|
|
Quote of the Week
"If I cannot do great things, I can do small things in a great way" ~ Martin Luther King, Jr.
(Article provided by Annie Hahn RN Addiction Medicine Service’s Center for Psychiatric and Chemical Dependency Services (CPCDS). This is a must read.)
...Persons interested in the Ambulatory detox program will need to have an initial evaluation in the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) The DEC is operational 24/7 and an evaluation can be done at any time. The DEC is located on the first floor of Western Psychiatric Institute and Clinic 3811 Ohara Street Pgh,Pa 15213 Patients will have a complete psychiatric evaluation, physical exam and test doses of detox medications. Patients are then sent home with appropriated detox medication and referred the next day to the Ambulatory Detox Clinic at the Oxford Building 3501 Forbes Ave 9th floor... His baby face, ball cap slung sideways on his head, and baggy pants belied his age. Matt was 29 but looked 16 years old when he went to the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) asking for help to quit using heroin. He had been using the drug for the past six years. “I’ve tried to quit before but I just could not make it through the withdrawal cold turkey.” In the DEC he was evaluated and started on an ambulatory detoxification protocol to help him safely withdraw from opiates.
His story was a familiar one to the staff at the DEC and Addiction Medicine Service’s Center for Psychiatric and Chemical Dependency Services (CPCDS). This innovative detoxification program is a collaboration between the DEC and CPCDS staff and has been operational since March 2003. The detox staff at CPCDS includes Annie Hahn RN, Rodney Williams MD and several other physicians, nurses and therapists who help out from time to time.
The next day, Matt continued his detoxification at CPCDS. He told the staff “I’m really glad you’re here. Drugs are ruining my life. I want to stop shooting dope. I tried to quit on my own a couple times, but just couldn’t.” Annie smiled, as she always does. She understood what Matt meant. During the detox visit, Annie checked Matt’s blood pressure, assessed withdrawal symptoms and initiated a discussion about “recovery” to let him know that getting sober was a lot more than simply stopping the drug use. Annie then consulted with Dr. Williams who examined Matt for medical and psychiatric co morbidity, and determined medication needs.
Matt’s father had come with him to the appointments. He was upset, worried and angry, which are common reactions of parents when a child becomes addicted. Annie listened to what Matt’s father said. She could hear the stress. She provided empathy, support, education and a sense of hope that his son could recover
On day 3 of detox both Annie and Dr. Williams re-evaluated Matt’s symptoms and motivation to change. Since he was feeling much better, Annie suggested he begin participation in the Partial Hospital program on site. Matt accepted and began that day. Some of the topics explored in the groups he attended over the next few weeks included – the disease concept of addiction, identifying and managing triggers, using the support of others, the availability of the community support system of NA/AA, learning to managing emotions and developing a long-term relapse prevention plan. Matt said it best about what he learned, “ I learned things could get better and I could have a life without drugs.”
WPIC has the only Ambulatory Detoxification program offered in Allegheny County. However, detox in and of itself is of limited value. All ambulatory detox patients are encouraged to continue treatment in a Partial Hospital or outpatient program as Matt did.
The majority of the 2000+ patients seen in the program thus far were addicted to opiates such as heroin and Oxycontin. While withdrawal from opiates is uncomfortable, it is usually not dangerous. Patients experience “flu-like” symptoms: chills, sweating, diarrhea, abdominal cramps and general body aches. Medications are given to ease the symptoms, reducing the experience to low-grade anxiety and restlessness. Detox is usually completed within 5-7 days. According to Annie Hahn RN, the “most serious complication” seen during detox is relapse and discouragement. The staff addresses these issues in their daily meetings with patients. A major goal is to help motivate the patient to engage in continued care, and participate in AA or NA meetings in the community.
If found to be medically appropriate patients may also be detoxed from alcohol or benzodiazepines in the Ambulatory Detox Program
Outcomes of the detox program have been encouraging. Of the patients who came for detox, over 60% completed the process. Among these completers, 70% participated in ongoing treatment.
