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NEWLY SOBER? 5 TIPS TO HELP YOU TO SOAR THROUGH THE HOLIDAYS BY LISA BOUCHER, RN
THE KAVA AND KRATOM CRISIS By Raul J. Rodriguez, M.D., DABPN, DABAM
PREVENTION STARTS WITH BEING INFORMED, EDUCATED AND SUPPORTIVE
Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
TREATING ADDICTED WOMEN DURING PREGNANCY
By Deja Gilbert, PhD, LMHC, LPC
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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. The Sober World wishes everyone a Happy Holiday. 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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HOW TREATMENT FOR A CHRONIC SUBSTANCE USE DISORDER EVOLVED INTO TREATING ACUTE EPISODES By Michael Weiner, Ph.D., MCAP
When we look retrospectively it’s easy to wonder, “How could this have happened?” It has little to do with how smart people have been or motives. It has more to do with how an entire culture has been trending. What has evolved is that: • Substance use disorders continue to be connected in thought with criminality • An acute care system has developed to treat episodic occurrences rather than long term care • Mutual support groups became a substitute for professional, recovery management • We continue to create shame by using language that is based in morality and not medicine. Let’s take a look at each statement: Substance use disorders (suds) are criminalized: A person with a substance abuse disorder (sud) had it made in the United States until somewhere around 1903. Life could not have been better. No one thought about which drugs should be legal and which ones restricted. All that a person had to do was visit their local apothecary (now more commonly known as CVS or Walgreen’s) and pick whatever they wanted off of the shelf. Laudanum, an opiate, was right there along with various concoctions containing alcohol, cocaine, and God knows what else. Was drug use a problem way back then? Probably! However, there were no DUIs because automobiles were just on the brink of being created. There were no airplanes to fly or heavy duty tractors to plow. Problems happened at home and were kept secret. At some point, people became concerned about opium smoking. Chinese people working on west coast railroads didn’t concern a lot of people. When young middle class Caucasian people began to imbibe, the government was forced to become concerned. So, they passed the Pure Food and Drug Act of 1903. This legislation didn’t do much about drugs being available. It just said that they had to be labelled. No big deal, right? Well, the really big deal happened in 1914 when Congress passed the Harrison Act. Everything changed! The day before the Harrison Act was signed in to law; suds were a medical issue that was treated in clinics around the country. The day after the Harrison Act became law, people with suds were no longer patients, they were criminals. The clinics that had been providing maintenance medications to addicts were immediately closed. Physicians who defied the Harrison Act and continued to provide maintenance medications to patients were jailed. The day after the passage of the Harrison Act the price of drugs on the street became 50 times more expensive than it was on the day before. Nothing linked addiction and crime more than the Harrison Act (1914). • The most significant effect of the Harrison Act was that it criminalized addiction. Prior to passage there was no connection between addiction and criminality. There is today. • “Narcotic” came to mean all illegal drugs (not just those that derive from opium). • Heroin and marijuana were deemed to be equally as dangerous and both remain federal schedule 1 drugs today. Schedule 1 drugs are perceived to have the most abuse potential and are the most highly regulated. • Alcohol and nicotine were left off of all of the Schedules provided by the federal government.
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The Harrison Act has shaped the way people think about drugs and addiction to this day. Many people still think that all illegal drugs are “narcotics.” Behaviors related to substance use disorders became threatening. We’re fighting a “war on drugs.” Our prisons are overflowing with people convicted of drug related crimes. The number of people in U.S. prisons is embarrassing. To this day, even patients at the highest end treatment centers sometimes refer to them selves as “convicts.” Sometimes it’s hard to tell whether a patient is “doing treatment” or doing time” (David Mee-Lee, M.D.) People with substance use disorders need to be responsible for the consequences of their behavior. However, recovery is not a sentence. We developed and continue to use an acute care model to treat a chronic disease: Why Acute Care? As far back as anyone can go one thing has always been true of getting people with suds to treatment. This one thing was true in the early attempts of Benjamin Rush, the asylums, gold, cures, and the Minnesota models. People with suds are not referred to treatment until their disease has reached the “severe” (DSM 5) stage. By the time this stage has been reached, a patient’s health has been compromised, a family has been devastated, and/or vocational, financial, and legal issues have broken a person’s spirit. By the time a person with a sud has been referred to treatment, the severity of the disorder indicates that acute care is necessary. I doubt that this is going to change anytime soon. Instead of providing long term disease management, the providers of residential care turned to Alcoholics Anonymous (AA) to support continued abstinence. Alcoholics Anonymous (AA) is a fellowship of men and women supporting each other one day at a time. Millions of lives have been changed. Is it really based on “attraction rather than promotion?” Probably not, but we can’t really blame AA for treatment centers pointing people in their direction. Perhaps treatment centers have done so partially because the resources for long term disease management were simply not available. All resources were for residential care. Not a lot of resources or funding left over. Residential treatment centers have become a minor league for AA recruitment. It’s hard to walk into a residential center and miss the 12-steps and 12-traditions scrolled on the walls. Patients are often guided through the first three to five of the twelve steps during the course of treatment. “Druggie Buggies regularly pull up to AA club houses. There is a difference between what needs to go on in treatment and the role of AA. It needs to be respected. More importantly, less than 50% of patients discharging from Continued on page 28
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Hope For A Bright Future 7
HOLIDAY SURVIVAL GUIDE WHAT EVERY ADDICT IN RECOVERY NEEDS TO KNOW AND DO By John Giordano, Doctor of Humane Letters, MAC, CAP
Google the word, ‘stress’ and you’ll find the definition to be: “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.” Ask someone fresh out of treatment and they’ll give you a completely different answer. Some may even tell you it’s a gnawing, debilitating and painful emotional condition they experience every woken minute of everyday. A more clinical description might be: a biological and psychological response experienced upon encountering a perceived harmful threat that we feel we do not have the personal and social resources to deal with it. However, it is important for you to know that our response to stress can be triggered by both real and imaginary threats and that everyone experiences stress on their own level. In other words, something you find stressful and difficult – such as public speaking – can feel like a walk in the park to others. Not all stresses are bad. What psychologists refer to as Eustress is beneficial stress which can be uncomfortable at the time it is experienced but has been associated with life satisfaction and wellbeing. The term Eustress refers to a positive response to a stressor where, through a process, we perceive stress as a challenge and find new motivation to accomplish a specific goal. Unfortunately, bad stress far exceeds good stress in the long-term effect on your health. For example, bad stress triggers our ‘fight or flight’ mechanism which is our primitive automatic survival instinct. This hard-wired response to perceived danger and/or threats changes our entire physiology. ‘Fight or flight’ causes the release of adrenalin and cortisol throughout our bodies and brains to give us the extra strength and awareness to fight or escape the perceived threat. Moreover, the body shuts down non-essential functions like digestion so that the blood can be channeled to critical areas such as major muscle groups. When you are in ‘fight or flight’ your vision may narrow, muscles become tense, you may begin to sweat and you become more aware, awake, focused. On the surface, a bout with ‘fight or flight’ may not appear to be that bad, but it’s never just one bout. Through the course of an average day everyone experiences some form of stress on multiple occasions. It could be someone cutting you off while driving to work, or an email from your boss, a project delay, money problems, a note from your kids teacher and a host of other encounters can trigger ‘fight or flight.’ This leads to elevated blood pressure and levels of stress hormones (adrenalin and cortisol) that take a toll on the body and mind. Moreover, cortisol depletes serotonin and dopamine in the brain and can actually damages the receptor sites of these neurotransmitters. This is of particular importance because serotonin and dopamine are two of the major four neurotransmitters that play a critical role in our mood and behavior. Dopamine and serotonin put the spring in our step and the smile on our faces. When these neurotransmitters function becomes compromised, depression, panic attacks, insomnia, negative thoughts, low selfesteem, eating disorders, chronic pain, migraines, and drug and/or alcohol abuse can easily slide in and take hold. Stress can be just as damaging to your gut. Most people don’t realize that we have a second brain in our gut, but it is true. The massive neural tissue – a.k.a. the enteric nervous system, produces 95% of the serotonin, and 50% of the dopamine found in our bodies. Groundbreaking research has revealed that our second brain does much more than merely handling digestion. In fact, they’ve discovered that it has a far more profound sway on our mood and behavior than previously ever considered. “A big part of our emotions are probably influenced by the nerves in our gut,” says Emeran Mayer, professor of physiology, psychiatry
