Industry Insider - June 2016

MAY/JUNE 2016

Vol. 2 No. 3

A Multitiered Continuum of Care pg. 4

Industry Trends: Quality Programs and Treatment pg. 6

An Interview with Michael DeLeon pg. 7

Sober St. Patrick’s Day pg. 11

Pioneers We Have Lost pg. 14

Michael Cartwright: Man on a Mission pg. 2

SUD Talks Take the Stage pg. 8

Industry Insider

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Letter from the Editor

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t may not have sounded like an excuse for a party, but physicians, health care professionals, community leaders, and state and federal officials all celebrated last month as addiction medicine was formally recognized as a new subspecialty by the American Board of Medical Specialties (ABMS) under the American Board of Preventive Medicine (ABPM).

This recognizes addiction as a preventable and treatable disease, helping to shed the stigma of misunderstanding that has plagued it for too long in the United States. Interestingly, it also provides a new career option for medical students, residents, and physicians interested in specializing in the treatment of addiction.

That announcement was swiftly followed by President Barack Obama addressing the 2016 National Rx Drug Abuse & Heroin Summit in Atlanta. President Obama participated in a panel discussion, the first time a president has participated in the Summit, and he included several new federal initiatives in his remarks.

All of these initiatives render it timely for the great chronicler of this landscape, Bill White, to identify and honor the pioneers we have recently lost on page 14. These resourceful and passionate leaders paved the way for addiction treatment and recovery to be at the forefront of the national consciousness in 2016.

The Rx Summit expanded its focus to address the emerging heroin crisis, which has been linked to the prescription drug problem that we all too often hone in on in these pages. During the sixty-seven hours of the event, the Summit’s “Life Counts Clock” revealed an estimated two hundred deaths due to opioid-related overdoses, adding urgency to the need to find a comprehensive, multifaceted solution.

“For decades, the recognition of addiction medicine has been promoted by ASAM. It has been a key part of our mission and couldn’t come at more critical time,” said ASAM President Dr. Jeffrey Goldsmith.

“With the staggering rise of substance misuse and addiction, expanding the expert workforce needed to address the challenge is paramount,” he added.

Intriguingly, that also brings other benefits such as health network inclusion for addiction medicine specialists and a recognition that those who provide expert care meet the “gold standard” in board certification. Recognition of this ilk has significant US educational implications too; it will make it possible for addiction medicine fellowship training programs to seek accreditation by the Accreditation Council on Graduate Medical Education (ACGME) leading to increased access to funding for fellowship training.

There’s no doubt that more decisions related to practice pathway, future certification exams, and maintenance of certification will be announced by ABMS and ABPM. ASAM hosted a special session at its 2016 annual conference in Baltimore, where officials probed the ramifications of this milestone and answered the questions of a new generation contemplating this career path.

We’ll continue to follow organizations of the stature of ASAM that are spearheading addiction medicine education, research, and treatment. ASAM recently released its “National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use” to assist clinicians prescribing pharmacotherapies to patients with addiction related to opioid use. It’s the first such national guideline to cover all FDA-approved medications available to treat opioid addiction.

Sincerely,

Stephen Cooke Editor, Treatment & Recovery Industry Insider

May/June 2016

2 Industry Insider

The Mission Continues: Michael Cartwright on American Addiction Centers, the Industry, and What it Takes to Beat Addiction Gary Seidler

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ichael Cartwright is a man on a mission.

Chairman of the board and CEOof the publicly traded American Addiction Centers (AAC) based in Brentwood, Tennessee, Cartwright has been a trailblazer in the addiction treatment industry and a noted entrepreneur in behavioral health for over twentyfive years. He headed the Foundations Recovery Network for almost fourteen years before starting AAC in 2011.

Following a steady stream of acquisitions throughout the country, AAC is the fastest growing provider of inpatient substance abuse treatment services, reaching just over one thousand beds at this time of writing.

In addition, the company has opened fifteen outpatient programs and aftercare residences, including the recent acquisition of a onehundred-bed hotel which will be converted to a recovery residence in Arlington, Texas.

In a wide-ranging interview with Industry Insider, Cartwright, a former mental health case worker and alcohol and drug counselor, reiterated his primary purpose to help people from all walks of life to overcome their addictions and mental health problems.

“I feel most fulfilled when visiting with patients and staff at our facilities,” said Cartwright, who readily admits he underestimated the amount of time he would need to spend as chairman of the board of a publicly traded company (AAC went public in October 2015).

Cartwright says AAC has and will continue to stick to its game plan to build a national brand based on solid clinical care, and he is “proud of the job we’re doing.”

AAC’s growth has not been without challenges, both on Wall Street and in the courtroom. A California indictment was unsealed last July charging multiple subsidiaries and former and current employees of the company with dependent adult abuse and murder. Shortly after, the company’s stock plummeted. The second degree murder charge was thrown out after a court hearing in March 2016.

Opening at $15 per share, AAC’s stock soared to over $40 per share before settling at around $20. As far as the company’s stock is concerned, Cartwright points out that the entire health care sector has been hit hard over the last several months. “Our company is solid,” he adds.

Cartwright candidly discussed current controversies around unethical marketing practices, overutilization of drug testing, and the apparently widespread practice of “paying for referrals.”

With regard to marketing in the addiction treatment field, Cartwright points to the difference between “aggressive marketing” and outright unethical behavior. “We (AAC) have seventy reps in the field who are marketing hard, using marketing standards. Some treatment providers have poor census and complain about others’ marketing practices when, in reality, they may not know the most effective ways of marketing,” he adds.

May/June 2016

“Urine drug testing is an essential component of addiction treatment,” Cartwright says. “Most providers are doing the right thing, but it seems ‘testing’ has been abused by certain programs.” Insurance companies, he says, need to clean things up with regard to urinalysis. “Now insurance companies are clamping down,” he adds.

As far as “paying for clients” is concerned, Cartwright says it’s black and white: “Any form of remuneration, direct or indirect, is unethical, period.”

As a leader in the burgeoning addiction treatment space, Cartwright agrees that the industry is undergoing unprecedented growth and change.

He recognizes that the industry is relatively young—“It didn’t really get rolling until the 1960s with Hazelden and AA”—and he believes the next fifty years will see enormous growth and maturation.

