When Drug Use is OK

It seems so much easier. I never have any trouble try to get patients take antibiotics or medicine for their blood pressure or diabetes. Patients almost never turn down pain meds--especially addicts. Clearly addicts have the hardest time saying no when it comes to drugs that in any way resemble those chemicals which live in the same neighborhood as their substance of choice. But tell an addict that you are going to give them a drug to treat their anxiety or depression or bipolar disorder (unless of course it is a Benzo) and you have a whole new fight on your hands.

It is not just addicts that have an aversion to psychiatric or psychotropic medications. Everyday, not some days, everyday; I have a conversation with someone who is reluctant to take a medication to treat their psychiatric symptoms. People believe that they can control their own thoughts. That they have control over their emotions. That unlike their pancreas or kidney or liver they actually have control over their brains. That is simply not true.

As a patient imagine how many times you have woken up and said that this will be a day when you will not feel depressed or you will not have a panic attack. And yet it happens anyway. The centers of your brain responsible for emotion (depression, anxiety, fear, happiness, etc)lie in your limbic system; miles from from your prefrontal cortex. It is the prefrontal cortex that you do have control over. It is there that you can scratch your head or memorize a poem. It is a whole different world in the limbic system however, and you have no more control over that region of your brain than any other organ in your body. Medications allow us to change the dynamics of the limbic system in a way that we can't otherwise do consciously. And they can do it quickly. When combined with psychotherapy they can do it more thoroughly than any other treatment modality.

Perhaps most importantly, when you say no to medicine you may be guaranteeing that you will stay on a path or psychiatric illness with no hope of recovery. Recent studies show that when untreated, illnesses such as depression can cause irreversible anatomical, hormonal, endocrinological, and physiological changes to the brain and the adrenal gland. These changes not only attenuate recovery but also promote increased incidence of heart disease, diabetes, and stroke.

Today the United States leads the world in very few areas. One area where we are miles ahead of the rest of the world is psycho-social illness. The numerous reasons for this will be a topic for another day. One thing is clear. If we want to change this dubious distinction then we must stop saying "no" to the right drugs! Take your medicine!

Labels: Addiction science

Everybody Hurts....Sometime.

It is not always easy--Recovery. In fact it is never easy. You have to want it bad. you have to be motivated, committed, and prepared to hurt. It is not for the weak of heart or those who are less than serious about the task which lies ahead.

Too often addicts do not have that level of commitment when entering rehab. Too often addicts will try to take shortcuts. Even worse is when an addict enters rehab without a true intention of putting in the work that is needed to get better. If you are not willing to hurt then you are not willing to become clean and stay clean.

I think where addicts fall short the majority of time is not during the actual rehab program, but instead it is upon re-entry to the "real" world. As hard as the beginning of a rehab program can be, it is nothing compared to the work that one has to do when you are back to all your stressors and triggers. So many people who have done beautifully during treatment watch all that work go up in flames when they relapse due to the pressures of everyday life.

There is nothing easy about rehab and sobriety. It hurts. There isno way around it. Don't try to minimize it. Own it. Work it. Win it.

"I"ll go to Rehab, But NO Drugs!!"

It is funny how addicts are able to compartmentalize and justify drug use. A woman entering rehab yesterday has been drinking 2 bottles of wine a day. She got off the plane drunk but ready for recovery! (how is it that a flight attendant can continue to serve passengers even when they have clearly exceeded their limit?) this is not her first program and she has never put together any substantial "dry" time. So now standing in front of me after an evaluation which clearly indicated that there was a very significant dual diagnosis, she firmly insisted that she would not take any "drugs" (medication).

A similar scenario occurred a couple days ago when an addict using methamphetamine, cocaine and alcohol insisted that he would enter rehab only if no one tried to treat him with "drugs". Clearly he considers his body a temple and doesn't want to pollute it with psychotropic medications!!

All addicts, particularly those with a significant dual diagnosis, will never be guilty of having insight and clarity of thought. This creates perhaps the biggest obstacle to effective treatment. We have often referenced within the pages of this blog that poor decision making skills are universal in the world of the addict and that does not just apply to their addicted world but also to their participation in rehab. Like many lay people who feel they know best when it comes to medical decision making, despite a complete lack of training or medical competency, addicts will not put themselves in the hands of their treatment staff and let go. It is particularly important for those addicts who have failed previous treatment and self imposed efforts to achieve sobriety to put their treatment program in the hands of those who are qualified. Simply put you have to let go to regain control.

