July 2017 - The Sober World by The Sober World,LLC

J U LY 2 017

VOLUME 6

ISSUE 7

IN MEMORY OF STEVEN

THE

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

DEADLY ADULTERANTS: NEW DANGERS OF ILLICIT DRUGS

By Mark S. Gold, MD

HOW DO I FEEL? By Scott Steindorff, Veteran film and TV writer/producer EVERYTHING CHANGES FOR FAMILIES IN RECOVERY By Dr. Stephen Odom, Ph.D.

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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. Wishing everyone a safe and happy July 4th. 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

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DANGER ZONE TEEN SUMMER SUBSTANCE USE AND TREATMENT By Stephen Gray Wallace, M.S. Ed.

Of summer, poet Darcy Cummings wrote of a “child leaving a walled school for the first time, stumbling from cool hallways to a world dense with scent and sound”. For many youth, a seasonal disconnect from the structured confines of formal education offers a chance to explore passions via experiential learning through travel, internships, jobs, summer camp and, well, just free time to hang out with friends. It is that last option that may pose the most risk. Why? Free time, less supervision and the potentially negative influence of peers can expose youth to more stress … and distress. As Christopher Bell, then a rising high school senior, and I wrote in a piece published by kidsinthehouse.com last July, “It’s true that for many young people the break from school is a welcomed respite from self-reported stress induced by classes, homework and extracurricular activities. Yet a significant number of adolescents who participated in a study conducted by the American Psychological Association (APA) reported also feeling stressed during the summer – and at levels higher than what even they believed to be healthy”. Unfortunately, just like many adults, adolescents may turn to alcohol and other drugs to find relief, reflection or reaffirmation of connection to the potent peer group. Original research revealed in my book, Reality Gap: Alcohol, Drugs and Sex – What Parents Don’t Know and Teens Aren’t Telling, details the ying and yang of peer dynamics – making friends both the number one reason why kids make poor choices and the number two reason they don’t. What’s the takeaway? Because teens (not parents) are the ones making choices in a season with, arguably, fewer adult eyes on them, the “friendship factor” may be multiplied. In other words, whom your children spend time with may very well dictate the decisions they make. How can you help? 1. Communicate your expectations for behavior, maybe especially with regard to substance use. Your children want to know what you expect from them and are more likely to try to please you than not. 2. Enforce consequences for breaking family rules and parental trust. Kids generally want to be held accountable for personal behavior. 3. Role-play responses to sticky situations. Just as for firefighters or football players, practice prepares them to do the “right” thing with split-second timing. 4. Designate a code word they can use if they need help extracting themselves from a difficult (and potentially dangerous) situation. Embarrassment is often a reason young people don’t say no. 5. Create a social contract to sign with teens. When parent and child each have a stake in the health and safety of each other, risk decreases. And what if all that fails? It is important that parents not underestimate the potential harm of substance use by youth. There are compelling arguments against such use in statistics related to car crash deaths and addiction. On that last topic, the news is mixed. Monitoring the Future (MTF), an ongoing study of the behaviors, attitudes, and values of American secondary school students, college students and young adults, revealed in its 2016 report, “Teenagers’ use of drugs, alcohol and tobacco declined significantly in 2016 at rates that are at their lowest since the 1990s”. That’s the good news. The bad news can be found in the report’s caution that marijuana use remains high for 12th graders.

With an ever-increasing amount of legalization of marijuana laws in states across the country, this trend may be viewed as alarming … as are rates of addiction. Heidi Heilman, President of the Massachusetts Prevention Alliance (MAPA) and founder and Chief Executive Officer of Edventi, a company focusing on drug use and addiction prevention and a collaborator at the Center for Adolescent Research and Education (CARE), recently submitted testimony to the Massachusetts Joint Committee on Marijuana Policy. In her written statement, she said, in part, “That marijuana is hazardous to the health of young people is indisputable. The health literature on marijuana use finds that using marijuana as an adolescent has a negative impact on both physical and mental health. Longitudinal studies show that individuals who start around the age of 15 and continue to be regular and significant users into early adulthood suffer memory loss, cognitive function impairment, diminished IQ, and lower educational success rates. Early users also suffer physically in terms of higher rates of respiratory diseases and higher rates of certain cancers. Regular marijuana users can develop dependence on the drug.” For clarification and amplification on dependence and addiction, I turned to Carter Barnhart, a CARE National Advisory Board member and national director of referral relations at Newport Academy. What is addiction? The National Institute on Drug Abuse (NIDA) defines addiction as when people who use drugs can’t stop taking a drug even if they want to. Teens who begin using substances never plan to get addicted. They might use drugs because they like how it feels, or because it dulls the pain and stress they’re experiencing, or because their peers are doing it and they want to fit in. The problem is that drug use can quickly turn to drug dependence, because drugs change the brain. How can parents spot the warning signs that their child may be using/abusing substances? Signs of teen substance abuse include loss of interest in oncefavored activities; social withdrawal; unexplained weight loss; secretive behavior; lack of focus; poor hygiene and diminished personal appearance. What options do parents have for treatment? Treatment options include outpatient and day treatment, hospitalization, and residential programs. Outpatient and day treatment programs provide varying levels of intensity and time commitment as the teen lives at home, while residential programs provide a safe, healing environment for recovery. An expert assessment is critical, as it can determine which type of treatment a teen needs in order to have the best chance of avoiding relapse. How can parents motivate a child to agree to treatment? It’s not always possible to motivate your child to agree to treatment. Denial is often part of substance use. It’s important to speak to Continued on page 34

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DEADLY ADULTERANTS: NEW DANGERS OF ILLICIT DRUGS By Mark S. Gold, MD

The “cutting” or “adulteration” of street drugs is common practice in the manufacturing, distribution and selling of illicit drugs, all in the name of increased profit. The term “adulterant” generally refers to addition of substances with some psychoactive effects such as caffeine, ephedra, or even paracetamol, which are cheaper than the main substance, have similar or complimentary effects when added, and thus help conceal the fact that the desired substance has been cut or diluted. Substances without psychoactive properties such as lactose, other sugars, or talc, are added to a drug primarily to increase the bulk or weight of the illicit substance, or for aesthetic purposes in order to fool the user. Some adulterants are simply the result of the particular manufacturing process used to make the drug. For example, illicitly manufactured methamphetamine is frequently contaminated by non-stimulant impurities such as lead or mercury (extremely toxic heavy metals), or from carcinogenic solvents used in the synthesis. These adulterants are highly toxic, causing numerous medical consequences including death. The proliferation of dangerous adulterated drugs is exploding. Deaths from unintentional overdose are now endemic, grabbing headlines across the nation, and not just in the hood or impoverished communities. Overdose from adulterated heroin, cocaine, prescription opioids or ecstasy is occurring throughout the socioeconomic strata, and is not biased by race, income or area code. In this paper, I will describe the most commonly adulterated drugs and explain the process and risks involved. Fentanyl In March 2015, DEA issued a nationwide alert on fentanyl as a threat to health and public safety. Apparently, nobody listened because during the last 3 years the availability of illicitly manufactured fentanyl has caused an unprecedented rise in overdose and deaths. Last year (2016) in Massachusetts, for example, three quarters of the state’s fatalities from unintentional overdose had fentanyl in their system—this is up from 57 percent in 2015. Regrettably, this trend is spreading across our nation. At the same time in San Francisco, two patients at the Contra Costa Regional Medical Center emergency department (ED) were seen for severe nausea, vomiting, central nervous system depression, and respiratory depression, just 30 minutes after ingesting what they believed was Norco, a prescription opioid pain medication that contains hydrocodone and acetaminophen that they bought from a friend. Analysis of the drug and specimens from the patient’s revealed that the pills were in fact counterfeit, containing dangerously high levels of fentanyl and a highly sedating phenothiazine called Promethazine (trade name Phenergan).

for opioids are increasingly difficult to attain, a cheap, easy to manufacture, non-pharmaceutical fentanyl is being sold as: 1. An ingestible (snorted or smoked) powder sometimes added to, or substituted for cocaine. 2. A small solidified dot on blotter paper for sublingual administration. 3. Tablets that are pressed and colored to look like prescription opioids such as Hydrocodone (Vicodin, Lortab) or Oxycodone (Percocet), which is what actually killed the music legend Prince in 2016. 4. Mixed with cheap heroin to dilute the dose while delivering a dangerously powerful, fast acting high. Over the past few years the headlines have shifted away from doctors simply overprescribing opioids in “pill mills” many of which were in southern Florida, to dealers and addicts forgoing the hassle of attaining prescription medication or manufacturing and imprinting counterfeit pills, to adding homemade fentanyl to cheap heroin. The reason is always market forces and profit margin. What Exactly is Fentanyl? Fentanyl is a synthetic opioid analgesic that is chemically similar to morphine but 50 to100 times more potent. Because of its high lipophilicity, fentanyl rapidly crosses the blood brain barrier which partially explains its extreme potency, rapid onset and potential for abuse. Fentanyl is a schedule II prescription drug that is commonly used during surgery with anesthesia, in carefully titrated amounts, administered by highly trained anesthesiologists. Fentanyl is also administered post surgically to control severe pain. More recently, fentanyl is used to treat patients with severe chronic pain. It can be delivered several ways including injection, transdermal patch, or as a dissolvable, sublingual lozenge. In its prescription form, it is available under the trade names Actiq®, Duragesic ®, and Sublimaze®. When properly and appropriately prescribed and managed by an experienced pain physician, fentanyl can be a Godsend for patients with severe chronic pain. Lethality Fentanyl is so lethal because it’s so strong and fast acting. How strong? One gram of pure fentanyl can be cut into approximately 7,000 doses for street sale. How fast? When I say fast acting, I mean it can kill you in the time it takes for the drug to pass from the injection site to the brain, I’m talking a few seconds, and unlike other opioids, there is not enough time to administer naloxone to reverse the effects. Even more frightening, fentanyl can kill via passive contact. Thus, exposure to an amount no larger than a few grains of sand is lethal. In fact, law enforcement professionals are being warned not to field test anything that might contain fentanyl due to the risk of passive exposure and death. Fentanyl and Heroin According to federal DEA field reports, the Mexican cartels have increased production of a fentanyl analogue known as acetyl fentanyl, which can be easily made in clandestine labs, and cost much less to produce. According to the DEA, acetyl fentanyl may be slightly less potent than fentanyl, but is still quite deadly and difficult to identify, as it is not yet included in most toxicology assays for identifying drugs in urine or blood. Hopefully, this will change soon.