Cartwright predicts similar growth to that of the mental health field, from inpatient models to community based models; more professionalism; new models of treatment including medication-assisted therapy; and, above all, treatment outcome studies to determine what works with specific models of care.

Michael’s treatment philosophy is based on fifteen federally funded research studies on dual diagnosis and addiction. He has created a five-pronged approach that has been integrated into all of his treatment facilities. By applying these five essential elements, he believes any individual can beat any addiction. This philosophy is outlined in his book, Believable Hope (2012).

An avid fitness enthusiast, Michael has experienced firsthand the dramatic transformation possible through exercise, nutrition, and total mindset and lifestyle changes when he lost sixty pounds in five months.

Michael established one of the largest national conferences and, more recently, launched the Lifestyle Intervention, an annual national conference held in Las Vegas, Nevada which focuses on all lifestyle addictions including food, obesity, sex, pornography, gambling, smoking, and gaming.

There is no end in sight for Michael Cartwright. He is focused on his goal to provide endless resources to those who truly want to release themselves from the grip of addiction. ■

Gary Seidler is the cofounder of Health Communications, Inc. and U.S. Journal Training. He serves as the consulting executive editor of Counselor and the Industry Insider.

Industry Insider

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May/June 2016

4 Industry Insider

Chemical Dependency: Why a Multitiered Continuum of Care is Crucial to Relapse Prevention Thomas G. Kimball, PhD, LMFT

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or severe and complex cases of addiction, appropriate intervention, ongoing support, and recovery management services are necessary. Extending the continuum of care over several years can prevent relapse and have a positive influence on individuals, families, and communities. This continuity of care has the potential to empower many addicts toward full remission and longterm recovery.

Despite being armed with the knowledge that addiction is chronic, it continues to be treated acutely rather than with a chronic disease model. Expanding the continuum of care beyond treatment episodes is necessary to ensure high-quality and effective care. While extending care, it is necessary to find balance between the provision of excellent treatment for patients, fair compensation for providers and a sound return on third-party payers’ investments. By gathering longitudinal data, the continuum can be enhanced. These data can be used to create evidence-based treatment models and intervention plans, and potentially prevent relapse before it occurs.

Decades of funded research show that addiction is a complex and chronic disease of the brain. The prolonged and often relapsing nature of the disease complicates treatment. Current modalities include detox, acute hospitalization, residential treatment, partial-day treatment, intensive outpatient care, and transitional and sober living environments.

Acute care practices, when utilized, can be effective for the stabilization and remission of the disease. Due to the likelihood of patient relapse, particularly in the initial stages of recovery, the need for access to an enhanced continuum of care is crucial. This is particularly relevant within the initial twelve to eighteen months after treatment due to the potential for and risk of relapse.

According to Nora Volkow, MD, the director of the National Institute on Drug Abuse (NIDA), the organization’s research has proved that addiction “is a complex brain disease characterized by compulsive, at times uncontrollable, drug craving, seeking, and use that persist despite devastating consequences” (2010). Addiction also is a developmental disease that usually starts in adolescence or even childhood and can last a lifetime if untreated.

BARRIERS TO A CONTINUUM OF CARE MODEL

Good health and medical care are essential for overall wellness and increased quality of life. Currently, the structure of treatment and aftercare for addicts is not cost-effective for most families and may not fit within the new health care paradigm. The current model does not include the additional costs and resources required to extend the con-

May/June 2016

tinuum of care many addicts require.

Health care reforms are needed that include an emphasis on payfor-performance and long-term support and results. In decisions being considered and made in the chemical dependency arena, there is an obligation to individuals, families, payers, and payees to provide the most effective care at reasonable and affordable costs. Balancing best practices and feasible practices is a distinct challenge that begins with detox and extends to treatment and aftercare. A model needs to be created, offering a balance that would include more effective, sustainable treatment for addicts delivered in a more cost-effective way by providers and insurance companies.

Insurance companies have begun to demand more accountability and assurance that their providers are delivering predictable, cost-effective care. An increased demand for accountability will result in more patients receiving high-quality care with evidence that their chronic disease is appropriately managed over time. With higher quality chronic disease management, the need for readmissions will decrease, saving health care dollars and increasing quality of life for addicts and their families.

COLLECTING LONGITUDINAL DATA IS KEY TO PREVENTING RELAPSE

Effective, sustainable treatment is measured by gathering longitudinal data relevant to long-term recovery from addicts or alcoholics, their families, and other stakeholders. Ongoing personalized support for addicts and their loved ones provides value and a foundation of trust that allows quality data to be gathered over time. This consistent support is crucial to addicts’ overall abilities to maintain long-term sobriety and has the potential to prevent relapse. Data gleaned from these conversations result in quantifiable information.

With enough data gathered from individuals graduating from different treatment facilities across the nation, the field would be armed with powerful information. Recovery data of this nature results in a quantitative, evidence-based feedback loop where treatment decisions made today are informed by accurate and relevant information from those currently in recovery. This type of data also allows for patients and payers to fully understand where the most effective treatment is available and which provider will render the best services for certain kinds of addiction. Evidence and predictive accountability will change the understanding of how treatment is provided and how addicts will ultimately maintain long-term remission.

Prevention of potential relapse is possible, as many who suffer from addiction engage in similar behaviors and thought patterns that can be detected prior to a use event. Intervening prior to patients’ return

Industry Insider to use is the ideal prototype. When addicts relapse, supportive relationships in an aftercare environment enable appropriate care—early intervention could help mitigate the effects of relapse, potentially reducing relational and societal costs of addiction. Recovery professionals can create a better vision of the risk of potential relapse, while family members have an opportunity to engage in behaviors that increase the probability of success.

The field of chemical dependency, treatment, and recovery is at a crossroads. Decisions made today will impact treatment and recovery for the next generation. Treatment and aftercare support for the chronic brain disease of addiction must go beyond acute care and unstructured, inconsistent attempts to offer peer support. By extending and enhancing the continuum of care, a collaborative balance of quality services, sustainable outcomes, and cost-effectiveness can be reached among all vested parties: patients, family members, providers, and third-party payers. ■

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References Volkow, N. D. (2010). Comorbidity: Addiction and other mental illnesses: Letter from the director. Retrieved from https://www.drugabuse.gov/publications/ research-reports/comorbidity-addiction-other-mental-illnesses/letter-director

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6 Industry Insider

Industry Trends Quality Programs and Treatment Michael Walsh, MS, CAP, BRI-I

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hat’s going on? Are we going back to the future? Is this a market correction? There have been times lately when I really don’t know what to make of all that’s happening.

