FRP

Family

Recovery FALL 2016 ISSUE Fall 2018 Edition

P R O G R AM

THERE’S NOTHING LIKE Family STRENGTHENING FAMILIES AMIDST ADDICTION

HOUSING Maryland

CAMPAIGNING FOR IMPROVED PUBLIC HOUSING

A NEW Start BALTIMORE IMPROVING THE COMMUNITY AND SERVING OTHERS

HELPING PARENTS FIND A BETTER LIFE WHEN ADDICTION Chooses YOU

LEARN MORE ABOUT FAMILY RECOVERY AND THE

SERVICES & PROGRAMS WE OFFER.

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CONTENTS To send a comment or question, write to: Family Recovery Program 239 Gay St,

Family P R O G R AM

Recovery FALL 2016 ISSUE

FEATURES 08 A MOTHER’S STRUGGLE FRP graduate reunites with her daughter 1 0 THERE’S NOTHING LIKE FAMILY FRP founder works to strengthen family structure 1 4 A PARTNERSHIP BUILT FOR CHANGE M-ROCC partners with FRP to support parents through addiction recovery 4 4 PLANTING THE SEEDS OF RECOVERY Gerald Hill works with clients to customize a process to a successful recovery 48 WHEN ADDICTION CHOOSES YOU Rita Randle helps recovering parents find a better life 52 A NEW START FOR BALTIMORE Dana Young commits his life to improving the community and serving others 56 HOUSING MARYLAND Local non-profit seeks to strengthen public housing network

Baltimore, MD (410) 605-0492

Family Recovery Program is published by theinfluence.org

6830 West Villard Ave Milwaukee, WI 53218

Copyright 2016 by theinfluence.org. No part of this publication may be reproduced in any form or by any means without the prior written permission of the publisher, excepting brief quotations in connection with reviews written specifically for inclusions in magazines or newspapers, or limited excerpts strictly for personal use. Printed in the United States of America. All rights reserved. 2018 CRG Media

IN THE NEWS 22 BEND BUT DON’T BREAK Yoga is being used to help people maintain recovery and avoid relapse 24 COPING WITH DISCRIMINATION Discrimination remains largely ignored as a cause of substance abuse 2 6 FIGHTING FIRE WITH FIRE Researchers look to combat addiction through repurposed pharmaceuticals 28 HIDDEN DANGERS Alcohol poses whole host of health concerns 3 0 MORE THAN SKIN DEEP Implant represents revolutionary approach to treating opioid addiction

3 2 UNDERSERVED AND UNDETERRED Overcoming the unique challenges LGBTQ individuals face with addiction 3 4 RELAPSE TRACKERS Fitness trackers can help prevent relapses 3 6 PROLONGING THE PAIN Study suggests painkillers may be having the opposite effect in the long run 38 GROWING CONCERN OVER HEROIN USE New poll shows Americans are increasingly concerned with the dangers that heroin use poses to the country 4 2 BOOM, BUST, AND DRUGS Study says economic downturn leads to increase in substance use disorders

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Visit In-Person: 239 N. Gay Street Baltimore, MD 21202

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ecause my family eeded me.

Because my family needed me. ryland opportunity compact

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Family Recovery Program

Mother’s

FRP GRADUATE REUNITES WITH HER DAUGHTER AFTER BATTLING ADDICTION

“IT WAS REALLY HARD BEING SEPARATED FROM HER.” -KIMBERLY EVANS, GRADUATE FROM FAMILY RECOVERY PROGRAM

After losing custody of her daughter, Kimberly Evans was approached by a Family Recovery Program staff member who handed Evans a card and told her that they might be able to help get her child back home. A year later, after graduating from the program, she has her daughter back.

“IT’S PROBABLY ONE OF THE BEST PROGRAMS I’VE BEEN A PART OF.”

-KIMBERLY EVANS

Young and alone Evans’ addiction began at a young age. She grew up in Baltimore with a mother who was addicted to alcohol and drugs. Her parents were separated and Evans lived with her stepfather, a man who sexually abused her when she was barely a teenager. Though she told her mother, the situation didn’t change and Evans eventually left home when she was just 13 years old. Moving in with her boyfriend who was in his 20s, she entered a new home that was as horric as the one she’d left behind. Her boyfriend was physically abusive to her throughout the two years she lived with him. “It was not a good situation to be in, especially as a child,” Evans says.

This led to a string of unhealthy relationships with other men who abused the young girl. Because of her age, she was dependent on the men to keep her from becoming homeless. The dependency became detrimental and she moved to her own place in her early 20s. Around this time, she began abusing cocaine, marijuana and alcohol as a way to cope with the hardships she’d faced. Noticing his daughter’s growing addiction problems, her biological father tried to get her to enter recovery in 2001. “I wasn’t ready,” Evans says about her rst attempt. “He was trying to do what was best for me, but I just wasn’t ready at the time.”

