Celebrating the Holidays with Recovering Family Members and Friends

This time each year can be stressful for anyone, but the holidays present a special challenge for people recovering from a substance use disorder. Those in long-term recovery typically are adept at navigating the minefield of temptation at holiday social gatherings. But many of those in their first year of recovery, their friends, and family members wonder how best to celebrate the holidays safely, comfortably, and joyously.

If your festivities will include someone with a year or more in recovery, you may simply want to ask if there is anything you can do to make the holiday better for them. They may want to bring a friend who’s also in recovery. They may have beverage preferences or want the flexibility to step out for a short while, either to attend a mutual aid meeting (e.g., Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery), make a call, or get some fresh air.

The holidays may come with expectations, such as shopping, travel, cooking, and multiple social gatherings. People in early recovery are often experiencing difficult personal or financial circumstances while at the same time trying to learn to live without the substance that had become central to their lives. While the holidays are a time to celebrate family and good cheer, they are also a time when other feelings can be heightened. Such feelings can include a sense of loss about a deceased family member, or feelings of hurt, resentment, anger, shame, or guilt about the past on the part of the recovering person, other family members, or both.

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Father and Son with a Thanksgiving Spread

Early recovery brings reawakened awareness of the harm one caused oneself and one’s family and friends during the course of the addiction. It is also a time when the brain and body are still actively recovering from the effects of addiction. Those in early recovery are relatively new at learning to experience, process, and manage feelings and to function in social situations without the use of a substance. Alcohol or other drugs may have served the recovering person as a social lubricant during the early stages of their use, helping alleviate social anxiety and feelings of not fitting in while simultaneously lifting their guard, making it easier to speak and act spontaneously.  The social events of the holidays can be challenging in a number of ways for the individual who is new to recovery.

Fortunately, many in early recovery do well during the holidays. The experience of sharing the holidays with family or friends can strengthen their recovery and reinforce the value of the fuller, more authentic way of life they are entering. The holidays can, in effect, be a time to reconnect and restore. To help foster a positive holiday environment for those in recovery, please keep in mind the following:

Tips for celebrating the holidays with family or friends in early recovery:

  1. You are not responsible for your guest’s recovery, even if that guest is your child, sibling, or parent.Behind the scenes orchestration to “help” the recovering person through the event can sometimes be unhelpful. Instead, reach out to him or her to see if there’s anything you can do to help the event  go smoothly. If you do, be ready and willing to accept “No, thank you” as the answer.
  2. Ask yourself if you and your family are ready to celebrate the holiday with the recovering person. Are there unresolved hurts or resentments that could make the holiday difficult for all? Does your family understand addiction and embrace recovery or is the topic shrouded in shame, an “elephant in the room”? Addiction affects not only the addicted individual, but the family as a whole. Denial or shame around addiction, if not appropriately addressed, can make the holiday difficult for the family and risky for the recovering person. So, it’s worth asking:Are you and your family ready?
  3. Ask your friend or family member if they are comfortable taking part in the celebration this year. Make sure they understand that it is perfectly OK to miss the celebration if that is what is best for their recovery. Their recovery comes first. It’s better to miss them this time around in order to increase the likelihood that they will be alive, well, and able to participate in future events.  Think of it as an investment that will pay dividends.
  4. If you will be serving alcohol, check to see if your invitee is comfortable with that. Note, even if you’re willing to host an alcohol-free holiday event, your family member or friend might not be comfortable attending if alcohol is not served simply because he or she is present.
  5. Ask if they’d like to invite someone or invite others who do not drink. Regardless of whether alcohol is served or not, the recovering person may want to invite a recovering guest. If you’re serving alcohol and have family members or friends who are in recovery or who do not drink, you may want to ask your guest if he or she would like you to invite them so that there will be other non-drinkers with whom to socialize.
  6. Ask what kinds of beverages they would like to have. While non-alcoholic “mocktails” may seem like a good idea—and many in recovery do enjoy them—they  may actually be a trigger for some people in early recovery, either because they visually remind the guest of cocktails or because they remind the individual that he or she can no longer drink. Despite all the pain and aggravation that alcohol and drugs may have caused the recovering individual, giving them up can result in a powerful sense of loss. Beverages such as hot spiced cider, hot cocoa, iced or hot tea or coffee are often welcomed. Some people in long-term recovery drink so-called “non-alcoholic” beer and wine. If this works for them, it is of course perfectly acceptable. It should be noted, though, that these beverages generally do include small amounts of alcohol. For people in the early stages of recovery from alcohol addiction, these beverages should be avoided.
  7. Provide time and space to step away from the group, if needed. Being able to take a walk, relax in a quiet room, step away to connect by telephone with another person in recovery, attend a mutual aid meeting, or gracefully depart early can be very important to a person in early recovery.
  8. Listen to them. If they don’t want any special steps taken to accommodate them, and both you and they are comfortable with them taking part this time, then simply go ahead.

