A P RI L 2 018 | VO LUM E 7 | I SS U E 4
I N M E MO RY O F S T E V E N
BASKETBALL AND REALITY TV STAR LAMAR ODOM FINDS RELIEF FROM ADDICTION WITH IBOGAINE
By John Giordano, Doctor of Humane Letters, MAC, CAP
PARKLAND STRONG ISN’T MERELY A SLOGAN By David Lam
NEW DEVELOPMENTS IN MEDICATION ASSISTED TREATMENT (MAT) By Raul J. Rodriguez M.D., DABPN
RESET THERAPY: AN ALTERNATIVE TREATMENT FOR ADDICTION By George Lindenfeld, Ph.D.
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A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. The Sober World is an informative award winning national magazine that’s designed to help parents and families who have loved ones struggling with addiction. We are a FREE printed publication, as well as an online e-magazine reaching people globally in their search for information about Drug and Alcohol Abuse. We directly mail our printed magazine each month to whoever has been arrested for drugs or alcohol as well as distributing to schools, colleges, drug court, coffee houses, meeting halls, doctor offices and more .We directly mail to treatment centers, parent groups and different initiatives throughout the country and have a presence at conferences nationally. Our monthly magazine is available for free on our website at www.thesoberworld.com. If you would like to receive an E-version monthly of the magazine, please send your e-mail address to patricia@thesoberworld.com Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. It is being described as “the biggest manmade epidemic” in the United States. More people are dying from drug overdoses than from any other cause of injury death, including traffic accidents, falls or guns. Many Petty thefts are drug related, as the addicts need for drugs causes them to take desperate measures in order to have the ability to buy their drugs. The availability of prescription narcotics is overwhelming; as parents our hands are tied. Purdue Pharma, the company that manufactures Oxycontin generated $3.1 BILLION in revenue in 2010? Scary isn’t it? Addiction is a disease but there is a terrible stigma attached to it. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, getting thrown out of school or even worse an overdose, that we realize the true extent of their addiction. If you are experiencing any of the above, this may be your opportunity to save your child or loved one’s life. They are more apt to listen to you now than they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin. I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from. There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are Interventionists who will hold an intervention and try to convince your loved one that they need help. There are detox centers that provide medical supervision to help them through the withdrawal process, There are Transport Services that will scoop up your resistant loved one (under the age of 18 yrs. old) and bring them to the facility you have To Advertise, Call 561-910-1943
chosen. There are long term Residential Programs (sometimes a year and longer) as well as short term programs (30-90 days), there are Therapeutic Boarding Schools, Wilderness programs, Extended Living and there are Sober Living Housing where they can work, go to meetings and be accountable for staying clean. Many times a Criminal Attorney will try to work out a deal with the court to allow your child or loved one to seek treatment as an alternative to jail. I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents. Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young-IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the best care suited for their needs. They need help. Deaths from prescription drug overdose have been called the “silent epidemic” for years. There is approximately one American dying every 17 minutes from an accidental prescription drug overdose. Please don’t allow your loved one to become a statistic. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com. We are on Face Book at www.facebook.com/pages/TheSober- World/445857548800036 or www.facebook.com/steven. soberworld, Twitter at www.twitter.com/thesoberworld, and LinkedIn at www.linkedin.com/grp/home?gid=6694001 Sincerely,
Patricia
Publisher Patricia@TheSoberWorld.com
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TALKING WITH AN ADDICT: ARE YOU A LAMB, LION OR OWL? By Judy Voruz, MA, CADCII, MAC, SAP
When you have a friend or loved one who is addicted to drugs or alcohol, you know that it’s super challenging to talk to them about their addiction. When you do, you run into all kinds of defenses. In their current mindset and understanding, they will do almost anything to be able to maintain their addiction, and especially, to avoid treatment of any kind. Below I use the metaphors of the Lamb, Lion and Owl to identify the alternative communication styles you may want to use when talking with your loved one. Communication Style The Lamb’s style of communicating is softer, more flexible, responds to resistance, distress or unhappiness with nurturing, and compromise. The Lion is confrontational, has strong opinions about what needs to be done, favors tough love and sees behavior as right or wrong. The Owl listens, asks questions to learn more, and reflects on what is being shared. Results of Each Style
container for change and healing.
The Lamb’s way can lack a sense of firmness, clarity, guidance or direction for their loved one.
3. “I miss the time we spent together. How can we start hanging out again?” It is so important to stay connected to your addicted loved one in any way you can. This may not be easy, and will require a high level of honesty on your part about your ability to be, or not to be, with the person’s behavior. If you are honest with them about your own limitations while expressing your love for them, you will continue to be a positive factor in their ability to create change.
The Lion’s communication is forceful, authoritarian, and based on preconceived notions of what their loved one may need. It usually evokes defensiveness, withdrawal or resentment. The Owl is there to draw out their loved one’s experience and provide an opportunity for them to reflect on and discover their desire for change and for finding their own wisdom and way out of addiction. Communication Scenarios Your loved one is not purposefully avoiding getting help or wanting to change. They are aware of their addiction and its consequences for themselves and those around them. However, they are caught in a cycle of negative perceptions that doesn’t allow them to see what is really happening to them. In their minds they feel they have no choice about whether they use or not. Because they see their addiction as the only solution to their uncomfortable or distressing feelings, which are created by their repetitive thought patterns, they quite naturally go into a defensive or protective mode; thus you encounter avoidance, anger, guilt, resentment, and blame. Therefore, talking with an addict about their situation requires a new understanding of addiction, what creates it and how to support your loved one in letting it go. Below are some typical communication scenarios that illustrate what works and what doesn’t. 1. “I need to tell you how I really feel.” This is often a disguise for assigning your feelings to the other person’s behavior. Feelings are the result of your state of mind about what’s happening in the moment. This is universally true for everyone. Realizing this can foster a powerful change in your understanding of what creates the experience of your loved one. With this insight, much of your reactivity to your loved one can calm down. Blame turns to compassion, curiosity about their experience, and a greater ability to access wisdom for finding a way forward. 2. “What can I do to help you?” The question starts from the attitude that there is something wrong with the other person and they need to be fixed. True, they have an addiction. Their addiction is their attempt to deal with negative mind states. These states create uncomfortable feelings which create the urge to drink or use. Once they see that they do not have to act on their thought/feeling, they can either heed the pull of the compulsion or let it go. As they continue to disregard the thought generated compulsion to use, overtime the urges will fade. Seeing your loved one as whole and in need of a new understanding, the nature of thought will change your perception of them and yourself. Gradually, you begin to have a greater ability to stay present and to listen without judgment. Bringing these qualities to your interaction creates the best
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4. “If you don’t have a problem, why did this “series of events” happen?” Questions or statements that remind the addict of all their bad behavior will only add to the already huge load of shame and guilt they carry about their addiction. Thus, the hold of addiction can tighten even more — often diminishing their ability to realize the effect of their using. Asking self-reflective questions provides a gateway for them into more awareness of their experience. A self-reflective question that creates an opportunity for learning rarely begins with “why.” “Why” takes us further down the rabbit hole of trying to “figure out” in our heads the source of the problem — the last place where we will find the answers we seek. We want to know what their experience is. Where do they think their feelings are coming from? Do they see a repeating pattern in their state of mind and behavior? And what happens when they engage in that repetitive pattern of thinking? We want them to be more conscious of their experience and to feel it being created by their attitude in the moment. Denial has too often been used as a club instead of signaling the need for greater self-awareness. 5. “I love you but I can’t do this anymore.” Before you decide to cut off contact with your loved one, it would be useful to understand where your feelings about your loved one are coming from. It seems as though they are coming from your loved one’s behavior much the same way that your loved one thinks their urges/feelings are coming from their addiction to a substance. In both cases, it is thought generated feelings that are the culprit. You might notice how much of your thoughts center on the addict and their addiction. You may be surprised to find that your feelings about your situation arise from your state of mind in the moment. When you take responsibility for your thought-generated emotions, you set an example for your loved one. You will begin to see how your habits of worry, anger, disgust, disappointment, etc., are being created inside of you. You will begin to separate your loved one from their behavior. However, if there are certain behaviors that are too difficult to be around, then it is good to identify those and set limits around them. For instance, you may not want to be with your loved one when they are under the influence. In this case, you can tell them not to call or come home if they have been using. Tell them to get a motel room and sleep it off or any other creative solution you come up with to shield yourself from the behavior. However, Continued on page 28
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RESET THERAPY: AN ALTERNATIVE TREATMENT FOR ADDICTION By George Lindenfeld, Ph.D.
