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  • Drug Courts in California

    Drug Courts in California

    ARTICLE OVERVIEW: A complete guide to California drug courts. We review eligibility requirements, how to get started, and what happens when you complete the program. A detailed explanation of the legal process here.

    TABLE OF CONTENTS:

    What is a Drug Court?

    California drug courts are problem-solving courts specially designed as an alternative to traditional criminal justice prosecution. These courts are mainly set up for non-violent, substance-related offenses. In short, drug courts put treatment and rehabilitation ahead of punishment.

    The main idea behind drug courts is that crime and addiction can be treated. The traditional approach of punishment has proven ineffective, otherwise, the system would have stopped it a long time ago. Compared to incarceration, addiction treatment improves the long-term outcomes because it addresses the root cause of drug-related crime. Treatment improves a person chances of reintegrating into the community and becoming a productive member of society. [1]

    In fact, there are numerous benefits of drug courts. Some of them include:

    • Promoting long-term recovery
    • Reducing crime
    • Reducing drug and alcohol use
    • Reunifying families
    • Saving tax money

    On average, treatment costs for California drug courts range from $900 to $1,600. Compared to an average cost of $5,000 per person for a minimal period of incarceration, perhaps you’ll agree that this seems to make economic and judicial sense. [2]

    If you or a loved one has recently been arrested or charged with a drug-related crime in California, we are here to let you know that treatment works! In fact, can help you if you are ready to start treatment. American Addiction Centers provides care to adults struggling with addiction and co-occurring mental health disorders. We can help you get better. Please call our hotline number today to speak with an admissions navigator. Hope is here.

    California’s Drug Court History

    The concept of drug courts spread across the country in the early 90’s. Getting treatment is a cost-effective and beneficial option for people who get into legal trouble. These courts offer more targeted help that gets at the root cause of the issue. But when did the state first begin offering drug courts?

    California’s first adult drug court began in Alameda County in 1991. In 1995, California’s first juvenile offender drug court began hearing cases in Tulare County. In 1998, The Department of Alcohol and Drug Programs started supporting the development of drug courts in California.

    California drug courts are much less formal than traditional courts. They are much more loosely structured, giving each court some flexibility as to how it will run. There is an ongoing dialogue between the judge, prosecutor, defense attorney, and defendant. The focus is on people rather than punishment. [3]

    California is committed to the concept that alcohol and drug treatment are preferable to the incarceration of nonviolent drug offenders. Indeed, the effectiveness of the drug courts has been proven by numerous scientific studies. It’s been shown to reduce re-arrest rates, lower costs and provide better treatment outcomes. It is not just clients who benefit from drug courts… but American society as a whole. [4] [5]

    Drug Court Requirements and Eligibility in California

    Each drug court in California has its own eligibility and exclusion requirements, so, when defining drug court eligibility, it’s better to first define who is not eligible to participate in a drug court. In general, you are not eligible if you have:

    • A prior conviction for a violent crime.
    • Been charged with a DUI and resulting serious injury.
    • Been charged with a crime involving possession of a firearm.
    • Been charged with a violent offense.
    • been charged with arson or sex crimes.
    • Been charged with drug possession with intent to sell.
    • Been charged with drug manufacturing or trafficking.
    • Refused treatment.
    • Unlawful presence within the United States.

    Additionally, you must be diagnosed with addiction in order to go through drug court. This makes sense. Plus, you must be eligible for probation in order to participate. Since the program takes place out of custody, you must be on probation in order to attend activities. Finally, you must not be under active deportation process.

    What laws support these guidelines?

    Drug court programs are legally authorized by California Penal Code 1000.5 PC. [6] According to this code, defendants are referred to drug court by written agreement of a judge, the prosecutor, and the public defender.  Graduation requirements vary, but usually involve the completion of educational and job training requirements with addiction treatment. Successful completion of a drug court program can result in a dismissal of the drug charges.

    In terms of eligibility, the most important criteria are that California drug courts are designed to treat non-violent drug-using offenders whose criminal history is related to drug abuse and addiction.

    The State of California has authored innovative legislature to back up the idea. Proposition 36, also known as the Substance Abuse and Crime Prevention Act, is a mandatory diversion program for those who qualify. Its main goal was to allow first and second-time, nonviolent offenders get treatment rather than go to jail. [7]

    Getting Started

    Currently, California has over 200 drug courts within its 58 counties. [3] The different types of Collaborative Justice Courts in California include:

    • Adult Drug Court
    • Back on TRAC
    • DUI/DWI Courts
    • Family Dependency Drug Court
    • Federal District Drug Court
    • Homeless Courts
    • Juvenile Drug Courts
    • Mental Health Courts
    • Re-Entry Courts
    • Tribal Healing to Wellness Courts
    • Veterans’ Treatment Court

    Drug Courts in California work according to certain models. There are four ways to enroll in a drug court program. Since each drug court in California has different criteria and each case is unique, it’s best to consult an attorney to learn more about how you can enroll into a drug court program as an alternative sentence. The main ways you can request participation in a CA drug court include:

    1. The pre-plea model allows drug possession offenders a stay of prosecution if they participate in a treatment supervised by the court.
    2. Post-plea models state that a defendant has to enter a guilty plea before entering treatment. The treatment lasts from nine months to three years.
    3. The post-adjudication model gives opportunity drug offenders to re-enter treatment after their conviction. But first, the convicted person has to serve the sentence. If the case is referred to drug court following a conviction at a jury trial, the trial judge has the option of retaining jurisdiction of the case or referring it to a calendar court.
    4. The civil model allows individuals to enter treatment as a condition of retaining or regaining custody of a child or children. Failure to complete the program can result in permanent loss of custody.

    So, what’s the process like?

    STEP 1: If you are eligible for a drug court, a judge will order a screening. This will be conducted by the Program Manager or Therapist involved in the program. Screening takes place in the form of an interview and it will usually last for an hour.

    STEP 2: After the screening, a multidisciplinary team will assess your record and personal history. This usually happens the same week or the week following the assessment. Screening and assessment ensure that each participant receives appropriate substance abuse disorder treatment services and community-based support.

    STEP 3: If it is decided that you will be accepted into the program, it is very likely that you will be placed in residential treatment or sober living program. You will be expected to complete the course of recommended treatment.

    STEP 4: Ongoing activities may be set up by drug court judges for you during and after rehab. You may need to attending ongoing counseling session, for example. Or, you may need to attend support group meetings. Compliance ensures success. Follow the drug court plan … and you’re on your way to a new life!

    STEP 5: Successful completion of a program entitles you to a dismissal of the related charges.

    The Process

    Drug Court is a four-phase program that usually lasts from 6 to 24 months. n California, drug courts usually implement a multi-phased treatment process. You will move from one phase to the next when you complete the requirements of the phase and make progress in your recovery. Poor performance during any phase may result in going back to a previous phase with more intensive monitoring and restrictions.

    In general, drug court programs in CA are divided into four phases. If you are a drug court participant in California you must complete all these phases in order to qualify for dismissal of charges and a clean legal record.

    1. Stabilization Phase. This first stage of treatment focuses on your  stabilization. The stabilization phase may include a period of detox, psychosocial and physical assessment and development of treatment plan. During this phase, you will have to attend court once a week.

    2. Intensive Treatment Phase. Abstinence from drugs and alcohol as a primary focus. This phase typically involves intensive individual and group counseling, attend weekly AA and NA meetings. Usually, participants attend court twice a week.

    3. Aftercare Review Interview Phase: You will continue with group therapy and individual counseling, and you will still have to attend support group meetings. Typically, during this phase, you will be interviewed by the Drug Court team. The interview will determine if you are ready to move to the last phase which is the aftercare. You are required to make monthly court appearances.

    4. Transition Phase. This phase focuses on the planning necessary to transition you out of the drug court, and relapse prevention strategies. The transition phase may emphasize social reintegration, employment and education, housing services, and other aftercare activities. You will have to attend court once a month.

    Treatment

    When the court orders someone to attend rehab, the next step is to gather a treatment team. The treatment team consists of a judge, attorneys, case managers, health care providers, and therapists. These professionals all work with the offender to ensure an effective treatment plan, and also to make sure the offender is complying with the court orders. Team members provide regular communication, encouragement, and support for the offender. But drug court also extends support to their friends and family members throughout the hearings, therapy, and discharge.

    Drug court participants in CA should be able access to a continuum of treatment and rehab services. [8] Treatment services should include:

    • Aftercare services
    • Attendance at support group meetings
    • Detox
    • Individual and group counseling
    • Inpatient or outpatient rehab
    • Mandatory drug tests
    • Medications
    • Regular appearances before the court

    You will be required to pay for the treatment, and you can choose where you want to be treated. Insurance may pay for all or part of a treatment program, and some facilities offer reduced or subsidized payments for qualifying individuals.

    The severity of your addiction and your dedication will determine your recovery time. However, it is expected that most participants should be able to successfully complete the treatment program after 10 to 24 months. If you cooperate with the court you can turn this situation at your advantage, your probation terminated or charges dismissed.

    Violations

    After enrollment in a drug court program, your progress will be closely monitored by the court. You are expected to be on time, to show up to and complete drug tests. You are also required to attend all group sessions and court dates. You will be asked to be honest.

    In other words, when you go through a drug court in CA, you are held accountable for your progress. You are expected to comply with the court’s orders and respect the court.

    In order to encourage compliance, behavioral changes and adherence with treatment, the court will use sanctions and incentives. Rewards for compliant behavior can include:

    • Certificate of graduation
    • Extended curfew
    • Gift certificates
    • Praise by the court or judge
    • Promotion to the next phase
    • Sobriety tokens
    • Termination of probation

    Conversely, sanctions for non-compliance may include: writing a letter to the court or to your case manager, coming to court more often, community service, time in jail, termination from drug court. Although there is no set number of violations that result in termination, persistent noncompliance are not tolerated. If you are terminated from the program, you will be sent back to court for sentencing.

    Still, most people successfully complete of all phases of treatment.  In some cases, probation may be terminated at the end of the program. In other cases, you must successfully complete the full three years of probation after participation.

    California Drug Court Statistics

    Drug courts are generally thought to be more effective than routine criminal justice case-processing at reducing rates of recidivism and drug use among offenders. There have been many successes in California Drug Court programs. Participants have remained off of drugs, stayed out of the criminal justice system, obtained their driver’s licenses, become employed, gone back to school, received vocational training and started their own businesses, and gained or regained custody of their children.

