you are not alone
what’s Killing us?
“Addiction is a family disease…one person may use, but the whole family suffers.”
If your family is like most others, you are not prepared for this, but something must be done — now. Having been in a similar situation, I started inCrisis Consultants to dramatically shorten the learning curve in finding the right solutions when addiction and/or mental illness hits your family. Those solutions include:
Interventions, if necessary, to get the individual to treatment.
Choosing the right treatment facility per the individual’s diagnosis; drug-use patterns; drug-related medical, mental & social problems; and financial resources, including insurance or no insurance.
Escorting the individual to rehab either locally or across the country.
Introduction to an attorney per the individual’s needs
One year case management to assist with the year-long treatment plan designed by licensed treatment professionals.
“I was always the black sheep. Then I started going to meetings and found the rest of the herd.”
We are not Saints
At this moment, you are asking yourself, “So, what do I do now? Who do I call? What do I need to know?”
Know this — you are not alone. Addiction is an equal opportunity abuser and it does everything to defend itself. It attacks families at every socioeconomic level — from Park Avenue to skid row. It doesn’t matter if you are male or female, employed or unemployed, young or old, any race or religion, everyone is fair game.
Just within the past year, over 50 million of us used an illicit drug. Over 20 million currently have an SUD — Substance Use Disorder — from drugs and/or alcohol.
Think of this when walking on a busy sidewalk, at a shopping mall, a sporting event, any public gathering — out of all those people you pass or with whom you are sharing a communal event, 1 in 14 of them (7.4%) over the age of 12 are currently suffering from an SUD.
That’s more than the population of New York State. More than those of us currently living with cancer. And, 8.5 million of them also have a mental disorder along with it — called a “co-occurring” or “dual diagnosis.”
Many of those who are dependent on drugs or alcohol are “functional” — 70% of those with and SUD are actively employed, 55% of them full-time — and the disease will worsen over time.
“Addiction doesn’t negotiate”
Those of you reading these pages who are 50 years-old or younger, the odds are that your death will be due to a drug overdose. And here’s a parent’s nightmare: overdose alone is the leading cause of death for those between the ages of 15 to 44 years-old.
While you should naturally be reaching 78 years upright on this planet, in 2017 up to 197 people per day in America joined the estimated 72,000 who overdosed on illicit substances. That’s more than the total of U.S. soldiers killed in Vietnam; more than car accident deaths at their peak; deaths due to AIDS at its zenith; and the highest ever number of gun deaths.
“No single factor determines whether a person will become addicted to drugs.”
Nora D. Volkow, M.D., Director of National Institute on Drug Abuse
Addiction is a chronic brain disease causing the inability to control the impulse to use a substance or repeat a process despite devastating consequences. It is not a moral failing, a result of bad character nor lack of will — though some unenlightened people still believe that. It is a chronic disease that alters the individual’s brain structure and function that cannot be stopped by the simple, “just say no,” or “just buck-up, will ya?”
What causes addiction? Nobody knows for sure, but research points towards it being a long-term illness resulting from the complex interplay between one’s genes and environment. Scientists estimate that genes account for 40% to 60% of a person’s risk of addiction.
Contributing factors are believed to be mental disorders, physical, emotional or sexual abuse and/or trauma. Other factors include parental substance use; availability of drugs or alcohol; exposure to stress; incarceration of a family member; poverty; and age when use begins. Some people with mental disorders use drugs to lessen the psychiatric symptoms, but actually intensify them in the long run.
As with other chronic diseases like heart disease, asthma, diabetes, hypertension, there is no cure, but it is manageable. Manageable through treatment and an evolving, ongoing support system so that anyone can live a self-directed, full, active, meaningful, loving, productive life just like anyone else on this planet.
“You know you’re an alcoholic when you misplace things — like a decade.”
In order to treat an SUD, it is necessary to know exactly what needs to be treated. The true diagnosis of an SUD is principally based on a clinical assessment by a licensed behavioral health professional. A tool licensed professionals often use is the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) — where 11 diagnostic symptoms define if there is a disorder and the severity of it.
Using in larger amounts or for longer than intended.
Wanting to cut down or stop using, but not managing to do it.
Spending a lot of time to get, use or recover from use.
Craving for the substance.
Inability to manage commitments due to use.
Continuing to use, even when it causes problems in relationships.
Giving up important activities because of use.
Continuing to use, even when it puts you in danger.
Continuing to use, even when physical or psychological problems may be made worse by use.
Increasing tolerance to the substance.
Range of severity:
Fewer than 2 symptoms = no disorder.
2 to 3 = mild disorder.
