inRecovery by In Recovery Magazine

The #1 Resource for Addicts and Their Families

SEPTEMBER/OCTOBER 2017

ANIMAL THERAPY Itâ&#x20AC;&#x2122;s Finding Success In Addiction Treatment

Overcoming

TRAUMA The Candid Interview with

BRIAN CUBAN: THE ADDICTED LAWYER Our National Obsession with

SOCIAL MEDIA

The Silent Consequence of Addiction

ADDICTED BABIES

More Online at www.InRecovery.com

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9/5/17 11:19 AM

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InRecovery Magazine September 2017

InRecovery.com

9/5/17 11:20 AM

Taking Responsibility for Addiction From the CEO’s desk:

JEFFREY FIORENTINO, MAcc

recently got into a conversation about the opioid epidemic with my sister who is a doctor and an OBGYN, and gave birth this year via a Caesarean (a/k/a C-section). She shared some eye-opening insights about her own personal experience and the changes in prescription practices at the big city public hospital where she is the chief resident. The good news is that prescription practices are clearly heading in the right direction. A typical mother leaving the hospital will be given one week’s worth of percocet for the pain after a C-section, while in the past it was for as much as a month. As for my sister, who is keenly aware of the potential for addiction, she got by on just one day of Tylenol 3 after discharge. This greater concern and mindfulness seems to be spreading throughout the country with respect to all opioid prescriptions in general. The US Centers for Disease Control and Prevention noted that the amount of opioids prescribed per capita peaked in 2010 and declined by 18% by 2015, with 13.1% of that decrease coming between 2012 and 2015. Much of that reduction occurred as a result of increased awareness in the medical community and some key action at the state level. National medical guidelines on opioid use and state prescription drug monitoring databases have played a big role. Doctors are now prescribing opioids for a shorter duration and in lower doses than they have in the past. Recent focus on “Pill Mills” by the Justice Department has also helped considerably. Three recent high-profile arrests single-handedly eliminated enterprises responsible for the distribution of almost 15 million opioid tablets. Nonetheless, the amount of opioids prescribed in 2015 is still triple the amount of opioids prescribed in 1999. It seems we still have a ways to go before we can start patting ourselves on the back. Another pressing issue is that lower prescription rates have merely pushed people who are addicted to heroin and other illicit street drugs, instead of toward treatment. I’ve written about this a number of times before, because it’s so important. Many unsuspecting people with legitimate InRecovery.com

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pain issues inadvertently become addicted through exposure to opioids. When a responsible doctor then cuts them off, they turn to more dangerous options. The main problem is two-fold. Doctors typically don’t ask patients about past history of addiction in the family in an H&P (History and Physical) like they would for heart disease or diabetes. That’s a big omission because addiction in a parent is highly predictive of potential addiction in a child; 40% if one parent was an addict, 70% if both were. Moreover, these patients-come-addicts don’t inform their doctor about the problem once it arises. The vast majority of people who are prescribed opioids, over 90%, do not become addicted, so most doctor’s do not focus on the importance of asking patients whether they need addiction treatment, once the prescription has run its course. Most mothers post-caesarean do not have an issue, whether given 7 or 30 days worth of pain killers. However, for the less than 10%, who are pre-disposed to the disease of addiction, it can be tragic and fatal. Opioids, heroin and fentanyl have that kind of grip on them. These people did not choose to become addicted by purposely ingesting something to trigger their disease, they mostly had addiction thrust upon them. I had a kidney stone last year; it was the most painful experience I’ve ever had. Some people describe it as similar to giving birth. I left the hospital with 30 days of oxycontin, prescribed by a well-meaning specialist concerned about my pain. I took it for one day and turned in the rest to my local pharmacy, deciding to grin and bear it. Just like my sister, I didn’t want to take any chances because addiction runs in our family and I know better than to put myself at that kind of risk; most people don’t. It got me to thinking that every prescription of opioids should come with a mandatory warning directly from the doctor or the requirement of viewing a brief video on the dangers of addiction from opioids. At least we’ll be doing something proactive about solving this problem and saving lives in the process, and with today’s smartphones, it’s an easy implementation. There are some other measured advances that also give us hope. Under the Comprehensive Addiction and Recovery Act, federal spending to combat the opioid ep-

idemic has increased 542% at Health and Human Services and 113% at the Justice Department. The 21st Century Cures Act approved $1 billion of additional spending toward this problem, over a two-year period. Even current Republican proposals on healthcare (if they ever get passed) dedicated as much as $45 billion to specifically combat opioid abuse, spread out over 10 years. But, as their fellow Republican and likely 2020 primary candidate, Ohio Governor John Kasich notes, it’s “like spitting in the ocean,” not nearly enough. The issue has become so pervasive that even large investment banks are weighing in on the subject. Goldman Sachs came out with a report in July indicating that the US workforce, and economy in general, is being dragged down by opioid abuse; something I wrote about back in June. “So, where’s this all leave us? Addiction is a disease, but as with all other diseases it requires a group effort. A combination of government funding, private enterprise, informative education from the medical community and, ultimately, personal responsibility, turned AIDS from a death sentence that killed 49,000 people at its peak in 1995, into a very treatable disease that most people now survive. That’s exactly the type of attention demanded by addiction. Government, the addiction treatment community, and general healthcare need to get on the same page and do their part. But, much like my sister and I, who made conscious decisions not to take chances with addiction, and the AIDS, diabetic and cancer patients, who actively pursue treatment, people at risk of addiction or in recovery need to do their part as well. If you are in recovery, or addiction runs in your family, you need to inform your doctor prior to taking any medications. Ask about non-addictive pain killer options and pursue physical therapy in the form of yoga and massage, as alternatives. We need everyone engaged to finally start putting addiction in its place.” Jeffrey Fiorentino is a writer, teacher and speaker in the areas of Business, Technology, and Addiction. He is the CEO of Kipu EMR, an electronic medical records system built specifically in, and for, Addiction and Behavioral Health Treatment. Mr. Fiorentino is also CEO of InRecovery Magazine, and CEO of PingMD, an Android and IOS telehealth app for connecting addicts in aftercare with their addiction treatment professionals.

InRecovery Magazine September 2017

9/5/17 12:22 PM

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9/5/17 11:25 AM

Let’s get back to a brighter future. We are RECO, one of South Florida’s most trusted addiction treatment providers. Since our founding, RECO Intensive Outpatient Program has been a leader in the addiction treatment field. At RECO, we believe that each individual is unique. Consequently, each treatment plan and metamorphosis in recovery must be unique, too. As we work to recreate joy and to instill patience, self-awareness, and responsibility in those who are suffering from addiction and co-occurring disorders, we understand and address the specific intricacies of each individual’s history.

Through our utilization of therapeutic techniques, distinctive group programming, and aftercare, we aim to create an environment that facilitates progress in recovery and emboldens clients within their newfound independence from addiction.

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9/5/17 11:25 AM

Top of Mind Opioids In Paradise

932

Opioid Deaths in 2016

Palm Beach Opioid involved deaths spiked from 143 in 2012 to 932 in 2016.

21%

Heroin Deaths in 2015

Palm Beach County led the state of Florida in 2015, registering 21% of all heroin related deaths.

Mar-a-Lago a ‘poster city’ for the nation’s opioid epidemic Opulent Palm Beach, Florida. Home to President Trump’s winter White House, Mar-a-Lago, playground for some of the nation’s wealthiest families and, as it turns out, a ‘poster city’ for for the nation’s opioid epidemic. The concerning facts were laid bare in a recent report issued by the County Commissioners.

100% 90 2,598 Increase...

Overdoses

Palm Beach babies born with Neonatal Abstinence Syndrome (addicted) doubled from 2010 to 2014.

$205,000

One medical center alone, the JFK Medical Center, in Palm Beach recorded 90 overdoses in 91 days.

Spending on Naloxone

Spending on naxolone increased from $18,000 in 2012 to $205,000 in 2016 in Palm Beach.

Naloxone Cases

Palm Beach County performed 2,598 naloxone* administered rescues in 2016, up from 420 in 2015.

This is a tragic reminder that addiction knows no bounds, it respects neither race nor wealth. It will take a concerted effort from all of us to turn this around.

*Naloxone is an emergency use chemical, commonly commercially marketed as Narcan, that can stop opioid effects in their tracks provided the overdose is caught early enough and given in sufficient dosages to counteract the amount of opioid ingested.

InRecovery Magazine September/October 2017 Issue CEO Business Development Creative Director General Manager Production Manager Copy Editor Marketing Director Subscriptions Layout/Design Dear Dr. Josh Contributing Writers

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Jeffrey Fiorentino Kim Welsh Dan Brown Bruce Matthews Nestor Suarez Marieke Slovin Nestor Suarez PFS Mags Errol Naraine Dr. Josh Lichtman Becky Sasso Michael Rohrs Gary Barba Gilbert Fiorentino Lawrence Hartman J. D. Claremont Mary Patterson Broome Dana Bowman Paul Fuhr Lindy Ariff Dr. Danielle Delaney Lisa Strohm, J.D., PhD. Linda DiGloria

InRecovery Magazine September 2017

444 Brickell Avenue, Suite 850, Miami, FL 33131 InRecovery.com

InRecovery Magazine is published 6 times a year by InRecovery Magazine, LLC, 444 Brickell Avenue, Suite 850, Miami, Fl 33131. Subscription rates (US dollars): 1 year $9.99. Single copies (prepaid only): $5.99 in US, $5.99 in Canada and Mexico and $9.99 in all other countries. All rates include shipping and handling. See website for subscription details. The magazine is published by founder Kim Welsh, printed in the US by American Web and distributed by Disticor Magazine Distribution Services. ©2017 InRecovery Magazine, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including by photocopy, recording, or information storage and retrieval without permission in writing from the publisher. For use beyond those listed above, please direct your written request to Permission Dept., email: editor@inrecovery.com InRecovery Magazine does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses and other damages incurred by readers in reliance of such content. Publication of any advertisement is not to be construed as an endorsement of the product or service offered. InRecovery Magazine (IRM) reserves the right to editorial control of all articles, stories and letters to the Editor. InRecovery Magazine assumes no responsibility for errors within its publication. The opinions expressed are those of the authors and do not necessarily represent the policies of IRM and should not be construed as endorsements. Furthermore, IRM will not be responsible for any claims, losses or damages (whether direct or indirect) arising out of or relating to the use of or reliance on the contents of this magazine.

InRecovery.com

9/5/17 12:23 PM

Doctor-owned, medically supervised mindfulness-based addiction treatment program located in Orange County, CA

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Rehabilitation Groups

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At Satori Recovery Center, we believe that individuals are not broken but that they have lost balance in their lives. Our mission is to take a “whole-person, whole-life” approach by offering a transformative treatment program to enable clients to regain balance in their lives. By bringing about a conscious state of awareness, our clients learn to engage in the present while letting go of recurring thoughts about the past and worry about the future. Mindfulness meditation practice allows an individual to be present in their life experiences and is a primary teaching at Satori Recovery Center. All clients are instructed in the practice of meditation and are encouraged to experience conscious states of deep silence and surrender. The transformative effect of meditation greatly improves impulse control and frustration tolerance. Balance is achieved by waking up to the present moment, hence the name Satori, which means “Awakening”.

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2760 Park Ave. Laguna beach, CA 92651

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InRecovery Magazine September 2017

9/5/17 11:27 AM

Articles

The #1 Resource for Addicts and Their Families SEPTEMBER/OCTOBER 2017

COVER Animal Therapy

ANIMAL THERAPY

IT’S FINDING SUCCESS IN ADDICTION TREATMENT

IT’S FINDING SUCCESS IN ADDICTION TREATMENT The best thing about dogs is that they are great companions. Even when it takes a patient a while to come around, the dog is forgiving, waiting to shower his owner with love. Page 28

OVERCOMING

TRAUMA THE CANDID INTERVIEW WITH

BRIAN CUBAN: THE ADDICTED LAWYER OUR NATIONAL OBSESSION WITH

SOCIAL MEDIA

The SILENT CONSEQUENCE OF ADDICTION

ADDICTION BABIES

More Online at www.InRecovery.com

CONTENTS Feature Stories

Theme

14 | Recovery Luminary of the Month 22 | Tough Love The renowned trauma therapist, rehab founder and author has a surprisingly simple method for treating trauma: start by asking the right questions.

16 | Rehab Professional of the Month

The last thing I thought I wanted was love, but at the same time, it was also the thing I craved.

A former therapist helps clients find their true north at Florida’s Lakeview Health, a luxury treatment center with a full continuum of care.

TOUGH

LOVE

20 | Forgiveness is the Best Medicine It is a gift we grant ourselves to free us of unwanted, painful feelings.

38 | Our National Obsession with

In 2013, more than a million women ended up in emergency rooms around the country due to heavy drinking.

24 | It Works If You Work It

It had been a long time since I’d taught without a hangover, and I was terrified.

28 | The Joy and Benefits of Canine Therapy

Dogs have played a major role as “man’s best friend” throughout civilization.

30 | Equine Assisted Therapy

Why do horses work so well for helping addicts find recovery? Is it their independence, size, intelligence or all the above and more?

32 |Addicted Babies

The Silent Consequence of Addiction.

33 | The Trouble with Trauma

Trauma underreported and not talked enough about.

42 | The Addicted Lawyer

Overcoming a lack of validation and identity is the key to opening the door to immense possibilities in recovery.

60 | The Ingenuity of an Addiction

It never ceases to amaze me, how creative the addicted mind can be in search of a new high. The latest technique, called “Dripping.”

Social Media

Finally, addiction is not only affected by the physical mechanics of the brain, but also by psychological factors.

10 | Is Advertising Driving More Women to Drink?

38 28 46

26 | Why Are Animals So Important in Recovery?

Sigmund Freud and Florence Nightingale are among the luminaries who understood the importance of our four-legged friends.

37 | Why Less Pain Medication

COLUMNS 46 | A Strong Leader in Yoga For Recovery

She Recovers co-founder Taryn Strong has perfected the practice of using yoga to bring the body and breath into recovery.

Equals Less Pain

50 | The Trauma Heart | Book Review

44 | Drug Use and the Law:

52 |The Importance of Aftercare

The UVA anesthesiologists reviewed a total of 101,484 surgeries between 2011and 2015 in which patients were sedated.

Addiction is a fierce master. It can drive you to lie, cheat and even steal, just to feed the beast. 8

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For most people it is a trauma that shatters them to their core, according to world renowned addiction treatment professional and now author Judy Crane.

Recovery is a tenuous thing, very hard to achieve and even more difficult to retain.

InRecovery Magazine September 2017

53 | Addiction Now

Dispatches from the front lines.

55 | Alcohol and Adolescence - A Lethal Mix

As a society, we are all too willing to understand that teenagers are curious, rebellious and want to experiment.

63 | Overdose Deaths: The Numbers Just Keep Getting Worse

The problem is growing so quickly that we can’t even obtain accurate statistics. InRecovery.com

9/5/17 11:28 AM

Marketing, Lead Generation, and Sales Solutions for the Addiction and Mental Health Industry We deliver custom-fit direct response integrated marketing, lead generation, and admissions solutions that are designed to fill your beds, ethically. Admit generation is the cornerstone of our services, and we understand the current challenges treatment centers are facing today. We have deep experience within the addiction and mental health industry, and we can help.

Lead Generation

In today’s market, raw unbranded third party leads just won’t work anymore. Yet lead generation has to be part of your admit generation strategy. So you have to do more with less, and you can by deploying process intelligence. We offer real lead generation solutions that fill beds and position you to meet current industry challenges.

Integrated Marketing

In order to compete in today’s marketplace treatment centers must tap into and integrate all marketing channels, such as SEO, PPC, SMO, directories, and other media sources. This marketing strategy is a “must” if you are to manage your cost-per-acquisition. Most marketing agencies can’t go beyond CPC and CPL. But We do, closing the loop back to cost-per-acquisition.

Admissions Solutions

Marketing is only half the solution. Today’s treatment centers must have a strong admissions team or their cost-per-acquisition will be unmanageable. Primary KPIs such as VOB Run %, VOB Accepted %, and Clinically Accepted % have to be carefully monitored and maximized. Advanced admissions call center strategies like Opener/Closer models, Call Handling processes, Call Management Platforms, and CRMs should be considered. We can help.

Our Services Include Treatment Center Growth Strategies Integrated Marketing Solutions Intelligent Lead Generation Sales Admission Services Call Center Services Call Management Implementation CRM Optimization

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(888) 599-5242 Recovery Marketing Consultants is an addiction and mental health marketing and sales consulting group headquartered in Newport Beach, CA. If you are interested in receiving an initial consultation and and needs assessment, please call us. We deliver results. InRecovery.com

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InRecovery Magazine September 2017

9/5/17 11:28 AM

Is Advertising Driving More Women to Drink?

ife often imitates art. It seems that’s now more true than ever and alcohol producers are counting on it. Scenes from movies and comedic online ads meant to be funny, can take on lives of their own, with consequences well beyond the computer and TV screen. As a result, many more women are drinking to excess than ever before.

In 2013, more than a million women ended up in emergency rooms around the country due to heavy drinking, with middle-aged women most severely affected. Alcohol related deaths for white women ages 35-54 has more than doubled since 1999, according to a study reported by the Washington Post study on health data, accounting for a whopping 8% of total deaths in this age group in 2015. What’s going on? I believe one of the key culprits is online ads, which seem to have a bit more edge to them nowadays. At one website, Mad Housewife, they quipped “the most expensive part of having kids is all the wine you have to drink.” Mommy’s Time Out, another popular online destination, shows two women engaged in casual conversation. “How much do you spend on a bottle of wine?” one asks. “I would guess a half 10

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hour,” is the reply. Woman are bombarded with vignettes of busy mothers sipping whiskey, guzzling wine and sidling up to the bar knocking down a few with male co-workers. The message, ‘it’s cool to be a drinking mom’. Clips from movies, gone viral online, are also proving problematic. In one scene from the movie “Trainwreck”, starring pop-culture Amy Schumer, she chugs an entire bottle of boxed wine from Trinchero Family Estates. Was it mere coincidence that winery was also one of the film’s producers? I think not. Young women then followed up online, emulating their cultural hero with videos of them chugging while promoting the product as “binge in a box”. The wine’s sales jumped 22 percent shortly thereafter. The liquor industry appears to be cloaking their advertising by coyly draping it in the flag of gender equality, “we’ve been creating similar ads targeting men for decades.” However, that just muddles the issue. They shouldn’t be glorifying drinking to excess to anyone - period. Not men, not women, not adolescents. Moreover, women are more easily affected by alcohol than men because they generally weigh less and also metabolize alcohol at a different pace. The US Surgeon General classifies binge

InRecovery Magazine September 2017

drinking as four drinks within two hours for women, but five when it comes to men. Women also have unique health concerns including increased risk of breast cancer, heart disease and certain nerve conditions. The biggest concern is that this new casual form of advertising is now becoming the new normal. It started slowly and continues its creep. Advertisers typically keep pressing the limits until they hit pushback, anything they can do to drive more sales and line their pockets. For people who aren’t addicts, there are certainly studies demonstrating some benefits from moderate drinking. Advertisers use that as their shield. However, studies have shown that Akai berry and Pomegranate juice have similar levels of anti-oxidants to red wine, without the alcohol. These benefits can also be achieved by taking Resveratrol, in the form of a pill. Moreover, studies like those always seem to discount the damage to addicts who get caught in the cross-fire, addicts who use such research as an excuse to drink or who mistakenly think they too can benefit. But addicts don’t do moderation. That’s why it’s important to print articles like this and to pass them along to others. We need to be that ‘pushback’ in order to keep the advertisers in check. InRecovery.com

9/5/17 11:30 AM

Letters to the Editor Have something to say? We’d love to hear from you. Send your compliments, criticisms, secret dreams, love letters or all of the above to us at editor@inrecovery.com. I have really been enjoying the new look and feel of your magazine. I find that the small articles and statistics add a lot of flavor to people’s ongoing stories of struggles and success in addiction and recovery. I have had my own personal history with addiction and have endured more rough days than I care to remember. Your magazine is one of the things I read to help keep me focused and on track. Dan, California Dear Dan: Thanks for the humbling words of encouragement. We are doing all we can to try and improve what we do around here. Our goal is always to be the #1 Resource for Addicts and Their Families. It feels very rewarding to get emails like yours to remind us that we actually can and do make a difference in people’s lives. Editor

To the Editor: I loved the recent article about Vance Johnson. I felt terrible reading about all that he went through but feel very motivated that he was able to go through all that and thrive in recovery. If someone like him, who was an idol of mine, can get through all this, it gives me a lot of hope for myself. Steve, Florida Dear Steve: Mr. Johnson is a very special man who has experienced a particularly tough journey. Thanks for the compliment and hang in there. Keep doing the work because your recovery is critical for you and your family. Editor

Dear Editor: I am writing about your magazine’s slant against marijuana. I have enjoyed it for most of my life and have never felt addicted. It never sent me into a tailspin like alcohol, and drugs like cocaine. In fact, now, it is my outlet to relax and helps me stay away from other drugs and alcohol. It seems most of the United States is in agreement with so many states now making it legal. When are you going to wake up and get this issue right? Sharon, Texas Dear Sharon: Sometimes the bravest and smartest decision that needs to be made is not the most popular. There is tremendous debate throughout the US and, I have to agree, that the war on drugs has not been effective. I am not suggesting that mass criminalization is the answer, we are very much against that. However, legalizing marijuana for anything beyond strictly controlled medical use opens up a Pandora’s box of unintended consequences. Does some good come of it? Sure, there are compelling arguments for both sides. Please remember, though, that marijuana production, distribution and use is still against Federal law, regardless of all of the actions taken by 29 states to date. In the end, we at InRecovery are clearly convinced that the dangers and problems of rampant expansion of access to and use of marijuana considerably outweighs the benefits of mass legalization, particularly just for recreational use.

