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US Government Takes Control From the CEO’s desk: JEFFREY FIORENTINO, MACC The national opioid epidemic is now front and center in American media and the government’s agenda because it has exacted a heavy financial and social toll. Its affects have been (1) mentioned in the minutes of the Federal Reserve and in reports by such venerable investment banks as Goldman Sachs, for having shaved off a significant portion of our country’s GDP, (2) was noted by the White House Council of Economic Advisors as having cost the US $504 billion in 2015 alone, and (3) has single-handedly been responsible for a multi-year reduction in the American life expectancy rate. The damage to destroyed families is incalculable. Our Federal government took note, allocating $1 billion toward the opioid fight in the 21st Century Cures Act, and then added another $12 billion, or so, in the continuing budget bills of January and March 2018. President Trump has additionally earmarked almost $17 billion more as part of his proposed budget for 2019. Funds are to be allocated in a wide variety of ways, ranging from additional treatment, increased law enforcement and the expansion of federal drug courts to provide alternative sentencing options for people whose crimes are clearly more driven by addiction than criminality. This is all very positive, but my issue with this strategy is that it will take years to fully implement and have an impact. One obvious way in which the government HAS attained more immediate results is via enforcement against unscrupulous pain clinics. Certainly the treatment of pain is important, but far too many of those clinics began to relax their standards for the sake of greed and came to be known as “pill mills” at which addicts could find doctors and pharmacists more than willing to enable their addiction. The federal, state and local authorities have also taken action against disreputable addiction treatment facilities and sober homes. While, perhaps, this effort has somewhat tarnished the image of addiction treatment in general, it was vital to eliminate those bad actors both for the sake of patients and the reputation of our community as a whole. Those recent specific legal clamp-downs had a major beneficial affect. They eliminated criminally run operations and simultaneously scared away others from doing likewise, while also leading InRecovery.com
to better prescription practices by doctors. While these are encouraging developments, they have unfortunately not totally eliminated the problem. Mexican cartels have stepped into the void producing and selling large quantities of heroin, fentanyl and carfentanil in modern production facilities. For that reason, a good portion of the aforementioned additional government funding will importantly be directed towards greater enforcement at the borders and in neighborhood-to-neighborhood combat against the street dealers spreading the disease. However, after having watched the war on drugs fought the same way for decades, I can’t help but feel this is not enough. It has turned into a stalemate in which we are consistently successful in battle but never win the war. That’s why I’m heartened by a potentially even bigger development. The groundswell of litigation brought against Big Pharma started as a murmur and has grown into a tsunami. It all began with the former Attorney General of Mississippi, Mike Moore, who one spearheaded the fight against Big Tobacco. He persuaded Ohio to bring a similar case against the
major pharmaceutical companies and that action has since morphed into over 400 lawsuits brought by cities, counties, states and Native American tribes across the country. They are following the model of our nation’s one huge success story in the fight against addiction. This has not only led to a continued decrease in smoking but also secured considerable funding for treatment and education. That is exactly the type of revolutionary pivot point we need in order to get out in front of the opioid crisis. The vast majority of that litigation has been consolidated into one large class action suit in front of Judge Aaron Polster in the Northern District of Ohio. In many ways, Ohio has been one of the hardest hit states and can be considered ground zero in the opioid battle. The claims brought by the plaintiffs detail numerous abuses by several large pharmaceutical companies including: (1) representations that new opioid-based products (such as oxycontin) were safe and non-addictive, (2) financially influencing (Continued on page 9)
Fighting Back Lawsuits brought by states, local municipalities and Native American tribes over opioids are mounting in places hit hard by the crisis. Estimated age-adjusted death rates for opioid and other drug poisoning, 2016 By state, per 100,000 population
Number of lawsuits filed in each state None 50 25 10
10 20 30 40 Wash.
Mont.
Ore. Wyo. Nev. Calif.
Utah.
Colo.
N.M.
N.D. Minn.
S.D.
Wis. Iowa
Kan. Okla.
Ill. Mo.
Ark.
N.H.
Mich.
Ind.
Ohio.
Ky.
Texas
Md. Del. W.Va. Va. N.C.
Tenn.
S.C. Miss. Ala.
Alaska
N.Y. Mass. Conn. R.I. Pa. N.J.
Ga.
La. Fla.
Notes: Lawsuit totals as of April 2. Doesn’t include lawsuits solely against Insys Therapeutics. Sources: Court filings (lawsuits); Centers for Disease Control and Prevention (death rates)
3
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Your Turning Point. The Effective Alternative To Traditional 12-Step-Based Rehab Today’s the day to begin recovery.
Turning Point Centers approach to treatment for addiction and co-occurring disorders is a viable alternative to many traditional 12-step based programs. We view our program as a compassionate culture of recovery. At Turning Point Centers, we believe the root cause of addiction is an attempt to escape the suffering in one’s mind caused by depression, anxiety, bereavement, abandonment, and most importantly, trauma. During an individual’s active addiction they develop a broken connection with themselves and with other people. As a non 12-step facility, the primary methods in which we help individuals reconnect are through Emotional Regulation Skills and Individual Therapy, as well as incorporating CBT, Motivational Interviewing, EMDR, and Group Therapy.
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Top of Mind
Is A Loved One An Alcoholic?
Drinking 4 or more of the following for women or 5 or more for men constitutes binge drinking, one of many clear signs of alcoholism. Many people are surprised to learn what counts as a drink. In the United States, a “standard” drink is any drink that contains about 0.6 fluid ounces or 14 grams of “pure” alcohol. Although the drinks below are different sizes, each contains approximately the same amount of alcohol and count as a single standard drink. 12 fl oz of 8-9 fl oz of 5 fl oz of regular beer malt liquor table wine (shown in a 12-oz glass)
about 5% alcohol
about 7% alcohol
about 12% alcohol
3-4 fl oz of fortified wine (such as sherry or port; 3.5 oz shown)
about 17% alcohol
2-3 fl oz of 1.5 fl oz of cordial, brandy liqueur, or (a single jigger aperitif or shot) (2.5 oz shown)
about 24% alcohol
about 40% alcohol
1.5 fl oz shot of 80-proof spirits (“hard liquor”)
40% alcohol
InRecovery Magazine
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Marketing Director
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Jeffrey Fiorentino Dan Brown Nestor Suarez/Marketing Addicts Nestor Suarez/Marketing Addicts PFS Mags Errol Naraine
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Alan Myers, Ph.D.
Matt Williams
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InRecovery Magazine is published 4 times a year by InRecovery Magazine, LLC, 55 Alhambra Plaza, Suite 600, Coral Gables, FL 33134. 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. ©2018 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.
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SPECIAL ISSUE
Welcome to our special “Show Season” issue of InRecovery, featuring stories and essays from the front lines of addiction and recovery, along with messages from the nation’s top treatment centers for SUD and Behavioral Health.
THE SEASON OF
HOPE
HOW TO CHOOSE THE RIGHT TREATMENT CENTER. GUIDELINES FOR SUCCESS IN RECOVERY THE PATH TO RECOVERY
Also available online. PLUS
INSIDE THE MIND OF AN ADDICT
CONTENTS iR_01_06-2018.indd 1
7/25/18 1:15 PM
Features
Columns
10 | Tips for Families Helping an
12 | Incarcerating A Generation of
Most family members feel helpless as they watch a child or parent slip further into the abyss of addiction.
If treatment is made available to everyone, then we can stem the tide of this losing battle.
14 | Luminary of the Month
27 | The Timelessness of Recovery
Addicted Loved One
Dr. Nora Volkow has had a long and distinguished career, single-handedly changing the state of addiction treatment.
16 | The Common Denominator
I didn’t ask to be born, let alone into this nightmare. It’s no wonder I started drinking and getting stoned..
65 | Food Addiction
Thoughts of drinking and using get awfully tempting when pressure begins to build like I’m trapped in a time warp.
36 | A Prisoner’s Tale
Contrary to popular belief, drugs and alcohol are widely available in prison.....where there’s a will there’s a way.
42 | Lifestyle Balance
Food addiction is one of the most ignored, as our nation struggles with a growing obesity problem.
Theme
Addicts Is A Recipe For Failure
Without balance we fall. The same goes for our recovery. Carefully consider these five important spokes for managing your life.
65
28 | Talking Points With Your Teen About Marijuana
Many parents have no idea how to even broach this topic of conversation.
21 | Overcoming the Pain
“You’re going to kill yourself,” my mom told me that last time I saw her. “I love you with all my heart but you’re on a tragic date with destiny.”
23 | Why Telemedicine is Important in Addiction Treatment
Receiving healthcare through this new powerful medium seems like a natural evolution. Telemedicine has finally arrived.
26 | Your Recovery Job Search
With a booming economy and a greater understanding of addiction as a disease, job opportunities are more plentiful than ever.
31 | The Path to Treatment
Patient advocacy services are popping up around the country to help struggling addicts obtain the treatment they’re entitled to.
33 | Is a 12 Step Program Enough?
12 Step programs have a one-size-fits-all philosophy because of the need to message a very diverse group.
46 | The Dreaded “Yets”
I haven’t gotten into a drunk driving accident yet. I haven’t woken up naked under a bridge yet.
64 | Beware of Your Type A Personality
A “Type A” personality is both a blessing and a curse. Much like fire, it can be used to both create and destroy.
33
58 | The Science of Addiction
Is a
A three page SPECIAL REPORT on exciting new developments in our understanding and treatment of addiction!
63 | Have
12 Step Program Enough?
To vs. Get To
One of the best aspects about getting and staying sober is the ability to start over..
35 | My Son’s Addiction
28
I refused to recognize all the clear and obvious signs in my son, until it was too late.
52 | Insight Into Gateway Drugs The initial use of “softer” drugs is the typical path people take before moving on to harder, more dangerous drugs.
52
62 | Inside the Mind of an Addict
I stop for one brief moment to wonder why I do this to myself and then return to normal programming, thinking about my next high. 8
36 InRecovery.com
(Continued from page 3)
doctors and medical professionals with excessive speaking fees, honorariums and free meals and vacations (68,177 doctors received more than $46 million between 2013 and 2015 alone, according to research by the Boston Medical Center), and (3) wanton disregard for patients’ welfare even as the representations and practices were clearly wreaking havoc on unsuspecting addicts in the making. Moreover, many of those same companies were simultaneously spending in excess of $10 million on lobbying groups to encourage the use of opioids, according to a February article in The Guardian. This groundbreaking litigation has since expanded to include retailers who knew, or should have known, based on the growing mountain of public evidence that they were a critical part of the deception. They shipped alarming quantities without notifying authorities and sold obscenely large amounts to individuals, well in excess of what they could have possibly personally consumed. The case is so monumental that the US Justice Department has even weighed in by filing a “statement of interest” because our nation itself has a major stake in the outcome. Moreover, some states (such as Florida) and cities (such as Miami) have elected to independently sue in the hopes of better settlement terms. The claims encompass such legal causes as fraud, racketeering, corruption and public nuisance, among many others. In the meanwhile, defendants are trying to shield themselves behind the cloak of FDA approval, that they were doing nothing more than selling a legally prescribed drug. That argument, however, falls hollow, given the abusive way in which they were pushing the drugs while simultaneously holding back information about its dangers. City, county and state budgets have been overrun by the damage caused as a result of opioid addiction. Emergency services and hospitals are overwhelmed, with some hard-hit locations reporting 90% of calls on any given night as opioid related. It has also led to more children in foster care and more families on unemployment and welfare. Overdose deaths too have forced some small towns to use refrigerated trucks and warehouses to supplement the local morgue. Yes, we need the additional funds that will come from resolving the litigation just to handle the aftermath, but equally importantly to work towards eradicating the root cause, by getting more money into prevention and treatment. The Judge himself is trying to fast-track settlement discussions and his methods are beInRecovery.com
ing called into question because litigation of this magnitude typically takes much longer to resolve. However, their is considerable logic to his unconventional desire to resolve things more quickly. After all, the clock is ticking. More people are dying every day and there are still an enormous number of pills on the street. The quicker we turn the tide the better, and Judge Polster understands this on a very personal level since a very close friend of his lost a daughter to overdose from her opioid addiction. The litigation itself already seems to be bearing fruit. Purdue Pharma, for example, no longer markets oxycontin due to all of the pressure and has even begun to dedicate funds toward warning society about the dangers of opioid addiction. Most importantly, there also seems to be a general sense that the parties want to reach an agreement - it’s only a question of what that amount might be. So what to do with all that money? The National Institute of Health (NIH) suggests we focus on three specific areas: (1) developing better overdose reversal and prevention interventions to reduce deaths, (2) finding new and innovative medications and technologies to treat opioid addiction and (3) finding safe, effective and non-addictive ways in which to manage pain. These are broad and laudable goals but what about the specifics? The National Institute on Drug Abuse (NIDA) and President Trump’s commission on the opioid crisis heavily recommend expanding access to and distribution of fast-acting naloxone, approved for use since 2015. Narcan is the most well-known and commonly used, and its manufacturer has recently pledged to offer it for free at schools and universities. Moreover, NIH is working with private partners to create longer acting formulations intended to extend the effectiveness of these life saving treatments. The NIH is also promoting greater use of additional medications for treatment of Opioid Use Disorder, which now relies solely upon naltrexone, buprenorphine and methadone. With respect to that, the Food and Drug Administration (FDA) is currently reviewing several options which might work in conjunction with and improve the efficacy of the three approved medications. It is anticipated that these will be made available in the near future. The NIH and NIDA likewise hold out hope for anti-heroin and anti-opioid vaccines which have been showing great promise. They are primarily designed to create antibodies which prevent the opioids from connecting to neurons in the brain.
Opioid overdoses by race Deaths per 100,000 US residents 15 12
White
9 6 3 0
Black
Hispanic ‘00 ‘05 ‘10 ‘15
Sources: Centers for Disease Control and Prevention (2016 data is provisional)
As for non-opioid pain reduction, there are several different approaches being studied from advanced pain relievers in the form of a pill to electronic brain stimulation and even gene therapy. Some insurers are also stepping in to do their part, like refusing to cover prescriptions for oxycontin (Cigna), and by modifying internal policies for reimbursing pain relief, which up until recently relied mostly on opioids as the cheapest alternative. An article in the Journal of the American Medical Association goes as far as to suggest that the FDA ban all “ultra-high-dosage” painkillers from the market (Kolodny and Frieden). Roughly eight million Americans are on long term opioid therapy for chronic pain with as many as a million taking dangerously high doses.
Ideally, the additional federal funding and any settlement with Big Pharma will result in speeding up the timeline for tackling these goals because the opioid crisis is a fast-moving, many headed hydra. It seems that each time we crush one dangerous component, like getting doctors to prescribe fewer pills, another one, like black tar heroin, fentanyl and carfentanil hitting the streets, only rises up to take its place. However, with one big push and infusion of funds, perhaps we can finally get ahead of this epidemic and reverse course just as was so effectively achieved in the fight against smoking. 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.
