SODAAT

Sobriety Through OutPatient (STOP) and One Day At A Time (ODAAT)

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FALL 2016 ISSUE

Learning the Hard Way Redirect your addiction to a fullling life

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Svices f adults & children alike STOP provides cost effective, integrated, culturally competent, state-of-the-art quality services in a safe, supportive, respectful environment that promotes recovery, societal reintegration, and self-sufciency as productive members for all those who seek/are referred for services. Our approach is to provide direct treatment and other supportive services that address individuals' total needs. STOP also recognizes the importance of treating individuals with dignity and respect, responding to their legitimate needs. We support and encourage our members to exercise their rights to actively participate in decisions affecting their lives.

Adult Svices • Assessment & intake • Orientation • Psychiatric consultation/interventions • Physical examination • Individual couples & family therapy • Family involvement / social supports • Psycho-educational group sessions • Therapy group sessions • Art & music therapy • Criminal justice system • Massage therapy • Reading and writing groups • Specialty and pre-vocational groups

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Yth Svices Stop's Priority Adolescent Recovery Center (SPARC) • Drug & alcohol treatment • Co-occuring mental/substance abuse disorders • Mental health services • Forensic services • Comprehensive assessment • Psychiatric & psychological evaluations • Medication management • Individual & group therapy • Art & music therapy • Family therapy • Educational support and tutoring

• Computer lab • Music group • Food service • Barber shop • Recording studio

2534-326 N Broad Street, STE 200 Philadelphia PA 19132

(800) 660-7867

CONTENTS To send a comment or question, write to: SOBRIETY THROUGH OUTPATIENT (STOP) 2534-326 N Broad Street, STE 200 Philadelphia PA 19132 (800) 660-7867

magazine

FALL 2016 ISSUE

FEATURES 08 UPROOTING ADDICTION Sometimes you have to dig deep

ONE DAY AT A TIME (ODAAT) 2532 North Broad Street Philadelphia, PA 19132 (215) 226-7860 x302

12 SPREADINGHOPE, ONE DAY AT ATIME One family continues a legacy of service and recovery 16 PREVENTIONONWHEELS BMX riding - a different kind of street life 46 REDEFINING RECOVERY A holistic approach with endless solutions 50 REACHINGOUT Bringing resources to the communities that need them most 54 LESSONS SINK IN Client finds unconditional support, time and again

SODAAT Magazine is published by theinfluence.org

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Copyright 2016 by AVA Consultants. No part of this publication may be reproduced in any form or by any means without the prior written permission of the publisher, excepting brief quotations in connection with reviews written specifically for inclusions in magazines or newspapers, or limited excerpts strictly for personal use. Printed in the United States of America. All rights reserved.

60 LEARNINGTHE HARDWAY Redirect your addiction to a fulfilling life

IN THE NEWS 24 BOOMING PROBLEM Elderly substance abuse issues expected to grow as baby boomers age 26 STARTING YOUNG Insight into adolescent addiction comes as new guidelines urge early prevention 28 FIGHTING FORTHE BRAIN DISEASEMODEL Model can complicate messaging in treatment plans 30 THEMISSING LINK Integrated treatment works best for victims of sexual abuse who are also addicts 32 RECOVERY U More college campuses are dedicating housing to students recovering from addiction

34 LEARNINGTODRINK Study finds alcohol changes the brain from the very first drink 36 ARE VACCINESTHE ANSWER? A new vaccine has been shown to prevent overdoses and stop opioid “designer drugs” from affecting the brain 38 FROM SMOKINGTODRINKING Marijuana users are five times more likely to develop an alcohol abuse disorder, according to a new study 40 THETURNING POINT New study looks to pinpoint transition from prescription opioids to heroin 44 GENERATIONAL BRAINDAMAGE Drinking during pregnancy presents parents with challenges beyond their own sobriety

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DON’T your WEIGH SELF

WE OFFER Individual & Group Services for those struggling with addiction and HIV/AIDS.

ESTEEM

ONE DAY AT A TIME ODA T

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Uprooting Addiction Outpatient recovery uses evidence-based treatment to support the individual

Treating addiction can be a lot like pulling weeds. You can get rid of its surface features by tearing out the leaves, by discontinuing drug use. But until you dig up the deepest roots of the problem, it’s often bound to return. “We try to get the person to change behavior. It’s a mindset, and we have to change the mind,” says Vincent Faust, marketing director of Sobrietyrough Outpatient (STOP). “A person can stay o„ drugs, but not be in recovery.” STOP digs deep with clients, guiding them through a variety of evidence-based treatment methods to e„ectively treat the underlying causes of addiction, and germinate a healthy, ful†lling life in recovery. A stable foundation For many addicts, meeting the basic needs of daily living can be a struggle. STOP welcomes clients at their lowest points, when they have few or no other options, and provides basics like clothing, shelter, food and community so they can focus on the deeper issues. “We get them raw,” Faust says. “ey come to us saying, ‘Hey, I wanna stop this madness,’ and some of them don’t even have a place to stay.” Many come straight from the criminal justice system, others from family interventions, others from the streets. All are at a vulnerable junction in life where they can choose to receive help or return to active addiction.e narrow window of time that an addict is open to help is an issue STOP recognizes by providing immediate assis- tance to those asking for help, before it’s too late. “If you have a broken arm and go to the doctor, you’re going to be treated that day. So why should this be any di„erent?” says Faust.

