April 2017 - The Sober World

A P R I L 2 017

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VOLUME 6

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ISSUE 4

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A N AWA R D W I N N I N G N AT I O N A L M A G A Z I N E

THE CURSE OF CHILDHOOD CELEBRITY

By Maxim W. Furek, MA, CADC, ICADC

PONTIFICAL ACADEMY OF SCIENCES (PAS) – FINAL STATEMENT ON THE GLOBAL DRUG EPIDEMIC

By Kenneth Blum, Ph.D.

IN IN MEMORY MEMORY OF OF STEVEN STEVEN

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A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. The Sober World is an informative award winning national magazine that’s designed to help parents and families who have loved ones struggling with addiction.

We are a FREE printed publication, as well as an online e-magazine reaching people globally in their search for information about Drug and Alcohol Abuse.

We directly mail our printed magazine each month to whoever has been arrested for drugs or alcohol as well as distributing to schools, colleges, drug court, coffee houses, meeting halls, doctor offices and more .We directly mail to treatment centers, parent groups and different initiatives throughout the country and have a presence at conferences nationally.

Our monthly magazine is available for free on our website at www.thesoberworld.com.

If you would like to receive an E-version monthly of the magazine, please send your e-mail address to patricia@thesoberworld.com Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. It is being described as “the biggest manmade epidemic” in the United States. More people are dying from drug overdoses than from any other cause of injury death, including traffic accidents, falls or guns.

Many Petty thefts are drug related, as the addicts need for drugs causes them to take desperate measures in order to have the ability to buy their drugs. The availability of prescription narcotics is overwhelming; as parents our hands are tied.

Purdue Pharma, the company that manufactures Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it?

Addiction is a disease but there is a terrible stigma attached to it. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, getting thrown out of school or even worse an overdose, that we realize the true extent of their addiction.

If you are experiencing any of the above, this may be your opportunity to save your child or loved one’s life. They are more apt to listen to you now than they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin.

I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from.

There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are Interventionists who will hold an intervention and try to convince your loved one that they need help. There are detox centers that provide medical supervision to help them through the withdrawal process, There are Transport Services that will scoop up your resistant loved one (under the age of 18 yrs. old) and bring them to the facility you have To Advertise, Call 561-910-1943

chosen. There are long term Residential Programs (sometimes a year and longer) as well as short term programs (30-90 days), there are Therapeutic Boarding Schools, Wilderness programs, Extended Living and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean.

Many times a Criminal Attorney will try to work out a deal with the court to allow your child or loved one to seek treatment as an alternative to jail.

I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents.

Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy.

He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him.

My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help.

Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com.

We are on Face Book at www.facebook.com/pages/TheSober- World/445857548800036 or www.facebook.com/steven. soberworld, Twitter at www.twitter.com/thesoberworld, and LinkedIn at www.linkedin.com/grp/home?gid=6694001 Sincerely,

Patricia

Publisher Patricia@TheSoberWorld.com

For Advertising opportunities in our magazine, on our website or to submit articles, please contact Patricia at 561-910-1943 or patricia@thesoberworld.com.

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PONTIFICAL ACADEMY OF SCIENCES (PAS) –FINAL STATEMENT ON THE GLOBAL DRUG EPIDEMIC: INSIGHTS FROM NEUROSCIENCE AND PSYCHIATRIC GENETICS.

By Kenneth Blum, Ph.D.

Final Statement Narcotics: Problems and Solutions of this Global Issue On November 24 and 25, 2016, the Pontifical Academy of Sciences (PAS) held a meeting at the Vatican with international experts, led and inspired by Pope Francis and Queen Silvia of Sweden, to develop a global view of the current drug epidemic and recommendations to reverse this trend, one that imperils the very elements of civil society: public health, safety and human progress. Millions of victims globally have succumbed to addiction. This is a contemporary version of slavery. It destroys autonomy and free will, a foreseeable outcome of using chemicals that artificially suppress and supplant natural brain reward systems in vulnerable people. Addiction especially threatens young people, as the vast majority of addictions can be traced to initiation during adolescence. This is a period of rapid brain development, with particular risk to the enduring harms of drug use.

An essential priority is to protect the brains of children and youth, by discouraging use of all drugs. The international epidemic is led by a globalized network of criminals and legal business interests, with children and youth as their primary targets. They have driven exponential growth of potent forms of cannabis, developed unclean highly addictive cocaine preparations, and created unregulated new psychoactive substances. Prescription drug diversion for non-medical misuse is rooted in different origins, but the risks of medication misuse can be as great or greater than illegal drugs.

PAS Recommendations ➢ Support the three UN treaties governing licit and illicit drugs, which are signed by virtually every nation. These treaties permit medical use of drugs, with tight regulations to prevent diversion for nonmedical use and which criminalize the nonmedical sale and use of these same chemicals.

Commentary: Unfortunately, criminalization alone may not be much of a deterrent. There are tight regulations to prevent diversion. However, in the United States, the rate of heroin overdoses is alarming. In Louisville, KY on February 12th 2017, there were 52 overdose calls in 32 hours probably from illegal Fentanyl-laced heroin. Targeting law enforcement and treatment seems more prudent. It has been noted that from 2000 to 2014 there was a 3000% increase in people seeking opiate/opioid treatment. However, treating the hypodopaminergic brain condition that drives addiction and all Reward Deficiency Syndrome (RDS) might be a better long-term goal. More funds need to be allocated for prevention strategies rather than to law enforcement. ➢ Governments have a moral and ethical responsibility to secure and defend the common good of their citizens. As trafficking of drugs imperils the health, security and the rule of law in nations, any compromise can be viewed as complicity.

Commentary: While it is true that complicity about drug trafficking imperils health, security and the rule of law, it is also true that complicity concerning the lack of research funding reflects the worse governmental and foundational complicity around the globe. Understanding and treating the cause of all addictive behaviors known as RDS needs to coincide with intergovernmental cooperation to enforce agreements to curb drug trafficking. ➢ Governments must unequivocally pursue drug trafficking at every level. They have a responsibility to denounce and criminalize corrupt banks, bankers and money launderers that profit from the drug trade, and thwart large-scale and local drug trafficking. ➢ Governments must not engage in any public, private or covert agreements to gain financial support for political or personal reasons from drug traffickers or industries. Such agreements

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subvert the common good, trust, health and safety of their people, especially, their youth.

Commentary: These statements make for bold and consequential goals for governments to pursue. Money from opium growing is currently being used to finance wars and cartels. Indeed the US government was accused of supporting Contra cocaine traffickers in Nicaragua in the 1980’s. Criminalizing bankers and thwarting global and local drug trafficking is no small task. ➢ Instead, governments have a public health, legal and moral responsibility to confiscate the gains of these traffickers/ industries and to use these proceeds to fund assistance programs for the victims, which include providing treatment, prevention, and medical services, family support, as well as educational and employment opportunities.

Commentary: The idea of funding research has been left out of this statement. It is the old “chicken & egg” conundrum whereby, for example, new treatments involving medical devices and even new anti-craving substances both pharmaceutical and nutraceutical could be supported by confiscated gains from traffickers/ industries. The experiments in Colorado and Washington with recreational marijuana may provide insights into, how money could be used to develop prevention tactics especially geared to our youth and in schools, as well as funding treatment, independent of insurance carriers.

Instead of providing treatment, prevention, and medical services, family support, educational and employment opportunities, some insurance companies flout the parity laws established under the Affordable Care Act and evoke Suicide ideation (SI) as being the only diagnosis acceptable for third party payment for residential addiction treatment past detox. This tactic of insurance carriers is as dangerous as the other aspects of drug trafficking. ➢ Governments should NOT use any ill-begotten gains from drug trafficking or sales to generate political messages, regulations or laws that foster use of abusable drugs and subvert public health and safety laws and regulations.

Commentary: The only time politics should play a role in providing for the health and safety of our people both young and old, is when new protective laws could be enacted to offset the perils of both drug and non- drug addictive behaviors. Although it is very unlikely that the recent Opioid epidemic in the US was a plot supported by money from drug trafficking, it was very likely an unintended consequence of political messages, regulations or laws. It may have originated with the idea of treating chronic pain as the fifth vital sign. In 1998, this idea lead to the release of a recommended policy from the Federation of State Medical Boards “reassuring doctors that they wouldn’t face regulatory action for prescribing even large amounts of narcotics, as long as it was in the course of medical treatment.” The federation said it received nearly $2 million from opioid makers since 1997.

Continued on page 36

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GETTING TO THE ROOT OF THE DRUG EPIDEMIC

By Sarah Scarbrough, Ph.D.

It is no secret that drug use throughout the United States continues to soar. Overdose deaths linked to substance abuse continues to rise, despite massive national attention and efforts to address it.

Although millions of dollars are being spent to curb this epidemic, more people are tragically losing their lives. The consequences of this epidemic are devastating: mothers and fathers are having to bury their children; kids are losing their parents far too soon; teenagers are losing their best friends.

If what we are doing is not working, how can we look at the issue differently? How can we begin to understand addiction? How can we prevent addiction or intervene after use has already began? We need to think critically about what we know about drug abuse - what are the factors and predictors that have been revealed to us in existing research? While there is not enough room in this magazine to come close to addressing it all, one critically important area, often avoided because of the negative stigma it carries, is trauma - primarily childhood trauma, or trauma-informed care, as it is termed in the research world.

Let’s dive in and understand trauma a little more and its correlation to drug use….

Research has shown the high correlation between significant childhood trauma and adult incarceration. This has been revealed through the Adverse Childhood Experience (ACE) test, which measures the 10 highest types of childhood trauma, including abuse (emotional, physical, verbal, and sexual), divorce, mental health, and incarceration. Each of these traumatic experiences have proven to be the most traumatic experiences a child (under 18) can undergo, thus having adverse effects on the child as they grow up, sometimes even affecting brain development. (If you have not taken an ACE test, google it so you can see your score).

Childhood Trauma and Resilience Adults incarcerated across the United States have an average ACE score of seven – meaning, out of the ten types of trauma outlined in the test, they have experienced an average of seven. Therefore, it is not difficult to see the extremely high correlation between childhood trauma and adult incarceration. In the jail where I work in Richmond, Virginia, the average ACE score is six and seventy-eight percent of our population battles addiction to drugs and/or alcohol; also, a sad statistic showing a high correlation between the two.

You may ask, then, what is the difference between the adult with a seven who is in jail versus one who is not? The answer is resilience - how someone acts or reacts in an adverse situation. If someone bounces back, tackles, and manages negative situations head on, they most often cope with trauma and hardship without engaging in negative behavior. However, if resilience is low, often meaning they have a high ACE score, an individual is more likely to attempt suicide, inject drugs, become obese, smoke cigarettes, become incarcerated, and/or even die years sooner. After all, high resilience typically comes from strong relationships, communication, and connections. The opposite is someone that often lacks a strong family network, does not have close relationships, does not feel strong connections to others and does not have anyone to confide in. As such, those battling childhood trauma, meaning those with higher ACE scores and having a low resilience, do not typically have the skills to cope and manage situations in a healthy manner. This results more often than not in seeking unhealthy lifestyles as a mechanism to cope and numb pain.

When looking at the trauma experiences outlined in ACE, each relates to relationships, or the lack thereof. Whether it be divorced or separated parents, incarcerated parents, or being abused, all directly correlate with relationships and broken connections. Each of these factors can contribute to low resilience.

Trauma and the Drug Epidemic How does this relate to the drug epidemic? Addiction often stems from drug use that began as a way to self-medicate. As a way

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to numb the pain or forget about it for a certain period of time, individuals often experiment with drugs. Sometimes, the streets come first, in that individuals sought ‘love’ and ‘family’ from the streets because they did not have it at home. Hanging in the streets, then introduced them to drugs, a way to self-medicate even further, then eventually becoming a full-blown addict.

It is important to remember, however, addiction does not discriminate.

Many often think those growing up in the projects, or those whose parents are in jail, are the only ones who experience addiction, but do not be fooled; addiction is seen in middle and upper class communities almost as frequently, however, it is not talked about and caught as often as it is in low-income areas. While those growing up in more affluent areas likely have lower ACE scores, those battling addiction often report feeling as if they are not a priority in the home, they have parents who work often and are not around much, or are given most anything they want - again dealing with broken relationships.