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and bio-behavioral sciences at the University of California, Los Angeles (UCLA). The gut has an inner ecosystem where 80% of your immune system lives. When healthy, your gut contains a solid balance of about 85% good bacteria and 15% bad. Stress depletes your good bacteria without you ever knowing. The flight or fight mechanism triggered by stress that I mentioned earlier can impact the blood flow to your gut by diverting it to areas in the body critical to flight or fight. This becomes more complicated over time as the effects of stress will deplete the good bacteria in the gut whose purpose is to protect you from stress. It’s a catch 22 with no go options. In addition, stress can weaken your guts intestinal lining – a.k.a. leaky gut syndrome or intestinal permeability – which allows some bacteria and their toxins, incompletely digested proteins and fats, and waste not normally absorbed to leak out and into the blood stream. No wonder stress around the holidays can be so overwhelming to addicts in recovery when you consider everything the mind and body are going through without it. However there are ways to minimize the stress by taking action before and even during any holiday event. Here is a list! GET STARTED ON THESE ITEMS RIGHT AWAY BEFORE THE HOLIDAYS Exercise I cannot impress upon you how important exercise is to your physical and emotional health. Just a thirty minute a day walk can reduce stress, lower your blood pressure, improve dopamine and serotonin function, promote new brain cell growth, aid in gut health, improves digestion, facilitate better sleep patterns, give you a better outlook on life and a host of other benefits too long to list here. Exercise is not an option. Supplements The reality is that we simply can no longer get all of the essential nutrients and minerals our body needs to stay healthy through food alone. That being said, here are two supplement recommendations: • Prebiotics, Probiotic and Enzymes Prebiotics, probiotics and enzymes are essential for gut health. An effective supplement regiment can replenish the good bacteria in your gut while helping maintain its balance and improving your mood and behavior. • Multiple Vitamins Make sure you find a multiple vitamin that contains all the Continued on page 30
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THE KAVA AND KRATOM CRISIS By Raul J. Rodriguez, M.D., DABPN, DABAM
The word “natural” can be very misleading when used in marketing campaigns for consumable products. People often assume that natural products are safe and healthy. This actually is true much of the time, but not always. There are 2 “natural”, plant-derived products that have been rapidly growing in popularity, but are far from safe and are certainly not healthy. Kava-Kava and Kratom are widely promoted online and locally in Kava bars as having relaxing properties and many health benefits. Most individuals who start to consume these products have no knowledge of the inherent risks. Kava-Kava, also known as Yaqona, has been traditionally consumed in many Polynesian Island cultures for its relaxing effects on the human brain. In places such as Vanuatu, Fiji and parts of Australia, it has been used for medicinal, religious, political, cultural and social purposes. Formal Yaqona ceremonies will often accompany important functions, usually involving a ritual presentation of the bundled roots as a sevusevu or gift, and drinking of the Kava itself. The significance and respect that Kava holds in these cultures is evident. The complications that it can cause are becoming increasingly evident now as well. When someone walks into a Kava bar, the last thing they are thinking of is going away to rehab in the next few months. Kava actually does have relaxing properties. The problem is that it can be abused and cause physical dependence with regular usage. The Polynesian cultures have depicted in great detail the patterns of abuse with this substance as well as the physical manifestations. Heavy users exhibit overall poor health, a swollen face, and scaly rash. In a manner resembling what happens with heavy regular use of alcohol and sedatives, cessation of regular use of Kava can also lead to a chemical withdrawal syndrome. This syndrome is characterized by anxiety, tremor, sweating and possibly even seizures. These problems can develop in an individual without any prior addiction problems. Kratom is another popular Kava bar item and has even greater physical dependence implications. Kratom is a leaf collected from a tree in the coffee family that has significant psychoactive properties. There are many purported medicinal uses for this substance, including serving as a natural alternative to treat depression, anxiety, addiction, diabetes, chronic pain and fatigue. Many individuals experience an increase in energy, elevations of mood, relief of pain and a general sense of well-being when on Kratom. The effects wear off and then the natural inclination is to take more. The benefits can be reproduced but soon physical dependence develops. The nature and severity of the physical dependence caused by regular Kratom use resembles that seen with opioids such as oxycodone and heroin. Affected individuals experience flu like symptoms, sweating, goose flesh, hot and cold flashes, body aches, leg cramps, weakness, fatigue, depression, nausea, vomiting and diarrhea. These symptoms usually last a week or longer in a dependent individual. Most people cannot stand it longer than a day or two and go back on the Kratom. It is at this point that individuals feel trapped and do not know how to get off. A full inpatient or outpatient opioid detoxification is required at that point. I have detoxed numerous such individuals that have been caught in this chemical trap. This effect is especially prominent in anyone who has a history of opioid addiction. Individuals with a history of addiction, even with an otherwise strong recovery, are especially vulnerable to the chemical effects of Kava and Kratom. They usually develop physical dependence very quickly, or are triggered to relapse onto their drug of choice. Some Kratom products that are made with grain alcohol will also cause full alcohol dependence as well as the opioid dependence. These substances are an ever-present threat on the internet. Local recovery communities, including the one in Delray, are devastated by all of the relapses caused by Kava bars selling to unsuspecting
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and vulnerable individuals. This has been made worse by the deliberate strategic placement of Kava in close proximity to hallway houses and recovery-meeting houses. The problem has grown to such a degree that specialty drug testing laboratories have long since developed tests to detect Kratom. Drug testing helps create accountability for vulnerable populations and facilitates early detection of a relapse. The number of relapses caused by these substances is alarming and community efforts have arisen to try and address the problem. A number of municipalities, including both Broward and Palm Beach Counties, have made attempts to ban Kratom. Both of these local counties were unsuccessful in this endeavor. I actually testified at one of these county commission meetings. The degree of bias in favor of the Kava bars that was demonstrated by some of the county commissioners was obscene. This matter finally reached the state level though and an actual statewide ban was passed at one point. Due to misleading public outcry from the consumers and purveyors of Kratom, this measure was thwarted and the substance remains legally and readily available. As of yet, nothing definitive has been done to curtail the negative community effect of these establishments and the problem continues to worsen. The urgency of the escalating heroin and fentanyl crisis has also drawn some attention away from this recalcitrant problem. Really it is all part of the same opioid epidemic, just the more insidious and less recognized part of it. Greater awareness and vigilance with regards to the high risks of consuming these substances, especially for individuals in recovery, will continue to be the primary means of trying to contain this public health crisis until a definitive legal solution can be found. Dr Rodriguez is the founder and Medical Director of the Delray Center For Healing, the Delray Center for Brain Science, and the Delray Center For Addiction Medicine. He is board certified in both Adult Psychiatry and Addiction Medicine, with a clinical focus on Treatment Resistant Depression, Bipolar Disorder, Anxiety Disorders, Addiction and Eating Disorders. The Delray Center is a comprehensive outpatient treatment center that incorporates the most advanced psychotherapeutic and medical modalities, such as Dialectical Behavioral Therapy (DBT) and Transcranial Magnetic Stimulation (TMS), in the treatment of complex and dual-diagnosis cases. www.delraycenter.com, www.delraybrainscience.com, www.mydrugdetox.com
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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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NEWLY SOBER? 5 TIPS TO HELP YOU TO SOAR THROUGH THE HOLIDAYS By Lisa Boucher, RN
