We want to thank Dr. James DiReda for offering another excellent guest post for us! Dr. DiReda has over twenty years experience working with individuals, families, and organizations to address alcohol, drug, and mental health issues. He holds a dual Ph.D. in Sociology and Social Work from Boston University. He is currently Director of Counseling and teaches at Clark University in Worcester, MA.

The Beast We Call Progression

Within the self-help network, the treatment delivery system, and prevention world, addiction is known as a “life-threatening progressive condition” that worsens if it goes untreated. We hear about it, and read about it all the time. However, when it looks you in the eye it becomes so much more real. I attended a function last night, and while there, saw a former client of mine who had “dropped out” of treatment somewhat abruptly about a year ago. When I met him he was employed at a long-held job, had a very charming young wife, and a newborn baby son.

I’ll call this client “Nick,” although not his real name. So Nick came to see me because he was struggling with a Percodan habit that he just couldn’t manage any longer. It was starting to cause real problems for him at his job, at home, financially, and internally. He was caught up in the obsessive aspect of addiction, and couldn’t seem to break free from it.

It clouded and tainted everything good in his life, and he wanted to stop. Ironically, he was one of those individuals that didn’t present with a long history of drug use that grew into a dependence on prescription pain meds. He had injured his back and was prescribed Percodan to alleviate his pain. It doesn’t take long to become addicted to a drug as strong as Percodan, and he was no exception. It soon consumed him and every waking moment of his life was spent thinking about getting more. He was addicted. So I saw him for about six months, and tried to help him to stop using the drug, which he could never seem to do. He could “white-knuckle” out a day or possibly two, but he always relapsed, until he finally disappeared.

Seeing him last night was a total surprise, but felt good. During our conversation he laid out his “progression,” which sounded almost textbook to me. We went right down the line as I asked him about work, he lost the job; wife, she had thrown him out; newborn, he sees him as his former wife allows; living arrangement, he’s back living with Mom and broke. So, that sums up the “progression” of addiction for anyone wondering what that term means.

Basically, it means that a person’s drug or alcohol use will wipe out anything good or positive in that person’s life if their condition goes untreated. Interestingly enough though, Nick had never told me about alcohol being a problem for him while I was seeing him, but last night he told me that he had pretty much stopped using the Percodan but couldn’t stop drinking and relapsing with alcohol. He also said that alcohol had pretty much always been a problem for him, but he never realized it until he quit the prescription drugs and went “crazy” with the drinking.

Nick’s story emphasizes the importance of us being aware that addiction is addiction, and whether it’s addiction to alcohol or Percodan or Cocaine, it is still a “life-threatening, progressive condition” that, if goes untreated, will worsen and take everything a person is willing to give, including their life.

Steve Miranda is Treatment Solutions Network’s Director of Special Projects, Steve recently retired from the Massachusetts Department of Corrections where he spent 22 years of his life pioneering new programs and saving lives as the Director of their Employee Assistance Program (EAP). That program services 5,200 employees, family members and retirees. As a loyal member of the Massachusetts Correction Officers Federated Union (MCOFU), Steve understands the needs of people who are affected by addiction. Steve is also passionate about helping others. Feel free to contact him anytime if you have any questions or know someone who may need help with an addiction problem. You may contact him at stevem @ tsnemail.com or by phone at (508) 525-5974.

Let me start by saying that I love my line of work, but if I hadn’t lost my own brother to addiction, I’m not positive that I would have been this passionate about not only helping addicts, but also helping their families. I currently work for Treatment Solutions Network, who in my opinion has the absolute best approach to working with addiction in the workplace and addiction period. I feel confident saying this because I’ve worked in this field for many years and seen firsthand how to lead addicts along a better path and unfortunately, I’ve also seen companies lead addicts right out the door without even a chance. Treatment Solutions Network fights for every individual to get well, which is why I wanted to become part of their team.

Now, I wouldn’t talk the talk if I personally hadn’t walked the walk. For the past 22 years I was posted up at the Massachusetts Department of Corrections, where I was fortunate enough to be the Director of their Employee Assistance Program (EAP). While in that position, my team serviced over 5,200 employees, family members and retirees so I learned a thing or two about addiction along the way. In fact, I dealt head-on with virtually every setback scenario you could imagine like drugs, alcohol, financial, post trauma, marital, and so on.

