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COPING WITH PANIC By Jessica Herz, LMHC
SMART RECOVERY® MOVES MASSIVELY ONLINE AMID COVID-19 By Joe Gerstein, MD, FACP
SPIRITUAL CONFUSION: A ROADBLOCK TO RECOVERY By Dr. K.J. Foster, LMHC, CAP
COMPULSIVE BEHAVIORSDEPRESSION AND ADDICTION THE ADDICTIVE StephenROLLERCOASTER M. Lange, Ph.D.
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
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A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. The Sober World is an informative award winning global magazine that’s designed to help parents and families who have loved ones struggling with addiction. We are a FREE online e-magazine reaching people globally in their search for information about Drug and Alcohol Abuse. Our monthly magazine is available for free on our website at www.thesoberworld.com or you can have it come to your inbox each month by signing up on our website. Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. It is being described as “the biggest manmade epidemic” in the United States. More people are dying from drug overdoses than from any other cause of injury death, including traffic accidents, falls or guns. Many Petty thefts are drug related, as the addicts need for drugs causes them to take desperate measures in order to have the ability to buy their drugs. The availability of prescription narcotics is overwhelming; as parents our hands are tied. Purdue Pharma, the company that manufactures Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it? Addiction is a disease but there is a terrible stigma attached to it. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, getting thrown out of school or even worse an overdose, that we realize the true extent of their addiction. If you are experiencing any of the above, this may be your opportunity to save your child or loved one’s life. They are more apt to listen to you now than they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin. I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from. There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are Interventionists who will hold an intervention and try to convince your loved one that they need help. There are detox centers that provide medical supervision to help them through the withdrawal process, There are Transport Services that will scoop up your resistant loved one (under the age of 18 yrs. old) and bring them to the facility you have chosen. There are long term Residential Programs (sometimes a year and longer) as well as short term programs (30-90 days), there are Therapeutic Boarding Schools, Wilderness programs, Extended Living
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and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean. Many times a Criminal Attorney will try to work out a deal with the court to allow your child or loved one to seek treatment as an alternative to jail. I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents. Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help. Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. We are on Face Book at www.facebook.com/TheSoberWorld/ or Twitter at www.twitter.com/thesoberworld, and LinkedIn at www.linkedin.com/in/patricia-rosen-95521051/ or www.linkedin.com/groups/6694001/ Sincerely,
Patricia
Publisher Patricia@TheSoberWorld.com
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SMART RECOVERY® MOVES MASSIVELY ONLINE AMID COVID-19 By Joe Gerstein, MD, FACP
Like the minor wave that precedes the tsunami, the first call came in early March from Roger Weiss, Professor of Psychiatry at Harvard Medical School and Chief of Addictions at McLean Hospital in suburban Boston. He broke the news to me gently: all 6 weekly SMART Recovery meetings at McLean Hospital had to cease and desist because all visitors to the campus who were neither staff nor patients/clients would now be barred from entry. I realized SMART Recovery would need to move massively online amid COVID-19 As volunteer advisor to SMART Recovery/Massachusetts, I am often the point of contact within the organization. I immediately contacted the facilitators of the four SMART Recovery meetings, the SMART Family and Friends meeting and the facilitator who visited the Detox Unit to present an Introductory Presentation each week and told them not to show up for their meeting. I advised them to contact participants if they had any way to do so, and to contact the central office in Ohio to obtain a ZOOM license. SMART Recovery is a 501c3 organization founded in 1994 to support mutual-aid groups using the evidence-based, MATcongenial, SMART Recovery 4-Point Program in free, weekly meetings, facilitated by trained volunteers, mostly peers, who have used the program successfully. A Central Office in Ohio, and thousands of volunteers, support a network of 3,600 weekly meetings globally, in 27 countries, and 2,300 in the US. Then, came the real tsunami wave. Email after email, and call after call, rattled onto my devices advising me that almost all hospitals (24 hospitals and rehabs in MA host SMART meetings), churches, veterans’ facilities, prisons, jails and Community Recovery Centers which hosted SMART meetings were halting face-to face meetings. This was an extremely disturbing development knowing the crucial importance of group cohesion and support to those attempting recovery from an addiction. Together, with the intrusions of the other depredations of the COVID-19 epidemic, the combination produced a toxic concoction for those trying to avoid their addictive propensities. Fortunately, SMART Recovery has had an active online community for over 20 years on www.smartrecovery.org, known as SROL. Initially limited to a meeting list, message board, chat room, and a library of recovery materials, the evident impact on group cohesion was made clear to my skeptical assessment of its capacity, when it attracted 40 participants from all over the US to an unprogrammed meeting at a resort in the Poconos in the Summer of 1997, after only 1 year of operation. In or around 1999, a number of online group recovery meetings were started on the website. Initially, these were text-only meetings. A couple of years later, an audio format was introduced. By then, the number of online meetings had grown to twelve. The number of online meetings continued to expand as demand grew, and an attendance verification component was added. By 2016 there were thirty meetings, with the addition of three Family and Friends meetings. Repeated breakdowns in the program that was supporting the meetings led the organization to substitute the newer ZOOM format about a year ago. This was a complex (and expensive) task, but was instituted and monitored by one of our Board members who was formerly the IT Director for a Fortune 500 company and was completed with only a few minor glitches. A huge re-training project was required for the thirty online facilitators, in the intricacies of the ZOOM system. However, we now had a video element available and a smartphone capacity. When the calamitous closings began to spread like a wildfire, it was all hands-on deck in Mentor, OH. An immediate decision was made at an emergency Board meeting to reach into the Reserve Fund (a crucial element of the financial solidity which enabled SMART to carry a Platinum Rating from GuideStar), as merited in this crisis situation. Employees were reassigned from their routine tasks to a task force