9
Tips for Families Helping an Addicted Loved One
M
ost family members feel helpless as they watch a child or parent slip further into the abyss of addiction. You want to help, read all the literature, and still can’t find a way to break through. You then go through stages ranging from enabling to forcefully insisting on treatment but nothing seems to work. The following are tips intended to help get you through this trying period when you feel that you’re at the end of your rope. Give Up the Role of Rescuer You’ve done all you can and you’re loved one is still not responding. There’s absolutely nothing you can do to make someone acknowledge his or her disease and want to get better. Nothing. Sure, you’ve brought the issue to their attention, but that’s the extent of it. You can’t do the treatment for them. Take a step back, relax, and let things play out. Allow their bills to go unpaid and documents to expire. They need to learn lessons on their own in order to come to their own realizations. As painful and frustrating as that might be, there’s no quick or instant fix. Maintain your Compassion Make sure to let them know just how much you love them as you cut them loose. Many addicts have no concept of responsibility until they’re forced to deal 10
with repercussions. When they do, they need to know that you’re still there for them emotionally. They’re still welcome to family dinners, get birthday presents, and the like, provided you do not give in to their manipulation. It will be a while before they stop asking for money or acting out for the sake of attention. When they lash out, set proper boundaries - you can’t give in to their shenanigans. Otherwise, give them a hug and kiss, and remind them that their worthy. Be There for Them When They’re Ready It’s normal to feel resentful and hurt in the face of an addict’s unloving and self-destructive behavior. You must nonetheless always remember that was just their addiction talking. The person you know and love is still in there trying to break free. You can’t force them into treatment but you can be there for them when they hit rock bottom and come to that conclusion on their own. Love almost always conquers all, provided you’re patient. Trust the Experts Once the decision is made to seek treatment, help your loved one find a place that is best suited for him or her. There are several types of proven therapy, and all work equally well. The trick is to find a place
that is most compatible with an addict’s preferences and state of mind. Does he or she like art, horses, adventure? Whatever it is, being in the proper environment can do wonders. These are supplements to the core treatment, but when they get a patient more engaged, it exponentially increases positive results. Don’t ever try to implement treatment on your own, that’s simply a recipe for disaster. Also, be there to help them stay strong in aftercare. Addiction is a disease that must be monitored for life. Heal the Family Unit Once all is said and done, with your family member now clean and sober, it’s time to work on the family unit. Get involved in group discussions under a professional’s care, jettison resentment, and cover yourselves with an enduring patchwork quilt of love. None of us is perfect. We bring greater meaning to our lives when we acknowledge and confront our imperfections and thrive in spite of them. Helping a loved one is a long and winding road full of potholes, but it’s so worth it when you reach your destination. InRecovery.com
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. To the Editor: Your focus on Adventure, Sports and Exercise in the last issue was a refreshing change of pace. I’ve become one heck of a workout aficionado in my recovery. It’s what helps keep me sane. I share that at all of my NA and other group meetings, trying to convert others as well. I’ve developed a lot of great workout buddies that way. It’s my proven method for staying sober. Eddie, Texas Dear Eddie: I couldn’t agree more. While recovery is unique to each individual, staying active should be a key component for everyone. I’m glad to hear it works so well in improving your life. I’ll keep an eye out for other great submissions from industry professionals and readers for inclusion in future issues. To the Editor: Your article on the “Dope Man” was profound and brought me to tears. How insane is this disease of ours? Too many people think addicts just lack the will to quit. If only it was that easy. My brain had flipped when I was in the depths of addiction. I barely have any clear memories from that period of my life. What will it take for the rest of the world to understand? Joanne, Georgia Dear Joanne: Cunning, baffling, powerful...sound familiar? I think the only positive news is that people ARE starting to understand. The opioid epidemic hitting families, loved ones and neighbors from firemen to school teachers, like never before, has certainly played a role. We addicts need to be handheld through treatment to find our way out of the fog and regain control over our lives. Sure, our recovery requires a certain degree of will, but without sobriety and the
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knowledge of our disease that comes with treatment, mere willpower doesn’t stand a chance. To the Editor: I’m writing to compliment you on the relatively new Science of Addiction section you added about a year ago. I’ve found the articles interesting, insightful and full of promise in my personal battle against addiction. I’m undergoing MAT (Medical Assisted Treatment) and appreciate learning all I can about the latest research developments with hope of a better solution. James, New York Dear James: Just to let you know, we added that section after serious consideration and reflection. How can we better serve individuals and families struggling with this disease? Prior to that, we primarily focused on personal stories of struggles, hope and success. However, as addiction continued to spike and ravage our nation, it occurred to us that we could perhaps be a greater part of the solution in providing more information to our readers. We are glad that people like you have taken notice and appreciate our efforts.
tinkered with nicotine levels just to make cigarettes more addictive. Nor was I aware that stuff like nicotine patches and gum are now manufactured by some of those same cigarette companies. I’ve gotten down to just occasional vaping and hope to one day eliminate that too. I’ve otherwise been sober for over five years now. I need to eliminate this one last issue to get full and final control of my addiction. Erica, Virginia Dear Erica: It’s great to hear about your sobriety - keep it up! We felt it was important to cover tobacco because hardly anyone discusses it anymore, as if it has gone away. It’s still a big issue, just not as big as it used to be. Good luck with kicking that habit and let us know when you do. I’d be glad to follow up with an update.
To the Editor: It’s so great that you covered smoking in your last issue. I’ve quit more times than I can remember, just to succumb again to the allure of tobacco. I was shocked to read that cigarette companies had once
11
Incarcerating A Generation of Addicts Is A Recipe For Failure MARK ASTOR, ESQ.
A
s a young Assistant State Attorney in Palm Beach County I was convinced that all offenders are bad and must be punished. That mandate seemed very much in line with the legislative intent in my home state of Florida which is to punish first and rehabilitate second. As I matured and began to prosecute more serious offenders, I began to see “repeat offenders” some of whom I had personally prosecuted, on more than one occasion. In Florida, punishment in circuit court (which is the court that has jurisdiction over all adult felony crimes) is dictated by the Punishment Code that creates a “floor” for punishment but no ceiling. As such, even a first-time offender can be sentenced to the maximum allowed by law for that particular crime, the minimum (the floor) is based on the defendant’s prior criminal history or lack thereof. The Punishment Code also dictates when the court must incarcerate a defendant and when a non-prison sanction, such as probation, is appropriate. What I began to notice was that many of the defendants I was prosecuting were being sentenced to prison because of multiple convictions, most of which were caused by addiction and mental illness. I lump them together because in my experience, the two are rarely seen separate and apart and should be treated as such.
12
A United States Department of Justice report suggests that roughly half of all inmates (both in the State and Federal systems) are suffering from mental illness. Of those inmates, almost two thirds (63%) had also used opioids in the month prior to their arrest. Those suffering from mental illness were also more likely to be homeless, be the victim of violence while incarcerated, come from homes where there is a family history of addiction, and have a family member who has also been incarcerated. It would appear that the revolving door of the criminal justice system is alive and well. My own personal observations and the above referenced statistics suggest that incarceration is not the way to solve the issue of addiction and mental illness that is slowly and increasingly destroying the fabric of our society. Moreover, our country has the dubious distinction of incarcerating more of its citizens than any other country on planet earth and that number increases every year. We incarcerate 693 people out of every 100,000 citizens, which is almost six (6) times more than the next nearest country, the United Kingdom. Florida is in the top ten (10) of states that incarcerates its citizens.
overdose related deaths was 60,000 and in 2017 that number had increased to 65,000. To put that into prospective, that is roughly the size of an average crowd at an NFL game. In 2017, the state of Florida housed almost 100,000 prisoners, almost 25% of which are repeat offenders. At a cost of just over $20,000 per year, per inmate, the state of Florida spends $200,000,000 every year on its inmate population. In my experience a thirty (30) day stay in a drug treatment facility costs from $10,000 to $20,000, and while there is a possibility of relapse the likelihood of death or prison is significantly higher when no treatment is offered at all. If treatment is made available to everyone, which is absolutely necessary if we are to stop the tide of incarceration and death, then we can stem the tide of this losing battle. It is time for the state and federal governments to come to both the financial and moral conclusion that mass incarceration is not the answer to the addiction and mental illness crisis we find ourselves in. The current funding of incarceration, is, and will continue to be, a recipe for continued disaster.
All of this incarceration seems to fly in the face of the number of people we are losing to addiction. In 2016 the number of InRecovery.com
Heroin use is part of a larger substance abuse problem. People who are addicted to...
ALCOHOL
MARIJUANA
COCAINE
2x
3x
15x
are
are
Rx OPIOID PAINKILLERS
are
...more likely to be addicted to heroin.
are
40x SOURCE: National Survey on Drug Use and Health (NSDUH), 2011-2013.
And Why Is This So Important? Because the number of calls to U.S. Poison Control Centers only continues to grow, January 1, 2017–November 30, 2017 (n=57,307)
1356
113
156
998
1555 741
204
365
84
841
2419
669
297 498
2422
800
521
1374
1797
661
630
137
757
1140
637 534
4835
2256
1668
1173
5802 1697
85
1911
930
219 599 473
DC Count = 118 DE Count = 108 NJ Count = 930 RI Count = 112
2074
705
Legend 2721
145
1661 1915
573 830
2303
318
84 - 1,228 1,228 - 2,372 2,372 - 3,516 3,516 - 4,660 4,660 - 5,802
Source: American Association of Poison Control Centers (AAPCC), Opioid (Narcotic) Pain Medications Alert. Available at www.aapcc.org.
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Luminary of the Month without evidentiary support. As a result, many professionals and society at large, still rejected the possibility that addiction was a disease.
Dr. Nora Volkow, M.D.
A
s the long serving Director of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow is probably the most quoted person in the field of addiction studies. It seems as if you can hardly read a periodical or article without coming across her name. She is the vaunted expert who people rely upon for sound advice and critical insights, and for very good reason. Dr. Volkow and her extensive research have led to many vital breakthroughs in our understanding and treatment of addiction. Practically since the dawn of time, society treated addiction as a moral failure. People who did not struggle with addiction could not possibly understand nor explain how and why individuals would purposely destroy their lives, in any context other than the lack of will. After all, for them, it was merely a matter of self-control. Why should that not apply to everyone? Alcoholics Anonymous began discussing addiction as a disease while simultaneously addressing the related moral failure, bridging the gap, but without clear evidence it was just a plausible opinion 14
Dr. Volkow knew something more was required to change settled opinion, that addiction was some form of morality test, there had to be more proof. She suspected that addiction might have something to do with the inner workings of the brain, after she was exposed to research involving PET (positron emission topography) scans of people being studied for schizophrenia. By applying the same technique to people addicted to cocaine, she clearly demonstrated a direct causal link by identifying a neurological component to addiction. The results were essentially revolutionary, uncovering the fact that abnormalities in the brain make it very difficult for addicts to exercise cognitive control and giver up their addictions. This turned the entire understanding of addiction on its head, creating an undeniable new paradigm, the disease model of addiction. Then, of equal importance, her study went on to describe the reasoning behind addiction’s vicious cycle of the downward spiral. PET scans proved that a person naturally prone to addiction is in turn directly impacted by the drug or alcohol abuse, leading to greater addiction itself. In other words, addicts make themselves more addicted every time they use. We would not be where we are today and achieving the results that we do in addiction treatment without Dr. Volkow’s hard work and dedication. Dr. Volkow’s success as a trailblazer did not come overnight. She earned her medical degree at the National University of Mexico and did her psychiatric residency at New York University where she first elected to study brain research. Her interest was piqued by the brain’s mechanisms - how humans are able to generate complex thoughts and emotions, and what makes each of us unique. While Dr. Volkow is best known for her work on addiction, she has also made important contributions to the neurobiology of obesity, ADHD and aging. Prior to her position at NIDA, Dr. Volkow spent the bulk of her career at the Department of Energy’s Brookhaven National Laboratory InRecovery.com
Dr. Nora Volkow, M.D., Director of the National Institute on Drug Abuse, National Institutes of Health (NIH). Director of Nuclear Medicine, Chairman of the Medical Department, and Associate Director for Life Sciences at the Department of Energy’s Brookhaven National Laboratory in Upton, New York. Associate Dean of the Medical School at the State University of New York - Stony Brook.
and then moved on to become Associate Dean of the Medical School at the State University of New York - Stony Brook. She was selected by President Bush in 2003 to head up NIDA and has been there ever since. It takes a special caliber of person to thrive in such a demanding position that is constantly in the spotlight, especially for over 15 years. She has published almost 700 peer-reviewed articles and received countless awards recognizing her esteemed professional life, including Time Magazine’s “Top 100 People Who Shape Our World” and “Innovator of the Year” from the US News & World Report, among many others. Given our nation’s current focus on the opioid epidemic, Dr, Volkow’s opinion and experience have been in especially high demand. She strongly believes the solution to the crisis must be multi-pronged, involving government agencies, public health officials, individuals physicians and private entities. “Drug addicts become slaves of the drug and addiction fundamentally changes the brain,” according to Dr. Volkow. “Addicts struggle between the choices they logically want to make, and know they should, and what the addiction compels them to do. It’s like you generate a battle within your brain...even though you cognitively want to stop, you are unable to do it.” Dr. Volkow has had an illustrious and groundbreaking life, yet it is obvious she still has so much more to contribute, as an unstoppable force in the battle against addiction. She has worked tirelessly with incomparable passion for so long, which leaves me to the logical desire of wanting to know more about what could possibly drive someone to be so determined. I found my answer in one of her quotes discussing the disease. “Being human, what we value most is our capacity to actually decide our actions, to have free will. That gets utterly disrupted by drugs. Because what drugs do is remove that freedom you have to make choices.” It is a very poignant point about her life’s mission. Her study of the brain is about preserving and protecting humanity, and we are very fortunate to have her focused on helping solve the problem of addiction. InRecovery.com
Dr. Nora Volkow, M.D., Director of the National Institute on Drug Abuse, National Institutes of Health (NIH). Director of Nuclear Medicine, Chairman of the Medical Department, and Associate Director for Life Sciences at the Department of Energy’s Brookhaven National Laboratory in Upton, New York. Associate Dean of the Medical School at the State University of New York - Stony Brook. 15
The Common Denominator My dad deflected at times, at others he escaped into his alcoholism, leaving me and my siblings to fend for ourselves.
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M
y mom was bi-polar with obsessive-compulsive disorder. It was a rough combination. I am sure it must have been terrible for her, acting out based on pure emotion, but it hardly seemed that way. She’d lash out about some minor something or other, or perhaps nothing at all, and then forget it moments later as if it never happened. She didn’t realize just how much it was affecting me or maybe she just didn’t care, or didn’t have the capacity to care. Who knows. Regardless, it was really rough growing up in that household always walking on eggshells, so to speak.
My dad deflected at times, at others he escaped into his alcoholism, leaving me and my siblings to fend for ourselves. Then one day he was gone, just picked up and left. He couldn’t handle my mom anymore, I get that part. But leave us all alone, abandon us? How’s that fair? I didn’t ask to be born, let alone into this nightmare. It’s no wonder I started drinking and getting stoned. It coincided with my dad’s departure, I must have been around 15 at the time. Looking back, I understand that my dad’s addiction played a role, addiction’s genetic after all. Plus, I needed to escape, just like my dad did, at least when he was still around. I miss him, I hate him - how can these feelings possibly ever resolve? Things, of course, got progressively worse, they always do. Mom kicked me out of the house by the time I was 17. Truth is, I was glad to be gone. I didn’t have the courage to do it on my own. I preferred to be drunk or stoned and sleeping till noon with a roof over my head and a full pantry in the kitchen. I’d now need to care for myself. However, at least I didn’t have to worry about when crazy might explode out of nowhere like an old car back-firing off in the distance. I tried a few jobs but couldn’t keep them as I bummed around from couch-to-couch at friends’ homes. That clearly only lasted for so long. It wasn’t a permanent solution. I had none. No plan, no idea of where my life was headed, other than living from high-tohigh. Then I ran out of couches. My drug use only got worse as I began shooting up daily to numb the pain, nicking odd trinkets here and there that I hoped people wouldn’t notice missing. I needed some way to pay for my habit. There’s something completely sobering about waking up on a park bench with a gun to your head as someone steals the last of your measly, meager possessions. I pissed myself in fright and handed the things over, then cried like a baby when he left. Out of pure desperation I turned to NA. I soon discovered that was everyone’s default setting in NA - desperation. My first meeting was awkward and uncomfortable, I knew absolutely no one and wasn’t exactly sure I wanted to be there. I’d found the place online. I showed up a few minutes early, still considering backing out, when someone noticed me. “First time, huh?”
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‘Was it written on my face or something?’ I thought to myself. “Yeah, how’d you know?” “Been sober 20 years now, sort of developed a sixth sense over time. One day you’ll know what I mean.” James took me under his wing as my sponsor and I heard some unbelievable stories that first night, some of which put my experiences to shame. At least I thought so. Then it occurred to me, ‘I’m not alone, I can do this thing.’ I left that meeting with the most intense sense of freedom I’d felt since I could ever remember. It’s hard to describe it. A burden was lifted from my shoulders. “I’m Alex and I’m an addict.” I admitted that. And, there were plenty of people just like me, willing to accept me with unconditional understanding. As I continued to attend that regular meeting, and added several others, I became fully aware of the theme. It’s one that played out time and again. Our stories all differed in one way or another. For some people, my story was actually the horrifying one to get them thinking, ‘wow, if he can survive and thrive, then I can too.” That’s the beauty of recovery. We’re all different, yet all the same. That common denominator, addiction leading to desperation, bringing us to meetings and then back to hope. Hope. Could we possibly live without that? The final common denominator that keeps us sound and sober in our recovery. 17
Residence XII is the Pacific Northwest’s premier alcohol and drug treatment center for women. We offer safe, inclusive and confidential treatment and support for women of all ages, backgrounds, and needs. Residence XII is a women-only facility offering inpatient treatment, a variety of outpatient services, a free family program and strong alumnae for ongoing support on the journey of recovery. NEW: We are excited to now offer Equine Therapy as part of our inpatient programs.
Inpatient Programs
Residence XII offers women a safe, structured environment to begin their journey toward recovery through our residential inpatient individualized treatment program.
Outpatient Programs
Residence XII offers several outpatient programs including Intensive Outpatient, Extended Care and Continuing Care – providing options tailored to wherever you are in your journey to recovery.
Family Program
Family members are impacted by addiction. We believe that support begins with the family. We offer free family programs for the loved ones of anyone in recovery. Get help for yourself too.
Our treatment plans are accessible and affordable. We offer free assessments and can usually get you in on the same day. We are in-network with most major insurance plans.
Helping women since 1981
Call now. 800.776.5944
2029 113th Ave NE, Kirkland, WA 98034
Synthetic Happiness
There are now over 1,000 apps promoting happiness or well-being that either teach you how to meditate, do yoga, or any number of other stress relieving activities while sending you positive affirmations or photos of sunrises and kittens. Instant happiness. It’s technology jumping in to solve another problem - or is it? Happiness comes from within. Sure, some fine-tuning, positive help can’t hurt, but there’s nothing that beats good ol’ human interaction. Unfortunately, that’s the exact thing all this technology is pulling us away from. So, instead of (or, in addition to) that happiness app, keep going to meetings, make time for friends or go visit family. Make yourself available emotionally, physically and spiritually, because that is your ultimate path to true happiness.
