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Thursday, October 9, 2014
Wednesday, October 8, 2014
October 8 Chp 10 v 17 TWELVE STEPPING WITH STRENGTH FROM THE PSALMS
Lord , you know the hopes of the helpless. Surely you will hear their cries and comfort them.(Gods Big Book NLT)
STEP 2 - Came to believe that a Power greater than ourselves could restore us to sanity.
Are you there yet ? Do you still think in your own perspective ? Are you still denying God ?
If you answered no , yes , and yes then you gotta a problem with pride ! If that's the case then you will remain addicted l;lost and helpless. Good news though , God knows what you hope for and dream about . Once you believe you have to trust and that is gonna be tough especially if your still struggling with active addiction. If you cant give trust then have blind faith and believe God can and will help you get sober. Faith comes by hearing Gods word found in His Big book . Purchase a Tyndale Life Recovery Bible and read a Psalm a day then talk to God and meditate . Like a boxer you have to go into training physical , spiritual , and mental if you want lifetime sobriety . God is in your corner ,Its time to get to work.
1 Timothy 4 :8 For while bodily training is of some value, godliness is of value in every way, as it holds promise for the present life and also for the life to come. (Gods Big Book NLV)
By Joseph Dickerson
Heroin Deaths Rise Sharply in Many States: Study
October 7th, 2014/
The death rate from heroin overdoses doubled from 2010 to 2012, according to a new studyfrom the Centers for Disease Control and Prevention (CDC). Years of over-prescribing of painkillers led to the increase in heroin deaths, the CDC said.
Deaths from heroin rose from 1 to 2.1 deaths per 100,000 people during that period. Deaths from prescription opioid painkillers declined, from 6 to 5.6 deaths per 100,000, Reutersreports. “The rapid rise in heroin overdose deaths follows nearly two decades of increasing drug overdose deaths in the United States, primarily driven by (prescription painkiller) drug overdoses,” the CDC researchers wrote.
They found 75 percent of heroin users in treatment programs who started using heroin after 2000 said they first abused prescription opioids. They switched to heroin because it was easier to get, less expensive and more potent than painkillers. In contrast, more than 80 percent of people who began using heroin in the 1960s said they didn’t start abusing another drug first.
The largest increase in heroin overdose deaths occurred in the Northeast, followed by the South.
“Reducing inappropriate opioid prescribing remains a crucial public health strategy to address both prescription opioid and heroin overdoses,” CDC Director Tom Frieden, MD, MPH, said in a news release. “Addressing prescription opioid abuse by changing prescribing is likely to prevent heroin use in the long term.”
The CDC is calling for improving access to medication-assisted treatment for opioid addiction and increased use of the opioid overdose antidote naloxone.
Many Who Abuse Prescription Opioids Don’t Know How to Respond to Overdose
October 7th, 2014/
Many young adults who abuse prescription opioids are not prepared to deal with an overdose, a new study finds. They tend to think prescription medications are less dangerous than heroin, the researchers say.
“What we found is that when it comes to how to handle an overdose, prescription opioid users who weren’t using drugs for official medical reasons were less savvy than, say, more traditional heroin-using populations,” study author David Frank of the CUNY Graduate Center in New York City told HealthDay. “In fact, they tend to have a pretty severe lack of knowledge and a lot of confusion about it, despite the fact that most have experienced overdoses within their drug-using network.”
Young people who abuse opioids think of themselves as being very different from people who use heroin, Frank said. He conducted in-depth interviews with 46 young adult New Yorkers, ages 18 to 32, who abused prescription painkillers. Almost three-quarters of the participants were white, and half had at least some college education.
The participants tended to see prescription painkillers as relatively harmless medication that was less addictive than heroin, and less likely to cause an overdose. Yet almost all the study participants said they knew someone who had overdosed on painkillers, or had overdosed themselves. The majority did not know about overdose prevention or response options, including the opioid overdose antidote naloxone.
In most cases, participants said when faced with an overdose, they used potentially ineffective methods such as slapping the person or placing them in a cold shower to revive them. Among those who had heard of naloxone, many thought it was expensive or difficult to obtain. In New York state, naloxone is distributed freely, along with training, at most official harm reduction or needle-exchange programs, the researchers noted. Many participants said these programs place too much emphasis on heroin use.
