Author: Justin Mckibben
First, I have to make it clear that any amount of treatment has the potential to make a difference. Every opportunity to take action in the right direction means something. So making the most out of our time is what is so crucial. Still, I want to look at why a month in rehab has become most insurers’ answer to the addiction issue.
Because different people progress through treatment at different paces there is no perfectly predetermined length of treatment. It isn’t a one-size-fits-all kind of thing. However, research shows that clearly good outcomes are contingent on adequate length of time in treatment. Arguably a treatment program of less than 90 days will show limited effectiveness in comparison to longer programs. Many recommend longer lasting treatment for maintaining positive outcomes. Yet, just around a month’s stay can be pretty typical among people who go to an inpatient facility.
So, who came up with the 28 days later standard of treatment? Why do most people only get this amount of time in treatment?
28 Days Later Routine
Kimberly Johnson is director of the Center for Substance Abuse Treatment at SAMHSA. This federal agency studies addiction treatment services. Johnson says,
“As far as I know, there’s nothing magical about 28 days,”
Anne Fletcher, author of the book Inside Rehab, agrees. Fletcher states,
“It certainly is not scientifically based. I live in Minnesota where the model was developed and a lot of treatment across the country really stemmed from that.”
According to Fletcher, the late Daniel Anderson was one of the primary architects of what has been called the “Minnesota model.” This methodology became the prevailing treatment protocol for addiction specialists a long time ago, but how?
The story starts in the 1950’s at a state hospital in Minnesota. Daniel Anderson attended to alcoholics living in locked wards, leaving only to be put to work on a farm. Anderson came up with the 28-day model to find a path for his patients to get sober and leave the hospital. Back then, it was innovative.
Marvin Ventrell, executive director of the National Association of Addiction Treatment Providers, has studied the model’s history. Ventrell says the month-long method comes from the belief that when-
“someone is suffering from addiction — and in the days that this began, we’re pretty much talking about alcoholism — it made sense to people that it took about four weeks to stabilize somebody.”
Ventrell went on to explain this is the norm because the insurance industry became willing to pay for a 28 day period of time. While many treatment providers believe we must adapt with the times, it would seem insurance companies aren’t so sure.
The early form of this 28 day model was designed for alcoholism. One big issue today is the model is used to treat opioid addiction. It is such a problem because recovering from addiction to powerful narcotic drugs just might be different than recovering from alcohol abuse. Therefore, it may require a different method. Yet, many still want to use the 28 day model as a cookie-cutter standard.
Now, to be fair Ventrell admits there isn’t enough research to prove the exact effective length for inpatient opioid addiction treatment. As we said, different individuals may have a different experience and require a different treatment plan. This is one reason why personalized recovery plans are so important.
Fletcher advocates it is incredibly important for treatment to move away from the default month-long model. 28 days is not going to work for everyone, and it would seem one of the biggest hurdles for those in the addiction treatment industry is convincing the insurance industry that the old “Minnesota model” isn’t always enough. 28 days may be enough for some people to make a beginning, but long-term recovery can be seriously influenced by more time learning about factors such as:
There are so many facets of recovery, it makes sense that the more time you have to learn them the more confident you can be in your ability to manage your recovery.
Make Time for Recovery
Besides the fact that giving people more time in a controlled environment can give them more time to focus on their recovery plan, there is also the element of dual diagnosis. While the 28 days model of treatment may have helped back in the 1950’s, we’ve learned a lot in the past 60+ years about addiction and other issues that co-exist.
Many people struggling with addiction are also having to battle with conditions pertaining to mental health disorders. Knowing what we know now, we see mental health disorders and addiction should be addressed simultaneously. If you ignore one, it can cause a relapse into the other later on. Various forms of mental illness can exist along with an addiction, including:
So for some, establishing a full diagnosis and then effectively engaging in the recovery process can take more time.
In the end, we should be making more time for individuals in need of treatment. Unfortunately, it can be an uphill battle with insurance companies. Some programs do exist that are extended inpatient programs, but these facilities still face resistance from insurers. At this point, it is about making the most out of the time you can get. Holistic drug treatment programs like Palm Partners emphasize the importance of exploring every area of recovery in detail, and design personalized recovery plans to make the time most efficient. Insurance companies may try to limit the opportunity, but the opportunity is still a real chance at real change.
