March is Problem Gambling Awareness Month

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In the United States, more than 7 million adults struggle with problem gambling. Since gambling disorders are often misunderstood, the National Council on Problem Gambling proclaimed every March to be Problem Gambling Awareness Month. The goal is to increase public awareness and shed light on treatment options and prevention.

 

One common misconception is problem gambling is just a bad habit or a sign of poor self-control, however, it’s a serious condition that can turn into an addiction and destroy lives. Gambling disorder is recognized by the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and is defined as repeated problematic gambling behavior that causes significant problems or distress.

 

Although a person might be a frequent gambler, it doesn’t mean they have a disorder. In order to receive a diagnosis of gambling disorder, a person must exhibit at least four of the criteria below within the last year.

  1. Need to gamble with increasing amount of money to achieve the desired excitement
  2. Restless or irritable when trying to cut down or stop gambling
  3. Repeated unsuccessful efforts to control, cut back on or stop gambling
  4. Frequent thoughts about gambling (such as reliving past gambling experiences, planning the next gambling venture, thinking of ways to get money to gamble)
  5. Often gambling when feeling distressed
  6. After losing money gambling, often returning to get even (referred to as “chasing” one’s losses)
  7. Lying to conceal gambling activity
  8. Jeopardizing or losing a significant relationship, job or educational/career opportunity because of gambling
  9. Relying on others to help with money problems caused by gambling

Source: American Psychiatric Association

Gambling & Co-Occurring Disorders
Although gambling doesn’t involve ingesting a substance, it produces similar effects on the brain as drugs or alcohol. Research shows that a person with one addiction is at an increased risk for developing another; many people with a gambling disorder also have a co-occurring substance use disorder.  According to a 2005 study, 73% of pathological gamblers also have an alcohol use disorder and 38% misused drugs. This isn’t surprising since alcohol is handed out at casinos across the country. Just like a person addicted to drugs or alcohol develops a tolerance over time, so does a person with problem gambling. They need to bet more money and  gamble more often to get the same emotional effect. As tolerance builds, a person develops an addiction.

Since it isn’t uncommon to develop more than one addiction, it is advised that people in recovery for substance use disorders also avoid gambling. When the reward centers of the brain are triggered by gambling, it could cause the person to crave drugs or alcohol, which could result in a relapse.

In addition to co-occurring substance use disorders, as many as 96% of people with a gambling disorder also have at least one psychiatric disorder. Studies have found 60% of problem gamblers have personality disorders, more than 50% have mood disorders, and more than 40% have anxiety disorders.

Treatment
Treatment is available for problem gambling, but according to the APA, only 10% of receive treatment. Approaches to treatment vary based on individual needs, but often consist of cognitive behavioral therapy, psychodynamic therapy, group therapy, and family therapy. Co-occurring substance use disorders or psychiatric disorders will also be addressed.

The National Council on Problem Gambling offers a variety of ways to get help including:

Helpful Links

Women & Addiction: A Different Experience

March is all about women; it’s Women’s History Month and International Women’s Day is Friday, March 8, 2019. It’s a time to celebrate women’s achievements, raise awareness of bias and encourage people to take action for gender equality. When you think about gender bias, you probably don’t connect that to substance use disorders. However, gender plays a role when it comes to the effects of drugs and alcohol as well as treatment.

The fact is, women experience addiction differently than men and they also have unique needs when it comes to treatment. Typically, such needs are not addressed by treatment programs, which prevents some women from seeking help.

 

Facts about Substance Misuse in Women

  • It takes less time and smaller amounts of certain drugs before becoming addicted.
  • Women have more drug cravings and experience more intense withdrawal.
  • Hormones can make women more sensitive to some drugs.
  • Women experience different brain changes than men and more physical effects on the heart and blood vessels.
  • Women are more likely to suffer from anxiety and depression, which increases the risk of substance misuse.
  • Trauma increases the risk of substance misuse and women experience higher rates of trauma, including sexual abuse and domestic violence.

Source: National Institute on Drug Abuse

According to Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Survey on Drug Use, over 23 million Americans struggle with an addiction, but only 11 percent receive treatment. While there are many barriers to treatment, some are gender specific. Pregnancy, lack of child care, fear of losing custody of children, and other family responsibilities are some of the reasons women don’t get adequate treatment for substance use disorders.

 

Families in Recovery Program at Liberation Programs

Liberation Programs’ recognized the unique needs of women and developed the Families in Recovery Program (FIRP), an inpatient program for pregnant and parenting women located in Norwalk, CT. The program began in 1994 and is unique in our region. It is the only program of its kind in Fairfield County and the only one in Connecticut where mothers can bring two children up to the age of 10 into the program with them. FIRP helps mothers overcome their substance misuse problems and acquire the skills and resources they need to provide safe, nurturing homes for their children, helping to break what is often a multi-generational cycle of poverty and addiction.