    SO, what are the number say about the effectiveness of drug courts? The data taken from the Collaborative Courts 2016 Annual Report by the County of Orange shows that:

    The adult and juvenile programs have saved more than $120.6 million through the avoidance of more than 852,848 custody bed days.

    The re-arrest rate for Drug Court graduates, three years after graduation, is 28.15% for any crime, compared with a re-arrest rate for comparable non-participants of 74%.

    The Drug Court program avoided 28,637 jail and prison bed days prior to the application of custody credits, which were stayed pending graduation in 2016— which translates to a cost savings of $4,196,179.

    Two drug-free babies were born to women while they were participating in Drug Court in 2016, bringing the cumulative total to 153 drug-free babies born since the inception of the program.

    Participants performed 1,275 hours of community service in 2016.

    During the year, 63 participants graduated from the Drug Court program, free of addiction and employed or pursuing educational goals. [9]

    Nationwide, the numbers show that drug Courts reduce crime by an average of 8% to 26%, with most estimates from 9% to 14%. Well-functioning drug courts reduce crime rates by 35% and the effects last at least 3 years. Additionally, the average recidivism rate for those who complete Drug Court is between 4% and 29%, compared to 48% for those who do not participate in a Drug Court program. Finally, for every $1,000 invested in adult drug courts, communities reaped approximately $2 to $4 in benefits, totaling roughly $3,000 to $12,000 per participant. [10]

    These numbers show the effectiveness and importance of drug courts.

    Drug courts can save lives.

    Drug courts help individuals.

    Drug courts heal our society.

    Completing California Drug Court

    You graduate from drug court when you complete all four phases of the program. You must be at least 90 consecutive days clean and sober. Except in unusual circumstances as determined by the judge, a participant who graduates after less than nine months in the program will remain on probation until the expiration of the nine-month period.

    But before you leave supervision, the court want you to have a strong recovery support system. This includes employment and stable housing. Then, graduation is a time to celebrate your accomplishments! You may invite your family and friends to join you at your drug court graduation. It’s often a life changing moment.

    What happens next?

    If you successfully complete a Drug Court program in California:

    • Your probation may be terminated early.
    • Your charges may be reduced.
    • Your case may be dismissed.

    Also, if you are involved in a child custody case, you may get your child back.

    Successful completion will give you the tools to become contributing members of society and your community.

    Your Questions

    If you still have questions about California’s drug court system, we encourage you to leave a question in the comments section below. We’ll try to respond to you promptly and personally.

    Reference Sources: [1] James E. Lessenger / Glade F. Roper (eds.) Drug Courts: A New Approach to Treatment and Rehabilitation
    [2] California Department of Alcohol and Drug Programs – Drug Courts Overview.
    [3] California Courts: Drug Courts
    [4] HHS: Drug Court Effectiveness: A Review of California Evaluation Reports, 1995–1999
    [5] National Institute of Justice: Do Drug Courts Work? Findings from Drug Court Research
    [6] California Legislative Information: California Penal Code 1000.5 PC
    [7] Proposition 36 Drug Treatment Diversion Program. Initiative Statute
    [8] California Courts: 2019 California Rules of Court
    [9] Superior Court of California County of Orange: 2016 Annual Report
    [10] Drug Courts: National Perspective
    Superior Court of California: County of San Diego: Drug Court Process
    Superior Court of California: Drug Court Participant Handbook

    View the original article at addictionblog.org

  • Treatment Options for Youth Diagnosed with Substance Addictions

    Treatment Options for Youth Diagnosed with Substance Addictions

    ARTICLE OVERVIEW: Adolescence is a time of self-discovery and experimentation and unfortunately for most teens, this means experimenting with alcohol and drugs. While some teens don’t end up addicted after their first few encounters, plenty of others do… leading to a lifelong struggle.
    Here, we’ll explore just what substances teens use. Then, we look at the direct interventions that can save your teen’s life. Finally, we invite your questions at the end.

    TABLE OF CONTENTS:

    Common Substance Addictions Teens Face

    1. Marijuana. Marijuana or weed remains hugely popular among teens with 45% of 12th graders reporting having used it at some point in their lives. [1] Most teens don’t consider marijuana addictive or harmful, explaining its popularity. [2]

    2. Alcohol. Alcohol is perhaps the most readily available and widely consumed substance among US teens. According to the 2017 Monitor The Future survey, up to 61.5% of 12th graders and 42.2% of 10th graders have taken alcohol at least once. [3]

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    3. Opioids. Prescription drugs are alarmingly easily available to teens with most obtaining them right in their home’s medicine cabinets. Common opioids abused by teens include codeine, Vicodin and OxyContin.

    4. Study aid drugs. Study drugs such as Ritalin, Adderall and Concerta are regularly misused by students in a bid to boost their grades. [4] These drugs sharpen focus and heighten attention spans, making it possible for teens to concentrate for longer periods. Unfortunately, they’re also highly addictive.

    5. Hallucinogens. Teens usually experiment with hallucinogens for fun and to “expand the mind” but before long, they’re hooked. Hallucinogens such as LSD, Salvia and magic mushrooms like psilocybin have seen a resurgence in teen use in recent years.

    Rehabs Offer the Best Treatment

    The signs of drug use and addiction vary with individuals and the substances used. It’s therefore recommended that parents know what signs to watch out for in their teens since early detection of illicit drug use might improve treatment outcomes. [5]

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    When it comes to treatment options, teen drug rehabilitation programs offer the best chance for teens to beat their addictions. As of 2015, there were more than 14,500 substance abuse treatment centers across the U.S. but only less than 10% of addicted teens are enrolled in these centers. This means that most of those who desperately need help aren’t receiving it.

    Even among those who access rehabs, full recovery from addiction isn’t completely guaranteed and about 40-60% of addicts eventually relapse. To parents, this might seem like failure and a futile endeavor. Why take my teen to rehab if they might start using again?

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    However, it’s important for parents to remember that addiction causes extensive damage mentally, physically and psychologically and is a tough habit to beat, especially for teens who are still growing.

    If your teen relapses that doesn’t mean that the rehab process failed. It simply means that treatment has to be reinstated with a few tweaks and adjustments. Most of all, parents should remember that taking their teens to rehab gives them a shot at regaining their lives.

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    Available Treatment Options

    There are two main types of rehabs:

    1. Outpatient rehab. This gives teens daily, part-time support so they don’t have to commit to residency. They arrive at the rehab center for appointments, therapy sessions then they’re free to return home. Outpatient rehabs are ideal for teens who don’t require constant supervision and those who don’t mind daily commutes.

    2. Inpatient rehab. These rehabs have proven hugely successful in helping teens fight addiction, especially when it’s become a deeply entrenched habit that significantly affects a teen’s life. The most common types of inpatient rehabs are residential treatment centers for teens where they enroll for a period of time, receiving full support to help overcome their addiction. One of the reasons inpatient rehabs are so effective is because teens are removed from the influence of the environment that led to their addiction.

    The Rehab Treatment Process

    Once your teen is admitted to rehab, they undergo a complete diagnosis then receive a custom treatment plan according to their addiction. The treatment program will likely include a variation of these addiction treatment modalities:

    1. Detox

    Detoxification is the body’s way of flushing out drugs or alcohol so that your teen can start healing. [6]  This is a natural process that takes anywhere between a few days and weeks depending on your teen’s individual situation.
    Since they’re in rehab, they’ll receive full professional care and assistance to make the detox and withdrawal process as comfortable as possible.

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    2. Therapy

    Teens in rehab take part in different therapies depending on their addiction and situation. Common ones include:

    Cognitive behavioral therapy. Usually done in individual sessions, this type of therapy seeks to uncover the thought patterns that drive a teen’s addiction and seek to reshape them. Teens learn how to develop strategies to help avoid high-risk situations as well as communication, problem-solving, coping and self-regulation skills.

    Family Therapy. Families influence most of a teen’s behaviors and beliefs and play a huge role both in developing and overcoming addiction. Family therapy, therefore, brings together those who are closest to the addicted teen in a bid to help them address underlying issues that caused the addiction in the first place. Families learn constructive ways of communicating, solving problems and bonding.

    Group Therapy. Participating in group therapy allows teens to share and draw strength from others who are going through similar issues. They learn more about themselves and the group can act as a support system and sounding board.

    Recreational Therapy. Most teens with a substance addiction end up so focused on feeding their addictions that they miss out on a huge part of their lives. Recreational therapy helps teens engage in leisure activities including sports, games, arts and crafts, helping them rediscover an enjoyable part of their life. Additionally, they get to improve their social skills by interacting with other teens in a healthy way while building positive personal traits.

    3. Medication

    Getting over an addiction sometimes requires the use of medication to restore normal health, reduce cravings or treat any underlying psychiatric disorders. Given the strong nature of some of these medicines, they should only be taken under strict medical supervision to avoid creating a new addiction.

    Helping Your Teen to Stay Clean

    It’s normal for parents to worry about helping their teens stay clean once they come home from rehab. One of the key components of successful rehabilitation is having an aftercare plan to prevent relapse. [7] A 12-step program like the Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can be invaluable in providing your teen with the guidance and support they need to stay clean. Scheduling one-on-one counseling for your teen can also help them stay on course with their recovery.

    It can be daunting to discover that your teen has a substance addiction but getting them the right treatment goes a long way towards helping them not only beat the addiction but also get their lives back on track.

    Reference Sources: [1] Addiction Blog: Trends in Popular Drugs Among Teens
    [2] NIDA: Monitoring the Future Survey: High School and Youth Trends
    [3] NIDA: Monitoring the Future Study: Trends in Prevalence of Various Drugs
    [4] Drug Abuse: History and Statistics of “Study Drugs”
    [5] Innovations in Clinical Neuroscience: Early Detection of Illicit Drug Use in Teenager
    [6] Addiction Blog: What is drug detox and how does it work?
    [7] Addiction Blog: The 3 Secrets of Successful Addiction Rehabilitation
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    View the original article at addictionblog.org

  • How Horse Riding Helps Addiction Treatment & Recovery

    How Horse Riding Helps Addiction Treatment & Recovery

    ARTICLE SUMMARY: Horses can help us develop emotional congruence, good boundaries, responses rather than reaction, perspective, and instinct. More on how to apply this to recovery here.

