Category Archives: Addiction

New Opioid and Fentanyl Strips Have Advocates and Critics

Dsuvia

There’s a new opioid in town called Dsuvia. It’s been all over the news lately, and it’s controversial.  An NBC News headline proclaimed “FDA approves powerful new opioid in ‘terrible’ decision.” The FDA was also accused of bypassing its own advisory process to approve the drug.

This drug, which is 1,000 time stronger than morphine, is usually given in IV form. This new formulation is a tablet taken sublingually and is to be used only in health care settings such as hospitals. According to the NBC article, it’s commonly used on the battlefield and similar emergencies “to treat intense, acute pain.”. It was actually the military that requested the pill formulation.

In the middle of the opioid crisis, the obvious question experts are asking is do we really need another opioid? Two criticisms are that there may be more deaths from overdosing with this drug, and health workers in confined health settings may find it easy to steal it. The FDA, however, says it has learned from the opioid crisis and has tightly restricted Dsuvia. It will not be available at pharmacies or for home use, the package is for single-use only, and it should only be used for 72 hours tops.

Side effects, not surprisingly can be horrendous: fatigue, possible breathing problems, and even coma and death. The cost will be $50 to $60 per pill.

Fentanyl

Test strips for Fentanyl

At the same time as a new opioid has been approved, there’s a new “tool” in the fight against opioid overdoses, according to several media outlets — a strip of paper that can test for fentanyl in batches of heroin. In October, The Atlantic reported a recent study found that drug users who employ them as a precaution before ingesting opioids or cocaine can possibly avoid overdosing.

Fentanyl is 50 times stronger than heroin and has been found in at least half of overdoses now. (As indicated, cocaine is often laced with fentanyl as well.) Researchers posit that if more people with substance use disorder had access to the strips, “they’d use less, or possibly not use … at all.” A YouTube video made by the Associated Press shows that when the strip is dipped into a drug, the appearance of two red stripes signifies fentanyl is present, and one stripe means it is not.

As we know, some states, and even cities, are more progressive than others. “… Baltimore; Philadelphia; Columbus, Ohio; and Burlington, Vermont—have started providing the test strips alongside clean needles. The California public-health department pays for the distribution of strips through needle exchanges.” Leave it to California to lead the way. 

However, some health agencies have questioned  the accuracy of the strips and whether or not a person would actually not take drugs they have right in front of them. Also, some experts want to see more research done.

There’s an obstacle as well: Some areas have “paraphernalia laws” that prohibit the use of devices to aid in doing drugs, except clean syringes, so these laws need to be amended to exempt test strips as well. 

The cost may also deter some users. Each strip costs $1.00, and users take drugs on average four times a day, so it’s not a cheap aid for people who don’t have money.

 

Diversion Programs Instead of Jail

The justice system has become a lot more just lately when it comes to people suffering from substance use disorders by offering diversion programs that allow people who abuse drugs and commit crimes to avoid jail time by attending treatment and engaging in long-term monitoring. Certain professionals such as police, doctors, and lawyers have their own way of offering support to those willing to accept help.


Pilots in the throes of addiction are another group that has benefitted immensely from caring colleagues.
Larry Smith, a former commercial pilot for Braniff and United Airlines who was addicted to several substances received incredible support from United Airlines, the FAA Medical Division, and the program for pilots called HIMS (more about that later). Today he is CEO of Get Real Recovery in San Juan Capistrano, CA, an FAA-approved treatment center he co-founded with his wife Lori in 2011.

In 2008, the Office of Aerospace Medicine of the FAA produced a report titled Drug Usage in Pilots Involved in Aviation Accidents Compared With Drug Usage in the General Population: From 1990 to 2005. It mentions a long list of drugs that pilots were using during that time, but what’s also scary is knowing that the report deals only with pilots involved in accidents. You wonder how many other pilots flew under the influence that weren’t involved in accidents.

Larry’s story is mesmerizing. In 1983 he received a DUI, although he was a furloughed pilot at the time. He received a second one that was reduced to a charge of reckless operation without alcohol. Larry now openly admits it should have been a DUI. He thought it was clever how he was able to duck under the radar for so long. Most alcoholics and addicts suffer from extreme denial, he says, and he was no different. Larry teaches that denial is the brain’s defense mechanism to protect the perceived right to use, not a character defect.  Addicted people will use every type of denial possible to avoid being detected. They hide their pain and self-disgust with charm or anger, whatever is necessary. Larry sees himself in others at every intervention, counseling session, and group that he facilitates.

