specializing in Intensive Outpatient Program / DUI Education Psychiatric Rehabilitation Programming
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415 East 33rd Street Baltimore, MD 21218
(410) 435-0469
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High Hopes
DUI Education Program
The High Hopes DUI Education Program is designed for individuals who may be at risk for developing a substance use disorder, or anyone with an interest in learning about the issue.
High Hopes offers a 12 hour, state approved curriculum including the topics listed below:
• Review the scope of the current drinking and/or impaired driving problem on the national, state, and local levels; including associated legal penalties. • Introduction to relevant alcohol and drug treatment terminology and definitions; including the medical model of addiction. • Identificaiton of the biological, psychological, social, and familial impact of alcohol and drug use disorders. • Familiarization with the recovery process, available treatment modalities, and community-based supports.
Services Offered Alcohol and Drug Education 12-Step Support Services Drug Urinalysis Alcohol Breathalyzer Screening Legal & Medical Referrals
Psychiatric Planning and Referral Aftercare & Follow-Up Services
“TREATING THE MIND, BODY, AND SPIRIT”
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CUSTOMIZED FOR A BETTER YOU
Hidden Danger New synthetic drug strains are making it difficult to diagnose overdose
Over the course of two days in mid-August, more than 95 people in New Haven, Connecticut, overdosed.
Their drug, however, wasn’t heroin. It was synthetic cannabinoids, commonly sold as K2, Spice, or potpourri. The fallout from the incident was so widespread that experts have referred to it as a “mass casualty incident.” In nearby Baltimore, a new study by the University of Maryland’s Center for Substance Abuse Research (CESAR) published this month articulates many of the problems with identifying and treating synthetic cannabinoid overdoses.
Researchers studied urine samples of patients with suspected synthetic cannabinoid overdose at two different hospitals, the University of Maryland Medical Center Midtown Campus in Baltimore and the University of Maryland Prince George’s Hospital Center in Cheverly, a suburb of Washington, D.C.
They almost immediately hit a snag with their study.
If the patients had been using Spice, why wasn’t it showing up in their urine?
“When we got the results back, it was just kind of amazing because we expected to find a large percentage testing positive for the synthetic cannabinoids metabolites we were testing for, and what we found was that in the first go around only I think one specimen testing positive for it,” said principal investigator Eric Wish, PhD, a principal study investigator and director of CESAR at the University of Maryland, College Park, College of Behavioral & Social Sciences.
Despite testing the urine for 169 different drugs, including 26 metabolites of synthetic cannabinoids, it simply wasn’t there. The issue, say experts, highlights an urgent need for improved testing for so-called new psychoactive substances, including Spice and synthetic cathinones, also known as bath salts. These new drugs don’t show up on standard drug tests, making it difficult to form a clear diagnosis. Designer drugs continually manage to dodge legislation because whenever a certain variety is outlawed based on its chemical structure, a new similar chemical is manufactured and sold legally.>>>
“People want to know what they’ve been exposed to,”
“While the press and the media talk about Spice and K2 like it’s a single type of phenomenon, the truth can’t be further from that,” Wish told Healthline. “Basically what you have is some chemist in another country, oftentimes the DEA says it’s China, who waits and they see what has been put on the prohibited list by the government. And then they go ahead and they tweak the molecule a little so it’s no longer on the prohibited list and then they make it available.” New diagnostic measures One year later, researchers implemented an updated drug-test panel that increased the number of synthetic cannabinoids from 26 to 46. Even with this improved panel, only about one-quarter of the samples tested positive. The study also highlights several other findings that could potentially help improve immediate care for individuals overdosing on newer drugs at emergency departments as well as future public health initiatives. For instance, where a patient lives can foretell what drugs may be in their bloodstream. Researchers saw that in patients at Prince George’s County. Nearly half of them also tested positive for the hallucinogen PCP. Those at the Midtown Campus hospital were far more likely to have cocaine and fentanyl in their bloodstream. “The study provides public health officials, provides patients themselves, an understanding of the risks that they are exposed to,” said Dr. Zachary D.W. Dezman, an assistant professor of emergency medicine at the University of Maryland School of Medicine.
