Four Circles Recovery

specializing in addiction recovery

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156 Clear Crossing Ln Horse Shoe, NC 28742

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At Four Circles Recovery Center, our philosophy is based on research-backed evidence that the ideal addiction treatment milieu for young adults includes the following three features: 1. A nurturing residential community 2. Intensive substance abuse treatment services 3. Experiential adventure-based therapy For clients who are struggling with substance abuse, addiction, depression, and related emotional or behavioral issues, we believe that a treatment program that is grounded in these three core components provides the life-changing experience that prepares clients to achieve long-term sobriety and pursue healthy, successful futures. To provide the effective comprehensive care that our clients deserve, we incorporate the following standards and principles into their personalized treatment plans: • Clinical Excellence – Our staff continues to invest the time and training that is necessary for Four Circles to be the most clinically sophisticated adventure-based substance abuse treatment program in the country. • Research Support – In addition to meeting the individual needs of each client, we show the value and efficacy of our program through independent research. • 12-Step Philosophy – The 12-Step model is an essential component of the Four Circles treatment philosophy. Our clients attend daily meetings, complete assignments based on the 12 Steps and learn to apply the 12-Step principles to their daily lives. • The Transformative Power of Nature – Removed from the pressures and stresses of daily life, and placed in a challenging yet inspiring outdoor environment, clients are given the time and space to look within themselves and discover the fundamental truths that will guide them through their recovery journey. • Family Involvement – At Four Circles, we know that substance abuse impacts the entire family, and we believe it is essential for clients’ loved ones to play an active role in the recovery process. “The admissions staff at Four Circles was very patient in answering our questions and concerns and the process was efficient and smooth. Now my son is two years sober thanks to the caring staff at Four Circles!” – Katie S.

As a recovery center dedicated to those we serve, we also embrace six core values: 1. Clinical Excellence – We tirelessly pursue the best possible clinical outcomes for our customers. 2. Integrity – We accept only the highest standards of care with respect to honesty, ethics, and morality. 3. Open Communication – We promote an environment in which the sharing of knowledge, ideas, and opinions is expected of everyone. 4. Teamwork– We value the power of teamwork in every facet of our company. 5. Mutual Respect – We foster a culture in which individual skills, experience, and talent are valued and used to our customers’ advantage. 6. Passion – We naturally demonstrate a passion in all that we do for our clients and employees.

What Level of Supervision Will My Loved One Receive? Our clients are supervised as outlined in our program manual by qualified staff members. The level of supervision clients receive is in direct correlation to the level of severity of their behavioral issues and as required by applicable laws and regulations. knowledgeable in the field of addiction and co-occurring mental health issues. Many of the program therapists are pursuing or have already earned multiple licenses, and have both personal and professional experience with addiction and recovery. We conduct background checks on all employees prior to hiring to ensure that they have the proper experience and training, and are in compliance with all state regulations. Staff who are certified in First Aid and CPR will be available to your loved one at all times. Our staff also receives ongoing training to enhance our quality of care. What Happens if There is an Emergency? We have established best practices and risk management procedures which include emergency preparedness training and response. Should there be an emergency situation, such as a natural disaster, you will be notified by someone within our organization with as much detail as possible, as soon as possible. Your loved one’s safety is our number one priority, and we will do everything it takes to keep our clients out of harm’s way. FAQ What are Your Staff’s Qualifications? Our clinical team is fully licensed and

May I Speak with Another Parent Who Sent Their Loved One to Your Program? Of course! We appreciate the fact that you are doing your due diligence when it comes to selecting the right program for your loved one and, as such, will provide you with a list of references for individuals who have given us permission to share their information. What is Your Success Rate? Your loved one’s success is dependent on many factors, the most important being the level at which you and your family choose to participate throughout the therapeutic process and your loved one’s willingness to make positive changes. We have voluntarily participated in independent research studies to determine success rates and subsequent behaviors. What Types of Problems/Disorders do you Treat? We provide innovative, adventure-based treatment services for young adults (ages 18 to 28) who are struggling with substance abuse, addiction, and co-occurring emotional or behavioral issues. Our holistic treatment program addresses the four circles of recovery: physical, mental, emotional and spiritual. We address co- occurring emotional and mental health concerns by using research-based clinical interventions that have proven effective with young adults who are recovering from addiction. Do You Offer a Continuing Care Program? Yes, we do. We understand that getting sober is just the beginning of the recovery process. Our staff works closely with clients, their families, and referral sources to create detailed discharge and aftercare plans, which includes helping clients develop a support system and identifying appropriate continuing care programs and support groups in their home communities. Does Your Program Treat Dual Diagnosis Clients?

