“Scientists announced that they have located the gene for alcoholism. Scientists say they found it at a party, talking too loudly.” Conan O’Brien [American late night Talk Show Host. b. 1963].

Although much can be said about alcoholism and its impact on society, one thing is clear- We are breeding a nation of alcoholics. Drinking has become part of our national past time. I myself have been guilty of the excessive use of alcohol- a condition not learnt until university days when, some may say, I took a “crash” course in drinking.

However, we in Trinidad and Tobago do have a serious problem. According to Hari D. Maharajh and Akleema Ali in “Crime in Trinidad and Tobago: the effect of alcohol use and employment,” a reduction in beer available for home consumption – a major public health concern- would significantly reduce the occurrence of minor offenses. In fact, the consumption of beer accounted for 64% of minor crimes in this country. However, this aspect of the impact of alcoholism will be looked at in another article.

The purpose of this article is to summarize the statistical literature concerning the effects of alcohol consumption on earnings and employment. One of the most important findings of this research is that alcoholism has both direct and indirect effects on earnings. That is, there is evidence that alcoholics’ earnings are depressed both because alcoholism causes reduced labour productivity and because it discourages investments in “human capital” (e.g., education). Problem drinking is also found to increase unemployment.

Original article by: Dr. Anderson Morris

Posted September 10, 2009

From:

http://addictionrecoverybasics.com/

Addicts should realize that their life can never be the way it was before their addiction. This does not mean that a recovering addict cannot live a healthy and fulfilling life. Rather, addicts should be aware that recovery is a process that always will need to be maintained.

Posted August 28, 2009

From:

http://www.dol.gov/asp/programs/drugs/workingpartners/sab/recovery.asp#q3

It used to drive me crazy early in addiction recovery when people would say ‘Bill you’re just not getting it’. I wanted to know how you are measuring my progress in addiction recovery, and by what standards are you judging me and saying that I’m not getting it. I’m doing just fine thank you; I would be petulant and angry. Clear as a bell to others, I was talking the game but not performing.

On the other hand, sometimes I would see no progress at all, be about to give up, and people would say ‘You’re doing great.’ or worse yet, ‘You’re doing exactly what you need to be doing at this time’. That would drive me nuts. I was so closed in my own head, you’re telling me I’ve got the answer, I don’t know what the heck the question is.

Looking for some signs of progress in addiction recovery, evidence if you will or a r yardstick that could compare myself to became a goal. Here are some concepts which I used and you may want to take a look at to measure your progress in addiction recovery:
# Have you cut off relationships with using friends for good?
# Have you begun to set clear and practical, attainable goals for your life?
# Does the idea of relapse scare you? What are you doing about it?
# Have you developed your own methods to deal with craving that work?
# Have you started to work hard at improving close personal relationships?
# Have you become invested in the recovery process, and are you doing what has been recommended?
# Is your opinion of yourself the same as others people’s opinion of you? Is your ego right-sized, neither too big or too small.
# Are you able to present yourself as you really feel without putting on masks and hiding behind defensive walls?
# Have you become open to growth, self improvement in recovery, and taken action to start that process?

These are just a few concrete indicators of progress in addiction recovery. At this point is not enough to be talking a good game. Our actions must be consistent with what we’re talking about. The above are just a few examples of the action steps that need to be taken, being in addiction recovery. Remember, self-esteem and the trust of others is acquired by consistently doing the right thing over an ever increasing length of time.

Posted August 20, 2009

From:

http://addictionrecoverybasics.com/2007/05/29/rate-yourself-on-these-measurable-signs-of-progress-in-addiction-recovery/#more-202

Drugs and alcohol have the capacity to provide short-term solutions to many of life’s problems. The difficulty of course, is that excess use of alcohol and drugs become the problem themselves.

I proposed the topic of what problems we’re trying to solve by the use of alcohol and drugs to a discussion group. We generated a list of items: 120 woman

Loneliness
Reducing stress
Handling anxiety
Coping with depression
I simply like to drink in drug, no problem.
My husband/wife – dysfunctional relationships
Low self-esteem
Feeling sorry for myself
Handling pain (both physical and emotional)

The list went on and on, I’m sure you get the idea. There is a reality here to be considered. Life is life, there are good times and bad times, we become frustrated with ourselves, other people, places and things.