I read an article in another industry publication that basically said everyone should go to in-network outpatient facilities and stay in their homes because all out-of-network programs are run by criminals. First of all, to say all of anything is anything is ridiculous and appears to me self-serving, because what they are inferring is that one group is all bad and one group is all good—seriously? Secondly, I felt like I was watching a political ad that infers that we are all cattle without the ability to think critically or act responsibly, so we should just trust that all of something they label thinks or acts identically and everyone who has an opposing position is a communist, a liberal or a conservative. It’s amazing how so many people can be easily grouped into just a couple of categories!

There are some in-network facilities I have seen that do a remarkable job with the funds they work incredibly hard to recover from some payers (see, I didn’t say all payers). There are also some incredible out-of-network facilities that charge a bit more, provide an exceptional product, and also work extremely hard to do it “the right way” financially, clinically, medically, and yes, even in their marketing practices.

Granted, there are some providers that have taken advantage of the system and let greed and/or ignorance dictate their business practices.

There are also some people many of us would prefer to find another line of work as we don’t condone anything about what they do. Some of these “treatment providers” are not treatment providers at all; they are criminals and should be treated as such. Not unlike every other business that has experienced rapid growth, there are some who look to take advantage. As an example, watch the movies The Big Short (2015) and Wall Street (1987).

There are, however, many issues of concern I’d like to address, such as the difference between levels of care in treatment. I often see news stories or read columns which seem to use the terms “treatment center,” “halfway house,” “sober home,” and “recovery residence” interchangeably. This is wrong; these are distinct and different levels of care that are no more similar than a pair of sandals from a souvenir shop are to a nice pair of Italian loafers. They are not even remotely the same and not everyone should get the same. For example, if I said, “Go see a therapist,” wouldn’t you ask what kind? There are physical therapists, occupational therapists . . . you get the idea.

The gentleman who wrote the letter talking about how everyone should stay home and only do outpatient treatment may not have considered evaluating clients’ level of care needs by their specific client profile.

We recently treated a twenty-three-year-old woman who lived at home with her father and had an addiction to heroin. My clinical team would vehemently disagree that she would be well served by staying at home

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and enrolling in an outpatient program since she also had suffered severe trauma partly due to the fact that her own father had been sexually molesting her since the age of twelve. It was our opinion that this lady would be best served by attending a long-term inpatient program where she could address co-occurring addiction, trauma, and mental health issues in a safe environment. However, payers have concluded that she is “better” after a couple of weeks of inpatient treatment.

One particular payer has basically stopped paying out-of-network benefits and is listing a number of reasons. The reality is that these payers know that some people aren’t collecting or even attempting to collect deductibles and patient responsibility, so they are daring everyone to fight. At the same time, they increase deductibles and patient responsibility so the likelihood of patients being able to afford treatment out-of-network get slimmer. Next will be the annual reduction in in-network reimbursement and the growth in profit margins for them, followed almost immediately by their claims that they cannot make a profit. If any of this sounds plausible to you, read Deadly Spin by Wendell Potter (2011).

If all the out-of-network facilities in Florida closed, we wouldn’t have the capacity to treat Florida’s addicts, let alone all the ones coming here from all over the country. In addition, medical tourism will be impacted negatively and hospitals and jails will be inundated.

We are talking about the number-one killer of Americans and we know that treatment works. If we continue to stand by and let this continue, we may very soon have a shortage of available beds and find ourselves running out of Narcan.We should be working towards a system that encourages good treatment and pays for ethical, quality treatment. ■ Michael Walsh, MS, CAP, BRI-I, is currently the executive director and COO at HARP Treatment Center. He is the former president/CEO of The National Association of Addiction Treatment Providers (NAATP). He holds a master’s degree in substance abuse counseling, is a certified intervention professional and a certified addiction professional with extensive knowledge, experience, and understanding of the treatment industry.

References Gardner, D., Kleiner, J., Milchan, A., & Pitt, B. (Producers), & McKay, A. (Director).

(2015). The big short [Motion picture]. USA: Paramount Pictures.

Potter, W. (2011). Deadly spin: An insurance company insider speaks out on how corporate PR is killing health care and deceiving Americans. New York, NY: Bloomsbury.

Pressman, E. R. (Producer), & Stone, O. (Director). (1987). Wall street [Motion picture]. USA: 20th Century Fox.

Industry Insider

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Michael DeLeon:

Filmmaker, Author, and Activist

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ichael DeLeon made an extreme pendulum swing from addiction to recovery. He started out as a gangaffiliated criminal who spent nearly fourteen years in prisons and halfway houses. Now he’s an unfettered advocate and educator on the reality of drugs and poor life choices. He runs his own nonprofit, Steered Straight, to motivate and inspire kids, especially atrisk juveniles. DeLeon is also a filmmaker with two documentaries on the opiate epidemic—Kids Are Dying and American Epidemic—and he’s written a book, ItCan’tHappenToMeism, which came out in January 2016.

The Industry Insider’s editor, Stephen Cooke, sat down with DeLeon for an interview about his work and his opinons on recovery.

Insider: How long have you been in recovery?

DeLeon: I have been in recovery from drugs since May 29, 2003— twelve years and some change.

Insider: Did you have a specific turning point in your journey?

DeLeon: I had two turning points. I was clean from May 18, 1995, the day I went to prison, until about 2001, nearly eight months out of prison. I had an accident and broke my neck, which triggered my addiction again. When I got out of prison a second time, in June 2007, I had the most tangential turning point in my life: I knew it was going to be my last time. Four years later, in July 2011, I had a spiritual awakening that can’t be explained, but brought my entire life into focus.

Insider: Since then, a lot of your work has been about helping others who have struggled with addiction or those who are at risk for the disease. What motivates you?

DeLeon: “To whom much is given, much is required.” Everything in my life has come full circle through service and the act of giving back.

I got a second chance at a life that I did not deserve, but I became convinced that I was worthy of it. At that point my recovery became

crystal clear. My recovery is sustained through service to others, service to my community, and my dedication to that service. My passion has met my purpose.

