Jan/Feb 2016
Vol. 2 No. 1
2016 Industry Forecast pg.4 NAATP Weighs in on Medication-Assisted Treatment pg. 6 The Broken System Exposed by The Addicts Mom pg. 7 16th Annual Caron Gala pg. 10 Panel Addresses Legal Marijuana
Dr. Oz Leads The National Night of Conversation pg. 1
Concerns pg. 12
Urine Drug Tests: Treatment Professionals Issue White Paper pg. 2
Jan/Feb 2016
Industry Insider
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Letter from the Editor In an effort to address the national problem of addiction, The Dr. Oz Show organized a National Night of Conversation on November 19, 2015 to encourage every family in the country to sit down to dinner, talk to their children about drugs, and have an open and honest discourse about addiction. Its partnership with Facing Addiction and Drugs Over Dinner brought together hundreds of affiliated organizations in the addiction field and will hopefully have continuing resonance with the participation of many federal agencies. Those who went beyond the empty plate and tuned in to his live webcast from a West New York high school saw vivid depictions that went beyond the confines of Dr. Oz’s TV show to depict the effects of addiction on the body, not to mention the American psyche. The National Night of Conversation was conducted in partnership with Facing Addiction, who organized the extraordinary UNITE rally on Washington, DC’s National Mall in October 2015, and Drugs Over Dinner, which has achieved extraordinary international renown for its global impetus to create meaningful dinner conversation with the goal to inspire change. The National Night of Conversation picked up on that and the celebrity status of Dr. Oz galvanized many American families on November 19 to have compassionate conversations about drugs and addiction. The 19th US Surgeon General Vivek Murthy, MD, appeared on The Dr. Oz Show’s November 10 broadcast to discuss his recently commissioned report on addiction and we will follow its genesis and distribution closely. Additionally, the show and its partnering organizations are offering a downloadable Parental Discussion Guide to help families through this sensitive conversation. The Insider sees too many parents befuddled by this American landscape and it’s good to read a guide that was developed with input and advice, not to mention that rare quality of cooperation in the face of a galling epidemic from the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Council on Behavioral Health, and Healthcorps, a high school program founded by Dr. Oz. Moving into this issue of the Insider, our Addict’s Mom feature on page 7 has its own take on the failure of this nation’s mental health and prison systems to adequately meet the needs of people with co-occurring disorders. One often hears that despair in the recovery circles in which we operate, coupled with the “What can I do?” questions that Dr. Oz probed throughout November. Confusion for parents is inevitable. Behavioral health programs are popping up in FL, sometimes just hatched by a maverick who sees a great piece of beachfront property, has an idea, and has the potential to cash out in a few years. As Dr. Andrea G. Barthwell—whose blueprint for proper urine testing protocols is on page 2—vividly describes, NIDA has defined the elements of treatment, but many new programs resist adoption of these scientifically derived principles in favor of their own recovery experience or a branded treatment model by a charismatic speaker who is on the road so much one wonders when he has the time to see patients. Dr. Barthwell also observes that there is ferocious competition for the public’s newly minted ACA cards that can pay for treatment or generate so much unrelated income from laboratory medicine that a provider can scholarship the whole treatment episode. So, what is a licensed clinician or mission-driven recovering person with a license to do when she finds herself working in a twenty-eight-day revolving door treatment mill? Dr. Murthy is speaking more often about the first ever, recently commissioned Surgeon General’s Report on addiction, which is expected to compile all the existing research, best treatment practices, and further define the scale and nature of the epidemic. In 2016 you can be certain that the Insider will continue to chronicle the pain—and indeed the solutions—that characterize the number one public health problem in the US. As the good doctor said on the National Night of Conversation, it’s a medical issue, but 27 million Americans use illicit drugs or prescription drugs for nonmedical reasons. Sincerely,
Stephen Cooke Editor, Treatment & Recovery Industry Insider
Jamison Monroe, Jr., Drugs Over Dinner, Newport Academy; US Surgeon General Vivek Murthy, MD; Mackenzie Phillips, actress; Dr. Oz, host; and Jim Hood, Facing Addiction (PRNewsFoto/The Dr. Oz Show).
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Jan/Feb 2016
Testing Matters Professionals Reach Consensus on Balancing Access, Quality, and Cost in Urine Testing for Substance Use
Andrea G. Barthwell, MD, FASAM.
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ubstance use in the US has reached epidemic proportions, with nearly forty-four thousand people dying each year of overdoses (NIDA, 2015). While 21.5 million Americans have substance use disorders (SUDs), 89.6 percent of them go untreated (SAMHSA, 2015). Urine drug testing can be an important tool in identifying and treating substance use. Currently, a general lack of certainty exists regarding the medical necessity of urine drug testing in addiction medicine and other clinical settings (Owen, Burton, Schade, & Passik, 2012). When properly used and correctly interpreted, health care practitioners can obtain objective clinical data to aid in the diagnosis, active treatment, and chronic care management phases of addiction treatment. Yet, clinicians often face complications in selecting the proper test method and interpreting results, and mistakes can result in serious consequences for patients. Recognizing a strong need for guidance, in February 2014 a diverse group of experienced addiction treatment professionals—led by Andrea G. Barthwell, MD, FASAM—developed a preliminary consensus on the proper usage of urine drug testing to identify and treat substance use. The consensus project arose out of a general lack of clinical knowledge, concerns related to unethical behaviors, and the growing trend of illadvised cost-saving measures by public and private insurers, which have created confusion and imbalances in the use of urine drug testing services in addiction medicine. Over the course of eighteen months, a panel of twelve professionals developed and refined a report, entitled Statement of Consensus on the Proper Utilization of Urine Testing in Identifying and Treating Sub-
stance Use Disorders, to document its clinical consensus. The report was based on an extensive literature review; a full-day, in-person panel meeting; and ongoing discussions. The panelists developed recommendations for best practices in urine drug testing with the following audience in mind: clinicians in any practice area to aid in identifying substance use; clinicians in addiction medicine as a component of treatment for an individual with an SUD; and clinicians in addiction medicine providing chronic care management to a person whose SUD is in remission. Payers and policy makers can use the report in efforts to inform coverage and utilization policies. The report is also useful for law enforcement officials, prosecutors, judges, and employers who seek to understand the use of urine drug testing in identifying and addressing substance use in the health care setting. The report provides an overview of the methods of testing, including the strengths and weaknesses of immunoassay and chromatographmass-spectrometry technology, referred to as presumptive and definitive tests respectively; defines key terminology; provides suggestions for which substances to select when testing; and identifies the need for accuracy. It goes on to provide recommendations stratified by the stages of SUD care: diagnosis, active treatment, and chronic care management. These recommendations address selection of test technology and substances, frequency of testing based on certain clinical considerations, methods to ensure individualized testing for each patient, and appropriate responses to test results. They require clinicians to structure utilization decisions on a case-by-case basis to optimize the quality of care and improve outcomes while reducing costs by avoiding excessive testing. With the creation of this report, the panelists hope to facilitate the use of urine drug testing by providing health care practitioners in various areas of practice with best practices to improve treatment of individuals with SUDs. The full report is available online. Dr. Barthwell is scheduled to speak at U.S. Journal Training’s 37th Annual Training Institute on Behavioral Health and Addictive Disorders on February 22, 2016 in Clearwater Beach, FL. ■ Andrea G. Barthwell, MD, FASAM, is an internationally renowned physician that has been a pioneer in the field of addiction medicine within the American Addiction Society of Medicine (ASAM) and a contributor to the field of alcoholism and addiction treatment. She is a past president of ASAM, was awarded fellow status, and is certified by the American Board of Addiction Medicine (ABAM). Dr. Barthwell currently serves as the medical director for Encounter Medical Group, PC and is the founder and CEO of the Two Dreams facilities.
