Scottsdale Intervention

New Recovery Resource for Students

2010-09-27T19:34:00.000-07:00

I am notifying all my friends who may know someone who could benefit from a new meeting I am starting up.

This meeting is for Students Living In Recovery from addiction to alcohol & drugs.

I need your help getting the word out. This meeting is the foundation for building a resource for people who are already in recovery and helping other students who need and want recovery. It is about bridging recovery and education; helping students who need addiction treatment stay in school (or return to school quickly after receiving primary treatment) and helping people who are in recovery get back in school, stay in school, and be successful in their studies and future goals.

Please forward this information to as many people as you know who are in recovery and in school and invite them to our meeting. They can just show up, no need to make a reservation or anything.

Thank you so much! If you want more info please call or email me, 602-696-5532 / karen@scottsdaleintervention.com. I'd love to talk more about it!
Karen

New SLIR meeting for Students Living in Recovery
Thursdays at 7pm (free/no charge)
Starting Thursday October 7, 2010

Open to all students who are currently living in recovery from addiction to alcohol & drugs
·Meet other students who have similar goals and challenges
·Be part of forming a recovering collegiate community at ASU and other local colleges
Be a resource for other students beginning recovery from addiction to alcohol & drugs
·Peer based structure, no therapist or counselor leadership

Centrally located at: ASU - Downtown Phoenix
Nursing Health Innovation 1 Building
500 N 3rd Street, Suite 157
Phoenix AZ 85004
(North East corner of 3rd Street & Taylor,entrance on Taylor)

Hope to see you there!

I am often asked, "What about people who don't like 12 step meetings, do you have any ideas about how to help them?"

2010-09-27T19:05:00.000-07:00

As a matter of fact I do have a few ideas about people who “don’t like 12 step”.
Sometime after graduation from this DBH (doctor of behavioral health) program I am in, I would like to write an article titled, “If vegetarians embrace a lifestyle motto of ‘I don’t eat meat”, why can’t alcoholics embrace a lifestyle motto of “I don’t drink”?

Of course, stopping drinking is not the same as stopping eating meat because vegetarians aren’t addicted to meat. Addiction is not simply a cognitive behavioral issue, although some would have you believe that it is. The choice argument fails again and again, yet some people/professionals refuse to accept that addiction recovery requires a spiritual change. Not religious, not god – but a change at the core of existence. A change that resolves the question, “what gives my life meaning?”.

The self exploration required to answer this deeply personal question requires support from a community dedicated to individuation and spiritual growth. 12 step programs offer just that. If you don’t like 12 step programs you are going to have to find this community somewhere else. Churches often offer this kind of support, but usually people who “don’t like 12 step” are religion resistant.

People don’t like chemotherapy either, but when the physician orders chemotherapy as the best chance at survival from cancer, patients accept it and do it. Addiction is a chronic progressive, and potentially fatal disease that requires a specific course of treatment. It isn’t any different than cancer.

It is often not the patient, but rather the physician or other health professional (including the psychotherapist), who “doesn’t like 12 step”, he doesn’t accept 12 step as a viable addiction recovery method. The professional hides behind the guise that the patient won’t accept 12 step recovery – however, if the therapist believes in the model of therapy he is presenting – the patient will most often also accept the treatment. These professionals who lack expertise in addiction treatment derail the addicted patient before he ever boards the train.

Why is it that addiction treatment centers worldwide use 12 step recovery as the basis of their treatment? The answer simply is that 12 step recovery works. Consistently over time, 12 step recovery has been the only model of addiction treatment to produce results. The little known fact is that people get clean and sober all the time. Addiction treatment experts witness this daily, I sure do.

The problem is that people who recover in 12 step programs do so anonymously. The problem with anonymity is that the general public including doctors, judges, and psychotherapists don’t have reason to have contact with these recovering people. They are anonymously going about living their happy, joyous, and successful lives free from active addiction. The patients and plaintiffs the doctors, judges, and psychotherapists have contact with are the ones who “don’t like 12 step”. They are the ones getting arrested, med seeking in doctor's offices, and showing up in emergency rooms and morgues after overdoses and alcohol/drug related accidents. Those things stop happening for people in anonymous 12 step recovery.

So I think the real question to ask is “Why do therapists and physicians without expertise in addiction treatment think they know better how to treat an addict than the experts?”

As Nick Cummings, PhD says, “all insight is soluble in alcohol”, therefore we need to sober up an alcoholic (or drug addict) prior to embarking on this expedition of self exploration. So the answer is ALWAYS abstinence. Not harm reduction, not controlled drinking - abstinence. Once a person has mastered abstinence for 1 year, he can decide if he wants to commit to an ongoing abstinent lifestyle. But not before one year.

And, by the way, anyone who can not possibly imagine one year without alcohol (or drugs) hints of addiction. A non-addict can take it or leave it. Only an addict will be emotionally attached to their chemical and fight for their right to use it.

At the root of addiction is a self-esteem issue. Although it may not appear this way on the surface, when you dig deep enough you will find that every addict suffers from the belief that he is not enough. Not smart enough, not pretty enough, not “whatever” enough; or simply stated, just plain “not enough”. Drugs and alcohol are used to buffer the person from that reality.

The fundamental belief system for the addict states “I can’t handle life without a chemical to get me through”. However, this belief system operates at the subconscious to unconscious level, so an addict presenting for treatment is walled off behind defense mechanisms that protect this belief. These defense mechanisms include; rage, people pleasing, “looking good”, hopelessness, workaholism, perfectionism, martyrdom, and a slew more. An untrained therapist will misinterpret these, and never see the suffering addict underneath.

