Sunday, April 13, 2014


Erasing Your Traumas
 
Could it be possible to erase memories of "people, places and things" that trigger us, including into addictive behaviors?



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By Jeanene Swanson

04/09/14
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Can Blocking Memories Help Addicts Recover?
Drunk Brains Forget Facts But Not Feelings
10 Memorial Days to Forget
New National Crisis: People Who Forget To Do Drugs

There are, undoubtedly, many memories that addicts would love to forget. For most recovering addicts and alcoholics, encountering the so-called “people, places, and things” that remind them of using bring on the strongest cravings. Research has shown that repeated exposure to these cues—and then not getting to use—may temporarily ease cravings, but the association returns over time.

And, cravings equal relapse for the majority of addicts within the first year of sobriety. “Dealing with cravings is a major obstacle to recovery,” says Michael Saladin of the Medical University of South Carolina, “so it’s a natural target” for treating addiction. Saladin is one of a few clinical investigators who is looking at ways to interfere with cravings on the molecular level, such that these emotional memories can be erased.


As with most things in life—and addiction—there will be no easy fix.

Over the past several decades, science has slowly but surely upturned the entrenched idea of memory being relatively static—or, consolidated from “short-term” to “long-term” storage in the brain once and then left to deteriorate over the course of a lifetime. There is considerable evidence that memory can be interfered with during the initial consolidation period—both drugs that block protein synthesis in the brain and electroconvulsive shock can disrupt the formation of memories. It wasn’t until the late 1990s that researchers began really looking into the process of reconsolidation—what happens to memories when they are re-activated, or, recalled after they have been put into long-term storage.

In fact, recent research has found that memories are actually labile, in other words, open to being updated or changed during a short period of time after being recalled. A now-landmark study from 2000 out of Joseph LeDoux’s lab at NYU, and co-authored by Karim Nader, now at McGill University, found that they could erase fear memories in rats by injecting a chemical into their brains that stopped protein synthesis during a timeframe of about 6 hours after recall—they called this the “reconsolidation window,” and just like with new memories, reconsolidated memories require new proteins to be made. This reconsolidation window has most recently appeared on the radar of addiction treatment specialists as a way to interfere with—and possibly “erase”—craving memories.

There have been many studies looking at memory reconsolidation since 2000, but most have been done on rats. In all these studies it is important to understand the concept of fear extinction training. Harkening back to Pavlov’s classical conditioning studies, a neutral stimulus (say, a bell ringing) can be paired with a fearful stimulus (say, a shock to the rat’s foot) such that the rat learns to associate the neutral stimulus with the shock. After a while, the neutral stimulus alone will elicit a fear response. In fear extinction training, the subject is repeatedly exposed to the neutral stimulus—and continues to experience the fear without the actual shock—until the fear goes away. However, the extinction training can “wear off,” so to speak—this explains in part why addicts go back to using when they re-enter their old environments away from rehab, or simply, after a long enough period of time passes. Finding a way to interrupt memory reconsolidation in recovering addicts would go a long way toward preventing cravings and relapse.

Pharmacological intervention

Since drugs that block protein synthesis aren’t safe to use in humans, scientists have turned to drugs like propranolol (trade name Inderal), an FDA-approved beta-blocker that is already widely used to treat hypertension and stage fright. It works by lowering levels of the neurotransmitter norepinephrine, which, as it turns out, can also interfere with memory reconsolidation—norepinephrine is required for protein synthesis.

In the late 1990s, researchers at UC Irvine showed that propranolol could affect the emotional salience of a memory—while it can’t erase a memory, it can make it less emotionally relevant. The application of this work can be found in recent studies involving patients with PTSD—it might help victims of trauma dissociate their emotional memory from cues that remind them of what they went through, whether war-torn violence or domestic partner abuse. After decades of groundwork research, Harvard’s Roger Pitman found in a 2002 pilot study that exposing patients to propranolol immediately after a traumatic event might prevent them from developing PTSD.

Are These Fifteen Behaviors Addictions or Compulsions?


The word "addiction" gets thrown around a lot these days—anything from sex to eating dirt—but what's the difference between an actual addiction and a compulsive behavior?


