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Addiction Recovery Bulletin

LISTEN – WHAT’S UP DOC? PROFITS? – 

March 8, 2021 – At one time, 73 percent of the prescriptions from two Tennessee drug-treatment clinics involved in the case were filled in Kentucky, a federal agent said.

The company named in the indictment is EHC Medical Offices, PLLC, which had clinics in Harriman and Jacksboro. Robert Taylor, a Tennessee doctor, owned the clinics during the time covered in the charges but sold them in 2018, according to court documents.

Taylor faces the most charges in the case, including conspiracy to illegally distribute buprenorphine and anti-anxiety drugs; conspiracy to falsify medical records, to launder money and to commit wire fraud and health fraud; money laundering; and taking part in transactions involving property derived from criminal activity.

Buprenorphine, often called by the trade name Suboxone, is a drug used to help people deal with an addiction to opioid drugs.

It is often diverted from legal sources and sold illegally. People addicted to drugs often use it to keep from getting sick from withdrawal when they can’t get drugs such as pain pills, but the U.S. Drug Enforcement Administration has said it can also be abused to get high.

The others charged in the case are physicians Evann Herrell, Mark Grenkoski, Kari McFarlane, Helen Bidawid, Stephen Cirelli, Eva Misra and Matthew Rasberry; nurse Lori Barnett, who managed EHC; and Kentucky residents Elmer Powers and Brian Bunch.

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Addiction Recovery Bulletin

OPINIONS ARE SPLIFFED – 

March 11, 2021 – Mr Green’s case is (sadly) all too familiar for clinical practitioners in psychiatry. Substance use comorbidity in psychotic disorders has been described as the rule rather than the exception, and it is often deleterious to the clinical course of illness.1 Cannabis (marijuana) is one of the most commonly used substances by patients with schizophrenia and related psychoses. Modulation of the endocannabinoid system by the main psychoactive component in marijuana, Δ9-tetrahydrocannabinol, can induce acute psychosis and cognitive impairment.2 Over the past 2 decades, there has been extensive research on the association between cannabis and psychosis.

To better understand the relationship, it is important to synthesize recent research—through the lens of systematic quantitative reviews—including associations between cannabis and psychosis risk; the epidemiology and phenomenology of psychosis and comorbid cannabis use; associations between cannabis use and clinical course; and outcomes in psychosis. Dichotomous outcomes are reported as odds ratios (OR) with 95% confidence intervals (95% CI). Continuous measures are reported as effect sizes (ES), where an ES of 0.2 is small, 0.5 is medium, and 0.8 is large.

more@PsychiatricTimes

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Addiction Recovery Bulletin

EASY AS RIDING A BIKE – 

March 4, 2021 – To cope with my father going missing, I started drinking nonstop. I couldn’t find any way to maintain happiness. I went on like that for two or three years, and I was let go from my job—I was a bike fitter at a bike shop—for drinking while working.

Once when I was coming off a binge, and I hadn’t had a drink for maybe 18 hours, I started violently convulsing; I had a grand mal seizure. I knew at that point that I was physically addicted and needed medical help. I met with a doctor who diagnosed me with severe depression and post-traumatic stress disorder (PTSD). My family helped check me into a three-month recovery program, and after that, I moved into a sober-living house.

I didn’t have a driver’s license, so I bought a blue fixie to ride to my job washing and waxing boats at Dana Point Harbor in Dana Point, California. I would ride it all the way from the house near Angels Stadium to the train station, and from the station to the harbor, and back again at night. I’d always loved riding bikes, as did my brother and dad, so these rides brought me a sliver of peace while everything else in my life felt out of control.

more@Bicycling

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Addiction Recovery Bulletin

HIGH ON ARRIVAL – 

March 11, 2021 – Phillips, whose parents were both in popular 1960s folk rock band the Mamas & the Papas, described her struggles with addiction after her tumultuous childhood during the annual Conference on Addiction at Utah Valley University on Thursday.

While attending a screening for “American Graffiti,” the early George Lucas film that Phillips acted in when she was 12, Phillips said she learned shocking details of her youth — ones she’d forgotten.