So, leave addiction treatment to the addiction treatment experts, who will give the proper prescription to an addicted person. It will go something like this, "I am sorry to tell you that you have a chronic, progressive, and potentially fatal disease that will kill you if it is not arrested. That's the bad news. The good news is that you have a 100% chance of 100% lifelong remission if you follow this treatment protocol. All you have to do is stop drinking/using, and go to AA or NA. Then, get a sponsor and work the steps - and one year from now you will be free from the active disease of addiction."

What do the initials BRI mean?

2010-08-16T19:58:00.000-07:00

You will notice that the interventionists at Scottsdale Intervention have the initials BRI-I or BRI-II after their name. This stands for Board Registered Interventionist level I or level II. The International Interventionists Credentialing Board (IICB) awards this registration to interventionists who meet professional standards of education, training, and experience.

Minimum Requirements for BRI I:
• Hold a current national or state recognized certification/license in a counseling related field.
• Have malpractice insurance, a minimum of 1,000,000/3,000,000.
• Have a minimum of 2 years of work experience conducting interventions.
• Successfully complete training/education on intervention.
• Adhere to Board Registered Interventionist Code of Ethics.

Minimum Requirements for BRI II:
• Be or meet the requirements to be a BRI I.
• Successfully complete training/education specific to addictions other than to alcohol and drugs, i.e., gambling, food, sex, etc.
• Have at least 5 years of work experience conducting interventions.

(adapted from http://www.iaodapca.org/certifications/bri/require.cfm)

It is important that your interventionist holds this credential. This professional credential assures you that your interventionist is trained and experienced. Further, the BRI requires that your interventionist uphold industry ethical standards and maintain a malpractice policy.

The BRI is the only intervention certification endorsed by the Association of Intervention Specialists (AIS). AIS sets the standards for interventionists internationally.

While it is legal for “just anyone” to facilitate an intervention, it is not ethical. Protect yourself and your loved one by hiring a Board Registered Interventionist.

Opiate Dependence Resulting From Treatment of Chronic Pain

2010-06-09T18:57:00.000-07:00

75 million Americans suffer from chronic pain and most are prescribed opiate drugs to help manage their pain. In the past 10 years opiate use has increased markedly. In fact, from 1997 to 2005 major opiate sales rose over 90%. This widespread use of potentially addictive opiates has caused problems for many patients. The purpose of the next few pages is to help familiarize you with the risks of and alternatives to long term opiate use.

To tell if your opiate medication is effectively treating your pain, answer these 3 questions:

1. Is your pain totally or mostly relieved, or at least significantly better?

2. Is your function maintained or improved?

3. Are the side effects (constipation, fatigue, mental clouding, respiratory

depression, nausea, sedation, euphoria or dysphoria, and itching) tolerable?

If you answered yes to all three of these questions then you do not need to read any further, this is successful opiod treatment and needs no intervention. If you answered no to any of these questions, you are not alone. Many people who began opiate treatment for pain have fallen down the same rabbit hole, and need to change their method of treating their pain to improve their functioning and overall satisfaction with life.

Opiate medications are good for treating acute pain (initial, short term pain like that following surgery or severe injury) and terminal (malignant) cancer pain, but are not effective for treating chronic pain (long term pain lasting more than 6 months). The most problematic side effects of long term opiate use are tolerance and hyperalgesia.

Hyperalgesia is an increased sensitivity to pain, which may be caused by damage to nociceptors (sensory receptors that react to potentially damaging stimuli by sending nerve signals to the spinal cord and brain causing the perception of pain) or peripheral nerves. Various studies of humans and animals have demonstrated that primary or secondary hyperalgesia can develop in response to both chronic and acute exposure to opioids. This side effect can be severe enough to warrant discontinuation of opioid treatment. A common scenario is that a patient is prescribed an opiate during the acute phase of pain and then continues the opiate through the chronic phase in which pain is usually less, but because of opiod induced pain the perception of pain is distorted. This patient is now treating pain caused by the opiate, with more opiate.

Tolerance of the drug naturally occurs with long term use of opiates, requiring more of the drug to get the same effect. Hyperalgesia compounded by tolerance means the dose and number of doses per day has to continually increase. The increasing doses of opiates lead to decreased levels of functioning as side effects increase. Many patients report increased depression, frustration, anger, social isolation, dependence on others, and overall dissatisfaction with life.

Some Common Mood Altering & Potentially Addictive Opiate Drugs

(this is not a complete list)

Brand Name	Generic Name
Hycodan	Hydrocodone/Methylbromide
Tussionex	Hydrocodone bit/Chlorphreneramine
Actiq	Oral transmucosal fentanyl citrate
Demerol	Meperidine
Dilaudid	Hydromorphone
Duragesic	Fentanyl
Kadian	Morphine sulfate
Methadone	Methadone
MS Contin	Morphine sulfate
Oxycontin	Oxycodone
Oxyfast	Oxycodone
Percocet	Oxycodone/Acetaminophen
Percodan	Oxycodone/Aspirin
Tylox	Oxycodone/Acetaminophen
Lorcet	Hydrocodone/Acetaminophen
Lortab	Hydrocodone/Acetaminophen
Norco	Hydrocodone/Acetaminophen
Subutex	Buprenorphine hydrochloride
Suboxone	Buprenorphine hydrochloride + naloxone
Tylenol/Codeine	Acetaminophen/Codeine
Vicodin	Hydrocodone/Acetaminophen
Vicoprofen	Hydrocodone/Ibuprofen
Darvocet-N	Propoxyphene/Acetaminophen
Darvon	Propoxyphene
Stadol NS	Butorphanol tartrate
Talwin NX	Pentazocine

