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The Lifelong Quest For Sobriety…The Ultimate Hero’s Journey—Part 39

Guest Blogger and long-time Council friend, Bob W. presents Part 39 of a series dealing with Alcoholism and Addiction from a Mystical, Mythological Perspective, reflecting Bob’s scholarly work as a Ph.D. in mythological studies.

In Greek mythology, the heiros gamos is a holy ritual, a sacred marriage of a god and goddess, or of an archetypal masculine and feminine, that results in a perfect union of certain key elements of the human experience. It appears in many other systems – mythological, spiritual and psychological – in the same context, a glorified union of the key elements of both genders of humanity.

It occurs to me, though, that we might see just such a phenomenon in the evolution of our own individual selves in the recovery process from addictions.

In broad psychoanalytic terms, the two key elements of the human psyche could be seen as the ego, the conscious element of ourselves – how and what we see of ourselves – and the self – that part of us that is who we truly are, at the core of our beings. The ego is what is crafted from the earliest times, formed by how we fit into the world in which we are raised.  In time it may be cloaked by a certain persona that we want (or are taught) the world to see. This may or may not be akin to our authentic selves. The self, on the other hand, is who and what we are at the core, from our earliest consciousness, regardless of how we were raised, or what happened to us over our lives.  It is the self that will ultimately define us.

For those of us inflicted with the diseases of alcoholism or addiction, our egos became the ruling elements of our psyche. Maybe we strove to achieve, working hard against all odds, and built a view of ourselves that was at best majestic, at worst massively grandiose. This view fed our alcoholism, both to elevate its absurdity as well as to medicate the hidden anxiety that it created.  When it got to be too painful to perpetuate, we crashed, monumentally. We hit that point at which there had to be another way to live in the world or the grim reaper of death would become our only companion in a descent to oblivion.

The journey to recovery thus begun also became a slow and developing process to rewire our own brains.  For this alcoholic, it signaled a journey of discovery to find myself, the core of who and what I am. The last stages of this journey, for me, is becoming a heiros gamos, a marriage of my ego and my self. The ego is still important to me, to us; it is the warrior part of us, that part infused with a healthy narcissism, enabling me/us to face the world without a debilitating fear that needs medication.  But the self, that core of who and what we are, must come forward, must rise up in stature to form a true union of equals with our ego.

The union thus created by my own heiros gamos, this spectacular sensation of finally feeling, fully and completely, who and what I am and what I can be, is a gift of grace of unimaginable magnitude.  More on this in a later note….

Cornyn, Feinstein Substance Abuse Prevention Bill Passes in Opioids Package

U.S. Senate Passes of The Opioid Crisis Response Act of 2018

The Council on Recovery applauds the efforts of the United States Senate in passing the Opioid Crisis Response Act of 2018 by a vote of 99-1. The bill included the Substance Abuse Prevention Act, sponsored by Senators John Cornyn and Dianne Feinstein. The following press release was issued shortly after the bill passed:

U.S. Senators John Cornyn (R-TX) and Dianne Feinstein (D-CA) released the following statements after their Substance Abuse Prevention Act, a bipartisan bill to reauthorize drug abuse programs, passed as a part of The Opioid Crisis Response Act of 2018.

“Our nation continues to suffer from a drug crisis, and this critical legislation will combat the supply of opioids and help individuals and families suffering from substance abuse,” said Sen. Cornyn. “By including the Substance Abuse Prevention Act in this bill, we will be able to strengthen the ability of law enforcement and healthcare agencies to reduce addiction and support those in recovery.”

“Drug addiction and overdoses have reached crisis levels in our country,” Sen. Feinstein said. “In order to address this issue we must strengthen the agencies and programs that are focused on stopping drug use before it starts, dismantle drug trafficking organizations and expand access to treatment. This bill embraces that strategy by reauthorizing the Office of National Drug Control Policy and other successful initiatives like the Drug-Free Communities and High Intensity Drug Trafficking Areas programs. The bill also establishes new programs to provide law enforcement with tools, training and equipment to detect and prevent fentanyl-related overdoses and to ensure families and children have more access to substance abuse treatment.”