To the Editor: Thank you for adding your new column on the Science of Addiction. It’s very heartening to learn about new developments in this fight. Many days I wish I could just wave a magic wand and rid myself of this disease. Reading about the “Mind over Matter” article in July and the “Search for a Cure” article in May, definitely makes me feel optimistic that one day I can perhaps be rid of this albatross around my neck. Jane, Virginia Dear Jane: I greatly appreciate your letter. Please understand that, at the moment, there is no cure for addiction. It is something that affects us addicts in both a physical and psychological way. There is still nothing that tops the hard work of focusing daily on our recovery. Science and medicine are making tremendous impact and perhaps, one day, will hold out the promise of having a greater impact at reducing our susceptibility to the disease. In the meanwhile, we all need to keep working the steps, reviewing our journals and doing everything else we can to stay on top of maintaining our sobriety.

“When angry count to ten before you speak; if very angry, a hundred.” Thomas Jefferson

InRecovery.com

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InRecovery Magazine September 2017

9/5/17 11:29 AM

It’s difficult getting someone to confront the demons of their addictions and explore recovery.

How Stress Can Lead to Relapse

he entire process of addiction treatment is fraught with challenges. Considering all of the hurdles, it sometimes seems incredible that anyone ever recovers at all. When someone has achieved sobriety, we often breathe a sigh of relief, finally again recognizing the person we knew and loved, who was hidden behind the veneer of addiction. Once found, it is critical to keep them there. The perennial leader of triggers that can lead one to relapse is stress, which can come at you from any side and take on many forms. Therefore, stress management must be an essential component of all treatment and aftercare programs. Stress is an inevitable fact of life. Some people deal with it better than others. We are all familiar with the stereotype of a business person with a bottle of something tucked away in the office desk, to relieve tension after a long day. Many of us have resorted to even harder drugs for the same reason. For someone with addictive tendencies, that’s just the beginning of a losing proposition. Interestingly enough, stress involves the release of brain chemicals, in a similar fashion to addiction, that were historically helpful for our very survival. It is the basic element behind our ‘flight or fight’ response, as well as an instinct that kept our forefathers following the herds as they

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hunted them down for sustenance. While it can still have some beneficial aspects, such as assisting us in an adrenaline filled presentation or speaking engagement, it is often something that leaves us feeling ill at ease. No one wants to feel ill at ease. This is particularly true for addicts, whose brains have been re-wired with a heightened sensitivity toward stress, as a result of their addiction. Which brings us back full circle as to why we can all certainly understand why stress is the number one trigger for relapse. So, the big question really is then, what can we do about it? Well, to begin with, treatment obviously needs to be a lot more than just about the addiction and getting clean. Lifestyle balance is a vital component of any recovery. Treatment centers and their employees need to embrace the philosophy of exploring the entirety of the patient and his/her life. Patients must not only be encouraged to open up in a safe environment, but must also be gently persuaded to confront what makes them uncomfortable. Moreover, no post-release treatment plan is complete without strategies on how to best combat stressful events as they arise, tailor-made for the unique conditions relating to each individual patient. Addicted patients must also be made aware that they need to be proactive in seeking this type of help, and educated on how to deal with stress in

InRecovery Magazine September 2017

a healthy and productive manner. Aftercare programs then need to pick up where treatment leaves off, with exercises, role play and discussions of scenarios in which patients can test their resilience in consequence free situations. This way, they can explore what the potential consequences may have been had they acted and see for themselves the true benefit of the ongoing treatment. Each patient must also be involved in support groups including both family and former addicts. Those of us in recovery, periodically, need something close to unconditional support, where we will not be judged, so long as we are committed to maintaining or re-engaging in our recovery. We all have moments of weakness and make mistakes, the choices we make in those circumstances are what make all the difference. It’s difficult enough getting someone to confront the demons of their addictions and explore recovery. Getting them to take treatment seriously and achieve sobriety, even more so. Once we’ve gotten them on the road to recovery, we must do all we can to help them stay there. There’s no possible way to eliminate stress, regardless of the amount of planning and foresight, that’s just not realistic. However, with proper planning, we can minimize the impact of any bump in that road, to help ensure that the recovering addict remains on the right track. InRecovery.com

9/5/17 11:31 AM

WEâ&#x20AC;&#x2122;RE MOVING RECOVERY IN THE RIGHT DIRECTION. Compass Recovery Center offers intensive outpatient programs for drug, alcohol and gambling addictions. We provide our clients with individualized treatment programs to start them on the path to long-term recovery. Compass Recovery Center is a stateâ&#x20AC;&#x201C;licensed outpatient treatment program.

WE OFFER SERVICES FOR GAMBLING ISSUES AND MORE.

Our experience has shown that individuals in early sobriety have a better chance at long-term recovery by attending an extended care program. Most of our clients come to us seeking quality aftercare following their initial addiction treatment or detox. We have found that our personalized treatment programs provide the level of extended care to help our clients successfully return to their lives.

InRecovery.com

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InRecovery Magazine September 2017

9/5/17 11:31 AM

Recovery Luminary of the Month: Judy Crane The renowned trauma therapist, rehab founder and author has a surprisingly simple method for treating trauma: start by asking the right questions.

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InRecovery Magazine September 2017

InRecovery.com

9/5/17 11:32 AM

Judy Crane

here isn’t much Judy Crane hasn’t seen. A child of the 60’s, she describes her early adult years as “sex, drugs, rock and roll, the Vietnam War, civil rights and rebellion in the streets.” There was also rebellion at home. When Crane was 27 years old, she woke up in bed next to her husband and found him dead of a drug overdose. As a widow with three kids, she couldn’t stop using drugs. She struggled and was in and out of detox until the summer of 1987, when she went to a detox center where somebody gave her a copy of the book Adult Children of Alcoholics by Janet G. Woititz. She read the book, identified with it, and realized her struggles with addiction and trauma were deeply rooted in her childhood. That’s when she made a decision to go to treatment and break the generational cycle of addiction. It was the beginning of her early trauma work. Healing trauma has become Crane’s raison d’être. After getting clean and sober, she earned a BA from Rutgers University and an MA from New York Institute of Technology. She was involved in AA and also worked extensively with a therapist on her own trauma issues. While employed as a counselor in a women’s treatment center in 1996, Crane noticed—both in her personal recovery meetings and in her work—that there was a common issue holding people back from fully embracing recovery; that issue was unresolved trauma. Unresolved trauma was causing the women she worked with to struggle and people with years clean and sober to not only be miserable and angry but also to repeat destructive patterns in their lives. InRecovery.com

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This realization planted the seed for Crane’s future endeavors. Crane hasn’t always found support for her trauma focused outlook from other addiction professionals, particularly in the early years of her career. At that time, she described “hard core” addiction professionals as focusing solely on addiction mental health without considering emotional health. She credits Judith L. Herman, MD, Dr. Peter A. Levine and Bessel van der Kolk, MD, among others, for influencing her with their pioneering work in trauma. Her most fierce admiration is reserved for Canadian physician Dr. Gabor Maté. She calls herself a “groupie” of Dr. Maté (rock and rollers never die, they just grow up), who believes not only in the idea that trauma is the cause of addiction but also in the role of neurotransmitters in healing addiction and trauma. Today, Crane is a Licensed Mental Health Counselor, Certified Addiction Professional in Florida, Certified Sex Addiction Therapist, Certified hypnotist, EMDR therapist, and specialist for healing trauma and PTSD. Crane is co-founder or founder of two rehab facilities specializing in addiction and trauma treatment: The Refuge and Ocala Guest House. She also serves as a trauma consultant for people around the world and has developed a training program for trauma therapists called (Spririt2Sprit.com). Now, in the summer of 2017, she is publishing her first book, The Trauma Heart. For additional information, a review of The Trauma Heart can be found on page 50

they talked about detox, he was desperate to keep taking the Adderall, claiming he needed it to concentrate. She probed deeper, asking David how long he had been taking Adderall. He responded that he’d been on some sort of stimulant to treat ADD since his mom sent him to a therapist for the first time when he was 8. Crane asked what happened when he was 8 that made his mom think he needed a therapist. He told her that was the age he quit paying attention in school and started having discipline problems. Crane asked why. He told her nobody had ever asked that question before and revealed that a camp counselor had molested him that summer. Crane said she’s met thousands of people with this same type of story in her career. She calls these individuals “Davids” and emphasizes that effective trauma treatment starts with asking the right questions and then probing until the client reaches his or her own truth. This is how the healing can begin. She explains that trauma is held deeply on a cellular level. Sounds, smells and circumstances can trigger the feelings of a past traumatic event at any time. When asked about the future of traumainformed addiction treatment, Crane says there will never be a quick fix. Traumainformed means just that: informed. Once all the facts are out in the open, the real work begins.

“Life is not lost by dying; life is lost minute by minute, day by day, in all the thousand small uncaring ways.” Crane’s take on trauma therapy is so Steven V. Bénet simple that it’s brilliant: ask the right questions. Her belief is that trauma can be identified and healed no matter what the behaviors are, as long as the client is willing to do some very deep work. She theorizes that many addicts and alcoholics with unresolved trauma have spent their lives being misdiagnosed and treated with little success because nobody ever asked the right questions. To illustrate this point, Crane tells a story of a young man she calls David. David came to Crane for help with his addiction. He had been in several rehabs without success. He was abusing meth, Xanax and prescribed Adderall. When

The Trauma Heart by Judy Crane See page 50 for full book review.

InRecovery Magazine September 2017

9/5/17 11:32 AM

Rehab Professional of the Month: Alan Goodstat

A former therapist helps clients find their true north at Florida’s Lakeview Health, a luxury treatment center with a full continuum of care.

Alan Goodstat’s career in addiction treatment spans over 25 years, when he received his master’s in social work from the prestigious Columbia University in the early 1990’s. His passion and dedication have motivated patients and co-workers alike to find the best in themselves and in each other. He serves as an inspiration within our community. Goodstat spent the early years of his career as a therapist. Then, realizing he had a flair for the business side of social work, he spent time as the director of several substance abuse 16

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Alan Goodstat

programs, including Mount Sinai Medical Center, Miami Beach. Then he was the Administrator/CEO of Focus Healthcare of Florida at High Point in Cooper City, FL.

improvement department, utilization review department, contracting and supporting the CEO and Board of Directors with special projects and acquisitions.

Goodstat was invited to join the Lakeview team when the center opened in 2001, and he has been involved ever since. Currently, Goodstat is Lakeview’s Senior Vice President and Chief Compliance Officer. Primary Responsibilities at Lakeview Health include: oversight of the compliance program, performance

Lakeview’s motto is “Find Your True North.” This means that their mission is to help clients discover what gives their lives purpose once drugs and alcohol are out of the way. Lakeview offers a full continuum of care for substance abuse and co-occurring disorders. Services include medical detox, inpatient and residential,

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a Partial Hospitalization Program (PHP), an Intensive Outpatient Program (IOP) and aftercare services. Lakeview offers support for families struggling with drug and alcohol issues and has also created an alumni support group. Goodstat has played an integral role in developing the programs at Lakeview Health and speaks fondly of the comprehensive range of services they provide. The staff and clients of Lakeview benefit from a culture of “servant leadership,” where every level of the organization is invited to contribute to the advancement of the goal in order to offer quality, personalized addiction treatment in a comfortable medical setting. Goodstat credits the Lakeview’s success with this philosophy, as well as its tight-knit group of talented medical, clinical and leadership staff. The beautiful Lakeview Health facility is located in the northeastern corner of Florida in Jacksonville, the most populous city in the state. The facility is just 25 miles from the Georgia border but quite far from the south Florida style sober living/outpatient model of treatment, both geographically and philosophically. The thriving city of Jacksonville is home to culture and commerce, and its coastal suburbs boast all of the beach vibes of Florida. The main Lakeview Health facility is located in Jacksonville’s Arlington neighborhood, just east of downtown and the St. John River. The state-of-theart Lakeview Health building recently underwent a renovation and expansion. As the name suggests, the sprawling facility overlooks a beautiful lake. The campus includes an administration building, Gym and conference center, clinical facilities and two counseling centers. There are gender-specific buildings for the men’s inpatient program, called The Star, and the women’s inpatient program, called The Rose. There are also off-site sober living apartments, which are available for clients who have completed the residential program and are enrolled in PHP or IOP. The grounds have plenty of outdoor spaces, including a meditation garden with a walking labyrinth. Lakeview Health also has an eye on expansion, with several new facilities currently in development. InRecovery.com

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Café and dining room

Goodstat describes the treatment experience at Lakeview as structured and medically supervised with a strong focus on healing the whole person. There is a basketball court, yoga studio, lap pool and luxury fitness center. Clients have the opportunity to work with a personal trainer during treatment to restore the health of their bodies, along with their minds. In keeping with Lakeview’s motto, clients are encouraged to look beyond their drug

and alcohol use to envision a future of joy and purpose. They are given therapeutic tools and life skills that will sustain them long after rehab. After more than a dozen years helping guide the course of Lakeview Health, Goodstat reflects on his career at the company by saying, “Success is all about having a solid team.” With a beautiful facility, a high rate of success and a bright future ahead, it seems that Goodstat and the team of dedicated professionals at Lakeview Health have found their true north.

Lounge and Relaxation Space

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GENDER MATTERS IN RECOVERY. MEN AND WOMEN OFTEN ENTER INTO ADDICTION FOR DIFFERENT REASONS and recovery is most successful when you’re able to address the underlying issues in a gender responsive program. See what happens when you build a new campus around the most contemporary ideas in addiction treatment.

RECOVERY CAN MEAN MANY THINGS. HERE, IT MEANS FINDING YOUR TRUE NORTH. LakeviewHealth.com/findanswers or call 866.314.5750

Shatterproof is a national nonprofit organization dedicated to ending the devastation that addiction causes families. Join us to show that no one should ever suffer alone. Unite in solidarity with other walkers and runners, supporting those who have lost a loved one to addiction and celebrating those who are living in recovery today. Every dollar raised brings us one step closer to ending the devastation of addiction in America.

Registration for the Shatterproof Rise Up Against Addiction 5K is open! Join us as we Rise Up and show that, together, we are stronger than addiction. Find a 5K near you and join other walkers and runners to bring the disease of addiction into the light. Register now at www.shatterproof.org

New York City Sunday, October 1 Pier 84

Washington DC Saturday, October 21 The Catholic University of America

Boston Saturday, October 28 Franklin Park Playstead

Atlanta Saturday, November 4 Piedmont Park at The Meadow

Rise Up Against Addiction! Register for the 5K Run/Walk. The cure to darkness is light. The cure to stigma is love. The cure to despair is hope. It’s time to Rise Up Against Addiction. Register now at www.shatterproof.org

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InRecovery Magazine September 2017

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9/5/17 11:34 AM

SOBERCITYNEWSLINE Abstinence for All?

We’ve all seen studies claiming light-to-moderate drinking can relieve stress and be healthy. I’ve always had my doubts. Most of those studies are funded by companies in the liquor industry. It reminded me of the early days of smoking, when cigarette companies advertised that smoking was good exercise for the lungs. Unbelievable! Right? We’ll, a recent independent study published in the British Medical Journal (BMJ), confirmed my suspicions.

Meth’s Meteoric Growth Ohio Takes on Big Pharma Most of us have seen episodes of the TV show Breaking Bad, about a neurotic High School science professor turned illegal drug chemist. He used beakers and toxic chemicals, gingerly manipulating them into potentially explosive concoctions on the way to producing methamphetamines, a highly addictive street drug.

The pivotal case claims that drug makers helped fuel the opioid addiction crisis by misrepresenting the addictive risks of their painkillers. “What they were saying was not true and they did it to increase sales,” remarked Ohio Attorney General Mike Dewine. Ohio has one of the highest opioid overdose death rates in the country. The additional toll on infrastructure like emergency services and Medicaid, combined with a swath of citizens who “can’t be employed...because they can’t pass drug tests,” is a huge additional tax on society. Well, somewhere along the way, in real life, an evil genius drug dealer figured out he could create the same end product using basic over-the-counter cold medicine - that’s when Meth use exploded.

The study followed 527 civil servants over the course of three decades. Volunteers periodically took brief cognitive tests and recorded their drinking habits. They were also occasionally given brain scans and subjected to more extensive memory tests. The end result, as few as 8 to 12 drinks a week were enough to cause noticeable brain damage. I’m sure we have friends, family and neighbors we care about who kick back and have a few, several times a week. Perhaps it’s a good idea to show them a copy of this article. As it turns out, abstinence might not just be for us in recovery, but a great policy for all. InRecovery.com

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Taking a page out of the handbook used to bring down Big Tobacco, the State of Ohio has brought legal action against a host of large pharmaceutical companies involved in the production of opioids. This working-class state has been particularly hard hit by the spread of addiction and is seeking a solution to both stem the tide and bring in much-needed funding for substance abuse treatment programs.

It wasn’t all that long ago, cold medicine could be purchased off the shelf. Now, we need to request it from behind the counter, sign a log and are limited to how much we can buy. The reason, it’s main ingredient, Pseudoephedrine. Using information easily researched via the internet, Pseudoephedrine can easily be converted into Meth, creating brain altering affects.

The reality is that cigarette smoking did not get reined in until States took action. Hopefully, Ohio’s attack on Big Pharma (now, joined by Mississippi, Missouri and Oklahoma) will soon motivate others to take a bite out of addiction and get more money funneled into treatment.

