Addiction Treatment; What are the Right Elements?

It is extremely important for those struggling with addiction to get the right help right away. Early intervention with the right medical and mental assessments and treatment can make a dramatic difference between recovery and continued addiction. When reviewing clinical outcome studies data relating to all mental health diseases it is evident that making the right diagnosis and establish the right modalities of treatment inclusive of pharmacological therapy with the appropriate dose coupled with the right mental health counseling will yield the best results. Also numerous mental health studies show that treating patients with counseling alone will yield a certain level of success. When treating with pharmacological therapy alone a certain level of success is achieved. But when combining these two treatment modalities there is a synergistic outcome that is greater in combination than either treatment modality used alone can achieve. Also when including alternative therapies for addiction treatment (i.e. acupuncture, physical exercise etc.) all these elements combined can help increase a positive clinical outcome. One final note on some interesting data that is very revealing when dealing with success rates with patients with any mental health disease in which addiction treatment would obviously be included. That all the right components of diagnosis and treatment must be made and implemented within the first six weeks of treatment and if this is not accomplished the addiction treatment plan is doomed to fail.

Addiction treatment needs to be based on each individual’s needs. Even though the disease of addiction usually presents with many of the same commonalities from person to person, the causes for the disease of addiction are many and varied and based on the individual’s needs so should the addiction treatment.

Addiction rehabilitation; A new Paradigm

The good old days of drug rehabilitation should stay just that; the good old days. Drug and alcohol rehabilitation programs have been around for many many years yet little has changed over those years. Unfortunately that includes success rates. Drug and Alcohol rehabilitation programs have been miserably unsuccessful since the beginning of time. The first real paradigm change came with AA and the "12 step program. That was more than 50 years ago. Since then programs have been stuck in the mud unable to muster up the energy to over come the inertia of change.

Well now it is time to break the mold and move forward in a new direction. A direction where drug and alcohol programs can treat addicts like real people with a real disease in a real world setting. Programs like that found at places like Hanley need to be avoided like a crack pipe. People who are entering drug and alcohol rehabilitation need to feel like they can recover with dignity. They also have to understand that the real world is right on the other side of that door and before they know it they are going to back in it and asked to function at a very high level. Twenty-eight days is hardly enough to change a behavior. Studies show it take a minimum of 3 months. But who has 3 months these days to drop out of sight. Not an impaired professional or even a stay at home Mom.

That being the case we have to start getting people ready to face the real world during their 28 day rehabilitation program and even let them experiment with it while they are still in treatment. This way if there is even the slightest hint of a problem we can address it while in therapy and encourage people to participate in an IOP program after their 28 day rehabilitation program.

That doesn't mean that we throw cation to the wind and put them in vulnerable positions. Supervision and baby steps are still very important. But a good rehabilitation program must be honest, open, respectful and understanding of their clientele and willing to recognize that the real world is where we really live. Twenty-eight days isn't a long time to get ready, but it can be done.

Insurance Reform; The Time is Now

What is the real purpose of health insurance? Who is the one who should benefit the most? Isn't the purpose of health insurance to ensure that a patient is cared for in the most complete and thorough way? But insurance companies clearly get in the way of everyone's health. The problem lies in the fact that insurance companies are in it for the money. Doctors have always been accused of allowing money to cloud their decision making when it comes to patient care. I will be the first to admit that that has been and occasionally continues to be true. However, the one thing you can say about that situation is that the patient always benefits. The doctor makes money by providing services that improves their health care. That is not the case with insurance companies. Insurance companies make money by not spending that money on patient care. If they spend money on patients that simple make less. That situation never benefits the patient. It is impossible to provide good healthcare and save money at the same time.

health insurance companies not only block our access to healthcare, they also block our access to insurance and inhibit our utilization of our benefits. It has happened over and over when a patient is seeking health or life insurance and a company simply says no for no good reason. They tell us that there is too much risk. That we are too unhealthy. Insurance companies are notorious for taking a condition that is not pathologic and telling you that this condition prevents you from getting coverage. They want to ensure that the population that they are insuring are not the neediest but the healthiest. The same is true of life insurance.

Heaven forbid that you should accurately try to use your insurance. You will be branded with all sorts of labels that you will never walk away from. Try to use your addiction benefits and tell some insurance company 10 years for now that you are in recovery and in perfect health. They will make you pay, literally and figuratively.

We need health reform in the US. The first step is to take the power away from insurance companies. Make them not for profit. the only person who should profit is the patient.

Recovery: Slow it Down

If there was one very significant and meaningful piece of advice that I could give every individual who is entering a treatment program it would be to SLOW DOWN. More so than any other obstacle to full recovery it is an addicts sense of urgency to rush the process that gets in their way. Addiction did not start over night. It did not last just a couple of days or even weeks. Yet, when every addict enters a treatment program the question that is paramount in their mind is "When is this program over?"