“I would recommend this program to any other young adult struggling with substance abuse! The holistic approach to treatment at Four Circles was finally the effective rehab I had been looking for.” – John K.

Talkin’ ‘Bout My Generation

NIDA Researchers Develop Screening Tool for Teen Substance Use This article is a condensed version of a piece that originally appeared on the National Institute on Drug Abuse (NIDA) website.

Teens’ use of addictive substances often goes undetected by health care providers. But NIDA-supported researchers have developed a Brief Screener for Tobacco, Alcohol and other Drugs (BSTAD), to help spot teens’ problematic habits. In a recent study, BSTAD developers Dr. Sharon Kelly and colleagues at the Friends Research Institute in Baltimore examined the frequencies of use likely to qualify a teen for a diagnosis of an alcohol use disorder (AUD), nicotine use disorder (NUD), or cannabis use disorder (CUD). The frequencies proved to be surprisingly low, according to the researchers.

Teen drug substance use revealed For the study, the BSTAD survey employed a few, simple questions about teens’ use of alcohol, tobacco or drugs within the past year.The teens’ BSTAD responses revealed that 22 percent had used alcohol in the past year, 16 percent had used marijuana, 10 percent had used tobacco, and 3 percent had used at least one illicit substance other

than marijuana. (Original article by Eric Sarlin, M.Ed., M.A., NIDA Notes Contributing Writer) 28

“ Health care providers should have a one-on-one discussion with teens who indicate any substance use to assess level of risk, provide brief advice, and, if necessary, recommend further assessment for a treatment intervention. “

-Dr. Sharon Kelly, Friends Research Institute

Analysis of the data showed that almost all teens who reported on the BSTAD that they had consumed an alcoholic beverage on two or more days during the past year had an AUD. Conversely, teens who reported drinking on fewer than two days were unlikely to have this disorder.The corresponding BSTAD cut point for an NUD was nicotine use on two or more days during the past year and for a CUD was marijuana use on two or more days. BSTAD enables early detection Using these cut points, the researchers found that the BSTAD was highly sensitive. Ninety-six percent of teens with an AUD, 95 percent with an NUD, and 80 percent with a CUD would be flagged as likely in need of further assessment for a brief intervention or referral to treatment. BSTAD’s specificity was also high: 85 percent of teens without an AUD, 97 percent without an NUD, and 93 percent without a CUD reported use below the cut points, and so would be correctly classified. “Very low substance use frequencies were found to be optimal in identifying these disorders,” Dr. Kelly comments. The BSTAD does not distinguish

Researchers encourage regular screening Both the World Health Organization and the American Academy of Pediatrics recommend screening all adolescent patients for substance use since problems later in life often originate in adolescence. Still, many providers do not regularly screen their patients for substance abuse. “Providers are extremely busy and need a quick and valid screening measure for identifying teens who use substances,” says Dr. Kelly. She and colleagues developed the BSTAD in response to a NIDA call for new tools to fill this need. To create the BSTAD, Dr. Kelly and colleagues added the questions about tobacco and marijuana to the widely disseminated National Institute on Alcohol Abuse and Alcoholism screen for youth alcohol use. In the validation study, the FRI research team administered the BSTAD in person to half of the participants, and the rest of the participants self-administered the instrument on an iPad. The teens reported a strong preference for the iPad. The iPad version offers the potential extra convenience that results can be automatically transferred into a teen’s electronic medical record. 

the severities of the disorders, she notes, so when it flags a teen, providers need to follow up with questions to determine appropriate interventions or referrals to treatment. Furthermore, Dr. Kelly says, “Health care providers should have a one-on-one discussion with teens who indicate any substance use to assess level of risk, provide brief advice, and, if necessary, recommend further assessment for a treatment intervention.” Providers also should rescreen teens regularly, because onset of substance use can occur abruptly during adolescence. Pediatrics recommend screening all adolescent patients for substance use since problems later in life often originate in adolescence. Both the World Health Organization and the American Academy of

Fifth Circle Extended Care Program Alcohol And Drug Rehab Center This treatment program is offered to young men between the ages of 18 and 28 who have completed programming in our main adventure-based treatment program, or are looking at continued work following their completion of other primary treatment for drug & alcohol addiction.

fourcirclesrecovery.com

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.

