Doors

No Wrong Door

By: Pat McGinn, CEO Harbor Hall

Never did I think that I would take abstinence as the central goal for treatment out of our policies and procedures.  However, that has changed in the last couple of years with the height of the opioid epidemic hitting the nation, the state and right here at home.  I never dreamed that abstinence would be a term that stigmatizes people where the use of medications is necessary to achieve a certain quality of life.  There was a time in my professional career when I thought the use of any medication was compromising a person’s sobriety.  I found it necessary to evaluate my own ideas, prejudices and biases.  This was very hard for me to do.  Even right now as I write this I am finding it hard to put into words.

Here at Harbor Hall, we witnessed the opioid epidemic spiral out of control over the past decade.  The peak of the crisis was 2012-2016 where we saw for the first time opioid addiction account for nearly 60% of all our admissions in the residential program.  We began to recognize that we needed to do something different, but we were not exactly sure what.

In 2017, myself and our clinical team visited Hazelden Betty Ford Foundation and received specialized training in the Comprehensive Opioid Response with the Twelve Steps (COR-12). The COR-12 program is an evidence-based program that was developed by the Hazelden Betty Ford Foundation.  The approach includes the use of medications.  These medications for opioid use disorders are an adjunct—an addition—to other treatment programming, such as extended psychological and psychiatric care, counseling based on the Twelve Steps, and other therapies. Harbor Hall believes that the medications without any supporting program is not as effective as participating in a program that combines both.

Outpatient Based Opioid Treatment (OBOT): It took some time and preparation but this past year Harbor Hall started a treatment program that specifically addresses opiate addiction. Central to this treatment are medications, typically Suboxone (buprenorphine-naloxone) and Vivitrol (extended-release Naltrexone) are provided in combination with other medical and psychosocial interventions designed to realize a person’s highest achievable recovery.  Based on the assessed ASAM level and the needs of the person served, Harbor Hall provides a comprehensive array of treatment services that includes counseling (individual and group), medication supports, social supports, continuing care coordination and other recovery enhancing services designed to enrich an individual’s quality of life.

Harbor Hall Philosophy: A substance use disorder is a chronic medical condition that responds best when treated with evidence-based, patient-centered, comprehensive care.  Harbor Hall believes that a broad approach that integrates the latest addiction science with the spiritual foundation of the twelve step philosophy while providing medication-assisted treatment (MAT) will provide the best pathway to long-term recovery efforts from opioid use disorders.

Needs Pyramid

Motivation to Change

Addressing each individual’s needs to develop a life that is free from substance misuse.

Article by: Chief Executive Officer – Patrick McGinn – MS, MA, LLP, CAADC, CCS-M

Whenever I am talking about motivation to change, my first thought goes back to PSYC 101 and Maslow’s Hierarchy of Needs. Dr. Abraham Maslow first described this model in 1954. It is still, to this day, considered to be a masterpiece in any discussion about motivation and change. Because of the simplicity of the model in explaining motivation it is a useful tool to begin to understand why we do some of the things we do, and how they play a role in substance misuse.

Maslow proposed a five level hierarchy of needs as the basis of his theory on motivation. The hierarchy of needs begins with physiological need, then progresses in sequence through safety need, belonging need, esteem need and self-actualization need. According to this hierarchical structure, the lower-level need has to be largely satisfied and its impact on behavior diminished before the person transitions to the next level.

Physiological Needs.

This is described as the most basic of needs, satisfying for the relief of thirst, hunger, and physical drives.

Safety Needs.

The need to be free from harm or danger, to have a secure and predictable daily life.

Love or Belonging Needs.

Beyond the needs of survival are the desires for nurturing, acceptance, respect, and caring relationships.

Esteem Needs.

Mental/emotional well-being, built on the perception of oneself as worthy and recognized by others, to be appreciated.

Last but not least….

Self-Actualization Needs.

Defined as the individual ability to recognize and develop capabilities to realize one’s fullest potentials.

Creating an environment to foster the motivation to change.

At Harbor Hall we believe that by addressing the individual needs as described above, the individual is more motivated to develop a life that is free from substance misuse. Our professional staff go all-out to make the facility comfortable, clean, and safe.

Our clients are well-nourished, there is opportunity for exercise and all physical needs are examined and addressed. Once the physical and safety needs taken care of, the residents and staff can concentrate and focus on the harder issues of therapy. Residents are assigned to a primary group. The treatment milieu is highly structured 24/7 and the residents are in primary and big groups participating in all activities together. A very strong emphasis is placed on connection with one another and a sense of comradery and kinship is developed.

Together residents work on anger, communication, conflict resolution, and other topics that support the attainment of belonging and being a part of. As a natural result to this process, esteem builds, spiritual concepts develop and residents being to gain confidence in their own abilities to address life situations. By the time a resident is discharged from treatment and they have responded well to the treatment process, they will be well on their way to recognizing their own unique potential and at the beginning of making plans to be successful in their life.