Background:

The Substance Abuse Prevention Act was originally introduced by Senators Cornyn and Feinstein to reauthorize drug abuse programs, and to provide assistance to various agencies so they can better combat opioid addiction and support those recovering from substance abuse.

  • Office of National Drug Control Policy: Reauthorizes the Office of National Drug Control Policy (ONDCP) at the White House, which oversees Executive Branch efforts on narcotics control and ensures efforts complement and strengthen state and local anti-drug activates.
  • Drug Abuse Prevention Programs: Reauthorizes several important programs under the ONDCP including the Drug-Free Communities Program and the High-Intensity Drug Trafficking Area Program and allows the ONDCP Director to participate in and expand opioid and heroin awareness campaigns which were authorized under the Comprehensive Addiction and Recovery Act (CARA).
  • Drug Courts: Reauthorizes Department of Justice funding for drug courts, which provide targeted interventions for individuals with drug addiction and substance abuse disorders and allows non-profit organizations to provide important training and technical assistance to drug courts.
  • Supporting Families with Substance Abuse Challenges: Provides resources to the Department of Health and Humans Services (HHS) for screening, treatment, supportive housing, and interventions in order to help support families as they battle substance abuse challenges.
  •  Better Substance Abuse Treatment: Directs the Government Accountability Office (GAO) to conduct a study on reimbursements for substance use disorder services and make recommendations in order to bring parity to and improve reimbursements.
  • Educating Prescribers: Requires Attorney General and HHS Secretary to complete a plan for educating and training medical practitioners in best practices for prescribing controlled substances.
  • Supporting Education and Awareness: Allows the Attorney General to make grants available to entities that focus on substance use disorders and specialize in family and patient services.
  • Sobriety Treatment and Recovery Teams: Authorizes the Director of ONDCP in coordination with SAMHSA to provide grants to establish Sobriety Treatment and Recovery Teams (START) to determine the effectiveness of pairing social workers and mentors with families that are struggling with substance use disorder and child abuse or neglect.

The following groups supported the Substance Abuse Prevention Act: the Community Anti-Drug Coalitions of America (CADCA), the Addiction Policy Forum, the National Association for Children of Addiction (NACoA), the Moyer Foundation, the National Council for Behavioral Health, the National District Attorneys Association, the Fraternal Order of Police, the National HIDTA Directors Association, the Partnership for Drug-Free Kids, the National Criminal Justice Association, the National Association of Police Organizations, and the National Association of Drug Court Professionals.

CNN Reports Nearly 30% of All Opioid Prescriptions Lack Medical Explanation

Nearly 30% of All Opioid Prescriptions Lack Medical Explanation [Click to watch CNN report]
This CNN story reported findings of a recent study by the Annals of Internal Medicine that indicated nearly 30% of all opioid prescriptions lack medical explanation:

(CNN) How large a role do doctors play in the opioid crisis? Nearly 30% of all opioids prescribed in US clinics or doctors’ offices lack a documented reason — such as severe back pain — to justify a script for these addictive drugs, new research finds.

In total, opioids were prescribed in almost 809 million outpatient visits over a 10-year period, with 66.4% of these prescriptions intended to treat non-cancer pain and 5.1% for cancer-related pain, according to a study published Monday in the journal Annals of Internal Medicine.

However, for the remaining 28.5% of prescriptions — about three out of every 10 patients — there was no record of either pain symptoms or a pain-related condition, the Harvard Medical School and RAND Corp. researchers say.

‘Inappropriate prescribing’

“For these visits, it is unclear why a physician chose to prescribe an opioid or whether opioid therapy is justified,” said Dr. Tisamarie B. Sherry, lead author of the study and an associate physician policy researcher at RAND. “The reasons for this could be truly inappropriate prescribing of opioids or merely lax documentation.”

Sherry and her colleagues, who analyzed data from the National Ambulatory Medical Care Survey for 2006 through 2015, say the most common diagnoses at doctor visits that lacked medical justification were high blood pressure, high cholesterol, opioid dependence and “other follow-up examination.”