    Tips for individuals or families in early recovery:

    • Have a plan for the holiday, including mutual aid meetings and calls to sponsor, mentor, recovering peer, counselor, clergy or others central to your recovery.
    • Identify risk factors that should be avoided and know how you will respond if they’re encountered.
    • Know your signs of potential relapse and take steps to address them.
    • Stay in touch with your key supports, such as counselors, sponsors, mentors, or recovering peers.
    • Keep it all in perspective: Nothing that happens, no matter how painful or unpleasant, is worth giving up one’s recovery.
    • If relapse does, occur, don’t delay acting out of shame or guilt. Get help immediately. There is still an opportunity to build on the progress you’ve made.

Link to original article here: Celebrating the Holidays with Recovering Family Members and Friends

For opiate addiction, study finds drug-assisted treatment is more effective than detox

Say you’re a publicly-insured Californian with an addiction to heroin, fentanyl or prescription narcotics, and you want to quit.

New research suggests you can do it the way most treatment-seeking addicts in the state do — by undergoing a medically-supervised “detoxification” that’s difficult, expensive and highly prone to failure.

Or you can try to quit the way that addiction researchers now widely agree it should be done (but rarely is): by combining abstinence programs with long-acting opioid medications such as methadone and buprenorphine, which allow patients to slowly wean themselves off their dangerous habit.

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Using drugs to treat opiate addiction is more effective and cheaper than detox programs, a new study says.

Neither method is easy, nor by any means failure-proof. But for each patient funneled into the second form of treatment, known as opioid agonist treatment, instead of the first, a study published Monday shows that taxpayers could reap substantial savings — $78,257 a person. And the patients themselves stand to gain longer and better lives.

Deep into a crisis of opioid addiction that claims 91 lives a day and holds close to 2.6 million Americans in its grip, the United States continues to suffer a yawning gap between what it knows about treatment and how the opiate-addicted are actually treated.

Close to 80% of those with an opioid-use disorder weren’t getting any treatment at all in 2015. Of the small sliver of those who did get some treatment, fewer than half in California got the kind of open-ended opioid agonist treatment that addiction researchers widely agree is most likely to lead to abstinence.

In fact, California, the state with the nation’s largest population of people with opiate addiction, still has regulations on the books that favor detox over opioid agonist treatment. For patients who are publicly insured, the state requires proof that a patient has tried detoxing two times or more and subsequently relapsed before it will pay for treatment with methadone or buprenorphine.

California’s Society of Addiction Medicine has said that medically managed withdrawal by itself should not be considered treatment of opioid use disorder. And exemptions to the state’s requirement are thought to be widely granted. Still, the language remains.

Published Monday in the Annals of Internal Medicine, the new study underscores that public policies that limit access to treatments such as methadone or buprenorphine don’t just shortchange patients who need help quitting; they’re costly to taxpayers footing the bill for their treatment as well.

If just one year’s worth of treatment-seeking opiate addicts were to get opioid agonist therapy instead of detox, the societal savings over the patients’ lifetimes would amount to $3.869 billion, the new study estimates.

Those patients would be in treatment longer, and the immediate cost of their treatment would increase, the new research finds. But over time, their increased likelihood of getting and staying clean would translate into lower downstream healthcare costs, a decreased likelihood of HIV infection (along with the costs of treating it), and less costly involvement with the criminal justice system.

“We believe our findings really do represent the reality in California,” said the study’s senior author, Bohdan Nosyk, a health economist with British Columbia’s Center of Excellence in HIV/AIDs. “The findings were really robust and, as new people come in, the savings will accumulate. So the numbers are conservative.”

Nosyk’s co-authors included addiction and epidemiological experts from UCLA’s Integrated Substance Abuse Programs and the Veterans Affairs Greater Los Angeles Healthcare System of Los Angeles.

In an editorial published alongside the study Monday, Drs. Jeanette M. Tetrault and David A. Fiellin said the new research strongly suggests that lawmakers should be using their policy clout to promote outpatient clinics that treat opiate addicts in their communities rather than costly inpatient units where patients go to detox.

“Threats to healthcare funding may have lasting consequences, especially if lawmakers do not heed the most science-based and policy-applicable data as decisions are being made,” wrote Tetrault and Fiellin, both Yale University internists with interests in addiction medicine.