A hard separation When she gave birth to her daughter two years ago, her baby was born drug-exposed. Though she had started recovery in 2012, she relapsed and was using while pregnant. Her baby was taken away and put in foster care. The decision to enroll in Family Recovery Program came out of the desperation to see her child again. “It was really hard being separated from her. Her foster parents are great people, but I couldn’t handle not being able to have her with me,” Evans says. Family Recovery Program transformed her life, helping her gain visitation rights, weekends and eventually full custody. They even connected her

with Dayspring Programs Inc., which helps provide transitional housing for women and children. The Family Recovery Program has provided a network of support that Evans still uses, even after graduating. She believes the program is special because of the attention, time and care they give to each individual. The staff are committed and hands-on in their work, ensuring clients receive and utilize any resource or treatment that is available. “It’s probably one of the best programs I’ve been a part of. They do whatever they can to help you,” Evans says. “It makes all the difference to have staff care that much. It denitely made a difference for me.”

There’s Nothing Like Family FRP founder works to strengthen family structure and create community

At the core of Dr. Jocelyn Gainers’ vision for Family Recovery Program is the power of community. “The focus has to shift from changing individuals to collective change. People don’t just exist as individuals,” says Dr. Gainers, executive director at Family Recovery Program (FRP). “We exist within our families and communities.”

“People don’t just exist as individuals.” - Dr. Jocelyn Gainers executive director Family Recovery Program

An alarming education

Dr. Jocelyn Gainers’ mother, who worked as a school counselor in Baltimore City, would often share stories about the students she worked with and the problems their families were facing. Years later, while doing undergraduate work in psychology, Dr. Gainers received first-hand exposure to those same hardships being endured by her community. She visited homes filled with poverty and dysfunctional family structures, providing her with insight into the effects of both. Dr. Gainers believes that trauma is the root of both of these issues. Lower-income communities generate more traumatic experiences in individuals. If the trauma is not properly healed, it affects the family as a whole. Each member of the family, including children, may be dealing with a unique trauma which, taken together, can create a toxic environment. To help repair this damage, Dr. Gainers is dedicated to identifying all possible resources that could help individuals heal and make families more stable. “I said to myself early on that if I had the chance to work with families and help them, I would do whatever it takes,” Dr. Gainers shares.

Family support At Family Recovery Program, families are treated together and encouraged to support one another. It’s especially beneficial for children to see their parents progress through recovery. “Most children we work with are fearful that their parents will leave again,” says Dr. Gainers. “I’ve seen kids get nervous when their moms leave the room. So once a family is reunified, we want to keep it that way.” FRP equips their clients with skills and resources that will help preserve their recovery long after leaving the program. The Parent Mentors Program allows FRP mentors to accompany parents throughout the day and help prepare them to be productive citizens and parents, helping them shop for their family’s groceries and taking them to community meetings. Recently, FRP also completed a project that will provide families with two and three bedroom houses for up to 18 months after leaving treatment. It aims to help maintain sobriety while keeping families close and comfortable.

A common goal In the 40 years since her mother first shared stories of Baltimore’s struggles, Dr. Gainers is worried that change isn’t occurring fast enough. While she sees more availability of resources, there’s still a pressing need to strengthen the network of public assistance facilities across the city. “What we try to do at Family Recovery Program is replicate community through our affiliations,” Dr. Gainers explains. “That’s how change can happen for the long-run.” They do this by connecting clients, businesses and government programs throughout Baltimore. Partnerships are essential to FRP, which runs as a non-profit and relies on outside providers and funding to help meet the needs of every client.

“We all help each other towards a common goal. It’s like a family.” “I’ve seen kids get nervous when their moms leave the room.” - Dr. Jocelyn Gainers 11

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A Partnership Built for Change M-ROCC partners with FRP to support parents through addiction recovery

Serving the community In 2013, two years after M-ROCC was founded, they received a grant that allowed them to expand their reach. They now provide technical assistance for clients who own or operate supportive housing and treatment centers. They’re also a central point for recovery-focused policy advocacy activities, hoping to generate awareness and funding to change the state of addiction recovery. M-ROCC works with their supportive housing affiliates to maintain standards for the recovery community. Part of the process involves an inspection of each recovery house that looks at organizational standards, fiscal management, the house location, as well as operational, recovery support and property standards.

Entering into the business of addiction treatment is a big endeavor. When planning to start and maintain a recovery house, it can be tough to know where to start. “The big question I get asked is how to tap into state funding,” says Carlos Hardy, CEO and founder of Maryland Recovery Organization Connecting Community (M-ROCC). “I help them understand what state mandates are for public services.” Hardy works with various programs across Baltimore, hoping to advocate and support anyone dealing with addiction so they can improve their wellness and sustain recovery. His organization partners with other programs across the city to build a strong network of support for every patient.

“I hope to make lasting change for Baltimore.” -Carlos Hardy CEO and founder Maryland Recovery Organization Connecting Community

This critical examination ensures that every house approved by M-ROCC can achieve its highest potential and provide excellent services to recovery patients. Hardy understands the treatment needs of those battling addiction because he has been in long-term recovery himself since 1993. He’s served in a range of leadership roles, working for Baltimore Substance Abuse Systems and serving as a director with Light Street Housing Corporation. His radio show “Beyond the Wire” discusses the misrepresented narrative of Baltimore portrayed in the media and offers a fuller perspective on the city. “I hope to make lasting change for Baltimore. I’ve committed my life to it,” he says.