New sobriety is one thing, but newly sober during the holidays – how in the world do people do that? The answer is- very well, indeed. Especially, if you follow these five key tips, which always helped me. The first key to staying sober during the holidays: you have to want to be sober just a smidgen more than you want to drink. I remember how it was in early sobriety. By the time December rolled around, I was only six months sober. I was at the point in my life when all the 30-something aged couples were in full party mode. The month between Thanksgiving and Christmas was an especially busy time. Friends sent invites to lavish Christmas parties with beautiful displays of food topped by even more festive drinks. My first inclination was, I can’t go. But then I remembered all the things I learned in recovery. We can go anywhere if we have a good reason. Wanting to participate in life and see friends, some that I knew I probably wouldn’t see again until next year, was my reason. So instead of bowing out of the festivities, I went to the party armed with a strategy: 1. Most people seek out the bar the moment they arrive at a party. I’d ask my husband to get me a club soda with two limes. If he wasn’t moving fast enough, I’d head to the bar and get my own. Holding what appears to be a drink in your hand minimizes anyone’s need to ask why you aren’t drinking. Club soda with a lime can be easily mistaken for a vodka tonic. 2. Have an exit plan. My husband knew that if I needed to leave (basically, if I started to salivate when I saw the beautiful drinks) I was out of there and no amount of cajoling on his part for me to stay would win. He accepted that. Now that Uber is popular there is no need to ever feel trapped or uncomfortable. If you need to leave – leave! 3. Seek out the people you wanted to reconnect with and get busy mingling. 4. Hit a meeting before the party, and make sure you feel spiritually fit. 5. Look at what you’ll gain instead of what you’re giving up. You can’t put a price on waking up the next morning without guilt or shame. On every occasion, the first 30 minutes were always the hardest. I had to stave off those twinges of jealousy, and not get sucked into my internal dialogue that wanted to whine and complain that it wasn’t fair and why could they all drink and I couldn’t? For some reason, I still equated alcohol with fun, but the truth was, drinking had ceased to be fun for me. I’m glad I heard people in recovery rooms talk about euphoric recall—that twisted mindset that is part of the disease of alcoholism that allows a person to forget anything bad that had ever happened to them while drinking and remembering only the good times. Now that I was armed with a bit of knowledge and had been warned that euphoric recall would crop up at some time or another, I knew what to do. I shut down those thoughts. I said a prayer. I had phone numbers of people in recovery. I had backup. I was taught by the wise women who tread before me to play the whole tape forward: what would a night of drinking look like for me? Could I predict the outcome? Could I know with any degree of certainty that I wouldn’t drink too much, make a fool of myself or shoot my mouth off in some inappropriate manner? The answer to all of those questions was, no. I couldn’t foresee what my behavior would look like once I ingested alcohol. My solution had to be abstinence, and the truth was, I wanted to be sober and stay sober more than I wanted to drink. The fun times of my drinking days were long gone. The last six months to a year before I quit—well, there wasn’t much fun left to be had. I reminded myself of the benefits of a sober life. I also reminded myself that I chose to get sober. I knew that for me, one drink would set the ball rolling downhill. No, it wasn’t worth it. I had to learn how
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to talk to people without the adjunct of booze, and yes, at first it was uncomfortable. Get comfortable with feeling uncomfortable. By the end of the evening, my state of mind had made a 180 degree spin. Without fail here’s how it looked: Everyone appeared to be roasted. The conversations sounded more like screaming matches. (I never realized how loud people spoke after a few drinks.) Too many of the women looked like they just woke up. They had mascara smeared under their eyes, and they couldn’t stop leaning on other people, the walls, and the furniture. Some even had to grip the couch or a chair back to keep from swaying. Others were barefoot, their shoes tossed away in a far corner or maybe wedged under the sofa. Slurred speech is not attractive on anyone. I also remember the time a friend of mine wearing a short black cocktail dress was supine on the floor doing the alligator dance. I was grateful it wasn’t me. It was refreshing to leave the party at a reasonable hour instead of being one of the cling-ons who overstay their welcome because they can’t pull themselves away from the free booze. I focused on the positives: I got to walk out of that party still looking like a lady instead of a lush with my self-esteem and dignity fully intact. I would wake-up the next morning without a hangover, my memory would be clear, and I’d have no regrets to chew on. Doesn’t sound bad, right? Sobriety can be tricky, but it doesn’t have to stop you from living life to the fullest. The only caveat is that when you are new in recovery, even having a plan may scare you to death, and that’s not necessarily a bad thing. A healthy fear of protecting your sobriety can be the motivating factor that allows you to stay willing to do what it takes. In that first year of sobriety, maybe you do need to skip the Christmas party. The world will continue to spin, but you don’t have to. It’s okay to set firm boundaries. It’s okay to say no. If you keep working on your recovery, by the time next year rolls around you’ll be a pro at navigating social situations, and you’ll be savvy enough to know when to go and when to pass. The truth is, you’ll have made a whole new host of friends and those drinking bashes may not look so enticing after all. After short stints where she trained polo horses, worked as a flight attendant, hairdresser, and bartender, Lisa Boucher revamped her life and settled in as a registered nurse. For past 28 years, she has worked with hundreds of women to overcome alcoholism, live better lives and become better parents. She was prompted to write “Raising the Bottom: Making Mindful Choices in a Drinking Culture,” published in June 2017, when she realized after 24 years of working in hospitals, that doctors and traditional health care offer few solutions to women with addiction issues. Learn more at www.RaisingtheBottom.com and follow her on Twitter and Instagram, @LBoucherAuthor.
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THE STATE OF ADDICTION AND THE BLUEPRINT FOR RECOVERY By Michael DeLeon
Abstinence is Not as Good as it Gets. There’s more to Recovery than staying clean and avoiding mind or mood-altering drugs. Tony Robbins talks about changing the STATE of our life by looking at and changing the BLUEPRINT of our life. He says, “Whenever you are happy with something in your life, it is because right now, the conditions of your life match your ‘blueprint’, or your belief about how life should be in that particular area. If life is not where you want it to be, it’s because the ‘blueprint’ needs to be changed.” In my opinion, addiction has a blueprint. So, does recovery from addiction. Whether that “Blueprint” for our recovery is working obviously depends on the perception we have toward the life we are living. Today, in the U.S., we are dealing with the worst public social addiction crisis this country has ever seen, and there are many opinions about what the blueprint for recovery should be. There is a huge movement to use medication assisted treatment (MAT) as a cure, even making it the standard of care. There are also blueprints for abstinence-based recovery. There are even blueprints where people celebrate their recovery through their faith alone. People state that there are many different paths to recovery. There are those who believe that recovery is itself the very path of managing addiction, rather than a destination free of all mind and mood-altering drugs. Who’s right? Is anyone wrong? Addiction has never been this bad in America and many believe it will get drastically worse. So, where do we go from here? Farrah Gray says, “We don’t get in life what we want – we get what we are.” I say the same holds true for recovery. We get what we are, but I believe what we “ARE” is what we “Believe” we are, and that’s determined by the identity that we form for ourselves. The path we take to recovery is the path we “believe” is going to take us there. We program ourselves and we identify ourselves and our success with that path. If we believe a fellowship and a program where we self-identify ourselves with a life-long term of “addict” or “alcoholic”, then we identify ourselves with that path. If we believe that a daily regimen of medication is the method to get us there, and we identify ourselves with the need for that medication, then that’s the path we will take. If we believe in our Faith so much that we rely on God to deliver us from the chains of addiction, then we program ourselves to that path. We literally program ourselves, and our identity is formed into that path. My question is, does that identity last forever? Is it the same identity for everyone on that path? Is one better than the other as is championed on social media and in recovery blogs strewn all over the internet? Do some people push paths as the answer for them, yet do even more damage to others by judging and stigmatizing people who choose those paths? Do we hinder and limit people by convincing them they can’t be completely free from the bondage of chemicals by mocking abstinence? People program themselves based on information, and that information often comes with agendas. People absolutely need all the information to make informed decisions. In 2002, Pastor Rick Warren wrote and published a book called, The Purpose Driven Life. It offered readers a 40-day personal, spiritual, journey and presented what Warren said were God’s 5 purposes for human life on Earth. He described it as a “Blueprint” for Christian living in the 21st Century. The book sold 30 million copies in just 5 years and remained on the New York Time’s Bestseller List for over 90 weeks. It received criticism as all “Blueprints” often do, but obviously had incredible impact in many people’s lives.