2014 map indicating the rate of overdose deaths (per100,000) in the US. (NIDA 2015) Highest concentrations are in red. Why now? As the opioid epidemic evolves, and legitimate prescriptions

Some experts speculate that the legalization of novel, high potency cannabis products (available as candy, sweetened and “natural” beverages, and popular vaporized products) has driven down the profit margin for Mexican cannabis. As a result, the Mexican cartel is flooding the market with cheap heroin, laced with acetyl-fentanyl to replace revenue lost to legally available cannabis products. Current street names (which change frequently) for fentanyl and acetyl-fentanyl-laced heroin include: Apache, Goodfella, Murder 8, TNT, and Tango and Cash, to name a few. Acetyl fentanyl is Continued on page 34

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EVERYTHING CHANGES FOR FAMILIES IN RECOVERY By Stephen Odom, Ph.D.

According to a Columbia University study, “40 million Americans age 12 and over meet the clinical criteria for addiction involving nicotine, alcohol or other drugs.” It is estimated that each chemically dependent person directly affects at least four others. The math suggests that an astonishing 160 million Americans are directly affected by addiction. When a family member suffers from an addiction, their family and friends suffer too. Family and individual functioning are inevitably altered by the chemically dependent person. His or her relationship to the mood-altering chemical gradually builds walls that neither the family’s love nor logic can penetrate until he or she receives treatment. The effects on the family are often experienced as anxiety, depression, guilt, anger, and even resentment. Often there is “helicoptering” or detective behaviors that go on because we believe that by knowing the who, what, when, where and how, we can stop the problem. The answers to these questions may never be answered, and they do not stop the addiction, but the ability of the family to play an instrumental part in an addict’s recovery, is possible. Unknowingly, however, family members can become enablers of the problem. Their genuine compassion for their loved one can cloud their judgment and prevent them from setting limits and boundaries that the addict desperately needs. Family members can experience many emotions with regards to the addiction and their loved one; sadness, anger, feeling they are to blame, and becoming judgmental. Moreover, the walls, emotions, and behaviors do not instantly dissolve when abstinence begins and often persist during and after treatment. Learning to trust, forgive and navigate a new course that includes healthy limits often requires professional guidance and support for the family, too. Where does one start? Identifying the fact that a loved one needs help, and seeking education on the developmental processes of addiction is the first step in helping a loved one struggling with an addiction. While the recovery process is an individual journey, the family members are along for the ride, whether they choose to be or not. To assist in this journey, there are resources available that can help educate family and friends of addicts and help them to understand the disease, including, Al-Anon for alcohol abuse, and Nar-Anon for narcotic abuse. Additionally, families must learn about the different treatment options available to help their loved one understand their choices. There are inpatient (residential) facilities and outpatient services, as well as various treatment offerings to meet the individual needs of the client. Even with the family’s support, however, the addict may not be willing to go to treatment. In many cases, an intervention is warranted. An intervention is a process where family members, with the help of a professional interventionist, confront the individual about their addiction and the damage it is causing themselves and their family and friends. In many cases, an intervention can, and does lead the person to treatment. Can the family still be involved when the addict is admitted into treatment? Research shows that family support during the recovery process is paramount for effective treatment and reduces the chances of a relapse by 20%. It also reduces despair, hopelessness, and conflicts that are linked to the recovery process. Family members can be supportive during treatment through family therapy and open discussions. Together they can work to change old habits, form new behaviors and family cultures to eliminate the client’s desire for drugs or alcohol. Family therapy also educates the family on behaviors associated with substance abuse and mental disorders and on the medical and psychological effects they are likely to encounter with their loved one throughout treatment and thereafter.

It is normal for family members to have adapted to the addictive behavior of their loved one as a coping mechanism before treatment. During treatment however, the family is advised on practical strategies such as support groups, and the enabling behaviors that they should avoid. Families that have lived with addiction have probably experienced damaging emotional and relational consequences. Addiction does not discriminate. Parents, spouses, partners, siblings, and children are all affected by the downward spiral of addiction. Therefore, the family member’s thoughts, emotions, and behaviors that came about because of the dependency, need to be surfaced, treated, and healed. The family, through specialized support, will learn to balance taking care of themselves and taking care of their loved one. Motivation is another fundamental element of the treatment process where the family can play a vital role in supporting the client. It’s important for the family to work together during this process, and be a unified front. During times of low motivation for the client, family involvement is particularly useful as it can boost the client’s commitment. As well, family support enhances compliance to medication management and overall engagement throughout the recovery process. What happens after treatment? After completing treatment, the client moves into the maintenance stage. Family members in this juncture play a significant role in the rehabilitation process by providing support and a safe environment, and most importantly, by taking care of themselves, and not becoming the “sobriety monitor.” The family should provide encouragement and compassion that can help their loved one feel supported and understood. Family can be an instrumental part of each step of the recovery process from getting a loved one into treatment, being a support system to them during treatment, and providing a safe-haven for when they return home. By working together — the addict, the treatment team, and the family — recovery is possible for everyone. Dr. Stephen Odom, Ph.D. is President, CEO and Chief Clinical Officer of New Vista Behavioral Health, the parent company of Simple Recovery, Infinity Treatment Centers, and Avalon by the Sea, Malibu.

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HOW DO I FEEL?

By Scott Steindorff, Veteran film and TV writer/producer Why do we want to change how we feel about ourselves? Are our feelings pleasant or unpleasant? If our feelings are unpleasant, we drink, eat or take a pill to change them. Or, if we are having pleasant feelings, we want to feel even better- so we drink, eat or take a pill. It’s not enough. I am not enough. I don’t like how I feel and I’ll do anything to feel better even if it’s harmful to me. Deep inside, I don’t care about myself. I am not enough. Like an unhealthy donut, I have a giant hole that I’m trying to fill. I am unaware of my emotions and feelings. I don’t understand them. When I was in my early twenties, I was feeling immense shame, sadness and inadequacy. I was confused about my emotions. I began drinking and snorting cocaine to change how I felt about myself. All those unpleasant feelings vanished when I was drunk or high. I felt comfortable, whole, perfect and powerful. No inhibitions, no fears. I loved that feeling and I did not want to stop feeling that way. I did not want to feel pain or the problems of my life so I avoided discomfort by being high. But the high inevitably turned into a low. When the high was over, I crashed… becoming depressed and filled with more unpleasant emotions. I needed more cocaine. I overspent, under-worked… always chasing the high. I needed to consume more and more of it and for longer periods. I needed to stay high, feel powerful… I did so much cocaine to feel this, that I would go into respiratory arrest and quit breathing. Then another crash… I could not stop. I risked my life many times to feel high. My shame, debts, painful feelings of inadequacy and anxiety compounded… My relationships were in jeopardy, I was feeling confused, hopeless, despair… I give up. How did it get this far? I am searching for a bottom of a bottomless pit. Help! I call a treatment center… I go… and in there, as I struggle to grasp what happened to me, I have a moment. A shift in my consciousness, a moment of hope. I feel I can recover. I can finally find myself and feel good. How can I feel that power I felt when high with no substances or dependency? I have been off substances for over 33 years. However, I have been dependent on money, smoking and love- anything,not to feel those unpleasant feelings. So how do I change those feelings… how do I become emotionally mature? This begins with self-discovery and awareness. I had to become my authentic self. We all lie about how we feel. When someone asks, “How are you?” Most people respond, “I am good,” even if we aren’t. As I begin to self-examine my internal beliefs about myself, I realize a significant point. I was raised to deny my feelings. I have stuffed them inside of me. Highly sensitive, I cried. I was told to stop crying. When I was angry, I was told to be happy. When I was super excited, I was told to calm down. And when I did something wrong, I was told shame on you! Parents, teachers, everyone around me as a child was telling me to deny my feelings, and if I did something wrong- here are some unpleasant feelings to top off your guilt and shame. Here are eight emotional states: • Love – affection, care, compassion, fondness, attraction • Joy – enthusiasm, excitement, thrill, happiness • Surprise – Can be pleasant or unpleasant, amazement, astonishment, or irritation and aggravation • Anger – rage, upset, resentful, mad • Sadness – grief, disappointment, loss • Fear – apprehension, anxiety, nervousness, unease • Shame – unworthy, regret, guilt, remorse

• Trust – belief, faith, honesty There are multitudes of feelings based on these emotions. I embarked on my elementary education of emotions. Why do I feel this way? What caused my unpleasant feelings? How do I heal them? Becoming self-aware… I feel unworthy because I was teased and bullied. This caused low self-worth, sadness, anger and shame. I healed this by being aware that I am not worthless, and I am good… I am not bad even when others say I am. I started understanding my unpleasant feelings and why they were inside of me. One by one, I plucked them out and replaced them with the truthful feelings. I was pained and full of shame, so I escaped reality by creating a fantasy world in my head. In my fantasy world, I felt worthy, happy and fulfilled. Ah, just like escaping my unpleasant feelings with drugs and alcohol! By understanding my beliefs about myself, I realized my strengths, weaknesses and talents. I came to honor my sensitivity as strength. I began to care about myself. I began to like myself and then love myself. I realized inside of me was a power… that I could use that power to express myself in work, relationships and life. I began to really feel good. I wasn’t afraid to express my feelings. I became transparent and the shame began to be replaced with self-confidence. Today, I ask myself many times each day, “How am I feeling? What am I feeling? Why am I feeling this way?” I don’t need to react to my feelings. For example, if I am angry, I don’t need to snap. I can express my upset feelings appropriately and not deny it. Every day I feel a variation of emotions. Like a song, poem or scene of a movie, I can observe my feelings. I have come to love feelings. I connect with my authentic self… artistic, sensitive, curious, compassionate, an explorer of life, a capacity for love and adventure… I no longer need to escape my feelings by using substances, people and fantasy to feel power. I have power in my life by connecting to my emotions and realizing their beauty. I have discovered my beauty by accepting my scars and healing my shame. Above all else, I live in the moment. There is no need to feel the past or create an artificial feeling of the future. The now is a beautiful moment to experience, no matter what I am feeling. Scott is a veteran film and TV writer/producer who has adapted many books for the big screen and currently has a few books in pre-production for adaptations. Scott recently completed a groundbreaking ten episode series for NETFLIX titled FIRE CHASERS, which will give audiences an unprecedented look deep inside California wildfires. He also recently produced JANE GOT A GUN, starring Natalie Portman, THE LINCOLN LAWYER, LOVE IN THE TIME OF CHOLERA, CHEF, starring Jon Favreau, the Golden Globe winning EMPIRE FALLS and top-rated TV show LAS VEGAS. Aside from this, Scott has been in recovery for over 30 years and has been helping people in Hollywood ever since. During this time he’s learned a lot about what works and what doesn’t work in addiction and recovery. He has now put together a team of the top scientists, doctors and therapists in the field of addiction and recovery to transform the programs that have been used for decades in order to produce new and better results to help people.