Twenty years ago, we knew very little about how memory was stored in the brain let alone how to alter it. Neither were we aware of the critical role that memory circuitry has within the context of the addictive process. Fast forward to the present time and now thanks to advances available through neuroscience, we have the means to alter the critical brain circuitry that sustains the addictive disease process. Unknown to many, we are able to do this through noninvasive means fairly quickly and straight forwardly. Unfortunately, part of the problem has been to bring these advances to the awareness of those who are front line providers of addictive services. Frequently, the word neuroplasticity is mentioned to describe how the brain is adaptable to changing circumstances, however, there is a shortage of specific information related to how to actually and specifically harness this ability and use it to create a transformative process. My goal in this article is to provide awareness of a treatment that can actually alter the brain’s memory circuitry through noninvasive means. To accomplish this objective, I’ll familiarize you with a number of important terms associated with this intervention that I’ve come to call RESET Therapy (Reconsolidation Enhancement by Stimulation of Emotional Triggers). I’d like to begin with a description of how trauma or cravings are stored in the long-term memory network of the brain. When this type of event occurs for the first time it is called Consolidation. After a period of time (some say up to a day or two) the trauma effect becomes locked into the memory system permanently. With addiction, it is likely built up over a variable period of time. An interesting aspect of this process is that each time the trauma memory and later the craving impulse is triggered, it goes through another storage process called Reconsolidation. Many researchers are currently involved in developing methods to intervene at the moment this restoration occurs. Some inject medications, some use light, some are even trying it through the tongue. I use sound! At this point you might be asking why would so many researchers be spending so much of their time trying to alter this process? The answer is pretty straight forward. If we can intervene at this crucial moment, the brain will restore the memory free of the emotional component in cases of trauma and weaken the strength of the craving in addiction. The following figure provides an overview of my perspective of the memory consolidation/reconsolidation process. The first egg shaped illustration is labeled ‘New Memory (active)’ obtained through ‘Learning’ and Consolidated into the stored ‘Inactive Memory’ circuitry. When reactivated either intentfully or not, the memory becomes active again and subject to modification through varied forms of intervention including sound.
Learning generates a new short-term memory trace. The consolidation process moves it to long-term memory. Active or passive retrieval brings it back into short-term memory. This is the magic moment where change can occur before it is restored into long-term memory again (Reconsolidation). Note in the green box, the memory as illustrated in the wave form is now altered permanently. Clinical experience indicates that the process can be changed with positive results within 15 to 20 minutes of modulated
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sound. A 2010 article caught my attention due to its inclusion of the terms ‘Drug Memory Reconsolidation’ in the title. The authors concluded that: “[M]emory reconsolidation could potentially be exploited to disrupt, or even erase, aberrant memories that underlie psychiatric disorders, thereby providing a novel therapeutic target. Drug addiction is one such disorder; it is both chronic and relapsing, and one prominent risk factor for a relapse episode is the presentation of environmental cues that have previously been associated with drugs of abuse. . . Relapse, the resumption of drug-seeking and drug-taking behaviour following a period of abstinence, can be unconscious, automatic and habitual (and is markedly influenced by the presence of environmental stimuli and contexts that have been paired previously with drug use. These drugassociated conditioned stimuli (CSs), or cues, can induce craving and activate limbic cortico-striatal circuitry in abstinent human addicts. . . treatments based upon the disruption of reconsolidation would be predicted to require few, and possibly even a single, treatment with a memory-disrupting drug in order to increase the likelihood of longlasting abstinence from drugs of abuse. . . treatments need to be developed that can target neurotransmitter systems involved in drug memory reconsolidation . . . without producing unacceptable sideeffects in human patients.” (Milton & Everitt, 2010) There is a somewhat different approach taken when the treatment of addiction becomes the primary focus. Within this context, I seek not only to down-regulate varied cravings associated with the addiction experience but also to up-regulate selected neural activity in the pleasure center network. As this type of activation of the pleasure centers occurs in addicts it facilitates a more normative response. Because of the strength developed due to the effects of the addictive agent, the cravings often have become so strong that we must take the extra step of selectively weakening them. To accomplish this objective, those triggers associated with the ‘high’ of the craving stimuli are ‘nuked’ by the ‘healing sound’ to facilitate the re-emergence of pleasurable senses that are not linked to or associated with the addictive experience. As an example, the following procedure utilizes the urge to smoke to exemplify the targeting of aspects of the addiction. He would imagine experiencing the “rush” as the nicotine hit his bloodstream and the ‘high’ that comes next. He would visualize the smoke curling up before him and the sensation of warmth entering his lungs. After a while, the client is asked to switch to the memory of the satiation or satisfaction felt when he is done with the drug of choice. In general, the urge-suppressing effects of RESETAddiction reduces craving for 2 to 3 days before a ‘creep-back’ effect begins to occur. One might perceive that if the urge returns within hours, the session was likely to have been ineffective indicating the need to again repeat the ‘tuning in’ process. With regard to the frequency of sessions, they should be scheduled Continued on page 30
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THE THREE MOST POWERFUL WORDS IN ANY RELATIONSHIP: “I TRUST YOU” By Jim Holsomback, MA and Louise Stanger, Ed.D, LCSW, CDWF, CIP
The cornerstone of all effective relationships is trust. When we think of verbs that often accompany trust, they tend to be words like ‘earned’ or ‘established’. Few words can indicate a fractured relationship as when ‘broken’ or ‘lost’ are paired with trust. It is noticeable when trust erodes, and those relationships can include business, personal and therapeutic. Industries spend large sums of money learning how to achieve trust. Marketing firms examine what names, phrases and messaging achieves it, and magazines have established quizzes that demonstrate whether someone has the capacity to be trustworthy. Simply put, TRUST is a billion dollar industry without a “how to” guide as to how to achieve, maintain and propagate. To complicate things further, trust is a word with great variability based on who is surveyed. Individuals have different standards as to how they begin to trust others or the process by which trust can diminish in relationships. What we share is a list of components that create a trustworthy relationship…..elements that people identify as important when they are in a relationship that emanates trust. Reliability When we think of products, few words help consumers cough up a few extra dollars other than knowing that they are purchasing a reliable product that consistently performs the way it is advertised. Reliability in relationships performs in a similar fashion. The concept of consistently doing what we agree to is an essential facet of establishing trust. In 12step philosophies, folks discuss walking the talk, meaning that what they say matches what they do. Being timely, following through, performing at a consistent level, “showing up and “suiting up” and being consistent to our professional, relational or therapeutic relationships will go a long way in being a trustworthy company, friend, therapist or sponsor. Fidelity This is defined as the quality of faithfulness or loyalty and adherences to specific practices and protocols. As behavioral health care providers, we must be faithful to the ethical guidelines set forth by our licenses, certifications and accreditations. Patients and families expect that you are offering services that are evidencebased and that research and clinical training informs their practice. Apologize While the robotic nature of being reliable sounds great, as humans, life can get in the way regardless of our perfect intentions and diligent work to try and be a reliable partner. We all make mistakes, and, in our imperfections, we may do something that we later regret. It is necessary when we wish to make amends or apologize, that we embody the spirit of trust. Effective apologies have three components and each are equally important...we like to call it the “ARC Method to Apologies”. Acknowledge: Be transparent! Be clear about what you did wrong and how you may have fractured the trust in the relationship. Use “I “and nonjudgmental terms when explaining. Example: Sally, I want to make amends to you. Last night I was preoccupied with all the texts I had received and didn’t hear what you were saying. In retrospect, I realize I was unavailable, so, to make sure I don’t do that again tonight, I am going to turn my cell phone off. Repair: What do we need to do to correct the situation? Can we go back and do something that we were expected to do? Showing that we really had intentions of being consistent and reliable can add a dynamic quality to an apology. Finding ways to repair a slight or emotional injury can boost the effectiveness of an apology. Commitment: Nothing can make an apology fall apart faster than repeating the same action for which we just apologized. This can be a difficult process for children and teenagers who can be really effective with the first two steps and then fall apart with the commitment. Remember that a lot of integrity and trust falls into the commitment of avoiding and engaging in the same untrustworthy act.
