Wednesday, August 20, 2014

Suncoast Moms Group Holds Remembrance For Those Lost To Overdose Deaths, Calls for Action August 31st for International Overdose Awareness Day

Suncoast Moms Group Holds Remembrance For Those Lost To Overdose Deaths,

Calls for Action August 31st for International Overdose Awareness Day 

SARASOTA, FL - Around the world overdose awareness events are held on August 31st; International Overdose Awareness Day (IOAD) is a global event held each year to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those lost or permanently injured as a result of drug overdose.
Hit hard by first the prescription drug epidemic, and now the increase in heroin deaths, moms  and families in the Suncoast area will be holding a vigil to remember their loved ones and send hope to those still struggling. Approximately seven Floridians lose their lives each day to preventable accidental overdose, with more than 100 lives lost each day nationwide.   #NotOneMore  has come to mean every life is worth saving to these Florida residents. 
An International Overdose Awareness Day VIGIL for Remembrance, Action and Hope will be held Sunday, August 31 at 7:00pm starting with dinner on your own at Ricaltini's Bar and Grille, 1997 Kentucky Ave, in Englewood, Florida.  The vigil begins at 8:00pm.
“If the loss of this beautiful boy wasn’t heartache enough, imagine how we felt when we discovered that there existed a simple antidote which might have saved him the moment I found him.” said Sarasota mom Jan Spring who discovered her son Derek overdosed at home. 
Families are calling for the community to learn more about overdose prevention and naloxone, also known as Narcan, a prescription medication that reverses opiate overdose. “Now is the time to acknowledge the lives lost to overdose, and in their name make naloxone available,” stated Julia Negron, organizer of the Suncoast Harm Reduction Project and mother of a son whose life has been affected by addictive illness and incarceration. 
“There are too many roadblocks to recovery now; there’s no rehab if you’re dead.” Advocacy groups have been popping up in response to the rise in heroin overdoses populated by mothers who have lost loved ones, treatment professionals, and public health advocates.  Demonstrations show how easy it is to use the currently available nasal naloxone spray and save a life.   “About an hour of training and any family member, caretaker or friend of someone at risk can feel comfortable having this medication and using it in an emergency,” states Negron, who is a trainer and prescribed to carry naloxone.  “Half of all overdoses happen at home.  It’s heartbreaking to work with mothers who’ve lost kids and realize intervention with naloxone could have saved them, but I applaud their courage in standing up and demanding to help save others.”
Fatal drug overdose has increased more than six-fold in the past three decades, and now claims the lives of over 36,000 Americans every year. Access to naloxone for families, caretakers, seniors and drug users is often limited by laws that pre-date the overdose epidemic. In an effort to reduce overdose mortality, 24 states have recently amended laws to increase access to naloxone in the community. Some studies show that increasing access to naloxone to laypeople can reduce the overdose mortality in the community by as much as fifty percent. The moms of the Suncoast Harm Reduction Project have been meeting with Florida legislators to do just that. 
"We have been blessed to get broad support from other Florida advocates in our efforts and hope we will be campaigning for statewide naloxone legislation soon” says Negron, who lost her own sister to overdose.  “In the meantime we will go on meeting, educating and holding vigils for our loved ones - we are tired of this waste of precious life.” 
The Suncoast Harm Reduction Project is an outreach project of the non-profit advocacy organization A New PATH (Parents For Addiction Treatment and Healing)   This event is the result of a coalition effort of the advocacy groups Suncoast Harm Reduction Project, GRASP, Broken No More, A New PATH, Brandi's Wish, Floridians For Recovery, United We CAN, The Addict's Mom, The Skeeterhawk Experiment and Moms United to End The War On Drugs.

