Wednesday, June 22, 2016

Mandatory Addiction Treatment Can Be Ineffective

addiction recovery
In the circles of addiction recovery around the globe, it is often said that people with substance use disorder need to want to get better in order to do so—often times a “rock bottom” experience is required for such a desire to arise. The friends and families of addicts and alcoholics know all too well that there is an element of truth to that idea. No matter how much you want someone to seek help and recover, the onus falls on the afflicted to accomplish the feat.

Naturally, there are exceptions, but most people with long term recovery would probably agree that they had to want sobriety—and did whatever it took to maintain it—before recovery came to fruition. It is no secret that relapse is quite common, being a part of many an addict or alcoholic’s story. Putting down the drink or drug can sometimes happen with ease, managing to not pick drugs or alcohol again is the hard part.

Recovery for the Wrong Reasons

People living with the disease of addiction will often find their way to treatment and/or 12-Step meetings on account of wanting to please someone close to them. And, while their intentions are no doubt good, the reality is that drug and alcohol use is merely a symptom of the mental health disorder known as addiction. Breaking free from the disease requires not only steadfast dedication to a new way of thinking and living, but also eternal vigilance.

Those who seek recovery to appease others will often “cherry pick” their way through the process, failing to see the forest for the trees. Another common saying in recovery is: “the only thing you need to change is everything.” The people who are willing to go the distance are typically those who want recovery for themselves; life had become so unmanageable that a paradigm shift was required.

Involuntary Recovery

In the United States, and in a number of other countries where illicit drug use is illegal, it has become more and more common to offer addiction treatment to those who would otherwise be sent to jail for a criminal charge like possession. While there is little doubt that treatment is certainly the preferable punishment, it is rare that those who complete required treatment will stay sober and live a life in recovery.

In prisons and jails across the country, the majority of people serving time were incarcerated for nonviolent drug offenses. This the byproduct of fighting a war on drugs for nearly half a century. Naturally, as we continue to face an unprecedented opioid epidemic, we cannot continue to arrest away the scourge of addiction. Offering access to treatment over jail is certainly the lesser of two evils, and may actually help people with a substance use disorder find recovery, said addicts will actually need to want recovery. We know that involuntary addiction treatment is not the most effective.

Mandatory Treatment

New research suggests that mandatory treatment for people with substance use disorders is not effective in reducing their drug use, BMJ reports. A global data analysis conducted by researchers at Boston Medical Center and Boston University School of Medicine found that most countries “often lack the capacity to treat substance use disorders.” What’s more, they found that treatments often fail to utilize effective treatment modalities.

"The evidence presented in this article provides additional argumentation supporting the position of all UN organizations that mandatory treatment settings do not represent a favorable or effective environment for the treatment of drug dependence," said Fabienne Hariga, MD, MPH, senior adviser to the United Nations Office on Drugs and Crime during the recent meeting in New York. "The United Nations therefore calls on States to transition from mandatory drug treatment and implement voluntary, evidence-informed and rights-based health and social services in the community.'' 

At Hemet Valley Recovery Center & Sage Retreat, we offer a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Please contact Hemet Valley Recovery Center & Sage Retreat 866.273.0868 to begin the journey of recovery.

Tuesday, June 7, 2016

American Opioid Epidemic Angel Programs

opioid epidemic
An unprecedented epidemic requires novel approaches, if the United States is ever going to rein in the prescription opioid painkiller and heroin epidemic that has brought hundreds of thousands Americans to their knees in despair—and thousands to their death. In 2014, 18,893 people lost their lives due to prescription opioid overdoses, and another 10,574 overdose deaths were linked to heroin, according to the Centers for Disease Control and Prevention (CDC). With such staggering statistics it may come as little surprise that overdose is now the leading cause of accidental death in the U.S. In that same year, over two million Americans met the criteria for having an opioid use disorder.

There are two sides to the American opioid epidemic. On one hand it is crucial that researchers and addiction experts pinpoint the causes that led to the opioid problem that became so dire; while on the other hand it is crucial that addiction professionals continue to do the good work they have done for decades in helping those in the grips of addiction and seeking recovery.

