Saturday, February 9, 2013
Fewer Teens Receiving Substance Abuse Prevention Messages From Media
The percentage of teenagers who receive substanced abuse
prevention messages from the media in the past year dropped from 83.2
percent in 2002, to 75.1 percent in 2011, according to a new government report.
Teens also received fewer school-based prevention messages, the
Substance Abuse and Mental Health Services Administration (SAMHSA)
found. Such messages reached 78.8 percent of teens in 2002, and 74.5
percent in 2011. An estimated 40 percent of teens did not talk with
their parents in the past year about the dangers of substance abuse, Newswise reports.
A recent SAMHSA report
found teen attitudes about the risk of substances such as alcohol and
marijuana have changed in recent years. From 2002 to 2011, the
percentage of teens who perceived great risk from heavy drinking
increased from 38.2 percent to 40.7 percent. During that same time,
there was a drop in binge drinking among teens, from 10.7 percent to 7.4
percent.
The report found the percentage of teens who perceived great risk
from marijuana use once or twice a week dropped, from 54.6 percent in
2007, to 44.8 percent in 2011. Teens’ rate of past-month marijuana use
increased during that time, from 6.7 percent to 7.9 percent.
“To prevent substance abuse among our adolescents, our young people
have to know the facts about the real risks of substance abuse, and
we’re not doing a very good job of that right now,” SAMHSA Administrator
Pamela S. Hyde said in a news release.
“It is time for all of us – the public health community, parents,
teachers, caregivers, and peers – to double our efforts in educating our
youth about substance use and engaging them in meaningful conversations
about these issues, so that they can make safe and healthy decisions
when offered alcohol or drugs.”
Relatives of Painkiller Overdose Patients Speak at FDA Hearing
Relatives of patients who overdosed on painkillers told
federal regulators Thursday they want changes on the labels of narcotic
painkillers, The Wall Street Journal reports. Pain patients concerned such action could limit their access to the medications spoke against the proposed changes.
They spoke at a Food and Drug Administration (FDA) hearing on the use of opioids
in the treatment of chronic pain. The FDA said it wants to gather
scientific evidence on issues including diagnosis and understanding of
patient pain, understanding and adhering to the labels of pain-treating
products, limiting opioid prescriptions and use, and abuse and misuse of
opioid medicines.
The FDA is considering a petition by Physicians for Responsible
Opioid Prescribing, a group of doctors and pain specialists, to include a
recommended upper daily dose on the medications’ label, and to limit
opioid treatment to 90 days, the article notes. The doctors’ group is
also recommending that opioids be indicated for severe pain, not
moderate pain, except in cancer patients.
Last month, a FDA advisory panel voted to strengthen restrictions
on hydrocodone combination drugs, such as Vicodin. The panel
recommended the FDA make the drugs more difficult to prescribe. If the
FDA accepts the panel’s recommendation, it will be sent to the
Department of Health and Human Services, which will make the final
decision.
Illegal Street Sales of Take-Home Doses of Methadone on the Rise
Illegal street sales of take-home doses of liquid
methadone, prescribed to treat opioid addiction, are on the rise,
according to law enforcement officials in Indiana, Kentucky, Virginia
and West Virginia.
The diverted methadone has been tracked to clinics operated by CRC
Health Corp., the article notes. CRC, owned by Bain Capital Partners, is
the largest U.S. provider of methadone treatment, according to
Bloomberg. Last year it operated 57 clinics in 15 states, Bloomberg reports.
Former employees say the company’s clinics are chronically
understaffed, which makes it easier for take-home methadone to be
abused. Former counselors say their heavy workload did not allow them to
adequately counsel patients.
The clinics provide take-home packages, some with just one dose, and
others containing as many as 30 doses. Police and prosecutors say in the
small towns where the company has clinics, methadone has surfaced in
criminal cases.
CRC Chief Executive Officer R. Andrew Eckert said take-home dosing
can help keep patients on methadone, and off illegal drugs, by not
making them come to the clinic every day for treatment. “Our mission is
to help these individuals, but sadly, we cannot report 100 percent
success,” he said. “No treatment provider can.”
