August 2017 - The Sober World

A U G U S T 2 017

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VOLUME 6

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ISSUE 8

IN MEMORY OF STEVEN

THE

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

COMPREHENSIVE

MCOs AND MEDICATIONS

AFTERCARE IS ESSENTIAL TO RECOVERY

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

By John M. Majer, Ph.D. and Ted J. Bobak, B.A.

DON’T BE AFRAID TO SAY THE “S” WORDTALKING TO KIDS ABOUT SUICIDE

By Phyllis Alongi, MS, NCC, LPC, ACS

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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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COMPREHENSIVE AFTERCARE IS ESSENTIAL TO RECOVERY

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

Anyone who has been through addiction treatment will tell you that one of the scariest moments is the second they stepped out the front door of the facility and walk alone back into their old environment. I’ve watched thousands take that step. Some were giddy while others had that ‘deer in the headlights’ look about them. What they all shared was an overwhelming fear of relapse and a determination to beat their demons and live a happy life free of drugs and alcohol. There was no way of telling at the time who would relapse and who would not; only the fact that a small percentage would continue on their path to recovery uninterrupted.

This is just one of the many undeniable truths regarding what happens after addiction treatment. All too often the perception of treatment is that it’s the end of something; when in reality it is the fragile beginning of a whole new life, fraught with insecurities and vulnerabilities. In over thirty years of treating addicts, not once did I meet one who wanted to return other than to say hello or encourage others.

The reasons for such a high relapse rate are many. In past articles I’ve gone to great depths explaining the genetic influences, not treating the brain, addict’s mental and physical conditions, ineffective treatment protocols, the insurance industry’s oversized influence on treatment and a host of other reasons why recovery can be so challenging. However, if I had to pick one reason why so many people relapse, it would have to be the short amount of time addicts have in treatment.

Philosophically speaking, two of the primary goals of every addiction treatment facility are to: 1) Gain the commitment from each and every addict individually to stop abusing drugs, alcohol and end their self-destructive behavior.

2) Help the addict build the foundation that will support a lifestyle free of these negative attributes while promoting recovery.

Although these goals don’t appear to be all that lofty, achieving them is a completely different story. What people on the outside rarely see is the addicts’ progression through the stages of treatment. They start out in detox where they are slowly weaned off of drugs or alcohol while often experiencing painful withdrawal symptoms. They are physically sick in an unfamiliar setting surrounded by strangers. Days later, sometimes longer, when they are admitted to the treatment center, their minds are still cloudy while their bodies adjust to their drug free state. At this point their brains are not capable of normal function. As hard as the staff at the treatment center tries, nothing sinks in during the first couple of weeks. Sure, they go to meetings, cognitive therapy and so on, but nothing really registers until their third week.

So with that being said, the reality is that most addicts only get a couple of weeks of effective addiction treatment. That is simply not enough time to reinforce a commitment of abstinence from drugs, alcohol and destructive behaviors much less built a solid foundation for a happy and productive lifestyle. Unfortunately, the vast majority of treatments centers do not have aftercare programs to address these shortcomings.

This is why, now more than ever, a comprehensive aftercare program that acts as an extension of addiction treatment centers and a precursor to recovery homes is essential to the success of anyone’s recovery.

Think of it as if you were building a house. Imagine two addicts who have just completed treatment walking out of a center. Each is dressed like a construction worker with a tool box in one hand and a set of blue prints in the other. The addicts have been taught how to use a few of the tools in the box very well, but are not sure what can be accomplished with most others. They look at the plans they were provided in treatment and have a general idea as to the house they

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want to build, but are vague on the details as to how to build it.

Now they stand at a crossroad, one chooses to ‘go it alone’ while the other seeks help at a ‘comprehensive aftercare program.’ At the end of ninety days, both addicts have built their house. Let me ask you something, how do you think the house built by the person who ‘goes it alone’ will look compared to the person who sought professional help in a ‘comprehensive aftercare program’? Which one has the strongest foundation? More importantly, how long do you think each house will stand?

When I explain it this way most people get it. There is no substitute for quality professional help especially when you are faced with a life changing situation. Considering that recovery is not fully stabilized until four to five years of sustained recovery, good aftercare programs become all that much more vital to a successful recovery.

Expect a comprehensive aftercare program to do much more than filling in the blanks. It goes without saying that they need to fulfill the obligatory services and so on. But more importantly they will function as an extension of addiction treatment; they pick-up where the treatment center left off. Using my previous example, a comprehensive aftercare program will teach addicts how to use all the tools at their disposal and help them build a foundation to support a sustainable drug/alcohol free lifestyle.

It wasn’t all that long ago when addiction was accepted as a chronic disease. Because it is centered in the brain, there is no cookiecutter therapy that works for everyone. I’ve always viewed addiction as a mosaic with the potential of many contributing factors; which is why all treatment needs to be individualized to the addict’s needs.

However, there are commonalities that are just too big to ignore.

A great example would be nutrition. Drugs and alcohol abuse causes major nutritional and brain chemistry imbalances that often can make cravings intensify. Most people don’t even know that we Continued on page 32

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THE LAND OF THE FREE AND DEPRESSED: TAKING A LOOK AT THE COST OF DEPRESSION IN AMERICA

By Kristen Fuller, M.D.

America, the land of the free and happy, isn’t exactly “happy”. Americans are stressed, burned out and depressed. Americans spend more time at work and less time on vacation compared to most other Western countries which may contribute to the tremendous depression statistics.

There is no surprise that depression affects approximately 15 million American adults, or about 6.7% of the U.S. population 18 years of age and older on a yearly basis. In the country where we measure our success by the things we own as opposed to our relationships with people who matter; happiness studies have proven that Americans are more dissatisfied with their lives than many other societies around the world. The World Happiness Report used by the United Nations, reveals that The United States, one of the economically wealthiest countries, comes in at #15 on the Happiness Scale. With statistics such as these, it is no surprise that the cost of depression from a financial standpoint is now a major burden on the United States. However, the cost of depression is not only measured from a monetary standpoint but can be measured by social and emotional hardships as well.

The diagnosis The famous mnemonic SIGECAPS is what we were taught in medical school in order to easily remember all of the diagnostic signs and symptoms for depression. Five out of nine of these symptoms must be present for a duration of at least 2 weeks for a diagnosis of depression: problems with Sleep, loss of Interest, feelings of Guilt, lack of Energy, loss in Concentration, change in Appetite, Psychomotor agitation and Suicidal ideation. Of course, many would argue that with only a minimum of a two week duration, often times depression is situational and can present in patients due to a breakup, financial hardship, a physical illness, or the loss of a loved one. Regardless if depression is situational or a major disorder; it is costing the United States a tremendous amount of money.

The numbers According to an article in the Journal of Clinical Psychiatry, “In the United States, depression is a leading cause of disability for people aged 15–44 years, resulting in almost 400 million disability days per year, substantially more than most other physical and mental conditions. The economic burden of depression, including major depressive disorder (MDD), bipolar disorder, and dysthymia, was estimated at $83.1 billion in 2000 in the United States. This total was composed of $26.1 billion in direct medical costs, $5.4 billion in suicide-related mortality costs, and $51.5 billion in indirect workplace costs”. This economic burden is continuing to rise as the most recent study in the Journal of Clinical Psychiatry revealed that annual costs related to major depressive disorder rose to $210.5 billion in 2010.

This drastic increase demonstrates that we as a society are failing at treating this disease. From missed days of work leading to loss of productivity, to the earnings made by the pharmaceutical and insurance companies; mental illness is now a thriving business.

This should not be surprising as we as Americans are hooked on pharmaceutical drugs. Patients walk into their doctor’s office with a virus but yet demand antibiotics and we as physicians are so overly concerned with our patient satisfaction ratings that we hand out these prescriptions. We are guilty of overprescribing for everything: chronic pain, anxiety, viral sinusitis, and the list continues on; hence why antidepressants are extremely profitable for the pharmaceutical companies but yet incredibly harmful on the United States economy.

Yes, studies have proven that antidepressants as well as psychotherapy are extremely efficacious in treating depression; however this does not change the fact that these medications are burning holes in our wallets.

The drug prices More than 30 million Americans are currently on antidepressants and we account for approximately five percent of the global population, but we buy more than 50 percent of the pharmaceutical drugs.

Antidepressants such as SSRIs and SNRIs cost an average out-ofpocket expense of $15 in 2010 for Americans who are covered by

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insurance. Of course with inflation this price has risen since 2010.

Retail prices (the cost without insurance coverage) for commonly prescribed antidepressants ranges from approximately $20 a month to more than $1,000 a month depending on the specific antidepressant, dosage, pill form (tab or capsule) and whether it is available in generic or brand name. For example, a 10mg capsule of fluoxetine (generic Prozac) costs $28 a month whereas a 10mg tablet of escitalopram (generic Lexapro) at retail cost is $87 a month.

The social factors According to Americans, money makes the world go ‘round and clearly economic hardship results from depression, however, financial disasters are not the only loss. Depression results in emotional and social burdens as well. Depression can result in relationship hardships and divorce, drug and alcohol addiction, self-harm and suicide, eating disorders and even physical abuse. All of these horrible effects cost our society even more financial hardship in their own individual entity. Drug and alcohol treatment can cost thousands of dollars out of pocket each month, divorce proceedings and lawyers are not cheap and funeral costs are not free; not to mention the emotional harm that occurs due to a broken family or the loss of a loved one. Self-medicating for depression by using a line of cocaine, a couple of shots of whiskey or a few painkillers may initially take the emotional pain away for a very short time but once that substance leaves your system; the depressive feelings come back and often hit harder than ever and may even spiral into an addiction. When depression strikes, it reaches beyond the depressed person, adversely affecting spouses, partners and children. According to studies, the divorce rate is nine times higher in couples in which a partner suffers from untreated clinical depression. It is known among mental health professionals that anyone living with a clinically depressed individual is at higher risk of developing clinical depression themselves.

