Independent Pharmacies Seek Greater Role in Fighting Prescription Drug Abuse

By Celia Vimont | April 23, 2014 | Leave a comment | Filed in Addiction,Community Related, Drugs, Prescription Drugs & Prevention

As the Drug Enforcement Administration (DEA) gears up for another National Prescription Drug Take-Back Day on April 26, the group representing independent pharmacists says its members are eager to help their communities get rid of unwanted or expired drugs year-round.

According to the National Community Pharmacists Association (NCPA), more than 200 tons of medications have been collected at more than 1,600 participating community pharmacies across the country since it created the voluntary Dispose My Meds program in 2009. Many of the medications being dropped off for safe disposal at community pharmacies come from excess mail-order prescriptions that are auto-shipped to patients, whether they want the medication or not.

“Our members are your mom-and-pop community drug store,” says Carolyn C. Ha, PharmD, NCPA’s Director of Professional Affairs and Long-Term Care. “More than half our members are from rural towns with populations of 20,000 or less. The pharmacists know their patients really well. The pharmacists are community leaders, they answer many healthcare questions and are committed to addressing prescription drug abuse.” Many people come into their local pharmacy asking what to do with their unused or expired medicines, often because they have teenagers and don’t want them poking around the medicine cabinet, or because they have grandchildren and don’t want them at risk of accidental poisoning.

People in small towns also want a safe place to dispose of medications, because of concerns they could end up in the water supply if they flushed them down the toilet, Ha noted.

Current DEA regulations do not allow pharmacies to accept unwanted or expired controlled substances including prescription opioid painkillers such as oxycodone or hydrocodone, stimulants such as Adderall or Ritalin, or benzodiazepines like Valium or Xanax. The agency is working to change those rules, and the NCPA supports those changes, according to Ha.

The DEA has proposed new regulations to give the public more options for disposing of unwanted prescription drugs, such as painkillers and sedatives. The new rules are designed to reduce the amount of highly-abused prescription drugs on the streets. The DEA proposes that law enforcement agencies and pharmacies serve as collection boxes for certain medications. The agency also recommends implementing mail-back programs to safely dispose of the drugs.

Under the proposed rules, for the first time, groups outside of law enforcement would be allowed to collect unused drugs for disposal. The proposal would also allow authorized retail pharmacies to voluntarily maintain collection boxes at long-term care facilities. The DEA also calls for continued use of prescription drug “take-back” events. No date has been set for the new regulations to be finalized.

“Pharmacies are a good place for people to drop off medications, because it gives people an opportunity to ask pharmacists questions, and some people may not be comfortable dropping them off at a police station,” Ha says.

If pharmacies are allowed to collect controlled medications such as opioids, the DEA rules will give specific guidance about security measures that need to be in place, to ensure the medications are not diverted. “Pharmacies are held to extremely tight regulatory controls regarding dispensing medications, so we think it’s a natural fit that we should be able to take them back as well,” observed Ha.

Many of the medications community pharmacies collect are the remains of 90-day supplies ordered from insurance companies. Some are expensive specialty drugs, such as inhalation solutions used in nebulizers by people with respiratory conditions, or diabetes drugs and supplies such as test strips and lancets used to test blood sugar levels. “Often, it’s cheaper for patients to order a 90-day supply, even if they don’t need it,” Ha says. The group has documented many cases in which patients or their families have brought in thousands of dollars of mail-order medication.

Some community pharmacies are barred from taking back any medications because of state or local regulations. Those pharmacies that do collect medications generally do so at no cost.

To find the community pharmacy nearest you that collects medications, visit www.disposemymeds.org, and click on the “Pharmacy Locator” tab on the top right side of the page.

Photo credit: National Community Pharmacists Association

FDA Panel Votes to Recommend Against Approving Morphine-Oxycodone Opioid

By Join Together Staff | April 23, 2014 | Leave a comment | Filed inGovernment & Prescription Drugs

An advisory panel of the Food and Drug Administration (FDA) voted Tuesday against approving a combination morphine-oxycodone painkiller, NPR reports. The drug, Moxduo, would be the first medication to combine both opioids in one capsule.

Moxduo’s manufacturer, QRxPharma, says the drug is intended to provide faster relief from moderate to severe pain, with fewer side effects than currently available opioids.

The vote against recommending approval of the drug was unanimous. The panel also voted unanimously that QRxPharma had not proved the drug is less likely to cause potentially life-threatening respiratory suppression, compared with taking oxycodone or morphine alone.

“I certainly wish that there was an opiate that could be counted on to decrease respiratory depression, and maybe one day there will be,” said panel member Gregory Terman of the University of Washington.

The panel questioned whether Moxduo offers any advantages over using oxycodone or morphine alone, the article notes. Panel members disagreed on whether studies conducted by the company showed Moxduo provides better pain relief, fewer side effects or lower risks of potentially fatal complications. Some experts said they were concerned the drug could be more easily abused than opioids such as Vicodin or Percocet.

The FDA is not required to follow its panels’ recommendations, but generally does so.

