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THE STRESS FREE FORMULA: HOW USING EMPATHIC COGNITIVE BEHAVIORAL THERAPY REDUCES ANXIETY AND CREATES INNER CALM By Arthur P. Ciaramicoli, Ed.D., Ph.D.
FLORIDA’S MARCHMAN ACT TO SERVE AS MODEL FOR COUNTRY’S OPIOID EPIDEMIC? By Joe Considine, Esq.
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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 firstname.lastname@example.org 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. To all you Moms - Happy Mothers Day. 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,
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THE STRESS FREE FORMULA: HOW USING EMPATHIC COGNITIVE BEHAVIORAL THERAPY REDUCES ANXIETY AND CREATES INNER CALM By Arthur P. Ciaramicoli, Ed.D., Ph.D.
The amount of stress in America and throughout the world is rapidly rising. We work too much, sleep too little, love with half a heart, and wonder why we are unhappy and unhealthy. Half of Americans indicate they lie awake at night due to stress, while three quarters experience stress symptoms—either physical, psychological, or both. Roughly 70 percent of Americans hate their jobs and feel disengaged, according to a 2013 Gallup poll, while two thirds of office visits to primary care doctors are stress-related. According to the World Health Organization, Americans die sooner and have higher rates of disease than 16 other affluent countries. We know that personal and professional success does not come without sacrifice, but it should not ruin our health and leave our relationships devoid of love and intimacy. Empathic CBT will help you take steps to free yourself from the obsession to use addictive substances; it will allow you to begin the process of finding meaning in your work, and in your relationships. We need to go beyond material reward to being able to establish genuine, healthy accomplishments throughout all aspects of life. Many people throughout the world are discovering that what they thought would bring them happiness has encapsulated them in an emotional prison, often an addictive prison, but there is still a path forward. The new combination of CBT, the power of empathy and the addition of how to change brain chemistry naturally is an integrative therapeutic method I have developed over the last 35 years. This unique psychology perspective will provide you with the most comprehensive approach to balance your mental and physical health while reducing stress significantly. CBT corrects distorted thinking, and empathy calms the emotional brain, so we can use this capacity to perceive others and ourselves accurately and thoughtfully. How we perceive is directly related to how much stress we accumulate. In addition, this approach teaches you how to produce your own natural brain chemicals that create calm, focused energy to do and be the best you can be. These three components produce a synergy that enhances our lives and releases our potential. Studies indicate that Americans have fewer friends; trust has decreased as well as the degree of empathy shown to others, while prejudice has increased and race relations have deteriorated. We have become a society that places a great emphasis on achievement, status and appearance and far less on character and relationships. Many people have learned how to achieve, but they do not know how to love and make lasting deep friendships, and this lack of love and relational connections is the missing ingredient that plagues their lives and creates addictive patterns. Our political climate of the past year, with presidential candidates emphasis on aggression, insults, lying and lack of integrity is symbolic of the lack of empathy, low trust and high stress in our current society. The Three Components of Empathic CBT Empathy Empathy is the capacity to understand and respond to the unique experiences of another. Empathy is not an emotion or a feeling but a capacity that is innately present. We are born with this capacity, and if not developed, it will atrophy like an unused muscle. In recent years, research on empathy has exploded. We now know we have empathy neurons, called mirror neurons. Mirror neurons send messages to our limbic system, the emotional center of the brain. The empathic connection then releases the neurotransmitters dopamine (creating a sense of desire), endorphins (pleasure and relaxation), and oxytocin (compassion and connection). We also know that stress, both acute and chronic, impairs empathic
accuracy, as worry about stressors draws a person’s intellect away from deciphering behavioral cues in everyday interactions. Because empathy is truth oriented and gives us the opportunity to perceive clearly and objectively, it is the ideal complement to Cognitive Behavioral Therapy. The deep emotional learning that holds onto past hurts—the brain’s negative feedback loop—can only be released and understood permanently with empathy. When we are hurt we are emotional and stressed, cortisol is released, which records our experience in a deep part of the brain. We then perceive similar situations to the ones that hurt us through our old emotions, not through our thoughtful, more accurate empathic lens, thus making for distorted perceptions. We put old faces on new faces. We can correct distorted thinking with CBT techniques, but the emotional part of the brain will return to negativity over time if the situations that hurt us deeply are not understood and resolved on both the emotional and cognitive level. Several outcome studies have indicated that CBT is effective in the short run, but traditional talk therapies are more effective in the long term. Combining the use of empathy with CBT assures the best outcome with the least amount of time. Brain Changes Do you remember every time you were hurt deeply in your life? I am guessing your answer is yes. Do you remember each time you have been given a compliment in your life? Probably not. Your hurts are stored in the emotional center of the brain, buried deeply so you will be protected in the future. Problem is they lead to theories about human nature. A negative view of life is formed as a result of hurts experienced in childhood or adolescence and this negative view is re-activated when you are stressed in adult life. A negative view creates cognitive bias, and you live your life believing the distorted fictional story you wrote about yourself at a time when you could not possibly see yourself and you’re potential accurately. This negative perspective creates stress and the stress hormone cortisol is prevalent in your system. High levels of cortisol kills neurons in the memory center of the brain, the unfortunate result is your ability to think clearly or creatively is compromised. Cortisol also binds negative memories, making for a stubborn entrenched view of yourself that is not very flattering. Empathic CBT will teach you how to change neurochemistry naturally, producing the hormones that provide a calm, focused state of mind rather than those that cause distress and discomfort. CBT CBT has been documented as being effective with depression, anxiety, eating disorders, low back pain, substance abuse, Continued on page 30
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GAMBLING: A BAD BET FOR YOUNG PEOPLE By Elizabeth M. George
“We finally found something for kids to do that is exciting, entertaining, and harmless…lets organize a ‘casino night’ at the high school”. Not so, according to scientific studies. Research reveals that 6% of young people and young adults have a gambling problem – compared to 1% of the adult population. Kids Don’t Gamble…Wanna Bet? Gambling is promoted with exciting images of instantaneous wealth, power, status and freedom – what is there not to like for a teen? Yet, for many young people, gambling has little to do with money. In reality, many young people gamble because of problems at home, low self-esteem, role modeling and avoidance of pain and grief. Problems at home and role modeling For teens with an unstable family life, such as parental alcohol or drug addiction, violence or abuse, gambling can be an escape from those painful realities. Gambling can also be family trips to the race track, poker playing, fantasy sports leagues, lottery tickets given to teens by respected adults, or bets on sports events and football/ basketball boards. These activities are all gates through which teens first enter the exciting and magical world of gambling. Unfortunately, these events usually come without any warning to the teen of the addictive nature of gambling. Research indicates that the adult role model gives no warning because they, too, are unaware of the addictive potential of gambling. Research reveals that when parents were asked about their children’s gambling (age 15 or less), only 8% indicated that they would be very concerned about their child’s gambling behavior. Low Self-esteem and Pain and Loss People love winners! For those young people who lack self-esteem, winning a bet provides a powerful boost in confidence and peeresteem. Most of us will go through loss and trauma in our lives. For a teen, trauma and loss can include loss of a job, position on a sports team, breakup of a relationship, divorce of parents or death of grandparent or friend. Most work through the loss with help of a support group of friends or family. Others who may have low self-esteem or may feel isolated and without friends, may turn to something to ease the pain - to anesthetize themselves from the unbearable loss. That something with which they medicate could be alcohol, drugs or gambling. College Students and Gambling College students are among the most vulnerable when it comes to gambling. A combination of free time, living away from home, online gambling, easy access to student loan money and credit cards; doesn’t mix well. Approximately 75% of college students gambled during the past year – some gambled legally, some did not – with 18% of students gambling weekly or more frequently. The most popular forms of gambling for this group include; lotteries, card games, sports betting, and fantasy sports. Research suggests that casino nights and poker tournaments are also popular at special events promoted by campus organizations. There are state lotteries and some casinos that allow 18 year olds to play, but the real cause has been the rise of online gambling. The Unlawful Internet Gambling Act of 2006 tried to restrict online gambling, but fantasy sports were declared a “game of skill”, rather than a game of chance, and were excluded from this regulation, giving way to an explosion of daily fantasy sports leagues. A credit card is all that it takes for a college student, or someone younger, to get wrapped up in the world of online gambling. Warning Signs of a Gambling Problem In a manner similar to other addictions, there is a progression to the
addiction to gambling. It is important to know the warning signs that may lead to more desperate behaviors if gambling continues. ● Frequent unexplained absences from classes ● Sudden drop in grades ● Progressive preoccupation with gambling ● Withdrawal from friends and family ● Visible changes in behavior and mood ● Decline in health and increased symptoms of depression ● Lies about gambling behavior ● Feels compelled to chase losses – with even more gambling ● Unsuccessful attempts to cut back or stop gambling ● Gambles to escape problems ● Exaggerated display of money or possessions ● Unexplained debt ● Borrows money to gamble ● Feels need to increase betting amounts Universities Step up to the Plate According to recommendations from the report, Gambling Behaviors, Beliefs and Motives among College Students in Ohio, “Campus counselors need to start asking about and screening for problem gambling with all students who come to the counseling center with any mental health or substance use issue given the high correlations for co-occurring disorders. Campus counselors need to seek training and certification in the delivery of problem gambling clinical services.” For example, the American Academy of Health Care Providers in the Addictive Disorders offers certification in drugs, alcohol, sex addiction, eating disorders, as well as gambling disorders. The University of Missouri program, Keeping the Score, was founded to collaboratively develop strategies for promoting positive, healthy choices among Missouri’s college students. The coalition, Partners in Prevention recognized the importance of understanding gambling is not a risk-free activity and that it is becoming increasingly important to learn risk factors, warning signs and strategies to protect yourself or someone you care about. The University of Denver expanded its Alcohol Council to include four other high-risk behaviors, including gambling. The goal is to be cognizant about high-risk behaviors among students that impact academic and personal success in a college environment. Oregon State University recognizes that gambling is a student health issue and has incorporated gambling and gambling disorders into its Student Health Services website. The gambling section covers: ● Facts on college gambling ● Problem gambling and warning signs ● Tips for safer gambling ● Treatment options for problem gamblers. Continued on page 30
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FLORIDA’S MARCHMAN ACT TO SERVE AS MODEL FOR COUNTRY’S OPIOID EPIDEMIC? By Joe Considine, Esq.