By Chris Bisogni

04/08/14
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To the layman, there is a fine line between indentifying the symptoms of an addiction, as opposed to what is known as compulsive behavior. There are many cases of such confusion; we often read or hear about those who are “addicted” to the likes of cleanliness, tanning, hoarding, cosmetic surgery and tattoos, to name a few. Debate continues as to whether these are addictions or compulsive behaviors.

By definition, a compulsion is a behavior which occurs in response to an obsessive thought that will only be relieved by engaging in the behavior. Therefore when the obsessive thought returns, as thoughts do, there is a perceived need to act on it, and the compulsion occurs. This stops the obsessive thought temporarily. An addiction is due to a brain chemical (dopamine), and is acted upon to elicit a desired heightened state of elation.

According to the American Society of Addiction Medicine (AMSAM), the “Short Definition of an Addiction” is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

The fact that AMSAM, as recently as August 2011, issued a statement announcing its new definition of addiction is evidence to suggest diagnosing actual addictions is not set in stone.

“At its core, addiction isn’t just a social problem or a moral problem or a criminal problem. It’s a brain problem whose behaviors manifest in all these other areas,” said Dr. Michael Miller, past president of ASAM. “Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It’s about underlying neurology, not outward actions.”

Armed with this information, we have handpicked 15 addictions/compulsive behaviors (yes some of them are extreme) and put them to the test to see just where they sit when put to the both the layman’s and expert’s opinion.

Eating dirt



As kids, many of us probably did this at least once, or knew someone who did, and there is a significant number of those who carry this onto into adulthood. Pica, as it is known, can be treated but if we address the AMSAM definition, there surely can be no reward for eating dirt. Verdict: Compulsive behavior

The Crescent and the Needle: The Remarkable Rise of NA in Iran


Narcotics Anonymous has thrived in Iran since 1990, second in membership and groups only to the United States. The Fix takes a look inside the phenomenon.



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By John Lavitt

04/07/14
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Afghan Kids Caught Up in Heroin Trade With Iran
Iran Deals Death to Drinkers
Despite Strict Prohibitions, Iranians Still Able to Get Drunk
AA vs. NA—What's the Difference?
Confessions of a Modern-Day Opium Fiend

As of 2012 there were 61,800 Narcotics Anonymous meetings worldwide. 27,650 in the USA and 15,955 in the rest of the world, except for Iran. There are 18,195 weekly NA meetings in Iran where Narcotics Anonymous was voted the top NGO by the government. How did such a paradoxical reality come to pass?

Shattering Expectations


Rebecca had experience being in tough situations at 3 AM in the morning. In the thick of her heroin addiction, she had been in jeopardy countless times. As the Assistant Executive Director of the Narcotics Anonymous World Services Office, she had traveled all over the world. She had led workshops for emerging NA fellowships in many Third World countries. Still, nothing had prepared her for standing in line at customs at the Tehran Imam Khomeini International Airport in 2006.

Standing next to NA Board Member Tom M. from Hawaii, Rebecca leaned on her old friend for reassurance. As a six-foot-tall blond woman with a poorly-tied impromptu veil, she knew she stood out; an American in the wrong place at the wrong time. Although Tom reassured her that everything would be all right, Rebecca kept thinking of the tabloid reports about Iran in the American media. She came of age during the Iranian hostage crisis. Night after night, the images of bound and blindfolded hostages on Ted Koppel’s Nightline had been downright terrifying.

After passing through customs, Rebecca and Tom were greeted by Siamak, the office manager of NA World Services Iran, and several other enthusiastic Iranian NA members. She was surprised they had stayed up so late. Rebecca felt her fears evaporating as she was met with smiles and respectful embraces. They got their luggage and headed into the city. “Tehran is huge,” Tom wrote in his Iran Diaries, “The city at 3:00 AM was still bustling.”

After a quick bite to eat, they wondered if they could take a rest. Siamak let them know that wouldn’t be possible until later because there was so much to do and see. There were people to meet and things to accomplish. Most importantly, the fellowship had set up a Narcotics Anonymous meeting where they would share their stories through translators.

With so many NA members wanting to attend, the fellowship had rented out a local sports arena. When Rebecca and Tom heard this, they looked at each other, a bit confounded. Rebecca thought, “I mean, a sports arena? How many people will be there?”

