Recovery Coach Training at Harmony

Recovery coaches can be a crucial element in a recovery journey. They may not offer primary treatment for addiction, do not diagnose, and are not associated with any particular recovery method. But they offer critical support and facilitate positive change—especially in early recovery.

“Our job is to promote recovery; it’s about being recovery positive,” says recovery coach Michael Maassel, the Director of Alumni and Recovery Support Services at Harmony Foundation. “A recovery coach is that sweet spot between a therapist and a sponsor because we have training but do not require a license. We’re trained to operate on a peer-to-peer level.”

According to addiction expert William White, recovery coaches provide:

Emotional support: demonstrations of empathy, love, caring, and concern in such activities as peer mentoring and recovery coaching, as well as in recovery support groups.

Informational support: provision of health and wellness information; educational assistance; and help in acquiring new skills, ranging from life skills to skills in employment readiness and citizenship restoration.

Instrumental support: concrete assistance in task accomplishment, especially with stressful or unpleasant tasks such as filling out applications and obtaining entitlements, providing child care, or providing transportation to support-group meetings and clothing assistance outlets.

Companionship: helping people in early recovery feel connected and enjoy being with others, especially in recreational activities in alcohol- and drug-free environments. This assistance is particularly crucial in early recovery when little about abstaining from alcohol or drugs is reinforcing.

 Similarly, Michael Maassel lists four main tasks for recovery coaches:

  • Promote recovery
  • Remove barriers
  • Connect people with support services
  • Encourage hope, optimism, and healthy living

Being recovery positive means convincing people that “recovery is great, that it allows you to be present so that people with addiction are actually convinced that they could live a sober life,” she says. It’s a cheerleading function: people with addiction frequently need to be persuaded that recovery is really worth it, that sobriety is more appealing than active addiction, i.e., misusing drugs and alcohol.

The second task of the recovery coach is removing barriers. “This is huge,” says Maassel. “Somebody comes to you saying ‘I can’t get sober,’ or ‘I don’t have people who believe in me,’ or ‘I live at this end of town, how am I supposed to get to the other end of town?’ Recovery coaches make it happen: ‘You don’t have a car, let’s get you a bus pass. You have money but no ride, let’s get you an Uber.’ Or we help them get involved in a group that can help them to get from point A to B.”

Recovery coaches listen with empathy and without judgment. “If they say ‘I can’t get sober,’ we ask them why they think that. Maybe they feel they have to do it a certain way because that’s what they have been told. Then it is for us to open their eyes and let them know that there’s not just one way to recovery. So, we’re removing that particular barrier.”

Recovery coaches try to remove roadblocks as much as they can. “If they say ‘I don’t have anybody to support me,’ we say, ‘You already have one person. I support you!’ But we also make sure we are not the only support avenue.

“We connect people with recovery support services, build up their resource bank, their recovery capital, their toolbox. We let them know it’s not just us they can rely on. We connect them with whatever services they may need or prefer, whether that’s 12-Step facilitation such as AA or NA, SMART Recovery, Recovery Dharma, or residential treatment.”

“We don’t want them to be singularly dependent on just one avenue because what happens if that avenue goes away,” explains Maassel. “We’re about diversifying their recovery. If something goes wrong with one avenue, they still have others. They should have no reason to say ‘no’ to their recovery.”

And finally, recovery coaches encourage hope, optimism, and healthy living. “Sometimes, a recovery coach may be the only person that gives them that hope. Recovery is a journey—there is no destination to reach—and it’s our job to move them forward. It can be a tough journey, and when they are down and out at times, it’s up to us to be there and support them.”

If you are interested in helping people sustain their recovery from addiction, Harmony Foundation is offering training for recovery coaches.

Who can be a recovery coach?

  • Credentialed addiction professionals
  • Treatment center support staff, volunteers, and alumni
  • Staff from behavioral health and government agencies
  • Representatives from inpatient and outpatient centers and sober living homes
  • Individuals, family members, and advocates of recovery

The CCAR Recovery Coach Academy© is a 4-day intensive training program focusing on providing participants with the skills needed to guide, mentor, and support anyone who would like to enter into or sustain long-term recovery from an addiction to alcohol or drugs. The next program is scheduled to begin on August 5th, 2021.