Written by: Melissa Healy

Link to original article here: For opiate addiction, study finds drug-assisted treatment is more effective than detox

 

3 Tips for Getting Through the Holidays Sober

It’s the most wonderful time of the year…. until it isn’t.

If you’ve walked into any major retailers lately there’s no denying that the holidays are upon us. True, the turkey hasn’t yet been served on Thanksgiving, but the marketing, holiday music and many social engagements are already all around.

When you were a kid the holidays may have been the most wonderful time of year, filled with gift-giving, family visits and parties. When you’re an adult, however, all of that can seem overwhelming, particularly if you’re trying to go about it sober.

“We hear so often in recovery circles that the holidays are really challenging and difficult,” said Nell Hurley, the executive director of alumni and recovery support at the Hazelden Betty Ford Foundation. “Everything is heightened around the holidays: pressure, expectation, stress and even joy.”

All of that holiday spirit can be overwhelming, so it’s key to have a plan for dealing with holiday stress and coping in a healthy way, rather than turning to drugs or alcohol.

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“At least for me as an addict, I always dealt with any emotion — stress, anxiety, sometimes even joy — by trying to dampen it with the use of alcohol,” said Hurley, who has been in recovery for nearly 20 years.

Here are some tips for staying focused on sobriety this holiday season:

1. Give Yourself The Gift Of Recovery

This holiday season put yourself on the top of your gift-giving list. The most valuable thing that you can give yourself is a continued investment in your recovery. Whether you are newly in recovery or have decades of sobriety under your belt, build in extra support during this busy time of year. Don’t let holiday demands derail you from going to meetings, since you probably need them more than ever this time of year. When you’re not in the rooms, take time for other self-care that keeps you connected to your recovery.

For Hurley, one gift that sobriety brings is the ability to take control of her life.

“That is the thing that I am most grateful for, the ability to make choices,” she said. “In active addiction my brain was always getting hijacked and I didn’t have the ability to make healthy choices. In recovery, we have the freedom and ability to make choices that we never had in active use.”

2. Be Firm With Your Family

Much of the stress around the holidays comes from interactions with family, particularly if you come from a family that is dealing with cycles of addiction.

“So many of us struggle with family and those relationships,” Hurley said.

“Whether we’re in recovery or not, we tend to adopt our parents’ traditions around Christmas, but being in recovery is about being able to finally make choices,” she said.

That includes deciding what you want your holidays to be like and setting firm boundaries when necessary.

“Do that reflection to decide what do you want on Christmas. What does New Years look like to you?” Hurley says. “Do what nurtures you and fills your cup, rather than defaulting to other people’s expectations.”

3. Slow Down

The holiday season can rush by in a blur, leaving us emotionally drained, exhausted and broke come January. Don’t let the holiday madness sweep you away this year. Instead, find quiet time to reflect on what sobriety has meant for you and for your relationships with the people you love.

“For me the whole key to learning how to do things differently has been around slowing down,” Hurley said. “Before getting into recovery, I’ve been on autopilot my whole life, reacting to situations, stress, anxiety and fear with alcohol. Being able to learn how to be present and feel it all, let it all in, and do it sober has been really hard, but also the thing that has allowed me to open up to my experiences.”

During the holiday season that might mean being aware of your discomfort around certain traditions or people.

“Recognize how you feel rather than powering through it,” Hurley said. “Recognize your reaction and your emotions like anxiety or whatever it is that’s going on.”

Then, rather than reverting to old coping mechanisms, decide on a healthier way forward.

“We need to give ourselves permission to do things differently,” Hurley said.

By: The Fix Staff 11/14/2017

Link to original article here: 3 Tips for Getting Through the Holidays Sober

 

ASU study: Communication is key for keeping your kids off drugs

It might be a difficult conversation to have, but a new study confirms that talking to your children about substances will help keep them off drugs.

The research, led by Jonathan Pettigrew, assistant professor in the Hugh Downs School of Human Communication, was recently featured in the New York Times article, “When Your Teenager Asks ‘Did You Smoke Weed?’”  The article highlights Pettigrew’s research that parents who provide direct information, guidance or advice about substances like marijuana, have adolescents who are less likely to experiment with drugs.

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A group of teenagers smiling for a selfie portrait.

“Warm families that welcome conversations on a variety of topics actually help prevent substance abuse,” said Pettigrew, who specializes in adolescent behavior.

Pettigrew collaborated with a team of researchers. They questioned more than 3,000 seventh and eighth grade students from 39 rural schools in Pennsylvania and Ohio about their use of alcohol, cigarettes and marijuana, the most commonly used substances in early adolescence.