This stands as another reminder of the vigilance required in our battle against addiction. Nowadays, Pot, Meth, Mollies, Opioids and many other drugs are being cooked up in various dangerous combinations. People are dying like never before from these experiments in search of a new high. It’s no longer just a question of fighting addiction for its own sake, it’s now more than ever about the critical battle of saving lives. InRecovery Magazine September 2017

9/5/17 11:34 AM

FORGIVENESS

is the Best Medicine

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InRecovery Magazine September 2017

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esentment is an emotional cancer. It forms deep inside and eats you alive with overwhelming anger and disgust. It can arise from anything, like being cut off in traffic, not being invited to a special event, or being passed over for that raise and promotion you deserve. It typically stems from frustration over being slighted and consumes you to your very core. If you’re not careful, it can also affect your physical well-being. High blood pressure, blocked digestion and psychological issues are all too common for people who wallow in resentment. Finally, resentment is, by far, one of the biggest triggers for substance and alcohol use and abuse. For all these reasons, and many more, it’s vital to use your ability to ‘forgive’ as a secret weapon, your medicine against resentment. It may not feel like it, but forgiveness is a choice. It is a gift we grant ourselves to free us of unwanted, painful feelings. I’ve always loved the analogy of ‘you can’t take poison to kill someone else’, because it really sums up the entire issue in a nutshell. While you sit around harboring resentment, taking the poison, the person who ticked you off, the object of your resentment, is walking around unaware, unaffected and without a care in the world. From a point of utility, resentment has to be one of the most useless emotions. Forgiveness as its counterpart, on the other hand, makes all the sense in the world. With a simple change of your mind-set, the pain can be gone in an instant, replaced by a sudden, serene rush of relief and calm. The key question then is how do I accomplish forgiveness? In some instances it’s relatively easy; a co-worker forgets your birthday for the first time because of a family emergency. It’s simple to let that one go. But, what happens when it’s something serious done by a person who you care about deeply and they’re not even willing to say “I’m sorry”? That’s when it’s toughest to forgive but when it’s also most necessary. “How dare they? I would never do that to them,” are probably two of the most common and dangerous thoughts that follow next. It comes so naturally, almost as automatic as breathing. Yet, it’s now that you need to get a handle on the situation for your own benefit. I suggest you keep the following exercise handy for those times when you are totally irked and InRecovery.com

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feel a nice lethal dose of resentment boiling up inside. It’s time to FORGIVE, for your sake, so let’s learn how to do that. oes the other person even know 1. D they offended you? We frequently assume the other person knows they slighted us. However, perhaps it’s all just a misunderstanding and he or she would have acted differently had he or she only known. It’s all about communication. You need to find out whether you’re making a mountain out of a molehill. 2. P ut yourself in the other person’s shoes. So, you’ve now had the conversation but the other person makes it clear they acted for a reason and if they had to do the situation all over again, it would turn out the exact same way. For example, if you get passed over for a promotion, there could be any number of reasons for that. Perhaps the other person had been around longer or they’re grooming you for another position, or perhaps your co-worker was simply better qualified. Whatever the reason, you need to be open-minded and do a self-check to determine if your ego is getting in the way of your rational thinking. 3. L earn the art of letting things go. You’ve had the conversation, or you’re positive a conversation will be futile, and there’s no good reason why you were slighted. The other person is just a complete jerk who doesn’t care. This is the time when a nice big, juicy helping of revenge can seem awfully appetizing - but where does that get you? Do you really need to be involved in an ever-escalating blood feud with someone until it eventually goes nuclear? Patience and forgiveness are the better part of valor. Not for them, for YOU. You have much better, more productive things to do with your time. Karma will eventually catch up with someone who is rude and hurtful, it always does. 4. G et some exercise. There’s nothing better than a long walk, a workout routine at the gym or even simple calisthenics to get your blood flowing, endorphins running and put you in a stable frame of mind. You’ll make better long term decisions when you are ‘out of the moment’ having blown off steam.

5. P ity the other person. There’s a scene in the movie “Waterboy” where Henry Winkler (formerly known as the “Fonz” from Happy Days, for us older folks) is frozen by fear as he looks at the other team’s intimidating coach. To overcome that, he begins to imagine the coach as a cute little baby. No more fear. This same exercise works using pity. When you realize just how pathetic the other person is, you set yourself free. 6. P ray for the other person. It is an extension if number 5 in some ways, but nonetheless important in its own right. Whether you understand it as reaching out to your Higher Power or just speaking something into existence, it will have a powerful impact on you, and that’s the point. You’ll find it much easier to forgive and put it behind you.

It is a gift we grant ourselves to free us of unwanted, painful feelings. Finally, and most importantly, you need to consider forgiving yourself. Your issue of resentment may not have to do with someone else, but rather frustration over something you’ve done or how you acted. You can’t change the past (Hakkunah Matatah for all you “Lion King” fans). Then again, even when resentment stems from the actions of another, it often involves a certain amount of self-hatred over the incident you blame yourself for being the victim. This can cause us to lash out at people who had nothing to do with the issue or crawl into a shell. Either way, it’s self-destructive. Nothing has ever been resolved by hating yourself. We are all human, we make mistakes. Get over it, forgive yourself and move on, for everyone’s sake. One cannot live his or her life carrying heavy emotional baggage from place-toplace. Resentment of yourself or others is nothing more than a way to sabotage your life. I remember a saying, “Give a man a fish and you’ve fed him for a day; teach a man how to fish and you’ve fed him for life”. So, I ask you to take the lessons from this article to heart and you too will have the tools to be fed for life.

InRecovery Magazine September 2017

9/5/17 11:35 AM

The last thing I thought I wanted was love, but at the same time, it was also the thing I craved.

What can anyone do to help a loved one with an addiction?

TOUGH

LOVE 22

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s a person who’s struggled with addiction, I’ve often thought about what went wrong, and what my friends and family might have done to prevent this seeming “tragedy.” More generally, I guess the question that needs to be asked is what anyone can do to help a loved one with an addiction? I think the most important thing you can do and also the hardest thing you will have to do, is to give unconditional love to your addicted loved one. You might be thinking, “well.... duh!”, but actually, providing non-judgmental, unconditional love to a person who is struggling with addiction issues is a lot harder than it seems. Loving someone who actively repels your affection is challenging at best, but for them to recover, it’s crucial. That may mean texting or leaving voicemails, emailing or writing letters all of which go unanswered for weeks or months at a time, but leave no doubt in your loved one’s mind that you care about them, love them and miss them. Although they may mostly be in a drug induced haze, they will have moments of clarity, and it’s at those moments when they can be reached and when they need to know they are loved and wanted, no matter what. I can tell you from personal experience, the last thing I thought I wanted was love, but at the same time, it was also the thing I craved. I wanted you to believe that I was happy and well adjusted, but the truth is, I felt lonely most of the time. I was uncomfortable with who I was, so I used drugs to help me feel more at ease in social situations. What began socially, became an everyday habit I couldn’t live without. I began demanding that my family and friends leave me alone, so I could do what I wanted. At the same time, I felt intensely ashamed and embarrassed about what I was doing to myself - I didn’t want to let anyone know how bad things were getting, so I would avoid phone calls and meetings with my family and friends. I think my parents may have wanted to respect my privacy and give me the space to work things out on my own. From time to time, when I was out of money or food, or needed a place to stay, I would pop back up as if everything was normal (like I wasn’t the source of tremendous worry InRecovery.com

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for them) and when I did, they would help me, but there were large gaps of time when I was off the grid and for lack of a better way of putting it, they allowed me to stay lost.

this may be uncomfortable for you to hear, and more uncomfortable for you to practice, it’s the truth. What you can do is love them and support them, sometimes from afar, all the while allowing them to experience the consequences of their own I wish my parents had talked to me direct- actions. When they are ready, and when ly about my issue and the effect it was hav- they ask for help, do what is comfortable ing on me and them. I know addiction is a for you. That may be as simple as driving difficult topic to broach, but I think honest them to a meeting, or taking them to treatacknowledgment on a regular basis helps. ment or even just listening while they cry. Don’t pretend that there isn’t a problem. I think a lot of folks hope the situation will For me, the experience of addiction bework itself out on its own, but usually that came about numbing my feelings - elimdoesn’t happen. Get involved and take an inating them, actually, and I think that’s active interest in your loved one’s struggle, common to most addicts. My advice to in a way that is helpful, but not demanding you - take any opportunity you have to or nagging. Let them know often, that you elicit feelings in your addicted loved one. care about them and you’re there for them. Allow them to express their feelings - don’t judge and don’t take anything personally. When I was in active addiction, I could be extremely hateful, and even though the outward expressions of my hate was directed at anyone who was in the vicinity, the real object of my loathing was me.

You cannot fix your loved one; they need to do the work themselves!

So what got me to the point where I was ready to make a change? Consequences the seriously bad consequences of my own behavior were what I needed to get me headed in the right direction. I’ll give you a specific example; I got arrested. I was in jail with a bond I couldn’t afford, and while my folks took my phone calls from jail while I was locked up, they wouldn’t bond me out. I remember them telling me, “You got yourself into this mess - you will have to get yourself out.” I was so angry, but my parents made their point. That was the toughest love they ever gave me, and ultimately, it’s what helped me to recover. I was finally forced to live with the consequences of my own actions. When there was nowhere else to turn, I had to dig deep inside myself, and that’s when I finally started getting better. For me, it was being arrested, but your loved one will need to have a consequence that is significant enough that they stop and take notice - losing a job, overdosing or a DUI whatever it is, let them experience it fully. Don’t minimize its impact on them. You cannot fix your loved one; they need to do the work themselves! And while

And last, I would strongly suggest you attend Alanon. For those of you who don’t know, Alanon is a support group for people whose loved ones are addicted. You’ll learn “tough love.” You’ll learn how to distinguish between tough love and withholding love, and you’ll learn how to avoid enabling. More importantly, you’ll have the support of others who have walked your path. They will be able to comfort you, because they’ve been through what you’re going through -- they’ve felt how you feel. Anyone will tell you, maintaining a relationship with a loved one who is struggling with addiction is challenging, and sometimes it feels impossible. But it also provides you an opportunity to learn about yourself. You will learn to recognize and accept your own limitations and you will learn your own capacity for love. And although at times, you may feel like you’ve reached the end of your rope, hang on and don’t let go, because recovery is possible. The “seeming” tragedy I described earlier has turned out to be one of the best learning and growing experiences of my life, and I have profound gratitude for family and friends who supported me on my journey.

InRecovery Magazine September 2017

9/5/17 11:39 AM

IT WORKS

IF YOU WORK IT

How Sobriety Changed My Work Life

It had been a long time since I’d taught without a hangover, and I was terrified.

ew things in life are more daunting than teaching an 8 am writing course to college freshmen. As I stand in front of a group of bleary-eyed students and shuffle my notes, I wonder if their lack of interest is directly related to my teaching skills or their late nights. I don’t know, and I don’t ask. I take a deep breath and dive into a lesson on persuasive rhetoric. I am doing all of this with no alcohol in my system. For most people, this is not a big deal, as it is rather early. Most people

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aren’t really thinking much about wine, or the lack thereof, at this time of the day. I am.

which was not without some crying. Last night was my first time grading essays without bourbon. Bourbon always helped those essays, I swear.

I am also recently sober, and everything is terrifying. I keep thinking I might burst into tears if someone passes me in the hall and dares to ask, “Hey, how are you?” I am suffering from a constant onslaught of firsts, like my recent first Friday night sober or my first trip to the store without stopping for liquor. I had my first dinner preparation without my beloved wine,

Now, it is my first day at work without a hangover. This is a good thing, of course, but even good things fluster me. Right now, I am shaky and unsure as I stare at my students. They stare back, waiting. Everything feels very raw and awkward, like I’m on a surreal first date with a bunch of rather sullen 18-year-olds. The whole thing just feels weird.

InRecovery Magazine September 2017

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I was not a morning drinker. This was a proud fact that I hung onto for years as proof that I was not an alcoholic. However, as I was an alcoholic, the morning thing didn’t really matter. It matters now because all this sober teaching so early in the day is really making me want a drink. “Let’s discuss how to persuade the reader,” I say. “What’s one way to get someone to give you what you want?” I’m ready to take a few notes on the board. The class stares at me, and I swear they all shift from one slouch to another, a choreography of apathy. We find ourselves in that academic high-noon showdown that every teacher deals with. I wait. They wait. At some point, somebody has to flinch and answer the damn question. “You could…bargain with them?” one quiet voice finally offers, and I grab onto it as if it was a proverb uttered by the Dalai Lama. We continue with our notes and discussion and make it through. As I walk back to my car, I sigh. Another first, done. There are so many more to tackle. Recovery is hard. Oftentimes, it means butting up against the world. Since I have been avoiding the world for so very long, this is tough. When I got sober, I did not go to an inpatient rehab. I attended a whole lot of 12-step meetings and basically forged ahead without any sort of time away from the world and all its nuisances, like people, places, and things. Inpatient recovery gives the gift of time and focus. Avoiding the “outside” for 28 days is a great start. Either way, eventually you are going to have to deal with the world, and bargaining won’t do you any good. Now, I am dealing with it at work. The world rubs up against me with my students’ lackluster performance on their last essay cycle and with my lackluster interest in their progress. The world is there with emails from my boss, deadlines to meet and bills to pay. The world scratches at me as I stop to fill my car with fuel, and I find myself staring morosely at the Bud Light truck across from me. “HERE WE GO” is emblazoned on a beer bottle that’s perched seductively on a mountaintop. It’s all icy and invigorating, and it makes me slump. Then I head home, and the world clamors on for a working mom who does two jobs and, honestly, could use a raise in both occupations. InRecovery.com

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A few weeks into sobriety, I was co-teaching with the theater professor. We set a time to meet. Unable to find a sitter, I had to bring my kids. We were meeting at the theater, and my colleague said, “Just bring them. They can run up and down the aisles, and we’ll get some work done.” Easy, right? I was a wreck. My kids were loud and nutty, running around, while we tried to iron out a semester’s worth of work. I sat back in one of the velvety cushioned chairs and wanted to cry. I was just so very nervous. I was panicked that this distinguished gentleman who exuded “professorial” and even wore tweeds would not be able to deal with sticky children in his space. I was nervous that my ideas for the course would seem ridiculous. I was nervous that my nervousness would be detected.

Recovery is hard. Oftentimes, it means butting up against the world. We sat high above, watching as my children danced across the stage. They were fascinated with the “theater in the round” concept of this space, a place where there are no wings and the audience has full view of the performance space. Because I am an English teacher, and I eat symbolism for breakfast, I had to smile to myself. This was how I did life. I was on stage all the time. All my entrances and exits were dramatic and deliberate. Every movement, foible or success was being watched and critiqued. It’s no wonder I used to go home, shut the curtains and drink over it. Now I was left with only the awareness of all these feelings. Clarity can be a bitch. The only way to survive a career, life and children while staying sober is to stop thinking of sobriety as an intrusion. Yes, recovery is work, and it takes time and dedication, but it doesn’t operate by barging in, overturning tables and uprooting my life. I had pretty much done that already. Sobriety doesn’t do chaos.

Because having a career is what adults do in general, sobriety wanted to fit right into that as well. After a while, the jangled nerves settled, my interior dialogue shut up, and I could just teach. The hangover-free, 8 am classes became a joy, at least for me. I learned to make eye contact in the hallways, banter with my coworkers, and make plans to meet for coffee and discuss curriculum. I carried my 24-hour chip with me to each class, and I placed it on the podium before teaching. That small medallion anchored me. In short, I got off the stage, for the most part. I did occasionally wonder if my colleagues had any idea about my momentous decision to get sober. I figured I had to be so different now that surely someone had noticed, but most people in my life were not paying nearly as much attention to me as I imagined they were. Still, worries about my reputation would bite at me. I wondered if my students knew, and my thoughts would get all tangled up in regret and shame. These worries left me feeling vulnerable and icky, but in hindsight they were pretty inconsequential. They were like that annoying anxiety dream I always get at the start of the school year. Maybe, you have a similar one? It’s the first day. I am late. I am lecturing about The Crucible, and I am also naked. This dream still happens, but thankfully the anxiety that is packed around it is just typical stress. It goes along with the dream where I am riding a rollercoaster as it collapses beneath me, or my favorite dream, where I am performing an entire one-woman play with no recollection of a script. These nightmares are a result of an over-active imagination and too much chocolate before bed, paired with the dayto-day stress that a working mother deals with. Today, I wake up and I am so grateful because the dream stays a dream. I could not say the same when I was drinking. In that territory, dreams and nightmares stalked me whether I was sleeping or awake. I now know these thoughts all point backward to my past. I am pointed forward now, and all I can do is keep going and let it go. It’s a better way. Not easier, or even less hectic, but better.

InRecovery Magazine September 2017

9/5/17 11:43 AM

Why Are Animals So Important in Recovery? Sigmund Freud and Florence Nightingale are among the luminaries who understood the importance of our four-legged friends.

hen it comes to using animals as part of therapy, three different kinds usually come to mind.

Service animals are primarily intended to assist owners who are blind or wheelchair bound but can provide some therapeutic benefits (though that isn’t the primary intended purpose).

Pet therapy typically involves volunteers taking gentle, trained pets to different settings such as schools, hospitals or homes specializing in elder care. It spreads

the gentle joy of being around and petting a happy animal.

Animal-assisted therapy entails social workers, counselors and therapists specifically and directly using the animals as part of the overall therapy. It’s this last kind of therapy we’ll be focusing on in this setion to help foster recovery.

“Until one has loved an animal, a part of one’s soul remains unawakened.” –Anatole France

ust thinking about petting or cuddling an animal can give you the ‘warm fuzzies’ all over. We are overwhelmed by an inexplicable, immediate sensation when presented with sweet, innocent animals like a dog, cat or horse (among others). The famous British Prime Minister, Winston Churchill, once stated, “There is something about the outside of a horse that is good for the inside of a man.” Why is that? Animal-assisted therapy has been proven to release a hormone called ‘oxytocin’ which helps reduce blood pressure and stress. Tests on cancer patients have demonstrated an increased release of endorphins resulting in lower levels of pain. Other studies have shown that caring for a loving animal can also minimize the risk of cardio-vascular disease while reducing fear and anxiety. It has also been used to treat autism and dementia among other mental health issues.

Interestingly enough, we have Florence Nightingale to thank for discovering the therapeutic value of animals in treating people with disorders. According to the journal Annals of Long-Term Care, she explored this technique in the 1800s. In the 1930s, Sigmund Freud, the father of modern psychotherapy, was known to bring his dog with him to therapy sessions. While it may sound like a technique ripped straight from the pages of Doctor Doolittle, animal-assisted therapy leads to a long list of physical and mental benefits, including: l Lower blood pressure l Improved cardio-vascular health l Reduced instances of depression l Reduced anxiety l Release of calming endorphins l Lower pain scale scores l Increased relaxation l Increased socialization

l l l l l

Better communication Diminished boredom and loneliness Greater independence Strengthened relationships More confidence

Moreover, one study even found that 56% of people found it easier to interact and talk more openly about their backgrounds when a pet was present. Carrie Fisher, famously known as Princess Leia from Star Wars, had a beloved therapy dog named Gary, whom she took everywhere. It helped her cope with substance abuse problems to maintain her recovery. So whether it’s a pot-bellied pig, hamster or one of the more traditional pets, animal-assisted therapy might just be something you should consider as part of your treatment and in sustaining your recovery. The overall increase in sense of wellbeing and multitude of benefits could be just what the ‘Doctor’ ordered.

Why are animals so great?

1. Help us think outside ourselves. 2. Keep us accountable. 3. Builds trust. 4. Reduces stress.

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InRecovery Magazine September 2017

5. They’re an excellent ice-breaker. 6. They’re Non-judgmental. 7. The painting “Dogs Playing Poker.”

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9/5/17 11:46 AM

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InRecovery Magazine September 2017

9/5/17 11:47 AM

The Joy and Benefits of Canine Therapy

“An animal’s eyes have the power to speak a great language.” --Martin Buber

ogs have played a major role as “man’s best friend” throughout civilization. The contribution of canines to our development cannot be overstated, especially since it breaks socio-economic barriers and touches all of humanity throughout the world. As it turns out, dogs are also hugely helpful in fostering recovery during addiction treatment. A simple lick from a dog can light up a person’s day; the joyous way a dog greets you can make you feel loved and appreciated. Merely interacting with a dog creates all kinds of “feel-good” chemicals, such as norepinephrine and adrenaline, which reduce stress hormones in the body. Researchers at Washington State University have concluded it likely also releases natural opioids within the brain, aiding in the restoration and normalization of the brain’s pleasure centers. Dogs were the first animal to be domesticated sometime around 30,000 years ago. In many ways, humans and dogs have evolved together from hunter-gatherers to farming and now industrialization. Nowhere else in nature do two predators consistently work together, let alone share a destiny. Dogs are also fiercely loyal, protecting humans over members of their own species. Then there are all of the “dog saving human” stories constantly in the news, involving people saved from accidents, predators and forces of natures, cut straight from an episode of “Lassie”. It happens all the time. There is an eternal bond between dog and man.