The Importance of Engaging Families in Recovery

Addiction is a family disease, making it also a disease of relationships.

In a recent webinar, Harmony Foundation family therapist Morgan Roy explained the impact of addiction on the family dynamic. Family engagement plays a vital role in recovery for the individual and the family system.

Family engagement is not an easy task as all family systems are different but one rule always applies: Everybody in the family system is deeply affected by the behavior of the addicted individual. Roy likened the “ripple effect” of addiction to the break shot in eightball pool billiards where the cue ball impacts all other balls on the table.

“Families need to recover, too,” said Roy, “and family support increases the likelihood of successful treatment, it can improve psychiatric symptoms, and help prevent a relapse.”

Addiction strains the relationships in the family no matter which member is the addicted person. “It doesn’t matter if it’s a parent, child, spouse, or sibling,” said Roy. “Every member of the family system struggles. Living with someone in active addiction is a daily challenge for everyone in the home.”

Roy emphasized the importance of systemic thinking. “All parts of the system are inter-connected and inter-related. If one part of the system changes, the other parts must change to accommodate those changes.”

The good news is that small, feasible changes can lead to big improvements. “Small changes lead to bigger changes,” explained Roy.

The key is family engagement and education. When families learn about the disease of addiction while their loved one is in treatment, “they are able to see that they are not alone in this process.” Knowledge is power for families. “When their person returns home from treatment, they will be able to meet them where they are at” and “there is a deeper understanding for what is happening in their person’s world.”

Family members typically have many questions:

  • How do I help my family member?
  • What do I do when my person comes home?
  • Is there more that I can do?
  • How do I trust them again?
  • How do we start over?
  • Could I have done more?

These are all important questions and they can be addressed in our family program. Families also learn the three Cs: They didn’t CAUSE the addiction, they cannot CURE it, and they cannot CONTROL it.

But Family members can SUPPORT their loved one by engaging with their own recovery plan and meet the person with the addiction where they are at rather than clinging to overly ambitious expectations. There is no cause for pessimism: families with addiction are “not broken but breaking through,” Morgan Roy told the participants of the webinar.

Due to the COVID-19 pandemic, Harmony is currently offering a modified family engagement workshop that is available to all families of current and former clients. This virtual education group has two goals. The first is to provide education to family members about the disease model of addiction and how it can help them come to understand their loved one’s condition.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

CDC Reports Alarming Surge in Overdose Deaths and Polysubstance Use

2020 is expected to have been another catastrophic year in the American addiction epidemic. There had been cautious optimism after drug overdose deaths had finally decreased slightly in 2018 only to peak again at 70,630 in 2019.

But that was before the COVID-19 pandemic hit the nation. Social isolation, fear of infection, and financial hardship seem to have resulted in a significant increase in substance misuse—with devastating consequences. The latest preliminary data released by the Centers for Disease Control and Prevention (CDC) show an alarming 29 percent rise in overdose deaths from October 2019 through September 2020—the most recent data available—compared with the previous 12-month period. According to the CDC data, more than 87,000 Americans died of drug overdoses over the 12-month period that ended in September, with a predicted number of deaths exceeding 90,000 for the first time.

“Illicitly manufactured fentanyl and other synthetic opioids were the primary drivers, although many fatal overdoses have also involved stimulant drugs, particularly methamphetamine,” reported Abby Goodnough in The New York Times.

Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) confirmed the trend at a recent national conference, saying that more deaths than ever involved drug combinations, typically of fentanyl or heroin with stimulants.

“Dealers are lacing these non-opioid drugs with cheaper, yet potent, opioids to make a larger profit,” she said. “Someone who’s addicted to a stimulant drug like cocaine or methamphetamine is not tolerant to opioids, which means they are going to be at high risk of overdose if they get a stimulant drug that’s laced with an opioid-like fentanyl.”

Polysubstance use, the consumption of more than one drug over a defined period, simultaneously or at different times—inadvertently or deliberately—is extremely dangerous. Mixing opioids like heroin or prescription painkillers like oxycodone with alcoholic beverages or stimulants like cocaine and methamphetamine can also be lethal.

