“Rethink value and recreate life” is the credo of Michael Dadashi, owner of MHD Enterprises in Austin, Texas. The company, which employs people in long-term recovery from addiction, recycles and resells electronic parts and computers.

Michael Dadashi, a recovering heroin addict with a knack for business, likes to say he was addicted to “more.”

“More drugs. More alcohol. More prestige. A bigger house, a better car,” Dadashi says. “I wanted more. When I was here, I wanted to be there.”

Cycling through rehabs, jobs and relationships, Dadashi had a spiritual awakening in 2009 at age 25 and has remained drug-free ever since. He tapped the wisdom of sober mentors, walked the 12 steps, invested energies in altruism and embraced the art of mindfulness. “I finally put my spiritual fitness first,” he says. “It was like God saying, ‘This external stuff that you’re trying to fill that void inside of you with is not working. This is an inside job.’”

Today, Dadashi is at the helm of a multimillion-dollar company – and people in recovery are a key part of his success. Former addicts comprise more than half the staff at MHD Enterprises, the electronics recycling firm that Dadashi built while in recovery to more than $7 million in annual revenues. Based in Austin, Texas, MHD was named one of the nation’s fastest growing private companies by Inc. Magazine three years in a row (2012, 2013, and 2014).

Men and women in recovery also rejoin the work force at Dadashi’s newest enterprise: he’s creating a mini “ecosystem” of recovery-related businesses – all taking root in a 30-year-old strip mall in east Austin.

Finding connection at the coffee shop, a favorite gathering place in the nonprofit 4D Community Center. The center is part of a village of recovery-oriented ventures in Austin.

“What we try to do is create an environment that is conducive to recovery, doing things that are going to feed the spirit,” Dadashi says. That might include morning meditation, “leaving during the lunch break to talk to their sponsor, or working one-on-one with other addicts, because there’s such a therapeutic benefit, one addict helping another,” Dadashi says.

“We’re trying to inspire transformation through purpose – not just ‘wash, rinse, repeat,’” (a reference to the revolving-door rehab that traps many people in addiction).

Criminal History, Bad Credit?

“This is where you can rebuild your life”

Local drug rehab centers are a recruiting source for Dadashi’s sober labor pool.

“We know from the treatment center that ‘Bob’ completed treatment, that he’s following the program,” says Gail Zorne, MHD’s chief financial officer and a former Merrill Lynch wealth management banker and broker. Zorne is also Michael Dadashi’s mother.

When she interviews job candidates, Zorne says most are candid about past drug arrests, jail time and the need to start over.

“They willingly say, ‘I’m sorry to say I totally screwed up my credit,’” Zorne notes. “And we say, ‘that’s fine, this is where you can rebuild your life.’”

Zach Pogue heard about a job opportunity through his counselors at a drug treatment center in Buda, Texas. He now works at Infinite Recovery, a treatment center created by Dadashi that serves as the anchor of the new recovery village.

Once addicted to alcohol, meth, and opioid painkillers, Pogue applies his recovery wisdom to guide others. He walks newbies through the 12 steps and teaches critical life skills – from how to write a resume and file taxes, to learning how to “show up” in relationships.

Pogue sees his own sobriety in a new light.

Zach Pogue of Buda, Texas, overcame addictions to methamphetamine, alcohol and opioids. Today he works as a life trainer at Infinite Recovery in Austin, Texas, mentoring clients and showing them skills to sustain sobriety. Zach is accompanied at work by his dog Delilah, who proclaims his owner’s progress by wearing a sobriety medal.

“I always figured in order to stay sober, I’d have to stay at home with my family and play board games. But that’s just not the case,” he says. “As long as I maintain a simple spiritual attitude, I can do anything that people who don’t suffer from addiction can do – like be around drugs and alcohol at concerts and not freak out.”

“We try to show through example,” Pogue says, “just getting people to buy in to their recovery as opposed to telling them how to live.”

“My parents and friends told me I needed to do something different, but no one ever showed me another way,” he says. “So (this environment) was how I was able to find a better way, through getting out of myself, helping others, and surrounding myself with positive people.”

A Ripple Effect

The mini ecosystem that Dadashi is building includes Infinite Recovery and a nonprofit community center open to the public. As many as 70-100 people join the Wednesday night meditation sessions that are held here. There’s also an exercise gym, coffee shop and stage for sober music events and fundraisers (donations are used to fund scholarships for sober living homes and travel to 12-step conventions).

Employees can join the city’s largest fellowship of Alcoholic Anonymous, which meets next door to the treatment center. There’s a nearby vape shop, operated by a person in long-term recovery, that helps former addicts kick their smoking habit with the aid of e-cigarettes. And plans are in the works for a hair and beauty salon being created by women in recovery.

“There are shopping centers all around the country that are in need of good businesses, that can be turned into these recovery ecosystems,” Dadashi says. He notes that the strip mall in Austin was a crime magnet before the recovery ventures arrived.

“People in recovery need connection, they need purpose, and when you can combine those two things – and they’re having fun, and recovery is cool – it’s having a ripple effect on the community at large,” Dadashi says. “These people are not relapsing, they’re not running up taxpayers’ money for having to go to the ER, they’re not driving drunk or doing crimes related to drug activity.”

The 4D Community Center includes a stage for sober concerts, a coffee shop, lounge and exercise area.

MHD Enterprises, whose customers include Discount Electronics, online re-sellers and overseas firms, is a springboard, Dadashi says, to invest in his passion for recovery. He hopes to create a blueprint for ecosystems nationwide that help people stay sober, inspired “through the work I did at MHD and my personal recovery,” he says.

A Family Inspires Healing

Leah Godfrey, a former IV meth user, has been drug-free nearly four years and now helps others achieve long-term recovery.

Leah Godfrey is beating the odds for drug relapse with help from the safe haven that Dadashi has developed. A single parent, Godfrey was a pro at hiding her methamphetamine habit. She ushered her daughters off to school and earned a stable paycheck as a county clerk. She showered her family with a mother’s love and a stream of lies.

“I was a very good actress,” Godfrey says of the façade that sparked “lies upon lies upon lies – as in, ‘I’m running to the convenience store to get a gallon of milk,’ when I was actually going to score dope.”

Her addiction played out with harrowing intensity as Godfrey graduated from pipes to needles. In 2012, she was hospitalized with a blood infection for injecting meth – a catalyst that led her to intensive rehabilitation and recovery.

Today, Godfrey works as an intake manager at Infinite Recovery, where more than 70 percent of her coworkers have also overcome addiction.

“This place has given me opportunities that I really never thought I would have,” says Godfrey, who is attending college part-time to become a licensed chemical dependency counselor. “I wake up in the morning excited to come to work.”
Continual support for sobriety is an obvious fringe benefit for Godfrey and her peers. But she has an even more powerful incentive: her two older daughters are working alongside her.

While they have not been addicted themselves, Leighton and Lindsey are part of the team. Leighton, 21, serves as Office Manager at Infinite Recovery; her sister, Lindsey, 19, is a recovery advocate and medical assistant. They say clients are often surprised to find a mother and her children employed at the treatment center.

Leah Godfrey (center) works as Admissions Discharge Intake Manager (ADIM) at Infinite Recovery in Austin. Her daughter Lindsey (left) is a medical assistant and recovery advocate at the center; her daughter Leighton (right) is the office manager. Godfrey says of her recovery: “Our complete family dynamic has changed. We have an authentic relationship. Everybody in my family has peace in their hearts now.”

“We know of recovery through our Mom, says Leighton. “When (clients) come in, they don’t have the best family relationships. And the impact that we put off as being a family shows them that there is hope.”

When she was 18, Leighton says her mother told her about the addiction, that it had gotten worse and she was going to treatment.

“At first, it was kind of a disappointment. I just had graduated high school, it’s not something I wanted to hear,” Leighton says. “After she went to treatment, I told myself it was time to reconnect with my Mom. I grew up some, we got together and talked, and since then it’s been great. We’re best friends again.”

Clients have asked Lindsey, ‘How did you gain the trust back with your Mom?’

“I tell them it takes a lot of time. When she was in treatment, I didn’t want to go, I was hurt. We grew up really fast,” Lindsey says. “I think that’s a part of how we are now. We are at the age when all of our friends are in college partying. And we go home and watch movies and hang out as a family, having sober fun with our Mom.”

Radical Change in Recovery

The vast majority of people employed by Dadashi pass the company’s random drug tests, says Zorne. Only a few have relapsed or been let go because of active addiction, she says.

A handful of others get hired, “stay a few days and leave, and then we don’t hear good news,” she laments. “Michael has been to far too many funerals for a 30-year-old.”

She reflects on her son’s battle with addiction, and knows his life could have taken the same turn.

“By 18, it was heroin. From 18 to 23, he went to rehab after rehab,” Zorne says. “I think all of the counseling and treatment over the years finally started making sense to him. He desperately wanted to be clean and sober, and he put his heart and soul into it. He had a spiritual awakening, God lifted the obsession.”

Zorne sees a profound change in her son these days.