Some Other Common Mood Altering & Potentially Addictive Medications

(this is not a complete list)

Type	Brand Name	Generic Name
Amphetamines	Adderal	Amphetamine aspartate/Sulfate
	Dexedrine	Dextroamphetamine
Barbiturates	Fioricet/Codeine	Butalbital/Codeine/Acet/Caffeine
	Fiorinal	Butalbital/Aspirin/Caffeine
	Phenobarbital	Phenobarbital
Benzodiazepines	Ativan	Lorazepam
	Dalmane	Flurazepam
	Halcion	Triazolam
	Klonopin	Clonazepam
	Librium	Chlordiazepoxide
	Restoril	Temazepam
	Serax	Oxazepam
	Tranxene	Clorazepate Dipotassium
	Valium	Diazepam
	Xanax	Alprzolam
Hypnotics (for sleep)	Ambien	Zolpidem titrate
	Lunesta	Eszopiclone
	Sonata	Zaleplon
Muscle Relaxants	Soma	Carisopropodol
	Equagesic	Meprobamate/Aspirin
Stimulants	Concerta	Methylphenidate
	Ritalin	Methylphenidate

Mel Pohl MD, 2008. A Day Without Pain, Central Recovery Press, Las Vegas NV.

Indications of Problematic Opioid Use

1. Taking more medication, more often than was prescribed by the physician

2. “Doctor shopping”, or attempting to get prescriptions from multiple doctors. Also, repeated episodes of “lost” prescriptions

3. Aggressively complaining about the need for higher doses or requesting specific drugs. An overwhelming focus on opiates during doctor visits that impede progress with other issues regarding pain management

4. Hoarding or saving drugs during periods of reduced symptoms

5. Taking pain medication to deal with other problems such as stress

6. Stealing or borrowing medications from other patients

7. Engaging in concurrent abuse of related illicit (illegal) drugs or alcohol

8. Family members or others expressing concern about a person’s use of pain medication

Is opiate addiction the same as opiate dependence?

Yes and no. Opiate dependence and opiate addiction both result in withdrawal symptoms upon discontinuation of use. For this reason, both are initially treated the same way. Treatment involves education as to why chronic opioids are likely to maintain pain, detoxification, treatment of pain with non-opioid analgesics and other complimentary and alternative medicine, psychological support, coordination of care, and promotion of healthful behaviors. Detoxification alone is rarely sufficient.

The psychology of drug dependence is powerful and must be taken into account.

For the opiate addict, additional addiction treatment is necessary to avoid future relapse with the drug. The risk of addiction needs to be understood and built in to all treatment using potentially addictive drugs.

Opiate Addiction

Risk factors for addiction can be considered in three categories:

1. Psychosocial factors

2. Drug-related factors

3. Genetic factors

The highest risk for addiction arises when risk factors in each category arise together. Pain patients with no genetic predisposition, no psychosocial factors, and taking stable doses of opioid for the treatment of severe pain in a controlled setting are unlikely to develop addiction. On the other hand, patients with a personal or family history of substance abuse, displaying one or several psychosocial factors, are at risk of developing addiction.

Ballantyne, J.,LaForge, S.(2007). Opioid dependence and addiction during opioid treatment of chronic pain. Pain 129 (2007) 235–255

Signs of Addictive Use

1. Continued use despite harmful consequences

2. Withdrawal from family, friends, or other social activities

3. Ignoring responsibilities such as work, school, family

4. Increasing dose, number of doses, extending use without doctor approval

5. Becoming defensive when confronted

6. Being overly sensitive to normally sensitive situations

7. Personality changes; energy & mood suddenly change

8. Doctor shopping; visiting numerous doctors and ER’s to get prescriptions

9. Forgetfulness

10. Ignoring appearance/personal hygiene & changing eating and sleeping habits

Complimentary & Alternative Medicine (CAM) Treatment

CAM’s do work, there are volumes of experiences and research to support them. The reason they are not more popular is that they take time and effort to work. Sustained effort is required to maintain sustained change. The pill is reliable, although imperfect, in it’s effect; it only lasts a few minutes to a few hours. Medication has been the therapy of choice in treating pain for one reason – it is easier for the patient and the doctor. It requires no work on the part of the doctor to write the prescription or on the part of the patient to take the pill. However, in light of the rising epidemic of opiate induced problems, CAM’s are increasingly being used by doctors and their patients for relief from pain, return to functioning, and increased life satisfaction.

CAM’s work well when used along with non-opiod medications. These non-opiod medications, some originally used for other conditions, are helpful in managing pain.

Non Opiod Medications

Drug Class	Brand Name	Generic
Anticonvulsants	Neurontin	Gabapentin
	Topamax	Topiramate
	Tegretol	Carbemazepine
	Depakote	Valproic acid
	Lyrica	Pregablin
Antidepressants	Elavil	Amitryptilline
(Tricyclics)	Norpramin	Desipramine
	Pamelor	Morpramine
(SSRI/SNRI)	Effexor	Venfalxine
	Cymbalta	Duloxetine
NSAIDS	Celebrex	Celecoxib
	Advil, Motrin	Ibuprofen
	Naprosyn, Aleve	Naproxen
	Indocin	Indomethacin
	Relafen	Nabumetone
Muscle Relaxants	Robaxin	Methocarbamol
	Baclofen	Liorisal
	Skelaxin	Metaxalone
	Flexeril	Cyclobenzaprine
	Xanaflex	Tizandine
Topicals	Zostrix	Capacins
	Lidoderm patches	Lidocaine

Mel Pohl MD, 2008. A Day Without Pain, Central Recovery Press, Las Vegas NV.

