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Using tobacco products is prevalent among people with substance use disorder (SUD).

“Persons with mental or substance use disorders or both are more than twice as likely to smoke cigarettes as persons without such disorders and are more likely to die from smoking-related illness than from their behavioral health conditions,” wrote Marynak, VanFrank, et al. in their 2018 study “Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities.”

The good news is that “many persons with behavioral health conditions want to and are able to quit smoking, although they might require more intensive treatment. Smoking cessation reduces smoking-related disease risk and could improve mental health and drug and alcohol recovery outcomes.”

Many modern, evidence-based addiction treatment centers are fully aware of these data and have made their programs nicotine-free. One of them is Harmony Foundation. In a recent webinar hosted by the National Association of Addiction Treatment Providers (NAATP), Harmony CEO James Geckler and Harmony’s medical director, Michael Rountree, talked about their experience with introducing a tobacco-free campus.

After exploring options during 2019, Harmony became tobacco-free in January 2020. “We knew that it supported people’s wellness, it made for better options for long-term recovery, and it spoke to our mission of being foundational,” said Geckler. “it had all the right pieces to it.”

Dr. Rountree explained the basic science. Many people in recovery want to quit smoking. ”Clients find treatment to be the appropriate place for quitting,” Dr. Rountree said. “And smoking cessation does not impair outcomes in patients presenting with substance use disorder.”

Not only does smoking cessation not impair outcomes, there is a “25 percent improvement in long-term abstinence for people with SUD.”

Some organizations fear a smoke-free campus will have a negative impact on the census. As the Harmony experience demonstrates, there is no real reason for concern. “We now have about one patient a month who is not admitted because of the smoking ban,” Geckler said. “If people object to the tobacco-free setup, we refer them to another treatment center.” Overall, the transition to a smoke-free campus “was easier than expected.” Dr. Rountree added that he was “stunned at the lack of complaints.”

Harmony Foundation prepared for the transition well. The team started having conversations with clients, staff were trained and supported with studies to promote tobacco cessation, and the campus itself had to be prepared. “We used to have smoking gazebos for cigarette breaks and smoke breaks were actually built into the schedule,” explained Geckler.

Before going smoke-free, Harmony had offered smoking cessation groups to clients interested in quitting. Now, all nicotine products are off-limits with the exception of patches and gums. Sometimes, clients bring e-cigarettes or nicotine pouches only to learn they are not permitted on campus. However, most clients understand why such products are not helpful when explained to them.

“Flexibility and patience are important,” said Geckler. “Appropriate training and good communication is key. We had to learn to look out for mail deliveries of tobacco and how to check clients’ baggage for tobacco products. We ended up with a cleaner campus—no more cigarette butts on the ground, and have better group attendance, as nobody has to finish a cigarette.”

Nicotine addiction is very similar to other substance use disorders. Like other drugs, nicotine engages the reward cycle of the brain. “A transient surge of endorphins in the reward circuits of the brain causes a slight, brief euphoria when nicotine is administered. This surge is much briefer than the ‘high’ associated with other drugs,” explains a webpage from the National Institute on Drug Abuse. Nicotine works like other psychoactive substances; consequently, cessation tends to support recovery from substance use disorders. Since 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. All our services are provided in a safe, culturally sensitive, tobacco-free environment and in a trauma-informed manner.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs and workshops, 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, seven days a week.

• 90% have been threatened or harassed at work
• 60–70% have experienced physical or sexual harassment by law enforcement officers
• 43+% report using substances to cope with stress and discrimination
• 41% report suicide attempts (compared to 1.6% in the general population)
• 10% higher rate of smoking than the general population

• Psychologists understand that gender is a nonbinary construct that allows for a range of gender identities and that a person’s gender identity may not align with the sex assigned at birth.
• Psychologists understand that gender identity and sexual orientation are distinct but interrelated constructs.
• Psychologists are aware of how their attitudes about and knowledge of gender identity and gender expression may affect the quality of care they provide to TGNC people and their families.

• We recognize how stigma, prejudice, discrimination, and violence affect the health and well-being of TGNC (transgender and gender non-conforming) people.
• We strive to recognize the influence of institutional barriers on the lives of TGNC people and to assist in developing TGNC-affirmative environments.
• We understand the need to promote social change that reduces the adverse effects of stigma on the health and well-being of TGNC people.

Addiction is a complex disease, making its treatment a fairly complicated task. Substances and certain behaviors can become addictive in the context of particular personal, biological, and cultural variables. To complicate diagnosis and treatment further, people can suffer from overlapping and interacting addictions. Continue reading “The Interaction of the Neuropathways of Addiction” →

*This presentation is no longer eligible for the 1 CE credit*

Women’s treatment is on the precipice of innovative growth if we maintain our focus on the wellness of the entire woman. Using the Biopsychosocial Model of Addiction and Recovery, we will review aspects of addiction, mental health, and trauma, highlighting the nuances that make women and their care unique. The intersection of these concerns makes treatment complicated and acute, yet it leaves room for extraordinary healing. In order to provide a path to wellness, we will provide a clinical framework to engage women in active treatment and their continuum of care. Continue reading “A Path to Women’s Wellness and Recovery” →

Addiction is a complex disease, and no two cases are exactly the same. An effective addiction treatment program is based on a careful assessment of the needs of each individual client.

