The Danger of Justified Anger

I will never forget the day I learned how to let go of justified anger. I had just gotten sober and attended an AA meeting, where they were reading out of 12 Steps and 12 Traditions. I was listening but not fully until I heard these words from Step 6, “Self Righteous anger can be very enjoyable.” In a perverse way we allow people to annoy us because it brings a comfortable feeling of superiority. We proclaim our own righteousness by criticizing them instead of taking the time to help them understand why and how they’ve annoyed us. I sat up straight and dove into the reading eager to learn more about it.My first addiction was resentment. I hated my father, who was a narcissistic, alcoholic republican. All of my memories were clouded with intense loathing for him and making him wrong. It was my driving force for most of my life. The reason I turned to alcohol. I was putting him in the wrong, but I was killing myself with my self righteousness. I couldn't live another moment with the anger inside me.I had tried everything I could think of to let go of the anger. I went to therapy, read every single self help book on forgiveness, wrote him letters, some I sent, others I burned. I had (on the advice of a guru) written his name on a balloon and let it go. The only thing that that accomplished was hating the guru. I had been to shamans and psychics. I felt alone. Nobody I knew had the level of resentment I had. I was dying. My justified anger was killing me.I went to see Abraham Hicks. He said to “lay new pipes” to not dig out the clogged pipe but to lay a new one so you can go with the flow. I was willing to try it. It sounded great in theory but there was a darkness in me I just couldn’t let go of. Then I discovered the Law of Attraction. It states that when you are indulging in self righteous anger you are blocking the path of Deliberate Creation. Deliberate Creation is a principle that enhances the manifestation process by helping you to eliminate the resistance whilst boosting your Law of Attraction powers to attract good things into your life. I immediately connected with that. I wanted to learn how to go from one to the other. I would do it in a heartbeat. No questions asked. I read all that I could about Deliberate Creation but It didn’t give me the steps to change. It just told me to change and I was left disappointed and frustrated once again.I went to a hypnotist who had been successful in getting me to quit smoking in one session. I did four sessions on letting go of self righteousness, but nothing changed. I was just succeeding in getting angrier.So on that day when I read about justified anger and self righteousness in the 12 and 12 and that it causes excessive misery in our lives, tears flowed down my face. Finally, I had a direction. I had a recipe. A book that was written before I was born, before my mother was born had all the answers.The first thing I had to do was admit to myself that I preferred to hang on to self righteousness. I had to admit that it was an addiction in itself. I had an ineffectual behavior and that I was getting a “hit” out of being right and making someone else wrong. That I was continually choosing to be a willing victim of my very own justified anger.I was asked, “Do you want to be right or do you want to be happy? I had to let go of the anger I had towards my father. Not for his benefit. For my peace of mind. Was I pardoning anything? No way in hell never. But I did what the book told me to do. I became “entirely willing to aim toward perfection.” I had my sponsor, I had the recipe, and I had the willingness. We seek progress not perfection in AA. I do not need to be perfect to experience unconditional love. No one does. It is free for all of us at any time. But striving for perfection keeps me doing the right thing. Not for anyone else but me. Doing the right thing gives me peace of mind. The right thing is never justified anger, it is deliberate, intentional creation from a place of love.I have a sponsor that helps me “unclog the pipe.” I asked my sponsor how I can be of service at this difficult time. She said, “Don’t silently scorn. Don’t make anyone wrong. Stay right sized. Don’t think I am better or worse than anyone. Take action from a place of love and change. What I am, is what I will see. To wholeheartedly be the change I seek to see.”Since I let go of justified anger and self righteous behavior I have now been able to practice Deliberate Creation. I can accomplish so much more and I produce quality work. I open myself up to creative energy and give myself over fully to the process.Getting in touch with my higher power and using that to take action instead of self righteous anger has completely changed my life for the better. Living from my heart is how I live today. It prevents me from a slip up of drinking, but more importantly, a slip up of emotional drunkenness.