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GOOD INTENTIONS IS NOT PREVENTION “PREVENTION IN MANY WAYS IS MORE VALUABLE THAN THE CURE” By Michael DeLeon and Cecelia King

Treatment and intervention without prevention is simply unsustainable. I understand that there are things we do in a triage or crisis situation that we wouldn’t tolerate in a more planned scenario. We are doing many drastic things and working hard in America to save lives and all of it is important, but without improving prevention efforts, without fully educating our youth to hinder the growth of demand, we will never stifle supply. We’re not spending prevention dollars where we need to and on what works. If this continues, the pandemic will worsen and millions will die unnecessarily. There are drones of Americans who are genuinely concerned about the drug epidemic. This is evidenced by over a billion dollars being donated, allocated, and spent on drug prevention each year. Thank you concerned citizens. Sadly, the number of teens having diminished coping skills and pacifying themselves with drugs continues to grow. How could this be? How can more people become addicted under the care of professionals having access to the scholarly reports that compare what works and what does not? In the presence of this wealth of information, we continue to put more than 70% of our prevention funding on the models that simply do not work. We have gotten it so blatantly wrong that even the mildest conspiracy theorist would be swayed to believe that this must be some intentional act of social negligence. So, can we talk about the elephant in the room? Addiction and addictive behavior will never go away. The vices will continue to change, but the threat of addiction will always remain. What tools do we have to manage the threat of addiction? What are our bestknown prevention tools? The most popular, most practiced, and most funded intervention is the Information Model of drug prevention. This is the practice of providing drug facts, descriptions and the personal outcomes related to use. The problem is, this model does not work. It does not adequately explain the cause or the effect of drugs on society. Studies of this intervention have yielded disappointing results and it has been found to be “ineffective.” Yet, most of our good intentioned prevention dollars are spent on this model and we continue to operate under its constructs. On the other hand, the best prevention model we have; educate our youth about the effects that drugs have on our world. It cultivates good decision making, promotes drug resistance techniques and adds more positive choices to the lives of those tempted by the many drug options. This prevention technique is called the Social Influence Model. It is one of the most recent models and studies say it is the “most promising intervention”. You would imagine all of us good intentioned contributors would have learned this information and begun to funnel loads of money in that direction. Instead, we complacently continue to do what is customary. We heavily fund programs we are accustomed to, instead of what works. Research indicates that students who are taught the social impact of drug use (Social Influence Model), tend to resist drugs and make better decisions. Our children are being born in the midst of a vastly ignored and sometimes socially accepted drug epidemic and we now have data that suggest; most students will not contribute to this drug epidemic if they are given knowledge of the ways it affects our society. It is their sense of protection for the world that causes them to resist. How inspiring it is to know that the young generally care about the world more than themselves. They may not care about their own physical, mental or emotional well-being enough to resist drugs, but learning how drug use impacts society has proven to be the best drug deterrent. When our kids know better, they will do better, and the world will become better for it. So, we must begin to ensure we are giving them the information that matters.

We have a duty to our youth, and we need to critically think about our next steps in prevention because doing the wrong thing is just as bad as doing nothing at all. How do we grow this sense of duty that has been proven to hedge off negative tendencies? Negative tendencies normally arise from social stagnation. What can we do to prevent the social stagnation amongst the youth? This question brings us to the last, and arguably, missing peg of prevention intervention: Purpose. Gaining an actual socially-contributing role gives us all purpose. Could purpose be the anti-drug? In what ways can they use their purpose to become a resource in their schools and communities before becoming of employable age? Let us consider leadership and peer mentor training as a proposed added intervention to cultivate social purpose. Systematically implemented peer leadership training allows students to begin to work in their social purpose. Leadership and peer mentoring could give students a purposeful social function and serve as a drug prevention intervention. After all, increased social function is an accepted indicator of improved physical, mental and emotional health. Adding this intervention, as a self-actualizing cognitive behavioral therapy, could give the Social Influence model added effectiveness. The Social Influence model inspires adolescents to make better decisions, like resisting drugs so they don’t harm their world. Systematic leadership/peer mentor training in schools teach our youth what they can do to help their world. That is where our dollars should go because through implementation of these interventions they will be prompted to both resist drugs and learn how to positively contribute to the world. That is the full circle lesson that needs to be taught in prevention. We seem to be collectively missing the mark. We are making an obvious misallocation of our good intentioned dollars. Our youth are desperate for purposeful, socially contributing roles and in the absence of these social roles in our community; they tend to seek pseudo cultures like gang and drug communities. We need to decide if we are ready to evolve from the ease of repetition and take the steps needed for radical change in prevention. Drug prevention is not only about drug education and drug resistance. It may also require us to find ways promote purpose. It is time to challenge the customary programs to stop focusing on drug information and become more socially focused. It is time to challenge each state’s Core Curriculum Standard on drug education to do the same. Moreover, it is time to figure new ways to give our youth meaningful, social roles that compete with the opportunities available to them in the street. DeLeon is the Director and Producer of the films” Kids Are Dying”, “An American Epidemic” and “MarijuanaX” His fourth documentary will be released in July, 2017 called, “Road to Recovery” and it will be screened at the Art of Recovery Film Festival in Lake Worth, Florida on July 8th, 2017. His fifth documentary, “Higher Power” will be released in September, 2017. Michael is the founder of Steered Straight Inc. He is also the National Marketing Director for Evolutions Treatment Center in Fort Lauderdale, FL. Cecelia King is Steered Straight’s Director of Curriculum Development.

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THE FLORIDA LEGISLATURE SENDS A MESSAGE TO THE COUNTRY – WE WILL PROTECT THE RECOVERY COMMUNITY By Jeffrey C. Lynne, Esq.

On June 14, 2017, the Florida Legislature sent to Governor Rick Scott for signature House Bill (HB) 807, which has unofficially been referred to as the “Practices of Substance Abuse Service Providers Act” and which comprehensive law implements several of the recommendations from the Palm Beach County Sober Home Task Force’s Proviso Committee and the Palm Beach County Grand Jury to address the problems within the substance abuse treatment industry. Effective July 1, 2017, HB 807 is a global approach to the regulation of the treatment and sober living industries which to date, have operated in a “grey zone” due to lack of clarity in existing laws as well as operated, by some, simply fraudulently. Here are some of the highlights: • Substance Abuse Licensure The Florida Department of Children and Families (DCF), the state child welfare agency charged with regulating and overseeing this multi-billion dollar medical healthcare industry, will be provided with new tools and additional funding (from significantly increased licensure and penalty fees) in an attempt to achieve its mandate of overseeing the treatment industry in Florida. A thorough review of Chapter 65D-30 of the Florida Administrative Code [the rules regulating treatment providers] will begin in October 2017 and are to be adopted by January 1, 2018 to address administrative management; standards for clinical and treatment best practices; qualifications of all personnel, including staffing ratios; and service provider facility standards. The bill also expands DCF’s authority to take action against a service provider to deny, suspend, or revoke a license due to any false representation made or omitted in the application process; upon belief that there is a threat affecting client health or safety; or upon any sufficient allegation of a violation of statute or rule, such as patient brokering. • Recovery Residence Referrals HB 807 expands the current restrictions relating to referrals from treatment providers to now also prohibit referrals from recovery residences to licensed service providers when that home is not certified by FARR (the Florida Association of Recovery Residences). There had been a prior exemption for referrals to a recovery residence by a treatment provider when that home was owned and operated by a licensed service provider. That exemption will terminate as of July 2018, after which all recovery residences, notwithstanding ownership will be required to obtain FARR certification. • Marketing Prohibitions: Deceptive Marketing In what is likely the most significant aspect of HB 807, the Florida Legislature created a series of new laws governing marketing specifically within the unique patient acquisition/lead generation space. In essence, HB 807 prohibits and makes criminal for a treatment provider, a recovery residence, or anyone who provides any form of advertising or marketing services on behalf of those entities to engage in any false or deceptive marketing practice that prevents a patient from making a fully informed decision as to their selection of treatment provider; where to obtain those services; and the services for which the provider is actually licensed. By way of example, a Florida-based provider or a marketing agent cannot create the website of “Atlanta Recovery Center.com” with the purpose of luring unsuspecting consumers who are looking for recovery services in the greater Atlanta, Georgia area towards a provider actually located in Florida or elsewhere. This “bait and switch” tactic, which is not otherwise tolerated in other regulated industries, is not clearly and specifically prohibited in Florida and by Florida-based marketing companies. Similarly, more sophisticated tactics have also been identified and made illegal such as “hijacking” an existing legitimate provider’s website using electronic links, coding, or some activation that surreptitiously directs the healthcare consumer to another

website. The burden is placed both on the marketing provider as well as the treatment center (or recovery residence) to ensure that no arrangement is entered into by or between those parties which would allow for this. These prohibitions also include generalized “addiction helpline” advertisements on TV and other media where the call center or a web-based platform does not disclose the entities for whom they are marketing. If blatant fraudulent marketing is involved, where a person knowingly and willfully makes a materially false or misleading statement or provides false or misleading information about a treatment provider, in marketing, advertising materials, or other media or on a website, with the intent to induce another person to seek treatment with that service provider, such behavior is now categorized as a felony, punishable by up to five (5) years in prison per count. • Licensure of Entities Providing Substance Abuse Marketing HB 807 goes another step further and now requires “entities providing marketing services” to be licensed by the very aggressive Florida Department of Agriculture and Consumer Services under the Florida Telemarketing Act. The law only subjects the entities, and not the individual salespersons, to licensure, but they will be regulated and subject to discipline in the same manner as commercial telephone sellers. In addition to any civil or criminal penalties for fraudulent or deceptive practices under current law, the bill will subject them to licensure discipline for such actions. Overall, this is considered only the first step in the ongoing necessary scrutiny and regulation of this important healthcare service. The Palm Beach County Sober Home Task Force has been funded by the Florida Legislature for a second year to continue its mission of ensuring that sufficient laws, rules and regulations are in place for best practices and to protect the recovery community throughout Florida and the United States. Jeffrey C. Lynne, Esq., is a national consultant to the addiction treatment and sober living industries and a partner in the law firm of Beighley, Myrick, Udell & Lynne, P.A. He was appointed by Palm Beach State Attorney Dave Aronberg to serve on the Proviso Committee of the Sober Homes Task Force for his in-depth knowledge of industry practices and for his long-standing reputation in the South Florida community for legal ethics. Mr. Lynne is also the Editor-in-Chief of the popular blog, SoberLawNews.com, where he addresses matters of importance facing the Substance Use Disorder treatment and housing industries and the delivery of behavioral healthcare services generally.

