2015: A New Year means New Goals … Here are SMART ways to achieve them!

New Year’s – a time to Nourish and Cultivate a New Beginning …

New Year’s is a unique holiday. As we celebrate the passage of time, it is typical during New Year’s for people to reflect on their lives and resolve to make beneficial changes. Every year millions of people make New Year’s resolutions. Unfortunately, only a small percentage of those will actually see their goals through. For those who do succeed, it isn’t about having good luck, rather about having the right tools and supports to go the distance.

“Life will not go according to plan if you do not have a plan.” – Unknown

Many of us can become discouraged from the countless times we have tried to make meaningful changes and have not seen the results. Resolutions can work! Goal setting is a highly effective tool and change is possible. Success begins with a well developed plan.

Are you using the SMART(1) way to set goals?

SMART is an acronym that provides a handy set of guidelines to help construct goals. Ask yourself the following SMART questions….

Specific: Is the goal clearly stated and the vision well defined?

Measurable: Does the goal have a time frame, completion date, how will success be measured, etc.?

Achievable: Is the goal realistic? Does it have a reasonable chance of success?

Relevant: Why is this goal important to pursue? Can other goals be built upon this one?

Trackable: How can you check and know if you are making progress towards your the goal or if it has been completed?

Go ahead and write down those New Year’s Resolutions, but don’t just put them aside and forget all about them. Maintaining awareness of your goals and enlisting ongoing support provides motivation and critical problem solving assistance when challenges in achieving your plans arise. Let’s face it, the notion of making lifestyle changes and achieving our goals may be simple, but it isn’t easy.  You are not alone if you find goal setting and decision making a challenging and at times frustrating.

These challenges are intensified by the impact that addiction has on the brain’s judgement and decision making centers. Research shows that drugs and alcohol affect the orbitofrontal cortex, coercing the brain system and hijacking one’s decision-making process(2). Abstinence based recovery offers the opportunity for the brain to regain improved executive functioning. Improved decision-making creates possibility for positive behavioral changes and for personal goals to be achieved.

As the minutes move closer towards the countdown beginning the new year, consider a different approach.

Give yourself the ultimate gift to the start of this fresh New Year 2015. If you choose to work with the experienced, compassionate treatment team at Center For Wellness, we will partner with you to develop achievable goals towards your recovery and wellness.  We are ready to help motivate and guide you along your journey of success!

How are you going to Nourish and Cultivate a New Beginning?

This article was co-authored by Susan Busfield, LPC, LCADC – Clinical Coordinator of the Substance Abuse Intensive Outpatient Program at Center For Wellness and Dr. Gagandeep Singh – Owner/Executive Director of Center For Wellness

1. Based on Edwin A. Locke goal setting research and theories

2. How Drugs Hijack Decision-Making in the Brain; Rick Nauert, PhD, November 27, 2012.  Online at: http://psychcentral.com/news/2012/11/27/how-drugs-hijack-decision-making-in-the-brain/48162.html

TIPS FOR STAYING SOBER DURING THE HOLIDAYS

This article was co-authored by Susan Busfield, LPC, LCADC – Clinical Coordinator of the Substance Abuse Intensive Outpatient Program at Center For Wellness and Dr. Gagandeep Singh – Owner/Executive Director of Center For Wellness

We are in the season of holiday festivities. Although various traditions may vary based on family, culture or religion, one thing is often common, stress around meeting expectations!

At a time of the year that is advertised to be filled of joy, smiles, and family togetherness, the experience can be stressful, anxiety provoking, or possibly even dangerous for individuals in recovery.  This article is intended to assist individuals in recovery from addiction to help them manage during the holidays.  Our aim is for this to be used as a guide for families who want to be supportive of the recovery process. Please utilize all of the tools and supports available to you, including 12-step meetings. Being strong in your recovery program will make all of the difference. Importantly, be sure to review your relapse prevention plan with your counselor and sponsor.

