The Recovery of Craig K.

“First responders are usually the first on the scene to face challenging, dangerous, and draining situations,” explains a Supplemental Research Bulletin by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “They are also the first to reach out to disaster survivors and provide emotional and physical support to them. These duties, although essential to the entire community, are strenuous to first responders and with time put them at an increased risk of trauma.”
According to the SAMHSA Bulletin, “It is estimated that 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and posttraumatic stress disorder (PTSD), as compared with 20 percent in the general population (Abbot et al., 2015). In a study about suicidality, firefighters were reported to have higher attempt and ideation rates than the general population (Stanley et al., 2016). In law enforcement, the estimates suggest between 125 and 300 police officers commit suicide every year (Badge of Life, 2016).”
Experiencing severe trauma is strongly correlated with substance use disorder (SUD). In a study investigating alcohol use in police officers following Hurricane Katrina, there was a significant association between involvement in the hurricane relief efforts and hazardous alcohol drinking (Heavey et al., 2015). In another study, the average number of alcoholic drinks after Hurricane Katrina increased from 2 to 7 drinks per day (McCanlies et al., 2014).
Many traumatized first responders attempt to alleviate their mental health symptoms with drugs and alcohol. Former police officer Craig K. was one of them. As a young man, the Harmony alumnus entered a work environment where you “push horrible calls to the back of the head,” downplay the horror, and move on. The traditional macho culture prevalent among first responders taught him how to “party like a cop” to release the stress.
When traumatic episodes start to show an impact you still don’t think you have a problem: “They tell you about the stress but they don’t build in a mechanism to deal with it.” One time, Craig was called to the scene of a helicopter crash. The smell of the jet fumes connected with the carnage he was forced to witness is etched into his memory. Craig refers to these traumatic events in his career as demons.
One of his main demons is the Columbine high school shooting. “To this day I can’t hear fire alarms,” he says. “I freak out when I hear fire alarms.” More than twenty years later, Craig is still angry with the teenage perpetrators.
In the aftermath of Columbine, his drinking “took another level” and he could not stop watching the news about the shooting on TV. Like many of his colleagues he was traumatized and felt the police were unjustly blamed for not doing enough to stop the massacre. Craig took it personally.
Family hardships followed: his son was born without an immune system and “everything was thrown out of kilter,” including his marriage. All the while his alcohol use disorder (AUD) became steadily worse. “We started going to therapy” but talking about the health problems of my son was just “an easy way to avoid talking about my problems,” Craig remembers. The inevitable negative consequences started to pile up, he left the police force and got a divorce.
The AUD kept destroying his life, “everything after 2011 is really cloudy.” At the end of last year, Craig finally realized that something was wrong. On New Year’s Eve, he was hospitalized for four days. “I still didn’t realize why I was shaking so much.” After his discharge, he started drinking again and by February he was back in the hospital. On that occasion, “the ER doctor tells me ‘if you keep this up, you’re going to die in three months.’”
By this time, however, Craig was firmly in the grip of active addiction, so he kept on drinking. After getting fired from his job, he saw his pastor who told him about Harmony Foundation. Craig was finally ready to change.
Traumatic life experiences are extremely common among patients with substance use disorder. Because of this strong correlation, trauma-informed care is an important part of addiction treatment at Harmony. All staff have been trained in trauma-informed care. When SUD patients arrive for treatment, they often have few coping skills to deal with their traumatic memories and emotional pain. They have to learn to manage emotions and situations without drugs and alcohol.
Craig finally realized that “ego was not his amigo.” Your ego “makes you cocky and doesn’t allow you to see your real self,” he says. “I rode the ego train 24/7.”
Things are much better now for Craig. “I don’t want to be that person anymore. I’m really excited that I am getting clear and more focused. I’m starting to understand things that I read in the Big Book, that we talk about in meetings, that I’m witnessing.”
At Harmony, he began to learn how to process his trauma, acquiring important coping skills. After his discharge, he connected with a sponsor within a week and—thanks to Zoom—was able to attend several meetings a day. The Daily Reflections and two other AA books go with him everywhere he goes.
“I have to work at this every day. It’s like a diet or going to the gym – you have to put in the work.” If you don’t work on your recovery every single day, you’re cheating yourself.
Recovery is always possible. If you or a loved one is struggling with substance use disorder, or you have questions about our programs, call Harmony today at (970) 432-8075 to get the help needed as soon as possible.