“The Hal S. Marchman Act was the first law of its kind in the country to get substance abusers into treatment via the courts.” The opioid epidemic has gripped the attention of the nation and we are increasingly hearing calls for drastic action. Several states have declared a public health emergency. Unfortunately, for Florida residents, there is a concern about how tourism will be affected by such a declaration. Respected veteran New York Times columnist, David Brooks, wrote that the opioid epidemic requires that we confront it as the scourge that it is. According to Mr. Brooks, there are roughly 2.5 million Americans addicted to opioids. Between 1999 and 2015, fatal overdoses soared from 8,200 annually to 33,000. In the last two years, more Americans died of opiate addiction than died in the entire Vietnam War. We are feeling it locally as well. The Palm Beach Post reported this week the staggering increase in the number of overdose deaths. “Every 15 hours last year, someone died of an opioid overdose in Palm Beach County, nearly double the rate of murders and fatal car crashes. The 590 opioid overdose deaths in 2016, an all-time high for the county, are nearly twice as many as the year before, according to the Post’s analysis of records from the Palm Beach County Medical Examiner’s Office. “That’s just a phenomenal number,” said Dr. Michael Bell, the Palm Beach County medical examiner. “I don’t see any stop.” That is the problem. Treatment – critical to recovery – is lacking. But as David Brooks pointed out, 90% of those with opioid disorders do not get treatment. Of those that do, “something like half of all sufferers drop out of treatment within a few months”. Brooks concluded: “It might be worth thinking about involuntary commitment too.” Florida’s Marchman Act may serve as the model for the country to address the issue of involuntary commitment in a healthy and constitutional way. Dr. Sally Satel, psychiatrist and lecturer at Yale University School of Medicine who has treated people addicted to heroin for a quarter century, recently wrote an article about the opioid epidemic for the The Wall Street Journal: “I speak from long experience when I say that few heavy users can simply take a medication and embark on a path to recovery. It often requires a healthy dose of benign paternalism and, in some cases, involuntary care through civil commitment.” Studies by UCLA and the National Institute of Mental Health in the 1990s and later studies which were published in the American Journal of Addictions (Use of Coercion in Addiction Treatment, January-February 2008) have strongly suggested that court sanctioned treatment is at least as effective, if not more effective than voluntary treatment, which is not court ordered. Florida’s Marchman Act provides the legal process for involuntary commitment for substance abuse. The State of Florida has created a law which is both sane and constitutional to help substance impaired individuals and individuals with psychiatric problems. The Hal S. Marchman Act was the first law of its kind in the country to get substance abusers into treatment via the courts. The law applies to Florida residents and non-Florida residents who are in Florida however briefly. Many treatment professionals around the country bemoan the lack of such a law in
their home states. Florida’s Baker Act provides for the involuntary commitment of individuals with psychiatric issues who are an imminent danger to themselves or others. The Marchman Act allows family members or friends to obtain court orders which can keep the addicted loved one in a structured environment for up to nine (9) months. The hope is that while in a safe and caring treatment facility for this lengthy period of time, the former abuser can acquire enough skills coupled with good nutrition, rest, medical attention, to navigate life without returning to substance abuse. This happens with time. The Marchman Act gives that time to the substance abuser. United States Surgeon General Vivek Murthy and mental health professionals tell us that addiction is a disease of the brain. The addict’s dopamine receptors are so highly and persistently stimulated by the use of substances that they stunt the executive decision making function of the prefrontal cortex (the part that tells the addict to stop using). It can take 12-18 months of abstinence for the creation of healthy neuropathways and for dopamine receptors to “quiet down” so that the usual pleasures of life – a beautiful sunset, a baby cooing, exercise, and tasty food – are satisfying. In my law practice, I see the effects of court ordered moderate and longer term treatment upon individual substance abusers who wanted no part of treatment and had to be compelled to treatment by the court. In many instances, these people know their lives are a mess and they do not like what they are doing to themselves but they could not imagine life without substances - their best friend. Often, in many instances, we see the person weeks later with a much healthier attitude and appearance than the person we first dragged into court. They are grateful that their families stood up for them. Also important is addressing family issues, such as enmeshment and codependency. Some family members will love the substance abuser right into a grave. Family members worry that the addict will be upset with them for taking action to save the addict’s lives. In some instances, family members think that the addict can be reasoned with to go to treatment. Unfortunately, many addicts do further damage to themselves and some even die while concerned family members take the time with trying “to reason with” or deal with their fear of “upsetting the addict”. These concerned friends and family need to know that the executive decision making part of the brain of the addict is not working and that the family member/friend needs to act in the best interest of the substance abuser by having them court ordered to treatment. They also need to know that once the addict is in treatment for a period of time, in many cases, the addict is relieved and grateful that the loved ones had the courage to act on their behalf. Continued on page 30
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SCHIZOPHRENIA AND SUBSTANCE USE DISORDER: THE SPLIT MOLECULAR GENETICS OF DOPAMINE AND ENDORPHINS By Kenneth Blum, Ph.D.
Schizophrenia Ranks among the top 10 causes of disability in developed countries worldwide. The prevalence rate for schizophrenia at any given time is the number of individuals affected per 1,000 total population in the United States, that figure is 7.2 per 1,000, approximately 1.1% of the population over the age of 18. At any one time, as many as 51 million people worldwide have schizophrenia. This means that a city of 3 million people will have over 21,000 individuals who have schizophrenia The Relative Prevalence of Schizophrenia
The major form of treatment is the known antipsychotics which favor blocking of dopaminergic activity, particularly in the dopamine D2 receptor sites. This article explores one very perplexing observation; the ever increasing rise of Substance Use Disorder (SUD) especially alcoholism in many patients diagnosed with Schizophrenia. The molecular basis of this puzzle is related to variations (polymorphisms) of at least one foundational gene- the Dopamine D2 Receptor Gene (DRD2). Understanding of this idea (hypothesis) may give rise to better diagnosis and targeted treatment in the future. It is by no means a universal remedy; it should spark scientific responses and further investigation. Split Molecular Dopamine and Endorphin Mechanisms The dopamine system has been implicated in both SUD and schizophrenia. A recent meta- analysis suggests that A1 allele of the DRD2 gene imposes a genetic risk for SUD, especially alcoholism and has been implicated in Reward Deficiency Syndrome (RDS) an umbrella term I coined in 1995, to help explain dopaminergic genetics and all common addictive behaviors.
Modified from J.A. Lieberman Source: BCSS Therefore, the approximate number of people in the United States suffering from: ● Schizophrenia: Over 2.2 million people ● Multiple Sclerosis: 400,000 people ● Insulin-dependent Diabetes: 350,000 people ● Muscular Dystrophy: 35,000 people Approximately 200,000 individuals with schizophrenia or manicdepressive illness are homeless, constituting one-third of the approximately 600,000 homeless population (total homeless population statistic based on data from Department of Health and Human Services). These 200,000 individuals comprise more than all the people of many U.S. cities, such as Hartford, Connecticut; Charleston, South Carolina; Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando, Florida; Winston-Salem, North Carolina; Ann Arbor, Michigan; Abilene, Texas or Topeka, Kansas. At any given time, there are more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manicdepressive illness are in hospitals receiving treatment for their disease. Approximately 10% of Americans who have schizophrenia commit suicide, a sobering reality for families with loved ones who have been diagnosed. There is currently no medical test to diagnose schizophrenia, demonstrating that we have much more to learn about the brain. Without such a test, doctors must rely on observations to come to a diagnosis. The annual cost of schizophrenia is estimated at $236 million. Schizophrenia has a similar prevalence between males and females, and it strikes males in their late teens and early 20s, interfering with this stage of early adulthood and professional development. Schizophrenia tends to occur later in women, showing up in their mid to late 20s, disrupting their adult lives. One interesting fact is that people who are treated for Schizophrenia are not more likely to commit violent crimes than anyone in the general population. Schizophrenia affects people differently, and there are some subsets of the disease. The major symptoms include hallucinations, delusions, thought disorders, poor executive functioning, and the inability to sustain everyday activity.
This article simply highlights two very essential but linked concepts. The first is a molecular mechanism which might explain why a subtype of people suffering from a schizophrenic diagnosis also have SUD. The second is a molecular mechanism that might explain why many people with schizophrenia, especially during a hallucinogenic phase, prefer to abuse alcohol as their drug of choice. In simple terms, the first idea (hypothesis) about why a subtype of people with schizophrenia also suffers from Substance Use Disorder (SUD) may be the involvement of dopaminergic genetics. The second idea is about why people, especially during the psychotic (hallucinogenic) phase of schizophrenia, choose alcohol as their drug of choice. Detailing the two hypotheses Since some psychotic symptoms caused by substances of abuse, mimic schizophrenia, it is hard to separate symptoms of schizophrenia, from SUD. It was suggested that psychiatric patients use substances to cope with anxiety and cognitive decline. It is believed that acute self-medication is pursued to ameliorate the symptoms associated with impaired processing of the reward system defined as Reward Deficiency Syndrome (RDS) Hypothesis 1 People with schizophrenia may be protected against SUD if they carry the usual complement of D2 receptors with the DRD2 A2 variant. With this said other gene variants could also be abnormal and cause too much dopamine activity including higher dopamine receptor activity. The possibility that D2 receptor (DRD2) gene A2 allele may act as a protective agent against the development of addiction to alcohol or other drugs of abuse; a subtype of non-SUD Schizophrenics was published in the journal Medical Hypotheses in 2014. Carriers of the dopamine D2 receptor gene (DRD2) A1 variant, on the other hand, have 30-40 percent lower D2 receptors in the reward system of the brain; they are set up at birth to have a high risk of SUD by not having enough of the reward neurotransmitters in their brain. People with schizophrenia and SUD may be carriers of the DRD2 Taq1 A1 allele, and other RDS reward polymorphisms and have low (hypodopaminergic) reward function. Clinical and epidemiologic studies have found a high frequency of co-occurrence of SUD and psychiatric disorders. Psychiatric comorbidity in drug abusers is associated with greater severity, higher incidence of risky behaviors; higher psychosocial impairment and an increased number of violent and criminal behaviors (see Figure 2). Continued on page 36
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FROM THE REAR VIEW TO A CLEAR VIEW By Michael DeLeon
“We live our lives forward, but only understand our lives backwards” ~ Epictetus The #1 reason why people don’t become who they want to be is because they’ve grown too attached to who they have been. Change is a mountain sometimes. Change from addiction is a mountain without a map. But change is necessary if one is to rise above the state of substance use disorder. In the midst of the worst public social health crisis America has ever seen, and with more people being affected by addiction than ever before, one has to wonder where we go from here. How do we overcome this pandemic? How will we avoid losing an entire generation of people? Things must change and they must change now. The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999–2014. Among the 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid. Illicit opioids are contributing to the increase in opioid overdose deaths. During 2015, drug overdoses accounted for 52,404 U.S. deaths, including 33,091 (63.1%) that involved an opioid. It has been estimated that when 2016 numbers are finally tallied, we will have lost 75,000 Americans – a 43% increase in just one year! I estimate that we will lose more than 100,000 people in 2017. Some might look at this prediction and call me Chicken Little, while others might not understand how such a dramatic increase will take place in such a short period of time. I personally believe that the current numbers defining this “epidemic” are incorrect. I believe it’s much worse than even the present numbers reveal. Therefore, those in recovery must take their recovery more seriously than ever before. On top of that, we must voice our recovery louder than ever before. Recovery needs to become the focus of our mission, not only to strengthen those of us who have found it, but to inspire those in our midst who seek it. This social issue needs more attention and collaboration than it ever has and everyone needs to get on the same page. This is most important especially for the Recovery community who has more hope and inspiration than any sector of society. We must encourage America to treat this issue with the attention it deserves and help families and communities understand that much of the answer is in connection and self-fulfillment. This is possible, and can be best achieved by the Recovery community. We can no longer allow the language of the victim to be dominant. The victor must have the stage. Victimstance is the most damaging and devastating self-defeating mindset in our country. For those caught up in addiction, and often, as a result- the criminal justice system, it’s more commonplace to simply blame the world. “My parents got divorced when I was very young”; “I was abused”; “I grew up poor”; My drug-dealing sibling turned me on to it”… I’ve heard them all. I’ve used them many times myself. It was when someone told me that I was inviting more problems into my life that I started to change. He told me to “Cancel My Membership to the Woe Is Me Club.” It was some of the best advice I had ever received. I don’t know if this mindset actually changes anything, but so many people I see caught up in their addiction can’t see their way out of it using their own powers. What you don’t want to hear is more than likely what you need to face. The truth is already in you. The validation just forces you to no longer deny it. I learned this recently both from self-reflection and by giving the advice to someone I mentor in early recovery. The
lesson came from both sides, and learning it both ways doubled its impact on me. I want to solve this addiction pandemic more than ever, and I ask myself how it can be done. We might not become a society that is completely free from addiction, but, I do believe we can drastically reduce the number of people affected. We’re at a point in our history where the life expectancy is actually decreasing faster than at any time on record. And it’s preventable. “Despair deaths” – alcoholism, drugs and suicide – are a big part of the problem and so is obesity, poverty and social isolation. It’s absolutely NOT just about opiates and heroin. They are merely the flavor of the day. To just focus on the death and destruction is missing the forest for the trees. If we are to greatly reduce those affected by this horrific pandemic, if we are to cease this preventable decline in the decrease of mortality, if we are to become a nation that doesn’t destroy itself from within, we must face not only the problems, but face ourselves. We must come together with one voice, shared goals and try to accomplish this together. In unison, in recovery, we can get to that place where we live our lives to the fullest and live free from addiction and the devastation of drugs. The ongoing epidemic of opioid deaths requires intense attention and action. In a November 2016 report, the Drug Enforcement Administration referred to prescription drugs, heroin, and fentanyl as the most significant drug-related threats to the United States. It’s comforting that some Government agencies are waking up. It is also comforting that the Administration is discussing it, but it’s a national crisis and a state of emergency is warranted across the board. We need to come together as ONE VOICE. Everyone in recovery and every family affected by addiction must come together. It’s going to take more than a village here – It’s going to take an Army. A Recovery Army. Please go to www.recoveryarmy.com and learn about the solutions we have proposed. Join us in this fight and help us change not only the conversation but the country’s response. Michael DeLeon is the Director and Producer of the films” Kids Are Dying” , “An American Epidemic” and “MarijuanaX” His fourth documentary will be released in June, 2017 called, “Higher Power”. His memoir, “Chasing Detours will be released in June, 2017. Michael is the founder of Steered Straight Inc. a nationallyrecognized educational program and he has just founded a national advocacy organization called, “Recovery Army” with RJ Vied of “Written Recovery. They are touring the country advocating changes in State and Federal Policy.
