Is Rapid Detox Dangerous? Addressing the Misconceptions

One of the most significant barriers to getting opioid treatment can be the idea of going through withdrawal. Anyone who has experienced withdrawals from opioids — which can include nausea, shaking, pain, or other excruciating symptoms — will go to great lengths to avoid experiencing the suffering of detox again. Often, this contributes to people continuing to use drugs.Rapid detox offers a safe and much more pleasant alternative to cold turkey withdrawal. The most premier rapid detox center in the world is Waismann Method®. Those lucky patients who medically qualify for this detoxification method can get through the detox phase, which requires only 2 – 3 days in an accredited hospital while under constant medical supervision. The process itself takes less than 2 hours under sedation, but the pre- and post- inpatient care are as important as rapid detox itself. Rather than going through days or weeks (in the case of methadone or suboxone) of uncomfortable and frequently severe symptoms, rapid detox allows you to quickly reverse your physical dependence on opioids so that you can focus on the social and emotional aspects of recovery.Is Rapid Detox Safe?Rapid detox is a safe procedure when the treating doctor has the necessary experience, the treatment is provided in an accredited hospital, and time is allowed for inpatient pre- and post- detox care. Although rapid detox can provide one of the highest detox success rates, it can also be dangerous when corners are cut.The Waismann Method® team only performs the procedure in a private room of a full-service JCAHO accredited hospital. The performing physician is a quadruple board-certified medical doctor and has over 21 years of experience in anesthesia-assisted opioid detoxification. Patients are admitted one day before rapid detox begins, for a comprehensive medical evaluation. This pre-treatment evaluation helps the medical staff understand the patient's health needs while allowing adequate time to stabilize some of the primary organ functions, which dramatically minimizes the possibility of unexpected complications during detox. During rapid detox, the patient sleeps under sedation while the treating doctor uses FDA-approved medications, including naloxone, to clear receptors of opioids. The treatment allows patients to achieve complete freedom from opiate dependence, without most of the prolonged and painful withdrawal symptoms.Is Rapid Detox Too Good to Be True?Compared to weeks of grueling withdrawal symptoms, getting through an opioid detox in a few days while under the supervision of highly qualified medical staff may seem too good to be true. But it is true. Rapid detox is an effective and safe option for people suffering from opioid use disorder.The conflicting attitudes toward rapid detox sometimes have to do with the culture of recovery. Some people are convinced that those who are dependent on substances deserve to go through the pain of detox - a lesson to be learned. Detox is often seen as a consequence of using opioids and as a necessary gateway to starting recovery.But in most cases, this is simply not the case — you don't learn from being in discomfort and pain - just the opposite. Many people keep on using because they fear the suffering during withdrawal and the likelihood of not completing detox. The valor of suffering does not compensate for the risks of continuing using. Rapid detox allows you to be emotionally present while engaging in treatment to work on the issues that lead you to substance abuse.What Happens After Rapid Detox? Removing all opioid drugs from the receptors is only the first step in complete detoxification. A clear understanding of the neurobiology of opioid dependence can be invaluable to the patients. It provides insight into patient behaviors, helps define realistic expectations, and clarifies treatment methods and goals.It is crucial to understand that when rapid detoxification occurs, an intensive regulation period follows. The next few days after detox, the patient feels raw. When opioids are suddenly discontinued, the drug inhibitory impact is lost, leading to jitters, anxiety, sleeplessness, and gastrointestinal issues. These abnormalities can be resolved in a few days, provided immediate and effective actions are taken. In other words, around-the-clock professional support after rapid detox is not just important, but necessary for the patient's safety and success.At Waismann Institute®, people who have undergone treatment receive immediate recovery support for a few days at Domus Retreat. This exclusive and private retreat provides highly-personalized recovery care, with stays ranging from 4 – 10 days. Additionally, this extra time in a supervised and supportive environment allows patients a few days with Naltrexone on board, which dramatically minimizes cravings and the possibility of a relapse.At Domus Retreat, people receive the care and support needed to obtain strength and stabilize the nervous system, which has been directly affected by opioid abuse. Patients also receive individual psychotherapy and therapeutic services to make this transitional and fragile phase much more comfortable.Are All Rapid Detox Centers the Same?Of course not. Rapid detox is a medical procedure that needs to be provided by a specific doctor and in a particular setting. The way to choose the best rapid detox center is first by making sure the treating doctor is board-certified. Board certification indicates that the doctor is aware of the latest advancements in their specialty, demonstrating the desire to be at the top of their profession while delivering the highest quality of care to their patients. Secondly, you want to know that rapid detox occurs in a private ICU unit of a JCAHO accredited hospital. The reason for a private room is so that you will have the doctors' undivided attention during the procedure. Any way you look at it, patients should receive medical care individually--in what other medical procedure are you side-by-side with strangers? Sharing a room with a stranger is not acceptable for many reasons. A JCAHO accreditation means the facility offers the gold standard in medical care; it’s an internationally recognized symbol of quality.Thirdly, other types of medically assisted opioid detoxification should be available for people who are not well-suited for rapid detox. A doctor should customize the treatment to the patient’s health needs. Having every patient, regardless of individual health condition, adapt to only one available treatment can be very dangerous.Lastly, patients should be provided with adequate inpatient time pre- and post-anesthesia detox. Treating a patient without enough information or sending them home (or worse, to a hotel room) immediately after detox is a recipe for disaster.Rapid detox is an effective medical treatment when performed, responsibly, by a skilled and experienced physician in a private hospital environment.