“In recovery, he’s become very spiritual, very kind . . . he’s so calm and he was never like that,” she notes. The proud mother relishes her son’s “fairy tale life” in recovery and shows off a photo of his new bride, Ylianna Guerra, who reigned as Miss Texas 2015 (and Miss USA First Runner-Up 2015).

“He’s got the girl of his dreams, he’s got a wonderful business, he’s reunited with his family, he has helped hundreds of people over the years,” Zorne says. “I wouldn’t have envisioned such a wonderful life for him.”

* * * * Photos by Brandi Nellis * * * *

America’s Epidemic of Drug Addiction

An estimated one in seven Americans (14.6 percent of the population) is expected to develop a substance use disorder at some point in their lives, according to a landmark report from the U.S. surgeon general. But only 1 in 10 people who are battling addiction are getting treatment.

“It’s time to change how we view addiction. Not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

Vivek Murthy, M.D., U.S. Surgeon General
“Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health”
Released Nov. 17, 2016

Deaths from drug overdoses in the United States have risen 137 percent since 2000, according to the Centers for Disease Control and Prevention (CDC). That includes a 200 percent increase in deaths from opioid painkillers and heroin. An estimated 78 people die each day from opioid overdose, according to the surgeon general.

Source: U.S. Centers for Disease Control and Prevention (CDC)

Families Confront the Stigma, Share their Heartache to Save Lives

No more whispering.

That’s the plea Patricia Byrne makes on her blog, “Heroin. Stop the Silence. Speak the Truth,” which has drawn more than 3.2 million hits since its launch last summer.

Bryne, the mother of a recovering heroin addict, puts a human face on the “silent killer:”

“A boy from my old neighborhood died this week. He was no longer a ‘boy,’ he was 26, but to me he was still one of the kids. They ran around in the summer as a pack. You could tell where they were by looking for their pile of bikes.

Scenes from those days of innocence keep flashing through my head – when they went from one house to another, rode their bikes to the playground or to the store . . . Now he’s gone. Heroin stole him.”

The boy next door is among those who die from drug overdose – 129 deaths every day in America. That’s an all-time high, according to the U.S. Centers for Disease Control and Prevention. And 61% of those deaths involve an opioid such as heroin.

More families are coming out of the shadows, shedding the stigma of addiction and sharing their sorrow publicly. Many are bone-weary from battling the disease. Heroin addiction has ravaged their loved ones and drained their finances after court fines, rehab stays, hospital emergencies and funerals.

This is how some Americans are grappling with loss, and sharing their truth in heroin’s wake.

To My Daughter’s Drug Dealer

Tina Louden coddles the pale pink urn that holds her daughter’s ashes. It’s a startling selfie that she posted on Facebook along with a bold rebuke:

“To My Daughter’s drug dealer, this is how I spend
my daughter’s birthday now …. how do you live with yourself???

. . . I don’t normally post pics like this but let’s make
this go viral so all the drug dealers see what they are doing to our families.”

Since Louden uploaded the message on August 15, more than 255,000 people have shared her post. Some of the comments blamed Louden’s daughter for doing drugs. Others speculated what kind of upbringing she had that led her to heroin. Drug users thanked Louden for inspiring them to get help, and many people debated whether addiction is a moral failing or chronic disease.

Here’s what an expert from the National Institute on Drug Abuse said in a 2014 interview with drugrehab.org:

“When we talk about addiction, we are dealing with a disease. It’s not just someone who is weak-willed or choosing to go down this particular path . . . We can visibly see, through the use of imaging technology, where drugs bind in the brain and what impact they have on the brain.”

— Dr. Jack Stein, Director of the Office of Science Policy & Communications
The National Institute on Drug Abuse (NIDA)

Relapse rates for addiction are similar to other chronic diseases, Stein said. He notes that Type I diabetics, for example, have a relapse rate of 30 to 50 percent (i.e., compromising their treatment by not taking insulin). For hypertension or asthma, relapse can be as high as 50 to 70 percent. And while someone makes the initial choice to do drugs, addiction alters the neurochemical and molecular structure of the brain, clinical studies show. Judgment and decision-making functions are impaired in people with addiction, and this can fuel self-destructive behaviors.

Louden’s Facebook post generated an outpouring of strong emotions, to which she recently responded: “I can’t thank all of you enough for sharing my photo and for all the kind words. I almost didn’t post this pic but I want all the parents of lost children to know they are not alone and that dealers need to be held responsible for selling poison to our children all over the world. GOD BLESS YOU ALL EVEN THE NEGATIVE PEOPLE.”

A Movie That Ends in Real Heartbreak

A somber parade of people gathers at St. William Catholic Church in Tewksbury, Massachusetts. Despite the blizzard outside, they’ve come to film the final scene of a movie from The Mark Wahlberg Foundation. But they’re not actors.

These are the heartbroken survivors of 57 young adults who died from drug overdose. They appear onscreen at the end of the movie “If Only,” clutching photos of their deceased loved ones. It’s a tribute to carefree young people in their prime – playing sports and winning trophies and cuddling their beloved pets.

Families hope the movie “If Only” will spark a national conversation about teenage drug abuse. The short film follows the lives of two boys who develop a prescription drug problem after they experiment with painkillers from the family medicine cabinet. One family seeks help for their son’s drug addiction; the other is in denial.

“I am sure that young adults are experimenting (with drugs), that most of them don’t think this is going to turn into a disease,” says Louise Griffin, who appears in the film. She lost her son Zachary to a heroin overdose that began with prescription pills.

“When we think about prescription painkillers, we think of it as something that’s going to cure us, make us feel better,” Griffin says. “And these pills, when not taken correctly, will kill us.”

To download a free copy of the movie “If Only,” visit: http://dropthemoff.com/ifonly/

Grief Takes A Punch

“Instructors will show you the proper way to hit a heavy bag and then you will release every emotion bottled up inside. LET IT GO!!!!!”

In Massachusetts, many families have been devastated by heroin’s hold. But some mothers are finding a spirited way to vent their anger and release their pain: a boxing support group.

Photo: Craig F. Walker/The Boston Globe

Catherine Fennelly started Let It Out, Inc., a boxing support group, after her son Paul died of an opioid overdose in 2015.

They bring their own boxing gloves and hand wraps, and cheer each other as they release their emotions on a punching bag. Let It Out meets at area gyms in Randolph, Haverhill and Braintree, Massachusetts.

“Talking is a great way to express how you feel but to hit something and get all the negative energy out, NOW that is a release,” writes Catherine Fennelly, who started Let It Out to help parents whose families are impacted by addiction deal with their anger, anxiety and sadness. For more information, go to: http://www.letitoutinc.org

Candid Tributes: A Wake-Up Call?

There’s a grassroots movement to confront the stigma of addiction and share the raw truth when people die from drug overdose. Nationwide, families are increasingly candid in obituaries and vigils for addicted loved ones. Before another family is shaken, they want to share their painful journey in the hopes of saving a life.

These are a few of the ways that young people are being remembered.

Credit: WGRZ TV, Buffalo New York

“Somebody loved that girl. She was somebody’s sister, niece, best friend,” says Tiffany Woods about her 19-year-old sister Tasheta, who died of a drug overdose earlier this year. At a vigil for Tasheta, the family spoke frankly about the heroin epidemic and prayed for others on a similar path. See Tasheta’s family speak out about addiction

Kelsey Grace Endicott

Kelsey Grace Age 23, passed away on April 2, 2016, from an accidental overdose. For many years, she fought a heroic battle with addiction. She had been sober for almost ten months, but her disease still had a powerful hold on her. We wish she had recognized the beauty and strength everyone else saw in her.

Kelsey did not want to leave this world. She yearned for a life without fear and pain; a life that would permit her to realize that the world was open for her to explore and that change was possible. During her adolescence, Kelsey hid her vulnerability with meticulously-crafted sarcasm, but in recent years, she had allowed her kindness and compassion to shine – she had found the courage to be herself. It is not true that everything happens for a reason. The reality of Kelsey’s death is devastating, and no possible reason can justify the loss of this beautiful young woman, who had so much to give to the world.

Emmett J. Scannell

1995 ∼ 2016

On April 20, 2016 our 20 year old son, Emmett J. Scannell lost his battle to Substance Use Disorder and died due to a heroin overdose. Emmett had been in recovery and sober in Alcoholics Anonymous for 2 years when he went off to college in late August 2014. Within 6 weeks, heroin came into his and our lives, stole him from us and Substance Use Disorder killed him in only 18 months.

Adored brother of Zachary Scannell and Alice D’Arpino of Mansfield. Beloved son of Aimee Manzoni-D’Arpino (and her husband John A. Manzoni-D’Arpino) of Mansfield and William E. Scannell (and his life partner, Brenda Rose) of Bridgewater; Nephew of Paula Mountain and Brian Mountain of Raynham and Brian Scannell of Raynham; grandson of Peter and Patricia Campos Manzoni of Easton and Paul Scannell and Nora Scannell both of Raynham; loving cousin of Josie Mountain, Scott Mountain, and Carley Scannell all of Raynham.

