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Wednesday, May 21, 2014
Heroin Trade on the Rise in New York, Alarming Law Enforcement Officials
/By Celia Vimont
May 20th, 2014/
Law enforcement officials in New York City say the heroin trade there is surging to the highest level seen in more than 20 years. The city has become a hub for the heroin market along the East Coast, The New York Times reports.
The city’s special narcotics prosecutor says the amount of heroin seized in investigations so far this year has already surpassed the total amount seized in 2013. Officials have not confiscated so much heroin since 1991, the article notes.
The heroin originates in Mexico. It is sold in New York to users all along the East Coast, in glassine envelopes costing between $6 and $10. Law enforcement officials say drug organizations are meeting the growing demand for heroin by setting up increasingly large and sophisticated operations in New York.
About one-third of heroin seized by the Drug Enforcement Administration (DEA) nationwide since October was found in New York State. In previous years, New York heroin seizures have accounted for about one-fifth of the total.
“We’re kind of the head of the Hydra,” said Bridget G. Brennan, a special narcotics prosecutor. “This is highly organized, high volume, and it’s being moved much more efficiently and effectively to reach out to a broader user base.” She is scheduled to testify about heroin trends during a City Council budget hearing today.
“It’s cheap, it’s potent and there’s a user demand here right now and they’re flooding the market,” said James J. Hunt, head of the DEA’s New York office. “In my time, we’ve never seen the amount of large heroin seizures like this.”
/By Celia Vimont
May 20th, 2014/
Law enforcement officials in New York City say the heroin trade there is surging to the highest level seen in more than 20 years. The city has become a hub for the heroin market along the East Coast, The New York Times reports.
The city’s special narcotics prosecutor says the amount of heroin seized in investigations so far this year has already surpassed the total amount seized in 2013. Officials have not confiscated so much heroin since 1991, the article notes.
The heroin originates in Mexico. It is sold in New York to users all along the East Coast, in glassine envelopes costing between $6 and $10. Law enforcement officials say drug organizations are meeting the growing demand for heroin by setting up increasingly large and sophisticated operations in New York.
About one-third of heroin seized by the Drug Enforcement Administration (DEA) nationwide since October was found in New York State. In previous years, New York heroin seizures have accounted for about one-fifth of the total.
“We’re kind of the head of the Hydra,” said Bridget G. Brennan, a special narcotics prosecutor. “This is highly organized, high volume, and it’s being moved much more efficiently and effectively to reach out to a broader user base.” She is scheduled to testify about heroin trends during a City Council budget hearing today.
“It’s cheap, it’s potent and there’s a user demand here right now and they’re flooding the market,” said James J. Hunt, head of the DEA’s New York office. “In my time, we’ve never seen the amount of large heroin seizures like this.”
Many “Super-Frequent” ER Users Have Substance Use Disorder: Study
/By Celia Vimont
May 20th, 2014/
Three-quarters of patients who visit a Detroit emergency room at least 10 times a year—known as “super-frequent” users—have a substance use disorder, a new study finds.
Doctors at Henry Ford Hospital in Detroit also found 47 percent of these patients were addicted to painkillers such as Vicodin and Dilaudid, according to Newswise. Researchers found 44 percent were addicted to other illicit drugs such as cocaine or marijuana, and 35 percent were addicted to alcohol.
The findings were presented at the annual meeting of the Society for Academic Emergency Medicine.
“Emergency departments cannot address the super-frequent users problem without addressing the underlying reason they’re here – their substance abuse problem,” study lead author Jennifer Peltzer-Jones, RN, PsyD, said in a news release. “Boosting federal and state funding for substance abuse programs could help alleviate some of the frequent use of emergency departments as sources of addiction care.”
The federal Drug Abuse Warning Network found an estimated 2.5 million emergency department visits involved drug misuse or abuse in 2011. Between 2009 and 2011, emergency department visits involving overall misuse or abuse increased by 19 percent, or by about 400,000 visits over the two years.
The study included 255 super-frequent users who were cared for at the hospital from 2004 to 2013. In 2004, the hospital created the Community Resources for Emergency Department Overuse (CREDO) to more effectively manage the increased frequent users in the emergency department with individual care plans. The researchers found before CREDO was created, the super-frequent users sought care in the emergency department an average of 32.4 times a year. Since 2004, the rate of super-frequent users who asked for narcotic painkillers in the emergency department decreased to 13.8 times annually.
/By Celia Vimont
May 20th, 2014/
Three-quarters of patients who visit a Detroit emergency room at least 10 times a year—known as “super-frequent” users—have a substance use disorder, a new study finds.
Doctors at Henry Ford Hospital in Detroit also found 47 percent of these patients were addicted to painkillers such as Vicodin and Dilaudid, according to Newswise. Researchers found 44 percent were addicted to other illicit drugs such as cocaine or marijuana, and 35 percent were addicted to alcohol.
The findings were presented at the annual meeting of the Society for Academic Emergency Medicine.
“Emergency departments cannot address the super-frequent users problem without addressing the underlying reason they’re here – their substance abuse problem,” study lead author Jennifer Peltzer-Jones, RN, PsyD, said in a news release. “Boosting federal and state funding for substance abuse programs could help alleviate some of the frequent use of emergency departments as sources of addiction care.”
The federal Drug Abuse Warning Network found an estimated 2.5 million emergency department visits involved drug misuse or abuse in 2011. Between 2009 and 2011, emergency department visits involving overall misuse or abuse increased by 19 percent, or by about 400,000 visits over the two years.
The study included 255 super-frequent users who were cared for at the hospital from 2004 to 2013. In 2004, the hospital created the Community Resources for Emergency Department Overuse (CREDO) to more effectively manage the increased frequent users in the emergency department with individual care plans. The researchers found before CREDO was created, the super-frequent users sought care in the emergency department an average of 32.4 times a year. Since 2004, the rate of super-frequent users who asked for narcotic painkillers in the emergency department decreased to 13.8 times annually.
More Than 10,000 Toddlers Get ADHD Medication Outside Guidelines
/By Celia Vimont
May 20th, 2014/
A new government study finds more than 10,000 toddlers in the United States are receiving medication for attention deficit hyperactivity disorder (ADHD) outside established guidelines. The report found children covered by Medicaid are most likely to receive drugs such as Ritalin or Adderall.
The American Academy of Pediatrics does not have guidelines for use of ADHD medications in children ages 3 and younger, because their safety and effectiveness in that age group has not been established, The New York Times reports.
“It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center in Atlanta, where the data was presented last week by researchers from the Centers for Disease Control and Prevention. “People are just feeling around in the dark. We obviously don’t have our act together for little children.”
A California behavioral pediatrician, Dr. Lawrence H. Diller, told the newspaper, “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”
Adderall is the only drug approved by the Food and Drug Administration for treating children below age 6 for ADHD. After some studies suggested use of Ritalin in preschool children with ADHD may be helpful, the American Academy of Pediatrics issued guidelines that authorize use of the drug in 4- and 5-year-olds, but only if formal training for parents and teachers to improve the child’s environment were not successful.
Several experts said hyperactivity and impulsivity are developmentally appropriate for toddlers, and more time is needed to see if they truly have ADHD.
A study published in 2012 found use of drugs for ADHD in children jumped 46 percent from 2002 to 2010. Ritalin was the top drug prescribed for teenagers, with more than four million prescriptions filled in 2010.
/By Celia Vimont
May 20th, 2014/
A new government study finds more than 10,000 toddlers in the United States are receiving medication for attention deficit hyperactivity disorder (ADHD) outside established guidelines. The report found children covered by Medicaid are most likely to receive drugs such as Ritalin or Adderall.
The American Academy of Pediatrics does not have guidelines for use of ADHD medications in children ages 3 and younger, because their safety and effectiveness in that age group has not been established, The New York Times reports.
“It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center in Atlanta, where the data was presented last week by researchers from the Centers for Disease Control and Prevention. “People are just feeling around in the dark. We obviously don’t have our act together for little children.”