“We try to get the person to change behavior. [Addiction is] a mindset, and we have to change the mind.” - Vincent Faust, marketing director of Sobriety Through Outpatient (STOP)

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Stabilized, the client experiences diverse forms of therapy that approach recovery from virtually every angle. In addition to standard talk therapy, Faust says clients take part in art and music as well as individual and group therapy.ey also have opportunities for computer literacy courses, barber shop training, health and wellness education and more.e range of services exemplify a holistic treatment model that STOP has pioneered for decades, says Faust. Constantly evolving Part of the reason STOP has been able to treat more than 13,000 clients since its founding in 1987 is due to its ability and willingness to incorporate the latest treatment models - to “stay ahead of the cutting edge” of addiction research, says Faust. He likens it to the progress in medical science overall, which bases treatment practices on the latest, most credible evidence to give patients the highest chances of recovery. But he recognizes that each individual experiences treatment di„erently, and says STOP welcomes struggling clients back any time they fall. “Failure happens.We’re not going to turn someone away just because they mess up a couple times,” Faust says. Recovery maintenance can be a trial-and-error process, and given STOP’s consistent evolution with a non-judgmental approach, for many clients it’s a matter of time before they discover what recovery looks like for themselves.

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AGENCY AD 2 Your Source for News and Information on Addiction, Recovery, and Everything In Between

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ODAAT PRESIDENT DEVOTES HIS LIFE EXPERIENCE TO HELPING PEOPLE RECOVER

“I WANT PEOPLE TO KNOW THAT THERE IS HOPE. IF I CAN DO IT, THEY CAN DO IT. ANYBODY CAN TURN THEIR LIFE AROUND.” - Mel Wells, president of One Day at a Time (ODAAT)

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one day at a time, a simple solution that birthed an organization.

STREET ADDICTION No one knows the ins and outs of One Day at a Time (ODAAT) quite like its president, Mel Wells. His involvement in the program goes back to the literal ground oor: the rst clients slept one room over from Wells in his childhood home, where his father founded the organization in 1983. The accommodations were modest, the aspirations lofty. Wells says his father, Rev. Henry T. Wells, started welcoming recovering addicts into his home after being released from detox. It wasn’t his rst time drying out, but he decided to make it his last. Like many other addicts facing a new world of recovery, the elder Wells was faced with the question of “what now?” His answer was to keep on living Wells himself is a prime example of how ODAAT’s holistic recovery plan can change a life of addiction to, in Wells’ case, one of service to others, proving that anyone can benet from a lifestyle change. Although Wells used drugs, he says he doesn’t consider himself an addict or alcoholic, and credits his success to his recovery. Caught up in a lifestyle of street crime like selling drugs, committing robberies, and violence, Wells says he saw his share of tragedy. He witnessed several friends shot to death in front of his eyes; one passed away in Wells’ arms, and he describes the situation as a desperate moment of clarity. “My moment of sanity was me looking at him dying in my arms and imagining that was me,” Wells says. “I didn’t want to be the next one to die.” He says the streets can either bestow you with a conscience, or strip it away, and he wants to help people of all ages hold onto hope, and avoid the fate of his peers growing up. According to Wells, out of 35 or so students in his fth grade class, he is one of three still alive today. The other two are incarcerated.

“I NEVER KNEW ANY DANGER AT HOME...ALL I SAW WAS LOVE.” - Mel Wells Mel took over leadership of ODAAT in 2005, continuing a tradition based on the founding principles of family, love and day-by-day living. The clients he sees today are just like the ones that shared his home growing up. Most are ex-criminals and recovering addicts, but Wells says he never feared their rougher sides, and quickly developed an open attitude of fearless acceptance. “I never knew any danger at home,” says Wells. “I didn’t know if we were poor or rich, all I saw was love.”

A MESSAGE OF HOPE

With lifelong experience practicing love and tolerance, Wells says he has watched ODAAT grow from a single bedroom to a network that helps more than 50,000 people annually. He has continued to expand ODAAT’s reach as president by implementing new outreach initiatives and programs, like heading up a landscaping team that exclusively employs ex-offenders who might have trouble nding employment elsewhere due to a criminal record. Wells’ leadership stems from a family approach he learned from his mother and father. And through his father’s life story and his own, Wells aims to convey the message to every person who encounters a struggle, big or small, that the future is not yet written, and the past doesn’t have to block a positive future. “I want people to know that there is hope,” he says. “If I can do it, they can do it. Anybody can turn their life around.”

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ADDICTION RECOVERY

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DRUG & ALCOHOL PROGRAMMING

MEN’S RAP WITH MEL WELLS

WOMAN’S RAP WITH MRS. WELLS

This group is facilitated by Mel Wells with emphasis on men sharing personal experiences and their strengths. Men who attend this group benet from learning practical ways in which to get involved within the community in a constructive manner both physically and emotionally. They learn to be an asset, take responsibility for their actions, and develop strength within their networks in order to foster positive relationships amongst victims, former users and dealers in the community.

