CALL TODAY With fast turnaround time, easy, convenient web-based interface and clear and understandable reporting we provide you the opportunity of better patient care. How Gateway To Sobriety Can Help You Our services are voluntary, and while we provide a structured nvironment for you to regain strength in battling your addiction, our main purpose is supporting treatment and recovery. While your addiction is the primary focus of all staff members, we also analyze all aspects of your life, such as your lifestyle and environment, to t y to get to th root f the issue.
7445 Park Place Blvd. Houston, TX 77087
832-767-1560
www.gatewaysobriety.com
832-767-1560
www.gatewaysobriety.com
”People who are in medication-assisted treatment need a safe place to recover.” --Jackie Eaton
Two decades of recovery, and aiding recovery Program director’s personal evolution Jackie Eaton, program director at Gateway to Sobriety, brings a wealth of experience to the position: 21 years as an addiction treatment professional, and –perhaps more important – 27 years of solid recovery. Eaton’s battle with substance abuse came to an end in 1991, due to an “intervention” by the state of Texas: he was arrested for possession and delivery of cocaine, and served seven years in prison. In retrospect, he considers his arrest a life- saving event. “Absolutely. I was locked up when I was out there using drugs, but I got set free when I went to prison. Without it I wouldn’t be the man I am today.” Eaton had made two unsuccessful attempts at treatment in the years before his arrest. “It was just something I did to get people off my back,” he recalls. But the third time, it worked. “I had gotten really tired; I had run out of people to con and places to go. I realized I didn’t want to live that life anymore.” He also felt bad about leaving his son and two daughters ”out there,” while he went to prison.
A new lease on life Eaton started taking classes in substance abuse while in prison. After he finished, he spent nine months in treatment under a Texas Department of Corrections program. One of the most important things he learned in treatment was “that I am not a bad human being; I was sick. Today, I am an asset to my family, the community and others who are struggling with drugs and alcohol. This is not work for me; it’s a ministry.” Post-incarceration, Eaton took community college classes in counseling and related subjects. He was hired as a house manager and then director of a respite center for people with tuberculosis and HIV. He also completed a counseling internship, and became fully licensed as an addiction counselor. After spending several years working as a counselor in outpatient and residential settings, and coordinating outreach for a mental health clinic, he joined Gateway in 2018, as lead counselor. Coaching r Getting He also functions as a recovery coach, which involves “finding out what their immediate needs are and what I can do for them at that moment. Even if they are not ready (for recovery), no matter what stage of change the clients are in, you can still work with them.” Eaton appreciates the approach to treatment and the overall environment at Gateway to Sobriety. “(Gateway Founder Abraham Nabil) is ‘the bomb.’ He really wants to help people, and we have created a family atmosphere here.” Looking ahead, Eaton plans to work with Nabil to open a sober living facility for people trying to recover from opiate addiction, especially those who are on
Some of the wisdom he conveys to counselors in training: “The first thing is, don’t judge people. You can’t give them advice on what they ought to do or need to do; you need to meet people ‘where they are at.’ We must educate, encourage and empower those who suffer that they can change, that they have the ability within themselves to change, if they put in a little work and have the desire to stay sober, and trust God and the process.” As counselors, “we have to be genuine and congruent, talk to the clients in their language and meet them where they are.” Eaton believes his own experience in addiction and recovery has helped him become a more effective counselor. “In my case, if I had not gone through it, I wouldn’t have the understanding and empathy I am able to have. One thing I found out is that there are many paths to recovery.” Above all, “recovery works.” medication assisted treatment (MAT). Most sober living houses have an “old school” attitude and will not accept recovering people who are on methadone, he notes. “People in MAT need a safe place to recover.” “We must educate, encourage and empower those who suffer that they can change, that they have the ability within themselves to change ”
-- Jackie Eaton, program director, Gateway to Sobriety
Life-altering work Addiction psychiatrist leads treatment team
”This addiction therapy work is life-altering for those who express their appreciation to us.”
-- Yahya Saeed, M.D.