5 Principles for Helping After a Relapse

People who relapse from their drug decisions feel discouraged and can benefit enormously from support. Unfortunately, well-meaning loved ones and counselors often make matters worse by focusing on the negative consequences, as in this situation:After two months of abstinence, Anthony was embarrassed and in despair about a one-night binge at a party over the weekend. Trying to help him get back on track, his friends focused on the harm. They hoped he would recognize the consequences of his relapse and avoid these setbacks in the future.“Look what you’ve done.”“Don’t you see the trouble this means.”“Now you’ve got to start all over again.”His “helpers” meant well with their negative messaging. They were following the harm-based theory of change, built on the premise that people will overcome drug problems when they see the totality of the harm from their drug use. Carried to an extreme, this means people have to “hit rock bottom” before they will really change. When harm ultimately brings them to their knees, then they will finally take action. Therefore, helpers believe that they should accentuate the negative by focusing on the harm. This awfulizing should motivate loved ones to do better in the future.The harm-based theory makes intuitive sense because recognition of harm is what initially gets people thinking that maybe they need to make some changes in their lives. However, to move from contemplation of change to effective action, they also need (1) a vision of a better life and (2) confidence that they can succeed in bringing about the desired change. After a relapse, they usually don’t need to be reminded about harm that is self-evident. In fact, they may be drowning in their regret. They feel discouraged and their self-confidence has been shaken. What people usually need after a setback is support in bolstering confidence that they could succeed.This doesn’t mean ignoring setbacks. Anthony didn’t need well-meaning helpers to say: “Just forget about it, move on.” In fact, it’s important to figure out what caused the slip so that it can be prevented from recurring. A big part of relapse prevention is studying setbacks, learning about triggers, and planning how to either avoid the triggers and/or respond differently to them in the future.PRINCIPLE 1: EMBRACE WITH COMPASSIONFamily and friends are most helpful when they embrace a person who has suffered a setback with understanding and compassion. A barebones example would be:“I’m so sorry that this has happened. I know you wanted to make a change, and this has been a setback.”A compassionate statement can be embellished with genuine affection, such as “I really care about you” or “I love you so much.”PRINCIPLE 2: ENCOURAGE CONFIDENCENext, people who relapse can benefit from encouragement from others who have confidence in their ability to succeed.“I want you to know I believe in you. I know that people are capable of overcoming drug problems and I know that you can do it.”This, too, can be embellished by commenting about previous demonstrations of strength and determination.PRINCIPLE 3: ASK ABOUT NEEDSToo often, friends and family members guess and make assumptions about what people need after a relapse. Helpers may even try to impose solutions. Instead, they could start by simply asking respectful questions.Is there something I could do or something you need from me?This not only shows respect, but also a real interest in providing support.PRINCIPLE 4: OFFER A REMINDER When setbacks occur, friends and family member can remind people about how the change process works – that relapses are to be expected and that setbacks offer the possibility of a learning opportunity. People who relapse can figure out what happened and learn from these difficult and often painful experiences. Friends and family members can offer a kind and simple reminder.“You know, you can think about what happened and determine what triggered this setback, learn from it, and get back on your agenda. Don’t give up. You can figure this out.”PRINCIPLE 5: PROMOTE PERSONAL RESPONSIBILITY Friends and family may or may not be able to help someone figure out their triggers and develop new ways to cope. That problem rests on the shoulders of the individual with the drug problem. There is work to be done. Be careful to avoid the common pitfall of trying to take over and be the fixer. It only diminishes the self-confidence of those who are disheartened by a relapse. Here’s a sample statement.“If you want to succeed in your decision and avoid the consequences of more setbacks, you will definitely need to face up to this problem. You can do this on your own or get help. If I can be helpful, I will.”Although Anthony’s friends didn’t help him figure out what triggered his relapse, his counselor took a supportive approach:“I’m glad you’re here today. I’m so sorry you suffered this setback. You know, relapses aren’t uncommon when you try to break bad habits or overcome addictions. What do you think happened? Let’s see what you can learn from this experience that can help you get back on your feet again.”Together they discovered that Anthony’s relapse occurred after an argument that led to intense anger toward his spouse. He left home angry and that triggered his use. Rather than dwelling on negative consequences, he and his counselor focused on the possibility of future success. Anthony began to work on marriage issues as well as new ways to manage his anger. He renewed his commitment to abstinence and then moved forward with pride and increased self-confidence. After the relapse, he benefited from compassion, respect, encouragement and guidance.