A California behavioral pediatrician, Dr. Lawrence H. Diller, told the newspaper, “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”
Adderall is the only drug approved by the Food and Drug Administration for treating children below age 6 for ADHD. After some studies suggested use of Ritalin in preschool children with ADHD may be helpful, the American Academy of Pediatrics issued guidelines that authorize use of the drug in 4- and 5-year-olds, but only if formal training for parents and teachers to improve the child’s environment were not successful.
Several experts said hyperactivity and impulsivity are developmentally appropriate for toddlers, and more time is needed to see if they truly have ADHD.
A study published in 2012 found use of drugs for ADHD in children jumped 46 percent from 2002 to 2010. Ritalin was the top drug prescribed for teenagers, with more than four million prescriptions filled in 2010.
Tuesday, May 20, 2014
MAY 20 v 24 TWELVE STEPPING WITH POWER IN THE PROVERB
The Lord directs our steps,
so why try to understand everything along the way?
STEP 2 - Came to believe that GOD could restore us to sanity.
Two of my favorite sayings are , Keep it simple and , one day at a time . God created you and this world and there is a purpose too everything and you could be the smartest person in the world and still not know everything . Why do we spend so much time trying to figure everything out. We are left with more questions than answers and I think that's the way God wants it . We are His kids and what do kids do when they are trying to figure something out . That 's right they seek out a parent .That's who God is , A Dad and our creator and He wants too help you along in life . All of your days are numbered and one day you will return home too Him . Someone mentioned too me , that we are spiritual beings having a human experience .So why not try and enjoy it . Instead we spend all our time trying to make life happen causing all types of stress and sickness . Then we self medicate to cope with the stress and rejection and depression . God has a plan start with the twelve steps and read the Proverbs. You just got to make up your mind to take it easy and enjoy life .
Provervb 3 v 5 v 6 -Trust in the lord with all your heart;
do not depend on your own understanding.
Seek his will in all you do,
and he will show you which path to take.
By Joseph Dickerson
A Drug Treatment Center Unlike Any Other
Sober College is a drug treatment center that specializes in helping young adult men & women ages 17 to 26.
Call us to learn about our innovative and effective approach to drug treatment: 877.628.6224.
HERE IS WHAT SETS OUR DRUG TREATMENT CENTER APART:
Tailored treatment for young adults: To be in treatment with people your own age, is much more appealing. Willingness in our drug treatment center is increased because our staffing and programming is specifically designed to capture the attention of young men and women aged 17 to 26.
Clinical care that treats the addicted brain: Since 2006, Sober College’s entire focus, curriculum and treatment methodology target healing the addicted brain. This was five years before the definition of addiction was re-defined by the American Society of Addiction Medicine as a disease of the brain.
Long-term rehab for life-long sobriety: For someone to maintain successful long-term recovery from drug and alcohol addiction, 30 to 60 days of treatment is not enough. We create life-long success through our innovative, long-term approach.
Don’t put your life on hold for rehab: Let’s face it. No one wants to be in treatment. At Sober College we understand this and have created a unique delivery that says, “If you have to be in treatment, then let’s make it as appealing as possible.”
High school or college, we’ve got you covered: Our groundbreaking “College and Rehab Under One Roof” is available to students in high school AND college. Call us today to find out more!
An Educated Addict’s Mom is an Empowered Addict’s Mom.
Are you an addict’s mom who needs help with codependency?
Debbie Sherrick, a codependency coach who is offering a free class to our TAM members.
About Debbie Sherrick:
Debbie Sherrick is a Holistic Codependency Coach. Motivated by my own personal journey to healing myself from the Inside Out, I love sharing my story of coming out of the shame, low self-esteem and the pain of codependency. I am a certified Holistic Health Counselor and Codependency Life Coach teaching people how to unite mind, body and spirit for a successful healthy life style to achieve more self-love and empowerment in their relationships and personal life. My passion is to educate and encourage others to become healthy emotionally, physically and to develop a deep spiritual connection in taking control of their own lives in these areas.
Information on Empower Hour Codependency Class:
On Tuesday, May 20th, 8pm EST Debbie Sherrick will be offering a free class “Why Detaching Never Fails” on the Empower Hour Show on Google+.
Debbie say’s “When it comes to codependency, some people are confused. We will be discussing some of the behavioral signs of codependency and the myths and confusion of what it "is not". We will see that it’s not so much what we do as WHY we’re doing it and why we struggle with our relationship with self and others.”
"The event is FREE but you must register to attend at www.empowerhourshow.com/live
Much love to all addict’s moms and their families....Barbara Theodosiou founder of The Addict’s Mom.
Visit The Addict's Mom at: http://addictsmom.com/?xg_source=msg_mes_network
Daily Quote
"There is absolutely nothing in ordinary human experience to compare with the joy of the presence of the Love of God. No sacrifice is too great nor effort too much in order to realize that Presence. " - David R. Hawkins
Today's Online Meetings
AA Meeting - 8:00 pm CST: "Face to Face"
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Sunday, May 18, 2014
MAY 18 v 24 TWELVE STEPPING WITH POWER IN THE PROVERB
There are “friends” who destroy each other,
but a real friend sticks closer than a brother.
STEP 8 - Made a list of all persons we had harmed, and became willing to make amends to them all.
What kind of a friend are you ? Misery loves company is what they say and it is one of the truest statements we will hear today . We can tell a lot about a person just by the people they associate with . People will come into your life for a reason ,season or a lifetime . You will know whose who soon enough but in the meantime be your own person .Do not shape your lives to please others or become what they are. Come out be separate and independent you have a destiny and you must live life to the fullest and I guarantee being an addict is not what God has planned for your life. According to the Bible you are a special treasure so believe it and live it.
Colosians 3 10 _ put on the new self, which is being renewed in knowledge in the image of its Creator.
There are “friends” who destroy each other,
but a real friend sticks closer than a brother.
STEP 8 - Made a list of all persons we had harmed, and became willing to make amends to them all.
What kind of a friend are you ? Misery loves company is what they say and it is one of the truest statements we will hear today . We can tell a lot about a person just by the people they associate with . People will come into your life for a reason ,season or a lifetime . You will know whose who soon enough but in the meantime be your own person .Do not shape your lives to please others or become what they are. Come out be separate and independent you have a destiny and you must live life to the fullest and I guarantee being an addict is not what God has planned for your life. According to the Bible you are a special treasure so believe it and live it.
Colosians 3 10 _ put on the new self, which is being renewed in knowledge in the image of its Creator.
By Joseph Dickerson
We are excited to announce
TAM Healthy Moms a new closed group focusing on the health and wellness
of Addict's Moms; We are proud to announce TAM NY State Coordinator Debbie Gross-Longo will be working in this group focusing on a healthier you to join visit https://www.facebook.com/
Visit The Addict's Mom at: http://addictsmom.com/?xg_
How Rock 'N Roll Can Save A Kid's Life
In New York, one program is bringing teens back from trouble with the power of black skinny jeans and electric guitars.
THE FIX
By Neville Elder
05/14/14
About 45 minutes from Grand Central Terminal the Graham school sprawls across 48 acres in the town of Hastings, New York. Elegant Victorian buildings peer down the Hudson river towards New York City. It could be a small university or an exclusive private school. It’s not. The Graham school was the first foster care institution in the US. It started the concept of foster care. Now it houses over 300 ‘at-risk’ day and resident students from New York City.
Downstairs in the canteen a dozen teenagers fill two hexagonal canteen tables with fixed seats. Other tables are stacked in the corner, the room is empty of furniture but full of life. A dozen girls and boys between 14 and 16 sit around and sulk, and chat and gossip. They doodle on notebooks and journals. They talk with staff, occasionally having to be gently reprimanded. They talk constantly, some never looking up from phones. One has a Fender Bullet electric guitar. I sit with him and try to tune it with an app on my phone, but the phone struggles to find the pitch without amplification. As stragglers shuffle in they have to knock on a heavy locked door to get access.
The whole idea is to say fuck you to society and fuck you to the fact you think these kids are garbage and you want to lock them away.
