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Courage to Change

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At Courage to Change in Airway Heights, Washington, we help restore dreams and open doors to great opportunities for many individuals. Learn their journey to success and share in their joy. Read our blog posts below.

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Contact us at 509-960-7938 or 509-934-2935 for your inquiries. You may also send us an email at [email protected].

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Unknown drug likely responsible for one death, 20 drug-related calls in Spokane

Posted on August 15, 2018 at 4:20 PM Comments comments (644)

Unknown drug likely responsible for one death, 20 drug-related calls in Spokane

Police said they received roughly 20 drug-related calls Tuesday of people acting in an "erratic fashion," indicating that there might be a substance in the area creating adverse health effects.

Author: Staff

Published: 10:14 PM PDT August 14, 2018

Updated: 12:56 PM PDT August 15, 2018

SPOKANE, Wash. — An unknown drug circulating Spokane is expected to be the cause behind a least one death and multiple police phone calls Tuesday, Spokane Police Department officials said.

Police said they received roughly 20 drug-related calls Tuesday of people acting in an "erratic fashion," indicating that there might be a substance in the area creating adverse health effects. Officials said the behavior observed was consistent with a stimulant and caused people to hallucinate, act unpredictable and sometimes act violently.

Police said many of the people Tuesday thought to have taken the unknown drug were walking in the streets and hallucinating. They were seen yelling to random people or objects that were not actually there.

A number of the individuals police came into contact with on Tuesday were eventually transported to the hospital for treatment.

Police said that although it is not possible to state definitively that the incidents were linked to a single drug, the similarities in behavior and the timeframe in which the incidents occurred indicate that it is highly probable that a common drug is responsible.

The Spokane Police Department Drug Unit is attempting to ascertain the source of the drug and the nature of the substance as of Tuesday.

If you witness a person who appears to be hallucinating and acting erratically, officials are requesting that you call 911 or crime check at (509) 456-2233.

© 2018 KREM


Art Therapy and Substance Abuse

Posted on November 30, 2017 at 2:35 PM Comments comments (94)

Art Therapy and Substance Abuse

Have you ever noticed how much listening to music on a drive home relaxes you after a long day?

Maybe you’ve even felt the sensation of being taken to another place when drawing!

It’s possible you’ve experienced the therapeutic benefits of art.

What is art therapy?

There are many types of therapy modules used by mental health professionals in treating individuals with mental illness and substance abuse disorders. Art therapy is one of them and is used as a means of expression through creativity to improve a person’s physical, mental, and emotional well-being. The American Art Therapy Association defines it as the therapeutic use of art making within a professional relationship, by people who experience illness, trauma or challenges in living and by people who seek personal development. 

Art can be used in various therapeutic ways. Creating art in itself can be therapeutic and it can additionally be used as a tool in “art psychotherapy”. Art Psychotherapy uses the creative process to find symbolism and understanding of emotions and experiences.

Art therapy does necessarily mean just painting and drawing. It can include other mediums of art like music, dance, drama and play, ceramics, sculpting, writing, etc.

History of art therapy: who started it, when and how

Art has been used since the beginning of human history as a medium for communicating and a tool to connect with others. It has been used by virtue of group interactions, conflict resolution, diagnosis and self expression. Art therapy can be traced back to the 1800’s however in the 1940’s it was defined as a therapeutic discipline.

Where does art therapy take place?

Creating art can be done anywhere and anytime however art psychotherapy usually takes place in hospitals, psychiatric and rehabilitation facilities, wellness centers, forensic institutions, schools, crisis centers, senior communities, private practices, and other clinical and community settings.

What is art therapy used for and how is it used in substance abuse disorder treatment?

Although art therapy is generally used as treatment for something- i.e. negative emotional state/ mental well-being- it can also be used for general stress, tension and self discovery. Even coloring has many benefits!

Because creating art is often times a nonverbal process, it can not only help individuals explore emotions but is also help communicate feelings or experiences that one may not feel comfortable talking about in regular conversation.

Other benefits include personal development, increased coping skills, enhanced cognitive functioning, exploration and understanding of feelings, reconciliation of emotional conflicts, increased self esteem, and improvement in reality orientation

Art therapy is specifically very beneficial to those in treatment for substance abuse disorder. It can help individuals work through the experiences, emotions and issues that have led to or worsened addiction. Art therapy has been used in substance abuse treatment since the 1950’s. There are many studies that show that using art therapy in substance abuse treatment centers enhance recovery. One study even showed that art therapy can help overcome ambivalence about recovery from substance abuse disorder. Art therapy can contribute to substance abuse recovery by decreasing the client’s denial of addiction, increasing the client’s motivation to change, providing a safe outlet for emotions and lessening the shame of addiction.

Substance abuse disorder is most successful when combined in addition to art therapy with other recovery services, such as detox, individual therapy, support groups, and family counseling.

What does an art therapy session look like?

The first thing to understand when participating in art therapy is that you do not need to be a good artist. You don’t need to make something pretty or nice, in fact, more meaningful things arise from some of the ugliest pieces.

For beginners, an art therapist may start out by having the individual or group create a magazine photo collage. The art therapist may give you a specific prompt when deciding on which images to pick. For example, you may be picking images that remind you of a certain relationship and as you are doing that the art therapist is helping if needed, offering their full attention to the clients, asking open ended questions and sharing their own observations. While discussing and viewing the finished piece, you may develop a different perspective on your problem. For example, you may find yourself focusing on a specific memory or event when talking about your piece or perhaps your made a different facial expression when looking at one of the images; this may lead you and the art therapist into another conversation and maybe to the root of the problem.

Professionals at Thrive Treatment Centers, understand the benefits that art therapy has to offer when in recovery for substance abuse. In addition to other therapy modules, Thrive Treatment Centers provide art therapy for clients on a regular basis. 

The Last House Sober Living can provide a safe and sober living environment while attending Thrive Treatment.

