treatment industry from preadmission through the intervention, admissions process, case management, referent relations, client services, and aftercare coordination for patients

Industry Insider

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Testing Matters Brian Crowley

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ith the recent pull out by Cigna from Florida from the 2016 Federal Health Insurance Marketplace, its lawsuit against Sky Toxicology in West Palm Beach, FL, may have some serious implications for the behavioral health industry. Cigna is claiming that Sky Toxicology and its affiliated labs used deceptive business practices, and among other things accuses them of engaging in fraud using a lucrative patient-referral kickback scheme.

Health care providers can learn much from this case and how to minimize their risks when it comes to providing laboratory services for their patients and the ever-changing behavioral health care landscape.

The key complaints in the suit by Cigna are but a few of many possible violation exposures that can turn any treatment facility into an overnight train wreck. Cigna claims that it paid more than $17.5 million to Sky Toxicology, $3.4 million to Frontier Toxicology, and $1.8 million to Hill Country Toxicology. According to the court , the same three people own all three labs. Let’s call all three labs “the Labs” for simplicity going forward. The overwhelming majority of these claims were submitted under ASO plans, which are managed by Cigna on behalf of an employer and funded by employees.

The big question I see coming out of this case is why have payers been paying such large reimbursements over the last five years to labs and only now these cases are coming into the public light. Surely, as a plan administrator, the payer has a fiduciary responsibility to its members to be cost effective and efficient. I am currently researching the payer’s perspective to better understand the situation to arrive at a good answer. Stay tuned for updates on this in upcoming articles.

Payers have the technology to manage our benefits and the issue of drug testing abuses has caused payers to react in what I would describe as an “overcorrection” on providers for all services it seems. This is very much a concern, particularly as insurers position themselves to reimburse only for evidence based treatment outcomes, using a “fee-for-value” model. If payers aim to entice providers to go In-Network, then we all need to do a better job of collaborating to provide a higher level of service that is transparent and accountable to all stakeholders with data integration capable of exposing unethical behavior on all sides and get back to focusing on patient care Providers in Florida are stepping up to lead the way with the formation of the Florida Behavioral Health Care Association. Founded by FADAA, this sister association places emphasis on the commercial for-profit providers and aims to hold its members accountable to defined standards, through its department called “The Business of Behavioral Health” which will focus on a code of ethics in provider marketing, parity, payer relations and workforce issues.

Join us over the coming months as we explore the different aspects of drug testing, such as new standards, medical necessity protocols, sustainable best practices and data analysis for outcomes benchmarking.

Note: I’m not an attorney, an accountant or a lab scientist. My opinions are simply my opinions based on my personal experiences of setting up nine labs in multiple states over the past five years. ■

Editor’s Note : At press time, Cigna pulled out of FL. Brian P. Crowley is founder of Integra Enterprizes. He has experience in the business of behavioral health, specifically drug testing, strategic business, and leadership development. He is chairman of the FBHA, Committee on Laboratory Services.

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Using Data to Improve Outcomes in Addiction Treatment Jacob Levenson & Kerby Stewart, MD

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nlike most health care specialties, the field of chemical dependency has largely eluded the demand for empirical outcomes data and consumers are often at the mercy of a system that has not always provided demonstrable outcome data. We can no longer afford to accept this rarefied approach.

Rapidly rising health care costs combined with the increasingly catastrophic consequences of treatment failure demand a dramatic improvement in the rates of achievement of long-term recovery from all substance use disorders (SUDs). Patients and their families face a confusing array of treatment programs that claim unique approaches to care and little-to-no demonstrated rates of success. Because the field has not been held accountable, health care consumers cannot make informed decisions and insurers are wary.

In the absence of universally accepted, nationwide standards, insurers are reluctant to provide coverage for unsubstantiated care despite the mounting evidence that untreated or poorly treated addiction results in astronomical increases in overall health care costs. Thus insurance coverage varies widely. There are no standardized outcomes data that report on the quality of treatment providers and/or the long-term effectiveness of their approaches.

Despite the emerging knowledge that outcomes data is integral to distinguishing quality providers, there appears to be concern from those who are not interested in (or are fearful of) being required to demonstrate the outcome data for the services they render. While claiming to individualize care for their patients, providers more often use an identical treatment approach with every client. This approach allows for economies of scale with regard to clinician and administrative time and relieves clinicians of the principled duty of directing their efforts toward treatment-based, science-driven assessments of disease severity and

coordination of authentic, individualized treatment.

The industry has the tools to gather and analyze long-term outcomes data in order for both treatment efficacy and the value of long-term recovery support to be measured and enhanced. Data can be used to guide payment for services that result in incentives for quality treatment rather than quantity, among other things.

One viable solution to this problem is a network dedicated to the provision of quality treatment and the utilization of resources to track and manage outcomes data to improve services and substantiate the long-term efficacy of chemical dependency programs. The network will function to empower an alliance of providers who demonstrate and improve treatment outcomes with the data necessary to navigate the changing reimbursement paradigm and provide quality providers with a way to effectively differentiate themselves to consumers.