One thing I believe to be a commonality among people with chemical dependency, or of users of drugs and alcohol, is a tendency to not know how to deal with life’s issues in a positive, not destructive way. Perhaps somewhere long the way the skills were just never learned. Another possibility is that the skills we learned in childhood were dysfunctional and we still use them as adults with little success.

I believe that one thing that absolutely must be done in recovery is to scratch off the option of returning to drug and alcohol use as a means of solving life’s problems. How am I going to handle the death of loved one, the loss of a job, celebrating the birth of a new baby?

I really don’t know, I’ll deal with it to the best of my ability when it happens. But one thing that is absolutely certain is that the option of returning to drug and alcohol use and abuse is no longer on the menu of options in my life.

That emotional and intellectual commitment to abstinence is only so much rhetoric if it is not backed by a plan of action. The intellectual decision to stop drinking is about 2 percent of the game. The other 98 percent involves having a concrete plan of recovery in growth in place, a relapse Prevention Plan, and an absolutely huge support network.

Posted on August, 19 2009

From:

http://addictionrecoverybasics.com/2008/12/15/if-drugs-and-alcohol-are-the-solution-then-what-is-the-problem/#more-663

There is a big difference between making the decision to stop alcohol or drug use and committing to a life of recovery.

While making the intellectual decision to quit using drugs and alcohol is a critical first step, many people make the serious error in believing that it is the only step. There is much more to it than that. The decision to stop drinking and/or drugging has to be coupled with actual abstinence. Many people stop for a time but cannot stay stopped.

Why? It might be a lack of commitment. There is no single method or recovery path; everyone must find the path that works for them. But here is a hint: 12 step groups have been around longer and helped more people than anything else. But, whatever path you choose, you must commit to the idea of not drinking or drugging again ‘no matter what’. Maintaining this level of commitment and dedication requires work and focus.

One recommendation is to develop a wide and deep support network. Having like-minded people in your group of friends can offer support when commitment wavers. There is a great deal of help available in recovery. In fact there is a whole culture of people in recovery that are willing to help anyone stay sober. This is a foundational concept of 12 step groups.

Sobriety is not something that can be achieved and that not paid attention to again. It is a continuing process rather than a destination or event completion. There has to be an element of belief that things will get better in the long run.

Addiction recovery is full of ups and downs. A strong support group and unwavering commitment can get anyone through the tough spots. I like the term ‘overwhelming force’ when describing the ferocity of commitment people in successful long term recovery exhibit.

Posted August 13, 2009

From:

http://addictionrecoverybasics.com/

The principles listed below are the result of long-term research studies on the origins of drug abuse behaviors and the common elements of effective prevention programs. These principles were developed to help prevention practitioners use the results of prevention research to address drug use among children and adolescents in communities across the country. Parents, educators, and community leaders can use these principles to help guide their thinking, planning, selection, and delivery of drug abuse prevention programs at the community level.

Prevention programs are generally designed for use in a particular setting, such as at home, at school, or within the community, but can be adapted for use in several settings. In addition, programs are also designed with the intended audience in mind: for everyone in the population, for those at greater risk, and for those already involved with drugs or other problem behaviors. Some programs can be geared for more than one audience.

Principle 1 – Prevention programs should enhance protective factors and reverse or reduce risk factors (Hawkins et al. 2002).

* The risk of becoming a drug abuser involves the relationship among the number and type of risk factors (e.g., deviant attitudes and behaviors) and protective factors (e.g., parental support) (Wills et al. 1996).
* The potential impact of specific risk and protective factors changes with age. For example, risk factors within the family have greater impact on a younger child, while association with drug-abusing peers may be a more significant risk factor for an adolescent (Gerstein and Green 1993; Dishion et al. 1999).
* Early intervention with risk factors (e.g., aggressive behavior and poor self-control) often has a greater impact than later intervention by changing a child’s life path (trajectory) away from problems and toward positive behaviors (Ialongo et al. 2001).
* While risk and protective factors can affect people of all groups, these factors can have a different effect depending on a person’s age, gender, ethnicity, culture, and environment (Beauvais et al. 1996; Moon et al. 1999).