Rising Alcohol Abuse Among Baby Boomers
T
he percentage of older adults engaged in high risk drinking has jumped over four percent according to a report published in JAMA Psychiatry, with actual alcohol use disorder (previously known as alcoholism) having more than doubled in the past decade. Alcohol related emergency room visits and cirrhosis of the liver are also on the rise for seniors. Why the spike in late-life drinking? Increased anxiety from a more intense tech-oriented society and growing life expectancies are the most likely culprits. Moreover, baby boomers were raised with a more laissez-faire attitude with respect to drugs and alcohol. In the face of all this, it’s important to remember that it’s never too late to seek recovery. In fact, studies have shown that older adults have better success rates in treatment than younger drinkers. So, be mindful of the risks and behaviors of aging loved ones to help them enjoy their rewarding golden years.
Sobriety-
The Fountain of Youth A recent study reported in the Journal of Epidemiology gives us yet another great reason to remain inspired in recovery. People who smoke, drink and do drugs are much more likely to be in poor health and age themselves more quickly both inside and out. Everything from skin to internal organs are significantly affected making people appear much older than they are. So, the next time euphoric recall “comes a knockin’” take a good look in the mirror and see that youthful person looking back at you in a vibrant recovery. InRecovery.com
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Overcoming the Pain
P
ain! That was my life. What a horrible way to live. Every step, each slight move, brought on bone-shattering agony, making it impossible to do anything. Just getting out of bed was a chore, let alone working a 9 to 5 job. Then came the depression. It’s a serious psychological challenge when you can no longer do the things you once did, particularly so when it all happens in an instant. I was lost on a raft in a sea of emotional turmoil trying to get my head on straight, attempting to adjust to my new normal. Geez, it sucked. I couldn’t watch TV or listen to music for months. Every single thing reminded me of my former life and what I once could do.
If I could only turn back time. That horrific accident never had to happen, yet in many ways it was practically inevitable. I’d gotten out of control but kept blindly rationalizing it away. ‘I can drive,’ I thought. ‘I’m not drunk.’ The problem is, what drunk person is in any kind of position to make that kind of decision? Foolish me. I should have gotten help sooner, I should have listened to my friends and family, I should have...Crash! I wasn’t sure what was happening, in fact I barely even remember any of it. I do recall everything moving in slow motion right before impact, that much was clear. From there it was all a dull blur, until I completely blacked out. Whether it was from the accident or alcohol, I still don’t know. Either way, it wasn’t good. I woke in a hospital bed, plugged into machines and with an IV drip in my arm, trying to get my wits about me. I was all alone, no flowers, no balloons, no cards. ‘I guess no one cares’ was the first thought that came to mind. The second was that I needed something to drink. InRecovery.com
I was already craving the alcohol. Even with the morphine drip numbing the pain of cracked ribs, a broken leg and some damage to my back. I kept pressing the button to administer another dose but was already at my limit. Where can I just get a drink? A friend eventually came to visit and I literally begged him to bring something of substance, but he declined. What a freaking horrible friend, right?
I woke in a hospital bed, plugged into machines and with an IV drip in my arm, trying to get my wits about me. I was released from the hospital with oxycodone, my new best friend, or at least so I thought. It worked just fine in the beginning but before too long it just wasn’t enough. I began mixing it with alcohol and xanax, and that helped a bit, until my prescription ran out. Can’t the darn uncaring doctor see I’m in pain? I left his office in disgust, determined to find another option. That’s when I truly began to plumb the depths of hell.
news sunk in. At one point my mom was my entire world. Her passing overwhelmed my senses and in my infinite grief something finally got through to my drug-addled brain. This saint of a woman gave me nothing but her best and I repaid her with shame and heartache. What have I done? That was my moment, the point at which I appreciated just how far I’d fallen and how many people I’d hurt. It was now clear to me why I’d woken in the hospital bed all alone. I can no longer play sports and the pain persists. I look back now and can’t believe that the accident wasn’t somehow my rock bottom. It took much more to finally get the message through to my sick head. I now get massages, engage in therapy and do just fine with non-opioid pain medications. Most importantly though, I celebrate each year of sobriety by placing flowers on the tombstone at my mom’s grave, knowing in my heart that she looks down from heaven with a sense of relief and great joy that I am back on track.
“You’re going to kill yourself,” my mom told me the last time I saw her. “I love you with all my heart, but you’re facing a tragic date with destiny if you don’t change,” she finished with tears welling up in her eyes. I thought about those words as I shot up some potent black tar heroin later that day, then quickly forgot them as the high kicked in. My mom died that night. I had ten missed phone calls on my cell phone as I woke in a puddle of my own puke. I wailed in a new kind of agony as the 21
WE BILL AND COLLECT
EVERY PENNY.
DISCOVER A NEW APPROACH TO BILLING. SUPERIOR MEDICAL BILLING, CODING AND COLLECTIONS Both billing and collections are extremely important in the revenue cycle process, however, it is not always easy to make sure that your behavioral treatment facility is being paid for all the services you provide. We at Coast to Coast provide ethical practices for all available billable services. Because healthcare providers receive the majority of their revenue through the processing of successful insurance claims, any billing mistake could cost you money. Sometimes there is a delay in billing, or insurance claims are rejected or denied for a variety of reasons. Knowledge of the insurance claim process, as well as efficient follow-up on each and every claim, minimizes the delays and rejections. HOW WE CAN HELP We can help you eliminate problems that may lead to a loss of revenue, such as errors in billing and coding. Coding errors, incorrect data entry (insurance information, patient demographics, etc.), an incomplete understanding of the ever-changing landscape of insurance processes, or simply a failure of your employee to understand how his or her job affects business revenue can result in your staff making costly mistakes.
Insurance Verification
Utilization Management Billing and Collections Financial Reporting Developmental Collaboration Personalized Services
Coast To Coast Medical Solutions 5700 Lake Worth Road, Suite 311 Greenacres, Florida 33463 annstortz@c2cmedical.net
Why Telemedicine is Important for Addiction Treatment MEGAN PETERSON ogy, which adds to the potential success of this format. Many patients may even find it more cost efficient as travel becomes unnecessary and appointments can be made during work breaks.
T
elemedicine involves treating patients at a distance. While it has come to the forefront as of late, its history dates back many years earlier. One of the first implementations of telemedicine included the use of two-way radios to reach far flung patients in rural Australia. In the 1960s, the use of the phone and video became lifelines between doctors and hardto-reach patients whether it was remote Native American tribes or NASA astronauts. As the internet and online communication grew in the 1990s, telemedicine took hold as a legitimate alternative to a traditional visit to a doctor’s office. In 1999, telemedicine gained credibility when Medicare allowed payments for telehealth consultations to under-served patients in rural areas. With the development of apps like Skype and Facetime, along with the growth of smart phones, the convenience factor brought telemedicine mainstream. Over 207 million Americans now own a smart phone and a recent Pew Research report revealed that 88% of Americans are online, with almost half owning a tablet computer. Receiving healthcare through these powerful mediums seems like a natural evolution, espe-
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cially since insurance companies too are now beginning to more universally reimburse tele-visits. Modern telemedicine has finally arrived. Interestingly enough, telemedicine isn’t only used outside of medical facilities. Hospitals and clinics utilize it to communicate internally. Doctors routinely consult with each other electronically and therapists treating disabled Vets may communicate with another VA Center. Major hospitals do likewise with their satellite clinics. For example, Kelsey Seybold, a large collection of clinics, practitioner and specialists in the Houston area, even offers telemedicine scheduling options directly on their website. With the ever growing need for mental health and addiction services, telemedicine offers a unique platform to address the varying lifestyles, commitments, and needs of patients. Many people find themselves overscheduled or away from available services. The ability to reach therapeutic services via phone or video can offer flexibility to meet these needs. Moreover, young patients have a higher comfort level communicating via technol-
Telemedicine could also have a huge impact helping one of the most underserved patient populations - those struggling with substance abuse. 2nd Chance Counseling Services is one such example, aiding patients from all across the Country, on different paths of recovery, from inpatient care to those who are new to recovery. Addiction treatment typically hits its highest hurdles once a patient has completed intensive treatment. That’s when regular, ongoing communication is most critical. Relapse rates increase dramatically once an individual heads back home and is exposed to everyday triggers and stressors. By creating a better flow of care and allowing a patient to meet their transition therapist before he or she is even discharged, it helps establish trust and rapport, allowing a more seamless continuation of treatment. As we all know, addiction has become a national epidemic. Local coroners around the country aren’t even able to keep up with all the tragic overdoses. Addiction is destroying entire families, leading to a lost generation. We need to use innovative new techniques like telemedicine to help turn the tide in this overwhelming battle. Many treatment centers have found it extremely effective for holding patients accountable and keeping them actively engaged in recovery. So, as you enter treatment, ask your facility what it offers in terms of telemedicine oriented care and aftercare. If you are already in recovery, explore all of the telemedicine options that can help you sustain your hard won sobriety. Leveraging technology to combat this disease can be the pivotal step that helps us finally get the upper hand. For additional information please go to: www.2ndchancecounselingservice.com 23
Choosing the Right
Treatment Center
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O
ne of the questions we are most frequently asked by our readers is how to find the treatment center that’s best suited for them or a loved one. With that in mind, we put together a helpful list of considerations. Consider it a checklist you should run down, as you weigh your options.
she might need. If it’s too low, that can stifle the group dynamic in which some patients find it easier to open up and find greater peer support. 7. What is the treatment facility like both in terms of appearance and ambience? Each location has its own personality. Some might be more spiritual while others might focus on keeping the patient busy at all times. Spend some time there and get to know staff before you or your loved one attends treatment. It’s no different then picking a camp or school. You want to do all you can to ensure comfort and success.
1. First and foremost, is the facility accredited and what kind of licensing does it have? Laws and regulations vary from state to state. The Joint Commission and the National Committee for Quality Assurance are two well known and respected organizations. You can also check with your state’s Better Business Bureau. 2. What level of education and training does the staff have? The location you select should have at least one full-time psychiatrist and medical doctor on staff. Beyond that, all clinicians should have a minimum of a Master’s Degree of education. The different levels for clinical staff are: • Licensed Clinical Drug and Alcohol Counselor. • Licensed Clinical Social Worker. • Licensed Professional Counselor. • Licensed Social Worker. • Licensed Associate Counselor. 3. The program must adhere to “evidence based practices”. There are several different types of treatment recognized to produce results and they are all equally effective. Feel free to Google that term as it relates to addiction treatment, to get a better idea. Some patients perform better than others under certain circumstances and in certain environments. Don’t be afraid to ask questions. True professionals are more interested in seeing you get the treatment that best fits your needs, even if that might be at another facility. 4. How much will all this cost? Ask them to be specific and indicate everyInRecovery.com
thing not included in their quoted price. Work with them to find out how much of it can be covered by your insurance policy. Then get it in writing! 5. How tailored is the program to a patient’s individual needs? For this we are talking about both clinical and support programs. How often will you be seen individually by doctors and clinicians as opposed to receiving group sessions? Would you be better off at a single gender facility? What kinds of support programs does the facility offer? Many provide art, music, massage, yoga and even animal assisted therapy. The options run the gamut. A patient who is happy and content in an environment is more likely to succeed in treatment. 6. What is the patient to counselor ratio? There is no magic formula on what the correct ratio should be. However, if it’s too high then the patient won’t get as much individualized attention as he or
8. What types of services are available to families? Is there a visiting day? Can the patient be contacted and/or reach out to others during his or her stay? There’s no right or wrong answer, just what feels best suited for you. You also want to ensure you get some coaching on how the family should relate to a loved one once treatment is over, whether it’s directly from that facility or via use of other resources. 9. Does the facility offer medically managed Detox? This may not apply to everyone entering treatment, but it does apply to too many so as not to be ignored. Withdrawal is ugly and painful. You want this part of the process to be as smooth and stress free as possible. 10. What about aftercare? Once treatment is over, recovery begins and it lasts for a lifetime. Addiction is a disease without a cure. The most precarious time for addicts in recovery is the first few months after they leave the cocoon of treatment. Most facilities offer some type of post-treatment support, however they can’t be there forever. The most important part is the transition. You need a facility that will work with you to ensure a smooth transition into a long and fulfilling life in recovery. 25
Your Recovery Job Search
T
o be perfectly honest, people in recovery have historically had issues re-entering the workforce. The biggest challenges are explaining why you may have been fired (often several times) and why there are gaps in your resume. The good news is that with a booming economy and a greater understanding of addiction as a disease, job opportunities are more plentiful than ever.
position. Give careful thought to how you can be an asset to their team. When you come in prepared for an interview it immediately impresses the interviewer and exponentially increases the odds of you getting that job.
Employers are willing to overlook past blemishes provided you are sincere and straight-forward.
The first thing you need to do is put together a resume. It will be tempting to fudge a bit here and there, so it’s time to practice some of that honesty you learned in treatment. Employers are willing to overlook past blemishes provided you are sincere and straight-forward. Think back to when you’ve received a letter from, or had a conversation with, someone and it was totally obvious that they were full of BS. Did you then respect or even listen to that person? Of course not. Well, feed off that experience because other people will be able to detect your BS just as easily. It’s time to put your best foot forward. Emphasize unique skills, talents and dedication. Set your self apart from the crowd by leveraging your sobriety skills to your advantage.
The actual interview is your chance to shine. Dress appropriately and be wellgroomed. Enter with confidence but not too cocky, in that same way we walk a fine line between self-confidence and over-confidence in recovery. You know what I mean. From there, offer a firm handshake, sit upright and look the interviewer in his or her eyes. A well-mannered and actively engaged candidate stands out from the crowd. After the interview, make sure to follow up with a “thank you” letter. It’s a nice touch that can make all the difference.
The next step is to prepare for the interview. Not every resume you send out leads to one so you need to be prepared to strike while the iron is hot. Do an online search to learn more about the company and the
You’ve probably noticed that I haven’t mentioned anything about your past addiction in the interview. There’s no clear answer as to whether you should bring it up yourself or not. You’ll need to feel
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this out for yourself. Nonetheless, always be prepared to explain the gaps and blemishes in your resume and ready to discuss your addiction. However, do it from a position of power, not from shame. Now I am sure you are wondering, ‘from power? What could you possibly mean?’ Fighting and defeating the demons of your addiction have empowered you in a way most people can’t even relate to. Feel free to discuss your new life revolving around meetings and your renewed commitment to never letting things spiral out of control again. The reality is that you are actually a better employment prospect in many ways, purely as a result of your addiction. You’ve demonstrated a capacity to succeed in the face of adversity, which is a quality highly valued in the workplace. It shows true grit. InRecovery.com
The Timelessness of Recovery ALLEN WEINTRAUB
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ome days I wish I could imagine a world without time. It creates so much stress in my life. It would be so great if I could just wish it all away.
Time creates pressure for me. I have to get up on time to catch the bus on time to be at work on time. So much can go wrong. There’s so little margin for error in the ongoing march of time. Then there’s the family events, happening at a certain time of the year, like Thanksgiving and Christmas. I have to show up on time, then discuss old times and must be reminded time and time again that I should be more advanced in my career, have a spouse and be thinking about kids. “You won’t be young forever,” they remind me, “time’s getting away from you.” It feels as if there’s just no way of escaping time. It’s at times like those, that the temptation for a little chemical tweak was my false solution, and the thought gets awfully tempting when pressure begins to build like I’m trapped in a time warp. Then there’s the opposite end of the spectrum, when I have too much time on my hands. What do to, what to do? Hobbies never really appealed to me, although I suppose I never gave them a shot. There’s InRecovery.com
always friends. After all, I used to share all my good times with them. The only problem is that the ones I have all seem to have the same general problem with time that I do. They all try to cure it with the same solution. It’s hard to get those thoughts out of my head. I now know better, but they still lurk and haunt me. Let’s get high and kill some time. Of course there are those times when time stands still. Like when you are waiting on a promotion, a big date or the results from an important exam. Time can’t move quick enough, as you stew in anxiety waiting for it to arrive. Anxiety, I hate anxiety. I know how to solve that. Unfortunately that same solution also has me not caring about what I was anxiously waiting on to begin with, but who cares. I’d lost all concept of time. That used to be my attitude and part of the problem. Time, as we all know, is relative. However, living from time to time (and moment to moment) without making time count, is a total waste of time. Living our lives in addiction as a hollow shell of ourselves was just such an existence. We fooled ourselves into thinking it eliminated our stress, pressure and anxiety, but it only
pushed them off to another time as we got lost in a black hole of time. You feel empowered when when others set aside time for you and you do likewise for others. Service, a dedication of time. Now that’s a great use of time. So are the time-honored habits we learn in treatment and a meetings. The tumultuous time of our lives is now in the past. After a brief time out, we’ve developed new skills to help us stand up to the test of time.