At the time of the screening years after the film’s initial release, Phillips was by then a mother in her 30s. A producer on the film asked her if she remembered when she got off a plane to film the movie, carrying a “fake leather suitcase” and all by herself. “And we said to you, ‘Where’s your guardian? You’re only 12. You can’t be all alone,’” Phillips remembered the filmmaker asking.

“And my heart started to pound. My hands started to shake,” Phillips said.

She learned the producer had needed to scramble to become her legal guardian for the duration of the film, and Phillips lived with his family.

“I had literally, absolutely no recollection and I still don’t to this day. I tell you that story because it gives a practical representation of how trauma lives … Trauma survivors don’t necessarily have memories,” Phillips said.

“But I have symptoms that have taken me throughout my whole life. Restlessness, irritability, trouble sleeping. All of these things,” she said.

That was just one example of a childhood with parents who suffered addiction Phillips shared during the conference, which took place virtually this year after being canceled last year due to the pandemic. Phillips appeared in her home in California over videoconferencing.

more@KSL

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Addiction Recovery Bulletin

MARKETING? – 

March 8, 2021 – When Margaret and John Millington’s son Simon was in the grips of an opioid addiction, his parents wanted to send him to a rehabilitation program. The only one available was called Narconon.

When he emerged at the end of three months he was better than they had ever seen, but he relapsed soon after and four years later died from an overdose, leaving his five-year-old daughter Maddie without a father. … Mrs Millington said “if there had been options, we wouldn’t have paid [for Simon] to go to Narconon”.

“It was the only option we had at the time. There were absolutely no government-funded rehabs around,” she said.

“We were happy to try anything to save his life, we just wanted to get Simon well.”

Narconon’s Yarra Ranges facility suspended operations in Victoria in 2019. Parks Victoria confirmed the group’s lease of its site, O’Shannassy Lodge, ended in June 2020. A new organisation under the Narcanon name was registered in March 2020, but a spokesperson from its parent organisation, the Association for Better Living and Education, said the future of the residential program and its current site was “uncertain”.

more@TheAge

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Addiction Recovery Bulletin

ANY DECREASE IS A WIN – 

March 10, 2021 – At the beginning of the global pandemic, uncorking a bottle of wine seemed to be the thing to do. A grip on a champagne stem felt like a grip on life, virtual happy hours were all the rage and there were plenty of memes about drinking making the rounds. But a year into quarantine, Dry January has come and gone, yet evidence suggests sobriety is sticking around. 

And it’s not just those who struggle with alcoholism who have embraced a sober lifestyle. There’s a growing group of people that are becoming sober or significantly cutting back on drinking to improve their health and well-being. Just ask Chrissy Teigen, for one.  

In fact, sales of non-alcoholic beverages at retail locations like grocery, liquor and convenience stores, continue to rise, according to NielsenIQ. As of late February, dollar sales of non-alcoholic beer were up 39% over last year; plus sales of non-alcoholic wine were up 34%. Meanwhile, online marketplace Etsy saw a 205% rise in searches for “sober or dry gifts” from Dec. 1 to Feb. 28, compared to last year, says trend expert Dayna Isom Johnson. 

More:If you canceled dry January during chaos at the Capitol, here’s why you should reconsider

Teigen revealed in late December that she had given up booze, crediting Holly Whitaker’s book “Quit Like a Woman: The Radical Choice to Not Drink in a Culture Obsessed with Alcohol” for helping with the transition. 

more@USAToday

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Addiction Recovery Bulletin

PRISON INDUSTRIAL COMPLEX – 

March 8, 2021 – As an emergency medicine physician, I often ask patients about their upbringing. Some describe terrible situations where I admit to myself that if I had been raised similarly, I might be escaping with drugs, too. I ask where they get the $50-$200 a day needed to sustain their habit. Many get others hooked because new users become paying customers. Then there’s petty crime, prostitution, and the major violence that plague our streets. I remember a discussion with one patient who had been a big-time dealer, and I asked him what he was making. His answer, “$25,000 per week, tax free.”