The study appears in the International Journal of Drug Policy.
Substance Abuse a Growing Problem Among the Elderly
October 7th, 2014/
A growing number of older adults are struggling with drug and alcohol abuse, experts tellThe New York Times. Alcohol abuse is the biggest problem among older adults, but the rate of illicit drug use among adults ages 50 to 64 is also on the rise.
“As we get older, it takes longer for our bodies to metabolize alcohol and drugs,” D. John Dyben, the Director of Older Adult Treatment Services for the Hanley Center in West Palm Beach, Florida, told the newspaper. “Someone might say, ‘I could have two or three glasses of wine and I was fine, and now that I’m in my late 60s, it’s becoming a problem.’ That’s because the body can’t handle it.”
Many older adults who drink are retired, the article notes. They may have lost a spouse, as well as their career, and feel they have no purpose. They may be lonely and depressed.
It can be difficult for doctors to differentiate between signs of chemical dependence, such as memory loss and disorientation, and normal signs of aging. Doctors often are not trained to discuss substance abuse with their older patients, or they don’t have the time to conduct a thorough screening.
“There’s this lore, this belief, that as people get older they become less treatable,” said Paul Sacco, Assistant Professor of Social Work at the University of Maryland in Baltimore, who researches aging and addiction. “But there’s a large body of literature saying that the outcomes are as good with older adults. They’re not hopeless. This may be just the time to get them treatment.”
A report issued by the Institute of Medicine in 2012 concluded substance abuse is a growing problem among older Americans, and the nation’s health care system is not prepared to adequately address the need. Up to one-fifth of Americans over age 65 have substance abuse or mental health conditions, according to the report.
Ecstasy Most Popular Illicit Drug on Black Market Websites
October 7th, 2014/
A year after the black market website Silk Road was shuttered by the FBI, many new sites selling illegal drugs have appeared. Ecstasy (MDMA) is the most widely sold illicit drug on these sites, according to a survey.
Almost twice as much MDMA is being sold online as marijuana, the second-most popular illicit drug. LSD, cocaine and amphetamines were the other top-five drugs sold on these sites, according to The Washington Post.
Dozens of black market sites have emerged in the past year, the article notes. Silk Road and three similar sites had about 18,000 drug items listed for sale last fall. In April 2014, there were 10 such sites, listing 32,000 drug items. By this August, there were 18 sites listing 47,000 drug items, according to the Digital Citizens Alliance.
Daryl Lau, a programmer, analyzed drug sales on these sites, concentrating on the nine illegal drugs the National Institute on Drug Abuse says are most commonly used: cocaine, heroin, opium, amphetamines, MDMA, ketamine, mescaline, LSD and marijuana. These drugs account for about 28 percent of all drugs listed on one of the new websites, Silk Road 2.0. Much of the remainder are prescription drugs, or synthetic drugs such as “2C” or “NBOMe.”
The black market websites allow users to rate their purchases. Because MDMA bought on the street is often laced with potentially dangerous ingredients, users may prefer to buy it online from a vendor who receives a high rating from other users, according to the newspaper.
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recreational drugs in recognition of the millions of people who are struggling with addiction, as well as the millions of people living in long term recovery. 
Tuesday, October 7, 2014
MTV's Out-There Teen Mom Star Now Talks Sober
Amber Portwood is returning to Teen Mom at two years sober and after prison — and looking to open her own rehab. She's a lesson in growing up and moving forward.
Photo via
09/26/14
For four seasons, Amber Portwood was one of the most controversial characters on the highly polarizing MTV reality show Teen Mom. A September 2010 episode showed her hitting and kicking ex-fiancé, Gary Shirley, while their young daughter stood at her feet, prompting an investigation from Child Protective Services. She was charged with three counts of domestic violence and sentenced to probation, but it eventually became clear that part of her erratic behavior was due to a severe opioid addiction.
The year 2011 proved to be a tough one for Portwood: she suffered the trauma of a suicide attempt, a stint in rehab, and losing custody of her daughter. She was arrested that December for violating her probation, but a plea deal allowed her to dodge a five-year sentence by completing court-ordered rehab. However, she made headlines in May 2012 by admitting to a judge that she had used drugs in rehab and asked to go to prison instead.
