Friday, July 31, 2020

Treating Co-Occurring PTSD with CBT

Co-Occurring PTSD
Cognitive behavioral therapy or CBT is an evidence-based modality for addressing unhealthy attitudes, behaviors, beliefs, and thoughts. The treatment is often used in addiction and mental health treatment centers. CBT has shown to be beneficial for treating an array of substance use disorder and co-occurring mental illnesses, including anxiety, depression, and post-traumatic stress disorder (PTSD).

Counselors and therapists trained to conduct the psycho-social form of intervention can help people find recovery. If you have undergone treatment for a mental or behavioral health disorder, there is an excellent chance that you received CBT. Hopefully, you were able to address and change unhelpful beliefs and are better able to cope with problems that arise in recovery today.

Overcoming obstacles in life can be extremely challenging for those with a history of substance use or co-occurring mental illness. It can be even more of a struggle to change core beliefs that one may have developed at a young age. In recovery, people discover that altering one’s outlook is often a prerequisite for making progress.

Learning to let go of certain mindsets that influence or lead to self-defeating and self-destructive behaviors is part of the therapy. CBT also helps people change how they see themselves in the world. It gives individuals the tools to adopt a position of selflessness, which allows them to form healthy and nurturing relationships with others.

Confronting Challenging Memories in CBT

It’s vital for patients to receive simultaneous treatment for addiction and co-occurring mental illness. Achieving long-term recovery depends on addressing all presenting conditions. If one condition is neglected, relapse is likely.

Interestingly, there’s been a debate for some time about using cognitive behavioral therapy to treat co-occurring PTSD. Since CBT strategies and techniques ask patients to confront challenging memories, some providers and patients argue it will cause alcoholics and addicts with PTSD to relapse. However, there is new research – supported by the National Institute on Drug Abuse (NIDA) – that may put such concerns to bed.

Co-occurring post-traumatic stress is prevalent amongst men and women living with addiction. According to researchers at the Johns Hopkins University School of Medicine, nearly a quarter of individuals with chemical dependency have PTSD. Jessica Peirce, Ph.D., and associate professor of psychiatry and behavioral sciences, and her colleagues took a close look at treating the above demographic with CBT.

The research team found that exposing patients to uncomfortable memories of their trauma didn’t lead to drug relapses after the first behavioral therapy session. Moreover, the authors report that PTSD severity, stress, and emotional problems lessened. By the ninth therapy session, the PTSD severity scores decreased by an average of 54%. The findings appear in the Journal of Traumatic Stress.

“Now that we have evidence that treating PTSD won’t impact recovery, patients can request therapy, and mental health providers have a duty to make it available to their patients,” said Peirce. “There is a lot more resilience within this population than many health care providers give them credit for, and not offering the proper treatment is doing patients a disservice.”

Heroes Program for Co-Occurring PTSD

The above research comes at a fortuitous time, given the scars of the pandemic. Many men and women working on the frontlines, such as first-responders, doctors, and nurses, may develop post-traumatic stress from exposure to COVID-19. Contracting a potential virus or the fears of becoming ill can take a toll on people mentally.

Many people may begin turning to mind-altering substances to quiet their minds, and some could develop an alcohol or substance use disorder. At Hemet Valley Recovery Center & Sage Retreat, we created a program for first-responders struggling with addiction and co-occurring PTSD. Please contact us today to learn more about our Heroes Program.

Wednesday, July 29, 2020

Compassion Fatigue | The Negative Cost of Caring

compassion fatigue

About Compassion Fatigue

Compassion fatigue is a condition characterized by emotional and physical exhaustion leading to a diminished ability to empathize or feel compassion for others, often described as the negative cost of caring. It is sometimes referred to as secondary traumatic stress (STS). According to the Professional Quality of Life Scale, burnout and secondary traumatic stress are two interwoven elements of compassion fatigue.

The Effects of Compassion Fatigue

Over time, healthcare professionals can find themselves struggling with their own responses to the trauma suffered by their patients. If not addressed, this can affect their physical and mental health, relationships, and overall work performance. Symptoms may frequently remain unnoticed, but may range from psychological issues such as dissociation, anger, anxiety, sleep disturbances, nightmares and feelings of powerlessness. Physical experiences may present themselves as nausea, headaches, general constriction, dizziness, and fainting spells. All are warning signs and need to be addressed or they will lead to health issues or burnout.