How Harmony Survived the 2020 East Troublesome Fire

2020 has been a tough year for many addiction treatment providers. The COVID-19 pandemic hit the United States in the spring and has made recovery work difficult ever since—for people with addiction and their therapists. “Getting sober during COVID-19 definitely has its challenges,” says Harmony alumna Shayla E. The Harmony Foundation had to implement a number of precautionary measures to ensure staff and client safety.

In October, Harmony suddenly faced another dangerous challenge: the East Troublesome wildfire. As with COVID, the entire Harmony community rose to the challenge.

“Before October 21, the East Troublesome fire had mostly been a nuisance,” reported The Colorado Sun, “burning through dense trees and steadily gobbling up terrain.” Then it suddenly turned into a massive firestorm and on October 22, it began to threaten the Harmony campus.

The leadership team immediately came together for an emergency meeting. “There were also other fires in the area,” remembers Harmony CEO Jim Geckler. “We had carefully monitored the Cameron Peak fire earlier that week, which was unsettling enough. Then the East Troublesome fire jumped the mountain and started to burn on our side on Thursday morning (Oct 22).”

It was time to make a decision. When fire officials issued a voluntary evacuation advisory, Harmony decided to play it safe and evacuate. After the leadership meeting made the call to leave and not wait for a mandatory evacuation order, Geckler explained the situation to the clients and let them know what to bring along.

“We had solid communication between all parties involved and because we had done a lot of preparation and training in the past, we were ready to go within 45 minutes. We packed up the medical center, had a great procedure in place for moving the belongings of clients and how to move medications safely. By 12:30 we were lined up caravan-style and ready to go.”

Everything went seamlessly because everybody communicated and everybody knew what they were supposed to do. “Strong communication between the leadership team, the staff, and the clients, as well as the ability of people to make the necessary decisions, allowed us to move forward quickly,” says Geckler.

The destination was a hotel in Greeley, Colorado. With the support of staff at the DoubleTree by Hilton Greeley at Lincoln Park, Harmony was able to successfully relocate all clients and continue to provide them with quality treatment in a safe, welcoming environment.

When Harmony’s chief marketing officer Gina de Peralta Thorne called ahead from the road, the only questions were ‘what do you need?’ and ‘when do you need it?’ “I told them we needed 28 rooms and conference space and that we were 20 minutes out,” remembers Thorne. “They were just remarkable at giving us what we needed to keep clients safe in their recovery. We even used the situation in therapy, discussing how the environment in the hotel was very different from the Harmony campus and how that worked for them.”

The medical team had to quickly build a makeshift detox facility in one of the rooms with an ironing board as a reception desk.

“We managed in an emergency setting,” says Jim Geckler. “I’m proud to say we had uninterrupted client care, every single decision throughout the evacuation was made around client care. It was inspiring to see how people rose to the occasion.”

“Our client-focused culture is collaborative. Over the past seven years or so, we worked diligently to integrate better with other care providers in Colorado,” says Geckler. “We make sure we’re there when they need us and there wasn’t a moment when we didn’t feel supported by others. I received lots of text messages inquiring whether we’re okay, some of them just saying let me know what you need—that made it manageable for us. We had deliveries every day of treats, bottled water, and games. People kept asking how can we be of assistance?”

Once in place in the hotel, the focus was on keeping clients safe. “Usually our patients are in a safe, relatively controlled environment but near the hotel, we had locations where people do drug deals and some clients told us the park was a trigger for them,” remembers Gina Thorne.

Even though the hotel was safe from the wildfire, the Harmony team now had to contend with other dangers. “There was a bar in the hotel, for example, and we had to make sure clients would not be able to order alcohol from their rooms,” explains Thorne. “But the hotel staff learned quickly to work with our unique population. There was never any negative reaction to our clients, the staff was gracious and courteous, they really bent over backward to make sure we got what we needed.”

Again, the open environment was used for therapeutic effect. “We talked about it all the time,” says Geckler. “We made the experience a celebration and congratulated clients on a regular basis. We talked with them and made sure they understood the exceptional circumstances.”

Geckler is convinced that this group of clients will have an exceptional recovery because they are connected in ways other people are not. “It was a bonding experience, and the clients have really embraced it.”