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DISCOVERING OUR MYSTICAL SELF By Maxim W. Furek, MA, CADC, ICADC
“This above all: to thine own self be true” ~ Shakespeare In his horrific autobiography “Tweak: Growing Up On Methamphetamines,” Nic Sheff reflects on advice given to him by Spencer, his sponsor. “As long as you look for someone else to validate who you are by seeking their approval, you are setting yourself up for disaster. You have to be whole and complete in yourself. No one can give you that. You have to know who you are – what others say is irrelevant.” That statement may come as a surprise to many, as we often place significance in what others say, think and feel. Since birth, we are bombarded with messages that shape and define us into personalities reflecting the beliefs and core values of our primary care givers, community, and political and religious structures. We gradually adopt some or all of these variables, the good, the bad, and the ugly. But, as we become lost in others, we lose ourselves in the quagmire of conformity. Conformity is a lesson soon learned. It preaches that one should be like their peers: Following rules. Coloring inside the lines. Being obedient. Not rocking the boat. But being exactly like others is not being true to ourselves. UN Secretary General Dag Hammarskjold (1905 – 1961) in Markings, shared a similar stoic philosophy. Consider his thoughts, “Accept your fate and give others the right to judge – because it should not matter anyway. It should not matter any way what they think, feel or say. What should matter is what you think, feel and say. Listen to your inner voice. Determine where you are placing your focus and energies. That focus should rightly be placed on yourself, your true self.” Detaching From Others Spiritual teacher Deepak Chopra revealed that, “It’s important to be yourself… Most people don’t know how much wisdom and power resides in the self, which is not the everyday self that gets mixed up with all the business of life, but a deeper self, which I call, for simplicity’s sake, the true self.” Chopra and numerous others have espoused the importance of understanding the true self and, in this article; I am suggesting a possible pathway that I simply call the “Journey of Self Discovery.” It is a pathway encompassing our relationship with the Devine as we attempt to discover our Spiritual or Mystical Self. This suggested pathway involves four steps: 1. Detach from others: To discover our true self we must separate and detach from others. Many of us search for satisfaction externally --- the product of hard work, accomplishment and expectation. We perform the work and expect the reward. But it is a never-ending wheel in a hamster cage. We remain slaves, exiled and searching for external fulfillment, something that is out of our immediate control and grasp. At some point, to discover ourselves, we must severe the chords that bond us to others. We must make an intentional break. Writer Madisyn Taylor suggests that, “Cutting the cord can help you separate yourself from old baggage, unnecessary attachments, and release you from connections that are no longer serving you… By cutting the cords that no longer need to be there, you are setting yourself and others free from the ties that bind.” It takes courage and self-confidence to march away from the maddening crowd. Individuals like Copernicus, Gandhi, Jesus Christ, Kerouac, Martin Luther King Jr., Mandala, Thoreau and others have risked ostracism, castigation and death as a result of their individualistic beliefs.
In his meditations, Roman Emperor Marcus Aurelius (121 – 180) observed and wrote about, “the tranquility that comes when you stop caring what they say. Or think or do. Only what you do.” Aurelius wisely instructed that tranquility is the noblest of goals, an attainable gift that resides within. 2. Detach from the ego: Secondly, we must detach from our ego, our false self, and the ongoing lies that we tell and retell to the world. The ego nurtures the false self, dictating that we are better than others. It commands that we acquire expensive materialistic goods that are worn like military insignias. The false self-separates us from the support of our comrades and from the grace of our Higher Power. The egodriven false- self compels us to join the “rat race” that inevitably drives many individuals to the nadirs of competition as they literally work themselves to death. This endeavor is dangerous for many, deadly for some and a waste of energy for everyone. Detach from the ego. Get off the treadmill. Refocus and reenergize. 3. Discover your Mystical Self: The Mystical Self is your connection to a Higher Power, Source or God --- whatever term you determine. The Beatitudes, delivered in Christ’s Sermon on the Mount, instruct, “Blessed are the pure in heart, for they will see God.” That spiritual vision grants us tranquility, peace and joy which dwell within our Mystical Self. Cooperation, kindness and serving others are all pathways to the spiritual. We can serve others by sharing love and kindness, showing appreciation and gratitude, and demonstrating forgiveness and acceptance. Serving others allows us to focus on an altruistic outreach and not on our personal agony and struggles. It is a positive distraction, a means of being a Twelve Stepper, and a way to direct our energies into a positive endeavor. Contributing to this greater good is a reward in itself, a way of making us feel better about ourselves and about our worth. This moment of clarity and tranquility results from listening to our small inner voice and from channeling our internal energies. It is about discovering who we are and allowing us to become our true self. Tranquility comes only from turning off the external noise and entering a place of cooperation and not competition. It is the instant when we eliminate the white noise, the background chatter, the incessant blathering and garbage emanating from our competitive monkey brain. The process of self-discovery is the most important journey that we can take. Connecting us to our Higher Source, it empowers and transforms, allowing us to discover our true needs and desires. 4. Nurture your spirit: One such desire is to nurture and protect our inner spirit, that vulnerable and innocent child. We are the stewards of our body, mind and spirit. No other human being can care for you or walk you through your journey. This is something that only you can accomplish. You cannot delegate it to others. When you have embraced this position, the energy source flows into you. You enjoy Continued on page 34
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COMMUNICATION By Andrea Perlin, LMHC
Communication is an essential life skill that allows individuals to better understand and connect with one another. Effective communication enables us to resolve differences, make connections, and build trust and respect. These skills are critical in all stages and experiences, but potentially most invaluable when it comes to families and individuals dealing with addiction and recovery. Individuals that find themselves in recovery and/or in a place of needing guidance, support, help or even just someone to listen to them, must be open, assertive and authentic in their communication. Following are five key ways to communicate effectively regardless of which side of the addiction recovery process you are on. • Be Assertive Assertiveness is the quality of being self-assured and confident without being aggressive. Luckily, being assertive is both a learnable skill and mode of communication. When you are assertive, you can more easily express your thoughts and feelings effectively; you operate from a position of equality and respect; and you respect your own rights, values and beliefs while respecting the rights, values and beliefs of others. Assertive people understand that we can work together for the mutual benefit of everyone involved. • Take Responsibility Taking responsibility for your own feelings as an addict or as someone helping others in addiction, will help you improve your communication when you feel angry or upset. One way to achieve this is by using “I” statements. “I” statements open dialogue and serve as a technique that will allow you to communicate what is upsetting while minimizing blaming. If our statements feel too blaming, the person we are trying to speak to will often become defensive.
support group. The ability to compromise with others will help you maintain promising interpersonal relationships with others because you won’t just dismiss their points of view, but rather incorporate them into the end result. Compromising is one of the easiest ways to communicate well! At the end of the day, good communication skills can be one of the best defenses against relapsing, as they will allow you to be vocal about your feelings and understanding of others. This is true for both the addict and those that are looking to help. Good communication can promote strong relationships that yield successful outcomes. Andrea Perlin, South Florida Outreach Coordinator for Better Addiction Care, which specializes in substance abuse placement on a national level, is also owner and founder of Boca Family Therapy. She is a Licensed Mental Health Counselor with extensive experience helping children, adolescents, adults and families in both individual, couple and group settings. She specializes in the assessment of children, adolescents and adults, offering insight for behavior management, anxiety, depression, addiction, divorce, infertility and adoption. Andrea also specializes in placement for individuals seeking treatment for substance abuse and mental health by providing a fitting roadmap for their personal recovery. Learn more from Andrea at firstname.lastname@example.org Andrea completed her Masters in Science at Barry University. She received both an MBA and BBA degree from University of Miami. Learn more at www.bocafamilytherapy.com. 954-603-0846
• Listen, Absorb, Think…Then Respond It’s critical that when communicating with someone in addiction recovery, that you do not react suddenly, abruptly or quickly. Instead, listen to what is being said, take a step back and think about the reason behind their words and actions. After you have listened, absorbed and come up with a reasonable and thoughtful response, you are ready to approach and communicate with the individual. A calculated response will also help you avoid a defensive and aggressive situation. • Don’t Take it Personal Not all conversations are going to be positive, easy or happy-go-lucky. Conversations can become serious and possibly even angry – especially when it comes to matters of addiction. When engaged in one of those conversations, it is important for all involved parties to step back and take a look at the bigger picture — meaning, don’t take the words of others personally. Understand that during a more serious conversation, things might get said in ways that they shouldn’t be. Try to address the issue at hand without getting wrapped up in the drama. • Compromise You’ve heard it before: You can’t always be right nor get your way. Every conversation is going to be different, and many times you are going to be forced to meet in the middle. Rather than remaining stubborn and digging your feet into the ground, find a way to compromise with the other person so both your needs get met. This is important for both the addict and his or her
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BIG PHARMA GETS THEIR MEN IN TRUMP APPOINTEES By John Giordano, Doctor of Humane Letters, MAC, CAP
Presidential campaigns have a way of eliciting bold and sweeping commitments from its candidates that don’t always translate into policy. It’s usually not until after cabinet and key positions are filled that the tea leaves reveal what is in store. After all; personal is policy. On the campaign trail, candidate Trump claimed that his supporters constantly spoke to him about the opioid epidemic. In response, he pledged to end the epidemic at a Columbus, Ohio town hall meeting last August; “we’re going to work with them (addicts), we’re going to spend the money, we’re gonna get that habit broken.” This promise became central to his campaign and reiterated in stump speeches throughout the remainder of the election. President Trump seems to be making good on his pledge. In March (2017) he appointed New Jersey Governor Chris Christie to head a federal commission whose sole purpose is to identify the status of the epidemic and make recommendations for the future. Christie – who lost a close friend to an opioid overdose and has been outspoken about the need for reform – has a personal interest in ending opioid abuse and overdoses which makes him the perfect candidate for this position. If there were a polar opposite of Governor Christie it might just be the President’s nominee to head the Food and Drug Administration, Dr. Scott Gottlieb. Looking at his CV you might think Gottlieb crafted his career – like an artist chisels a statute out of a block of stone – specifically for this appointment. Dr. Gottlieb, 44, is very accomplished. According to his Wikipedia page, Gottlieb is a physician, internist at Tisch Hospital, clinical assistant professor at New York University School of Medicine and conservative health policy analyst. He has held many positions in federal government including being a member of the White House Biodefense Interagency Working Group, Deputy Commissioner for Medical and Scientific Affairs at the U.S. Food and Drug Administration (FDA) during the Bush Administration and has testified as an expert witness before committees of the United States House of Representatives and Senate on issues related to FDA regulation, healthcare reform, and medical innovation. Gottlieb is also a cancer survivor who regularly writes healthcare policy op-eds for many national newspapers and magazines, and is a frequent guest on cable TV shows. But there is another side to Dr. Gottlieb that not all have seen. Before he studied medicine, Gottlieb worked as a healthcare analyst at the Baltimore office of Alex. Brown & Sons, an investment bank. Since 2007 he has been a partner at New Enterprise Associates, which he describes as “one of the worlds largest and most active venture capital firms.” His focus at the firm has been on health care investments. In addition, he is also a senior principal at the investment bank TR Winston, and partner at the hedge fund Arcoda Capital Management; all health care–centric finance groups. He has served on five pharmaceutical companies’ boards and is currently a member of GlaxoSmithKline’s product investment board. Gottlieb is also a resident fellow at the American Enterprise Institute where he researches the FDA and the Centers for Medicare & Medicaid Services. Due to his nomination, Gottlieb was required to provide Health and Human Services associate general counsel for ethics, Elizabeth Fischmann, disclosure statements revealing any conflicts of interest or financial ties to companies in the health industry. In his report, Gottlieb stated he has approximately two dozen healthcarerelated companies in which he has a financial interest. Gottlieb also stated he would divest his interests in those companies within 90 days of his confirmation. Harvard professor Daniel Carpenter, an expert on the FDA, stated that; “These are not relationships whose influence just disappears once he resigns from a corporate board. If (Gottlieb) is confirmed,
he would be the most interest-conflicted commissioner in American history, by far.” Upon news of Gottlieb’s nomination, The Pharmaceutical Research and Manufacturers of America’s (Pharma) CEO Stephen J. Ubl sent out congratulations stating; “We look forward to working with Dr. Gottlieb in his new role, as they seek to modernize the drug discovery and review process and advance competition in the biopharmaceutical market.” According to Market Watch, a Mizuho Securities USA survey found “72% of 53 drug companies polled favored Gottlieb for the position.” Gottlieb’s disclosure statements reveal a troubling relationship with opioid manufacturers and distributors. According to a federal database, he received more than $400,000 in payments from pharmaceutical companies between 2013 and 2015. From 2016 to present Gottlieb has accepted almost $45,000 in speaking fees from firms involved in the manufacture and distribution of opioids. Public Citizen’s Health Research Group director, Dr. Michael Carrome, had this to say about Gottlieb; “He is someone who has been an industry shill and has spent most of his career dedicated to promoting the financial interests of pharmaceutical corporations.” “He is entangled in an unprecedented web of close financial and business ties to the pharmaceutical industry and was no doubt chosen because he is well-suited to carry out the President’s reckless, ill-informed vision for deregulating the FDA’s review and approval process for prescription medications, including opioids.” On April 5, 2017, Gottlieb appeared before a Senate panel for a confirmation hearing. Gottlieb was quoted as saying that “the opioid addiction is the biggest crisis facing the agency and will ‘require dramatic action,’ including finding ways to spur development of nonaddictive alternative painkillers as well as addiction treatments.” He said tackling the crisis would be his first priority. At the conclusion of the meeting, the ranking Democrat on the Health, Education, Labor and Pensions Committee, Senator Patty Murray (Wash.), said she believed the panel needed to slow down the vetting process, to give time to review Gottlieb’s “unprecedented financial entanglements in the industries he would regulate as commissioner.” The most important question still unanswered is which Dr. Scott Gottlieb will we get? Will it be the cancer surviving internist with compassion for others suffering from disease, a man who is determined to quickly expedite the approval of generic and orphan drugs? Or will we get the Washington insider venture capitalist hell-bent on getting more drugs approved at a faster pace with ambivalence towards drug efficacy and public safety? This almost feels like election season all over again – a lot of talk and promises made by people who will never be held accountable Continued on page 38
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Where compliance is a journey not a destination YES, YOU CAN BE MORE EFFECTIVE! What if itâ€™s our own lack of knowledge thatâ€™s responsible for the poor treatment outcomes we are continuing to battle? We have all heard how genetics and biology play a role in chemical addictions, but do we really understand it? Do we really understand the significance of these findings? And if so, what is being done about it? How do you apply it? When I got into this field, I felt very uncomfortable and quite ill-prepared about treating an illness we know very little about. Addictions have been around for thousands of years, and although our attitudes towards those with addictions have improved tremendously, our approach to treating this illness has not really changed all that much. For the most part, we are still relying on our own, and very individualized, common sense. Donâ€™t get me wrong, our theories are wonderful, and they do make good sense, but donâ€™t they all seek to unravel the truth behind why some people develop addictions and others donâ€™t? Are they not a search for answers? What if the answers we have been looking for, all these hundreds of years, can be found right here in the science we have now? This book will challenge your beliefs and help you to bridge the gap between science and treatment. In doing so, it will arm you with the knowledge and confidence it takes to be more effective. There are no miraculous cures here, but science has provided the answers we need to take treatment to the next level and propel us into the future. Science is changing how we view and address chemical addictions, so donâ€™t be left behind. Visit my webpage at: www.theafflictionofaddiction.com and order your copy now. This is my gift to you. The time is ripe to reap the rewards of all our untapped knowledge. Change is in the air and the future is upon us! Welcome to the 21st Century!