For many pain patients, their pain becomes part of them. It defines them. It consumes their identity. In other words, they become their pain. But their pain is not who they are – it is simply the pain they feel. Chronic pain does not go away. But it can be diminished and controlled. The person can take control of their life back. Chronic pain does not have to mean chronic suffering. Many pain patients have learned to give up the opiates and manage their pain by using these techniques. When they do they report moments, days, even weeks, without pain. They report decreased levels of pain. They report increased ability to engage in joyful activities. They are able to live without the constant distraction of pain. They get control back from the helplessness of chronic pain, and so can you.

Following is a list and brief description of some Complimentary and Alternative Medicine (CAM) treatments from Dr Mel Pohl’s book, A Day Without Pain. These techniques are used in chronic pain treatment programs. Consider this a smorgasbord of options to pick and choose from. They work best when several are used in conjunction with one another. For more information about these treatments please ask your health care provider.

· Exercise. When you are inactive your body becomes de-conditioned, which can add substantially to your pain. Exercise helps pain by decreasing weight and taking pressure off joints and vertebrae, increases flexibility which decreases stiffness and aches, builds strength to take pressure off joints and bones, increases serotonin levels which improve mood and blocks perception of pain in the brain, and strengthens the heart and circulatory system. Many chronic pain patients are resistant to begin an exercise program, fearing the movement will cause more pain. However, in reality - it is the lack of movement that causes more pain.

· Nutrition. Eating “junk foods” is easy to rationalize when you are not feeling well. But eating healthy foods like green leafy vegetables, lean fish & meats, fresh fruits, and whole grains leads to being and feeling healthy which helps fight pain sensations.

· Meditation & Imagery. When people meditate they can increase the amount of natural painkillers in their body and produce pleasurable brain chemicals.

· Chiropractic therapy. Many patients report a reduction in pain with the use of regular chiropractic manipulations. There are hundreds of different techniques and manipulations used by chiropractors.

· Physical therapy. Physical therapists use many different modalities to treat pain. They include manipulation, traction, therapeutic exercise, functional training, patient education and counseling about movement and body mechanics, ice & heat therapies, electrical currents, and other new techniques to remove adhesions.

· Stretching, Pilates, Yoga, & Tai Chi. All of these methods work to improve pain on many levels; body awareness, mindfulness, core strengthening and awareness, postural balance, increased range of motion, spinal stability, stress relief, improved circulation, weight reduction, and inner peace.

· Acupuncture. Acupuncture is thought to relieve pain by increasing release of endorphins (brain chemicals related to euphoria and happiness). Studies show that acupuncture is especially effective at relieving neck and low back pain.

· TENS (Transcutaneous Electrical Nerve Stimulation). TENS units are small battery operated devices that produce a signal to interrupt pain transmission to the brain. They can be worn externally or implanted by a surgeon.

· Massage & Aromatherapy. Massage relaxes tight muscles and tissues and improves oxygenation, circulation, and blood flow to painful areas. Aromatherapy claims to stimulate the brains limbic system awakening and strengthening the body’s self-healing chemicals. It works the same way as smelling freshly baked chocolate chip cookies makes you hungry!

· Cognitive restructuring and psychotherapeutic therapy. Thoughts profoundly affect mood and the perception of pain. Cognitive restructuring of negative thinking about pain improves a sense of power and control over the pain and reduces the perception of pain. It also decreases muscle tension associated with the emotions of pain.

· Hypnotherapy. Relaxation suggestion therapy can help change behaviors, like nail-biting and smoking. It is also helpful in treating depression, PTSD (post traumatic stress disorder), phobias, fears, anxiety, stress, and sleep disorders. It is helpful in treating pain by addressing the physical and mental aspects of pain.

· Biofeedback. People are taught to control some normally involuntary processes such as muscle tension, blood pressure, and the perception of pain with the use of electrodes from a measuring device.

· Support groups. People who experience chronic pain find that their pain is lessened when shared with other people who have the same experiences they do. When treating addictive opiate use, 12 step groups are the primary source for social and recovery support. For the non-addicted, chronic pain support groups are commonly held in hospitals and pain management centers.

Substitution Therapy

Medications such as Buprenorphine (Subutex and Suboxone) and Methadone are being prescribed by some physicians to treat some opiate dependent patients. The rationale motivating this therapy is to replace the addictive opiate medication with a less harmful synthetic opiate medication and eventually taper the patient off the drug completely. The problem with substituting one drug for another is that the patient becomes dependent upon the replacement drug and has difficulty tapering off the low doses of the medication. In most reported cases of Suboxone therapy the duration of Suboxone use has exceeded the time spent abusing. There is no evidence based data to suggest when or if substitution therapy can be discontinued.

These medications may be effectively used for 1 to 5 days during the medically supervised acute detoxification period, but long term use of these medications is only appropriate for a small percentage of the population. There are two situations where substitution therapy is beneficial:

(1) Once all other treatment options have genuinely been exhausted, it may be necessary to maintain a patient on a small dose of a substitution medication.

(2) The other appropriate use for substitution therapy is for palliative care (end of life care). Although it would be unusual to diagnose opioid misuse during treatment of terminal pain, this is not because terminally ill patients do not experience problems related to opiate drugs, but rather that it is not seen as problematic if they do. For them, the primary goal of treatment is palliation, not functionality, and therefore a substitution medication may provide better quality of life than continuation of high doses of opiates.

