Monday, February 18, 2013

Commentary: Why the Term “Enabling” Does More Harm Than Good

The term “enabling” is commonplace in the field of addiction. It is used within support group settings, in treatment programs and throughout the professional literature about addiction and the family. I consider it one of the most frequently misunderstood terms in our field. In fact, as my research about family caregivers of people with substance use disorders has evolved, I have come to loathe the term “enabling.” Here is why.
There is a great deal of misinterpretation about what qualifies as behavior that is “enabling.”
Webster’s  definition of the term includes: “a) to provide with the means or opportunity; and b) to make possible, practical or easy.” Wikipedia notes that enabling also is used “to signify dysfunctional approaches that are intended to help but in fact may perpetuate a problem….” Examples include taking responsibility, blaming others or making accommodations for a person’s harmful conduct, so that the person is shielded from the harm it may do and the pressure to change.
Using these definitions, doing your son’s laundry might be considered enabling, as it makes it easier for him and takes responsibility for the chore away from him. In actuality, it may or may not be enabling –depending on the context. If you do this chore to make things easier for your son because he attended a self-help meeting – you probably are supporting recovery – not enabling self-destructive behaviors. On the other hand, if you are doing your son’s laundry because he was drunk all weekend and will be embarrassed to go to school or work in unlaundered clothes, then you are enabling him to continue engaging in self-destructive behavior. You are helping him avoid the negative consequences of drinking.
I find family members often are confused over the issue of what constitutes enabling. Some have ardently been told that any support offered to a recovering child or spouse can be considered enabling. The philosophy seems to be that the person needs to learn to “fend for themselves” or “live life on life’s terms.” This is difficult to argue. We all need to learn the necessary skills to survive and thrive in our environments. Especially as parents, it is our responsibility to foster this in our children. But it does not mean that we cannot help our loved ones in productive ways.
Recovery, especially early recovery, is hard work. Offering to support the intense effort of this work can be helpful. For example – if a loved one does not have access to a car, it is supportive to offer to drive her to AA meetings, or soccer practice or any other recovery-supporting activity.
Some say that the addicted person must take responsibility for coordinating his or her own travel – and indeed – this can be a good goal. But offering to help at first or occasionally does not enable the person to escape the negative consequences of addiction – and it can help to support recovery.
It is loaded with negative and judgmental connotations that are misplaced.
Worse yet, enabling is sometimes described as “dysfunctional,” which can lead family members to the conclusion they are dysfunctional and have let their loved one down. The important distinction that is sometimes missed is that it is the behavior that is dysfunctional, not the person. The vast majority of parents that I have met have only done what most parents do; that is try their best to help their child. They engage in the same behaviors as other parents. It is just that they find themselves in a strange and difficult situation where behaviors that normally are helpful do not function that way.
I believe that the term enabling causes more harm than good. I would like to get rid of the term altogether.
Rather than labeling a family member’s behavior as “enabling,” focus on the consequences of the addicted person’s behavior. Ask yourself – by doing this, do I allow him or her to avoid a negative consequence of the drinking or drug use? If the answer is yes, resist the urge to intervene. It is important that the person experience the negative consequences that substance abuse renders. Also ask yourself – by doing this, am I encouraging  efforts he or she has made at recovery? If the answer is yes, go for it! It is helpful to recognize and show signs of support and appreciation for the hard work that an addict undertakes to sustain recovery.
We must remember that addiction is a disease and recovery requires ongoing maintenance. This is a lot of work – and supporting the WORK of recovery can be a loving thing to do.
Kimberly Kirby, PhD
Director of the Parent’s Translational Research Center; Senior Scientist