For parents reading this, I encourage you to think deeply and determine where your child falls on the spectrum if they are using drugs and/or alcohol. Many parents scramble trying to figure out how to get their child off of drugs or alcohol. The addict may be sent to the best treatment center in the community, the parent may ground them or keep them from hanging out with the ‘bad influences.’ I would venture to say though, that these attempts often do not work.

Often, it simply starts with establishing a new relationship with your child; tell them you are proud of them, use positive affirmations, show concern and enthusiasm about their day, meet their friends, or attend sporting events. While jail or treatment is often needed, the root cause for the addiction must be determined, and then addressed, in order for sobriety to be long-term.

The longer discussion of “what do I do,” is complex. However, the first step is understanding the root cause, which this article has sought to provide. Once understanding is obtained, overcoming the addiction can begin. Seeking professional help is often necessary, be it through an authentic recovery support and peer-based model, which is my typical recommendation, or through a counselor, or 12-step meetings.

In the meantime, you are encouraged to look into the 42-resiliency factors, which are building blocks of how to build resilience.

From the addict to their family, law enforcement and the community, to business productivity and victims of those under the influence, drugs and/or incarceration touch almost every pocket of our society. As such, it is time for us to take a much deeper look and a more strategic approach into the root cause. In the words of my boss, Sheriff C.T. Woody, Jr. of the City of Richmond, “instead of putting a Band-Aid on the wound, it’s time we treat the cause.”

Sarah Scarbrough, Ph.D. is the Program Director under Sheriff C.T. Woody, Jr. in the Richmond City Sheriff’s Office in Virginia.

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IMPAIRED BABY BOOMER CLIENTS MARCHMAN ACT AND GUARDIANSHIP PROCEEDINGS: HOW DO FAMILIES HELP THEIR SUBSTANCE ABUSE IMPAIRED ELDERLY MEMBERS

By Joseph M. Considine, P.A.

An elderly man in his late 60s, a husband and father of adult children, has been abusing alcohol daily for many months in his retirement and is beginning to experience memory and cognition issues. He is admitted to the hospital with delirium tremens and it is suspected that he may have some form of dementia associated with Wernicke Korsakoff as a result of not getting the necessary medical assistance while having the DTs. The impaired husband has recently made questionable decisions regarding his finances and his wife is very concerned that he will be taken advantage of financially. His wife and adult children need to know a course of action to get him the help he needs for his alcohol abuse and to prevent him from recklessly and unwisely spending his money.

The family faces a number of difficult issues. Are the memory and cognition issues secondary to the alcohol abuse or the product of an independent, organic process of dementia? How do they know if the cognitive and memory deficits are temporary, related to the abuse of substances, or more permanent? What if dad is unwilling to voluntarily go to treatment or to let a family member take over the finances for a while?

The foregoing questions and many more questions are faced daily by families of elderly substance abusers. Many elderly patients do not want to admit they need help or are unwilling to admit there is a substance abuse problem. Many adult children do not want to confront the reality that their parent is an alcoholic or an addict.

Nor do these adult children want to risk the wrath of the elderly parent which can lead to them possibly being written out of the will for taking action to protect that parent. Nevertheless, action needs to be taken if the elderly alcoholic is to have a chance at a remaining productive and happy life.

It is clear that without some type of intervention, the elderly impaired individual, especially one with initial cognitive deficits will only get worse, never better. The consequences of not intervening on an elderly individual is life threatening.

In the event, the man (in our example) is unwilling to go to treatment or to get help; the family has little choice but to file a Marchman Act proceeding in Florida under Chapter 397, Florida Statutes. The Marchman Act allows a family to ask the Court to order a loved one to substance abuse treatment for an initial period of time - up to 90 days with further extensions of time in treatment being permitted, if necessary. In such a case as described herein, the court will in all likelihood enter a treatment order requiring inpatient residential care for no less than sixty (60) days. The court can later add time to that order for a step down in the level of care if indicated and to require a sober living environment if a return to residence is not appropriate.

At the same time, the family must consider filing for the appointment of an emergency temporary guardian (“ETG”) to take temporary control of the impaired elderly individual’s assets and over his person. In Florida, such a proceeding is governed by the Probate and Guardianship Code, Chapter 744. The court can appoint a limited guardian of the person’s financial affairs or may appoint a plenary guardian over his person and his financial affairs.

In a Petition For Appointment of an Emergency Temporary Guardian, a family member must allege sufficient facts, including in many instances, the pertinent facts from the Marchman Act petition which would indicate to the court the severity of elderly person’s impairment and cognitive and memory losses. The court will enter an order for the appointment of an emergency temporary guardian If the court finds the matters alleged establishes that there exists an imminent danger that the physical and mental

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health or safety of the individual will be seriously impaired or that the property of the person is in danger of being wasted, misappropriated or lost unless immediate action is taken. Such an order will delegate to the ETG the financial and personal decisions of the impaired person including treatment and medical care decisions. Because the order for an ETG will deprive the person of certain rights to manage his affairs pending further hearing and order of the court, ETG appointments are only for 90 days. The Court will conduct a hearing shortly after 90 days to determine whether the person should be determined to have capacity or not, and if the person needs a more permanent guardian. The evidentiary burden is significant for the family trying to establish the need for an emergency temporary guardian because the relief sought deprives the individual of rights.

The family will have a better idea in 90 days of treatment and abstinence from substances as to whether or not the elderly loved one’s cognitive and memory issues are improving or not. In cases where there is marked improvement, the guardianship case can be dismissed and the elderly person’s rights restored.

Joe Considine has practiced law in South Florida since 1983.

His practice is limited to family law and addiction related law including the Marchman Act. Joe has handled over 1500 litigation cases in his career, appearing in courts throughout Florida. Joe works extensively with families whose loved ones have substance abuse and mental health problems as an attorney. He lectures throughout Florida on family law matters including the Marchman Act and other substance abuse related issues.

Joe grew up and lives in West Palm Beach, has three adult children and loves mountain biking.

His website is: www.joeconsidinelaw.com Telephone is 561-655-8081 Email address is joe@joeconsidinelaw.com

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ON THE ROAD TO RECOVERY

By Michael DeLeon

There are two types of pain; One that hurts you and One that changes you When I embraced my mission to become part of the solution instead of part of the problem, I had no idea where the journey would take me. I had lost four young adults on my caseload to a drug overdose and it was some of the worst pain I had ever experienced. They weren’t my biological children and in no way can the pain and loss I experienced be compared to the pain and loss their family suffered, but it shook me to my very core.

I felt I had failed them miserably. As their counselor, I felt that I could have done more. I was already working in prevention and advocacy at the time, trying to bring people together in various aspects of this fight, but I never imagined how that pain was going to change me.

The proverbial “War on Drugs” was in reality, a war on drug addicts, not drugs. It created a prison industrial complex in America. Our State prison system ballooned from 400,000 prisoners in 1980 to over 2.4 million today, not to mention county jails, correctional programs, community programs, treatment programs, probation, parole, drug courts etc. It’s an escalating problem with catastrophic results. Handcuffs and prison personally saved my life so I tend to disagree with those who feel we don’t need jails and prisons.

Sometimes, the threat of criminal consequences can be the catalyst to urge an addict to take that first step – that “Nudge from the Judge”. But locking people up in and of itself doesn’t work.

Incarceration without treatment is futile.

Most of the current news about this pandemic is dismal. Overdose deaths from heroin increased four-fold from 2002-2013. Overdose deaths from other opioids increased dramatically as did overdose deaths from synthetic drugs and prescription medication. 2016 was the worst year we’ve ever seen, and 2017 will be even worse.

I predict more than 100,000 overdose deaths this year. I hope I’m wrong, but with the way things are going this first quarter, the pace is unfortunately very real.

It’s irrefutable that America finds itself in the middle of the worst public social addiction crisis in its history. Anyone you talk to today either has a family member struggling with addiction, or knows someone that is and everyone seems to know someone who has died of an overdose. But, it’s certainly not the illicit drugs that are causing most of the problems. Most of this pandemic lies outside of the traditional illicit drug focus and lies at the foot of the pharmaceutical industry.

Fortunately, there still is hope. With all the numbers and statistics, losses and family tragedies, there are real stories of survival.

There are people who have battled their addiction and won. It has been estimated that there are more than 23.5 million Americans in Recovery. Whether the number is slightly higher or lower, it doesn’t really matter. There are millions and millions of men and women who have been able to overcome their addiction. The more we share with those who struggle the truth about those who have found recovery, the more we will inspire people to find their own road to recovery. It’s real, it’s everywhere and it’s possible.

Recovery is happening all around us and I set out to capture the stories that only those in recovery could tell. Not the war stories or horror stories, but the stories of overcoming those horrors and the many tales of success. I began a television talk show in the Philadelphia market (SNJTV – www.snjtoday.com) called The Road to Recovery. It has been extremely successful and is now in its third season. I have been able to share people’s stories and family struggles, expert opinions and the upside of down. I have interviewed incredible guests who share amazing stories. Each

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show seems to get better than the last! But, I decided I wanted to do this not only in PA but across the country. I wanted to get out there on the road across America to share these stories of hope and recovery. I call them “inspirational chronicles of success”. I started travelling more, and as I started meeting new people, I began capturing their narratives on video. I decided it was time to take “The Road to Recovery” literally “on the road”.

Many people believe that the “War on Drugs” was a failure. I knew we needed a new “war” and it needed to be a war on addiction, not on drugs or addicts. And we needed a new “Army” – a Recovery Army. I was determined to build this Recovery Army and I set out to do just that. I wanted to recruit people and I knew that the best way to do it was to go out there and build it. So, I worked incessantly over the past year to acquire a Tour Bus to go “On the Road to Recovery” and share as many people’s stories of Recovery and Hope as possible. I just began this national mission and I am very excited that the Recovery Army Tour Bus is on the road! I want to capture the beautiful stories of Recovery across America and share them with those who are still struggling. I want to push Advocacy efforts further than they’ve ever been pushed before. I want to bring prevention efforts into schools everywhere and make the biggest difference I could ever make. But to do this, I need your help, support and above all, I need to bring everyone together.

This pandemic is no longer a war we can fight while splintered and siloed. We can only fight it side by side, together, in unison, united!

Reach out and find out what you can do to be part of the solution at www.recoveryarmy.com Help me get into your schools, centers and facilities around the country. Meet me in your city to share your story and join together. Join the Recovery Army. It will take all of us to turn the tide on this American pandemic.

Michael DeLeon is the director and producer of the films” Kids Are Dying” and “An American Epidemic” He has released his third documentary, “MarijuanaX” which looks at the legalization of marijuana in America. His fourth documentary will be released in May, 2017 called, “Higher Power”. Michael’s memoir, called, “Chasing Detours” will be released in May, 2017. Michael founded the Recovery Army - a national outreach program touring the country this year. Michael is the founder of Steered Straight Inc., a motivational outreach program for youth and young adults. He is also the National Marketing Director for Banyan Treatment Center.

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13

WHY AFTERCARE IS MORE IMPORTANT TO RECOVERY TODAY THAN EVER BEFORE!

By Paul Huljich

Not long ago the Centers for Disease Control and Prevention (CDC) released their 2015 Drug Overdose Death Data and the numbers are disconcerting. Overdose deaths have quadrupled since 1999.

In the latest year of record, 2015, opioids—prescription and illicit— were involved in 33,091 deaths, more than any year prior and a 15% increase from the 28,647 overdose deaths in 2014. Opioids are the number one cause of accidental death in the U.S. Just as concerning is the relapse rate. This is an area that doesn’t get as much attention as deaths, but is important just the same.

Unfortunately, relapse statistics are hard to come by. There is no one reliable source like the CDC that keeps track of such statistics.

From what I can glean from online sources, the low end number that continually pops up is 40 percent, while some believe in certain circumstances it can be as high as 85 percent.

If anything at all, these statistics tell us that aftercare is more important to recovery today than ever before.