When they arrived at the Arena in mid-afternoon on a workday, the car had to navigate through a maze of parked vehicles to reach the back entrance. Ushered down the kind of hallway where one usually only sees professional athletes, rock stars and security guards, Tom could hear the roar getting louder and louder. In the Iran Diaries, he described the experience of entering the arena:

“…the members all started clapping and then chanting as they clapped. You know why they are clapping and you know exactly who you represent. I thought holy shit, this is off the charts. Rebecca says to me, ‘What did we ever do to deserve this experience?’ I said we shot a lot of dope, that's all, and beyond that we have just showed up like any other member.”



Over 24,000 Iranians in recovery greeted the NA World Services representatives in celebration. But it wasn’t Tom and Rebecca they were cheering; it was NA itself. Coming from the United States, they represented the birthplace of Narcotics Anonymous, a program that had saved so many lives and become such a force for good in Iran.

All of Rebecca’s fears of going to a fundamentalist country as an American citizen evaporated as the tradition of Persian hospitality, the passionate belief of the Iranian NA members and a truly universal celebration of recovery became the zeitgeist of the moment. Tears came to her eyes as she looked up to see banners hanging in the arena with the traditional recovery proverb written in English specifically for them, “Just For Today.”

Tom described the power of the moment when he wrote, “There were several rows of women in the back of the room. Becky shared as a woman with 27 years clean. You can imagine the impact that had. When we spoke and said how long we were clean they all chanted out something in Farsi that I later found out meant, ‘and may nothing ever take it from you.’”

May nothing ever take it from you because recovery from the depth of addiction is a blessing and a miracle all over the world. It doesn’t matter the name of the country or the tenor of the politics. But the looming question is how did this happen? How did Narcotics Anonymous become so successful in Iran?

The Quality Of Narcotics Anonymous In Iran

Founded in the United States in 1953, Narcotics Anonymous officially describes itself as a "nonprofit fellowship or society of men and women for whom drugs had become a major problem.” Since the rocky beginnings of this 12 Step program in California when police harassment was common, the fellowship has spread and today can be found in over 130 countries across the world. After the United States, the country with both the most weekly meetings and the largest population in the fellowship is the Islamic Republic of Iran.

Rebecca described her impression in an interview with The Fix, “What we talk about as principles in 12 Step fellowships, the Iranians in NA live and embrace in a way that impacted my own recovery for the better. The lengths they will go to help an addict in need was inspiring; a lesson in true recovery.”

The NA World Service office in Chatsworth has become accustomed to excluding Iran from worldwide reports; the Iranian phenomenon skews the figures. Statistics From the 2008 NAWS Report include the following:

1. Iran accounted for 126,000 copies of 447,000 Basic Text sales worldwide (the Basic Text is to NA what the Big Book is to AA)

2. The Iran office distributed one million key tags, including 200,000 multi-year key tags: 9% more than the United States

3. Iran distributed 1.7 million NA information pamphlets; this number was greater than the rest of the world combined

Since the Islamic revolution in 1980 that overthrew the corrupt regime of the Shah, Iran often has found itself at odds with the Western world in general and the United States in particular. But the story of Narcotics Anonymous in Iran has nothing to do with politics or international conflicts or religious fundamentalism. The surprising success of NA in Iran is based on a remarkable commitment to recovery by the fellowship and an ardent focus on continuing to reach out to the newcomer.



NA World Services was not aware of the true success of Narcotics Anonymous in Iran until 2003 when Iranian members started reaching out for guidance. Chatsworth knew that NA in Iran existed, but, according to Rebecca, their impression was that it was a struggling movement. The movement did have a bumpy start in October 1990 when Mohsen T. returned to Iran from the United States and tried to start a NA meeting in an Iranian rehab center.

At the time, Mohsen had only one year clean. He had joined NA while living in Los Angeles and was so taken with the program that he hoped to bring it back to his home country. Unfortunately, the Iranian rehab tried to co-opt that first NA meeting and attach their name to it. Not wanting to violate the traditions, Mohsen had to abandon the project.

Later, according to an anonymous source for The Fix from the NA WS office in Iran, Mohsen started meeting in private homes with three other Iranians who had experience in 12 Step programs in the United States and Canada. These men bumped into each other by happenstance, an example what people in recovery call a God Shot.