It feels as if there’s just no way of escaping time. Time. What does it mean to you? Do you remember your first kiss, your first love, your first great accomplishment? Then, of course, there’s the cry of a newborn baby or the soft caress of a parent. Those special times were all timeless and priceless. Just like our time in recovery. It’s opened our eyes and hearts to the reality of what an amazing time we are offered each and every day. And, when we take the time to seize the moment, we discover we’re having the time of our lives. 27
Talking Points With Your Teen About Marijuana
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any parents have no idea how to even broach this conversation. Some of them smoked pot themselves as teens and don’t want to be hypocrites. However, we’ve learned so much more since then about its dangers. The following important facts are intended to be helpful for engaging a loved one in a productive conversation. 1. Marijuana is a mind altering drug that rewires the brain. The National Institute on Drug Abuse has conducted studies demonstrating that cannabis acts similar to other drugs, causing permanent damage and even rewiring the brain to make it more prone to addiction. 2. Drugged drivers now kill more people than drunk drivers. According to the Governor’s Highway Safety Association, 43 percent of people involved in fatal crashes tested positive for drugs as compared to 37 percent who showed alcohol levels above the legal limit. 3. It’s a catalyst for brain disease. Researchers at Tel Aviv University have identified a causal connection between ado28
Too many people mistakenly believe that marijuana is safe and non-addictive. lescent marijuana use and schizophrenia. People already susceptible to the disease are markedly more likely to exhibit symptoms as a result of use. 4. Increased suicide risk. Scientists at Louisiana State University conducted a study indicating that people who ingest cannabis are more likely to contemplate the idea of suicide. 5. First time college use is on the rise. In fact, the rate of co-eds using pot is now higher than at any other time in the past 30 years, according to a report by a group called Monitoring the Future. The excess free time and party culture combined with
increased ease of access from mass legalization is a troubling recent development. 6. Use by pregnant women is also up. A CBS News survey indicated that 14 percent of pregnant teenagers were smoking pot, endangering their unborn baby. Such irresponsible behavior has been tied to birth defects and learning disabilities. 7. Problematic interactions with other drugs. This issue is two-fold. Using marijuana impairs rational thinking, making you more likely to try another drug when high. Then, certain types of drugs mix badly with cannabis, magnifying the dangerous effects of both. Too many people mistakenly believe that marijuana is safe and non-addictive. The pro-marijuana lobby has been pushing this agenda nationwide, ignoring the clear and obvious negative consequences. They use poorly constructed science to justify behavior they want to engage in. Don’t believe the hype. Marijuana is seductive, addictive and dangerous. Zero tolerance is the only viable option for a lifetime of recovery. InRecovery.com
Teen Marijuana Use Trending Higher
The University of Michigan Institute for Social Research noted that cannabis use by high schoolers nudged 1.3% higher to an astonishing 24% in 2017. The study canvassed 45,000 students in 380 schools nationwide. Unsurprisingly, the increase mirrors the national trend of mass state legalization of marijuana. The problem has been further compounded by the meteoric growth of vaping as a cool alternative to actual smoking. I am par-
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ticularly alarmed by this trend because it can feel awfully tempting to an addict in recovery to seek alternatives to his or her drug of choice, and the marijuana industry is doing all it can to make pot seem addiction free. However, any drug use, including marijuana, alters the brain which continues to develop into a person’s mid-20s. You’ve only got one brain and one life, use them wisely.
Teen Overdose Death Rate on the Rise
hen I think about our growing drug overdose crisis, the first thing that comes to mind is a middle-aged person hooked on opioids. After all, that’s been the singular largest growing segment driving overdose deaths. However, a report released by the Center for Disease Control demonstrates that the crisis has far reaching consequences in the adolescent community as well.
when things all rapidly began to change, rising 19% in the year that followed. Over 80% of these deaths were accidental, with 80% of those (65% overall) attributed to opioids. The report highlights the clear need for greater prevention and early detection of drug abuse. The youth of the nation are our greatest resource. They represent the hope of tomorrow. We need to provide them with hope and education to reach their full potential and prevent them from becoming a statistic.
Drug overdose deaths among Americans aged 15-19 was actually in steep decline, with a 26% drop from 2007-2014. That’s
Public Schools The Times They are a Changing
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vividly recall Junior High School when an upset stomach or scraped knee during recess might get me sent to the onsite nurse. They were constantly called into service for minor ailments, our educational Florence Nightingales. Now, however, through a program run via the Denver public school system, they’re required to take on an even more serious role treatment of students with substance abuse problems. The program began in 2015 and has treated students as young as age 11, although the average age is 15. It comes as no surprise that marijuana abuse accounts for 95% of their cases, considering Colorado was one of the first states to legalize marijuana back in 2012. All six counselors in the program have full caseloads of 35 students each and there is unfortunately a solid wait list of students beyond that. Many people who need and are asking for treatment still can’t receive it. Yet, the program is certainly a step in a positive direction as reflected in higher school attendance and fewer suspensions. It would seem that the school nurse isn’t just for aspirin anymore. 29
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The Path to Treatment
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s we all know, the most difficult part of getting someone into treatment is to get him or her to admit there is a problem. However, things don’t get all that much easier from there. It’s a process that requires additional care and persistence straight from the start. The thing is, anything worth doing requires some effort. The recovery process is no different. So let’s discuss the next steps as a guide on the path to Sobriety. What most people do next is search out more about the disease to try and find the best possible treatment. They also find all they can read about treatment center options. However, things aren’t always so clear. While most people have heard of Hazelden and the Betty Ford Clinic (now under common ownership), there is little standardized information to help you decide which providers might offer the best services for you or your loved one. If addiction was treated more like cancer, you could simply go online and immediately find a ranking of the top hospitals in the country, even broken down by specialty for your specific type of cancer. Finding quality addiction treatment requires more extensive research and an inefficient guessing process that doesn’t always work out perfectly. That’s at least part of the reason behind why relapse is such an issue. Moreover, regardless of which hospital you chose for your cancer treatment, you could rest assured that your were fully or substantially covered by insurance. That’s not always the case when it comes to addiction.
So what can you do? For that reason, a number of patient advocacy groups have sprouted up as of late, in
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order to help patients navigate the choppy waters of insurance coverage. You see, in most instances, the insurance company will throw up objections and roadblocks as they battle to keep a lid on expenses. They do not have your best interests at heart. They also try to shortchange treatment, suggesting that you get by without certain types of treatment or with fewer days in detox or at an in-house treatment facility when you probably would do better with more. At that point, most patients just submit to the insurers will and accept what they’re given. Why? They’re ashamed to be an addict to begin with and are either exhausted, have lost their will to fight or don’t even realize that fighting is an option. Patient Advocacy Services (PAS), located in West Palm Beach, Florida, is one such group that helps patients obtain all of the benefits they are entitled to. Most insurance policies are complicated, making it difficult for the average person to understand. Your average person also isn’t aware of the full array of treatment available, so that he or she can argue for what might be necessary. For example, additional treatments such as art therapy, massages, equine therapy and numerous others can be included to help foster traditional ad-
Most insurance policies are complicated making it difficult for the average person to understand.
diction treatment to make it more effective. Groups like PAS, eliminate much of the headache and hassle because they are experts in this area. They start by reading your actual policy to find out what’s in there. This helps them advise you on the best treatment center that won’t break the bank. They also negotiate directly with your insurer and treatment center to try and reduce the amount you need to pay out of pocket as a deductible, co-pay or co-insurance. Finally, they are fully versed on the Parity Act and will hold insurers’ feet to the fire to ensure they comply. The Parity Act essentially states that addiction coverage must be administered exactly the same as the insurer administers general medical coverage. That’s often not the case. By forcefully persuading an insurer to comply, a group like PAS will typically get you much needed treatment for a longer period of time and at lower cost than if you had gone things alone. They not only help you traverse the minefield and obtain the coverage you deserve, they sometimes even save you money well in excess of their fee. Like with everything in life, it’s best if you look before you leap. A well informed person is a well armed person, to get the best possible treatment for you or your loved one. Patient advocacy groups are a new trend flowing out of a general need, to get the best possible services for the growing epidemic of people unfortunately becoming addicted. All it takes is a phone call. You’ve got nothing to lose. Call one in your area and pick their brain to see if they can be of help to you.
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What’s in a Blame?
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’ve blamed myself most of my life for my addiction. After all, so many people pointed it out to me for so many years. If it was so obvious to them, why did I prefer denial? Blacking out is normal, it happens to everyone. So does speeding out so bad that it feels like your heart’s about to burst, it’s part of the experience.
adventure attached to it. I moved around from city-to-city and career-to-career fancying myself a wild spirit who simply needed to explore what life had to offer. Unfortunately, most of that spirit came from a bottle or the end of a pipe. I kept on running and my demons came along for the ride.
To be perfectly honest, I knew it might be a problem but the only thing scarier than the trouble I was getting into was the inability to escape that trouble by being sober. So even as I broke bones, needed stitches and got into car accidents as a result of my use, that wasn’t nearly enough to make me stop.
It was time for serious inner self-reflection.
Then there was my fiance’. She was an incredible woman, one of those humanitarian types who was impossibly more beautiful inside than out. She tolerated my indulgences (as I liked to call them) for a while but then threw down the gauntlet with an ultimatum. Well, I wasn’t about to be bullied into quitting by anyone, even by the love of my life. Man, was I an idiot. I’ve pined for her ever since as she went on to become a social worker, have two amazing kids and the perfect marriage.
Even when I concluded I’d had enough, looking back on the shattered wreckage of my life, there was still more to be done than just getting sober. It was time for serious inner self-reflection. I was abused as a kid. It happened so long ago that I chose to forget. Well, maybe not forget but definitely chose not to remember because there was nothing I could do to save that poor, scared, lost child. Or, at least so I thought. What I came to realize though was that the lost child was still in there, lurking in the shadows of a dark corner of my mind. I invited him out into the light and for the first time lifted the fog of blame.
My life was a wreck but I called it fun. Disorganized chaos has a certain sense of
What’s happened to you? What’s your trauma? Perhaps it’s time to take yours
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head on if you haven’t already done so. I’m so grateful I took that journey because it has given me the strength and courage to move on. So, now I’ve successfully eliminated the shame. It’s much easier to do so when you’re in recovery. I also no longer find a need to escape. Escape what, after all? I tried drugs, alcohol and moving around the world, only to discover whatever I was trying to escape was still right there by my side. The challenges of each day now make me stronger and help me grow. I take on new and different adventures, even things I once thought beyond my ability, things I once wouldn’t dare try when my addiction was in charge. The only regret I might have, if you can even call it that, was that I wish I had done it all sooner. Then again, things happen for a reason, when they’re supposed to happen. I wasn’t ready sooner and probably would have failed. All things happen at their proper time. Now it’s time to stop blaming yourself too. Our Higher Power knows what’s in our best interests much better than we do. Resisting His will is a recipe for pain while accepting it is a condition for true power and inner peace. Take a look within, help calm your troubled heart, and you too will discover a blame free recovery. InRecovery.com
Is a
12 Step Program Enough?
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lcoholics Anonymous was formed as the initial 12 step program, with the best of intentions. Its principles of service and paying sobriety forward are firm bedrocks in making it one of the most charitable organizations of all time. Its regular focus on meetings also helps keep members grounded in recovery, with support and reinforcement from others with similar struggles. And, while AA’s impact has profoundly saved and changed countless lives - it seems that the 12 step program may not be the complete solution for everyone. 12 step programs have a one-size-fits-all philosophy. It comes about by default. After all, it’s trying to message people from all different races, creeds, cultures, socio-economic backgrounds and genders. That’s a pretty broad group. However, we all do share one key thing in common addiction. That’s a strong unifying bond for most of us, but it’s just not enough for some. Some people take issue with admitting to a spiritual malady that somehow affects addicts but not the rest of the population. They believe it is unhealthy to come at sobriety from a point of moral inferiority,
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on many people’s 5th step list.
full of selfishness, self-pity, depression and anger. These people believe there should be greater focus on the positives. Many addicts simultaneously display such good qualities as sensitivity and empathy, and are otherwise good mothers, fathers and friends, in spite of their addiction. According to them, recognizing your addiction doesn’t have to require throwing out the baby with the bathwater, so to speak. These same people also believe that AA’s roots of spiritual illness run counter to the growing mountain of evidence that many, if not most, addictive behavior can be traced back to trauma. Someone who has been abused or suffered great loss can only be helped so much by attending meetings, searching within at his or her spiritual sickness. In reality, he or she is the by-product of some major shock that needs addressing. Going solely to AA would be tantamount to putting a bandaid on a broken bone. You are not being selfish when you experience pain from your parents’ divorce, yet that shows up
The 12 step program is steeped in identifying and addressing character flaws. Perhaps that’s something that would be wonderfully helpful to many people, addicts and non-addicts alike, as part of therapy. For most addicts though, just doing a 12 step program without something more is an ineffective disservice to the healing process. Addiction arises as a result of your genes and everything you’ve experienced. The first part makes you either more or less prone, and the extent of your circumstances acts like the trigger. Think of it as mixing two things together. Drop some chocolate in diet coke and nothing happens. Drop a Mento in water and again nothing happens. However, drop a Mento in diet coke and you get a messy, explosive chain reaction. Google it on Youtube if you don’t believe me. So please be mindful of your treatment needs in addiction. Most people require something more than the communal self discipline of the 12 step. Consider all aspects as part of your solution in order to maximize success and minimize potential damage of explosive combinations in your life. 33
Not Feeling AA? Try Club Soda
Norway Leading by Example
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reatment vs. Punishment - which is more effective for curbing addiction? It’s never typically a question of all or nothing, with most countries shading toward one or other side of the spectrum, but always somewhere near the middle. Norway, however, may be the first to engage in the social experiment of placing all of its weight behind treatment. Detractors fear this lopsided approach will only encourage more addiction, while advocates
counter that the threat of incarceration is never enough to convince a determined addict that treatment is the only solution. While the proposal has still not been signed into law, the position does have some powerful advocates. The Norwegian Minister of Health actually recently changed his position on decriminalization. How will this all turn out? Ideally this program will do as intended and get more people into treatment where they belong.
Seek Treatment or Face Jail Time
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lub Soda is just one small part of the growing national sober movement. It consists of a group of people from Brooklyn, New York who felt alcohol was playing too great a role in their lives. The thing was, most had tried AA but it didn’t feel authentic. They couldn’t relate to being out of control but wanted to put on the brakes nonetheless. They also wanted more fun social events to help motivate their decision not to drink. The Soda part of the name stands for Sober or Debating Abstinence. It’s actually a very catchy way to assist people in coming to terms with their relationship with alcohol. Many other like clubs are sprouting up all around the country. So keep an eye out for one in your neighborhood and feel free to share a happy “Cheers” over your next club soda. 34
It’s a tough subject in which to stake a position. We all know prison is not the solution for addiction, but what if it’s used as a tool to help someone reach rock bottom? Pennsylvania has what it calls the Good Samaritan Law, designed to encourage people to report overdoses without fear of repercussions. It’s meant to save lives. Others feel it just leads to an extension of the inevitable since it’s not combined with motivation to make the drug abuser want to change. That’s why they’ve proposed legislation mandating people who overdose to seek treatment within 30 days. If they refuse to comply, then they’re hauled off to jail. Politicians posture that without this carrot and stick approach we’re practicing institutionalized insanity - expecting the results to change while the actions remain the same. As one County Executive stated, “desperate times call for desperate measures.”
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My Son’s Addiction
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he path from teen to adulthood is full of pitfalls. I’d always heard that navigating those waters were particularly difficult for a parent but never fully appreciated its gravity until I was confronted by the challenges. My son hit his teenage years and all seemed just fine. His grades were good, he was athletic and popular. Come his mid-teens I realized he began to dabble in marijuana and alcohol, but nothing serious. I easily rationalized it away as a rite of passage. Didn’t I do the same? There were some nights that he got a bit out of control but so did I way back when, when I was learning my limits. He went off to college and got into a great business program at a top school. We were elated and very proud. At the beginning I heard from him almost daily but that eventually petered off. That’s normal though, right? He was finding himself, feeling his oats and learning responsibility, or so I thought. It got to the point that emails and phone calls went unanswered for a few days at a time as he fell off the grid. Yet, I deluded myself into believing it was all part of growing up. The bird leaves the nest to find his independence. It struck me as strange when he wanted to switch schools at the end of the semester. We nonetheless respected his choice and
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gave him some space. As it turns out, he couldn’t switch because he’d failed threeout-of-four classes. He was homesick, or so he said. He moved back home, took off a semester and then headed to a local college. We monitored him for signs of problems and didn’t see excessive drug or alcohol use, just leisurely recreational activity. At least that’s how it appeared. He got As and Bs for an entire year, and regained our confidence to the point we supported his decision to live off-campus with friends. He still needed to grow up. That’s what worked for me as I transitioned to adulthood. All seemed fine and back on track.