I am proud to say that our team was very successful at what we did and the simple reason our EAP resources were so effective was because we made it as simple as possible for the employee and their families. We did our best to be a one-stop shop, which in essence meant that when you came to us with a situation, we weren’t going to send you out the door with a bunch of homework, we were going to assess your particular situation and find a solution for you and your family. This obviously made the situation a great deal more bearable for the individual and their family, but also, the employer saved time, stress and money. An EAP is generally a peer-elected post for just that reason, you need to be a conduit between the problem and the solution for both the employer and employee. It is a fine line but one that must be done with pride and respect.

It was during this time when I had the good fortune to work with Treatment Solutions Network and see that their organization had the same goal as my EAP team, just on a much grander scale. Treatment Solutions Network is the ultimate one stop shop and has saved countless lives as a result. One of the most difficult situations for an EAP to face is working with Public Safety Officers struggling with addiction. These officers have a career built on public perception and are far less likely to ask for help than your average employee. Treatment Solutions Network is comprised of former officials and Public Safety Officers who have been humbled by personal hurdles in the past and are now in a position to apply their unique wisdom and experience to people in need of help. When I saw how members of the Treatment Solutions team were able to take the one stop shop notion to a level I never imagined and apply multiple services beyond drug and alcohol treatment, but stress, counseling, family therapy, and mental health to name a few, I knew I wanted to be part of their team.

The Treatment Solutions team is built with the finest union and business leadership from the workforce and a network of the absolute best resources available in the addiction and recovery industry. It only takes one call and not only will you have a solution, but also you’ll have the best possible solution for your specific need and equally important, the needs of your family. This is the finest team I’ve had the good fortune to be a part of and while I personally lost a family member to the disease of addiction, along with Treatment Solutions, I have been able to keep countless families alive and together.

We may think our perception of alcoholism is pretty advanced today, but it has taken many years to get to this point. Dr. Morris Chafetz, who was instrumental in that change of public opinion, passed away last week.

Dr. Morris Chafetz’ Early Career

Back in 1970, when Dr. Chafetz was appointed as the very first director of the National Institute of Alcohol Abuse and Alcoholism (NIAAA), most Americans viewed alcoholism as a social crime and a moral flaw. Dr. Chafetz himself had only recently overcome those prejudices. When he graduated as a psychiatrist from medical school, he accepted the only position he could find, which was starting a new alcohol treatment center. He is reported as not being happy about the position, mostly because of his view of alcoholics. He was quoted later in his life as saying, “I did not think much of alcoholic people. I did not like them; I just was not the least bit interested in them.” (1)

After a short time helping alcoholics recover, he changed his mind, which led him to strive to change public opinion as well. “It only took me a few months of listening to these patients to recognize my prejudices and the prejudices of others,” he said. “I realized that this issue reflected every social health policy problem being faced by the country.” (1)

Improving Public View of Alcoholism

Chafetz became the first director of the NIAAA, from 1970-1975, during which time their annual budget increased from $6.5 million to $214 million. The federal agency was created to provide funds for programs in the U.S. and around the world that promote awareness for alcoholism and that help prevent and treat it. 

Today, many people credit Chafetz with changing people’s view of alcoholics. We still have a long way to go, but more and more people today recognize alcoholism as a disease that can be treated rather than a character flaw. With more treatment programs and better treatment options, more people are able to recover from alcoholism. “I remember saying in one of my first speeches that alcoholism was America’s most treatable untreated illness, and I still feel that way,” Chavetz said. (1)

It all starts with education. If more people are open to talking about the problem, more people will admit to having the problem, and more people will seek treatment for it. “Having experienced the extent of my own prejudices and my own ignorance of the issue, I was bound and determined to turn the country around and to treat alcoholics as ill human beings who needed treatment, not as bad people who should be ignored and neglected,” Dr. Chafetz said. (1) He certainly dedicated his life to helping other people see alcoholism in a new light.

Sources

(1) Morris Chafetz, 87, Dies; Altered View of Alcoholism

Are people with addictions any “sicker” than anyone else?

