News

Podcast: Foundations of Hope, Health and Wellness

Lisa Love

Lisa Love, MSW, LCSW, CBIS
Therapist

 

Gina Thorne:                      Hi everyone, welcome to the Harmony Foundation podcast series. My name is Gina Thorne, and I’m the chief marketing officer here at Harmony. And I’m pleased today to be joined with Lisa Love, who is the owner-operator of foundations of Hope, Health, and Wellness out of Casper, Wyoming. Welcome, Lisa.

Lisa Love:                            Thank you Gina, it’s a pleasure to be here. Continue reading “Podcast: Foundations of Hope, Health and Wellness”

Podcast: Hilltop Mediation

Gina T.:                 Hi everyone. Welcome to the Harmony Foundation podcast series. I’m pleased today to be joined with Amber Hill with Hilltop Mediation, and we’re going to be talking a little bit more about mediation services. It’s one of those things that people only hear about, usually, when there’s big conflict that’s going on and, usually, it’s family conflict and so I’m sure some folks are probably curious about mediators, and why Harmony. Continue reading “Podcast: Hilltop Mediation”

Harmony Fights Opioid Epidemic with HOPE

More than two-thirds of drug overdose deaths in the United States in 2017 involved opioids, according to the Centers for Disease Control and Prevention, escalating an epidemic the CDC says “continues to worsen and evolve.” From 2016 to 2017, opioid-related overdose deaths increased 12 percent overall, surging among all age groups 15 and older.

The CDC report’s recommendations for curbing opioid-related overdose deaths include “increasing naloxone availability, expanding access to medication-assisted treatment, enhancing public health and public safety partnerships, and maximizing the ability of health systems to link persons to treatment and harm-reduction services.”

Naloxone is a medication often used by first responders because it can rapidly reverse opioid overdose. It is an opioid antagonist—it binds to opioid receptors and can reverse and block the effects of other opioids. It can quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain relievers.

Medication-assisted treatment (MAT) is used to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. Medications used for the treatment of opioid use disorder are buprenorphine (Suboxone, Subutex), methadone, and extended release naltrexone (Vivitrol). Some of these drugs are controversial in the recovery community because they are themselves opioids.

The National Institute on Drug Abuse, a US government research institute, clarifies that contrary to what some critics say, “methadone and buprenorphine DO NOT substitute one addiction for another. When someone is treated for an opioid addiction, the dosage of medication used does not get them high–it helps reduce opioid cravings and withdrawal. These medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.”

The use of these medications should always be combined with behavioral counseling with the ultimate aim of ceasing all substance misuse.

HOPE – Harmony’s Opioid Programming Experience

Harmony has provided all clients with medication-assisted treatment 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 cravings, and give the patient time to heal from the psychological, social, and spiritual wounds of addiction.

“It’s important to remember that MAT is only a small part of the picture,” says Harmony’s medical director Christopher Reveley. “That is why we call it ‘medication-assisted’ treatment, because by itself it is not the treatment. Used alone it has a low probability of being successful.”

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.

Medication-assisted therapy may help stabilize the patient for these challenges in early recovery. “It gives people an opportunity to step out of the chaos of addiction and consider other ways of being,” says Dr. Reveley. “I never felt that buprenorphine was meant as a lifelong or even long-term solution.” Although there may be exceptions. It all depends on the individual needs of the patient. Reveley remembers a patient who had been on methadone for 46 years. “He tried to taper off a dozen times and relapsed to heroin use every single time. His family was initially very opposed to him being on methadone but eventually they told him ‘this is working, your life depends on it.’ So there are people on either end of the bell curve but in most cases buprenorphine is only a small but important part of the solution.”

Buprenorphine can be an important tool, especially in early recovery from opioid use disorder. The medication offers patients the opportunity to start living a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin and other opioids. People are dying every day from opioid overdoses, especially in the age of the fentanyl scourge. Buprenorphine may provide the buffer that enables them to launch into sustained recovery. It is a buffer that can save people with addiction from a potentially lethal overdose.

Harmony has been treating addiction for 49 years and HOPE is now 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.

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 opioid use disorder and needs help, call Harmony at 970-432-8075 and one of our admissions specialists can discuss next steps.

Why Recovery Needs Healing Space

Addiction is a family disease. The Recovery Book advises family members of people in recovery that “Everyone in your family, as well as other people in your lives, has been affected by addiction in some way. Now you all need to work on getting your lives back to some kind of normal.”

Michael Arnold is a recovering alcoholic who now works as an alumni relations manager at the Harmony Foundation. In a recent Facebook Live with her twin sister, Michael and Casey talked about the impact Michael’s addiction and recovery had on their relationship. Both siblings demonstrated how important clear and honest communication is for the family dynamic.

Michael talked about the need to share with “brutal honesty what addiction can do to your family.” Casey talked about how hard it was for her to watch Michael decline in active addiction, realizing there was nothing she could do, that Michael had to save herself.