People with Opioid Use Disorder Deserve Medical Treatment

Opioid use disorder and alcohol use disorder are physical conditions. Although people might start abusing opioids or alcohol to numb physical, psychological, or emotional pain, the use of these substances leads to a physical dependence, in which the brain and body require more of the substance just to avoid becoming sick. People dealing with these conditions deserve access to high quality medical detox, but many people who need this service don’t get it.Before you choose a treatment program for you or your loved one, it’s important to understand medical detox. For people who are dependent on opioids or alcohol, medical detox provides a fast and effective way to address dependency. With dependency behind them, the person can go on to address any underlying causes of their substance abuse, like physical or psychological pain. Because of this, medical detox is an important first step to living life without drugs or alcohol.Is medical detox the same as medication-assisted treatment?It’s easy to confuse medical detox and medication-assisted treatment, but they’re actually completely different. Medication-assisted treatment (MAT) is often used to treat opioid use disorder. While MAT is effective and can reduce the risk of relapse, it comes with a major downside to your health and wellbeing: it involves continuously taking opioid medications.The medications used for MAT, including suboxone and methadone, are themselves opioids. Sure, they’re much less harmful than street opioids like heroin or fentanyl. But the fact remains that if you’re on MAT, you’re still dependent on opioids.At Waismann Method® Opioid Treatment Specialists, we believe that everyone deserves the chance to live without using opioids or alcohol — even in prescribed circumstances. That’s why we offer medical detox that treats the dependency on drugs or alcohol entirely. We deliver medically-assisted detox in a hospital that allows you to get off opioids for good.After detoxing you from opioids, we use naltrexone (also known as vivitrol) to help control any cravings. Unlike suboxone or methadone, naltrexone doesn’t have any opioids, so you cannot become dependent on it. In fact, this medication blocks the brain’s opioid receptors, eliminating cravings without introducing new habits or dependencies.Addressing dependency once and for allMany people want to live their lives with as few medications as possible. Even if you are dependent on opioids or alcohol, living life without ongoing medications could be a possibility for you. More people with opioid use disorder and alcohol use disorder need to be aware that medically-assisted detox is an option that they should explore. We believe that this is the most effective treatment for opioid use disorder. So, what exactly is medically-assisted detox? Waismann Method® Opioid Treatment Specialists provide the medical detox treatment in a full service, JCAHO-accredited hospital, in a private room, which many people find safer and more comfortable than a rehab or an outpatient detox facility. Once there, you’ll meet with one of our doctors, discussing your health history and any underlying medical conditions that you’re dealing with. Then, we’ll discuss the best medically-assisted detox option for you, including rapid detox and anesthesia-assisted rapid detoxification.During all decisions, your safety is a priority. That’s why all care is delivered under the watch of a quadruple board-certified medical director, Michael H. Lowenstein, M.D, and why there are different detox options available.Patients usually spend one to two nights in the hospital depending on which detox procedure they receive along with their individual health needs. As part of our treatment, you complete your detox at our private recovery center, Domus Retreat, for post-procedure care and continued support. There, we will work with you to give recommendations about how best to treat any underlying factors that contributed to your substance abuse, whether that was trauma, physical pain, or untreated psychological conditions.Dignity in detoxDetox is often the biggest barrier to getting help. People are afraid of having to physically suffer through the withdrawals with minimal support. Opting for medically-assisted detox allows you to get over that first hurdle comfortably so that you can begin building your new, opioid-free life.

The Murder of George Floyd Is Normal in an Abnormal Society

There is no need to wonder why George Floyd (age 46) was murdered in broad daylight in Minneapolis, Minnesota, on May 25, 2020. The script of his death is written deep in the ugly drama of U.S. history.I Can’t Breathe 2020Officer Derek Chauvin’s knee sat on George Floyd’s neck for eight minutes and 46 seconds. After that time, George Floyd was dead. From the moment Chauvin put his body on an unarmed man, George Floyd said—eleven times—I can’t breathe.Scientists who study human respiration say that untrained people can hold their breath from between thirty seconds and two minutes; anything more than that results in a process that leads eventually to death.I Can’t Breathe 2014Officer Daniel Pantaleo slammed Eric Garner onto the New York City sidewalk just minutes after Garner had helped resolve a dispute on the street. Pantaleo pushed Garner’s face onto the pavement, and Garner said—eleven times—I can’t breathe.Garner lost consciousness, did not receive medical care in the ambulance, and was pronounced dead soon after arriving at the hospital. He died, effectively, of suffocation.DismayedBoth Floyd and Garner were African American; both were men who struggled to make a living in a harsh economic environment.The UN Human Rights head Michelle Bachelet wrote a powerful statement in response to the death of George Floyd: “This is the latest in a long line of killings of unarmed African Americans by U.S. police officers and members of the public. I am dismayed to have to add George Floyd’s name to that of Breonna Taylor, Eric Garner, Michael Brown and many other unarmed African Americans who have died over the years at the hands of the police—as well as people such as Ahmaud Arbery and Trayvon Martin who were killed by armed members of the public.”Each year in the United States, more than a thousand people are killed by the police; African