The data continues to pile up that most effective treatment regimens must include the use of psychotropic medications and even the judicious use of benzodiazepams to allow addicts to overcome their dual diagnosis and by proxy their addiction. Addicts are not the only ones who are limited by their insight to accept this fact. Sadly their are many "old school" addiction programs who haven't gotten the memo either. They are practicing antiquated recovery techniques that simply don't work for the majority of addicts. You don't have to look any farther than treatment failure rates to know this to be true.

So when looking for a treatment program look for one well versed in dual diagnosis and one will to put a round peg in a round hole and a square peg in a square hole. Every addict is different and a good program individualizes treatment.

Synergy Goup Services; A New Treatment Paridigm

We at Synergy Group Services have had almost 20 years of dealing with the disease of addiction at times as patients, and as family members. Addiction has touched our lives in the "first person". This experience is invaluable when our attention is directed towards helping our clients move forward to their own recovery. Studies show that parents who remember what it is like to be a child have fewer conflicts with their children than those who have no such memory. Placing ourselves into the shoes of those around us makes all of us more understanding; more forgiving; more real.

We now live our lives primarily in the "third person" as therapists, administrators, and physicians. but we never forget what it is like to have been there in the first person. This uniquely qualifies us to care for everyone who has experienced the many faces of addiction. Whether you are a patient or a family member or just a significant other, there are all sorts of obstacles that you must hurdle to achieve recovery. Perhaps one of the most significant obstacles is embarrassment. Embarrassment that leads to cover-up and excuses. embarrassment that hinders recovery because you can't fix what you are not willing to uncover or reveal. We have HEARD all the excuses. We have USED many of the excuses.

Addiction touches more lives than any of us will ever know. The challenge is to get it out in the open so that everyone can heal. Not just the person who is addicted but everyone he or she has ever touched in a meaningful way. We will help you find the answer to the questions "Why do I use?", "Why did they do this to our family?", "How can we find help?" It all stats with honesty and openness. All of us have had our issues. We must relate to each other in the "first person"

Are you embarrassed? Are you afraid? Do you feel alone? Your NOT. Get over it. Get help. Tell me how we can help.

Addiction Treatment; If We Could Only Fix the Parents

"Like father, Like Son." "A chip off the old block." "The apple doesn't fall far from the tree."

Sound familiar? All sayings designed to demonstrate how simple genetics really are. All created to show that in life it is not what your know or who you know, but instead where you came from. Lucky of unlucky. It really is that simple. At the end of the day we can move the dirt around a bit to modify the landscape but there is only so much we can do to change the basic materials we are given.

That being said when it comes to understanding a person with addiction and getting a handle on what tools they possess for change, it is always best to look up one or two branches above them and see what's there. Unfortunately there is often a great deal of pathology. When that is the case you really get an opportunity to see we at times an addicts hands are tied. Sometimes the family pathology is so severe that you have to wonder how anyone survived in this gene pool.

Addicts are often hand cuffed by their genetics and have to work extra hared to overcome the limitations that their parents have unknowingly place upon them. Family therapy can be very enlightening and no decent treatment program should be without some sort of family program. Not only does it serve to help heal the disrupted family dynamics but it gives everyone involved a chance to understand what we are working with and what our limitations might be. The saddest of situations is when you have an addict who is desperate to heal and they are being held back by a family member who never bothered or cared to see and treat their own pathology. I saw that today during family therapy when a girl who has worked so hard to get better will probably only do so if she completely severs her ties with her incredibly disease father.

So addiction is not always the addicts fault. Sometimes it was just in their stars and mother nature is a powerful force.

Addiction recovery: No Glamor, No Awards

It is Academy Awards night. red carpet, glamor, and awards. Robert Downey, Jr. is nominated for an award tonight. Win or lose he is already a major winner. Last year it was Amy Widenhouse who received all the attention during the Grammy Awards. she was nominated and won a Grammy, but her biggest award is pending.

What Robert Downey, Jr. and Amy Widenhouse have in common is their addiction to drugs. Despite Widenhouse's Grammy, Downey has the biggest award. He is clean.

Hollywood often glamorizes addiction. Stars often get a tremendous amount of attention for their addiction troubles. But for the great majority of addicts there is no glamor and there will be no awards nor any publicity and notoriety.

