ADDICTION AND RECOVERY UPDATES

LET’S TALK ABOUT….RECOVERY AND TREATMENT UPDATES!!! To keep you up-to-date with what is going on in the field of recovery and treatment I offer you these facts:

DO DRUG ABUSERS FULLY RECOVER?

There are many variables to project full recovery: type of drugs used, the quality and quantity used, the environment used in, and the length of use.  My belief is that no one really totally recovers; the experience in itself will forever change the person using, their family, and other loved ones.

Now we are learning that Fentanyl overdoses, (Ask MAx, 040716) “… Fentanyl is so potent it only takes minutes without breathing and they’ve got brain complications..”. says Dr. Del Dorscheid, St. Paul’s Hospital, Vancouver. He said that he is seeing “more and more brain injuries caused by overdoses. He estimates up to 90% of his overdose cases suffer from brain minor injury to complete loss of brain function.

Consequently, even when a drug abuser commits to never using again, they will never be the same. Also, as the numbers rise, more up-to-date approaches to addiction recovery need to be included in treatment approaches that will address the brain injuries.

WARNING ABOUT CARFENTANIL!

Carfentanil, a drug never intended for human use, with a potency 10,000 times that of morphine, used as a sedative for large animals, like elephants, and cut into heroin and other street drugs, is becoming more prevalent.

The National Institute of Drug Abuse (NIDA) published a nationwide warning from the Drug Enforcement Administration (DEA) about human use of the opioid sedative carfentanil underscoring its danger.

As previously discussed in this column, the DEA had cautioned that emergency first responders must wear hazmat gear when approaching an overdose body in a known carfentanil area as it can be lethal if inhaled, or, if absorbed through the skin.

Imagine having to identify a loved one’s body wearing a hazmat suit!?

GAMBLING: HIGHLY UNDERRATED ADDICTION

Results of serious research into the connection of substance abuse disorders and gambling disorders are starting to surface.

Gambling is as insidious as any substance abuse disorder. Gambling disorders destroy individuals and families.

The National Gambling Impact Study Commission found that 2.7% of American adults have a gambling problem.

Gambling Disorders are recognized in the official Diagnostic and Statistical Manual of Mental Disorders (DSM–5) defined as “Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress…”

Professional observations of my own clients over a 15 year period indicate that compulsive gambling is like the “default” addiction during early recovery, particularly among clients that are on prescribed maintenance drugs, like methadone.

Early studies by Seth Himeloch, MD, MPH, University of Maryland, has suggested that people who are on maintenance treatment are “…over 8 times more likely to be using opioids during methadone treatment…” Dr. Himeloch research provides new diagnostic tools to address this possible co-occurring problem.

Thanks to the turn of the 20th century insights by Dr. William D. Silkworth, Towns Hospital, NY, proclaiming addiction a “disease”, and, the ongoing research through the 21st century, that identified all addictions as a “disease of the brain”, we continue to discover new ways to treat people with addiction disorders. That’s progress to support!

Glad we talked about this. Of course, it is just my opinion.

This column is reprinted from the Springfield Times (SpringfieldTimes.net) weekly column "Ask MAx". The Springfield Times is published weekly for Thursday delivery. Subscribe at 541-741-7368.

You can comment on this article and make suggestions for future columns: maxfabry@LifestyleChangesCounseling.com. Or, snail mail your topics to Lifestyle Changes, PO Box 1962, Eugene, OR  97440.

ADDICTION AND RECOVERY: 5 STAGES OF TREATMENT

LET’S TALK ABOUT….TOO MUCH, TOO SOON!!! The biggest advantage to individual treatment vs group treatment, is the emphasis on individual client-centered therapy. No two people that suffer from substance disorders are the same. For the most part, the five stages of treatment, as recommended by the National Institute of Health/SAMHSA, is integrated as an outline for success. (read details at https://www.ncbi.nlm.nih.gov) These guidelines are used to measure where the client is, and, where we go next.

These stages are unique to the individual who maneuvers through each at their own speed. There is not a time limit on each stage. And, while the individual will begin to move forward through the stages, they may also go backwards (referred to as “relapse”), or, jump around from one stage to another (often continues to exhibit signs of remission—not using, but old behaviors are showing up)

The five stages of internal healing from substance disorders:

1.      Denial—tries to convince themselves and others their use is normal and not a problem. Avoids talking about the possibility of a substance disorder.