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to immediately list meetings which no longer had a venue available, and was listed as on hiatus. As ZOOM licenses were acquired for a meeting, and the facilitator accessed the training video which was developed for the three-times weekly live training sessions, the designation was changed to “now online.” Four hundred “local” ZOOM meetings were put online within three weeks, and after urgent requests, new trainees were found to increase the number of “national” online meetings to fifty. Unfortunately, some of these “national” meetings were inundated by 200-300 participants during the transition, not an ideal number for a SMART Recovery meeting which is meant to be interactional. A couple of local online meetings were “ZOOM-bombed” by interlopers, but luckily, this was a rare occurrence. Some meetings decided to introduce passwords for participation that needed to be obtained from the facilitator prior to the meeting. UK SMART Recovery and SMART Recovery Australia, also support online meetings, and these are now integrated with the US/Canada meetings, so that meetings are available virtually “around the clock.”. SMART Recovery moves massively online amid covid-19! Generally speaking, the transition for participants from Face-ToFace to ZOOM meetings has been smooth. Some people have struggled with, or have been intimidated by the technology, but this is actually more complicated for the facilitator than the participant. Facilitators often “go to the whiteboard” to demonstrate one of SMART’s 14 TOOLS and this can be accomplished in the ZOOM format’s share function. Although only 25-40% of the participants in the “national” meetings turn on their cameras, 90%+ do so at the “local” online meetings. Uptake by participants has been ragged because although some groups maintain google groups or Facebook sites where the new URLs can be posted, some had no means of direct communication and had to wait for the switch from “on hiatus” to “online”, which sometimes took up to 7 days. “Poor Little Rhode Island, the smallest of the 48” as the old song says, was the first state to successfully move all of its eight meetings online. Of course, for those who do not own a smartphone, or do not have access to a broadband connection capable of at least 25 Mbps transmission, the regular ZOOM format is not going to be accessible. However, there is a capability of phone-in participation, although not with the video component. Occasionally, a meeting in an indigent geography has chosen to preserve the face-to-face format as the only reasonable way to continue the meetings, using meticulous cleaning, masks and social distancing. What the long-term outcome of SMART Recovery’s move massively online amid covid-19 will be on the popularity, or even, on the existence of Face-To-Face meetings once they are safe again is conjectural. We will have to wait to see. “Passing the hat” is now kaput. For a listing of SMART Recovery online meetings, go to www.smartrecovery.org/meetings and enter your zip code for local meetings. For the “national” meeting list go to www.smartrecovery.org/community. Dr. Joe Gerstein is the Founding President of Smart Recovery www.smartrecovery.org www.smartrecovery.org/meetings www.smartrecovery.org/community
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SPIRITUAL CONFUSION: A ROADBLOCK TO RECOVERY By Dr. K.J. Foster, LMHC, CAP
Spirituality is considered to be a critical component to achieving a successful recovery. In fact, it’s the cornerstone of most 12-Step programs. It’s also a concept that’s frequently misunderstood, which can create a significant roadblock for many. It’s been my experience, that spiritual confusion is often the result of religious bias associated with the concepts of spirituality and spiritual practice. Truth be told, 12-Step programs, although touted as “spiritual” in nature, can contribute to this issue of spiritual confusion, especially, if you know anything about the history of 12-Step programs, in particular Alcoholics Anonymous (AA). AA was the first 12-Step program and served as the model and basis for all those that have since followed. The use of the word “God” and “Higher Power” along with the use of Christian prayers in AA, all derived from the program being rooted in Christianity. In response to spiritual confusion, bias, and outright aversion to the religious feel of 12-Step programs, secular programs such as LifeRing and SMART Recovery have become very popular. One of the major distinctions being the emphasis on human efforts rather than divine intervention. Within these programs, your spiritual or religious beliefs are encouraged to remain private. And although I believe these programs are beneficial alternatives to 12-Step recovery, I do believe the philosophy of these programs don’t do much to clear up the issue of spiritual confusion. Recovery Dharma is another popular alternative to 12-Step that is an off-shoot of Refuge Recovery. Both programs are based on the use of Buddhist principles to achieve a successful recovery from any addictive behavior or compulsion. They encourage each individual to follow their own path to recovery through Buddhist practices and principles. My assertion here is not of one program being better than any other, but that there is a place and a need for all of them. My assertion is that spirituality is, in fact, critical to a successful recovery, no matter what program you’re participating in, whether it be 12-Step, SMART, LifeRing, Dharma or any other. My assertion is that all of these programs are “spiritual” in nature and that spirituality and spiritual practice is essential to recovery success, even for an atheist! This is where an understanding of spirituality and spiritual principles outside the context of religion can help the spiritually confused to gain more clarity, resilience and recovery strength. You see, I myself was once spiritually confused. My understanding of spirituality, like many others I’ve met and worked with, used