Reporting on CORE Conference Summer 2016
I attended this conference on Amelia Island Florida in July. The membership goal is to improve accessibility to and the quality of addiction treatment and to promote recovery solutions.
The conference is “structured as a forum to increase the collective understanding of the addiction recovery processes.” Participants are eager, in general, to improve addiction treatment outcomes by better integrating abstinence-based practices and Twelve-Step principles into therapeutic initiatives.
Four themes emerged during the four day event.
More often, meds are being delivered in a physician’s office, administered in many cases by the physician’s assistant. Atlanta has seen this trend with Adderall. Used to be, a psychologist or psychiatrist would diagnose ADD or ADHD and submit the treatment plan with a prescription. Nowadays, people can get a prescription, without the rigorous assessment that was required formerly. In the case of opioid addiction, many physician’s assistants are writing the treatment plan. And many are not necessarily trained to develop it. Doctors’ offices are focused on harm reduction, which is good. But do they understand the cravings? Do they understand how medication could actually threaten authentic sobriety? These were the sorts of questions and issues that were explored.
Suboxone is used as a detox agent, and it represents a $1.5 Billion market. Doctors wrote 9 million prescriptions last year. One expert stated, “And guess what? It’s harder to kick than heroin.” Insurance companies encourage its use, allegedly, because users don’t need to go into detox, which costs insurance companies money. Many experts rejected claims of its benefits, because “it undermines the brain’s ability to present as one’s authentic self.”
Without “full surrender to abstinence, people cannot engage in recovery and 12-step (programs) as their own, real, authentic selves,” said the CEO of a recovery program. Otherwise, claimed many experts, people trying to recover can remain isolated and addicted.
“Full surrender” to medication-free recovery made a suboxone prescription sound sketchy, at best. But there is no question that some specific co-occurring disorders warrant medication.
4. Pornography addiction is a big ugly taboo problem. It is impacting a lot of folks, particularly 12-16 year olds who watch online. It has serious implications for brain receptors, in terms of the stimulation, even compared to what certain drugs do to the brain. I don’t know anything more, but will keep you posted.
The many dedicated professionals were on hand at CORE who are committed to helping people recover and lead full and happy lives – they were nothing short of inspiring. I am so glad I was able to attend and learn more about what they do, how they help others. Want to learn more about CORE?
You are not alone. But it’s time to get help, whether you think you need it or not. Talbott Recovery Atlanta and Aspen Group provided me with the same document on Anger. It offers rich insight and advice.
The document suggests first answering these 5 questions:
Do you feel guilty for your rage?
Do you feel remorse for hurting others?
Are you or others embarrassed by your behavior?
Are you disappointed in yourself?
Are you afraid you may hurt someone in anger?
Do you feel hopeless and/or full of shame?
What is Anger?
Well, it’s quite simply a response to stress that usually comes from inaccurate perceptions of events. And contrary to what some might think at a given moment, it is generated from thoughts and beliefs that CAN BE CHANGED.
Anger Is Called the Great Manipulator
It is often used to manipulate others into getting what they want, kind of the way bullies bully people to get what they want. And it might win in the short term, but rarely in the long term. Anger, sadly, can make people feel powerful and in control, even when they are not.
Anger is a Bad Habit
We make ourselves angry by engaging in angry thinking:
Judging an event as unfair or hurtful
Demanding (should and shouldn’ts/always and never)
You Know Your Triggers, So Move from Anger to Thinking
Breathe and count to 10 before responding
Take a time out away from the situation to cool off and gain perspective
Wash your hands in cool water and drink cool water
Ask for help from someone nearby who is calm
Set a time to talk or use a mediator
Choose your “battles” wisely
Have structure in place that outlines rules and expectation
Use an “I feel” statement
Take verbal accountability for hearing your anger: say “I’m sorry” and talk about what you choose to do differently
Enter a safety contract with your family to outline your strategy for intervening to stop acting out of anger
Anger Hurts Teens
It leaves a teen feeling powerless, unable to change, fearful, alone, embarrassed, humiliated.
As a result, teens can feel revengeful, betrayed, falsely accused, rejected, stressed, inadequate, frustrated and guilty. It’s important to get on track and stay on track with teens.
Here are some self-help books that the document recommended.
Calming the Family Storm: Anger Management for Moms, Dads, and all the Kids by McKay and May bell
When Anger Hurts Your Kids by McKay, Fanning, Paleg, Landis. And check out these sites:
The Substance Abuse and Mental Services Administration (SAMHSA) is a remarkable organization dedicated to helping Americans, particularly recovery professionals and people in crisis, to better navigate substance abuse issues with better tools and information. It also performs research on programs and tracks and reports outcomes. This checklist is beneficial to any parent who is trying to make a decision about what comes next for their teen in crisis. Whether a parent is alone in this journey or working with a therapist, law enforcement office, or school counselor, the list is a dependable guide to understand quickly what one must look for in terms of support services.