But Portwood made the most of her rock bottom moment by completing drug rehab in prison and furthering her education, and was eventually released on parole in November 2013, after serving just sixteen months behind bars. She has largely kept a low profile ever since, but will co-star on a new season of Teen Mom that premieres next year.
Portwood spoke exclusively with The Fix about the role her daughter has played in her sobriety, her struggle to overcome sex addiction, and why she’ll never return to prison.
Where are you now in your sobriety?
I’m over two years sober now. One of the main things I learned in prison and in AA meetings is that in order to stay sober, you have to change your people, places and things. That’s exactly what I did. I don’t hang around the same people that I used to. I moved away from Anderson (Indiana). It’s hard work, but I take my sobriety seriously and doing that was absolutely necessary.
How big of a role has your daughter (five-year-old Leah) played in you staying sober?
She’s my everything. She was the main motivator to better myself and get out of prison and she’s the main motivator for me to continue staying sober. She makes my days better. I look at her and just start smiling. It just reminds me of why I’ve worked so hard these last few years.
It was hard at first because I only saw her three times when I was in prison and she had grown up so much during that time, so I had to relearn a lot of things about her. We’re at a great place in our relationship now, though.
When did your drug use first begin?
My addiction started before I was ever approached by Teen Mom. My dad was an alcoholic, so I grew up around addiction. I did a lot of partying as a teenager and did things like pills and drinking. But it was when I discovered prescription medication that things started to get out of hand.
My drug of choice was opiates. I had a love affair with opiates. I was eating Fentanyl patches while I was in rehab, on house arrest and in drug court. It took over my life.
I think a lot of people were surprised to read in the book that you also struggled with sex addiction.
I’m still trying to figure out where it came from and that’s been a work in progress, but obviously the main component is that you want to feel loved. I also just have an addictive personality, in general.
I’d like to start dating again eventually, but it’s also hard for me to get into a relationship with someone or fall in love. I get bored easily. And I’m sure part of that hesitance has to do with the eight years I spent with Gary (Shirley, the father of her child). I need to learn how to fall in love again and trust again.
You received a lot of criticism initially for choosing prison over remaining in court-ordered rehab. Did that bother you at all?
It was frustrating and annoying because people didn’t understand why I chose to go to prison and they made their own assumptions. But I knew why I did that and so did my family. They supported my decision. And ultimately, I had to do what was best for me. I can’t live my life making choices based on what other people think.
It seems like that decision served you well in the end.
You’re surrounded by hell in prison, but you can choose to live in it or work to get out of it. I chose to get out of it and worked so hard to do that. I completed drug rehab in prison, completed parenting classes, got my GED. I became the administrator of the CLIFF (Clean Lifestyle is Freedom Forever) program, which helps prisoners get sober. Once I got myself clean, I wanted to spend time helping others do the same. I found that my purpose is to help others.
I wasn’t going to just give up on myself. And if I got in there and just lived the prison life, it would have defeated the whole purpose of leaving court-ordered rehab. It was important to make the choice to get something out of that experience.
The other women in there would always tell me that I had to get out. And I promised my friends in there that I would help other people when I got out. They taught me to never give up and that it’s never too late to change. It’s hard work to do that, but it’s possible if you want it enough.
You’ve been open about your faith in other interviews, so how much has that played a role in your sobriety?
I’ve always believed in a higher power, but I wasn’t aware of it as much, until I got into the program. I’ve been through so much for only being 25 and thought there had to be a reason for that. I don’t go to church or necessarily speak about my beliefs, but I do consider myself to be spiritual.
Besides the upcoming season of Teen Mom, what are your plans for the future?
I want to open up a rehab eventually, but I’m just figuring out the first steps to doing that now and know it’s going to take a long time. But I want to have at least one rehab open by the time I’m 30 and want these facilities to be going long after I die. I also want to move more into public speaking and sharing my story. I just want to continue to be a good mom and keep being of service to others.
McCarton Ackerman has been a regular contributor to The Fix since 2011. He last wrote about Bad Grandpas and Jessica Kirson.
Insurers Balk at Funding Addiction Treatment
Taxpayers fund the lion's share of addiction treatment—79.2%, or $22.2 billion—but private insurers avoid helping with the tab, often using denial tactics.