Addiction recovery is a tedious process in which for most the only award is going to be reward that comes from being clean. A personal and private battle fought not in the press or on "Page 6". A struggle in which while there may be many setbacks there is hope that at the end of the day the disease will not prevail.

Work hard. The glamor and the awards are greater than you can possibly know. There is little in life that could have more meaning and that could yield a greater since of pride than beating your addiction.

Addiction Recovery: Trust Me

Insight and honesty. These are qualities that we have often talked about on these pages. Qualities that are often lacking in the personal armentarium of an addict. More specifically lacking in the fabric of those who have a dual diagnosis at the root of their addiction. Bipolar patients in particular are well known for their inability to guide the course of their lives using honesty and insight as their beacons to foster reasonable behavior and foster quality interpersonal relationships.

In both those who have a co-morbidity or dual diagnosis and those who do not, in addition to the challenges they face in overcoming deficiencies in insight and honesty, all addicts must develop a sense of trust in order to overcome their addiction. for a myriad of reasons addicts and alcoholic have been unable to stop the momentum of their disease and change the path of their lives to enter a world of recovery and sobriety. Even those most highly motivated to change have difficulty succeeding. Therefore in order to change the dynamic and head sown a different path they must develop a sense of trust in those who are qualified to help them.

One of the biggest challenges that addicts face in putting their trust in someone who can make decisions for them that they can stand behind. Learning to rework your decision tree is extremely difficult and so during that process you must, as an addict, put your trust in someone who can make good decisions for you Trust in your family, therapist, and physician will help put your recovery on the right path.

Addiction Services: A Testimonial

To whom it may concern;

Thanks to the staff and facilities of Synergy Group Services, Inc, I am able to get my life back. Their unique style is tailored to each individual needs. I was able to focus on my recovery in a healthy/non-institutional facility.

I believe Synergy’s approach to recovery has set me up with a solid foundation to take on the rest of life’s obstacles.

Thank you Synergy Group Services, Inc,

B.G.

Adicition Rehab: "I hate this place!"

last week while interviewing a client who had recently started her drug addiction program, she was convinced that this program was not for her. She didn't like the therapy. She didn't like the house. She didn't like the dual diagnosis that she received. She was lonely. She missed her parents. She didn't fit in with the other clients. SHE WANTED TO GO HOME!

Today was a whole different story. Everything was the polar opposite. She was a different person with a different story.

Rehab is not easy. Good rehab is uncomfortable. Good therapy makes you uncomfortable. If it doesn't then you are wasting your time and your money. The transition, in particular, is the most difficult time. Think back to those first few days at college, the starting of a new job, or just walking into any social situation where you are a newcomer amongst veterans; it just is not that easy. Now multiply that by a factor of many and this should help you understand how difficult the first few days of therapy can be. but just like you don't quit school or your new job, you cannot give up a treatment program just because the first few days are rough.

Resist the temptation to give in to the whines of your child or loved ones in the first week of their program. Stand firm because if the program is worth its weight and its cost then the dynamic will change and in a short time they will be well on their way to recovery.

Holistic Treatment of Drug and Alcohol Addiction

In recent years there has been a lot of discussion as well as more alcohol and chemical dependency treatment centers embracing the concept of Holistic Treatment. What is the basic treatment concept of a Holistic Treatment program? On first blush Holistic Treatment to some might sound like a far out super spiritual concept of alcohol and chemical dependency treatment. Nothing could be further from the truth. The basic concept of a Holistic Treatment Program is to treat Body, Mind and Spirit. The disease of addiction has a multi faceted affect on the individual. It negatively affects body, mind and spirit. Therefore, to treat the entire disease of addiction all three components of the disease must be addressed appropriately.

When evaluating treatment outcomes as accurately as we can, it is obvious that the treatment failure rate is much too high and definitely unacceptable. The basic core of many alcohol and chemical dependency treatment programs is Twelve Step. Everyone who is either operating an addiction treatment program or has been positively impacted by Twelve Step knows and understands the value of Twelve Step. But, the key question to be asked is should we be satisfied with positive treatment outcomes as low as 5-15% 90 days after clients are discharged from treatment? I for one, feel that these type of clinical treatment outcomes are just not acceptable. This prompts me to ask the obvious question, what can we do to better improve our success rates in treating alcohol and chemically dependent clients?

