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Evidence continues to indicate that primary care offices could serve as effective sites for identifying alcohol use problems that might require specialty services. One of the latest studies offers the somewhat surprising finding that adults could be screened successfully in the offices of their children’s pediatricians.
Published in the November issue of Pediatrics, the study conducted at three pediatric clinics in New England found that most parents would be completely comfortable with being screened for alcohol problems by their child’s pediatrician, or through a computer or paper-and-pencil survey. Both parents who were not found to have alcohol problems through use of a questionnaire and those who were found to have alcohol problems said they would generally be comfortable with this screening, though the group found to have problems was slightly less supportive of the idea overall.
Lead study author Celeste Wilson, MD, a pediatrician with Children’s Hospital Boston and Harvard Medical School, says some procedural details will likely need to be worked out before this kind of screening becomes routine in pediatricians’ offices. But she also points out that pediatricians already ask parents about a number of family health indicators that could affect their young patients’ well-being, from smoking in the home to domestic violence.
“I see this as a very powerful relationship, that of the parent and the pediatrician,” Wilson says.
What might tend to confound pediatricians is the question of what resources they can tap into at the community level if some of their patients’ parents screen positive for an alcohol problem. This is where the role of specialty addiction treatment providers in a community could surface.
“I do think it would potentially be quite helpful if addiction treatment professionals made outreach to pediatric providers,” Wilson says. “Pediatric providers in offices would actually welcome that. One of the concerns is that pediatricians don’t really know what’s out there.”
The study, funded by the Robert Wood Johnson Foundation, cites an 11% likelihood that a screening conducted at a visit to the pediatrician will indicate a positive result. That is in line with positive screening rates derived in other primary care settings.

Labels: drug abuse, drug rehab, Drug-Addiction-Rehab, drug-testing

The Screening, Brief Intervention, and Referral to Treatment (SBIRT) program can reduce illicit drug use among patients seeking medical care in a wide variety of health care settings such as hospitals, physician offices, and community clinics, a study finds.SBIRT uses a variety of techniques to screen patients seeking medical health for signs of substance abuse. If a patient screens positive for a substance abuse problem immediate steps are taken to help the patient effectively deal with the problem before the patient’s health and well-being deteriorate.
The report in the journal Drug and Alcohol Dependence found that rates of illicit drug use dropped by 67.7 percent six months after patients using illicit drugs had received help through a SBIRT program. In addition, heavy alcohol use dropped by 38.6 percent. Illicit drug users receiving brief treatment or referral to specialty treatment also reported other quality of life improvements:
• 29.3 percent reported feeling generally healthier• 31.2 percent reported experiencing fewer emotional problems• 15.4 percent reported improved employment status• 64.3 percent reported fewer arrests• 45.8 percent who were homeless reported no longer being homeless Currently, most screening and brief intervention programs are directed primarily toward screening and assisting patients to reduce heavy alcohol use -- a use for which SBIRT has been long been shown to be highly effective.

To help expand SBIRT use and determine its efficacy for addressing illicit drug use and alcohol use, the Substance Abuse and Mental Health Administration (SAMHSA) began awarding grants to states and tribal organizations beginning in 2003. The report announced today is based on an analysis of the data provided by six of the grant recipients. SBIRT can be used in a wide variety of healthcare settings including primary care centers, hospital emergency rooms, trauma centers, and other community settings, and provides options for addressing the particular substance abuse problems of patients.
For many patients with less severe problems a health care provider may briefly intervene by discussing the problem with the patient and offering steps to address it. Brief treatments for the problem may also be offered within the healthcare setting or a community setting. In more severe cases, a healthcare provider usually refers the patient to a more specialized setting for assessment, diagnosis, and appropriate treatment.
“Over 20 million Americans with substance abuse problems don’t get the treatment they need – largely because they don’t seek it,” said SAMHSA Acting Administrator Eric Broderick, D.D.S., M.P.H. “These findings show that SBIRT can play an important role in helping people recognize they may have a substance abuse problem and that help is available.”
The article was authored by Dr. Bertha Madras, former deputy director for Demand Reduction at the Office of National Drug Control Policy (ONDCP) and currently at Harvard Medical School; Dr. Wilson Compton of the National Institute on Drug Abuse (NIDA), National Institutes of Health; and Dr. H. Westley Clark, Ms. Deepa Avula, Mr. Tom Stegbauer, and Dr. Jack Stein of SAMHSA. The report was based on data drawn from a network of health care facilities treating a wide variety of patient populations. At least 459,599 patients seeking medical treatment at these facilities were screened for alcohol and illicit drug use during the course of the study, with 104,505 (27 percent) screening positive for heavy alcohol or illicit drug use.
Programs followed up with a random sample of patients screening positive for heavy alcohol or illicit drug use to determine whether their alcohol and illicit drug use levels had changed six months after they had been screened in the SBIRT program.
“We see great promise in this approach to identifying those most in need of intervention and treatment for substance abuse problems,” said NIDA Director Nora D.Volkow, “We are committed to learning more. NIDA has awarded over $4.2 million in new grants this year alone for more SBIRT clinical trials in real-life settings.”
“Promoting services like SBIRT to all parts of the nation is a crucial part of SAMHSA’s mission to reach everyone struggling with substance abuse issues,” said Dr. Clark, director of SAMHSA’s Center for Substance Abuse Treatment.
A copy of the complete report is available at http://dx.doi.org/10.1016/j.drugalcdep.2008.08.003