He was finding himself, feeling his oats and learning responsibility, or so I thought. Come late October he hit me with, “Dad, I’ve been reading a lot of stuff by Elon Musk and other intellectuals. I really don’t get much out of my classes. I’m thinking
college is a waste of time.” I was shocked and disheartened but open to the possibility of a semester off come January, so he could find himself. ‘Who knows, maybe he is the next Bill Gates or Mark Zuckerberg?’ I begged him to at least keep his grades up as a back-up, just in case, so he’d have more options. He agreed. Unfortunately the wheels fell off that agreement pretty quickly as he failed out of college for a second time. I was fooled again. The funny thing is that I really should have known better. I spent most of my life as an addict and had only come to terms with it about four years ago. How did I not see this coming? I’d been studying everything I could, yet I refused to recognize all of the clear and obvious signs in my son, until it was too late. I suppose I was simply too close to the subject. I’ve since done the only thing I can. I’ve pulled the rip cord and stopped enabling him. He’ll sadly need to find rock bottom on his own. Which brings me back to the question - Is it really too late? As I reflect on that, I realize it never is. I’ll be there with the offer of therapy and open arms when my son is ready. I just hope he gets there quickly because in the meanwhile it is tearing the hearts of the entire family to pieces as we drift through a heavy, dark fog with no end in sight. 35
A PRISONER’S TALE L. SCOTT HARTMAN
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s they say in AA and other 12 Step programs, there are only three places you can end up if you refuse to seek help for your addiction: (1) death, (2) an insane asylum, or (3) prison. Well, as it turns out, sometimes even something like entering the gates of prison doesn’t get someone to rock bottom. Contrary to popular belief, drugs and alcohol are widely available in prison. They may not be as easily obtained and will cost more, but where there’s a will there’s a way. Home-made brews compete with more expensive stuff smuggled in from the outside. Also, the higher up you go in security, the more likely it is that the administration will look the other way. Officers prefer not to get between someone and their fix when that someone is already serving a life sentence and has little left to lose. In any event, this tale is about a friend at a low security prison who still wasn’t prepared to quit, even though his addiction squarely led to his incarceration. My friend was a well-educated man, imprisoned for fraud, still in shell shock from his new surroundings. It wasn’t all too long before he came across a nice Cuban gentleman distilling some hooch, which tasted little different than house wine that might be served at some Italian “hole in the wall” restaurant. ‘Not bad,’ he thought, and began a regular Friday evening, happy hour-like routine. Soon he made more acquaintances and his private relaxation time morphed into a more raucous get together. Friday evening then spanned the entire weekend and into the week, as he risked getting caught, being locked up in solitary confinement and being shipped to a higher security prison far away from his loved ones and family visits. He even quickly and conveniently forgot the intense terror he felt holding a juice bottle full of alcohol, when stopped and questioned by a passing lieutenant.
Lightning. It was high proof liquor made from anything available and potentially poisonous, but addiction’s like that. We take chances to the extreme. He even tried suboxone when it was offered while he was drunk, just to see what it was like. He hated how it made him feel. Yet, that still didn’t stop him from doing it again the very next week, once again while he was drunk. He was out of control. The exact same out of control that fed his addiction on the outside and helped him justify the behavior leading up to his white collar crime.
Contrary to popular belief, drugs and alcohol are widely available in prison. The COs (correction officers) came in one Sunday morning and started breathalyzing people at random. It seems that someone snitched out the crew, dropping off a “paper shiv” (an anonymous note, just as effective as any knife) with the police. The COs pointed to my friend and his heart began to race, as his life ran before his eyes just like it did on the day of his indictment. ‘Oh my God, what have I done? Will I never learn?’ rumbled through the haze of his brain as he prepared to wreak yet more
havoc in his family’s life. The CO gave my friend the test and he blew, or at least pretended to. You have to blow hard enough for the meter to register. My friend put on one hell of a performance. He looked like the Big Bad Wolf trying to blow down the Three Little Pigs’ house made of bricks it was worthy of an Oscar. After four attempts, the CO just gave up, assuming the problem was his faulty machinery. That happens in prison, the equipment is old and third rate. My friend was dismissed and walked away stoically. He came back to our cell, broke down and cried. That was my friend’s “come to Jesus” moment. At that point it was finally, vividly clear that addiction had ruined his life and was about to take him even lower - lower than mere prison alone. He imagined telling his three kids that daddy would now have to serve several more years. He saw their faces in his mind’s eye and it finally sunk in. Prison is hell. Addiction is hell. Addiction in prison is off the charts! The tension and emotion is beyond anything you can imagine. It’s something you NEVER want to experience. So, I kindly ask you to remember my friend’s story if and when you are feeling weak and fear you may relapse. Alcohol and drugs are cruel masters. However, you’ve already seen the fury of addiction and rock bottomed once. Please let it be your last because sometimes just entering the prison gates alone isn’t enough to make someone reach their true rock bottom.
The addictive attitudes still remained. It wasn’t bad enough that he put his wife, kids and parents through the stress and shame of his criminal behavior. Now he was on a collision course for losing his “good time”, with the potential of adding several more years onto his 10 year sentence. After a while the wine wasn’t enough and his group ratcheted things up to White InRecovery.com
Three places you can end up if you refuse to seek help for your addiction: (1) death, (2) an insane asylum, and (3) prison. 37
People, Places and Things “People, places and things” should be a mantra we repeat everyday. As life goes on, so to speak, after treatment, it becomes all too easy to fall into old routines. Not necessarily right away, but with time. We seek out comfort or are presented with tough choices, and what could possibly feel more comfortable than old familiar surroundings. People, places and things. Coming out of treatment feels like a huge accomplishment, often accompanied by a graduation. And, while it truly is something to be proud of, the reality is that it’s only the beginning. The beginning of a new life full of promise and hope. It’s tremendously exciting but scary as hell. I remember my first week out of treatment, running from meeting to meeting. It felt so safe, like a warm puffy cloud or grandma’s baked cookies. I couldn’t help but think, ‘yes, these people all know me, although we’ve never met before. They get me, we’re kindred spirits.’ I emotionally took them with me
wherever I went. It was awesome and it was stabilizing, but it still wasn’t reality. No one can keep up that kind of intensity forever. It’s when fatigue kicked in that life got real. I cut down to two meetings a week because that seemed about right. I otherwise followed the playbook and picked up a sponsor plus a couple of sponsees. I also did the occasional treatment exercise to keep things fresh, but eventually things started to slip just a bit. ‘I get tired at night, there’s no reason I can’t skip a part of my new routine,’ would pop into my head. It was no big deal, I wasn’t at risk of relapse. However, I was having a hard time finding that proper balance between the constant will to stay sober and a routine of sobriety that began to feel like work. People, places and things. I bumped into an old friend. We used to use together but he wasn’t an addict like me. Perhaps he’ll be okay to hang out with. I told him I’m in recovery. He’ll be supportive and not tempt me to use, at least I hope not.
How about a ball game? It’s been a while and the home team is making a strong run for the playoffs. Man, that would be fun, but then I realize just how much I miss an ice cold beer on a warm summer’s day. Is it worth the risk? Then, of course, came another friend’s huge promotion. Everyone was going out to celebrate and she was treating. It would be rude not to go, right? I know in my heart that I need to avoid things like that but it could be career suicide not to attend. How do I get out of it without killing my career? The challenges of people, places and things take on a greater meaning as we go about living life. We can never let our guard down. Our disease doesn’t take vacations. In fact, it is constantly looking for a way back in. What better way is there to do that than through some innocent looking, old familiar person, place or thing? We must jealously protect our recovery like a fine jewel. It took a long time and a lot of hard work, to find it, cut it and polish it to a perfect shine. It would be life shattering to lose it in one mindless fell swoop. Cherish your sobriety and mind the people, places and things in your life because you’ve worked too hard to get there.
The challenges of people, places and things take on a greater meeting as we go about living life. 38
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The Benefits of
Mindfulness
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niversity College of London psychologists conducted a mindfulness study on 68 women who were heavy drinkers. They discovered that getting them to focus on noticing their cravings without acting upon them, several days a week, for just 8-9 minutes per day, had a material impact. Consumption reduced by more than one-third. Even that “ultra-brief ” experience with mindfulness led to noticeable change. That same concept also assists us in recovery. Using mindfulness to create greater inner awareness and increase self-discipline is an incredible tool for maintaining sobriety.
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Chaos
ntropy is a term used by scientists to explain the fact that the universe, left to its own devices, tends to disorder. It started with The Big Bang, and things have been constantly exploding and bumping into each other ever since. Even here on Earth, cups shatter when you drop them, and wires and hair always tangle. It seems as if all of creation conspires against order. That logic makes a lot of sense looking back at our lives prior to recovery. We made poor decisions, or simply reacted on auto-pilot, and chaos reigned. However, by considering our Higher Power and thinking before we act, we keep chaos from interfering with our recovery. For me, Chaos is a label that stems from lack of knowledge. I once had it described to me as sitting by a babbling brook and being hit by a sudden random splash as water flowed past a rock in a certain way. You could sit there for hours or days and it may not re-occur; then again it could happen just moments later. Science considers this chaos because it can’t be broken down into a neat little formula. However, what science fails to InRecovery.com
recognize is that our Higher Power works with a level of mathematics well beyond our capacity to understand. Why must we struggle with the chaos of addiction? It’s a tough but legitimate question, after all, addiction feels like one giant curse. However, consider this, would you still be the same enlightened person you are today without that test? Our character has been forged in a trial of fire enabling us to stand up to all challenges. Stephen Hawking, for example, was one of the greatest minds of our time, but was struck with a debilitating disease leaving him incapacitated most of his life. For most of us this would be a horror beyond comprehension. However, would he have arrived at the same monumental insights into the universe if he wasn’t trapped in his own mind? Humanity is much better off as a result of this “tragedy”. It’s all too easy to be distracted by chaos in recovery. You might face personal, professional and social demands pouncing on you all at once. However, by using your recovery tools, you’ll pass the test and be stronger for it in maintaining your sobriety. 39
Beware of the O
ne of the least discussed topics in addiction treatment, is also one that often presents one of the biggest problems what to do with a problem patient.
Now, I’m sure you’re wondering. ‘why is that important to me?’ After all, I’m only a patient myself. However, patients can be problematic for different reasons which can ultimately impact your treatment. For some, it’s the inherent trauma that leads to the addiction. There is a huge, deep-seeded underlying factor, even bigger than the addiction itself, that must be addressed. Without treating the trauma, recovery will never take hold. For others, they never wanted to be in treatment in the first place. They’ll either rebel or go through the mo-
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tions trying to satisfy a parent or spouse, knowing that they’re going to drink or use the first chance they get. There are also people with serious anger issues who are going to be pissed off no matter where they are. Their short temper can lead them into constant conflict because they are addicted to their anger just as much as any substance. Finally, there’s the inevitable withdrawal. There are very real and critical biological changes associated with sobriety, especially when an addict quits cold turkey. The good part is that this last issue is typically temporary as the body re-discovers stasis. The problem patient is an issue for several reasons. You have what is commonly
referred to as the 90/10 rule. It basically describes the fact that a small percentage of patients take up most of the time, to the detriment of others. Secondly, these problem patients usually also distract others, whether in group therapy or during break times, undermining treatment and the entire recovery environment. Finally, these patients sometimes even fall into relapse mid-treatment, dragging other patients down along with them. This process is always a balance for the administrators running the addiction treatment facility. Many people in treatment simply don’t want to be there, particularly in the beginning. We are flawed canvasses, trying to be restored to health. If most of InRecovery.com
Patients can be problematic for different reasons. For some, it’s the inherent trauma that leads to the addiction.
Problem Patient us patients were rational and easy to deal with, we probably wouldn’t need treatment to begin with. Many problem patients are merely crying out for help and don’t know how to communicate. It brings to mind a parent with a young child constantly reminding him or her to “use your words” instead of acting out physically. The thing is, at one time or another, the administrators have seen the most rebellious of patients make a full recovery. That experience inspires them not to give up, hoping the problem patient is just about to turn the corner. It also makes things more disheartening for everyone when a patient is expelled, and everyone is left wondering whether he or she just needed a little more time for pivotal change. InRecovery.com
How do administrators determine who is worth the extra time and effort? There’s no easy answer. It’s human nature to be more empathetic to someone who has severe trauma underlying his or her disorder, but they are also the toughest to treat. On the opposite side of the spectrum, the angry patient often puts staff off regardless. It’s very tough for someone to get motivated when he or she feels as if the patient is “biting the hand that feeds him”. They take each patient as they find him or her. Interpersonal relationships in treatment work the same way as they do in real life, driven by personalities and character traits. Someone who reminds staff of that favorite old aunt will invariably get special attention.
So why is all this so important? When we are in treatment, we are literally fighting to save our lives. Treatment groups are only as strong as the weakest link. If you are in a group with a problem patient, notify administrators immediately to get the problem remedied as soon as possible. If you are in a program and can’t identify the problem patient, take a long, hard look in the mirror. It might just be you. Be honest, be fair, be considerate. We are all in this together, struggling against the disease of addiction. Addiction doesn’t fight fair, so we need to give it our all, because united we stand a much better chance.
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Lifestyle Balance MICHAEL BURKE
Physical Health Emotional Health
Healthy Relationships Job Satisfaction
Community Involvement
It’s all a matter of holding yourself accountable or calling yourself out when need be. 42
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arly on in recovery it seems impossible to imagine that you need to abstain from drugs and alcohol forever.
Oh no!!! You mean never again???? But how??? Then many of us go through rigorous therapy at a treatment center and learn to take it one day at a time. But in taking things one day at a time, we must incorporate lifestyle balance into our daily routine. Now, never in a million years would I have ever been educated on this concept had I not gone through treatment, and looking back on it now, it seemed so insignificant at the beginning of my sobriety. However, as time progressed and clarity began to sink in, the meaning behind this formula became obvious. We all know recovery is NOT easy but when you come to think about it, is anything in life that is lucrative or rewarding simple to achieve? No!!! Not by a long shot, because if it was then everyone would have it. The lifestyle balance formula is broken down into five major components often referred to as “spokes,” and in order to flow successfully throughout your after life of recovery, you must make sure that they are ALL alligned properly to avoid any chance of a possible relapse. Relapse is an ugly word in the addiction treatment field, but an unfortunate reality for many addicts and alcoholics. That’s why lifestyle balance is so critical. Physical Health During your initial process of recovery this component is extremely important to factor in to your day to day life. At the height of my addiction I weighed in at 292 pounds, which at a height of 5 foot 7 inches tall, is nothing to brag about. I was totally out of balance in this particular area. I am proud to say that my sobriety has brought me back in touch with the level I need to be at, which is my current weight of 175 pounds. Now that’s more like it!!! Anyhow, your main physical health goals should be supported by two (2) key areas, which are exercise and sleep. Without this, nothing else will fall into place. This automatically ties to your emotional state of mind, relieving anxiety and stress, which are major triggers for a relapse. When we first go through treatment, we as addicts have a tendency of overemphasizing physical health because we’ve neglected InRecovery.com
ourselves for so long. We still yearn for that immediate gratification and seem to satisfy it through exercise in search of a rocking “Hot Bod”, not to mention the self esteem boost that comes with it. Emotional Health For a lot of us, particularly myself, this was extremely difficult. Many of us coped with our emotions in the past by consuming drugs and alcohol to numb our emotions such as joy, fear, or even a sense of sadness. Here, we once again begin to identify with and express our emotions without chemical stimulants or mind altering substances. For a lot of us moving forward, we must implement the proper coping skills to assure ourselves that we will remain recovery bound. Healthy Relationships In this particular spoke you must be mindful of the most common triggers involving people. In the past this led to destructive and erratic behavior because of whom we associated with. Keep in mind that healthy relationships have a huge affect on your lifestyle balance. This area comes in direct connection with your emotional health spoke as well as your job satisfaction spoke, which we will now review. Job Satisfaction Now, this particular component personally was a huge issue for me in the past. During my active addiction, I was always in search of more, which in my case was money. Endless hours for me in the office always gave me a sense of fulfillment, accomplishment, and a valid reason to indulge in my extra curricular activities as an avid drug user. I was your classic case of a workaholic, and with that came a lot of excess stress and anxiety. As addicts, we must remain mindful of ensuring we don’t minimize the danger that comes from the lack of job satisfaction. As we all know, stress and anxiety are in fact major triggers for a relapse.
Osment and Helen Hunt, where someone does a good deed and you pass it on to a number of different people. Well, this is very similar to it. In recovery it is referred to as “12 stepping it”. Step Twelve (12) of the big book calls for us to carry the message to alcoholics and addicts and to practice these principles’ in our affairs. I, personally, feel this method is a truly effective manner for maintaining my sobriety. There is no greater feeling than knowing you can assist someone in bettering themselves. Now that we know all five components, or spokes that make up a proper lifestyle balance, I hope that this can assist you in structuring your life in recovery. There’s a Japanese concept called “Kaizen” which is an important philosophy that we could tie into treatment because it directs us to make small daily improvements that will eventually result in huge advantages. Remember, it’s all about the little things we do that make all the difference in our lives. Our end goal is to prevent a relapse. In order to do so, we must always be vigilant to remain sober. I believe it is imperative that you perform random spoke checks every so often to reassure that you are equally balanced, after all, your sobriety relies on this. It’s all a matter of holding yourself accountable or calling yourself out when need be. Now, it’s not the end of the world should you be out of balance, and always remember that practice makes perfect. We were addicts and alcoholics for many years, and something of this magnitude takes time. “Work it, you’re worth it,” as they say in the meeting rooms. All in all, recovery takes work, time, and a lot of patience, but the end result is beautiful and amazing. In the end, I would not trade anything in the world to feel the way that I do right now. So implement this formula into your life and I know it will be beneficial to you all. Stay sober my friends!!!