One solution to address the low success rates of treatment is to research alternative or agentive treatments. When I researched alternative treatment options I embraced the concept of a well planned and implemented Holistic Treatment design. In my opinion the program design incorporates the key elements of Twelve Step as well as blending the key elements of a Holistic Treatment design. There are numerous legitimate elements of Holistic Treatment such as acupuncture, physical fitness protocols, massage therapy just to mention a few. These elements are well accepted as proven elements that can add to the potential for success.

The disease of addiction is insidious, manipulating and a challenge to treat. Therefore the treatment of this disease must be creative and utilize all the tools available to achieve success in treating alcohol and chemical dependency. If you where a client afflicted with an addiction what type of treatment program would you embrace?

Addiction Services: From a Family that Knows

We at Synergy Group Services have had almost 20 years of dealing with the disease of addiction at times as patients, and as family members. Addiction has touched our lives in the "first person". This experience is invaluable when our attention is directed towards helping our clients move forward to their own recovery. Studies show that parents who remember what it is like to be a child have fewer conflicts with their children than those who have no such memory. Placing ourselves into the shoes of those around us makes all of us more understanding; more forgiving; more real.

We now live our lives primarily in the "third person" as therapists, administrators, and physicians. but we never forget what it is like to have been there in the first person. This uniquely qualifies us to care for everyone who has experienced the many faces of addiction. Whether you are a patient or a family member or just a significant other, there are all sorts of obstacles that you must hurdle to achieve recovery. Perhaps one of the most significant obstacles is embarrassment. Embarrassment that leads to cover-up and excuses. embarrassment that hinders recovery because you can't fix what you are not willing to uncover or reveal. We have HEARD all the excuses. We have USED many of the excuses.

Addiction touches more lives than any of us will ever know. The challenge is to get it out in the open so that everyone can heal. Not just the person who is addicted but everyone he or she has ever touched in a meaningful way. We will help you find the answer to the questions "Why do I use?", "Why did they do this to our family?", "How can we find help?" It all stats with honesty and openness. All of us have had our issues. We must relate to each other in the "first person"

Are you embarrassed? Are you afraid? Do you feel alone? Your NOT. Get over it. Get help. Tell me how we can help.

Anxiety; It's One of the Biggest Obstacles

It is anxiety that most often gets in the way of recovery. Anxiety is one of the biggest obstacles that every addict faces before, during, and after treatment. It anxiety is not dealt with head on and thoroughly the recovery will not be possible.

Prior to entering treatment every addict experiences anxiety about coming clean. Clean with regards to being honest about their drug use and clean with regards to becoming drug free. The process of withdrawal or detox can be extremely anxiety producing and anxiety as those withdrawal symptoms kick in will drive an addict to take their next drug rather than having the ability to "tough it out". Clearly the anxiety about confronting your demons and agreeing to enter treatment is another obstacle.

Once in treatment there is the anxiety associated with treatment itself. The discomfort one feels by entering a program with strangers, not know what to expect during the treatment program and working with the therapists themselves. Good therapy makes everyone uncomfortable and that is perhaps more true for an an addict. You must have a desire to get uncomfortable in order for treatment to have any chance and truthfully many addicts just don't have the insight to do it. If they can conquer their fears and their anxiety enough to allow themselves to get honest then they have a better chance.

Lastly, there is the anxiety associated with discharge. staying clean and sober during treatment is the easy part. It is after discharge when the work really begins and the going gets tough. Moving back into the real world where your triggers live is when you will really know if recovery is a possibility. Imagine the stress. Imagine the anxiety.

Choosing a program that understands the importance of dual diagnosis and treatment of anxiety with both counseling and medication if necessary will make all of this an easier process and increase your chances for recovery.

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.

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.

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.

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.

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.

The Cost of Meds vs. The Cost of Rehab

Recovery does not come cheap. Financially, emotionally, and even physically there is a huge cost that must be paid in order to complete the transition from addiction to recovery. The financial burden is often one that is very difficult for the family and client to bare. Rehab is expense. Even an average program can cost up to a thousand dollars a day. Unfortunately cost does not in any way equate to quality. You don't always get what you pay for and I will save the discussion of how to pick the right program for another day. for now let it suffice to say that to pay for one treatment program is hard enough; to pay for more than one is almost impossible.