I’ve come to watch the beginning of the Road Recovery’s (RR) workshop. It’s an organization that connects musicians and the arts with vulnerable and troubled kids in care. RR partners with the institutions in a unique way to help change the course of their lives for the better.
Adam Roth is pure rock‘n’roll. With his grey hair slicked back over shaved sides, his guitar-pickin veteran hands are covered with old-school tattoos. He’s tall and skinny with a boyish face and wears desert boots with black skinny jeans. He’s been sober for ten years. He opens a guitar case and takes out a beautiful vintage Hofner hollow-body guitar and plugs it into an amplifier with an electronic ‘squawk.’ He sits down amongst notebooks and backpacks and strums a few chords. The amp stirs the empty room with a natural reverb. Some of the kids look up.
“Who’s got some words? Who wants to go first?” says Adam, a gold tooth gleaming in his beaming grin.
This is their last chance. The children who come here to Graham from the care of NYC social services are in serious trouble. Many have problems with drugs and alcohol. They’re not yet adults but if they don’t get their shit together soon they’ll be flushed into the New York State penal system.
Cheyenne, 15, sits down on the seat next to Adam and without too much encouragement starts singing a lilting bluesy ballad a capella. She reads from a crumpled piece of paper torn from a legal pad.
“We try so hard to be different - but it’s never gonna be alright,
This is the present - my life is a constant fight...”
Her voice is sweet and surprisingly well rounded. Something like Macy Gray meets Billie Holiday. A natural vibrato lifts above her shyness and above the hum of conversation.
“Like a decaying flower - everything just dies,
I will some-day have the pow-er I’m tired of these lies..”
Adam strums his guitar gently with his thumb and fingers, his head tilted towards her song picking out the root notes for her sad melody. He finds the chords easily and they grow stronger as Cheyenne’s voice repeats the phrases to her song. They go around again. She closes her eyes and repeats the phrases, gently swaying to the guitar player's swinging 6/8 rhythm, it’s got an almost Cuban feel and on the last lines - No more judging.. no more fighting - Adam lets the strings ring out and instinctively Cheyenne takes the cue to deliver the last line.
“I will survive.”
Applause breaks out. It’s a song, virtually fully formed in three takes. Everyone is impressed. Cheyenne giggles, reveling in her moment.
By the end of the hour Adam has helped two more kids write songs. These will form the basis for a live concert in 14 weeks' time. It will include dance, art and just about anything else the kids enrolled in the RR program can get excited about.
Gene Bowen, one of the founders of RR, believes that building a relationship with these children through music and art will get them off the fast track to prison.
“A lot of these kids have never had a solid continuous committed relationship in their life. We say, we're going to be here every Thursday night at 6pm for 14 weeks. Even that basic thing.. seems like a foreign idea [to them].”
Adam, like other sober musicians, brings a unique cachet to the project. Rock ‘n’ rollers are anti-establishment by their very nature. They bring their experiences into the Graham school and say:
I identify with you.This is what I did to get myself out of these situations and I’m in recovery from drugs and alcohol. This is where it took me. No one else gave a shit so I had to take responsibility. Whether you can see it or not this is an opportunity. I know, because I’ve been down this road.
Bowen, a former tour manager with the Allman Brothers Band and Alice In Chains, was brought to his knees by his addictions. From touring the world with the biggest rock bands he ended up turning a wrench at a venue in New Jersey, building the stages for the stars he once hung out with. When he got sober in 1993 his life turned around and he got a gig working for Columbia Artists Management putting together tours for orchestras and ballet companies. It kept him busy and kept him off the road. A couple of years later, Jack Bookbinder - who was managing Jeff Buckley for Sony - asked him go out on the road. Jack wanted Gene because he was sober. He refused. If he wanted to stay sober the madness of a rock ‘n’ roll tour was precisely the last place he could go.
“Sony’s hierarchy at the time was full of sober people who knew they needed a babysitter for their ‘pet rock.’ They’d made a huge investment [in Buckley], they knew they needed someone sober to protect their investment.”
Jack persisted. Exasperated, Gene made them an offer he knew they’d refuse. But they didn’t. Gene demanded that if he felt squirrely or freaked out at any time on the tour he could bail. Suddenly, he was back on the road, but this time with a network of sober people embedded in the entertainment industry.
What I saw in the canteen with Adam and the kids was the beginning of the RR program. Gene told me what comes next.
“We build a relationship, we build trust organically over a period of time - which is how we effect change, right? You’re 15, everyone’s told you’re a fucking a loser, a waste of time. We’re saying you have value. I’m 50 you’re 15 guess what? I can save your ass and you can save mine, we can do this together.”
As for the musicians, Adam says:
“We’re working as equals. I’m a rock ‘n’ roll guy - what could be better than writing a bunch of songs and then putting on a show. Fucking great, you know?”
Gene looks for a ‘seamless partnership’ with the methodology of the institution. The Graham staff must interact with the activities.
“It’s the only way this works - no bystanders! You want to be in the room? Beat a drum! And support us with eyes and ears. [Obviously] RR staff don’t have the skills to spot behavior that may result in further problems. We had one kid handing a RR staff member poetry. That gesture, which seemed to be building confidence, was actually acting out. They [Graham school staff] spotted it. They said: ‘this is what you need to do - if this kid is going to be affectionate don’t be affectionate back.”
When the Graham staff engage in the workshops, when they themselves are vulnerable, it breaks down barriers and opens up lines of communication. The kids then tend to seek out those staff members outside of their RR time. Perhaps they’ve been working on dance moves for the workshop, so they’ll take their ideas to that staff member who has been with them in the workshop stumbling around with two left feet.
“We do a newsletter,” Gene told me. “All our staff have to shoot me an email with a synopsis of their workshops. I send it through the hierarchy and let everyone at Graham know what’s going on so when a Graham staff member sees a kid around the school, he says ‘hey you’re working on that song? That’s cool, how did you write it?' It brings everyone together. Pretty soon it becomes part of the culture of the institution.”
But it’s not all ‘High School Musical’. Some of the children at Graham have severe behavioral problems. What I saw with Adam was only the second workshop of that series. It was beautiful and the mood was upbeat and supportive. But tempers can flare from time to time and the Graham school staff then step in to break things up.
“We’ve had riots,” Says Gene, his eyes twinkling, “But you know, if it doesn’t go in a ditch at least once, it isn’t going to work.”
The successes are hard won. But they’re worth it.
“So there’s this kid. . . every time I see this kid he says ‘Fuck you..! I want to kill you.' That's my whole conversation with him! I don’t know what to do with him! All he wants to do is play basketball - I don’t like sports but I ask him: ‘You any good? Can you dribble?' He says: ‘Fuck you, of course I can dribble.’ ‘Can you dribble two balls?.. How bout you dribble two basketballs and create a drum beat?’ Suddenly he’s involved, and he’s on stage at the final concert as the backbone for a dance."
"The whole idea is to say fuck you to society and fuck you to the fact you think these kids are garbage and you want to lock them away. But there is hope, they can become productive members of society.”
Gene waited ten years to lean on his connections in the music industry. He didn’t want RR to turn into a circus and perhaps endanger the kids. New York City is a pilot for a bolder, more remarkable project.
Recovery on the road. The idea Gene was kicking around started on the first Buckley tour in 1996. It was to use sober musicians and road crew when they’re on tour, passing through the cities where they put on the shows, to reach out to the local community and help kids in trouble, kids trying to get clean, to introduce the ideas I saw in Adam Roth’s workshop in the Graham School.
When he was out on the road it was the downtime that bothered Gene - all that sitting around waiting for something to happen. When he came back from the Jeff Buckley tour, Gene was still part of the team but as Jeff was writing a new album Gene was sitting on his hands, trying to figure out what to do next. He didn’t want to be a tour manager for the rest of his life but he’d committed to another four years on the road with Jeff. He talked with Jack Bookbinder and Jeff Buckley about the Road Recovery idea, about maybe taking it out on the next tour. They loved it. But then tragically, Jeff Buckley died. Everything fell apart. In the chaos that followed Gene found an unlikely ally in Buckley’s mother Mary. She saw Road Recovery as a beautiful memorial for Jeff.