Prescription Drug Abuse Fueling Rise in Heroin in Spokane

Posted on October 14, 2017 at 12:55 AM Comments comments (28)
SPOKANE, Wash. - The increase in prescription drug abuse is fueling a rise in heroin addiction, according to detectives at the Spokane Police Department. A growing number of people who've started abusing expensive prescription drugs are now switching to heroin, which is cheaper and easier to buy. The abuse begins when prescription drugs, like well known Oxycontin, is stolen from the prescribed market and sold to the black market. This most commonly occurs when addicts, across all age groups, steal legitimate painkillers from family or friends' medicine cabinets and then sell them on the streets. In other cases, people will rob pharmacies for the painkillers. In rare instances, police say, doctors and others in the medical community illegally sell painkillers on the black market. The illicit delivery of prescription drugs is referred to as 'pill diversion' and it's a growing problem in the Inland Northwest. As one Spokane Police sergeant described it, "We are aware of the top level of the ice berg. I think we don't know how deep in the water the iceberg goes." Chris' Addiction Story: After what he's been through, Chris can't help but be proud of the simple things like the cut of a good suit. "It's a Hickey Freeman," clutching the lapel of his suit said with a laugh. Chris did not want to provide his last name for this story. Chris is a tax consultant who now lives in Coeur d'Alene, Idaho. He's been clean for more than a year. "I feel like a good person. I feel like I've been given my life back." It's a fresh start and a long way from his past - a past that nearly killed him. "I have what are now considered high class problems whereas a couple years ago I'm like 'Well who am I going to rob to buy some heroin?'" Chris is a recovering heroin addict. He began using in college and no one saw it coming. At the time he enrolled at the University of California San Diego, he was an officer in the Army with a scholarship on the University's fencing team. His undoing was partying. "I was always a huge computer nerd in high school, always kind of a nerd, you know, a loser," he said. "Then I found out, if I get super hammered and do a bunch of crazy stuff at parties, I was a cool guy. You know, the fun party guy." While at parties, Chris began using Ketamine, a strong anesthetic known as "Special K" on the streets. Before long, he was spiraling out of control. He was binge drinking and using marijuana, cocaine and painkillers like Hydrocodone, Oxycontin, and Fentanyl . By his sophomore year, the Army officer was a full-blown opiate addict smuggling Ketamine and prescription drugs from Mexico back to the States. By his senior of college, painkillers and money were in short supply. Withdrawals made him violently ill. "You get to a point where you're not using to get high, you're using to not be in withdrawals, not be dope sick," he said. Desperate for his next fix, Chris made a harrowing decision to shoot up the hardest drug of them all: heroin.  "It got so bad that I was doing four grams of heroin a day, which is a lot of heroin," he continued. So that means about every six hours, I'd be in withdrawals and I'd have to use heroin every six hours so I wouldn't get horribly sick." Heroin brought him to the brink of death. By his senior year, Chris was so strung out, he'd dropped out of school, he was homeless, and he overdosed twice. "You get to a certain point in the whole addiction cycle where it just doesn't seem conceivable that you're ever going to get out," Chris continued. "I was a hope-to-die dope fiend." Chris' story is an increasingly common one in the Inland Northwest. Police say prescription drug abuse across the area is fueling a rise in heroin; and not just any heroin but black tar heroin. "I would say, one-third to one-half of the cases that we investigate involve heroin," a Spokane Police sergeant said. This sergeant, who is undercover, works for the Spokane Police Department's Special Investigative Unit, or SIU, which deals with street level drug users. Statistics show that SIU'S heroin arrests shot up from 61 in 2010 to close to 95 in 2012. In one particularly large bust last year, cops netted $24,000 heroin sales from a Spokane dealer. The sergeant says the sheer popularity of prescription pills is driving up their cost, making black tar heroin cheaper and easier to get. "Heroin is a cheaper alternative to prescription drugs," the sergeant confirmed. On the streets of Spokane, one 30 milligram prescription pill costs about $30.00. A gram of heroin costs roughly $60.00. But if opiate addicts have to pop multiple pills to get high, heroin users can shoot up for a fraction of the price. Some former addicts told KHQ that, at the end stages of an opiate addiction, they will need to spend at least $600 a day on prescription pills just to function. "The prescription drugs are real expensive when you consider how much someone would use during the course of the day," the sergeant continued. "If you take a 30 milligram Oxycontin tablet, grind it up, and smoke it, that might get you enough through a half a day." Detectives say nearly all of the black tar heroin in Spokane comes from Mexican drug cartels. Users will crack off a chunk of the rock-like substance, mix it with water, heat it, draw it up into a syringe, and inject it intravenously. Unlike pills, which are made in a factory and whose potency is known, black tar heroin is almost always cut with dangerous ingredients. "The heroin that we have here, that might be 7%." That being said, heroin is notorious spikes in potency, especially with new shipments, which means the addictive street drug is much more likely to be deadly. According to the Substance Abuse and Mental Health Services Administration, initiations to heroin have increased 80 percent among 12- to 17-year-olds since 2002. In 2009, the most recent year for which national data is available, 510 young adults between the ages of 15 and 24 died of a heroin overdose. However, local data from the Spokane Regional Health District suggests heroin overdoses in Spokane County only account for a small amount of drug-related deaths. Health Risks: Heroin almost exclusively an IV-use drug which creates many health risks. The sergeant said it is not uncommon for police to execute a search warrant in a home and find several people with an advanced case of MRSA or some other infectious disease to the point where "it's very obvious that their life is compromised." This puts the officers at risk for blood borne pathogens as well. "This is a piece of the world like nobody could imagine," the Sergeant said. "It's a nightmare." Recovery: For Chris, his nightmare got worse before it got better. At his lowest point, he hatched a plan with his fiancé at the time to end his misery. "We had this plan where we were going to go buy counterfeit hundreds, use the counterfeit hundreds to buy hand grenades, and go on a crime spree and blow ourselves up with some police," he said. But on the way, Chris says, he got pulled over for driving under the influence. "That DUI saved my life." That DUI set into motion a string of events that led Chris to recovery. He hasn't used heroin in four years and he's been clean of any drugs or alcohol since August 2011. For Chris, it's a second chance at life. "I love my life. I've the greatest life ever." Chris encourages others like him, who

