INTERVIEW WITH DR. PAUL HOKEMEYER WHAT EXACTLY ARE ”ADDICTIVE BEHAVIORS”
SCHOOL’S OUT!
SUMMER SURVIVAL TIPS FOR PARENTS OF TEENS
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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.
one (under the age of 18 yrs. old) and bring them to the facility you have 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.
We directly mail our printed magazine each month to whoever has been arrested for drugs or alcohol in Palm Beach County as well as distributing locally to the schools, colleges, drug court, coffee houses, meeting halls, doctor offices and more throughout Palm Beach and Broward County. We also directly mail to rehabs throughout the country and have a presence at conferences nationally.
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.
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. I know that many of you who are reading this now are frantic that their loved one has been arrested. No parent ever wants to see his or her child arrested or put in jail, but 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 To Advertise, Call 561-910-1943
Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help. Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com. We are on Face Book at www.facebook.com/pages/The-Sober- World/445857548800036 or www.facebook.com/steven.soberworld, Twitter at www.twitter.com/thesoberworld, and LinkedIn at www.linkedin.com/pub/patricia-rosen/51/210/955/. Sincerely,
Patricia
Publisher Patricia@TheSoberWorld.com
For Advertising opportunities in our magazine, on our website or to submit articles, please contact Patricia at 561-910-1943 or patricia@thesoberworld.com.
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INTERVIEW WITH DR. PAUL HOKEMEYER By Patricia Rosen
Dr. Paul Hokemeyer is a Manhattan, Boca Raton, FL and Malibu, CA based Marriage and Family Therapist who serves on the panel of experts for “The Dr. Oz Show” and as a Fox News Analyst. In addition, he is the Senior Clinical Advisor for Caron Ocean Drive, an executive level residential treatment center. He is an internationally recognized expert on treating individuals and families of wealth, power and celebrity for mental health and addiction issues. His academic and clinical research has been published by Lambert Academic Press, The Journal of Wealth Management, and Family Therapy. He is frequently quoted as an expert in a host of media outlets including The New York Times, The Wall Street Journal, WebMD, YahooShine, Men’s Health and others. Patricia: I have read that prior to you becoming a doctor you were a corporate attorney. What made you decide to go into the field of medicine? Tell us a little about your education. Dr. Hokemeyer: I entered the field of behavioral health after experiencing an existential crisis in the wake of 9/11. When the tragedy occurred, I was living in Amsterdam, working for Greenpeace International. After watching the towers collapse, I knew the world I lived in would be changed forever. In my horror and despair, I resolved to move back to America to be closer to my family and the people I loved. Several years earlier I walked away from a highly successful law career in the private sector because I found the practice inconsistent with my ideals of being of service in the world to help people maximize their personal and spiritual potentials. After leaving Greenpeace and Amsterdam, I moved back to Los Angeles to sort out the next phase of my life. I spent the following year in periods of quiet reflection punctuated by unresolved agitation searching for my passion. Once I identified my passion as the process of healing, I decided to go back to school for a master’s degree in clinical psychology. As part of the program, I started working with very marginalized human beings at a free clinic in downtown Los Angeles. At the same time, I began working with an incredibly wealthy family in Beverly Hills. I was fascinated by how people who occupied two very different positions on the economic spectrum were very similar at their core. They both felt disconnected and lost in the world. They both longed for deeper connections to their selves, to others and to their Gods; and they both were looking for happiness that comes from meaningful engagement. What was different, however, was the type of interventions needed to connect with them and help heal their pain. But while there was enormous academic and clinical support for working with the poor and powerless, there was little patience or compassion for the emotional struggles of people of wealth. “How can you stand those people?” was the typical comment I’d hear when discussing my work in Beverly Hills. I was shocked by how professionals who prided themselves in their humanistic stance could put an economic threshold on people who deserved compassionate and culturally competent care. Noting a need to expand the notion of compassionate care to include everyone regardless of their place on the power and economic spectrum, I decided to go back to school and get my PhD in psychology. Patricia: I was reading a story on the website where you were talking about someone with Compassion Fatigue. I will have to get you to write an article on that because I am sure many of the families out there reading this are suffering from that right now! Can you tell us what Compassion Fatigue is and give an example of it? Dr. Hokemeyer: Compassion fatigue describes the exhaustion, frustration and despair that families and loved ones of people who suffer from behavioral health issues experience. It results from the chaos, insanity and betrayal these people feel when the person they
love so dearly seems so dead set on self- destructing. I see it all the time in my practice- the parents of the son who won’t take his bipolar medication and self -medicates with drugs and alcohol; the wife of the husband who won’t end his relationship with his mistress; or the husband of the wife who’s addicted to a cocktail of white wine, Xanax and Ambien. Even though they love the patient dearly, they burn out to the never-ending stream of chaos, disappointment and destruction caused by addictions’ hands. Patricia: How can a person overcome it? Dr. Hokemeyer: The best way to overcome it is by first acknowledging it exists and that you’re not a bad person for feeling it. I find that labeling conditions, including unpopular diagnosis like borderline personality disorder, is incredibly helpful. Once people understand they suffer from a real condition that is found among others, they can start marshaling their resources to heal. These resources include processing their experience with other people, engaging in self-care, setting boundaries and creating a plan for their life that doesn’t center on taking care of the person suffering from the addiction. Patricia: I understand you are also an expert in wealth identity constructs. Can you explain what this is and how it relates to addiction? Dr. Hokemeyer: I approach my work around wealth, power and celebrity as a cultural competency. While there are legions of clinicians and treatment centers that diligently market to elite patients, precious few understand and effectively work in the unique power dynamics these patients bring to the treatment relationship. Like other minority groups, elite patients have distinct cultural markers that present obstacles to treatment. These obstacles include suspicion of outsiders, the ability to control and manipulate their world to protect their addictions, unhealthy dependencies, and the stress of holding the projections of the world around them. Patricia: What is your approach for treating patients with this? Dr. Hokemeyer: My approach is relational and systemic. Emotional and behavioral health issues arise relationally and are cured relationally. The key of course is replacing negative and destructive relationships with positive and reparative ones. The first relationship that needs to be addressed is the relationship the patient has with his or her self. They must understand their relationship to their body and see their disease as a biological condition hard wired into their brain and central nervous system. They must then look at the formative relationships in their lives, the ones that provided the blue print for how they view their selves and their place in world. In this regard, I draw heavily from attachment theory. I’ve found most successful people who suffer from addictive disorders also suffer from an insecure attachment. In spite of their external bravado and material success, deep at their core they feel unsafe in the world. I also find many have a history of trauma or neglect in their childhood. This trauma hyper activates their central nervous system and makes them reach for things outside their selves to self soothe and guard themselves from emotional pain. Central to healing from these relational disorders is establishing a strong therapeutic alliance with their clinician to explore and dismantle systemic forces that support their disease. For elite patients, people who exist as a minority in the world by virtue of their celebrity or wealth, the psychotherapeutic connection requires a heightened sensitivity and empathetic understanding by the clinician. It’s an art that unfortunately too Continued on page 38
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WHAT EXACTLY ARE “ADDICTIVE BEHAVIORS”? By Bruce S. Liese and Carina Fowler
Bill’s wife, Pat, is concerned about him. She complains that Bill “smokes like a chimney.” Josh’s mom continually asks him to get off the computer. She is certain that he spends too much time playing online games. It really disturbs her that he has no other interests and seems to spend every waking hour playing online. Gina is angry with herself because she can’t pay her bills. And she admits that she can’t pay her bills because she has gambled away all of her income and savings. Andrea’s sister, Marie, is worried about her. Whenever Marie visits Andrea she notices that there are empty vodka bottles in the trash. What do Bill, Gina, Andrea, and Josh have in common? Most would recognize that all four are actively engaged in addictive behaviors, and a growing number of addiction researchers would agree. Still, there has long been disagreement over how to answer the question “What is an addiction?” In the past, many might have argued that Gina and Josh did not have an addiction because their gambling and online gaming didn’t involve the ingestion of a chemical substance. However, today, the growing scientific literature suggests that addictions are not exclusive to substances, but that we can become addicted to certain behaviors as well. Evidence from biology and psychology suggests that addictions can be both chemical and behavioral. Functional Magnetic Resonance Imaging techniques (fMRI) can show us what is going on in people’s brains. These machines take pictures of people’s brains, and when part of a person’s brain is active, that portion stands out on the fMRI’s picture. fMRI studies show us that many types of addiction stimulate the same pathway, the brain’s reward system. When you experience something that you like or enjoy, a chemical in your brain (a neurotransmitter) called dopamine sends a message from one part of your brain (the ventral tegmental area) to another part of the brain (the nucleus accumbens), resulting in a feeling of pleasure. In fMRI studies, addicted brains “light up” similarly when looking at whatever they are addicted to. So, if we put Josh in an fMRI machine and show him pictures of World of Warcraft, and then put Bill in the machine and show him pictures of cigarettes, the pictures of their brains would look very alike. Interestingly, research suggests that people at high risk for substance use disorders are also more likely to develop behavioral addictions. In 2000, a study conducted by Wendy Slutske and her colleagues at the University of Missouri found that men likely to develop problems with alcohol were also likely to develop problems with compulsive gambling. Another interesting research finding is that people who struggle with addictive behaviors often transition between addictive behaviors. Some people would label this behavior “symptom substitution.” Bill, for example, might start compulsively playing Internet games while he tries to quit smoking. An exciting concept that has emerged in the fields of behavioral and chemical addictions is the “addiction syndrome,” a term coined by Harvard psychologist, Howard Shaffer. He views addiction as a group of related symptoms that develop together over time. But what exactly is a syndrome? AIDS is a good example. The same group of symptoms marks AIDS: HIV infection, a damaged immune system, and death by rare infections. Even though the infection that ultimately kills someone with AIDS differs from patient to patient, the underlying cause of death is the same. Addiction, Shaffer argues, is similar. Just like AIDS, it can reveal itself in different, but similar ways. A person with an addiction may have problems with gambling, cocaine, or alcohol, but the root causes of the addiction will be similar. Shaffer calls these the distal and proximal causes of addiction. Distal causes of addiction can be thought of as risks of developing an addiction, while proximal causes can be thought of as more immediate causes. To help think about the addiction
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syndrome, let’s return to our friend Andrea from above. Andrea had a genetic risk for developing alcohol problems. At 22, she began drinking to help deal with her father’s death. For Andrea, her genetic risk is a “distal” cause because it made her vulnerable to alcohol problems. Her father’s passing was a “proximal” cause because it was the event that actually triggered her to start drinking. While Shaffer thinks about addiction as a syndrome, experts also look at addiction in terms of the behaviors that make it up. English psychologist Mark Griffiths says that an addictive behavior has six components—salience, mood modification, tolerance, withdrawal, conflict, and relapse. To understand Griffiths’ model, let’s look more in depth at Gina, our gambler. Gina goes to the casino four or five nights per week. For Gina, gambling is the only activity she engages in outside of work, and it dominates her thinking. Even at work, Gina finds herself constantly working out strategies for how to win more money playing cards and working the slot machines. In other words, gambling is highly salient, meaning that the activity is the most important thing in her life. Gina says that going to the casino makes her feel excited, but also oddly calm—as if she knows that the casino is where she is supposed to be. Gambling modifies her mood. Gina says she used to gamble only once a month or so, but now she must go more regularly in order to feel the same “rush” from winning. Over time, she has built up a tolerance to gambling. When she cannot go to the casino during her occasional business trips, Gina becomes extremely irritable, showing signs of withdrawal. Gina’s gambling is also producing conflict in her life. Her behavior deeply concerns her husband, who wants her to consult a psychologist or a physician, but when he has mentioned it before, they have had a big fight. So, then, what is an addiction? Well, it depends on whom you ask. While some physicians and researchers hold fast to the idea that addiction can only be chemical, a growing body of research in neuroscience and psychology shows us that addictions can be behavioral as well as chemical due to shared pathways in the brain, underlying causes, and behaviors. Bruce Liese, PhD, ABPP is a Professor of Family Medicine and Psychiatry and Courtesy Professor of Psychology at the University of Kansas. Dr. Liese is a scholar, teacher, clinician, and clinical supervisor who has lectured and presented workshops nationally and internationally. He has more than 50 publications and has coauthored two texts on addictive behaviors with Dr. Aaron T. Beck. Dr. Liese was also Editor of The Addictions Newsletter for ten years, an official publication of APA’s Division 50 (Addictions). For this work he received the Division 50 President’s Citation. Carina Fowler, BA, is a 2013 graduate of Washington University in St. Louis. She was the recipient of Washington University’s 2013 Arnold J. Lien Prize for Outstanding Graduate in Political Science. She plans to apply to graduate programs this fall.