Tuesday, August 12, 2014

Drug Relapse Denial and How it Kills | Tessie Castillo

Drug Relapse Denial and How it Kills | Tessie Castillo


Denial can be deadly. When teenagers aren't educated about sex because adults insist that it's not happening in schools, the outcomes are unplanned pregnancy and sexually transmitted diseases. When we don't teach kids about designated drivers because we deny they would drink underage, the next casualty of drunk driving may be our own. This denial is especially apparent when it comes to drugs and addiction. We know that drug overdose is now the leading cause of accidental death in the United States. We know that people are at the greatest risk for overdose if they relapse after a period of abstinence - such as right after leaving a drug detox, treatment center, or methadone clinic. We also know that most people do relapse, usually many times, during their recovery period. Common sense would dictate that if we value human lives, we should provide people with the education and tools to prevent an overdose, which kills many before they get a chance to recover. And yet, not only do few detox facilities, treatment centers, and methadone clinics in the U.S. provide overdose education, most are outright hostile to the idea. How has this relapse denial persisted within the treatment system? And more importantly, how can we change it before more lives are lost?

For Dr. Andrew Kolodny, Chief Medical Officer of the Phoenix House Foundation treatment centers, the explanation lies in history.

"Originally, treatment programs were built on long-term models with people living in residential programs up to a year at a time," he explains. "The expectation was that after completing treatment, clients would be abstinent from drugs for the rest of their lives, so there was no need for overdose prevention education. But in the current climate, insurance companies won't pay for long-term treatment, so people are detoxed for 30 days or less and then released. Not only does this treatment model not help people with addiction, it sets them up for an overdose."

Because drug tolerance drops during periods of detox and recovery, relapse is especially dangerous. If the person returns to using the same amount of drugs he was using before, the chances of a potentially fatal overdose increase dramatically, particularly if opioids such as prescription pain relievers, heroin or methadone are involved. According to a study in the New England Journal of Medicine, inmates who detoxed in prison are 129 times more likely to die from an overdose than the general population during the first two weeks after release.

Given the inadequate levels of treatment for addiction, high incidence of relapse, and widespread availability of opioid prescriptions, one would think that the treatment system would devote a fair amount of resources to educating clients about these risks. Not so. Instead, the majority of substance abuse programs and methadone clinics resist allowing overdose prevention education into their facilities. Most are also against programs such as naloxone distribution, which provides people at risk for overdose with naloxone, a safe, effective medication used to reverse opioid overdose.

Much of the resistance to overdose education lies in the fact that most treatment programs are based on an abstinence-only model. Because providing overdose prevention education and/or naloxone suggests that relapse is a possibility, many facilities exclude overdose education over concerns that it clashes with the abstinence message. But to many treatment providers, such thinking not only goes against empirical evidence about the behavior of people who struggle with addiction, it has also cost countless lives.

"It is unrealistic to expect someone to come into treatment one time and be cured," says Stephanie Almeida, founder of Full Circle Recovery Center, a harm reduction-based treatment center in Franklin, North Carolina. "The norm is for people to engage the system multiple times."

So why does relapse denial persist? Dr. Kolodny says that inertia and resistance to change are largely responsible for the reluctance of the traditional treatment system to incorporate overdose prevention. "Getting people to do things differently is always a challenge," he says.

For Pam Lynch, Co-Director of the WhoSoEver Collaborative in Michigan a nonprofit that works to reform the way society treats addiction and mental health, the reasons are more sinister. "Our current system has done a largely ineffective job of handling the disease of addiction...many [state-funded treatment centers] are essentially subsidiaries of the criminal justice system," she says. "The treatment system needs an overhaul, in a big way. We cannot simultaneously punish and heal people living with this disease."

The causes of addiction are complex and layered, as are its solutions. It's clear from the alarming statistics on relapse and overdose death that the current treatment model is not working. Reform, however, is an enormous and daunting task. In the meantime, we should make every effort to keep people struggling with addiction alive until the broken treatment system can be fixed.