Doing it right “Family Recovery Program is a great example of how you do this thing right,” Hardy says, talking about FRP’s efforts to grow the recovery community and help expand access to resources. “Their focus is on family reunification. That’s the driving force behind everyone who works there.” FRP partners with M-ROCC to provide a holistic treatment that aids clients in all aspects of their lives. Hardy works closely with Dr. Jocelyn Gainers, executive director of FRP, to bring superior recovery options to Baltimore. “A lot of the time, centers throw up their hands and say this is the best we can do. Family Recovery Program proves there’s no limit to how much a treatment center can do for their clients,” says Hardy. “They go above and beyond for every patient and the community as a whole.”

“Their focus is on family reunification.” -Carlos Hardy

The Family Recovery Program s uccessfully reunites families by o ff ering specialized

programs to meet the recovery and life skills needs of parents.

www.frp-inc.org Family Recovery Program

Family Recovery Program 410-605-0492

Genesis Program The mission of the FRP Genesis Track is to reduce a child’s exposure to out-of-home placements when that child is removed for a second time from a parent’s or legal guardian’s care before the child exceeds the age of seven due to parent’s substance abuse and recent relapse. The FRP Genesis Track provides intensive case management, bi-weekly to monthly oversight by the court, placement in an appropriate substance abuse treatment program within 24 hours of their referral (if available) and other supportive services including transitional housing and mental health services over a six to twelve month period.

www.frp-inc.org

Phoenix Track The Family Recovery Program (FRP) has developed the Phoenix Track, which is an accelerated 6-month program with specialized groups that focus exclusively on marijuana use and abuse, recovery from marijuana abuse and the coping skills to enjoy a sober lifestyle.

Family Recovery Program

410-605-0492

Horizon Program

www.frp-inc.org

The Family Recovery Program (FRP) has been partnering with BCDSS to assist in reunification efforts since 2005. On July 1, 2012, FRP introduced the Horizon Program. The focus of the Horizon Program is to prevent removal of the child/children ages 0-7 of CPS and Family Preservation Units’ cases that otherwise would have substance abuse as the primary factor as the reason for removal.

Family Recovery Program

On average, FRP parents spent 138 days in treatment; non-FRP parents spent 82 days in treatment.

www.frp-inc.org

FAMILY RECOVERY PROGRAM

410.605.0492

Bend But Don’t Break Yoga is being used to help people maintain recovery and avoid relapse

Yoga is no longer exercise your annoying, health-conscious friend won’t stop talking about. The ancient practice is now being used to help people recover from addiction. While scholars estimate yoga was developed sometime around 300 to 400 B.C., the practice hasn’t stopped changing over the last 2,000 years. A new wave of yogis are now helping people in recovery connect their spiritual and physical sides through yoga by combining the practice with more traditional 12-step elements. “It’s just a way of coming back to a sense of wholeness,” says Nikki Myers, a yoga therapist who helped develop the 12-step yoga system. “We use yoga as a process in order to bring that reintegration.”

Myers says she developed the system primarily as a means of relapse prevention. She says a typical 12-step yoga session would begin the same way most 12- step meetings do, with a focus on sharing and discussion of important recovery topics. Once the “meeting” portion of the session is over, the group will then move into a series of yoga poses designed to help participants focus on their physical recovery. “A focus needs to be on the body- based piece as well as the cognitive piece in order for wholeness to really be manifested,” Myers says. “Once you include those things, the whole idea is that these will begin to offer us a set of tools that we can use both on the mat in the yoga practice and off the mat when the triggers of life show up.”

“It’s just a way of coming back to a sense of wholeness.” - Nikki Myers, yoga therapist

The right tools Myers says the idea that yoga can provide a set of tools is critical as the practice of yoga is much more than the poses themselves. She says there’s also a focus on breathing techniques, a meditation of sorts, and a connection to one’s physical reactions that can prove vital when faced with difficult circumstances. Myers recalls how one woman who participated in 12-step yoga later found herself in a very stressful situation at home with her kids misbehaving and everything going wrong. She said she could feel the negativity boiling up inside her. It was the kind of stress that had triggered her to drink in the past, but the woman said in that moment she was able to relax and calm herself by focusing on her breathing and remembering the feeling of tranquility she had experienced in class. “It had a way of creating a space, giving her tools to create a space between her reactions and instead take a different neural pathway,” Myers says. “These are the kind of tools that we’re looking to have people use.” “A focus needs to be on the body-based piece as well as the cognitive piece in order for wholeness to really be manifested.” - Nikki Myers

Not a replacement Myers is quick to point out that yoga is not a substitute for traditional 12-step support, but rather an additional measure that some people may find helpful. She says some people have pushed back against the practice, but others have been enthusiastic about its power, with classes spreading across the country and even internationally. Myers says she hopes that one day 12-step yoga will be as common as other treatment programs. But she says as long as people are maintaining sobriety and finding wholeness within themselves, she’ll be proud of the difference her system has made. “We’ll tell people, ‘Notice this in your body, what it really feels like,’” Myers says. “Healing only happens in safe space.”