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Patience For better or worse, trust is an established process. Effective relationships often take months or years to build, particularly when trust is lost. A simple trust metaphor- For each day we are reliable, we get $1 in the trust piggy bank. Depending on the importance of the relationship, we start to accumulate a decent amount of money/ trust in the bank. Unfortunately, when trust is fractured, so are our savings, and the size of the withdrawal often can be months or years of savings. At worst, our piggy can be foreclosed upon and trust cannot be reestablished. At best, we begin our savings plan and try to avoid large withdrawals from our savings account in the future. For those who are followers of Brene Brown, this is the concept of the marble jar. If I am a marble jar friend of yours, I am the person you can count on and reach out to when in need. If I break that trust, you end up taking marbles out of the jar and my ability to rebuild that trust is not easy. Often in families, where a loved one experiences substance abuse, mental health and/or chronic pain disorder, patience and trust is challenged. In recovery, all can begin to rebuild and put those marbles back in the jar. Validate Validation is a key component to building trust in all categories of relationships. In business, validating a customer’s needs, goals and concerns can go a long way in establishing a trusted partnership. In relationships, demonstrating that we care about and understand our partner’s/friend’s emotions, needs and perspectives solidifies their willingness to not just engage in the relationship, but it can often result in reciprocal validation for your emotions, needs and perspectives. Validation can also show that we can demonstrate interest in the other person’s experience, reflect their emotions, and show that their experience makes sense (assuming there is wisdom in their experience). There are few things that help connect people other than knowing that the other party is invested enough to understand where they are coming from and that their experience matters and is valid. Avoiding Judgments Few things can damage relationships like harsh judgments. At their core, judgments are a necessary part of human experience. Finding out that someone’s experience with a product or relationship was ‘great’ often suffices rather than detailing each and every moment of the experience. However, judgments often reflect poorly on the ‘judger’ as well as the person, product or relationship that they are judging. It is much easier to derive information about something (both positive or negative) when we provide statements that are factual and measured. Those conversations also convey information that is clearer and more trustworthy. Again, using “I feel” terms and conveying how one feels about what is happening is a great way to begin to establish trust, be transparent, vulnerable and respond in an affirming clear way. Understanding Both Sides It is typically easy to understand our own needs and wishes in a relationship, and when we get what we want or need, we feel effective. Equally important is being curious about the other person’s needs, and finding ways where both parties’ needs are
Continued on page 30
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NEW DEVELOPMENTS IN MEDICATION ASSISTED TREATMENT (MAT) By Raul J. Rodriguez M.D., DABPN
The mechanisms of addiction have a very strong biologic and physiologic basis, in addition to the psychological and spiritual components. It makes perfect sense then that the right kinds of medical interventions would have a strong positive impact on sobriety. These types of treatments, especially when coupled with effective psychological treatment modalities, have consistently yielded previously never seen higher success rates. New interventions have been developed and implemented over the last several years and have become the new standards of care in addiction treatment. These therapies have become increasingly relevant and have collectively started to be referred to as Medication Assisted Treatment or “MAT”. Naltrexone is a medication that has existed for a number of years and finally has been implemented as one of the major modalities for Medication Assisted Treatment. Naltrexone is a partial opioid receptor antagonist. It was first released under the trade name Revia as an agent to decrease alcohol cravings. Revia was found to be effective in reducing alcohol cravings as well as reducing the neurochemical reward from actual drinking. It has been used for many years successfully for this indication. Because of the opiate receptor antagonist properties, this medication has also been highly useful in treating opiate addiction. Naltrexone will effectively block the effects of an opiate, including heroin. This blocking ability helps prevent sudden and impulsive relapses. This blocking ability is even more pronounced in the long- acting depot injection formulation. Vivitrol is the brand name of the long-acting injectable form of naltrexone. It was first indicated for alcoholism and later received the FDA indication for opiate dependence. The Vivitrol shot lasts up to 4 to 5 weeks, making impulsive relapses even less likely. If someone wants to relapse onto opiates, they essentially have to maintain that intention until the shot wears off. This forced delay allows the patient the opportunity to seek out support and use recovery skills to prevent the relapse from happening. Even just knowing that a full relapse is not chemically possible already reduces the amount of time and mental energy someone would be willing to devote to contemplating a relapse. This helps reduce cravings for opiates. The Vivitrol also is effective in reducing alcohol cravings and seems to have a greater effect than Revia. Individuals who use Vivitrol for 1 to 2 years have dramatically higher success rates overall. Other even longer acting formulations such as implants that can last several months are currently in development A treatment modality really needs to work if it is to receive a medical indication by the FDA, even more so if it is to become the standard of care. Subutex and Suboxone, for the treatment of opiate or “pain pill” addiction, have also emerged as the new standard of care for opioid dependence with unparalleled success rates. These medications have revolutionized addiction treatment, creating a major shift from the old “28 day” inpatient care model to an outpatient model. Patients no longer have to go “away to rehab” and can actually detox while still working and caring for their families. Both of these medications have Buprenorphine, an opiate agonist-antagonist that binds to the opiate receptor and exerts an effect while blocking conventional opiates, as the primary active ingredient. Buprenorphine neutralizes much of the extreme and exaggerated biological drive to use opiates, resulting in a drastic reduction in cravings. Some receive Subutex just for detoxification. Others benefit from a daily dose or “maintenance” with Suboxone, which profoundly suppresses opiate cravings and would actually interfere with any opiates consumed in a relapse. These daily doses have a stabilizing effect and are in no way intoxicating when taken correctly. Patients that are properly treated with Buprenorphine are usually perfectly alert, energetic and generally feel very good. They do
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not get or look “high” while taking this medication, remaining fully functional. The leveling of the playing field created by these medications gives individuals a fair chance at working on their sobriety without the burden of obsessive cravings. Patients that are relieved of this craving burden have a better probability of maintaining full abstinence from illicit substances and increasingly distancing themselves from the drug life. After an extended period of sobriety, the elements of the drug world that use to repeatedly pull them back in, becomes a distant memory. A person taking Subutex or Suboxone appropriately, as prescribed by a qualified physician, is considered to be fully “clean and sober”. There are some groups in the recovery community who argue that patients that are on Suboxone are not sober. Some of this is due to having witnessed the potential drawbacks to buprenorphine. Buprenorphine has a very limited ability to induce intoxication on its own. Overuse typically will not do much, other than cause severe constipation. It usually would have to be mixed with something else, such as a benzodiazepine, to get some type of intoxication out of it. Much like with any other medication with even the smallest potential for abuse, someone, somewhere, has found a way to exploit that potential. The other concern with buprenorphine is diversion. This is really the bigger problem. When dispensed in large quantities, buprenorphine gets traded, sold, and otherwise distributed in some illegal manner. Most of this diversion ends up in the hands of people trying to detox themselves or trying to hold themselves over between opiate binges. This is the primary challenge in developing MAT halfway houses. New medical technology has been developed to address these issues, dramatically reducing the risks of misuse and diversion. New long acting formulations of Buprenorphine have been developed that completely eliminate diversion and overuse. Sublocade, the most relevant of these new developments, was approved by the FDA on November 30th, 2017 for the treatment of severe Opioid Use Disorder. Sublocade is a subcutaneous injection of a buprenorphine formulation that quickly solidifies underneath the skin. The solidified buprenorphine releases medication slowly over 4 weeks. This provides a steady blood level for a very long period of time. This also eliminates any psychological reinforcement related to daily pill taking. Since the dose can be administered only by a qualified and licensed medical professional, there is no opportunity for self-dosing and thus no over-consumption. Since it can only be administered in a medical setting there is also no opportunity for diversion. With these key advantages, Sublocade is considered the ideal option for MAT in the community and even a MAT halfway house. Relapse rates fall drastically when these medical treatments are combined with psychological treatments, greatly improving the prognosis for motivated and compliant patients. Continued on page 30
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PARKLAND STRONG ISN’T MERELY A SLOGAN By David Lam
Wednesday February 14, 2018- Valentine’s Day. A day that will forever be etched in our memory. It was a day that Parkland, our home for the past 18 years, lost its innocence. In a matter of minutes, beginning at 2:21pm, seventeen innocent souls perished. If only we could turn back the clock. You see, Parkland isn’t like any other town. It’s a rare piece of Americana that is disappearing across our country. It’s our few remaining bastions of suburban utopia where families gather to provide a haven for their children. It’s a community where neighbors greet each other. In fact, many of us know each other well and care genuinely for our fellow residents. We often stop and say hello, whether it’s at our local dry cleaner’s, or the Starbucks on Hillsboro Blvd or the one on Coral Ridge Drive…just blocks away from Marjory Stoneman Douglas High School. Tragically, it is now the infamous site where the shooting took place. When a deranged gunman opened fire on unsuspecting students and teachers that fateful day, he murdered not only seventeen lives, he destroyed our Parkland. Or did he? On that very evening after the shooting took place, our city immediately organized a vigil at the Parkland Amphitheater, led by community rabbis and lay leaders. More than 30,000 people showed up in a matter of hours! There were news agencies from all over the world covering the event. While tears and melancholy filled the air, we began to witness the resilient spirit of our town almost immediately. Scores of students, many of whom were hunkered down in classrooms just a few short hours before, came out to console their peers. Others arrived to pay their respect and to mourn for the loss of their classmates. As if united by a divine calling, we witnessed the incredible solidarity of the students in attendance. Overnight, a movement in Parkland had begun- a movement that will have far reaching effects upon the annals of our country’s history. I’d witnessed the aftermaths of other mass shootings: Orlando, Las Vegas, Sandy Hook, even Columbine. But Parkland was different and not just because it took place in my home town. There was an undeniable feeling in the air beginning on the eve of the vigil. Somehow, we all knew that the students of Stoneman Douglas and the city of Parkland would react differently to this act of atrocity. Undoubtedly, we were not going to let this tragedy go away lightly- or ever. The days immediately following the shooting saw our streets lined with protestors and activists, led mainly by vigilant students and angry parents. From Parkland to Coral Springs, from across America to the nation’s capital, the spirit of Parkland resonated loud and clear. While still grieving, many of us occupied ourselves with communal affairs. We called our neighbors and city officials asking how we can help. We simply wanted to do something. We all felt this was our way to heal. But does one truly heal from a traumatic event such as this? Several weeks later, while the city of Parkland is trying to get back to normal, there is undoubtedly a dreadful cloud hanging over the residents of this once utopian town. Media reports of the shooting continue to pour in as if to serve as a perpetual reminder that our beloved hometown will now be remembered as another dark chapter of gun violence in American history. While the students of Stoneman Douglas have since returned to school, few could imagine the horrific memories that they must now confront daily walking the same corridors that were lined with the blood of their seventeen teachers and classmates killed on Valentine’s Day, February 14, 2018.