Americans are three times more likely to be killed by the police than whites, and African Americans who are killed by police are more likely to be unarmed than whites. Most of these killings are not associated with serious crime. Astoundingly, 99 percent of the officers who kill a civilian are not charged with a crime.Permanent Depression“The Depression,” the poet Langston Hughes wrote of the 1930s, “brought everybody down a peg or two.” It was different for African Americans, for they “had but few pegs to fall.”Garner was accused of selling loose cigarettes on the street, violating excise tax laws to make a few dollars; Floyd was accused of using a counterfeit $20 bill. Even if these accusations could have been proved, neither were earth-shattering crimes; if they had gone to court, neither would have earned these men death sentences. They were killed after being accused of minor infringements.When Hughes wrote those words, Lino Rivera, a 16-year-old Afro-Puerto Rican boy, had been arrested for shoplifting a 10-cent penknife. A crowd gathered when the police went to arrest him, a rumor spread that he had been killed, and Harlem rose up in anger. A government report later showed that the protests were “spontaneous” and that the causes of the unrest were “the injustices of discrimination in employment, the aggressions of the police, and racial segregation.” This report could have been written last week. It suggests a permanent Depression.System Cannot Be ReformedHistorically, police aggression has come before any unrest. In 1967, unrest in Detroit spurred the U.S. government to study the causes, which they assumed would be communist instigators and an inflammatory press. The riots, the National Advisory Commission on Civil Disorders (the Kerner Commission) said, “were not caused by, nor were they the consequences of, any organized plan or ‘conspiracy.’”Instead, the Kerner Commission said that the cause of the unrest was structural racism. “What white Americans have never fully understood,” the report noted, “is that white society is deeply implicated in the ghetto. White institutions created it, white institutions maintain it, and white society condones it.” By “ghetto” the report’s authors meant the atrocious class inequalities in the United States that had—because of the history of enslavement—been marked by race.Rather than address the deep inequalities in society, the American government chose to heavily arm police officers and send them to discipline populations in distress with their dangerous weapons. The commission proposed instead “a policy which combines ghetto enrichment with programs designed to encourage integration… into the society outside the ghetto.”Nothing came of that report, as nothing has come of any of the reports that stretch backward 150 years. Rather than genuinely invest in the well-being of people, the American government—whether governed by Republicans or Democrats—cut back on social programs and cut back on welfare spending; it allowed firms to erode wages and it allowed them to diminish working conditions. What was terrible in 1968 only became worse for the working-class Black population.The financial crisis of 2008 stole from African American households’ savings that had been accumulated through generations of work. By 2013, Pew Research found that the net worth of white households was 13 times greater than African American households; this was the largest such gap since 1989, and it is a gap that has only widened. Now, with the global pandemic striking the United States particularly hard, data shows that the disease has struck African Americans and other people of color the most. Some of this is because it is African Americans and other people of color who often have the most dangerous frontline jobs.If Eric Garner and George Floyd earned a minimum wage of $25 for decent work, would they need to be in a position where a belligerent police officer would accuse them of selling loose cigarettes or of passing a counterfeit bill?They Are NormalSociety in the United States has been broken by the mechanisms of high rates of economic inequality, high rates of poverty, impossible entry into robust educational systems, and remarkable warlike conditions put in place to manage populations no longer seen as the citizenry but as criminals.Such processes corrode a civilization. The names of Michael Brown, Sandra Bland, Eric Garner, Tamir Rice… and now George Floyd are only the names of the present moment, written in thick ink on cardboard signs across the United States at the many, many protests that continue to take place. The taste of desperation lingers in these protests, along with the anger at the system, and the outrage seems to have no outlet.Donald Trump is an exaggeration of the normal course of history in the United States. He takes the ugliness to the utmost limit, bringing in the army, sniffing around for the legal possibility of the mass detention of demonstrators. His is a politics of violence. It does not last long. It is hard to beat the urge for justice out of an entire people.As you read this, somewhere in the United States, another person will be killed—another poor person whom the police deem to be a threat. Tomorrow another will be killed; and then another. These deaths are normal for the system. Outrage against this system is a logical, and moral, response. This article was produced by Globetrotter, a project of the Independent Media Institute. Reprinted with permission.Source: Independent Media Institute

Zoom Is an Ineffective Substitute

