Recovery from addiction is one of the hardest things a person can do and there are really no shortcuts. The addicted person has to put in the work. Recovery can be difficult emotionally, socially, and neurologically, even with the support of the most compassionate therapists and the most sophisticated addiction treatment program.
And although recovery may be the road less traveled, it is the more rewarding one, leading to a purposeful, more fulfilling life.
However, if someone is “drowning in addiction” they have to be willing to make the effort to swim to get better—and that can be hard. “Sobriety and recovery is a daily practice,” wrote Michael Maassel, Harmony’s director of alumni and recovery support services, in Drowning in Addiction: A Personal Guide to Recovery. “Transformation requires work, tending, weeding, and more action… Recovery is about taking ownership of your life and choosing to no longer be the victim, but the victor.”
Many people with addiction were desperately trying to numb their emotional pain by engaging in substance misuse and then were trapped in a hellish addiction cycle that only made that pain worse. Recovering from this disease involves hard work and difficult changes. Patients have to give up their maladaptive coping mechanisms—drugs and alcohol—and substitute them with healthy coping skills but that requires some adjustments.
“Change is hard for some of us,” reminded Maassel her listeners on her weekly podcast at the end of 2020. Change—even change for the better—is often an uncomfortable process while sticking with “the devil you know” can seem the easier less troublesome option.
“Willingness to open up and be accountable” is key, said Maassel’s guest on episode 33, health coach Sage Burmeister. “Change is the flow of the universe, don’t get stuck in one place” just because it seems the easier option. Fortunately, help is always available, you just have to look for it. “Community is the biggest support for change,” said Burmeister.
Taking on hard challenges is difficult for everybody, too many people continue with an unsatisfactory situation simply because changing it seems too much trouble. “Every day, we have countless opportunities to take the easiest, yet least satisfying road,” wrote Lori Deschene on Tiny Buddha. “We can turn to the things that comfort and numb us instead of acknowledging the things we want to change. We can do what comes naturally instead of recognizing and honoring what we do passionately. We can justify the path of least resistance by ignoring our strongest instincts.”
So often, we’re cheating ourselves by choosing the easy way out. But slacking off can be dangerous for people with addiction as recovery requires focus and the willingness to work on getting better every day. There are many healthy routines like meditation and breathwork that can help you be present and show up for yourself. You just have to do it.
Recovery may not be easy but it 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.
Misuse of Anti-Diarrhea Drug Loperamide Still Rising
Loperamide counteracts diarrhea by slowing the contractions of the intestines. But since its chemical structure resembles an opioid, it can induce euphoric brain effects if consumed in extraordinarily large amounts. In addition to uncomfortable constipation, it can be toxic and lead to serious heart conditions, ileus (paralysis of the intestine), and addiction.
A 2016 study confirmed that loperamide is misused by people attempting to self-medicate their opioid addiction, sometimes with fatal results. “Loperamide’s accessibility, low cost, over-the-counter legal status, and lack of social stigma all contribute to its potential for abuse,” said lead author William Eggleston, PharmD, of the Upstate New York Poison Center, in Syracuse, NY.
In September 2019, the US Food and Drug Administration (FDA) announced approved package size and package type limits for over-the-counter brand-name tablet and capsule forms of loperamide to address the misuse issue by limiting each carton to no more than 48 mg of loperamide and requiring unit-dose blister packaging.
“Abuse of loperamide continues in the United States, and taking higher than recommended doses can cause serious heart problems that can lead to death,” reported then Acting FDA Commissioner Ned Sharpless, M.D. in 2019. “The FDA has worked with manufacturers to approve package size limitations and unit-dose packaging for certain over-the-counter loperamide products. These changes are intended to increase the safe use of loperamide products without limiting over-the-counter access for consumers who use these products for their approved uses at the approved dose, according to labeling.”
The FDA requested that online distributors take voluntary steps to help reduce the risks of loperamide abuse and misuse by not selling more than one package of these drugs to each customer.
Apparently, these measures have been ineffective. “Between 2010 and 2015, the National Poison Data System showed a 91 percent increase in loperamide overdoses,” wrote Bryan Paul Negrini, M.D. recently on Addiction Professional. “A 2019 study from Rutgers University confirmed that loperamide overdoses have gone up over the last few years, and a 2020 study from QJM: An International Journal of Medicine has also confirmed that non-medical misuse of Loperamide is common.”
Dr. Negrini tested the progress of the FDA’s packaging efforts by sending his 16-year-old son to a couple of pharmacies “with $50 to purchase as many Imodium tablets as he could. In both cases, he came out with boxes of hundreds of tablets and was never asked why such a young kid needed so many Imodium tablets.”