Shutterstock
09/22/14
Taxpayers fund the lion's share of addiction treatment – 79.2%, or $22.2 billion – through government-sponsored insurance programs and grants from the Substance Abuse and Mental Health Services Administration to subsidize uninsured patients.
In other healthcare fields, the situation is reversed, with private insurers picking up more than half of healthcare costs. But when it comes to covering addiction treatment, they balk, either failing to offer any addiction-related coverage or rejecting insurance claims.
The Affordable Care Act promised to close the coverage gap for addiction and mental health claims in several ways: by mandating the creation of medical homes that integrate behavioral health into their delivery system, by expanding overall funding for care and by increasing the variety of services available to patients. The ACA also included provisions requiring more plans to comply with the Mental Health Parity and Addiction Act requiring group health insurers to extend mental health benefits that are no more restrictive than those they offer for other care.
But whether addiction treatment providers will see true parity in coverage for their services remains to be seen.
“There's a potential over time for seismic change in the way we are funded due to the ACA,” says Ed Higgins, CEO of JSAS HealthCare, Inc., an outpatient addiction services provider in New Jersey. Higgins, a 40-year-veteran in the addiction treatment industry, calls himself a “born optimist” and says his organization is just beginning to hear from insurance providers about potential changes in coverage.
Right now, taxpayers and patients themselves are much more likely to foot the bill than private insurers – even those whose policies say they cover addiction care.
Medicaid picking up the tab – but for how much longer?
In 2010, private payers were responsible for 55.6% of medical expenditures in the U.S., but only 20.8% of addiction treatment spending, according to CASA Columbia's 2012 report, Addiction Medicine: Closing the Gap Between Science and Practice. That is, private insurers covered $5.8 billion of the $28 billion total spent on addiction treatment that year. The majority of people who went to rehab in 2010 – 65% – reported using Medicaid or other, non-Medicare public funds such as military insurance, and 27% used Medicare. (Patients could report more than one source of funding, and 23% said they'd received financial help from family members.)
That's despite the fact that most rehab facilities are privately run: in Inside Rehab (2013), journalist Anne Fletcher notes that as of 2004, about 58% of rehabs were organized as private nonprofit corporations, with just under a third operating as for-profit facilities. The remaining 12% were public programs run by local, state, federal or tribal governments.
And while Medicaid foots the bill for most addiction treatment, accessing care can be tricky for patients who have it. Some private rehab facilities won't take clients with public insurance. Those that do, often place a cap on the number they do take.
“In New Jersey, we have waiting lists (for Medicaid patients) because if you take too many Medicaid patients, it kills your budget,” Higgins says. As in other medical settings, patients with private insurance or those who pay out-of-pocket have to subsidize to cover the gap left by low Medicaid reimbursement rates.
Another source of public funds for addiction treatment: substance abuse and mental health block grants administered by the Substance Abuse and Mental Health Services Administration, which fund priority treatment for uninsured people, as well as prevention and services not covered by public insurance. Grant funding is noncompetitive and governments have some flexibility in determining how they'll spend them – which means they can be subject to political whim.
That Medicaid shoulders such a large portion of all reimbursements for addiction treatment, and that 25 states chose to opt out of the ACA's mandate to expand Medicaid funding, raises a couple of significant questions about how funding will trend in the coming years. (One question: is the number of uninsured in those states expected to increase?) According to a study published in Health Affairs, opt-out states are likely to see an 18.1% decrease in the number of uninsured people, versus 48.9% in states opting in. It also looked at likely health outcomes among low-income people and projected worse health outcomes and higher likelihood of medical financial catastrophe, as well as increased mortality. The study didn't look specifically at outcomes relating to drug abuse – though among the handful of metrics it considered were catastrophic medical costs and diagnoses of depression, both of which frequently accompany substance abuse. It also notes that the ACA cut funding for safety-net hospitals, reducing the resources available to those who will remain uninsured in the coming years.
Given that Medicaid pays such a high percentage of reimbursements for funding, it will be interesting to see who picks up the tab for low-income people in treatment over the next few years. Will opt-out states rely more heavily on SAMHSA funds for care – or will rehabs be able to count on private insurers to pick up the slack?