In order to successfully navigate the critical juncture the field of addiction treatment is facing, providers must be prepared to collect, measure, and demonstrate their data. We don’t gamble when selecting other segments of our health care, and it is time we stop gambling with our selection of addiction treatment facilities. ■Jacob Levenson founded Austin-based MAP Health Management, LLC. in 2011, and has served as CEO since its inception.t Kerby Stewart, MD, is a clinical director with MAP, an organization on the threshold of introducing a resource never before available to treatment providers and health care consumers.

References National Institutes of Health (NIH). (2007). The science of addiction: Drugs, brains, and behavior. MedlinePlus, 2(2), 14–7.

Nov/Dec 2015

Industry Insider

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The Quilt: A Symbol of Love, Unity, and Hope Sherry Schlenke, MEd

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or the pioneer women who carved a life from the daunting wilderness of the American frontier, the family quilt was indispensable in providing warmth against the frigid winter nights. Early quilts were made from scraps of fabric, often taken from wornout clothing and blankets. Chicken feed, sold in bags made of colorful, patterned cotton material, provided the frugal farm wife fabric for her quilts.

The very thread of the family history was woven into the quilt through hand-drawn patterns that told a story significant to the occasion: a newborn baby, double wedding rings, a boy fishing, a girl wearing her sun bonnet, the log cabin, the cross of Jesus, the harvest, Thanksgiving, Christmas, Easter, trees, spring flowers—the list of patterns is endless. All the

patterns were made lovingly, painstakingly, by hand, with fingers pricked thousands of times, often leaving behind little specks of a mother’s blood. Women sat in a sewing circle, working together on one quilt, united by their role to continue the circle of life.

For the young women, the quilt signified hope for a husband and family of her own.

Stored in a “Hope Chest,” her quilt was a portion of her dowry.

The AIDS quilt circulates the nation and the world, raising awareness of the dreadful disease, while memorializing its victims. Advocates are united by the cause of finding a cure, while lifting the stigma and educating future generations.

And now, through the efforts of dedicated, resilient, volunteer moms, we have The Ad-

dict’s Mom (TAM) quilt, also signifying love, unity, and hope.

The TAM quilt embodies the love we have for our children; the never-ending, unexplainable mother’s love. Despite their flaws, despite the wounds, heartache, and grief that they have inflicted upon us, we will always love our children.

The TAM quilt symbolizes the unity of a group of determined women, led by the remarkable Barbara Theodosiou, whose own beloved boy died this year. TAM moms stand united against the disease of addiction, united against the stigma of addiction, and united against the mistreatment of our children by the broken mental health and prison systems.

TAM moms stand united and undefeated as they “Share without Shame” the moment-by-

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moment agony of being the mother of a child suffering from addiction.

The TAM quilt instills hope that our loved ones find recovery. Hope that funds are made available to assist our children, hope that towns across our great nation will emulate the Gloucester Project and provide treatment rather than imprisonment. Hope that our children who have died, as has my own beloved boy, and far too many others, are finally at peace, after the torment of living with addiction. Hope that they did not die in vain. Hope that they will be remembered for all time as a reminder of the devastation to our families that accompanies the disease of addiction.

And hope, as the disease of addiction reaches epidemic proportions, that the greater community will join us in our battle to protect and preserve our future generations.

Barbara and the administration would like to extend our deepest gratitude for the tireless volunteers who have worked to make our TAM quilt come to life. Now our children will live forever. ■ Sherry Schlenke, MEd, is a wife, mother, and teacher. She holds a master’s of education degree in special education, and has taught children with special needs for over twenty years. Upon learning that their teenage son was addicted to heroin, Sherry and her husband tried every means possible to help him recover. Tragically, he died of an overdose in August of 2013. Grief stricken, Sherry joined The Addict’s Mom, an online support group for mothers of addicted children. She serves as an executive assistant to the founder, Barbara Theodosiou.

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Urine Drug Testing in Addiction Brian Crowley, Andrea Barthwell, Alan Goodstat, Jennifer Bolen

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o many articles have been written on posttraumatic stress disorder (PTSD) and trauma that involves symptoms associated with events such as rape, violence, and murder, but we rarely hear or talk about psychological or emotional trauma, something that is experienced by a large portion of people admitted to mental health and addiction recovery centers. Emotional trauma includes verbal abuse, shaming a child, psychological abuse that humiliates us, and actions and behaviors that consistently slams us against the concrete, making us think twice about ourselves and manifesting into symptoms and traits of low self-esteem that are often debilitating and hinder our ability to function successfully in

everyday life.

I am a trauma therapist and the owner of two substance abuse and mental health recovery centers in Delray Beach, FL, and I’ve seen the effects that emotional trauma has had on more than 90 percent of my patients. This is a staggering number, and it seems to have been made into the norm instead of the exception.