“You can’t go back and change the beginning, but you can start where you are and change the ending.”
– C.S. Lewis

naloxone hci close up photo

Another Day, Another Overdose, but There is Hope.

Overdose deaths in Michigan: What is causing them and what is being done about it.

Article by: Chief Executive Officer – Patrick McGinn – MS, MA, LLP, CAADC, CCS-M

Dark Times

I woke up this morning, turned on the news and discovered that yet again another person has been taken due to an overdose.  I can only assume that this is an opiate type overdose, as that seems to be happening more and more each day.  This past week alone there has been four overdose deaths that I am aware of in Northern Michigan alone.  This is very alarming and leaves me with the question of what is next?

Last week a past resident of Harbor Hall made a post on our alumni Facebook page.  The post was very inspirational and uplifting.  This person stated that he was utilizing all of the tools, was going to meetings and had made excellent connections in the recovery community.  Two days later he was found passed out in the bathroom of his place of employment.  Narcan was administered but he was not revived.  He was pronounced dead shortly afterward.

As I was writing my comments about the recent overdoses, I received a letter from a mother of a past Harbor Hall resident.  In this letter she stated that her son had gained so much and understood what he needed to do to maintain a sober/clean life.  When he left Harbor Hall he was happy, confident and strong.  He had made tremendous growth.  When he returned home he did not continue to actively work on his recovery.  In January he overdosed and passed away.  This mother stated that she has now lost two loved ones to the addiction and her daughter is in recovery today.  I can only imagine the pain that this family is suffering as the result of addiction.

A Deadly Drug

I need to say something about the drug fentanyl as I believe that the recent deaths are related to it.  According to the DEA Resource Guide on Drugs of Abuse (2017 ed).   Fentanyl is a potent synthetic opioid drug that is approximately 100 times more potent than morphine and 50 times more potent than heroin. This drug has been around since about 1959.  Over the past several years there has been a reemergence of trafficking, distribution and abuse of illicitly produced fentanyl.  This has been associated with the dramatic increase of over dose fatalities.  Fentanyl can be injected, snorted, smoked, taken orally, put on blotter paper.  Illicitly produced fentanyl is sold alone or in combination with other substances like heroin, methamphetamine or cocaine and has also been identified in counterfeit pills, mimicking pharmaceutical drugs such as oxycodone. Overdose may result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning.

Battling Addiction

The disease of addiction is cunning, baffling and powerful.  I have been in the addictions field for over 30 years now and I struggle to understand what the key is to a successful recovery.  There are a wide variety of solutions.  Some say that the 12 step program is the way, others may say it is church and others suggest that cognitive solutions are best.  In his book “Slaying the Dragon” (2014),  William White describes five models of treatment:

  1. The medical model that emphasizes genetics and neurobiological roots to addiction.
  2. Psychiatric model which views addictive behavior as self-medication of emotional distress or psychiatric illness.
  3. Psychological model viewing substance-related problems as consequences of maladaptive learning.
  4. Sociocultural model viewing substance related problems as consequences of a dysfunctional family, or peer socialization.
  5. Spiritual model that views these problems as the result of failed searching for meaning and purpose in one’s life.

I believe, as William White, that they are all true to one extent or another.  Treatment interventions need to be designed to address all aspects of self.

Treatment Success is Different for Every Individual

At Harbor Hall we use our PIES model: Physical, Intellectual, Emotional, and Spiritual.  However, when it comes to treatment, we could have the best approach in the world but the individual still needs to make a heart-felt, personal decision to do something different.  Without that personal decision there is no amount of knowledge that will keep a person sober.  Also with the decision is commitment, “are you willing to do what ever it takes to remain clean and sober?”  This is an internal process, there is new learning involved but the process cannot be taught forced by external entities.

Recovery is Like Learning to Ride a Bike… Backwards

The video below is The Backwards Brain Bicycle.  It is about 7 minutes long and it is worth watching.  In recovery treatment, we ask the individual to change every aspect of themselves and to remain that way – essentially re-wiring their brains so that new, pathways are created that support healthy habits.  This video demonstrates how longs it takes for an adult to learn something new, and how easy it is to relapse.

In recovery, we say practice, practice, practice and you will get it.  Then one day something clicks in the individuals brain and we begin to see a change from the old behaviors to new.  When an individual stops, or is inconsistent in his or her recovery process, the return to old behavior or old learning happens very fast.  As in the video, what took eight months to unlearn how to ride a normal bicycle (learning a new habit), took less than an hour to revert to riding the bike the “normal” way (old habits). This scenario rings true about addiction treatment and an individuals ability to change through a process called neuroplasticity. I touched on this a little in a blog post about stigma.

So what does this have to do with keeping people from dying? Quite a bit actually but this is a very complicated problem.