Harmony stayed in Greeley for a whole week, finally returning to Estes Park on October 29. “We now have faced two unbelievable situations this year and we never considered shutting Harmony down,” says Geckler. “Our role is to be of service to our clients who are looking for help—we couldn’t just abandon them. We were able to keep stability for our clients and we were able to celebrate their achievements under difficult circumstances. Everybody stepped up and simply asked what they can do to help. In years to come, I will look back with pride on what we accomplished during this fire emergency.”

COVID Pandemic Drives Rise in Drug Overdose Deaths in Colorado

Drug overdose deaths in Colorado have been on the rise since March, coinciding with the full onset of the coronavirus pandemic, reported The Gazette in September. “By May, according to state health department data, the number of drug overdose deaths reached nearly twice the average from recent years. In May, 128 people died of overdoses in Colorado, compared to 73 in 2019, 79 in 2018, and 64 in 2017.”
Denver is on pace for a record number of fatal drug overdoses, reported Denverrite on Oct 1. “It took nine months in 2020 for Denver to match the number of fatal drug overdoses from all of last year.” Data show that the majority of drug deaths in the Colorado capital involve multiple substances, “with 60 percent of deaths involving three or more drugs and 19 percent involving five or more. The increase in deaths locally has been fueled by fentanyl, a powerful synthetic opioid that can be up to 50 times stronger than heroin.”
Alcohol consumption has also increased significantly across the country. USA Todayreported in October about a new study showing that “American adults, particularly women, are drinking more amid the COVID-19 pandemic.” Alcohol consumption has increased by 14 percent compared with a year ago, including 17 percent for women, according to a report published in the JAMA Network Open. The study also showed a 41 percent increase in heavy drinking for women—defined as four or more drinks for women within a couple of hours and five or more for men.
Mental health and addiction professionals are not surprised to see more cases of substance use disorder (SUD) and more overdose deaths as the pandemic continues. “There are certain things that we know that happen with a stressful event like a pandemic or 9/11 or if the stock market crashes,” the president of the Mental Health Center of Denver, Dr. Carl Clark told The Gazette. “Anxiety goes up, depression goes up, suicides go up, and people’s use of substances goes up.”
Alcohol and drug misuse are strongly correlated with mood disorders like anxiety and depression. Substance use disorders are frequently the result of people under significant stress trying to self-medicate intense stress or mental health issues.
And just when SUD and mental health patients need help the most, outreach programs and treatment providers struggle to help with in-person care limited to reduce the spread of COVID-19 while states—including Colorado—struggle to find the funding for urgently needed support. “In Colorado, substance use treatment and prevention services, behavioral and mental health services saw a $20 million cut in funding as the state tax revenue plunged,” reported The Denver Post.
Harmony Foundation is a dual-diagnosis-capable facility serving clients with SUD and co-occurring mental health disorders. Clients who are diagnosed with mental health issues—such as anxiety, depression, and other trauma-related responses—will meet with our mental health and medical staff to address medication management. We work with our clients to teach them healthy coping skills to help them manage their co-occurring issues.
Despite difficult circumstances, Harmony continues to serve clients during the COVID-19 outbreak and is taking extra precautions to ensure staff and client safety. If you or a loved one are struggling with alcohol or drug addiction do not delay seeking treatment. If you have questions about our programs, call us at 970.432.8075 to get the help needed as soon as possible