Last night, I and the other residents of my recovery house saw a man vigorously performing a scatological act on himself. A bathtub was involved. While it’s going to be a long time before I contemplate a bath, it was just another night of Zoom bombing during an online meeting during this pandemic. Forgive me, but it seems our country, and the larger world, is unraveling at the seams. I often contemplate if we’re living in the end times. The Romans had their day in the sun, and this may be the end of ours. I’d say this pessimistic line of thinking is a consequence of the years I’ve lost to addiction, but I’ve always been this way. My mind is like a jaguar on a treadmill, always moving rapidly but not really getting anywhere.Maybe my bleak outlook has something to do with the fact that my compatriots and I attempting to scramble out from the cloud of addiction have been unwillingly deprived of our only method for not imploding. The absence of physical meetings has had an enervating effect on my psyche.. We have been relegated to the internet because of an aggressive bat virus. Bureaucratic mouthpieces have told us that meeting in the flesh would put lives at risk. While that’s not exactly false, it is frustrating.[1] The program, which I reluctantly adhere to because I have no alternative[2] has been deemed non-essential by our government. This action, specifically the government declaring something superfluous for the greater good, strikes me as ludicrous. Tons of Americans, tons of humans, are reliant on abstinence programs to stay among the living. What about our greater good? These abstinence programs are effective in no small part because they garner a sense of community and camaraderie. That in-person contact and discussion, and in a sense shared misery, is mystifyingly powerful. Speaking candidly, I haven’t quite bought into the actual meat and potatoes or concrete sharing portion of these meetings. But I now realize how much I cherish the small talk and cigarettes before and after meetings.[3] A massive portion of the country, the world even, suffers from the disease. That other pandemic, COVID, has tyrannically forced us on to the internet and deprived us of that person-to-person contact, that fortifying sense of community, that is essential to our survival. Governors, and the government, should certainly contemplate the consequences of classifying our haphazard panacea as non-essential. The act of classifying physical meetings as non-essential is only made more aggravating upon considering that cannabis dispensaries were initially deemed essential in California. Recreational cannabis users often claim that it is critical medicine they need to subsist. It should be abundantly apparent to any non-troglodytic governor that meetings should be similarly classified.The wrench, being COVID, pelted into the machine, being physical meetings, is not the only pernicious issue we face related to this new normal.[4]  Zoom bombing has, well, bombed us. That’s precisely how the aforementioned bathtub scene invaded my field of vision. But Zoom bombing goes further than the briefly obscene and crosses into dangerously hazardous territory when these bombers (sadistic teenagers, sad-sack individuals, or I can’t even contemplate the other possibilities that would drive someone to bomb a 12-step meeting) begin harassing meeting attendees through their microphones. I’ve witnessed some truly disturbing hectoring; the kind that could jeopardize already tenuous sobriety during these arduous times. Female attendees are importuned to display their bosoms, traumatic share notwithstanding. Attendees are denigrated for their appearance. F-bombs are flying. I’ve witnessed attendees get heckled to the point of tears and flee the session. Are they OK? I have no idea. But I’m sure the bombers lived to bomb another day. My peers have countless other examples. The puerility is breathtaking, if not surprising Enough already. Governors, I implore you to lift restrictions on our supposed non-essential meetings. Meetings can meet social-distancing guidelines and take other precautions. They're certainly safer than church choirs.I realize that security measures can be put in place within Zoom to prevent bombing, but they are often at the expense of the recovering alcoholic and drug addict. Most large-scale meetings now disable the chat feature of the Zoom call to prevent a steady stream of obscenities and racial epithets from our bomber buddies. As a result, attendees are unable to share their phone numbers quickly and easily, if they’re so inclined. Zoom meeting chairs also now password lock their meetings. This safeguard prevents people who desperately need that camaraderie – possibly to stay alive – from easily accessing meetings. If you’re flirting with rock bottom, you’re probably incapable of fumbling with numbers and words and special characters.[5] Meetings can also be hosted on Skype or other video chat services, but Zoom is by far the most ubiquitous platform currently available. Yes, some preventative measures are marginally effective. The “waiting room” feature in a Zoom call doesn’t prohibit access to meetings, a Zoom host can restrict access to the screen-sharing feature, which prevents hormonal adolescents from punishing us alcoholics and addicts with indecorous videos.[6] But these are all band-aids, inadequate remedies to a paramount dilemma that ignore the heart of the issue. The solution to absurdity is not implementing a proportional amount of absurdity; asking those in the program to forego meetings is exactly that..[1] From this point on, read anything that is in bolded text in a facetious “Krusty the Clown” voice.[2] Well I do have an alternative, but been there, done that..[3] I’ll concede and recognize that I need the core/big book-oriented sharing portion of the meeting to stay in this thing. I would still be watching tv in my underwear pounding Budweiser if it weren’t for the spiritual principles of the program..[4] Ideally, COVID made visible wouldn’t take the form of a wrench. It would probably be a soiled adult diaper, but that wouldn’t be feasible within the context of the metaphor, as it wouldn’t break the machine. Instead, it would probably just rip the adult diaper to shreds and regurgitate it as a sort of fecal firework..[5] This frustrating phenomenon happens at an alarming frequency. At least, at a much higher rate than it should. Too often the password for the meeting is simply absent from intergroup websites, is outdated, or can only be accessed by emailing the chair of the group, and often the email is conspicuously omitted from the page. It’s ridiculous to require someone who could quite likely be fresh off a relapse to dive through an absurd number of virtual hoops..[6] It’s a sad reality that many meeting chairs are technologically inept. Please don’t come at me with ageism daggers out. These hosts are kind, benevolent souls who can’t contemplate, let alone combat, a Zoom bombing in real time. I refer you to Grandpa Simpson trying to fix the family TV in season 7, episode 14.