Labels: drug abuse, drug rehab, Drug-Addiction-Rehab

Morningside Recovery is proud to announce the launch of their new website for Morningside Academic Institute at soberinstitute.org. The Morningside Academic Institute was developed and established in the Fall of 2006 by Brendan Bickley, Director of Education, and Jana Triplett, Director of The College Program.

Sharing the visions of NAATP, the National Association of Addiction Treatment Providers, "to promote, assist and enhance the delivery of ethical, effective, research-based treatment for alcoholism and other drug addictions" Morningside Recovery's Academic Institute was established. Comparisons of addiction treatment programs coupled with academic programs and addiction treatment programs without academic programs found success rates with academic programs surpassed those without.

Morningside Recovery's Brendan Bickley specifically studied the affects of pairing an academic program with a recovery program. Examining the T.E.A.C.H. Program, a voluntary program placing clients in addiction counselor training classes at a local community college, to discern the success of clients enrolled in an academic program opposed to those not enrolled see "An Evaluation of the T.E.A.C.H. Program: Addiction Treatment Coupled with Higher Education" by Paul Alexander and Brendan Bickley for the Department of Criminology, Law & Society, University of California, Irvine.

Morningside Academic Institute provides the unique opportunity to continue academic studies while in recovery.

Before going into treatment I had dropped out of college and didn't know where I was headed with my life. I had no idea what to do. I was using drugs and drinking all the time. I went into treatment and spent ninety days in Morningside's residential program before transferring into the college program. It was just what I needed. I needed the structure and help the program offered because before when I tried to do college on my own I couldn't do it. The therapists and counselors were all great. The Academic Institute helped me get on track with school and even helped me to figure out what I wanted to do with my life. I got a 4.0 my first semester and a 4.0 my second semester and I'm planning on transferring to the University of California, Irvine next year. It truly was a great, life changing experience.

What does an "Academic Program" entail?

The components of our academic program extend beyond just class time. Morningside Recovery's Academic Institute builds life skills and clients work towards new academic and career goals with direction and focus. Counseling and strategic planning are a continuous and ongoing part of our program. Morningside Academic Institute supports students in not only their journey to sobriety, but supports students in their studies, academic plans and future careers.

Academic Counseling: academic assessment, additional testing, transcript review, academic credit transfer, and the creation of a Strategic Academic Action Plan

Life Skills: Debt management, interpersonal relationships, time management, budget planning

What kind of academic programs are available?

Academic programs can be tailored to fit many circumstances. Whether a client is working towards a GED, rebuilding a college transcript after experiencing an academic crisis or gaining entrance to a graduate program an education counselor will meet with the client and design a program specifically for their recovery goals. Careful consideration is taken to ensure the client's ongoing recovery is balanced with their academic program. Morningside Recovery has experience in helping clients navigate the application and transfer process.

• Vocational Training: Drug & Alcohol Counseling Classes to become a licensed addiction treatment expert, Nursing, Psychiatric Technician, Massage Therapist, Chef or Culinary Arts Graphic Design, Firefighter, Paramedic, Court Reporter
• MAI Students have enrolled in programs at: Orange Coast Community College, The Art Institute, FIDM, Chapman University, and Saddleback College in Mission Viejo among others
• MAI Students have continued their studies at: University of California Irvine, University of California Los Angeles, University of California Berkley, Cal State Fullerton, University of Chicago, Tulane University, New York University, University of Texas Austin, Pepperdine University, Cal State Long Beach, Rutgers University, Chapman University

For more information on Morningside Recovery's Academic Institute please visit our new site at soberinstitute.org.