When I was in the General Assembly, in a 2018 public hearing, I asked Baltimore State’s Attorney Scott Shellenberger how much crime in the greater Baltimore area was due to drugs. His answer: “Upwards of 85%.” Those numbers apply across our state. The drug trade is vast in scope and sophistication. People with substance abuse disorders need drugs daily, and there’s a global network to meet that craving. It starts overseas, where opioids and cocaine are processed and then distributed via well-established lines. The billions spent on drugs are funneled back to the drug cartels by financial mechanisms that would rival a Wall Street investment bank. Where does all that money end up? Ultimately, it goes to dangerous overseas drug cartels and terrorist organizations, like the Taliban, ISIS and al-Qaida. We continue on a policy trajectory that is destroying our society from the inside while shipping vast sums of money to those who would destroy us from the outside.

more@BaltimoreSun

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Addiction Recovery Bulletin

DR. DEATH – 

March 4, 2021 – Blatti pleaded not guilty at an arraignment in Nassau County Court and was ordered jailed pending a March 30 court appearance. He faces up to 25 years to life in prison if convicted on the most serious charge.

“This doctor’s prescription pad was as lethal as any murder weapon,” Nassau County District Attorney Madeline Singas said.

A message seeking comment was left Thursday with Blatti’s lawyer.

Prosecutors said they believe this is the first time a New York doctor has been charged with murder in the second degree under the theory of depraved indifference to human life. A doctor in the Rochester area was charged with last month manslaughter in connection with a patient’s opioid death.

Blatti was previously arrested in 2019 on charges including criminal sale of a prescription for a controlled substance, forgery and reckless endangerment. That case is being consolidated with the one filed Thursday.

The five patients in Thursday’s indictment died between 2016 and 2018.

They included a 31-year-old volunteer firefighter who struggled with opioid use for nine years, a 50-year-old woman who suffered from acute neck pain and a 44-year-old electrician with back pain, asthma and COPD, prosecutors said.

more@ABCNews

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Addiction Recovery Bulletin

VIVA LA HIERBA! – 

March 10, 2021 – MEXICO CITY — Lawmakers in Mexico approved a bill Wednesday night to legalize recreational marijuana, a milestone for the country, which is in the throes of a drug war and could become the world’s largest cannabis market, leaving the United States between two pot-selling neighbors.

The 316-to-129 vote in Mexico’s lower house, the Chamber of Deputies, came more than two years after the Mexican Supreme Court ruled that the country’s ban on recreational marijuana was unconstitutional and more than three years after the country legalized medicinal cannabis.

The chamber approved the bill in general terms Wednesday evening before moving on to a lengthy discussion of possible revisions introduced by individual lawmakers. In its final form, though, the measure is widely expected to sail through the Senate before being sent to President Andrés Manuel López Obrador, who has signaled support for legalization.

The measure, as of Wednesday night, would allow adults to smoke marijuana and, with a permit, grow a small number of cannabis plants at home. It would also grant licenses for producers — from small farmers to commercial growers — to cultivate and sell the crop.  If enacted, Mexico would join Canada and Uruguay in a small but growing list of countries that have legalized marijuana in the Americas, adding further momentum to the legalization movement in the region. In the United States, Democrats in the Senate have also promised to scrap federal prohibition of the drug this year.

For “Mexico, given its size and its worldwide reputation for being damaged by the drug war, to take this step is enormously significant,” said John Walsh, director of drug policy for the Washington Office on Latin America, a U.S. advocacy group. “North America is heading toward legalization.”

more@NYTimes

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Addiction Recovery Bulletin

by Julie Lyons, LICSW

PUTTING OURSELVES BACK TOGETHER – 

March 12, 2021 – Coming out about addiction to the public, friends and loved ones these days may not have the shame that it did in the past; it may even seem easy, but it is only one part of an internal battle for emotional freedom. There could be hidden twists and turns that carry a powerful stigma; mental illness. Attempts to get down to the causes and conditions necessary to recover can be excruciatingly painful at times and cause relapse over and over. Reprieve from addiction can become impossible even when deeply committed to participating in a rigorous and supportive recovery program.  Some try sequestering themselves in luxurious treatment facilities and ocean retreats. They may hire private recovery coaches or top therapists and still continue to experience failure after failure.Disillusionment leads to feeling isolated and alone; hiding a “secret” too “crazy” to share with another human being; losing hope, blaming others or giving up on recovery.