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Just a few weeks prior to the Stoneman Douglas tragedy, Spark of Hope launched the First Responders’ Recovery Program called the Cindi McCue Initiative which provides substance abuse treatment and mental health counseling services to our country’s finest. It was named after a police officer that took her own life in 2015. Spark of Hope wanted to give back to those whom have dedicated their careers to serve and protect us. Many first responders often put their lives on the line and witness unspeakable tragedies daily. We had no idea at the time that such a tragedy could hit so close to home. Since then, we’ve mobilized our First Responders’ campaign beyond the local communities and seek to nationalize it throughout the country, by the grace of G-d. Spark of Hope is also an active player on the planning committee of the Broward County Mental Health Summit, alongside the Broward Sheriff’s Foundation and 2-1-1 Broward. The mission is to promote mental health awareness and education throughout South Florida. Spark of Hope’s inaugural event will take place on Wednesday September 12, 2018 featuring many supporters including FPL, Broward County VA, Broward Sheriff’s Office, Baptist Health and Wells Fargo. Additionally, Spark of Hope has set up complimentary mental health counseling services and trauma workshops, including Trauma Yoga therapy to those affected by the Parkland tragedy. We will continue to provide these services free of charge to anyone so long as there is a need. Moreover, Spark of Hope has dispatched our trained counselors and therapists to neighboring organizations such as 2-1-1 Broward, and to local schools, to provide the needed services to the many employees, volunteers and students that they so rightfully deserve. So long as Spark of Hope exists, we will endeavor to do more. For in the words of Dr. Martin Luther King, Jr. “darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.” And through unconditional acts of love, Parkland will overcome, for we are indeed Parkland Strong! David Lam is the Executive Director of Spark of Hope, a Joint Commission accredited behavioral health treatment center in Margate, Florida. A former marine struggling with PTSD, David has made it his lifelong mission to promote awareness and acceptance for those battling mental health and substance use disorders. For more information, please visit: www.ethicaladdictiontreatment.com
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WHAT IS A LEVEL 4 TRANSITIONAL CARE HOUSE? Sunset House is currently classified as a level 4 transitional care house, according to the Department of Children and Families criteria regarding such programs. This includes providing 24 hour paid staff coverage seven days per week, requires counseling staff to never have a caseload of more than 15 participating clients. Sunset House maintains this licensure by conducting three group therapy sessions per week as well as one individual counseling session per week with qualified staff. Sunset House provides all of the above mentioned services for $300.00 per week. This also includes a bi-monthly psychiatric session with Dr. William Romanos for medication management. Sunset House continues to be a leader in affordable long term care and has been providing exemplary treatment in the Palm Beach County community for over 18 years. As a Level 4 facility Sunset House is appropriate for persons who have completed other levels of residential treatment, particularly levels 2 and 3. This includes clients who have demonstrated problems in applying recovery skills, a lack of personal responsibility, or a lack of connection to the world of work, education, or family life. Although clinical services are provided, the main emphasis is on services that are low-intensity and typically emphasize a supportive environment. This would include services that would focus on recovery skills, preventing relapse, improving emotional functioning, promoting personal responsibility and reintegrating the individual into the world of work, education, and family life. In conjunction with DCF, Sunset House also maintains The American Society of Addiction Medicine or ASAM criteria. This professional society aims to promote the appropriate role of a facility or physician in the care of patients with a substance use disorder. ASAM was created in 1988 and is an approved and accepted model by The American Medical Association and looks to monitor placement criteria so that patients are not placed in a level of care that does not meet the needs of their specific diagnosis, in essence protecting the patients with the sole ethical aim to do no harm.
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RECOGNIZING THE CHOICE OF RELAPSE PREVENTION By Maxim W. Furek, MA, CADC, ICADC
Many have heard the time-worn expression, “relapse is the rule and not the exception.” Relapse is always lurking somewhere. It is only as close as the next drink or that next line of cocaine tempting us with its seductive white line. There is a difference between a “slip” and a “relapse.” A slip, considered less serious than a relapse, is often spontaneous and not a calculated event. Slips occur when people pick up alcohol or drugs after a period of sobriety but stop almost immediately. As soon as they achieve sobriety, they return to abstinence. A relapse (“fall again”) is far more serious, indicating that the individual has returned to their former addiction. This relapse may last for extended periods of time, signaling that recovery attempts have been completely abandoned. “If you relapse, don’t view it as the ultimate failure,” says Donna M. White. “It is this type of thinking that will keep you sick. If you were able to stay clean and sober before, you will be able to do it again. Reach out to others and seek help. Begin working your recovery program again. Process the events and emotions that led to relapse so that they are not repeated. By processing these situations, you can learn from your mistakes. This will only help you in your journey in recovery.” Recidivism is the tendency to relapse into a previous condition or mode of behavior. Because of brain development, poor conflict resolution skills and environmental factors that contribute to recidivism, adolescents who enter treatment for alcohol and other substances of abuse, tend to demonstrate a higher incidence of relapse than adults. Not everyone believes that relapse is a prerequisite and Gerard J. Egan argues against this widespread conviction: “It has been believed that relapse is a part of recovery and that for most people trying to get clean and sober it is just a rite of passage ... Those who believe that relapse is a necessary part of recovery need to recognize that there is a universal principle that ‘what we believe is what we conceive and achieve.’ If we think that failure is necessary prior to success then that becomes the proverbial self-fulfilled prophecy...” Relapse prevention is about “keeping it green” and not becoming too confident, too complacent or too secure in our recovery. Abstinence alone is not enough. Self-discipline and willpower alone will not prevent relapse without profound lifestyle changes. According to Stanley J. Gross, “A lifestyle change is not easy to make or maintain. Lapses and relapses do occur. Some people relapse several times before new behavior becomes a regular part of their lives. Thus, it is important to learn about and use relapse prevention techniques...” Changing one’s lifestyle may be the most important recovery strategy. We must commit to a lifestyle of total abstinence surrounded with new people, places and things. (NOTE: Some will argue that total abstinence is not necessary, that some can drink in careful, calculated moderation. That strategy is not one shared by this writer. Still, there is more to recovery than people, places and things. The following is a collection of possible strategies as suggested by associates currently in recovery. 1. Connect with your higher power and your spiritual self, asking for help and guidance. Discover your spiritual self. Use that spirituality as a resource to help free you and deliver you to a higher, nondestructive, place. Pray. Turn it over to God or to your personal Higher Power. “Let go, let God.” It is possibly the most important thing. There is no recovery possible and relapse is a surety if left to our own devices and self-will. 2. Attend a 12-step support meeting and connect with a group. Surround yourself with supportive, caring individuals. The 12-step
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programs allow those in recovery, or those attempting to begin the process of recovery, to understand the experience of others. Discuss your feelings and urges. Pay attention to those who have just gotten clean. Listen to their struggles and remind yourself of how horrible addiction can be. Utilize the strength, experience and hope that is an integral part of AA, NA and other support groups. They can save your life if you let them. 3. Keep yourself safe. Remove yourself from the temptation. Get rid of the items that are a part of your addiction- drugs, alcohol, paraphernalia, pornography, food, phone numbers, gambling advertisements, etc. Get rid of them if you can. Hide them if that is more practical. Don’t temp yourself and don’t give yourself a green light that communicates that it is okay to see or interact with these very items that may lead you to travel the same destructive path. Do not share space with these items symbolic of your weakness, your vulnerability, your addiction. You do not need them in your view nor in your life. 4. One day at a time. That concept may work for many but for others a 24-hour period is far too long. For some a five or tenminute period of total abstinence may be all you are currently capable of attaining. Work on that to perfection and then extend that period of time, longer and longer, as you begin to take control of your life and your recovery. 5. Dispute. As Albert Ellis stated in his Rational Emotive Therapy, you need to dispute your thinking. Ellis called it the most powerful cognitive method ever invented. Don’t believe your past ideas and conclusions. Develop a new way of thinking and new conclusions based on confidence and positive energies gleaned from your ongoing recovery process. 6. Create a safe place. Design an environment where you are supported, protected and totally free from your addiction. That safe environment may include a support group, sponsor, network of positive friends and all of the tools that you have developed to begin your road to recovery. Experience and celebrate the warmth of your personal safe harbor. 7. Celebrate choice. We ultimately have control of our destiny. That control is all about exercising our choice of basking in the healing sunshine or in the toxic darkness. We always have a choice of either doing something to enhance our recovery or furthering our self-destruction. Choice is a powerful action steeped in positive philosophy, energies and empowerment. Continued on page 28
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LEGAL CORNER FLORIDA’S MARCHMAN ACT ASSURES CONFIDENTIALITY By Joe Considine, Esq.
hurt themselves without legal consequences as violation of the court order will result in the incarceration of the individual to compel compliance with the court order. Unfortunately, the Marchman Act is still not understood and therefore underutilized by families and treatment professionals at least in part due to a lack of education, the lack of treatment beds for indigent people, concerns about the lack of confidentiality of the process and the problems with individuals leaving treatment contrary to a court order. Moreover, there are problems related to the timing within which court orders can be obtained. This article will address the issue of confidentiality. Subsequent articles will address the several other issues stated above. Florida’s Marchman Act found in Florida Statutes Chapter 397, “Hal S. Marchman Alcohol and Other Drug Services Act”, allows families, friends or those with knowledge of an individual with substance use disorder into treatment using the courts. In enacting Chapter 397, the Florida Legislature showed the appropriate gravitas regarding substance use disorders as a serious and terrible problem to society and families. Section 397.305 sets forth the problem: “Substance abuse is a major health problem that affects multiple service systems and leads to such profoundly disturbing consequences as serious impairment, chronic addiction, criminal behavior, vehicular casualties, spiraling health care costs, AIDS, and business losses, and significantly affects the culture, socialization, and learning ability of children within our schools and educational systems.”