The simple truth is that you cannot rush the process. Recent science tells us that it takes a minimum of 90 days to change a behavior. Teaching an old dog new tricks takes time. It also takes a team of talented, committed people in a well structured treatment program. These people are handcuffed if an addict tries to rush the program. Keep in mind that someone (family, loved ones, insurance companies, charities, and the government) is paying a lot of money to get the ball rolling and put an addict in such a program. Yet invariably the addict will try to rush the process. The addict will insist that they are OK and on their way to recovery. But it takes time. Every addict needs to take a breath and slow down. It is the speed at which they want to run through the program that becomes their biggest enemy.

It is completely understandable. Good therapy is uncomfortable. It is difficult to face your demons. It is difficult to see where you have been and struggle to get where you need to be. Success will be enhanced significantly if you slow down. Your brain is not paint color on a wall--it will not change with a simple stoke of the brush. Addiction behavior is the manifestation of complex physiologic, hormonal, endocinolgical, and even anatomical changes within the brain and that process typically took years to take the shape that it has on the first day of treatment. To change that dynamic is one that takes time. In Orthodontics teeth move within hours of placing of the braces yet the braces stay in place for many months to ensure stability of the mouth. That analogy is appropriate for the brain as well. The wheels of motion of change are set in motion in the first couple of weeks but change takes months to become permanent.

Slow down. Take a breath. Recovery is a process that cannot be rushed.

Powerless vs. Powerful; You choose

Which is better? Powerless to your addiction or full of power to move forward and through it to a world of recovery? Out of control and letting your addiction take your wherever it wants to or in control of your life and choosing a path that takes you toward a world of independence? Independence from your addiction. Independent enough to say that " I want my life back". To say "I have left that person controlled by drugs behind and now I will enter the world the way people free from addiction know it".

Traditional 12 step programs ask us from the very beginning to admit that we have no power. That we are out of control. that the disease is a stringer entity than we are. Is that true. Is a person who decides to take his or her life back from an addiction really weak. Or do they possess the strongest of all powers.

At some point in the recovery process a conscious decision must be made that an addict will take his life back. That you will leave your addiction behind and never revisit those demons again. a decision must be made that life will be lived in the mainstream. A job will be held. A rent will be paid. A bank account will be opened and a family will be spared. Spared the emotional and financial turmoil which has been brought into their lives without invitation by the decisions of an addict.

When your ready to get clean it will be time to take your life back. Take control. Embrace the power of recovery and walk through the door that allows you to enter the real world.

Medical Opinions: Everyone has one

Physicians go to medical school for 4 years. Following medical school, which even on quiet weeks requires 60-80 hours of work, they enter more specific and demanding training in their chosen specialty for anywhere from 4 to 8 years. that's a total of 8-12 years after 4 years of college to hone their skills and begin to independently care for patients. their education does not stop there. Physicians are dedicated and mandated to continue their education for the entirety of their professional careers. good physicians learn to blend compassion with science in order to make the best decisions possible to provide the highest level of care for their patients. And what do they get for all of this effort? They get the opportunity to defend their practice management decisions with patients who have absolutely no qualifications to challenge those decisions. Somewhere, somehow along the way patients develop medical opinions that they often hold in higher esteem than those of their physician.

Where do they get this information that they use to develop these opinions? The internet is a very frequently accessed source. Is it reliable? A study from Harvard Medical School recently concluded after an extensive review of internet information that up to 70% of medical information on the internet has some level of medical inaccuracy. Books are another source. Recently a family told me that they did not want to use medication to treat their child diagnosed with ADHD because a book they read was strongly against it. they said that it was the opinion of the author that medications increased the risk of a child with ADHD becoming an addict. Not only was the book written by a Chiropractor who had no training in either ADHD or psychopharmacology but he had his fact backwards. the overwhelming body of evidence proves that treating children early with ADHD PREVENTS the development of substance abuse. Other sources include parents, friends, relatives, people in the grocery store and Starbucks, or just anyone who is willing to listen to your story. Everyone will always share their opinion whether they are qualified or not, even if you don't solicit it. A patient told me yesterday that her Mother is positive that the shortness of breath she is experiencing cannot under any circumstances be anxiety but is in fact asthma. "Wow", I said to myself, "She's good." Not really.

I do not believe that every physician should be completely paternalistic in the practice of medicine and make every decision for their patients. I believe that practicing good medicine is a partnership between physician and patient and that it is the duty of the physician to guide their patients when their are reasonable options for their treatment. When there is only one clear path to take we should encourage our patient to take it. But when there are several reasonable paths we can provide highly educated guidance to help our patients make a choice that is their best interests.

We defer to all sorts of experts when we need help. Everyone from tradesmen to professionals. Don't let your medical opinions get in the way of your health.

Squeeze Life

"Don't waste any days." "Stop and smell the roses." "Don't sweat the small stuff." "Life is short."