Drugs, Brains, and Behavior: The Science of Addiction

Posted on September 29, 2017 at 3:00 PM Comments comments (83)
Drugs, Brains, and Behavior: The Science of Addiction Treatment and Recovery Can addiction be treated successfully? Yes. Addiction is a treatable disease. Research in the science of addiction and the treatment of substance use disorders has led to the development of evidence-based interventions that help people stop abusing drugs and resume productive lives. Can addiction be cured? Not always???but like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction???s powerful disruptive effects on their brain and behavior and regain control of their lives. Source: The Journal of Neuroscience, 21(23):9414-9418. 2001 These images showing the density of dopamine transporters in a brain area called the striatum illustrate the brain???s remarkable potential to recover, at least partially, after a long abstinence from drugs???in this case, methamphetamine.27 Does relapse to drug abuse mean treatment has failed? No. The chronic nature of the disease means that relapsing to drug abuse at some point is not only possible, but likely. Relapse rates (i.e., how often symptoms recur) for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components. Treatment of chronic diseases involves changing deeply imbedded behaviors, and relapse does not mean treatment has failed. For a person recovering from addiction, lapsing back to drug use indicates that treatment needs to be reinstated or adjusted or that another treatment should be tried.28 Source: JAMA, 284:1689-1695, 2000 Relapse in this chart refers to patients who experience recurrence of symptoms that requires additional medical care. The recurrence rates are similar across these chronic illnesses, underscoring that drug use disorders should be treated like other chronic conditions; symptom recurrence serves as a trigger for renewed intervention. What are the principles of effective substance use disorder treatment? Research shows that combining treatment medications (where available) with behavioral therapy is the best way to ensure success for most patients. Treatment approaches must be tailored to address each patient???s drug use patterns and drug-related medical, psychiatric, and social problems. Addiction need not be a life sentence. How can medications help treat drug addiction? Different types of medications may be useful at different stages of treatment to help a patient stop abusing drugs, stay in treatment, and avoid relapse. Treating Withdrawal. When patients first stop using drugs, they can experience a variety of physical and emotional symptoms, including depression, anxiety, and other mood disorders, as well as restlessness or sleeplessness. Certain treatment medications are designed to reduce these symptoms, which makes it easier to stop the drug use. Discoveries in science lead to advances in drug abuse treatment. Staying in Treatment. Some treatment medications are used to help the brain adapt gradually to the absence of the abused drug. These medications act slowly to stave off drug cravings and have a calming effect on body systems. They can help patients focus on counseling and other psychotherapies related to their drug treatment. Preventing Relapse. Science has taught us that stress, cues linked to the drug experience (such as people, places, things, and moods), and exposure to drugs are the most common triggers for relapse. Medications are being developed to interfere with these triggers to help patients sustain recovery. Medications Used To Treat Drug Addiction Tobacco Addiction Nicotine replacement therapies (available as a patch, inhaler, or gum) Bupropion Varenicline Opioid Addiction Methadone Buprenorphine Naltrexone Alcohol and Drug Addiction Naltrexone Disulfiram Acamprosate How do behavioral therapies treat drug addiction? Behavioral treatments help engage people in substance use disorder treatment, modifying their attitudes and behaviors related to drug use and increasing their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive use. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer. Treatment must address the whole person. How do the best treatment programs help patients recover from the pervasive effects of addiction? Gaining the ability to stop abusing drugs is just one part of a long and complex recovery process. When people enter treatment for a substance use disorder, addiction has often taken over their lives. The compulsion to get drugs, take drugs, and experience the effects of drugs has dominated their every waking moment, and abusing drugs has taken the place of all the things they used to enjoy doing. It has disrupted how they function in their family lives, at work, and in the community, and has made them more likely to suffer from other serious illnesses. Because addiction can affect so many aspects of a person???s life, treatment must address the needs of the whole person to be successful. This is why the best programs incorporate a variety of rehabilitative services into their comprehensive treatment regimens. Treatment counselors may select from a menu of services for meeting the specific medical, psychological, social, vocational, and legal needs of their patients to foster their recovery from addiction. Cognitive Behavioral Therapy seeks to help patients recognize, avoid, and cope with the situations in which they are most likely to abuse drugs. Contingency Management uses positive reinforcement such as providing rewards or privileges for remaining drug free, for attending and participating in counseling sessions, or for taking treatment medications as prescribed. Motivational Enhancement Therapy uses strategies to evoke rapid and internally motivated behavior change to stop drug use and facilitate treatment entry. Family Therapy (especially for youth) approaches a person???s drug problems in the context of family interactions and dynamics that may contribute to drug use and other risky behaviors. For more information on drug treatment, see Principles of Drug Addiction Treatment: A Research-Based Guide, and Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide. Prev Next This page was last updated July 2014