Community Involvement Last but not least, we have the fifth (5) and final spoke which should be the most fulfilling. I refer to this spoke simply as “Paying it Forward”. I am sure many of you saw the movie starring Haley Joel 43
We know it takes courage to be the best version of yourself
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We are focused on providing a safe space for the LGBTQ+ community through a creative approach to drug and alcohol addiction treatment. Our program is dedicated to enriching the emotional health and well-being of our clients while focusing on topics related to the experiences of lesbian, gay, bisexual, transgender, non-biidenced-based behavioral therapies, trauma-informed care, spiritually-inclusive 12 Step recovery and integrative practices such as nutrition coaching and meditation to maximize a client’s potential for long-term recovery.
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Trauma Healing • Love and Relationships • Recovery Through Journaling • Letting Go of Fear • Mindfulness • Life Skills Program
Arrive with the desire to grow …. For more information, please contact us Call 561-899-6088 or visit inspirerecovery.com 909 North Dixie Highway, West Palm Beach, FL 33401
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OPIOIDS
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may be used for Lethal Injections
t sounds like something torn straight from a Hollywood script. Some political crackpot notices people dying on the streets from overdoses and thinks, “that would be very effective to solve our backlog of people sitting on death row.” Truth, however, is often equally as strange as fiction. The states of Nevada and Nebraska are now exploring the possible use of fentanyl, 50 times more powerful than heroin, for state ordered executions. Lack of supply of approved
drugs has made it challenging for states to comply with court orders, and states like Florida, Ohio and Oklahoma are independently pursuing other options. It would be strangely ironic for fentanyl to serve such a purpose as politicians fight the scourge of opioids hitting the streets. Opioid aided lethal injections has still not gained approval for that very reason. That fact, however, may just change in the very near future.
Opioid Use Overtakes Tobacco
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hroughout most of our country’s history, tobacco use has far outpaced the use of any other drug. However, as a result of recent events, that’s no longer the case. According to the United States Department of Health and Human Services, more than 91.8 million Americans 18 and older used prescription painkillers in 2016 as compared to 75.4 million who used tobacco products. This is both a testament to declining smoking rates and an alarming wake-up call as to just how extreme our nation’s dependence on painkillers has become. As frustrating as the opioid epidemic is, our experience with tobacco holds out hope. Smoking is also heavily addictive, yet we have managed to make incredible progress through education, litigation and behavior modification. As a result, smoking has been in decline for the past 50 years. Several states and cities are already beginning a push against the large pharmaceutical companies with lawsuits, which did wonders in the fight against Big Tobacco. As fellow partners in recovery, we must join them to help create greater awareness as part of our credo of “service”. Together, we can make a difference.
DEA Drug Prescription Take Back Day
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Year 2016
Americans 18 and older
75.4 million
used tobacco products
91.8 million
used prescription painkillers
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n the past, many of us gave little thought to what we should do with leftover medication. In fact, I remember my first time trying valium, as a teenager. My friend swiped it from his mom’s medicine cabinet. Like many youth still do today. That’s why the U.S. Drug Enforcement Agency (DEA) rolls out a nationwide program, twice a year, to combat this issue. Now in its 8th year, Prescription Take Back Day resulted in the collection of 456 tons of prescriptions pills at more than 5,300 separate locations last year. That’s a big deal and a lot of potentionlly dangerous drugs taken out of circulation. So, kindly make friends and family aware of this semi-annual event and help educate them on the importance of safely discarding unused pills. This way, we can all be part of the ongoing solution in the fight against addiction. The next Drug Prescription Take Back Day is in October 2018. Please check out the DEA website for a location near you. 45
The Dreaded Yets
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hat is it about addiction that makes us so pre-occupied with the “yets.” I haven’t gotten into a drunk driving accident yet. I haven’t blacked out yet. I haven’t woken up naked under a bridge yet. I haven’t overdosed yet. Yet, as we fell ever deeper into our addiction and actually hit some of those markers, we just moved our bright red line to a “yet” further down the road. For that reason, I’d like you to sit down and think about that ultimate “yet.” The thing that occurred which made you so miserable as to finally seek that elusive sobriety. I want you to feel the moment and vividly recall those emotions because that ultimate “yet” is a powerful tool to help you maintain your recovery. My ultimate “yet” was a doozy. I’d spent all night partying with friends, although for the life of me I could not tell you who they were. It started with booze and quickly transitioned to the point I had no idea what I was taking. Coke, probably, meth, perhaps, heroin, most likely. The night devolved into a collage of visions slowly slipping from my grasp until it faded into a fuzzy, blurry image that eventually went black. I woke up alone in what seemed to be a hotel room, with clues strewn about like in the movie The Hangover. There was a halffull glass of something with the name of a bar on it and a random party hat, among numerous other items I evidently picked up along the way. I looked at my watch and thought ‘not too bad’ as I saw that it was only 1 pm, only to be rapidly shocked in horror when I noticed the date - two days had passed!
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I returned to the lobby and got the most perplexed look from the desk clerk when I asked, “excuse me, but where am I?” “The Sheraton,” he replied, thinking he’d answered my question. “No, I mean what city?” “Miami, Florida.” ‘Holy Crap!’ I thought. I’d started the night in New York. ‘How the heck did I get here?’ Things only got more complicated as I picked up a payphone to call a friend or relative, only to realize I didn’t know any phone numbers by heart. They were all in my missing smart phone. In the meanwhile, my parents were going absolutely nuts, calling hospitals and morgues, thinking I’d been in an accident, died or had possibly been kidnapped. At that point, my head was killing me, so I tried to buy aspirin but $3.42 wasn’t enough and the first two credit cards I tried were totally maxed out. Thankfully, a nice bellman who could relate to my predicament, overheard my plight and offered me some. At least I’d have some relief.
The night devolved into a collage of visions slowly slipping from my grasp until it faded into a fuzzy, blurry image that eventually went black.
I did a quick body check, no injuries, thank God, and took inventory of my possessions. I still had my watch, that was a good sign, and my wallet too. And, while my cell phone was gone, I discovered $3.42 in change and several random matchbooks. All in all, that seemed about right, Lord knows I’ve woken up to worse.
Now with my bearings, I got a ride to Miami International Airport happily discovering I still had some limit on one remaining card, and waited several long hours for a flight home. I returned home and got online to discover thousands of dollars in charges I didn’t recognize but which slowly began to fill in the blank holes of my life what a mess!
I took a shower and got dressed, sheepishly slinking through the lobby in my dirty, smelly clothes. And, while I knew absolutely no one, I couldn’t help but feel embarrassed doing the walk of shame. I stepped outside to hail a taxi ride home, only to realize that I recognized absolutely nothing. Geez, what the heck have I gotten myself into?
It might seem funny, on some level, but in reality there’s nothing funny about risking my life like that and I instinctively knew it. I’d certainly had my issues before, but nothing like this. That was my ultimate “yet” and I recount that story to both keep myself in check and hopefully help you maintain the strength to retain your recovery. 47
Shopping -
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A Co-Addiction?
hink you might be addicted to shopping? That idea is not so far-fetched. The same way that our brain drove us to our primary addiction, it can drive us to others. And, while shopping in general might be harmless, taking it to the extreme can negatively impact relationships and your financial situation.
5. Can you resist the temptation to shop or is it overwhelming?
1. Is your shopping spree an isolated instance of over-indulgence or is it common practice?
6. Do you continue to shop despite no savings or, even more troubling, excessive credit card debt?
2. How much stuff in your closet, cabinet, garage, etc. has never been used or used only once?
Do yourself a favor. Take a long, hard look at your habits. Over-shopping may not be as destructive as drug or alcohol addiction, but it can still cause serious damage. Get control of the problem before it too leads to serious consequences.
3. How much time do you spend shopping? 4. Are you buying too much for others, or stretching yourself beyond your means?
GAMING ADDICTION
According to Dr. David Sack, Chief Medical Officer for Elements Behavioral Health, an estimated 5-7% of the population struggles with a shopping addiction, spending in excess of what they can afford.
Think you might have a shopping addiction? Consider the following:
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I
s online gaming an addiction? That’s a question being tossed around a lot lately. It seems to have all the hallmarks of addiction, at least for those people who can’t seem to put the darn things down. It can be an all consuming obsession that compels some gamers to continue even as it leads to clear, dangerous and negative consequences. Yet, many professionals protest against using substance use criteria to video and digital gaming. This debate is particularly interesting in light of comments by one of Facebook’s early key executives, Sean Parker. He claims that Facebook was purposely created and designed to maximize it’s addictive allure. And, when you think about it, how much real difference is there between social media and gaming? I suppose that’s why social media is also subject to the same debate. The World Health Organization seems to be weighing in on the topic with upcoming changes to add gaming as a recognized, problematic addiction. Why is this so important? Because cross addiction is a constant, chronic risk for all of us in recovery. We unwittingly put our sobriety in jeopardy when when we’re not mindful of our surroundings and actions. Playing on your computer, pad or cell phone, may seem benign but for some people it can be a serious issue when that little bit of entertainment gets out of control. InRecovery.com
Guidelines for Success in Recovery
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uccess in both recovery and life requires discipline and a certain amount of self-sacrifice. The following is a list of recommendations on what to “give up” in order to reach your full potential: 1. Give up excuses - You are responsible for your own life. Excuses are nothing more than useless excess baggage holding you back. 2. Give up searching for the “Magic Solution” “If only ____________” is a dangerous mindset. No one thing will occur to make you happy or successful. What you’re looking for is inside of you right now so start your search there. 3. Give up perfectionism - You are afraid to take the next step because things are not yet perfect. The problem is that things never are and never will be. The universe is chaotic. Remember that refusing to take action is also a choice. 4. Give up your unhealthy lifestyle - Eating poorly and lack of exercise or sleep literally affects your brain and leads to depression. You gain greater control over your emotions when you lead a healthy lifestyle. 5. Give up your need for control - We’re all guilty of this one. Whether it’s control over a significant other, a child or even aspects of our own lives in the hands of others. Do your best, then accept what comes - it was meant to be. 6. Give up multi-tasking - Can some people do it? Sure, but for us in recovery it’s a recipe for disaster. Do things thoughtfully, mindfully and purposely to stay on track. 7. Give up toxic friends - Negative people find the rain cloud in every silver lining and the problem in every solution. You deserve joy, hope and optimism in your life. 8. Give up the need to be liked - Believe it or not, some people hate Disney World, chocolate and even puppies. You can’t please everyone, so why bother. Trying to do so is a frustrating exercise in futility. 9. Give up wasting time - Time is the most precious commodity because once it’s gone there is no getting it back. Use it wisely and productively. Focus on goals and moving in a positive direction. 10. Give up shortcuts - Anything worth doing is worth doing right and to the best of your ability. Shortcuts merely leave you shortchanged and typically involve an element of risk that is counter-productive to your sober lifestyle.
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Book Review
Losing a Loved One by Suzanne Wachtell, LCSW
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he loss of a child to addiction is one of the most tragic events that can occur in someone’s life. We’ve shared stories of such heartache before, here at InRecovery, in articles such as the one about Shatterproof.org back in November 2017 and the one about A&E’s “Dope Man” in our March issue. Each sad tale has its own nuanced expression of grief but also the important lessons that can be gleaned from such circumstance. Losing a Loved One conveys another powerful message regarding the destructive impact of addiction and the hope that can spring from life’s most painful experience. Ms. Wachtell comes at this all from a particularly informed perspective, since she is a clinical social worker, psychotherapist and renowned life coach. Her unique insights and professionalism in the face of her personal tribulations are profound. In fact, the mere reality that an event like this could possibly happen to someone so mindful and aware of the perils of addiction, shocks us all into the realization that if it can happen to someone like her, then it most surely could happen to anyone. As Ms. Wachtell’s son drifted into addiction, her career shifted as well, from grief counseling to becoming an expert on addiction. She saw first-hand what it was doing and was adamant to be part of her son’s solution. She became keenly aware of the pain and helplessness that addicts struggle with as Ms. Wachtell got involved in addiction treatment empowerment groups and relapse prevention. Despite all of her efforts, knowledge and wisdom, her son 50
died from an accidental heroin overdose at the age of 27. Ms. Wachtell’s own personal grief led her to reach out and share one of the most pivotal messages that come from addiction. It can be overpowering. Even with all the love, support and best intentions, no one can make an addict want to get better. He or she must make that ultimate decision and embrace it. All the counseling in the world will not make a difference if the person receiving it is unwilling to accept it. Which brings us, perhaps, to Ms. Wachtell’s most important point. She provides 20 suggestions for dealing with the pain, which are set forth as follows: 1. You deserve a happy heart. 2. Life is here today, gone tomorrow. 3. Enjoy the moment - make memories.
11. People are truly gone when they are forgotten. 12. What brings you hope? The love in your heart never fades, ever. 13. Mediums can help give closure and answer questions. 14. If someone connected to you with love, they become your guardian angels. 15. Dreams are true visits when we are blessed to receive them. 16. Celebrate life. Not one moment of death.
4. Don’t let anything take away your joy.
17. Death is a natural cycle in each life, embrace it.
5. We can’t change the direction of the wind, but we can change the direction of our sails.
18. There are no rules in grief, only strategies to help healing.
6. Just because you are handed a cactus, does not mean you have to sit on it. 7. Don’t let loss define your identity. Live life fuller.
19. Healing is really important. It’s the only way to move from grief to joy. 20. Death is permanent.
9. The pain you feel when someone dies never leaves you, but suffering is a choice.
This book is excellent for anyone struggling with a family member bouncing in and out of treatment or has sadly lost someone to this disease. It’s not your fault. You deserve to be happy and free from guilt. And, along those lines, Ms. Wachtell’s book can help ease the pain.
10. S mile when you see a sign that reminds you of your loved one.
Losing a Loved One: by Suzanne Wachtell, LCSW
8. One of the best ways to make yourself happy is to make other people happy.
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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.
Breathing Under Water: Spirituality and the Twelve Steps.
(by Richard Rohr O.F.M. Publisher: Franciscan Media 2011) We are all addicted in some way. When we learn to identify our addiction, embrace our brokenness, and surrender to God, we begin to bring healing to ourselves and our world. In Breathing Under Water, Richard Rohr shows how the gospel principles in the Twelve Steps can free anyone from any addiction—from an obvious dependence on alcohol or drugs to the more common but less visible addiction that we all have to sin. Available on Amazon.
Stop Drinking Now.
(by Allen Carr. Publisher: Arcturus Publishing Limited 2015) Allen Carr’s Easyway is the most successful stop-smoking method of all time. Over the past 30 years, it has helped millions of smokers from all over the world to quit. Stop Drinking Now applies Allen Carr’s Easyway method to problem drinking. By explaining why you feel the need to drink and, with simple step-by-step instructions to set you free, he shows you how to escape from the alcohol trap. Available on Amazon.
Beautiful Boy: A Father’s Journey Through His Son’s Addiction
(by David Sheff. Publisher: Mariner Books 2009) David Sheff ’s piece for the New York Times Magazine, My Addicted Son, won an award from the American Psychological Association for Outstanding Contribution to Advancing the Understanding of Addiction. It led to his #1 New York Times Best Seller, Beautiful Boy, which was named the best nonfiction book of 2008 by Entertainment Weekly. Beautiful Boy was also an Amazon Best Book of 2008. Available on Amazon.
Between Breaths: A Memoir of Panic and Addiction
(by Elizabeth Vargas. Publisher: Grand Central Publishing, Reprint edition 2017) Vargas discusses her accounts of growing up with anxietywhich began suddenly at the age of six when her father served in Vietnam-and how she dealt with this anxiety as she came of age, to her eventually turning to alcohol for relief. Available on Amazon. InRecovery.com
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Insight into Gateway Drugs W
e’ve often heard that alcohol, marijuana and nicotine, traditionally in the form of tobacco but increasingly as an oil in connection with vaping, are gateway drugs. What that means is that initial use of these “softer” drugs is the typical path people take before moving into harder ones like heroin, cocaine and meth.