2.      Acceptance And Letting Go—accepting that they “may have a problem”—usually triggered by a “life happens” event, such as a DUII. Open for treatment discussion.

3.      Seek Treatment—after reflecting on how they “got to this place” they make a decision that they are making the right choice by focusing on the future. They choose a treatment provider.

4.      Mental Clarity—during the first month of recovery, the body detoxes, and the brain begins to improve mental and emotional function.

5.      Commitment to Recovery And Ongoing Counseling—with mental clarity, the process of working toward a healthier lifestyle can begin.

“As clients move through different stages of recovery, treatment must move with them, changing therapeutic strategies and leadership roles with the condition of the clients. These changes are vital since interventions that work well early in treatment may be ineffective, and even harmful, if applied in the same way later in treatment.” (NIH)

Irvin Yalon, M.D., Psychotherapist, defined 11 therapeutic factors that contribute to healing from substance disorders. Among the factors:

• Instilling hope—“Hope is essential for people who are coping with serious and prolonged psychological stress...hope and coping is dynamic and reciprocal; each in turn supports and is supported by the other.” Susan Folkmna, PhD, UCSF.
• Universality—clients need to see that they are not alone, that others have similar problems. Talking with other known substance disorder friends and family members, visiting 12 Step support meetings, listening to TED talks, etc.
• Resolve family issues and develop socializing techniques—correct ineffective social habits that had undermined relationships, including long-standing conflicts with family and friends.
• Existential factors—coming to terms with hard truths, such as : each of us is responsible for the ways in which we live.

Managing the stages and therapeutic factors is easier to track with individual counseling. These are some of the tools used to help identify that they are doing too much, too soon. For instance: 30days after “treatment”, the client is returning to family life, working, and, going to school (=relapse). Doing too much, too soon is not a good thing.

Glad we talked about this. Of course, it is just my opinion.

This column is reprinted from the Springfield Times (SpringfieldTimes.net) weekly column "Ask MAx". The Springfield Times is published weekly for Thursday delivery. Subscribe at 541-741-7368.

You can comment on this article and make suggestions for future columns: maxfabry@LifestyleChangesCounseling.com. Or, snail mail your topics to Lifestyle Changes, PO Box 1962, Eugene, OR  97440. 

ADDICTION AND RECOVERY: CHANGE

LET’S TALK ABOUT…..CHANGE! As a nation, we are preparing for a huge change in leadership which will, consequently, trickle down to challenge each of our individual sensibilities. Like a pebble in a pond, the changes “on high” will influence what we choose to create in our own life.

Change is constant. How people react to the change is individual, and, ultimately, determines individual growth and creates understanding of the nation and the world.

People usually approach change in one of three ways:

1.      Fear

2.      Excitement

3.      Creatively

People that generally apprehensively approach life do so based on preconceived and/or learned fears. The Maartan “Philosophical Dictionary” explains that “Fear” is defined as “Expectation of something undesirable or painful.

“…fear is one of the great movers of mankind: Fear of pain, fear of failure, fear of what others may think or say, fear of seeming different from most, fear of failing to please the powerful, fear of God, fear of The Party….the list is endless….It would seem as if much that goes into the making of human society is based on human fears...and that just like most fears are mostly not realistic.”

“Few men are willing to brave the disapproval of their peers, the censure of their colleagues, the wrath of their society. Moral courage is a rarer commodity than bravery in battle or great intelligence. Yet it is the one essential, vital quality for those who seek to change a world that yields most painfully to change.” Robert F. Kennedy

Then there are those of us that see change as a new adventure. Every morning we wake up excited to experience what the day will bring us. If the day doesn’t bring something fast enough, we find a way to create the excitement ourselves:

1.      Start a unique business

2.      Write a blog to inspire change

3.      Volunteer with an activist group

4.      Serve on community committees

5.      Always speak your truth from your heart

All five of these activities involve contributing to change.

“Let no one be discouraged by the belief there is nothing one person can do against the enormous array of the world's ills, misery, ignorance, and violence. Few will have the greatness to bend history, but each of us can work to change a small portion of events. And in the total of all those acts will be written the history of a generation.”  Robert F. Kennedy

There are also those talented clever people that use their creativity through pose, satire, and visual arts to make creative change through individual interpretations.