Discrimination, whether based on race, gender, or sexual orientation, has long been thought to be a contributor to substance abuse. Now a new study has confirmed the relationship between discrimination and addiction, but it’s also brought up many more questions that still need to be answered in order to improve treatment outcomes. Researchers at the University of Iowa recently completed a peer review study in which they looked at 97 previous studies on discrimination and alcohol use. Their goal was to summarize the collective knowledge researchers have uncovered throughout the years, and what they found confirmed in more detail what many had previously suspected.

“Generally there is good scientific support, but the evidence is mixed for different groups

and for types of discrimination.” - Dr.Paul Gilbert, University of Iowa

overtly racist or sexist to another person. But less research has been done on what are known as micro-aggressions, small everyday occurrences that can rub a person the wrong way. That research is improving, but there are other factors that need to be more fully explored. While studies have looked at historical trauma in the African-American population, the concept has not been fully investigated with regards to Hispanic and Asian populations. “This notion of historic trauma could be really relevant to other groups, but it hasn't received much attention at all,” Dr. Gilbert says. “This is something we should pay attention to.” All of this adds up to the fact that treatment providers may be missing a key piece of the substance abuse puzzle.

The team found that discrimination did indeed lead to an increase in drinking frequency, quantity of alcohol consumed, and in the risk for alcohol use disorders. Researchers say drinking can represent a coping mechanism in response to the stress caused by discrimination, and several studies showed clients acknowledging this direct link themselves. But when looking at specific populations and types of discrimination, the picture becomes less clear. “The story is that generally there is good scientific support, but the evidence is mixed for different groups and for types of discrimination,” says Dr. Paul Gilbert, the study’s lead author. “We don’t really know comparing one type or one level to another.” For example, much research has been done on interpersonal discrimination where someone is

But just because the intricacies of how discrimination affects drinking aren’t yet fully understood, that doesn’t mean our current knowledge base can’t be helpful. Dr. Gilbert says simply knowing that experiences with discrimination can drive drinking could inform the way treatment providers interact with clients, opening new areas of their lives to explore during treatment. “It can serve as sort of an early warning or indicator,” Dr. Gilbert says. “For treatment providers, it’s worth looking at: is there something that may be keeping folks from accessing services or affecting outcomes?”

Dr. Gilbert says treatment providers should continue to address discrimination as part of a holistic approach to recovery. He says it will be up to researchers to fill

in the gaps to find the precise ways that discrimination affects drinking behavior. “We’ve got good evidence on this level of interpersonal discrimination,” Dr. Gilbert says. “We’ve gotten the low-hanging fruit, now it’s time to start working on the stuff that’s a little further up the tree.”

“It can serve as sort of an early warning or indicator.”

FIGHTING FIRE WITH FIRE

D espite years of stigma, medication-assisted treatment (MAT) is steadily gaining in popularity among treatment providers. Government groups like the U.S. Department of Health and Human Services are actively campaigning to get more providers to oer MAT as a potentially vital resource for patients. While such groups often promote well-known medications such as methadone and buprenorphine, drug researchers are looking for new medications that could be a lifeline to patients in need. But new medications can cost millions to research and take years to get on the market. at’s why some researchers are taking a closer look, and nding success, with drugs already approved by the FDA. CURBING COCAINE USE Researchers at the University of Pennsylvania say a drug already on the market for diabetes may be able to curb cocaine use. e FDA-approved drug Byetta, used to regulate blood sugar in diabetic patients, is derived from a natural hormone known as GLP-1. e research team looked at how the hormone functioned in rats and found that the same hormone that regulates food intake could be used to suppress cocaine consumption. “ese results are very provocative and suggest these compounds could be repurposed for drug addiction,” says Dr. Heath Schmidt, one of the lead researchers. “We have seen a reduction in cocaine consumption…but it doesn’t completely abolish it.” Currently, there is no FDA-approved drug for the treatment of cocaine abuse. But because Byetta and a similar drug have already gained federal approval, researchers say that leaves fewer hurdles before they could be used in treatment settings. Although still far from human trials, researchers say they’re optimistic, especially because their research suggests the hormone is not specic to cocaine and could be used in treatment of other substance abuse disorders. “I think this opens up a large world view with regards to this system in the brain,” Dr. Schmidt says. “ere’s really a lot to be explored here and I think it’s really an exciting time to be in the eld and exploring the GLP-1 system.”

ADJUSTING ALCOHOL CONSUMPTION Another team of researchers at the University of Queensland in Australia believe the FDA-approved drug pindolol could be used to stop alcohol abuse. Pindolol is an anti-hypertensive medication used to treat high blood pressure. But because of the way it interacts with neurotransmitters in the brain, they believe it could also be eective in treating alcohol use disorders (AUDs). To study the drug’s eect, the team used mice and exposed them to an alcohol consumption regimen similar to a binge drinking cycle common in humans. For mice also given pindolol, the team found they were able to reduce drinking in the long term (after at least 12 weeks). e team did not see as positive of results in the short term (only four weeks), but they say they’re still excited about its potential uses. “Although further mechanistic investigations are required, this study demonstrates the potential of pindolol as a new treatment option for AUDs that can be fast-tracked into human clinical studies,” the authors wrote.