Some valuable notions to keep in mind during this time:

1. Recognize that holidays may be filled with unrealistic expectations for intimacy, closeness, relaxation and joy. Our holiday may not match what is “Seen on TV”. Acknowledging your distress about the holidays is normal, and it does not make you a bad person.  Others’ and our expectations are often the predominant stressor and relapse trigger during this time of year.
2. Remind yourself that what you decide to do this year can be changed next year. For example, often individuals facing their first sober holiday are not ready to ‘take on the whole family’ with all of their (hopefully) well-meaning questions or comments. Especially in cases where holiday traditions include alcohol or other substances, a person in recovery is faced with a temptation they are not necessarily ready to handle. It is okay to decline this year and let supportive family know you are needing some time substance free.  It may be wise to consider spending time around sober supports and participating in events such as an AA or NA holiday function or ‘Alcathon’.
3. Re-evaluate family traditions. Create new traditions that put an emphasis on recovery and togetherness.  As a corollary to the previous point, some traditions may not be conducive to maintaining sobriety or minimizing triggers, especially early on in recovery.  It is perfectly acceptable to find alternatives to prior activities that may now seem unhealthy or a risk for relapse.
4. Have a Plan!  Do not delay making difficult decisions.  Ask if you can spend time with family who are visiting out of town on another day, rather than the actual holiday, so the focus will be on the visit and not on the party. Perhaps arrive early to a dinner and leave early, before too much imbibing takes place. If you have a sober support, bring them along.
5. Avoid excessive free time. In early recovery unstructured time is potentially dangerous. Be aware of interruptions in your schedule, as being held accountable by others, or holding ourselves accountable, can be challenging in light of this “downtime”. Idle time can lead to increased relapse triggers such as boredom, decrease in utilizing recovery supports and coping strategies, and an increase in anxiety and racing thoughts.
6. Be honest with people. Addiction is a disease and taking responsibility for your recovery is positive.  With this responsibility comes the need to have forthright communication.
7. Be honest with yourself. Not everyone is going to trust you just because you have made a few changes, as trust takes time to rebuild.  Understanding this will help allow for more realistic expectations of others, and less disappointment and hurt feelings.
8. Increase your supports. Attend more meetings, volunteer to help at meetings, get involved with speaking engagements, increase phone contacts, attend out patient treatment, and work with your counselor and/or sponsor.
9. Focus on self care. A primary focus of recovery is to utilize coping strategies and increase our personal self care. Meditation, deep breathing, journaling and mindfulness practices are an important part of this component of recovery.
10. The holidays may bring, with them, a sense of responsibility or pressure to compensate for past mistakes, but this is not the time to run up the credit cards out of guilt or trying to make amends.  This goes in hand with self care, as well.
11. Avoid power struggles. Work to keep your communication clear with family and friends around you, to avoid strain on relationships due to unfair expectations.  The maintenance of healthy boundaries is vital and it is best to communicate these clearly.  Some examples may include discussing the importance of needing time for meetings, changing expectations around gift giving, etc.
12. Incorporate acceptance.  Remember: Grant me the serenity to ACCEPT the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

NJ FIGHTS OPIATE OVERDOSE WITH DISTRIBUTION OF NARCAN

Naloxone, trademarked as Narcan, is an opiate antagonist which counteracts the life-threatening depression of the central nervous system and respiratory system caused by an opiate overdose. This medication has the potential to reverse possibly fatal opiate overdose. Narcan, which is a spray delivered through the nose, is being distributed in emergency treatment kits for heroin overdose in every county in the state. Each kit contains the drug, a nasal applicator and an atomization device that converts the medication into a spray. The kits have a shelf-life of a little more than 18 months.

Distribution of Narcan gained publicity in March of 2014, when more than 28,000 EMTs signed waivers certifying them to carry and administer the drug. In less than a month, the drug had helped save more than 40 lives in Ocean County, where a largest increase in heroin overdose has been seen. By April, Governor Chris Christie announced a pilot program for Monmouth and Ocean counties which allowed law enforcement to also carry and administer the drug.  There has been a demand for an expansion since the program has proven to be successful. Gov. Christie plans to expand the program to all state police officers and local law-enforcement offices across all 21 counties.  Update per Dr. Singh: Recently, Narcan was used in Hamilton Township (Mercer County) to reverse overdose in a young adult male, saving his life.

