Visit their page at Sober Musicians
Saturday, May 31, 2008
Friday, May 30, 2008
"We are a community in which men and women traumatized by homelessness, addiction and mental health challenges can come to know ourselves as loved and as instruments of love in the lives of others with gifts to share."
Recovery Café's mission statement is no corporate, fluff marketing verse. It can't afford to be. The individuals who are currently abiding by this creed have fought through dogged pasts, creating a brighter future for themselves and others, all while exercising the very demons luring them back to the darkness of their former lives.
I walk past the Recovery Café most times I hop the free ride zone downtown. To be honest, I've been putting off writing / researching this blog because I was a little scared at what I might find, both inside the center and inside myself upon a visit.
But this was the week...I couldn't put it off any longer.
I walked the two blocks to Second and Bell, continually going over the questions that I had already scratched in my Roaring Springs Composition notebook, merely hoping to talk to someone who works there (calling ahead would be too professional), get my questions answered, shoot some photos, and be on my way - still emotionally unattached. David Coffee ("...like what you drink in the morning") the Café's director, made sure that didn't happen.
After bumbling into the café, I came across David hunched over a contract. David's around 5'9" with medium to short dark hair, prickling with grey. Hailing from DC, his Northface jacket now firmly marks him as a Seattlite. He would need some more time, but I was more than welcome to take some photographs, but not inside; the café houses a few women battling histories of domestic violence, and are hiding from their former "family" with their new family. At that moment, I knew this wasn't going to be an in and out operation.
Not long after, David joined me outside and needed no prodding to begin discussing the café, leaving me scrambling for scribble space in my notebook.
Four years ago, the café was started by a group of women who saw a hole in Seattle's otherwise stellar housing / work program agencies. The Recovery Café is rooted in the idea that former addicts and trauma victims need more than 28 days for a full recovery – they need a lifetime. Although former addicts and trauma victims were finding places to live and work, they still didn't have a support system, a clean support system, to keep them focused on their recovery. Their "deferment" of life regarding family and health needed assessment, answers, and healing .
"So that's where the café comes in," explains David, "it gives whoever wants it, as long as there clean and sober, the chance to make new friends, and through those friends to gain support and trust."
David introduced me, making me sound very important, to no less than ten people attending the days thirty minute meditation session, member introduction, and meal - each of them saying the same thing when asked what the best part of the café is:
"Being part of a community."
It's the simplest of comforts - feeling like a part of something. Each person I met also came with another, a partner of sorts. Phil had Karyn and Karyn had Phil. J. Garland had T. Rose, and they've known each other since Alcoholics Anonymous 20 years ago. In a weird way, I kind of had David, and this was not intentional, I believe it's just how things happen there. The openness, warmth, and camaraderie I felt in the time spent at the café was nothing short of authentic.
And that's why the café is successful. It breeds trust through it's many meetings, meditations, and meals. First, a member has to sign a contract, this can even be a daily contract (David told me of a gentlemen who on some days could not personally bring himself to sign the contract, knowing he might break it) that each person will act in accordance with the café's mission and goals. Once a member, you've earned access to the support needed for future growth, and even some of the special events like art focused activities, or Open Mic Night every third Saturday where members take their shot at amateur entertainment.
Even harder than trying to crack some jokes though, is completely prying open one's darkest self to a circle of focused eyes, but this is what Recovery Café excels at due to the high trust level. David Shull is Recovery Café's support services coordinator and facilitates the survivors group meetings. After naively explaining to David that my idea of a support meeting is only what I've seen on television, (thank you, Celebrity Rehab!) he makes me feel better confirming that my impressions aren't that far off.
"I only talk about 97% of the time, and if I'm talking more than that then something isn't right. I'm more of a facilitator than anything else."
Shull echoed the same secret that some of the members told me regarding what's needed to fully heal and move on:
"You have to go deep enough to bring it out..."
The David's make up a third of the full time staff, leaving duties to the over 240 volunteers that participate in the café's mission. Many of these volunteers are members themselves that help with various things around the café, but other volunteers come in a totally different form. By having "successful" individuals as volunteers, the café serves as a comfortable space for members to ask volunteers questions about their life and successes on their terms where as they might not feel comfortable doing the same on a bus or while shopping. Again, without trust within the café's walls, conversations and learning of this magnitude could never take place.
The café itself is struggling for the best of reasons, lack of space for it's growing community. Currently in a 1,700 sq. foot space, the tour didn't take long once meditation was finished. Aside from the comically large Starbucks donated espresso machine (I guess they do some good things while taking over the world) the smallish kitchen can't boast much more than some prep space and a microwave while the café's members are all congregated in one of three rooms, each of differing sizes specifically for intimacy demands, the smallest reserved for one or two person sessions. The plan now is a 4k sq. foot space with street access to keep the café notion central. Visibility and accessibility are top priority along with staying in Belltown. Spread the word.
Special thanks to the David's and everyone kind enough to answer my questions, letting me into a small space of trust that I don't believe I earned. The quizzical optimism I witnessed in a place that has heard so many sad stories, with more to come, was something I've only seen in a few others. After now being present in this odd sanguinity again, one that breads statements like, "it's just incredible the changes that happen here," amidst cases of failure, I realize it takes rare persons committed to service with realistic optimism. David Coffee is not in denial nor blind to the fact that some addicts or victims plunge back into their old ways. What he is however, along with Recovery Café's other employees, volunteers, and members, are people who have the chance to see a happy ending every day.
Now, I think I understand why they do it: The afterglow is quite something.
Wednesday, May 28, 2008
It’s not a news flash that Pike County has an above average percentage of drug abusers, nor is it a revelation that opiates are the drug of choice for most of the area’s addicts.
And, with the recent trial of Billy Reed, who was convicted of manslaughter for killing a motorcyclist while driving under the influence of methadone and other drugs, some in the county have questioned methadone’s use in the treatment of opiate addiction.
One of methadone’s opponents is the state’s largest anti-drug coalition, Operation UNITE, which favors abstinence-based treatment.
“In general, UNITE is greatly concerned about any method that would treat addiction without counseling. Methadone just exchanges one drug for another. We don’t see it as an effective way of treating a person with substance abuse issues,” said UNITE Communications Director Dale Morton.
Joe Chapman, the director of the methadone-prescribing Williamson Treatment Center, disagrees.
“I’m a firm believer in abstinence (treatment), and it works for a lot of people. We’re here for those it doesn’t work for,” he said, adding that those being treated with methadone, as a requirement to receive the drug, must attend counseling treatment.
And, while abstinence-based treatment is the more noble of the two, methadone treatment is arguably the more successful one. According to UNITE’s Web site, of the 1,591 adults and juveniles who have entered its drug court program, only 594, or 37 percent, have graduated.
“Most that go through treatment end up relapsing,” admitted Morton, who added it takes several rehabilitation attempts, in many cases, to achieve success with abstinence-based treatment.