While we recognize there is still a long way to go, we are proud to offer this program to women in our community. We hope other treatment providers across the nation will begin to integrate additional services, such as child care and transportation assistance, to make treatment accessible for anyone who wants help.

Black History Month: African Americans Who Have Made an Impact on Addiction Treatment and Psychology

Throughout Black History Month, our nation honors African-Americans who have made significant contributions to our country. Famous names such as Martin Luther King, Jr., Rosa Parks, and Frederick Douglass probably come to mind. As we close out the month, Liberation Programs would like to take an opportunity to introduce a few whose names may not be well known but who have made significant contributions to the treatment of mental illness and addiction.

 

Image of Dr. Maxie Clarence Maultsby Jr. Maxie Clarence Maultsby, Jr, M.D. (1932-2016) 

Dr. Maultsby was the founder of rational behavioral therapy, a type of cognitive behavioral therapy and counseling method. His work explored ways in which people can help themselves manage emotions and behaviors. In fact, his work helped make emotional self-help a legitimate focus of scientific research and clinical use. The type of therapy and counseling that Dr. Maultsby created is the first short-term drug-free technique of psychotherapy that produces long-term therapeutic results.

 

Image of Jacki McKinneyJacki McKinney, M.S.W. 

Ms. McKinney is a survivor. She experienced trauma at a young age and battled addiction and mental illness later in life. She is a family advocate specializing in issues affecting African-American women and their children, and is also a founding member of the National People of Color Consumer/Survivor Network. Ms. McKinney has been a consultant and advisor to the Center for Mental Health Services and is known for her moving

presentations to national audiences on issues such as seclusion and restraint, intergenerational family support, and minority issues in public mental health. She is a recipient of Mental Health America’s highest honor, the Clifford W.  Beers Award, and received a Lifetime Achievement Award from the Substance Abuse & Mental Health Services Administration (SAMHSA) for her distinguished leadership and her advocacy on behalf of trauma survivors.

 

Related imageArthur C. Evans Jr., PhD

Dr. Evans is the Chief Executive Officer of the American Psychological Association. Prior to this role, he served as commissioner of Philadelphia’s Department of Behavioral Health and

Intellectual disAbility Service. There he improved health outcomes and increased efficiency of service by adjusting the agency’s treatment philosophy, service delivery models, and fiscal policies. Evans spent the early part of his career in Connecticut as the deputy commissioner of the Connecticut Department of Mental Health & Addiction Services (DMHAS). In this strategic role, he implemented recovery-oriented policies that addressed healthcare disparities and increased the use of evidence-based treatment practices.

 

The work Dr. Evans has done throughout his career has been recognized nationally and internationally, and he has been the recipient of prestigious awards.  He was named Advocate for Action in 2015 by the White House Office of National Drug Control. In 2013, he received the American Medical Association’s top government service award in health

care, the Dr. Nathan Davis Award for Outstanding Government Service. In 2013, Evans was also recognized by Faces and Voices of Recovery with the Lisa Mojer-Torres Award for his dedication to mental health advocacy.

 

Image result for Lawrence S. Brown, MDLawrence S. Brown, MD 

Lawrence S. Brown, MD is the Chief Executive Officer of START Treatment and Recovery Centers in Brooklyn, NY. Prior to this role, Dr. Brown led prominent organizations in the addiction treatment field. He served as President and Chair of the American Society of Addiction Medicine (ASAM), as Chairman of the Board of the United States Anti-Doping Agency, and as a Board Member of both the College on Problems of Drug Dependence (CPDD) and the National Black Leadership Commission on AIDS.

 

Dr. Brown’s scientific contributions have resulted in the publication of over 100 peer-reviewed articles, chapters, and abstracts that focus on complications that stem from addiction and improving treatment of substance use disorders.  He is the recipient of the Addiction Medicine Physician of the Year Award from The New York State Office of Alcoholism and Substance Abuse Services. He is currently a member of SAMHSA’s Drug Testing Advisory Board and he is a fellow of the New York Academy of Medicine, the American College of Neuropsychopharmacology, American Society of Addiction Medicine, and The College on Problems of Drug Dependence. He also serves as medical advisor to the National Football League.

 

These individuals have dedicated their lives to improving treatment and services for those impacted by addiction and/or mental illness—and they made significant contributions along the way.  They are pioneers in our field of behavioral health, and we are grateful for their leadership.

 

3 Ways to Be Kind to Yourself

Be Kind Drawing

February 17, 2019 is Random Acts of Kindness Day. While it’s great to do nice things for others, it’s important to remember to be kind to ourselves too. Chances are, you are much nicer to a stranger on the street than you are to yourself. Think about the conversations you have in your mind throughout the day. How do you talk to yourself? It might not seem like a big deal, but that narrative in your mind shapes many aspects of your life, especially when you are in recovery.

The Role of Kindness in Recovery
Most people who become addicted to drugs or alcohol began using substances to feel better. They try to suppress insecurities and negative feelings, such as anxiety, worry, fear, depression, and loneliness. What starts out as a coping mechanism to make it through the day turns into an all-consuming addiction, leaving a person with very little self-esteem.