In a statement, QRxPharma Managing Director and Chief Executive Officer John Holaday said, “We are obviously disappointed in the outcome of today’s meeting, but remain confident in the advantages of Moxduo compared to morphine and oxycodone. This is a necessary therapy for patients with moderate to severe acute pain. We are committed to bringing to market safer therapies for pain, such as Moxduo, and preventing opioid abuse.”

Insurers Should Use Prescription Monitoring Databases to Reduce Overdoses: Report

By Join Together Staff | April 23, 2014 | 1 Comment | Filed in Healthcare,Insurance, Prescription Drugs & Prevention

Health insurers should use state prescription monitoring databases to reduce overdoses from abuse of opioids and other prescription drugs, according to a new report.

Sharing data between prescription monitoring databases and insurers would allow the companies to better detect inappropriate prescribing and dispensing, according to the report by the Prescription Drug Monitoring Program (PDMP) Center of Excellence at Brandeis University.

Most health insurance programs, including Medicare, Medicaid and workers’ compensation programs, only see data about prescriptions for which their particular plans have paid, MedicalXpress reports. PDMPs provide a patient’s complete outpatient prescription history for controlled substances. Allowing insurers to see all of their enrollees’ activity, including prescriptions paid for by other insurers, would allow them to spot patients who are “doctor shopping,” or who are acting in collusion with a street dealer, the report noted.

“At a time when the misuse and abuse of prescription opioids has reached epidemic levels, it’s important that third party payers be able to use states’ prescription monitoring data to make sure these drugs are prescribed appropriately,” Peter Kreiner, Principal Investigator of the Prescription Drug Monitoring Program Center of Excellence, said in a news release.

“Opioid abuse is the most urgent issue in workers’ compensation,” said Bruce Wood, Director of Workers’ Compensation with the American Insurance Association. “Giving workers’ compensation payers access to PDMP information would permit them to see if an injured worker is getting opioids from multiple sources.”

The report is the result of a meeting of more than 75 medical insurers, federal agency leaders and state PDMP administrators. It was discussed this week at the National Rx Drug Abuse Summit in Atlanta.

Those in Recovery Should Speak Out, Give Hope to Others: Drug Policy Official

By Join Together Staff | April 23, 2014 | 1 Comment | Filed in Addiction &Recovery

People in recovery from substance abuse should speak out and give hope to others in similar situations, according to the Acting Director of the Office of National Drug Control Policy.

Michael Botticelli, speaking at a forum in New Haven, noted 23 million Americans are recovery. Only about one in nine people with a substance use disorder receive treatment, he said. Botticelli said stigma and denial about substance abuse are obstacles to treatment, the Associated Press reports.

Botticelli is in long-term recovery from addiction, celebrating more than 24 years of sobriety.

“We know that one of the biggest reasons people don’t ask for help is shame and denial,” he said. “We need to break that silence. We’ve done it with other diseases and we can do it with substance use and we can do it with recovery.”

Music Festival Organizers Plan Greater Security to Prevent Drug-Related Deaths

By Join Together Staff | April 23, 2014 | Leave a comment | Filed in Community Related, Drugs & Prevention

Organizers of the Electric Zoo music festival say they are planning tighter security this year, after two drug-related deaths occurred at last summer’s event.

The three-day festival, held in New York City over Labor Day weekend, will include drug-sniffing dogs, extensive pat-downs, and undercover officers who have a background in narcotics investigations, The Wall Street Journal reports.

Last year, New York Mayor Michael Bloomberg canceled the last day of the festival after the deaths occurred.

The festival’s promoters, Mike Bindra and Laura DePalma, said they plan to hold the festival at the same location. They note they have not yet received a site permit from the Department of Parks and Recreation, but added that usually happens later in the year.

If the festival takes place, fans will be required to view an anti-drug public service announcement online in order for their festival wristbands to activate. The event will start later in the day, to reduce exposure to the sun. In addition, the organizers will scrutinize vendors more closely. The festival may place “amnesty bins” at the gates, so fans can drop off illicit substances before they are searched. These bins are used at music festivals in Europe. They were also used last year at a music festival outside Atlanta called TomorrowWorld, which attracted 50,000 fans.

“We don’t want to be finger-wagging,” Mr. Bindra said. “‘Just say no to drugs,’ we can all agree, has been ineffective in the past.”

Last year’s Electric Zoo festival included safety measures such as on-site emergency treatment centers, free bottled water, and periodic safety announcements. After the event, the promoters brought together an advisory board of doctors, security consultants and DJs to prevent future drug-related deaths.

APRIL 23 v 13 TWELVE STEPPING WITH POWER IN THE PROVERB

Do not withhold correction from a child,

For if you beat him with a rod, he will not die.