When you are looking for a recovery program for your teen, here is a list of services that you should feel are required.
What about Weed? For parents who don’t think it is addictive, read this excerpt from an article published on CNN.
We now know that while estimates vary, marijuana leads to dependence in around 9 to 10% of adult users. By comparison, cocaine, a schedule 2 substance “with less abuse potential than schedule 1 drugs” hooks 20% of those who use it. Around 25% of heroin users become addicted.
The worst is tobacco, where the number is closer to 30% of smokers, many of whom go on to die because of their addiction.
There is clear evidence that in some people, marijuana use can lead to withdrawal symptoms, including insomnia, anxiety and nausea. Even considering this, it is hard to make a case that it has a high potential for substance abuse. The article continues, “The physical symptoms of marijuana addiction are nothing like those of the other drugs I’ve mentioned. Withdrawal from alcohol… can be life threatening.
I do want to mention a concern that I think about as a father. Young, developing brains are likely more susceptible to harm from marijuana than adult brains. Some recent studies suggest that regular use in teenage years leads to a permanent decrease in IQ. Other research hints at a possible heightened risk of developing psychosis.
Much in the same way I wouldn’t let my own children drink alcohol, I wouldn’t permit marijuana until they are adults. If they are adamant about trying marijuana, I will urge them to wait until they’re in their mid-20s when their brains are fully developed.”
Dr. Herbert Kleber, M.D., professor of Psychiatry, Columbia University, and pioneer in research and treatment of substance abuse, spoke at a National Center on Addiction and Substance Abuse (CASA) seminar on July 7, 2016. He stated that “…14 to 17 year old brains might not recover (from marijuana abuse) until they are 25 or older. “He also noted that edible marijuana can take one hour to kick in and can trigger a psychotic episode. Something to think about if you’re over 21 and consuming it in states where its sale is legal. For details that the professionals read on addiction, here is CASA’s most recent report on addiction.
12-Step Programs are communities whose members come from all walks of life. They share a set of guiding principles outlining a course of action for tackling problems including alcoholism, drug addiction and compulsion. Per Wikipedia, a 12 step program was originally proposed by Alcoholics Anonymous as a method of recovery from alcohol. The original Twelve Steps were first published in 1939; then they were adapted and became the foundation of other 12-step programs.
American Psychological Association summarized following as hallmarks of 12-step programs:
Many 12-step and AA meetings will group people by age segment (any by sex, and by newcomers versus longstanding members). A young teen or adult will probably hear about a circumstance much like their own if they get in a group that is more a reflection of them, as opposed to a group with lots of adults.
Here are a few characteristics of the program, which probably need to coincide with other programs or support:
www.al-anon.alateen.org for teens
www.alanon.org for parents
Atlanta has a big drug problem. So many programs exist for substance abusers. Where to begin is tricky, because each person’s problem is unique and different from another’s. Let’s start chronologically by age, with programs from young teens to young adults.
Psychology Today Magazine has a website where you can comb through numerous options and get a sense of not only what you might need, but also what might sound like a fit, after you have received an assessment. But on the left column, you can refine your search, quickly.
Wilderness programs for teens and young adults tend to jump-start the recovery and results process. For the most part, a teen needs to commit to such a program for at least 30 days, and while these programs are lauded for having quicker outcomes, some teens and young adults might need to stay up to three months. What’s more, insurance rarely pays for them, claiming they are “camps”, which is unfortunate. They carry a heavy cost, but many of the programs have scholarships and payment installments available.
While we are not endorsing Aspen Wilderness programs, their site provides a good explanation of what makes Wilderness popular. Some are located in Georgia and North Carolina. It is a good starting place, Click Here to learn more.
Substance Abuse and Mental Health Services Association (SAMHSA) has a good overview of what you need to be considering and keeping in mind as you get close to a decision.
Metro Atlanta Recovery Residences: gender specific programs and sober living environments that enable young adults to continue school or work. Scholarships are available, as well as male mentoring.
Kennesaw State University Center for Young Adult Addiction and Recovery – Focus is on the college student. Criteria are pretty demanding. Students need to be clean and sober for at least six months, have a certain GPA, and be willing to live in a sober community. Young adults who want to stay in college in a supportive community can find it here. But they must earn the privilege of participation with extended sobriety.
Talbot Recovery Center: 3 locations in Georgia and a free one hour assessment available.