The Symphony Orchestra of the Serenity Prayer on Zoom

Virtual AA meetings. Here we are. Well, actually, here I am and there you are. Instead of sitting side-by-side in a Church basement, we are sitting face-to-face from far away. The video transmission of my face rides on rapid data that translates into pulses of light and electricity streaming from my computer to yours. At least that’s what I read when I Googled, “How does the internet work?”At the beginning, I wasn’t sure if virtual meetings could work. Spirituality via Technology? It had never been done in AA. What I came to discover, and I hope you have too, is they do. The program and community found a way. We couldn’t change what was happening in the world, but we had the wisdom to know we could change how meetings worked.In the meetings we once knew, I especially treasured the ending in prayer combined with physical embrace. The encompassing circle of faces, bodies and hands being held made me feel one with every person in the meeting – almost as if there was a rapid transmission translated into pulses of light and electricity streaming from my hand to yours. Perhaps things haven’t changed much at all.There is a setting on Zoom where the full screen always shows who is speaking and you see the rest of the attendees in little screens above. At the end of every meeting, people unmute themselves to say the Serenity Prayer together which allows for every person to flash briefly across the full screen.When the prayer begins, the different faces that flicker before my eyes represent every facet of human life: young and old, women and men, Trans, Gender Variant, Black, Asian, LatinX, White, rapper, punk rocker, artist, lawyer, nurse, garbage man, CEO, grocery store worker, student, bicyclist, jogger, comedian on the weekends, surfer, wife, husband, brother, sister, daughter, ex-con, son, father, mother, cousin, neighbor, beginner, old timer, comeback, day counter, day one. Right before me, an entire world of sobriety fits neatly inside of a box. As it does, I hear the most beautiful music to my ears in the most imperfect fashion.The Serenity Prayer is said in “unison” but is off-key, jumbled, ill-timed, and completely out of sync due to everyone’s different internet lag times. In this perceivably flawed rhythm of voices, I hear a perfect symphony. Each of these voices turn into instruments of God. The high voices sound off like trumpets. The low voices pound like a bass drum. Different quick voices dance together like piano keys and I hear a sharp, clean tap, tap, tap. A hopeful voice comes in like a slow and soulful trombone. A sad voice plays like a woody, wafting, violin. Someone who is happy sounds like the pull of a harp string. Someone who speaks quietly and shyly, becomes a soft note from a flute.Behind it all, the conductor, a meeting chairperson, watches us in concert, no longer reaching for each other’s hands inside of a circle but reaching for each other’s eyes, ears and heart inside of a square. I travel to these meetings no longer on the New York Subway but instead on the cold keys of my keyboard riding the zips and zaps of technology. However, the warmth and true connection that penetrates through my screen during the end of every meeting brings me to a visceral feeling.Some days when I see and hear the Symphony Orchestra of the Serenity Prayer on Zoom, I cry at the beauty of our perseverance. Other days, I smile as wide as the web itself.The Serenity PrayerGod grant us the serenity to accept the things we cannot change.The courage to change the things we can.And the wisdom to know the difference.

Accepting Help as a High-Functioning Addict

When you’re a high-functioning addict, it can be easy to deny your disease. After all, things aren’t falling apart. You still have your job, your family, your nice house — from the outside everything looks great. Maybe you’ve wondered if you’re drinking a bit too much, or you spouse has said something along those lines. That might be enough to get you into treatment, but to really better your life you need to accept your disease in order to change.It sounds simple, but sometimes accepting your weaknesses is even harder than putting down drugs or alcohol. You’re a successful person and have been told for years that you’re doing well. You have control over your career and finances. So, recognizing that you no longer have control over your drinking or drug use can feel like a direct affront to who you are. That’s where treatment for high-powered individuals comes in.Getting Honest, If Only With YourselfEven if you can bluff or badger your way through business meetings, you need to bring your true, honest self to your recovery. If you are putting up facades or trying to project an image, you’ll only be cheating yourself. In order to really reap the benefits of recovery you must be willing to be vulnerable, something that is very uncomfortable for many high-powered individuals.Start by asking yourself, “Who am I?” The challenge here is getting beyond the title on your office door. You probably have many external qualifiers that you can use to tell people who you are: I’m a CEO, a CFO, an athlete, an investor, a founder. But when those are stripped back, who are you really? What is important to you?Answering this question can take time because we’re so used to being focused on external qualifiers. Take some time to think about this and mull it over. Then, jot down your thoughts in a notebook or journal.Let Go Of Your EgoSometimes, the ego gets a bad rep. The ego is focused on the self. It drives you to go what’s best for you. Your ego tells you how good you are, and pushes you to be even better. There’s nothing wrong with that — it can help you achieve great things.However, sometimes you need to push your ego aside. Even though addiction is a disease just like any other, there continues to be a lot of shame around it. Because of that, your ego may resist labeling yourself as an addict. Your ego might tell you that you don’t need treatment. It might say that you can figure this all out on your own.This is a case where you have to rise above your ego. Again, it’s time for vulnerability. It will be uncomfortable to put your ego aside and humble accept that you need help — but it will lead to you having your best life in the long run.Find the Right CareAs a boss, you know the importance of having the right people around you. Without a good team you wouldn’t be as successful as you are. The same is true when it comes to finding a treatment center.High-powered individuals and executives need a certain approach to drug and alcohol treatment. It’s going to look very different from treatment for a young adult who is down on her luck. Executive treatment plans involve you — because you are a vested player in your recovery. They empower you to make choices and continue to live a comfortable lifestyle, while also challenging you to take a hard look at your behaviors and patterns.Addiction is a disease that can affect anyone, but how exactly it plays out depends on your life. Finding a team that is experienced in working with high-functioning addicts can help you to approach treatment and recovery in a way that fits into your life; rather than expect you to give up everything you’re familiar with in order to get treatment.Sober Partners provides residential treatment in Newport Beach, California. Get more information at their website, by calling 855-982-3247, or on Facebook.

Damaged from the Git-Go!