Powerful creative change-makers include: fairy tales (Dr. Suess “The Bread and Butter Battle”), lyrics to music (Joan Baez “Where Have All The Flowers Gone), movies (Orson Wells “Citizen Kane”), novels (Robert Penn Warren “All The President’s Men”), art (Chamomile Tea Party “Vote Your Conscience”), TV (“House of Cards), theater (Lin-Manuel Miranda’s “Hamilton”, and, of late, social media, particularly “Twitter”, have all been powerful change-makers.

And, let us recognize, never forget, and defend the most powerful creativity is as a result of free speech and free press.

“…each of us can work to change a small portion of events…” Robert Kennedy.

Glad we talked about this. Of course, it is just my opinion.

This column is reprinted from the Springfield Times (SpringfieldTimes.net) weekly column "Ask MAx". The Springfield Times is published weekly for Thursday delivery. Subscribe at 541-741-7368.

You can comment on this article and make suggestions for future columns: maxfabry@LifestyleChangesCounseling.com. Or, snail mail your topics to Lifestyle Changes, PO Box 1962, Eugene, OR  97440.

ADDICTION AND RECOVERY: DONE WITH TREATMENT--NOW WHAT-!?!

LET’S TALK ABOUT…COMPLETED TREATMENT PROGRAM—NOW WHAT? One of my clients called to proudly announce that he had completed his 30 day “treatment program”. I was as proud of him as he was of himself for being “clean and sober for 30 days!” His next question “Now what, MAx?”

My response “Now the work really begins.”

Being “clean and sober”, whether for 30 days or 30 years, doesn’t mean you are in total recovery. It means that you are giving your mind, body, and spirit a time-out from abuse with alcohol and/or drugs.

Being “clean and sober” means that your mind and body have started to detox enough to make a serious decision about committing to a healthier lifestyle.

Being “clean and sober” means working on putting your mind, body, and spirit in perfect healthy alignment.

One of the important recovery concepts learned in both traditional and holistic treatment programs is that you are not alone in either your addiction, or, your recovery: there will always be a convenient 12 Step program available to support your efforts. It provides an environment of people that have had similar experiences, so everyone knows your story and is prepared to share their experiences and what helped them with their success.

“Support” is crucial during the early recovery period. For many, because they burned so many bridges, 12 Step may be their only support. The lucky ones are those that have had families that have hung in through the worse of the worse: angry meltdowns, theft, homelessness, jail, and other antisocial behaviors. These are character traits learned while living and surviving in the world of addiction. 

Recognizing and changing these behaviors is where the work really begins.

Having a supportive family is like having a jump start on healing. As you continue to detox, being around your family will help you slide back into the strong foundation that is based on your family’s healthy values and beliefs. The family is the ideal deprogrammers necessary to lovingly reindoctrinate you back to familiar conventional thinking.

A healthy family and friends make up a huge factor for successful recovery.

From a holistic approach for substance abuse disorders, here are other factors that lead to a successful healthier lifestyle:

Have a regular routine that addresses the mind, body, and center.

   -Address individual nutritional needs that allows the body to heal nutrient depletion

   -Drink lots of water to allow easier physical movements and the ability to think clearer.

   -Regular moderate and high intensity aerobic exercises, as suggested by the Guidelines of          American College of Sports Medicine, that allows for a better chance of abstinence, decreases anxiety, and eases withdrawal and depression symptoms.

   -Surround yourself with healthy people that strive to be even better people, and, know that you deserve to be one of them.

   -Review, renew, and renovate your values and your beliefs—being in recovery means that you have learned a lot more about life, update based on the lessons you have learned.

   -Define your purpose and make daily steps to live it.

FAMILY MATTERS in recovery.

YOU WANTING to change is the KEY to recovery.

Glad we talked about this. Of course, it is just my opinion.

This column is reprinted from the Springfield Times (SpringfieldTimes.net) weekly column "Ask MAx". The Springfield Times is published weekly for Thursday delivery. Subscribe at 541-741-7368.

You can comment on this article and make suggestions for future columns: maxfabry@LifestyleChangesCounseling.com. Or, snail mail your topics to Lifestyle Changes, PO Box 1962, Eugene, OR  97440.!