Philip Herschman, Chief Clinical Officer of CRC, told Bloomberg the
company follows specific and rigid state and federal rules when it
decides which patients may obtain take-home doses. The company conducts
spot-checks, in which it calls back patients to clinics, to account for
their take-home bottles, he said. If a patient tests positive for any
illicit substances, take-home doses are suspended immediately, he added.
State regulatory records show this is not always true. The records
also indicate CRC’s clinics have not met staffing standards on more than
50 occasions.
Commentary: Hazelden Responds to America’s Opioid Epidemic
Too many people are hooked. Too many are dying. The problem is too big to ignore.
Over the past decade, America has experienced a rampant rise in the
number of people addicted to prescription painkillers, heroin and other
opioids. We truly face an epidemic.
According to the Centers for Disease Control (CDC), the death toll
from prescription painkillers has increased from 3,000 overdose deaths
in 1999 to 15,500 in 2009. The CDC also reported almost 500,000
opioid-related emergency room visits in 2009, and found that about 12
million Americans reported nonmedical use of prescription opioids in
2010.
At Hazelden, we are on the front line of this crisis, which is
hitting youth particularly hard. At our youth facility in Plymouth,
Minn., opioid addiction increased from 15 percent of patients in 2001 to
41 percent in 2011.
The problem deserves a vigorous response. That’s why Hazelden has
introduced a new treatment protocol specifically for opioid-dependent
patients.
The new protocol builds on our traditional care in two ways: by
weaving the specific features and challenges of opioid addiction into
all aspects of treatment, and by incorporating certain medications. We
now assess opioid-dependent patients to determine the need for
medication assistance. Some patients get none, particularly those who
refuse it or whose addiction is less severe. Some receive
buprenorphine/naloxone. Others utilize extended-release naltrexone. In
all cases, medication is adjunct to, and never a substitute for, our
usual evidence-based approach, which includes: psychological and
psychiatric care; Twelve Step-based individual and group therapy;
lectures; and a focus on peer, family and recovery community support for
additional structure and accountability. All of those care components,
in turn, now have an opioid emphasis. For example, we provide
opioid-specific groups, lectures and individual therapy to our
opioid-dependent patients.
Buprenorphine — an opioid itself — is a partial agonist, meaning its
effect is significantly less than the full agonists to which so many are
addicted, such as morphine, Vicodin® and heroin. It’s a safe and proven
means of helping people recover from their opioid of choice on the way
to complete abstinence. Taken daily, buprenorphine inhibits craving,
improves treatment retention, reduces relapse and improves support group
attendance. Naltrexone, our other available medication, is an opioid
antagonist. Injected once a month, it blocks the brain’s opioid
receptors, eliminating the ability for opioids to produce intoxication
or reward.
The adjunctive medication assistance helps address this population’s
hypersensitivity to physical and psychic pain, which puts them at higher
risk of leaving treatment early, relapsing and accidentally overdosing.
While abstinence remains the ultimate goal, medication helps to ensure
patients stay in treatment long enough to acquire new information,
establish new relationships and become solidly involved in recovery.
Research shows medication-assisted treatment is both effective and
safe. As such, it has been endorsed by health regulators and policy
advocates throughout America. In our view, medication taken to treat the
disease of addiction is not unlike pain medication given to
post-surgery patients: if used as directed, under the care of a
physician and not as a means of intoxication, it greatly assists in
recovery.
One of Hazelden’s values is to “remain open to innovation.” Another
is to “continue a commitment to Twelve Step fellowship.” This new
program reflects those values and, as a response to the opioid epidemic,
offers additional hope, healing and health to those who need it.
Marvin D. Seppala, MD
Marvin D. Seppala, MD, is Chief Medical Officer at Hazelden,
and an adjunct Assistant Professor at the Hazelden Graduate School of
Addiction Studies. His responsibilities include overseeing all
interdisciplinary clinical practices at Hazelden, maintaining and
improving standards, and supporting growth strategies for Hazelden’s
residential and nonresidential addiction treatment programs. Dr. Seppala
obtained his M.D. at Mayo Medical School in Rochester, Minnesota, and
served his residency in psychiatry and a fellowship in addiction at
University of Minnesota Hospitals in Minneapolis. He is author of Clinician’s Guide to the Twelve Step Principles, and Prescription Painkillers: History, Pharmacology and Treatment, and a co-author of When Painkillers Become Dangerous, and Pain-Free Living for Drug-Free People.