Principle 2 – Prevention programs should address all forms of drug abuse, alone or in combination, including the underage use of legal drugs (e.g., tobacco or alcohol); the use of illegal drugs (e.g., marijuana or heroin); and the inappropriate use of legally obtained substances (e.g., inhalants), prescription medications, or over-the-counter drugs (Johnston et al. 2002).

Principle 3 – Prevention programs should address the type of drug abuse problem in the local community, target modifiable risk factors, and strengthen identified protective factors (Hawkins et al. 2002).

Principle 4 – Prevention programs should be tailored to address risks specific to population or audience characteristics, such as age, gender, and ethnicity, to improve program effectiveness (Oetting et al. 1997).

Principle 5 – Family-based prevention programs should enhance family bonding and relationships and include parenting skills; practice in developing, discussing, and enforcing family policies on substance abuse; and training in drug education and information (Ashery et al. 1998).

Family bonding is the bedrock of the relationship between parents and children. Bonding can be strengthened through skills training on parent supportiveness of children, parent-child communication, and parental involvement (Kosterman et al. 1997).

* Parental monitoring and supervision are critical for drug abuse prevention. These skills can be enhanced with training on rule-setting; techniques for monitoring activities; praise for appropriate behavior; and moderate, consistent discipline that enforces defined family rules (Kosterman et al. 2001).
* Drug education and information for parents or caregivers reinforces what children are learning about the harmful effects of drugs and opens opportunities for family discussions about the abuse of legal and illegal substances (Bauman et al. 2001).
* Brief, family-focused interventions for the general population can positively change specific parenting behavior that can reduce later risks of drug abuse (Spoth et al. 2002b).

Principle 6 – Prevention programs can be designed to intervene as early as preschool to address risk factors for drug abuse, such as aggressive behavior, poor social skills, and academic difficulties (Webster-Stratton 1998; Webster-Stratton et al. 2001).

Principle 7 – Prevention programs for elementary school children should target improving academic and social-emotional learning to address risk factors for drug abuse, such as early aggression, academic failure, and school dropout. Education should focus on the following skills (Conduct Problems Prevention Research Group 2002; Ialongo et al. 2001):

* self-control;
* emotional awareness;
* communication;
* social problem-solving; and
* academic support, especially in reading.

Principle 8 – Prevention programs for middle or junior high and high school students should increase academic and social competence with the following skills (Botvin et al. 1995; Scheier et al. 1999):

* study habits and academic support;
* communication;
* peer relationships;
* self-efficacy and assertiveness;
* drug resistance skills;
* reinforcement of anti-drug attitudes; and
* strengthening of personal commitments against drug abuse.

Principle 9 – Prevention programs aimed at general populations at key transition points, such as the transition to middle school, can produce beneficial effects even among high-risk families and children. Such interventions do not single out risk populations and, therefore, reduce labeling and promote bonding to school and community (Botvin et al. 1995; Dishion et al. 2002).

Principle 10 – Community prevention programs that combine two or more effective programs, such as family-based and school-based programs, can be more effective than a single program alone (Battistich et al. 1997).

Principle 11 – Community prevention programs reaching populations in multiple settings—for example, schools, clubs, faith-based organizations, and the media—are most effective when they present consistent, community-wide messages in each setting (Chou et al. 1998).

Principle 12 – When communities adapt programs to match their needs, community norms, or differing cultural requirements, they should retain core elements of the original research-based intervention (Spoth et al. 2002b), which include:

* Structure (how the program is organized and constructed);
* Content (the information, skills, and strategies of the program); and
* Delivery (how the program is adapted, implemented, and evaluated).

Principle 13 – Prevention programs should be long-term with repeated interventions (i.e., booster programs) to reinforce the original prevention goals. Research shows that the benefits from middle school prevention programs diminish without followup programs in high school (Scheier et al. 1999).

Principle 14 – Prevention programs should include teacher training on good classroom management practices, such as rewarding appropriate student behavior. Such techniques help to foster students’ positive behavior, achievement, academic motivation, and school bonding (Ialongo et al. 2001).

Principle 15 – Prevention programs are most effective when they employ interactive techniques, such as peer discussion groups and parent role-playing, that allow for active involvement in learning about drug abuse and reinforcing skills (Botvin et al. 1995).

Principle 16 – Research-based prevention programs can be cost-effective. Similar to earlier research, recent research shows that for each dollar invested in prevention, a savings of up to $10 in treatment for alcohol or other substance abuse can be seen (Aos et al. 2001; Hawkins et al. 1999; Pentz 1998; Spoth et al. 2002a).