Hearing and witnessing the patient’s stories of abuse and trauma can weigh heavily on the professional, causing feelings of stress. Experts have found that self-care techniques both psychological and somatic can reduce susceptibility to the internalization of traumatic stress and compassion fatigue.

How to Recover

Reducing compassion fatigue can be as simple as working with the feelings which occur during the interactions with patients. It means checking with yourself, how your body feels or does not feel, giving yourself permission to take care of yourself. Taking a deep breath, moving and stretching, this helps in regulating your nervous system and decreasing the symptoms of stress.

Studies have shown that keeping a positive attitude toward life, having a sense of humor and focusing on all the good things in your life is extremely helpful. Additionally, finding a balance with your work and private life by finding a support system, regular supervision, the use of relaxation techniques and of course take that vacation you planned. Let go of the feeling that you don’t have the time for you!

Stay safe.

Friday, July 24, 2020

The Business and War on Drugs: Supply and Demand

war on drugs
In 1971, at the height of the Vietnam War, President Richard Nixon made a bold proclamation. He declared the opening of a new battlefront more than eight thousand miles from the jungles surrounding My Lai—The United States of America. The conflict would take the lives of significantly more Americans than those lost in Southeast Asia between 1955 and 1975.

The enemy: illicit drugs, the people who use them, and those who sell the mind-altering substances. Nearly 50 years later, the “war on drugs” continues with no evidence of victory in sight, and every indication the problem is exponentially worse than before.

It’s often said that the road to hell is paved with good intentions. Do some drugs have the power to ruin and steal lives? Yes. Are the men and women who manufacture and get rich off the suffering of others beyond reproach? No. Should actions be taken to steer individuals away from harmful substances and dissuade the sale of drugs? Of course. But, at what cost?

There isn’t any way to justify the damage caused by criminalizing the disease of addiction and irrevocably changing millions of people’s lives for the worse. There is no excuse for having the most significant number of incarcerated people in the world despite the fact that United States only makes up a fourth or fifth of the global population.

A Troubling Policy

President after president has run on reigning in the “drug problem” in America platform. Hubris, self-righteousness, and racism led to enacting draconian drug laws. Addiction was long chalked up to a moral failing, and addicts became socially outcast deviants. Considering what we know now about the science of mental and behavioral health disorders, it’s impossible not to look back and gasp at the barbaric treatment of the afflicted.

Our war on drugs created the “prison industrial complex.” One in five incarcerated people is locked up for a drug offense, according to the Prison Policy Initiative. In the 21st Century, you can still be sent to jail for a marijuana law violation (663,367 in 2018) in several states. It’s worth noting that many arrested for petty crimes were trying to get money to feed their addiction.

It’s also common to be charged with possession while committing a more serious crime; the more severe offense goes into the datasets. So, the number of people behind bars because of the war on drugs is much higher than what the data reflects.

What’s more, a disproportionate number of inmates are people of color. Black Americans make up 40 percent of the incarcerated population but represent only 13 percent of U.S residents. You cannot discuss the war on drugs without considering the role race and ethnicity have played.

The first anti-opium laws (1870s) targeted Chinese immigrants, The Guardian reports. Anti-cannabis laws (1910-20s) were meant for Mexican workers. Crack cocaine laws overwhelming impacted blacks in the 1980s and `90s.

One of America’s answers to our substance use problem is to pressure governments in other countries to crack down on drug manufacturers. Much blood has been spilled to that end, and cocaine, meth, and heroin are still coming to meet our demand. The Drug Policy Alliance reports that more than 200,000 people have been killed in Mexico’s drug war since 2006.

The Business of Drugs: Supply and Demand

Millions of Americans battle with a substance use disorder day in and day out. Addiction is an epidemic in the United States, and incarceration is not a cure for the condition.

Most public health experts and many lawmakers know that the war on drugs is a failure. New policies are required, as well as a concerted focus on shattering stigmas and providing evidence-based treatment for all. Lives would be saved if the federal government diverted a fraction of the annual $47+ billion spent fighting the war on drugs toward addiction treatment.