Insider: You are working on a lot of fronts, with your nonprofit, documentaries, and books. What is the most challenging part for you?

DeLeon: My biggest challenge is wanting to do more than I physically can. I am impatient, and in some ways I think I am trying to make up for lost time. I get frustrated that I can’t get more done. Of all the obstacles to have, I suppose that’s not a bad one. But I often have to stop and reflect, and give up some things that I am working on.

Insider: What advice do you have for people starting the journey— the ones feeling intimidated, scared, and alone?

DeLeon: To never ever give up on recovery, no matter what. The worst times in recovery trump the best times in addiction.

In addition, we shouldn’t be complacently telling people early on that relapse is part of their journey. It doesn’t have to be, and coping with urges and cravings gets easier as recovery grows. And recovery will grow if we give ourselves a chance.

Insider: What do you believe is waiting for addicts on the other side of recovery?

DeLeon: What’s waiting for them? The life that their higher power destined them to live. True destiny in the form of meaning.

Insider: How do you define what it means to “thrive” in your recovery?

DeLeon: To thrive in recovery means to grow. Some simply survive in recovery, and that’s okay, but it’s not living to our full recovery potential. To thrive in recovery is to fulfill our true recovered nature. It’s taking the journey through recovery, even if we never reach a destination. ■ Read more about Michael DeLeon’s work at www.SteeredStraight.org.

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8 Industry Insider

SUD Talks Take the Stage Jeffrey C. Lynne, Esq.

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here is a common saying which is floating through the recovery community as of recently, which is that the opposite of addiction is not sobriety, but rather community. And science is continuing to support the notion that connectivity amongst human beings is a stronger buffer against relapse from substance use disorder (SUD) than abstinence and counseling—and perhaps medication-assisted treatment (MAT)—alone.

Continuing in this line of thought, the Delray Beach Drug Task Force and its visionary leader, Executive Director Suzanne Spencer, have continued to push this concept forward by holding the first ever “SUD Talks” (www.sudtalks.org) on Thursday, February 11, 2016, at the historic Crest Theater in downtown Delray Beach, Florida. Attended by the who’s who of the recovery community and coupled with progressive law enforcement, educators, civic leaders, business owners, and interested citizens, the SUD Talks was modeled after the ever-popular TED Talks, but with a subject focused upon how each individual in society is responsible for being their own “agent of change.”

Fulfilling its name as being the “Village by the Sea,” the City of Delray Beach itself was a major sponsor of the event, alongside “Visionary Sponsor” Michael S. Weiner, Esq., of the Weiner & Thompson law firm; “Idea Sponsor” Advanced Recovery Systems; “Thinker and Doer Sponsor” the Fred & Gladys Alpert Jewish Family & Children’s Services; along with The Hanley Foundation and The Home Depot.

“Moving,” “motivational,” and “inspiring” are just a few of the words repeated throughout the night, as the various speakers made presentations ranging from eight to forty-five minutes on topics such as The Hanley Foundation’s Dr. D. John Dyben’s discussion on “There is No Such Thing as a Discount Human Being”; Dr. Elaine R. Rotenberg’s conversation about “When Denial Becomes an Affliction”; to the main speaker for the evening, the nationally renowned conversationalist Dr. Carl Hammerschlag’s topic of “Healing in Community: Not Cutting Edge Nor Leading Edge, But ‘Healing’ Edge!” which led to a standing ovation.

Taking groundbreaking action in the recovery field is nothing new for the Delray Beach Task Force or for Mrs. Spencer. We hope this is simply the beginning of the next level of open community-based conversations to take place not only in Delray Beach, but countywide, statewide, and nationally. ■

Jeffrey C. Lynne, Esq., 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.

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Suzanne Spencer, director of The Delray Beach Drug Task Force, hatched the idea for SUD Talks and spearheaded its February launch.

Dr. John Dyben, spiritual director for Origins Behavioral Health’s Hanley Center, led the event modeled after the popular TED Talks.

Jeffrey Lynne, Esq. led a lively panel discussion with the speakers after each talk at the historic Crest Theatre.

Industry Insider

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Addiction: The Thief of Time Sherry Schlenke

This essay is dedicated to Barbara Theodosiou and her beloved son, Daniel Montalbano.

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hen my son died in 2013 of a twenty-year heroin addiction, I desperately needed a support network. Fortunately, I discovered The Addict’s Mom (TAM) on Facebook. TAM has been a lifeline for me, as I share my tragic story with other mothers whose own children have forced the devastation of addiction upon their families.

Following is a story that is very meaningful to TAM Founder Barbara Theodosiou; she wishes for it to be shared.

Since the beginning of recorded history, humans have wanted, or indeed needed, to find ways to keep track of time. Whether we consult the stars, rely on a sundial, make notches on tree bark or look at our watch, cellphone, computer, or bedside alarm clock, we humans mark the passage of time.

Time is especially important to us when we are expecting a child. We visit our physician on a regular schedule, we count the months and days until the baby’s birth, and during delivery, our labor pains are timed.

Then we bring our baby home, and we obsess over feeding times, nap times, and developmental milestones. Should he be crawling? Sleeping through the night? Potty trained?

Talking? We frantically consult our baby books to see if our baby is meeting expectations on time. We record every moment in the beautiful baby book that was a gift from our family: the age when we see his first tooth, his first solid food meal, his first words, his first haircut, his first day of school.

Barbara also recorded her baby Daniel’s milestones, which he reached at the expected ages. He was exceptionally bright, but as each year passed, Barbara noticed that Daniel’s behavior was different than that of her other children. Daniel became agitated easily, obsessing over seemingly unimportant things.

Barbara describes how he would measure a specific amount of shampoo and hair gel into his palm. He timed how long he scrubbed his hair, again making certain to be exact each time. Daniel’s day was marked in units of

time: he wrote poetry, sketched, and painted at the same time each day. If his schedule was disrupted, he became extremely nervous.

These ritualistic behaviors haunted Daniel at school, most especially during interactions with his peers. By middle school, Daniel had been bullied, beaten, and ostracized, completely misunderstood by everyone, with the exception of his devoted mother. He turned to drugs as a way to cope with his inner demons.

As Daniel began his tragic journey, he would discover that his time was no longer his own.