NIDA’s prevention research program addresses all stages of child development, a mix of audiences and settings, and the delivery of effective services at the community level. The Institute focuses on risks for drug abuse and other problem behaviors that occur throughout a child’s development. Prevention interventions designed and tested to address risks can help children at every step along their developmental path. Working more broadly with families, schools, and communities, scientists have found effective ways to help people gain the skills and approaches to stop problem behaviors before they occur. Research funded by NIDA and other Federal research organizations—such as the National Institute of Mental Health and the Centers for Disease Control and Prevention—shows that early intervention can prevent many adolescent risk behaviors.

References

Aos, S.; Phipps, P.; Barnoski, R.; and Lieb, R. The Comparative Costs and Benefits of Programs to Reduce Crime. Vol. 4 (1-05-1201). Olympia, WA: Washington State Institute for Public Policy, May 2001.

Ashery, R.S.; Robertson, E.B.; and Kumpfer, K.L.; eds. Drug Abuse Prevention Through Family Interventions. NIDA Research Monograph No. 177. Washington, DC: U.S. Government Printing Office, 1998.

Battistich, V.; Solomon, D.; Watson, M.; and Schaps, E. Caring school communities. Educational Psychologist 32(3):137–151, 1997.

Bauman, K.E.; Foshee, V.A.; Ennett, S.T.; Pemberton, M.; Hicks, K.A.; King, T.S.; and Koch, G.G. The influence of a family program on adolescent tobacco and alcohol. American Journal of Public Health 91(4):604–610, 2001.

Beauvais, F.; Chavez, E.; Oetting, E.; Deffenbacher, J.; and Cornell, G. Drug use, violence, and victimization among White American, Mexican American, and American Indian dropouts, students with academic problems, and students in good academic standing. Journal of Counseling Psychology 43:292–299, 1996.

Botvin, G.; Baker, E.; Dusenbury, L.; Botvin, E.; and Diaz, T. Long-term follow-up results of a randomized drug-abuse prevention trial in a white middle class population. Journal of the American Medical Association 273:1106–1112, 1995.

Chou, C.; Montgomery, S.; Pentz, M.; Rohrbach, L.; Johnson, C.; Flay, B.; and Mackinnon, D. Effects of a community-based prevention program in decreasing drug use in high-risk adolescents. American Journal of Public Health 88:944–948, 1998.

Conduct Problems Prevention Research Group. Predictor variables associated with positive Fast Track outcomes at the end of third grade. Journal of Abnormal Child Psychology 30(1):37–52, 2002.

Dishion, T.; McCord, J.; and Poulin, F. When interventions harm: Peer groups and problem behavior. American Psychologist 54:755-764, 1999.

Dishion, T.; Kavanagh, K.; Schneiger, A.K.J.; Nelson, S.; and Kaufman, N. Preventing early adolescent substance use: A family centered strategy for the public middle school. Prevention Science 3(3):191–202, 2002.

Gerstein, D.R.; and Green, L.W., eds.; Preventing Drug Abuse: What Do We Know? Washington, DC: National Academy Press, 1993.

Hawkins, J.D.; Catalano, R.F.; Kosterman, R.; Abbott, R.; and Hill, K.G. Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatric and Adolescent Medicine 153:226–234, 1999.

Hawkins, J.D.; Catalano, R.F.; and Arthur, M. Promoting science-based prevention in communities. Addictive Behaviors 90(5):1–26, 2002.

Ialongo, N.; Poduska, J.; Werthamer, L.; and Kellam, S. The distal impact of two first-grade preventive interventions on conduct problems and disorder in early adolescence. Journal of Emotional and Behavioral Disorders 9:146–160, 2001.

Johnston, L.D.; O’Malley, P.M.; and Bachman, J.G. Monitoring the Future National Survey Results on Drug Use, 1975–2002. Volume 1: Secondary School Students. Bethesda, MD: National Institute on Drug Abuse, 2002.

Kosterman, R.; Hawkins, J.D.; Spoth, R.; Haggerty, K.P.; and Zhu, K. Effects of a preventive parent-training intervention on observed family interactions: Proximal outcomes from Preparing for the Drug Free Years. Journal of Community Psychology 25(4):337–352, 1997.

