Addiction

Harmony Foundation Responds to the Opioid Epidemic with HOPE

Posted on by Christy Weeks

by Christopher Reveley, MD, and Annie Peters, PhD, LP

The Opioid Epidemic

According to the National Institute on Drug Abuse (NIDA), nearly 100 people die from opioid overdose in the United States every day, and 2.6 million Americans struggle with opioid addiction. The prescribing of opioid pain relievers became much more common in the late 1990s, and it soon became evident that these medications were powerfully addictive. Opioid overdose deaths have increased significantly in the years since. Many of those addicted to heroin started with the abuse of prescription opioids.

Overdose along with the spread of HIV, hepatitis C, and withdrawal syndromes in babies born to addicted mothers constitute a nationwide crisis that has overwhelmed the resources of state and local health care delivery services. Recently, the White House identified the opioid epidemic as a national public health emergency.

How is Harmony Responding to Opioid Epidemic?

Harmony Foundation in Estes Park, CO, has been treating addiction for 48 years and has fostered a generation of long-term recovery support for individuals and families. Harmony’s mission is to provide the foundation for sustained recovery from the diseases of drug and alcohol addiction. Harmony staff is committed to continuous improvement and closely monitors a client experience, treatment response, and the research literature on addiction treatment. In the field of opioid addiction research, advances in behavioral treatment, neurobiology, and brain imaging have given treatment programs guidance in developing better services. Harmony now offers HOPE – Harmony’s Opioid Programming Experience. HOPE is offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.

HOPE: Medical and Clinical Approaches

HOPE begins with thorough medical and psychological evaluations. Collaboration with the client, 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 Opiate Support Groups led by a professional addiction counselor. This group addresses the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid rapid relapse. In this setting, clients support each other and are educated about the process of recovery.

Harmony has provided all clients with medication-assisted treatment (MAT) for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce craving, and give the individual time to heal from the psychological, social, and spiritual wounds of addiction.

HOPE clients may choose to avoid medications altogether or use only sleep and anxiety-reducing medications during the acute withdrawal period. For others, naltrexone, an opioid receptor blocker, can prevent the euphoria of opioid use and help control cravings, thereby changing the client’s drive to use illicit opioids after treatment.

Buprenorphine

This partial opioid agonist, administered in a tapering protocol, may be chosen by the treatment team and client to ease symptoms of severe opioid withdrawal during detoxification. On an individual basis, this medication may be continued during early recovery, most commonly for those with severe and persistent opioid addiction. Care following residential treatment may include ongoing buprenorphine to provide a craving-free foundation for the client as they rebuild damaged interpersonal and work relationships and regain physical and emotional health. The ultimate goal with all treatment approaches is complete abstinence from all opioids.

While some may question how an opioid medication (buprenorphine) can help someone recover from opioid addiction, this treatment approach is supported by organizations such as the World Health Organization, the American Society of Addiction Medicine, the Substance Abuse and Mental Health Services Administration, NIDA, the Veterans’ Administration, NAADAC – the Association for Addiction Professionals, and the National Association of Addiction Treatment Professionals. Due to the number and quality of research studies that have been completed on the use of buprenorphine in treating opioid use disorders, the level of evidence for the effectiveness of buprenorphine treatment is considered to be high (Thomas et al., 2014). Positive outcomes typically include improving retention in treatment and reducing illicit opioid use.

The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.

If you or someone you know is struggling with opiate addiction and needs help right away, Harmony is here to help. Call us at 866-686-7867 and one of our admissions specialists can discuss next steps.

References

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis

Center for Behavioral Health Statistics and Quality (CBHSQ), 2016. 2015 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Thomas, CP, Fullerton, CA, Montejano, L, Lyman, DR, Dougherty, RH, Daniels, HS, Ghose, SS, & Delphin-Rittmon, ME. Medication-assisted treatment with buprenorphine: Assessing the evidence. Psychiatric services, 65(2), 158-170.

Continuing Care after Treatment: How to Keep Recovery Moving Forward

Posted on by Christy Weeks

Addressing long term recovery often takes more than one episode of primary residential treatment. While the purpose of residential treatment is to provide a safe, structured living environment to help an individual stabilize, detox from drugs and alcohol and begin the early healthy coping skills necessary to help them on their journey to sobriety, it is just the beginning. A good in-patient residential treatment program does not stop once the client completes 28-30 days of treatment. The introduction of a strong continuing care plan should begin once the client completes detox before they exit in-patient treatment.