So, is there a solution to these economical and social hardships caused by depression? If there is, we as Americans have yet to discover it.

Recognizing depression is just as important as learning key tips in attaining happiness. The science of happiness is another topic to be discussed; but has shown great potential in individuals who are miserable and are on the border of depression. Non-pharmacological therapies have proven to be efficacious in treating depression. Light therapy, acupuncture, yoga, meditation and exercise can help cultivate happiness; however, these therapies also cost money. Perhaps it is how we as Americans live that result in such high rates of depression leading to increasing costs. What if we worked and lived in a society where we were allowed more vacation and time off to spend with our families, were not constantly inundated with materialistic items and did not have to take out a loan for higher education or to pay off our medical bills? If we lived more like the Scandinavian societies; I would imagine that depression rates would plummet and as a result the cost would drastically lower.

Kristen Fuller, M.D., is a clinical content writer for Center For Discovery and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a physician and author, who also teaches and contributes to medicine board education. Her passion lies within educating the public on preventable diseases including mental health disorders and the stigma associated with them. She is also an outdoor activist and dog enthusiast.

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DON’T BE AFRAID TO SAY THE “S” WORDTALKING TO KIDS ABOUT SUICIDE

By Phyllis Alongi, MS, NCC, LPC, ACS

Through my work as Clinical Director of the Society for the Prevention of Teen Suicide, I frequently get asked by parents,” How do I talk to my child about suicide? What is the appropriate age to talk about it? What tools do I need? If I talk to my child about suicide, am I planting the idea in his or her head? Do I just come right out and ask?”

The answer I provide -arm yourself with knowledge and get the facts. The latest statistics issued from the Centers for Disease Control and Prevention indicate suicide is the second leading cause of death ages 10-24 in the United States. We know early suicide prevention education, known as upstream prevention, is necessary, as well as the need to practice self-awareness. What are your attitudes and feelings toward suicide? Then, check those attitudes at the door. Before you speak to your child about suicide, know the warning signs, risk factors, protective factors and the appropriate resources.

Choose a good time to talk, be conversational, be honest. Speak to your child the way you normally would. Keep good eye contact.

Be direct, don’t be afraid to say the “S” word-ask directly about suicide. Talking about suicide doesn’t put the idea in someone’s head. Listen to your child and really hear what he or she is saying.

Don’t judge. Don’t minimize your child’s responses. If you’re worried, ask more questions; say three very important words, “Tell me more.” Having those “difficult” conversations with your child can be uncomfortable, almost daunting at times, but we need to have those sensitive discussions despite our feelings. First, practice selfevaluation. What are your feelings or attitudes regarding suicide?

Any ideas or judgements you may have regarding suicide will filter through when discussing the topic with your child and alter the way you speak about it, possibly preventing a frank discussion.

As parents, your role in suicide prevention is crucial. You know your child’s moods and behaviors better than anyone else. If you see behavior that concerns you, ask your child about it, be sure your child knows that he or she can feel comfortable about coming to you for help. Reiterate that you are there to listen and not to judge, and that you are there for your child, no matter what he or she has to say.

Be willing to seek professional help. If your child is struggling, he or she will need to be evaluated by a trained, mental health professional, who is knowledgeable in suicidal ideation and will make appropriate referrals for level of care and ongoing treatment.

Remember, you are not a mental health professional or a crisis response worker. If you know a loved one is in immediate dangercall 911 right away!

Know the risk factors There are a number of reasons why someone would consider completing suicide. We need to look at the risk factors involved and keep in mind that every case of suicide is unique. Risk factors may include existing mental health issues, such as depression; personality traits such as aggression or impulsivity; previous attempts; family history of suicide; exposure to suicide; access to means; stressful environmental factors such as loss or trauma; any serious chronic pain issue; and substance abuse. Many times, there are multiple reasons, coming together like “a perfect storm.”

It is difficult for anyone in crisis to make healthy decisions, particularly when experiencing intense emotional pain. The adolescent brain is not fully developed, therefore, problem-solving skills are lessened. Adolescents do not possess the same finetuned reasoning skills as adults.

Know the warning signs. The following signs may mean that a youth is at risk for suicide, especially if that person attempted suicide in the past. The Society for the Prevention of Teen Suicide utilizes

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the acronym FACTS (Feelings, Actions, Changes, Threats and Situations) as a way to easily remember the warning signs.

• Feelings-Expressing hopelessness about the future • Actions-Displaying severe and overwhelming pain or distress • Changes-Showing worrisome behavioral cues or marked changes in behavior, including: withdrawal from friends or changes in social activity; anger and hostility; or changes in sleep • Threats-Talking about, writing about, or making plans for suicide • Situations-Experiencing stressful situations including those that involve loss, change, create personal humiliation, or involve getting into trouble at home, in school or with the law These kinds of situations can serve as triggers for suicide. If you notice any of these warning signs, talk to your child, express concern about what you are observing in their behavior.

What you can do to foster protective factors in your child?

Encourage your child to participate in school, community and/or athletic activities. A sense of connectedness and belonging is a strong protective factor. Ensure your child’s physical, emotional and mental health needs are met. Accentuate the positive; self-esteem building is crucial to social and coping skills. Model fine-tuned problem solving skills, anger management and emotion regulation.

Know your resources!

There are numerous, quality resources available. Get familiar with the local mental health agencies and private practitioners in your area. We encourage everyone to utilize the SPTS website www. sptsusa.org Teen suicide prevention is conversation adults must be comfortable with and are having with their teens. Prevention works.

The video “Not My Kid: What Every Parent Should Know” available on our website, is a 17-minute video recognized as Best Practice and includes the most frequently asked questions parents have about teen suicide. Additional resources that are helpful for parents are; • www.sptsusa.org • www.Suicidepreventionlifeline.org • www.AFSP.org • www.jedfoundation.org If you or anyone you know is struggling, encourage them to call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) If you have an IMMEDIATE concern about someone’s safety, call 911 IMMEDIATELY! Suicide is a preventable problem! Get the FACTS, gain confidence and have that conversation.

About the organization The Society for the Prevention of Teen Suicide (SPTS) was founded in 2005 by two New Jersey fathers, who each experienced the

Continued on page 34

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TEN STEPS TO PROFESSIONAL SUCCESS

By Maxim W. Furek, MA, CADC, ICADC

Is there a link between success and happiness, and, if so, are successful people happier than those less fortunate?

Anurag Prakash Ray, offers a pragmatic approach, proposing that, “Positive thinking and positive attitude attracts prosperity, peace and happiness. It also exposes us towards the path of achievements and success.”

Although the question is difficult, it has already been answered in varied ways. Defining happiness and success has been just as elusive for graduates from Harvard Business School’s Class of 1963. The list from candidates includes good health, doing what you love, being in a happy marriage, raising successful children, and being totally honest.

What didn’t make their lists is, perhaps, even more significant. Not one saw wealth as the mark of a happy and fulfilled life. In fact, one grad took issue with anyone who would put too high a value on financial success, saying, “Those who persist in believing wealth brings happiness are to be pitied.”

Irrespective of love, sacrifice or pity, success is not cost free.

Success demands faith and courage. It demands dedication and perseverance and it demands a visionary gaze. Luckily, there are concrete steps we can take to assure professional accomplishment, as suggested by the following.

1. Use your imagination. Envision the goal. See your goal clearly and imagine crossing the finish line ahead of the others.

Intelligence, perseverance and good timing are essential elements of success, but as Napoleon Hill declared in his bestselling book, Think and Grow Rich, an initial step towards that goal is imagination. The goal must be envisioned and designed; it must be celebrated and savored. Hill believed that, “You will never have a definite purpose in life; you will never have self-confidence; you will never have initiative and leadership unless you first create these qualities in your imagination … the most marvelous, miraculous, inconceivably powerful force the world has ever known.”

2. Stay within yourself. Don’t look outside for quick and easy answers. No one has the answer to your questions but you. You are the key. You are the guru. Your name is right up there with Deprah Chopra, Echart Tolle, Cardwell Nuckols, Oprah and Wayne Dyer.

The fact that we look elsewhere, in external corners and crevasses, for truth and validation, is a sign of unrealized potential.

3. Don’t limit yourself. You are never finished; your mission is never completed. There is always more to do, to achieve, to accomplish.

Don’t stop. Don’t settle for the top of the mountain. There are other peaks, mountains and summits. The sky is the limit. “Many people limit themselves to what they think they can do. You can go as far as your mind lets you. What you believe, remember, you can achieve,” says business leader and entrepreneur Mary Kay Ash. 4. Discover your purpose. Seek out that which you were meant to be and that which you were meant to do. That process of discovery is the key to happiness. Finding your life’s mission and devoting your life to realizing that dream, is the key to happiness.

Your dream will inspire and catapult you to another realm and what many define as happiness.

Consider the words of Yalom: “The search for meaning, much like the search for pleasure, must be conducted obliquely. Meaning ensues from meaningful activity: the more we deliberately pursue it, the less likely are we to find it. In therapy, as in life, meaningfulness is a byproduct of engagement and commitment.”