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

Children are the key to our future. My daughter just turned eighteen and it took a lot of apologies and long talks to try and fix the damage I caused our relationship . There are times when I get caught up in the could , would , and should haves . My daughter deserved a lot more than what she got . I was so selfish I barely gave her the time of day . Addiction is the worse form of selfishness and it will steal all that is important to you . Growing up I did not get enough correction like the Proverb mentions and what you have is a dysfunctional adult .If you have kids and you are in active addiction I guarantee your kids are going to grow up just like you dysfunctional and out of control. Correcting your children when in active addiction is something you should not exercise because your out of control and your children are mirror image of your behavior . This is the main reason your children don't listen or respect you ,how can they when you are so out of control. The bottom line you gotta work the steps everyday , pray everyday tell your children you have made some mistakes explain to them we can work together we can all get past this terrible part of our lives and begin together to live life the way it is meant to be lived. 

Ephesians 6:4 Fathers, do not provoke your children to anger, but bring them up in the discipline and instruction of the Lord.

By:Joseph Dickerson

Approval of Powdered Alcohol Labels was a Mistake, Government Agency Says

By Join Together Staff | April 22, 2014 | Leave a comment | Filed in Alcohol,Government & Marketing And Media

The approval of labels for a powdered alcohol product called “Palcohol” was a mistake, the Alcohol and Tobacco Tax and Trade Bureau (TTB) said Monday. Palcohol gained widespread publicity in recent days after it was reported the government agency approved the labels.

A representative for the agency told the Associated Press the approvals for Palcohol’s labels were issued in error. Palcohol’s parent company, Lipsmark, said on its website, “We have been in touch with the TTB and there seemed to be a discrepancy on our fill level, how much powder is in the bag. There was a mutual agreement for us to surrender the labels. This doesn’t mean that Palcohol isn’t approved. It just means that these labels aren’t approved. We will re-submit labels. We don’t have an expected approval date as label approval can vary widely.”

The company says it plans to offer powdered alcohol in six varieties, including rum, vodka, Cosmopolitan, Mojito, Powderita and Lemon Drop. According to the company, a package of Palcohol weighs about an ounce and can fit into a pocket. It warns people not to snort the powder.

Palcohol, when used as directed, by adding five ounces of liquid to it, is equal to a standard mixed drink, according to the company. It will be sold anywhere liquor can be sold, and the buyer must be of legal drinking age to purchase it. “It will be available both in the United States and abroad and it can also be bought online,” the company states on its website.

Children Often Prescribed Potentially Dangerous Codeine in the ER: Study

By Join Together Staff | April 22, 2014 | Leave a comment | Filed in Parenting,Prescription Drugs, Research & Youth

Children treated in the emergency room for pain or coughs are often prescribed codeine, a potentially dangerous opioid, a new study finds.

Organizations including the American Academy of Pediatrics and American College of Chest Physicians recommend against using codeine for coughs or upper respiratory infections in children, according to Reuters.

While codeine prescription rates decreased from 3.7 percent to 2.9 percent between 2001 and 2010, many children still received the drug. Between 559,000 and 877,000 children were prescribed codeine in the emergency room each year during that time, the researchers report in Pediatrics. Codeine can be dangerous because it slows breathing. Up to one-third of people break down the drug much faster than usual, which can lead to an overdose, the article notes. About one-third of children who take codeine have no relief from symptoms, while one in 12 can accumulate toxic amounts of the drug, causing slowed breathing and possible death.

Dr. Alan D. Woolf, a pediatrician at Boston Children’s Hospital who wrote an editorial that accompanied the study, told Reuters that parents whose children are prescribed codeine can ask the doctor if there is an alternative treatment. “At Boston’s Children Hospital, we’ve taken it off the formulary so you can no longer easily prescribe it,” he said.

Study author Dr. Sunitha Kaiser of the University of California, San Francisco said codeine prescriptions for children are an issue outside of the ER. “Despite strong evidence against the use of codeine in children, the drug continues to be prescribed to large numbers of them each year,” she said in a news release. “It can be prescribed in any clinical setting, so it is important to decrease codeine prescription to children in other settings such as clinics and hospitals, in addition to emergency rooms.”

She noted ibuprofen is equal to or better than codeine for treating injury pain.

New Clemency Rules Aimed at Inmates Serving Time for Nonviolent Drug Offenses

By Join Together Staff | April 22, 2014 | Leave a comment | Filed in Drugs &Legal

The Justice Department on Monday announced new clemency criteria, aimed at inmates who are serving time for nonviolent drug offenses. The goal is to reduce the nation’s federal prison population, the Associated Press reports.

Attorney General Eric Holder described the new criteria for evaluating clemency petitions in a video message. The new rules are expected to result in thousands of new clemency applications, he said. Clemency applications take into account the seriousness of the crime, whether the person accepts responsibility for the crime, and their behavior since they were convicted. The Justice Department also considers input from the prosecuting office.

Traditionally, most requests for pardons and sentence commutations have not been granted. President Obama only commuted one sentence during his first term. That would change under the new criteria.

“The White House has indicated it wants to consider additional clemency applications, to restore a degree of justice, fairness and proportionality for deserving individuals who do not pose a threat to public safety,” Holder said. “The Justice Department is committed to recommending as many qualified applicants as possible for reduced sentences.”