State struggles to find homes for mental health patients 

Scientists in Australia have been studying the effects of naloxone on mice in connection to alcohol intoxication. Their hope is to find ways to use the drug to help keep people sober.

Naloxone

Naloxone is currently used to treat heroin overdoses in humans, but now, researchers are hoping the drug will provide benefits to alcohol abusers and alcoholics as well. The drug targets the same receptors in the brain that certain other substances target. When used as a remedy for heroin overdose it actually counteracts the depression of the central nervous system and respiratory system and as a result, saves the person’s life. When used to combat alcohol, it is thought to keep the user from feeling the effects of alcohol by again working on certain cells in the brain. Researchers found that mice that were given the drug in the study were less tipsy and less impaired.

No Appeal to Some

It is hard to say just what impact this drug may have, if any, on problem drinkers. If it does work like researchers are hoping it will, people who take it will not feel the effects of alcohol. For many people, this drug will hold very little appeal. After all, most people that drink do it for the feeling they get and it would be pointless to drink if it wouldn’t help them feel better. Unfortunately for too many people, alcohol becomes the tool to help them relax and to wash away life’s problems. Alcohol also helps people loosen up and be more outgoing. For these people, a stay-sober pill is the last thing they would want to take.

Beneficial to Others

For problem drinkers, however, it is a different story. Someone who acknowledges that they binge drink too often or just need to get control over their drinking might find the stay-sober pill to be very helpful. If a person doesn’t feel they have the self-control to stay sober, yet they want to stop drinking, this pill would take away the pleasure of drinking.

Naloxone can also be implanted into a person so that they do not have to be responsible for taking the pill regularly. This would allow a continuous release of the medication into their system so that whether they like it or not, alcohol wouldn’t have the effect on them that it once did. By removing the rewards for drinking, supporters of this medication hope that more people, including alcoholics, will be able to get a handle on their alcohol consumption.

While on the one hand science continues to come up with ways to better our lives and make things easier, sobriety is one of those things that requires hard work and dedication to achieve. As with any treatment program or sobriety aid, a person won’t really get better until they want to put forth the effort to do it. Thinking that a simple pill can solve an alcoholic or binge drinker’s problems is misleading. While it certainly can help with the process of sobriety, it will also require hard work and dedication.

Sources

Researchers developing stay-sober pill to help treat alcoholism

Pill to counter bad booze moments  

Is a ‘Stay Sober’ Pill in the Works?

Former first lady Betty Ford died last month at the age of 93. Betty was instrumental in creating awareness for drug and alcohol addiction, as she herself was a lifelong recovering addict.

A History of Addiction

Betty Ford’s struggles with drugs and alcohol began in 1964 when she suffered a pinched nerve injury. She was put on prescription painkillers, and before long she began taking more and more pills. The pill abuse, combined with increased alcohol abuse, became an addiction she couldn’t shake. Even during her time in the public eye as her husband served his brief term as president, Betty Ford was a drug addict and an alcoholic. The stress of being the first lady and having to raise four children with a husband that was so busy led to an increased dependence on drugs and alcohol just to get by. She once said that her addiction was “an escapism from all that living in a fishbowl to a certain extent and the pressure of always having to be ‘on’ when perhaps you feel very ‘un-on’ or very down inside.” (1)

It became so bad that people began to detect a problem as she went on television talk shows or spoke at events. Her inability to remember things and her slurred speech didn’t go unnoticed by many. Finally, when she was living on the west coast with her husband after he lost the 1976 presidential election, Ford’s family knew Betty needed help. They staged an intervention in 1978, when Betty was 60, and it opened her eyes. “I collapsed into tears,” she said later. “But I still had enough sense to realize they hadn’t come around just to make me cry; they were there because they loved me and wanted to help.” (2) She sought treatment and lived the rest of her life as a recovering addict.

Open and Honest

Of course, the natural reaction would be to cover up a flaw as big as drug and alcohol addiction, but Betty Ford came to realize that trying to hide an addiction is one of the main problems with drug abuse and alcoholism in our society. She decided to be honest about her struggle in order to help many others overcome theirs.

Betty Ford was always known for her candor and honesty. While her political views and openness disappointed and frustrated some, her work in the area of addiction treatment has helped millions. Betty Ford always said that if addiction could happen to her, it could happen to anyone. She faced embarrassment and went public with her weakness and even founded the famous Betty Ford Treatment Center in California. She worked hard to offer programs that worked for everyone, and she personally encouraged many women and celebrities through their recovery.

