For many addicts, the shame of facing their illness is second only to their fear of going to treatment. They don’t want to leave home and they don’t want to get help with a group of strangers.

Imagine the relief the addicted person feels when he or she learns that their family has selected Eric Clapton’s treatment center, Crossroads, on the beautiful island of Antigua. The combination of first-class medical treatment with sea breezes and 12-Step recovery is a special gift.

Crossroads Antigua

I had the pleasure recently of taking another patient to Crossroads and spending time with Executive Officer, Kim Martin. Under her expert direction, the center has expanded its already extensive services, providing a warm and professional environment for the treatment of chemical dependency.

Many families think that Crossroads must be fabulously expensive, but nothing could be further from the truth. The treatment is very competitively priced and some scholarships are available for those who need it.

Others think that treatment in Antigua must be a glorified vacation, but this is not the case. A discussion with an admissions counselor and a look at the weekly schedule will dispel any ideas that patients will simply be lounging in the sun. Crossroads provides serious treatment for serious people in a beautiful setting.

Another benefit is the family program, offered once per month. It provided critical support and education for families, along with the opportunity to reconnect with their loved ones. What better place to begin again?

I’ve had a number of patients at Crossroads over the years, but every time I come back I wish there had been more. We use many treatment centers in our private practice, many of which are listed on this website. But Crossroads will always have a special place in my heart.

–Jeff Jay

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The official magazine of Al-Anon (Al-Anon Faces Alcoholism) interviewed Debra Jay. This article represents one of the first times that an author and clinician specializing in intervention has been interviewed in this journal. The article can be read here:

http://lovefirst.net/wpt/debra-jay-al-anon-faces-alcoholismm/

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Dr. Patricia Maryland (on left) and Debra Jay

The Love First family is so proud of Debra. She was recently honored at the 54^th Annual Detroit Bishop’s for her work in the field of addiction and recovery. She received the Sister Letitia Close Award, which recognized her efforts in helping women affected by the disease of addiction.

Dr. Patricia Maryland, President and CEO of St. John Providence Health System, presented the honor at a sold-out fundraiser. The event was held in the Grand Dining room the Detroit Athletic Club in support of treatment for Catholic clergy at Guest House.

Debra Jay is the author of No More Letting Go (Bantam 2006). She is also co-author of the best-selling Love First (Hazelden 2008) and Aging and Addiction (Hazelden 2002). She continues to work with families whose loved ones struggle with addiction or are in early recovery. Debra remains committed to moving the field of addiction treatment forward by developing trainings for clinical interventionists. She continues to work with the treatment community to develop new programs. For those of us who work with her every day we are in awe of her energy and creativity. She holds herself to a high standard and expects those who work with her to hold themselves to a similar standard. The next few years will be an exciting time for all of us who work with Debra Jay and Love First.

–Jamie Loffredo

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I’ll admit it. When I got sober, my diet was lousy. Fast food, doughnuts, cookies, ice cream and way too much coffee. The idea of eating right meant getting a salad to go with a full slab of ribs.

Although I was doing a good job of going to meetings, I was still beating my brain up. A constant flow of sugar and caffeine kept me on an energy roller coaster. I’d often stay out late at night talking with people from the meetings at the local greasy spoon, eating apple pie a la mode and drinking coffee until midnight. When I got up for work early the next morning, I often felt as bad as I did in my drinking days.

There’s a brief article on this subject here: Drew Ramsey, M.D.: To Fight Addiction, Feed Your Brain. One of the most important things people in early recovery can do is to start

Here are my top three physical things people should do to bolster early recovery.

1. Eat three healthy meals a day. The real thing. Just like momma taught you. Watch the sugar, especially if it’s not part of a meal. Rebuild the body and brain you’ve been hammering the last few years.
2. Limit caffeine after noon. And don’t expect to get a decent night’s sleep if you drink any coffee after dinner. You don’t need to be a speed freak. Eight hours of sleep will revolutionize your life. And if you read something in bed, you’ll sleep like a baby.
3. Get some exercise every day. I don’t care how embarrassingly puny the exercise is, at first. Take a walk around the block, ride a bike, anything. If you want to give your body a treat, get a few sessions with a personal trainer at a gym to get you going. Or a yoga place. Whatever.