Kosterman, R.; Hawkins, J.D.; Haggerty, K.P.; Spoth, R.; and Redmond, C. Preparing for the Drug Free Years: Session-specific effects of a universal parent-training intervention with rural families. Journal of Drug Education 31(1):47–68, 2001.

Moon, D.; Hecht, M.; Jackson, K.; and Spellers, R. Ethnic and gender differences and similarities in adolescent drug use and refusals of drug offers. Substance Use and Misuse 34(8):1059–1083, 1999.

Oetting, E.; Edwards, R.; Kelly, K.; and Beauvais, F. Risk and protective factors for drug use among rural American youth. In: Robertson, E.B.; Sloboda, Z.; Boyd, G.M.; Beatty, L.; and Kozel, N.J., eds. Rural Substance Abuse: State of Knowledge and Issues. NIDA Research Monograph No. 168. Washington, DC: U.S. Government Printing Office, pp. 90–130, 1997.

Pentz, M.A.; Costs, benefits, and cost-effectiveness of comprehensive drug abuse prevention. In: Bukoski, W.J.; and Evans, R.I., eds. Cost-Benefit/Cost-Effectiveness Research of Drug Abuse Prevention: Implications for Programming and Policy. NIDA Research Monograph No. 176. Washington, DC: U.S. Government Printing Office, pp. 111–129, 1998.

Scheier, L.; Botvin, G.; Diaz, T.; and Griffin, K. Social skills, competence, and drug refusal efficacy as predictors of adolescent alcohol use. Journal of Drug Education 29(3):251–278, 1999.

Spoth, R.; Guyull, M.; and Day, S. Universal family-focused interventions in alcohol-use disorder prevention: Cost effectiveness and cost-benefit analyses of two interventions. Journal of Studies on Alcohol 63:219–228, 2002a.

Spoth, R.L.; Redmond, D.; Trudeau, L.; and Shin, C. Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs. Psychology of Addictive Behaviors 16(2):129–134, 2002b.

Webster-Stratton, C. Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology 66:715–730, 1998.

Webster-Stratton, C.; Reid, J.; and Hammond, M. Preventing conduct problems, promoting social competence: A parent and teacher training partnership in Head Start. Journal of Clinical Child Psychology 30:282–302, 2001.

Wills, T.; McNamara, G.; Vaccaro, D.; and Hirky, A. Escalated substance use: A longitudinal grouping analysis from early to middle adolescence. Journal of Abnormal Psychology 105:166–180, 1996.

* Information for this InfoFacts was taken directly from the publication, Preventing Drug Use among Children and Adolescents, A Research-Based Guide for Parents, Educators, and Community Leaders, Second Edition, National Institute on Drug Abuse, 2003.

Posted August 10, 2009

From:

http://www.drugabuse.gov/infofacts/lessons.html

More than two decades of scientific research have yielded a set of fundamental principles that characterize effective drug abuse treatment. These 13 principles, which are detailed in NIDA’s new research-based guide, Principles of Drug Addiction Treatment: A Research-based Guide, are:

1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each patient’s problems and needs is critical.
2. Treatment needs to be readily available. Treatment applicants can be lost if treatment is not immediately available or readily accessible.
3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. Treatment must address the individual’s drug use and associated medical, psychological, social, vocational, and legal problems.
4. Treatment needs to be flexible and to provide ongoing assessments of patient needs, which may change during the course of treatment.
5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The time depends on an individual’s needs. For most patients, the threshold of significant improvement is reached at about 3 months in treatment. Additional treatment can produce further progress. Programs should include strategies to prevent patients from leaving treatment prematurely.
6. Individual and/or group counseling and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding nondrug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships.
7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. Methadone and levo-alpha-acetylmethadol (LAAM) help persons addicted to opiates stabilize their lives and reduce their drug use. Naltrexone is effective for some opiate addicts and some patients with co-occurring alcohol dependence. Nicotine patches or gum, or an oral medication, such as bupropion, can help persons addicted to nicotine.
8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way. Because these disorders often occur in the same individual, patients presenting for one condition should be assessed and treated for the other.
9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification manages the acute physical symptoms of withdrawal. For some individuals it is a precursor to effective drug addiction treatment.
10. Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase treatment entry, retention, and success.
11. Possible drug use during treatment must be monitored continuously. Monitoring a patient’s drug and alcohol use during treatment, such as through urinalysis, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that treatment can be adjusted.
12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place them or others at risk of infection. Counseling can help patients avoid high-risk behavior and help people who are already infected manage their illness.
13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Participation in self-help support programs during and following treatment often helps maintain abstinence.