Sources

(1) Former first lady Betty Ford dies at 93

(2) Betty Ford showed strength in admitting weakness for alcohol, pain medicine

History of the Betty Ford Center

There are certain times in our lives that we are more prone to binge drinking. Someone struggling with alcohol abuse or alcoholism should be especially aware of these times and avoid them or find a way to manage their urge to drink.

Binge drinking is defined by the National Institute on Alcohol Abuse and Alcoholism as a pattern of drinking that brings a person’s blood alcohol concentration to 0.08 grams or above. About 75% of the alcohol consumed by adults in the United States is in the form of binge drinks, and binge drinking can be responsible for accidents, injury, alcohol poisoning, and liver disease, among other things. (1)

The situations listed below are kinds of triggers that for some people, mean it’s time to start binge drinking. There are many other triggers that are specific to individual people, but these situations happen in most everyone’s life and cause many people to drink.

A night out with friends. Even though we claim peer pressure is a teenage thing, it really can still affect us our entire life. A fun night out with friends is often a time to drink. Even moderately responsible individuals can be tempted to binge drink when out enjoying time with good friends.

After a stressful day. We are really good at feeling entitled to do things to make us happy. If we suffer through something, we want to reward ourselves. If we feel hurt or wronged, we want to make ourselves feel better. We’re not always good at handling stress and problems in a healthy way. Many of us, instead of relaxing after a hard day in a healthy way, will have a drink or two. When done in moderation this may not be harmful, but for someone prone to alcohol abuse or who is an alcoholic, drinking away one’s stress can be dangerous.

Being alone. Being alone can have negative consequences on us. There are times when having some peace and quiet are welcome. However, if someone must spend time alone when they don’t want to, it can be a risky time, because loneliness can make us do things we wouldn’t normally do. We might self-medicate our cares away by drinking. The problem with this situation is that there is no one around to see what we are doing or to stop us, and the result is that lonely drinking can be more damaging.

Family gatherings. People may joke about how hard it is to spend time with family, but for many families this is very true. Even anticipating a family get together can drive some people to drink, because of the stress and dysfunction this time can bring. Other people wait until they are at a family gathering and then negative interactions with family members can cause them to drink.

Binge drinking can cause injury or death, and should be taken seriously. If you or someone you know has a problem with alcohol abuse, consider getting help.

Sources

(1) Binge Drinking

St. Patrick’s Day celebrations trigger binge drinking

Alcoholics Life

We know it is important to identify and get help to people who are addicted to drugs or alcohol. But as a new survey suggests, putting this into practical methods is often difficult to do.

Substance Abuse and Health Screens

The study was done by researchers at Boston Medical Center (BMC) and Boston University School of Medicine (BUSM). They found that people who abuse unhealthy substances are less likely to take part in preventative health services. This study looked at the number of patients that went in for services such as mammograms and vaccinations, and found that those with substance abuse problems were less likely to use these services than the general public. Researchers concluded that, “We speculate that persons with unhealthy substance use who are not engaged in primary care at the high thresholds used in these analyses may have substantially lower receipt of preventive services.” (1)

Lack of Substance Abuse Screening

It is important for a person’s overall health that they get these regular screens and preventative services. But if we apply the same logic to screening for substance abuse disorders, we find a larger problem. Someone with a drug or alcohol addiction is less likely to have a primary physician who would recommend these tests but who would also screen for substance abuse disorders. Therefore, substance abuse screenings done only in doctor’s offices are not effective in reaching a large proportion of people with substance abuse problems.

This relationship can work both ways. We need to either find a way to get these people in to doctors offices to be screened for substance abuse and preventative health services, or we need to find another way to get substance abuse treatment to these people so they are more likely to take care of their overall health also.