A 2020 study published in the Journal of Substance Abuse Treatment warned that “polysubstance use is common in hospitalized patients with substance use disorders and identifying patterns of polysubstance use can guide clinical management. Hospital providers should prepare to manage polysubstance use during hospitalization and hospitals should broaden care beyond interventions for opioid use disorder.”

The CDC reported that “in 2019, 76 percent of cocaine-involved overdose deaths in the US also involved opioids, punctuating a trend dating back to 2009 that saw overdose deaths involving cocaine and opioids increase at a faster pace than overdose deaths involving cocaine alone.”

“Researchers also found that from 2009 to 2016, overdose deaths involving psychostimulants (such as methamphetamine, amphetamine, and methylphenidate) but no opioids was higher than the rate of deaths involving both drugs, but the pattern reversed from 2017 to 2019, with overdose deaths involving both now outpacing deaths involving only psychostimulants,” reported Tom Valentino in Addiction Professional.

“Rates of co-involvement of opioids in drug overdose deaths involving cocaine and psychostimulants were found to vary by region across the US, hitting the Northeast region of the country hardest in 2019,” wrote Valentino. “Overall in the US, 76 percent of the 15,883 drug overdose deaths that involved cocaine also involved at least one opioid, but 83.1 percent of cocaine-involved deaths also involved one or more opioids in the Northeast. Meanwhile, 63 percent of cocaine overdose deaths in the West involved at least one opioid, the lowest rate of any region.”

Misusing more than one drug concurrently can also complicate addiction treatment and recovery. Drugs taken in combination can boost the narcotic effects of the substances in unforeseeable ways. Their toxic effects increase and withdrawal symptoms become more severe and prolonged.

Harmony Foundation is one of the longest-running and most successful addiction treatment centers in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

How the Great Outdoors Can Boost Your Recovery

Nestled on a 43-acre campus in the Rocky Mountains just outside of Estes Park, Colorado, Harmony Foundation is one of the longest-running and most successful drug and alcohol addiction treatment centers in the world. Throughout its history, Harmony has been able to utilize its proximity to nature in the healing process.

“Outdoor therapy for people in addiction recovery is the idea that spending time in the outdoors can offer the benefit of a new outlet for self-discovery,” Roy DuPrez, founder of Back2Basics Outdoor Adventure Recovery, recently wrote on Addiction Professional. “If a person is suffering from addiction, outdoor therapy is another tool on the path to recovery. Although spending time outdoors won’t cure a substance use disorder on its own, making the effort to spend more time in nature offers some important benefits for people in recovery.”

Connecting with nature is a powerful weapon in the battle against addiction. In his 2018 book, Lost Connections, British writer and journalist Johann Hari argues that depression and anxiety—important comorbidities for substance use disorder (SUD)—are primarily driven by nine disconnections, including being disconnected from other people, meaningful values, and from the natural world. It follows that if people with depression, anxiety, and/or addiction re-connect with people and the natural world, their chance of healing improves.

DuPrez agrees. “Recovery requires a multifaceted approach focusing on a person’s mental, physical, and emotional health. By spending time in the outdoors, holistic benefits include: reduced depression, improved physical fitness, better sleep, enhanced cognitive function, opportunities to build relationships, and decreased risk of relapse.”

When people are surrounded by a natural environment they process stress differently, making the task more manageable. Being in nature shields people from the many over-stimulating, anxiety-inducing situations in our busy modern world.

“Combating boredom is another major issue for individuals in recovery and is a common cause of relapse. Boredom can be combated by starting a new outdoor hobby. Skiing, mountain biking, hiking, fishing, and photography are all great ways to get outside. Once a person has begun getting out in nature, they will begin feeling less anxious and less stressed. Stress reduction is part of the outdoor experience.”

A major reason for that stress reduction is the spiritual dimension of the great outdoors. Wilderness is able to teach people a healthy sense of humility while intuitively affirming their place in the universe. Connecting with nature is “a great conduit to giving up the notion of being in charge,” says Harmony’s spiritual advisor, Bill Myers. “You’re humbled by nature, and it’s true humility through connection, rather than separateness through humiliation. Most people with addiction have plenty of experience with humiliation but not true humility. It is a release of the ego that is not a diminishment, not an absence but a connection to something.”