It is no secret that the opioid scourge has been driven largely by over a decade of over-reliance and overprescribing of opioid pain medications. Subsequent efforts to combat rampant over prescribing and widespread unused medication diversion throughout the country, by way of prescription drug monitoring programs (PDMPs) and prescription drug take-back campaigns had an unintended, albeit hardly unsurprising, consequence in the form of heroin use.


Unintended Consequences

Here’s the rub, both lawmakers and doctors can make it next to impossible to acquire prescription opioids, and people will still find a way to get their hands on an opioid of some kind—such as heroin. If steps are not taken to advance and expand addiction treatment resources, simply making it harder to acquire a drug does not mean that the dependence and addiction will fade away. Opioid withdrawal is extremely unpleasant; most addicts will do whatever it takes to avoid the symptoms that accompany it—even if that means doing a drug that that one often says they would never use.

Over the last few years the nation has seen a dramatic rise in heroin use among people from all walks of life, the opioid epidemic has shown us that everyone is eligible. Historically, the idea that we could arrest our way out of addiction has been the status quo, despite the fact that it is widely accepted that incarceration does little to stifle addiction. Unlike the crack epidemic in the 1980’s and the heroin scourge in New York in the late 1960’s which affected people of ethnic descent or those on the lower end of the socioeconomic spectrum—today’s prescription painkiller and heroin crisis in the United States crosses the stereotypical boundaries of previous drug epidemics in this country.

The majority of today’s heroin users began down the perilous road of opioid addiction with prescription pain medications. People from all age groups, ethnic background and various social strata have turned to heroin for three reasons, the drug is:
  • Easier to Acquire
  • Less Expensive
  • Often Times More Potent
Heroin is Schedule I narcotic, meaning, it is a drug with no currently accepted medical use and a high potential for abuse. Unlike, drugs like OxyContin (oxycodone), which are classified as Schedule II and are legal to have with a prescription, heroin is illegal across the board. Those caught with heroin, at least traditionally, were at risk of jail time. Thus beginning a cycle of drug use, incarceration, release, relapse and recidivism. In the wake of the opioid epidemic we face, both lawmakers and law enforcement understand that how they once handled addiction did not work and thinking outside the box is required for stemming the tide of opioid addiction in this country.


Surrender Salvation

Just over a year ago, a police chief in Massachusetts started a program in Gloucester that encouraged those who were addicted to opioids to go to a police station and surrender their drugs; in return, they would be given access to substance use disorder treatment services instead of handcuffs, NPR reports. Gloucester Police Chief Leonard Campanello’s Police Assisted Addiction and Recovery Initiative (PAARI), or so-called “Angel Program,” has made multiple headlines and has been widely hailed as a success. Now, a year later, 400 people have taken advantage of the program, and more than 100 police departments in the U.S. have developed similar programs modeled on of the Angel Program. “We had to stop trying to arrest our way out of this problem,” said Campanello.

“We’re an entity that — right, wrong or indifferent — has a very loud voice in this right now and that people seem to be paying attention. Our job is to lend that voice to people who are suffering from this disease and their support groups.”


Recovery is Not Impossible, It’s Necessary

Opioid addiction is deadly disease that claims over 70 lives a day in the United States alone. Failing to access addiction treatment services, usually results in dire outcomes. Those who want to break the cycle of addiction and are willing to take certain steps to bring that to fruition, can do so with the guidance of those who walked the path before them. Recovery begins with reaching out out for help. At Hemet Valley Recovery Center & Sage Retreat, we offer a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Please contact HVRC & Sage Retreat 866.273.0868 to begin the journey of recovery.

Wednesday, April 20, 2016


If you follow this blog, by now you are familiar with the story of my friend Chris. It is not unlike many of your stories. Chris fell into a bad cycle with drug use. The drug of choice: One of the scariest - crystal meth. He tried to kick the habit on his own, toiling in the throes of addiction for over a year and a half. He became desperate, started blowing off friends and family, and eventually hit rock bottom. Bottom for Chris was sitting for over a week in a psychiatric ward of a Pennsylvania hospital - skin lacerated by incessant scratching, rotting teeth - a shell of himself, lost both mentally and emotionally. It was a living hell for all of us.