Drug Screening Through Primary Care Doctor

Working with primary care doctors is a good way to identify and help people with an addiction, and there is more help in place today for doctors who are doing substance abuse screenings. NIDA and the American Society of Addiction Medicine launched a program this year that creates a support network for doctors that have found patients that struggle with an addiction. For those people with substance abuse problems that go to the doctor, this program is a valuable tool. “Physicians are in a really unique position not only to identify patients with substance abuse problems but also to serve as prevention resources. [Doctors have the capability] to identify people who have started using drugs but have not yet become addicted,” said Gaya Dowling of NIDA. (2)

Drug Screening Elsewhere

However, there are still many addicts who avoid doctors offices whenever possible. There must be other ways to screen for substance abuse among these people that so desperately need help. There is a push to get hospitals, urgent care clinics, and shelters to do more screening on individuals they see. These locations are more likely to have addicts walk in who have no other resources for help. With the right kind of training and screening techniques, we can do more to help people with an addiction who may not be looking for help on their own.

Sources

(1) Substance Abusers Less Likely to Use Preventive Health Services

(2) Phone, email service offers tips on drug abuse screening

Unhealthy Substance Use A Risk Factor For Not Receiving Some Preventive Health Services

We’ve come a long way from the early days of Alcoholics Anonymous. While still the foundation for millions of people working to achieve sobriety, one of the basic principles of AA is being challenged by today’s world. Some people think that the principle of anonymity for recovering alcoholics is outdated, but others still believe we should embrace it.

Alcoholics Anonymous

As the name intentionally states, AA organizers firmly believe that remaining anonymous is important to recovery. It allows people recovering from addiction to escape the stigma associated with their addiction. A new pamphlet distributed at AA’s annual conference in New York was designed to clarify the boundaries of anonymity, because of the trends that are moving addiction recovery out into the open.

Rehab in the Media

In recent years celebrities, authors, and politicians have declared their recovery to the world. Countless memoirs, articles, and movies have been dedicated to the sobriety of both famous and not so famous individuals. We are also so accustomed to hearing about the latest celebrity in rehab that we don’t even bat an eye at it anymore. We certainly don’t live in a time of anonymity anymore.

Proud to be Sober

Some people go so far as to argue that anonymity is not healthy either. “Anonymity protects, but it also hides.” (1) “Having to deny your own participation in a program that is helping your life doesn’t make sense to me. You could be focusing light on something that will make it better and more honest and more helpful.” (2) “It’s seems crazy that we can’t just be out with it, in this day and age. I don’t want to have to hide my sobriety; it’s the best thing about me.” (3)

Many people struggling with addiction do not really turn the corner to living a sober life until they have come clean with friends and family. Oftentimes, when a person is open and honest about their struggles, they are able to find people that will help and support them through the process. Some people who are straightforward about their recovery from addiction become a source of strength and encouragement to others struggling with the same thing. Being forthcoming with a life challenge is not always a bad thing.

Benefits to Anonymity

That is not to say that AA is out of date or that it has nothing to offer in today’s society. In a world where private pictures are posted on the Internet for all to see, a little anonymity can be a good thing. Even with the advances we’ve made in reducing the stigma associated with alcoholism, there are many people who would lose their jobs or suffer other consequences if word got out that they were a recovering alcoholic. The fact that AA requires all members to uphold not only their own but others’ anonymity helps ensure that privacy is maintained. 

Sources

(1) Can AA survive our tell-all era? 

(2) Some Recovering Addicts Finding They Don’t Want to Be Unknown

(3) Dropping the anonymity rule would be disastrous for Alcoholics Anonymous

A report released by SAMHSA last week says that most people with an alcohol abuse disorder don’t know they have a drinking problem. The statistical analysis shows that Americans are in denial about alcohol abuse and that we need to do a better job of educating the public about this problem.

Statistics of Alcohol Abuse and Addiction

The report, released April 7th, concludes that 98.8% of the people in our country with an alcohol abuse disorder do not think they have a problem. It goes on to say that only 7.8% of the 6 million Americans with alcohol dependence recognize their need for help.