Choose your saying. They all add up to the same thing; Squeeze life. This is not a dress rehearsal. You certainly cannot push the rewind button. And there are no second chances to make a first impression. So while I am not saying that we can always get it right every time the first time, I am saying that we should try. There are many things in life that we have no control over and therefore we should not worry about what we cannot control. But the one think we can control, the one area where we always have a choice is our attitude. Our outlook on life, and the way that we approach everyday and everything in that day, is what defines us. It is really very simple. Happy or sad. Positive or negative. Selfless or selfish. Caring or not. Half empty or half full.

Those who are on the negative side of each of the above often say they have no choice. How can they be positive or cheerful. Just look at what is happening in their lives. They have no luck. It is not a matter of luck. It is one of design. consciously or unconsciously these type of people have chartered a course in their lives where there is no other option but to have bad things happen. Why; because negative thinking creates negative action in your life.

Positive people on the other hand have it quite the opposite. all good things come from those who are content. have you ever met someone who was rich and miserable or poor and happy. Of course you have. the difference is outlook and contentment.

With that in mind I would suggest that those who are content and positive and happy waste no days in their lives. Life is indeed short and those around us will be better served in all ways if we choose to live our lives to the fullest. Particularly as parents we can give our children no greater gift than that of a positive outlook and the commitment that we will live our lives to the fullest. That is the greatest legacy that we can leave. Negativity is a cancer and hope is the cure.

If you die today, regardless of your age, will those closest to you say that you were cheated? If the answer is yes--you wasted too many days. You failed to squeeze life.

An Addict's Story--In her own words

Before I ever tasted a drop of alcohol or inhaled a hit from a joint, I was an addict. I was addicted to chaos. From early childhood to present day, I've been addicted to chaos. I thrived on chaos; it was the only thing I knew. Chaos was normal. Chaos was my life. My life has been unpredictable, unstable; chock full of turmoil and unparalleled terror.

My mom's descent into alcoholism began for her at age 25. By the time I was born it was in full force. My earliest memories are of yelling, screaming, breaking glass, and sobbing. Mom would be kicked out or Dad would leave, or I would be sent off somewhere, confused and scared of my family.

At age 5, my uncle moved in with us to help out because my Mom was emotionally unavailable. My uncle began molesting me at that time and by age 7 I'd already been raped twice. this continued for years and I still suffer from silent screams that rage in my little soul.

I never knew safety. I desperately wanted to know safety. I never knew consistency. I desperately wanted to know that too. But how would I find those? Thus, alcohol entered the picture.

I was 18 when I began drinking and it became the love of my life. Before alcohol I was terrified of the unknown; built into a nervous frenzy shell of a person. I loathed myself and I loathed my life. But with alcohol I felt nothing. With alcohol I felt good. With alcohol I could breathe. I was comfortable in my own skin and I felt like I found my miracle.

My descent into alcoholism was quick. Within months I got laid off from my job, was in a few car accidents; was transported to the ER for alcohol poisoning; detoxed numerous times; got arrested for DUI; etc. I drank alcohol around the clock almost every single day. It was at that time that I was first referred to rehab which I heavily protested. After I left I went to two other rehabs; neither of which kept me sober.

Weeks before I came to Synergy I was held at gun point in a stranger's apartment. I was raped and beaten for 5 hours. I thought I was going to die that night. It was terrifying, but relieving. I didn't know how I felt- I was scared to die, but I welcomed it.

I hit rock bottom after that. I swallowed a full bottle of Trazadone (65 pills) and 2 pints of vodka. I woke up days later in the ICU. I had been intubated and in a semi-coma. My heart rate was 38. I was closer to death than I's ever been.

Coming to Synergy has truly saved my life. Cliché as that sounds, it is the truth. The people who work here CARE. They don't pretend to know everything but they know how to treat and heal people. I feel at home when I'm at Synergy. They are a very caring and loving group. I have never in my life met people like them who are willing to go to any lengths to help someone.

I've never been so grateful in my life. Do you need to find a home? A treatment center to feel warm and welcomed?

Addiction Behavior; Is It a character Flaw?

Sometimes. But in the majority of cases that is simply not the case. Many would argue that addicts have control over their behavior and can control their addiction like a light switch. I would suggest that until an addict is given the proper tools they are no more in control of their addiction or their thinking than any person is of any other illness. Cancer patients can not will their cancer to go away and an addict cannot will their addiction to go away either. People even in the medical profession have not come to grips with the fact that addiction, like any other psychiatric illness, controls the person who has it and not vice versa. Addiction and psychiatric illnesses are real diseases that require real treatment. People want to believe that they can control their minds but that could not be father from the truth. It takes work. It takes counseling and therapy in combination with an individualized medication regimen to give an addict the proper tools to achieve recovery.

Once an addict has been given the proper tools, meaning having controlled their dual diagnosis to achieve clarity of thought and insight, then and only then does the true recovery process start. It is at that moment that an addict can start to take control of their lives. If under those circumstances an addict fails to exhibit clear and rational thinking and continues to choose drug behavior over clean behavior it is at that point that you are dealing with a character flaw. In medical terms a character flaw is really defined as a personality disorder. personality disorders are the most difficult to treat. They require years of intense psychotherapy and a willingness on the patients part to accept change. Thats the difficult part.