5. Accept responsibility. Accept responsibility for the good and the not so good. Stop complaining about the weather, the economy, or the lack of customers. You need to forge through these obstacles, striving towards your goal.

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6. Enjoy the trip. It’s never about the goal. It’s about “living the moment” of the journey and all of the single steps leading to that goal. Take your time. Just keep traveling in the direction that your life’s purpose is taking you. Enjoy your personal journey. Before we find contentment in our successes, we should honestly examine those goals. Sir Edmund Hillary, the 20th century explorer and mountaineer who was the first to reach the peak of Mount Everest (along with fellow climber Tenzing Norgay) proposed, “Human life is far more important than just getting to the top of a mountain.”

7. Find something to say or to sell. Articulate your personal philosophy. Amass a unique body of knowledge, formulate a theory, and write a book. Put your valuable research into a well-defined, well-articulated package. Then go out and market and promote it.

Examples of these marketable philosophies include best-selling books that have been called “transformational.’ This esteemed body of literature includes Stephen R. Covey’s The 7 Habits of Highly Successful People (1989); Dale Carnegie’s How to Win Friends and Influence People (1936); Anthony Robbins’ Awaken the Giant Within (1992) and Og Mandino’s The Greatest Salesman in the World (1968). These “self help” books have changed millions of lives by providing hope, confidence and empowerment.

8. Network. Introduce yourself to the universe. Meet people.

Interact. Enjoy the varied energies of other personalities. Let your passion be evidenced by your direct eye contact and firm handshake. Sell yourself. Let your confidence show through.

9. Celebrate your autonomy. You are a blessed child of the universe. There is nobody else like you. You are different, unique and cut from an extraordinary cloth. You contribute much to the fabric of the universe with your individuality. Child psychologist James Dobson writes, “I have observed that the vast majority of those between 12 and 20 years of age are bitterly disappointed with who they are and what they represent. In a world that worships superstars and miracle men, they look in the mirror for signs of greatness, seeing only a terminal case of acne.”

10. Work hard. Don’t stop. Success does not just happen. There is a tried and true process, a formula leading to success. We rarely hit it out of the park the first time around. Determination and perseverance are key. Take time to reevaluate what goals are really important.

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FOLKS GET HIGH ON LA CIENGA BLVD MORE ON MARIJUANA

By Louise Stanger Ed.D, LCSW, CDWF, CIP and Roger Porter

In an episode of the hit NBC television series The West Wing - a show that follows the day-to-day of a fictional democratic President and his cabinet - the surgeon general makes a remark about marijuana legalization during an online chat. “I can tell you that marijuana poses no greater public health risk than nicotine or alcohol and doesn’t show the same addictive qualities as heroin and LSD,” the surgeon general claims. Without political support from congress, the President on this fictionalized TV Show asks for the surgeon general’s resignation.

At the time of the airing of the episode in the early 2000s, popular opinion in the United States was in line with the president’s move to fire the surgeon general regarding marijuana use and the impact her words had on the public. However, like marriage equality before it, marijuana legalization has turned quickly in the American cultural milieu. In fact, the state of Nevada, which passed marijuana legalization in November, will initiate state recreational cannabis sales on July 1, 2017 according to the Nevada Tax Commission as reported at The Daily Beast. This comes in record time as many other states - seven total and the District of Columbia - have passed similar expansive measures that take years to set-up and regulate. Before long, nationwide legalization may be standing at the doorstep of the Supreme Court.

With the rapid change in public opinion and the onslaught of legalization, it is paramount to understand: the potential risk factors marijuana poses for users; changes in the law related to regulating the drug; and ways parents and health experts, schools and communities can engage in open discourse about this issue.

To begin, marijuana is a mind-altering drug. According to the National Institute on Drug Abuse (NIDA), the main psychoactive chemical in marijuana, responsible for most of the intoxicating effects that people seek, is delta-9-tetrahydrocannabinol or THC. NIDA reports that the “high” caused by THC have other effects, including: “altered senses and time, changes in mood, impaired body movement, difficulty with thinking, problem solving and impaired memory.”

With evident mind-altering effects from using marijuana, researchers and scientists have performed various research studies to understand the long-term effects of the drug on the brain and body. For example, adolescents experimenting with the drug for the first time, may experience negative effects later in life.

A recent study published at Tel Aviv University titled “Cannabis Use in Adolescence Linked to Schizophrenia” found that “smoking pot or using cannabis in other ways may serve as a catalyst for schizophrenia (a disorder caused by an imbalance in the brain’s chemical reactions) in individuals already susceptible to this disorder.” And a recent controversial article published in Great Britain’s the Daily Mail by Dr. Max Pemberton, a British medical doctor, journalist and author, who works full time as a psychiatrist in the National Health Service, links marijuana use to violent behavior.

“Regular use has been found to double the risk of a psychotic episode or of developing schizophrenia,” writes Pemberton.

Back in the United States, where legalization takes hold of new states with each passing election, recent data shows the use of marijuana is on the rise amongst youth in states like Colorado and Washington where it is legal, and is climbing elsewhere as well. A study from Monitoring the Future, an organization that commissioned researchers at the University of Michigan and paid for by NIDA, to look at substance abuse in young adults, found that 51% of college-aged students (19-22) in 2015 used marijuana for the first time, an uptick from 41% in 2014 and shows the highest percentage rate of use in Monitoring the Future’s 36-year-long look at this demographic and substance abuse.

Though usage is up due to legalization and a turn in public opinion,

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lawmakers and government agencies are grappling with a wide range of new products and uses for THC with unforeseen consequences.

Legalization has seen the rise of “synthetics” or marijuana-related products that are synthetically made in a lab. According to a report by the Hazelden Betty Ford Institute for Recovery Advocacy, synthetic marijuana may contain “THC concentrations of up to 80 percent,” which is much higher than average levels in regular marijuana.

Because of this higher potency, the report found that individuals who use synthetic cannabis were “30 times more likely to visit an emergency unit than those who use traditional forms of cannabis.”

The report also looked at a recent study of high school students who use synthetic marijuana, which found an “increased risk for using other drugs such as cocaine, heroin and ecstasy; getting into a physical fight; having unprotected sex; and riding with intoxicated drivers, compared with those who used marijuana only.” And since new synthetics become available in the market each year, it’s difficult for lawmakers to keep up with informing the public of the potentially dangerous effects of these products.

In addition to synthetics, lawmakers are seeing a rise in “dabbing,” the practice of consuming the vapors of marijuana extract, a highly potent waxy substance. This rise in potency has health experts concerned for the effects it has on cognitive function. “Not only is the method of production explosive (the New York Fire Department have reports that link fires to local production of dabbing substances), but the use has serious physical and psychological side effects,” says James J. Hunt, special agent in charge of the Federal Drug Enforcement Administration’s New York division to the New York Times.

So why the shift to dabbing? Not only does the substance contain a much higher concentration of THC for a bigger high (dabbing can have a concentration of up to 80%); it boasts an edge - a new wave - over plain old pot. As one teenager interviewed for the New York Times about dabbing puts it, “marijuana is the beer of THC, as dabbing is to vodka.”

Marijuana legalization is also seeing changes in the law related to drug-impaired driving. Lawmakers are working to maintain safety and protection for drivers on the road as marijuana-related traffic incidents rise. According to the Governors Highway Safety Association report on drug-impaired driving, “in experimental settings, marijuana impairs psychomotor skills and cognitive functions associated with driving, including vigilance, time and distance perception, lane tracking, motor coordination, divided attention tasks, and reaction time.”

As such, the report found that in Colorado, where marijuana has been legal since 2012, “the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive was 4.5% in the first 6 months of 1994, 5.9% in the first 6 months of 2009, and 10% at the end of 2011.” And in California (where marijuana has been Continued on page 32

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MCOs AND MEDICATIONS: CONTEXTUAL FACTORS THAT INFLUENCE PSYCHIATRIC COMORBIDITY ASSESSMENT

By John M. Majer, Ph.D. and Ted J. Bobak, B.A.

Co-occurring psychiatric disorders pose additional challenges for persons recovering from substance use disorders (SUDs). Psychiatric comorbidity (commonly referred to as “dual diagnosis”) involves having a psychiatric disorder in addition to a SUD. Investigations have shown they’re not uncommon though prevalence rates of comorbidities vary across studies due to research factors (e.g., design, methods, scope of inquire). Investigations typically have some limitations, and in psychiatric comorbidity research this would include limiting the scope of inquiry to a number of specified psychiatric diagnoses/ categories, whether participants currently (and/or historically) met diagnostic criteria, identifying matches in terms of substance use type (e.g., alcohol use disorder) to another mental disorder (e.g., major depressive disorder), and assessing psychiatric problem severity regardless of diagnosis. It is likely that empirical investigations and other contextual factors inform clinical assessment to some degree.

For instance, in the United States, managed care organizations (MCOs) were created to ensure the highest quality of care by making treatment providers more accountable in order to receive insurance reimbursement. MCOs grew considerably since the 1980s, resulting in treatment providers having to justify their services on a frequent basis. This provided for a checks and balances system to prevent fraud while ensuring consumers were receiving quality care. However, this ultimately created a system where MCO agents (usually possessing a bachelor’s degree and no advanced clinical training or extensive experience) had significant influence on patient assessment/treatment by informing clinicians what would (and what would not) be reimbursed on a case-by-case basis.