“Have you seen the Stromberg baby?” were the first words my father heard when the nurse attending my mother hustled out of the maternity ward delivery room. She was talking to a co-worker who was wandering down the crowded hallway.Rightfully alarmed, my father darted out of the expecting parent’s waiting room and confronted the agitated nurse.“What’s wrong with my baby?” he nervously blurted out. Realizing how her high-pitched statement must have scared him, the nurse took my father’s arm and eased him back into the lounge.“You have a son,” she informed him, “and he was born with his eyes wide open! The biggest eyes I’ve ever seen on a newborn.” My dad was overjoyed; a son is what he had been hoping for, although he told my mother that he really didn’t care what sex it was as long as the baby was healthy. The nurse had more information she needed to share with my father.“The reason your son’s eyes were so large and wide open was he came out with the umbilical cord wrapped around his neck and he was turning blue. He was likely in some kind of distress.” Shaken by this news, my dad wanted to know if the baby was okay.“Yes," the nurse assured him. "The doctor was able to untangle the cord and the baby had begun breathing normally,” but there was another problem my father needed to be made aware of; my mother had developed a case of impetigo, a very contagious skin infection and she needed to be put into isolation until the condition cleared up, usually in a week or so.This meant that I would have no contact with my mother during the first crucial week of my life. Maternal-infant bonding, I’ve learned, influences the child's psychological and physical development. I would likely be affected by these seemingly minor events for the rest of my life. I was damaged from the git-go!Possibly out of guilt from the circumstances of my birth and her debilitating skin disease, my mother became overly protective of me. I was the Baby Jesus in her eyes, which is strange because we are Jewish. As a young child, the two most significant things she tried to instill in me was the belief that I was destined for greatness, and that her medicine chest contained pills and potions that could cure whatever ailed me. Other than that, I lived a pretty normal life until my late teens when I fell in love with drugs and alcohol. My early adult years were spent in the entertainment business where consumption of drugs and alcohol seemed the norm. I had a great deal of success and a few failures, but during all times, I drank and used with increasing disregard to the consequences that began to befall me.After I hit my bottom, scrounged around there for a while, and eventually got my life back on track in my 12-step recovery program, I was introduced to a strange psychotherapist who said he could help me understand why I behaved in ways that were extremely self-destructive. He specialized in why people became alcoholics and drug addicts, and assured me he had a “method” that cured alcoholics.He seemed like an interesting enough guy, albeit a little out there, until he told me that all addicts and alcoholics were predisposed for addiction at birth! That many alcoholics were “blue babies,” like me, who were born with the umbilical cord wrapped around their necks, hence depriving them of life-giving oxygen. He further went on to explain that these people spend their lives, in effect, gasping for air or anything that makes them feel safe and alive.As if that wasn’t enough of a whacko theory, he then outlined the treatment he devised for treating alcoholics. Now, here’s where it gets surreal… After explaining his beyond far-fetched theory, and with permission, he hypnotizes his patients, walks around behind them and puts them in a rear choke hold, just like you see in an MMA bout. He continues this assault until the patient passes out, at which time the good doctor talks his subject through what he calls “the rebirthing process,” during which he relieves them of the trauma they experienced traveling down the birth canal and replacing that traumatic journey a euphoric new experience of birth. Koo Koo right?So what is the point of this crazy story?Well, in the course of my 37 plus years of recovery I’ve heard many explanations of why people become alcoholics. Childhood abuse, low self-esteem, abandonment, poverty, heredity, and any number of explanations and excuses. For me, the simple truth is I don’t know why I became an alcoholic, but I did. Fortunately, I found a way to put my disease in remission, subject to my maintenance of the solution I found in my 12-step recovery program. As a guy named Louie from New Joisy once said to me after our AA meeting, “Alcoholics Anonymous woiks, and it woiks good!”

3 Ways to Give Yourself Grace in Recovery

Early on during the pandemic, you might have had grand ideas of what you would do with all your expected free time. With fewer places to be, you might learn to play the piano or finally delve into that workout routine. Maybe you’d read all those self-help books or attend more virtual meetings. You would do everything you dreamed about during treatment.Since then, you’ve probably realized that you’re not quite as productive as you thought you’d be during quarantine. Whether you’re well-established in recovery or newly sober, this time of uncertainty can be overwhelming, so it’s important to allow yourself the grace and understanding to acknowledge that sometimes, progress is slow in recovery.There are periods when — even without a pandemic — recovery happens at a slower pace than you would like. That’s all right. Here’s three steps to find peace with the pace of your progress.Give Yourself Space and GracePicture this: your friend is newly sober. She’s doing a great job of living life without drugs or alcohol. But, she’s frustrated. She wants a better job and a nice person to go on dates with. She beats herself up when she makes small mistakes, like falling into old patterns of self-sabotage.What would you tell her? You would probably celebrate the progress she’s made, and encourage her to be patient. Now, put yourself in her shoes. When you’re looking at your own progress it’s easy to be self-critical and frustrated rather than celebratory and empathetic.Grace means “courteous goodwill.” We often extend grace to others, but forget to save some for ourselves. Instead of understanding that we’ll make mistakes even when we’re trying our best, we beat ourselves up over missteps. Next time you find yourself turning a critical eye inward, replace that criticism with grace, telling yourself you’re doing great.Take A Step BackWhen you’re living recovery each and every day, the small changes you’re making become your norm. You might not see the healthy glow on your cheeks, or recognize how amazing it is that you no longer live a life ruled by cravings.Taking a step back to see how far you’ve come can help you celebrate the real progress you’ve made. This is best done using hard, concrete facts that you can look at. Scroll through your social media and see how the image that you project today is different from a year ago; look at your finances and celebrate that they’re no longer in disarray; read through an old journal and recognize the patterns you used to repeat.Recovery takes a lot of hard work. It’s important to acknowledge that and appreciate everything that you have done for yourself.Give Yourself Permission To Be SatisfiedPersonal growth is important — it’s great to always be striving for the next rung on your ladder to success. But sometimes, continuously moving can be exhausting. It’s okay to have periods when you move forward more slowly, or just stay put for a bit.This is especially important during the COVID crisis. Everyone around the globe is dealing with a lot of stress right now. There’s the physical health crisis, and the accompanying mental health crisis brought on by fear and uncertainty. Many people are dealing with financial uncertainty as well.You might find that now isn’t a time to grow — no matter how well-intentioned you were about those guitar lessons or that new knitting kit. During these uncertain times, just surviving and keeping your recovery going is something to celebrate. When things return to normal you can focus again on your next big goal.Now, more than ever, we’re forced to face the fact that we can’t always control what’s happening in our lives. Still, you can focus on small, daily habits that help keep you clean and sober. Tend to the essentials for your recovery, whether that’s meditation, exercise, meetings or mentorship, but give yourself permission to let the other things go. After all, they’ll all be there again when life — sooner or later — gets back to normal.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