It’s about Saving Lives

I would be remiss if I did not say something about Naloxone or NARCAN.  Naloxone is a prescription medicine that is used to reverse an opioid overdose and can be administered by injection or nasal spray. https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio

Naloxone is safe and effective and has been used by medical professionals for decades.  Opioids can slow or stop a person’s breathing and Naloxone helps the person wake up and continue breathing.  Naloxone is a tool that can save lives.  Pharmacist are being asked to educate people on how to administer and there is an effort to make NARCAN available without a prescription. (Photo: http://upnorthlive.com/news/local/ludington-man-saved-by-overdose-reversal-drug)

Michigan’s Good Samaritan Law

This relatively new, perhaps little known law states that during a drug overdose, a quick response can save a life. However, people illegally using drugs sometimes fail to seek medical attention during an overdose for fear of alerting the police to their illegal drug use.  In order to prioritize saving lives, Michigan passed a Good Samaritan law in 2016.  Michigan’s Good Samaritan law prevents drug possession charges being filed against those that seek medical assistance for an overdose in certain circumstances. This law makes saving lives the priority during a drug overdose, not criminal prosecutions of illegal drug users.

I implore all of us to be vigilant.  This problem effects all of us.  Some more directly than others but it certainly impacts our community as a whole. I do not want to see any more people dying.  I believe that the solutions needs to involve all of us.

Peace

Butler Center for Research Articles

Below are two excellent fact sheets to understand some of the research and trends in this ongoing opioid crisis.

Prescription Rates of Opioid Analgesics in Medical Treatment Settings

Prescription Opioids and Dependance

Stigma of Substance Abuse and Addiction

Article by: Chief Executive Officer – Patrick McGinn – MS, MA, LLP, CAADC, CCS-M

Webster dictionary defines stigma as a set of negative and often unfair beliefs that a society or group of people use as a mark of disgrace with a particular circumstance, quality, or person.  “The stigma of having addiction will always be with me.”

Synonyms: shame, disgrace, dishonor, ignominy, opprobrium, humiliation.

According to the World Health Organization (WHO, 2012): “stigma is a major cause of discrimination and exclusion and it contributes to the abuse of human rights.  When a person experiences stigma they are seen as less than because of their real or perceived health status.  Stigma is rarely based on facts but rather on assumptions, preconceptions, and generalizations.  Stigma results in prejudice, avoidance, rejection and discrimination. Family, friends and the general public can carry negative feelings about drug use or behavior. They may even use derogatory terms such as “junkie,” “drunk,” “crackhead”, “criminal”, “thief”, “scum”, “gutter bum” and many more.  These thoughts, feelings, and labels can create and perpetuate stigma.”

Unfortunately people who experience stigma regarding their addiction or negative behaviors are less likely to seek treatment services.  Perceived stigma in hospitals or doctors’ offices discourage people from accessing needed health care services.

Addiction, unlike any other public health concern, is viewed as a moral issue and not a health issue.  Also, addiction, unlike any other public health concern creates antisocial behaviors.  Antisocial behavior patterns are a common characteristic of addiction.  With the brain hijacked from the drugs, the addicted person will regularly make bad choices, of which many are calculated.  Addicts make many bad choices that cause pain for those around them.  The research is clear that the active addict will continue to take a drug despite the negative consequences involved.  They know that family, social and career are disrupted by their drug abuse, but they cannot stop.

Neuroplasticity

A term that has become a recognized term in addiction treatment is neuroplasticity.  Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.  This however takes time.  This process of “rewiring” the brain from addiction to more socially adaptive behaviors can take from 12 months to 3 years and in some instances even longer.

When thinking about addiction we must be careful not to simply reduce the addict simply to moral failure.

Treatment at Harbor Hall extends beyond abstinence or symptom management by helping people achieve a full, meaningful life in the community. Prior treatment, legal history, medication assisted treatment, or other pathways are not viewed as a predictor of poor treatment outcomes and is not used as grounds for denial of treatment. Post treatment continuing care services are an integrated part of the service continuum rather than an afterthought. Focus is on all aspects of the individual and the environment, using a strength-based perspective and emphasizing assessment of recovery capital.

The Pipe Exercise

By: Patrick McGinn, CEO

Today I asked a group of clients to participate in an exercise that I call it the pipe exercise.  The groups are given a kit of PCV pipes cut to a variety of different lengths along with a variety of connectors, elbows, and types with an end cap.  The task is to construct a design using all of the pieces.  Sounds simple enough… but this is not a simple task at all.

Varied Paths and Varied Results

As I watched the groups struggle, I observed some interesting things.  First were the roles that individuals in the group took on.  There were at least 2 people in each group that jumped right in and took the lead.  Others stayed back and would observe and then eventually start to give input, there were also people that I would describe as “cheer leaders”. They would encourage their team members, cheering for their success.  And in each group, there was one person that did not participate at all.