to be understood relative to religion, during a time in my life when I didn’t want to have anything to do with religion. There were two powerful turning points for me in going from spiritually confused to spiritual clarity. The first was learning about spirituality relative to the trinity of beliefs, practices and experiences. The other was learning about behavioral kinesiology relative to consciousness and power. Let’s first look at the spiritual trinity: beliefs, practices and experiences. Beliefs are exactly that, your beliefs. What do you believe? Do you believe in God or no God? Do you believe in a Higher Power? Do you believe in Nature or Science or Energy? Maybe you believe a little of this and a little of that. It doesn’t matter and yet it does matter. It doesn’t matter in that you have a right to believe whatever you choose to believe. It does matter, in that you need to know what you truly believe. Perhaps you grew up believing something simply because you were told to believe it. Yet, there has always been this feeling in your gut. This nagging, this questioning. Is that what I really believe? Gaining clarity is important because it will impact your spiritual practice. The second spiritual trinity is practice. Religion is a way in which many people choose to practice their spiritual beliefs. But it’s not the ONLY way! There are many other ways to practice spirituality. Some examples would be in nature, in exercise (such as yoga), in relationships with others, or in artistic pursuits (such as music and
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art). There are a multitude of different ways to practice spirituality. There is also another part to this concept of “spiritual practice.” What is spiritual practice? Spiritual practices are positive actions you take to cultivate the growth of your spirit. A strong and powerful spirit translates into a strong and powerful recovery. The third spiritual trinity refers to our experiences. This is where understanding how our experiences impact our beliefs and our practices is helpful in gaining more spiritual clarity. For example, many people have experienced deaths and tragedies in their lives that have made them question what they believe and for some, completely change what they believe. Perhaps going from believing in God to not believing in God. This, in turn, impacts how they practice spirituality or in extreme circumstances can result in discontinuing any spiritual practice whatsoever. On the other hand, there are many people who have had near-death experiences, or the like, that have similarly resulted in a total change in their belief and spiritual practices from not believing in God to believing in God. Either way, our experiences can have a powerful impact on our beliefs and the ways in which we choose to practice spiritual principles. Moving on to the second turning point for me in gaining more spiritual clarity, happened as the result of a book I read by Dr. David Hawkins, “Power versus Force.” For me, it confirmed everything that I had come to believe about spirituality and spiritual practice, and with research to back it up! The information presented in this book is based upon research conducted starting in 1965 through 1994 relative to behavioral kinesiology. The depth and breadth of this book is impossible to accurately summarize within the context of this article. That said, I’ll attempt to explain as best I can. Kinesiology is a well-established science, with extensive research supporting the kinesiologic response: A positive stimulus provokes a strong muscle response and a negative stimulus results in a demonstrable weakening of the muscle. This research resulted in a testable phenomenon relative to consciousness and the energy and power associated with measurable attractor patterns and energy fields. Dr. Hawkins presents an anatomy of consciousness that lays out the arch of human spiritual evolution from its lowest expression and frequency (shame) to its highest (enlightenment). Higher consciousness radiates a beneficial and healing effect, verifiable in the human muscle response, while non-true and negative energy fields induce a weak muscle response. Think about this relative to addiction recovery and spiritual practice. It supports core principles commonly held to be true across religions and across cultures: love is more powerful than hatred; truth sets us free; forgiveness liberates both sides; unconditional love heals; and courage empowers. Active addiction weakens a person’s life force to the point of powerlessness. Therefore, as part of a successful recovery program, all things that weaken life energy should be reduced and avoided. This includes shame, guilt, confusion, hatred, fear, pride, hopelessness, anger, resentment and falsehood. In contrast, that which uplifts and energizes life force is to be realized. This includes truth, courage, Continued on page 14
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OVERCOMING ADDICTION FOR THOSE ON THE AUTISM SPECTRUM By Ron Sandison
Serving others produce a chemical reaction in your body that makes you feel a natural high and better about yourself. Recent research studies have shown that people with autism who drink or use legal drugs are more likely to become addicted to, or otherwise, abuse these substances than those who are not on the autism spectrum. Dr. Duneesha De Alwis wrote, “People on the autism spectrum can be socially withdrawn, so drinking with peers is less likely. But if they do start drinking, even alone, they tend to repeat that behavior, which puts them at increased risk for alcohol dependence.” I have been employed in the mental health field for over ten years at Havenwyck Hospital, and counseled people with substance abuse for over fifteen. During this time, I have noticed a pattern between people who recover and those who continue to relapse. Those who recover have both a positive attitude and accountability. Stay positive. Don’t become discouraged in your quest for recovery. Your addiction was a process; now it controls your life. The pleasure spectrum theory explains the vicious cycle of addiction. You get high to feel pleasure, taking your mind off life, but every time you get high, it takes more potency to get the same fix—so you continue to use more and more until you are addicted. Once addicted, you cease to get high only for pleasure and to free your mind, but to avoid the pain of withdrawal. Now you get high to feed the destructive beast. Notice addiction took time, so does recovery. The only difference between a successful person and a failure is a successful person rises one more time, then he or she falls. As Charles Spurgeon says, “By perseverance the snail made it on the ark.”