Emmett was a National Honor Society student who graduated from Bridgewater Raynham Regional High School in May 2014. Unfortunately he is not the first member of his class to die from Substance Use Disorder. Emmett was a sophomore at Worcester State University where he was studying computer science on a full academic scholarship. But most recently he had, and died from, Substance Use Disorder. Emmett was a caring, funny, smart, young man with the potential for greatness. He loved his brother and sister, biking and snowmobiling and had a smile and charm that could light up a room, but it won’t ever again because he had and died from Substance Use Disorder.

You see Substance Use Disorder is not something to be ashamed of or hidden. It is a DISEASE that has to be brought out into the light and fought by everyone. It continues to cut down our loved ones everyday. Please do whatever you can to fight it so that you never have to feel what everyone one of us who has lost a loved one is feeling right now. We all thank you for your condolences and prayers and ask that you continue to pray for Emmett’s soul and our family.

Painting to Heal, Uplift Others

She calls her paintings the “Angels of Addiction.”

Art therapy is a powerful meditation on grief for Anne Marie Zanfagna, who lost her daughter Jackie to heroin overdose in 2014. The New Hampshire artist found peace in painting a colorful, pop-art style portrait of Jackie. “It was like spending time with her,” Zanfagna says. “It provided a lot of comfort.”

Other parents soon asked Zanfagna to paint their children who died from drug overdose. Today, more than 40 families from New Hampshire to California have received a portrait, which Zanfagna donates as part of her non-profit, Angels of Addiction. Her goal is to raise awareness and de-stigmatize the heroin epidemic.

“Not a day goes by that I don’t look at this picture more than once,” says Amanda Jordan of her son Christopher’s portrait. “It makes me feel there is still a piece of him with me.”

To see the drugrehab.org feature story on “Angels of Addiction,” click here.

They Walk to End Overdose

Wearing neon T-shirts with a blunt message — “Stop Heroin” — people are rallying their communities to save lives. Stop Heroin walks have been organized in Missouri, Kentucky, Ohio, Indiana and Illinois since May 2013. That’s when Gee and Brittney Vigna founded “Walking for Wellness: Stop Heroin” in memory of their loved one, Nicky Vigna, who succumbed to overdose at age 20.

“This drug took my sister, and I will do anything and everything in my power to take it down,” writes Brittney Vigna on her website. “The only way to stop it from taking more lives is to get people to stop using. Protect yourself, and your children, and talk about this. Educate yourself, your family, and anyone you know. STOP HEROIN.”

All proceeds from the walks go to local drug abuse prevention and education efforts. If you would like to join a walk or start a walk in your community, go to: http://www.stopheroin.org.

Resources

Harm Reduction Coalition – How To Recognize The Signs Of An Opioid Overdose

Harm Reduction Coalition – How To Respond To An Opioid Overdose

Drop Them Off – Keeping Kids Safe From Prescription Drugs

GRASP – Bereavement Support: GRASP (Grief Recovery After A Substance Passing)

Drug Free – Parent Handbook: How To Find The Right Help For Your Child With An Alcohol Or Drug Problem

Above The Influence – Helping Teens Stand Up To Negative Influences

TREATMENT HOTLINES:

1-800-NCA-CALL (800-622-2255)
24-hour helpline operated by the National Council on Alcoholism and Drug Dependence

1-800-662-HELP (4357)
24-hour National Drug and Alcohol Abuse Hotline, Center for Substance Abuse Treatment

1-800-273-TALK (8255)
National Suicide Prevention Lifeline, a confidential 24-hour hotline for anyone in crisis

Gone Too Soon:
“Angels of Addiction” Portraits Immortalize Young Lives Lost to Opioid Epidemic

Paintings by Anne Marie Zanfagna remember heroin’s young victims – including her daughter Jackie, bottom left.

Losing a child to heroin overdose is a sorrow that is unfolding across America. One grief-stricken mother finds solace in a unique labor of love: painting vivid portraits of young people whose lives were cut short by addiction.

When heroin claimed her daughter Jackie in 2014, Anne Marie Zanfagna spent a year in a fog. She lived like a recluse, struggling to get through days of profound sadness.

“I thought I needed to do something to get outside of my own head,” she recalls.

So the New Hampshire artist decided to paint a picture of her daughter. Using Jackie’s favorite pink and purple colors, Zanfagna created a bold, pop-art image that captures her daughter’s soulful eyes and pensive smile.

“It was like spending time with her,” Zanfagna recalls. “It provided a lot of comfort.”

Zanfagna showed Jackie’s portrait to other bereaved parents, who asked her to paint their sons and daughters. Some, like Amanda Jordan, met Zanfagna through “Mercy Street,” a monthly gathering of people affected by addiction, which Zanfagna attends with her husband Jim at First Baptist Church of Plaistow, New Hampshire.

A painting of her son Christopher helped Jordan cradle memories of a big-hearted young man. “Christopher was always the kind of person who would talk to anyone, just so they knew someone cared — even it he didn’t know that person,” she says. “His smile and laugh were contagious and lit up a room.”

Christopher died of a heroin overdose on September 5, 2015. He was still grieving the death of his girlfriend, who met the same fate a year before.

“Not a day goes by that I don’t look at this picture more than once,” Jordan says of the painting. “It makes me feel there is still a piece of him with me.”

Christopher’s painting is a source of strength for his family, his mother says. “I just remember thinking how amazing it was because she captured his smile. I showed it to my other children and they love looking at it.”

Today, about 40 families from New Hampshire to California are the beneficiaries of Zanfagna’s art therapy, which has given her new purpose. She started a non-profit, “Angels of Addiction,” using her paintings to raise awareness of the heroin epidemic.

“That is my number one mission, I want to put a face to the number,” Zanfagna says.

The statistics that drive the heroin epidemic are staggering. Deaths from heroin overdose have tripled since 2010, and the drug claimed 10,574 American lives in 2014, according to the Drug Enforcement Administration (DEA).

New Hampshire recorded the nation’s largest increase in deaths from opioid overdose – which includes heroin and prescription narcotic painkillers – from 2013 to 2014. Nationwide, there was a 14 percent increase in opioid-related fatalities during that time period, but in New Hampshire, opioid deaths skyrocketed 73.5 percent, according to the U.S. Centers for Disease Control and Prevention (CDC).

Jackie’s death was especially poignant for her family, because she had been in recovery and was drug-free for 11 months when she overdosed on Oct. 18, 2014.

Addiction experts say that’s a common cause of heroin-related deaths: users resume taking the drug after a period of abstinence and are especially vulnerable to overdose, since they have a decreased tolerance for heroin. Others accidentally overdose because of heroin’s higher purity in certain markets. Or they may switch from abusing prescription opioids to cheaper, more accessible heroin and take their chances with every batch (in the eastern United States, highly potent fentanyl is sometimes mixed with or disguised as white powder heroin, according to the DEA).

Putting a human face on the heroin epidemic helps Zanfagna in her efforts to de-stigmatize addiction. Painting also helps her recall more positive memories with Jackie, whose battles with bipolar tendencies preceded her heroin use.

“After Jackie died – and I found this true with all the other mothers – their memories are shot,” Zanfagna says.

She’d prefer to reminisce about the joys of motherhood, instead of the countless doctor visits to get her daughter help, or the chaos of addiction that led the family to lock up their valuables and install an alarm system.

Jackie, her mother recalls, was also a kind soul and caring Aunt who much preferred a sunny beach to cold New England winters. She dabbled in modeling and was an accomplished cook – often making dinner for her father when her mother worked nights. And Jackie adored animals – especially her adopted Labrador, Rayna, and her cats Cookie and Otto.

“When I paint people, I try to bring out the best in them, make them vibrant and happy. It’s just the way I like to do it,” Zanfagna says. “Right now, I’ve been thinking, ‘What are some of those good memories that I have of (Jackie) in the last year?’ She asked me to brush her hair the week she died, because it was very long, and so I would brush it for her. And that was a nice moment. It’s sad to think that’s what you’re holding on to.”

Zanfagna exhibits the “Angels of Addiction” collection at local libraries and art galleries, and hopes to display her portraits at the New Hampshire statehouse. Earlier this year, she joined a New Hampshire delegation and brought her paintings to Washington, advocating for greater treatment access and funding for recovery care. Zanfagna’s non-profit also awarded its first college scholarship in 2016.

Despite these efforts, the artist says there’s an urgent need to change the landscape before more lives are lost and families shattered.

“If you go five minutes any place around here – in any direction – you can get heroin,” Zanfagna says. “It’s still a big problem.”

To see more portraits and learn about the non-profit “Angels of Addiction,” go to www.angelsofaddictions.org

Portraits are free and given to families of teens and young adults who have died of drug overdose. Donations are accepted, and a link to support the work of “Angels of Addiction” can be found on the website

“He got started with Percocet, 5 milligrams. That wasn’t enough after awhile,” says Louise Griffin, Zachary’s mother. “From there he went to OxyContin. The drug dealers told him – when OxyContin wasn’t available – that he should try heroin, because it would give him a better and quicker high.”

Despite forcing her son into treatment – and sustaining him through seven rehab programs in two states – Zachary often relapsed. Each time, his addiction grew worse and the family’s odyssey more frightening.