Emotional abuse halts personal growth and throws up a roadblock with every situation, circumstance, and choice life presents us with.

Symptoms of emotional abuse can include loss of sleep, anger, frustration, feelings of disempowerment and helplessness, flashbacks, violence, and a loss of trusting our instincts and ability to make comprehensive and positive

Nov/Dec 2015 choices. However, once we become aware of something, we have the power to change it.

This is something that we abused people need to understand is not in our control, but the way we choose to use it is in our control. Understand that at a certain point in our lives, usually the moment we realize we are in charge of our own life, we give up the excuse of playing the victim, and are responsible for the choices we make. Blaming others at this time is obsolete; it’s just an excuse.

Living in that kind of vibrational pattern gets wrapped into the fabric of our behaviors; it filters into our DNA. Releasing this negative energy that has built up in our bodies is the first step to clearing the mind to make better rational decisions.

Energy healing practices such as yoga, meditation, core energetics, neurovibrational beds and devices, listening to healing music (No, it doesn’t have to be the typical mediation guru music, but change the station a bit, add in some new music themes and genres that you’ve always listened to), healthy diet, exercise, following principles and practices that bring peace of mind, and of course a little clinical hypnosis with spiritual growth therapy (SGT) helps too.

When we experience trauma or a traumatic event, the emotion of the event is not processed correctly, getting stuck in one part of the brain.

The way human beings process information is from one side of the brain to the next, allowing all the information associated with that event to be stored in the subconscious for later use.

However, when the emotion gets stuck, and when the mind is triggered by anything associated with that event, the mind reacts as if the event is happening again, and reacts accordingly with anxiety, depression, fear, and frustration in a heightened sense. But the event is not actually happening, confusing the mind to the point where we seek to cope with what we are experiencing.

Hypnotherapy works by processing the emotional circumstances related to the abuse which became stuck in parts of the brain, therefore disconnecting the emotion from the abuse and allowing the mind to think clearly, reasonably, and rationally about the abuse without the negative coping skills—addiction, cutting, self-injury, eating disorders, low self-confidence—that had been associated with the abuse. The protocols of SGT teach and guide patients towards a path where the ability to self-heal is manifested into reality through practices explained in the book Let Your Soul Evolve: Spiritual Growth for the New Millennium (2014).

The point is to teach the brain—both conscious and subconscious—how to cope positively and successfully with current circumstances, choices, and decisions, without the distractions

spiritual growth

therapy.com

A New Way of Thinking

Industry Insider

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of the past. Purpose connects us to our heart, strengthening self-confidence. The goal is to produce truly free and peaceful human beings.

The way we treat each other, especially our children, is paramount to the survival of the human race. What children need is encouragement and positive, loving, kind attention and strong intellectual stimulation; we want them to be smarter and more worldly than ourselves. This is how we make good human beings and give the world a peaceful future.

Children should know only peace, encouragement, passion, purpose, heart consciousness, education, and of course love. It is our responsibility to set up the future for the generations to come, where they live in a world that knows only peace. ■ Paul D. Alleva, MSW, worked with clients at South County Mental Health Center’s Baker Act and Dual Diagnosed Unit as well as various drug treatment centers in the South Florida area, Paul has achieved outstanding recognition for his clinical work with addictions and trauma and in various administrative duties within the addictions and mental health fields.

References Alleva, P. D. (2014). Let your soul evolve: Spiritual growth for the new millennium. Sarasota, FL: First Edition Design Publishing.

Spiritual Growth Therapy (SGT) is a therapeutic way of living that incorporates spirituality into everyday life. Thinking and making decisions from a foundation of love and connection and with a future purpose that finds love and comes from the heart. Promoting individuality with a community driven connection that benefits and prospers all involved is the goal behind spiritual growth.

Our devotion is to all individuals who need that extra help. We’ve created a spiritual paradigm to heal people suffering from substance abuse and mental health symptoms within our licensed treatment centers.

Visit our blog for intriguing articles on current events, philosophy, and spiritual growth!

www.SpiritualGrowthTherapy.com

CALL NOW! 844-305-4357

10 Industry Insider

Nov/Dec 2015

Recovery Month Overseas Deirdre Boyd

Kate, the Duchess of Cambridge, visited a women-only prison which houses a Twelve Step recovery program run by the Rehabilitation for Addicted Prisoners trust, greeted here by its Chairman David Bernstein.

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his past September witnessed many events throughout the UK and the rest of the world to celebrate Recovery Month. Let’s look at some events.

UK EVENTS

Perhaps the longest lasting impact will be Professor David Best’s survey on UK Life in Recovery conducted with colleagues at Sheffield Hallam University. “The report is issued to mark National Recovery Month, a global, governmentbacked celebration of the people and organisations who work in the areas of treatment and recovery, as well as service users themselves involving city region partners,” the University said (2015). It also organized a free cycle ride, including bike hire, for up to one hundred people in recovery. Gone are the days, not that long ago, when academia refused to acknowledge that recovery from addiction was even possible.