People are dying in US prisons, and not just from COVID-19

Randall Jordan-Aparo, Darren Rainey and Latandra Ellington are not household names. But like Michael Brown, George Floyd and Breonna Taylor, they were killed by law enforcement officers.Not police officers, but corrections officers.No dataset tracks the number of people in prison who die at the hands of those hired to keep them safe. The Bureau of Justice Statistics reports that between 2012 and 2016 – the most recent data available – approximately 128 state and federal prisoners died from homicide or accidents per year. The agency does not separately report incidents involving prison staff versus prisoner-on-prisoner violence. This is also likely to be an undercount since many investigations of suspicious deaths in prison are done internally by corrections departments.In the absence of detailed and reliable data, what we do have are accounts of sadistic and retaliatory violence by prison guards against people in prison. According to investigations by the Miami Herald, corrections officers gassed Randall Jordan-Aparo as he begged for help, likely killed Latandra Ellington for speaking out about sexual abuse and scalded Darren Rainey to death in the shower.Just as insidious are routine “use of force” incidents that are clearly excessive. In June, for example, Florida corrections officers beat Christopher Howell to death while removing him from his cell after he reportedly “refused a command.”State neglect of prisonersAlthough it doesn’t receive the same national media attention as police brutality, there is an ongoing humanitarian crisis in U.S. prisons. As a sociologist, I have researched and written extensively on the history of state prisons – which hold two-thirds of people incarcerated in the U.S. – and the causes of mass incarceration.Similar to excessive police force, brutality by prison officers is part of systemic state violence against people of color, and Black people specifically. As I explain in my book, “Building the Prison State: Race and the Politics of Mass Incarceration,” racist ideas about irredeemable “criminals” helped convince state legislators to spend approximately US$70 billion to build 1,000 prisons in the 1980s and 1990s. By 2007, operating expenses for state corrections departments had increased 250% to $56 billion a year.After the election of President Barack Obama, a wave of white racial resentment galvanized by the Tea Party movement swept business-backed fiscal conservatives into state houses across the country. As promised, governors and state legislatures began to defund a variety of state agencies and programs. Where politicians had once protected already underresourced departments of corrections from spending cuts, they now began to delay maintenance on prison facilities and strip state prisons of educational programs down to what one Florida state legislator called “bare and naked incarceration.”As a result, state prisons today are severely underfunded, understaffed, overcrowded and deteriorating.‘A callous disregard’In Florida, the state I have researched most extensively, fiscal austerity hit the Department of Corrections early, under the leadership of Gov. Jeb Bush, and continued long after he left office in 2007. The Miami Herald chronicled the decline. In 2012, after five years without a raise, the state cut thousands of corrections officer positions by moving from an eight- to a 12-hour shift. By 2017, the Herald reported, the state could not fill 2,500 corrections officer positions left open because of high turnover and low pay. And, in 2019, the new Florida Department of Corrections Secretary warned that years of budget cuts and legislative indifference have created a system at the brink of a “death spiral.”The consequences of understaffing are compounded by prison overcrowding. According to an analysis by ProPublica of federal data, between 2011 and 2018, 32 states closed one or more prisons, without corresponding reductions to the state’s overall prison population. This year, as coronavirus hit, at least 16 state prison systems – in every region except the Northeast – had seriously overcrowded prisons, according to local news reports.Most departments of corrections contract with private companies to provide health care in state prisons. The rising cost of medical care and reduced state budgets squeezed these companies’ profit margins. As a result, the existing barely adequate health care in prisons deteriorated. At Ely State Prison in Nevada, for example, there was no full time physician on staff for 1,000 male prisoners. According to one medical expert, the medical neglect he saw amounted to a “callous disregard for human life and human suffering.” Since 2010, courts have ordered at least 10 state departments of corrections to fix substandard health care in the states’ prisons. In 2018, a U.S. District Court fined the Arizona Department of Corrections for “not taking its obligation seriously” as people in prison continued to die from medical neglect.Prison overcrowding, inadequate prison health care and a lack of infrastructure to manage the outbreak of disease has led to an alarming number of COVID-19 cases in state prisons. In San Quentin State Prison, just outside of San Francisco, more than one-third of prisoners have tested positive for COVID-19. According to The New York Times, in mid-June the five largest known clusters of the virus were inside correctional institutions.Since the first week of May when prisons recorded a high of 87 prisoner deaths, as of mid-July every week on average 42 people die in prison of COVID-19.No accountabilityWhen prisons are understaffed, offer no programming and provide inadequate mental health care, maintaining order becomes more difficult. The use of solitary confinement increases. Resentment builds. Studies show that officers who work in chaotic and hostile work environments are more likely to adopt an “us vs. them” mentality and resort to retaliatory violence.Prison officers’ acts of violence are often not reported. The blue code of silence that people associate with police applies equally to corrections officers. Prison staff that come forward are threatened and harassed. And, even more than police departments, prisons are not transparent. It is often only through local news media investigations that we hear these stories.Corrections officers are rarely held accountable through civil lawsuits or criminal prosecution for their acts. The Miami-Dade County prosecutor Katherine Fernandez Rundle, who faces a real challenger in the upcoming primary for the first time since she was elected in 1993, declined to prosecute the prison officers who locked Darren Rainey in a scalding hot shower and left him there to die. The family of Rainey, a middle-age Black man with a diagnosed mental illness, later settled a civil rights lawsuit against the Florida Department of Corrections for $4.5 million.Governors and state legislators have little political incentive to improve prison conditions. Sadistic, violent and other unconscionable acts by corrections officers against people in prison don’t provoke the same public outrage as police murders of people in their homes and communities. Under the system of mass incarceration, those we have marked as “criminals” are denied not only their civil rights but their humanity.Heather Schoenfeld, Associate Professor, Boston UniversityThis article is republished from The Conversation under a Creative Commons license. Read the original article.