References National Institute on Drug Abuse (NIDA). (2015). Overdose death rates. Retrieved from http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Owen, G. T., Burton, A. W., Schade, C. M., & Passik, S. (2012). Urine drug testing: Current recommendations and best practices. Pain Physician, 15(Suppl. 3), ES119–33. Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Mental and substance use disorders. Retrieved from http:// www.samhsa.gov/topics/mental-substance-use-disorders
PROGRAM AT-A-GLANCE
Designed for treatment program owners, administrators, admissions and marketing personnel, and all providers interested in the future of addictions and behavioral health treatment. MONDAY • FEB 22 2:00–3:30 pm
hat’s Your Measure? Understanding the Importance W of Key Performance Indicators William McCormick, Medivance Billing Services
4:00–5:30 pm
Developing a Comprehensive Digital Marketing Plan Ruchi M. Sanghani, Melanie Haber, Recovery Brands, Inc.
TUESDAY • FEB. 23 2:00–3:30 pm
Distinguishing Quality Client-Centric Providers John Lehman, Jeffrey Lynne, Mark Fontaine
4:00–5:30 pm
Urine Drug Testing in Addiction
Brian Crowley, Andrea Barthwell, Alan Goodstat, Jennifer Bolen
Sept/Oct 2015 Vol. 1 No. 1
“At an exciting time for the treatment industry, we are proud to launch the Industry Insider edition of Counselor magazine and its accompanying ‘special track’ at several USJT conferences. In the midst of fast-moving changes in the nation’s health care agenda, and with so much tumult in the business machinations of the SUD (substance use disorder) industry, this regular publication and its digital presence will be an invaluable guide to a world where longterm, sustainable recovery is supported by quality services and ethical providers. The Insider, as a magazine and as a conference track with compelling speakers and expertise, will focus on our future.” —Stephen Cooke, Editor
UNITE: Rally For The Ages pg.2
AAC Buys Marketing Assets pg.9
Recovery Housing— End Of Gold Rush pg.12
CARON Focus On Elderly pg.19
A Technological Pathway to Support Recovery pg.20
Nov/De
c 2015
Vol. 1
Claudia Black Young Adult Center Opens
2016 Presid ential Cand idates Talk Addic tion pg. 2
LEADERSHIP
Indust ry Tre nds: CEUs and Confe rences pg.
Lessons to Live By
4
Testin g Ma tters pg. 5
Using Data to Im prove Outco mes pg. 6
Robe rt 101 & Weiss: Sex Ashle y Mad Addiction ison
CCAP P Celeb rates Year of Fir sts pg. 14
Carol McDa id: Lobb ying for Recov ery pg. 15
No. 2
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Jan/Feb 2016
2016 Industry Forecast:
The Need for Treatment Will Outpace Services William McCormick, MBA
E
ach day we should rise with the goal of living a life filled with love and good health, and free from hurt, harm or danger. Seeing those affected by the diagnosis of addiction should provide reasons for us to want to conclude the work that’s needed in this industry. The Affordable Care Act, with its gallant objectives of reducing health care costs and expanding coverages for those without insurance, has created a population of people who now have coverage and are in search of qualified providers. Capacity will be a prime discussion in the industry going forward. Today, as millions of individuals cry out in search of sobriety, all of us have a pertinent role in the dynamics associated with ensuring that every single person, regardless of how they became addicted, actually gets accelerated and clinically appropriate treatment. Therefore, as we change our behavior to help those in need, let’s keep in mind the many aspects of why we are involved in behavioral health on a daily basis. Competition amongst providers should not be a motivating factor. There is no need to operate from the mindset of competition, rather the only fight we have is with the “real” competitor in our industry: addiction. Now as we begin another year of learning about the realities of our behavioral health and substance abuse markets, please allow an overview of what we are witnessing before us. Over the past few years a number of unprecedented changes have occurred in the behavioral health and substance abuse fields, all playing a pivotal role in how the industry has now roused anticipated growth as depicted by the number of acquisitions. Changes include the shining light on new synthetic drugs invading our streets and the formation of the Independent Coalition of Treatment Providers (ICOTP) with its consistent message of demanding enhanced treatment authorizations, operational compliance, accreditation, and stiff sanctions aimed at unethical business practices.
PREDICTIONS
The global attention on addiction, coupled with the constant opening of new treatment facilities offering all levels of care, sets the foundation for 2016. Therefore, as we gear up
for this new year and try to foretell what 2016 means for all us, one categorical prediction I have is that because the number of individuals needing a place for treatment is growing faster than the accessibility of services from qualified treatment facilities, providers of services will need to prepare for capacity. Additionally, I am sure that the demands from those responsible for ensuring payments are paid according to the patient’s benefits will increase. They will want to verify how well each patient is faring in treatment, as well as how each treatment facility is recording such outcomes. I believe that a great deal of humanity today understands and will concur with me that the impact and benefits of having quality treatment facilities operating with clean hands and offering clinically appropriate treatment services in our communities is really what we yearn for. We also know the value of what data means in this equation. Gathered information provides us an abundance of insight into how we can strategically design suitable pathways for dealing with countless issues and demands. It also affords the opportunity to use a set of metrics to analyze patterns of behavior and how we should respond to the serious addiction problem we have in this country. For instance, in the findings reported in the 2013 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Service Administration (SAMHSA), they estimated that roughly about 23 million Americans over the age of twelve were addicted to or had abused some level of drugs or alcohol (SAMHSA, 2014). Despite what our data is telling us, we continue to see the increasing promotion of alcohol and a number of synthetic drugs on our streets. For example, in South Florida we are dealing with the new street drug called alpha-PVP, or “flakka.” According to Frank Adderley, the chief of police for the city of Fort Lauderdale, whose department has been facing this new epidemic first hand, flakka was created in a laboratory in China and imported into the local community. What I learned from him is that flakka is highly addictive and can cause delusions and aggression. The street dealers are marketing and selling it by making the claim that flakka
gives users a rare euphoric high. Although flakka might produce that high, it also can provoke a condition called “excited delirium,” involving paranoia, hallucinations, and sometimes even violent behavior. After learning of the destruction it causes, I started reading more about this severely addictive drug, which based on my account has been around for some time. In addition to the imbalance associated with the growing supply and demand scarcity, many treatment facilities across the country will also be faced with the direct review of clinical documentation. Most recently, many payers initiated their requests to prove medical necessity and will probably continue throughout 2016. This will be the focus for all insurance payers because they have been able to decipher the discrepancies associated with proper charting. So, to prevent any delays in payments, treatment providers will need to prove medical necessity prior to making payment. Under such urgency, clinical teams will be under the microscope to align proper and ample documentation related to the therapeutic assessment and operational efficiency reviews imposed by the various insurance payers. ■ William McCormick, MBA, is the CEO of Medivance Billing Services, Inc., and lends a wealth of marketing and operations expertise to the behavioral health field.
References Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Results from the national survey of drug use and health: Summary of national findings. Retrieved from http://www.samhsa.gov/data/sites/default/files/ NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdft
Jan/Feb 2016
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Industry Trends Mergers and Acquisitions: A Major Component of the Evolving Industry Michael Walsh, MS, CAP, BRI-I
Left to right: John Lehman, president of the Florida Association of Recovery Residences (FARR); Michael Cartwright, president and CEO of American Addiction Centers; Jeffrey Lynne, attorney at Weiner, Lynne, & Thompson, PA; and Michael Walsh, COO of HARP Treatment Centers.
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few months ago I wrote a piece about conferences in our field and recently I was asked to participate on a panel at the U.S. Journal Training (USJT) conference in Fort Lauderdale, FL. Interestingly, when I pulled up to the hotel which is now the Westin, I realized it used to be the Sheraton Yankee Trader, a hotel I knew very well back in the spring break days of the early 1980s. Needless to say things have changed— things about me, about that hotel, and about Fort Lauderdale. The lively panel on emerging trends was the inaugural Treatment & Recovery Industry Insider Lunch, which took place on Friday, October 23, 2015 during USJT’s 8th National Counseling Advances Conference on Family, Addiction, and Relationships as an extension of the dialogue generated by the new Industry Insider addition to Counselor magazine. USJT and the Insider presented “The Challenges of Distinguishing Quality Client-Centric Providers—and How that may Play into Payer Behaviors—in Florida’s Ground Zero and Beyond.” This state certainly needs all the help it can get
for a purpose-driven period of keeping mental health professionals informed, and I commend USJT and the Industry Insider for offering that. In the epicenter of Florida’s SUD tumult, this ninety-minute panel was the first of many that’ll help USJT guests and the general public to distinguish quality providers in the current environment of health care reform amid mixed messages for addicts and their families. Panel guests included Michael Cartwright, president of American Addiction Centers (AAC), John Lehman, president of Florida Association of Recovery Residences (FARR), Jeffrey Lynne of Weiner, Lynne, & Thompson, PA, and me. In the midst of fast-moving changes in the nation’s health care agenda, these events at USJT conferences will provide an invaluable guide to a world where long-term, sustainable recovery is supported. I am a big believer in knowledge as a powerful resource. Knowing the history of our industry and business in general can assist in developing strategies which can be helpful in the future. I don’t think I can predict the future—I’m not a
mind reader—but there are certain characteristics in business and human nature which I believe remain consistent in a sea of change. There are trends, bubbles, growth spurts, downturns, and evolution in any industry. There are also differences in corporate philosophies, motivations, business plans, and goals. Our industry is in the midst of a cycle of change which many predict will have benefits and consequences. This is not unique, but suffice it to say that I predict the recent period of fastpaced growth in which clinical and therapeutic advances have coincided with a fair share of fraud and abuse will inevitably lead to a natural purging—evolution, if you will. With the onset of the Affordable Care Act and related health care reform initiatives, there is so much information and rapid change that it is often challenging for the public as well as for addiction professionals to know where to focus first. “Mergers and acquisitions” is a term used often recently in our field. There are many who believe this trend will continue much as hos-
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pitals and mental health facilities have experienced it in the not-too-distant past. A few large players have emerged—and will continue to emerge—and occupy a large share of our market. Cartwright spoke eloquently about the challenges that he has faced as he’s catapulted AAC into new territory in its becoming the first business focused solely on addiction treatment to go public, raising $75 million in an IPO. That doesn’t necessarily mean that the smaller, niche programs and centers will disappear, but it will create some challenges as the business side of our industry becomes more mainstream. There is a part of me that is extremely sad about this trend; I was brought up in an era of mission-driven organizations that spent much more time focusing on the therapeutic side of this and much less time concerned about business. That had its advantages, but also left many struggling to continue providing exemplary services in a growing, competitive business market. Some began taking shortcuts and profits began edging out mission in the corporate makeup of a minor but extremely visible and troublesome segment of the industry. Simultaneously, we were entering a period of more public awareness of the disease and a willingness to publicly discuss it. This coincided with a surge in the supply of addictive drugs and increased demand which has contributed to a rise in deaths and more public
concern as the negative consequences of this disease make it the number one health crisis in our country. As each of our guests endorsed from their different perspectives, payers are beginning to realize that the solution isn’t refusing to pay; the related health costs from not treating addiction far outweigh the cost of treatment. But many in positions of power do not understand this disease or the benefits of ethical and appropriate treatment. Some politicians are speaking candidly about the epidemic which has had its grip on our nation for decades. For years we only heard “Just Say No” or other catch phrases touting our “success” in the war on drugs. Each day on the news I hear about some tragedy which is affecting either my community or another US town. The numbers of individuals dying from addiction have skyrocketed and exceed any other form of death, including disease and war. Yet there are only occasional references to this in the media. Jeff and John observed that we see more coverage of the fraud and abuse that has been brought to light by ethical providers—those who are sick and tired of watching as opportunists invade our space and take advantage of consumers—than coverage of the senseless loss of life that has been proliferating in our society as we blindly pretend it isn’t happening. This is the time for an informed, proactive
approach to addiction treatment, prevention, and education. It is time for a real investment in recovery. It is time for the recovering community—which includes individuals, families, friends, and businesses—to join forces and begin to eradicate this epidemic. At the UNITE to Face Addiction rally in Washington, DC last year, the Surgeon General announced his plan to tackle this disease, which is a great start. Americans need to wake up and smell the coffee. It’s here, it’s everywhere, and if mergers and acquisitions can help raise awareness and our ability to provide proper long-term care to eradicate this disease, then bring it on; we need all the help we can get! ■
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.
NAATP Weighs in on Medication-Assisted Treatment
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n response to recent press coverage regarding the use of medication-assisted treatment (MAT) in the care and treatment of addiction and substance abuse disorder substance use disorders, the National Association of Addiction Treatment Providers (NAATP) is pleased to provide this statement describing its position on MAT in the treatment of substance use disorders. NAATP Executive Director Marvin Ventrell said, NAATP is pleased with the recent focus and attention on addiction treatment. We have been waiting for this momentum for a long time. It is essential, now, that we get it right, that we integrate rather than isolate systems of care, including MAT and biopsychosocial care. Our industry embraces this approach. A good example of that is NAATP member Hazelden Betty Ford Foundation’s publication, Integrating the Twelve Steps with Medication-Assisted Treatment for Opioid Use Disorder. This is all part of a recovery-oriented system of care and that is the kind of thinking and approach we need now. NAATP’s value statement, adopted following the Nashville Summit in 2013, provides further guidance on the importance of multiple and integrated responses to substance use disorders. NAATP believes that addiction is a chronic disease and supports the use of individualized, multifaceted, multiphasic, and interdisciplinary service provided along a continuum of care. This care includes biopsychosocial care and MAT used as part of a combined holistic treatment approach. NAATP members have long endorsed this model including, contrary to recent news reports, the use of MAT. NAATP believes that MAT, used in conjunction with biopsychosocial care, including Twelve Step care and peer-driven support, provide patients with the best chances for recovery. ■ Source: https://www.naatp.org/naatp-provides-industry-position-on-mat/
Jan/Feb 2016
Industry Insider
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The Broken System Sherry Schlenke, MEd
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aniel Montalbano, the son of The Addict’s Mom (TAM) founder Barbara Theodosiou, was a victim of the broken system of our community mental health facilities and prisons. Dr. Harold Metzner of the University of Colorado uses the term “broken system” to describe the failure of this nation’s mental health and prison systems to adequately meet the needs of the population of people who have a diagnosis of co-occurring disorders; that is, a serious mental illness (SMI) comorbid with a substance use disorder (SUD).