The numbers of patients seeking Ambulatory Detox continue to increase. The increase speaks to the growing epidemic of opiate addiction in both the inner city and the suburbs, without regard to race, gender, age, or socioeconomic status. One of the most important goals of the staff who work with the ambulatory detox patient, is to decrease the numbers of those patients who use detox as an end in itself, but use it as the first step on that road called “recovery.”
Persons interested in the Ambulatory detox program will need to have an initial evaluation in the DEC (Diagnostic and Evaluation Center/Emergency Room WPIC) The DEC is operational 24/7 and an evaluation can be done at any time. The DEC is located on the first floor of Western Psychiatric Institute and Clinic 3811 Ohara Street Pgh,Pa 15213
Patients will have a complete psychiatric evaluation, physical exam and test doses of detox medications. Patients are then sent home with appropriated detox medication and referred the next day to the Ambulatory Detox Clinic at the Oxford Building 3501 Forbes Ave 9th floor
Further information about the Ambulatory Detox Program may be obtained by calling Annie Hahn RN (412) 246-5278. Questions about the program are welcome.
Read More......
Debuting THURSDAY, MARCH 15 (9:00-10:30 p.m. ET/PT), with the centerpiece documentary ADDICTION, the series is eye-opening and ultimately hopeful, providing guidance in navigating the often confusing world of addiction treatment and recovery.
"How can we comprehend the concept of a person who wants to stop doing something and cannot, despite catastrophic consequences? That is what we are up against. Some people don't want to speak about addiction, or compare it to other chronic diseases. Well, this is a disease, a treatable disease, and it needs to be understood. HBO's ADDICTION project is an initiative that will help people understand more about this illness, its advancements and how to find help."
-- Nora Volkow, MD, Director of the National Institute on Drug Abuse
HBO's Groundbreaking 14-Part Series, The ADDICTION Project, Kicks Off March 15
January 18, 2007
"How can we comprehend the concept of a person who wants to stop doing something and cannot, despite catastrophic consequences? That is what we are up against. Some people don't want to speak about addiction, or compare it to other chronic diseases. Well, this is a disease, a treatable disease, and it needs to be understood. HBO's ADDICTION project is an initiative that will help people understand more about this illness, its advancements and how to find help."
-- Nora Volkow, MD, Director of the National Institute on Drug Abuse
Los Angeles, CA –- One in four Americans has a family member who is struggling with addiction. Over 80% of people with substance abuse or dependence disorder started using before age 18. Currently, addiction affects 22.2 million Americans. Yet only 9% are receiving the treatment they need.
In partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), HBO launches the ADDICTION project, an unprecedented multi-media campaign aimed at helping Americans understand addiction as a treatable brain disease, as well as spotlighting new medical advancements.
Debuting THURSDAY, MARCH 15 (9:00-10:30 p.m. ET/PT), with the centerpiece documentary ADDICTION, the series is eye-opening and ultimately hopeful, providing guidance in navigating the often confusing world of addiction treatment and recovery.
For the first time, HBO will use all of its digital platforms, including the HBO main service, multiplex channels, HBO On Demand, podcasts, web streams, and DVD sales to support a campaign that includes a 14-part documentary series, a book published by Rodale Press, four independent addiction-themed films, a robust website and a national community grassroots outreach campaign funded by the Robert Wood Johnson Foundation.
All films will initially be offered during a free HBO preview weekend from Thursday, March 15 to Sunday, March 18 in participating cable systems.
"HBO is utilizing all of its platforms to develop programming directly targeted to the various needs of the American public on this complex public health issue," says Chris Albrecht, HBO's chairman and CEO. "Our resources are committed to illuminating, demystifying and defining addiction – a problem that is riddled with misconceptions."