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Change your appetite. You will hunger for what you feed on. Certain sights, tastes, sounds, places, people, remind you of your addiction. Keep away from these, it will only feed the addiction. John Wesley, the founder of the Methodist movement, said, “What you feed in your life will grow.” Feed on things that lead to sobriety—friends who encourage you, places that symbolize hope, activities that remind you of your B.C. days (before addiction). Discovery or rediscovery of fun activities. Addiction can make life appear black and white, lonely or scary— find fun activities to bring color back into your world. One of the reasons for recreational therapy is many substance abusers have forgotten how to have fun apart from using. Fun activities can include: bike riding, going to the beach, walks in the park/woods, watching funny movies, or drawing. Serve others and learn to put your problems in perspective. The saying, “Before you can help others, you have to help yourself,” is a half-truth. As you serve others you begin to realize that your problems Continued on page 14
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COPING WITH PANIC By Jessica Herz, LMHC
Most individuals have experienced panic at some point in their lives. Experiencing a feeling of panic can be very scary, especially at times like these, with the COVID-19 pandemic on every news channel. Panic may feel like the only way to react to the situation. Panic is a normal human instinct. Our brains are wired for survival, and this is their way of keeping us alive. However, in some situations, we do have control over what we should or should not panic about. Questioning why we panic, and becoming self-aware of the way we respond to events in our lives, can provide us with some much-needed answers. With that being said, we must always remember: The only thing we can control in life is how we respond to things that happen to us. So, how do we know if it is helpful or harmful for us to panic in a particular situation? Later in this article I will discuss alternative ways of coping with panic in stressful situations, but first let’s explore what panic looks like. Panic can take on many forms because of the multitude of symptoms involved. Some symptoms are cognitive, and some are physical. Examples of symptoms are: difficulty breathing, uncontrollable thoughts, excessive worry, the inability to slow down, feeling like your heart is racing, feeling sweaty, having a feeling of losing control, feelings of impending doom, chest pains, lightheadedness, increased blood pressure, feelings of choking and more. Sometimes, panic can look more cognitive- meaning more in your head, and less of a physical reaction. But a lot of the time, panic is more physical consisting of bodily reactions. Here are some suggestions on how to cope with situations more productively before panic sets in: 1. Learn how to recognize the early thoughts that contribute to future panic. Maybe you have more anxious thoughts than usual or thoughts that may make you feel out of control. These thoughts could be felt minutes, hours, or even days before panic presents itself. Learning to recognize these triggering thoughts before the reaction of panic becomes unbearable or uncomfortable is vital in decreasing the chances of panic setting in. 2. Learn how to recognize the behaviors that contribute to future panic. Are you more tired than usual? Feeling more fatigued or stressed out? Are you getting physically ill? Are you eating healthy and taking care of yourself? Are you drinking more coffee than usual or using substances to cope with your feelings and thoughts? All of these behaviors can contribute to future panic due to the increased stress they physically put on the body. 3. After recognizing thoughts and behaviors that happen before a panic, go ahead and put into place healthy self-care actions. Maybe you need to take a day off from work to regroup and re-energize? Maybe you need to take a warm bath or go for a walk outside to clear your mind? The goal is to identify the thoughts and behaviors that happen before the panic behaviors start to minimize the chance of having a panic attack or future panic behaviors. Nevertheless, if you are in a situation where panic has already begun, that doesn’t mean there is not a way of coping with the panic, and working through it. Here are some suggestions on how to cope with situations more productively while panic is currently a problem: 1. Deep breathing techniques. Breathing techniques are more than just breathing or telling yourself to breathe. The skill and practice of deep breathing can lower blood pressure, decrease stress, can relieve pain, and even more. Use this script to help you learn how to speak to yourself and walk yourself through a breathing exercise when feeling panicked: “Okay- now relax… and breathe in… 1…2…3....4… and breathe out 1…2...3...4… Breathe in... relaxation… breathe out... stress... Now again...slow down...breathe in ...1...2...3...4...” And repeat. Repeat for as long as you need to, in order to begin feeling calmer and less panicked. This is great for coping with panic.
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2. Think of a happy moment or your happy place (option: write about it)- Think of a moment or a place that makes you feel happy. Now, in the most detail possible, describe and really imagine yourself at your happy place or happy moment. To help with detail, think about the people you were around during this time, how the air smelled; the colors and shapes of the objects around you. Think about the sounds around this moment, and the way the air felt on your skin. Here is an example and script you can say when experiencing that happy moment/ happy place: “I like to think about a wide open beach, no one around except for me. It is morning time and the humidity is low. There is a perfect breeze that gently moves my hair back and forth. It feels like it is the perfect temperature out; not too hot and not too cold. I am wearing a t-shirt and shorts and my toes are digging slightly into the sand. The sounds around me consist only of soft waves, brushing up against my feet and the water feels smooth as it touches my toes. The color is clear and see-through. The water is a perfect temperature, just brushing up on my feet after each wave passes and moves gently back into the ocean. The sun is shining on my face; not too brightly, but just enough to feel warm and comfortable. I am at complete peace in this moment. My shoulders relax, my face relaxes, and my body feels like it is melting into the sand. I am content at this moment. I can always find this moment if I want to. It is always with me.” 3. Focus on something positive; something to change your current train of thought - It is important to have this option for healthy coping because it can be used any time you want to, just like the happy moment/ happy place. Some examples are: Call a friend that you know who will make you feel better or laugh; Text a funny picture to a friend or family member, and wait for their response; Put on your favorite song that makes you feel good. 4. Step Outside/Change your physical position- Changing your surroundings can change your train of thought. Go outside, look up at the sky and think about all the things in your life that