There are plenty of reasons why we’re in such a failed state of addiction treatment today. I suspect part of the problem is the myth that 30 days of inpatient treatment is enough to help addicts find their way to recovery. The origins of the 30-day model go back to the 1950s where two young men, neither of whom had prior experience treating addicts or alcoholics, chose 30 days for their treatment parameter. Their decision had no basis in science or proven effective medical protocols.

Despite its shortcomings, this novel approach has proven itself over time to be effective and provides the foundation for addiction treatment as we know it. But today treatment centers face far greater challenges that they did nearly 70 years ago when alcoholism was the leading addictive disease. Opioid and other chemical addictions take longer to treat than the 30-day model which is so effective for alcoholics.

I’ve spoken with quite a few treatment professionals with hands-on experience, and there is a common thread to every conversation.

The vast majority of professionals in addiction treatment will tell you they simply do not have enough days with the addict to assure successful outcomes; they’re limited by the system they’re forced to work within. I’ve seen research suggesting it can take up to three years before an addict’s brain chemistry returns to normal. Addiction professionals tell me it takes a couple of weeks after detox for an addict’s mind to clear enough to reach them.

So in reality, addicts only get about two weeks of comprehensive addiction treatment in their first 30 days.

This is where a good aftercare program fills the void. Addicts are very raw when they leave a treatment facility. It is when they walk out the door of the center that they are most vulnerable to relapse.

Fundamentally, aftercare is intended to prevent relapse, but services vary across facilities. A good program will continue where the treatment program left off. They have a steady routine of daily meetings and open access to coaches, therapists, and doctors. The better programs will teach life skills that replace old self-destructive patterns that are so hard for addicts to break. Recovery is an ongoing process and these are skills every addict will need for a successful recovery.

In my experience with my own struggles and with those I have helped over the years, I find the holistic aftercare approach of mind, body, and spirit—addressing both the physical and psychological component of addiction—to be the most effective approach with the strongest potential for better outcomes.

You should expect more from a holistic aftercare program than you would from others, as they address the broader issues that contribute to a successful recovery. For example, organic meals are a requisite.

Most people don’t know that we have a second brain in our gut that

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influences our mood and behavior. Food supplies the raw materials that make our feel-good brain chemicals, as well as the antioxidants that help neutralize the myriad of toxins that we are exposed to daily— and that takes a toll on our physical and mental health. Organic meals will minimize that assault and aid in the healing process as well.

Meditation and yoga are also staples found in holistic treatment.

Combined with regular exercise, these activities reduce stress, improve your immune system, and help you regulate your mood.

Acupuncture, vitamin, and chiropractic therapies are also effective modalities founded in holistic aftercare.

Most people who have been in treatment leave the facility with confidence and a bright outlook on their future—and then life happens. The stressors of everyday life have a magnified effect on someone fresh out of rehab. It’s safe to say that half of them will relapse within one year of treatment, most often far sooner. A good aftercare program can help change that. It can provide the much needed support and an extra layer of relapse prevention at a critical juncture when an addict is most vulnerable. It is the first step following treatment that will make a significant impact on the success of a person’s recovery.

Repetition is the mother of all skill and learning. Good aftercare programs often start where the treatment center stopped, using the same fundamental approach that has been proven effective.

Repeated and practiced over and over under an expert’s supervision, these skills start to become second nature to an addict in aftercare before he or she faces life’s stressors. This is a critical step in reducing the risk for relapse while providing solid footing for when they do reenter society.

Recovery is a one day at a time process. A good aftercare program will make it easier for people to stay on their path of recovery.

Considering the state of our addiction treatment in its current form, I firmly believe aftercare is no longer an option but rather a requirement for anyone committed to their recovery.

Paul Huljich is the founder of LifeREstyle Wellness Center.

Originally from New Zealand, stress management and LifeREstyle coach Paul Huljich has become one of America’s top stress experts and the award-winning author of Stress Pandemic: Nine Natural Steps to Survive, Master Stress, and Live Well. Written to help people deal with all levels of stress, Stress Pandemic outlines a practical, effective, and proven approach to achieving longevity and complete wellness.

Huljich is a frequent speaker at wellness conferences, universities, and events hosted by the National Alliance of Mental Illness. He also conducts motivational LifeREstyle seminars and workshops, including at the Omega Institute in New York and in Hawaii. Huljich has opened the LifeREstyle Wellness Recovery Retreat in Redondo Beach, California, which has implemented his nine-step overall wellness plan with great success. Huljich can be reached through his website: www.lifeRestyle. org Prior to his work in the mental wellness field, Paul co-founded Best Corporation, a pioneering, publicly-listed organic foods company of which he was Chairman and Joint-CEO. Read more about his journey from breakdown to recovery and wellness on his website.

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15

SUPERCHARGING RECOVERY WITH EXPOSURE THERAPY

By Brian M. Berman, Psy.D

Understanding how addiction functions is one of the most important factors for implementing successful treatment. Research indicates that substance abuse serves as a way to avoid unwanted internal stimuli including thoughts, emotions and physiological sensations, which can result in addiction if avoidance is chronic.

This process of escaping one’s internal world is often referred to as “experiential avoidance” and is thought to be one of the primary underlying mechanisms of addiction. While experiential avoidance is considered a main contributor to chronic drug and alcohol use, it is not just specific to addiction. It is also thought to underlie mental health disorders including social anxiety disorder (SAD), generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). In other words, one cannot be diagnosed with PTSD simply because trauma has occurred, or meet criteria for social anxiety disorder just because anxiety was experienced in social situations. Similarly, feeling sad does not solely constitute a diagnosis of depression, and obsessive thinking does not establish OCD. Instead, it is the way in which individuals cope with their internal distress through ritualistic avoidance patterns which produces mental health diagnoses and addiction.

Because addiction and mental health disorders both function as patterns of avoidance, they can concurrently be treated using a “transdiagnostic” approach to treatment. There is excellent data supporting the efficacy of “exposure therapy” as this transdiagnostic approach, which is the treatment of choice for the aforementioned mental health disorders. Exposure therapy is a treatment aimed at helping individuals alter maladaptive avoidance patterns while remaining present with aversive stimuli (internal or external). In other words, the goal of exposure therapy is to “expose” the person to the very distressing stimuli that he/she typically avoids. Studies aimed at identifying the mechanism of change in established treatment packages consistently point to exposure therapy as being the single most impactful intervention across protocols. Because addiction functions in the same manner as other mental health disorders, it stands to reason that exposure therapy would be an equally efficacious treatment intervention when applied to addiction.

There are many different approaches to exposure therapy, but perhaps the most well-known approach is Prolonged Exposure Therapy (PET) because of its high success rate for treating PTSD. By exposing the patient for prolonged periods of time to stimuli representative of his/her trauma, the patient learns to alter avoidance patterns, adjust to interoceptive cues, reduce distress to internal stimuli and inhibit conditioned responses. Another form of exposure therapy is called Exposure Therapy with Response Prevention (ERP) and is the most successfully utilized intervention for OCD. With ERP, the patient is exposed to stimuli which triggers his/her obsessive thinking and is then prevented from engaging in compensatory rituals or compulsions. For example, a person who obsessively worries that the door is unlocked is prevented from checking the locks and encouraged to “sit” with the feelings of uncertainty. Because substance use is often a failed attempt to escape the distress of ritualistic behavior, effectively treating these disorders with exposure therapy should indirectly reduce the chance of relapse.

Newer methods for implementing exposure therapy have recently been applied directly to addiction. One such method is called mindfulness meditation, which is a commonly practiced intervention across mental health and addiction fields. Practitioners teach mindfulness skills for a variety of reasons, but what many fail to recognize is that it is actually an exercise in exposure therapy.

Mindfulness can be defined as “purposefully observing internal stimuli, in the present moment, nonreactively, and in a manner which is kind and compassionate to the self”. When approached in this way, the individual learns to be exposed to each unpleasant thought and unwanted feeling without avoidance or escape. This

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includes cravings, withdrawal symptoms, urges, thoughts and other internal triggers specific to addiction. This sort of nonreactive exposure is critical if an individual wishes to make decisions based on a valued life direction (Values), rather than escaping uncomfortable feelings (Experiential Avoidance).

One interesting truth inherent in human nature is that humans possess opposing intrinsic desires. Human beings strive to live a life of value, while paradoxically attempting to avoid any accompanying distress. And yet the irony of this duality is that valuable life experiences are almost always accompanied by uncomfortable feelings. This unorthodox relationship between values and distress highlights the way that one’s unwillingness to experience discomfort prevents the opportunity to pursue a life that is fulfilling. For example, most people find value in their employment because of the way that work adds meaning to their lives. However, if unwilling to experience the internal feelings associated with work, such as anxiety or frustration, then the avoidance of these stimuli will make maintaining a job more difficult. In another example, experiencing a shared deep relationship with a significant other may be what is considered most valuable. However, if this person is unwilling to experience feelings of hurt, rejection and anger typically associated with relationships, then superficial connections are the most likely outcome.

When decision making is guided by avoidance of exposure to unwanted feelings rather than directed by values, the individual experiences a significantly lower quality of life. If decision making is mindful and “values-driven”, the individual has greater flexibly to choose how they want to respond when exposed to internal stimuli, rather than just escaping. Mindful exposure therapy creates the opportunity to supercharge traditional addiction treatments with a gold standard mental health intervention. This two-pronged approach permits exposure to both mental health and addiction stimuli, while continuing to provide the flexibly to pursue values.

Exposure therapy continues to be one of the most powerful interventions applied to mental health disorders and has significant implications for individuals suffering from addiction. Because experiential avoidance is active across diagnoses, exposure therapy is an excellent transdiagnostic approach to treat addiction and co-occurring disorders. Since mindfulness meditation is already a familiar intervention in the addiction field, it is a viable vessel in which to export exposure therapy to this population and increase values-driven behavior. Using mindfulness as an exposure therapy can introduce a well-established and validated treatment into the Wild West of recovery.

Dr. Berman is a licensed Clinical Psychologist providing psychological evaluations, psychotherapy, training and clinical supervision at the Retreat at Lancaster County’s inpatient drug and alcohol facility. Dr. Berman also offers outpatient therapy in his private practice in Bryn Mawr, PA, specializing in the treatment of emotion dysregulation, addiction, anxiety, depression, trauma, eating disorders and chronic pain. Dr. Berman earned a Doctorate of Psychology from La Salle University and also holds Master’s Degrees in Clinical Psychology from La Salle University and West Chester University.

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QA &

CHANGES ARE ON THE HORIZON

WITH JEFFREY C. LYNNE, ESQ.

Florida continues to be the Recovery Capital of the United States and is embarking on an effort to raise the bar of regulation to ensure that people, who come to the state for these services, can be assured that the care and housing they are provided is on par with the state’s excellent reputation for medical healthcare. With that understood, what changes are on the horizon in 2017?

Marketing: The single largest source of confusion for providers is the legal acquisition of patients. For parents and loved ones, the ability to identify ethical and appropriate providers has been riddled by an unregulated landscape. Proposed for 2017 is a series of laws to create transparency in treatment and housing marketing. Call centers will be required to identify who their clients are and would-be “marketers” will have to be licensed, and hopefully, achieve a level of professional education so they can best place patients with matching treatment centers.

The oversight on these changes will be key to ensure predatory marketing is not allowed to fester.

Teeth in Regulation: Like other states, Florida has assigned oversight of this multi-billion dollar industry to the social service agency, Department of Children and Families (DCF). When the state turned off the funding to DCF, a lifetime ago, and created a very permissive licensing structure for treatment providers, coupled with the largest drug abuse epidemic in our nation’s history, the conditions were perfect for abuse. While this is all set to change in 2017, again, regulation requires regulators, which requires funding, something that our federal government and state government have been slow to recognize, until now.

Robust Law Enforcement: While the phrase “patient brokering” has become synonymous with the obvious failures within the present treatment and housing industry in Florida, it has finally been recognized by the Palm Beach County Grand Jury as well as the legislativelyfunded Sober Home Task Force that on a more basic level, many providers simply do not have the education, background, or resources to be operating a treatment program. Still, there is no prohibition from them doing so. Therefore, in concert with licensing regulators, law enforcement will be taking a more robust role in 2017, coming on the heels on many high profile arrests in November and December of 2016.

Sober Home Regulation: Cities and counties continue to demand regulation of sober living residences, but for all the wrong reasons.