Before long, standards of care and hierarchies of disorders (in terms of what was reimbursed) were established. By the early 1990s, benefits were limited to “carve-out” plans and pre-set conditions imposed by MCOs. Benefits for persons seeking treatment for SUDs had been reduced. Some have argued that the lack of comprehensive services available to those seeking SUD treatment created the “revolving door” pattern of service utilization, including those with psychiatric comorbidity. Unfortunately, controlled studies on the cost, quality, and outcomes for SUD treatment that were sanctioned by a managed care system were absent.

Changes in reimbursement policies implied SUDs (and personality disorders, that no longer were reimbursed by most insurance companies) were not bona fide mental disorders. It didn’t take long for some clinicians to erroneously (or intentionally) look for evidence to suggest patients seeking treatment for SUDs had a “severe mental illness” (SMI) in order to meet the threshold for insurance coverage. In short, a zeitgeist emerged where SUDs were minimized, SMI such as major depressive disorder, bipolar disorder, and schizophrenia was considered more serious than SUDs, and clinicians were looking for signs/symptoms of SMI -that might not have really existed- among their patients.

We (the authors) have worked in various capacities with persons with SUDs since the late 1980s, and have learned anecdotally that many seeking SUD treatment were told things at intake such as, “You really don’t have depression, but I have to mark this down in your chart in order to admit you.” or “We can’t treat you unless you’re hearing voices or feel like harming yourself,” as a way of scripting patients. Likewise, we have observed questionable documentation from patient records (and from colleagues disclosures) in terms of inflated global assessment of functioning scores (under previous DSM systems), diagnostic histories that were incredulous, and the practice of not documenting personality disorders in charts out of fear that doing so would disqualify reimbursement for services.

The implementation of MCOs in recent decades created a contextual backdrop that influenced assessment. We argue that in

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the U.S., persons seeking recovery from SUDs: 1) Have been susceptible to misdiagnosis as a way to pay for treatments; 2) Went through a revolving door system of service delivery because services were not comprehensive as they once were, and in some cases; 3) Were led to believe that they had a co-occurring disorder that didn’t exist. Certainly, some had comorbidity. But others displayed signs/symptoms that intake workers and practitioners suspected (if not hoped) would fit diagnostic criteria for some other-than-SUD disorder to meet managed care thresholds.

There is a dearth of empirical support to guide clinicians in the assessment/diagnostic formulation for this population, particularly in the area of differential diagnosis (i.e., distinguishing the best diagnosis among others that would appear to fit the symptoms).

However, some investigations during the height of MCOs’ influence have implications for assessing persons with SUDs who present symptoms that are truly indicative of co-existing disorders versus those that are substance-induced. In addition, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V; APA, 2013) provides clear criteria for engaging in a differential diagnosis when working with persons who present with substance use. We urge clinicians to be acutely mindful of, and accountable for, signs/ symptoms that suggest the presence of: 1) substance-induced disorders 2) substance/medication-induced mental disorders when assessing persons who present with any recent substance use, including prescribed medications.

Likewise, we question the practice of prescribing medications to persons with SUDs. There must be sound basis to warrant their use, especially medications that have possible psychoactive effects (i.e., altering one’s mood/mind), within the first 30 days of abstinence.

Prescribed “substances” might alleviate some symptoms, but they can and do create other symptoms that have great potential to sustain an erroneous diagnosis. Assessment is suspect when diagnostic symptoms are a consequence of medication.

Medicating patients in their first month of abstinence increases the risk of iatrogenic (healer-induced) psychopathology. Clinicians prescribing medications to persons with SUDs within the first 30 days of abstinence must exercise expert judgment and have strong basis to guide and substantiate this intervention. It is rather interesting that pharmacological interventions have been popularized by marketing strategies while the risk of misdiagnosis has increased over the past couple decades. Nonetheless, clinicians who prescribe medications Continued on page 34

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LIVING BEYOND

A Monthly Column By Dr. Asa Don Brown

MOVING BEYOND YOUR PAST “It is beyond a doubt that all our knowledge begins with experience.” ~ Immanuel Kant Have you ever been confronted with your past? Does your past seem to creep up on you like a thief in the night? For so many, when we are reminded of our past, we are reminded of our perceived failures, mistakes, and problems that have occurred within our life. Rarely are we faced with the challenge of living down our successes and positive achievements. When I speak of moving beyond your past, it is not to deny those errors that have occurred within life, rather, it is to move forward and to live life anew. It is to live life beyond our failures and our successes and to begin living as a person of worth and value.

START ACCEPTING YOUR FAILURES AND SUCCESSES If I were to start a personal list of my past failures and successes; I would need an encyclopedia to list them all. Why then do we keep a running list of our perceived failures and in some cases our successes? Why are you continuing to be defined by historical markers in life? For who you are is much more than those perceived markers that line your virtual roadmap. After all, our failures and mistakes are simply learning curves on our journey of life.

Moreover, we need to begin learning to accept our person beyond our perceived failures and mistakes. Have you ever encountered an individual who is constantly dwelling on the past? How does or how did this individual make you feel? Interestingly enough, I have seldom met an individual whose focus is on their successes, yet when I did, they seem to be living in that moment on a constant basis. Many years ago, I met an individual who had been a success in a professional sport. Over the years, this particular individual was constantly reminding me and others how successful he had been. This individual seemed to rely on his achievements for recognition and personal acceptance. Eventually, this individual would discuss with me that he felt stuck in the past and was unable to move forward with his life.

I have also had the privilege of serving individuals who have overcome major addiction. As a clinician, I have had a number of patients who struggle with letting go of the past. Sadly, I have also witnessed a number of these individuals struggle with defining themselves as an addict, rather than having an addiction. Unlike physiological health issues; those who struggle with mental health challenges are often defined by the diagnosis or the causation of their struggles. Thus, it is vitally important that you begin recognizing that you are not an addict, but rather, you have an addictive habit or disease. Just like a physiological disorder, you are no more a cancer or a broken limb, than you are an addict.

There are also those who refuse personal responsibility. When someone is denying involvement in a perceived failure or wrong; the motivational mechanism to deny such involvement is cognitive dissonance. Cognitive dissonance is the state of having inconsistent or inaccurate beliefs, thoughts or attitudes of his or her past. For many, cognitive dissonance occurs when they refuse to accept responsibility of one’s personal past. “Dissonance is most painful when information crashes into our view of ourselves as being competent, kind, smart, and ethical—when we have to face the evidence that we have made a bad mistake.”

REFUSE TO BE DEFINED BY YOUR FAILURES OR YOUR SUCCESSES For anyone trying to live up to his or her successes or failures, they will always be looking to the past. Our failures and successes are the same; they are merely mile markers on our historical roadmap and are not representative of our real person.

For how many people have you known that have made profound mistakes? Do they allow the mistakes of their past to define them?

As a person, you must begin to value and cherish the internal you.

For whom you are goes well beyond the historical markers in this life. For you are a person of considerable worth, value, and ability.

If you want to truly experience life, you must begin moving beyond the successes and failures of this life. Yet, I want to clarify that living beyond your past does not eliminate the scars left behind, or your personal responsibility in this life. Moreover, I am trying to express that no one should be defined by those markers, rather they should be recognized by their current personhood.

MOVING BEYOND THE CONCEPTS OF YOU “Live out of your imagination, not your history.” ~Stephen R. Covey What is it about your past that you are so attached to? Do you find comfort in your past? Do you feel that you can never live down your past therefore you have chosen to embrace it?

Did you know that living and reliving traumatic events can have a dire effect upon your psychological health and well-being? Did you also know that living and reliving your past can literally alter the physiological makeup and networks within your brain? Why then, are you continuing to provide a stage for those historical markers to perform? It is of vital importance that you begin moving beyond your historical self.

MOVING BEYOND “Life is too short to waste any amount of time on wondering what other people think about you. In the first place, if they had better things going on in their lives, they wouldn’t have the time to sit around and talk about you. What’s important to me is not others’ opinions of me, but what’s important to me is my opinion of myself.” ~ C. JoyBell C. For while our failures and successes help mold us, they should never be allowed to define us. For who we are, is much more than perceived errors; for who we are, are people of value, of substance, worth, dignity, and approval. Our experiences help mold us, guide us, and provide us significant knowledge to maneuver in this life.

When you begin thinking upon your past, remember to consider them nothing more than historical markers in this life.

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

Personally, I comprehend the rationalization of separating myself from my past mistakes. I too have felt compelled to be seen in a particular light, but it was not until I realized that accepting my failures and successes, is accepting my humanness and uniqueness in this life. I am neither compelled, nor should I be compelled to be defined by those historical markers in life. For after all, those historical markers are simply pinpoints within our life. Our historical markers should never define our personhood.

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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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CODEPENDENCY AND ADULT CHILDREN

By Jacqui Jarzab EdD, LMHC, CAP and M.K O’Regan MS, MCAP

There is no consensus for the definition of codependency. The concept has been evolving over the past several decades from the self-help culture to the treatment industry. Some people find the use of the term codependency enlightening. However, lack of agreement on the definition and overgeneralized use of the term has caused some to determine that codependency is not a legitimate concept; they completely object to its use. How someone develops codependency can be a mystery. Codependency may emerge in the family of origin or adulthood. Another confusing factor is that many chemically dependent individuals are also codependent. So don’t worry if you are confused. You are in good company.

M.K. O’Regan developed a succinct and practical working definition of codependency early in her career as a counselor for chemically dependent individuals and loved ones. It was necessary to develop a pragmatic definition which appealed to clients who were identifying issues of codependency for the first time as well as those with previous knowledge. This working definition is: “Codependency is when I focus so much on another person, I lose the ability to take care of myself.”