Medical Detox: The Importance of Aftercare

Medical detox allows you to rapidly address the physical dependence on opioids. Within days, you can remove cravings for drugs or alcohol from your life, under the supervision of a medical team. But with the physical side of dependence addressed, what comes next? Getting personal, individualized aftercare following Opioid and Alcohol Detoxification Treatment is a critical first step to a healthy life without drugs and alcohol.“We have seen patients that just gave up because they believe they have failed so many times that they are not willing to go through all the emotional and physical suffering to fail again,” says Clare Waismann, founder of Waismann Method® Opioid Treatment Specialists and Domus Retreat. But “most of the time they didn’t fail – the treatment center failed them because they did not receive treatment based on their needs, they received treatment based on a preset protocol.”Getting individual treatment that is highly personalized can help you succeed in recovery.Healing with Respect and Dignity Society tends to treat people with addiction terribly. There is a lot of stigma and shame connected to substance use disorders, and that often gets integrated into various recovery options. Often times, treatment centers prescribe a set of steps or aftercare approaches, without assessing or considering the person receiving them, what that person actually wants and, more importantly, needs.Domus Retreat, the aftercare facility that works with Waismann Method® clients, takes a different approach. Rather than making clients feel like just another body without autonomy, instead of putting them in group sessions where they feel unseen and unheard, Domus Retreat aims to clearly understand, support, and respect each individual’s needs.At Domus, clients are reminded that they have nothing to be ashamed of. It is natural to get lost, and honorable to seek and receive help. With this productive thought in mind, it is easier for people to move toward a future that is hopeful and positive. Positivity, hope and self-respect set a foundation for a successful recovery.“We try to have people enjoy the sun, try to show them that every hour they will feel better regardless of where they started from,” Waismann says. “By the time they leave, they know they can feel good without drugs, even if they relapse. Even if things don’t work out as expected when they get home, there is hope because in a short time they have learned that life is livable without drugs..”An Aftercare Approach Designed for YouAt Domus Retreat, clients can stay from anywhere between 4 and 28 days. They have access to one-on-one psychotherapy, private yoga sessions, massage, and more. They are able to spend time working with professionals to decide what they want to address now that they have dealt with their physical dependency. This often means taking steps to address the pain that caused drug abuse, whether that pain is physical or psychological.“Because we have very, very few patients at one time, we try to individualize their treatment as much as possible,” Waismann says. There is accountability, but to individual goals rather than prescribed benchmarks of success in recovery. This allows people to focus on the things that will make the best impact on their overall health.At Domus Retreat, clients also have the chance to address any physical or mental health diagnoses that came up during treatment. Oftentimes, talking with mental health providers can result in reevaluating diagnoses that clients had before. With drugs no longer masking the root problem, it is easier to see the real symptoms.“It is very difficult to make an accurate diagnosis when the patient is emotionally influenced by the substance they are using,” Waismann says.Health care professionals create customized treatment plans for each client based on their all-encompassing medical and psychological assessment. Throughout treatment, the team looks for effective and feasible ways to optimize each client's plans to sustain long-term recovery. One of the most important goals for the Waismann Method® and Domus Retreat team is to establish a trusting and nurturing relationship with each individual, ultimately creating hope.The Bottom LineThe purpose of a good aftercare program is to heal, restore, and better the lives of each client. Anyone who has experienced substance abuse or mental health issues knows that sustaining a healthy life is a work in progress. It is a natural part of being human to expect and need a helping hand along the way. Recognizing this need and seeking help is the first and most important step in creating a healthy and loving relationship with yourself.

How Those With Obsessive-Compulsive Disorder Cope With Added Angst Of COVID

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.“I’ve been doing really, really well,” Trondsen said. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ ― but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”Trondsen, 38, a Costa Mesa, California, therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care center. And because he also has body dysmorphic disorder, he said, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent KFF poll found that about 4 in 10 adults say stress from the coronavirus negatively affected their mental health. (KHN is an editorially independent program of KFF, the Kaiser Family Foundation.)But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about COVID-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.Dr. Katharine Phillips, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, said it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of COVID-19.“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects ― good treatment protects against relapse in these patients,” Phillips said.Those with OCD feel compelled to repeatedly perform certain behaviors, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.Carli, who asked that her last name be withheld because she feared professional repercussions, can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from Jersey City, New Jersey, into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli said. “I try to ask people, Are you doing this? Are you doing that?”Elizabeth McIngvale, director of the McLean OCD Institute in Houston, said she has noticed patients struggling to differentiate reactions, as Carli described. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.McIngvale was diagnosed with OCD when she was 12, with behaviors like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.“It’s just a part of my life and how I maintain my progress,” McIngvale said.Lately, she’s found herself consumed with fears of harming or infecting others with the COVID-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she said she’s been handling the pandemic better than some people around her.“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale said.“OCD patients are resilient,” she added. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”Wendy Sparrow, 44, an author from Port Orchard, Washington, has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow wrote in an email.Depending on how long the pandemic lasts, Sparrow said, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.“I definitely am needing therapy,” Trondsen said. “I realized that even if it’s not specifically to relearn tools for the disorders … it’s more so for my mental well-being.”Carli has struggled with finding the right treatment for her OCD.But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them ― to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While skeptical at first, she has appreciated the convenience of teletherapy.“I never want to go back to actually being in a therapist’s office,” Carli said. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”Patrick McGrath, a psychologist and head of clinical services at NOCD, the telehealth platform Carli uses, said he’s found that teletherapy with his patients is also beneficial because it allows him to better understand “how their OCD is interfering in their day-to-day life.”Trondsen hopes the pandemic will bring increased awareness of OCD and related disorders. Occasionally, he’s felt that his troubles during this pandemic have been dismissed or looped into the general stress everyone is feeling.“I think that there needs to be a better understanding of how intense this is for people with OCD,” he said.