For immediate assistance to help a loved on in need of a drug or alcohol intervention please call us at (866) 725-8565.

Labels: academic-recovery, Drug-Addiction-Rehab, morningside-academic-institute, naatp, sober-institute

The NAATP 2008 Annual Addiction Treatment Leadership Conference is currently being held at the Renaissance Esmeralda Resort in Indian Wells May 18-21, 2008.

"The National Association of Addiction Treatment Providers shall be the organization that enables addiction treatment providers to grow and thrive in a changing healthcare and political environment."--NAATP Vision Statement.

As we look into the 21st century the demand for a coherent unified voice from the addiction health care advocates remain. Addiction is a health issue, sharing more in common with chronic diseases such as diabetes, heart disease and asthma, yet the majority of patients remain untreated and undertreated.

NAATP is the organization which draws from the various addiction disciplines to create a single voice in the arena of addiction. With proper research, education, and public policy we can help to change the landscape from one of shame and blame to one of healing, treatment, hope and understanding.

Labels: addiction, addiction-treatment, chronic-disease-model, Drug-Addiction-Rehab, naatp

Prescription Drug Warning: Percocet

You are a woman, about 35 years old. You are not feeling well and you go to the doctor. He prescribes a medication that will alleviate your pain. You take this medication, just as the doctor ordered, for a few weeks. You feel great. After three weeks, you stop, and start getting nausea, your legs start cramping, and you can't sleep. What is the problem?

The problem is that on top of your original physical condition you are now addicted to a prescription drug: Percocet.

Addiction to prescription medication can begin innocently with a prescription legally obtained from a physician. The strength and addictive qualities of this commonly prescribed medication can trigger addictive behaviors in those using percocet as prescribed.

Use Prescription Drugs Safely

1. Always follow medication directions carefully.
2. Don't increase or decrease doses without talking with your doctor.
3. Don't stop taking medication on your own.
4. Don't crush or break pills.
5. Be clear about the drug's effects on driving and other daily tasks.
6. Learn about the drug's potential interactions with alcohol, other prescription medicines, and over-the-counter medicines.
7. Inform your doctor about your past history of substance abuse.
8. Don't use other people's prescription medications and don't share yours.

Labels: Drug-Addiction-Rehab, Percocet, prescription-drugs

A client may be referred to STC from a primary care facility (e.g. The Betty Ford Center) and literally brought to the doorstep. With his/her belongings in duffle bags and the ubiquitous cigarette dangling, the clients are admitted. The intake process requires extensive paper work, pictures taken with a Polaroid, and meetings with directors and their particular Case Manager. The initial questionnaire provides the first intelligence information on specific addictions and personality issues. The client must reveal which drugs are preferred, how often, and in what form (intravenously, orally, or inhalation), in addition to providing basic information like age, sexual history, family systems, and so forth.

The Case Manager quickly becomes a most trusted friend or the worst enemy within days of admittance. He or she will be the one to processes the information the client provides and produce a written assessment that becomes part of a permanent dossier, the first step in "intelligence gathering."

After the initial in-take sessions, the client is placed into one of 13 houses STC manages. An "intake house" holds clients who have less than thirty days of sobriety. Client placement strategy is elusive to say the least. Only the Director of Operations has the authority to move clients from one house to another, and sometimes there seems to be no rhyme or reason for the moves. A client may be relocated three or four times during their 90-day stay. Problems with house mates can be a reason for changing, power struggles account for a few, but in most cases, the Directors oversee the progress and confers with the House Parent as to where the client would be most successful in his bid for sobriety.

The Director of Operations oversees all decisions and all special operations, backs all the tactics of his "field agents." The term "field agent" will be used to describe any staff employee who is not involved in the clinical side of treatment. It is interesting to note the length that the D.O. will go if forced to defend one of his staff members. In an effort to manipulate, clients have become skilled in lying and spreading misinformation to parents in order to achieve their own goals. STC is adept at running through the obstacle courses thrown up by disenfranchised addicts and their enabling parents.

This brings up the issue of parental involvement. Much of the clinical and operational staff's time is spent on dealing with parents. There are times when it is necessary for parents to receive more clinical attention from a client's case Manager than the client receives. More often than not, it seems the parents need treatment as much as their addicted children.

