Sober N Clean

Nineteen communities across Australia will share $3.6 million from the federal government to tackle binge drinking.

The first round of community grants to fight excessive drinking was part of a $53 million government initiative, Health Minister Nicola Roxon said on Monday.

The grants went to grassroots projects including programs that offered alternative activities to pubs, a safe party initiative and a post-formal mystery tour for high school students.

"We in the Rudd government do understand that binge drinking is a problem," Ms Roxon said.

Ms Roxon said 10 per cent of 12-17 year olds were binge drinking every week.

The number of young women aged 18-24 who were hospitalised because of alcohol had doubled in the last eight years, and more than 750,000 Australians were physically abused last year by people under the influence.

"Not only does it hurt our society it hurts the economy as well," Ms Roxon said, adding the social cost of alcohol misuse was estimated at $15 billion each year.

Labor has committed $14.4 million to grassroots grants, as well as $19 million for early intervention and $20 million for an advertising campaign.

Ms Roxon said the states needed to agree on rules for the responsible service of alcohol and pub and hotel lockouts.

"There are different rules that apply across the states and territories," she said.

"We believe this is a national problem and the community would be better served by there being national consistency.

"But that involves health ministers and police ministers, it involves each jurisdiction, (and) some are very wedded to theirs being the most successful one, others want to see the evidence that's coming in from the different states and territories that have been trialling their lockouts," she said.
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source: The Age

Take The First Step
Dr. Michael Levy

Q: I have been hearing that parents of opioid-addicted children want more information about naltrexone. Do you have any experience with this treatment? Does it work? Thanks.

A: There are two ways that naltrexone-type medication is being used for the treatment of opiate addiction. I say naltrexone-type medication because in general, naltrexone is an oral form of the medication naloxone, and naloxone is also used, which can be injected or inhaled. One use of this drug is to increase abstinence rates and enhance treatment outcome, and the other is to counter an opiate overdose.

First, naltrexone is a pure opiate antagonist, which means that it blocks the effects of opiates because it binds on the same receptor sites that opiates bind to in the brain. If a person has ingested naltrexone and uses opiates, the person will not feel the effect of the opiate.

Naltrexone has been around for many years, and while it is effective, its use has been fairly low for a number of reasons. One big reason for this is that many individuals who struggle with opiates are ambivalent about taking this drug because they clearly will not be able to get high on opiates if they have naltrexone in their system. As often there is ambivalence about changing, compliance with taking this drug has been low.

However, if a person is very motivated, treatment outcome can be very good. As I always say, ongoing psychosocial therapy in conjunction with taking this medication is also important. There are also naltrexone implants that can be used, which increases compliance as the naltrexone in the implant lasts for an extended period of time and there is no need to remember to take it daily. Finally, an injectable form of naltrexone, called Vivitrol, can also be used, which lasts for one month. However, Vivitrol is not FDA-approved for the treatment of opiate addiction, but some physicians have been using this off-label for that purpose.

Narcan, or naloxone, is also used to treat opiate overdoses and saves lives. If a person who has overdosed on opiates is given this drug, it rapidly will counter the effects of opiates and reverse the overdose. This drug is given at emergency rooms and by emergency medical technicians (EMTs).

There are also several pilot programs in Massachusetts that give a nasal form of Narcan to opiate addicts, as well as friends and relatives of opiate addicts. These individuals are trained how to use Narcan in the event that someone has overdosed on opiates. This obviously allows the opiate overdose to be treated quickly, even before EMTs arrive, and helps to save the person's life. CAB is one of the pilot programs and a person can call 781-592-4477 to find out more about this.

So in answer to your question, different forms of naltrexone are being used for the treatment of opiate addiction, both to help individuals recover from opiate addiction, and to treat, on an emergency basis, opiate overdoses. This medication can be helpful to opiate addicts who are motivated to stop using opiates, and on an emergency basis, it can clearly save someone's life.
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source: http://www.gloucestertimes.com

Johnson’s study to evaluate effectiveness of anti-nausea medication in reducing alcohol craving, binge-drinking tendencies in 300 young adults ages 18 to 25

University researchers are preparing to launch a study that has the potential to influence the way alcohol dependence in young adults is treated.

Bankole Johnson, chair of the department of psychiatry and neurobehavioral sciences, will lead a clinical test of the effectiveness of ondansetron, traditionally used as an anti-nausea medication, in treating alcohol abuse in adults ages 18 to 25.

“Ondansetron ... contains a chemical that reduces [the] craving for alcohol and binge drinking,” Johnson said.

The clinical study will involve eight weeks of treatment with the drug, Johnson said, including two sessions of psychosocial intervention and follow-up monitoring. Three hundred people who are currently binge drinking will take part in the study, he said, most likely including a number of University students.

The study — which will take about four years to complete, according to Johnson — is being funded by a $3.2-million grant from the National Institute on Alcohol Abuse and Alcoholism. Raye Litten, associate director of the division of treatment and recovery research at NIAAA, said the institute is particularly interested in Johnson’s study because of the young age of the population Johnson will be testing.

Litten said the average age of people who participate in NIAAA clinical trials is about 40, despite the fact that the average age of the onset of alcohol dependence is 20 to 21. According to Litten, high risk drinking behavior — which he defines as drinking more then five drinks in one night for men and drinking more then three drinks for women — can lead to longer term effects in this younger age group including dependency.

“If he finds this [drug] is effective, you could treat people as they develop [dependence] at an earlier age, rather than let it progress,” Litten said, adding that currently, most people take at least eight years to seek treatment for alcohol abuse.

“This could prevent long-term effects much better than letting [abuse] go on for years and years,” he said.

An earlier study conducted by Johnson concluded that ondansetron is not very effective in treating later-onset alcohol abuse, Litten said, but also found the drug is more effective for cases of early onset alcohol abuse, making it an “ideal drug to test on this population.”

The study also will focus on the effect of genetics on treatment response, Johnson said.

“If a person has a certain genetic profile, he or she may respond better to the drug ... and have fewer side effects,” Litten said, expanding upon the genetic aspect of the study. “It would be nice, before you give someone a drug, to know if they have a chance to respond to it.”

If his hypothesis is confirmed, Johnson said doctors could be able to offer medication targeted toward binge-drinking students for the first time.

125 Unitarian Universalist congregations now offer ministries to people struggling with addiction.

The cover story of the summer 2004 issue of UU World profiled the Rev. Dr. Denis Meacham’s drive to help congregations develop ministries to those who struggle with addictions. When Meacham started his own addictions ministry at First Parish in Brewster, Massachusetts, in 2000, there were no others. Today around 125 congregations have such ministries and a move is underway to gain official recognition and support for addictions ministry from the Unitarian Universalist Association.

In 2004 Meacham wrote The Addiction Ministry Handbook, now considered the bible of UU addictions ministry. One person who bought the book after reading the UU World article is Bill Norton, a member of Shoreline Unitarian Universalist Church in Shoreline, Washington.

“I had an epiphany when I read that article in the World,” said Norton. “My own addiction and recovery experience and the possibility of ministry for addictions came together. I stood up in the middle of church and waved Denis’s book and said ‘I’m interested in doing this. Come see me if you are too.’” People did, and now Shoreline has a thriving addictions ministry. Norton is the program’s co-facilitator.

Shoreline’s addictions ministry includes Chalice Circle, a covenant group focused on addictions. The ministry also provides workshops and an occasional worship service, and has trained people as “first responders” to react to immediate needs. “Now anyone in pain knows where to come,” said Norton. “We don’t fix the problems, but we’re a source of information and support.”