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MUSIC…MAKES THE PEOPLE…COME TOGETHER. AND HEAL! By P.D. Alleva, MSW
Have you ever heard of the healing power of laughter or music? How many songs do you have in your iPod and what significance does each song or artist have for you? We relate dates, times, events and the greatest moments of our lives to song and music. Three times a week I go for a two mile walk, headphones on and music blaring, allowing my thoughts to roll over in my mind to provide feedback and conclusions to daily problems and concerns to conjure up some positive thinking and solutions. Music is everywhere; it binds us as a society. Watch the many music awards or go to a concert, you’ll never feel more in unison with your fellow humans than when your favorite band belts out your favorite song and all the people in attendance have united in a thousand voices to sing as one.
Human beings are creatures of habit. We fall into cycles that are either good, bad, or both, and when a change begins to present itself, or a crossroad of life emerges, some of us take the challenge by the horns, others falter, and then some of us just simply freak out altogether. These are the times to listen to something new, a new beat, a new drum, a new musician or band, or even a new era of music- it’s a fact people, Mozart works for babies and it will work for you too. Switch your favorite radio station to a classical or jazz station or a classic rock or pop station. Change your morning radio show to something else as well. These simple changes allow your mind to be prepared for change while giving your brain the proper time to manifest and process the information and changes you are going through.
Music can clear your mind and enrich your soul. My wife and I went to see Andrea Bocelli on Valentine’s Day and during the performance the female opera singer he had brought on stage with him reached a high note that filled the arena so perfectly, so clearly and so profoundly, I turned to my wife and said, “My Lord, my soul has just been enriched!” I wonder now at what frequency that note had reached. There is much discussion in the scientific community concerning the frequency of 528 Hz, which is ascribed to be the frequency for which the sun emanates its core energy, as well as the frequency that comes from our hearts in the form of joy. It is also the frequency used by biochemists to repair broken DNA. I’m more than sure if there was any broken DNA in the arena that night, that note would have repaired them all.
Here’s another possible lesson from music. Instead of spending your nights in front of the classical boob tube and watching another episode of reality television or taking on a new comedy or drama series that’ll be sure to tap and zap your time and effort, take a night where you and your spouse, you and your friends or you and your kids click on the radio and listen to some good music and allow the conversation to flow from your lips like a space ship rocketing into outer space. See and feel how such an event plays out with your family. Light some candles, eat, drink and be merry, as the saying goes. I’m more than sure you will all be pleasantly surprised with the outcome of such a night. Plan on similar nights at least once a week.
The healing powers of music date back to thousands of years B.C., when the philosopher, mathematician, scientists and psychologist, Pythagoras, healed people using frequency vibrations in the form of music. That’s correct; Pythagoras was more than the guy for which most of us were annoyed by the essential Pythagorean Theorem in high school math class. Music is known as the highest form or artistic expression, for no other medium of art can change our mood in an instant. It’s the perfect stress relief, self-confidence booster and lends to our mental wellness. Music can also be used to aid in our personal self-improvement. For those who have difficulty meditating, music offers the perfect avenue to do so. I wrote above about taking a walk with my headphones on and allowing my thoughts to roll over in my head; this is a form of mediation, a practice that leads to conclusions and sharpness of the mind. But there are also many other ways to use music to “clear your head.” People often get stuck in making decisions, or fall into a rut when life starts pouring down challenges, one after another, and it seems like we will never be able to get out of. These are the times when I would suggest switching the channel.
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Music truly does bring people together; it’s just about a no brainer. I’m not going to try to stuff any particular music down your throat, your all big boys and girls and can make decisions on your own, however, I wouldn’t be doing my due diligence if I didn’t suggest listening to some smooth jazz, classical or meditative music to help heal the mind as you are moving through changes and transitions in your life. These types of music mediums help the mind to settle down and relax, allows your mind to process information with a calm and meditative state of mind, a relaxed and focused brain where the answers you are seeking to current problems come into awareness and are uncovered like that moment where you finally find your car keys with a quick remembering of where you had placed them to begin with. The answers are always already in play, we just need some help uncovering them. Live long and prosper! Paul is the founding owner of Lifescape Solutions and Evolve Mental Health which he opened in December of 2011, based on a new model of healing and psychotherapy called Spiritual Growth Therapy. His newest book Let Your Soul Evolve: Spiritual Growth for the New Millennium 2nd edition describes the model.
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THE SILENT ASSAULT ON AMERICANS WITH ADDICTIONS: INSURANCE COMPANIES PLAY DOCTOR PART II By: John Giordano DHL, MAC
This is the second installment of “Insurance Companies Play Doctor.” Among other things in the first segment, I outlined how many people like Avery – a bright young woman with a promising future whose life fell apart after becoming addicted to heroin in college – are trying their best to get off drugs but are being diverted away from treatment due to insurance payment complications and put on methadone or suboxone. This is a pattern that occurs with increasing frequency everyday. I also delved into the similarity between healthcare industry’s business model and that of casinos and bingo parlors in that both profit the most when they pay out the least. I also pointed out the insanity of literally placing our health in the hands of an industry whose mere existence depends on not providing you and I with the healthcare we paid for. As fate would have it, I recently met a substance abuse case manager who works for one of the major health insurance companies. It was in a social setting that I found Angela (not her real name) to be very well educated, kind and warm. She earned her masters degree in health. We were having a wonderful conversation until the inevitable happened; the subject of addiction treatment and health insurance came up. Although we both remained cordial towards each other, the mood changed making the tension became palpable. Angela started the conversation with a defense of her position. She explained to me how back in the day doctors got rich by over-proscribing addiction treatment and it is her job to make sure her company only pays out for what is “medically necessary” in accordance with The American Society of Addiction Medicine (ASAM). I could only think that what she was referring to was years ago when I first got involved with addiction treatment when 30 days meant intense level 1 residential treatment. This is the first stage where a person spends their entire time living at the facility while being treated for their disease by their doctors, therapists and trained staff. What Angela quoted me were the core principles of assembly line treatment where addiction treatment protocols are no different then that for a broken bone; a one size fits all. Once a patient passes an ASAM benchmark they’re moved on the conveyer belt to the next station on the line never to return; just like setting a broken bone – put a cast on it and in six weeks take it off and everything will be just ducky. While ASAM may sound all neat and tidy to the layman, the reality is that addiction treatment is non-linear – it doesn’t follow a straight path. Anyone who has been involved in addiction and/or mental health treatment – even in the slightest way – knows it follows a curvy path. There are highs and lows, twists and turns; it looks more like a roller coaster then a straight assembly line conveyer belt. As I tried to explain this to Angela I was quickly shut down. She was having nothing of it and went on to tell me that even today centers are over billing for unnecessary protocols, tests and expenses. My agreement with her position seemed to calm her a bit. The reality is treatment centers are like any other business and you will find some bad apples among the operators. Yet if you talk to a number of treatment centers as I do, many of the owners will tell you that the insurance companies have squeezed them so tightly that they can’t stay in business without using some form of creative billing. I’ve spoken with many practicing doctors and therapists who work everyday in the facilities treating their patients who are afraid to tell the insurance company someone is improving for fear that they’ll mandate a lower level of treatment before the patient is ready. I decided to take control and shifted the discussion to outcomes.
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Angela informed me that out-patient treatment – the least expensive drive-through treatment available – was showing great results; and later admitted there is no imperial data to support that claim. She also reminded me that the treatment centers could challenge her decisions and have the case arbitrated by one of their physicians. Upon hearing their physicians roll, I asked Angela if she was familiar with the Physicians Health Program. She looked at me like I had two heads. The Physicians Health Program came into presence in the early 70’s. At the time, many talented doctors were loosing their license to practice because they became addicted to the drugs they were prescribing, illicit drugs and also alcohol. The Physicians Health Program was created by doctors to act as an intermediary between addicted doctors and the medical board. They oversee the treatment of doctors in rehab. It’s a five year program that begins with intense level one, 90 day residential treatment, sometimes longer. The Physicians Health Program is the most effective addiction treatment protocol available boasting a success rate of over 75%! Every doctor with a license to practice knows about the Physicians Health Program. Any competent doctor in addiction treatment knows that the longer a patient stays in intense level 1 residential treatment, the greater their chances are for a better outcome. This is where the hypocrisy becomes so thick you could cut it with a knife. The healthcare industry has proven that they can hire doctors – the ones Angela referred to as arbitrators – who are aware of effective treatment protocols, and for a few pieces of silver will look the other way and recommend treatment based on company profits but conflicts with the best interests of a vulnerable patient; sickening. What really got to me about my conversation was how warm Angela was until we began talking about addiction. It was as if a switch went off in her head and she became very cold and callus. Angela was unabashed in her description of the adversarial relationship existing between her and treatment centers. She clearly presented her perception of treatment centers being petty thieves whose prime objective is to rob her company vault of all its treasures. Angela’s delivery left no doubt that she has dehumanized treatment workers – and to an extent addicts – in her own mind. Never did it seem to register with her that these are helpless people who paid their premiums and desperately need treatment. I never got the impression that she realized her decisions could be the difference between life and death. Not once did we speak of the consequences of the decisions she made daily. Her views were so skewed towards the insurance company she works for that I really don’t think she could emotionally handle the complete reality of it all. Most of the conversation was about money and very little about effective treatment. Angela, and I’d suspect the vast majority of her coworkers are no more qualified to be addiction/mental health case managers than I Continued on page 42
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FOCUS ON WHETHER PEOPLE ARE DOING GOOD, NOT WHETHER THEY ARE DOING DRUGS By Dr. Carl Hart
Why do people who previously had problems related to their drug use introduce themselves by telling us the length of their sobriety? That’s what I was thinking as I sat and listened to a group of “recovering” faith leaders among others. I had been invited to speak about my research and views on drug addiction. Around the room we went. “Hi, I’m Janet and I’ve been clean for 20 years… I’m John and I’ve been in recovery for addiction the past 12 months.” Each person proudly proclaimed how long she/he had been abstinent. It was as if, the substance itself had been the problem, or as if, the outcome measure, abstinence, was a proxy for the speaker’s virtue. They had fought the devil and won. As a neuropsychopharmacologist who has spent nearly 20 years studying the neurophysiological, psychological and pharmacological effects of recreational drugs, I found this scene surreal. Having given thousands of doses of these drugs to people and carefully studied their immediate and delayed responses, my findings show that the addictive potential of even the most vilified drugs such as crack cocaine or methamphetamine is not extraordinary. In fact, nearly 80 percent of all illegal drug users use drugs without problems such as addiction. In other words, drugs aren’t the devil or something that is inherently evil. It’s true, some people – the other 20 percent or so – struggle to control their consumption of various substances, which have disrupted their ability to meet important obligations, including childcare, employment, social, etc. It would be a mistake, however, to conclude that the substance itself is the problem. People become addicted for a variety of reasons ranging from psychiatric disorders to economic desperation to underdeveloped responsibility skills. That is why it is, first, critically important to determine the reasons underlying each person’s addiction before perpetuating myths about the cause or intervening with half-baked solutions. For example, if a person is abusing alcohol to deal with anxiety or trauma, effective treatment of the psychiatric illness should lessen the abuse of alcohol. Likewise, providing responsibility skills to some addicts will go a long way in helping them temper their overindulgence in disruptive behaviors. When it was my turn to speak, I started by acknowledging the fact that I had been unclean for the past 25 years. Although it wasn’t my intention, this remark proved provocative as it elicited perplexed stares from those listening. The goal wasn’t to advocate recreational drug use or to disclose my personal pleasures for some frivolous reason; rather, it was to draw attention to how some people in recovery, including the clergy, focus on less relevant and less important outcome measures such as sobriety duration. How well one meets their social, familial, and/or occupational responsibilities are considerably more vital outcome measures than simply abstaining from the use of a substance. I am far more concerned about an individual’s contributions to human rights or to her community than whether she used heroin recently. For argument’s sake, though, suppose those in recovery announce their sobriety length to indicate a measure of self-control. Even still, this information is inadequate to determine whether self-control is being exercised for socially appropriate or desired purposes. It’s not difficult to imagine someone abstaining from alcohol use to avoid the potential cognitive dampening effects while they commit a crime or multiple crimes. Some may recall Bill Cosby’s anti-drug PSA from the 1970s urging young people to avoid amphetamines; he’s accused of drugging and sexually assaulting women during the same time. Granted, I recognize the importance of exercising self-control. It allows many people to function better, especially in the face of competing demands. But, knowing something about one’s ability to exercise self-control in one limited domain provides virtually no