“‘I’m going to help you get this going,' she said. She [gave me] a good kick in the ass! She was [the] cheerleader! And she’s still on the board of RR. In those darkest hours she kept pushing me with the words: ‘random acts of kindness.’ She wanted [Road Recovery] to be Jeff’s legacy.”
The plan to set up programs within local communities by piggybacking on the rock shows on tour should work on two simple principles. The workshops must be a ‘seamless partnership’ with the institutions that host them, and once up and running they must sustain themselves when the Road Recovery staff withdraw.
“The crew going in is the tip of the iceberg. Local people, local sober musicians take over and [the local community] become[s] self-sufficient.”
“Getting the seed money to start things was hard work, everyone was saying when you’ve got something we can see working we can talk again, well now [Jack Bookbinder and myself] have proved it.”
It’s been fifteen years since Road Recovery began and now there are self-sustaining programs in such far-flung places as Texas, New York, Alaska and Oklahoma. How does that Jonathan Richman song go? Oh yes!
"1,2,3,4,5,6 Roadrunner roadrunner..."
Neville Elder is a regular contributor to The Fix. He recently wrote about online dating in sobriety and the incompetence behind lethal injections.
In New York, one program is bringing teens back from trouble with the power of black skinny jeans and electric guitars.
THE FIX
By Neville Elder
05/14/14
About 45 minutes from Grand Central Terminal the Graham school sprawls across 48 acres in the town of Hastings, New York. Elegant Victorian buildings peer down the Hudson river towards New York City. It could be a small university or an exclusive private school. It’s not. The Graham school was the first foster care institution in the US. It started the concept of foster care. Now it houses over 300 ‘at-risk’ day and resident students from New York City.
Downstairs in the canteen a dozen teenagers fill two hexagonal canteen tables with fixed seats. Other tables are stacked in the corner, the room is empty of furniture but full of life. A dozen girls and boys between 14 and 16 sit around and sulk, and chat and gossip. They doodle on notebooks and journals. They talk with staff, occasionally having to be gently reprimanded. They talk constantly, some never looking up from phones. One has a Fender Bullet electric guitar. I sit with him and try to tune it with an app on my phone, but the phone struggles to find the pitch without amplification. As stragglers shuffle in they have to knock on a heavy locked door to get access.
The whole idea is to say fuck you to society and fuck you to the fact you think these kids are garbage and you want to lock them away.
I’ve come to watch the beginning of the Road Recovery’s (RR) workshop. It’s an organization that connects musicians and the arts with vulnerable and troubled kids in care. RR partners with the institutions in a unique way to help change the course of their lives for the better.
Adam Roth is pure rock‘n’roll. With his grey hair slicked back over shaved sides, his guitar-pickin veteran hands are covered with old-school tattoos. He’s tall and skinny with a boyish face and wears desert boots with black skinny jeans. He’s been sober for ten years. He opens a guitar case and takes out a beautiful vintage Hofner hollow-body guitar and plugs it into an amplifier with an electronic ‘squawk.’ He sits down amongst notebooks and backpacks and strums a few chords. The amp stirs the empty room with a natural reverb. Some of the kids look up.
“Who’s got some words? Who wants to go first?” says Adam, a gold tooth gleaming in his beaming grin.
This is their last chance. The children who come here to Graham from the care of NYC social services are in serious trouble. Many have problems with drugs and alcohol. They’re not yet adults but if they don’t get their shit together soon they’ll be flushed into the New York State penal system.
Cheyenne, 15, sits down on the seat next to Adam and without too much encouragement starts singing a lilting bluesy ballad a capella. She reads from a crumpled piece of paper torn from a legal pad.
“We try so hard to be different - but it’s never gonna be alright,
This is the present - my life is a constant fight...”
Her voice is sweet and surprisingly well rounded. Something like Macy Gray meets Billie Holiday. A natural vibrato lifts above her shyness and above the hum of conversation.
“Like a decaying flower - everything just dies,
I will some-day have the pow-er I’m tired of these lies..”
Adam strums his guitar gently with his thumb and fingers, his head tilted towards her song picking out the root notes for her sad melody. He finds the chords easily and they grow stronger as Cheyenne’s voice repeats the phrases to her song. They go around again. She closes her eyes and repeats the phrases, gently swaying to the guitar player's swinging 6/8 rhythm, it’s got an almost Cuban feel and on the last lines - No more judging.. no more fighting - Adam lets the strings ring out and instinctively Cheyenne takes the cue to deliver the last line.
“I will survive.”
Applause breaks out. It’s a song, virtually fully formed in three takes. Everyone is impressed. Cheyenne giggles, reveling in her moment.
By the end of the hour Adam has helped two more kids write songs. These will form the basis for a live concert in 14 weeks' time. It will include dance, art and just about anything else the kids enrolled in the RR program can get excited about.
Gene Bowen, one of the founders of RR, believes that building a relationship with these children through music and art will get them off the fast track to prison.
“A lot of these kids have never had a solid continuous committed relationship in their life. We say, we're going to be here every Thursday night at 6pm for 14 weeks. Even that basic thing.. seems like a foreign idea [to them].”
Adam, like other sober musicians, brings a unique cachet to the project. Rock ‘n’ rollers are anti-establishment by their very nature. They bring their experiences into the Graham school and say:
I identify with you.This is what I did to get myself out of these situations and I’m in recovery from drugs and alcohol. This is where it took me. No one else gave a shit so I had to take responsibility. Whether you can see it or not this is an opportunity. I know, because I’ve been down this road.
Bowen, a former tour manager with the Allman Brothers Band and Alice In Chains, was brought to his knees by his addictions. From touring the world with the biggest rock bands he ended up turning a wrench at a venue in New Jersey, building the stages for the stars he once hung out with. When he got sober in 1993 his life turned around and he got a gig working for Columbia Artists Management putting together tours for orchestras and ballet companies. It kept him busy and kept him off the road. A couple of years later, Jack Bookbinder - who was managing Jeff Buckley for Sony - asked him go out on the road. Jack wanted Gene because he was sober. He refused. If he wanted to stay sober the madness of a rock ‘n’ roll tour was precisely the last place he could go.
“Sony’s hierarchy at the time was full of sober people who knew they needed a babysitter for their ‘pet rock.’ They’d made a huge investment [in Buckley], they knew they needed someone sober to protect their investment.”
Jack persisted. Exasperated, Gene made them an offer he knew they’d refuse. But they didn’t. Gene demanded that if he felt squirrely or freaked out at any time on the tour he could bail. Suddenly, he was back on the road, but this time with a network of sober people embedded in the entertainment industry.
What I saw in the canteen with Adam and the kids was the beginning of the RR program. Gene told me what comes next.
“We build a relationship, we build trust organically over a period of time - which is how we effect change, right? You’re 15, everyone’s told you’re a fucking a loser, a waste of time. We’re saying you have value. I’m 50 you’re 15 guess what? I can save your ass and you can save mine, we can do this together.”
As for the musicians, Adam says:
“We’re working as equals. I’m a rock ‘n’ roll guy - what could be better than writing a bunch of songs and then putting on a show. Fucking great, you know?”
Gene looks for a ‘seamless partnership’ with the methodology of the institution. The Graham staff must interact with the activities.
“It’s the only way this works - no bystanders! You want to be in the room? Beat a drum! And support us with eyes and ears. [Obviously] RR staff don’t have the skills to spot behavior that may result in further problems. We had one kid handing a RR staff member poetry. That gesture, which seemed to be building confidence, was actually acting out. They [Graham school staff] spotted it. They said: ‘this is what you need to do - if this kid is going to be affectionate don’t be affectionate back.”
When the Graham staff engage in the workshops, when they themselves are vulnerable, it breaks down barriers and opens up lines of communication. The kids then tend to seek out those staff members outside of their RR time. Perhaps they’ve been working on dance moves for the workshop, so they’ll take their ideas to that staff member who has been with them in the workshop stumbling around with two left feet.