Friday, February 15, 2013

Generic Drug Distributor Sues Suboxone Maker for Monopolizing Treatment Market

The generic drug distributor Rochester Drug Co-Operative Inc. has sued the maker of the opioid addiction treatment Suboxone for allegedly monopolizing the opioid treatment market, Bloomberg reports.
The maker of Suboxone (buprenorphine and naloxone), Reckitt Benckiser Group, developed a film version of Suboxone that is placed under the tongue, to replace the tablet form of the drug. According to the lawsuit, filed in U.S. District Court in Wilmington, Delaware, this prevented competition, because pharmacists cannot substitute the cheaper generic version.
“Reckitt concocted a multifaceted anticompetitive scheme, executed over the course of several years, to maintain and extend its monopoly power,” Rochester Drug stated in its complaint. The article notes Suboxone is used to help control opioid withdrawal symptoms.
In September, 2012, Reckitt notified the Food and Drug Administration it was voluntarily discontinuing the supply of Suboxone tablets in the United States, due to increasing concerns with children’s exposure and risk for accidental poisonings. The U.S. Poison Control Centers found consistently and significantly higher rates of accidental unsupervised pediatric exposure with Suboxone tablets, compared with the film.

ADHD Drugs Not Effective in Many Young Children, Study Concludes

Treatment for attention deficit hyperactivity disorder (ADHD) does not appear to help many young children, a new study concludes.
The study followed 186 children, ages 3 to 5, who had moderate to severe ADHD. Six years after their diagnosis, about 90 percent still showed symptoms such as over-activity, impulse control or inattentiveness, according to Bloomberg.
Two-thirds of the children were on medication. These children did not show significant differences in ADHD severity, compared with those who were not taking drugs. Almost two-thirds of treated children had significant hyperactivity and impulsivity, compared with 58 percent of those not taking medication.
“ADHD in preschoolers is a chronic and rather persistent condition, one that requires better long-term behavioral and pharmacological treatments than we currently have,” study author Mark Riddle of the Johns Hopkins Children’s Center in Baltimore, said in a news release.

NAADAC Institute Education Update


Don't miss these great opportunities to earn CEs, advance your professional life and enhance your practice through live seminars, independent study or online!

What Does Science Say? Reviewing Recovery Research

Thursday, February 28, 2013
12pm - 1:30pm EST (11 CST/10 MST/9 PST)

More Information & Registration
This webinar will review what is known about the resolution of severe alcohol and other drug problems from the standpoint of scientific and historical research.  The review will include information on the prevalence of recovery as well as thepathways, styles, stages, degrees and durability of recovery.

Upcoming Recovery-Oriented Webinars:
 
Defining Recovery-Oriented Systems of Care (ROSC)
Wednesday, March 13, 2013
3 - 4pm EST (2 C/1 M/12 P)


The History of Recovery in the United States and the Addiction Profession
Tuesday, March 26, 2013
12 - 1:30pm EST (11 C/10 M/9 P)
More Information & Registration


Using Recovery-Oriented Principles in Addiction Counseling Practice
Wednesday, April 10, 2013
3 - 5pm EST (2 C/1 M/12 P)
More Information & Registration


The Role of Peer Recovery Support Specialists (PRSS) in the Addiction Profession
Tuesday, April 23, 2013 
12 - 1:30pm EST (11 C/10 M/9 P)
Including Family & Community in the Recovery Process
Wednesday, May 8, 2013
3pm - 5pm EST (2 C/1 M/12 P)


Exploring Techniques to Support Long-Term Addiction Recovery for Clients & Families
Thursday, May 23, 2013
12pm - 2pm EST (11 C/10 M/9 P)


Collaborating with Other Professions, Professionals & Communities
Tuesday, June 4, 2013
3pm - 4pm EST (2 C/1 M/12 P)


www.naadac.org/education/webinars

Presenter: William (“Bill”) White is a Senior Research Consultant at Chestnut Health Systems, past-chair of the board of Recovery Communities United and a volunteer consultant to Faces and Voices of Recovery.  He has a Master’s degree in Addiction Studies from Goddard College and has worked full time in the addictions field since 1969 as a streetworker, counselor, clinical director, trainer and researcher.   Bill has authored or co-authored more than 400 articles, monographs, research reports and book chapters and 16 books.  His book, Slaying the Dragon - The History of Addiction Treatment and Recovery in America, received the McGovern Family Foundation Award for the best book on addiction recovery.
Price:
Education is FREE to all professionals
 
CE Credit: 
Members of NAADAC receive 1.5 CEs for FREE after successfully passing an online CE Quiz.  Non-members of NAADAC receive 1.5 CEs for $20.
 