Diversion Programs Instead of Jail

 Larry’s addiction to alcohol started in 1965 at 14 years old. He started using cocaine occasionally in the 1980’s, and by 1998 he advanced to smoking crack. “I recognized I had a serious problem then, but I didn’t know what to do,” he recalls. He was afraid to turn himself in to the EAP or HIMS programs as he mistakenly thought he would be immediately fired if the truth about his chemical dependencies was exposed. 

 On February 3rd, 1999, a vice squad of 12 masked men with shotguns and riot batons used a battering ram to invade his home in Ohio. His arrest quickly made the national news. Smith was released from jail on February 5th and received a call from his chief pilot. He thought he was going to be fired, but instead, his boss offered him treatment. His first treatment center was too lenient with clients, so United’s EAP transferred him to Cornerstone of Southern California.  He admits now, “I wasn’t a model patient; nevertheless, I fell in love with recovery!”

Nine months later Smith flew a 747 from SFO to Kona with 400 passengers on board. He gives all the credit to God and a forward-thinking airline. The FAA, United’s EAP and Management, an Aviation Medical Examiner, a psychiatrist and the Pilot’s Union (ALPA) all closely monitored Captain Smith’s progress for 5 ½ years. During this time, Larry became a licensed counselor and started speaking on addiction and the hi-jacked brain. Immediately after being released from FAA Monitoring, he spent eight years as a volunteer Union Rep to United Airlines EAP. Then and now, he guides and counsel pilots who abuse alcohol and drugs.

 As the HIMS website explains: “The HIMS program was established to provide a system whereby afflicted individuals are treated and successfully returned to the cockpit under the FAA Special Issuance Regulations (14 CFR 67.401).”

It’s rigorous:

“The purpose of the HIMS program is to effectively treat the disease of chemical dependency in pilot populations in order to save lives and careers while enhancing flight safety. The HIMS concept is based on a cooperative and mutually supportive relationship between pilots, their management, and the FAA. Trained managers and peer pilots interact to identify and, in many cases, conduct an intervention to direct the troubled individual to a substance abuse professional for a diagnostic evaluation. If deemed medically necessary, treatment is then initiated. Following successful treatment and comprehensive continuing care, the pilot is eligible to seek FAA medical re-certification.

The FAA requires the pilot to be further evaluated by a specially trained FAA Aviation Medical Examiner (AME) who then acts as the Independent Medical Sponsor (IMS) to coordinate the FAA re-certification process. The medical sponsor provides oversight of the pilot’s continuing care. This care includes a monthly interview by a trained flight manager and by a pilot peer committee member, as well as periodic follow-up observations. Because of the relapse potential of chemical dependency, the monitoring will typically continue for several years after the pilot resumes his duties. The HIMS program is designed to ensure the pilot maintains total abstinence and to protect flight safety.”

Larry explains some of the challenges pilots face this way: “Pilots are great at following directions, like the checklist we give them in recovery, but they’re not so great at processing what’s within. We find that some had trauma in their early life. For example, some were at war, and some grew up with rigid fathers and co-dependent mothers and so forth, and counseling helps them see what may have caused them to drink and help them get out of their own minds.”

In 2010 he wrote The Daily Life Plan Journal, a goal-setting journaling guide for people in recovery to be able to simply draw lines on airplane-like gauges to assess their feelings and emotions. For example, instead of asking them to mark their flight level, they’re asked, What is your motivation level “right at this moment?” It’s an effective way to journal for people who don’t like to write or have difficulty expressing themselves in writing. This journal allows a person to simply put pen to paper and measure their feelings by drawing a line. 

In addition, he wrote a book about overcoming addiction called Flight to Transformation. The book is part memoir and part a strongly spiritual walk through recovery. He’s also expanding his treatment knowledge to include MAT–Medically Assisted Treatment, and the use of Stem Cells in recovery.