Helping a Loved One

Posted on September 13, 2017 at 1:35 PM Comments comments (8)
When you first realize your loved one may be addicted, you may fear losing someone very precious to you to this scary, confusing and overwhelming disease. Addiction is all of those things, and it???s also something that???s too big to face on your own. So the first thing you should know is that with treatment and help, recovery is possible. It can be hard, though, to know where to start. What you???ll need to do first is formulate a plan that will set into motion the process of pulling your loved one out of a life of active addiction and closer to one of health, recovery and sobriety. It won???t be easy, as you likely already know. But information is a powerful tool and you should take comfort in the fact that you???ve already taken a giant step toward helping your loved one by caring enough to recognize an addiction and beginning the research you???ll need to be an effective helper and source of support. Here???s a five-step action plan you can start right now to turn your worry into meaningful help for the person you love: If you???re in a medical emergency, take action. First and foremost, if you think your loved one needs immediate medical attention now, call 911. If you suspect he/she has overdosed or is having unmanageable symptoms due to intoxication, withdrawal or side effects from a food disorder, again, be sure to seek medical attention ASAP; addictions ??? especially substance use disorders and food addictions ??? can be life-threatening. If your loved one is experiencing any suicidal thoughts or taking action to kill themselves, again, call 911 right away. Emergency medical attention and hospitalization can provide needed help, but on their own they are not treatments for addiction. Research treatment options. By the time you???ve come to wonder whether someone you care about might be addicted, there???s a good chance they already are. Addiction treatment can help whether the problem is mild, moderate or severe; a person doesn???t need to ???hit bottom??? for treatment to be effective. A great research tool is the Substance Abuse and Mental Health Services Administration???s Behavioral Health Treatment Services Locator, which can also be reached by calling 800-662-HELP (4357); this resource can help you find treatment centers in your area and across the country and you can search for facilities that accept private insurance or Medicare/Medicaid and ones that offer sliding-scale fees, meaning your loved one pays according to his/her income. You may also want to reach out to your friend or family member???s physician, who may ask you to bring your loved one in for a check-up, to make a diagnosis and to recommend a course of treatment, if necessary. For more information on choosing a treatment center, go to How to Choose Treatment for Your Loved One. Call treatment centers. Once you have a list of treatment centers (whether inpatient, outpatient or day treatment facilities) you think might work for your loved one, ask him/her if they???d you to call several to find out more. You can also ask them to check your loved one???s insurance benefits (they will typically do this at no cost to see how much care will be covered and how much he/she will need to pay out-of-pocket). Ask questions, including whether the facility treats the addiction(s) your relative or friend has and if they currently have space for new clients/patients. For more essential questions to ask, go to How to Choose Treatment for Your Loved One. Talk to your loved one. This can be the hardest part: telling your loved one that you believe that treatment is needed and that it???s essential for him/her to go as soon as possible. Caring enough to recommend treatment is definitely not easy, but it???s often necessary.Because addiction is a chronic disease and a progressive one, it will continue to worsen over time, in most cases, if nothing changes. The addict will continue to hurt him/herself and many others in the wake of their need to use. Just as you???d be quick to help a loved one with another chronic disease, such as cancer or diabetes, if they were unable to make good decisions about their care, sometimes those who love an addict must step in and persuade the person that care is needed, and quickly.When it???s time for these difficult conversations you should also take into consideration how likely it is that your friend or family member will leave or become violent. If this is the case, you might want to ask for more support from extended family, friends and your broader social network. If you???re considering an intervention find a professional interventionist (log on to the Association for Intervention Specialists??? member database to locate ones near you). An interventionist is trained to meet with an addict, usually along with loved ones, and persuade him/her to enter treatment.  An interventionist can often help you not only stage the intervention, but offer advice on a specific treatment center and plan or provide transportation to the treatment center.Know that even if your loved one isn???t completely ready for treatment, it can still work. According to the National Institute on Drug Abuse, treatment doesn???t need to be entered into voluntarily for it to be effective. Be supportive. If your partner, relative or friend goes into treatment encourage them to follow the treatment plan the center has created for  him/her; this will likely include abstaining from the substance(s) and/or problematic behavior(s), counseling and possibly attending mutual support self-help groups (12-step or SMART Recovery, for example). You should let your loved one know he/she has your complete support and love. There are any number of ways you can show your support: by attending family weekends when your relative or friend is in rehab; offering to drive him/her to meetings post-treatment; taking care to avoid anything that might trigger a relapse; and attending support groups like Al-Anon that will also help you take care of yourself, enabling you to be there when your loved one really needs you. Support groups and family counseling sessions are invaluable for caregivers; they???ll teach you how to stop enabling relative or friend???s addiction, as by, for example, stopping offers of money or housing if the person is still using, or changing long-standing family dynamics that help perpetuate addiction. Be sure, though, that if your loved one decides to leave treatment; fails to comply with the conditions of treatment (yours and/or his/her health care providers???); doesn???t work toward recovery; and/or continues to use, you should talk to the care coordinator at the treatment facility a counselor or the interventionist you???re working with, if you have one. In some cases, for example, an interventionist or therapist may use a model of intervention that has families work together in specific ways to stop enabling an addiction. They may tell you to cut off financial support, stop making excuses for the one you love or to hold your loved one accountable for managing his or her own life; it all depends on your unique situation. Intervention When you think of an intervention, what probably comes to mind is a dramatic confrontation (as seen on TV) in which an addict is bombarded with accusations by tearful family members and friends who force the addict into a waiting car, bound for a detox center. In reality, interventions can be many things. There are brief interventions, which may last for five minutes to a half-hour, during which a doctor screens a patient during an appointment for a substance use disorder and then advises the patient to stop using to see if the patient can do it on his/her own. Or an intervention might be a series of mini educational sessions or workshops which family members invite the addict to attend; everyone then  gathers over a period of a couple of days to learn more about addiction and how it???s affecting the family. The result may be that other family members, not just the person with the addiction, are asked to enter counseling or support groups for their depression, addiction or enabling habits. An intervention can be, too, an intimate, heartfelt, out-of-the-blue talk with a small group of family and