One-year Death Rate of Opioid Use Disorder Similar to Heart Attacks

“Hospitalized patients with opioid use disorder (OUD) die at a rate comparable to people who suffered heart attacks within a year of hospital discharge,” according to a new study from Oregon Health & Science University.

The study published in the Journal of Addiction Medicine found that almost 8 percent of patients with OUD died within 12 months of being discharged. The authors say their findings highlight the need for addiction care in the hospital, as well as generally improving health systems for patients with substance use disorder (SUD) who also have other medical conditions.

They concluded that “hospitalized patients with OUD are at high risk of death, from drug and non-drug-related causes, in the year after discharge,” and suggested that “future research should consider not only overdose, but a more comprehensive definition of drug-related death in understanding post-discharge mortality among hospitalized patients with OUD, and care systems should work to mitigate the risk of death in this population.”

A severe opioid use disorder is a life-threatening disease, requiring comprehensive addiction treatment. Overdose deaths—largely driven by opioid misuse—soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the US government reported in July. That latest estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to an alarming 29 percent increase.

A comprehensive treatment plan may include the prescription of three FDA-approved drugs as part of medication-assisted treatment or MAT. Medications used for the treatment of opioid use disorder are buprenorphine (Suboxone, Subutex), methadone, and extended-release naltrexone (Vivitrol). Research shows that a combination of medication and therapy can successfully treat OUD, and for “some people struggling with opioid addiction, MAT can help sustain recovery,” according to the US Department of Health and Human Services. “MAT is also used to prevent or reduce opioid overdose.”

Harmony Offers HOPE

As a modern treatment provider, Harmony has offered clients with OUD medication-assisted treatment for a number of years. Harmony’s Opioid Programming Experience (HOPE) is a combination of education, counseling, and the use of medication in early recovery. HOPE expands MAT to include medications that alter the physical response to opioids, reduce cravings, and give the patient time to heal from the psychological, social, and spiritual wounds of addiction.

At Harmony, HOPE begins with thorough medical and psychological evaluations. Collaboration with the patient, members of the interdisciplinary team, and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly support groups led by a professional addiction counselor. These groups address the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse. In this setting, clients support each other and are educated about the process of recovery.

Harmony Foundation is one of the longest-running and most successful addiction treatment centers in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Keep It Simple!

Michael Maassel has been cheering up and inspiring the recovery community every Monday morning since the horrendous early days of the COVID-19 outbreak. It’s an important mission during a pandemic that has been such an emotional drain for so many people in recovery from addiction.

In May 2020, she launched the popular “Monday State of Mind” podcast. Inspired by her own sobriety and wellness journey, the director of alumni and recovery support services at Harmony wants to spread the wealth of knowledge of how you can take the fundamentals of recovery and apply them in your life whether you are in recovery or not.

In episode 84 of “Monday State of Mind,” Michael talked with her colleague Chris Conn, donor relations manager at Harmony Foundation, about how to keep your recovery real and simple. Many people are unsure how to present their recovery in the wider community. How to refuse an alcoholic beverage at a family gathering, public event, or party? How to handle the often awkward moment when somebody offers you a drink?

No need to overcomplicate the issue, says Chris Conn. “Our culture has become much more accepting,” he says. Recovery from addiction “no longer freaks people out.” Many people will now appreciate your sobriety and simply say “cool” when you tell them about it. Often, they are impressed with you making a change like that.

Chris himself was brave enough to break the news in a job interview. When asked why he had moved from Minnesota to Colorado his reply was “I moved out here to get sober.” He was really nervous about his forthright answer but the interviewer wanted to know more and Chris believes his honesty actually helped him get the job. “At that moment I was authentic,” Chris recalls and they liked that “I put that much work and effort into changing my life.”

Sobriety is no longer just for people with addiction, either. “There are lots of people who are choosing to lead an alcohol and drug-free life for many reasons,” says Michael. “It’s becoming very acceptable socially” and that works in your favor if you are in recovery.