Julie Hernandez is a coordinator of the Addictions and Recovery Ministry at Pacific Unitarian Church in Rancho Palos Verdes, California. The UU World article also sparked a conversation among members of her church. They bought the handbook, started a committee and within a few months an addictions ministry was formed. “We launched it and people came to our events and now we have a vibrant program,” said Hernandez.

The addictions team brings speakers to the church and organizes seminars on addiction-related topics. The team is visible every Sunday with an information table. Articles on addiction appear regularly in the church newsletter, and the ministry has trained a team of first responders. A “Twelve-Step, Seven-Principles” group has evolved into a covenant group. Said Hernandez, the group “provides people who are on a spiritual search, as they try to overcome addictions, with an opportunity to explore a twelve-step program that uses the lens of the UU Principles.”

“There are a lot of people who are troubled by the Christian and male-oriented language of the Alcoholics Anonymous meetings,” added Hernan­dez, who turned away from alcohol five years ago. “That’s why I came to Pacific Unitarian after entering recovery. After I read the Seven Principles, I knew for sure no one there would tell me what I should be thinking. Unitarian Universalism is in a wonderful position to help people like me.”

The program is working on a variety of levels, said Hernandez. “There are lots of people now that we can call on for help. The interest in events is very much on the rise and the feedback just gets better and better.” She said events attract from fifteen to fifty people. Ministerial support is also important, she noted. “A very large part of our ministry’s growth and vitality is due to the Rev. (John) Morehouse’s unflagging support and enthusiasm.”

The Rev. Alex Holt, who recently moved from the Woodinville, Washington, Unitarian Universalist Church to become consulting minister in Yakima, Washington, has become the facilitator of a UUA task force on addictions ministry. It is working toward official UUA recognition and support of addictions ministry. The Rev. Jory Agate, the UUA’s ministerial development director and a member of the task force, notes that ministers, as well as lay people, struggle with addictions. She anticipates that a UUA addictions ministry would be developed through the collaboration of many UUA staff groups, including Ministry and Pro­fessional Leadership, Congregational Services, and the youth and young adult offices. “We all need to work together on this issue,” she said. When Holt, a recovering alcoholic, visits a church that’s thinking about an addictions ministry, he’ll ask at a Sunday service, “How many of you, over your lives, have been affected directly or indirectly by addiction, including behaviors and substances?” Nearly everyone responds.

Holt notes that most of the people in a congregation who will respond to an addictions ministry will be family and friends of people with addictions. “People who have a family member in crisis want to know what they can do.” The primary addictions are alcohol, drugs, sex, food, and gambling, he said.

When Holt is invited by a congregation, he generally leads a Sunday service and follows it with a three-hour workshop in the afternoon. “We find people have an incredible craving to share their stories,” he said. “Out of that we help them develop the basics of an addictions ministry program that is safe, open-minded, and supportive, but not therapy. We try to give people resources and community without judging them.”

The UUA’s Pacific Northwest District, where Holt’s congregation is located, has one of the first district-wide addiction ministries. Eleven PNWD congregations have such ministries.

At Saltwater Unitarian Universalist Church in Des Moines, Washington, a worship service about members’ experiences in 12-step groups led to the formation of an addictions ministry there, said Kristen Parman-Bethard, addictions ministry team chair. The ministry includes a lending library with information about a wide range of substance and behavioral addictions. There are alternative Alcoholics Anonymous and Al Anon (for family and friends) groups that allow people to define “Spirit of Life” for themselves. The team held a class on prescription medications and has sponsored two “Recovery Sunday” services. “They weren’t terribly well attended,” said Parman-Bethard, “however, I believe the people who needed to be there were there. Several people contacted members of our team to say how much the service touched them.”

“Our church has been helped by making this a topic that is more open for discussion,” said Parman-Bethard. “Many people have concerns about family members or other loved ones and now they have safe people to talk to. Some have concerns about themselves and they also know we are here. I would say we don’t have a dynamic presence, but rather a ‘ministry of presence’ that is always visible and supportive.”
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source: http://www.uuworld.org

Addiction to drugs and alcohol is a devastating problem in the U.S., and overcoming it is no easy task.

Now, Central New Yorkers in recovery have another resource to rely on.
Friends of Recovery is an organization founded to provide an outlet and networking opportunities to those recovering from addiction. Formed in 2007, the local affiliate of the national organization states as its mission to “provide social, recreational and educational activities to support people in recovery as well as their families and friends.”

“There are people in recovery in all walks of life,” said Kimberly Sacco, executive director of the Syracuse-Onondaga Drug and Alcohol Abuse Commission, one of the partners in Friends of Recovery. “We want to provide as many resources as we can in the community.”

Friends of Recovery is the result of a collaboration between numerous community organizations, including the Syracuse-Onondaga Drug and Alcohol Abuse Commission, the Prevention Network, Crouse Hospital, Syracuse Teen Challenge, Tully Hill Chemical Dependency Treatment Center, Rescue Mission, Altamont Treatment and the Center for Community Alternatives.

“It’s really a community collaboration,” Sacco said. “A lot of different groups work together to make it happen.”

The group, which is free, is open to everyone, whether they are recovering from addiction, have a family member or friend in recovery or just want to help out with events, mailings and other activities.
“It’s open to anybody who wants to be a part of that support system,” Sacco said, “and anybody who feels like they need support.”

Sacco said no particular recovery program is advocated by Friends of Recovery.
“Nothing is pushed,” she said. “We recognize faith-based programs, 12-step programs – we’re sort of non-denominational. Anything that works for people.”
The local organization was founded last September, Sacco said.

“In recognition of National Recovery Month, OASAS [New York State Office of Alcoholism and Substance Abuse Services] sponsored a luncheon at LeMoyne Manor in Liverpool,” she said. “The state wanted to expand their programs. Previously, the focus had been on treatment, then on prevention. The state wanted to focus on recovery and complete that triad.”

In order to come up with a program to address recovery services, people from across Onondaga County met for a brainstorming session.
“The goal was to set up places and organizations around the state for people in recovery to get services,” Sacco said.

Friends of Recovery was established as just such a resource. With an $11,000 grant from the Onondaga County Department of Mental Health, the group has been able to hold events, like their first, a family bowling night in November of 2007 that attracted some 500 people. They also host an annual Recovery Day celebration at the Inner Harbor; this year’s event took place on Saturday Sept. 13.

Friends of Recovery holds meetings on the second Wednesday of every month at which they discuss various programs and welcome addiction professionals as speakers. The meetings alternate between afternoons – 12 to 1:30 p.m. – and evenings – 5:30 to 7 p.m. – in order to accommodate anyone interested in coming. All meetings and events take place at the Salvation Army building, 667 South Salina St., Syracuse.
In addition to its regular meetings, Friends of Recovery has begun holding coffee hours at 7 p.m. on the first Tuesday of every month.

“It’s just an opportunity for a cup of coffee and some networking and fellowship with other people,” Sacco said. “You can come and just sit and drink coffee, or you can meet other people. There’s no agenda.”
The organization also offers family movie nights on the last Friday of the month.
“It’s a family event,” Sacco said. “It’s a lot of fun.”

The goal of the group is to not only provide support for those in recovery and their families, but also to remove the stigma attached to addiction.
“Addiction is recognized as a disease,” Sacco said. “Recovery from addiction is just like recovery from cancer or heart disease. You’re just as much a survivor for coming through that.”
For more information, e-mail FORCNY@yahoo.com.
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source: http://www.cnylink.com

I was disappointed to read Peter Schrag's comments regarding Proposition 5 in his Sept. 2 column, although I can understand how well-meaning and thoughtful people can be misled by this deceptive initiative.

I agree with Schrag's concern for those who are drug dependent, but I oppose Proposition 5 because I believe it will do so much harm to so many people.

