News

Clinical Boundaries

Posted on by hadmin

Ann_Matino_Executive_DirectorWorking within the field of addiction treatment provides unique challenges to professionals with respect to keeping boundaries while providing compassionate care. When individuals working in treatment centers are also in recovery—and both staff and clients are involved in community groups and fellowship—lines can blur with the best of intentions. The opportunities for all staff forming more of a friendly relationship and less of a professional one are also increased in residential settings. One common issue is “over sharing.” Sharing one’s story is an important piece of recovery. When, however, does staff sharing details of their story become more about the staff member than about the client? How much personal information should clients know about their treatment providers?  Another issue can be the “physical comfort” aspect of fellowship. Many women in treatment have experienced sexual abuse and physical trauma and may also have deep rooted sex/love/relationship issues or addiction.  How do staff manage this for themselves, in community meetings and in the milieu?

Setting and keeping good boundaries requires practice, effort and professional collaboration—regardless of the role of the provider in the treatment setting. In addition to boundary issues specific to the substance use disorder treatment field, all staff should be aware of general boundary guidelines and principles of ethics set forth by behavioral health licensing entities—even if they themselves are not licensed or credentialed. One way to increase awareness of boundary issues is to have a forum to discuss case examples—perhaps in a staff meeting or before or after a designated training day. Specific training on this subject would also be very valuable as most staff want to do the right thing but need guidance in understanding boundary issues.

The Rose House is a 16-bed, gender-specific, dual-diagnosis treatment center in Boulder County, Colorado.  For nearly 10 years, our three-month-plus program has been helping women heal through evidence-based addiction, mental health, and trauma treatment.

The Rose House: Women get better here.

Ann Matino, LCSW
Executive Director, The Rose House
303-204-4524
amatino@rosehousecolorado.com

Harmony CEO speaks out about GOP sponsored bill

Posted on by hadmin

Yesterday, Congress voted to repeal and replace the Affordable Care Act with a new GOP-sponsored bill, which will now go to the Senate for confirmation. While this bill passed by a very small margin (217 votes to 213) it did pass. From a treatment center perspective, I would like to share my opinion (keep in mind this is my opinion) on the current proposed plan, as it relates to treatment.

For decades, treatment providers worked hard, lobbied hard, and ultimately gained parity for mental health and substance use disorders—meaning that these conditions needed to be covered “as any other illness” in health insurance plans. It was a giant step in getting care for those individuals suffering from diagnosed mental health and substance use disorders. The next step was the inclusion in the Affordable Care Act of treatment for these illnesses as an “essential benefit.” This was, in the eyes of those of us working in this field, a triumphant victory! Millions of individuals who previously lacked coverage for mental health and substance abuse treatment gained that coverage and were able to seek help.

The current plan would reverse the essential benefit provision at the federal level and place the decision of providing or not providing coverage for mental health and substance use disorders to each individual state. State legislators would decide whether or not to include treatment for mental health and substance abuse as required coverage within their state. We could see ourselves in a situation where families have to move state to state to purchase needed coverage, or where pre-existing conditions prevent addicts or alcoholics from obtaining coverage for treatment. This is not far-fetched. In my tenure at Harmony, I have seen insurance carriers refuse to pay for treatment under the pre-existing condition clause, just because an alcoholic went to AA before going to treatment.

I feel this bill is a giant step backward and very short-sighted. The potential impacts of individuals not getting appropriate treatment for these illnesses are numerous, frightening, and have been well documented.

Next steps? I am hopeful that the bill in its current form will not pass the Senate. I am hopeful that the changes made by the Senate (and there will be many) will re-establish essential benefits and protection for those with pre-existing conditions. I am hopeful that the Senate will not rush this bill through, as the House of Representatives did, and will carefully weigh the analysis of this bill by the OMB. The OMB’s report on the previous House bill estimated that over 20 million Americans would lose coverage. The House members did not bother to wait for a determination of this number for the new bill, and it could be higher.

Once modified by the Senate, the bill will return to the House of Representatives for another vote. I think it is critical—as concerned citizens with both personal and professional knowledge of substance use and mental health disorders—that we contact our congressional representatives and our Senators, and make our opinions known.

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.”

Alcohol Use Disorder Screening

Posted on by Christy Weeks
alcohol use disorder

Alcohol use disorder (AUD) affects millions of Americans, a disorder which can have serious impact on one’s health and can be fatal. Without effective, evidence-based treatments, the chances of recovery are slim. Sadly, many young adults have an AUD which usually arose in their teenage years. Preventing teenage alcohol misuse and abuse is crucial, and doctors can play a huge role in intervening early on.

New research has found that physicians who ask teens just one question about drinking frequency in the past year can help them determine who is at risk for developing an AUD down the road, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) press release. The study involved almost 1,200 young people ages 12 to 20. The findings were published in the Journal of Pediatrics.

“Primary care physicians are encouraged to screen adolescents for alcohol problems, yet many do not, citing time constraints and other issues,” NIAAA Director George Koob, PhD said in a news release. “This study demonstrates that simple screening tools such as those in NIAAA’s Youth Guide are efficient and effective.”

