Friday, March 29, 2019

Fentanyl: Opioid Epidemic's Third Act

The number of overdose deaths involving fentanyl was stable in 2011 (1,663) and 2012 (1,615), according to the Centers for Disease Control and Prevention (CDC). Then, there were 18,335 fentanyl-related overdose deaths in 2016. The dramatic rise is staggering enough to give anyone pause. The opioid crisis in America is far from over despite a national, collaborative effort to stem the tide of use and abuse.

Merianne Rose Spencer, a statistician at the CDC and study co-author, tells NPR that the fentanyl death toll presented in the study is at the low end. She says that it is likely that many fentanyl-related overdose deaths went uncounted.

Fentanyl and its synthetic cousins are extremely dangerous. It boasts potency levels 100 and 50 times stronger than morphine and heroin respectively. Making synthetic opioids, arguably, the deadliest drugs on the planet.

It can be helpful to view the rise in synthetic opioid use as the third act of the decades-old scourge. What began with prescription painkillers, the article notes, followed by heroin and now fentanyl. All three opiate iterations carry a significant risk of addiction and overdose. Given that these powerful narcotics are not going to disappear, public awareness about the promise of recovery is a must.

The Rising Tide of Fentanyl in America

While the American West Coast has been relatively unaffected by the growing ubiquity of synthetic opioids, the East Coast and Midwest has not. Why? The article notes that it may owe to the fact that black tar heroin is more prominent on the Pacific Coast.

In the Midwest and along the Atlantic seaboard heroin typically is sold in white powdered form, sometimes referred to as “China White.” Mixing fentanyl with powdered heroin is easier to do and more natural to disguise. Many overdose victims are caught unaware of the presence of fentanyl in their heroin.

There are several notable findings in the CDC's report, including that far more men are succumbing to synthetic opioids than women. Men are perishing at close to three times the rate. Ricky Bluthenthal, a professor of preventive medicine at USC's Keck School of Medicine, tells NPR that the gender discrepancy likely correlates to men being more likely to use alone, compared to women.

Traci Green, deputy director of Boston Medical Center's Injury Prevention Center, has a slightly alternative explanation. She says that while women are more likely to use with another person, they are also more likely to reach out for help. They are more likely to call 911 or seek treatment.

"Women go to the doctor more," she says. "We have health issues that take us to the doctor more. So we have more opportunities to help." 

Any time a patient presents to a doctor exhibiting signs of an opioid use disorder it is an opportunity to promote recovery. Green says physicians can take the chance and encourage their patients to seek treatment. Many of fentanyl’s victims are not traditional opioid use disorder cases. Men and women using cocaine or methamphetamine are at risk of exposure.

Whether by accident or looking to increase demand, dealers may be purposefully getting people hooked on opioids, according to the article. David Kelley, deputy director of the New England High Intensity Drug Trafficking Area, says "That's something we have to consider."

"The fact that we've had instances where it's been present with different drugs leads one to believe that could be a possibility."


Increasing Number of Dangers Accompanying Addiction

The CDC report is cause for significant concern for several reasons, to be sure. However, the fact that people using any drug have the potential to be exposed to synthetic opioids is alarming. Addiction has always been risky and will always carry the potential for unfortunate tragedy. The growing prevalence of fentanyl exponentially ups the stakes.

If you or a loved one is battling a substance use disorder, we strongly encourage you to reach out to Hemet Valley Recovery Center & Sage Retreat for support. Unlike most treatment centers, we have a Chemical Dependency Rehabilitation Hospital (CDRH) license. That means we can provide programs and medical services at one location.

Take the first step and by calling 866-273-0868 today for a confidential assessment.

Thursday, March 21, 2019

Facing Addiction in America Means Helping Others

addiction recovery
Most people in recovery circles know the names Bill W. and Dr. Bob, the co-founders of Alcoholics Anonymous (AA). A smaller number know the name Marty Mann. While she wasn’t the first female member of AA, she was one of the first to join the Fellowship. Even still, some people refer to her as “The First Lady of Alcoholics Anonymous.”

Those familiar with the basic text of AA – typically referred to as the “The Big Book” – may have read her contribution. The chapter "Women Suffer Too" appears in the second through fourth editions. At a time when alcoholism and drug addiction was primarily considered to be a moral failing, Marty Mann was pushing back. In the 1940s!