ABOUT THE ADDICT’S MOM In Barbara’s words,
I discovered within a six-month period that two of my sons were addicts. My first reaction was to become physically ill. I was completely lost in the sadness of addiction, feeling shock, fear, and confusion. It was through my own brokenness that The Addict’s Mom was born. I knew deep inside that I was not the only mother who was suffering with her children; there had to be so many other moms going through the same horror that I was experiencing. I wanted to connect with those moms and create a forum where their pain and feelings could be shared with others who would be empathetic; a safe place where moms could “Share without Shame” their experiences, their sorrows, their anguish, and their fears of being the mother of a child with the disease of addiction. TAM began as an online, grassroots national and international support network, and has grown to over fifty thousand members, with a chapter in all fifty US states. Members meet online and in person to educate, advocate, and act as liaisons between policy makers, mental health professionals, and families of those suffering from the disease of addiction. In local communities, TAM sponsors events dedicated to heighten awareness of the disease, to reduce the stigma of the disease, and to promote changes in the legal system affecting those with the disease. Through pledges from our generous donors, TAM is now able to offer treatment scholarships to the loved ones of our members. As drug use and subsequent imprisonment and death among our youth reach epidemic proportions, TAM is becoming a force for societal change.
THE BROKEN SYSTEM AND DANIEL
The first component of the broken system often begins in elementary school. Daniel was likely a child with undiagnosed high functioning autism. He was cognitively gifted, and therefore it is probable that he had Asperger’s syndrome. When Daniel entered the school system, he was very misunderstood. Being socially awkward, Daniel was bullied—at the bus stop in the morning, at school, and on the bus home. Additionally, because he lacked coping mechanisms for his social and emotional problems, Daniel acted out in class. People with autism suffer from “theory of mind,” in which they are completely unaware of the perceptions and feelings of others. According to Stephen M. Edelson, PhD, of the Autism Research Institute, “Theory of mind refers to the notion that many autistic individuals do not understand that other people have their own plans, thoughts, and points
Barbara Theodosiou, founder of The Addict’s Mom.
of view. Furthermore, it appears that they have difficulty understanding other people’s beliefs, attitudes, and emotions” (n.d.). Thus, Daniel did not realize just how very inappropriate he acted, and he did not understand when others reacted to him in a negative way. As Daniel advanced through his school years and continued to have behavior problems in class, his teachers placed him in isolation, further distancing him from his peers. The parents of the other students complained that Daniel was too disruptive in class. He was disliked, mocked, and ostracized by his peers. Substance abuse is not unusual in individuals with autism, and Daniel’s progression to substance use is predictable. He told his mother that he began using drugs at the age of thirteen as a way to escape the reality of his painful life. Daniel was not referred for educational or psychological evaluation by the school staff, and they did not implement behavior modification, conflict resolution strategies or promote positive peer interactions. The school system was indeed broken in Daniel’s case. The Mental Health System Barbara consulted a child psychiatrist when Daniel was thirteen. Unfortunately, he was misdiagnosed with ADHD, which has a high comorbidity rate with autism. By this time Daniel was also experiencing auditory hallucinations, which may indicate a thought disorder. The misdiagnosis of ADHD was also due in part to the reluctance of the professional to “label” a young boy with a psychiatric diagnosis. Barbara followed the recommended treatment options, which included therapy. Because Daniel’s problems at school continued to escalate, Barbara removed him and he finished his general educational development (GED) test for high school equivalency through the local community college. Being completely distanced from his peer group, however, exacerbated his social deficits. Further, his continued substance use resulted in an increase in symptoms of a psychological disorder.
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Jan/Feb 2016
At the age of sixteen, Daniel was admitted to a psychiatric hospital. He did not improve, however, and he continued to use drugs after his release. Further, Daniel spent another year of his life in a state-run psychiatric hospital. He remained fairly stable for a brief time after his release, but he always reverted to his drug use. Was this mental health system also broken for Daniel? We will never know. Barbara and Daniel would soon discover that decisions regarding his welfare and mental health would be made by others who were often misguided, misinformed, and ill-equipped to interact with Daniel’s cooccurring disorder. Daniel began living the vicious cycle common to all mentally ill and substance users, as he became a victim of the greater community mental health system combined with the prison system. The cycle for Daniel was overdose, transport to an emergency room, physician-enacted civil commitment to the psychiatric unit for a threeday stay, release to a treatment center, complete or leave treatment, become homeless, find a shelter, leave shelter, commit a petty crime (shoplifting), public intoxication, loitering, arrested with excessive violence by the police, housed with felons, brutalized in jail, placed in isolation, and suffer over-all mistreatment by the broken systems. Barbara reports that Daniel was subjected to Florida’s civil commitment laws perhaps twelve to fifteen times per year. Daniel’s psychiatric records read like the DSM-5: obsessive compulsive disorder and generalized anxiety disorder; depression and possible delusional disorder involving paranoia; bipolar disorder; suicidal ideation; an unspecified mood disorder; stress-related trauma; rage, poor impulse control, feelings of worthlessness, hopelessness, and personal failure; withdrawn and introverted; and substance-induced psychotic disorder. At some point, Daniel was accurately diagnosed with a co-occurring disorder of mental illness and substance use, although the exact diagnosis of the mental illness is still unclear due to the many years that Daniel used drugs, and the many evaluations by a variety of experts in overlapping fields of psychology, psychiatry, social work, and medicine. He was also determined to be eligible for disability benefits, as it seemed unlikely that he would ever remain stable long enough to maintain gainful employment. The Prison System According to Dr. Metzner, once the sufferers of SMI and SUD come to the attention of authorities, they experience first-hand the complete failure of the community mental health and prison systems. Tragically, in order to protect them from assault and brutalization by the other inmates, the mentally ill are often placed in isolation, as was the case with Daniel. For persons with serious mental illness, psychological stressors such as isolation can be as clinically distressing as physical torture. Daniel, whose most serious crime was shoplifting, was devastated physically, emotionally, and mentally by his horrible experiences while incarcerated. In the summer of 2014, Daniel once again fell victim to the broken system. Transported to an ER because of an overdose, he was committed to a psychiatric unit. There he became psychotic due to withdrawal symptoms and an allergic reaction to the medication being used to treat him. While thrashing in his bed, Daniel accidentally struck a security guard and was charged with a felony. He was transported to jail, where he was housed with felons with extensive criminal records. He was assaulted and placed in isolation to protect him from the other inmates. Death Daniel was permitted to go to treatment off-property, but during an altercation instigated by another boy at the treatment center, Daniel
was threatened by the staff with police intervention. He believed that he would be taken to prison for a probation violation, and once again be housed with the dangerous felons. Fearful, he fled the center, and was never again seen alive. He drowned in a canal just a few miles from his home. Daniel Montalbano was just twenty-three years old. Shockingly, the coroner’s office failed to identify Daniel’s body for ten days. His frantic mother, family, and the entire TAM community had begun a nationwide missing person search for Daniel, unaware that he was, in fact, lying in a steel drawer a few miles from home. Barbara and those who loved him hope that Daniel finally found the peace that eluded him in life.
HOW SERIOUS IS THIS PROBLEM?