ADDICTION AND RECOVERY: MEMORIAL TO DWIGHT LEE

LET’S TALK ABOUT…THE LEGACY OF DWIGHT LEE!!! Dwight Lee has been a resident of Eugene/Springfield, OR, since the early eighties. Not only were his treasured twin daughters born here, the transformation of his life took place. He was a dedicated spiritual guide for people on a journey of addiction.

Dwight was born in the small village of New Haven, Michigan, in 1945. Like most people born 1945 to present, Dwight’s small town upbringing set the foundation for coping strategies that he would need to address the changes in the world that would influence his life: the revolutions of the 50’s, 60’s, 70’, including the Civil Rights Movement.

He found his place in sports, primarily as a running back football player starting in high school, all-star Michigan State, including the 1966 Rose Bowl; he eventually was recruited by the San Francisco 49ers, then traded to the Falcons. These are the stories that everyone wanted to hear from Dwight; they were the most difficult stories he would have to repeat as his path continued forward and downward.

Dwight once recalled to me his step by step decline starting as a small town black boy heralded for his size and athleticism, “flung into a limelight where you are treated one way while “performing” for the crowds, and, another way off the field as a young black man” growing up during the civil rights movement.

“When you come from where I did, you don’t know about the temptations coming your way…and, how all those temptations will take everything away from you…”

Dwight would reminisce about the fame and riches that came to him because of his talents, and, how it, all too soon, led him into the path of dark challenges that would eventually lead him to the great man he really was—not a sports figure, but a spiritual guide for others that were led down the pathway to nothing.

Dwight and I had both started working in the field of addictions around the same time. Our paths crossed when we shared an office while working for a treatment center. Dwight immediately became my mentor, my friend, and, eventually, a business partner. When we would get scolded for our “rebel” approaches, Dwight would say:

 “…We don’t work for them (administrators), MAx. We do what we do for the client. They aren’t guiding us, God is guiding us. We always need to do what is right for our client—and God will let us know what that is. You listen to Him, not them.”

When we started a private practice, Della, his beloved wife, wrote these words for Dwight’s bio on the website: “Dwight Lee’s losses to alcoholism and drug addiction were many: a professional football career;…his reputation, self-respect, and freedom; and the near loss of his second wife and twin daughters.  His gains?  A life of consequences, (that led to) working to help recovering addicts and alcoholics and spreading the word of God through his Christian faith.”

DWIGHT LEE

 RIP: 1945-2016

My mentor and an

authentic human being

You lived your journey well,

and,

 you made a difference.

AND SO IT IS!!

Glad we talked about this. Of course, it is just my opinion.

This column is reprinted from the Springfield Times (SpringfieldTimes.net) weekly column "Ask MAx". The Springfield Times is published weekly for Thursday delivery. Subscribe at 541-741-7368.

You can comment on this article and make suggestions for future columns: maxfabry@LifestyleChangesCounseling.com. Or, snail mail your topics to Lifestyle Changes, PO Box 1962, Eugene, OR  97440.

WISE USE OF TR

Reprinted from SPRINGFIELD TIMES, Eugene, OR

SPRINGFIELDTIMES.NET 

Dear MAx,

I recently retired with a great plan to travel, do some hobbies, learn new things—I was really excited about this new life that my wife and I were going to start. No sooner did we make our first travel plans that our 29 year old son announced that he was moving home because things were uncertain at his job. That was two years ago. This just isn’t what I thought retirement was going to be. 

How can I get my son out on his again so my wife and I can get on with our lives?

 

Robert

Dear Robert,

Adult children returning home seems to be a common theme these days. You and your wife are experiencing what so many other empty nestors are experiencing: the boomerang generation.

The boomerang generation is part of approximately 76 million Generation Y group born from 1978 to 2000. According to the US Census, in 2006, of the people between 18 and 24 years old, 53 percent of American males and 43 percent of American females were living at home with their parents. With the economical challenges presently being presented I am sure future Census data will show that both the numbers and age of people returning home is increasing.

Boomerang adults aren’t the only unexpected twist happening with the retiring population.

Census data also shows that there are over 6 million grandchildren being raised either directly, or indirectly, by their grandparents. And, according to a 2008 AARP Newsletter, it is estimated that over “50 million people are caring for chronically ill or elderly relatives during any given year.”

