Sept13 issue

Growing Old Sober Wife of a Doors Rocker Warns About Drug Overdoses Substance Use, Anxiety & Fear: Causes & Correlations in an Age of Adolescent Anxiety Our Addictive Society Part II: The Neo-Opium Wars The New “High”: Hand Sanitizers I Will Not Help The Addict To Kill My Son Different County, Different Policies regarding Drug/DUI charges

Gardens and Horses Play Parts in Wayside House’s Recovery Program

The Overdose Crisis Face Down Alcoholism with Four Healthy Choices Stop the Flow of Money!

From Surviving to Transformation: Hope, Addiction, Loss, and Trauma (H.A.L.T.) Don’t Let Anxiety and Fear Keep You from Getting Help Dealing with Anger Addiction The Crossroads Club… A Tributue to Dana TWO’S COMPANY, THREE’S A CROWD I Didn’t Know Adolescent Drug Use, Misuse and Addiction

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A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. This magazine is being directly mailed each month to anyone that has been arrested due to drugs, alcohol and petty theft in Palm Beach County. It is also distributed locally to all Palm Beach County High School Guidance Counselors, Middle School Coordinators, Palm Beach County Drug Court, Broward County School Substance Abuse Expulsion Program, Broward County Court Human Resource Department, Local Colleges and other various locations.

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.

Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. Florida is one of the leading States where people come from all over to obtain pharmaceutical drugs from the pain clinics that have opened everywhere.

The availability of prescription narcotics is overwhelming; as parents our hands are tied because it is legal.

Doctors continue writing prescriptions for drugs such as Oxycontin, and Oxycodone (which is an opiate drug and just as addictive as heroin) to young adults in their 20’s and 30’s right up to the elderly in their 70”s, thus, creating a generation of addicts.

Addiction is a disease but it is the most taboo of all diseases. 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 Transport Services that will scoop up your resistant loved one (under 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

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Schools, Wilderness programs, Extended Living and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean.

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

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

These groups allow you to share your thoughts and feelings. As anonymous groups, your anonymity is protected. Anything said within those walls are not shared with anyone outside the room. You share only your first name, not your last name. This is a wonderful way for you to be able to openly convey what has been happening in your life as well as hearing other people share their stories. You will find that the faces are different but the stories are all too similar. You will also be quite surprised to see how many families are affected by drug and alcohol addiction.

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. Please don’t allow them to become a statistic.

There is a website called the Brent Shapiro Foundation. Famed attorney Robert Shapiro started it in memory of his son. I urge each and every one of you to go to that website. They keep track on a daily basis of all the people that die due to drug overdoses. It will astound you.

I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com.

I wish everyone a happy Labor Day. Sincerely,

Patricia

Publisher Patricia@TheSoberWorld.com

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IMPORTANT HELPLINE NUMBERS 211 PALM BEACH/TREASURE COAST 211

www.211palmbeach.org FOR THE TREASURE COAST www.211treasurecoast.org FOR TEENAGERS www.teen211pbtc.org AAHOTLINE-NORTH PALM BEACH 561-655-5700

www.aa-palmbeachcounty.org AA HOTLINE- SOUTH COUNTY 561-276-4581

www.aainpalmbeach.org FLORIDA ABUSE HOTLINE 1-800-962-2873

www.dcf.state.fl.us/programs/abuse/ AL-ANON- PALM BEACH COUNTY 561-278-3481

www.southfloridaalanon.org AL-ANON- NORTH PALM BEACH 561-882-0308

www.palmbeachafg.org FAMILIES ANONYMOUS 847-294-5877

(USA) 800-736-9805

(Local) 561-236-8183 Center for Group Counseling 561-483-5300

www.groupcounseling.org CO-DEPENDENTS ANONYMOUS 561-364-5205

www.pbcoda.com COCAINE ANONYMOUS 954-779-7272

www.fla-ca.org COUNCIL ON COMPULSIVE GAMBLING 800-426-7711

www.gamblinghelp.org CRIMESTOPPERS 800-458-TIPS (8477)

www.crimestopperspbc.com CRIME LINE 800-423-TIPS (8477)

www.crimeline.org DEPRESSION AND MANIC DEPRESSION 954-746-2055

www.mhabroward FLORIDA DOMESTIC VIOLENCE HOTLINE 800-500-1119

www.fcadv.org FLORIDA HIV/AIDS HOTLINE 800-FLA-AIDS (352-2437) FLORIDA INJURY HELPLINE 800-510-5553 GAMBLERS ANONYMOUS 800-891-1740

www.ga-sfl.org and www.ga-sfl.com HEPATITUS B HOTLINE 800-891-0707 JEWISH FAMILY AND CHILD SERVICES 561-684-1991

www.jfcsonline.com LAWYER ASSISTANCE 800-282-8981 MARIJUANA ANONYMOUS 800-766-6779

www.marijuana-anonymous.org NARC ANON FLORIDA REGION 888-947-8885

www.naranonfl.org NARCOTICS ANONYMOUS-PALM BEACH 561-848-6262

www.palmcoastna.org NATIONAL RUNAWAY SWITCHBOARD 800-RUNAWAY (786-2929)

www.1800runaway.org NATIONAL SUICIDE HOTLINE 1-800-SUICIDE (784-2433)

www.suicidology.org ONLINE MEETING FOR MARIJUANA www.ma-online.org Ruth Rales Jewish Family Services 561-852-3333

www.ruthralesjfs.org WOMEN IN DISTRESS 954-761-1133 PALM BEACH COUNTY MEETING HALLS central house 2170 W Atlantic Ave.

SW Corner of Atlantic & Congress Club Oasis 561-694-1949 Crossroads 561-278-8004 www.thecrossroadsclub.com EasY Does It 561-433-9971 Lambda North Clubhouse www.lambdanorth.org The Meeting Place 561-255-9866 www.themeetingplaceinc.com The Triangle Club 561-832-1110 www.Thetriangleclubwpb.com BROWARD COUNTY MEETING HALLS 12 STEP HOUSE 954-523-4984

205 SW 23RD STREET 101 CLUB 700 SW 10TH DRIVE & DIXIE HWY LAMBDA SOUTH CLUB 954-761-9072

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We all marvel at the beauty of the butterfly, but rarely do we consider what it went through to become that butterfly. – Maya Angelou

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Substance Use, Anxiety & Fear: Causes & Correlations in an Age of Adolescent Anxiety

By Daniel P. Villiers, Ph.D

There are 73 million school-aged children in the United States and approxmately10 million of them experience daily and intrusive levels of anxiety. I am astounded by the fact that anxiety disorders are the most common mental health condition in the US across all age groups and that there has been a 700% increase in the last 40 years among school-aged children. These statistics support my belief that we are living in an age of adolescent anxiety, making the awareness of this epidemic, and the impact it is having on our children even more pertinent. Despite the destructive qualities of the anxiety disorder on all facets of life, they are generally considered the most treatable psychological condition, yet only one third gets any form of treatment. Did you know that there are as many as 3 million kids refusing to go to school due to severe anxiety and related conditions, most of who either already are, or will become, virtually housebound? I refer to this latter group as a generation of “Children in Hiding;” a lost generation of boys and girls in basements and bedrooms who have become dependent on avoidance as a way to cope. From developing nocturnal sleep schedules, nighttime computer use, and daytime sleep, they have discovered a way to connect with the outside world while not having to connect with the outside world.

Whether the child’s anxiety is moderate and manageable or has evolved into something severe and paralyzing, anxious kids are some of the most vulnerable to developing problems with alcohol and drugs. The purpose of this article is to create awareness of the nature, experience, and prevalence of this epidemic, and inform and inspire the victims, and their families, to break free from the cycle of anxiety, self-medication, and addiction.

I met Jim when he was 16 years old. He had been housebound for 11 months.

I would meet him in his home as the severity of his panic disorder and social anxiety prohibited therapy in my office. Jim was a bright, well-behaved, a sweet natured child. With the onset of puberty and some mild school bullying, he began missing a few days a week of school. Jim received an IEP, and was provided a home school tutor. I attended the IEP meeting and remember saying clearly, “This academic accommodation of allowing him to study at home will only worsen his school avoidance as his avoidance is his was to cope with anxiety.” The team didn’t seem to get it, or didn’t want to. Within months, Jim went from a place of intermittent school attendance to complete school refusal and social isolation. With the passing of each week, Jim was learning that the self-medicating benefits of avoidance in preventing his anxiety and fear were more powerful that the most productive 50 minute hour of CBT that I could give.

He refused to continue therapy three weeks after that meeting. Three years later, I found out from Jim’s parents that his anxiety had worsen, he refused any home schooling or therapy, had developed frequent suicidal ideation, had recently become dependent on marijuana and Xanax, and was on the computer playing video games for 12 hour day.

Jim’s experience is not a unique case; in fact he is one of many children trapped in a cycle of anxiety, fear, and avoidance, or “AFA” as I call it, where avoidance is used as a self-prescribed coping strategy.

What are the Anxiety Disorders?

Anxiety is a normal reaction to stress, and fear; an evolved cognitive mechanism to prepare or protect oneself from a real or perceived threat.

Paradoxically, what was once a mechanism to solely prepare and protect us from harm, seems to have evolved into something annoyingly unnecessary at best and pervasively destructive at worst. Individuals with an anxiety disorder are at great risk of going from serving a beneficial function to something that is intrusive, controlling. Without treatment, it can infect a person’s natural ability to be the arbiter of real threat and more the victim of perceived danger.

While there are a wide range of anxiety disorders, the following are the most prevalent among adolescents and young adults: Social Anxiety Disorder, Generalized Anxiety Disorder, Panic Disorder, Specific Phobias, Obsessive Compulsive Disorder, and Post-Traumatic Stress disorder (PTSD).

• Social anxiety disorder involves an overwhelming fear of evaluation and judgment from others, and the experience of anxious symptoms, feelings of embarrassment, and a self concept unfairly portrayed as weak and inadequate.

• Panic Disorder involves feelings of terror that strike suddenly and repeatedly, and often involve an increased or irregular heart rate, sweating, and chest pain. With time, symptoms of panic can become the cues for potential panic, where the fear of panic itself can be equally as frightening as the panic attack itself. In teenagers, symptoms can include muscle tension, a refusal to move (also known as the freeze response), and crying or tantrums. While these

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behaviors may look like an act of defiance, in children and adolescents, it also serves a purpose of avoiding going somewhere where anxiety and panic might be triggered, or as a response to prevent an emotionally dysregulating state. This can lead to the development of agoraphobia, a condition involving avoidance of places and situations where escape would be difficult or embarrassing should a panic attack occur.

• Obsessive Compulsive Disorder sufferers experience intrusive thoughts related to a fear (obsession), that cause them to perform certain compulsions or routines to decrease the associated anxiety. Adolescents and adults can have a range of clearly distinguishable obsessions and compulsions, such as an obsessive fear of contamination leading to compulsive hand washing to more subtle forms, such as an obsessive fear of academic imperfection leading to re-writing a paper 10 times. Some individuals may suffer from Pure Obsessional OCD where obsessions are reported without clear or observable compulsions. These obsessions present as intrusive, unwanted thoughts, or “mental images,” of them doing something they consider to be harmful, immoral, and/or sexually inappropriate. These thoughts can be frightening due to the fact that they contradict their own beliefs, intent, and desires.

• Post-traumatic stress disorder (PTSD) is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally detached or numb in adulthood, or emotional and behavioral unpredictable during adolescence.

• Specific phobia is an intense fear of a specific object or situation, such as driving over a bridge, snakes, heights, or flying. The level of fear or perceived threat is significantly out of proportion to the actual threat and may cause the person to become avoidant of places where the threat might arise. A common specific fear among children and young teens may be of their parent dying which is often perpetuated by separation anxiety disorder. Separation anxiety disorder is frequent and intrusive displays of fear and distress when confronted with situations of separation from the home or from a specific attachment figure.

• Generalized Anxiety Disorder involves excessive, unrealistic worry and tension, even if there is little or nothing to provoke the anxiety. Among adolescents, academic anxiety and chronic perfectionism are common additional features depending on the social and cultural values of the home and/or school environment.