Pseudo-Science and the Need for a Better Solution

Not so long ago, I was a regular attendant at meetings of Alcoholics Anonymous, America’s foremost response to the twin problems of alcoholism and addiction. I was a genuine "winner," as we were sometimes called, meaning an engaged, entrenched, active long-timer, a 12-step practitioner with uninterrupted clean-time extending over multiple decades. It was largely thanks to AA that I learned how to be a drug-free and sober human being.I successfully lived the AA lifestyle for a quarter of a century. I am the literal opposite of a revolving-door type, or your standard AA-hater. I am stating these autobiographical facts because my essentially positive experience has direct bearing upon the reliability and veracity of my subsequent critical observations. It behooves me to simply point out, with tongue in cheek, that my doing so is not the result of any sour grapes.My problem with Alcoholics Anonymous and the 12-step sub-culture in general has to do with their nature as pseudo-science. Pseudo-science refers to any given explanation which is either presented as, or accepted as, scientifically plausible, despite a lack of scientific veracity. A pseudo-scientific account is one which is considered to be equally truthful, and genuinely explanatory, as one which has been scientifically validated, even though it is not the result of an epistemologically sound process such as the scientific method, and therefore does not merit the same degree of confidence.Eventually I had to leave the fellowship, and this was due primarily to my experience of awakening to the fundamental truths of atheism. AA is a very religious organization in every sense, although members are generally loath to acknowledge this fact. This religiosity includes the fundamental intolerance, and the proselytizing, so endemic to the Abrahamic religions of Christianity and Islam. "Carrying the message" is written into the 12-step program and is, in fact, touted as an important way of staying clean. One carries the message to another, who carries the message to yet another, who carries the message, on and on like that. It was only upon leaving that I came to recognize many of AA’s glaring defects. In retrospect, I was able to acknowledge how 12-step recovery essentially functions much like a sobriety ponzi-scheme, from which only a rare few garner the genuinely elusive, long-term benefits, pseudo-scientifically claimed to be available to all who "thoroughly follow our path."There is an inherent institutionalized prejudice against alternative approaches. One is discouraged from speaking of different methodologies. AA dogma was, and remains to this day, glaringly anti-alternative, and particularly anti-science. A single line or two, on "making a normal drinker out of an alcoholic," is all that appears in the text of Alcoholics Anonymous, summarily dismissing empiricism and scientific R & D with:Science may one day accomplish this, but it hasn’t done so yet. (AA 3:31)Of course, the assumption that the goal of science would be to make us into "ordinary drinkers" is itself rather dubious and small-minded to begin with. There is an endless array of possibilities which science can bring to bear on solving problems of this kind. But the 12-step mind set dominates the field of recovery, both in terms of short-term detox and treatment facilities, and also regarding long-term lifestyle changes. As with Christianity more generally, it’s "my way or the highway."The more time one spends immersed in the subculture, the more difficult it becomes to think outside the box, to think in any alternative way about the problem, or possible solutions. This hinders the process of developing alternative approaches and perspectives, and thereby of improving the current unarguably poor success rate. Once you’ve bought the package, you become invested in the belief that it’s a "spiritual" problem, and only a "spiritual" solution, requiring a "higher power" of some kind, will work. In a classic falsifiability move, anyone who claims otherwise is summarily dismissed as being "in denial." Does this sort of unfalsifiable, self-justifying language sound familiar? Certainly, as it constitutes a major component in the religious thinking so central to the world-dominating religions of Christianity and Islam.Suboxone is one example of a good, though admittedly not perfect, scientific alternative. After 23 years of total abstinence, I suffered a major back injury while playing basketball. I was in severe, chronic pain, and forced to have surgery. This whole scenario necessitated a regular regimen of intensive, doctor-prescribed opioid use, legitimately, for physical pain. But, being the addict I am, it was not long before I was well beyond what the doctor ordered. Unable to stop by any other means, including intensive step work and immersion in the fellowship, Suboxone freed me from the obsession, the overwhelming cravings which I suspect only an alcoholic or addict can truly understand. At the same time, it allowed me to bypass the extremely difficult and unpleasant process of opioid withdrawal. Suboxone literally saved my life.Several years after leaving AA, I am currently happier and more stable than ever before in my life. But, despite this first person account, most 12-step members can be counted upon to object, to offer a handful of very predictable critical responses. Because Suboxone actually administers a small dose of opiate along with the blocker, many would claim that I’m not actually "clean and sober." They would also claim that I am "in denial," and not in genuine recovery, but merely a "dry drunk," because I am not engaged actively in step work, have no sponsor or sponsees, do not attend meetings or have a "higher power" in my life. Despite a total lack of any scientific evidence whatsoever, they cling steadfastly to the belief that the 12-steps are required for genuine, bona-fide "recovery." This is the very epitome of what is meant by pseudo-science.How much of this way of thinking stems from the early Christian roots of Alcoholics Anonymous? The most popular method for dealing with alcoholism before AA came into existence was a Christian fellowship known as the Oxford Group. Bill Wilson, a drunkard and a salesman from small town New England, fell back upon the Oxford Group’s fundamental principles when he fathered AA into existence in the 1930’s.During one of his many detox/treatments, Bill was given the "Belladonna Cure." Completely ignoring the fact that he was under the influence of a potent, toxic, mind-altering drug, Wilson interpreted the subsequent hallucinogenic experiences in a familiar Biblical manner. His prophetic interpretation of the proverbial white light experience, with its mystical aura and spiritual connotations, served to make his message all the more