Addiction Genetics; The Genes Don't Fall Far From the Tree

"He's a chip off the old block". "Like father like son". Sound familiar? Two phases often used when we are proud of our children and looking to take a little credit for their virtues. However, when it comes to addiction and the psychiatric pathology that goes along with it, this is where the problem often lies.

When addiction rears its ugly head in a family, particularly when it is associated with a psychiatric illness or diagnosis, it is almost never the index case within the family. When you take a close at the family tree of the addict and pay particular attention to substance abuse history and psychiatric history you will more often than not see that the origins of the current problem lies in the genes of the individual. Let's look at two particular problems, bipolar disorder and ADD. If a parent is bipolar then their offspring is six times more likely to be bipolar and if the parent has ADD then their children are ten times more likely to be ADD than those children who come from "normal" parents.

Think about your own experiences have had the opportunity to know the parents and watch the children grow up just like them. This is why many kids have no real chance to escape their pathology and that they are doomed from the outset to repeat the sins of their parents.

We must keep this in mind when creating a treatment plan for any person who has entered rehab. It is why in our program we spend a significant amount of time looking at the family. We look at the dynamics and the family history and use that to create a family treatment plan that best addresses everyone's needs. It also helps us in recognizing the true dual diagnoses that a client is dealing with which we believe assists in treatment success.

Another Detox Disaster

It happened again to day. I saw another young woman who was recently discharged from a detox program in Miami who was a complete mess. Having spent 10 worthless days in a program where she did not know what they did for her she was clearly worse off than if she had never gone in the first place. More and more I am completely convinced that detox programs are not only a waste of time but a huge waste of money. Detox programs are like ambulance chasing attorneys that make you believe that they are there to help the helpless but in reality are really only in for their own gain. detox programs are a disaster more often than not and with that in mind I have just one word of advise, "Skip the trip to Detox!!"

There is absolutely no reason to ever go to detox. I don't care what you substance of choice is, you can do better as an outpatient. You will receive better care, more attention, less pain, less withdrawal, and better long term results for significantly less money if you do your detox under the guidance of a certified and well qualified physician. With the advent of such medications as Suboxone patients will achieve excellent results and be able to enter their treatment program sooner and in a better frame of mind.

Do yourself a favor and avoid deotx disasters. Detox as an outpatient.

Truth or Dare

Or should I say, "Dare to tell the truth". Why is that addicts lie? Last while speaking to an addict, who had just returned from a trip to his home town for the holidays where he spent two weeks with his parents, he told me that he had had a "minor slip up" and had "used" on one occasion. Yeah right. Today he told me that he was lying (no surprise) last week and wanted to set the record straight. The "minor slip up" included 180 Lorcet, 180 Percocet, and 60 Xanax in a period of two weeks. Not only did he find a bottle that he had stashed at home but even paid a visit to his local doc for a script for the Percocet. Shame on the doc for writing the script! He assured me when he got back to his treatment program that he had been off the narcotics for the past week but had taken much more Ultram than he had been instructed. Upon leaving the office he told me how much better he felt that he had cleared the air. Before he left the office I found out that he lied to me again!!!

If you put an addict on an operating table and opened hem up you still could not find the truth. It happens everyday in my office and in our treatment program. Last week an alcoholic told me she only drank one day over the past 30. her husband told me today that she was sober only one day over the same period.

Obviously the primary motivating factor behind the lies of an addict is that they just don't want us to know how much they are using. But why minimize it? What purpose does it serve once you have decided to proceed with treatment. In the midst of lying an addict does their greatest disservice to themselves. They are really just lying to themselves and until they come to grip with the truth then recovery is just a myth.

Intervention; Act 1, Scene 1

Honesty is the best policy. Except for addicts. It should be but addicts aren’t typically known for their honesty. There is an old saying that if an addict’s mouth is moving then they are lying. Clearly this lack of honesty can significantly inhibit their ability to proceed down the path of recovery. Addicts often minimize their disease in all aspects ranging from how much they use to how their disease impacts the lives of those around them.

In addiction to limitations in their honesty addicts often are challenged when it comes to insight. They often do not or can not see where their disease has taken them and how they can get out of the throws of this disease and back on track

Thus the need for an intervention. By way of an intervention it gives those closest to an addict an opportunity to help them with both their honesty and their insight. Then thinking behind an intervention is quite simple; overwhelm the addict with a mountain of evidence that leaves them no wiggle room to minimize their disease any longer and hopefully do so in a way that helps them accept the need for treatment. That’s the tricky part. That’s the part that requires planning and the guidance of a trained interventionist. It requires advance planning with skillful production and direction. At times it may even require a dress rehearsal in order to make sure that everyone is completely prepared to play their role in the event.

Interestingly enough interventions don’t always have to occur prior to the initiation of a drug treatment program. An intervention can even be useful in the midst of a treatment program. There are many occasions when an addict enters treatment but fails to fully open up and therefore is not fully taking advantage of the program. This leads to a waste of time and money and clearly inhibits recovery. At times like this and intervention can be just what the doctor ordered to help change that dynamic.