Prevalence and Comorbidity Current research demonstrates that anxiety disorders are the most common mental health condition across all age groups with prevalence rates ranging from 18-24%. After depression, substance abuse has the third highest prevalence rate of 10-14% among adolescents, with anxiety and depression having the highest comorbidity rate. The term comorbidity refers to two disorders occurring together, and research clearly shows that more than half of individuals with a substance use disorder also suffer from another mental health condition.

Multiple studies utilizing data from the National Epidemiology Survey (2011) have found between 40-60 percent of adolescents diagnosed with an anxiety disorder have a comorbid substance use disorder. Further, that generalized anxiety disorder (GAD) and panic disorder (PD) have the highest associations with drug use disorders, and PTSD and OCD were both most commonly associated with alcohol use disorders versus drug use disorders.

There are at least three scenarios in regard to the origin of co-occurring anxiety and substance use: 1) drug abuse can cause a mental illness, 2) mental illness can lead to drug abuse, and 3) drug abuse and mental disorders are both caused by other common risk factors. In regard to the anxiety disorders, especially among adolescents, there is overwhelming support the self-medication hypothesis, also known as “the tension-reduction” hypothesis.” This asserts that attempts to reduce anxiety with the use of substances can then lead to the development of a comorbid substance use disorder. For example, Kushner et al. (2008) found consistent evidence for anxiety disorders occurring before a substance use disorders in at least 75% of cases, and that other risk factors, such as family history of drug abuse plays an influential role. In regard to the remaining 25% from Kuchner’s study, substance use and abuse can lead to the development of anxiety in later adolescence.

In regard to the “drug of choice” among adolescents with teenagers, the reContinued on page 30

The New “High”: Hand Sanitizers

By Terry Marvin

Responding to germ-conscious consumers with the development of pocket size anti-bacterial products, makers have also unwittingly opened the door to a bizarre new trend especially among teenagers: Ingesting ethanol-based hand sanitizer to get high.

“As with cough medicines and extracts that often contain 60-percent or more ethanol, this common household product delivers an even greater punch that alcoholic beverages like vodka or tequila, which typically contain less alcohol,” says Terry Marvin, Program Director for The Recovery Team in North Palm Beach, FL A few swallows of hand sanitizer produces the same intoxicating effects of a traditional alcoholic beverage. The result? Slurred speech and unresponsiveness with side effects that range from sedation and loss of coordination to life threatening conditions as is being reported by poison control centers around the country.

“And, truth is, this latest substance to get high isn’t all that new. It’s right up there with sterno – the canned jellied fuel used to keep food in buffet chafing dishes warm. Like sterno, hand sanitizer contains a dangerous mix of chemicals that can result in severe neurological damage as well as other unintended consequences.”

Moreover, the low cost and widespread availability of the product has added to its popularity especially among those who are unable to purchase alcohol legally. It’s relatively easy to purchase the pocket size bottles, which are the equivalent of two to three shots of hard liquor since stores clerks rarely think twice about selling hand sanitizer products to adolescents, says Marvin.

Adding to its accessibility is the plethora of videos that demonstrate “recipes” for using products that can heighten the effect of drinking hand sanitizer. Videos show teens drinking the product as well as demonstrating how to make the product stronger and more tolerable to drink. For example, one YouTube video demonstrates how to heighten the potency of hand sanitizer by using salt. Another demonstrates straining the alcohol from the product using a slice of bread.

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“The bottom line with this – and all the other ‘new’ ways to get high that are sure to follow – is to create the desire for abstinence,” says Marvin.

“Through education and support, each of our therapists therapeutically create and support that desire through all of the programs that we offer to our clients. We focus on promoting life without mood or mind altering substances – a life that is free of drugs and alcohol and all their variations. That’s our job.”

Terry Marvin is Program Director for The Recovery Team in North Palm Beach, FL where he brings a diverse background of strong leadership and management, which includes more than 30 years’ experience in law enforcement. He is a certified police officer in the State of Florida and has completed his education hours toward his CAP certification. www.recoveryteam.org

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Growing Old Sober

By David J. Powell, PhD

Check it out. Most of the articles written about sobriety focus on early stages of recovery and that’s appropriate. Early recovery brings an array of issues that are important to address. However, long-term recovery needs to be addressed also. Just because I have been sober for some time does not exempt me from the usual issues people encounter as they age. This article will speak to some of these issues.

Stages of Life How does one know they are getting older, besides looking in the mirror? There are four markers of aging: • Biological/chronological: I’ve lived more years than I’m going to live. If you are over 40, you’re likely in life’s second half, at least as far as actuarial tables are concerned. Life’s second half usually brings with it different issues, such as physical pain, career changes, the few inches around the waist that were not there ten years ago. When someone tells you at 50 they can do what they were doing at 20—they likely were not doing much at 20. Aging brings biological changes.

• Social: aging brings social changes, such as loss of jobs, facing retirement, the kids are out of the house and you become an “empty-nester.” These can be exciting or frightening changes, depending on how one looks at them.

• Psychological/emotional: the old adage is “you’re only as old as you feel” may be true at 40 but less so at 60. Now, I wake up with a few more aches and pains than before. I look in the mirror and see age lines that never existed. And I begin to feel older, which is not a bad thing. One of the inevitable truths of life is you’re going to grow old; you’re going to die, despite what the anti-aging commercials on television may say. And as we age we see the seeds of our ancestors in us. Ever look in the mirror and said to yourself, “Oh now, I’ve turned into my father/mother?” All those qualities they had that you did not want to have in yourself, you now see coming out.

• Spiritual: in life’s second half you ask different questions. Instead of “how” am I going to live, support my family, develop a career, you ask “why” questions. What’s it all about? Is that all there is? What legacy do I want to leave behind after I’m gone?

in treating women, lack of women-sensitive treatment).

The road of life is rarely a straight journey. It is filled with many unexpected twists and turns in the road. The road to recovery is also filled with many changes. Combine life’s changes with the changes that happen in recovery, we face important and interesting challenges. The good news: recovery happens. Sobriety is possible.

David J. Powell, Ph.D. is Assistant Clinical Professor, Yale University School of Medicine and President of the International Center for Health Concerns, Inc. He has been a mental health and substance abuse professional since 1965 and is widely regarded as the leading expert on clinical supervision in the substance abuse field.

I Will Not Help The Addict To Kill My Son

By Sandy Swenson

Life’s Issues in Aging Sobriety gives us the ability and skills to deal with the “normal” issues we face in life: loss of loved ones, loss of relationships, empty nesting, career changes, physical impairment, and grieving. Recovery is a process not an event. Life is a continuum of ever-deepening circles. Put those two ideas together and we begin to understand what growing old sober might look like. In life, discovery often precedes recovery. You wake up one morning and realize, “Oh, that’s what that’s all about. I didn’t realize it at the time, but now I understand. We live life forward and understand it backwards.

Recovery goes through stages, even as life does. In the beginning, we have an early awareness and acknowledgment about what life might be like clean and sober. We go through periods of incubation, consideration, where we have to ponder “what does that mean?” This leads to activity and action where we begin to make changes in our life. Rehabituation happens where we see changes in our attitudes, values and life style. Active recovery occurs somewhere down the road, over time. It’s said we spend the first five years of recovery trying to find our marbles and then the rest of our life trying to figure out what to do with them.

As we gain sobriety and age as well, we face profound life changes which can become triggers to relapse if not addressed.

• Often we climb the ladder of success only to find out the ladder was against the wrong building. We ask ourselves “Is that all there is?” What we sought in our younger years may no longer provide us the same sense of meaning and purpose.

• The power, possession, prestige, privileges, and perks we sought in our early years can become meaningless now as we age.

• As we age, we face profound questions about dealing with aging parents, raising a family, facing retirement, asking ourselves “will there be enough” to sustain us through life. Our fears can overwhelm us. These questions, if left answered, can lead to relapse.

• Life is a journey of transformation, from success to significance. If you do not transform your pain, you transmit it. You take it out on yourself through abuse. Being in the presence of changed people changes us. And love will always transform us. In the Program, we say, hang out with winners, transformed people.

• Recovery is always about letting go. Success has virtually nothing to teach you in life’s second half. We learn more about life from what we’ve had to let go of vs. what we retain. But, everything I’ve had to let go of in my life has claw marks on it—I do not let go of things easily. I want to hold on to them as long as possible, which causes me suffering and pain.

• Recovery is about who am I? What’s life about? What else is there? He who has a “why” in life can live with any “how.”

• You cannot do all of your homework at the end. The journey of transformation begins early in sobriety. Recovery means actively addressing these profound issues in life.

• Women in recovery may face issues unique to them: internal barriers to recovery (shame, trauma), external barriers (misdiagnosis, stigma, child care transportation, money), and systemic barriers to recovery (inadequately trained caregivers skillful

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My baby grew up to be an addict. There was a time when I believed a mother’s love could fix anything, but it can’t fix this.

For too many years I thought I was helping Joey. I thought I was doing my job by keeping him out of trouble and getting him out of trouble and believing his lies. I snooped and stalked and tried to out-manipulate his manipulations. I did everything and anything to make things right. I tried to keep my child from suffering, because that’s what a mother’s love does.

I loaned Joey money when times were tough, but not wanting to make times any tougher, didn’t ask him to pay the money back. I made excuses for Joey’s new selfcentered meanness and I pretended not to hurt when he missed my birthday or when his place at our Thanksgiving table remained empty. I believed Joey’s explanations for his sunken eyes and shaking hands and I believed his convoluted denials of drug overdoses and emergency room DOA revivals. (Well, sort of.) When Joey was arrested -- the times I knew about -- I showed up in court as a reminder that he was loved and had reason to head in another direction; I even stayed when he bared his teeth at me and hissed. I wrote letters to the judge (damage control) pleading for Joey to be sentenced to rehab not jail. And then I listened as Joey blamed everyone he could think of for why he did end up in jail; the only person not to blame was the one looking at me from the other side of the smudgy glass.

Three times Joey was convinced or cornered into going into addiction treatment. And three times Joey played it and everyone around him like a game and then walked away. I connived. I wheedled. I cried. I begged. And, I continued to aid and abet and enable like a champ.

I did everything I could to protect Joey from himself until finally I realized it wasn’t him that I was protecting. I was protecting the addict. Making it easy for the addict. Giving the addict one more day to further consume my son’s body and mind.

I was helping the addict to kill the son I was trying to save.

My motherly love would need to be contorted and redefined.

There’s nothing about this kind of love that feels good. But I’m not doing it for me. It’s not called Tough Love because it’s mean. It’s called Tough Love because it is tough to do.

I will do nothing, ever again, to help the addict. Because, if I do, I have no hope of ever seeing my son. I love Joey. And it is because I love him that I am done.

Sandy Swenson is the mother of two sons, one of whom is an addict. Living in suburban DC, she writes about the place where love and addiction meet.

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Our Addictive Society Part II: The Neo-Opium Wars

By John Giordano DHL, MAC

I received so much positive feed back and questions from my last article “Our Addictive Society” that I was encouraged by readers to write a follow up. In this second installment my focus is on what I call the “Neo-Opium Wars” that is taking place right now, here on our streets in America!

This is an issue that is very close to my heart. I’ve been involved in addiction treatment for nearly thirty years. In that time, nice people with addictions have died in my arms. I nearly lost my only son to this disease – the most painful experience of my life. I look around today and all I can see is that drugs – mostly opiate based – are more accessible than ever.

When I first became an addiction counselor it was rare to see someone with an addiction to a prescription drug. Today my center is flooded with them. We’ve seen more than double the number of heroin addicts in the last year.

A while ago I read a statistic so shocking that I literally became sick to my stomach. It led me to the realization that we are now living in the “Neo-Opium Wars” era. It’s taking place right here on our soil. Of all the prescription opiate painkillers manufactured and sold in the world, Americans consume eight out of every ten. Do we suffer that much more pain compared to the rest of the world? Keep in mind this statistic doesn’t include illicit narcotics such as heroin. So how did we get here?