Mann’s introduction to AA came in the form of The Big Book; her psychiatrist, Dr. Harry Tiebout, gave her a copy in 1939 and recommended she attend a meeting. Following a rough start, Mann was able to realize long-term recovery. In 1944, she organized the National Committee for Education on Alcoholism (NCEA) to break the stigma and promote the disease model of addiction.

People know the NCEA today as the National Council on Alcoholism and Drug Dependence (NCADD) or as Facing Addiction with NCADD. In 2015, NCADD merged with Facing Addiction, a national nonprofit organization dedicated to finding solutions to the addiction crisis. Marty Mann passed away on July 22, 1980, but her legacy lives on – as does the excellent work from the organization she built.

If you are interested in learning more about Marty Mann, there are many great sources to choose from, including texts like Dr. Bob and the Good Oldtimers, A Biography of Mrs. Marty Mann: The First Lady of Alcoholics Anonymous, and In Search of the Mysterious Mrs. Marty Mann.


Facing Addiction in America

Unlike many of Mann’s contemporaries, she was not hesitant to share her struggles with alcoholism, her recovery, and her beliefs about what she viewed as a public health crisis. According to In Search of the Mysterious Mrs. Marty Mann, she held that (1) alcoholism is a disease, (2) the alcoholic can be helped and is worth supporting, and (3) addiction is a public health problem and therefore a public responsibility. Mann also believed it was a family disease – her father died of alcoholism.

NCADD reports that 21 million Americans suffer from addiction. This is an unsettling statistic, and the actual figure is probably much higher. However, the organization also points out that there are 25 million Americans in recovery from addiction. The goal is to make the latter number grow exponentially in the years to come.

How Americans view addiction today is much different than when Marty Mann found sobriety. What’s more, many people in recovery – like Mann – are now willing to discuss their experience, strength, and hope openly. Two such people who are sharing their sobriety with the world are Eagles guitarist Joe Walsh and Beatles drummer Ringo Starr. The powerhouse musicians and addiction recovery advocates sat down recently with Rolling Stone.

Last fall, Starr and his wife presented Walsh (25 years sober) with the highest humanitarian award for activism in the addiction recovery community, at a Facing Addiction with NCADD gala in New York City, according to Rolling Stone. An interesting aside is the fact that Starr and Walsh are both brothers in sobriety and brothers-in-law. The two are married to Marjorie and Barbara Bach; the sisters are also in recovery. The publication points out that the two couples have more than a century of sobriety, collectively.

Carrying the Message: There is Life After Addiction

Each day, men and women come together to help each other stay clean and sober. There are hundreds of different programs that one can turn to for help, but they all share a common feature: fellowship. You are invited to read the entire Rolling Stone interview with Starr and Walsh at length. The two musicians have a lot of insights about recovery and helping others find strength. The Eagles guitarist tells the magazine:

I got sober because of a fellowship of men and women who were sober alcoholics. That’s how I got sober. After a couple years, I talked about [my sobriety] with other alcoholics and tried to help them. The only person who can get somebody else sober is somebody who’s been there and done that. 

I realized that I do more good showing people that there’s life after addiction. So I decided it’s okay to go public because everybody knew anyway, and if I save one life showing that there’s life after addiction I feel good about it. I believe that’s part of why I lived.

 You can watch Joe Walsh’s acceptance speech below:

If you are having trouble watching, please click here.


Addiction Treatment with Hemet Valley Recovery Center

At HVRC, our programs utilize the principles of 12 Step Recovery, along with individualized care that includes treating the whole patient: psychologically, socially, spiritually, and physically. Our dedicated team of addiction professionals can help you or a loved one heal and find long-term recovery. Please take the first step by contacting us at your earliest possible convenience to learn more about our programs.

Thursday, March 14, 2019

Mental Health in the Hospitality Industry

mental health
In 2015, approximately 14 million people were working within the restaurant industry; by 2026 this number is expected to reach over 16 million, according to Statista. Add millions more hotel staff and caterers into the mix. A statistically significant number of Americans fall under the umbrella of this job sector. More importantly, many service industry workers – from celebrity chefs down to people working in the “dish pit” – are struggling with mental illness.

People working in the field often work long, irregular hours; most people earning minimum wage and hoping to supplement their income with tips. Merely put, working in hospitality comes with significant stressors, not the least of which stem from dealing with people who are - at times – unruly, impatient, and unkind.

Still, there is a natural calling for some to the field. For those who do not love the work, the money makes it more palatable. The other benefit or reason that many individuals choose to work in the field is that employers will hire people with little education and even less experience. For those who can’t pass a drug test too, the appeal is obvious.