Recovery is Always Possible—Even During a Pandemic

Harmony alumna Shayla E. was discharged after her successful treatment in March. It was a very challenging moment in her life. Recovery from addiction is hard enough in normal times, but Shayla had to stay the course in the middle of an escalating pandemic.
“Getting sober during COVID-19 definitely has its challenges,” she says. During her residential treatment at Harmony, Shayla was sheltered from the constant stream of news about the pandemic but then she found herself in a situation where “everybody was terrified of each other.”
“It was nerve-racking, in-person meetings were not necessarily taking place,” she remembers. “I was nervous about attending my IOP (intensive outpatient program) without actually meeting other people or seeing my therapist in person.”
Intensive outpatient treatment is certainly a different experience on Zoom, but Shayla was able to form great relationships with members of her group and with her therapist.
Following treatment, Shayla chose a sober-living arrangement—the “best decision I could have made, especially during COVID,” she says. Shayla had previously relapsed because she isolated herself too much after treatment but she learned from that experience. This time, she was not going it alone.
“I did not have the opportunity to isolate in that home. I was always around a bunch of girls, and we were all stuck together, always finding creative ways to pass the time.” She had clear goals and requirements—such as how many meetings to attend—and it really helped her to stay sober and accountable.
This time her recovery was all about community and building strong relationships to support her. She looked for AA meetings online and attended daily or weekly. She focused on being open and honest, talking with people—she even got her sponsor via Zoom.
The coronavirus precautions are challenging, she says, especially if you’re introverted, but it’s doable. “Just put yourself out there. Say ‘I’m new, I’m a bit afraid, this is where I’m at, and I need help.’ People will definitely reach out. I was surprised to see how many people wanted to sponsor. The amount of support is really remarkable.”
“Good communication so important,” says Shayla. “I was able to help a lot of people as well.” She came well prepared with recovery tools she acquired at Harmony.  “I definitely rely a lot on my grounding tools, my breathing exercises. I make sure I have a solid morning routine—getting up on time, making my bed, meditation, prayer, and yoga, if I have enough time. Getting involved in AA meetings definitely has been important to me, that’s how I keep building my community.”
She stays in touch with the Harmony community and journals a lot. “It’s all about staying open-minded, and not being judgmental—everybody’s different.” At the same time, don’t be too serious, have some fun, and be yourself.
Shayla has a message for addicted people who think they can’t do it, who believe that recovery is too hard for them. “I know it’s a horrible pandemic but it gave me the time, and the opportunity to slow down, to actually focus on myself and work a program. It’s definitely worth considering going into treatment at Harmony Foundation—that place saved me, I don’t think I could have done it without their support.”
Harmony continues to serve people suffering from a substance use disorder during the pandemic and has implemented a number of precautionary measures to ensure staff and client safety. Delaying addiction treatment can be even more dangerous than COVID-19.
Shayla knows recovery is not easy. “Getting sober is hard but if you know in your heart that you want recovery and you feel now is the time, do it! Reach out to anyone you know, strangers, Harmony alumni, we are here for you,” she says.
“It’s possible, it’s doable, and it’s a lot better on the other side.”

September is National Recovery Month

Each year, Recovery Month celebrates the achievements of people in recovery from addiction. It’s an opportunity to promote new evidence-based treatment and recovery practices, the emergence of a strong and proud recovery community, and the dedication of service providers and community members across the nation who make recovery in all its forms possible.
Recovery Month is also an important reminder that the addiction crisis is far from over. Tens of thousands of people die from the disease of addiction each year. Drug overdose deaths increased again in 2019 in the United States, according to new preliminary data released by the Centers for Disease Control and Prevention in July. The CDC predicts that the final count for 2019 will be close to a record 72,000 overdose deaths, while 2020 is widely expected to exceed even that number because of the impact of the COVID-19 (coronavirus) pandemic.
The theme for this year’s Recovery Month is “Join the Voices for Recovery: Celebrating Connections.” Addiction is frequently driven by intense stress, trauma, extended periods of anxiety, prolonged grief, depression, and isolation.
Connections are crucial for a sustained recovery and COVID-19 has seriously disrupted traditional ways of connecting in recovery. With physical distancing measures and other restrictions in place across the US, meetings and counseling sessions for those who struggle with addiction had to be moved online in many cases. But that situation has also presented new opportunities.
“With the help of modern technology, we have the chance to be more connected than ever before,” says Michael Arnold is the director of alumni and recovery support services at Harmony Foundation. “The time COVID-19 is giving us at home is actually the greatest gift that our recovery can receive. If you are concerned about being isolated at home, pick up the phone, tablet, or use your computer to reach out to someone.”
Michael also found another engaging way to help people in recovery snap out of any dark moods they may be experiencing. In May, she started a podcast called “Monday State of Mind” to give the recovery community a positive start into the workweek. “I know the good that happens when I choose to be consciously aware of my state of mind,” she says. An alumna of Harmony herself, Michael continues to use the tools that were given to her while she was there as a patient.
The federal government’s Substance Abuse and Mental Health Services Administration (SAMHSA) is also utilizing the internet, offering a number of webinars during Recovery Month that cover medication-assisted treatment, employment support, communities supporting recovery, and the importance of integrating recovery support services.
Millions of lives in America have been transformed through recovery. Unfortunately, these successes in the battle against addiction frequently go unnoticed. Recovery Month gives everybody a chance to celebrate these accomplishments.
Harmony Foundation continues to serve clients during the COVID-19 outbreak and is taking new precautions to ensure staff and client safety. These include strict hand-washing protocols, heightened and ongoing disinfection of all areas at facilities, as well as updated admission assessments to consider previous travel, potential exposure, and health status. All new admissions will have additional medical screening upon campus arrival.