Each group floundered at the beginning: starting, stopping, taking apart, and starting over.  At approximately 20 minutes into the project I whispered a hint to success into the ear of one member in each group.  This is the point when all the groups basically stopped and start over.  Within about 30 minutes the first group completed the task.  They were quite proud of themselves.  I instructed the other groups to continue until they were finished.  5 minutes later the next group completed then shortly after that the third group finished.

The forth group continued to struggle.  They were beginning to give up.  I heard statements like, “what’s the use, we are in last”, “this is stupid”, and “we should just give up”.  All the while the others were jeering and poking fun at their lack of success.  Then the leader of the last group asked the group who finished first if they would help them figure it out.  The response was very interesting as one or two from each group got up and went over to that group to help and within 5 minutes they were done.  The whole room erupted with cheers at the success.

The four designs were very different from one another.  They were not even close to looking alike, but each accomplished the task.

This Process Looks a lot Like Recovery…

The varied paths and mixed results is very much how recovery looks in real life.  The task of getting clean and sober is usually very difficult for most people, especially at the beginning.  We are given minimal instruction and expected to complete the sober task successfully.  If it was as simple as “one size fits all”, there would be no need for treatment centers.  For many people there are starts and stops. Sometimes you just have to take apart and rebuild all over and look for a different way.  Some people may get ridiculed or made fun of or looked at differently if they “do not get it” the first time around.  This is also true in the recovery community, where some people may be ostracized because they relapsed.  This attitude may send some people further into the spiral of addiction as they may not seek help a second or third time.

Sober Success is the Goal – No Matter the Path

Many people come into treatment in despair and are ready for change, but they do not know how the recovery pieces fit together. Attending lectures, groups, going to doctor appointments,  one-on-one sessions, skill building activities etc. all are pieces that may be put together differently for each individual.  Success for me may not be the same as success for you.  Each person needs to decide how to put the pieces together that work the best for them.  We know for sure that sober success does not happen in a vacuum. We need the input of other people. “I can get this, with a little help from my friends”

The Election Reminds Us That Our Political System Is Failing Addicted and Mentally Ill Individuals

by David Sack, M.D.

The hot-button topic in our current election cycle is the economy. Basically, finances seem to be the sole focus of nearly every campaign. And why not? With unemployment rates hovering in the 8 percent range, our nation’s financial situation is a major issue. But almost as many Americans suffer from a serious mental illness as are unemployed, and there are many more people dealing with addiction than are unemployed. Even in an economy-driven election — perhaps especially in an economy-driven election — politicians should be paying attention to these facts. After all, whether it is a debilitating mental illness such as bipolar disorder or a mind-addling addiction to prescription medications, these issues cost our nation serious money. And the amount increases when the problems are left untreated or passed off to the criminal justice system.The simple fact is that just about everyone knows someone — a loved one, a friend, a co-worker — with a mental health or addiction issue. Nevertheless, politicians routinely ignore the need to treat these populations. Perhaps this neglect stems from the fact that addiction and mental illness have historically been viewed as moral failings as opposed to treatable illnesses. Alcoholics were seen as hopeless bums and a drain on society, drug addicts were degenerate criminals to be feared and thrown in jail, and the mentally ill were unfortunate creatures best hidden away in locked rooms or placed in asylums “for their own good.” Sadly, even though the medical and scientific communities now possess considerable evidence indicating these once-upon-a-time “facts” have little, if anything, to do with the reality of alcoholism, drug addiction and mental illness, our socio-political system continues to wallow in the see no evil, hear no evil, speak no evil dark ages. Rather than dealing with these problems head on, we choose to either ignore them or use the judicial system to sweep them under the rug.This unhelpful attitude has, over the last several decades, led to a bevy of unfortunate, expensive and wildly unsuccessful federal, state and local policies focused on interdiction and punishment rather than treatment. And in most respects these moth-eaten “contain and control” strategies persist despite the ever-growing mountain of evidence clearly demonstrating their abysmal inadequacy. Consider, for instance, the tried and truly failed idea that we can “arrest” our way to a drug-free America. Today, there are more than seven million Americans under the supervision of the criminal justice system, with a large percentage of that number in on drug offenses. Yet more people than ever are dying drug-related deaths. However many people we lock up, the ravages of addiction continue unabated.

If we look at the matter objectively, we see clearly that the war on drugs is over, and everybody lost. So why do we continue to address the “addiction problem” primarily through the criminal justice system? Rather than dumping countless billions into a quagmire of policies that we know don’t work, couldn’t we refocus our efforts and funnel these same resources into improving our treatment methodologies and making that treatment affordable, accessible and without stigma?