It’s also okay to use a little humor to deal with awkward situations. Chris remembers answering questions like “Why are you not drinking?” with “every time I drink, I break out in handcuffs.” And if there was laughter, he would follow up with “seriously, I end up in jail if I do this.”

It’s not always easy. Michael recalls how in early recovery she was sometimes afraid of losing friends if she didn’t drink—if people found out her truth. Chris went through the same phase but then realized if “somebody wants to dissociate from me because I stopped using drugs and alcohol, they were not a healthy person for me to be in my life from the get-go. People that love me the most accept me for who I am.”

Not only did Chris disclose that he had been addicted to substances, but he also came out as a gay male. In the end, only two people dropped him from their lives because of that. “I realized, I’m better off with that. The same goes if you’re disclosing that you’re an alcoholic or an addict,” he says. “If somebody drops you out of their life because you’re taking charge of your sobriety, I feel, that person shouldn’t have been in your life to begin with.”

On the other hand, there’s no obligation to “recover out loud” like Michael and tell everybody about your sobriety. Everybody is different. You can simply just say “I’m not drinking right now.” It’s perfectly alright to keep it brief and to the point.

Remember, recovery is one day at a time. It’s perfectly legitimate to tell people it’s for health reasons such as trying to get fit. Keep it simple and stay sober!

Harmony Reaching Out to the Wider Recovery Community

The opposite of addiction is connection, they say, and for more than 50 years, Harmony Foundation has helped people with addiction reconnect, promoting their physical, emotional, and spiritual healing. Our alumni program plays an important role in that endeavor. Harmony doesn’t just keep in touch with its alumni, we also like to integrate with a wider community of like-minded organizations.
 
“Harmony continually reaches out to the recovery community in Colorado and beyond,” says Michael Maassel, Harmony’s director of alumni services and co-president of Treatment Professionals in Alumni Services (TPAS).
 
At a recent TPAS event, she shared with fellow alumni services how to work with local organizations in order to stimulate creative ideas for more effective programming, service work, and engaging with the larger community.
 
Back home in Colorado, Michael is doing just that. “For example, we’re collaborating with Colorado Artists in Recovery,”  she explains. CAiR offers a variety of workshops to fuel the creative spirit. It utilizes recovery-oriented principles to provide a safe, encouraging, and inclusive environment for people affected by substance misuse and mental health issues.
 
“We’re also working with the children’s program of the Hazelden Betty Ford Center,” says Michael. In a recent webinar for Harmony Foundation, Lindsey Chadwick, the program’s manager, explained how addiction affects the children in the family of the addicted person and what therapists can do to help children heal from the trauma of addiction.
 
“Generally, we’re connecting our alumni with other recovery-focused groups and organizations,” says Michael. “We really want to diversify their recovery, engage their own, individual personality, and give them as many tools as possible to be successful.”
 
At the moment, Harmony is working with three recovery residences in Colorado to help them with their missions. One is Purpose House Sober Living in Fort Collins where Harmony operates a recovery center.  Purpose House offers men in early recovery a safe and supportive living environment to increase their chances of creating a life of happiness and purpose in long-term sobriety.
 
Amethyst House in Loveland which is part of Recovered Humans provides a safe and sober environment for women in Colorado. Route2Recovery provides sober living accommodations, recovery peer coaching, and family coaching.
 
As a special gift for the holiday season, Michael asked all three to create Amazon registries for things they need for their sober living facilities. “The holidays can be tough for people in recovery,” she says, “and we wanted to make this time of the year a little easier for them.”

She chose this online method to enable more alumni to participate in this service project. “This way, it’s not just people in Denver or Colorado who can be part of it,” says Michael.
 
The registry links are:

“The great thing about this is they get supplies sent to their doorsteps for a whole month, it’s like getting little surprise gifts day after day, making it easier for new arrivals who may not have shampoo or razors, or laundry detergent. And it’s a great way to say thank you to sober living homes who were an important part of the recovery of many of our alumni.”
 
