America’s addiction crisis is now so pandemic that it features on one of the most popular TV programs for children. As was revealed in a recent episode, one of the Muppet characters on “Sesame Street” is struggling with a big, “grown-up” problem. Show producer Sesame Workshop created a series of videos in which young Karli talks to her friends about her mom’s struggle with addiction. Karli came to “Sesame Street” in May to stay with a foster family because her mother was “having a hard time.” Continue reading “Addiction Reaches Sesame Street”
September is Recovery Month and this year the Substance Abuse and Mental Health Services Administration (SAMHSA) celebrates the 30th anniversary of this addiction awareness campaign. The 2019 theme, “Join the Voices for Recovery: Together We Are Stronger,” emphasizes the need to share resources and build networks to support the many paths to recovery. It reminds us that mental health and substance use disorders affect all of us and that we can all be part of the solution. Recovery Month highlights inspiring stories to help many people from all walks of life find the path to hope, health, and overall well-being.
One of those inspiring stories is Michael Arnold’s recovery from alcohol addiction. Michael’s alcohol use disorder almost killed her but she turned her life around and now works as an alumni relations manager at the Harmony Foundation. “Every day is a day of recovery, of course, but Recovery Month is that much more focused and there is more intention behind the message of hope that we are all trying to put forward, emphasizing that you can recover,” says Arnold.
Recovery Month began in 1989 as “Treatment Works! Month,” which honored the work of substance use treatment professionals in the field. A lot has changed in 30 years of fighting the stigma of addiction. “Every single year it’s getting better—especially now that alcohol and drug addiction is recognized as a disease of the brain,” says Arnold. “More and more people are starting to show more compassion and desire to understand instead of judging.”
Harmony is celebrating Recovery Month with a 50th-anniversary alumni reunion and a special workshop. “It will look at vulnerability, communication, and owning your sobriety,” explains Arnold. “Behind the ‘stronger together’ motto there is a lot of vulnerability for people in recovery and the workshop will discuss that.” Michael’s own motto is “recover out loud!” Her way of dealing with the disease is to help others, sharing the story of her addiction and recovery instead of hiding her past.
“Our addiction wants us in isolation—completely alone,” she says. “Our addiction wants us in the dark. How do we combat this? Together. Together, we can recover. In order to live a healthy life in sobriety, it is imperative to have a community. When we recover together, we become part of each other’s solutions.”
To spread the message that the door to recovery is always open, she has co-authored a book about recovery. “Our book is all about the fact that addiction doesn’t discriminate, and so recovery doesn’t, either. We work together, no matter what your pathway to recovery may be.”
You can be part of Recovery Month, too
One way to help your community rally around treatment and recovery is to encourage
social media user-generated content. Urge participants to use hashtags like #RecoveryMonth, #RisforRecovery, or #Recovery. Encourage them to share their personal stories about recovery and to tag their friends, family, and other members of their community. A local social media campaign is something easy for people to participate in and can foster a positive, collaborative spirit among community members.
SAMHSA’s Recovery Month toolkit provides a lot more information, resources, and ideas on how to get involved. With your help, the millions of Americans affected by mental and substance use disorders, including co-occurring disorders, will be lifted up into a life in recovery, filled with hope, health, and personal growth.
by Michael Rass
Harmony has provided addiction treatment at its Estes Park center in Colorado for half a century. In the beginning, Harmony was a place where alcoholic men could “dry out,” attend AA meetings, and then return home. Over the years, this first treatment approach was expanded to include group therapy sessions, the expertise of a physician, and a treatment protocol based on the Minnesota Model.
Beginning in 2008, Harmony expanded its detoxification facilities and revised its protocol to include Subutex detox methods for opioid addicts. More recently, Harmony added the HOPE Program which offers medication-assisted therapy using buprenorphine to clients with opioid use disorder.
Led by chief clinical officer Annie Peters, Harmony has now upgraded its dual diagnosis capabilities. Dr. Peters developed a roadmap for Harmony to become a dual-diagnosis capable facility serving clients with SUD and co-occurring mental health disorders. Dual diagnosis (also referred to as co-occurring disorders) is a term used for patients who experience a mental illness and a substance use disorder simultaneously. Harmony is now fully dual diagnosis capable.