On Demand:
Watch previously recorded NAADAC webinars for free and gain CE credit. This webinar will be recorded and posted to our website:
 
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Continue to register for the event and do not attend. You will automatically receive links to the archived webinar, PowerPoint slides, CE Quiz and more after the webinar.
Become a member of NAADAC to earn free CE credit for all NAADAC webinars & online courses (over 75 CEs): www.naadac.org/join
Sober Truth on Preventing (STOP) Underage Drinking Act Grants  
The Center for Substance Abuse Prevention (CSAP) is accepting applications for fiscal year (FY) 2013 Sober Truth on Preventing Underage Drinking Act (STOP Act) grants. The purpose of this program is to prevent and reduce alcohol use among youth ages 12-20 in communities throughout the United States.  Applications due by March 1, 2013.  Full Details 
AAPNY Conference: Meeting the Challenge through Education of the Addiction Professional

Join NAADAC and the Association for Addiction Professionals of New York (AAPNY) on March 8th and 9th, 2013 for a two-day, two-track education forum in Riverhead, NY. Earn 6.5 continuing education credits per day. Trainers are presenting skills based, five-hour tracks to learn evidence based skills.
  • Clinical Supervision presented by Tom Durham, PhD
  • Co-Occurring Disorders presented by Gerry Schmidt, MA, MAC, LPC
  • SBIRT: Guide to Screening, Brief Intervention and Referral to Treatment presented by Shirley Mikell, NCAC II, CAC II, SAP
  • Relapse Prevention: Romancing the Brain in Recovery presented by Cynthia Moreno Tuohy, NCAC II, CCDC III , SAP
Download the Brochure
Register Online
Want to Offer NAADAC CE Credit for Your Trainings? Become a NAADAC Approved Education Provider  
 
The NAADAC Approved Education Provider emblem signifies that an organization, government agency or educational institution has voluntarily opened its educational programs to examination by an independent body. The NAADAC Approved Academic Education Provider program ensures that continuing education programs are accepted by the National Certification Commission (NCC) for initial applicants or for those re-certifying for the NCAC I, NCAC II or the MAC.  In addition, many states automatically accept training hours from NAADAC Approved Education Providers towards state certification and re-certification.

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Conflict Resolution for Recovery by Cynthia Moreno Tuohy Coming Near You!

This therapeutic training created by Cynthia Moreno Tuohy is skilled-based and focused on how the brain works in conflict and strategies to affect the quality of recovery in relationships. Participants will be able to help reduce relapse and sustain recovery of adult and adolescent substance use, abuse and dependent persons by improving their conflict resolution knowledge, attitudes & skills.

Hosted by the West Virginia Association of Alcoholism & Drug Abuse Counselors
March 26-28, 2013, in Charleston, WV
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Indiana Association for Addiction Professionals 9th Annual Spring Conference
April 12-13, 2013, in Indianapolis, IN
More Information
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Phone: 703.741.7686
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Saturday, Feb. 23: COA Open House

On Saturday, February 23 from 12:00 to 4:00 pm, City of Angels NJ, Inc. will host its 4th annual Open House at the Dwier Center (392 Church Street, Groveville, NJ).
  
This inspiring, educational - and free - event features a great lineup of speakers including Dr. Karl Benzio from Lighthouse Network, who will discuss how addiction affects the brain; Dr. John J. Blette, who will describe evidence-based interventions for offenders; Justin Sabatino from Recovery Compliance Inc., who will discuss personalized compliance programs for recoverees; and keynote speaker L.A. Parker, who will talk about his journey of recovery to a successful career in journalism.

Many community groups and treatment centers will be on hand to provide details about their services, including Summit Behavioral Health, The Retreat, Seabrook House, Livengrin, Addictions Victorious, Nar-Anon, Narcotics Anonymous, Young People in Recovery, Celebrate Recovery, Launching Point, and many others.