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The best thing about dogs is that they are great companions. Even when it takes a patient a while to come around, the dog is forgiving, waiting to shower his owner with love. Several studies have demonstrated that involving dogs in therapy also facilitates greater communication with the therapist, as the patient learns how to trust and open up. A 2009 study by Mississippi State University and Lindsey Wilson College also noted increased self-esteem. Addicts usually struggle with a warped self-image that can be repaired by a dog’s unconditional love. Many treatment centers use Labradors and Golden Retrievers because they are so calm, loving and physically durable. Durability is important because some patients lack basic empathetic and social skills at the outset. They transform as they go through the program and bond with their dogs. They learn to care for and love a pet that is wholly dependent on them. For patients with allergies or asthma, a Golden Doodle or Labradoodle serves as a great, reasonable alternative. The process of the therapy at most of these treatment centers involves patients thoroughly caring for and playing with their dogs. It is seamlessly intertwined with traditional therapy. Schedules include taking the dogs for a walk, giving them fresh food, engaging in affectionate play time and even cleaning up the kennel. It’s a subliminal and easy way to teach responsibility. Canine therapy is particularly helpful for teens and people who have experienced a

InRecovery Magazine September 2017

trauma. When the underlying reason for addiction is a serious trauma, then you really haven’t accomplished anything if you only treat the addiction. Canine therapy breaks down barriers and makes those in recovery feel safe. It helps them to once again engage life in a healthy manner. As for teens, it helps get them out of their awkward shell. Many of them still haven’t figured out how to get comfortable enough to communicate, but that all changes once they start bonding with their dog. What often occurs, is that teen patients come to appreciate the fact that they need to care for themselves first in order to care for a puppy. That is a huge motivator for a teen who falls in love with his or her pet, which is typically the case. The best part of all this is that you also leave therapy with a friend for life, who helps keep you in check. That’s where aftercare is particularly unique for dog-assisted therapy. All members of the family become stakeholders in the recovery. The biggest problem for an addict arises when he or she gets home, is doing well and everyone lets their guard down. As a new member of the family, your adorable pet is a constant reminder that recovery is not an event, it is for life. There are numerous treatment centers throughout the US, but two in particular that stand out are The Cottages of the Palm Beaches and Ashwood Recovery at Northpoint. If you are in the unfortunate need of addiction treatment, then canine therapy should be considered as an inventive therapeutic technique to nurture a long-lasting recovery. InRecovery.com

9/5/17 11:48 AM

Yes, There Is Something Called Goat Yoga You’ve heard of downward dog, but have you heard of goats climbing on you when you’re in the pose? Lainey Morse’s Albany Farm, which is located in Oregon, has become the center for a popular, off-beat craze that has created a waiting list 1,200 people deep. Goat Yoga, as she has coined the term, resembles regular yoga in all respects except that Morse’s eight goats roam among the participants and climb on their backs as they do poses. The sessions work wonders for people with depression or anxiety. “It’s hard to be sad,” Morse noted, “when there’s a baby goat jumping on you.”

Animals are born who they are, accept it, and that is that. They live with greater peace than people do.” –Gregory Maguire

Recovery is for the Birds I loved birds as a kid, but never really knew why. I could sit for hours watching seagulls dip, dive, swerve and kerplunk in search of a meal. I also had a favorite uncle who loved to take me to the park to feed the pigeons; they ate straight from our hands. There was always something special about birds that nourished my soul and, for anyone who feels the same way, animal-assisted therapy using birds can have the same effect. Birds are so free, watch them soar in the sky. They’ve captured our imaginations since the dawn of time as we dreamed of joining them in elegant flight. They are also willing to come down and join us

on earth, for personal interaction. They may not provide the same companionship as your favorite dog, horse or feline, but there’s an incredible unspoken bond that develops when you interact with them. It’s hard to put your finger on it, but it makes you feel so special that they’ve taken the time to stop by to make the connection. When it comes to recovery, treatment centers are experimenting with many new and innovative techniques. Why? Because it’s all about what works, for each and every individual. Our ability to relate to and admire birds is a natural catalyst that can be helpful in maintaining a lifetime of sobriety.

Dances With Wolf Therapy The classic Kevin Costner movie Dances with Wolves has a central theme, which focuses on the strong bond Costner’s character develops with members of a wolf pack. Some therapists have taken that relationship to the next level as part of addiction treatment. Wolf Therapy is an unconventional but impactful method that takes patients out of their comfort zone and toward a more meaningful, lasting recovery.

by Native Americans as great teachers or “pathfinders.” Wolf Therapy creates a primal bond between human and wolf by helping patients manage their emotions of fear and awe in the presence of these wild, intelligent creatures. Many treatment centers work with wolves that have been mistreated by humans or abandoned by their pack. This way, the animals and their human counterparts can share in the healing together.

Wolf Therapy builds on the deep connection between humans and wolves, animals that have long been regarded

While playing with wolves is not for the timid, the activity can provide unique insights into team-building. Watching

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wolves engage in their complicated pecking order can remind us of our own complex, interpersonal relationships. In short, those weighing treatment options who love nature and have a sense of adventure should perhaps consider taking a walk on the wild side with Wolf Therapy.

InRecovery Magazine September 2017

9/5/17 11:47 AM

Equine Assisted Therapy Why do horses work so well for helping addicts find recovery? Is it their independence, size, intelligence or all the above and more?

ix thousand years ago, wild horses roamed the plains of the world. They were like many prey animals—fast, living in large herds and generally nonaggressive. In the Copper Age, the Botai civilization of the Urals began to hunt them for their meat and skins and later for domestication. In horses, the Botai found a great, quick-witted and forgiving partner that gave them a huge strategic advantage over other clans of their time. Over time, all civilizations came to include horses as part of their culture. What is it about horses that brings out a unique response in people? Perhaps, it’s because they’re not seen on every block like a cat or dog. Maybe, it’s the horse’s air of independence—the wild stallion, tamed just enough to become a loving companion in the Wild West or out on the farm. Then, of course, there’s the horse’s elegance on the racetrack and in riding competitions. In all likelihood, it’s a combination of all of the above and more that makes horses such tremendous aids when treating a person who is struggling with addiction. A horse’s sheer size can be intimidating, but this is actually considered positive for therapy. Their tender side is intertwined with an independent streak, ensuring that the human-horse relationship takes on significant meaning. A person doesn’t need to ride a horse to develop a rapport. 30

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Patients are encouraged to start by hand feeding horses hay, carrots and sugar cubes. They move on to petting and grooming the gentle giants; in this way, both human and horse get to learn about each other. Horses are very intelligent. A rich, indepth unspoken communication occurs during the process, leading to a meaningful bond. Horses, like humans, have distinct personalities, so therapists take great care in pairing the correct person with the right animal. Riding a horse certainly provides a powerful added dimension to the experience. Interacting with horses helps people learn a lot about themselves. Horses have no hidden agenda, are clear about their needs and do not tolerate bullying. You need to earn a horse’s respect for it to follow your lead. Unlike a dog, horses don’t readily offer unconditional love, nor are they single-mindedly self-interested, like many cats. Horses require some effort. They not only need the people caring for them to be responsible, but they also require those people to communicate well. It is for these reasons that horses are so useful in treatment. Horses’ innate nature as prey makes them extremely sensitive to potential predators. As a result, they pay close attention to the moods and behaviors of humans. Horses are Zen

InRecovery Magazine September 2017

masters and provide instant feedback. Most treatment centers utilizing equine therapy are passionate about their horses, and that shines through in treatment. It’s no accident that most of the rehabs that offer equine therapy are standout facilities. Mending Fences, for example, is named after a top racehorse that was leading in the prestigious Preakness when he rounded a turn, badly, broke his leg and was euthanized. In the horse’s honor, the owners turned their farm into an equine rehabilitation center, but five years later a trainer and horse were killed in a freak accident. The owners were devastated. Then, motivated by the movie Crazy Heart, in which Jeff Bridges played a down-onhis-luck country music star, they turned the farm into a place of healing for both horses and humans alike. Heroes & Horses is another exceptional location where patients can benefit from equine assisted therapy. Like all other animal-assisted therapies, equine therapy helps people struggling with addiction to cope with feelings and emotions, so they can better manage their behaviors in a healthy way. Combined with traditional treatment, equine therapy hones physical abilities while building cognitive skills and trust as part of a comprehensive path to recovery. InRecovery.com

9/5/17 11:52 AM

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InRecovery Magazine September 2017

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9/5/17 11:52 AM

ADDICTED BABIES The Silent Consequence of Addiction.

s an OBGYN, on most days I have the best job in the world, sharing good news with parents to-be, playing my humble role in bringing about the miracle of life. Then there are the other days, when the news is a bit more grim. It’s now happening more-and-more with the spread of addiction. The increase in the number of babies born with Neonatal Abstinence Syndrome (NAS) is growing at an alarming rate, as more pregnant women find themselves unable to wean themselves from opioid painkillers and heroin. NAS occurs when a baby is born to a mother who was using opioids during pregnancy. The drug passes through the bloodstream via the placenta, from mother to child. The effects on the baby in the womb are significant; reduced oxygen flow and nutrition to the fetus, among other effects, seriously impact fetal development, often resulting in higher instances of premature birth, low birth weight, and miscarriages. Once the baby is born, the situation gets particularly gut-wrenching. The newborn goes through withdrawal, which includes excessive crying, tremors, gastrointestinal dysfunction, diarrhea, respiratory distress, sweating and sneezing, among other symptoms. Instances of NAS are dramatically on the rise as reported by The Substance Abuse and Mental Health Services Administration (SAMHSA) and articles in the August 2016 Journal of Addiction Medicine. Sadly, I’ve seen the actual evidence with my own eyes. Babies born with NAS must be given special care. Historic techniques such as swad32

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dling, use of a pacifier and caring for the baby in a quiet environment are helpful. It’s also been determined that breast feeding is soothing and safe because little, if any, of the opioids flow into the breast milk. Finally, in some of the most severe cases, doctors are even utilizing short acting opioids to wean the babies off their addiction. NAS affected 21,732 infants in 2012 according to the 2016 US Surgeon General report “”Facing Addiction in America””, a five-fold increase from the year 2000. This resulted in hospital stays eight-times longer, on average, at an estimated cost of $1.5 billion. On the bright side, cases of Fetal Alcohol Syndrome (FAS) are decreasing, in the face of greater awareness. FAS occurs to a person whose mother drank alcohol during pregnancy. They struggle with many of the same issues as NAS babies (low birth weight, poor motor skills, etc.) but are not born addicted. FAS, however, is associated with numerous other problems such as behavioral issues, low intelligence, and unique, unusual head size and facial features. Unfortunately, it appears that the rapid rise of NAS is far outpacing the ground we’re gaining with FAS. The tragic fact is that the vast majority of mothers and mothers to-be never even imagined becoming addicts. Most people hooked on opioids got started by taking prescription painkillers. It has been a difficult issue for our nation, as we’ve become more educated and aware of just how addictive opioid painkillers can be.

InRecovery Magazine September 2017

The issue of NAS really hits home for me on a personal level. I have a friend who gave birth nine weeks early, as a result of complications. While this development had nothing to do with NAS or FAS, it gave me a newfound understanding and appreciation for what these parents and babies experience. I watched firsthand as my friend’s daughter struggled to breathe because her immature lungs were not yet ready. She was put on a respirator and constantly struggled to dislodge the tubes. It broke my heart to see her connected to all sorts of machines and fed intravenously, because her weak stomach could not hold fluids. It was the toughest period of my entire life, viewing my friend’s baby suffering through a hospital window, as we prayed daily, impatiently waiting for her precious treasure to be healthy enough to go home. I can’t even imagine how much more painful that all would have been had her baby been going through withdrawal at the same time. If you are addicted to opioids, I implore you to get help now before it has a serious impact on both your physical and mental health. As a pregnant woman, the implications are even more drastic because of your weakened immune system during pregnancy and the tremendous dangerous impact it has on the fetus. You cannot let it continue. Do it for your sake, do it for the sake of YOUR precious treasure, because decisions you make now will affect BOTH of you for the rest of your lives.” InRecovery.com

9/5/17 11:53 AM

THE TROUBLE TRAUMA WITH

rauma is statistically underreported, not talked about enough, and, as anyone working on this field will tell you, it’s everywhere.

PTSD stands for Post Traumatic Stress Disorder. We often associate the disorder with combat vets returning from deployment deeply disturbed by events that have transpired overseas. We often picture an irritable old man scanning his living room for safety, suddenly finding himself diving behind a couch because a car backfired. While the number of vets struggling to overcome PTSD is a sad truth, the effects of trauma can be found much closer to home. In our sons, daughters, brothers, sisters, mothers and fathers who are struggling with the disease of addiction. It’s no secret, we use substances to numb the pain we feel. For those who have experience with PTSD and trauma symptoms they are numbing nightmares of being attacked, flashbacks of memories of abuse, panic attacks, and deep wells swimming with feelings of shame and unworthiness.

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During the years I’ve worked in this field as a trauma therapist, I’ve seen it all. Clients who have tried to stuff their emotions down, lock them up, and throw away the key of memories that have been so painful they have never told another soul before their work with me; even though they have called out silently through the track marks and cuts on their arms and legs, the emergency room visits from another overdose, and isolating from those who love them. And if your loved one didn’t already have trauma when he or she turned to their addiction, the mere nature of addiction will hand it to them on a platter of tears and pain. Addicts have seen friends die before their very eyes, seen drug deals go wrong, and sold their bodies for their next high. I have patients who have trauma that haunt them from highs gone badly. Using drugs as an effort to self medicate the painful after effects of trauma is an aspect of addiction that is not talked about enough. And it should be, the survival of our loved ones is dependent on this con-

versation, albeit a difficult one, but most aspects of addiction are hard. There is hope. People are doing this difficult self work and getting better. There are many types of trauma treatments that are helping clients like EMDR, psychosomatic processing, and types of clinical hypnotherapy like Rapid Resolution Therapy. There are treatment centers that offer trauma treatment alongside formal chemical dependency treatment. There are talented, trained professionals that are helping their clients, and your loved ones, move through trauma and towards a life of hope and resiliency. Find them! For more information on this subject please visit the website IamaRockstar.me. There’s no reason for you to go though this pain and unwarranted shame alone. Together, we can set you on a firm new path in your recovery.

InRecovery Magazine September 2017

9/5/17 11:52 AM

Soberlink Melds Mobile Technology with Sober Accountability

andom drug testing to monitor one’s alcohol intake may put the fear of God in the newly sober, but it’s not exactly a recipe for serenity in recovery. Meet Soberlink, which promotes scheduled testing with some legit blood alcohol content monitoring, to smooth out the process. It isn’t exactly a Breathalyzer, per se. It’s FDA-cleared, mobile-breath sobriety technology. In layman’s terms, it’s a handheld device with facial recognition software and a blood alcohol content (BAC) detector but zero aspirations for doling out DUIs. When a person breathes into Soberlink, both their BAC and their glamour shot/sober selfie are registered and uploaded into an online system. This system sends BAC results via email or text to a list of pre-approved people. Then, those people know without a doubt that their client or loved one is 100% sober. If they don’t get a test result, they know to ask what’s up. The tool was initially utilized most often in the criminal justice system, which makes sense. Soberlink founder and CEO Brad Keays’ father owned a monitoring company regulating people on house arrest through breathalyzer testing. Keays saw an opportunity for people in recovery, who no doubt might feel like they’re on house arrest in the early days, and he rolled out the first Soberlink device in 2008. His goal was and still is to empower and improve outcomes for people leaving treatment.

Generally, treatment professionals use Soberlink to keep tabs on a client after rehab. As such, most people undergoing exhale patrol have an addiction specialist getting 34

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If you’re looking for a device that can help keep a person in recovery accountable to the people who care about them, SoberLink’s got you covered.

the test results. These certified providers master the system, activate their client and set their testing (breathing) schedule. Soberlink’s Share Program is its fastest growing offering because it opens up the door for the individual in recovery to purchase the product and work directly with the company. You know how the saying goes: money can’t buy happiness, but it can buy a high-tech device that’ll keep an alcoholic in line. “Most treatment programs don’t offer continued care,” says Andy Rothman, Vice President of Sales at Soberlink. “We needed to make a pathway to allow the newly sober to create a recovery network. We deal directly with the person in recovery. We talk to them about how the system works. We encourage them to include people who are going to support their recovery: a therapist or recovery coach. It’s a way to share with loved ones that takes away subjectivity and thoughts of ‘Are they drinking or are they not?’” One successful Soberlink-er reported, “I used this for a show of faith for my employer and family. I have been sober over two years and still use Soberlink once a day, every night. It has been a helpful tool in keeping me sober, and I just signed up with my monitor to use Soberlink for another year.” Soberlink has a boatload of success stories, a victory they mostly attribute to being an alternative to random testing, which often creates more angst than accountability. It’s structured incentive rather than sudden in-

InRecovery Magazine September 2017

vasion. Most clients test first thing in the morning, once in the afternoon, and again during that early evening “witching hour,” formerly known as, “It’s five o’clock somewhere,” one of the most common trigger times. Testing hour is the new happy hour! Wondering what happens if someone wanted to drink between test times? Rothman’s got an answer. “If someone wants to have it, they absolutely can,” he says. “We’re talking about people who don’t know how to stop. It’s not sustainable. Rather than setting them up for failure, we’re setting them up for a program that’s easy to comply with.” Also, when problem drinkers start consuming alcohol, they usually end up behaving problematically. If they were able to control their intake in order to beat the game of daily, scheduled BAC testing, they probably wouldn’t need to be gaming Soberlink in the first place. The effectiveness of this tool is evident through its many happy (and did we mention, sober?) customers. “Soberlink has been an indispensable tool for maintaining my sobriety,” one client raved. “It gives me accountability to the people who matter the most to me and has been invaluable for rebuilding the trust that my drinking destroyed.” From the treatment professional to the concerned loved one to the person who’s new to alcohol-free life, taking advantage of tech-savvy innovations like Soberlink seems like a no-brainer and a lifesaver. Getting excited to use a Breathalyzer? Now that’s true recovery. InRecovery.com

9/5/17 11:53 AM

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Provides Structure, Adds Accountability and Builds Trust Patients receive scheduled test reminders via text messages

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info@soberlink.com

Submit test remotely with wireless technology and Facial Recognition

•

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InRecovery Magazine September 2017

www.soberlink.com

9/5/17 11:53 AM

Dear Dr. Josh: Do I Need Rehab? Dr. Josh Lichtman, answers your medical (and occasionally spiritual) questions. First up: letting an alcoholic know if rehab is necessary Dear Dr. Josh: There is no doubt in my mind that I am a pretty severe alcoholic. Do I need to go to treatment, or can I just get sober on my own? - On the Fence Dear Fence, You need to go to treatment. You probably are reading this and think that this is just a knee jerk response from a dude in a white coat. It truly is not. Yes, I know people who have gotten sober without formal treatment, and I have also seen plenty of patients who can’t get sober despite great treatment. Ultimately, the only way anyone gets clean is if he or she really wants to get clean. My point is this: there is no such thing as half-way sober; the only way to get clean is to be all in. Good treatment will provide you with the safe and supported container that will make getting and staying sober much easier. Most treatment starts with a medical detox for certain substances, depending on the severity of the problem. The withdrawal from some substances, including alcohol and benzodiazepines (Xanax, Ativan, Valium, Klonopin, etc.), can actually be life threatening if not treated appropriately. These situations require a medical detox 36

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with close monitoring and medication. Other drugs—opioids, crystal meth and cocaine—do not have life threatening withdrawal symptoms but can still leave a person feeling awful while the body kicks it. This can be alleviated with a detox that not only includes medications to treat withdrawal symptoms but also the possibility of using other medications to smoothly taper the body off opioids, such as Suboxone. Honestly, detox isn’t as bad as you may imagine; it is just a physiological process. One of the most recent alcoholics I detoxed told me that he felt guilty because it wasn’t painful at all for him. He likened it to camp but without S’mores or popsicles.

If your treatment includes psychotherapy, it could be trauma therapy, cognitive behavioral therapy (CBT), supportive therapy, psychodynamic therapy, EMDR, DBT or lots of other acronyms. Honestly, there isn’t enough space in this magazine to discuss them all. We’ll leave that to future columns. Psychiatry will probably also be a part of treatment; this is where a physician will interview you and determine whether or not medications such as SSRI’s or mood stabilizers may be helpful. There are also usually case managers and counselors on hand to help with the practical parts of getting your life back on track.