“We do a newsletter,” Gene told me. “All our staff have to shoot me an email with a synopsis of their workshops. I send it through the hierarchy and let everyone at Graham know what’s going on so when a Graham staff member sees a kid around the school, he says ‘hey you’re working on that song? That’s cool, how did you write it?' It brings everyone together. Pretty soon it becomes part of the culture of the institution.”
But it’s not all ‘High School Musical’. Some of the children at Graham have severe behavioral problems. What I saw with Adam was only the second workshop of that series. It was beautiful and the mood was upbeat and supportive. But tempers can flare from time to time and the Graham school staff then step in to break things up.
“We’ve had riots,” Says Gene, his eyes twinkling, “But you know, if it doesn’t go in a ditch at least once, it isn’t going to work.”
The successes are hard won. But they’re worth it.
“So there’s this kid. . . every time I see this kid he says ‘Fuck you..! I want to kill you.' That's my whole conversation with him! I don’t know what to do with him! All he wants to do is play basketball - I don’t like sports but I ask him: ‘You any good? Can you dribble?' He says: ‘Fuck you, of course I can dribble.’ ‘Can you dribble two balls?.. How bout you dribble two basketballs and create a drum beat?’ Suddenly he’s involved, and he’s on stage at the final concert as the backbone for a dance."
"The whole idea is to say fuck you to society and fuck you to the fact you think these kids are garbage and you want to lock them away. But there is hope, they can become productive members of society.”
Gene waited ten years to lean on his connections in the music industry. He didn’t want RR to turn into a circus and perhaps endanger the kids. New York City is a pilot for a bolder, more remarkable project.
Recovery on the road. The idea Gene was kicking around started on the first Buckley tour in 1996. It was to use sober musicians and road crew when they’re on tour, passing through the cities where they put on the shows, to reach out to the local community and help kids in trouble, kids trying to get clean, to introduce the ideas I saw in Adam Roth’s workshop in the Graham School.
When he was out on the road it was the downtime that bothered Gene - all that sitting around waiting for something to happen. When he came back from the Jeff Buckley tour, Gene was still part of the team but as Jeff was writing a new album Gene was sitting on his hands, trying to figure out what to do next. He didn’t want to be a tour manager for the rest of his life but he’d committed to another four years on the road with Jeff. He talked with Jack Bookbinder and Jeff Buckley about the Road Recovery idea, about maybe taking it out on the next tour. They loved it. But then tragically, Jeff Buckley died. Everything fell apart. In the chaos that followed Gene found an unlikely ally in Buckley’s mother Mary. She saw Road Recovery as a beautiful memorial for Jeff.
“‘I’m going to help you get this going,' she said. She [gave me] a good kick in the ass! She was [the] cheerleader! And she’s still on the board of RR. In those darkest hours she kept pushing me with the words: ‘random acts of kindness.’ She wanted [Road Recovery] to be Jeff’s legacy.”
The plan to set up programs within local communities by piggybacking on the rock shows on tour should work on two simple principles. The workshops must be a ‘seamless partnership’ with the institutions that host them, and once up and running they must sustain themselves when the Road Recovery staff withdraw.
“The crew going in is the tip of the iceberg. Local people, local sober musicians take over and [the local community] become[s] self-sufficient.”
“Getting the seed money to start things was hard work, everyone was saying when you’ve got something we can see working we can talk again, well now [Jack Bookbinder and myself] have proved it.”
It’s been fifteen years since Road Recovery began and now there are self-sustaining programs in such far-flung places as Texas, New York, Alaska and Oklahoma. How does that Jonathan Richman song go? Oh yes!
"1,2,3,4,5,6 Roadrunner roadrunner..."
Neville Elder is a regular contributor to The Fix. He recently wrote about online dating in sobriety and the incompetence behind lethal injections.
One Simple Way to Save Taxpayers $7B Annually
Giving drug offenders treatment instead of prison time benefits us all.
THE FIX
By Paul Gaita
05/15/14
The “war on drugs” carried out during 1980s has resulted in a critical situation in America’s prisons. We have the highest incarceration rate in the world with 2.2 million individuals behind bars in this country, and more than half of those at federal level are serving time for drug charges. At the state level, nearly half of all prisoners have been locked up for nonviolent offenses. The cost of this quixotic pursuit: states had paid $44 billion on prison expenses by 2007 - a 127 percent increase from 1987. During the same period, expenditure for higher learning rose only 21 percent.
Despite these staggering numbers, the zero tolerance policies of the period continue to wreak havoc in our social system, as evidenced by a report by the American Civil Liberties Union, which revealed that more than 3,000 federal prisoners currently serve life sentences for non-violent crimes, with 79 percent of those individuals incarcerated for non-violent drug charges. More than 18 percent of them are serving life without parole for their first offense.
Though both the federal and state governments have been slow to repeal many of these draconian laws, growing opposition from representatives of and adherents to both parties have spurred the rise of numerous programs and proposals that give alternatives to incarceration for drug offenses. An estimated 67 percent of Americans believe that the government should offer treatment for offenders facing jail time for illegal drugs, including 51 percent of all Republicans who responded to the Pew Center’s research.
Such programs are believed to reduce the nation’s massive prison population, as well as the financial toll taken each year to house prisoners, which as of 2013 stood at nearly $7 billion, or a quarter of the Justice Department’s yearly budget. Research conducted in part by Temple University and published in the online journal “Crime & Delinquency” found that only ten percent of state prisoners who abuse drugs or are drug-dependent receive medically based treatment while incarcerated. If that ten percent had received treatment in community-based programs instead of serving jail time, the prison system would save $4.8 billion - nearly the amount paid out to the Bureau of Prisons. Those savings would nearly triple if just 40 percent of eligible offenders received the same sort of treatment.
Diversion programs such as drug courts have offered a first line of defense by keeping low-level drug offenders out of the state prison system. Eligible participants receive a year of treatment under close supervision while pursuing full-time status as either an employee or student. The results have been extremely positive - 75 percent of all drug court graduates remain arrest-free for at least two years after leaving the program, and have saved taxpayers between $3,000 and $13,000 per client - but research from the Urban Institute suggests that for such programs to be truly effective, offenders facing serious charges at the federal level would need to be enrolled. Currently, less than one percent of federal drug cases are referred to drug courts.
Attorney General Eric Holder has thrown the weight of the Justice Department behind diversion programs at the federal level while also calling for an extensive overhaul of sentencing guidelines. The Smarter Sentencing Act of 2014, sponsored by a bipartisan group of senators including Democrats Patrick Leahy and Sheldon Whitehouse and Libertarian Rand Paul, also aims to reduce mandatory minimums at the federal level. But as the drug court program has shown, the greatest force for change regarding drug laws has come at the state level. Twenty-seven states reduced their drug laws between 2009 and 2013, including lowered penalties for possession and use of illegal drugs and the abolishment of automatic sentence enhancements.
New York’s notorious Rockefeller Drug Laws, which set mandatory long prison sentences for drug offenders at all levels, received a substantial overhaul in 2009, including the implementation of Article 216 of the Criminal Procedure Law, which allowed judges to offer drug court alternatives to non-violent offenders. Texas, which spent over $2 billion on prison expenses between 1983 and 1997, found itself out of space in its jails by 2007 and in need of $900 million to continue operating their current prisons. Leaders from both parties joined forces to offer a range of diversion programs that not only reduced the state’s crime rate but also allowed them to close three prisons.
Similar efforts in Maryland, Arkansas and 13 other states produced a dramatic drop in imprisonment rates between 2007 and 2012, with California leading the way with a 26 percent reduction. The Golden State has frequently led the way in offering diversion programs as an alternative to their prison situation, which numbered more than 130,000 individuals in 2009. Proposition 36, or The Substance Abuse and Crime Prevention Act of 2000, saved California taxpayers between $10 and $13 million by releasing from custody over 1,000 nonviolent inmates. The recidivism rate was less than two percent - below state and national averages.