Friday, February 8, 2013
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Study Links Lower Drinking Age With Increased Risk of Binge Drinking
The ability to legally buy alcohol before age 21 is
associated with an increased risk of binge drinking later in life, a new
study suggests. The study included more than 39,000 people who started
drinking in the 1970s, when some states allowed people as young as 18 to
purchase alcohol.
People who lived in states with lower minimum drinking ages were not
more likely to consume more alcohol overall, or to drink more
frequently, compared with those in states with a legal drinking age of
21. However, when they did consume alcohol, they were more likely to
drink heavily, Science Daily reports.
“It wasn’t just that lower minimum drinking ages had a negative
impact on people when they were young,” lead author Andrew D. Plunk,
PhD, of Washington University School of Medicine in St. Louis, said in a
news release. “Even decades later, the ability to legally purchase alcohol before age 21 was associated with more frequent binge drinking.”
Plunk found the effect of the minimum legal drinking age was greatest
among men who did not attend college. “Binge drinking on college
campuses is a very serious problem,” he said. “But it’s also important
not to completely forget about young people who aren’t on college
campuses. In our study, they had the greatest risk of suffering the
long-term consequences linked to lower drinking ages.”
Even decades later, men who grew up in states with a legal drinking
age less than 21 were 19 percent more likely to binge drink more than
once a month. Among those who did not attend college, the risk of binge
drinking more than once a month rose by 31 percent.
The study appears in the journal Alcoholism: Clinical & Experimental Research.
Thursday, February 7, 2013
From The Partnership of Drugfree.org
Thank you. The stories that have been posted on The Hope Share are giving others hope. A precious thing, when it comes to addiction.
You can keep this chain of hope going. Please add a comment to someone’s story today to remind others that they are not alone. A few words of encouragement – an “I understand” or “I know what you’re going through” can go a long way, inspiring others to keep working on their recovery.
Launching The Hope Share has
been a labor of love for me. We wanted to create a place where people
everywhere could share their stories and feel supported. Where together,
we could dispel the stigma of addiction and provide hope to those
suffering.
Please comment on a story today and offer inspiration to someone.
Because of you, we are changing lives. Thank you from the bottom of my heart.
Sincerely,
Kristi Rowe
Director
Director
The Partnership at Drugfree.org
P.S. If you’ve submitted your story but don’t see it yet on The Hope Share, please be patient. We’ve been inundated with stories, and I promise it will be published soon! In the meantime, please comment on someone's story and give them hope.
Wednesday, February 6, 2013
Sharing Your Story
By Doug Fields
Therefore, go and make disciples of all nations...
Matthew 28:19a
When I use the word care, I’m referring to something deeper than simply being nice. Nice is nice. I appreciate it when someone opens the door for me or pulls out my chair. But caring for others involves something much more than being nice. I want to challenge you to learn to care for someone’s spiritual condition, to care about his connection with God, to care enough to make sure she knows about the good news of forgiveness and eternal life.
I know it’s not popular these days to talk about evangelism. Many Christians don’t even like that word anymore. But, I’m not asking you to do anything fanatical. In fact, if it’s easier for you, I want you to put aside the word evangelism if there’s too much negative baggage connected to it.
Instead, I’m inviting you to fall increasingly in love with God. That’s the plan. Fall in love with all His majesty and glory and goodness. Get to know the Savior as never before. When that happens, Scripture says that the love of Christ will compel you (2 Corinthians 5:14). When we know God intimately, that gives us a new power to care for the spiritual condition of others. Then, as God gives you opportunity, simply share your transformational story with others, where they can be exposed to an option that can move them from stuck to starting anew, with a Power that is greater than their own.
The important thing to remember is that people are hurting and can benefit from hearing of your experiences with Jesus. People in pain need to hear that they’re not alone and that someone else has made it out from underneath the pile. People who are lonely need to hear about how you’ve found community. People who live without a relationship with God need to hear that life is so much better when they discover it’s not all about them—it’s about God. People who are caught in a lifestyle of sin and darkness need to hear the story of someone who lived there and found the light.
Sharing personal stories about Jesus reveals the power of God. You don’t have to be a perfect Christian, have everything together, or know all of the answers. God invites you to be in the process—and perhaps, along the way, help someone else get a fresh start. When that happens, hold on…you’re in for a spiritual growth ride of your life.