This modern, evidence-based approach to addiction treatment acknowledges the important role mental health conditions play as drivers of substance use disorders. People may misuse drugs and alcohol because of mental health issues like trauma, depression, and anxiety. “If co-occurring conditions aren’t addressed, clients are more likely to relapse because they may be drawn to substance use to self-medicate those issues,” says Dr. Peters.
People with addiction may also have traumatic experiences as a result of their substance use. “When people are using substances, they may find themselves in dangerous, potentially traumatizing situations that cause further emotional pain, which then leads to more substance use,” says Peters. “This is a difficult cycle for people to pull themselves out of without help.”
Traumatic life experiences are extremely common among patients with substance use disorder. Many suffered adverse childhood experiences. “Studies of drug addicts repeatedly find extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual, and emotional abuse,” writes Canadian physician Gabor Maté in his seminal addiction study In the Realm of Hungry Ghosts.
Because of this strong correlation, trauma-informed care is an important part of addiction treatment. All staff at Harmony have been trained in trauma-informed care. “When people come to treatment, they often have few coping skills to deal with traumatic memories and emotional pain,” says Peters. “Our primary goals are to help them feel safe in the world, manage emotions and situations without substances, and improve their self-esteem and quality of life.”
Trauma-informed dual-diagnosis care begins with a careful assessment. “Every client gets screened for mental health disorders,” says Harmony therapist Gretchen Leezer. “We identify the needs of the patient and establish which ones we can start working on immediately while they are at Harmony and what follow-up treatment they should get once they have been discharged.”
It’s important to address mental health issues as soon as possible, even if the main focus of treatment is the addiction. “When someone comes into addiction treatment with a long history of depression, anxiety, suicidal thoughts, or trauma, we want them to leave here with a roadmap for recovery from all of these difficulties,” says Peters.
Harmony mental health professional Uric Geer likens Harmony’s dual diagnosis approach to a Möbius strip which can be created by taking a paper strip, giving it a half-twist, and then joining the ends of the strip to form a loop. If one side reveals the SUD and the other the mental health disorder, then the twist makes both sides visible whereas a normal paper ring would keep the condition on the inside hidden from view. “If you only treat what’s visible on the outside—the substance use disorder—then an important part of the problem remains hidden and untreated,” says Geer.
The treatment team at Harmony works hard every day to address all relevant needs a client might have. “The culture at Harmony is simply amazing,” says Harmony psychologist Rob Leach. “The leadership has a great vision and the team as a whole is extremely dedicated. They put in great effort to meet clients where they are and develop individual treatment plans. There is great coordination of care. Really listening and meeting clients where they are, creates an atmosphere of trust and that’s crucial for their recovery.”
by Christopher Reveley, MD, and Annie Peters, PhD, LP
The Opioid Epidemic
According to the National Institute on Drug Abuse (NIDA), nearly 100 people die from opioid overdose in the United States every day, and 2.6 million Americans struggle with opioid addiction. The prescribing of opioid pain relievers became much more common in the late 1990s, and it soon became evident that these medications were powerfully addictive. Opioid overdose deaths have increased significantly in the years since. Many of those addicted to heroin started with the abuse of prescription opioids.
Overdose along with the spread of HIV, hepatitis C, and withdrawal syndromes in babies born to addicted mothers constitute a nationwide crisis that has overwhelmed the resources of state and local health care delivery services. Recently, the White House identified the opioid epidemic as a national public health emergency.
How is Harmony Responding to Opioid Epidemic?
Harmony Foundation in Estes Park, CO, has been treating addiction for 48 years and has fostered a generation of long-term recovery support for individuals and families. Harmony’s mission is to provide the foundation for sustained recovery from the diseases of drug and alcohol addiction. Harmony staff is committed to continuous improvement and closely monitors a client experience, treatment response, and the research literature on addiction treatment. In the field of opioid addiction research, advances in behavioral treatment, neurobiology, and brain imaging have given treatment programs guidance in developing better services. Harmony now offers HOPE – Harmony’s Opioid Programming Experience. HOPE is offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.