These numbers almost seem unbelievable. How could that many people not know they have a drinking problem? Could it be that the administration’s definition of alcohol abuse or dependence is so much more stringent than the public’s definition? SAMHSA classifies alcohol abuse as when someone puts themselves or others in physical danger, has trouble with the law, or has problems at work or in relationships because of their drinking. Alcoholism is a more serious disorder that involves alcohol addiction, an inability to stop drinking, and problems with work and relationships because of drinking. (1)

Justifying Alcohol Abuse

If what SAMHSA says is true, we must be a society flooded with alcoholics and alcohol abusers. Actually, if we look around, we might have to admit that we do see people abusing alcohol frequently. Almost any young person going out with friends is going to drink, and they see nothing wrong with it because that’s just what they do. Someone coming home from work may not think twice about having a number of drinks at night, because they worked hard all day and they deserve it. It is possible that people today just don’t see their drinking as a problem because we have become so numb to the alcohol abuse around us.

Perhaps some of the people taking the survey for this study were just not being honest, or maybe they didn’t want to admit to anyone that they have a drinking problem. Most people, however, were probably too busy justifying the reasons they abuse alcohol to see the problem it is really causing in their lives.

Education

Some people really don’t know that they have a drinking problem, and it is very clear that not enough people are getting the treatment they need for an alcohol problem. That’s why this report is important. Education is imperative, from telling people of the dangers of binge drinking, to helping people see the need for treatment for alcoholism.

SAMHSA administrators are hoping their report helps Americans see the seriousness of alcohol abuse. The report was released on National Alcohol Screening Day, a time when people are encouraged to talk about the alcohol problems that they or a loved one face.

“SAMHSA’s spotlight provides striking evidence that millions of Americans are in serious denial regarding problem drinking,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Individuals, friends and family members clearly need help and support in confronting and doing something about the problem. Without help alcoholism can be fatal. As a nation we need to ask ourselves why we stand by and allow so many people to self destruct before intervening. National Alcohol Screening Day provides one day to have the conversation we should be willing to have every day until screening for alcohol problems becomes the norm — just like heart disease, cancer, and diabetes.” (1) 

Sources

(1) Only 1.2% of Alcohol Abusers Know They Need Help: Report

Few Alcoholics Realize They Need Help

Nearly all American adults with untreated alcohol use disorders don’t think they need treatment

Native Americans are known for their natural healing and their holistic remedies. One way some tribes have begun to heal their own who suffer from alcoholism is to use Peyote, which is deemed an illegal substance to the rest of the country.

History of Peyote

Peyote has been around as long as inhabitants of North America have. Researchers estimate use of Peyote to have occurred as early as 3780 B.C. Specimens of the plant have been found in burial caves and in archeological digs. The substance, a spineless cactus, is chewed or boiled as a tea, and it gives psychoactive effects to users. Peyote has been used for thousands of years to treat fever, toothaches, skin disease, diabetes, and even blindness. Peyote, called the “sacred medicine”, is common in Native American religious rituals, including the legendary Ghost Dance. Even when Peyote became a Schedule I drug in the U.S. because of its psychoactive effects, Native Americans became exempt from the law, based on their religious purposes for the drug.

Peyote for Healing Alcoholism

Peyote, in recent years, has been used as a treatment for alcoholism among Native American peoples. It is used extensively in the Native American Church (NAC) for alcoholism recovery and emotional healing. The NAC has more members from the Navajo Nation than any other tribe, and is centered in southwestern United States. It’s main goals are faith, hope, charity, and sobriety. When used in a spiritual healing rite for alcoholism, Peyote “offers the opportunity for self-understanding through ritualized introspection and self-examination.” (1)

Native American Church Family

While many people would consider the use of Peyote to cure alcoholism as a new and successful holistic remedy, many people credit the work of the church as having the healing powers. Members of the NAC are a close family, and they act as a support system to those striving for sobriety. In fact, the church as a whole abstains from alcohol use completely. This camaraderie and sense of being in it together can work wonders with someone trying to give up the addiction of alcoholism. NAC members share everything in their lives, including their worship and prayers, their pains, and their struggle for sobriety. This bond is very much like the bond between a sponsor and a recovering alcoholic, or among members of an AA support group.

Not only do Native Americans claim that Peyote offers pure healing power to cure alcoholism, but the Native American Church itself plays a large part in healing alcoholism. Just as anyone recovering from an addiction needs the help and support of others, Native American tribes have found this to be an important part of healing.

Sources

(1) Peyote Use in the Treatment of Alcoholism in the Native American Church

Peyote & Mescaline

NIDA InfoFacts: Hallucinogens – LSD, Peyote, Psilocybin, and PCP