As long as there are drugs, there will be people who use them; some will develop a problem, and others will not. While the nation huddles at home during the pandemic, it might be an excellent opportunity to reflect on what the war on drugs has cost us. A new documentary series aims to get us thinking about the policy of prohibition.

The premise of The Business of Drugs, former CIA agent Amaryllis Fox contends, isn’t about facing the truth that America has lost the “war on drugs.” On the contrary, the series calls for “looking at the policies themselves rather than the fight to enforce them, and asking ourselves if in fact prohibition has any logical hope of working, or whether it’s a residue of a moralistic stance that I think is no longer relevant in our society.”

“The only way for us to tackle this is to have a very logical, adult conversation as a nation about whether there’s any possibility of demand going away,” Fox said. “And if not, what do we need to do in terms of legalization and regulation to bring an end to the violence and mass incarceration that this policy has created?”  

Warning: The trailer depicts drugs. Please refrain from watching if you have concerns about being triggered.

If you are having trouble watching, please click here.


Evidence-Based Addiction Treatment

At Hemet Valley Recovery Center, we help men and women break the addiction cycle and adopt recovery programs. Our highly skilled team of clinicians and substance use disorder experts can give you or a loved one the tools to lead a fulfilling and productive life. During the COVID-19 pandemic, we are adhering to both CDC and state guidelines to ensure our clients are safe.

Please contact us to learn more about our center for recovery.

Saturday, July 18, 2020

Addiction Treatment Island

The history of addiction recovery in America is fascinating and disturbing, from barbaric, draconian “treatments” to sanitariums to the upscale, evidence-based centers of today. While we have come a long way over the centuries, there is still a long way to go in the fight against stigma.

Many men and women working a program of addiction recovery today find themselves with a plethora of downtime. Sheltering in place, stay at home orders, and staggering unemployment has led to the new normal we are facing. Those in the fellowship might use this opportunity to learn more about the history of recovery.

How society went from viewing addiction as a crime to accepting that behavioral health disorders are treatable diseases is a remarkable story. Progress has been hard-fought and is a never-ending quest. Learning about the struggle of those who came before us might help you find the courage to continue your journey during these challenging times.

Not far from where the co-founder of Alcoholics Anonymous, Bill Wilson or Bill W., lost everything on Wall St. in 1929, sits a small island with a storied past. Located at the western end of Long Island Sound in the Bronx Borough of New York City, New York, you will find Hart Island. Largely unknown by NYC residents, Hart Island is perhaps better described as the “Island of the Dead.”

The tiny island has a dark past, and if you were struggling with alcohol in the 1950s, you might have called it home for a stint. What’s more, you might have found yourself residing there between 1967 and 1977 if you had a substance use disorder.

Prison, Psychiatric Hospital, Addiction Treatment, and Potter's Field

It would probably take 20 posts to cover the entire, multi-hatted history of the little member of the Pelham Islands archipelago. Beneath the topsoil rests more than a million souls and growing, according to The Hart Island Project. NYC officials authorized the mass burial of some COVID-19 pandemic victims; such was the case in 1870 during yellow fever and the 1980’s AIDS epidemic.

Hart Island has had many public uses over the centuries, beginning in 1864 with training the 31st Infantry Regiment of the United States Colored Troops, according to the New York Correction History Society. Confederate troops were imprisoned there during the war as well. During the same time, the burials of impoverished New Yorkers and Union soldiers became a practice.

While the incarceration (precursor of Rikers Island) and mass burials (replacement of potter’s fields now known as Washington Square Park and New York Public Library in Manhattan) were the most common uses of Hart Island, it also played a role in the history of mental health and addiction treatment. In 1885, The Pavilion, a psychiatric hospital for women, was built.

The New York Daily News reported that from 1951 to 1954, the homeless and alcoholics were housed on the island. In 1955, some twenty years after Alcoholics Anonymous’ inception, the Department of Correction opened an alcoholism treatment center on Hart Island. A year later, those being treated might have looked out the window and seen Nike Ajax missiles; it was the height of the Cold War after all.


Following the island prison closure in 1966, six heroin addicts who met in detox proposed creating a drug addiction treatment center on Hart Island—The Phoenix House, The New York Times reports. A year later, it opened and operated for a decade, moving back to the mainland. The organization – still in operation today – became an alternative to prison for addicts. The model is even replicated in prisons throughout the U.S. today.