”It’s important to treat the entire individual, not just the addiction.” - Yahya Saeed, M.D., medical director, Gateway to Sobriety
Breaking through denial
One of the primary techniques employed by the addiction counselors at Gateway is a technique called motivational enhancement therapy. The goal is to help the individual “figure out for themselves the benefits of abstinence, versus the potential jeopardy of continuing to use,” Dr. Saeed says It's an indirect method. “We don't point it (negative consequences) out to them; we ask them 'How has alcohol (or drugs) affected your life?' As they describe it, they come to understand the negative impact addiction has had in their life.” The technique can be useful in helping break through the denial that is often a part of the addiction process. “Treatment only works if the patient is not in denial. If someone is in denial, we don't contradict them. The staff assesses if a client is ready for treatment. By the time they come to us, they under- stand that they need to be treated.” Based on his career so far, Dr. Saeed be- lieves he made the right choice of medical specialty. “Generally, of all the branches of psychiatry, addiction psychiatry is the most rewarding branch – in the sense of being able to change people's lives, and patients appreciating that. “As a general psychiatrist, you hardly ever get thanked for the work you are doing. But this (addiction therapy) work is life-altering for those who express their appreciation to us.”
Yahya Saeed, the medical director at Gateway to Sobriety, brings unique expertise to the challenge of helping people who are struggling with addiction to drugs or alcohol.
The son of a diplomat, Dr. Saeed was born in Pakistan, grew up in Mexico, and came to the U.S. at the age of 16. He decided “fairly early in life” he would like to become a physician; four of his uncles were physicians. A 1999 graduate of Ayub Medical College in Pakistan, he completed a residency in adult psychiatry at Louisiana State University, and then a fellow- ship in addiction psychiatry at Yale University, where the program is ranked as the top one of its kind in the U.S. A high percentage of people treated for addiction also have a co-occurring mental health disorder, such as depression, anxiety or other conditions. Working in the field, Dr. Saeed has been struck by the need for a collaborative, team approach to treatment, involving physi- cians, therapists and social workers. “They all play an important role,” in treating dual-diag- nosis patients, he notes. Treating the disease of addiction One of the most important principles in treating addiction is treating it as a disease, Dr. Saeed says. “You can’t come into it with a preconceived bias about the individual. Addiction is not just a habit or a lack of willpower; it’s a disease and we need to treat it that way.” Also, because addiction is also physically damaging to the body, “it’s important to treat the entire individual, not just the addiction.” In recent years, one of the most important advances in treating addiction has been the de- velopment and refinement of medication assisted treatment. (MAT). To reduce the cravings that can lead to relapse, “there are some very good medications available, and especially for opioids and alcohol addiction. When the medication decreases cravings, the patient can stay more focused on the other aspects of treatment.”
Gateway to Recovery uses buprenorphine for opiate addiction and naltrexone to help clients who are alcoholics.
Recovery is only possible when the client accepts that he or she has an addiction problem and wants to do something about it. Along with physical effects, it’s also essential to treat the psychological effects of addiction.
832-767-1560
www.gatewaysobriety.com
7445 Park Place Boulevard Houston, TX 77087
OPIATE + OPIOID ADDICITON What is the difference between Opiates and Opioids?
OPIATES
OPIOIDS
A Natural Pain RemedIES
SYNTHETIC PAIN MEDICATIONS
VS.
Opium
Oxycodone
Thebaine
Hydrocodone
Morphine
Oxymorphone
Codeine
Hydromorphone
Heroin
What Medications Treat Opiate & Opioid Addiction?
Naltrexone
These medications act directly upon the opioid receptors; more specically the mu receptors. Because the effects of these medications vary at the receptor level, there can be different clinical effects during treatment.
ReVia | Depade | Vivitrol
Methadone Dolophine
Buprenorphine Suboxone | Subutex
A FULL AGONIST binds to the receptor and activates it by changing its shape - inducing a full receptor response.
A PARTIAL AGONIST binds to the receptor and activates it with a smaller shape change in the receptor that includes a partial receptor response.