Interventions can be stressful, painful, and inspiring all at the same time. With the right intentions and planning they become a major step in saving the life of someone you love.

Addiction Recovery: Chase it like you Chase your drugs

Many years ago when my family member was struggling with addiction I attended a Naranon meeting. During the evening I heard something that was so poignant that I have never forgotten it. What I heard that night was from an addiction therapist that was a guest speaker and this is what he said” people attempting addiction recovery should chase their recovery with the same intensity that they chase their drugs”. This statement almost knocked me off my chair. Think about the intensity, creativity, manipulation, persistence and patience that individuals exhibit when chasing drug dealers and drugs.

How many addiction treatment programs do individuals need to attend before they get it? “It” being long term addiction recovery; one program, five or ten? It is certainly not unusual to speak with some people that have attended ten or more programs and are still not in recovery from alcohol and substance abuse. Why is recovery so hard for these people? What is it that is missing so they don’t get it? What do they need to do to accomplish recovery? How many people go into an alcohol and chemical dependency treatment program and within thirty to ninety days of discharge have relapsed? The truth is relapse from most alcohol and chemical dependency treatment programs can be as high as 75-95%. Do people intentionally sabotage their addiction recovery so that they can continue to struggle with the disease of addiction? Is this life so wonderful that this now becomes ones life goal?

Obviously the disease of addiction and associative recovery is very complex and multi-dimensional. So recovery does require appropriate individualized treatment based on an individual’s needs. And as different as the reasons for one’s addiction and differences of therapeutic needs, one aspect that at least to me would be necessary and consistent to achieve and sustain addiction and alcohol recovery is to utilize the same intensity, creativity, manipulation, persistence, and patience that one would use to chase their drug dealers and drugs. Can one imagine that if people in recovery would utilize these same behaviors in a positive way how successful they could become in their recovery process.

Early Recovery;Are Relationships Appropriate

One of the basic suggestions for people beginning their recovery is that intense, serious relationships with the opposite sex should be avoided for at least a year.
Observationally over twenty years I have seen numerous situations develop that would certainly support this recommendation. There are a variety of reasons why people in early recovery should avoid this type of relationship. The first and foremost is the development of lack of focus for recovery when these relationships develop. When these relationships occur in early recovery the focus now is directed towards the relationship and recovery now is relegated to a secondary priority. Recovery from addictions especially in the early stages must be the primary focus with 100% of energy directed toward this goal. Once addiction recovery is no longer the primary focus and goal the individual is doomed to fail.

Secondly, when addiction recovery takes a back seat to this new found relationship ones ability to think more effectively about positive decisions needed for addiction recovery to be successfully accomplished are hindered. Also many of these relationships that develop while in the early stages of addiction recovery become very intense very quickly. Often times these relationships occur between two people that are attempting recovery. This combination in the relationship usually leads to more problems and consequences that either party had anticipated.
Two people entangled in an intense relationship of which neither is capable of dealing with appropriately at this point in their addiction recovery. Relationships under normal circumstances can challenge the most stable person. Dealing with the potential of numerous stressors can derail the most committed person in recovery.

One additional problem that can occur with relationships existing between two people early in the addiction recovery process is that the relationship is often among two people struggling with their own lives and issues essentially not really making this relationship a match made in heaven.

Conventional wisdom suggests that people in recovery do not even consider this type of relationship for at least a year. After reviewing some of the pitfalls of some of these relationships one can easily come to conclusion that conventional wisdom regarding serious relationships is wise advice. A person in recovery should gain a significant amount of clean time as well as being well on their way with dealing with and understanding the issues that contributed to their addiction.

The wait may be well worth it by allowing the person to have a totally different perspective on relationships and the type of person they might want to have a relationship with.

ADHD and Addiction: The True Story

Why is it that parents PRETEND to have their child's best interest at heart when they discuss their reluctance to start the child on medication for their ADD or ADHD? Knowledge is power and unfortunately for many parents with ADD children they would have to be classified as "weak". Parents look to all sorts of sources of information from Chiropractors to alternative medicine specialists to herbalists to anyone who shares a common opinion about how an ADD child should be cared for. The problem is that they have the process backwards. You don't formulate an opinion based on a lack of knowledge and then seek out people who share your thoughts. Instead you should thoroughly research all the information available and then rely on credible experts in the field to guide you and your child through the best treatment options available.

A family recently told me that they would not start their 9 year old son on medication for his ADHD because the medication would eventually lead to him becoming an addict. When asked where they obtained this information about the link between ADHD medications and addiction I was told that it was from a book written by a chiropractor. A CHIROPRACTOR!! To the best of my knowledge Chiropractors are not trained in the treatment of mood disorders and if they were they are not licensed to prescribe medication. So is it any surprise that they would object to medication. The problem with that thinking is that they couldn't be farther from the truth and they are creating a situation where rather than helping a child they are instead setting that child up for a life time of problems. This is what happens when you try to extend your influence outside the realm of your qualifications.

