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OCD Treatment with CBT and ERP
A Work in Progress: Greater Collaboration and Seamless Integration of Healthcare Delivery Services as Provider Networks and Holding Companies Expand.
Opioids: Last Week Tonight with John Oliver
Billy Joel Believes his Problem Drinking is a Symptom of Depression, Rather than the Other Way Around
Warriors of Dignity

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"It's time to stop trying to fit a square peg into a round hole in addiction treatment."
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Articles, News and Blog

Are We a Nation Suffering From Post Traumatic Stress?


A Punitive Article About Substance Use Disorders Misunderstands the Author's Message.  But Is This Just the Tip of the Iceberg? 

"@nytimes changed the headline on this story in the Sunday paper, but it's still awful." -- Maia Szalavitz, author. 

The editor lacks empathy or understanding of individuals with substance use disorders.  I agree that the headline is awful and inaccurate.

But for me there is a greater concern:                                                                           

Are We a Nation Suffering From Post Traumatic Stress?  Has Trauma in the U.S. Caused Increased Substance Use and Impaired the Country's Judgment?

I am seeing less empathy, more bigotry and violence against misunderstood groups based on mental illness, race, class, sexual orientation, gender, religion and culture in general.Research has shown a link between PTSD and increased substance use (i.e. the rising substance use concerns in Japan since the tsunami, earthquakes, nuclear plant damage, etc.).

I am saddened by the growing anger, contempt and intolerance of those who are different in this country. To see the support of Donald Trump in this country is a sad testament about the susceptibility of a terrorized, traumatized people preyed upon by a would-be leader who is a lightening rod of fear and hatred; a man who lacks understanding of the Constitution, yet has the support of so many angry Americans.

When we see the unimaginable and horrendous terror of beheadings, mass shootings, bombings and other murderous events against innocent young children as well as adults, we are traumatized, then re-traumatized again by the next violent episode that occurs.  Is it any wonder that we face a growing opioid epidemic correlated with trauma in this country?

Oppression is on the rise against not only Americans with Substance Use Disorders and disabilities, but also against American values as a whole. This is trauma and Post Traumatic Stress on a grand scale in America (and throughout the western world). 

Unfortunately, it comes as no shock that the New York Times is not immune. Author Maia Szalavitz has every right to be bothered by the stigma against people with substance use disorders who she writes about.  The Times has lost its clarity and objectivity regarding this segment of the population.   

But I believe this is a part of a greater response to terrorism that truly hits home. American values are being challenged.   

In order to heal, the American people will need a harm reduction approach in legislature that supports empathy, understanding and unity for a traumatized nation in crisis.       

http://theinfluence.org/a-truly-awful-new-york-times-article-shows-how-addicted-people-are-still-seen-as-unworthy-of-life/


Coming Labor Day...


This Labor Day Scott W. Stern, Empowering Psychotherapy and Corporate Services 

Comes to Putnam and Westchester Counties.

______________________________________________________________________

Adult, Adolescent, Senior and Family Integrative Psychotherapy Focused on Substance Use Disorders, Addictions, Anxiety, Obsessive-Compulsive Disorder, Trauma and Post Traumatic Stress.



Stellar Response to Integrative Harm Reduction Workshops at the Inaugural NASW Addictions Institute Conference in New York, New York


Friend and colleague Andrew Tatarsky and I presented drawing from our personal and professional experiences in the field from the abstinence-only treatment model to Integrative Harm Reduction. We presented to well over 110 attendees. Even the Harm Reduction skeptics responded positively to treatment alternatives.

Andrew and I are considering giving the presentation again in additional settings.

"During our presentation yesterday at the NASW Addictions Institute Conference in NYC, Scott Stern and I shared our personal/professional journeys from the straight jacket of abstinence-only thinking to our integrative harm reduction perspectives in a way that was new vulnerable territory for me. 

We decided to bring 'treatment trauma' front and center into the conversation. I shared my experience of having been a surviver of 'treatment trauma' as a 15 year old member of a 'therapeutic community'.  

Scott shared his experience of having been a perpetrator of 'treatment trauma' when he worked as a clinician in an abstinence-only rehab early in his career. 

We explored the ways in which both the surviver and perpetrator are affected and how these experiences can be transformed into creative, passionate action for positive change, something Mark Epstein discusses movingly in his Trauma of Everyday Life. We felt that the audience was intensely engaged with our stories. 

I received an email last night from a woman who attended thanking us for sharing our stories and telling me that she had similar experiences in her life. She said she found our talks very affirming and personally helpful. 

Scott and I are considering giving this presentation in other places."