“I watched as this beautiful child morphed into this stranger that I could not recognize,” Griffin says. “He needed more heroin, he stole from me, he manipulated, he lied. I had to put deadbolts on my bedroom door. My bank account got drained. I have no jewelry left.”

Zachary made progress in Florida, where he had been drug-free for two months and enjoyed a new circle of friends committed to recovery. A month before his 22nd birthday, Zachary was hopeful when he called his mother from a sober living home, Griffin recalls.

“He had just gotten a job and on Day 60, he called me and said, ‘Mom, I’m 60 days clean. I’m doing great, I got a job.’ And on Day 61, he was dead.”

* * * * * *

Zachary’s accidental overdose from an opioid relapse mirrors the alarming rise of teen drug abuse and addiction. The dangers are portrayed in the new film, “If Only,” from the Mark Wahlberg Youth Foundation and Millenium Health.

Set in Middlesex County, Massachusetts – a community hard hit by the opioid epidemic – “If Only” follows the lives of Isaac and Connor, best friends who develop a prescription drug problem. The teens experiment with painkillers from the family medicine cabinet, and get high at house parties where young people share a bowl of pills. One family seeks help for their son’s addiction; the other is in denial.

“If Only” ends with an aching scene from real life. Clutching photos of their loved ones, families gather in St. William Catholic Church to remember 57 young people, their lives cut markedly short by addiction.

“Prescription drug misuse and abuse has reached epidemic proportions in the United States, and this film illustrates the danger this poses to youth today,” says Nicole Beckstrand, Vice President of Integrated Communications for Millennium Health, a California-based drug-testing company that co-sponsored the film.

To spread awareness of the problem, “If Only” parallels a public health campaign, Drop Them Off (http://DropThemOff.com/), which promotes safe use, storage and disposal of prescription medications.

An estimated one in six teens reports using prescription drugs to get high or change their mood, and most say they get the drugs from family and friends, according to the Partnership for Drug-Free Kids. The number of teens who misuse or abuse a prescription drug at least once increased 33 percent between 2008 and 2012, to about 5 million teens, according to the 2012 Partnership Attitude Tracking Survey.

Easy access to medicines, lax attitudes and few warnings from adults contribute to the misconception that prescription drugs are less harmful or addictive than other drugs, experts say. New research also suggests that the abuse of prescription opioids is a gateway to heroin use for many people (since heroin is typically a cheaper, more accessible opioid).

“I think the most important message is how quickly a young person can go from one pill to addiction, it can happen that fast,” says Griffin, whose son’s addiction followed the trajectory from prescription opioids to street drugs.

Every day in the United States, an estimated 114 people of all ages die from drug overdoses, and 61 of those deaths (53%) are due to prescription medications, according to the U.S. Centers for Disease Control. The majority of deaths involve opioid pain relievers such as oxycodone (Percocet, OxyContin), hydrocodone (Vicodin) and methadone.

It’s a growing public health crisis, with a 146% increase in fatal drug overdoses between 1999 and 2012, according to the Centers for Disease Control. Drug overdoses are now the leading cause of injury death in America – responsible for more deaths among people ages 25-64 than motor vehicle accidents.

New federal regulations that began in 2014 place tighter restrictions on potentially addictive opioid pain medications. Under the new rules, physicians can no longer phone in a prescription for hydrocodone combination products (hydrocodone + acetaminophen). Patients must see their doctor to obtain a new prescription every 90 days, and they need to bring a physical prescription to the pharmacy.

To keep opioids out of the hands of kids, the Drop Them Off campaign is reaching out to 6.1 million Twitter users, Beckstrand says. Actor Mark Wahlberg and other celebrities post video messages using the hashtag #DropThemOff, and the campaign website includes parent/teen conversation starters and guidelines for reducing access to prescription drugs.

“We wanted to take a grassroots approach to providing information about the problem, steps to safely use, store and dispose of prescription drugs, and materials that empower adults to initiate discussions with young people about the dangers and consequences of misusing prescription drugs,” Beckstrand says.

Since Zachary’s fatal overdose in 2013, Louise Griffin has become impassioned about preventing more tragedies. She’s working to reduce the stigma of addiction, so that more families seek help. And she started Zack’s Team Foundation, http://www.zacksteam.org/ which provides scholarships to send people to treatment; so far, the non-profit has funded rehab stays for 10 young adults, Griffin says.

Calling a child’s death from drugs “the loneliest thing a parent has to go through,” Griffin started a local chapter of GRASP, a bereavement support group. She also recruited the families who appear in the film “If Only” to share their loss (they braved a New England blizzard to appear in the film).

“I am sure that young adults are experimenting (with drugs), that most of them don’t think this is going to turn into a disease,” Griffin says. “When we think about prescription painkillers, we think of it as something that’s going to cure us, make us feel better. And these pills, when not taken correctly, will kill us.”

Resources for Parents & Teens

FREE DOWNLOAD: “IF ONLY”
http://dropthemoff.com/ifonly/
Short film about the dangers of prescription drug misuse and abuse among young people.

DROP THEM OFF
http://dropthemoff.com/
Public information campaign to keep kids safe from prescription drugs. Includes tips for talking to your child about prescription drug dangers, and simple steps to safeguard your home and reduce access to opioid medications.

The Drop Them Off campaign is co-sponsored by the Mark Wahlberg Youth Foundation, Millenium Health and The Partnership for Drug-Free Kids’ Medicine Abuse Project.

STOP MEDICINE ABUSE
http://stopmedicineabuse.org/
Prevention campaign that addresses teen abuse of over-the-counter cough medicines. Includes a parent talk kit and other resources to help teens make smart decisions.

LEARN TO COPE
http://www.learn2cope.org/
Online support for parents and family members with a loved one who is addicted to opioids. While Learn to Cope is based in Massachusetts and hosts meetings there, the website includes an online community forum, FAQs for treating opioid addiction and a section on realistic expectations for substance abuse treatment.

GRASP (Grief Recovery After a Substance Passing)
http://grasphelp.org/
Bereavement support group, with chapter meetings in 30 states, for families or individuals who have lost a loved one to substance abuse or addiction. The website includes information on how to start a chapter in your area.

TREATMENT eBOOK: HOW TO FIND THE RIGHT HELP FOR YOUR CHILD WITH AN ALCOHOL OR DRUG PROBLEM
http://www.drugfree.org/wp-content/uploads/2012/04/treatment_guide-2014.pdf
Parent handbook on appropriate addiction care for teenagers, from the Partnership for Drug-Free Kids. Includes how to pay for treatment, the role of family therapy and other topics.

PRINCIPLES OF ADOLESCENT SUBSTANCE USE DISORDER TREATMENT: A RESEARCH-BASED GUIDE
https://www.drugabuse.gov/sites/default/files/podata_1_17_14.pdf
In-depth primer on the principles for effective drug and alcohol treatment for teenagers. From the National Institute on Drug Abuse (NIDA).

FAMILY TIP SHEET ON RESIDENTIAL PROGRAMS
http://www.buildingbridges4youth.org/sites/default/files/BB-Family-Tip-Sheet-expanded.pdf
Addresses questions about residential treatment for a child with emotional and behavioral challenges. Published by Building Bridges, a national family support initiative.

ABOVE THE INFLUENCE
http://abovetheinfluence.com/
Helps teens stand up to negative pressures or influences. The site includes ways to help a friend with a drug or alcohol problem, and tips on making healthy decisions.

MUTUAL AID/SUPPORT GROUPS
http://www.facesandvoicesofrecovery.org/guide/support/
https://ncadd.org/recovery-support/mutual-aid-support
Extensive list of mutual aid organizations, 12-step programs and other support resources

HOTLINES

1-800-NCA-CALL (800-622-2255)
24-hour helpline operated by the National Council on Alcoholism and Drug Dependence

1-800-662-HELP (4357)
24-hour National Drug and Alcohol Abuse Hotline, Center for Substance Abuse Treatment

1-800-273-TALK (8255)
National Suicide Prevention Lifeline, a confidential 24-hour hotline for anyone in crisis

Louise Griffin holds a picture of her son, Zachary Gys,
who died at age 21 after relapsing on opioid drugs.

]]> https://www.drugrehab.org/help-center/addiction-to-methamphetamine-signs-of-abuse-health-risks-and-how-to-get-help/ Tue, 09 Jun 2015 19:42:16 +0000 https://www.drugrehab.org/?post_type=help-center&p=32314 Methamphetamine — one of the world’s most toxic and addictive drugs — has triggered a public health crisis in many U.S. communities.

A potent central nervous system stimulant, meth creates an intense dependence that can ravage the user’s health and physical appearance. Others are also at risk, since meth addiction frequently breeds violent crime, identity theft, and child neglect and endangerment. Clandestine meth labs pose serious health hazards to the community, including a strong risk of explosion or fire. Toxic chemical waste from makeshift meth labs is often dumped into local rivers or top soil, threatening the groundwater supply.

Radical Brain & Behavior Changes

Meth is a white crystalline powder that users typically snort, smoke or inject. Chronic meth use is associated with severe health dangers including brain damage, extreme weight loss, rampant tooth decay (“meth mouth”) and sometimes irreversible organ damage, strokes or death. Meth abuse can also induce psychotic or violent behaviors.