The fentanyl factor Fentanyl, a powerful synthetic opioid, is increasingly showing up across the United States with deadly results. In this study, researchers found that among all substances, fentanyl was the most likely to be found in combination with multiple other drugs. In some specimens, it was detected with as many as 12 others — indicating that users either aren’t aware what is in their drugs or that users of fentanyl are regularly using many different drugs simultaneously. “I’ve had a number of patients who once they were told they were fentanyl positive… started to seek treatment,” he added. Currently, fentanyl doesn’t show up on common “dip tests” used in hospitals, but Dezman hopes that will soon change. Synthetic cannabinoids, fentanyl, and synthetic cathinones represent a new challenge for members in the healthcare community to identify and treat, but by understanding which drugs are being used in which communities, better education and treatment options can be developed. “We can track people down to a particular area code, and that allows us to do things like create, potentially, a mobile van for education efforts to educate the neighborhood on the dangers they are being exposed to, signs to look out for an opioid overdose, distribute naloxone, and potentially also start a mobile opioid maintenance therapy van [to provide] methadone or Suboxone,” said Dezman. People “want to know what they’ve been exposed to,” said Dezman.
OPIATE + OPIOID ADDICITON What is the difference between Opiates and Opioids?
OPIATES
OPIOIDS
A Natural Pain RemedIES
VS.
SYNTHETIC PAIN MEDICATIONS
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 speci cally 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.
IfYou’reLostInTheSeaOf ADDICTION
THEREISAWAYBACKTOSHORE
Patients who wind up in emergency rooms because of drug use have far more types of drugs in their systems than the standard screening test used by hospitals is catching, a new study has found.
While the drug epidemic has focused on opioid use, two-thirds of patients who ended up at two University of Maryland Medical System emergency rooms in 2016 had multiple drugs in their systems — up to six were found in some urine samples. Emergency rooms tend to use a basic urine test that, like a pregnancy test, turns colors when it detects certain chemicals in drugs. The test is quick and inexpensive, but detects fewer than a dozen drugs, including opioids. The tests don’t detect drugs such as fentanyl and oxycodone, both of which have contributed to record overdoses across the country. Knowing what drugs a patients has taken can help doctors better decide a course of immediate treatment, as well as follow- up treatment such as rehabilitation, said doctors from the two emergency rooms and researchers from the Center for Substance Abuse Research at the University of Maryland, College Park. “We need to know the drug trends to know how to help people,” said Dr. Zachary D.W. Dezman, an attending physician in the emergency room at Midtown. Urine samples were tested from 106 patients at Prince George’s and 69 from the Midtown campus. Patients in Baltimore tested positive mostly for marijuana and fentanyl, a highly potent synthetic often added to heroin without users knowing.
The results highlight the complexities that exist in the current epidemic, said principal investigator Eric Wish, director of the Center for Substance Abuse Research. In some cases, dealers are mixing drugs without the knowledge of users. Many of the patients whose urine was tested misinformed doctors about what they had taken. “It used to be [drug users] didn’t want to admit what they were taking,” Wish said. “In this age they don’t know what they are taking.” Maryland’s drug-related deaths increase for seventh straight year, reach all-time high in 2017. “People are like walking drug stores now, there are so many drugs in their system,” Wish said. “A lot of the treatment now is focused on opioids. The important thing for the medical and treatment community to know is they are using far more than opioids.” Lawmakers and public health officials need to know the extent of fentanyl use to help reduce it, he said. “The emergency room is a place from which you can launch those public health efforts,” he said.
PSYCHIATRIC REHABILITATION PROGRAM
PSYCHIATRIC REHABILITATION PROGRAM
The specific objectives of PRP are to make people who are affected by mental disorders recover from their illness, being inclusive and feel equality with others and have services received to grow and change their status in society. Mental Health Programs such as PRP for adults promote awareness s ifi o je tiv s of P ar t p le w ar a t b t l dis r rs r r fr t ir il n s , b in in lusiv a f l lit wit ot rs a h s r ic s r iv t gr a t ir st t s in s iet . t l H lt Pr r s s as f r a lts pr t a r s t m t l h lt is s, a c ic , siz h rig ts, inf r lic p lic , a ie e it f r t l h lt c r c r le t t r h lt c r , r stig a is rimin tio a inst t s wit about mental health issues, independence and choice, in emphasize human rights, inform public policy, achieve equity for mental health care comparable to other health care, reduce stigma and discrimination against those with mental illnesses besides gaining employment in an in integrated system for independence. t l il n s s b sid s g inin lo t in a in int r t s st f r in .