Another factor that should move treatment-funding numbers in the next few years: the push to legalize marijuana. According to numbers released by SAMHSA, in 2007 37.5% of all rehab patients were referred by the court system due to a drug- or alcohol-related offense. Fifty-seven percent of rehab patients listing marijuana as their drug of choice were referred by the court system – accounting for a sizeable chunk of rehabs' revenues. With two states having legalized pot, two more kicking around legalization initiatives and others mulling medical marijuana, revenues from court-referred patients should trend downward, though it's hard to say now how much. So far, the state of Colorado doesn't have data on the number of court-referred patients in rehab for marijuana use post-legalization; public health officials in Washington didn't respond to The Fix's inquiry.
"I can't tell you how many people have died in this process"
The CASA report succinctly pinpoints the reason Medicaid pays so much more for substance abuse treatment, despite the fact that when it comes to health care in general, the situation is reversed: “The concentration of spending for addiction treatment in public programs suggests that insurance across the board does not adequately cover costs of intervention and treatment, resulting in costly health and social consequences that stem from untreated addiction and that fall disproportionately to government programs. National data indicates that individuals with private insurance are three to six times less likely than those with public insurance to receive specialty addiction treatment.”
Anthony Rizzuto, provider relations representative for the Seafield Center, an inpatient/outpatient drug treatment provider in Westhampton Beach, New York, paints a bleak picture.
When a family comes in to have one member assessed for treatment, he says, he does a bio-psychosocial assessment to determine the best course of treatment. He'll make a recommendation – in the case where a patient is withdrawing from heroin use, he typically recommends titrating methadone and a few days of inpatient treatment – and calls the family's insurance provider.
Often, private insurers will reject the claim, saying that since withdrawal from heroin isn't lethal, suboxone and outpatient treatment should be adequate.
It's discriminatory, he says: “If you break your arm, that's not lethal either. But not to treat it would be inhumane.”
Once the claim is rejected, families will try a number of things. If they have the means, they'll pay for treatment out-of-pocket. Or they'll call friends for ideas, sometimes dropping a child from insurance so they can become eligible for Medicaid and therefore be covered.
“People are calling the police on their kids to get a protective order, so then they get 28 days of rehab,” Rizzuto says. “People are actually giving alcohol or Xanax so it will show up on the UA. Those withdrawals are lethal, so they can get treatment.”
On the flip side, says Mark Parrino, director of the American Association for the Treatment of Opioid Dependence, some insurance companies may reject a claim based on a failed urinalysis. Or commercial insurers will cover methadone for a pregnant woman in jail, but not for a man – a discrepancy he says is motivated more by liability fears than care standards.
“They say, 'We'll deny claims if there's a positive toxicology report because it means the treatment is not successful.' How do we know it's not successful? Is that the only yardstick of success? Is the patient not dying, a yardstick of success?”
The slippery definition of "medical necessity"
Critical-care nurse, Nora Milligan, nearly lost her adult son to two heroin overdoses, both reversed by emergency medical technicians. He detoxed painfully in jail – and only after his second arrest was he approved to get into a long-term treatment program, she says, adding he's been clean and sober and living in sober housing for several months. Her insurance company, Fidelis, has yet to pay for any part of his care.
“Each insurance company can make up their own medical necessity, and they don't have to tell you what it is,” Milligan told the New York State Senate Task Force on Heroin and Opiate Addiction.
Milligan worked in concert with Rizzuto to urge the passage of S4623, which would require group insurance plans to cover drug and alcohol treatment recommended by a certified health professional – and, critically, requires a standard definition of “medical necessity” to prevent discrepancies like those that left her son in a holding pattern for years.
That passed in June, as part of a bipartisan deal that would also crack down on illegal sales of pharmaceuticals. (The state will now be allowed to monitor the phone calls of physicians suspected of selling pharmaceuticals illegally, and penalties will be tougher for doctors and pharmacists who do.)
Milligan wants addiction taken out of the criminal justice system and understood as a medical condition.
“NY has really taken the lead. It's finally getting it,” Milligan says.
Christen McCurdy is a freelance writer in Portland, Oregon. Her work has appeared in Pacific Standard, The Oregonian, Bitch, The Lund Report and a host of small newspapers and trades.
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