Harmony’s Annual Scholarship Event Virtual This Year

Harmony’s annual sponsorship gala will have to be different in 2020. This year’s event on September 18 had to move online because of the ongoing COVID-19 pandemic. But just like in years before, Harmony’s first virtual fundraiser “Step By Step” will aim to change the lives of those who need a little extra support for their recovery.
The one-hour event will include a silent auction and alumni testimonials. Proceeds from the event will financially help those with the desire, but without the means, to receive the addiction treatment they need. Harmony alumnus Josiah B. was a previous recipient of financial assistance. He did everything he could to change his life and go into recovery but he just didn’t have the right insurance.
When his case manager had to tell Josiah that his insurance would only cover one week of treatment unless he needed “life-supporting care,” he struggled to just take in that information, “feeling really hopeless and very triggered.”
Josiah thought he had to leave treatment and go home. “I felt hopeless and wanted to give up at that point,” he remembers. Harmony’s financial assistance program changed all that. “Being able to get those last three weeks was so crucial to my recovery. Having that foundation is so crucial. Every day counts.”
Being able to finish his treatment at Harmony because of the financial help, and getting the building blocks for the foundation of his recovery made all the difference for Josiah.
He was excited when he learned about the funding, but he also thought “this is why you’re here, Josiah, why you’re reconnecting with your Higher Power. Why you need to be here, to be able to trust that the process works, and put your faith in that.”
“I had a lot of peace the day before I finally decided to apply for the scholarship,” Josiah remembers. “It’s okay,” he told himself. “You’re in good hands. There are people supporting you that you don’t even know. The people at Harmony are supporting you; your Higher Power is supporting you. Everything kinda fell into place.”
Should you consider donating Josiah would say, “please do because there are so many people who are in the position that I was in and even worse. Donations will get people the help they need to finish their time in treatment. That’s huge. Every day I was at Harmony was monumental and I wouldn’t trade a single day for anything else.”
If you would like to help out and be a sponsor at our Step-by-Step fundraiser, contact Judy Keller at Harmony, please. : jkeller@harmonyfoundationinc.com

States Trim Mental Health Programs Amid Global Health Crisis

It’s been a tough few months for many Americans. A once in a century pandemic has so far killed more than 140,000 people in the United States, causing untold grief and distress while sending the economy into a tailspin.
As if painful isolation from friends and family and anxiety over catching a deadly virus wasn’t bad enough, May and June saw the addition of social unrest and protests over widespread racism. This kind of prolonged, relentless stress cannot remain without consequences.
Mental health and addiction professionals across the United States are now warning that the need for behavioral health services is growing. But while the need for services is growing, many states are faced with budgetary shortfalls. “Colorado is cutting spending on a number of mental health and substance use treatment programs,” Markian Hawryluk reported for Kaiser Health News and The Denver Post in July.
“In Colorado, lawmakers had to fill a $3.3 billion hole in the budget for fiscal year 2020, which started July 1. That included cuts to a handful of mental health programs, with small overall savings but potentially significant impact on those who relied on them.”
Tragically, state legislatures have been forced to consider healthcare cuts and delay new health programs even in the midst of a healthcare crisis. But many lawmakers and health experts are concerned the cuts needed now to balance budgets could make the situation far worse down the line.
“Healthcare cuts tend to be on the table, and of course, it’s counterproductive,” Edwin Park, a health policy professor at Georgetown University told Colorado Public Radio. “When there’s a recession, people lose their jobs and health insurance the very moment when people need those health programs the most.” Some of those cuts were offset by $15.2 million in federal CARES Act funding allocated to behavioral healthcare programs. Some programs, however, were completely defunded.
Doyle Forrestal, CEO of the Colorado Behavioral Healthcare Council, worries that resources won’t be there for an emerging wave of mental health and substance use disorders unleashed by the pandemic. “People who are isolated at home are drinking a lot more, maybe having other problems — isolation, economic despair,” she told Kaiser Health News. “There’s going to be a whole new influx once all of this takes hold.”
Isolation and despair are indeed widely acknowledged drivers of addiction and mood disorders. At the same time, physical distancing measures implemented to contain the COVID-19 outbreak have made it more difficult to provide treatment. A lot of therapeutic face-to-face engagement cannot simply be replaced with an online platform. Harmony continues to serve people suffering from a substance use disorder and has implemented a number of precautionary measures to ensure staff and client safety. Delaying addiction treatment—even during a pandemic—is not a good idea.
Harmony has provided cutting-edge treatment at its Estes Park center in Colorado for half a century. Our 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 trauma, depression, and anxiety—all currently intensified by the pandemic.
If co-occurring conditions aren’t addressed, clients are more likely to relapse because they may be tempted to use substances to self-medicate those issues. All staff at Harmony have been trained in trauma-informed care. Modern addiction treatment requires a comprehensive, holistic approach that addresses all mental health issues relevant to the substance misuse and provides a solid foundation for sustained recovery from addiction.