Naltrexone is another medication sometimes used to treat opiate dependence. Naltrexone is an opiate inhibitor that blocks the effects of the opiates. It does not have any pain relieving effects. It is used as a deterrent to taking opiates since any euphoric effect will be blocked. Again, using this substitution drug does not address the underlying problem; it shifts the dependence to another medication. Simply discontinuing the use of this medication, or any of the substitution medications, will reverse its effects.

References

Ballantyne, J. (2007). Opioid Analgesia: Perspectives on Right Use and Utility. Pain

Physician 2007; 10:479-491• ISSN 1533-3159

Ballantyne, J., LaForge, S. (2007). Opioid dependence and addiction during opioid

treatment of chronic pain. Pain 129 (2007) 235–255

Ballantyne, J. (2007). Opioid Misuse in Oncology Pain Patients. Current Pain and

Headache Reports 2007, 11:276–282

Cicero,T., Inciardi, J., & Muñoz, A. (2005). Trends in Abuse of OxyContin® and Other

Opioid Analgesics in the United States: 2002-2004. The Journal of Pain, Vol 6, No 10 (October), 2005: pp 662-672.

Cummings, J. (2009). Chronic Pain Management. Lecture and accompanying written

Materials, September 27, 2009.

Mendelson, J., Flower, K., Pletcher, K., Galloway, G. (2008). Addiction to Prescription

Opioids: Characteristics of the Emerging Epidemic and Treatment With Buprenorphine. Experimental and Clinical Psychopharmacology 2008, Vol. 16, No. 5, 435– 441 1064-1297/08/$12.00 DOI: 10.1037/a0013637

Modesto-Lowe, V., Johnson, K., Petry, N. (2007). Pain Management in Patients with

Substance Abuse: Treatment Challenges for Pain and Addiction Specialists. The American Journal on Addictions, 16:424–425, 2007, DOI:10.1080/10550490701525566

Pohl, M. (2008). A Day Without Pain. Central Recovery Press, Las Vegas, NV.

Streltzer, J., Johansen, L. (2006). Prescription Drug Dependence and Evolving Beliefs

About Chronic Pain Management. American Journal of Psychiatry 163:4,

April 2006

Wikipedia. http://en.wikipedia.org

4 Common Myths About Intervention

2009-04-28T21:30:00.000-07:00

1. Intervention is a dramatic, emotionally charged, and stressful event.

2. The addicted person is given an ultimatum to “get help or else!”

3. The addicted person is whisked off to an out of state treatment center by the interventionist, who has been flown in from out of state.

4. You should only do an intervention when things get really bad.

The truth about how I do an intervention:

1. The intervention isn’t an “event” at all; it is a loving, caring, respectful process. The family gathers with the person they are concerned about to express their concern and fears and to make an offer to help. The addicted person is sometimes invited to this meeting, but when the element of surprise is determined to be valuable it is treated the same as if you were to stop by to visit a sick friend in need. The intervention is well planned and calm. No one is ever forced to do anything and everyone is free to leave at any time. Everyone is treated with dignity and respect at all times, I do not allow any yelling, name calling, or blaming to occur at any time during the process.

2. The addicted person is offered the opportunity to take control of his/her life by taking the first two steps toward recovery which are (1) to admit the need for help and (2) to accept the help being offered. What comes next is not an ultimatum, but rather a vow for health. Whether the addicted person chooses to accept help or not, the family members will take control of their lives by vowing not to continue to enable addiction. Everyone involved in the intervention is taught how to heal themselves and reclaim their personal freedom.

3. There are many different treatment options. Not everyone needs 30, 60, or 90 days of residential treatment. Those who do are offered the treatment program most clinically and geographically appropriate for their recovery needs. Each situation is treated individually. Sometimes the best treatment option is outpatient counseling linked with 12 step support. No matter what treatment is offered, a family member always accompanies the IP to the treatment facility; I usually don’t go at all.

I specialize in local intervention. There are plenty of people who need my help right here. The Association of Intervention Specialists provides a list by state of professional interventionists at www.associationofinterventionspecialists.org. I recommend you consult this list to find an interventionist in your area. There may be no reason to pay the additional travel costs to get an out of state interventionist to come to you when there may be a qualified interventionist close by.

4. How bad is “bad enough”? Please don’t sit around and wait for your loved one to “hit bottom”. That’s downright cruel. You should never feel guilty about speaking your truth and making an offer to help; it’s what healthy people do. An intervention is fail proof because at a minimum the family members heal. They break their dysfunctional code of silence and enabling behaviors and this ALWAYS has a healing effect on the disease process.

Why Intervene Now?

2009-04-09T16:32:00.001-07:00

The stress of the current economic situation has a direct effect on addictive behaviors. In times of stress addiction prone people increase their consumption of alcohol, drugs (prescription and street drugs), food, or their gambling, sexual or work behaviors. The addiction serves as an escape from stress and worry; it is a coping mechanism.

The problem is that addiction does not help in the long run. Addiction is a chronic, progressive, and potentially fatal illness that creates more problems for the one addicted and the people close to him or her. It is usually a family member or close friend who first recognizes the need for help. The addict often rationalizes and justifies his addiction, this is characteristic of the denial associated with addictive disease.

Intervention is the act of breaking denial and shedding the light of reality and hope on the addictive situation. Because of the denial process, an intervention from outside the addict is always needed to facilitate help. I used to tell concerned family members and friends that there was nothing they could do; they would have to wait for the addictive disease to run it’s course and for the addict to “hit bottom” before he would be willing to get help. “Hopefully he will not die first” I would think to myself.