    TABLE OF CONTENTS

    By Susan E Conley

    Getting Started

    When I started riding horses, I was 41, going on 42 years old and had never been near an equine in my life. The closest I came was standing near to the carriage horses that congregated on Central Park South, daring a pat now and then until their drivers chivvied me off as it was clear I was not a potential client.

    I took up the sport due to my burgeoning codependency recovery: having left my marriage to a substance abuser, I decided to do something for myself. Never mind that it seemed as precarious an undertaking as trying to ‘make’ someone clean and sober; I took a notion to do it and unexpectedly found a hobby that helped me get healthy in mind, body and spirit.

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    A World of Healing

    I soon found that many of the behaviors that I employed on a daily basis were going to get me into serious trouble with the animals; the equestrian lifestyle, in many ways, is antithetical to the codependent lifestyle, or indeed any addiction lifestyle.

    For example, in The Tao of Equus, Linda Kohanov speaks of ‘emotional congruence’, of being in alignment with your mount, a state which can only come into being when the rider is in line with herself. In my case, being congruent meant:

    • Not lying.
    • Not fudging.
    • Not making up stories about the way things should have been, could have been, or ought to have been if only someone in my life hadn’t abused substances.

    5 Ways Horses Help With Addiction

    The more time I spent around horses, the more I realized that I was not only learning how to ride, I was also learning how to be the sort of person I wanted to be: clear, calm, a person who was becoming emotionally stronger as well as physically.

    I guessed my improvement had to be down to the horses, because that was the only new thing in my life, but surely that was impossible?

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    It is completely possible, and there’s a whole world of healing that employs horses as therapeutic partners, covering client bases from children struggling with autism and ADD, to people of all ages with learning and physical challenges. It’s a fascinating field that’s growing by leaps and bounds, but how does being around a horse help us with our issues?

    Here are five ways that horses can become a healing touchstone for addicts in recovery. And don’t worry: you don’t have to ride the horse to reap the rewards.

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    #1 Body Language

    To refer to Kohanov’s example of congruence, you can’t fake anything around a horse.

    You may think you’re covering up your feelings, but a horse can spot your true mood a mile away.

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    As herd animals, their safety is inextricably linked with being in harmony with their herd mates. Should a predator approach, it is vital the herd be able to move as one in order to protect the group. They achieve homeostasis as a form of protection, and extends to the humans who would interact with them.

    Philippe D’Helft, a practitioner with EAGALA, Equine Assisted Growth and Learning Association, explains. “Horses are hyper vigilant and have constant awareness of each other and their place in the herd, and they apply the same to us,” he says. “They are constantly watching our body language, our breathing, the way we move and then they mirror that. And then depending on the way we behave, they react a certain way.”

    A 2017 study via the University of Sussex involved 30 horses and examined the animals’ reactions to human body language. Humans who approached in a non-threatening, submissive manner, with arms and legs held close to the body and in a slight slouch drew the horse towards them; those who rocked up with chests puffed out and arms in an aggressive posture such as hands on hips or elbows out were avoided by the animals.

    Horses are well able to pick up much subtler clues, and will mirror back to you what’s going on inside, even if you think you’ve got your outside sorted. You’re either a potential herd member, or you’re threat.

    #2 Good Boundaries

    Failure to set good boundaries when working with horses is dangerous, to both human and animal. They are much bigger and stronger than we are and it is paramount to ensure the horse respects you and your space. Get your foot stepped on one time by a 1200 pound creature, and you learn fast.

    However, there’s a difference between being aggressive and assertive.

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    As shown above, aggressiveness sets you up in the horse’s mind as a predator and they will do everything in their power to remove themselves from your presence. If you are assertive, you set yourself up as a leader and this also dovetails nicely with the herd mentality. In the interests of self-preservation, a horse is always happy enough to defer to a stronger creature.

    If you can be that strong for a horse, you can be that strong for yourself.

    #3 Response, Not Reaction

    Quite a lot of horseback riding and working with horses on the ground is repetitive. You do the same things over and over, and yet due to variable conditions — weather, your health, the horse’s health, the instructors mood, your mood, the horse’s mood — little things can have great impact.

    In the past, changes outside of my control used to send me into a tailspin. I’d react in the snap of a finger, and start fixing things before I knew whether they were actually broken or not, or most importantly, whether it was my business to do so.

    Horses are sentient beings and they are always reacting to their environment. In order to stay safe around them, we must learn to respond to their reactions; that is, we begin to learn to read a situation and make conscious decisions how to behave.

    Because many of our tasks around the horse, from grooming to show jumping, require a set process, it allows us to become more aware of ourselves in the situation and gives us the opportunity to build our own lexicon of responses.

    We become able to assess, with clarity and calm, what the best solution in a given situation is and to put it into gentle action.

    This was a real watershed for me in my own recovery: I began to see that I had choices, that I was able to be clearheaded and to make decisions based on evidence, and not old coping mechanisms or distorted feelings.

    #4 Perspective

    EAGALA specializes in training psychology and horse professionals to work as teams, in order to apply techniques to help all sorts of populations, including people in addiction recovery.

    Sometimes when we’re deep in our challenges, we can’t see the wood for the trees – or the feed buckets for the traffic cones.

    D’Helf cites an example in which a client was asked to use simple props – that feed bucket, those traffic cones, along with rings, lightweight poles and mounting blocks – and build areas in a riding arena that symbolize certain aspects of their lives. The horse is then set at liberty in the arena, and the instructor and the client pay attention to where the horse goes… or doesn’t.

    “We’d say that we noticed that the horses went with them in other areas that they’ve built, and were happy to share those spaces with them, except for one, and the client will say, ‘Well, it’s generally not a great place to be, nobody wants to go there with me,’” he explains. “We’d ask what the space represented and the answer was ‘The bookies’. The fact that they see it for themselves is very powerful.”

    #5 Trusting Your Instincts

    As a codependent, I never trusted myself, even the evidence of my own eyes and experience.

    Horses have helped me recover and build upon my ability to believe that I can trust myself to know what’s correct, what I have still to learn and work on.

    I began to know, even as my butt hit the saddle, how I was going to get on with a horse. I began to learn how to be as gentle with myself as I was with a horse. I learned when to say ‘no’ (to a horse that was too frisky for me), and when to say ‘yes’ (even though I was a tiny bit nervous.) I learned that I would always be learning, which resulted in humility, a cornerstone of 12-step recovery. Humbled before the horse, I paradoxically became stronger in myself, and continue to grow and heal every day I am around them.

    Your Questions

    Do you have any questions for Susan? Perhaps you’d like to share an experience about your work with horses? Please leave your questions in the comments section at the end. We try to respond to all real life comments with a personal and prompt reply.

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    About the Author: Susan E Conley is the author of Many Brave Fools: A Story of Addiction, Dysfunction, Codependency… and Horses, available now from www.horseandriderbooks.com. Follow Susan on Twitter and Instagram @manybravefools.
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    View the original article at addictionblog.org

  • A New Addiction Intervention Book: INTERVIEW with Dr. Louise Stanger

    A New Addiction Intervention Book: INTERVIEW with Dr. Louise Stanger

    Addiction and Families

    Addiction affects an estimated one in three American families. So, how do these families get help? Some struggle along on their own. Other families seek help directly treatment providers: detox clinics, psychotherapists, addiction treatment centers, or addiction counselors. Still other families are just lost.

    Still, there is one group of professionals that bridge the gap between families and treatment…

    Interventionists.

    In the next decades, behavioral healthcare professionals will need to increasingly both identify and refer families coping with substance use disorders to treatment. And interventionists practicing solid principles taken from social work and family systems theory may hold the key to our collective progress.

    A Book That Can Help

    A new book called, “The Definitive Guide to Addiction Intervention: A Collective Strategy” introduces clinicians to best practices in addiction interventions. It literally bridges the gap between the theory and practice of successful intervention. Today, we speak with the originator of this strategy, Dr. Louise Stanger.

    Dr. Stanger has developed and refined her invitational method of interventions over decades of working with families. She has performed thousands of family interventions throughout the United States and abroad. And we’re pleased to have her here for a digital interview!

    ADDICTION BLOG: What was your inspiration for writing this book?

    DR. LOUISE STANGER: After growing up in a family with substance abuse and writing about many of these stories in my memoir and in the public sphere, I started to think about what message I’d like to leave for future generations of social workers in this space.

    I maintain that it is very important for the future generations of social workers, psychologists, marriage and family counselors, alcohol and other the drug counselors, doctors, nurses, etc. to not just read one book about one person’s methodology, but to be able to learn a variety of different strategies. Questions like where strategies come from, what is the evidence behind intervention strategies, how have these strategies developed and changed, etc. to inform the reader and open their eyes to the broader scope of intervention and its modalities. As such, I like to think of these strategies as “invitations to change.” The idea is to provide a textbook at your disposal to learn and teach from.

    The truth is that 155 people die from opioids every day – it’s a global crisis, and we need new ways to train professionals across many levels in schools and in practice to help people and their families.

    ADDICTION BLOG: What do you think is the most important message that clinicians can “take home” after a reading?

    DR. LOUISE STANGER: The most important message is that change is possible.

    The key to this, which is talked about in the book, is CIS or Collective Intervention Strategies. This means that in order for an intervention to be successful, a collective team of family members, friends, colleagues, associates, business partners, managers and co-workers must be assembled to bring change in a person’s life, which is the intervention part of it. And finally, strategies, in that nothing is set in stone, we adapt to the unique needs of each individual.

    As a whole, Collective Intervention Strategies is a powerful model for inviting change that readers can take home.

    ADDICTION BLOG: How do most people or families get help for addiction?

    DR. LOUISE STANGER: How do they get help? That’s a great question.

    Talking with and connecting with professionals that are trained in process addictions, substance abuse, chronic pain, etc. You can also get help. Addiction is always bigger than the families, so it’s always best to seek out professional help from a mental health clinic, substance abuse clinic, or clinicians. Help is available. Families don’t have to do it alone. Not alone. For example, they can do 12-step. But when their hearts are breaking, they call.

    ADDICTION BLOG: Do you find that people misunderstand the field of mental health treatment and/or the work that you do? Do you find professionals even have a bit of trouble when it comes to certain areas of your work?