One common argument against the above idea is that federal and state governments should not be throwing their limited financial resources at a tiny segment of the population when so many larger, more pressing issues (i.e., the economy) need to be addressed. Of course, this argument fails to recognize that arresting and incarcerating drug users, oftentimes repeatedly, without addressing their underlying issues costs, over time, significantly more money than helping those individuals identify and overcome their problems through proper treatment. And the financial costs don’t end with arrest and incarceration! The number of work-days lost to addiction is incalculable, costing employers millions, perhaps even billions. And what about the healthcare system? Medical expenses for an untreated alcoholic are triple those of a nonalcoholic.

Furthermore, as mentioned earlier, addicted and/or mentally ill people are hardly a “tiny segment” of the U.S. population. It is thought that approximately 12 percent of Americans suffer from alcohol or drug addiction, and approximately 5 percent suffer from a serious mental illness. (A “serious mental illness” is an emotional or psychological disorder resulting in a functional impairment that substantially interferes with or limits one or more major life activities.) And these numbers take into account only the individuals directly affected by the disorder. We should also consider the millions of children, spouses, parents and friends who are indirectly affected.

Nevertheless, most jurisdictions determinedly perpetuate policies of interdiction, arrest and incarceration — probably because seeming “soft on crime” is a good way to lose votes. Thus, resources for dealing with addiction and mental illness have become highly politicized, with policies that sound good to the voting population winning out despite their well-documented lack of success.
Happily, not all is doom and gloom on the political front. Earlier this year, in April, the Obama administration released its thoughtful, informed, and progressive 2012 National Drug Control Strategy, building nicely on the president’s initial Drug Control Strategy introduced in 2010. Basically, the administration’s policy is grounded in three research-based premises that are now widely accepted in the addiction treatment community:

1) Drug addiction is not a moral failing; rather, it is a preventable and treatable chronic brain disease.

2) People can and do recover from addiction.

3) Criminal justice reforms are needed if we truly want to stop the cycle of drug use, crime, incarceration, release, more drug use, and re-arrest.

In part, the president’s policy focuses on the two most current drug-related challenges: the prescription drug epidemic, and the millions of people who need substance abuse treatment but do not receive it. If it is followed through — and that’s still a big if — the new approach will respond to the aforementioned two challenges by diverting nonviolent drug offenders into treatment, and expanding overall access to treatment. For instance, the Affordable Care Act will force insurers to cover drug addiction treatment as they would any other chronic disease. Overall, the new policy is a revolutionary and long-overdue shift in the federal approach.

Unfortunately, addiction and mental illness have (as usual) been placed on a back burner in the current presidential election, with state and local races following suit. Campaign speeches and advertisements are focused on the economy, while the ongoing issue of treating rather than ignoring and/or incarcerating a large, constantly growing and needful segment of our population remains unaddressed. Until this attitude of political neglect changes, we’re likely stuck with the current jumble of antiquated laws that do more harm than good. Thus, the individual suffering of millions of people — not to mention their friends and families — will continue, as will the unwarranted funding of numerous failed drug control strategies. Yes, the new National Drug Control Policy is a significant step in the right direction, but at the moment it’s a lone beacon of light that most politicians are choosing to ignore in favor of “vote grabbing” topics.

David Sack, M.D., is board certified in addiction psychiatry and addiction medicine. As CEO of Elements Behavioral Health he oversees a network of addiction treatment centers that include Promises, The Ranch, The Recovery Place, and The Sexual Recovery Institute.

Even though the elections are over, this article is still relevant with facts pertaining to current drug control strategies.

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Spirituality in Recovery

Dan Thompson, MA writes on the importance of spirituality in recovery.

What does spirituality have to do with recovery at Harbor Hall?  Everything!  At our Residential Treatment Center, we concur with 12 Step writings, on page 83, “The Spiritual life is not a theory, we have to live it.”  There is another phrase we identify with that reminds us: “we are spiritual people on a human journey”.

Our understanding of spirituality is that it is the aspect of humanity that refers to the way individuals seek and express meaning or purpose, and the way we experience sacred or holy connection to the moment, to self, to others, to our environment, to a Higher Power, or to God (as we understood Him).

In our care, you will be welcomed and accepted wherever you are at spiritually and/or religiously.  Whether or not you refer to a Higher Power, to God, or regardless how you assign yourself as perhaps atheist, agnostic, theist, or deist, you will be welcomed and treated fairly and justly.

We believe in the power of the human spirit that exists within each of us, and that with proper help can be relieved, revived, and/or restored.  Our core teaching on spirituality promotes a kind of lifestyle practice that is honorable, whereby the basic spiritual habits which reflect our pursuit of transformation involves discipline, accountability, servant hood, humility, and safety.   We also refer back to our lifestyle that resisted change, where we dishonored our self and others with habits influenced with bitterness, arrogance, danger, lawlessness, and self-centeredness.