The most “official” event was held by Public Health England where it relaunched its mutualaid toolkit, refreshed user involvement guidance, and explained how capital funding contributed to this stream of work.

Definitely the largest event was the 7th UK Recovery Walk, based for 2015 in Durham, which aims to “spread the message that prevention works, treatment is effective, and recovery from addiction is a lived reality in millions of people’s lives” (Faces and Voices of Recovery UK, 2015). This has seen controversial years, when harm reduction service users were bused in, some high on methadone, and marchers were seen with bottles of alcohol under their arms. However, the concept and organization have matured. Speakers ranged from the Bishop of Yarrow to a government commissioning manager—due to free NHS health services, few people take out insurance, so local-government funding is the dominant model in the UK—to local directors of Public Health and PHE, as well as people in recovery and cofounder AnneMarie Ward.

One of the singers featured at the walk was Henry Maybury, whose music video for Lost Days, dedicated to his brother dying from alcoholism, will make you cry. It now has over one million hits on YouTube.

The longest walk was one hundred miles

round Anglesey on September 4–10. There were also local walks in Portsmouth, Chester, Sheffield, Sefton, Manchester, Bradford, Weston, Hampshire, Wiltshire, Middlesbrough, Bournemouth, Newbury, Cambridge, and Derbyshire as well as Scotland. Mental health professionals joined in with the “Walk a Mile in My Shoes” event in Edinburgh where they strolled with carers and people with lived experience for a friendly conversation. There was also a recovery run in Lancashire. For those who prefer two wheels to two legs, Cycle for Recovery took place in Weston Super Mare, along with bike rides to the walks.

Continuing the physical fitness theme, there were football tournaments, Bristol Drugs Project joined a Dragon Boat Race and Doncaster Drug and Alcohol Services undertook the gruelling Three Peaks climbing challenge.

On an artistic note, the Grace Note Choir Chester, formed of people in recovery, sang on September 1 and the Faces Of Recovery photograph exhibition opened two days later, then Portraits of Recovery. The Fallen Angels Dance Theatre, also formed of people in recovery, performed on September 7.

AROUND THE WORLD

While Recovery Walks started in the United States, many countries have adopted their own, with massive crowds in Ireland and Australia, for example. The Sydney Recovery Walk celebrated the lives of people in recovery from addiction and recognized the recovery support services across Sydney, Australia and beyond.

In other events, focusing on documentary films that explore the themes of addiction and mental health issues, the South African Recovery Film Festival was hosted in both Cape Town and Johannesburg again during September. In its third year, the Festival has partnered with The South African College of Applied Psychology (SACAP) and aims to educate, entertain, and inform as well as promote the solutions and successes of recovery. ■ References Faces and Voices of Recovery UK. (2015). The UK recovery walk. Retrieved from http://www. facesandvoicesofrecoveryuk.org/what-are-the-walks-about/ Sheffield Hallam University. (2015). Volunteering and working are central to addiction recovery. Retrieved from http://www.shu.ac.uk/mediacentre/volunteeringand-working-are-central-addiction-recovery

Nov/Dec 2015

Industry Insider 11

The Legal Beat OxyContin Abuse Rises Jeffrey C. Lynne, Esq

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mericans are becoming “primed” for heroin addiction through the growing use and abuse of prescribed opioid painkillers, the Centers for Disease Control and Prevention (CDC) has reported (2013).

Heroin use has increased across the US among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes. Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid painkillers.

In the meantime, pharmaceutical giant Purdue Pharma continues to not be held truly accountable.

For those who didn’t know, Purdue is the manufacturer of legalized heroin, known by the tradename OxyContin.

As far back as 2001, Connecticut Attorney General Richard Blumenthal issued a statement urging Purdue to take action regarding abuse of OxyContin; he did note that, while Purdue seemed sincere, there was little action being taken beyond “cosmetic and symbolic steps” (Office of the Attorney General, 2001).

After Purdue announced plans to reformulate the drug, Blumenthal noted that this would take time, and that “Purdue Pharma has a moral, ethical, and legal responsibility to take effective, meaningful steps to rectify the problems” (Office of the Attorney General, 2001).

OxyContin was “re-formulated” only as recently as 2010 to discourage patients from crushing the tablets for snorting or injection.

Purdue Pharma discontinued the older version of its blockbuster drug due to its association with addiction, overdose, and death.

But nothing has really changed.

In fact, earlier this year Perdue was scheduled to meet with the FDA in long-planned, two-day meeting to evaluate whether the abusedeterrent features Purdue said they put into their newer version of their drugs actually translated into reduced rates of abuse by pain patients. Previously, the FDA required Purdue Pharma to conduct longterm, follow-up studies tracking rates of abuse, addiction, overdose, and death with the updated drug.