For mental health issues such as depression, bi-polar and borderline personality disorders. Skyland Trail has a new Atlanta campus for young adults, as well. And they offer thorough assessments; but clients need to be 18 or older.
I didn’t write this, but I found it a while back and am searching for the author. It has been helpful to a number of friends, with thanks to countless professionals who care so deeply about our teens.
Teens in early recovery are extremely vulnerable to relapse. It can be hard to understand why a teenager would work so hard to achieve sobriety only to fall back into drug use−but that’s the power of addiction.
Studies suggest that between 50 to 90 percent of addicts relapse at least once in the first four years of sobriety, and most relapse many times. Triggers for relapse can be as mundane as hearing a certain song on the radio or as significant as hanging out with friends from the old drug crowd.
Although relapse is considered normal and predictable, knowing the common triggers for relapse and having an action plan can help teens and their families guard against any slip-ups. Here are a few common relapse triggers to watch out for:
Unless teens remain on guard, their thoughts will likely turn back to old behavior patterns when they are around the people or places associated with their past drug use. Old friends who still use drugs will use peer pressure, teasing and subtle manipulation to get a teen in early recovery to return to their “fun” old self. These friends may not be ready to confront their own drug use and will not respond positively to someone who questions their habit or forces them to take a look at their own behavior.
Each adolescent has their own set of high-risk friends, places and situations that they must sacrifice for the sake of their sobriety. In drug rehab, teens can practice ways to cope with those triggers, make new friends who don’t use drugs and find sober activities they can enjoy.
After maintaining their sobriety for a time, many teens want to “test” their willpower by going back to certain places or social situations. This can be risky and seldom makes teens feel more secure in their recovery.
While it’s risky to stay in touch with old friends who use drugs, it’s equally risky to be socially isolated. Teens in early recovery need to closely follow the relapse prevention plan they created during drug rehab. This plan likely includes attending 12-Step meetings and therapy sessions to get support from other people in recovery and to have someone they can go to when the urge to use arises. Without this support system, teens start to feel alone in their struggles, which may make them want to start using again.
Being around drugs of any kind can trigger a craving to use. Even the sight, smell or sounds associated with a drug can bring back memories of the way drugs made the teen feel, as well as an overwhelming desire to use again. Most teens in early recovery will need to get rid of all paraphernalia, photos or any other item related to drugs or alcohol in order to avoid temptation.
A common pitfall for teens is thinking they can use drugs, as long as they avoid what used to be their drug of choice. So if they were hooked on painkillers, they figure it’s safe to drink alcohol. The reality is that addiction to one drug easily transfers to another drug (and even other compulsive behaviors like video game addiction, gambling and spending). If a teen has abused drugs before, they will likely need to abstain from all mood-altering substances for the rest of their life.
Many teens first start using drugs to cope with stress brought on by school, relationships or home life. Although adolescents learn new coping skills in drug rehab, it is common to revert back to old methods when life gets tough.
Before drug rehab, when conflicts arose, drugs or alcohol would allow the teen to escape the situation. Now, the teen must practice new ways of coping, such as taking a walk, calling a friend, journaling or some other form of healthy expression.
Establishing a daily routine, including getting up at a certain time or joining a club that meets regularly, may help teens maintain a sense of control in their lives. While predictability can help, teens will eventually have to learn to accept that they cannot control everything.
Self-confidence and an optimistic outlook are protective factors against relapse, but over-confidence is one of the most common reasons for relapse. The 12-Step principles remind teens that humility and an admission of powerlessness over addiction are essential for lasting recovery. But after staying sober for a period of time, some teens are so proud of their accomplishments that they don’t think they need to follow their relapse prevention plan anymore. They stop attending meetings and become less vigilant in monitoring their emotions and cravings.
A close cousin to over-confidence is complacency. Some teens in early recovery start to take their sobriety for granted. They become complacent, assuming if they’ve been able to maintain their sobriety for a certain amount of time, they no longer need to monitor their mental state, attend meetings or follow their relapse prevention plan with the commitment they started with.
In many cases, teens begin to wonder if they can use only occasionally or have just one drink without returning to their addiction. They want to prove to family and friends that they no longer have a problem. Unfortunately, complacency often leads to relapse.
Addiction frequently goes hand in hand with mental illnesses such as depression and anxiety. Something that aggravates an underlying mental illness can also trigger the desire to use drugs or alcohol. Teens with co-occurring disorders require dual diagnosis treatment that addresses both their substance abuse and psychiatric illness. After formal treatment ends, they also need to carefully monitor their state of mind through journaling, therapy and other forms of self-reflection.