Conversely, of the 200 people currently under treatment at the Pikeville Treatment Center, 85 percent of those, “maybe more,” are being treated successfully, according to Dr. Steven Lamb, who prescribes methadone at the clinic.
Chapman said 86 percent of the 700 patients treated at his center are performing successfully.
Success, however, in terms of methadone, does not equal rehabilitation as it does with abstinence treatments. Addicts do not stop being addicts because they switch from heroine, Oxycontin, Lortab, or another opiate, to methadone, which is also an opiate, said Lamb. They are merely addicted to a less-destructive drug.
Success with methadone, said Lamb, is defined when a person stops committing anti-social acts and begins committing pro-social acts. In other words, “they stop robbing drug stores and selling their babies’ diaper money,” and, instead, they become better parents, get jobs, or, in some way, they become more beneficial to society.
Part of methadone’s success — and in UNITE’s shortcomings — can be attributed to the nature of opiate addiction, which, according to Chapman, is “the most difficult addiction to overcome.”
Lamb said the reason it is so hard for opiate addicts to stop using is that after a person has been on narcotics for a long time, something happens to his brain. He said even people who have been using for a short time have trouble, because once they stop taking the drugs, they get sick and suffer withdrawal symptoms.
For these reasons, addicts “can’t go 24 hours without thinking where the next pill is going to come from,” he said, and obtaining more drugs become the addict’s constant thought.
Lamb said methadone is successful because it allows people to stop craving street drugs. Under medical supervision, a “therapeutic dose” can be obtained, which is strong enough to block the thought of drugs from a person’s mind, but not so strong as to make the person drowsy.
Because patients are less plagued by the thought of drugs, they can focus on improving their lives and are able to search for friends who aren’t drug users. Finding friends who do not use, said Lamb, greatly reduces chances of relapse.
Unfortunately, what makes methadone is so successful at treating opiate addiction is also liable for the negative aspects of the treatment.
While it is a safer opiate alternative than street drugs, it is not a less addictive one, and people usually stay in methadone treatment for years or longer.
“Once you start (methadone), it’s terribly hard to stop,” said Lamb.
Chapman said the average treatment time for patients in the Williamson clinic is three years.
Lamb said the treatment at the Pikeville clinic takes no less than six months, but, for some, it takes years, and others may never stop treatment.
Lamb said the more slowly one comes off the drug, the better chances he has of staying off. But, staying off, said Lamb, is even harder than getting off.
He said many times people who successfully stop taking methadone or other opiates go about six or 12 months and then “the get in a rut. They start to feel awful and give up.” When they feel bad, he said, they often go back to using street drugs.
Methadone itself is a street drug, and can be harmful when used in that scenario.
The Kentucky Office of Drug Control Policy said methadone was the leading cause of overdose deaths in the state during 2006, and was detected in 41 percent of the 484 overdose death cases throughout the state. May times other drugs were also detected along with methadone.
But Chapman said clinics are not to blame. Though they do get blamed for the drug’s diversion onto the street, in reality, he said, clinics are only responsible for a small fraction of the methadone on the street.
Lisa Walls, assistant director for the Kentucky Division of Mental Health and Substance Abuse, agrees. She said most of the methadone obtainable on the streets was prescribed by private doctors, some of whom can prescribe the drug for pain, but not addiction.
Walls said the majority of street methadone is in the form of tablets, but methadone clinics only dispense liquid methadone, because it has less abuse potential.
While a physician may write a monthly prescription for pain, the most that can ever be taken out by a patient at a methadone clinic is a week’s dosage, and only a handful of patients are even allowed that much.
For a patient to be able to take out one day’s dose of liquid methadone, he has to have been a patient at the clinic, passing every drug test, and participating in counseling, for at least 90 days in Kentucky, or at least 30 days in West Virginia. For a patient to be able to take out a week’s worth of methadone, he has to have been a well-behaved patient for over a year, in Kentucky, or nine months in West Virginia.
Another problem with methadone treatment arises, as with the case of Billy Reed, when a patient on methadone relapses back to taking street drugs. Though mandatory drug testing is performed at clinics in both states to detect this scenario, even if a patient is found to be taking other drugs along with his methadone, he has to be weaned off the drug. Prescribers cannot just stop giving the drug to non-complying patients right away.
Testimony and evidence showed that Reed had methadone, Xanax, Valium and alcohol in his system in a blood test taken two hours after the wreck on Jan. 7 that killed Ronnie Church.
According to Lamb, it is very dangerous for a patient taking methadone to also take street drugs, especially if those drugs are Xanax and alcohol. He said the combination of Xanax, methadone and alcohol is deadly, and is the cause of most methadone-related overdose deaths.
Another dangerous consequence of a patient on methadone taking street drugs is that it impairs their driving ability, which methadone, when taken properly and by itself, does not do, said Lamb.
And, as the area has recently witnessed, when patients decide to use their methadone as an ingredient in their drug “cocktail,” and then decide to get behind the wheel, deadly consequences can arise as well, though not always for the drug abuser.
source: Appalachian News Express
Tuesday, May 27, 2008
It is a scene that has become alarmingly familiar across Australia: young drunks, an increasing number of them female, smashing into one another with fists, bottles, clubs and even knives in alcohol-fuelled brawls.
On Queensland's Gold Coast, this year's Australia Day celebrations erupted into violence as hundreds of youths turned on police after the arrest of a drunken teenager.
In Perth, one man was killed and dozens of others hurt when pubs and clubs exploded into fights following the screening of a middleweight bout between boxers Anthony Mundine and Danny Green.
In Melbourne, James Macready-Bryan, 21, suffered brain damage in a fight and is now fed through a tube, needing round-the-clock care.
And violence is only one of the grim consequences of what governments, alcohol and drug bodies and youth and social organisations say is an epidemic of binge drinking.
Road and other accidents, health and medical problems and serious social issues have been forced up the political agenda by growing concern and an estimated annual cost to the nation of more than A$15 billion ($18.3 billion).
A survey by Roy Morgan Research released last month by the National Alliance Against Alcohol Related Violence found that 84 per cent of Australians believe binge drinking is on the rise, and that 60 per cent fear violence from drunks when they go out at night.
In New South Wales, almost 45 per cent of the more than 74,000 assaults reported in the 12 months to last September involved booze.
A 2005 secondary students' alcohol and drug survey reported that in any given week, about one in 10 of the nation's 12- to 17-year-olds binge-drinks or drinks at risky levels.
Another study of community football clubs made by the Centre for Youth Drug Studies found that 13 per cent of 18- to 20-year-olds drank 13 or more standard drinks each time they visited their club.
The study revealed that 70 per cent of males and 30 per cent of females considered drinking an important club tradition, and 83 per cent overall left the club as a driver.
Programmes and campaigns to stem the rising tide have mushroomed throughout Australia as governments, police, alcohol and drug bodies, social and community groups and sporting codes begin to realise the scope of the problem.
Last month, 30 organisations joined up to form the alliance against alcohol-related violence, with plans to use the combined weight of some of the country's most influential social welfare people and researchers to prompt more government action.