There are several advantages to this brief working definition: • The essential problem is defined: A person’s attention is hyper-focused on others. They cannot focus on themselves long enough to discover their true thoughts and feelings.

• A solution is implied: Flexibility of focus allows a person to focus on self, in order to do the “Feel, Deal, and Heal” work required of recovery.

• The definition is skill based: Flexibility of focus is an essential skill in recovery. A person must know where his/her attention is, on self or on other.

• The definition is constructed as an “I statement”: Many people are skilled at focusing on others and overuse “You statements”. Use of the first person singular, I, clarifies exactly where the focus is.

• The definition is not black and white. Ask an addict if they have had a good day and they will answer according to whether or not they used, Yes or No. Ask a codependent the same question and the answer is not so simple. They may know what their loved one’s day was like, but be oblivious to their own conditions.

There are many behavioral styles of codependency. The common thread linking them together is that some developmental or relational need has not yet been met. This may lead to unresolved fear, and shame based psychological, social and spiritual problems. A recovery program such as the 12 step programs of Al-Anon, Alateen, Adult Children of Alcoholics and Other Dysfunctional Families (ACA), and Co-Dependents Anonymous (CoDA) address the holistic nature of the healing. Recovery is acknowledged as a process, not an event.

The rewards of recovery are transformational. As often stated in the 12 step rooms of recovery, “We learn to live life on life’s terms.”

Al-Anon, the 12 step program for family and friends of alcoholics founded in 1951, identified two of the family system roles- the Chemically Dependent person and the Enabler. Al-Anon describes an enabler as someone who becomes over responsible for the progressively under responsible alcoholic. Typical behaviors of the Enabler are fix, rescue, protect, control and hyper-focus on the alcoholic/addict. Al-Anon does not use the label codependent. The term had not yet been created when Al-Anon was established.

Family System theorists expanded the understanding of codependency as they compiled information about children of alcoholics. Children of alcoholics exhibited certain characteristics as a result of living with overwhelming stressors. Raised with the spoken/ unspoken rule of a dysfunctional family system of “Don’t Talk, Don’t Trust, Don’t Feel”, the children took on specific survivor

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roles in the family system. Trapped in their roles, children of dysfunctional families learn to stuff their feelings. Unless the child is fortunate enough to experience a therapeutic intervention, the problems associated with stuffed feelings are compounded during adolescence and adulthood.

Added to the roles of the “Chemically Dependent” and “Enabler” are the: “Hero”, “Scapegoat”, “Lost Child” and “Mascot”. Despite differences in outward appearances, all the roles have something in common. Due to stuffed feelings of fear and shame, each of these types of children are hyper- focused on the external world.

The Hero child becomes aligned with the Enabler and learns to be over responsible. They become experts at getting positive attention. Hero children exercise a high need to control in order to feel safe and cope with their fear of failure. These children become the family’s socially acceptable representative to the outside world and are high achievers.

The Scapegoat child does not compete with the Hero Child for positive attention. They become experts at getting negative attention. They are rebellious and frequently get into trouble. The role of these children is to be the new family problem. They take the focus off the adults’ dysfunction.

The Lost child appears independent and learns to survive by becoming virtually invisible.

They become experts at getting no attention.

However, avoidance is not autonomy. These children require little of the family’s already limited resources of attention. As one mom said, “That’s my no sweat kid!”

The Mascot child breaks up the tension in the family.

They become experts at getting positive attention.

These children have an unusually well-developed sense of humor and provide distracting entertainment to the family. Despite a high level of sociability, the Mascot desperately requires approval.

Adult Children are adults who internally carry the dictates of their childhood roles, “Don’t Talk, Don’t Trust, Don’t Feel”. A person who has chronically focused on others, has stuffed their own emotional energy.

However, recovery is possible. For instance, once the codependent gains some recovery skills, they realize the value of identifying their own feelings. Dealing with feelings is a big deal! Feelings are E-motions, energy that needs to move. Recovering codependents learn to move emotional energy rather than stay stuck in old feelings.

Recovering codependents have learned, “Do Talk, Do Trust, Do Feel”. Self-worth improves and authentic relationships with themselves and others blossom. CoDA (coda.org) identifies 12 promises for the recovering codependent. Three of these are: • “I overcome my fears and act with courage, integrity and dignity.”

• “I am capable of developing and maintaining healthy and loving relationships.”

• “I gradually experience serenity, strength, and spiritual growth in my daily life.”

The definition of codependency is still nebulous, however, it is amazing how many lives are saved and improved due to recovery from codependency.

Jacqui Jarzab EdD, LMHC, CAP began her career as a hypnotherapist for the systemic desensitization of early trauma. As an Adult Child she began recovery through the Anon Anew treatment center. She remains passionate about 12 Step recovery work.

M.K O’Regan MS, MCAP began her career after completing the Chemical Dependency Counselor Trainee Program at Hazelden in Minnesota. She has a private practice as a Life Coach and conducts psychoeducational groups at her office in Jupiter, Florida.

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HOPE FEST HOPES TO RAISE MORE THAN AWARENESS TO FIGHT THE OPIOID EPIDEMIC A communal sober rally is scheduled for Sunday, September 10, 2017 in Lakeworth, Florida

(kosher) will be available on-site for purchase. All proceeds will go to benefit those affected by the opioid crisis.

Fort Lauderdale, FL, May 18, 2017 - Spark of Hope and Partners in Hope are organizing a community rally to promote positive action and awareness on the opioid epidemic. This one day gathering will be the first of its kind as it seeks to bring together a local as well as national panel of experts, lecturers, artists, musicians, volunteers and concerned citizens whose collaborative efforts would hopefully curtail and eradicate the heroin opioid crisis that has killed scores of young people in our country.

When: Sunday, September 10, 2017 9 am to 9 pm RSVP/Sponsorship/Volunteer/Inquiries: Info@sparkofhope.net or call toll-free (844) 398-9204

“The timing couldn’t be better,” said Gina Beckwith, Director of Public Relations for Spark of Hope. “As we were gearing up to promote this rally, Governor Scott just declared opioid abuse a public emergency in the state of Florida.” Beckwith hopes the rally will create more than just awareness. “We need action, whether it’s through legislature or the community. Too many deaths have occurred and talking about the epidemic simply isn’t enough.”

For more information or to purchase tickets to the event, please visit: www.hopefest17.com

The rally will take place at a 20-acre campground in Lakeworth,Florida. It is scheduled to feature live music, motivational speakers, meditation, AA/NA meetings, team-building activities, vendors, raffles, prizes and much more.

“We are inviting everyone to take part in this unprecedented event,” said Meegan Evans, Clinical Supervisor for Spark of Hope. “We are sick and tired of reading the tragic headlines and negative statistics on this dreaded epidemic. Our goal is to create positive action through positive outreach. Hence, this is why we call it Hope Fest.”

Tickets for Hope Fest are $15 per person. Parking is free and food

To Advertise, Call 561-910-1943

Where: 7495 Park Lane Road Lakeworth, FL 33449

Donate: http://www.sparkofhope.net/partners-in-hope/ About Spark of Hope Spark of Hope is a newly licensed outpatient substance abuse treatment center located in Margate, Florida.

About Partners in Hope Partners in Hope is a 501C3 non-profit organization established to help those suffering from substance abuse with vital treatment and social services.

For more information or to donate, please call: (954) 590-8363 Contact Information Spark of Hope Gina Beckwith Director of Public Relations (954) 590-8363 ext. 14 www.sparkofhope.net Ginab@sparkofhope.net

23

THE LEGAL CORNER FLORIDA DUI LAWS AND PENALTIES

By Myles B. Schlam, Esq., CAP

Penalties for a DUI in Florida Pleading guilty or no contest to the crime of Driving under the Influence in the State of Florida has statutory minimum mandatory penalties that must be imposed by the court. That means the lawmakers up in Tallahassee have decided to take away some of the discretion of the Miami-Dade, Broward and Palm Beach Courts in determining what sentence to give to someone pleading to or found guilty of Driving Under the Influence. Note that these are minimums for a Florida DUI conviction. The Court can impose more; in fact, for a DUI, the court can impose jail. However, understand that these Florida statutory minimums are required only when convicted of a DUI. If the DUI attorney negotiates a reduction of the charge from a DUI to, say, reckless driving, then the minimum mandatory penalties do not apply. If the DUI attorney negotiates a dismissal of the case, then the penalties do not apply. If the DUI attorney wins the case at trial, then the penalties do not apply.

Below I have listed the possible penalties associated with a DUI conviction in the State of Florida.

Possible Jail Time A standard first time DUI conviction can result in up to 180 days in the county jail. If the blood alcohol level was over a .15, or if a minor was in the vehicle at the time of the incident, then the maximum jail time is increased to 270. If there was damage to another person or his property, the maximum jail time is 365 in the county jail. A second DUI conviction is punishable by up to a year in jail. A third DUI conviction within ten years of a previous DUI can be a felony if the prosecutor so chooses, and is punishable by up to five years in prison. A fourth or subsequent DUI conviction is also punishable by up to five years in prison.

For a first time DUI in Florida, the prosecution oftentimes does not seek jail time. However, when there is an accident involved, or some other aggravating conduct by the defendant, the prosecutor may seek a term of incarceration as part of the sentence for the DUI. For a second time DUI conviction in Florida that is within five years of a previous DUI conviction, there is a minimum of 10 days required in the county jail.