Opium – the base from which painkillers and narcotics are derived – has been a big part of global trade since its discovery. It was a highly sought after product during the ‘New Stone Age.’ The Sumerians – who cultivated opium in lower Mesopotamia (Iraq) – called it the ‘joy plant,’ which many experts believe is a reference to its recreational use, circa 3400BC. They shared their methods with the Egyptians who cultivated their own. Their finished product found its way throughout the Mediterranean. Eventually, opium became available in all of the populated regions.

However, it was the Chinese who had the most tumultuous history with opium on record. Although the Chinese used opium for medical purposes for thousands of years, it wasn’t until the fifteenth century that it was widely used as a recreational drug. Addiction was ramped. It was said that people sold all of their personal belongs to purchase more opium.

In 1729 Opium became a banned substance in China. But, as you would suspect with any addictive substance, there was still a high demand for opium and a few opium traders exploited it.

The British had developed a taste for tea but the Chinese had little interest in trading for British manufactured goods. They demanded silver – which was in short supply – for payment. The Brits were buying three times as much as they were selling to the Chinese, making tea very expensive and creating a huge trade deficit.

British opium traders began tipping the scales in their favor while lining their own pockets at the same time by illegally selling opium – produced in India under the British East India Company monopoly – on the Chinese black market. They used small boats to smuggle opium chests into rivers and deltas along China’s coastline. The ruling Chinese emperor at the time initially looked the other way because it created an indirect tax on Chinese subjects, thus adding to the government’s treasury. It wasn’t until 1839 – after the devastating social impact of opium – that Emperor Daoguang declared a war on drugs. His military raided known British opium stores in China and destroyed 20,000 opium chests. It was China’s “Tea Party” that triggered the first opium war.

The Chinese Empire was soon decimated. It lost both the first and second opium wars, forcing the country to accept opium imports from foreign countries. The social impact was devastating. By the late 1800’s it was estimated that over 27% of the Chinese adult male population was addicted to opium. But they were not alone; opium addiction was on the rise across the globe. However, the economic impact under the post opium war guidelines was a watershed for business. Opium traders began cultivating opium in China. By the early 1900s, China became the world’s foremost opium producer with more than 22,000 tons a year. It took another fifty years for China to rein in the runaway opium addiction.

Opium was a huge business during this era. The decisions made by government officials skewed towards commerce with no regard of the social impact, helped fuel China’s rapidly growing addiction to opium. It destroyed millions of lives. But at the same time, the revenue and taxes generated from opium sales helped grow treasuries and lift economies during a competitive economic time. So it is with this in mind that I look to our current conflict, the “Neo-Opium Wars,” which is taking place on

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two fronts right here in America, legal and illicit.

As I mentioned before opium plays a large role in the global economy.

It takes a business to move a product from a raw material to a finished product, through distribution channels, to retailers and finally to the end user. It takes a big business to move a product such as opioid prescription painkillers in large quantities through the cycle and into the hands of the end users.

I am by no means anti-pharmaceutical. There are a lot of life-saving drugs available that improve our quality of life. The pharmaceutical companies invested billions of dollars to research these drugs and gain FDA approval. I believe there is a place for opiate painkillers when there is trauma or severe pain that can’t be treated holistically.

However business is business. At the end of every ninety days, these Titians of pills must face and answer to Wall Street and their stock holders. They have to show a profit and an increase over last year’s sales if they want to keep their job, reputation and status. That is just the unvarnished reality.

Pharmaceutical companies and nearly all other businesses are subjected to principles that can determine their future success and failures. One of those principles is supply and demand. Where ever there is a demand, there will be a supply. Pharmaceutical companies who sell opiate painkillers are subject to the same laws of supply and demand as any other business. It stands to reason that the demand for painkillers would be a relatively flat without many spikes. Combine that with competition and you’d expect price to remain low. Yet the exact opposite is occurring.

USA Today: “Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available.

That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States.” According to the New York Times, Opioid prescriptions are up 33% between 2001 and 2012 while revenue from sales jumped 110% to $8.43 Billion during the same period. This to me simply defies gravity.

The East India Company learned an invaluable lesson when their traders were selling opium to the Chinese – addictive drugs create many repeat customers.

Living in Florida has many benefits. Tropical weather, beautiful sunrises and some of the best food in the world make this state a great place to live. However there is one dark spot in our history that was responsible for the death of thousands of people – pill mills. Pill mills threaded the legal needle between legitimate pain centers and retail storefront for drug dealers. It took a while, but the state past legislation over two years ago that shut down these modern day opium dens. At their height, Florida pill mills were responsible for over 80% of Oxycontin domestic sales. Florida interstate highways were jokingly referred to as “The Oxy Express” by out of towners traveling to Florida for the easy access to Oxycontin.

Oxycontin is a narcotic painkiller produced by Purdue Pharma, a privately family owned company started by three brothers. Arthur, Mortimer, and Raymond Sackler who were all psychiatrists that worked in a Queens’ mental hospital in the 1940s. Arthur left his practice to join a boutique advertising agency in New York City specializing in marketing pharmaceuticals. He earned his way into Medical Advertising Hall of Fame by being the first to market drugs to doctors by lavishing them with fancy junkets, expensive dinners, and lucrative speaking fees.

OxyContin was more of a marketing success than a medical breakthrough. The brothers dusted off an old oxycodone formula that was available in generic form for decades and added a time release mechanism they claimed greatly reduced the addictiveness of the drug.

The FDA approved OxyContin for sale in late 1995. The brothers followed Arthur’s marketing plan to the letter and sales went through the roof. The company generated $3.1 billion in revenue in 2010.

The first hint that OxyContin was more addictive than claimed occurred in the first couple of years it was on the market. Purdue Pharma heard the clarion call but changed nothing and continued to tell doctors it was safe. In 2007, a U.S. District Judge ordered Purdue Pharma to pay a $634.5 million fine for misleading the public about the painkiller’s risk of addiction. Purdue Pharma’s revenue was 1.3 billion that year. The fine did nothing for the people who were now addicted to OxyContin Continued on page 24

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Wife of a Doors Rocker Warns About Drug Overdoses

By Julia Negron

Only it wasn’t really so far out, it was just sad. I developed a drug habit right along with my second husband, Three Dog Night singer Chuck Negron. We took ODs in stride, happy to survive, part of the price, part of the game.

Who knew we would survive long enough to look back in sadness on the wasted lives and unsung songs, the unwritten poetry, the unpainted art.

My own life was saved twice by Narcan (naloxone), administered by the private paramedic we kept on call. In 1984, my own baby sister Connie died of a drug overdose. In 1985, I checked myself into rehab at Cedars hospital, and never shot heroin again.

As time marched on I would see my own son on life support, another overdose!

He is okay today, and in recovery, thanks to medical intervention. But not so lucky were all the other rocker parents who did lose their children. Oscar Scaggs, Jessica Rebennack, Andre Young Jr - so many kids of music legends lost. All lives that could have been saved, like mine, if overdose prevention and awareness was part of drug education in schools, medical facilities and rehabs.

I can’t help but think back 40 years ago; to the time I got up close and personal with overdose. The Sunset Strip scene of 1966, 1967’s “Summer of Love” and the Monterey Pop Festival were my rock ‘n’ roll training grounds. I was working in the A & R department of Liberty Records, and by 1968 I had moved in with and was soon married to rock icon John Densmore of the Doors.

A most fabulous lifestyle; all fun and no consequences. I often look back and wonder what the world would be like if we knew then what we know now. We did not know what dangerous games we were playing.

I remember an intimate birthday dinner party for Jim Morrison before he went to Paris. We all laughed when another Doors wife and I rolled up the birthday present we had found for Jim - a Courvoisier cognac bottle decanter on wheels made to look like an antique war cannon. Today I might choose something different.

Even then there were whisperings about some of our favorite musician friends being “real” junkies - Tim Hardin, James Taylor? It was hard to believe. Then came the news - both Jimi Hendrix and Janis Joplin were dead.

But the real shock came when my own mother died of an overdose at 47 years old. Still, I saw it as a fluke or even expected, after all my mother had a long history of drug and alcohol problems.

Then Jim. Jim Morrison! Even our own little rock circle didn’t seem to know an overdose killed Jim. Today I have no doubt that it did - and that his life could have been saved.

Suddenly, hearing about someone you knew from the music scene dying from an overdose became commonplace. “Remember so-and-so, the drummer from so-and so?” “Yeah why?” “He OD’d.” “Far out.”

Aug. 31 is International Overdose Awareness Day. Today we know that all life matters and things can change. Now that I am a cleverly preserved rock dowager, relying on my stories and memories for thrills, I’ve painfully watched a younger generation of rockers die of overdoses. Their numbers are legion, the sadness intolerable - they would have practiced their art for another 40 years like my lucky living peers have. Alive today, long gray hair, our leather pants bursting a little bit at the bum. We are still full of stories and music, all the promise that rocked life in the ‘60s. I want that young life and music to continue.

On Aug. 31 I will be taking my hippie sensibilities out of mothballs for a street protest in Hollywood to raise awareness that drug overdose is preventable. It is a medical emergency that needs to be treated with urgency, dignity and without fear of arrest. If Jim Morrison were alive today he would have at least written a poem about it and maybe joined me - gray hair, bursting leathers pants and all.

Julia was born in New York City, went to high school in Santa Barbara and college in LA. She has been in personal recovery since 1985. She found a career in substance abuse counseling and is certified as an Addiction Specialist since 1990, supervising and training residential addiction treatment staff. Now retired, Julia is currently active in advocating for changes in our punitive drug policies, reducing stigma, and (since her own son’s incarceration) ending mass incarceration. Her passion is to end ‘caging” of drug offenders. Her goal is to move the issue of drug dependence out of the hands of law enforcement and courts and give it to the professionals who are best suited to work with addiction as a public health issue. Julia Negron is a co-founder of “Moms United to end the War on Drugs” and a Board Member of “A New PATH (Parents for Addiction Treatment and Healing”) She currently lives in Sarasota, FL.

The Overdose Crisis

By Gretchen Burns Bergman

There is nothing more tragic than young lives being lost unnecessarily before they have a chance to reach their full potential. The grief experienced by parents and family members left behind is heightened by the sense of frustration and even rage, that this loss could have been prevented. Yet, many don’t talk about accidental fatal overdose because of shame and stigma.

August 31 is International Overdose Awareness Day…a day to acknowledge individual loss and family grief when loved ones have suffered overdose. This day of awareness was started in Australia by members of the Salvation Army and Community Health Development programs in 2000, and is acknowledged worldwide today.

California has the highest number of overdose deaths in the country. According to the Centers for Disease Control, drug overdose now ranks as a leading cause of accidental death in the United States, second only to motor-vehicle accidents.

It is the leading cause of death among people who use drugs around the world.

These numbers are rising due to prescription opioid drugs.

I am the mother of two sons who have addictive illness. My older son is in longterm recovery and works as a drug and alcohol counselor. In his profession he helps people to find recovery and live meaningful lives. His story could have had a darker ending. Many years ago he was left unconscious after partying with his friends. Thankfully, a Good Samaritan took him to the emergency room and called me. I waited for hours in the middle of the night not knowing if he would live or die.

My younger son has been in a position to save the lives of his drug using friends several times, with the use of naloxone. Worry is my constant companion.

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I wonder how many of our sons and daughters have survived an overdose, and we don’t know it, or realize how lucky we are that they still have futures to look forward to. Parents of drug users have panic attacks, not because they are co-dependent, but because they know their offspring are in real danger. Remember the saying, “Do you know where your children are?” warning us to keep close watch on our kids to keep them safe. This haunts us even when our child becomes an adult, when we understand that addiction is a life-threatening disease.

I have several friends who have lost a child needlessly to overdose. After her son Jeff died of an accidental overdose, Denise Cullen started helping others suffering from what she calls this “unique, stigmatized and isolating grief.”

There are solutions that can save lives, like Good Samaritan policies that provide limited criminal immunity for both the witness and the victim of an overdose. Unfortunately witnesses of an overdose often don’t call 911 out of fear of arrest for associated drug use. We now have a 911 Good Samaritan law in California. Naloxone, a non-narcotic drug that reverses overdoses could be made more available. We must adopt strategies that will keep people with drug problems alive for the cure.