Myers likes to investigate with his clients how we are connected to powers beyond ourselves. “It helps us understand our rightful place in the world,” he says. “Instead of thinking ‘I’m in charge of my life, and I’m charging ahead doing all these things,’ we get to see how we are connected.”

Harmony Foundation is a dual-diagnosis-capable facility serving patients with SUD and co-occurring mental health disorders. Clients who are diagnosed with mental health issues—such as anxiety, depression, and other trauma-related responses—will meet with our mental health and medical staff to address medication management. We work with our clients to teach them healthy coping skills to help them manage their co-occurring issues.

Despite difficult circumstances, Harmony continues to serve patients during the COVID-19 pandemic and we are taking extra precautions to ensure staff and client safety. If you or a loved one are struggling with alcohol or drug addiction do not delay seeking treatment. If you have questions about our programs, call us at 970.432.8075 to get the help needed as soon as possible.

When Easier is Not the Better Option

Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
(Robert Frost, 1916)

Recovery from addiction is one of the hardest things a person can do and there are really no shortcuts. The addicted person has to put in the work. Recovery can be difficult emotionally, socially, and neurologically, even with the support of the most compassionate therapists and the most sophisticated addiction treatment program.

And although recovery may be the road less traveled, it is the more rewarding one, leading to a purposeful, more fulfilling life.

However, if someone is “drowning in addiction” they have to be willing to make the effort to swim to get better—and that can be hard. “Sobriety and recovery is a daily practice,” wrote Michael Maassel, Harmony’s director of alumni and recovery support services, in Drowning in Addiction: A Personal Guide to Recovery. “Transformation requires work, tending, weeding, and more action… Recovery is about taking ownership of your life and choosing to no longer be the victim, but the victor.”

Many people with addiction were desperately trying to numb their emotional pain by engaging in substance misuse and then were trapped in a hellish addiction cycle that only made that pain worse. Recovering from this disease involves hard work and difficult changes. Patients have to give up their maladaptive coping mechanisms—drugs and alcohol—and substitute them with healthy coping skills but that requires some adjustments.

“Change is hard for some of us,” reminded Maassel her listeners on her weekly podcast at the end of  2020. Change—even change for the better—is often an uncomfortable process while sticking with “the devil you know” can seem the easier less troublesome option.

“Willingness to open up and be accountable” is key, said Maassel’s guest on episode 33, health coach Sage Burmeister. “Change is the flow of the universe, don’t get stuck in one place” just because it seems the easier option. Fortunately, help is always available, you just have to look for it. “Community is the biggest support for change,” said Burmeister.

Taking on hard challenges is difficult for everybody, too many people continue with an unsatisfactory situation simply because changing it seems too much trouble. “Every day, we have countless opportunities to take the easiest, yet least satisfying road,” wrote Lori Deschene on Tiny Buddha. “We can turn to the things that comfort and numb us instead of acknowledging the things we want to change. We can do what comes naturally instead of recognizing and honoring what we do passionately. We can justify the path of least resistance by ignoring our strongest instincts.”

So often, we’re cheating ourselves by choosing the easy way out. But slacking off can be dangerous for people with addiction as recovery requires focus and the willingness to work on getting better every day. There are many healthy routines like meditation and breathwork that can help you be present and show up for yourself. You just have to do it.

Recovery may not be easy but it is always possible. If you or a loved one is struggling with substance use disorder, or you have questions about our programs, call Harmony today at (970) 432-8075 to get the help needed as soon as possible.

