Sober Transitions

NOW HIRING! TWO Full-Time Office Positions in the H.B. Office/ Orange County

NOW HIRING!
TWO Full-Time Office Positions in the H.B. Office/ Orange County

Recovery Care Monitor: Requires a CADC license or will consider right candidate needing  Internship hours to meet the CADC requirements.

Case Manager: Meets requirements of a licensed counselor or CADC.

Email Resume and References to : monitoring@hiredpower.com

We are looking to fill these positions by the end of March.  More details about the position will be provided at the interview stage. PLEASE NO PHONE CALLS about the position - EMAIL ONLY!

Connecticut Juvenille Courts test using recovery coaches to help addicted parents

The Alcoholism and Drug Abuse Weekly, Vol. 21, No. 14, dated April 6 reported:

Three agencies with very different agendas — substance abuse, child welfare, and the courts — are coming together in Connecticut to facilitate the recovery of addicted parents whose children have been removed from the home. Called the Recovery Specialist Voluntary Program (RSVP), the initiative is starting as a pilot program in three juvenile courts.

The RSVP will use recovery specialists, also referred to as recovery coaches, who are trained in addiction to help guide parents to treatment and help them stay in it. If parents recover sooner, they can be reunified with their children sooner, and decrease foster care costs for the state. 

Read entire article here:

ALSO

See the Connecticut Department of Children and Families official release announcing the new R.S.V.P. program.

Admissions for Prescription Painkiller Abuse on Rise

Alcohol treatment still heads list but figures decline, report finds...

TUESDAY, March 17 (HealthDay News) -- Admissions for treatment of prescription painkiller abuse in the United States have risen dramatically over the past decade, from 1 percent of all substance abuse admissions in 1997 to 5 percent in 2007, according to a government report released Tuesday.

Alcohol was still the leading cause (40 percent) of the 1.8 million substance abuse treatment admissions in 2007, but has declined from 50 percent in 1997, said the Substance Abuse and Mental Health Services Administration report.

Among the other findings in the Treatment Episode Data Set (TEDS) 2007:

• The percentage of admissions primarily due to heroin use was about the same in 2007 as it was in 1997 -- 14 percent.
• The percentage of admissions primarily due to methamphetamine/amphetamine abuse was 4 percent in 1997, rose to 9 percent in 2005, then decreased to 8 percent in 2006 and 2007.
• Admissions for marijuana abuse increased from 12 percent in 1997 to 16 percent in 2003 and have remained steady since then.

"The TEDS report provides valuable insight into the true nature and scope of the challenges confronting the substance abu se treatment community. By carefully analyzing this data, the public health community can better anticipate and address emerging needs," Dr. Eric Broderick, SAMHSA acting administrator, said in an agency news release.

The TEDS report provides demographic and other information on substance abuse treatment admissions from state-licensed treatment facilities across the United States. It doesn't include information on all treatment admissions but is the largest, most comprehensive study of its kind, according to the news release.

More information

SAMHSA has more about substance abuse treatment.

Intensive Case Management Improves Abstinence

Intensive Case Management Improves Abstinence and Employment among Substance Dependent Women Receiving Temporary Assistance for Needy Families


Research Summary and Comments

Women with substance use disorders (SUDs) receiving Temporary Assistance for Needy Families (TANF) have high rates of co-occurring mental health and social problems and experience severe and persistent barriers to employment. Researchers examined 2-year differences in abstinence and employment outcomes among 302 women with substance dependence receiving TANF. Participants were randomized into 2 groups: usual care (screening and referral to treatment with limited outreach if patients failed to attend the first treatment session), and intensive case management (ICM) (a manual-guided intervention involving identification of barriers to treatment, assistance getting into and during treatment, coordination of needed services, weekly meetings with a case manager, and incentive vouchers for attending treatment).

• Although the usual care group had higher rates of employment than the ICM group during the first year, this relationship reversed in year 2, with the rate of improvement significantly higher over time in the ICM group.
• The mean abstinence rate across 24 months was also significantly higher in the ICM group (47%) than in the usual care group (24%).
• At 24 months, abstinence was higher among ICM participants who were working (3 of 5) compared with participants in the usual care group (1 of 3).