That being said it is imperative that any addict do whatever they can to prevent relapse. In many instances that means taking your meds!! Yet too often I hear that meds are expensive and patients can't afford to take them. the reality is that patient can't afford not to take them. In most instances between the cost of generic medications and generous patient assistance programs, drugs have never been more affordable. Every pharmaceutical company has very liberal patient assistance programs that provide free medication. But even with all that a monthly supply of medications can cost $200-$300. That is a lot of money. yet it is still cheaper than rehab. If you don't take your meds you are destined to relapse. It is not a possibility. It is a reality.

Rehab is expensive. Relapse is more expensive. Take your meds.

Why are Substance Abuse Treatment programs 28 days.

I often have families ask me, “How long is my loved one going to need to be in treatment”? Families always want to know how long it will take their loved one to “get better”. The interesting thing is that despite the fact that most programs are 28 days, all the research shows that the ideal length of time is six to nine months. The idea is that during this time the client would transition into a less restrictive level of care as time progresses. So if that is what the research tells us than why are programs 28 days?

The answer is that the length of treatment was influenced by what the insurance companies were willing to pay or should I say not willing to pay. The average client that does have insurance coverage has approximately 28 days for the entire calendar year (if they are lucky). Many of them have only one inpatient stay a lifetime. This becomes very difficult considering the average rehab client has been in rehab more than once and often times it takes more than one try for them to really get into a recovery based lifestyle.

Many programs provide partial scholarships to assist families, but even with that many families still can’t afford treatment. I have often wondered if insurance companies covered longer periods of time in rehab if the need for repeat visits to rehab would be as common. Based on the research, it would make sense that longer stays in rehab would yield more positive outcomes.

Although, I have been focusing on the insurance companies that cover 28 days, there are many people with health insurance who have no substance abuse treatment coverage. I am not sure how this is the case considering it is a disease just like any other disease. I guess 28 days is better than nothing, but we still have a long way to go. Have you found yourself frustrated with the limitations of your substance abuse coverage? Did you feel like you were backed into a corner and that your hands were tied? Has anyone challenged the insurance company and won??

Those who can-- do; those who can do it better--Teach

Remember the saying,"those who can, do...those who can't, teach...and those who can't teach, teach gym".

It is not true. In fact it is rarely true. The truth is that those who teach are truly often the most intelligent and insightful. When looking for a doctor, for instance, look for one that is actively involved in academic medicine at the same time that they are maintaining a private practice. This is the balance that represents the best of both worlds. A physician who is best qualified to care for his patients is one who has blended the academic world with the real world.

We spoke on an earlier page in this blog about how addicts who are able to truly achieve recovery are those who can walk away from the world of addiction including meetings. However an addict who is able to revisit that world as a teach or a therapist often offers special gifts. They speak the voice of a survivor. They bring with them insights that a non-addict can never achieve or relate to. It may even be important to maintaining their own recovery. Every time one teaches--one learns. No matter who you are or what you are teaching. And so many addicts have the opportunity to maintain their own sobriety and keep learning every time you teach.

You don't have to be a therapist to teach. Sponsors teach. At least the good ones do. alumni teach. Never turn down the opportunity to give back to a program by going back as an alumnus and telling your story. there is a lot to be gained by the people in that program by hearing the story of someone who not only made it out, but made it all together.

the perfect place when you're in a bad "place"

"Like a bridge over troubled water...". That's the way Simon and Garfunkel described it. It is the help that we can provide to those who are in need. When you are in the depths of addiction there is virtually no way to get out by yourself. crossing those trouble waters requires a helping hand. A hand that understands addiction in every way--Science, dynamics, family issues, personal and legal problems. A hand that will not be judgmental. A hand that has faced addiction and all that it has to throw at you.

At Synergy Group Services we are all those things. We are a physician owned and family run rehabilitation program in West Palm Beach, Florida. We have experienced addiction as a family and have dealt with every aspect of addiction on both sides of the fence. Now we live on the side of recovery as therapists, administrators, and physicians ready to give state of the art care not only to the addict but to their loved ones as well.

We believe that we have a unique approach to addiction therapy not only because of our background but because of our philosophy as well. We blend the elements of "12 step" with Holistic therapy to ensure that we give our clients every possible opportunity to succeed.

Call us and find our how we can help your family when someone you love is in a bad "place".