Addiction therapists who are oppressive to their clients create or re-create traumatic experiences for substance users. This was the old school training I received when I started working in the field 29 years ago. I've evolved in my commitment to empowerment and integrative harm reduction. So can the addiction treatment field as a whole.

U.S. finally admits to research findings that prove cannabinoids kills cancer cells.

“There is now promising research into the use of marijuana that could impact tens of thousands children and adults, including treatment for cancer, epilepsy and Alzheimer’s, to name a few. With regard to pain alone, marijuana could greatly reduce the demand for narcotics and simultaneously decrease the number of accidental painkiller overdoses, which are the greatest cause of preventable death in this country.”
 


That’s according to the US government, which has added a page on the use of cannabis and cannabinoids to their official cancer advice website.

The National Cancer Institute, part of the US Department of Health, now advises that ‘cannabinoids may be useful in treating the side effects of cancer and cancer treatment’ by smoking, eating it in baked products, drinking herbal teas or even spraying it under the tongue.

The site also lists other uses including: Anti-inflammatory activity, blocking cell growth, preventing the growth of blood vessels that supply tumors, antiviral activity and relieving muscle spasms caused by multiple sclerosis.

To do research on marijuana, scientists need approval from numerous federal departments and approval is extremely rare. Subsequently, this designation has prevented researchers from conducting clinical trials of cannabis as a treatment for cancer in humans.

The system is laid out in such a way that it creates a dynamic where physicians refuse to even consider cannabis, despite seeing evidence that it works. Without it being legitimized through clinical research and practice standards, doctors fear professional repercussions and potentially losing their license to practice medicine.

According to Dr. Gupta,

“There is now promising research into the use of marijuana that could impact tens of thousands children and adults, including treatment for cancer, epilepsy and Alzheimer’s, to name a few. With regard to pain alone, marijuana could greatly reduce the demand for narcotics and simultaneously decrease the number of accidental painkiller overdoses, which are the greatest cause of preventable death in this country.”
 
Currently, a bipartisan bill, authored by Rand Paul, R-Kentucky, Cory Booker, D-New Jersey, and Kirsten Gillibrand, D-New York — titled the Compassionate Access, Research Expansion, and Respect States Act of 2015, is in the Senate. This act would ease many of the current restrictions, simplifying the study of cannabis for research.

Dr. Gupta hits the nail on the head when he poignantly stated:

“We should legalize medical marijuana. We should do it nationally. And, we should do it now.”

The potential benefits from research into the medical uses for cannabis know no bounds. We could quite possibly be at the precipice of one of the greatest medical breakthroughs of our collective lives. If only the federal government would get out of the way and allow science to study this potential cure for cancer.

The time is now for us to make the changes we want to see happen; a medical revolution is taking place before our eyes. Please share this article with everyone you know to help awaken people to the potentially life-saving properties of cannabis and the cutting edge research that is proving it.

http://worldhealthsupport.com/u-s-just-admitted-that-cannabis-does-kill-cancer-cells/

 From 2013:

A scientist in the United Kingdom has found that compounds derived from marijuana can kill cancerous cells found in people with leukemia, a form of cancer that is expected to cause an estimated 24,000 deaths in the United States this year.

“Cannabinoids have a complex action; it hits a number of important processes that cancers need to survive,” study author Dr. Wai Liu, an oncologist at St. George’s University of London, told The Huffington Post. “For that reason, it has really good potential over other drugs that only have one function. I am impressed by its activity profile, and feel it has a great future, especially if used with standard chemotherapies.”
Liu’s study was recently published in the journal Anticancer Research. 

It was supported by funding from GW Pharmaceuticals, which already makes a cannabis-derived drug used to treat spasticity caused by multiple sclerosis.

The study looked at the effects of six different non-psychoactive cannabinoids — compounds derived from marijuana that do not cause the “high” associated with its THC ingredient — when applied alone, and in combination, to leukemia cells.

Cannabinoids displayed a “diverse range of therapeutic qualities” that “target and switch off” pathways that allow cancers to grow, Liu told U.S. News & World Report.

Liu stressed to HuffPost that his research was built around the testing of the six purified cannabinoid forms — not traditional cannabis oil, which Liu described as “crude” in comparison and generally containing 80-100 different cannabinoids. 

“We do not really know which are the ones that will be anticancer and those that may be harmful,” Liu said.

During the study, Liu and his team grew leukemia cells in a lab and cultured them with increasing doses of the six pure cannabinoids, both individually and in combination with each other. His study says the six cannabinoids were CBD (Cannabidiol), CBDA (Cannabidiolic acid), CBG (Cannbigerol), CBGA (Cannabigerolic acid), CBGV (Cannabigevarin) and CBGVA (Cannabigevaric acid). 