They continue to articulate that these “businesses” have no business being in a residential neighborhood. While the Congressional Record leading to the adoption of the original Fair Housing Act; the Fair Housing Amendments Act of 1988; and the Americans with Disabilities Act of 1990, all tell a story of a population hostile to anyone who wasn’t deemed “normal” by the masses, we have also come to understand and learn that not all sober living residences are created equal.

Some homes have proven to be mere fronts for persons housing people in active addiction, in order to be sold or bartered to the nexxt treatment center with demand.

This is expected to come to an abrupt halt in 2017 as “Recovery Residence” regulation continues to gain acceptance from the recovery community itself, in order to weed out the unscrupulous from the true healers and caregivers. The Florida Association of Recovery Residences (FARR) has been the agency assigned with such regulation, but given an unfunded mandate. This too appears to be on the horizon of change.

Florida maintains only a “part-time” Legislature, which meets for a mere 60 days in the Spring. While the anticipated legislative proposals come directly from a request of the Legislature itself, and would therefore seem to be a statewide priority, there has been a political history of “punting” the ball until there is a collective sense of absolute crisis. We appear to be in that situation now and for that reason believe immediate change is on the horizon. If you have questions on how these changes could potentially impact your organization, contact Beighley, Myrick, Udell & Lynne, P.A. today.

ETHICAL REPRESENTATION. PROVEN RESULTS. To learn more about Jeffrey Lynne or Beighley, Myrick, Udell & Lynne, P.A. contact him at Tel 561.549.9036 or via email jlynne@bmulaw.com

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17

REPEAL AND REPLACE CUTS ACCESS TO ADDICTION TREATMENT

By John Giordano, Doctor of Humane Letters, MAC, CAP

What is it about healthcare that the greatest country the world has ever known can’t seem to get right? Nearly eighteen-cents out of every dollar spent in this country goes to some form of healthcare, yet premiums continue to rise exponentially while deductibles go through the roof and coverage shrinks. We spend much more on healthcare than any other country but we get far less for our money. Let’s face it; healthcare in the U.S. today has become a political hot potato that no one wants on their plate for too long. But regardless of where you see yourself standing on the political spectrum, I think we as Americans can all agree that we expect a fair shake and to get what we pay for.

Like most people, I am frustrated and angry about our current state of healthcare. Many want to blame the Affordable Care Act (ACA), popularly known as Obamacare, for the source of their indignation and as a consumer I can see why. Premiums for my wife have doubled in the last three-years to nearly two-thousand dollars a month. That is as much if not more then most people’s mortgage payment. I can only imagine the pain and anguish other families less fortunate than mine go through when they realize they simply cannot afford health insurance anymore.

However, as a professional, I’d be remiss if I didn’t point out a few of the positive effects the Affordable Care Act has achieved. First and foremost, people with preexisting conditions can no longer be denied health insurance or be charged more because of them. Additionally, lifetime limits on most benefits – also referred to as a cap on the benefits – are prohibited in any health plan or insurance policy.

But more to the subject of this conversation, the Affordable Care Act’s inclusion of mental health and substance use disorder services as one of the ten essential health benefits has done more to expand access to treatment for those afflicted than any other previous legislation.

The Affordable Care Act mandated most individual and small employer health insurance plans – including all plans offered through the Health Insurance Marketplace – to cover mental health and substance use disorder services. In addition, states with expanded Medicaid Alternative Benefit Plans – a Federal/State partnership – also must cover mental health and substance use disorder services.

This piece of legislation took mental health and addiction out of the dark shadows where they have been hidden away since the beginning of time and placed them squarely in the mainstream of healthcare. It is the single greatest advancement in access to mental health care since President Kennedy’s well intended Community Mental Health Act of 1963 (CMHA) – and access to addiction treatment ever in America.

Whether or not you perceive ACA to be a success or failure depends on how you choose to view it. There are legitimate arguments on both sides of this issue.

Prominent investor extraordinaire Warren Buffett, CEO of Berkshire Hathaway has said that “healthcare problem is the No. 1 problem of America and of American business.” In an interview with Bloomberg Television, Buffett stated; “It’s the tapeworm, essentially, of the American economy, and we have not dealt with that yet. Obamacare is a step in the right direction in many ways.”

Other business people I’ve spoken with were not as kind claiming healthcare is cutting deeply into their profits and creating a barrier to their growth and success.

On the other side you find people who – for the first time – have access to mental health and addiction treatment. In a report by Jayne O’Donnell and Terry DeMio and printed in USA TODAY (Jan. 8, 2017), the authors revealed; “The people helped the most by the ACA are the ones most likely to suffer from poor mental health and addiction. Nearly 30% of those who got coverage through Medicaid expansion have a mental disorder, such as anxiety or schizophrenia,

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or an addiction to substances, such as opioids or alcohol, according to the federal Substance Abuse and Mental Health Services Administration. That compares to the more than 20% of the overall population — 68 million people — who experienced a diagnosable mental health or substance abuse disorder in the past year, the American Psychiatric Association says.”

While on the stump, President Trump made the opioid epidemic and addiction treatment a center piece of his campaign. He reinforced that position in his first speech before Congress in late February when he stated; “We will stop the drugs from pouring into our country and poisoning our youth and we will expand treatment for those who have become so badly addicted.” “Expand treatment” – the President’s exact words.

But despite all of this reassurance, vulnerable people with mental health issues and/or addictions, their families, loved ones and treatment providers fear that their newly created access to treatment may be snatched away from them with the repeal and replacement of the Affordable Care Act. Early reports from beltway insiders say there is good reason for their concern.

The American Health Care Act is the proposed replacement for the Affordable Care Act that is currently being voted on in house committees. It is the brainchild of House Speaker Paul Ryan and has been endorsed by President Donald Trump. Reception for the bill has fallen pretty much down party lines, although not all republicans are on board. Conservatives say it doesn’t go far enough while other republicans – mostly from states that expanded Medicaid – find it goes too far.

Healthcare in America is a complicated labyrinth with more twists and turns than a ride at your favorite amusement park. Just a small change to one item can affect dozens of related items connected to it. That being said it’s not possible for me to go into detail of the disparities between ACA and the proposed AHCA. However, the four key areas between the two involve Medicaid, tax credits, insurance mandate, and age-based premiums.

In January 2017, President-elect Trump told The Washington Post that “we’re going to have insurance for everybody that would be much less expensive and much better.” The Congressional Budget Office’s (CBO) – lead by republican appointee Keith Hall – scoring of the American Health Care Act tells a completely different story.

According to CNBC; “Many more Americans would be uninsured, and insurance premiums would temporarily spike under the leading Republican proposal to repeal and replace Obamacare, according to a new estimate that also projects the plan would cut the federal deficit. 14,000,000 million more Americans would become uninsured next year if the American Health Care Act is signed into law, the Congressional Budget Office estimated. By the year 2026, a total of 24,000,000 million more Americans would be uninsured than they would be under Obamacare, the CBO said.”

Continued on page 38

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CERTIFIED RESIDENCES

How can a parent searching for a legitimate service provider choose a quality program Certifying safe and for their son or daughter to reside? State digniďŹ ed recovery of Florida relies on FARR certification as confirmation that the program, staff and residences for property comply with nationally recognized individuals standards.

FARR regularlyseeking audits compliance and provides a path for residents, families peer-supportive housing. and community members to file a complaint if warranted, ensuring that operators remain compliant with standards. FARR ( 561-2990405) is the oversight agent for sober homes.

Please check with NARR ( 855-355-6277) Join Volunteer Support to gain information in your state who is certifying sober homes.

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THE CURSE OF CHILDHOOD CELEBRITY

By Maxim W. Furek, MA, CADC, ICADC Two-edged sword Childhood celebrity is a dangerous two-edged sword, a sinister proposition of the bitter and the sweet. Sitcom fame and perfectly scripted lines are often contradicted by real-life drama. The child star is granted instantaneous celebrity but robbed of their childhood. Many former stars offer dark cautionary tales. A sad list of child celebrities who self-destructed includes Scotty Beckett, Gary Coleman, Corey Haim, Anissa Jones, Ashleigh Aston Moore, River Phoenix and Brad Renfro.

Is there a child celebrity curse? Do the majority of child stars statistically end up as public train wrecks? Disney stars including Orlando Brown, Miley Cyrus, Bobby Driscoll and Britney Spears would indicate a disturbing trend. Cast members of Different Strokes, Dana Plato, Gary Coleman and Todd Bridges, have all suffered from drugs and criminality. Another cadre of troubled child stars provide a virtual trip through a day care of broken hearts: Robert Blake, Amanda Bynes, Macaulay Culkin, Edward Furlong, Lindsay Lohan, Tatum O’Neal, Haley Joel Osment and Mackenzie Phillips come to mind. Sadly there will be more.

Former “Partridge Family” star, Danny Bonaduce, fell on hard times after his TV series concluded. The celebrity ended on the streets, homeless, at one point living in his car. He developed a crack addiction and attempted suicide. But the former child star offers a telling anecdote. “When I went to rehab, I was the only ex-child star,” he said once, “but there were nine dentists.”

The ensuing conversation should not be about the curse of dentistry or childhood celebrity, but about the curse of fame. Fame makes the world small and insular. Like Copernicus, stars place themselves in the center of the universe concluding that the world revolves around them. As confidence is inflated, the larger picture is blurred and empathy for those “lesser” individuals, less dynamic, less successful, lost.

In J. M. Barrie’s classic 1904 play, Peter Pan, or, The Boy Who Would Not Grow Up, Peter refuses to mature, and flies off to magical Neverland for adventures with mermaids, Indians, and the wicked pirate Captain Hook. Peter only wants to have fun. He wants to stay young forever.

Child celebrities are a personal link to our own childhood innocence. We remember them, frozen in a nostalgic, cinematic time capsule. We watched them grow before our eyes fondly remembering those wide eyes and inquisitive stares.

But then too, we watch as the innocent, childlike image matures and hardens into an alien caricature of a previous self. The child star morphs into the adult. They develop wrinkles and sags and facial

Barrie’s timeless fairytale is embedded into our modern day lexicon. The Peter Pan syndrome was coined by pop psychology author Dan Kiley in his book Peter Pan Syndrome: Men Who Have Never Grown Up. Although the Peter Pan syndrome is not a medically accepted diagnosis, it has relevance to aging child celebrities struggling with destiny and the misfortunes of fame.

In his song “Childhood” (1995), Michael Jackson reflected upon his lost youth: “People say I’m not okay ‘Cause I love such elementary things... It’s been my fate to compensate, for the childhood I’ve never known,” he lamented. Joseph, his manager father, physically and verbally abused him. It was the pound of flesh extracted from young Michael, who persevered and become one of the most influential performers of all time.

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features that rebel against their former identity. The soft lines of youth replaced by a hardened, callused reality.

How sad that they have grown when we liked them so much better in their youth.

Dubious mixed blessing Fame is a dubious mixed blessing, or perhaps not a blessing at all. Stardom’s yellow brick road is littered with carcasses of those who mismanaged their success.

Sudden fame can handedly destroy one’s identity and sense of self. What childhood celebrities desperately need is to be educated about the pitfalls of early success. Child stars need protection from an entourage of sycophants and unsavory influences exploiting the naive star for their own purposes.

In August 2013, Garrett offered his hard-earned wisdom to one of today’s teen idols Justin Bieber. “Do not believe your own publicity,” Garrett advised the young pop star, in an interview with FoxNews.com. “Sussing out who your real friends are is full-time work. Every scum bag, every drug dealer, every chicken hawk wants a piece of you.”

Garrett himself knows all too well how challenging it can be to gain fame so young. “When you’ve got that sort of power, at that young age,” Garrett said, “and everything at your doorstep, you put out that bad boy image. At that age, testosterone, hormones, all of the money, you see what else you can get away with.”

Fame comes with a price. Being famous stunts one’s emotional and social development. Personal freedom and independence are delegated to others. The star loses his/her ability to resolve life conflicts. There is no need to be concerned with the little details because you are the star. People cater to you. They take care of your business. They write your lines, select your wardrobe and create your character and off camera persona.