Why cellphone videos of black people’s deaths should be considered sacred, like lynching photographs

As Ahmaud Arbery fell to the ground, the sound of the gunshot that took his life echoed loudly throughout his Georgia neighborhood.I rewound the video of his killing. Each time I viewed it, I was drawn first to the young black jogger’s seemingly carefree stride, which was halted by two white men in a white pickup truck.Then I peered at Gregory McMichael, 64, and his son Travis, 34, who confronted Arbery in their suburban community.I knew that the McMichaels told authorities that they suspected Arbery of robbing a nearby home in the neighborhood. They were performing a citizen’s arrest, they said.The video shows Arbery jogging down the street and the McMichaels blocking his path with their vehicle. First, a scuffle. Then, gunshots at point-blank range from Travis McMichael’s weapon.My eyes traveled to the towering trees onscreen, which might have been the last things that Arbery saw. How many of those same trees, I wondered, had witnessed similar lynchings? And how many of those lynchings had been photographed, to offer a final blow of humiliation to the dying?A series of modern lynchingsIt may be jarring to see that word – lynching – used to describe Arbery’s Feb. 23, 2020, killing. But many black people have shared with me that his death – followed in rapid succession by Breonna Taylor’s and now George Floyd’s officer-involved murders – hearkens back to a long tradition of killing black people without repercussion.Perhaps even more traumatizing is the ease with which some of these deaths can be viewed online. In my new book, “Bearing Witness While Black: African Americans, Smartphones and the New Protest #Journalism,” I call for Americans to stop viewing footage of black people dying so casually.Instead, cellphone videos of vigilante violence and fatal police encounters should be viewed like lynching photographs – with solemn reserve and careful circulation. To understand this shift in viewing context, I believe it is useful to explore how people became so comfortable viewing black people’s dying moments in the first place.Images of black people’s deaths pervasiveEvery major era of domestic terror against African Americans – slavery, lynching and police brutality – has an accompanying iconic photograph.The most familiar image of slavery is the 1863 picture of “Whipped Peter,” whose back bears an intricate cross-section of scars.Famous images of lynchings include the 1930 photograph of the mob who murdered Thomas Shipp and Abram Smith in Marion, Indiana. A wild-eyed white man appears at the bottom of the frame, pointing upward to the black men’s hanged bodies. The image inspired Abel Meeropol to write the poem “Strange Fruit,” which was later turned into a song that blues singer Billie Holiday sang around the world.Twenty-five years later, the 1955 photos of Emmett Till’s maimed body became a new generation’s cultural touchstone. The 14-year-old black boy was beaten, shot and thrown into a local river by white men after a white woman accused him of whistling at her. She later admitted that she lied.Throughout the 1900s, and until today, police brutality against black people has been immortalized by the media too. Americans have watched government officials open firehoses on young civil rights protesters, unleash German shepherds and wield billy clubs against peaceful marchers, and shoot and tase today’s black men, women and children – first on the televised evening news, and, eventually, on cellphones that could distribute the footage online.When I conducted the interviews for my book, many black people told me that they carry this historical reel of violence against their ancestors in their heads. That’s why, for them, watching modern versions of these hate crimes is too painful to bear.Still, there are other groups of black people who believe that the videos do serve a purpose, to educate the masses about race relations in the U.S. I believe these tragic videos can serve both purposes, but it will take effort.In 1922 the NAACP ran a series of full-page ads in The New York Times calling attention to lynchings. New York Times, Nov. 23, 1922/American Social History ProjectReviving the ‘shadow archive’In the early 1900s, when the news of a lynching was fresh, some of the nation’s first civil rights organizations circulated any available images of the lynching widely, to raise awareness of the atrocity. They did this by publishing the images in black magazines and newspapers.After that image reached peak circulation, it was typically removed from public view and placed into a “shadow archive,” within a newsroom, library or museum. Reducing the circulation of the image was intended to make the public’s gaze more somber and respectful.The National Association for the Advancement of Colored People, known popularly as the NAACP, often used this technique. In 1916, for example, the group published a horrific photograph of Jesse Washington, a 17-year-old boy who was hanged and burned in Waco, Texas, in its flagship magazine, “The Crisis.”Memberships in the civil rights organization skyrocketed as a result. Blacks and whites wanted to know how to help. The NAACP used the money to push for anti-lynching legislation. It purchased a series of costly full-page ads in The New York Times to lobby leading politicians.Though the NAACP endures today, neither its website nor its Instagram page bears casual images of lynching victims. Even when the organization issued a statement about the Arbery killing, it refrained from reposting the chilling video within its missive. That restraint shows a degree of respect that not all news outlets and social media users