4 to 5 = moderate disorder.
6 or more symptoms = severe disorder.
A professional diagnosis typically comes up as one of the following:
Substance Use Disorder — SUD.
Primary SUD and Secondary Mental Disorder (Dual Diagnosis).
Primary Mental Disorder and Secondary SUD (Dual Diagnosis).
“The right plan is the one that works for that individual.”
Mike Early, NorthBound Addiction Treatment
When I started working with families, I met with a family in my conference room — nine of them came to meet me. I well remember one of the adult male members asking, “All I have to do is Google “rehabs” and I see hundreds of them out there. Why are we hiring you?”
“Actually, there’s 14,500 of them out there,” I replied. “Can you tell me which is the right one for your nephew?”
Awkward pause, then, “Good point,” he said.
There are over 14,000 certified drug and alcohol treatment programs in the U.S., according the SAMHSA — the Federal government’s Substance Abuse and Mental Health Services Administration. All you have to do is pick the right one for you or your loved one. The point is, if you’ve never done this before and know nothing about rehab, how do you do that?
In the simplest of definitions, formal treatment at a reputable treatment facility typically incorporates a combination of detox, behavioral therapies and medications, then structures an aftercare plan or RSS — Recovery Support Systems — when the individual is transitioning back into the “real world.”
However, no one treatment facility nor one single treatment is the “right one” for every individual and disorder. Just as there is no set timeline when everyone achieves long-term recovery, there is no one plan that is going to fit everyone. Treatment has to be tailored to address each person’s drug-use patterns and drug-related medical, mental and social problems.
As there are patients with varying diagnoses, there are rehabs with varying programs and strengths in treating various maladies — as well as several additional factors that fit a particular individual or not. The key is finding the right one for the right individual.
Once I have a diagnosis, I first focus on the facilities specializing in that particular diagnosis for that individual’s placement.
This is where I specialize. Due to my unique set of resources and relationships nationwide, I work only with facilities that value the patient’s welfare as the primary mission. They deserve their sterling reputations through evidence-based results, their owners and staffs are dedicated to proper treatment, they are members of the NAATP (National Association of Addiction Treatment Professionals), plus certified by The Joint Commission and/or CARF.
Here’s one reason I love working with facilities that have integrity — if they don’t feel that are the right fit for a particular individual, they routinely refer other rehabs — and will even call them for you! The “good guys” in this business all know and respect each other. They don’t see other rehabs as competitors; they see that what’s good for one facility is good for them all.
When a crisis due to addiction or mental illness hits a family, that is the precise time when families are most vulnerable, desperate to find the right solution to their existential plight. The over $40 billion per year treatment industry is unregulated and making ruthless charlatans rich through exploitive, unethical “treatment centers” and bogus drug testing. Not to mention the defrauding of insurance companies, which only makes accessing effective treatment more expensive for the rest of us. The rehabs who promise anything just to get your business are the outliers and everyone knows who they are.
A reputable specialty facility structures at least a one-year plan incorporating 90 to 120 days of a combination of behavioral therapies and possible medications coupled with an aftercare plan incorporating RSS — Recovery Support Systems — when the individual is transitioning in the “real world.”
Documented research and treatment experts insist that the longer the treatment, the greater the odds of long-term sobriety and recovery. To lessen the chances of relapse and increase the chances of successful outcomes, experts assert that anything less than 90 days of formal treatment at a specialty facility is of limited effectiveness.
The aftercare plan — RSS — should not only be for the balance of one year, but also serve as a roadmap for a lifetime of continued recovery that must be continually assessed and modified to meet the individual’s changing needs including:
Accompanying MAT, if necessary;
Continued education, employment or community service while residing in a supervised sober living environment;
Individual and group counseling sessions;
Changes and adjustments adapting to the individual’s current and future lifestyle.
Statistics show that maintaining a structured aftercare program for 3 years, including living in a sober environment, dramatically increases long-term recovery outcomes. Plus, I am consistently told by those in life-long recovery that 12-step meetings — or one of the other mutual support programs — continue to be a lifetime endeavor critical to their recovery.
“Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring .”
Nora D. Volkow, M.D.; Director of the National Institute on Drug Abuse
Relapse is frequently part of the journey — especially for millennials — not the failure of treatment. I have witnessed parents lamenting, “Well, there goes that money down the drain. What good did that do?”
A hard and expensive lesson, but one to learn nonetheless. The chronic nature of addiction means that relapsing is not only possible, but likely since its recurrence rates are similar to other chronic diseases like diabetes, asthma, hypertension with relapse rates of 50% to 70%. More than 60% of people treated for an SUD relapse within the first year of discharge from treatment and remain at increased risk of relapse for many years.