A New PATH (Parents for Addiction Treatment & Healing) holds a candlelight vigil each year on August 31,which is International Overdose Awareness Day, to honor individuals who have lost their lives to overdose. Gretchen Burns Bergman is Co-Founder of A New PATH & Lead organizer of Moms United to End the War on Drugs national campaign. www.anewpathsite.org.

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I Didn’t Know Adolescent Drug Use, Misuse and Addiction

By Nina Kramer, Teacher at Inspirations for Youth and Families

Susan B. heard a knock on her door Tuesday, November 19th, 2002, that every parent dreads. It was the news that her 22-year-old son had been shot to death by their neighbor because he had entered their premises while high on Psychedelic Mushrooms and Marijuana.

John B. was your “typical teenager.” He was active in sports through high school, a high academic achiever, was social, and was a talented artist. Susan admits that her son might have “experimented” with drugs through his teen years, but she in no way thought that his use could have led to this. When asked if she thought he was an addict, she replied that she just didn’t know.

The story of John B. was told to me by his best friend. (Names have been changed to protect the anonymity of the individuals represented in this article).

The boys grew up together in South Florida, attending private school, family barbeques and weekend camping trips. They also used drugs together. Their parents knew little of what the boys were doing through the years. Today, drug use, misuse and addiction in adolescents throughout South Florida and nationwide is rampant, there is an epidemic.

I teach English to residential teens seeking treatment for substance abuse and behavioral problems. Currently we have teens from as far away as Tacoma, Washington right to our very own backyard. The ages are as varied as the geography. In this article, I interviewed a 13-year-old male who abuses marijuana regularly and a 17-year-old female who has been here twice for poly-substance abuse. Poly-substance is a fancy term that is used to describe what many teens call “garbage heads.” These are the children using anything they can get their hands on: Heroin, Methamphetamines, Opiates, Benzodiazepines, Ecstasy, LSD, Marijuana, Alcohol and other drugs. There are more male teens here than female, but we have seen a rise in females over the last two years.

There are several areas of concern to take into consideration when evaluating teen drug use. For parents like Susan B. it is too late to address and understand what her son John B was going through. Parents need to actively engage their children in conversations about drugs. They need to find out what types of drugs their teens are using, what is triggering their drug use and educate themselves on what signs to look for in substance abuse. They also need to learn about relapse, relapse prevention, and finally, why and how teens stay sober. The goal of substance abuse education is to help parents never have to say, “I didn’t know” again.

Why does my teen want to use drugs and what kinds of drugs are they using?

On July 17, 2013 I asked 42 teenagers that were in treatment for substance abuse and behavioral issues why they had used drugs. The survey was random and anonymous and the answers were quite revealing. They said that they used for many reasons but some things they said really stuck out in my mind.

Many of the teens said they used drugs because they wanted to escape, enjoyed how it made them feel, wanted to have fun/be social or were curious and bored.

Some, however, used for all together different reasons. Chad S. said he used to lose weight, another admitted his use was because he was angry with his father, and another because she thought her mother was never there for her and didn’t want her. Family problems came up again and again. Others said that they used the drugs to self-medicate for depression, anxiety or because they couldn’t handle reality. Three separate teens said they used because they were bullied.

I interviewed Clinical Director Marlene Rodriguez, LCSW, and Primary Therapist Michele NeSmith, LMFT, with one question on my mind: what kinds of drugs are teens using today? Rodriguez responded quickly with one steadfast word: Marijuana.

“Marijuana,” she stated, “is used by teens because it is both accessible and acceptable. Teens think that it is ‘not a big deal.’”

Turning to NeSmith I asked, which drugs they are seeing more of this year than last? She also had a singular answer for me: “pills”. Pills, however, encompass a greater area of drug use and abuse. Both NeSmith and Rodriguez agreed that the majority of teens they treated were using MDMA (3,4-methylenedioxy-Nmethylamphetamine) or Ecstasy, but that prescription drugs are equally prevalent.

NeSmith said that, “medicine cabinet drugs like Benzodiazepines, Hydrocodone and other Opiate derivatives, and even cold medicines have become a big problem for teenagers.”

The teens echoed NeSmith’s statement adding that they are still using alcohol but that it is much easier for them to take pills from their parent’s medicine cabinet than it is for them to take liquor. Alcohol, NeSmith told me, had “lost the appeal – there

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were more fun drugs to do.”

How do I know if my teen is using drugs or headed towards a relapse?

Lying, manipulation and change in behavior came up again and again when I asked this very important question .Primary Therapist Lisa Cohen, LMHC said that, “they like to lie and manipulate their parents into making them think that their drug use is their fault…they will say things like ‘how dare you”, “you treat me like a baby” etc.. She added that blaming, anger and defensive behavior is very common with teens that are abusing drugs.

Primary Therapist Hernaldo Morales, M.S., MFTI, agreed with Cohen and added that inconsistent behavior or changes in behavior are significant indicators that a teen is using drugs or headed back towards a relapse. He said, “There are two things that come to mind (when thinking about relapse or signs of drug use), the teen shows inconsistent behavior and there is no motivation or interest in previous goals or activities.” He added that things in their life just, “stop!”

I asked the teens to tell me some sure signs when someone is using drugs and their answers ranged from the obvious to the obscure. Some of the obvious indicators included moodiness, missing money, lighters and eye-drops, consuming large amounts of food and staying up late at night. More atypical indicators were reported by Chad S. who said: “Almost everyone who uses drugs in the adolescent phase is usually a compulsive liar. They lie about very basic things. It could be as simple as the shoes they wore last Tuesday to the color of their hair a month ago. Many of the other teens echoed Chad’s admission.

Some teens use drugs to lose weight and some might even have an eating disorder. Adolescent male anorexia is on the rise and often co-occurs with drug abuse. The female teens agreed that weight loss, lying or change in appearance were also key indicators.

I spoke to a few parents who admitted using incense to cover up the smell of Marijuana when they were teens but were quite surprised themselves by the admissions of their own children who used the same devises (with the addition of towels against the door, excessive perfume and room spray) to cover the smell of smoking crack. One teen admitted that he preferred to wear only white t-shirts while smoking crack and often didn’t change his clothes for days, a habit he called, “going hamster.”

Primary Therapist Lisette Lacosta, M.S. RMHCI, said that there are also several signs that are not so obvious when a teen is using drugs or has relapsed. She pointed out that what can be seen as typical moodiness or shyness is often isolation. She said that if a parent can catch the teen in the “emotional-phase” of relapse, they may be able to deter it. The teen may say things like, “I’m fine,” or suddenly like a switch, they turn off, and are no longer interested in talking about emotional issues with a parent at all. This emotional phase is, “when things are starting to get out of control,” or “unmanageable.” Lack of support could lead to the next two stages: mental and physical relapse.

What makes my teen want to stay sober and how do I prevent relapse?

The quintessential question then is, how do we keep teens sober? There is no easy answer to this question. I queried both teens and clinicians, and have been engaged in the research process myself as I work towards my Masters in Social Work (MSW) as a student at Florida Atlantic University. The research is varied and the longitudinal studies are limited. Primary Therapist Damien McKnight, MED, said that a multi-dimensional approach is best. He stated that, “having a support system is essential. They must go to NA (Narcotics Anonymous), AA (Alcoholics Anonymous) Meetings, stay humble, and not believe that they are cured, as well as keeping open and honest communication about the possibility of relapse”.

These are key components to keeping teens sober.

A 16-year-old male teen in his second rehab said that the best way to stay sober is to change friends. He said that he thought he could hang out with the same people and watch them use drugs and not participate, but he was clearly wrong.

Another teen emphasized the need for a rigid schedule. She said that free time was not good for her because she always wanted to use drugs when she was bored. Still, another teen emphasized developing a “moral conscious” and staying connected to a “higher power.” He also said that enjoying the “other things in life” are important to staying sober.

If my teen is abusing drugs, what can I expect them to get out of a rehabilitation facility?

I hurried past the office of Clinical Director Sam Glenn, LCSW expecting to see a closed door. Glenn’s door is often closed because he is always engaged in teen Continued on page 30

Gardens and Horses Play Parts in Wayside House’s Recovery Program

By Marlene Passell

Delray Beach – When Cathy Cohn took over the reins as executive director of Wayside House earlier this year, she recognized some untapped resources there. First, she saw beautiful grounds around the gazebo that provide lots of space for gardens – flowers, trees and herbs. Then she discovered that a staff therapist is certified in equine therapy. Ms. Cohn saw possibilities in both that would benefit the clients of the residential addiction treatment program.

Now, just a few months later, both therapies are underway. Weekly, clients travel to Tradewinds Park in Broward County to learn how to handle their own insecurities, frustrations, and lives through their interaction with horses. Therapist Erin McNamee leads the women through exercises with the horses to help them discover their own strengths and weaknesses and how to make changes that will help their recovery. All this is done without ever getting on a horse, but by working with them side by side.

“I may ask a client to lead a horse through a series of obstacles. Some clients are hesitant, afraid the horse won’t do as they ask; others may show anger or frustration; and others are resourceful in how they coax the horse along. How they respond tells them a lot about how they handle obstacles in their own lives and we then work on solutions,” said Ms. McNamee.

Ms. Cohn continued to seek out a way to develop the lush grounds around Wayside House into a garden that could be maintained by clients as part of their therapy. Then, another small miracle happened: a former client dropped in wanting to give back to the place that had served her so well in her recovery.

For women by women

Paula Broughton found great healing power in gardening around the grounds while she was at Wayside House more than 20 years ago. Since then, she has become a horticulture therapist. She happened to stop by Wayside House shortly after Ms. Cohn joined the organization. She, too, saw the possibilities for incorporating horticulture into the therapeutic program at Wayside House and offered her services.

Since then, one of the organization’s donors has helped financially and Ms. Broughton has begun the design, to create, among other things, a tropical fruit forest and gardens using tropical and native plants. It will include flowers that draw butterflies and herbs that clients can nurture and then harvest for use in food prepared in Wayside House’s kitchen.

Both of these new therapies round out a fully holistic program that also includes meditation, yoga and art therapy.

For more information on Wayside House’s addiction recovery programs, call 561.278.0055 or visit us as www.waysidehouse.net Marlene Passell is the communications manager for Wayside House.

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waysidehouse.net 561-278-0055 15

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Different County, Different Policies regarding Drug/DUI charges

By Myles B. Schlam, J.D.,CAP/CCJAP/ICADC

As a Criminal Justice Addiction Professional in the State of Florida, I have had experience with multiple counties and their individual court systems.

Interestingly there are major differences between some of the counties courts I have worked regarding the way they handle and process substance abuse cases, including DUI’s. Here are some facts: Dade County started one of the first Drug Court diversion programs in the country, followed by Broward County in 1991. Most of the other counties all have some form of Drug Court presently.

Broward County is the only county I know of having a Misdemeanor Drug Court division run by a county court judge. Instead of 1 year of treatment required, it is only 6 months, and then the case will be dismissed upon successful completion.

The Broward Misdemeanor Judge has recently informed me that the court would also be accepting defendants who had other drug-related misdemeanor offenses such as Prostitution and Petit Theft. Palm Beach County is a bit more rigid in some respects than its counterparts in Broward or Dade. For example, if you are attending Drug Court in Palm Beach County, you must reside in Palm Beach County. In Broward, it is totally permissible for a client who lives in another county or even state to reside in their home residence and attend treatment in their resident county/state. In these cases, the treatment provider must still be approved by the Court and meet all requirements of Drug Court treatment providers. The client does not even have to be present at monthly status hearings so long as monthly reports are provided to the court. Also, In Palm Beach County, clients must call in to Pre-trial Supervision daily and if their “color” is called, they must provide a UA sample that day.

In Palm Beach Drug Court, there are 4 phases each client must complete. In Broward there are only 3. In both counties, treatment must be for the duration of at least one year and a maximum of 18 months. We had a recent case in Palm Beach County which was automatically filed into Drug Court. The client met the requirements of being a first time offender with no prior convictions. However, on our first Drug Court appearance, he was told by the court that he was disqualified from Drug Court due to the fact that he also had been charged with a DUI which was incidental to the drug charge. So in essence, a misdemeanor DUI disqualified an otherwise eligible and willing participant in Drug Court from getting treatment and the opportunity to have his case dismissed upon completion of Drug Court.