have used.A curious double standardCritics of the shadow archive may argue that once a photograph reaches the internet, it is very difficult to pull back from future news reports.This is, however, simply not true.Images of white people’s deaths are removed from news coverage all the time.It is difficult to find online, for example, imagery from any of the numerous mass shootings that have affected scores of white victims. Those murdered in the Sandy Hook Elementary School shooting of 2012, or at the Las Vegas music festival of 2017, are most often remembered in endearing portraits instead.In my view, cellphone videos of black people being killed should be given this same consideration. Just as past generations of activists used these images briefly – and only in the context of social justice efforts – so, too, should today’s imagery retreat from view quickly.The suspects in Arbery’s killing have been arrested. The Minneapolis police officers involved in Floyd’s death have been fired and placed under investigation. The videos of their deaths have served the purpose of attracting public outrage.To me, airing the tragic footage on TV, in auto-play videos on websites and social media is no longer serving its social justice purpose, and is now simply exploitative.Likening the fatal footage of Ahmaud Arbery and George Floyd to lynching photographs invites us to treat them more thoughtfully. We can respect these images. We can handle them with care. In the quiet, final frames, we can share their last moments with them, if we choose to. We do not let them die alone. We do not let them disappear into the hush of knowing trees.[Insight, in your inbox each day.You can get it with The Conversation’s email newsletter.]Allissa V. Richardson, Assistant Professor of Journalism, University of Southern California, Annenberg School for Communication and JournalismThis article is republished from The Conversation under a Creative Commons license. Read the original article.

In Hard-Hit Areas, COVID’s Ripple Effects Strain Mental Health Care Systems

In late March, Marcell’s girlfriend took him to the emergency room at Henry Ford Wyandotte Hospital, about 11 miles south of Detroit.“I had [acute] paranoia and depression off the roof,” said Marcell, 46, who asked to be identified only by his first name because he wanted to maintain confidentiality about some aspects of his illness.Marcell’s depression was so profound, he said, he didn’t want to move and was considering suicide.“Things were getting overwhelming and really rough. I wanted to end it,” he said.Marcell, diagnosed with schizoaffective disorder seven years ago, had been this route before but never during a pandemic. The Detroit area was a coronavirus hot spot, slamming hospitals, attracting concerns from federal public health officials and recording more than 1,000 deaths in Wayne County as of May 28. Michigan ranks fourth among states for deaths from COVID-19.The crisis enveloping the hospitals had a ripple effect on mental health programs and facilities. The emergency room was trying to get non-COVID patients out as soon as possible because the risk of infection in the hospital was high, said Jaime White, director of clinical development and crisis services for Hegira Health, a nonprofit group offering mental health and substance abuse treatment programs. But the options were limited.Still, the number of people waiting for beds at Detroit’s crisis centers swelled. Twenty-three people in crisis had to instead be cared for in a hospital.This situation was hardly unique. Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened. Mobile crisis teams, residential programs and call centers, especially in pandemic hot spots, had to reduce or close services. Some programs were plagued by shortages of staff and protective supplies for workers.At the same time, people battling mental health disorders became more stressed and anxious.“For people with preexisting mental health conditions, their routines and ability to access support is super important. Whenever additional barriers are placed on them, it could be challenging and can contribute to an increase in symptoms,” said White.After eight hours in the emergency room, Marcell was transferred to COPE, a community outreach program for psychiatric emergencies for Wayne County Medicaid patients.“We try to get patients like him into the lowest care possible with the least restrictive environment,” White said. “The quicker we could get him out, the better.”Marcell was stabilized at COPE over the next three days, but his behavioral health care team couldn’t get him a bed in one of two local residential crisis centers operated by Hegira. Social distancing orders had reduced the beds from 20 to 14, so Marcell was discharged home with a series of scheduled services and assigned a service provider to check on him.However, Marcell’s symptoms ― suicidal thoughts, depression, anxiety, auditory hallucinations, poor impulse control and judgment ― persisted. He was not able to meet face-to-face with his scheduled psychiatrist due to the pandemic and lack of telehealth access. So, he returned to COPE three days later. This time, the staff was able to find him a bed immediately at a Hegira residential treatment program, Boulevard Crisis Residential in Detroit.Residents typically stay for six to eight days. Once they are stabilized, they are referred elsewhere for more treatment, if needed.Marcell ended up staying for more than 30 days. “He got caught in the pandemic here along with a few other people,” said Sherron Powers, program manager. “It was a huge problem. There was nowhere for him to go.”Marcell couldn’t live with his girlfriend anymore. Homeless shelters were closed and substance abuse programs had no available beds.