The alliance wants alcoholic drinks to be exempted from competition policy and placed under separate regulations, fewer liquor outlets and reduced opening hours, and for all drinks to be taxed by volume of alcohol.
Prime Minister Kevin Rudd's Labour Government is already moving, launching a national binge drinking strategy in March and increasing the tax on "alcopops" - sweetened mixed drinks targeted at young, and especially female, drinkers.
Rudd's A$53 million strategy will tackle binge drinking on three key fronts. More than A$14 million will go to community groups - especially sporting organisations - through grants for programmes designed to deter binge drinking, warn of its dangers, and develop codes of practice.
Major sporting organisations, including netball and the rugby and football codes, have already signed on and will developed harmonised alcohol codes.
Rudd has warned that their performance on responsible drinking will affect future Government funding.
A further A$19 million will be spent on early intervention and diversion programmes, with pilot projects expected to be launched in each state by the end of the year.
Supporting this will be a A$20 million campaign on television, radio and the internet, based on successful anti-smoking, safe driving and HIV/Aids campaigns and designed to confront youths with the costs and consequences of binge drinking.
source: New Zealand Herald
Monday, May 26, 2008
Experts seek new ways to reduce alcohol-related road fatalities as the nation's annual death toll of about 17,000 hasn't budged in over a decade.
With drunken-driving rates stuck at a level that has changed little over the past decade, experts are recommending new approaches that may offer the best hope of reviving the great gains made against DUIs during the 1980s and early 1990s.
One method relies on technology: Stopping drunks from driving before they can get started. Another is treatment: Making hard-core drinkers not only serve time but also helping them overcome their addictions.
"It's now becoming increasingly difficult to make (the statistics) go down," said David Hanson, a retired sociologist from the State University of New York at Potsdam who has studied alcohol and drinking for more than 40 years. "If we keep trying the same old approach, it's probably not going to make much of a difference."
The old approach, stricter laws and the efforts of advocacy groups such as Mothers Against Drunk Driving paid off significantly, according to a study released this month by the National Highway Traffic Safety Administration. That report also cites the aging of the driving population and an increase in female drivers, who are less likely than men to drink and drive.
But as in 1997, 20 percent of the drivers involved in fatal crashes are legally drunk, and the number of alcohol-related traffic deaths has not budged. It's as though the country is stuck, forced to live with an annual death toll of about 17,000 people.
In a possible sign of resignation, some states have even raised the idea of relaxing some strict drinking laws that are widely credited with saving lives. Discussions have popped up recently in several states, including South Dakota, Vermont and Wisconsin, about lowering the legal drinking age to 18 under certain circumstances.
Nicole Nason, administrator of the highway safety administration, would consider that a disaster.
"The challenge is how do we drive the numbers down even further, knowing that we can't give an inch in terms of aggressive law enforcement or targeted advertising or working with our advocacy partners," she said. "How do we do even more?"
The most widely accepted answer is to turn to technology, namely alcohol ignition interlock systems. These devices, installed in the cars of convicted drunken drivers, link a blood-alcohol monitor to the ignition. If the driver has been drinking, the car won't start.
source: Chicago Tribune
Saturday, May 24, 2008
Early on in recovery I was advised that whenever I encountered a desire to drink that I should "Think the drink through". The idea was that I would then recall the misery, the trouble, the suffering and humiliation that taking that one drink always led me through and then I would be able to effectively scare myself 'straight'.
Imagine that. An alcoholic so scared of alcohol and the consequences that he just does not drink - no matter what. Well guess what? Alcoholics DRINK no matter what! We don't get "scared straight".
Let’s take a cue from the former Democrat governor of New York, Al Smith, whose famous trademark phrase in his era was, "Let's look at the record."
Before joining my extended family here on lovely Cape Cod ten years ago and I was still running around New York City on Wall Street playing the big shot Investment Banker - actively engaged in the drinking life - I used to "Think through the drink" all the time. Maybe even every time I drank. In my head the outcome was always pretty similar.
"Let's see now . . . I will drink this drink and get a little tipsy . . .. then I will drink more and get just a little messed up . . . . .not too much . . . . don’t want to be slurring my words or pissing my pants. . . . then I will call up my limo and head up to D’Bronx . . . . Amsterdam Avenue . . . to get me a nice size package of blow . . . . not too much or I‘ll end up staying out all night . . . . but the good stuff . . . . from the Colombians. Then I’ll come back downtown and go to 21 where some gorgeous blonde in a miniskirt and fishnet stockings will hook up with me at the bar . . . and want to wrap her legs around me while we party and drink and snort and have a ball. . . .. then I can go home to my wife - at a decent hour . . . . . . . maybe by two AM . . . like nothing happened . . .. get a few hours sleep and then go to work in the morning - refreshed enough to get through the day and as Oliver Hardy used to tell Laurel, "and no one will be the wiser, Stanly. Ummph!"
Yeah . . . . that's the ticket!
That was the type of script I always wrote in my head when thinking the drink through. Too bad that it never seemed to work exactly the way I thought it should. I just thought it might - and so I made sure that I drank - just in case it would work out. I wanted to be ready.
What usually really happened was I would end up in Chinatown somewhere with a six-pack in the back of the limo, bar hopping and blowing chunks out of the back door at every other red light, scaring the freakin' bejeebers out of my driver - ending up back home in Queens with no money and a bloody shirt - to face my wife Nancy, who by now was in tears, waiting on the living room couch. “You did it again!” she would cry. "Why?"
"I don't know." It was my only honest answer. And then we would both cry together. That is MY record.
I am reminded of this from AA's book, "The fact is that most alcoholics, for reasons yet obscure, have lost the power of choice in drink. Our so-called will power becomes practically nonexistent. We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink.
The almost certain consequences that follow taking even a glass of beer do not crowd into the mind to deter us." (Alcoholics Anonymous" 24:1)
I guess the experience of the alcoholic co-writers of the above quote pretty much jives with mine. As with most "Stupid Heavy Drinker Tricks" like this one or even "Keep it Green" or "Call your sponsor before you drink" or whatever other lip flapping , non-AA, Pop-Fellowship sloganism you want to use - that might work well for non-alkies - but accomplish the exact opposite of their intent for the real alkie - "Thinking the drink through" always ensured that I would drink - not prevent it.
I do not really know of any real alcoholics whose "thinking through the drink" did not always produce a happy ending - albeit a fictitious one. Man, not only are we insane but truly we are strangely insane. Some folks just don't get us - do they? Some of ‘us’ don’t even ‘get us’.
Thursday, May 22, 2008
The Ralph Perdue Center is re-opening its residential drug and alcohol treatment program, the only one of its kind in Fairbanks, after a yearlong hiatus that forced some substance abusers to leave town for help.
Starting June 2, the center will begin treating patients again but the program will be smaller and nimbler than what was offered in the past, said Guy Patterson, director of behavioral health services for the Fairbanks Native Association, which operates the Ralph Perdue Center.