Principles of Drug Addiction Treatment: A Research-based Guide (NCADI publication BKD347) has been mailed to NIDA NOTES subscribers in the U.S. Copies of the booklet can be obtained from the National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847, 1-800-729-6686.

Posted August 7, 2009

From:

http://www.nida.nih.gov/NIDA_Notes/NNVol14N5/tearoff.html

AlcoholScreening.org reaches milestone during National Alcohol Awareness Month

BOSTON, MA – “Is my drinking risky?” At AlcoholScreening.org, over one million people have now learned the answer to this question by taking a confidential, free online screening to assess their drinking patterns. Visitors to the free health-screening website receive personalized feedback, finding out if their alcohol consumption is likely to be within safe limits — or if it may be harmful to their health now, or in the future. They also find out whether they drink more or less than other people of their age and gender.

AlcoholScreening.org was developed by Join Together, a project of the Boston University School of Public Health. Based on the AUDIT (Alcohol Use Disorders Identification Test), a standard in screening instruments, this simple, anonymous test takes only a few minutes and provides confidential results. AlcoholScreening.org was launched in April 2001, and the website delivered its millionth health screening on April 7, 2009. The milestone coincides with National Alcohol Awareness Month.

“Thanks for the statistics, I just thought it was ‘normal’. I will try to cut down, I knew I was at risk because of my family tradition, yet I thought I was still on the safe side. I have clear data to re-evaluate my habits,” wrote one user.

AlcoholScreening.org also features answers to frequently asked questions about alcohol and health consequences, and provides links to support resources and a national database of 11,000 local treatment programs. Hundreds of sites link to AlcoholScreening.org and more than fifty organizations use its syndication option to integrate AlcoholScreening.org into their own websites. Syndication also allows these sites to add local resource information.

“Consumers across the country use the Internet to get health information. It makes sense that they should use it to learn whether they may have personal health risks related to their alcohol use,” said David Rosenbloom, Join Together Director. “Research shows that questions about alcohol consumption patterns, coupled with brief feedback about risk levels or referral to assessment or treatment, when appropriate, can lead individuals to reduce risky drinking over sustained periods. Reducing risky drinking patterns can prevent injuries from car crashes and other mishaps, long term illnesses, and problems with family, community members or with law enforcement.”

Take the Test: Visit AlcoholScreening.org

Join Together works to advance effective alcohol and drug policy, prevention and treatment. Major funding is provided by the Robert Wood Johnson Foundation. More information about Join Together is available at: http://www.jointogether.org/aboutus/.

Sponsored by the National Council on Alcoholism and Drug Dependence, Inc., (NCADD) since 1987, Alcohol Awareness Month encourages local communities to focus on alcoholism and alcohol-related issues throughout the month of April. Alcohol Awareness Month began as a way of reaching the American public with information about the disease of alcoholism – that it is a treatable disease, not a moral weakness, and that alcoholics can and do recover.

Posted August 3, 2009

From:
Join Together
580 Harrison Avenue, 3rd Floor
Boston, MA 02118

http://www.jointogether.org/news/yourturn/announcements/2009/one-million-people.html

Once the problem of addiction is recognized, individuals can begin the process of recovery by following a treatment plan. Recovery is the process of overcoming both physical and psychological dependence on a psychoactive drug, with a commitment to sobriety.

What is the difference between treatment and recovery?

Treatment and recovery are interconnected, but not the same. As the NIDA Principles of Drug Addiction indicate, treatment is an important component to the recovery process.

According to the Center for Substance Abuse Treatment (CSAT), “treatment” is defined as in- or outpatient services that focus on initiating and maintaining an individual’s recovery from alcohol or drug abuse and on preventing relapse. Treatment can include detoxification, group or individual counseling, rehabilitation and the use of methadone or other prescription medications. It also can involve drug or alcohol education and self-help groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Quite often, treatment is considered the “light at the end of the tunnel” for those afflicted with substance abuse addiction. Unlike addiction itself, treatment is a positive process, involving a variety of support systems that systematically help lead individuals to successful, fulfilling lives without drugs and/or alcohol.