    DR. LOUISE STANGER: I think people by far don’t understand how substance abuse and mental health interface and work hand in hand. They don’t understand the duality or triality of what happens. The two are not mutually exclusive, and as such, must both be assessed (along with any other influencers) to get the best possible picture of the person and begin to build a comprehensive treatment plan.

    For instance, I appreciate the ASAM definition of addiction – it’s a disease of the brain and causes changes in brain chemistry. As such, people are afraid to address the complexity of humans and all the aspects. Therefore, when helping a family or a loved one, it’s very important to understand and learn about that particular individual, you must do a retrospective – bio, psycho, and social – to understand how to help and what kinds of treatment will fit their life.

    As for the professional sphere, there are many people who claim they are pros but have not been properly trained. I don’t think a 5 day training makes one an interventionist. Sometimes it feels like the Wild, Wild West out there. I think there needs to be more education and schooling, professional classes and programs that illustrate intervention as a real treatment option. We need it in our undergraduate, graduate and doctoral programs, across fields of work including counseling, nursing, pre-med, etc. to build it out as a field of study.

    ADDICTION BLOG: How do you hope this book will impact the field of substance use disorder treatment? Where do you hope to see treatment advance within the coming years?

    DR. LOUISE STANGER: My hope is that this book is adopted by both training centers, colleges and universities and hospitals, behavioral health care treatment centers, the legal system centers, senior living centers, doctors, Nurses, Funeral Directors, etc.

    This book takes a deep dive and discusses clinical and reverse interventions, which can be performed in a variety of milieus, shedding light on aspects of intervention that aren’t always talked about in trainings and certification programs. I hope professionals will hire and cultivate staff trained in the strategies talked about in the book, so that knowledge, standards and practices are a part of their tool box.

    In coming years, we are going to see more telephone and internet-based treatment options, the use of AI and other technological advances. Though nothing will replace relationships, we will have higher standards based on improved educational qualifications and higher standards of accreditation for treatment centers – all good things for behavioral health care. The ongoing opioid epidemic will spur change by demanding robust and low cost treatment options to address this issue.

    We will also address ethical issues. For example, the hiring of professionals for treatment centers will need to address marijuana legalization. Questions will arise: do treatment centers have progressive abstinence? Or a firm baseline? Can hired professionals use one substance over another? The ethics of these questions will come to fruition as the issues play out over the next couple of years.

    ADDICTION BLOG: Would you offer a bit of insight for our readers as to how they can best handle trauma and addiction in their family? What are some of the best steps they can take themselves if facing a drug or alcohol problem within the home?

    DR. LOUISE STANGER: The first step is to define trauma as an overwhelming experience that cannot be integrated and one that elicits multiple defenses and dysregulates the person. Or, it can be described as a stress that causes physical or emotional harm that you cannot remove yourself from.

    Then, we may unpack the etiology of the trauma, which may be objective or subjective. Objective trauma is what took place i.e. I fell off a ladder, I was told I was no good, I would never amount to anything, my father was emotionally abusive, I was in a car accident, etc. Subjective trauma is how the person perceives what took place and the emotional aftershocks. This can come from adverse childhood experiences, and the effects of trauma is cumulative over time.

    Once this is understood, seeking out and talking with trained professionals who can put you on the path to recovery is integral to the process.

    Professionals must ask: how can we help clients who experience trauma and then substance abuse/addiction rise to their best possible selves? Also, it is important to give treatment recommendations to other family members so they too can be the best they are. This is a holistic approach to treating a wounded person, and it always comes back around to CIS or Collective Intervention Strategies as the best approach.

    Folks may also consider visiting a 12-Step group such as Alcoholics Anonymous, Al-anon, Narcotics anonymous, etc. And of course there is me in my own independent practice. I always tell my clients that help is just a phone call away.

    ADDICTION BLOG: Through the process of writing, did you learn any important lessons or come across information that you weren’t expecting?

    DR. LOUISE STANGER: I didn’t have any big surprises. I found it humbling that with all the research and time working on this book, I circled back to the one truth that has been consistent in my work – it is imperative to meet the client where they are at. It’s about understanding who they are, where they come from, their family dynamics, traumas, and their place in the world.

    The best theory in the world won’t take into account this human element. With unique people, a multitude of cultures, gender expressions and the changes in our genetic diversity, we must embrace difference as a teacher. That way, you can help plan a strategy that meets their unique needs.

    ADDICTION BLOG: Are there any future projects you’re currently working on and/or have in mind? What kind of impact are you hoping to leave on the mental health world with the addition of this book?

    DR. LOUISE STANGER: I continue to write public blogs – openly discussing the major topics in the behavioral health field. One thing I will wrestle with through public discourse, presentations, trainings and daily practice is ethics in the digital age. Specifically with marijuana legalization, how will this affect the workforce? There will be a multitude of implications and I’m excited to dive in and explore with my practice, clients and continued commitment to service of the behavioral health industry.

    Finally, my hope is that this book is adopted my many universities and schools across the globe. I’m excited about the e-platform, which will make it a living source of knowledge for professionals to keep up to date and relevant for future generations. Also, I hope that whatever my next writing venture is – whether it’s a book, a collection of blogs, or more thought pieces – that it will seep into the mainstream and become a larger public discourse than we’ve seen related to these topics. A wider audience would help ease the stigma of substance abuse and mental health in the public sphere.

    ADDICTION BLOG: Do you have some inspiration you can leave for our readers who are currently handling addiction for themselves or a loved one?

    DR. LOUISE STANGER: Keep doing what you’re doing. As I put in my memoir, keep falling up, which means that stumbles, detours and falls are part of the human experience, so long as you’re out there living and moving forward.

    I strive to look for strengths and goodness in people so everyone may rise to their best possible selves. I hope that readers and those out there struggling with these kinds of issues will do the same. Help is just a phone call away and hope is possible. Dig deeper, think harder, look further, rise stronger.

    ADDICTION BLOG: Do you have anything else you’d like to add?

    DR. LOUISE STANGER: Thank you for the opportunity to be a part of your blog. I appreciated working with you as an editor. Your contributions are immeasurable.

    In closing, I want people to know every day they are inviting people to change, help is available, solutions are possible.

    View the original article at

  • Addiction, Autism, and Sensory Integration

    Addiction, Autism, and Sensory Integration

    Neurodiversity and A Changing World

    Previously, I wrote about the intricacies I learned about neurodiversity from my granddaughter, Alexandra. When she was very young, we noticed how certain fabrics bothered her. She had difficulty smiling, responding to her name when called and was otherwise distracted. She appeared distant, lost in a far- away land.

    After learning of her diagnosis as autistic spectrum disorder (ASD), early intervention, extensive therapy and working with professionals has given Alexandra the communication and social skills to run, laugh, talk and play like any other 5-year-old. Though this journey has its challenges, it spurred me to dig deeper, learn more, and further develop my skills and understanding of neurodiversity in all its forms.

    Researchers and scientists have come a long way in uncovering the different forms of learning that autistic individuals use to experience the world.

    Still, there is much to learn about neurodiversity. Specifically, we need to focus on autism in an increasingly technologically advanced world and a growing population. In fact, the Centers for Disease Control and Prevention (CDC), in a new report published April 26, 2018, found new data on the prevalence of autism in the United States. This surveillance study identified 1 in 59 children (1 in 37 boys and 1 in 151 girls) as experiencing autism spectrum disorder (ASD).

    Autism Linked to Addiction

    In addition to new-found statistics, I also discovered research that linked autism to addiction – a finding that is commonly dismissed amongst behavioral health professionals as irrelevant or untrue, as cited in The Atlantic’s article about autism and addiction. Despite this common misconception, my research uncovered information on the topic that I believe is imperative to talk about and spur conversation that will lead to new therapies and modalities in working with and understanding neurodiversity.

    If you don’t believe that people who experience autism may also be at risk for a substance abuse disorder, just ask Shane Stoner, a 44-year-old man who discovered his autism after a bout with heroin addiction.

    “I felt like heroin gave me confidence,” explains Stoner, in The Hidden Link Between Autism & Addiction (Atlantic Magazine , March 2017). “I could get out of bed in the morning and do the day. No matter what happened, it made me feel like it was going to be alright.”

    After a run-in with the law, Stoner entered a detox program to kick his addiction to heroin, but it wasn’t till years later that he received his autism diagnosis. The diagnosis opened his eyes – it helped him understand his strange behaviors, his heightened experience of severe anxiety, and the way he relates to the world around him.

    “It explained Stoner’s sensitivity to things such as tags on his t-shirts, and his succession of obsessive interests. It clarified why he had such a difficult time fitting in as a child, his problems with roommates in college—and why he continued to struggle with social connections as an adult.”

    Likelihood for Substance Use Disorders

    Stories like Shane Stoner’s are becoming more prevalent. In fact, a new study in Sweden – the first to explore the link between people with autism and addiction – found that individuals with autism who have average or above average intelligence quotients (IQs) are twice as likely to become addicted to alcohol or other drugs than their peers.

    This study looked at 26,896 Swedes diagnosed with autism born between 1973 and 2009. Researchers found, in addition to the general population of autistic people having double the risk of addiction, there is an elevated risk amongst those with autism with an IQ of 100 or above.

    Furthermore, researchers looked at co-occurring disorders and found that those with autism and a dual-diagnosis of attention deficit hyper-active disorder (ADHD) “increases the risk of addiction fourfold; among those with an IQ in the typical range or above, ADHD increases the risk eightfold.”

    These findings help us understand how someone with autism may develop a substance abuse disorder.

    A Clearer Picture Emerges

    Decades ago, when patients exhibited severe signs of autism, their need for caretakers (and not living independently) made it difficult to obtain alcohol or illegal drugs. The assumption also prevailed that an autistic person’s penchant for obsessive compulsive behaviors such as strictly following rules made it unlikely to experiment with drugs or alcohol. It has been noted that children with autistism display little fear and enjoy twirling, spinning, roller coaster rides, climbing walls, and other high risk behaviors

    However, now that researchers and clinicians have learned more about autism spectrum disorder, the Swedish study and stories like Shane Stoner’s help us see a clearer picture of autism and addiction.

    Stoner did not understand the source of his anxiety, nor his strange behaviors, but when heroin was introduced to him as a way to cope and give him confidence, we can understand how the door was opened to an addiction.