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A Monthly Column By Dr. Asa Don Brown
THE PERCEPTION OF AN ADDICTION “Addiction is the only disease that tells you that you don’t have a disease.” ~ Jason Z.W. Powers The general perception of addiction is that all addicts are capable of quitting and that they choose not to quit due to weak character or a moral defect. This sort of perception is misguided, misinformed and simply erroneous. “People are not always accurate and objective at perceiving themselves, their circumstances and (much less) those around them. People’s perceptions can be biased by their beliefs, expectations and context, as well as by their needs, motives and desires. Such biases have important consequences” when considering those who struggle with an addiction. Unfortunately, those involved directly or indirectly with addicts often have a much skewed view as well. The legal system itself identifies those who have been arrested for possession of a controlled substance and addicted to the controlled substance, as a criminal rather than someone who is struggling with an addictive issue. In fact, “of the 2.3 million inmates crowding our nations prisons and jails, 1.5 million meet the DSM-IV medical criteria for substance abuse or addiction, and another 458,000, while not meeting the strict DSM-IV criteria, had histories of substance abuse...”, and nearly 85% of those imprisoned are struggling with an addictive issue. “Even after years of public statements that drug addiction is a disease, many continue to subscribe to a moralistic view of addiction and to see addicted people as immoral, weakwilled, or as having a character defect requiring punishment or incarceration.” Nothing can be further from the truth. Those who could be described as an addict range in age, intellectual quotient (IQs), careers, familial and social environments and academic backgrounds. For some addicts, there is little self-control in relationship to the addictive issue, while for other addicts they are capable of making choices around their addiction. Either way, the addiction has a stronghold on the individual. The stigma continues to plague those who struggle with addiction. Whether or not addicts are driven by the allure or attractiveness of the addictive issue, a chemical imbalance, or a biological physiological or psychological predisposition; those who struggle with addiction continue to be plagued by stigma. For so many addicts, there is undoubtedly comorbidity between the addiction and a psychological condition. “The stigma associated with drug addiction has directly deterred young investigators who might otherwise be interested in pursuing careers in addiction research and treatment.” As a practitioner, I have yet to meet an addict that is not struggling with a psychological style, trait, or disorder. INTOLERANCE “The greatest problem in the world today is intolerance. Everyone is so intolerant of each other.” ~ Diana, Princess of Wales I recently had an opportunity to listen to an individual lecture on drug addiction and drug addicts. The main focus of the lecture was presented on the manufacturing of leading illegal narcotics. As I listened, I began to feel completely disheartened with this individual’s intolerance of the drug addict, the dealer, and the manufacture. Most appalling, the individual described these individuals as “cockroaches” and that they should be “squashed”. While the heart of his message was focused on the designer and dealer; it was apparent that “the cockroach” had become his battle cry. Throughout his message, he discussed how we needed to end the methamphetamine epidemic. While I completely agree that we need to end this most egregious epidemic, I disagree with the major theme of intolerance. Regrettably,
I have recently heard this same message being spouted from the lips of various professionals, governing bodies, and institutions. This message of intolerance has caused me grave concern for those struggling with and even those who are dealing illegal substances. For if we declare the addict, the dealer, and/or the manufacture our enemy, then we are waging war upon a community that desperately needs our help. Undoubtedly, I too, would travel to the utmost reaches of the galaxy to protect those that I love, but we need to rethink our approach and communication when discussing the community of addiction. Perhaps, we need to take a moment to pause and reexamine our pursuit of illegal substances and addicts. For after all, we are human and deserving of a good life; whether or not someone has committed a criminal act, we need to approach each person as someone’s beloved child. An article posted on Stanford University’s website, discussed the war on drugs and the lack of detectible success. “The United States (along with many other countries) has focused its efforts on the criminalization of drug use (manufacturing and dealing). Efforts of interdiction and law enforcement have not been met with decreases in the availability of drugs in America.” In order to defeat the problem, “society has to abandon the puritanical idea that drug users are morally defective...” and focus on “...treating our addicts through rehabilitation and preventing the use of drugs through education.” THE SYSTEM IS FAILING OUR ADDICTS “Prohibition goes beyond the bounds of reason in that it attempts to control a man’s appetite by legislation and make crime out of things that are not crimes.” ~ Abraham Lincoln The United States has been engaged in the war on drugs for nearly 60 plus years. However, there is little evidence to support that criminalization has proven a productive solution. Moreover, the criminalization of illicit drugs has made the U.S. the largest prison system internationally. While ideally, prisons should be a place of rehabilitation, they have become cesspools of criminal activity. Prisoners are neither being rehabilitated, nor are they being offered a credible education to issues that landed them in prison in the first place. According to the National Institute on Drug Abuse, the “...recidivism in 15 states found that one-quarter of individuals released returned to prison within 3 years for technical violations that included, among other things, testing positive for drug use.” We must begin to rethink how we are approaching and treating addiction. EDUCATION VS STIGMATIZATION Intolerance and stigma are void of education. “Advocacy can be assisted by private foundations, industry, universities, and other professional organizations as well as physicians and scientists in leadership roles. They can translate research findings and new clinical developments for existing advocacy groups and community leaders, and emphasize the importance of a strong research infrastructure.” As a society, it is prudent that we consider new strategies to reach the public at large, by creating a neo-consciousness around the underlying issues of an addiction. Furthermore, it is important that we rethink our stances, provide substantive information, offer real solutions to detour the addictive behavior, and strategize to eliminate the causation of addiction. Author: Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com References Provided Upon Request
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GOLF AND ADDICTION RECOVERY? South Florida is known globally for golf courses and addiction treatment resources. You would be amazed to know that the same strategies used in your golf game can help in addiction recovery, whether you are a scratch golfer or a beginner. Emotional mastery and composure, identifying things that you can manage, what you cannot control and being present in the moment are prime examples of techniques that can improve your game and life. Defining oneself not by performance, setting goals that are possible and believing in self can be learned. If the substance abuser is motivated internally to enter treatment instead of at the urging of loved ones, friends and colleagues, their chance of recovery is so much better. For that reason, addiction programs are dual purpose now. They are designed to engage potential people looking for recovery. Holistic amenities may attract woman, wilderness adventures for young adults or golf swing instruction and play for sports minded boomers and seniors. These added activities make addiction treatment more relevant. For instance, if one was able to improve their golf swing as well as learn to enjoy life sober, one may consider participating. Of course, solid medical and physiological services are still the basis of treatment. But to some, the addition of golf makes the process feel more like a positive experience than a punishment. Golf alone is not enough for successful long term recovery, but lessons learned during play can make a big difference in the course of life. Addiction Reach manages the practices of treatment providers that offer customized concierge addiction recovery services for individuals, couples, and families in all stages of recovery, including GOLF THERAPY. For a complimentary consultation call 561-427-1900 or visit www.addictionreach.com
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CAKE - CHRONIC PAIN - COURAGE
BY LOUISE A. STANGER ED.D, LCSW, CDWF, CIP AND ROGER PORTER In the hit independent movie Cake, Jennifer Aniston plays a woman who knows pain. Barely surviving a horrific car accident which kills her 3-year-old son, she is left with a scarred face and wounds with pins in them decorating her arms, legs, and back. Consumed with bodily pain and emotional grief, she cannot sit, rather, she must lie down in a prone position. While she attempts physical therapy and group counseling, her unresolved grief and anger soon lead her to make friends with OxyContin, hydrocodone and alcohol. She unsuccessfully uses sex as a means of release with anyone she can find, from her gardener to passing-by strangers. In her sorrow, she refuses all help, rejects her husband and lets rage be her only ally. At one point, desperate for more pills, she begs her trusted housekeeper to take her to Mexico so she can smuggle pain medication back into the United States. Like so many men and women who have experienced debilitating traumatic injuries, her physical injuries were compounded by anxiety, grief, rage, depression, alcohol and other drug use. In earnest, her attempts to manage long-lasting chronic pain gave way to a dangerously devastating empty lifestyle that reaches beyond the stories Hollywood tells and into the communities in which we live. In the United States, chronic pain affects 133 million Americans; and 65% of Americans seek care for persistent pain at some point in their lives. In total, this issue affects more lives than diabetes and heart disease combined. Pain is big business for the healthcare industry - an estimated $100 billion is spent annually to manage pain, including healthcare expenses, lost income, and lost productivity at work and home. In lieu of these growing numbers, one must distinguish between acute and chronic pain. Acute pain is short term, typically brought on by a physical ailment such as inflammation or injury, and clears up when the source is treated and heals. Chronic pain, however, is long-lasting, generally over three months of persistent pain. Chronic pain is believed to be a disease that causes changes in the nerves and persists long after the initial source of the pain heals. Physical therapy, surgery, and nerve blocks are common forms of treatment as well as alternative treatment approaches like acupuncture, mindfulness and massage therapy. Many Americans through no fault of their own turn to prescription drugs which have been prescribed, including opioids, antidepressants etc... to address their chronic pain. This has inadvertently given rise to the opioid epidemic - a catch twenty-two whereby the very cure for pain coupled with over prescribing sparks an addiction that can cause serious harm. Though most patients who are prescribed pain pills use responsibly, research shows close to five million Americans are taking prescription pain medication in unsafe ways. Since chronic pain is a serious condition that can cause months and even years of pain, people who use painkillers long-term can develop problems such as hyperalgesia. Hyperalgesia is a condition where a person becomes overly sensitive to pain. Doctors and researchers have linked this phenomenon to opioids. Essentially, the prolonged use of pain medication to treat pain develops a change in the person’s nervous system, so that their pain threshold goes down and sensitivity goes up. Jay Tracy, a clinical psychologist at both the Chronic Pain Rehabilitation Program and the Phoenix Center for Pain Services, both in Golden Valley, MN, says “opioid-induced hyperalgesia is not fully understood. [Still] it is apparent that a person can become hypersensitive and hyper-responsive to painful stimuli due to the use of opioids.” It’s a vicious cycle - more pain sensitivity prompts the person to increase pain medication use and it builds. As such, Dr. Tracy says “clinicians and patients should be aware of the risks and implications when using opioids.” Despite these challenges, treatment centers such as Driftwood Recovery (Dr. James Flowers) and Las Vegas Recovery (Dr. Mel
Pohl) and other behavioral health pain recovery programs are at the forefront of this issue. Recently, Dr. James Flowers treated a woman named Harriet who suffered from a clipped nerve during a surgery to remove a small tumor from her cervical spine. The clipped nerve induced intense pain. After months of trying to manage the chronic pain with medications, Harriet arrived at fentanyl, an extremely potent substance not far from heroin, which led to 10 years of misuse and addiction. Harriet became so consumed with the medication that she could no longer walk, lost her family business and insurance, and slipped into a deep depression. To begin treatment, Harriet completed detox to rid her body of foreign substances. Medically assisted detoxification is the process of removing the substance from his or her system at a measured pace to ease the symptoms of withdrawal. Withdrawal is the normal reaction of an individual’s body to the sudden removal of drugs or alcohol and can be very uncomfortable. After detox, Harriet had a 20% reduction in her pain level simply due to hyperalgesia. She then attended a chemical dependency educational class on medication management and addiction, along with a series of cognitive behavioral therapy sessions. She found support in her team of friends and family, as well as yoga and a walking class. Forty-five days later, Harriet reduced her pain by more than 70%, resumed a regular fitness program, and got her family and career back on track. In addition to injury, chronic pain can develop from a birth defect. I recently worked with a family who has a 22-year-old son named Jordan with scoliosis, a birth defect that causes a curve in the spine, which can lead to difficulty walking and breathing. For Jordan, his complications from scoliosis caused chronic pain. He endured several surgeries and began taking pain medications to ease the pain. Though very bright, Jordan was bullied from a young age for his birth defect, which in turn heightened his emotions and fueled his anxiety, anger and depression. He used the pills to escape the pressures of growing up with a disability that gave him chronic pain. Jordan received treatment at several centers where physical activity was a major component to help with the curvature of Jordan’s spine. He is at a continuing care residential treatment center and has made huge progress participating in counseling sessions, group activities and exercise. There are also new methods coming to the forefront to help individuals treat chronic pain. A new study published in the journal Addiction in 2016 by a team from the Veterans Administration Ann Arbor Healthcare System’s Center for Clinical Management Research found a non-drug approach that combines behavioral therapy and social support to help manage pain. In the study, 55 Continued on page 38
How can a parent searching for a legitimate service provider choose a quality program Certifying safe and for their son or daughter to reside? State digniďŹ ed recovery of Florida relies on FARR certification as confirmation that the program, staff and residences for property comply with nationally recognized individuals standards. FARR regularlyseeking audits compliance and provides a path for residents, families peer-supportive housing. and community members to file a complaint if warranted, ensuring that operators remain compliant with standards. FARR ( 561-2990405) is the oversight agent for sober homes. Please check with NARR ( 855-355-6277) Join Volunteer Support to gain information in your state who is certifying sober homes.