Since they were all newcomers, according to a NA member from Iran, “It was another 4 years before NA really took hold in Iran. Once members accumulated some time and worked the steps, they began translating NA literature into Farsi and the fellowship took off.”

When the NA World Service office was contacted in 2003, the initial reaction was nothing less than utter surprise. The movement had grown so big and so fast that the office staff in Chatsworth thought surely something had gone wrong. Had the government become directly involved? Had NA in Iran become co-opted by a religious movement?

In order to find out what was really happening, Rebecca described the next steps taken: “In 2004, someone from the region we trusted went to check it out and discovered that NA in Iran was not only like NA as we knew NA, but it was even better. Better in the enthusiasm, better in carrying the message to the addict who still suffers, better in terms of a commitment to their own recovery and helping others find the same path. In May of 2005, a branch office of NA World Services was opened in Iran.”

When asked why Narcotics Anonymous proved to be so successful, a member of the NA WS Iran office told The Fix:

a) The early and continuing efforts to translate NA literature into Farsi and distribute it to NA members

b) A powerful service structure with dedicated trusted servants

c) The traditions of Persian culture that worked so well in conjunction with the 12 Steps and 12 Traditions of NA.

Friday, April 11, 2014

APRIL 11 v 12 TWELVE STEPPING WITH POWER IN THE PROVERB


It is foolish to belittle one’s neighbor;
    a sensible person keeps quiet.


STEP 8 -  Made a list of all persons we had harmed, and became willing to make amends to them all.


I think we are all guilty of violating this one ! When I see the word neighbor and I automatically assume it is the folks that live in the house next store. What I think the Proverb is trying tell us is it could be the person your next to in the store or someone your passing on the street. Your neighbors are everywhere it does not matter where you are. Now lets be honest when I see someone dressed like an idiot , I cant help myself , I gotta say something even if it is under my breath .I cant count the number of times I put my foot in my mouth and got caught saying something about someone. We all have to remember words can wreck a life ! I can still hear the words thrown at me as a kid rolling around in my head . Talking bad about yourself and others is gonna cause a lot of drama in your life , haven't you had enough of that . To eliminate stress keep your mouth shut ! To remove guilt and regret sincerely commit step eight . Once you have made that list keep it clear by keeping your opinions too yourself . Making amends can be costly but very liberating !


1 Peter 3:10 - For he that will love life, and see good days, let him refrain his tongue from evil, and his lips that they speak no guile:

By : Joseph Dickerson

Dear Joseph,

You understand better than anyone the challenges and joys that recovery can bring. You know just how long the journey to sobriety can be, and that it often touches everyone in a family. When those who have been affected by this issue talk about what they’ve been through and how they’ve handled it, they in turn provide hope and comfort, and encourage others to open up as well.

That’s why we created our new public service campaign, which uses real people telling their own stories of recovery, just as you have. We want to encourage people everywhere to join you and this growing community to share their experiences with addiction and recovery.

Check out the new television spot and share it with your friends and family to encourage even more people to share their stories. Because one story can change someone else's.

View the new PSA >

 
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Vermont Becomes Second State to Take Action Against Zohydro Prescribing
 
By Join Together Staff | April 10, 2014 | Leave a comment | Filed in Community Related, Government, Prescription Drugs & Prevention


Following the decision by Massachusetts Governor Deval Patrick to order a ban on prescribing and dispensing the pure hydrocodone painkiller Zohydro, Vermont’s governor announced an emergency order to make it more difficult for doctors to prescribe the drug.

Vermont Governor Peter Shumlin said he joins the many critics of the drug, who are wondering why the Food and Drug Administration (FDA) approved it, according to the Associated Press. “What puzzles all of us is the recent FDA action to approve a new opiate that’s stronger and likely to be even more addictive because of its strength,” he said.

In January, Shumlin spoke about Vermont’s “full-blown heroin crisis” during his State of the State address. He focused his entire speech on drug addiction and its consequences.

When Governor Patrick announced the Zohydro ban, he cited a public health emergency stemming from opioid abuse. Zohydro is designed to be released over time, and can be crushed and snorted by people seeking a strong, quick high. It was approved for patients with pain that requires daily, around-the-clock, long-term treatment that cannot be treated with other drugs. Other hydrocodone drugs on the market, such as Vicodin, also contain acetaminophen.