Reconnecting to a life of purpose in recovery is a life-long journey. If you or a loved one are struggling with alcohol or drug addiction, do not delay getting treatment because of the holidays. Call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Harmony CEO James Geckler Joins Alumni Services Association

Discharge from an addiction treatment program is not the conclusion of the healing process but only the next step in the long recovery journey. The new connections with peers and therapists forged during residential treatment or in an intensive outpatient program should be continually fortified and not neglected after discharge.

The opposite of addiction is connection, it has been said. Harmony Foundation is an over 50-year-old nonprofit addiction recovery program that promotes physical, emotional, and spiritual healing. Its alumni program plays a crucial role in that effort.

To further emphasize the importance of alumni programs, Harmony Foundation CEO James Geckler recently joined the national board of Treatment Professionals in Alumni Services (TPAS), an organization dedicated to the development of long-term recovery support for individuals following their acute treatment period.

The TPAS approach is based on a client-centric approach to activities that promote connection, continual education, and the celebration of recovery. TPAS’s vision is to foster dynamic collaboration between addiction treatment professionals seeking to improve outcomes for people in recovery from addiction.

“Jim’s name in the industry is synonymous with innovation as an organization but he also believes in the value of the individual. He has a natural ability to recognize a person’s potential, providing them with the tools to be their best,” commented Michael Maassel, Harmony’s director of alumni services and co-president of TPAS.

Mental health and addiction services are more needed than ever after the COVID-19 pandemic intensified the already escalating mental health crisis in America and the correlated addiction epidemic.

TPAS’s mission is to provide the skill sets necessary to make an impact with the prioritization of peer support over profit. Harmony Foundation, which has been led by Geckler for some five years, is fully aligned with that concept and has changed the lives of tens of thousands of people with addiction.

“For addiction treatment and mental health programs, TPAS is one of the most effective channels for supporting positive change,” added Geckler. “I look forward to helping effect change for the better and highlight the positivity of lives in recovery—an aspect of the disease of addiction often overlooked by the public.”

The Connection Between Trauma and Addiction

There is a robust correlation in the scientific literature between trauma and addiction.

Trauma and other mental health conditions are frequently co-occurring with substance use disorder (SUD) because many people with addiction are primarily misusing substances to self-medicate emotional pain caused by trauma.

“Many individuals who develop substance use disorders are also diagnosed with mental disorders, and vice versa,” explains an information page of the National Institute on Drug Abuse (NIDA). “Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa.”

“The primary reason individuals use drugs of abuse is due to their immediate psychological effects. Alcohol and other drugs (in addition to rewarding behaviors) change the way individuals feel by producing pleasure (i.e., positive reinforcement) and reducing dysphoria,” wrote Amanda Giordano, Ph.D., in a recent article for Psychology Today. “For individuals with dysregulated stress systems resulting from trauma, drugs of abuse can offer a reprieve from chronic hyperarousal and anxiety. Alcohol, benzodiazepines, opioids, and cannabis products have calming intoxication effects, some of which even serve to slow down the central nervous system.”

Trauma-Informed Care

If trauma is an important driver of addiction, it follows that trauma should be addressed in addiction treatment.

“Trauma-informed care (TIC) acknowledges the need to understand a person’s life experiences in order to deliver effective medical care,” wrote psychiatrist Lantie Jorandby on Psychology Today in July. “It also assumes that trauma has occurred in many of our lives, that it can continue to affect us in powerful and debilitating ways, and that it needs to be considered when we receive mental healthcare.

“Patients with SUD who are experiencing trauma symptoms often come into treatment with an internal fire alarm going off all day long,” wrote Jorandby. “They have trouble relaxing. They have trouble trusting. They don’t sleep well. And they frequently experience panic attacks and nightmares.”