The good news is that overdose prevention education and naloxone programs are spreading all over the country. Getting treatment centers on board will be critical to success, and already a number of them are moving towards a model that includes such programs. With 125 recovery centers throughout the country, Phoenix House Foundation is in the process of equipping every residential program with naloxone in case relapse happens while a client is still in treatment. Under Dr. Kolodny's leadership, Phoenix House has launched a pilot program in their Rhode Island facility to teach overdose prevention education and instruct clients on where to get naloxone when they leave.

"We are moving away from the silly idea that everyone who leaves residential drug treatment will be abstinent for the rest of their lives," says Dr. Kolodny. "We educate them on how tolerance changes after a period of abstinence, the increased risk of relapse after release, the dangers of mixing different types of drugs, and how to respond when witnessing an overdose."

After the pilot program is tested and evaluated, it will be replicated in other facilities throughout the country. Dr. Kolodny says that state regulations that mandate overdose prevention in treatment centers are the most effective way of moving towards a model that allows for overdose prevention and naloxone distribution.

For Almeida, the whole treatment philosophy needs to change before centers will start to accept overdose prevention.

"I think it will take grassroots efforts from people affected by overdose deaths or people who have engaged in the treatment system and had poor outcomes," says Almeida. "With enough of their voices, we might see change."
Almeida's program at Full Circle Recovery Center provides overdose prevention training in-house and also distributes naloxone kits to clients with training on how to recognize and respond to opioid overdose. She receives the kits courtesy of the North Carolina Harm Reduction Coalition, whose naloxone distribution program distributed over 2500 kits between August 2013 and June 2014 and reported 95 successful overdose reversals during that time.

Drug overdose is currently the most urgent public health crisis in the United States. Advocates and people who have lost loved ones to a relapse should unite to urge detox programs, treatment centers and methadone clinics to provide overdose prevention education and naloxone to every client leaving their facility. Treatment centers are at the forefront of the fight against addiction and we need them on board if we hope to save lives. Even worse a tragedy than losing so many people to overdose is losing them just as they seek help. It doesn't need to happen. And it won't if we stand up and do something about it.

Wednesday, August 6, 2014

It's Lonely at the Bottom

It's easy to throw around terms like "tough love," "enabler," and "rock bottom." Living with those terms is another story.