Many authorities cite the vast amount of responsibilities these celebrity children encounter, thrust under the spotlight and forced

to face all of the emotional aftereffects of growing up too quickly --all of this happening at a breakneck speed accentuated by media reporting on the celebrity’s every word and action. There is no respite. The coverage is incessant and relentless. Even when they walk off the stage, their private lives are invaded by paparazzi and celebrity gossip.

Allure of celebrity Frank Sinatra warned about the allure of celebrity and the spider’s web of fame. Ol’ blue eyes wrote to a young George Michael, who at 27 complained about the “tragedy of fame” in 1990: “Talent must not be wasted. Those who have it … must hug it, embrace it, nurture it and share it, lest it be taken away from you as fast as it was loaned to you” (Arroyo, 2016).

Fame is the ultimate gateway drug. It offers an exhilarating high that rapidly conquers and destroys. We read about the tragedies, the drug use, incarcerations and fatalities of youthful stars. Bad news travels fast. Catastrophes make titillating headlines. Stories about stars who squandered their innocence and bright promise for immediate gratification are many. Singer George Michael provided a stark example of those titillating headlines. Michael was arrested in 1998 in a Beverly Hills park, after being caught in a “lewd act” in a public lavatory by an undercover officer. That unfortunate event would haunt the singer for his remaining years. Michael, who died in 2016 should have heeded Sinatra’s advice and nurtured his fame.

Still, many childhood stars, provided with proper guidance and parenting, have managed a happy, productive life. They have not resorted to substances to deal with life’s stressors, have not selfdestructed in view of their adoring public. Shirley Temple, Ron Howard, Jodie Foster, Neil Patrick Harris and countless others represent that healthy and functional cluster of child celebrities. In another category are those survivors who have hovered near the brink: Drew Barrymore, Todd Bridges, Robert Downey Jr., Corey Feldman, Jaimee Foxworth, Rob Lowe and Britney Spears are in that privileged group.

Michael Jackson, who epitomizes the Peter Pan syndrome, was not among the fortunate ones. He died in 2009 from acute propofol and benzodiazepine intoxication. The King of Pop once admitted, “I am Peter Pan in my heart”. Jackson named his 2,700-acre Los Olivos, California property “Neverland Ranch.” He said that it was his way of claiming a childhood that he never had.

Maxim W. Furek, MA, CADC, ICADC is passionately researching the essence of happiness. His rich background includes aspects of psychology, addictions, mental health and music journalism. His book Sheppton: The Myth, Miracle & Music explores the psychological horror and eventual survival experienced by two entombed coal miners. Learn more at shepptonmyth.com

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NEONATAL ABSTINENCE SYNDROME THE INNOCENT CASUALTIES OF OPIOID ADDICTION

By MaryBeth Cichocki, RN

With most of the media coverage focusing on the number of overdoses per day, we have forgotten about the growing population of infant “addicts”. Those precious little babies who suffer with no understanding of what is happening inside their tiny little bodies. They have no way of knowing that their physical suffering is not a normal part of infancy.

These innocents are the babies born to addicted women.

The medical community refers to these infants as suffering from Neonatal Abstinence Syndrome (NAS). NAS is a diagnosis of symptoms related to opioid withdrawal in infants whose mothers used either illegal or legally prescribed drugs during their pregnancy. Symptoms of NAS vary depending on the length of time and variety of drugs ingested by the pregnant woman.

During my years spent in NICU nursing, I witnessed many heartbreaking situations. Many were full term babies born with undiagnosed genetic conditions who died shortly after their birth, and others were born too early to survive in spite of the technology we used to save them. But the patient’s that hit me the hardest were the infants born who had to experience the horrors of withdrawal. I call them the innocents, the casualty of their mother’s addiction.

As a NICU nurse, I’ve experienced addiction from the very beginning of life when the baby first left its mother’s womb. I took care of the littlest beings who knew nothing about opioid abuse.

These babies were bathed in a world of feel good drugs. Their placenta joined them to their mother and carried the poison directly to their cells. Opioids would pass through the placenta along with oxygen and nutrients, bathing their forming organs with the mother’s highly addictive drugs.

These babies became addicted to the exact drugs that hijacked their mother’s brain. After birth, the infant is still dependent on the blood supply of drugs that have been cut off cold turkey at the slice of the cord. Within hours of their drug supply ending, these precious innocents would start to experience the ugliness pain known.

Some would experience a withdrawal so profound that many days I would shed tears as I held, swaddled and rocked these precious victims of addiction. Piercing screams secondary to neuro irritability would shatter the NICU atmosphere. These infants screamed like their skin was being ripped off their bodies. Shrill and high pitched.

Nothing like the cries of a healthy newborn but reminding me of a wounded animal caught in a death trap. I would spend hours offering them their pacifiers, swaddling and rocking them to no avail. Their cries were only the beginning of the hell they would suffer. Soon, tremors would shake their tiny bodies; some so severe they would experience seizures. Their muscles would become tight enough for them to stand upright in my lap!

These babies would vomit any nutrition we tried to feed them, their brains unable to coordinate the normal feeding patterns of suck, swallow and breathe. NAS infants would bite the nipple and thrust themselves backwards as if doing a backflip into a swimming pool.

Feedings would take hours of trial and error, finding the perfect hold and nipple that would be accepted by these confused babies. I remember feeling like I won the lottery after getting several ounces into my tiny patient’s mouth, only to be heartbroken as I held the same baby minutes later as he vomited every ounce into my lap.

Deep sleep eluded them, vibrating chairs and swings were the go to aids that helped these irritable souls find their much needed rest, keeping their cubbies quiet and dark and daring anyone to disturb them when they finally fell asleep. I would stand guard over the sleeping baby, arguing with doctors who picked these precious few moments to do an exam. Hours were spent walking my tightly swaddled babes as I prayed for a miracle. Periods of quiet and comfort were rare. NAS babies experience an overstimulated central nervous system as their dependence on their mother’s drug

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continues weeks, and in some cases, months after birth. Chronic diarrhea kept their bottoms raw. Every diaper change was met with wails that would break the hardest of hearts, tomato red bottoms would be revealed. I would cringe as I gently wiped with one hand while trying desperately to comfort with the other. Blood tinged wipes were evidence of their bodies attempt to rid itself of the poison that bathed their cells since conception. I remember using an oxygen mask on a baby’s bottom as he lay with his butt exposed on my lap. Oxygen was known to help heal the broken down skin and I would position myself in a rocker with a tight hold on my squirming patient hoping to provide moments of comfort.

My NAS babies also needed constant clothing changes. Excessive sweating was another symptom that their bodies struggled to overcome. These babies looked like they just ran a marathon in 100 degree heat with droplets of sweat falling from their wet foreheads.

Somedays, my attempts to keep them comfortable and to prevent further injury reminded me of watching my adult son suffer the same withdrawal symptoms from opioids. Seventy percent of NAS babies experience the exact same abstinence symptoms as an adult. The withdrawal experienced by these innocents is as raw and ugly as any I’ve ever witnessed with my son and maybe worse. Their tiny bodies going through a hell that they can’t control or understand.

The only humane thing we could do was to give these infants what their bodies craved- drugs. Infant medically assisted treatment –MATyes, that’s exactly what we did. Just like an adult taking Methadone or Suboxone, we used liquid Morphine. Every three to four hours depending on the severity of their symptoms, I would draw up a syringe and drop the precious liquid into their mouths and hold them close to my heart hoping to feel their bodies relax, praying for sleep.

Giving a baby a narcotic was a double edged sword for me, but, knowing it would help minimize the hell and help decrease the cravings that kept them from enjoying the comforts of being a baby eased my troubled heart. Witnessing their first experience with life in this condition is so heartbreaking and my only hope was that in the weeks to come we would slowly be able to wean the drugs out of their system and allow these tiny patients the opportunity to experience the comforts of a normal infancy and a nurses loving touch. ♥ MaryBeth Cichocki is a registered nurse living in the state of Delaware. She lost her youngest son, Matt, to an overdose of prescription drugs. After his death she was unable to return to her world of taking care of critically ill babies in the N.I.C.U. and now devotes her time raising awareness and educating the community on the dangers of addictive prescription drugs.

In May of 2016, MaryBeth became co-director of Kim’s Place, a recovery home for women in Delaware.

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Seacrest Resource Center is full service Behavioral Health Care Consulting Firm, which provides results and not promises. Our services include assisting organizations in seeking initial State Licensure/Certification, The Joint Commission Accreditation, and CMS Certification in any state in the U.S. Linda Potere, CEO, President, MBA, CAP, LHRM, CHCQM, CAS, NCACII, CMHC has over 30 years experience licensing and accrediting organizations and has obtained state licensure and TJC accreditation for over 200 organizations with stellar results.

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Where compliance is a journey not a destination WHAT IS A LEVEL 4 TRANSITIONAL CARE HOUSE? Sunset House is currently classified as a level 4 transitional care house, according to the Department of Children and Families criteria regarding such programs. This includes providing 24 hour paid staff coverage seven days per week, requires counseling staff to never have a caseload of more than 15 participating clients. Sunset House maintains this licensure by conducting three group therapy sessions per week as well as one individual counseling session per week with qualified staff. Sunset House provides all of the above mentioned services for $300.00 per week. This also includes a bi-monthly psychiatric session with Dr. William Romanos for medication management. Sunset House continues to be a leader in affordable long term care and has been providing exemplary treatment in the Palm Beach County community for over 18 years.

As a Level 4 facility Sunset House is appropriate for persons who have completed other levels of residential treatment, particularly levels 2 and 3. This includes clients who have demonstrated problems in applying recovery skills, a lack of personal responsibility, or a lack of connection to the world of work, education, or family life. Although clinical services are provided, the main emphasis is on services that are low-intensity and typically emphasize a supportive environment. This would include services that would focus on recovery skills, preventing relapse, improving emotional functioning, promoting personal responsibility and reintegrating the individual into the world of work, education, and family life.

In conjunction with DCF, Sunset House also maintains The American Society of Addiction Medicine or ASAM criteria. This professional society aims to promote the appropriate role of a facility or physician in the care of patients with a substance use disorder. ASAM was created in 1988 and is an approved and accepted model by The American Medical Association and looks to monitor placement criteria so that patients are not placed in a level of care that does not meet the needs of their specific diagnosis, in essence protecting the patients with the sole ethical aim to do no harm.

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25

TIME TO UP THE STANDARDS: PART II

By Myles B Schlam, JD., CAP/CCJAP

In my last article, Time To Up the Standards ( January 2017), I wrote about the state the addiction treatment milieu is presently in and emphasized the necessity for increasing standards in the fields. I am a member of the 15th Circuit Sober Homes Task Force which was formed in July of last year and has made great progress under the leadership of State Attorney, Dave Aronberg and Chief Asst. Al Johnson. We have made over 20 arrests so far with many more to come. A grand jury was convened, which was the first of its kind in Florida to examine the state’s billion-dollar substance abuse treatment industry and offer recommendations on how to improve it. The report cites deceptive marketing as a common practice that threatens to exploit a vulnerable class.

To illustrate, people looking for treatment call an 800 number thinking they are calling a legitimate treatment center and speaking to a professional. The fact is they are usually talking to a telemarketer in a boiler room where the call has been routed.

This person is going to tell the perspective client whatever they want to hear to ensure that they come to that facility. Some will even go as far as sending the client a plane ticket to reel them in.

These marketers are usually rewarded with some type of bonus for the number of clients they bring into the facility - as a straight per client commission would be a more obvious violation of the Stark Act, a Federal law which prohibits patient brokering. The State of Florida also has laws in the book against patient-brokering, which have gone largely unenforced in this industry due to the lack of regulation and the general culture of acceptance within the field.

The grand jury report recommends the state certify marketers, force them to provide disclaimers and criminalize deceptive marketing practices and providers. This is a start. However, we need to penetrate much deeper than just the unethical marketing which is going on at the admission level. We need to look at the actual treatment being provided to the clients once they are enrolled, as well as the Case Management services provided, which should include discharge planning. I reiterate from the last article, the need to hire qualified clinicians with educational degrees as well as clinical field experience.