The ADDICTION project showcases the work of many of today's leading documentary filmmakers, including Jon Alpert; Kate Davis and David Heilbroner; Susan Froemke; Liz Garbus and Rory Kennedy; Eugene Jarecki; Barbara Kopple; Albert Maysles; D.A. Pennebaker and Chris Hegedus; and Alan and Susan Raymond.
ADDICTION brings together leading thinkers and organizations that are at the threshold of new treatments. Current advances in brain imaging science make it possible to see inside the brain of an addicted person, pinpoint the parts of the brain affected by addiction, and see how the addict's brain differs, ushering in a great many advances in medical treatment. In fact, treatments for addiction are now as effective as treatments for other chronic relapsing diseases such as diabetes, hypertension or asthma.
A candid depiction of the emotional, psychological, social and political toll that addiction takes on the country, the ADDICTION project demonstrates conclusively that the disease is treatable and shows that there are millions of Americans in long-term recovery.
Topics covered include: the nature of addiction, addiction in the workplace, and the protracted insurance battles waged by families, as well as the difficulty of finding and getting adequate treatment.
The ADDICTION project will be supported by an unprecedented 30-city nationwide community outreach campaign funded by the Robert Wood Johnson Foundation and coordinated by Join Together, Faces and Voices of Recovery, and the Community Anti-Drug Coalitions of America (CADCA).
The ADDICTION project is produced by John Hoffman and Susan Froemke and executive produced by Sheila Nevins.
For additional information, contact Roberta Leis at roberta@jointogether.org.
Read More......
Wishes
Posted by:Ken Sutton--Wednesday, January 24, 2007
(this was written in concert by the parents at the Bridget to Hope Meeting. The meeting is in the Donor Conference Room of Passavant Hospital on Babcock Blvd. ever Wednesday from 7 PM to 8:30 and is open to all)
At the Bridge to Hope meeting there is a tremendous amount of real world experience dealing with the impact of the disease of addiction on our families. These are wishes that we have shared when looking back on this ordeal. These wishes are voiced about our children but apply equally to brother, sister or other loved ones. Our wish for you is that the sharing of what we have learned will be helpful.
I wish…
...I had known I wasn’t alone through all of this and that there was a good support system out there. When I reached out and had a chance to talk with others I realized I wasn’t going crazy.
...I had understood that taking care of myself was just as important as helping my addicted child recover. I had to get better so the cycle of enabling could be broken.
…I had understood that addiction could occur in any family. It is not just something that happens in dysfunctional families. Being a role model or even a great parent role model is not enough to stop the disease of addiction.
...I had known the huge impact this disease would have on my entire family; and I had taken steps to make sure everyone got the help they needed earlier rather than later.
...I had understood how very important it is to have everyone who is supporting a child’s recovery (all parents, family members, church, school and others) on the same page.
...I had understood that there is a strong spiritual component to recovery from this disease; that church can be a significant resource for my child and my family. Churches have experience dealing with other addicts in the congregation and they can help us understand that recovery comes from faith in a Higher Power.
…I had been able to “let go and let God” sooner. Recovering from the impact of addiction in the family is a process that takes time and is different for each person.
...I had known and really understood what terrible lengths my child would go to (lying, stealing, running away and much worse) to obtain drugs. Valuables needed to be removed from my child’s grasp before the family heirlooms ended up in the pawnshop never to be seen again.
...I had understood the difference between encouraging and enabling. Enabling resulted in spending upwards of $10,000 on heroin over the years.
...I had known I was enabling my child to use drugs when I lied for him and protected him from consequences. Addiction is a situation of opposites where your heart will rule your decisions instead of your brain. You are not helping your child by protecting him from the consequences of his actions no matter what your heart tells you.
... I wish I had known that someday I would feel good about my child being in jail because he is safe and not using drugs.
...I had listened to that little whisper from my heart that told me my child was using drugs.
...I had paid attention to the warning signs: dropping grades, withdrawal from sports and school activities, disappearance of old friends (the “good kids”), new friends who had first names but no faces or last names, increased secret phone activity, sneaking out …etc.