As we who have experienced the devastation of having an addicted child know very well, addiction is a thief of time. We lose time with our child when he is in treatment, in jail or homeless. He no longer spends any time with the family. In our quest to cure our child, we lose time with our spouse, our work, our friends and family, and most important, our other children.

In jail, Daniel was not permitted time to draw or paint or write. He couldn’t spend time measuring his shampoo or washing his hair.

How Daniel would spend every minute of every day was determined by others. His mother could visit at specific times. Time using the telephone was restricted.

As time passed, Daniel’s emotional state worsened. Upon release from jail, Daniel often relapsed. Then, he spent his time in a psychiatric hospital. In one instance, he asked his mother to buy him a watch, which was prohibited at the hospital. Daniel needed this watch for his own peace of mind, to avoid disruptions in his schedule. Knowing how restless and agitated he would become, Barbara lobbied fiercely for permission to bring Daniel an inexpensive

watch, which would help to alleviate his stress as a baby finds relief from his pacifier, blanket or favorite toy.

When Daniel was released from the hospital, Barbara asked him to give her the watch, so that it would not be lost, as he lost all of his possessions to the streets, to treatment centers or in prison.

Not only does addiction steal our family time, our holiday time, and our sleep hours, ultimately, addiction steals our child from us.

Barbara, as many of us have, watched as Daniel’s addiction gripped him mercilessly. He was powerless to overcome it, despite countless attempts at recovery. Daniel Francis Montalbano lost his young life in March of 2015.

After our child is gone, we spend time looking at his picture, remembering family times, and remembering our child before addiction stole his soul. After he has died, we spend our time weeping, feeling guilty, and grieving.

Often, hours will pass as we do nothing; we simply stare into the empty spaces, while our heart slowly crumbles into pieces.

For those of us who remain among the living, we must find ways to cope with our loss.

Barbara, as all mothers do, keeps cherished mementos from each of her children. The clay handprint, the crudely drawn finger painting, the reindeer made from a clothespin. And in Barbara’s special cabinet, placed with the keepsakes of all of her children, is a beaten and battered watch face. The strap is missing, the crystal is chipped, and the screws and pins are lost. As Barbara gazes at the watch, she remembers her Daniel, and his brief life.

A troubled life, a tragic life, and a life in which there was not enough time. ■ Sherry Schlenke 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. Sherry and her husband tried every means possible to help their teenage son recover from heroin addiction, but 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 now serves as an executive assistant to the founder, Barbara Theodosiou.

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10 Industry Insider

AROUND THE

STATES

NEVADA:

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truggling and overcoming his own addictions, Joe Engle launched the Las Vegas chapter of the group There is No Hero in Heroin (TINHIH).

The organization puts on annual events to raise awareness about addiction.

According to his biography on the TINHIH website, since the death of his son, Reese Engle, who died in July 2011 from a heroin overdose, Joe “has been involved in many service and community involved projects including events for The American Cancer Society and various drug and alcohol addiction related programs. After his son passed in 2011, Joe has been seeking a way to help other families afflicted by similar tragedies, and to help addicts suffering and in need.”

The face of the modern heroin user could be any eighteen- to twentyfive-year-old, regardless of gender, ethnicity or socioeconomic status, said Dr. Mel Pohl, medical director of the Las Vegas Recovery Center (LVRC).

Pohl estimates 30 percent of LVRC’s patients are twenty-five years old or younger and, among them, heroin is the primary drug. These heroin addicts generally come from affluent or reasonably successful families, have previously been functional members of society and often are in relationships, he said.

Engle says the goal of his organization is also to help raise funds for people to go through rehabilitation. He says he draws inspiration from his son, who didn’t have the chance to escape the cycle of addiction.

“All the awareness that we have brought on, all due to him,” he said.

“So, his memory is living on, and he’s making an impact in this world.”

Since Engle launched his organization, he has paid for room and board at sober living houses for fifteen people. He says the next step is

INDIANA:

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advocating for easier access to treatment facilities. One day, he says he hopes to open a recovery high school that can give full focus to teens trying to beat addiction. ■ Source: http://www.tinhihlasvegas.info/who-we-are-1.html

ABBIE HOFFMAN’S NEPHEW ADVOCATES AT HOLISTIC HOUSE

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ustin Hoffman believes that he was able to defeat his addiction with a natural ingredient found in certain plants known as ibogaine, and now he has found a calling to help others and does just that by welcoming suffering addicts into his home.

Hoffman went from a recovered addict to a philanthropist, and opened Holistic House last year to help other addicts and spread the message of holistic medicine. Like his uncle, Abbie Hoffman, who stirred the world as a political and social activist, Justin aims to make a positive contribution to society.

Hoffman’s path to recovery—postibogaine aftercare—requires a rigorous schedule of daily yoga, exercise, and organic, home-cooked meals.

These healthful meals are prepared by in-house chef and Holistic House graduate Julian Mesa for each of the residents, but Hoffman also has a commitment to keeping clients active outside its residence. “Sometimes, maybe once a week, we take them out for pizza and a movie.

It kind of keeps them grounded, and reminds them that there’s still a world out there,” he says.

Throughout their program they include activities such as going on nature hikes at Red Rock Canyon, Mount Charleston, and other landmarks located in Las Vegas. ■ Source: http://www.prweb.com/releases/lasvegas/holistichouse/prweb13219760.htm

ndiana Governor Mike Pence says the state is taking a “three-legged stool approach” to confronting drug abuse and addiction in Indiana by making more treatment options available, strengthening law enforcement, and increasing prevention efforts, signing a full slate of bills aimed at curbing illegal drug use in Indiana.

Representing the treatment leg of that stool is a bill making naloxone, the narcotic overdose nasal spray commonly known as Narcan, more widely available across the state.

“We are today, through this effort, making life-saving medications available that have saved lives, and will continue to save lives from overdose in the state of Indiana,” Pence said during a bill signing ceremony at Hope Academy, a drug recovery high school in Indianapolis. The governor also affirmed that Indiana State Police will be fully trained and able to deploy Narcan.

Among the seven drug-related bills Pence signed, one focused on enforcement says someone convicted of repeated drug dealing felonies cannot get suspended sentences. Another, aimed at prevention efforts, adds restrictions to the sale of pseudoephedrine, a key ingredient in meth production. ■

May/June 2016

Industry Insider 11 NEW HAMPSHIRE:

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overnor Maggie Hassan has enlisted New Hampshire’s top drug prosecutor to oversee the state’s response to the ongoing opioid and heroin crisis.