Seeing Addiction ‘From Both Sides’ A counselor’s journey to recovery
Charles Wiley, a counselor at Gateway to Sobriety, likes to say he has “sat on both sides of the desk.” That means he not only has experience helping other people with addiction, he has personally experienced addiction and then recovery. As is often the case, Wiley's own addiction and recovery experience provided motivation for him to become a professional counselor. A Houston native, Wiley began playing professionally in R & B bands as a teenager, playing trombone, keyboards and flumphet (a trumpet-flugelhorn hybrid). He also worked as a music producer at recording studios in Dallas and Atlanta and a music, math and language arts teacher in Houston. Wiley began occasionally using cocaine, which eventually escalated into a full- blown addiction that derailed his career as a teacher. After two felony convictions for his substance use, he was mandated to seek help for his addiction. Wiley made two attempts at treatment but was unable to remain clean. “At those times I wasn’t ready,” he says, looking back.
Science degree in Addiction Counseling and he feels the things he learned in the course of his addiction and recovery have helped make him a more effective counselor, better able to “recognize and empathize.” Wiley believes “there are two types of people who come to treatment: some of them have hit rock bottom and know they need help and others that are mandated by the courts to enter treatment; many of them don't believe they have a problem, especially the marijuana smokers.” In those cases, education is one of the key strategies to break through a client's denial and their lack of knowledge. During the psycho-educational group sessions, the client is educated on the process of addiction and the continuum of drug and alcohol use. They are also given several self- assessment assignments. Each is guided to take a written inventory of the consequences of their drug and alcohol use and where their use has taken them. The process helps open their eyes to a realistic view of their situation; “help them identify their reasons for using drugs in the first place, and identify their place in the continuum of drug/alcohol use,” Wiley says. “They weigh the negative versus positive consequences of their use and that leads them into the motivation they need to change.” In the process, “we see a lot of ‘a ha’ moments,” Wiley notes. GETTING HEALTHY IN GROUPS Participation in group therapy sessions is one of the vital parts of treatment. “People come into treatment with guilt, shame, fear, and dishonesty; those are the concepts that keep us 'stuck.' So we
work on those. Hearing other people's experiences in group gives them the chance to see that they are not alone, and helps to rid themselves of this guilt and shame they have been holding internally.” Relapse and how to prevent it is another topic that takes up a large portion of the psycho-educational sessions. “We help every client identify their triggers, warning signs, and high- risk situations for using, both internal and external, and help them develop coping strategies for each. We also help and guide them to talk about emotions.” What does Wiley appreciate most about the approach to treatment at Gateway? “I like the fact that (Gateway founder) Abraham Nabil, allows us as counselors to do what we need to do to help each client. Some of us have been in the field longer than others; but all of us have been on both sides of the desk, so we know what is necessary for recovery.
”Some know they need help, and others are mandated by the courts to enter treatment.” - Charles Wiley, counselor, Gateway to Sobriety
STARTING A NEW CAREER
After his cocaine use led to jail and a prison term, decided to become an addiction counselor, earning LCDC certification at Houston Community College in 1996. Wiley found work as a counselor intern in an inpatient treatment facility for addicts living with HIV, a transitional living facility for mental health and substance abuse, and a transitional living facility for homeless women; each of those facilities eventually closed. Over the next few years he worked in retail and warehousing, but had a relapse that led to five more years of active addiction. In early 2008, he was arrested a third time for cocaine possession and sentenced to county jail. After 30 days and a nine-page, hand-written letter to the judge, he was released and placed on deferred adjudication probation. That was a turning point for Wiley. “Something snapped.” Wiley realized he had hit the proverbial bottom. He completed his probation successfully, 14 months early and was finally able to maintain lasting sobriety, helped by the support he found by participating in a Cocaine Anonymous 12-step group. Wiley's battle with addiction isn't something he would like to experience again. In 2018, he received his Master of
“In order to keep this gift we have received, we must give it away.”