Once you’re medically stable, you engage in the meat of treatment (or for the vegans out there, the meat alternative?). This usually involves intensive group therapy, process groups and instructional groups like relapse prevention. If you’re thinking, “Now hold it there, Mr. Doctor, I’m not into sharing my feelings with a bunch of strangers,” just know that group therapy is the best method I know for showing people that there are other people just like them. Also, there will inevitably be at least one person in the group who is way more screwed up than you, and this may make you feel better (unless, of course, you are that person).

Several programs include other therapeutic modalities like meditation, yoga, art therapy, family therapy and even surfing, writing, sweat lodges and paintball (yep, paintball).

InRecovery Magazine September 2017

All of this can be done on an outpatient basis, where you can live at home, or in a sober living house, but residential treatment is highly recommended. I hope you find the right program for you. I recommend checking the InRecovery directory for options. Hey, if you find a place that provides S’mores, let me know. I think a number of my patients would like that. InRecovery.com

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WHY LESS PAIN MEDICATION

EQUALS LESS PAIN

ewsflash! If the medical community acts more mindfully and responsibly in handing out pain medication, that will go a long way toward helping us make greater progress in fighting the plague of addiction. It’s a sane, logical message, but unfortunately is taking longer than we’d like to spread through the hospitals, clinics and doctors’ offices around the country. That’s why I’m hopeful that a recent initiative by the University of Virginia Health System (UVA), in which patients’ pain scores improved considerably even as doctors gave fewer opioids, can serve as a role model for the rest of the nation. The UVA anesthesiologists reviewed a total of 101,484 surgeries between 2011 and 2015 in which patients were sedated. During this time frame, doctors were encouraged to minimize the use of pain medication to no more than was absolutely necessary. As a result, the average amount of opioids given per surgery declined a InRecovery.com

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whopping 37 percent. At the same time, surgical patients self-rated average pain score, on a scale of 0-10, declined from 5.5 to 3.8, a 31 percent improvement. How can we explain this? One of the key doctors in the study, Dr. Marcel Durieux, pointed out two major reasons why that was likely the case. First, it has been clearly proven that opioids themselves make patients more sensitive to pain. So, by reducing the dosages, the opiates were actually more effective. Second, was the increased use of non-opioid pain medications like licodaine and acetaminophen (up over 120%). As it turns out, in most instances, these lower level medications for pain control were more than sufficient to get the job done. “There is very clear evidence that people can become opioid dependent because of drugs they get during and after surgery,” remarked Dr. Durieux. “I think that by

substantially limiting opioids during surgery, we’ve made an important step in addressing that problem.” The UVA initiative was implemented as a reaction to America’s opioid epidemic. The intention was to be proactive in stemming the tide of a process that regularly, although unintentionally, creates new opioid addicts. Interestingly enough, along the way, the UVA researchers not only proved their point, that they could effectively reduce opioid dependence by being more careful in their prescription practices, but they did even more. By demonstrating that a reduction of opiate use combined with an increase in nonaddictive alternatives is actually MORE effective at addressing pain, they have created a model of safer best practices for the medical community to follow in the implementation of all pain management throughout the country.

InRecovery Magazine September 2017

9/5/17 11:54 AM

SOCIAL MEDIA

OUR NATIONAL OBSESSION

here’s a fine line between addiction and obsession. Addiction is a disease that lasts a lifetime; obsession is an overwhelming desire that leads one to distraction, to the exclusion of all else. As I watch the world evolve around me, I see people recklessly Tweeting and driving, breaking off relationships via What’s App, 38

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and spending more time at a dinner table surfing Facebook than they do enjoying the company of the person directly in front of them. Given all the attention paid to the virtual world, with my fellow human beings walking around zombie-like, smart phones glued to their hands commanding all their attention, I can’t help but

InRecovery Magazine September 2017

wonder whether we’re all engaged in one giant mass addiction that will impact society for generations. Addiction is commonly associated with drug or alcohol abuse, gambling, smoking over-eating and even sex. However, regardless of how it manifests, they all InRecovery.com

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stem from the same inner-workings of our brains. It has been determined that both ‘nature’ and ‘nurture’ play key roles in determining if someone will become an addict. If a person has one parent who is an addict, there’s an estimated 40% chance that she too will become an addict. That rate almost doubles if both parents are addicted. Yet, if someone born at greater risk of addiction is not exposed to the stimuli then the addiction with not arise. This is particularly born out by an NCASA study at Columbia University, published in 2011, demonstrating that if someone begins using drugs or alcohol prior to the age of 18, they have a 25% chance of becoming an addict as an adult. However, if use does not begin until after 21, that percentage drops to 4%. Since practically the entire world is exposed to smart phones from a young age nowadays, this study would seem to argue for a broad potential social media surge of addiction on each and every main street. But let’s delve further. The brain is made up of approximately 86 billion nerve cells called neurons. Neurons communicate with each other through chemical messengers called neurotransmitters. Some neurotransmitters are inhibitory, making it less likely that the receiving neuron will carry out some action. Others are excitatory, priming them to send signals to other neurons, inducing an action. The cycle of addiction disrupts the normal functions of some of these networks. The brain’s neural networks favor pleasurable experiences over non-pleasurable experiences. This is generally controlled through the distribution of dopamine, serotonin and other brain chemicals. Under normal circumstances, this serves us well, allowing us to enjoy such things as great food, sex and love. However, in an addicted brain, this chemical distribution gets thrown out of whack. Studies using PET scans and MRIs showing brain activity in both addicts and non-addicts, demonstrate a clear distinction in how they function. Brains of addicts become so impacted by the disease that they sense diminished enjoyment in things that would otherwise routinely be pleasurable, the brain simply wants more of what it is addicted to. Moreover, when an addict is not engaged in the addictive behavior, feelings of stress trigger norepinephrine, dynorphin and corticotropin, further nurInRecovery.com

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turing the pull of the addictive behavior. It not only feels good while you are doing it, it also feels bad when you are not. In fact, recent studies have even shown similarities between the addicted brain and people struggling with post-traumatic stress disorder, further highlighting the critical nature of the disease. Finally, addiction is not only affected by the physical mechanics of the brain, but also by psychological factors. When someone is deprived of whatever is fueling his or her addiction, it triggers physical cravings or urges to engage in that behavior, as indicated above. However, that’s only the half of it. Addicts are also haunted by the specter of something called ‘euphoric recall’. They remember how much fun they had while engaged in the activity. How many times have you felt a phantom buzzing on your leg or in your purse and assumed it was your cell phone? Well, you’re not alone. Using Social Media gives many people the pleasurable experience of connecting with the world and feeling validated. This euphoric recall increases your use of this medium and is yet another key factor to be considered in this debate. This issue is more than merely academic. Researchers at the London School of Economics found that when students were banned from having cell phones at 91 schools, those 130,000 students exhibited a 6.41% increase in academic performance. Students previously identified as underachievers notched a 14.23% increase. Whether it’s an addiction or simply an obsession, it clearly has an impact on our day-to-day lives.

Which brings us back to the main question - does our national obsession with social media and smart phones rise to the level of addiction? Based on all the factors listed above, I think it’s clear that most people would not meet the clinical criteria for addiction. However, considering the general prevalence of addiction and cross-addiction in society, and the general topic of this magazine and its readership, I would guess that a number of you reading this article might just qualify. But, please understand, that’s no reason to panic. Certain cross-addictions can actually be healthy (such as exercise), particularly if they help to avoid other, more problematic addictions, and are not ‘all-consuming’. The only way to get at the heart of the issue is through honest introspection. So, I politely suggest we consider our own personal social media habits and behaviors and conduct a personal account. Are our virtual lives materially and negatively affecting our real ones? If the answer is “no”, then great! However, if the answer is “yes”, then it might be time to do something about that and support groups abound (paradigmmalibu.com, crchealth.com, addiction.com). As with all things addiction, it’s best to get out ahead of the issue before it becomes a problem. For additional information on this perspective, please Google the article: Technology Addiction: Are we Raising a New Generation of Addicts, by Lisa Strohm, JD, PhD.

InRecovery Magazine September 2017

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NEWSLINE

UPDATES FROM THE EDITORS

Addiction Doesn’t Discriminate

A successful university academic in Canberra, Australia recently lost hundreds of thousands of dollars gambling on slot machines, undermining the fiction that gambling primarily harms only those in lower income brackets. Professor Brown tried to stop by self-imposing limits, something most of us addicts have tried at one time or another, only to find herself not only busting through her limits but also using techniques to skirt the local ATM withdrawal regulations. Her addiction nearly destroyed her relationship as she drained the family’s joint accounts.

A Small Victory

The FDA recently withdrew a prescription opioid named Opana ER from the market, after continued signs of the medicine’s abuse. It is twice as strong as Oxycontin and was designed to be time released, but addicts were crushing the pills to get a massive high all at once. In response, the manufacturer added a coating, making the pill crush proof. Undeterred addicts then learned how to liquefy and inject it. It’s all part of the troubling downward spiral addiction arms race. While withdrawal of Opana ER is hardly a panacea, it’s at least a step in the right direction.

Local authorities are investigating why casino management let her keep gambling and did nothing to support a regular customer so obviously in need of help. Regardless of how that turns out, it serves as a constant reminder that addiction can affect anyone at anytime. No one is immune to its alluring, destructive power.

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InRecovery Magazine September 2017

Librarians to the Rescue

Chera Kowalski is your typical mild-mannered librarian and now a regular hero after saving someone from an overdose with a double shot of Narcan and some CPR - and she’s not alone. Philadelphia, Denver and San Francisco are three cities now training librarians as first responders to the overdose epidemic, in an attempt to assist the over-burdened ambulance and fire department emergency services. As it turns out, libraries have come to be known as safe public places to get high by heroin abusers, who sneak into bathrooms to use. Libraries try to limit this problem, posting bathroom monitors and requiring ID, but they can only do so much. It’s tough on both the kids now exposed to this harsh new reality and librarians serving double duty helping someone find a book and administering first aid. It’s a rough commentary on the current state of addiction and only a temporary stop-gap to save lives until society comes up with a better, more comprehensive solution.

InRecovery.com

9/5/17 11:57 AM

6 Ways to Better Sleep in Recovery There’s nothing more helpful than waking up energized to power through another exciting day in recovery. 1. Wash Up Where’s your face been today? It may look clean, but it’s not. Don’t roll around in those germs all night, smooshing them into your pillow. Wash up for a clean night’s sleep. 2. Floss and Brush Simple flossing adds an average of 2-3 years onto someone’s life span. Besides eliminating plaque and keeping cavities at bay, brushing your teeth gives you a cool, refreshing feeling as you lay down to rest.

3. Treat Your Face Use an astringent, and massage night creams into your face to help you relax. You will also minimize wrinkles and dry skin in the process. 4. Lubricate Your eyes dry out during the night, making them irritated. Apply liquid tears to eliminate itchiness and redness. 5. Power Down Turn off your cell phone, put the iPad away and turn off the TV. Eliminate everything that can buzz, ping or beep you back into consciousness. 6. Pamper Yourself Try a nice lavender pillow spray, the soft sounds of nature or upgrade your sheets. Do whatever it takes to create a soothing environment for a restful trip in the land of nod.

SLEEP

Opioid Manufacturers Meet Their Match

Mike Moore is an unstoppable force. As Attorney General of Mississippi, he spearheaded the charge against Big Tobacco back in 1994. He almost single-handedly marshaled a multi-state onslaught that resulted in a $246 billion settlement. The addictive habit of smoking tobacco has been in major decline ever since. Mr. Moore is now a private attorney, bringing this same firebrand attitude to tackle Big Pharma and the opioid epidemic. Mr. Moore started by meeting with Attorney General Mike DeWine from Ohio, the state hardest hit by the problem and generally recognized as ground zero for the introduction of fentanyl, a particularly lethal form of opioid. Since then, he has helped persuade Mississippi, Missouri and Oklahoma, plus a number of cities and counties, to come on board and join the litigation. Ten years ago, Mr. Moore was also involved, when an affiliate of Purdue Pharma and three of its executives pled guilty to criminal charges of misleading the public, resulting in a $634.5 million fine and settlement. It is hoped that the new litigation can help stem the tide of aggressive marketing by opioid manufacturers while putting money into state and local coffers to fund addiction treatment programs. Opioid medication is a $9 billion market in the US. While opioids are FDA approved and often medically recommended to treat pain, they are also highly addictive. Rush Limbaugh, a national radio personality, and Kurt Angle, a famous professional wrestler, are two public examples of patients who inadvertently became addicts as a result of regular medical treatment. That’s why opioids are so scary. It’s not as if these patients sought out illicit drugs. They took prescribed medication under a doctor’s supervision. It really drives home the point that addiction can affect anyone. How will this all work out? Mr. Moore says he isn’t pursuing opioid litigation “as a money grab.” He wants to keep the issue in the public eye to fight addiction and recover money for treatment. Based upon his unqualified prior success, it’s good to know that we have people like Mr. Moore on our side in the ongoing battle against addiction.

InRecovery.com

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InRecovery Magazine September 2017

9/5/17 11:57 AM

Lawyer THE ADDICTED

An Interview with Brian Cuban

Law school may have been the ideal hiding place for his addiction, but this sober former lawyer, author and recovery advocate learned that real life doesn’t offer the same cover.

bright line demarcation; it was more that I had lost all my clients. I eventually just transitioned into something that made me happier.

Your official sobriety date is April 8, 2007. Do you have an official date that marks the end of your legal career?

As I went through my struggles and recovery, I noticed there was a tendency within the legal profession to avoid seeking help. I noticed a culture of fear. I took stock of my life in law school and realized how little help there was at that time. I decided there was a book that needed to be written. In a very timely fashion, the Hazelden Betty Ford ABA study came out with the finding that one in three licensed

n authority on male eating disorders and body dysmorphic disorder, Brian Cuban is an author and soughtafter public speaker. He’s in recovery from drug addiction, alcoholism, an eating disorder and practicing law. In his newest book, The Addicted Lawyer (Post Hill Press, release date June 13, 2017), Cuban explores his own foray into a legal career, the prevalence among lawyers toward addiction and the intense fear for individuals in this field around seeking help.

Around 2008 or 2009, I stopped practicing law. My legal career kind of died during my addiction. I really can’t say there was a 42

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Since you haven’t been actively practicing law for a few years, what inspired you now to venture into writing about addiction in the legal field?

InRecovery Magazine September 2017

attorneys is a problem drinker. I had started writing the book well before that, so it was a fortuitous thing. You write, “Although the thought of law school had never crossed my mind before that moment, it instantly became an appealing option; not because I wanted to be a lawyer, but because I saw the opportunity to spend three more years hiding from myself.” I think this is a very relatable sentiment to people struggling with addiction and substance use disorder. When and how did you have this revelation? I was a criminal justice major at Penn State in 1983, and I was a senior, waiting in the placement office of my major, lamenting InRecovery.com

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what I was going to do with my life, and afraid of the real world. I was even terrified of going outside. I was an alcoholic. I was bulimic and also exercise bulimic. My days were spent running, drinking, sleeping it off and isolating. I didn’t have the necessary skills to function in the workforce. I certainly didn’t have effective coping skills. I heard a couple of guys talking about going to law school. It seemed to be a perfect solution; I could drink, run and isolate. It’s not an uncommon thought process in addiction. The stress and nature of law school never entered my mind. It was all about survival, repeating the cycle. Do you think the substance abuse issues often associated with lawyers applies to most high-stress, high profile professions? What issues are unique to lawyers? Of course, every profession comes with its own unique stressors. Law is no different. Both the stress and the culture of fear around seeking help are problematic. Lawyers have a higher rate of alcohol use than doctors. That tells you something. The law profession attracts type-A personalities who may be susceptible to more substance abuse issues. Lawyers in general seem to feel the need to portray invulnerability, and many do not seek help until things blow up in their faces. One of the hardest conversations I have with lawyers is convincing them that it’s better to do something now than to wait until something bad happens that may put their life, family or freedom at risk.

How do you think the legal profession enables addiction? There is certainly a systemic culture of drinking throughout the profession that begins in law school. It will take education and work to turn that around. When you combine this with the culture of fear within the profession around loss of clients, licenses and prestige, and an inability to maintain a certain lifestyle, it means addicted lawyers often take longer to seek out help. Every state has a legal assistance program that’s confidential and protected by statute. Lawyers are afraid that if they use such programs, the bar may find out, and they could lose their jobs. You write, “We must challenge prevailing attitudes and behaviors that simultaneously encourage unhealthy lifestyles while discouraging helpseeking.” Can you elaborate on this and how it applies to the legal field and law school in particular? This is my major initiative. I wrote this book to change prevailing attitudes and behaviors. I regularly speak with many law school deans who are working hard to change them. There has to be a userfriendly pipeline from mental health to law schools so people aren’t afraid of the negative consequences of seeking help. One man you interviewed dropped out of NYU law school to go to treatment; then, he returned to finish law school at Stanford years later, which is so inspiring!

That’s a great example. Whether in law school or the collegiate community, dropping out is one of the biggest fears. I want people to know that you can pause to take care of mental health and make it back. It’s really okay. I didn’t go into recovery until I was in my mid-40s. It’s never too late to redefine your life. What do you do on a daily basis to maintain your recovery? I still attend 12-step meetings. I wake up every day and reassess where I am in my recovery. I see a psychiatrist weekly. I take medication to deal with clinical depression and body dysmorphia issues. Today, substance addiction recovery is not my biggest challenge. My biggest challenge is my relationship with exercise and food. I must stay constantly present so I don’t end up doing nine Flywheel classes a day. It would be easy to be triggered back into exercise bulimia. My family has been very supportive in my recovery, and I’m very lucky for that. Do you have any final thoughts? Wellness is not the same as addiction recovery. Wellness doesn’t cure cocaine or alcohol addiction. Meditation and yoga are great augmentations to recovery, but we don’t want to see someone who is struggling say, “Well, I’m doing these wellness things; I don’t need to address my underlying issues.” Law firms must learn to distinguish between getting help for addiction and viewing wellness as part of recovery. Wellness is never a substitute for the core basics of getting sober.

RUNRUNRUN Many find success by running the road to recovery 1. Burns off extra energy and reduces stress. 2. Increases blood flow to the brain, leading to clearer thinking. 3. Boosts self-esteem, confidence and sense of achievement. 4. Reduces cravings for drugs, alcohol and unhealthy foods. 5. Improves overall health, especially for your heart and brain. 6. Feeds happy thoughts and emotions. 7. Gives you a better attitude and hope for the future. InRecovery.com

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InRecovery Magazine September 2017

9/5/17 11:58 AM

Drug Use and the Law Alternative Sentencing

ddiction is a fierce master. It can drive you to lie, cheat and even steal, just to feed the beast. Almost all of us have heard stories to that effect, many of us know someone driven to such madness and sadly, for some, I might be speaking directly to you. It is a road of personal sorrow that can even overcome your most powerful fears, like losing a job a family, or even going to jail. It’s powerful stuff. And that last part, jail, is playing an ever increasing role, with a 2016 study by the National Drug Court Institute noting that over 127,000 people were sentenced using drug courts in 2014. Our new normal has hundreds of thousands of drug addicts and alcoholics flowing through the criminal justice system for committing acts stemming from their addiction. Most are warehoused in prisons in a state of involuntarily sobriety but without any substantive treatment. You probably even have a friend or family member now in the system. Most return to the same lifestyle they were in prior to incarceration and end up repeating the same behaviors all over again. It is a huge waste of taxpayer money, compounded by the social cost of so many people out of the workplace.