Metzner’s research reveals some dismal statistics (personal communication, May 11, 2015): • •15 to 20 percent of our prison population has a SMI. • •60 percent of state correctional systems responding to a survey on inmate mental health reported that 15 percent or more of their inmate population had a diagnosed mental illness. •30 • to 35 percent of inmates in isolation across the nation have a SMI. • •22 of 40 state correctional systems reported in a survey that they did not have an adequate mental health staff. As TAM members are experiencing and reporting, when their children are released from prison, the cycle begins again. The cycle will end eventually—in recovery, imprisonment for a lifetime or death. Dr. Metzner advocates for systemic change as delineated by professional organizations. For example, the National Commission on Correctional Health Care (NCCHC) has crafted a series of guidelines for accommodating the mentally ill and/or those with SUDs in the prison system (2010). Institutions are not required to implement the guidelines, but there are accreditation procedures should an institution wish to follow the recommendations. The American Psychiatric Association (APA) and the American Medical Association (AMA) have also created recommendations, but not formal guidelines for the institutions. Dr. Metzner states that institutions can be sued if they are not meeting the standards, however, “class action suits filed by a large group of people are the only way to bring about change” (personal communication, May 11, 2015). Unfortunately, all of the individual lawsuits must involve the same system, so in Daniel’s case, Barbara has little or no recourse.
POTENTIAL SOLUTIONS
Mental Health America (MHA), an advocacy group, reminds us that people with mental illnesses and substance use disorders are an especially vulnerable population (n.d.). The mentally ill who are involved in the criminal process must have access to community-based treatment aimed at recovery; such treatment is termed a “diversion program” and needs to be implemented before booking the person. MHA advocates for recovery-based, individualized treatment, delivered by appropriately trained staff. Individual therapy, group therapy, structured educational, recreational or life-skill-enhancing activities and other therapeutic interventions are needed, but there is not enough money or highly trained staff to provide these services. According to Judge Steve Leifman, law enforcement and correctional officers have increasingly become the lone responders to people in crisis due to untreated mental illnesses (Eleventh Judicial Circuit of Florida, 2010). For example, “on any given day, the Miami-Dade County Jail houses approximately 1,200 individuals with SMI, which
Jan/Feb 2016 is approximately 17 percent of the total inmate population, and costs taxpayers more than $50 million annually. The county jail now serves as the largest psychiatric facility in the State of Florida” (Eleventh Judicial Circuit of Florida, 2010). This is a sad state of affairs and further enforces the broken system theory for treatment of the mentally ill who commit crimes. There is some hopeful news, however, as communities across the nation are beginning to recognize the crucial need for better treatment of these poor unfortunate souls. For example, ten years ago, Miami implemented a program called the Eleventh Judicial Circuit Criminal Mental Health Project (CMHP). The purpose is to divert nonviolent misdemeanor defendants with a SMI or co-occurring SMI and SUD, from the criminal justice system into community-based treatment and support services. The program has expanded to serve defendants who have been arrested for less serious felonies. The program operates two components: a crisis intervention team training for law enforcement officers, and a component that serves individuals booked into the jail and awaiting adjudication. According to Judge Leifman, all participants are provided with individualized transition planning including community-based treatment and support services: “The CMHP is proving to be an effective, costefficient solution to a community problem by eliminating gaps in services, and by creating productive and innovative relationships among all stakeholders who have an interest in the welfare and safety of one of our community’s most vulnerable populations” (Eleventh Judicial Circuit of Florida, 2010). The National Alliance on Mental Illness (NAMI) strives to increase awareness and understanding of the mentally ill through its partnership with the University of Memphis crisis intervention training program. Recognizing that law enforcement personnel need to be better trained to interact with persons with co-occurring disorders, crisis intervention training (CIT)—boasting a forty-hour curriculum—is the most comprehensive police officer mental health training program in the country. There are currently crisis intervention training programs in forty-five states as well as the District of Columbia. For the CIT program to be effective in dealing with the mentally ill who commit a crime, law enforcement, mental health, and advocacy agencies must work together. The Gloucester, MA police department, through the Police-Assisted Addiction and Recovery Initiative (PAARI), is now offering treatment as an alternative to prison for people with SUDs, with or without a SMI. Through a letter-writing campaign that targets community law enforcement organizations throughout our nation, TAM is actively promoting the PAARI program. PAARI was started to support local police departments as they work with opioid addicts. Rather than “arrest our way out of the problem of drug addiction,” PAARI-committed police departments (PAARI, 2015): • •“Encourage opioid drug users to seek recovery • •Help distribute life-saving opioid blocking drugs to prevent and treat overdoses • •Connect addicts with treatment programs and facilities • •Provide resources to other police departments and communities that want to do more to fight the opioid addiction epidemic” The monetary cost of our broken system is but one challenge. The human cost cannot be overstated. Many changes must be implemented, according to Dr. Metzner. First, money for facilities, therapists, and physicians must be allocated. Then, those suffering from a co-occurring disorder who commit petty crimes need to be housed in a special needs unit with access to treatment, therapy, medications, and com-
Industry Insider
9
munity and social interactions. These types of programs are known as “integrated therapies.” According to Dr. Harold Koplewicz, child and adolescent psychiatrist and president of the Child Mind Institute, With an approach that treats the whole person, these programs not only include the psychological side of recovery, but also the physical side with diet, exercise, and social aspects. Some key factors in an effective integrated treatment program can include education, case management, sessions on creating healthy relationships, Motivational interviewing, counseling, and long-term community building and life skills courses” (“A Beginner’s Guide,” n.d.). Experts from these special needs facilities or programs design individual reentry programs to help clients transition back to society. As evidence demonstrates, reentering society and maintaining sobriety are two challenging factors that may lead to relapse.
CONCLUSION
Sadly, the public is both unaware of and apathetic to the plight of those suffering from co-occurring disorders, and the accompanying burden placed on their loved ones. Few lawmakers are willing to address these issues. There is little or no public support, and therefore elected officials have been reluctant to provide the funds and leadership needed to ensure that prisons have sufficient mental health resources, and that law enforcement personnel are adequately trained to interact with these sufferers. Grassroots campaigns promoted by organizations like TAM are the best hope to raise public awareness of addiction, and to lobby for funding. As Barbara stood strong and brave at the funeral of her precious boy, she reminded all of us that we must remain steadfast, we must stand strong and united, and we must follow Barbara’s lead in our mission to educate society, to advocate for our children, to lobby for changes in the broken system, to promote prevention of substance use, and to secure treatment for our family members who are suffering from the deadly disease of addiction. ■ 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.
References “A beginner’s guide to the RX drug abuse epidemic in America: Part four: The mental health factor.” (n.d.). Retrieved from http://www.foundationsrecoverynetwork.com/a-beginnersguide-to-the-rx-drug-abuse-epidemic-in-america-part-4-the-mental-health-factor/ Edelson, S. M. (n.d.). Theory of mind. Retrieved from http:// www.autism.com/understanding_theoryofmind Eleventh Judicial Circuit of Florida. (2010). Criminal mental health project. Retrieved from http://www.jud11.flcourts.org/scsingle.aspx?pid=285 Mental Health America (MHA). Position statement fifty-six: Mental health treatment in correctional facilities. Retrieved from http://www. mentalhealthamerica.net/positions/correctional-facility-treatment National Commission on Correctional Health Care (NCCHC). (2010). Substance use disorder treatment for adults and adolescents. Retrieved from http://www. ncchc.org/substance-use-disorder-treatment-for-adults-and-adolescents Police-Assisted Addiction and Recovery Initiative (PAARI). (2015). About us. Retrieved from http://paariusa.org/about-us/
10 Industry Insider
Jan/Feb 2016
Caron Philadelphia Hosts 16th Annual Richard J. Caron Award of Excellence Gala to Benefit Patient Scholarships
Left to right: Daniel J. Hilferty, president and CEO of Independence Blue Cross; Doug Tieman, president and CEO of Caron Treatment Centers; and Board Chair Casey Duffy.