Physical illness is also problematic, particularly if a doctor prescribes painkillers or other drugs as a form of pain management. Teens who self-medicate a mental or physical illness may find themselves becoming dependent on drugs of relief. For this reason, self-care is essential. A healthy diet, exercise and adequate sleep will help guard against exhaustion and physical illness.
Though it may seem counter-intuitive, positive life events and emotions can also trigger relapse. For example, getting straight A’s, falling in love or getting into a good college could be cause for celebration and reignite the desire to use drugs.
If an adolescent spends time thinking obsessively about how it felt to be high or telling “war stories” to friends about past drug use, this is an indication that relapse is imminent.
Without drugs, many teens in recovery don’t know what to do with their free time. A bored teen is a teen who is asking for trouble. Drugs are exciting; there are other activities and hobbies that are equally thrilling without the high level of risk. Teens can get involved in rock climbing, white water rafting, or some other adventure sport. They can also keep busy with school activities, clubs, sports, exercise or hanging out with sober friends.
We all want life to go out way, but even the most fortunate among us won’t always get what we want. Many teens fall into the trap of self-pity; feeling impatient that recovery isn’t happening fast enough, wondering why they have to deal with addiction and rehab, and questioning why other people can go out for a drink with friends and they can’t. They begin to feel entitled to have a drink or use drugs because they’ve been sober and worked so hard.
Though it isn’t fair, this is the reality of addiction. It’s better to accept the good and bad life deals rather than feeling like a victim.
So you have found a program. And you are aware that it is time to pile in the car and get to an intensive outpatient center (IOP) or inpatient program. It’s time to get real answers, for your unique, specific crisis. Understanding what different programs offer is critical to knowing that your child or loved one will get the help that they really need. Here are some questions that will help you differentiate programs, along with suggestions for what else you should expect before sending someone you care about to an IOP.
It’s OK. A lot of recovery centers are for-profit. A lot are not. Many do not offer outcomes reporting or track for them. But they should be able to provide family references to contact.
Detailed learning for parents can be found at The American Academy of Adolescent Psychiatry website.
This site also has another great resource of questions to ask a program or facility which can be found at this link.
Before you say anything to your child, take a deep breath. Remember that hope and optimism are key components to restoring health. And that 50% of a problem is resolved once we know what the problem is.
The best way to find out just what is happening is to remain calm and ask what’s going on. A lot of times, kids will tell us. Next step might be an intervention in which the parents address a behavior change, describe what happens when the behavior changes, and ask again for an explanation. The best tools to get you ready for the conversation start here:
CRAFFT is a rapid assessment you can ask your teen to take. It is an acronym of first letters of key words in the 6 screening questions. The questions should be asked exactly as written.
CRAFFT is a 2009 MassHealth insurance provider-approved behavioral health screening tool for use with children under the age of 21 from 2009. It was recommended by the American Academy of Pediatrics’ Committee on Substance Abuse for use with adolescents.
There are more questions to ask when confronting your child about drug abuse. Learn different approaches and decide what is right for you.
Arrested development is behind a lot of teen substance abuse. This will help you understand why the problem is not specific to your teen. And P.S., Hazelden Programs can help you with a phone assessment of your family’s drug problem.
click on this link to get access to more great materials. Click Here.
Every teen substance abuse issue is different. So relying on hear-say or sound bits from others, while a start, will not help your teen recover from an alcohol arrest or a drug problem.
You need help. You need it now. Here’s the core of what you need to know. It’s more than a drug guide. We’ve listed links or downloads for the best insights to answer “what now?”
The chart on the link below has valuable info. It describes street names of drugs so you know what to look for in a text. It explains how drugs are used, what they look like, why they’re dangerous, and it includes statistics and signs of abuse. Note to self, “contrary to popular believe, marijuana can be addictive.” Download it now! From Partnership ™ for Drug-Free Kids.
Another Easy What You Need to Know. This link has an exploded view of every drug that teens are misusing today, with detail and dangers on each. We have Federal tax dollars to thank for this comprehensive, user friendly link. Courtesy of National Institute on Drug Abuse.
Take the assessment to figure out what really might be going on. Then have your loved one who’s suffering take one. This comes by way of Haselden Betty Ford Foundation, which has other helpful resources and programs for youths and young adults, even for parent who need help dealing with their children. View this resource here.
Here are a few other helpful resources. You can get a free assessment at Talbott Recovery in Georgia. Another option: make a call for free one hour assessment for young adults . Talbott Recovery 800-861-4290 Dunwoody Campus 404-952-2500. Or check them out online.
Don’t let the word addiction frighten you. This 7 page document is a comprehensive snapshot of what you and your teen can do now to get help – the right help.