Taking Drugs on the Job

With all the evidence available, there’s no denying some employees have used drugs while working, whether they shot up in a restroom, or popped a few pills at their desk, for example. An article in The New York Times holds that  ”As the opioid epidemic continues to rage…, the fallout is increasingly manifesting itself at construction sites, factories, warehouses, offices, and other workplaces.”

An earlier post on addiction in Silicon Valley mentioned that substance abuse in the workplace took place in offices there as well. But this article focuses on a construction worker, an employee in an industry that has been found in the past to have one of the highest rates of addiction of any field. Today it has “the second-highest rate of pain medication and opioid misuse after the entertainment, recreation and food business,”  according to the article, and construction workers also have “twice the addiction rate of all working adults.”

According to an 11-year old survey by the National Safety Council, at the time, 70 percent of employers said that prescription drug abuse had affected their businesses, relating to absenteeism, injuries, accidents, and, of course, overdoses even then. Understandably, there were positive drug tests as well.

Taking Drugs on the Job

The construction worker in the article has overdosed on the job several times, and was revived with Narcan by a coworker at least twice. He never went to rehab, until he was fired and returned to his hometown. He joined the local construction union, which was a lifesaver. He had an outstanding arrest warrant which proved troublesome in getting him into a program, but union officials talked a judge into letting him serve his time in rehab. So far, he has been clean and is working, thanks to his union.

The current statistics are not good: in 2016, 217 workers died from overdosing on alcohol or other drugs at work, which was a 32 percent increase from 2015. Overdose deaths in workplaces have increased every year since 2010. That includes someone at Fiat Chrysler Automobiles, a crawfish fisherman in Louisiana, and a Sam’s Club warehouse worker in Texas. The guy down the street in your neighborhood, the man sitting next to you on the bus, or the father of a boy on your son’s little league team.

The article reports that few businesses are willing to acknowledge the drug use at their company. Yet certain enterprising business people do and are willing to help, like Alan Hart, president of Giovanna Painting in Spencerport, NY.  Maybe it has something to do with the fact that he’s in recovery himself. He tries to help workers enter rehab, although he doesn’t offer employees health insurance. He also fires workers he suspects of abusing drugs while working.

It would be naïve to think drug use doesn’t go on in the workplace, and just like addiction can hit anyone, so drug use can appear in any business.  Perhaps you heard of the teacher who OD’d in a school bathroom and died, although his wife had no idea he was on drugs. The news traveled as far as the United Kingdom.

In the corporate world, perhaps disseminating more information about Employee Assistance Programs would help. (For that matter, a comparison of programs would be a good thing, along with what laws mandate as far as offering employees treatment.) In addition, perhaps there should be guidelines for what employees can do if they suspect a co-worker of taking drugs, not as a punitive measure, but to try and address the problem. And of course, Narcan could be made available in workplaces. At least companies could discuss these approaches and others.

 

ERs Are Stepping Up to Help With Addiction

Addiction Treatment Centers

 

Leave it to California to take the lead when it comes to a group of hospitals trying a new way of helping those addicted to opioids—having ERs administer buprenorphine (aka Suboxone) when someone enters in the throes of withdrawal. (Lest anyone forget, buprenorphine is weaker than other opioids. It activates “the same receptors as other opioids, but doesn’t cause a high if taken as prescribed,” says the article in The New York Times.) A 2015 study by researchers at Yale-New Haven Hospital found that when ERs have done this, the people who get the buprenorphine are more likely (twice as likely, in fact) to be in treatment after a month than people who were only given an informational packet that included phone numbers related to treatment. As a result of the study, an ER specialist who heads the buprenorphine program at Highland Hospital in Oakland convinced the California Health Care Foundation to give his hospital a grant to try the novel method.

 

ER Departments

Out of the box idea? Sure. But it seems to be working. Now ER doctors are calling the lead author of the study every week, she said in August, and ER departments in Camden, NJ, Brunswick, Maine, Philadelphia, New York, Syracuse, and Boston are also offering buprenorphine.The doctors need training to prescribe the medication, as well as a license from the DEA to prescribe it unless someone is in withdrawal, so ER doctors are in a good position to treat those patients. “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” the lead author of the study said. “They’re beyond thinking they can just be a revolving door.”