Earlier this month, the U.S. Sentencing Commission, which advises federal judges, recommended shorter prison sentences for most federal drug trafficking offenders. Up to 70 percent of these offenders would receive shorter prison sentences if the commission’s recommendations are not opposed by Congress.

APRIL 22 v 10 TWELVE STEPPING WITH POWER IN THE PROVERB

Throw out the mocker, and fighting goes, too.

Quarrels and insults will disappear.

STEP 1 - We admitted we were powerless over our addictions—that our lives had become unmanageable. 

Whats it gonna take for you to realize that addiction is the cause of all this sadness and anger . Your loved ones cant keep taking your insanity what you are doing is wrong to them , God and yourself . We understand you maybe hurting and all we want is you to find a way to feel better get sober and find peace . TOUGH LOVE IS JUST THAT AND IT IS TOUGHER ON THE ONES WHO HAVE TO USE IT . TOUGH LOVE IT IS NOT THERE WAY OF TRYING TO CONTROL YOU SO TELL YOUR PRIDE TOO SHUT UP. It is killing them a little each day being helpless unable to stop you from killing yourself over and over again that's what you do every time you use. Consider your loved ones just for a moment ,and reflect on all the pain you have caused them and yourself. All the stuff mentioned in the Proverb will keep you separated and isolated from the only people on this planet who truly love you but your addiction has convinced you that love is something you don't deserve. Addiction is the biggest lie in the world and it steals everything from you and if you let it you will lose your life and soul . Sincerely commit step one ,realize enough is enough and you want to live . Reach out and ask for help ! Recovery is possible ! 

John 14 -6 - Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me.

By - Joseph Dickerson

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APRIL 21 v 16 TWELVE STEPPING WITH POWER IN THE PROVERB

The person who strays from common sense

will end up in the company of the dead.

STEP 3 -Made a decision to turn our will and our lives over to the care of God .

In my active addiction I was a dead man walking , A zombie , lifeless no purpose just one focus ! Picture a zombie from the movies  , head forward arms out mouth open  grrrr druuuggggsssss   druel running down the lip. Living a life of addiction is no life at all . The control addiction has is mind boggling and the destruction it causes is indescribable . Step one and two are only the beginning but step three is a must if you don't want to be a drug zombie anymore in the company of the dead . God also has given us an instruction manual (Bible) it is the cure for Zombizm in addiction along with the steps of course. Foolishness , addiction , and pride will keep you in zombie state , Surrender , humility and God in control along with right living , working the steps , and common sense will keep you sober.  

Galatians 5 v 1

It is for freedom that Christ has set us free. Stand firm, then, and do not let yourselves be burdened again by a yoke of slavery.

By : Joseph Dickerson

Let’s Get Serious About Treating Addiction

By Dr. David Rosenbloom | April 9, 2014 | 4 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.

Drug Free World: Substance & Alcohol Abuse, Education & Prevention

Drug Free World: Substance & Alcohol Abuse, Education & Prevention

APRIL 19 v 2 TWELVE STEPPING WITH POWER IN THE PROVERB

Enthusiasm without knowledge is no good;
    haste makes mistakes.

STEP 11 -  Sought through prayer and meditation to improve our conscious contact with God  , praying only for knowledge of His will for us and the power to carry that out.

 Going into and maintaining sobriety should be done with enthusiasm and excitement . Well at least it is for me . Everyday is a new adventure ,I feel at times like a child discovering brand new wonders at the amusement park. At this stage of my recovery Fifteen years in  June, and as I get older I have come to realize we need to keep it simple , learn as much as you can , and help as many people as you can.  When you take it slow and listen your chances of making mistakes is reduced .There will be times when you screw up but don't let the self pity wagon  take you for a  guilt trip on the relapse roller coaster. A  good sign of maturity in recovery is when you can get right back up on your feet like you never missed a beat  . Staying sober will show you what life is meant to be and for those of us in recovery step eleven should be the code we live by .

Jeremiah 29 : 11 - 13  For I know the plans I have for you,” says the Lord. “They are plans for good and not for disaster, to give you a future and a hope.  In those days when you pray, I will listen.  If you look for me wholeheartedly, you will find me !

By : Joseph Dickerson

Warning Signs: 5 Red Flags in Kids Who Are Susceptible to Addiction
Be sure your child isn't at risk for addictive behavior by keeping an eye out for these signs.



Shutterstock


By Marissa Rosado
Source The Fix
04/16/14

Even if you’re on Facebook, you might not be privy to every aspect of your child’s social life. Adolescents, by nature, seek independence by detaching from their parents and keeping more of their lives to themselves. These formative years are also characterized by changes in the brain that allow drug abuse to occur more easily than at other times. How can you, as a parent, reduce the risks of your child engaging in substance abuse and becoming an addict? Below I've listed five signs that indicate your teen is extra-vulnerable to using drugs or alcohol, and what you can do about it.