What do you do when one relapses? Does it mean that treatment was a waste of resources? Your hard-earned money down the drain? No, not at all, far from it. Relapse does not mean failure. Treatment of chronic diseases involves changing deeply rooted behaviors.
Relapse is the time to reinstate treatment, but with adjustments or even a completely different approach.
“Treatment teaches the addict tools to help the addict get sober. However, the addict gets sober when he/she truly wants to get sober — it is completely up to the addict.”
Walt Quinn, Cumberland Heights
After thirty years in the entertainment industry out of Los Angeles, Neal Nordlinger originally came to Oklahoma City to raise funds and run an Internet start-up he founded. Because of his family's journey through addiction and recovery, Neal began receiving a plethora of appeals for advice from individuals and families also hit by drug and alcohol abuse. It was a natural, intuitive reaction for Neal to start and run full time inCrisis Consultants to provide attorney and treatment options available to those in need per their financial and insurance resources. Based both in Los Angeles and Oklahoma City, the response has been overwhelming.
A graduate of the University of Southern California's Cinema School, Neal spent the majority of his career producing feature films, television mini-series and series on location throughout the U.S. and worldwide.
According to the National Survey on Drug Use and Health (NSDUH), an estimated 20 million Americans aged 12 or older used an illegal drug in the past 30 days. This estimate represents 8% percent of the population aged 12 years old or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription drugs used without a prescription. And, despite the numbers, for many people, the Facts About Drugs are not clear.
Facts About Drugs:
Marijuana: Each year more teens enter addiction treatment with a primary diagnosis of marijuana dependence than all other illegal drugs combined.
Cost to Society: The estimated cost of drug abuse exceeds $190 Billion:
$130 Billion in lost productivity
$20 Billion in healthcare costs
$40 Billion in legal costs including efforts to stem the flow of drugs
Beyond the financial cost is the cost to individuals, families and society:
Spread of infectious diseases such as HIV/AIDS and hepatitis C, either through sharing of drug paraphernalia or unprotected sex
Deaths due to overdose or other complications from drug use
Effects on unborn children of pregnant drug users
Impact on the family, crime and homelessness
Most Commonly Used and Abused Drugs:
Without question, the most commonly used and abused drug, after alcohol, is marijuana. Other common drugs of abuse include cocaine, heroin, inhalants, LSD(acid), MDMA (ecstasy), methamphetamine, phencyclidine (PCP), steroids (anabolic), Vicodin, OxyContin and other prescription drugs.
Short-Term Effects of Drug Use:
Drugs are chemicals and while each drug produces different physical effects, all abused substances share one thing in common. They hijack the normal function of the brain and change the way the brain responds to issues of self-control, judgment, emotion, motivation, memory and learning.
This is why the person feels differently — the signals coming and going from the brain have been changed. Although this can cause temporary euphoria it can also cause hallucinations, anxiety, paranoia, and uncontrolled behavior. It can cause your respiratory (lungs) and cardiovascular (heart) systems to malfunction or fail.
And, there are social consequences to using drugs including losing the trust of friends and family; poor performance at school or work; quitting activities you enjoy; making bad decisions like placing yourself at risk to be a victim of violence, drugged driving; getting pregnant and surrounding yourself with other people who use drugs.
Long-Term Effects of Drug Use?
Beyond the short-term risks and consequences are the potential long-term effects. It depends on the drug, but all drugs can cause negative health effects and can lead to addiction.
Whether you become addicted to marijuana, OxyContin, heroin, Xanax, cocaine, methamphetamine or Vicodin, the effect on the brain and your life is the same: an uncontrollable craving to keep using that is more important than anything else in your life, including your family, friends, co-workers, career, school and even your own health, security and happiness.
(Used with permission from the National Council on Alcoholism and Drug Dependence, Inc. (NCADD)www.ncadd.org )
Frequently Asked Questions (FAQ’s): Drugs:
Question: Does marijuana use lead to the use of other drugs?
Answer: While most marijuana smokers do not go on to use other illegal drugs, long-term studies of high school students show that few young people use other illegal drugs without first using marijuana. Using marijuana puts people in contact with people who are users and sellers of other drugs and are more likely to be exposed to and urged to try other drugs.
Question: Why do some drug users become addicted, while others don’t?
Answer: Risk factors for becoming drug addicted, like other conditions and diseases, vary from person to person. But, the common risk factors include: 1. Genetics- your family history, 2. Age when you start taking drugs, 3. Family (including abuse, neglect and traumatic experiences in childhood) and Social Environment (including access to drugs) and 4. Types of drugs used.