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INTERVIEW WITH KURT ANGLE By Patricia Rosen, Publisher of The Sober World Kurt Angle is more than one of the greatest Professional Wrestlers of all time. He’s a living Legend. And for the past four years, he’s been in recovery for opioid abuse. Recognized worldwide as a Professional Wrestler, actor and spokesperson since winning the Gold Medal in the 1996 Olympics, Kurt is the first and only 13-time World Heavyweight Champion. But while he is considered one of the greatest wrestlers of all time and a fierce competitor in the ring, this top professional athlete admits the toughest thing he ever had to conquer was his addiction to opioids. Kurt admits he was up to 65 Vicodin a day before entering rehab. But after rehab, he was faced with the fact there wasn’t any aftercare and to make matters worse, stigma. He was told to keep his rehab and recovery quiet. But as Kurt began to witness firsthand the escalating opioid epidemic nationwide – he knew keeping quiet was not an option. Fueled by his desire to stay on the path of recovery, as well as the loss of his sister to a heroin overdose, Kurt decided to create a mobile app that could act as a monitoring and support service that would be available to anyone in recovery 24/7/365. But the only thing technical Kurt was familiar with was his famous Angle Slam in the ring. So he teamed up with the leading addiction technology expert in the United States, Dr. Harold Jonas, the CEO and Founder of Sober Network Inc. in Delray Beach, Florida. Dr. Jonas brought a unique and highly specialized skill set to developing Kurt’s Anglestrong recovery monitoring service as a mobile app. He faced his own addiction to heroin and subsequent recovery – now approaching almost 30 years. Dr. Jonas and his team have spent almost two decades designing technology products to help those in recovery. As a Psychotherapist and Licensed Therapist in the State of Florida since 1996, Dr. Jonas has also developed an expertise with web development and award-winning app development. He’s responsible for the concept, design and launch of multiple directories serving the addiction and recovery industry – most notably Sober.com. In 2016, his FlexDek MAT Edition mobile app, designed to help combat the raging opioid epidemic, was awarded First Place in a nationwide Opioid Recovery App Challenge sponsored by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Dr. Jonas’ new “FlexDek”, is a simple yet comprehensive program with a full menu of features providing client and care manager tools for remote patient monitoring, data collection and reporting. It provides simple yet highly beneficial resources such as communication tools, reports, data collection and more via specialized iOS and Android mobile apps. The ultimate goal is to provide support so FlexDek users can more effectively manage their health and change unwanted behaviors interfering with their overall wellness. The collaboration between Kurt Angle and Dr. Harold Jonas
proved to be a great match. Kurt’s Anglestrong monitoring service delivered by mobile app was built on Dr. Jonas’ award-winning FlexDek platform. As a result, it created a recovery management mobile app unlike any other. Anglestrong’s multiple features include a daily checkin, and if you don’t check in every day – the lifelines you have loaded into the app will be notified. This includes family members, loved ones or friends and your sponsor. It also teaches accountability, but if you do relapse, Anglestrong is GPS enabled and you’ll get the help you need. As a high tech recovery monitoring service, Anglestrong’s goal is to help people in recovery avoid relapse, rehospitalization and overdose. We invited Kurt Angle to share with our readers how addiction can deal a blow to anyone – including a wrestling legend who has faced some of the toughest men on earth in the ring. In our discussion, he is honest and candid about his recovery, with the hope that his unfiltered story will benefit someone reading it here. Patricia: I always like to start my interviews with a little background on what your life was like growing up. Tell us what it was like? Kurt: I’m a hometown, all-American guy who was born and raised in Pennsylvania. I was the youngest of five kids. Growing up, when my sibling were teens, they were already experimenting with marijuana. It was the 70s so it seemed to be more acceptable back then. It bit a couple of them in the ass later on in life, though. Anytime you start to experiment with any drug, it can snowball into a serious problem. But I never tried drugs. My addiction didn’t start until my first neck injury when I was prescribed opioids to help me get rid of my pain. Patricia: How old were you when that happened? Kurt: My addiction didn’t start until a doctor prescribed me opioids for my broken neck – I was just 34. The minute I took them – I knew I was hooked. Patricia: That is unfortunately the problem with many people. They don’t realize how easy it is to become addicted. Did you like sports at a young age? Kurt: I excelled in athletics. In high school I was all about football and wrestling. I was an All-State linebacker in football. But when it came to wrestling – that’s where I was at. I was undefeated in my freshman year, made it to the state tournament sophomore year, placed third in the state tournament junior year and I become the 1987 Pennsylvania State heavyweight champion in my senior year. I decided to pursue amateur wrestling over football in college. I went to Clarion University of Pennsylvania where I set school records and became a local celebrity. Patricia: Your family must have been very proud of you. I understand that your father struggled with addiction. What was that like and how did that affect your family? Kurt: My dad struggled with alcohol and tragically he died when I was just 16 years old. He was a hard-working man – he did
construction. He was killed in a crane accident at work. It was a pivotal moment in my life – I just remember vowing to myself to become a champion for him, because I knew there was nothing else in this world that would have made my Dad happier.
hospitalized and overdosing. It’s that simple. I want to combat the raging opioid epidemic and help save tens of thousands of people who are dying each year. I just can’t keep quiet and standby – I’m going to do something about it.
Patricia: You certainly were true to your word. Was alcohol a problem for you as well? I understand you were arrested for four DUIs in five years.
Patricia: I understand you lost your sister to a heroin overdose. I am so sorry. As you know, I lost my son to an overdose and it just makes you want to try and save everyone, doesn’t it?
Kurt: My wrestling schedule at the time was nonKurt: Thanks Patricia. And I’m deeply sorry for the stop and I was constantly in the spotlight, in the loss of your son. It’s just a part of your heart you ring, wrestling with 300+ pound guys. I had some can’t get ever get back. injuries, so I’d take my doctor-prescribed opioids and wash them down with whatever my drink of It does make you want to do something to save choice was for that particular night. When you mix everyone. When I first came out of rehab, because pills and alcohol you do some really crazy things. of my celebrity status – everyone told me not to When I traveled, I was drinking and driving, and Dr. Harold Jonas, the CEO and talk about my addiction and recovery to anyone. I Founder of Sober Network Inc. I got nailed a bunch of times. After my last DUI, was like – “No way, that isn’t going to happen!” The I realized I had a serious problem and I decided first step in combating the raging opioid epidemic nationwide is to to clean myself up. I approached my recovery with the same crush the stigma. That has to stop. Last year the media reported dedication I approach my wrestling with – failure was not an option. that there were more than 53,000 opioid overdoses – you think I’m Patricia: So you knew you needed help. What were your feelings when you first went into treatment?
Kurt: I went to rehab because I knew I was losing control of myself, my life, my career and my family. I knew I had to change. So, I get to treatment and go through withdrawal – and that’s like going over a mountain. You’re sick as though you’re dying, sweating, going to the bathroom all the time and throwing up with cold sweats. Its complete hell and the worst feeling in the world. I’m one of the toughest guys – a professional athlete – and it took me a week of this hell to get through withdrawal and detox. And once you get through that – then you start the learning period about addiction and recovery, and begin to start taking your life back. Patricia: What was it like for you in treatment? Kurt: When I was in rehab, I was blessed to have the best people doing a tremendous job taking care of me. The entire staff made sure I was getting healthy, eating right, exercising, going to classes all the time, and learning about addiction and my own recovery. The thing that seems to be missing for most people is aftercare. So you power through committing to go to rehab, withdrawal and detox and all the other phases of rehab. And then the typical person gets out and says “Now what?” I’m fortunate to have the financial resources and a kind of OCD commitment to my recovery. I did it for myself, my family and my career. But for the typical person coming out of rehab – it can be really, really tough. Patricia: So what was that “Aha!” moment when you said “the Anglestrong app is what people need!”? Kurt: Like I said, getting out of rehab leaves you feeling unsure of what comes next. I’m one of the lucky ones, but if you’re the typical person working every day for 8 to 12 hours and you have a wife or husband, a couple of kids – the stress can add up quickly. Plus it’s expensive if you want to pay for a psychiatrist, psychologist, recovery coach or counselor. So, for quite a while now, I had wanted to provide people in recovery with my own recovery app that could be an affordable monitoring service that would be there for them 24/7/365. I knew what I wanted – because I had been through active addiction. I had in my mind what would work best. I knew people needed a recovery monitoring service, delivered on their smartphone as a mobile app – because let’s face it – no one is without a mobile phone nowadays. My personal hope is that my Anglestrong mobile app will help put an end to people relapsing, being re-
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going to be quiet? Yeah, that’s not happening.