The truth is simply this: every piece of reputable medical literature in the recent past tells us completely opposite what the Chiropractor had to say. Early intervention with medication in the ADD or ADHD brain helps to prevent addiction while late intervention makes a child more susceptible to addiction. the brain is an organ in many ways similar to other organs in that if you allow it to go untreated irreparable damage will occur. Everyone thinks that they can control their brain. That is true if you need to scratch your head. It is not true if you want to control the deeper centers of your brain that are responsible for behavioral disorders like ADD and ADHD. Only medications in combination with behavioral therapy and ADHD coaching have been shown to fix that.

Finally, let me share a thought with you on dosing. Once a decision has been made to start medication that medication must be given at the appropriate dose. The appropriate dose is defined as that dose at which the behavioral problem has been completely better. It not fair to a child to let them taste what it feels like to be "normal" for a couple hours rather than a whole day. If you had pneumonia you would never tell the doctor to give you enough antibiotic to make you some better. You want to be totally better. The same principle applies to ADD treatment. Take the right does of medicine to get completely better. Less medication is not a good thing if it doesn't work. Use the right dose.

People for whatever reason easily develop opinions about the field of medicine. Leave in the hands of the fight experts and just be a parent. This will lead to what parents really should care the most about; the best outcome for their child.

Negative Thinking, Part II

"If you change the way you look at things then the things you look at will change."

Any comments?

Negative Thinking; What's the Cure?

What makes the glass half empty? Why is it that one person has the "worst day ever" while someone else has "just another day" when in fact they had mirror image days? What makes one person a positive person and another a negative person?

The answer is, there is no simple answer. It is DNA, it is personality, it is attitude, it is a choice. It is a multitude of things bundled up to create who we are. The real question is whether or not it can be taught and whether someone who is a negative thinker can ever change the course of that thinking and become a positive thinker. I believe that the answer is yes. But it takes work.

The fact that it takes work in of by itself implies that there must be a conscious decision to stop being negative and start being positive. That alone may be an impossible task because it takes a positive frame of mind to invite change. Negative thinkers may be doom from the onset because they may be too negative to think that change is possible. They may say, "What's the use" or "Why should I bother".

Addicts are very prone to negative thinking but they are clearly not alone. One thing is clear; more successful people and happy people are positive thinkers rather than negative thinkers. Life is short. Too short to be negative. Too short to be unhappy.

If you are negative it is time for a change. No one wants to be infected by the negative thinking of someone so feed of the positive energy of a "half full" person and change your course once and for all. It is amazing how your life will change. Remember that there really is no such thing as good luck and bad luck; just positive thinking with preparation and negative thinking.

In His Own Words; George

"My name is George. I live in New Jersey. In Jersey I dreaded everyday waking up without my drug. I could not live that life any longer. I was miserable. I found myself selling off my most prized possessions and spending every dollar I made from work. I could not take it any longer. So I went to my Mother and asked her for help.

Asking my Mother was the best thing I could have ever done. she was supportive and offered to put me in a detox center if I was willing. The day she dropped me off at the detox was the happiest day of my life. When I got there I had the most positive attitude and took control of myself and looked at how my life was before detox and I would never like to go back to that. While I was in detox I spoke to my social worker and my Mother about moving to Florida to join Synergy Group Services. I felt as though that would be best for me to stay on my path to sobriety. I felt as though Synergy is going to be a great learning experience for me; to interact with other addicts living on the out side world and not in an inpatient place where there are no temptations. Synergy yesterday helped me realize who my closest friends and family are. They also showed me who aren't as close to me anymore That I would bring back to my circle of family and friends. Will Synergy help me stay on my path to sobriety?"

UPDATE: George spent 5 weeks at Synergy Group Services. After a rocky start during the first 10 days George showed remarkable improvements in his mental and physical health. His personal growth was nurtured by extensive individual and group therapies which allowed him to gain the insight he needed to feel confident about his recovery. All of this was aided by the recognition and treatment of his dual diagnosis that was fostering his drug use. George demonstrates several important principles about creating affective change in one's life: asking for help, choosing the right program, a commitment to change, intensive individual therapy, improving your mind and body simultaneously, addressing your dual diagnosis, and taking your time. George incorporated all these aspects into his treatment plan and stayed a little longer just to make sure he got it. He did and we wish him well.

Overcoming Recovery Inertia; Feelings Lie

Ever wonder why New Year's resolutions never work. Studies show that 80 percent of people who have made a New Year's resolution have failed in their efforts by Valentine's Day. A common reason for that is the fact that change just can't happen because we will it to. If that was the case it probably would have happened already. Effective change must incorporate two important elements: time and help. Studies show that it takes 90 days to effect change of a behavior so there must be a willingness to go the distance. And that change is more likely to be permanent if we don't go it alone. Think about how many times you have thought about making a change and failed in that process. Well success is more likely to be achieve if you fist change how you are going about making that change. One way you go do that is with the help of a therapist or a life coach. Seeking help to make your change is not a sign of weakness. It is a sign of insight and dedication to success. We all need help at times and showing a willingness to accept help is very important to the process of change. Even professional athletes need coaches and willingly accept their advise.