That was his breaking point. For many, it gets worse. Some never make it back to sanity. Many see the inside of a jail cell. Too many die.

Luckily Chris has a network of friends who really care for him. He swallowed his pride and confided in some of us. We recognized the severity of his addiction and brainstormed about how we can help. We were willing to pool our resources together to do whatever was necessary for our friend, but our funds were limited. Especially when a reputable inpatient addiction program costs anywhere from $20-thousand to $60-thousand.

By the grace of a higher power, a friend in the industry read my first blog about Chris and asked how she might help. A few brief phone calls later, Chris was cleared to receive a scholarship to a wonderful program at Champion Center in Lompoc, CA for nominal costs. He worked the program for 30 days, updated us when he could and we began to recognize the friend we had temporarily lost to this disease.

But as we all know, addiction doesn't just disappear and neither do the underlying issues that often causes someone to turn back to a drug of choice. Naturally, there was concern upon his return to the environment he left. The setting for all which turned sour in his life. The place where he lost his way and succumbed to his disease. The house which shelters so many nightmares and horrific memories.

Well the good news is that Chris is celebrating his three month anniversary today. He decided to share something with his group of friends our of gratitude.

Here it is:
On the date of three solid months of recovery, I wanted to send a comprehensive update to the group.  
Heartfelt Thanks
First and foremost, I wouldn’t have made this milestone without the love and support from each and every one of you on this distribution list. There are a few add-on’s to the list – but for this group, it doesn’t matter when you got added – all of you have showed up – every time, faithfully.   It is often heard that a run like mine makes you no better or no less than anyone else in the recovery group.
While that is true, I am reminded daily that this is a support group like no other.
In addition to making the 90 day mark, I also grateful to mark one month of my return home from California.  It has not been without it’s challenges.
When I walked into Alder Street on March 11th – it looked, and smelled exactly as I had left it in the dark days of January.  That, combined with items literally unmoved for two months left me with crippling and vivid nightmares of the past two years.  I had almost resolved myself to the fact that every time I would close my eyes, I would wake up, panicked, that I had gone on a 4 or 5 day run.   While this wasn’t unique to the house (it started the last week in California), I was prepared by the team in CA to be ready for it – and use coping skills to move through it.
The house has since been cleaned from top to bottom, pictures on the walls have been changed, and while I am still plagued by vivid recall, it has reduced considerably in the last two weeks. 
I worked with Dr. Todd, the Champion Center trauma specialist on dealing with the memories and experiences of the last two years within these four walls.  Dr. Todd was insistent that I correct the problem “the way Chris P. would correct the problem” - not run from it – but simply stand up and fix it.  It has been a struggle every day to have the courage to stand up and wade through the tornado that I allowed to almost take me out.  I am so grateful to at least have a roof over my head – and yet, these are tough days – I am rebuilding life, one step at a time – and this has been a challenge like no other. 
I was able to gain strength and clarity in California, and being the eternal planner and armed with a solid game plan, my first few days home were intentionally scheduled. 
The Return to Alder Street
Joe M. was the first person to come meet me for dinner and a night out on my return – and while I almost had him bring his bottle of backup holy water, dinner and Mass was the best possible way to come home.  If there was anything I needed to do – it was to be “of thanks” for coming out of this with my mind.   
Soon after, I invited my friends Brian and Jeff over for my first “home cooked meal” - and that was an intentional invite.  While many of you don’t know Brian and Jeff yet, you will, soon.  If anyone was going to help me make a fresh start at this kitchen table, it was going to be the two of them.   Without a doubt, we chased a lot of demons out of this kitchen that night over chicken cutlets, and it was the best possible way to reopen this kitchen to life.  
Since then, I’ve tried to see and talk to as many of you as possible. Brian, Fred, Daniel and I traveled to literally the top of Liberty One.  Kevin, Maddie and I walked through Rittenhouse.  Meg and I have gotten back into our routine of meals together. Doyle and I have shared coffee together, and I got to welcome Gonz home from California.  Most importantly, I’ve gotten lots of needed love from the Beck and Saffici girls (and a high five from John Patrick).  Next week, I’ll finally get to meet Cece, give Tosti a long overdue hug, and hopefully, find a table at Paesano’s for me and Flocco and have a long overdue “Paesano” and a very cold RC Cola. 