In fact, the FDA has been urging (but not requiring) companies to design new painkillers with tamperresistant features to make them more difficult to abuse.

Deaths linked to opioid pain medications like OxyContin and Vicodin have quadrupled since 1999 to an estimated 16,000 in 2013, the most recent year for which the Centers for Disease Control and Prevention reports figures, which data demonstrates, according the verbiage from the CDC itself, that these painkillers are essentially “the worst drug epidemic in US history” (Liebelson, 2015).

In late 2013, the FDA tried to make it significantly harder for doctors to prescribe Vicodin, Lortab, and other highly addictive painkillers that have killed tens of thousands of Americans over the past decade. While lawmakers praised the agency’s move, the very next day, over the objections of its medical advisory board, the FDA approved Zohydro, a new drug that has five to ten times more of the heroin-like opioid hydrocodone than Vicodin!

According to Avi Israel, whose twenty-year-old son committed suicide after being addicted to doctor-prescribed hydrocodone, “If you approve this pill, you surely will be signing a death sentence for thousands of people, especially young kids” (Liebelson, 2015).

Meanwhile, Purdue unsurprisingly pulled out of that federal meeting to review the company’s “harder-to-abuse” version of its much-debated drug. An executive for Purdue Pharma says the company “wants more time to review and analyze its data” (Perrone, 2015). As a result, the company has withdrawn its application that was slated to be reviewed before a FDA committee.

The excuse provided: “Given the complexity of epidemiological research and the unprecedented nature of this exercise, we’ve made the decision to complete additional analyses,” said Dr. Richard Fanelli, the company’s head of regulatory affairs, in an emailed statement (Perrone, 2015).

FDA meetings are typically planned months in advance and cancellations are highly unusual.

The agency must present detailed evaluations of the company’s application and coordinate travel for outside experts who advise the federal government.

Let’s be abundantly clear and speak plainly: Doctors prescribe de-facto heroin for a wide range of ailments, from postsurgical pain to arthritis and migraines. However, medical experts state that the only ethically and morally appropriate role of these drugs should be used for the most severe cases, such as cancer pain or end-of-life care.

So, quite simply, we are allowing the guys and girls in the white

lab coats to be licensed drug dealers promulgating the worst drug epidemic in US history. And then, when our loved ones become unsurprisingly addicted, they are left to fend for themselves in our communities, which localities historically demonize and stigmatize the addicted; our states and federal government underfund treatment; and regulators do not give us the tools to separate the good from the bad providers.

But we continue to march on.

Keep the faith. ■ Jeffrey C. Lynne opened his own Delray Beach, FL law firm in 2010 and merged it with fellow land use attorney Michael S. Weiner and commercial litigator Laurie A. Thompson to form Weiner, Lynne, and Thompson, PA. As a result of his work with substance use disorder (SUD) treatment and housing providers, Mr. Lynne has forged a reputation as a leader in defining the role played by SUD treatment within our communities; he has led discourse about the need and right to provide safe, affordable housing for those in treatment in addition to those established in recovery.

References Centers for Disease Control and Prevention (CDC). (2013). Opioids drive continued increase in drug overdose deaths. Retrieved from http://www. cdc.gov/media/releases/2013/ p0220_drug_overdose_deaths.html Liebelson, D. (2015). Defying medical board, FDA approves painkiller that could be the next OxyContin. Retrieved from http:// www.motherjones.com/politics/2013/11/ zohydro-pain-killer-addictive Office of the Attorney General. (2001).

Attorney General calls for major changes in the marketing and distribution of OxyContin.

Retrieved from http://www.fda.gov/ohrms/ dockets/DOCKETS/01n0256/c000241A.pdf Perrone, M. (2015). Oxycontin maker bows out of meeting on harder-to-abuse drug. Retrieved from http://bigstory.ap.org/article/174611 f3aafb4004842d863c69df305f/oxycontinmaker-bows-out-meeting-harder-abuse-drug

12 Industry Insider

Nov/Dec 2015

The Science of Mutual Help in Recovery John F. Kelly, PhD federal, state, and community prevention initiatives; and professional treatment. In addition to these considerable, formal efforts, peer-led mutual-help organizations have flourished in most communities in the past eighty years, perhaps stemming from recognition at the grassroots level of the need for more flexible, rapidly accessible, and ongoing support that can mitigate relapse risk at little to no cost.

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ver the past eighty years, Alcoholics Anonymous (AA) has grown from two members to over two million members. AA and similar organizations such as Narcotics Anonymous (NA) are among the most sought sources of help for substance-related problems. But it is only relatively recently that the scientific community conducted rigorous studies on the clinical utility and health care cost-offset potential of mutual help groups, and developed and tested professional treatments to facilitate their use.

Professionally delivered interventions designed to facilitate the use of AA and NA, such as Twelve Step facilitation (TSF), are now “empirically supported treatments” as defined by US federal agencies and the American Psychological Association. So let’s get a closer look at a few of the six lessons learned during the past fifteen to twenty years on how mutual help organizations can help individuals suffering from substance use disorders (SUDs) while cutting health care costs.