1) Risk Taking


Important rewiring is taking place in your teen's brain. This rewiring ultimately prepares your child for moving out of your home and becoming more independent. The level of dopamine, an important neurotransmitter associated with reward, is lower in adolescents, but when it is secreted (by engaging in new and exciting behaviors), it is released in higher concentrations than in adults. This results in the adolescent having a much stronger drive to engage in dopamine-secreting activities. Drug-taking releases dopamine, but so does achieving a goal (even if it's a new level in a video game) or learning a new skateboard trick or acing a test. When you notice that your teen is bored, remember that it will take innovative and interesting activities to relieve his or her boredom. Do not discourage your child from taking risks, but try to direct the risk-taking in as responsible a way as possible. Try to eliminate boredom as a trigger for drug use.

2) Anxiety

In the face of a new challenge, how does your child react? A certain amount of anxiety is normal, and can even act as a motivating force. When the anxiety becomes extreme, however, your child may feel desperate for a solution. Many addicts and alcoholics are perfectionists and as children they sought approval at all costs. The anxiety can be overwhelming and push your child to seek relief in drugs or other destructive behavior. Alternatively, this drive for perfection (straight A's, perfect athlete, piano prodigy) can backfire and cause your child to simply give up. This is a setup for drug use too: The pain of failure is unbearable, especially in a family where expectations are high. Drugs ease that pain.

Take the pressure off your child. Let him pursue his own interests and experience the joy of achievement for achievement's sake. Go easy on rewards and punishments. Let your child know that he is loved unconditionally. When your kid believes in himself and wants to reach goals because of an internal drive, not because he's seeking approval, he will not need to look elsewhere for validation/comfort.

3) Depression

Although moodiness is a characteristic of adolescence, long-lasting or frequent depression is not. In 2013, there were reports that children as young as five years old were showing signs of depression. It’s awful, and heartbreaking, but it’s a reality we have to discuss. Keep an eye out for a few specific behaviors. Does your child complain that she is always tired? Does she sleep too little or too much? Has she suddenly lost or gained an appetite? Trust your instinct on this one. Kids get tired from staying up too late and appetites increase with growth spurts, but if these behaviors seem extreme or are accompanied by a loss of affect, your child may be suffering from depression. Untreated depression and other mood disorders may lead to self-medication with drugs. Maintain open communication with your child by being non-judgmental and if something seems wrong, ask about it.

If you have concerns but can’t seem to get any answers from your child, reach out to teachers, coaches, babysitters, or anyone else who spends considerable time with your child. Have they noticed a change in your child’s demeanor? Are they able to shed light on a recent event you weren’t aware of?

4) Social alienation

Has your normally social child become isolated? Does your teen prefer to be alone than with his peers? Does your kid feel ostracized or left out?

Address social alienation before it becomes a problem. Kids do drugs in order to fit in with their peers or to escape the pain of isolation. School situations such as bullying, dealing with a learning disability, or not fitting in with the other kids all create tremendous pressure and anxiety. Maintain communication with the school so you know what's going on. Spend enough time with your child that she knows she can trust you with her feelings and confide in you. Many adult addicts say that they felt different as children. You may not be able to create a social life for your child, but if you acknowledge this "different" feeling and assure your child that she is okay anyway, you will go a long way to helping her feel safe and comfortable in her own skin. Talking about your own social challenges when you were a child is also very helpful in letting your kid know she'll make it through the tough times.

5) Emotional avoidance

If your child is unable or unwilling to experience difficult emotions, she may be setting herself up for substance use later in life. Pushing feelings down requires effort, and addicts learn to use drugs to cope with difficult emotions. Whether your child's emotional avoidance is a result of trauma or conditioning or something else entirely, it needs to be addressed if you want your kid to experience a healthy and fulfilling life.

Lead by example. When you’re feeling frustrated/angry/upset, articulate those feelings. Show your child that you don’t have to punch holes in the wall to feel better. Sometimes relief is as easy as saying how you feel out loud. Also let your child know that feelings can be overwhelming, but they always pass.

We advise seeking professional help if your child displays emotional avoidance. Sometimes the inability to feel emotions is a sign of something deeper, some trauma that needs to be addressed, or some organic problem like depression or another mental illness. Many addicts have never received proper treatment for their mental illness and consequently they self-medicate with often disastrous results.

***

There is no magic trick to ensuring that your child will not abuse drugs or become an addict. Nor is there a fool-proof way to predict addiction or abuse. Open and honest communication, however, goes a long way toward maintaining a healthy relationship with your child so that if and when problems do arise, you can address them before it's too late.

My Trip Through the Wilderness
After trying everything else to help my son, we tried "wilderness therapy." The results were mixed, at best.



Not the solution. Shutterstock


By Katie Bernard

04/14/14 Source The Fix




Wilderness “goons” usually roust teens from their beds in the middle of the night, when high-schoolers are too groggy and disoriented to fight their transport to an outdoor therapy program.

But I told the transport company that Jake doesn’t turn in until 3 and wouldn’t sink deep into REM sleep until 7. So as Good Morning America awoke the country, Chris and Corey—the transport team—quietly rolled their rented Camry into our driveway.