Fighting drug addiction is an issue that is very close to my heart. I believe in rehabilitation and not incarceration. But successful rehabilitation needs accountability and so often demands direct intervention in the life of someone who is addicted to drugs, rather than waiting for them to seek treatment "when they are ready."

Too many addicts are never ready or don't live long enough to become ready. That's why drug courts and judicial involvement in pushing offenders into treatment and keeping them there is vital to making rehabilitation work for so many drug- dependent individuals.

Proposition 5 promises rehabilitation – but actually prevents it. Instead of helping break the addict's cycle of self-destruction, it actually feeds the cycle by allowing addicts to continue using drugs while in treatment, without any consequence.

Proposition 5 would cripple successful rehabilitation programs and dramatically limit the power of drug-court judges to help those who need it most. It will take limited resources away from proven programs and waste them on mandated programs that have already been shown to be failures.

Proposition 5 will cost billions; if it could deliver on its promises that would be a price worth paying, but it won't deliver because it can't. It is fatally flawed at its foundations because it rewards those who continue to take drugs while in treatment, instead of requiring accountability.

While virtually all of California's sheriffs, district attorneys, police chiefs and probation officers oppose Proposition 5, it would be a mistake to suggest that their opposition is no more than a knee-jerk response. Enlightened law enforcement leaders are among the strongest supporters of drug-treatment programs and consider such programs a vital part of the solution.

Sadly, Proposition 5 shifts funding away from programs that demand accountability and into "harm reduction" programs whose goals are to make drug users better-informed consumers. Highly effective programs like Delancey Street or Narcotics Anonymous require those enrolled in treatment to quit using drugs, which means they wouldn't qualify under Proposition 5's "harm reduction" theory. Under Proposition 5, those in "treatment" could continue using drugs and even commit additional felonies, without fear of consequences. That alone should cause serious-minded people to question Proposition 5.

Yes, Proposition 5 does shorten parole from three years to just six months for drug dealers caught with up to $50,000 of methamphetamine, and, yes, Proposition 5 could allow those arrested for auto theft, identity theft and a host of other crimes involving victims to escape real consequences if they continued to violate the law.

We all need to look beyond the simplistic and the cliché and recognize that truly effective drug treatment programs with real accountability are in our best interests. The real problem with Proposition 5 is that it is not about stopping drug use. If it were, it would mandate funding for ongoing drug testing instead of prohibiting that funding, and it would not give drug sellers a reward for the harm they do to so many.

This poorly designed and dangerous initiative will deliver more drug addiction and more pain for thousands of addicts, their families and our state's communities. It is opposed by Mothers Against Drunk Driving, the League of Latin American Citizens and prominent treatment professionals. It is opposed by former Gov. Gray Davis and by Sacramento County District Attorney Jan Scully and Sheriff John McGinnis. I strongly urge that this dangerous and misguided measure be given the scrutiny it deserves.
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source: The Sacramento Bee, http://www.sacbee.com

Ottawa's fight to shut down Vancouver's controversial supervised injection site will be heard by the B.C. Court of Appeal next April.

The federal government is appealing a B.C. Supreme Court decision that struck down sections of Canada's drug laws as unconstitutional because they prevent the facility, known as Insite, from operating.

The judge gave Ottawa until June 30 of next year to bring the Controlled Drugs and Substances Act in line with the Charter of Rights and Freedoms, and gave Insite a constitutional exemption to stay open in the meantime.

Madam Justice Anne Rowles of the appeal court announced yesterday that three days will be set aside for the appeal beginning April 27.

But a lawyer for the federal government noted that could mean a decision might not be issued before the lower court's ruling takes effect.

"The Attorney-General asks that the appeal be heard as soon as there is available time to hear it," said Paul Riley, who had hoped for a hearing as early as December.

"The implications are significant - what we're talking about is an order declaring an important law of no force and effect."

But Judge Rowles said other lawyers' schedules meant the case couldn't be heard until the spring.

A lawyer for the Portland Hotel Society, which runs Insite and helped launch the initial court challenge, said that if Ottawa was concerned about the deadline, it should be working to update the law, not speed up the appeal process.

"The government should be doing their work as we speak," Joseph Arvay said.

Insite opened in Vancouver's Downtown Eastside in 2003 under an exemption from federal drug laws, but Ottawa now wants the facility shut down. Insight allows addicts to inject their own narcotics under the supervision of medical staff.

Mr. Justice Ian Pitfield of B.C.'s Supreme Court ruled in May that denying drug addicts access to the health-care services offered at Insite violates their Charter rights to life, liberty and security of the person.

It's not clear what will happen if the Conservative government hasn't passed updated legislation by Judge Pitfield's deadline of June 30 and if the appeal isn't successful.

Lawyers at yesterday's court hearing suggested either side might apply to have the deadline extended, though Judge Rowles said that's an issue to be decided later.

A spokeswoman for Health Minister Tony Clement said the minister had no comment about the appeal and said the timing is at the discretion of the court.

Officials with the federal Attorney-General's office and the Justice Department were unavailable.

The case involves a complex mix of appeals and cross-appeals involving the federal government, the two local groups that launched the initial court challenge and at least three intervenors.

The B.C. government is already an intervenor, and the B.C. Civil Liberties Association and the Vancouver Coastal Health Authority are expected to apply to intervene in support of Insite.

"The civil liberties association, like the plaintiffs themselves, is responding to what in essence is a health-care crisis in the Downtown Eastside," the association's lawyer, Ryan Dalziel, said in an interview. "The service is saving lives."

The health authority, which works with the non-profit Portland Hotel Society to operate Insite, plans to keep the facility open indefinitely unless a court rules otherwise, said spokeswoman Anna Marie D'Angelo.
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source: The Globe and Mail, http://www.theglobeandmail.com

A drug, designed to stop the euphoric effects of alcohol, could one day be used to prevent reformed alcoholics from relapsing, say US researchers.

And scientists say a kill-joy pill like this may also be useful in treating a range of overly-pleasurable pursuits.

Professor Tamara Phillips and colleagues from the Oregon Health and Science University report their study of the effects of the new drug on mice in a recent issue of the Proceedings of the National Academy of Sciences.

Phillips and team hope the drug, which blocks a stress receptor, could not only stop alcoholics from relapsing, but also stop pleasurable feelings gained from cocaine and even food.

"This drug has great potential to treat not only alcoholism, but other stress-related disorders as well," she says.

The drug, called CP 154,526, was originally developed and donated for testing by drug giant Pfizer, maker of the popular drug Viagra.

CP 154,526 physically binds to a receptor in the brain called corticotrophin-releasing factor one (CRF1).

The receptor blocks corticotrophin-releasing factor (CRF), a chemical released by alcohol that is thought to create pleasurable feelings.

"It's like you put the key in a lock but don't turn it," says Phillips. "Then you break the key off so no one can use it."

In the study, the researchers gave the drug to mice that had been given a steady supply of alcohol.

Mice given the drug were less likely to gesture for another drink, compared to mice that didn't receive the drug.

The effect doesn't last long - less than an hour - but it doesn't have to, according to the scientists.

"The euphoria you experience with alcohol is extremely rapid and mostly happens within the first 15 to 30 minutes after your first drink," says Phillips.

"Without that initial euphoric reaction, you are less likely to have that second, third or fourth drink."
Other effects not blocked

While the drug should prevent users from feeling happy from alcohol, it doesn't block the other effects of alcohol, such as the inability to walk in a straight line or slurred speech.

It also won't help with withdrawal symptoms or hangovers.

The researchers hope to enter human clinical trials in the next year.

If the drug is approved for human use, the patient would have to ingest the drug soon after or before their first drink for it to be effective.

CP 154,526 isn't the only drug that could help alcoholics stop drinking.