Substance use and related disorders confer a massive health, social, and economic burden.

Globally, alcohol kills 3.3 million people annually. It is the leading risk factor for death among males aged fifteen to fifty-nine and it is the third leading risk factor for disease burden around the world. In the US, alcohol use is the third-leading cause of preventable death and the financial impact of SUD is estimated to approach $600 billion per year.

In most developed nations, the societal response to these endemic public health problems has been multipronged, including prohibiting certain substances; attempts to reduce consumption through price controls, taxation, and licensing of sales outlets (in the case of alcohol);

Mutual-help organizations help offset this burden and can be studied empirically.

By far the largest and most researched of these peerled mutual-help organizations is AA. Sophisticated scientific evidence supports the role of AA and similar groups in helping people to achieve abstinence and maintain recovery. We now have a strong evidence base in support of professionally delivered interventions to effectively engage individuals with these community resources.

AA purports that the primary mechanism through which recovery from alcohol addiction is achieved is through a “spiritual awakening” which is realized by following a sequential Twelve Step program. Such spiritual processes might seem antithetical to empirical study, but research over the past twenty years has shown that there are many aspects of AA and its mechanisms of action which are amenable to empirical study, including spirituality and spiritual practices. Studying AA empirically is not without its challenges, particularly in terms of the gold standard of treatment research: the randomized controlled trial (RCT). The tightly controlled and highly insulated context of an RCT runs counter to the way real-world AA groups are conducted. AA is attended anonymously and usually voluntarily, no records are kept about who attends and what is said, and groups vary widely in

SIX LESSONS FROM THE PAST FIFTEEN TO TWENTY YEARS:

• •Substance use and related disorders are a massive health, social, and economic burden.

• •Mutual-help organizations help offset this burden and can be studied empirically.

• •Mutual-help groups confer clinically-meaningful benefits for many different types of people over and above formal treatment.

• •Mutual-help groups work through mechanisms similar to those in formal treatment.

• •Mutual-help groups can reduce health care costs by reducing patients’ reliance on professional services without detriment to, and possibly enhancing, outcomes.

• •Empirically supported clinical interventions increase patient participation in mutual-help groups and enhance treatment outcomes.

Nov/Dec 2015 their size and content. Because AA is freely accessible in the community, it can seem unethical to randomly assign some RCT participants to attend and prohibit the attendance of others. These issues have led researchers to examine AA through other methods, such as through naturalistic, prospective, effectiveness studies which use sophisticated methods to account for self-selection biases (e.g., statistical controls, propensity scores, and instrumental variable analyses).

Researchers have also examined the efficacy of professionally delivered TSF treatments, which systematically encourage and facilitate Twelve Step meeting attendance, relative to other treatments that neither encourage nor forbid attendance. Together, these types of research show the benefits of AA attendance in a way that has both scientific integrity and real-world relevance.

Meaningful benefits for many different types of people, over and above formal treatment.

There have been hundreds of empirical studies on AA, summarized in several meta-analyses and one Cochrane review. These reviews indicate that AA is associated with a moderate effect on alcohol and other drug use that is on par with professional treatment. For some people, mutual-help group participation alone is an effective intervention for substance use disorder.

Questions can arise as to whether AA is less suitable for certain groups of people, particularly dually diagnosed people, those taking psychotropic or antirelapse medications, atheists or agnostics, women and youth. But the available empirical evidence suggests that, for the most part, such people do benefit from participation in regular AA meetings. One exception might be people with severe impairments in psychosocial functioning and reality testing—such as SUD with schizophrenia—who might benefit more from dual-diagnosis mutual-help groups such as Double Trouble in Recovery. Similarly, although young people can benefit from attendance at AA and NA meetings, benefits can be enhanced at meetings with at least some same-aged peers.

Mutual-help groups work through mechanisms similar to those in formal treatment.

Over twenty years ago, the Institute of Medicine called for more research on how AA works. A recent review of the research on the mechanisms of change in AA revealed that AA helps people to attain and maintain recovery through multiple mechanisms, many of which are also activated by formal treatment. Most consistently and strongly, AA appears to work through mobilizing adaptive changes in the social networks of attendees; for instance, decreasing pro-drinking social ties and increasing pro-abstinence social ties, and enhancing coping skills and self-efficacy for abstinence in high-risk social situations. ■ John F. Kelly, PhD, is Harvard University’s first professor in addiction medicine, president of the American Psychological Association Society of Addiction Psychology, and associate editor for the journals Addiction and the Journal of Substance Abuse Treatment. He is also founder and director of the Recovery Research Institute at Massachusetts General Hospital (MGH), program director of the Addiction Recovery Management Service, and associate director of the Center for Addiction Medicine at MGH. He has served as a consultant to US federal agencies such as the White House Office of National Drug Control Policy (ONDCP), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institutes of Health (NIH); to non-profits such as the Hazelden Betty Ford Foundation; and to foreign governments. Dr Kelly has published over one hundred peer-reviewed articles, reviews, and chapters in the field of addiction.