“The big problem here is that all crisis services are connected to each other. If any part of that system is disrupted you can’t divert a patient properly,” said Travis Atkinson, a behavioral consultant with TBD Solutions, which collaborated on a survey of providers with the American Association of Suicidology, the Crisis Residential Association and the National Association of Crisis Organization Directors.White said the crisis took a big toll on her operations. She stopped her mobile crisis team on March 14 because, she said, “we wanted to make sure that we were keeping our staff safe and our community safe.”Her staff assessed hospital patients, including Marcell, by telephone with the help of a social worker from the emergency room.People like Marcell have struggled during the coronavirus crisis and continue to face hurdles because emergency preparedness measures didn’t provide enough training, funds or thought about the acute mental health issues that could develop during a pandemic and its aftermath, said experts.“The system isn’t set up to accommodate that kind of demand,” said Dr. Brian Hepburn, a psychiatrist and executive director of the National Association of State Mental Health Program Directors.“In Detroit and other hard-hit states, if you didn’t have enough protective equipment you can’t expect people to take a risk. People going to work can’t be thinking ‘I’m going to die,’” said Hepburn.For Marcell, “it was bad timing to have a mental health crisis,” said White, the director at Hegira.At one time Marcell, an African American man with a huge grin and a carefully trimmed goatee and mustache, had a family and a “pretty good job,” Marcell said. Then “it got rough.” He made some bad decisions and choices. He lost his job and got divorced. Then he began self-medicating with cocaine, marijuana and alcohol.By the time he reached the residential center in Detroit on April 1, he was at a low point. “Schizoaffective disorder comes out more when you’re kicked out of the house and it increases depression,” said Powers, the program manager who along with White was authorized by Marcell to talk about his care. Marcell didn’t always take his medications and his use of illicit drugs magnified his hallucinations, she said.While in the crisis center voluntarily, Marcell restarted his prescription medications and went to group and individual therapy. “It is a really good program,” he said while at the center in early May. “It’s been one of the best 30 days.”Hepburn said the best mental health programs are flexible, which allows them more opportunities to respond to problems such as the pandemic. Not all programs would have been able to authorize such a long stay in residential care.Marcell was finally discharged on May 8 to a substance abuse addiction program. “I felt good about having him do better and better. He had improved self-esteem to get the help he needed to get back to his regular life,” Powers said.But Marcell left the addiction program after only four days.“The [recovery] process is so individualized and, oftentimes, we only see them at one point in their journey. But, recovering from mental health and substance use disorders is possible. It can just be a winding and difficult path for some,” said White.Seeking HelpIf you or someone you know is in immediate danger, call 911. Below are other resources for those needing help:— National Helpline: 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov.— National Suicide Prevention Lifeline: 1-800-273-TALK (8255).— Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746.

Pandemic Presents New Hurdles, and Hope, for People Struggling with Addiction

Before Philadelphia shut down to slow the spread of the coronavirus, Ed had a routine: most mornings he would head to a nearby McDonald’s to brush his teeth, wash his face and — when he had the money — buy a cup of coffee. He would bounce between homeless shelters and try to get a shower. But since businesses closed and many shelters stopped taking new admissions, Ed has been mostly shut off from that routine.He’s still living on the streets.“I’ll be honest, I don’t really sleep too much,” said Ed, who’s 51 and struggling with addiction. “Every four or five days I get a couple hours.”KHN agreed not to use his last name because he uses illegal drugs.Philadelphia has the highest overdose rate of any big city in America — in 2019, more than three people a day died of drug overdoses there, on average. Before the coronavirus began spreading across the United States, the opioid overdose epidemic was the biggest health crisis on the minds of many city officials and public health experts. The coronavirus pandemic has largely eclipsed the conversation around the opioid crisis. But the crisis still rages on despite business closures, the cancellation of in-person treatment appointments and the strain on many addiction resources in the city.When his usual shelter wasn’t an option anymore, Ed tried to get into residential drug treatment. He figured that would be a good way to try to get back on his feet and, if nothing else, get a few good nights of rest. But he had contracted pinkeye, a symptom thought to be associated with the virus that leads to COVID-19, so the evaluation center didn’t want to place him in an inpatient facility until he’d gotten the pinkeye checked out. But he couldn’t see a doctor because he didn’t have a phone for a telehealth appointment.