156 CLEAR CROSSING LN • HORSE SHOE, NC 28742 877.896.5003 CONTACT US TODAY

WE ARE PROUD TO PROVIDE A HIGH LEVEL OF QUALITY CARE TO ALL OUR PATIENTS.

Dead people don’t get into recovery

D. Waters Is Suboxone a Reasonable Treatment Option for Opioid Addicts? After twenty years of providing substance abuse treatment I can tell you that the ultimate goal of anyone battling an addiction is total abstinence. Every addict and alcoholic eventually figures out they can not control their usage, and moderation is unrealistic. Learning to live life on life’s terms is part of the process of learning to live abstinent. Self-help programs like Alcoholics Anonymous(AA) and Narcotics Anonymous(NA) do a great job of helping people understand their addiction, themselves, and effective solutions for coping with their disease. Dead people don’t get into recovery Opioid addicts are not terribly different from any other addict or alcoholic, except the risk of death by accidental overdose is huge. People are dying in droves from opioid overdose. The current heroin epidemic is even more dangerous than the pain killer epidemic it replaced. Relapse rates are tremendous. Unfortunately, it may take years before an individual addict is ready to give the 12-Step AA/NA

I’ve truly never seen anything work better, and when it works it’s a beautiful thing.

process the thorough try it requires to be effective. Therefore, Suboxone is a terrific option for chronic relapsers. You can’t generally get high from it, unless you haven’t used in awhile, or never used in the first place. You can’t overdose on it from use or abuse, and any other opioid you take while it’s in your system will be nullified and wasted.

Not the solution, but maybe a good step forward Suboxone is not the solution, but in many cases it’s better than nothing, and a good response for chronic relapsers who are risking death from overdose. At least the addict is getting some exposure to treatment which is more likely to lead to recovery in the long run. Suboxone buys people time and keeps them alive. There are quite a few people who’s funerals I’ve attended that I wish had gotten on Suboxone. You can’t treat the dead.

The Subs knock down the monster cravings almost completely, and people don’t go through the nasty withdrawal that’s so painful. Once dysfunctional people who couldn’t hold a job, or were constantly on the obsessive hunt for the next fix suddenly become much more functional, and the addiction looks like it’s in remission. They can work consistently, they stop chasing the drugs, they have more money and can care for themselves and their families, and their addiction doesn’t seem to be ruling their lives. It seems like magic! Very few people actually wean off Suboxone successfully Suboxone users often wrongly think they’re cured because they look and feel more functional. Then they think all they have to do now is wean down, or taper off the medication, which is what the clinic doctors help them manage over a number of months to years. The problem is they’ve done nothing about the underlying addiction and all the addictive thinking and coping that go along with it that drive the addiction from within. They haven’t developed any social support, or learned anything about themselves and their disease. We like to say that using, or putting some chemical into the body, is only a symptom of the underlying disease. Abusing substances is not the actual disease—just a symptom. As soon as they stop using the Subs the addiction is still there and ready to start expressing itself all over again through the many painful ways it does. Chemically addicted people cope with life stressors with chemicals—that is, unless they make some fairly significant changes. Suboxone changes nothing in the end. Suboxone changes nothing A combination of Suboxone treatment coupled with AA/NA (with Sponsor and Step work) is a great thing. At Crossroads Counseling we require anyone with a substance abuse issue

to attend AA/NA, obtain a Sponsor, and work the 12-steps. If they don’t we won’t sign-off on their program. Most Suboxone clinics require their participants to attend at least one counseling meeting a month. Unfortunately, this is almost completely useless unless the individual engages in a personal program of recovery that addresses not only the biological issues, but the social, psychological, and spiritual issues related to the disease, as well.