I have watched every episode of Law & Order on TV and thought I had a pretty good knowledge of the law; yet, I still had to go through all those years of college and law school and then pass the Bar Exam. It should be even more stringent to become an Addiction Professional considering we are treating people with a medical disease.

I believe that treatment centers should only be owned and operated by people with a medical background or who are licensed/certified personally under the appropriate state statute. If they are going to bill insurance as medical providers, they should be required to have all the proper credentials as such. Sober Homes can be owned and operated by anyone. Up until now the municipalities have had little success with any regulation of these homes because they used the ADA (American Disabilities Act) and The Fair Housing Act as their shield. However, we have now found other ways to hold them accountable, such as requiring accreditation in order for them to receive any referrals from state licensed treatment facilities. More regulation is better, as these facilities have been operating like the Wild West for much too long.

will come from the appropriate place – the treatment industry itself. Some may try to pass these costs on to their clients – but we will be watching carefully. The grand jury report concludes that the “proliferation of fraud and abuse within the substance abuse treatment and recovery residence industries requires immediate attention by the Legislature.”

Parents should be very wary of treatment centers which employ the marketing tactics I have described. These marketers know that the parents are desperate to get help for their loved one and will use that desperation along with the parent’s understandable desire to believe they are being steered in the right direction. I urge the families to speak with an independent Addiction Professional prior to making any decisions about where to place your child.

Parents should also examine all Explanation of Benefits (EOBs) they receive from the insurance companies. Look for things like excessive UA testing, and make sure they have not billed for a level of care which was not received. For example, if the patient was in IOP (Intensive Outpatient) but was being billed for PHP (Partial Hospitalization) that would be a problem.

Many facilities have a Medical Director on paper only. In other words, they have contracted with a Psychiatrist who may be present once a week to make rounds, but most of the “treatment” is handled by a nurse practitioner. Make sure that the therapists at the center are all qualified addiction professionals, not only the clinical director.

You are literally putting the life and safety of your loved ones into their hands – Please do your homework and be sure that they are in qualified and competent hands! There is a myriad of other things to be aware of when placing your loved one in treatment and again I suggest you do your homework and ask questions. If you need help navigating through the perfidious sea of treatment centers, feel free to contact me and I will assist you and your family in any way I can.

Myles B. Schlam, JD, CAP/CCJAP Advocare Solutions, Inc. - CEO (954)804-6888 www.drugtreatmentpro.com

The Task Force is also recommending raising industry fees to hire more regulators, making it easier for investigators to access patient records, toughening penalties for illegal patient referrals and requiring commercial sober homes to be licensed. They have recommended fines be increased for multiple violations of the patient-brokering statute. (Violating the patient-brokering statute is a third-degree felony, punishable by a maximum of five years in prison – for each count).

The funding which will be necessary for cleaning up this industry

26

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The contest is open to all artists 18 years of age or older.

Entries may be submitted digitally to Crossroadsartcontest@Gmail.com.

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27

LIVING BEYOND

A Monthly Column By Dr. Asa Don Brown

THE RELATIONSHIP BETWEEN BULLYING AND ADDICTION “Never be bullied into silence. Never allow yourself to be made a victim. Accept no one’s definition of your life; define yourself.” ~ Harvey Fierstein According to research by Partnership for Drug-Free Kids, it suggests that children who bully may have a higher probability of developing an addiction. “The researchers reviewed a survey of almost 75,000 students, which included questions on bullying and substance use. The survey found bullying was more common among middle school students than among high school students, and that substance use was more common among high schoolers.”

At the heart of bullying are feelings of shame, disapproval, disconnection, and immense isolation. While the mental health field has primarily focused on those who are bullied; we often forget that the bully is someone who frequently is dealing with biopsychosocial challenges. For it is common for a majority of bullies to struggle with a low self-esteem, lack of confidence, and ultimately the feelings of shame and inadequacy. “Shame is connected to the intensely painful experience of believing that we are flawed and unworthy of love, acceptance and belonging.” Research has shown that bullies are often children with a history of family violence, abuse, neglect, and maltreatment. Research further shows that bullying may be derived from academic or social challenges.

“Students who bully their classmates are more likely to use cigarettes, alcohol and marijuana, compared with their peers who aren’t bullies...” What is the catalyst or personal attraction for someone to become a bully? Rarely does someone purposefully choose to become a bully; just as rare as it is for someone to choose a life of crime. Sadly, the behavior is something that evolves over time, necessity and environment factors. The conscience of the bully is often seared by negative events, traumatic experiences; neglect, maltreatment and being victim of abuse themselves.

As young children are developing, they begin learning important psychosocial and behavioral cues. Unfortunately, if the child’s environment is lacking in support, then the child is more apt to develop negative coping mechanisms. The negative coping mechanism may develop into strategies of bullying, which ultimately may serve as a way for the child to receive favorable or unfavorable attention. The ambition for most bullies is simply to fit in.

FITTING IN

all children be viewed as worthy, valuable and acceptable. For children, an authority figure can leave a lasting impression FITTING IN AND ADDICTION When children struggle with feelings of acceptance, approval, and love, they may do whatever it takes to receive such personal validation. For children, they are still learning the concepts of personal validation, admiration, and how to self-soothe.

Children who learn positive and constructive coping mechanisms are capable of providing internal comfort, nurturing, and an unconditional love unto oneself. Whereas, children who lack in the ability to positively and constructively cope, have a higher propensity of seeking negative validation. While negative validation may cause one child to become a bully of others; for another, the negative validation may develop into strategies of self-degradation and admonishment.

Either way, children who receive negative validation are more apt to seek out any form of approval, support or acceptance.

Fitting in is a core attribute of the human nature. As humans, we desire and we thrive upon unconditional positive acceptance and approval. If we are incapable of finding positive acceptance and approval, then we are more likely to seek out negative acceptance and approval. Thus, children who may already be prone to peer pressure may discover a world of acceptance through acts of bullying; or they may discover that they are receiving attention, even it is due to a negative behavior. After all, children are seeking ways to feel unconditionally accepted, loved, and approved.

THE SOLUTION Approach each child with an unconditional spirit. While we may have unconditional love and acceptance of another, we may not always approve of their behaviors, deeds or actions. When discussing a child’s behaviors, be certain that you distinguish between the child’s behaviors, acts or deeds and the child worthiness; for we are all acceptable, lovable, and worthy of approval. Who we are has nothing to do with our failures or achievements. A majority of people act out because they feel unacceptable, unlovable, and unworthy. “While it’s important to hold kids accountable for their hurtful behaviors, resist the temptation to label them as ‘bullies.’ Reach out with love, understanding and compassion and try to understand the deeper issues impacting them.”

As an authority in the life of the child, you must empower them to be their own advocates. When children are empowered:

“Issues of bullying, bias and harassment are often linked to human differences.” People simply want to fit in, be admired, and be respected, but for the life of the bully, they often feel like an outcastdisrespected, disapproved, and constantly criticized. The bully develops into his or her persona, they are not born bullies. “The person engaging in bullying behaviors may also feel so much emotional pain and shame that they ‘protect themselves’ by fighting or acting aggressively toward others,” or choose to use various substances or partaking of illegal activities to manage emotional pain and shame.

Statistically, “only 1.6 percent of middle school students not involved in bullying reported marijuana use, compared with 11.4 percent of bullies.

Among high school students, 13.3 percent who were not involved in bullying used marijuana, compared with 31.7 percent of bullies. The study found similar results for alcohol and cigarettes.”

• they will advocate for their personal needs • they will influence others to advocate for themselves • they are capable of accepting personal responsibility • they have a clearer understanding of unconditional love, acceptance and approval • they learn to reject and avoid negative influences • they learn to be a good influence upon others • they ultimately learn that real happiness is derived from an internal sense of peace

Research suggests that children who are acting out should be held accountable, but as an authority in the life of the child, you must resist classifying them as a bully. Ultimately, while the behavior of the child may be egregious in nature, the child is not. The lifelong implications of labeling a child a bully can have a profound effect upon the child’s ability to fit in and feel accepted. It is essential that

Author: Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com References Provided Upon Request

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Children are not little adults; rather they are developing into adulthood. The influences in the life of a child can prove either detrimental or positively influential.

May you begin living beyond.

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FOR ADVERTISING OPPORTUNITIES PLEASE CALL US AT 561-910-1943.

Look for your FREE issue of The Sober World in your bag at the following Conferences/Events:

It Happens to Boys- March 24, 2017- Austin, TX DFW Behavioral Health Symposium- March 29-April 1, 2017- Irving, TX Innovations in Recovery- April 3-6, 2017- San Diego, CA UFAM 2017 Rally- May 18, 2017- Lansing, Michigan NAATP- National Addiction Leadership Conference - May 21-23, 2017- Austin, TX West Coast Symposium on Addictive Disorders- June 1-4, 2017- La Quinta, CA Innovations in Behavioral Healthcare- June 19-20- Nashville, TN C.O.R.E- Clinical Overview of the Recovery Experience- July 16-19, 2017- Amelia Island, FL Moments of Change- October 2-5-Palm Beach, FL Cape Cod Symposium- September 14-17, 2017- Hyannis, MA

For more information contact Patricia at patricia@thesoberworld.com www.thesoberworld.com To Advertise, Call 561-910-1943

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From The Hearts of Moms LOVING A CHILD WITH ADDICTION

By Suanne Wachtel, LCSW

So many parents today are struggling to support and love their addicted child. This enormous epidemic is killing our children, destroying our families, and making us question what kind of parents we have been. From guilt to shame, any parent traveling the addiction road with their child is suffering from helplessness.

Could we have done something to prevent this? Could we have stopped this insanity with better discipline, more love, and military school? As parents, we want our children to be safe, healthy, happy and productive. Whoever had a child, wanting them to be a slave to addiction? From pot to heroin, video games to gambling. What mother thinks, oh yes, when my child overdoses I will know what to do, when my kid gets arrested, I’ll make sure to get a good lawyer, when my child steals and lies to support their habit… I’ll understand!

I’m a licensed clinical social worker with a full time practice in Boca Raton, Florida. I run two groups weekly for addicts going through recovery. My son died of a heroin overdose three years ago this month. I had no idea he was using heroin, or that he had a “serious” addiction problem. As naïve as that sounds , until I worked at a rehab and was lucky enough to ask the questions to the actual clients struggling with addiction, did I first gain insight into the true world of an addict, their struggles and reasons for using.

What I have learned is that the “feelings” people get from the drug they become addicted to, is what they seek forever more. That “feeling” is more powerful than love, logic or fear. Addicts tell me how they will do ANYTHING when they are actively using to get their drug-to achieve the “feeling”- at any cost.

Many tell me they have wonderful loving families… but it makes no difference. The drive, the obsession to get high goes beyond their control. As a parent, how do you watch… you don’t, we try anything to save our children, including sacrificing our own health and wellbeing in the process.

Let Go … doesn’t mean; not care Let Go ... means love and don’t get involved Let Go … means let them make their choices, good or bad Let Go … means encourage them, don’t “fix” it, don’t help so much Let Go … means develop faith that they will choose life … sobriety Let Go … means understand, you can’t control the outcome It’s “their” journey … pray, send love

It is NOT our faults! Can we totally be off the hook, probably not, but if your child is an addict, rest assured, you are not alone and it doesn’t make you a bad person or a bad parent! There are so many variables as to why one child becomes an addict and another doesn’t. We do our best in a war without weapons. Praying and hoping that our child will see the light and be one of the many that do recover and resume a healthy life.

At the end of the day, we all get to choose our path … addiction, illness , definitely can create huge detours but in this war between our children and drugs … we have to remember we can only do so much to control the outcome. In my case, we lost our beautiful son at 27 to drugs. It was not our fault or a result of a lack of love and caring … heroin won, addiction won, and we lost a beautiful soul who graced our lives and brought smiles to our hearts.

Loving a child with addiction is a huge challenge! Definitely was not a chapter in my copy of Dr. Spock! As stated in the book The Prophet by Khalil Gibran, published in 1923: “Your children are not your children. They are the sons and daughters of life’s longing for itself. They come though you and not from you. –And though they are with you, yet they belong not to you. You may give them your love but not your thoughts. For they have their own thoughts. You may house their bodies but not their souls. For their souls dwell in the house of tomorrow, which you cannot visit, not even in your dreams.” This prophet understood the idea of not being able to control the outcome of our children’s destiny, for we can only control our reactions to life and our choices for our own lives.