HOPE: Medical and Clinical Approaches
HOPE begins with thorough medical and psychological evaluations. Collaboration with the client, members of the interdisciplinary team and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly Opiate Support Groups led by a professional addiction counselor. This group addresses the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid rapid relapse. In this setting, clients support each other and are educated about the process of recovery.
Harmony has provided all clients with medication-assisted treatment (MAT) for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce craving, and give the individual time to heal from the psychological, social, and spiritual wounds of addiction.
HOPE clients may choose to avoid medications altogether or use only sleep and anxiety-reducing medications during the acute withdrawal period. For others, naltrexone, an opioid receptor blocker, can prevent the euphoria of opioid use and help control cravings, thereby changing the client’s drive to use illicit opioids after treatment.
This partial opioid agonist, administered in a tapering protocol, may be chosen by the treatment team and client to ease symptoms of severe opioid withdrawal during detoxification. On an individual basis, this medication may be continued during early recovery, most commonly for those with severe and persistent opioid addiction. Care following residential treatment may include ongoing buprenorphine to provide a craving-free foundation for the client as they rebuild damaged interpersonal and work relationships and regain physical and emotional health. The ultimate goal with all treatment approaches is complete abstinence from all opioids.
While some may question how an opioid medication (buprenorphine) can help someone recover from opioid addiction, this treatment approach is supported by organizations such as the World Health Organization, the American Society of Addiction Medicine, the Substance Abuse and Mental Health Services Administration, NIDA, the Veterans’ Administration, NAADAC – the Association for Addiction Professionals, and the National Association of Addiction Treatment Professionals. Due to the number and quality of research studies that have been completed on the use of buprenorphine in treating opioid use disorders, the level of evidence for the effectiveness of buprenorphine treatment is considered to be high (Thomas et al., 2014). Positive outcomes typically include improving retention in treatment and reducing illicit opioid use.
The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.
If you or someone you know is struggling with opiate addiction and needs help right away, Harmony is here to help. Call us at 866-686-7867 and one of our admissions specialists can discuss next steps.
Center for Behavioral Health Statistics and Quality (CBHSQ), 2016. 2015 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Thomas, CP, Fullerton, CA, Montejano, L, Lyman, DR, Dougherty, RH, Daniels, HS, Ghose, SS, & Delphin-Rittmon, ME. Medication-assisted treatment with buprenorphine: Assessing the evidence. Psychiatric services, 65(2), 158-170.
Two new government reports found that there was a sharp increase in emergency room (ER) visits associated with the use of the drug tramadol, HealthDay reports. Tramadol is an opioid narcotic painkiller used for moderate, severe or chronic pain, and is the active ingredient brand-name pain medications, such as Ultram, Ultracet, Conzip and Ryzolt. Between 2005 and 2011, tramadol-related ER visits increased 145 percent.
The drug’s adverse reactions can include seizures and a reaction known as serotonin syndrome, which is potentially fatal, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Mixing tramadol with other drugs can be dangerous as well, especially when used with anti-anxiety medications, alcohol or other narcotic painkillers.
In 2005, there were almost 11,000 ER visits tied to tramadol. In 2009, almost 26,000 people were seen in the ER for tramadol and by 2011 there more than 27,000, according to SAMHSA. The highest increase in ER visits due to tramadol was among adults 55 and older, the article reports. The reports showed that the increase of tramadol-related ER visits was higher among women than among men.
“Tramadol and other pain relievers can help to alleviate pain, but they must be used carefully and in close consultation with a physician,” said SAMHSA Chief Medical Officer, Dr. Elinore McCance-Katz, in an agency news release.
“Like all medications, tramadol can cause adverse reactions, which can be even more severe if the drug is misused. We must all work to lower the risks of taking prescription drugs,” McCance-Katz said.