“I got myself stuck, and I’m trying to pull everything back together before it totally blows up,” he said.Rosalind Pichardo wants to help people in Ed’s situation. Before the pandemic, Pichardo would hit the streets of her neighborhood, Kensington, which has the highest drug overdose rate in Philadelphia. She’d head out with a bag full of snack bars, cookies and Narcan, the opioid overdose reversal drug.She’d hand Narcan out to people using drugs, and people selling drugs — anyone who wanted it. Pichardo started her own organization, Operation Save Our City, which initially set out to work with survivors of gun violence in the neighborhood. When she realized that overdoses were killing people too, she began getting more involved with the harm reduction movement and started handing out Narcan through the city’s syringe exchange.When Pennsylvania’s stay-at-home order went into effect, Pichardo and others worried that more people might start using drugs alone, and that fewer first responders would be patrolling the streets or nearby and able to revive them if they overdosed.So, Pichardo and other harm reduction activists gave out even more Narcan. A representative for Prevention Point Philadelphia, the group that operates a large syringe exchange program in the city, said that during the first month of the city’s stay-at-home order, they handed out almost twice as much Narcan as usual.After the lockdowns and social distancing began, Pichardo worried that more people would be using drugs alone, leading to more overdoses. But Philadelphia’s fatal overdose rate during the pandemic remains about the same as it was this time last year. Pichardo said she thinks that’s evidence that flooding the streets with Narcan is working — that people are continuing to use drugs, and maybe even using more drugs, but that users are utilizing Narcan more often and administering it to one another.That is the hope. But Pichardo said users don’t always have a buddy to keep watch, and during the pandemic first responders have seemed much more hesitant to intervene. For example, she recently administered Narcan to three people in Kensington who overdosed near a subway station, while two police officers stood by and watched. Before the pandemic, they would often be right there with her, helping.To reverse the overdoses, Pichardo crouched over the people who she said had started turning blue as their oxygen levels dropped. She injected the Narcan into their noses, using a disposable plastic applicator. Normally, she would perform rescue breathing, too, but since the pandemic began she has started carrying an Ambu bag, which pumps air into a person’s lungs and avoids mouth-to-mouth resuscitation. Among the three people, she said, it took six doses of Narcan to revive them. The police officers didn’t step in to help but did toss several overdose-reversal doses toward Pichardo as she worked.“I don’t expect ’em to give ’em rescue breaths if they don’t want to, but at least administer the lifesaving drug,” Pichardo said.In her work as a volunteer, she has reversed almost 400 overdoses, she estimated.“There’s social distancing — to a limit,” Pichardo said, “I think when someone’s life is in jeopardy, they’re worth saving. You just can’t watch people die.”Even before Philadelphia officially issued its stay-at-home order, city police announced they would stop making low-level arrests, including for narcotics. The idea was to reduce contact overall, help keep the jail population low and reduce the risk of the virus getting passed around inside. But Pichardo and other community activists said the decreased law enforcement emboldened drug dealers in the Kensington neighborhood, where open-air drug sales and use are common.“You can tell they have everything down pat, from the lookout to the corner boys to the one actually holding the product — the one holding the product’s got some good PPE gear,” said Pichardo.More dealers working openly on the street has led to more fights over territory, she added, which in turn has meant more violence. While overall crime in Philadelphia and other major cities has declined during the pandemic, gun violence has spiked.Police resumed arrests at the beginning of May.Now when she goes out to offer relief and hand out Narcan, Pichardo packs a few extra things in her bag of supplies: face masks, gloves and gun locks.“It’s like the survival kit of the ’hood,” she said.For those struggling with addiction who are ready to start recovery, newly relaxed federal restrictions have made it easier to get medications that curb opioid cravings and stem withdrawal. Several efforts are underway among Philadelphia-based public health groups and criminal justice advocacy organizations to give cellphones to people who are homeless or coming out of jail, so they can make a telehealth appointment and get quicker access to a prescription for those medicines.During the pandemic, people taking medication-assisted treatment can renew their prescription every month instead of every week, which helps decrease trips to the pharmacy. It is too soon to know if more people are taking advantage of the new rules, and accessing medication-assisted treatment via telehealth, but if that turns out to be the case, many addiction medicine specialists argue the new rules should become permanent, even after the pandemic ends.“If we find that these relaxed restrictions are bringing more people to the table, that presents enormous ethical questions about whether or not the DEA should reinstate these restrictive policies that they had going in the first place,” said Dr. Ben Cocchiaro, a physician who treats people with substance-use disorder.Cocchiaro said the whole point of addiction treatment is to facilitate help as soon as someone is ready for it. He hopes if access to recovery can be made simpler during a pandemic, it can remain that way afterward.This story is part of a partnership that includes WHYY, NPR and Kaiser Health News.