James Vara is a senior assistant attorney general who has led the drug prosecution unit for three years. He primarily deals with felony drug prosecutions and drug-related death cases. He is expected to take on the role of Governor’s Advisor on Addiction and Behavioral Health, sometimes informally known as the ‘drug czar,’ in early April. He also sits on the opioid task force of the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery.

More than four hundred people died from drug overdoses in 2015, with many the result of overdosing on fentanyl, a drug that is far more powerful than heroin. Deaths have continued to climb since 2013.

Duties of the job include making sure state agencies from corrections to justice are effectively working together and identifying gaps in New Hampshire’s prevention, treatment, and recovery efforts.

Funding for the job is created through a one-year grant by the New Hampshire Charitable Foundation. Vara replaces Jack Wozmak, who resigned from the job earlier this year after facing scrutiny over his performance. Hassan’s office said Vara is a strong choice for the job because he is well respected by lawmakers, law enforcement, and addiction recovery and treatment professionals statewide. ■ Source: http://www.wcax.com/story/31528328/hassan-taps-top-drug-prosecutor-as-new-drug-czar

NACOA President and CEO Sis Wenger with Emerald Spirits Award winner Dr. Patricia O’Gorman.

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ober St. Patrick’s Day celebrated its fifth consecutive year in New York and the pivotal part of the program—and indeed the March 17 party that proves that sobriety can indeed be fun— was the presentation of The Emerald Spirit Award.

The 2016 Emerald Spirit Award was presented to NACoA founder Patricia O’Gorman, PhD, by Executive Director William Spencer Reilly during Sober St. Patrick’s Day NYC. The award is given annually to honor extraordinary dedication and devotion to improving the lives of family members of alcoholics and addicts.

Dr. O’Gorman accepted the award for her work in focusing national attention on Children of Alcoholics. A best-selling author, psychologist, and international speaker known for her warm and funny presentations, Dr. O’Gorman did not disappoint at a boisterous Irish celebration after the parade in Manhattan.

“I want all to know of this powerful, international movement, Sober St. Patrick’s Day, whose goal is to have this holiday again become a family celebration without the alcoholic madness,” said Dr. O’Gorman in accepting the award at The New York Irish Centre (NYIC) in Queens, New York.

The event was founded by William Spencer Reilly in 2012 as a fun celebration about the best of the Irish and Dr. O’Gorman was keen to place it in historical context: There is nothing like getting an award to make you pay attention to the group that is giving it. This was my experience when I was told I was receiving the Emerald Spirits Award from Sober St. Patrick’s Day. Sober St. Patrick’s Day? I had vaguely heard of the group, but now I needed to learn more. What I found surprised and excited me so much that I need to share it with you.

Sober St. Patrick’s Day has the goal of returning this holiday back to its roots as a family day and move it away from an annual bar crawl or “It’s great to get drunk” day. But its goal is not no drinking, its goal is no drunking. The hope is to make this a happy family day instead of the day so many of us dreaded as children, due to the violence in our families this day represented. ■

May/June 2016

12 Industry Insider

Testing Matters The State of Urine Drug Testing in Behavioral Health in 2016 Brian P. Crowley

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uring the first quarter of 2016, I travelled extensively, meeting various stakeholders to discuss new changes in drug testing that are creating new challenges and disrupting business models, health plans, and payment methods. Part of our collaborative conversation is focused on changing the mindset about the role of drug testing from that of a commodity service of lab results to a vital resource of clinical value, integral to patients’ complete continuum of care.

In February at the 37th Annual Training Institute for Behavioral Health and Addictive Disorders, I facilitated a discussion panel with a diverse number of stakeholders to share our perspectives on where drug testing is headed for 2016. The opinions were varied, yet the central theme was that the need for urine drug testing in behavioral health continues to grow in influence and importance to the majority of medical and clinical decisions.

There has long been much confusion among physicians and clinicians about what drugs should be tested, using what technology, and to what extent should certain classes of drug be tested when under certain levels of care. Questions regarding frequency of testing are very much a relevant topic, since the confusion originated from the lack of clear, credible, medical, and clinical guidelines surrounding drug testing.

This confusion has been exploited by a small number of providers who have profited immorally. As a result, we created a payer tug-of-war.

One provider described a payer’s actions as having created a “napalm effect” on the commercial out-of-network substance abuse community, especially in Florida. The activities by payers may only temporarily contain the problem, until it morphs into a much bigger problem. The impact of these changes will continue to have a profound effect on providers and patients—some good and some not so good.

Reforming the drug testing market will be first and requires a multiphased approach, beginning with education and vision. Then there should be accountability with real consequences, courage, humility, patience, persistence, and a real commitment from stakeholders to collaboratively create real solutions to very real problems. These complex problems need to be identified and prioritized collectively; meaning that payers and providers need to come to the table and begin an open dialogue as we begin to rebuild a bridge of trust and not a firing range in the court room.

A comprehensive solution must be installed so stakeholders can focus on providing high-quality care, instead of continuing to overburden health systems dealing with overutilization, fraud, and abuse. Reform will take place in the form of better access to qualified and shared in-

May/June 2016

formation, leveraging technology to improve outcomes, and automating decision making in certain circumstances when it comes to drugs tested, frequency, and duration of testing based on treatment plan.

How these market dynamics will impact the lab business is our focus. Here’s a breakdown of what I envision happening in the testing business for 2016.

•• For larger providers and health networks in the making, the question of a make-versus-buy approach to get into the lab business will be white hot. Creating a centralized laboratory operation carries significant risk and will require competent due diligence into risks, compliance, ownership, structuring, operations, technical expertise, and health IT to determine the full cost of delivering care and quality.

•• Payers moving to an in-network or bundled-per-member rate will motivate out-of-network providers into some form of hybrid evidence-based, shared risk or possibly a capitation payment model. If they attempt to push providers straight into in-network, this may stall the adoption process. Finding a transitional hybrid model with retrospective reimbursements in place while piloting future delivery models will be paramount for care, cost, and quality if payers and providers are going to be able to optimize delivery of care. The total cost of patient care as substance abuse and mental health is integrated into the total care continuum model has yet to be fully understood and implemented.