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information about the type of person they are, about how well they care for their fellow citizens, particularly the least among us. These qualities, I had hoped, would have been emphasized during my meeting with the faith leaders. They weren’t. There was a time, not long ago, when it was acceptable to ascribe human characteristics to drugs, blame them for our shortcomings, and exploit our fears about them as a distraction for other abhorrent behaviors. For decades, magazines and newspapers routinely ran stories connecting drugs to heinous crimes, and some even claimed that black people under the influence of cocaine were impossible to control even when bullets were fired into their hearts. Dr. Edward Williams wrote in his 1914 New York Times article entitled, NEGRO COCAINE “FIENDS” ARE A NEW SOUTHERN MENACE, “The drug produces…a temporary immunity to shock--a resistance to the knockdown effects of fatal wounds.” More than one hundred years later and armed with a voluminous scientific database, we no longer have an excuse for indulging in myths and misinformation about drugs. People in recovery should discard the public ritual of professing their clean time; it doesn’t convey relevant information. Instead, it misplaces the focus such that we have become more concerned about a person’s drug use than their character. Dr. Carl L. Hart is an associate professor of psychology in the departments of psychiatry and psychology at Columbia University and is the author of the recently released book “High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society.” Twitter - @drcarlhart
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EMDR IS CRITICAL IN TREATING MEN’S TRAUMA AND ADDICTION By Jim Snow, M.Ed., CAP, EMDR, ICADC
Do men really suffer from trauma? Men’s trauma issues have historically been solely associated with Post Traumatic Stress Disorder (PTSD) attributed to combat. However, men’s trauma and PTSD issues are not so limited. For too long men’s trauma has been overlooked or misdiagnosed by those in the helping professions. Chronic substance abuse, aggression, fear, detachment, dissociation and anti-social traits are characteristic of trauma. Gender and cultural biases about men not only interfere in identifying trauma in men, but also are a barrier for men seeking substance abuse treatment. After all, men are tough, strong and don’t cry, right? The result of this misidentification is chronic recidivism in addiction, on-going family suffering and countless lives that have been destroyed. Most, if not all men suffering from addiction have experienced trauma. That trauma may be from childhood physical or sexual abuse, emotional abuse or neglect, or it may be trauma stemming directly from addiction. Regardless of the source, men suffering from addiction are traumatized. Most men afflicted with addiction have witnessed or been involved in violence while trying to get or use drugs. Bar fights, over-doses and death are common. Many men with severe opiate addiction have traded sex for drugs, often times resulting in sexual and physical trauma. The point is, men with addiction usually have a trauma history. What is trauma? Trauma is the reaction to an overwhelmingly negative experience that is perceived as life-threatening. Trauma takes a variety of forms including emotional, physical, sexual, combat, violent crime, and more. The result is a physiological change to the individual’s brain and central nervous system. The individual lives in a state of hyperarousal, fear and anxiety. According to the American Psychiatric Association, the diagnostic criteria for PTSD include: 1 Exposure to and actual or threatened serious injury, sexual violence or death in one of the following ways: a Directly experiencing the event b Witnessing events occurring to others c Learning that traumatic events occurred to a family member or friend. d Experiencing repeated extreme exposure to aversive details of the traumatic event 2 The presence of intrusive symptoms associated with the traumatic events beginning after the event occurred which includes memories, recurring distressing dreams, dissociative reactions including flashbacks, intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events. What is EMDR? In 1987, Francine Shapiro, Ph.D., the originator and developer of Eye Movement Desensitization and Reprocessing (EMDR), noticed that disturbing thoughts she had been replaying in her mind seemed to evaporate while she was walking. Dr. Shapiro focused on the events that took place when she realized her disturbing memories started to abate. The disturbing memories evaporated as she deliberately moved her eyes back and forth rapidly. She explored this phenomenon further with friends and colleagues and found that through stimulating both hemispheres of the brain, people were able to eliminate, or reprocess the disturbing emotions associated with a memory. Since Dr. Shapiro’s discovery, vast amounts of research and evaluation have been conducted on EMDR. Today, this therapeutic approach is a valid, evidencedbased practice that has been proven to be effective in helping people heal from trauma and anxiety. The foundational principal of EMDR is that the human body and mind are self-healing. However, trauma and disturbing memories can be
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blocked from healing in the same way that an open wound can be blocked from healing by an infection. Through a prescribed series of steps, the blocks to healing are removed and the mind can “reprocess” traumatic memories and events. The emotional energy surrounding an event or memory evaporates. The intrusive thoughts, feelings, nightmares, and other symptoms of traumas and PTSD are eliminated. One of Dr. Shapiro’s patients reported that his traumatic memory from a combat mission “looks like a paint chip at the bottom of a pool.” He was able to reprocess the suffering from his combat experience. EMDR Helps Men Heal From Trauma Multiple myths about men’s reactions to trauma exist in our culture. These include such perspectives as, “men don’t experience trauma; only women do,” “men are not as disturbed by sexual abuse as women,” “men are built to be tough,” and many others. Due to these gender and cultural biases, men’s trauma has been minimized or, worse yet, dismissed by the helping professions. Engaging men in treatment for substance abuse issues and trauma is challenging; men don’t talk about their feelings, emotions or experiences. Yet we expect men entering treatment to display these characteristics. Group and individual work is focused on expressing feelings, but in our society, men are educated to be resistant to these types of expression. Our culture trains men to function in only one way, but when addiction problems arise, we expect men to function in a completely different manner with completely different rules. Is it any wonder that recidivism into active addiction is so high? Through implementation of EMDR, men are able to access, identify and process painful memories and emotions quickly and efficiently without entering into that vulnerable position of emotional selfdisclosure. Since EMDR is completely client centered, the client is empowered to determine what is addressed in each session. The client may choose to end the session should the experience become overwhelming. The client drives the process, not the clinician. In some instances, the client may choose not to disclose the event or memory that is the target of the session. Not revealing the details of an event or memory has little bearing on the outcome of the session. The use of EMDR is critical in the treatment of men with trauma and addiction because it doesn’t require men to shed gender role expectations immediately. This is not to say there is no value in the use of other clinical approaches or tools, but it takes time to develop rapport and safety before men fully disclose their histories. In working with men, developing awareness of emotions, taking risks to trust and becoming vulnerable with others is important. The application of EMDR provides men in treatment immediate and profound relief. Experiencing this relief is powerful and encourages men to more fully engage in the treatment process. Jim Snow is the Clinical Director at Seastone of Delray. He brings more than 25 years of experience in trauma work, substance abuse, mental health and family therapy. Jim is an EMDR practitioner and an Associate Member of the EMDR International Association. He holds a Master of Counselor Education from Penn State and is a Certified Addictions Professional and holds International Certification.
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SLOWING DOWN THE INITIATION OF ADOLESCENT SUBSTANCE USE: PREVENTION IS THE KEY By Fred Dyer, PhD., CADC
Research informs us that most young people who initiate the use of alcohol, tobacco, or other substances do not go on to develop a problem with substance dependence. Nevertheless, one-third of young people begin a journey down the road to dependence. Before addressing the difference between adolescents whose use becomes addictive or dependence and those who do not develop these problems, it is important to ponder the underlying reasons, from research and those adolescents provide, why they use. It is a well-established premise that adolescent substance use begins with experimentation. With that said, the more salient question to be answered is the motivation behind their experimentation.
factors are those predictors that buffer the effects of risk factors on substance use, and promotive factors are those predictors that have a direct negative relationship with substance use. Longitudinal prospective research studies have identified seven factors that promote positive social development: 1) High intelligence 2) Resilient temperament 3) Social, emotional, and cognitive competence 4) Opportunities for pro-social involvement 5) Recognition for positive involvement 6) Bonding, and healthy beliefs 7) Standards for behavior
Prevention and intervention research provides three motives: 1) A coping motive 2) A drug-experience motive 3) A peer-influence motive Identifying and understanding the motivation for alcohol and drug use has definite prevention and treatment implications. In short, a simple question to ask any adolescent in counseling, whether individual or group, is, “What purpose do alcohol and drugs serve?” and with an understanding of the motive for use, as well as the purpose, therapists, prevention specialist, and interventionists can proceed to provide a connection to the risk factors. Risk factors are those predictors associated with an increased likelihood of substance use or other behavioral disorders. An important question often asked by parents is where they should look for risk factors. Risk factors have been found in the individual (e.g., genetic predisposition) and the environments in which young people are socialized, including the family (e.g., family conflict), the school (e.g., school failure), the peer group (e.g., friends who use substances) and the community (e.g., availability of alcohol and drugs). It is necessary to point out that many of the risk factors for substance use can eventuate into other problems, including but not limited to, delinquency, teen pregnancy, dropping out of school, violence, depression, and other problem behaviors. In examining risk exposure, there are two common patterns. For some children, risks begin to accumulate early, because early development challenges without protection lead to increasing challenges as youth are exposed to new environments (e.g., school, peers). This has been referred to as a “snowball pattern” of risk. For example, a mother smoking during pregnancy might impact fetal and early childhood development, which may lead to cognitive delays. Such delays may, in turn, lead to poor school adjustment and greater association with other poorly achieving youth in school settings. These factors can lead to great vulnerability to early substance use.
It is necessary to understand that the first three factors are comprised of individual characteristics that protect adolescents, even in the presence of risk. The last four protective factors involve three environmental processes that protect adolescents. The identification of risk and protective factors that lead to the development of prevention approaches, seek to increase protection while reducing risk. Wide ranging types of programs have been found to be effective, not only in the prevention of alcohol and drug use, but also with their corresponding problems. School-based Programs Effective school-based programs include enhancing, instructional, and classroom management skills, using classroom curricula that promote social, emotional and cognitive competence, and tutoring. School programs focused on improving academic performance and bonding to school and reducing classroom management problems have produced reduction in early aggressiveness. The following represent effective policies and programs for presenting problem behaviors: • • • • • • • • • • • •
Prenatal and infancy programs Early childhood education Parent training After-school recreation Mentoring with contingent reinforcement Youth employment with education Organization change in schools Classroom organization, management, and instructional strategies School behavioral management styles Classroom curricula for social competence promotion Community and school policies Community mobilization
Protective and Promotive Factors
In conclusion, it is important to understand that, regardless of the prevention approach, the focus should be on both reducing risk and enhancing protection for the adolescent. For maximum effect, prevention programs should address risk and protective factors early, and only those prevention interventions that have demonstrated effectiveness should be used to address community profiles of risk and protection. The implication is clear, the earlier we as prevention specialists, therapists, staff workers, consultants and all those who have a passion for working with adolescents start with prevention interventions and approaches, the sooner we can save lives, because saving lives is the ultimate goal in our work.
In any discussion of adolescent substance use, the questions often asked are, “Why is it that some adolescents exposed to risk factors succumb to alcohol and drugs and others who are exposed to those same factors do not?” “What motivates those who do not succumb to go on and develop healthy lifestyles and not become involved in problem behaviors?” The answers lie in the identification and utilization of protective factors that promote positive outcomes and which protect against the impact of risk exposure. Protective
Fred Dyer, PhD., CADC, is an internationally recognized speaker, trainer, author and consultant who services juvenile justice/detention/residential programs, child welfare/foster care agencies, child and adolescent residential facilities, mental health facilities and adolescent substance abuse prevention programs in the areas of implementation and utilization of evidence-based, gender-responsive, culturally competent, and developmentally and age appropriate practices. He can be reached at www.dyerconsulting.org
A second pattern of risk is exposure to friends who use drugs and to positive norms about drug use. Over time, this exposure, when not countered with protective factors, may lead some to succumb to this snowstorm pattern of risk. For example, greater exposure to drug availability, favorable attitudes toward use, peer use, and weakening from the family during a time of increasing dependence may lead some youth, even those without earlier patterns of risk, to develop substance use problems.