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

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LIVING BEYOND

A Monthly Column By Dr. Asa Don Brown

ENCOURAGING AN ADDICT DURING A TIDE OF DISCOURAGEMENT “Fatigue, discomfort, discouragement are merely symptoms of effort.” ~ Morgan Freeman If you have lived for any length of time, then you have most certainly faced a tide of discouragement. When someone is faced with a tide of discouragement, they may feel overwhelmed and discouraged by the magnitude of the obstacle before them. For many facing discouragement the emotions are like a heavy swell darkening the sky above; they are often seeking a hand to hold, a shoulder to lean upon, and an ear to hear. What is it to face discouragement? When we face discouragement, we commonly have feelings of hopelessness, despair, isolation and loneliness. It could further be described as the complete loss or absence of hope, but the good news is, there is hope. You are not alone in this experience, for everyone will be forced to manage the highs with the lows. While the highs and the peaks of life are desirable; it is the lows that remind us to appreciate the view from the valley. The lows compliment the highs, through emphasizing our uniqueness and our richness in life. We seldom fully appreciate life’s accomplishments until we are faced with life’s challenges. Feeling discouraged is completely normal. It is healthy to feel discouraged, but you must recognize that such feelings can and often do affect one’s physical and mental health. We have all faced moments of discouragement, but it is how we handle ourselves during these challenging times, that will demonstrate our ability to prove effective or ineffective. Discouragement often occurs when we lose confidence or enthusiasm in the journey towards health and well-being. It is the intent of discouragement to cause you to feel alone, isolated, and without support. Always remember that you are not alone in this journey that we call life. For those struggling, there are two basic responses to personal feelings of discouragement: to internalize - proving more shy, reserved, and withdrawn; or to externalize - proving mildly, moderately or severely agitated through verbal and nonverbal interactions and communications. When someone struggles with an addiction they may find themselves discouraged; it may prove more intense and profound because of the addictive habit. THE GENERAL CATALYST OF DISCOURAGEMENT “It is impossible to live without failing at something, unless you live so cautiously that you might as well not have lived at all, in which case you have failed by default.” ~ J.K. Rowling We have all dealt with discouragement, disappointments, perceived failures and personal setbacks. The severity of the discouragement may drastically range within the frequency, longevity, and intensity for each person and episode; such an attack can play havoc with the human psyche. While there are a number of reasons someone may feel discouraged, the following reasons may perpetuate such feelings: • Frustration: When we are frustrated we have an overwhelming feeling of discouragement, because our perceptions have informed us that we have an inability to change, modify, or achieve a specific task. Frustration may skew our perception of life making it bleak and lacking positive possibilities. • The Perception of Failure: Our perceptions may skew our reality. What is failure other than a marker informing us that we can improve? Even the word failure conjures up images of doom and despair, but the reality is, there is always hope. There is no such thing as failure. For failure really does not exist, except for the meaning that we provide unto it. If we do not achieve a particular result, try-try-again. For the benefit of failure is an education and it teaches us a new approach and techniques to overcome the obstacle. Failure is merely a perception of an obstacle and it is up to us whether or not we will choose to allow the obstacle to

block us from our potential. • Discomfort: As a firefighter, it is tempting to give into discomfort during training. When we are faced with an obstacle of personal discomfort, you may be lacking in physical or mental effectiveness. Whether you are facing mental or physical discomfort in life; it is when you are uncomfortable that you will develop triggers reminding you of the unpleasant experience. Thus, these memories will remind you of how you may successfully overcome such unpleasant experiences. • Fear Behind Our Perceptions: The fear behind our perceptions may manifest from real and potential threats, or from the perception of harm. We may have a fear of inadequacy, incompetency and not having the necessary skills to complete a task successfully. The fear of failure is an authentic fear, but is seldom based on reliable facts or information. “Fear is behind more discouragement than we’d like to admit. The fear of criticism ‘What will they think?’ The fear of responsibility ‘What if I can’t handle this?’ and the fear of failure ‘What if I blow it?’ can cause a major onset of the blues.” • Feeling Isolated: If I am feeling isolated, I am more apt to feel discouraged and in my discouragement feel even more isolated. The feelings of isolation are normal, but it is in our isolation that can intensify our mental health issues such as despair, hopelessness, and depression. • Exhaustion: “When you’re physically or emotionally exhausted, you’re a prime candidate to be infected with discouragement. Your defenses are lowered and things can seem bleaker than they really are. This often occurs when you’re halfway through a major project and you get tired.” The repercussions of discouragement are that we may choose to quit. Those experiencing discouragement may be feeling a barrage of emotions. The emotions may be informing an individual that they are incapable of succeeding or achieving a specific set of desires. They may be informing an individual that they are helpless and powerless. The emotions may manifest into deep despair, loneliness, isolation, low self-esteem, and the general lacking of confidence and self-worth, but the reality is, there is always hope and possibility. HOW DO WE OVERCOME THE BLUES OF DISCOURAGEMENT? Do not be afraid of seeking a word of encouragement from another. Always be willing to seek advice and comfort during challenging times. You are not alone and you are completely normal. BREAKING THE CYCLE OF DISCOURAGEMENT • Accountability Partner: This is someone that you can lean upon, have your voice heard, and they too can mirror the same needs at times of desperation. Hearing of someone else’s challenges can reinforce the idea that you are not alone, as well as, strengthen the integrity of your own internal person. • Proving Resilient: Be certain to work on your personal self-esteem and self-confidence before you face a bout of discouragement. Establishing such parameters will reinforce your personal integrity and strengthen your internal personal dialogue. • Community Involvement: This will allow you to see that you are not alone in this game called life and will provide you insights into how others face personal challenges. • Avoid Comparisons - Do not compare yourself to others. When you establish an accountability network you create a support group that you can trust, lean upon, and gain concrete advice. The key to life is to learn from our moments of perceived failure, disappointment, and setbacks. For after all, failure is merely a challenge of life begging you to maneuver around an obstacle. Are you willing to allow life’s setbacks to limit or block you from your potential? Are you going to allow a moment of weakness or vulnerability to be your defining moment? As we learn to overcome life’s disappointments, we must learn to focus upon the positive and upon life’s possibilities. Author: Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com References Provided Upon Request

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BOOK PICKS YES, YOU CAN BE MORE EFFECTIVE! What if it’s our own lack of knowledge that’s responsible for the poor treatment outcomes we are continuing to battle? We have all heard how genetics and biology play a role in chemical addictions, but do we really understand it? Do we really understand the significance of these findings? And if so, what is being done about it? How do you apply it? When I got into this field, I felt very uncomfortable and quite ill-prepared about treating an illness we know very little about. Addictions have been around for thousands of years, and although our attitudes towards those with addictions have improved tremendously, our approach to treating this illness has not really changed all that much. For the most part, we are still relying on our own, and very individualized, common sense. Don’t get me wrong, our theories are wonderful, and they do make good sense, but don’t they all seek to unravel the truth behind why some people develop addictions and others don’t? Are they not a search for answers? What if the answers we have been looking for, all these hundreds of years, can be found right here in the science we have now? This book will challenge your beliefs and help you to bridge the gap between science and treatment. In doing so, it will arm you with the knowledge and confidence it takes to be more effective. There are no miraculous cures here, but science has provided the answers we need to take treatment to the next level and propel us into the future. Science is changing how we view and address chemical addictions, so don’t be left behind. Visit my webpage at: www.theafflictionofaddiction.com and order your copy now. This is my gift to you. The time is ripe to reap the rewards of all our untapped knowledge. Change is in the air and the future is upon us! Welcome to the 21st Century!