”All of us have been on both
sides of the desk, so we know what is necessary for recovery.” --Charles Wiley
Two-P
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POWER OF ATTRACTION
Recent research indicates that magnetic stimulation to the brain may work to curb addictive tendencies in humans, according to research covered in a recent Smithsonian.com article. Researchers tested transcranial magnetic stimulation (TMS) in humans in an attempt to curb cocaine addiction. The treatment used magnets on cocaine addicts for ve consecutive days, followed by once-a-week treatments for three weeks. The number of participants was only 29, but the ndings were still encouraging: Of the 13 people who received an all-TMS protocol, 10 exhibited what researchers determined to be substantial improvement in controlling cocaine cravings. “I have met with these patients, I have seen them, I have seen their families,” says Antonello Bonci, a neuropsychopharmacologist and National Institute on Drugs researcher who co-authored the study, to Smithsonian.com. “They are alive, they are well . . . something has clearly happened to these people.” Researchers Think Magnets Can Help With Drug Addiction Impulses
Magnetic Stimulation
The Mayo Clinic denes TMS as “a noninvasive procedure that uses magnetic elds to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatment hasn’t been effective.” It works through an electromagnetic coil that is placed directly on a person’s head, near the forehead. The electromagnetic simulation painlessly delivers a magnetic pulse that stimulates nerves in the PFC—the part of the brain also involved with mood control and depression, as well as addiction. “We know that addictive drugs change many, many brain regions, as many as 90 or more, and these regions are organized into overlapping circuits. We have no idea how, given this enormous complexity, just shutting down or tuning up one single region can produce such profound effects,” Bonci says, adding that drug addicts “are often unable to switch from a counterproductive behavior to another, more benecial, one. They get stuck in repetitive, compulsive behaviors, such as using drugs.” Bonci tells Smithsonian.com that he is currently in the process of launching a larger, placebo-controlled, double-blind study of cocaine addicts. “This is a pilot study—we have a lot of work to do,” says Bonci. “I think that we will know, in just a few years, if this will become an accepted treatment.”
Many Uses For TMS
Researchers are looking into the potential of TMS as an effective treatment for a number of ailments. The National Center for Biotechnology Information (NCBI) researchers have studied how TMS can be used for obsessive-compulsive disorder, Parkinson’s disease, and epilepsy. The Journal of Headache and Pain published work studying the effects of TMS researchers studying TMS treatment for alcohol craving suppression and addictive behaviors. NCBI also published a study on TMS and binge eating disorder and comorbid depression, and The Journal of Clinical Psychiatry published a story on the effects of high-frequency repetitive TMS stimulation for decreasing cigarette smoking. Research on the effects of TMS aims to not only explore better ways to treat illness, but also to better understand TMS. “Though the biology of why TMS works isn't completely understood, the stimulation appears to affect how this part of the brain is working,” writes Mayo Clinic Staff in their overview of TMS. One of the primary reasons for pursuing TMS as a treatment alternative is that, unlike other medications, it doesn't have signicant side-effects. “TMS is well-tolerated and associated with few side-effects and only a small percentage of patients discontinue treatment because of these,” write Johns Hopkins Medicine Psychiatry and Behavioral Sciences researchers. treatment on migraines. The journals of Neuroscience Letters and Neuroscience & Biobehavioral Reviews published work by
“We know that addictive drugs change many, many brain regions, as many as 90 or more, and these regions are organized into overlapping circuits. We have no idea how, given this enormous complexity, just shutting down or tuning up one single region can produce such profound effects.”
— Antonello Bonci Neuropsychopharmacologist Director of National Institute on Drug Abuse’s Intramural Research Program
Scientists search for the ‘Holy Grail’
On October 24, 2018... President Trump signed a new, bipartisan bill to combat the opioid addiction epidemic. Politicians are hailing it as a major step forward, while addiction and treatment experts say it falls far short of
A package of more than 70 bills introduced targeting the opioid crisis, the Support for Patients & Communities Act:
• Reauthorizes funding from the Cures Act, which put $500 million a year toward the opioid crisis, and makes some policy changes intended to give states more • Creates a grant program for “Comprehensive Opioid Recovery Centers,” which will attempt to serve the addiction treatment and recovery needs of their communities (in part by using what’s known as an ECHO model). • Removes restrictions on medications for opioid addiction, allowing more types of health care practitioners to prescribe the drugs.