Thankfully, the Florida Legislature addressed the concerns about confidentiality in the recent legislative session by amending the Marchman Act to make it clear that the public should not have access to records of Marchman Act court proceedings. Families that I see in my practice are concerned about the confidentiality of the Marchman Act. I am frequently asked about the issue of non-disclosure. Historically, circuit courts throughout the state handled disclosure of court records related to the Marchman Act in different ways. Some clerks of circuit courts allowed evidence of a Marchman Act filing on the Clerk’s docket. Most circuits denied access to members of the public of the actual court filings but there were a few instances Continued on page 28
Those words were written in 1993. Today, one would have to add the staggering death rate and the loss of a generation to that list of horrors. In setting forth the above language it was made clear just how serious the Legislature viewed substance abuse. “Substance abuse impairment is a disease which affects the whole family and the whole society and requires a system of care that includes prevention, intervention, clinical treatment, and recovery support services that support and strengthen the family unit.” And then the Legislature went further: “It is the goal of the Legislature to discourage substance abuse by promoting healthy lifestyles; healthy families; and drug-free schools, workplaces, and communities.” While anyone who works with the Marchman Act realizes, the Act has issues in need of addressing by the Legislature to bring it closer to meeting the above-stated goals. And it is clear that the goals need to be refined to stop the death toll and to provide more effective intervention. Nevertheless, the Marchman Act remains a vitally effective tool using the courts to obtain the help for people who have substance use disorders. Serious and creditable research confirms that involuntary treatment, including through the courts, is at least as effective, if not more so, than voluntary treatment. While this law has been historically underutilized, more and more mental health and treatment professionals are recommending it as a course of action for beleaguered families and friends. These folks, worn out trying to get their loved ones to stop using drugs/ alcohol, are turning to the courts via the Marchman Act to get help for their loved ones via admission into treatment. The existence of a court order requiring the individual to enter treatment is compelling and persuasive to the substance user that he or she can no longer
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~Lamar Odom two days after Ibogaine treatment.
BASKETBALL AND REALITY TV STAR LAMAR ODOM FINDS RELIEF FROM ADDICTION WITH IBOGAINE By John Giordano, Doctor of Humane Letters, MAC, CAP
Lamar Odom’s performance on the basketball court earned him honors any athlete – young or old, professional or amateur – regardless of their sport would proudly display in their trophy case. Odom’s Olympic team won bronze in 2004 and he won a gold medal in the FIBA World Championship (World Cup) in 2010. Odom won two NBA championships in 2009 and 2010 with the LA Lakers and was named the NBA Sixth Man of the Year in 2011. Mitch Kupchak, the Lakers’ general manager, said of Lamar, “he is the most popular player in our locker room.” All of his success on the court brought him fame in the sports world; however, it was his marriage to Khloé Kardashian in 2006 that put him on TV screens in the living-rooms of millions of people who didn’t know him from his athletic achievements. His appearances on “Keeping Up with the Kardashians” led to his own reality show “Khloé & Lamar.” On the surface everything seemed just fine – a couple living a storied life that most could only dream of. That is of course before Lamar’s off camera secret life was revealed on October 13, 2015 when he went into a coma and was placed on life support in a hospital because of a drug overdose. Odom is not the first national celebrity to fall from grace and certainly won’t be the last. If anything, it shows how this disease does not discriminate – it can happen to any one of us at any time. Lamar survived his near death experience. In the aftermath, family members said he was firmly on the road to recovery; but close friends latter learned otherwise. Even after a brush with death and addiction treatment, Odom continued to experience drug cravings and desires – it happens more than most realize. Believing he could not say no, Lamar recently connected with a good friend of mine- Mike ‘Zappy’ Zapolin for help. Over the years, Mike and I have spent countless hours together discussing the merits of alternative therapies for addiction. He produced the documentary film with Deepak Chopra and Michelle Rodriquez titled: “The Reality of Truth” that has millions of views on YouTube. Zappy correctly directed Lamar to Ibogaine therapy. They had to go out of the country for treatment because Ibogaine is a schedule 1 drug in the US, whereas most other countries do not specifically prohibit it or regulate it including Mexico and Canada. To put this into context, Ibogaine and other drugs including Marijuana were swept into this classification during a time of social unrest in the US. It was in the late 60’s near the pinnacle of the Hippie movement when Government officials were reaching for anything to quell the
“It’s a great day to be alive!”
~Lamar Odom two days after Ibogaine treatment. uprising. Aside from the CIA experiments at the Federal Narcotics Hospital in Kentucky in the 50’s, no formal FDA approved studies had been conducted at the time Ibogaine was banned to determine if it had any medicinal value whatsoever. Ibogaine is a natural occurring substance in the root bark of the Tabernanthe iboga shrub, a perennial rain-forest plant found predominately in Western Central Africa. For hundreds of years, Ibogaine has been safely used in religious ceremonies performed by Bwiti practitioners in Gabon, Africa to promote radical spiritual growth and resolve pathological problems. They also use it in rite of passage ceremonies, initiation rites and acts of healing. My first hands-on exposure to Ibogaine was in the mid 1990’s when Dr. Deborah Mash asked me to join her staff. Dr. Mash, who at the time was a Professor of Neurology at the University of Miami, School of Medicine, was conducting clinical trials of Ibogaine on the West Indies Island of St. Kitts. This ended up to be the only clinical trial ever approved by the FDA. Dr. Mash is one of the world’s
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leading authorities on Ibogaine. She has made it her life’s work to understand the molecule and explore all of its therapeutic values. It was on St. Kitts under Dr. Mash’s tutelage where I, like most people first exposed to Ibogaine, was absolutely floored by what I’d seen. Part of my responsibilities included preparing the patient for treatment. This afforded me a terrific opportunity to get to know them and learn about their drug abuse history. What I’d learned was that nearly all the people had been in treatment before and most had been through treatment multiple times. These people were desperate chronic relapsers who had been abusing drugs for years – some for decades – starting as early as 14 years-old. I couldn’t help but to think that for many of the people I was preparing for treatment that this was their last vestige of hope for recovery. During Ibogaine treatment, the patients go into what many call an ‘awaken dream state.’ For lack of a better definition, I call it the convergence of the conscious and unconscious minds. Ibogaine is an organic psychoactive substance that induces hallucinogenic effects. In saying this, many people become discomforted and immediately stigmatize Ibogaine because of its association with LSD. It’s like a boomerang effect where we automatically group similar entities together regardless of their differences. I’ve personally experienced both Ibogaine and LSD – I can tell you the experiences are worlds apart. Albeit Ibogaine is intense, it is not addictive and does not produce the wily LSD experience described to us in the 60s. Ibogaine tends to be introspective while other substances such as LSD tend to cause visual hallucinations in a person’s surroundings. Everyone’s Ibogaine experience is different, but most say they found themselves on a transcendent journey back in time, often to their childhood where they observe critical parts of their lives from a third person perspective. One patient told me it was like watching a movie of his life. It’s like a ‘trip down memory lane’ where a person has the strength to come to grips with all the painful emotions swept under the carpet and forgotten so many years ago. Odom had a similar experience. He mentioned he spoke with his mother, who died of colon cancer when he was 12 years-old, and to his grandmother who raised him. Lamar also mentioned to Zappy that “I realize now the bad decisions I have made in life.” This admission was a first for Odom, but fairly common in Ibogaine therapy. Once a patient was awake from treatment, it was my responsibility to sit down with them to discuss their visions and help interpret what they meant. This is a critical aspect of treatment that maximizes the experience. From this vantage point, I found that more times than not, Ibogaine therapy provides individuals with a crystal clear view of bad choices they’ve made throughout their life that contribute to the root of their addiction. There is another important aspect of Ibogaine therapy that Lamar and everyone I treated in St. Kitts experienced – no withdrawal symptoms and loss of cravings and desires to do drugs. The exact mechanisms continue to elude researchers and scientists, but it is a fact that administered correctly by trained medical professionals, Ibogaine ‘interrupts addiction’ – it essentially resets the brain to preaddiction settings. Consequently, the patient does not experience the pain commonly associated with drug withdrawal nor do they crave or desire drugs after treatment. If presiding addiction treatment protocols provide a window to recovery as any honest addiction treatment practitioner will tell you, Ibogaine opens an airport hanger door. It is that big. However, Ibogaine has a shelf-life in the system that varies. For
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some people the effects begin to wear off in about 30 to 120 days, while with others, it can be years. There is no rhyme or reason to it, it just occurs at different rates in everyone. “It’s a great day to be alive!” – Lamar Odom two days after Ibogaine treatment. When coming out of Ibogaine treatment, most people feel empowered like they can accomplish anything and everything is possible. Certainly you don’t want to put a cork in that bottle, but I also feel that it is imperative to channel that emotion and sentiment in the right direction because it has the potential to fade away in a short period of time. This is all the more reason to get into recovery treatment immediately after taking Ibogaine. Throughout my 33 plus years treating addiction, I’ve treated hundreds of individuals immediately after Ibogaine and can tell you first hand that it is light-years ahead of prevailing protocols. It is like treating a person before their addiction; someone who is alert, cognizant and eager to move forward with their life in a positive and worthwhile way. However, even with all of Ibogaine’s many putative medical values, it is not without risk. People have died in Ibogaine treatment. It is because of the underground environment many clinics operate in today and the lack of regulation, that it is difficult to put a fine point on this statistic. It is known that in many of the reported cases there were complications due to pre-existing conditions such as heart and/or liver disease, another drug in the patients system and other complexities that were the cause of death. It is also important to note that the number of Ibogaine related deaths is in no way even remotely close in size or scope to the more than 600,000 avoidable drug overdose deaths in the US between 2000 and 2016. Is Ibogaine effective in treating addiction? In a recent interview, Dr. Mash had observed, “We did 3-month, 6-month, and 1-year followups and were estimating that between 40% and 50% of our patients had remained clean after treatment. If you have one out of two people being a success, that is amazing.” Ibogaine is not recovery, but rather one giant step towards recovery.