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I reflect on this book often and on the many books of Tony Robbins that have impacted my life. There are also numerous other people and periodical sources where I find guidance, advice, strategies and ideas. Zig Ziglar, Les Brown, Eric Thomas, Jack Canfield, Jim Rohn and many others have helped me form my personal blueprint for life in recovery. I don’t propose that my blueprint is best for everyone and I don’t propose it for anyone else. But if I can emulate and model myself after some great minds of people who have lived great lives, then I can serve as an example to people who are caught in an addiction that once strangled me. I re-programmed myself. I changed my perception about the state of my life, and I took massive action to make change happen. I didn’t rely on other people to do it for me. I didn’t rely on an addictive medication or requirements that I adhere to a regimen that limited my daily activities. I decided what kind of life it was that I wanted, I found people who were living that kind of life, that kind of recovery, and I programmed myself to do the things I needed to do to live that way. There’s a way beyond what we’re programmed for, and that’s to program ourselves. Often, we’re told in addiction that we’re not capable of designing that program ourselves, given the state we find ourselves in after years of addiction. Maybe that’s true, but if early recovery begins within the program guidelines of other people’s paths, is there a time we take ownership and responsibility for our own lives and the recovery from our current state? I believe there is. When that time is, is obviously determined based on the kind of life we want and the kind of future we wish to create. It’s determined by modeling ourselves after someone or some path that is working for the people we wish to emulate who are living the kind of lives we wish to live. It’s determined by changing the state of mind that we live in. It’s accomplished by looking at our own perceptions of our own path, determining whether it’s taking us to where we want to be, and making conscious efforts to alter the path. The STATE of addiction is dire. It’s not getting better, it’s only getting worse. But when we find ourselves in that STATE, I believe we need to understand that there was a BLUEPRINT that got us there, and there’s a BLUEPRINT that keeps us there. Why is it that so many people have dreams, yet so few people are living them? Why is it that so many people in addiction WANT a life in recovery yet so many people fall short of having it long-term? We’ve developed things in our lives that aren’t working. We need to change our patterns. I was told that I was a broken person that needed to be fixed. I was told I had a disease without a cure. I was told that I was going to be an addict for the rest of my life, that once an addict – always an addict. I was told my brain had been altered and that I was going to be affected forever. I formulated my identity around these concepts and built a “State” within which I lived and patterns were designed Continued on page 22
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LIVING BEYOND
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
PREVENTION STARTS WITH BEING INFORMED, EDUCATED AND SUPPORTIVE “Prevention is all about persuasion.” ~ Theodore Caputi For many parents, a child’s return to school may be met with a bag of mixed emotions, reservations and hesitations. They may have concerns about the potential of peer pressure, discrimination, school violence and exposure to various legal and illegal substances. Preventing or safeguarding a child from making the wrong choices may prove the parents’ greatest nemesis. Why? For far too long, we were lectured on the benefits of tough love and various campaigns on how to “Just Say No.” The truth is, tough love rarely works and seldom benefits the person facing his or her serious problems. After all, we know that those who are struggling with various addictions are often wrestling with a combination of issues. These issues are rarely singular in effect; rather, they are frequently made up of a number of comorbid issues including: the biological, psychological, physiological and sociological. A parent’s fears may be associated with our own personal perspective on childhood. The fears may be fostered by listening to the local or national news, social media, the town gossip, and/or a person’s professional training. As summer has ended and school has begun; parents may be exhibiting a number of fears and concerns associated with school. Additionally, a child’s fear may only intensify a parent’s fear of the unknown and the “what ifs.” Do not allow the fears to become the wedge between you and your child. It is your duty to be and become an informed parent. PREVENTION STARTS WITHIN THE HOME Prevention begins with honest and open discussion about alcohol and drug use. Children are not the only ones that need to be learning about the effects of alcohol and drug use. For a large number of parents, we are uninformed. Parents need to learn about the potential and harmful side-effects of alcohol and drugs. Being an informed parent will help you to recognize the signs and symptoms of substance and alcohol use, as well as other issues that may be influencing your child. We know that healthy and frequent communication is key to good relationships, it is the lack therein that is often behind the broken relationships. Prevention begins with you. As a parent: 1. 2. 3. 4. 5.
Regularly reinforce your child’s self-worth and self-esteem Be an active participant in your child’s life. Develop a steady stream of active and healthy communication. Be an involved participant in your child’s academic life. Always be willing to allow your child to discuss uncomfortable topics. 6. Be well informed and educated on topics that may have a direct or indirect impact on the life of your child. 7. Discuss the dangers of legal and illegal substances. 8. Be consistent with your rules and boundaries. 9. Always reinforce an environment of honesty and integrity. 10. Teach your children to choose his or her friends wisely. 11. Be a regular participant in your child’s extracurricular activities (e.g. sports, band, clubs) 12. Always forgive for the mistakes that they have made. 13. Be an example of taking ownership and responsibility for your own life.
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14. Deny any room for excuse. Do not allow room for the shame or blame game. 15. Teach your child to set high, but realistic standards in life. 16. Most of all, always offer your child unconditional love and acceptance. Being a positive role model, does not mean that you must be perfect. Rather, being a positive role model means that you take ownership and responsibility of your life: the good with the bad; the wrongs with the rights; the successes with the failures. Teaching personal responsibility is one of the keys to prevention. PREVENTION THROUGH AWARENESS Research has indicated that the physiological and psychological mind of an individual is not completely developed until they reach the age of 25. It is frightening to think that a child could alter his or her own potential in life by a single moment in time. “Teens often feel indestructible and might not consider the consequences of their actions, leading them to take dangerous risks- such as abusing legal or illegal drugs.” As parents, we must take under careful consideration our own actions, as well as the actions of our children. “Prevention is much easier than treating the addiction. Waiting to educate your child about drugs until they are 13 or 14 years old is too late. In our experience, many addicted teens started using alcohol at age 9 or 10, then went to more potent drugs. Teaching children to absolutely fear taking drugs, other than medicinally, with permission of a parent, needs to start as young as 5 or 6 years old. Keep it simple for young kids, but be serious. Bend down and look into their eyes when you mean business. You might say, ‘Never, ever take a pill or any medicine from anyone, not even a friend, no matter what they tell you. You can become addicted! You could die!’ Does the child know what that means? Probably not yet, but they know by the tone of your voice and the energy of your words. As they get older, you can discuss it more extensively.” PREVENTION THROUGH EMPOWERMENT Personal empowerment occurs when we recognize that all humans were made equally. It occurs when we recognize that no one has a right to infringe upon our personal right to safety and care. Likewise, it teaches us that we should never infringe upon other’s personal rights to safety and care; nor should we allow others to breach those rights. We empower others by making them aware of the risk factors associated with at-risk behaviors and the consequences that may follow if they so choose to partake of those behaviors. We empower our youth not only by making them well-informed, but by teaching them to expect more for their own lives. Empowerment is essentially giving an individual the right to make decisions or dictate his or her own life. The empowerment of the individual occurs when we: 1. Establish a healthy parameter of expectations: what is allowable and what is not 2. Maintain time for one another: family time is bonding time 3. Forgive one another and forgive ourselves 4. Love one another: Love thyself 5. Maintain a regular routine of healthy and respectful communication While one aspect of personal empowerment is about making autonomous decisions; another aspect is about teaching the individual to have a new perspective on life and self. For many individuals, it is much easier to show love unto another, than it is
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SUMMONING OUR INNER MANTRA By Maxim W. Furek, MA, CADC, ICADC