In an effort to find an answer that leads to treatment for an addict there seems to be a lot of discussion about the tough love approach. Some of those stories include those families who have lost a child to overdose after following the tough love recommendation of a therapist—meaning they estranged themselves until the child reached “rock bottom” and was ready for treatment.
Some move to new homes, towns or even states in an effort to restart their lives, free from the turmoil of a family dealing with addiction. Eventually, for some, their loved one does hit the rockiest of bottoms—they overdose and die alone. I also know parents who followed the tough love advice with success, and recommend it as the only way to help their child and keep their sanity.    
Twenty years ago I sat with my son’s therapist to discuss his substance abuse and relapse issues. She couldn’t tell me what my son’s drug of choice was, leaving me to come to my own conclusions which, in retrospect, were a bit na├»ve. I leaned across her mahogany desk where the timer was ticking away the minutes allotted for my session, looked up at her and asked, “What can I do?”
That was the first time I heard of the concept of tough love. She told me that when he hit rock bottom, he would be ready for a meaningful, long lasting treatment and recovery.
Rock bottom? I wondered what the heck she meant by rock bottom? She explained to me that rock bottom is the hoped for result of tough love—when you love your child enough to remove him from your home, no longer provide him with food or clothing, and basically disassociate yourself from his life until he becomes distraught enough to ask for help—or is jailed or near death. The therapist assured me that he would eventually come begging for my help, and then his recovery could begin.
She told me I had to stop enabling my son and practice tough love.  
When he hits rock bottom then it is okay for me to provide him with food and clothing?  When he hits rock bottom I can give myself permission to help him?  I was confused and I was angry about what she was suggesting. While she talked, my mind wandered back in time to that tiny newborn child who clutched my finger with his little hand like he would never let go because he trusted me to be there for him when he was good, when he misbehaved and yes – when he fell into a place where only a mother’s love lives. And now this woman was telling me to abandon my child – to give up? To turn my back on my first born son? I thought “rock bottom” okay, I get it.  
When my son was in the 8th grade he was depantsed in the boy’s locker room while the gym teacher looked on laughing, explaining later that boys will be boys. An hour later the principal called me to tell me they couldn’t find my son at school. I immediately drove to the school and my son was nowhere to be found. The rural school was about five miles from our home and it was raining. I drove slowly along the road looking for my son back and forth twice. Finally I saw what looked like some clothing in the ditch along the road. I stopped my car, got out and found him there soaked, laying in the mud, humiliated and sobbing. Rock bottom, Okay I think I’ve got it now - that was an example.
When my son was in the 12th grade he called me at work to tell me that he loved me and that he didn’t want to live anymore. He felt that God had deserted him and that neither God nor I could protect him from our volatile home situation. He had taken two bottles of pills. After a trip to the ER his stomach was pumped and he was admitted to the adolescent suicide psychiatric unit where he stayed for several months. Okay, I get it - I think he had reached rock bottom.
NO, I said to myself as I was driving back home alone after meeting with this tough love-loving therapist—I will NOT make a conscious decision to sit by and watch my son hit rock bottom before I offer him help. I will love him unconditionally until he feels like he is worth saving. I will love him when he steals from my bank account and hold him in my arms as he apologizes. I will replace the money he took from his brother’s birthday cards and hold his hand as he tells me how ashamed he is. I will sit and rock him as he sobs in my arms after another ruined family outing or holiday. We will sit at length and discuss behavior issues, anger issues, life issues and his self-loathing trying to make sense of it all. I will cry with him as he grieves a failed marriage. I will watch him suffer as he fights with his addiction and when he detoxes. I will cover him with blankets when he shakes uncontrollably and use cold packs to keep his fever down. I will spoon feed him vegetable broth when he can’t keep solid food down. I will buy emergency one way plane tickets. I will do it because I love him unconditionally. I don’t love him any more or less because he made a bad decision in the moment that changed his life forever. I will do it because he is worth saving.
My thoughts wandered back to my own experience with tough love when I was 19 and I remembered an argument with my mother and the ultimatum she gave me as I walked out the door. She said, “If you leave now, when you come back your clothes will be on the front porch.” Right! - I thought as I drove my car out of the driveway. But when I returned the doors were locked and all of my personal belongings were in boxes on the porch. Now that was tough love. The reason for the argument isn’t important here. My mother and I reconciled, and even sometimes laughed about my defiance. I never moved back home. But I will always remember the feelings on that night of hopelessness and feeling abandoned and unloved, not to mention homeless and alone.
So, yes, I was an enabler. I met my son every day where he was at in his life without judgment. I enabled my son to live at home as long as he wanted to. When he moved away I sent him tickets to come home when he needed to. When he called crying because he had relapsed and was embarrassed, I told him to never be ashamed of who he was.
And then when he hit rock bottom for the last time, I signed the papers to bring his body back home. I picked out clothing and made funeral arrangements and I designed a headstone for his grave—just like the mom who practiced tough love. So which is right? Who knows! Even the experts don’t agree. 
I believe it is a combination of making a decision based on the availability of support, your own tolerance level, having tried everything that seems logical, being at a loss about what to do next and finding yourself willing to try anything.
I like this quote from The Water Giver—“Motherhood is about raising and celebrating the child you have, not the child you thought you’d have. . .and, if you are lucky, he might be the teacher who turns you into the person you’re supposed to be.”
Diannee Carden Glenn is based in North Carolina and Florida and has been campaigning for the last year for overdose prevention. She last wrote about the death of her son from a heroin overdose.

Addiction and Dependence: Two Very Different Sides of Opioid Abuse

Addiction and Dependence: Two Very Different Sides of Opioid Abuse