A third time DUI within 10 years of a prior DUI conviction in Florida requires a minimum of 30 days in the county jail.

Fines and Court Costs The fine for a first time DUI in Florida is between $500.00 and $1000.00. If a .15 or higher blood alcohol content is obtained, or there is a minor in the car, then the fine is between $1000.00 and $2000.00.

A second DUI conviction within 5 years of a previous prior DUI conviction will result in a fine of between $1000 and $2000. If there is a .15 or higher BAC or a minor in the car, then the fine is between $2000 and $4,000. A 3rd DUI conviction or more will result in a fine between $2000 and $5000.

Probation and cost of supervision A DUI conviction will often include a probationary term of up to one year for a misdemeanor and five years for a felony. Cost of supervision while on probation is not cheap; usually 50-60 dollars a month during the period of probation. The other penalties of the DUI conviction, like the DUI School and the fines, are considered conditions of the probation. If the conditions are not completed while on probation, the probationer can be violated. If violated, the probationer could face up to the entire term of incarceration that he was facing before he was put on probation. For a first time DUI, that means violating probation could result in up to 180 days in the county jail.

Ignition Interlock and Impoundment The ignition interlock is another costly condition of probation that

24

might accompany a DUI conviction. Specifically, a first time DUI conviction with blood alcohol content of over .15 will result in a 6 month ignition interlock requirement. A second DUI conviction in Florida with blood alcohol content over .15 requires 24 months of the ignition interlock device. In Miami-Dade, Broward and Palm Beach counties, the device is roughly $200.00 to install, and has a monthly service fee of between $50.00 -100.00. Note: The interlock device is required even if you do not own a vehicle!

Just the other day, a Judge in Broward stated on record that this requirement never made sense to her. A lot of judges have stated the same, but the legislature has made it statutory.

Any second or subsequent DUI conviction in Florida will result in the impoundment of the vehicle, unless doing so would be a hardship to the family of the driver. There are exceptions that may apply if the vehicle is operated for business purposes.

Driver’s License Suspension Even though the Florida DMV has likely already administratively suspended the license after the arrest, a DUI conviction results in a separate and distinct driver’s license suspension. On a first DUI conviction, the court will order a 6 -12 month license suspension. A second within 5 years of a prior DUI conviction will result in a five year suspension. A third DUI within 10 years of any one prior DUI is also a minimum of a five year driver’s license suspension. A third DUI within ten years of convictions for any two prior DUI’s in Florida is a ten year suspension. The fourth conviction is a lifetime Florida license revocation.

The driver is eligible for a hardship license immediately on a first time DUI if the DUI School is complete. On a second DUI within 5 years of a prior conviction, the driver is eligible for a hardship license after 12 months. On a third conviction within 10 years of a prior DUI conviction, the driver is eligible for a hardship license within 12 months. On a third, within ten years of two previous prior DUI convictions, the driver is eligible for a hardship license after 24 months. On a fourth DUI conviction, no possibility exists for a hardship license.

DUI School Every Florida DUI conviction will require DUI school. The first conviction will require Level 1 DUI School. A second or subsequent DUI conviction requires multiple offender school. Any substance

Continued on page 34

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SCHLAM LAW, P.A. ď€ ď€‚ď€ƒď€„ď€…ď€†ď€ƒď€„ď€‡ď€ˆď€‰ď€Šď€†ď€‹ď€‡ď€…ď€‰ď€Œď€†ď€?ď€‰ď€†ď€‡ď€ ď€Žď€?ď€?

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When you're in a jam...better call Schlam!

• Misdemeanors • Felonies • Marchman Acts*

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MYLES B. SCHLAM, Esq.

Attorney and Counselor at Law Certified Addictions Professional**

95 4 - 8 0 4 - 6 8 8 8 Myles@SchlamLaw.com www.SchlamLaw.com

Serving all counties in Florida* Based in Palm Beach county *by appointment only. subject to advance notice and approval. **Certification through the Florida Certification Board not the Florida Bar.

To Advertise, Call 561-910-1943

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25

THE OTHER SIDE OF THE COIN

By Dr. Alison Tarlow

The reputation of South Florida drug treatment has now spread across the globe. Whereas before, the recovery mecca known as Delray Beach was a little known fact to, well, many residents of Delray Beach. The epidemic-like proportions of opioid-abuse, as well as overdose and death, and the abundance of treatment centers and “sober homes” have catapulted our once serene oasis for sobriety into a den of iniquity. The media are feverishly covering stories of insurance fraud, scam-artists, and everyone from doctors to barely-qualified “recovery coaches,” who are being blamed for taking advantage of families and their loved ones when they are in their most vulnerable state. As if families were not paralyzed enough by the fear of opioid addiction gripping onto their beloved kin; now they have to question every relapse, every new treatment center, and every new halfway house, over and over again. And I say this because the relapse rates for opiate addiction are both astounding, and incredibly demoralizing. The bad news is that the chances of a “one and done” treatment experience with opioid addiction are low.

The good news is that research has determined that treatment can and does have a cumulative effect, meaning that being in treatment any number of times does not negatively correlate with the chance of long-term recovery. In fact, statistics tell us that the opposite is true: more treatments, and longer treatment stays, are both positively correlated with the ability to sustain long-term sobriety.

So what is the other side of the coin? The other side is the one that touts hundreds upon thousands of people whose lives have been saved because of the treatment and concomitant recovery support that they found in South Florida. Not only are there some of the best national and international treatment programs located here, but there are also leading doctors, pharmacologists, and evidence-based interventions. From CBT to DBT to MAT (we treatment providers love our 3-letter acronyms); we also work tirelessly to develop industry standards that are soon followed by other states. We have task forces and state laws in action, and we are a trailblazing state for addiction treatment laws around the country. We are a hub for state-of-the-art conferences, and people from around the nation and the world come to Florida to attend our educational programs to receive the most upto-date information in the field of substance abuse and treatment.

If we take a look back, we can see why Florida has become so infamous for substance abuse, treatment, and recovery. In 2010, Florida was considered the pill mill capital of the country. In 2012-2014, the pill mills and pain management clinics were regulated and closed down by the DEA. Addicts were no longer able to buy pills like Oxycontin so readily and cheaply. Supply and demand drove up the costs of the highly-abused narcotics, and so heroin became the cheaper and more accessible way for the addict to get their fix. And gone were the days of the “street junkie.”, now, opiate addicts were coming from all walks of life; suburban kids, housewives and business men. Between 2012 and 2017, heroin made a massive comeback but now the drug is frequently being mixed with Fentanyl, a synthetic opioid used for surgical anesthesia.

This mix has produced a much greater risk for overdose and death, and the drug combination is the number one killer of young people across the United States. In reaction to this, South Florida recovery facilities began to rise. What began as the few and the reputable programs in South Florida soon became as common as Starbucks... practically one program or recovery house on every corner. There was, by all accounts, a treatment boom. It was not so different from the mortgage crisis, in which an economic boom brought out the crooks looking to scam and make a fast buck. It seemed that there was money to be made off the people seeking treatment, and so just like every other industry boom that has unfolded in the history of our country, the bad guys started to emerge among the good guys, to see how they could economically, and perhaps even literally, rape those most vulnerable, who were seeking treatment to save their lives. And so the dirty side of treatment began to rise to the surface, and the Megan Kelly’s of the media decided to cover the issue from its most ugly angle. Let’s face it: the world loves a story, and the seedier, more “under-belly” version, all the better.

26

Permit me please to share a short anecdote: In the early 2000s, I worked for a renowned women’s eating disorder facility as a lead psychologist. We were approached by an award winning photographer who was looking to shoot a documentary film on Eating Disorder treatment and recovery. The director spent many months shooting at the facility, and many more months editing and producing the film.

The film was met with critical acclaim, and went to the Sundance film Festival in 2006. My first awareness regarding the approach to this film came to me when the producers were looking for several main characters to follow in treatment. These personalities, we were told, needed to be raw, gritty, and heart-wrenching. The protagonists of the film had to be suffering and struggling, and the more unmanageable their symptoms and behaviors, the better. Although I realized it was a documentary, rather than a fictional tale, it was clear that the filmmaker was not seeking out a happy ending. Of course, it was not supposed to be a fairy-tale. The most compelling individuals - the lost souls - were sought out for the film. By the time the editing was complete, most of the scenes that remained demonstrated the harshest aspects of treatment, and the most demoralizing of outcomes.

Was this an accurate representation of what we did each and every day to help these women who are struggling with a life-threatening illness? Was this an accurate representation of professionals working in treatment, individuals seeking recovery, and treatment outcomes?

No. What would have been a more accurate representation would not have made the Sundance film Festival, nor would it have made for a massive HBO documentary following. In fact, two years after the film was made, one of the characters died. The producers went back and added a line to the end of the film, informing viewers of this tragic, final outcome. Heart-breaking-yes. Compelling- absolutely. What you don’t get to read is the follow up on the two other main characters, both of whom went on to develop full lives, including a family, professional success, and overall health and happiness- despite any struggles they had to overcome.

And so, back to the other side of the coin; what about the success stories that have sprung from the hub of recovery in South Florida?

Well, truth is, there are simply too many to discuss. There are thousands of people filling up the meeting rooms of NA/AA/ and various other “A’s” around Dade, Broward, and the Palm Beaches.