Liu and his team then assessed the viability of the leukemia cells and determined whether or not the cannabinoids destroyed the cells or stopped them from growing.

Although promising, Liu also said that it remains unclear if the cannabinoid treatment would work on the 200-plus existing types of cancer.

“Cancer is an umbrella term for a range of diseases that fundamentally differ in their cellular makeup, [and] which occur as a result of disturbances to growth controls,” Liu said. 

“Chemotherapy works by disrupting these dysfunctional growth signals. Therefore, any cancers that have these profiles should respond to the chemotherapy. It just so happens that a number of cannabinoids can target these very same mechanisms that make cancer what it is, and so any cancer that exhibits these faults should respond well to cannabinoids. The flip side is, of course, that other cancers may not have these same genetic faults and so cannabinoids may not work as well.”

According to the Centers for Disease Control, 7.6 million people die from various forms of cancer each year worldwide.

When asked if smoking marijuana has the same or similar effects as ingesting the pure cannabinoid compounds he studied, Liu said he thinks it’s unlikely.

“Smoking cannabis introduces a number of potential problems,” Liu said. “First, the complex makeup of cannabis that contains about 80 bioactive substances means that the desired anticancer effect may be lost because these compounds may interfere with each other. Second, we see that delivering the drug either by injection or by a tablet would ensure the most effective doses are given. 

Smoking would be variable, and indeed the heat of the burning may actually destroy the useful nature of the compounds.”

In 2012, researchers at the California Pacific Medical Center in San Francisco found that CBD (cannbidiol), a non-toxic, non-psychoactive chemical compound found in the cannabis plant, could stop metastasis in many kinds of aggressive cancer.

The National Cancer Institute has also funded some research into cannabis and cancer, including a 2012 study that looked at the effects cannabis compounds have on slowing the progression of breast cancer, spokesman Michael Miller told U.S. News and World Report. 

However NCI has not funded research on the effects of cannabinoids on leukemia.
Liu stressed that much work is still needed, and said that finding support for marijuana-derived medicines can be polarizing.

“Although there is much promise, I struggle to find enough support to drive this work on,” Liu said. “The mention of cannabinoids can polarize the public, who understandably link cannabis smoking with cannabis-derived drugs.”

Liu told the Seattle PI’s Pot Blog that he hopes to start clinical trials involving humans in 12 to 18 months.

http://www.huffingtonpost.com/2013/10/25/marijuana-cancer_n_4158865.html

http://www.whiteoutpress.com/articles/2014/q3/marijuana-destroys-cancer-tumors-says-nih-and-new-study/

Isn't it time to stop arresting people for marijuana use and to end cannabis prohibition? 

The Politics of Stigma and Addiction

What carries more stigma: whether someone misuses/abuses substances by choice, or if it because addiction is a chronic disease?




The courts have historically viewed addiction as a choice, not a sickness. Thus, people with addictions have gotten jail time instead of professional help.

When we fight for the human rights of those affected by Substance Use Disorders (SUD's), we need to improve the perception of addicted individuals as a public health issue.

Many advocates speak out to destigmatize addiction by proclaiming substance use is a decision, NOT a "sickness", "condition", "ailment" or treatable "disease." Meanwhile, the White House Office of National Drug Control and Policy's Czar, Michael Botticelli, defines SUD's as a "brain disease." 

According to the National Institute on Drug Abuse, "Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.  It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and lead to many harmful, often self-destructive, behaviors."


NIDA reports it is because of stigma that:

Some people don’t get treatment.
Some doctors won’t treat addicts.
Some pharmaceutical companies won’t work toward developing new treatments for addicts.

http://archives.drugabuse.gov/…/welc…/aboutdrugabuse/stigma/ 

Does it make any difference how addiction is defined?  You bet it does! But not for the reasons you might think.  Political ramifications of how the public perceives addiction abound with great impact.

For instance, imagine the cost if insurance companies, the courts, medical establishments, and the general public believed repeated substance use is by choice.  

Insurance companies would debate about what constitutes medically necessary treatment, drug courts would become even more powerful, there would be fewer treatment facilities, less funding for addiction programs and research, disdain and judgments by the general public against people with an SUD or other addictive disorder, shame for individuals and families struggling with this disorder, and a greater number of fatalities.  A scary thought!


The conundrum is that whether you believe addiction is a disease or a choice, it may hold less stigma to regard SUD's and addictive behaviors (such as compulsive gambling, debiting, gaming, sex, etc.) as a treatable sickness.  

We need to strategize which option empowers the most people psychologically, emotionally, financially, socially and medically.