Industry Insider 13

Kennedy Memoir Bares All Stephen Cooke

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n the last issue of the Insider we featured the work of The Kennedy Forum, and more media attention dominated October for Patrick Kennedy as his memoir A Common Struggle bared all about his family’s health and alleged addictions.

The portrait of his father, the late US Senator Ted Kennedy, and his mother Joan, broke what he calls a “conspiracy of silence” about how alcoholism poisoned the family. Others are disputing the account, including his older brother, Ted Kennedy Jr., a Connecticut state senator.

Those inner-family disputes are not uncommon, according to Counselor Advisory Board Chair Dr. Robert Ackerman, cofounder of the National Association for Children of Alcoholics. Dr. Ackerman states, “Patrick Kennedy and his ‘conspiracy of silence’ bring into the light the disastrous nature of anonymity for children of alcoholic parents.”

All of this comes on the heels of the report from The Kennedy Forum that parity legislation is not grabbing the federally mandated attention at the state level that is required.

Janell Ross from the Washington Post writes, Sometimes when the funds exist, as Patrick Kennedy wrote in his new book released this week, the honesty required to get help is not there or is too slow in coming. And for everyone else, access to drug detox and rehabilitation treatment—the gold standards for addiction management—are only as accessible as what their insurance companies and charity will cover. The odds of survival and recovery for these people are even slimmer (2015).

While many recent events around addiction have been encouraging and motivational, it also underscores, as does Dr. Ackerman’s work, the extraordinary amount of heavy lifting that needs to be applied in the United States to prevent this epidemic from getting worse. ■ References Ross, J. (2015). Obamacare mandated better mental health-care coverage.

It hasn’t happened. The Washington Post. Retrieved from https://www. washingtonpost.com/news/the-fix/wp/2015/10/07/obamacaremandated-better-mental-health-care-coverage-it-hasnt-happened/

14 Industry Insider

Nov/Dec 2015

Mergers & Acquisitions Foundations Sold to Universal Health

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niversal Health Services (UHS) has acquired Foundations Recovery Network, LLC for approximately $350 million. The transaction, approved by the Federal Trade Commission, is expected to be completed in the next few weeks.

Foundations will add 322 residential beds in four facilities —Black Bear Lodge, Atlanta, GA; The Canyon, Malibu, CA; Michael’s House, Palm Springs, CA; and The Oaks at La Paloma, Memphis, TN—and eight outpatient centers to the Universal portfolio, with 140 more beds in the pipeline.

According to UHS, Foundations will serve as a platform for growth in its new substance use disorder service line. The deal brings with it Foundations’ direct-to-consumer marketing model—which includes a call center, a national sales team, and web marketing—as well as the organization’s conference events.

A spokesman for the Pritzker family, the majority shareholder of Foundations, said UHS “is a company which we trust to further our commitment to the treatment of addiction, which is at epidemic levels in our country.”

Rob Waggener, the CEO of Foundations, said the future of health care is consolidation of providers and payers, integration of substance

abuse disorders with mental health disorders, and providing proven value for payers and consumers. “Those who pick their partners early in this evolution, and pick their partners wisely, will succeed in the long term,” he told Behavioral Healthcare.

Alan B. Miller, CEO and chairman of the board of UHS, said, “We are pleased to announce the acquisition of Foundations. We were attracted to their proven track record of providing high-quality treatment and their reputation for excellence in this very attractive market segment.

They bring expertise as a published authority of integrated treatment and also have excellent clinical programs and customer relationships.”

UHS is one of the nation’s largest hospital companies, operating, through its subsidiaries, behavioral health facilities, acute care hospitals, and ambulatory centers at two hundred locations throughout the United States, Puerto Rico, the United Kingdom, and the US Virgin Islands.

According to analysts, UHS is riding the tailwinds of the Affordable Care Act, which increases insurance coverage for behavioral health care, including addiction services. Its competitor, Acadia Healthcare Company, has completed more than a dozen acquisitions in the past year, most notably CRC Health Group, which it bought in February. ■

CCAPP Celebrates Year of “Firsts”

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alifornia Consortium of Addiction Programs and Professionals (CCAPP) members gathered in Burbank, CA to celebrate a year of firsts and a legacy of achievement at the Annual Conference Membership Meeting on October 3.

“The enthusiasm and energy is incredible,” said newly appointed CCAPP CEO Pete Nielsen. “We have moved past consolidation and are now putting that energy into moving forward on all of our goals.”

Nielsen comes to the organization with a vast understanding of the addiction treatment profession, having worked as a counselor, program manager, and clinical supervisor.