Patients enrolling in the new program will stay no longer than a month, Patterson said. The treatment program has eight beds, less than half the number of beds it offered before, although it is expected to grow to 16 beds next year.
“We’re trying to create something that will allow flow of treatment,” Patterson said.
The Ralph Perdue Center closed its residential treatment program last year due mainly to lack of funding.
Part of the problem was that patients with no means to pay for treatment were staying for extended periods of time, making it difficult for new people to get help.
Tanana Chiefs Conference has joined with FNA to operate the residential treatment program, which Patterson said is modeled after the Lakeside-Milam Recovery Centers in Washington state.
Patients will go through four phases of treatment, described as denial, admittance, acceptance and surrender, Patterson said.
The program will touch on multiple facets of patients’ lives, including diet, exercise, sleep and controlling other compulsive behaviors.
The Perdue center’s residential treatment program is the only program in Fairbanks open to any adult. FNA offers two other residential treatment programs for adult substance abusers but each caters to a specific population, homeless people and mothers of young children.
Patterson said he has a waiting list of 14 people who want to enroll in the residential treatment program, although none are confirmed.
Sharon Walluk, a regional behavioral health specialist for the state, works with area substance abuse and mental health providers. She expects the center’s eight beds to fill up fast.
Fairbanks is a hub for the Interior, Walluk said, serving other communities, including Nenana, Tok and Galena.
“It’s needed,” she said.
The executive director of the Fairbanks Community Behavioral Health Center, some of whose clients suffer from addiction on top of mental illness, agreed that Fairbanks needs a substance abuse treatment center.
“We’re very excited that it’s opening,” Gail Atchison said.
Patterson said the second-floor rooms inhabiting the program have been painted. Security measures, such as mirrors mounted on the ceilings, are being added, and the rooms are being professionally cleaned.
An open house is scheduled for Wednesday from 2-6 p.m. at the Ralph Perdue Center at 3100 South Cushman St. Tours will commence and refreshments will be served.
source: Fairbanks Daily News-Miner
Wednesday, May 21, 2008
Massive drug operations springing up under noses of unsuspecting residents
They're appearing everywhere, from apartments to million-dollar mansions.
So lucrative is the marijuana trade that growers aren't discriminating between low income neighbourhoods and upscale suburbs.
Experts say grow ops are being found in virtually every neighbourhood in Calgary, with major operations leaving homes in a decaying mess of mould costing tens of thousands of dollars to repair.
On May 9, police raided the one of the largest residential marijuana grow operations discovered in the city's history.
The assessed value of the Patterson Crescent S.W. home where 2,445 plants were found is $1.2 million. Neighbours appear to have had no idea there was a massive grow operation in their midst.
That case reinforces how any neighbourhood in Calgary -- rich or poor -- is potent territory for sophisticated marijuana grow operations.
Due to the clandestine nature of the trade, it's unknown the number of grow ops in the city. Last year, Calgary Health Region inspectors closed dozens of homes where police found evidence of drug operations.
Meanwhile, Roger Morrison, a former sergeant supervisor with the Southern Alberta Marijuana Investigative Team, said that during his time with the unit "we always commonly said we have a minimum of 3,000 in Calgary."
In a recent interview, Ald. Diane Colley-Urquhart said: "We have no idea at this point whether we have 3,000 grow-op houses or 10,000. But, we do know it's a serious problem."
The Patterson Crescent operation had all the hallmarks of organized crime, says an expert on marijuana grow ops.
Darryl Plecas is a professor at the University College of the Fraser Valley and has studied the marijuana cultivation trade in both British Columbia and Alberta.
Homes in upscale neighbourhoods can prove attractive to pot growers for a number of reasons.
Large homes simply have more room.
"The single most important thing in this case is square footage," Plecas said of the Patterson Crescent grow op. "Twenty-five hundred plants is one hell of a large grow operation for a residential home."
Many such homes are also set off from the property line, he said, making it harder for police to smell marijuana as they gather evidence for a search warrant.
The homes tend to have attached garages -- allowing privacy for the loading and unloading of equipment and plants.
Grow ops have undergone two substantial changes over the years, Plecas said.
They have clearly become larger and increasingly sophisticated in their ability to produce more within the same space.
Secondly, Plecas said, grows in B.C. are proving the single largest source of funding for organized crime.
"People have this impression that they're ma and pa, burnt out hippies, growing a plant or two," he said.
But that's not the case. Plecas's research in both B.C. and Alberta found growers often have lengthy criminal records -- many with convictions for violence.
"We're talking seasoned criminals," Plecas said. "And that also fits to the whole matter organized crime is into it up to its eyeballs."
The profits from growing marijuana are so large that homes prove to be an expendable cost of doing business.
"Most of the time they just don't care how beat-up the house becomes," said Vicki Wearmouth, a Calgary public health inspector specializing in grow ops.
"They can be really in rough shape by the time we go in there with water leaks and that sort of thing."
Wearmouth works closely with police who raid residential grows.
Often, she finds the exhaust from the furnace and hot water tanks are disconnected so CO2 filters out and spurs the growth of plants.
A hole is burrowed through the foundation walls where growers steal electricity and bypass the meter.
Also, Wearmouth said, the amount of equipment used to grow the plants produces a lot of heat.
"If they've been going on for quite some time, there's a significant amount of water damage with the heat," Wearmouth said.
That means a substantial and toxic mould problem. The properties must be "remediated" before they are again habitable.
That can mean the entire home must be gutted to its bare bones; the drywall removed and the insulation stripped out.
Such an extensive process can cost around $150,000 depending on the size of home, says the executive vice-president of the Calgary Real Estate Board.
"They're scary, for one thing," Ron Esch said of residential grow operations. "They're scary in that there are a lot them out there, and if they are not remediated properly, they are a real problem. They're a risk, they're a real health risk for buyers."
Esch said the real estate industry is doing everything it can to ensure realtors know how to spot a home with a previous grow operation and deal with it correctly.
That's important information to be relayed to buyers, he said.
The concern, Esch said, is when mould has infested the home, but the remediation process isn't adequate.
Former grow houses are a frustration, he said: "Sometimes innocent people will buy these properties or landlords will end up with these properties that are totally devalued because of these kinds of (grow) operations."
Also at issue, Colley-Urquhart said, is there are no real remediation standards in Canada.
"I have been told by residents . . . that they would move into these houses, and then when they go to hang a picture on the wall, the hammer goes right through the drywall because it's all mouldy and wet."
Esch estimates there are between 25 and 30 former grow-op homes on Calgary's multiple listing service at any one time.
Plecas's research looked at all cases of known marijuana grows in Alberta between 1997 and 2004.
The number of grows was substantially fewer than in B.C., and Plecas credits Alberta with keeping a lid on the problem. He said law enforcement in Alberta has a good record of investigating the complaints that come their way.
Plecas said a substantial difference between the two provinces is that those caught growing marijuana in Alberta are more likely to go to prison -- and for longer periods -- than in B.C. However, he said he's recently seen Alberta judges tending toward lighter sentences.