This would not have happened in Broward, as there the DUI count would have either been severed and sent to a misdemeanor court or a plea would be taken on the DUI, but in no case would a defendant have been disqualified from participating in Drug Court due to a concurrent DUI. It is my opinion that a DUI if anything is a strong indicator of probable substance abuse and especially when occurring incidental to a drug charge. When questioned about this policy, the Palm Beach Drug Court Administrator told me that they were working on getting a policy whereby Drug Offenders with a concurrent DUI would be eligible for Drug Court. Presently though, the DUI is considered an “aggravating factor” in Palm Beach County when concurrent with a Drug Possession charge, thereby disqualifying a person from the option of Drug Court. In contrast, the very same week I had another female client with no prior record at all who was charged with simple Drug Possession in Palm Beach County and the case was not filed directly to Drug Court. Instead it went to a regular felony division and now we will have to file a motion to have the case transferred to Drug Court.

Another example of Intra-county inconsistency involves DUI diversion programs.

Dade County was the first in South Florida to implement such a program where first-time DUI offenders could have their case diverted and eventually dismissed after 6 months and completion of all requirements (DUI classes, Victim Impact classes, payment of fines, etc). Palm Beach county has just recently started their own DUI diversion program whereby the case will not be dismissed like Dade, but it can be reduced to a Reckless Driving. Reckless Driving is also a Misdemeanor and the same points are carried as with a DUI. The fine is also the same as is all the counseling and educational requirements. Orange County (Orlando area) also has a 1st time DUI diversion program.

The only significant differences are the Drivers License Suspension which is mandatory in a DUI, but not for a Reckless. Also Probation is rarely given in a Reckless Driving, but often is for a DUI. Most importantly, a defendant may be granted a “Withhold of Adjudication” on a Reckless Driving, but never for a DUI. The reason for this is because Florida State Statutes provide that all DUI’s must be adjudicated. A “Withhold of Adjudication” is very important because in that case a client may be eligible to have their criminal record Sealed. Because ASI has a special unit for Sealing and Expungement of criminal records, we always stress the importance of getting that Withhold of Adjudication. A conviction of any crime (Misdemeanor or Felony) will exclude a client from getting any record Sealed or Expunged EVER. Broward County has yet to implement a diversion program for DUI’s and has strict minimum-mandatory sentences for two or more DUI’s. Two DUI’s within a 5 year period is a minimum-mandatory 10 days in jail. However, the courts in

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Broward have been consistently favorable in granting ASI’s clients the option of completing our court-approved treatment program in lieu of jail time or at least minimizing jail time. That is because the Judge has the discretion of considering residential treatment in lieu of jail time based on the individual circumstances surrounding each case. Likewise, we have also had a good success rate of having drug offender sentences converted or at least partially converted from jail time to our court-approved treatment programs. It is also important to have the consent of the State Attorney’s Office for any such alternative sentence.

The above are just examples of some of the differences in various counties court systems. In conclusion, it should be noted that most circuits and counties in Florida have their own unique systems and nuances in processing drug-related and DUI charges. It is important that the clients and their attorneys be familiar with these county-specific procedures. Each circuit/ county also has their own court administrators who will ensure that specific qualifications are adhered to. In order to more effectively serve our clients, ASI has hired attorneys from specific South Florida counties to handle our clients’ criminal charges and get the most favorable results for them. We review each client on a case-by-case basis taking into account all primary and external factors in their case.

In our experience, a criminal case can sometimes be the turning point for a substance addicted or abusing client. Our endeavor is to guide them through this process with the hopes that they will find recovery and not become recidivists in the criminal justice system. ASI is available for consultations and both in and out-of-custody evaluations by appointment only. We are also approved to conduct court-ordered evaluations. We work together with a large network of Treatment Providers throughout the Florida and the USA. Clients who suffer from a Mental Health Disorder in addition to Substance Abuse will be referred to one of our Dual Diagnosis facilities.

Myles B. Schlam is a nationally recognized expert in Drug Addiction and the Criminal Justice System and an Internationally Certified Alcohol and Drug Counselor (ICADC). He is one of approximately 100 Criminal Justice Addiction Professionals (CCJAP) in the State of Florida. Mr. Schlam is a graduate from St. Thomas University School of Law (Class of ’02) where he specialized in criminal law and interned with the Public Defender’s Office. ASI is licensed by the Florida Department of Children and Families and operates in throughout the State of Florida.

Don’t Let Anxiety and Fear Keep You from Getting Help Dealing with Anger Addiction

By Marty Brenner, C.C.D.C.

There’s probably no person living who has not at some time or another, experienced severe negative emotions. However, when these feelings of anger happen again and again, and seem to be beyond the individual’s control, they are in fact an addiction. And, when this addiction moves to rage, it is a condition that must be addressed for the good health of the individual and everyone around him.

Anger is not always negative; it can be channeled into positive achievements.

If a particular social condition arouses negative emotions in you, this can motivate you to take the steps necessary to do something about it. Rage, on the other hand, is purely negative, and has absolutely no positive aspects.

When it becomes a dependency recurring again and again, it can be destructive to relationships and to personal well-being.

Seeking help to control such an addiction; whether for you or for someone else, can be challenging. The stigma often associated with such requests, can cause fear and hesitation. Some of this comes from guilt; the feeling that the condition needing help is somehow the individual’s fault. It helps to understand the source of these feelings. Anger or rage often stems from unmet needs or situations over which the individual feels he or she has no control. The outburst of emotion will often give momentary satisfaction, but, in the long run will not solve the original problem. When the outbursts continue to happen, it can lead to even greater feelings of guilt, which can then lead to full-blown panic attacks, which represent a danger in themselves.

Overcoming the fear associated with getting help to deal with your problem is not easy, but it can be done. First, it must be understood that when the condition is extreme, it is hard to stop. Without professional external help, such conditions can become impossible to deal with. Feelings of guilt and shame can increase angst and make it difficult for people to seek help.

Continued on page 20

To Advertise, Call 561-910-1943

ANGER ADDICTION COUNSELING SERVICES

If you, a family member or someone you know is in trouble for Anger or Drug/Alcohol Abuse Call Marty

TALK TO

Marty

• Court Approved for Anger in Florida • Individualized sessions • Addiction Recovery and Life Coaching

213-500-8865 Marty Brenner, CCDC

Anger Management Specialist ll Certified Addiction Therapist C.A.T.ll Cer Con Conveniently Located in Del Ray Beach marty@talktomartyb.com www.martybrenner.com

“People can change” 19

Stop the Flow of Money!

By Allison Bottke

Spring garage sales are seasonal celebrations in my Midwest town. Along with cleaning out the clutter, the high point of these community events is visiting with old friends who stop by and meeting new folks—getting a taste of the amazing difference in humanity.

“Edna” was the perfect example. I didn’t have the baby clothes she was searching for, but after visiting with her for close to an hour, I wanted to rush out and buy some for her. (Apparently my enabling includes strangers as well as family members.)

During our chat, I found out that Edna worked three jobs, one full time and two part time. The job interview she’d had that day was for a third part-time job. As Edna talked, she collected items from my garage sale, placing them on the picnic table where I sat, and told me how much her daughter could use each item for her house.

“I sure hope I get the job,” she confided. “I need it to help my daughter pay for her car.

She bought a new SUV last year, and she can’t make the payments now.” She then told me her daughter was a stay-at-home mom with two children and a third on the way.

Now, I’m the first to admit I’m not a very shy person, and I probably overstep my boundaries from time to time (okay, often), but this is a matter near and dear to my heart. I had to know more about this situation. Why was Edna responsible for making her daughter’s car payment? How long had this been going on? I looked at Edna’s car, a late-model Ford in reasonably good condition from what I could see, yet far from new.

“How many hours a day do you work now?” I inquired.

She rattled off her schedule. “About fifteen hours on Mondays, Wednesdays, and Fridays. Tuesdays and Thursdays are short days at only ten hours each, and on weekends I only work five hours each day. That’s why I’m looking for another parttime job on weekends in the afternoons.”

My heart ached. This woman worked seven days a week! Why did her daughter need a new SUV that I was told cost almost $500 per month in bank payments—not counting gas, insurance, and maintenance? I thought back to my first car when my son had been a baby—a sturdy, used Dodge Polaris bought at a police auction.

Sure, the times had changed, but when did parents start feeling responsible for supplying their adult children with vehicles better than their own at the cost of their health? How long could a woman in what I presumed to be her late fifties be expected to keep this grueling schedule? And did her daughter even care?

Perhaps the saddest part of all is the lack of recognizing this enabling lifestyle for what it is: a crippler of both the adult child and the parent. But once we do finally own up to our negative behavior for what it is—and how damaging it’s become— we won’t be able to pick up where things left off. God willing, we will feel a deep conviction in our soul to make changes, to stop our enabling behavior.

One of the critical first things we must immediately stop is the flow of money to our adult child. We must stop being the First Bank of Mom and Dad or the Community Bank of Grandpa and Grandma. And that is particularly important in today’s economy, when funneling unlimited funds to our adult child could not only cause them harm but also force us into bankruptcy—or worse.

Don’t misunderstand. I’m not advising you to march up to your adult child and declare, “That’s it! The gravy train stops right now!” The flow of money must stop, but unless your adult child has broken the law and been told to leave your home immediately (as in the case of drugs or other criminal behavior), this severance of financial dependency must first be carefully considered and planned by you and your spouse and any other enablers in the immediate equation: grandparents, siblings, and other family members and well-meaning friends.

No matter how angry we may be, no matter how broken our heart, we must act in love. Our goal is to release and empower our adult child, not to bring them even more pain than this change in our behavior will most certainly cause. Therefore, stopping the flow of money is not the only thing that must be carefully planned.

Remember, although it is our prayer that our adult children become healthy, independent, and responsible members of society, just because we develop a plan and present it to them does not guarantee they will joyfully embrace the change or even recognize it for the opportunity that it is. What they do with their lives as a result of our implemented boundaries—financial or otherwise—will be their choice.

Our primary goal is not to stop their negative behavior, or to stop their drug or alcohol abuse, or to stop their lying, cheating, stealing, or the never-ending chain of excuses we’ve grown accustomed to hearing and they’ve grown accustomed to delivering.

We’d love for all those things to stop—but it’s up to them to change their lives, their behaviors, their habits. Our part is to stop our negative behaviors, gain SANITY in our own lives, and if we’re married, in our life as a couple. Stopping the flow of money to our adult child is often the most crucial—and the most difficult—step we will take in this process.

Whether we are on a fixed income or blessed with abundant financial resources, whether their request is for $20 or $20,000, we must stop coming to the rescue with

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our checkbook. Our money must cease being the life preserver that buoys up our adult children, keeping them afloat through yet another storm. We might be amazed at just how well our adult children can swim when given the opportunity to do so.

More important, they just might be surprised at their own ability to survive without our financial life support, a powerful lesson that no amount of money can purchase.

Developing an Action Plan Once you’ve come to the decision to cut off the flow of money to your adult child (and possibly set other boundaries as well), you must first develop an action plan.

Begin by making a detailed list of all your personal life goals and the ultimate destination you wish to reach in your lifetime. I’m not talking about what you would like your adult child to achieve. This is about you. This is your chance to dream on paper. Everyone must do this individually, and if married, you must also do this as a couple, making sure your ideas of a destination are compatible.

For example, if my goal in life is to raise cattle on a ranch in Wyoming and my husband’s goal is to make a killing on Wall Street and live in a plush condo on Central Park, then we have a bit of a problem, a failure to communicate, as it were. However, it is not unusual in a marriage where the focus has been too long on an adult child and not on the marriage, for a couple to get out of sync in their ultimate destination as husband and wife. That’s why it’s so vital that we begin to communicate openly, without reservation. We must understand that not only are we presenting our adult child with a new paradigm, but as a couple we are also entering a new stage in our marriage. Our roles as parents of an adult child are going to change, starting now. We may need to correspondingly adjust our goals as a single adult or as a married couple.