Individuals who have participated and completed treatment programs are considered to be “in recovery.” Thus, recovery is recognized as “…an ongoing process of improvement–biologically, psychologically, socially and spiritually–while attempting to maintain abstinence from alcohol and other drugs.” (Strawn, Julie, WIN, “Substance Abuse Welfare Reform Policy,” Issue Notes, Vol. 1, No. 1, 1/7/97. p.3) Furthermore, individuals can be forced into treatment, but cannot be forced into recovery. Recovery from alcohol and other drug abuse is a voluntary process, and a strategy to reach recovery should include treatment. Therefore, treatment is not a long-term solution to alcohol and other drug addiction, but a commitment to recovery is. In addition, some people become “clean and sober” solely through continuous participation in 12-step programs, instead of through treatment. They, too, consider themselves “in recovery.”
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What are the steps of recovery?

There are six stages that addicts must undergo for long-term recovery:

Transition – The period of time needed for the addict to realize that safe use of alcohol or other drugs for them is not possible.

Stabilization – The period of time in which the addict experiences physical withdrawal and other medical problems and learns how to separate from the people, places and things that promote drug abuse.

Early recovery – When an individual faces the need to establish a chemical-free lifestyle and builds relationships that support long-term recovery.

Middle recovery – The time for developing a balanced lifestyle where repairing past damage is critical.

Late recovery – The period of time in which the individual identifies and changes mistaken beliefs about oneself, others, and the world that causes or promotes irrational thinking.

Maintenance – The lifelong process of continued growth, development and management of routine life problems.
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Do addicts ever fully recover?

Addicts should realize that their life can never be the way it was before their addiction. This does not mean that a recovering addict cannot live a healthy and fulfilling life. Rather, addicts should be aware that recovery is a process that always will need to be maintained.
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Is abstinence/sobriety the same as recovery?

No. Sobriety or abstinence is simply refraining from the ingestion of alcohol or other drugs. Recovery is the process by which the ingestion of alcohol or other drugs is recognized as problematic and avoided.

Posted July, 31 2009

From:

http://www.dol.gov/asp/programs/drugs/workingpartners/sab/recovery.asp#q1

By Bob Curley

Addiction treatment is included in the minimum benefits packages in all three major national healthcare reform bills now being considered by Congress, and each also includes equal coverage of addiction-related services as outlined in the 2008 Wellstone parity bill.

Carol McDaid of Capital Decisions, who lobbies on behalf of addiction treatment and prevention organizations,said that of the five “big buckets” that advocates for addiction services need to fill in the healthcare reform debate, at least these two are being treated favorably by lawmakers, while work still needs to be done on three others — prevention, workforce development, and electronic health records.

“We’re thrilled [addiction treatment is] in at this point,” said Victor Capoccia, Ph.D., director of the Closing the Addiction Treatment Gap (CATG) program, which this week issued a white paper stating that covering addiction treatment services under healthcare reform could make a major contribution to cutting health costs.

Compared to the last big health reform battle on Capital Hill — Hillary Clinton’s ill-fated stab at universal coverage in 1993-94 — “we’re in much better shape as a field in terms of advocacy,” said McDaid.

That’s due in part to the fact that the field waged a recent and successful battle for inclusion in and passage of the parity law, so the arguments in favor of addiction treatment coverage are still fresh in policymakers’ minds, noted McDaid.

Also, federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of National Drug Control Policy have been far more engaged in collaborating with the field under the Obama administration, and cooperation between the addiction and mental-health communities has matured and coalesced around the Coalition for Whole Health, said McDaid.

For example, SAMHSA recently issued a consensus statement calling for addiction and mental health services to be included in healthcare reform and outlining a series of core principles for reform, while the Coalition for Whole Health has drafted legislative language reflecting the field’s priorities.

CATG, funded by the Open Society Institute, helped organize a July 17 briefing for Washington, D.C., policymakers on the case for addiction treatment in health reform. The hearing, which was attended by more than 230 people, will be followed by a series of regional policy panels during the Congressional summer recess, according to Capoccia. The group also sponsored a survey released in June showing that a solid majority of American support inclusion of addiction treatment in national healthcare reform, and plans a more detailed followup survey later this summer.