Most people are aware that excessive alcohol consumption is bad for your liver. But new research shows it can also be harmful to other parts of your body and put you at risk for a number of diseases previously thought to be unrelated to alcohol use. 28

Trouble breathing A research team from Loyola

Cancer nightmare

Cardiovascular concerns Heart disease is the number one killer of people worldwide, and medical experts everywhere have been trying to gure out how to reduce the risks associated with cardiovascular conditions. New research suggests they should take a closer look at alcohol. While some studies have suggested that low levels of alcohol consumption can improve heart health, a team of researchers from the University of California - San Francisco found that to be a bit of a mixed bag. In studying health dierences between people living in “dry” (alcohol sales prohibited) and “wet” (alcohol sold more freely) counties in Texas, they found varying results. “Greater access to alcohol was associated with more atrial brillation and less myocardial infarction and congestive heart failure,” the authors wrote. “Although an increased risk of congestive heart failure was seen shortly after alcohol sales were liberalized.” So while they did see a dip in some cardiovascular conditions, the results also show a clear link between alcohol access and various health problems. Researchers said policy makers should use this information when establishing laws to protect public health. “We believe that our results have broadly applicable health implications relevant to people with and at risk for various types of cardiovascular disease,” the authors wrote.

When people think about substances that can cause cancer, they often think of cigarettes or other tobacco products. But a new study shows alcohol may also be a major contributing factor to no fewer than seven types of cancer. A researcher from the University of Otago in New Zealand, Dr. Jennie Connor, looked at a number of studies dealing with cancer and alcohol and found strong evidence that excessive drinking can cause cancer in seven parts of the body. Connor identi ed those areas as the “oropharynx, larynx, oesophagus, liver, colon, rectum and breast.” She wrote that while there are always limitations to determining exactly what caused a speci c disease, the evidence is overwhelming. “Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8 percent of all cancer deaths worldwide,” Connor wrote. “Con rmation of speci c biological mechanisms by which alcohol increases the incidence of each type of cancer is not required to infer that alcohol is a cause.”

University in Chicago recently found that excessive drinking could also cause problems in the respiratory system. e team looked at levels of nitric oxide in the exhaled breath of over 12,000 people. Nitric oxide protects against a number of respiratory diseases and can even be used in medical settings as a treatment for sick infants. e researchers found that excessive drinkers had less nitric oxide in their breath, meaning they were more susceptible to respiratory infection and disease. Although more research is still needed to determine the full extent of the relationship between alcohol and nitric oxide, the authors of the study said the results are troubling. “Alcohol use impacts several lung diseases, and heavy consumption has been associated with poor clinical outcomes,” the authors wrote. “e fractional excretion of exhaled nitric oxide (Feno) has clinical implications in multiple airways diseases.”

Sign of the times Experts say the newly approved implant also provides a big boost to the concept of medication-assisted treatment (MAT) in general. For years, the idea that someone could achieve recovery through the use of drugs like methadone and buprenorphine was rejected by many professionals in the eld who saw complete abstinence as the only true sobriety. Many still hold that belief, but attitudes appear to be changing. Top government ocials say they want to increase the amount of MAT taking place at the country’s treatment centers. Several states as well as the federal government have enacted laws making it easier for physicians to prescribe medications like buprenorphine, but they say too few patients receive the medication they need. National Institute on Drug Abuse, in a statement. “is product will expand the treatment alternatives available to people suering from an opioid use disorder.” ] [ "Opioid abuse and addiction have taken a devastating toll on American families.” - Dr. Robert M. Cali, FDA Commissioner “Scientic evidence suggests that maintenance treatment with these medications in the context of behavioral treatment and recovery support are more eective in the treatment of opioid use disorder than short-term detoxication programs aimed at abstinence,” said Dr. Nora Volkow, director of the

M edication-assisted treatment is growing in popularity and acceptance among addiction recovery professionals. And now it’s taken a revolutionary step forward that could oer renewed hope to thousands of people struggling with an addiction to opioids. is summer, the U.S. Food and Drug Administration approved a new buprenorphine implant to treat opioid dependence. Buprenorphine had previously been available only as a pill or a dissolvable lm placed under the tongue. But the new implant, known as Probuphine, can administer a six-month dose of the drug to keep those dependent on opioids from using by reducing cravings and withdrawal symptoms. "Opioid abuse and addiction have taken a devastating toll on American families,” FDA Commissioner Dr. Robert M. Cali said in a statement. “We must do everything we can to make new, innovative treatment options available that can help patients regain control over their lives.” e implant comes in the form of four one-inch rods that are placed under the skin on the upper arm. e implant must be administered surgically and comes with the possibility of certain side eects, but experts say it could be more convenient and more eective for patients. ey say by eliminating the need to take pills, ll prescriptions and generally manage their medication, it makes it easier for people to focus on the other areas of their recovery while making it less likely someone will lapse in their treatment plan.