PRP brings creative ways of becoming independent and recovery from serious mental illness and maintenance of jobs. The intent is to promote the development and implementation of effective program to enhance healthy psychological development of minds and reduce mental health barriers to mental stability. brin s cr tiv w s of in in t a r r fr s rio s m t l il n s a int of jo s. int t is t pr t t lo t a im le t tio of tiv pr r t e lt ps lo ic l d lo t f min s a r m t l h lt r iers t m t l st ilit . The overarching goal is to offer services that reduce barriers to independence, learning, protection of rights and choice and enhance healthy psychological development of people affected by mental stress and disorders. o r r in g l is t o r s r ic s t t r b r iers t in , le r in , pr t tio f rig ts a c ic a e lt ps lo ic l d lo t f p le a t b m t l str s dis r rs.
WHO ARE THE BENEFICIARIES OF PRP? The people served under PRP include adult individuals that have deteriorating mental and emotional well-being. They also include individuals with dual diagnosis of Developmental Disability and Mental Illness. These individuals face the threats of persistent thoughts of suicide, persistent feelings of hopelessness and despair, feelings of anxiety and nervousness; sleeplessness; difficulty in concentrating; and increased use of drinking and smoking. I I I p le s r u r P in lu lt in ivid ls t t h t rior tin m t l a e tio l l - in . T als in lu in ivid ls wit d l dia sis of lo t l Dis ilit a M t l Il n s . s in ivid ls f t t r ts of rsist t t ts of s icid , rsist t f lin s of h les s a s ir, f lin s of a iet a r s s ; sle les s ; diffi lt in tr tin ; a in r s us of rin in a s in . h la of a tit or e s iv tin , diffi lt in m in d isio s, s r wit r ls fr t s iet . T s ar p le wit rs sitivit , p ic, o b iors t s w h r v ic s. They have lack of appetite or excessive eating, difficulty in making decisions, and suffer withdrawals from the society. These are people with hypersensitivity, panic, odd behaviors and those who hear voices.
FINDING THE KEY TO YOUR STABILTITY AND INDEPENDENCE
Program Goals • MENTAL HEALTH EDUCATION
• MANAGEMENT OF DAILY LIVING SKILLS • MANAGE PERSONAL CARE AND HYGIENE • GUIDANCE IN SOCIAL INTERACTIONS • LINKS TO COMMUNITY RESOURCES • PARENTING AND FAMILY SUPPORT SKILLS • ACADEMIC AND EDUCATIONAL GUIDANCE • STRESS MANAGEMENT SKILLS • ANGER MANAGEMENT SKILLS • LINKS TO EMPLOYMENT SERVICES • ASSISTANCE FILLING OUR SERVICE FORMS
Baltimore's 'Staying Alive' program found to be successful in combating overdoses By Carley Milligan – Digital Editor, Baltimore Business Journal Aug 22, 2018, 12:59pm The number of overdose reversal drug kits distributed and overdose reversals reported in Baltimore both increased between 2015 and 2017, according to data from the city's health department. A city audit of the department presented Wednesday found the Staying Alive Drug Overdose Prevention and Response Plan has been successful in its goal to reduce the rate of deaths from opiate-related overdoses in Baltimore. Self-reported data from the Baltimore City Health Department showed 13,151 naloxone kits, a medication that reverses the effect of an opioid overdose, were given out between 2015 and 2017. In each year, the number of kits distributed increased, starting with 1,909 in 2015, 4,721 in 2016 and 6,521 in 2017. Determining the exact number of successful overdose reversals is more difficult, the audit found, because some individuals do not report reversals due to stigma, lack of treatment or other reasons. The available data comes from the health departments and its teams throughout the city, showing that 1,439 reversals were reported in 2016 and 2017. Nearly 70 percent, or 979, took place in 2017. In an email, Baltimore City Health Commission Dr. Leana Wen called the figures "conservative" because it does not include reversals administered by Emergency Medical Services, the Baltimore City Police Department and unreported reversals by residents.
"Reporting accurate data is important, but even more so is getting naloxone into the hands of our residents to save lives," Wen said. Malcolm Green-Haynes, chief of finance and administration for the city health department, said the department is revisiting the reporting process for overdose reversals as well as its training protocol for both internal and external organizations providing naloxone kits.