Remember the oft-quoted definition of insanity: Insanity is repeating the same behavior and expecting different results. Now is the time to stop repeating the behavior that has not produced the desired results. Now is the time to change course, to stop believing the lie that this is the last time you will financially bail them out. It’s time to stop destructive behaviors and patterns, and start charting a firm and focused course that will get you—and your spouse—to your ultimate destination.

If in the course of your new journey your adult child manages to find his way as well, this will be an answer to prayer. And although there is no guarantee that your new choices will be embraced by your adult child, you still need to make them….for your child’s sake and for your own piece of mind.

Stop the Flow of Money is an excerpt from Setting Boundaries with Your Adult Children, Six Steps to Hope and Healing.

Allison Bottke is an author, speaker, and entrepreneur. An innovative, risk-taking, faith-extending woman, Allison believes in being spiritually tenacious! - Visit www.allisonbottke.com or www.settingboundries.com

Don’t Let Anxiety and Fear Keep You from Getting Help Dealing with Anger Addiction

By Marty Brenner, C.C.D.C.

Continued from page 19

A certain amount of anxiety concerning the unknown is normal and to be expected, and dealing with dependence issues involves a huge unknown. But, if the affected person learns to like himself or herself, either independently or with help from those in close relationships, the first major hurdle has been crossed. Next, it helps to identify and take steps to satisfy unmet needs, often an initiator of outbursts.

Finally, while anxiety can cause rises in blood pressure, and are extremely uncomfortable, there is no record of it actually causing significant physical harm. The things we fear; disapproval or censure of others for instance, hurt our feelings, but do not harm others. When we reach that realization, some of the anxiety is relieved almost immediately; much like the child who is finally convinced that there isn¹t actually a bogey man hiding under the bed.

If you or a loved one is suffering from this problem, don’t let fear of the unknown keep you from getting help.

Marty Brenner specializes in Anger Management, Domestic Violence Counseling, Alcohol Addiction and Drug Addiction. He is a Certified Chemical Dependency Counselor and Anger Management Specialist II. He is court approved and offers individual sessions. If you , a family member or someone you know is in trouble for Anger or Drug/Alcohol Abuse , call Marty at 213-5008865 .For more information please go to the website www.talktomartyb.com or e-mail him directly : marty@talktomartyb.com

To Advertise, Call 561-910-1943

21

Face Down Alcoholism with Four Healthy Choices

By Barbara Altman

Alcoholism tears many families apart. You may be experiencing the same type of trauma I grew up with. It’s my wish to transcend pain to promise by extending hope to others. I’m addressing three issues in this article.

• I will tell a part of my family story • I will talk about unhealthy responses to family trauma • I will discuss healthy responses you can use to transcend the challenges of alcoholism in your family.

I was nine years old the first time I saw my father drunk. We had just had a joyous family gathering. As I ran into the kitchen I saw my father grasping two door jambs and trying to hold himself up. He was screaming at the top of his lungs. I stood frozen in place, thinking he was about to die right in front of me! My mother stood frozen to the floor, looking indescribably sad.

He was lunging forward, I was screaming, and she was crying. “Call the doctor! Call the hospital! He’s dying! He’s dying!” My mother told me he was celebrating because he had just found a job. So if he was celebrating, why was he dying? Why was she sad? And why was I so frightened?

I looked up at my mother, wanting her to pick me up and tell me everything would be fine. As I was to learn later on, for one whole year, she had not seen him drunk. He was working the night shift at the local police department as a dispatcher. He had just been hired as a milk driver at a local dairy and he stopped off at a tavern to celebrate. This is what my mother told me. He was to celebrate thousands of times over the next eighteen years. I had to ride in the car with him when he was drunk at least five times a week.

That night I felt so alone. Why didn’t mother pick me up and hold me as I cried? Why didn’t she comfort me with her touch? Why was she ignoring me? It would take years to realize that she was protecting me when she pushed me behind her. And absorption in her own disappointment kept her from noticing me in a comforting way.

Alcoholism can have catastrophic effects on the whole family including economic reprisals, emotional effects on children, and health devastation for every family member.

The financial impact can pervade entire families. Adult alcoholics can experience compromised ability to get work that supplies their family’s basic needs. Their alcoholism may impede job performance and the ability to work well with others. In addition, they may lack the self-esteem and job skills needed to sustain employment.

Many times the effect becomes generational, even with children who do not become addicted. According to Claudia Black, children and spouses of alcoholics can experience depression, particularly when abuse is also present. Depression often manifests in an inability to relate well to others, slowed thinking, and chronic unresolved anger. All three seriously compromise life development, job performance, and relationships. So the economic, relational, and life skills implications can be enormous.

I have become an advocate for the development of healthy responses to life stresses. Three generations of Altman men were affected by alcoholism. There may have been more involvement in previous generations. I wouldn’t be at all surprised if that were true. My grandfather was put out of his home at the age of thirteen. He was an illegitimate child born to a woman who later married and had four more children from that marriage. They were horribly poor. His mother informed him that he could no longer live there because they did not have enough money or food to provide for the others. How that must have crushed that poor child! At age eighteen he lay on some railroad tracks and prayed for a train to come along.

eleven years apart. He was out of the house by the time I was nine years old. Two years later, he and his wife and child lived with us briefly. It was one of the most difficult six months of my life. Now I had to deal with two alcoholics. Both he and my father raged at the whole family routinely.

Time marched on and the dysfunction grew exponentially. When I was fourteen I began to binge eat on sugar. By the age of fifteen, I became psychotic, meaning that I was hearing voices and seeing things that were not there. Looking back, I find it interesting that we all started into our unhealthy habits in our teens.

The pattern I see is one of pain begetting more pain, followed by more pain, and followed by near destruction of our lives.

So the question is: How can this be reversed in alcoholic homes? I have several ideas about this.

• Face the problem head on. Give it a name. Refuse to hide it. Go out of your way to talk about the problem in appropriate situations outside the family. Children of alcoholics are often advised to keep it a secret. As long as the alcoholic is drinking, remaining quiet about it enables that family member to continue to drink.

• Seek counseling: AA has programs set up to help teenagers of alcoholics, spouses, and friends. Celebrate Recovery is a remarkable twelve step program that helps family members and alcoholics recover.

• Focus on family strengths. We tend to become what we think about.

Putting an emphasis on family talents gives a positive spin to the situation. As we focus on family gifts, those same gifts can manifest in us. Just remember to avoid denying the problem in the process of doing this.

• Learn to adopt healthy behaviors in response to the stress and trauma of living with an alcoholic.

I am passionate about this. I became psychotic because I developed an unhealthy behavior. My brother and my father adopted the same alcoholic tendencies my grandfather had. This cycle can and should be reversed.

So how can you capitalize on your strengths and begin to heal the trauma?

Dr. Martin Seligman has a wonderful program called positive psychology.

I would suggest considering tapping into his website http://www. authentichappiness.sas.upenn.edu/default.aspx and taking the strengths test. When we live in our talents, healing becomes much more within scope. Find your passion. What makes you want to get up in the morning?

What gives you pleasure? What motivates you? Learn to live in your motivation and interests, and help your family to do the same. I have a therapist who has seen clients abandon their drug and alcohol habits because they have found their empowerment in their strengths. They no longer needed addictive substances to mask the pain.

You can find the passion in your life by living in your gifts. The power of the positive is quantitatively much stronger than the power of pain.

Is your gift music? Perhaps developing that part of your life would help.

Is your gift an appreciation of beauty? Getting involved in an art class might be productive. My brother devoted a good part of his life to his painting. He had an extraordinary gift for artwork. His earliest works were absolutely catastrophic. But he learned to develop it. I have an amazing picture of his in my music studio.

Are you a catalytic leader? Catalytic leaders have the ability to bring two opposing sides together and have them shaking hands and finding common ground.

Fortunately, one did not appear on the scene. When he was in his thirties, he left Austria and came to the United States. He met and married my grandmother who had also emigrated from Austria. Alcoholism had its hold on him by then. He started drinking in his teens, shortly after he was put out of his home. Typical of many alcoholics, he turned to violence. My father and his siblings were often forced to kneel on raw corn when they disobeyed their parents.

Do you have the gift of giving? That is one of the twenty six gifts listed in Dr. Seligman’s work. Volunteering may work wonders in your life.

When my father was sixteen he witnessed my grandfather trying to rape and strangle my grandmother. My father started drinking right after that.

Pain begat more pain and the next generation was impacted with all that negativity. He brought the same dysfunction to our family that he endured in his. Would the cycle never stop?

Barbara Altman is the author of “Recovering from Depression, Anxiety, and Psychosis: My Journey through Mental Illness” originally published in 2011 under the title “Cry Depression”. This is available on Amazon.

If you decide to order a book on amazon, send your receipt to AltmanB@ sbcglobal.net and I will send you free of charge my ten steps to managing stress and my ten steps to great sleep.

At age sixteen my brother began to drink heavily. He and I were born

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Finally, look at your family strengths and try to encourage family members to find common ground.

This is a challenging pursuit. But it’s so much healthier to live in promise than to live in pain. I wish the best for all of you.

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23

From Surviving to Transformation: Hope, Addiction, Loss, and Trauma (H.A.L.T.)

By Rivka Edery, L.M.S.W.

The consequences of surviving trauma are complex, making it difficult to formulate a recovery and treatment plan. The most common defense mechanism, and the toughest one to work through, is denial. Throughout human history, lack of knowledge and nonacceptance of the perpetrators misdeeds has placed the suffering of survivors behind an armored wall, perpetuating traumatic effects. No recovery can occur behind this wall of forced silence, ignorance and lack of helpful resources. Over the last two decades, research has revealed the frequency of traumatic events, and their injurious effects on a survivor’s psyche. Mental health professional have come to understand the connections between unresolved trauma and serious psychological problems.

The survivor’s decision to begin a process of healing begins with the admission of what happened to them. This involves working through the defenses employed to shun from consciousness the excruciatingly painful memories of the traumatic events. Having passed through this phase of remembering (in any way possible), the acceptance of the truth of the traumatic experience moves the survivor towards resolution. Thus begins the creation of an internal, healing space for the survivor to feel what remained frozen in time, banished and unwelcome in consciousness. By going through the felt experience, the survivor can let go and access healing. The way is open to be in charge and responsible, embracing difficulties as well as personal assets and gifts.

Over the course of each survivor’s life, there will be people who will criticize any efforts to acknowledge and heal from traumatic experiences. Such nay-sayers accuse survivors of using their histories to live in the past, or to make excuses for personal problems. This criticism comes from those who have limited empathy, or may be in denial about their own mistreatment. Qualified trauma specialists know that the stress from repression manifests itself in serious life difficulties. The perpetrators themselves will often intimidate their victims in an attempt to enforce silence.

Although the absolute recall of traumatic events is not possible, the overwhelming consequences and burden on the untreated survivor deserves attention.

The role of spirituality in trauma recovery is often misunderstood and subsequently minimized. There is a great need for understanding the healing potential of spirituality in addiction and trauma recovery. Utilizing spirituality as part of trauma –informed care, while detailing the complicated puzzle of the survivor’s inner reality, requires a step-by-step process of applying spiritual tools to each phase of recovery. This process significantly alters a life of pain and confusion. In order to engage in a truly effective treatment process, including utilizing spiritual tools to help surmount the challenges a survivor has to face in order to heal, the survivor has to be prepared to go down this road.

Trauma survivors usually have a difficult time experiencing their vulnerability and the attending feelings of having once been profoundly helpless and alone. The process of unearthing one’s memories and re-experiencing anguish requires the help of skilled, knowledgeable and spiritually grounded professionals who have done healing work on themselves. With issues as delicate and sensitive as deep emotional wounding, each survivor and counselor must approach the recovery path with patience, self-love, selfcare and the development of an appropriate support network.

The Twelve Steps of Alcoholics Anonymous comprise a spiritual program used to treat alcoholics and other individuals with a range of self-destructive and addictive tendencies. The potential for transformation in trauma-recovery lies in the powerful spiritual process that has its own mysterious element to it. Due to the nature of the wound of trauma that is so often intertwined with addiction - a comprehensive approach to healing the physical, mental and spiritual wounding is essential. It is my hope that survivors will consider incorporating a rich spiritual component to their recovery, and encourage others to do the same.