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aron Philadelphia honored Daniel J. Hilferty, president and CEO of Independence Blue Cross, with the Richard J. Caron Award of Excellence at its 16th annual gala on Wednesday, November 4, 2015 at the Kimmel Center for the Performing Arts. The event raised more than $500,000 to support patient scholarships. Special guest artists included Eric Bazilian, Rob Hyman, and David Uosikkinen of the American rock band The Hooters. “We are thrilled to honor such a special individual,” said Doug Tieman, president and CEO of Caron. “Addiction is a disease that impacts people from all walks of life. Dan has been a passionate advocate for addiction treatment programs and has gone above and beyond to make a difference in the community.” Since Hilferty became CEO of Independence Blue Cross, one of the nation’s leading health insurers, the number of people the company serves has tripled to nearly 10 million in twenty-
four states and the District of Columbia, including 2.5 million in southeastern Pennsylvania. “We have all seen how addiction can tear a family apart,” said Hilferty. “But Caron shows us how treatment can not only heal a family, but also make them stronger than ever. I’m grateful for the exceptional team at Caron for their passion and commitment to education, treatment, and recovery.” More than 485 guests attended the gala, with Brian Taff, coanchor of Action News at 4 PM (6ABC) and Action News at 10 PM (PHL17), as the master of ceremonies, and event cochairs including Marguerite Schroeder and Lone H. Spillard. Caron also honored Duane Morris, LLP with the 2015 Partner in Recovery Award. Evolving from a partnership of prominent lawyers in Philadelphia a century ago, Duane Morris exemplifies a commitment to the community and strong values of philanthropy and good citizenship. In 2014, eighty-five volunteers
dedicated over 3,350 hours of pro bono legal assistance to aiding human trafficking survivors, and another fifty volunteers dedicated over one thousand pro bono hours to assist veterans and service members seeking disability benefits, compensation for combat injuries, and other aid. Duane Morris has provided Caron with philanthropic support for more than fifteen years and has encouraged staff to serve in volunteer capacities on Caron committees and the Philadelphia Regional Advisory Board. Funds raised at the gala will support patient scholarships throughout the continuum of care provided at Caron Pennsylvania and Caron Renaissance. Caron Philadelphia holds parent support groups and is active in prevention and education throughout the Philadelphia region. ■ Source: https://www.caron.org/media-center/newsresearch/press-releases/16th-annual-philly-gala
Jan/Feb 2016
Industry Insider 11
Chooper’s Foundation Focuses on the Role of Community attendees that the conversation is no longer nature versus nurture as a primary casual factor, but rather how nature affects nurture and how nurture affects nature (epigenetics). Dr Maté’s lectures illuminate the relationship between trauma, addiction, mental health, and the need for people to belong. In terms of etiology of a disorder, he has a flair for broadening the inquiry regarding trauma to what did not happen to the person and skillfully and intuitively demonstrated through interaction with the audience that addiction is not just a result of what happened to the addict, but what should have happened and never did. At USJT’s Newport Beach, CA conference, Dr. Maté, introduced by Jamison Monroe, Jr. of Newport Academy, provided an inspirational, consciousness-raising lecture. Guests who attended in ME and in International speaker and best-selling author Dr. Gabor Maté spreads message.
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he kickoff event to a series of lectures at the elegant Franco Center in Lewiston, ME—sponsored by Tim Cheney and Adrian Hooper, the cofounders of The Chooper’s Foundation and Chooper’s Guide, and Marty O’Brien of Grace Street Services—featured the theme “Set and Setting: What Role Does Community Play in Transforming the Lives of Those Consumed by Addiction?” The event featured Dr. Gabor Maté, the best-selling author and internationally renowned speaker on the subject of trauma and its relationship to addiction and mental health, who also presents regularly at U.S. Journal Training (USJT) conferences. In addition to Dr. Maté, Merideth Norris, DO, an ABAM-certified physician and the medical director of Grace Street Recovery Services, presented on the topic “Recovery Medicine: The Neuro-
science of Place and Belonging,” and Tim Cheney presented on the topic “Language as a Catalyst for Change: Sociolinguistics and the Promulgation of Mental Health and Addictive Disorders as a Deviant Behavior.” Nature versus nurture as the primary causal factor for mental health problems and substance use disorders has been a highly debated topic amongst social scientists for over the past fifty years. Until the recent advances in the areas of neuroscience and epigenetics, addiction and mental health professionals have typically confined their practice to one treatment model, which has demonstrated minimal efficacy. The current opioid epidemic demands that we reevaluate and dramatically change our perspective regarding the essence of addiction and the approach typically used today to treat addiction. We are failing and
Dr. Gabor Maté with Chooper’s Foundation founders Tim Cheney and Adrian Hooper.
people are suffering and dying. Chooper’s Guide, The Chooper’s Foundation, and Grace Street Recovery Services selected Dr. Maté as their keynote speaker for his unique capability to gently and clearly articulate and educate the
CA would urge all who provide addiction and mental health services and are interested in or provide trauma-informed care to become familiar with Dr. Maté’s work. ■
12 Industry Insider
Jan/Feb 2016
Legal Marijuana Poses New Challenges: An Expert Panel Focuses on the Threat to Teens Gary Seidler
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hether or not one favors the decriminalization and/or legalization of marijuana, the increased use of cannabis by young people poses serious challenges to caregivers. An expert panel—gathered at U.S. Journal Training’s (USJT’s) Western Conference on Behavioral Health and Addictive Disorders—reflected on the history and evolution of marijuana policy from the draconian measures of the 1960s to the outright legalization and commercialization seen today in an increasing number of states. The panel, held in Newport Beach, CA and titled “Marijuana: The Good, The Bad, and The Ugly,” tackled issues such as decriminalization, legalization, and medical usage. Moderator Stephen Sideroff, PhD, a professor in the Department of Psychiatry at UCLA, stated that we can lose perspective. He pointed out that, historically, marijuana has flown under the radar in the mistaken belief that it is quite benign, at least when compared to other, more “dangerous” drugs. David E. Smith, MD, founder of the HaightAshbury free clinic and medical director of Muir Wood Adolescent and Family Services, added a fifty-year perspective to the panel, going back to the “Summer of Love” (1967)—the height of the pot and acid counter-culture. At that time, possession of marijuana, which was also known as the “killer weed,” in some cases resulted in life imprisonment. “Clearly, the law was doing far more harm than the drug itself,” Dr. Smith recalled. What hasn’t changed is the closed mindedness of forces on both sides of the question of legalization. According to Dr. Smith, “Then, as now, if you say anything about the pro-legalization forces there’s an outcry from those who don’t want to hear it,” and vice versa. “Knowledge and intellect are still dismissed,” Dr. Smith added. Dr. Smith referred to the recently published American Medical Society on Addiction (ASAM) policy which calls for a balance between safety and health. “As a physician who practices a clean and sober life, I revert to my pledge to ‘do no harm.’ I don’t recommend marijuana, but I don’t have a problem with a physician who does,” he said. On the question of medical marijuana, Dr. Smith recalled that advocates were clear—medi-
Left to right: Pete Nielsen, newly appointed executive director of CCAPP; Ben Cort, community liaison for CeDAR/ University of Colorado Hospital; David E. Smith, MD, the original founder of the Haight-Ashbury clinic and chair of addiction medicine at Muir Wood Adolescent and Family Services; Jennifer Golick, Muir Wood’s clinical director; and Dr. Stephen Sideroff, panel moderator.