Naltroxone, which affects opioid receptors, is often effectively used in combination with counselling to stop relapse, but for some people it has little or no effect.
Treating hedonism

Phillips and her collaborators are testing their drug specifically for treating alcoholism, but she says that since CP 154,526 binds to a receptor involved in stress and anxiety more generally, it could help treat a number of overly-pleasurable pursuits.

That view is backed up by Dr George Koob, a scientist at the Scripps Research Institute in La Jolla, California, who also studies CP 154,526 but was not involved in Phillips' study.

"CRF antagonists [like CP 154,526] could help re-establish homeostasis involved with hedonic disregulation," says Koob. "This drug could be of use in many different situations."

Other studies have shown that CRF helps regulate the pleasurable effects of nicotine, heroin and cocaine, says Koob.

"In every system there is a yin and a yang, and the same goes for hedonic activities," he added.

"With lots of pleasure there is usually a crash as well."
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source: ABC News in Science

New regulation bans tobacco use in programs for other dependencies

By now, most people understand the dangers of smoking and the benefits of a tobacco-free environment — but it never hurts to make the point again, and what better entity to do so than the state and what better time to start than the present?

On the anniversary of the Clean Indoor Air Act, the commissioner of the New York State Office of Alcoholism & Substance Abuse Services announced a proposed Tobacco-Free regulation for all programs funded or certified by her office — no tobacco use in any facilities, any grounds under provider control or any vehicles owned, leased or operated by the programs.

That places New York in a group of states that require all of their chemical dependence prevention and treatment programs to become tobacco-free. The new regulation took affect July 24.

Commissioner Karen M. Carpenter-Palumbo presents a compelling argument for the need: Up to 92 percent of the chemically-dependent population smokes, even though the overall state average is 18.2 percent. Research shows that those in chemical dependence treatment programs are more likely to die from a tobacco-related illness than from alcoholism or drugs.

The new regulation should be a direct benefit to the 110,000 New Yorkers within the Alcoholism & Substance Abuse Services system on any given day — but the state-funded agencies must also work to ensure that the new tobacco- free environment in those programs does not deter new or current clients.

Part of treating addiction is treating nicotine, said K. Michael Cummings, senior cancer research scientist and director of the Tobacco Control Program at Roswell Park Cancer Institute. More and more, Cummings said, experts find that people who are still smoking also tend to have other “comorbidities,” substance abuse problems and, possibly, mental health issues such as depression.

The percentage of those in New York state and nationally who smoke is declining, but those who do smoke tend to have fewer resources to quit — so if the state is investing funds to help people end their cocaine, alcohol or heroine addiction, nicotine addiction also should be treated.

This is a shift from the mind-set of years ago in the treatment field, when forcing clients to give up cigarettes was taboo. The belief was that quitting tobacco would have an adverse affect on getting addicts to quit alcohol or drugs. There have been enough studies completed now to suggest that is not the case, as Cummings said, adding that he hasn’t seen evidence that people will forgo substance abuse treatment because they can’t light up a cigarette indoors.
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source: The Buffalo News, http://www.buffalonews.com

Ten years ago, a small group of people frustrated by the rising cost of treating addiction decided to try to turn back the clock.

Managed care was eroding the Minnesota Model, the residential treatment programs that made the state the place to go to get sober. Hundreds of treatment centers around the country were closing as insurers tried to cut costs. The survivors, such as the famed Hazelden Foundation, were under pressure to show clinical results. They added medical staff, pushing prices beyond the reach of many.

The little group tried a different path.

They eschewed the clinical psychiatry and pharmaceuticals embraced by the rest of the industry, going back to the roots of the treatment movement: a full month's residence, surrender to a higher power and support from a community of former addicts.

"We went in a direction nobody was going -- simpler, more affordable," said John Curtiss, a longtime Hazelden executive who left to start the new venture.

They called it "The Retreat."

Now housed in a former nuns' retreat in Wayzata's Big Woods, it offers a one-month residential program for about $4,000, about one-seventh of what Hazelden charges. Its outcomes are comparable to that of other major centers, with 50 percent of those who come through abstaining from alcohol and drugs for 12 months afterward, Curtiss said.

Ten years after its inception, The Retreat hasn't exactly reversed the course of American addiction treatment, which continues to get more expensive. But it has thrived and spawned similar centers in Sioux Falls, S.D.; Auckland, New Zealand; and Hong Kong.

"The Retreat is a model for the nation of affordable treatment that works," said U.S. Rep. Jim Ramstad, a recovering alcoholic and longtime national advocate for better access to treatment. He is a regular volunteer at the Retreat.

Making access affordable

On a recent morning, two dozen women gather in a sun-filled room to study the "Big Book," the bible of Alcoholics Anonymous. Young and old, they bend over the volumes, pages heavily underlined.

Ralph C., a bearded, bow-tied volunteer, is talking about spiritual surrender.

"Is it possible that there is a power that has more horsepower out there?" asks Ralph C., who uses just his first name in line with AA's philosophy. "Am I beginning to suspect it's not another man who's going to fix this? Or a counselor or a drink?"

Quit trying to play God, he tells them.

They are among the few who have managed to get affordable help on the road to recovery. Many others never do. In 2006, 23.6 million people age 12 or older needed treatment for addiction, but only 2.5 million, or 10 percent, got it, according to the U.S. Department of Health and Human Services.

Cost is often a barrier -- with most programs charging $30,000 or more for a month-long stay. Not all insurance covers treatment, and not all centers accept insurance.

The Retreat draws half of its patients from Minnesota, the rest from as far away as India and Australia. The average age is 38 and most have college educations.

The program isn't for everyone. With no clinical staff, the typical client is medically stable and highly motivated. Eighty percent have been through previous treatments.

"We wanted to create a dignified, safe place to go, away from the burning house of addiction," Curtiss said.

If they're suicidal or otherwise need medical help, the Retreat refers them to Hazelden. Other centers in turn refer patients here.

"They have a niche," said Ron Hunsicker, president of the National Association of Addiction Treatment Providers. But the fact that the program hasn't been copied by many suggests its clientele may be limited, Hunsicker said. More addicts are showing up for treatment these days needing medical care.

But William Moyers, executive director of Hazelden's Center for Public Advocacy, differs. "I believe the Retreat is the future of recovery," he said. "It's crucial to replicate it." There is a need for cheaper alternatives for those who relapse, he said.

It was the Retreat, Moyers said, that inspired Hazelden to start its Lodge program in 2002, a nonclinical retreat on its Center City campus.

Letting go of insurance

Curtiss was a patient at Hazelden in the 1970s and returned as a counselor. He worked his way up to vice president of Hazelden's national operations, overseeing multibillion-dollar expansions into New York and Chicago.

In the early 1990s, health insurers, anxious to cut costs, were scrutinizing chemical dependency programs. As insurers insisted on medical diagnoses, addiction centers duly produced them.

"You want to see pathology? We'll show you lots of pathology," said Curtiss, describing the mood of the day. As centers hired more medical staff, costs went up further.

Others were uneasy.

"We were going down the wrong path, trying very hard to make alcoholism into a mental illness," said Dr. George Mann, former director of treatment at St. Mary's Hospital in Minneapolis, now part of Fairview Health Services.

Mann, Curtiss and others began meeting to discuss solutions. In 1998, with a grant from the Johnson Institute, they opened a facility with 20 beds in the old Pillsbury mansion in Minnetrista. Curtiss staffed and furnished it for the grand sum of $177,000.

The Retreat didn't register as a treatment center. Instead, it is regulated by the state Department of Health as "board and lodging." It has grown into an 80-bed campus in Wayzata and runs 54 sober living beds in St. Paul for program graduates.