Although the implant is certainly a new alternative, it has yet to show any increased success in keeping people from relapsing compared to the pill or lm tablet. In a study of the implant’s eectiveness, they found that 63 percent of people given the implant were free of illicit drugs at six months, compared to 64 percent of people who took buprenorphine by pill. Still, those rates are much higher than the success rates of people who follow abstinence-only treatment plans. And ocials hope the new implant will lead more people to get MAT, increasing the number of successful recoveries across the country. 31

Underserved And Undeterred Overcoming the unique challenges LGBTQ individuals face with addiction A s more and more addiction treatment centers are looking for ways to tailor programs to address the individual needs of clients, one section of the population is being largely overlooked. Advocates say treatment providers need to be more aware of the unique issues and barriers facing the LGBTQ community. Numbers don’t lie LGBTQ individuals at much higher rates than they do the heterosexual population. Some estimates show an addiction rate between 30 and 40 percent, compared to around 10 percent of the population in general. While statistics also show that LGBTQ individuals enter into treatment more readily than the rest of the country, they also face program. Advocates say 46 percent of homosexual men and women have had a homophobic therapist, and 34 percent felt their sexuality was seen as irrelevant. While putting sexuality aside to address addiction glance, advocates say recognizing those recovery. Need for understanding Understanding a person’s sexuality and gender identity can be as important as understanding their race or ethnic background in that it can uncover potentially hidden sources of stress or trauma that may contribute to substance use. Just as counselors should consider the social experiences of African-Americans, so too should they consider the unique circumstances faced by members of the LGBTQ community. “In order to not continue to create trauma towards the LGBTQ community, the more culturally competent a person or work/recovery environment is, the better,” says Molly Gilbert, director of business development for the PRIDE Institute in Minnesota. 32

e PRIDE Institute specializes in addiction treatment for the LGBTQ community, and Gilbert says a lack of understanding or awareness by treatment providers can create barriers for people seeking treatment. Even for organizations that seek to become “inclusive” communities, they may not set up a program that accurately addresses LGBTQ concerns, or providers may not realize how they are doing harm to LGBTQ individuals, transgressions known as micro-aggressions. “Micro-aggressions occur daily towards the community and educating heterosexual colleagues, supporters and the rest of society is key in helping to diminish these daily slights and harm,” Gilbert says. Education first To improve treatment outcomes and the experiences of LGBTQ people in general, advocates say it’s vital that treatment providers, physicians, and social service

employees educate themselves on some of these unique challenges and barriers. But they also say LGBTQ people need to educate themselves as well. “Educating the LGBTQ

community on the dangers of abuse of alcohol and drugs, and the fact that the

community is actually being targeted by

institutions such as big tobacco, alcohol companies and drug manufacturers is key,” Gilbert says. With very few LGBTQ-specic treatment centers across the country, advocates know many

LGBTQ individuals will end up in heteronormative treatment facilities. And while that can present problems, Gilbert says with the right education and the right system in place, recovery is attainable. “With the right therapy coexisting with a mainstream treatment center, we believe it is doable.”

“There’s a lot of information that can be gained from when somebody relapses.”

- Dr. Stephanie Carreiro, University of Massachusetts

Fitness trackers could help prevent relapses

Dr. Carreiro says wearable biosensors can detect a relapse event for some substances (like heroin and cocaine) by sensing a change in heart rate or other physical conditions. The treatment provider can then use the tness tracker’s other information, like the time and location of the relapse event, to develop a prole about the conditions that prompt a patient to use. “It gives us very specic contextual information and serves as that reminder to the patient that someone could potentially know right away when they relapse,” Dr. Carreiro says.

Fitness trackers, or wearable biosensors, like Fitbit and Jawbone are the latest tness trend to gain widespread popularity. But some believe they could be used to treat addiction as well. New research suggests the devices can be used to reliably detect relapses, which could then give treatment providers the information they need to prevent relapses in the future. “There’s a lot of information that can be gained from when somebody relapses,” says Dr. Stephanie Carreiro, a researcher from the University of Massachusetts.

ACCOUNTABILITY MATTERS That accountability to someone who could see the relapse is an important step in moving past simple self-reporting and drug testing. People can lie during self-reports and drug testing will only show that drugs were used, but not information like how much was used, when it was used, and where. Because the sensors can be easily removed, the system will only work for patients who are truly motivated to stay sober. Dr. Carreiro says rather than a big brother scenario with treatment providers tracking a patient’s movements, the devices simply connect a patient to their support network.

“We could potentially trigger an interaction with a patient just seeing if they’re okay and need some help,” Dr. Carreiro says.

“It definitely served as a reminder that there was something motivating them to stay sober.”

- Dr. Stephanie Carreiro

SIMPLE REMINDER In a study of 15 patients, nearly everyone kept wearing the devices even when relapsing. Dr. Carreiro says that’s because many people are already used to wearing tness trackers, and the treatment plan simply ts into the daily routines they’ve already established. Researchers also say just having a physical object on a patient’s wrist to remind them about their dedication to sobriety can be enough to prevent a relapse. “Multiple people looked at it and thought of going back to jail or being there for their children,” Dr. Carreiro says. “It denitely served as a reminder that there was something motivating them to stay sober.”

WHAT ABOUT PREVENTION? The ultimate goal is to prevent relapses and keep patients on the path to sobriety. While the technology is advancing quickly, researchers say the collective knowledge base simply isn’t there yet to predict a relapse event. But as they conduct more studies and develop better algorithms with the information gained, they should be able to tailor interventions to a specic patient and hopefully keep them from relapsing. “We need to continue to dene different proles so that we can get a more complete understanding of what’s happening,” Dr. Carreiro says. “That’s when it will be the most powerful.”