you are grateful for. Enjoy the different colors you see and the way the air feels. Or stay inside and go lay down, go sit down in a different room, go make a bath or take a shower and soak your body in cold or hot water. With these skills in mind, we can cope differently with our situations that used to cause us panic. Learning how to identify your thoughts and behaviors before panic sets in is the most effective way to keep these feelings under control, no matter what situation you may find yourself in. Panic is not always necessary. Self-care and selfawareness are the keys to changing our thoughts and behaviors, which can lead to happier, healthier lives. Jessica Herz is a Licensed Mental Health Counselor. She specializes in personality disorders, mood disorders, anxiety, and addiction. Working with individuals of all ages, she implements an individualized approach to helping clients better understand their thoughts, emotions, and behaviors. She provides individual, couples, and family counseling and therapy services. Learn more about Jessica and her private practice at www.herzcounselinggroup.com
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COMPULSIVE BEHAVIORS- THE ADDICTIVE ROLLERCOASTER By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
Addiction is a chronic and compulsive disease that has an ability of taking over your complete person. While it may start off innocent enough; the compulsive nature of the disease is capable of consuming your life. The compulsion is driven by a desire to feel a particular way. You may be driven by the perception of an unfulfilled area of your life being met. Compulsive behaviors may make you feel reassured, secure, more courageous and capable of completing basic tasks in life. The intoxicating nature of the disease has an ability of making you feel invincible, but it is all along providing you a false sense of security. Addiction often begins with a harmless relationship to the addictive substance. You may have started off by having an occasional drink at a party or with close friends. The dependency on the substance begins to take hold when an individual’s desire becomes compulsive. Individuals with a substance abuse disorder (e.g. alcohol, drugs); may have led a perceivably normal life before becoming addicted to the chosen substance. The argument often is; did the substance choose the individual, or did the individual choose the substance? Either way, the substance changes the organic structure of the brain. These changes occur through the rewiring of the brain’s pathways. Compulsive Behaviors can lead to addiction. Distorted or compulsive thinking is what drives an addict. Whether an addict is addicted to a substance or any other vice; the catalyst for the cravings is caused by the changes that occur within the brain. Scientific research has shown that the brain’s rewiring is responsible for individuals having more intense cravings, desires, and generally making it more difficult to be released from the substance. Moreover, the same studies have indicated that the substances often cloud the individual’s judgement; ability to make rational decisions; coping mechanisms; perceptions; and cognitive and behavioral functioning. Why does this occur in the first place? While the substance may vary from person-to-person, the desire or craving for the substance is often stimulated by a similar need; the need to feel, or to relieve unsettled emotions or feelings deep inside the psychological makeup of an individual. For many users, the substance may be the individual’s way of coping. It may be their way of managing personal stress and anxiety. The individual may find comfort or relief when using this specific substance. They may find that they are capable of escaping the “reality” of life; even if for a short time. The benefits of the escape may outweigh the risk involved with using the particular substance. The user may not even be aware of the risks associated with the substance; or they may think that they are different and that they are in control. Nevertheless, the substance finds its way into taking over the individual’s life. The substances not only affect the overall health of the brain, but research has clearly shown that brain function may be the least of an addict’s worries. The substance can affect any extremity or bodily organ within the human anatomy. Physiologically, each drug has a different relationship with the body. The body may interact one way with the consumption of an inhalant, while reacting entirely different with a substance that is digested. It really depends upon the method of use and the type of substance consumed; whether the substance is being digested, injected or inhaled. The method of delivery will affect the impact of the substance and what type of “high” the individual experiences. It is important to understand that the method of delivery has a direct effect upon how quickly an individual reacts to the consumed substance. When an individual injects him or herself with a substance, the substance enters the bloodstream and there is almost an instant high; whereas, an individual digesting a substance would experience a delayed effect. Over time, we know that every substance will have an effect upon the human condition. When an individual reaches this stage, they are more than likely a full-fledge addict, and completely dependent
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upon their chosen substance. At this stage, an individual’s brain is highjacked, and the pleasure associated with the addictive behavior becomes rote; mechanical or a habitual act. Strangely enough, substance users are frequently aware of their problem, but they are unaware of ways to end the addictive cycle. The addict often feels as though the magnitude of their problem is beyond help. It is often described by addicts as though their life is like an out-of-control rollercoaster. Initially, the rollercoaster ride may have been an exciting and thrilling experience; but as the ride continues and intensifies, the addict becomes less of a participant and more of a hostage. The ride takes over their life- it is an addictive rollercoaster! The dynamics of the individual’s home life and work life are commonly affected. The substance user may have a deep desire to end the ride, but the mechanics are no longer in the rider’s control. When an addict has reached this stage, it is often difficult to reach them. For the addict is often fearful of admitting to their relationship with the addictive substance, out of the perceived fear of rejection and humiliation. Moreover, family and friends may perceive them as unapproachable or incapable of reaching them at this stage. It is extremely important to recognize that addicts began using because of an unresolved issue within their lives. Unless the issue is resolved, the addict has a greater propensity of relapse. Even with drug and alcohol treatment, an addict is more likely to begin using again if they have unresolved baggage. It is not uncommon for an addict to begin reusing to resolve the unsettled issue(s) as a strategy of coping and managing these unresolved issues. Therefore, it is of the utmost importance that an addict resolves the original catalyst for the substance use. As with any addiction, the beginning of one’s recovery occurs the moment that they acknowledge the addiction. It is not uncommon for an addict to resist acceptance and responsibility. The ownership of such issues makes the addict feel vulnerable, and for many addicts, the feeling of being vulnerable is a sign of weakness. It is important to recognize that you are not weak if you have an addiction. You are not weak when you accept responsibility, and you are not weak if you are vulnerable. Those struggling with addiction and compulsive behaviors, should be encouraged to follow through with treatment. The treatment process may vary depending upon the individual and the type of addiction. It is not uncommon for individual’s struggling with an addiction to have a multilayered treatment strategy. The treatments may include: intensive hospitalization; therapeutic treatment centers; outpatient programs; self-help groups or 12-Step programs (e.g. Alcoholics Anonymous, Narcotics Anonymous); and a variety of other psychological and therapeutic modalities. Being vulnerable is key to the recovery process. Addicts must accept Continued on page 12