Comments by Norma Finkelstein, PhD, LICSW
This study provides support for those who advocate that ongoing treatment is critical to successful employment outcomes for women with SUDs. In addition, ICM appears to yield significantly better outcomes in both abstinence and employment for this population. Most government agencies providing financial assistance offer limited screening and treatment referral for clients with SUDs, usually with limited success. These results demonstrate that more intensive interventions can significantly improve employment outcomes in this group.

Reference:
Morgenstern J, Neighbors C, Kuerbis A, et al. Improving 24-month abstinence and employment outcomes for substance-dependent women receiving temporary assistance for needy families with intensive case management. Am J Public Health. 2009;99(2):328–333.

Article courtesy of Join Together

Prevention Education

Download the report and tell a friend! 

We ask our schools to do a lot of things besides prepare our kids to compete in the global economy – including teaching them to stay healthy and safe. But what is really happening when alcohol and drug education gets squeezed in with an ever-growing list of requirements in thousands of schools across the nation? 

We asked 3,500 teachers, school administrators, and other educators to tell us. Find out what we learned, and tell a friend:

Prevention Education in America's Schools:
Findings and Recommendations from a Survey of Educators

One Drug May Help People Both Lay Down The Drink And Put Out The Cigarette

provided by: Medical News Today

A popular smoking cessation drug dramatically reduced the amount a heavy drinker will consume, a new Yale School of Medicine study has found. Heavy-drinking smokers in a laboratory setting were much less likely to drink after taking the drug varenicline compared to those taking a placebo, according to a study published online in the journal Biological Psychiatry.

The group taking varenicline, sold as a stop-smoking aid under the name Chantix, reported feeling fewer cravings for alcohol and less intoxicated when they did drink. They were also much more likely to remain abstinent after being offered drinks than those who received a placebo, the study found.

Additionally, there were no adverse effects associated with combining varenicline with alcohol in the doses studied. When combined with low doses of alcohol, varenicline did not change blood pressure or heart rate, nor did it seem to induce nausea or dizziness.

"We anticipate that the results of this preliminary study will trigger clinical trials of varenicline as a primary treatment for alcohol use disorders, and as a potential dual treatment for alcohol and tobacco use disorders," said Sherry McKee, associate professor of psychiatry at the Yale School of Medicine and lead author of the study. Smokers are more likely to drink alcohol and to consume greater quantities of alcohol, and they are four times more likely to meet criteria for alcohol use disorders. Diseases related to tobacco use are the leading causes of death in alcoholics.

"A medication such as varenicline, which may target shared biological systems in alcohol and nicotine use, holds promise as a treatment for individuals with both disorders" according to McKee.

McKee said that 80% of participants receiving varenicline did not take a drink at all, compared to 30% of the placebo group. The findings suggest that varenicline has the potential to be at least as effective in reducing drinking as naltrexone, another drug found to reduce alcohol consumption in heavy drinkers. Unlike naltrexone, varenicline is not metabolized by the liver and may be safe to use by those with impaired liver function, a frequent consequence of heavy alcohol use, McKee said.

Other Yale authors of the study are; Emily L.R. Harrison, Stephanie S. O'Malley, Suchitra Krishnan-Sarin, Julia Shi, Jeanette M. Tetrault, Marina R. Picciotto, Ismene L. Petrakis, Naralys Estevez, and Erika Balchunas.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health.

YALE

View drug information on Chantix; Naltrexone Hydrochloride Tablets.

Study Sees Transatlantic Decline in Youth Marijuana Use

February 18, 2009  (Excerpted from Join Together )

Adolescents in the U.S., Canada and most countries in Europe are using less marijuana, perhaps because they also are socializing less, according to researchers who reviewed previously published prevalence studies from dozens of countries.

The Associated Press reported Feb. 2 that the review of data on more than 93,000 15-year-olds concluded that marijuana use declined in the U.S., Canada and in Western Europe between 2002 and 2006.