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SCHOOL’S OUT! SUMMER SURVIVAL TIPS FOR PARENTS OF TEENS By Mendi Baron, LCSW
It’s summertime! For teens, the countdown to summer break has begun. The structure of school, busy scheduling and balancing act of extracurricular activities and homework will soon transform into unadulterated independence. Summer is a time for teens to slow down the pace and relax for twelve weeks. Long days and warm sunshine, freedom from schoolwork and responsibilities, hanging out with friends and sleeping until noon is on the horizon. For some parents that scenario is a nightmare. Even if you have planned a long family vacation, or your teen is off to camp for the entire summer or attending summer school, there will still be hours each day of the summer that your teen has absolutely nothing to do. The thought that a teen will neither be productive nor have every minute of their summer planned out can throw some parents into panic. The fear is that not doing anything, or taking the summer “off” won’t look good on that not so far off and ever-important college application. Or worse, mixing boredom, less structure, minimal adult supervision with the teens “need” to break away from parental control and achieve independence is a recipe for trouble and possibly risky behavior and experimentation with drugs and alcohol. Don’t let the start of summer turn into conflict, crisis, or the countdown until September. The key to keeping your teen out of trouble and away from bad influences and creating both a positive and memorable summer experience is to provide consistency and stability by: • Keeping to a basic household schedule for mealtime, household tasks, bedtimes and curfews throughout the summer. • Maintaining the same clear and reasonable boundaries as to what is expected, acceptable behavior and what is NOT permitted both under your roof and outside the home. • Staying clued in to what your teen is doing with whom, where and when. • Balancing structured and unstructured time (which does not translate into “unsupervised” time). Don’t let summer turn into no-man’s-land for your teen. Here is the Summer Survival Toolkit for Parents of Teens: 1. A spontaneous staycation Rather than taking the classic epic planned summer vacation, which can be ripe for disaster, try a staycation filled with activities and outings in driving distance. A quick escape from daily routines can strengthen family bonds and have everybody in their own bed by nightfall. 2. Delight in downtime Studies show that teens today are over-scheduled, sleep-deprived, digitally distracted, and sapped out even over the summer. Downtime is essential for the teen brain and body development. Summer allows more time for teens to rest, relax, reflect, and replenish. “Unstructured” and “unplugged” time, reading, listening to music, walking the dog, going for a bike ride, or just doing nothing also allows for parents and teens to connect, de-stress, and daydream together. 3. For the love of learning Summer can offer time for your teens to explore,
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discover, and learn new things or a new skill. Ask your teen if there is something they want to try? Invite your teen to explore something they have never done before. There may be a teen program in art, music, or dance or perhaps a course at a local zoo, planetarium, natural history or science museum? 4. Growth, responsibilities, and random acts of kindness Getting involved in volunteer work not only keeps teens occupied, but also more importantly it helps teens take the focus off themselves and develop a sense of purpose and personal responsibility. Encourage your teen to find a volunteer organization that sounds interesting: an animal shelter, a senior home, a soup kitchen -- some place where they will experience the joy of giving back - even if it is just one day. 5. Teen entrepreneur What better way to provide your teen with financial independence and encourage their ability to take on responsibilities outside the family, and structure their time then to start their own business? Babysitting, lawn care, and dog walking are all perfect jobs for reliable teens over the summer -- and sometimes this can carry on through the school year. Summer break is an opportunity to build your family structure and strengthen your relationship with your teen. Giving your teen time to recharge their mental and physical energy with a balance of structured and unstructured activities let’s them return to school refreshed. Your teen will be grateful for your encouragement and involvement both in the short and the long run. Mendi Baron, LCSW, a passionate advocate for teens in the field of mental health and addiction and the go-to expert to start the conversation on critical issues that impact teens and their families, is the founder and CEO of Evolve Treatment Centers based in Southern California. For more information, please go to www.evolvetreatmentcenters.com
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3/27/15 10:36 AM
SUCCESSFUL RECOVERY REQUIRES “NORMAL” SOCIETY TO SET ASIDE STIGMA By: Jeffrey C. Lynne, Esq.
For almost 30 years, Delray Beach has quietly been a welcoming place for people in recovery. By 2007, Delray Beach had been recognized nationally by the New York Times as being an oasis of sobriety, where people came from all across the nation to join this ever growing recovery community. Though intended to be a positive article about human coexistence and tolerance, local communities across the country, from Delray Beach, Florida to Newport Beach, California viewed this article as confirmation that a “cancer” was “metastasizing” within our country in the form of substance abuse treatment providers and those in recovery who were “immigrating” into “their” cities under the protective shield of the federal Fair Housing Act and the Americans with Disabilities Act. Though sad to admit, our experiences in city halls across the state have demonstrated that we Americans have an odd cultural aversion to people in recovery. Americans – with our slogan of “individual accountability and self-responsibility” – have come to fear and loathe people in recovery or those who suffer from mental illness. Similarly we do not like to see or properly care for our elderly, our infirm, or our disadvantaged either. Our elderly are placed in assisted living facilities; our infirm in hospitals; and our disadvantaged in our ghettos. But we seem to keep a special place in our hearts for addicts.
By 2007, Delray Beach had been recognized nationally by the New York Times as being an oasis of sobriety, where people came from all across the nation to join this ever growing recovery community. Underlying this fear is the malignancy of stigma. A diagnosis of mental illness carries with it legal disabilities as well as social rejection. Surveys show that people with Substance Use Disorder are the most negatively perceived of all disabilities and, until recently, were denied the right to care by insurance companies, causing hundreds of thousands of Americans to be denied necessary care from an affliction that was not of their own making. Initially, we too were naïve as to what a “sober home” was. We thought it was a place where people who were arrested for drugs went to live. Or a place where people checked themselves in to “dry up” until they were sober. Through it all, we have come to recognize that there are real and serious threats to our communities from poorly run and unsupervised sober living residences. However, this is no different than any other “bad neighbor” would be, and the reality on the ground is that there is no evidence that a sober living residence has a negative impact upon a community. And the facts support this: • Recovery residences have no effect on the value of neighboring properties. More than 50 studies have examined their impact on property values probably more than for any other small land use. Although they use a variety of methodologies, all researchers have discovered that group homes and halfway houses do not affect property values of even the house next door. They have no effect on how long it takes to sell neighboring property, including the house next door. They have learned that community residences are often the best maintained properties on the block. And they have ascertained that community residences function so much like a conventional family that most neighbors within one to two blocks of the home don›t even know there is a group home or halfway house nearby. • Recovery residences have no effect on neighborhood safety. A handful of studies have also looked at whether community residences compromise neighborhood safety. The most thorough study, conducted for the State of Illinois, concluded that the residents of group homes are much less likely to commit a crime of any sort than the average resident of Illinois. It revealed a crime rate of 18 per 1,000 people living in group homes compared to 112 per 1,000 for the general population.
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• Recovery residences do not generate adverse impacts on the surrounding community. Other studies have found that group homes and halfway houses for persons with disabilities do not generate undue amounts of traffic, noise, parking demand, or any other adverse impacts. But notwithstanding the facts, even the most educated of our society - a population that presents prototypically as “liberal” on a variety of social issues such as race discrimination and homophobia – continue to demonstrate deep seeded fear and antagonism towards people with Substance Use Disorder, their families, and their treatment providers. National studies of this phenomena found two trends to have emerged. First, virtually every person had a visceral reaction that people in recovery are addicts laying on gurneys with an IV in their arm, drooling at the mouth. Once released from treatment, the belief was that “those people” return to their zombie-like ways of crime and dependency. Second, not a single person accepted, on any level, the argument that discrimination against persons based on disability is like discrimination based on race, religion, or sexual preference. They refused to take seriously the arguments that disabilitybased discrimination is as pernicious, as harmful, and as morally reprehensible as other types of discrimination. “They choose to stick that needle in their arm” was the most frequent response. To them, addiction remained a choice, a moral failure of character. Clearly, there is a pervasive set of assumptions which most people seem to hold about people with Substance Use Disorder and mental health issues that are not imbued upon others in our culture with disabilities. This set of erroneous presumptions continues to make it difficult at best to get policy makers and local elected officials in particular to take any action which supports successful outcomes in the substance abuse treatment continuum. What adds insult to injury perhaps is that, while the public may speak in private about their other prejudices, they feel completely comfortable and validated when openly expressing their stigmatizing beliefs about people in recovery, as if “those people” have a defect of character that is a universal truth. This belief system in our society is both insidious and corrosive in its power, and has led to too many people electing to forego treatment and remain inside a bottle of booze or behind a prescription of pills. But the more entrenched society became in trying to isolate and segregate the Recovery Community from “our” community, the more we realized that we, who defend the rights of people in recovery, were experiencing the same stigma, the same rejection and the same discrimination that those who we were representing experienced their entire lives. Seeing ourselves at the precipice of what now was clearly a tipping point of a social movement, we all have rededicated our efforts and our commitment to representing the Recovery Community, treatment providers, and those who offer recovery residences. The “Freedom Riders,” redux. At the same time, we were not naïve to the fact that many others have descended upon our communities simply to make a profit in the treatment industry. What was once a mom-and-pop cottage industry of reputable clinicians and providers has morphed into a haven for anyone who could operate a desktop analyzer. Local residents, and the treatment industry itself, have called upon their local elected officials to rein in this problem of unscrupulous treatment providers and sober homes that were merely fronts for patient brokering. Continued on page 42
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LIVING BEYOND
A Monthly Column By Dr. Asa Don Brown
FORGIVENESS “When you hold resentment toward another, you are bound to that person or condition by an emotional link that is stronger than steel. Forgiveness is the only way to dissolve that link and get free.” ~ Catherine Ponder Forgiveness is essential for moving beyond the problems, heartaches, and pains associated with one’s past. For so many, they choose to cling to the past. Choosing to cling to the past is like requesting to be reintroduced to those egregious events, hoping for a different result. If you have been plagued with memories associated with your past, I beseech you to let go of those chains of bondage and begin moving forward towards health and happiness. “To forgive is to set a prisoner free and discover that the prisoner was you.” ~ Lewis B. Smedes Living in the past may bring comfort in your familiarity, but it will not bring the real change that you have been seeking; to be released from the bondage of the past. What essentially is forgiveness? Forgiveness is the purposeful action of allowing the anger and resentment associated with one’s past to be authentically released. The byproduct of forgiveness is the ability to feel free of the burden and bondage associated with the memories that have long held you captive. Consider the following, could you imagine being literally chained to your past. Moreover, what if each negative memory was a piece of luggage, how difficult would it be to travel? Would you have the
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ease of carrying a simple carryon, or would you have to request your own private jumbo jet? “True forgiveness is when you can say, ‘Thank you for that experience.’” ~ Oprah Winfrey Forgiveness is recognizing that while we may, or may not, be responsible for the egregious events associated with our lives; that we are ultimately responsible for making the most out of our lives. Whether you have had a life free of trauma, abuse, neglect, and addiction, or your life has been filled with the most troubling of experiences; life is about living it abundantly. If you desire to live a life filled with peace, then you must choose to move forward and move beyond the troubles associated with your life. Living life to its fullest sees each event, whether good or bad, as an opportunity to learn. It denies the individual the ability to make excuses, rather promotes the individual to make the most out of life. Living life to its fullest recognizes that we will most assuredly encounter challenges, but that we can choose to see each challenge as a mere obstacle begging to be breached. Are you choosing to see the challenges of your life as a mere obstacle or as a permanent roadblock?. May you begin living beyond.