“The mantra, taking us into the present moment and beyond the ego, slips through the narrow gate into the city of God.” ~John Main, Benedictine Monk. Robert Schuller (1926 –2015), an American Christian televangelist, pastor, motivational speaker, and author, built a career upon the empowering aspects of “possibility.” The televangelist was principally known for the weekly Hour of Power television program. He was also the founder of the Crystal Cathedral in Garden Grove, California, where the Hour of Power program was later broadcast. Schuller advised that we should, “Cut the word ‘impossible’ out of (our) vocabulary and be a ‘possibility thinker.’” Schuller focused on what he believed were the positive aspects of the Christian faith. Schuller encouraged Christians and nonChristians to achieve great things through God and to reach for their dreams. He wrote, “If you can dream it, you can do it!” Schuller’s awesome possibility, when realized, results from a nurturing environment and unique genetic code. Personality emerges early and continues to change in meaningful ways throughout our lifetime. Beginning from childhood we chose our roles. Winners take action. They lead by example following their dreams and reciting positive mantras. Losers make excuses. They languish in their merry-go-round world of self-pity and impossibility. Lofty goal Joe McConaughy, 25, offers an excellent example of a ‘possibility thinker,’ an individual who pushed far beyond personal boundaries to claim his dream. His goal was to run the Appalachian Trail in record time, by himself and with no outside assistance. The rugged Appalachian Trail is a 2,190-mile stretch that extends from Springer Mountain, Ga., to the top of Mount Katahdin, Maine’s highest peak. McConaughy, a gifted athlete, had already thru-hiked the Pacific Crest Trail in 2014 in just over 53 days. He approached the Appalachian Trail with a determined confi dence and a welldefined goal. McConaughy began his hike in the early morning of July 17, 2017 and verified his location through GPS updates. The former Boston College track and cross-country runner, nicknamed “Stringbean,” accomplished his lofty goal, burning across the famed Appalachian Trail in a record time of 45 days, 12 hours and 15 minutes. He navigated the trail covering an incredible 48 miles per day, running through blinding rain and harsh winds. It was the fastest known traverse of the trail. It is easier to comprehend the extent of McConaughy’s unbelievable physical conditioning and effort, but how can we understand the mental state needed to pull off this seemingly impossible task? Many have struggled and suffered The Appalachian Trail’s challenge, soon realizing that only the strongest of the strong survive. Perhaps McConaughy developed a personal mantra combining determination and self-confidence. He had plenty of time to think, to reflect, and to keep his inner voice grounded and true. His mantra had to be a strong and positive one. Perhaps it went something like this … I can make it. I can survive. I can push beyond my limits. I can get there. I can break through the darkness and see the light. I can do this. I will do this. And he did. It was August 31, 2017. After completing his ordeal, McConaughy described his arrival at the Katahdin summit “greeted by 70
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mile winds, hail, rain, mist and endless boulder scrambles.” McConaughy further explained, “After a 37-hour push, I managed 110.8 miles straight to do what I had to do, more than I have run at once by almost 50 miles. I honestly don’t know what to say. I’m in shock and pain, joyful and thankful, humbled and tired, in disbelief and exhilaration. I will be forever perplexed and appreciative of what the wilderness brings out in myself and others. I hope anyone watching is at least inspired to become more involved in the outdoors. Every day has been a battle, but I am very thankful to be safe and have accomplished my dream...” McConaughy realized his dream through physical preparation, mental toughness and an all-important positive mantra. Allie Burdick of RunnersConnect, instructs, “Practice your mental toughness. If you don’t practice, it won’t work. You cannot suddenly use a mantra you do not fully believe in… During practice come up with a mantra that works for you,” she says. “Be careful to use positive words like ‘stronger with every step’ instead of something like ‘can’t stop, won’t stop.’” According to Tris Thorp, Lead Educator and Vedic Educator at the Chopra Center for Wellbeing, “The word mantra can be broken down into two parts: ‘man,’ which means mind, and ‘tra,’ which means transport or vehicle. In other words, a mantra is an instrument of the mind—a powerful sound or vibration that you can use to enter a deep state of meditation.” At the Chopra Center, students are given a personalized mantra, their Bija, believed to be the sound vibration the Universe was making at the time of their birth. This mantra is repeated silently over and over during the meditation practice to assist the student in transcending the activity of the mind, helping access heightened levels of awareness. Maranatha Although most believe mantras to be solely the domain of Eastern religions, namely Hinduism, Buddhism, and Islam, they have their place in Christianity as well. John Douglas Main OSB (1926 – 1982) was a Roman Catholic priest and Benedictine monk who presented a way of Christian meditation using a prayer-phrase or mantra. Drawing directly from the Gospels and the early Christian mystical tradition, Main advocated using the ancient Christian prayer-word Maranatha consisting of two Aramean words meaning, “our Lord comes,” or is “coming.” Main’s work became the World Community for Christian Meditation (WCCM). Another influential thinker and motivator was Og Mandino (19231996). Recognized as “the most acclaimed self-help writer of this
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10/17/17 12:39 PM
TREATING ADDICTED WOMEN DURING PREGNANCY By Deja Gilbert, PhD, LMHC, LPC
Addiction to drugs or alcohol is a serious, potentially lifethreatening condition during any stage of a woman’s life. The disorder becomes increasingly alarming and problematic, however, when the woman is pregnant. Drug and alcohol abuse during pregnancy – and the devastating effects it can have on women, babies and their families – is not a new problem. As rates of opioid addiction have begun to skyrocket in the United States, the Centers for Disease Control and Prevention is now estimating that between 2 and 5 percent of all school children may be affected by fetal alcohol spectrum disorder (FASD) and has propelled the problem to the forefront of discussion and research. “We have a serious problem in this country with pregnant women who are addicted to drugs or alcohol,” said Kristi Dively, D.O., who with her training in obstetrics and gynecology, leads the Pregnant Women’s Program at Retreat Premier Addiction Treatment Centers. “And the tragedy is compounded because it is extremely difficult for these women to get the help they need for themselves and their unborn children.” Caring for pregnant women addicted to drugs or alcohol is difficult, as both the physical and social needs of patients tend to be complex. Many practitioners and treatment centers are simply not equipped to deal with the multi-faceted and difficult problems of this population. The consequences of not getting help, however, are not only disastrous for families, but carry with them an extraordinary societal toll. Overall hospital costs for treating neonatal abstinence syndrome and the baby’s resulting withdrawal following birth, increased from $732 million in 2009 to $1.5 billion in 2012, according to a 2015 article in the Journal of Perinatology. Additionally, the lifetime cost of treating an individual suffering from FASD, one of the leading causes of birth defects in the United States, is estimated at $2 million. Retreat Premier Addiction Treatment Centers, with locations in Pennsylvania and Florida, specializes in treating pregnant women who are addicted to drugs or alcohol. Women with any substance abuse disorder who need detox and/or residential treatment are accepted up to 32 weeks of gestation, which is a critical time for fetal development. Those beyond 32 weeks are considered on an individual basis for the program.
Gynecologists, Retreat offers medically-assisted detoxification and therapy. Dively, a board-certified OB/GYN on-staff physician makes sure patients are monitored throughout their stay and have the specialized obstetric care they need including ultrasounds and lab work. Patients also participate in counseling and educational programs in a compassionate, spiritual setting. Founded in 2011, Retreat accepts patients from all locations who are 18 or older and offers a range of treatments and services tailored to the needs of each individual. Retreat’s specialized treatment program for pregnant women was started in April 2016 to provide a holistic treatment approach to care for their unique physical, emotional and psychological needs. “There is a clear need to help women who are pregnant and struggling with addiction. Increasing their likelihood to stay sober will have lasting effects on the baby and the physical and mental health of their family,” said Dively. According to Dively, of the babies born to date from mothers who participated in the program, each of the moms were sober before delivering - and remain sober today. Deja Gilbert, PhD, LMHC, LPC is the Chief Business Officer at Retreat Premier Addiction Treatment Center For more information on the prenatal program, please contact Retreat at 855.859.8810.
As recommended by the American Congress of Obstetricians and
THE STATE OF ADDICTION AND THE BLUEPRINT FOR RECOVERY By Michael DeLeon
to live recovery a certain way. I stayed clean and sober, but had never really moved beyond that state. I began to really look at and analyze successful people, and I looked at the blueprints for their lives. Relating their success in life to building a life in recovery showed me that I could change my patterns and perceptions, and that’s what I did. Often blueprints for homes or buildings are similar. Often blueprints for roads or bridges are similar. More often than not though, there are variations and differences – even slight ones. Many people are running around saying there are different paths to recovery, yet slam other people’s paths because it’s not theirs. Many people also use erroneous data and claimed facts how their path works best and slam 80-year old methods as outdated even though millions of people succeed through them. Many people are profit-minded and hinder the lives of others when they put their own agenda ahead of the health and wellness of others. Still others mock and ridicule faith-based paths because they refuse to open their mind to miracles. This movement is trying to define and re-define “Recovery” as
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if it’s the same for everyone, or that it’s a destination we can all agree on. It’s a personal thing and a personal path and can only be measured by growth. Every day, in life, and in recovery, we should be growing. My blueprint for recovery is mine, and it’s measured constantly by my own growth. As long as I’m growing, as long as I’m serving others, as long as I’m motivating others and helping people as I grow in myself, I feel good about my “State” of life. I’ve developed new patterns to live by and my blueprint for life, for recovery is under constant design changes. It’s part of my growth, and although it’s my blueprint, I think it can work for many people. Michael DeLeon is the Director and Producer of the films” Kids Are Dying”, “An American Epidemic”, “MarijuanaX”, and “Road to Recovery”. His fifth documentary will be released in January, 2018 called, “Higher Power”. His memoir, “Chasing Detours will be released in January, 2018. Michael is the founder of Steered Straight Inc. a nationallyrecognized educational program and a national advocacy organization called, “Recovery Army”. He is the National Recovery Advocate for Transformations Treatment Center in Delray Beach, Florida.
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DOES RELAPSE MEAN TREATMENT FAILURE? By Terence T. Gorski
Relapse in most cases is not self-inflicted. Relapse-prone patients experience a gradual progression of symptoms that create so much pain that they become unable to function in sobriety. They turn to addictive use to self-medicate the pain. These patients can learn to stay sober by recognizing these symptoms as relapse warning signs, identifying the self-defeating thoughts, feelings, and actions they use to cope with them, and learning more effective coping responses. Unfortunately, most relapse-prone patients never receive relapse prevention therapy; either because treatment centers don’t provide it or their insurance or behavioral health provider won’t fund it.
