Insight Family Center

specializing in addiction recovery

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5884 Faringdon Place Suite 200 Raleigh, NC 27609

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Offering the highest quality of experienced professionals in a safe, comfortable, professional environment to support each client in all aspects of living a more fulfilled life through; providing the tools and support needed to identify the origin of the problem and then working together with our client’s, to reach their personal goals.

Insight Family Center provides: Psychiatry, Medication Management, Outpatient Therapy and an Opioid Management Clinic.

Insight Family Center, LLC understands the importance of familial values not only to assist individuals in their progress but also to enrich the community as a whole. We have extensive experience in mental health, extending over 25 years. Insight Family Center, LLC is governed by high standards and is a member of the American Counseling Association (ACA) and American Medical Association (AMA) as well as part of many other professional organizations.

“The best vision is insight.” -Malcom Forbes

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OPIOID ADDICTION: “LET’S TALK ABOUT IT.” Learn how family members and other support groups in our communities can extend COMPASSION & SUPPORT

to people in recovery and to their families

Drug abuse has a long and storied history in the United States, and we’ve been “at war” with it since 1971 under the Nixon administration. But no matter who is in office, the federal drug budget continues to increase. It’s moved from $23.8 billion in 2013 to almost $27.5 billion in 2017. The current administration seems to be taking a hardline approach to drug use. President Donald Trump and Attorney General Jeff Sessions have advocated for strict sentences for drug-related offenses, even as far as the death penalty in some cases. Given the uncertain future and lack of significant progress to date, it’s fair to wonder where drug abuse is most pronounced and which areas are most at risk in the current political climate. This report attempts to answer those questions by comparing the 50 states and the District of Columbia across 20 key metrics, ranging from arrest and overdose rates to opioid prescriptions and meth- lab incidents per capita.

Overall Rank (1=Biggest Problem)

State

Total Score

Drug Use & Addiction Rank

Law Enforcement Rank

Drug Health Issues & Rehab Rank

District of Columbia

62.97

Missouri

57.73

New Hampshire

55.65

Michigan

55.35

West Virginia

53.98

New Mexico

52.14

Indiana

51.69

Rhode Island

50.99

Kentucky

50.57

Pennsylvania

50.54

Massachusetts

49.99

Colorado

49.58

Wyoming

49.14

Tennessee

48.78

Oregon

48.42

Delaware

47.85

Alaska

47.72

Maine

47.33

Arkansas

46.77

Maryland

46.70

Ohio

46.66

Montana

45.96

Vermont

45.77

Nevada

45.66

Connecticut

45.00

New York

44.48

Illinois

44.38

Louisiana

43.77

New Jersey

42.53

Florida

42.08

Arizona

41.79

North Carolina

41.51

South Carolina

40.76

South Dakota

39.37

Oklahoma

39.35

Mississippi

39.20

Texas

39.10

Virginia

38.61

Georgia

38.44

Wisconsin

38.20

California

38.08

Washington

36.85

Idaho

35.43

Nebraska

34.64

Alabama

34.59

Hawaii

33.62

North Dakota

33.36

Kansas

33.17

Utah

30.05

Iowa

29.90

Minnesota

27.03

LGBTQ & S u b s t a n c e A b u s e

LGBTQ youth, like straight youth, use alcohol and other drugs to experiment, to fit in with peers, and to relieve anxiety and emotional pain. LGBTQ youth are at higher risk for use due to the experience of stigma and discrimination related to their sexual orientation or gender identity. In a society where heterosexuality is the norm, LGBTQ youth may face rejection, avoidance, hostility, and harm where they live, learn, work and play. LGBTQ youth who “come out” to their families open face disapproval, mistreatment, and violence, and may even be forced to leave their homes. At school, LGBTQ youth consistently face victimization and bullying by other students, including verbal and physica harassment, and physical attacks. The stress of having a stigmatized identity increases the risk of drug abuse for LGBTQ youth, who may use substances to cope with the multitude of challenges they face.

Over recent years research has shown that when compared to the heterosexual population, the LGBTQ community is more inclined to use drugs and alcohol, have greater rates of substance abuse, and continue drinking heavily as they grow older. There are many factors that lead LGBTQs to abuse drugs and alcohol. Homophobia, discrimination, and violence due to LGBTQ sexuality and gender expression can not only lead to substance abuse but also mental and physical problems. LGBTQs also face tension in their relationships and employment.

