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CONTENTS To send a comment or question, write to: Micah House

FEATURES 08 FAITH FOR A CHANGE Community and faith are keys to success 12 HELPINGHERSELF Women’s outpatient graduate learns value of self-worth 16 A FAITHFUL LEADER COO is aligned with faith and evidence-based treatment 20 KNOWTHY SELF Retiring Senior Counselor reflects on qualities she can pass on 46 GIVING BACK, NOT GIVING IN CD Tech knows how it feels to be a client at Micah House 50 WELCOMING A NEWCLIENTELE Outpatient program offered for women to recover together 54 FROMMESSTO SUCCESS Joleen Murphy needed a push into recovery

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Copyright 2016 by AVA Consultants. 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.

60 THEMICAHHOUSE A poem by Melinda Waltrers

34 UNDERSERVED AND UNDETERRED Overcoming the unique challenges LGBTQ individuals face with addiction 36 RELAPSETRACKERS Fitness trackers can help prevent relapses 38 PROLONGINGTHE PAIN Study suggests painkillers may be having the opposite effect in the long run 40 GROWING CONCERNOVER HEROIN USE New poll shows Americans are increasingly concerned with the dangers that heroin use poses to the country 44 BOOM, BUST, ANDDRUGS Study says economic downturn leads to increase in substance use disorders

IN THE NEWS 24 BEND BUT DON’T BREAK Yoga is being used to help people maintain recovery and avoid relapse 26 COPINGWITH DISCRIMINATION Discrimination remains largely ignored as a cause of substance abuse 28 FIGHTING FIREWITH FIRE Researchers look to combat addiction through repurposed pharmaceuticals 30 HIDDENDANGERS Alcohol poses whole host of health concerns 32 MORETHAN SKINDEEP Implant represents revolutionary approach to treating opioid addiction

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Faith for a Change For Micah House’s clinical supervisor, community and faith are keys to success

As clinical supervisor at Micah House, Anthony Holmquist-Burks is living proof of the efficacy of a faith-based, community-focused program. Although never a client himself at Micah House, his personal turnaround in 1999 came as a result of some of the same major tenets he now implements into the program. He recalls his life-changing brush with fate walking through his neighborhood in North

“Next thing I know, they’re praying for me.They scooped me off the floor,” he says. “I know now that I was transformed by faith and by God that day.” He recalls his experience with renewed faith as nothing short of miraculous, and carries this message with him in his role at Micah House, where he witnesses transformations on a regular basis through a few simple, yet often elusive, principles.

Minneapolis, where he had spent decades abusing crack cocaine and alcohol, and coming across a tent revival. He decided to take a closer look at the faith-healing sanctuary. “I know now that I was transformed by faith and by

Suggestions welcome Counseling came naturally to Holmquist-Burks, who began his tenure at Micah House as an LADC. Now, he oversees clinical staff and writes policy to maintain the client-centered focus of the program. “It’s important to meet the client where they’re at,” he says. “Many times, clients come here without a lot of faith, and we try to help them gain some understanding in that area.”

God that day.” - Anthony Holmquist-Burks clinical supervisor Micah House

Healing through pain As with any healing process, Holmquist-Burks notes, recovery involves some level of pain. It’s why so many turn to drugs or alcohol, conditioning themselves to seek out a quick, short-term solution. During their stay at Micah House, however, they gain a safe space to work through that pain over the course of time - it’s an option many have never experienced, or even considered. “You can either go back to the same thing you always do,” says Holmquist-Burks, “or find where you can be consoled, where you can be loved, taken care of, and walk through the pain with others.” And along with faith, this is the crux of Holmquist-Burks’s recovery, and perhaps the greatest indicator of lasting improvement: community. When he sees newcomers connect with their Micah House peers and develop meaningful relationships to carry within treatment and beyond, he knows the miracle beginning to run its course. “Birds of a feather,” he says. “If you hang out with people getting high, that’s what you’re going to do. If you can switch that up, then you can turn things around.”

The understanding doesn’t have to come right away, Holmquist- Burks explains.They just need to be open to suggestion - something Holmquist-Burks had to learn, too, when he entered recovery. “It was hard to listen to others at first because of my own stubbornness,” he says. “So once I dropped that wall and became able to listen is when the healing began.” Working from each individual’s starting point personalizes the experience, highlighting their strengths and revealing specific areas for improvement. Addressing one area at a time through suggestion and feedback, trial and error, Holmquist-Burks looks on as an ever-growing sense of hope takes root, thanks to small triumphs stacking up throughout the healing process at Micah House.

“It’s important to meet the client where they’re at.” - Anthony Holmquist-Burks

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Helping Herself Micah House’s first women’s outpatient graduate learns value of self-worth Like many first-timers in treatment, Melinda Walters didn’t know what to expect coming into the program.