Transitionally relapse-prone patients tend to have more severe addictions that are complicated by other problems. They have the capacity, however, to learn from each relapse episode and take steps to alter or modify their recovery programs to avoid future relapses.
Relapse is not necessarily a sign of treatment failure. Between one half and two-thirds of all patients treated will relapse, but at least one half of all relapsers will find long term recovery. The belief that relapse means that treatment failed ignores the fact that, for many patients, recovery involves a series of relapse episodes. Each relapse, if properly dealt with in treatment, can become a learning experience which makes the patient less likely to relapse in the future.
Even chronically relapse-prone patients are not hopeless. In 1988, I had dinner with over sixty skid row alcoholics who had completed a relapse prevention program at Alexandria Regional Detox Center. These people were previously labeled as hopeless and given short-term revolving door non-medical detox. All were sober for over six months after participating in weekly outpatient relapse prevention groups coupled with twelve step programs. All of these people wanted to stay sober. Prior to relapse prevention therapy, they did not know how. Once they learned effective strategies for identifying and managing relapse warning signs, they were able to stay sober in spite of the other serious problems they experienced.
Chemically dependent/addicted people can be divided into three groups based upon their recovery and relapse history. One third of all patients are recovery prone and maintain total abstinence from their first serious attempt. Another third are transitionally relapse prone and have a series of short-term and low consequence relapse episodes prior to finding long-term abstinence. The final third, the most difficult patients to treat, are the chronically relapse-prone patients who can’t find long-term sobriety no matter what they do. Recovery-prone patients tend to be addicted to a single drug, have higher levels of social and economic stability, and do not have dual diagnosis or serious coexisting problems. They are what are often referred to as “garden variety addicts” who have uncomplicated addictions.
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Chronically relapse-prone patients tend to have severe addictions complicated by serious dual diagnosis. Most chronic relapsers have either: severe post-acute withdrawal caused by the effects of chronic alcohol and drug poisoning to the brain, a coexisting personality or mental disorder, or a serious coexisting physical illness. Many fail to recover because these coexisting conditions are not properly diagnosed and treated.
Terence T. Gorski is an internationally recognized expert on substance abuse, mental health, violence, and crime. He is a prolific author and has published numerous books and articles. Recovery books, tapes and resources authored by Terry Gorski are available through Herald House Independence Press, 1-800-767-8181 or www.relapse.org. To learn effective relapse prevention strategies and techniques attend the Relapse Prevention Therapy Certification School April 16-20, 2018.
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THE LEGAL CORNER HOW DO FAMILY LAW COURTS DEAL WITH SUBSTANCE ABUSE TREATMENT By Joe Considine, Esq.
In our family law practice, we frequently see the influence of substance abuse in dissolution of marriage cases. Sadly, many marriages would have a better chance at working and not ending in divorce were it not for substance abuse. There are a number of issues with which divorcing spouses and their therapists must contend with before or during a divorce. Should a substance abuse impaired spouse in a divorce setting get treatment? How will a family court judge view a substance impaired individual who decides to go to treatment? Should the impaired individual’s mental health therapist testify in a family law court proceeding? How will treatment for substance abuse impinge on decisions of time sharing with children? THE DECISION TO SEEK TREATMENT Whether or not the substance impaired spouse contemplating divorce or in the midst of a divorce proceeding should seek treatment is best left to the joint counsel of the client’s therapist and attorney; however, it is generally a good idea to be guided by the notion of Safety First. If the spouse has lost the power of selfcontrol with respect to substances, or is a danger to himself or others, or lacks the sound judgment to know that what he is doing is not good, he should get help immediately. Of course, each case is unique and the impaired spouse should rely on the wise counsel of an attorney and a therapist with experience in family matters and substance abuse. If the impaired spouse is worried about whether or not seeking help will hurt him or her in the divorce case, the answer must be measured in the light of what happens if the person does not receive help. Hence, the controlling principle should always be Safety First. If a client is impaired as a result of abusing substances, the advice must always be to get help first regardless of the status of the marriage. It is important that the client know that substance abuse treatment is protected under the law. An individual who has sought treatment or therapy for substance abuse has a right to expect confidentiality and non-disclosure of treatment records and all matters discussed during the course of treatment. There are strong and wise policy reasons behind confidentiality and non-disclosure. It is necessary to the rehabilitation of the substance abuse impaired individual that that person feels comfortable that what is said in therapy or treatment stays there and is not repeated in court. The law regarding access to a spouse’s treatment records is clear. Almost always, records of a spouse’s treatment or therapy are confidential, privileged and unavailable to the other spouse in a divorce or child custody/time sharing matter. Confidentiality and non-disclosure are codified in various applicable laws. For instance, the Florida Evidence Code, F.S. 90.503(2), provides that a “patient has a privilege to refuse to disclose, and to prevent any other person from disclosing, confidential communications or records made for the purpose of diagnosis or treatment of the patient’s mental or emotional condition, including alcoholism and other drug addiction, between the patient and the psychotherapist...” The Marchman Act provides rights to individuals receiving substance abuse services, with a right to confidentiality of individual records. The records of service providers which pertain to the identity, diagnosis, and prognosis of and service provision to any individual are confidential in accordance with the Marchman Act and with applicable federal confidentiality regulation. Such records may not be disclosed without the written consent of the individual to whom they pertain except that appropriate disclosure may be made without such consent. These
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records are only obtainable upon a court order showing good cause for disclosure. Moreover, the provisions of HIPPA (42 U.S.C.A. Section 290dd-2) provide that records of a substance abuse program are confidential and cannot be disclosed without express order of court “after application showing good cause”. Therefore, in a family law case, when one spouse requests the treatment records of the other spouse, the requesting party has a terribly difficult burden to meet including overcoming the evidentiary privilege and the confidentiality provisions of Chapter 397, Florida Statutes, and 42 U.S.C.A. Section 290dd-2. It is a burden rarely, if ever, met. SHOULD THE THERAPIST TESTIFY IN FAMILY LAW COURT Many therapists know full well the value of the “therapeutic alliance” between client and therapist. The “therapeutic alliance” is that relationship of confidentiality and trust between the therapist and her client which encourages openness and candor in the clinical setting and sessions. A therapist who is asked to testify on behalf of a client should give serious consideration to the damage which will be done by testifying. Sometimes lawyers or the client will call the client’s therapist to testify as to the fitness as a parent. The evidentiary privilege is waived when the therapist testifies. Lawyers, clients and therapists need to jointly determine whether to interrupt the therapeutic alliance between the therapist and client by having the therapist testify which then permits inquiry into all matters discussed with the client in therapy. I never use the client’s therapist to testify unless there is no other possible way to get evidence of recovery and fitness before the court. The better practice is to not have the therapist testify and to have the client undergo a psychological evaluation by a forensic psychologist who is then able to testify as to the parent’s fitness. BALANCING OF INTERESTS NECESSARY - CLIENT NOT NECESSARILY HARMED IN THE DIVORCE CASE IF SHE GOES TO TREATMENT The spouse/parent/client must always be encouraged to go to treatment and recover from the addiction. If not, to do so, would result in a violation of the Safety First principle even if there is a pending or looming divorce case. If there is an addictive process,
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the individual’s safety and health should come first. The client should be assured that the act of going to treatment will not be used against them, whereas, if there is a significant substance abuse issue and there is no attempt at treatment, the court will take the untreated substance abuse into account when making its decisions. I try to get clients to take a long view and assure them that they will always have unsupervised time sharing and access to their children if they get help and keep clean and sober, but their access will be limited or supervised if they continue to abuse substances. The court always wants to protect the children and see the benefits of treatment to the children and the individual parent. An appellate court wisely wrote that: “As a matter of policy, we decline to affirm a result which, under the facts of this case, effectively penalizes an otherwise fit, competent parent for the commendable action of recognizing an addiction to prescription drugs, seeking assistance with, and successfully completing treatment for that problem. Wyatt v. Wyatt, 689 So.2d 1140 (Fla. App. 3 Dist. 1997) And successful completion of treatment has served as the basis for a modification of restricted time sharing after a period of recovery. A father was able to get a custody decree modified where he presented evidence that he had recovered from his addiction to substances. The father had the testimony of two doctors licensed in mental health counselling and friends that he had not relapsed in his addiction and did not have problems with his supervised time sharing with the children. The Court ruled that the Father had proven a substantial and material change in circumstances and that a change from supervised to unsupervised time sharing was in the best interests of the children. The fact that dad went to treatment and then stayed clean and sober won the day for him in his efforts to get more time sharing with his children. COURTS SLOWLY CATCHING UP WITH SCIENCE Having indicated in this article that it is generally a good idea to get help when needed, we would be remiss in not pointing out that the law and the courts lag behind the science of addiction. The science of addiction and alcoholism informs us that it is a disease which involves an involuntary process. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, sets forth criteria for substance use disorders which are based on decades of research and clinical knowledge. Courts are being informed more and more about the science of addiction but there is still a great deal of work to do to educate judges and magistrates. The law and the courts usually lag behind science and so there is a paucity of direction from the courts on how to factor substance abuse impairment into a decision regarding many aspects of a divorce case including time sharing, child support and awards of alimony. Nevertheless, if there is an impending divorce and substance abuse is an issue, it is always advisable to seek treatment and to make a good faith effort to recover. Addiction is not a voluntary issue and the courts generally do not punish the addict but there should be attempts to recover. If you have questions, feel free to send them to me at our email address: joe@joeconsidinelaw.com. Joe Considine has practiced law in South Florida since 1983. His practice is limited to family law and addiction related law including the Marchman Act. Joe works extensively with families whose loved ones have substance abuse and mental health problems as an attorney. www.joeconsidinelaw.com