Here are LGBTQ facts you need to know now. • Minority stress contributes to high substance abuse within the LGBTQ community • According to the The American Psychological Association, minority stress is defined as “the relationship between minority and dominant values and resultant conflict with the social environment experienced by minority group members.” • The daily stresses of social prejudice and discriminatory laws in such areas as healthcare, relationship recognition, and in the workplace contribute to minority stress. • On top of this, LGBTQs are often deterred from pursuing treatment because of the LACK of adequate competence and understanding in the healthcare system. This can lead to inept and irrelevant service and discrimination.

• LGBTQs are up to 200 percent more likely to smoke tobacco than their heterosexual peers. LGBTQ safe spaces have been subjected to heavy targeted marketing. Alcohol and tobacco companies have exploited the concept that both bars and clubs are safe spaces for socializing within the community by providing instant access to tobacco and alcohol. LGBTQs to experiment with not only tobacco and alcohol but other substances for coping with social stresses. Numbers don’t lie. Statistics have proven just how strong of an IMPACT this has on the LGBT community. abuse, particularly with methamphetamines and amyl nitrate, in addition to drugs used to treat erectile dysfunction, further increase the chances of contracting HIV and various STDs. • The risk of contracting HIV or passing it along to others increases when a person abuses drugs and alcohol because they’re more likely to engage in risky behaviors such as unprotected sex or sharing needles. • This has led many • Drug use in the LGBTQ community also puts them at greater risk sexually. • Alcohol and drug

SAMHSA PUBLISHES BEST PRACTICES ON MEDICATION-ASSISTED TREATMENT FOR OPIOID USE DISORDER Best Practices

Treatment Improvement Protocol 63, “Medications for Opioid Use Disorder,”

reviews the use of methadone, naltrexone, and

buprenorphine, the three FDA-approved medications to treat opioid use disorders.

Data indicate that OUD-treating medications are both cost effective and cost beneficial

The Substance Abuse and Mental Health Services Administration has published new guidance to help health care professionals better understand medications that can be used to treat Americans with opioid use disorder (OUD). Treatment Improvement Protocol (TIP) 63, “Medications for Opioid Use Disorder,” reviews the use of methadone, naltrexone, and buprenorphine, the three FDA-approved medications to treat opioid use disorders. TIP 63 provides guidance for health care professionals and addiction treatment providers on how to appropriately prescribe these medications and effectively support patients using these medications for OUD treatment. “We know that people can and do recover from opioid use disorders when they receive appropriate treatment, and medication-assisted treatment’s success in treating opioid use disorders is well documented,” said Dr. Elinore F. McCance-Katz, assistant secretary for Mental Health and Substance Use. “TIP 63 emphasizes that increasing access to medications to treat opioid use disorder will help more people recover, enabling them to improve their health, living full and productive lives.” TIP 63 is part of SAMHSA’s larger response to the opioid crisis. More access to treatment with OUD medications is critical to closing the gap between treatment need and treatment availability and an important public health strategy. Data indicate that OUD-treating medications are both cost effective and cost beneficial.

The Links between Substance Abuse, Depression, and Suicide Among Veterans A number of studies have shown that there are links between veteran substance abuse, depression, and suicide. In one study that involved roughly 600 veterans who were deployed to either Afghanistan or Iraq, 39% of the vets were screened and showed positive for probable alcohol abuse. 3% of the vets screened were positive for probable drug use. A larger study that involved more than 675,000 active duty personnel determined that the rate of both substance use disorders and depression has increased among active members of the military. Another study determined that the rate of suicide across all military services in the USA increased between 2005 and 2007.>>>

Veteran substance abuse is a growing problem in the USA. As military members return from deployment suffering from physical and mental health problems and disabilities due to their experiences while deployed, substance abuse becomes more prevalent. Combat today is vastly different than it was even 40-50 years ago, and the new war on terror has increased the trauma and emotional toll combat has had on our service members. Prescription drug abuse is on the rise among veterans because many are treated with powerful narcotic pain medications for injuries. Over time, veterans can become dependent on these drugs and eventually an addiction can develop. Alcohol abuse and addiction is also more common among the military population while some other substances are used far less frequently and are far less of an issue. Why is Veteran Substance Abuse so Common? There are several different reasons why veteran substance abuse is so common. These service members have gone through some very tough and traumatic experiences while they were deployed, and this has left psychological or physical scars, sometimes both. Substance abuse may be an attempt to self-medicate or to deal with problematic symptoms of mental or physical disorders or injuries. Any veteran who has issues with alcohol or drug abuse should seek proper substance abuse treatment as soon as possible. Veterans who have a substance abuse issue can contact the US Department of Veterans Affairs for treatment program options. This help can be sought in the private sector also. Substance abuse is a problem that will not just go away.