friends (even co-workers). At work, it could even result in treatment becoming a condition of employment, as when an executive is approached by the CEO with a written ultimatum: Go into treatment now, or you???re fired. An intervention can be so many things because there are a number of different methods (more on those below). Experienced interventionists, whose job it is to guide an addict into accepting treatment, often use a mix of methods they???ve found work best for getting their clients into treatment and sustained recovery ??? the ultimate goals. Keep in mind that interventionists can help with any number of addictions, including a wide variety of substance or behavioral addictions, like alcoholism, drug addiction, gambling disorder, video gaming addiction, food addiction, sex addiction and related mental health issues. By and large, the confrontational intervention in which the addict is humiliated and forced into treatment is not the norm. Addiction is now better understood as a chronic disease, so a respectful, loving, informative intervention that doesn???t put the addict on trial is what leading interventionists say works best. As Bill Maher, CIP, a Virginia-based certified intervention professional, puts it, ???There are no kidnappings, no angry dumping on the patient.??? He subscribes to a gentler, information-focused tact himself. ???In my experience, it is not necessary to surprise them to intervene on them. I like to truly educate the whole family,??? which includes the addict, says Maher, who???s also a certified alcohol drug counselor with over 25 years??? experience. No matter which method you choose, an intervention is not recommended as something to DIY; enlisting the help of a pro is a smart idea for everyone involved. ???The outcome of this particular event is going to affect a whole family,??? says Earl Hightower, CIP, a Los Angeles-based certified intervention professional. ???To base this process on things you read in a book or on the Internet and to not have real life experience in the room when you begin this process is a terrible mistake,??? warns Hightower, who???s also a certified chemical dependency counselor who has been an interventionist for 30 years. ???An intervention brings you face-to-face with the disease.??? To find a professional interventionist, contact the Association of Intervention Specialists (AIS) or the Network of Independent Interventionists (NII); their websites contain member directories. Even if you don???t see an interventionist there who???s located near you, don???t worry; most are willing to travel long distances to help families in crisis. Anyone you choose should be a certified intervention professional (CIP). Those with this certification typically also have other credentials as well such as certified chemical dependency counselor (CCDC), certified alcohol and drug counselor (CADC) and/or psychologist. Don???t forget to consider their years of experience doing intervention work, too. The person you decide to hire may also bring his/her own experience of addiction to share. This can be useful in helping this stranger to connect with the addict (though you should, of course, choose someone who is solidly in their own recovery). ???Calling an interventionist indicates a loved one has quite a bit of pain and their level of concern has pierced their own denial,??? says Maher. Rates for an intervention vary widely across the country and depend, too, on the experience of the interventionist and if flights, accommodation or other travel expenses are necessary. Fees range from as little as $1,500 up to $10,000 and are paid up-front; the cost is not covered by insurance. While an intervention may seem costly, when considering what???s at stake and the potential costs that can be incurred when a loved one isn???t treated (illnesses, injuries, hospitalizations, car accidents, lawyer fees, bail, even funeral expenses), many families decide to give professional services a try, especially when an interventionist claims high success rates in getting patients into treatment. You should always ask an interventionist his/her success rate, and also inquire about and check references, contacting families they???ve helped. Hiring a pro will only work, though, if there???s follow-through. According to a 1999 study in the Journal of Consulting and Clinical Psychology, 70% of spouses and parents planning an intervention didn???t go through with it. However, 75% of those who did hold the intervention were successful in getting their loved one into treatment; more parents than spouses were able to sway their loved one to get help. The purpose of an intervention is to show the addict how destructive their behavior is to themselves and those they love. Interventions are typically planned in advance, and whoever you hire to run yours will meet with the family or friends of the addict ahead of time to do an assessment of the situation,  which includes whether there???s a history of co-occurring disorders (meaning a mental health issue(s) in addition to the addiction), says Hightower, who follows this five-part progressive plan based on the Johnson model (see below) for interventions: assessment, coordination, preparation, intervention and post-intervention. ???This pre-intervention information helps me identify the road map for the best opportunity for success,??? says Hightower, who adds that he often has to slow down families who are in crisis mode and want to rush to the intervention stage. ???You get one first, best shot,??? he tells them, so planning is essential. Next comes the coordination meeting during which the interventionist selects the group of people most likely to assist in getting the addict to accept treatment. These are people whom the addict most respects and with whom he/she has the closest bond. Then there???s a preparation meeting at which everyone reviews the plan and their roles in it. An escort team is selected (these are the people who help take the person to the treatment facility if he/she agrees to go), and the group strategizes on what to say and do if the addict doesn???t cooperate. Lastly, the group comes together for the actual intervention. The key here, stresses Hightower, is for the entire group to remain calm and flexible. ???When you are intervening, the addict can get quite agitated,??? he says, ???and it???s important that the family not escalate the situation and remains quiet.??? What if the addict leaves? ???We have a plan for if the addict walks in, looks around, knows it???s an intervention and just walks out,??? says Hightower. ???Addicts are experts of compartmentalization,??? he explains. ???When everyone important in their life comes together, the addict realizes, They all now know!??? The addiction is no longer a secret, and, generally speaking, the addict will return to the intervention even if he/she initially walks out. Following the intervention ??? which, Hightower says, typically ends with the addict going into treatment, albeit sometimes begrudgingly ??? he debriefs the group during the post-intervention phase, remaining a source of support for the family. There are a variety of intervention models in use. And while some research has looked at success rates for some of the models below, there are no studies that have compared all the intervention models to one another. You should also know that the success of any model also depends largely on the expertise and skill of the interventionist who uses it. If you???re looking to intervene on a loved one, here are some of the most common intervention models you???re likely to encounter: Johnson Intervention Model: This is the most widely known type of intervention, developed in the 1960s by Episcopal minister Vernon Johnson, a recovered alcoholic. With this model, the focus is on the five-step plan described above and on confronting the addict as early as possible, before the disease progresses, and persuading them into treatment. Invitational Intervention Model: This model focuses on the addiction, not the addicted individual. The addict is considered to be simply a participant who???s instrumental in helping the entire family recover from the disease of addiction. Family members and friends who may also have chemical dependence issues, mental health