I don’t tell people that anymore. I tell people that if you love someone who has an addiction problem you owe it to him and to yourself to intervene on the addiction and make an offer of help. Waiting around for someone to lose a career, or a marriage, or a home, or get arrested, or die is inhumane when you have a solution.

Intervention, when done right, is not an act of judgment and ultimatum. Intervention is an act of love, dignity, and hope. It provides a lifeline to a drowning person. Quite simply, it saves lives.

Addiction is a treatable disease. There is plenty of local, high quality, affordable treatment available. Treating the disease isn’t the biggest problem. Getting people to accept treatment for addiction is the biggest challenge. Interventionists are trained at just this process. A professional intervention provides a high likelihood of someone agreeing to get help.

Further, an interventionist can provide support to the family members. Family members need support with understanding what they can and can’t do to help. Many times it is precisely the well intentioned acts of family members that are keeping the addict sick. Once family members and friends understand the addictive disease and the role they are playing in it, they are highly motivated to make changes that promote addiction recovery.

The danger of economic times like these is that while the need for addiction treatment is on the rise, the rate of people accessing addiction treatment is falling. The reason for this seems to be two-fold.

1) Fee for service treatment (or treatment that is not being paid for by insurance but out of pocket by the consumer) has decreased because people are tightening their budgets, spending less, and cutting corners wherever they can.

2) Insurance reimbursed addiction treatment is also affected because some have lost jobs and hence their insurance benefits and those who still have jobs are hesitant to access EAP or insurance paid treatment for fear of losing their jobs. Addiction treatment is confidentially protected by AZ statute, however, time away from work to attend treatment could shed an unfavorable light on an employee and make them more susceptible to lay off.

It is dangerous to put off addiction treatment because as the disease progresses, the consequences and despair increase. The longer an addict stays in active addiction the worst off he becomes. His physical and mental health plummet, and he loses more and more quality of life. The addictive behavior itself becomes a slow form of suicide.

Without treatment addiction kills people. It doesn’t say “Addiction” as the cause of death on the death certificate. It says things like, “cirrhosis of the liver, heart failure, kidney failure, AIDS, motor vehicle accident, gun shot to the head, hanging”, but it is because of an untreated addiction that many of these people have died.

67% to 97% of those people who attempt addiction recovery make it. The 97% is from a study of Navy Pilots treated at early onset with primary residential treatment, 3-5 years of monitoring, and a return to flying within the first year. This is evidence that addiction is a very treatable disease once treatment is accepted by the addict.

I like to wrap up my conversations about Addiction Intervention with this message:

Intervention, if nothing else, is so addicts don’t have to die not knowing that there is a better way to live, and family members and friends don’t have to go to funerals not knowing that they did all that they could.

How Does An Addiction Interventionist Stay Sensitive to the Current Economic and Environmental Situation?

2009-03-14T09:31:00.000-07:00

Since I began my practice, Scottsdale Intervention and Counseling LLC, my purpose has been to provide my local community with a comprehensive resource for addiction treatment. When anyone in my “neighborhood” has a problem with addiction or knows someone with a problem with addiction I hope they will call me so I can help.

In the early stages of recovery from addiction and codependency people need a lot of support and an Intervention on the addicted system is usually the first order of business. The addict and the family members need to learn about the addictive process and how to best treat it. Once they are motivated to get treatment, they need help determining which treatment option is best suited to their unique needs.

Sometimes I provide the treatment myself, in my office. And sometimes I refer them to another treatment provider. There are instances when the best treatment approach is to send a person far away from home, hoping they will never return, and will build a new life for themselves far from negative local situations. There are also instances when the best treatment provider for a unique situation is located in another state. More often, however, it is most effective to utilize local treatment and recovery resources.

Using local resources is beneficial for the addict because she builds her early recovery foundation in the environment she will continue to work and live. Staying close to primary family members makes it convenient for them participate in family programs at the treatment center. Local codependency treatment and recovery resources can also be utilized for family members and friends.

When you use local resources you avoid travel. Travel adds to the cost of treatment (these valuable dollars could be going to support additional treatment) and travel (especially airline travel) costs the environment by burning carbon based fuels.

It is also environmentally friendly and usually less expensive to use a local Interventionist. A local Interventionist will be better acquainted with local treatment resources and will typically be less expensive because you do not have to pay for travel expenses.

The AIS (Association of Intervention Specialists) provides a list, by state, of credentialed professional Interventionists on their website at www.associationofinterventionspecialists.org. When choosing an Interventionist make sure they are BRI-I or BRI-II credentialed. The BRI (Board Registered Interventionist) credential ensures that your Interventionist meets professional standards of training, education, and experience. Only BRI credentialed Interventionists are listed on the AIS website. AIS sets the standards for Addiction Interventionists world wide.

Addiction Intervention: How To Help Someone Who Doesn’t Want Help

2009-03-10T21:44:00.000-07:00

Addiction is a brain disease. Science has determined this by a variety of clinical studies, laboratory experiments, and brain scans. The brain of an addicted person processes addictive chemicals and behaviors differently than a non-addicted brain. Further, the addicted brain processes the chemical/s or behavior/s of choice at a survival level. So, biologically an addict’s brain interprets using as surviving; not using as not surviving.

This explains a lot. It explains why addicts continue to use despite a slew of negative consequences. When they lose their jobs, marriages, dignity, respect; when they go to jails and hospitals they often still don’t stop using.