The Twelve Steps of Alcoholics Anonymous have helped countless addicts. This healing process is based upon spiritual principles that speak to the human spirit.

The Twelve Steps can help you with any issues that cause emotional suffering. You can apply them to specific emotional problems, confusion, unresolved pain, areas that you seek growth and happiness.

Consider each of the Twelve Steps as a Power Tool you carry around in your toolbox, for use at any time. Steps One through Three are the “Surrender Steps”, Steps Four through Nine will heal your memories, and amazingly, they will “clear away the wreckage of the past”. You will also realize that due to the effects of trauma, you have misunderstood a lot about yourself, other people and the God of your understanding. As you earnestly apply these Steps to your life, you will get to the truth about yourself, other people, and the God of your understanding. All three can be distorted due to impact from trauma.

The great truth about any living organism is that it is either growing or dying; there is no maintenance. This is completely true of our spiritual condition: you are always either moving towards growth, or towards regression. Eventually, if you are open and honest with yourself, and vigorously apply these spiritual principles in your life, spiritual laws will begin to replace everything you have learned. A life based upon these principles will become your habit for living. If you are like most well-defended people, you may

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be resistant and closed-minded to any of these ideas. For you I say your ego needs to face its limitations before it can assist you in your growth. In addition, The All Powerful Creator will not do for you what you are supposed to do for yourself. Recovery via application of spiritual principles and concepts can be somewhat of a mystery, and there is no ‘spiritual silver bullet’. The best way to start this process is to surrender to the mystery, and not try to solve it. You do not know if this program will work for you until you try it - thoroughly, honestly, and consistently.

You may find that by exploring the Twelve Steps, in the context of your traumatic history it stirs up the pot of emotions inside you. This may be a new experience in your life, which happens when you seek “conscious contact” through a spiritually sound and disciplined practice. Try to follow through with the process, and let your thoughts and feelings be as they are. If you are in the habit of fleeing from yourself, try a new way of responding and simply be with those feelings. If it touches you in some way, and you are tempted to flee from yourself, know it is the Great Reality that Lives inside You that is nudging you toward the pain of healing. You will learn how to remove the blockages that prevent you from loving yourself and other people. This self-love is necessary to the process of trauma recovery. If you operate out of a False Self, that False Self will collapse by working these Twelve Steps. It is natural to be afraid of the truth, and the fact-finding process of reaching for the truth. You will discover the joy of the truth setting you free to experiencing love and service.

The great paradox that lies in this process is that out of trauma, loss and addiction, is the rising phoenix of Hope. She emerges as a symbol of transformation, and signals to the trauma survivor towards the Great Spirit of Healing and Compassion. It is there for each and every one of you.

Rivka Edery, L.M.S.W. is a resident of Brooklyn, NY. She has a Bachelor’s of Arts in Social Science and a Masters in Social Work from Fordham University Graduate School of Social Service. Applying the ancient spiritual principals of the Twelve Steps of Alcoholics Anonymous saved her life, and continues to guide her in every area. It is for this reason that she wrote the book: “Trauma and Transformation: A Twelve Step Guide”, using these time-tested principles directed towards trauma survivors, available at Amazon. To contact Ms. Edery for speaking or consulting, please call (646) 691-7771 or e-mail info@rivkaedery.com. www.rivkaedery.com

Our Addictive Society Part II: The Neo-Opium Wars

By John Giordano DHL, MAC

Continued from page 10

or the people who died because of it. Oxycodone was the leading cause of drug overdoses and drug related deaths in Florida for many years – contributing to more than 1,500 deaths in 2010 alone. More Americans die every year from prescription drugs than from motor vehicle accidents, or heroin and cocaine combined. 37,485 Americans died from prescription drugs in 2009 alone! It sure looks a lot like China in the 1700 and 1800s to me. People dying horrible deaths while opium trader’s profit.

I’m not suggesting that all pharmaceutical companies operate this way.

However business is business. Four times a year at the end of each the quarter, the Wall Street executives and stockholders rarely ask companies how they made their money; just how big are the dividend checks. Pharmaceutical companies are subject to the same scrutiny.

I do often wonder what guides the pharmaceutical CEO’s decisions. I also wonder if lawmakers and regulators look in the same direction as the Chinese emperor for the sake of the economy and treasury – the other way.

Hopefully this article has opened your eyes to some of the things taking place in the backrooms that influence your health. I would suggest to you that you take control of your health and look into holistic remedies first. I’ve been involved in holistic nearly my entire life. We’ve used a comprehensive evidenced-based holistic approach at my center from its inception – and I can tell you first hand holistic works.

John Giordano DHL, MAC is a counselor, President and Co-Founder of G & G Holistic Addiction Treatment Center in North Miami Beach and Chaplain of the North Miami Police Department. If you have any questions, please do not hesitate to call me directly at 305-945-8384.

Also for the latest development in cutting-edge treatment check out my website: www.holisticaddictioninfo.com

To Advertise, Call 561-910-1943

25

TWO’S COMPANY, THREE’S A CROWD

By Mary Detweiler

Every person reading this has some understanding of the destruction wreaked on a marital or significant relationship when one of the partners engages in an extramarital or extra-relationship affair with another person. Every person reading this also understands that the damage is caused by the breaking of the cardinal rule for marital and significant relationships. That cardinal rule, of course, is two’s company, three’s a crowd.

Did you also know that similar damage is wreaked on a marital or significant relationship when one of the partners engages in an active addiction? How, you might ask? Well, an addiction is a relationship. When someone is addicted to a substance and/or a behavior, that person is in a relationship with their substance or behavior of choice, the same as if they were involved with a person. Further, the relationship with the object of their addiction is the most important relationship in his/her life. He or she will do anything to protect that relationship and keep it alive, i.e. deny it, lie about it, cover it up, minimize it, blame others, etc.

In my article last month, An Addiction is an Addiction is an Addiction, I made the point that it is possible to become addicted to a behavior the same way it is possible to become addicted to a substance. Some common behaviors people become addicted to are: overworking; overeating or controlling of eating (anorexia or bulimia); spending; shopping; gambling; engaging in pornography; promiscuity; caretaking; people pleasing/approval seeking; controlling other people and situations. I made the further point that individuals who are addicted to a behavior or behaviors are not any better or any different than individuals who are addicted to substances. They are simply programmed differently.

When two people who are dating decide to get serious about their relationship they spend much time together. This time is needed to get to know each other and build a solid foundation for the relationship. During this phase of relationship building the upholding of the two’s company, three’s a crowd rule is critical. It’s also not usually an issue because the new relationship is the most important relationship in each of their lives. Once the relationship is established and the foundation is laid, regular couples’ time is still important, even if they have been together for decades to nurture the relationship and keep it vibrant and alive. The same rule of thumb (two’s company, three’s a crowd) continues to be critical to uphold for quality couples’ time.

When a person with an addiction enters into a significant relationship, he or she is not entering into that relationship alone. Rather, he or she is bringing an already established important relationship into the new relationship. When someone who is in an already established significant relationship develops an addiction, he or she involves a third party in the relationship. In both of these scenarios the guiding principal of two’s company, three’s a crowd is impossible to uphold.

No relationship is 100% healthy or 100% unhealthy. Every relationship has healthy characteristics and unhealthy characteristics. It is a continuum and every relationship is somewhere on the continuum between healthy and unhealthy.

For our purposes we will call relationships healthy if they have more healthy characteristics than unhealthy ones, and vice versa for unhealthy relationships.

A relationship in which one or both individuals are engaged in an active addiction will be considered an unhealthy relationship. Having an addiction present in a relationship is having a toxin present in that relationship. Health is impossible.

We will consider a healthy relationship to be one in which the couple’s decision to commit to each other is based on a choice to stand by each other and love each other no matter what. It is not based on a feeling. It is based on a decision. Love, in this context, is not a feeling, it is an action. It is beyond our flawed human capacity to always feel loving toward our partner however, it is not beyond our human capacity to act loving, even when we don’t feel loving. It takes an act of will and a conscious decision not to be ruled by our emotions.

This is difficult but not impossible. Therefore, if a marriage or significant relationship is to be successful and healthy, it must be based on a decision and it must be characterized by loving behavior.

Addictions wreak havoc with our decision-making capacity. Inherent in the definition and understanding of addiction is that it is compulsive. Individuals with an addiction are no longer in control of their substance use or behavior.

The substance use or behavior is controlling them.

Most of the behaviors which individuals become addicted to are normal, needed, natural behaviors. Once they become addictions, however, the behaviors are no longer being engaged in for the purpose they were intended.

They are being engaged in excessively and compulsively for an entirely different purpose. For example, one is not working to earn a living, one is overworking to avoid feeling feelings or one does not eat to live, one lives to eat because the eating keeps emotional pain at bay. There comes a point where one crosses a line from engaging in a normal behavior to engaging in an

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exaggeration of a normal behavior which then becomes a rigid self-defeating pattern .One crosses the line when one moves from choice to powerlessness.

A healthy relationship is also based on equality. In order for equality to be present in a relationship, each individual needs to be a whole person. He or she does not need the other to complete him or her. Frequently an incomplete person looks to a partner to complete them. Rather than taking responsibility for their own growth and development as a person, they look to their partner to fill in their blanks. For example, if someone has difficulty taking care of self, they may enter into a relationship with a compulsive caretaker and thereby avoid needing to develop this aspect of their personality. The catch though is that he/she then needs their partner to remain a caretaker. Any effort the partner may make to overcome this compulsive behavior will be discouraged if not outright sabotaged by the other person. This is not loving behavior.

A whole person is one who is independent emotionally, socially and intellectually.

Emotional independence involves taking responsibility for one’s feelings. Though another person’s words or behaviors may trigger feelings of anger or sadness in us, we get angry or sad because of what is inside us. It’s like rubbing salt into an open wound. The wound is ours. The salt is the other person’s words or actions. The salt would not hurt us if we did not have that particular wound. So, an emotionally independent individual takes responsibility for his/her pain and does not blame the hurt feelings on another person’s words or actions.

Social independence involves taking responsibility for developing and maintaining friendships separate from our significant other. This alleviates putting too much weight on our partner or significant relationship to fill all our needs for friendship and recreation. It is damaging to a relationship to carry this much weight.

Intellectual independence means that we take responsibility for keeping our minds active and alert. We seek out new information in order to keep learning.

We think for ourselves and form our own opinions. This goes a long way in keeping the relationship vibrant. Relationships in which both partners are intellectually independent are not characterized by power struggles. Both individuals have accepted the reality that they do not have to think or feel the same way about all things. They have learned to agree to disagree.

Addictions rob us of our capacity to be independent emotionally, socially and intellectually because addictions, by definition, involve dependence. To be addicted to a substance or behavior is to be dependent on that substance or behavior. The addictive process begins with a desire to medicate or numb emotional pain. Once we find the substance or behavior that works to alleviate our pain we begin to use that substance or engage in that behavior with increasing frequency, increasing duration, increasing intensity, and increasing variety. These increases are necessary because we quickly develop tolerance.

That is, we become accustomed to our substance or behavior of choice and need more of it to get the effect we want. As the addictive process progresses, the dependence grows and the capacity for emotional, social and intellectual independence diminishes.

Finally, a marital or significant relationship by definition involves intimacy. Important point: intimacy does not equal sex. Sex is one aspect of intimacy, however, it is not the only or the most important aspect .The type of intimacy being discussed here is emotional intimacy. Emotional intimacy may lead to sexual intimacy; however, emotional intimacy is a worthy and satisfying goal in and of itself.

Honesty about who you are and how you are feeling at any given time is a nonnegotiable ingredient of emotional intimacy. It goes without saying that if emotional intimacy is to develop and flourish in a relationship, each partner must be willing to fully and consistently share on a feeling level. Therefore, emotional intimacy always involves reciprocation and openness between two willing and committed partners. If one or both partners are dependent on substances and/or behaviors to medicate emotional pain then feelings are deadened and emotional sharing is virtually impossible. Intimacy either is never established or, if it has been established, it vanishes.