The dangers of loperamide misuse are very real. One of Dr. Negrini’s patients recently died a few days after he first saw him. He had been using the opioids “heroin and fentanyl on and off for at least a decade and had additionally started misusing Imodium.” His autopsy report attributed the death to “drug poisoning with loperamide.”
Opioid use disorder is a serious condition, requiring comprehensive professional treatment and should not be self-treated using medications such as Loperamide. “We have not seen active use of Loperamide on admission at Harmony, however, we have protocols in place to educate our clients about the impact this drug has in response to opioid addiction and use other more appropriate medications to help with the detox process,” says Harmony’s medical director Michael Rountree, M.D.
As one treatment option, Harmony offers HOPE – Harmony’s Opioid Programming Experience. HOPE is offered to all Harmony patients with OUD. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these patients’ needs.
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 opiate support groups led by a professional addiction counselor. This group addresses the specific challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse.
Despite difficult circumstances, Harmony continues to serve patients during the COVID-19 pandemic and we are 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.
Reconnecting in Recovery
The Importance of Engaging Families in Recovery
*This presentation is no longer eligible for the 1 CE credit*
The Persistent Stigma of Addiction
One of the biggest barriers to going into recovery from a substance use disorder (SUD) is stigmatization. Although now widely described as a chronic disease, addiction still carries a significant stigma for patients—even among healthcare professionals.
“Stigma on the part of healthcare providers who tacitly see a patient’s drug or alcohol problem as their own fault leads to substandard care or even to rejecting individuals seeking treatment,” warned the director of the National Institute on Drug Abuse (NIDA), Nora Volkow, M.D., on her blog in 2020. “People showing signs of acute intoxication or withdrawal symptoms are sometimes expelled from emergency rooms by staff fearful of their behavior or assuming they are only seeking drugs. People with addiction internalize this stigma, feeling shame and refusing to seek treatment as a result.” Health conditions ranging from cancer and AIDS to many mental illnesses may lead to some people avoiding those patients but addicted individuals are all too often actually blamed for their disease, “even though medicine long ago reached a consensus that addiction is a complex brain disorder with behavioral components,” as Dr. Volkow points out. But too many Americans, including many in the healthcare sector and the justice system, continue to view addiction as the consequence of moral weakness and flawed character.
Sean Fogler—a physician in recovery himself—encountered this prejudice firsthand.
“The stigma of addiction comes from the negative feelings that many healthcare professionals harbor for people struggling with substance use disorders, and their beliefs that poor personal choices, ‘moral failing,’ and defects of character are to blame for the disease. These feelings and beliefs mirror those of the general public,” wrote Fogler on Stat News in 2020.
Although they should know better, healthcare workers may actually shame people with addictions more than others do, according to Fogler. “A recent study exploring emergency physicians’ attitudes toward patients with substance use disorders found that the majority had lower regard for patients with substance use disorders than for patients with other conditions affecting behavioral health. Among physicians participating in the survey, only 10 percent agreed that they ‘enjoy giving extra time to patients like this.’ These physicians found it more rewarding to treat patients with obesity, diabetes, trauma, and even those with COPD who smoke.”
This is an unfortunate situation because addiction continues to be a significant health crisis in the United States and emergency departments can play an important role in referring SUD patients to appropriate treatment programs. For example, ERs could implement a screening process called SBIRT (screening, brief intervention, and referral to treatment). SBIRT can be performed in a variety of settings and does not have to be performed by a physician. SBIRT incorporates screening for all types of substance use with brief, tailored feedback, and advice. Simple feedback on risky behavior without judging can be a powerful impetus for changing patient behavior and engaging them with treatment programs.
“No one chooses to develop this disease,” explains the American Society of Addiction Medicine (ASAM). “Instead, a combination of genetic predisposition and environmental stimulus—analogous to other chronic diseases like diabetes and hypertension—can result in physical changes to the brain’s circuitry, which lead to tolerance, cravings, and the characteristic compulsive and destructive behaviors of addiction that are such a large public health burden for our nation.”
Stigmatizing people with addiction as morally derelict on the other hand is counterproductive and unprofessional.
“Stigma violates the right of people with addictions to be human, strips us of our dignity, and says to us that we have no value,” writes Fogler. “It evokes feelings of shame so deep they are hard to know unless you’ve experienced them. This isn’t the kind of shame that guides us or tells us we’ve made a mistake. It’s toxic shame, the shame that tells us we are the mistake—something those of us with this disease come to believe.”
Shaming and punishment are detrimental and will not address the needs of the patient or promote recovery. Addiction is a complex biopsychosocial disease requiring comprehensive evidence-based treatment methods. Many people with addiction misuse substances in an attempt to self-medicate underlying mood disorders.
