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:
Figuring out what program, what approach, is right for your teen or young adult — is no easy decision and is best evaluated with a professional substance abuse counselor. NIH National Institute on Drug Abuse states, “Research studies on addiction treatment typically have classified programs into several general types or modalities. Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications.”
Most, however, start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use. As stated previously, detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. Detoxification should thus be followed by a formal assessment and referral to drug addiction treatment.
Because it is often accompanied by unpleasant and potentially fatal side effects stemming from withdrawal, detoxification is often managed with medications administered by a physician in an inpatient or outpatient setting; therefore, it is referred to as “medically managed withdrawal.” Medications are available to assist in the withdrawal from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.”
NOTE: If your child does not need to detox, he still might need intensive residential treatment. So first assess the extent of the problem. People who need to detox can die if they skip that step. Here are some programs. For detail, visit this NIH link about different types of programs.
Long-term Residential Treatment programs provide care 24 hours a day, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC), with planned lengths of stay of between 6 and 12 months.
These programs provide intensive but relatively brief treatment based on a modified 12-step approach. These programs were originally designed to treat alcohol problems, but during the cocaine epidemic of the mid-1980s, many began to treat other types of substance use disorders. They consisted of a 3- to 6-week hospital-based inpatient treatment phase, followed by extended outpatient therapy and participation in a self-help group, such as AA.
These programs vary in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs, school commitments, or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education.
Group counseling capitalizes on the social reinforcement offered by peer discussion and to help promote drug-free lifestyles. Research has shown that when group therapy either is offered in conjunction with individualized drug counseling or is formatted to reflect the principles of cognitive-behavioral therapy or contingency management, positive outcomes are achieved.
These programs are exactly what they sound like. Wilderness programs use wilderness expeditions for the purpose of therapeutic intervention. A range of programing exists, and the philosophy behind it is to use “experiential” outdoor education to create positive outcomes in the areas of self-concept and self-esteem, along with improved social behaviors in areas such as trust and mutual support. Many therapists I have encountered believe this is an “efficient” approach for teen and young adult males, relative to other options.
Insurance providers in general offer limited or no coverage for these programs. Even court ordered programs usually require an out-of-pocket spend.