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WHAT IS NAD (NICOTINAMIDE ADENINE DINUCLEOTIDE)? By Bruce Berman, MD, ABFP

Nicotinamide Adenine Dinucleotide (NAD+) is a coenzyme that also acts as a neurotransmitter at times. It is in charge of fueling the oxidation of cells in our bodies and is an essential process for every person, especially after the age of 40. After 40, cell oxidation begins to deplete. It is also deficit in persons with addiction and mental health diseases. There are many amazing positive factors that NAD+ brings to the body. It heals the organs and is the most natural way to invigorate, revitalize and restore the brain’s faculties. The NAD+ coenzyme was first discovered in 1906 by British biochemists Arthur Harden and William John Young. They noticed that adding boiled and filtered yeast extract accelerated alcohol fermentation in unboiled yeast extracts. They called the unidentified factor responsible for this effect a conferment. Then, in 1938, the vitamin precursors of NAD+ were identified when Conrad Elvehjem showed that liver has an “anti-black tongue” activity in the form of nicotinamide. In 1939, the first strong evidence was found that niacin is used to synthesize NAD+. Later, in the 1940’s Arthur Kornberg made another important contribution towards understanding NAD+ metabolism by being the first to detect an enzyme in the biosynthetic pathway. The metabolism of NAD+ has remained an area of intense research well into the 21st century. In 2000, the discovery of the NAD+ dependent protein deacetylases called sirtuins by Shin-ichiro Imai and coworkers at the Massachusetts Institute of Technology brought heightened interest. David Sinclair from Harvard sensationalized the findings, “The scientists identified that the metabolite NAD+, which is naturally present in every cell of our body, has a key role as a regulator in protein-to-protein interactions that control DNA repair.” This is a huge breakthrough in anti-aging! This has all led to a natural form of detox therapy based in the science of Orthomolecular Therapy. The term was coined by professor and psychiatrist Abram Hoffer. In the 1950’s, Hoffer gave high doses of niacin to people with schizophrenic episodes. Bill Wilson, the co-founder of AA, was so thrilled by the effects of niacin, that he dedicated 11 years of his life from 1960-1971 to the study, research and treatment of alcoholic schizophrenics. Wilson organized the very first Schizophrenic’s Anonymous group in Saskatoon, which was very successful. All group members took large dosages of niacin daily. The niacin that can be purchased in a retail store has some helpful effects, but very limited. This is similar to the NAD pills that can be purchased online. They offer some similar effects as NAD+ treatment, but limited. The United States Patent Office delayed issuing a patent on the Wright brothers’ airplane for five years because it broke accepted scientific principles. This is actually true. And so is this: Vitamin B-3 - niacin - is scientifically proven to be effective against psychosis, yet the medical profession has delayed endorsing it. Not for five years, but for fifty plus years! Abram Hoffer stated, “Vitamin B-3 exists as the amide in nature, in nicotinamide adenine dinucleotide (NAD). Pure nicotinamide and niacin are synthetics. Niacin was known as a chemical for about 100 years before it was recognized to be vitamin B-3. It is made from nicotine, a poison produced in the tobacco plant to protect itself against its predators, but in the wonderful economy of nature which does not waste any structures, the nicotine is simplified by cracking open one of the rings, thus becoming the immensely valuable vitamin B-3.” Abram Hoffer said, “To my astonishment and delight, there were almost an immediate response and patients who would ordinarily take 3 to 6 months to shows an adequate response to vitamin B3 were responding on NAD in days and weeks”. Abram Hoffer’s central study concluded that illness, including mental illness, is not caused by drug deficiency. But much illness, especially mental illness, may be caused by a vitamin deficiency. This makes sense and has stood up in clinical trials again and again. The benefits include

good cholesterol levels, sleep improvement, appetite, glowing skin, reduction or elimination of cravings, revitalization and restoration of brain cells. Overall, the whole body improves. One might think doctors would run to offer magical NAD+ to their patients. There are a few ways to administer NAD+ to the body. There is the oral component; however, this does not work as well as other applications. There is also the nasal version which is being used during aftercare, and it works well for better clearance. There is also an experimental patch undergoing research as I am writing this. The most revolutionary effect comes from the intravenous protocol. It is a ten day protocol that is being perfected by Dr.Mestayer. Dr.Mestayer comes from the swamps of Louisiana and has been researching and practicing for over 14 years with 1000 patients from all over the world. Those same patients reported very minimal to 0 cravings after the treatment and have been able to come back to their daily functions, which is absolutely astonishing. Dr.Mestayer has been able to help patients with PTSD and neurodegenerative diseases, arthritis and depression. One would ask, “How come there’s no FDA approval and more clinical research for this treatment?” If you can vividly see on the second or third day a person’s skin glowing and cognitive skills returning to crisp functionality, then why won’t the government jump in to help millions of suffering addicts? There are a lot of unanswered questions, but we know one fact- NAD+ is utilizing one’s own body to heal and that is a magnificent fact. And here is more good news. This therapy is appropriate for anyone with: ● ● ● ● ● ● ● ●

any chronic condition or “auto-immune disease” any unknown, strange, undiagnosed illness any chronic pain from an injury or illness high blood pressure high cholesterol diabetes any addictions low energy

Side effects include flushing and some dizziness, which later goes away. For years, NAD+ was ordered from Africa where it has been available for quite a while, but there are now producers of 100% solution here in the United States. There are NAD centers in Great Britain, Australia, California, Arizona, and we now have access to it here at home in South Florida. Dr. Berman is the Medical Director at Future Now Detox, which uses NAD. He founded Palm Beach Holistic Health Center and has, for the last ten years, been exclusively practicing functional and integrative medicine in regards to general and addiction medicine, with its’ emphasis on addressing causes. He became frustrated treating only symptoms of disease with toxic pharmaceutical drugs While practicing for almost twenty years within the allopathic, symptombased model, he realized that, even though at times their symptoms were controlled, very few patients actually were cured. Due to the recent advances in addiction medicine including intravenous treatments and natural supplements, Dr. Berman has seen an increase in positive outcomes.

www.thesoberworld.com

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THE LEGAL CORNER FLORIDA MAKES THE MARCHMAN ACT EASIER TO USE ASSURING FAMILIES OF CONFIDENTIALITY By Joe Considine, Esq.

Florida’s Marchman Act found in Florida Statutes Chapter 397, “Hal S. Marchman Alcohol and Other Drug Services Act”, allows families, friends or those with knowledge of an individual with substance use disorder to get the afflicted person into treatment using the courts.

Thankfully, the Florida Legislature addressed the concerns about confidentiality in the recent legislative session by amending the Marchman Act to make it clear that the public should not have access to records of Marchman Act court proceedings.

In enacting Chapter 397, the Florida Legislature showed the appropriate gravitas regarding substance use disorders as a serious and terrible problem to society and families. Section 397.305 sets forth the problem:

Families that I see in my practice are concerned about the confidentiality of the Marchman Act. I am frequently asked about the issue of non-disclosure.

“Substance abuse is a major health problem that affects multiple service systems and leads to such profoundly disturbing consequences as serious impairment, chronic addiction, criminal behavior, vehicular casualties, spiraling health care costs, AIDS, and business losses, and significantly affects the culture, socialization, and learning ability of children within our schools and educational systems.”

Circuit courts throughout the state have handled disclosure of court records related to the Marchman Act differently. Clerks of circuit courts have interpreted existing laws regarding confidentiality differently in deciding whether to allow evidence of a Marchman Act filing on the Clerk’s docket. Most circuits have denied access to members of the public of the actual court filings but there are instances where unfortunately access was granted to the public. In our practice, we have always taken the position that there should be no disclosure whatsoever of anything to do with a Marchman Act filing or disclosure of any pleadings or records. It has been my opinion that the mere mention of a person’s name in the context of a Marchman Act case filing on the Clerk’s docket is a violation of federal and state law. It was obvious that there was a need for uniformity and that had to come from the Legislature. Thanks to the efforts of people like Johnnie Easton (former assistant to Palm Beach County Commissioner Melissa McKinlay), Commissioner McKinlay and State House Representative Joseph Abruzzo, the need for non-disclosure was brought to the attention of the Florida Legislature and the amendment was passed into law in the last session of the Legislature. Continued on page 32

Those words were written in 1993. Today, one would have to add the staggering death rate and the loss of a generation to that list of horrors. In setting forth the above language it was made clear just how serious the Legislature viewed substance abuse. “Substance abuse impairment is a disease which affects the whole family and the whole society and requires a system of care that includes prevention, intervention, clinical treatment, and recovery support services that support and strengthen the family unit.” And then the Legislature went further: “It is the goal of the Legislature to discourage substance abuse by promoting healthy lifestyles; healthy families; and drug-free schools, workplaces, and communities.” While anyone who works with the Marchman Act realizes, the Act has blemishes which need addressing by the Legislature to bring it closer to meeting the above-stated goals. And it is clear that the goals need to be refined to stop the death toll and to provide more effective intervention. Nevertheless, the Marchman Act remains a vitally effective tool to use the courts to obtain the help for people who have substance use disorders. This law has historically been underutilized; however, more and more mental health and treatment professionals are recommending it as a course of action for beleaguered families. Friends and family members, worn out trying to get their loved ones to stop using drugs/ alcohol, are turning to the courts via the Marchman Act to get help for their loved ones via admission into treatment. The existence of a court order requiring the individual to enter treatment is compelling and persuasive to the substance user that he or she can no longer hurt themselves without legal consequences as violation of the court order will result in the incarceration of the individual to compel compliance with the court order. Moreover, we know from extensive research that involuntary treatment, including through the courts, is effective and at times more effective than voluntary treatment. Nationally, there are many calling for use of involuntary commitment through the courts to help deal with the scourge of the opioid epidemic. Unfortunately, the Marchman Act is still not understood and therefore underutilized by families and treatment professionals at least in part due to a lack of education, the lack of treatment beds for indigent people, concerns about the lack of confidentiality of the process and the problems with individuals leaving treatment contrary to a court order. Moreover, there are problems related to the timing within which court orders can be obtained. This article will address the issue of confidentiality. Subsequent articles will address the several other issues stated above.