Colorado’s Meth Problem

“Drug bust nets $762,000 in meth, heroin and more near Colorado Springs,” reported The Gazette in April. Unfortunately, it was not an unusual headline for the region.

In February, KMGH in Denver reported on the indictments of 30 people, “accused of being members of a Denver-based drug trafficking group with suspected ties to a Mexican cartel. According to the report, “federal agents seized a slew of drugs in the case, including about 400 pounds of methamphetamine and 15,000 fentanyl pills—a powerful synthetic opioid—that were disguised as prescription oxycodone, according to the U.S. Attorney’s Office in Denver.”

Like several other states in the western United States, Colorado has an escalating meth problem. “The methamphetamine problem has come back with a vengeance,” Jason Dunn, Colorado’s US Attorney told Colorado Public Radio (CPR) last year. “Meth hasn’t grabbed headlines like opioids have, but it has flooded cities throughout the Southwest over the last five years. Law enforcement now says the region is in the midst of a meth crisis.”

The Bureau of Justice Assistance (BJA), a subdivision of the US Department of Justice, issued a 40-page report in December 2019 on the resurgence of methamphetamine which stated that “law enforcement and public health resources around the country, including forensic laboratories, have reported marked increases in the use, abuse, and availability of methamphetamine.” The report suggested that “the resurgence of methamphetamine may also suggest a trending away from opioid abuse.”

The resurgence of methamphetamine in recent years can indeed be seen as a consequence of the intense efforts by law enforcement and public health officials to contain the opioid epidemic, primarily by restricting access to opioid pain relievers. It is not uncommon, however, for people in active addiction deprived of access to certain substances to simply switch to a different one if the underlying reasons for the substance use disorder are not addressed in the form of comprehensive addiction treatment.

Despite the return of methamphetamine misuse, drug-overdose deaths were actually slightly down across the nation for the first time in 20 years, according to a new analysis by the Rockefeller Institute of Government. But then the COVID-19 pandemic struck and since the implementation of coronavirus-related stay-at-home orders, county health offices are reporting more overdose deaths and more calls for opioid-overdose antidotes. Stress and isolation are powerful drivers of addictive behaviors.

In Colorado, the meth resurgence has had another troubling effect. According to CPR, “Colorado law enforcement authorities shot someone, on average, once a week for the past six years,” giving Colorado the 5th highest rate for fatal law enforcement shootings in the United States. “Most of those shot were white, male, high on drugs—often methamphetamine—or alcohol and carrying a weapon.” Methamphetamine is a powerful stimulant that can make users feel invincible and paranoid at the same time—a dangerous combination.

It is misguided to think of the ongoing addiction crisis in America primarily as an “opioid” epidemic simply caused by irresponsible over-prescription of opioid pain relievers. Keeping the focus on one substance and treating it as the root of the problem is unlikely to end this crisis. The next substance is always on the horizon.

The complex disease of addiction requires comprehensive treatment and a life-changing commitment to recovery. Depriving people in active addiction of access to one addictive substance with a concerted law-enforcement effort has failed repeatedly in the past. In the case of the meth resurgence, most of the media coverage is focused on drug seizures and interdiction measures at this point. Rarely do you come across articles or blog posts that describe people addicted to methamphetamine as having an illness that deserves treatment and compassion. If we want to create effective change at both the human and community level then we must change the way we approach how we look at the disease.