As it states on page 110 of Twelve Steps & Twelve Traditions, our effort with clients is fueled by the hope and truth that the “eyes of men and women open with wonder as they move from darkness into light, to see their lives quickly fill with new purpose and meaning, to see whole families reassembled, to see the alcoholic/addict outcast received back into his/her community in full citizenship, and above all to watch these people awaken to the presence of a loving Presence or Higher Power in their lives”.

In our recovery treatment program, spirituality has everything to do with our sanity, serenity, trust, respect, and joy.  These are the results we strive for and believe can occur in treatment under the professional, clinical, and spiritual care that is offered through our program.

Blessings to you

 

A Guide to Intervention

Prior to getting a professional interventionist involved, most families have tried to confront their loved ones about their destructive behaviors. Many times this was ineffective because you tried to go it alone and separately, where your concerns could be easily defended against by mechanisms that the substance abusing person engages in to keep everyone away from the heart of the problem. The concerns were not presented with the support of other family members and/or friends and there was not a concerted effort to plan for contingencies, if the loved one chose not to engage in the recovery process. You probably have fears that an intervention will fail and begin to think that you may never get your loved one away from the negative lifestyle that they continue to be involved with. This usually leaves you feeling more alone and isolated and imagining that there may be no hope to potentially save your loved one’s life.

Oftentimes the person engaging in the negative behaviors is believing that they are not affecting anyone around them. A “true” professional intervention differs from that of individual “conversations.” It is carefully planned and orchestrated. No one wants to know that their behavior is hurting the people around them and the intervention is an; “eye-opening” experience that leaves little room for denial.  It can be a very powerful process because of the level of emotion that is displayed by the caring partners that are helping to; “open the person’s eyes as to how their behavior has affected those around them.”

The ultimate goal is to engage the person in a partnership to get them on the road to true recovery. You want the loved one to “go to treatment, start engaging in recovery, so that you can welcome back the person that you love and care about”

Family intervention uses the power of love and concern to break through denial and get your loved one into treatment. By organizing family members and friends in a very specific way, as laid out in Love First, we are able to get results that were impossible in the past.

The keys to a successful intervention are planning, preparation and technique. Many people think they’ve tried everything, but often family members have been working against each other. They‘ve never taken an organized approach or worked with a professional interventionist

Intervention unifies the family and gets everyone working together. Before the intervention ever takes place, the team goes through a planning a rehearsal process that leaves nothing to chance. Take a look at this intervention checklist.

Here’s an excerpt from Love First, by Jeff Jay and Debra Jay:

In the past, expressions of love were delegated to a few brief sentences during an intervention. We’ve learned that when we expand the role of love in intervention, it is love that first breaks through denial, not toughness. Using love first, we often never have to use tough love.

Jeff Jay is a professional interventionist, educator and author. He is a graduate of the University of Minnesota, and a certified addictions professional. His work has appeared on CNN, the Jane Pauley Show, PBS, Forbes Online and in professional journals. He has served as president of the Terry McGovern Foundation in Washington, DC, and on the boards of directors for several professional organizations.

Jeff Jay is the co-author of Love First: A New Approach to Intervention for Alcoholism and Drug Addiction, and co-author of At Wit’s End: What You Need to Know When a Loved One Is Diagnosed with Addiction and Mental Illness, a book on dual disorders published in April 2007 by Hazelden. He heads a national private practice that provides intervention and recovery mentoring services. He is a former clinician with the Hazelden Foundation and Sacred Heart Rehabilitation Center.

Debra Jay has worked as an interventionist since 1996 and is currently in private practice, providing intervention training and consultation services, with an additional specialty in older adult intervention. She previously worked for the Hazelden Foundation as an inpatient addiction therapist with both men and women in primary and extended care. She also facilitated the Hazelden family program and coordinated the older adult program.

Debra Jay is the author of No More Letting Go: The Spirituality of Taking Action Against Alcoholism and Drug Addiction, published by Bantam in 2006. She has also co-authored two Hazelden Guidebooks: Love First: A New Approach to Intervention and Aging and Addiction: Helping Older Adults Overcome Alcohol or Medication Dependence.

Debra Jay is a nationally known speaker and has regularly appeared on the Oprah Winfrey Show. Most recently, she was seen on The Dr. Oz Show. She is a graduate of Ohio State University.

Jeff and Debra live in Grosse Pointe Farms, Michigan and travel nationally. They write a monthly column on alcohol, drugs, and family for the Grosse Pointe News.

Harbor Hall is very committed to the process of recovery and helping people to change their lives. Sometimes there is a necessity to get an intervention specialist involved to engage your loved one in the recovery process. We support; “Love First’s” model of clinical interventions and believe that they are true professionals who can help you and your loved one on the path to recovery. Check them out here: Love First

 

 

Choosing the Right Drug Rehab for Your Loved One

Helping a loved one who is addicted to drugs or alcohol requires a lot of love and patience – and a fair amount of research. In addition to deciding whether your family would benefit from the services of an interventionist, you will need to carefully evaluate your drug rehab options.