“We were surprised that morphine was able to induce these really long-lasting changes,” says Dr. Peter Grace, the study’s lead author. Dr. Grace says the cause of the chronic pain increase has to do with cells that form part of the immune system. He says if those areas could be isolated or their eects reduced, the resulting pain may not be as great. “If it does turn out to be a relevant issue to patients, then what our study suggests is that targeting the immune system may be the key to avoiding these kinds of eects,” Dr. Grace says. “Opioids could essentially work better if we could shut down the immune system in the spinal cord.” e team’s research only looked at spinal cord injuries and morphine, and did not study other opioids that are commonly prescribed to patients experiencing pain. But he said it’s likely drugs like Vicodin or OxyContin could aect other parts of the body in a similar way. “While we haven't actually tested other opioids in this particular paradigm, we predict that we would see similar eects,” Dr. Grace says.

ain relievers are supposed to relieve pain. It sounds simple enough, but new research suggests a common pain medication may actually be prolonging chronic pain. Morphine is an opioid painkiller commonly prescribed in hospitals and clinics, and while it is eective in the short term, doctors don’t always consider the potential consequences for pain down the road. at’s why a team of researchers based out of the University of Colorado - Boulder set out to study how morphine treatment aects chronic pain, and found some troubling results. e team, which used mice with spinal cord injuries, found that in mice not given morphine, their pain thresholds went back to normal about four to ve weeks after the injury. But mice who were given morphine didn’t see their pain levels return to normal until around 10 to 11 weeks, meaning the use of morphine eectively doubled the length of their chronic pain. P

Chronic problem Chronic pain can be debilitating for many people facing serious health problems, and it can also be a key factor in substance abuse. Many people report developing a dependence on opioids after having them prescribed for an injury. But new research suggests the number of people who develop dependency issues because of chronic pain may be far higher than people realize. A study from researchers at Boston University looked at a group of nearly 600 people who had either used illicit substances or misused prescription drugs.

ey found that 87 percent reported suering from chronic

pain, with 50 percent of those people rating their pain as severe. ey also found that 51 percent of people who had used illicit drugs like marijuana, cocaine and heroin had done so to treat their pain. While many prevention eorts focus on recreational users, the numbers suggest that chronic pain plays just as prominent a role in substance abuse. “Many patients using illicit drugs, misusing prescription drugs and using alcohol reported doing so in order to self-medicate their pain,” the authors of the study wrote. “Pain needs to be addressed when patients are counseled about their substance use.”

CONCERN OVER HEROIN USE GROWING

New Poll Shows Americans Are Increasingly Concerned With

45 percent of Americans think heroin use is a bigger problem in their communities than shows they’re not wrong. According to the Centers for Disease Control, heroin-related overdose deaths nearly quadrupled from 2002 to 2013. Experts fear the numbers will continue to rise, with recent data showing roughly 156,000 Americans began using heroin in 2012 alone. Political Discourse a time when lawmakers and treatment providers are struggling to combat the rise in heroin overdoses. Several states have passed legislation making it legal to purchase Naloxone, a drug that works as an antidote for opiates, and Congress is considering several bills that would change the way federal authorities handle drug issues.

ore and more Americans are feeling the dangers of heroin, with nearly half of adults describing heroin abuse as a very serious problem,

according to a recent poll.

1,000 U.S. adults about heroin abuse, with 49 percent saying they thought it was a very serious problem, and another 38 percent saying they thought it was somewhat serious. heroin epidemic is hitting, with one-third of respondents saying they personally know someone who has become addicted to heroin or another opiate. Numbers Don’t Lie Public perception of heroin use has changed quickly over the last few years. A Rasmussen Reports survey in November of 2015 found

groups to increase understanding of addiction as a disease, 28 percent said those who use heroin are most to blame. Still, the poll showed public opinion remains somewhat balanced, with 48 percent of people saying all groups are equally to blame. A Universal Issue races. Although black and Hispanic Americans were more likely than white respondents to cite heroin as a very serious problem, all three groups had similar views on nearly every other question. across almost every demographic over the past decade, and poll numbers show perception and reality are more in line than most would like to admit.

commander-in-chief have also paid closer attention to the heroin epidemic, with the issue playing a more prominent role in this year’s presidential campaign than it has in

past election cycles. Who’s To Blame?

voters are paying close attention to the problem may come as no surprise considering how much blame the public puts on them. Of those surveyed, 5 percent said the U.S. government and those who decide how heroin users are treated are most to blame for the current heroin problems. In comparison, drug dealers themselves were singled out by only 11 percent of “49 percent of U.S. adults think heroin abuse is a very serious problem, and 38 percent say it’s somewhat serious.” -

Call: 410.605.0492 Visit Online: frp-inc.org

Visit In-Person: 239 N. Gay Street Baltimore, MD 21202

Family Recovery Program

Because FRP families utilized less foster care and were more likely to achieve reunification, FRP cases were less costly to the child welfare system. The total net cost savings per year of Baltimore City FRP operations was nearly $1,004,456 or approximately $5,022 per served family.

www.frp-inc.org

Boom, Bust, and Drugs Study says economic downturn leads to increase in substance use disorders When the economy tanks, drug abuse goes up. That’s the finding of a new study which shows the state of the economy is closely linked with substance abuse disorder rates for a variety of substances. The study, conducted by researchers from Vanderbilt University, the University of Colorado and the Substance Abuse and Mental Health Services Administration (SAMHSA), found the use of substances like ecstasy becomes more prevalent during economic downturns. Researchers also found that other drugs like LSD and PCP see increased use only when the economy is strong. But for overall substance use disorders, the findings were clear.