In December 2012, a panel of experts assembled by the FDA voted against recommending approval of Zohydro. The panel cited concerns over the potential for addiction. In the 11-2 vote against approval, the panel said that while the company’s manufacturer, Zogenix, had met narrow targets for safety and efficacy, the painkiller could be used by people addicted to other opioids, including oxycodone.

Zogenix announced it will assemble an oversight board designed to spot misuse of the drug.

The FDA’s decision to approve Zohydro has been criticized by some legislators and public health groups. FDA Commissioner Margaret Hamburg has received letters protesting the decision from 28 state attorneys general and four senators, among others.

Substance Abuse Treatment Much More Likely for Men: Report
 
By Join Together Staff | April 10, 2014 | Leave a comment | Filed in Alcohol, Drugs & Treatment

A new government report finds twice as many adult men as women entered substance abuse treatment facilities in 2011. The report found 1.2 million men, and 609,000 females, entered such facilities that year.

Among teens 12 to 17, the rate of substance dependence for both males and females was about 7 percent, UPI reports. The findings come from the Substance Abuse and Mental Health Services Administration (SAMHSA). Teenage boys were more likely to abuse marijuana, while teenage girls were more likely to abuse alcohol.

Twenty-two percent of women ages 18 to 24 said marijuana was their primary substance of abuse, compared with 3 percent of men the same age. Women 65 and older were almost three times as likely to abuse prescription painkillers such as oxycodone, compared with men of the same age.

“This report provides insight into how age and gender relate to substance abuse, SAMHSA Chief Medical Officer Elinore McCance-Katz said in a news release. “SAMHSA believes that health care professionals can use this information in designing programs that are better tailored to effectively meet the treatment needs of both genders.”

Thursday, April 10, 2014



APRIL 10 v 8 TWELVE STEPPING WITH THE POWER IN THE PROVERB

 
The wise are glad to be instructed,
but babbling fools fall flat on their faces.



STEP 2 - Came to believe that a Power greater than ourselves could restore us to sanity.



God knows we all need step two ! When I was lost drifting in the sea of my addiction God and friends sent me many life boats to get out of the angry sea. For some insane reason I convinced myself that I can get to shore on my own . The water was way above my head at times and it was a struggle every minute of everyday to keep from going under and drowning . Eventually I could not tread water anymore and I was left with a do or die decision . The next time a life boat comes along I will have to grab the hand that is reaching out for me. Gods hand is always reaching out you just have to grab it . God comes in the form of family friends and anyone else who wants you out of the sea safe on dry land . God and family have a better plan for your life and it is not you drowning in the sea of addiction.



JAMES 4 : 10 - Humble yourselves in the sight of the Lord, and he shall lift you up.

By Joseph Dickerson

    
COA on News 12
Last Friday, City of Angels was featured on News 12 in a special report on the new overdose prevention drug, Narcan. 
To watch the show, click here.
 

Recovery Coach Training at COA
From April 26 to May 2, 2014, City of Angels NJ, Inc. will offer Recovery Coach training for anyone interested in serving as a guide or mentor to people in recovery or seeking recovery. 
 
This week-long, 30-hour training class is invaluable for anyone living or working with addiction sufferers including counselors, health care professionals, teachers, friends and family. It can make a big difference in how you interact with, and how much you can actually help, people with addictions and upon completion, participants will be certified as Recovery Coaches. 
 
Early registration rates will be in effect for the COA Recovery Coach Academy for the next few days ONLY, so if you are interested in this program, please register online right away. For details and to register, click here. 
 
Questions? Contact CityofAngelsNJ@hotmail.com.
New on COARR

Let's Talk About Recovery!
 
The COARR archives have recently been expanded with show photos and links to resources. Catch up on your favorite shows and listen to episodes you missed!
 
COARR can be accessed via any Internet-enabled device - for the free smartphone app, visit your iphone or android store.
  
 
Tomorrow (Thursday, 4/10) at 9:00 pm, Redneck talks about prostitution & addiction
 
This is happening to families in Hamilton! Don't miss this important radio show in which Hamilton moms talk about how their addicted daughters were held as prostitutes in return for drugs. 
 