If you’ve looked into drug rehab at all, you know it can be difficult to find the one that is best suited to your loved one. The sheer number of rehabilitation centers, compounded by the fact that they all make the same claims, can make the decision process overwhelming.

What features are truly important? How can you dig through the marketing talk to figure out what’s really being offered? Here are 10 must-ask questions for any drug rehab you’re considering:

1. Is the facility licensed and accredited?

Many drug rehab centers claim to provide a high standard of care. The best way to substantiate those claims is through objective third parties. Look for drug rehabilitation centers that have been licensed by the state and accredited by such national organizations as the Joint Commission and CARF (the Commission on Accreditation of Rehabilitation Facilities). These accrediting bodies require programs to meet rigorous standards of patient care and quality programming.

2. Does the staff have the credentials to provide expert care?

A drug rehab program is only as good as the people providing patient care. The therapists and staff will be the ones “in the trenches” with your loved one, exploring deep-seated issues and offering guidance on how to live a happy, productive, and sober life.

While life experience, particularly a personal recovery story, can make the staff relatable, it is also important that they have the qualifications to provide high-quality care. The treatment team should include licensed drug counselors and master’s level therapists, among other specialists. A favorable staff-to-patient ratio is another important consideration.

3. Does the drug rehab center treat co-occurring mental health disorders?

Most people who struggle with addiction also suffer from one or more co-occurring mental health disorders, such as depression, anxiety, or a personality disorder. While all of these conditions are highly treatable, they require a specialized type of care from a multidisciplinary treatment team.

Research shows that integrated treatment that addresses all disorders simultaneously is the only effective way to address dual diagnosis. Many drug rehab programs claim to treat dual diagnosis, but the ones that do so effectively will have special programming for dual disorder patients and access to a psychiatrist and other professionals.

4. What is the philosophy of the treatment center?

The 12-Step principles serve as the foundation of treatment at some of the most effective drug rehab programs. If the treatment center you’re considering doesn’t utilize the 12 Steps, find out why and if alternatives, such as SMART recovery and Life Ring, are available. Decades of research have proven the value of 12-Step programs, which provide a framework for lifelong recovery and offer meetings in most communities all over the world.

5. What kind of reputation does the drug rehab have?

There are few indicators of quality as reliable as the informed opinions of others. While online reviews can be dubious, programs that have made a good name for themselves in the community typically have been around for many years and have happy customers recommending their services to others. Those with strong reputations are also likely to welcome you onsite for a tour and provide names of alumni who are willing to share their experiences and advice.

6. Will treatment be tailored to the specific needs of my loved one?

Every drug rehab center has a core “program” as the guideline for treatment. But the best drug rehabs will then tailor this program to the specific needs of each patient, seeking out the blend of therapies that will give that individual the best opportunity for lasting recovery. As the patient grows in their recovery, the treatment plan adjusts to their changing needs.

7. Will my loved one be safe and comfortable?

Recovery requires rigorous honesty, a willingness to confront the past, and a great deal of soul-searching. While the work of recovery isn’t always comfortable, the experience of drug rehab can be.

A number of drug rehab centers offer all of the amenities of resort living, such as swimming pools, private rooms, beautiful views, and highly desirable locations. Some provide assistance with legal problems, interventions, and other services. It is also important that the drug rehab foster an environment of safety and support, where the patient’s privacy is well-guarded and their emotional security protected.

8. What types of therapies and activities are offered?

Typically, a drug rehab center that offers a wide variety of therapies (including gender-specific options) will give your loved one the best opportunity to find what works for them. Most programs offer the basics, including medical detox, individual, group, and family therapy, and cognitive-behavioral therapy.

Other programs go a few steps further, offering art therapy, equine therapy, EMDR for trauma, experiential therapy, and others. Better yet, some programs will offer programming designed to treat mind, body, and spirit, including yoga, acupuncture, massage, and other holistic therapies. Make sure to ask about relapse prevention and continuing care planning as well long-term treatment options.

Also be sure to take into account the types of activities offered and whether they are a match for your loved one. Are there certain types of activities your loved one enjoys? Are they an outdoors person or more of a city dweller? Some programs promote outdoor recreation such as hiking or rock climbing, while others may schedule outings to theaters, shops, and local entertainment venues.

9. Does the program work with insurance?

Cost shouldn’t be an obstacle to getting quality drug rehab treatment. Even some of the most luxurious drug rehabs accept insurance and will work to maximize your benefits and/or create a payment plan.

10. Will I be part of my loved one’s treatment?

Family members and loved ones are an important part of drug rehab treatment. Whether entering short- or long-term treatment, the eventual goal is for the patient to return home to their family. In order for this transition to be successful, family members must learn about the disease of addiction and how best to support their loved one in recovery.