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Meet the Addiction Predators
From handlers of addicted celebrities to garden-variety "sober coaches," the addiction treatment world can be a rat's nest of opportunists, charlatans—and worse.
Art: Danny Jock
“If you try to
get rid of me, she’ll be dead and I’ll piss on her grave… You’d better
learn that I control everything,” threatened Sam Lutfi, Britney Spears’
self-proclaimed former-manager, according to Through the Storm,
Lynne Spears’ memoir. Spears alleges that Lutfi acted as a jealous
predator and jeopardized her daughter’s health and safety by grinding up
and mixing her medication. Lutfi subsequently filed a lawsuit against
the pop star’s parents, claiming libel, breach-of-contract, and
defamation. He hoped to appeal to the jurors’ sympathetic side by
arguing that the release of the book left him depressed, suicidal, and
overwhelmed with death threats. The case was dismissed in early
November.
The extraordinary circumstances of
Britney’s life hardly represent the norm, but Lutfi’s behavior indicates
a disturbing trend in the lurid overlap between celebrity and
addiction. Whether we’re rapidly detoxing addicted patients on cable TV,
announcing Lindsay Lohan’s latest rehab-stint in the tabloids, or
awarding a book deal to Cat Marnell,
our popular culture has turned a particularly voyeuristic lens onto the
disease of addiction. Troubled celebrities are no longer heroes in the
vein of Marilyn Monroe, Dean Martin, or even gonzo journalist Hunter S.
Thompson. The public's interest in the escapades of Hollywood’s latest
party girl has grown into, for some, a lucrative obsession. And as a
consequence, the sensationalist behavior of damaged celebrities has
become a target—even an investment—for some. Call them the addiction
predators.
Take,
for instance, David Weintraub, a TV talent agent who has alchemized
troubled stars into skyrocketing ratings, spinoff shows, and a
multimillion dollar management/production company. For starters, he
channeled his addled clients—Guns n' Roses drummer Steven Adler, porn
star Mary Carey, fallen Miss Teen USA Keri Ann Peniche, and many more—onto Dr. Drew Pinsky's demented showcase for addiction in action, VH1’s Celebrity Rehab.
The series follows the treatment and transformation of a cast of famous
addicts, but as anyone in recovery knows, the sudden surge of income
and exposure that results from the appearances can seriously complicate
the recovery process.
“Very often, business overrides the treatment, and that’s where we've gone today. Treatment has lost some value because people want to make money instead of helping others get clean and sober."
“There’s
nothing quick f..... fixable about sobriety,” says Recovery Life
Skills Coach Lisa Neumann—who makes it clear that she has not worked
with celebrities. Treatment professionals at large have raised concerns
about the extreme transformations depicted on Celebrity Rehab
after just one month of treatment. For Derek Salazar, Maintenance
Counselor at Recovery Solutions of Santa Ana, the shortening of
treatment in general is concerning. “Very
often, business overrides the treatment and that’s where we have gone
today," she says. "It’s sad to say that treatment has lost some value
because people want to make money instead of helping others get clean
and sober. When I got sober I spent 22 months in Phoenix House and it
saved my life.”
New, controversial service roles
have emerged within recovery communities to complement acute care.
Along with hit dramas like CBS’ Elementary, celebrities like Owen Wilson
and Robert Downey Jr. have commercialized these peer recovery support
services by hiring sober companions to keep an eye on them for anywhere
between $750-1,500 per day. Because of the excessive costs some peer
recovery support specialists demand, these services have gained a
reputation as the newest accessory of the troubled elite. But Neumann
has a different take. “If you can
pay $100 per hour to have someone follow you around your house, do it,"
she says. "But if you’re considering giving up addiction, it’s not time
for a recovery coach. You need to be done considering giving up addiction for it to be cost and time effective.”
It’s not that Neumann, the author of Sober Identity: Tools for Reprogramming the Addicted Mind,
wants to leave perpetual relapsers at the door; she’s just not
interested in wasting anyone’s time: “I won’t work with someone until
they get sober. I’m here for a phone call, a meeting, an assignment, or
an e-mail. But I’m not going to charge you for that.”