Opioid dependence, which accounted for only 2.2% of these diagnoses, cannot explain why a doctor failed to give an adequate reason for prescribing addictive painkillers.

“If a doctor does not document a medical reason for prescribing an opioid, it could mean that the prescription is not clinically appropriate,” Sherry said. “But it could also mean that the doctor simply missed recording the medical justification for an opioid, perhaps due to time constraints, clinic workflows or complicated documentation systems.”

We cannot assume that poor record-keeping “indicates a nefarious purpose on the part of the doctor,” she added.

Social media’s contribution

Tim K. Mackey, an associate professor at the University of California, San Diego School of Medicine and director of the Global Health Policy Institute, described the new study as “an important analysis,” with the findings highlighting “gaps in our understanding of why clinicians prescribed opioids.”

Mackey, who did not participate in the research, believes that the study could lead to stricter prescribing guidelines, which in turn could give rise to “unforeseen consequences.” For example, if new guidelines and initiatives make it harder for people to access opioids from hospitals and clinics, “this could shift demand to more accessible platforms, including the internet,” he wrote in an email.

“The public health danger of sales of opioids online has been well recognized by the US government, with a US General Accounting Office report from as early as 2004 warning about pain medications available online without a prescription,” he said.

Mackey’s own research highlights how online pharmacies use social media to sell controlled substances while drug dealers use Twitter to sell opioids by including their phone or email information.
Someone may start by getting medication for a legitimate “pain” diagnosis, but once they become addicted, their health provider may no longer be willing to write scripts, Mackey said.

“After exhausting friends, relatives and other personal contacts, many may go to illicit channels, including street buys no longer confined to the ‘street’ but digitized on social media,” he said. Some turn to internet pharmacies despite concerns about fraud and identify theft.

“Either way, this dangerous progression of different access points that continues to enable the opioid epidemic is not well understood,” Mackey said.

With more data needed to make sense of this public health crisis, technology companies, regulators, law enforcement and researchers need to come together to share ideas, innovations and research, he said.
“Unfortunately, some of this needed collaboration may be elusive,” he said. He explained that researchers who use machine-learning and Twitter’s public application programming interface to detect illicit online activity are prevented from sharing their findings with law enforcement due to Twitter’s terms of use.

“This leaves regulators like the US Food and Drug Administration and the US Department of Justice in the dark about how they can cut off this dangerous channel of access that may continue to fuel the opioid crisis even after we make strides in other areas, such as physician prescribing,” Mackey said.

Sherry said another key finding of her study was that “physicians were especially lax at documenting their medical reasons for continuing chronic opioid prescriptions” despite government guidelines from 2016 recommending “periodic formal re-evaluation” in cases of long-term opioid treatment.

“It is now more important than ever for physicians to transparently and accurately document their justification for using an opioid so that we can identify and rectify problematic prescribing behavior,” Sherry said. “Our findings indicate that we still have a long way to go to reach this goal.”

Center for Recovering Families IOP Program Completion Rate Twice the National Average

The Council on Recovery’s Center for Recovering Families posted a 74% completion rate per episode of care for its Healing Choices intensive outpatient treatment program (IOP) during the 2018 fiscal year. This rate of completion is 14% higher than 2017 and more than twice the national average reported in the most recent survey by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The rate of completion is based on discharge data routinely tracked by treatment facilities and reported to SAMHSA, and may be one of the best indicators of program success. In the case of Healing Choices, nearly three-quarters of the clients who entered this intensive eight-week outpatient treatment program completed it and many continued in the Center’s aftercare program. The latest national data provided by SAMHSA indicates the average completion rate for IOP programs is only 32%.

Lori Fiester, Clinical Director of the Center for Recovering Families, gives credit for the success of the Healing Choices program to her dedicated staff. “They have been the ones facilitating these treatment groups,” Fiester says, “and behind every great group facilitator is a whole team that touch on the clients and their families with their assessment and individual and family sessions.”

The Center for Recovering Families provides a wide range of clinical services and counseling for individuals and families across the entire spectrum of mental health and substance use disorders. Since becoming part of The Council on Recovery in 2002, the Center has helped thousands with programs aimed at prevention, education, treatment, recovery for children, adolescents, and adults. Healing Choices is the flagship of the Center for Recovering families, and is unique among IOP programs in its ability to help individuals and their families recover.