I am at peace because I now understand as a mom, it was not my fault and only he could have changed this outcome … not me. ♥

I have encouraged many parents to understand that after every attempt to help, our children have failed… we need to let go… with love.

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Suzanne Wachtel, LCSW is a no nonsense, seasoned psychotherapist. She has a private practice in Boca Raton, Florida and devotes much of her time to helping those struggling with addicted loved ones and the loss of family members to drugs. She arms us with tools to cope and strategies to handle the pain that goes hand in hand with loving an addict. She is kind, insightful and very wise.

Suzanne lost her own son to a heroin overdose 3 years ago. Her goal is to not let it identify her but instead, to take the experience and use it to teach and help others. Life is not what happens to us … It’s how we handle it that matters. Through individual and groups, she helps us heal. Please visit my web site at www.therapy-boca.com

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IMPORTANT HELPLINE NUMBERS

A New Path www.newpath.org Addiction Haven www.addictionhaven.com Bryan’s Hope www.bryanshope.org CAN- Change Addiction Now www.addictionnow.org Changes www.changesaddictionsupport.org City of Angels www.cityofangelsnj.org FAN- Families Against Narcotics www.familiesagainstnarcotics.org Learn to Cope www.learn2cope.org The Long Island Council on Alcoholism and Drug Dependence www.licadd.org Magnolia New Beginnings www.magnolianewbeginnings.org Missouri Network for Opiate Reform and Recovery www.monetwork.org New Hope facebook.com/New-Hope-Family-Addiction-Support-1682693525326550/ Parent Support Group New Jersey, Inc. www.psgnjhomestead.com P.I.C.K Awareness www.pickawareness.com Roots to Addiction www.facebook.com/groups/rootstoaddiction/ Save a Star www.SAVEASTAR.org TAP- The Addicts Parents United www.tapunited.org

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ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG

818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG

800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG

800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG

800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG

800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM

561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET BROWARD COUNTY MEETING HALLS 101 CLUB 954-573-0050 LAMBDA SOUTH CLUB 954-761-9072 WWW.LAMBDASOUTH.COM PRIDE CENTER WWW.PRIDECENTERFLORIDA.ORG

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DOES TOUGH LOVE EQUATE TO WELLNESS OR DESTRUCTION? A GLIMPSE INTO ONE FAMILIES EXPERIENCE

By David M. Kolker, LCSW, J.D., MCAP

Heroin abuse in the United States is reaching epidemic proportions. According to SAMHSA, between 2007 and 2012, the number of Heroin users has doubled from an estimated 375,000 to over 665,000. Additionally, in 2010, the number of deaths as a direct result of overdose surpassed auto accident deaths.

It is impossible to avoid the facts about Heroin. We are bombarded daily by the national and local media and extensive online resources. So, is tough love the answer? I recently met a family whose daughter is a client and whose son had recently died from a Heroin overdose. The story they recounted was as follows: The father told me, “we are here to get help for our daughter, she is a Heroin addict.” He went on to recount a story of “tough love” in regard to his son who died of a Heroin overdose four months prior, at the age of 23. Mr. Jones stated that his son had been admitted to 7 Florida drug rehab programs between the ages of 18-23 and the longest period of sobriety he was able to attain was 11 months clean. He stated, “my son was plagued, he wanted to stop, he asked for help repeatedly and in the face of all the professionals, we continued to attempt to help.” He went on to recount “Finally, we gave in to the professionals and decided that ‘tough love’ was the answer and we would no longer accept our son’s phone calls, refuse to provide financial support and let him hit rock bottom. The professionals told us this was the only way and we listened. The result for us was that our son died of an overdose in a McDonald’s bathroom, alone.”

This is a story that I hear regularly. Professionals recommend that parents ‘cut them off’, ‘let them find their own bottom’ and tell them ‘you are killing them by helping them’. I seriously struggle with this approach and I am personally ridiculed by the local treatment industry for going against the grain and what they term ‘clinically appropriate guidelines’. I am termed ‘rouge’ and ‘severely enabling’ as well as, it has been stated ‘He allows them to relapse and this is killing them’. My response to this ridicule is to dig in and try to help individuals get well regardless of the theoretical approach. My job is to help, not kick people to the curb.

Quite possibly, 40 or 50 years ago, waiting 10-20 years till an alcoholic hit his bottom was acceptable; however, today, 20 something heroin addicts will not live 10-20 years, much less 2-3 years. For those espousing tough love, in essence, they are quite possibly sentencing an addict to death. Obviously, the addict is responsible for his/her own recovery, but we have a responsibility to take the person where they are at and attempt to help if they ask. Research in this area has demonstrated, in the legal system, that forced drug rehab vs. non-coerced treatment (tough love) yields no difference in terms of retention and outcomes (see below for citation).

correct analysis, we need to address the problem, the internal emotional pain rather than modeling a means of creating more pain through tough love.

Mr. Jones finally stated “I blame myself for giving up on my son and I won’t make the same mistake twice. I have to live with the consequences not the professionals who provide the same recommendations to every family.”

Miller, N.S & Flaherty, J.A. Effectiveness of coerced addiction treatment (alternative consequences): A review of the clinical research (January 2000) J of Subst Abuse Treatment, Volume 18, Issue 1, Pages 9-16. Available online at: http://www.ncbi.nlm. nih.gov/pubmed/14698797 David Kolker is both a Licensed Clinical Social Worker that has a law degree from SIU Carbondale and a Master’s in Social Work from Florida Atlantic University. He is the Clinical Director and CEO of SLO Recovery Centers in Delray Beach, Florida. He can be reached at davidk@slorecoverycenters.com or by visiting the website at https://slorecoverycenters.com.

Regardless of these observations, tough love does not work with an addict. Anyone who has worked with this population would be hard pressed to report that an addict responds to tough love. The opposite is true. Without failure, every addict I have worked with wants to be loved and wants to feel loveable but none of them will tell me that because they believe if someone knows this, they will abandon them and see them as weak. By modeling love and compassion, it provides the freedom to aggressively confront given the addict who knows it is coming from a loving place.

Addicts have been thrown to the curb (or felt as if they have) most of their lives. The idea that a person is in pain because they are an addict, rather than the pain they are in created the addict provides different solutions. If a person is in pain because they are an addict, the rational solution would be to remove the drugs (through detox) and the problem should be eradicated; however, alternatively, if the pain created the addict, which I believe is the

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SUD TALKS 2017

The 2017 SUD Talks event U.S. for SUD: Stand Together as One was enjoyed by everyone. The speakers were amazing and it was nice to see a community come together. The Friday night VIP party was a great start to a wonderful weekend. Thank you Suzanne Spencer and the Delray Task Force for all you do!

Congress Woman Lois Frankel

Visionary Media Sponsor, The Palm Beach Post, Christine Stapleton; Panelist and Investigative Reporter Pat Beall, panel moderator

Delray Medical Center, Thinker and Doer Sponsor, Dr. Ashok Sharma; Speaker Jeffrey Lefton

Speakers, Sponsors, Founder and Producer

Mike Hendren, Chairman of the Delray Beach Drug Task Force

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ROOFIES ON THE RISE: HOW TO PARTY SMART

By Nancy B. Irwin, Psy.D., C.Ht.

Savannah woke up late the morning after St. Patrick’s Day, feeling strange…groggy and panicky. It was a workday, and she’d neglected to set her alarm. Not like her at all. When she saw the time on her nightstand clock, she leapt out of bed, but fell, feeling oddly weak. If she hurried, she could make it to work on time, but she felt so weird. What had she done last night? Had she relapsed? Why was her 27-year-old brain having a “senior moment?”

“Wait a second…” she thought, looking down and noticing she still had on half her clothes. Not like her to sleep with her bra on, not to mention her sweater. Where were her panties? As she looked into the mirror, she questioned: “Why do I still have on make-up?” A creepy sensation radiated through her body from her core. She felt cold and tingly all over, and began moving through her apartment looking for clues as to how she went to sleep with her sweater, bra and make-up on and nothing else. “I certainly remember doing things like this when I was in college and drinking like a fish, but I’ve been sober for 3 years now…..what the…” As she walked through the living room, she noticed the front door was shut, but unlocked, with her keys still hanging in the doorknob in the hallway of the common area. “OMG…” she thought. “My keys were in the doorknob all night!” She quickly locked it, and leaned against it, heart thumping, head throbbing, eyes darting around half expecting to see someone, calling out, “Hello? Anyone here?” No answer. She then noticed there were a few flecks of hardened mud on the carpet, leading from the door to her bedroom. Not much, but there were definitely imprints in the carpet of shoes much bigger than her own.

For the life of her, Savannah could not recall how she got home last night, nor who had come with her. She had lived alone for a few months now since her boyfriend broke up with her and moved out, and she was not in any headspace to have sex with anyone at this point in her life. Who was here last night? Should she call the police? But, what would she say? She made some coffee and sat on the couch, scratching her head trying to remember last night.

She had gone to a local sports bar with some other single friends to celebrate Valentine’s Day. She did recall Julie canceling at the last minute via text. But Amanda made it, and they sat at the bar, ordered mocktails….then what???? * * * Sadly, Savannah’s experience is hardly rare. Young women (and men, as well as older women and men) wake up with amnesia about the night before. Sexual assaults occur every two minutes, and drug-facilitated rapes have been rising, particularly on holidays where resorts, clubs and bars are more crowded than usual. This provides easier access for those perpetrators seeking opportunities to have sex with an unresponsive partner. Another reason for this rise may be the spotlight on Bill Cosby, who allegedly raped 40 women with the facilitation of sedatives.

“Date rape” drugs are used to spike non-alcoholic drinks as often as alcoholic beverages, and have no tell-tale scent, flavor, or discoloration. There are many date rape drugs, but the most common is Rohypnol, whose street name is “roofie,” a strong sedative. The victim has no idea until she has ingested it, and unless she is very sensitive to this fast-acting drug, will be rendered unconscious and easy prey for a rapist. Within 20-30 minutes, a victim may begin to experience: dizziness, difficulty breathing, confusion, feeling drunk even if she is drinking a soda or water, nausea, sweating or feeling chilly, chattering teeth, difficulty walking, blurred vision, and disorientation. Indeed, she may show none of the symptoms and simply lose consciousness. Please note that both genders are victims of sexual assault, yet the author is using the feminine pronoun herein for simplicity; as well, the overwhelming percentage of reported sexual assaults are by

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females, with only 15% of males reporting sexual assaults. Fully, 60% of all rapes are never reported at all.

The danger of surreptitiously drugging a recovering alcoholic or substance abuser is particularly painful in that, not only can this criminal act be devastating, but it technically breaks sobriety.

Other common date rape drugs are GHB (Gamma Hydroxybutyrate) and Ketamine. They can all be detected in the body system for 12-72 hours after ingestion. Victims have reported waking up in a cheap hotel, in an alley, in a park, or in their own car or even their own bed.

Perpetrators in a busy venue are simply viewed as a stand-up guy taking care of his drunk girlfriend. They can then go through her purse, learn from her driver’s license or phone where she lives, use her house keys and assault her in her own bed.

If you think you may have been drugged, do not change clothes or shower. Go immediately to an Urgent Care, call 911 or the National Sexual Assault Hotline at 800-656-HOPE for a forensic exam/rape kit, including tests for pregnancy and sexually transmitted diseases.

Unfortunately, the amnesia (partial or full) that is a result of date rape drugs can be long-lasting or permanent. Depression, anxiety, shame and guilt frequently follow, as well as potential sexually transmitted diseases or pregnancy. Many victims state that living with the unknown is the worst dynamic to live with. Psychotherapy with a trauma expert can help mitigate these effects.

A “healthy paranoia” can help you to enjoy socializing safely: 1. Be careful of what you post on social media.

2. If you do drink alcohol, know your limit.

3. Have a plan with trusted friends and respect it no matter what.

4. Never accept a drink from a stranger.

5. Take your drink with you if you go to the bathroom. Even leaving it with a trusted friend is risky…he/she may get distracted.