"The "Staying Alive" program consists of several initiatives including the Syringe Exchange Program."
"Continuing to expand this program — based on its current success, and the trend line exhibited in the data from the audit findings — should be a priority for the city as it contin- ues to address the opioid epidemic," Wen said. The "Staying Alive" program consists of several initiatives including the Syringe Exchange Program, which provides clean needles to reduce the frequency of HIV and other blood borne infections. It also includes training and access to naloxone though treatment centers in the city.
The opioid crisis in Maryland has continued to grow despite efforts to provide more addiction treatment and overdose prevention resources. Fentanyl-related deaths grew from 1,119 in 2016 to 1,594 in 2017, according to information released in July on unintentional drug and alcohol-related intoxication deaths from the Maryland Department of Health. Preliminary data from the first three months of 2018 indicate that there were 653 unintentional drug and alcohol-related intoxication deaths in Maryland. There were 579 opioid-related deaths, 500 of which involved fentanyl.
Baltimore City has seen an increase in the number of Naloxone kits distributed and the number of successful overdose reversals reported between 2015 and 2017.
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By Morgan Eichensehr – Reporter, Baltimore Business Journal Jul 12, 2018, 7:00am CVS Health has installed safe medication disposal units in 19 of its pharmacies across Maryland, in an effort to help prevent opioid abuse and misuse.
w “This is for those medications that are sitting in your home that are no longer needed,” Davis said. “So maybe a patient had a broken leg and needed opioids for the pain, but has some pills left over — those drugs can be easily diverted for abuse by anyone who has access, and we want to help prevent that.” In addition to the medication disposal effort, the CVS Health Foundation is helping to fund opioid-related efforts at the local level, by awarding up to $2 million in grants to community health centers dedicated to supporting opioid addiction recovery. In Baltimore, a $85,000 grant is going to Total Health Care. The funding will be used to develop and implement care models to increase participation in Total Health Care’s substance abuse treatment program. Davis said taking part in combating the opioid crisis is in line with CVS’s mission as a health care company. “Our pharmacists are uniquely positioned as part of the local health care systems to play an important role in educating and also intervening on this issue,” Davis said. “Our mission is about helping people on their path to better health, and one of the ways we can do that is through heightened safety around prominent public health issues.” Maryland is among states across the U.S. that have been ravaged by the deadly ongoing opioid epidemic. Tom Davis, vice president of professional services for CVS Health (NYSE: CVS), said CVS is seeking to support communities that have been affected by the crisis with its medication disposal kiosks. The units will allow patients to drop off unused or excess pills from old prescriptions, so they can be handed over to police and safely disposed of.
CVS looks to prevent
prescription opioid misuse with disposal kiosks in Md.
I recently returned to Buffalo after living five years in Maryland where, in the first nine months of 2017, overdose deaths related to heroin, fentanyl and other opioids reached a new high of 1,501. In response to a mandate from Gov. Larry Hogan, my colleagues and I developed an opioid awareness program for all newly admitted students at Johns Hopkins University. The recent move by the Town of Tonawanda to equip its police officers with naloxone moves that department from being aware to taking action to save lives. Amid the nation’s opioid crisis, why are communities slow to adopt the lifesaving antidote naloxone? On April 5, U.S. Surgeon General Dr. Jerome Adams issued an advisory recommending that more Americans carry naloxone – not just emergency responders and law enforcement personnel, but average citizens. Recent reports from the Centers for Disease Control and Prevention suggest that more than half of opioid overdose deaths are caused by synthetic drugs, including fentanyl. While heroin overdoses evolve in minutes to hours, fentanyl is faster acting and more potent, evidenced by that overdose evolving in seconds to minutes. In his study, “Characteristics of fentanyl overdoses – Massachusetts, 2014-2016,” Dr. Alexander Walley reported that among people who witnessed naloxone being administered, 83 percent said that two or more naloxone doses were used before the person responded. Of those who died from fentanyl overdoses, 90 percent had no pulse by the time emergency medical services arrived. [in Maryland] overdose deaths related to heroin, fentanyl and other opioids reached a new high of 1,501
THERE IS LIFE AFTER ADDICTION
415 East 33rd Street / Baltimore, MD 21218 410-435-0469
eedom FROM ADDICTION is possible ! BEGIN TODAY! WWW.HIGHHOPESPRP.COM
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