“Problematic use (i.e., substance use disorder) goes up significantly when the economy weakens,” says Christopher Carpenter, one of the lead researchers. “Our results are more limited in telling us why this happens.” Researchers say it’s possible that people turn to substance use as a means of coping with a job loss or other major life changes caused by economic pressures, but their particular study did not pinpoint an exact cause and effect. Not all drugs are equal The study showed that a downward shift in the economy has the biggest impact on painkillers and hallucinogens. Rates of substance abuse disorders were significantly higher for those two categories than any other class of drug.

Researchers also found the change in disorder rates was highest for white adult males, a group which was one of the hardest hit during the Great Recession. They say more research is needed to determine exactly how the economy and drug use are related, but they say the study highlighted some key groups for prevention and treatment workers to target during future economic downturns.

“Problematic use (i.e., substance use disorder) goes up significantly when the economy weakens.” - Christopher Carpenter, Vanderbilt University

Slippery slope Despite some lingering questions, researchers were able to show the significance of the economy’s role in problematic substance use. The study showed that even a small change in the unemployment rate can have a tremendous impact on the risks for substance abuse disorders. “For each percentage point increase in the state unemployment rate, these estimates represent about a 6 percent increase in the likelihood of having a disorder involving analgesics and an 11 percent increase in the likelihood of having a disorder involving hallucinogens,” the authors write. Previous studies have focused on the economy’s link to marijuana and alcohol, with many looking at young people in particular. This study is one of the first to highlight illicit drugs, which given the current opioid epidemic, holds important lessons for those working to curb problematic drug use.

When it’s needed most The study bears significant weight for treatment facilities and public policy makers in particular. During economic downturns, government agencies typically look to cut spending on treatment programs as a way to save money, something researchers say may be more costly in the end. “Our results suggest that this is unwise,” Carpenter says. “Such spending would likely be particularly effective during downturns since rates of substance use disorders are increasing when unemployment rates rise, at least for disorders involving prescription painkillers and hallucinogens.”

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“Spending would likely be particularly effective during downturns since rates of substance use disorders are increasing when unemployment rates rise.” - Christopher Carpenter, Vanderbilt University 43

Planting the Seeds of Recovery Gerald Hill works with clients to customize a process to a successful recovery

It’s been 19 years since Gerald Hill met Dr. Jocelyn Gainers. They worked together at Mountain Manor Treatment Center before coming together again. “She called me up to see if I wanted to join her at Family Recovery Program and I said yes,” Hill says. “It’s been amazing to be a part of this.”

“It took being set still to see what was really going on with myself.” - Gerald Hill case manager Family Recovery Program

A hard look Hill serves as case manager at the Family Recovery Program. He assesses clients and refers them to the best suited program based on their unique needs, reviewing the client’s substance abuse history, mental health, housing, education and physical health needs. A recovery plan is created next, highlighting one or two areas of focus so clients are not overwhelmed at first. Hill understands the challenges of entering treatment. At age 16, he began using due to peer pressure. What started as adolescent fun began to control his life. His addiction led him to multiple incarcerations. The confinement of jail forced him to reevaluate his life. “You realize one day that your whole life has passed in prison. When I first got in there, I was calling others mister. By the end, the young guys were calling me mister,” Hill says. “But, for me, it took being set still to see what was really going on with myself. I had to take a hard look at my life, being 46 and sitting in jail without an identity. I was just a number.” Hill admits he had to be selfish at the time, putting himself before anyone else and exploring his spirituality. It was terrifying to evaluate parts of himself he had been ignoring for so long, but that was the process that lead him to recovery. When he decided to enter treatment, Hill didn’t have any money or transportation. There were no housing programs. Clients were told when and where to show up, otherwise they were on their own. He hopes clients understand what a blessing it is to have the resources that are now available at centers such as Family Recovery Program.

Giving what you get “I am so proud of her. She’s been a wonder to her field,” Hill says about Executive Director Dr. Jocelyn Gainers. “She works so hard to keep the center running but is always approachable too. She’ll come in, greet everyone and take a walk with a client. I think that’s important for them to see.” The clients at Family Recovery Program do see it. The warmth and efforts of the entire staff are undeniable. They work with each individual to plan a successful recovery and equip clients with the tools they’ll need to carry on after graduating from the program. Their alumni groups meet once a month to support recovered clients and allow them to share their experience and guide others through the treatment process. “After you get help, it’s important to give it back,” says Hill. “That’s what I had to do and it’s very rewarding. We plant seeds for the clients and after a year or so we begin to see the fruit. It’s amazing to watch.”

“We plant seeds for the clients and after a year or so we begin to see the fruit.” -Gerald Hill

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