Woman’s Rap with Mrs. Wells focuses on getting women in recovery to discuss and reect on their inner feelings. The emphasis is to reduce the negativity and blame they harbor for themselves. Those feelings can also trigger relapse and deter them from setting long-term goals. Simply, this group empowers women to discuss their pain and focus on being triumphant in their lives.

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LIFE ON LIFE

James Powell facilitates this group. Mr. Powell assists clients with connecting to a more meaningful life. Group members are expected to learn how to live “life on life’s terms,” a phrase coined by Reverend Wells, without returning to self-destructive behaviors such as drug use or crime and learn how to use life skills successfully. Through our life services and support, clients are engaged in such activities as learning to cook, working a consistent schedule, skill building techniques like internet job search engines, and volunteerism for the greater good.

SPIRITUAL GROUP

This group is open to all persons regardless of their faith and is facilitated by ODAAT volunteers, Chuck and Rob, from the Philadelphia Church of Christ. The men and women who attend this group are lead to look deeper into themselves and the situations they encounter. The group focuses on helping participants grow into self-reliance and empowerment over their circumstances. We support them through their cognitive dissonance in order to become accountable for their decisions.

OUR FOCUS IS ON PROVIDING PEER SUPPORT AND PROMOTING HEALTHY, POSITIVE LIFESTYLES.

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On Wheels BMXlife gives opportunities to at-risk youth through BMX bikes “I see the bikes as a means to get through to kids about other initiatives.” - David “Joby” Suender outreach coordinator and assistant to the president at ODAAT

BMXlife is a One Day at a Time (ODAAT) youth initiative that launches this summer to get kids on the streets - in a positive way. In its inaugural season, kids will learn pedestrian and bike safety, as well as the “rules of the road,” says David “Joby” Suender of ODAAT, who started the initiative. Many participants do not have access to bikes at home, so it could be their first time putting foot to pedal on one of 10 new bikes the program provides.

Beyond the riding, Suender hopes to convey bigger messages of prevention. “I see the bikes as a means to get through to kids about other initiatives - violence, drugs, healthy living,” he says.

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Philly freestylin’ Once they learn the basics, their surroundings provide ample room to progress. Suender says Philadelphia is particularly well-suited for BMX riding in particular, a form that can involve performing tricks on manmade features in the cityscape. “It’s great because of the environment that’s readily available to these kids,” Suender says. He goes on to describe the city’s features, historic and contemporary, that provide a wealth of obstacles for BMXers to tackle. The city has been featured numerous times in skateboard and BMX videos, and a rider need not travel far to find a handrail to grind down, or a concrete ledge to jump off.

Two wheels, endless opportunities For those less inclined to the thrill of street riding, BMXlife covers many alternative aspects of riding. Suender says there are other valuable opportunities that biking can offer. He says having a hobby like biking can keep kids motivated and focused on something other than gangs and street life. The physical activity promotes healthy living, and the bike itself can serve as a sustainable means of transportation. Taking a look at the broader BMX industry, Suender says he will educate kids on filming, editing, photography and the mechanics of bike repair. “Maybe one of the kids won’t be into the riding aspect, but they’ll be into the mechanical side, or the filming and editing,” Suender says. “This will set them up with interests they can pursue down the road.” They are all skills Suender has successfully employed in his own BMX career. He says that BMX riding has enabled him to travel domestically and abroad, with his riding featured in videos, magazines and websites. It lends credibility to his message for the kids he works with, that they can do whatever they put their mind to. No matter which direction BMXlife leads its participants, the BMX culture presents opportunities that might not reach the kids through other media. And at the very least, Suender’s leadership sets an example for kids at risk. “I’m trying to provide a male role model and mentorship,” he says, “because a lot of these kids are coming from broken homes and don’t have any other outlets.” “Maybe one of the kids won’t be into the riding aspect, but they’ll be into the mechanical side, or the filming and editing. This will set them up with interests they can pursue down the road.” - David “Joby” Suender

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Ryan White participates to supplement nutritional meals and reduce food deserts.

WHAT WE OFFER

Medical, behavioral health, housing referral services, in addition to some small grants, and food vouchers to clients.

OTHER SERVICES

HIV prevention and Case Management services to assist consumers reducing physical and mental health barriers.

IN OUR COMMUNITY North Philadelphia Human Services Development Corporation (nphsdc.org)

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TRANSITIONAL HOUSING OFFICE OF ADDICTION SERVICES RECOVERY HOUSE

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SERVICES PROVIDED

For FY15, UAC/ODAAT continues to provide services for individuals referred by the Ofce of Addiction Services (OAS) via the Forensics Intensive Recovery (FIR) Program, Treatment Court or Immediate Punishment Unit.

RESIDENTS Residents must remain compliant with the required services and meetings, which included ve outside Narcotics Anonymous (NA) or Alcoholic Anonymous (AA) and ve in-hour meetings per week along with onsite D&A groups. Residents may also attend other programming, including Veterans Affairs programing, Parkside Frankford, or Methadone programs. Our successful residents remain compliant by completing daily activities and chores such as morning mediation, community meetings and street clean ups. They continue their one-on-one sessions with the site supervisor and staff for at least one hour per week. They meet monthly to discuss housing concerns and general information pertinent to their care while at the facility. Game and movie night, social events and outings continue to occur on a regular basis, and residents are invited and continue to participate in these events. While not mandated, it is strongly encouraged to help the residents with the development of social skills and communication skills. Lastly, NA and recovery materials are made available for review and learning.