However, statistics such as these have not convinced all state lawmakers to pursue similar revisions to their drug laws. In Tennessee, Governor Bill Haslam recently signed into law a bill that would prosecute pregnant women for using drugs. The media is also calling on Florida legislators to repeal a law that hands down a mandatory three-year sentence for the possession of seven hydrocodone tablets without a valid prescription.
But as greater numbers of the population embrace the idea that treatment and diversion programs will produce more positive and financially responsible results than jail time, the hope is that stories like these are the exception to the rule, rather than the norm.
Paul Gaita is a Los Angeles-based writer. He has contributed to The Los Angeles Times, LA Weekly, Amazon and The Los Angeles Beat, among other publications and sites.
Giving drug offenders treatment instead of prison time benefits us all.
THE FIX
By Paul Gaita
05/15/14
The “war on drugs” carried out during 1980s has resulted in a critical situation in America’s prisons. We have the highest incarceration rate in the world with 2.2 million individuals behind bars in this country, and more than half of those at federal level are serving time for drug charges. At the state level, nearly half of all prisoners have been locked up for nonviolent offenses. The cost of this quixotic pursuit: states had paid $44 billion on prison expenses by 2007 - a 127 percent increase from 1987. During the same period, expenditure for higher learning rose only 21 percent.
Despite these staggering numbers, the zero tolerance policies of the period continue to wreak havoc in our social system, as evidenced by a report by the American Civil Liberties Union, which revealed that more than 3,000 federal prisoners currently serve life sentences for non-violent crimes, with 79 percent of those individuals incarcerated for non-violent drug charges. More than 18 percent of them are serving life without parole for their first offense.
Though both the federal and state governments have been slow to repeal many of these draconian laws, growing opposition from representatives of and adherents to both parties have spurred the rise of numerous programs and proposals that give alternatives to incarceration for drug offenses. An estimated 67 percent of Americans believe that the government should offer treatment for offenders facing jail time for illegal drugs, including 51 percent of all Republicans who responded to the Pew Center’s research.
Such programs are believed to reduce the nation’s massive prison population, as well as the financial toll taken each year to house prisoners, which as of 2013 stood at nearly $7 billion, or a quarter of the Justice Department’s yearly budget. Research conducted in part by Temple University and published in the online journal “Crime & Delinquency” found that only ten percent of state prisoners who abuse drugs or are drug-dependent receive medically based treatment while incarcerated. If that ten percent had received treatment in community-based programs instead of serving jail time, the prison system would save $4.8 billion - nearly the amount paid out to the Bureau of Prisons. Those savings would nearly triple if just 40 percent of eligible offenders received the same sort of treatment.
Diversion programs such as drug courts have offered a first line of defense by keeping low-level drug offenders out of the state prison system. Eligible participants receive a year of treatment under close supervision while pursuing full-time status as either an employee or student. The results have been extremely positive - 75 percent of all drug court graduates remain arrest-free for at least two years after leaving the program, and have saved taxpayers between $3,000 and $13,000 per client - but research from the Urban Institute suggests that for such programs to be truly effective, offenders facing serious charges at the federal level would need to be enrolled. Currently, less than one percent of federal drug cases are referred to drug courts.
Attorney General Eric Holder has thrown the weight of the Justice Department behind diversion programs at the federal level while also calling for an extensive overhaul of sentencing guidelines. The Smarter Sentencing Act of 2014, sponsored by a bipartisan group of senators including Democrats Patrick Leahy and Sheldon Whitehouse and Libertarian Rand Paul, also aims to reduce mandatory minimums at the federal level. But as the drug court program has shown, the greatest force for change regarding drug laws has come at the state level. Twenty-seven states reduced their drug laws between 2009 and 2013, including lowered penalties for possession and use of illegal drugs and the abolishment of automatic sentence enhancements.
New York’s notorious Rockefeller Drug Laws, which set mandatory long prison sentences for drug offenders at all levels, received a substantial overhaul in 2009, including the implementation of Article 216 of the Criminal Procedure Law, which allowed judges to offer drug court alternatives to non-violent offenders. Texas, which spent over $2 billion on prison expenses between 1983 and 1997, found itself out of space in its jails by 2007 and in need of $900 million to continue operating their current prisons. Leaders from both parties joined forces to offer a range of diversion programs that not only reduced the state’s crime rate but also allowed them to close three prisons.
Similar efforts in Maryland, Arkansas and 13 other states produced a dramatic drop in imprisonment rates between 2007 and 2012, with California leading the way with a 26 percent reduction. The Golden State has frequently led the way in offering diversion programs as an alternative to their prison situation, which numbered more than 130,000 individuals in 2009. Proposition 36, or The Substance Abuse and Crime Prevention Act of 2000, saved California taxpayers between $10 and $13 million by releasing from custody over 1,000 nonviolent inmates. The recidivism rate was less than two percent - below state and national averages.
However, statistics such as these have not convinced all state lawmakers to pursue similar revisions to their drug laws. In Tennessee, Governor Bill Haslam recently signed into law a bill that would prosecute pregnant women for using drugs. The media is also calling on Florida legislators to repeal a law that hands down a mandatory three-year sentence for the possession of seven hydrocodone tablets without a valid prescription.
But as greater numbers of the population embrace the idea that treatment and diversion programs will produce more positive and financially responsible results than jail time, the hope is that stories like these are the exception to the rule, rather than the norm.
Paul Gaita is a Los Angeles-based writer. He has contributed to The Los Angeles Times, LA Weekly, Amazon and The Los Angeles Beat, among other publications and sites.
Is Your Doctor Addicted to Drugs?
Learn how to tell if your healthcare provider is using and what to do to safeguard yourself.
THE FIX
By Cathy Cassata
05/13/14
Imagine going in for a routine kidney stone removal. The surgery goes as expected, and all seems well, until several weeks later you start feeling so ill that you rush to the emergency room, where you discover that you’ve caught the potentially deadly liver disease Hepatitis C.
This was Lauren Lollini’s terrifying reality in 2009. “I had no idea what Hepatitis C was. When I saw a specialist a few days later, we went over the risk factors and it just didn’t make sense. I had gotten a tattoo years before but had given blood many times since then so it was kind of a mystery how I could have gotten it,” said Lollini. “The only thing that seemed like a possibility was that I had surgery a few weeks before. I asked the doctor if I could have caught it then. He said ‘maybe’ and just kind of dismissed the notion.”
But several weeks later, Lollini’s suspicion was confirmed when the Colorado Health Department informed her that an addicted surgical technician, Kristen Parker, who worked at Rose Medical Center in Denver where Lollini received surgery, was arrested for stealing fentanyl laid out in operating rooms in preparation for surgery. Despite having Hepatitis C, Parker would inject herself with the fentanyl that was intended for patients and then refill the same syringes with water or saline solution, leaving the patients without the intended medication and exposed to Hepatitis C. Parker infected 24 people with Hepatitis C between the Fall of 2008 through the Spring of 2009.
Parker’s act of stealing drugs is called “drug diversion,” and it's an issue that’s happening more than you might think. Alarming research revealed by USA Today in April 2014 stated that more than 100,000 doctors, nurses, technicians and other health professionals struggle with substance abuse or addiction.
WHY IS DRUG DIVERSION SUCH A PROBLEM?
Kimberly New, JD, BSN, RN, president of the Tennessee chapter of the National Association of Drug Diversion Investigators, which aims to educate healthcare providers and law enforcement on investigation, prevention, detection and resolution of drug diversion cases, says the nature of the job plays a part. “Healthcare providers have a high stress profession whether they’re a physician, nurse, radiology technician, lab technician or other provider. They see patients die and experience a lot of vicarious trauma. Many have compassion fatigue, and physical injuries because of the actions that they go through in the course of their job - lifting patients, turning patients, etcetera,” she explained. “A recent nurse I found diverting said he started using because the medication he was taking for back pain from lifting patients wasn’t cutting it anymore.”
Still, New says the number one factor in healthcare diversion is access and availability. “Controlled substances are right there at their fingertips. People find ways to access these drugs that are in the facility where they work. If they have access to the medicine cabinet, that makes it easier, but we find other providers who figure out ways to divert even if they don’t have that access,” said New.