A recent report from the Task Force on Heroin and Other Opiate Use by New Jersey’s Youth and Young Adults described the “skyrocketing use of heroin and other opiates” as the “number one health care crisis confronting New Jersey.” According to the state attorney general’s office, there were 449 deaths reportedly caused by heroin and morphine in 2011. Heroin use has risen drastically in New Jersey since then, with reports on overdose deaths climbing to 591 in 2012, and 380 in the first six months of 2013.  A former DEA agent, Michael Pasterchick, from Monmouth County has stated that, although the levels vary, the purity of street samples can be as high as 95 percent. New Jersey, therefore, has some of the purest heroin in the nation.

In May of 2013, the Department of Health Office of Emergency Medical Services issued the Overdose Prevention Act which aided in reducing the fear associated with reporting opioid overdoses. The Act provides immunity for civil and criminal liability for people who are not healthcare professionals, who administer Narcan in an emergency. In combination with the Overdose Prevention Act, the New Jersey Department of Health estimates that the use of Narcan saves roughly 12-20 lives a month.  Due to immunity regulations, the public is able to have naloxone in their home and some experts even encourage the public to pick up a prescription at a local pharmacist.

For those seeking professional help with substance abuse issues, Center For Wellness is an Intensive Outpatient Program offering ethical, evidence-based treatment to adults and adolescents. Clients are encouraged to participate in a variety of individual and group therapies designed to develop the tools necessary to succeed in recovery.   Please visit our website at www.centerforwellnessnj.com to learn more about our programs and how we can be of assistance.

This article was written by Danielle Feldman, LAC – Substance Abuse Counselor at Center For Wellness, with input from Dr. Gagandeep Singh – Owner/Executive Director

Originally published on www.centerforwellnessnj.com 

RECOVERY AND THE FAMILY

You may have heard it said, “Addiction is a family disease.”  This phrase often refers to the impact of the symptoms and behaviors that a substance use disorder has on the family members and friends of the identified ‘addict’.  The physical and emotional struggle is often overwhelming, associated with the stress, loss of control, enmeshment, and other such factors frequently present in a co-dependent relationship. Sometimes overlooked, and often misunderstood, are the emotions family and friends feel which are associated with their loved ones recovery process.  There is an impact, at distinct phases of recovery, that family and loved ones appear to experience for themselves. It is for this reason that the family is strongly encouraged to participate in the formal and social aspects of the treatment program. Attendance at  Al-Anon, other 12 Step groups, seeking individual counseling, and other family supports become essential to the family’s recovery.  Families in recovery can become part of the solution and learn to also focus on healing themselves. This is very supportive for the addict too, as it may relieve some of the guilt and shame that may drive the addiction.

 Although the following phases are often distinct and take place in a similar sequence as presented, it is important to note that a recovery process is not a linear event. Some of these phases may appear out of order, or not surface at all. There may be overlap between these phases, as well. Each individual and his or her healing process is unique. Individual family members may frequently experience different phases at varying times, this can cause further tension and stress within family relationships.

D: Despair. The loved ones often feel despair when the addict first decides to enter a treatment program. Many fear loneliness, loss of control, failure, financial stress, embarrassment, and shame. It is often at this point that the family is most desperate for help and seeking resources.

R: Relief. Several days to weeks after the addict has been in treatment, there is a welcome feeling of relief. Constant worry about the safety of the addict subsides, there is reduced tension in the home and a feeling, sometimes for the first time, of a possibility of hope for the individual’s future.

A: Anger. Individuals experience different awareness levels and modes of expression of this anger. On the one end of the spectrum are those that overtly feel and express their anger toward the addict, whereas others may express it as complaints about physical ailments in themselves, idiosyncrasies of the treatment program, or deny having any negative feelings at all. Some family members displace the feeling of anger toward others and experience the addict as the victim.