    Though his addiction led him to eventually uncover his autism diagnosis, stories like these help us see that more research must be done to uncover more about neurodiversity.

    Sensory Integration as Treatment

    Now that we see the bigger picture of autism and addiction, an emerging modality to help with addiction may be in sensory integration. What is sensory reintegration?

    According to the Novak Djokovic Foundation (NDF), a global organization committed to giving children equal access to quality preschool education, sensory integration has been defined as,

    “the ability to take in information through senses, to put it together with prior information, memories, and knowledge stored in the brain, and to make a meaningful response.”

    I had the privilege of speaking at the Post Traumatic Growth Symposium in Utah this year, where I toured two facilities, Recovery Ways and The Heritage School that employ sensory integration rooms used as a form of therapy. What is a sensory integration room? Again, according to the NDF, this is:

    “a special room designed and equipped to stimulate the senses of hearing, sight, touch and smell. It is a place where people with sensory integration disorder can explore and develop their sensory skills, and also where they can relax, relieve stress and anxiety.”

    Stormy Hill, an occupational therapist at Recovery Ways, the Utah-based treatment center where I visited a sensory reintegration room put it this way, saying its goal is:

    “to teach the patient to stay grounded, to stay organized, to stay calm within an emotional range, no matter what life is throwing at them.”

    In the rooms I visited, there were climbing walls and swings, and everything was soft to the touch. There were even fiber optic sets, interactive fiber optic light cables that you could pull, bend, stretch and coil.

    Sensory Integration Rooms as Clinical Tools

    During my time in the room, I learned that sensory integration, an emerging type of therapy for dual-diagnosis clients, can be used for a wide range of clients and patients. In fact, sensory integration is suitable for children or adults with autism, concentration disorder, sensory impairments, mental development or insufficient development problems, speech difficulties, learning disabilities and behavioral problems.

    I dug deeper and was fascinated to discover these rooms could be beneficial in de-escalating an upset client. They might serve as a place to hit pause, to rethink what is upsetting them and pushing them to want to leave treatment AMA. I watched how my usual hypervigilant self -calmed down by playing with the manipulatives and realized how easy it would be to open up about past traumas hiding behind fiber optic cables while swinging in a hammock.

    I was further jarred into my senses when the OT offered me a hot chew. WOW! Whatever I was focused on, ruminating about was suddenly jarred out of my sensibility or existence. The sweet bitter taste startled me and altered my senses and my thought processes. I was immediately pulled into refocusing my thoughts, my sensibilities. I marveled over this experience thinking how wonderful it was to stop my obsessions by simply giving me a candy and putting me inside this magical room.

    I thought this might be a perfect way to facilitate a clinical intervention with a patient. In this room, the combination of manipulatives juxtaposed with a hot chew will allow one to settle down and process the pros and cons of rash decision making.

    In that moment, I wondered, “Why don’t all treatment centers have sensory rooms?”

    As we peel back more layers of understanding behavioral health, addiction, neurodiversity and autism, I’m encouraged to see researchers and behavioral healthcare professionals employ these types of strategies with their patients. Likewise, it’s imperative that we keep our eyes open to the way addiction affects neuro-diverse learners and develop protocols and strategies that meet the needs of this ever emerging population.

    View the original article at

  • A Checklist for Hiring an Addiction Interventionist

    A Checklist for Hiring an Addiction Interventionist

    ARTICLE SUMMARY:This article offers guidelines on how to select a professional interventionist when you are ready to confront a family member about a drug or alcohol problem.

    ESTIMATED READING TIME: Less than 10 minutes.

    TABLE OF CONTENTS:

    Readiness for Help

    So, you’re ready to find an interventionist.

    Most likely, you’re at your wit’s end. You may not be sleeping at night from worry. You might feel like the world is spiraling out of control. And you may be angry, frustrated, and downright sick of the person in your family who’s using drugs or alcohol.

    Guess what?

    These are all normal feelings!

    Selecting and working with an interventionist might be the best thing that you can do for your family. The right person will have just the right combination of techniques and words to move your entire family into a new era. The right person will also have experience and a track record to show for it. Plus, the right person will not only get your loved one into rehab, s/he will guide your family on what to do next.

    So, the decision about WHO is best for your family should not be taken lightly. Your choice will be informed by your specific needs, situation, and case. And you need to do your research. We hope that this informative article will help!

    Credentials

    Currently, addiction interventionists are not required to attend university, pass certification exams, or be approved as “clinicians” before they begin to practice. In fact, it’s a bit like the Wild, Wild West.

    Still, a skilled interventionist should be highly trained in addiction interventions. The right person can help you and your family get unstuck. However, it can be tricky to make a decision on credentials alone. Some interventionists are licensed clinicians, some are trained by colleagues, while others have experience under their belt.

    Q: So, what should you be looking for, in terms of credentials?

    A: Basically, you need to know that the person KNOWS what they’re doing…and has the experience to back it up.

    Clinical skills are helpful and desired when looking for an interventionist. However, credentials are not a prerequisite. Experience matters. Plus, it can also help to work with other professionals who complement interventions. Trained attorneys, psychiatrists, psychologists and others who themselves are in recovery are excellent allies.

    THE BOTTOM LINE IS THIS: Regardless of the interventionist’s academic background, you need to figure out:

    1.  What they know.
    2.  Who they’ve been trained by.
    3.  What mentoring they’ve had.
    4.  What skills they bring to the table.

    How Much Do Interventionists Charge?

    Interventionists charge from $2,500 to $10,000 or more for their services. The price will depend on the level of service offered and the person’s experience with interventions. For example, some interventionists offer coaching to families for 3-6 months after the intervention is over. Others will end their work with your family when your loved one enters treatment, or after a family weekend.

    When interventionists partner with or work for treatment centers, the intervention may be lower priced than for someone who works independently. This is because the intervention may be just another service of the entire rehab process. Note also fees are not necessarily less if you pick an interventionist in your state versus across the country.

    When considering costs, keep in mind the ultimate value of the result. The upfront costs might seem high, but in exchange, you’re increasing the chances your loved one will attend rehab and get their life back on track. How much is that worth to you?

    As a comparison, according to the U.S. Bureau of Labor Statistics, as of 2017, the average annual salary of counselors working in the field of addiction was $43,300. Interventionists on the higher end of the earnings scale, or 90th percentile, earned $60,000 and those on the lower end of the earnings scale, or 10th percentile, earned $25,140.

    How to Find an Interventionist

    There are a few ways you can identify the best person for your family.

    1. Search member directories of the professional associations.

    It is important to find someone with experience, the appropriate licenses/certifications for your needs, and a strong code of ethics. Two professional guilds list members’ credentials, licenses, and certifications. So, where finances are concerned, be sure that you clarify fees and services up front.

    To look for an interventionist, search the member listings for the NII and AIS:

    2. Seek a reference from a mental health professional.

    Second, the National Council on Alcoholism and Drug Dependence recommends that you seek help from the following professionals for intervention services:

    •  An alcohol and addictions counselor
    •  An addiction treatment center
    •  Psychiatrist
    •  Psychologist
    •  Social Worker

    Some of these professionals may have experience in interventions themselves. Other times, a mental health professional can refer you to a colleague or someone with a good reputation in the field. The organization also suggests that you reach out to NCADD Affiliates to be connected to referrals.

    3. Call us for help.

    The telephone number listed on this page will connect you to a helpline. All calls will be answered by American Addiction Centers (AAC). Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists. The helpline is offered at no cost and with no obligation to enter treatment.

    Whatever route you choose, we recommend picking up the phone and interviewing at least three people that you want to work with. Use the checklist at the end of this article to guide your conversation. Finally, confirm references that the person offers and have conversations about the person’s methods.

    Do Interventionists Work?

    Yes, professional interventionists work.

    According to the Association of Intervention Specialists, research suggests that up to 90% of professionally guided interventions succeed at getting the person into treatment. Whether your loved one will find and maintain a drug-free life is more of a long-term investment. In fact, someone facing addiction needs to put in a great deal of effort to change their thoughts and behaviors.

    But if you’re doing an intervention correctly – and using the Collective Intervention Strategy outlined in the book, The Definitive Guide to Addiction Interventions – the family system will change. So, regardless of whether your loved one goes to treatment or not, the system will never be the same.

    Therefore, every addiction intervention has the possibility to be successful.

    A Printable Checklist

    It’s important for families who hire an interventionist to first check out an interventionist’s credentials and amount of time they have spent in the field. You’ll also want to know more about their services, costs, and personal experience with addiction. Here are is a checklist of questions that you can use to help you vet professionals. Feel free to write answers to the questions…or use the space for your own notes.

    □ Credentials
    □ Licensed Clinical Professional Counselor, LPC or LCPC
    □ Licensed Mental Health Counselor, LMHC
    □ Licensed Clinical Social Worker, LCSW
    □ Masters or Doctorate of Psychology, Masters in Psychology, Psy.D.,
    □ Marriage and Family Therapist, MFT

     

    Member of professional association (circle any of the following)

    • AIS: Association of Intervention Specialists

    • NII: Network of Independent Interventionists

    • American Hospital Association

    • NATAP: National Association of Addiction Treatment Providers

    • NAADAC: National Association for Alcoholism and Drug Abuse Counselors

    • NASW: The National Association of Social Workers

    • CARF: Commission on Accreditation of Rehabilitation Facilities

    • CADAC: California Association of Alcohol and Other Drug Counselors

    □ Is the interventionist independent or employed by a particular treatment center or centers?

     

    □ What is the person’s academic background, training, and/or experience background?

     

    □ Is the interventionist in recovery him/herself, or not?

     

    □ Does s/he work alone or have a team?

     

    □ What exact services does s/he provide? What is the cost?

     

    □ What services do they not provide?

     

    □ What are their professional affiliations?

     

    □ What do they specialize in (not all people can do everything)?

     

    □ What does their engagement offer? Length of service and actual services.

     

    □ What is the length of time for their engagement? Does the person work with you and your family AFTER initial treatment placement?

     

    □ How accessible is the person or their team to you? Can you reach the person 24-7? What’s the turn around time on phone calls, emails, etc?

     

    □ Does the interventionist have references you can call for verification?

     

    Your Questions

    We hope to have set you on the right path for getting help.

    But we understand you still may have questions.