This is Part II of a special series on human trafficking in Hamilton. 
To listen to Part I from last week, click here.
 
 
Listen to past COARR shows any time:

For "Women & Addiction" with Terri Thomas, click here.

For "Hope Fiend" with Minister Rich Mollica, click here.

For "Emotional Sobriety" with Andy Finley MFT, click here.

For "Journey Thru the 12 Steps with the Life Recovery Bible," click here.

For "Share Your Scars" with Vicki, click here.

For "Wings Over Water: Creativity in Recovery" with recovery musician Kathy Moser, click here.

For "Laughter & Recovery" with stand up comic Wil B. Kleen, click here.

For "Relationships in Recovery" with Alexa, click here.

For "Saving Lives" with COA Director of Interventions Tom Redneck Clark, click here.

For "Nar-Anon Families of Addiction Information Line" click here.

New on the COA YouTube

This is why we don't give up
This is why we don't give up
This video was filmed at City of Angels in early March. It shows the power of the human spirit - that it is always possible to bring an addiction under control, even when all seems lost. To watch, click the link at right.

To listen to Brett talking with COA Director of Interventions Tom Redneck Clark on his COARR show, "Saving Lives", click here. In this radio show, Brett describes how his addiction developed and ultimately took him to prison. Despite the odds, he found recovery and is now re-building his life.
 
Meet the New COA Baseball Team!
Spring is here and that means...baseball! This year, COA has its first-ever men's baseball team. The players are in recovery and will battle other teams in the NJ Amateur Baseball League.

For updates on the team and their game schedule, check out the COA Facebook page or the COA page on the NJABL website. 
For the COA Facebook page, click here. For NJABL, click here.
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Daily Quote

"Acceptance is the key to my relationship with God today. I never just sit and do nothing while waiting for Him to tell me what to do. Rather, I do whatever is in front of me to be done, and I leave the results up to Him; however it turns out, that's God's will for me." - Big Book of Alcoholics Anonymous, p. 420


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 Let’s Get Serious About Treating Addiction
 
By Dr. David Rosenbloom | April 9, 2014 | 3 Comments | Filed in Addiction, Drugs, Insurance, Mental Health & Treatment


Every few years the media report an epidemic of heroin overdose deaths; often after a celebrity like Phillip Seymour Hoffman dies to set off the spark. This time the spike in deaths—which is real– is being attributed to heroin mixed with fentanyl. Attention will fade but the deaths will continue. We wring our hands about overdoses, but do little to make effective treatment widely available. Our continuing refusal to prevent and treat addiction is a medical and social scandal.

Here are the policy changes I believe we must make to end this scandal:

1) Complete the transition to individual health insurance with complete coverage for addiction treatment. The bulk of addiction treatment today is provided by small free standing programs that depend on contracts with public entities for treatment “slots” or individual out of pocket payment. The programs with contracts are responsive to their funders, not to the patients who may be filling a slot at the moment. The organization and funding of our treatment system works against developing a long term relationship between patient and provider that is key to successful long-term recovery. When a patient leaves, the treatment entity has no continuing contact with that person. Obamacare can cover almost all the people with addiction in the country if states, employers and insurers implement it properly. Sadly, some existing treatment programs are dragging their heels or opposed to getting their patients covered because they find it easier to bill the state or because they cannot meet the administrative and clinical requirements for accepting insurance payments.

2) Integrate addiction, mental illness and medical treatment around individuals with severe addiction. Telling a patient who is unemployed, homeless, addicted and mentally ill to go someplace different for each service or to wait weeks for an appointment is malpractice because the providers know it will not happen. We should force consolidation of addiction treatment, mental illness and medical care providers to coordinate and take care of the most severely ill patients in one place. The few places where this kind of care is provided now get much better results for their patients.

3) Increase insurance payment rates for addiction treatment to a level that meets providers’ costs, draws in new responsible providers, and pays for the required coordination. Very low Medicaid and private insurance payment rates create and perpetuate the shortage of quality treatment. Appropriate payment rates will attract higher quality providers.

4) Reward longer stays in treatment and stop using providers that are unable to successfully retain patients in treatment long enough for it to be effective. Longer time in treatment, inpatient or outpatient, improves outcomes. Research shows that drug treatment for less than 90 days is generally not effective, but very few public or private insurance programs authorize that much treatment now. It is shocking that some treatment programs still throw a patient out if he relapses during treatment. Relapse is part of the disease and a signal for more treatment, not a reason to end it.