Step One--Let's pick a Program

Is it location? Is it the size of the program? Is it the experience of the therapists and administrators. Is it the ability to deal with the disease of addiction. Does the type of drug matter--oxy, heroin, hydrocodone, alcohol, etc.... Is group vs. individual therapy; or a combination of both? Is about Holistic vs. Traditional? Does Dual diagnosis matter?

The reality it is all the above. Plus one very important ingredient. You must be committed to your choice and comfortable with the notion that you will do whatever it takes to move past the disease of addiction and to the road where a new life begins. One without drugs. One where the person you will become will be unrecognizable from the person you are leaving behind.

What makes a good program is this. It starts with a program where the administrators care right from the first phone call. It begins and end with with individual attention on day one. Secondly size matters. Smaller more intimate programs are more likely to give you individual attention and design a program that most closely fits your needs. To that end, while group therapy is important, All groups pale in comparison to individual therapy. Small programs are more like to give you the individual attention you need to achieve the results you are looking for. In the midst of that individual therapy Dual Diagnosis is critical. Eighty percent of all bipolar patient have in some time abused something. Seventy percent of all chronic substance users are bipolar. One thing is clear. If the proper dual diagnosis is not made--you will not get better. Therefore any program you attend must have a physician available at all times to make the right diagnosis and help you with your recovery. As for Holistic vs. traditional; I believe in Holistic. You must not forget about your body and your soul as you heal you mind. Programs that address you in your entirety are more likely to be successful than those who do not.

So how do you define a good program? How does your family define it? Their needs must be addressed as well so you can all heal together

Behind every door...

...you never know what to expect. I am sitting in my office waiting for a new client to arrive. At this point I know very little about him. I know he is a youn male from Texas with an addiction to oxycodone and that is it. I don't know how he is currently feeling or what he is thinking. Is he in detox? Is he feeling pain? Is that pain emotional or physical? Probably both. Is he regretting his decision to come to rehab? Did he even make that decision or did someone make it for him? Is he motivated to move forward to recovery or is he just wasting our time and someone's money? Time will tell.

This business is not glamorous. You have to leave your intentions to get rich at the door when you sit on the treatment side of this business. The failures will break your heart. The stories-by the clients and the families-are gut wrenching. But when someone gets it; when the light comes on and recovery is the only option; there is little in life as rewarding. To have the opportunity to significantly impact on the outcome of someone's life is a gift. It is a special opportunity that words don't justify. By directly influencing and guiding one's path from addiction to recovery literally serves to save their life. Few jobs compare.

So who is this young man about to arrive? Will I be able to help him. Does he want to be helped. I don't know yet. But he will get every morsel of my attention. Every drop of my ability to work with him and help him help himself. Because you never know who will survive.

What does "God" have to do with it?

So what is the answer? What does "God" have to do with it? Is it his fault that you became an addict? I think not. Then is it His responsibility to participate in your recovery? I think not. God did not have anything to do with picking up your first drink or ball of heroin. He did not hand you your first oxycodone or light your crack pipe. He did not misaligned the planets to create the set of circumstances which were so grave that you had no choice but to relapse. He cannot in any way be held accountable for your addiction. And so because of this you cannot ask "God" to hold your recovery in His hands. Like it or not, that is all on you!

Steps 2 and 3 of the the 12 Step Program bring "God" into recovery. First, in step 2, by saying that it is a higher power that will in essence set you free and then, in step 3, by saying that it is "God" specifically who will guide you on your path to recovery.

I am a Catholic. Raised in a traditional Catholic Italian small town family. I attended Catholic school from kindergarten through graduate school. I am not an addict, but I have "lived' in that world for the past 8 years and I can tell you one thing. "God" has nothing to do with your recovery.

Addicts often say that their recovery is in "God's" hands. That in the midst of their recovery they are "blessed". We are all blessed and the course of our lives is in our own hands. The higher power that will drive you to recovery lives in the power of your mind and spirit which creates the determination and drive that you need to change the course of your life. That to me is known as spirituality. It is not the spirit "above " us but rather the "spirit" within us. Every addict is responsible for their addiction and therefore they are responsible for their recovery. It is equally their responsibility to utilize the tools around them--therapists, doctors, family, programs, sponsors, and themselves--to assist in that recovery. But don't put it on "God's" shoulders. That just gives you someone else to blame if you relapse. Take control of your own life. Be the source of your own power.