CALL NOW 1-800-951-6135
Author: Shernide Delva
There are two sides to every story, and when it comes to alcoholism, the same saying holds truth. A new study examined the changes in the brain that makes a person prone to alcoholism. What they discovered is that there are two types of alcoholic brains: anxiety-prone and impulsive.
Anxiety and impulse control issues are common among alcoholics and the difference between the two could lie in changes in the brain tissues. The brain tissue of alcoholics experience changes that are different from the non-alcoholic brain. Over time, the brain tissue changes from consuming alcohol. Researchers have discovered that there are two types of alcoholic brains: anxiety-prone (Type I) and impulsive-depressive (Type II) and brain changes are exclusive to one type or the other.
Type I Alcoholics: Type I alcoholics typically become dependent on alcohol later in life. These types are prone to anxiety and use alcohol increasingly to resolve these issues.
Type II Alcoholics: These types tend to get hooked on alcohol at a younger age and exhibit anti-social impulsive behaviors.
The brain is a complex organ so not every alcoholic fit into these two categories, the researchers noted.
“From the viewpoint of the study setting, this division was made in order to highlight the wide spectrum of people suffering from alcohol dependence,” said lead researcher Olli Kärkkäinen. “The reality, of course, is far more diverse, and not every alcoholic fits into one of these categories.”
Regardless of what “type” of an alcoholic you are, there are similarities in the brain of all alcoholic. All alcoholics have an increase of a steroid hormone called dehydroepiandrosterone that affects the central nervous system. This could explain why many alcoholics become tolerant to the effects of alcohol after chronic, long-term use.
In addition, all alcoholics showed decreased levels of serotonin transporters in brain regions. This means that alcoholics have difficulty with mood regulation. They tend to be seeking this happy chemical and have a decreased level of serotonin transporters in the brain. This could explain why many alcoholics experience social anxiety.
Researchers will be using the results from this study to come up with new treatments for alcoholism that take into account the distinct differences between Type I and Type II brains.
“These findings enhance our understanding of changes in the brain that make people prone to alcoholism and that are caused by long-term use,” said researcher Kärkkäinen. “Such information is useful for developing new drug therapies for alcoholism, and for targeting existing treatments at patients who will benefit the most.”
In Western countries, it has been estimated that around 10-15% of the population qualify as alcohol-dependent. Across the world, alcohol is causing as much damage as all illegal substances combined. It is important to note these differences so medical personnel knows how these cases can differentiate.
Most of all, it is important that those who have struggled with alcoholism to seek help as early as possible. People who drink large amounts of alcohol for long periods of time run the risk of developing serious and persistent changes in the brain. The damage could be a combination of the alcohol consumptions along with poor general health.
Often, alcoholics have deficiencies in their health. Thiamine deficiency is extremely common in those with alcoholism and is a result of overall poor nutrition. Also, it can be hard for those struggling to make staying healthy a priority. Thiamine is crucial to the brain. It is an essential nutrient required by all tissues, including the brain. Many foods in the United States are fortified with thiamine; therefore, the average healthy person consumes enough of it.
Alcoholism can cause major damage to your brain and overall health if left untreated. This article simply confirms the reason why it is so important that those struggling with alcoholism seek professional help. Trying to fix the problem on your own is not the best solution, especially when you are not aware of how your mind and body is functioning. We are here to help. If you or someone you love is struggling with substance abuse or addiction, don’t wait. Please call toll-free 1-800-951-6135.
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
It’s about time someone said it to your face. Yes… you read that title right…
Drunk driving is tragically irresponsible and has a habit of causing irreparable damage to not only the drunk driver, but also to the innocent individuals who lose their lives to drunk driving accidents in America. Every year an astonishing number of people are killed in drunk driving accidents, and community leaders and organizations all over the nation have used shocking, innovative and informative strategies to change these statistics. One bar in Los Angeles, California has done something pretty amazing to raise awareness, delivering very direct doses of reality and consequence to patrons through a live video in the bathroom mirror.