Labels: Drug-Addiction-Rehab, Spy-Games, teen-drug-abuse

It is a full moon on a Saturday night in Newport Beach, California. Every crime except murder increase during a full moon and tonight is no exception. Jim, a tattooed and weathered man in his late fifties, or maybe is early thirties, its hard to tell with recovering drug addicts and alcoholics, is sitting at his station in a building which has come to be known simply as the "Center" when his Motorola cell phone/two way radio beeps loudly. Jim reaches into his holster, pulls out his cell phone and holds it up to his ear in one swift motion. He presses down on the talk button and waits for a beep. "Yeah, this is Jim." Another loud beep. "This is Mark, I'm over at the 48th Street house and there's no sign of Scott." Jim sighs, "It's still only ten minutes past curfew, swing by on your way back from sweeps and check again." Beep. "I asked his roommates if they knew where he was and they were being quiet about it." Jim's mind starts racing and he immediately shifts gears. "Alright, I was worried about this. I think he went off with Sabrina after the meeting tonight. They were acting strange, and I knew something was up." Beep. "So what do you want me to do?" Beep. "Search his room, leave a note on his bed for him to call me, and make sure you keep your phone on. I'll get back to you."

Jim sits back in his chair and thinks for a moment before dialing a number on his phone. "Hey, this is Jim, is Sabrina there? She isn't. Where is she? You don't know." Jim's tone takes on a knowing sarcasm. "You know where she is, so just tell me. Is she with Scott? That's what I thought." Jim switches back to his radio and beeps John, another field agent who is always out on the streets patrolling the local area. "Yeah John, this is Jim, I need you to hunt down Scott and Sabrina, it looks like they're running. Remember that Scott has overdosed on Heroin three times before he came to us so be ready." Beep. "I think I know where to look for them. I'll take care of it." John signs off. Not twenty minutes go by before a John's signature black Chevrolet pulls up in front of the Center and Scott and Sabrina, two white, middle-class twenty year olds, spill out onto the sidewalk. John gets out of his car smiling as Sabrina vomits into the gutter. "Where did you find them?" Jim asks. "They were trying to hitchhike their way back from a bar in the next town. They didn't put up much of a fight. They knew they were caught. It looks like Sabrina just tried heroin for the first time." Sabrina moans as she bends over at the waist in anticipation of further rebellion from her stomach. Jim beeps someone with his radio and only a beat goes by before Mark's voice can be heard. "Did you find them?" "Yeah John just brought them back, but they're going to need a ride to detox." "I'll be there in five minutes." Jim slips his phone back into its holster with a smile. Then, turning to Scott and Sabrina, he says, "You should know by now that you were going to get caught. Now you'll have time to think about your actions at the Ranch." Jim looks at Scott who is hanging his head in shame. Sabrina looks worse. Jim bends down to check her vitals. "I feel like I'm going to die," Sabrina manages to get out. "Not tonight you won't. You'll be alright," Jim says. Within ten minutes, two field agents pull up in front of the Center. The man loads Scott into his car, the woman takes Sabrina. Within the next hour, both clients will be packed and moved out of their houses in Newport Beach. They will spend the next week in two different lock down facilities specializing in harder to reach Steps Treatment Center clients. A strangely unique drug and alcohol treatment facility, STC takes pride in their covert tactics and control measures.

When The Betty Ford Center is mentioned in conversation, most people know what it is. And lately, Promises in Malibu has been featured in the media because of its famous clients. But these are just two of the many 28-day inpatient drug and alcohol rehabilitation facilities that have sprung up all over the country. One of these is the low-profile STC, a unique facility that began in 1986 and is now one of the largest and most complicated rehabilitation centers in the United States. The facility boasts one of the highest success rate in the country. But there are questions about the effectiveness of a program that is as enigmatic and unrestrictive as STC. To many outside observers in the recovery industry, STC is a mystery, called into question ever since its inception many years ago. This is the subject of the inquiry: How does the treatment program work? Does the open format work as effectively as they claim it does? An investigation of the inner organization will discover whether this type of drug and alcohol rehabilitation program can maintain the kind of daily observation and monitoring that other facilities find imperative to treating the addict.

Labels: Drug-Addiction-Rehab, Spy-Games

Labels: Drug-Addiction-Rehab, Dual-Diagnosis-Treatment