Refreshments will be provided by Groveville's best Italian restaurant, Family Nest.

Don't miss this once-a-year opportunity to learn about new approaches to addiction recovery and new resources for recoverees and their families.

For details about this event, including speaker times and bios, please click here. To watch videos of some of last year's speakers, click here.
Sunday, Feb. 24: Art Retreat at COA
From 2:00 to 5:00 pm on Sunday, February 24,
Red Tent Today will host an Art Retreat at the Dwier Center (392 Church Street, Groveville, NJ). 
 
The Art Retreat is a spiritual experience where participants use paints, pastels and other media to create visual representations of their thoughts and feelings. It's also just a lot of fun! No need to be an accomplished artist to join in...all are welcome from the trendsetters to the "creatively challenged".
 
To learn more about Red Tent Today, click here.
 
This event is limited to 15 people. There is no charge. If you would like to attend, please email CityofAngelsNJ@hotmail.com to reserve a place.
Free Tax Help for Recoverees
Have you claimed your income tax refund this year?

City of Angels NJ's Treasurer, Cathy Levine, has generously offered to
 provide free assistance filing state and federal income tax for any recoveree with at least six months in sobriety. Cathy is a certified public accountant (CPA) and for many years has run an accounting business.

Cathy can be contacted at catmelev@verizon.net.
 Tidbits 
 COA hosts support group meetings for both addiction sufferers and their families every day of the week at the Dwier Center (392 Church Street, Groveville, NJ). This includes 12-step meetings, a Sunday night Spirituality Meeting and the popular Sunday morning family support group, The Breakfast Club. To check out our online calendar, click here.
 
 
For directions to the Dwier Center, click here. 
 
 
The COA website now offers an Addiction News Feed with the latest studies, reports, new and other info on addiction. It's updated in real time with the top 30 articles. To read the feed, click here. 
New videos are up on the COA YouTube channel. To watch, click here.
    


Join COA's Pinterest community! To visit the boards, click here.
 
   
  
Keep current on COA activites - join the COA group on Facebook!  COA news is posted first on Facebook, and this page often has photos not available elsewhere. Click here to visit.
 

City of Angels NJ, Inc. is a non-profit organization that provides many services to addicts and their families including interventions, recovery support, Family Program, counseling services and more. All of our services are provided at no charge.

Thursday, February 14, 2013

Florida Task Force on Prescription Drug Abuse and Newborns Releases Report

A task force of doctors, public health experts and social workers in Florida has released a report designed to combat the growing problem of babies born to mothers who are addicted to prescription drugs.
The report found more than 1,560 babies born in Florida in 2011 were diagnosed with symptoms of neonatal abstinence syndrome (NAS). These babies often spend three weeks in neonatal intensive care, with a cost as high as $53,400 per baby. In contrast, the typical hospital cost for a healthy newborn is $9,500, according to the Tampa Bay Times.
NAS babies suffer from withdrawal symptoms such as tremors, abdominal pain, incessant crying, rapid breathing, and sometimes seizures, the report notes.
The task force made recommendations in the areas of prevention, intervention and best practices, and treatment. It recommended that hospitals be required to report babies born with symptoms of NAS, as they do with babies born with infectious diseases such as measles and tuberculosis. The group wants to help treatment facilities reach more women, and recommended considering new laws to offer pregnant women immunity for seeking substance abuse treatment.
Task force member Dr. Ken Solomon, a neonatologist, told the newspaper more research is needed to identify the best way to treat newborns in withdrawal. He noted that some hospitals administer methadone, while others use morphine.
Neonatologist Dr. Mary Newport said she is concerned about the long-term effects of NAS. At her hospital, 30 percent of neonatal intensive care unit admissions last year involved drug exposure. “We’ve had this rash of all of these children who had this very intense drug exposure, and then withdrawal and treatment for that. They are about to hit the school system,” Dr. Newport said.