•• A new paradigm for urine drug testing (UDT) will redefine its value by becoming a best-in-class outcomes asset to the health system it serves. When behavioral health integrates into the comprehensive care model, drug testing will have a profound effect on managing other chronic diseases. Data analytics will support strategic decisions in care delivery as drug testing and labs become a more vertically integrated component of the health care network.

Rumors are rampant about provider closures, lawsuits, and investigations. Action on the payer side is evidenced by multiple reports of extensive audits for drug testing services, labs, and treatment services.

The limits on drug frequency are creating additional problems for providers and patients, such as increased risk and liability issues when testing is denied at admissions for what is considered an essential, initial baseline test. Without mutually agreeable universal standards and protocols, payers are facing additional costs of doctor-to-doctor prior authorizations, denials, appeals, and lawsuits. They are also experiencing lengthy and expensive disputes defending their position when attempting to claw-back prior reimbursements paid. All the while, both sides are still very much a distance away from agreeing on what makes delivery of care better and positively impacts the bottom line.

Industry Insider 13 America needs us to make this work; we have too many people struggling with addiction who need care. We have the people and the power to create change, but we seem to be lacking the conviction. If improving patient care is truly our number one value and priority, then stakeholders must begin to rebuild trust and be accountable to each other and to patients, the customers. We all have to do our part, it’s that important!

Over the last two years I have invested a lot of time and money attempting to create sustainable solutions for some of the bigger issues in drug testing for behavioral health.

I’m excited to say that we have a plan and are developing tools, concepts, and approaches that have real potential to be a game changer for health care. Stay tuned for more on this in future issues of the Industry Insider’s “Testing Matters” column.

Now back to the new 2016 drug testing fees and protocols. I said it starts with education; this means getting your own house in order when it comes to understanding and implementing the new medical necessity guidelines for 2016. Here’s the first insight about the new paradigm in drug testing: reading it in some article is not going to cut it. Health professionals need formal training in this crucial skill and providers and payers need to step up and make it happen. Beginning in April, we will be launching the 2016 Urine Drug Testing Medical Necessity Training series. The launch will be part of the inaugural episode of “Testing Matters TV,” a video podcast show hosted by myself and special guests from the payer and the provider sides.

In this training you will learn about drug testing fundamentals such as: •• •• •• •• •• •• ••

Clinical value of substance use testing New language for a new paradigm Identifying and treating substance use disorders Risk stratification for UDT Drug selection and cross-reactivity Recommendations for proper utilization of UDT Critical success factors

Sign up now at www.testingmatterstv.com to register for the prelaunch webinar and get engaged! The event is limited to one hundred seats. When you sign up, you automatically enter a contest to win a free Testing Readiness Assessment worth $5,000! ■

The Man Who Never Wrote a Song John McAndrew

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orking in treatment centers all these years, I’ve had a frontrow seat to how music affects the brain, the body, and the spirit. It never ceases to amaze me when people wake up and start their healing process right in front of my eyes.

I want to share a story of something that happened recently at Cumberland Heights in Nashville, Tennessee, where I work.

The process always starts with meeting people where they are, musically and spiritually speaking. We start by playing music together and getting comfortable with each other. Next we talk honestly about where they are in their recovery. One particular patient played guitar, but not for long, and was not very confident in his abilities. I made sure he knew that what he did know was good. Our talks made it clear to me that he was ready to start a new life.

I asked this patient to start journaling about his thoughts and feelings and bring them next week to start writing a song. He replied, “I’ve never written a song, do you think I can?” My response was, “I know you can.”

The next week he brought in some lyrics, and we took pieces of those and added others, and then started with some easy piano chords so he could join in on guitar.

We talked more about his powerlessness, and he said, “I ain’t going back!”

That became his working title, and the song flowed out of him after that. The voice he found was new to him, and it was fun to see him smile about how well he could sing. We finished the song and did a rough recording so we could save the work.

The following week, during Spiritual Emphasis Day at Cumberland Heights, patients got an opportunity to get up and do creative things in front of the whole population. On this afternoon, the man who never wrote a song—let alone performed in front of people—got up and played his song.

It was amazing to see him find things inside himself he never knew were there, and when the standing ovation faded, he was in tears. In his place now stood a man who had made his first real commitment to recovery and to the solution.

It happens over and over again, and it is a testament to the power of the human spirit and the power of music. I’m blessed to have that front-row seat. ■

Brian P. Crowley is founder of Integra

John McAndrew is a singer/songwriter and piano player from St. Paul, MN

Enterprizes, a brand of companies designed to

who currently lives in Nashville, TN. John was recently honored by NAADAC with

raise standards in health care through better

the 2012 Presidents Award for his work nationally in the field of recovery. While

integration of medicine, technology, and data.

touring, John speaks and performs for audiences across the country, working

He has extensive insight and experience in the

regularly with Cumberland Heights in Nashville, TN, WestBridge in Manchester,

business of behavioral health, specifically drug

NH, Hazelden in Center City, MN, Cirque Lodge in Sundance, UT, and English

testing, strategic business, and leadership

Mountain Recovery in Sevierville, TN. John’s newest CD is called “Forgiven.”

development. Currently, he is chairman of the FBHA, Committee on Laboratory Services.

May/June 2016

14 Industry Insider

Pioneers We Have Lost William L. White, MA

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t seems a fitting time to add pioneers we have lost to honoring recently deceased leaders who exerted great influence on the history of addiction treatment and recovery in America. Here is a sampling of the men and women who made a difference in the addiction field through their life’s work.

MICHAEL BOYLE (1947 2015)

Michael Boyle was chief executive officer of Fayette Companies, a behavioral health organization in Peoria, Illinois. He was a leading champion of evidence-based addiction treatment and the integration of mental health and addiction treatment services. He conceived and led the Behavioral Health Recovery Management Project, which exerted a great influence on the emergence of recovery management and recovery-oriented systems of care in the United States.

AUDREY CONN KISHLINE (1956 2014)

Audrey Kishline founded moderation management in 1994 to promote a moderation-based approach for nondependent problem drinkers. Media coverage of her book and presentations, her continuing personal struggles with alcoholism (including the deaths of two people in an alcohol-related car crash), and her subsequent tragic death all fueled debates about abstinence versus moderation as approaches to the resolution of alcohol problems.

through Storytelling (2015). Dr. Kurtz was the consummate AA historian and devoted the later years of his life to exploring the growing varieties of AA experience and alternative pathways of addiction recovery.