State and County courts began experimenting with treatment related programs commonly known as ‘diversion’, almost 30 years ago, as a form of alternative sentencing. The Federal Court in the Central 44

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District of California began successfully copying that model in 2012 and the Federal Government is planning on expanding some form of it nationwide, under a $1 billion mental health and substance abuse law enacted in early 2017 – The 21st Century Cures Act. Diversion is essentially court ordered treatment, offered as an attractive carrot to addicted defendants who qualify. It is also backed up by a substantial stick in the form of imprisonment, should the defendant fail to comply with the program. Perhaps you’ve seen the movie 28 Days starring Sandra Bullock. That’s a good example of how it works. Programs can last as long as two years and include regular check-ins and random drug tests. As you can imagine, diversion programs tend to have a very high success rate because, after all, when you are faced with the stark reality, standing ashamed in a majestic courtroom - who really wants to go to prison? Diversion is limited to non-violent, low-level offenders who do not have a prior criminal record. They must demonstrate the capability to benefit from the program, complete an evaluation by a mental health professional and show they are truly committed to getting sober and staying clean. If you, or a loved one, find yourself in the unfortunate situation of involvement in a crime as a result of drug abuse, please mention the option of diversion to your attorney or court appointed public defender, so they can pursue that as an option on your behalf.

InRecovery Magazine September 2017

This type of sentencing actually offers a lot of benefits to the community as well. It helps to relieve congestion in the courts already wrestling with overcrowding, and addresses the root cause of those particular crimes as opposed to just treating the symptoms. It also allows members to remain in the community, contribute to society and provide for their families who might otherwise apply for public assistance programs. Finally, it keeps them with their kids to help eliminate the persistent cycle of crime that all too often gets handed down from generation-to-generation. In the overall scheme of things, diversion is a much more cost-effective option than incarceration. Let’s face it, drugs can turn the best of us into criminals, under the wrong set of circumstances. For many, these diversion programs are the first opportunity they’ve ever had to receive medically supervised rehabilitation. That, combined with the significant consequence of non-compliance, makes people take the program very seriously, with a 50-75% average graduation rate However, if I could change anything, I would recommend extending supervision under the program out to a total of 5 years. Studies have proven that this length of aftercare is what’s required to drive relapse rates below 15%. Expanding use of alternative sentencing options, along with enduring aftercare, will go a long way toward saving the lives of addicts while benefitting society at the same time. InRecovery.com

9/5/17 12:00 PM

Infinite Change. Lasting Recovery.

elcome to Infinity Treatment Centers, where men and women pursue genuine, lasting change at our Southern California rehab facilities. Infinityâ&#x20AC;&#x2122;s luxury accommodations invite privacy and seclusion while offering access to vista hikes, beachfront walks, and urban recreation. With the support of our esteemed clinical team, we provide a full continuum of care, from detox and residential treatment to outpatient therapy and sober living.

Medical Detox

Every individual who comes to one of our Los Angeles locations for addiction treatment has a unique background and set of beliefs. Our team of masters and doctorate level therapists will create a personalized treatment program and closely monitor how the person is responding to each component to make adjustments throughout the treatment process.

Designed for men and women who have already completed residential care, are living at home, and have demonstrated success in recovery, our PHP takes patients to the next level in their sobriety pursuit.

Detox is the beginning of our care continuum: a chance to cleanse your body and prepare for treatment. Clients benefit from around-the-clock clinical support as they jumpstart their recovery journey.

Residential Treatment

With evidenced based cognitive behavioral therapy and psychoeducational groups, 24/7 access to clinicians and therapists, you are invited to pursue personal growth and achieve sustainable sobriety.

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Allowing clients to meet work and family obligations while living at home, our IOP includes relapse prevention groups, life skills workshops, stress management training, individual therapy, and community building.

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Infinity Treatment Center is a member of New Vista Behavioral Health family of treatment centers InRecovery.com

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InRecovery Magazine September 2017

9/5/17 12:36 PM

A Strong Leader in Yoga For Recovery She Recovers co-founder Taryn Strong has perfected the practice of using yoga to bring the body and breath into recovery.

LOW LUNGE

Lengthens hip flexors, stretches psoas and benefits the lower back. Balances and opens our sacral chakra, an energetic channel located at the pelvis/hip area. When the sacral chakra is blocked, it hinders our ability to let go and “let it flow;” we may feel stuck or unable to move forward. Helps to build mental focus, as well as energetic and physical stamina. Empties out our “junk drawer,” where we store suppressed memories, emotions, feelings and traumas.

hen Taryn Strong took her first yoga teacher training in 2007, the concept of incorporating yoga into recovery was still pretty underground. “I couldn’t even find a book on it,” she remembers. As the daughter of two alcoholics, she’d been attending 12-step meetings with her parents since she was little. Strong was first drawn to yoga after her own struggles with addiction, and she is now in long-term recovery from drugs and alcohol, self-harm, codependency and disordered eating.

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InRecovery Magazine September 2017

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MEDITATION

PIGEON

Restful sleep, which is helpful for those with insomnia.

Stretches psoas, benefits the lower back and stimulates blood flow to hip area.

Slows down our thoughts, which helps us pause when triggered.

Teaches us to sit with discomfort, which is necessary to learn in recovery.

Teaches us to witness our thoughts without attachment or reaction.

Helps us to open and release a place where we store a lot of stress, trauma, anxiety and emotions.

Helps us to focus and relax.

CHILD’S POSE Calming, restful and restorative. Opens up the back, shoulders, neck and hips. Teaches and reminds us what potent medicine taking the time to pause, rest and go inward can be Connects us with the relaxation response in the body.

Shows us how to sit with and feel our emotions as they arise.

She was baffled that in all the time 12-step culture had been permeating the world, no one had thought to incorporate the ancient Hindu, spiritual discipline of yoga into it. “Twelve-step programs are really good at addressing the mind and spirit, but not the body,” she explains. With so many doctors and therapists recommending yoga to their patients, especially those new to recovery, Strong saw the need for a program adapted to fit their unique needs. “A regular yoga class could be quite triggering for someone in early recovery, especially those recovering from PTSD or sexual abuse,” says Strong. As she explains it, the powerful combination of released emotions and the hands-on physical adjustments a well-meaning instructor might use to correct a pose can actually trigger a stress response in the body and make that person more vulnerable to relapse. Strong specializes in trauma-informed yoga, which uses inviting language and encourages students to explore and adjust poses as needed. “For a long time their body wasn’t a safe place to be, or maybe InRecovery.com

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they were numb and not feeling much at all,” she says. “When they take one of my classes, they start to feel again. If they notice that what they’re feeling is painful, they back off or modify the pose. It’s a safe place where they get to be in control, and that can be very empowering.” At 16, Strong started using cocaine and meth supplied by an older drug dealer boyfriend. “My parents got me to a therapist and 12-step meetings, and I stayed clean for a few years,” she remembers. Then her mother was diagnosed with cancer, and Strong moved to Victoria, BC to be close to her. “I didn’t know many people and thought we might lose her, so I started drinking and using again to cope,” she says. She also discovered yoga, which would not only save her but also grow to something much bigger than she realized at the time. “My yoga teacher started talking about gratitude, which hadn’t even occurred to me, and surrender and letting go, and it really resonated,” she recalls. “I started doing yoga every day and began feeling grateful and peaceful.”

Later, Strong tried drinking like a “normie” but again found she was struggling with a drug and alcohol problem, and that’s when she focused on Yoga for Recovery. She found a Yoga For Trauma training center and took Nikki Myers’ Yoga of 12 Step Recovery course in 2014. She has been perfecting her own style ever since. Strong’s mother Dawn Nickel beat her cancer and the two of them went on to create She Recovers, a company with a loyal, online following that is well known for their retreats and events designed around radical self-care and empowering women to recover so they can help others do the same. The highlight of Strong’s recovery was coteaching a class alongside her yoga and recovery hero, Elena Brower, at the She Recovers event in Manhattan last May. “Getting to witness Elena in her element, teaching yoga to a room filled with more than 200 women in recovery, has been the best moment in my life so far,” she says. “If it weren’t for my own recovery, I wouldn’t have been there. It was a gift for the path I’ve chosen.”

InRecovery Magazine September 2017

9/5/17 12:06 PM

TIME STRESS AND

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InRecovery Magazine September 2017

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9/5/17 12:09 PM

Self-Care and Self-Awareness in an Age of Instant Gratification

sn’t it interesting that as a society, we collectively lament that we “don’t have time” for all of our responsibilities, while simultaneously complaining that we need to change our habits and find time for self-care? As a crisis counselor, interventionist and doctor, I am often on call for emergencies. I handle urgent problems like assault and suicide attempts. The people who reach out to me are in crisis; the last thing they need to consider are my needs, my busy schedule, or what I might be in the process of doing when they call. It is my responsibility to dial down the chaos. If I can’t remain calm in the eye of the storm, I should not be in a career where that’s required. With practice, I have learned how to handle almost any situation without losing my head. It is often said that one cannot serve from an empty vessel. This is a universal truth that applies to those of us who work in the field of recovery and mental health care, as well as for any person in recovery. Simply stated, you have to take care of your own spirit first. Awareness of what is realistic and important is absolutely necessary to maintain our sanity. Many of us in recovery are self-admitted “people pleasers” who feel immense guilt when we put ourselves first or when we have to say “no” to others. Our smart phones demand our attention. We feel guilty if we cannot or do not respond immediately to the incessant ringing, pinging and flashing. We compromise peace in our own souls when we over-commit. It has almost become a badge of honor to complain about having so much to do and to beat ourselves up for being “behind.” This has become a constant conundrum. I repeatedly address this issue in my personal life, and I advise clients and people working for my company to do the same. I invite you to begin the process by thinking about how much you can realistically handle. When I am overwhelmed, I first ask myself this question: Is it on fire? Is this situation, InRecovery.com

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text, call or email something that cannot wait? I ask this question because in my line of work, some things are, figuratively, on fire. I may have a book deadline, a live radio show that I need to be present for, or a client in distress. Some fires can be put out easily or at least temporarily. Can I ask the publisher for a few more weeks? If I call my client and offer some helpful words, will that soothe their urgency? Does that friend of mine need me to text right now to reply to the picture of their child going down the slide? Can I lovingly say no? The answer most of the time is no, it isn’t on fire and yes, the matter can wait. There is something to be said about allowing yourself to be in the moment and not pulled in all directions by the increasingly hectic, high-tech pace of our lives. Selfcare means taking care of yourself. Getting dragged into high drama or into the needs of every person who asks for your time is a recipe for disaster. For many of us in recovery, it is also a recipe for relapse. Not everyone and everything deserves a front row seat in our lives, and we need to respond and adjust thoughtfully and accordingly. We cannot sustain a healthy existence if we are under too much stress and pressure, or are feeling rushed and chaotic. Therefore, we must learn to stand up for ourselves. Just how necessary is it to jump into the fray? Oftentimes, things will resolve themselves if we simply “stay in our own hula hoop.” Our own recovery comes first. Our own peace comes first. Our own families, our own healing, and our own livelihoods and lives, depend upon that reality. We can commit to creating a more manageable life. We can set boundaries with the electronic devices we depend upon by using already-installed features to make them more amenable to a busy lifestyle, and by not allowing ourselves to be at their mercy all of the time. Our phones are not beepers; they only make noise if we have sounds turned on. There is a “do not disturb” feature so that only the most urgent

Counseling Advice for a Constant Recovery Conundrum calls ring through. You can even put individual texts on silent, and answer them later or not at all. Seek professional counseling if you need support or assistance in creating a new structure in your life. This is a major life transition, and most of us need help to power through to the other side. Finding a balance that works for your individual needs is a great way to exercise that selfcare muscle. Learning to say “no” to people who cause you stress or with whom you no longer enjoy common ground can be an opportunity to grow. Language is powerful, and looking at a list that you can’t possibly finish breeds negative selftalk. Break tasks into bite-sized, manageable chunks. It is difficult to handle a list like this: Exercise. Run all errands. Pay bills. Finish book. It’s easier to complete a measurable list: Take a 30-minute walk. Buy dog food. Pick up dry cleaning. Pay phone bill. Complete a chapter. Designate a set time to work on something about which you have procrastinated, and work on it over the course of a few days. In doing so, that closet will actually get cleaned out, and you will no longer feel behind. One step at a time, and in our own time, we move ahead if we are taking steps forward. Time is not our enemy, it simply is. We all have the same 24 hours in each day. More than ever, self-care must be part of our daily recovery. Time is non-refundable, and it is up to us to spend it wisely. An investment into the time and care of and for your Self is something you will never regret; it will reap endless dividends.

InRecovery Magazine September 2017

9/5/17 12:09 PM

Book Review

The Trauma Heart

ll of addiction first starts with a trigger. For most people it is a trauma that shatters them to their core, according to world renowned addiction treatment professional and now author Judy Crane. These traumas are almost impossible to imagine, let alone deal with, and this subject as lived by both the author and her patients makes for a particularly compelling read. Judy Crane's raw honesty and willingness to share some of the most personal aspects of her life, serve as an inspiration to anyone who has had the misfortune of experiencing extreme, tragic circumstances. I have been shot and stabbed and had many black eyes and broken bones. I have been arrested multiple times and I have been held physically and emotionally hostage. I have spent three weeks in a psychiatric hospital with methamphetamine psychosis and a shattered elbow in a cast --In my wildest dreams...I never would have expected to find recovery at forty-two, complete my master's degree at age fifty, become licensed as a therapist at age fifty-two and start a treatment center at age fifty-seven, sell the treatment center at sixty-seven and found another treatment center at seventy-one. 50

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Her book also adeptly explores the traumas of some of her patients, adding depth and perspective to this weighty topic. These tales express sadness and despair as we learn more about each unique character's own journey of hurt and trauma induced self-destruction, searching for a way to escape the pain. Addiction. The topics range from childhood sexual abuse to PTSD and the addictions run the gamut. She also focuses on all aspects of addiction from secret-keeping to relapse, and from overdose to recovery. Ms. Crane brings a powerful message to her story and those of others, as someone who struggled and not only found a way out, but discovered how to thrive. She's a living testament to the expression "Whatever doesn't kill you makes you stronger." Some of the events or situations leading to trauma might include: l

Abandonment and neglect Emotional, physical, spiritual and sexual abuse Accidents, fires, natural disasters, random acts of violence, financial concerns, events that can involve too much, too little or sudden loss

InRecovery Magazine September 2017

errorism, constant and repetitive T viewing of terror events on TV or social media ivorce, adoption, bullying, domestic D violence, multiple moves, death or loss of pets

Medical or mental health issues

Death or suicide of family members

Grief issues

eterans, war, or having a loved one V experience war or combat

Intergenerational trauma

In utero trauma

The best part of The Trauma Heart is that it is more than just a story about reinforcing the hope for a brighter tomorrow. Ms. Crane uses all of the lessons learned by herself and others as teaching tools, by including helpful thoughts and questions at the end of each chapter. She encourages growth not only through her words, but by her method as well. The Trauma Heart is available at HCIBooks.com and provides a special kind of therapeutic entertainment we could all use more of in recovery.

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The BOOKSTAND Recovery is the subject of countless books, blogs, films, CDs and apps. Below are some titles worth a look. If you would like us to include your books, blogs, films, CDs or apps in this column, please contact editor@inrecovery.com.

Expect Delays: How to Reclaim Your Life, Light and Soul After Trauma (Danielle Delaney, CreateSpace, 2017).

You CAN heal ENTIRELY from severe, deep trauma â&#x20AC;&#x201C; without needing a lobotomy. The author shares the traumatic experiences of her assaults, and her journey of recovery and growth into the powerful woman and trauma expert she is today. Recovery is not a simple path, and you will encounter detours and delays along the winding road. Learn new tools and belief systems for living through it and surviving. Discover how to endure and to emerge victorious. Available on Amazon.

Recovery: Freedom from Our Addictions (by Russell Brand, 2017).

With a rare mix of honesty, humor, and compassion, comedian and movie star Russell Brand mines his own wild story and shares the advice and wisdom he has gained through his fourteen years of recovery. Brand speaks to those suffering along the full spectrum of addictionâ&#x20AC;&#x201C;from drugs, alcohol, caffeine, and sugar addictions to addictions to work, stress, bad relationships, digital media, and fame. Brand understands that addiction can take many shapes and sizes and how the process of staying clean, sane, and unhooked is a daily activity. Available on Amazon

Rewired: A Bold New Approach To Addiction and Recovery (by Erica Spiegelman, 2015).

Rewired is a new, breakthrough approach to fighting addiction and self-damaging behavior by acknowledging our personal power to bring ourselves back from the brink. Centered on the concept of self-actualization, Rewired will guide you towards not only physical sobriety, but a mental, emotional, and spiritual sobriety by learning to identify key principles within yourself, including authenticity, honesty, gratitude, and understanding a need for solitude. Available on Amazon.

101 Tips for Staying Clean & Sober (by L. Scott Hartman, InRecovery Press, 2017).

Some days in recovery are more difficult than others. Life comes at us fast and from many different angles, challenging our ability to cope. Mr. Hartman offers 101 engaging tips for staying on the road to recovery. Includes exercises and affirmations for staying inspired and focused. Things run more smoothly with preventative maintenance. Does your recovery deserve any less? Available on Amazon. P

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InRecovery Magazine September 2017

9/5/17 12:09 PM

THE IMPORTANCE OF

AFTERCARE

ecovery is a tenuous thing, very hard to achieve and even more difficult to retain. Even the decision to seek recovery requires courage and a tremendous sense of purpose. The addiction treatment community and society at large places a high value on getting addicts to a point of sobriety and spends a lot of money to get them there. Unfortunately, that’s exactly the point at which we start to fall short. Imagine a car company. It spends a considerable amount of time developing a new model, from blue-prints to 3D imaging, testing and engineering, finally culminating in the rollout of a shiny fleet of vehicles off a modern assembly line. Everything is teed up, all is perfect, but they then decide to spend absolutely no money on marketing. I’m sure we’d all view that as a terrible decision, as the fancy new cars sat idle on the car lots, wasting away and depreciating with each passing day. Well, in many ways, our system for addiction treatment is doing just that. Most addicts get serious about recovery only after they’ve hit rock bottom. They go to Detox, 28 day programs, or any number of in-patient or out-patient facilities to begin the expensive process of getting clean. Even when the treatment is covered by insurance, the medically su-

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pervised hand-holding of people through acute care, at the beginning of treatment, is done at great cost, and rightfully so. After all, what wouldn’t you do to save a life? However, once the patient is out of the woods and standing on his or her own two sober feet, he/she may look a lot better, but his/her disease of addiction is far from gone. Yet, like that car company that tried to save money by going cheap on marketing, we do a disservice to patients and the entire recovery process, right at the point that treatment is most cost-effective. The average relapse rate can vary depending on the type of addiction and the type of treatment, but generally is in the 60%80% range. Most people in recovery relapse a few times before recovery finally takes hold. However, that relapse rate goes down markedly, to below 15% (an 85% success rate), when addicts stay in a supervised aftercare program for at least 4-5 years. The numbers speak for themselves. Several treatment centers have rolled out aftercare programs, but only as an adjunct to their primary treatment. Moreover, the insurance industry is not giving aftercare the funding nor the priority it deserves. Greater adaptation of the disease model of addiction is helping to re-shape public opinion, but not nearly quickly nor effectively. That’s why it is so critical for fam-

InRecovery Magazine September 2017

ilies struggling with addiction to get involved and put a human face on the issue. 28 million Americans are abusing illicit drugs or mis-using prescription drugs, which also deeply affects families and friends. Imagine what a political movement of over 100 million people could accomplish if we marshaled together all the people truly affected by addiction. So, recovery may be tenuous, but the good news is that there’s something we can do about it. If you or a loved one is in the midst of recovery, then ask for, no, demand a comprehensive aftercare program. Review it to make sure it makes sense to you. Don’t be afraid to ask questions, don’t be shy about getting involved. No one is going to look out for you better than YOU. Also take the time to make your voice heard in Washington by contacting members of Congress and Senators on the issue. Let them know that medical care MUST include addiction treatment with ongoing ‘aftercare’ as a key component. Congress passed a $1 billion program at the end of 2016 and that was a good start, but it realistically is just a drop in the bucket, in the grand scheme of things. You have already made a major investment in getting sober, so see this through to the end and reap the rewards you surely deserve for all your hard work. InRecovery.com

9/5/17 12:10 PM

ADDICTIONOW

DISPATCHES FROM THE FRONT LINES Non-Addictive Opioids? Not so fast.... As I recently read about RoxyBond, an opioid with supposed “abuse-deterrent properties”, I couldn’t help but feel as if I was having Deja Vu all over again. Here we go, the FDA approving another pain relief medication destined to wreak it’s own special brand of havoc at some future point in time. After all, opioids got their start thanks to a 101 word article (a mere 5 sentences) in the New England Journal of Medicine, describing a basic analysis of 11,822 hospital patients who took a narcotic pain killer at least once. It finished with, “we conclude that despite the widespread use of narcotic drugs in hospitals, that development of addiction is rare in medical patients with no history of addiction.” We now know that statement to be categorically wrong. Then came Purdu Pharmaceuticals in the late 1990s, touting their new and improved, time-released Oxycontin, designed to be addiction proof. Another representation that turned out woefully catastrophic. In the meanwhile, the overdose death toll continues to climb: 48,000 in 2014, 52,000 in 2015, and 59,000 in 2016. Think twice (or more) before you even consider taking RoxyBond as part of necessary medical treatment. Remember, the current opioid epidemic began with 5 simple sentences, it remains to be seen how it will all end. InRecovery.com

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Alcohol problems By The Numbers

Bike Therapy

United States l

8 6.4% of adults have drank alcohol in their lifetime 7 0.1% of adults have drank alcohol within the past year 5 6% have drank alcohol within the past month 6 .9% report binge drinking within the past month 7 % report having engaged in “heavy” alcohol consumption the past month 1 5.1 million adults have Alcohol Use Disorder (9.8 million men/5.3 million women). 6 23,000 adolescents have Alcohol Use Disorder

There’s something about the combination of fresh air and endorphins that does a body good. It staves off boredom and helps your mind wander into the Zone, fostering happy thoughts and emotions. Bike therapy is an ideal way to stay active in maintaining your sobriety. Another great part about it, is that there’s no need to do it alone. Bicycle clubs can be found throughout the country, some even specifically formed to help those in recovery. They also mix-up the terrain from highways and byways to cross country through the woods, to keep things fresh and interesting. Bike therapy is something that can also be enjoyed with the entire family. So, if you’re looking for something to spice up your recovery, consider the good ol’ fashion American bicycle. You’ll be amazed how the simple things can be so rewarding!