F: Fear. Fear is almost always about the future. Loved ones fear relapse, financial burdens, job loss, exposure, and long-term effects the disease may have on children and other family members. Fear can be realistic or it can be exaggerated. Regardless, it can be immobilizing to the family member. 

T: Tolerance. In time, the family and loved ones learn to tolerate the diagnosis of substance use disorders. This phase can be misinterpreted as acceptance but it is the beginning of the recovery journey.  Family members who have established their own supports have a better understanding of the disease and more tools to assist them with coping.

D: Disappointment. Family members expect sobriety to bring along with it an absence of earlier “personality defects” with the recovering addict returns home. When they realize that their loved one’s personality is virtually unchanged, and problem behaviors persist, it can be very upsetting. Families with realistic expectations of the addicts recovery process can reduce the impact of disappointment.

R: Reality. The recovering family realizes that life goes on, with new commitments and challenges. Recovery becomes an accepted part of the family rhythm. Family may change traditions or rituals to incorporate a lifestyle and attitude of recovery. 

A: Acceptance. The recovering addict and their family begin to feel comfortable sharing their history of chemical dependency with others. The emphasis shifts from shame and guilt to self- forgiveness and gratitude.

G: Growth. The family members and loved ones may experience a thirst for more knowledge, a greater ability to focus on themselves, and a deeper connection with the recovering addict. This is also the time they may take the opportunity to offer support and give back to helping others in a healthy way.**

It is again important to remember that guidance by professionals through the above steps and transitions is important to the success of the person struggling with the addiction, as well as the family.  It is for that reason that family sessions, and often family groups (education-based), are part of treatment.

 

At Center For Wellness, a strong emphasis is placed on the role of the family for this reason.  Our Intensive Outpatient Program utilizes the family support, as well as the opportunity to educate the family, to create the best outcomes for those seeking help. 

Visit us at www.centerforwellnessnj.com for more information.

**The information regarding the above phases was modified in part from the article, The Disease of Addiction: Origins, Treatment, and Recovery, by Daniel H Angres, MD, Kathy Bettinardi-Angres, APRN, CADC

This article was written by Susan Busfield, LPC, LCADC – Clinical Coordinator of the Substance Abuse program at Center For Wellness, with input from Dr. Gagandeep Singh – Owner/Executive Director

Treatment Resources for Addiction

Note by Dr. Gagandeep Singh – Owner/Executive Director at Center For Wellness: There is a tragic irony in the fact that this article was written before the passing of Robin Williams.  If we learn anything from his passing, it is that we must be vocal and outspoken about mental health and substance abuse issues.

In 2013 the National Survey on Drug use and Health stated that out of the 23.5 million Americans who needed treatment for abusing drugs and alcohol, only 2.6 million were receiving it. Drug and alcohol addictions are among the most commonly devastating and costly problems in the United States, and seeking the appropriate treatment can greatly reduce the risk of health and financial complications while increasing quality of life. According to the Substance Abuse and Mental Health Services Administration there are over 11,000 addiction-treatment centers in the United States, so why are so few Americans seeking help and what are their options?

The treatment of drug and alcohol addictions requires a tremendous amount of physical, emotional, and mental healing. Part of the healing process is dealing with denial, a common defense mechanism, that can be experienced by both the individual as well as their family and friends. This person may feel that they have their substance use under control, or family and friends may not believe that their loved one has a problem at all. Social stigma is another reason that an individual may avoid seeking treatment. They do not want to seek treatment for fear of admitting to others that they have a problem. Some individuals might be concerned that their addiction will portray them as weak or flawed, and therefore may avoid publicly acknowledging their need for help. Other factors that can prevent people from seeking treatment include; believing that one can help themselves without professional guidance, lack of appropriate finances and resources, fear of sharing with others, and simply not knowing where to begin.

In the throes of drug and alcohol addictions, individuals are often unable to function in their daily lives and can also experience physical withdrawal symptoms.  This often can lead to a vicious cycle where the patient is unable to break free of the addictive behaviors. Treatment options vary for those suffering from addiction, and can be dependent on the type of substance(s) abused as well as the level of severity of the substance use. There are many different types of treatment programs that, when coupled with self-help groups, can be very successful at promoting and maintaining recovery.