Before any of the above takes place one must admit that there is a need for change and show a willingness to start the process. Getting the emotional energy to do so requires overcoming emotional inertial Emotional inertia is the force that resists change. It comes from all sorts of sources. One of the primary sources of emotional inertia is our feelings.

The thought of change brings with it anxiety and fear as well as a lack of confidence that we can be successful. These feelings are lying to us. they tell us that we can't do it. That you have failed in the past and you will do so again. that thought of failure makes the inertia stringer and the likelihood of success even less. But the reality is that those feelings that sit on one side of your shoulder whispering in your ear need to be ignored while we pay attention to the logic on the other side of our shoulder that says that change can work. don't give in to your feelings. Overcome them. Overcome them with the help of your coach, your doctor, and at times even your medication.

Your feelings are lying to you. You can change.

Intervention to Rehab, Skip Detox

20 years ago hospitals were filled with patients. Patients would go to their Doctor and say they just needed to go into the hospital for a couple days of rest. Doctors would tell patients that they would be admitted to the hospital for a couple of days to "run some tests" Today hospitals are mostly empty. Illnesses that were once thought to be so serious that constant observation was surely needed in the hospital are now treated completely as outpatients.

Fast forward to the standard of care for detox in 2008 and you will find that there is no need for anyone to be admitted to a detox center. Thanks to a better understanding of the detox process and the medications needed to keep a patient comfortable and detox can be done either at home or right in a rehab treatment center skipping the need for inpatient detox. Perhaps the greatest vehicle used to facilitate outpatient detox is Suboxone. Often referred to as expensive Methadone, Suboxone is in a class by itself. Head and shoulders above Methadone. Suboxone allows you to take control of your addiction as early as day 1 and clearly by day 3 at the latest. Recent data confirms that long term Suboxone use is far superior to short term use with regards to overall treatment success (maintenance of sobriety). Inpatient detox centers who insists on coming off your Suboxone in 5 days could not be making a bigger mistake and are proving that they are in fact inferior to outpatient detox programs.

So do yourself a favor and skip a trip to detox--shop for a Suboxone doc instead.

It's Easy to Stay Clean in Rehab

Ever wonder why that is. An addict can go on a binge for days or weeks, or an alcohol can drink for years , but then they enter rehab and they become a model citizen--until they are discharged.

It is really quite simple. Being in rehab is often like being in the land of OZ. Nothing about it is real. An addict or alcoholic is taken away from all their stressors and triggers and can focus on just one thing; themselves. Real life was checked at the door. For the first time in quite some time, and for once justifiably so, all about them. Nothing else matters except getting clean and staying clean.

Unfortunately this idea world doesn't get to last long. For many reasons outside of the control of the addict it will only last for 28 days. It is nowhere nearly enough time. Studies show that in order to change any behavior, no matter how trivial it is, takes at least 90 days.

That is a formula for disaster. It is perhaps one of the most common reasons for relapse. place an addict in an environment which gives hem a taste of success and then pull the rug out from under them and ask them to go back to all their stressors and triggers and stay clean. It is almost impossible. It also doesn't help that addicts get a false sense of security after a brief period of sobriety and thing that they are completely recovered. It can't happen that quickly and it drives home the importance of aftercare, IOP programs, and the notion that you must slow down the recovery process.

Staying clean in rehab is easy but don't let it fool you.

Unconventional Drug Rehabilitation, A New Paradigm

The good old days of drug rehabilitation should stay just that; the good old days. Drug and alcohol rehabilitation programs have been around for many many years yet little has changed over those years. Unfortunately that includes success rates. Drug and Alcohol rehabilitation programs have been miserably unsuccessful since the beginning of time. The first real paradigm change came with AA and the "12 step program. That was more than 50 years ago. Since then programs have been stuck in the mud unable to muster up the energy to over come the inertia of change.

Well now it is time to break the mold and move forward in a new direction. A direction where drug and alcohol programs can treat addicts like real people with a real disease in a real world setting. Programs like that found at places like Hanley need to be avoided like a crack pipe. People who are entering drug and alcohol rehabilitation need to feel like they can recover with dignity. They also have to understand that the real world is right on the other side of that door and before they know it they are going to back in it and asked to function at a very high level. Twenty-eight days is hardly enough to change a behavior. Studies show it take a minimum of 3 months. But who has 3 months these days to drop out of sight. Not an impaired professional or even a stay at home Mom.

That being the case we have to start getting people ready to face the real world during their 28 day rehabilitation program and even let them experiment with it while they are still in treatment. This way if there is even the slightest hint of a problem we can address it while in therapy and encourage people to participate in an IOP program after their 28 day rehabilitation program.