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Pregnancy is one of the most meaningful chapters of any mom’s life. For moms-to-be struggling with substance abuse or mental health disorders, it can also be one of the most difficult. Research shows that if mom is battling addiction, her newborn will come into the world battling it, too. Without proper treatment, both mom and baby’s lives can be at risk. Retreat offers comprehensive prenatal care that focuses on mom and baby simultaneously. Our on-site OBGYN works with closely with our patients, on behalf of their families’ futures. Find us on Social:
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LOVED ONES OF THOSE STRUGGLING WITH OPIOID ADDICTION By Leah Johnston-Rowbotham, MS, APRN, BC, CDC
I have worked for over thirty some years in the field of behavioral health as a therapist, university faculty member, and advanced practice nurse. My experience has covered more ground than I could or would want to share in this article. But there is an overwhelming occurrence happening right now to our adult children that drives me to comment. Maybe because I have been listening to loved ones of those struggling with opioid addiction, and reading about an epidemic that is overtaking our country. In the beginning, many of us might have placed it in the: “oh my god, isn’t that terrible” category. Later, some of us became more deeply aware of it and became involved in some of the psychoeducational and supportive programing needed on a very elementary level as our knowledge of and our understanding about how such an epidemic began to evolve. Well, I think that the opioid “crisis” in our country, in our states, our counties, our towns and our families, can no longer be termed an epidemic. It is robbing us of thousands of our young adults on every given day. (72,000 Americans died from overdoses last year, more than died in car accidents). Young adults did not wake up one morning and say, “When I grow up, I want to be an addict and maybe even overdose with some heroin laced with fentanyl one day.” These young people are our neighbors, our students, our children, our children’s’ friends. We car pooled them. We taught them in church school. We fed them at our kitchen tables. We hugged them, we loved them. We saw the brightest of futures for them. We are now losing them in droves. I remember an old term from the bible that used to scare me when I was a young child. It was the word “Plague.” It described a disastrous evil; something that was intended to immediately and with utmost intensity grab an entire community’s attention. I honestly and truly believe that we have a “plague” happening right now and that it is not getting enough of our attention. Yes, there have been hot lines set up with numbers given out which give out more numbers with even more numbers often directing us to another set of numbers. There are 911’s to call. There are police and EMT’s carrying more Narcan with them on every tour than school nurses carrying EpiPens. There are emergency departments bending over backwards to help and there are more and more insurance companies paying less and less for the longterm care that it takes to get even one person with an addiction to opioids started on a path to recovery. There are lonely, scared, and physically, chemically, emotionally, and socially ill young adults struggling every day with a chronic relapsing chemical brain disease. There are loves ones of those struggling with addictionparents, partners, siblings, and friends who are devastated, angry, hurt and beyond sad. They feel helpless, depressed, and often alone. They feel that overwhelming aloneness of guilt, shame, failure and a sadness that does not have words to express. And there are many of us who feel that 3 funeral services of young adults in the matter of one month of a friend or a friend’s child from an overdose can be seen in biblical terms as beyond that of an epidemic. I may not be considered to be very religious (a sense of the spiritual, yes), but I had enough exposure to religious education as a child to recognize the signs of a plague… of a disastrous evil descending upon a people and I think that we are in the midst of one as dramatic as that may sound. But as far as I am concerned, it seems to be a pretty dramatic and devastating time right now when so many of us are losing so many of our loved ones to opioids. A few out of the thousands of families and friends who have loved ones struggling with opioid addiction have found some hope at parent support groups. I know of one that meets in Montclair on Thursday evenings at Hackensack’s Mountainside Hospital at
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6pm. It never claims to have all the answers. It does not, nor does it claim to take all the pain away, but it does listen, lets you listen, and “gets it.” It is a confidential place. It is a hopeful place. It is a safe place. It is a place with some suggestions; sometimes even some opinions; but never judgement. It is a place to at least come to and try. I remember an old member saying once: “I only hope you allow yourself to come and to take the chance on feeling even a little better after being here.” From all my years in behavioral health I have learned one certain thing: sometimes just spending a little time with others who have survived some of the same devastating situations as you have, or are still experiencing, can be helpful and even at time comforting. I hope more people in need of such a group will come and give it a chance; will try and find other such groups, will give their loved one who is addicted a chance, and in the meantime give themselves a chance. At least that is what I think! Leah Johnston-Rowbotham is a nurse practitioner specializing in behavioral health, a faculty member at Seton Hall University’s College of Nursing and a published poet She is a lecturer and workshop and group facilitator specializing in behavioral health, the effects of opioid addiction on loved ones, and women’s’ issues throughout the tri state area. She has created and implements a weekly “STOOP TIME GROUP” program in Montclair. She resides in Montclair where she is working on creating stoop groups for “new” nurses and mature women still working as she continues to write every day.