Most of the students reported that they have talked with their parents about drug use.  Those who hadn’t talked to their parents were more likely to report that they had tried illegal substances.

“This finding is important to share with parents, especially given that these substances are often believed to pave a path toward more problematic substance use,” Pettigrew said.

He says that because youth hear direct messages about substances from the media, peers, and prevention programs, “parents, too, should join the conversation with their children.”

The good news is that students reported that their parents are the individuals with whom they are most likely to talk about substances, and consider credible sources of drug information.

“The cultural stereotype of a rebellious teen is a bit overblown,” Pettigrew said. “Sure it happens, but not for everybody, and not the majority.”

At what age should you have “the drug talk” with your children?

“The foundation needs to be laid in seventh and eighth grades,” Pettigrew said. “If parents are  laying out their expectations, maintaining warm friendships with their children, and handling conflicts well, then they are setting themselves up for later on when their child says ‘I have a friend who wanted me to smoke weed with him, but I wanted to talk to you about it.’”

Jonathan Pettigrew is also an affiliate scientist with ASU’s REACH Institute, which endeavors to increase community access to prevention programs and advance research, education and the health and well-being of children and families.

Link to the original article here: ASU study: Communication is key for keeping your kids off drugs

Survey: nearly half of Americans have a family member or close friend who’s been addicted to drugs

It’s a statistic that shows America’s drug addiction crisis is truly an epidemic.

This is America on a drug addiction epidemic: Nearly half of US adults have a close friend or family member who’s been addicted to drugs.

That comes from a Pew survey of US adults conducted in August, which found that 46 percent meet the criteria.

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It’s not just opioids. According to the National Survey on Drug Use and Health, in 2016 approximately 20.1 million Americans 12 or older had a substance use disorder. About 2.1 million had an opioid use disorder. The biggest group was for alcohol use disorder, with about 15.1 million reporting an alcohol addiction. (A caveat: Since the survey is based on households’ self-reports, these are very likely underestimates.)

But opioids have been the key driver of the recent US increase in drug overdose deaths, from nearly 17,000 overdose deaths in 1999 to more than 64,000 in 2016. We don’t have reliable drug-by-drug data for 2016 yet, but over the previous few years nearly two-thirds of overdose deaths were linked to opioids.

Last week, President Donald Trump declared the opioid epidemic a public health emergency — activating a very limited set of tools to address the crisis. This week, his opioid commission is expected to release its final recommendations on dealing with opioids.

The opioid epidemic goes back to the 1990s, with the release of OxyContin and mass marketing of prescription painkillers, as well as campaigns like “Pain as the Fifth Vital Sign” that pushed doctors to treat pain as a serious medical problem. This contributed to the spread of opioid painkiller misuse and addiction, which over time also led to greater use of illicitly produced opioids like heroin and fentanyl. Drug overdose deaths have climbed every year since the late ’90s as a result.

Last week, President Donald Trump declared the opioid epidemic a public health emergency — activating a very limited set of tools to address the crisis. This week, his opioid commission is expected to release its final recommendations on dealing with opioids.

The opioid epidemic goes back to the 1990s, with the release of OxyContin and mass marketing of prescription painkillers, as well as campaigns like “Pain as the Fifth Vital Sign” that pushed doctors to treat pain as a serious medical problem. This contributed to the spread of opioid painkiller misuse and addiction, which over time also led to greater use of illicitly produced opioids like heroin and fentanyl. Drug overdose deaths have climbed every year since the late ’90s as a result.

The issue has really turned into two simultaneous crises — which Keith Humphreys, a Stanford University drug policy expert, has described as the dual problems of “stock” and “flow.” On one hand, you have the current stock of opioid users who are addicted; the people in this population need treatment or they will simply find other, potentially deadlier opioids to use if they lose access to prescribed painkillers. On the other hand, you have to stop new generations of potential drug users from accessing and misusing opioids.

Addressing two crises at once will, obviously, require a lot of resources. But as I previously explained, we have a pretty good idea of what these resources would go to: They could be used to boost access to treatment, pull back lax access to opioid painkillers while keeping them accessible to patients who truly need them, and adopt harm reduction policies that mitigate the damage caused by opioids and other drugs.

Some states are attempting to confront this issue. Vermont, for example, has built a “hub and spoke” system that treats addiction as a public health issue and integrates treatment into the health care system. Potentially as a result, the state was the only one in New England to have a drug overdose death rate below the national average in 2015.