 

Detox Centers in Northern California

 

Treatment in the ER

It’s a rare opportunity to meet people where they need help and get them started on medication for their addiction, the article notes. In some places of the country, it’s not easy to find a doctor who takes insurance AND prescribes buprenorphine. After their ER visit, ideally a person will follow a “wheel and spoke” approach, where they first go to a treatment clinic (the hub), adjust to the medication, and then see a doctor in a primary practice (the spoke). Treatment in the ER involves buprenorphine under the tongue, and usually, a prescription for Suboxone, in the form of strips that will dissolve in the mouth and thus are harder to abuse. Then the person is directed to meet with the head of the addiction program in his clinic, where he’s available one day a week.

 

Detox Centers

 

Even signs posted in the waiting area of Highland ER reaching out to those suffering from opioid use disorder are helping. A woman there for a respiratory infection saw one and told her brother about the signs, and he decided to enter the program. Recently released from prison, he was hoping to stay clean, especially because he had a job offer. Now he had “a stable source of treatment.” California was willing to provide the grants to have this program flourish. Two-thirds of Highland Hospital’s 375 patients in withdrawal accepted the medication and had an initial appointment at its addiction clinic. Not only that, but California has started to require detox centers and residential centers to allow residents to take either buprenorphine or methadone, medication-assisted treatment, which has had a history of controversy. That’s also ground-breaking.

 

For more information or to contact our Detox Centers in the Bay Area call (866) 596-9391.

 

Helping Addicted Inmates

The number of people suffering from substance use disorder who likely think they won’t end up in jail is probably large—especially if they have good jobs. They never think it will happen to them. But it can. As a recent episode of the TV program Dopesick Nation showed, even formerly responsible citizens may find themselves stealing, forging prescriptions, and so forth to support their habit.

 You may have heard we’re not doing nearly enough for substance abusers who end up in jail. But there are a few programs around the country that seek to help these people, often in small towns, that can serve as examples for other towns. Here are a few.

Peer recovery coaches in NJ

 In one NJ town, certified peer recovery specialists are volunteering to work with those suffering from substance use disorder who are incarcerated. In a new program called Next Step, the volunteers are called coaches, and they help to steer prisoners into treatment.

Bail reform in certain areas of the country means that nonviolent offenders are being released earlier, and for addicts, that usually means without treatment or the offer of treatment. (And many [most?] likely got little help in jail.) Although it’s too soon to comment on the program’s success, shortly after the program was instituted at the jail, nearly half of those screened entered treatment.

One of the county prosecutors noted that when people are sent to jail, it’s often their lowest point, a good time to try and convince them that treatment may save their life. Several local organizations have stepped up to provide clinical assistance, including a social services organization helping inmates find jobs, a recovery center, a peer recovery organization and a hospital.

 Having a peer in recovery work with an incarcerated person is another tool in the toolbox to help someone get healthy and return to society.

Helping Addicted Inmates

The Start Strong 3 E’s in Kentucky

There’s a new treatment program in the detention center in Kenton County, KY, in which inmates are expected to be “Employed, Enlisted, or furthering their Education,” 12 weeks after release, according to the program director. The key in this area, which has suffered greatly in the opioid addiction crisis? The jail is partnering with Aetna Better Health and getting help from the Hazelden Betty Ford Foundation.

 The concept involves giving medication not only to quell cravings or ease withdrawal symptoms, but to stabilize patients getting therapeutic care in jail. They will then have the option to stay with medication assistance during and after their incarceration, according to a local TV station. And, luckily for these inmates, there’s an aftercare program with intensive job training.

Vivitrol and Counseling in Central New York State

In Onondaga County, NY, addicted inmates are given the opportunity to have injections of Vivitrol and attend counseling sessions. According to the Vivitrol website, the medication “is a non-addictive, once-monthly treatment proven to prevent relapse in opioid dependent patients when used with counseling following detoxification.”

Chicago’s Thrive program

Inmates suffering from substance abuse in a Cook County jail who are not in the drug court program are being offered naloxone on release and will be monitored “in a modified version of the sheriff’s electronic monitoring program.” (For example, caseworkers who worked with one woman on the inside will continue to work with her once she’s released.)