I’m in the best shape of my life now. I feel better, think more clearly and have more energy than I did at 30. I wish I hadn’t waited so long to follow all the directions.

-Jeff Jay

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Painkiller abuse in the USA: Opana overtakes OxyContin. Good article in USA Today about the next wave of prescription drug abuse in the US. But as with Oxycontin, a new formulation may cause addicts to adapt a different strategy.

-Jeff Jay

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The media is finally highlighting and doing a pretty good job in discussing the dangers of opiate dependence in relation to pain management. The Fine Line Between Pain Management And Opiate Addiction Those of use working in the chemical dependency field have been watching this snowball over the past decade. In the late 1990′s there were news articles about hilly billy heroin (otherwise known as OxyContin) overrunning rural counties in Maine and Kentucky. Celebrities have been dying from their dependence to prescription medications for years, i.e. Heath Ledger. The media and publicists refer to it as medication mismanagement or an unfortunate interaction with medications. One of my favorite surfers, Andy Irons, died in 2010 from a prescription drug overdose. At the time, and to this day, no one speaks of Irons as an addict. Just that he died of an overdose related to prescription medications.

As a therapist in this field I am witness to the struggle of hundreds of addicts as they fight for their recovery. Some come by the disease innocently, hooked by an open script from a dentist, multiple knee surgeries, and so forth. Others use the relationship with the doctor as a means to protect their disease. “I am not going to stop taking the xanax, my doctor ordered it” or “I still need one vicodin because my back is really damaged and the doctor says that is all that will help.” My personal approach to those responses is simple, please sign the release of information and let us call your doctor together. The disease informs the client that there is no way that Jamie is going to talk to my doctor. This becomes a wonderful opportunity to educate the client about the disease of addiction and how it continues to try to protect itself, even when the client knows that they want to get healthy.

So knowing that there continues to be an increase in prescription drug dependence were do we go from here. I believe that the chemical dependence field must take charge and become a leader in how we treat chronic pain. Our counselors should take an active role in the development and use of non-narcotic pain management programs. The author of this article does a nice job identifying some effective approaches to treating pain without the use of opiates. There needs to be additional programing using EMDR and the mindfulness based therapies. Our field must educate medical professionals and share our knowledge on chemical dependence. Our national groups like NAADAC  and ACA and government agencies like SAMSHA and NIDA need to fund campaigns educating the public and professionals to break away from the “pill a day” mentality that fuels our healthcare system. Change is possible but it will require groups of professionals to saying there is a different way to do this.

–Jamie Loffredo, MA LPC NCC CAADC
 

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The media is finally acknowledging a growing trend in drug use amongst teens and adults. Synthetic Marijuana Usage Alarms American Pediatricians. The article outlines what many of use in the chemical dependence treatment field have seen for the past few years. I will say that it seems the problems associated with synthetic cannabis are getting worse. Over the last year I have received at least one phone call a day from an upset parent about their teenage son or daughter who is behaving erratically.  The conversation usually follows with the parent disclosing, “and Julie smokes this stuff called spice. What is this? Where do they get this stuff from?” My answer typically stuns the parent–”The gas station.”

The calls I receive from parents are typically about a child whose behaviors have become so erratic and disruptive that the parent is scared and considering hospitalization. There are reports that the use of synthetic cannabis have led to psychotic like episodes. When used in combination with other legal drugs like Adderall, the effect can be prolonged manic episodes. Anecdotally my clients report upsetting mood swings and have levels of anxiety.

I learned about synthetic cannabis from a drug court client. She was heroin dependent in partial remission but was smoking spice regularly since it was not detectable. Needless to say she relapsed on the heroin shortly after her disclosure. Because of her I started asking different questions of my court ordered clients. It was amazing how many clients were using the synthetics. Their belief was it is okay since it is “only” like marijuana, and the court cannot test for it.

Our attitude toward the use of drugs has shifted dramatically over the past decade. Marijuana is heralded as a miracle cure all. The use of cannabis has filtered into every inch of our pop culture. In session with my clients I have heard hundreds of times that marijuana isn’t even a drug. So with the creation of synthetic cannabinoids, the psychoactive ingredients in cannabis, a new product found it’s way into the market place and effectively into our junior and senior high schools.