Why does it matter if you’re kind to yourself? It matters because you need to believe your life is worth fighting for in order to be successful in recovery.

 

3 Ways to Be Kind to Yourself

1. Rewrite Negative Thoughts
“The real difficulty is to overcome how you think about yourself.” – Maya Angelou

Find a mantra or affirmation that resonates with you and repeat it to yourself every day. Wear it on a bracelet, put the words on your mirror or say them in your head while you drive. It might feel silly, but even if you don’t fully believe the words you’re saying, your attitude will shift and become more positive over time. When you try to change a behavior or thought process, it feels like you’re putting on an act, but you have to go through the motions before it becomes habit. Science supports the “fake it til you make it approach!

2. Forgive Yourself

Nobody is perfect and you shouldn’t hold yourself to unrealistic expectations. Stop beating yourself up for your past. Doing so actually can trigger a relapse. Instead, let go of the past, forgive yourself and focus on the present moment. That’s easier said than done, so it’s best to work with trained therapists who can help you work through feelings, accept the past for what it is and move forward.

3. Be Nice to Others

Being kind to other people is beneficial to you too. There are actually proven health benefits to being kind. According to RandomActsofKindness.org, kindness:

  • Decreases pain by producing endorphins in the brain.
  • Reduces stress and slows aging; “Perpetually kind people have 23% less cortisol.”
  • Decreases anxiety levels.
  • Improves depression by stimulating the production of serotonin, which acts as an antidepressant.
  • Lowers blood pressure. “According to Dr. David R. Hamilton, acts of kindness create emotional warmth, which releases a hormone known as oxytocin. Oxytocin causes the release of a chemical called nitric oxide, which dilates the blood vessels. This reduces blood pressure and, therefore, oxytocin is known as a “cardioprotective” hormone. It protects the heart by lowering blood pressure.”
  • Increases energy levels.
  • Increases your lifespan. “Giving help to others protects overall health twice as much as aspirin protects against heart disease. People 55 and older who volunteer for two or more organizations have an impressive 44% lower likelihood of dying early, and that’s after sifting out every other contributing factor, including physical health, exercise, gender, habits like smoking, marital status and many more.“

Are you inspired to perform a random act of kindness? Here are some ideas to get you started.

Medication-Assisted Treatment and its Life-Saving Benefits

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A Message from Our CEO

Last month I talked about the importance of increasing access to treatment and doing whatever we can to save lives. In order to do so, we must provide people with all evidence-based treatment options available, including medication-assisted treatment (MAT).

Although medications have been used to treat opioid withdrawal and addiction for decades, there is resistance among the treatment community and patients. According  to the American Society of Addiction Medicine, only 30% of treatment programs nationwide offer MAT and less than half of eligible patients receive medication in treatment programs.

I believe we have an obligation to offer MAT to our recoverees because it’s the best option for sustained recovery. In fact, studies show that 90% of people in recovery for opioid addiction will relapse within the first year without one of the approved MAT medications. It’s important to note—medication assists treatment— it is not a cure.  Recovery is an active process that requires psychosocial and recovery supports. In addition to medication, individuals must learn skills to cope with life and regulate themselves and their mood without substances in order to succeed in recovery.

What is Medication-Assisted Treatment?
MAT is the use of medications, in conjunction with counseling and other behavioral therapies, to treat substance use disorders and prevent overdoses. The most common medications used for MAT are methadone, buprenorphine and naltrexone. Methadone and buprenorphine both suppress opioid withdrawal and reduce cravings by acting on the opioid receptors in the brain, without producing euphoria. Naltrexone works differently; it controls withdrawal and cravings by blocking the receptors, eliminating the euphoric effects of opioids.

Benefits of Using Medication-Assisted Treatment
Overdose deaths have steadily risen over the past 40 years, as noted in Science Magazine, which has forced us to rethink treatment approaches. As a result, more people are coming to understand the value of MAT and the role it can play in a person’s recovery.

In 2012, the prominent addiction organization, Hazeleden, realized the benefits of MAT and incorporated it into their treatment facilities. More recently, a New York Times article profiled a Tennessee-based facility whose leadership incorporated MAT into their program.

Research has shown, when used at the prescribed doses, these medications don’t produce a high in recoverees; instead, they allow the person to function normally and increase the likelihood that they will remain in a treatment program. Additionally, the use of these medications reduces the risk of infectious diseases and criminal behavior associated with drug use. It also improves the chances that a person will be able to gain and maintain employment.

As I have said before, at Liberation Programs, we do whatever we can to save lives. We understand that MAT plays an important role in recovery. I am happy to see that attitudes are shifting and becoming more accepting of this proven treatment. Many lives can be saved when we work together to decrease the stigma associated with MAT and educate people about its benefits.

Warm regards,

John Hamilton, LMFT, LADC
President and Chief Executive Officer