When Treatment is done right!!!!

This is an article promoted by a NAMA member and Methadone Advocate who has been working his tail off to assure the existance of treatment in Johnson City, Tennessee.

http://www.johnsoncitypress.com/Opinion/article.php?id=105510#axzz2PxuPsb4q

The case for a clinic

Published March 18, 2013

I am the manager and co-owner of Tri-Cities Holdings LLC, the business applying to open an opiate addiction treatment and counseling clinic in Johnson City. I would like to respond to the March 8 editorial opposing the location of a methadone clinic in your city.
First, I completely understand that community members may feel apprehension at the idea of having an opiate addiction treatment in your community. I’m hopeful, however, that as Johnson City citizens study this issue, they might come to understand that this treatment option is necessary and would be beneficial to Johnson City and the greater Tri-Cities area.
Opiate addiction is an epidemic in the United States, is higher in Tennessee and even higher in the Tri-Cities area.
Let me start with some quick facts about opiate treatment clinics. First, one of the clinic treatment options — methadone — is not “meth.” Meth is slang for methamphetamines — an illegal stimulant that is widely abused and has caused widespread social problems throughout our country. Our proposed clinic has nothing to do with this scourge.
Second, our clinic is not a “pill mill.” Pill mill is slang for doctors who overprescribe large quantities of painkillers that can cause addiction and abuse. Our clinic is the opposite of a pill mill. We seek to get people off pills.
Third, opiate treatment clinics provide substantial social benefits. Around 80 percent or more of opiate treatment clinic patients are employed, maintain a household and support a family. Illegal drug use or criminal activity will get a patient discharged from treatment. In contrast, 80 percent of untreated opiate-addicted people support their addiction through crime. Addicts also are more likely to leave their families, have higher rates of HIV and tuberculosis, engage in criminal activity and have higher unemployment.
This fact is commonly known as the “80-80 rule” that concisely summarizes the social decision that a community makes in deciding whether to offer a legal opiate- treatment option.
We can all agree that untreated addicts create multiple problems for cities and communities like Johnson City. Our goal is to provide the treatment that alleviates the problems associated with this epidemic.
Fourth, our clinic intends to be entirely private pay and will not take a dime from public health coffers. Allegations of a drain on public funds are simply not true. Patients pay for their own treatment, which is much cheaper than an illegal drug habit running hundreds of dollars per day.
There was a past effort to open a clinic that failed. In 2003, the Tennessee Health Facilities Commission granted a permit to open a drug treatment clinic in Johnson City.
That permit decision was reversed by an administrative law judge, who ruled that the commission did not have a quorum when it voted 8-0 to approve the certificate of need. There was a unanimous decision by the Health Facilities Commission then that there was a need for an opiate treatment clinic in Johnson City. There is an even greater need now than in 2003.
You should know that some of the patients in these clinics are injured veterans from Iraq and Afghanistan who have become addicted to opiates. Currently, they must drive between 100 to 200 miles a day to a clinic if they want opiate-addiction treatment. In fact, the nearest in-state clinic is in Knoxville, which is 106 miles from Johnson City. Current rules prohibit a patient from bringing home even one extra day’s dosage during the first 45 days of treatment — so a new patient must drive between 4,500 miles (out of state and back) and 9,000 miles (to Knoxville and back) during the first 45 days of treatment.
Multiple studies show distance is a primary obstacle to treatment, so requiring Johnson City residents to drive such enormous distances to seek treatment results in many just giving up and going back to pill mills, illegal pill dealers and heroin.
Right now, at least 1,000 citizens of Johnson City and the Tri-Cities area are addicted to opiates and are being treated at clinics in Knoxville and outside of Tennessee.
From an economic perspective, our clinic will be a big positive for Johnson City. Our clinic will offer more than 20 good-paying counseling, nursing and administrative positions. Our proposed location is located in the already medical-zoned part of Johnson City, like many other medical services businesses.
When we first began looking for a location, we were committed to finding an appropriate and accessible location some distance away from residential neighborhoods and schools. We determined that this is an ideal location.
Study after study shows that opiate treatment clinics raise employment rates, improve family lives and lower crime rates. A 2012 University of Maryland Medical School study found no geographic correlation between opiate treatment clinics and criminal activity.
It is important to note that people who are addicted to opiates and are seeking treatment are sick and are protected under the Americans with Disabilities Act and the Rehabilitation Act of 1973. Denying disabled people convenient access to treatment, and forcing them to drive hundreds (in this case thousands) of miles for treatment is a violation of federal law.
The prescription drug epidemic is an enormous problem in Johnson City and the Tri-Cities area that must be addressed like the rest of the United States. We have devoted a substantial amount of time finding a location that is not near a church, school or park.
We believe that the proposed clinic can be a part of that solution but we also know of the need of prevention, particularly as it pertains to our youth. For that reason we are prepared to fund a local program to help local at-risk youth. In this regard our goal would be to start that program soon after the clinic opens.
If you are ready to reduce crime, increase employment, reduce drug usage, reduce transmission of HIV and TB and increase family stability, I encourage you to write a letter of support:
Health Services and Development Agency
The Frost Building Third Floor
161 Rosa L. Parks Blvd.
Nashville, TN 37243

Steve Kester is manager and co-owner of Tri-Cities Holdings LLC, the business applying to open an opiate addiction treatment and counseling clinic at 4 Wesley Court. He is a part owner of nine other methadone clinics in four states.

Read more: http://www.johnsoncitypress.com/Opinion/article.php?id=105510#ixzz2TC71KaA5

This Videos come from "Drug War Chronicals"

This Videos come from "Drug War Chronicals"

Author, Filmmaker, Drug Reformer Mike Gray Dies

We received word Wednesday that

Mike Gray, probably best known in the drug reform community as the author of "Drug Crazy: How We Got in this Mess and How We Can Get Out," has died.

Mike Gray, RIP

A fixture at drug reform conferences for the last decade, Gray had been a staunch advocate of ending drug prohibition and had worked with Robert Field at Common Sense for Drug Policy to publicize the abuses of the drug war and assist local activists seeking reform. Among his many works at CSDP were the DVDs "Law Enforcement Against Prohibition," highlighting spokespersons of the group by the same name, and "Cops & Clergy Condemn the War on Drugs."
Born in 1935 in Darlington, Indiana, Gray received an engineering degree from Purdue University, but found his life's work in documenting political violence as a filmmaker. He was a cofounder of the Chicago-based Film Group, a pioneering collection of documentary filmmakers whose works included "The Murder of Fred Hampton," the Chicago Black Panther leader gunned down by police in 1969. Gray's iconic coverage of the police riots at the 1968 Chicago Democratic convention were seen around the world.
Gray moved to Los Angeles in 1973, where he expanded his creative endeavors to include screenwriting credits for four-time Oscar nominated "The China Syndrome" and other films, for episodes of "Star Trek: The Next Generation," as well as a number of books. His written work addressed issues such as the nuclear accident at Three Mile Island and the use of the death penalty, as well as drug reform. In addition to "Drug Crazy," Gray returned to the issue of drug policy with "Busted: Stone Cowboys, Narco-Lords, and Washington’s War on Drugs."
Gray won the Writers Guild of America Award for Best Original Drama and was nominated for an Academy Award for Best Original Screenplay, and for the BAFTA Award for Best Screenplay.
Your reporter conversed briefly with Gray at the California NORML conference in January. He didn't appear to be in ill health; his death comes as a shock, if not a surprise, given his age. He will be missed.

]

 

See the whole story http://stopthedrugwar.org/chronicle/2013/may/01/author_filmmaker_drug_reformer_m

Obama's White House Announce Brain Mapping Initiative

White House Announces Brain Mapping Initiative

Mark Willenbring, MD at Substance Matters: Science and Addiction - 3 weeks ago

*Whew! Long drought! I was caught a bit off guard by the response to Jane Brody's column about Inside Rehab, which generated a lot of inquiries and new patients for Alltyr! All good things, plus opening the new office in downtown St. Paul and many other activities have left me a bit overwhelmed. Today's blog is written by Ian McLoone, a graduate student at the University of Minnesota Master of Professional Studies in Integrated Behavioral Health. Ian has been working with me learning about clinical work, as well as helping with Alltyr Clinic and other activities. He's going to be a... more »

Some books and articles on Science and lack of it in Mental Health Treatment.

Distinction between Science and Pseudoscience.

1. Wikepedia Pseudoscience
http://en.wikipedia.org/wiki/Pseudoscience


Skeptics Quack Watch
2. Article by Rory Coker, Ph.D. "Distinguishing Science and Pseudoscience"
http://www.quackwatch.org/01QuackeryRelatedTopics/pseudo.html

3. Scott O. Lilienfeld, Steven Jay Lynn, Jeffrey M. Lohr "Science and pseudoscience in clinical psychology" here is a little --Youtube I have not hear yet, but seems to be accurate http://www.youtube.com/watch?v=7766-w3luyw

4. "The Great Ideas of Clinical Science: 17 Principles that Every Mental Health Professional Should Understand"  Scott O. Lilienfeld, William T. O'Donohue

5. One final article which is very important is "Why Bogus Therapies Seem to Work" by Barry L. Beyerstein PhD.

http://www.csicop.org/si/show/why_bogus_therapies_seem_to_work/

I feel shamed and betrayed by my own profession. I have read each and every one of this books

and articles. I have become such an skeptic about mental health and substance use disorder

treatment that each time I hear a claim be made by even some of this authors I check and double

check most of their work. It is tiring but nevertheless I have been hot aired so much I feel that

treatment has devastated my life both economically and socially. Before I die, I have made my

commitment to assure that patients learn about the need for science and the fact that we

are being bamboozled by people who maybe nice some times, but are nevertheless quacks.

New Report Outlines Global Strategy to Reduce Harmful Drinking

 

 

I provide and support certain specific articles that I think is consistent with the goals of this blog. If you see any time that I do not give credit where it is due, please inform me via email right away at worsetrreatmentihad@gmailcom so that I can provide the credit where it is due.  Your support and following is always appreciated, so do respond to the article, if you agree disagree, or best of all if
you are familiar with scientific studies that may be inconsistent with the question at hand. That is the way science works. One of the defiition or description of science is "bend over backwards trying to prove your most beloved theory wrong"


New Report Outlines Global Strategy to Reduce Harmful Drinking

Mark Willenbring, MD at Substance Matters: Science and Addiction - 6 days ago

New Report Recommends Public Health Focus on Harmful Drinking vs. Eliminating Consumption**** Tuesday, February 26, 2013**** International Center for Alcohol Policies (ICAP) **** Findings Run Counter to Current Public Health Approach, Discredit Traditional Perspectives**** WASHINGTON, DC--(Marketwire) - The traditional public health perspective on alcohol and noncommunicable diseases is indicted in a new report from the International Center for Alcohol Policies (ICAP). "Alcohol misuse and global health: The case for an inclusive approach to harmful drinking" discredits the tradi... more »

The Narcotic Farm: A Bit of History

And here is about my pet peeve.  Also from Janaburson's Blog All about opioid addiction and its treatment with medication

At http://janaburson.wordpress.com

The Narcotic Farm: A Bit of History

Posted by janaburson in Buy My Book!, History of addiction, History of Opioid Addiction, methadone, methadone in jail, Relapse. Tagged: addiction history, treatment history. 1 Comment