What is a continuing care plan? A continuing care plan is a collaborative partnership between a clinical case manager, the client and the therapist to design an individualized plan that provides a safety net of resources to continue their addiction treatment work. This could include Partial Hospitalization, Intensive Outpatient and active 12- step programming and sometimes sober living.

Why is continued “step –down” treatment important for long-term sobriety? According to NIDA, relapse is common in addiction treatment, with relapse rates being between 40 and 60 percent. Preventing relapse must include a continuing care plan that supports the individual in their early recovery. The Journal of Psychiatry published a 2014 review article, “The Continuing Care Model of Substance Use Treatment: What Works, and When Is “Enough,” “Enough?” Findings suggest that the overarching objective of any continuing care model should be to sustain treatment gains attained in the primary phase in an effort to ultimately prevent relapse.

In addition to our early primary addiction treatment offered at Harmony Foundation, we have also included a clinical case management team trained to work in partnership with the client and therapists to identify the “right” plan for each person. With over 47 years of treating individuals with substance use disorders, we have fostered partnerships with external providers to help our alumni be successful. “The most critical aspect of building a continuing care plan with our clients is letting them drive their recovery planning process. Telling them what to do and where to go doesn’t allow them to embrace their recovery.” says Alyssa Hansen, Director of Clinical Case Management.

Fostering this partnership and building a continuing care plan has shown positive results. According to M. Vannicelli , overall, continuing care participation in the first 3 months following discharge from residential treatment appears to be significantly related to fewer days since last drink and lower levels of alcohol-related impairment at both 3 and 6 months. Harmony has seen its own positive results in post-treatment engagement with over 54% of clients staying connected to a continuing care plan after 12 months.

When exploring residential treatment, asking about continuing care is as important as learning about the detox process. Without a solid, compassionate and collaborative continuing care team working with the client to approach life outside of residential team, clients may not be sufficiently prepared for their early journey of sobriety.

To learn more about Harmony Foundation Clinical Case Management, Click Here to listen to the team talk more about their important work in facilitating a recovery direction that is designed to be supportive and engaging, helping clients succeed.

New Treatment for Alcohol Use Disorder

Posted on by Christy Weeks
alcohol use disorder

This month we are talking about alcohol, because April is Alcohol Awareness Month. The annual occurrence involves a number of events taking place throughout the country, with the aim of increasing public awareness and understanding about the dangers of alcohol use. Alcohol Awareness Month is sponsored by the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) – the leading advocacy organization in the world addressing alcoholism and drug dependence since 1942. This year’s Alcohol Awareness Month theme is: “Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use.”

Having an unhealthy relationship with alcohol during adolescence can lead to an alcohol use disorder as early as young adulthood. Parents who have open, honest conversations with their children drastically reduce the likelihood of their kids using drugs or alcohol. The more teenagers know about the dangers commonly associated with alcohol use, the greater the chance they will stay away from the insidious substance.

“Alcohol and drug use is a very risky business for young people,” says Andrew Pucher, President and Chief Executive Officer of NCADD, “and parents can make a difference. The longer children delay drinking and drug use, the less likely they are to develop any problems associated with it. That’s why it is so important to help your child make smart decisions about alcohol and drugs.”

Unfortunately, many young adults are already living with an alcohol use disorder (AUD), which is why researchers have a huge incentive to develop effective treatments. Residential treatment centers give people struggling with alcohol the best shot at recovery, but there are times when medications are used to help prevent relapse, such as:

  • Acamprosate
  • Naltrexone
  • Disulfiram

While some people recovering from alcoholism respond well to the aforementioned medications, others have not been so fortunate. Researchers from QUT’s Institute of Health and Biomedical Innovation may have found a new treatment for AUD, and the beta blocker pindolol has already been approved by the Food and Drug Administration (FDA), Science Daily reports. The findings were published in Addiction Biology, the Journal of the Society for the Study of Addiction.

“Drugs currently used for AUDs (alcohol use disorders) — acamprosate, naltrexone and disulfiram — have limited success — so this is a ground-breaking development with enormous potential,” said Professor Bartlett who is based at the Translational Research Institute. “In an internationally-significant breakthrough, our study showed pindolol was able to reduce ethanol/alcohol consumption, particularly in relation to binge drinking, a key behaviour observed in human alcohol dependence.”

Nonviolent Drug Offenders See Light Again

Posted on by Christy Weeks

Addiction is not a crime! It isn’t a moral failing or a lack of constitution. Addiction is a disease of the mind that requires treatment and a program of maintenance, if recovery is to be possible. For decades, the United States government’s solution to addiction was locking up “offenders” and essentially throwing away the key. Even if a non-violent drug offender was released, the likelihood of recidivism was staggering.