‘Detox’ (detoxification) programs are medically monitored facilities for individuals whose physical withdrawal symptoms are potentially physically dangerous or pose a threat to successful recovery. These programs are helpful in the early stages of recovery by medically stabilizing the individual and providing them with follow up resources once discharged.

Inpatient or residential programs require patients to stay in these facilities overnight, attend daily group therapy sessions, individual counseling sessions, family involvement, recreational activities, and provide a general introduction into the recovery lifestyle. These programs generally involve commitments lasting anywhere from 28 days to 90 days.

Outpatient programs offer a wide variety of services, but typically involve involvement in multiple group therapy sessions several days a week (in NJ, 9 hours per week are required in total), weekly involvement in individual therapy sessions, and family counseling sessions as needed (usually monthly).  These programs are known as intensive outpatient programs.  Once patients complete such a program, they are typically referred to ‘traditional outpatient’ treatment, which may involve weekly individual and/or group therapy sessions.

Center For Wellness (www.centerforwellnessnj.com) is licensed through the Division of Addiction Services.The clinical model is evidence-based and employs a variety of therapeutic techniques and approaches in order to best serve the consumer.  Family involvement is a valuable aspect of our program.  The client and the family both receive education on pertinent topics related to the presenting concerns. Patients are also encouraged to attend self-help meetings, such as Alcoholics Anonymous or Narcotics Anonymous, and are referred to an individual therapist following discharge as part of an aftercare plan, to maximize successful recovery.

Please visit our main website at: http://www.centerforwellnessnj.com

This article was written by Danielle Feldman, LAC – Substance Abuse Counselor at Center For Wellness, with input from Dr. Gagandeep Singh – Owner/Executive Director

Originally published on www.centerforwellnessnj.com 

August 12, 2014 

Understanding Addiction

Note from Dr. Gagandeep Singh – Owner/Executive Director of Center For Wellness:  There is a tragic irony in the fact that this article was written before the passing of Robin Williams.  If we learn anything from his passing, it is that we must be vocal and outspoken about mental health and substance abuse issues.

What is Addiction?

Addiction is a complex brain disease. It is characterized by compulsive, at times uncontrollable, drug/alcohol craving, seeking, and use that persists even in the face of extremely negative consequences. For many, addiction becomes chronic, and the  progression of symptoms occurs over time. Relapse is often a common occurrence, even after long periods of abstinence. Treatment works, and recovery is possible.

How quickly does someone become addicted to a substance?

There is no easy answer to this for several reasons. If and how quickly you might become addicted to a drug depends on many factors, including your genetic make up, the biology of your body, the type of substance used, and other variables.  All drugs are potentially harmful and some may have life-threatening consequences associated with their use. Individuals also have varying sensitivities to substances. While one person may use a drug one or many times and seem to suffer no ill effect, another person may be particularly vulnerable and overdoses with the first use. There is no way of knowing in advance how someone might react. Symptoms and consequences from addiction can develop over time. Sometimes less obvious reactions may be taking place without the user fully being aware of the total impact on their health, relationships, or lifestyle.

How do I know if someone is addicted?

If a person is compulsively seeking and using substances despite negative consequences or conflict, this is an indicator of problematic use or, possibly, addiction. Has the person’s use been the cause of problems such as loss of job, debt, legal issue(s), or physical or emotional problems brought on by regular use? Often family conflicts begin to arise, changes in a person’s social relationships occur, and more time, money, and energy are spent seeking, using, and recovering from the use of substances. There is no perfect screening tool or test to show if someone is addicted, however professionals are able to determine risk factors and identify patterns that might indicate addiction among adolescents or adults.

What are the physical signs of substance abuse or dependence?