Misuse of Anti-Diarrhea Drug Loperamide Still Rising

People with opioid use disorder (OUD) sometimes attempt to ease withdrawal symptoms by misusing a common over-the-counter medication: loperamide, a drug that helps control symptoms of diarrhea and is widely sold under the brand name Imodium.
Loperamide counteracts diarrhea by slowing the contractions of the intestines. But since its chemical structure resembles an opioid, it can induce euphoric brain effects if consumed in extraordinarily large amounts. In addition to uncomfortable constipation, it can be toxic and lead to serious heart conditions, ileus (paralysis of the intestine), and addiction.
2016 study confirmed that loperamide is misused by people attempting to self-medicate their opioid addiction, sometimes with fatal results. “Loperamide’s accessibility, low cost, over-the-counter legal status, and lack of social stigma all contribute to its potential for abuse,” said lead author William Eggleston, PharmD, of the Upstate New York Poison Center, in Syracuse, NY.
In September 2019, the US Food and Drug Administration (FDA) announced approved package size and package type limits for over-the-counter brand-name tablet and capsule forms of loperamide to address the misuse issue by limiting each carton to no more than 48 mg of loperamide and requiring unit-dose blister packaging.
“Abuse of loperamide continues in the United States, and taking higher than recommended doses can cause serious heart problems that can lead to death,” reported then Acting FDA Commissioner Ned Sharpless, M.D. in 2019. “The FDA has worked with manufacturers to approve package size limitations and unit-dose packaging for certain over-the-counter loperamide products. These changes are intended to increase the safe use of loperamide products without limiting over-the-counter access for consumers who use these products for their approved uses at the approved dose, according to labeling.”
The FDA requested that online distributors take voluntary steps to help reduce the risks of loperamide abuse and misuse by not selling more than one package of these drugs to each customer.
Apparently, these measures have been ineffective. “Between 2010 and 2015, the National Poison Data System showed a 91 percent increase in loperamide overdoses,” wrote Bryan Paul Negrini, M.D. recently on Addiction Professional.  “A 2019 study from Rutgers University confirmed that loperamide overdoses have gone up over the last few years, and a 2020 study from QJM: An International Journal of Medicine has also confirmed that non-medical misuse of Loperamide is common.”
Dr. Negrini tested the progress of the FDA’s packaging efforts by sending his 16-year-old son to a couple of pharmacies “with $50 to purchase as many Imodium tablets as he could. In both cases, he came out with boxes of hundreds of tablets and was never asked why such a young kid needed so many Imodium tablets.”
The dangers of loperamide misuse are very real. One of Dr. Negrini’s patients recently died a few days after he first saw him. He had been using the opioids “heroin and fentanyl on and off for at least a decade and had additionally started misusing Imodium.” His autopsy report attributed the death to “drug poisoning with loperamide.”
Opioid use disorder is a serious condition, requiring comprehensive professional treatment and should not be self-treated using medications such as Loperamide. “We have not seen active use of Loperamide on admission at Harmony, however, we have protocols in place to educate our clients about the impact this drug has in response to opioid addiction and use other more appropriate medications to help with the detox process,” says Harmony’s medical director Michael Rountree, M.D.
As one treatment option, Harmony offers HOPE – Harmony’s Opioid Programming Experience. HOPE is offered to all Harmony patients with OUD. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these patients’ needs.
HOPE begins with thorough medical and psychological evaluations. Collaboration with the patient, 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 specific challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse.
Despite difficult circumstances, Harmony continues to serve patients during the COVID-19 pandemic and we are taking extra precautions to ensure staff and client safety. If you or a loved one are struggling with alcohol or drug addiction do not delay seeking treatment. If you have questions about our programs, call us at 970.432.8075 to get the help needed as soon as possible.