Anyone who has ever had the opportunity, or has chosen hospitality as a career choice, knows that it is a hotbed of alcohol and drug use. In a sense, drinking and drugging are woven in the fabric of the service industry. Many employees juggle the job with alcohol dependence, substance use disorder, and other co-occurring mental health disorders. They require support desperately.


Addiction, Stress, Anxiety, and Depression in the Service Industry

Last year, millions of people around the globe found themselves mourning the loss of celebrity chef, writer, and television host Anthony Bourdain. The Parts Unknown star was not shy about disclosing his battle with both addiction and depression. On June 8, 2018, Bourdain took his life in France; it was a sad day that sent shock waves across the foodservice industry and beyond.

While a tragic loss, the Kitchen Confidential author's death forced the people working in hospitality to consider mental health seriously. Patrick Mulvaney – proprietor and chef at the farm-to-table sensation Mulvaney’s B&L in Sacramento – views Bourdain’s death as an opportunity to confront a local mental health epidemic, Civil Eats reports. In 2018, Sacramento's hospitality industry lost 12 people to mental health complications. The loss of life became even more personal for Mulvaney when his close friend and former coworker, Chef Noah Zonca who suffered from depression and addiction, died suddenly.

“It was brutal. Just in between middle of December and middle of January, four people died in Sacramento, hospitality people. Three of them were either working or had worked for us before, and one was a long time Sacramentan. So, this is about as ‘home’ as home can get,” Mulvaney told Civil Eats

The hospitality and food industry ranks highest among 19 industries for illicit drug use and third highest for heavy alcohol use, according to The Substance Abuse and Mental Health Services Administration (SAMHSA). The organization reports that people working in the field are more likely than others to struggle with mental illness and addiction.

Partnering with Kaiser Permanente, the James Beard Foundation, et al., Chef Mulvaney has created a pilot program to break the stigma of mental health in the industry, according to the article. First launched in Mulvaney’s restaurant, “I Got Your Back” is a peer-to-peer or near-peer counseling program that trains select employees to be able to spot the signs of mental distress in a co-worker and check-in to see if they require support.

Suicide happens in bursts or waves; it’s not individual incidents. You need to be cognizant of something called ‘contagion’ and how it manifests after traumatic incidents,” says Mulvaney. He adds that “If we can affect even one person, then we’re good at my restaurant.”


California Addiction and Co-Occurring Mental Health Treatment

We invite any adult who is struggling with alcohol, substance use disorder or co-occurring mental illness to reach out to Hemet Valley Recovery Center & Sage Retreat. Our highly credentialed hospital-based, recovery center is in-network with most insurance providers. Please call for a confidential assessment today to take the first step toward living in recovery. 866-273-0868.

Wednesday, March 6, 2019

First Responders: Trauma, Mental Health, and Suicide

People living in California have seen the rapid rise of wildfires. Millions of acres have burned in the last decade and a half, and more than 150 Californians have lost their lives in such fires — including firefighters. In 2018 alone, 1,035,939 acres burned; in the “Camp” fire, 86 people perished.

Devastating forest fires are not a rare phenomenon in the Golden State. Drought and hotter summers lead to larger, more severe fires. Each time nature or human error results in a natural disaster, millions of people are affected, and a group of some the bravest Americans put their safety on the line to snuff out the flames. It takes a special kind of individual to volunteer to run into an inferno, but such individuals are not immune to the trauma that can accompany such heroic actions.

According to data from the Firefighter Behavioral Health Alliance, at least 115 firefighters and emergency medical service workers committed suicide in 2017. The suicide rate among first responders is estimated at 18 per 100,000 people, compared to 13 per 100,000 with the general population, according to a report by the Ruderman Family Foundation and federal data. More firefighters took their own lives than died in the line of duty between 2014 to 2017.

First Responders Experience Trauma Regularly

Research indicates that the prevalence of post-traumatic stress disorder (PTSD), binge drinking, and depression is higher among firefighters than the general population, The Los Angeles Times reports. Repeated exposure to traumatic events – whether it be in fires or fatal car wrecks – takes a severe toll on a person’s psyche. Moreover, society expects first responders to be brave and heroic every day; this has the unintended effect of causing the affected to keep quiet about their mental health problems.