Alcohol misuse costs the US $249 billion Globally l

lmost 6% of worldwide deaths are attribA utable to alcohol consumption lcohol consumption is the 5th leading A risk factor for premature death Alcohol is responsible for 25% of all premature deaths in the 20-39 year old range.

Source: National Institute on Alcohol Abuse and Alcoholism

InRecovery Magazine September 2017

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Re-Purposing Prescription Drugs to Fight Addiction

wo of the world’s most acclaimed universities, Harvard and MIT, have begun creating a library that catalogs the ways thousands of drugs that may have great “off-label” uses (secondary uses not originally contemplated by the manufacturer). Some scientists are now pouring over millions of data points for information that could be helpful in combating alcoholism. The idea is to find drugs that affect the brain function and can turn off the strong cravings that literally compel alcoholics to drink. Developing a new drug can take as long as 10 years and cost $1 billion or more. This new data library of existing drugs provides a wealth of information that can save time and money in the battle against addiction. George Koob, the director of the National Institute of Alcohol Abuse and Alcoholism is a big supporter of this project. He notes that over 90,000 people are killed as a result of alcohol each year (between overdoses and auto accidents), almost

three times the number killed by opioid overdoses, that we see broadcast daily on the news. There are currently three drugs approved by the FDA to treat alcoholism, Disulfiram, Naltrexone and Acomprosate, but less than 20% of alcoholics get any treatment. However, with the discovery of other options, perhaps the issue can get wider recognition and result in more recoveries. There are a few drugs showing some promise, including one called Gabapentin, and they may be ready to begin human trials before the end of the year. These advances are very positive , but regardless of the outcome, it’s important to remember that there will never be a magic elixir to cure alcoholism. There are still psychological and social factors contributing to the disease. Nonetheless, hope springs eternal for a drug to stop cravings, which would go a long way toward making the goal of recovery that much easier to obtain.

Beware of Patient Brokers

ou’ve made the decision to get treatment but are still unsure what’s best for you. You’ve begun searching online and checked the InRecovery. com website, when all of a sudden you hear an advertisement on the radio. Someone is touting his services to find the perfect addiction treatment center to suit your needs. You’re later surfing the web and see the same ad, and maybe later again while watching TV. The offer can seem pretty tempting. If you’re like me, you’ve made some pretty awful decisions in the past and would love to have someone relieve you of that burden. “Please choose for me.” The problem is that these experts are frequently just selling you out to the highest bidder. It’s called Patient Brokering, and it’s illegal. Not for you, the patient in need of treatment, but for them, the people preying off your desperation. Their offer to send you to the ideal location is actually only ‘ideal’ for them, and the unscrupulous addiction treatment center paying the broker a commission to direct you there. Authorities are cracking down on this practice, with one such example the recent arrest of a former Palm Beach County deputy officer and one-time Florida State House of Representative candidate, charged with 15 counts. Addicts face enough burdens with their disease, as it is. The last thing they need is additional obstacles in their way. So, as you sit down to make a choice of where to go, and make no mistake, it’s a very important choice, please ask friends and family for advice. Do the research, put in the effort, ask questions and learn how to again begin trusting your own instincts. It’s a life skill you’ll need to develop and it will help keep you safe from dishonest strangers who don’t have your best interests at heart.

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InRecovery Magazine September 2017

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ALCOHOL and ADOLESCENCE

A LETHAL MIX

patterns. The goal was to identify ways in which the drinkers’ brains communicated between regions as contrasted against the non-drinkers. The results were both astounding and troubling.

The study, conducted by the University of Eastern Finland, compared 27 youths aged 13 to 18 who drank heavily in their teen years, against a group of 25 non-drinking teenagers of similar age, gender and education level, who served as the control group. The scientists then followed the groups and caught back up with them between the ages of 23 to 28, using brain scans to analyze differences in their wave

The results demonstrated several key differences between the groups, however, the most important distinction was the fact that heavy drinkers exhibited significantly greater activity of something commonly referred to as GABA (gamma-amniobutyric acid). A normal amount of GABA, in and of itself, is important for the proper functioning of a healthy brain, but excess amounts, like that indicated in the brains of the heavy drinkers, frequently lead to anxiety, depression and any number of other neurological disorders. So, in other words, drinking in excess clearly puts people at considerably higher risk for troubling long term conditions.

started drinking in my early teens. It was no big deal. My dad drank, my uncles drank, all my friends drank, all my parents’ friends and my friends’ parents drank - in fact, who didn’t drink? It was socially accepted, an adult right of passage. I’m sure many of us may have experienced the exact same thing. That’s why a recent Adolescents and Alcohol study confirming the devastating destruction alcohol has on the young brain, really caught my attention.

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One thing the study didn’t do, which I wished it had, was confirm the brainscans resulted in a greater percentage of drinkers actually experiencing anxiety, depression or one of the other possible effects. This study makes a very important point, I just feel that they missed out on an opportunity to really hammer it home, by connecting all the dots. As a society, we are all too willing to understand that teenagers are curious, rebellious and want to experiment. We did the same as kids and it has been like that for generations. The thing is, we didn’t know any better at the time and neither did our parents. Well, now we do. We can no longer look the other way and assume things will be okay. Science proves it to the contrary. It’s time to be proactive and forcefully educate the youth of today on the inherent dangers of teen drinking before we doom an entire next generation to the exact same fate.

InRecovery Magazine September 2017

9/5/17 12:11 PM

Healthy Co-Addictions as a Treatment Tool

hile all addictions may share the same root cause, they manifest differently from person-to-person. Some are addicted to alcohol, others to gambling, some to a particular drug and others to over-eating. In fact, most people who suffer with addiction usually also struggle with cross-addiction between several or more things, further exacerbating the problem. You see, addiction is a form of obsession. A person gets a chemical jolt in his brain from engaging in a certain behavior, and is then driven by that bolt of adrenaline, dopamine and serotonin, again and again. I got my first taste of this on the front lines in business, ‘winning or losing’ daily, I really enjoyed the adrenaline rush of ‘winning deals’. It’s that sensation that drives addiction, and that’s part of the good news; not all addictions are necessarily bad for you. Yes, you read that correctly. Finding a healthy co-addiction can actually be a very productive way to re-direct your disease in a positive direction. An addict’s biggest enemy is boredom; as they say ‘an idle mind is the devil’s workshop’. The obsession commandeers your inner voice to the point of blotting out all else. There’s a very good reason why many treatment centers focus on hobbies and activities as part of the overall treatment. Whether it’s equine therapy, sculpting,

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crochet, Tai Chi, painting or just working out, the options are only limited by your interests and imagination. Lately, adult coloring books have been all the rage. The point is to find something that fulfills you, that keeps your attention in a meaningful way, to otherwise distract you from the negative addiction that drove you to seek treatment. In certain instances, many patients then become obsessed with this new activity, but that’s not necessarily a negative outcome. Ideally, of course, the goal is to re-train an addicted mind away from obsession altogether, but that’s not always an attainable goal. It’s therefore important to be realistic and, on occasion, even enable someone towards a healthy co-addiction, under the right set of circumstances. One of the difficult challenges then, is actually finding a suitable replacement. Many addicts have been under the influence of the disease for so long, they don’t even know which way is up. In addition, while different hobbies may run the gamut, it’s impossible for any given treatment facility to realistically offer more than a few options. It’s therefore often best if family and friends get involved in both selecting the treatment facility and serving as guides in the entire process. It can be confusing, as sobriety kicks in and the person re-discovers himself for the first time in a long while. It is obviously more

InRecovery Magazine September 2017

helpful for someone in Recovery to share this new part of his life with someone he cares about. It increases the likelihood that this new behavior will stick.

“An idle mind is the devil’s workshop” However, despite the benefits, it’s important this new activity be supervised to a certain extent, because even a healthy co-addiction can be problematic if taken to the extreme. Everything is best in moderation, but addicts generally don’t do well with moderation. They also don’t do well in supervising themselves. Too much working out can be dangerous, being engaged in artwork to the exclusion of all else can make someone overly vulnerable. Yet, I’ve met dozens of addicts who go to AA meetings 5-7 times a week and sponsor as many as 10 sponsees; they make helping others their new addiction. Few people would consider that unhealthy. There is a fine line to be drawn, and that can only be done on a case-by-case basis. There’s no single correct answer but, as with most things, I find that mindfulness and common sense rule the day. Addiction is a tricky foe. An addict’s brain is not wired the same way as the average person. There are no easy steps or quick fixes. Getting to the point of sobriety is a huge challenge, but it typically occurs under strict supervision in a controlled environment. The true tests arise once intensive treatment is complete. That can be the scariest part. People in Recovery need viable alternatives to keep their former lives at bay. The biggest impediment to staying clean are past ‘people, places and things’. By providing new habits and offering attractive ‘other’ choices, we better assist addicts in re-starting their lives on a new foot on their long road to a lifetime of Recovery.

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9/5/17 12:12 PM

The Science of Addiction An Asthma Drug to help Curb Alcoholism?

budalist is a name most people have never heard of. It is an anti-inflammatory drug that has been used for years in Japan for the treatment of asthma. The results of a recent study at the University of California, Los Angeles (UCLA), now reveals that this drug could also have a role to play in the fight against alcoholism.

The treatment of alcoholism is most often dealt with through mental and emotional healing. Typically, it’s provided in a medically supervised treatment center, an out-patient setting or through support groups such as Alcoholics Anonymous. These programs have done wonders, enabling the rebuilding of families and saving countless lives. They’ve been critical for helping someone in the throes of addiction better understand his or her illness and provides the educational tools necessary to fight the disease. However, the one thing they can’t do is turn off the lingering physical cravings that escape all logic. The Ibudalist research evaluated a group of men and women who drank seven or more alcoholic beverages per day, for more than 21 days a month - people clearly struggling with severe alcoholism. For the first five days, they were given dosages of the drug. On the sixth day, they received the equivalent of four drinks directly into the blood stream via an intravenous feeding tube, to see how their bodies would tolerate alcohol in their system. Scientists were pleased to discover that the subjects reported fewer cravings for alcohol and overall improved moods as a result of taking Ibudalist. The study’s lead author and UCLA psychology professor, Lara Ray, noted “we found that Ibudalist is safe and well tolerated.” What she found most promising was not only did the drug diminish the desire to drink, but it did not induce any side effects when a subject drank alcohol in combination with the drug. That is a problem common with other Medically Assisted Treatments (MATs) used to combat alcoholism. Addiction is the number one disease in America. On any given weekend evening, almost 8% of people stopped at roadside InRecovery.com

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checkpoints test positive for alcohol in their system, 2% of whom are over the legal limit. Driving while impaired accounts for over 1/3 of our nations 40,000+ auto accident deaths. A seminal study from Harvard in 1983 entitled “The Natural History of Alcoholism” reported that alcoholism was a major cause of liver disease, depression, neurosis, divorce and toxic relationships. Despite increased awareness, those same conclusions still prove true today. This study provides hope and some interesting insights. Several current MATs for alcohol work by making the alcoholic sick when he or she drinks. Many people are therefore quite reluctant to adhere to a long-term program. Ibudalist also apparently has a positive impact on people who

drink to the extreme. These are the ones who most notoriously reject pleas to enter treatment and, even once in treatment, are most difficult to help get and stay clean. However, despite these benefits, I am left wondering whether the drug is equally effective on people who are less alcoholic than those included in the study, and about the reliability of the ‘self-reporting’ aspect of the study since no control group was mentioned. I am also left curious about the medical reasons behind why an anti-inflammatory drug would have these properties. Researchers indicated they will be conducting additional studies. I look forward to keeping you abreast of those ongoing results.

InRecovery Magazine September 2017

9/5/17 12:12 PM

Meditation Isn’t Just for Yogis

t’s Monday morning and the weekend’s over. I feel a sense of loss, an emptiness that I just can’t explain. It’s sunny outside, my family’s near me, but my mind is wandering uneasily towards an abyss that I just can’t explain. That happens to all of us, and it’s a rather normal part of life. However, for us addicts, it can sometimes be debilitating. Don’t let it be debilitating; you don’t have to let it be that way. There’s an ancient art that I use to cope with almost anything in life and it’s the art of meditation and yoga. I was one of those people that was repelled by even the words “meditation” or “yoga”. Whenever I heard the words, my brain instinctively smelled patchouli oil and incense. I thought of it as some fluffy newage-mumbo-jumbo fad that would eventually go away. Well, I was wrong and I can safely say that meditation and yoga are, by far, some of the best tools in your tool chest to cope with addiction.

enced these benefits. Yoga and meditation have been around for over 5,000 years and are an integral part of numerous cultures, religions, and people. So, who am I to argue with 5,000 years of proof?

Obviously, we all need to cope at different times for different reasons, but the methods of yoga and meditation are very similar. If

It may seem hard at first, but the mind is a powerful tool, and pretty soon you will be transported to that thing.

My wife is a huge yoga fanatic and she had been trying to convince me to attend one of her classes for months. But, like many of us addicts, I was stubborn and knew it wasn’t for me. There was nothing she could do to convince me otherwise. She outwitted me, however, with a dash of data and a dollop of my doggy. She signed all of us up for a doggy yoga class on the beach and shared all the data points showing the benefits of yoga and meditation. All of that helped, of course, but what really convinced me to incorporate it into my philosophy coping was the profound ease with which I was able to calm my mind and disappear from everything. Meditating that day on the beach was like putting all of my problems on a rocket-ship out to space, while I got to stay here and enjoy the serenity that is earth and nature. And I can safely say, that I’m not the only one that has experi58

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InRecovery Magazine September 2017

you can, try and join a yoga class you can attend on a regular basis. You won’t just see benefits while you are meditating, but they will stay with you throughout your week. Furthermore, the sense of community and camaraderie with your fellow yogis is a time-tested way of coping. However, if you’re one of those people that just doesn’t have time to attend a regular class or don’t want to fully commit to one just yet, don’t lose hope. The beauty of yoga and meditation is that they are as easily accessible as air. Try this: the next time you find yourself feeling anxious or a bit unnerved and want to calm yourself down, just find a nice comfortable spot to sit down. It can be on the ground or on a chair. It doesn’t really matter as long as you’re comfortable. Then just close your eyes and concentrate deeply on your breathing. Breath in and out slowly and methodically. You’ll find your mind calming to a point where you will actually hear your heart beat. As you’re breathing, start thinking about something you love. It can be anything: a place you visited, a relative, a favorite song, or a book. Think about that something, touch it with your mind, feel it, love it, and cherish it. It may seem hard at first, but the mind is a powerful tool, and pretty soon you will be transported to that thing. Stay there as long as you like and when you find yourself comfortably calm, slowly open your eyes and come back to this world. As your eyes open, your world will be more vivid, more serene, and just a bit more perfect. Yoga and meditation, like all coping mechanisms, work so well because they are a speed bump for our minds. One of the biggest challenges for us addicts is to tame our thoughts and yoga and meditation help us do just that by reminding us of the beauty of life and nature. Just remember, there are really no rules in practicing yoga to cope. You just need to figure out what works best for you on your personal journey of recovery. InRecovery.com

9/5/17 12:39 PM

The Gory Impact of Addiction

e inherently know we are damaging our brains and bodies when we use drugs, however we hardly ever stop to think about the specifics. Sometimes it’s the details that capture our attention. I know that smoking can lead to lung cancer, but it wasn’t until I saw my uncle drowning on the fluid in his own lungs during his final week of life that it really hit me so dramatically. Well, the same applies to drugs and alcohol. Perhaps by taking the time to walk through the details, I’ll touch some of you who are now mindlessly indulging in your addiction, but considering recovery. Ingestion of opioids slows down many of your body’s critical functions. Most importantly, it reduces your ability to breathe and capacity to process oxygen. This leads to cellular death, particularly in your brain. If this continues long enough, it can lead to something called anoxic brain injury. If you survive, it can affect your speech, vision, hearing, motor skills, ability to recognize things or regulate your emotions, and even send you into a vegetative state. All too frequently it leads to death as you suffocate. Consumption of alcohol irritates the stomach lining and enlarges blood vessels in the InRecovery.com

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esophagus, which can rupture and lead to painful immediate death. You can also fall into positional asphyxia, when a sleeping or unconscious person slumps in such a way that the air is obstructed, or you simply choke on your own vomit. More long term, your liver gets scarred, leading to cirrhosis or alcoholic hepatitis. It can also inflame the pancreas causing pancreatitis and excruciating pain. Moreover, it significantly increases the likelihood of oral, liver, esophageal and stomach cancer. If you’re lucky, you’ll only end up with memory loss, brain shrinkage and psychosis. Methamphetamines, cocaine and other similar drugs that fit into the category commonly known as ‘uppers’, have their own drastic affects. They cause your heart to race and enlarge even to the point of bursting. They increase the rate of respiration and impact your blood pressure both to the high and low side, as it increases strain on veins and capillaries during use and knee-jerks in the opposite direction once the drug is out of your system, scrambling your brain in the process. They also lead to anxiety, agitation, depression and engagement in careless behavior that frequently puts your life at risk.

Use of drugs or alcohol during pregnancy can cause major damage to the mother and baby alike. The mother’s bodily functions and immune system are already under tremendous stress to begin with. The added impact of any kind of foreign substance only further negatively impacts her fragile state of health. Alcohol and drug use also impacts the development of the fetus, leading him or her to be born with mental and/or physical impairment. They are at the very least born with fetal substance syndrome, including experiencing agonizing withdrawal during his/her precious first few days. The psychological effect of that alone can last a lifetime. When it comes to addiction, we are all aware of the long term harm, but for some reason it doesn’t register quite like it should. We need something to shake us into realization, like passing a horrible car wreck, to trigger our empathy and get us to embrace it on a personal level. While I take no great pleasure in presenting the gory details, I am hopeful that I’ve at least reached a few of you so that you might more seriously consider heading into treatment and beginning your recovery before it’s too late.