“I’d heard a lot of horror stories about people going into treatment and coming out worse off,” she says, “but I feel so much better for doing it. It’s amazing.” She needed an initial push from the courts to come into treatment - it was a condition of her probation, and the benefits didn’t present themselves immediately. Walters says it took a month or so to get comfortable in her new environment and routine. But once she did, she says her internal problems began to unravel, enabling her to practice a newfound regimen of self-care and experience a world of satisfaction with herself she had never known existed. “I’ve always been a caregiver in life, so I naturally take care of people,” she says. “I’m learning how to take care of myself now, and it’s a really, really good feeling.”

Tools of the trade Walters says the coping tools she learned at Micah House have helped her in ways that far exceed sheer sobriety. A long-time sufferer of fibromyalgia, Walters has seen drastic improvements in her physical and mental health.

“I’m learning how to take care of myself now, and it’s a really, really good

feeling.” - Melinda Walters client of Micah House

“My anxiety is less, my panic attacks are gone, my depression is way down,” she says, “and I’ve never been able to control that ever in my life.” She no longer feels the need to self-medicate, as much of her pain was brought on by high stress levels. It’s a fairly common paradox of drug use - her long-term dependence on marijuana and other substances came about largely as a way to cope with pain and stress, and in the end only made things worse. She still carries a folder of all the techniques she learned at Micah House as a self-curated toolkit for life’s new trials. “I’m able to get out there, live my life and put these things to the test,” she says as she flips through the well-worn pages. One of the lessons includes learning to let go of past wrongs, and making way for repairs in interpersonal relationships. “I learned how to forgive - not only other people, but myself,” she says. “I never knew how much that meant. I was holding onto these little grudges and before I knew it, it was eating a hole in me 12 years later.” Blessings and bouquets

Now with a clear focus, Walters is free to pursue creative forays that once fueled her passion. As a self- proclaimed “jack of all trades,” Walters has a range of skills to choose from, ranging from artist and poet to carpenter and beautician. For the near future, her sights are set on reprising her role as a florist, a job she says allows her to explore creative arrangements and indulge her caregiving side without going too far and neglecting herself. She remembers fondly a time when she would arrange bouquets to pass out to mothers in her neighborhood on Mother’s Day, and the look on the women’s faces when Walters’ bouquets were the only recognition some of them would get. “It just makes people so happy,” she says.

“I learned how to forgive - not only other people, but myself. I never knew how much that meant.” - Melinda Walters

And most importantly, thanks to internal revelations instigated by the tools she learned at Micah House, Walters knows it makes her happy, too.

For all those who enter this house of sanctuary, giving no regards to race or religion, are bonded by a common thread and struggle, life. . We are all connected to each other like the links of a chain, no one more or less important than the other. We are all responsible for the uplifting of each other, so unity, peace, love, and prosperity is unto all who pass through these doors of opportunity, the opportunity to begin a new day.

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program. And through her years of education, clinical and administrative experience, she knows how to implement such a program. Moses has earned a bachelor’s degree in human services with a certicate of competency in chemical dependency, a master’s degree in public health administration and a Ph.D. in public administration. She started her rst internship in 1983 at the same treatment program she graduated from three years prior, and her decades of experience in the eld have solidied her belief in the efcacy of evidence-based treatment models.

“WE CONTINUE TO HAVE AMAZINGLY PASSIONATE, DIVERSE STAFF TO MEET THE INDIVIDUAL NEEDS OF OUR CLIENTS.” - COO Deb Moses, Micah House “It’s always been a very grassroots, community-based program with great passion for the clients we serve,” says Moses. “We continue to have amazingly passionate, diverse staff to meet the individual needs of our clients.” As a person in long term recovery herself, she knows rsthand what makes an effective treatment D E B M O S E S commenced work as chief operating ofcer of Micah House in late June 2016, but she is no newcomer to the organization. She has worked as a consultant since Micah House’s launch in 2004 and, in fact, helped found the programs that preceded Micah House and evolved into its current state.

M I C AH HOUS E C OO I S A L I GN E D W I T H F A I T H AND E V I D E N C E - B A S E D T R E A TME N T

W A L K I N G I N F A I T H A major component of her own recovery, and a dening trait of Micah House, says Moses, is a strong foundation of faith. While many treatment programs run on a binary distinction between religion or spirituality, Moses distinguishes “faith” as something more - something that facilitates belonging to a structured community with an established belief system. It’s something less formal than religion and more concrete than spirituality, she says. “It doesn’t matter what that faith is, but that it is an

“I THINK THE SKY’S THE LIMIT, BECAUSE THIS IS A PROGRAM THAT BRINGS SOMETHING THAT OTHER TREATMENT PROGRAMS DON’T.” - Deb Moses

established faith that you can be a part of,” she says. “Not just a thought process, but something you can join into. Faith within a community.” Moses adheres to Judaism, which is where she has found she can have the greatest impact in the greater community. But there are plenty of different faiths working in harmony at Micah House, leaving a client free to choose his or her own system of beliefs. “William [Lockett] is a Christian minister, I’m Jewish, we have Muslim staff and we all work together in the understanding that faith helps toward recovery. You need a belief system,” she says. “We’re not afraid to call it ‘faith.’” K E E P I N G I T P E R S O N A L Moses reserves the details of her personal recovery journey for specic times when it has the greatest potential to impact another. She knows what methods worked for her, but also recognizes the diversity of her clientele and the narratives of their lives. This goes back to her faith in evidence-based treatment, and the value of an individual nding him or herself. “I use my story at personal times when I believe it’ll be helpful to someone,” she says. “Anyone can be successful and I try not to say, ‘I did it this way,’ because my life’s been so different than a lot of others.” And the therapeutic community she found that saved her life at age 19 is what she seeks to recreate at Micah House, a program she does not see shrinking anytime soon. “I think the sky’s the limit,” she says, “because this is a program that brings something that other treatment programs don’t.” 17