High power consumption is an emblem of marijuana grow ops. And a former Calgary police officer who left the service in 2007 has developed a special meter to detect those stealing electricity.
Roger Morrison's technology has already led police to four marijuana grows in the Chestermere area. Last year, during a test on a neighbourhood of 603 homes, six of Morrison's meters found nine grow operations in just one hour.
From the outside, only three of those 13 homes had any visible signs they housed a grow op, he said.
"That was extremely surprising for me," Morrison said. "That was an extreme wake-up call for me and some of the guys in the unit that maybe we don't really know how vast this problem is."
Morrison's meter detects atypical consumption between the primary line and the transformers that feed 80 to 100 homes in a neighbourhood.
The technology immediately notifies the utility company when a primary line shows a home with excessive consumption.
Someone from the utility can then test the particular transformers and find out which residence is the culprit.
"If you turn your hot tub on, that's not going to trigger this," Morrison said. "If you weld for two hours, that's not going to trigger this. It has to be a consistent, large power draw."
He said Canada has become a haven for marijuana production: "There's no way the amount of marijuana that we're producing in Canada can be consumed by Canadians.
"A vast majority of it is getting shipped down to the States where the profits are so much larger."
Meanwhile, tracking power consumption that's not stolen has helped push out residential marijuana grows in some jurisdictions of British Columbia.
Three years ago, the Surrey fire service began an experiment.
"I just was so frustrated with the lack of response from the system -- (it) did not seem to be deterring -- that we invented something different to achieve the same result and that's getting (grow operations) out of our neighbourhoods," Surrey fire chief Len Garis said in a recent interview.
The department obtained power consumption data from BC Hydro on homes that were suspected of growing marijuana.
Safety investigations based on high power consumption found nearly 94 per cent of the homes had serious electrical problems -- in almost all cases, they housed a grow op.
In 2006, B.C. passed legislation requiring BC Hydro to provide the addresses of residences with unusually high power consumption.
The first set of data in Surrey revealed almost 1,000 homes that met the threshold and were the likely abodes of marijuana grow ops.
Notices are posted on the doors, warning of an inspection in 48 hours. And while that gives time for growers to move out their crop, the safety inspections prove an annoyance and disruption to the trade.
That has prodded many growers to simply leave Surrey, Garin said, noting complaints concerning grow ops dropped by 38 per cent last year.
"It seems to be so that they're just simply moving out, because it's all about the money," Garin said. "And if they're not able to produce a crop undisturbed, they're going to lose money, their investment."
The legislation, however, is facing several court challenges from B.C. residents whose homes were inspected.
Last fall, a report from Alberta's Crime Reduction and Safe Communities Task Force suggested the province look at legislation similar to that in B.C.
Alberta Justice will work on the recommendation in due course, said spokesman David Dear. He noted "there are legal issues involved around that kind of information, as well as there are privacy considerations."
The solicitor general of Alberta also noted in a recent interview that many grow ops are simply stealing power and bypassing the meters.
Fred Lindsay said by this fall the province will have two investigative teams that will act under civil law.
If they inspect a home and find something awry, Lindsay said, "they will then have the ability to lock that house down for 90 days."
© The Calgary Herald 2008
Tuesday, May 20, 2008
Three-quarters of drinkers do not know a typical glass of wine contains three units of alcohol, a survey for the Department of Health suggests.
The YouGov survey of 1,429 drinkers in England found more than a third did not know their recommended daily limit - 2-3 units for women and 3-4 for men.
The survey coincides with a government campaign to promote careful drinking.
Ministers are concerned people are unaware that glass sizes have increased and some drinks have become stronger.
The internet survey found half those questioned drank alcohol at least two or three times a week.
And although 82% said they knew what a unit of alcohol was, 77% did not know how many units were in a typical large glass of wine.
More than half (55%) thought a large glass of wine would contain two units, when it actually contains three.
Nearly three out of five (58%) did not know a double gin and tonic contains two units.
More than a third (35%) did not know that an average pint of beer (ABV 4%) contains more than two units - although some strong lagers contain three units.
And 36% of women and 50% of men knew their recommended daily drinking limits were 2-3 units and 3-4 units respectively.
The Office of National Statistics revamped its assessment method to take into account the increased glass sizes and strength of alcoholic drinks last December.
The Know Your Limits campaign aims to tell drinkers how many units are now in their drinks and help them stick to their recommended limits.
There is a series of new adverts on television, radio and newspapers showing the number of units in individual drinks.
The adverts use ordinary family situations to help people understand how many units are in typical alcoholic drinks and warns them how too much regular drinking can damage their health.
Public Health Minister Dawn Primarolo said people are not necessarily aware of how much they drink and how much it can harm their health.
"Glass sizes have grown larger and the strength of many wines and beers has increased, so it's no wonder some of us have lost track of our alcohol consumption.
"We aim to give people the facts about how many units are in different drinks in a non-judgemental way. Then they can then make their own assessments about how much they want to drink in the future."
Mrs Primarolo said the campaign was aimed at over 25s who were less aware of what a unit was than younger people.
Some 32% of drinkers aged 18-24 correctly said that a large glass of wine contains three units, compared with just 18% of drinkers over 55.
Royal College of General Practitioners chairman Professor Steve Field said: "When it comes to alcohol GPs are used to hearing half truths about half measures.
"People need to have a better grasp of how much they're drinking by adding up their units.
"Alcohol can be a major contributing factor in many health disorders so it's vital that people think about how much alcohol they drink," he said.
Joe Korner, from The Stroke Association, said the organisation fully supports efforts to make people aware of the health risks associated with excessive drinking.
"There are around 1,100 haemorrhagic stroke deaths every year associated with alcohol and statistics show that women who drink over double their recommended limits are more than four times likely to suffer a stroke, and men almost twice as likely," he said.
Mark Hastings, of the British Beer and Pub Association, said: "We fully support the aim of giving people information on which to make their own decisions.
"But the government needs to be careful not to target the sensible majority while failing to tackle abuse by the minority.
"What people need is realistic advice and sensible action, not interference with their own judgement."
source: BBC News
Friday, May 16, 2008
A variety of middle-class people are making a conscious but careful choice to use marijuana to enhance their leisure activities, a University of Alberta study shows.
A qualitative study of 41 Canadians surveyed in 2005-06 by U of A researchers showed that there is no such thing as a 'typical' marijuana user, but that people of all ages are selectively lighting up the drug as a way to enhance activities ranging from watching television and playing sports to having sex, painting or writing.
"For some of the participants, marijuana enhanced their ability to relax by taking their minds off daily stresses and pressures. Others found it helpful in focusing on the activity at hand," said Geraint Osborne, a professor of sociology at the University of Alberta's Augustana Campus in Camrose, and one of the study's authors.