Other programs, in Indiana, Orange County, Florida, and Cincinnati, Ohio and Kings County, California, to name a few, show that a number of jails realize they can contribute to finding solutions to substance abuse in this country. Whether it’s to offer Suboxone, Naltrexone, Vivitrol, peer coaches, and counseling and job training, or a combination, these programs can serve as a blueprint for other jails.

 

72,000 Deaths

Can the news from the Centers for Disease Control about 2017 drug overdoses BE any bleaker? The years 2016-2017 saw a record number of people dying from overdoses, which was more deaths than from guns, car crashes, or H.I.V.

Someone has done an analysis. Drugs are deadlier now (often due to mixing them with other substances besides the main drug), and more people are using. The good news is that where the deadlier drugs arrived earliest, such as in New England, some states are seeing the number of overdoses drop. Could that be from diligent public health campaigns and offering more addiction treatment, which they were hitting the problem with? 

However, the writer reminds readers that you can’t totally trust the numbers. With an epidemic like the Zika virus, an infectious disease, people sought help, and public health officials moved, quickly. But with addiction, there’s that pesky STIGMA (detailed in an earlier post on this site this month), so that drug users may not have been truthful about their drug use when polled. Also, some drug users don’t have telephones or are hard to reach, and some deaths take longer to be researched and reported than others.

Deaths from Drug Addiction

As mentioned earlier, another reason for the astronomical number of deaths is that the drug supply is changing, as noted by an associate professor at the Brown University of Public Health. Fentanyl is being added to heroin, methamphetamine and cocaine, and even anti-anxiety medicines known as benzos, or benzodiazepines. (Stay tuned for a post on older people mixing benzos with opioids.) That’s especially bad news for “older, urban black Americans; those who used heroin before the recent changes to the drug supply might be unprepared for the strength of the new mixtures,” according to the article.

The East seems to be in a better position than the Midwest relative to this one part of the epidemic, because heroin that makes it way to the West is usually “processed into a form known as black tar that is difficult to mix with synthetic drugs.” The East, however, usually has a white powder that combines well with fentanyl.

Let’s hope that Dayton, Ohio, which has been in the news as a “hot spot” for opioid use, is the way of the future for other states. The county has a new emergency response strategy, is utilizing federal and state grants to combat drug use, and has reduced opioid prescribing and provided addiction treatment to prisoners in jails.

drug addiction treatment centers

Drug Addiction Treatment Centers

There are other hopeful signs: Congress may step in with bills that mandate reductions in prescribing opioids, among other things, and along the same lines, experts are reminding people that we need more funding of public health programs.

There’s yet another action that might help which requires no funding and little effort. A behavioral economist at the University of California and the Chief Medical Examiner-Coroner for Los Angeles County wrote an opinion column to suggest that medical examiners and coroners tell doctors when their patients die of overdoses. They wrote that they believe that more careful prescribing would result if doctors were told, and they even set up a trial in San Diego County in 2015 to test their thesis.

They had a letter sent to half the doctors in the study who had prescribed opioids about that doctor’s patient’s death after each one happened. The letter wasn’t threatening “and gave the clinician a path toward safer prescribing.” The results of the study indicated doctors did reduce their prescribing and started fewer patients on opioids.

Every little bit helps, or at least people are trying.

For more information on our drug addiction treatment centers contact our rehab in California, Summit Estate, by calling (866) 569-9391

Some Good News In Fighting the Opioid Epidemic

A New Medication

 On June 6, CBS TV profiled an early stage biotechnology company called Blue Therapeutics that has developed a non-addictive painkiller. Pharmaceutical companies have been talking about developing less addictive painkillers lately, but their definition refers to pills that would be more difficult to crush and so forth. Blue Therapeutics supposedly has the real thing, which means that people looking for pain relief will not become addicted with this medication as has happened so often with other pain relief. This company’s medication clings to different receptors that are non-addictive and so it “eliminates the narcotic high,” according to a company executive who was interviewed. Unfortunately, the medication won’t be available for about five years. It’s in clinical trials now.