    Please ask any question in the comments section below. We do our best to respond to each real-life situation with a personal and prompt reply. And if we can’t help…we’ll refer you to someone who can!

    We wish you all the best.

    —–

    Reference Sources: The Definitive Guide to Addiction Interventions, A Collective Strategy
    Available via Routledge Press or on Amazon.

    View the original article at

  • Can I Plan an Intervention on My Own or Do I Need Help?

    Can I Plan an Intervention on My Own or Do I Need Help?

    ARTICLE SUMMARY: This article reviews why most families need expert help during an intervention…and what planning is required. Your questions are welcomed at the end.

    ESTIMATED READING TIME: 10 minutes

    TABLE OF CONTENTS:

    Most Families Need an Expert

    Most families need outside help to get a loved one into rehab. I didn’t know this until I started working with expert, Dr. Louise Stanger on the book we wrote together, “The Definitive Guide to Addiction Interventions.” I learned that interventions are highly stylized conversations that require clinical skill.

    Why do most families need an expert?

    Simply, because it’s difficult.

    Trying to convince someone to get help for a drinking or drug problem requires experience and an understanding of common objections. Interventions can be potentially explosive, even if the person knows what’s coming. And you don’t know what’s going to happen. This is where experience can really help.

    Plus, loved ones who are using psychoactive substances are often in denial that s/he needs help. Denial is like a wall…with the right words, it can come tumbling down. But are you ready to talk with your loved one calmly, objectively, and rationally about addiction issues? If you’re honest with yourself…probably not.

    Additionally, we know that one form of addiction bleeds into another: co-occurring mental health disorders such as depression, anxiety, personality disorders, juxtapose with medical problems such as chronic pain, legal or school issues. The complexity of what’s really going on is a mystery to most families.

    Finally, consider this: Most people do not want to change.

    Creating movement and shifts within a family dynamic require thoughtful expertise. And while you might need to dish out anywhere from a few thousand dollars to many thousands…training, specialization, and experience are worth the money! In fact, moving someone to the point where they’re willing to change takes more than just the simple formula you’ll see on other blogs online: Write a letter – Speak the facts – Your loved one goes to rehab. It just doesn’t happen like that.

    Working with an interventionist can often get your loved one into treatment quicker and more efficiently than if you try to intervene on your own.

    Do You Need Help, or Not?

    So, are you at a point where you need a professional? Take a look at the following questions. You and your family might want to hire a professional addiction interventionist if:
    • You support (consciously or unconsciously) a loved one who is using mind-altering substances. This includes financial support or emotional support.
    • You have difficulty setting healthy boundaries or even knowing what boundaries are.
    • You experience somatic symptoms, lack of sleep, rage, endless tears, repeated illness, stomach aches, migraines, etc.
    • You have been unsuccessful in addressing a loved one’s substance abuse, mental health disorder, chronic pain, co-occurring disorder, legal trouble, or school and professional failures.
    • You have been unsuccessful convincing your loved one that s/he needs help.
    • You have a history of complex trauma, substance abuse, or co-occurring disorders in your family of origin.
    • You cannot function daily due to your fear of doing/not doing something different to change your loved one.
    • You think constantly about your loved one. Or, you have gotten to a point of disconnecting from the world around you; looking at the situation is too painful.

    What Does an Interventionist Do?

    An interventionist works with you, your family group, and the identified loved one (the person drinking or using drugs) to help that person accept medical treatment for addiction. In order to get to “Yes”, an interventionist should be able facilitate and guide the following:
    •   Team Formation
    •   Family Mapping
    •   Retrospective Bio-Psycho-Social Analysis
    •   Case Strategy
    •   Treatment planning and placement
    •   Aftercare recommendations
    •   Family engagement in the healing process

    Further, communication skills are essential to interventions. Interviewing skills and solution focused skills are critical. Throughout the process, the interventionist manages all team and third party communication. S/He serves as a liaison. For example, individual phone interviews with prospective team members may be required. Or, an interventionist may need to provide safe escort or transport to the selected treatment center.

    Case management is also required for the evidence-based interventionist. Treatment center matching and referrals are necessary. Likewise, follow-up and regular case management with treatment centers while clients attend rehabilitation programs is critical. Finally, consultation and coordination of aftercare as well as Solution-Focused Family Recovery Coaching for all team members ensures lasting change.

    Not all interventionists have these skills. You can download our Checklist for Hiring an Interventionist to learn what criteria are best as you choose the right person for your family.

    Logistics

    There are a few things that an interventionist should coordinate both before and during the intervention. This includes:
    • Set date and times for meetings.
    • Select a neutral, safe venue(s) for the Pre-intervention and Intervention Meeting.
    • Book the venue in advance.
    • Identify who will be present.
    • If someone is not present, decide how you will include them (by Skype, phone, or letter).
    • Communicate the time, date, and location to all accountability team members.
    • Arrange for food to be present at the venue.
    • Review entrances and exits to venue.
    • Identify pets, if any, and care for them during the Intervention.
    • Make sure there are enough seats available (round tables if using are better than rectangles).
    • At homes, pull chairs and couches around to create a safe setting.
    • Identify other places where one may go and speak with the identified loved one in a less formal setting.
    • Arrange for photographs to be present. What photographs might be helpful? For example, if the ILO had a close relationship with a grandparent that has died, one might put a photograph in an empty chair or have to share to help move someone to change.
    • Work with a lawyer, medical professional, counselor, medical nurse, or treatment center representatives when necessary.

    Security

    • Make sure you have access to a phone always, even in remote locations.
    • Hire same gender transport professional(s), when needed.
    • Hire a medical nurse to accompany the identified loved one to the treatment center in cases of extreme drug dependence to prevent withdrawal.
    • Complete a full security check upon arrival at the venue.
    • Lock down (under lock and key) any firearms, weapons, or knives, etc.
    • Gather home keys, car keys, IDs, and phone from the identified loved one upon arrival.
    • Gather keys of interior and exterior areas of the home from the family.
    • Call in the help of executive protection professionals, when needed.

    Travel

    • Make sure that tickets are open and flexible.
    • Book tickets to the treatment facility on a “loose” return itinerary to allow for missed flights.
    • Make sure that if using safe transport services that escorts are gender specific or if you use two people for transport one has to be same gender.

    Review

    • Review entire plan with team mate and other outside professionals.
    • Review plan with the accountability team.
    • Review who you want to give invitation to attend meeting.

    Q: What happens when you go one-on-one with someone in active addiction?

    A: You lose!

    Adding an interventionist to your team can help ensure success and get your loved one into treatment quicker and more efficiently than if you were to try to intervene on your own.

    To learn more about addiction intervention, please give us a call. Or, leave us a question in the comments section below. The telephone number listed on this page will connect you to a helpline answered by American Addiction Centers (AAC). The helpline is offered at no cost and with no obligation to enter treatment. Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists.

    If you’re ready for help, pick up the phone.

    You don’t need to hold an intervention on your own.

    Reference Sources: The Definitive Guide to Addiction Interventions, A Collective Strategy
    Available via Routledge Press or on Amazon.

    View the original article at

  • Family Addiction Intervention | Why an Invitation Is Always Best

    Family Addiction Intervention | Why an Invitation Is Always Best

    ARTICLE OVERVIEW: DO NOT ambush a loved one in an intervention. It will end with resentment. Instead, consider an explicit invitation. Here is how and why.

    ESTIMATED READING TIME: 10 minutes or less.

    TABLE OF CONTENTS:

    What Is a Family Intervention?

    A family addiction intervention might just be the best thing you ever spend your time and money on. But what is it? And why would you consider spending thousands of dollars on an intervention in the first place?

    An intervention is an invitation to change. The interventionist’s end goal is to get someone struggling with an alcohol or drug problem to enter treatment. As such, an intervention is a critical conversation. In some cases, this is a life or death conversation. And in the best cases, an intervention is a life-saving conversation.

    However, interventionists do not work one-on-one, as in individual counseling. Interventionists always work with groups, family systems. They do this for two reasons: first, addiction affects the entire family; second, groups provide a larger context and sphere of influence when combined. Change must take place in the context of people, places, things, thoughts, and feelings.

    A successful intervention has the potential to transform not just the identified client, but an entire family.

    I didn’t know about the efficacy of treating the entire family during an intervention until I started working with expert, Dr. Louise Stanger on the book we wrote together, “The Definitive Guide to Addiction Interventions.” But it totally makes sense: change happens on a systemic level. If we only expect one person to change, it won’t be sustainable.

    Evidence states it takes much longer than most people think to change a habit: an average of 66 days. The goal of professional interventionists is to work with the whole family system while the identified patient is in and out of primary treatment, so that all may change. Treatment gives people time to grow and change. The correct treatment or placement will also provide families with the help they need to disengage and rethink how they may love, as well.

    Why Use the Invitational Method?

    So, writing the book with Dr. Stanger also taught me about types of interventions. There are four current models of addiction intervention:

    1. The Surprise Model
    2. The Invitational Model
    3. The Systems Model
    4. The Action Model

    Of these, some elements work better than others. And the main point of advice I’d give to anyone who wants to plan an intervention is this:

    Stop ambushing people by surprising them with an addiction intervention!

    During typical interventions, members of the drug/alcohol user’s social network participate directly in the process, often secretly or without the person’s knowledge. These folks gather together and surprise the individual to ask her/him to go to treatment. The idea is that if a person is surprised they will have less time to ruminate and their defenses will be lowered. The theory is that when startled, a person ill be more likely to say, “Yes” to treatment.

    Nothing is further from the truth.

    Often, Surprise Model interventions generate great upset and distrust. As noted in the 2017 Surgeon General’s Report, “Facing Addiction in America”:

    “Confrontational approaches in general, though once the norm even in many behavioral treatment settings, have not been found effective and may backfire by heightening resistance and diminishing self-esteem on the part of the targeted individual.”

    People report feeling disrespected, ambushed, and shamed. They report feeling cornered or pressured into treatment. It’s no wonder that many of them drop out of treatment. In fact, dropout rates seem to increase as relapses occurred. Many identified loved ones who were subject to the Surprise Model of Intervention reported this type of rebellious thinking:

    “At first, I stopped my drug and alcohol use because of the pressure from the Intervention, but then I found myself thinking ‘I’m not going to be told what to do!’ so I started using again.”