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THE LEGAL CORNER VIOLATION OF PROBATION IN FLORIDA By Myles B. Schlam, Esq., CAP

When a defendant is sentenced to Probation in Florida they are basically being granted a chance to stay out of jail or prison assuming that they adhere to the conditions of Probation. The defendant, by accepting the terms of Probation, is basically signing a contract with the court stating that they can manage themselves without having to be “rehabilitated” in jail or prison. The consequences of violating Probation can be very serious, especially in Florida. In fact, it is my opinion that Probation can sometimes be a set-up for certain types of Probationers. Violations of probation can happen very easily, and can occur if your probation officer has any reasonable grounds to believe you violated the terms of your probation in any material way (Florida Statutes § 948.06). If there is suspicion you violated your probation, any law enforcement officer may then arrest you, or the judge can issue a warrant for your arrest. Community Control as defined in Florida Statutes § 948.001, is supervised custody in the community, home or another place that has specific rules and requirements. For example, licensed halfway houses are considered community control. Community control is daily supervision and surveillance by law enforcement officers, including weekends and holidays. Community control is stricter than probation, and is available to offenders who commit certain crimes that would not otherwise be available for probation. For example, those who commit serious felonies or felony offenders who have a criminal background may be eligible for community control, but would not be eligible for probation. However, violating terms of community control can result in the same penalties as probation violations. When one is accused of violating Probation (VOP), they are in a strange predicament because they were already sentenced for the original crime. The Probationer has less legal protection then if they were being charged with a new crime. Under Florida Statute §948.06, there is no right to a jury trial in a VOP hearing, which means that the Probationer is basically at the mercy of the Judge. There is no right to bond while awaiting a hearing for a VOP. This means that a person accused of murder may be able to bond out of jail, while someone who was on Probation and violates (with a dirty urine, for example) will have to sit in jail until the VOP hearing. There is also no Statute of Limitations on a VOP, which means that the Probationer cannot just stall or wait for things to “blow over.” Also, hearsay is admissible against you in a VOP hearing, which means that whatever a Probation or Police Officer says you did can be admitted without any further proof. Also, under §948.06, guilt does not have to be proven beyond a reasonable doubt. Basically that means that if you were over 50% more likely to have violated your probation in the opinion of the Judge, you may be charged. My advice to someone on Probation who may have relapsed on alcohol or drugs is to seek the advice of a professional before giving a confession to your Probation Officer. Similar to the police, anything you say to your Probation Officer can and will be used against you in a court of law. This is especially so in the case of a VOP, where hearsay is admissible and the burden of proof is so low. Not withstanding advice from friends in the fellowships to “be honest in all your affairs,” this is one of those cases where you want to proceed with caution. How can Probation be violated and what are the consequences? Some of the ways in which individuals tend to violate probation can include, but are not limited to:

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• Positive Drug or Alcohol tests; • Failure to attend required treatment programs, courses or 12-step meetings; • Failure to pay the fines and fees required as part of your probation terms; • Not reporting to your probation officer on the correct date and/or time; • Failing to report if you have changed addresses during the probationary period; • Leaving the city, county, or state, without obtaining permission from the courts or probation officer; • Contacting someone who has an order of protection against you; or • Possession of firearms. In Florida, a Judge can make one of three decisions if you violate your Probation. They can either: 1. Reinstate your Probation 2. Modify your Probation 3. Revoke your Probation. The best case scenario of course is to have Probation reinstated. If Probation is modified, this will usually mean an extension of time on Probation and perhaps additional requirements, such as community service hours, additional fines, or completion of a Drug Treatment program. Continued on page 32

SCHLAM LAW, P.A.

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

• Misdemeanors • Felonies • Marchman Acts* MYLES B. SCHLAM, Esq.

Attorney and Counselor at Law Certified Addictions Professional**

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

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

NEW HYBRID AFTERCARE RECOVERY CENTERS MAKING AN IMPACT By John Giordano, Doctor of Humane Letters, MAC, CAP

Stephen Loyd, like most of his college contemporaries, was struggling to keep up with his rigorous course work. He found it to be stressful beyond words. It was just by chance that someone passed him an opioid painkiller. The experience forever changed his life. He continued to take opioids through his residency and well into his career as an Internist – taking up to 100 pills a day. After his father intervened, Dr. Loyd was reported to have entered a ‘special’ rehab program for doctors. Health care practitioners learned early on that addiction knows no boundaries. Doctors, nurses and others in the field were especially vulnerable because of their easy access to prescription opioids and the lack of security around the deadly drugs. Healthcare professionals with promising careers found themselves on the street without a job because they became addicted to the very same opioid drugs they prescribed or administered to their patients. It was in the early 70’s when the Physicians Healthcare Plan (PHP) was initiated to help rehabilitate doctors who had succumbed to these highly addictive drugs. A short time later, programs were developed for nurses and other healthcare professionals with addictions. But these programs were not the same as those available to you and me. The vast majority of the PHP programs required a minimum of 90 days of inpatient treatment that quite often turned into 180 days. In addition, there is a structured aftercare plan that can last for up to 3 years or more from what I have been told. Yet, with this seminal knowledge, we find ourselves in the midst of the 30 day addiction treatment myth. This begs the question, if 90 to 180 days of inpatient therapy with a long term comprehensive aftercare plan is required of our best and brightest, how much therapy would be appropriate for someone that is not a doctor or nurse who have spent years and decades studying the mechanisms of disease and healing? Any intellectually honest person would conclude more comprehensive therapy is necessary including a medical and psychological spiritual component. The 30 day inpatient program was initially designed to treat alcoholics. The plan was developed in the mid 50’s by two men, neither of whom were doctors or had any prior experience treating addiction or alcoholism, at a Minnesota state mental hospital; ergo “The Minnesota Model.” The program showed positive results and spread to treatment centers across the country. Insurance companies accepted the 30 day program as a treatment standard. Keep in mind, this was the 50’s when alcoholism raged and opioid addiction was nearly non-existent. Today we face bigger challenges. The beginning of the opioid epidemic coincides with the launch of pharmaceutical painkillers and designer drugs in the mid-1990’s. Every year since, opioid and designer drug abuse has grown exponentially. Treatment centers are filled with people addicted to drugs; yet treatment protocols remain firmly rooted in therapies for alcoholism. The healthcare field and the insurance companies have not adjusted to the realities of this epidemic. The clear and simple reality is that 30 days of addiction treatment is just not enough. I have been involved in hands-on addiction treatment for well over thirty-years and can tell you first hand that 30 days are an inadequate amount of time to treat someone addicted to drugs. When I owned and operated my own treatment center we always encouraged addicts to stay in nearby recovery homes after their treatment. We also had an ‘Aftercare for Life’ program for everyone who went through our program. Often they would stay for up to 90 days. We know how to fix this; we know what to do. The Physicians Healthcare Plan – which has a 76% success rate – lays out the road map for effective addiction treatment. However, the addiction treatment field and the insurance industry’s failure to conform

to programs built on evidence based and scientifically proven modalities have opened the door to an entirely new concept in aftercare treatment. Please don’t get me wrong, recovery homes done correctly do a terrific job of helping addicts find recovery. What I am talking about is a new concept in aftercare, a hybrid aftercare recovery program that fills the void created by the 30 day model between treatment centers and recovery homes. This new concept picks up where 30 day addiction treatment ends. It acts more like an extension of treatment than it does a recovery home. It’s an action program for dealing with life on life’s terms. These hybrid aftercare recovery programs build on what was started 30 days before in treatment. Anyone who has been in treatment will tell you their days are full. There is a lot of information for them to absorb. Unfortunately, the brevity of 30 days doesn’t allow enough time to embellish on what is being taught. The adverse consequence is that addicts either get it or don’t. There is also brain function to consider. Drug abuse is so destructive to the brain that it can take up to three years before function returns to normal. That being said, how much information an addict can absorb, comprehend and apply varies from person to person. This is where the new hybrid aftercare recovery program comes in. They continue the continuity established at the treatment facilities. People are still expected to go to meetings daily and visit regularly with counselors – and the obligatory urine tests and so on. In addition, this new program teaches the same exact principles you’d find in a quality 30 day program in addition to a comprehensive life enhancement wellness program. Because addicts have already been exposed to these essential fundamentals, this new program has the ability to go into greater detail and explanation in conjunction with a comprehensive live recovery program. But where these new hybrid aftercare recovery centers differentiate themselves is in the additional services they provide. More often than not they treat co-contributing factors to addiction and teach life skills. Bear in mind that addicts need to relearn nearly everything. For some, it’s something as simple as boiling an egg. But for most, it’s a lot more challenging than that. They have to prepare themselves to repair their relationships with family and loved ones. Many need to learn how to interview for a job or how to reenter their old workplace. These and other skills are often taught in the new hybrid aftercare recovery program. Moreover, this new concept is much more likely to delve into the cocontributing factors to addiction than most other aftercare facilities. For example, we know that addiction is an imbalance of the brain’s chemistry that often involves the neurotransmitter Dopamine. A proper regiment of the correct amino-acid and vitamin supplements can help correct this issue. This may sound strange to you but the latest science shows that Continued on page 32

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DECODING THE ADDICTION DILEMMA By Carol Howe

A Familiar Tale Recently I had the pleasure of engaging in a counseling session with a young woman who was in considerable distress over her binge eating. An excerpt from her email “I start each day with good intentions but as soon as I get any emotional disruption, food becomes my friend…I can hear my ego so strongly saying “This will make you feel better, go on, you can start the diet tomorrow”… I know there have been many times when I have been 100% determined to not turn to food and feel my emotions when they come up - but it’s like the silver tongued devil is inside of me that has a greater pull when these situations actually arise…When an emotional binge comes, literally, there is no stopping me.” You can hear the reliance on willpower strategies to change her habits and their consistent failure. That’s because, as so many have found out the hard way, willpower is ineffective in the face of the pull toward addictions. Note the key element in her statement - an “emotional disruption.” Since these unhealed emotions/disruptions are fueling the pull, not knowing their origin or how to regulate them leaves one handicapped, with wise decisions/choices a near impossibility. Where Does Emotional Pain Come From? Emotional pain, the driver of addictions and the pull to selfmedicate originates from thoughts that constantly occupy your mind. If they are fear-based conflict-ridden thoughts, stemming from false, hurtful ideas you hold about yourself, the brain “hears” that as a threat and dutifully responds by producing a generous dose of stress hormones. This chemical cocktail floods the body, is taken up into the 60 trillion cells in your body, and THAT determines your emotional/feeling state. Therefore, how you feel your emotional state - is determined by your brain, directed by your thoughts, creating your body chemistry, so pain is produced only by yourself. And thus, happiness is denied only by yourself. That sounds crazy at first because the world teaches that other people, laws, governments, financial situations, bodies, germs, the environment, and more, determine how you feel; thus making us their “victims.” Unfortunately, we have learned this teaching well and have not challenged it. Now this presumption must be unlearned if we are to take our rightful, powerful place in creating our emotional experience. The Real Culprit - Unexamined Beliefs In the early years when your core beliefs were laid down, your brain did not have the ability to assess the accuracy of any given idea, word, thought, action, or experience you encountered, so everything downloaded unfiltered and unquestioned into your unconscious mind as the truth, where, to this day, it drives your experience. By the time a person is six or seven, those incorrect and hurtful beliefs about being unworthy, undeserving, not measuring up, etc.… are firmly set and we are literally imprisoned with them. All this unexamined programming about “what’s wrong with us” plays the central part in all our addictions because it creates our upsetting emotional states, which we avoid and deny through self-medication. What Part Do “Others” Play In My Distress? Outside influences do, indeed, trigger a habitual fearful belief which then initiates the cascade that flows from thoughts to body chemistry to emotions. The important key is “trigger and not cause!” Nothing or no one has access to your brain to make these decisions leading either to peace or conflict, comfort or pain, and thus, no external cause is possible. The best news of all is that brains have this brilliant ability called “neuro-plasticity,” allowing for easy rewiring. So, no matter how long you’ve believed things that