Progress on Prevention

Addiction-field advocates have made some progress towards ensuring that alcohol and other drug prevention services are included in the preventive-health provisions of the healthcare reform legislation. The bills will also cover screening and brief intervention for problem drinking as a covered preventive service. “This is enormously important, because research has shown that widespread screening can lead to significant reductions in alcohol related medical expenses,” said David Rosenbloom, president and CEO of the National Center on Addiction and Substance Abuse (CASA) at Columbia University.

However, “There are certainly gaps in how coverage will be included” for prevention services, cautioned Capoccia.

Advocates also are working to ensure that addiction-treatment professionals can share in the workforce-development programs envisioned under the various bills, such as forgiveness for educational loans and increased slots for medical residents. “It could become a real issue if we get parity and have a big increase in patients with no providers to serve them,” pointed out McDaid.

Finally, field leaders are pressing lawmakers to ensure that addiction-treatment providers can tap into assistance to develop and enhance electronic health records to improve coordination and efficiency, while at the same time recognizing the special confidentiality issues inherent in addiction treatment, McDaid said.

Currently, the addiction field “comes out better in the House Tri-Committee bill,” said McDaid, although she stressed that the measures are “good across the board.” None of the bills deal with the specifics of healthcare benefits, which would be spelled out after passage by special committees established under the reform act.

A ‘Secret Weapon’ to Cut Healthcare Costs

Capoccia goes beyond arguing for simple inclusion, arguing that expanding addiction treatment for the estimated 20 million American who need it could be a “secret weapon” for cutting overall healthcare costs in the U.S. “When you treat people, their use of general medical services and associated costs both decrease,” he said. “Even if you only help one-fifth, 25 percent of them, it begins to translate into lost of money on an annual basis — to say nothing of the fact that people with an illness should get treatment, period.”

CASA’s Rosenbloom urged lawmakers to consider raising the federal tax on alcohol as part of health-reform legislation. “It will raise a lot of the money needed to pay for reform and also lower future medical care costs,” he said. “When the price of alcohol goes up, problematic drinking by young people and the small number of very heavy drinkers goes down.” Rosenbloom said research shows that governments currently spend $7 dealing with the consequences of excessive alcohol use for every dollar they collect in alcohol taxes.

McDaid — who would like to convince lawmakers to get the Congressional Budget Office to score addiction treatment services and conduct a cost-benefit analysis of inclusion in health reform — said she’s not surprised that the public and members of Congress are reacting sharply to the cost of healthcare reform now that specifics are emerging. She expects that the debate will stretch out much further than the summer.

“I still believe we will get something done, though I think Congress may be in until Christmas Eve,” she said. “The question is how significant will it be — will it be incremental or a whole-system reform?”

McDaid is less concerned about Congress backtracking on providing coverage for addiction treatment services. “I think many of the victories we have had will be sustained” in whatever reform bill passes, she said.

What Comes After Reform?

For the addiction field, the hard work will hardly be starting if and when the ink dries on a healthcare reform bill. While lawmakers may be willing to finally deny the myth that addiction treatment is too expensive and accept that it saves money in the long run — and Washington’s recent embrace of drug courts suggests they are — the field still faces tremendous challenges in terms of accountability and lack of integration with the mainstream healthcare system.

Capoccia said that there is good outcome data to support certain types of treatment, such as medication-assisted programs and those using motivational enhancement and interviewing techniques. Standards developed by the National Quality Forum have been adopted by some states to guide purchasing decisions.

But many programs still lack credible outcome data, and Capoccia predicted that programs that lack accountability and quality standards will be “winnowed out” within five years of healthcare reform passing. “Accountability is written all over healthcare reform,” he said.

Capoccia added that healthcare reform is likely to force addiction treatment providers to become more sophisticated and comprehensive in the services they offer to the patients they “own” — namely, those with severe or persistent addiction or mental-health problems. “If we own them, we’ll have to provide or link to general medical care, too,” he said.

Currently, however, “Our field is woefully unprepared to make the changes necessary to operate in a healthcare-reform environment,” said Capoccia.

Posted July 27, 2009

By: Bob Curley

From:

http://www.jointogether.org/news/features/2009/positive-prognosis-for.html