6. If assaulted, file a police report and seek immediate medical and psychological help.

Dr. Irwin is a doctor of clinical psychology on staff at Seasons Recovery Center in Malibu (www.seasonsmalibu.com) as a primary therapist and hypnotherapist, and is also in private practice as a certified clinical hypnotist in West Los Angeles (www.drnancyirwin. com). A frequent media guest, she is the author of YOU-TURN: CHANGING DIRECTION IN MIDLIFE (2008) and co-authored BREAKING THROUGH: Stories of Hope & Recovery with Seasons’ clinical director, Dr. Mark Stahlhuth.

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PONTIFICAL ACADEMY OF SCIENCES (PAS) – FINAL STATEMENT ON THE GLOBAL DRUG EPIDEMIC: INSIGHTS FROM NEUROSCIENCE AND PSYCHIATRIC GENETICS.

By Kenneth Blum, Ph.D.

➢ Reject drug legalization for recreational purposes as a hopeless, mindless strategy that would consign more people, especially the disadvantaged, youth, the poor and the mentally ill, to misery or even death while compromising civil society, social stability, equality, and the law.

Commentary: Action speaks louder than words, the “War on Drugs” and prohibition failed. While this is indeed the most difficult aspect related to our current drug epidemic, there are two sides to the coin.

Certainly, we know from scientific evidence that abuse of marijuana, especially at very high THC concentrations (up to 97% in some wax forms), can induce harmful mental consequences including psychosis and dependence. On the other hand, incarceration is not the answer either; this has failed. Truly understanding both the neurogenetic trait and epigenetic (environmental) state involved in addictions and educating the wider public about the consequences for our youth of legalization of recreational marijuana may succeed.

Neurobiologically, the brain regions involved in decision –making are compromised in our youth because myelination continues until individuals reach 24-25 years of age. It is also known that low dopamine function (dopamine D2 receptors numbers decline with age) can induce aberrant substance or non-substance behavioral addictions in elders.

The most intelligent approach is to provide strict regulations on the sale of marijuana products. While the SMART group has good intentions, it is human nature for people to want to get “high.” As thinking minded people we must begin to carefully craft workable laws against human nature instead of harmful thoughtless unenforceable doctrines. ➢ Create a balanced drug strategy, coordinating public health and criminal justice systems to curtail supply, discourage drug use and promote recovery – as a more effective method to treat addiction than incarceration. The primary goal of addiction treatment is longterm care and recovery.

Commentary: Definitely, we, as right thinking people should discourage drug use and promote recovery without incarceration of the victims of uncontrollable addiction. However, we must also appreciate that like any chronic disease/disorder/syndrome; RDS could be a life –long issue. In fact, there is enough scientific evidence to strongly suggest that at least 50 % of the contribution is genetic and the other 50% is epigenetic (environmental). The concept of long-term in the world of insurance carriers translates to an uncanny short –term detox and months of outpatient treatment.

This of course borders on the ridiculous because if genetic polymorphisms in the reward system of the brain are involved this could very well be a life –long condition. ➢ The foundations of this balanced strategy are fundamental human rights, which include drug prevention and recovery among the world’s diverse faith communities, with a special focus on the goal of protecting youth from drug sales and drug use, in accordance with Article 33 of the Convention on the Rights of the Child.

Commentary: While it is well recognized that the world’s diverse faith communities provide indispensable positive work to prevent or protect youth from imbibing, drug prevention and recovery should be universal and reach out to non-believers as well. It must be recognized that while certain gene variations have been linked to an acceptance of God, other gene variations seem to prevent such acceptance. While religion may have positive benefits including selfhelp organizations, it is the biology not faith, that induces craving for aberrant drug and non- drug seeking behaviors. Faith can help heal, but without addressing the core neurobiology of the condition, the recovery process is filled with white knuckle resistance and possible

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relapse and addiction transfer, moving from one addiction to another such as gambling, overeating and more. However, a certain percentage seems to prevail by accepting the doctrine of “becoming powerless.” Nevertheless, independent of religion we should uphold Article 33. “(Drug abuse): Governments should use all means possible to protect children from the use of harmful drugs and from being used in the drug trade. ➢ The prevention of addiction among youth (less than age 21) is a high priority, and achievable by rejecting the use of marijuana and other rewarding substances.

Commentary: Addiction professionals are concerned about any involvement preteenagers and young adults’ have with substance abuse. The development of the Pre-Frontal Cortex (PFC) is undergoing significant changes in adolescents prior to reaching the mid-20s, and, appropriate decision making in this population is hijacked. These concerns provide the impetus to continue relevant animal and human neuroimaging studies.

Early genetic testing for addiction risk alleles will offer valuable information that could potentially be utilized by their parents and caregivers to encourage the rejection of the use of marijuana, and other rewarding substances. To combat this significant global dilemma and help our youth lead normal productive lives, epigenetic (environmental) influences, including attachment -known bonding substances oxytocin/vasopressin and parenting styles, may modify various reward genes which effect dopaminergic function. ➢ The underlying reasons for this priority need to be conveyed to youth and their parents in collaboration with health, educational and local communities.

Commentary: This is easier said than done. It seems on the surface a good orderly goal involving parents, young people and even educational systems. This idea had some of its early beginnings in the late 60’s but has failed. Our young are influenced by their peers to use or even abuse, and by their parents drinking alcohol, taking pain pills, long –term stimulants prescribed for ADHD or weight loss, smoking marijuana, and being too busy in the pursuit of the ”American Dream. We all need a change in not just what we say to our youth but what we do. ➢ Educate the public with up-to-date scientific information on how drugs affect the brain, body and behavior, to clarify why legalization of marijuana and other drugs for recreational use is poor public policy, poor public health policy and poor legal policy.

Commentary: While this statement seems reasonable and at least in the United States and other countries, the enormous efforts of the National Institute on Drug Abuse (NIDA) and National Institute on Alcohol Abuse and Alcoholism (NIAAA) continue to feed the public with up-to-date scientific information on how drugs affect the brain, body, and behavior (including marijuana). Education alone is not the real answer. Through the advent of neuroimaging and genetic tools, we are unraveling the mysteries of how drugs work on the brain and body. Just recently, NIAAA published in Biological Psychiatry, a neurobiological framework to be incorporated in potentially targeting all RDS behaviors involving both genetics and neuroimaging. The work of others further framed this neurobiological approach in Austin, Texas showing that 1,000 or more genes are altered up or down by alcohol and the hunt for substances to reinstate “genetic normalcy” may have powerful benefits in the future.

With this in mind, based on neuroscience a “reward deficiency solution system” that combines early genetic risk diagnosis, urine drug Continued on page 38

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37

REPEAL AND REPLACE CUTS ACCESS TO ADDICTION TREATMENT

By John Giordano, Doctor of Humane Letters, MAC, CAP

The Washington Post claims that; “The (CBO) report predicted that premiums would be 15 - 20 percent higher in the first year compared with those under the Affordable Care Act but 10 percent lower on average after 2026. By and large, older Americans would pay “substantially” more and younger Americans less.” “For a 64-year-old making $26,500, the cost (premiums) would rise sharply, from $1,700 to $14,600.”

President Trump had a short response to the CBO’s scoring of AHCA; “Don’t believe it.” His hand picked Health and Human Services Secretary, Tom Price, said; “We think that CBO simply has it wrong,” and “The CBO report’s coverage numbers defy logic.”

Yet POLITICO, who claims to have access to an internal White House missive from their own Office of Management and Budget (OMB), is reporting; “A White House analysis of the GOP plan to repeal and replace Obamacare shows even steeper coverage losses than the projections by the Congressional Budget Office, according to a document viewed by POLITICO on Monday. The preliminary analysis from the Office of Management and Budget forecasts that 26,000,000 million people would lose coverage over the next decade, versus the 24,000,000 million CBO estimates. The White House has made efforts to discredit the forecasts from the nonpartisan CBO.” POLITICO also claims that based on the documents they observed, a total of 54,000,000 million Americans would be uninsured in 2026 under the GOP’s American Health Care Act. How would the American Health Care Act impact access to mental health and addiction treatment? On their website (APA. org), The American Psychological Association “voiced serious concern regarding the bill to repeal and replace the Affordable Care Act, arguing that it would reduce mental health and substance use coverage for millions of Americans enrolled in Medicaid and contribute to the loss of coverage for millions more individuals.”

Philosopher, essayist, poet and novelist George Santayana once famously said; “Those who cannot remember the past are condemned to repeat it.”

From my perspective, the last significant push for greater access to mental health care came in the early sixties with then President

Continued from page 18

Kennedy’s Community Mental Health Act of 1963 (CMHA).

Although well intended, many state fiscal conservatives viewed CMHA as a way to cut costs and closed many of the state run mental institutions. The effects of their actions are felt deeply today where we have 10 times the number of severely mentally ill patients being warehoused in jails and prisons rather than under a doctor’s care in psychiatric hospitals or clinics. The perceived cost savings were far exceeded by the real expenses of dealing with the abandoned mentally ill patients.

There are many flaws with the Affordable Care Act. Personally, I’m very upset that my premiums are rising out of control. Professionally, I find the ACA proscribed addiction treatment program lacking and in need of a serious overhaul. I strongly believe that change is needed to strengthen and stabilize America’s health care system. As much as I dislike Obamacare, it is clear that the repeal and replace American Health Care Act is not an improvement – in fact far from it. AHCA would put access to mental health and substance use disorder services back into the bottle and kick it all the way back to the stone age – and we simply cannot afford to go backwards.

Regardless of how you feel about healthcare in America today, make your thoughts known by calling your congressmen and senator. Phone calls matter. There is a new app called 5calls. org that makes it easy to find your representative and their contact information. Exercise your rights and give it a try.

John Giordano, Doctor of Humane Letters, MAC, CAP, is an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals.

For the latest development in cutting-edge addiction treatment check out his website: www.holisticaddictioninfo.com

PONTIFICAL ACADEMY OF SCIENCES (PAS) – FINAL STATEMENT ON THE GLOBAL DRUG EPIDEMIC: INSIGHTS FROM NEUROSCIENCE AND PSYCHIATRIC GENETICS.

By Kenneth Blum, Ph.D.

monitoring, and nutrigenomic dopamine agonist modalities and mRNA reward gene expression pre-and post treatment has been proposed. ➢ Harness religion to support substance abuse prevention and treatment. Drug use can devastate the soul and a loving relationship with God. Drug use in our communities tests our faith. The faithful have a precious opportunity to engage in preventing this tragic form of modern chemical slavery. For those now enslaved, they can confront the challenge of addiction and achieve their emancipation.

Commentary: While the concept of God should not be underestimated and many studies have verified its positive effect; the idea that acceptance of GOD can achieve emancipation from locked in addiction seems simplistic. We must embrace the fact that “reward deficiency” (hypodopaminergic function) the cornerstone of all repetitive addictive behaviors, is based in neurobiological, genetic, and epigenetic antecedents expressed in unwanted uncontrollable seeking behaviors. So, although engaging and accepting spirituality alone to prevent or recover from this” tragic form of modern slavery” is counter-intuitive, it would have some positive epigenetic effects. However, would it be more reasonable to achieve the laudable goal of prevention by initiating at birth a

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validated genetic test to determine risk for RDS? Not to label a newborn, but together with a balanced view of spirituality, provide more natural ways over time to boost dopamine function. Many activities can boost and maintain natural “pro-dopamine regulation”.

They include music, art, food, exercise therapy, meditation, Yoga and neutraceutical dopamine agonist therapy. We must realize that the use of powerful narcotics like methadone and buprenorphine, with or without a narcotic antagonist, does not heal addiction.

Instead, it locks people young and old into an addictive state, blocking natural dopaminergic function. The real chance to not just achieve emancipation but real-time prevention is to find ways to bring about “dopamine homeostasis.” Acceptance of God for some (with the God acceptance gene) is just the beginning of the journey.

Kenneth Blum, B.Sc. (Pharmacy), M.Sc., Ph.D. & DHL; received his Ph.D. in Neuropharmacology from New York Medical College and graduated from Columbia University and New Jersey College of Medicine. He also received a doctor of humane letters from Saint Martin’s University Lacey, WA. He has published more than 550 abstracts; peer-reviewed articles and 14-books.

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