That doesn't mean that we throw cation to the wind and put them in vulnerable positions. Supervision and baby steps are still very important. But a good rehabilitation program must be honest, open, respectful and understanding of their clientele and willing to recognize that the real world is where we really live. Twenty-eight days isn't a long time to get ready, but it can be done.

Addiction Rock Bottom, Why does it have to be so deep?

Conventional “wisdom” in the field of addiction says that an addict often must “hit bottom” before they will be ready to begin the process of recovery. My question is, “Why does the bottom have to be so deep before that process begins?” Why wait until ones’ life has been completely turned upside down before you realize that you need help. Some would say that the consequences must be great before the disease of addiction finally sinks in. I would say that in most instances consequences don’t matter to an addict. If consequences mattered then the “bottom” would never exist at the point at which an addict’s life is essentially destroyed.

Recently a mother of 3 who drinks too much drank too much in front of her children. It was not the first time. It was not the second time. It has happened on enough occasions that the children could see it coming and implored their Mother not to let it happen. When it did happen they were justifiably upset and the following day the emotional burden was evident on their faces. Evident to everyone it would appear except their Mother. Clearly the Mother has made a choice that her children’s emotional well being is not as important to her as is her alcohol. Shouldn’t the pleas of her children to stop drinking be her “bottom”. Does she really have to wait for someone to get physically hurt or her children to get emotionally scared?

An alcoholic recently received her first DUI. Her attorney told her she did not need to enter treatment. Why not? Is the attorney waiting for her to dive deeper to her “bottom”? Why isn’t the first DUI deep enough? Shouldn’t this be a big enough wake up call to seek treatment before she ends up in jail or someone gets killed?

Lastly an addict in our program is about to lose his family. Estranged from his wife and children, unemployed and just starting to get the message that it is time for help. His problems started years ago but a sense of urgency to change the direction of his life is just catching up to him now. He is too late. His “bottom” is too deep for his family to deal with and they have moved on; emotionally and physically.

I am not sure how we can get the message out to everyone in need. Consequences alone will not do it. We see over and over again that addicts don’t get the message until the “bottom” is so deep that everyone that they care about is jumping ship. We must find a way to bring the “bottom” up to a more acceptable level before lives are destroyed.

There is an old saying, “A fool closes the gate after the horses are gone”. An addict needs to hit his “bottom” before it is too late. Don’t let the bottom be too deep and this won’t happen.

“It’s The Little Things That Can Cause Failure”

Once, many years ago one of my mentors mentioned to me “take care of the little things and all the big things will be taken care of.” This seems simple enough to say but sometimes very difficult for some of us to follow. In recovery from any addiction it seems that it is the little things that are not followed is what gets us into trouble. What is about not taking care of the little things in our recovery that leads us back down the road to relapse?

Conceptually when we take care of the little things it is usually a sign that we are also taking care of the big things that are important to our recovery. Why is it that when we stop taking care of the little things it seems shortly after that we stop taking care of the big things? And we all know what happens when we stop taking care of the big things in our recovery, we are no longer in recovery, but in relapse mode. Let’s attempt to examine why this downward spiral takes place. First question that needs to be answered is why do we stop taking care of the little things in our recovery? Do we become lazy, complacent or just don’t think we need to take care of these things because they just don’t seem important enough to warrant the effort?

My theory is that once we determine that some of the smaller responsibilities are no longer worthy of our effort, then shortly after that we have the mentality that the bigger responsibilities in our recovery are no longer worthy of our efforts also. In summary I believe what happens is once we deem the little responsibilities don’t need to be accomplished our minds soon tell us we don’t need to take care of any of our commitments in recovery, big or small. Recovery to be achieved must be taken very seriously and all the components of the recovery program, big or small, must be taken very seriously. So would you agree with one of my old mentors, “take care of the little things and the big things will be taken care of”.

In His Own Words

After years of alcohol use, the progressive us increased to a point where my life had become unmanageable. It was affecting my health and the relationship with my family and friends. Initially I attempted to attain sobriety o my own. This was a complete failure. After many bad episodes attributed to alcoholism, i realized that I needed professional help. through my family and my doctor I was directed to Synergy Group Services, Inc. for professional rehabilitation. This was the best decision I had made for myself, for a solid recovery and follow up care. I would recommend synergy Group Services, Inc. to anyone who is committed to recovery and getting their life back.

It is working for me!

Steve

In With the New...

Now that you have had the opportunity to review the past year and evaluate what needs to be thrown out and what should be kept, it is time to look ahead with optimism for the year to come.

think about positive changes to focus on. Eliminate negative people or situations from you life. A change in the direction of your life starts with a change in your thinking. If you have been unhappy with things in your life then change starts at the top. Literally the top of your brain. You must make a decision that part of what has created an addiction or any other negative influence in your life is your own decision making. It was a conscious decision to maintain a bad relationship, or allow a negative person to influence your decision making, or a boss to treat you badly.

This is your opportunity to change all that. The person whom you have been waiting to change is never going to change. You must change instead. Change your thinking. Change the direction of your life. Positive things only.