Researchers led by Emmanuel Kuntsche of the Swiss Institute for the Prevention of Alcohol and Drug Problems also found that the teens were spending less time going out with friends at night -- a finding they said could be related to the drug trend since youths who spend more nights away from home are more likely to smoke marijuana.

Kuntsche said that instant messaging, e-mail and cell phones "may have partly replaced face-to-face contacts, leading to fewer social contacts in the evening."

The research was published in the February 2009 issue of the Archives of Pediatrics and Adolescent Medicine.

U.S. Has Highest Levels of Illegal Drug Use

In spite of the most stringent drug policies and punitive laws in the world, the United States also has the highest levels of lifetime illegal cocaine and marijuana use, according to a study of more than 54,000 people in 17 countries.

The United States also has the highest rate of lifetime tobacco use but comes in third in alcohol use, behind the Ukraine and Germany. The study, by Louisa Degenhardt of the University of New South Wales (Sydney, Australia) and colleagues, is based on the World Health Organization's Composite International Diagnostic Interview (CIDI).

Cocaine and Marijuana Use

The survey, which asked participants about their lifetime cocaine, marijuana, tobacco and alcohol use, found that 16.2% of people in the United States have used cocaine at some point during their lives. This rate was almost four times the rate of the second-place country, New Zealand, where 4.3% said they had tried cocaine.

The researchers also found that 42.4% of people in the United States reported marijuana use during their lifetime. New Zealand was second with 41.9%, but the two countries were far ahead of the other 15 in lifetime marijuana use.

Drug Policies Are Not Enough

"Drug use is related to income, but does not appear to be simply related to drug policy, since countries with more stringent policies towards illegal drug use did not have lower levels of such drug use than countries with more liberal policies," Degenhardt and her colleagues write.

"The United States, which has been driving much of the world's drug research and drug policy agenda, stands out with higher levels of use of alcohol, cocaine and cannabis, despite punitive illegal drug policies, as well as (in many U.S. states) a higher minimum legal alcohol drinking age than many comparable developed countries," the authors report.

"The Netherlands, with a less criminally punitive approach to cannabis use than the United States, has experienced lower levels of use, particularly among younger adults," the report says. "Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in nation-level rates of illegal drug use."

Drug Use Rates Higher Among Younger Participants

Here are some of the other key findings of the study:

• Males were more likely to have used all drug types, but that gender gap is closing among the youngest participants.

• Younger adults were more likely to have used all the drugs in the study than the older adults.

• Those who were never married or previously married had higher rates of tobacco, cocaine and marijuana use, but not alcohol use.

• Higher income was associated with higher rates of both illegal and legal drug use.

• Tobacco use is more prevalent among people who have been previously married but less likely among those never married.

• Alcohol use by age 15 was much more common among Europeans than in the Middle East or Africa.

Survey Results Not Static

"There was greater drug involvement among younger than older adults in all countries, suggesting that drug use has and may continue to change over historical time," the authors write. "Interestingly, there was also evidence to suggest that male-female differences in risk of initiating drug use may be changing in more recent birth cohorts.

"This change was a consistent finding across countries, suggesting that a general shift may be occurring with respect to the traditional sex differences so often documented with drug use."

_Source:

Degenhardt L, et al. (2008) "Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys." PLoS Medicine 1 July 2008

Treatment is Over. Now What if a Relapse Happens?

by A. Thomas McLellan, Ph.D.

Summary

• Some of the most challenging aspects of recovery occur after treatment is over, because recovered people frequently suffer relapses.
• Family preparation for the post-treatment period can help minimize the damage and disappointment of a relapse.

Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year.

It is critical that patients, their families and friends prepare for the possibility of lapse and relapse. The preparation should include early detection of a lapse and establishment of steps to keep that problem from becoming a full-blown relapse. Two sets of activities can reduce the likelihood of relapse and reduce the severity if it does occur.

Treatment-Related Preparation

A good addiction treatment program prepares patients to:

• recognize they have a problem that will require continued management and monitoring
• learn and practice some of the fundamental skills needed to recognize and overcome the urge to use or drink when these situations emerge
• be engaged in a continuing care program such as AA and receive regular monitoring of substance use through urine screening or breathalyzer
• receive periodic phone calls or in-home visits following care to monitor their recovery

These generic elements of effective planning during treatment are among the best clinical practices available to forestall lapse. This planning should involve families so they can better understand the treatment issues, be prepared to support the recovery plan and be aware of signs of lapse.