“While the data confirms the success of Healing Choices,” Fiester says, “it’s our people who make that happen. The connections they make with their clients, paired with their therapeutic skills, are unparalleled.”

For more information about Healing Choices or any other programs at the Center for Recovering Families, call 713-914-0556 or contact us online.

 

 

 

The Lifelong Quest For Sobriety…The Ultimate Hero’s Journey—Part 38

Guest Blogger and long-time Council friend, Bob W. presents Part 38 of a series dealing with Alcoholism and Addiction from a Mystical, Mythological Perspective, reflecting Bob’s scholarly work as a Ph.D. in mythological studies.

In Herman Melville’s classic, Moby-Dick, Captain Ahab was near mortally wounded by a powerful albino sperm whale named Moby Dick.  He became obsessed with the need to kill Moby Dick and, in a subsequent whaling voyage aboard the whale ship Pequod, he hijacks the vessel and crew and sets out on this murderous quest.  The whale is too powerful, however, and, in the end, the whale destroys the Pequod killing Ahab and all the ship’s hands in the process, all the men except Ishmael, one of the seamen who is also the narrator of the book.

In the description of Ahab’s obsession with Moby Dick early in the book, Ishmael (Melville) describes it as follows: “The White Whale swam before him as the monomaniac incarnation of all those malicious agencies which some deep men feel eating in them, till they are left living on with half a heart and half a lung. [….] All that most maddens and torments; all that stirs up the lees of things; all truth with malice in it; all that cracks the sinews and cakes the brain; all the subtle demonisms of life and thought; all evil, to crazy Ahab, were visibly personified, and made practically assailable in Moby Dick. He piled upon the whale’s white hump the sum of all the general rage and hate felt by his whole race from Adam down; and then, as if his chest had been a mortar, he burst his hot heart’s shell upon it.”

In our days steeped in alcohol and drugs, we may have experienced serious incidents of trauma, not unlike Ahab’s initial encounter with Moby Dick, situations which became monstrous resentments, resentments which we medicated ad nauseam with alcohol and drugs. When we got sober, these “demonisms of life” didn’t go away; we just lost the mechanisms to medicate the feelings. We soon learned that dealing with these situations and events, these deep seated resentments, without the medicating effects of alcohol and drugs required a new set of tools and a connection to a power greater than ourselves. Meetings, reading the literature, rigorously working the Steps with a sponsor, and staying close to multiple friends in the Fellowship became a daily process to handle the issues that arise from those feelings and resentments that continually show up in different forms in our daily lives.

The power of these recurring resentments can become debilitating at times, but we learn to deal with them. For, to give them power, to allow them to control us as his hatred of Moby Dick controlled Ahab, would be to insure our ultimate demise in much the same way, and perhaps as ultimately dramatic, as was Ahab’s.

September is National Recovery Month

National Recovery Month (Recovery Month) increases awareness and understanding of mental and substance use disorders and encourages individuals in need of treatment and recovery services to seek help. Recovery Month celebrates individuals living their lives in recovery and recognizes the dedicated workers who provide the prevention, treatment, and recovery support services that make it possible.

This year’s Recovery Month theme focuses on urban communities, health care providers, members of the media, and policymakers, highlighting the various entities that support recovery within our society. The theme, “Join the Voices for Recovery: Invest in Health, Home, Purpose, and Community,” explores how integrated care, a strong community, sense of purpose, and leadership contributes to effective treatments that sustain the recovery of persons with mental and substance use disorders.

The 2018 observance also aims to increase awareness and encourages audiences to take advantage of the increased dialogue around the nation’s behavioral health needs and the increased emphasis on tackling our nation’s opioid crisis.

Throughout September, The Council will use its website and social media channels to promote resources that help our community educate individuals about mental and substance use disorders. We will encourage individuals and families to seek treatment and recovery services for these disorders and highlight the programs The Council offers that can help.

National Recovery Month is part of a national campaign sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).