cal marijuana today, legalization tomorrow. “Medical marijuana is like a pile of dung; underneath the dung are some pearls of wisdom,” said Dr. Smith, who called for more research, training, and continuing medical education. “The biggest single concern,” Dr. Smith continued, “is marijuana use by adolescents. Previously, we did not appreciate the long-term effects of marijuana on the brain.” With sixteen years of experience working with kids and families, especially involving marijuana, Jennifer Golick emphasized that in terms of potency, today’s marijuana has no resemblance to the “harmless” pot of back in the day. “It is a highly addictive substance that is destroying children’s brains,” she added. Golick suggested that we think of adolescent addiction as a pediatric disease. “Addiction is the only pediatric disease that we wait to treat,” said Golick. “We can’t wait for our kids to hit bottom.” She said, “We can’t treat a pediatric disease with an adult model. Rather, we need to look at adolescent substance abuse as a constellation of issues and intervene as early as possible.” Ben Cort, the director of professional relations at the Center for Addiction Recovery and Rehabilitation (CeDAR), brought a contemporary
perspective of a professional and father of three small children from CO, which he described as “ground zero.” Cort pointed out that there is a massive gap between the decriminalization debated in many states and the commercialization of marijuana in his state. Cort also pointed out that the THC component of yesteryear’s marijuana was 0.3 to 0.5 percent, while today’s THC concentration can be as high as 36.8 percent and marketed as “heroin-ana.” Moreover, marijuana “concentrates” account for 40 percent of all marijuana in CO. “The only way you are going to understand what’s going on in Colorado is to abandon your constructs of what marijuana is. Today’s weed is something altogether different,” Cort said. Pete Nielsen, CEO of the California Consortium of Addiction Programs and Professionals (CCAPP), called for legislators in his state to include significant dollars earmarked for all addiction treatment, not just marijuana, as they debate legalization. Unlike CO, WA, and OR, CA needs to set aside “45 percent of tax revenue for treatment,” Nielsen suggested. ■
Jan/Feb 2016
Industry Insider 13
AROUND THE STATES OHIO: Voters rejected a ballot initiative that would have legalized marijuana despite millions of dollars spent by investors hoping to profit from the measure’s passage. Issue Three in the state would have made it the first in the Midwest to legalize the recreational use of marijuana. But 65 percent of OH voters rejected the measure, even though the pro-pot advocates paid an estimated $6.2 million to air TV ads supporting it, according to analysis of data from Kantar Media/CMAG, a media tracking firm, by The Center for Public Integrity. The TV spots said the measure would help sick children and hurt drug dealers, among other benefits, but controversy had surrounded it in OH due to what opponents called its “monopoly” provisions. The proposed constitutional amendment called for allowing only ten farms to sell wholesale marijuana—farms owned by the investors bankrolling the campaign. Opponents assembled a broad coalition of groups representing doctors, clergy, sheriffs, accountants, and other professionals. In their messages, they decried the measure’s “monopoly” and the possibility of children getting their hands on legal pot. Pro-pot advocates aired more than ten times the number of TV ads opponents aired, but the controversial marijuana legalization measure divided even pro-marijuana activists, with some groups offering tepid support and others keeping a safe distance. OH pot activists who didn’t like Issue Three’s monopoly provisions are already gearing up to try to pass a pro-legalization ballot initiative in 2016, this time without the controversial components. Meanwhile, at least five other marijuana legalization measures are expected to appear on ballots across the country in 2016. Source: http://www.publicintegrity.org/2015/11/03/18819/ ohioans-reject-marijuana-legalization-measure
FLORIDA: Bob Lynn, EdD, has been named chief clinical officer for Origins Behavioral HealthCare, one of the nation’s best known brands in residential substance abuse treatment. He’s been a visionary and leader in the field of addiction treatment for over forty years, and has served as Origins’ chief clinical advisor since 2012. In this new expanded role, Dr. Lynn will oversee the entire clinical team at Origins and enhance
its renowned, spiritually infused, science-based programs. “Dr. Lynn’s passion for providing client-focused treatment based on outcomes research aligns perfectly with our approach and will reinforce the framework of our treatment model,” said Origins CEO Drew Rothermel. “He has the experience and expertise to strengthen our blend of clinical, medical, and spiritual programs, and this move will position Origins for continued growth and expansion into new markets.” Dr. Lynn is an internationally recognized lecturer, researcher, and clinician in the field of counseling psychology and substance use disorders. Over his forty-year career, he has held leading positions in many clinical settings and has been a long-term faculty member at Rutgers School of Addiction Studies. He is a senior fellow in biofeedback, a licensed therapist, a master family therapist, and a clinical supervisor. Origins acquired West Palm Beach-based Hanley Center in December, 2014, aligning two of the best treatment centers in the country into a powerful stand-out in the recovery industry. It now offers age- and gender-specific residential treatment centers in West Palm Beach, Vero Beach, and Singer Island, FL, and South Padre Island, TX. Source: https://www.originsrecovery.com/ dr-bob-lynn-named-chief-clinical-officer/
TENNESSEE: For almost forty years, Onsite has helped individuals, couples, and families overcome dysfunctional patterns through intensive workshops lasting four to six days from its Cumberland Furnace, TN location. While these life-changing intensives have been essential to its mission, CEO Miles Adcox recognized a need for longer care and support last year. Onsite’s experience, longevity, and reputation provided the foundation for creating extended care treatment for trauma and codependency. After years of planning, Miles Adcox and his team opened Milestones at Onsite one year ago. Milestones at Onsite has now completed a year attending to residents stuck in their process because of varying unresolved traumas, attachment issues, and family of origin dysfunction. Staff members rallied to shape a structured program that is flexible enough to accommodate the unique strengths, abilities, needs, and goals of each client. Sustaining clients for thirty to ninety days while tending to their individualized personal and clinical needs
Milestones at Onsite
and providing a warm feeling of hospitality has been a tall order, but not without rewards. Using experiential therapies, trauma repair, group, individual, and family work, and many other modalities, the Milestones programs have provided tools to work through painful issues and create a heathy self-care plan for moving forward that perfectly complements the workshops for which it is renowned. Cumberland Heights Launches Fiftieth Anniversary Campaign Cumberland Heights drug and alcohol rehabilitation center has launched a new advertising campaign with the theme of “Recover Life.” Advertising in this campaign features alumni and alumni families, stemming from an extraordinary half-century that has yielded a Cumberland Heights Alumni Association with more than ten thousand members in the Nashville area alone. One of the campaign’s consistent visuals is a coin noting the fiftieth anniversary, modeled after the ubiquitous recovery concept of sober coins. In the TV spots, the staff members hold up a Cumberland Heights sober coin while saying how many years they have been in recovery. “Helping someone recover their life from the grip of addiction is the most important benefit we provide our patients and their families,” said Martha Farabee, chief development and marketing officer. “We wanted the campaign to reflect our success and our expertise in helping people live a life free from drugs and alcohol. With many of our staff members living successfully in recovery, they are role models for patients and able to build trust that is crucial for the recovery process.” The ads will be highly visible on TV, billboards, radio, in print, and on various digital channels in middle TN, and more will follow during its celebratory 2016. Source: http://www.cumberlandheights.org/cumberlandheights-launches-new-ad-campaign-recover-life/
14 Industry Insider
Jan/Feb 2016
Keeping Track of Mental Health Parity