“When people call 911, they want someone there who’s going to be brave and heroic and handle the situation,” said Jeff Dill, a retired fire captain in Illinois who is a licensed counselor and founder of the Firefighter Behavioral Health Alliance. Dill adds that when job-related stress crops up “we bury it.” 

When mental illnesses – anxiety, addiction, depression, or PTSD – are ignored, those suffering are at extreme risk of decline and self-harm. First responders require support. They need to be able to discuss and process their experiences without fear of judgment.

"You can certainly imagine where difficulties within the job, perhaps not having effective coping strategies …would lead to post-traumatic stress or depression, which might result in alcohol use, which could lead to the end of a relationship or loss of a job," said Marc Kruse, clinical psychologist with the Austin Fire Department and Austin-Travis County Emergency Medical Services in Texas.

Will Mitchell, whose firefighter son Ryan committed suicide in 2017, and Jason McMillan, who fought fires alongside Ryan Mitchell, took part in a trauma retreat to deal with his anxiety and depression recently, according to the article. Now the two men are working to make firefighters more aware of behavioral health problems, the article reports. Equally important, they are fighting to end the shame that first responders associate with seeking help. Throughout the U.S., fire chiefs, labor leaders, and counselors are stepping up their efforts to help firefighters before their despair leads to self-harm.

HVRC “Heroes Program”

At Hemet Valley Recovery & Sage Retreat, we offer a program for first responders struggling with alcohol or substance use disorder and co-occurring mental illness. Please contact us today to receive a complimentary assessment, call us at 866-273-0868. Treatment is available, recovery is possible, and we can help you take the first step toward healing.

Friday, March 1, 2019

Co-occurring Disorders: Substance Use and Eating Disorders

co-occurring disorders
More than half of individuals living with an alcohol or substance use disorder meet the criteria for a dual diagnosis. When mental illnesses like depression, post-traumatic stress disorder, or eating disorders affect people living with addiction, such instances are referred to as co-occurring disorders.

When seeking addiction treatment, it is vital that men and women choose a center that can address both substance use and co-occurring mental illness. An inability to screen, diagnose, or treat the whole patient will result in poor recovery outcomes for dual diagnosis cases. Treating the entire patient is of critical importance when it comes to facilitating long-term recovery.

If a person begins a program of recovery and does not have a means of coping with the symptoms of their dual diagnosis, it puts her or him at high risk of relapse. At HVRC, our team of highly trained professionals is careful to address each patient's mental health concerns throughout treatment. We rely on several therapeutic activities to help men and women manage their symptoms of mental illnesses, so they can heal and prosper in recovery.

Many individuals who seek substance use disorder treatment are unaware that they are battling with another form of mental disease. Following detox, a clearer picture of the patient emerges; this allows experts to diagnose and determine a course of action for managing any co-occurring psychological disorders affecting the client.

National Eating Disorders Awareness Week

This week, the National Eating Disorders Association bring disordered eating into the spotlight. The organization's goal is to encourage society to fight back against diet culture, promote body acceptance, and encourage people struggling with eating disorders to seek help. They make clear that conditions like Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), and Avoidant-Restrictive Food Intake Disorder (ARFID) are not choices, but serious biologically influenced illnesses.

National Eating Disorders Awareness Week is also about sharing facts with affected people and the general public. The association's goal is to inspire hope in those suffering and let them know that a full recovery is possible. Since psychological disorders often accompany each other, it makes sense that many people battling an eating disorder may also contend with substance use disorder. Moreover, men and women living with eating disorders abuse drugs and alcohol regularly. It is also not uncommon for a person to work a program of eating disorder recovery and then develop an alcohol or substance use problem. The National Eating Disorders Association shares that:  

Up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population. Up to 35% of individuals who abused or were dependent on alcohol or other drugs have also had eating disorders, a rate 11 times greater than the general population. 

Please take a moment to learn more about eating disorders and co-occurring substance use:

If you are having trouble watching, please click here.

Substances that men and women with eating disorders abuse most frequently include:
  • Alcohol
  • Amphetamines
  • Cocaine
  • Heroin
During NEDAwareness week, we can all help in getting the word out that both substance use and eating disorders are treatable and recovery is possible. Please click here to join the conversation.


California Chemical Dependency Treatment Program

At Hemet Valley Recovery Center & Sage Retreat, we can help you or a loved one make lasting changes. We provide individualized care that prioritizes the psychological, social, spiritual, and physical aspects of the whole person. For more information regarding our program, please contact us today.