Over the decade, about 3,500 clients have come through the monthlong program, a third of those with financial help provided by donations. The center doesn't have contracts with insurers.

Stoked by volunteers

In any month, 250 volunteers lead chapel services at The Retreat, drive patients or teach the "Big Book." They not only help keep costs down, they form a vital safety net of recovering addicts.

Alcoholism is "not a disease where people bake casseroles and come over," said Dee L., a volunteer wearing a business suit and pearls. A client three years ago, Dee now returns often to tell her story. She does it as much for herself as for them: "This is how I stay sober."

Even board members continue to work for free. The top executive, Curtiss, is paid $140,000 a year.

An early volunteer at The Retreat was Andrew Zimmern, host of the Travel Channel's "Bizarre Foods."

Zimmern left New York City and checked into Hazelden in 1992, in his words: "a homeless, alcohol- and drug-addled wreck." He credits Hazelden for saving his life. Luckily for Zimmern, his former business partner had continued to pay his health premiums, so insurance covered his treatment.

After he left, Zimmern became concerned that too many people couldn't afford the same. So he volunteers at the Retreat.

"We all know recovery works at its simplest," he said, "when one alcoholic talks to another."
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source: Minneapolis Star Tribune, http://www.startribune.com

New York became the first state in the country to require all state-run addiction treatment centers to help their patients quit smoking. The plan, which went into effect last week, requires treatment centers to help patients quit smoking by offering nicotine replacement therapy, including nicotine gum and patches, to all smokers. For those lacking health insurance, the nicotine replacement therapy will be free of charge.

The treatment centers also will be required to be smoke-free. Officials estimate the new law will impact up to 250,000 patients. Approximately 92 percent of those in alcohol and other drug treatment programs are cigarette smokers, according to estimates.

As someone who dedicates my life to advocating for treatment for those struggling with addiction and as someone who is personally addicted to cigarettes, I have mixed feelings about the new rule. I applaud the effort to help people quit smoking, but am worried that the smoking ban may deter some smokers who are hoping to quit other addictions from seeking help.

Helping smokers kick the habit will save lives and should be applauded. More than 400,000 people die prematurely from cigarettes — more than all other legal and illegal drugs combined.

It is important that public health officials and treatment providers acknowledge that cigarettes — a legal drug — can cause as many health problems as the more demonized illicit drugs. Having a proactive strategy to help people quit is a positive initiative that should be supported.

The second piece of the new law is more problematic. Prohibiting smoking at the treatment centers may sound like a worthwhile public health objective, but it is clear that this policy will discourage some people from seeking treatment. Some people may be seeking treatment for drugs like alcohol, heroin or cocaine, but they may not be ready to quit smoking.

Do we really want to set up barriers and conditions for people that keep them from seeking treatment? Not everyone can or wants to abstain from all drugs all at once. If someone wants to quit heroin, but is not ready to quit cigarettes, we should not discourage them from getting help.

Much of the campaign to help people quit cigarettes is positive and lifesaving. It is smart, cost-effective and humane to offer people free assistance and tools for quitting the harmful habit.

But let’s remove the smoking ban at the treatment centers. We need open doors that encourage people to get help for their problems, and not establish inflexible rules that drive people away from life-saving programs.

While some may desire a more perfect world where people quit all drugs at the same time and never relapse, the reality is that some may need to quit different drugs at different stages and relapse is a common experience. Let’s help people where they are at and not let perfect be the enemy of good.
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source: The Buffalo News, http://www.buffalonews.com

Governor Cuts Funding To Money-Saving Drug- And Alcohol-Treatment Centers

When the Illinois General Assembly sent Gov. Rod Blagojevich a budget that was $2 billion dollars short on revenue, he had to veto something. So far, the governor has ordered reductions of $1.4 billion.

In Wednesday night's "Truth in Politics" CBS 2 Political Editor Mike Flannery reports on one program where cuts appeared to be short-sighted. It may, in fact, be the dumbest budget cut ever.

One of the governor's cuts was $55 million in funding for drug- and alcohol-treatment programs that the federal government would have matched penny-for-penny. The cut has forced programs across the state to shut down and many of their tens of thousands of clients are likely to end up in jail, costing taxpayers far more.

At an Alsip site called "A Safe Haven," women trying to kick addiction to drugs and alcohol get enough help that their children can live with them, even if they've previously been taken away. Beginning Monday, though, all 120 of the women and kids there will have to leave.

Demetria Woods said, "not knowing where we're gonna go, what happens next, where will we live, the children … how this affects us is overwhelming.

Anthony Cole, vice president of the Haymarket Center, said, "It means you're gonna have increased homelessness, increased people committing crimes, increased neglect and abuse of children, increased burden on Cook County Hospital, increased burden on mental health institutions, because where else can these people go?"

Haymarket got a letter from the state Wednesday; their award-winning addiction-treatment center is losing nearly $4 million.

Come next Monday, they'll be forced to close half the beds in the detox unit. Recovering cocaine user Porcha James said she is thankful she and her son are already in.

"Without Haymarket and places that provide treatment or recovery, I and my son of 12 would be homeless, I would probably be selling drugs or doing lots of other illegal activity," James said.

"We're going to turn them away at the door. It doesn't make sense. They're going to go back and continue to do drugs and not care about their responsibilities as parents," Cole said.

"A Safe Haven" founder Brian Rowland said, "That's what tears me up. I mean, they can't take care of these kids. These kids are going to end up back in the care of (the Illinois Department of Children and Family Services."

According to a University of Chicago study in 1994, up to 80% of the state's prison population committed crimes related to substance-addiction; $1 spent on addiction-treatment saves at least $7 by reducing crime, child abuse and diseases such as HIV/AIDS.

The Illinois House voted to restore most drug- and alcohol-treatment money, leaving it up to the Illinois Senate to keep the funding in place, but the Senate President Emil Jones has indicated he won't bring senators back until after the November election.
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source: (© MMVIII, CBS Broadcasting Inc. All Rights Reserved.)

Growing numbers of hospital patients are being treated for liver disease due to alcohol abuse, a Dublin specialist has warned. Prof John Crowe, director of the Centre For Liver Disease in the Mater Hospital, revealed the hidden toll of heavy drinking: over a seven-year period, the number of hospital patients discharged after diagnosis with drink-related liver disease went up by 234pc.

He pointed out that statistics showing Irish people are downing more units per head means we are out of step with most other European states, where consumption is falling.

"Significantly, the annual advertising spend on sport sponsorship is not available," he added.

"From a medical perspective, the effects of excess alcohol consumption can be divided into acute and long-term injury."

A&E departments are left to cope with patients suffering coma, physical injury, self harm including suicide attempts, psychiatric disturbance and withdrawal syndromes due to alcohol abuse.

"Between 1995 and 2002, annual alcohol-related admission and discharges increased from 9,254 to 17,378, which is a 92pc rise.

"Significantly, the discharge diagnosis of alcoholic liver disease has increased by 234pc, from 705 cases in 1995 to a total of 1,745 in 2004.

"This increase is highly significant because it illustrates the emerging burden of chronic alcoholic liver injury that exists within the community," he wrote in the Irish Medical Times. It usually remains undetected until significant complications leading to irreversible liver damage has occurred.

His own experience in the Matter has shown that internal hospital referrals of patients with advanced alcoholic liver disease increased from six cases in 1996 to 114 in 2006. Men outnumber women by two to one and the average age is 50 years.

Over the same time, discharges with a diagnosis of alcoholic cirrhosis rose by nearly 300%.
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source: Independent ie, http://www.independent.ie/

State's only public treatment system says 93% of patients aren't using other opiates

A client of the Charleston Center of Charleston County takes a dose of methadone.