“Methamphetamine changes the brain in a number of ways,” says Dr. Richard Rawson, Co-Director of UCLA Integrated Substance Abuse Programs and Professor-in-Residence at the UCLA Department of Psychiatry. “Areas of the brain that control feelings of pleasure, memory, judgment, alertness, sleep/wake cycles and appetite are affected by methamphetamine use.”

While multiple neurotransmitters are impacted, meth’s primary focus is the brain’s reward/pleasure center, the dopamine system. Meth floods the body with dopamine, creating a short-lived euphoric rush. Users may become energetic and hypersexual, engaging in dangerous behaviors as they lose their inhibitions. They typically also go long periods without sleep (some users will be awake several days), and have little appetite. Anorexia and malnourishment is common with long-term meth use.

The chemical imbalance that meth creates leads to an intense crash when the drug’s effects wear off. Users may experience severe depression, paranoia and irritability, which feeds the cycle of addiction. Tolerance to meth occurs rapidly, with users requiring more of the drug to get high — as their physical and mental health deteriorates.

“Methamphetamine profoundly deregulates dopamine functioning when it produces its acute affects,” Rawson says. “And there are persistent changes that appear to last for weeks and months when people discontinue methamphetamine use.”

Prevalence

As an illegal recreational drug, methamphetamine is known by many street names — including crank, meth, speed, crystal, glass and ice. The U.S. Food and Drug Administration has approved limited medical use of methamphetamine hydrochloride for the treatment of narcolepsy, ADHD and a form of obesity. However, the drug is rarely prescribed due to its health risks and highly addictive potential.

Most of the illegal meth in the United States is produced in super labs in Mexico and here, operated by organized crime. The rest is made by amateur chemists in homegrown labs, using Internet recipes that may include the over-the-counter cold medicine ingredient, pseudoephedrine — along with battery acid, antifreeze and other toxic chemicals.

• The number of Americans who use meth on a monthly basis is approximately 0.2 percent of the population (440,000 people), down slightly from previous years, according to the 2012 National Survey on Drug Use and Health (NSDUH).
• More than 12 million Americans (4.7 percent of the population) have tried meth at least once, according to NSDUH
• Emergency room visits related to meth use rose 52 percent between 2007 and 2011, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). There were 67,954 meth-related ER visits in 2007 vs. 102,961 in 2011, according to SAMHSA.
• A majority of emergency room visits related to meth (62 percent) also involve other drugs such as marijuana or alcohol, according to SAMHSA.

Signs of Addiction

There are many signs that you or a loved one may be dependent on meth. These are among the changes in behavior and appearance that can occur, according to The Partnership for a Drug Free America:

Physical Symptoms:

Weight loss, abnormal sweating, shortness of breath, nasal problems or nosebleeds, sores that do not heal, dilated pupils, burns on lips or fingers, track marks on arms

Mental Symptoms:

Paranoia, anxiousness, nervousness, agitation, extreme moodiness, severe depression, hallucinations, delusions of parasites or insects crawling under the skin

Behavioral Symptoms:

Withdrawal from family/friends, change in friends, disinterest in previously enjoyed activities, increased activity, long periods of sleeplessness (24-120 hours), long periods of sleep (24-48 hours), incessant talking, irritability, twitching/shaking, itching, decreased appetite, erratic attention span, repetitious behavior such as picking at skin, pulling out hair, compulsively cleaning, grooming or disassembling and assembling objects, aggression or violent behavior, false sense of confidence/power, convulsions, carelessness about appearance, deceit or secretiveness

Paraphernalia:

Rolled up paper money or short straws, pieces of glass/mirrors, razor blades, burned spoons, surgical tubing, syringes/needles

Getting Help

Treatment for meth addiction should address not only the physical dependency but also meth’s effects on the brain and body (i.e., malnutrition, dental disease, mood disturbances, HIV or hepatitis if contracted, etc.).

The search for medications to treat methamphetamine has been underway since the 1980s.

“It has been a very frustrating process,” says Rawson, the UCLA researcher. “Many medications have appeared to show promise, but when carefully tested in double-blind trials, they produce no more effect than placebo. There are intensive efforts to identify medications that may have value in treating methamphetamine users, but at present we don’t have one.”

Research on vaccines that would reduce cravings for meth show great promise, Rawson says; these are now in development.

“Until these efforts prove fruitful, a number of behavioral treatments have the best evidence of support,” Rawson says. These include psychosocial treatments such as Cognitive Behavioral Therapy, which helps people cope more effectively with cravings and break habits that lead to drug relapse.

Rawson says researchers are currently evaluating the benefits of physical exercise in assisting with recovery from meth dependence. Clinical trials are also being conducted on the effectiveness of an ADHD drug, lisdexamfetamine, to treat meth addiction.

If you or someone you care about is using meth, don’t delay getting help. The long-term effects of meth use are devastating, and addiction is a progressive disease. But it is treatable, and millions of Americans are in long-term recovery — enjoying healthy, drug-free lives. Treatment for meth addiction can literally save your life.

Resources for Recovery

These resources can help you find the right care to start your recovery:

What Treatments Are Effective for People Who Abuse Methamphetamine?

Tips from Parents, Video Stories and Other Resources on Meth & Addiction:

DRUGREHAB.ORG

Drugrehab.org provides FREE informative guides on addiction and recovery — such as our Guide to Choosing the Right Rehab, which outlines best practices for treatment. We also provide FREE referrals to respected rehabilitation centers nationwide – including the latest evidence-based treatment approaches and aftercare programs. All calls are confidential and help is available 24/7.

Drugrehab.org is an independent service, not funded by or affiliated with any treatment center. To find help for meth dependence, call our experienced counselors today at:

888 – 957 – 3422

MUTUAL AID/SUPPORT GROUPS

These websites include online forums, mutual aid organizations and 12-step programs for people with meth and other drug addictions:

http://www.facesandvoicesofrecovery.org/guide/support/

https://ncadd.org/recovery-support/mutual-aid-support

http://www.addictionsurvivors.org/

HELP HOTLINES

1-800-NCA-CALL (800-622-2255) 24-hour helpline sponsored by the National Council on Alcoholism and Drug Dependence.

1-800-662-HELP (4357) 24-hour National Drug and Alcohol Abuse Hotline offering information and referral services to people seeking treatment and other assistance; sponsored by the Center for Substance Abuse Treatment (CSAT)

A mother is heavy with anxiety, worried that her son will suffer a drug overdose. She’s living with chronic hyper-stress — trying to shield her younger children, neighbors and friends from the chaos of addiction.

A husband feels like he’s walking on eggshells, wearily resigned to avoid another confrontation with his alcoholic wife.

Grandparents take on the role of primary caregivers — stepping in to save their grandchildren from a disheartening scene of illicit drug use, turmoil and neglect.

As millions of parents, siblings and others can attest — addiction is a family disease. Everyone is affected, or compromised when their needs come second to the impaired relative. Often, the entire family is held hostage by the crisis of a loved one’s drug or alcohol addiction.

A professional intervention can help restore the family’s well-being and in some cases, start lifesaving recovery for the addicted person.

“What many people don’t understand is that if they started the process of intervention sooner, they may not feel as exhausted in the end,” says Phil Scherer, Board Chair of the Association of Intervention Specialists, an international nonprofit network of board-registered interventionists. Scherer has conducted hundreds of family interventions since 1996 and is Director of the Illinois Institute for Addiction Recovery.

“Addiction wears people down, it’s not just the person suffering from the addiction but it wears down entire family systems.”

How Intervention Works

Contrary to voyeuristic TV portrayals, an ethical professional intervention doesn’t have to be an ambush, Scherer says. There’s no physical coercion — it’s more of a loving invitation to change. And family members are changing also, learning new ways to relate to addiction.

“You’re not going to berate or shame somebody into treatment,” Scherer says. “Addicts can do shame and negativity all day long.”

Scherer believes that people with substance abuse disorders are among the first to understand they have a problem. “They’re just the last to want to do anything about it,” he says, “because in their minds, it’s the only thing that gives them what they need to survive – even though it’s killing them.”

A Family-Centric Approach

Professionals use various models of intervention to motivate a loved one into treatment.

The original intervention protocol, the Johnson Model, does carry an element of surprise – as family members confront the addict directly about the damage the drinking or drug use has caused. Members of the addict’s social network state in clear terms the consequences that will happen if treatment is refused.

Many interventionists, including Scherer, prefer a more non-confrontational approach that puts the entire family in recovery.

These newer, family-centric methods include ARISE, the Systemic Family Model and the Community Reinforcement Approach and Family Training (CRAFT), an intervention that combines behavior therapy with family skills training to encourage a recovery path. Scherer and a colleague developed the Family Meeting Approach, which combines elements of all the intervention models.

“I approach the intervention from a family systems point of view,” Scherer says. “If I can change how the family engages the addiction, not so much the addict, I think almost all interventions are a success.”

The goal is to educate and empower families with options if the loved one refuses treatment – “so they don’t remain enslaved and exhausted by the addiction,” Scherer says.