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FROM YOUR PAIN. OUR FOCUS IS ON PROVIDING PEER SUPPORT AND PROMOTING HEALTHY, POSITIVE LIFESTYLES. FROM THE HUNGER.

ONE DAY AT A TIME ODA T

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“Everything we know about older adults and substance abuse probably doesn’t apply to Baby Boomers.” - Dr. Alexis Kuerbis, CUNY - Hunter College 24

overall numbers present a problem. “We’re grossly understaffed in being able to handle these problems,” says Dr. Dan Blazer, a psychiatrist at Duke University who has studied the issue extensive- ly. “It’s a problem. I think it’s a problem that’s going to get larger as time goes on and we’re probably already seeing evidence of that.” But there’s also an issue of attitude. Baby Boomers, in general, have a more relaxed view of substance use, and experts fear they may carry those behaviors later into life. “There’s no evidence that they’re going to automati- cally stop when they hit 65 years old,” Dr. Blazer says. “They’ve used them all their life, they say, ‘Why shouldn’t I use them now?’”

Even though elderly people show substance abuse issues in a much lower percentage than other age groups, the problem is more prevalent than many realize. And it appears it’s only going to get worse. Studies vary, but generally show between 2.2 and 9 percent of older adults have an alcohol use disorder, and experts say they’re already seeing a rise in marijuana and opioid abuse issues. With the large population of Baby Boomers aging, substance abuse numbers in the elderly population are expected to continue to rise, presenting serious problems for treatment providers and family members. Researchers say the problem is two-fold: part is sheer numbers, the other is attitude. With the number of older adults in the U.S. expected to increase from 40.3 million to 72.1 million between 2010 and 2030,

Experts say the lifestyle of elderly people presents a unique challenge for physicians and treatment providers. For example, because retired people don’t work, substance use doesn’t present a problem at their jobs, a HIDDEN DANGERS typical red ag for younger people. Experts also say too often doctors fall victim to their own prejudices and don’t ask the right questions that could lead to a diagnosis.

substance use. Although success rates in treatment can be better for older adults, the way they’re treated isn’t necessarily the same. Dr. Sacco says older adults respond better to more collaborative treatment programs that give them options. “For so long it was trying to t older adults into these programs, but now it might be changing these programs to t older adults,” Dr. Sacco says.

“People think this person doesn’t look like a substance user,” says Dr. Paul Sacco, an expert on substance abuse in older adults. “Sometimes physical problems associated with alcohol abuse are assumed to have a different cause in older adults.” Substance abuse can be even riskier for older adults as their bodies become less resistant to the stresses brought on by

PLANNING AHEAD

different for an older adult.” But because Baby Boomers use substances more than previous senior groups have, experts say treatment providers may have to nd new ways to treat an old problem. “Everything we know about older adults and substance abuse probably doesn’t apply to Baby Boomers,” Dr. Kuerbis says. “All bets are off.”

To mitigate the expected problems as much as possible, experts say we need to train more counselors and physicians on how to best treat older adults, and how to spot potential problems in the rst place. “With just a little bit of education about older adults, I think you could make a very big impact,” says Dr. Alexis Kuerbis, a researcher who also works with older adults. “The rst step is awareness on what might be

“We’re grossly understaffed in being able to handle these problems.” - Dr. Dan Blazer, Duke University

StartingYoung Insight into adolescent addiction comes as new guidelines urge early prevention

Treatment providers have known for years that adolescents are more susceptible to drug use and consequently, addiction. But now they might know why. Researchers recently discovered a specific pathway in the brain that makes adolescents more prone to problematic substance use, which could lead to stronger prevention efforts. By studying how cocaine affected the behavior of young and adult mice differently, researchers found that a mechanism in the brain which regulates specific protein production also controls addictive behaviors. By manipulating that mechanism, researchers were able to mitigate cocaine’s addictive effects. “Now we have a bidirectional switch that can turn on and off the cocaine-induced changes in the brain,” says lead researcher Dr. Mauro Costa-Mattioli of the Baylor College of Medicine.

“ The excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction. ”

- Dr. Mauro Costa-Mattioli, Baylor College of Medicine

One size fits all What’s most exciting about the study is that the pathway does not appear to be specific to cocaine. A second study examining nicotine returned similar results, leading researchers to believe any treatments targeting the pathway would be effective for all substances. “In the case of nicotine, it’s exactly the same thing,” Dr. Costa-Mattioli says. “All the drugs of abuse, they reduce the activity, they hijack or change this mechanism.” Researchers say they’re still interested to see if the mechanism plays a role in the transition from social substance use to more problematic use. But they say simply identifying such a crucial link of the substance use chain could lead to significant prevention methods. “Of course, the excitement of this study is that now perhaps we have a signalling pathway that could be targeted for the treatment of addiction,” Dr. Costa-Mattioli says.