HOW ARE PATIENTS HARMED?
Cases like Lollini’s are the most dangerous instances of drug diversion and the hardest for the patient to detect in the situation. “Since Lauren was unconscious, there was no way for her to suspect something was wrong. Becoming educated on the topic is patients’ first line of defense,” said New.
The first thing to know is that nurses are the number one healthcare provider population who have regular access to controlled substances and who have a job responsibility to administer controlled substances. New says patients can be harmed in the following three ways by an impaired nurse or other healthcare provider in a similar role:
Tampering and substitution. Like Lollini’s experience, this is when a provider will remove a controlled substance from a syringe or vial, inject themselves with the substance, and then replace it with water or saline. “The patient doesn’t get the medication they were supposed to, and is also potentially exposed to blood borne pathogens that the diverter has. It’s like sharing needles,” stated New.
Delivery of care in an impaired state. Nurses who divert are often times in intensive care or emergency care settings. “These are critical care environments where they need to be making succinct decisions and may not be capable of doing that if they’re impaired. This really puts patients at risk when they need immediate and attentive care,” New said.
Withholding medication from patients in need. In these instances, the provider simply doesn’t give a patient the medication they need and instead steals the medication or takes the medication for themselves. “They place their addictive needs above those of the patient, leaving the patient untreated and possibly in pain,” stated New.
HOW CAN PATIENTS PROTECT THEMSELVES?
Prior to seeing a provider, New suggests checking with his or her state medical board (for physicians) and licensing boards (for nurses) to find information regarding any recorded disciplinary issues against the provider. “Also visit social media sites that offer reviews of providers. And if you’re having surgery, ask who is going to be involved with your care,” she said. “Patient care in an institutional environment has changed a lot. Years ago there was this blind faith in physicians, and patients just trusted them to do the right thing. Patient care has become much more consumer-based and really it’s the patients that are advocates for themselves, and are empowered to ask questions.”
If having a procedure, New says always have an advocate with you. “During recovery, this person can watch as medication is administered and can be a presence so the provider knows you’re not alone,” she said.
The Centers for Disease Control and Prevention’s Only One Campaign, which aims to educate on safe injections, suggests that patients (and advocates) ask healthcare providers the following questions before they receive an injection:
Will there be a new needle, new syringe, and a new vial for this procedure or injection?
Can you tell me how you prevent the spread of infections in your facility?
What steps are you taking to keep me safe?
Speaking up about pain management is another way to protect yourself. “Sudden unrelieved pain from methods that previously worked is something to address right away. For instance, if a patient is getting morphine and it’s working great and then one particular day it’s suddenly not working, that’s when you need to tell someone,” said New, adding that you should tell a supervisor, not the nurse in case the nurse is diverting. “Pain during procedures should be expressed immediately. There was a case in Minnesota where a CRNA, who is usually the person delivering the anesthesia, told the patient that he needed to ‘man up’ prior to his procedure. He nearly jumped off the table as the surgeon made the incision. The CRNA was diverting the patient’s pain meds.”
When it comes to providers you already know, New says it can be difficult to notice if they’re using because often times providers who are diverting don’t always fit the stereotypical profile of somebody who’s a drug addict. “Many are very high achievers and enormously liked by everybody. Often times they’re even award winners, and receive many compliments from patients. The drugs they take can give them a state of euphoria, allowing them to super perform for a time. Over time, they will spiral downwards if they’re allowed to continue to divert,” she said.
Learn how to tell if your healthcare provider is using and what to do to safeguard yourself.
THE FIX
By Cathy Cassata
05/13/14
Imagine going in for a routine kidney stone removal. The surgery goes as expected, and all seems well, until several weeks later you start feeling so ill that you rush to the emergency room, where you discover that you’ve caught the potentially deadly liver disease Hepatitis C.
This was Lauren Lollini’s terrifying reality in 2009. “I had no idea what Hepatitis C was. When I saw a specialist a few days later, we went over the risk factors and it just didn’t make sense. I had gotten a tattoo years before but had given blood many times since then so it was kind of a mystery how I could have gotten it,” said Lollini. “The only thing that seemed like a possibility was that I had surgery a few weeks before. I asked the doctor if I could have caught it then. He said ‘maybe’ and just kind of dismissed the notion.”
But several weeks later, Lollini’s suspicion was confirmed when the Colorado Health Department informed her that an addicted surgical technician, Kristen Parker, who worked at Rose Medical Center in Denver where Lollini received surgery, was arrested for stealing fentanyl laid out in operating rooms in preparation for surgery. Despite having Hepatitis C, Parker would inject herself with the fentanyl that was intended for patients and then refill the same syringes with water or saline solution, leaving the patients without the intended medication and exposed to Hepatitis C. Parker infected 24 people with Hepatitis C between the Fall of 2008 through the Spring of 2009.
Parker’s act of stealing drugs is called “drug diversion,” and it's an issue that’s happening more than you might think. Alarming research revealed by USA Today in April 2014 stated that more than 100,000 doctors, nurses, technicians and other health professionals struggle with substance abuse or addiction.
WHY IS DRUG DIVERSION SUCH A PROBLEM?
Kimberly New, JD, BSN, RN, president of the Tennessee chapter of the National Association of Drug Diversion Investigators, which aims to educate healthcare providers and law enforcement on investigation, prevention, detection and resolution of drug diversion cases, says the nature of the job plays a part. “Healthcare providers have a high stress profession whether they’re a physician, nurse, radiology technician, lab technician or other provider. They see patients die and experience a lot of vicarious trauma. Many have compassion fatigue, and physical injuries because of the actions that they go through in the course of their job - lifting patients, turning patients, etcetera,” she explained. “A recent nurse I found diverting said he started using because the medication he was taking for back pain from lifting patients wasn’t cutting it anymore.”
Still, New says the number one factor in healthcare diversion is access and availability. “Controlled substances are right there at their fingertips. People find ways to access these drugs that are in the facility where they work. If they have access to the medicine cabinet, that makes it easier, but we find other providers who figure out ways to divert even if they don’t have that access,” said New.
HOW ARE PATIENTS HARMED?
Cases like Lollini’s are the most dangerous instances of drug diversion and the hardest for the patient to detect in the situation. “Since Lauren was unconscious, there was no way for her to suspect something was wrong. Becoming educated on the topic is patients’ first line of defense,” said New.
The first thing to know is that nurses are the number one healthcare provider population who have regular access to controlled substances and who have a job responsibility to administer controlled substances. New says patients can be harmed in the following three ways by an impaired nurse or other healthcare provider in a similar role:
Tampering and substitution. Like Lollini’s experience, this is when a provider will remove a controlled substance from a syringe or vial, inject themselves with the substance, and then replace it with water or saline. “The patient doesn’t get the medication they were supposed to, and is also potentially exposed to blood borne pathogens that the diverter has. It’s like sharing needles,” stated New.
Delivery of care in an impaired state. Nurses who divert are often times in intensive care or emergency care settings. “These are critical care environments where they need to be making succinct decisions and may not be capable of doing that if they’re impaired. This really puts patients at risk when they need immediate and attentive care,” New said.
Withholding medication from patients in need. In these instances, the provider simply doesn’t give a patient the medication they need and instead steals the medication or takes the medication for themselves. “They place their addictive needs above those of the patient, leaving the patient untreated and possibly in pain,” stated New.
HOW CAN PATIENTS PROTECT THEMSELVES?
Prior to seeing a provider, New suggests checking with his or her state medical board (for physicians) and licensing boards (for nurses) to find information regarding any recorded disciplinary issues against the provider. “Also visit social media sites that offer reviews of providers. And if you’re having surgery, ask who is going to be involved with your care,” she said. “Patient care in an institutional environment has changed a lot. Years ago there was this blind faith in physicians, and patients just trusted them to do the right thing. Patient care has become much more consumer-based and really it’s the patients that are advocates for themselves, and are empowered to ask questions.”