“Nobody can fix the addict without the addict’s cooperation,” he adds, stressing that ultimately the impaired person must fully commit to recovery. “I can help provide information that empowers them to make different, healthier choices. The same holds true for the family.”

No Surprises, No Secrets

After careful intervention planning, the addicted loved one is notified of the family meeting in advance. Removing any manipulation or unwelcome surprise gives the person one less reason to resist, Scherer says.

He advises families to explain to their impaired relative that they’re changing the way they deal with the situation. The dialogue might be something like “we’ve engaged a person to talk to us about family problems.”

“I try not to use the word ‘interventionist,’ I try not to use the word ‘addiction,’” Scherer says. “Everybody at the meeting is going to have the opportunity to talk about family problems.”

The interventionist forms a team that may include caring family members, clergy and others concerned about a loved one’s substance use. They strategize on where and when to meet, and express their love to the addicted person in calm, nonjudgmental tones.

“It’s hard to push back against a group of people who care enough about you to risk losing your relationship by asking you to get help – so they don’t lose you to addiction,” Scherer says. He notes that a colleague refers to interventions as a “love fest” that motivates recovery.

Instead of needling the addicted person about drinking or drug use, Scherer encourages family members to champion the benefits of a clinical assessment. He recommends saying “Let’s go get an assessment from a professional to see if you have a drinking problem, let’s let them make the call.”

Changing Family Dynamics: Everyone Plays a Role

The addicted person is not the only one who must take action, Scherer says. All family members need to examine their roles in the family dysfunction and forge new relationships with their addicted loved one.

“They have to be willing to take a look at how they engage the person, they have to be willing to speak the truth and not be afraid of the pushback that’s going to happen,” he says. “They need to say, ‘Am I paying (the addicted person’s) bills, am I overlooking inappropriate behaviors, am I walking on eggshells, am I moralizing this disease?”

A vast majority of people with addictions get angry when confronted, Scherer says, and many people acquiesce. “It’s part of them being worn down by addiction.”

He teaches family members how to detach with love, establish boundaries and begin shaping new family dynamics.

“We talk about family strengths, we talk about family history because we want to take a look at what part the ancestors may have played in this family’s level of dysfunction,” Scherer says. “I ask people what they perceive to be the problems in the family and then we talk about solutions. Part of the solution is asking the person who has an addiction to seek help.”

An experienced interventionist is trained to recognize nonverbal signs of depression in a family member – and engage that person to determine any safety concerns. “There may be various problems going on that need attention, from depression to enabling to addiction to any number of things,” Scherer says. “It’s not just the person with the addiction who has to change.”

A professional interventionist is also skilled in overcoming manipulation and using techniques to calm a volatile meeting.

“One of things I do if a room starts to get loud is I start talking. But I talk more softly because I want people to hear what I have to say,” Scherer says. “My only rule when doing a family meeting is that people have to be respectful.”

Scherer says interventions can be life-changing for family members – even if the loved one battling addiction refuses to get treatment.

“In my practice, over 80 percent of the people go to get treatment and families are improved,” he says. In cases where there’s no progress made by the addicted relative, “the families feel better because they have different information, they feel a different level of responsibility. They see it more as the other person’s problem.”

“After they go through the intervention process, the vast majority of people say, ‘Wow, I’m not supposed to know how to fix this. It’s not my responsibility to know all the answers.’”

Intervention Tips For Families

Here are some guidelines for families considering a professional intervention to help an addicted loved one:

• Overcome your fear. A bold step may be necessary to save lives and overcome the ravages of addiction, Scherer says. “What keeps family members frozen is the fear that if they do something different, they’re going to lose the (addicted) person emotionally, or that they will distance themselves from the family,” he says. “I would ask them to take a look at what the probabilities are for the relationship if they don’t overcome their fear.”

• Enlist ethical, professional help. Don’t go it alone or trust an untrained person to orchestrate an intervention for your loved one, Scherer says. The results could strain the family even more and compromise any future recovery efforts. “If you’re being pressured, you’re probably talking to the wrong people,” he says.

Scherer recommends interviewing practitioners and finding a board-registered interventionist for multiple reasons: they’ve been formally trained in the art of professional intervention, hold a license or certification in a counseling-related field, have documented experience working in addiction recovery, with peer evaluations and supervised practicums, and must adhere to a code of ethics. In addition, a board-registered interventionist carries malpractice insurance and participates in continuing education programs to strengthen their skills. They are also typically trained in multiple intervention methods, and may have specialized training in gambling, food, sex or other addiction disorders.

• Take time to carefully plan. This is critical, since a poorly planned intervention rarely motivates a loved one toward recovery.

Some of the planning considerations include choosing a time for the meeting when the addicted loved one is sober; composing a team of non-threatening people who can remain calm during the intervention; rehearsing what to say about the addiction; having a plan to start rehabilitation immediately if the person agrees to get help; and establishing new family rules regarding the addiction. A relapse prevention plan, with actions that family members can take to support recovery, should also be part of effective intervention planning.

• Be prepared for anger and rejection. An intervention can unleash a rollercoaster of emotions, as the addicted loved one faces the family. Prepare to detach, with love, so that you can avoid enabling the addiction and create a healthier relationship with your impaired relative.

Sidebar Article:

Five Common Myths That Can Derail Recovery

False perceptions about drug and alcohol addiction can keep people from seeking effective treatment. Here are five consistent myths about substance abuse, from the Association of Intervention Specialists:

Myth 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to.

Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.

Myth 2: Addiction is a disease; there’s nothing you can do about it.

Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments.

Myth 3: Addicts have to hit rock bottom before they can get better.

Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost it all.

Myth 4: You can’t force someone into treatment; they have to want help.

Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.

Myth 5: Treatment didn’t work before, so there’s no point trying again.

Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.

The Life in Recovery Survey shows the positive change reaction that occurs when people get better, says Tom Hill, Director of Programs for “Faces & Voices in Recovery,” a grassroots advocacy movement that sponsored the survey.

“We are happier, are better parents and family members, better workers and employees, pay our taxes and debts, volunteer in our communities and are more engaged and responsible citizens,” Hill says. “And the longer we are in recovery, the better the outcomes.”

The national online survey measured data from 3,228 participants in long-term recovery from drug and alcohol addiction. On average, participants had been in active addiction for 18 years and over half had been in recovery for at least 10 years.

Compared to when they had an active addiction, the benefits associated with recovery included:

• A ten-fold decrease in illegal activities and involvement with the criminal justice system (DWIs, arrest, incarceration, etc.)
• A 50 percent increase in steady employment
• A ten-fold decrease in Emergency Room visits
• A 50 percent increase in participation in family activities
• A doubling of paying back personal debt and paying bills on time
• A nearly three-fold increase in volunteering/civic engagement and in planning for the future (i.e., saving for retirement)
• A four-fold decrease in reports of untreated emotional/mental health problems

“What it says is that people in recovery become contributing, positive role models,” says Dr. Alexandre Laudet, who conducted the survey for Faces & Voices and serves as Director of the Center for the Study of Addictions and Recovery at the National Development and Research Institutes, Inc.

Findings from the survey, published in 2013, emphasize the need for longer-term, well-funded studies on the impact of recovery, Laudet says.

“There’s an enormous amount of research and federal funding that’s devoted to showing the harm of addiction. We know that,” Laudet says. “There is essentially no research on how things change and improve when people initiate and sustain recovery.”

Despite neuroscientific evidence that shows addiction is a chronic brain disease, a deep social stigma remains. Currently addiction affects an estimated 23.2 million Americans, but only about 10 percent are receiving the treatment they need, according to the National Institute on Drug Abuse (NIDA).

“If it was a different disease, people would be up in arms, marching down the street,” Laudet says. “As long as we treat it as a crime or moral weakness, people will die.

“We have to care about addicts. Most people don’t care about an addict until it’s their son or brother or daughter or sister.”

Adding to the stigma, Laudet says, is the negative media exposure on addiction — with scant coverage about the many success stories of recovery.

“The media always features the scandal stories of active addiction and relapse,” Laudet says. “They never highlight the benefits and the joys that people in recovery experience and contribute to society.”

The Life in Recovery Survey reveals that over time, post-addiction life gets even better. For example, participation in family activities increases from 68 percent during active addiction to 95 percent for those in recovery at least 10 years. There’s also a greater number of people in longer recovery who pay taxes, have good credit, further their education, vote, maintain steady employment, and take care of their health.

“It takes time to regain everything that was lost to addiction. All of the benefits increase over time, gradually,” Laudet says.

For more information on the survey findings, and the recovery movement, go to: http://www.facesandvoicesofrecovery.org/

Anna is under pressure. Her boyfriend Tony has drained her checking account to buy drugs, and now he wants Anna to get high so she can relax. “C’mon, let’s take a hit,” he tells her. The phone rings and it’s Anna’s friend — who presses her to join a birthday party at the bar.

What should Anna do? What would you do?

It’s a familiar scenario for many people in recovery: how to respond when confronted with drugs and alcohol.

Anna and Tony are professional actors in a novel, computer-based training program known as CBT4CBT (Computer-Based Training for Cognitive Behavioral Therapy). The program teaches people new skills to prevent addiction relapse — such as how to stand up for themselves and assertively refuse drugs and alcohol.