are not true which are causing yourself so much heartache, you can decide to change your mind now, automatically starting that rewiring process. Befriending Your Emotional State The first essential remedial step toward healing is to stop running from uncomfortable or fearful emotions. Embracing, welcoming, melting in, without judgment or opinion toward any feelings, will allow them to dissipate. This sounds foreign because avoiding pain and fear, definitely not acceptance, were modeled for us. Counterintuitive as it seems, this opening up and moving toward, rather than away from, immediately begins a releasing and relaxing process because as you befriend anything, including feelings, you give different more helpful signals to your brain and it responds with a new, more “positive,” chemical mix. Changing Your Mind As The Long-Term Strategy When emotions have calmed, discovering those unfortunate beliefs is the second and long-term step in trading them in for more loving and accurate ones, and hence, a freer and happier life. Many of the “misconnected dots,” your programmed beliefs, were installed at a survival level and challenging these programs about what you have to do, or not do, to stay safe seems dangerous to your well-being. If you begin to be mindful and introspective, you can discover those misconnected dots that are creating the problems of pain, loneliness, lack of success, and peace. You then can trade fearinducing beliefs for ones that support you, helping you realize you are kind, good, deserving, and valuable. I hope you are beginning to see that knowing how your physiology and psychology combinehow your thoughts result in your emotional states - is essential for your security and well- being. The Power of Self-Discovery My client could easily recognize the pain that drove her to her eating and was also able to own the shameful and hurtful things she believed about herself that were constantly causing her body to produce distressing and fearful emotions. Taking full responsibility for where we put our attention, rather than retaining the outworn idea that our pain is caused by something/someone besides ourselves, always produces positive results. It’s so affirming to hear that we’re really in the driver’s seat, and no matter how long our self-sabotaging habits have been in place, we can and must change that programming, rewire our brains, and addictions begin to fade away automatically. Since we all have been/are addicted to something, this is welcoming and comforting news for everyone! Carol Howe is one of the original and most respected teachers of A Course In Miracles. A personal friend of co-scribe Bill Thetford, she wrote his biography, Never Forget To Laugh. Throughout her 40 year career with ACIM, she has guided many thousands on their journey to inner peace. To download a free copy of her latest book “The Best Guide Ever to A Course In Miracles,” visit www.carolhowe.com/p/ebook

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CERTIFIED RESIDENCES

From The Hearts of Moms A MOTHER’S TALE: THE HEARTBREAK OF ADDICTION AND DEATH By Roz Busch, LPN

Before July 13, 2011 I was the mother of an addict. After that date, I became a bereaved parent grieving the loss of my 24 year old son Jon. My husband and I adopted Jon and brought him home when he was just a few days old. We loved our new baby and envisioned a long wonderful life for him. Searching my soul and mind for answers, I wondered how a bright, smart, happy boy could grow up to become an addict. Jon had an enormous vocabulary and by the age of two and a half he could say “anesthesiologist”, which thrilled my husband, as that is his profession.

received counseling and the residents cared very much for each other. How proud he was to receive a one year clean NA chip!

Drowning in sorrow, I asked myself “how did this happen”? What could I have done differently? Why did he have to die? One thing I can say with certainty is that everything I did to help Jon was out of love.

I was now in a surreal numbing world no parent should ever be in! “Making arrangements” for my son was devastating. His best friend gave a eulogy that had everyone in tears. Jon was very loved.

Jon started drinking at around the age of 13. I found this out from his own writings while in a rehab center. I believed this because of all the illnesses he experienced throughout his teenage years. He suffered with episodes of bronchitis and allergies his entire life. He developed an ulcer and even became nocturnal at one point. I did the dutiful thing a parent would do and took him to the doctor. No one, including me or my husband suspected substance abuse at this point. Something bad was happening to my child. My next plan was to seek out a psychologist. Hoping to get answers, I sat with Jon before the doctor. I expressed my concerns and Jon met with him privately. He diagnosed that Jon is a bright child with some difficulty handling daily living stresses. The day arrived when there was no denying Jon’s substance abuse. His behavior was becoming volatile and erratic and his friends changed drastically. One day the phone rang. There was a police officer at the other end, “I have your son on the ground in handcuffs and he is under arrest”. My world exploded at hearing those words. He told me the procedures Jon would go through and not to hurry because it takes a long time to “process” him. I remember thinking how calm and polite the officer was in comparison to the nightmare scenario playing out. And so began a new chapter in Jon’s life. This experience led him to his first rehab center. There he was diagnosed with bipolar disorder and was immediately treated for it. A cycle of halfway houses and relapses began. He attended NA meetings and my husband and I went to Nar-Anon. We learned there was nothing we could do to make Jon stop using drugs. We could love and support him but he had to work the program himself. At last we found a halfway house that was the perfect fit for Jon. He

Jon replaced drugs with food during this period. His smoking and weight gain was taking a toll on his health. We received a call that our son was in the emergency room, diagnosed with Acute Respiratory Distress Syndrome. ARDS fills the air sacs in the lungs with fluid depriving the blood stream of oxygen. For three and a half weeks we visited the ICU praying Jon would get better. Then came the most devastating phone call of all. Our boy would not make it!

My life was altered forever. I wasn’t prepared for the bombardment of tears and pain that came from losing my child. No one is. What was I to do? The first two weeks I talked to Jon a lot and made a collage of his pictures. Amy Winehouse died twelve days after Jon. I wanted to reach out to her parents but of course I could not. I was desperate. Two weeks later I found a grief group with women going through the same situation as me. That was my lifeline! I know others that have gotten tremendous help by seeing a professional counselor. It will be six years in July that Jon is gone, and I can say that grief is a lifetime endeavor. When I first started my grief journey I was told I would feel better one day. I said, “No way! I don’t believe it”. It turned out that I was wrong. One thing to remember is that things experienced during grief are normal. The pain, crying and emptiness comes in waves. Slowly over time these feelings space out providing more and more relief helping the healing process. It is perfectly normal to feel anger. I was angry at a variety of things, people and situations. I also knew there was nothing I could do to change the past. Keeping emotions bottled up inside is not good so I verbalized my anger in private and eventually it subsided. Holidays were hard and at first, I could not put out decorations and avoided social gatherings. It is important to do what feels right. I feel each person is the boss of their own grief. No one should be forced into uncomfortable situations until they are ready. I was thankful for the faithful and understanding people who stayed in my life. Talking about my child, sharing pictures and memories was vital to me. I am good at putting on the “happy” face which I did to make others feel more comfortable and to give myself relief from the misery. Small steps need to be taken. It doesn’t matter if it is taking a walk, working in a garden, or looking at pictures - anything to keep busy for a short time. Eventually my times of keeping busy grew, giving me more time to heal. My child will always be at my side. I feel surrounded by him and I even see his lips turn up in a smile when I stare at his picture. I am told the butterfly is a sign from Heaven. Since writing these words, one butterfly flew in my face, five around my feet and one flew into my hat. A mother’s wishful thinking maybe? I will always grieve the loss of my son and remain faithful to keeping his memory alive. My love is forever! Roz Busch is the mother of three. She is a Licensed Practical Nurse as well as an award-winning artist. She also enjoys writing poetry and playing the piano.

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IMPORTANT HELPLINE NUMBERS

A New Path www.newpath.org Addiction Haven www.addictionhaven.com Bryanâ&#x20AC;&#x2122;s Hope www.bryanshope.org CAN- Change Addiction Now www.addictionnow.org Changes www.changesaddictionsupport.org City of Angels www.cityofangelsnj.org FAN- Families Against Narcotics www.familiesagainstnarcotics.org Learn to Cope www.learn2cope.org The Long Island Council on Alcoholism and Drug Dependence www.licadd.org Magnolia New Beginnings www.magnolianewbeginnings.org Missouri Network for Opiate Reform and Recovery www.monetwork.org New Hope facebook.com/New-Hope-Family-Addiction-Support-1682693525326550/ Parent Support Group New Jersey, Inc. www.psgnjhomestead.com P.I.C.K Awareness www.pickawareness.com Roots to Addiction www.facebook.com/groups/rootstoaddiction/ Save a Star www.SAVEASTAR.org TAP- The Addicts Parents United www.tapunited.org

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ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG 818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG 800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG 800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG 800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG 800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM 561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET BROWARD COUNTY MEETING HALLS 101 CLUB 954-573-0050 LAMBDA SOUTH CLUB 954-761-9072 WWW.LAMBDASOUTH.COM PRIDE CENTER WWW.PRIDECENTERFLORIDA.ORG 954- 463-9005 STIRLING ROOM 954- 430-3514 4TH DIMENSION CLUB WWW.4THDIMENSIONCLUB.COM 954-967-4722 THE BOTTOM LINE 954-735-7178

FLORIDA MAKES THE MARCHMAN ACT EASIER TO USE ASSURING FAMILIES OF CONFIDENTIALITY By Joe Considine, Esq.