Michael recalls doing things to her family that “just weren’t nice.” Casey remembers all too well. Seven years ago Michael helped to put her twin sister briefly in jail—just to hurt her. Michael was in such a bad place that to hurt her sister made her feel better.

“I never thought I could be close with Michael again, never thought I could trust her again,” Casey said. But change can happen. Recovery can work miracles. “Michael has changed. She is not the person she was seven years ago,” Casey said. “She is not that selfish person that put me in jail. She’s working very hard at it every day.”

For desperate family members the trick is to be patient and supportive. “Don’t hammer people in recovery about all the mistakes they made in active addiction” all the time. “Show your love,” Casey said. “You need to have grace and patience with them. As family members you have to give them space to recover, the harder you are on them the worse it’s going to be.”

Appealing to people in the audience who have family members with addiction, Casey said, “You have to choose either to be there and support them or walk away. You can’t live in the middle and hold their past wrongdoings against them—that doesn’t help them recover. I have nothing but complete love for Michael now and I’m just so proud of her. It’s been a journey for both of us.”

Michael shared her side of that journey. Only “when I went through rehab did I get the tools to tell myself everyday to have that patience, to be so grateful that I’m sober. I have to know that my family will trust me; that they should realize that I’m a changed person but time is not on my side.”

It’s important to remember that recovery is a process. “I thought simply that Casey and I would be okay now that I’m sober. The relationship would be fine but it wasn’t,” Michael remembers. “Casey gave me that space for about a year to recover, but then she said ‘we need to talk about what happened’ so that we can move forward.”

Casey had to tell Michael what she had done to her and “she took it hard. I love you, I forgive you, but you have to earn the trust back.” That shook Michael, “but now our relationship is even stronger because you have to be able to open up about these things or they will simply fester.”

Making amends is an ongoing process for Michael now and Casey knows it. “Michael is ruthless and relentless about her recovery—she has even written a book about it. She is working hard every single day and that is all you can ask.”

The Insurance Dance with Recovery in Mind by Jim Geckler

Collaboration

We recently received a Facebook post regarding frustration over Harmony’s handling of payments made through insurance. I wanted to use this opportunity to discuss questions and concerns about our partnerships with insurance partners and how we believe it helps benefit access to treatment.

First and foremost, insurance companies make it easier for us to cover some of the cost of treatment, a service that many of us do not plan for when the time requires it. When we consider our personal relationships with insurance partners, how many of us would be able to have yearly physicals, emergency procedures, or access to treatment? As a provider, Harmony works with our insurance partners to provide the appropriate level of care for the appropriate period of time.

Harmony has a 49 year history of providing a residential level of care; this is the highest level of care for people suffering from substance use disorder. We have a responsibility to our clients to stabilize them medically, assess their conditions, provide them with a diagnosis, work with them to create a foundation for sustained recovery, and construct a comprehensive continuing care plan which will support their recovery. The relationships we have fostered with insurance partners has allowed us to work collaboratively to support access to care along the continuum. Under the umbrella of the American Society of Addiction Medicine (ASAM), together, insurance companies and treatment providers alike are held to the highest standards of care for addiction treatment. This common language, reviewed in tandem with insurance providers determines what level of care an individual requires.

Sometimes there is disagreement.  For example, when Harmony feels that a client would be better served by remaining at a residential level of care and an insurance provider feels they would be successful at the next level.  Other times, a client would like to remain in treatment, however our expert clinical and medical staff believe they are ready to move toward self-management of their own recovery at a level of care which empowers them to practice the early skills of recovery they learned here. In most cases, to arrive at a decision to move a client to the next level of care, involves a conversation with our Medical Director and a physician reviewing the case for the insurance company. We work to keep people at the appropriate level of care indicated by our clinical staff recommendations based on the client’s progress.

Harmony has a dedicated utilization review team, clinical professionals who work with our insurance partners, staff, and clients to keep people at the level of care which will provide them the greatest opportunities for success. When it is determined that funding for residential care has ended, we work to inform the client as quickly as we are able. Unfortunately in this situation the determination for a shift in levels of care is immediate, funding ceases that day. In order to ease the transition for clients and families, Harmony is committed to absorbing the expense of an additional night’s stay for clients. This is not common practice and comes at a fair cost. For example, in the month of July, we provided $28,000 in housing and care at no additional expense to clients. We are able to continue to do this through the generosity of our donors. We recognize the challenge and frustration of learning at 4 pm that one no longer has financing for treatment, however we are dedicated to continue to support our clients during this transition period.

There is nothing magical about 28 days of treatment. We have heard the 28 day timeframe used for many years, growing in public awareness with the Sandra Bullock film. The reality is that proven success is driven by long term engagement in treatment within a full continuum of care, at multiple levels  increasing the opportunity  for self-management.

We will always remain committed to providing access to treatment whenever possible, using all means necessary to help individuals receive treatment that can build an early foundation of recovery.  This could look like something as short as a few days or as long as 4 months.  Either way, our partnerships with insurance and our recommendations for treatment will always be the focus in providing individualized care for clients.

Jim Geckler is the Chief Executive Officer for Harmony Foundation.