Dr. Asa Don Brown Author: Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com
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2015 FARR ORLANDO 2015 FARRSUMMIT Summit--AUGUST August 4TH 4th AT at OMNI Omni CHAMPIONSGATE ChampionsGate Orlando FARR Annual Summit will be held at the Omni Hotel Champions Gate in Orlando as a FADAA preconference event August 4th, 2015. The 300 seat venue is expected to sell out early due to passage of sober home (or recovery residence) legislation (HB21) by the Florida legislature in 2015. Recovery Residence owners and managers of all four distinct support levels (I, II, III & IV) will attend the Summit to learn how this law impacts their operation.
drawings, including an Apple Watch, is earned through badge scanning at exhibitor tables. Guest who register all twelve scans will be entered “into the hat”. In total, the “Raffle Bonanza” will feature ten prizes valued at over $3,000.
The afternoon session is highlighted by John Shinholser’s presentation “Building Recovery Ready Communities”. Mr. Shinholser and his wife, If certification is voluntary, then what’s the big deal? What Carol McCaid, founded are these standards referenced by the legislation? How McShin Foundation in 2004. does an individual achieve the new designation The McShin Foundation is “Recovery Residence Administrator”? Are owners Virginia's leading non-profit, required to pass background checks? These and other full-service Recovery questions will be addressed during the FARR Summit. Community Organization Please visit www.farronline.org to register. (RCO), committed to serving Beyond a comprehensive discussion regarding the individuals and families in legislative impact to PHPs, IOPs and Recovery their fight against Substance Use Disorders Residences, the FARR 2015 Summit focuses on Recovery (SUDs). While providing the tools for recovering Oriented Systems of Care (ROSC) and Recovery individuals to create positive lifestyles, McShin aims to Management (RM). FARR is honored to welcome Dr. spread the word of recovery and educate families, Ijeoma Achara who will introduce “Recovery Capital; communities, and government regarding SUDs as well as including domains, survey & measurement scale as a reduce the stigma attached to them. This remarkably fundamental underlying mission of recovery effective method of Peer-Peer Recovery Support housing.” Services (PPRSS), which employs recovering addicts and alcoholics to educate, mentor, and spread the message of Dr. Achara is a central figure in recovery to individuals new in sobriety, is a charter the movement to shift addiction treatment from varying models member of the Association of Recovery Community Organizations (ARCO) and recently recognized as one of of acute bio psychosocial only five CPRSS accredited RCOs in the United States. stabilization to models of sustained recovery Several announcements of importance to Florida’s Recovery management and to wrap RM Community will be unveiled at the Summit. The next year approaches within larger promises to be an exciting, purpose-driven period in the recovery-oriented systems of care (ROSC). Dr. Achara has tradition of excellence our state has developed over the worked extensively in the behavioral health field. Currently last half century. Some of the principle challenges to that she consults with state and local government entities as reputation we have collectively faced over the last five well as with provider organizations regarding the provision years will soon be behind us. As is true of most human of recovery oriented care and the development of recovery services industries, ours has its fair share of scam artists oriented systems of care. and predators who seek to line their pockets with tainted gold mined by a vulnerable population. Their day of At noon, Summit exhibitors will host a complimentary buffet, where each will briefly present to the three hundred reckoning will surely arrive with much fan-fare, pomp and circumstance. FARR will do our best to channel the (300) guests gathered ensuing media frenzy towards one core, and undeniable together for lunch. The truth: that the Florida Recovery Industry, including SUT venue is located in the providers, aggressively pushed back against the “bad National Ballroom offering guys” who invaded our space. The result of that push back over 6,000 square feet, is what the public may soon witness on their television crescent round seating and sets. In contrast, the FARR 2015 Summit focuses on our projector screens that flank future and promises to deliver valuable content intended to our presenters. Twelve exhibitor tables line a 114 foot wall inspire, empower and facilitate the “Good Guys” in their inside the ballroom. While this is a “content-focused quest to guide those who seek our help as they transition event”, networking breaks have been built into the full day into a world where long-term, sustainable recovery is event schedule to ensure guests have an opportunity to supported by quality services and ethical providers. engage with our exhibitors. Eligibility for high profile raffle 28
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WHAT YOU NEED TO KNOW ABOUT ILLICIT DRUGS TODAY By Alyssa Cavanuagh, ARNP, MSN
Drug abuse is a serious problem in the United States, especially among young people who are using a new generation of designer drugs. These drugs mimic the effects of traditional recreational drugs but contain ingredients that can cause serious health hazards to the consumer. Friends and family members are often the first to detect drug abuse problems, so learning to recognize the signs of drug abuse can lead to early, potentially lifesaving treatment. DESIGNER DRUGS Designer drugs are created in homemade laboratories or other concealed locations. The maker often creates a designer drug by blending drugs with psychoactive effects, such as cocaine or morphine, with over-the-counter materials. The resulting designer drug causes new and frequently unknown effects on the consumer’s brain, behavior, and body. Some makers offer designer drugs on the internet, often labeling the product “not for human consumption” to avoid prosecution. Just over 14 percent of U.S. respondents in the 2014 Global Drug Survey said they had purchased drugs online within the previous year. Consumers use designer drugs in the same ways as they use other drugs, by swallowing, snorting, smoking or injection. The various types of designer drugs and administration methods produce different effects, both wanted and unwanted. Synthetic cannabinoids, including K2, spice, herbal incense, create an effect similar to marijuana. Cathinones, including bath salts and 2-C drugs, imitate the high of LSD. Depending on the drug, the consumer may experience exhilaration, long periods of wakefulness or sleepiness, or lack of appetite. Unwanted effects can include panic attacks, aggressive behavior, paranoia and hallucinations. Other effects include nausea, significant blood pressure changes, seizures, slurred speech and blackouts. These drugs can even cause death. Synthetic Cannabinoids Synthetic cannabinoid products emerged onto the U.S. drug market in 2008 as legal alternatives to marijuana. Authors of the Global Drug Survey said that synthetic cannabis products were the most commonly used novel psychoactive drug across their sample of participants. The researchers also found that synthetic cannabis users were 30 times more likely to need emergency medical treatment than traditional cannabis users. The United States DEA says that poison control centers received about 5,200 calls regarding exposures to synthetic cannabinoids in 2012. Budder Budder, also known as marijuana wax or butane hash oil, is a heavy, sticky substance with a reputation for greater toxicity and higher potency than standard marijuana. Country crime labs in Broward, Palm Beach, Miami-Dade and other South Florida counties have been unable to record the actual number of budder cases in those areas because laboratory tests identify Budder as marijuana. Laboratories are working on new testing methods to properly identify this substance. Producers manufacture budder locally in marijuana grow houses, despite the great risks involved in budder production. An explosion occurred during an attempt at manufacturing budder in Boca Raton during May of 2014, damaging the windows of the grow house. Police officials confirmed budder production as the cause of the destruction. Budder can be dangerous outside the grow house too, potentially causing hallucinations, heart palpitations, paranoia, extreme anxiety, and can even spur the onset of psychosis. Flakka Flakka is another new designer drug that has been increasingly popular in Palm Beach County. Flakka, otherwise known as gravel or bath salts, is a crystalline substance that looks like rock candy
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and produces effects similar to crystal meth. A cheap alternative to meth, flakka is transported from overseas and purchased online. The active chemical in flakka is alphaPVP or methylenedioxypyrovalerone (MDPV), which frequently causes paranoia, feelings of unease, and severe psychosis. WHY ARE DESIGNER DRUGS DANGEROUS? Abusing any drug is dangerous because of the risk for adverse effects that could lead to serious bodily harm or even death. Healthcare professionals have provided care for drug users for decades, creating emergency treatment plans based on the known effects of various ingredients in the abused drug. Designer drugs usually come from illegal laboratories, so it is impossible for the consumer to know exactly what is in the drug or how strong its effects will be. The unknown ingredients in designer drugs make it difficult for emergency responders and emergency department workers to determine the best course of treatment in cases of adverse reactions to and overdoses on designer drugs. In these cases, healthcare professionals rely on laboratories capable of testing a wide variety of substances commonly found in designer drugs. Without these highly sensitive laboratory tests, emergency department doctors can only treat whatever symptoms the patient presents. Laboratory testing is also an essential monitoring tool for drug treatment facilities. KNOWING THE SIGNS OF DRUG ABUSE CAN SAVE A LIFE Using and abusing drugs is serious. Left unaddressed, drug use can result in side effects, including dependence, addiction, and overdose. Anyone concerned that a loved one is abusing drugs can learn to recognize the physical, behavioral, and psychological warning signs of drug abuse. The physical signs of drug abuse depend largely on the drug used but can include: • • • • • • • • • •
Bloodshot eyes Pupils that are abnormally large or small Frequent nosebleeds Changes in appetite Unexplained weight gain or loss Change in sleep patterns Poor grooming or hygiene Unexplained injuries Unusual odor on body, breath or clothing Shakes, tremors, slurred speech, poor coordination
Behavioral signs include deteriorating performance at work or school, loss of interest in hobbies, decreased motivation, unusual or unexplained need for money, borrowing, and stealing. Psychological signs of drug abuse include an unexplained change in attitude or personality, irritability or sudden mood changes, inappropriate emotional responses, or appearing fearful or paranoid. Knowing how to recognize the signs of drug abuse can lead to early treatment and can even save a life. If you or someone you know has a drug problem, contact a drug addiction treatment facility or mental health professional in your area. Alyssa Cavanaugh, ARNP, MSN, is the lab manager for Advanced Diagnostic Laboratory Services, LLC, a full reference laboratory that specializes in complete laboratory testing for substance abuse and pain management, as well as laboratory consulting for High Complexity LC-MS labs. To learn more about ADLS, please visit us at www.myadls.net or call (561)221-0353
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ADDICTION IN OUR MIDST: UNDERSTANDING THE ANXIOUS FAMILY SYSTEM By Dr. Kenneth Perlmutter
Addictions, compulsions, and mental illness generally show up in families wounded by legacies of loss and illness frequently going back several generations. A family system with addiction in its DNA manifests a cluster of environmental characteristics which can be thought of as expressions of the system’s distress. Central among these is anxiety and this systemic anxiety both impairs individual members while simultaneously coloring and corroding the household and developmental atmosphere. One of its most toxic effects underlies family members’ inability to manage the emotional experience of life in the family in a balanced way. As a result, life in the system becomes more about coping with the experience of the environment than about growing, thriving or developing. In turn, pathological, or impaired coping strategies are adopted such as numbing, blaming, leaving, fixing, and sacrificing. These frequently take on compulsive aspects which promote the cycles of illness and relapse that occur across the generations. In her germinal book The Alcoholic Family in Recovery, Dr. Stephanie Brown identifies three domains to consider in order to obtain a robust picture of the alcoholic (or wounded) family system: the family environment, its rituals and rules, and the prospects for individual development. This article will explore some of the features of the anxious family system, the most common ways members have learned to cope, and suggest some strategies for shifting the system toward health and balance. When asked, people who grew up in such settings describe the household as: “tense, unpredictable, chaotic, dangerous, disconnected, toxic, violent, and empty.” Human beings carry the ability to cope with high levels of adversity and stress. In the secret and shame filled environment of the wounded family system, members are rarely helped to manage their adverse emotional experiences nor is there much conversation or exploration of the impact of each other’s actions on one another or on the system itself. The condition that develops can best be described as “StressInduced Impaired Coping.” And, as said earlier, these strategies perpetuate the cycles of relapse and illness while simultaneously being passed on to the next generation. Here’s a list of some of the most common ways members cope with life in such an atmosphere: Escape. Fix. Blame. Distract. Let’s think of these as behaviorally defined roles and look at each in turn. The Escapee relies on separating himself from the environment. This is achieved either through numbing behaviors (drinking, using, processes) or leaving (isolating, moving away, staying away). Emotionally, escapees report they often feel anxious, blamed, forgotten, ashamed, numb and targeted. They say others respond to them by “shaming, chasing, blaming or ignoring” them. The Fixer comes in several versions. Directors tell everyone how to conduct themselves and hold high expectations for conformity. When others don’t cooperate, punishment, verbal violence or other retaliation follows. Martyrs rely on infinite giving (cooking, cleaning, shopping, helping) to soothe others and themselves; and Brokers -make deals with themselves and others trying to keep everyone “happy” by figuring out what each needs and trying to provide that or talk them into accepting a substitute. Emotionally, fixers report they often feel anxious, used, drained, rejected and depressed. They say others respond to them by “wanting more, rejecting, relying, complaining or leaving.” Blamers can either be finger pointers who make sense of things by identifying one member as coming up short or causing the problems. Blamed ones, or scapegoats, take the blame and by doing so resolve their anxiety by pre-determining how others will respond to them (blaming, correcting, shaming). Emotionally, blamers report feeling anxious, invisible or totally focused upon, powerless or in control, and ignored or like a broken record. They say others respond to them