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Total improvement Experts say the benefits of implementing early intervention efforts far outweigh the cost. Although limited data exists, studies show investing just one dollar can produce anywhere from a few dollars to $26 in cost savings down the road. “Thus a well-designed, well- implemented early childhood intervention can dramatically benefit the community and society as well as improve children’s and families’ quality of life,” Dr. Volkow says. But the benefits of early intervention go beyond substance abuse. Experts say many of the risk factors for substance abuse are the same indicators for other social, behavioral and academic problems. They say creating a prevention program to address and reduce the risk of substance abuse will pay big dividends across the board. “Interventions designed to reduce early risk factors show benefits in a wide range of areas,” Dr. Volkow says. “Including improved personal and social functioning, better performance in school, and less involvement with the juvenile justice system or mental health services.” 

“ Early childhood intervention can dramatically benefit the community and society as well as improve children ’ s and families ’ quality of life. ” - Dr. Nora Volkow, NIDA director

First eight years To address adolescent drug use, experts say prevention efforts have to start earlier than most would expect.The National Institute on Drug Abuse (NIDA), the government’s top agency on substance use, recently released new guidelines suggesting prevention education should start in the first eight years of a child’s life. Officials acknowledge that early childhood is not a time period normally associated with drug use. But they say factors with family, school and community environments can shape development of certain emotional and behavioral issues that can manifest in substance abuse problems even decades later. “Central to intervening early is the idea of shifting the balance of risk and protective factors in a way that builds a foundation for optimal social development and resilience,” says NIDA Director Dr. Nora Volkow.

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“The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility.” – Dr. Nora Volkow, Dr. George Koob, Dr. AThomas McLellan

Fighting for the Brain Disease Model Model can complicate messaging in treatment plans

Fighting public opinion can be an uphill battle, sometimes even a futile one. Despite years of progress and scientific advancements, researchers and treatment providers still find themselves having to convince the general public that substance use disorder is a disease. But it’s a message that can often complicate treatment plans as much as it seeks to inform.

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Setting the Record Straight Earlier this year, three of the nation’s leading drug experts wrote a paper seeking to explain, once and for all, how substance use affects the brain in the same way as similar diseases. In an article published in the New England Journal of Medicine, NIDA Director Dr. Nora Volkow, NIAAA Director Dr. George Koob, and Treatment Research Institute founder Dr. AThomas McLellan say they hope to reaffirm the brain disease model while simultaneously addressing common misconceptions about addiction. “The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility that frame drug use as a voluntary, hedonistic act,” the authors write. The authors argue that public skepticism about the brain disease model comes from researchers’ inability to articulately describe the relationship between changes in neurobiology and the behaviors associated with addiction. Although countless scientific studies have proven the brain disease model to be accurate and effective, the authors admit more work may be needed to change public perception. “A more comprehensive understanding of the brain disease model of addiction may help to moderate some of the moral judgment attached to addictive behaviors and foster more scientific and public health–oriented approaches to prevention and treatment,” the authors write.

“You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” – Bob Rohret, MARRCH executive director

 Scientific studies attest that a person’s brain chemistry can be altered as a result of addiction.This fact can provide a needed explanation as to why continued use can still be a problem for people who clearly desire to get clean. “When you start to apply an explanation of why certain behaviors occur,” Rohret says, “it provides people some comfort in understanding why they’re doing what they’re doing.” Mixed Messages But as confident as many in the medical community are about the nature of substance abuse disorder, the idea that addiction is a disease presents something of a double-edged sword for treatment providers. “The messaging has to be sort of finessed,” says Bob Rohret, executive director of the Minnesota Association of Resources for Recovery and Chemical Health (MARRCH). “You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” Rohret says treatment providers have to inform those in recovery about the nature of their disease, while also making sure knowledge of that disease doesn’t become a crutch or an excuse for inaction. When presented correctly, Rohret says patients should understand their addiction and responsibility toward it in much the same way someone with heart disease may understand their affliction. Although they cannot change the biological makeup of their body immediately, they can make behavioral changes and take actionable steps that lead to more positive outcomes.

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Integrated treatment works best for victims of sexual abuse who are also addicts. Researchers have found a dramatic link between the

“ 1 out of every 6

occurrence of sexual abuse and substance abuse. According to alcoholrehab.com, “sexual abuse victims are three times more likely to suffer depression, six times more likely to suffer PTSD, 13 times more likely to abuse alcohol and 26 times more likely to abuse drugs than those who have not been sexually abused.” They go on to say that one out of every six women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime.

women and one in 33 men in America have been the victim of sexual assault or rape in their lifetime. ” -alcoholrehab.com

Integrated treatment

Treatment centers are beginning to recognize the need for integrated treatment techniques for victims undergoing substance abuse recovery. Since there’s such a high prevalence of sexual abuse among addicts, integrated treatment offers a fuller recovery for sexual abuse victims. Trauma-focused Cognitive Behavior Therapy (CBT) is one common form of treatment. In CBT, individuals are offered psychoeducation, therapy instructing and empowering them to deal with their condition in an optimal way. Stress management tools are also helpful. Individuals can be taught to change their situations or their reactions and how to maintain appropriate personal boundaries. The regulation of emotions can be a challenge for a person who has been sexually abused. In CBT, clients learn what emotions are socially tolerable and they learn how to be flexible enough to permit some spontaneity. Survivors are also taught how to delay emotional reactions as necessary.