Harmony Foundation is a dual-diagnosis-capable facility serving patients 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 patients during the COVID-19 pandemic and we are 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.
Wellbriety: Cultural Approaches to Treating Trauma and Addiction in Native Americans
Although the Native American population of the United States remains relatively small compared to other ethnic groups, indigenous people struggle disproportionately with a vast range of health and social issues—including substance misuse.
In 2018, Randall Swaim and Linda Stanley tracked rates of substance use among American Indian adolescents attending schools on or near reservations since 1974 and found that “American Indian adolescents have consistently reported the highest levels of substance use compared with other US racial/ethnic groups.”
Swaim and Stanley found that lifetime and last-30-day substance use rates and relative risk were significantly higher for nearly all substances among American Indian youths.
“The harm associated with high rates of use and early initiation for American Indian youths includes increasing rates of use in early and later adulthood, higher risk of developing a substance use disorder, and more alcohol-related problems, including alcohol-attributable death. Furthermore, American Indian and Alaska Native youths are more likely to need treatment for a substance use problem than all other US racial/ethnic groups.”
In a recent presentation for Harmony Foundation, Don Coyhis, the founder and president of White Bison—a nonprofit company dedicated to creating and sustaining a grassroots “Wellbriety” movement that provides culturally based healing for indigenous people—explained the historical background of this addiction crisis and pointed out culturally specific ways to tackle it.
According to the White Bison vision statement, “Wellbriety means to be sober and well. Wellbriety teaches that we must find sobriety from addictions to alcohol and other drugs and recover from the harmful effects of drugs and alcohol on individuals, families, and whole communities. The ‘Well’ part of Wellbriety is the inspiration to go on beyond sobriety and recovery, committing to a life of wellness and healing everyday.”
As in many cases of substance use disorder (SUD), trauma plays a crucial role. Many studies have shown a link between exposure to traumatic experiences and substance use disorder. SUDs are highly comorbid with PTSD and other mood-related conditions, such as anxiety and depression.
In the case of Native Americans, entire communities have been traumatized by a dramatic loss of their culture and forced assimilation. Don Coyhis blames the infamous boarding schools of the 19th and 20th centuries in particular.
Between the 1870s and 1960s, over 100,000 Native American children were sent to nearly 500 boarding schools across the United States. They were largely modeled after the flagship United States Indian Industrial School in Carlisle, Pennsylvania, founded in 1879.
Officially justified as a path for Native Americans to achieve equality with European-Americans by immersing students into mainstream American culture, Carlisle and similar schools remain deeply controversial today as they forced children to leave their families at young ages and give up their indigenous cultures, languages, religious and spiritual beliefs, and even their names, thus traumatizing generations of Native people.
The boarding schools unleashed “seven generations of intergenerational trauma,” says Coyhis. The traumatic experience of the boarding schools did not only affect individual students but also their descendants to this day. There are now strong indications that trauma can be passed on genetically to subsequent generations.
“Today the hypothesis that an individual’s experience might alter the cells and behavior of their children and grandchildren has become widely accepted,” wrote Andrew Curry in Science in 2019. “In animals, exposure to stress, cold, or high-fat diets has been shown to trigger metabolic changes in later generations. And small studies in humans exposed to traumatic conditions—among them the children of Holocaust survivors—suggest subtle biological and health changes in their children.”
For Coyhis, the unresolved grief over the attempted eradication of Native culture is behind the many problems plaguing indigenous communities today. Before the boarding school system disrupted native lives, spirituality, ceremonies, native languages, and cultural values conveyed by tribal elders sustained traditional social structures.
The boarding school period destroyed those structures and instead laid a foundation of anger, guilt, shame, and fear leading to substance misuse, mental illness, suicide, sexual and child abuse. “Many thousand Native Americans grew up with early childhood trauma,” said Coyhis. “This led to lateral violence and addiction.”
Healing begins with understanding the past and reconnecting with the indigenous value system. The Wellbriety method is about re-engaging with a Native worldview focused on harmony with the Earth. Understanding the historical trauma can be seen as the first step for Native Americans to break the cycle of anger, shame, substance misuse, and violence.
They need to process the loss of their culture, their land, their language, and basically their entire way of life. To heal this trauma, White Bison’s Wellbriety offers four directions of healing to counter intergenerational trauma, jealousy (family rivalries), early childhood trauma, and unresolved grief. “There is so much death in our communities,” said Coyhis, “and not only from old age.”