The two 20-something men looked more like a couple of camp counselors than the muscle I expected. Standing in the driveway with these guys from the J. Crew catalog, my husband and I—a couple of 60-somethings—signed paperwork, rehearsed the wake-up drill, then led them to Jake’s room before he suddenly awoke and ran.

Stepping over the chaos of clothes and dirty dishes on his bedroom floor, I touched Jake’s shoulder, told him we love him and that this transport team would take him him to a wilderness therapy program outside Ashevlle, N.C.

As I recited my lines, Cory grabbed Jake’s cell phone lying by the bed, and Chris scouted the room for weapons—standard procedure. There were no weapons, just a loaded weed grinder and bong.

Jake smiled slightly when he realized he wasn’t dreaming: He knew kids who went to wilderness and presumed he’d someday land there, too.

“Guys, give me 10 more minutes,” he said, pulling the blanket over his head and rolling over for a little more sleep.

My husband and I waited in the kitchen as the goons—that’s what wilderness kids call escorts—helped our only child throw on a pair of shorts and a knitted poncho that reeked of pot. Flanked by his escorts, Jake walked past us without a word, and slid into the back seat of the silver sedan, where he napped throughout the 10-hour ride between Northern Virginia and the North Carolina rain forest.

For most wilderness moms, watching their kid leave with God knows who, for God knows what, is the worst moment of their life.

For me—not so much.

Why We Tried Wilderness

Wilderness therapy uses the non-negotiable nature of Nature to rehabilitate addicted and defiant teens. It was the only therapy we hadn’t tried to help Jake manage his ADHD, Oppositional Defiance Disorder, Adoption Attachment Disorder, and his relatively recent dive into recreational drugs. By the time Jake was 16, he had been treated by:
A childhood analyst specializing in adoption issues, who helped 4-year-old Jakey correct the notion that we had stolen him from his birth mother.
A behavioral consultant, who said the analyst was a waste of money, and that 8-year-old Jake needed charts and chits to help modify his out-of-control behavior.
An NIH-worthy drug trial to discover which cocktail of stimulants, mood stabilizers and anti-depressants would help 11-year-old Jake pull through grade school.
A therapeutic boarding school that killed us emotionally and financially but was the only way to turn down the heat that was consuming our home as Jake crashed into adolescence at 13.

The result of all the “help”?

Jake was cordially invited not to return to the mainstream boarding school, which followed the therapeutic boarding school. He finished his junior year hell bent on breaking every rule we set. He refused to get a summer job, take a class, or do anything productive with his summer. He smoked weed in his room all day; rendezvoused with his pot dealer in our driveway at midnight; called me a cunt, and told his father he’d dance on his grave.

So when the escorts took our son away, I felt relief. I doubted that Jake would return the “confident and empowered” child the brochure promised. But I figured, at the very least, he’d be better off hiking, camping, and making fire with a bow and stick than inhaling drugs in his bedroom all summer.

Almost a year and $35,000 later, I can’t swear I was right.

The Ways of Wilderness

The world of wilderness programs, which serves over 10,000 U.S. kids a year, is varied and vast. Programs mostly are located in rugged areas – Utah, Idaho, parts of North Carolina that see 90 inches of rain per year. And they fall into two basic categories.
Expedition Programs: Teens live in the wilderness for about two months and don’t see civilization again until they graduate.
Base Camp Programs: Teens alternate two-week wilderness treks with a week of classes and, often, a week of equine therapy; rinse and repeat the monthly routine until the teen is ready to transition back home or to a boarding school.

Both types of programs include individual and group therapy.

My best friend sent her 15-year-old daughter, who was trading sex for drugs, to an expedition program in the Utah mountains. There, Victoria filled plastic bottles with boiling water to warm her sleeping bag during winter nights. Today, she’s 20, works a fulltime job, takes college classes, and smokes pot nightly with her steady boyfriend. For Victoria, wilderness therapy had mixed results.

We sent Jake to a “wilderness lite” program in western North Carolina during the rainy season. He camped and hiked during downpours, then dried out at base camp where he studied snakes in an environmental science class, and tended a horse named Hal; evidently, the emotional lives of horses and teens are similar.

Each week, my husband and I talked with Jake’s primary therapist, Will. At first, Will’s goal was to help Jake reconnect with us, and heal our family. Halfway through Jake’s 10-week stay, Will gave up that ghost—Jake (like his horse) wouldn’t budge. So, the therapist focused sessions on helping Jake launch himself into adulthood.

Great for Jake; too bad for us.

Jake’s goal, of course, was to move through the program and get out. We were told he got along with everybody—counselors, kids, horses. He worked hard to “bust his coal,” the first step toward starting a fire without matches—the holy grail of wilderness training.

And he wrote terse, weekly letters to us, where he shared his feelings: “I don’t hate you for sending me to wilderness,” he wrote. “I hate you for other reasons.”

As the summer wore on, my husband and I sunk deeper into hopelessness. We hit bottom when Jake’s “Letter of Accountability” arrived during the homestretch of his wilderness stay. The LOA, as the kids call it, is their mea culpa, where they own the reasons they landed in the woods.