“Simple steps such as following directions for use, letting your doctor know if you are experiencing a problem, locking up medications for safe storage, and proper disposal of unused medications are easy steps people can take to help reduce potential harm to themselves and others,” she said.
Young adults are increasingly at risk of prescription drug abuse. This has been proven especially true for prescription stimulant drugs like Adderall and Ritalin.
Young adults use these drugs as a study aid or “party aid” because they allow them to stay awake longer. Normally indicated for Attention Deficit Disorder (A.D.D.), Adderall and Ritalin contain amphetamine salts and similar chemical compounds which increase the amount of dopamine circulating in the brain. They help those with A.D.D focus, but give the feeling of hyper-alertness for those without A.D.D.
The number of young adults visiting the emergency room after abusing stimulants has quadrupled over the past 6 years – from 5,600 visits in 2005 to 23,000 in 2011. The Substance Abuse and Mental Health Services Administration (SAMHSA) attributes this rise to young adults having greater access to stimulants. According to their data, in 2011 the majority of young adults had access to stimulants by getting them from friends and relatives.
Peter J. Delany of SAMHSA says the rise is pronounced among those 18-25 years old. Unfortunately, many young adults aren’t aware of the health and legal consequences of abusing stimulants. In many states, possessing just one pill without a prescription is a felony charge and having as few as 5 pills can be considered trafficking.
The health consequences can also be severe – especially when combined with alcohol. Many young adults end up visiting the emergency room with palpitations, severe anxiety, paranoia and heart and blood vessel problems. Some even end up with psychosis after taking too much over an extended period of time and some get alcohol poisoning because stimulants mask the effects of being drunk.
For a young adult, the legal and health consequences can be lifelong. What often starts out as innocent use of stimulants – such as using them during finals at college – can quickly turn into not-so-innocent consequences because of the addictive nature of stimulants.
At Harmony Foundation we understand the consequences of addiction among young adults, which is why we have created special Young Adult Recovery Track. We help bring young adults back from the often-quick downward spiral of prescription drug abuse.
A recent survey from SAMHSA suggests that opioid abuse is on the rise in Western states including Colorado.
About 5 years ago, painkiller addiction reigned in Southern and Appalachian states. The abuse of opiates like OxyContin was well known as “hillbilly heroin” from the high percentage of southerners abusing it. But today states like Colorado, Oregon, Washington and Idaho have among the highest rates of opioid abuse.
For example, according to SAMHSA, as many as 6.5% of Oregon residents abuse opioids and deaths from overdoses climbed 172% between 2004 and 2011. Southern states like Kentucky have seen a reduction in painkiller abuse at 4.5% ranking it at 31 in 2011 compared to 6 in 2009. Many attribute this to policies that were enacted following statistics of opioid abuse. When the statistics were high in the South, there were several efforts made to curb abuse such as creating state task forces to crack down on prescribing privileges of physicians and the enforcement of harsher penalties for illegal possession and using false prescriptions.
The growing rate of opiate abuse in the West is attributed to a greater supply of prescription painkillers from drug trafficking rings and lenient prescribing rights for doctors who operate “pill mills” with limited restrictions. Recent articles have covered incidences of doctors in Nevada and Southern California who are recklessly prescribing large quantities of oxycodone.
The drugs are then transported to neighboring states like Colorado – a state that has seen its fair share of prescription drug overdoses and is working to curb them. For example, Colorado addiction treatment centers have stepped up their specialized programs for those addicted to opioids and the Colorado School of Public Health has created an online course to train prescribers statewide. The course gives healthcare providers guidelines on pain management. According to Alfred Gilchrist, the CEO of the Colorado Medical Society, “The goal of this private-public initiative is to help improve practice, address the epidemic of opioid prescription-associated health problems and improve care.” The course includes training on assessing risk for addiction, using the Prescription Drug Monitoring Program (PDMP) to stop those who engage in “doctor shopping” and other risk reduction practices.
If you or a loved one is struggling with opioid addiction and are seeking addiction treatment for painkillers, Harmony Colorado has affordable addiction treatment programs for men and women suffering from prescription addiction.