The Veterans Alcohol and Drug Dependence Rehabilitation Program The Veterans Alcohol and Drug Dependence Rehabilitation Program is a veteran substance abuse treatment and rehab program operated by the Department of Veterans Affairs. The program offers a variety of therapies and support services to eligible veterans who have a substance abuse disorder. Treatment services are provided at numerous VA medical centers and clinics around the country. In order to qualify for veteran substance abuse treatment through the VA the veteran must be enrolled in the VA health care system. In addition, the veteran must have a discharge that is not dishonorable. Honorable, General, and Under Honorable discharges are usually eligible.

Why are Some Service Members Hesitant to Use the VA for Substance Abuse Treatment? For some who need veteran substance abuse treatment the VA may not be the preferred treatment provider for a variety of reasons. The wait times at some VA locations can be extensive. There is still a stigma associated with substance abuse, and some veterans may feel that they could receive better treatment and care in the private medical sector instead. Rural Areas May Pose Unique Challenges to Effective Substance Abuse Treatment Another potential obstacle to proper veteran substance abuse treatment is location, and vets in rural areas may have far fewer treatment options open to them. In some cases when there is not an appropriate VA facility within a reasonable distance a veteran may be able to seek private sector care that is covered by the government. Substance Abuse and PTSD In many cases veteran substance abuse and PTSD or other mental health issues are co-occurring disorders, and both disorders must be treated in order for the veteran to fully recover. If the substance abuse is addressed and treated but the other mental health disorders are not then the substance abuse is far more likely to start again in the future.

These service members have gone through some very tough and traumatic experiences

COMPREHENSIVE ADDICTION TREATMENT

ADDICTION IT'S A KILLER

RECOVERY FOR LIFE

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Dual Diagnosis When two conditions occur together, whether they are psychiatric or medical in nature, it is expected that the symptoms of both conditions interact in some way. Moreover, the interaction of symptoms can have an impact on the course of both conditions, as well as the outcome of each condition individually. Individuals with a dual diagnosis of substance abuse and anxiety are expected to exhibit more functional impairments, which include negative impacts on both their occupational and social functioning. Moreover, dually diagnosed individuals pose unique treatment difficulties to professionals. Rates of Substance Abuse and Anxiety Both substance abuse disorders and anxiety disorder are among the most commonly diagnosed psychiatric conditions in the United States. In fact, the lifetime prevalence rate for a substance abuse disorder has been estimated to be around 14.6% and the lifetime prevalence rate for an anxiety disorder has been estimated to be about 28.8%. Further, findings from studies using samples drawn from both the community, as well as clinical populations, have indicated that being diagnosed with either a substance abuse disorder or an anxiety disorder places the individual at an augmented risk for developing problems with the other. Though nearly all of the anxiety disorders have been linked with substance abuse problems, panic disorder—with or without agoraphobia—is the second leading anxiety disorder related to substance abuse (odds ratios = 1.0-9.2). Substance abuse problems and anxiety disorders both are among the most commonly occurring psychiatric problems within the United States. In the U.S., 14.6% of the population have suffered from substance abuse and 28.8% have suffered from anxiety.

Medically Assisted Treatment One class of medications that has received support for its role in treating comorbid anxiety and alcohol abuse is selective serotonin reuptake inhibitors (SSRIs). More specifically, both paroxetine (brand name: Paxil) and sertraline (brand name: Zoloft) have been explored among samples of individuals who have been diagnosed with alcohol abuse and anxiety. Findings from these studies, however, remain mixed with some finding support for reduced symptoms of both anxiety and alcohol dependence, while others do not. As such, more work is needed to explore the role of selective serotonin reuptake inhibitors on symptoms of comorbid substance abuse and anxiety. One anti-anxiety medication, buspirone (brand name: BuSpar) has received support for its role in treating both alcohol abuse and symptoms of anxiety. Further, the anticonvulsant medication topiramate (brand name: Topamax) has demonstrated potentially positive results in treating individuals with cocaine dependence and symptoms of anxiety.