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by “arguing, expecting the worst, and using them to insist there is only one problem, usually located in one member.” Lastly, the Distracter uses high activity and achievement to make life tolerable and cope with the systemic anxiety and distress. These are some of the most highly anxious members of the wounded system. Super-stars get everything right and are proof the system is “fine.” Super-providers are too busy to be involved in the emotional life of the family as they are “making all the money” and “keeping the system afloat.” And the entertainers are the Robin Williamses of the family who keep everyone laughing and amused in a desperate attempt to provide some soothing distraction. Emotionally, distracters report high anxiety they manage through their distracting behavior (work, achievement, money obsession), burnout risk, used, trapped and invisible. They say others respond by “wanting more, expecting the impossible, and leaving them out of the family’s emotional center.” Note that anxiety is a core emotional experience associated with each of the roles. As members deepen their commitment to their behaviorallybased solutions, they experience some relief or protection. At the same time the system becomes more rigid and opportunities for complex emotional expression, connection and acceptance and individual development become increasingly limited. As a result, the overall experience of anxiety worsens. Members use words like “tense, scary, eggshells and rollercoaster” to describe the effect of anxiety on the system and how it saturates the emotional atmosphere. Further, as members increasingly rely on escaping, fixing, blaming and distracting, the unconscious aspects of systemic and individual shame press to the fore. In most wounded systems there is an underlying sense the system and/or its members are defective in some way – a defect that if revealed would result in a psychic catastrophe or collapse. Brené Brown calls this a sense of “being undeserving of love,” or belonging. A toxic cycle develops in which the shame denying results of impaired coping are reinforced by the pain avoidance (denial) the impaired coping originally developed to provide. In turn, everyone gets sicker; the culture becomes one of pain avoidance and denial (of shame) and is repeated generation after generation. It should be noted that the system’s specific losses, tragic incidents from past generations (if any) and traumas are often unknown. In general, they are always believed to be too terrible to face. A distressful undercurrent flows beneath the family’s daily life and adds layers to what Dr. Joe Cruse calls the “emotional abscess” or untreated wound that exerts an insidious and corrosive reinforcing effect. Secrets, shame, and chaos saturate the family atmosphere. As an introduction to this work in the family system we begin by Continued on page 42
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LIVING WITH AN ADDICT – ALCOHOLIC By Darlene Lancer
Living with an addict can be a living hell. Unpredictable and dangerous, yet sometimes exciting and romantic. Never knowing when we’ll be blamed or accused. Not being able to dependably plan social events. As the addict becomes more irresponsible, we pick up the slack and do more, often becoming the sole functioning parent or even the sole provider; yet we’re unable to lean on our partner for comfort or support. Meanwhile, we rescue him or her from disasters, medical emergencies, accidents, or jail, make excuses for no-shows at work and family gatherings, and patch up damaged property, relationships, and self-inflicted mishaps. We may also endure financial hardship, criminality, domestic violence, or infidelity due to the addict’s behavior. We worry; feel angry, afraid and alone. We hide our private lives from friends, co-workers, and even family to cover up the problems created by addiction or alcoholism. Our shame isn’t warranted; nonetheless, we feel responsible for the actions of the addict. Our self-esteem deteriorates from the addict’s lies, verbal abuse, and blame. Our sense of safety and trust erodes as our isolation and despair grows. My focus is on alcoholism, but many of the feelings that partner’s experience are the same, regardless of the type of addiction. Alcoholism is considered a disease. Like other addictions, it’s a compulsion that worsens over time. Alcoholics drink to ease their emotional pain and emptiness. Some try to control their drinking and may be able to stop for a while, but once alcohol dependency takes hold, most find it impossible to drink like non-alcoholics. When they try to curb their drinking, they eventually end up drinking more than they intended despite their best efforts not to. No matter what they say, they aren’t drinking because of you, nor because they’re immoral or lack willpower. They drink because they have a disease and an addiction. They deny this reality and rationalize or blame their drinking on anything or anyone else. Denial is the hallmark of addiction. Drinking is considered an “Alcohol Use Disorder,” when there’s a pattern of use causing impairment or distress manifested by at least two of the following signs within a year. When the person: 1. Drinks alcohol in greater amounts or for a longer period than was intended 2. Has a persistent desire or has made failed attempts to reduce or control drinking 3. Spends great time in activities to obtain or use alcohol or to recover from its effects 4. Has a strong desire to drink alcohol 5. Fails to meet obligations at work, school, or home due to recurrent drinking 6. Drinks despite the recurrent social or interpersonal problems caused or worsened as a result 7. Stops or reduces important activities due to drinking 8. Drinks when it’s physically hazardous to do so 9. Drinks despite a recurrent physical or psychological problem caused or worsened as a result 10. Develops tolerance (needs increased amounts to achieve desired effect) 11. Has withdrawal symptoms from disuse, such as tremor, insomnia, nausea, anxiety, agitation Alcoholism is “a family disease.” It’s said that at least five other people experience the effects of each drinker’s alcoholism, coined “secondhand drinking,” by Lisa Frederiksen. We try to control the situation, the drinking, and the alcoholic. If you live with an alcoholic, you’re affected most, and children severely suffer because of their vulnerability and lack of maturity, especially if their mother or both parents are addicts. It’s painful to helplessly watch someone we love slowly destroy him
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or herself as well as our hopes and dreams, and our family. We feel frustrated and resentful from repeatedly believing the addict’s broken promises and from trying to control an uncontrollable situation. This is our denial. In time, we become as obsessed with the alcoholic as he or she is with alcohol. We may look for him or her in bars, count his or her drinks, pour out booze, or search for bottles. As it says in Al-Anon’s “Understanding Ourselves,” “All our thinking becomes directed at what the alcoholic is doing or not doing and how to get the drinker to stop drinking.” Without help, our codependency follows the same downward trajectory of alcoholism. There is hope, and there is help for the addict and for codependent family members. The first step is to learn as much as you can about alcoholism and codependency. Many of the things we do to help an addict or alcoholic are counterproductive and actually can make things worse. Listen to the experience, strength, and hope of others in recovery. Al-Anon Family Groups can help. You will learn: • Not to suffer because of the actions or reactions of other people • Not to allow ourselves to be used or abused by others in the interest of another’s recovery • Not to do for others what they can do for themselves • Not to manipulate situations so others will eat, go to bed, get up, pay bills, not drink, or behave as we see fit • Not to cover up for another’s mistakes or misdeeds • Not to create a crisis • Not to prevent a crisis if it is in the natural course of events* Attend an Al-Anon meeting in your area or online. Read and do the exercises in my book, Codependency for Dummies. Darlene Lancer is a Licensed Marriage and Family Therapist and expert on relationships and codependency. She’s the author of two books: Conquering Shame and Codependency: 8 Steps to Freeing the True You and Codependency for Dummies. Her ebooks include: 10 Steps to Self-Esteem, How To Speak Your Mind - Become Assertive and Set Limits, Spiritual Transformation in the Twelve Steps, and Codependency Recovery Daily Reflections. Learn more at www.whatiscodependency.com ©Darlene Lancer 2014 *Reprinted with permission of Al-Anon Family Group Headquarters, Inc., Virginia Beach, VA.
FlexDek® is the Scientifically Proven Method to Dramatically Reduce Relapse Rates FlexDek® is a new mobile app designed for everyone who is interested in participating in another’s ongoing care. This can be a Spouse, Sponsor, Children, Care Giver, Therapist, Coach or Case Manager. It is compatible with I-Phone, Android and all tablets. For Loved Ones, use it to passively monitor how recovery is progressing based on consistent input by your loved one. When needed, proactive intervention can be accomplished. Let’s face it, trust is long gone and everyone wants it back. What better way than to use today’s technology for the betterment of all involved. This is a proven method to change unwanted behaviors without the usual overbearing, perceived as controlling conversation; did you really go to the meeting? Are you really not drinking? FlexDek® will make your life easier and more relaxing. Put the accountability where it belongs, on the recovering person, then sit back and wait for the alerts to sound. No news is good news!
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DON’T BELIEVE EVERY “TRUE” STORY YOU HEAR By Charles Rubin
There is nothing quite so innocent as the face and demeanor of someone addicted to drugs or alcohol telling you that he will get off substances and stay off them. And furthermore, that he will get a job, and stop hanging out with questionable people and that you will never again be disappointed by him and that he will make something of himself and, and, and. If it sounds too good to be true, that’s the way it’s designed to sound. You’re no dummy, but every fiber in your body wants to believe that this person (for the sake of simplicity we’ll call your son), someone you dearly love, someone you keep thinking as a curly-headed little angel of five, has finally decided, after years and maybe decades, to get his act together. You listen with joy and relief and for the thousandth time you truly believe with all your heart that everything you are hearing will, without a doubt, materialize. This is your greatest wish, your sole desire in life, the very reason you live, the very reason you have neglected all other relationships, the very reason you have put all other matters such as your own physical, mental, and emotional health on hold. Not only is the story always the same, but so is the pitch. It would be so much easier if only, the addict says, he could raise a thousand dollars to tide him over till he finds a job, or for those college courses that you have wanted him to take, or for the first and last month’s deposits on an apartment, or for, and here’s the clincher, the agonizingly painful wisdom teeth that have to be pulled. Sounds plausible and he does have a point: Who, he argues, can concentrate on a job when those agonizingly painful wisdom teeth are throbbing. Who could concentrate on a college course? So out comes the checkbook and off your beloved goes, heading for a wonderful new life chapter. But more likely to his drug supplier. And so that wonderful new life chapter never materializes, and now the addict is back again, looking suitably abashed, giving you another Academy Award-winning performance, apologizing for not having lived up to the agreement and all the endless agreements before that. Out comes the checkbook--with its rapidly diminishing funds--once again. And out the window goes all memory of the promises never kept, the valuables stolen from you, and the violent outbursts that have left you battered. Forgotten are the sob stories about how the addict was so cruelly evicted from his apartment by a terrible landlord just because the rent hadn’t been paid for six months, and how his car got towed away because it was parked in a non-parking zone and how there was no money to get it out and how without a car it’s impossible to get a job because how is a person, so willing to work, supposed to get to the job? May I, as someone who has been in this position with my own addicts and who has counseled many people who have also been in this position dare suggest that you might want to be in this position? Okay, that sounds preposterous, but look at it- you have allowed abuse of all kinds to go on in your life year after year. I’m just sayin’ that maybe you need to be needed in this exceedingly bizarre relationship. Or maybe because if you don’t keep shelling out money the person may disappear out of your life and forever be lost to you. Now that’s a dreadful thought :). As if that could really happen. It’s not something you ever have to worry about because a drug or alcohol addict never actually stays away. The addict may periodically be absent for a while (probably right after ‘payday’ when he can get tanked up), during which time you will be pulling out your hair with worry, but he is soon back, confident that you will, almost gladly, bail him out of his latest jam. His usual platform is that he ‘truly’ wants you to know how sorry
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he is, how repentant, how sincere, how he wants to make it up to you, how he isn’t asking for money, just love and forgiveness and the chance to prove to you that he is a good person, a responsible person, and that he will repent. Yeah, right. If you really think this is not about money, you should have your head examined. Not to be rude, but you should have your head examined anyway. Because in very short order, the addict is going to inform you of the illegitimate child that has been born, the fact that you are now a grandparent, and how the child is starving to death for lack of milk and how the mother and child are forced to sleep in a car and that the car is freezing cold. The soap opera is really getting good now. You have a grandchild? How joyous is that? You are a grandparent and you need to act like one. Sight unseen, you agree to monthly payments for the upkeep of this baby. You insist that they move out of the car and into an apartment. You even write a check for the apartment, for food, clothes, medical care, and oh yes, the addict wants to go into a rehab, but that costs money, too. A rehab! He’s got a substance abuse problem??? You weren’t sure. Of course you will pay for it. Who should you write the check out to? Make it out to cash, you are told. Your beloved disappears once again. No sign of a grandchild. No way to get in touch. No fiction writer could come up with a tale like this. But scenes like these are happening all over the world. Soon, the addict is back. You are told that the mother of your grandchild has gone to live with a band of roving minstrel singers and that she has stolen all the money you have provided, including the money for the rehab. Of course you believe this story because, of course, it is true. Everything you have ever heard from this individual has been true. He wouldn’t lie. You may have raised a drug addict and a thief and someone who has on various occasions attacked you physically, and sent you to the hospital but a liar? Never! If you have read the above and identify with it, get thee to an Al Anon program, quick. This is one true story you can believe. Charles Rubin is the author of “Don’t Let Your Kids Kill You: A Guide for Parents of Drug and Alcohol Addicted Children” which is an international bestseller and the only book on the market that focuses on the recovery of the parent.