COMPULSIVE BEHAVIORS- THE ADDICTIVE ROLLERCOASTER
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Continued from page 10
complete responsibility and recognize that they have an ability to regain control of their life. There is no absolute “cure” that will eliminate or relieve the symptoms that led up to the individual becoming an addict. The addict will need to be an intricate part of their journey to recovery. Dr. Asa Don Brown is one of the most sought-after speakers in the world today. Whether it’s learning how to recover from the effects of trauma or learning to live an effective life, Dr. Brown has an array of speech topics that can cater to your organization or company’s needs. As a clinician, Dr. Brown found that if you want to genuinely reach people; you must reach them through positive communication, interaction, energy and leadership. asadonbrown.com
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CELEBRITIES AND THEIR DOCTORS- FIRST DO NO HARM By Maxim W. Furek, MA, CADC, ICADC
Celebrities and their doctors…drug dealers emanate from every stratum of society. They can be politicians, leaders of drug cartels, or respectable physicians. And while not every highly publicized celebrity death is a back-door drug deal, they often are the result of legitimate medical treatments. The phrase “first do no harm” represents the essence of the Hippocratic oath, translated as, “I will…abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked…” Numerous examples can be cited of the relationship of celebrities and their doctors. Tom Petty, Prince and Elvis Presley died of legally prescribed narcotic painkillers, while the deaths of Michael Jackson and Anna Nicole Smith were suspect. The following cases represent the deadly patient-doctor relationship that are the sad domain of tabloid newspapers and Hollywood exposes. Elvis Presley Dr. George Nichopoulos, Elvis Presley’s personal physician, was in the ambulance with Elvis on August 16, 1977, the day Presley died. Dr. Nick, in 1977 alone, prescribed 10,000 doses of amphetamines, barbiturates, narcotics, tranquilizers, sleeping pills, laxatives, and hormones to his patient. Even though a jury trial exonerated Dr. Nick of criminal liability, he was still disciplined by the Tennessee State Board of Medical Examiners and temporarily lost his license. Laboratory studies of Presley’s autopsy found 11 drugs present at the time of his death, all “consistent with medical treatment.” The medical examiner ruled that Elvis died of cardiac arrhythmia and not drugs. Following a twenty-year court battle, Dr. Nick’s license was revoked. The King and Dr. Nick: What Really Happened to Elvis and Me? was published in 2010, 15 years after Dr. Nick had been barred from practicing medicine and 33 years after Presley’s death. Dr. Nick said that Elvis was adept at “doctor shopping” and that he didn’t know about all of the other drugs that the star was taking. He emphasized, “I don’t regret any of the medications I gave him. They were necessities.” Dr. Nick said that he treated Elvis primarily for arthritis, an impacted colon, and insomnia, but was unaware of him taking any other prescribed medications. Prince Legendary musician Prince was 57 when he died of an accidental fentanyl overdose at his Paisley Park studio, on April 21, 2016. The artist suffered from chronic pain, and took excessive amounts of fentanyl, 50 times more powerful than heroin, to deal with it. A detailed toxicology report revealed “exceedingly high” amounts of fentanyl. The amount found in his body was absolutely deadly. Prince had 67.8 micrograms of fentanyl per liter of blood in his body; many deaths have occurred at just three micrograms per liter of blood. His liver contained 450 micrograms of fentanyl per kilogram, well over the level of what would be considered cause for “fatal toxicity,” which includes any amount of fentanyl over 69 micrograms per kilogram. There were other drugs as well. Dr. Michael Schulenberg treated Prince, but prescribed oxycodone in the name of bodyguard Kirk Johnson, days before Prince died, knowing the drug would go to Prince. The Minnesota Board of Medical Practice reprimanded Schulenberg and ordered him to pay a civil penalty of $4,648. Prince’s family members filed a wrongful death lawsuit against the Minnesota doctor, Walgreens, which filled prescriptions for Prince, and Trinity Medical Center that treated him for the opioid overdose. Schulenberg disputed that allegation, although he paid $30,000 to settle a federal civil violation alleging the drug was prescribed illegally. Tom Petty Musician Tom Petty died of an accidental drug overdose. The singer was prescribed pain medications, including Fentanyl,
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oxycodone and generic Xanax. He was also taking generic Restoril, a sleep aid, and generic Celexa, for depression. Petty lived and died in pain. He suffered from a broken hip and yet continued to honor 53 concert dates “keeping his commitment to his fans.” Petty had just completed a successful 40th Anniversary Tour. His level of pain was described as “unbearable.” The cause of death was “multisystem organ failure due to resuscitated cardiopulmonary arrest due to mixed drug toxicity” and the manner of death was “accident,” the medical examiner’s news release said. Petty also suffered from coronary artery atherosclerosis, emphysema, and knee problems. He died on October 2, 2017 at the age of 66. In all of the references used to research this article, and unlike the other celebrities, there have been no mentions of Petty’s physician or medical staff. Anna Nicole Smith Anna Nicole Smith, 39, died in a Florida hotel room. Her personal psychiatrist, Dr. Khristine Eroshevotz, was also there on that tragic day when the TV reality star overdosed. Because traditional sleep medications such as Ambien were ineffective, Eroshevich had prescribed Smith the sedative chloral hydrate. The combination of chloral hydrate and four prescription benzodiazepines, usually prescribed for anxiety, depression and insomnia, were found in her bloodstream: Klonopin (Clonazepam), Ativan (Lorazepam), Serax (Oxazepam), and Valium (Diazepam). Continued on page 14
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SPIRITUAL CONFUSION: A ROADBLOCK TO RECOVERY By Dr. K.J. Foster, LMHC, CAP
CELEBRITIES AND THEIR DOCTORS- FIRST DO NO HARM By Maxim W. Furek, MA, CADC, ICADC
Continued from page 6