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I’m looking forward to working with Zappy and Lamar on his recovery. Zappy has been filming Odom’s Ibogaine experience and will be producing a documentary that will be available in the very near future. John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Aftercare & Chronic Relapse Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Beach Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment, check out his websites: www.PreventAddictionRelapse.com www.HolisticAddictionInfo.com
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For the Families THIS YEAR, ASK MOMS HOW TO LOVE By Hanna Liebman Dershowitz, Esq.
At this moment in history, when we are undergoing a reexamination of what male leadership has looked like, it is fitting to examine how many of our policies have reflected not just the identity but also the values traditionally associated with male leadership. This country has pursued paternalistic and punitive policies in many realms, but most particularly in our criminal justice system. If we are looking for a way to demonstrate how to lead with our more, shall we say, maternal instincts, let’s demand a smart, simple, practical change: decriminalize drugs and instead employ a whole different kind of intervention—the kind a mother would use if her child was in trouble. This would be nothing short of redefining how we love our people in this country. Oh, and by the way, it also would save money and lives. We know what maternal care looks like in our homes. If my daughter came to me with drastically reduced grades on a report card, I would not reflexively send her to her room; keep her away from her family, friends, and learning environment; and punish her. I might instead ask her what has been going on: is she having trouble concentrating on or understanding the material; are other students being mean to her; is she sitting in the back and can’t see the board; or is something else going on? My husband and I might work with her on a plan to marshal resources needed to address any problems. Maybe extra help at school, a hearing aid, whatever we think would be best for her once we understand what is going on. We’d hug her a lot and tell her that she will feel better. This is part of how you love your child when she is having a problem. I am like every other mom: I sometimes do and sometimes don’t show up for my children in the ways they need—but I always try. I am fortunate that on my ideal day at least I would have the best intentions and be able to offer my children resources. But on our worst day I hope none of us as a caregiver would abdicate the care and lavish on the punishment the way our criminal justice system does. Just look at how our system has purported to love our collective children in various levels of crisis. I have seen it second-hand, through the experiences of mothers who have lost children to the criminal justice system or even to death because their children were in some capacity involved with drugs. In my decades of work toward ending drug prohibition, I met and now know and care about many of these women. They have had their children taken away, and have been divorced from control over or even involvement in medical decisions about care, all because of societal failures to deal appropriately with substance use. Instead of making widely available drug treatment, job training, and other services to people who need a gentle nudge—the kind moms are good at—to help keep our young people on track, our criminal justice practices tearing families apart at their most vulnerable moments and wrench away whatever stability they have established. The usurpation of mothers’ roles (I use mothers but intend to include fathers and all women and all allies to this style of governance) permeates our justice system and all of our governing systems. In all of these areas we have failed our children, and as moms, we have the mandate to end this as surely as we must continue to band together to change workplace behavior toward women. Rather than sinking into bitterness, mothers I know are building mom-entum for a movement to restore sanity to our overly harsh, wasteful, and ineffective drug laws. It stands to reason: mothers
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were the driving force behind the repeal of alcohol Prohibition, and they will be the backbone of the necessary repeal of modernday prohibitions that cause more problems than they solve. Some reforms mothers can also champion now are access to medicationassisted treatment, distribution of life-saving Naloxone, and creation of safe injection facilities—sensible harm-reduction measures to make our current prohibition regime less damaging to our communities and our children. Because we need so desperately to change our drug policies, I have been a member of the Moms United to End the War on Drugs campaign of A New PATH (Parents for Addiction Treatment and Healing) since its inception a decade ago. Moms United’s mission is to end the violence, mass incarceration, and overdose deaths that are a result of current punitive and discriminatory drug policies. It is important to me as a mother that my children grow up in a country that rejects these ineffective and damaging drug war policies. So as our public debate looks at the behavior of the men in power toward women in the workplace, let’s not forget how that paternalistic instinct has informed policies like the war on drugs, and led us down a path of moral bankruptcy. Instead, let’s look to moms for credible policies. Moms United has crafted a good set of principles to start with: https://engage.drugpolicy.org/secure/ sign-petition-moms-united-end-war-drugs-bill-rights. But in the name of love, let’s really commit this year to rethinking the punitive policies we have embraced. Yes, we discipline our children; but we also encourage them, teach them, and expose them to positive influences. Even when they falter or misbehave, we offer them love and positive reinforcement for better choices. We hug them even if they have disappointed us. We all need a big hug these days. Hanna Liebman Dershowitz is a writer and an attorney who has focused her legal career on criminal justice reform, particularly drug policy. hannadersh@gmail.com 310-754-9180, 212-499-9131 Hannadersh.wixsite.com/home
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IMPORTANT HELPLINE NUMBERS
A New PATH www.anewpath.org Addiction Haven www.addictionhaven.com Bryan’s Hope www.bryanshope.org CAN- Change Addiction Now www.addictionnow.org Changes www.changesaddictionsupport.org City of Angels www.cityofangelsnj.org FAN- Families Against Narcotics www.familiesagainstnarcotics.org Learn to Cope www.learn2cope.org The Long Island Council on Alcoholism and Drug Dependence www.licadd.org Magnolia New Beginnings www.magnolianewbeginnings.org Missouri Network for Opiate Reform and Recovery www.monetwork.org New Hope facebook.com/New-Hope-Family-Addiction-Support-1682693525326550/ Not One More www.notonemore.net/
ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG 818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG 800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG 800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG 800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG 800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM 561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET
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LIVING BEYOND
By Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.
THE HIJACKING OF A PRECIOUS MIND “I do not ask the wounded person how he feels, I myself become the wounded person.”