When he tried to quit using OxyContin, heroin and other opiates cold turkey, Ken S. said the pain was so great he felt it in the marrow of his bones.

Ken, 40, who chose not to give his last name so he could remain anonymous, said that about a year ago he landed on the doorstep of the Charleston Center of Charleston County, a drug and alcohol treatment program that runs the state's only public methadone program.

He had been abusing opiates since he chugged a bottle of codeine cough syrup at 10 years old. And he was at the end of a two-year spree of heavy abuse of prescription opiates and heroin that left him in fear of losing his job and his family.

He was so out of control, Ken said, that he physically and verbally abused his wife as his child watched. "My 9-year-old son was scared of me," he said.

Ken was so ashamed of what he'd done that he tried to stop using the drugs, but the withdrawal symptoms were unbearable. He found himself doubled over and vomiting in the shower as nearly scalding water washed over him.

"It was disgusting," he said. He knew then that he desperately needed help.

He remembered hearing that a former girlfriend, who also was an opiate addict, had participated in a methadone program and was successful getting off the drugs.

So, Ken showed up at the Charleston Center. It was his last hope, he said, "the last house on the block."

Ken said he hasn't abused drugs in about a year. And he takes the methadone only as prescribed.

He's rebuilding his life with the help of the methadone program, which includes counseling and regular drug screening. He also is part of a 12-step recovery program. For the first time in many years, Ken said, he can think about doing things to help others instead of simply thinking about himself and planning to get more drugs.

He's aware of the stigma surrounding methadone programs, how they conjure images of homeless junkies injecting themselves with heroin.

Ken is employed, middle class, married and has never used a needle. He thinks the negative stereotype keeps other addicts from seeking the help they need.

Methadone, a long-acting synthetic opiate, has been used to treat heroin and other opiate addicts since the 1960s. Some addicts treated with methadone gradually decrease their dosage until they are drug-free while others stay on it for decades. They don't get high from methadone, and are able to function normally, including holding jobs.

According to the White House Office of National Drug Control Policy, methadone is a rigorously well-tested medication that is safe and efficacious for the treatment of narcotic withdrawal and dependence.

Still, it remains controversial with the public and among some alcohol and drug treatment professionals who believe that only abstinence-based programs are effective.

Dr. Jack Emmel, medical director of the Charleston Center, winces when people ask him whether treating heroin and other opiate addicts with methadone is simply trading one drug for another.

When it comes to opiate addiction, he said, "you'll find no program that has the success rate of a good methadone program."

Addiction to shorter-acting opiates, which include heroin, OxyContin, Lortab and Vicodin, severely alters a person's brain chemistry, he said, while methadone stabilizes it.

Methadone, however, doesn't work quickly. It takes many months, even a year in some cases, for an addict's brain chemistry to return to normal, Emmel said.

Addicts who attempt to stop using opiates too quickly experience severe withdrawal symptoms and are likely to return to abusing the drugs, he said. Ninety percent of such addicts who stop cold turkey, even those whose withdrawal is medically supervised, relapse, he said.

Ed Johnson, program administrator for the center's opiate treatment program, said patients who use methadone fare better.

The center's random drug tests have found that 93 percent of patients who are using methadone aren't using any other opiates. And 65 percent aren't using any other drugs. Those rates indicate that the methadone program is more successful than most drug treatment programs, not just programs for opiate addiction, he said.

Johnson said the stigma surrounding methadone programs has worsened after some recent highly publicized drug overdose deaths involving methadone and other drugs.

Methadone also is used as a painkiller, he said, so it ends up on the street. But most addicts use it only when no other opiates are available. It doesn't give them a good high, but it holds off painful withdrawal symptoms, he said.

Johnson and Emmel said the center's staff thinks gradually decreasing the dosage of methadone and becoming drug-free or staying on the drug long-term are both viable options.

"A person whose methadone dose is adjusted properly is 100 percent functional," Emmel said. And some people can't get off it, just as some people with diabetes can't eliminate the need for insulin by changing their diets and exercising.

The center serves about 250 patients in the methadone program, Johnson said. They are all different ages and come from all walks of life. Fewer than half use needles. Most abuse prescription drugs.

The state has 10 private methadone programs, including one in Charleston.

The Center's program is self-supporting, and patients pay about $13 per day, Johnson said. That includes methadone and counseling. Without counseling, most patients would likely relapse, he said.

Ken says that's true for him. In the year he's been on methadone, he's been "working full-throttle on recovery," he said. He's been decreasing his dosage of methadone over the past several months, and expects to be off of it and completely drug-free by mid-August.
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source: Charleston Post and Courier, http://www.charleston.net

For the last few years, I've thought a lot about how to change the treatment system so that helps more people overcome addiction and gain a better life. At one stage, I had come to the conclusion that I needed to work with the people at the top, to help them understand the shortcomings of the current treatment system and see how it could be changed.

I gave a talk at the FDAP Annual meeting last year where I described the shortcomings of the system and emphasised that unless we did something we would end up like the American treatment system in the late 1980s and early 1990s - money was slashed and the system collapsed. I also pointed out the way we needed to move forward, which I
have reiterated in the Wired In 'Way Forward'.

I had a very positive response to my talk from a senior person within the NTA and I thought that I could enter into some long-term dialogue with the NTA that would lead to positive change. A change to a treatment system that is based on people attaining recovery - and I mean a genuine recovery, not some politicised excuse of recovery - is inevitable sooner or later. I thought that I could help speed up the process.

Well, after seeing the Paul Hayes article in the Guardian today, I realise how naive I have been. I'm not going to go into any great detail about the article, but I have to confess that it has made me angry. I quote, 'Hayes dismisses his critics as a few academics, politicians and "ideologues" stocked up by the media'. This is absolute rubbish - Paul Hayes either has his head very deeply buried in the sand or he is deliberately being untruthful.
There are many, many thousands of people out there who know that the current treatment system is NOT working and is causing damage to many people. These people who know the truth come from many different aspects of life - they are users, ex-users, family members, practitioners, commissioners, members of the general public, etc.

I've been in the North West for the past couple of days and it was quite clear to me that the people I spoke to all knew many people who know the system is not working and are tired of the NTA spin. Even some commissioners who do not really care about people with substance use problems realise that the way methadone is being used in many treatment programmes is not reducing crime and is storing up problems for the future.

Anyone can use words to create a false story, mislead people by playing with facts, and distract them by creating false concerns. Sooner or later such people are found out for what they are doing. It is time that Paul Hayes is found out for what he is doing. I encourage those people who do not believe that the current treatment system is working to write to Gordon Brown and tell him. Write and complain that Paul Hayes is misleading the country about what is truly happening.

We are talking about people's lives here. They are far more important than defending the current treatment system. Mr Hayes may think that few people will stand up and be counted - and maybe initially this will be the case. But there is a gathering momentum in the country for a treatment system that is focused on improving people's lives - rather than giving them a pill to keep them quiet - with an increasing number of people getting fed up with Mr Hayes's spin. The day of reckoning will come.
People with substance use problems need opportunity, choice and hope. The UK treatment system is not providing these key elements.

I leave you with a quote from Stuart Honor,
'It is no great trick to take an impoverished, unemployed individual who is addicted to heroin (and crack?) and turn him (sic) into an impoverished, unemployed individual who is addicted to heroin, crack, methadone and/or alcohol and benzodiazepines.'
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source: http://davidclarkwired.blogspot.com/

The head of the National Treatment Agency dismisses 'ideologues' who claim his organisation's addiction programmes aren't working. 'The evidence in favour is overwhelming'.