In many ways this makes a lot of sense. While these softer drugs might be frowned upon or their use accepted only in moderation, they are abundantly legal throughout much of the United States. There’s much less stigma attached to them, but they do retain a certain element of moral taboo. After all, you need to be over 21 to drink, smoke or ingest them. However, once one taboo falls, it’s only a short leap toward breaking another by moving on to illegal substances. Moreover, we humans don’t do our best thinking under the influence of pot and booze. They lower inhibitions, making us more prone to risky 52
behaviors. Well, as it turns out, there’s also a biological case to be made in substantiating the “gateway hypothesis”. A report published in the American Association for the Advancement of Science provides tremendous insight into how alcohol use might impact the likelihood of later cocaine dependence. These researchers had already reviewed prior studies indicating that 91% of cocaine users had first used alcohol and 85% had first used nicotine. However, while those polls were powerfully informational, they did little to establish a direct link between cause and effect. That why this new study is so pivotal. The study divided mice into two groups. The first had prior exposure to alcohol and the second had none. Cocaine was then introduced and subsequently taken away. What the scientists found was that the alcohol exposed mice were dramatically more compulsive in requesting cocaine,
even to the point of accepting the negative consequences of shocks to feed their addiction. This is no different than the continued use we see in human addicts despite negative consequences. The clear end result of the study was definitive proof that prior use of alcohol made the mice’s brains more inclined to become addicted to cocaine. The re-wired brain. It’s a concept that comes up time and again in research and the articles covered by us here at InRecovery Magazine. The facts speak for themselves, even cigarettes are problematic. The “gateway hypothesis” makes common sense and is now borne out by science. It’s another reminder that we need to also consider the generational challenge of addiction, as we keep learning more about this disease. We must find news ways to get through to our youth so they need not learn lessons the hard way, as we did in our spiral down into addiction. InRecovery.com
Is Detox a Necessary Part of Treatment? For most people the answer is a resounding “yes.” A patient’s drug of choice typically throws off his or her body chemistry to such a degree that they are no longer the same person you once knew. At times it can even feel as if they are possessed when they might say or do anything to feed their disease. In those instances, Detox is necessary for treatment to even have a chance. Going through Detox can also be a very painful experience as withdrawal kicks in. A patient is not in a stable frame of mind while going through this
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The average alcohol proof has been progressively increasing.
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ALCOHOL The Proof is in the Pudding
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hile our nation makes some progress increasing awareness of the dangers of drinking to excess, an unwelcome development has snuck up on an unsuspecting public. As it turns out, the average proof (strength of alcohol) has been progressively increasing in lock-step, according to an article in Bloomberg Businessweek. This disturbing turn of events is destined to drive even more people to struggle with addiction. So, do your loved ones a favor and share this story to help keep friends and family from unwittingly joining our ranks.
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ordeal. However, once the drugs leave a patient’s system, he or she is much more likely to be open-minded and receptive to the challenge of treatment. While not all patients require Detox as a mandatory protocol, it’s important to be mindful not to be “penny wise and pound foolish” by avoiding it solely because of time or cost. Leave the ultimate decision in the hands of professionals who can best guide your loved one into the proper treatment.
Addicted Babies
continued...
B
ack in September 2017 we carried a powerful piece on the tremendous impact addiction has in affecting both unborn fetuses and newborn babies. Since we published that article, things unfortunately only continue to get worse. The rate of babies born with Neonatal Abstinence Syndrome has quadrupled over the last 15 years, but some rural counties are affected even more dramatically. Sullivan County, Tennessee has a reported rate of 50.5 cases per 1,000 births, leading the country with more than 8 times the national average. It can cost upwards of $60,000 to treat each individual baby and most mothers are uninsured. And, while the financial costs are considerable, the social ones are incalculable. “When you see those babies scream, you see them claw, you see them shake, it makes the problem real,” remarked Sullivan County Attorney General Barry Staubus. “It’s not an abstract problem. It’s a baby that never had a chance.”
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A
The Resurgence of Meth
ddiction to methamphetamines is one of the most difficult to treat. It imprints on the brain more strongly than any other drug, making it extremely tough to break the cycle. A dozen years ago, Congress enacted legislation to curtail access to the chemicals necessary to create meth, found in common cold medicine. As a result, they stemmed the tide against its rapid growth. By limiting supply and increasing criminal enforcement via taking out meth labs, meth addiction was on the wane. Unfortunately, times have changed. Where there’s a will there’s a way and addiction never sleeps. Mexican drug lords
took note of this void and developed their own industrial-sized, sophisticated labs south of the border. Custom agents are now seizing 10 to 20 times the amount of meth as they did a decade ago, and meth related deaths are on the rise. Meth has never been purer, cheaper or more lethal. At nearly 100 percent pure and at $5 per hit, meth is very difficult to resist. As the government searches for answers to the opioid epidemic by curtailing the legal prescriptions creating an assembly line of addicts, those users seek out cheaper alternatives like heroin and are increasingly turning to meth as well. The addicted brain screams to be sated in one way or another. If it can’t have the drug it has be54
come accustomed to, it will seek out other options to calm the storm. And it’s not just opioid users, meth is now so cheap that it’s even an alternative to crack cocaine. While meth related deaths have not reached the same epic proportions as reported in the news for opioid overdoses, they have nonetheless risen at an alarming, dramatic pace. Six thousand people died from stimulant related overdose in 2015, up 255 percent from ten years earlier, and now constitutes 11 percent of all drug related deaths. In the past five years, legal seizures of meth have tripled while seizures for other drugs have declined or only seen modest gains.
also charged with meth related crimes. As a Portland Police Sergeant so eloquently noted, “Tweakers are jacked up. They have lower inhibitions and are awake 24/7...so burglaries become easier.” Meth use has also hit other states pretty hard, such as Montana, Oklahoma, South Dakota and Hawaii. It’s a pandemic in the making that will soon rival or even surpass the opioid related one. As authorities press harder in those states, cartels are now looking to branch out in others, much like a squished balloon creates a new bubble. It’s a cat and mouse game with no end in sight. The tough truth is that while opioid abuse is getting all of the attention and increased
METH
Our nation isn’t facing an opioid problem, it is facing an addiction problem. Some parts of the country are much harder hit than others. In Portland, Oregon, for example, twice as many people died from meth overdoses than did from heroin in 2016. Meth also correlates to much higher criminal activity because it puts users in a frenzied state. More than one in five burglars and 40 percent of car thieves were
support, we will accomplish nothing if users simply switch gears to another drug of choice. Our nation isn’t facing an opioid problem, it is facing an addiction problem. Politicians must come to this realization and do something about THAT before it’s too late. InRecovery.com
DISRUPTING ADDICTION ON COLLEGE CAMPUSES
OUTPATIENT CENTERS • RECOVERY RESIDENCES • MENTORING & MONITORING PROGRAMS At The Haven at College, we believe that every college student in recovery from substance use issues deserves to get the most from their college experience. We are the leading national provider of oncampus addiction treatment and recovery support services, based at premier universities across the US. We offer a continuum of innovative programs—including The Haven Recovery Residences, The Haven Outpatient Centers, and The Haven Mentoring and Monitoring Programs—allowing us to meet students exactly where they are. An inclusive community, The Haven welcomes all college or collegebound students who are committed to their recovery. University of Southern California • Drexel University • University of Redlands • University of California Santa Barbara University of San Francisco • Miami University Oxford Ohio • University of Maryland • Tufts University (Coming 2019)
Learn more about our programs by calling us at 310 822 1234 • Email works too at info@thehavenatcollege.com thehavenatcollege.com Member
The Haven is an active member of the Hazelden Betty Ford Patient Care Network, a clinical collaboration of quality health care organizations that share a philosophy about the best evidence-based treatment for substance abuse, as well as a commitment to improving patient outcomes.
ELEVATE
360 WELLNESS
Boutique Outpatient Treatment in Midtown Manhattan
The Elevate model differs from most addiction centers in that all of the treatment provided is based on scientifically proven techniques and we strive to make treatment interesting, engaging, accessible, and even, dare we say... fun for the patient.
Elevate is a boutique outpatient addiction treatment center located in Midtown Manhattan that uses science-based technology, and highly trained psychologists to provide the highest quality in addiction treatment. CALL TODAY. BE SEEN TOMORROW.
917-776-9929
WHAT DO WE DO? We provide exceptional individualized care for patients and families struggling with alcohol, pain medication, and other substance use.
OUR VISION Through continuous research, evolving technologies, and evidence-based care, we plan to lead a revolution in addiction care with one simple goal: to help our patients create and live healthy and happy lives.
OUR BELIEF We have a deeply held belief that people struggling with addiction deserve professional respectful treatment that works.
369 LEXINGTON AVENUE, SUITE 328, NEW YORK, NY 10017
Drug Court Funding
D
rug courts have proven to be an effective solution in remediating the impact of addiction. They afford people the opportunity to receive treatment instead of being tossed in jail, only to repeat the cycle of use upon release. The problem is, most cities and states have tight budgets which have not only limited expansion of these courts, but also put those in operation at risk of closure. That’s a big reason behind why the Substance Abuse and Mental Health Services Administration (SAMHSA) developed a program to offer grants supporting drug courts.
SAMHSA had $76 million available for 2018, offering $400,000 per year for up to five years, for qualifying programs. While that may not seem like a lot, it can make all the difference in keeping these essential courts going in the face of a budget gap. While it would be ideal for local governments to prioritize and completely fund them, that’s unfortunately not always the case. Perhaps with ongoing support by SAMHSA and continuing proof of effectiveness, these courts will someday get the appropriate funding they require and deserve.
Civil Commitment of Substance Abusers
I
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n our last issue, contributing writer and attorney Mark Astor gave us a thorough and thoughtful review of Florida’s Marchman Act. This law enables family members to force someone who is out of control into treatment. It is often an option of last resort, born out of desperation, to try and keep a loved one from killing himself or herself. Many other states have similar laws. We decided to dig further and learn more about what that entails to help you mentally prepare.
would probably have soon been heading to real prison, or worse, anyway.
The reality is, it’s a wake-up call that looks and feels like prison. Committed substance abusers are handcuffed, put in orange jumpsuits, live in cramped prison-like quarters and are monitored by correction officers. It may sound rough, but if things got so bad that you are considering this option, then your family member
Let’s face it, addiction sometimes puts us in situations where we are forced to choose between the better of two undesirable options. No one wants to place someone they care about in a prison-like program. However, given the circumstances, it’s clearly better to do something than let your loved one slip away and potentially lose his or her life.
Committed abusers first go through detox and then attend mandatory treatment in the form of one-on-one sessions with drug treatment counselors and group sessions with other addicts. They are forced to confront their demons. Unfortunately, the success rate isn’t as high as we would like though, because someone needs to want treatment for it to truly be effective. Nonetheless, once sober, many abusers do find that desire and drive to stay clean.
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SCIENCE
Pain Relief Without Opioids Science is at the beginning of a new revolution in treating human health and improving the quality of all our lives. The CRISPR gene editing technique holds itself out as prime example, enabling scientists to fine-tune people’s genes, eliminating various diseases. 2018 is a watershed year for this as more FDA approvals are granted and the promise shown in the lab gets to demonstrate itself with real-world, life-saving applications. This type of technological thinking is now being applied to pain relief, in an effort to deflect the opioid epidemic. Researchers are focusing on other, non-addictive ways to deflect pain receptors. One such study is led by a research team out of the University of Texas at Dallas, which has identified specific molecules that bind with nerve receptors to eliminate pain. They strongly believe that this technique can help the almost 20 million Americans who suffer with a condition known as Neuropathy, arising from damaged nerves. Early indications are that this compound called UK - 1114 can alleviate pain at one-sixth the dosage of opioids with up to 48 hours of relief. If the results of human testing bear this out, this would be welcome news to the tens of millions throughout the globe who struggle with chronic pain and are rightfully terrified of opioids’ addictive side-effects. The chemical properties of Sea Snail venom, interestingly enough, provide another ray of hope. It targets a separate molecular pathway that reduces pain. This pain-killing compound occurs naturally in types of mollusks with cone shaped shells. As it turns out, nature itself is at least equally as inventive as mere mortals in a lab. It concocts all sorts of potential if we just stop to take a look. Early tests have shown this pain relief process can last up to 72 hours. We are at an exciting stage of human history. Conventional thinking on disease is being turned on its head, as cures for typically fatal diseases, such as cancer, regularly make the rounds in medical journals and on the daily news. It gives us all cause to pause and consider that perhaps addiction too will be overcome, with a little bit of cooperation between humankind and mother nature.
Telemedicine
for AfterCare
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A survey conducted by the National Business Group of Health reveals that 56% of employers planned on offering telehealth for behavioral health services as a covered benefit in 2018, which would include addiction treatment related services. It also noted that more employers are embracing various forms of technology to improve access to behavioral health care. Why is that? Use of such technology for general health care has proven itself both practical and cost effective. Moreover, employers are hard-pressed to find qualified employees to fill vacant positions in a time of record low unemployment. It only makes financial sense for them to help employees like never before. In fact, several employers noted the opioid epidemic in particular as a driving force behind their shift in policy. So, contact human resources at your company or ask questions of employers at your next local job fair. You may just discover that your online AfterCare is fully covered, helping to promote your long term recovery. InRecovery.com
SCIENCE
Poisonous Frogs Fighting Addiction Poisonous dart frogs of Central America are some of the most brilliantly colored animals on earth. They are also some of the most deadly despite being smaller than the size of your pinky. Unlike most other poisonous creatures, the frog is infused with poison throughout its body, instead of releasing it from a protective sack like a snake or spider. These frogs must therefore have an ability to withstand the toxin. This ability may hold a key to human immunity from all drugs since, in reality, there is little distinction between drugs and poison. It’s just a matter of dosage and degree. In an experiment, scientists collected material from 28 separate species of frog and discovered that a slight variation in just three amino acids made all the difference between life and death. The frog’s own chemical receptors were altered to prevent its body from processing the toxin. As it turns out, we humans share a similar receptor system, providing new insight into how we might alter our own receptors to do likewise with respect to some of today’s most dangerous drugs. If successful, these amazing creatures may provide a key piece of the puzzle in helping us combat addiction, way beyond just their natural beauty.
Another
Pain Fighting
Innovation
Most chronic pain arises from some type of back injury, which is typically the most difficult to treat. The lack of pain relieving options can prove to be a real challenge for those of us in recovery who know full well to stay away from opioids. That’s why the increased effectiveness and use of a device known as a Spinal Cord Stimulator is such great news. The device is implanted under the skin at the base of the spine and emits mild pulses of electrical current to nerve fibers in the spinal cord. Scientists believe it interrupts pain signals that are carried from the nerves to the brain. Manufacturers are now racing to develop even smaller and less invasive implants that may not require surgery. Increased competition among several companies now offers greater choice while bringing down the cost. So, if you are in the unfortunate situation of experiencing serious back pain, ask your doctor about neurostimulating implant options - you’ll likely be glad that you did.
Breathalysing for Drugs
Recent work by Swedish scientists is bringing breathalysing for drugs, like we now do for alcohol, one step closer to reality. They’ve developed a new technology that detects tiny quantities of drugs in a person’s breath. The study reported in the Journal of Breath Research notes that screening has successfully detected methadone and other drugs, and may even be helpful in detecting an entire range of diseases. The study’s author noted that exhaled breath contains a number of lipids and proteins which can not only be used for discovering drug use, but also provide tell-tale clues of other potential health issues. Thanks to this new method, it seems that it may only be a matter of time before we see widespread use of this device at police roadblocks, picking out drivers operating under the influence of drugs. Perhaps we’ll also soon see them in doctors’ offices as well, in an innovative one-two combination of this revolutionary new technology. InRecovery.com
BREATH DRUG
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SCIENCE
New Developments for
Anti-Opioid Vaccine
Back in May 2017, we reported on a potential heroin vaccine being finalized by The Scripps Institute out of southern California. The only problem was, while it showed great success with heroin, it had no impact on prescription opioids. Well, now scientists from the Walter Reed Army Institute in conjunction with the National Institute of Health and the National Institute of Drug Abuse have developed their own vaccine specifically to combat opioid abuse. Much like the Scripps’ vaccine, it’s intended to eliminate the high someone receives when ingesting the drug, so as to undermine motivation to take the drug to begin with. However, the good part is that they’ve formulated it in a way that still allows lifesaving Narcan and certain Medical Assisted Treatment (MAT) to get through and help patients. While it’s still in the testing stages, there’s hope that this too can be yet another component of our battle against addiction.
Easing Opioid Withdrawal One of the major hurdles for a person struggling with opioid addiction is getting through the debilitating withdrawal phase. For many users, it’s the fear and dread of gut-wrenching sickness that keeps them using just so they can feel “normal”. Well, thanks to a new device recently approved by the FDA, science will have removed one more obstacle to recovery. The device is called the Bridge and it’s about the size of a half dollar. It gets placed behind the ear where a battery operated chip sends pulses to nearby cranial nerves, blocking pain and making it easier for someone to weather the withdrawal. Patient testing has demonstrated an 85 percent reduction in withdrawal symptoms as soon as one hour after initial use. At a reasonable cost of only $500, there is a good degree of optimism that the Bridge can be part of a comprehensive solution to get more opioid and heroin abusers on track for recovery.
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DID YOU KNOW?