Many of these people gain years of clean time and then get jobs helping others in recovery. These are people who go back to school and complete their degrees. These are people who are allowed back into their family homes, lives, and hearts. These are the people holding out their hands in sponsorship or support to addicts who are new to recovery. These are bosses giving jobs and 2nd, 3rd, and even 4th chances to young people who are desperately trying to turn their lives around. These are people who extend their hands and their hearts to those family members who were not so fortunate on their journey to recovery, and say with humility, “There but by the grace of God, go I.” The good news is that, with focus on the South Florida treatment industry by the Federal Government for the past few years, many Continued on page 30

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CERTIFIED RESIDENCES

YES, YOU CAN BE MORE EFFECTIVE! What if it’s our own lack of knowledge that’s responsible for the poor treatment outcomes we are continuing to battle? We have all heard how genetics and biology play a role in chemical addictions, but do we really understand it? Do we really understand the significance of these findings? And if so, what is being done about it? How do you apply it?

When I got into this field, I felt very uncomfortable and quite ill-prepared about treating an illness we know very little about.

Addictions have been around for thousands of years, and although our attitudes towards those with addictions have improved tremendously, our approach to treating this illness has not really changed all that much. For the most part, we are still relying on our own, and very individualized, common sense.

Don’t get me wrong, our theories are wonderful, and they do make good sense, but don’t they all seek to unravel the truth behind why some people develop addictions and others don’t? Are they not a search for answers? What if the answers we have been looking for, all these hundreds of years, can be found right here in the science we have now?

This book will challenge your beliefs and help you to bridge the gap between science and treatment. In doing so, it will arm you with the knowledge and confidence it takes to be more effective. There are no miraculous cures here, but science has provided the answers we need to take treatment to the next level and propel us into the future.

Science is changing how we view and address chemical addictions, so don’t be left behind. Visit my webpage at: www. theafflictionofaddiction.com and order your copy now. This is my gift to you. The time is ripe to reap the rewards of all our untapped knowledge. Change is in the air and the future is upon us! Welcome to the 21st Century!

www.theafflictionofaddiction.com To Advertise, Call 561-910-1943

27

From The Hearts of Moms SENIOR ADDICTION “HOW DO WE KNOW IF OUR PARENTS HAVE A PROBLEM?”

By Suzanne Wachtel, LCSW

We worry about our children, we commit our lives to helping our kids recover and reclaim their lives. I’ve written many articles about the pain and struggles surrounding a child with addiction. From loving them to dealing with their death... addiction has taken a very large place in our family dynamics.

When we parent an addict, it consumes us, debilitates us and breaks the bank emotionally and financially! With that being said, most families are not discussing the hardship of an elder in the family suffering with addiction. From mood swings, to sadness to extreme anger… seniors are dealing with addiction big time! Doctors have been prescribing opiates for pain to seniors without hesitation over the past 15 years. Leaving us now with mothers, fathers, uncles, and aunts suffering from addiction with all of the trimmings!

Most families have been noted as having said “they are old, let them get wasted” attitude. There are specialty rehabs for seniors suffering from addiction with a very low number of clients. Most seniors are addicted to pain medication, oxycodone, Percocet etc.… and Xanax, Klonopin and other highly addictive medications that doctors have prescribed for decades without a second thought.

Now that so many doctors are under the microscope for over prescribing highly addictive, dangerous drugs, seniors are having trouble getting refills on their prescriptions. These seniors that had no idea they were addicts, are facing withdrawal, dope sickness and have no idea what is going on. Many seniors in pain are being turned away and being told that they can no longer fill their prescriptions, without going to detox, without understanding that these medications that they rely on are red flagged and under scrutiny.

I work with a family whose father is 78 years old. He has had 3 spinal surgeries over the past 8 years and has been prescribed pain medications for years. He has been and continues to be in chronic pain, so the doctors continued to prescribe pain pills and Xanax the

28

entire time. He, to this day denies that he is a hard core addict and never was told that he was becoming addicted to the medication he became dependent upon.

Suddenly, this elder, was facing the reality that his addiction to pain medication was so advanced, that no doctor would prescribe more than 10 pills at a time, after he had been getting more than 120 pills at a time!

He went into withdrawal; depression, pressure drops (50/102), sweats, diarrhea, vomiting, shaking and severe mood swings. The family had no awareness that this was withdrawal from opiates (same as heroin) and that these were serious drugs. Not detoxing safely (in a medical environment) could in fact kill him!

Many of our seniors are addicts and have no idea. Neither do their families…

Please be aware that this is a huge growing epidemic and talk about it.

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.

Suzanne can be reached at http://therapy-boca.com/ or at Swachtelcsw@gmail.com

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IMPORTANT HELPLINE NUMBERS

A New PATH www.anewpath.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

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

954- 463-9005 STIRLING ROOM 954- 430-3514 4TH DIMENSION CLUB WWW.4THDIMENSIONCLUB.COM 954-967-4722 THE BOTTOM LINE 954-735-7178

29

THE OTHER SIDE OF THE COIN

By Dr. Alison Tarlow

illegitimate operations have been found out and shut down.

Furthermore, the pop-up programs and sober homes looking to make a fast buck, with minimally-trained and experienced staff, have folded. Key scammers have been arrested, tried, and sentenced, leaving room for the legitimate, professionally-run, morally and ethically-guided programs to remain. South Florida has been under the spotlight, and therefore, if you find the right people, and ask the right questions, you can and will find wonderful treatment facilities and sober homes that have every intention of helping your loved one. These programs offer empirically-based treatments, and with highly-trained professional staff. These facilities have master’s level clinicians, doctoral level clinical directors, and psychiatrists who specialize in addiction medicine and medication-assisted treatments.

These are programs that are accredited by both state and private agencies, in order to maintain the best possible standards of care and treatment. These are professionals most concerned with saving lives, who will do what it takes to help those who demonstrate that they truly want the help. Years of training and experience in this field allow these professionals to know and understand the difference between those who are just treatment surfing, and those who are really there to save their lives. We know that chances can’t just happen once or twice, but that sometimes to really “get” recovery, you might have to go a few times around in treatment, or more.

We know that it can be hard to put your finger on what makes that difference; that “a-ha” moment when the light-bulb goes on, or the spiritual awakening occurs, or the God Moment happens. It could come from a process-oriented group, a psycho-educational tool, a talk with a behavioral health tech who has 3 years clean and understands exactly the struggle it takes to remain in treatment and

Continued from page 26

complete the program. It could be from opening the Big Book and reading a paragraph that resonates. And maybe it is from hitting the bottom and feeling sick and tired of being sick and tired. Whatever it is, it happens, and it happens in South Florida – at our treatment centers, at our sober homes, and at our 12 step meetings. There are passionate, ethical professionals in South Florida, and we are willing to guide you as to what is in the best interest of your loved one. We will be at the task force meetings to be sure we understand the laws, and speak up about what changes we believe are necessary for the betterment of the community. We are on the front lines, working 24 hours a day, 7 days a week, to prevent another overdose and death from happening. We rejoice when we learn that a client who came to South Florida for treatment two years ago, just picked up their 2-year medallion back in Colorado, and another picked up 7 years after coming to South Florida for treatment from Charlotte, North Carolina, and never went home again, but instead remained here to get educated and give back to the recovery community. We cry when we learn that we have lost a battle and feel devastated, and then have to get back up again, and go back into the fight; for it is a war on addiction, and we are the soldiers. And for every media horror story, there are countless success stories. And every day, there is hope.

And that, my dear readers, is the other side of the coin.

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the states of Florida and Pennsylvania. She is also a Certified Addictions Professional, and Florida Supreme Court Certified Family Mediator.

She is Clinical Director of Holistix Treatment Centers, including Holistix Margate, and The Detox Center, West Palm Beach.

Keynote Speaker Steve Ford For registration and more info, visit FoundationsEvents.com

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FOLKS GET HIGH ON LA CIENGA BLVD MORE ON MARIJUANA

By Louise Stanger Ed.D, LCSW, CDWF, CIP and Roger Porter

Continued from page 14

decriminalized since 2011) the research shows that “there was no change in THC positive driving among weekend nighttime drivers, but there was a significant increase in crash fatalities involving cannabinoids.” Still, since much of this research is new and legalization is in its infancy, the writers of the report qualify their findings with: “for many drugs the relationship between a drug’s presence in the body, its effect on driving, and its effects on crash risk are complex, not understood well, and vary from driver to driver.”

Even though impairment from marijuana use alone on drivers can be difficult to decipher, what is known is that drug combinations (such as marijuana with alcohol) is particularly risky. The Governors report found that the combination of marijuana and alcohol “dramatically impaired driving performance” and that “use of alcohol and marijuana together produces significantly higher blood concentrations of THC than just marijuana use.”

Despite these alarming trends, public opinion in favor of marijuana use continues to rise. “The percentage of adults and adolescents who believe regular use of marijuana poses ‘no risk’ tripled from 5% in 2004 to 15.3% in 2014,” reports the Substance Abuse and Mental Health Services Administration (SAMSHA). As such, it may take quite some time before researchers and clinicians, lawmakers and educators can inform the public enough to create an awareness about the changes marijuana legalization is having on its users.

Though there is controversy surrounding this issue, researchers on the matter explain, “we believe strongly in the paramount importance of educating the public about the dangers and potentially addictive dynamics of all drugs, including marijuana.” On the flip side, though researchers who authored the Hazelden Betty

Ford Center white paper on the topic “oppose the use of marijuana as a “medicine” unless it has been approved by the U.S. Food and Drug Administration (FDA), we still understand the cannabis plant has some medicinal qualities and support further research.”

Therefore, it is up to our communities to raise awareness, ask questions, and be proactive about voicing concerns that come out of the administration and distribution of such a drug.