Welcome to the Harmony Foundation Recovery Blog. This blog is intended to enhance the recovery process for Harmony alumni and friends through information sharing in an extended fellowship. We know that the correlation between healthy long-term sobriety and participation in the recovery fellowship is very strong. Sobriety is not a solitary activity; it is a community activity. Our 12-step programs are a major source of that community, but experience teaches that we grow spiritually when we extend ourselves beyond our “neighborhood meeting” as well.
The blog will:
- Give Harmony Alumni and friends an opportunity to reach out to the place where it all began, the friends you made here, and the new friends you will make.
- Keep alumni aware of what is new at Harmony, provide information about upcoming events, and help alumni be of service to the community.
- Provide greater community awareness of the disease of addiction and recovery services.
Enhancing our recovery fellowship…
I’m privileged to write this first blog. I am the new Director of our new Harmony Community and Alumni Relations Office (CARO). Our office exists to enhance communication between Harmony and its alumni, provide continued services to our alumni, and to provide greater community awareness of the disease of addiction and recovery services. It is an honor to do this work for this institution and our office takes its obligation very seriously. It is our hope that through this blog, and the many other new alumni and community programs under development, the Harmony community will become larger, stronger, and more helpful than it has ever been.
Our 12th step tells us, “Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics [and addicts], and to practice these principles in all our affairs.” This is the privilege and obligation of all of us. We help others and we enhance our own sobriety when we carry the message. And “we have to give it away in order to keep it.” So this blog, if you will, is your opportunity to live in the joy and fellowship of the 12th step. As it says in the 12 & 12:
The joy of living is the theme of the Twelfth Step, and action is the key word. Here we turn outward toward our fellow alcoholics who are still in distress. Here we experience the kind of giving that asks no rewards. Here we begin to practice all Twelve Steps of the program in our daily lives so that we and those about us may find emotional sobriety. (Twelve Steps and Twelve Traditions p. 106)
We know that recovery is a lifelong journey. While your recovery may have begun at Harmony, it continues and grows wherever you are. Recently, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) adopted a new working definition of recovery that recognizes this and the value of community relations in the process, as follows:
Recovery is a process of change whereby individuals work to improve their own health and wellness and to live a meaningful life in a community of their choice while striving to achieve their full potential. Principles of Recovery:
- Occurs via many pathways;
- Is holistic;
- Is supported by peers;
- Is supported through relationships;
- Is culturally-based and influenced;
- Is supported by addressing trauma;
- Involves individual, family, and community strengths and responsibility;
- Is based on respect; and
- Emerges from hope.
Harmony Foundation shares this belief and welcomes SAMHSA’s new definition as an affirmation of the treatment field’s work, and as motivation for our continued support of one another. We believe we have a greater opportunity than has ever existed to provide a foundation for lifelong recovery and to continue to support one another as we leave treatment and begin our lives in recovery.
Clear away the wreckage of your past. Give freely of what you find and join us. We shall be with you in the Fellowship of the Spirit, and you will surely meet some of us as you trudge the road of Happy Destiny. May God bless and keep you until then. (Alcoholics Anonymous, p. 164)
We would be honored if you would subscribe to our blog and we welcome your comments.
Won’t you join us?
Marvin Ventrell, JD is the Director of CARO – the Community and Alumni Relations Office at Harmony Foundation. CARO’s function is to support Harmony Alumni in the recovery process post-treatment. CARO also works to educate the public on the disease of addiction and Harmony’s services. Marvin believes his work at Harmony is the culmination of a lifelong journey of professional service. During his 27-year career, he has been an attorney, a public interest association director, and a teacher. He is the author of two books and numerous professional journal articles. His career has been dedicated to advocating for children and families in crisis and developing institutional systems to address community needs. He previously served as CEO of the National Association of Counsel for Children and the Juvenile Law Society. He is a recipient of the University of Colorado Kempe Award and the American Bar Association Child Advocacy Award, and is a Bar Fellow Emeritus of the Colorado Bar Foundation.