    Just imagine, you’re struggling with a substance abuse or mental health disorder and a pack of people descends upon you. Well, we know that substance abuse and mental health disorders are beset with shame and feeling awful. If families choose set up an ambush or an adversarial relationship to begin, you’ve got to work through the resentment first.

    How Invitational Interventions Work

    I agree with Dr. Stanger, in that the best way to frame an intervention is by using The Invitational Model. In this model, you invite your loved one to a family meeting and rely on willing participation of all involved. According to founding practitioners, this style of intervention does not require threats or consequences; they state that less than 2% of families even talk about consequences. So, there are often no letters involved. No bargaining. No ambush.

    Instead, emphasis is on family education, developing strategy, and communication. The desired outcome is not only on treatment engagement of one person. The desired outcome also includes long-term, intergenerational family well-being and recovery.

    During an Invitational Intervention, the family has a Chairperson who helps organize members and works directly with the interventionist. The interventionist or clinician guides the family strategy and facilitates from between 2-5 face-to-face sessions. S/He completes a family genogram, conducts interviews with family member, coaches family members on crafting recovery messages, and directs conversations toward change. Some interventionists focus on a specific “Change Plan” customized to the ILO’s needs for treatment. Finally, the group invites the ILO to change. If there is no movement by the last meeting, the group sets limits and consequences in a loving, supportive way.

    To read a complete description of all intervention models, please order my book here.

    How to Do an Intervention

    The best way to do an intervention is with the help of a professional interventionist. The Intervention itself is a well-orchestrated event, a drama that is created and stylized. There are many skills that go into the intervention: counseling, social work, and psychotherapy are at the heart. Still, the main goal of the intervention is this:

    Interventions help move the identified loved one to change and to accept treatment.

    It is important to note that some interventionists stop there. Some interventionists are only interested in moving or getting someone to treatment. However, when interventionists drop you at this point, it can result in many negative outcomes:

    •  Complications
    •  Financial problems
    •  Increased complexity
    •  Legal problems
    •  Relapse
    •  Treatment drop-out

    Indeed, what happens after the intervention is equally important. A good interventionist will help you navigate through treatment, support group attendance (12-Step work, ALANON, ACA, Open A.A. Meetings, or SMART Recovery are most often used), and possibly dealing with refusal for treatment. You’ll need to continue to learn how to take care of yourselves as you deal with substance abuse, process disorders, physical issues, and mental health issues in the system.

    Families also need to learn to set healthy boundaries, for themselves and their loved ones. Family members may be referred out for care to family counselors, individual therapists, recovery coaches, or other behavioral/mental health care providers.

    The key point is this: follow up is crucial to the success of developing healthy family systems.

    So, select an interventionist who can use a systemic approach that includes case management and active coaching over time. From experience, it can take many months for a family to become “collective” and to operate in harmony again.

    Intervention Services Near Me

    There are a few ways you can identify the best person for your family.

    1. Search professional associations.

    The Network of Independent Interventionists (NII) and the Association of Intervention Specialists (AIS). list members’ credentials, licenses, and certifications for professional addiction interventionists. You can search member listings here:

    2. Seek a reference from a mental health professional.

    The National Council on Alcoholism and Drug Dependence (NCADD) exists as the nation’s premier advocacy group for addiction treatment. This NGO recommends that you seek help from the following professionals for intervention services:

    •  An alcohol and addictions counselor
    •  An addiction treatment center
    •  Psychiatrist
    •  Psychologist
    •  Social Worker

    Some of these professionals may have experience in interventions themselves. Other times, a mental health professional can refer you to a colleague or someone with a good reputation in the field.

    3. Call us for help.

    The telephone number listed on this page will connect you to a helpline answered by American Addiction Centers (AAC). The helpline is offered at no cost and with no obligation to enter treatment. Caring admissions consultants are standing by to discuss your treatment options, which can include family intervention specialists. So, if you are ready to get help for you or a family member, reach out and pick up the phone.

    Your Questions

    Still have questions about how to hold a successful family intervention for addiction?

    Please reach out.

    You can leave your questions in the comments section at the end of this page. Or, you can call us on the phone number listed above. Whatever you do…do something. Nothing changes until something changes.

    View the original article at

  • Did You Know Carfentanil Is 5000 Times Stronger Than Heroin?

    Did You Know Carfentanil Is 5000 Times Stronger Than Heroin?

    ARTICLE OVERVIEW: Recently, drug dealers have been cutting heroin with carfentanil to increase profit. However, this medicine is not meant for human use. In fact, carfentanil was originally designed to tranquilize large mammals. This article reviews what you need to know about carfentanil, the dangers associated with it, and tips for finding treatment if you’re struggling with an addiction. At the end, we invite you to ask questions. We try to respond personally and promptly to all real-life questions.

    ESTIMATED READING TIME: Less than 10 minutes.

    Table of Contents:

    What is Carfentanil?

    Carfentanil is very similar to the synthetic opioid analgesic, fentanyl. To date, it’s not only one of the most potent opioids available, it’s the most potent opioid on the streets. In fact, it’s estimated to be 100 times stronger than fentanyl. And fentanyl is already 50 times stronger than heroin!

    Carfentanil is estimated to be 10,000 times stronger than morphine.

    However, carfentanil wasn’t created for people to use. Back in 1986, the chemical was labeled under the brand name “Wildnil”. It was used in tranquilizer darts designed for large mammals such as elephants. Carfentanil was the perfect drug for this task, as the overdose risk is similar to that of its cousin, fentanyl, but still contains much higher opioid activity.

    The risks involved with human consumption of carfentanil are HUGE. Overdose risk is extremely high. All it takes is 1 microgram to provoke psychoactive effects. With that in mind, it’s understandable why drug dealers are cutting it with heroin. Even the smallest amounts of the opioid cause dosing reaction, and in this way, a small supply of the drug can cause heroin profits to soar.

    But how does such a powerful drug affect the brain?

    How Does it Affect the Brain?

    Effects of carfentanil are similar to other opioids. The chemical components of these drugs attach themselves to opioid receptors within the brain which are responsible for:
    • Dopamine
    • Norepinephrine
    • Serotonin

    These receptors are attached to neurotransmitters which then carry chemical signals throughout the rest of the body. This can be highly effective if you’re experiencing severe pain in a particular area, as these neurotransmitters travel to where a pain is most intense and change the way that we perceive pain. Opioids can also case euphoric effect, the feeling of being high.

    The effects of opioids are strong and very addictive. Short-term effects from taking an opioid drug like carfentanil include:

    • Drowsiness
    • Feelings of euphoria
    • Pain relief
    • Sedation

    People develop an addiction to opioids through a chemical change in the brain and body. Over time, the body becomes drug-dependent; we chemically develop a necessity for the drug as a means of feeling normal. Without the drug, the body goes through withdrawal.

    Though this happens over a period of time, it should be noted that it doesn’t take long to develop dependence on opioids: usually, drug dependence can occur with about 3 weeks of regular use. When use persists, a person is unable to stop despite the negative effects the drug has on her/his life. In these cases, an addiction can begin.

    Why Overdose Happens

    Opioids are already dangerous in and of themselves. A synthetic opioid like carfentanil that is thousands of times stronger is even more dangerous. As mentioned above, it only takes 1 microgram of carfentanil to trigger activity within a human brain. However, at 20 micrograms, the dose becomes lethal.

    In fact, it’s been determined that of all the dangers of carfentanil, overdose is most likely. Cincinnati, Ohio experienced these consequences in just one weekend where 30 people overdosed because the drug was added to heroin. In the same area, the following weekend, another 78 overdosed.

    An overdose occurs when you take too much of a drug. It literally overwhelms the body. In particular, opioids affect the regulation of breathing and heart rate. When you take too much of an opioid drug, your respiratory and cardiovascular systems slow until they stop. How can you prevent an overdose?

    There are signs to be aware of when someone is experiencing an overdose:

    • Body goes limp.
    • Breathing or heartbeat slows or stops.
    • Face grows very pale and/or seems clammy upon touch.
    • Lips or fingernails turn a purple or blue color.
    • Seizure.
    • Unable to be awakened or cannot speak.
    • Vomiting or making gurgling sounds.

    Overdose Precautions

    So, what should you do if someone overdoses?

    IT’S VITAL YOU CALL 911 IMMEDIATELY!

    A fatal overdose can be prevented under the right medical attention. Calling emergency services needs to be your first priority. However, there are a few steps you can take in order to administer immediate action:

    • If naloxone is available, administrate it. Most likely, the medical professionals who arrive will use it as a means of stopping the overdose. Naloxone quickly blocks the effects of opioids within the body. You can either inject it into the muscle or spray it into the nose.
    • Attempt to keep the person awake by talking to him/her and try to keep them breathing, through CPR if necessary.
    • Make sure the person is placed on their side. This prevents them from choking on bodily fluids.
    • Stay by the person’s side until emergency services arrive. When it comes to an overdose, there’s no telling what can happen within just seconds.

    When it comes to opioid overdoses, most can be prevented through careful steps. When it comes to carfentanil, the story is a little different as it’s so powerful of a drug. Since so little can cause an overdose – and most don’t know whether or not or how much of their drugs are cut with carfentanil – there are GREAT risks involved.

    And these risks go beyond an overdose.

    Carfentanil Health Risks

    Synthetic opioids cause rapid depression within your central nervous system as well as immediate effects including:
    • Drowsiness
    • Increase in blood pressure (particularly, in the brain)
    • Lethargy
    • Muscle spasms
    • Nausea
    • Paranoia
    • Postponed or decreased respiratory function
    • Respiratory arrest
    • Tightening of chest muscles

    However, just as with other opioids, there are also long-term problems which can occur from a prolonged period of use. These include:

    • Abdominal distention and bloating
    • Addiction
    • Brain damage
    • Constipation
    • Development of mental health issues, such as depression or anxiety
    • Development of tolerance
    • Heart complications
    • Liver damage
    • Nausea and vomiting

    Furthermore, since carfentanil can be laced with heroin, there are health risks involved for people who inject as a means to get high including:

    • Gangrene
    • Hepatitis B (HBV)
    • Hepatitis C (HCV)
    • Human Immunodeficiency Virus (HIV)

    According to medical examiners and coroners, the number of deaths due to carfentanil increased by 94% from the second half of 2016 (421 deaths) to the first half of 2017 (815 deaths).