Not every case of substance use disorder (SUD) requires detoxification or residential treatment. The Diagnostic and Statistical Manual of Mental Disorders 5th edition, also known as DSM-5, used by physicians to diagnose SUDs offers three levels of severity—mild, moderate, or severe on the basis of how many of the eleven diagnostic criteria are met by the patient.

The level of care in a treatment program may also depend on what kind of therapy the client is able to do. Carol (not her real name) is a professional woman in her fifties. She developed an alcohol use disorder (AUD) when she was in her forties.

Like many other busy professionals, she was using alcoholic beverages mostly in a reasonably responsible social fashion. “I never had a problem with alcohol until my late forties,” she remembers. Unfortunately, alcohol misuse can creep up on you incrementally.

The first two criteria for AUD are “alcohol is often taken in larger amounts or over a longer period than was intended” and “there is a persistent desire or unsuccessful efforts to cut down or control alcohol use.” Carol ignored those warning signs and continued to use alcohol frequently.

“My drinking was entirely in the closet, hidden from my employer and my family,” says Carol. She was so “well-functioning” on the outside that nobody even believed she had a problem. “I went to my doctor loaded, and he still wouldn’t believe it. He told me, ‘you’re not an alcoholic; you don’t have a problem,’ and I said, ‘oh yes, I do.’”

Cravings for alcohol increasingly played a major role, and Carol’s recurrent alcohol use resulted in a failure to fulfill major role obligations at work. (DSM-5 criteria 4 and 5).

Carol realized she needed help but being aware of the stigma of addiction, she also didn’t want to jeopardize her career. She tried Alcoholics Anonymous (AA), but it didn’t quite work for her. Carol continued drinking. “It was horrible. I started spreading alcohol purchases across a number of liquor stores to hide my alcohol consumption.

Eventually, she was able to open up to her husband. “I gotta go to rehab,” she told him, and he has shown great support for her recovery ever since.

An acquaintance suggested giving Harmony a try. We had just begun to offer a virtual intensive outpatient program (IOP)—in the middle of the COVID pandemic. It turned out to be the perfect fit for Carol. “They screened me whether I needed outpatient, residential, or another level of care,” she remembers. A 12-week participation in the program is recommended but Carol liked it so much that she stayed a while longer.

Addiction is often referred to as a family disease, meaning addiction affects the family dynamic in multiple ways. Carol’s husband and their adult children have supported her recovery wholeheartedly. Family support can lower the risk of dropping out of treatment and also reduce the chance of renewed substance use, discourage relapse, and promote long-term recovery.

Carol took full ownership of her recovery. The Harmony IOP “was a saving grace for me. The virtual sessions were almost as powerful as going in person. I did my best to discipline myself, not leave the room or look at my phone just as if it were an in-person meeting. I wanted to keep it real and not get distracted.”

Addiction is a progressive disease, and there is no need to wait for “rock bottom” before seeking help. People with substance use issues can start at the level of care that’s right for them anytime, whether that’s residential, partial hospitalization, or intensive outpatient treatment. There is no need to wait; it’s much better to get the help you need before it’s too late.

Carol is now active in Harmony’s alumni program and regards the time spent in the IOP and the launch of her recovery as one of the best years in her life.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs and workshops, 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, seven days a week.

Active addiction can put even a functional family system into crisis mode. Drug and alcohol addiction is a disease that has a deleterious impact on all members of the family, not just the person using substances. Some families try to deal with the situation by staging an intervention.

“Just as CPR is often the first lifesaving step in helping a heart attack victim, intervention is the most powerful step that a family can take to initiate the recovery process,” wrote Jeff and Debra Jay in Love First.

Unfortunately, there are many misconceptions about intervention. It’s not what you see on TV—at least not a good intervention. An effective intervention is not an emotional ambush but a loving, caring experience that need not be confrontational. It should be designed to preserve the person of concern’s dignity—after all, addiction should be treated as a disease, not as a reprehensible moral failure.

A well-planned, expertly guided intervention can avoid pitfalls and thus provide a launchpad for lasting recovery from addiction. Structured Family Recovery® (SFR) helps prevent relapse by creating a “family recovery team.” This team supports the addicted person during treatment, after treatment, and throughout the first year of recovery.

Carver Brown is a certified recovery coach and trainer with the Connecticut Community of Addiction Recovery (CCAR) and an SFR counselor. He is also a grief recovery specialist certified by the Grief Recovery Institute. Lauren Kirschberg graduated from the University of Alabama, where she studied adult development, family systems, and addiction. She began working in the addiction recovery field in 2010 alongside Brown. Kirschberg is a Love First clinical interventionist. Continue reading “A Good Intervention Can Be the Launchpad for a Successful Recovery” →