~ Walt Whitman
As a clinician, I have always believed that at the heart of an addiction is a psychological history. I have rarely met an individual who has begun using without a significant history. It is not to say that some addicts are without a psychological predisposition, but I have never encountered an individual who was struggling with an addiction that began the addiction without a catalyst. It is intriguing to me that there seems to always be a critical turning point that an individual finds themselves transforming from a user to an addict. The user is almost always someone who is struggling with poor self-image, self-esteem and sense of self-worth. Whether the addict is struggling with a substance issue, or a number of other addictive issues- sexual desires, gambling, computer, etc.; the addict almost always finds comfort in his or her addictive habit. THE ADDICTIVE HABIT, THE BRAIN DISEASE According to the National Institute on Drug Abuse (NIDA) “Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain—they change its structure and how it works.” Arguably, the brain disease is not like other biological and organic brain disorders such as Alzheimer’s, Schizophrenia, Parkinson’s, diabetes, and strokes, rather the brain disorder itself occurs after the use of a substance. It is sort of like the argument of the chicken and the egg: would the brain disorder have occurred if the user had not started using originally? Originally, the addict is not drawn to a specific substance based on the need for that specific substance, but rather, the substance in most cases is accessible. Thus, the user chooses the substance on a matter of relative convenience, affordability, likability and a personal craving. THE HIJACKING OF THE BRAIN Most commonly, the addict enters the realm of addiction without the intent of becoming addicted. The user may find comfort, satisfaction, and a refuge from his or her life. The user is often trying to escape life or a specific element of his or her life. As a clinician, I have never met an individual who chooses to become an addict. In time, the mind of the addict becomes hijacked by the allure and the comfort of the substance. In effect, the user is no longer tempted, but is at the mercy of his or her addiction. According to the NIDA, “with the continued use, a person’s ability to exert self-control can become seriously impaired; this impairment in self-control is the hallmark of addiction. Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of addiction.” THE REPERCUSSIONS OF ADDICTION While we understand that substance addictions can lead to countless deaths and individuals being hooked on drugs, we often neglect to take into account the other variables such as: familial and spousal abuse, criminal activities, child endangerment and neglect, and the overall breakdown of a
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society. The repercussions of addictive substances are decaying the very fibers and morality of our society. THE REWIRING OF THE BRAIN The psychosocial life of the addict is not only made vulnerable to the addictive habit, but the physiology of the brain is threatened. “Addiction causes hundreds of changes in brain anatomy, chemistry, and cell-to-cell signaling, including in the gaps between neurons called synapses, which are the molecular machinery for learning.” The restructuring and rewiring of the brain is responsible for drastic personality changes. Over time, the addictions are capable of altering the perceptions, attitudes and worldviews of the addict. The changes can lead to a decrease in productivity and performance as an employee or as a student. Unfortunately, many who are addicted lose primary social supports; while developing social networks that are merely interested in fueling the addictive habit. Thus, the ability to triage the individual and assist them with overcoming the addiction decreases. The probability of recovery diminishes with time and the longevity of use. RESCUING THE ADDICT As we consider the recovery process, we must remember that the addict’s biopsychosocial makeup has been compromised. For many, the challenge becomes commitment to the treatment process. It is important to recognize that the addict’s makeup has been compromised with creating a plan for care and treatment. RECOGNIZING THE RISK FACTORS For many, “risks of drug abuse increases greatly during times of transition. For an adult, a divorce or loss of a job may lead to drug abuse; for a teenager, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations.” While an individual may be at risk, it is not an indication that they will become an addict. There are a number of protective factors that can prevent someone from becoming an addict. The protective factors include: family support; financial stability; steady income; having set ambitions and goals; positive relationships; academic support and success; and a feeling of personal self-worth and value. REGAINING CONTROL Whether or not an individual has developed an addictive habit; it is of critical importance that they have a support system in place. Support systems may not ensure that someone will thrive, but they will act as insulators protecting an individual from compromising situations. A support system may include anyone interested in the welfare of another. A support system may be comprised of any number of individuals including: family, friends, peers, and professionals. Healthy social support can help an individual maintain sobriety or avoid temptation. When we are receiving such support, we feel empowered, healthier, and capable of managing our lives. Research has shown that healthy social support can reduce features of anxiety and depression. We are enabled to manage our affairs, cope, and make healthier decisions when receiving healthy social support. Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com References Provided Upon Request
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ADDICTION AMNESIA By Michael DeLeon
Writer and Philosopher George Santayana is attributed with one of the most famous insights about progress, change and retained experience. He stated, “Those who cannot remember the past are condemned to repeat it.” His famous quote has been repeated, tweaked and challenged on numerous occasions over the years, and it’s one of those oftenreferenced phrases by numerous people, famous and non-famous alike. One of the most famous challenges to the quote’s logic came from Socialist and novelist Kurt Vonnegut where he stated, “I’ve got news for Mr. Santayana- we’re doomed to repeat the past no matter what. That’s what it is to be alive.” Whether Mr. Vonnegut is correct or not, you must consider the importance of learning from the past. If we cannot remember the lessons we learned, or worse yet, if we ignore those lessons, then it likely puts us in a position to learn those mistakes again. Why re-learn lessons that are already learned? Why go through havoc when havoc already taught us what we could’ve avoided in the first place? Why learn from our mistakes, and then subject ourselves to the same lessons? That doesn’t seem too logical to me. It certainly doesn’t make sense when it comes to addiction. I don’t agree with Mr. Vonnegut. I believe that, “to be alive” as he put it is to live a life where I don’t have to learn the same lessons over and repeatedly. This concept has presented itself to me in more prevalent ways over the past few months. As America’s addiction pandemic worsens and the societal cost increases, I see more and more people that have amassed years in recovery from addiction lose their life to a relapse. Many people are left puzzled, completely devastated, asking the question, “Why?” Relapse after years of recovery just doesn’t make sense to me and the only answer I’ve been able to come up with is that people in recovery from Addiction fail to remember the horrors of that addiction, and the relapse is no longer a lesson. I call it “Addiction Amnesia” – forgetting the horrors of addiction and relapsing in that addiction. “Those who cannot remember the past are condemned to repeat it.” In today’s pandemic, that relapse increasingly means DEATH!
“Addiction Amnesia” can be deadly. We must remember the horrors and downside of addiction and never forget the lessons of that stage in our lives. We can never forget what we put ourselves through and what we put our families through. We can never forget what we lost, and in our recovery, what we gained. Many people live by the adage, “Forget the past, don’t worry about the future, live in the present”. While I embrace the premise of the saying, I don’t believe it applies to every aspect of life, especially recovery. Far too many of us live life defined by the choices we made in the past, by our addiction. This shouldn’t be the case. Each new day presents opportunity to become a new person on a new road destined for a new future. But completely forgetting the past is a huge mistake. When you simply forget the past, you miss out on its fullest potential. I believe you forget the understanding of your strength and the respect of your weaknesses. I believe we lose sight of the purpose we have found and the causes we’ve embraced through our struggles. I believe we forget those environments that threaten us and the toxicity of the relationships which brought us harm. I believe we forget the temptations that trip us and the pursuits that distracted us. I believe we return to the habits that harmed us if we fail to remember them. In recovery, we cannot forget the past, we must learn from it. We can learn from it by asking the right questions. There are life-giving lessons we can learn from the lessons of our past. We can never define ourselves by our past, but it would be very sad, and possibly deadly, to forget our past completely when it offers so much potential for our life, and our future. Michael DeLeon is the Director and Producer of the films” Kids Are Dying”, “An American Epidemic”, “MarijuanaX”, and “Road to recovery”. His fifth documentary will be released in 2018 called, “Higher Power”. His memoir, “Chasing Detours will also be released in 2018. Michael is the founder of Steered Straight Inc. a nationally-recognized educational program and a national advocacy organization called, “recovery Army”.
My third grade teacher once told me that, “there was no education in the second kick of a mule”. I didn’t understand the saying at the time, but years later, it came back to me with full understanding. She was a teacher, but she was the wife of a farmer. They had a big farm with lots of animals and they had a few mules. When you are around a mule, you learn pretty quickly where you should and should not stand. Standing directly behind that mule is often a bad place to be. When that mule kicks you with his hind leg, it is a very painful experience. If after that, you get kicked again, there’s no new education. You just didn’t learn anything the first time. That advice has always stuck with me through my adult life. It has sometimes come up in my mind as a reflection after “getting kicked” a second time in life. Making the same mistake repeatedly really makes little sense. As a conscious, educated adult, I shouldn’t have to learn the same lesson multiple times. In today’s addiction pandemic, there are a plethora of people who profess to understand addiction, and further yet, claim to understand how to solve it. Relapse is one of those phenomenons where many people weigh in to try to explain why it happens, and how to prevent it from happening again. Synthetic chemicals and fentanyl are changing the outcome of much of the relapse repetition because more and more of the relapses taking place in America are literally ending people’s lives. More and more people are literally losing any possible second chance to come back from a relapse. The expression, “One more time” is starting to take literal hold and people die from that one more time. We must understand that to prevent ourselves from losing our lives, we can no longer accept this new-age trend that relapse is part of recovery. It doesn’t have to be, and in this day and age, it can’t be. A relapse might be the end of not only our recovery, but our life.
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FLORIDA’S MARCHMAN ACT ASSURES CONFIDENTIALITY By Joe Considine, Esq.