If having a procedure, New says always have an advocate with you. “During recovery, this person can watch as medication is administered and can be a presence so the provider knows you’re not alone,” she said.
The Centers for Disease Control and Prevention’s Only One Campaign, which aims to educate on safe injections, suggests that patients (and advocates) ask healthcare providers the following questions before they receive an injection:
Will there be a new needle, new syringe, and a new vial for this procedure or injection?
Can you tell me how you prevent the spread of infections in your facility?
What steps are you taking to keep me safe?
Speaking up about pain management is another way to protect yourself. “Sudden unrelieved pain from methods that previously worked is something to address right away. For instance, if a patient is getting morphine and it’s working great and then one particular day it’s suddenly not working, that’s when you need to tell someone,” said New, adding that you should tell a supervisor, not the nurse in case the nurse is diverting. “Pain during procedures should be expressed immediately. There was a case in Minnesota where a CRNA, who is usually the person delivering the anesthesia, told the patient that he needed to ‘man up’ prior to his procedure. He nearly jumped off the table as the surgeon made the incision. The CRNA was diverting the patient’s pain meds.”
When it comes to providers you already know, New says it can be difficult to notice if they’re using because often times providers who are diverting don’t always fit the stereotypical profile of somebody who’s a drug addict. “Many are very high achievers and enormously liked by everybody. Often times they’re even award winners, and receive many compliments from patients. The drugs they take can give them a state of euphoria, allowing them to super perform for a time. Over time, they will spiral downwards if they’re allowed to continue to divert,” she said.
Alcoholism and Genetics:
What You Need to Know
THE FIX
By Jeaneane Swanson
05/12/14
In biology class, most of us were taught to believe that specific traits are passed on through our genes: if I have the “Alzheimer’s gene” or the “breast cancer gene,” there’s a probable chance that my son or daughter will carry that gene. However, what about more “complex” diseases like depression, or alcoholism? While alcoholism does tend to run in families—and has a genetic component—how exactly is it passed on?
In recent years, more and more studies are showing that there is another level of inheritance at work: epigenetics. Literally “above the genome,” epigenetic marks are chemical “tags” that can be put on or taken off DNA, and their purpose is to control the expression of genes. Some tags turn genes on, while others turn genes off. These tags come in the form of molecules called methyl groups or acetyl groups, and they can also appear on the outside of the DNA strand. In the nucleus of every cell, the very long strands of DNA coil around proteins called histones; these histones can be more “open” or “closed,” depending on what tags reside on the surface.
These “tags” can be helpful and are very important for many biological processes. For example, in the development of an embryo into a baby, epigenetics plays a huge role in making sure embryonic cells differentiate at the right time and place. Ever wonder how a small handful of cells become heart and lung and brain cells, and all the other cells in our bodies? Since every single cell contains all of our DNA, some genes have to be turned off, while others left on, in order for there to be different types of cells.
However, the epigenome is ever changing; marks can come, and marks can go. In fact, the epigenome is highly sensitive to the environment. Environmental Factors such as diet, stress, and exposure to environmental toxins can alter the arrangement of these tags and cause disease. And, it’s being increasingly shown, disease in not just us, but in our kids, and our grandkids. Groundbreaking—and controversial—studies by epigenetics researcher Michael Skinner at Washington State University have not only brought to the forefront the idea of endocrine disruptors, but that these environmentally harmful chemicals can leave marks on the genome that can be passed on through germ cells—sperm and egg—to next generations. This new field has become known as transgenerational epigenetic inheritance.
And while there are examples of traits that have been inherited across multiple generations in everything from seeds to rodents to humans—DNA methylation patterns in response to environmental toxins, for instance—“no one has looked in terms of drugs of abuse,” says Ghazaleh Sadri-Vakili, an assistant professor at Harvard Medical School and the director of the neuroepigenetics laboratory of the MassGeneral Institute for Neurodegenerative Disease. That is, until now.
Building off this previous work, several recent studies in rodents have, indeed, delved into how drug and alcohol use affects the epigenome of the offspring. While mothers can harm the baby in utero, as well as subject it to stress and abuse as a child, researchers are beginning to ask the question: Can the effects of parents’ substance abuse be felt by their children, even if they stopped using years before?
These new findings suggest that if a parent uses drugs, he or she could pass on that DNA “damage” in the form of inherited epigenetic changes. What’s more, these epigenetic changes can predispose the offspring to not only becoming addicts, but to having to grapple with the behavioral traits that make it so hard to resist the pull of using, like impulsivity and heightened sensitivity to drugs.
THE EPIGENETICS OF ADDICTION
The hallmarks of addiction are tolerance and then, sensitization. Sensitization happens when a user becomes overly sensitive to a drug’s high or rewarding effect; accompanied by intense cravings and often, relapse. Eric Nestler, a leading figure in studying the epigenetic changes associated with addiction, discovered two key transcription factors that remain turned on after using drugs, thereby leading to symptoms of tolerance. (A transcription factor is a protein that parks itself next to a gene and turns it on.)
However, what was keeping the transcription factors around, they themselves being proteins from active genes? “The heightened sensitivity, it turns out, stems from epigenetic modifications of the genes,” Nestler, who is the director of the Friedman Brain Institute at the Mount Sinai School of Medicine, wrote in an article for Scientific American magazine in 2011.
In recent years, Nestler’s lab has conducted a series of studies on rodents that show how cocaine use can affect the genetic activity in certain parts of the brain. In one, he found that chronic cocaine use changes the pattern of acetyl and methyl tags on hundreds of genes within the brain’s reward center; and these changes make these genes more active when subsequently exposed to cocaine. In another paper, they found that chronic cocaine administration dials down the activity of certain molecules that remove acetyl groups, and of certain molecules that add methyl groups—in both cases making the genes more active with more cocaine. Epigenetic modifications have been observed in rats that use alcohol, nicotine, cocaine, amphetamines, and opiates.
Many of these changes are transient, lasting only a few hours after the animal receives the drug. Some last much longer, however; Nestler’s group has seen changes last as long as a month, and they’re looking into even longer times. In fact, if Skinner and others are right, it’s the very long-lasting nature of these epigenetic changes that make them heritable.
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May 16, 2014
Lighthouse Network's Weekly eNews Update
Featured in this issue:
Suicide is 10th Leading Cause of Death in U.S.;
Someone Commits Suicide Every 14 Minutes 
Every 14 minutes, someone in the United States chooses to end his or her
life-105 lives every day. Suicide is the 10th leading cause of death in
America, and a main risk factor for suicide is struggling with mental
illness.
"Many who have committed suicide or attempted to take their own life see no way out of the pain, depression and hopelessness they are feeling," said Lighthouse Network's Dr. Karl Benzio. "Counseling and treatment CAN help, especially treatment options with a Christian and biblical focus. For example, the Bible is full of hope, as evidenced in verses such as Jeremiah 29:11: 'For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.' When we discover, acknowledge and treat mental issues and mental illness, we have a greater chance of preventing suicide from happening, and restoring hope for our loved ones." Continue reading...
Identify the Warning Signs of Addiction
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5 Levels of Substance Abuse Take the Quiz: Are You a User or an Addict? Behavioral Warning Signs of Alcohol or Substance Abuse Take an Alcohol / Drug Addiction Self-Assessment Test
Addiction and Mental Health Awareness Bracelets
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Edging Forward DVD Series
Mastering the Art of Godly Decision Making
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Edging Forward is a nautical term that describes inch-by-inch progress
and methodical advance toward your destination by repeated small
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Life's storms pound us, pushing us backward, so how will we reach our destination? Deciding to become Disciples of Christ, we have made commitments in our hearts and minds to live God-honoring lives, but nobody teaches us how, so we struggle in our journey. Edging Forward teaches you how to navigate these storms and thrive.
Edging Forward, a unique and groundbreaking eight-lesson (25 min. each) series by Christian Psychiatrist, Karl Benzio MD, equips you with the key concepts to understand, apply, and master the skills for Godly decision-making, helping you reach your goals of Godly fulfillment and the Mind of Christ.
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