Reconnecting in Recovery

The opposite of addiction is connection it has been said. In one of the most popular TED Talks, addiction and mental health journalist Johann Hari discussed the underlying causes of addiction and famously concluded that the opposite of addiction is not sobriety but connection. Elsewhere, Hari suggested that depression is largely driven by lost connections.
Hari’s statement “echoes a theme that I and many 21st century addiction specialists have espoused for years,” wrote Robert Weiss on Psychology Today in 2015. “Addiction is not about the pleasurable effects of substances, it’s about the user’s inability to connect in healthy ways with other human beings.”
For many addiction professionals, it’s also about the inability to connect with something greater than ourselves—something much more intangible than human affairs. Strangely enough, finding one’s spiritual path and connecting with a higher power starts with reconnecting with yourself.
In active addiction, “we are not accustomed to inhabiting our bodies,” says Harmony’s spiritual advisor, Bill Myers. An active poet, teacher, and tireless “explorer of the spirit,” Bill is a friend to all faiths and spiritual traditions. Addicted people focus primarily on the next fix, he says, with little regard for their emotional or spiritual selves.
In treatment, they “come out of detox, alert in a way they haven’t been in quite a while.” This change can be fairly daunting, so Bill usually begins the process of reconnection in small increments. “I like to start by saying ‘let’s stay in our body, let’s re-embody ourselves.’ It’s simple things like going outside and putting feet on the ground, breathing the fresh air. What happens if we just close our eyes and listen?”
Reconnecting with your physical body and mindfully experiencing your environment without distraction is something many people with substance use disorder haven’t done since they were kids. Learning to be present takes practice and Bill doesn’t want to overwhelm patients.
“It could just take five minutes of quiet first thing in the morning,” says Bill. “Nowadays, many of us are used to reaching for the iPhone as soon as they wake up.” Maybe, they should try quiet meditation to connect with their spirituality instead of starting the day with relentless stimulus.
“That’s what clients can do here at Harmony after detox, even before they get out of bed. You don’t need a special place, just lay there and be present,” recommends Bill. The impulsivity and obsessive behavior of addiction are notoriously difficult to break. “That’s why I say, ‘start really small’ with only five minutes but stick with it. If we go for 30 minutes of yoga and meditation right away, we tend to fail quickly and get discouraged.”
Frustration and aggravation are not always easy to handle in recovery and pose a relapse

The Importance of Engaging Families in Recovery

*This presentation is no longer eligible for the 1 CE credit*

This workshop will focus on why family engagement is a vital role in recovery for the individual and the family system, how COVID has impacted family support, and the tools used today in 2021 to keep families engaged in their own recovery work.

Presented by:
Morgan Roy, MA, MFTC
Family Therapist – Harmony Foundation, Inc.

Morgan Roy has a Bachelor of Science in Applied Psychology with a specialization in Positive Psychology and a Masters in Marriage and Family Therapy from Regis University. Morgan has extensive experience working with family systems, couples, young adults, and adolescents. Morgan has training and education in Gottman Method couples therapy and is currently Level 2 certified and a certified leader of The Seven Principles of Making Marriage Work.

The Persistent Stigma of Addiction

One of the biggest barriers to going into recovery from a substance use disorder (SUD) is stigmatization. Although now widely described as a chronic disease, addiction still carries a significant stigma for patients—even among healthcare professionals.

“Stigma on the part of healthcare providers who tacitly see a patient’s drug or alcohol problem as their own fault leads to substandard care or even to rejecting individuals seeking treatment,” warned the director of the National Institute on Drug Abuse (NIDA), Nora Volkow, M.D., on her blog in 2020. “People showing signs of acute intoxication or withdrawal symptoms are sometimes expelled from emergency rooms by staff fearful of their behavior or assuming they are only seeking drugs. People with addiction internalize this stigma, feeling shame and refusing to seek treatment as a result.” Health conditions ranging from cancer and AIDS to many mental illnesses may lead to some people avoiding those patients but addicted individuals are all too often actually blamed for their disease, “even though medicine long ago reached a consensus that addiction is a complex brain disorder with behavioral components,” as Dr. Volkow points out. But too many Americans, including many in the healthcare sector and the justice system, continue to view addiction as the consequence of moral weakness and flawed character.

Sean Fogler—a physician in recovery himself—encountered this prejudice firsthand.

“The stigma of addiction comes from the negative feelings that many healthcare professionals harbor for people struggling with substance use disorders, and their beliefs that poor personal choices, ‘moral failing,’ and defects of character are to blame for the disease. These feelings and beliefs mirror those of the general public,” wrote Fogler on Stat News in 2020.

Although they should know better, healthcare workers may actually shame people with addictions more than others do, according to Fogler. “A recent study exploring emergency physicians’ attitudes toward patients with substance use disorders found that the majority had lower regard for patients with substance use disorders than for patients with other conditions affecting behavioral health. Among physicians participating in the survey, only 10 percent agreed that they ‘enjoy giving extra time to patients like this.’ These physicians found it more rewarding to treat patients with obesity, diabetes, trauma, and even those with COPD who smoke.”