It’s like killing yourself Don’t face opioid addiction alone. GET HELP TODAY.

5884 Faringdon Place Suite 200 • Raleigh, NC 27609 | (919)239-4041 | www.insightfamilycenter.com

IT CAN BE DIFFICULT TO ADMIT YOU HAVE A SERIOUS ADDICTION. WE KNOW... TRUST US.

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INSIGHT FAMILY CENTER

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At Insight Family Center, LLC we provide premium mental health and substance abuse services.

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Depression & Substance Abuse

Dual Diagnosis When an individual has both depression and an addiction, it is called a Dual Diagnosis. A Dual Diagnosis can be made up of any combination of a mental disorder (anxiety, depression, bipolar disorder) and addiction (drugs, alcohol, sex, gambling). Dual Diagnoses that include depressive disorders are among the most common forms of the problem; in fact, the Journal of Clinical Psychiatry reports that one in three adults who struggle with alcohol or drug abuse also suffers from depression. What makes a Dual Diagnosis so hard to treat is that each disorder can intensify the symptoms of the other. Drinking excessive amounts of alcohol, for instance, is not going to make the depression better; in fact, it will make the condition more serious. And conversely, if a person is an alcoholic, their depression will likely keep them from attaining the proper mindset to overcome their addiction to alcohol. Medication Assisted Treatment Medication therapy is a core component of recovery for many Dual Diagnosis patients who are faced with depression. Antidepressant drugs have helped many individuals who struggle with this disorder cope with their symptoms and lead stable, fulfilling lives. Finding the right approach to pharmacological treatment can take time and patience, but with the help of qualified staff who are trained in Dual Diagnosis treatment, prescription drugs can provide valuable support. Support, encouragement and motivation are essential tools in the battle against depression and substance abuse. Clinical depression can drain your energy and make you feel that rehab is a hopeless cause. Individual counseling, peer group support and family counseling can give you the strength you need to continue your recovery journey in spite of the challenges you face. If you’ve been using alcohol for years to bury your depressive symptoms, you may find that your depression rises to the surface in sobriety.

Depression affects millions of people – keeping them from living normal, happy lives. The Centers for Disease Control and Prevention (CDC) estimates that 10 percent of Americans suffer from this psychiatric disorder. Substance abuse is common among people who are battling a depressive disorder. Because alcohol is a central nervous system depressant, the use of this drug tends to trigger depression symptoms like lethargy, sadness and hopelessness. However, many depressed individuals reach for drugs or alcohol as a way to lift their spirits or to numb painful thoughts. As a result, depression and substance abuse feed into each other, and one condition will often make the other worse. Depression is all too often a gateway into drug and alcohol use. It’s easy to see why. Those who experience feelings of depressions take alcohol and drugs in order to escape their negative emotions. But those who are clinically depressed are going to stay depressed if they do not seek treatment. And if these individuals are using drugs and alcohol on a regular basis, chances are their usage will soon turn into full-blown addiction as they continue in a vain attempt to self-medicate.

not just a bad habit It’s NOT JUSTA BAD HABIT

Recent research and dialogue in the political sphere have brought long-simmering questions about addiction to the forefront: Is addiction truly a disease? Do addicts deserve to be treated like people who have a Recent res arch and ialogue in the political spher have brought long-sim ering questions about ad iction to the fore: Is addiction truly a disease? Do addicts deserve to b tr ated like people who hav a dise s that’s outside their control? disease that’s outside their control? While most researchers agree with the so-called disease model of addiction, stereotypes and cultural bias continue to stigmatize those with addiction because they made an initial choice to consume substances. However, Columbia University researchers point out that “choice does not determine whether 34 While most res archers agre with the so-called isease model of ad iction, ster otypes and cultural bias continue to stigmatize those with ad iction because they made an initial choice to consume substances. However, Columbia University res archers point out that “choice does not det rmine whether