Dangerous New Synthetic Opioid Found in Counterfeit Painkillers

A new, dangerous designer drug has reached the United States—in the middle of a deadly viral pandemic. Isotonitazene is a synthetic opioid so novel that it has not even been banned by the authorities yet.

Barry Logan is a leading authority on forensic toxicology and chief scientist at forensic firm NMS labs. He told Vice in March that his colleagues have identified isotonitazene in samples from more than 200 deceased drug users in the midwest and northeast since August last year. “Isotonitazene is the most persistent and prevalent new opioid in the US,” said Logan.

According to USA Today, isotonitazene has been detected in the blood of people who died of overdoses in Illinois and Indiana, where it was mixed with cocaine. It was also reportedly found in Canada last year.

The new drug—deemed as potent as fentanyl—comes in a white or off-white powder form or is pressed into counterfeit opioid pills. Designer drugs always tend to be one step ahead of the law and this new synthetic is no exception. It is currently not on the US Drug Enforcement Agency’s controlled substances list simply because there hasn’t been enough time to classify it.

Bryce Pardo, an associate policy researcher at the Rand Corporation, told Vice that drug laws simply cannot cope with the seemingly endless drugs being produced by underground chemists in China. “Our drug control laws are old, and the ease of chemical innovation, cheap shipping, and the ubiquity of the internet have all stretched the applicability of these laws.”

Isotonitazene seems to have arrived in the United States following an aggressive global crackdown on illicitly made fentanyl. It represents a typical pattern in the seemingly endless “War on Drugs”: When governments focus their supply interdiction efforts on one substance, the market will start delivering alternatives.

The resurgence of methamphetamine in recent years is a good example of that pattern. While opioid misuse may have peaked nationwide, people with addiction have been switching to other substances. “Nationally, since late last year, meth has turned up in more deaths than opioid painkillers like oxycodone and hydrocodone. In 14 of the 35 states that report overdose deaths to the federal government on a monthly basis, meth is also involved in more deaths than fentanyl, by far the most potent opioid,” The New York Times reported last year. “Provisional data from the CDC shows there were about 13,000 deaths involving meth nationwide in 2018, more than twice as many as in 2015.” Now, we’re witnessing the emergence of a new synthetic opioid as well.

A focus on disrupting the supply of addictive drugs has never worked because it doesn’t address the reason for the demand. The actual misuse of drugs and alcohol is only one aspect of a substance use disorder and not necessarily the most important one. That is why Prohibition, the “War on Drugs,” and the “Just Say No” campaign all failed to achieve their objective.

Addictions are frequently driven by underlying mental health issues such as anxiety, depression, and trauma. If these issues are not addressed within a comprehensive treatment approach, sustained recovery is unlikely to happen.

Addiction cannot be reduced to substance use, it is not simply chemically caused by the presence of drugs and alcohol in the human body. Addiction is a complex biopsychosocial and spiritual disorder with many interlocking conditions and mechanisms. “By itself, nothing is addictive,” wrote Maia Szalavitz provocatively in her influential 2016 book Unbroken Brain. “Drugs can only be addictive in the context of set, setting, dose, dosing pattern, and numerous other personal, biological, and cultural variables. Addiction isn’t just taking drugs. It is a pattern of learned behavior.”

Addiction affects the body, mind, and spirit. It is a disease requiring comprehensive treatment in an integrated care environment. Recovery from addiction is also a personal quest for meaning and connection with other people, our human nature, and the entire universe.

How Addiction Affects Body, Mind, and Spirit

By Michael Rass

Addiction cannot simply be reduced to substance use, chemically caused by drugs and alcohol in the human body. Addiction is a complex biopsychosocial and spiritual disorder with many interlocking conditions and mechanisms. Many addiction professionals view it as a disease of the mind, body, and spirit.

A Disease of the Body:

Most psychoactive substances are regarded as toxins by the human body and its defense system. A healthy liver will try to purge any amount of alcohol as soon as possible, for example. Different substances have different effects on the body. Alcohol destroys brain cells and depresses the central nervous system, while cocaine is a stimulant, raising blood pressure and heart rate. Both substances, like others, trigger the release of certain chemical messengers in the brain, known as neurotransmitters. The main ones are dopamine, which elicits pleasure, norepinephrine causing arousal and focus, and serotonin, which causes feelings of happiness, counteracting negative emotions.