We here at Micah House strive to educate clients in order to help them get back on their feet and live independently. Living Skills Lectures Include: • Health Education • Cooking/Housekeeping • Hygiene • Helping those less fortunate

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Everyone deserves a fresh start I BELIEVE, I SHALL, I WILL. BUT YOU DON’T HAVE TO START ALONE Individual treatment plans are designed to meet each client’s specific needs. To find out more, please give us a call (612)314-2460 or visit us online victorythroughfaith.com . 19

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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.”

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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.

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“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.”

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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.

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.”

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

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.”

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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

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.

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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.

U n d e r s e r v e d 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 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. 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

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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

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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.”

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CONCERN OVER HEROIN USE GROWING

New Poll Shows Americans Are Increasingly ConcernedWith

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.” -

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theinfluence.org is an online platform to have a voice in the national discussion on addiction and recovery.

"For all those who enter this house of sanctuary, giving no regards to race or religion, are bonded by a common thread and struggle, life. We are all connected to each other like the links of a chain, no one more or less important than the other. We are all responsible for the uplifting of each other, so unity, peace, love, and prosperity is unto all who pass through these doors of opportunity, the opportunity to begin a new day." .

I BELIEVE, I SHALL, I WILL.

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.

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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

C D T E C H K N OWS H OW I T F E E L S T O B E A C L I E N T A T M I C A H H O U S E

“I’VE GOT ALL THEIR BEST INTERESTS AT HEART. THEY CAN TRUST ME WHILE I’M ON DUTY,” - Augustus Gilmore, CD Tech at Micah House

“WHEN YOU’VE ENCOUNTERED GOD AND RECOVERY, THEN YOU GO BACK OUT, IT’S JUST PAINFUL.” - Augustus Gilmore

THE RIGHT FIT Gilmore had been in recovery for a time before he sought help at Micah House. In fact, he had previously worked at another treatment center. But a failed long-distance relationship combined with other personal challenges took his focus from recovery and led to a relapse. His use picked up where it had left off before his last stint in recovery, and only worsened after the death of a close friend. Getting back into recovery for the last time proved to be as much of a struggle, if not more, than the rst time. “When you’ve encountered God and recovery, then you go back out, it’s just painful,” says Gilmore. “It’s the shame and guilt of ‘how’d I get back here again?’ and it feels hopeless.” He tried other treatment centers and managed to put together eight months of clean time before relapsing again. Feeling like “a wreck - physically, mentally, spiritually,” he caught a glimpse of hope when he arrived at Micah House. Immediately he felt comfort in the laid-back homelike atmosphere and amongst the warm welcome of staff members. A longtime Christian, the faith-based approach helped with his beliefs and pushed him to re-awaken spiritually. After four months of hard work and dedication to recovery, Gilmore graduated from Micah House and started taking classes shortly after. He hopes to nish his LADC degree in 2017, but is grateful for his current role at Micah House, a place that has given new meaning to his life for the past seven years. “It’s a good purpose to have an impact, to be able to change people’s lives,” he says. “Just like I found hope and love here, I can be an example of that to the people I’m surrounded with today.”

An unexpected opportunity presented itself roughly ve years ago while Augustus Gilmore was in school to become an LADC. A class assignment led him to interview Pastor William Lockett, founder and CEO of Micah House. He nished the assignment, but not before Pastor Lockett offered him a job as a CD Tech. Having been a client at Micah House in 2009, Gilmore eagerly seized the opportunity as a chance to give back to the program that helped him get his own life back on course. “Recovery isn’t easy, I understand that,” he says. “But to be able to participate in it, that’s what it’s all about - giving back.” USING WHAT HE KNOWS Being not only in recovery, but a graduate of the very program he now serves, strengthens Gilmore’s insight into what new clients are going through. He works the overnight shift, so oftentimes he is the only staff present for clients to go to when they need help. “I try to provide a safe, secure welfare for clients, whatever their needs,” he says. “I can be that go-between for the clients and their counselor and listen effectively.” Effective listening, he says, stems directly from values he’s learned through his own recovery, which began at Micah House. Patience, tolerance and a high level of respect towards clients are necessary values in his role, all of which benet from a sense of empathy that allows him to connect on a personal level. “I’ve got all their best interests at heart,” he says. “They can trust me while I’m on duty - that’s real important to me. I genuinely care for these guys.”

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