Individuals can be taught to change their situations or their reactions, and how to take good care of themselves.

 Integrated treatment for those suffering from substance abuse addiction and sexual abuse greatly increases the chance that this person will remain sober for the long haul.They can also experience greater joy and healing than if they were treated for substance abuse alone. Telling their story One effective aspect of CBT is for the person to do a “trauma narrative.” In addition to telling their story by the spoken word or writing it down, they can also use drawing, painting or other art forms to communicate the trauma.The narrative can then be shared with a safe person, like a trained therapist or substance abuse counselor.The hope is that the survivor will be able to let go of some of the trauma. Healing can then take place. Another facet of CBT is behavior management training. Clients are encouraged to stay calm in an emotionally charged situation, manage their own responses, learn what limits are appropriate, handle challenging questions and learn how to prevent physical confrontations with others. According to the Rape, Abuse and Incest National Network (RAINN), survivors are also encouraged to do what they can to heal themselves. Good sleep and nutrition, exercise, and regular routines like starting and ending the day in a peaceful way are a good place to start for people from this background. Those in recovery are also urged to write down leisure activities they find enjoyable and engage in those activities regularly. Clients are also encouraged to use journaling and inspirational reading to further grow in their recovery. Finally, having a supportive group of friends and family will help an individual recover emotionally from this kind of trauma.

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INSERT 5 More college campuses are dedicating housing to students recovering from addiction

House parties, keg stands and spring break. The stereotypical images of American college life may revolve around drinking and party culture, but that image may be changing as more universities look to make campus a welcoming space for recovering addicts to live and learn. In the fall of 2016, a growing number of colleges will debut new Living-Learning Communities (LLCs)

specically for people in recovery. While LLCs typically occupy a oor of a dormitory and center on a shared interest or academic eld, these new student housing sections will provide a safe and positive environment for recovering students

“It’s something I’ve always wanted to see implemented at the university,” says Dr. Gerard Love, a drug and counseling professor at Slippery Rock University in Pennsylvania where a new eight-person LLC will open in the fall of 2016. Slippery Rock ofcials hope to offer recovery-related programming at least once a week with topics such as nutrition, team building and spirituality. The hope is that the apartment-style living space will provide students a network to help them focus on both academics and recovery..

E R

“I see them as being leaders here on campus.”

– Kris Barry, University of Minnesota - Rochester

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“It’s really just about being around like-minded people and developing that ‘we’ as a support system.”

INSERT 5 – Dr. Gerard Love, Slippery Rock University

“Universities are supposed to be about dialogue, and having this is a great opportunity for dialogue,” Dr. Love says. “Bringing this whole notion of addiction out of the shadows and increasing understanding, I think will be a good byproduct of this.”

“It’s really just about being around like-minded people and developing that ‘we’ as a support system,” Dr. Love says. Dr. Love says simply having a recovery space on a college campus could help change perceptions about recovery and remove the stigma surrounding addiction.

Ofcials at the University of Minnesota – Rochester will also be opening a new recovery LLC for the fall 2016 semester. Ofcials say it’s necessary to provide recovering students with the tools they need to succeed academically and in their personal lives. “Historically, students who are in recovery really struggle to come back to campus without that [supportive housing] program,” says Kris Barry, the school’s health and wellness advocate. The LLC will house six to 10 students and feature evidence-based recovery programming. Ofcials say the LLC speaks to the school’s mission as a health-focused university. But more than that, they say they hope to foster a culture of personal growth among all students, particularly those in recovery. “I see them as being leaders here on campus and then taking that and changing the dialogue about addiction,” Barry says. “We know that the traditional college experience can be hostile to the goals of anyone in recovery, and we want to support them as much as possible.”

Boyd Austin says student communities centered on recovery provide a welcome relief for students to explore their university in a supportive and positive way. “It oers a space, it oers a culture, it oers a community of people who are engaging in college in the same way,” Boyd Austin says.

Experts say universities are increasingly adding recovery programs focused on creating a community among students, but ones incorporating housing are still few and far between. “This started about 30 years ago, but it has really taken off in the last 10 years,” says Amy Boyd Austin, president-elect of the Association of Recovery in Higher Education.

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Learning to Drink

Study finds alcohol changes the brain from the very first drink

“ Drugs of abuse basically hijack the normal learning and memory processes. ” - Dr. Dorit Ron University of California - San Francisco

Preventing escalation

The NIAAA-funded study did not establish a relationship between initial use and addiction, or even problematic drinking. But the hope is that further understanding of how alcohol affects the brain initially could lead to better treatment and prevention efforts down the road. “If we can control that step, we may be able to prevent further escalation,” Dr. Ron says. More research is needed to determine which other components of the brain are affected by initial alcohol exposure. Dr. Ron says she believes the changes that occur during first exposure could be reversed with prolonged abstinence from alcohol. But she said the more a person drinks, the harder it is to reverse those changes as the brain forms stronger connections to drinking.