Handcuffs and cell bars do not treat addiction, they only serve to put a scientifically accepted mental illness on the back burner; the disorder simmers until the day of release, at which time it comes forward and is brought to a rolling boil. Without the tools and resources necessary to remain abstinent, the vast majority will find themselves behind bars again. It is a vicious cycle that has been the status quo for too long.

Over the last decade, lawmakers have slowly come to terms with the fact that they can no longer treat addiction, and those who suffer from the disease, the way they have in the past; fear of punishment does little to detract addicts from continuing to use. Politicians from both sides of the aisle have begun to push for changes with regard to mandatory minimum sentences, rules that take sentencing out of the hands of judges. Right now, as these words are written, thousands of people are sitting behind bars for anywhere from 20 years to life – the result of nonviolent drug offenses.

Fortunately, we may be able to learn from the mistakes of our past, doing away with draconian mandatory minimum sentences and releasing those who are serving unjust terms for the crime of addiction. President Obama has done a lot in his tenure to undo some of our mistakes, granting clemency to hundreds of nonviolent drug offenders. In fact, the President has commuted the sentences of 248 prisoners thus far, more prisoners than the last six presidents put together, The New York Time reports. On Wednesday, the President commuted 61 sentences, more than one third of which were serving life sentences.

“Most of them are low-level drug offenders whose sentences would have been shorter if they were convicted under today’s laws,” President Obama said on his Facebook page. “I believe America is a nation of second chances, and with hard work, responsibility, and better choices, people can change their lives and contribute to our society.”

A Vaccine for Heroin?

Posted on by Christy Weeks
heroin

The American prescription opioid epidemic has affected millions of Americans and their loved ones. Efforts to curb painkiller abuse had the unintended effect of leading to a scourge of heroin use – as the drug is often times cheaper, stronger and easier to acquire in the wake of prescription opioid crackdowns. Heroin abuse has become a major public health concern in both urban and rural America, due to the rise in both addiction and overdose death rates. While there is help available in the forms of treatment and 12-Step recovery, relapse rates are particularly high among opioid addicts.

Scientists continue to develop new methods intended to give addicts the best shot at successful recovery, and believe it or not, in the near future there may be a vaccine available that will prevent people from getting high if they use. Research was published last month that dealt with developing a vaccine that would prevent people from getting high if they use the powerful opioid narcotic fentanyl – an analgesic that is 80 to 100 times more potent than morphine, and 50 times stronger than heroin.

What’s more, clandestine laboratories are manufacturing fentanyl which is then being mixed with heroin to make it more potent. Heroin users are often unaware of the presence of fentanyl, an ignorance that can prove fatal. Admixtures of heroin fentanyl can severely depress respiratory function, which can result in death.

Working with mice, researchers were able to inject the animals with booster shots that would train their immune systems to attack the fentanyl molecules in the bloodstream before the drug crossed the blood-brain barrier resulting in euphoria or potential overdose, The Daily Beast reports. Additionally, when the researchers injected the mice with lethal doses of fentanyl, the mice survived.

“The idea that [the researchers] can make an effective vaccine is very cool. It’s a good accomplishment,” says Phil Skolnick, director of the Division of Pharmacotherapies and Medical Consequences of Drug Abuse at the National Institute on Drug Abuse (NIDA), who was not involved in the study. “You have to trick the body, and it requires a fair amount of trickery.”

If the human clinical trials are successful, it could eventually lead to the development of a heroin vaccine. The vaccines would be specific to particular drug molecules. If people in recovery from heroin addiction are vaccinated, it could significantly deter relapse because the user would know that they will not experience the desired euphoric affect.

Until such time, the best opportunity of successful recovery rests on effective, evidence-based addiction treatment programs. If you are battling with prescription opioid and/or heroin addiction, please contact Harmony Foundation to begin the journey of recovery.

Senate Votes On Comprehensive Addiction and Recovery Act

Posted on by Christy Weeks
CARA

With presidential candidates crisscrossing the country discussing how to handle the prescription opioid and heroin epidemic, lawmakers in D.C. are also hard at work to combat the problem as well. It is no secret that democrats and republicans often disagree about major issues; one thing lawmakers from both sides of the aisle can agree on is that something needs to be done – sooner rather than later.