Intergenerational trauma has to be treated with intergenerational healing, “a combination of immense healing, community training, and a return to the ceremonies, spirituality, and the cultural ways of our people” by bringing back:
- Culture
- Language
- Land
- The people’s physical, emotional, mental, and spiritual health
- Religion
This reversal is based on the traditional indigenous worldview of four elemental concepts at the cardinal directions: Fire (white) in the north, the land (red) in the east, air (yellow) in the south, and water (black) in the west. Each cardinal point represents important teachings for Native Americans. Walking the “Red Road” of healing involves finding the Creator (red), finding your Self (yellow), finding your relatives (black), and finding the wisdom of the elders (white).
This traditional indigenous philosophy was renewed at a meeting of elders in the early 1990s which predicted a time of healing in the future, explained Coyhis. It was prophesied that the healing time would come when an eagle lands on the moon. When the elders heard Neil Armstrong reporting from the lunar surface in 1969 that “the Eagle has landed,” they took that to mean that the healing time would begin.
Another vision saw a spider build a web all around the globe and a woman would come to speak on the web and she would be heard around the world. The launch of the world wide web on the internet in the 1990s is considered to be the fulfillment of that prophecy.
These native visions counter trauma and despair with belonging and hope. “The Sacred Hoop can bring the four directions together, allowing for forgiving the unforgivable, unity, healing, and hope,” said Coyhis. Only this kind of holistic approach can break the cycle of intergenerational trauma.
Harmony has long utilized a holistic approach to healing trauma and addiction as well. 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, 7 days a week
The Wellbriety Movement
*This presentation is no longer eligible for the 1 CE credit*
How Recovery Became a Life-Changing Experience for This Family
“Harmony has made a big difference in my life,” says Brad. That’s why Angie and he are now trying to give back and help others beat the disease of addiction—or at least “get ahead of it.”
“We have great role models in Brad’s parents when it comes to helping out in the community,” says Angie. “We know how lucky we are. That’s why we want to help because everybody who needs it should have the opportunity to go through a program like Harmony and come out on the other side as we did.”
They want to continue to donate their time and money, stay actively involved, and always remember “how lucky we are to have come through this because we have close relatives who did not.”
“Recovery is not something you can take for granted,” says Brad. The first few days of treatment at Harmony, he didn’t want to be there, remembers Brad with a smile on his face. But at the end of the experience after “accepting and diving into” his therapy, Brad didn’t want to leave. “It wasn’t easy but the more I got into the work involved, the more I got out of it and realized how much it was helping me.”
Brad realized what he learned in treatment does not only apply to addiction. “Some of the things you learn at Harmony apply to everyday life.” The location also played an important role. “The mountains have always given me peace and tranquility,” he says.
“This wasn’t Brad’s first attempt at rehab,” remembers Angie. “He had tried an intensive outpatient program before but it didn’t stick.” As time went on and Angie learned more about the disease of addiction, her expectations changed. “I’m in awe of Brad and our son for what they have gone through, their discipline and self-control,” says Angie. They are taking their recovery very seriously.
“The way the Harmony program was structured made me want to go there,” she jokes. “All the self-reflection and digging deep and looking at why you do the things you do.” She knows it was a hard few weeks for her husband but she thinks the program is structured really well. “When you look at your physical health, your mental and spiritual health, you make sure it’s all well-rounded and you’re not just bumping down the road. And Harmony hit all those points, which is really amazing. I learned a lot from Brad and how he dealt with his disease.”
“One of the important tools you learn at Harmony is self-examination,” says Brad. “It’s very important to continue with that throughout your recovery because you can start veering off track. If you don’t continue that self-examination to realize when you’re getting a little off, you’re gonna be in trouble.”
“The last thing most people want to do is look at themselves, but it’s so helpful and so important,” says Brad. An important tool for Angie was Harmony’s family program. “I learned a lot about the medical side of addiction,” she says. “I understand now that these individuals do not choose to be addicted. They may have made bad choices that bring their addiction along further but in the end, they didn’t choose it.”
In a good family program, family members learn how to deal with the substance use disorder and move forward instead of just “throwing their emotions at it.” It was important for Angie to realize that it was not Brad’s choice to have this disease.
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.
Assertive Community Treatment
*This presentation is no longer eligible for the 1 CE credit*
In this presentation we will discuss an interdisciplinary team approach that provides flexible, ongoing and comprehensive support to individuals with co-occurring disorders and their families. ACT is based around the idea that people receive better care when their mental health care providers work together. The mission of ACT is to help people become independent and integrate into the community as they experience recovery. Continue reading “Assertive Community Treatment”
Staying Connected With the Harmony Hub
“Everything we do for alumni is in the app,” says Michael Arnold, Harmony’s director of alumni and recovery support services. “Event schedules, volunteering opportunities, ways to be of service, peer support meetings—it’s all right there.”
After downloading the app, Harmony alumni are able to: