Audio Journal - Podcast Series

Welcome to our audio journal series. InterAct LifeLine, a technology service focused on helping addictions treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse.

Episode 19 - InterAct Studios: Exploring the Risk Factors of Addiction with Dr. Sandy Newes
Carolyn: (00:00) Hello, I'm Carolyn Bradfield. And I'd like to welcome our listeners to the Audio Journal series from interact LifeLine. Interact LifeLine is a technology service focused on helping addiction treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse. **Introduction Music** Carolyn: (00:27) Good afternoon everyone, or morning whenever you're listening to this podcast. This is Carolyn Bradfield. I'm the CEO of Interact Lifeline and we are starting a new series in our podcast called Interact Studios. In this podcast we're going to have conversations with people that are from our industry in the mental health addiction and recovery space. And hopefully people that listen will learn a lot from our talk. So what I'd like to do today is introduce you to Dr. Sandy Newes. say hi, Sandy so people can hear your voice. Sandy: Hi everyone. Carolyn: I'm in Atlanta, Georgia. Sandy is in lovely Asheville, North Carolina, and, Sandy and I have known each other for a number of years. We worked together in the industry at Phoenix outdoor, an outdoor behavioral healthcare program in North Carolina. Sandy was our clinical director, as well as our testing psychologist. And so I have a deep level of respect for her in terms of her understanding of working with adolescents and young adults who had been struggling with substance misuse and addiction. And beyond working with adolescents and young adults, Sandy also has had significant contact with their parents, to help them understand the journey that their own with their loved one in terms of working, and helping them recover. Sandy also in my opinion, is one of the best testing psychologists in the country and so she does a complete analysis of an individual to understand their learning styles, their behavioral issues, and their mental health issues to provide parents and the individual with a thorough understanding of what's causing them to struggle along with making recommendations to move forward and to be healthier. Sandy has an extensive history in training and education. She works with other clinicians to help them better understand how to work with at-risk clientele, and she is especially focused on those that are struggling with substance misuse. So Sandy, you've got a million credentials, to your name, but beyond what I just shared in terms of our personal experience together, round out for the audience, the other areas that you focus on. Sandy: (03:21) So my broad areas are trauma, chronic stress, anxiety and self regulation issues of which addiction is a part of that. And I really believe that those are the underlying pieces in addiction. And so I have a private practice and Asheville as Carolyn mentioned. And not only do I test do testing, I see individual clients, about a third of my practice are adult or young adults, primarily in adults, some adolescents, but in early recovery or mid level recovery from addiction, as well as people who are struggling with chronic stress and anxiety. And I incorporate a real brain-based focus on working. So I use skills to help regulate the nervous system and help teach people how to balance their brains, which has everything to do with behavior. And I also incorporate neurofeedback into that. And then I do training around those types of things for not only clinicians, but also staff at therapeutic programs nationwide. Carolyn: (04:24) You are by far one of the smartest people that I know and certainly well-respected in the industry. So again, you're welcome. so, and yeah, our first initial minutes in this conversation, we've used the word addiction quite a lot. And as a psychologist you've treated hundreds of adolescents and young adults that are struggling with addiction over the years. So let's get the audience a level set definition of what addiction really is. So in layman's terms, can you just give us a good understanding about what we're, what we're facing here, what really is addiction? Sandy: (05:08) Sure. There's a tremendous amount of science around the way addictive substances impact the brain. And, but I'm not going to go into that right now, but it is really important to understand that this is a brain-based disease that people who, whose substance use moves into addiction have a different response to the same substances and their chemical responses and their brain respond differently than people who use and don't become addicts. And so essentially what happens is some kind of different chemical process happens in the brain that leads an individual, It can start in adolescence and move into adulthood. That leads them to become increasingly preoccupied with using the substance. That sets up a whole different brain-based kind of physiological response and that leads to increased preoccupations and ultimately cravings and those preoccupations and cravings lead to the individual really not recognizing the impact of their behavior or prioritizing the substance use above all of that. So it has nothing to do with willpower, moral or character. It has everything to do with the way the brain interacts with the substance that continues to worsen over time. Carolyn: (06:27) You know, I'm glad that you mentioned that this is not what a lot of people think it is, which is a moral failing or a series of bad choices. But actually the disease has a real root in science and you know, a real brain disorder that makes these choices more and more difficult for a person that is seeking the substance, and Interact, We've been studying the government statistics. And so we know that once a person enters rehab for substance misuse and addiction and they come out after their 30 days, there's an extraordinarily high relapse rate sometimes, often as high as 85% in the first year. So what makes this disease of addiction so doggone difficult to treat? Sandy: (07:17) Well, there's a couple of different factors. The first is that these traditional 30 day programs are really focused 100% on helping a person gets sober, which has to happen obviously for them to recover from addiction. But they teach all of these structures and they just don't hold up in the real world because the stresses that an individual faces away from the treatment program tend to override all of the understanding that the person has gotten in their treatment program where they were isolated from stresses of day to day functioning. Not to mention temptation for addiction. So, you know, there's that, there's the excessive focus on just plugging them into these structures that we hope will be helpful, such as 12 step that which can be helpful, but for some people isn't theirs. But bigger than that, I think there's a huge miss of the brain-based piece, which relates to the mental health issues that underneath addiction is suffering underneath that are mental health issues. And associated with all of that is the way that events, that one experiences in one's life impacts their brain. So stressful events, overwhelming events, traumatic events impact our brains. And then that sets us up for that physiological brain-based response to addiction that I already mentioned. So our brain gets into this place of activation from stress, from trauma, from difficult things. And then the substances have more of an effect. And so without addressing that underlying brain-based self-regulation piece, people leave treatment programs committed to sobriety. But the environment happens, life happens, stress happens, our brain gets into a dysregulated state, it gets more activated, it gets more stressed essentially. And then it becomes more and more difficult to simply not use by going to meetings and doing all the other things that are taught in these 12 step based programs. Carolyn: (09:20) You know? So for my own personal experience with my daughter, she would go to a treatment program for 30 days. She would get clean and sober look great, but then come out and struggle. And for a lot of the reasons that you meant, you mentioned that it also seems to move that a lot of treatment revolves around looking at this as an acute disease. So after 30 days you're, you know, you're much better and not really the chronic disease that it is. You want to talk a little bit about, why addiction is a lifetime worth of management versus 30 days in rehab? Sandy: (10:00) Well, it's because that once your brain, I mean, so there's so many different levels to that question. That's a really difficult question to answer. But I mean, at a neuroscientific level, once your brain gets hardwired into, you know, that this substance, there's literally neural pathways that are built in the brain that like this substance is the thing that makes you feel better. And so when that gets activated, that really takes over and becomes so preoccupying in a distorted way. People don't realize that. But beyond that, there's an inner part that, you know, there's an interpersonal factor. So most of the stressors and traumas and overwhelming events that we experience in our modern day life. You know, there's like events like car accidents and you know, difficult things, but it's a lot interpersonal, this family stuff or it's rejection or it's lost. It's, you know, getting bullied by peers. It's getting kicked out of the group. It's, you know, failing to make the soccer team. All of these things are really difficult, immense to navigate in adolescence. And they have something to do with deep belonging and struggles with interpersonal relationship, which set up relationships to be the thing that triggers people into getting overwhelmed and they're getting activated. And when we get activated and we get overwhelmed, our thinking brain literally goes offline. We know this also from neuroscience, that stress, that activation leads us to be unable to use our good thinking skills, which is don't go to the bar, don't pick up. That's a really bad idea. Go to a meeting, talk to your sponsor. That all requires your ability to kind of think your way through and make it happen. But what we know is when our brains get activated, I refer to as getting "out of the zone" that thinking brain goes offline and then often all of those things go out the window. So one of the missing links in treatment is that people have these relationships that are safe and kind of contrived essentially in a treatment program. And then we go out into the real world and relationships are hard and we're not teaching people how to develop and maintain and stay in and feel safe in relationship or choose people that they can do that with wisely. So there's all of these different kind of things that are essentially stacked against the addict ability to recover because we're missing some of those components in the treatment programs and relationships skills and self regulation skills and managing stressors of life skills like that's inherent. That's that is the whole life. And when you don't know how to manage those things and keep yourself regulated and keep stress from overwhelming, you, the capacity to really think through and keep using all the good coping skills that we learned in treatment becomes really diminished at times of heightened stress or activation. Does that make sense? Carolyn: (13:08) Yeah, that makes total sense. And you know, you and I worked together at Phoenix outdoor and that program focused on adolescents, 13 to 17 years old. So all those skillsets of regulation, making good choices, that help keep you healthy are, are lots more difficult for an adolescent because they just aren't mature enough yet. So, you know, at Phoenix outdoor, we not only work with a number of adolescents, but we had a very robust family support program, so we had the opportunity to talk with and engage with lots and lots of parents. And so based on your experience in the program, how aware do you think parents are, and understanding the extent to which their kids who were coming into our program were struggling with the diseases still? Do you think they, they understood it, knew it or we're just not educated? Sandy: (14:11) I mean, I think that hardly any of them understood or knew very little about it, especially at the adolescent level. I mean there's so many different cultural lenses through which we view substance use and some, you know, subcultural groups like using drugs and alcohol and adolescence is considered normal and it's just, it's almost considered a rite of passage in other groups. You know, it's so far from parents own worldview or their own lens or their own experiences, adolescents that they literally don't even see it when it's right in front of their face. And that's not their fault. It's because they're not watching for it. And then kind of all of that really culminates in parents really not knowing when, you know, quote unquote experimentation has become really problematic, either because they're, their child is hiding it so well or they're not being alerted by the schools or anywhere else, or they're just not conditioned to see it as a problem. But all of that, it's just parents are very uneducated about how serious that can get, how rapidly it can progress. And essentially more than that, like how much addiction really takes hold of a person. And I think that's the part that people just don't get, is that like intense preoccupation and how it drives somebody into their own world to where it seems like a completely reasonable thing to deal from parents or you know, do things that are extraordinarily hurtful to the people who care about them in order to get at the drugs or the alcohol that they're looking at. And I think that's the part that people don't get. you know, and then they start just trying to punish and shame the child and essentially that just contributes further to the problem. So by the time we get here, it's way more difficult to address the issues than it is if we'd, if parents were more educated and saw some of those more early warning signs. Carolyn: (16:14) Sandy, as you know, from knowing me, that parallels my own personal experience. my daughter started using substances beginning with alcohol, then cascading into drugs at age 14. And I was completely uneducated about the risk that was out there. I had no idea about how much trouble that she was in at that point. so I appreciate and understand that my own experience paralleled, that of the clients that we worked with. So I've thought about this a lot, especially given the fact that my daughter is no longer with us. But if you could have a conversation with those parents when their kids are not in our program, but they were much younger, what warning signs should they pay attention to that their child might be at higher risk of developing this disease? What would you say to somebody who's kids eight, not 18. Sandy: (17:22) The first thing is look at your family history. So there is undeniable research that families who for whom addiction runs in the family, whether that'd be alcoholism or drug addiction or just problematic substance use or heavy substance use that that runs in the family. If you can look back and the parents and the grandparents and the aunts and the uncles and going back, the more that there is, the more at risk your child is. And so that that simple fact alone should be informing parents view from minute one. If you have a strong family history of addiction or problematic substance use, then it's really important to begin really early taking active steps to keep your child from ever using. The second piece of that is that age of first use is strongly associated with addiction. So kids who start using earlier are more likely to become addicted. So if you have on 11 year old who's out experimenting with marijuana, this is not quote unquote normal behavior. I mean it is in some circles and it is among some groups, but this is not healthy. And so it's really important to come down really hard on that. And by that I mean, I don't mean like punitive and horrible. I just mean like take that as a tremendous risk factor. And if you've got both of those things, age, early, age of first use and a strong family history, then you're headed for trouble. Or you could be your, your percentages are much higher risk to looking at those factors. The next one is, Carolyn: (19:07) Let me interrupt you because I want to explore that one thing a second. So my daughter was 14. So age of early use would definitely apply to her. And also from our research we understand that use has become pervasive in middle school. So kids are starting to use much, much younger than that. Talk a little bit about the developing brain and when it really gets developed and what happens when you interrupt that development with substances. I think people need to understand why early use well is critical, Sandy: (19:45) Right. So in adolescence, essentially our brains become scrambled. So they did, they've kind of, associated adolescence with like around the age of three when you're born and you did start to develop neural structures and then kind of early on in childhood, those things sort of reorganize and restructure themselves. And kids go through periods where they cannot control their impulses is essentially the toddler years. And they've associated adolescence with that, that the brain kind of organizes itself through early childhood and in adolescence it all kind of splits apart and then restructures itself again. And so adolescents are extremely prone to problems with impulse control. They have difficult time regulating their emotions cause at the same time they're also separating from parents. That's part of their job is to create an identity separate from parents and other caregivers in school and things such as that. So all of this creates a perfect for drugs and alcohol to come in while the brain is restructuring itself, enter drugs and alcohol and suddenly pathways that are associated with wanting that substance are formed. So there's like literally neuropathways that create this connection to craving drugs and alcohol. At the same time. This is a really critical time for adolescents to be learning how to have healthy, increasingly more mature, connected, intimate relationships with people other than family members. Learn how to manage their emotions, learn how to make good, healthy decisions, learn how to control their impulses. Like, yeah, well, yeah, sure you want to drive your car a hundred miles down the highway cause it seems fun, but not a good idea. So you're not going to do it. But so all of these different things create this perfect storm where drugs and alcohol not only create neural pathways and again those with a history of addiction and their family are more versed for this. But then drugs and alcohol curb the normal development of some of these essential skills that set adolescents and young adults up to move into healthy adulthood where they can control their impulses, make good decisions, choose things that are healthy for them, recognize risk, what isn't, isn't safe for them to do what is or isn't good idea. And ultimately it really impacts the brain's overall developmental process. Now, brain doesn't fully develop until age of 25. We know that the frontal and prefrontal cortex, which is the thinking brain, is not fully developed until age 25. And so we add that into the mix and adolescence and into young adulthood and it really negatively impacts that part. And that part is critical for an independent, well-functioning, successful adult who's able to initiate decisions, engage in a career, raise a family, and have good, healthy relationships. Carolyn: (22:53) So, you've mentioned this a couple of times in our conversation about, kids that are not in their zone. And I want to go back to, the focus that we talked about, which is, you know, the conversation we might have with mom and dad, much earlier, to point out what, who's at risk. So let's talk a little bit about the overly emotional child who's constantly blowing hot and cold. Who just can't seem to stay in the zone where they're not exploding or overreacting. How much should we as parents be worried when we have a child like that, as a potential risk factor for some that someone that might misuse substance and develop addiction. Talk about kids not staying in their zone? Sandy: (23:45) That's a great question. So, I was actually gonna say that as kind of the third risk factor for parents to watch for, which is kids who can't emotionally regulate, and emotionally regulate means, you know, a child who just gets overwhelmed by their emotions and it can start when they're young with good emotions. Like it doesn't have to be all quote unquote bad or difficult emotions. But when you see a child who gets overrun with excitement or overrun with anger or overrun with anxiety, and they can't shift out of it and it skews their perceptions of things and they just get wrapped up in it, or when they get upset, they just lose control of themselves. Like they yell and they scream or they throw things and they just have an extraordinarily difficult time calming down. Like that is high, high risk for addiction right there. And the reason is is because enter drugs and alcohol and suddenly you can calm down, enter drugs and alcohol and suddenly that overwhelming anxiety that you're experiencing is no longer an issue. And you can go out into the world and talk to people and become really upset or mad, enter drugs and alcohol and suddenly you can calm that feeling. So these overwhelming feelings, enter drugs and alcohol and they become like seemingly the perfect tool. So not only that, like, Oh wow, does that ever feel amazing? But also then when you begin to use that instead of learning healthy, mature skills to regulate your emotions, which we call getting back into the zone, right? Then we don't, we miss the opportunity to learn the skills. And so the drugs and alcohol become increasingly more important for that. All of that then relates to the development of the brain, right? That frontal and prefrontal cortex, which is required to do that. So those three things all are, are happening at the same time. And it starts with a child who struggles with regulating their emotions in early childhood. And I'm talking again early childhood can be toddlerhood all the way up to like age eight, nine, 10. I have a nine year old right now who really struggles when he gets mad. All those things happen. And I know that that puts him at high risk and that's something that I need to monitor. So I need to teach him those skills now so that he doesn't need drugs and alcohol as much later to help him with it. Carolyn: (26:13) Yes. I think that's an excellent point. You know, that if you've got a child that's struggling with that, just be on higher alert. The other thing that I know you and I mutually experienced when we've worked with adolescents at Phoenix outdoor, we observed that a large percentage of them have problems keeping up with their schoolwork. How might those kids that struggle with learning differences be at higher risk. Why, might they, why do we have such a large percentage that had learning issues in our program that focused on substance misuse? Sandy: (26:54) Well, I mean, there's a lot of different factors to that too. There's kind of the internal experience of never quite feeling like you fit in, always struggling, always falling behind. So, you know, substances become a way to manage that, those self esteem issues. There's also the fact that many types of learning issues, especially, you know, ADHD being one of them also negatively impact the capacity to self-regulate. So it, it again relates to the frontal part of their brain that, you know, great brain in the front, the frontal cortex is required to regulate emotions. So when you have learning differences of some sorts, that part becomes even more impaired. Putting one at higher risk for the things that I just mentioned. And then there's the social aspects of it that, you know, using drugs and alcohol in adolescents and young adulthood is essentially a way to be cool. The way to get attention. It's a way to find, you know, social power and social capital, in a world in which maybe you feel like you're being left behind. And so that classic, you know, kid who like hangs on the outskirts and lures the other kids over to get attention and look at me, I looked at, I'm so cool, I got drugs. You should hang out with me. Isn't this fun? You know, that kind of thing becomes extraordinarily compelling for a child who's always felt like they're on the outskirts, not to mention the drugs and alcohol might help them figure out like, Oh, look at me, I can, you know, have a few drinks and be social. So helping to manage all the social anxiety. So certainly that puts kids also at higher risk for a variety, for a variety of different reasons. So it's also something to begin to notice in elementary school if your child is having learning differences, just taking those extra steps to know that they're at higher risk. So we got to watch more carefully and be more proactive from a prevention perspective. Carolyn: (28:49) You know, I think it also falls that a kid can fall in both ends of the spectrum. They can either have learning differences, so they might get made fun of because they can't keep up. But then you take the kid on the opposite end of the spectrum that's super smart and they may be socially awkward as well, so they get bullied. You know, so I think that we, we as parents need to look at both ends of the spectrum as well. So, another risk factor that we're aware of and I know that we've talked about before, are something that we call adverse childhood experiences. So, you know, often times society worries most about the, the kid whose home life is in disarray there they've suffered abuse, violence, they live on the other side of the tracks. Their environment is really chaotic, but I think you and I both learned that children can experience other issues that they consider to be difficult or adverse that they have a hard time responding to. So I'll take my own situation with Laura. The year that she started using, she entered high school for the first time, she changed her sport from soccer to rowing. We moved to a new neighborhood and I got married, you know, so like you talk about like all these changes and, and, her balls. So talk a little bit about the impact of these adverse or negative childhood experiences as it relates to elevating, a kid's risk. What the parents need to know. Sandy: (30:38) Well, it's because of the way that it impacts our brains. Again, I mean it all comes down to brains and how addiction is a brain based disease. And so anything that's going to impact our brains can be ultimately associated with higher risk for addiction. And so what we now know is that, you know, they refer to it as trauma or adverse childhood events, ACEs, that the higher the, you know, the more of those that you have more impacts your brain development, which I can say more about but, it's important to recognize that these are, these events are anything that overwhelms a child's ability to cope or anything at all in a child's life that overwhelms their sense of safety and security and predictability in their world. And so why that impacts our brains is because then that activates the part of our brain that is 100% focused on keeping us alive. And it sets us into survival mode, which is a much more reactive mode, which is really adaptive when we live in the woods and you've got bears and tigers working about that are ready to eat you. So you can react really fast. But it's not really adaptive in a world in which there aren't really predators and where the predators are essentially other people, their family members or their people at school or their teachers. And that's just a brain-based. Again, that's not that really is that not that divorcing parents are really tigers, it's just that that sets up the, the survival part of the child's brain. And when the survival part of the brain is in charge, it's really reactive. We're scanning the world for threat. And again, it takes that thinking brain offline or it diminishes its functioning. So the more of these events that we experience more activated, our nervous system is in readiness to fight tigers or to run from tigers or to freeze in the face of tigers. And that puts us in a really reactive state, which in that reactive state is the exact opposite of what kids need to be able to learn, to be able to engage in healthy relationships, to learn math, to plan, and ultimately to control their impulses and to control their emotions because it impacts the thinking part of the brain. The thinking part of the brand new, slow, the survival part of the brain moves fast. When a child experiences overwhelming events, the survival brain is in charge. And so it diminished the capacity for the child to develop the ability to self regulate. And that ability to self regulate means emotions and behaviors. And that has everything to do with whether or not they're going to be able to choose not to use drugs or alcohol or to be able to regulate their use if they do choose to use. Carolyn: (33:17) So one of the things that I know for sure with parents of, elementary school kids is that they don't feel like they should focus on a disease that their children may never get. But, the reality based on government research is that we know one in 10 adolescents will become addicted before they even leave high school. And now we've explored a lot of the reasons why you focused your conversation on the genetic link and how critical that is. It's the same as if somebody has a genetic link to diabetes. There's a much higher chance that, a child will develop diabetes in their lifetime. You talked about emotional regulation and the importance of, watching a kid more closely if he's becomes dysregulated. We've talked about learning differences, kids that can't keep up or that are overly intelligent, being different and, and struggling to fit in. And we've talked about these adverse childhood experiences that, the child has a fight or flight response to that really causes their brain to go into overload. So I'm sure people listening to this, if their mom and dad or grandparents were probably freaked out at this point, now that we've gone through that. but let's talk about what mom and dad should be doing to lower the risk. So if they could only do three things to lower the risk that their child will be one of those statistics, what advice would you give them? What are the top three things they ought to be thinking about? Sandy: (35:07) That's a really good question. I mean I would really focus on that emotion regulation piece. And if you don't know what that means, right? That means you can look up mindfulness for kids, mindfulness in schools, and it's not all mindfulness. I talk about it as kind of trauma and resilience or self regulation skills, but mindfulness is an easy entry point to that. Teach your kids skills, how to regulate their emotions, teach them how to calm down, teach them to recognize when they're out of their zone and teach them ways to get back in their zone. Related to that, if you can, you don't get your schools on board with that. That's a really critical piece is to begin. And more and more schools are doing it. They're kind of recognizing that it falls under the umbrella of trauma informed care, but it's really a preventative tool. So get involved in, in ways with communities, with teachers in ways that your kids learn that and begin to just language that at school. Like normalize that. Like, Oh wow, you're having a hard time regulating your anger. How do we help you get back in your zone? Those kinds of things are so, so critical. the second is really educating your child and yourself. Like recognize what those early warning signs are, what is or is not normal and start talking to your kids about that early. Like one of the things that my friend says that her dad always said to her is that "some things are too good and you must never do them." And I think that's valid, right? Like, you know, teach kids about addiction, but this is a thing and let's not pretend it's not happening. Because even if it doesn't happen to your child's, certainly they're going to know somebody for whom it does. And you know, just begin to have an open dialogue and do your best to stay in relationship with your child. Spend time with them, keep those lines of communication open. And as part of that really monitor technology use, which is a whole separate conversation, but I'm convinced that too much technology use is a gateway drug and three, assess your risk factors like look at your own family history, look at your child. Does they, do they struggle with emotion regulation? are they at higher risk? Do they have a community of kids that they connect with that they feel safe and supported and valued and understood and if not, start early and try to help them find that. And then last just take active strides to really look for the places where they might actually be able to use and keep your eyes on it, right? Like, like you know, maybe consider drug testing early, but certainly supervise them very closely. Do not hesitate to monitor their phones. Look, listen, look at their calls, look at their texts, find out where they are on social media, pay attention and just tell your child that that's why you're doing it. It's my job as a parent to keep you safe. There's a lot of things out there that are not safe for you. Drugs and alcohol is a big one. And I'm going to watch you really, really closely while you learn the skills to be able to work through this to yourself. But until then, I'm going to step in and help you be able to make good decisions, because this could kill you and I'm not willing to let that happen. So really taking those kinds of steps from an early age, not from an alarmist perspective, but from a prevention perspective. And if you normalize it when they're in elementary school this is what we're doing to protect you for the future, then it's not so hard to bring it in later when you might get more pushback cause you're already doing it. Carolyn: (38:53) So, in recap, the things that parents ought to be doing proactively are teaching their kids to, be able to emotionally regulate themselves, stay in their zone. I'm getting connected to schools and communities so that you know what's going on and that you're having conversations, educate yourself as parents, understand the disease, understand the risk factors and find an age appropriate way to talk to your children early so that they are educated and not scared, but they're educated. Monitor their technology, monitor the kids. Consider drug testing. I don't think there's anything wrong with it, but you know, as parents, your job is to keep them safe and you should do all those things. I'm going to add to that, list Sandy and you can comment on it. My personal advice, and this is after struggling with my daughter for 15 years would be as follows, adopt the attitude that it can happen to you. We grew up in the middle class neighborhood, we had great neighbors. My kid was girl scout, et cetera. You would never look at her and think that she's at risk. So I think we all need to adopt the attitude, no matter what we see in elementary school. It can happen to your kid. And once it does, it makes life a lot more difficult. The second thing I would advise parents would be to not be ashamed. it is no reflection on your parenting skills. It has no reflection on your moral failing if you have a child that develops the disease. So being transparent about it, asking for help, connecting with others that have expertise I think is critical, and not blaming yourself, for what's happening to your child. The third thing I would advise parents, and you mentioned it, but I want to bring it up again, which is when when your kids are actively seeking substances, they will do things that will terribly hurt your feelings. They will steal from you, be mean to you, try and misdirect you. And it's really not a reflection of how much they do or don't love you. It's just a part of the disease and you have to understand that they'll do things that don't make sense to you. But it is not personal, it's just a function of the disease. So if you could stand to give parents any last words of advice before we wrap up, what would you tell them? What would be your best piece of advice? Sandy: ( 41:33) Intervene earlier instead of later. If you have a child that you can see as high risk and their risk is emotion regulation or anxiety, get them into therapy in elementary school there's no stigma, there's no problem work to create the structures before they ever use. And if they start using early intervene actively, quickly. So get them into therapy. Don't hesitate to put them in a treatment program as an adolescence if they need it. Wilderness therapy often also referred to as outdoor behavioral healthcare can be super effective for adolescents, but the earlier we intervene, the better it is. Don't hesitate to take, to really respond really, really strongly. And again, as you're, if you, your assessment of your risk factors goes up, then the degree to which sort of the magnitude of your response early on should also go up. Like don't wait until they're using heroin. You know, by that time the recovery is so much more difficult, take and take active strides to keep them from using. The longer that they can go without using, the more their brains will be developed. So, so start early, respond, you know, strongly get the structures in place to support them both avoiding using and that they have a place to go if they do use. And really beyond that, the biggest thing that's that I think is hard about recovery is for people, adolescents, adults, all of us to, to find community. And that's, I think one of the biggest things that I didn't mention that drives people back to relapse. So create community for your kids that isn't about technology. Help them find friends, help them find groups, socialize with other parents who share your values so that they have a place to land where they feel supported and they feel safe. And I think that that is hugely important and start that early. Carolyn: (43:46) So Sandy, very good conversation. I thank you so much for your insight and wisdom. Hopefully, this will be shared around with parents, with grandparents and others that want to know more about the disease that need to understand who's at risk and ways to protect them. So this is Carolyn Bradfield and Dr. Sandy Newes with Interact Lifeline Studios. We thank you for your time and attention and we will end the podcast. Thank you so much, Sandy. Sandy: (44:18) Thank you for having me, Carolyn. I appreciate it. You're certainly welcome. Outro: Interact lifeline here to make a difference in how people manage the disease of addiction, reducing the right of relapse and improving the recovery process. We offer treatment and collegiate recovery programs, a technology service to keep families connected to treatment, to support communities and to family. This is Carolyn Bradfield and you've been listening to our Audio Journal from Interact Lifeline.
Episode 18 - The Gift of Community
Make connections to help support you as you battle addiction If you are struggling with addiction or have an addict in your family, going it alone is never a good idea.  I was fortunate in many ways that when my 14-year old daughter began her struggle, I had close friends that were there for me who had watched Laura grow up and knew I needed help.  And people were there for me throughout the 15 years we battled the disease, and in the end when she overdosed and died. You need help and support around you to give you perspective, a sanity check, relief and acceptance and that comes by finding a community that you can connect to.  Communities help us feel connected and a part of something, but they also have strong benefits when it comes to helping you as you battle the disease of addiction for yourself or for a loved one. Communities allow us to benefit from the lessons others have learned so we don’t have to learn from our own mistakes.  Communities can inspire us when we watch members achieve things that go right in their lives.  Communities give us contacts we can call on when we need help.  Knowing others that are going through the same things we are, learning from them and getting their support is a very important gift that you can give yourself. Our company, InterAct LifeLine, supports collegiate recovery communities, organized groups for people in recovery on college campuses.  The gift of belonging to those communities as a student is a higher graduation rate, a higher GPA, a much lower return to substance misuse and frankly, friends you keep your entire life. For those struggling with addiction, finding communities of sober, like-minded people promotes healthy social interaction replacing the circle of people that misused substances with others that you can connect with without worrying about being around drugs or alcohol.  Communities provide support when counseling is not available, and its people are often just a phone call away. But if you are a family member that is helping a loved one fight addiction, finding communities of other family members may not be as obvious as it is for the person who is finding community in addiction support groups.  Here are a few ideas for where to go find the gift of community. Connect to online support groups. Social media can be a powerful tool to find others that are going through the same challenges you are, share your thoughts without judgment, and find strategies that help you move forward.  For me, I belong to several Facebook groups focused on loss of a loved one from overdose.  The stories I read are sad, but also reminders of how many of us are turning grief into purpose trying to make a difference in the lives of others.  All it takes on Facebook is to access groups, enter keywords to find groupa that you relate to the most and ask to join. Find a support community in Al-Anon or other organizations.  Most of us have heard of Alcoholics Anonymous and Narcotics Anonymous, AA and NA, but did you know that the same organization has support groups for families who have a loved one battling addiction?  It’s called Al-Anon that uses the same 12-step philosophy to help families heal.  If 12-Step is not your thing, then there are many other ways to connect to family support groups.  If you just google “family support groups for addiction” you will get links to a number of support communities and likely find those who have meetings in your area. Find a non-profit focused group on family support.  As I mentioned earlier, I lost a daughter to overdose and found a non-profit called Compassionate Friends that focuses on helping families cope with loss.  SAMSHA, a government organization focused on substance abuse and mental health, has a national hotline that can connect families to support organizations.  (1-800-662-HELP).   There is Parents of Addicted Loved Ones or PAL for short with a national directory of meetings in your area which have both an educational component and time for sharing.  The list goes on and on, but these non-profits are here to help, connect you to others who are going through the same issue, and are easily found online. And don’t forget about the support group you already know, your family and friends.  The people closest to you may not be fully aware of how you struggle, so they often seem to sit on the sidelines until you ask them to jump in.  They may not be able to empathize at the level you would like them to because it’s hard to understand unless you have experienced coping with an addicted loved one, so it’s up to you to paint a picture of how your life has changed and what you struggle with. And it’s also important that you are clear about the type of help you need.  Do you just need a friendly ear to air out your issues?  Are you asking for them to weigh in on what they think you should do?  Do you need a partner to help you solve a problem?  Or do you just need a break to focus on something that’s fun and normal? Takeaways Often when we struggle with addiction, it seems right to hide what is going on because we are ashamed, shy about sharing our struggles, and don’t believe we can find people to understand and support us.  However, this thought process is counterproductive to helping you manage through what is arguably one of the most difficult challenges you will face.  The gift of community is powerful, keeps you centered, helps you with strategies and most importantly, reminds you that you are not the only one struggling.  Communities reinforce the fact that you   are not alone in this fight.
Episode 17 - The Gift of Self-Care
How to keep yourself healthy, centered, balanced & connected when you struggle with an addicted loved one This will be my second Christmas without my daughter Laura who struggled for 15 years with addiction but lost her life to overdose on December 21, 2017, right before the holidays. In the two years since her death, I’ve taken care of myself in some ways, but not in others.   Battling addiction with a loved one or battling it as an addict takes a toll on you personally. There is the stress of not knowing what is going to happen next, the lack of sleep when you stay up through the night hoping to hear the door open and your loved one walk in, the constant anxiety.  If you don’t care for yourself, then your health and well-being will suffer. Self-care is complex, but it’s a gift that you should try and give yourself.  Don’t think of it as something selfish, but rather something necessary to stay strong.  Here are some thoughts for all of us who need to do more to care for ourselves with the gift of self-care. Set healthy boundaries.  When you are surrounding by addiction, you have to set physical, emotional and mental limits so that you avoid being manipulated, used or violated by the addicts in your life. Boundaries are simply guidelines that you express to others so that they know how you want to be treated and what happens when they cross those boundaries.  In my relationship with my daughter, some of the boundaries I set included what I needed her to contribute to the house while she was living there, how I needed to be communicated with respectfully, and the rules around any type of substance use around me or in my home. Take care of your body.  For me, taking care of my body was not on my “to do” list after my daughter died.  As a result, I gained weight, ate poorly, got very little sleep and just overall felt physically weak.  When you are fighting addiction yourself or on behalf of a loved one, you have to take care of your body.  Start by adding a healthy dose of exercise to your routine.  You don’t have to do cross-fit or run a marathon, but you can start by simply walking 30 minutes a day. Exercise releases those endorphins that make you feel better, relieves stress, and helps you connect with others if you engage in sports activities. Because sleep affects our mood, helps us keep a healthy weight and reduces stress, trying to keep a regular sleep pattern is important.  Start by recognizing what your sleep patterns are and where they are off balance.  Then change your routine to eat earlier, not watch TV as your go to sleep routine, and keep your room cool and quiet. And finally, eating healthy has some very strong benefits.  If you are in recovery, then don’t replace drug use with a new bad habit of eating poorly like adding processed foods or sugars.  A good diet improves your mood and is a cornerstone of selfcare. Use mindfulness to reduce stress and increase a feeling of well-being.  Mindfulness is the practice of purposely focusing your attention on the present moment and accepting it without judgment. Being mindful makes it easier to appreciate the pleasures in life as they occur, helps you become fully engaged in activities, and creates a capacity to deal with the adverse events that has been coming your way.  And if you are struggling with addiction, there are quite a few zingers that you struggle with.   People who practice mindfulness find that they are less likely to obsess about what may happen to them in the future or have regrets over the past.  Mindfulness helps people become less preoccupied with success or concern themselves on how others might judge them.  There are many ways to practice mindfulness, but most often this is done with meditation, and finding time to sit quietly, let your thoughts come without judging them, and focusing on relaxed breathing. Self-care means finding balance in your life. When you are struggling, it’s very tempting to be single threaded on fighting the disease itself and start to drop things that you found enjoyment in.  Your life can quickly get out of balance. Balance involves doing the things you have to do but making sure to not drop the things that you like to do.   And watch out for areas where you might be overdoing it.  For a time, my daughter went to multiple AA meetings every single day, but then failed to do other things that kept her healthy like exercising or just connecting with friends. Practice social selfcare. It’s very easy to withdraw when you are suffering.  You may not want to let others in and have to explain your struggles to them but letting others in is an important part of self-care.  There are a number of support groups where you will find others that are experiencing some of the same issues with addiction that you are.  There are family members and friends willing to support you if they know what kind of help or understanding you need.  You may want to talk to a counselor or therapist so you can process your feelings by talking about them out loud.  Self-care involves finding and nurturing connections so that you don’t go it alone. Remember that being an addict or having one in your family takes a toll on your most valued relationships, so it’s important to keep in contact with them, be honest about your struggles and get support. And don’t forget about practical self-care.  Anxiety comes from things that we feel are out of control, so look around you and see what might look like it’s within your control that you can do something about.  If your house is a mess, then bring order to the chaos by cleaning it up.  Go through your clothes and stuff and take a lesson from Marie Kondo and if your stuff doesn’t give you joy, then find a way to rehome it.  When my daughter died, we sold our 5,000 square foot home and moved to something smaller requiring me to purge all of those things that I had stuffed away that I never used.  Getting control of the clutter and getting rid of it was a form of practical self-care. Takeaways Self-care is an integral part of healing yourself and making well-being a priority.  To give yourself that gift, you need to let people know how you want to be treated, focus on your physical well-being, use mindfulness to keep yourself centered, find balance in your life, and staying connected to others.  Self-care also means keeping our environment stress free, clutter free and organized.  Self-care is a gift that you can give yourself that brings balanced to a life that addiction has thrown out of balance.
Episode 16 - The Gift of Forgiveness
One of the bests gifts to give yourself during the holidays, forgiveness This will be my second Christmas without my daughter Laura who struggled for 15 years with addiction but lost her life to overdose on December 21, 2017, right before the holidays. But even when Laura was with us, holidays were often stressful because I never knew what kind of tension and drama she might create for the family. It’s so easy to sit back during the holidays and beat yourself up. Your friends are all having a wonderful Christmas dinner, opening their gifts, and connecting with family. Your family may have been turned upside down, so you reflect on how you managed to get yourself in this mess. You look at what you did or didn’t do to create such a dysfunctional family, holiday or in my case lose a loved one. So now it’s time to open up the gift of forgiveness. It’s not your fault. I repeat, it’s not your fault. Your loved one had a genetic predisposition to develop the disease of addiction because the genes that trigger it run in families. Ten people could go to a party, have a drink and not feel uncontrollably compelled to keep going. But that 1 person in 10 that is genetically pre-disposed will have their brain’s reward center triggered to need more of the substance that caused their dopamine production to go wild. It’s not your fault that those genes ran in your family just as it’s not your fault if you have diabetes in your genes. Your loved one didn’t develop the disease because of you. Don’t blame yourself because of your parenting. Parenting is hard enough no matter what someone tells you. Everyone makes mistakes and you’ve likely made more than a few when it comes to managing an adolescent that become oppositional, then defiant, then a drug user and then an addict. Trust me that I was one of those parents with my daughter Laura. But you need to give yourself a break. It’s hard to make the best decisions when you are in the middle of a war and under siege. Addiction may have come on quickly not giving you the time to be fully informed and ready. Everyone makes mistakes, even parents with those picture-perfect kids. It’s time to forgive yourself for any parenting missteps during this crisis. Forgive those people around you. You are going to be surprised at the friends, family and co-workers who just didn’t understand the depth of your struggles. You may feel their scrutiny and disapproval and find them distancing themselves from you. Although that may seem terrible, it’s perfectly understandable that they don’t really understand because nobody can unless they have walked in your shoes. When I first sent my daughter Laura to wilderness therapy treatment, I chose a New Year’s Eve party to announce my decision to my friends, some of which knew about our struggles and others did not. I was greeted with, “How could you?” and “Why didn’t you try other things first?”. At first, I was insulted and horrified that they just didn’t get it because that was one of the hardest decisions of my life. But then on reflection, I began to understand why they didn’t get it. They had never had an experience like this. I decided to forgive those people and years later shared with them how their comments did me a favor to enlighten me about how to better manage my conversations with others when it came to my daughter and help others do the same. And finally, forgive the addict you love. My daughter did some terrible things in the throes of her disease. She would go months without answering my calls or texts making me fear if she was safe. She would attack me verbally when I pressed her about her behavior. She lied to me to get me to do the things that she needed so she could keep using drugs. Although I was angry with her, fortunately, I let that go before she overdosed and died. In her final weeks, I shared with her that we were both adults and had the right to make adult decisions, even though we were in disagreement about what those decisions were. Addicts can be the most frustrating, unlovable, and difficult people to be around. But in the light of the brain disorder they have, it’s important to direct your anger and frustration where it belongs most, at the disease itself. It’s not to say that you should roll over and just let any behavior go. When your loved one crosses boundaries and treat you disrespectfully, you should develop language that goes something like this: I have a problem that I need your help with.When you do this, this is how it makes me feel.In the future, I would appreciate it if you could change what you do.Can I get your help on this? Takeaways Forgiveness is a difficult thing, but powerfully healing. Forgive yourself first because addiction is a complex disease to understand and it’s not something that you caused. Forgive yourself for mistakes you make along the way in trying to help your loved one. Forgive others around you who haven’t walked in your shoes and may not understand. And most importantly, forgive your loved one. They wouldn’t have chosen to live such a difficult life and you never know when your next encounter with them might be your last.
Episode 15 - The Gift of Knowledge
The holidays can be a dreaded time of the year if someone you love is suffering or has lost their battle with the disease of addiction.  This will be my second Christmas without my daughter Laura who struggled for 15 years with addiction but lost her life to overdose on December 21, 2017, right before the holidays.  It’s hard to think about gift giving during this time of year, because the holidays may be filled with regret, grief, or stress.   This Audio Journal focuses on gifts, not for others on your list, but those that you should give to yourself.  Today’s episode is devoted to the gift of knowledge. I’ve talked to countless parents and family members who are struggling to make sense of their loved one’s substance misuse, crazy behavior, and personality change.  We often mistake addiction as a moral failing or a series of bad choices, failing to recognize that addiction is a chronic complex brain disease.  Now, let’s figure out how to unwrap the gift of knowledge so you are more prepared to deal with it. Start with understanding the science behind addiction.  Addiction is a brain disease and there is a scientific underpinning about how it manifests itself and progresses.  Let me take another brain disease that millions of us know about as an analogy, Alzheimer’s. There is a scientific and physical reason that people’s memories disappear.  It has to do with plaque coating the transmitters in the brain that allow one to process and act on information.   Once there is enough plaque build-up, signals can’t get through and memory fails.  People that have Alzheimer’s are not being difficult or frustrating’ their brain is misfiring. The human brain is wired to reward us when we do something pleasurable. Exercising, eating, and other pleasurable behaviors directly linked to our health and survival trigger the release of a neurotransmitter called dopamine that makes us feel good and encourages us to keep doing what we’re doing.  But the brain can also be rewired in harmful ways when it’s exposed to drugs. When someone takes a drug, their brain releases extreme amounts of dopamine causing the brain to overreact, reducing dopamine production in an attempt to normalize these sudden, sky-high levels the drugs have created. And this is how the cycle of addiction begins because the individual will seek those substances to get that dopamine rush. So that’s part of the science of addiction.  It’s the brain’s rewiring to overproduce dopamine levels that rise and crash, causing the person to seek more of the substance to level themselves out.  You next level of knowledge should be around the condition itself.  Addiction is not an acute disease that can be treated quickly and cured.  It’s a chronic condition that will last a lifetime and requires on-going maintenance and management.  When you treat diabetes, you can’t take insulin just once, feel better right away, then stop. You have to manage yourself with medication, diet and lifestyle change over a lifetime.  The same is true of addiction. People go to rehab to treat the acute symptoms and get stabilized.  They come out looking healthy, but it’s a mistake to believe that because their acute symptoms have been dealt with the person is cured.   Without the proper long-term plan, the chances are 85% that they will return to substance misuse in less than a year following rehab.  It’s important to know the difference in the characteristics of an acute vs. a chronic disease so you know that you must play the long game. That brings us to the next knowledge gift which is know how to manage the disease long-term.  This is the most complex part of the equation and requires the most knowledge and research.  It’s important that you understand that the recovery and disease management process have many components.  First, there is a need for structure and accountability.  Because addiction has impacted the logic center of the brain, making the smallest decisions on what to do and where to go may be difficult for an addict, so the more help in this area the better. Then, there is a need for connections.  Addicts need to connect with treatment professionals, connect with each other for support, and connect with family.  The more people that are in the equation, the better the recovery process.  Next, there is the need to maintain a healthy lifestyle.  This involves a good diet, exercise, stress reduction, anxiety management and a commitment to health and wellness. For some people, medication is helpful, something we call Medication Assisted Therapy or MAT.  This has to be a careful decision because some medications, as with my daughter Laura who used Suboxone, can be misused and counterproductive to recovery. The bottom line is that having the knowledge of how to manage the disease long-term empowers you to make the right decisions to support yourself or your addicted loved one. And the final gift you need to unwrap is the knowledge of how you fit into the process.  The family’s understanding, support, and role in the recovery process is critical to the long-term health of the person that is addicted.  It starts with understanding that this is a disease, not a moral failing so the addict doesn’t feel more shame and guilt than he or she already does.  It then falls to what you can do to help treat the disease vs make it worse.  If you have a diabetic in your family, you don’t feed them cake.  It’s important to know what you should do and what you should avoid to help keep your loved one healthy.  The first “to do” on the list is to set expectations and boundaries so the person knows what to expect from you.  The next is to understand the warning signs that your loved one is being triggered to return to substance use coupled with an understanding of how to have that conversation and what they are willing to do to let you help them.  There are many more elements that go on this list, so it’s important to understand the “do’s and don’ts” of your role in the recovery process. Takeaways Knowledge is a powerful gift and with the disease of addiction, it’s critical.  You have to understand the science behind the disease, the characteristics of the condition, how to manage it as a chronic disease and your role in keeping the person you love healthy.   It’s said that knowledge is power and with the disease of addiction, empower yourself to understand it so you can manage it on behalf of yourself and your loved ones.
Episode 14 - Gifts to Give Yourself During the Holidays
The holidays are the most wonderful, but often the most dreadful time of the year if someone you love is suffering from or has lost their battle with the disease of addiction.  This will be my second Christmas without my daughter Laura who struggled for 15 years with addiction but lost her life to overdose on December 21, 2017, right before the holidays.  But even when Laura was with us, holidays were often stressful because I never knew what kind of tension and drama she might create for the family. For those of us who have been through the struggle our perfect holiday gift might be that of peace, tranquility, and for the person who we remembered before they developed the disease to be the one that shows up for the holidays.   For me, my perfect gift would be just one more moment to watch Laura unwrap her gifts, sit by the fire or laugh at the dinner table.  So, knowing that we likely get gifts that are well meaning, but not exactly what we wished for, here are some gifts that you can give yourself for the holidays that can last you throughout the year and hopefully for a lifetime. Give yourself the gift of knowledge.  I’ve talked to countless parents and family members who are struggling to make sense of their loved one’s substance misuse, crazy behavior, and personality change.  Yet, they have failed to research the disease of addiction, understand how it progresses, learn how it changes the brain, and what it takes to treat it.    You would never think to fight cancer without going online, understanding the symptoms and how the disease progresses, checking out treatment options and learning how to beat it.  The same applies with the disease of addiction.  Give yourself the gift of knowledge so you can understand it, have a strategy to respond and know what to do to fight the disease. Open up the gift of forgiveness. It’s not your fault.  I repeat, it’s not your fault.  Because I’m empowered with an understanding of the disease, I don’t blame myself for my daughter’s death or her 15-year struggle.  And I’ve forgiven myself for any wrong decisions I made along the way when we were in the middle of the fight.  Addiction is complex and often the decisions the person afflicted makes are irrational and confusing.   Until that person decides to get healthy and manage the disease, you don’t really have the power to cure it for them.   If a diabetic eats cake, fails to take their insulin and doesn’t follow the doctor’s instructions, do you blame yourself if they get sicker?   The same is true with addiction Unwrap the gift of self-care. It’s super hard battling the disease and believe me the fight takes a toll on you personally.  There is the stress of not knowing what is going to happen next, the lack of sleep when you stay up through the night hoping to hear the door open and your loved one walk in. There’s constant anxiety.  If you don’t care for yourself, then your health and wellbeing will suffer. Self-care is complex, but may involve a health and wellness routine, mindfulness & meditation, counseling, or connecting with friends and doing something fun. Look for the gift of community. Going this alone is never a good idea.  You need help and support around you to give you perspective, a sanity check, relief, and acceptance.  There are many communities you can connect to, but for me, I turned first to my close friends and family who watched Laura grow up, saw how I parented, and didn’t judge my parenting skills.  Then, it was going to a community of other parents who had put their children into treatment and who were going through a shared experience with me.  I relied on Al-Anon to gain perspective on the disease of addiction and our role in the process of healing.  I’m now involved in several Facebook groups where parents share their experiences in losing someone to overdose.  Remember, you are not alone. Takeaway Trust me, that I personally understand how it feels not only to battle addiction with a loved one, but to lose someone when they lose the fight.  But my personal philosophy is that if you don’t understand the disease, forgive yourself for the things you feel you did wrong, care for yourself so you don’t become one part of the collateral damage, and look for help and support  in others, you will have a much harder time coping with the circumstances you now find yourself in. Now, I haven’t always followed my own advice.  When Laura died, I stopped doing the things that were keeping me healthy.  I ate poorly, gained weight, stopped exercising and didn’t manage my grief as well as I could have.  But that is changing, and I’ve given myself the gifts that I just shared with you which is part of my journey to return to health, wellness, and happiness. Keep tuning into the Audio Journal over the holidays, because I am going to give you some practical advice on each of these gifts, how to find them, and how to make sure you unwrap them.
Episode 13 - Parent Playbook - Asking for Help
This Audio Journal series focuses on what it takes to coach your family through the Opioid Crisis with the right game plan, a playbook, an understanding of your opponent and help from your “assistants” when it’s called for.  This episode will focus on why you need a good staff around you because no game is winnable if you are the only coach calling the plays. Football coaches know that they don’t have all of the answers.  That’s why they rely on their assistants. Nick Saban of Alabama has hired the best assistant coaches, relies on their advice, and lets them take the lead in their area of expertise. Managing your child when he is oppositional, defiant, losing ground at school, and using drugs that can cause overdose at any minute is not something parents should try and manage without help.  There are plenty of good assistants out there to help parents adjust their strategy, send in better plays to protect their children, and know when the game plan that they have is just not working.  This all seems logical, but parents often fail to know the when, the who and the how to ask for help.  Let’s focus on “the when”.  I would seriously doubt that a football coach waits to consult his assistants after the game gets out of hand.  They ask for advice early and often.  But the same is not true of parents when their child is in trouble.  That’s because parents are often ashamed, traumatized or confused.  It’s never a good idea to wait to ask for help.  When you see your child’s grades drop, their behavior change, or just are worried that things are not right, ask for insight, advice, or help right away.  Waiting can have deadly consequences allowing adolescents to keep using drugs, engage in dangerous behaviors and sometimes lose their lives to overdose. And what about your “pre-game strategy”.  You should avail yourself of the help, strategy and advice of others to learn how you should prevent substance misuse and go on the offense before you have to play the much harder game of defense when your child is already in trouble.  You may want to take a look at one of InterAct LifeLine’s portals called Rethink the ( where there is an abundance of education about the disease, how to talk to kids, and prevention strategies you can use. Now, let’s explore “the who”.   There are so many people out there that parents already know who can be helpful.  All you have to do is ask.  Let’s start with people at your child’s school.  Teachers have their ear to the ground, know when kids are falling behind, and may see behavioral issues before you do.  I started my career as a middle school teacher and believe me, I knew what was going on. Get to school, schedule a conference with teachers and invite the guidance counselors to join.  If they don’t know all the answers, they will now have their radar up and can be on high alert on your behalf. Then think about your neighbors and friends, particularly those who have kids the same age as yours.  My friends and neighbors were the first to alert me that I had a problem with my daughter Laura.  Their kids were telling them what they were seeing her do at school and the bad crowd that Laura was hanging out with.  Fortunately, I didn’t have to ask for their help; they offered it, but it taught me a lesson that sometimes your best allies are those closest to you. And then there are times when you need professional help.  Consider engaging the services of an adolescent therapist that is trained in substance misuse and addiction.  Think about having a full psycho-educational assessment to understand the issues driving behavior as well as any learning differences that are making their school performance much harder.  Some families opt to hire an educational consultant, experienced in at-risk adolescents who can help you assess the extent of the problem, offer solutions and recommend treatment options. And now for the “how” to ask for help.  Asking for help should seem relatively straightforward but it is almost never that simple. For some parents, it doesn’t seem natural to admit that they can't manage their teenager and have lost control.  They are almost always mortified by the behavior and ashamed to reveal what’s happening.  Parents, I’m telling you that it’s so critical that you swallow your pride, admit what is going on, and be honest about the details. Here is a strategy that works.  Start with letting the individual know that you need to have a confidential conversation about something you are struggling with that is causing you a great deal of stress and anxiety.  Then, let them know who it involves.  Don’t try and make it a hypothetical situation about someone else when it’s you that needs the help.  And don’t hold back when you are giving that person the details.  It will be hard to share your kid’s struggles, but people can’t help you if they don’t know the facts. And finally, let the person know what role you want them to play.  Do you need them to just be a good listener so you can get the problem out in the open to better process it?  Do you need them to offer advice?  Or are you looking for a partner or individual to help you solve the problem?  Takeaways When my daughter Laura got into trouble at age 14, I was fortunate to put my ego, fear and pride aside and accept what my friends shared with me to let me know Laura was in trouble.  I sought the school’s advice to see where Laura was in her academic performance and what we could do to keep her in school and get her back on track.  I put Laura in therapy with someone who specialized in working with adolescents.  And when that didn’t work, I hired an educational consultant to give me a deeper assessment, recommend a treatment program and a strategy to get her enrolled. Asking for help is a sign of strength, a recognition that a team is better than any one individual to solve a problem, and that you can push past your reservations for the sake of your child to get the help you need.
Episode 12 - Parent Playbook – No Unforced Errors
This Audio Journal series focuses on what it takes to coach your family through the Opioid Crisis with the right game plan, a playbook, an understanding of your opponent and help from your “assistants” when it’s called for.  This episode will focus on how to avoid unforced errors that put your parenting game at risk. I watched Auburn and Alabama slug it out in the Iron Bowl with three touchdowns coming from errors made by both teams.  Unforced errors can make the difference between a win and a blowout.  Think about all the games that have been won or lost based on turnovers, missed assignments, dropped passes, or interceptions.   Often these unforced errors result when players or coaches don’t stick to the game plan, are unprepared or just not paying attention. There are number of unforced errors that parents make that are critical mistakes leading to big problems when it comes to drugs and alcohol.  Let’s look at those mistakes and ways to avoid them. The first unforced error is chalking up your child’s troubling behavior to growing pains or just being a teenager.   You’ve been living with your child for years, watching how they behave, perform in school, and if they comply with the rules. But then all of a sudden, things start to change.  They start to get defiant and disrespectful.  They have huge mood swings.  They begin to hide out in their room and keep you away from their friends and what they are up to.  They dress differently and their friend group has changed.  Are these signs of teenage growing pains?  Maybe, but if your child’s actions start to disrupt your family life, cause you to be suspicious and distrustful, or cause them to underperform in school or in their favorite sports team, look deeper and get an outside opinion to see if you have a bigger issue than that of just being a teenager. Another unforced error is to fail to secure items in your house that your child should not have access to.  If you drink and have bottles of alcohol lying around, it’s time to lock up your wine and your liquor cabinet.  Substance misuse often begins by sneaking alcohol from your supply and refilling your bottles with water.  If you have unused prescriptions from a doctor or dentist’s visit or a stay in the hospital, safely dispose of those expired medications or lock them up.  You don’t want to be your child’s drug dealer.  And unfortunately for some families, you need to stop leaving cash or valuables lying around.  This was one of my unforced errors and my daughter Laura took leftover Vicodin, raided my wine cellar and took money out of my wallet.  I left my car keys on a rack by the door, enabling her to sneak out at night, take the car and meet up with people she shouldn’t have been with. And what about the error of trying to be the cool parent.  I’ve talked to many parents who believe that it is inevitable that their teenagers are going to drink or smoke pot, so why not keep them safer by having them experiment with those things at home.  Big mistake.  Exposing the teenage brain to substances while it is still developing is a sure-fire way to risk your child may be the 1 in 10 that will develop the disease of addiction. It’s important that you understand the science behind adolescent brain development and what substances do to short circuit the normal brain development process.   My daughter began using drugs at age 14, developed the disease of addiction, and fought it for 15 years.  Her brain development stopped about that age making it much harder for her to become a functional adult. And what kind of signal are you sending to your child when you allow them to break the law by using alcohol before they legally are allowed to so or to smoke pot when it’s still illegal in most states?  And don’t believe for a minute that your kid can’t get addicted to marijuana.  It’s much more potent than when you were in college.   It’s never cool to let your teenagers use drugs and alcohol in your home or to participate with them. In addition to trying to be cool, another unforced error that parents make is trying too hard to be liked.  A football coach never thinks about whether his players will like him less when he sets up the starting lineup, makes a substitution, or sits someone on the bench.  Coaches can’t win if you second guess all your decisions, benchmarking them on a popularity index.  The same is true in parenting. Expect your teenagers to dislike many of your decisions when you have to make them in order to keep your kid accountable, have them comply with the rules, and keep them safe.  So, don’t hesitate to put them on restriction, take their phone, and confiscate their car keys if they break your rules.  And what if their behavior is sending up warning signals that cause you to suspect they are using drugs?  Then, get much more aggressive with your responses.  Search their room, drug test them, monitor their electronics, and restrict who you let them connect with. Remember that you are a parent first and foremost, not a participant in a popularity contest. One of the biggest errors a parent can make is being too ashamed to ask for help.  You will know it when things have gotten beyond your control.  I knew it when Laura was 15.  I tried to lock down the house and alarm the windows, but Laura continued to sneak out.  I took her to school, only to have her walk out the back door and fill her water bottle with vodka that she bought from the seniors.  And finally, she went missing for days.  I was mortified by her behavior, but knew I needed help and I involved everyone I could to give it to me. I understand that many parents are ashamed that things have gotten so out of control and the good kid their family, friends and neighbors knew is doing things that are terrifying.  But the mistake is hiding, waiting, or failing to disclose what you are struggling with.  Remember, you’ve likely never seen situations like this before, so call for backup.  You have school guidance counselors, church leaders, friends, family, therapists and a host of others ready to step in and assist. And last but not least, it’s always an unforced error when you fail to get the facts so you can make better decisions.   In the mid-2000’s we founded and ran a licensed adolescent treatment program and worked with hundreds of families whose teens were out of control, using drugs, and in need of an intervention.  They seemed in shock when their teenagers spilled the beans to us, revealing what they were up to and how they had kept their parents in the dark.  We realize where there is smoke there is fire, and the fire is a lot hotter than you realize.  Parents have quite a few tools to find out what their kids are up to, but often fail to use them. A simple drug test you buy from CVS or Walgreens will give you an idea what substances your kids may be using.  Monitoring your child’s electronics will let you know who they are texting, what they are saying, if they are researching subjects on the Internet that are drug related or if they are connecting with their drug dealers.  Use the tools, get the facts, and then make better decisions. Takeaways Teams that have unforced errors like turnovers, dropped passes or stupid penalties often lose the game because of those mistakes.  Parents can’t afford to make those mistakes because the stakes are so much higher. Don’t chalk up troubling behavior to teenage growing pains unless you have all the facts to support that conclusion. Make your home a safe place by removing or locking up items that can cause trouble such as unused prescriptions or alcohol.  Don’t try and be the cool mom and dad letting your kids drink and do drugs with you or in your home.  And don’t try and go it alone without asking for help when things have become beyond your control. When my daughter Laura got into trouble at age 14, I was naïve, took my eye off the ball and made quite a few unforced errors. Those errors allowed her to get away with her drug use long enough to become addicted and struggle with the disease that took her life 15 years later, only 2 years ago.  Unforced errors, no matter how innocent they may seem at the time, can have deadly consequences.
Episode 11 - Parent Playbook – How to Be Data Driven
This Audio Journal series focuses on what it takes to coach your family through the Opioid Crisis with the right game plan, a parent playbook, an understanding of your opponent and help from your “assistants” when it’s called for.  This episode will focus on the value of analyzing the data to understand the facts so you can make the right play calls. Nick Saban at Alabama implemented a GPS tracking system to monitor his player’s activity in practice so he could better predict if his team’s practice strategy wore his players out or kept them ready to go, particularly in post-season play.  He relied on data as much as his experience and instincts to create the right practice plan. Unfortunately, technology was not there when my daughter Laura started going off the rails in high school, using drugs, and engaging in very risky behavior. So, what type of systems, data, and facts do you need to have at your disposal to make better decisions on behalf of your child to protect them? Answer the question that is most critical. Is my child using drugs?  I’ve talked to quite a few parents who think their kids are in trouble, caught them drinking or smoking pot, and suspect they are doing more. But they’ve never drug tested them to confirm what they suspect.  A drug test may show that they did indeed smoke pot or a breathalyzer can confirm how much alcohol they have been drinking.  So, if that data comes back confirming what you suspect don’t hesitate to ground your kid, let them know that more testing is likely, take their car keys away and make sure they get and understand why this is a big deal. However, your decisions as a parent might be entirely different if the test reveals that they are doing something more dangerous like testing positive for cocaine, meth, opioids or heroin.  You may need to go above and beyond grounding them and taking their car.  The bottom line is that you need to know the facts to make intelligent decisions. Drug testing kits are inexpensive, easy to find at any local drug store or online, and easy to use.  Just follow some simple guidelines.  Make them random.  Research the potential countermeasures your kid may use to fool the test.  And most importantly, never apologize for using a test that could save their life and give you the data you need. Monitor how your child is connecting with others electronically.  Cell phones and laptops are now common tools that most middle and high schoolers use obsessively.  When they are used appropriately, they allow parents to stay in touch with your kids and allow kids to learn more about the world around them.  But those same tools can also be a way for kids to get into trouble.  My daughter used her phone to coordinate sneaking out in the middle of the night to smoke pot on the golf course, connect with high-school seniors who were selling her vodka she used during school and later with her drug dealers. So, let’s get the facts when it comes to understanding if your kids’ electronics are an asset or a liability.  Cell phone have parental controls so you can disable them at night.  You can install software to monitor texting.   The same applies to tablets and laptops.  Don’t hesitate to use software to monitor keystrokes so you can know what your kids search for, who they message, and what they are posting on social media.  And don’t forget to disable or take away the laptop before you go to bed because it’s also an engine to message their friends. Verify that your kid is where they say they are.  When my daughter Laura was in high school, she let me drop her off at school only to leave through the back door.  She had me take her to sports practice only to leave with a friend.  She told me that she was at dad’s house and told her dad she was with me. You get the picture.  As she got older, we installed a GPS tracking system on her car to follow where she was and to know what parts of town, known for drug dealers, she was in.  Today’s kids have smart phones and they are never very far away from them.  That gives you the opportunity to use technology to locate the phone thus locating the kid.  Our company InterAct LifeLIne is going above and beyond and in 2020 will offer SafetyNet, a technology program for parents that combines wearables and mobile technology to keep your kid located, remind them to show up for their commitments and verify that they are there by asking for check ins.  Before SafetyNet comes online, use the find my phone feature to keep track of where your kids say they are. Know the facts about your child’s school performance. When my son and daughter came home from school, I might have asked, “How did your day go?” or “How did you do on that test?”  The standard response that every parent hears is “good”, “fine”.  One of the key indicators that your child is engaged in substance misuse is a dramatic and unexpected drop in grades.  So how do you get the data you need to know the facts and not wait for the report card to come out. First, ask if your school has a parent portal.  If so, grades and assignments are posted regularly and not just at the end of the semester.  Ask your childrens’ teachers for their email address or look on the school’s website to find their contact information.  Reach out to teachers periodically to not only understand your children’s grades, but if they are missing homework assignments or underperforming unexpectedly.  And if the data tells you there’s a problem, request a live meeting with the teachers and school counselors to see what they know. Monitor your kids’ connections and posts on social media.  Back to my daughter Laura.  Facebook and Instagram weren’t around when she was in high school, but the minute she got her Facebook account, the first thing I did was to look at who she friended.  There were the usual suspects that had been her friends and soccer teammates in middle school, but then there were quite a few others that were clearly part of the drug culture, which was easy to spot from their posts and pictures.  Insist that you are one of their connections on social media, then monitor their timeline frequently.  If you have technology to monitor the keystrokes on their smart phones, tablets or laptops it’s a lot easier to keep tabs on what they post and who they connect with.  Takeaways If you are walking on the field in the fight against substance misuse and addiction and have none of the data you need to make strategy or game-time decisions, then be prepared to have a much more difficult time winning.  You need to know where your kid really is, who they are with, and what they are up to.  You need to have the data to know if your child is using and if so, what drugs are in their system.  You need to get the facts about how they perform in school to see if there is a drop off.   And look closely at their connections and posting history on social media. My daughter started her journey into drug use and addiction over 17 years ago when technology wasn’t as sophisticated to give me the facts I needed, so I was playing the game with the wrong information, flying blind and often making the wrong calls.  Laura lost her battle 2 years ago when she overdosed and died.  I often think that if I had the command of the facts, the outcome might have been different and the loss we took might have been avoided.
Episode 10 - Parent Playbook: How to Play Offense
Audio Journal, Podcast
If you listened to the last Audio Journal, we focused on what it takes to coach your family through the Opioid Crisis with a game plan, a playbook, an understanding of your opponent and help from your “assistants” when it’s called for.  This episode will focus on what every successful college football coach knows and understand, that it’s much easier to play offense vs. always be on the defensive. Football coaches don’t start preparing during the game; they start way in advance by scouting the competition, evaluating their players, understanding what plays produce results and just committing the time to do their homework.  Your child may or may not ever use drugs or get addicted, but the reality is that 1 in 10 high schoolers will develop the disease of addiction before they even leave high schoool and that child may be yours.  We’re going to start the Parent Playbook by understanding how you can play offense before you have to play the much more difficult game of defense. Playing offense in the game against substance abuse begins with a good prevention strategy.  It’s hard for parents to get motivated to execute a prevention strategy when their child is a good student, a girl scout, an athlete and an all-around good kid.  All of those things applied to my daughter until she started using drugs at age 14, became addicted and was in for the fight of her life, only to overdose and die after a 15-year struggle.  I never played offense, so I spent 15 years playing the tougher game, defense. Here’s how to execute a good offensive prevention strategy. Start your game strategy by understanding the risk factors.  The disease of addiction runs in families so understand if it’s present in yours, your spouse’s or your extended family.  Developing the disease requires a genetic link that kicks off the propensity of one’s brain to respond in overdrive in the presence of drugs and alcohol.  Children that find it difficult to regulate their emotions, who have been bullied, who have had learning differences are all at higher risk.  And think about children who have experienced other changes or difficulties they struggle with like managing through a divorce, a move to a new neighborhood or school, enduring stressful situations or trauma. They are statistically at much higher risk than other kids, so evaluate if this applies to your family.  InterAct LifeLine has been collecting great content and education and making it available in online portals to help parents understand the risk of addiction so they can be better prepared. All you have to do is visit and there is great information waiting for you. Next, talk to your kids and educate them about the risks.  Executing an offensive strategy is most successful when you prepare your team to understand the game they are playing. Start early and have conversations about substances in an age-appropriate way.  Kids learn science in school, so give them a science lesson on what might happen to the brain when they drink or do drugs.  Help them know what drugs are out there and what they need to do to avoid them.   In addition to helping parents understand the risk of addiction, InterAct also gives you the help you need to use the right words to begin the conversation with your kids at any age. Consider proactively and randomly drug testing your middle or high schoolers. Don’t think of drug testing as a punishment, but rather as a gift.  Your kids can now blame their crazy parents when they choose to turn down the chance to smoke pot or take pills because they can tell their friends they are being drug tested and are sure to be caught.  Drug tests can be bought at any drug store and are cheap and easy to use.  Your child may try and fool the system, so you have to make tests random and take countermeasures to make sure that the tests give you the right results. Trust but verify.  My daughter would tell me that she was at rowing practice, with a friend, or engaged in a school activity.  But that wasn’t the truth.  She was not where she said she was and engaged in activities that she didn’t want me to know about.  Back then, I didn’t have the same technology tools that parents have today.   You have the ability to find my iPhone or install technology on your kid’s phone or laptop to monitor their keystrokes and messages.  Our company InterAct LifeLine is going to help parents out with our 2020 product release, SafetyNet to use the smart phone coupled with wearables to help you geolocate your child and ask for check-ins to prove they are where they said they would be.  Coach from the field not from the stands.  If you are going to play offense, you have to know the players on the field.  Volunteer at your child’s school, meet with the teachers, and understand the environment by talking to other parents. Know your child’s friends, have them over, meet their parents, and understand what their environment is like if your child goes out with them or over to their house.  There is nothing that compares to being right in the middle of the action vs. being in the stands, having your child tell you what is going on through their filter. Takeaways Addiction is a chronic disease just like diabetes.  Once you have developed it, you will always have it and have to manage it to stay healthy.  You and your child will always be playing defense instead of offense.  That’s why a good offensive strategy focuses on prevention and includes understanding the risk factors and helping your children understand the risks.  Playing offense may include proactively drug testing your kids to give them an excuse to still be cool and blame everything on you.  You should try and communicate that while you trust your child, today’s deadly drug environment requires you to verify.  And no game is won if the coach is not totally involved. Had I been educated and prepared to play offense with both my son and daughter, I might have been able to prevent or delay Laura’s drug use giving her brain a chance to develop so it was less vulnerable to the substances that kicked off the disease.  Instead, after Laura began using drugs at age 14, I stayed on the field playing defense for 15 long years, a very difficult game that unfortunately I didn’t win as she overdosed and died 2 years ago.   So, let’s commit to prevention and playing offense because nobody wants to play the same game as I did.
Episode 9 - Using the Parent Playbook to Coach Your Family
Audio Journal, Podcast
We’re coming to the end of the college football season where an elite group of teams will realize their dreams of winning their division, being tapped for a bowl game or being selected for the national championship playoffs.  Every one of the teams had one thing in common; they started their season with a game plan, did their research and homework to create the plan and adjusted it dynamically for each and every game. Coaches like Nick Saban of Alabama, Kirby Smart of Georgia, Dabo Swinney of Clemson or Ryan Day of Ohio State lead their staff to look at the talent they’ve recruited, understand their opponents, analyze the impact of playing at home or away and spent  countless hours crafting a game plan that will produce a win. If you are the coach of your family and have children, particularly adolescents, the most important game you will ever play and one you cannot afford to lose is against the disease of addiction brought on in large part by the Opioid Crisis.  You have to have a game plan, a playbook, an understanding of your opponent and get help from your “assistants” Here is an overview of what college football coaches do to win each and every week and the lessons that we, as the coaches of our families, can learn when we are on the field, fighting against the drug use that sidelines our kids, takes them out of the game, and cripples or kills them. First, you have to prepare for game day.  Football coaches don’t start preparing during the game; they start way in advance by scouting the competition, evaluating their players, understanding what produces results and just committing the time to do their homework.  Your child may or may not ever use drugs or get addicted, but the reality is that 1 in 10 high schoolers will develop the disease of addiction so you may be the ones that have to take the field.  You need to act “as if” you will get the call to play in the game of your life and be prepared in advance.  Learn the factor that contribute to make your children more at risk.  Ask yourself what are the telltale signs of drug use?  Understand your opponents: the drugs, the bad friends, the dealers so if you get the call, you’ve done your homework. And think about how much harder it is to play defense when your child is already using vs. offense where you focus on prevention.   Learn how to control the game by being proactive, educating your child, monitoring them, and executing a prevention strategy. Become data driven.  Nick Saban at Alabama implemented a GPS tracking system to monitor his player’s activity in practice so he could better predict if his team’s practice strategy wore his players out or kept them ready to go, particularly in post-season play.  He relied on data as much as his experience and instincts to create the right practice plan. If you are walking on the field in the fight against substance misuse and addiction and have none of the data you need to make strategy decisions, then be prepared to have a much more difficult time.  You need to have the data drug tests provide to know if your child is using and if so, what drugs are in their system.  You need to get the facts about how they perform in school to see if there has been a drop off.  You need to know where your kid really is, who they are with, and what they are up to. Good coaches don’t commit unforced errors.  Every college football coach cringes at unforced errors that can make the difference between a win and a blowout.  Think about all the games that have been won or lost based on turnovers, missed assignments, dropped passes, or interceptions.   Often these unforced errors result when players or coaches don’t stick to the game plan, are unprepared or just not paying attention. There are number of unforced errors that parents make that cause them to make critical mistakes leading to big problems when it comes to drugs and alcohol.  They fail to notice the warning signs.  They don’t hold their child accountable for their actions.  They don’t have a handle on where their child is, who their friends are and what they are up to.  These unforced errors can make it much more difficult to get the result you need. Know when to pivot.  I’ll never forget the National Championship, Georgia vs. Alabama, Kirby Smart against Nick Saban.  I sat in Mercedes Benz stadium watching the Bulldogs pummel the Crimson Tide in the first half.  But in the second half, Saban adjusted, pulled out his starting quarterback, changed the game plan and beat us in overtime.  He pivoted when he needed to. Ben Franklin tells us that the definition of insanity is doing the same thing over again and expecting a different result.  It’s time to pivot when your attempts to get a correction from troubling and dangerous behavior your children are engaging in that aren’t working.  A pivot means changing the game plan that may include seeking treatment for your child, random drug testing, monitoring locations where they say they are and requiring check ins, a change of schools or a host of other decisions that can change the trajectory of the game.  Be willing to make a game time decision when you are not getting the right result. Rely on your assistants.  Good coaches know that they don’t have all of the answers.  That’s why they rely on their assistants. Back to Nick Saban of Alabama.  He has hired the best assistant coaches, relied on their advice, and let them take the lead in their area of expertise. Managing your child when he is oppositional, defiant, losing ground at school, and using drugs that can cause overdose at any minute is not something parents should try and manage without help.  There are plenty of good assistants out there to help parents adjust their strategy, send in better plays, protect their children, and know when they need to change the game plan completely. Takeaways I’m sure many of you listening to this are thinking that you may never have to take the field because your kids are never going to be those 1 in 10 who use drugs, get addicted, and have their lives changed forever.  I was one of those parents who lost their daughter to overdose 2 years ago.   I was never prepared to play the game because I didn’t do my homework to understand the reality of drug use in our community, now known as the heroin triangle.   I didn’t have a good game plan, the right assistants or pivoted quickly enough.  The result was that Laura struggled with addiction off and on for 15 years, only to lose her battle at age 29. Parents, you are the coach of a game that you have to win.  Winning requires hard work, strategy, persistence, getting help when you need it, changing what doesn’t work, and keeping your child safe.  This is the first in a series of Audio Journals that take the parent playbook, break it down for you, and help you coach a winning game.
Episode 8 - Technology to Take on the Opioid Crisis
Audio Journal, Podcast
Audio Journal Technology to Take on the Opioid Crisis When I look at my iPhone or open up my laptop, I’m like most people going to Facebook.  But unlike most people, I’m not spending very much time checking in with my friends or searching for the latest products I can’t do without.  I’m watching the posts of families in Facebook groups that I belong to that are expressing profound grief, sadness and despair over losing a loved one to overdose or their own personal struggles with addiction.  I belong to those groups because my daughter Laura overdosed and died two years ago after struggling for 15 years battling heroin, opioids and meth. Addiction, driven in large part by the opioid crisis, is killing many of our young people at an alarming rate, decimating rural communities who lack access to treatment, costing our economy over a trillion a year, and ruining the lives of millions of families nationwide.  After processing my grief over the loss of my daughter, I decided to do something about it using the technology my company built over the last 8 years that has served countless businesses who sell services through independent sales agencies. In my business career, I’ve become aware of technologies that are transforming medical healthcare making it easy and affordable to monitor patients in their home, have telehealth doctor visits and transmit vitals to the cloud.  I decided that it was time to see if my company’s technology could also transform addiction and mental healthcare and change the trajectory of how we extend care, monitor people struggling with the disease, improve how people recover and start to reduce those rising death rates. The treatment industry has to find a way to make a shift and leverage technology the same way that medical healthcare has.  There are too many patients and not enough therapists to keep up with everyone that needs help, patients need better ways to access treatment remotely, the cost of treatment needs to go down, patients need to be connected to treatment longer and our understanding of the disease needs to change. So, this year I created InterAct LifeLine, a technology company that partners with treatment providers to accomplish all of those things.  Beyond that, we support the very successful collegiate recovery communities so they can automate themselves and serve the growing number of students that need their help.  In a little less than a year, we’ve been able to transform the technology we have used in the business marketplace and launch successful pilot programs in collegiate recovery and addiction treatment.  Here is what we are doing and why it is works. InterAct keeps people connected longer.  The research is clear.  If you stay connected to a treatment program for at least six consecutive months, the chances are that relapse will go down.  Why is this critical?  The relapse rate after a 30-day stay in rehab is around 85% in the first year often in the first couple of months.  There are a lot of reasons for that alarming statistic, but the main one is that although addiction is a chronic disease, but we treat it like an acute one.  That means that once the patient looks good after rehab, we release them without a good way to have the longer-term treatment plan that they really need. So how does InterAct’s technology keep people connected?  Technology provides programs with portal technology that automates many of the processes that staff would be required to do to run an extended care program.  Let’s take a look at how that works. First, we help programs provide structure and accountability for their clients once they have left a residential setting.  When you go to treatment, your day is planned for you.   Your meals, therapy sessions, group meetings and even down time is scheduled, and frankly, there is a lot of comfort and security in not having to make those decisions when you are fighting to get healthy.  But when you check out, that structure goes away leaving the person to make those decisions, fend for themselves and lose the accountability that is so helpful in staying healthy.  InterAct’s technology offers personal calendars where the program or the individual can add commitments like meeting with their sponsor or recovery coach, going to an AA meeting, or showing up at work.  Text reminders are sent multiple times before each calendar event and the system can ask for the person to “check in” so they know that the program cares and is holding them accountable.  Having a schedule seems simple, but for someone trying to recover, this level of structure is often quite difficult. Our technology promotes connections to community.   Alcoholics Anonymous is one of the most successful and long-standing group organizations in the world.  Collegiate Recovery Communities produce higher GPA’s & graduation rates and astoundingly low relapse rates among their participants.   Why is that?  The answer is that being connected to support communities is a vital component for addicts to stay healthy.  Knowing that, how does technology make it easier for programs to keep their participants connected?  There are many times people just can’t or won’t make it to a face to face meeting.  The live too far away, don’t have the right transportation, or may be overly anxious about meeting others face to face.  That’s where technology comes in handy because all you need is a connection to the Internet and a smart phone to get connected to community.  InterAct provides virtual support groups with guided discussions over webinar technology.  Portals have offer online discussion forums for people to ask questions, share solutions, and get help.  And for collegiate recovery programs, we are building a national directory of program alumni so they can get in touch with each other, no matter where they live. Our technology automates the processes of reaching out and checking in.  The staff at any program don’t have enough hours in the day to sit down and call everyone, text them or check in one by one.  That’s where InterAct’s technology comes in.  Our portal system can send out reminders to login or show up for meetings automatically.  We create simple questionnaires that people can respond to that let a program know how they are doing.  The technology can even score those responses and alert the team if there are issues that need to be addressed.  And that brings us to education.  It is so vital that people understand not only the disease but the ways you can maintain your health.   If you have heart disease, you are educated to modify your diet, your exercise and change many things about your lifestyle.  Do those things and your chances of dying from a heart attack drop dramatically.  The same thing applies to the importance of education in addiction.  Once you understand the disease, you can create a nutritional and exercise plan, use mindfulness and meditation to reduce anxiety, and learn how to treat other disorders like depression that often go hand-in-hand with the disease. InterAct is built for education.  We have created an extensive online content and education library, with information collected from the best resources out there, carefully organized by subjects to make things easy to find.  Every program that works with us has a portal that is connected to the library for a continuous feed of great information.  And portals don’t wait for people to come look.  The system automatically alerts you when there is an interesting article to read, a video to watch, or an e-book to download with links to go right to it. And then there is help for the family.  I’m particularly passionate about this because having a family that’s involved, educated about their role in the recovery process and healthy themselves after being in a battle they didn’t choose dramatically improves how their loved one and the family recover.  Our technology delivers a robust family support program that is turnkey for the program that has our solution. Portals provide education not only for the patient, but for their family.  Virtual support groups and discussion forums keep families connected for ideas, strategies and help.  InterAct partners with telehealth organizations to provide connections to family therapists or psychiatrists so families can start to heal and repair their family systems.  And we’re partnering with professionals to create an online family assessment tool to give that family more insight into where they need help. So, how will we know if this is working or not?  Technology can help give us the answers.  So many programs don't have the time or resources to follow up on their patients to understand how effective they are.  Keep a patient connected longer-term and you have a much better understanding of your results.  Our technology is data driven.  We record how often you visit the portal and what content you interact with.  We know if you checked in to appointments, how you answered your questionnaire, or if you read your messages.  That data can be compiled and used to produce outcomes studies so programs can adjust and get better. And it doesn't stop there.  We are now working on a partnership with a well-known fitness tracking company to take data continuously out of wearables that track your steps and your vitals, scrub that data, and use it to monitor your recovery health.  Imagine being alerted if someone is going into overdose, knowing where they are, and getting help in time.  Imagine understanding your stress levels and proactively being able to reduce them.  Or what about monitoring your sleep patterns so you can get the rest you need.  All of that data is out there, and we will repurpose it so we keep people safer and healthier. In 2020, we will use the same technology with its monitoring and tracking capabilities, power to connect people to community, educate them, and the ability to detect overdose and launch SafetyNet, a prevention program for parents and adolescents.   1 in 10 students develop the disease before they leave high school, but it’s entirely preventable if you are educated, know the risk factors and take steps to prevent it. Takeaway Technology alone can’t solve the opioid crisis, but it can make a profound difference.  We believe in partnerships and providing this important weapon to the programs and treatment professionals that are in the fight every day.  Look at the impact technology has had on medical care and just imagine what it can do for people trying to recover from addiction.  Then ask yourself:  What if we can provide treatment to more people and keep them connected longer?  What if we can bring families into the process and help them heal at the same time?  What if we can monitor your vitals and better protect you from overdose? I ask those questions every day and wonder what if I had had those tools for my own daughter.  Perhaps she wouldn’t have been one of those statistics and she would be at our Thanksgiving table and opening her Christmas presents.  InterAct is dedicated to make sure that more families can spend the holidays together so it’s a time of joy and not one of grief and regret.
Episode 7 - The Elderly, the Forgotten Victims of Addiction
Audio Journal, Podcast
Audio Journal The Elderly, the Forgotten Victims of Addiction For 20 years, my mother in law had a great relationship with the man she fell in love with when she met him on a cruise at age 74.  But things changed dramatically a few years ago.  As he aged, he experienced a number of health issues that plague so many of the elderly.  His joints started to fail, his health declined, and he began to experience persistent pain.  Enter a less than competent doctor who managed his health issues with only one strategy, prescribe opioids. It didn’t take long for the 90-year old to become addicted, needing more and more of the medications to manage his pain so he could get through the day, despite the fact that those medications became less effective over time.  He was now addicted, and along with many other addicts, his loving and caring personality changed.  He became angry, irritable, blaming and abusive.  He engaged in the same drug-seeking behavior we would normally associate with a teenager. Ultimately the relationship ended when my mother in law had enough and now, she’s spending her final years alone. Is this story unique among the elderly?  Unfortunately, it is not. It is estimated that 17% of individuals over age 65 struggle with the disease of addiction.  Perhaps they’ve been struggling with addiction for years, but more often they have developed the disease after being over prescribed pain medication without a long-term plan to transition from pills to deal with the underlying causes of the pain. The fact is that addiction among the elderly goes unrecognized and undiagnosed robbing them of getting the help that they need.  This trend is made worse because family and medical professionals are not informed about the risks of addiction in the elderly, office visits to the doctor are often hurried and healthcare providers often overlook substance abuse among the elderly. Not recognizing addiction in the elderly is made worse because they often have medical or behavioral disorders that mimic symptoms of substance abuse, such as depression, diabetes, or dementia. There are certain times in an elderly person’s life that make them more vulnerable for developing addiction.  Here are a few. People retire.  You get up and go to work daily, have a purpose, and have structure in your life.  Then you retire, have lots of time on your hands, miss your work friends, and have a hard time adjusting.  Stress around making that change often motivates individuals to turn to alcohol to cope.   Not to mention that many of the elderly haven’t planned well enough so the loss of income and financial stress also becomes triggering events. The person has experienced the death of a family member, their pet or close friends.  As we age, the people that have been important in our lives start to die off.  One loses their spouse, their best friend, or their brothers or sisters.  Grief and depression set in and substances became a coping mechanism. As we get older, our sleep patterns change.  I remember that my dad when he aged, he began to wake up in the middle of the night, move to the couch and find it hard to go back to bed.  With changing sleep patterns, the elderly may seek relief in prescription pills. Being relocated or placed in a nursing home is often a catalyst for being overprescribed.  Audit the medications a nursing home patient takes, and you might be astounded at how many mood stabilizers, pain pills, sleeping pills and anti-anxiety drugs are prescribed so these individuals become more manageable.  The downside consequence is that they become addicted and face the consequences that come along with the disease. The people most at risk are those facing mental or physical declines.  My mother in law’s husband had joint problems, needed hip replacement and experienced chronic pain.  My mother in law had osteoporosis and multiple trips to the hospital with broken bones.  She was on a long-term diet of opioids that had totally lost their effectiveness. Drug and alcohol abuse among the elderly is particularly dangerous because senior citizens face more deteriorating effects brought on by sustained substance abuse. As we age and reach 65, we have a decreased ability to metabolize drugs or alcohol along with increased brain sensitivity to them. This makes it dangerous for seniors to use drugs or alcohol at all, even if the person isn’t addicted. Prescription benzos, such as Valium, that are used to treat anxiety, pain or insomnia, are some of the most dangerous prescription drugs for seniors. Doctors love prescribing them even though they are highly addictive. The rate of senior citizens addicted to benzos has increased every year. So, now that you know that we have a real problem with our senior citizens, what should we do about it?  The first step is to recognize if there is a problem and here are some clues. Watch out for slurred speechLook for physical changes such as weight loss, decreased appetite and unkempt appearance or poor hygiene.Notice an increase in their drinking habits.  If they normally had an occasional glass of wine, but now drink daily, that’s a warning sign.Watch for repeated requests to go to the doctor without a corresponding medical reason to do so.  My father in law was doctor shopping for pain pills.Notice repeated falls or blackouts.  That may not be aging, but substance abuse.Think about behavior you would spot in your teens as being problematic that may be characteristic of drug seeking – lying, hiding, anger or deflection.Watch for other mental issues such as anxiety or depression. Now that you suspect substance abuse or addition, what should you do?   This is different than working with a teenager that you have control over, so you have to manage it differently. First, attend doctors’ meetings with your family member.  Challenge the doctor on their pain management strategies and propensity to prescribe.  Ask for strategies that get to the root of the problem vs. just masking it. If your loved one is in a nursing home or assisted living, ask for a medication review.  You may be shocked at how many drugs they are on and what is just not necessary. Be loving, but direct with your loved one if you suspect a problem. Tell them what you are observing and collaborate to help them address the problem.  Don’t be judgmental and prepare that they may be resistant to the conversation but be persistent. Consider treatment.  Research indicates that older people do just as well in addiction treatment as do younger ones.  A recovery strategy for the elderly may just help them refocus on find purpose in their lives, giving back, and being less disconnected and unhappy. Takeaway In the midst of the Opioid Crisis, let’s not forget that we owe it to our seniors to pay attention, recognize that they are vulnerable, and we should take steps to help them live a pain free, addiction free and happier life.
Episode 6 - The Power of Gratitude
Audio Journal, Podcast
Audio Journal The Power of Gratitude You may be struck that the topic of this audio journal is gratitude, especially in the midst of the opioid crisis, the deaths of 70,000 people each year from overdose and the ravages of an addiction pandemic. After the loss of my daughter Laura to overdose 2 years ago gratitude has been the one thing that has helped me through what could have been an unbearable loss.  I am grateful for the time I had with her, for the lessons her disease taught me, for having the insight to use my knowledge of technology to create a new company to take on the opioid crisis and for my friends who have reached out, stayed in touch and have been supportive. I belong to Facebook groups focused on addiction and the loss of loved ones to the disease and one overarching theme is that grief has sucked people into the deepest and darkest of holes that they cannot seem to crawl out of.  Not only have they lost a loved one, but they’ve lost marriages, friends, jobs, and most tragically themselves.  If you are struggling with addiction yourself, trying to create a recovery plan, attempting to  help a family member who is trying to get clean and sober, or trying to cope with the loss of someone you loved from overdose, here are some reasons to consider a shift in focus to appreciate what you still have vs. what you have lost,  Here is how gratitude is helpful. Being grateful makes you a happier person.  Research reveals that if you just spend 5 minutes a day writing down what you are grateful your feeling of long-term happiness will go up and sustain itself over time. Gratitude reduces your feelings of jealousy.  When my daughter starting using drugs at age 14 and spent most of her teenage and young adult years in and out of treatment, I found myself feeling jealous when I watched my friends shop for their daughters’ prom dresses, teaching them  to drive or contemplating where  they were  going to college.  However, I was blessed in having several young ladies in my life without their mothers that allowed me to do those things that I couldn’t do with Laura.  My gratitude at having those opportunities and experiences did wonders in making those jealous moment disappear. Gratitude makes us less self-centered.  When we face challenges, it’s natural to focus on how bad we feel and how those challenges affect us.  Being grateful by its very definition causes us to start thinking about others which can be very healing.  For me, I tell Laura’s story repeatedly in an effort to offer insight and help to other struggling families making me grateful that I had the opportunity to help. Gratitude helps you exert and regain more control over your life.  Addiction is a disease by its very nature that causes one to lose control over choices.  If you have an addicted family member, you understand how little control you have over getting them to stop using and stop taking risks.  Studies have found that gratitude increases people’s self-control, and it increases their ability to wait.   According to the researchers, gratitude is like a self-control buffer helping you be ready to resist temptation and do the right thing. An attitude of gratitude promotes health.  Dealing with addiction takes a toll on your health Research shows that grateful people are generally healthier, so it’s good to get all the help we can. So, knowing that gratitude makes you happier and healthier and has a range of other benefits, how in the face of overwhelming challenges can we start to develop gratitude in our lives?  The secret is to start small, and over time, gratitude becomes part of who you are. Start by focusing on what you have, rather than what you don’t have. When you struggle with addiction yourself, have a family member that is struggling or experience the grief over the changes in your life or the loss of a loved one, it’s easy to focus on what you have lost. Practicing gratitude is all about being thankful for what you have versus focusing on all the things that you don’t have, which makes you feel negative, jealous and angry. Honor the progress you or others around you have made.   Recovery is a series of small victories that combine into lasting change.  Don’t beat yourself or others up when there are setbacks, rather be grateful for the steps forward. Appreciate the small things.  We are surrounded by a host of small things that improve our lives, give us pleasure, or make us smile.  Take time to think about how good your first cup of coffee tasted, how pretty your rose bush is, the cardinal that landed on your window or just the feeling of sunshine on your face. Sometimes it helps to write things down in a gratitude journal so you can look back and remember things that made you smile. Make it a goal to give to others daily.  Teaching someone how to solve a hard math problem helps you be better at math. Being generous with your time by extending yourself to others is a big part of practicing gratitude. There are plenty of ways to give back in small ways.  Pay for the Starbucks coffee for the person behind you.  Help someone bring their groceries in.   Lend an ear to someone else struggling.  Over time those small acts of kindness add up and increase your sense of well-being. Learn how to meditate. Mindfulness meditation involves focusing on the present moment without judgment. Some people practice mindfulness by focusing on a word or a phrase, but it is also possible to focus on what you're grateful for (the warmth of the sun, a pleasant sound, a favorite food). Takeaways I lost my daughter Laura just before Christmas, so coming into the holiday season could be a time of regret, loss, and sadness.  Although I have those feelings, I also take this time to reflect on what I still have, be grateful for those gifts and recommit to be of service to others who struggle with their at-risk teenager who they just caught with pills, their spouse who is on their 3rd treatment  program and how they are going to pay for it, the student trying to manage their recovery in college....and  the list goes on. Gratitude has helped me acknowledge the goodness in my life, the ways I can continue to make an impact through InterAct LifeLine, and the strength I’ve been given to turn grief into purpose.
Episode 5 - Turning Grief into Purpose
Addiction, debunk, Mental Health, program, Recovery, Treatment
Podcast Transcript: Turning Grief into Purpose How My Company Transformed to Take On the Opioid Crisis If there ever was a charmed life, I was sure that I was living it. I grew up in the perfect small town, raised by the picture-perfect parents. My grades were outstanding, and I breezed through college, married the popular guy from my hometown and settled into having it all....2 beautiful kids, a loving husband and a technology career. But sometimes life throws you curve balls, and it threw me some big ones that hit me right between the eyes and knocked me for a loop. My handsome husband descended into alcoholism leading to a divorce when I turned 40. Not understanding that we were dealing with addiction, a disease that runs in families, I was blindsided when my 14-year-old daughter began using drugs that took us on a 15-year journey of rehab, relapse and more treatment. I got educated through my experience with Laura, even opening a licensed therapeutic program for adolescents, but I was not prepared for the knock on the door that came at 4:00 AM when two very nervous and uncomfortable Roswell police officers let me know Laura had overdosed and had been “transported”. For two agonizing days we watched her struggle on life support only to learn what I already had accepted that she had been without oxygen for too long and her brain had lost the ability to tell her body what to do...she was dying from the inside. Although many friends and family held vigil with us at the hospital, one conversation stood out with a friend Laura had met in treatment who found her path to recovery after a serious heroin addiction. She said something surprising as we passed time in the waiting room, “You know, Carolyn, you and I are now in a position of privilege.” She went on to explain that we had a story to tell, an experience we had learned from, and the ability to change lives to prevent other families from experiencing the heartache of drug addiction and overdose. And that was the moment that everything changed for me. Starting the Journey Being the businessperson that I am, I started researching, reading, writing and thinking. Some of what I found shocked me. Laura was not alone in being on the hamster wheel of treatment and relapse. 85% of those that go to rehab relapse in the first year, often in the first few months after treatment. Laura was back in treatment over 10 times during the years. People were treating her addiction as an acute disease – 30 days and you’re good to go. But in reality, this disease is chronic, just like diabetes, and needs management over a lifetime. And treatment providers did a great job stabilizing the patient but didn’t continue to work with or follow them, despite research that proved a significant reduction in relapse if they did. The importance of connections After talking to a number of people in long-term recovery, in collegiate recovery communities and those running treatment programs, I realized that “connections” were a strong indicator of those that could make the move from rehab to long term recovery. So, what do people suffering from addiction need to be connected to? Let’s start with their treatment program. My daughter checked in and almost always developed trusted relationships with the program, got help getting sober, and bared her soul to her recovery coaches and therapists. Staying connected to those that helped her in the most critical time of need could have helped Laura craft a plan to recover. 30 days of rehab was not enough time and the structure, accountability and on-going education she needed was not there once she checked out. Government research indicates that individuals who stay connected to their treatment program for at least 6 consecutive months following rehab have a much lower rate of relapse. Addictions treatment depends heavily on group support, a very important way those having gone through treatment recover. The most successful group support organizations are AA and NA, Alcoholics and Narcotics Anonymous. If patients could stay connected to the same groups of people they bonded with in acute treatment or rehab, then those trusted relationships could be extended offering comfort in a shared experience. But sometimes making and keeping those connections are problematic because individuals may not have transportation, are worried about their privacy or just ashamed of their disease. And what about the connection to family? Many families became disconnected as they tried to navigate the difficulties in helping their loved one manage a disease they just didn’t understand. But family understanding, help and support is critical to recovery. So, what if those connections could be repaired and strengthened? When a family has an addicted loved one, the family system becomes dysfunctional, under attacked, stressed beyond belief, so finding a way to reconnect needs to be addressed and prioritized. As we can see, connections to treatment, support communities and family can make all the difference in helping people sustain recovery. As it just happened, I own a technology company that makes connections possible every day in the business world. We use our portals to connect vendors to channel sellers, educate them and inspire them to action. So, I started asking myself a number of “what if” questions. What if the same technology could be used to create connections for those that had been in addictions treatment? What if we could use our services to educate and engage families? What if we could help treatment programs automate and keep their patients connected longer so they could get the extended treatment they needed without having to be in in-patient care? What if we could provide the desperately needed accountability, structure and education individuals so desperately needed? The answers were right in front of me. Our technology was built for this purpose and had all of the features and capabilities that we needed. And that’s when we decided to create InterAct LifeLine to take the technology that had served the business world so well and repurpose it in service of addiction treatment and recovery. One of the things I’ve been able to do in my long career is use technology to change processes with the best example coming from my time the audio teleconferencing industry. The addictions treatment industry is right for a process change. And that’s where InterAct comes in. I found lots of mobile apps floating around the addiction world, most of them attempting to bypass the treatment provider and go straight to the individual. I decided that partnership with providers was a better strategy and that offering services using technology could extend the relationship with the patient and their family, offer education and understanding, add accountability and structure and create connections to support communities. Here is our vision for InterAct LifeLine to support extended treatment, reduce relapse and improve recovery. Every treatment program using InterAct gets their own portal, an online location to house education, support connections, and outreaches to patients and families.Program portals are connected to a centralized content library where the best resources from around the country on addiction, recovery, family support and wellness strategies automatically refresh portals with current content.Structure and accountability are achieved with personal calendars, appointment reminders, and check-ins. Clients commit to a schedule and we help them keep it.Families participate in discussion forums, attend virtual support groups and are offered telehealth connections to family therapists.Mobile technology can keep patients located and monitor their vitals to detect overdose. In 2019, we’re testing with addictions treatment programs and collegiate recovery communities and getting great results. Our hope is to reach as many programs as possible, increase access to treatment, take on the opioid crisis, and help people understand and manage this chronic disease. Back to Laura for a minute. It’s heartbreaking to think what might have happened if she had these tools available when she struggled so hard to turn things around. I’m committed to the goal of helping families with other loved ones like Laura not go through the grief and suffering that addiction brings. We make strides with other diseases all the time...AIDS is no longer a death sentence....cancer is being beaten back.....and certainly we can do the same thing with addiction.
Episode 4 - Market Drivers for Technology in Mental Health and Addictions Treatment
Addiction, debunk, Mental Health, program, Recovery, Treatment
Podcast Transcript: Every president since Bill Clinton has tried to tackle the question of how to improve healthcare in America, but the government can’t seem to find its footing with a solution that pleases everyone. But quietly, private enterprise has been advancing the ball in medical care by introducing new insurance models, concierge medicine and technology solutions to make access to healthcare more streamlined and cost effective. These advances, driven by the private sector, are dropping the cost of accessing primary care, allowing people to get connected from the privacy of their home, and making it less likely that they will readmit after a stay in the hospital. Unfortunately, the world of mental health and addictions treatment has not yet taken advantage of technology in the treatment process. Addictions and mental health patients just don’t have access to the same digital experiences that streamline treatment, lower cost, and reduce the chances that they will readmit needing more acute care. In this audio journal, we will take a look at the drivers in the mental health and addictions treatment world that make having a technology strategy essential and not optional as we go into 2020. Let’s look at what is going on in the marketplace that make incorporating technology into treatment an important trend. Number one is a severe shortage of treatment professionals. The shortage of mental health professionals in the United States is a huge and growing problem, especially as the country continues to move towards realizing the importance of mental health treatment. In the U.S., nearly 1 in 5 people have some sort of mental health condition, according to the Journal of the American Medical Association. A 2016 report released by the Health Resources and Services Administration projected the supply of behavioral health workers to be approximately 250,000 people short of the projected demand by 2025. The bottom line is there are just not enough people to treat those that need it. Technology has the potential to make the professionals that we do have more efficient and better able to treat more clients using solutions like telehealth appointments. Unfortunately, the opioid crisis is driving demand The need for more effective and accessible substance abuse treatment has increased with the opioid addiction epidemic, specifically in more rural areas. The numbers are alarming. It is estimated that over 10 million people in the US currently abuse opioids with 130 people dying each day from overdose. And the crisis is more acute in remote areas that have many residents who been come addicted and need to be treated. Unfortunately, those areas are less attractive to treatment professionals. However, connecting to patients remotely with telehealth appointments or other virtual options allow the professional to be anywhere and have a conversation with a patient that needs their help, even in harder to reach areas. Some patients just can’t get to a treatment professional. Patients who have been treated and are recovering at home, patients who are not mobile because they lack adequate transportation, have lost their license, and who live in rural, remote areas often can’t make it to their appointments. As long as a patient has a way to connect to the internet, telehealth enables them to access therapists, recovery coaches and support groups. There is definitely a need to reduce stigma and increase privacy with some patients. While there’s a broader acceptance that addiction is a disease that requires treatment and other mental health disorders often come with the landscape, stigma is still a problem for some patients. Often, the shame and stigma associated with the disease is more crippling than the disease itself. Access to treatment through telehealth solutions can offer patients more options to ensure their privacy is protected. Weekly therapy appointments or group support meetings could be done over the web from home or after work hours so patients can maintain their privacy. Staying connected reduces relapse. It’s a fact that the relapse rates after an in-patient rehab stay are 85% in the first year, often in the first few months following treatment. We would never accept these poor results for any other medical treatment, but it’s become the norm in the world of addiction treatment. Although there is not a consensus about why so many people relapse, one statistic is clear: the longer a person stays connected to the program that offered rehab treatment, the lower the relapse rate is. Technology offers the opportunity to automate the extended care process, keep patients connected longer and improve outcomes. Offering technology solutions as treatment options makes it easier to produce outcome studies. When someone comes out of a 30-day rehab, they look healthy, have drugs out of their system and start the recovery process. So, ask a treatment program how that person is doing a year from now, the true test of treating a chronic disease successfully, and most programs will not be able to tell you. If programs were able to extend treatment, follow their clients, and use technology to measure how people are engaging and recovering, then measuring the effectiveness of the treatment would be easier. Technology provides the opportunity for data driven solutions to understand patient outcomes. Takeaways The addiction and mental health industries can no longer afford to ignore the technologies that are transforming medical healthcare. There are too many patients and not enough therapists to keep up with everyone that needs help with technology being one of the best solutions to create efficiencies to treat more people with less resources. Beyond that, patients need better ways to access treatment remotely, reduce the cost of treatment, maintain their privacy, and keep connected to treatment longer.
Episode 3 - Debunking Addiction Myths
Addiction, debunk, Mental Health, program, Recovery, Treatment
Podcast Transcript: Debunking Addictions Myths We live in a world of urban myths. You’ve heard the stories that we never really landed on the moon; it was all shot in a sound studio. Or what about the myth that we are storing aliens in Roswell, New Mexico after their space crafts cashed on Earth? Myths seem to be part of our culture, but unfortunately, they exist in the way people view others who struggle with addiction. Let’s look at some of the more common myths and debunk them as we get more educated about the reality behind addiction. Myth #1: Addiction is a choice. Nobody would make the choice to be addicted. Perhaps the person made the choice to misuse substances, but certainly did not make a choice to become an addict. Addiction is a “complex disease of the brain and body that involves compulsive use of one or more substances despite serious health and social consequences”. For an addict, the “reward center” of the brain that produces a pleasurable feeling, is hijacked when the drug or substance is used. The brain naturally produces dopamine, a reward neurotransmitter, but the use of drugs or alcohol produces an excesses release of dopamine each time it used. This results in a “high”. Once the high wears off, the individual’s brain craves more of the drug to obtain the same pleasurable rush it received the first time. To continuously achieve the high the drug will have to produce a similar dopamine release each time. This requires an ever-increasing amount of the target substance. What may look like a choice to you is a brain-driven compulsion to the addict. Myth #2: Willpower and choices are all that’s needed to get and stay sober. It is more than simply choosing to ignore the urge to use drugs, it’s a recognition that addiction is a CHRONIC and COMPLEX brain disease which is an important first step in eliminating this addiction myth. Addiction creates neurological changes that alter one’s ability to think and act. And while the person may able to verbalize their desire to quit, the brain will convince them otherwise. Recovery from substance abuse requires a process that addresses the whole person. With some tools and support, recovering addicts will be able to better combat physical and psychological dependence on their drug use healthfully and what looks like bad choices will slowly disappear. Myth #3: Addiction only happens to certain kinds of people. Addiction can happen to anyone, no matter their upbringing, what neighborhood they live in, who their parents are, their personality type, or school performance. There are genetic, social, and psychological risk factors that put some people at greater risk—but it has nothing to do with a person’s character. My normal middle-class family lost both a husband and a daughter to the disease. Nobody would have ever guessed that we would be at risk. It can happen to anyone, at anytime and anywhere. Myth #4: People with addiction are hopeless. Many people can and do keep the disease of addiction in remission, most often referred to as recovery. Once treatment begins, someone with a substance use disorder can manage the disease, just as they would any other chronic illness. With the right treatment, recovery is possible for everyone. Myth #5: Treatment for drug addiction should be a one-shot deal. Like many other illnesses, drug addiction is a chronic disorder. To be sure, some people can quit drugs "cold turkey," or they can quit after receiving treatment just one time at a rehab facility. But most of those who abuse drugs require longer-term treatment and, in many instances, repeated treatments. Addiction is not an acute disease you are cured from in 30 days. It is like other diseases that require a lifetime of management to stay healthy. Myth #6: People have to hit rock bottom before they seek help. You don’t wait for the most severe symptoms to happen when you are having heart issues. You go to the ER. Many factors motivate a person to enter and complete substance abuse treatment before they hit "rock bottom." Pressure from family members and employers, as well as their own recognition that they have an unmanageable problem; can be powerful motivating factors. Teenagers under the age of 18 can be admitted to treatment by their parents even if they are not willing participants. Myth #7: Addiction should be treated alone without focusing on other mental health issues. Addiction is a complex brain disease and the same rewiring of the brain is often accompanied by other disorders such as anxiety, depression or PTSD. Addiction treatment should take a holistic approach to identify and manage the other disorders to ensure sustained recovery. Addressing the myths of addiction requires that we educate ourselves, educate those that are struggling with the disease, their families, loved ones, friends and coworkers. Education elevates understanding and empowers people to best support the individual as they go through the long-term process to manage and control the disease. Let’s debunk the myths and face the reality of how we should view the disease and those that are afflicted. InterAct LifeLine’s mission is to help provide that education to clients of treatment programs, to families going through the journey and to anyone else that is struggling to manage the disease. Being informed is a first step in reducing relapse, improving recovery, and not judging people who are trying to return to health and wellness.
Episode 1 - Recovery or Remission? How We Think About Treatment for Addiction
Addiction, Mental Health, program, Recovery, remissiioin, Treatment
Podcast Transcript: InterAct LifeLine Audio Journal Recovery or Remission? Intro We’d like to welcome our listeners to our audio journal series. I’m Carolyn Bradfield, CEO of InterAct LifeLine, a technology service focused on helping addictions treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse. Audio Journal September was National Recovery Month, created by the Substance Abuse and Mental Health Services Administration otherwise known as SAMHSA. Held every September the focus is to educate people that substance use treatment and mental health services can enable those with mental and substance use disorders to live healthy and rewarding lives. I’d like to dig into addiction and the concept of recovery in the way we treat people that are struggling with the disease. The first thing we need to define is the type of disease that addiction represents. When a person develops the disease, the symptoms are often acute, severe and obvious. People experience a loss of control over choices, cravings and compulsive using, and physical withdrawal if they don’t maintain substance use. There are many other conditions that you would recognize that also have acute symptoms. You pass out from diabetes, can’t breathe during an asthma attack, or experience chest pains during a heart attack. The symptoms appear rapidly but can be treated if caught in time averting a tragic outcome. However, diabetes, asthma and heart disease don’t just go away after a stay in the hospital. They are chronic conditions that stay with you and require on-going treatment and maintenance to keep them in check. In other words, people with those diseases can live healthy and productive lives as long as they take steps to manage their disease, even if the condition is always present. Addiction must be thought of in the same category, a chronic disease, yet when we treat the symptoms in rehab, reversing those acute symptoms we pronounce the individual “recovered” or in recovery. I often wonder if the better term for what we’ve accomplished is that we put the individual into remission? Let’s explore the difference in the two terms. Recovery, in the medical sense, means that the person has all signs of the disease gone and there is a complete return to health. You break a bone, set it, and now your arm is as good as new. You experience appendicitis, get your appendix removed, and the symptoms never return. We tag those with the disease of addiction as “recovered” or “in recovery” if they complete treatment and are no longer using. But perhaps the better way to think about it is that the disease is in remission. A person with the disease has a brain with a predisposition to use again if it is triggered with stress, anxiety, poor health habits and temptations in their environment. They are not really recovered, but rather living healthy lives because they are treating their chronic condition that is now in remission. Recovery, the term used by SAMHSA and so many others, does not mean that you are disease free. But it does not mean that if you complete rehab, you can go out into the world, return to the habits that brought the onset of the disease and stay healthy. Recovery should mean that you craft a long-term plan to stay in remission that includes a health and wellness strategy that keeps you asymptomatic. Unfortunately, we continue to treat addiction as an acute disease, manage the symptoms, but fail to have a longer-term plan to stay healthy. That is why relapse rates, according to SAMHSA, are in the 85% range in the first year following acute treatment. If this were any other disease that could be put into remission, an 85% rate of having the acute symptoms return so quickly after expensive treatment would be totally unacceptable. Imagine going to your dentist having crown, only to tell you to expect that it will fall out in a month or so, you would never accept that. Here are some thoughts on how to truly put the disease into remission vs. simply “recover” only to need acute treatment again. #1 Stay connected to treatment longer Studies show that individuals who maintain a connection with the program that treated them for the acute symptoms, aka rehab, for 6 consecutive months following treatment dramatically reduce the rate of relapse. You don’t have to occupy a bed in a rehab facility to continue treatment. There are on-going after-care options through intensive outpatient programs, addictions therapists and other aftercare solutions that offer structure, accountability, and create new habits to promote health and wellness. #2 Get connected to a community There is nothing that compares to having a community of others who are committed to managing their disease in a healthy way. Community allows one to share strategies, get support to overcome struggles, and focus on a lifestyle that is free from substances. Communities can be physical through meetings or virtual through online support groups. Take collegiate recovery communities as an example. According to the Association for Recovery in Higher Education, individuals who join a collegiate recovery community on campus have a higher GPA, higher graduation rate, and lower relapse rate. Students stay connected to each other, to a shared experience, and to a shared strategy to maintain wellness. #3 Stay connected or reconnect to family Most families are undereducated about the disease of addiction. They don’t understand the malfunctioning of the brain and the irresistible urges to misuse substances, chalking up the condition as a moral failure vs. the disease that it really is. Connecting to an educated family ready to support the individual with the disease provides structure, understanding, support and help to craft a strategy to stay in remission. Let’s celebrate those that are committed to overcoming their disease, recovering from the acute symptoms and maintaining a plan to keep the disease in remission so they can continue to live a healthy and productive life. InterAct LifeLine is here to make a difference in how people manage the disease of addiction, reducing the rate of relapse and improving the recovery process. We offer treatment and collegiate recovery programs a technology service to keep individuals connected to treatment, to support communities and to families. This is Carolyn Bradfield and you’ve been listening to our audio journal from InterAct LifeLine.
Episode 2 - The Case for Family Support
family support, improve recovery, reduce relapse
Podcast Transcript: InterAct LifeLine Audio Journal The Case for Family Support Intro Hi, I’m Carolyn Bradfield and I’d to welcome our listeners to our audio journal series from InterAct LifeLine InterAct LifeLine is a technology service focused on helping addictions treatment and collegiate recovery programs keep individuals connected to treatment, to community and to their families to improve recovery and reduce relapse. Today our focus is making the case about the importance of keeping families connected as a critical factor to relapse prevention and recovery. Years ago, my 15-year old daughter Laura became a danger to herself as her drug use escalated out of control. I got professional advice, enrolled her in a wilderness therapy program, followed by a long-term commitment to a therapeutic boarding school. Right after enrollment in the school, 20 families gather for our orientation. It took us 4 hours to go around the room, introduce ourselves and share why are child had enrolled. The room was full of emotion. We were all heartbroken that we had failed to keep our child safe, that they were using drugs, and had to be stabilized in wilderness. As I thought about how we could have been more prepared and less traumatized, it became clear that none of us had received any family support or guidance during the wilderness programs. We were totally unprepared emotionally to leave our child in the hands of others to finish out their high school experience. That insight led me to create Phoenix Outdoor, a licensed adolescent wilderness program in North Carolina. The first order of business was to create a family support program that soon became the gold standard in the industry and later incorporated into most wilderness therapy programs. I’d like to share why family programs are critical when it comes to supporting a loved one who is either in treatment or managing their recovery process. Families are undereducated about addiction It’s very easy to focus on the behaviors that have disrupted your family life. From my own experience, I was angry and frustrated when Laura snuck out, took the car on a joy ride, didn’t show up for school, and began to steal things. I knew she was using drugs, but had no idea that her drug use had initiated the onset of the disease of addiction. My situation repeats itself in most families. We get angry, think that our loved one has more control over their actions than they do, and fail to understand the science behind this brain disease. Family support programs should provide an education on the condition so families better understand how it develops, progresses and can be treated. Families are traumatized by the experience. There is nothing worse than the fear you feel when your child is missing, is putting themselves in harm’s way, or is threatening you. I experienced many sleepless nights when Laura was unaccounted for, knowing she was with a dangerous crowd, and not knowing how to find her. Add to that the shame that I felt when my friends talked about the accomplishments of their children knowing that my child may not make it through high school or even make it home at night. Being traumatized lowers a family’s ability to understand the situation, know how to make good, rational decisions in support of their loved one who is struggling and how they can take care of themselves. A family support program gives them an opportunity to share experiences with other families who are struggling, get counseling and develop a way to move past the trauma. Decision making has become much more difficult I shared that it took 4 hours for 20 families to introduce ourselves through our tears and sadness of sending our children away in order to keep themselves. Without a family support program to help guide us none of us were really prepared to make such an important decision. We didn’t have the support to explore whether our child come home under different circumstances, if a shorter-term stay would have worked, or what other options we had in front of us. The bottom line is that in order to make good decisions on behalf of your loved one or with your loved one, having family support to guide that process is critical. The family system may not be functioning well Having an addicted family member can weaken or destroy even the most healthy of family systems, but in one that is already weak, dealing with addiction can be catastrophic to the family. In my own case, I was divorced, newly remarried, starting a new job where I traveled and dealing with raising my two teenagers without the involvement of their father. When Laura became compromised, it not only put my marriage at risk, but made it very difficult on my teenage son, my parents and other family members who stepped in to help. Had we worked on our family system, changing the way we managed our communication, structure and accountability for Laura, and helped her understand and manage her disease, the family system would have functioned much better. Create an environment for recovery Someone who has undergone treatment for addiction may very well either return to live at home or reconnect with their family. Families who have gone through and continue to go through a family support program learn the do’s and don'ts about how to support their loved one so they create an environment that supports recovery. They learn how to hold that person accountable without blame. They learn how to communicate openly about what they struggle with. They better understand wellness strategies and how to implement them for the entire family. Incorporating the family into treatment and into the recovery process does not begin and end with a 1-day visit to a treatment program or the occasional Al-Anon meeting. It requires on-going education to understand the disease and how to treat it. Families need to get healthy, move past the anger and trauma, and become good decision makers for themselves and sometimes for their family member. They need to stay connected to others in their situation for support, strategies, and guidance. Without family support, it’s much harder for the addict to stay in recovery, begin to regain a sense of who they were before substance use, and to reconnect to the family. InterAct LifeLine is dedicated to helping improve recovery and reduce relapse through our technology services used by collegiate recovery and treatment programs. A key component of our programming is family education, family support, and an automated way to help programs keep families connected. I’m Carolyn Bradfield and you’ve been listening to the InterAct LifeLine audio journal.