challenges or enabling issues develop coping and treatment plans for themselves, too, in an invitational intervention. While most of the time the addict may enter treatment as a result, this isn???t the only goal of this type of intervention. Brief Intervention: When someone is screened for substance use and found to be at risk for a problem, a doctor or nurse may make brief attempts during an office visit to try to change drug or alcohol use or refer their patient to treatment. A study led by Richard Saitz, MD, MPH, chair and professor, of the department of community health sciences at Boston University School of Public Health, found that brief interventions may have some merit for certain substances but not others. ???The best evidence now suggests that brief intervention for drugs has no efficacy among people identified by screening in primary care settings,??? says Dr. Saitz. ???On the other hand, for smoking, it does have some efficacy, and for excessive drinking it does, too, though not for people with alcohol disorders. It is important not to confuse what brief intervention might work for ??? its potential is for people who do not have addiction but instead for those using in a way that risks health consequences.??? For some, it may take several conversations to have an effect. Family-Focused Intervention Models: Several types of distinct intervention models have at their core an effort to educate family members (which can include friends as well) ??? in specific, changing how they interact with an addict: Community Reinforcement and Family Training (CRAFT): Family members are trained in communication skills, getting the addict to enter treatment and motivating their loved one to remain in recovery. One study randomly placed family members into either a 12-step or CRAFT program. Those in the CRAFT program for drug addiction were more likely to have their loved one enter drug treatment (a 64% entrance rate versus 17% for those who attended a 12-step program for family members of addicts). Systemic Family Intervention (SFI):  This model is similar to CRAFT, says Maher. SFI views addiction as a family disease. ARISE® Intervention: The ARISE® method relies on two consultations with family members before an intervention. The family lays out consequences if the addicted individual does not enter treatment. Unilateral Family Therapy: According to the American Psychological Association, in this type of intervention, family members learn to stop nagging, enabling and acting in negative ways that feed their loved one???s addiction. Pressures to Change Procedure:  Loved ones are educated on how to encourage alternative activities to drinking, to stop enabling the alcoholic or drug addict and to apply pressure to the person who???s using to get them to stop or moderate their drinking or drug use. When you are thinking of hiring an interventionist, be sure to ask which model(s) he/she will use. While Hightower uses the Johnson Intervention Model, Maher says the combination of the Invitational Intervention and Systemic Family Intervention models have worked best for him. ???In my experience, most [people] intervened on will voluntarily transport and admit themselves into treatment, and the whole family enters into the recovery process,??? Maher says, which translates into better odds for a successfully recovery. Understanding Addiction It can be hard ??? nearly impossible even ??? to understand how your loved one became addicted to a substance or behavior or comprehend how deeply addiction is now affecting his/her life. Part of the reason addiction is so puzzling is because too often we still believe in old rhetoric and mistakenly think that if our loved one was  only had more willpower or tried harder or had better morals, then he/she could give up this behavior and all the damage that it does. If only treating addiction were so simple. Addiction is now understood by experts as a chronic brain disease. Other chronic diseases include asthma, hypertension and diabetes, and just like these illnesses, addiction requires ongoing treatment and vigilance. Addiction affects brain circuits that are responsible for releasing dopamine ??? a neurotransmitter that helps control our movement, our emotions and our ability to feel pain and pleasure. Addictive substances and behaviors stimulate the reward center of the brain in such an intense way that an addict will seek out the sensation or ???high??? again and again, trying to get the same response. The craving for the feeling brought on by the substance and/or is so great that using becomes compulsive, so addicted individuals seeks it out again and again ??? no matter how much the addiction hurts them or those around them. The brain???s decision-making ability is also affected by drugs, and so are the bodily systems that control serotonin, a chemical that regulates mood and sleep, as well as glutamate, which is involved in learning and memory. So what your loved one may need most from you right now is your understanding. That you know that the disease they???re struggling with is just that: a disease, and one that is not only chronic, but progressive, meaning that it is very likely to get worse if the person doesn???t change in some way. What you say and do now can make a big difference in how much your partner, friend or relative will trust you. And you may well need that trust if you want to persuade your loved one to enter and stay in treatment, and then to maintain their sobriety later. But the addicted person isn???t the only one that could benefit from support and help, typically. As someone who cares deeply for a person struggling with addiction, you, too, may need counseling and/or the help of a support group in order to handle your own disappointment, anger and fear (among other emotions) over your loved one???s addiction. Getting this sort of help is essential to your own health, but it also enables you to be that source of support and strength. The demands on the family and friends of an addict can be intense, not least because your loved one is exhibiting unhealthy and unpredictable behavior that is leading him/her further away from being the person whom you know and love. Good places to turn in your quest to better understand the disease of addiction are family counselors, licensed marriage and family therapists, addiction counselors, social workers and certified intervention professionals. All can help you learn coping strategies and ways to handle your loved one???s addiction so that the disease doesn???t overtake your life and your own health. Reach out to your insurance company for referrals to mental health professionals who can help you in one-on-one counseling sessions or in family or couples therapy. Ala-non is another invaluable resource for families struggling to understand the roots of a loved one???s disorder. There are meetings held in cities and towns across the country (and the world) at which you can commiserate with other families facing this debilitating disease. When the realization that addiction is now part of your family???s life sets in, it can be difficult to plan how you???ll get your loved one to accept treatment. Many addicts are unwilling or unable to recognize that they need help. It???s worth contacting a professional, certified interventionist to get professional guidance when you and your loved one???s other friends and family decide to approach your loved one with the idea that you want him/her to go into treatment, or even that you???ve arranged to have a bed ready at a treatment facility. The guidance of someone who???s been there and helped to guide numerous families into recovery can be comforting and reassuring during such a difficult time. For all you may feel that you???re losing right now, bear in mind that recovery is possible, and with time, hard work, support and love, you are likely to get back the person you love. Sources: American Psychological Association; ARISE® Intervention; Association of Intervention Specialists; Earl Hightower, CIP; Frontiers in Psychiatry; Journal of Consulting and Clinical Psychology; Bill Maher, CIP; National Institutes on Drug Abuse; Network of Independent Interventionists; Richard Saitz, M.D., MPH; Substance Abuse and Mental Health Services Administration