vivid and valid, imbuing it with divine, super-human authenticity. Alcoholics by the millions, including my young and impressionable self, gobbled that shit up. Despite being raised in a non-religious household, I found myself anticipating my very own prophetic, white light, burning-bush type experience shortly after leaving the adolescent treatment ward at Hazelden and beginning my 90-in-90.Wilson intentionally fashioned the fellowship upon Christianity. His steps numbered 12 in an homage to Christs apostles, while they simultaneously mirrored the check-list format so familiar from the ten commandments. Portions of Alcoholics Anonymous, the highly venerated "Big Book" that is fundamentally the organization's scripture, are read aloud at meetings. The most frequent reading is the opening portion of Chapter 5, with the telling title How it Works. This is where you‘ll find Bill Wilson’s infamous steps, recognized, copied, and employed around the world, and for far more than alcoholism alone. In a flagrant pseudo-scientific manner, these are generally accepted to be an essential element of the "program of recovery," both within AA, as well as within the majority of America’s 15,000 rehab facilities.As the opening paragraphs introduce these steps, we find this unambiguous gem:Without help it is too much for us. But there is One who has all power — that One is God. May you find Him now!Wilson’s steps follow, consisting of no less than 7 specific references to an interventionist, loving, paternalistic deity. Afterwards, this ubiquitous reading is finished off with the "ABC’s of recovery":(a) That we were alcoholic and could not manage our own lives.(b) That probably no human power [i.e., science, medicine, etc.] could have relieved our alcoholism.(c) That God could and would if He were sought.Bill Wilson and the text Alcoholics Anonymous are clear and demonstrative examples of apotheosis, the process by which a human being, and their words or works, are deified or divinized. As a participating member, I regularly heard claims like "god spoke through Bill W.", that Bill was "divinely inspired," and that the book itself was "sacred." Sections of the book are inscrolled. They hang from the walls of every meeting in a classic parchment-style format, intentionally reminiscent of Egyptian papyri and Biblical times, all in an effort to gain a measure of authenticity-through-antiquity, doing Cecille B. DeMille proud.Just as with biblical or quranic scripture, passages are oft-quoted, repeated, chanted, highlighted, memorized, prayed upon and meditated upon. Questions regarding addiction or recovery are answered with quoted lines from the work, oft considered to be wholly authoritative: "See? It says so right here." There have been efforts to change the primary text, but they have met with steadfast resistance, in spite of the fact that the text is grossly outdated and problematically ineffective.And, in the end, it is this ineffectiveness which is really the bottom line. Members are disinclined to acknowledge two fundamental truths about Alcoholics Anonymous:One: it’s religious as hell, andTwo: it’s secretly, disturbingly ineffective.If the latter were not the case, one might be more inclined to consider forgiving the former. I know the nightmare that is addiction and alcoholism intimately and first-hand. I would not wish this particular affliction upon my worst enemy, as the saying goes. In my mind, anything which works to help someone out of its agonizing throes is worthy of consideration. I would begrudge no sufferer any feasible solution to this dire and woeful condition. I am not so much anti-AA as I am anti-pseudo-science. I am opposed to "solutions" which do not actually solve the problem at hand.While notoriously difficult to measure, there is nonetheless general agreement amongst professionals that the success rate of AA hovers somewhere around 10%, with an estimate of 20% being considered generous by most. I am simply pro-improved success rate, which necessitates me being pro-alternative. AA represents a faulty, problematic answer to what is a very serious problem. Unfortunately, by its very nature, it serves to hinder alternative efforts at improving the chances of those who are afflicted with this particularly vex-some condition.What is my purpose in writing this essay? What is the point? Just more “AA bashing”? Several responses come to mind. First of all, members of Alcoholics Anonymous, especially those who have become counselors, therapists, volunteers, or are otherwise involved in the multibillion dollar per year treatment industry, should stop being "in denial" themselves, and begin opening themselves up to alternatives. They should stop denying that AA is fundamentally religious; they should stop denying that its success rate is very poor; and they should seek to be especially critical of the manner in which the big book and the propaganda of the old-timers nurture a "blame the victim" mindset.It is either simply flat-out false, or at best pseudo-science, to tell newcomers “god could and would if he were sought.” You are simply surrendering them to the placebo effect when you do so. And when they fail to attain their goals, many will fan the flames of misery by blaming themselves for the failure. People do not necessarily fail at 12-step because they didn’t try hard enough, or didn’t have a low enough bottom, as are commonly held to be the case. The problem is much more that 12-step is pseudo-science, and works for only a very small percentage of those who suffer from our condition.Equally important, all of us must acknowledge that 12-step is pseudo-science. As such it is both claimed and understood to be more effective than it truly is. So long as we continue to believe confidently that it is a "spiritual problem," which can only be solved with the help of a "spiritual solution," with help from a "higher power," we will continue to have results which roughly parallel those of the placebo effect only. More practical, pragmatic, evidence-based, and genuinely scientific solutions will continue to be looked upon as infringement, and those who propose them continue to encounter condescension, derision, intolerance, and rejection.If you have 10 or 20 years, and you work helping others in the profession, in treatment facilities, or sponsoring a lot of others, then you are probably more of a part of the problem than you realize. Enthusiastically seek out and encourage alternative approaches which are, rather than pseudo-scientific in nature, genuinely evidence-based. Stop promoting the steps as if they cured alcoholism or addiction. They don’t. “Rarely have we seen a person fail who has thoroughly followed our path” is a false claim of a pseudo-scientific nature, a lie that has sent countless alcoholics and addicts to their grave. It is time for a change.