The focus was on adult users who were employed, ranging in age from 21 to 61, including 25 men and 16 women from Alberta, Quebec, Ontario and Newfoundland whose use of the drug ranged from daily to once or twice a year. They were predominantly middle class and worked in the retail and service industries, in communications, as white-collar employees, or as health-care and social workers. As well, 68 per cent of the users held post-secondary degrees, while another 11 survey participants had earned their high school diplomas.
The study also found that the participants considered themselves responsible users of the drug, defined by moderate use in an appropriate social setting and not allowing it to cause harm to others.
The findings should open the way for further scientific exploration into widespread use of marijuana, and government policies should move towards decriminalization and eventual legalization of the drug, the study recommends.
"The Canadian government has never provided a valid reason for the criminalization of marijuana," said Osborne. "This study indicates that people who use marijuana are no more a criminal threat to society than are alcohol and cigarette users. Legalization and government regulation of the drug would free up resources that could be devoted to tackling other crime, and could undermine organized crime networks that depend on marijuana, while generating taxes to fund drug education programs, which are more effective in reducing substance abuse," Osborne added.
The study was published recently in the journal Substance Use and Misuse.
source: Science Daily
Monday, May 12, 2008
Prescription drug addiction continues to rage nationwide and across the region, despite state and federal intervention.
In 2006, nonmedical use of prescription painkillers drew the highest number of new users, or "initiates," than any other illicit drug, with 2.2 million users, according to the 2006 National Survey on Drug Use and Health.
And according to the U.S. Drug Enforcement Administration, there are nearly 7 million Americans abusing such drugs today – more than the number of those using cocaine, heroin, hallucinogens, ecstasy and inhalants combined.
Despite the alarming statistics, many insurance companies don’t cover substance-abuse treatment. In fact, Medicaid in Virginia didn’t cover the cost for anyone but pregnant women until last July.
Lisa Williams, director of the suboxone treatment program at Highlands Community Services in Abingdon, said one of the most difficult obstacles in combating prescription drug abuse is the availability of the drugs and the lack of viable treatment options.
Until 2005, methadone was the only treatment for opiate addicts, but it has a number of drawbacks. First, it can only be distributed at clinics, which in rural areas such as Southwest Virginia can be far away. Second, methadone gives its user a feeling of euphoria that mirrors the effect of an opiate, and the more methadone you take, the greater the high.
And perhaps the most telling drawback is the spike in methadone overdose deaths in the western district of Virginia. According to the state medical examiner’s office, there were 264 fatalities in 2006 from drug overdoses, 70 because of methadone. It’s the leading cause of fatal overdoses in the state.
Suboxone was introduced in the U.S. in 2005 as an alternative to methadone. Like methadone, the drug works to placate withdrawal symptoms and cravings in opiate addicts.
But, Williams said, the drug is superior in several ways. Because it does not give its user a feeling of euphoria, it has little potential for abuse. It simply satiates the cravings. It also has a "ceiling effect," which means exceeding the prescribed dose does not increase the patient’s relief.
Suboxone also can be prescribed by certified physicians across the country, which makes the treatment more convenient in rural communities.
But there are drawbacks. Strict criteria govern the treatment. In order to start on the drug, a patient must be in a specific phase of withdrawal and cannot be taking certain other drugs that interact poorly with suboxone. Also, only certified physicians can administer the drug, and they are limited in the number of patients they can treat.
Williams said those enrolled in her program have an astonishing 87 percent success rate at beating their addiction.
But some say the drug may not be all it’s cracked up to be. Suboxone is the most expensive drug per milligram on the black market today, said Richard Stallard, head of the Southwest Virginia Drug Task Force. An 8-milligram pill sells for $25 to $30 on the street, which means 80 milligrams – the average dosage of OxyContin – would cost more than $400, he said.
"There have been several suboxone arrests. I am not saying that it doesn’t work when used properly," he said. " ... But to say it has no potential for abuse is totally wrong. No one is going to spend $30 on a pill that don’t make you feel good when you use it."
Stallard said he started seeing the drug on the street about two years ago.
"Not many weeks go by in this area that there is not a suboxone purchased by undercovers [police]," he said. "I was here when oxy came in the mid-’90s. It started slow and then got big. Suboxone has some similarities."
Women and men tend to have different types of stress-related psychological disorders. Women have greater rates of depression and some types of anxiety disorders than men, while men have greater rates of alcohol-use disorders than women. A new study of emotional and alcohol-craving responses to stress has found that when men become upset, they are more likely than women to want alcohol.
Results will be published in the July issue of Alcoholism: Clinical & Experimental Research and are currently available at OnlineEarly.
“We know that women and men respond to stress differently,” said Tara M. Chaplin, associate research scientist at Yale University School of Medicine and first author of the study. “For example, following a stressful experience, women are more likely than men to say that they feel sad or anxious, which may lead to risk for depression and anxiety disorders. Some studies have found that men are more likely to drink alcohol following stress than women. If this becomes a pattern, it could lead to alcohol-use disorders.”
As part of a larger study, the researchers exposed 54 healthy adult social drinkers (27 women, 27 men) to three types of imagery scripts – stressful, alcohol-related, and neutral/relaxing – in separate sessions, on separate days and in random order. Chaplin and her colleagues then assessed participants’ subjective emotions, behavioral/bodily responses, cardiovascular arousal as indicated by heart rate and blood pressure, and self-reported alcohol craving.
“After listening to the stressful story, women reported more sadness and anxiety than men,” said Chaplin, “as well as greater behavioral arousal. But, for the men … emotional arousal was linked to increases in alcohol craving. In other words, when men are upset, they are more likely to want alcohol.”
These findings – in addition to the fact that the men drank more than the women on average – meant that the men had more experience with alcohol, perhaps leading them to turn to alcohol as a way of coping with distress, added Chaplin. “Men’s tendency to crave alcohol when upset may be a learned behavior or may be related to known gender differences in reward pathways in the brain,” she said. “And this tendency may contribute to risk for alcohol-use disorders.”
There is a greater societal acceptance of “emotionality,” particularly sadness and anxiety, in women than in men, noted Chaplin.
“Women are more likely than men to focus on negative emotional aspects of stressful circumstances, for example, they tend to ‘ruminate’ or think over and over again about their negative emotional state,” she said. “Men, in contrast, are more likely to distract themselves from negative emotions, to try not to think about these emotions. Our finding that men had greater blood pressure response to stress, but did not report greater sadness and anxiety, may reflect that they are more likely to try to distract themselves from their physiological arousal, possibly through the use of alcohol.”
source: Alcoholism: Clinical & Experimental Research
Sunday, May 11, 2008
A hard-charging outsider brought corporate sensibilities and a clash of cultures to the addiction center.
CENTER CITY, MINN. - Hazelden Foundation, the treatment mecca that made Minnesota a top destination for beating addiction, is in many ways enjoying some of its best years as a business.
The number of patients is growing. Donations are up. There's a new graduate school. A new women's center overlooks a lake on the bucolic campus.
So why, in just over a year, have nearly all of its top executives resigned?