The days are not without strife.  While the accomplishments seem insignificant on the surface – they are exponentially hard to execute.  Not because of the complexity of task – but more so for the recognition that every time something is crossed off the list, I have to recognize and realize the dramatic devastation that I allowed into my life that brought me to my knees – and know that I have to work so much harder to secure things that I’ve had in place since I was 14.  To me, it seems almost catastrophic – and I have to allow myself a fixed time to grieve, and then simply move forward.  Not moving forward keeps me in place, and I have never been one to sit still. 
Since 14, I’ve had a checking and savings account.  I’ve had to live off of a “Greendot” card with “valued customer” on the front since January.  I walked into the PNC Bank at 10th and South on Tuesday, with 150.00 in checks and started again, from scratch.   The task to open the account was easy – the recognition that I was starting with less than what I did when I was 14 was not.
This goes for every task, every transaction, every interaction.   Without an SSRI, or tranquilizer or sedative, I have to work through this on my own, and put myself to bed at night, on my own.   When I left California, I really felt like I had gotten my groove back – but it has become abundantly clear that my groove is still a ways off.   I need to celebrate each day, rebuilding on a better foundation than when I started at 14 and continue to put one foot in front of the other. 
I laugh a lot more these days, and sometimes I even surprise myself at the tone in which the words come out.  There are days when I don’t even recognize myself – because I haven’t heard that kind of hope in my voice since late nights at St. Cassian Hall – thinking about all the things that could be.
And then there are days when you want to cry, but I’ve cried enough, so I might as well just laugh. 
Continuum of Care
I cannot express enough to this group how grateful I am that you all rallied to send me to the Champion Center. 
Someone asked me at CMA where I went to rehab.  I started telling them about my experience, and they responded:  "Wow dude.  My rehab was in Chester, and it was infested with Bed Bugs." 
There are simply no words.  The care was and continues to be extraordinary. 
I’ve had the ability to reach out to two of my favorite counselors - Roberta (Bob) Russell and Gina Phelps and I credit them for stepping up to the plate and answering every question I asked – related to recovery and life.  I cannot adequately describe how much they have helped me through this entire ordeal. They faithfully save time for me – even with their current inpatient load.  I know that the Holy Spirit worked through them. 
I’d also be remiss if I didn’t include my friend Geoff H. in this list, who I met through the program. Bob said to me right before I left that he would be my solid link to recovery, and she was right.  Geoff and I talk weekly, and he’s making a trip out to Philly in May. I was completely broken by the time I had arrived to Lompoc, and Geoff was the first person to hear my “story” with no filter, and he didn’t blink.  If I had hoped for anyone to be in the foxhole with – it was him – and I am excited for all of you to meet him in person.  He’s an amazing and dear friend – and I know he’s a phone call away. 
Just for Today
It doesn’t really matter that I have 90 days under my belt.  What matters is today.  And today, I’m grateful. 
Today was a full day.  My friends in California would joke that I would come out of classes and proclaim “I’m DONE” and wave my hands over my head.  By the time I left, my fellow classmates would just look at me and say “DONE – I’M DONE!”.  That’s how I feel about today.
But tomorrow, God willing – I’ll start again. 
In May of 1999, I quoted Eleanor Roosevelt when she said that “we gain strength, courage, and confidence in every experience where we look fear in the face, and did something we thought we could not do.”  That’s so true – today. 
Tomorrow morning, I’m starting the day with Doyle, over coffee, and not celebrate 90 days, just celebrate today – and being one day closer to a better, more genuine, authentic me.  I have to have faith that the rest will all fall into place. 
Love you all more -
PS:  While I’m giving you a first hand account, I wanted to pass along this article that’s making the rounds.  It’s spot on, and worth the read.

Hemet Valley Recovery Center & Sage Retreat offers a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Call Hemet Valley Recovery Center & Sage Retreat 866.273.0868 or visit our website.