Treatment approaches for Drug Addiction

Posted on August 16, 2017 at 1:35 PM Comments comments (11)
Treatment Approaches for Drug Addiction Share Revised July 2016 NOTE: This fact sheet discusses research findings on effective treatment approaches for drug abuse and addiction. If you???re seeking treatment, you can call the Substance Abuse and Mental Health Services Administration's (SAMHSA's) National Helpline at 1-800-662-HELP (1-800-662-4357) or go to www.findtreatment.samhsa.gov for information on hotlines, counseling services, or treatment options in your state.  What is drug addiction? Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and changes in the brain, which can be long lasting. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop. The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person's ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive. This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior. Addiction is a disease that affects both the brain and behavior. Can drug addiction be treated? Yes, but it???s not simple. Because addiction is a chronic disease, people can???t simply stop using drugs for a few days and be cured. Most patients need long-term or repeated care to stop using completely and recover their lives. Addiction treatment must help the person do the following: stop using drugs stay drug-free be productive in the family, at work, and in society  Principles of Effective Treatment Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program: Addiction is a complex but treatable disease that affects brain function and behavior. No single treatment is right for everyone. People need to have quick access to treatment. Effective treatment addresses all of the patient???s needs, not just his or her drug use. Staying in treatment long enough is critical. Counseling and other behavioral therapies are the most commonly used forms of treatment. Medications are often an important part of treatment, especially when combined with behavioral therapies. Treatment plans must be reviewed often and modified to fit the patient???s changing needs. Treatment should address other possible mental disorders. Medically assisted detoxification is only the first stage of treatment. Treatment doesn't need to be voluntary to be effective. Drug use during treatment must be monitored continuously. Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses. How is drug addiction treated? Successful treatment has several steps: detoxification (the process by which the body rids itself of a drug) behavioral counseling medication (for opioid, tobacco, or alcohol addiction) evaluation and treatment for co-occurring mental health issues such as depression and anxiety long-term follow-up to prevent relapse A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems. How are medications used in drug addiction treatment? Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions. Withdrawal. Medications help suppress withdrawal symptoms during detoxification. Detoxification is not in itself "treatment," but only the first step in the process. Patients who do not receive any further treatment after detoxification usually resume their drug use. One study of treatment facilities found that medications were used in almost 80 percent of detoxifications (SAMHSA, 2014). Relapse prevention. Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for treatment of opioid (heroin, prescription pain relievers), tobacco (nicotine), and alcohol addiction. Scientists are developing other medications to treat stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use. Opioids: Methadone (Dolophine®, Methadose®), buprenorphine (Suboxone®, Subutex®, Probuphine®), and naltrexone (Vivitrol®) are used to treat opioid addiction. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone blocks the effects of opioids at their receptor sites in the brain and should be used only in patients who have already been detoxified. All medications help patients reduce drug seeking and related criminal behavior and help them become more open to behavioral treatments. Tobacco: Nicotine replacement therapies have several forms, including the patch, spray, gum, and lozenges. These products are available over the counter. The U.S. Food and Drug Administration (FDA) has approved two prescription medications for nicotine addiction: bupropion (Zyban®) and varenicline (Chantix®). They work differently in the brain, but both help prevent relapse in people trying to quit. The medications are more effective when combined with behavioral treatments, such as group and individual therapy as well as telephone quitlines. Alcohol: Three medications have been FDA-approved for treating alcohol addiction and a fourth, topiramate, has shown promise in clinical trials (large-scale studies with people). The three approved medications are as follows: Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some patients. Genetic differences may affect how well the drug works in certain patients. Acamprosate (Campral®) may reduce symptoms of long-lasting withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (generally feeling unwell or unhappy). It may be more effective in patients with severe addiction. Disulfiram (Antabuse®) interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include flushing (warmth and redness in the face), nausea, and irregular heartbeat if the patient drinks alcohol. Compliance (taking the drug as prescribed) can be a problem, but it may help patients who are highly motivated to quit drinking. Co-occuring conditions: Other medications are available to treat possible mental health conditions, such as depression or anxiety, that may be contributing to the person???s addiction. How are behavioral therapies used to treat drug addiction? Behavioral therapies help patients: modify their attitudes and behaviors related to drug use increase healthy life skills persist with other forms of treatment, such as medication Patients can receive treatment in many different settings with various approaches. Outpatient behavioral treatment includes a wide variety of programs for patients who visit a behavioral health counselor on a regular schedule. Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as: cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs multidimensional family therapy???developed for adolescents with drug abuse problems as well as their families???which addresses a range of influences on their drug abuse patterns and is designed to improve overall family functioning motivational interviewing, which makes the most of people's readiness to change their behavior and enter treatment motivational incentives (contingency management), which uses positive reinforcement to encourage abstinence from drugs Treatment is sometimes intensive at first, where patients attend multiple outpatient sessions each week. After completing intensive treatment, patients transition to regular outpatient treatment, which meets less often and for fewer hours per week to help sustain their recovery. Inpatient or residential treatment  can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include: Therapeutic communities, which are highly structured programs in which patients remain at a residence, typically for 6 to 12 months. The entire community, including treatment staff and those in recovery, act as key agents of change, influencing the patient???s attitudes, understanding, and behaviors associated with drug use. Read more about therapeutic communities in the Therapeutic Communities Research Report at https://www.drugabuse.gov/publications/research-reports/therapeutic-communities. Shorter-term residential treatment, which typically focuses on detoxification as well as providing initial intensive counseling and preparation for treatment in a community-based setting. Recovery housing, which provides supervised, short-term housing for patients, often following other types of inpatient or residential treatment. Recovery housing can help people make the transition to an independent life???for example, helping them learn how to manage finances or seek employment, as well as connecting them to support services in the community. Is treatment different for criminal justice populations? Scientific research since the mid-1970s shows that drug abuse treatment can help many drug-using offenders change their attitudes, beliefs, and behaviors towards drug abuse; avoid relapse; and successfully remove themselves from a life of substance abuse and crime. Many of the principles of treating drug addiction are similar for people within the criminal justice system as for those in the general population. However, many offenders don???t have access to the types of services they need. Treatment that is of poor quality or is not well suited to the needs of offenders may not be effective at reducing drug use and criminal behavior. In addition to the general principles of treatment, some considerations specific to offenders include the following: Treatment should include development of specific cognitive skills to help the offender adjust attitudes and beliefs that lead to drug abuse and crime, such as feeling entitled to have things one???s own way or not understanding the consequences of one???s behavior. This includes skills related to thinking, understanding, learning, and remembering. Treatment planning should include tailored services within the correctional facility as well as transition to community-based treatment after release. Ongoing coordination between treatment providers and courts or parole and probation officers is important in addressing the complex needs of offenders re-entering society. Challenges of Re-entry Drug abuse changes the function of the brain, and many things can "trigger" drug cravings within the brain. It???s critical for those in treatment, especially those treated at an inpatient facility or prison, to learn how to recognize, avoid, and cope with triggers they are likely to be exposed to after treatment. How many people get treatment for drug addiction? According to SAMHSA's National Survey on Drug Use and Health, 22.5 million people (8.5 percent of the U.S. population) aged 12 or older needed treatment for an illicit* drug or alcohol use problem in 2014. Only 4.2 million (18.5 percent of those who needed treatment) received any substance use treatment in the same year. Of these, about 2.6 million people received treatment at specialty treatment programs (CBHSQ, 2015). *The term "illicit" refers to the use of illegal drugs, including marijuana according to federal law, and misuse of prescription medications. Points to Remember Drug addiction can be treated, but it???s not simple. Addiction treatment must help the person do the following: stop using drugs stay drug-free be productive in the family, at work, and in society Successful treatment has several steps: detoxification behavioral counseling medication (for opioid, tobacco, or alcohol addiction) evaluation and treatment for co-occurring mental health issues such as depression and anxiety long-term follow-up to prevent relapse Medications can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions. Behavioral therapies help patients: modify their attitudes and behaviors related to drug use increase healthy life skills persist with other forms of treatment, such as medication People within the criminal justice system may need additional treatment services to treat drug use disorders effectively. However, many offenders don???t have access to the types of services they need. Learn More For more information about drug addiction treatment, visit: www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/acknowledgments For information about drug addiction treatment in the criminal justice system, visit: www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations/principles For step-by-step guides for people who think they or a loved one may need treatment, visit: www.drugabuse.gov/related-topics/treatment References Center for Behavioral Health Statistics and Quality (CBSHQ). 2014 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015. Substance Abuse and Mental Health Services Administration (SAMHSA). National Survey of Substance Abuse Treatment Services (N-SSATS): 2013. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. HHS Publication No. (SMA) 14-489. BHSIS Series S-73. This publication is available for your use and may be reproduced in its entirety without permission from the NIDA. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