Why?

When groups of coping skills, past behaviors or parts of the personality have been given diagnostic labels bearing the stigma of mental illness, finding peace in recovery can remain unreachable. Shame and secrecy about underlying conditions create thoughts of being marginalized and different, impeding the process of staying clean or abstinent from a particular substance.

So, what is the solution?

Having the “honesty, open mindedness and willingness” to consider that everyone has unique, multifaceted parts of their personalities often used as coping skills, we might be able to accept and embrace ourselves; our imperfections and our differences. Then a label telling us who we are and what we are capable of accomplishing might not limit us.

How do I know this?

I struggled with addiction for 20 years, afraid of facing the deep truth about myself; avoiding looking at the underlying components of my personality that I felt were repugnant and embarrassing by using drugs, alcohol and other substances.

I just couldn’t keep doing the same thing over and over. I stayed sober, went back to graduate school and actually finished. I earned a master’s degree, became a licensed therapist and secretly diagnosed myself. But now I knew from the inside how even therapists stigmatized mental uniqueness and did not believe that people could change.  I didn’t know then that these carefully compartmentalized elements of me actually held the answer to my problem and freedom from the cycle of addiction. I found out later people with the ability to form separate aspects of themselves to help them cope are extremely intelligent, creative and high functioning. They absolutely can learn how to operate their brain in a new way by creating new neural pathways.  I managed to stay clean long enough to find someone who could help me; a therapist who believed that by identifying, accepting and listening inside, I could learn how to “integrate” these amazing resilient and genius elements of myself. I was not stuck; misdiagnosed with bipolar or borderline personality disorder or accused of being psychotic or schizophrenic. I dedicated myself to doing everything that I could to “change my personality”, immersing myself in recovery programs, reading self-help books, working hard in therapy, studying neuroscience, metaphysics and transformational thought.

So, what WAS the label that I refused to believe was a life sentence and a reason to go back to drinking or take my own life?

The over-arching condition used to be called Multiple Personality Disorder. Renamed in the DSM-V (The fifth edition of The Psychiatric Diagnostic and Statistical Manual) as Dissociative Identity Disorder, a condition that develops when a child directly experiences or is exposed to severe mental, physical or sexual abuse and neglect between birth and approximately age 5 or 6, when the brain requires necessary nurturing and care to form the emotional building blocks for healthy maturation. Alternate personalities (alters) or parts are created as coping mechanisms for survival. Kind of like having several stand-ins for the main actor, so they don’t get hurt doing a stunt or have to get naked for a scene. What used to be thought of as a rare and difficult to treat mental illness is more common than has been noted in the research. (After all, I nor any of my clients or the others I have interviewed been part of any “research” on mental illness.  The truth is, in the hundreds of people that I have assessed, aspects of self exist on a spectrum (some people having more complicated parts than others) that when acknowledged, provide answers to the long-standing issues that hindered their ability to thrive. Most people are able to incorporate parts of their personality without much work where others who have distinct and noticeable parts had been previously misdiagnosed, over-medicated, or worse.  As Hollywood successfully produced media like Sybil, Split or the binge-watched series The United States of Tara, perhaps though, viewing Dissociative Identity Disorder through the lens of entertainment we have only furthered fear and ignorance.  And fear and ignorance are what kept me from coming out about the aspects or parts of myself; what kept me from staying clean and sober. Ironically, we have watched the demise of great artists, actors and musicians who were part of an industry that both exploited and perpetuated the stigma of mental illness. Perhaps there will come a day when we can call it Mental Diversity and truly celebrate our unique contributions to the world.  So, what’s it like for me today? I am a sober and productive member of the community, giving back what has been given to me. I live and work in sunny California, enjoying loving and healthy relationships.

Julie Lyons, LICSW

Transformational Psychotherapist, Certified Life Coach and

Dissociative Identity Expert. Julie is a sought-after consultant by treatment facilities, emergency departments, insurance companies, other therapists, medical and psychiatric professionals and has provided education to individuals, couples and families across the globe.

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