Sunday, April 3, 2016


Something is rotten in the state of Florida. "Junkie hunters," or rather human pariah's who operate under the guise of "marketers" are recruiting addicts in the rehab capital of the world to earn a quick dollar. It's a gross abuse of a broken system - one which is in desperate need of a policing overhaul and overall reform. What's worse than these "care centers" and their headhunters turning profits by preying on the weak?

The practice of brokering bodies into rehabs is hurting addicts in real need of quality treatment.

In South Florida’s Delray Beach, home to hundreds of rehab facilities and halfway houses, scams abound to profit off of addicts and their insurance policies. “Marketers” act like headhunters, picking up addicts when they’re down, then bringing them to rehab centers and halfway houses for a fee — usually about $500 per head. It's downright fraud.

Because the best way to milk insurance is to cycle addicts through detox, rehab, and outpatient programs, there’s plenty of incentive to keep them relapsing. Five recovering addicts told BuzzFeed News that some marketers give their recruits money for drugs so they test positive on urine tests when checking into treatment. “He told me, ‘You gotta be dirty to go to detox,’” one addict told BuzzFeed News, describing a marketer who gave him cash for drugs.

And what's more, is that it is a cyclical game of fraud with a seemingly endless network of pawns. A bottomless pool of players, desperate enough for money to perpetuate the hideous scam to no foreseeable end.

Take the personal story of Ira, as recently reported by a BuzzFeed article on this growing trend:

Byron Ira, a 45-year-old from Indiana who’s recovering from drug addiction, shows how easily a brokered patient can become the broker.

After going through rehab in his home state and relapsing, in November 2015 he contacted the HART Foundation, a nonprofit group that connects addicts with rehab centers. He then got a text, he says, from someone in the sales office of a rehab center in South Florida called C.A.R.E. Addiction Recovery, asking for his insurance information and some questions about his drug use.

“The next call I got was flight information,” he told BuzzFeed News. “The day after Thanksgiving, I got picked up at the Fort Lauderdale airport.”

(Mitchell Wallick, the executive director at C.A.R.E., said the facility only pays for patients’ travel if they sign a promissory note promising to pay it back; Ira denies signing anything before his flight, though he notes it’s possible he signed something during his intake once he was in Florida. He says he has never received a bill of any kind from C.A.R.E.)

Ira had googled the place ahead of his flight and was expecting a 12-step-based holistic center far from home where he could change his life. Instead, he spent most days at “the Center,” an office building where addicts did group and individual therapy, but not based on the 12-step program. Nights were spent mostly back at the residence, a two-bedroom apartment housing four men.

The residence and the Center were understaffed and crowded. During his 23-day stay, Ira estimates he made it to only about five 12-step meetings outside the rehab center, because the staff didn’t have access to enough vans to take the residents anywhere. (Wallick denied these allegations, saying that patients are taken to 12-step meetings every night.)

Shortly before Christmas, Ira’s counselor at C.A.R.E. told him he was ready to rejoin life on the outside. But the doctor in charge of the counselors didn’t want to hear it. Ira was told that if he chose to leave, despite his counselor’s recommendation, it would be against medical advice.

Out of the almost $22,000 the program charged Ira’s insurance, they were only reimbursed $1,638.50. So Ira believes that they were trying to keep him another week in order to cover the cost of his flight. Wallick declined to confirm or deny that Ira was a patient, citing privacy laws.

Ira left the facility. A few weeks later, a man who Ira says was a patient at C.A.R.E. during his stay texted Ira with an offer. The former patient said he was making $1,500 for every insured addict he recruited to C.A.R.E. He invited Ira to join in recruiting patients, but Ira says he declined to participate.

The above story is just one of many. Addicts are being recruited from the streets and in some cases, poached from other rehabs by these head hunters, acting as patients from within. What's worse, the patient isn't receiving the highest quality care, but instead are being placed in overcrowded, understaffed facilities. Some of the halfway houses and sober living residences affiliated on the backend of these scams have claimed incidents of sexual assault and even drug dealing, by the house managers. There is very little in the way of monitoring or regulation for these houses, and they're often run by people who are extremely fresh in recovery or actively using.