Such symptoms need to be addressed in therapy and all staff at a treatment center should be aware of their significance in order to avoid triggering or re-traumatizing the patient inadvertently.

“The need to address trauma is increasingly viewed as an important component of effective behavioral health service delivery.” stated the US Department of Health and Human Services

Substance Abuse and Mental Health Services Administration in SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach (2014)

“A program, organization, or system that is trauma-informed realizes the widespread impact of trauma and understands potential paths for recovery; recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system; and responds by fully integrating knowledge about trauma into policies, procedures, and practices, and seeks to actively resist re-traumatization.”

Integrating knowledge about trauma into therapy allows patients to work on their treatment plan in a calmer state, facilitating better outcomes.

Trauma-informed care “has done so much to transform and inform addiction treatment, and patients with SUD are responding well to it,” wrote Dr. Jorandby. In the TIC environment, patients can feel confident that they:

  • Will be safe while in treatment.
  • Will have a voice in their care.
  • Will benefit from a TIC-trained clinical staff that is collaborating with them
  • Will know that their therapy is always positive, never punitive.

Harmony Foundation has long utilized a holistic approach to healing trauma and addiction. All staff at Harmony have been trained in trauma-informed care. Realizing that addiction is a biopsychosocial and spiritual disease, Harmony’s treatment program promotes physical, emotional, and spiritual healing, empowering patients to embark upon a lifelong journey of recovery.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

People with Autism at Higher Risk of Substance Misuse

Substance misuse is more prevalent among people with autism spectrum disorder (ASD) than among sex- and age-matched control cohorts, according to Taiwanese research.

The retrospective analysis found that those with autism had a significantly higher risk for substance use disorder (SUD) than those without autism, reported Huang, Yang, et al.

The study, published in JAMA Pediatrics, revealed a three-fold increased risk for a drug use disorder and a two-fold higher risk for alcohol use disorder. In addition, those with autism and a co-morbid substance use disorder had a more than three-fold higher risk of death during an average follow-up period of 8.1 years.

A number of psychiatric comorbidities were more prevalent among people with ASD, including intellectual disability, attention deficit hyperactivity disorder, tic disorder, epilepsy, obsessive-compulsive disorder, mood disorder, anxiety disorder, and impulse control disorder.

The Taiwanese research confirms that patients with ASD are vulnerable to developing SUD. “The impact of ASD on the lives of individuals is strongly influenced by co-occurring medical, developmental, or psychiatric conditions. SUD is one important, but little studied, co-occurring condition,” wrote Espen Ajo Arnevik and Sissel Berge Helverschou in their systematic review of autism spectrum disorder and co-occurring substance use disorder in 2016.

Despite the correlation, there is a distinct lack of screening and treatment options.

“Patients with co-occurring autism spectrum disorders (ASD) and substance use disorder (SUD) require special attention from clinical services,” wrote Arnevik and Helverschou. “Screening for this co-occurrence is not generally an integral part of routine clinical assessments, and failure to identify and understand this group of patients may contribute to a worsening of their symptoms and/or an increase in drug abuse.”

As with other mental health disorders, self-medicating with drugs and alcohol is likely to worsen symptoms.

“Substance abuse may represent a particular vulnerability factor, as the intoxication may further decrease the ability of individuals with ASD to anticipate the consequences of their behavior and make it even more difficult to behave according to formal and informal laws,” explained Arnevik and Helverschou. “There is a high prevalence of anxiety reported in ASD generally, and possible links between anxiety and substance abuse as self-medication have been hypothesized by several authors.”

Like their Taiwanese colleagues, they also noted the elevated suicide risk.

“In ASD populations, there is also a heightened risk of suicidal behavior. An article published in The Lancet in 2014 reported that, among 374 adults (256 men and 118 women) diagnosed with AS, 66 percent self-reported suicidal ideation, 35 reported plans or attempts at suicide, and 116 (31 percent) reported depression.”