Like an engaging soap opera, the CBT4CBT vignettes feature contemporary story lines and plenty of melodrama. And the characters seem to resonate with their audience, according to several research studies sponsored by the National Institute on Drug Abuse (NIDA).

In one study, cocaine-addicted individuals who did CBT4CBT training for eight weeks were significantly more likely to stay abstinent than those on standard treatment alone (methadone maintenance). The study, published in April 2014 in the American Journal of Psychiatry, also showed that CBT4CBT participants reduced their use of other drugs and continued to improve at a six-month follow-up.

Q & A with the Creator of CBT4CBT:

Here’s a discussion with Dr. Kathleen Carroll, who developed the CBT4CBT program with her team at Yale University School of Medicine. Dr. Carroll, is the Albert E. Kent Professor of Psychiatry at Yale University School of Medicine and Principal Investigator of the Psychotherapy Development Center as well as Principal Investigator of the New England Node of the Clinical Trials Network, both funded by the National Institute on Drug Abuse (NIDA).

Why did you create a computer program for Cognitive Behavioral Therapy?

Dr. Carroll: I think it’s a wonderful way of helping more people get access to this evidence-based approach.  Its hard to find a good CBT therapist in a lot of settings, and it’s particularly hard in rural areas and for under-served populations.  It’s also much less expensive than a live therapist—all you need is Internet access, and the program is always there, 24/7.

We’ve worked hard to make the program relevant for all kinds of individuals who may be using any kind of drug or alcohol, and people can tailor it to their own needs. They can cover the material in any order they like, at any speed, and repeat material if they need a ‘booster’.

What does the research conclude about CBT4CBT?

Dr. Carroll: That our 7-session of CBT4CBT looks a lot like standard clinician-delivered CBT.  It increases abstinence within treatment, and the effects are durable even after people leave treatment.

The CBT4CBT episodes have the feel of a daytime soap opera. Was this intentional?

Dr. Carroll: We knew we had to teach skills, but wanted to do it in an entertaining and engaging way to keep the user’s attention.  Movies and stories featuring interesting people who are struggling with the same problems a lot of our patients struggle with, in real-life settings, and using everyday conversational dialogue seemed a great way to do this.  We’ve been doing psychotherapy research with addicted people for over 30 years at our clinics at Yale, and so had plenty of material to draw from.

We got lots of input and feedback from clinicians and patients as we built it, including the professional actors and directors we hired to do the movies—they got really into it and all of them said they learned a lot of CBT!

What are the drawbacks of using an e-learning platform to deliver therapy?

Dr. Carroll: The drawback is that the program can’t do much other than teach the skills and provide support for practicing skills outside of session.  Unlike a clinician, it can’t build a strong relationship or address other kinds of problems (emotional, medical, family), and it can’t intervene in a crisis, so that’s why we restrict its use to individuals enrolled in inpatient or outpatient treatment.

What’s the timeline for making CBT4CBT accessible to anyone in recovery?

Dr. Carroll: So far, we have only tested CBT4CBT as an add-on to standard care, that is, with a clinician seeing each individual regularly to evaluate substance use and other problems, address problems and crises that the computer isn’t designed to address, and so on.

We are currently conducting a study comparing CBT4CBT used alone (minimal clinician involvement) to standard care and CBT delivered by a clinician, and we’ll have those results in a year or two.  If CBT4CBT turns out to be safe and effective as a stand-alone, we would probably make it available directly to individuals.

We’ve only been making CBT4CBT available outside of clinical research studies for a few months, but four or five clinics have already picked it up.

How can someone in recovery find more information on CBT4CBT?

Dr. Carroll: A lot of information is available on our website, http://www.cbt4cbt.com/

The site includes a demonstration of the program and a lot of information about CBT and our work. CBT4CBT is a very new treatment, and it’s not yet reimbursed by insurance, so in order to move this to qualify for reimbursement, it’s important it gets out into clinical use.   If you look at the demo and think you’d like to try it, contact your clinician and see if they’d like to add CBT4CBT into their practice.

If you live in Connecticut or nearby, you might also be able to participate in one of our research trials—we’re currently testing CBT4CBT as treatment for both drug and alcohol use, and just started a study with a version for people who speak Spanish. You can find more information at http://www.pdc.yale.edu/index.aspx

Can you offer any advice to people seeking help for addiction?

Dr. Carroll: I think it’s important for people seeking help for drug or alcohol problems to become educated consumers. Some clinics still use practices that have not been shown to be very helpful or even harmful; it’s perfectly appropriate to ask the hard questions before enrolling or starting treatment: “What evidence-based approaches do you use here?”  “Which ones would you think would be most useful for me, and why?”  “What kind of outcomes can I expect from this clinic and how is it monitored?”

A recent book by Anne Fletcher, “Inside Rehab” has a lot of great tips and resources for finding treatments that work.

Key characteristics of addiction, as defined by the American Society of Addiction Medicine (ASAM), include:

• Inability to consistently abstain from substance use
• Impairment in behavioral control
• Craving or increased “hunger” for drugs or rewarding experiences
• Diminished recognition of significant problems with one’s behaviors and interpersonal relationships
• A dysfunctional emotional response

Recovery from addiction is possible with effective treatment – which is best achieved through a combination of self-management, mutual support and professional care provided by trained and certified professionals, according to ASAM. See also our“ Guide to Choosing the Best Rehab.”

Applying the principles of self-compassion to addiction recovery:

Your inner critic could be putting your recovery at risk.

If you beat yourself up over past drug use — and then relapse to numb feelings of unworthiness — you know how self-criticism can backfire. A wealth of scientific research says it pays to do the opposite: be kind to yourself.

“People who score high in self-compassion are happier, they cope well with stress and have better immune response to stress,” says Dr. Kristin Neff, a pioneer in self-compassion research and an associate professor of human development and culture at the University of Texas.

“Self trash-talk,” Neff says, “is a double-whammy: when we judge ourselves harshly, we are both the attacker and the attacked. And hundreds of research studies show that indulging an inner tyrant ‘has a strong negative link to anxiety, depression and stress.’ For many people, one of their biggest sources of pain is self-criticism, and they don’t even know they’re doing it to themselves.”

The Science of Self-Compassion:

Self-Kindness, Common Humanity, Mindfulness

In her book, Self-Compassion: The Proven Power of Being Kind to Yourself, Neff details three core components necessary for self-compassion. By combining these principles, a person can replace demoralizing thoughts that may lead to addiction relapse. They can also begin to quash destructive patterns of fear, negative self-worth and isolation.

Treat Yourself Kindly

“First, treat yourself as you would a friend you really care about,” Neff says. “If you’re suffering in some way, and give yourself kindness and support and don’t mercilessly judge yourself, then you reduce the negative mind states. But you’re also generating a positive state of feeling cared for, supported and accepted.” Research shows that self-compassion helps decrease levels of cortisol, the stress hormone, and stimulates the release of Oxycontin, the bonding hormone that helps us feel safe and secure, a fact to which Neff makes reference.

Common Humanity

The second component of self-compassion is acknowledging that human nature is imperfect and we all fail. Recognizing this shared humanity helps us feel more connected to others, rather than being isolated by our suffering. “When you fail and make a mistake, remember that this is the human experience,” states Neff, “Often people think something has gone wrong when they fail, as if normal is that everything’s perfect. So what happens is there’s a sense of isolation, thinking everyone else is leading these normal, perfect lives.”

Mindfulness

Third, self-compassion requires us to relate to our situation with mindful awareness — rather than ignoring our pain, exaggerating our problems, or constantly battling negative emotions. “Mindfulness basically says, ‘I see this is really painful right now,’ says Neff, “You need to be aware that you’re suffering in order to be kind to yourself, to open your heart to yourself.”

Self-Compassion Is Not Self-Indulgence

Self-compassion is often misunderstood as self-indulgence, which Neff makes note of, but there is a fundamental difference.

“The dividing line is whether or not behavior is healthy in the long run or harmful in the long run,” she says. “A compassionate, caring parent, for example, won’t let a child get away with unacceptable behavior but will not shame the child. And that translates to how we treat ourselves.”

“A fair amount of research,” she continues, “shows that you’re more likely to take responsibility, if you have self-compassion. It’s safe to admit that you caused harm when you aren’t going to beat yourself up.”

Self-compassionate people may feel guilt, but not shame. Neff says that people think: “I’m not really thinking about you if I feel shame, I’m thinking about what a bad person I am. The self-criticism leads to shame, and shame is unhealthy.”

Instead, people who treat themselves kindly are more likely to forgive themselves and be resilient when they fail. Relating humanely to the self also can improve relationships. Neff comments that “Self-compassionate people apologize more, they’re more likely to take personal responsibility for the mistakes they’ve made. They’re more likely to want to repair those mistakes. Unlike self-esteem, the practice of self-compassion does not depend upon endless comparisons with others. And when things go wrong, self-compassion does not threaten the ego.”