We don’t have to keep re-inventing the wheel.
We can investigate the success rates of addiction treatment methods used over the past century, see what worked, and what didn’t work. We can use programs of proven benefit or we can continue to spend money on programs repeatedly shown to have little benefit.
From 1935 until 1962, drug addicts were treated at a unique facility, part jail and part treatment hospital. Initially named the United States Narcotic Farm, it was later changed to the U.S. Public Health Service Narcotics Hospital. Even after this name change, most people still called it the Narcotic Farm.
This facility was located on twelve acres of Kentucky farmland. The facility was created by the Public Health Service and the Bureau of Prisons, meant to serve a dual purpose. It was a treatment hospital, where drug addicts could voluntarily be admitted for treatment of their addiction, and it was also a federal prison, where drug offenders were sent to serve their sentences. About two thirds of the inpatients were prisoners and the other third were addicts, voluntarily seeking help for opioid addiction. Both types of patients were treated side by side. For over forty years, it was the main drug addiction treatment center in the United States, along with a similar facility in Ft. Worth, Texas, which opened in 1937.
The Narcotic Farm was a massive institution for its time. It had fifteen-hundred beds, and housed tens of thousands of patients over its forty years of operation. It was located in a rural area of Kentucky, which gave it space for numerous operations to engage the prisoners – now called patients – in all types of job training. (1)
The Narcotic Farm really was a farm. Besides growing many types of vegetables, there was a working dairy, and livestock including pigs and chickens. These operations provided food for the patients and staff of the facility and provided work for the patients. The patients provided the labor to keep the farm going and it was hoped they would simultaneously learn useful trades. In addition to farming, they learned skills in sewing, auto repair, carpentry, and other trades. Besides teaching new job skills, it was hoped that fresh air, sunshine, and wholesome work would be beneficial to the addicts. (1)
For its time, the Narcotic Farm was surprisingly progressive in its willingness to try multiple new treatments. For the forty years it operated, many different treatments were tried for opioid addicts. It offered individual and group talk therapies, job training, psychiatric analysis, treatment for physical medical issues, Alcoholics Anonymous meetings, art therapy, shock therapy, music therapy, and even hydrotherapy, with flow baths to soothe the nerves. Despite these options, the Farm apparently retained many of the characteristics of a prison, with barred windows and strict security procedures. (1)
The Narcotic Farm had its own research division, the Addiction Research Center (ARC), which became the forerunner of today’s National Institute on Drug Abuse (NIDA). The Narcotic Farm did pioneering work, using methadone to assist patients through withdrawal, and helped establish the doses used to treat opioid addiction. Methadone was used only short term, for the management of withdrawal symptoms, and not for maintenance dosing at the Narcotic Farm. The Farm also trained a dedicated group of doctors and nurses, who were pioneers in the field of addiction treatment. It provided new information on the nature of addiction.
Admission to the Narcotic Farm allowed an opioid addict some time to go through opioid withdrawal, eat regular meals, work in one of the farm’s many industries, and have some form of counseling. However, after leaving the hospital, the addicts were entirely released from care and supervision, with no assistance to help re-enter their communities. Most times, they returned to their same living situation and old circumstances encouraged relapse back to drug use and addiction. As a result, two follow up studies of the addicts treated at the Narcotic Farm showed a ninety-three percent and ninety-seven percent relapse rate within six months, with most of the relapses occurring almost immediately upon returning home. Many addicts cycled through the Public Health Hospital multiple times. (1)
The Narcotic Farm was eventually turned over to the Bureau of Prisons in 1974, as the treatment for addiction was de-centralized. Since the studies found high relapse rates for addicts returning to their previous communities, it was hoped by moving treatment centers into communities, these addicts could have ongoing support after they left inpatient treatment.

1. Nancy P. Campbell, The Narcotic Farm: The rise and fall of America’s first prison for drug addicts, (New York, Abrams, 2008)

Probuphine: the Injectable Suboxone

From Janaburson's Blog All about opioid addiction and its treatment with medication
@ http://janaburson.wordpress.com/

Posted March 30, 2013 by janaburson

Last week, the FDA’s advisory committee voted to approve Titan Pharmaceutical’s Probuphine. This is an implantable form of buprenorphine, a drug more commonly known under the brand names of the sublingual forms Suboxone and Subutex.
Probuphine is a slender rod, as pictured above, containing buprenorphine that is released into the body over time. Probuphine is meant to be inserted a few days after the patient has stabilized on sublingual buprenorphine. Four of the Probuphine rods are inserted under the skin of the inner upper arm in a fan formation, just like birth control implants such as Norplant. Four rods contain 320mg of buprenorphine, released over six months.
Probuphine has been touted as the answer to this country’s problem with Suboxone and Subutex drug diversion. Even though studies show most people who buy Suboxone off the black market use it to stay out of withdrawal and not to get high, many officials are appalled at how the medication, intended to treat opioid addiction, seems to be a new favorite street drug. But implantable Probuphine, for obvious reasons, is highly unlikely to be diverted to anyone besides the patient for whom it was intended. With this implantable form of the medication, pediatric exposures would be practically non-existent.

To read the whole story http://janaburson.wordpress.com/


This is one of the Dr. I follow up.