Patricia: No, we can’t or we will never eliminate the stigma! Please tell my readers how Anglestrong works and why this is so important to the future of aftercare? Kurt: I knew what I wanted in the Anglestrong mobile app – but I needed the right tech team to help me create it. So I teamed up with Dr. Harold Jonas, the CEO and Founder of Sober Network Inc. His company is located in Delray Beach, Florida and it’s the top addiction technology firm in the country. Dr. Jonas is also one of the leading addiction treatment specialists in the United States. So, I knew there was no one better than Dr. Jonas to launch Anglestrong – he is the real deal. He and his team at Sober Network Inc. created the award-winning FlexDek platform Anglestrong is built on – and there’s really nothing else like it. It has a lot of different features which are really beneficial to a person who is in recovery and it acts as a recovery monitoring service on your iOS or Android phone – for $1 a day. It’s easy to get started – anyone can download Anglestrong from the App Store or Google Play. You create your account, complete a profile, set up your lifeline supports and follow the directions for check-ins; then your well-being is monitored and your supports are notified if you’re at risk. That’s the simple overview. But it’s a very cool concept because the features are easy to use, even though the technology behind it is pretty advanced. Anglestrong powered by the FlexDek platform teaches you accountability, and if you do relapse – it’s GPS enabled to get you the help you need quickly. Patricia: It sounds easy enough and with all the overdoses, a built in GPS sounds like a really good idea. Kurt: Some people in recovery have asked me why they need Anglestrong if they can just go for free to NA or AA meetings. Yes, you can do that. However, Anglestrong is there for you 24/7/365 as your own personal recovery monitoring service. At midnight or 4 am – around the clock - it’s there. No waiting for a meeting or for someone to open an office in the morning. If you need help – it’s right there on your phone. You have your check-ins, lifeline supports, and daily reminders to keep you on track, a goals section to further accountability, a Soberometer that clearly shows your progress visually, reports displaying your progress, positive support messages from me, and even a monthly video conference call with me that’s interactive. Anglestrong has been a passion project of Continued on page 36
THE STRESS FREE FORMULA: HOW USING EMPATHIC COGNITIVE BEHAVIORAL THERAPY REDUCES ANXIETY AND CREATES INNER CALM By Arthur P. Ciaramicoli, Ed.D., Ph.D.
fibromyalgia and some personality disorders. There has been less evidence-based research on stress and CBT. One of the criticisms of CBT, despite its overall success, is that the changes created may not endure due to the lack of focus on emotionally conditioned learning, which we know is quite difficult to extinguish. Empathic CBT addresses this issue comprehensively so that the emotional, conditioned negative learning can be understood in depth and changed in lasting fashion. De-Stressing Your Life Empathic CBT will take you on a journey that has the potential to affect both your thinking and emotional brain. First, empathic CBT will allow you to uncover the origin of your learned reaction to stress, especially focusing on how you typically perceive that which leads to stress. Secondly, expanding your empathic range will help you see yourself and others accurately. Lastly, CBT will then help you reverse false beliefs and as you perceive yourself and others more clearly you will become calmer and more relaxed as you learn to produce feel good chemicals rather than stress hormones. You will then be in a position to perceive accurately rather than projecting worry forward based on old conditioned ways
GAMBLING: A BAD BET FOR YOUNG PEOPLE By Elizabeth M. George
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of responding. Empathic CBT will free your mind of old views that have produced stress and compromised your life. In the process, you will uncover positive aspects of your personality that have remained hidden under the clouds of stress and old conditioned ways of reacting. Arthur P. Ciaramicoli is a licensed Clinical Psychologist who has been treating clients for more than 35 years. Dr. Ciaramicoli is in full time private practice and Co-Director of Integrated Success Consultants. He has been on the faculty of Harvard Medical School for several years, lecturer for the American Cancer Society, Chief Psychologist at Metrowest Medical Center, and Director of the Metrowest Counseling Center and of the Alternative Medicine division of Metrowest Wellness Center in Framingham, Massachusetts. He has also appeared on national television and hundreds of radio shows throughout the nation. Dr. Ciaramicoli’s is the author of several books, his newest is, The Stress Solution: Using Empathy and Cognitive Behavioral Therapy to Reduce Anxiety and Develop Resilience released in June of 2016. His website is www.balanceyoursuccess.com. His twitter handle is docapc.
FLORIDA’S MARCHMAN ACT TO SERVE AS MODEL FOR COUNTRY’S OPIOID EPIDEMIC? By Joe Considine, Esq.
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The University of Alabama created the Gambling Action Team to facilitate campus-wide awareness and assistance strategies to address problem gambling. The Team provides practical information, learning opportunities and educational and awareness programs for the student body, targeting student-athletes, graduate students, freshmen and faculty.
Healthy brain functioning take many months to develop. Hence, the traditional 28 days of treatment is insufficient. Long term treatment allows for the creation of healthy neuropathways that enhance the abuser’s chances for long term sobriety and allows for the dopamine receptors to, in essence, “calm down”.
University of Minnesota Duluth Continuing Education offers an online certificate course, Studies in Gambling Addiction Certificate Program, www.nati.org/oll to assist campus counselors and other mental health professionals in the identification and treatment of college students with a gambling problem.
We must re-evaluate the belief that no one gets sober until and unless they want to. This belief has to be scrutinized especially in the context of the staggering number of deaths brought about by the opioid epidemic. Can we afford to wait for the addict to want to get clean? This new thinking is supported by science.
Gambling on the Radar Screen
The country needs laws such as the Marchman Act which permits the court to place a substance abuser under varying levels of structure and care for up to nine months. Involuntary commitment via Florida’s Marchman Act is a vital and necessary tool in the fight against the opioid epidemic.
Parents, educators, campus counselors, mentors, afterschool programs and others who interact regularly with students need to: ● Recognize that gambling is not a totally harmless form of entertainment. ● Young people are at an elevated risk for developing a gambling addiction. ● Encourage policies that address internet gambling and hosting casino nights in schools. ● Start talking to young people about responsible gambling and the addictive nature of gambling. ● Add gambling to the radar screen of at-risk behaviors for young people. Elizabeth M. George is the Chief Executive Officer of the Minnesota-based North American Training Institute (NATI). Ms. George was a founding board member of the National Center for Responsible Gaming and provided expert testimony on underage gambling before the Congressionally-appointed National Gambling Impact Study Commission. She has also presented responsible gaming training programs, including Red Flags & Referrals to an array of tribal governments as well as public and private sector gaming companies.
Joe Considine has practiced law in South Florida since 1983. His practice is limited to family law and addiction related law including the Marchman Act. Joe has handled over 1500 litigation cases in his career, appearing in courts throughout Florida. Joe works extensively with families whose loved ones have substance abuse and mental health problems as an attorney. He lectures throughout Florida on family law matters including the Marchman Act and other substance abuse related issues. Joe grew up and lives in West Palm Beach, has three adult children and loves mountain biking. His website is: www.joeconsidinelaw.com Telephone is 561-655-8081 Email address is email@example.com
WHERE YOUR MD MEETS MY JD: WHEN THE DOCTOR SAYS YES, BUT THE TREATMENT TEAM SAYS NO. By Judge Jodi Debbrecht Switalski
It’s a disease. It’s not a disease. Well, it changes the structure of the brain, just like diabetes changes the structure of the pancreas. But it’s a choice. “They” chose to use drugs…. Or did they? According to the National Institute on Drug Abuse and several published studies1, 80 percent of heroin users reported using prescription opioids prior to heroin. 60% of opioid related deaths occur in patients who have been given prescriptions according to prescribing guidelines by medical and dental boards and 3.5 million adolescents had their first introduction to opioid medications following a third molar extraction.2 11% of high school seniors have used an opioid nonmedically before they graduate.3 Physical dependency then addiction can start before we, as judges, even have an opportunity to intervene making the success of recovery much, much more difficult. Does it really matter? What really matters, I submit to you, is the process moving forward. We should all be able to agree that recovery is a process. Treatment requires exploring numerous pathways to recovery. For the judge and treatment team, the trick is finding the pathway to recovery for each individual. Sometimes this means setbacks or violations of the terms of probation, but this is not, to me, a failure. If a method of treating cancer does not work, we do not simply incarcerate or give up on the individual. We shift the treatment approach. To this end, treatment courts have an added benefit: the synergy of monitoring and intervention, vulnerability and investment, mentors and recovery coaches and a diverse team whose valued education and experience are crucial to the success of the individual. An individual who for whatever reason is suffering from a disease or a situation that in most cases, began innocently – with a prescription from their doctor.
her own consulting firm, Switalski Consulting LLC, where she consults nationally on informed consent and prescription abuse with medical and dental practitioners. She also speaks nationally with The Stutman Switalski Group LLC before hundreds of audiences and performs almost as many consulting engagements on issues surrounding substance abuse and risk evaluation and mitigation strategies for medical and dental practitioners. She is married to a treatment court judge, has two children, three step-children and two grandchildren. (end Notes) 1. Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers – United States, 2002-2004 and 2008-2010. Drug Alcohol Depend. 2013;132(1-2):95-100. Lankenau SE, Teti M, Silva K, Jackson Bloom J, Harocopos A, Treese M. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy. 2012; 23(1):37-44. Muhuri PK, Gfroerer JC, Dvies MC; SAMHSA. Associations of nonmedical pain reliever use and initiation of heroin use in the United States. CBHSQ Data Review. http://www. samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.pdf. Published August 2013. Accessed October 8, 2015. 2. Manchikanti L, Helm S 2nd, Fellows B, et al. Opioid epidemic in the United States. Pain Physician. 2012; 15(3 Suppl):9-38. Further, Wisdom teeth removal is reportedly inflammatory in nature alone and therefore should not require an opioid but rather an NSAID, acetaminophen, ibuprofen or something much less addictive. Despite this, dentists rank number 5 in the country for writing prescription opioids behind internal medicine, primary care, nurse practitioners, and orthopedic doctors. 3. https://www.drugabuse.gov/news-events/nida-notes/2017/04/nonmedical-opioidheroin-use-among-high-school-seniors#.WPPThJE7ttU.gmail. Published April 14, 2017. Retrieved April 15, 2017. 4. 259 million prescriptions for opioids were written in 2012 (CDC). Despite this, medical practitioners and students receive little to no education on addiction, substance abuse, behavioral therapy, mental health, etc. Only recently have some medical and pharmacy schools added an elective class to their curriculum and continuing medical education credits have been highly recommended but gaining little traction.