The best drug rehab programs strongly encourage family involvement throughout treatment. Although there may be a short “blackout” period when the patient is not in contact with family members during the first few days of treatment, the program should offer family therapy, visitation, and a family program through the rest of the patient’s stay.

Getting straight answers to these questions will simplify your life at a time when life is anything but simple. With this important decision out of the way, you and your loved one will have taken the first step in the incredible transformation that happens during drug rehab.

5 Reasons Addicts Leave Treatment Early – And How To Prevent It

By David Sack, M.D.

Getting an addict into drug rehab isn’t always an easy task. Getting them to stay there can be even harder. Here are five of the most common reasons people leave drug rehab against medical advice, along with suggestions to help the addict stay committed to their recovery.

1. “Detox is too painful.”

Research shows that the first week of drug rehab is the time when most addicts ask themselves, “What the heck am I doing here?” Withdrawal symptoms, drug cravings and an unfamiliar environment can fill the addict with anxiety at the same time they are deprived of their primary coping mechanism: drugs. Some addicts rationalize that they felt better when using drugs and give up on rehab before treatment really begins.

Prevention Tip: Detox can be made more comfortable with medication and alternative therapies such as neurofeedback, acupuncture and massage. Even if the addict isn’t feeling great, they should try to get involved in as many treatment activities as possible.

Rather than isolating, their peers will help them realize they are not alone and see the hope that treatment brings. The earlier the addict develops trust and rapport with a therapist, the more likely they will listen to the therapist’s recommendations and push through the uncertainty.

2. “I’m not like these people.”

This is a common assertion made after the addict attends their first 12-Step meeting or group therapy session. It is the nature of the disease for addicts to think they are different, smarter or stronger than other addicts. This belief allows them to put up emotional walls between themselves and others and to avoid doing the soul-searching work of recovery.

Prevention Tip: If an individual would fare best in the company of like-minded peers, try to find an appropriate drug rehab program for their needs. Once in treatment, cognitive-behavioral therapy can help the addict turn their focus on differences into recognition of similarities. Education about denial can teach the addict that their disease is driving them to rationalize leaving rehab.

3. “I don’t like it here.”

If an addict wants to go back to using drugs, they must find a justification to do so, both for their own peace of mind and to appease their loved ones who desperately want them to get well. Rather than accepting responsibility for their own recovery, they may place the blame elsewhere – often on the food, accommodations, rules, treatment schedule, staff or other patients.

Prevention Tip: In some cases, the addict’s concerns may be legitimate. Perhaps something can be done to make them more comfortable, such as changing roommates or switching therapists. Or perhaps another treatment center would be a better match, particularly if the individual struggles with co-occurring mental health disorders that aren’t being addressed.

It is always wise to stay involved with treatment and listen to a client’s concerns to determine whether they can be addressed or the individual is merely looking for an excuse to leave. In the latter case, it is essential for family members and other treatment professionals to present a united front, offering loving reminders about why the addict needs to complete treatment. Family involvement and family therapy aid in the process, but “rescuing” an addict from drug rehab merely enables the addiction to continue.

4. “I already know this stuff.”

In addiction recovery, there are certain themes that get repeated throughout treatment. This is because repetition is how we learn. Sometimes it isn’t until the second or third go-around that the addict truly embraces a particular recovery principle or gains new insight. In some cases, the addict may use this excuse to avoid dealing with the painful memories and feelings being explored in therapy.

Prevention Tip: There are many ways to show addicts that no matter how much they think they know, they can always learn more. These include having outside speakers share their stories of recovery, offering alternative therapeutic modalities that the addict hasn’t yet explored, maintaining a full schedule of recovery-related activities, and discussing the likely outcome if the addict follows through on their plan to leave.

5. “I can do this on my own.”

At some point during treatment, most addicts develop a type of confidence that is both healing and potentially damaging. After maintaining their sobriety for a while, they feel healthier than ever and are assured of their ability to stay clean. It is at this point that some believe they are “cured” of addiction and anxiously wish to return to their families and careers.

Prevention Tip: Research shows that the longer an addict stays in treatment the better their chances of avoiding relapse. Believing they “know it all” may be a sign of progress but is also a red flag that more education and treatment are necessary. Step-down levels of care (e.g., moving from inpatient to outpatient or a transitional living environment) allow addicts to test their new recovery skills with ongoing professional support.

In many ways, drug rehab is an exercise in faith. We ask addicts to draw on coping, interpersonal and distress tolerance skills they haven’t yet developed, based on the assurance of others that recovery is possible. Change is hard for an addict, but stillness can be even harder. With the support of family and a team of professionals, addicts can stay still long enough to experience the many rewards of recovery.

David Sack, M.D., is board certified in psychiatry, addiction psychiatry, and addiction medicine. He is CEO of Elements Behavioral Health, a network of treatment centers that focus on addiction treatment, eating disorders, and dual diagnosis.