• Expands an existing program
• Advances new initiatives to educate and raise awareness about proper pain treatment among health care providers. • Attempts to improve coordination between different federal agencies to stop illicit drugs like fentanyl at the border, and gives agencies more tools to improve detection and testing at border checks. • Increases penalties for drug manufacturers and distributors related to the over-prescribing of opioids.
responders, such as police and
naloxone, a medication that reverses opioid overdoses.
• Allows federal agencies to pursue more research projects related to addiction and pain. • Makes several changes to Medicare and Medicaid to attempt to limit the over-prescription of opioid painkillers within the programs and expand access to addiction treatment, including lifting some of the current restrictions that make it harder for Medicare and Medicaid to pay for addiction treatment.
It also authorizes HHS to develop grants to support people who are in recovery transition to independent living and jobs, as well as develop a pilot program to provide temporary housing for those recovering from substance abuse. of the bill provides measures to prevent synthetic opioids like fentanyl from entering the U.S. According to the Centers for Disease Control, total opioid deaths did not increase in 2017, but deaths due to fentanyl overdoses did. Data shows the drug, which is about 50 times more potent than heroin, caused nearly 30,000 fatal overdoses last year. access to medication-assisted treatment. It removes the cap on the number of patients to whom drugs like buprenorphine, a drug cravings and easing withdrawal, from 100 to 275, and expands a grant program allowing medication-assisted treatments.
strengthen the federal government’s response to the opioid crisis,” Sen. Rob Portman (R-OH), who helped put together the legislation, said in a statement after the Senate vote. “Importantly, this bill will increase access to long-term treatment and recovery while also like fentanyl from being shipped into the United States through our own Postal Service.” On the other side of the debate, Leana Wen, M.D., the former health commissioner of Baltimore (and incoming president of Planned Parenthood), said that the legislation “is simply tinkering around the edges.” Daniel Raymond, director of policy and planning for the Harm a bad thing, but I do think to some degree it’s a political document,” Raymond told the Washington Post. “When you drill down into it, it’s not that there aren’t good ideas, but it doesn’t reach the level of, this is what our nation needs right now.” and Mental Health Services Administration (SAMHSA) to allow organizations to develop opioid recovery centers in a community. It also requires the Department of Health and Human Services to determine best practices and then create a grant program implementing those policies or procedures, such as the use of recovery coaches, which has
Trial evaluated effectiveness for common injuries
Four Groups of Patients The patients were randomly assigned to one of four groups. One group received a pill for their acute pain that contained a combination of ibu- profen and acetaminophen, the ingredients in Advil and Tylenol. The other groups were given a pill for their pain that contained a prescription opioid as well as acetaminophen, either oxyco- done and acetaminophen (Percocet), hydroco- done and acetaminophen (Vicodin), or codeine and acetaminophen (Tylenol No. 3). All the patients were asked to rate their pain immediately before taking the pain medication and again both one and two hours afterward (before they left the emergency department). The assessments were done using an 11-point scale (0 = no pain; 10 = worst possible pain). The study found that the intensity of pain was similar among all four groups before they took the medication, with a mean score of 8.7 on the scale. The pain then declined over time in all
As the over prescribing of opioid pain medications has become a major public health concern, health care providers have been paying more attention to over-the count- er-drugs that could be used instead, without the risk of addiction. A recent study published in the Journal of the American Medical Association (JAMA) has confirmed that OTC meds ibuprofen and acet- aminophen are just as effective as prescription opioids at reducing acute pain caused by com- mon injuries.It is one of the few “real world” studies that has made the comparison. A team of researchers led by Andrew Chang, M.D. of Albany Medical College, studied 411 patients (aged 21 to 64) who had sought med- ical care at two urban emergency departments after having sprained, strained or broken an arm or leg. (About 20 percent of the patients had fractures.)