We know that bullying is linked to the quest for high self-esteem,” she says, “Self-compassion is not dependent on judging yourself positively, it’s just dependent on treating yourself kindly and that’s available both when you succeed and especially when you fail.”

Catalyst For Positive Change

Is self-criticism the way to motivate positive change, as many people believe? “The research shows just the opposite,” says Neff, “What happens is, you’re afraid of failure and lose faith in yourself. The solution is to see yourself as someone intrinsically worthy of respect, even in tough times.”

“Self-compassion is a good source for positive change, but the reason you want to change is because you care about yourself and you don’t want to suffer,” she says, “You still want to recover from addiction, but the reason you change is not because you’re an inadequate human being unworthy of love, but because you are a valuable human being.”

Boost Your Self-Compassion

To find out how self-compassionate you are, Kristin Neff provides this free quiz:

http://www.self-compassion.org/test-your-self-compassion-level.html.

Most people score around 3.0 on the 5-point self-compassion scale, Neff says, so you can interpret your results accordingly.

And if you’re too hard on yourself, how do you silence the inner critic and still an agitated mind?

“A really powerful way to change the relationship with yourself is to drop out of your head and get into your body,” Neff says. “All mammals, including humans, respond to gentle warm touch. Start by doing something that relaxes your body — put your hand on your heart or your belly, cradle your face gently in your hands, like you’re soothing a child.”

“Sometimes your body can go there before your mind can,” she states, “Your body feels less anxious, less stress.”

A variety of free guided meditations to boost self-compassion are available on Neff’s website:

http://www.self-compassion.org/guided-self-compassion-meditations-mp3.html

You can also try these exercises in self-compassion:

Exercise 1: How Would You Treat a Friend?

Please take out a sheet of paper and answer the following questions:

1. First, think about times when a close friend feels really bad about him or herself or is really struggling in some way. How would you respond to your friend in this situation (especially when you’re at your best)? Please write down what you typically do, what you say, and note the tone in which you typically talk to your friends.
2. Now think about times when you feel bad about yourself or are struggling. How do you typically respond to yourself in these situations? Please write down what you typically do, what you say, and note the tone in which you talk to yourself.
3. Did you notice a difference? If so, ask yourself why. What factors or fears come into play that lead you to treat yourself and others so differently?
4. Please write down how you think things might change if you responded to yourself in the same way you typically respond to a close friend when you’re suffering.
5. Why not try treating yourself like a good friend and see what happens?

Exercise 2: Self-Compassion Break

Think of a situation in your life that is difficult and is causing you stress. Call the situation to mind and see if you can actually feel the stress and emotional discomfort in your body.

Now ask yourself:

1. This is a moment of suffering?

That’s mindfulness. Other options include:

• This hurts.
• Ouch.
• This is stress.

1. Suffering is a part of life

That’s common humanity. Other options include:

• Other people feel this way.
• I’m not alone.
• We all struggle in our lives.

Now, put your hands over your heart, feel the warmth of your hands and the gentle touch of your hands on your chest. Or adopt the soothing touch you discovered felt right for you.

Say to yourself:

1. May I be kind to myself?

You can also ask yourself, “What do I need to hear right now to express kindness to myself?” Is there a phrase that speaks to you in your particular situation, such as:

• May I give myself the compassion that I need?
• May I accept myself as I am?
• May I learn to accept myself as I am?
• May I forgive myself?
• May I be strong?
• May I be patient?

This practice can be used any time of day or night and will help you remember to evoke the three aspects of self-compassion when you need it most.

For more self-compassion exercises and free guided meditations, go to http://www.self-compassion.org/

Kristin discusses more on self esteem and self-compassion here.

The Space Between Self Esteem And Self Compassion:

What Is Self Compassion?:

Some facilities offer low-interest loans, scholarships, sliding-fee scales or financing options. Centers that receive state or federal subsidies will accept lower-income patients (based on bed availability; there may be waiting lists). Other rehab centers are funded by religious groups and charitable organizations that grant scholarships based upon bed availability. There are also “therapeutic community” programs that will accept patients who cannot pay for treatment.  In this situation, the patient will usually work during the day in exchange for room/board and treatment in the evenings (the program will often have contracts for some sort of manual labor).

Typical Cost & Coverage

The full cost of drug and alcohol rehab can range from $10,000 per month for outpatient treatment, on average, to $20,000-$30,000 or more for monthly inpatient residential stays. Cost varies with the location, type of services and amenities offered by each facility. Keep in mind that your investment in treatment reduces the cost of continually buying drugs and alcohol, and the consequences that may be associated with addiction – including lost wages, legal bills, incarceration, bankruptcy, overdose and declining health.

If you have no treatment history, insurance plans will typically approve partial hospitalization or intensive outpatient treatment for approximately 30 days.  If you have been to treatment in the past but relapsed, plans will typically approve about 30 days of residential inpatient treatment, followed by 30 to 60 days of partial hospitalization or day treatment and/or intensive outpatient care. There are some plans that cover treatment at 100 percent after an out-of-pocket maximum is met.

Affordable Care Act

Beginning in 2014, the Affordable Care Act (Obamacare) expands substance abuse benefits for Americans, especially those who did not have access to rehab before. The legislation includes mental health and substance abuse in its list of 10 “Essential Health Benefits,” putting addiction treatment on a par with coverage for regular medical care. Under the Affordable Care Act, insurance companies cannot deny pre-existing conditions including substance abuse.

Previously, many lower-income Americans only had access to rehab treatment through the criminal justice system, when rehab was mandated by a drug court. Now, with access to insurance through the Affordable Care Act – which expands Medicaid coverage and low-cost insurance options – more people with addiction can access rehab treatment.

If your company has a drug-free workplace program, FMLA benefits still apply to any serious health condition, including “any period of incapacity or treatment connected to inpatient care such as substance abuse treatment,” according to FMLA employment law. Ask your human resources director for more information about your employer’s FMLA compliance; you can also learn more at: http://www.dol.gov/elaws/fmla.htm

The Americans with Disabilities Act (ADA) and the Rehabilitation Act also provide job protections for people in recovery or treatment for addiction.

In general, employers “may not deny a job to or fire a person because he or she is in treatment or in recovery from a substance use disorder, unless the person’s disorder would prevent safe and competent job performance,” according to the U.S. Department of Health and Human Services. The employer must provide “reasonable accommodations” when needed, such as changing work hours to let an employee attend treatment. Employers must also keep confidential “any medical-related information they discover about a job applicant or employee, including information about a past or present substance use disorder.”

The ADA applies to all state and local governments and private employers with 15 or more employees; the Rehabilitation Act applies to federal employers and other public and private employers who receive federal subsidies or contracts.

All rehab employees sign a confidential agreement to protect your personal information, and should follow the “Consent to Release Information” form that identifies your wishes for sharing personal information. All rehab facilities in the United States must comply with the Health Insurance Portability and Accountability Act (HIPAA). This law establishes national standards for securing the privacy and integrity of individual electronic health records, with criminal penalties for violations.

In its “Principles of Effective Treatment” the National Institute on Drug Abuse states: “Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment.”

Adequate time in treatment enables the clinical staff to address any co-occurring health issues that you may have – for example, depression that occurs alongside addiction. And it gives you time to learn new behavioral changes that can help you overcome life’s challenges and improve your health and relationships.

Like diabetes management or other chronic diseases, relapse is common in addiction. This does not mean failure, but rather a need for treatment to be reinstated or adjusted. Recovery is an ongoing process, and multiple treatment episodes may be required to achieve long-term sobriety.

Inpatient programs are residential facilities that provide intensive treatment for addiction. Typically, they include full-time medical staff and 24-hour onsite nursing care. As an inpatient, you may receive medically-supervised detoxification (detox) to safely rid drug toxins from your system, and a combination of therapeutic treatments to aid your recovery. This can include pharmaceutical therapies such as Naltrexone to reduce cravings for alcohol or opioids, and wean you from the drug.

As a resident of an inpatient program, you may also receive Cognitive Behavioral Therapy and other psychosocial treatments to help you build new life skills and overcome relapse. You’ll be immersed in a supportive peer community with daily activities focused on addiction recovery.

Outpatient programs provide addiction treatment and therapy without an overnight stay. As an outpatient, you have more freedom to go home or return to work after treatment (for convenience, you may want to choose an outpatient rehab that’s close to home). But you also face the challenge of staying clean and sober in your regular environment.

Outpatient facilities provide day treatment and aftercare/relapse prevention programs including group and family counseling, 12-step programs and research-based interventions such as Cognitive Behavioral Therapy and Motivational Interviewing.

At least 17.5 percent of adults with a mental health condition also have a co-occurring substance use disorder, according to the 2011 National Survey on Drug Use and Health. And people addicted to drugs are about twice as likely as the general population to suffer from mood and anxiety disorders, according to the National Institute on Drug Abuse.

Ask the rehab facility if they have a research-based dual diagnosis program (one such model is known as Integrated Dual Disorder Treatment (IDDT), developed by Dartmouth Medical School). Look for staff physicians who are certified in addiction psychiatry, and counselors with advanced degrees and experience in treating dual diagnosis cases. Ask how your care will be coordinated so that everyone is working toward your recovery.