So what happens when the disparity of the treatment courts with regard to prescription policy precludes recovery success? When philosophy or principal impugn our ability to see the pathway to recovery? And how is recovery defined any more anyway? While some judges order that a participant in treatment court take no medications, others allow medical “expertise” to influence judicial/ treatment decision making. For example, while consulting with a participant in treatment court and the team recently, the participant advised that one of his drugs of choice was Xanax. Ironic then that his drug of abuse is also the drug that his doctor has prescribed for him despite clear disclosure. Does that even make sense? And, what authority do we, the judiciary and/or the treatment team, composed of professionals from every discipline and educated in mental health and substance abuse, many of whom are in long term recovery themselves, have to override the medical order? As medical professionals, you have been taught to treat the symptoms of reported diagnoses… but have you been taught about substance abuse? About screening, assessment, monitoring and accountability in recovery? About informed consent? When do the patient satisfaction surveys, and MACRA reimbursements interfere with your ability to adequately diagnose without the use of behavior therapy? Do we, as educated and invested judges and treatment teams, know more than your MD is willing to learn and invest? The answer, at times, is yes.4 And that then, is when my JD clashes with your MD. I suggest we get on the same team. Together, we can Be the Change. We can, Do Something. Judge Jodi Debbrecht Switalski is a former sobriety, drug and veterans treatment court judge in Michigan with a background in interpersonal violence, mental health and substance abuse. She stepped down from the bench to practice law with Lippitt O’Keefe Gornbein, PLLC and started
From The Hearts of Moms BELIEVE IT OR NOT, IT’S NOT PERSONAL! By Annie Highwater
“I hate you! You are the worst Mother ever! You’re a terrible Dad! You’re such a #@%$#!! This is ALL your fault!” Sound familiar? Could be your angry son or daughter. Could be a teen, an adult, an addicted loved one. Whoever is spewing, it leaves you feeling like you drank poison and then took a stomach punch from Mike Tyson. There was a time in my own life when my soul was a sponge for the vicious spewing of vitriol; it was rampant in my family. I was constantly trying to manage or sidestep chaos and conflict. I would absorb it, take it to heart, try everything to resolve it and spend hours analyzing it. That did not serve me well when I was dealing with behaviors that addiction can cause. It took a while for me to untangle from these dynamics and create a life void of craziness. Untangling was a process. These days I talk with a lot of people going through it and I hear the same experiences. Details vary, dynamics don’t. Certain gutwrenching things occur when you have dysfunction and/or addiction in your family. Even more if it resides in your home. Things go missing, there are pressures for money, arguments over car keys and rides, so on and so forth. The presence of addiction completely changes the trajectory of a family and can turn a once peaceful atmosphere upside down. A recent email I received: Hi Annie, So my daughter called this morning. She wanted to use my credit card for work clothes and said she would repay me in a few months. I didn’t want to do it this time. I know the routine- she will return the clothes and once again I won’t ever see a dime of my money. I said no. She then went on a 10-minute tirade, ranting about what a terrible, selfish person I am and how much she hates me. She said I was never a good mother, I am a worthless person and that everyone hates me. All because I said no! I’m afraid of how hateful she will be the next time I see her. I don’t even know her anymore. How did you manage??” In times past, I questioned myself and my sanity when there were flare ups of this sort. I would rack my brain and try to understand what I did wrong, why I was so worthless. What I could do to fix it. Or I would make the mistake of being lured to defend myself, never getting to the bottom of it. Finally, I realized, these conflicts don’t rise up with fairness and logic, they aren’t going to suddenly become fair and logical, even if I argue back until I’m out of oxygen, or I submit in order to have relief. I will confess, I got fed up and gave it right back sometimes, returning vicious for vicious. This was not dignified for anyone. Backlash against boundaries can be horrendous, especially when first setting them. What a horror when your own child (or any loved one) quickly becomes hateful. I remember the shock of it. We are some years past that, I’m more than grateful to say I’ve gone almost 5 years without conflict, dysfunction or active addiction present in my daily life. I say that to say this: if you feel caught in an unending cycle of conflict, peace is possible. Boundaries do eventually work. At one time my life
felt out of control with turmoil and conflict. As much as I know how that feels, I know peace is possible. I often hear from people who, like this frustrated Mother, are in the midst of this type of struggle, people who feel helpless and exhausted. I don’t offer advice outside of direction toward support; support is crucial! Find support online, or in a meeting, the sooner the better. I also always recommend seeking information and education. I tell folks what a therapist trained in family dysfunction told me: “Annie, you have to do whatever it takes for you to be okay, for you to be safe and at peace. For your environment to be as healthy as possible. Work on how you respond and what you allow.” And I tell people this - it’s not personal. This behavior is par for the course, it occurs with the disease of addiction, it’s not okay, it’s terribly painful and at times traumatizing. But it’s not personal. Realizing it’s not personal is a hard place to come to and it’s definitely a process, it takes time. It feels personal. Your personal belongings may become damaged or go missing. Your personal space is violated. Your personal character can oftentimes be assassinated. But the reality is, the adversarial behavior is not personal. Years after the fact, when the damage was done, amends had been made and things had settled, I once asked my son if he meant the things he’d said to me. I asked straightforward, “Did you mean those things? Did you think those things?” His answer was a solid no. “No Mom,” he explained, “I had to do whatever it took to get what I needed and get out of the conversation. I was desperate. I wasn’t thinking logically. My brain was altered, I was out of control. I couldn’t even allow myself to stop long enough to think about how bad you must be feeling, even though deep down I knew it. I was constantly running on sensory overload; your feelings were collateral damage.” Anyone in the path of someone active in addiction is liable to be collateral damage. It’s symptomatic. It’s not personal. This is why taking care of yourself is vital. Protecting oneself, setting boundaries and having a plan for the behavior is critical. Your healthiness will promote healthiness over time. It’s a process, it takes time. When I began working on my confidence and worth, not receiving those words, things started changing. When I handled heated situations with calm, disengaged responses instead of being hyper-reactive, eventually they stopped happening. Going to meetings, getting informed, therapy work, calling supportive friends and taking it day by day all helped bring my life to a more manageable place. I can tell you this after all of that; don’t give up hope or give in to despair. It’s not personal, peace is possible, it’s a process. Annie Highwater is the author of “Unhooked, a Mother’s Story of Unhitching from the Roller Coaster of Her Son’s Addiction”. She is a long distance runner, health and wellness advocate and researcher of behavioral science; specifically including family pathology and concepts of dysfunction and conflict. Annie resides in Columbus, Ohio where she has worked in the insurance industry. She also enjoys writing, yoga, hiking, the great outdoors and visiting her son in Southern California as often as possible firstname.lastname@example.org
IMPORTANT HELPLINE NUMBERS
A New Path www.newpath.org Addiction Haven www.addictionhaven.com Bryanâ€™s Hope www.bryanshope.org CAN- Change Addiction Now www.addictionnow.org Changes www.changesaddictionsupport.org City of Angels www.cityofangelsnj.org FAN- Families Against Narcotics www.familiesagainstnarcotics.org Learn to Cope www.learn2cope.org The Long Island Council on Alcoholism and Drug Dependence www.licadd.org Magnolia New Beginnings www.magnolianewbeginnings.org Missouri Network for Opiate Reform and Recovery www.monetwork.org New Hope facebook.com/New-Hope-Family-Addiction-Support-1682693525326550/ Parent Support Group New Jersey, Inc. www.psgnjhomestead.com P.I.C.K Awareness www.pickawareness.com Roots to Addiction www.facebook.com/groups/rootstoaddiction/ Save a Star www.SAVEASTAR.org TAP- The Addicts Parents United www.tapunited.org
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ALCOHOLICS ANONYMOUS WWW.AA.ORG AL-ANON WWW.AL-ANON.ORG 888-425-2666 NAR-ANON WWW.NAR-ANON.ORG 800-477-6291 CO-DEPENDENTS ANONYMOUS WWW.CODA.ORG 602-277-7991 COCAINE ANONYMOUS WWW.CA.ORG 310-559-5833 MARIJUANA ANONYMOUS WWW.MARIJUANA-ANONYMOUS.ORG 800-766-6779 NARCOTICS ANONYMOUS WWW.NA.ORG 818-773-9999 EXT- 771 OVEREATERS ANONYMOUS WWW.OA.ORG 505-891-2664 NATIONAL COUNCIL ON PROBLEM GAMBLING WWW.NCPGAMBLING.ORG 800- 522-4700 GAMBLERS ANONYMOUS WWW.GAMBLERSANONYMOUS.ORG 626-960-3500 HOARDING WWW.HOARDINGCLEANUP.COM NATIONAL SUICIDE PREVENTION HOTLINE WWW.SUICIDEPREVENTIONLIFELINE.ORG 800-273-8255 NATIONAL RUNAWAY SAFELINE WWW.1800RUNAWAY.ORG 800- RUNAWAY (786-2929) CALL 2-1-1 WWW.211.ORG ASSOCIATION OF JEWISH FAMILY AND CHILDRENS AGENCIES WWW.AJFCA.ORG 410-843-7461 MENTAL HEALTH WWW.NAMI.ORG 800-950-6264 DOMESTIC VIOLENCE WWW.THEHOTLINE.ORG 800-799-7233 HIV HOTLINE WWW.PROJECTFORM.ORG 877-435-7443 CRIME STOPPERS USA WWW.CRIMESTOPPERSUSA.ORG 800-222-TIPS (8477) CRIME LINE WWW.CRIMELINE.ORG 800-423-TIPS (8477) LAWYER ASSISTANCE WWW.AMERICANBAR.ORG 312-988-5761 PALM BEACH COUNTY MEETING HALLS CLUB OASIS 561- 694-1949 CENTRAL HOUSE 561-276-4581 CROSSROADS WWW.THECROSSROADSCLUB.COM 561- 278-8004 EASY DOES IT 561- 433-9971 THE TRIANGLE CLUB WWW.TRIANGLECLUBPBC.ORG 561-832-1110 LAMBDA NORTH WWW.LAMBDANORTH.NET BROWARD COUNTY MEETING HALLS 101 CLUB 954-573-0050 LAMBDA SOUTH CLUB 954-761-9072 WWW.LAMBDASOUTH.COM PRIDE CENTER WWW.PRIDECENTERFLORIDA.ORG 954- 463-9005 STIRLING ROOM 954- 430-3514 4TH DIMENSION CLUB WWW.4THDIMENSIONCLUB.COM 954-967-4722 THE BOTTOM LINE 954-735-7178
A MOTHER’S PLEA TO SAVE THE AFFORDABLE CARE ACT By Gretchen Burns Bergman
My two sons are alive and well, so this Mother’s Day I’m speaking out in gratitude for the Affordable Care Act. For the sake of millions of parents whose loved ones struggle with addictive illness, I am relieved that the ACA wasn’t repealed. Therefore I must speak out, not as a policy wonk, a healthcare professional or even a person in recovery myself, but as a Mom. I believe that my younger son is over two years sober today because he was able to get health insurance through the ACA. In prior years a “pre-existing condition” (opiate dependency) barred him from getting insurance that would cover the degree of treatment he needed for his decades of IV drug use, as well as the length of time he needed in residential treatment to heal and find recovery. Because of his mandated insurance benefits, he was able to receive six months of intensive residential treatment. I know that the ACA is still threatened and I’m concerned that new proposed healthcare plans will slash money for treatment and reduce access to lifesaving health services for people who have substance use disorders. We are losing far too many precious lives unnecessarily due to health issues associated with drug use and to the accidental opioid overdose epidemic. I’m a lucky mother, because both of my sons have survived accidental overdoses. They have found and are sustaining recovery, and they are helping other people by working in the addiction treatment field today. They understand the necessity for policies that reduce the harms associated with drug use and addiction, because despite the odds, they managed to survive, heal and thrive. But, I can’t be complacent and count my blessings while so many other lives are gravely at risk. Prior to the Obama administration paltry few people could access treatment. And, insurance didn’t cover substance use treatment services. As a humane drug policy advocate, I get calls from distraught family members every day, who know that their loved one has a life-threatening disease, but feel powerless to help. I have been in that insane maze for decades with my own sons. I’ve been down the road where you put every penny you can gather to get them into 30 days of treatment, only to have them right back out and a slave to the needle the next day. And, I have stood by helplessly as society and the criminal justice system labeled them and treated them like criminals for non-violent drug use. According to Michael Botticelli, President Obama’s Director of National Drug Control Policy, “We know that many people who are injecting drugs have viral hepatitis. We’ve seen outbreaks in parts of the country with people with HIV…People need access to highquality, comprehensive healthcare if they’re really going to deal with these issues.” Director Botticelli personally knew the devastation of untreated addictive illness, and he listened to moms like me. We were working together to address this critically urgent problem.
States, because of the corruption, gangland violence and deaths that it caused. We are at it again at a critical time in our history. Today mothers are leading the charge to end the disastrous war on drugs and failed punitive prohibitionist policies that have wreaked such havoc on our families. Moms United to End the War on Drugs representatives from across the nation and around the globe are telling their stories in an effort to call attention to the tragic loss of lives and liberties caused by the drug war. Moms are united in advocating for therapeutic and restorative drug policies. I urge other mothers to speak out for our maternal rights to protect our children and families and to demand healthcare services that should be a basic human right for all. The Affordable Healthcare Act isn’t perfect, but it begins the process of honoring and caring for all lives, and together we can continue to make it better. Gretchen Burns Bergman is Co-Founder of A New PATH (Parents for Addiction Treatment & Healing), and lead organizer of the international Moms United to End the War on Drugs campaign. www.momsunited.net.
DISCOVERING OUR MYSTICAL SELF By Maxim W. Furek, MA, CADC, ICADC
Continued from page 16
renewed spirit, better health and an enhanced quality of life. Conversely, with your new center, you will instinctively assume responsibility for your thoughts and actions. Nobel laureate Albert Schweitzer (1875 – 1965) alleged, “Man must cease attributing his problems to his environment, and learn again to exercise his will – his personal responsibility in the realm of faith and morals.”
But, today’s administration threatens to undue all of the progress we have made. The impact of repeal would be seen in an increase of untreated disease. It would increase homelessness and crime, thereby threatening public safety. But most importantly it would increase accidental overdose, the steady and tragically unnecessary loss of lives to untreated addictive illness and the inherent health problems associated with it.
The message is clear: Do not blame others. By blaming them you surrender control and hand over your power. Do not give away your power. Do not abdicate your responsibility. Assume responsibility for your life and become the loving and protective steward of your inner spirit.
Mother’s Day can be a lovely time to spend with your family honoring motherhood. When we look at history, the celebration is also one of maternal strength and action. Mother’s Day was started in North America as a response to the carnage and deaths from the Civil War. Mothers protested the futility of their Sons killing the Sons of other Mothers. In the 1930’s a group of mothers were instrumental in ending alcohol prohibition in the United
Maxim W. Furek, MA, CADC, ICADC is passionately researching the essence of happiness. His rich background includes aspects of psychology, addictions, mental health and music journalism. His book Sheppton: The Myth, Miracle & Music explores the psychological horror and eventual survival experienced by two entombed coal miners. Learn more at shepptonmyth.com
Every one of us is a spiritual creature, each on a personal journey of self-discovery. The moment that we discover our mystical self and experience true inner peace, will be the greatest of possible rewards.