individuals can become addicted even after only taking opioid pain meds for a few days. One study found that one in five people given a 10-day supply of opioid painkillers became long-term users. More M.D. Education Needed Don Teater, M.D., medical adviser of the non-profit National Safety Council, says doctors need more education to understand the draw- backs of prescribing opioids. “Doctors get a lot of training in the physical aspects of health, but not the mental aspects,” says Teater, a family physician in North Carolina whose practice focuses on treatment of pain and the treatment of opioid use disorder. “We don’t get training in addiction. Often, a doctor will start a patient on opioid pain med- ication and continue it for awhile. Then if the doctor feels the patient is asking for too much medication, the doctor will cut them off, and abandon them. There needs to be a greater understanding of the emotional component to pain. We also need to have a better under- standing of the disease of addiction.” According to a white paper from the Council, there is little evidence that opioids are helpful when used for chronic pain.
four groups – and by similar levels: 4.3 points in the ibuprofen/acetaminophen group, 4.4 points in the oxycodone/acetaminophen group, 3.5 in the hydrocodone/acetaminophen group and 3.9 in the codeine/acetaminophen group. The researchers said the major limitation of the study is that it had the patients assess their pain only while they were in the emergency department. The study did not evaluate how the ibuprofen/acetaminophen combination would work in comparison to opioids once the patients went home. Also, the participants had a specific type of acute pain – from sprained or broken arms and legs. “Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sus- tained treatment to patients already addicted to opioids, in whom it may take many years to achieve recovery,” Demetrio Kyriacou, M.D., a senior editor at JAMA and a professor of emer- gency medicine at Northwestern University, wrote in an accompanying editorial. Yet, as Kyriacou also acknowledges, “stemming the opioid addiction crisis will … require reex- amination of the long-standing assumptions that opioids are superior to
non-opioids in most clinical situations requiring man- agement of moderate to severe pain.” Studies have shown that nearly one-third of adult patients seeking care at U.S. hospital emergency departments are given prescriptions for opioid painkillers, even if their visit was not pain-relat- ed. That is a dangerous practice, since some
“In fact, some evidence shows they may be detri- mental and increase risk of addiction and premature death,” the paper says.
There is little evidence that opioids are helpful when used for chronic pain.
www.gatewaysobriety.com TO LEARN HOW GATEWAY TO SOBRIETY CAN HELP YOU - VISIT OUR WEBSITE
7445 Park Place Blvd. Houston, TX 77087
832-767-1560
Getting on the
right path
Staff member looks forward to counseling career
“Recovery doesn’t have to be boring.”
Since 2017, Houston native Jennifer Alvarado has been an administrative assistant on the staff at Gateway to Sobriety. But she is much more than that: Alvarado also makes a valuable contribution as a recovery advocate, helping and supporting people who are struggling with substance abuse and addiction. Like many people, when Alvarado began using alcohol and drugs at an early age, she had no idea her use would eventually lead to a life-changing addiction. Substance abuse made Alvarado's high school years difficult, but she eventually got help, spending two weeks in inpatient and six months in outpatient treatment.
-- Jennifer Alvarado, administrative assistant, Gateway to Sobriety
After getting her recovery started, Alvarado worked as a community health worker, and earned an asso- ciate's degree in human services at Houston Community College. She is also working to become certified as an addiction counselor (LCDC), which she expects to receive in May. better ways to deal with emotions without using chemicals, and also “earned some good things about myself,” increasing her self-esteem and self-confidence to accomplish her goals. She enjoys passing on the lessons she has learned in recovery, to help other people. “I've always loved helping people,” she notes. “Some (addicted) people say life can't be fun if they're not using drugs; but recovery doesn't have to be bor- ing.” Since joining the Gateway staff in 2017, Alvarado has appreciated the dedication she's seen. “They are really passionate about what they do here; they really want to help clients recover.” Starting a career Looking back at her time in treatment, Alvarado learned
“They are really passionate about what they do here; they really want to help clients recover.”
-- Jennifer Alvarado
7445 Park Place Blvd. Houston, TX 77087 832-767-1560
www.gatewaysobriety.com
FROM While your addiction is the primary focus of all staffmembers here at Gateway to Sobriety - we also analyze all aspects of your life, such as your lifestyle and environment, to try to get to the root of the issue.
832-767-1560
7445 Park Place Blvd. − Houston, TX 77087
www.gatewaysobriety.com
ADDICTION
To learn more about our programs & services call or Visit Us Online 832-767-1560 www.GatewaySobriety.com
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