Last month President and Chief Executive Ellen Breyer became the most recent of six executives to go, leaving a leadership vacuum just as a slew of initiatives launch.
The answer seems to rest in a clash of cultures -- between an iconic Minnesota institution steeped in tradition and a hard-charging manager who tried to haul it into the 21st century corporate world.
Admirers describe Breyer as a visionary who modernized the 59-year-old nonprofit institution, forging contracts with insurers and revamping its publishing business. Detractors bemoan a focus on money as a departure from Hazelden's mission of treating addicts, insured or not.
"Ellen was recognized for taking on an organization that I'm not sure wanted to be managed," said Ron Hunsicker, president of the National Association of Addiction Treatment Providers (NAATP). He credits Breyer with improving Hazelden's finances.
"The question is: Is it a happy organization? That's a delicate balance," he added.
Breyer was hired five years ago to reverse Hazelden's slide in an increasingly competitive national treatment market. Despite rosy financials, it hasn't regained its former stature. The choice of the next chief may determine whether Hazelden does that, or becomes just another little rehab on the prairie.
Thirty years ago, Hazelden was the place a rock star like Eric Clapton would fly to from London for what was simply the best chance in the world to get sober.
Still highly regarded, it is no longer the go-to place it was in the 1970s and 1980s. Back then, as William Cope Moyers wrote in his 2006 memoir "Broken," to be treated at Hazelden was to be "part of a community of strangers who knew intimately why each of us was there, and so we all felt as one."
It started in 1949 in a farmhouse where men followed a recovery program based on the Twelve Steps of Alcoholics Anonymous. Teams of psychologists, chaplains and clinicians developed an approach that was copied worldwide.
But by the time Jerry Spicer became chief executive in 1992, managed-care companies had decided they didn't like what had become known as the Minnesota Model, with its costly, long-term inpatient approach. They preferred cheaper short stays and outpatient care. Hazelden felt the cost pressure. Hundreds of other centers closed or downsized.
An outsider moves in
A decade later, Spicer's successor, health care executive Nick Hilger, lasted one year. In 2002, Breyer was plucked from Hazelden's board and made president and chief executive.
She had been vice president for marketing at Ryan Companies, a commercial real estate developer. Breyer brought an outsider's corporate sensibilities to the insular treatment field.
Hazelden inked a contract with Blue Cross and Blue Shield of Minnesota, which now brings in about 30 percent of Hazelden's patient revenue.
That Blue Cross contract opened the floodgates to insured patients but squeezed out those at the high and low end. Therapists and alums used to referring patients couldn't always get their self-paying patients in the door. At the opposite end, charity care fell.
Still, it was hard to argue with the numbers: In 2007, Hazelden had operating revenues of $109.3 million and a record 10,754 patients. Donors gave a record $12 million.
Despite Hazelden's traditional devotion to abstinence-based treatment, Breyer approved use of new pharmaceuticals to treat addiction.
She won some fans. "People generally thought highly of Ellen," said Jill Wiedemann-West, Hazelden's senior vice president and chief operating officer of clinical and recovery services. "She brought a vision."
But to others, she represented a break from the Hazelden of old, where being in recovery was a credential as good as any fancy academic degree.
"The addiction field has been known for its warmth, its compassion, its affirmation," said Hunsicker. "Ellen brought with her a bit of an aloofness."
The treatment community felt the changes. "Hazelden used to be looked at as the mother ship, the mecca," said Dan Cain, president of the Twin Cities treatment agency RS Eden. "That level of awe, of deference, has diminished significantly."
Breyer sees Hazelden's role differently: "There's the recovery movement, and there's the AA movement. Then there are organizations, Hazelden being one of them, trying to provide services to people in these movements. We are not exactly the same. ... Sometimes people think we should match up."
The exodus begins
In 2006, Breyer brought in the Hay Group, New York consultants who grouped Hazelden's activities into three "strategic" businesses: treatment, publishing and the graduate school. Fundraising was a fourth important area.
"Trying to get your hands around that organization was like trying to sort stuff out of cotton candy," Hunsicker said. "Ellen, for good, better or worse, rolled up her sleeves and said I'm going to build some accountability."
That year, the National Association of Addiction Treatment Providers named Breyer Administrator of the Year.
By the next year, Hazelden executives began leaving.
General counsel Ivy Bernhardson became a Hennepin County judge. Carol Falkowski, director of research communications, is now director of chemical health at the Minnesota Department of Human Services. Both declined to be interviewed.
Chief Medical Officer Dr. Marvin Seppala left to head an in-home treatment program. Vying to return as Hazelden's chief executive, he declined to talk.
Mike Ranum, chief financial officer and chief administrative officer, joined an architectural firm in St. Paul. He did not return calls for comment. Nor did Tom Galligan, former market development chief.
All left, Breyer said, because of other opportunities. The departures "had very little, if anything, to do with me," she said.
Moyers, working on public policy, had become Hazelden's most recognizable public face. He also tried to leave last year but stayed after Hazelden funded a Center for Public Advocacy and put him in charge.
Moyers said he viewed the changes Breyer made as "necessary, challenging and inevitable" but added: "I knew it was going to be hard to get resources for things other than our bottom line."
The chairman of Hazelden's board of trustees, Norbert Conzemius, acknowledged that there was friction but said "every CEO that's trying to get a job done and manage change is going to meet resistance."
The last straw
Early this year, Breyer announced she was moving Hazelden's headquarters from near Center City to downtown Minneapolis. She wanted to raise Hazelden's Twin Cities profile.
Some employees and board members felt that location was all wrong. "There's nothing about it that reflects the spirit of Hazelden. It's entirely corporate," said a senior executive, who asked to remain anonymous. That move, the executive said, was the final straw.
On Feb. 1, Breyer told the Minneapolis St. Paul Business Journal her office would be at US Bancorp Center on the Nicollet Mall.
On Feb. 9, she suddenly backed out of a NAATP board meeting in Phoenix, explaining she had to attend a special Hazelden board meeting. Breyer said she resigned at that meeting because she had exceeded a self-imposed tenure of five years.
She leaves an organization scrambling to carry out initiatives she launched, including modernization of the Center City campus and a commitment for a $10 million expansion in Oregon.
Hazelden has begun rebuilding its leadership, although three positions -- chief executive, chief medical officer and chief financial officer -- remain open.
The next chief, said Hunsicker, needs to be "someone in recovery, someone well-known in this field. They can't bring in another outsider."
source: Star Tribune
Saturday, May 3, 2008
He's a 35-year-old husband and father who grew up in a small suburb of Worcester. Prescription drugs led to heroin.
"I was doing dope every day."
She is a wife and mother, who got hooked on vicodin after surgery.
"I was just sick and tired of spending my money on drugs. I wanted to be clean," he told Team 5 Investigates.
But that changed when their doctors prescribed buprenorphine, also known as suboxone. "It got me clean for the first time in 10 years so they work, if you take them the correct way," he said.
"I was getting my life back," the mother said.