NANCY K. MELLO, PHD (1935 2013)

Dr. Mello cofounded the Alcohol and Drug Abuse Research Center at McLean Hospital and worked in the field for more than forty years. She and her husband, Dr. Jack H. Mendelson, conducted numerous studies on alcoholism and also published the first study on the potential use of buprenorphine in the treatment of opioid addiction.

WILLIAM O’BRIEN (1924 2014)

William O’Brien cofounded Daytop Village in 1963 and became a leading figure in the movement to develop therapeutic communities for the treatment of drug addiction. He helped establish therapeutic communities in more than sixty countries and was one of the founders of the World Federation of Therapeutic Communities.

DONALD EDWARD “MICKEY” EVANS (1932 2014)

GARRETT O’CONNOR, MD (2015)

Donald “Mickey” Evans was the founder of Dunklin Memorial Camp—a faith-based refuge or recovery colony for men seeking recovery from addiction—in rural Florida. Mickey’s life and service were very influential in the Christian recovery movement and reflect the long history of resources outside the traditional treatment system to help those affected by addiction.

Garrett O’Connor served as medical director of the Betty Ford Center’s licensed professionals treatment program, chief psychiatrist of the Betty Ford Center, and president of the Betty Ford Institute. He taught in the Departments of Psychiatry at the Johns Hopkins University School of Medicine and at UCLA. He was a champion of addiction training for primary care physicians and psychiatrists and had a deep interest in the cultural roots of alcoholism among the Irish.

JIM GILLEN (1954 2015)

DAVID POWELL, PHD (1945 2013)

Jim Gillen served as director of recovery services at the Providence Center in Providence, Rhode Island. He was a leading figure in the rise of a news recovery advocacy movement and the development of local recovery community centers.

WILLIAM GLASSER, MD (1925 2013)

Dr. Glasser was a psychiatrist whose development of reality therapy exerted a profound influence on the treatment of addiction in the mid-twentieth century, particularly treatment within the growing network of therapeutic communities and Minnesota model alcoholism treatment programs.

ERNIE KURTZ, PHD (1935 2015)

Dr. Kurtz is best known for his books Not God: A History of Alcoholics Anonymous (1991); Shame and Guilt: Characteristics of the Dependency Cycle (2007); and Experiencing Spirituality: Finding Meaning

May/June 2016

At the time of Dr. Powell’s death, he was teaching within the Department of Psychiatry at Yale University School of Medicine. He faithfully served the addiction field for more than four decades and was best known for his pioneering publications and presentations on clinical supervision, and for his efforts to train addiction professionals in more than eighty countries. His books include Clinical Supervision in Alcohol and Drug Abuse Counseling (2004) and Clinical Supervision: Skills for Substance Abuse Counselors (1980).

BENY PRIMM, MD (1928 2015)

Dr. Primm was the founder and long-tenured executive director of the Addiction Treatment and Research Corporation in Manhattan and Baltimore. He was a forceful public health advocate during the early days of the AIDS epidemic, a highly respected proponent of medicationassisted treatment of opioid addiction, and a longtime leader within the American Association for the Treatment of Opioid Dependence. He also

Industry Insider 15

served as director of the Center for Substance Abuse Treatment.

MAX SCHNEIDER, MD (1922 2014)

Dr. Schneider was a leading figure in addiction medicine for more than fifty years. He was also well known for his leadership on the boards of the California Society of Addiction Medicine, the American Society of Addiction Medicine, and the National Council on Alcoholism and Drug Dependence as well as for groundbreaking films on addiction that were widely used to educate patients, addiction professionals, and the public.

ED SENAY, MD (1927 2014)

Dr. Senay was a pioneer in addiction medicine, who, in collaboration with Dr. Jerome Jaffe, championed a multimodality system of addiction treatment within the Illinois Drug Abuse Program that was widely replicated in the 1960s and 1970s. He mentored generations of aspiring addiction professionals (including myself), and published innumerable papers and four books.

BARRY STIMMEL, MD (2014)

Dr. Stimmel was the founder and longserving director of the Mount Sinai Narcotics Rehabilitation Center and the founding editor of the Journal of Addictive Diseases. He also served as a consultant to the White House Office on National Drug Control Policy. His

books included Alcoholism, Drug Addiction, and the Road to Recovery: Life on the Edge (2002) and Pain and its Relief without Addiction: Clinical Issues in the Use of Opioids and Other Analgesics (1997).

DOUG TALBOTT, MD (1924 2014)

Dr. Talbott was the founder and first medical director of Talbott Recovery Campus, an Atlanta-based addiction treatment program that specialized in the treatment of impaired physicians and other impaired professionals.

Dr. Talbott was a key figure in the early development of the American Society of Addiction Medicine.

BETTY ANN WEINSTEIN, PHD (1941 2013)

Dr. Weinstein taught at the Catholic School of Social Work and the Rutgers Summer School of Alcohol and Drug Studies. Generations of students benefited from her papers and presentations on new diagnostic tools and the clinical management of denial.

CHARLES WINICK, PHD (1922 2015)

Dr. Winick was a sociology professor who challenged prevailing views of heroin addiction in the 1960s with his New York State Narcotics Commission studies concluding that most people addicted to heroin “matured out” of addiction without professional assistance. He

also collaborated with Dr. Marie Nyswander on developing a clinic for the treatment of addicted jazz musicians in New York City and served during the 1950s on the board of the National Advisory Council on Narcotics—the umbrella organization of Narcotics Anonymous in New York City.

There is a way that the reach of our lives can be extended through the influence we exert upon others and, if we are fortunate, on the larger unfolding of history. The men and women previously mentioned are among those who achieved such extended influence. That reach is something to which we can each aspire. ■

William L . W hite, M A, is an Emeritus Senior Research Consultant at Chestnut Health Systems/Lighthouse Institute and past chair of the board of Recovery Communities United.

Bill has a master’s degree in addiction studies and has worked full-time in the addiction field since 1969 as a streetworker, counselor, clinical director, researcher, and well-traveled trainer and consultant. He has authored or coauthored more than four hundred articles, monographs, research reports, and book chapters and seventeen books. His book, Slaying the Dragon: The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery.

May/June 2016