    Carfentanil Trends and Statistics

    The Center for Disease Control and Prevention analyzes opioid death through death certificates from 32 states and the District of Colombia. Of their analysis of fatal opioid doses between July 2016 and June 2017, it was discovered that – of 11,045 opioid overdose deaths – 1,236 (11.2%) had positive test results for carfentanil.

    Furthermore, the trends of overdose have been found to be area specific.

    • Within 2016 and 2017, Ohio had the largest number of carfentanil laced opioid deaths with September of 2016 being the peak month at 86 deaths.
    • Opioid overdose deaths where Carfentanil was present increased across the world in the second half of 2016, from 54 countries affected to 77.

    These trends are able to give us insight into how Carfentanil has only recently made its way into the illicit market. For the most current drug-related trends, including where synthetic opioids are making an appearance, you can follow the National Institute on Drug Abuse’s Emerging Trends and Alerts for all the latest information.

    Basic to Treatment

    If you or someone you love is currently struggling with an opioid addiction, it’s vital to seek help. The risks are too great. You are literally playing with your life. From experience, we promise you:

    You or your loved one has the ability to stop and start a new life!

    Addiction treatment typically works like this:

    1. First, a Medical Assessment

    Medical assessment forms the basis of any treatment plan. When you’re ready to get help, a team of doctors, nurses, and therapists will perform physical and mental exams. You can expect to go through a full medical exam, provide blood and/or urine samples, and go through interviews. This first assessment is crucial to your treatment plan. A good medical assessment should take from 1-2 hours to complete.

    2. Then, Medical Detox

    In order to get past physical dependence, your body must undergo withdrawal. This is the process of removing an opioid from your system and getting back to your natural body chemistry – a state known as “homeostasis”.

    Since opioid withdrawal has some risks such as dehydration and relapse, it’s important you find a detox facility. This will allow you to be in a controlled and safe environment while medical treatment to ease withdrawal symptoms. You can expect to be in detox for about a week, with symptoms peaking 72 hours after your last dose of opium. These symptoms include:

    ◦ Abdominal cramping
    ◦ Agitation
    ◦ Anxiety
    ◦ Diarrhea
    ◦ Dilated pupils
    ◦ Goosebumps
    ◦ Increased tearing
    ◦ Insomnia
    ◦ Muscle aches
    ◦ Nausea
    ◦ Runny nose
    ◦ Sweating
    ◦ Vomiting
    ◦ Yawning

    3. Psychotherapies

    Once an opioid is out of your system, you’re going to experience strong. This is due to the fact that your brain has been dependent on opiates and must readjust back into day-to-day life without it.

    Typically, psychotherapies are designed to teach you how to handle everyday emotions and life stressors. They are highly effective not only in showing you how to live a sober life but also in helping with any mental health conditions which may have arisen due to your opiate use. Furthermore, psychotherapies will reduce cravings. Typical therapies include:

    ◦ Behavioral Therapy
    ◦ Cognitive-Behavioral Therapy (CBT)
    ◦ Community Reinforcement and Family Training (CRAFT)
    ◦ Contingency Management
    ◦ Dialectical Behavior Therapy
    ◦ Group Therapy
    ◦ Family Therapy
    ◦ Individual Counseling
    ◦ Integrative Approach
    ◦ Motivational Interviewing
    ◦ Multidimensional Family Therapy
    ◦ Narcotics Anonymous (NAA)

    4. Pharmacotherapy (Medication)

    Medications can help to reduce withdrawal symptoms and cravings. When it comes to opioid withdrawal or longer term maintenance, typical medications prescribed are:

    ◦ Buprenorphine
    ◦ Loxifidine
    ◦ Methadone
    ◦ Naltrexone

    5. Education and Aftercare Services

    Once you begin to learn enough to get back into your day-to-day routine, you’ll have the option learn more. Addiction treatment programs should educate you about how drugs affect your brain … and how to cope without them. You may also be invited to go to meetings to connect with others who are going through the same thing. A support system helps maintain sobriety and stops you from isolating. Other aftercare services include ongoing counseling, sober living houses, and alumni programs.

    Where to Find Help

    When trying to find treatment, it can be difficult to know where to turn. Luckily, addiction treatment is more understood and accepted as a medical condition within the healthcare system. Medicare and Medicaid are being updated to include reiumbursements for addiction treatment. Likewise, state and federal grants aim to increase your access to needed medications and treatment.

    So, where do you go first? The first point of contact can be your general doctor or family physician. S/He can perform a brief assessment and then refer you to treatment centers within your area. From there, you can begin researching different types of treatment programs and their requirements. You can also find help through specialists like:

    Furthermore, keep an eye out for support groups either outside or within your treatment program.
    The people involved in these will help you along the recovery process. If you need to reach out to someone immediately, here are some hotline numbers to contact:

    • Drug Hotline: 877-736-9802
    • National Clearinghouse for Alcohol and Drug Information (NCADI): 800-729-6686
    • National Council on Alcoholism and Drug Dependence Hope Line: 800-475-HOPE (4673)
    • National Drug and Alcohol Treatment Referral Service 800-622-4357
    • National Suicide Prevention Helpline: 800-273-TALK (8255) or 800-SUICIDE (784-2433)
    • Substance Abuse Helpline (available 24/7): 800-923-4327
    • Relapse Prevention Hotline: 800-RELAPSE (735-2773)

    When you’re ready to look for treatment, we’re always glad to help! Feel free to give us a call. Or, you can leave us a personal question in the comment section below.

    Your Questions

    Still have a question about carfentanil? If you have any questions, we invite you to ask them below. If you’d like to share information about carfentanil or offer some advice about opioid addiction, we’d also love to hear from you.

    We try to reply to each comment in a prompt and personal manner.

    View the original article at

  • Innovative Discharge Planning for Addiction Treatment Aftercare

    Innovative Discharge Planning for Addiction Treatment Aftercare

    Harold C. Urschell III, MD, MMA – Chief Medical Strategist at Enterhealth

    Successful Solutions to Long-Term Recovery

    Treatment for drug or alcohol addiction isn’t finished when a patient leaves a residential or outpatient treatment program. In reality, life after treatment is when a person’s recovery genuinely begins. After all, this is when the skills learned in recovery are really put to the test.

    At Enterhealth, our individualized programs are designed to teach our patients the skills necessary to stay cognizant of their own behaviors (the good and the bad), better recognize and regulate their emotions and, ultimately, prevent relapses before they occur so that the person can live a healthy, fulfilling and independent life in recovery.
    So, what should an innovative addiction treatment discharge plan include? Ideas here. Then, we invite your feedback or comments at the end.

    When does discharge planning start?

    Discharge planning begins early in the beginning of treatment and is a critical component of a patient’s personalized treatment plan. It’s basically a roadmap for how they are going to live life after inpatient or outpatient treatment, and it includes things such as:

    • Additional or ongoing therapies
    • Ongoing medication management
    • Drug testing
    • Support groups

    …and more. Due to the fact that each patient will have their own individualized treatment plan, Enterhealth’s discharge plans are also unique to each patient.

    But even more, treatment needs to account for a person’s need for physical, emotional, and social support. In this light, some of the more successful lifecare (our version of aftercare) treatment components include:

    Transitional Living or Sober Living

    Transitional housing – also commonly referred to as “step-down housing” or “sober living” – is a type of living arrangement which helps patients (typically those who go through inpatient treatment) slowly ease back into life at home, school and/or work. With staff onsite 24 hours a day, patients are carefully monitored and must adhere to curfews and random drug testing. Transitional living homes also typically provide things such as emotional support, life coaching and other supportive elements and programs. patients are also required to re-engage with society again, whether through employment, volunteer work or education.

    Medication Management

    Many of those in recovery require maintenance doses of anti-addiction medications to help curb and control cravings both during and after treatment. These medications – when taken properly – are safe and effective. We have to remember that addiction is a lifelong disease of the brain, and many people will require medication to keep this disease under control. Others will have the ability to taper off their medication as their brain begins to heal over the course of many months/years.

    Other patients take medications for psychological/behavioral issues such as anxiety, ADHD, insomnia or depression. It is critical that patients are taught the risks and benefits associated with any prescription medication, as well as ways to prevent misuse and abuse.

    12-Step and Support Groups

    In order to develop a robust support system and learn practices to improve and maintain their recovery, 12-step meeting and support groups are extremely helpful. Groups such as these provide a new sober group of peers, encouragement, and help individuals find the motivation to stay in recovery for the long term.

    Some of the more popular 12-step meeting and support groups include Alcoholics Anonymous, Narcotics Anonymous, Celebrate Recovery and SMART Recovery.

    Whenever possible, family involvement should be a major component of a patient’s circle of support. Whether they are involved in family counseling through Enterhealth or another psychiatric treatment provider, or even with groups such as Al-Anon/Alateen and other Al-Anon Family Groups, family support can be a major component to a successful recovery.

    Recovery Coaching and Sponsorship

    Sponsors and recovery coaches are usually individuals who are in recovery themselves. Their primary function is to help people new to recovery transition to life after treatment. Not only are they a friend to lean on in recovery, but they’re also someone to hold the individual accountable and help them make wise choices, attend their outpatient treatment appointments and stay on their recovery plan. It is also common for recovery coaches or sponsors to attend various support meetings with the person they are mentoring in recovery.

    How to Best Approach Discharge Planning

    Enterhealth believes that an evidence-based holistic approach to drug and alcohol addiction treatment is the best way to ensure that patients receive the best care and get the best outcomes for recovery, and this approach extends to our discharge planning as well.

    A successful recovery is most often the result of multiple components working together to treat not just the addiction, but also the underlying psychological issues, physical ailments and real-life stressors which may have shaped the addiction in the first place.

    For this reason, board-certified psychiatrists and therapists should combine their expertise to create treatment and discharge plans that address each patient’s needs from start to finish. They should also try work closely with the family (when possible) to get them involved in the discharge process as soon as possible, as they can be instrumental in keeping a patient on the right track for recovery.

    Your Questions

    We hope to have provoked some thought about critical components of aftercare for addiction treatment. But you may still have questions. Please leave any questions or comments in the section below. We love to hear from our readers! And we’ll try to respond to you personally and promptly.

    To learn more about drug and alcohol addiction treatment or to inquire about using Enterhealth’s services for you or a loved one, please be in touch. We’d love to hear from you.

    View the original article at addictionblog.org