As America wrestles with the changing landscape of marijuana use, informing the public is a top priority for many. Dr. Amelia Arria, Associate Professor and Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, is at the forefront of doing just that. She urges researchers to “look at patterns of high-potency cannabis and new routes of administration so we can more thoroughly understand the impact of marijuana on our society.” Public campaigns - such as the ones used to raise awareness about drunk driving and the health risks associated with nicotine in cigarettes seen in the 1960s and 70s - may be the best way to keep our roads and communities safe.

Dr. Louise Stanger - speaker, educator, clinician, and interventionist - uses an invitational intervention approach with complicated mental health, substance abuse, chronic pain and process addiction clients.

Her book Falling Up: A Memoir of Renewal is available on Amazon and Learn to Thrive: An Intervention Handbook on her website at www.allaboutinterventions.com.

Roger Porter has marketing and filmmaking degrees from the University of Texas at Austin. He works in the entertainment industry, writes screenplays and coverage, and when he’s not doing that he tutors middle and high school students.

COMPREHENSIVE AFTERCARE IS ESSENTIAL TO RECOVERY

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

Continued from page 6

have a second brain in our gut that, among other things, influences our behavior. Nutrition plays a major role in the health of our gut.

Combine all of this with a western diet full of processed foods, GMOs and calories but low in nutrition and you have a recipe for relapse.

Comprehensive aftercare programs are in front of this. They will have an Amino acids (the precursors to neurotransmitters a.k.a. our ‘happy brain chemicals’) therapy that will restore balance in the brain chemistry. In addition, they will teach addicts nutritional basics and make recommendations for supplements that you just cannot get through food.

Exercise has been a pet peeve of mine for quite some time. I cannot stress upon you just how important exercise is – regardless if you are an addict or not – for both your physical and mental health. Take a twenty-minute walk; go for a bike ride or a long swim.

You will notice a change immediately. You’ll feel lighter on your feet and clear minded. Good aftercare programs will provide some form of daily exercise while furnishing a tailored plan that an addict can take with them and apply throughout their life.

challenges. Yet due to forces outside of their control and through no fault of their own, treatment centers can struggle to meet the new challenges and provide addicts with everything they’ll need for a successful recovery.

There is a mountain of scientific evidence that tells us that the longer a person stays in a treatment environment the more likely it is that they will have a successful recovery. We know this to be true and why comprehensive aftercare programs have become essential to successful recoveries. These programs not only reinforce what has been accomplished in treatment but also pick-up where they left off. They provide the tools and a strong foundation for a sustained recovery.

Most comprehensive aftercare programs are based in the 12 step program and include a spiritual and emotional growth component.

They may also include life skills training to help addicts find jobs and patch up broken or damaged relationships with friends and family.

John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Aftercare Recovery Center,’ 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 Beach 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 websites:

Addiction has evolved. In the last twenty-five years addiction has taken on a whole new face constructed with new and more difficult

www.HolisticAddictionInfo.com

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www.PreventAddictionRelapse.com

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DON’T BE AFRAID TO SAY THE “S” WORDTALKING TO KIDS ABOUT SUICIDE

By Phyllis Alongi, MS, NCC, LPC, ACS

Continued from page 10

devastating loss of a teenage child by suicide. SPTS firmly believes that accessible, quality education and public awareness about teen suicide can save young lives. The core values that define SPTS and its founding board have a passionate commitment to the value of life, belief in the effectiveness of evidence based suicide prevention strategies, dedication to removing public stigma about suicide and conviction that accurate information and education about suicide can save lives. The mission of SPTS is to reduce the number of youth suicides and attempted suicides by encouraging public awareness through the development and promotion of educational training programs. SPTS offers a variety of resources on its website that can be downloaded and duplicated at no cost. For more information on what you or your community can do to help prevent suicide please visit us at www.sptsusa.org.

Phyllis Alongi is the Clinical Director of the Society for the Prevention of Teen Suicide. She is a Licensed Professional Counselor and has numerous years of counseling experience with children, adolescents and adults in both partial care and Intensive outpatient settings. She is a former educator with over 10 years of teaching experience. Phyllis is in private practice in Brielle, NJ. Phyllis conducts suicide prevention training to schools, agencies and community organizations nationally. Phyllis is proud to share in the vision of such a meaningful and dynamic organization such as SPTS. Phyllis is frequently interviewed on the topic of Suicidology and has been quoted in numerous publications including, The New York Times, People Magazine and Psychotherapy Networker.

FLORIDA DUI LAWS AND PENALTIES

By Myles B. Schlam, Esq., CAP

Continued from page 24

abuse treatment deemed appropriate must be completed as a condition of the probation. The probationer must pay for all of this.

Community Service Every conviction requires 50 community service hours. These can sometimes be purchased with an additional fine to the court.

Finally: If you are facing mandatory jail time for any of the above DUI categories, there are cases where the jail time may be converted into treatment time in a residential rehab setting. The Defendant will usually have to admit that they have an alcohol or drug problem and are eager to seek treatment for their substance abuse problem.

In most cases, the amount of residential treatment time must be greater than the amount of jail time offered. For example, if the State is asking for 60 days jail time, we would normally propose a 90 day treatment plan in lieu of jail time. This is strictly up to the discretion of the Court with the consent of the State Attorney’s Office.

Myles B Schlam is an Attorney at Law in the State of Florida specializing in criminal defense and the Florida Marchman Act. He is president of Schlam Law, P.A. He graduated from Florida Atlantic University for undergrad in ’95 where he earned a degree in criminal justice/psychology.

Mr. Schlam is a former co-chair of the Broward Re-entry Coalition and a former Guardian Ad Litem. He presently sits on the 15th Circuit Sober Homes Task Force as well as the Broward County Mental Health Task Force where he advocates for better and more ethical treatment for the substance abuse/mental health population. (954) 804-6888, www.schlamlaw.com

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MCOs AND MEDICATIONS: CONTEXTUAL FACTORS THAT INFLUENCE PSYCHIATRIC COMORBIDITY ASSESSMENT

By John M. Majer, Ph.D. and Ted J. Bobak, B.A.

Continued from page 16

should highly consider these contextual factors, and also consider the highly litigious context of U.S. society in that the burden of proof will fall upon them to justify their practices in legal matters resulting from suspected malpractice.

References Available Upon Request John M. Majer, Ph.D. received his Doctorate in Clinical Psychology (community emphasis) at DePaul University, Chicago, IL. He started his career working with persons with SUDs in the late 1980s and shifted his interests in serving this population as a researcher and consultant. Presently, he is a Professor of Psychology at Harry S. Truman College, one of the City Colleges of Chicago in addition to providing consultation in both research and legal matters. Dr. Majer’s ongoing consultation with DePaul’s Center for Community Research was instrumental in the awarding of a participatory action research grant by the Center on Minority Health and Health Disparities. He has over 35 publications in peer-reviewed (not open-access contingent) scholarly outlets and serves as a reviewer and consulting editor for a number of journals. His areas of research include persons with substance use disorders (and those with psychiatric comorbidity), 12step involvement, and the Oxford House model of residential care.

Ted J. Bobak, B.A. earned his undergraduate degree in Psychology at Governors State University, University Park, IL. Presently, he is a graduate student in DePaul University’s Community Psychology doctoral program. He has been active in the field of treatment/recovery from SUDs for over 6 years. His research interests include SUDs treatment/prevention.

TEN STEPS TO PROFESSIONAL SUCCESS

By Maxim W. Furek, MA, CADC, ICADC

Continued from page 12

Laura Huckabee-Jennings offers an interesting perspective on our discussion. She says, “The secret to happiness is actually not at all related to setting goals and achieving them. Happiness is a state of mind that allows you to be content and appreciate each moment for what it brings, and to increase it by honoring your personal core values and purpose. The good news is that you can create happiness in almost any circumstance. We know stories of people in moments of great hardship and even torture who found happiness and joy, and others who seem to have great material, career or family success, and yet happiness eludes them.”

Does success share a common thread with happiness? Salah Barhoum has suggested another possibility, astonishingly correct in its simplicity. He instructs, “Don’t let success determine your happiness but instead let your happiness determine your success.”

Barhoum’s circuitous exercise in semantics offers food for thought and consideration.

Maxim W. Furek 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 miraculous and supernatural events experienced by two entombed miners. Learn more at shepptonmyth.com

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BE OF SERVICE. OUR TEAM WILL GET YOU THERE. Close-working relationships define the culture and service philosophy of Beighley, Myrick, Udell & Lynne P.A.. Every member of the Firm is committed to providing the highest caliber of legal service and professional counsel. Call us today if you want to work with a firm who does well by doing good.

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

JOIN THE RECOVERY BUSINESS COUNCIL

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The Recovery Business Council will be the gathering place and the clearinghouse for making South Florida the most exceptional Recovery Community in the nation.

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The contents of this book may not be reproduced either in whole or in part without consent of publisher. Every effort has been made to include accurate data, however the publisher cannot be held liable for material content or errors. This publication offers Therapeutic Services, Drug & Alcohol Rehabilitative services, and other related support systems. You should not rely on the information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining medical or health related advice from your health care professional because of something you may have read in this publication. The Sober World LLC and its publisher do not recommend nor endorse any advertisers in this magazine and accepts no responsibility for services advertised herein. Content published herein is submitted by advertisers with the sole purpose to aid and educate families that are faced with drug/alcohol and other addiction issues and to help families make informed decisions about preserving quality of life.

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