Jake confessed so much in that seven-page letter, we figured he lifted some capers from stories he heard around the campfire. Here’s a sample.
“I smoked weed 3-6 times a day, whether I was away at school or home."
“I abused cough syrup, painkillers, Ecstasy, cocaine.”
“I stole money and credit cards from you.”
“I had sex with trashy girls.” (That’s the part we’re pretty sure he made up.)

There was a lot of accountability; absolutely no remorse or apology. We half-way expected him to end the LOA with: “And I’d do it all again.”

In the beginning of August, when Jake was a few sparks away from starting his matchless fire, we began making a post-wilderness plan for him. Most wilderness teens don’t return home right away. They go on to other drug rehabilitation programs, therapeutic boarding schools, or alternative schools that contain them until they can contain themselves, or they turn 18—whichever comes first.

We picked an Idaho program that taught a healthy lifestyle and a “zest for life.” But as we drove Jake to his fourth home in five years, he delivered a parting shot.

“I did drugs in wilderness.”

According to Jake, a student injured in wilderness returned to the program with a leg cast and percocet prescription. Jake said he traded his fruit rations for the painkiller.

When I could breathe again, I shot an email to Will. He interviewed the boy with the cast, who denied the allegation, then ticked off the field protocols employed to make sure pills are swallowed, not traded. Counselors make the kids stick out their tongues, swish water around their mouths, and pull out their cheeks. Will’s conclusion: Jake despised the other “gentleman” and was trying to get him in trouble. Case closed.

Perhaps that’s what happened; honesty is not Jake’s strong suit. But the wilderness program never interviewed my son, nor asked for a drug test—steps I would have taken if someone claimed drugs were exchanged in my wilderness program.

Was Wilderness Worth It?

Today, Jake is watching howler monkeys and finishing high school online in Central America, where his school maintains a branch. He lives in a small village where life is simple, and family is everything.

We Skype with him weekly, and things are a lot better than they were. He tries to be pleasant, and we try to be happy with the effort. He’s scheduled to come home in late May with a high school diploma and five college acceptances under his belt.

Happy ending? Jake told us recently that he plans to smoke pot when he comes home, but not in the house, and only now and then.

“I don’t want to be a stoner,” he said. “I want to be a business major.”

Hey—it’s a start.

Katie Bernard is a pseudonym.

The 10 Craziest Athlete Excuses For Failed Drug Tests | The Fix

The 10 Craziest Athlete Excuses For Failed Drug Tests | The Fix

Nutrition and Recovery: How Healthy Eating Can Help You Stay Sober
Eating healthy, research shows, can go a long way toward helping you on the road to addiction recovery.


Shutterstock


By Jenny Smiechowski 
Source The Fix
04/15/14


There is a common belief in the addiction recovery world that when you are overcoming a drug or alcohol addiction you should allow yourself to indulge in all the sweets, fats, and junk food you want. After all, why restrain yourself from harmless junk food when you have bigger beasts to slay? Evidence suggests, however, these eating habits may be hindering you more than they’re helping you on your path to recovery.

The Nutritional Double Whammy

The nutritional dilemma faced by recovering addicts is two-fold. First, the very act of ingesting drugs or alcohol wreaks havoc on the body. Alcohol, for example, impedes nutrient breakdown and assimilation resulting in nutritional deficiencies. Opiates tend to cause gastrointestinal issues, and, during opiate withdrawal, severe vomiting and diarrhea can lead to nutrient depletion. Stimulants suppress appetite which can lead to an insufficient intake of calories and nutrients.

In addition to the purely physiological implications of drug and alcohol abuse, there is another factor that results in a less than stellar nutritional report card for addicts: lifestyle. A person consumed by addiction is less likely to eat healthfully. Some drugs cause you to eat too much, others too little. At the height of their drinking, alcoholics often derive as much as 50 percent of their daily calorie allowance from alcohol itself. In most cases, the need for the addictive substance is prioritized over the need for, say, a whole-grain turkey sandwich or other high-quality, nutrient-dense food.

Given the nutritional standing of most recovering addicts, it’s surprising that proper nutrition is not emphasized more in recovery programs. Mounting evidence points to one emerging consensus: nutritional therapy can significantly help those recovering from addiction. It seems like common sense (because it is), but proper nutrition has the potential to make those in recovery feel better both mentally and physically. Furthermore, research suggests that the inclusion of nutrition education in substance abuse treatment programs can increase participants’ success in achieving recovery.

How Nutrition Helps the Healing Process

Proper nutrition helps recovering addicts (and everyone else) feel better because nutrients give the body energy, help build and repair organ tissue, and strengthen the immune system. Because recovering addicts have usually damaged vital organs during the course of their drug or alcohol abuse, good nutrition provides them with the nutritional building blocks they need to begin restoring these damaged tissues.

Nutrition also plays an important role in mood. Research suggests that changes in your diet can alter brain structure both chemically and physiologically, and influence your behavior. Furthermore, the consumption of certain foods has been tied to increased production of key neurotransmitters like serotonin, which enhances mood.