Person Centered Treatment - Why it works

Posted on August 2, 2017 at 7:20 PM Comments comments (29)

Personal-centered therapy is a common therapeutic approach used by counselors and psychologists to treat substance abuse issues. Person-centered therapy is also referred to as client-centered therapy, person-centered counseling and Rogerian psychotherapy after its founder, psychologist Carl Rogers.

 

The basic foundation behind person-centered therapy is that the client is the main focus. The therapist works to build an atmosphere where the client feels comfortable and understood, which encourages a trusting relationship and allows for treatment progress. The therapist provides a non-judgmental, sympathetic attitude towards the client and shows an unconditional, genuine concern for meeting the client’s needs. Unlike more traditional therapeutic approaches, client-centered therapy refrains from asking questions, making direct observations, and assigning blame. The idea of person-centered therapy is for the client to feel comfortable enough to come to terms with issues and solutions on his or her own. When the client establishes a relationship with the therapist, he or she becomes more expressive and open to exploring issues. This way of thinking allows clients to discover solutions themselves and avoid feeling as if their therapists are making an intrusive diagnosis.

Why Is Person-Centered Therapy Effective for Addiction Recovery?

 

Person-centered therapy has proven to be an especially effective tool for the addiction recovery process. This therapeutic approach allows addicts to recognize their issues on their own, which is exceptionally helpful because most addicts are in denial when it comes to their addictive, self-destructive behavior. Rather than feeling forced into treatment or recovery, addicts are more likely to respond to therapy when they have the ability to communicate and express themselves free from judgment or accusations. Addicts feel understood by their therapists and more willing to talk about their lives and issues. As their therapists continue to show empathy, support and understanding, addicts are able to eventually dig deeper into their issues at their own pace.

 

Person-centered therapy is effective for long-term addiction recovery because addicts have the opportunity to establish accountability for their behavior as they come to conclusions and solutions on their own. The decisions and discoveries addicts come across prepare them for making decisions and changes that enable long-term recovery. Person-centered therapy is a significant benefit to the addiction recovery process because it opens the door for self-growth and establishes a trusting relationship between recovery professional and client. This relationship can break down walls that addicts may have towards other professionals, relationships or the recovery process itself.

Person-Centered Therapy Information

 

If you think person-centered therapy will work for you or a loved one, please call 509-960-7938 to learn more.  Recovery professionals are ready to answer questions and provide you with the information you need on person-centered therapy and other options for addiction recovery treatment. We’re here to help you find the addiction services that will fit your personal recovery needs. If you’re ready to break free from addiction, call today.

Haven for Recovering Addicts Now Profits From Their Relapses

Posted on July 28, 2017 at 1:35 PM Comments comments (32)
Scott McIntyre for The New York Times DELRAY BEACH, Fla. ??? It was the kind of afternoon that cold-weary tourists revel in as they sip mojitos near the beach ??? a dazzling sun, a sky so blue it verged on Photoshopped and weather fit for flip-flops. But the young visitor from Arkansas, curled up into a ball near the sidewalk, had a better reason to be grateful. He was alive. ???You are overdosing on heroin,??? Sean Gibson, a paramedic captain with the Delray Beach Fire-Rescue, had told him earlier this year, after the man fell off his bike, hit a chain-link fence and collapsed, blood trickling down his face. Mr. Gibson sprayed Narcan, an opiate blocker, up the man???s nose as he lay on his back and, before long, the man ??? who had shot up heroin at a recovery group home ??? sat up, polite and embarrassed. ???Thanks, guys,??? he said, before being taken to the hospital as a precaution. In a nation awash in opioids, there are few, if any, places where this kind of scene plays out more often than this artsy beach town of 15 square miles. Here, heroin overdoses long ago elbowed out car crashes and routine health issues as the most common medical emergencies. Last year, Delray paramedics responded to 748 overdose calls; 65 ended in fatalities. In all, Palm Beach County dealt with 5,000 overdose calls. Unlike other places in the United States that have been clobbered by the opioid crisis, most of the young people who overdose in Delray Beach are not from here. They are visitors, mostly from the Northeast and Midwest, and they come for opioid addiction treatment and recovery help to a town that has long been hailed as a lifeline for substance abusers. But what many of these addicts find here today is a crippled and dangerous system, fueled in the past three years by insurance fraud, abuse, minimal oversight and lax laws. The result in Palm Beach County has been the rapid proliferation of troubled treatment centers, labs and group homes where unknowing addicts, exploited for insurance money, fall deeper into addiction. Continue reading the main story

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