Link to the full article here: Survey: nearly half of Americans have a family member or close friend who’s been addicted to drugs

Success Story: MAT, Combined with Counseling, Working for North Carolina Woman

Lona Currie is alive. She’s lucky and she knows it, but for a long time, she only wished she would die. That’s the depths that her addiction and co-occurring depression had taken her before she finally found the treatment she needed to recover.

Lona, 43, began drinking alcohol excessively when she was just 11 years old while spending the weekend drinking with her father. She realized even at that young age that alcohol would take away the pain of a childhood filled with mental, sexual, and physical abuse at the hands of her stepfathers. Making matters more complicated, she realized at a young age that she was gay, something that was not readily accepted in the small towns in North Carolina and Alabama where she grew up. When she was 14, she discovered opioids in her grandmother’s medicine cabinet and “found something that could take every wrong in your life and make it tolerable. I found out what happiness and joy was.”

“There’s a big difference between someone who gives you medication and someone who wants to cure you.”  -Lona Currie

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Now, Lona is a fierce advocate for the use of medications for treatment paired with counseling to treat her opioid use disorder. She knows firsthand that taking a medication alone without counseling does little to address her underlying causes of addiction. “People think just the medicine will do the job, but the rest is in the head.”

In Lona’s case, depression and a childhood filled with physical and emotional abuse fueled her disorder, one that could not be adequately addressed until she began a regimen of methadone paired with counseling. “There’s a big difference between someone who gives you medication and someone who wants to cure you,” Lona says.

But the road Lona had to take before finding a treatment that worked for her was challenging.

After a stint in the Army, Lona suffered an undiagnosed stomach condition and was a frequent visitor to emergency rooms and clinics. Soon, she was identified as someone who was misusing opioids, and clinicians refused to prescribe her more, so in an effort to stop the pain she turned to black tar heroin. Though she took any drug she could get her hands on-cocaine, heroin, marijuana-after 1996, it was all opioids, and as often as possible. She overdosed three times, and was revived by Narcan each time, and once spent a week in a coma.

“I was losing people I loved and I was angry it wasn’t me,” she says. “There’s nothing positive in the life” of a person with an opioid addiction.

Each time she sought treatment, which she did numerous times, she faced the stigma that so many of those addicted to opioids face. “When you’re addicted, it’s important to tell the truth,” she says. “But you’re not honest because you are treated so badly when you do tell the truth.” She’d tried methadone alone, and it worked-for a while. When she relapsed that last time for nine months, it changed her life.

“I got to a place where I said, ‘I just don’t want to do this anymore.'”

That’s when she found the program she is still in today and credits it for saving her life. Her wife, who also has an opioid use disorder, has been in recovery one and a half years. While Lona has found methadone to be most effective for her, her wife has found success with buprenorphine to treat her opioid use disorder.

Now, even small things are huge victories: holding a steady job, creating a budget, paying bills. “I learned how strong I am,” she says.

Do you have a success story?

PCSS Projects wants to hear about your positive outcome, changes in your prescribing practices, community efforts, etc.

Email Jane and share your success story with her!

 

8 Care Principles to Improve Substance Use Disorder Treatment

Task force cites medication-assisted treatment, universal screening as key to better outcomes.

More than 20 million Americans struggle with substance use disorder (SUD), and upwards of 33,000 people died from opioid overdose in 2015. Fortunately, effective treatment exists. Medication-assisted treatment (MAT), which pairs U.S. Food and Drug Administration-approved drugs with behavioral therapies, reduces both illicit opioid use and overdose fatalities.

But access to MAT remains elusive for many people largely because treatment providers do not always provide their patients with the evidence-based care shown to be most effective. Public and private payers can play a key role in addressing this problem by encouraging their enrollees to use providers who deliver high-quality, evidence-based care and rewarding those who do.

As a needed step in this direction, the new Substance Use Disorder Treatment Task Force— launched last spring by Shatterproof, a national nonprofit organization dedicated to the implementation of evidence-based solutions to address the SUD epidemic—created a list of national principles of care for SUD treatment to help guide effective care. These eight evidence-based principles have been shown to improve health outcomes and save lives. Sixteen insurance companies have agreed to identify, promote, and reward SUD treatment that aligns with these principles, which are:

  1. Universal screening for SUD across medical care settings.
  2. Personalized diagnosis, assessment, and treatment planning.
  3. Rapid access to appropriate SUD care.
  4. Engagement in continuing long-term outpatient care, with monitoring and adjustments to treatment.
  5. Concurrent, coordinated care for physical and mental illness.
  6. Access to fully trained and accredited behavioral health professionals.
  7. Access to FDA-approved medications.
  8. Access to nonmedical recovery support services.