Problems that are presented can include privacy being invaded, finances being stretched, and feeling disoriented as to what your role as a parent is in this situation. Your role is no longer parent to child. What do you think would happen if you parented adult to adult?

Combining lifestyles of two different generations can be very difficult. Neither generational lifestyle is right nor wrong; it is just different. Here are some suggestions of how you may be able to return to a blissful retirement:

1. Set a projected date of when your son will leave. This date can be a month, a year, two years, what ever is agreed upon. This date offers a light at the end of the tunnel.
2. Set rules which would include your son conforming to your lifestyle; you do not have to conform to his lifestyle. Address use of alcohol and/or drugs, TVs, computers, video games, bringing dates home, etc. 
3. Charge rent. If you are in a solid financial situation and don’t really need the money, put the money in a bank account that would be available for his relocation.

Remember that even though you are coming from a place of love for your child, he is an adult. Have confidence in yourself that you and your wife gave him a good foundation to survive in the world and to work hard to create his own reality.

After all, Robert, you  and your wife have worked hard to create this retirement time in your life: start enjoying your TR (time remaining). “The best is yet to come.”

Glad we talked about this. Of course, it is just my opinion.

Be well on your autumn journey.

________________________________________________________________

Have a question about addiction, recovery, or other life transitions: ‘Ask MAx’. Send questions to Lifestyle Changes, PO Box 1962, Eugene, OR  97440; or, e-mail your questions to:  maxfabry@lifestylechangescounseling.com

________________________________________________________________________

LIFESTYLE CHANGES COUNSELING SERVICES

MA FABRY COUNSELING

105 W. “Q” Street, Springfield, OR  97477

Mail: PO Box 1962, Eugene, OR  97440

541-510-2548   maxfabry@lifestylechangescounseling.com

www.lifestylechangescounseling.com

NORMIES TEST FOR SOBRIETY

Reprinted from SPRINGFIELD TIMES, Eugene, OR

SPRINGFIELDTIMES.NET 

Dear MAx,

I met the most fantastic woman while training for a marathon.When we completed the marathon I knew she was “the one”. I was devastated when she broke up with me because, she said, I was a “normie” and her sponsor told her that she wasn’t ready for a relationship—particularly with a ‘normie”. What?!! What is a “normie”?

Sean

Dear Sean,

One of the earliest definitions of the word “normie” was to describe anyone that did not have a diagnosis of a mental illness. The word is commonly used in 12-step meetings to describe people that have no clue about addiction and/or their process of recovery.

According to a recent article by Carole Bennett, MA, in The Huffington Post: “Normal, daily stressors that the "normie" might take in stride can turn into monumental issues of such a catastrophic nature that their coping devices are non-existent or too early in their infancy to deal with the situation at hand.”

Human beings have a “flight and fight” brain mechanism that prompts them to do one or the other when they think they are in danger.

“Normies” are usually triggered to “fight” because they have the ability and skills to work (fight) through the ups and downs of life experiences.

Recovering people, on the other hand, are triggered to “flight”: “…monumental hurdles to the alcoholic/addict and life on life's terms can be so daunting and overwhelming, their thinking tells them to bail at whatever cost.” The scientific explanation of this reaction is explained by the disruptions of neuro-pathways that generate states of well-being. The “flight” is the by-product of the brain’s inability to process stressful situations.

Most people know that “detox” is the necessary beginning for someone dependent on alcohol and/or other drugs. This is the period of time that toxins are freed from the body. The common time period used by treatment centers is approximately six weeks. In actuality, depending on the length of use, and other simultaneous chemical abuse, it could take the body up to two years to detox; up to five if methamphetamine dependence is a factor.

Once someone is stabilized in their addiction, usually by a 12-step program, they may be prone to experiencing post-acute withdrawal symptoms that can linger for weeks, months, or years. This is an indicator that the recovering person needs to supplement their “recovery” to individualized treatment.

Twelve-step programs are incredibly successful supporting total abstinence, which is what an addict needs –particularly in the early stages of recovery. “The Big Book of Alcoholics Anonymous” reminds program participants that the program is to be used in cooperation with other “professionals in their community”. These professionals include therapists, clergy, and physicians.