One drink is all it takes. That’s what one research team found when studying how even the first exposure to alcohol can affect a person’s brain. A team from the University of California - San Francisco exposed mice to alcohol and then studied the synapses (connections) in their brains.The team found that even the first drink produced significant changes in the brain’s biological structure, calling the changes a “learning event.” “This is basically the first step,” says Dr. Dorit Ron, one of the chief researchers. “You are basically placing a memory trace.” Dr. Ron says the entire study was based on the idea that “addiction, and not just alcohol addiction, is thought to be a maladaptive form of learning and memory.” In essence, the study showed that first exposure to alcohol primes the brain for further use and lays the foundation for future “learning.” “Drugs of abuse basically hijack the normal learning and memory processes,” Dr. Ron says. “The behavior becomes habit.”

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Predicting behavior

A new study also suggests that the earlier a person starts drinking, the stronger those connections may become. Researchers recently set out to identify which substance people use first in their lives and found the majority of people try alcohol before any other substance.The team also looked at how a person’s age when they start drinking affects substance use later in life. Researchers say the earlier someone starts drinking, the more likely they are to use more than one illicit substance, and they’re also more likely to develop an addiction. “It’s a very nice predictor for polysubstance use,” says Dr. Adam Barry, the study’s chief author. “The later you delay, the closer you are to 21, the less likely you are to be alcohol dependent or dependent on other substances.”

“ Alcohol consumption among youth doesn’t occur in a vacuum. ” - Dr. Adam Barry, Texas A&M University

 strategies that prevent drug use and then applying those in an alcohol setting.” Curbing use Researchers acknowledge there’s a difference between a first sip and a first binge drinking event. But they say age at first use of any kind is still a good predictor of behavior later in life. To combat problematic drinking, Dr. Barry says educators need to address all factors of a child’s life, not just the substance itself. In keeping with new guidelines from the National Institute on Drug Abuse, Dr. Barry and his team recommend beginning substance education as early as third grade. “Alcohol consumption among youth doesn’t occur in a vacuum,” Dr. Barry says. “It’s really just trying to find evidence-based

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Treating addiction with vaccines is a relatively new idea with many unanswered questions

ARE VACCINES THE ANSWER

that arise out of a lack of research. But a new study suggests vaccinating against illicit drugs is not only possible, it could be extremely effective. At the Scripps Research Institute in California, researchers were looking for a way to guard against the lethal and addictive effects of synthetic opioid “designer drugs.” A potentially deadly opioid, fentanyl, is often used as a heroin substitute or mix-in by drug dealers, so researchers developed a vaccine to try to mitigate its effects. Researchers injected mice with three rounds of the vaccine and then exposed them to doses of fentanyl. They found the vaccinated mice did not display any “high” behaviors even months after the last series of vaccine injections. Researchers say the immune systems of the mice developed antibodies that successfully blocked the drug from reaching the brain. “The results were the best we’ve ever seen for any drug vaccine,” says Paul Bremer, a graduate student at Scripps Research Institute who worked on the study.

A new

HAS BEEN SHOWN TO PREVENT OVERDOSES AND STOP OPIOID “DESIGNER DRUGS” FROM AFFECTING THE BRAIN vaccine

The results were the best we’ve ever seen for any drug vaccine. - Paul Bremer, Scripps Research Institute

“ WE WERE ABLE TO BLOCK EXTREMELY LARGE - Paul Bremer DOSES OF FENTANYL TO PROTECT AGAINST OVERDOSES

SAFE AND POWERFUL Not only was the vaccine able to stop intoxication (something researchers suggest could aid in opioid addiction treatment), the vaccine also proved extremely effective in blocking the potentially lethal effects of fentanyl as well. While the chemical is not necessarily toxic in itself, it does produce psychoactive effects that can shut down breathing and stop a person’s heart. Researchers say mice injected with the vaccine could withstand doses of fentanyl up to 30 times the normal rate. “It was just a rst generation vaccine, but it did prove to be very potent,” Bremer says. “We were able to block extremely large doses of fentanyl to protect against overdoses.” A SINGLE PURPOSE Researchers say the vaccine would not protect against heroin or oxycodone, and a mixture of vaccines would be needed to protect against all opioids. But that was somewhat by design. To make sure the vaccine would not interfere with any medications a person may take responsibly later in life, researchers targeted specic molecules so the vaccine would only block fentanyl and its derivatives.

“For unrelated drugs that you would be taking, there would be no effect from the vaccine,” Bremer says. LOOKING TOWARD THE FUTURE Although still in the early stages of development, researchers say the vaccine represents an exciting step forward in drug vaccine research. The lab is beginning more advanced trials on a similar heroin vaccine which should give them a better idea of how successful the fentanyl vaccine could become. But until more testing can be completed, researchers say they were pleased with the progress and excited for the future of vaccines in the treatment of addiction. “This concept of using a vaccine for addiction isn’t just an academic pursuit, it could really be used in practice,” Bremer says. “I think it’s really promising.”