Using a computer-based questionnaire at a primary care clinic, the teens involved in the study were asked about how much alcohol they use and were screened for an AUD, the press release reports. The researchers found that 10 percent of those over age 14 met the diagnostic criteria for an AUD. The NIAAA funded study found that 44 percent of teens between 12 and 17 years old who had at least one drink on three or more days in the past year met the criteria for AUD. But everyone who drank that much was at risk for alcohol problems. Thirty-one percent of 18-20 year olds who reported 12 or more drinking days in the last year were found to have an AUD.

“This finding confirms that a single question can be an effective screen for AUD,” said lead researcher Duncan B. Clark, MD, PhD, Professor of Psychiatry at the University of Pittsburgh Medical Center.

If you are a young adult and believe that you have a problem with alcohol, please contact Harmony Foundation. Our Young Adult Recovery Track (YART) is specifically tailored for treating young adults with substance use disorders, let us help you begin the journey of recovery.

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.

Testing Cannabis Edibles for Potency

Posted on by Christy Weeks
cannabis-edibles

Last month we wrote about what is known as “marijuana tourism,” the act of traveling to states where recreational marijuana use is legal. With four states allowing adult cannabis use, there are a number of options for people who want to experience the end of marijuana prohibition first hand. A number of marijuana tourists are not regular users, and may or may not have ever used extremely potent strains of marijuana or edibles that can be purchased at pot shops. In the state of Colorado, researchers found that emergency rooms have seen a surge of visits by out-of-staters experiencing marijuana-related medical problems. Many of the incidents involved marijuana edibles which, it turns out, can be difficult to gauge with regard to the dosage of tetrahydrocannabinol (THC) present in such products.

There is a growing concern about inconsistent and inaccurate dosage information listed on the labels of marijuana edibles, which can mislead potential users. In response, scientists have developed a new method for measuring the level of marijuana compounds present in edibles, Science Daily reports. The scientists exhibited their work this week at the 251st National Meeting & Exposition of the American Chemical Society (ACS).

“Producers of cannabis edibles complain that if they send off their product to three different labs for analysis, they get three different results,” says Melissa Wilcox, who is at Grace Discovery Sciences. “The point of our work is to create a solid method that will accurately and reliably measure the cannabis content in these products.”

Jahan Marcu, Ph.D., from Americans for Safe Access and vice-chair of the newly formed ACS Cannabis Subdivision, points out that inconsistent and inaccurate labeling is important because eating cannabis is different than smoking, according to the article. Cannabis edibles are metabolized differently than when marijuana is inhaled, which can produce a stronger high that comes on slowly and has a longer lasting effect.

“It’s a lot easier for an individual to control their dose when smoking,” Wilcox says. “The effects of edibles can take a while to happen. You eat them, and then wait to see how you feel in an hour or two. If you ingested too much, you could be in for an unexpectedly bad experience.”

The current method employed for analyzing the potency of edibles involves using a high performance liquid chromatography (HPLC), the article reports. Marcu notes that HPLCs were not designed to have food injected into them, the sugars, fats and starches hinder the machines ability to produce accurate results. In order to combat the problem, the researchers developed a technique that separates the cannabinoids from the rest of the food. They then inject a liquid containing only the marijuana compounds into the HPLC.

People traveling to take part in the marijuana experience should be fully aware of the risks present with cannabis use. While the drug is legal for both medical and recreational use in a number of states, it does not mean that the drug cannot have adverse effects on people and it can also be habit forming. If you believe that cannabis use is negatively affecting your life, please contact Harmony Foundation.

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.

Marijuana Tourists’ Emergency Room Visits

Posted on by Christy Weeks
marijuana

When it comes to which mind altering substances carry the greatest health risk it is probably fair to say that most Americans would agree that marijuana is at the bottom of the list – as is evident by the continued lightening of restrictions when it comes to the use of cannabis. In the last 20 years, since California became the first state to legalize the use of medical marijuana, more and more states have hopped on the “green train,” medical marijuana is now legal in 24 states and Washington D.C. Four of those states and Washington, D.C. have also legalized adult recreational use, with more states expected to follow suit this November.

The State of Colorado is one of the four states that have legalized adult cannabis use, and in 2014 sale began throughout the state. Legalization, like one might expect, has brought about a surge in marijuana tourism, that is people who would like to walk into a store and buy marijuana, just like one would by a six-pack of beer. The novel experience is a not without risk, a new report has shown a spike in emergency room visits involving out-of-state visitors experiencing marijuana-related medical problems, HealthDay reports. Between 2013 and 2014, the number of marijuana tourists visiting the University of Colorado Hospital emergency room doubled, according to a research letter published in the New England Journal of Medicine.

“People in Colorado are becoming more experienced with use of these products,” said study co-author Dr. Andrew Monte, an assistant professor of emergency medicine at the University of Colorado School of Medicine in Aurora. “Sometimes visitors to the state, it’s more difficult to get the educational information in their hands. They may be less experienced with the particular products in the state. They haven’t been exposed to the deluge of public health messaging.”

While marijuana may be perceived as being a benign substance, a number of marijuana products contain extremely high levels of tetrahydrocannabinol (THC) – the main psychoactive ingredient that produces the high marijuana users experience. Monte points out that the majority of ER visits are the result of marijuana affecting pre-existing medical conditions, according to the article. Cannabis edibles are also responsible for a large number of emergency room visits, which if too much is consumed can cause severe vomiting.

It is important to keep in mind that on top of physical health risks, marijuana can become habit forming and potentially lead to addiction. If marijuana is negatively impacting your life, please contact Harmony Foundation for assistance.