…I hadn’t convinced myself that this was “just a phase” or adolescent “right of passage.” That I knew how to distinguish between normal teenage behavior and drug related behavior.
…I had known more about the drug situation in my community and school. As parents, we are ignorant of the drug problem with a capital “I”. We have to educate ourselves about street drugs, their potency and symptoms of use, as well as the potential for abuse of prescription or other medicine that we may have in the house.
...I had listened to the clues I was given by teachers and the school principal. I think many people knew or suspected about my child’s drug use before it was acknowledged at home.
…I had understood that drugs are literally everywhere including churches, schools, recovery meetings, rehabilitation centers and places of employment.
…I had known that even when I tried to make my child safe by “grounding” them that drugs could easily be “delivered” to the house.
...I had understood that no matter how much I loved my child, how much I cried, how much I hurt, how much I bribed, how much I punished, I couldn’t make my child stop using drugs.
…I had known that treatment was not a one-shot deal and not a cure.
... I understood what a really long process recovery from addiction is (years not months) and that after abstaining from drug use it takes them a long time to catch up with their peers intellectually and socially even though they want so much to be normal.
…I had been aware that all recovery meetings are not the same and I had to shop around to find the right program for my child.
...I had never given up on my child. Recovery takes time. “Just for today” are watchwords. What a difference two years makes! There isn’t any good reason to give up hope.
...I had challenged the educational professionals at school more. There is a truant officer at some schools to support efforts to keep your child in school but you have to ask. There are alternative education programs at some schools but you have to ask.
...I had questioned the doctors and the experts more. Addiction can masquerade as depression. I think the age of the child is an issue in treatment. Techniques that work well with a 23-year old may not be appropriate for a 13-year old.
…I had known about Act 53, a government funded program to involuntarily court order a child into treatment without a criminal record.
…I had known that drug tests could be manipulated.
Read More......
The Alliance Against Highly Addictive Drugs is a not-for-profit community based organization that includes many school districts, faith based and other organizations as members. They have just put up their new website at drug-alliance.org and you can learn all about them there. It is free to join and you can do so online. If you were a member in the past you must reenter your information to stay on the email list.
This site also contains several parent videos some of which were done in partnership with Juvenile Probation. You can view these videos online but first you have to request a username and password. You can make this request via email to Probation Officer Woodward.
One of the best things about the web site is that it provides an online, web based user searchable database of service providers of all types. Service providers must enter their own information on the web site and again, there is no charge for this. Please share this information with any community based service providers you know and encourage them to enter their information.
Read More......
We had eight parents attend. Lots of time for updates. While most parents were experiencing positive things, on any given day that might not be the case. I guess that is life. The Steelers had one of the best years in the franchise last season. This year they can't make the playoffs.
The better our teenagers do on probation, in recovery, and in their lives- the more we expect. However, the ebb and tide of the recovery process usually, if we are lucky, gives you two steps forward and one step back. If we aren't lucky, then one step forward and two steps back. In fact, one of the recurring themes in this meeting was that we learn from failure.
Also, sometimes we have to make the same mistakes over and over until we get it. In recovery people talk about "getting sick and tired of being sick and tired."
The positive thing for most of the teenagers of our parents that come to PSST is that when our teenagers make mistakes, they usually don't get away with it. We apply consequences for bad decisions. We allow the natural consequences for bad decisions to take place, refusing to rescue our teens from the predicaments in which their bad judgment or drug abuse has put them. That helps the learning from failure thing to work.
One question that comes up a lot is this: Why, if they knew they would probably get caught, do they do it anyway? And searching for that answer sometimes leads one to surmise this: there must be something bothering them, that if we could just figure out what that is, and sort of fix it, address it, treat it, whatever it, and then they would not relapse.