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The task force brings together public and private payers as well as advocates, policymakers, and other stakeholders. The Pew Charitable Trusts hosted the inaugural meeting of the task force this fall, during which members met to outline and discuss principles of care. Following that meeting, the group refined and reached consensus on the final list, with principles based on research from the past 30 years, including recommendations from the 2016 “Facing Addiction in America: Surgeon General’s Report on Alcohol, Drugs, and Health.”

The task force will continue its work by focusing on implementing the principles, providing a platform to learn and share innovative strategies, and measuring the initiative’s success. In particular, the task force will examine the possibility of establishing a process for certifying providers who have implemented the principles. It will also engage with the broader stakeholder community in the next phases of work.

By joining together, patients, providers, and payers have the opportunity to dramatically increase the quality of substance use treatment in the United States. Incorporating these evidence-based principles of care in insurance programs is a much needed step forward in addressing the opioid epidemic and improving the lives of people with SUD and their families.

Link to original article here: 8 Care Principles to Improve Substance Use Disorder Treatment

Fault Lines Documentary on Addiction Features Chillicothe

CHILLICOTHE – Four young girls bounce on a trampoline, laughing just before the sounds of a 911 call cut in: “My mom is on the floor and my step-dad’s face is pale and they’re not waking up.”

The juxtaposition of what should be a carefree childhood with the reality hundreds of Ohio children are facing is how the newest Fault Lines short documentary “Heroin’s Children” opens. While the child’s 911 call and other children’s calls in the 25-minute documentary are from elsewhere in Ohio, the intimate stories shared are Chillicothe residents.

Fault Lines, which is Al Jazeera English’s Emmy and Peabody award-winning documentary program, is the latest of a seemingly never ending line of non-local news and documentary programs drawn to Chillicothe to show the toll the opiate epidemic is taking on the community, the state, and across the nation.

While seemingly being the poster child of an epidemic has been trying for the community, Fault Lines Senior Producer Laila Al-Arian said it was the willingness of the community to talk openly about addiction that attracted her attention.

“When I started doing research about the impact of the heroin crisis on children, I came across some great reporting from Chillicothe, including local profiles and pieces in the Gazette. Unlike a lot of other cities and towns across America, it’s clear that many people in Chillicothe are open to speaking about their experiences with drug addiction, so we found that many doors were open to us,” Al-Arian said via email.

“The fire chief, police captain, mayor, school principal, hospital and so many others were so open about giving us access to their spaces and their lives. The prevailing attitude that we came across in Chillicothe is a willingness to tell this story because only when people can see it for themselves will they be able to grasp the severity of the problem … During a time when there seems to be so much suspicion and mistrust of the media, we found it refreshing that people saw a point to meeting and talking with a crew from Washington DC.”

The documentary is emotionally intense. Josh Rushing helps guide the conversation, presented from different perspectives. There’s Amanda Howard who shares how the grip of heroin addiction impacted her ability to be a mother; Tisa Beeler who talks about raising her four granddaughters; and Alexis Lightle who heartbreakingly struggles with wishing her parents had never been addicted to drugs even though it means she’d never been born.

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Alexis Lightle sits at her father Andrew Lightle’s grave at Grandview Cemetery in a scene for Fault Lines’ short documentary “Heroin’s Children.” Andrew died from a drug overdose in November 2015.

“Their lives are even more precious than my own, I think,” Lightle told Rushing, wiping away tears. Her dad, Andrew Lightle, died of a drug overdose in November 2015 – one of 40 who died of drug overdoses in Ross County that year.

“Heroin’s Children” also touches on community solutions through a visit to Adena Regional Medical Center where Donna Collier-Stepp runs a program for pregnant women who are addicted to drugs. While Rushing was there, women shared their shame, guilt, and fears.

“The women were incredibly strong and brave, and wanted to tell their stories in order to help others. So many of them said they were tired of the stigma associated with drug addiction and that they were willing to speak on camera because if they could help one person or one family, it would have been worth it,” Al-Arian said.

The documentary also went along with the Chillicothe Fire Department to a double overdose on Clay Street where there’s also a woman holding a baby talking to first responders. Ross County Coroner Dr. John Gabis appears in the documentary, referring to the epidemic as the black plague, a zombie apocalypse.

While the Fault Lines crew saw a variety of different ways Chillicothe is attempting to combat the opiate epidemic, such as the drug-free school programs and efforts by the Heroin Partnership Project, Al-Arian said they could only fit so much into a short documentary and wanted to really focus on intimate stories. However, she said they are planning additional shows where they intend to delve more into how communities are responding to the opiate epidemic.