The little orange pill has been called a miracle drug by many medical experts. Suboxone is a safer way than methadone to treat heroin and painkiller addicts. Unlike methadone, a doctor prescribes suboxone.
"It prevents people from feeling withdrawal and it also gets rid of the craving," said Dr. Dan Alford, an opioid specialist with the Boston University Medical Center.
Suboxone is the only opioid for which doctors need special training and certification before they can prescribe it. Alford estimates that only 2 percent of physicians in the country, and in Massachusetts who are eligible to get the certification, actually do.
"Physicians aren't motivated to take this on, to embrace this," Alford said.
Patients prescribed suboxone sometimes get multiple refills, and often get little medical supervision. Only a small dose is needed, so some recovering addicts trade pills for heroin or OxyContin, or sell suboxone for between $5 and $15 per pill.
A recovering addict who declined to let Team 5 Investigates use his name said, "If you are getting a prescription of 120 and selling 90 of them, that's $900."
Team 5 investigates spent a day riding along with Tim O'Connor of the Worcester Police Vice Squad, and saw the problem firsthand.
"Those are his pills, he's just selling them," said O'Connor. He added that suboxone is starting to surface in nearly every drug bust.
A man who worked with police during a recent sting told Team 5 Investigates, "I walked to the first corner, looked around and asked for 'boxone. One guy had crack, one had dope, the other had suboxone."
Suboxone was never meant to be a street drug. In fact, it's the centerpiece of a multimillion-dollar government effort to shift the treatment of opiate addiction away from methadone clinics to private doctors' offices.
Even suboxone's manufacturer, Reckitt Benckiser Pharmaceuticals, uncovered disturbing trends in a report sent to the FDA earlier this year, including evidence of lax or inappropriate prescription by doctors. At a drug treatment center in Lynn, Mass., the report noted that a third of drug abusers said they used "bupe" to get high. More than a quarter of suboxone exposures involved children younger than 6 who found and ingested the drug in their homes. And, when mixed with other drugs, suboxone can be fatal. There have been 15 reported deaths since 2005.
Experts say the promise of suboxone treatment is tremendous when it's dispensed and supervised properly. But the great concern is, like the widely abused painkiller OxyContin, it is too often ending up in the wrong hands.
"I think similar to what happened with OxyContin, where there was a perception among the youth that it was safe, that it is a prescription medication, it's safe, so that is a concern," said Alford. "The solution is not clear to me."
Friday, May 2, 2008
Drug users can be taught to identify and quickly respond to overdoses of heroin or other opioids as effectively as medical experts, a Yale University study suggests.
The study supports efforts of some drug counselors, physicians and public health experts who have started community-based programs to train addicts and supply them with the opioid antagonist drug naxolone in order to respond to potentially fatal drug overdoses.
Naxolone, a medication lacking in abuse potential and routinely used by emergency medical personnel to treat heroin and other opioid overdoses, can be administered by a simple muscular injection. The drug temporarily combats effects of an overdose until medical help can arrive. Critics of such a harm-reduction strategy, however, have questioned whether drug users have the ability to recognize an overdose and can properly administer the drug. This study, recently published in the early online edition of the journal Addiction, suggests this concern is unwarranted.
"You have to keep people alive long enough to get access to drug treatment for their addiction,'' said Traci Craig Green, a doctoral candidate in the Yale School of Public Health and lead author of the research "You can't treat a dead person."
Ten individuals who were regular users of heroin or other opioid drugs such as oxycodone or hydromorphone were enrolled in the study at each of six sites across the United States. They were divided into two groups, one with members who had previously received training in overdose response and one with members who had not. Individuals were interviewed to determine if they could recognize signs of opioid overdose and when it was appropriate to administer naxolone. Their responses were then compared to those given by a group of medical experts.
The training, conducted well before the interviews were done, included recognizing differences between overdoses caused by opioids and those caused by other substances such as cocaine, for which use of the drug naxolone is not indicated.
"The study shows opioid users with training can spot an opioid overdose, are less likely to miss true opioid overdoses, and can determine whether naloxone should be administered and when it should not be administered,'' Green said.
The study was funded by the National Institute of Mental Health. Other authors included Robert Heimer and Lauretta E. Grau from the school of public health.
Thursday, May 1, 2008
VANCOUVER - Treatment works for homeless, mentally ill drug addicts, despite many public myths that it doesn't, a senior public health authority said Tuesday.
It often seems that it fails because the treatment available in B.C. is sporadic, underfunded and a patchwork, Dr. Patrick Smith, a vice-president of the Provincial Health Services Authority of B.C., said at a conference on mental illness and addiction.
Smith said the evidence that treatment works for mental illness and drug addiction is stronger than the evidence for treatments for other diseases like cancer and diabetes.
"There are many things we don't understand about mental health and addiction, but there are many things we do understand," Smith told about 150 people at the conference. "Treatment works. I can't emphasize this enough. It's no longer okay for our leaders to believe there are not evidence-based approaches."
Afterwards, he said the reason people think treatment isn't effective is that the kind of treatment most mentally ill and addicted people get is so limited and erratic that it's bound to fail, the same way that giving someone a tenth of the dose of penicillin they need for an infection is also bound to fail.
"When you look at treatment that's applied with scarce resources, there's more failure," he said.
He pointed to the difference in the way cancer is treated in B.C., compared to addiction. The province has a comprehensive and aggressive system of care, which means people everywhere in the province have good access to the same standards of care.
As a result, B.C. has the best health outcomes in Canada for people with cancer.
The same could happen with addiction if the same resources and standards were applied, he suggested.
Smith and others emphasized that people have to stop seeing addiction, especially when it's combined with mental illness, as some kind of problem that can be cured with a magic-bullet, one-time-only miracle cure.
That's not realistic because it's an ongoing health problem, like diabetes, and needs to be treated that way.
"We are talking about chronic-disease management," said Soma Ganesan, the medical director of the psychiatric wards at the University of B.C. and Vancouver General Hospital. Ganesan said there needs to be a national strategy that comes with real money.
Others throughout the day agreed with Smith and Ganesan that the problem is not a lack of effective treatment, which they saw as including everything from early intervention and prevention to harm reduction to full-scale detoxification and recovery services.
But there are all kinds of gaps and dysfunctions in the system, particularly for the homeless mentally ill and addicted.
For years, mental illness and addiction treatments were run separately. That changed in 2003, but many speakers still talked about the fact that mental-health counsellors will often demand that clients get off drugs before getting help for their psychiatric problems.
As well, there are all kinds of barriers to communication. The drug-policy coordinator for Vancouver police, Insp. Scott Thompson, said his officers spend hours with mentally ill clients, picking them up and taking them to emergency rooms. Then they're told they can't have any follow-up information because it's a privacy violation.
The one-day conference was organized by the City of Vancouver as a way of focusing attention and building momentum to get system changes and more resources for people who have both psychiatric and addiction problems, a group that is a big part of the city's rising homelessness population.
source: © The Vancouver Sun 2008