Unlike
much of the substance abuse treatment industry, recovery coaching is a
non-clinical, non-professional service provided by people who are
experientially credentialed. While many coaches receive some kind of
formal training, it's their first hand knowledge that provides the
foundation for their expertise. With other service providers like
recovery residence managers and sober companions, recovery coaches
constitute a growing niche within the treatment industry known as peer
recovery support specialists, or peer workers. But the peculiar nature
of the professional non-professional is raising some concerns—and plenty
of confusion.
For Bill White, Senior Research Consultant at The Lighthouse Institute, a division of Chestnut Health Systems, “There
are numerous misconceptions of the recovery coach role, mostly due to
the wide variations in role responsibilities to which the title is being
applied, whether it's peer/professional, paid/volunteer, full/part
time. And there's a wide variety of organizational settings in which
coaches and other recovery support specialists are now working. It'll
take several more years before this role is clearly defined and
evaluated in terms of its influence on long-term recovery outcomes.”
White,
who has served in the addictions field for 40 years, adds that this
ambiguity parallels that present during the early history of the
addiction counselor. But for now, with no accreditation system, recovery
coaches have little to distinguish themselves from one another besides
their sobriety date—and their social media presence.
Recovery
coaching may have emerged as a form of service work done between close
members of indigenous recovery communities, but today, private coaches
need effective marketing and outreach strategies to compete with larger
companies. For Neumann, the importance of online marketing was
unexpected. “If McDonalds cut their advertising budget,” she says, “they
wouldn’t have any customers left—but not me. I don’t want to spend
money on advertising. My work should speak for itself.”
Her marketing scheme is completely against the traditional approach of the 21st century:
fewer advertising dollars are necessary to keep an existing client than
to find a new one. “I don’t want you to be here if you’re not catching
on,” she explains. “I’m not doing my job if you still need me every week
after a year.”
With companies advertising
recovering coaching as a sort of “catch-all” solution for all of the
addicts who hate AA and prefer not to take time away from work to check
back into treatment after they have been kicked out, Neumann’s message
of hard work and personal integrity is not a very competitive one.
Companies like Sober Champion aren’t afraid to play up the job’s
celebrity reputation, using references to filming schedules and
socioeconomic status to lure clients in: “For those who can afford one, a
Sober Coach or a Sober Companion is an outstanding addition to any
post-acute treatment program.”
While
the research of peer-based work is highly limited, studies of the
essential services provided by recovery coaches suggest that it is a
potentially promising practice as an adjunct to treatment. Leaders in
the field also acknowledge the significance of the peer-relationship.
According to Michael Walsh, the President and CEO of the National
Association of Addiction Treatment Providers (NAATP), “Done
well, I believe sober coaching can be the difference between compliance
with an aftercare plan and non-compliance and the longer someone is
engaged in aftercare the better their chance at sustaining recovery.”
But without a uniform accreditation system, there is little
accountability to quality assurance, ethical practice, or peer
integrity.
In
2010, the need for greater organizational hierarchy came to a head, so
Faces and Voices of Recovery began to establish a national accreditation
system.
“Accreditation,
not certification,” clarifies Tom Hill, Director of Programs at Faces
and Voices. “Most people use the two interchangeably.” The distinction
is important, he explains, because accrediting recovery communities,
organizations, and programs will allow Faces and Voices to take a
comprehensive approach to a range of issues rather than attempting a
piecemeal solution by credentialing or licensing individual people. By
providing a framework for effective oversight, management, and
accountability, the system will work in tandem with current efforts to
license individual workers.
A
large part of the initiative’s value, which is scheduled to be ready in
time for 2014’s Affordable Care Act, is its research potential, which
could allow the peer recovery support services industry to achieve
higher quality assurance and increased confidence from both the public
and the field. But prior to tackling large-scale issues of access,
accountability, infrastructure, and public confidence, Faces and Voices
must address one of the most fundamental and controversial issues facing
peer workers today: role definition and clarification.
While
providing coaching services as a part of his career as an
interventionist, Walsh encountered perhaps the most common ethical
concern with peer workers: whether recovery coaches are getting paid to
sponsor newcomers. “I had a
sponsor say that [recovery coaches and other peer workers are just paid
sponsors] to me,” he says. “After a few months of watching me work with
families who might not have otherwise continued to engage a
professional, he told me he understood.”