THEY ARE MORE THAN YOU THINK LIKE YOU

80 percent of the babies born to heroin-addicted mothers are born addicts. Like mommy, like baby. fourcirclesrecovery.com

E R

Our extended care program supports those who have completed our unique treatment program and are ready to return home.

156 Clear Crossing Ln • Horse Shoe, NC 28742 | fourcirclesrecovery.com

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

Alcohol & Drug Addiction Treatment Program for

At Four Circles, we offer a women’s-only drug and alcohol addiction treatment program designed to empower young women who prefer to address their issues with the support of other females.

fourcirclesrecovery.com

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.

156 Clear Crossing Ln Horse Shoe, NC 28742 Call Us 877.896.5003

We recognize that taking the first step in seeking a treatment program can be

www.fourcirclesrecovery.com difficult, and we want you to know that our compassionate staff is here to support you through the journey of lifelong recovery.

Listening to others that have battled addiction, learning from them, and having their support will help you get through this difficult disease. 156 Clear Crossing Ln • Horse Shoe, NC 28742 WWW.FOURCIRCLESRECOVERY.COM

The harsh reality is that opioids are killing thousands of people in this country, many of them young people

State legislators focused on opioid addiction treatment and prevention in schools and prisons Thursday while reviewing bills that would both use medications to thwart overdoses and assist in recovery. A bill making its way through the Legislature would require all schools with grades 9 to 12 to have policies for training nurses on how to administer naloxone. The schools would also have to keep a supply of the medication ready. “The harsh reality is that opioids are killing thousands of people in this country, many of them young people,” Assemblyman Vincent Mazzeo, D-Atlantic, bill sponsor, said in a statement. “Narcan has been proven to save lives. Having it readily available in schools can help ensure that our schools are ready to respond in every emergency situation.” Several South Jersey schools, including Millville, Mainland Regional High School, the Egg Harbor Township School District and the Ocean City School District, already have such policies in place. As of 2017, New Jersey ranked eighth in the nation for drug overdose deaths among people ages 12 to 25, according to the national nonprofit Trust for America’s Health. There have been an estimated 654 overdose deaths in New Jersey since Jan. 1, according to the Department of the Attorney General.

The bill would require that nurses be taught how to use the anti-opioid drug and have a prescription standing order for naloxone to keep it in supply. There were more than 14,300 uses of naloxone in the state last year, state data shows. If passed, the law would also provide immunity from liability for school nurses and other employees when an opioid reversal is performed. Nearby, members of the Assembly Health and Human Services Committee reviewed a bill sponsored by Assemblyman Herb Conaway, D-Burlington, that would require state correctional facilities to offer inmates naltrexone and naloxone just before their release. Naltrexone, known by its brand name Vivitrol, is a type of nonopioid medication- assisted treatment (MAT) for a substance-use disorder. Studies have shown medication-assisted treatments like naltrexone, methadone and buprenorphine have successfully been used to reduce relapse rates and help people maintain recovery from opioid addiction. Vivitrol completely blocks the euphoric and sedative effects of opioids. Recipients often need a monthly shot of the medication administered by a medical professional.

At John Brooks Recovery Centers in Atlantic City and Pleasantville, Vivitrol is just one medication-assisted treatment offered to inpatient and outpatient patients, but it is coupled with counseling and other treatment education. Alan Oberman, CEO of John Brooks Recovery Center, said that while the bill looks well intentioned, giving one shot of Vivitrol, which costs about $1,000, to an outgoing inmate without follow-up or counseling only buys that person about three or four weeks of sobriety before they may use again. “It’s more than just giving an injection, which at least requires a nurse to do it, and many outpatient programs in the community don’t have medical staff there to do it regularly,” he said. While methadone and buprenorphine are MATs that have been on the market for some time, Vivitrol is relatively new. John Brooks and the Atlantic County jail teamed up last summer to create the state’s first mobile methadone program for inmates. Oberman said they now offer inmates Vivitrol, but they haven’t yet had any takers.

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OPIOID ADDICTION: “LET’S TALK ABOUT IT.” Learn how faith communities can extend COMPASSION & SUPPORT

to people in recovery and to their families

If you or someone you love is serious about recovery, Do You Need Help?

156 Clear Crossing Ln Horse Shoe, NC 28742

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