CCAPP members and boards honored retired CEO Susan Blacksher’s contributions to the organization and the field with an award presentation at the Annual Membership Meeting and dinner.

Kristina Padilla, who recently joined NALGAP’s board of directors, was CCAPP CEO Pete Nielsen (left), and Kristina Padilla, director of business promoted to director of business development and education. Other CCAPP development and education. board appointments included Lori Newman (president), Warren Daniels (vice president), Tim Sinnott (treasurer), and Stephanie Sobka (secretary).

Additionally, Lee Fitzgerald was presented with the Visionary Award, Mary Hubbard received the VIP Award, Warren Daniels received the Shining Star Award, and Ramona Robertson received the Guiding Light Award.

Finally, tribute was made to Volney Dunavan, who passed away the week of the conference. Dunavan had served CCAPP’s predecessor organization, the California Association of Alcohol and Drug Abuse Counselors (CAADAC), in a number of positions for more than two decades. ■

Nov/Dec 2015

Industry Insider 15

Carol McDaid: Lobbying for Recovery Stephen Cooke

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nyone who attended the recent flurry of Washington, DC events (see the “Letter from the Editor” on page one) would have encountered the articulate and passionate advocacy of Carol McDaid. As she professed from the stage of the UNITE rally, for which she is Policy Director, Carol is an individual in long-term recovery, an addiction advocate, principal at Capitol Decisions, Inc. in Washington, DC, a government relations firm where she specializes in addiction and mental health policy, and cofounder of the McShin Foundation in Richmond, VA, a peer recovery community organization. Join us in this Q&A. How did you get started as a lobbyist for recovery?

By sheer luck, grace, and synchronicity! During the Clintons’ early 90s failed effort to pass health reform, health lobbyists were in high demand. I was asked to come and interview at a boutique government relations firm to lead their health care practice. I was a mid-level trade association lobbyist at Blue Cross Blue Shield Association, so leading the health practice for a firm with Fortune 500 clients would be a big promotion for me. As I was interviewing, the head of the firm hands me a written list of clients I would have to service and Hazelden was on the list. He asked me, “Do you know who they are and what they want out of health reform?”

Three years earlier I was a patient at Hazelden and I was convinced him mentioning Hazelden was part of a grand conspiracy. While I was currently silent about being in recovery, I had not been quiet in the way I practiced my alcohol and drug use.

I was offered the job two weeks later and ultimately had to tell my boss I had been a patient at Hazelden before he found out during our first client visit to Hazelden. After I told him, he said, “McDaid! These people are going to think I’m a genius; that I have gone and hired one of their own to lobby for them! Here’s what we are going to do. Play along in Minnesota and act like I knew you went there, and then we will get Betty Ford and the rest of them [rehabs] as clients and you can become the addiction lobbyist in Washington.”

What interested you in the policy aspects of recovery?

Initially it was my own experience in 1989 of needing addiction residential care while working at a large employee benefits consulting practice. Even some of the smartest folks at the practice that helped intervene on me, and were experts in employee benefits, had no idea that our health plan—which indicated it covered up to thirty days of residential addiction treatment—in fact did not allow access to the coverage. I had failed at outpatient two times, but the plan said I had not met the “fail first requirement” in the plan because the “fail first clock” started over if I missed an outpatient appointment. I felt angry about that because I know many people do not have family who can pay for their care like mine did for me.

As I continued to work in the field, my husband and I started an addiction peer recovery organization where I live in Richmond, VA called the McShin Foundation. Not only did I see individuals get multiple (and in my view inflated) drug charges, but once they got out they couldn’t drive or get a job, a student loan, an apartment or public housing. Having had my life transformed as a result of my recovery, these injustices make me angry and compelled my work in the addiction policy area.

What are the most challenging aspects of advocating for recovery in Washington?

Four things: lack of resources and reimbursement, shame and discrimination, public safety impact, and lack of payer recognition of the cost benefit analysis of investing in addiction prevention, treatment, and recovery.

Not only are prevention, treatment, recovery, and research underfunded in Washington, but the entire advocacy effort on addiction is much smaller and has fewer resources than other advocacy groups.

The shame associated with having and treating this illness is an externally and internally driven problem, as is the volitional nature of the illness. Both public and private payers often

ignore the growing costs of untreated addiction and fail to see the benefits of investing in quality addiction care and recovery.

What are the three biggest changes that need to be made, from a policy standpoint, which would enhance the effectiveness of our current approaches to addiction?

Fully implement and enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) Financial investments in addiction prevention, treatment, recovery, and research Repeal discriminatory laws that prevent people in or seeking recovery from addiction from getting education, employment, health care, and housing (just to name a few) the same way individuals without criminal records related to this illness do If you could tell the general public one thing about recovery, what would it be?

Over twenty-three million people are in long-term recovery. We are your neighbors, coworkers, and family members, not derelicts. Recovery saves lives, dollars, helps build stronger communities, and is a good investment of taxpayer dollars. ■