Question: Can you get addicted even though you only do it once in a while?
Answer: YES. For most, drug addiction is a process - not an event. Most people who use drugs do so with an intention of only using once or once in a while. No one decides that they want to be an addict. But, we are dealing with addictive drugs that directly affect the brain. It is easy for occasional use to change to frequent use or constant use- that is addiction. The only thing we know for sure - if you don't do drugs, you definitely won't become addicted.
Question: Are over-the-counter (OTC) drugs dangerous?
Answer: All drugs, regardless of whether they are illegal, prescription or over-the-counter (available without a prescription), change your body and can be potentially harmful. Some over-the-counter drugs can cause serious problems or even death, if used incorrectly. The only safe way to take any over-the-counter medication is exactly as directed and for the specific problem for which it is intended.
Example: OTC Cough and Cold Remedies: The health risks of abusing OTC cough and cold remedies include impaired judgment, nausea, loss of coordination, headache, vomiting, loss of consciousness, numbness, stomach pain, irregular heartbeat, seizures, panic attacks, cold flashes, dizziness, diarrhea, addiction, restlessness, insomnia, high blood pressure, coma, and death. Like any other drug, overdoses from over-the-counter medication can occur.
Question: What drugs are the most commonly abused?
Answer: Each year, the National Institute on Drug Abuse (NIDA) tracks drug use trends among high school students (8th, 10th and 12th grades) through the Monitoring the Future Study (MTF).
The following is a list of the most commonly abused drugs among 12th graders starting with the most frequent: marijuana (21.4% of high school seniors used marijuana in the past 30 days....more than the number smoking cigarettes – 19.2%), Vicodin, amphetamines, cough medicine, Adderall, tranquilizers, salvia, hallucinogens, OxyContin, sedatives, MDMA- ecstasy, inhalants, cocaine and Ritalin.
Question: Can a person be too young to become addicted to drugs? Answer: No. And, research and experience show that the younger someone starts using drugs, the greater the chance that they will become addicted.
Question: Are prescription drugs dangerous?
Answer: All drugs are chemicals that affect the body and how it functions. Unfortunately, too many people don't realize that prescription drugs can be as dangerous as street drugs. Prescription drugs require a prescription from a doctor because they are powerful substances, need to be regulated and taken under a physician's care.
Even if a person is prescribed a medication, taking more of that drug than the recommended dosage is dangerous, including accidental overdose. Medical supervision is needed to avoid dangerous drug interactions, as well as potentially serious side effects. And, prescription drugs can be addictive. Between 1995 and 2005, treatment admissions for abuse of prescription pain relievers grew more than 300%. Using prescription drugs without a prescription and medical supervision is unsafe and illegal.
Question: Marijuana is just a plant... is it really that dangerous?
Answer: Yes, marijuana is a plant but it has very real health consequences, including drug addiction. While some people think marijuana is a “harmless drug,” actual experience and the real science show a different reality. More teens are in treatment with a primary diagnosis of marijuana dependence than for all other illegal drugs combined.
Question: How do I know if I or someone close to me is addicted to drugs?
Answer: The short answer....if you or someone close to you is having a problem with drugs and they continue to use, it’s time to get help. Continued use, despite negative consequences, is a powerful indicator of addiction.
Question: How quickly can I become addicted to a drug?
Answer: There is no easy answer because there are many different factors involved. A person's genetic makeup (family history of alcoholism or addiction) clearly plays a role. In fact, that's why some people seem to become addicted almost immediately, but for others, it may take more time. And, some drugs are more addictive than others. For some, one time use can prove to be fatal. Choosing to use drugs is like playing a game of chance. But, if you do, the earlier you stop, the more likely you will be to avoid addiction and the harmful brain changes that result.
Question: What is drug addiction?
Answer: Addiction is a chronic disease. It is a complex disease characterized by craving, seeking and using drugs that affects every organ system in the body, including the brain. Repeated use of drugs changes the brain—including the way it looks and functions. The changes in the brain interfere with a person’s ability to think clearly, exercise good judgment, control behavior, and feel normal without using drugs.
Question: If drug addiction is a disease, is there a cure?
Answer: There is no cure for drug addiction, but it is a treatable disease and millions of people are living lives in long-term recovery. Recovery from drug addiction, like other chronic diseases, is a lifelong process. Just as the addiction has impacted every aspect of your life physically, emotionally and socially, recovery requires making major changes to the way you live, deal with life’s problems, and relate to others.
(Used with permission from the National Council on Alcoholism and Drug Dependence, Inc. (NCADD)www.ncadd.org )