 Acupuncture

 People in recovery from heroin and methamphetamine addiction might suffer from anxiety and fear like Sarah Downs, the woman featured in an article appearing in several newspapers in May. She was at the Pickaway Area Recovery Services (PARS) in Ohio, for acupuncture, which she hoped would ease the symptoms she experienced since getting sober for three months prior. Jimmy Laux, a chiropractor associated with the program, eased needles into her ears in a new program for the center. What’s interesting is that a judge is linked to the program as well. He heard about Laux because he sends defendants to a recovery facility, and Laux educated him about acupuncture for easing addicts’ recovery. This judge has pledged almost $13,000 for treatment for people who don’t have the funds to pay for it themselves. Acupuncture isn’t meant to be used in isolation, the article said. NAR-ANON and AA meetings are also important, as well as therapy. But the executive director of PARS said that his research “shows that people in recovery who undergo acupuncture stay clean at a higher rate than those who don’t.”

drug rehab programs

 Brain Stimulation

 It’s surprising that brain stimulation isn’t more well-known than it is when it was publicized as far back as 2015. On a site called Addiction Recovery Guide, run by a psychologist, Magnetic Brain Stimulation and Transcranial Direct Current Stimulation are mentioned as promising research. Magnetic Brain Stimulation stimulates nerve cells in the brain’s prefrontal cortex, which controls impulsive behavior. The article says it’s been used since the 1980 to treat depression, and in a study using it for cocaine addiction, patients were able to reduce their cocaine use and had few cravings after eight sessions. This information was published in the European Neuropsychopharmacology Journal (December 3, 2015). Transcranial Direct Current Stimulation has also been used for depression and anxiety, and was also was found to decrease cravings for drugs, although more study on how many sessions and what length is needed. This information was published in the October 2016 issue of the Annals of Neuroscience.

 Exercise

 The fact that exercise is good for people in recovery is nothing new. Treatment centers often have exercise programs, and clients are advised about the benefits of exercise, But if you thought that was only to return a person to health, you should know that exercise can have actual positive effects on recovery. In June  U.S. News cited a study which found “daily aerobic exercise altered dopamine signaling in the brain in ways that make alcohol and other substances of abuse less appealing or rewarding.” The lead author also said that exercise also increases functioning of the brain’s frontal areas, which help inhibit cravings. For information on drug rehab programs please contact our rehab in California at (866) 569-9391

Drugs and Alcohol in the Workplace, and Companies That Hire People in Recovery

Alcohol Addiction

You may have seen news segments about companies that allow—even encourage— employees to drink at work. According to a 2012 article on ABCnews.go.com, ad agencies do, or at least they did at that time. One firm’s employee said that it “incentivizes and enthuses” employees, and another said it helps the creative process. Tech companies were mentioned as allowing drinking, too, especially after a “win.” The article even quoted a study that found a little alcohol enhances the creative process.To allow drinking at work brings up a host of issues. Take employees in recovery, for example. These people are often counseled on how to handle the question “Why don’t you drink?” or the taunt, “C’mon, have just one with us” in social situations, but they shouldn’t be placed in this situation at work. Also, what if someone gets in an accident on the way home? Isn’t the company wholly or partially at fault, like a bar is? (The situation is different for people in dangerous jobs; there are strict workplace rules about drinking on the job.)

In most jobs, it’s not easy trying to perform when suffering from alcohol use disorder (although people who are on the road a lot, or executives who aren’t accountable can get away with it easier, it seems). When employees are found to have a problem, however, it’s often strongly suggested that they attend rehab with the help of an Employee Assistance Program. Drinking while at work is such a touchy subject that the government includes the rules in their handbook for supervisors: Alcoholism in the Workplace: A Handbook for Supervisors. Here is a succinct explanation of guidelines and laws around drinking at work: 

“Federal legal protections for alcoholics in the workplace are designed to encourage them to seek help without jeopardizing their employment. However, those protections do not extend to alcoholic behavior in the workplace.

Two federal laws impact employment decisions related to alcohol use, abuse and alcoholism. The first, the Americans With Disabilities Act, requires employers to grant accommodation to disabled employees; it defines disabilities as conditions or disorders that substantially limit a major life activity. If your employee can prove that alcoholism prevents him or her from performing the job properly, you may be required to grant an accommodation for the purpose of rehabilitation. The second law, the Family and Medical Leave Act, prohibits employers from discharging employees who take extended absences to treat their alcoholism.