WHAT IS A LEVEL 4 TRANSITIONAL CARE HOUSE? Sunset House is currently classified as a level 4 transitional care house, according to the Department of Children and Families criteria regarding such programs. This includes providing 24 hour paid staff coverage seven days per week, requires counseling staff to never have a caseload of more than 15 participating clients. Sunset House maintains this licensure by conducting three group therapy sessions per week as well as one individual counseling session per week with qualified staff. Sunset House provides all of the above mentioned services for $300.00 per week. This also includes a bi-monthly psychiatric session with Dr. William Romanos for medication management. Sunset House continues to be a leader in affordable long term care and has been providing exemplary treatment in the Palm Beach County community for over 18 years. As a Level 4 facility Sunset House is appropriate for persons who have completed other levels of residential treatment, particularly levels 2 and 3. This includes clients who have demonstrated problems in applying recovery skills, a lack of personal responsibility, or a lack of connection to the world of work, education, or family life. Although clinical services are provided, the main emphasis is on services that are low-intensity and typically emphasize a supportive environment. This would include services that would focus on recovery skills, preventing relapse, improving emotional functioning, promoting personal responsibility and reintegrating the individual into the world of work, education, and family life. In conjunction with DCF, Sunset House also maintains The American Society of Addiction Medicine or ASAM criteria. This professional society aims to promote the appropriate role of a facility or physician in the care of patients with a substance use disorder. ASAM was created in 1988 and is an approved and accepted model by The American Medical Association and looks to monitor placement criteria so that patients are not placed in a level of care that does not meet the needs of their specific diagnosis, in essence protecting the patients with the sole ethical aim to do no harm.
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INTERVIEW WITH DR. PAUL HOKEMEYER By Patricia Rosen
Continued from page 6
few clinicians possess. Clinicians need to understand their own issues around wealth, power, and celebrity, and use it in a way that fosters an authentic connection rather than assuming an idealized, intimidated or pandering stance. Once the proper foundation is made, I then work collaboratively with my patients in a host of established psychotherapeutic techniques to enable them to heal from their past and successfully manage their future.
and many are drowning even with two incomes. What has been sacrificed in this dynamic is the wellbeing our children.
Patricia: Can you elaborate a little on the difference working with a celebrity as opposed to the average person and share any stories you might have?
Patricia: Anxiety is the number one mental health issue facing children today with one out of every 10 kids suffering from it. Can you tell us why anxiety is so prevalent today in children and what can parents do about it?
Dr. Hokemeyer: In our society and culture, celebrities are viewed as objects and stripped of their humanness. For some reason, we find it perfectly acceptable to make fun of celebrities when they struggle with addictions and other mental health issues. Rather than honoring their privacy and allowing them dignity, they are put on reality shows and objectified to sell gossip tabloids. When Lindsey Lohan was struggling with her issues, the media had a field day making her look like a fool. Just recently, Justin Beiber was brutally roasted on Comedy Central. This mean spirited mockery would be unacceptable if a non-celebrity was struggling with mental health or addiction issues. In addition, clinicians who are hired to treat celebrities are frequently manipulated and blinded to their duties of care by the brilliance of their patients’ star power. Michael Jackson died as a result of a drug administered by his private physician. Health Ledger by a cocktail of prescription drugs. No one properly intervened on Whitney Houston when it was known for decades she had a debilitating substance abuse issue. To effectively treat celebrities, a clinician must earn their trust and create a solid and challenging therapeutic frame with empathy, compassion and integrity. This task is much harder than it sounds. It’s an art that requires a mature and seasoned clinician who has a strong sense of self, a highly intelligent mind and the capacity to simultaneously challenge the patient while empathizing with the emptiness and profound fear that frequently comes with their fame. Patricia: In your opinion, do you feel a celebrity has it that much harder to overcome their addiction than your average person? Dr. Hokemeyer: Yes. Celebrities occupy a unique position in the word. They exist as hyper-exposed, hyper-criticized, hyperobjectified and hyper-vulnerable beings. The risks they take in putting themselves out in the world are extraordinary. They bare their hearts and souls to millions of strangers who only want them for their veneer. Things go fine as long as these millions enjoy and approve what they see, but when a wrinkle appears, literally or figuratively, the public decimates them. In addition, success is a powerful energetic that is difficult to manage and hold. My celebrity patients and I talk about success as an electrical current. Yes, it has extraordinary properties if properly directed and utilized, but if improperly channeled, it holds the power to kill. Also, celebrities often lack a robust network of family and friends they can trust and turn to for support. The relationships in their lives are often parasitic and opportunistic. The systems they operate in are motivated by their financial success instead of their emotional wellbeing. They’ve spent their physical, intellectual and emotional capital overcoming the incredible odds to become a celebrity, and in this struggle haven’t developed healthy coping strategies. Patricia: Interesting. What do you feel the remedy is for the epidemic of pharmaceutical overdose deaths in our country? Dr. Hokemeyer: Better parental support so that parents can be parents instead of robotic machines that feed our consumer driven economy. I attribute the epidemic in addictions of all kinds to a breakdown of our family systems. Historically, parents were able to be there for their children to support them through their developmental challenges. Today, however, both parents need to work to keep afloat,
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We need to get back to good old-fashioned human relationships. There is an extraordinary amount of pain in the world that isn’t being effectively processed through online connections. People need physical connections with other people. We’re built to be in relationships with human beings, not online profiles.
Dr. Hokemeyer: The modern world we live in is complicated, competitive and chaotic. The Internet has dramatically changed the way we receive and process information. Our kids are hyper stimulated and hyper exposed to a never-ending barrage of information. Their central nervous systems have not adapted to the pace at which information is thrown at them and as a result, they’re on sensory overload. We’ve also gone too far with permissive parenting. Yes, it’s important for kids to find and develop their voices, but they also need strong boundaries and better limit setting from their parents. Parents need to let their kids know they love and will protect them. In providing these firm and secure boundaries, parents will contain their children’s fears and diminish their anxiety. They also need to model self-care and acceptance of their imperfections. By modeling acceptance of imperfection, they will teach their children it’s ok to be human and that the value of life is in the learning and exploration of its vast opportunities. Patricia: Mental illness includes anxiety, OCD and depression to name a few, which they say 1 out of every 4 adults is affected by. Why is there a stigma surrounding mental illness? Why aren’t people more forthcoming about how they are feeling and get help in order to deal with their feelings/emotions? Dr. Hokemeyer: There’s still shame and stigma around mental illness and in particular addictions because for centuries we’ve only been able to see the path of destruction left in their wake. Unlike other diseases where the damage is contained in the patient, addictions and mental health issues spill out and infect everyone in the patient’s life. They cause chaos and senseless destruction. They make us feel powerless and test our patience and our love. They infuriate us with their hostile aggression. So it’s perfectly natural that from this place of anger, we project a whole host of stigmatizing qualities onto the patient. These human beings become objects, receptacles for the anger we feel over our inability to control them and their disease. They make us feel weak and we blame the patient for our weakness. The patient, in turn comes to identify with these projections. They pick them up and come to define themselves as worthless victims trapped in a hopeless and shameful situation. Fortunately, the tide has begun to turn. The work that’s coming out of brain and genetic mapping is extraordinary. It’s showing us in very concrete ways the physical origins of the disease and enabling us to develop effective medical interventions to treat it. We’re beginning to see that mental health issues are biological issues rather than issues of morality and lack of agency and control; and in this expanded knowledge, we’re able to embrace the humanness of the patients who are afflicted. Patricia: What is Aevidum and how did you get involved with them? Dr. Hokemeyer: Aevidum is a student run organization that creates positive mental health environments where all students feel accepted, appreciated, acknowledged, and cared for across the nation. The word Aevidum, means “I’ve got your back,” and was Continued on page 40
LIFE’S ONION®
Breakthrough Therapeutic Tool Produces Big Results for Clinics and Clients We all know the saying about what to do when life gives us lemons - make lemonade! But what do you do when life gives you onions? If you’re Mark Wetherbee, founder and creator of Life’s Onion, you make a therapeutic tool so innovative that it is awarded a patent. Life’s Onion is a handheld, onion-shaped device with 12 peels which transforms into a flower when opened. People in self-help and therapy record their goals and achievements on the actual peels, and peeling them back to flower petals as progress is made. It’s a simple tool, but its application is what makes it unique: while there are other methods of tracking improvement, Life’s Onion is the only product which marks people’s progress in a tangible, visual form and remains with them to reinforce their successes. One Life’s Onion user stated, “It will be a daily reminder of my journey through treatment, self-reflection, growth, and continued success in life.” It is not often that people have a visible reminder of their growth and achievements outside of the therapeutic environment, and this was clearly the creator’s goal. Life’s Onion incorporates elements of journaling, art therapy, Cognitive Behavior Therapy and Schema Therapy. The tool can be used by an individual or with any therapeutic modality or style. In addition to the tool itself, there is a full package of support materials designed to integrate Life’s Onion into existing programs. After more than 3 years of research, development and field trials, Life’s Onion is now being made available to the public. To find out more visit: www.lifesonion.com
To Advertise, Call 561-910-1943
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STEP ONE: “WHAT’S THE BIG DEAL ABOUT STEP ONE?” OR “POWERLESS OVER ALCOHOL” By Joe Herzanek
We admitted that we were powerless over alcohol and that our lives had become unmanageable. –Step One, AA 12-Steps After many years in recovery, I know that I must not forget this one principle–I will always be an addict. –Joe Herzanek Whether you are a fan of twelve-step programs or not, the first step an attendee will hear offers a great deal of wisdom. The alcoholic/addict should never venture into the world without remembering the important bit of knowledge that Step One provides: Chemically dependent people will not ever be able to gain control over their substance use. Millions of addicted people have tried, and many have even died trying. Not one truly addicted person has ever successfully returned to social use.
more than this one crucial admission. Recovery and rebuilding what was lost takes substantial time and effort. But it will all be in vain if this one fundamental principle is forgotten. A Humbling Realization Once the power or ability to control how much a person can use is lost, it is lost forever. Any attempt to regain control is futile. This applies to the user who is brand new to recovery as well as to the addict/alcoholic with over two decades of abstinence. No one is tougher than addiction, and it’s one wound that time cannot heal. You, as a person close to the situation, should understand this fundamental step as a foundational principle. It’s a humbling realization. This article is excerpted from the book Why Don’t They Just Quit? What families and friends need to know about addiction and recovery.
Admitting Powerlessness After many years in recovery, I know that I must not forget this one principle–I will always be an addict. Confusion on this matter can lead to disastrous results. My substance use took me places I didn’t want to go, cost me more than I wanted to pay and kept me longer than I wanted to stay. My addiction is now in remission. Just the same, it is alive and well–ready to inflict a lot of pain on me. To forget this would be my greatest mistake.
Joe Herzanek, a man who battled his own demons of addiction over thirty years ago. He often tells others, “I know people can change. If I can do it, anyone can!”
I have a friend who owns a treatment center in the Colorado Rocky Mountains. He accepts only men who are highly motivated to change. The program is a four-month-minimum-stay facility, cash only, no insurance. The entire focus is on Step One. It’s for men who have made several attempts to quit, only to find themselves stumbling again and again. Frustrated and broken, they arrive at the treatment center willing to do whatever it takes to regain their sobriety. This facility teaches men that the key to recovery starts with a true admission of powerlessness.