Individualized treatment allows the recovering person the opportunity to identify and change “using” behaviors, learn skills to confidently interact with “normies”, and to continue their quest for a healthier lifestyle. When seeking a qualified addiction counselor, life coach, be sure they are certified for addiction treatment.

As for you, Sean, attending Alanon will provide any “normie” with the information and insight they may need for being in a committed relationship with a recovering person.

“If you judge people, you have no time to love them.” Mother Teresa.

Glad we talked about this. Of course, it is just my opinion.

Be well on your insightful journey.

_____________________________________________________________________

Have a question about addiction, recovery, or other life transitions: ‘Ask MAx’. Send your questions to Lifestyle Changes, PO Box 1962, Eugene, OR  97440; or, e-mail your questions to:  maxfabry@lifestylechangescounseling.com

_____________________________________________________________________________

LIFESTYLE CHANGES COUNSELING SERVICES

MA FABRY COUNSELING

105 W. “Q” Street, Springfield, OR  97477

Mail: PO Box 1962, Eugene, OR  97440

541-510-2548   maxfabry@lifestylechangescounseling.com

www.lifestylechangescounseling.com

BOUNDARIES FOR LIFE AND SOCIAL MEDIA

Reprinted from SPRINGFIELD TIMES, Eugene, OR
SPRINGFIELDTIMES.NET 


Dear MAx,

Even though my daughter is very intelligent, she tends to trust people too quickly. Shortly after she meets someone she will talk their ears off sharing information about herself that might not be appropriate. Recently one of her “best friends” shared some very personal confidential information about her on the internet.  As a result, she has been put of probation with her job, lost many of her friends, and feels so mortified she doesn’t want to leave her home. How do I help her through this difficult time.

Ruth

Dear Ruth,

Use to be that slandering by word of mouth among social groups would cause repercussions like your daughter recently experienced. These days slandering, or violating someone’s confidence has extended to the worldwide internet.

In the world of face to face communicate there are three varying levels of disclosure used depending on how long, how well, and how trusted someone is in our personal social circle:

-Intimate: These are people that we have known for a long period of time (usually all our lives), who know everything about us, and still love, accept, and care about us. These are not limited to family and other relatives. This is usually the smallest “social group” in our circle. You feel comfortable enough with these folks to share anything about your life.

-Acquaintance/Friends: These are people that we meet throughout our life journey: colleagues, cliques, interest groups, etc. They may, or may not, know a lot about us, but they don’t know everything. Some of these people slowly make their way to the perimeters of “intimate”, but may never cross that line; others move out toward the next level, lose touch, and only become a distant memory as we move on. This part of the social circle may contain the majority of people in your life. You would tend to censor what you share.

-Strangers: These are people that we deal with on a commerce level, impromptu social events, and long-ago “acquaintance” level. These people may know your name, but not too much more. We share the least amount of disclosure with these people; they quickly move in and out of our life.

The worldwide internet has created an “anything goes” disclosure platform.

Social networking services provide platforms for people to focus on building networks, relationships, and share ideas, general thoughts, and common activities. A survey completed in 2011 found that 47% of Americans use a social networking service. These platforms are not always friendly, welcoming, or safe.

Social networking created a new social malady: cyber bullying. It started with cyber-bullying of middle school and high school students, and has now become a way of freely defaming, or casting shadows on anyone’s character—adult or child.

Two evil beliefs of social networking:

1.      If something is written for the public to read—it is true: NOT TRUE

2.      Everything written on the internet is true—NOT TRUE

To avoid destructive disclosure, on or off line, maintain the three levels of social disclosure listed above.

As for your daughter, Ruth, ask her to look at the people that have surrounded her with positive support and love through this time. What she will learn is that she has a strong intimate group.

______________________________________________________________________

Have a question about addiction, recovery, or other life transitions: ‘Ask MAx’. Send your questions to Lifestyle Changes, PO Box 1962, Eugene, OR  97440; or, e-mail your questions to:  maxfabry@lifestylechangescounseling.com

_________________________________________________________________

LIFESTYLE CHANGES COUNSELING SERVICES

MA FABRY COUNSELING

105 W. “Q” Street, Springfield, OR  97477

Mail: PO Box 1962, Eugene, OR  97440

541-510-2548   maxfabry@lifestylechangescounseling.com

www.lifestylechangescounseling.com