Accommodating alcoholic employees means giving them time to seek treatment for their condition. It does not mean reducing an alcoholic’s workload or otherwise changing their terms and conditions of employment. It also does not mean forgiving misconduct induced by alcohol or alcoholism. If, after receiving rehabilitation treatment, the employee continues to underperform, the law’s protections no longer apply. Likewise, the recidivist alcoholic is not entitled to FMLA-protected leave for subsequent breaches. The employer may reasonably expect that after a leave of absence for rehabilitation, more will not be required. In addition, no accommodation is required for the employee who denies having a problem.”

Drug and alcohol rehab programs

Drug Addiction

According to a headline in the Washington Post, “Drugs in the workplace are at their highest level in a decade.” Quest Diagnostics reports that opioids in the bloodstream and urine are down, but the incidence of other drugs is up. (And that’s only related to people who went for testing!) Cocaine and methamphetamine use is up in certain states, as well as marijuana in those states that have legalized marijuana for recreational use. Unfortunately, in three states, pot use is up in safety-sensitive jobs, which include truck driving, rail, and those in nuclear power plants, to name three industries. Federal contractors and recipients of federal grants, and “safety- and security sensitive industries” are legally required to have a drug-free workplace policy as under The Drug-free Workplace Act of 1988, but other industries are not. To protect workers’ rights, four acts lay out the limits on steps an employer can take in investigating and setting consequences for employee drug use. SAMHSA (the Substance Abuse and Mental Health Services Administration) advises companies to seek legal representation when deciding their policy on drug testing to avoid being sued for invasion of privacy, for example.

Check Out These Companies 

Here are four companies that hire people in recovery (which often means they’ve served time, too): Venturetech Drilling Technologies in West Knoxville, Texas, Envirosafe Stripping Inc. in Carnegie, PA., Creative Matters in Los Angeles, and Dave’s Killer Bread in Milwaukie, Ore. There are also federal and state programs that help formerly incarcerated people get jobs. For example, the U.S. Forest Service has a program that links non-profit organizations that employ these people with companies that need reclaimed lumber. For more information on our Drug and Alcohol rehab programs please contact us at (866) 569-9391. 

 

Men, Alcohol and Abuse

Often, in articles and posts about men and alcohol, you see numbers, such as how many drinks per day are “safe” for a man (which varies according to what source you use.) The amount for a woman is usually listed as well. Or, you might find information on the effect of alcohol on a man’s fertility, for example. But this post is comes after the start of the #MeToo movement, so it’s about the violence that occurs when certain men drink, especially those in positions of power. It’s a topic that has been in the news lately. It’s also relevant in a blog on addiction since high-level executives are occasionally in the news for alcohol use disorder.

Note: It’s well-established that women, as well, can be violent when they drink. This is not to excuse them or say that only men are violent when they drink. And couples can become violent with each other when they drink to excess. But again, this post is informed by the #MeToo movement.

Powerful Men Drinking

One noted journalist who recently wrote an article called “First the Drinks, Then the Hitting,” in the hard copy of The New York Times (online copy may have a different headline), began by mentioning “educated, affluent” women and “a certain cultural panic” that exists around the amount of their drinking (and is often written or talked about in the media). “There is no corollary for men from a similar demographic position,” she says. Indeed, Eric Schneiderman’s “fall from grace” – he was the New York attorney general before he resigned– brought to the forefront the problem of affluent and powerful men drinking and becoming physically abusive toward several women. One of his accusers noted that he was a heavy drinker—having two bottles of wine and then taking a bottle of Scotch into the bedroom and getting “plastered,” which happened five nights a week according to her. (Why the girlfriends stayed with him is head-scratching, but that’s a subject for another time.)

Drug and Alcohol Rehab Programs

Alcohol Intervention

There’s an unspoken supposition in magazines and other media today, according to the article. Women are depicted as worried about going too far when they drink, as a result of the pressures of work and parenthood, while men’s magazines “still pay reverence to the cocktail culture [for men].” The underlying assumption is that men who have succeeded know something about self-regulation, but apparently many don’t. Schneiderman is not the only powerful man to be accused of physically abusing girlfriends or wives; there’s also former White House aide Rob Porter and Silicon Valley entrepreneur Abhishek Gattani, but the others weren’t described as being inebriated when the abuse allegedly happened.