Mirror, Mirror at the Bar
This powerful campaign was quite literally an “in your face” tactic for raising awareness about the dangers of drunk driving in the Los Angeles bar. A video of the campaign is currently also circulating the internet, and once I stumbled upon it I was very impressed by how they used this unique technique to reach out to people in real time… people who may or may not have been exactly the person who needed to hear it that night.
In the video of the campaign you watch several male patrons enter a restroom. After supposedly “handling their business” the men walk up to the sink to wash their hands, and suddenly the mirror flashes to the image of a man dressed in jail-house blues staring them in the face. Then once he starts talking to them and interacting, they realize this is LIVE, not just a pre-recorded commercial.
Of course a few of them are a little freaked out… I mean, you would have to wonder how long this guy has been watching you from some hidden camera… but once the conversation gets going the real motive comes out pretty quick, and it can be pretty intense.
Inmate Kris Caudilla
The live video stream is of Kris Caudilla, an inmate in prison who has been convicted of drunk driving and is currently serving 15 years. Caudilla asks one man what he is drinking, some he asks how their night is going… then drops some real-time-live-action TRUTH on them, sharing his story of being out one night having drinks with friends, then deciding to drive drunk he was in an accident and killed someone.
That someone was a police officer- 44 year old Deputy James Anderson Jr. Caudilla drove head-on into Anderson’s patrol car with a blood-alcohol level of 0.158. The office later died at Shands Jacksonville hospital in Florida. Caudilla plead guilty to DUI manslaughter and testified in court, taking full-responsibility for Anerdson’s death. Caudilla was 27 at the time of the accident.
In the mirror Caudilla speaks his truth to men drinking at a bar on the other side of the country; men that stand in paralyzed shock holding cocktails and glasses of beer as another man trapped by his decision tells them with conviction,
“He had 4 children, a wife and I took him away from them…
I made the choice to drink. I made the choice to get in the car. You don’t have to make that choice…
So take a good look in the mirror man. Should you be driving tonight?”
In the video you can see the look on their faces, and you can tell some are second guessing a lot in these few passing moments. To watch this video, click HERE.
Reflection From Inside Campaign
This video is part of the Reflection From Inside campaign that has been put together by We Save Lives as part of a progressive effort to:
- Educate people
- Hold drivers accountable
- Support victims’ rights
- Help others find the courage to intervene
We Save Lives (WSL) is an international coalition that works to help protect the public by preventing crashes and crimes from “the 3 Ds” which are:
- Drunk driving
- Drugged driving
- Distracted driving
We Save Lives works through legislative efforts and grassroots organizing at the national, state, and local levels to make a difference on the road.
While many would say this is a “major buzz-kill”, and plenty have if you find the video on Facebook and read through some of the more less-sensitive comments, the fact is this is a powerful and profound way to try and pull the attention to something that is incredibly important.
So what if it “kills your buzz” for a little bit… it is better than doing nothing and letting you get behind the wheel and kill another human being. Even if not everyone listens, it might make a huge difference to the person who does.
I feel like this campaign is an amazing and creative way to try and interrupt the thought process to introduce the dangers of drunk driving to the people that need it most… people who are drunk and possibly going to drive! Every opportunity we have to make a statement and raise awareness in a new way gives us the chance to change something. Grabbing someone’s attention at a pivotal moment like that could be the difference between life and death. I applaud the creators and participants in this campaign, and I hope more people take this warning to get home safe.
Fatal drunk driving accidents occur all across the country, claiming thousands of innocent lives, all because of those who get drunk and get behind the wheel. Saving lives could be as easy as stopping yourself from driving drunk, and if you have a habit of drunk (drugged) driving perhaps it is time to consider how getting help could save your life, and others. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Shernide Delva
In an effort to curb what many consider to be the worst public health drug crisis in decades, the CDC has issued a series of guidelines and restrictions intended to reduce the abuse of prescription painkillers. On Tuesday, the federal government released these CDC standards, ending months and months of disagreements with pain doctors, and drug industry groups. However, many are still asking the same vital question: will these guidelines even work?
The CDC guidelines will be the first national standard for prescription painkillers. The guidelines are intended to provide a more sensible approach to prescribing highly addictive medicines. In the past, drugs like OxyContin and Vicodin were easily prescribed to patients. Although efforts have been made to reduce the amount of prescriptions prescribed in the medical community, these guidelines will further limit how opioid medications are distributed.