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Marijuana users are five times more likely to develop an alcohol abuse disorder, according to a new study

When it rains it pours. The old idiom may be familiar to many drug users who often find themselves battling more than one addiction. While previous research has shown multiple substance abuse disorders often go hand in hand, a new study suggests simply using marijuana can lead to a much higher risk of developing an alcohol use disorder.

Finding the Link Researchers at Columbia University analyzed data from 27,461 people who had used marijuana at the time of first testing, but had no history of alcohol related disorders. When researchers checked back three years later, they found marijuana users were five times more likely to have developed an alcohol abuse disorder.

Researchers said they were surprised the link wasn’t between marijuana use disorder, but simply marijuana use itself. “I think it’s important for people to be aware that there are certain behaviors that come with specific risks,” says Dr. Renee Goodwin, one of the lead researchers. “It would be particularly useful for youth.” Because youth are at a higher risk of experimenting with both drugs and alcohol, researchers said educating them about the total scope of risk is not only important, but could help curb problematic behaviors. “Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder,” Dr. Goodwin says. “Statistically it should.”

“I think it’s important for people to be aware that there are certain behaviors that come with specific risks.” -Dr. Renee Goodwin

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“Preventing or delaying the onset of marijuana use could prevent or delay the onset of alcohol use disorder.” -Dr. Renee Goodwin

Uses In Treatment For those already struggling with marijuana or alcohol use disorders, researchers said the knowledge that the two behaviors are linked could help people see the bigger picture of their addiction, and could prove useful in their journey toward recovery. “In some ways it may seem self- evident, but it may not be,” Dr. Goodwin says. “If you’re trying to quit drinking, it’s good to know that quitting marijuana could increase your chance of being successful.”

Zero relationship to mood and anxiety disorders As marijuana use has increased in the U.S., with some states even voting for legalization, some have wondered what the psychological cost will be to users. To investigate the question further, other researchers at Columbia University also conducted a recent study to determine if a link exists between increased marijuana use and psychiatric disorders. Although the results, published in the journal JAMA Psychiatry, mimicked previous research in showing a strong relationship between marijuana use and other substance abuse disorders, the findings in regards to psychiatric disorders were much different. The study showed no relationship between marijuana use and increased instances of mood and anxiety disorders, only substance abuse disorders. But despite the lack of a connection, researchers still cautioned against public policy that could lead to increased marijuana use. “The lack of association between more frequent cannabis use with increased risk of most mood and anxiety disorders does not diminish the important public health significance of the association between cannabis use and increased prevalence and incidence of drug and alcohol use disorders,” the authors wrote. 

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New study looks to pinpoint transition from prescription opioids to heroin

Stopping heroin use before it begins may be the best remedy for the country’s growing epidemic. A new study looks to pinpoint the times and ways that young people rst use the dangerous drug in hopes of strengthening prevention efforts. For three years, researchers at Wright State University tracked nearly 400 18- to 23-year-olds in Columbus, Ohio, who used illicit prescription opioids but were not opioid-dependent. Of the 362 participants, 27 eventually transitioned to heroin, a rate of 7.5 percent. “We were surprised at the number of people who transitioned to heroin,” says Dr. Robert Carlson, the study’s lead researcher. “We had really no idea of what exactly we’d be able to predict.”

Predicting risk

Researchers found several predictors of increased risk of heroin use, starting with the ways in which the opioids were being used. Those who crushed or snorted the prescription drugs were far more likely to transition to heroin. “It increases the speed at which the drug is hitting the system and makes people much more liable to becoming dependent,” Dr. Carlson says. “If people can become aware that if they even think about starting to use via a non-oral route, they are heading off on a very dangerous path.”

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“We were surprised at the number of people who transitioned to heroin. ” - Dr. Robert Carlson, Wright State University

Racial divide

The new NIDA-funded study targeted 18- to 23-year-olds because they are arguably at the highest risk for substance abuse. The study did not look at other age groups. But when considering the factors that may move a person from prescription opioids to heroin, Dr. Carlson believes age is just a number. “I wouldn’t think the risk factors for transition to heroin would be much different regardless of age group,” Dr. Carlson says. While the risk factors may be the same across age groups, the most deadly effects of heroin use are not. Research has shown that those most at risk of a heroin-related overdose fall in the 25 to 44 age range. It’s important to keep in mind that the vast majority of prescription opioid users will not move on to heroin. And signicant research is still needed to determine the social, environmental and biological factors that contribute to a person transitioning to heroin. But Dr. Carlson says he’s encouraged by the progress being made and believes the groundwork has been laid to develop effective treatment and intervention programs. “The really exciting thing to come out of this is it really gives us a rm foundation of some variables that could be targeted to prevent transition to heroin and transition to dependence,” Dr. Carlson says. Targeted approach The study also saw a difference in race among those who eventually turned to heroin. Despite roughly half the participants being African-American or Hispanic, all of the individuals who ultimately used heroin were white. Although the study could not determine the reasons behind such a strong racial divide, Dr. Carlson suggests that social networks, generational use and other circumstances could be signicant factors. National data shows the heroin epidemic has increasingly hit white males the hardest. The Centers for Disease Control estimates that between 2002 and 2013, heroin use among non-Hispanic whites increased 114 percent. Age is just a number

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