The treatment program at Harmony Foundation has full dual-diagnosis capabilities, serving clients with SUD and co-occurring mental health disorders. Harmony’s modern, evidence-based approach to addiction treatment acknowledges the important role mental health conditions play as drivers of substance use disorders. People may misuse drugs and alcohol because of mental health issues like unprocessed trauma, depression, anxiety, or ASD. If co-occurring conditions aren’t addressed, clients are more likely to relapse because they may be drawn to substance use to self-medicate those issues.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (866) 686-7867 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

The Importance of Relationships in Recovery

One of the most devastating aspects of addiction is the damage it causes to relationships with intimate partners, family, friends, or colleagues. Many treatment programs recognize the important role of relationships in the healing process—especially within the family.

Kelly E. Green’s new book Relationships in Recovery is a comprehensive overview of the crucial role relationships play in the battle against addiction. Through her work with hundreds of clients, the psychologist and addictions expert has learned that social support is a key aspect of the recovery process.

“Most people enter recovery for substance abuse problems hoping not just for improvement in their addiction but also for improvement in their relationships. That’s because the majority who seek treatment report having interpersonal problems and relationship distress,” Dr. Green writes, “in many cases, substance abuse has both caused relationship problems and become a way of trying to cope with them.”

In many important aspects, addiction is a relationship disease and not simply misuse of substances. “The idea that recovery should be wholly an individual journey reinforces the idea that addiction is solely a character flaw,” says Green. “That idea has been disproven by loads of research, and although individual recovery is critically important, so is relationship recovery.”

Relationships in Recovery aims to help people in recovery “improve a broad range of relationships and relationship skills.” It is a guidebook that provides readers with many worksheets to discover what impact their substance use had on their relationships and what impact their relationships can have on their recovery.

Dr. Green emphasizes that recovery is primarily a process of change to improve health and wellness, rather than just achieving and maintaining sobriety.

Why the focus on relationship skills in recovery? “The impact of our relationships on our quality of life can be profound. Most of us tend to feel better when our relationships are doing well.”

What kind of relationships are we talking about? “All kinds of relationships are important in life, and all kinds of relationships are important to your recovery.” Interestingly, her checklist of possible relationships starts with “relationship with God or spiritual being(s)” before listing romantic partners, relatives, and other relationships.

Many of Dr. Green’s clients ask her questions like “How do you repair relationships that have been damaged by addiction?” and “How long does it take?”

Toxic relationships can indeed be a big problem. “An essential skill for recovery is finding ways to minimize the harmful effects and maximize the helpful effects the relationships in your life have on your addiction recovery efforts,” writes Green.

She cautions her readers not to fall for certain myths about relationships:

Myth #1: Relationships automatically improve when recovery begins
Myth #2: Recovery starts as soon as you’re sober
Myth #3: Apologies fix relationships
Myth #4: The support of loved ones is always helpful

Number 4 is especially important because sometimes loved ones will engage in what’s known as enabling behavior. While trying to help, friends and family members may actually make the situation worse by protecting the addicted person from the negative consequences of their actions, thus delaying the decision to get help for their substance use disorder.

An effective treatment program explores the unhealthy and healthy aspects of their clients’ relationships, ideally with the participation of affected family members, so the whole family can heal.

As Dr. Green explains, this requires developing effective communication skills, rebuilding trust (by being honest with one another), and setting healthy boundaries. An “important goal of healthy interpersonal boundaries is allowing you to connect with others to build meaningful healthy relationships.,” explains Dr. Green.

All of this requires a lot of work. “Addiction recovery is hard,” warns Green. “Relationships are hard. Relationships, while you’re overcoming addiction, are extremely hard.” Nevertheless, people in recovery and their loved ones should not be discouraged and use the skills and strategies outlined in the book to keep working on their recovery and “strive for progress, not perfection” as they improve their “quality of life through recovery and reconnection.”