Let's look a bit closer at this logic. They relapse. Therefore something is broken and needs fixed. "None of the rehab people were able to get my teen to talk about what was really bothering him. If he could talk about what was really bothering him, if someone could just get him to talk about it- he could stay clean." What makes this logic a tough nut to crack, and it is, because I see it time and time again with parents, is that there is some truth to it.
Yes, indeed there are issues galore. No, the teenager had not talked about all the issues. Would it help his recovery if someone could help him talk about all these issues? Certainly. However, in recovery from highly addictive drugs, we must factor in one other huge thing to this logic: EUPHORIA.
The extreme high that the addict feels is such a powerful reinforcer that it can outweigh the certain consequences that will follow. At the time the teen wants to get high, he doesn't care about the consequences because he knows that for a short time he will experience the bliss of drug use. The drive to get high can also be more important than whether or not certain issues have been resolved. So, what are we left with? Are we powerless over our teen's recovery from addiction? Yes, of course. Only our teenager can decide that they want to change their life.
But are we powerless over our own parenting activities? Hopefully not. We can send powerful messages to our teen addict by the actions that we take or fail to take. And sometimes that can help. For example, since we know that recovery from highly addictive drugs happens more often when the addict is working a strong 12-step recovery program, we can devise parent-strategies geared to enhance the recovery process. Can we work our teenager's recovery program for him? Of course not. But if we know that our teenager is not serious about his recovery, we can see the relapse coming down the road. If a parent chooses not to address this- then all one can do is wait for the relapse. Of course we all know how risky that can be. Each relapse is not only devastating in so many ways but each relapse runs the risk of death.
When all else fails, if we are lucky we can insist that our addict at least remain somewhere where they can't hurt themselves- like in an inpatient drug rehab or in a Court placement. The gift of Clean Time- even though it is bought dearly with great cost of emotional pain and financial pain, is sometimes all we can do. Will one more Court placement do it? We do not know. Only time will tell if the "miracle" has happened. With highly addictive drugs, we are really are waiting for a miracle. The good news is that with the gift of Clean Time - we sometimes get it.
Back to the two steps forward and one step back- or heaven help us- the one step forward and two steps back. With success we expect more, but let us not forget to compare our teenager's success, especially during the step-back process, with where our teen would be if we had never provided intervention. Are they more or less healthy? Have they had any success in education? Are they more or less drug free? Do they go though periods when they are really doing quite well in recovery? Have they at least been exposed to the 12-step program so that they know where to turn later in life? Now compare that to the rapid loss of weight, the stolen items sold for drugs, the lies, the sleepless nights not knowing where your teenager is or what he is doing to provide himself with drugs. When we do that comparison, maybe things do not look so bad.
I think the one of the reasons that I'm writing this today- is that our last meeting, the first one of the New Year, was one in which everyone present found some positive focus. One youth, who lived in a halfway house relapsed to Heroin and ran away on New Year's Eve. However, he took a new attitude with him back to inpatient treatment. He seems to feel genuine remorse for what has happened. His mother has never seen that before. Also, we found him by the next day so he could not hurt continue to hurt himself with Heroin. And out of that tragedy his mother found a really strong statement to make to her teenager. She said, “Everyone is working harder on your recovery than you are. Until you are working as hard as everyone else- I am backing off.” What she meant by that was not that she was giving up, but that she was done running out to visit him all the time and trying to make sure that he was comfortable. We could write a separate post (or book) just about what that statement means, because it is so powerful- and yet complicated.
Another teen is coming home after three weeks at Shuman, and he is bringing a new attitude home with him, one that we have not seen yet. It is one of humility and willingness to do what he needs to do to be successful on probation this time. Also, we are trying some supervision approaches that we have not tried with him before, including Electronic Home Monitoring and visual aides to chart his success.
One teen lied about an overnight outing that was approved by parents. However, the girl was found not to be where she was supposed to be. Also, she admitted to drinking alcohol. The parent busted her immediately because of good, strong parental supervision. And for the first time, this teenager complied with all parental sanctions, including no more overnights, without a making a fuss. Historically, this is very rare with this teenager.