After seven years at the helm of the National Treatment Agency for Substance Misuse (NTA), Paul Hayes is adamant that the addiction programmes he has overseen during his tenure are working. Not everyone is so convinced. On Radio 4 last week, Hayes was forced to defend his record against criticism that the current strategy of "treatment management" - using, for example, methadone for heroin addicts rather than "curing" their addiction - was failing and wrong-headed.

Hayes dismisses his critics as a few academics, politicians and "ideologues" stoked up by the media. He says any notion that investment in treatment programmes - central government funding has risen from £60m in 2001 to £400m in 2008-09 - has been a failure is wrong. The idea that treatment based on harm reduction could be replaced in future by an "abstentionist" approach, where success is measured primarily by the number of addicts "cured", is misguided, he insists. "We need to keep maintenance prescribing as an integral part of the drug treatment system because it stabilises people, reduces crime, reduces deaths."

The number of problem users in contact with treatment services has more than doubled in the last 10 years, from 85,000 to 195,000. Hayes says this is a clear indication that the system is working, but is far from the whole picture. Treatment centres, he insists, are also about taking the opportunity to ensure they help "as many people as they can to overcome their addiction, leave treatment and get on with their lives. But that's always been the objective of policy, so to a large extent a false division has been created. Rather more has been made of this very sharp split than it actually warrants."

There is an element of electioneering and political expediency to the current debate, Hayes suggests. "There was a political consensus for some time that drug treatment was a good thing and that, therefore, the more we had of it the better. There was consensus that the maintenance-led prescribing regime, which has got all the evidence behind it, is right. The National Institute for Clinical Excellence says it's the right approach, the World Health Organisation says it's the right approach - but always with an expectation that those people who could leave treatment free of their drug dependency should be encouraged to do so."

So if this is the case, why is there a debate now? Is it that the evidence doesn't stack up? Hayes says the evidence is clear and robust. "There are 130% more people in treatment than when we started [in 2001], rather than half the people dropping out because treatment isn't of good quality."

Chaotic lifestyles

But it isn't just about treatment numbers, he says. The impact on crime and a reduction in the social fallout from the chaotic lifestyles of problem drug users is also important to understand, he insists. "Long-term crime is falling, and when we match the criminal histories of people going through the treatment system, we show a reduction in arrests and charges. A York University study showed that for every £1 invested in treatment, the community gets £9.50-worth of benefit back - most of which is crimes that haven't happened."

Hayes suggests criticisms began to gain traction a year-and-a-half ago when the Conservative party's Social Justice Policy Group, headed by Iain Duncan Smith, published its Breakdown Britain report. A lengthy document examining the causes of social breakdown and poverty, the report concluded that an "explosion of addiction" was a major factor in fostering wider social exclusion. The possibility that policy might change direction under a future Conservative government was also mooted when it asked if current policy was "treating the symptoms rather than the causes", and concluded that treatment was being pushed in "the wrong direction, preferring maintenance to recovery".

Hayes insists that, despite the signs of a sea change indicated by Breakdown Britain, "the political reality" is very different. "If you actually scrape away the rhetoric of Breakdown Britain, you find people saying, 'Yes, methadone does work. We're not actually anti-methadone, but it's been given too much of a role in the past.'" He cautions against reading too much into the report. "What you promise in opposition and what you are forced to deliver in government are very different. You have to face the reality of the evidence and the resources you have available."

But how can Hayes be so sure that drastic changes in policy direction are not on the horizon if a Conservative administration does make it to Downing Street? If past performance in government is anything to go by, he says, then pragmatism dictates what is done. He points out that the "shift in policy away from an abstinence-driven policy towards a harm reduction policy took place when Margaret Thatcher was prime minister".

It also comes down, he says, to the fact that "very few people will deny there's a correlation" between drug dependency and crime. He argues that this, along with the "many complex problems" such as mental health difficulties that tend to come with people who are drug-dependent, tends to steer politicians down a more pragmatic path when in power.

So does Hayes concede anything to his critics? He admits that if the funding dries up things could get difficult - but says there is enough "for the moment". He also accepts that as the cash has been "pumped in" and local treatment services have expanded, quality of provision and cost-effectiveness has not always kept up. "You can't do that overnight," he says, adding that improving the quality of services - and therefore outcomes - will be a focus for the NTA for the next three years. Addressing critics who might say progress isn't coming quickly enough, he responds: "There is inevitably a time lag between the investment and the investment bearing fruit."

As for the future, Hayes sounds confident. "The evidence in favour of current approaches to treatment are overwhelming," he says. "The evidence and the cost-effectiveness will stand the test of examination and will stand up to whatever political spin is put on it. It may well be recast, relabelled, repackaged, but the evidence is the strength."
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source: The Guardian U.K

The Center for Behavioral Health offers treatment to help people regain control of their lives

At first, Erika Sternberg and Dan Templeman used prescription painkillers to relax and have fun on the weekends.

Then Erika's father, whom the Boise couple loved dearly, died about two years ago. That tragedy changed the role of drugs in the couple's life. Vicodin, a prescription opiate, wasn't for having fun. It was for getting numb.

"I couldn't have a peace about (the death)," Sternberg said. "It really disturbs my soul."

During two years of drug use and attempts to quit, the couple hit bottom several times.

The Center for Behavioral Health in Meridian opened when the couple needed it most.

With daily treatment, Sternberg, 27, and Templeman, 30, have started to put their lives back together.

Until this spring, Idaho was one of only a few states without a methadone clinic. Methadone is a synthetic form of morphine that helps most people wean themselves from opiates or heroin.

The Center for Behavioral Health, which opened April 7, is part of a for-profit chain of centers in nine states. The outpatient facilities offer treatment and counseling for every addiction.

Fewer than 30 people are in treatment at the Meridian center, partly because of the downturn in the economy, said co-owner Brant Massman, of Boise.

"The response has been very positive," Massman said. "However, because of the economy being where it's at, I can't say that things are booming."

For Templeman, the road to addiction started with surgery to remove his gall bladder. "That's pretty much how most people get hooked on stuff like Vicodin," he said.

At first, Templeman simply asked his doctor for more refills "and then pretty much you just buy them from people," some of whom had unused prescriptions, including for OxyContin, which carries a national reputation as a highly addictive opiate sometimes prescribed to relieve severe pain.

Sternberg was making good money at an office job and bought presents for Templeman, who worked at the Boise Airport.

In addition, she said, "We had gotten my wedding ring."

Eventually, Templeman's sources of prescription painkillers dried up. He decided to use heroin. He said it was to wean himself off prescription painkillers.

"First, we did it just on the weekends, and it just gradually increased," Sternberg said. "We'd do it two days in a row and then ... after a while you just have to have it."

Desperate to hang on to their jobs, the two tried to find a detox center in Boise to get help. With no health insurance, they came up empty. They were missing a lot of work and performing poorly because of their drug habits, and they were afraid of losing their jobs. They pawned possessions to get money.

"It was both depressing and humiliating," Sternberg said. "There were several times I would just break down and cry, but I just couldn't stop."

Through relatives and friends, they heard about a detox program in Seattle, but were unable to stay long enough for aftercare and were using again within a few months.

They went to a methadone clinic in Ontario, but fell behind on paying for their medication and were forced to leave the clinic for nonpayment.

Withdrawal followed.

"You want to keep thinking of ways to die, but you are too weak to do it," Sternberg said. "If there had been a gun, you would have pulled the trigger, because you just want it to end. You don't want to die, but you want a way out."

Since starting their treatment at the Meridian clinic things are looking up.

"For the first time, I don't crave any alcohol or drugs or anything," Sternberg said.

At the Meridian clinic, the couple pays $55 each a week for a daily dose of methadone in a cherry-flavored liquid.