Joe is a dynamic speaker, the former host of Recovery Television, producer of several DVDs, and author of the award-winning book “Why Don’t They Just Quit? What families and friends need to know about addiction and recovery.” written for families or friends struggling to help a loved one recover from alcohol or drug addiction. His book along with the companion DVD “The 10 Toughest Questions” offer rare insights into the mind of the substance abuser and how it impacts the family.
Once a recovering addict is convinced of their inability to ever control their using, they will no longer attempt to do so if they want to maintain their recovery. Incorporating Step One into a person’s life requires a daily ongoing shift in thinking–sometimes referred to as “one day at a time.” Lifelong recovery obviously involves much
Chaplain Joe Herzanek is the president and founder of Changing Lives Foundation. As a state certified addiction counselor in Colorado he spent over seventeen years working in the criminal justice system as the Chaplain/Addiction Counselor at both the Boulder and Weld County Jails.
Joe specializes in “crisis counseling” for those situations that seem hopeless or impossible. He’s especially gifted at helping families find their way “out” and partnering with them to formulate a plan. Email jherzanek@gmail.com or for more info. www.drug-addiction-help-now.org
INTERVIEW WITH DR. PAUL HOKEMEYER By Patricia Rosen
created by students in 2004 after they lost one of their classmates to suicide. I became involved with the organization after meeting their founder, the sister of the student whose life was prematurely lost and their faculty advisor, Joe Vulopas, in the green room of Good Morning America. I was blown away at how these high school students were approaching mental health issues in such a supportive, innovative and shame free way. They became my heroes and I joined their board of directors. Check them out at www. aevidum.com and send them your love and support. Patricia: I will! What advice can you give a family member who lost a loved one through suicide and feels guilty that they didn’t see the signs, or saw signs and didn’t take it serious enough? Dr. Hokemeyer: I’m direct and honest with my advice. I’d tell the family member the truth, which is that the loss will remain with you for the rest of your life and will profoundly impact its trajectory. It’s up to you, however, to sort out how you’re going to incorporate your
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Continued from page 38
loss into the unfolding narrative of your life. Are you going to honor the person who passed by utilizing the loss to create a life filled with meaning and purpose or, will you stay stuck in your despair thereby perpetuating the destruction? The best way to honor the person you lost is to make meaning out of it and embrace the life that lies ahead. Nietzsche, an existential philosopher said, “He who has a why to live can bear almost any how.” You’ll need to heed Nietzsche’s sage advice and embrace a why to move, if ever so labored and haltingly, through your overwhelming pain. It will be the greatest challenge of your life, but like others before you, you can make a why out of the senseless how. Patricia: You are really a wealth of information, no wonder why you are called upon by so many different media outlets. I want to thank you for taking time out of your busy schedule to do this interview. Dr. Hokemeyer: My pleasure, thank you for the work you do.
Look for your FREE issue of The Sober World
You can now find The Sober World at every Starbucks in Palm Beach County as well as schools, colleges, doctor offices, meeting halls and more throughout South Florida. We directly mail to anyone who has been arrested for drugs or alcohol in Palm Beach County, as well as various treatment centers throughout the country. A free issue will be in every attendee’s bag at the following conferences/events:
- 2015 NAATP ANNUAL -
ADDICTION TREATMENT LEADERSHIP CONFERENCE MAY 16 - 18 / CARLSBAD, CA
• West Coast Symposium on Addictive Disorders - May 28-31, La Quinta, CA • NAATP - May 16 - 18, Carlsbad, CA • Innovation in Behavioral Healthcare - June 22-23, 2015, Nashville, TN • C.O.R.E - Clinical Overview of the Recovery ExperiencesJuly 19-22, Amelia Island, FL • Cape Cod Symposium on Addictive Disorders - September 10-13, Hyannis, MA • 2015 Moments of Change - September 28 - Oct. 1, Palm Beach, FL
This year’s conference is fast approaching and it is promising to be a great conference! The 2015 Conference will be hosted at the Omni La Costa Resort and Spa located in beautiful Carlsbad San Diego – about 40 minutes north of San Diego. This year’s conference will feature leading speakers in the addiction treatment field, with a focus on spirituality, public policy and leadership topics to help treatment leaders improve their quality of care and success of their business. The weekend event kicks-off Friday May 15, wi the NAATP Spirituality Summit PreConference. As in years past, 2015 with the Annual NAATP Golf Outing will be hosted on Saturday May 16, 2015. CALL: 561-429-4527 www.naatp.org/events/annual-conference
To Advertise, Call 561-910-1943
• 2015 Lifestyle Intervention Conference- Oct 6-8- Las Vegas, NV
The Sober World is a free national online e-magazine as well as a printed publication. We use an educational and informative approach as an outreach to parents, families, groups and others who have loved ones struggling with addiction.
CONTACT US TODAY!
For information regarding advertising in our magazine or online please contact Patricia at 561-910-1943 or e-mail patricia@thesoberworld.com Visit www.thesoberworld.com
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THE SILENT ASSAULT ON AMERICANS WITH ADDICTIONS: INSURANCE COMPANIES PLAY DOCTOR PART II By: John Giordano DHL, MAC
am to be an aerospace engineer. A well paid billing manager yes, but certainly not a case manager which could imply they’re acting in some way with interests of the patient in mind. In fact, they are nothing more than a carefully fabricated image intended to give you the impression that the healthcare industry employs professionals in the field. But the veneer is paper thin. Just one scratch exposes Angela and her co-workers as being well educated in just about everything except addiction, mental health and their treatment. If I was forced to render a guess I’d say Angela has never even stepped foot in a treatment or detox center much less spent any time with a powerless person in the throes of trying to turn their lives around. I’d also go out on a limb and speculate that nearly all of her co-workers – if not all – are in the same boat. After my conversation with Angela I couldn’t help but to harken back to the 2008 election cycle when some presidential candidates suggested that government run health care would create ‘death panels’ and put ‘the government between patient and doctor. As clearly shown within, their prediction partially came to fruition in the respect that death panels have indeed become part of the healthcare landscape. Where the candidates’ prophecy fell short in accuracy is the fact that the death panels are run by private sector insurance companies and not the U.S. Government. Healthcare company case managers like Angela are standing squarely between addicts and their doctors and therapists. The insurance companies’ are literally dictating treatment by way of the purse strings. The treatment facility either abides by the insurance companies’ demands or they don’t get paid – simple as that. What is best for the patient and best practices never enters into the conversation. The curtain has been pulled back and enough fact has been
SUCCESSFUL RECOVERY REQUIRES “NORMAL” SOCIETY TO SET ASIDE STIGMA By: Jeffrey C. Lynne, Esq.
Continued from page 12
exposed that no one is fooling anyone anymore. The hollowed out, cost-cutting addiction treatment protocols designed by the healthcare industry and implemented by treatment centers is woefully inept. This cost driven model was never designed to be effective, but rather to provide the illusion of treatment. There is a mountain of scientific research complete with real life case studies that prove addiction treatment can be very effective. The best example of this is the Physicians Heath Program’s 90 day intense level one residential treatment followed up with long term comprehensive aftercare. As long as the patients remain faceless and the case managers and insurance company doctors can sit protected in their private cubical, addiction treatment will continue down this unsustainable path. The only action that could possibly change the course is a public outcry. For those of us fortunate enough to have gone through rehab know we didn’t do it on our own. We relied on each other to produce a positive outcome. If we are to effect positive changes in the healthcare industry, we need to band together one more time. All I ask is that you contact your congressman and senator and ask them what they are doing to prevent the insurance industry from dictating addiction treatment protocols. If you can’t do it for yourself, please do it for the person behind you who needs treatment but is being blocked by the many barriers put up by the insurance industry. This is our battle and this is our time to shine! John Giordano DHL, MAC is a counselor, President and Founder of the National Institute for Holistic Addiction Studies and Chaplain of the North Miami Police Department. For the latest development in cutting-edge treatment check out his website: http://www.holisticaddictioninfo.com
ADDICTION IN OUR MIDST: UNDERSTANDING THE ANXIOUS FAMILY SYSTEM By Dr. Kenneth Perlmutter
Continued from page 24
As the Florida Legislature has just passed legislation which seeks to curb the abuses in the sober living industry, we are cautiously optimistic that we are embarking upon the start of a collective and joint effort to provide the safe space that is required for personal healing. However, we remain guarded, as we must, that these “consumer protection” laws do not become yet another pretext to discriminate under a different name. Words can be powerful weapons, as can be belief systems. We remain hopeful that we, at “ground zero” of this civil rights movement, are now sharing the path away from stigma and towards healing, and that the mantra of “taking back our communities” includes those in recovery. Jeffrey C. Lynne, Esq., is a Shareholder in the firm of Weiner, Lynne & Thompson, P.A., representing behavioral health treatment providers and owners of recovery residences across the State of Florida, with particular emphasis in the legal areas of local zoning, housing, real estate, licensing, compliance, regulation, and business litigation. Mr. Lynne has been recognized across the country as a leader in progressive public dialogue about the role that community based substance abuse treatment has within our society and the fundamental civil right of citizens in recovery from addiction to housing of their own choosing. Their website, SoberZoneLaw.com is the convergence of the practice of the law governing all aspects of owning and operating a substance abuse treatment program or sober living environment that meets the constantly-changing regulations for compliance in the 21st century behavioral health care model.
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Continued from page 32
guiding members to: 1) Describe their experience of life in the family including how they’ve learned to cope 2) Define their roles and find a metaphor that captures what they’ve become (e.g., doormat, chauffeur, life jacket, buoy, bullhorn, suicide counselor) 3) Put into words the covert messages members have received about how they’re expected to conduct themselves (e.g., we need you to be strong; or, don’t rock the boat) 4) Identify small shifts members can make to interrupt their usual way of participating in the family deal. These shifts promote healthy connection and emotional detachment with love. The next article will describe specific strategies for helping wounded family members promote system shift and health. Dr. Kenneth Perlmutter is a California Psychologist (PSY25112) who has dedicated his career to improving the lives of individuals and families experiencing addiction and other behavioral health difficulties. Founder of The Family Recovery Institute and Clinical Director of the Mind Therapy Clinic in Corte Madera and San Francisco, CA, he has also served on the Graduate Faculty at San Francisco State University Counseling Department and as Associate Professor of Chemical Dependency Studies at Cal State East Bay. He oversees family programming and provides clinical consultation and supervision for several well-regarded California treatment centers. Please visit www.FamilyRecoveryInstitute. com or email FamRecovery@gmail.com
What makes Holistic Recovery Center different?
Treatment Programs: ` Addiction
` Adult Residential
Holistic Recovery Center’s focus is highly individualized. The client to therapist ratio is never more than 6 clients per therapist. Holistic Recovery Center offers more weekly one-on-one sessions than virtually anywhere else.
` Dual Diagnosis
Holistic Recovery Center is truly holistic. The focus is on healing the mind,body and soul, not just the substance abuse, for a full and lasting recovery.
Out/Inpatient:
Some of the everyday holistic activities include: beach yoga, chiropractic, acupuncture, meditation and more. Client centered facility with 35 beds to ensure the best level of care. Holistic Recovery Center also offers fully furnished apartments with the finest amenities a home could offer. Holistic Recovery Center provides full spa treatments such as manicures, pedicures and haircuts. Enjoy yourself while in treatment with weekend activities such as Go-Kart racing, sporting events, trips to local art museums, etc.
To Advertise, Call 561-910-1943
` Residential Relapse Recovery ` Substance Abuse • Alcohol • Cocaine • Methamphetamine
• Marijuana • Opiate
` Intensive Outpatient Program ` Outpatient
` Partial Hospitalization (Day Treatment)
` Residential Inpatient Treatment Give up the daily struggle that is caused by active addiction and begin a new chapter in your life, it can all start with a simple phone call!
1-877-673-9048
www.holisticrecoverycenters.com 7709 Davie Road Extension Hollywood, FL 33024 1-877-673-9048
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P.O. BOX 880175 BOCA RATON, FLORIDA 33488-0175 www.thesoberworld.com
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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