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Chillicothe Fire Department personnel roll a man on a gurney to an ambulance after a drug overdose at a Clay Street home earlier this year. A crew from Fault Lines road along to the call where two people had overdosed during filming for the short documentary “Heroin’s Children.”

“It was … inspiring to see how Chillicothe as a community is coming together to really openly talk about the issue and do something about it, including the program at Chillicothe High School that encourages kids to be drug free,” Al-Arian said.

She is hopeful showing the toll addiction has on families and children can help break down stigma and lead to more action to combat the opiate epidemic.

“I hope this short film gives people a real sense of what it’s like being in a family struggling with drug addiction and to understand the impact its having on people, whether it’s your friends or neighbors or people who live across town,” she said. “I hope more empathy and understanding will create an urgency to devote the necessary resources to fight this epidemic and help families who are suffering.”

“Heroin’s Children” is available to watch in full on the Fault Lines’ YouTube channel at:  “Heroin’s Children:” Inside the US Opioid Crisis

Naloxone reverses 93% of overdoses, but many recipients don’t survive a year

(CNN) As the opioid overdose epidemic continues to surge, public health officials and first responders have turned to naloxone, the drug that reverses overdose, to help combat the rising tide. New research from Brigham and Women’s hospital in Boston shows its effectiveness.

A review of emergency medical services data from Massachusetts found that when given naloxone, 93.5% of people survived their overdose. The research looked at more than 12,000 dosages administered between July 1, 2013 and December 31, 2015. A year after their overdose, 84.3% of those who had been given the reversal drug were still alive.

“With this reversal agent, we’re saving the vast majority of people,” said Dr. Scott Weiner, lead author of the study and an emergency physician at Brigham and Women’s Hospital. “These are people who got naloxone by ambulance. So we saved them. The lesson learned is not that naloxone is failing; it’s working.”
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But it also means that once saved from an overdose by EMS, a patient had about a 1 in 10 chance of not surviving a year. About 35% of those who were dead a year later died of an opioid overdose. And that should be a concern, Weiner said: “It doesn’t treat the underlying problem.”
The findings are being presented Monday at the American College of Emergency Physicians’ annual conference in Washington.
In 2014, only 12 states allowed basic EMS staff to administer naloxone for overdose. Today, laws in every state allow the drug to be administered by anyone, from a physician to a family member.
Dr. Sharon Stancliff, an expert on opioid overdose prevention, said that although it has long been known that naloxone is effective at keeping people alive, it was the first time she recalled seeing such specific numbers regarding its effectiveness.
“It’s really important data, and there’s a lot we can do with it,” said Stancliff, medical director of the nonprofit Harm Reduction Coalition, who was not involved with the research.
According to the US Centers for Disease Control and Prevention, last year alone, there were an estimated 64,000 fatal drug overdoses, most of them from opioids. And for each fatal overdose, there are approximately 30 nonfatal overdoses — many of the cases appearing in emergency rooms across the country. In fact, between 2005 and 2014, the rate of opioid-related emergency visits increased by 99.4%.
Stancliff believes that these hard numbers could be used to help persuade emergency rooms to change how they handle overdoses.
Weiner agreed and said the next steps on what to do with a patient are key in helping stop the drug overdose crisis. In emergency rooms, once people recover from an overdose, they may be given a list of phone numbers for treatment centers but not much else.
It is important to get people “engaged in treatment as soon as possible,” he said. A number of innovative emergency departments are working toward this, whether by bringing recovery specialists into the emergency room or even by having treatment facilities nearby.
“Some of the ERs in New York are really jumping on it, starting people on buprenorphine,” a medication used to help wean people off opioids, Stancliff said.
Weiner hopes that these data can be used to help persuade clinicians to figure out the next steps — and persuade patients to take those steps.
“If I’m taking care of a patient in the ED, I want to be able to tell them what the real chances of dying are if they continue using. I can look them in the eye and say, ‘you have a 1 in 10 chance of dying in a year if we don’t get you treated,’ and I think that’s really powerful,” Weiner said.
Written by: Nadia Kounang, CNN

Healthcare Providers Helped Bring About the Opioid Epidemic; Now It’s Time to Help End It

Some programs already in place, many more needed

By Toby Cosgrove., M.D.

Cleveland Clinic president and CEO

Too many of the stories we hear about opioid-related deaths start the same way – with a patient prescribed a pain medication for an injury or medical procedure.

The stories then progress to street drugs like heroin or fentanyl, leading all too often to death. In 2016, about 60,000 Americans died of opioid abuse, an American death toll greater than the whole of the Vietnam War.