Drug and Alcohol Rehab Programs

Schneiderman has tried to say that he was engaged in consensual relationships involving role playing or rough sex. But in an article on bondage, dominance, sadism and masochism, practitioners say that his sexual encounters and those of former Governor Eric Greitens of Missouri “bear little resemblance to consensual B.D.S.M. encounters.” Not only that, B.D.S.M practitioners warn against “partaking in violent sexual activity while drinking alcohol or taking drugs.” You can cause serious damage if you don’t have your faculties about you. The World Health Organization calls this type of abuse Intimate Partner Violence and says that alcohol consumption, especially at harmful and hazardous levels, is a major contributor. The National Institute on Alcohol Abuse and Alcoholism says, “Individuals with alcohol problems attack more frequently, are more likely to inflict serious injury, are more likely to commit sexual assaults, and are more likely to be violent outside of the home than are batterers without a substance abuse history.” More people need to get the message and know that they’ll be prosecuted when victims comes forward. For more information on our drug and alcohol rehab programs please call (866) 569-9391.

Marijuana and Opioids—What’s the Link?

The Marijuana and Opioids Relationship

What’s the relationship between pot and opioids? According to a May article in the Poughkeepsie Journal in New York, part of the USA Today Network, smoking marijuana has the ability to decrease the use of opioids. Specifically, some states that allow the use of medical marijuana and recreational pot have seen declines in opioid prescribing. Medicaid patients are getting fewer prescriptions filled, and in the states where recreational pot is legal, the declines are even greater. The implication, of course, is that if you smoke pot, you don’t need pain relief at the level that opioids provide and don’t seek it.  

The author of the report by the Rockefeller Institute of Government that cited these numbers called marijuana “a potential tool for addressing the opioid crisis.” Additional studies in this area, such as an upcoming one by the National Institute of Health, are on the horizon.

 

Marijuana and Chronic Pain

This latest one will test “whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV.”

There have also been negative reports about using marijuana for medical reasons, however, such as one in the American Journal of Psychiatry indicating that pot use “increases the risk of an opioid-use disorder.”

The Poughkeepsie Journal article raised also asked about the general harm, or potential risks, in smoking marijuana, and then attempted to answer it. For example, the National Academy of Sciences published a report in 2017 which found that for people who smoke while driving, the odds of being in a motor vehicle accident rose by 20 to 30 percent. (But you already knew about this; you read something similar in this blog about driving and smoking in a May post.)

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Marijuana and Mental Health

Heavy marijuana use also increases the risk of being diagnosed with a psychosis, and there’s a small risk of developing bipolar disorder. However, the author notes that it’s “hard to establish causality.” He asks, “Are people who smoke pot more likely to develop mental health problems or are people with mental health problems more likely to smoke pot?”

The author summed up by saying that the findings are of questionable significance because almost all risks cited are relative, and overall, the risks are quite low. We need more research, he said, and we may then find more harms. For now, he’s in the camp that points out (believes?) pot’s effects are less harmful than those associated with tobacco or alcohol.

With the legalization of medical marijuana, doctors have another option in providing pain relief besides opioids OR medical marijuana: prescribing a combination of the two. A 2015 article in Forbes reported that “using medical marijuana along with prescribed opioids does not increase the likelihood of a patient abusing alcohol or other drugs.” However, “subjects did report higher rates of alcohol and other drug use than the general population.”

 

Outpatient Addiction Treatment Center

Not many addiction counselors seem to speak publicly about their personal feelings about marijuana for treating pain and other conditions, or about recreational marijuana, for that matter. Yet I’ve heard of one counselor who told the parents of a young man addicted to heroin that he didn’t have a problem with the man smoking pot if it helped him stay off heroin. You wonder if this view is widely held among addiction professionals when a number of them say that pot is still a drug, and it’s possible to become addicted to it. For example, a noted golfer once went to rehab because he couldn’t stop smoking. Wouldn’t it be interesting to see results of a poll that questioned addiction professionals about their personal feelings? For more information contact our outpatient addiction treatment center at (866) 569-9391