acceptance, compassion, kindness, love, joy and peace. This is where I argue that regardless of your recovery program, regardless of your religion, regardless of whether or not you believe in God or you don’t believe in God, spirituality is a necessary and critical practice in order to successfully recover from addiction… even for the atheist! The way to gaining strength, resilience and a powerful recovery is through the practice of spiritual principles. What are you doing today to gain more strength, resilience and power? Dr. K.J. Foster is Founder of Fostering Resilience, LLC, Co-Founder of the Center for Sobriety, Spirituality & Healing and Family Program Director at the Beachcomber Family Center for Addiction Recovery. She is a Resilience Expert, Educator, Entrepreneur, Public Speaker, YouTube Creator, and Author of The Warrior’s Guide to Successful Sobriety, available at www.drkjfoster.org
OVERCOMING ADDICTION FOR THOSE ON THE AUTISM SPECTRUM By Ron Sandison
Continued from page 7
were not as bad as you thought—realizing every person has his or her own cross to bear. Serving others produces a chemical reaction in your body that makes you feel a natural high and better about yourself. Don’t be afraid or ashamed to seek professional help. Be aware that certain withdrawals can kill you, such as alcohol, benzos, and opiates. Dr. Adi Jaffe, the director of Alternative Behavioral Health at UCLA, warns, “Withdrawal from these drugs is like trying to turn the heat up in a cold house with a broken thermostat and an out of control heater—it won’t always lead to disaster, but it’s a bad idea.” If while withdrawing from these drugs, you develop a fever, extreme nausea, diarrhea, or DT (delirium tremens), you need to seek immediate medical attention. Seek friends and family members to hold you accountable. Your accountability partner shouldn’t be someone who is also in the process of recovery—the blind leading the blind. Instead it should be someone who is not afraid to confront you and put your feet to the fire. Dietrich Bonhoeffer wrote, “As long as I am by myself in the confession of my sins everything remains in the dark but in the presence of a brother or sister the sin has to be brought into the light.” Your accountability partner should encourage you to examine the effect of your behavior on others, your environment, and your personal life as well as the benefits of change. Keep faith for recovery. Never stop dreaming of life without addiction. Place your faith in a higher power to get you through the storms ahead. Addiction keeps you from fulfilling your purpose in life—so break free. A man placed his wet clothes in the dryer—forty minutes later, checking his clothes, they were still wet. He examined the main pipe that brings hot-air only to discover a robin’s nest. This nest prevented the dryer from fulfilling its purpose of drying clothes. After removing the nest—the dryer could again accomplish its purpose. Ron Sandison works full time in the medical field and is a professor of theology at Destiny School of Ministry. He is an advisory board member of Autism Society Faith Initiative of Autism Society of American and board member of The Art of Autism. Sandison has a Master of Divinity from Oral Roberts University and is the author of A Parent’s Guide to Autism: Practical Advice. Biblical Wisdom published by Charisma House. Ron is a blogger for Autism Speaks, the Art of Autism, Autism Parenting Magazine, and the Mighty. He speaks at over 70 events a year including over 20 educational conferences. Sandison is the founder of Spectrum Inclusion. Website http://www.spectruminclusion.com
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Continued from page 13
In addition, Smith had taken Benadryl (Diphenhydramine) and Topamax (Toprimate), an anticonvulsant GABA agonist. All of those drugs likely contributed to the tranquilizer effects of the chloral hydrate-benzodiazepine combination, causing Smith’s death on February 8, 2007. According to the medical examiner, Eroshevich had written eleven prescriptions, later called “pharmaceutical suicide” by a pharmacist who refused to fill one of Eroshevotz’s prescription orders. Smith’s former boyfriend Howard K. Stern and physicians Eroshevotz and Sandeep Kapoor were charged with “illegal conspiracy to prescribe, administer and dispense controlled substances to an addict.” Eroshevich’s license was suspended for 90 days and she was placed on five years of probation by the state licensing agency for wrongly prescribing opiates and other misconduct. As part of her Medical Board discipline, she had to undergo a psychiatric evaluation and take an ethics course. A jury acquitted Stern and Eroshevich on most of the 11 charges involving drug prescriptions given to the former Playboy Playmate. Michael Jackson The death of Michael Jackson, 50, was ruled a “homicide” by the Los Angeles County coroner. Jackson died of an overdose of propofol, a powerful sedative used to induce sleep. Jackson’s personal physician, Dr. Conrad Murray, a Houston cardiologist, administered the propofol prior to the singer’s death on June 25, 2009. Murray had been treating Jackson for insomnia for six weeks and gave Jackson 50 mg of propofol diluted with the anesthetic lidocaine every night. Propofol (Diprivan) is an extremely dangerous drug used as a general anesthetic and administered intravenously in operating rooms. It works as a depressant on the CNS, but once the infusion is stopped, the patient wakes up almost immediately. Murray was not the only physician to treat the troubled rock star. Another five doctors and a nurse practitioner are believed to have also attended to Jackson’s medical needs. “Detectives ... believe that the miscellaneous prescriptions, from multiple doctors ... could have contributed to his death,” the official affidavit stated. It added that “it cannot be determined whether the cause of death is due to the actions of a single night and/or a single doctor, or the grossly negligent treatment of several doctors over an extended period of time.” After a sensational trial, Murray was convicted of involuntary manslaughter. He was sentenced to four years in jail, but only served two. Evidence presented to the jury painted Murray as an individual more concerned about himself, and his image, than as Michael Jackson’s caregiver. Even as Jackson stopped breathing and suffered cardiac arrest, Murray chatted on his phone and sent and received e-mail and text messages. Murray also lied to paramedics and emergency doctors and delayed calling for help. We have heard these tragic stories for far too long of celebrities and their doctors. Like a series of old television reruns, this saga continues through each decade, as we witness the deaths of our beloved celebrities, some with physicians at their side, silently passing away. Perhaps we need to be reminded of the Hippocratic oath, and that our primary concern is of the patient’s safety and well-being. First do no harm. Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis. jungle@epix.net
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