This has to stop and healthcare providers have a key role in turning the tide. One of the most sobering statistics, from a physician’s point of view, is that over 75 percent of opioid and heroin deaths begin with a prescription pain killer. The healthcare industry bears some responsibility.

That’s not to say that patients aren’t in legitimate pain. They are, maybe as many as 100 million by some estimates. But we as healthcare providers have to approach pain differently, smarter.

Declaring the opioid crisis a National Public Health Emergency is a good first step. But we in healthcare can’t wait for Washington. We have approaches at our disposal that can effect very real change.

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Better policies have shown to make a difference quickly. In just the past few months, we’ve:

  • Reduced the number of opioid prescriptions exceeding 3 days by 50 percent in our emergency departments, simply through education and communication.
  • Reduced the number of patients receiving opioids by one-third in a group of colorectal surgery patients.
  • Hired a full-time Doctor of Pharmacy, who as a pain-management specialist can improve prescribing practices and clinical care.
  • Designated every hospital unit with “pain champions,” who are conversant with alternative pain strategies.

What it boils down to is this: healthcare providers have to make this a priority and we have to give physicians the tools they need to effect change.

Essentially, we can attack the opioid epidemic in four ways: giving healthcare providers the prescribing tools and resources they need; insisting on team engagement among hospital departments; tracking prescribing data and demanding accountability; and sharing information with other hospitals in the region.

Our electronic medical records system has been an indispensable tool. It has allowed us to connect directly to the Ohio Automated Rx Reporting System (OARRS); now, a physician can see a patient’s history of controlled substances within seconds while formulating a treatment plan. Also, our patient-provider agreements and consents are stored electronically so anyone who cares for that patient can see it, review it and update it as appropriate.

At the same time, we can use the electronic medical record to gather data so that we truly understand current practice – What type of patients are being prescribed narcotics? Which departments prescribe opioids most often? – then use that data to standardize care across the system.

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Here are a few more approaches we’re using at Cleveland Clinic:

A Twist on “Just Say No”: Saying “no” to patients who are seeking narcotics for pain relief is difficult. That’s why we’ve instituted training courses for physicians on how to decline opioid requests from patients, with an emphasis on being compassionate. These are difficult conversations and the stakes are high. We must help our physicians navigate this by giving them the skills, strategy and practice to show empathy while managing emotion, setting boundaries and employing de-escalation tactics when needed.

Getting Back on TREK: Back pain strikes about 31 million Americans at some point during their lives. All too often, the first-line treatment is surgery or pain killers. At Cleveland Clinic, we are offering a different approach. Back on TREK (Transform Restore Empower Knowledge) is a pilot program treating patients with chronic low back pain (with or without leg pain), with the goal of restoring function through non-surgical treatment approaches and providing patients with tools to manage their pain without narcotics. The program utilizes a combined treatment approach of psychologically informed physical therapy; pain neuroscience education and behavioral medicine sessions utilizing cognitive behavioral therapy and psychological education techniques. More than 60 percent of patients showed significant improvement in pain and disability; over half demonstrated significant reduction in fatigue, pain interference, and overall physical health.

Painless mastectomy: An experimental drug, Exparel, is a local, time-released anesthetic used after a mastectomy to help patients with the worst of the pain — the first four days — so patients can avoid opioids.

Narcotic-free colorectal surgery: A program at Cleveland Clinic Akron General replaces narcotics with pre-surgical pain management, peripheral nerve blocks during procedure, and encouragement for the patient to get out of bed and move around within 4 to 6 hours of getting to the recovery floor. Of 80 patients in the program, one-third avoided narcotics. As a result, readmission rates and surgical costs dropped, hospital stays were shortened by 50 percent, risk of complications were reduced, and recovery improved with less pain.

New “ERAS” of recovery: Several medical centers, including Cleveland Clinic, have been developing the concept of “fast-track” or “enhanced” recovery after surgery. Recently, comprehensive research has indicated that an ERAS (“Enhanced Recovery After Surgery”) methodology that permits patients to eat before surgery, limits opioids by prescribing alternate medications, and encourages regular walking reduces complication rates and accelerates recovery after surgery. ERAS can reduce blood clots, nausea, infection, muscle atrophy, hospital stay and more. Patients are also given a post-operative nutrition plan to accelerate recovery, and physicians are using multi-modal analgesia, limiting the use of narcotics.

The good news is that the fight against the opioid epidemic is moving in the right direction. Everyone – hospitals, physicians, lawmakers, law enforcement and the general public – see this as the national emergency that it is.

By leveraging the tools at our disposal – or by creating new tools – we can save lives.

Link to original article here: Healthcare Providers Helped Bring About the Opioid Epidemic; Now It’s Time to Help End It