This rampat, statewide crisis of insurance provider fraud has caused Cigna to pull its coverage in the state of Florida for 2016. More may follow if the problem persists. These pariahs are also stripping patients of quality care, while creating a huge disadvantage for patient referrals to ethical treatment facilities, not only in Florida but other states. Many of these "recruited" addicts come from out of state, often lured in by highly ranked search engine call center links.

Some of these effects may only represent the consequential tip of iceberg if real legislature isn't soon passed, reforming how patients can be recruited and brokered. Something has to change and soon.

Hemet Valley Recovery Center & Sage Retreat offers a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Call Hemet Valley Recovery Center & Sage Retreat 866.273.0868 or visit our website.


Monday, March 21, 2016


Johnny Manziel used to be known for creating dazzling plays on the football field and exciting fans in stadiums everywhere. He was nicknamed, "Johnny Football." He had a storied college football career at Texas A&M, won the Heisman trophy (awarded to the best college football player), and was drafted by the Cleveland Browns in the first round of the 2014 NFL draft.

Two weeks ago, he was released by the Cleveland Browns and is now facing serious assault charges against his former girlfriend, Colleen Crowley.

Football fans and pundits are still asking the question, "Should our team consider signing Johnny Football? 

They should first be asking, will Johnny Manziel ever get the help he needs? Manziel has had a longstanding substance abuse problem, which has long been overlooked due to his amazing skillset on the gridiron. But only those closest to him seem to recognize, that if Johnny doesn't really seek the treatment he desperately needs, there will be no more Johnny Football. There will be no more football, period. 

According to the Dallas Morning News, Manziel’s father, Paul, tried getting his son to enter a rehab facility in January, shortly after Johnny’s 23rd birthday. When his son refused, Paul Manziel told the paper: “I truly believe if they can’t get him help, he won’t live to see his 24th birthday.”

This would not have been Manziel's first stint in a rehab facility.

Last Spring, the Browns quarterback had entered Caron Treatment Center for undisclosed issues, and when he was discharged in April—just in time for the first offseason workout of 2015—those around him saw a different Manziel. He was more focused, especially when it came to football. The Browns training staff noted that he looked less bloated. His skin was even glowing.

But only two weeks into the season, after his starting job as quarterback was again taken away, Manziel relinquished to his substance abuse problem.

By midseason, the quarterback had fallen back into old habits. It’s a familiar pattern: Manziel straddles the line between becoming the professional football player many believe he can be, and the kid from Kerrville who can’t help but sabotage himself.

Manziel and Ex-Girlfriend Crowley
Manziel’s career has plunged to new depths after another year of off-field recklessness. Just 22 months after drafting him as their presumed franchise quarterback, the Browns have officially moved on, cutting Manziel two Friday's ago. (His final stat line in Cleveland: 14 games, 57.0 percent completion rate, seven touchdowns, seven interceptions, seven fumbles.) An accusation of an ugly assault hangs over him; according to an affidavit, ex-girlfriend Colleen Crowley said that on Jan. 30 Manziel struck her so hard her eardrum ruptured. A Dallas grand jury is contemplating an assault charge.

He has been dropped by his agent, Erik Burkhardt, and his marketing team. As recently as early January, league sources say at least two teams—one being the Cowboys—had legitimate interest in Manziel. That was before the alleged assault on Crowley. Now, those same sources say that unless Manziel seeks treatment, he’s “untouchable.” His actions since Crowley’s accusations surfaced—chugging bottles at nightclubs from Miami to West Hollywood, dancing at a strip club—demonstrate such apparent disregard, it raises the question: If he never plays football again, does he even care?

When is enough... enough for Johnny Football? He's already left millions of dollars and the prestige of being an NFL-starting QB in the wake of his excessive partying. When is it time that Johnny Football will recognize that the ongoing party is getting darker by the day, and soon the lights will go out. It's now or never for him to realize that he is not only risking a career, but also risking his life.

Hemet Valley Recovery Center & Sage Retreat offers a full continuum of care including: Acute Medical Detoxification, Rehabilitation, Residential, Partial Hospitalization and Recovery Residences.

Call Hemet Valley Recovery Center & Sage Retreat 866.273.0868 or visit our website.