Harmony Foundation has long recognized the importance of family involvement in the recovery process. Due to the COVID pandemic, Harmony is currently offering a modified family engagement workshop that is available to all families of current and former clients.

The virtual education group has two goals. The first is to educate family members about the disease model of addiction and how it can help them understand their loved one’s condition. The second is to give family members time to express themselves and begin to heal their own pain, while also engaging in self-examination. The three-hour session is facilitated by a licensed therapist.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (866) 686-7867 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Supporting Children Affected by Addiction

Addiction is often described as a family disease.

“Addiction is a family disease that stresses the family to the breaking point, impacts the stability of the home, the family’s unity, mental health, physical health, finances, and overall family dynamics,” warns the National Council on Alcoholism and Drug Dependence (NCADD) on their website. “Living with addiction can put family members under unusual stress. Normal routines are constantly being interrupted by unexpected or even frightening kinds of experiences that are part of living with alcohol and drug use.”

In a recent webinar for Harmony Foundation, Lindsey Chadwick, manager of the children’s program at the Hazelden Betty Ford Center, explained how addiction affects the children in the family of the addicted person and what therapists can do to help children heal from the trauma of addiction.

Addiction has a high probability of perpetuating itself: a troubling 75 percent of adults in treatment grew up with addiction in their families, explained Chadwick. Children living through abuse, violence, and other traumatic events such as parental substance misuse often suffer the ill effects of what are known as “adverse childhood experiences” for the rest of their lives.

An additional risk factor is a possible genetic disposition. According to NCADD, “genetics make up 50 percent of the risk for alcohol and drug dependence.”

Supporting children traumatized by addiction isn’t easy. They often find creative ways to suppress their trauma. Many of them internalize addiction expert Claudia Black’s family rules of addiction: don’t talk, don’t trust, don’t feel. One way of breaking through that wall of denial is drawing. Often it’s easier for children to draw what they cannot verbalize. Chadwick presented three examples during the webinar.

 

The first image, entitled “Fighting” showed a profoundly sad child with the parents arguing in the hallway. The prevailing colors are cobalt blue and gray. The second image, called “Broken Promises” depicted a child eagerly waiting for their dad to show up while the father is shown injecting drugs in another room. The third picture, showing awake, illustrated the attempt of a traumatized child to deal with the death of a parent. The drawings—harrowing examples of what children affected by substance misuse are going through—can serve as a starting point in therapy.

Another indicator can be observing the role the child has assumed in the family dynamic. According to addiction educator Sharon Wegscheider-Cruse, the co-founder of the National Association of Children of Alcoholics (NACOA), kids often try to manage the situation by assuming certain roles in the family, such as the “family hero” who is trying to make everyone in the family look good, the “caregiver” who tries to keep everyone in the family happy, the “mascot” or “jester” who uses humor to keep things on a superficial level to protect others and themselves from feeling the painful truth of the addiction, or the “lost child” who just checks out emotionally.

Unfortunately, these coping mechanisms do not help process the trauma but mainly suppress it in unhealthy ways. Therapists need to recognize these survival modes and turn them into the support that helps children thrive. Prevention research suggests that children in families with addiction need three critical things, explained Chadwick: age-appropriate information, skill-building, and attachments to safe adults.

They need to understand that addiction is a disease and that the situation in the family is not their fault. They need to understand that people with addiction are not bad people although they sometimes do bad things. Children need to realize that they are not alone and that it’s okay to talk about their feelings.

It’s equally important to listen to the children to find out how addiction has affected them and help them realize there are people who understand what they are going through. In this case, “listening” includes talking, drawing, playing, and the support of the group.

Finally, Chadwick emphasized the important function of playing. It’s how children do self-care and it helps create safety. Children impacted by addiction need to attach to safe people and a safe place to cope with the trauma. And as Chadwick put it, it’s a child’s number one job to have fun!

Harmony Foundation is one of the longest-running and most successful addiction treatment programs in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (866) 686-7867 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.