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arityTrack is a collaborative project that works to aggregate and elevate the parity implementation work taking place across the country. It aims to be the central site for mental health and substance use disorder parity information for multiple audiences. ParityTrack examines the current state of parity implementation across the country through the Parity Reports, which analyze legislation, regulatory actions, and litigation at the federal and state levels. The Parity Reports are one of the key components of the site and provide information to consumers about their rights under both the Federal Parity Law and state parity laws. The Parity Reports help empower consumers to exercise these rights by connecting them with state-based organizations that can provide assistance in the event of a parity violation. By maintaining up-to-date information on parity implementation, ParityTrack is also able to identify critical issues that will lead to improved access and equity and inform resources developed in conjunction with partnering organizations that help various stakeholders address these issues. ■ Source: https://paritydata-prod.s3.amazonaws.com/ documents/6/attachments/ParityTrack.pdf?1433781443
Recovery Brands Launches Pioneering Online Community
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ecovery Brands, LLC announced its latest online community resource, Voices of Hope, designed to inspire transparency, trust, and support among individuals who have experienced or been affected by addiction. The community is a part of Recovery.org, a Recovery-Brands-operated site built to connect people with information and resources that aid in recovery from substance abuse and behavioral disorders. According to the company’s research, 68.3 percent of the 515 respondents attended a group meeting within the last thirty days, and of this group the average group/support sessions attended each month was 6.1. Of the 87.2 percent of people who identified support groups as being helpful for recovery, there were no reported differences of opinion as it related to years in recovery. This perhaps suggests that support groups remain important throughout the entire recovery process. Furthermore, 67 percent of respondents will first turn to a member of their support group in a critical time of need. When asked what factors are most important in creating a support system, the top five words were “trust,” “un-
derstanding,” “support,” “love,” and “family.” In addition, the company’s previous research published in the Journal of Addiction suggests that group counseling is the most significant influencer of alumni treatment satisfaction. “There’s a clear need for people to recognize the impact of the human connection in the recovery process,” said Ruchi Sanghani, director of research at Recovery Brands. “While there are many important factors, you can’t ignore the fact that for a vast majority of people, it’s crucial to have a trustworthy support group who can understand what they are going through.” “Recovery Brands was founded for the sole purpose of helping people find quality treatment and recovery options that they want and need, and Voices of Hope is another avenue for us to do that,” said Abhilash Patel, cofounder and president of Recovery Brands. “Stigma and isolation are major obstacles to seeking treatment and living in recovery, so we wanted to create a safe place where personal stories could be shared to encourage and strengthen those in the recovery community.” Patel continued, “It’s highly important that readers coming to our site not only have access to educational informa-
tion, but also a support system.” The company connects individuals seeking addiction treatment and information with resources to make informed decisions about their care and tools to access providers who can help. Its portfolio of authority websites— including Rehabs.com and Recovery.org—provides online directories, rehab reviews, forums, and professional communities that have supported thousands in making the life-saving decision to pursue recovery. In addition to its role in providing consumers with comprehensive resources, Recovery Brands offers treatment providers a leading marketing platform to elevate their online brands through paid media packages across its websites. Recovery Brands, LLC, now operating as part of Sober Media Group, LLC, a digital media arm of American Addiction Centers, will present at the forthcoming inaugural Treatment & Recovery Industry Insider Symposium on “Developing a Comprehensive Digital Marketing Plan.” ■ Source: http://www.medicalnewstoday. com/releases/302552.php
Jan/Feb 2016
Industry Insider 15
Coining In Ryan Miller, NCRC-II
THE “O” STANDS FOR OPEN ARMS
The days, weeks, and months prior to treatment are often the darkest and most trying of times for those who seek help at Futures. With this realization, our empathetic staff is ready and eager to assist in the healing process that has seen the restoration of life in so many of our alumni. We are here to help facilitate the healing of the past and are committed to offering insight and practical application for a brighter future.
THE “I” STANDS FOR INVESTMENT
Futures of Palm Beach.
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rom its inception, a dedication to innovation has been interwoven into the fabric of Futures of Palm Beach. As we rapidly approach our third anniversary, we have begun to realize the hopes and dreams made possible by years of steadfast dedication. In January 2015 we unveiled our newest ceremony, titled “Coining In.” Here, clinical and continuing care programming meet early in the recovery process as a means to welcome our newest clients to all that a life lived in recovery has to offer. Before jumping into the origin, purpose, and meaning of “Coining In” at Futures, it is important to shed light on the newly minted medallions that are presented to our clients during the ceremony. The medallions have an antique brass finish, circumference of 5.5 inches, and incorporate the gold and blue Futures logo colors. Within the brass-, blue-, and gold-encompassed circle lives a cutout of the Futures tree emblem, depicted on both the front and back of the medallion. The tree, in all its brilliant resolution and detail, stands alone, unaccompanied by any words or suggestion to its origin, purpose, and meaning. Unlike many recovery-related medallions that instantly tell a story related to treatment or laud lengths of sobriety or clean time, the Futures coin does not tip its hand or prematurely tell an often deeply personal story. The anonymity conveyed by the medallion itself invites curiosity and interest, while respecting the coin’s recipients and their own recovery journey. The multipurpose coin can be carried or displayed anywhere, as both an individual
reminder of what was, what is, and what’s to come and as a conversation starter if and when the medallion’s owners are ready. Weekly, the medallions are presented in small groups to new clients entering residential treatment. The “Coining In” ceremony itself is unique for a variety of reasons and serves as a tonesetter for the continuation of treatment and the ongoing recovery to come. At Futures, we believe residential treatment is but the beginning of the recovery journey. This philosophy stands in contrast to the traditional graduation or “coining out” that is utilized at many treatment centers. Our “Coining In” ceremony serves as a welcoming to the Futures family and an invitation to engage in a life of recovery. The process of “Coining In” at Futures serves a few purposes that might best be summed up with the acronym COIN.
THE “C” STANDS FOR COURAGE
The very definition of courage is doing something that frightens us. The period following detoxification can be amongst the scariest of times for individuals in early recovery. Gone are the substances that many used for years to cope with life, as are the medications used to ease withdrawal symptoms. Thoughts of “Did I make the right decision coming to treatment?” or “Can I do this?” are common. At Futures, we recognize the strength it takes to make the decision to ask for help, and we are here to support clients for the duration of their recovery.
The decision to enter treatment and willingness to engage in recovery serves as arguably the biggest investment of one’s life. As our clients invest in changing their lives, we invest in them during residential treatment and long after. Continued client care through alumni services serves as the bridge from clinical care to everyday, ongoing recovery. During “Coining In,” clients are oriented to the various lifelong recovery opportunities afforded our alumni. Regular communication, ongoing lifetime treatment, national alumni meetings, and monthly sober outings are but a few of the support services offered. Futures’ investment provides our alumni an avenue to a safe, supportive, and enjoyable recovery.
THE “N” STANDS FOR NEW LIFE
Many newly recovering individuals feel a sense of being given a second chance. Often, old dreams awaken and new ideas take shape, sending our alumni on paths not possible prior to treatment. We stand committed to supporting our alumni however we can. The newly bestowed coins serve as a symbolic reminder of the hope that accompanies a new life in recovery. The story behind each individual Futures coin is sure to be highly personal and awe inspiring. ■ Ryan Miller, NCRC-II, is the alumni coordinator and coleader of Treatment Professionals in Alumni Services.