A D V E R T I S I N G
O P P O R T U N I T I E S
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UFAM 2017 Rally- May 18, 2017- Lansing, Michigan NAATP -National Addiction Leadership Conference- May 21-23, 2017- Austin, TX West Coast Symposium on Addictive Disorders- June 1-4, 2017- La Quinta, CA Innovations in Behavioral Healthcare- June 19-20, 2017- Nashville, TN C.O.R.E- Clinical Overview of the Recovery Experience- July 16-19, 2017- Amelia Island, FL Cape Cod Symposium- September 14-17, 2017- Hyannis, MA Moments of Change- October 2-5-Palm Beach, FL Recovery Results Conference-November 28-29- Dallas, TX
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SCHIZOPHRENIA AND SUBSTANCE USE DISORDER: THE SPLIT MOLECULAR GENETICS OF DOPAMINE AND ENDORPHINS By Kenneth Blum, Ph.D.
This first hypothesis was developed in-part because of the extensive co-occurrence of substance use disorder (SUD) with schizophrenia. The involvement of dopaminergic neurotransmission in the genetics (antecedents) of schizophrenia, as well as genetic vulnerability to reward deficiency is well established. Multiple genes interact with multiple environmental factors that influence many psychiatric conditions (behavioral phenotypes). Evidence suggests that schizophrenia is a complex genetic disorder involving many (polygenic) inherited genes. For example, genetic studies have sought to identify subtypes (endophenotypes) of schizophrenia to improve the reliability of diagnosis. Some chromosomal regions where these genes are located have been shown more than once to have an association with being susceptible to schizophrenia. Many of the genes that are associated in genetic studies with psychiatric conditions code for the proteins involved in neurotransmission in the synapses. Genetic studies are complicated by fuzzy diagnostic boundaries and the presence of similar behaviors (phenocopies). For example, the symptoms produced by schizophrenia are similar to some symptoms produced by drugs of abuse. The association of the DRD2 A1 variant with both high SUD risk and schizophrenia suggests this common thread.
Continued from page 12
interesting idea concerning a role for gamma-endorphin in schizophrenia and alternative pathways being involved in both schizophrenia and SUD. They showed that plasma levels of gamma-endorphin (a peptide called (des-tyr) gamma-endorphin [DTGE]) were significantly lower in Schizophrenic patients compared to normal healthy volunteers. Gamma Endorphin can reduce hallucinogenic experiences, and these studies found that people with schizophrenia have reduced amounts of this chemical that occurs naturally (endogenously) in the brain. What is even more significant, it was reported that alcohol increases these peptides in the brain and may be a physiological reason that schizophrenic patients abuse alcohol to reduce psychosis. In animal studies, Jackson and associates reported a reduction of behavioral effects of ethanol by DTGE. This is one way that this finding may explain alcohol abuse in a subtype of people with schizophrenia.
Hypothesis 2 One plausible mechanism for alcohol seeking in people with schizophrenia and SUD, based on previous research, may be a deficiency of gamma type endorphins that has been linked to schizophrenic type psychosis. In 2014, my laboratory also proposed that alcohol-seeking behavior in people with schizophrenia may serve as a physiological self-healing process linked to the increased function of the gamma endorphins, thereby reducing abnormal dopaminergic activity at the brain reward center, the nucleus accumbens (NAc). Moreover, earlier work by van Ree and de Wied in the 80’s from the Netherlands provide an
INTERVIEW WITH KURT ANGLE By Patricia Rosen
Continued from page 29
mine fueled by my own loss, grief and struggle with addiction, so to see it come to life has been an incredible experience. It just goes to show – you don’t have to stay quiet – you can do something to help - and if we all come together we can enact change. Patricia: It definitely takes more than one person to enact change. In your life, there have been so many medals and awards, not to mention film, TV appearances and radio. What has been your biggest accomplishment to date? Kurt: The Olympic Gold Medal was my biggest accomplishment by far – that’s the big one. No doubt my recent induction into the WWE Hall of Fame is a close second. Lately, it has been a whirlwind. When I left the WWE in 2006, there was always that feeling of hope I had that I would return some day. It took me 11 years and with the recent WWE Hall of Fame ceremony in Orlando – its official - I got my ring. It’s a totally incredible feeling. I am now in every wrestling hall of fame. I never thought I’d be called one of the greatest ever in wrestling – it’s truly a sport I love. But being clean the last four years has really been the key – it’s shown me what’s possible when you stay on the path of recovery. And on this path – I’ll definitely stay. Patricia: I am so happy for you. Thank you so much for the interview and congratulations on all you do!
DTGE = gamma-endorphin (a peptide called (des-tyr)-gammaendorphin Dopamine and opioid peptide interaction in Schizophrenia and alcoholism Left side: Carrying the DRD2 A1 increases the “wanting” of alcohol and in carriers with a low gamma-endorphin (DTGE) would augment the risk for psychosis leading them to increased selfmedication by using alcohol. Right side: Carrying the DRD2 A2 may be protective against alcohol drinking in Schizophrenics. Lack of Gamma Endorphin (DTGE) in utero leads to an over-expression of DRD2 A2. Center: However, some Schizophrenics with the DRD2 A2 allele along with unknown reward gene polymorphisms may use substances due to lack of reward. Conclusion Based on these two ideas, research involving neuroimaging, genome-wide association studies (GWAS), and investigation of the environmental (epigenetic) effects, and the relationship between neurogenetics and systems biology will help to unravel the role of dopamine in psychiatric illness and SUD. Understanding the split molecular mechanisms related to both dopamine and endorphins may potentially result in better treatment and prevention of the devastating fatal effects of alcohol and drug abuse. Kenneth Blum, B.Sc. (Pharmacy), M.Sc., Ph.D. & DHL; received his Ph.D. in Neuropharmacology from New York Medical College and graduated from Columbia University and New Jersey College of Medicine. He also received a doctor of humane letters from Saint Martin’s University Lacey, WA. He has published more than 550 abstracts; peer-reviewed articles and 14-books.
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Keynote Speaker: Glennon Doyle Melton is the author of the inspiring New York Times best-selling memoir, Carry On, Warrior. She is also the founder of Momastery.com, where she writes essays from the heart about marriage, motherhood, faith, addiction, recovery and serving the marginalized.
For registration and more information, visit FoundationsEvents.com 37
BIG PHARMA GETS THEIR MEN IN TRUMP APPOINTEES By John Giordano, Doctor of Humane Letters, MAC, CAP
for their statements once their appointment is approved by congress. If there is one thing that I’ve learned watching our political process, it is that personal is policy. The President is going to fill key positions with the people who will carryout his vision. That being said, perhaps a look into the President’s recent activities will give us better insight to the new direction of the FDA. One of the first groups Trump met with after becoming president in January was the pharmaceutical industry. Trump, who stressed on the campaign trail that “pharmaceutical companies are getting away with murder,” threw caution into the wind by telling big pharma execs that he plans to cut the FDA’s regulatory playbook. “Instead of it being 9,000 pages, it’ll be 100 pages. We’re also going to be streamlining the process so that from your standpoint, so that when you have a drug, you can actually get it approved -- if it works -instead of waiting for many, many years.” In early April (2017) insiders reported that Trump intends to tap former lawyer and current Rep. Tom Marino for the position of U.S. Drug Czar (Office of National Drug Control Policy – ONDCP). Marino, who is currently serving his third term as the U.S. Representative for Pennsylvania’s 10th congressional district, is not without controversy. In 2016, Marino authored and supported the Ensuring Patient Access and Effective Drug Enforcement Act. The bill’s supporters claim it struck the right balance between the needs of patients, the pharmaceutical industry, and law enforcement. However, detractors of the bill claim the legislation undercuts the DEA’s ability to hold pharmaceutical drug distributors accountable for the diversion of large amounts of opioid pain relievers. More specifically, Joseph Rannazzisi, JD, RPh, head of the DEA Office of Diversion Control, cautioned the bill, backed by a pharmaceutical industry lobbying campaign, would protect corporations engaged in criminal activity. “This bill passes the way it’s written we won’t be able to get immediate suspension orders, we won’t be able to stop the
Continued from page 22
hemorrhaging of these drugs out of these bad pharmacies and these bad corporations. What you’re doing is filing a bill that will protect defendants in our cases.” If you look at Christie, Gottlieb and Marino’s appointments independently, you might not think much about any one of them. However, when you take into consideration that Christie’s job ends in November and Gottlieb and Marino serve at the President’s pleasure, the tea leaves begin to reveal their secrets. The FDA is the most important government agency to our economy in that it regulates industries that account for nearly 25 percent of consumer spending in the U.S. That represents a lot of jobs and prosperity, something else former businessman and current president Trump promised on the stump. He can only keep one of his promises, end the opioid epidemic or open the flood gates at the FDA. Which promise he intends to keep will be reflected by the actions Gottlieb takes as head of the FDA. I have not given up hope because we still have a voice in this discussion. Make your thoughts known by calling your congressmen and senator. Phone calls matter. There is a new app called 5calls.org that makes it easy to find your representative and their contact information. Exercise your rights and give it a try. John Giordano, Doctor of Humane Letters, MAC, CAP, is the founder of ‘Life Enhancement Recovery Center,’ an Addiction Treatment Consultant, President and Founder of the National Institute for Holistic Addiction Studies, Chaplain of the North Miami Police Department and is the Second Vice President of the Greater North Miami Chamber of Commerce. He is on the editorial board of the highly respected scientific Journal of Reward Deficiency Syndrome (JRDS) and has contributed to over 65 papers published in peer-reviewed scientific and medical journals. For the latest development in cutting-edge addiction treatment check out his website: www.holisticaddictioninfo.com
CAKE - CHRONIC PAIN - COURAGE
BY LOUISE A. STANGER ED.D, LCSW, CDWF, CIP AND ROGER PORTER veterans took part in therapy rooted in the psychological theories of pain, and felt the effects last up to a year. “We want to take the focus off the pain and into functioning and finding pleasurable ways to spend time,” says Mark Ilgen, the study’s lead author and psychologist specializing in addiction research. Although combining behavioral therapy and social support is in the ground stages as a way of managing pain, Dr. Ilgen sees a connection. “There’s a strong link between depression and pain. Pain is responsive to mood, and mood is responsive to social support.” The theory behind this approach is self-management of pain. The person experiencing chronic pain needs help learning to think, feel, and do better, despite the persistence of pain. Much the same way Harriet and Jordan found recovery through therapy and educational support. Self-management programs engage the individual in problem-solving, pacing, decision-making, and taking action to manage their pain. Research continues to support that abstinence from mind altering substances is an integral part of pain recovery along with evidenced based modalities that allow an individual to live effectively. Family education is viewed as an integral part of the treatment plan. Families must learn about chronic pain, and how addiction may start with a simple prescription. With the medical community re-thinking how opioids are prescribed, and the attention being given to training behavioral health care
Continued from page 26
professionals in this arena, there are new ways developing to more effectively deal with chronic pain and the co-occurring issues of depression and anxiety that arise from these conditions. References Provided Upon Request Dr. Louise Stanger is a speaker, educator, clinician, and interventionist. She uses an invitational intervention approach with complicated mental health, substance abuse, chronic pain and process addiction clients. Her book Falling Up: A Memoir of Renewal is available on Amazon and Learn to Thrive: An Intervention Handbook on her website at www.allaboutinterventions.com. Roger Porter has two bachelor degrees, film and marketing, from the University of Texas at Austin. He works in the entertainment industry, writes screenplays and coverage, and when he’s not doing that he tutors middle and high school students.
CORNERSTONE CARES We proudly maintain a 7:1 client-to-therapist ratio, so that our staff, including the Medical Director, Physicians, Clinical Director, and Licensed Mental Health Counselors, can personally work with clients to create individualized treatment programs.
TRADITIONAL AND CO-OCCURRING RECOVERY PROGRAMS Cornerstone Recovery Center offers both a Traditional Recovery Program and a Co-occurring Mental Health Program. The Traditional Program includes 12-Step and SMART Recovery programs, giving clients the option to choose a recovery path that is best suited for them. The Co-occurring Mental Health Program primarily focuses on addressing mental health disorders through integrated treatment.
OUR RECOVERY PROGRAMS INCLUDE: » Designated areas for Traditional and Co-occurring Mental Health clients
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Published on May 1, 2017
Published on May 1, 2017
An award-winning national free monthly magazine for the family and friends of loved ones suffering from addiction. Love our articles, interv...