“This is the first time the federal government is communicating clearly to the medical community that the risks outweigh the potential benefits of these drugs,” said Dr. Andrew Kolodny, head of Physicians for Responsible Opioid Prescribing, which supports the guidelines. “It’s one of the most significant interventions by the federal government.”
These guidelines recommend what many addiction experts have long called for which is pushing doctors to recommend other pain management options. The CDC guidelines also limit the amount of prescriptions a doctor can prescribed at one time.While these new guidelines are non-binding, they are likely to have a huge influence in the medical community.
New CDC Painkiller Prescription Guidelines
Just to give a brief overview, here are some of the main specific guidelines that will be implemented in the next coming months.
- Doctors should first try ibuprofen and aspirin to treat pain prior to prescribing more high-risk drugs such as opioid medications.
- Opioid treatment for short-term pain should last only three days, at the longest seven days. This will be a significant change. Currently, doctors prescribe for anywhere from two weeks to a month of opioid medications for short-term pain management.
- Doctors should have patients undergo urine tests prior to getting prescriptions.
- Doctors are to participate in a drug tracking system to ensure patients are not getting medicine from somewhere else. Currently, 49 states have these systems yet only 16 are required to use them.
- These guidelines will not apply to patients receiving cancer treatment or end-of life treatment.
The new guidelines are a dramatic shift from the ideology of the 1990s. Back then, an initiative to fight for pain management resulted in opioid prescription painkillers soaring in popularity in the medical field. Pharmaceutical companies and medical experts pushed to have these drugs readily available because at the time, they were thought to be effective solutions to treat back pain and arthritis without the fear of addiction. Boy, were they wrong back then.
Now, as overdoses continue to mount, and addiction claims more and more lives each year, the country is desperate for an answer. While these guidelines may have good intentions, other professionals argue that more rules can cause more harm than good. Recent tighter restrictions on painkillers have resulted in the drugs soaring in cost on the black market. As a result, a significant number of addicts turn to heroin to satisfy cravings.
For nearly two years, these standards have been bitterly opposed by Big Pharma and pain doctors who feel that these guidelines will only post unfair hurdles for patients who really do suffer from chronic pain. They argue that drug addicts will simply find another way to get their fix, like heroin. Opponents of the new guidelines also believe that these rules are an incursion into the role of doctors.
Dr. Thomas R. Frieden, director of the disease centers, responded,
“It’s become increasingly clear that opioids carry substantial risk but only uncertain benefits — especially compared with other treatments for chronic pain.”
He continues to support the guidelines, stating they are meant to be “a tool for doctors and for patients to chart a safer course,” describing them as a benchmark for medical practice, not an unbending dictate. The idea, he said, is to balance the risks of addiction with the needs of patients.
“For the vast majority of patients with chronic pain,” Frieden said, “the known, serious and far too often fatal risks far outweigh the transient benefits. We lose sight of the fact that the prescription opioids are just as addictive as heroin. Prescribing opioids really is a momentous decision, and I think that has been lost.”
Essentially, Frieden is saying these new guidelines are meant to help with the addiction crisis and certainly are not meant to prevent those with chronic pain from receiving medications they need. Furthermore, it is uncertain the effects opioid medications have on chronic pain in the long run, so we can not assume that restricting these drugs cause any harm to those patients.
Considering how urgent the addiction epidemic is, something has to be done, and at least these new guidelines encourage conversation. Education and prevention is the key. Each year, the data is increasingly more frightening. There clearly is not a one-stop solution to all of this. Do you think these guidelines will be effective? If your or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Justin Mckibben
This definitely isn’t the first time we have asked questions about the concept of forcing someone into alcohol or drug addiction treatment. We have examined in the past whether or not this is an effective way to address addiction and we have evaluated whether or not it is a good idea to try and force your loved ones into treatment.
While some still think that forcing someone who refuses to stop using drugs or drinking to go to treatment is the only way from saving themselves, there are still a lot of people out there who think “tough love” approaches such as this just flat out down work. A lot of people in recovery will tell you most people won’t make the necessary changes in their life until they are ready and willing to make those changes, but others will tell you that a lot of people don’t realize how serious the issue is and need to be hit with a strong dose of reality before it is too late.