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For the Families MY RECOVERY STORY By Marilea Rabasa
Al-Anon has saved my life, and I love sharing my experience, strength and hope. This is how I give back to a miraculous program that has given me a blueprint for living well and being happy. I was decidedly UNHAPPY when I found the rooms of recovery. I was so miserable—and had been for so many years—that I was willing to try anything in order to find contentment and hopefully sleep at night. And I was absolutely certain that my happiness resided in the wellness of someone else. But I had a lot to learn... So let me give you the short version of my 69 (Ouch!) years. I grew up in Massachusetts, the youngest of three children in a pretty dysfunctional household. My father was an alcoholic, along with his sister, his father and his grandfather. My parents fought all the time, mostly around his drinking, and my mother was severely depressed. This melancholia rubbed off on me and I’ve struggled with depression ever since I was very young. Well, in 1948 “a fat baby was a healthy baby,” so mom never stopped feeding me. Before I knew it, I was a food addict growing into a fat child and morphing into an obese teenager, ballooning to 200 pounds. Mom was so embarrassed by my appearance that she took me to a diet doctor, who prescribed diet pills for me. I quickly became addicted to them mostly because they lifted me out of my depression. But, not having any spiritual recovery under my belt yet, I still turned to food for comfort. I struggled with both bulimia and anorexia for many years before I learned to manage my eating in a healthy way. They’re still around, my twin trolls I call them, sulking in a corner wondering why I don’t want to play anymore! But hard drugs? I never touched them again after I got married. I wanted to have children. I married a guy I met where I was working near Boston and he joined the Foreign Service. So our marriage was spent traveling around some interesting places. Two of my children were born overseas. But there were stresses that went along with life in the diplomatic service. We lived through two assassinations very close to us and I grew afraid for my children. Also, I wanted a career in teaching, but that couldn’t happen with our moving so frequently. So, after 15 years, I divorced my husband and returned to Washington, D.C. and started a teaching career. That worked out really well, but raising three kids on my own was hard. My middle child, Annie, was twelve when her father and I divorced, and she entered into a cave of depression I don’t believe she’s ever come out of. She also, just before the divorce, went through a brief period of anorexia. Somehow she held it together on the outside; she was in therapy and seemed to be okay. She did well in school and even graduated from college. But when she was 21, she moved out on her own and that’s when she started using hard drugs. First methamphetamine, then cocaine, and then heroin. It’s been fifteen years now; she’s bounced in and out of recovery, in and out of four rehabs. But she’s still in active addiction living in San Francisco, and isn’t anything like the child I raised. Drug addiction is a brain disease, not a moral failing, and it’s a particularly cruel thief. I miss my daughter so much, and I haven’t seen her in almost five years. Fifteen years ago I joined Al-Anon seeking the magic bullet to save Annie. That’s why I joined, but that’s not why I’ve stayed. I was a very hard sell when I looked at the first three steps:
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1. Admit my powerlessness? Never! I brought her into the world. It was my job to protect her and save her—or die trying. 2. Came to believe a power greater than myself could restore me to sanity? I’m insane? What’s insane about trying to save my child? 3. Turn my will over? Hell no! I’m firmly CSR: Compulsively SelfReliant Well, my best thinking got me into the rooms. With that attitude, I was just giving lip service to the program. And after six years of playing God with Annie, I had a complete nervous breakdown and had to retire from a job I adored. This is where the rubber hit the road for me, and this is where I started reading the roadmap that was right in front of me. It’s a simple program, but it isn’t easy. My willfulness and stubbornness held up my recovery for quite a while, but I’m glad I kept coming back. Looking at Annie was like seeing my reflection in a mirror: both of us with eating disorders, both of us doing what millions of Americans do all the time: self- medicating, in our case using amphetamines to deal with our depression. It’s always hard to watch a loved one suffer, but this hit very close to home for me. I had a lot of survivor guilt to work through. I love the 3rd step prayer, “Relieve me of the bondage of self,” because I truly have been enslaved by my defects for too many years. When I turn them over, I feel the weight of the world lift off my shoulders. And another thing that the program has given me is a sense of humor. I love to laugh now, at myself most of all, and see the comedy in things; there’s a lightness in me that I never had before. I am just a child of God, and I am worthy of happiness. We all are. I’ll close with one of my favorite sayings, this one by Winston Churchill’s mom, Jenny Jerome who, despite all her fame and fortune, had her own personal struggles: “Life may not be all that we want it to be. But to make the best of it as it is is the only way to be happy.” I would wish that for all of my readers, and above all the humility to be grateful for what God has given us. Life can still be a wonderful adventure. It’s all a matter of perspective. God Bless! Marilea Rabasa is a blogger and author of A Mother’s Story: Angie Doesn’t Live Here Anymore by Maggie C. Romero (pseudonym) published by Mercury HeartLlnk and available on Amazon. She can also be found on www.recoveryofthespirit.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 Not One More www.notonemore.net/ P.I.C.K Awareness www.pickawareness.com Roots to Addiction www.facebook.com/groups/rootstoaddiction/ Save a Star www.SAVEASTAR.org TAP- The Addicts Parents United www.tapunited.org
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ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG 818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG 800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG 800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG 800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG 800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM 561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET BROWARD COUNTY MEETING HALLS 101 CLUB 954-573-0050 LAMBDA SOUTH CLUB 954-761-9072 WWW.LAMBDASOUTH.COM PRIDE CENTER WWW.PRIDECENTERFLORIDA.ORG 954- 463-9005 STIRLING ROOM 954- 430-3514 4TH DIMENSION CLUB WWW.4THDIMENSIONCLUB.COM 954-967-4722 THE BOTTOM LINE 954-735-7178
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HOW TREATMENT FOR A CHRONIC SUBSTANCE USE DISORDER EVOLVED INTO TREATING ACUTE EPISODES By Michael Weiner, Ph.D., MCAP
residential care engage with AA during their first year after discharge. A major portion of that 50% drop out later on. We have got to do something different. Suds are chronic diseases that require long term disease management. Shame and criminalization led to residential care being provided in remote locations with restricted communication (yet we tell patients, “don’t isolate”) Traditionally, Minnesota model residential treatment programs have been located in remote areas, e.g. Center City, Minnesota. Access to phones and computers is limited. The supposed reason for isolating the patient is so that treatment will be the only thing to focus on. That’s not the reason. The reason is remote locations with restricted communication gives us a break from having to see or think about a person who has left a blemish on a family and on our culture. After all, don’t cancer patients also have to focus on their treatment? The fact that it also provides a judge with a 30 day option that is less expensive than jail makes isolating an offender seem very attractive. The shame that we create: We think that the temperance movement is over but it’s not. The hangover lingers. We carry the shame forward by continuing to use the same language. The lapse/relapse language within this phrase is historically rooted in morality and religion, not health and medicine... ...was linked in the public mind to lying, deceit, and low moral character–a product of sin rather than sickness (White, 2016). “Recurrence” works much better. It is not shaming and it encourages better communication with the medical community. “Active/in remission’ works as well as does “active/inactive.” Rather than cry out about the stigma that society imposes, we would do well to look at the stigma that we create and fix it. Eliminating “relapse” would be a step in the right direction. Very thorough language changes have been recommended by Dr. Michael Botticelli while he directed the Office of National Drug Control Policy (ONDCP). The changes using “ambivalence” rather than “denial” and first person language- I have a substance use disorder as opposed to “I’m an alcoholic.” The shame can be lifted. So, I think that this is where we are. Question becomes “how does a system that is providing care for acute episodes evolve into one that provides lifespan recovery management? The answer is, “very slowly.” We have a system now that sends people to treatment without thoroughly assessing which level of care is most appropriate. If the assessment is done at a facility that only offers Intensive Outpatient Treatment, that’s where the patient winds up.