5) Require hospitals, health centers, HMO’s and other primary providers, as a condition of their participation in Medicaid, Medicare, and public employee health programs, to demonstrate that they diagnose all patients with alcohol and drug disease and that they have a clinically sound program that gets individuals the care they need. Today, most hospitals refuse to provide addiction treatment at any appropriate scale even though many of their patients would have better clinical outcomes if they got brief interventions or treatment.

6) Stop the revolving door at detoxification programs. Current policy and reimbursement get the patient out the door as soon as he or she is “medically stable,” whether or not the person is connected or ready to enter real addiction treatment. The vast majority of people who leave detox without directly entering and staying in treatment quickly relapse. Many think they “failed” treatment but the truth is they never had any treatment, just detoxification.

7) Stop arresting people for non-violent drug offenses. And stop putting people back in jail or prison for non-violent addiction related probation violations. Our current policies ruin thousands of young lives. Addiction is a disease, not a crime. Drug court programs are fine, but they touch only a tiny proportion of the people in the criminal justice system who need treatment.

David L. Rosenbloom, PhD, is Professor, Boston University School of Public Health and former Director of Join Together.

This feature was originally published on the BU Today website.

Largest Health Insurer in Massachusetts Has Cut Narcotic Prescriptions
 
By Join Together Staff | April 9, 2014 | 1 Comment | Filed in Community Related, Insurance, Prescription Drugs & Prevention


Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, announced it has reduced prescriptions of narcotic painkillers by about 6.6 million pills in the past 18 months. The insurer limited the amount of opioids that members could obtain without prior approval of the company, WBUR reports.

Since the changes were implemented in July 2012, prescriptions for opioids including Percocet have declined by 20 percent, and those for long-lasting drugs such as OxyContin have declined by 50 percent, Blue Cross Blue Shield of Massachusetts President Andrew Dreyfus told The Boston Globe.

An initial review of prescription information, launched in 2011, revealed more than 30,000 of the company’s members received opioid prescriptions that lasted for more than 30 days. “What we found out is in looking at patients who deserved to get pain medications or needed pain medications, many of them were getting significantly more than they would need,” Dr. John Fallon, Senior Vice President and Chief Physician Executive, told WBUR.

Under the program, patients are initially given shorter-term prescriptions for opioids. Patients seeking long-term prescriptions must go through a review process. Before patients are given more medication beyond the new limits, they must be assessed for the risk of addiction, and must agree on a treatment plan with their doctor.

Patients with cancer or other terminal illnesses are exempt from the rules.

“In the past, physicians said that no one should be in pain, and people gave more prescription medication than they probably needed, and that led to supply sitting around, which was then used for inappropriate reasons,” Fallon said. “Now I think there’s an awareness in the physician community how hazardous these medications are.”

Treatment for Heroin Addiction Can Be Difficult to Find, Experts Say
 
By Join Together Staff | April 9, 2014 | 2 Comments | Filed in Drugs, Healthcare, Insurance & Treatment

People seeking treatment for heroin addiction face a number of obstacles, including a lack of treatment beds, expensive care, and insurance companies that refuse to pay for inpatient rehab, according to ABC News.

Most insurance companies will not pay for inpatient heroin detoxification or rehab because withdrawal from the drug is generally not deadly, according to Anthony Rizzuto, a provider relations representative at Seafield Center, a rehabilitation clinic on Long Island, N.Y. He says insurance companies either claim the patient does not meet the “criteria for medical necessity” for inpatient care, or they require the patient to first try outpatient rehab and “fail” before being considered for inpatient treatment.

Most experts say inpatient care is often needed for a person addicted to heroin. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps, kicking movements and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose, and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health can be fatal.

The symptoms of withdrawal are so bad that many people go back to using heroin, often with deadly consequences. Even people who are able to stop using heroin without treatment often relapse. They may overdose because they use as much heroin as they did before, but their system can’t handle the same level of drug as before they went through withdrawal.