This is an unfortunate situation because addiction continues to be a significant health crisis in the United States and emergency departments can play an important role in referring SUD patients to appropriate treatment programs. For example, ERs could implement a screening process called SBIRT (screening, brief intervention, and referral to treatment). SBIRT can be performed in a variety of settings and does not have to be performed by a physician. SBIRT incorporates screening for all types of substance use with brief, tailored feedback, and advice. Simple feedback on risky behavior without judging can be a powerful impetus for changing patient behavior and engaging them with treatment programs.

“No one chooses to develop this disease,” explains the American Society of Addiction Medicine (ASAM). “Instead, a combination of genetic predisposition and environmental stimulus—analogous to other chronic diseases like diabetes and hypertension—can result in physical changes to the brain’s circuitry, which lead to tolerance, cravings, and the characteristic compulsive and destructive behaviors of addiction that are such a large public health burden for our nation.”

Stigmatizing people with addiction as morally derelict on the other hand is counterproductive and unprofessional.

“Stigma violates the right of people with addictions to be human, strips us of our dignity, and says to us that we have no value,” writes Fogler. “It evokes feelings of shame so deep they are hard to know unless you’ve experienced them. This isn’t the kind of shame that guides us or tells us we’ve made a mistake. It’s toxic shame, the shame that tells us we are the mistake—something those of us with this disease come to believe.”

Shaming and punishment are detrimental and will not address the needs of the patient or promote recovery. Addiction is a complex biopsychosocial disease requiring comprehensive evidence-based treatment methods. Many people with addiction misuse substances in an attempt to self-medicate underlying mood disorders.

Harmony Foundation is a dual-diagnosis-capable facility serving patients with SUD and co-occurring mental health disorders. Clients who are diagnosed with mental health issues—such as anxiety, depression, and other trauma-related responses—will meet with our mental health and medical staff to address medication management. We work with our clients to teach them healthy coping skills to help them manage their co-occurring issues.

Despite difficult circumstances, Harmony continues to serve patients during the COVID-19 pandemic and we are taking extra precautions to ensure staff and client safety. If you or a loved one are struggling with alcohol or drug addiction do not delay seeking treatment. If you have questions about our programs, call us at 970.432.8075 to get the help needed as soon as possible.

Wellbriety: Cultural Approaches to Treating Trauma and Addiction in Native Americans

Although the Native American population of the United States remains relatively small compared to other ethnic groups, indigenous people struggle disproportionately with a vast range of health and social issues—including substance misuse.

In 2018, Randall Swaim and Linda Stanley tracked rates of substance use among American Indian adolescents attending schools on or near reservations since 1974 and found that “American Indian adolescents have consistently reported the highest levels of substance use compared with other US racial/ethnic groups.”

Swaim and Stanley found that lifetime and last-30-day substance use rates and relative risk were significantly higher for nearly all substances among American Indian youths.

“The harm associated with high rates of use and early initiation for American Indian youths includes increasing rates of use in early and later adulthood, higher risk of developing a substance use disorder, and more alcohol-related problems, including alcohol-attributable death. Furthermore, American Indian and Alaska Native youths are more likely to need treatment for a substance use problem than all other US racial/ethnic groups.”

In a recent presentation for Harmony Foundation, Don Coyhis, the founder and president of White Bison—a nonprofit company dedicated to creating and sustaining a grassroots “Wellbriety” movement that provides culturally based healing for indigenous people—explained the historical background of this addiction crisis and pointed out culturally specific ways to tackle it.

According to the White Bison vision statement, “Wellbriety means to be sober and well. Wellbriety teaches that we must find sobriety from addictions to alcohol and other drugs and recover from the harmful effects of drugs and alcohol on individuals, families, and whole communities. The ‘Well’ part of Wellbriety is the inspiration to go on beyond sobriety and recovery, committing to a life of wellness and healing everyday.”

As in many cases of substance use disorder (SUD), trauma plays a crucial role. Many studies have shown a link between exposure to traumatic experiences and substance use disorder. SUDs are highly comorbid with PTSD and other mood-related conditions, such as anxiety and depression.