This means recovering addicts can use food to feel better physically (as their bodies receive the nutrients they need to repair prior damage and operate on a more optimal level) and mentally (as they eat foods that enhance their mood and overall well-being). In many cases, feeling better will reduce the risk of relapse, as demonstrated conversely by the fact that recovering addicts with poor dietary habits are more likely to relapse. Additionally, in some cases, addicts are so unfamiliar with the feeling of hunger, they misinterpret hunger as a drug craving and fall face-first into relapse. This potentially disastrous mistake can be easily remedied by eating frequent, healthy meals.

Seeking Support

When adding nutrition to your addiction-fighting arsenal, it is important to collaborate with a trained nutritionist who can tailor your diet to your specific needs in recovery. No matter where you live, there is surely a trained nutritionist nearby, and there are even some who specialize in addiction recovery.

David A. Wiss, MS, RDN, CPT, founder of the Los Angeles-based nutritional practice Nutrition in Recovery, is one such nutritionist. Wiss is a Registered Dietitian Nutritionist with a Master’s Degree in Nutrition and Dietetics from California State University, Northridge who has dedicated his nutritional expertise to helping those with addiction use diet to their advantage rather than detriment.

Wiss says he was inspired to specialize in addiction recovery nutrition after working as a personal trainer at addiction treatment centers and witnessing first-hand the poor nutritional habits that were encouraged. “I noticed that most of these facilities provided unlimited amounts of junk food to their clients. I decided to dedicate my career to changing that paradigm,” said Wiss.

In some cases, like that of Colorado-based Master Nutrition Therapist Patricia Farrell, a nutritionist’s own struggle with addiction sets him or her on the path of healing through nutrition. Having overcome addiction herself, Farrell brings a passion to her addiction-focused nutrition practice that comes from a personal understanding of the challenges her clients face. In fact, it was during the time she spent in recovery meetings that she had an epiphany about the importance of nutrition in addiction recovery.

“I used to go to this lunch-time recovery meeting and everybody had their bag of McDonald’s and their coffee, and then there were cookies served afterwards,” said Farrell. “It was obvious to me just looking and listening to these people that they did not feel well and it dawned on me that the first thing you want to do when you are recovering and you don’t feel well is to use. That is why I went into nutrition therapy and my expertise is drug and alcohol recovery.”

The Sugar Saboteur and Food as a Substitute Addiction

In her practice, Farrell strongly emphasizes sugar regulation. It is not uncommon, says Farrell, for people recovering from drug and alcohol addiction to become addicted to sugar. Alcoholics are especially prone to sugar addiction and to the energy rollercoaster that accompanies it, but sugar addiction affects other addicts too. Farrell believes that eating in a way that promotes blood sugar spikes and crashes is a recipe for disaster when it comes to maintaining your sobriety.

“When you get that blood sugar crash, your body craves sugar. In an alcoholic’s mind, and it works this way in a drug addict’s mind too, when you crave sugar it immediately translates in your brain to alcohol and you get a really strong craving for alcohol. It may be a craving that you can’t control,” said Farrell.

By regulating their blood sugar, says Farrell, recovering alcoholics can avoid the sugar highs and lows that often send them running for a drink. According to Farrell, in many cases, an addict’s overwhelming urge for his or her next fix is actually a sugar craving in disguise.

The tendency for recovering addicts to develop sugar addiction as they withdraw from alcohol or drugs is an example of a very common phenomenon in addiction recovery: the development of a substitute addiction to food. It is not uncommon for those recovering from addiction to turn to food as a replacement. According to a study published in the international research journal Appetite, men in the early stages of recovery often practice dysfunctional eating habits, including substituting food for their drug of choice. According to Wiss, this is one of the primary issues he addresses in his practice.

“I often get patients who have been to treatment before and have developed severe eating dysfunction while in treatment,” said Wiss. “Some people can gain up to 20 lbs in their first month of treatment from binge eating, emotional eating, and food addiction. By disrupting these patterns through nutrition education and counseling, most of my patients end up staying sober and become interested in a healthy lifestyle, including nutrition and exercise.”

APRIL 18 v 6 TWELVE STEPPING WITH POWER IN THE PROVERB

Fools’ words get them into constant quarrels;

they are asking for a beating.

STEP 5 - Admitted to God, to ourselves and to another human being the exact nature of our wrongs .

Why must it come to the point of severe beating for us to realize we don't have all the answers . We lose so much over and over yet we continue the same behaviors .Coming out of addiction and committing step five showed me that arguing with everybody was  my way of still trying to control everyone and everything in my life . It also showed me that it was ok to not know everything .When I realized this I really started to get better , and the people in my life were able to start to tolerate being around me . My stress levels dropped dramatically , admitting  you are wrong in any situation and asking  for forgiveness is one of the most liberating experiences in recovery .

Matthew 18 :15 - Moreover if thy brother shall trespass against thee, go and tell him his fault between thee and him alone: if he shall hear thee, thou hast gained thy brother.

By Joseph Dickerson