Continued from page 6
management in 2015. Dr. John Kelly and William White did so much more extensively in their book Addiction Recovery Management (2011). Change doesn’t happen over night, although it would be nice if it did. We need to keep chipping away and eventually get to “lifespan recovery management”. References provided Upon Request
Michael Weiner has held faculty positions at the University of North Carolina and at the Rochester Institute of Technology. He has been a Director and Researcher for Behavioral Health of the Palm Beaches since 1999. He provides services at Behavioral health of the Palm Beaches and at Veritas Palm Beach. He regularly publishes in journals and presents at conferences. LifespanRecMgt@gmail.com
LIVING BEYOND
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
PREVENTION STARTS WITH BEING INFORMED, EDUCATED AND SUPPORTIVE Continued from page 18
to have love for oneself. It is of utmost importance that we teach others the need for unconditional self-love and acceptance. What does it mean to live unconditionally? We learn to live an unconditional life by the expectations that we set for ourselves. If I am willing to allow anyone to compromise the integrity of my personal worth or value, then I have compromised my unconditional state. Likewise, if I have unconditional love for myself, then I will reject anything that is offered to the contrary. Furthermore, I will not offer others anything but respect and integrity too. Living an unconditional state means that I will accept myself beyond the good or the bad; my failures or my successes; and that I will love myself beyond the parameters that I may have set or that may have been set by others. As parents, we must model the behaviors that we wish for our child to exhibit. We must be clear with our expectations and desires. We must advocate for our own rights, as well as the rights of others. We must be well-informed and educated on topics that may have an impact upon our lives and the lives our children. We must avoid excusing at-risk behaviors and uplift positive behaviors. We must be willing to seek out advice, critiques, and feedback. Finally, we should help our children to prove resilient, empowered, and to live life unconditionally. Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com Reference Provided Upon Request
We need independent assessments that use the six ASAM dimensions to recommend an appropriate place to begin recovery. We need to stop complaining about the “stigma” that society places on suds and start to focus on the shame that we create. Drs. Botticelli and Mee-Lee have made very powerful suggestions. Patients with chronic diseases such as diabetes and hypertension are monitored for a lifespan. When symptoms become active, levels of care become more intense. Does this make sense? I laid out my best attempt at laying out a model for lifespan recovery
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HOLIDAY SURVIVAL GUIDE WHAT EVERY ADDICT IN RECOVERY NEEDS TO KNOW AND DO By John Giordano, Doctor of Humane Letters, MAC, CAP
minimum daily requirements especially amino acids; they are the building blocks for many neurotransmitters. Get Plenty Of Sleep Sleep and mood are interconnected. The less sleep you have the more vulnerable you are to irritability, stress and a plethora of other illnesses and problems. Adequate sleep resets the brain and is essential to good health. It helps reduce stress and keeps you feeling your best. In addition, new research has revealed that sleep benefits your gut’s good bacteria as well. Call Your Sponsor And Go To Meetings Sometimes the best plan is to simply have a plan. You know the holidays can be stressful so why not put some thought into what it is that will trigger your stress and develop a plan to address it with your sponsor beforehand? Also, create prepared responses for any awkward questions you can think of. You also may want to talk about managing your expectations. Too often we get caught up in a mental image of what the holidays should be while ignoring the reality of what it is.
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then releases ‘feel good’ chemicals (neurotransmitters dopamine, endorphins and serotonin) that will reduce stress and actually make you happy. I’d like to take this opportunity to wish you, your family and loved ones the most blessed holidays and I’d also like to remind you to smile. John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Aftercare Recovery Center.’ He is an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Beach Chamber of Commerce. Giordano 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: www.PreventAddictionRelapse.com www.HolisticAddictionInfo.com
Stop Beating Yourself Up It’s very common for an addict to feel low around the holiday season because of their past behavior. Don’t do it. The best gift you can give anyone this holiday season is the gift of recovery – that includes you! WHAT TO DO DURING THE HOLIDAYS Start Each Day Reviewing Your Plan To Fend Off Relapse You’ve invested time with your sponsor now it’s time to reap the rewards. It is vitally important that you start every day with a close review of your plan. Rehearse your prepared responses for awkward questions. This will lead you in the right direction and help you build confidence and overcome issues and stressors before they occur. Bring Along A Close Friend For many in recovery, this will be the first time they face friends and family in large groups after their treatment. That is a lot but not insurmountable. Bringing a friend along who doesn’t drink, smoke, or use drugs can be the buffer that lessens the intensity and adds to an enjoyable experience. Develop An ‘Escape Plan’ Before A Holiday Event Even with all of your best efforts preparing for a holiday event, you never know exactly what challenges you’ll face. Having an exit strategy helps in a couple of ways. First it lowers the intensity of the event because in the back of your mind you know you can always escape. Next, you have a blueprint that allows for a graceful exit should you find yourself in a stressful environment. Avoid Sugar and Sugary Desserts Eating refined sugars in cookies and holiday desserts while guzzling soda is exactly what you don’t want to do. The negative effects are far reaching, but for this conversation let’s just say that it will stress you out as well as your body and your brain. It kills body and brain cells while leaving you feeling woozy, nervous, fatigued, and shaky. Nothing good comes from refined sugars. Most Importantly, Smile! Many people think we smile because we’re happy, but it’s a two way street. It turns out the brain pays attention to our body movements and this effects our emotions. So if you’re feeling sad or blue during the holidays, just smile. The brain interrupts the turned up corners of your mouth as a sign that you are happy. It
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SUMMONING OUR INNER MANTRA By Maxim W. Furek, MA, CADC, ICADC
Continued from page 20
generation,” Mandino has sold over 36 million copies worldwide of his many books. As an example, his 1968 text, The Greatest Salesman in the World, has sold fourteen million copies and has been translated around the world into 18 languages. Mandino’s instructions were a call to action. He believed that a person needed to assume responsibility for his/her destiny. He strongly encouraged people to place words into action as they recited his pro-active mantra, “I will act now. I will act now. I will act now. With these words I can condition my mind to perform every action necessary for my success,” he proclaimed. Mandino’s was a lesson of mind over matter, of doing, not being, and of taking control of our destiny through action and determination. Mandino was a possibility thinker, a dreamer whose personal mantra evolved, inspired by self-help motivators W. Clement Stone and Napoleon Hill. Angel Chernoff, another self-help motivator, has furthered our discussion. Chernoff’s article titled “40 Powerful Mantras to Help You Think Positive,” appears to have been tailor made for Appalachian Trail endurance runner Joe McConaughy. It reads cryptically, “When things are tough, you must be tougher. Don’t pray for an easy life. Pray for the strength to endure a tough one that leads to success.” And succeed he did, savoring his victory in record time, with the wind to his back and a summoned mantra swirling in his head… I can make it. I can survive. I can push beyond my limits. I can get there. Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis. Learn more at www.shepptonmyth.com
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Take the first step towards recovery. Learn more about our detox services. Drug and alcohol detoxification is an intervention in the case of physical dependence to a drug or alcohol, the practice of various medical treatments for symptoms of withdrawal. Individuals who have been habitually using alcohol or drugs for a period of time will develop a chemical dependency, and it can be dangerous to try detox without medical assistance. The body and brain build up compensating measures when using certain drugs and alcohol, and simply stopping “cold turkey” can potentially cause seizure, respiratory depression and stroke. A thorough drug and alcohol detox center program preceding a drug or alcohol rehabilitation program ensures the process of recovering from addiction will have a lasting and significant effect. 1st Step’s drug detox center safely helps a substance abuser through the experience of withdrawal from habitual use of drugs and alcohol. The drug detox process often includes medication to manage dangerous and unpleasant withdrawal symptoms, making the transition safer and more tolerable. Drug detox medications can be administered both on inpatient and outpatient basis, through medical supervision. 1st Step offers a comprehensive recovery plan and treatment available to transition individuals who complete detox into the next phase necessary to ensure their ability to remain drug free. Call today for information and availability of our detox and drug and alcohol rehabilitation services.
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