Even patients who do get some insurance coverage for heroin treatment generally don’t get 30 days in a residential center. The average duration is 11 to 14 days, according to Tom McLellan, CEO of the nonprofit Treatment Research Institute in Philadelphia. After insurance companies stop paying, facilities discharge patients, even if they are not done with treatment.

The average cost of a 30-day inpatient stay is about $30,000.

States That Don’t Expand Medicaid Leave Millions of Mentally Ill Uninsured: Report
 
By Join Together Staff | April 9, 2014 | Leave a comment | Filed in Community Related, Healthcare, Insurance, Legislation, Mental Health & Treatment

About 3.7 million Americans, who live in states that have not expanded their Medicaid programs under the Affordable Care Act, suffer from mental illness, psychological distress or a substance use disorder and don’t have health insurance, according to a recent report.

Twenty-four states have not expanded their Medicaid programs, according to USA Today. In the states that did expand Medicaid, about 3 million people with a mental health or substance use disorder, who were formerly uninsured, now are eligible for coverage. The findings come from the American Mental Health Counselors Association (AMHCA).

The Affordable Care Act originally required states to expand Medicaid benefits, but in 2012, the U.S. Supreme Court allowed states to opt out of participating in the expansion.

“It is really a tragedy,” said Joel Miller, Executive Director of AMHCA. “When uninsured people with mental health conditions, such as depression, gain Medicaid coverage, they become healthier and life expectancy increases, but in states that refuse to expand Medicaid, citizens will see their hopes dashed for a better life and better health.”

The report findings come from the National Survey on Drug Use and Health, which counted people with serious mental illness, serious psychological distress, and substance use disorders. The group found almost 75 percent (2.7 million adults) of all uninsured persons with a mental health condition or substance use disorder who are eligible for coverage in the non-expansion states live in 11 southern states that have rejected the Medicaid expansion: Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia.

More than 1.1 million uninsured people who have serious mental health and substance abuse conditions live in just two states — Texas (625,000) and Florida (535,000). These more than 1.1 million people are eligible for coverage under the new Medicaid expansion program, but won’t receive it, the report noted.


PRO-ACT Family Addiction Education Program helps families address drug and alcohol addiction




Next free sessions start May 1, 6 or 7 at various locations in five counties



When someone is addicted to drugs or alcohol, the disease affects the entire family. Each month PRO-ACT (Pennsylvania Recovery Organization–Achieving Community Together) hosts a free Family Addiction Education Program to help individuals and families recognize and address an addiction problem in a spouse, parent, child or other loved one. Led by trained volunteers who have been in the same situation, these information and support programs begin the first week of each month and run one evening a week for three consecutive weeks. Each session lasts two hours.



Programs are offered at several locations throughout the five-county southeast Pennsylvania region:

· Tuesdays—From 7 p.m. to 9 p.m. in Media and Northeast Philadelphia.

· Wednesdays—From 6 p.m. to 8 p.m. in Pottstown; from 6:30 p.m. to 8:30 p.m. in North Philadelphia; and from 7 p.m.to 9 p.m. in West Chester.

· Thursdays—From 6:30 p.m. to 8:30 p.m. in Northern Liberties; 7 p.m. to 9 p.m. in Bristol and Colmar.

Sessions are free and confidential—first names only. Pre-registration is required. To register, call 800-221-6333, weekdays 9 a.m. through 5 p.m., or visit http://councilsepa.org/programs/pro-act/family-education-program/.

Wednesday, April 9, 2014



APRIL 9 v 12 TWELVE STEPPING WITH POWER IN THE PROVERB

If you become wise, you will be the one to benefit.
If you scorn wisdom, you will be the one to suffer.



STEP 12 - Having had a spiritual awakening as the result of these steps, we tried to carry this message to others and to practice these principles in all our affairs.



WISDOM - knowledge that is gained by having many experiences in life. : the natural ability to understand things that most other people cannot understand.

 
Step twelve is more than a step for those of us who work it on the daily . It is a milestone a Chapter in our lives that was fought for. We are not born with the gift of wisdom ,it is earned and I would not trade one single day of my struggles and suffering . The sorrows , struggles , and pain of our past made us the hard core Recovery advocates we are today . The knowledge and wisdom we have fought for and earned must be honed into a gift used in saving those like we once were .



Matthew 5 41 And whoever makes you go one mile, go with him too .
By : Joseph Dickerson