When the drug first came on the market in the mid 2000′s it was believed that the euphoric sensation created from smoking spice was the result of combining different natural herbs. It was discovered that the manufactures of the natural incense where spraying a chemical, the synthetic cannabis, on to the product. It turned out to be not so natural.

Initially there were only a few varieties found on the market. Posh, Spice, and K-2 were the most popular varieties. The federal government and many state governments began to pass legislation banning the chemical compounds that were in existence. But as we know, drug dealers (sorry, chemists) are crafty. They adjusted the chemical structure of the compound creating new “legal” varieties. Currently in many states there are dozens of varieties of synthetic cannabis available and being openly sold in gas stations and head shops.

With parents I provide education on the use of synthetics. Most want to have their teen placed in a residential treatment facility. I encourage them to contact their insurance provider to advocate for themselves and their child that their insurance should pay for some or all of treatment. The sad truth is that insurance providers know very little about the synthetics and since drugs like marijuana are deemed a non-medical issue, inpatient treatment is not approved. Parents then have their hands bound. Their child continues to have access to the drug, their only immediate options are intensive outpatient treatment or outpatient treatment, and as we discuss in a moment, there is limited means to monitor the use of the substance.

Drug testing is not a reasonable option at this time. Only three of the strands can be detected through urinary drug screens. These are very expensive tests usually priced over $50 a screen. The tests have limited capability due to the explosion of new chemical compounds that are not detectable. Probation, which has served as an effective support for abstinence, is not able to test for the presence of these substances. Parents do not have the ability to test at home limiting their response.

Where do we go from here? Parents must be educated on the existence of synthetic cannabis. They need to know that a powerful and dangerous drug (other than alcohol and tobacco) is being sold at the corner gas station. As treatment providers we need to continue to stay on top of these trends. I believe those of us in the chemical dependence field do a good job knowing what is out there and what sits on the horizon. We need to advocate for the public and educate medical and mental health providers on what is occurring so that the pediatric physician, the emergency room nurse, the family internist and the school social worker is now knowledgeable enough to start asking the right questions.

–Jamie Loffredo, MA, LPC, NCC, CAADC

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Many of my clients will report “feeling stuck.” The feeling keeps them from reaching their goals or engaging others authentically in their relationships. They are unable to trace these feelings back to any significant life event. They report symptoms of anxiety, inability to concentrate, restlessness, low self esteem, and other common mental health issues that are seen regularly in therapy practices. In talk therapy we may spend months, if not years, talking about the symptoms with minimal results. We may even identify a past experience that triggers the current feelings. However being able to identify the root may not be enough to relieve the current symptoms.

Using the EMDR approach in therapy we target the experience. Using the eight phase structure we reprocess the past experience to alleviate the current symptoms. The neural networks associated with the memory are “cleaned” and the appropriate, healthy associations are made.

Most of the literature on EMDR focuses on the impact of significant trauma or the resolution of post traumatic stress disorder. There is limited discussion on the benefits of the EMDR approach to resolve issues related to “lesser” traumas.

These small “insignificant” moments are the ones that in EMDR lingo we refer to as little “t” traumas. These are events that we tell ourselves are no big deal and that we should be able to let roll off our back. These events may include not being invited to a birthday party at age 8, not being asked to play during recess, messing up a classroom presentation, or a million miscues we experienced from our parents. When these events are not processed appropriately they becoming blocking events. In the addiction field we talk about how a client is delayed developmentally by the drugs that they abuse. The EMDR approach is very similar. The Adaptive Information Processing Model (AIP) indicates that when we are unable to process an experience appropriately it becomes locked in our neural networks in such a manner that it impacts the processing or flow of new material. Essentially we start collecting a lot of dust on our mind’s lens.

Using the 8 phase structure and the use of eye movements and other bi-lateral stimulation the material is reprocessed and the lens is cleaned. The effect is not just to the past material but generalizes to future events. Clients who enter therapy to work on these “stuck” moments are pleasantly surprised by the speed in which they feel better.

It should go without saying that for clients working a 12-Step program of recovery, EMDR is an adjunct, complimentary therapy and not a substitute. EMDR can help people get to the next level.

–Jamie Loffredo

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