It also explains why an Intervention is necessary to help an addict accept treatment for addiction. An addicted person is ill equipped to take rational action against addiction. He is deluded by a malfunctioning brain. Intervention gets his attention, it raises consequences. Intervention can be a formal meeting of loved ones expressing their love and concern and offering a chance at a new way of life or it can be an intervention in the form of an arrest, a divorce, or getting fired from a job. A formal Intervention meeting is the gentler way, it can occur prior to more serious consequences.

Intervention offers hope in an otherwise hopeless appearing situation. Most of the time the addict goes to treatment following an Intervention. And some of the time they stay in treatment, and some of the time they don’t. Some of the time they go on to live clean & sober lives and some of the time they relapse back in to addiction after treatment. Some of the time they eventually get clean and sober after a relapse and some of the time they die in active addiction. Those are the facts of addiction. Those are the facts of any chronic, progressive, fatal disease.

If the goal of Intervention is only to get an addict from point A (active addiction) to point B (the treatment center) then Intervention is successful most of the time. I, however, do not believe that is enough. I believe the goal of Intervention is healthy change for everyone involved. It is an opportunity for all affected by addiction to recover; to recover their freedom, their dignity, and their lives. Even if an addict does not recover from addiction, Intervention teaches family members how to recover. Improved health for every member of an Intervention process is equally important.

When deciding to Intervene, an initial question to resolve is “to surprise or not to surprise”? When I present both the surprise and invitational Intervention approaches, most families I work with tell me that if they were to invite their addicted love one to an Intervention “they would never show up”. This is a logical response. To be quite honest, when I was drinking and drugging I can’t imagine volunteering to attend a meeting to talk about “my problem”. This is why most of the Interventions I facilitate are of the Johnson (Surprise) Model. I believe in the Johnson Model, it works. It allows family and friends to make an offer of life and this offer is most often accepted.

In the spirit of full disclosure, I must also say that sometimes when you surprise someone they are not grateful for it. Sometimes the addict is quite angry at the Intervention team members, especially me. Sometimes no matter how much Intervention team members try to express their love and concern, what the addict hears the loudest is that you “tricked me, lied to me”. That can create a big barrier to the addict accepting the gift of recovery.

This raises a good argument for the invitational model of Intervention. Believe it or not, most addicts do show up for a scheduled family meeting to talk about the problems facing all of its members. The addict doesn’t usually want to come, and he will try to get out of it; convince the family it is not necessary. But if everyone sticks to the plan, the meetings happen and eventually the addict shows up. The invitational model works.

Again, in the spirit of full disclosure, I must also say that the invitational model of Intervention usually takes longer to complete than the Johnson Model. It often requires a series of family meetings over the course of weeks to months. It takes intense commitment from all the members of the Intervention team over a longer period of time.

In the end, the recovery success rate is the same. Among all those people attempting recovery motivated by formal Intervention meetings (surprise or invitational), court order, homelessness, divorce, losing their children, hospital admissions, suicide attempts, etc. the rate of recovery is about 66%. This is broken down in to the law of thirds. One third of those attempting recovery get it the first time and go on to live free from active addiction for the rest of their lives. The second third relapse for a period of time and then eventually get it. The last third do not ever get it, they die in active addiction.

Recovery is possible. The statistic I quote most is this: The AMA (American Medical Association) says “Addiction is the most treatable of all diseases. It has a 100% chance of 100% life long remission”. Any addict can recover and go on to live a healthy, happy life free from active addiction.

Whether you choose to invite or not invite an addict to an Intervention is a personal choice. Either method works, the best choice will depend on the circumstances of your unique situation. We will make this decision together in our first meeting. The most important thing is to take action, to learn how to step out of the problem and into the solution.

The last thought I will share is this; If nothing else, Intervention is so addicts don’t have to die not knowing that there is a better way to live and family members and friends don’t have to go to funerals not knowing that they did all that they could.

Treating Addiction: What works?

2009-01-05T09:20:00.000-08:00

I have what some may think is a unique perspective when it comes to knowing what works when treating addiction. I’ve been an addict for at least 33 years. I figure my addiction started when I was 12 years old and I discovered that food comforted me emotionally. At 15 I found alcohol and that was the beginning of a 15 year run of alcohol and drug addiction for me. At age 30 I found recovery. I didn’t just happen upon it. My family organized it for me. My mother called an interventionist and got the ball rolling. This is how it happens for most addicts; someone who cares about him “gets the ball rolling”.

I know addiction from the inside out. I have been an addict in recovery for over 14 years now. I have been treating other addicts professionally for over 13 years. I have studied and acquired degrees, certifications, and credentials in counseling, gambling addiction, sex addition, intervention, and chemical dependency. I have worked in detox units, residential treatment programs, and outpatient treatment facilities. I have worked with indigent and homeless populations as well as wealthy and high profile clients.

Addiction runs a predictable course, no matter who or where you are. Addiction is chronic, progressive and fatal. I have kept a list over the years that I affectionately call “Dead Addicts”. That’s it, “Dead Addicts”. That is how we addicts end up if we don’t get in to recovery, it is that simple. On my Dead Addicts List I have 19 names of addicts I have known, many I have treated in some capacity over the years, who have died in their disease. This list motivates me. It motivates me to stay clean and sober personally; and it motivates me to never stop trying to help other addicts recover. Every time an addict dies I say the same thing, “That was not necessary”.
It is not necessary because I know how to treat addiction. I know what works.

And here it is:
90 in 90. Go to at least 90 AA or NA or CA meetings in 90 days. That means at least one meeting per day for at least 90 days. While you are there, buy an AA Big Book or NA Basic text and read it. Find a sponsor and start working the 12 Steps. This isn’t rocket science, you could almost teach a monkey to do it. So there are no excuses, just do it. I’ve never met anyone too stupid to recover, I have met a lot of people too smart to recover. These “smart” folks think they don’t really need to do “all that”. They can “get it” with less effort. Several of these “smart” people are on my Dead Addicts list.