something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices like diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices.” Experts say that applying the distinction of choice to addiction creates biases that justify inadequate treatment. It begs the question New Jersey Gov. Chris Christie asked during a 2015 town hall meeting in New Hampshire. When Christie’s mother was diagnosed something is a disease. Heart disease, diabet s and some forms of cancer involve personal choices like diet, exercise, sun exposure, etc. A disease is what hap ens in the body as a result of those choices.” Experts ay that ap lying the distinction of choice to ad iction creates biases that justify inadequate treatment. It begs the question New Jersey Gov. Chris Christie asked uring a 2015 town hall me ting in New Hampshire. When Christie’s mother was diagnosed with lung cancer at 71 as a result of addiction to tobacco, he noted that with lung cancer at 71 as a result of ad iction to tobacco, he noted that

no one suggested that she should not be treated because she was “getting what she deserved,” he said. “Yet somehow, if it’s heroin or cocaine or alcohol, we say, ‘Ahh, they decided that, they’re getting what they deserve,’” Christie remarked. HOW ADDICTION WORKS After satisfying basic human needs like food, water, sleep and safety, people feel pleasure. That pleasure is brought by chemical releases in the brain. This is according to Columbia researchers, who note that the disease of addiction causes the brain to release high levels of those pleasure chemicals. Over time, brain functions of reward, motivation and memory are altered. After these brain systems are compromised, those with addiction can experience intense cravings for substance use, even in the face of harmful consequences. These changes can stay in the brain long after substance use desists. The changes may leave those struggling with addiction to be vulnerable to “physical and environmental cues they associate with substance use, also known as triggers, which can increase their risk of relapse,” write Columbia researchers.

not just a bad habit treatment and continued monitoring and support or recovery.

THE COLUMBIA RESEARCHERS DO HAVE SOME GOOD NEWS: Even the most severe, chronic form of the disorder can be manageable and reversible, usually with long term

5884 Faringdon Place Suite 200 Raleigh, NC 27609 Call Us 919.239.4041

All people have value and should be supported to reach their full potential for independence and self-sufficiency.

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I N AN EFFORT to encourage new treatments for opioid addiction, the Food and Drug Administration plans to begin permitting pharmaceutical companies to sell medications that help temper cravings, even if they don’t fully stop addiction. The change is part of a wider effort to expand access to so-called medication-assisted treatment, or MAT. The agency will issue draft guidelines in the next few weeks. A senior agency official provided details of the proposal to The New York Times. the agency said it would soon publish two guidances, recommendations for drugmakers, on the issue.

The new approach was signaled Saturday by the health and human services secretary, Alex M. Azar II, in remarks to the National Governors Association. Mr. Azar said the agency intended “to correct a misconception that patients must achieve total abstinence in order for MAT to be considered effective.” While the Trump administration has generally supported medication-assisted treatment, Mr. Azar’s predecessor, Tom Price, was not completely on board with it. Mr. Price caused an uproar among treatment experts when he dismissed some medications that reduce cravings through synthetic opioids last spring as substituting one opioid for another. He subsequently walked back those comments, saying officials should be open to a broad range of treatment options. Mr. Azar, who took office late last month, said he would work to reduce the stigma associated with addiction and addiction therapy, and would not treat it as a moral failing. The opioid epidemic is considered the most unrelenting drug crisis in United States history. In 2016, roughly 64,000 people were killed by drug overdoses, including from prescription opioid painkillers and heroin. to correct a misconception that patients must achieve total abstinence in order for MAT to be considered effective. Noting federal data showing that only one-third of specialty substance abuse treatment programs offer medication-assisted treatment, Mr. Azar said, “We want to raise that number — in fact, it will be nigh impossible to turn the tide on this epidemic without doing so.” Mr. Azar’s comments echo those of the F.D.A. chief, Dr. Scott Gottlieb, who has made battling opioid abuse a priority for his agency. Dr. Gottlieb has moved to reduce opioid prescriptions by doctors and dentists and to promote more medication- assisted treatment, defined as drugs used to stabilize brain chemistry, reduce or block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions. The F.D.A. has approved three drugs for opioid treatment — buprenorphine (often known by the brand name Suboxone), methadone and naltrexone (known by the brand name Vivitrol) — and says they are safe and effective combined with counseling and other support. But the agency said it would soon publish two guidances, recommendations for drugmakers, on the issue.

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