Post-Treatment Preparation

To prevent and contain relapse the family should agree to fully participate in planned continuing care activities. Families and all concerned others can take five helpful steps:

• Have copies of the continuing care plan prominently displayed to reduce ambiguity and promote full communication and response.
• Early in formal treatment, ask the family member in treatment to describe in writing some of the very early signs and behaviors that may lead to his/her lapse and relapse. For example, he/she might write something like "I will begin hanging out with my friend Jimmy," "I will not do my homework" or "I will stop attending AA meetings." As the family member undergoes continuing care, regularly refer to these written descriptions to monitor the recovery process.
• During formal treatment, as the individual thinks about relapse scenarios, ask what s/he thinks should be done when early relapse signs emerge. Use these words to develop a contract that includes an action plan the family will follow when any of these signs surface. For example, s/he might write "take my cash and credit cards," or "increase the urine screens." Be prepared - before the relapse happens - to take the type of actions contracted.
• Receive and display the results of post-treatment urine screens. Discuss any positive results openly and honestly.
• Monitor and support changes that are consistent with a drug-free lifestyle. In other words "catch him doing something good" and then support it appropriately.

Excerpted from:  HBO: ADDICTION: AFTERCARE

From Treatment to Sustained Recovery

by William L. White, M.A.

Professional treatment of alcohol and drug problems can start someone on the road to recovery, but a few weeks of treatment should not be mistaken for long-term recovery.

If you have severe alcohol and other drug problems, you should know that successful recovery from these problems involves significant changes over time in:

• personal identity and beliefs
• family and social relationships
• daily lifestyle

It is about where you live, how you work and play, who is included and excluded from your life, and how you cope with the stresses of daily life. Recovery is more than just not drinking or using drugs; it is about putting together a new and meaningful life in which alcohol and drugs no longer have a place. Recovery from addiction is not like getting over an infection for which we can rest and take medication for a week or two and then get back to our otherwise unchanged lives. Those who view treatment for addiction in this way make up the group for whom treatment does not work. Recovery from addiction is closer to how someone successfully manages diabetes or heart disease - conditions that require sustained decisions and actions for life.

The Good News

• The positive effects of addiction treatment are substantial, as measured by sustained sobriety (about one-third of those treated) and decreases in substance use and substance-related problems.
• Active participation in treatment aftercare meetings and recovery support groups such as Alcoholics Anonymous can significantly improve your chance of permanent recovery, improve your quality of life and prolong your life expectancy.
• Combining professional treatment and attending recovery support meetings improve your chances of recovery better than either activity alone.
• Lifetime recovery rates of people with a substance use disorder approach or exceed 50%. There are millions of individuals and their families in long-term recovery from the effects of severe substance use problems.
• There are multiple pathways and styles (secular, spiritual, religious) of long-term addiction recovery
• Recovering people can go on to lead lives of significant achievement and community service.

Excerpted from HBO: Addiction: Aftercare

FIVE SOBERING FACTS ABOUT WHAT HAPPENS AFTER ADDICTION TREATMENT

1. Most people completing addiction treatment are fragilely balanced between sustained recovery and resumption of alcohol and drug use: more than half will consume alcohol or other drugs in the year following discharge from treatment.

2. The window of greatest vulnerability for relapse after treatment is the first 30-90 days following discharge.

3. Between 25-35% of people who complete addiction treatment will be readmitted to treatment within one year, and 50% will be readmitted within five years.

4. Recovery is not fully stabilized (point at which future risk of future lifetime relapse drops below 15%) until four to five years of sustained recovery.

5. Sustained addiction can be lethal: relapses following addiction treatment produce high death rates from accidental poisoning/overdose, liver disease, cancer, cardiovascular disease, AIDS, suicide and homicide.

Courtesy of: HBO: Addiction: Aftercare