One teen quit her job and lied to her parents about it. She might be entering into a difficult phase of her mental health issues as she is beginning to show some signs of emotional difficulties. Ok, but the parent is on to it, applying limits to her behaviors where appropriate and insuring that she receives the proper psychiatric attention. Also, this girl is clean still and working a 12-step program after release from treatment months ago.
Another 20 year-old appears to be putting a strong recovery together after a relapse four months ago. His parents don't think all of his relapses are yet behind him, but for today he is clean, working a program, and attending college from a men's halfway house.
Another youth is now almost three years clean, holding a job and living independently. He is paying his own bills. While his mother is concerned that he is starting to back off on attending 12-step meetings, he still did an outstanding presentation for Probation on 1-8-07 at the Westview Crime watch meeting. He has done public speaking for us before, but this is the strongest message I have ever heard him give. His comments for the teenagers and his message to the parents in the audience were very powerful.
Another teen that lives in a halfway house got fired from his job, has no money to pay his rent, but seems to be still be working a strong recovery program. He has four months clean. And his mother also delivered a strong message at the same Westview Crime watch meeting. Her first-time experience with public speaking was emotional. She said (through tears) that she told herself that she would not cry. It certainly touched parents in the audience. Her message was one of: "pay attention, supervise, drug test, and don't be too sure your child is not involved with drugs. If you find out that they are involved with drugs- ask for help- you are not alone. And if they are involved with drugs, you're going to need all the help you can get." It was very moving- and if she is reading this- thank you so much for being willing to get the word out.
Thank you from both Val and I to all the parents who turned out for this meeting. Often, when I tell people that I am a Probation Officer who works with teenagers with drug problems, I am asked "How can you do that? Isn't that hard? Don't they relapse?" Yes- it can be frustrating. However, having parents like you guys who are willing to fight so valiantly to try to save your teenager's lives- you guys make it all worth while! Val and I have often said that the best part of our jobs is coming to group to meet with your guys! What you do is very inspirational not only for other parents, but for us!
Happy New Year to everyone from Val and I and we wish you all two steps forward in the coming year!
Type rest of the post here
Read More......
We are making some changes about when and at what time we meet. For example, we might dump Monday night meetings in favor of Saturday mornings. Let us know what you think.
For January and February we are changing to first and third Saturday mornings just because both of the scheduled Monday dates fall on holidays. Also, at our next meeting on 1-20-07 (Saturday) we are experimenting changing the time of the meeting from 9:00 AM to 8:00 AM. This would allow us to finish our meeting by 10:30 AM instead of 11:30 AM. Please let us know your opinion of what days and what times we should meet. We are listening. You can post here or call me at 412-247-6365 to register your opinion.
Read More......
Books
Posted by:Ken Sutton--Sunday, January 07, 2007
I have had several books recommended to me in the past couple of weeks that I want to share with you. What books have you read that you have found helpful and would like to share with others? Please leave a comment or drop me an email with a full review and I will post it. Note - the links are to Amazon.com. If you buy used books you can get all three of these for less than $10, two of them are less than $1 each. We do not have any financial relationship with Amazon.com.
 The first book “70 x 7 and Beyond: Mystery of the Second Chance” by Monty Christensen, Roberta L. Kehle was recommend by a parent at the group this week. She gave it to her child as a Christmas present and said it was well received and served to spark some interesting discussion.
 The second book is “Back in Control” by Gregory Bodenhamer. The PSST group has used this book in the past and I was curious about it. The author, a California PO, shares his tips and wisdom for controlling difficult children. His solutions are elegantly simple and easy to put into practice. Worth the read.
 The third one is a book that I wish someone had given me when I first learned my child was an addict, “Addictive Thinking” by Dr. Abraham J. Twerski the founder and medical director emeritus of Gateway Rehab. Twerski shares the wisdom he has gained in a way that answers so many questions for parents.
Read More......
|
|