Please take a moment to watch a short video about Hart Island:

If you are having trouble watching, please click here.


Chemical Dependency Recovery Hospital

We hoped you enjoyed a glimpse of the history of addiction treatment in America. We hope it will inspire you to learn more. If you are struggling with drugs, alcohol, or co-occurring mental illness, please contact Hemet Valley Recovery Center to learn more about our programs. HVRC is a Chemical Dependency Recovery Hospital, which allows us to provide our clients access to more than 100 physicians who specialize in a full spectrum of fields.

Thursday, July 16, 2020

Recovery Community Impacted by Pandemic

At Hemet Valley Recovery Center & Sage Retreat, our thoughts and prayers are with the families who have been severely impacted by the pandemic. We understand that millions of Americans are grieving and fearful of contracting the coronavirus. In many states, the public health crisis is worsening, so it is critical to stay safe and healthy.

Reports abound that the addiction and mental health recovery communities are exceedingly vulnerable of late. Fear, isolation, uncertainty, and financial concerns are traumatizing, and trauma can bring about or trigger symptoms of mental illness.

Data collected by the U.S. Census Bureau indicates that a third of Americans are showing signs of clinical anxiety or depression. Amid the pandemic, 50 percent of adults experienced a depressed mood, compared to 25 percent before COVID-19. Dr. Maurizio Fava, psychiatrist-in-chief, within the Department of Psychiatry at Massachusetts General Hospital, says:

"It's quite understandable the COVID-19 pandemic is likely to cause significant stress and psychological distress for a large proportion of the population. And we know the rates are progressively increasing." 

Since upticks in mental illness rates and behavioral health disorders like addiction dovetail typically, it will probably not surprise you to learn that drug and alcohol use is on the rise as well. In May, Dr. Elinore McCance-Katz, assistant secretary at the Department of Health and Human Services (HHS) and head of the Substance Abuse and Mental Health Administration (SAMHSA), warned that the pandemic was the impetus for more substance use and overdoses nationwide.

Nearly two months later, the director of the National Institute on Drug Abuse (NIDA) shares that opioid use, relapse, and overdose deaths are spiking. Dr. Nora Volkow warns that we were still contending with an opioid epidemic before coronavirus and that it could be worse than before.

Isolation is Detrimental to People with Substance Use Disorders

As if the pandemic wasn't hard enough for every American, with some 3.5 million infected and more than 135,000 dead, the psychological toll is proving to be enormous. Dr. Volkow shares that social distancing reduces disease transmission, but it also adversely affects people living with mental illness and addiction, WBUR reports. She reports that doctors are worried about intentional overdoses and other methods of suicide.

"We have to face the reality that ... isolation is particularly hard for people suffering from substance use disorders, also depression or other psychiatric disorders," says Dr. Volkow. "Withdrawal and isolation actually just in general exacerbates the problem." 

In the interview, the NIDA director shares that opioid overdoses may have increased 30 to 40 percent since the pandemic began. She says it's harder to track overdoses because autopsies are not being conducted in some communities due to an overburdened healthcare system. We may never know the exact number of overdose deaths in 2020. Moreover, state lockdowns reduce the opportunities for people to administer the life-saving overdose reversal drug naloxone.

"The fact that we're very isolated now, if someone is taking opioids and they overdose, the probability that someone sees them and can give them naloxone, which is necessary to reverse the overdoses, is much less likely," says Dr. Volkow. 

Ever-rising unemployment rates mean that countless members of the recovery community are jobless. Financial uncertainty is stressful, which can trigger a relapse or lead people down a worse path. Volkow rightly points out that, "If you're trying to achieve recovery, one of the components is that you want to integrate yourself to everyday life, and now it's much harder to get jobs."

Those who've relapsed amid the pandemic must seek assistance immediately before matters worsen. It may feel like you are cut off from support, but help is out there, and treatment centers are still operating. Please do not let guilt stand in the way of getting back on track.

California Addiction Recovery Center

If you are struggling with addiction and require treatment for the first time or experienced a relapse in recent months, please contact Hemet Valley Recovery Center for assistance. Our dedicated team is here for you during these difficult times and can help you get on the path to long-term recovery.