16% 22.9% 14.3% 47% 58% 2% 10% l
of State budgets around the country are spent on addiction and substance abuse.
of college students meet the medical definition of drug addiction.
of Americans over the age of 12 have an addiction. of Americans say they are willing to listen to their doctors about addiction, but only 6 percent of addiction referrals are from doctors.
of individuals with addiction have another serious health condition. of the money spent by the US government on addiction goes to treatment and prevention.
of people struggling with addiction seek treatment.
ore people suffer from addiction M than from cancer or heart conditions.
l
e US consumes about 80 percent of the worlds opioids, Th but has less than 5 percent of the world’s population.
l
pioid overdoses are now the leading cause O of death for Americans under the age of 50.
l
oughly 8 million Americans are on long R term opioid therapy for chronic pain and as many as 1 million are taking dangerously high doses.
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A New York Experiment
W
hat if we plow $38 million into more treatment instead of policing? It began as a novel idea and was sprung into action as New York City overdoses spiked to 1,374 in 2016, mostly from opioids. Operating under the name Healing NYC, the program primarily included greater use of naloxone (an opioid reversal medication) and underwriting a support group comprised of former heroin addicts hoping to lift others like themselves into sobriety. City run clinics, at the same time, also made buprenorphine more readily available as part of medically assisted treatment, to serve as an additional part of the solution. How are things working out? While there are still no concrete stats, anecdotal evidence seems to show numbers moving in the right direction. Perhaps with greater resources applied nationwide, this program can serve as a role model allowing others city’s to emulate New York’s apparent success in getting more people into treatment instead of into body bags and behind bars.
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family
friends job...
Inside the Mind of an Addict
W
hy is it that no one understands me? Can’t they see I’m hurting and crying out for help? Yet my friends have stopped calling and my parents won’t give me a dime - what’s wrong with them? I don’t need them, I don’t need anyone. I’ve got this just fine, I can go it alone. Alone. I hate being alone. The silence is haunting. The TV and internet are momentary distractions. I’m bored. I know what will make this all better, and I start drinking. It’s only 10 in the morning. Ahhhhh! The first beer goes down nice and smooth but it doesn’t do the trick. I down a couple of shots of Southern Comfort as I open a fresh cold one. Now that’s more like it. My neighbor pops by, he knows where to find me and is misunderstood, just like me. We should be at work but we took the day off. Too much stress. We won’t bother to call in either, just make up some excuse about being sick or my cat dying. It worked last time, didn’t it? It isn’t my fault I have bad luck with cats. My boss will un62
derstand. Even if he doesn’t, to heck with him. The job sucks anyway. Where was I? Oh yeah, a six pack in plus additional shots, but now with a drinking buddy. You know what would make this perfect? Some coke. My buddy just happens to have some. Awesome! It has the proper effect of making the alcohol even more fun as we blather on like the Chipmunks about nothing at all. We won’t remember a word of this conversation, but it sure feels good. My cell phone rings. Ugh, it’s mom. ‘Just let it go to voicemail,’ I think, and that’s exactly what I do. She calls again and then a third time. Now I’m getting paranoid who died? I answer her fourth attempt and she starts in with a “hi honey.” I love my mom but I’m not in the mood for any of this, especially when she asks “are you okay? You sound sick.” I assure her that I’m fine and from there on all I hear is “blah, blah, blah,” as I wonder how much longer I need to stay on the phone
and when I can do my next line. It seems like hours even though she’s mercifully done within five minutes. Some other people call during the day and then my boss. What a freaking buzzkill. I choose to ignore them all. I’m busy for Christ’s sake. The day moves on and we’re having a grand old time as we occasionally knock over bottles and accidentally spill stuff, making a mess of my apartment. I barely notice. But you know what would make this day complete? Some heroin. We check our pockets to pool our resources and call a dealer who’s courteous enough to deliver faster than Domino’s. Now this is bliss. I pass out in a complete stupor without a care in the world. I wake up hung over and miserable, soldiering forward into the shower to prepare for work. After all, I’m totally broke. God, I hope I still have a job. I stop for one brief moment to wonder why the heck I do this to myself, and then return to normal programming, thinking about the next possible time I can get high. Why is it that no one understands me? InRecovery.com
HAVE TO vs. GET TO MATT WILLIAMS
A
s people in recovery, we all face starting over and taking another chance at our goals, dreams and desires. We face setbacks, challenges, roadblocks, time, financial insecurity, and other adversarial issues. One of the best aspects about getting and staying sober is the ability to start over. At any time we can start over and give ourselves a new beginning to the day. I used to walk through my day and was unaware of the language that I used. How many times do we say “I have to go to work or I have to go here or there” That kind of language sounds and looks normal to most and at one point I used those same words. “I have to go and workout today or I have to run today for my training.” Those words are incredibly wrong and I learned that early on in sobriety. When I was first starting to come around I would tell my support group “I have to go or I have to do.” At one point, a good friend stopped me in the middle of talking and said “hey!’ You don’t have to do sh** which stunned me and through me off track. He stopped and said you don’t have to do anything today……You GET to: You get to go and you get to do. In early sobriety I learned a very important lesson in certain language that I was using. I started to pay attention to
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my language and how I spoke about daily activities. I find that working with people and listening to how they speak allows me to better understand what is standing in their way from accomplishing their fitness goals. Most of the time people share about not HAVING time to do anything and that they HAVE to do so many other things than take care of their health and wellness. It is not a priority and the same cycle of starting and stopping a health program continues. It is only by changing our language and stating that we GET to work out, we GET to eat healthy, we GET to live our life as best we possibly can does the process of starting over begin. We all made tough decisions and have arrived at living our best sober life. Each day we GET to do the things that led us to sobriety one day at a time. It can be the same for our health, wellness and fitness program. Some helpful suggestions to launch a health and fitness goal oriented program is to decide what you want, write it down, tell a coach and or accountability person about it and change your language. You get to live life every day, one day at a time. Look at the time you get in the day and
take massive action to get it done. Everyone gets the same 24 hours and how you start is how you finish. Get up early and change your routine. You will be amazed how much you can get done early in the morning before the sun comes up when most others are sleeping. It is quiet, there are less distractions and noise and it gives you the time to start the day with a giant step forward. Prepare meals for the day and what you want to eat. By thinking ahead and preparing you are more likely to eat and stay on track than when having no plan at all. Everyone loves to grab lunch and go out but if prepared you are more likely to stay on track. Finally write 3 things down for the day that you can repeat to yourself when a challenge comes up and you get the tendency to fall off track. For me it is: I get to live a healthy life, I get to put in the effort and I get to be sober. Those 3 statements change my mindset if I am struggling throughout the day. Remember, at any time you can start over however when you change your language from “have to” into “get to” it doesn’t seem like you starting over all of the time. Here is to another awesome day of GETTING to live. Enjoy the day and be awesome. 63
Beware of Your Type A Personality
T
he expression “Type A” personality has been around for decades, describing someone who is hard-wired with a strong drive for success. It can lead to an all consuming passion in search of a goal, and feelings of invincibility, which only increase with each dose of achievement. However, those same powerful urges that motivate a Type A personality simultaneously represent all of the hallmarks that can lead to addiction. That’s why we Type A personalities need to be even more vigilant and careful than everyone else. The famous musician Tom Petty, who died last year of a tragic, accidental drug overdose, stands out as such an example. He was clearly very talented and driven. He also felt an unwavering commitment to his fans, as exhibited by completing his final 53 date tour with a fractured hip. However, he was also plagued by emphysema, chronic knee problems and advancing coronary artery disease. Yet, the show must go on. Petty typically used numerous pain medications during an average day, just to get by, but that all accelerated on tour as his fractured hip evolved into a full break. The post-mortem discovered a toxic mix of fentanyl, oxycodone, xanax, restoril and celexa in his system on the day of his passing. It was an untimely death that shocked the music industry and fans around the world. Tom Petty stands out because he is famous, but he is really just a proxy for all other Type A personalities in all kinds of careers and from all walks of life, men and women a like. Pain comes in all sorts of forms and variations from physical to emotional, and usually some combination of both. The desire for a quick fix from drugs and alcohol is an overwhelming temptation. And, even as we are aware of the potential consequences, our feelings of invincibility leave us convinced that we are somehow above it all. The most unfortunate then overdose, with the remainder of us struggling with the self-sabotage that accompanies our disease. Then again, that same powerful drive can also be used as an ally. After all, you are the woman or man who can accomplish anything. Perhaps you were strong enough to resist peer pressure and temptation to begin with, and have been a teetotaler your entire life. Great! If not, and you recognize that you’re in over your head, you need to reach out for help and re-discover that powerful inner you to help heroically lift yourself back to sobriety. We may feel “all powerful” but none of us can do recovery alone. No one can. Besides, that “all powerful” sensation eventually presents itself as nothing more than an illusion as we come to realize that such only exists in our Higher Power. A Type A personality is both a blessing and a curse. It’s much like fire which can be used to both create and destroy. How will you use yours? When you recognize and understand the power of addiction, you are truly in control. Your Type A personality can then help you to mold a beautiful life, instead of sending you headlong in a precariously dangerous direction down a steep embankment of destruction and despair. 64
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F
Food Addiction
ood Addiction is one of the most common and challenging types of addiction. Why? Because the vast majority of the population at large is constantly mindful of what they eat in order not to gain or lose too much weight. They therefore assume it’s all just a matter of self control. Our brains are wired to find ways to cope when we are impacted by stress. I’m sure we can all relate to seeking out comfort foods like ice cream or fried food when we feel sad or agitated. There’s absolutely nothing wrong with that in moderation. How about when the stress doesn’t stop because it’s a result of lingering trauma? Acting out through addiction then turns into a dangerous and destructive coping mechanism. Food addiction, in many ways, is little different than drugs and alcohol when you consider the end results. Yet, food addiction is one of the most ignored, as our nation and others around the world struggle with a growing obesity problem. It leads to increased health issues and medical costs. The US obesity rate is close to 40% today (according to the National Center for Health Statistics), as compared to around 30% just 15 years ago. France, a country known to be particularly rule oriented and fat phobic, or “grossophobie” as they like to call it, had a similar 33% rise during that time frame to 16%. Japan and China also have well-documented issues as fast food and processed foods high in sugar have become more prevalent in their diet. And, while much of this is being talked about, little is being accomplished in reversing the trend. The primary reason for that is because obesity is shrouded in stigma and shame.
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It begins with overweight children who are made to feel awkward in sports and social situations. It then continues into adolescence and adulthood as peer groups and business networks effect a clear but
unspoken bias. Jean-Francois Amadieu, a sociologist at the Sorbonne in Paris, conducted a study demonstrating that overweight men were 3 times less likely to be offered a job, with the percentage jumping to over 6 times for overweight women. This shame, in turn, has led to a counter-movement that obesity is beautiful and acceptable. I tread lightly here into these sensitive waters because a certain number of people are certainly biologically challenged by a slow metabolism or other health issues. However, when someone’s bodyweight is excessive because his or her eating is out of control, then there’s cause for concern. This is especially so when it impacts a person’s health and quality of life. We are not shooting for super-model slim (unless that comes naturally to you), we are searching for a balanced body weight that can, of course, include curves and elegant contours. We each have our own, unique and beautiful body type. It’s all a question of nutrition and eating a well rounded diet in proper proportions. We can’t ignore the issue of food addiction simply because we fear either: (1) the ignorance of shame from those who believe it’s merely a question of self control, and (2) the backlash of political correctness. People who are addicted to food and eating unhealthy need treatment just as much as any other addict. Unaddressed trauma will surely kill someone over time, one way or another. The good news is that food addiction is probably the most easily treated, it doesn’t leave many of the same lasting scars and euphoric recall as the others. With a concerted effort, the support of loved ones and an abundance of self-care and accountability, we can do a lot more toward lowering obesity rates, helping improve the lives of many struggling addicts in the process. 65
THE VALUE OF COMMUNITY SUPPORT It makes me realize I am part of a larger purpose.
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e all know meetings are important, but sometimes it’s tough to put our finger on exactly why. I find that it’s helpful to sit back and consider those reasons in order to stay motivated on those days when I don’t particularly feel like showing up. 1. It provides positive examples - I see what others are going through and are able to overcome. It provides me with role models for staying the course and overcoming obstacles. 2. It reminds me that I have a life beyond my struggles - I tend to focus on the negatives and minimize the positives in my life. It’s a challenging thought process from which to break free. The community helps me find my objectivity. 3. It’s a source of stability - Going to meetings helps me keep on a schedule and hones the responsibility of being on time. 66
I also see familiar faces as we all hold each other accountable for clear thinking in our sobriety. 4. It gives me a chance to give voice to my feelings - I live most of my life in my own head. We all do. Sometimes it’s difficult to realize just how irrational some of those thoughts are, until I share them out loud with others. 5. It helps me see my blind spots - Sometimes I just don’t know what I don’t know. Yet, when I speak, it becomes obvious to others around me who share their insights for my personal benefit. 6. It reminds me that I am worthy of the caring of others - I am in a group of like-minded individuals who want to share the gift of sobriety. We are all there to be positive and support each other. It reminds me that others truly do care.
8. It reminds me to jealously guard my recovery - At times I start to feel all too comfortable and conveniently ignore potential dangers and pitfalls. Meetings help me remember to be cautiously mindful of old “people, places and things.” 9. It provides me with hope - There is always someone in there who has had a struggle worse than mine and who has been sober longer than I have. I look up to them. Their example serves as an inspiration, keeping me positive when things get tough. 10. It makes me realize I am part of a larger purpose - When I both give and receive through meetings, it becomes clear that we are all part of something so much bigger than just our own struggles. Understanding that notion gives my life greater purpose and meaning.
InRecovery.com
Recovery in the Rockies. AspenRidge: Colorado’s Premier Drug Rehab and Alcohol Treatment Center
At AspenRidge, addiction and alcoholism are treated with a combination of cutting edge addiction and mental health therapies, with an emphasis on trauma. We fuse our clinically savvy approach with Twelve Step recovery to ensure access to a community of recovering persons long-term. We recognize that family and community systems are impacted by addiction, and effectively treat these peripheral issues as well with family workshops, therapeutic family communication and optional family therapy sessions. We ensure the highest level of care by maintaining national accreditation through the Joint Commission of Accreditation, Health Care, and by strictly employing licensed clinicians with masters degrees, many of whom have licenses in addiction or mental-health, and certifications in the other (the purpose being to treat co-occurring addiction and mental health disorders as effectively as possible.) Everything at AspenRidge is done in the context of client-centered care.
A variety of assessment and intervention tools are used determine a client’s needs from the beginning to the end of their treatment experience. The treatment experience includes psychiatric evaluation and psychopharmacological treatment when necessary, therapies include groups and individual sessions. These sessions utilize process, narrative, equine assisted, animal assisted, psychoeducational, EMDR, Brainspotting, solution-focused, Rational Emotive Behavioral Therapy (REBT), Cognitive Process Therapy (CPT) Dialectic Behavioral (DBT), family systems, and cognitive therapies (i.e. CBT) to name just a few. Our evidence-based therapies treat addiction in tandem with mental-health disorders ranging from post-traumatic stress-disorder (PTSD), to anxiety disorders, mood disorders, personality disorders, and many others.
Partial scholarships available.
Intensive Outpatient Treatment that changes lives. Donna Segrin Admissions Director DSegrin@AspenRidgeRecovery.com Mobile, Admissions: 928-899-5828
Two Locations
AspenRidge Recovery 900 S. Kipling Pkwy Lakewood, CO 80226 Fax:720-541-7851
AspenRidge North 706 South College Ave #201 Fort Collins, CO 80524 Fax: 970-825-5784
Business and Financial Services for Behavioral Health T R E AT M E N T P R O V I D E R S BUSINESS OWNERS BANKERS and BROKERS I N V E STO R S
What does prosperity mean to you?
“The Prosperity team knows behavioral health billing and finance inside and out. They’re conscientious, ethical, reliable, and hard-working. With them managing the business side of things, I can focus on what I love and what I do best: taking care of patients.”
Billing and Collections
Whether you work with commercial insurance, Medicare/Medicaid or private pay patients, our team manages the entire process, from submitting initial invoices to appealing denials and posting payments against patient accounts.
Utilization Review
Michael Gillis
Sunspire Health (Chief Clinical Officer)
Our experienced team will work with your clinical staff to understand each patient’s circumstance and obtain authorization for the appropriate level of care and length of stay.
Accounting
Our experts will handle all of your accounting needs from simple bookkeeping through complex accrual-basis accounting, financial statements and reporting.
Back Office
We make sure that AP and cash management don’t fall through the cracks, and all your financial responsibilities are professionally handled.
Tax Consulting
Our experts will help you maximize tax opportunities available through credits and incentives in a wide variety of areas.
Managed Care Negotiation
We perform value proposition analyses of in-network contracts and negotiate contracts on your behalf.
Data and Analytics
We aggregate data from different systems and present it in user-friendly reports to provide real-time, relevant information and actionable insight.
Your prosperity is our passion
We teach your staff policies and procedures to maximize upfront collections, and our team can assist with post-discharge follow-up.
20 Brace Road, Suite 202, Cherry Hill, NJ, 08034-2634 www.prosperitybh.com
Patient Responsibility
(888) 525-8524