where access was granted to the public. In our practice, we have always taken the position that there should be no disclosure whatsoever of anything to do with a Marchman Act filing or disclosure of any pleadings or records. It has been my opinion that the mere mention of a person’s name in the context of a Marchman Act case filing on the Clerk’s docket is a violation of federal and state law. It was obvious that there was a need for uniformity and that had to come from the Legislature. The Marchman Act was amended in 2017. Section 397.6760 makes it very clear that Marchman Act court records are confidential. All petitions for involuntary assessment and stabilization and all court orders and pleadings are confidential and exempt from the Public Records Act. The public is not allowed access to Marchman Act records or pleadings. Personal identifying information may not be published by the Clerk on a court docket or in a publically accessible file. There is disclosure permitted but only to limited classes including the parties, their attorneys, guardians of the impaired individual, and the individual’s treating health care providers. A person or entity other than the classes of people mentioned above may gain access to Marchman Act records upon a showing of “good cause.” Since this law is new, there is no specific case which interprets “good cause” in this instance. However, there are cases which have construed “good cause” in other settings
TALKING WITH AN ADDICT: ARE YOU A LAMB, LION OR OWL? By Judy Voruz, MA, CADCII, MAC, SAP
Continued from page 6
always keep in mind that your thoughts about their addiction and their situation is different from who they are. If you have decided to maintain a relationship, then the easiest and most effective way to stay connected is to simply listen to them. Listen for what they are saying on a deeper level. Listen for some truth or logic in how they see their experience. This will provide the context and basis for a conversation about the way forward and the possibility of change. The stance and attitude you assume in talking with your loved one makes a huge difference in how they will respond to you and your efforts to support them to change. In truth, there is no one right way to talk to your loved one about their addiction. Sometimes, being soft and flexible like the lamb may work. Other times, the tough love of the lion is needed. My bias is toward the way of the Owl because it honors your loved one’s experience and gives them space for insight and self-discovery. As you deepen your understanding of the universal truth that feelings are created by thought in the moment, not by the person, the situation or the behavior, you will be more and more in touch with the source of wisdom, clarity and well-being. Any blame, shame or guilt will give way to a sense of compassion for your loved one who is also simply caught in a misunderstanding about the source of their experience. Guided by this deeper aspect of yourself, you will have a larger capacity to interact with your loved one in a way that provides the best support for them to let go of their addiction. Judy Voruz is a family counselor who has specialized in helping families and individuals struggling with addiction since 1985. She holds a Master’s Degree in Counseling Psychology and is a Certified Alcohol and Drug Counselor. For five years, Judy served as a family counselor at the world-renowned Hazelden/Betty Ford Foundation, where she developed curriculum for their residential family program. judy@wisecaring.com www.wisecaring.com
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Continued from page 19
involving treatment information and presumably those cases may provide some guidance in this instance. In those cases, “good cause” is a very difficult matter to show. Disclosure of information about treatment and records of treatment is strongly disfavored as a matter of public policy by the courts generally. There are very good therapeutic reasons for this policy. As a society, we want people with substance use disorder to get help. It is important to their recovery that these individuals are assured and feel confident that the fact they have entered into treatment; matters they discuss with therapists; and how they do in treatment, should not be made public. Hence, there are protections against any disclosure present in federal HIPPA laws and the protection of non-disclosure contained in the Florida Evidence Code and other statutes at the state level. There are additional changes which are needed in the Marchman Act to make it more workable for families and more responsive to the needs for recovery. We shall address some of those in subsequent articles. Joe Considine has practiced law in South Florida since 1983. His practice is limited to family law and addiction related law including the Marchman Act. Joe works extensively with families whose loved ones have substance abuse and mental health problems as an attorney. www.joeconsidinelaw.com
RECOGNIZING THE CHOICE OF RELAPSE PREVENTION By Maxim W. Furek, MA, CADC, ICADC
Continued from page 18
8. Exercise. Go for a walk, jog, climb mountains, exert yourself. Do something physical as a means of diverting negative focus to another place. Connect with all of the powerful natural highs surrounding us. Physical movement stimulates the neurotransmitters, flooding the central nervous system with healthy natural agents. 9. Learn to relax. Meditate. Feel the serenity. Listen to the stilled voice within. Experience the peace and tranquility, feel the calming of the cravings and search to satisfy your addiction. That is your real self, the one free of fear, competition, frenetic pace and all the other ills of the world. 10. Transform. Allow yourself to transform into the safe, beautiful individual that you are, an individual who will experience rebirth and the joy of healing. Witness the shifting of power from the addiction to abstinence as your life regains balance and stability. Born into this world, it becomes our quest to discover our place in the universe as we learn, grow and evolve into spiritual completeness. Maxim W. Furek, MA, CADC, ICADC has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book Sheppton: The Myth, Miracle & Music blends facets of the psychological, miraculous and supernatural in a true ordeal of survival. Learn more at shepptonmyth.com References Provided Upon Request
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THE THREE MOST POWERFUL WORDS IN ANY RELATIONSHIP: “I TRUST YOU” By Jim Holsomback, MA and Louise Stanger, Ed.D, LCSW, CDWF, CIP
Continued from page 10
met with some reciprocity. This comes easy for some people and more difficult for others. Being clear about what we need, why it is important, and understanding the needs of the ‘other side’ can lead to effective negotiation, reciprocity and a sense of connection that helps bring both parties closer together. Think about being a parent. Your child asks you for something: a sleep over at someone’s home, borrowing the car or asking for money. For co-parenting families, discuss the decision with your spouse before giving a response and reply in a united fashion. Nothing fractures a relationship more than having someone say “yes” and the other person giving a firm “no”. How do you establish trust in your personal or professional relationships? Are there components that you have found essential in establishing effective, trustworthy relationships? Pay attention to relationships where you have accumulated a lot of ‘trust in the bank’ as well as those that you feel are particularly trustworthy to evaluate what components are consistent in those relationships... Let us hear from you so that we may benefit from your experiences Jim Holsomback is the Director of Clinical Outreach and Marketing at McLean Hospital and Program Director at Triad Adolescent Services in Lexington, MA Jim has served as The Director of Adolescent Educational Services and the Coordinator of Adolescent and Young Adult Placement Services. Dr. Louise Stanger is a nationally recognized expert in the mental health and addiction field. She is also an expert in Sudden Death, grief and loss and had the distinction of working with the Widows and Widowers of 911. She has been the PI or Co-PI on over 4 million public NIH- NIAA or US Dept of Education grants related to alcohol prevention. Louise is a Published author of Falling Up A Memoir of Renewal, Learn to Thrive – An Intervention Handbook. Currently, Dr. Stanger is the Consultant and creator of Driftwood Recovery’s Courageous Family Program, a chronic pain, mental health and substance abuse facility in Texas. She continues to speak all over the country and creates original curriculum for conferences. www.allabout interventions.com.
NEW DEVELOPMENTS IN MEDICATION ASSISTED TREATMENT (MAT) By Raul J. Rodriguez M.D., DABPN
Continued from page 12
Strong motivation and treatment compliance are essential for successful treatment of any type. Knowledge of available treatment options is equally as important. Anyone who seeks treatment needs to be informed and not limit his or her options due to ignorance or fear of something new. Individuals suffering from addiction should be encouraged to do their own research and speak to qualified professionals when making major treatment decisions. Medication Assisted Treatment has come a long way with some key developments in just the last 12 months. Considering the increasingly lethal evolution of the opioid epidemic, these new forms of MAT could not have come at a better time. MAT is an invaluable tool available to patients that make the difference between life and death. Dr Rodriguez is the founder and Medical Director of the Delray Center for Healing, the Delray Center for Brain Science, and the Delray Center for Addiction Medicine. He is board certified in both Adult Psychiatry and Addiction Medicine, with a clinical focus on Treatment Resistant Depression, Bipolar Disorder, Anxiety Disorders, Eating Disorders and Addiction. The Delray Center is a comprehensive outpatient treatment center that incorporates the most advanced psychotherapeutic and medical modalities, such as Medication Assisted Treatment (MAT), Dialectical Behavioral Therapy (DBT) and Transcranial Magnetic Stimulation (TMS), in the treatment of addiction and complex and dual-diagnosis cases. www.delraycenter.com www.delraybrainscience.com www.mydrugdetox.com
FOUNDATIONS EVENTS
INNOVATIONS IN BEHAVIORAL HEALTHCARE NASHVILLE, TN | JW MARRIOTT
RESET THERAPY: AN ALTERNATIVE TREATMENT FOR ADDICTION By George Lindenfeld, Ph.D.
Continued from page 8
proactively in order to keep the urge from reappearing. Some therapists have made RESET-Addiction available in their office for a client to self-administer on an as-needed basis as a preventive measure. Others advise purchase of the equipment so that it is available to the patient whenever necessary. Once a patient has successfully reduced the craving from a treatment session, the therapist should advise that if the craving seems to be returning, place attention and focus back to where it was during the previous session, and remember/hum the resonant sound. I have had several reports that the effect often re-neutralizes the craving. Dr. George Lindenfeld is a Diplomate in Clinical Psychology, trauma and anxietal expert, author, RESET Therapy trainer and speaker on PTSD and anxiety issues. www.drlindenfeldresettherapy.com Reference Provided Upon Request
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Up to 14 CE and CME credits will be available for psychologists, interventionists, therapists, psychiatrists, social workers, addiction counselors and medical personnel in the behavioral health field. Pending CE board approval.
KEYNOTE SPEAKERS BECCA STEVENS
Author, speaker, priest, social entrepreneur, and founder and president of Thistle Farms, which is a movement dedicated to supporting female survivors of trafficking, prostitution and addiction
MILES ADCOX
Owner and CEO of Onsite and Milestones at Onsite, author and speaker on topics such as emotional leadership, inspiration, communication, organizational health, creative flow, family systems, trauma and emotional wellness
July 2-3, 2018
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Elan Recovery + Wellness utilizes adaptive testing for real time data measurements to improve outcomes for our clients.
At Elan Recovery + Wellness, we employ only evidence-based treatment components proven to produce the achievement of long-term recovery from addiction and co-occurring disorders. Our programs are led by Master’s level clinicians with a proven work history of successful experience in addiction and mental health treatment.
ENDEAVOR – Elan’s traditional program for those struggling with substance abuse and co-occurring disorders. Elan focuses on both the physical and psychological emotions driving addiction. VALOR – Elan’s non-denominational faith based and Christian-centered recovery program. Welcoming men and women of all faiths and religions this program helps individuals reconnect with their faith. TRIUMPH – Elan’s program for individuals in need of a trauma informed care approach to their treatment and have identified trauma in their history.
Elan...Where Excellence Drives Performance elanrw.com 32
741 US-1 NORTH PALM BEACH, FL 33408
Call 844-277-4686 or Text 954-914-1967 www.thesoberworld.com