This week, the Senate voted in favor (86-3) of the Comprehensive Addiction and Recovery Act (CARA), a bill which would give federal grants to states and local governments to help fund the fight against our nation’s crippling health crisis, USA Today reports. If a final vote on the bill’s passage is in favor, it will give the Attorneys General the power to fund improvements in:

  • Prescription Drug Monitoring Programs
  • Addiction Treatment
  • Prevention
  • Education

CARA was sponsored by Sheldon Whitehouse of Rhode Island, a Democrat, and Rob Portman of Ohio, a Republican, according to the article. A bill which would put at least $80 million towards treatment, prevention and recovery. While the bill’s support is definitely a step in the right direction, the bill would not actually fully fund $725 million needed to accomplish everything that its sponsors intended. Unfortunately, an effort to add $600 million in emergency funding to the bill was blocked last week.

One of the states affected the most by the opioid crisis is New Hampshire. While a small state, they are losing lives every day to overdoses. The effort to garner the additional funding was led by Senator Jeanne Shaheen, D-N.H.

“There is simply no excuse for Congress providing emergency funding for the Ebola and swine flu epidemics, while ignoring an opioid crisis that’s killing a person a day in the Granite State,” said Shaheen.

If you are struggling with opioid addiction, please contact Harmony Foundation. We can help you build the foundation for sustained addiction recovery.

New FDA Commissioner Supports Abuse-Deterrent Opioids

Posted on by Christy Weeks
abuse-deterrent-opioids

It does not matter how someone uses prescription opioids, they can be dangerous and potentially lead to a deadly overdose. However, it could easily be argued that the greatest risk is associated with intravenous (IV) use; opioid addicts will crush their pills, mix the powder with water and inject. In order to combat the use of opioid narcotics in unintended ways, pressure was put on pharmaceutical companies to develop formulations of their painkillers that are harder to abuse – known as abuse-deterrent opioids.

Critics of such efforts argue that harder-to-abuse painkillers are merely a band-aid, and have little effect on the opioid epidemic. While the new formulations are more difficult to use, addicts often find their way around tamper resistors and/or turn heroin as a cheaper, stronger alternative. Nevertheless, such arguments can easily be countered with ‘anything is better than nothing.’

The U.S. Food and Drug Administration (FDA) has a new commissioner who has vowed to support abuse-deterrent opioid efforts, the Associated Press reports. Dr. Robert Califf told a panel of FDA advisers that he is pledging to do “everything possible under our authority to prevent abuse, save lives and treat dependence.”

The new commissioner’s declaration is just one facet of an interagency effort to end the American opioid epidemic. However, Califf made clear that the FDA alone cannot resolve the current crisis, according to the article. Since 2010, Califf’s agency has approved five abuse-deterrent opioids, and there is reportedly another 20 such drugs in development. FDA Commissioner Califf plans to work with outside advisers and he has a comprehensive plan for addressing the prescription opioid scourge, which claims as many as 44 lives per day.

He stated that the agency will add more cautionary warning labels to the opioid narcotics prescribed the most, the article reports. What’s more, the FDA will encourage the safe disposal of unused medications, which will prevent narcotics from ending up in the wrong hands.

“What we can do is work with prescribers, professional associations, patient advocates and state and local partners — essentially the entire country — to encourage safe use and disposal of opioid medications,” said Califf. 

If you or a loved one struggles with prescription opioid and/or heroin addiction, please contact Harmony Foundation. We have been helping people break the cycle of addiction for decades, teaching people about the resources needed for a living a life on the road of recovery.

Young Adult Non-Medical Adderall Use

Posted on by Christy Weeks
Adderall

Amphetamine salts, such as Ritalin ® or Adderall ®, are prescribed by physicians to treat attention deficit hyperactivity disorder (ADHD). While prescription stimulants can be an effective ADHD treatment, the drugs are commonly diverted and used by people who want an edge for studying. Others will use the drugs to get high or for extra energy for partying longer. Stimulants are highly addictive, and abuse can lead to a number of serious health problems. What’s worse, the majority of stimulant users are unaware of the risk amphetamines pose.

The non-medical use of drugs like Adderall is especially common among young adults, typically those enrolled college. Small doses of amphetamines can increase people’s focus, helping them study for prolonged periods of time. In heavy amounts, the drugs can lead to life threatening side effects, including nausea, vomiting and seizures. In fact, new research shows that while prescriptions for stimulants have remained fairly level in recent years, non-medical use of Adderall by young adults has risen by 67 percent and associated emergency room visits rose by 156 percent, UPI reports. The study was conducted by researchers at Johns Hopkins University and was published in the Journal of Clinical Psychiatry.