The physical signs and symptoms of substance use vary depending upon the person and the drug being abused. In addition, each substance has short-term and long-term physical effects. For example, someone who abuses marijuana may have a chronic cough, or worsening of asthmatic conditions. Stimulants like cocaine, increase heart rate and blood pressure, whereas opioids like heroin may slow the heart rate and reduce respiration – in overdose, these can be fatal. Tolerance is a condition where a person’s body begins to adjust to the effects of a substance and the body’s response is to require more of that substance to get the same desired effect. When a person has developed a tolerance to a substance and uses said substance, withdrawal can occur as the substance is leaving the body. Withdrawal effects vary based on the person, the substance, and the amount of substance used. For example, withdrawal from alcohol could vary from a ‘hangover’, dehydration, headache, irritability, sensitivity to light, to more severe symptoms like tremors (shaking hands/body), seizures, and dangerous changes in blood pressure.

Isn’t addiction a voluntary behavior?

A person may start out taking substances voluntarily, but, as time passes and progression evolves, the behavior and use begins to change from voluntary to compulsive.  One of the reasons why this is believed to occur is because the continued use of drugs and alcohol changes your brain. The changes that happen can be subtle or dramatic and can lead to emotional or behavioral shifts.

Isn’t becoming addicted to substances just a character flaw?

Addiction is a brain disease.  Every type of drug of abuse has its own individual mechanism for changing how the brain functions.Regardless of which drug a person is addicted to, many of the effects on the brain are similar. The effects include changes in memory, mood, motor coordination, thought process, and body function. These changes have a large influence on multiple aspects of a person’s behavior. A substance can become the single most powerful motivator in the addicted person’s existence. He or she may find themselves doing almost anything for the drug, despite the risk, and experiencing, of a range of significant negative consequences. This comes about because substance use has changed the individual’s brain, their behavior, and their social and other functioning in critical ways.

Are there effective treatments for addiction?

Addiction can be effectively treated with behavioral based therapies and, for some, medication assisted therapies can help.  Treatment may vary for each person depending on the type of substances being used and the individual’s specific circumstance. A professional can assist with determining the appropriate level and course for treatment. In many cases, multiple strategies and resources may be needed to achieve success. Treatment that addresses the problem from multiple disciplines has been proven to show good results.  For example, an individual may first require a medically monitored detoxification from the drugs to safely and successfully withdraw from the substance(s). This often follows emotional and behavioral changes made in a treatment setting (inpatient or outpatient) with cognitive-behavioral strategies, employing group and individual counseling modalities. Identifying and making changes in lifestyle are an important component of effective treatment and recovery. This often includes developing a network of sober supports such as those in 12-step programs, along with other resources to assist emotional and social changes. The most important factor determining successful treatment is the individual struggling with the substance use, themselves. Their willingness and desire to utilize treatment tools and recovery supports towards effective change are of paramount importance to successful treatment.

What can I do to help someone with addiction?

Many family and friends find themselves wanting to help a loved one, especially when that person is in a crisis situation. It is often at these times that well intentioned people may inadvertently enable unhealthy addictive behaviors.  It is hard to accept, but often the best way family or friends can help is by letting the situation unfold and encouraging the person to seek help and treatment. Educating yourself about the complex disease of addiction, understanding the symptoms, patterns, and behaviors associated with addiction is very helpful. Family and friends need resources and supports too!  Attendance at 12-step meetings such as ALANON, or CO-Dependence ANONYMOUS can help the individual deal with their own feelings that arise from loving someone with an addictive disease. The best steps family and friends can take are to realize they did not cause the addiction, they cannot control it, and they cannot cure addiction, but treatment and support for all affected is available!

Center for Wellness Is an Intensive Outpatient Program offering exceptional treatment to adults and adolescents identified with substance use disorders. In order to nourish and cultivate a new beginning clients are encouraged to participate in a variety of individual and group therapies designed to develop the tools necessary to succeed in recovery.

Visit our main site: http://www.centerforwellnessnj.com

This article was written by Susan Busfield, LPC, LCADC – Clinical Coordinator of the Substance Abuse program at Center For Wellness, with input from Dr. Gagandeep Singh – Owner/Executive Director