Change your playmates, playgrounds, & playthings. This means don’t hang out with the people you used to drink or use with, don’t go to the places you used to drink or use, and get rid of the paraphernalia and other items that represent your alcohol or drug use. So, dispose of those Jagermeister T shirts, you don’t need that Budweiser neon sign anymore, Uncle Charlie gets the vintage wine collection, your shot glass collection goes too. No exceptions. That is the first half of it. Change means you let go of something old and replace it with something new. You have to find new playmates, playgrounds, and playthings. It is important to recognize that in between letting go of the old, which needs to happen immediately, and forming new relationships and habits there is a lag period. You will feel lonely and empty during this lag period. Expect it and prepare for it. If you are going to at least one 12 Step meeting per day that will help a lot with the lonliness. These changes can be accomplished outpatient, although that requires a high degree of internal motivation on the part of the addict. He must be willing to change everything he thinks and everything he does. Everything. Not some things, not most things, everything. Granted this may not occur overnight but it when it does, things tend to go well. When it takes time to occur, relapse is likely. Sometimes this relapse can be just what the addict needs to prove to him that “his way” will not work; it can be the catalyst to internal motivation. Other times this relapse can be the demise of the addict; he may die on this run or the next. He may never again summon the motivation to get clean – and ultimately he will die in his addiction.
A grim tale, yes. But the reality, nonetheless.

Detox the first 3 to 5 days. You have to detox in a safe manner. Alcohol and most narcotic drugs require a medically supervised detox. Acute withdrawal from these substances can be fatal if not treated professionally. Any hospital or treatment center detox unit will work.

Next, secure a safe & sober living environment. Your home or the home of a relative can work if it is truly a sober environment consisting of people who support you in doing everything you need to do to recover. If you do not have this type of built in support there are a lot of sober living environments available to you. These are available in every price range; from free to $100,000 for 30 days.

Find a sober support group you can spend at least 6 hours with daily, anything less will not suffice. If you are living in a sober living home or treatment center this is already taken care of. If you are living in your own home or the home of a relative it means you will need to spend at least 6 hours every day at 12 Step meetings and with other recovering addicts. This may sound like a lot to manage. But once you start going to meetings you will understand that the one hour meeting most often continues at a coffee shop. Or you spend an hour talking with your sponsor before or after the meeting. Or you hang around the Alano Club (Alano Clubs are dedicated 12 Step meeting places that are open all day and accessible between meetings) and meet with other recovering addicts who help you learn how to stay clean and sober today.

You must maintain your recovery for the rest of your life. Recovery will forever be priority number one. Anything that comes between you and your recovery has to go. This is not difficult once you have developed a clean and sober way of life. If you work a diligent and complete recovery program your first year, you will develop a strong foundation that will carry you the rest of your life. If during the first year you establish friendships and relationships with sober people, you secure a job that supports recovery, or you start school that will set you up in a career that promotes recovery, and you live in a safe and sober environment these things will lay a foundation upon which you can build a healthy, happy, clean & sober life. I was recently sitting around my dining room table with 10 other recovering addict friends enjoying a New Years Eve meal. We spontaneously polled this group of addicts who have been clean and sober for 4 to 20 years. Every one of us began our recovery by attending 90 meetings in 90 days. We all changed our playmates, playgrounds, and playthings. This is not a coincidence. It isn’t exactly a clinical study either. But it is certainly noteworthy!

Let me say a thing or two about 12 Step Programs. 12 Step Programs work. Anyone who tells you otherwise has not worked a program diligently and completely. AA (Alcoholics Anonymous) was the founding 12 step program. It began in the 1930’s and has been successfully helping alcoholics get sober and stay sober ever since. In the 1950’s NA (Narcotics Anonymous) began to help drug addicts get clean and stay clean. Then in the 70’s CA (Cocaine Anonymous) came along. Through the years all addiction has been treated with a variance of AA’s program. The 12 steps treat addiction of any kind. Gamblers, sex addicts, cigarette smokers, food addicts, and the list goes on – have all found freedom and recovery with the 12 steps. The 12 step program is the only method that has consistently over time achieved positive results with treating addiction. If something else worked better, the treatment industry would be pushing that. But nothing else has ever worked as well, consistently over time, as the 12 Steps. If you’ve tried AA before and “it didn’t work” – I suggest to you that it probably wasn’t AA that wasn’t working. It was you who wasn’t working the program diligently and completely. So give it another try. Approach it this time as if your life depends on it, because it does.

As I mentioned in the first paragraph, it is typically a family member who “gets the ball rolling”. Every recovering addict I have known got clean and sober because it was someone else’s idea. The nature of the brain disease of addiction precludes the addict from being able to help himself. An intervention from outside the addict must occur if an addict is ever going to recover. In my next BLOG I will talk about How to Help Someone Who Doesn’t Seem To Want Help: The Invitational and Surprise Models of Intervention.

You can be free from addiction, forever.

2009-01-02T09:55:00.000-08:00

Addiction not only destroys the lives of addicts. Family members can be just as devastated by this family systemic disease. My focus is to help addicts and families find peace and dignity - to go on to live healthy, happy, and productive lives.

My message is HOPE! No matter what stage of recovery or pre-recovery you or your loved one is in - I want to help you move toward health and freedom.

Yes! There is hope. You can be free from addiction, forever.