The new amendment is Marchman Act, Section 397.6760, which makes it very clear that Marchman Act court records are confidential. All petitions for involuntary assessment and stabilization and all court orders and pleadings are confidential and exempt from the Public Records Act. The public is not allowed access to Marchman Act records or pleadings. Personal identifying information may not be published by the Clerk on a court docket or in a publically accessible file. There is disclosure permitted but only to limited classes including the parties, their attorneys, guardians of the impaired individual, and the individual’s treating health care providers. A person or entity other than the classes of people mentioned above may gain access to Marchman Act records upon a showing of “good cause.” Since this law is new, there is no specific case which interprets “good cause” in this instance. However, there are cases which have construed “good cause” in other settings involving treatment information and presumably those cases may provide some guidance in this instance. Disclosure of information about treatment and records of treatment is strongly disfavored as a matter of public policy by the courts generally. There are very good therapeutic reasons for this policy. As a society

VIOLATION OF PROBATION IN FLORIDA By Myles B. Schlam, Esq., CAP

Continued from page 25

A good attorney can be successful in persuading the court to reinstate probation or modify it with completion of a drug treatment program, oftentimes, being one of the terms. Through my work in the addiction field over the last decade, I have forged relationships with many of the treatment providers in the community as well as department of corrections officials. This scenario, however, has been effective mostly for drug offenders who have violated probation with either dirty urine or other substance abuse related violations. The worst case scenario is that the Judge can revoke Probation and sentence the defendant to the maximum penalty for the original charge. This is scary because someone who is on probation for a felony drug possession charge can technically be sentenced to five years in prison for dirty urine. The way some judges see it, the defendant has already been given a break by getting probation. Even with all the issues that arise for violating probation in Florida, you do have options that may put you in a more favorable position. A good advocate will know how to employ strategies to give you the best chance at succeeding. In some cases, your attorney can argue the merits of the violation itself in an attempt to get the violation dismissed, or at least get probation reinstated. However, a plan of action must be developed and proposed to the Court. When it comes down to it, a probation violation is not something to be taken lightly. You need an experienced and qualified attorney to intervene on your behalf. Myles B. Schlam brings a unique array of experience and expertise to Schlam Law, P.A. as both an Attorney and an Addiction Professional. This unique blend of expertise is invaluable to achieving the most effective courtroom advocacy. Myles is committed to getting the best possible outcome for his clients. He also represents families who are trying to get treatment for their loved ones under the Marchman Act. He has over 10 years’ experience working with substance abuse clients, both in private and publicly run facilities. www.schlamlaw.com

Continued from page 24

we want people with substance use disorder to get help. It is important to their recovery that these individuals are assured and feel confident that the fact they have entered into treatment; matters they discuss with therapists; and how they do in treatment, should not be made public. Hence, there are protections against any disclosure present in federal HIPPA laws and the protection of non-disclosure contained in the Florida Evidence Code and other statutes at the state level. There are additional changes which are needed in the Marchman Act to make it more workable for families and more responsive to the needs for recovery. We shall address some of those in subsequent articles. Joe Considine has practiced law in South Florida since 1983. His practice is limited to family law and addiction related law including the Marchman Act. Joe has handled over 1500 litigation cases in his career, appearing in courts throughout Florida. Joe works extensively with families whose loved ones have substance abuse and mental health problems as an attorney. www.joeconsidinelaw.com

NEW HYBRID AFTERCARE RECOVERY CENTERS MAKING AN IMPACT

By John Giordano, Doctor of Humane Letters, MAC, CAP Continued from page 26

the gut may play a role in depression, anxiety and addiction. Leaky gut syndrome interferes with the body’s natural absorption and distribution of essential vitamins and minerals which could lead to depression and addictive behaviors. Correcting this can have an effect on behavior. Exercise is another staple of the new hybrid of aftercare recovery centers. I cannot emphasize enough how important exercise is to your overall well-being regardless if you are an addict or not. It reduces stress, improves dopamine function, keeps your body and brain chemistry balanced, your muscles tone and rids your body of dangerous toxins. Exercise can help with and extend recovery. Drug and alcohol abuse tears up the body and brain – exercise is at the top of the list of things you can do to repair it. These are just a few of the many evidenced-based and scientifically proven effective modalities and services being offered by the new hybrid aftercare recovery program. I am encouraged by what I am seeing. Overcoming addiction is a process of application and action. Even though treatment centers are providing a good foundation for recovery, I believe it is the continued guidance, teachings and repetition that can make the greatest contribution to an individual’s recovery – much like the Physicians Healthcare Plan (PHP) 90 to 180 day program. And this is exactly what the new hybrid aftercare recovery program does. John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment, check out his websites: www.PreventAddictionRelapse.com www.HolisticAddictionInfo.com

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Keynote Speaker Steve Ford

Keynote Speaker Marsha Linehan For registration and more information, visit FoundationsEvents.com

A D V E R T I S I N G

O P P O R T U N I T I E S

To reach thousands of families and treatment providers call us today to advertise in our magazine. FOR ADVERTISING OPPORTUNITIES PLEASE CALL US AT 561-910-1943. Look for your FREE issue of The Sober World in your bag at the following Conferences/Events:

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DEADLY ADULTERANTS: NEW DANGERS OF ILLICIT DRUGS By Mark S. Gold, MD

not approved for medical use in the United States and currently a schedule I controlled substance under the Federal Controlled Substances Act. Meaning, it has no legitimate medical use. Recent DEA surveillance reveals that acetyl fentanyl laced heroin cost a little more on the street than regular heroin, yet it sells because users believe it’s extreme potency produces a higher-high, and thus worth the few extra dollars. Remember, opioid addicts are always looking for the better high and will often risk their lives to get it. Cathinones Cathinone is a stimulant found in the khat plant in East Africa and in southern Arab regions. When its leaves are chewed it produces a mild stimulant effect, not unlike the coca leaves in the Andes region of South America. Synthetic Cathinones, recently known as “bath salts”, are often sold as or added to street stimulants such as methamphetamine, cocaine and MDMA (Ecstasy and Molly). In fact, buyers seek “Molly” because they prefer the effect from cathinone laced Ecstasy, rather than pure MDMA. It may be a moot point because recent surveillance data shows that most street Ecstasy contains high doses of synthetic cathinones. This results in more profit for the dealer and the manufacturer. Cathinones are popular because like all drugs of abuse, they stimulate the release of dopamine in the striatum. In addition, like Ecstasy (XTC) which was initially dubbed the “love drug”, synthetic cathinones inhibit the reuptake of serotonin, and to a lesser degree, norepinephrine, producing a unique and somewhat “warm” euphoria. Additionally, cathinones are a hydrophobic molecule that easily crosses the blood-brain barrier. Cathinones also affect the peripheral nervous system (PNS) by blocking adrenergic receptors, thus inhibiting smooth muscle contraction. This can result in blurred vision, increased blood pressure and heart rate to dangerously high levels. Like XTC, some users blunt or prune the serotoninergic nerve endings in their brain causing serious and sometimes intractable depression and significant and possibly permanent cognitive deficits. Lesser known additives and adulterants include talc, an easily attainable and finely ground powdery substance often added to cocaine or heroin to add bulk and to dilute the purity to increase profits. But, talc can cause serious medical problems due to the combined toxicity with the psychoactive substance, and the route of administration. For instance, injecting or snorting talc can cause granulomas in the lungs or liver. Other common adulterants in street drugs include quinine, which is frequently added to heroin. Quinine can cause serious, unpredictable and life-threatening blood disorders and cardiovascular reactions including low platelet count and hemolytic-uremic syndrome which leads to progressive renal failure and other serious sequelae. The local anesthetic lidocaine, and an anti-parasitic drug called levamisole are often added to cocaine and other street stimulants. It is understandable why lidocaine is used to cut cocaine-they are both fast acting local anesthetics, but why levamisole? Recent research reveals that levamisole may be partially metabolized into an amphetamine-like compound which could increase dopamine concentration in the reward pathway and thus activate endogenous opioids. In other words, it can mimic the effects of cocaine at a fraction of the cost. The DEA has estimated that 69% of the seized street cocaine contains levamisole which is associated with several types of severe blood disorders including leukopenia, agranulocytosis, multifocal inflammatory leukoencephalopathy and Neutropenia. Other highly toxic and dangerous adulterants such as strychnine and even ground glass have been found in samples of street drugs, which obviously result in serious medical complications and death. As America’s drug epidemic evolves, technologically savvy, but ethically challenged chemists have figured out that selling adulterated street drugs is a highly lucrative business that shows no sign of

Continued from page 8

recession. It follows that if these amateur pharmacists can make acetyl fentanyl, they will soon learn to make even more potent analogues including carfentanil, of which the toxicity has been compared to that of nerve gas. Why? Carfentanil has a quantitative potency that is approximately 10,000 times stronger than morphine and at least 100 times more potent than fentanyl, with psychoactive response in humans starting at approximately 1 microgram. For this reason, carfentanil is intended for use in large-animals only as its extreme potency makes it too dangerous for use in humans. To date, most illicit carfentanil is imported from China, but it won’t be long before stronger fentanyl analogues such as carfentanil will be homemade by amateur chemist and sold cheaply in the US. What can we do? Education of the public to create awareness and professional education for medical and treatment professionals is a good start. Yet, as in all prevention efforts, parents of young children provide the greatest hope, because no addict’s first drug is heroin or fentanyl. Delaying initiation to all intoxicants is the only proven prevention strategy. In addition, increasing basic scientific research germane to the neurobiology, etiology and pathophysiology of addictive disease is desperately needed if we are to stay ahead of the profit motivated purveyors of these poisons. References Provided Upon Request Mark S. Gold, MD, Chairman of the RiverMend Health Scientific Advisory Boards, is an award-winning expert on the effects of opiates, cocaine, food and addiction on the brain. His work over the past 40 years has led to new treatments for addiction and obesity which are still in widespread use today. He has authored over 1000 medical articles, chapters, abstracts, journals, and twelve professional books on a wide variety of psychiatric research subjects, including psychiatric comorbidity, detox and addiction treatment practice guidelines.

DANGER ZONE TEEN SUMMER SUBSTANCE USE AND TREATMENT By Stephen Gray Wallace, M.S. Ed.

Continued from page 6

him or her calmly, with compassion and clarity. Explain that your decision to get her help is an act of love on your part, not of anger or rejection. It might be useful to ask your child how he envisions life unfolding and how drugs might affect life goals. Good advice during the fun, free days of summer is that closer parental oversight might be necessary to keep kids safe and out of the danger zone. Stephen Gray Wallace is President and Director of the Center for Adolescent Research and Education (CARE), a national collaborative of institutions and organizations committed to increasing positive youth outcomes and reducing negative risk behaviors. He has broad experience as a school psychologist, adolescent/family counselor and college professor. He currently serves as director of counseling and counselor training at Cape Cod Sea Camps, a member of the professional development faculty at the American Academy of Family Physicians and the American Camp Association and a parenting expert at kidsinthehouse.com, NBCUniversal’s parenttoolkit.com and TeenSafe. Stephen is also an expert partner at RANE (Risk Assistance Network & Exchange). For additional information about Stephen’s work, please visit StephenGrayWallace.com. © Summit Communications Management Corporation 2017 All Rights Reserved References Available Upon Request

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

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

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