As long as an active addiction or addictions are present in a relationship, the relationship will deteriorate. This process will likely continue until the consequences of the addiction hurt more than the fear of confronting it. When the pain of the addiction finally outweighs the fear, one or both partners are ready for recovery and then hope is finally possible.

Mary Detweiler is a Licensed Clinical Social Worker and an Adult Child of an Alcoholic who worked as a mental health professional for 27 years. She is currently leading a Celebrate Recovery ministry in Manheim, PA and is the author of When Therapy Isn’t Enough and When Religion Isn’t Enough. Her blog/website is www. isntenough.wordpress.com..

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The Crossroads Club… A Tributue to Dana

THE CROSSROADS STORY

Founded in 1982, Crossroads is a Twelve Step facility for those who earnestly desire to maintain total abstinence from alcohol and drugs. We are a refuge for fellowship, camaraderie and more importantly, provide a place to enhance both spirituality and inner strength to cope with addiction.

ALWAYS HERE FOR YOU We are open 365 days of the year. We have over 145 meetings each week. More than 45 are 12 Step Groups that hold their recovery meetings here. Every day we have over 800 attendees pass through our doors and each week there could be as many as 5,600.

PAYING IT FORWARD Crossroads provides a “Living Skills” program for the recovering individual. These classes and seminars teach individuals skills that can help them to lead a productive life and prevent relapse.

GIVING BACK “Living Skills in the Schools” carries the message of the deadly dangers of drugs and alcohol directly to the classroom. Young people who are in recovery, “tell their story”. The myth, the lie, the tragedy of drug and alcohol use is presented through real life journeys. The education, the message, the way to prevention and recovery, the hope, is all explained by those who have been there and back. This is the best of what Crossroads provides. This program saves precious lives.

THE “GOD THING” My name is Chris... Since the beginning of my recovery, I keep having strange “God Things” happen to me. In my addiction, I asked God for all kinds of “things”, important things (I thought). Usually I didn’t get any of the “things”. I was sure my request for these things got lost; otherwise, He would have been all over it and taken immediate action. But, now that I am so busy in my recovery with meetings, prayer and giving back, I haven’t had the time to make up my list of “things”. But now, the weird thing is, I have been experiencing unexpected –serenity. Miraculous, enlightening, calming, so much better than the “things” I previously asked for. And, I didn’t even give him a list!

Another miracle is I met Dana, Crossroads’ Office Manager. She just appeared in my life and hired me. Who would have guessed? My life has changed dramatically since then. Yep, you guessed it; this was a “God Thing”. She is in recovery, she lives her truth, and she is in demand by all for the example she sets. I hope you get to meet her because she has more hands to help with, more ears to listen, more laughter to heal, more serenity to work toward, more thoughts you’ve never considered, more heart than you can bear, more bizarre behavior you won’t believe, than anyone else I know! She is Dana. She has given everything she has to everyone who comes her way. She gets it. Dana has just celebrated her Sober Anniversary, and I wanted to pay a tribute to her sobriety.

A TRIBUTE TO DANA’S LIFE IN RECOVERY Step I…When it comes to alcohol, Dana would call herself a “powerless nut job”. Admitting unmanageability, she daily cries out “I can’t take this anymore! I am going home and throwing the covers over my head! But every day, Dana picks up the phone to hear “Please, I don’t want my son to die. Can you help me?” Protectively, she answers, “I’m so glad you called Hun.” Then, I watch and listen as Dana saves a life.

Step 2…Every day, our crazy office reaches an insane crescendo. I think the day the world ends will be much like this. To restore her sanity, Dana leaps into action, turning to her Higher Power which is greater than herself…new shoes. Buying a new pair of shoes prevents her from killing all living things in her path.

Step 3…Dana is a strong willed, in control; get it done kind of gal. Love that. But when she is overwhelmed by what she cannot control, she turns all of it over to God. Then she does the next right thing….gets out of her own way.

Now, the matter in God’s Hands is that every day for years, Dana has visited her sick and dying friend. She fed and bathed her, put on silly hats, danced for her and talked to her about God. Felice Priest Ledbetter died this month, August 3. Her angel Dana created a beautiful journey for Felice, walking with her right into God’s Hands. Dana is a model for letting go and letting God do what he does best. Then she does what she does best….gives of herself to others.

Step 4…Made a “fearless” moral inventory of ourselves. Yep. Dana does.

It goes like this, “Oh My God. I can’t believe I just did that…Oh well…

He’ll just have to get over it.” But then as part of her recovery she revisits her thoughts and actions of the day. Later, she will often say, “You know I was thinking about this last night and I don’t think I did the right thing. I should have been more patient or kind or offered to do more.” I know her inventory is fearless and I know she starts each new day with the respect and love of another in her heart.

Steps 5-6-7…When Dana admitted the exact nature of her wrongs…. she was done…over…it was enough. She asked God to remove them, knowing if He did not, she would die. And so, every day, she humbly

affirms to the world, “I am one sick puppy, but God loves me, and I love me, and I love you and I love my shoes.”

Then someone comes to the office, crying and shameful. “Dana, what can I do to end the pain? No one will ever forgive me.” Immediately, her warmth fills the room, her arms reach out, and she says, “It’s OK Hun. It’s really OK. I have been there before and I will help you. Have you had something to eat? Sit down here Hun. Everything is going to be OK.” She gives all of herself and opens up with the exact nature of her wrongs. “It will be OK Hun. God is here with you. We’re all here for you.” I watch a suffering soul breathe in Dana, calm and encouraging, always invoking God’s name. Eyes will dry, a deep breath is taken and Dana will walk this hopeful soul down the hall to the next meeting, making introductions and giving a big hug.

Steps 8-9…For a list of persons Dana has harmed, there is a special excel spreadsheet. To these persons, she will make amends. But I also want you to know there is “another list”. These are the people that have tested her kindness, ignored her value, never said thank you and have in general just pissed her off. She calls these people “Really?...Really?

Those people will also hear from her, and they can expect bodily harm.

I know that it is imminent, when they appear at the office door. Here it comes! “Hi Hun! Where have you been? I was just thinking about you?

Everything going well?” Rageful thoughts yes, but never an unkind word.

Later she informs me, “Listen, I understand where she was coming from….I should have been more understanding”. I never expect anything less from Dana.

Steps 10-11-12…Continue to take personal inventory, promptly admit when wrong, pray to improve conscious contact with God or shoes, practice these principles in all affairs…..This is how I watch Dana live life, with prayer, deep into her recovery, close to her God, compassionate to all, looking to do the next right thing. She is truly joyous, happy and free.

It is a “God Thing” that we met. I am so grateful that each day, I have front row seats to watch this woman I so admire live in her truth and with her God. Dana is the spoon full of sugar that makes the medicine go down.

Her recovery rocks!

HAPPY ANNIVERSARY DANA The Crossroads Club 1700 Lake Ida Road, Delray Beach, Florida 33445 • 561.278.2428 www.thecrossroadsclub.com A nonprofit Corporation • 501 C-3 Federal ID 59-2224993

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Substance Use, Anxiety, & Fear: Causes & Correlations in an Age of Adolescent Anxiety

By Daniel P. Villiers, Ph.D

search is somewhat inconclusive. There is evidence to support that marijuana dependence is the most common among individuals with an anxiety disorder who are 13 to 20 years old, with comorbidity rates ranging from 35% to 67%. Studies have generally found that alcohol abuse is the second most prevalent (rates from 18%-45%, followed by benzodiazepine abuse (rates from 10-24%). Cocaine, opiates, hallucinogens, and other prescription medication abuse had rates from 3% to 6%, with some proposing that anxiety and fear among teens serves a protecting factor against the use of harder drugs Future Directions My life as a teenager was circumscribed by anxiety; the decisions it made for me and the chronic avoidance I used to cope. My teenage experience with severe anxiety, and ultimate recovery, inspired my personal and professional commitment to helping teenagers suffering from anxiety disorders. In 2011, with the support of the Becket Family of Services, I founded the Mountain Valley Treatment Center, a not-for-profit short term residential program exclusive to the treatment of adolescent anxiety. While many cases of anxiety can be treated in outpatient settings, residential treatment is the logical next step when anxiety starts to interfere with a child’s academic functioning and school attendance. Mountain Valley sought to fill the void in highly specialized treatment options for teenage anxiety disorders, where residents could benefit from being around other kids with the same or similar challenges. The power of this shared experience couples with 2-3 months of intensive exposure therapy, and other evidence-based treatments for anxiety disorders, treatment has proved highly effective.

The success of Mountain Valley’s specialization inspired Jay Wolter, president of the Becket Family of Services, and Dr. Francis Moriarty, clinical director of the Mountain Valley Treatment Center (www. mountainvalleytreatment.org) to open the Penikese program. Located on a small island off the coast of Martha’s Vineyard, Penikese serves adolescent males suffering with both “internalizing” mental health conditions (i.e., disorders of anxiety and depression) and mild substance use disorders. Cofounder, Dr. Moriarty states:

I Didn’t Know Adolescent Drug Use, Misuse and Addiction

By Nina Kramer

Continued from page 14

interventions, parent interviews, staff reviews or other crises of the moment. I seized the opportunity to ask what might be the singularly most important thing for a parent or teen to know when they leave treatment. I asked Glenn, “What is the most valuable skill that a teen will acquire when they have completed treatment”?

Glenn paused for quite some time before answering this question. I could see the years of slogans flying though his mind, ‘let go and let God,’ ‘people, places and things,’ ‘coping skills,’ ‘relapse prevention,’ and ‘go to meetings.’ I had often heard these sayings and ideas myself around the treatment center. He began to speak about one of them, and then shook his head, no.

“When a teen leaves treatment,” he looked up and said with his hands folded in a prayer like position, “they will know without a doubt the necessity of actively practicing recovery as a lifelong process.”

I have no doubt as I watch the teens walk out the doors that they understand this, and many other valuable things about substance use, misuse and most importantly addiction. The thing that I have learned from watching them, their families, and all those who love them is that maybe, just maybe, if Susan B. had said something besides I didn’t know, her son might be alive today. My favorite moment is when a teenager leaves Inspirations. I watch them hug their parents. I watch them both cry. Finally, I hear a relieved mom and dad say, “Thank you for giving me my son back.”

Nina Kramer is an English Teacher at Inspirations for Youth and Families. She is pursuing her Master’s Degree in Social Work at Florida Atlantic University.

Inspirations for Youth and Families employ solutions based on 12 Step methods of recovery for the treatment of teens. For more information, please go to www. inspirationsyouth.com/sw

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Continued from page 6

One common assumption about a substance use disorders is that one must hit “rock bottom” in order to be ready for treatment. At Penikese we believe quite the opposite. Our goal is to catch a young person at the earliest possible recognition of use and abuse and to simultaneously treat the underlying internalizing mental health condition.

Over the last few years, I have discovered an abundance of kids who, due to AFA with or without depression, have kept under the radar. While these kids are often very bright and well-behaved, they are just, if not more, vulnerable to going from a place where substance use was their ‘selfmedication discovery,’ to that slippery road of a life of dependency and addiction.

As the research illustrates, adolescents with an anxiety disorders are some of the most vulnerable to substance use. The addition of substance abuse makes the viscous cycle of AFA only harder to break. While the developmental relationship of anxiety and substance abuse is of great importance to guide treatment, it is important for parents to know that there is hope for their child. It is my hope that with a greater awareness of the common relationship between anxiety disorders and substance use, we can help understand and inspire victims of addiction to start their journey to recovery.

Dr. Dan Villiers is the founder and director of admissions of the Mountain Valley Treatment Center, the first non-hospital residential program for the treatment of adolescent anxiety in the United States. Dan is a graduate of Kenyon College, received Master’s Degrees from Kent State University and Dartmouth College, and a Combined Ph.D. in Counseling and School Psychology from Northeastern University. Dr. Villiers has published several peer-reviewed articles, presented at conferences across the country, and has appeared on radio and TV in the area of child & adolescent anxiety and related disorders. For further information and support, please contact Dr. Dan Villiers at dvilliers@mountainvalleytreatment.org

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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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