InRecovery Magazine September 2017

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The Ingenuity of an Addiction acetaldehyde, which are known carcinogens. However, the growing availability of marijuana in the form of THC oil, makes that use the inevitable next troubling step in the evolution of this concerning trend. It could also be used to experiment with any number of other drugs typically consumed by smoking. This is of particular concern because of its growing availability to adolescents. Study-after-study demonstrates that people who start smoking in their youth are as much as 80% more likely to become addicts as adults, than their non-smoking counterparts.

ddiction is a powerful motivation. It never ceases to amaze me, how creative the addicted mind can be in search of a new high. The latest technique, called “Dripping”, with its fancy nickname and optically alluring thick clouds of flowery smoke, seems like it came straight out of a Madison Avenue marketers’ playbook. Tobacco, alcohol and sugar producers of the world have made huge profits for generations promoting the idea that their products will make you feel sexier, happier, refreshed or more fulfilled. Over time, these same tactics were studied and adopted by the entire drug counter-culture, tempting potential addicts with new ways to excite and tease the brain. Their ability to innovate and market by developing new techniques and creating inventive nicknames continually takes on new forms. The potential for abuse with this new process appears is limited solely by users’ capacities to be creative.

harmful chemicals and the elimination of second-hand smoke. What goes unaccounted for, is that the growing popularity has led to increased use by adolescents legally prohibited from smoking, as well as several other alternative uses for these devices including smoke trick competitions, helping to foster the “cool” factor.

“Dripping” is derived from people vaping electronic cigarettes, battery operated devices that heat liquid and turn it into a vapor, instead of smoke, which a person inhales. E-Cigarettes have been universally promoted as a safer alternative to smoking traditional cigarettes because proper use leads to a lower ingestion of

“Dripping” itself is pretty simple. It involves the dropping of e-cigarette liquid directly onto the hot coils of the electronic cigarette to produce a thicker, more flavorful smoke. This is dangerous enough in and of itself because it exposes users to higher levels of nicotine and other harmful toxins such as formaldehyde and

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Their ability to innovate and market by developing new techniques and creating inventive nicknames continually takes on new forms.

InRecovery Magazine September 2017

The CEO of the Tobacco Vapor Electronic Cigarette Association, defends e-cigarettes by pointing out that users who ‘drip’ represent just a small sliver of the people who enjoy vaping and that the existence of vaping does reduce the smoking of more harmful traditional cigarettes. He emphasizes that the industry in no way condones “dripping” because, “at the end of the day, I don’t think they serve any kind of purpose”. However, we must appreciate the fact that he’s motivated by a particularly biased perspective, not all that much different from those in the alcohol industry with their ‘responsible drinking’ campaigns. It’s developments like this which highlight the importance of flexibility and open-mindedness in addiction treatment. We are constantly bombarded with frustrating twists and turns, making it seem like we’re playing one giant game of addiction ‘whack-a-mole’. One minute, we’re combating synthetic drugs like FLACCA (bath salts), and the next minute, synthetic marijuana like K2, then the wind changes and “Dripping” is all the rage. Our need to remain vigilant and aware of new developments is more important than ever. We are often fragile and susceptible to the latest trend with a cool name. Unless we’re persistent and consistent in our recovery these trends have a way spiraling out of control. The stakes are high. That’s why it’s critical for us to loudly voice our concerns when troubling challenges develop. It’s important to nip them in the bud before we find ourselves bracing for yet another tidal wave of substance abuse pounding up against our shores. InRecovery.com

9/5/17 12:31 PM

f you were asked for your opinion regarding an admired institution, I’m sure that the ‘Hospital’ would be near the top of your list. It’s the place where numerous lives are saved, on a daily basis, and where medical professionals work in concert in a poetically orchestrated opera of ‘doing no harm’, as memorialized in the Hippocratic Oath. Yet, even as doctors regularly toil in the best interests of their patients, things can go awry as evidenced by a study indicating that one of every forty-eight emergency room patients prescribed pain medication will likely become an addict, ONE IN FORTY-EIGHT, as reported in the New England Journal of Medicine. Emergency. The word pretty much says it all. During emergencies all reasonable steps are taken to solve the immediate crisis without much concern for long term effects. If we don’t solve the emergency now then there’ll be no long term effects to worry about later. That’s the essence of emergency. Unfortunately, the rampant use of opioids during such emergencies, to relieve extreme pain, can lead to a lifetime of problems for the unsuspecting emergency room (ER) patient. One of the key problems is that there is little standardized practice for deciding on prescriptions; pain treatment is largely im-

provised. One physician might prescribe 30 pills of 5 milligrams of Oxycodone, while another might prescribe twice that dose. This is born out by a study indicating that patients discharged from ERs with an opioid prescription varied from 7% for low prescribing physicians to over 24% seen by more generous prescribers who sometimes even extended use for 12 months, or longer. The importance of this luck of the draw is made more apparent by the fact that patients seen only once by a physician who often prescribes opioids were 30% more likely to become opioid abusers than patients seen by more conservative prescribers. This problem could be better resolved by development of general protocol throughout the medical community. However, even if protocol was merely enacted within individual hospitals, reminding doctors to be more mindful and think through prescription scenarios in advance, that would go a long way towards lowering the incidence of opioid addiction. The challenge, of course, is finding the balance. How can physicians restrain excessive prescribing without undermining legitimate treatment of pain? We need to reach a consensus on best practices and then teach them both in medical schools and in continuing medical education courses. From there, doctors’ prescription of pain medication can also be regularly evaluated. Doctors are already evaluated on a

THE

number of topics, including patient privacy. The urgency of the opioid epidemic is that serious, that it should rise to the same level of concern. Moreover, most States now monitor prescriptions as well. Therefore, it would not be all that hard to implement. Finally, patients themselves need to be more proactive in their own medical care. Doctors should encourage patients to go online and educate themselves on their condition and the dangers related to their medication. This last point is particularly critical. We MUST inform ER staff and, in fact, all physicians if we are addicts or at risk of addiction. It’s vital that we fully explore all non-addictive medical alternatives such a lidocaine and ibuprophen. And, even if it is determined the pain will be unbearable without the use of opioids, they must be restricted to the bare minimum. Recovery is so hard fought and so hard won. We must get integrally involved in our own personal medical care to ensure that our recovery is not undone by unintentional administration of drugs that can take us back down a long, dark path. Opioid addiction is one of the most serious threats now facing the nation. In some cities, overdose deaths are up over 1,000% in just the last 15 years. That’s obscene! People are literally dying in the streets. If we can get everyone involved in the ER prescription process, including ourselves, to be more mindful, then perhaps we can transition hospitals from being part of the problem to being part of the solution.

EMERGENCY ROOM

DILEMMA

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InRecovery Magazine September 2017

9/5/17 12:14 PM

THES BERLIFE

A Meditation Retreat as Therapy

We all sometimes feel as if we can use a little extra boost. We might be feeling a bit beaten down by life or just at a low point in our recovery in need of a little extra pick-me-up. Sometimes a brief change of pace and internal focus can be just the trick to rejuvenate and re-motivate us in living healthy lifestyles. Why a Meditation Retreat? Most people make very conscious decisions about getting enough exercise, watching what they eat and even having some type of personal relationship with their Creator. However, how often do you take a time out to personally explore yourself? We are driven by emotions but rarely take the time to investigate why they’re there and what we can do to make them more productive. That’s where a Meditation Retreat can come in handy. Meditation Retreats come in all shapes and sizes. They can be small and intimate or large and motivational. Most are run by a particular individual (like a Yogi) or organization, so the program will vary based upon the individual’s or group’s belief system. It’s therefore important to choose wisely in order to find one that mirrors your own views. The most important part though, is that all of them involve the inner exploration of YOU. This can help unlock feelings you have been wrestling with, which often underlie and support your addiction. It’s your chance to take a guided tour of YOU. It’s funny, but most of us think we know ourselves pretty well without doing this. However, after one of these retreats, whether for just a day or a long weekend, you’ll be amazed by the secrets you discover as you turn over those internal rocks in your mind. The Meditation Retreat, another tool in the toolbox of sustaining recovery. For additional information on Meditation Retreats, please check out these websites 1440.org/mindful

AllThingsMindful.org

Rythmia.com

Faith-Based Recovery

Beware of the Dentist?

Most of us are familiar with the 12 Step Program. It’s the bedrock of all the ‘Anonymous’ programs, beginning with Alcoholics in the 1930s and now fighting all forms of addiction. The vast majority of 12 Step Programs involve recognition of one’s Higher Power and that without Her/His help, we are powerless to overcome our addiction. Several programs have since been adapted to work within specific faiths whether Catholic, Muslim, Hindu, Jewish or Native American. Frequently those religious affiliated programs can be the most effective because they also involve active engagement beyond just merely fighting the addiction.

I don’t know about you, but I associate the dentist with pain. My teeth are really sensitive, so I beg for extra pain relief for something as simple as a cleaning, let alone something more serious. For a procedure like pulling teeth or a root canal (I’ve had both), the pain can be excruciating. That’s why dentists were always so willing to prescribe opioids, as a logical response to treating their patients.

Faith based coalitions typically start from a position of compassion. Each faith itself recognizes the potential of repentance and, as a result, they are all open-minded to the concept of addiction as a disease rather than a moral failure. As a unified community with a commitment to charity, many are also more willing to dedicate additional resources in combating the disease. Faith based groups are also more effective in community outreach. One pilot program in Minnesota involves training Imams (Muslim religious leaders) to recognize symptoms of mental illness and addiction, to help guide their members into treatment. In Pennsylvania, a number of pastors regularly get together to share ideas on how they can better engage parishioners in need of help. If you or someone you know is seeking recovery, or has sought recovery and failed in the past, faith-based recovery may be an attractive option. The extra support could be exactly what’s necessary to set things on the right track.

Dentists have long been frequent prescribers of immediate release opioids like Vicodin and Percocet. More than 3.5 million people have their wisdom teeth pulled each year. That’s a lot of teeth and a lot of pain medication. A 2011 Journal of American Dental Association study estimated that dentists were responsible for 12% of the fast-acting opioid pain relief prescriptions. This puts them right up there with family medicine and internal medicine doctors as the top prescribers. Problematically, as much as 23% of opioids in the US are transferred by patients to people who do not have a prescription. Dentists are becoming aware of this issue and changing their practices accordingly. Up until recently, dentists would routinely prescribe 30 or more pills of narcotics for a simple tooth extraction. They now view that as excessive and have greater appreciation for the consequences. They are also turning more often to over-thecounter medications like Motrin, Advil and Aleve. While no doctor wants to see his patient in pain, non-opioid pain relievers are proving to be equally, if not more effective in most instances. This reality runs in contrast to the old beliefs that opioids were always better. Thankfully, this new mind-set is now common in all US medical schools and is being well-communicated throughout the dental community, at least eliminating one reason to be afraid of your dentist - LOL!!! If you are in recovery, please inform your dentist (or for that matter all doctors) so they can medicate you accordingly without putting your recovery at risk.

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InRecovery Magazine September 2017

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9/5/17 12:17 PM

Overdose Deaths: The Numbers Just Keep Getting Worse

was recently reading an article in the New York Times, noting that anywhere from 59,000 to 65,000 people died from drug overdoses in 2016, with nearly two-thirds of that figure coming from opioid abuse. I found this astounding for two reasons. First of all, the range. The problem is growing so quickly that we can’t even obtain accurate statistics. Secondly, because of the dramatic rise. The number of overdose in 2015 was 52,404 (approximately 33,000 of which were from opioids) as reported in Vox.com and in the Washington Post and 47,055 in 2014 (approximately 28,600 of which were from opioids) according to the US Surgeon General’s Report on Addiction (the “Report”). Overdose deaths are growing at a rapid rate, with virtually all of increase attributable to opioids alone. There are so many competing reasons for the increase, that it’s difficult to keep track. According to federal data, 89 percent of people who meet the criteria for alcohol and drug use disorder don’t get treated. Some are in denial, others say it’s too inconvenient, many don’t even know that mostto-all of their treatment can be covered by insurance. Or can it? That’s another part of the problem. In theory and by the letter of the law, it’s supposed to work that way. Medicaid, for its part, uses about 25% of its budget for drug addiction treatment, $7.9 billion in 2014. However, private insurance company pushback in the form of denial of claims and an ever-growing tidal wave of bureaucratic paperwork has made colInRecovery.com

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lecting on insurance coverage an imposing nightmare. Moreover, the Mental Health Parity and Addiction Equity Act, designed to ensure fair treatment and coverage of addiction as a disease, like other chronic medical diseases, is routinely ignored without repercussions. There’s no one out there policing the insurance companies to do as mandated. Finally doctors are now only beginning to fully comprehend the consequences of their years of over-prescribing. Purdue Pharma, in particular, was legally pushing Oxycontin on doctors almost as aggressively as a street-corner thug hustling illicit drugs, making billions of dollars in the process. It took a long time for the medical community to truly appreciate just how addictive opioids actually are. Now, President Trump and Attorney General Jeff Sessions have vowed to take this fight to the streets. The reasons is that while doctors around the country have begun minimizing the legal prescription of opioids, the slack is being taken up by sophisticated drug cartels. They see a huge opportunity in the market of addicts now being deprived of legitimate means to get their fix. Cheap black heroin, fentanyl and carfentanil (strong enough to take down an elephant) are being hawked within our communities. Trump believes that by building a wall and doubling down on the ‘war on drugs’ he can make a difference. It remains to be seen. In the meanwhile, the problem is that we don’t have the luxury of time. The Report

indicated that, on average, it can take as long as 8 to 9 years after an addict formally seeks help for recovery to take hold. Many opioid addicts will be dead long before that time frame. Recovering addicts need to better arm themselves against the temptations that are out there and take measures to distance themselves from them. A yearover-year, 10-15 percent increase in overdose deaths is intolerable, a 20% increase in opioid deaths unacceptable. This is really scary stuff. The more we know and understand drugs’ destructive power, the better chance we have to help people maintain their recovery and escape being the next nameless statistic. That’s why we’re investing so heavily in the future here at InRecovery and through our sister companies like Kipu Systems and PingMD, to develop a RecoveryBound program. Recovery Bound picks up where treatment leaves off. While recovery itself is for life, there are different needs throughout the various stages. The first year of sobriety is most tenuous and the treatment therefore most intensive. So much emotional and physical capital was spent to get clean. It’s critical we help keep you there. Years 2 through 5 pose their own sets of challenges. We can breathe a bit easier but discipline and supervision must be maintained as a safeguard against temptation. It’s all part of the Recovery Continuum. You’ll be seeing more of this in 2018 as we take fresh new steps toward changing and improving the face of long term recovery.

InRecovery Magazine September 2017

9/5/17 12:16 PM

Recent Advances in Opioid Deterrence

he science of pain is intriguing. It wasn’t all that long ago that a shot of whiskey was the pain reliever of choice. Modern medicine has since become acquainted with aspirin and ibuprofen for treating minor aches, various forms of anesthesia for use in operations, and different formulations of opium, for addressing chronic pain. Chronic pain has proven particularly challenging though, because opioid based medicine has proven to be highly addictive. That’s why research on (1) a new class of non-opioid pain killer reported on at ScienceMag.org, and (2) an anti-heroin vaccine developed by The Scripps Institute (“TSI”), hold out such promise. Non-Opioid Pain Relief Researchers report they’ve discovered a new molecule that halts pain and eliminates addiction, while limiting interference with healthy cell function. This finding could have a huge impact because pain and addiction typically have similar biochemical roots, making treatment difficult without affecting normal cell activity. For example, opioids interrupt pain by

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affecting certain enzymes known as ACs (adenylyl cyclases), but that in turn makes other functions of the cell skyrocket, triggering addiction. This new process avoids that problem by targeting only one of the ACs (out of 10), minimizing negative changes in the cells. Researchers came upon this molecule after studying a plant compound known as Forskolin, which actually supercharges the AC enzyme. However, drugs that increase an enzyme’s output can often be used to decrease it as well, because they interact with the same target site. In doing so, the scientists were able to create a compound that reduces sensitivity to pain with the same potency as an opioid, but without the addictive side effects. Anti-Heroin Vaccine We at InRecovery magazine originally wrote about TSI back in May, regarding an innovative new medical technique they were working on to help the brain forget it’s addicted. It seems they’ve now come up with another great prospect.

InRecovery Magazine September 2017

Working in conjunction with Virginia Commonwealth University, TSI has created an anti-heroin vaccine that works by exposing a person’s immune system to the heroin molecule. This, in turn, teaches the immune system to produce antibodies against the drug, preventing the heroin molecules from reaching the brain and causing feelings of euphoria. Testing done on primates has demonstrated effects lasting as long as 8 months. The vaccine, 8 years in the making, only seems to work for heroin and not opioid based pain killers, at the moment, but research continues. Unfortunately, neither of these positive developments will be available at your local drug store any time soon. Scientists are still working through some of the pitfalls, and need to conduct additional studies prior to clinical trials. However, given the inherent problems with opioids and the need to treat chronic pain, these preliminary results are certainly welcome news. InRecovery.com

9/5/17 12:17 PM

Keynote Speaker Steve Ford is the son of President Gerald R. Ford and Betty Ford whose life journey negotiated the bumpy road from the White House to a successful acting career. As a motivational speaker, his story both entertains and inspires audiences as he recounts his familyâ&#x20AC;&#x2122;s battles with alcoholism, including his own recovery.

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9/5/17 12:17 PM

Fill-In the

blanks!

Bucky Sinister

is a stand-up comedian and author of nine books, including Black Hole: A Novel and Get Up: A 12-Step Guide to Recovery for Misﬁts, Freaks and Weirdos..

SOBER STAND-UP COMEDIAN EDITION

B ucky Sinister

Often when p eople ask me about my reco very, I want to tell them how ______________ very _______it mak es me. They te nd to think I al ways feel ______________ __________ or ______________ ____. Of cours e, when you’r sober, the har e dest part is pro bably ________ ______________ ___. Still, ther incredible ben e are eﬁts, like ____ ______________ ______________ ______________ ______________ _ _and ________ ______________ ______________ ___________. M favorite aspec t of sobriety is y ______________ as well as the occasional op nity to ______ portu______________ ______________ ___. But if I co uld trade lives any other sob with er person, it w ould probably be___________ _________ ______________ ______________ ______________ __. Yet here’s my real confe something I’d ssion, never tell my _____________ or ____________ : ever since I go sober, I’ve bee n obsessed wit t h ____________ _________. Still , when I’m feel particularly al coholic or like ing acting out, I w ill ____________ ______________ ______ or ________. If m y ____________ ___________ ev er knew I tho ______________ ught __________, th ey’d probably ______________ ______________ Of course, that _____. ’s not nearly as ______________ __ __ ______________ I did when I w _____ as what as in active ad diction when I ____________ _. Thankfully, ______________ I ____________. Just thinking about that mak es me realize to add ________ I need ______ to my gr atitude list.

mot ivated like I’m about t o drink

cry in a closet not crying in a closet waking up wit h t he same money I had t he night before being entirely aware of ever y ch oice I make fellowship per form for a gr oup of sob er people a head liner because t hen I’d be able t o head line comedy clubs trainer dentist donuts & ice cream call someone go t o a meet ing AA Fr iends about food t his much. have a food intervention fo r me obsessive and morally d ebilitating drank have never relapsed newcomers

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9/5/17 12:19 PM

In today’s behavioral healthcare environment, you need a billing company that provides the very best in revenue cycle management. Since our inception in 2010, Billing Solutions has taken pride in its team of qualified clinicians and expert RCM managers who make the success of your facility

the number one priority. We are industry leaders with extensive experience navigating our providers through the dynamic challenges and obstacles of the behavioral healthcare landscape. Billing Solutions is continuously improving its own claims process, and regularly implementing new and innovative technologies that create

VERIFICATION OF BENEFITS | UTILIZATION REVIEW BILLING & COLLECTIONS | REIMBURSEMENT NEGOTIATIONS APPEALS | CREDENTIALING | STAFF TRAINING

877.708.9615 | billingsolutions.net InRecovery.com

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better integration, and faster, more accurate adjudication. This results in data that produces real actionable business intelligence for your facility. We want to be more than just a billing company–we want to be a trusted extension of your organization and a source of solutions. Billing Solutions, LLC.

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InRecovery Magazine September 2017

9/5/17 12:19 PM

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9/5/17 12:20 PM