The pair recently began working at Deseret Industries, where they make less than $6 an hour hanging clothes and sorting merchandise for a second-hand store. Deseret Industries, sponsored by the Church of Jesus Christ of Latter-day Saints, will also provide up to $3,000 to help the non-Mormon couple learn a trade or career skills, they said.

The couple's only wish: That the state's Medicaid program would help addicts pay for maintenance, as a few other states do.

"(Addiction) can affect anybody," Sternberg said. "It doesn't mean that you're a bum or homeless or a junkie or any of those things."
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source: http://www.idahostatesman.com

I applaud Scotland's Future Forum on their forthright recommendations for the development of treatment and care services for those with drug and alcohol problems. Doubtless there will be criticism of proposals to prescribe pharmaceutical heroin. However, it should be noted that this already occurs elsewhere in Europe, and in North America, and safe injecting areas are available. Indeed, limited prescription of heroin already occurs within the UK, with some success. The prescription of heroin, methadone, and alternatives such as Suboxone, all have a potential role to play in moving drug users along the road to recovery.

In combination with the Scottish Government's significant new investment in the education, prevention, and treatment of alcohol problems, and the recently published Road to Recovery drugs policy, it is to be hoped that we might see a significant improvement in treatment and care services, with commensurate improvement in outcomes, and fewer drug and alcohol-related deaths.

It is also heartening to see a growing recognition that addiction is not simply a problem that can be treated medically and which only affects the individual. Rather, alcohol and drug problems affect families, organisations and society as a whole. As such, solutions must be found that are medical, psychosocial, economic, and cultural.
advertisement

I look forward to parliament's response.

Dr Gary Tanner, Clinical Lead, Alcohol and Drug Services, NHS Lanarkshire, Coathill Hospital, Coatbridge.
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source: http://www.theherald.co.uk

Most addicted people need help to find a way to live clean, sober lives. Treatment Centers, therapists and specialists are often the last stop in the vicious cycle that is substance addiction.

Maryland 6/03/2008 07:29 PM GMT (TransWorldNews)

TreatmentCenters.com is a national directory for treatment centers, therapists and specialists. We offer a free, simple and comprehensive index that provides assistance and guidance for those seeking help regarding alcohol addiction, drug addiction, eating disorders, cancer and many other conditions that affect the mind, body and soul. We also offer a wide variety of addiction and illness treatment centers, as well as individual counselors that can address your specific needs. We include peer support and detoxification programs. In addition, we can provide you with many resources for outpatient and residential programs.

Making the choice to seek treatment for an illness or addiction can be challenging. Our goal at TreatmentCenters.com is to make that job easier for you. We provide a bridge between people seeking treatment and the centers, physicians and counselors who provide that treatment. Keeping in mind that any disorder can affect the entire family, we provide resources and information for friends and family members as well. If you are a person seeking treatment, you will find a vast number of resources on our site.

If you are a professional offering services, we provide a first class showcase for what you have to offer. Our site consists of an easy to use search center that will match your needs to the services provided by professionals in your area. We also offer discussion forums where you can dialogue with others about various relevant topics. We provide cutting edge news on a variety of treatment related topics and offer a blog section in which you can journal about your personal experience.

Many individuals will not seek treatment for various reasons. It has been our experience that 'active' addicts and alcoholics, as well as people afflicted with different addictions or physical conditions can sometimes lose the ability to reason. A therapist or specialist for a specific illness or addiction issue, or a full-fledged residential treatment center can and will help. You, and/or your loved one, can find it at TreatmentCenters.com.

We appreciate input to further refine and maintain the efficiency of this website.
Please contact us with your thoughts. Thank You.

"Turn over a new leaf with TreatmentCenters.com"

Our motto "Hope, Help, Heal, and Happiness" shows the path.
You provide the hope. We provide the help


TreatmentCenters.com is a national directory for treatment centers, therapists and specialists. We offer a free, simple and comprehensive index that provides assistance and guidance for those seeking help regarding alcohol addiction, drug addiction, eating disorders, cancer and many other conditions that affect the mind, body and soul.


For further information, please contact us at 713.992.2828.
Sales: palmer@treatmentcenters.com
Webmaster: dan@treatmentcenters.com
http://treatmentcenters.com
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source: TransWorld News

As the government tries to tackle anti-social drinking by targeting parents, the BBC's Jon Kelly speaks to a couple who say they are powerless to prevent their son abusing alcohol. All names have been changed.

Luke Thomson had always been a model son - caring, sensible and hard-working.

But after falling in with a group of friends whose lives revolved around heavy drinking, his parents soon witnessed an ugly transformation.

As a result of his bingeing, Luke would become aggressive, abusive and suicidal. His work suffered, he spiralled into debt and lost his driving licence.

Horrified at the changes in their son, mother Amanda, 53, and father Andrew, 55, have battled to help him, but Luke - now 21 - remains beyond their reach.

From being a sensitive young man, he turned into someone with a split personality
Andrew, father

"It's heartbreaking to watch this happening to a boy that I love," says Amanda.

"But however much we try to help him, it's his friends he listens to - not his parents. That's what the government don't understand."

Downward spiral

Like Andrew, she is deeply sceptical of the home secretary's plans to prosecute adults whose children are caught boozing in public.

For three years they have tried everything to curb Luke's drink problem, to little effect. Stripping the house of alcohol has failed, as have attempts to keep him away from the friends whose influence they believe has had such a pernicious effect.

And as a professional couple from the rural south of England, Andrew and Amanda warn that their situation could happen to anyone.

Luke had been a well-behaved and considerate teenager, but his downward spiral began on his 18th birthday when the new group of friends thought it would be funny to get him hopelessly drunk.

After staying up with his son all night as the teenager experienced his first dose of alcohol poisoning, Andrew hoped it would at least put his son off booze for life. But he was to be proved wrong.

"We'd never had any problems with him growing up, and I'd always been quite anti-alcohol," Andrew recalls.

"But from being a sensitive young man, he turned into someone with a split personality."

As they grew more and more concerned about Luke's increasingly heavy alcohol intake, his parents found they were powerless to help.

He moved into a flat with his new friends, who were used to spending the entirety of each morning sleeping off their hangovers.

Andrew and Amanda believed the group were taking advantage of their son, who had saved carefully as a teenager to buy his own car.

But every time his parents tried to reach out to him, Luke pushed them further away.

"I'd tell him his drinking was out of control, and he'd say, 'I'm too old for you to tell me what to do,'" remembers Amanda.

"Eventually I was so concerned that I spoke to one of the girls he lived with that I thought Luke was becoming an alcoholic.

"So she went and said to him that all I wanted to do was interfere and he should keep away."

'Real problem'

Luke's drinking came to a head when, after a drunken row with his friends, he sat alone at the wheel of his car.

He had kept the engine switched off, but when the police spotted him he was charged and eventually given a 20-month ban.

Until he admits he has a problem and gets help, there's no way out
Amanda, mother

Unable to drive, his prospects at work as an estate agent suffered and his confidence plummeted further.

Two months later, addled with debt, he moved back home. But Andrew and Amanda were still unable to stop his binges.

His mother believes that a girlfriend might help Luke find the self-assurance and maturity he needs to break out of his self-destructive lifestyle, but a vicious cycle keeps him trapped.

"Because he's always drunk he finds it difficult to meet girls. And that makes things worse, because it means his confidence is hit even harder," she says.

"Until he admits he has a problem and gets help, there's no way out for him."

Andrew says his family's experience shows that parents cannot always control the anti-social drinking of children - grown-up or under age.

"The real problem is how cheaply alcohol is sold in shops and supermarkets, and how it is portrayed in the media - soap opera characters turning to it at the slightest problem.

"Punishing parents is not the solution. We are already the ones who suffer the most."
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source: © BBC MMVIII