Now the conversation has been brought up just in time for the United Nations General Assembly Special Session on the World Drug Problem (UNGASS), which hasn’t met since 1998, and some new research may put this whole concept to bed once and for all. But it doesn’t just say that forced treatment is ineffective, but goes as far as to say it can be a violation of human rights.
Compulsory Addiction Treatment
Compulsory Addiction Treatment, also sometimes referred to as Involuntary Addiction Treatment, refers to the mandatory enrollment of people into drug treatment programs, typically forced inpatient treatment.
This method of treatment is still used today, and in some places in the world it is used a lot more aggressively than others. Sometimes the individuals forced into compulsory addiction treatment are not even necessarily drug-dependent.
Now there is of course a big difference between compulsory addiction treatment and coerced addiction treatment, which is when individuals are given an ultimatum to either attend an addiction treatment facility of serve jail time. Drug courts often court order this kind of treatment, but it is still an option and not forced onto someone who doesn’t want it.
New Study Stats Do Not Satisfy
When the International Centre for Science in Drug Policy (ICSDP) introduced its recent research to the UNGASS they showed their studies had found that compulsory addiction treatment does NOT seem to have any real benefits, and after treatment compulsory addiction treatment does not reduce:
- Drug use
In a press release given after the findings of the study were announced it was stated:
“This consistent with growing calls from experts to replace the use of compulsory treatment with voluntary, evidence-based, and human rights compliant health and social services to address drug dependence,”
The study’s principal investigator from ICSDP, Dr. Dan Werb stated:
“The evidence clearly indicates that forcibly enrolling individuals does not result in sustained, positive outcomes.”
Dr. Werb explained that this new investigation raises serious questions about the growing dependence on compulsory approaches to drug addiction, particularly in places like:
- Southeast Asia
- Latin America
The researchers thoroughly studied and revised current scientific literature available in order to assess the efficacy of compulsory addiction treatment, and in doing so they claim to have two key discoveries concerning compulsory addiction treatment.
- Compulsory addiction treatment is less effective than non-compulsory methods at promoting long-term abstention or reducing criminal recidivism
- Compulsory addiction treatment actually has negative impacts on drug use after treatment, as well as on arrests or incarcerations, compared to voluntary methods.
Human Rights Violations
When it gets down to this part, I think back to an article I wrote about forced addiction treatment in Guatemala where a team of head-hunters would be dispatched by families members to wrangle and addict and drag them off to a dingy crowded building to detox in huddles like cages animals at the slaughterhouse… So for me it wasn’t too much of a surprise when the investigators of this recent study said there is strong evidence of human rights violations in compulsory addiction treatment programs, including torture and other forms of punishment for drug dependent individuals.
Mr. Rick Lines, executive director of Harm Reduction International, made his own statement condemning the conduct of some compulsory addiction treatment centers, stating:
“The routine use of physical violence, sexual abuse, and forced labor in compulsory treatment centers seriously undermines the human rights of detainees,”
The center I wrote about in Guatemala actively forced internees to clean the floors or to work at night as forms of punishment. The treatment plan consisted only of chores, religion and sometimes violence, and individuals were often tied up in the streets and brought there to be kept behind barred windows for months or years at a time.
The team who put out this recent study recommended that evidence-based methods of treatment should be implemented as they have been found to reduce drug use and repeated criminal offenses after treatment. The more humane, compassionate and public health-oriented addiction treatment archetype will be front and center at this year’s UNGASS, and hopefully even more progress will be made in revolutionizing treatment of addiction on a global scale.
Forcing someone into treatment may seem like a last resort for a lot of families frantically trying to stop the ones they love from causing more havoc or hurting themselves, but usually the solution lies in working together to make a choice for change.
As the stigma of addiction fades away and the worlds of science, psychology and politics grow a better understanding of addiction our world changes and how we treat those who suffer changes. Effective and holistic addiction treatment saves lives with compassionate and personalized treatment, and Palm Partners believes in providing the incredible treatment to help create change for life. If you or someone you love is struggling with substance abuse or addiction, call toll-free 1-800-951-6135