The
road to mutual understanding and role clarification may not be an easy
one, as the debate between experiential authority and formal education
has a long history in the field of addiction medicine. But for many
addicts looking for peer recovery support services like overeater Erika
Alvarez, empathy is a priority: “I was looking for someone I could
trust, someone I admired and someone who could understand me fully
(someone who had lived an addiction and overcame it). Basically someone
who could really guide me effectively.”
Because
addicts sometimes feel vulnerable to the power differential between
themselves and addiction professionals, and the external accountability
that controls the relationship, peer workers are often in the unique
position to receive sensitive information from addicts in a way that
professional, clinical treatment providers may not. But for Neumann,
recovery coaches should work in collaboration, rather than in conflict,
with the medical community. “I’m not trying to take anything away from
the medical or the research community,” she explains. “That’s not my
platform. My platform is about doing the work, and if you need
medication or AA to do the work then go get it.”
Salazar,
who has been working with addicts since 1995, agrees that there is a
place for everybody in the field of addiction, as long as they are
licensed and certified. But he has some concerns about the language we
have attached to certain peer recovery support services: “I
do believe this term ‘coaching’ is terminology used in a different
manner so that there’s no need to get licensed and certified," he says.
"If you’re just coaching and not treating or counseling, there’s less of
a need to get licensing. It’s a manipulation of words.”
When
your troubled past is the leading credential for your current career,
it's hard not to see the need for an organizational hierarchy with
national standards. Both Walsh and Salazar mentioned hearsay concerning
inappropriate coach/client relationships. Just a few days before I saw
her, Neumann encountered a recovery coach who was still drinking.
Without more structure, peer workers who work in private practice in
states without certification have little accountability to anything but
the law. Efforts to accredit and systematize a service that developed
from a mentor-mentee-like relationship must be approached cautiously,
though.
“With
opportunities also come challenges,” says Hill, expressing his concerns
about the potential over-professionalization of the practice. “We’re
trying to build systems that will ensure that the ‘peerness’ will stay
in tact.” White echoed his sentiments, adding, “Professionalization
efforts to date are mimicking other roles whose knowledge sets are based
on pathology and intervention paradigms rather than a recovery
program.”
White’s
work suggests that we take great care in order to avoid
over-commercializing the role of peer recovery support specialists.
Professionalization efforts can inadvertently undermine the very essence
of these services because people tend to detach from their communities
when they learn to view themselves and their professional organizations
as the source of their authority. Without the support of their recovery
communities, and without the full acceptance of the interdisciplinary
teams they work with, peer workers can encounter a lack of support for
their own recovery.
While
the public’s infatuation with the peer recovery support specialist has
almost exclusively centered on the extreme cost of celebrity recovery,
Hill does not want us to forget that anyone can be taken advantage of.
In fact, treatment centers have a history of financially exploiting
those in recovery. “We don’t want peers to become exploited,” he
explains. “We want them to be valued for their life experiences and what
they bring to the table.”
This isn’t lost on Bill McAdam, an alcoholic who lost 17 years of sobriety with a shocking suicide attempt. “I
had always been somewhat skeptical about paying someone to give me
information I already knew," he says. "But there was this feeling that I
got from Lisa [Neumann] that as much as she was in the coaching
business she explained the Universal Law [of Compensation] about what
she did and the value I had to apply to it,” he concluded, “Without a
shadow of a doubt it’s the best money I have ever spent.”
For
Neumann, who is trained and certified through the International
Coaching Academy (ICA), experience will always be the greatest teacher;
but with all the horror stories, hearsay, and confusion surrounding her
profession, she’s looking forward to the clarity and legitimacy the
Faces and Voices accreditation system will provide.
“I’m
not here to dazzle you or convince you that sobriety is awesome,” she
explains, “I’m here to walk you through whatever it is you say you want
in your life, and if it doesn’t work I’ll give you your money back.”
Still,
for the famous, the busy, and the wealthy, there are plenty of
expensive “Motivators and Cheerleaders” available to follow you around
and search your belongings.
Chelsea Carmona is a freelance writer whose work has been featured in The Washington Post, Al Jazeera English, The Christian Science Monitor, The San Francisco Chronicle, and The Guardian. She works for The OpEd Project, a social venture founded to increase the range of voices and ideas we hear in the world. Follow her on Twitter: @CarmonaChelsea
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