Unfortunately, many young adults do not view the use of stimulants as being dangerous. What’s more, amphetamine narcotics are most commonly acquired from one’s friends and family. The researchers point out that misconceptions about the use of Adderall can be deadly, resulting in high blood pressure and even a stroke.

“[The study] suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion — people taking medication that is legitimately prescribed to someone else,” said former Johns Hopkins student Dr. Lian-Yu Chen, now a researcher at National Taiwan University Hospital. “Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.”

If you are struggling with non-medical amphetamine use, it is vital you seek help immediately, please contact Harmony Foundation. Breaking the cycle of addiction is a difficult process. We offer the most effective treatment environment for young adults, we can help you begin the healing process and the journey into recovery.

Poll: Heroin Addiction Is A Serious Problem

Posted on by Christy Weeks

One of the major concerns being voiced by voters is the prescription opioid epidemic, and the scourge that followed in its wake now being referred to as having reached epidemic proportions. With each day that passes with the nation continuing to struggle with how to curb the opioid crisis in America, more people are being affected – even if they themselves are not the ones addicted to opioid narcotics. In fact, a new poll shows that more than one-third of respondents know someone who has struggled with prescription opioid or heroin addiction, The Huffington Post reports. The findings come from an online poll conducted between January 20-22, and involved 1,000 completed interviews.

The new HuffPost/YouGov poll showed that nearly half of respondents (49 percent) view heroin use as a serious national problem, and 87 percent say that the heroin problem is at least a somewhat serious problem. Interestingly, when respondents were asked who should be held responsible for the heroin problem in America, almost the majority said an equal share of fault falls on:

  • Drug Users
  • Drug Dealers
  • Government
  • Law Enforcement

Who is to be held to account for the problem is somewhat irrelevant, what is important is how we, as a nation, plan to address the crisis. Greater access to addiction treatment services needs to be made available; many addicts who are in need of help often need to wait long periods of time to receive the help they so desperately require. What’s more, making clean needles and the life saving drug naloxone more readily available will not only stop the spread of infectious disease – it will save thousands of lives.

Fortunately, the President will ask congress for $1.1 billion dollars next week to fund addiction treatment services across the country, USA Today reports. Funding such programs is a clear sign that America no longer agrees with the idea that addiction can be swept under the rug through arrests, and subsequent jailing. Treatment is our best fight against addiction.

If you or a loved a one is suffering from opioid addiction, please contact Harmony Foundation. Harmony is one of the longest running, most successful, treatment programs in the world, our experienced addiction treatment team can help you begin the journey of recovery.

The Brain Disease Model of Addiction

Posted on by Christy Weeks
addiction

Our understanding of addiction has come a long way in a relatively short period of time; how the disease is viewed and treated are perfect examples of the progress we have made. Not too long ago, society’s answer to addiction was to dismiss those who used drugs and alcohol to the point of despair as having a shortage of willpower and perpetually hedonistic. The government’s response was to arrest and jail people who sold or abused mind altering substances, essentially branding millions of Americans as social pariahs for something that they were unable to control.

After decades of draconian drug policies, U.S. jails and prison populations exponentially grew, costing taxpayers billions of dollars each year. What’s more, when offenders with substance use disorders were released, more often than not they would be re-incarcerated for similar offenses.

Advances in medicine and our understanding of the brain has given scientists the ability to see that addiction is not a voluntary lack of self-determination and personal responsibility, but rather a disease of the brain; and, like any disease, for one to recover they require intensive treatment. Today, in most states people with substance use disorders are given the option of treatment in lieu of jail, and for those who are willing to do the work – recovery is possible.

Treating addiction as a mental illness is still a hard pill for many people to swallow, the reasons for this vary. One reason for this is that neurobiology is difficult to understand, another may be that the idea that using drugs and alcohol is a voluntary decision. The list goes on, but treating addiction as a mental illness has allowed experts to develop more effective treatments and sound prevention methods.

A review of available research conducted by the director of the National Institute on Drug Abuse (NIDA), Nora Volkow and colleagues, about addiction as a brain disease was published in the New England Journal of Medicine (NEJM). The goal was to enlighten those who question the brain disease model of addiction. The review of research produced a clear outline supporting the model, and we encourage you to read it in full. Dan L. Longo, M.D. writes:

“Advances in neurobiology have begun to clarify the mechanisms underlying the profound disruptions in decision-making ability and emotional balance displayed by persons with drug addiction. These advances also provide insight into the ways in which fundamental biologic processes, when disrupted, can alter voluntary behavioral control, not just in drug addiction but also in other, related disorders of self-regulation, such as obesity and pathologic gambling and video-gaming — the so-called behavioral addictions.”