In the case of Native Americans, entire communities have been traumatized by a dramatic loss of their culture and forced assimilation. Don Coyhis blames the infamous boarding schools of the 19th and 20th centuries in particular.

Between the 1870s and 1960s, over 100,000 Native American children were sent to nearly 500 boarding schools across the United States. They were largely modeled after the flagship United States Indian Industrial School in Carlisle, Pennsylvania, founded in 1879.

Officially justified as a path for Native Americans to achieve equality with European-Americans by immersing students into mainstream American culture, Carlisle and similar schools remain deeply controversial today as they forced children to leave their families at young ages and give up their indigenous cultures, languages, religious and spiritual beliefs, and even their names, thus traumatizing generations of Native people.

The boarding schools unleashed “seven generations of intergenerational trauma,” says Coyhis. The traumatic experience of the boarding schools did not only affect individual students but also their descendants to this day. There are now strong indications that trauma can be passed on genetically to subsequent generations.

“Today the hypothesis that an individual’s experience might alter the cells and behavior of their children and grandchildren has become widely accepted,” wrote Andrew Curry in Science in 2019.  “In animals, exposure to stress, cold, or high-fat diets has been shown to trigger metabolic changes in later generations. And small studies in humans exposed to traumatic conditions—among them the children of Holocaust survivors—suggest subtle biological and health changes in their children.”

For Coyhis, the unresolved grief over the attempted eradication of Native culture is behind the many problems plaguing indigenous communities today. Before the boarding school system disrupted native lives, spirituality, ceremonies, native languages, and cultural values conveyed by tribal elders sustained traditional social structures.

The boarding school period destroyed those structures and instead laid a foundation of anger, guilt, shame, and fear leading to substance misuse, mental illness, suicide, sexual and child abuse. “Many thousand Native Americans grew up with early childhood trauma,” said Coyhis. “This led to lateral violence and addiction.”

Healing begins with understanding the past and reconnecting with the indigenous value system. The Wellbriety method is about re-engaging with a Native worldview focused on harmony with the Earth. Understanding the historical trauma can be seen as the first step for Native Americans to break the cycle of anger, shame, substance misuse, and violence.

They need to process the loss of their culture, their land, their language, and basically their entire way of life. To heal this trauma, White Bison’s Wellbriety offers four directions of healing to counter intergenerational trauma, jealousy (family rivalries), early childhood trauma, and unresolved grief. “There is so much death in our communities,” said Coyhis, “and not only from old age.”

Intergenerational trauma has to be treated with intergenerational healing, “a combination of immense healing, community training, and a return to the ceremonies, spirituality, and the cultural ways of our people” by bringing back:

  • Culture
  • Language
  • Land
  • The people’s physical, emotional, mental, and spiritual health
  • Religion

This reversal is based on the traditional indigenous worldview of four elemental concepts at the cardinal directions: Fire (white) in the north, the land (red) in the east, air (yellow) in the south, and water (black) in the west. Each cardinal point represents important teachings for Native Americans. Walking the “Red Road” of healing involves finding the Creator (red), finding your Self (yellow), finding your relatives (black), and finding the wisdom of the elders (white).

This traditional indigenous philosophy was renewed at a meeting of elders in the early 1990s which predicted a time of healing in the future, explained Coyhis. It was prophesied that the healing time would come when an eagle lands on the moon. When the elders heard Neil Armstrong reporting from the lunar surface in 1969 that “the Eagle has landed,” they took that to mean that the healing time would begin.

Another vision saw a spider build a web all around the globe and a woman would come to speak on the web and she would be heard around the world. The launch of the world wide web on the internet in the 1990s is considered to be the fulfillment of that prophecy.

These native visions counter trauma and despair with belonging and hope. “The Sacred Hoop can bring the four directions together, allowing for forgiving the unforgivable, unity, healing, and hope,” said Coyhis. Only this kind of holistic approach can break the cycle of intergenerational trauma.

Harmony has long utilized a holistic approach to healing trauma and addiction as well. Realizing that addiction is a biopsychosocial and spiritual disease, Harmony’s treatment program promotes physical, emotional, and spiritual healing, empowering patients to embark upon a lifelong journey of recovery.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at 970.432.8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, 7 days a week