The repeated, artificially elevated release of these neurotransmitters will eventually cause changes in the brain of the addicted individual, providing the increasingly rigid neurological structure for the psychological aspects of addiction. In addition to slowly changing the mind of the addicted person, substances like alcohol, crystal meth, cocaine, and others will have a pathological impact on the physical body, damaging major organs, the cardiovascular system, the skin, and teeth as well as causing dangerous infections, malnutrition, and chronic pain conditions. Most people suffering from a severe substance use disorder (SUD) have been neglecting their physical fitness for a long time, having completely given up on anything resembling a healthy lifestyle.

A Disease of the Mind:

For psychiatrists, addiction is primarily a disease of the mind. The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)—the diagnostic manual widely used by psychiatrists in the United States—states that “all drugs that are taken in excess have in common direct activation of the brain reward system, which is involved in the reinforcement of behaviors and the production of memories.” These psychoactive substances “produce such an intense activation of the reward system that normal activities may be neglected.”

Eventually, this “intense activation” may trap the user in an addiction cycle of craving, using, and withdrawal, leading to renewed craving. In the psychiatric jargon of the DSM-5, “the essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems.” In other words, compulsive substance use, despite negative consequences. The user is now caught in a cycle of drug or alcohol use that requires ever-increasing amounts of the substance just to feel “normal.”

The question is, how did the addicted person get there? Why the “intense activation” in the first place? And then again and again? This is where other mental health issues typically play a crucial role. Most addiction professionals now believe that substance abuse is not simply caused by irresponsible pleasure-seeking but should, in most cases, been seen as an attempt to self-medicate serious mental health conditions like posttraumatic stress disorder, major depression, or anxiety. And those are often connected to highly traumatic life events the individual is unable to handle in a healthy way. The “intense activation” is supposed to numb intense emotional pain.

Due to the phenomenon of tolerance this numbing can only be maintained with ever-higher doses of drugs and alcohol while the brain tries to counteract the unnatural surges of neurotransmitters in an effort to rebalance its hormonal setting. At the same time, more and more toxins will do more and more damage to the well-being of the user. Meanwhile, the continual degradation of the physical body causes more stress and emotional pain, providing further motivation to continue with substance misuse. Body and mind are caught in a deadly down spiral: the addicted mind will make the body sicker, and the degraded body will exacerbate the cravings driving the addiction.

A Disease of the Spirit:

For many addiction professionals, addiction goes beyond this body-mind interaction, though. They also view it as a disease of the spirit. In his influential study, Canadian physician Gabor Maté compared addiction to the “realm of hungry ghosts,” one of six types of rebirth in Asian mythology. It is said to be the abode of restless spirits suffering from insatiable cravings and unhealthy attachments, condemned to inhabit dismal places.

At the heart of the addiction problem is a deeper malaise: the disconnection from the Higher Power—whatever that might be, a missing sense of purpose, a failure at authentic self-actualization, the highest level in Maslow’s pyramid of human needs.

This ethereal aspect of the disease is often a hard sell in an increasingly agnostic society. It doesn’t easily correspond to medical and scientific concepts and spirituality can mean very different things to different people. Whatever it is, Americans are increasingly identifying with it.  “About a quarter of US adults (27 percent) now say they think of themselves as spiritual but not religious, up 8 percentage points in five years,” according to a Pew Research Center survey conducted in 2017.

Many of them see spirituality as a personal search for the meaning of life, for connection with the entire universe—with a Power greater than ourselves. They do not necessarily seek a religious practice defined by mandatory observances, rules, and prohibitions. Instead, they want to connect with a Higher Power rooted in love and compassion—a Power that gives human beings perspective, meaning, and a life of purpose.

It is a perspective of the utmost importance to people in recovery. Many succumbed to a life of despair because they lacked a spiritual outlook. Sadly, our current culture seems to promote mostly vanity, instant gratification, zoning-out, and craving for material distractions, all things that are dangerous for a person in recovery. Addiction is a demon trying to disconnect us from our spirituality, the Higher Power, and our fellow human beings. To recover fully from addiction we must strengthen the body, heal the mind, and reconnect to our spirituality. This takes time and effort. A lot of time and effort. That is why recovery is a life-long pursuit.