Friday, July 24, 2009

Healthcare Reform Must Prioritize Treatment for Addictions, Mental Health, Report Says

Healthcare Reform Must Prioritize Treatment for Addictions, Mental Health, Report Says

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How to Raise a Drug-Free Kid: The Straight Dope for Parents

Every parent dreams of a healthy, productive and fulfilling future for their child. However, the sobering truth – and greatest threat to that future -- is that nearly every child in America will be offered drugs or alcohol before graduating high school.

Based on nearly two decades of research at The National Center on Addiction and Substance Abuse (CASA*) at Columbia University, and his experience as Secretary of Health, Education, and Welfare, CASA Founder and Chairman Joseph A. Califano, Jr. has written a comprehensive, straightforward, readable and usable guide to keeping kids drug free during their formative pre-teen, teen, and college years.

In HOW TO RAISE A DRUG-FREE KID, Califano expands on CASA’s two most important findings – the child who stays away from drugs, tobacco, and abusing alcohol until age 21 is virtually certain to steer clear of these substances forever, and teens who learn about the risks of drugs from their parents are much less likely to try them. The book also offers advice on many of the most daunting parenting topics, including:

* When and how to talk to your kids about drugs and alcohol.
* How to respond when your kid asks, “Did you ever try drugs?”
* How to know when your child is most at risk.
* How to prepare your teen for the freedoms and perils of college.

Visit the website at: www.StraightDopeforParents.org

Wednesday, July 22, 2009

Substance Abuse Signs in Teens or Children

What are some of the signs that my child may be using or abusing drugs or alcohol? A few of the many substance abuse symptoms are outlined below.

• Child has been experimenting with drugs or alcohol.
• Child has been found in possession of drug paraphernalia.
• Child admits using drugs or alcohol.
• Child has been having problems with law enforcement.
• Child has been having problems with school.
• Child has been having problems with authority figures.
• Child has expressed concern or loss of control over their life.
• Child has shown lack of motivation or concern for their future.
• Child has begun to neglect their appearance or hygiene.
• Child has shown unexpected weight loss.
• Child has been stealing/borrowing money.
• Child has developed a poor self-image.
• Child has changed friends.
• Child has changed dress or appearance.
• Child has slipped in grades or job performance.
• Child has been skipping school or classes.
• Child has started to lie or have manipulative or deceptive behavior.
• Child begins to show disrespect or disregard of family values.
• Child has run away from home.
• Child starts ignoring curfews or house rules.
• Child has demonstrated violent outbursts or hostility toward friends/family.
• Child has become depressed or withdrawn.
• Child has injured themselves or others.
• Child begins to possess unexplained valuables.
• Child takes valuable items or money from your purse, wallet or home.
• Child has lost interest in healthy activities.
• Child has become verbally or physically abusive.
• Child had glassy/red eyes.
• Child has slurred speech.
• Child develops reckless or inappropriate behavior.

Any of the above may be indicators of a serious, potential substance abuse problem, which may warrant that a child submit to an involuntary assessment and stabilization under the Florida Marchman Act.

Monday, July 20, 2009

Shame - by Howard Spector

There are several emotions that parents experience when dealing with a son or daughter who is using drugs. Fear is one, distrust is another, and then there is shame. Fear and distrust are to be expected when your child exhibits certain types of behavior, deception, disrespect, justification and general avoidance of other family members. Traits that are so common among these young people who have made a bad and possible fatal choice in their lives, because once usage becomes addiction, their life will become a living hell.

They will no longer use drugs to feel good, they will use drugs to prevent the unbearable feeling of withdrawal. It is very important that you act on those emotions, whether it is direct communication or intervention if that becomes necessary. Shame should never be part of the equation. In the case of a young drug user, I believe shame is only self serving for a parent and counterproductive for the child.

I feel no shame regarding my son David, who lost his battle with addiction after approximately 20 years of using opiates which started at about the age of thirteen. During the periods in David’s life when he used opiates, he exhibited most of the negative behavior I mentioned above. During the periods of his life, almost a seven year period, from the age of twenty five to the age of thirty two that he did not use drugs, he exhibited qualities that were the real David. He consoled others, ran N.A. meetings, and went into a prison in Florida to hold meetings for inmates.

He went back to college at the age of twenty six, made the dean’s list, and was accepted into a masters PHD program in Psychology at Nova Southeastern University. His dream was to get his degree so that he could help others. How can I have shame?

Why he relapsed (and, within a year he was gone), I will never have the answers and will always have sadness – but, never shame.

I know other parents who have lost a child to drug addiction. I have heard some say their child died of a heart attack or some other mysterious illness. They are concerned about how their friends and acquaintances will view them as the parent of an addict. Most people, who do not understand, tend to criminalize addiction. This is and must be treated as a disease. They are worried about this negative stigma being attached to their status in the community, when they need to be forth righteous helping other parents to understand what to look for , how to deal with and possibly avoid this happening to their child.

All of us parents who have had this tragedy happen in their lives can look back at how we raised our children and think about possible mistakes made, what if I would have created a stronger bond during these formative years, spent more quality time, really focused on the relationship, would it have made a difference? This is only natural, and is a subject for another discussion. Shame or cover up does not belong in any discussion.

I spoke at David’s funeral, first by acknowledging that my son died of an overdose after struggling for twenty years with his addiction. I then went on to talk about the many good things he accomplished in his life. I closed by saying David is and always will be my hero.

The only shame a parent should experience is their own, if each day that they speak to their children they neglect to tell them that they love them, as I now do every time I talk to my daughter.

Addiction Recovery Legal Services, LLC (www.arlshelp.com) wishes to thank, Mr. Howard Spector, a good friend, for his submission and future inclusion in the Broward County Sheriff’s Office Parent Toolkit to battle prescription medicine abuse. © 2009

A Family Guide to the Florida Marchman Act

by Contributor: Raymond G. Ferrero III, Esq.
www.linkedin.com/in/raymondgferreroiii/
CEO / Ironlight Consortium, LLC.
 https://twitter.com/iron_light


Let me first introduce myself. I am Raymond G. Ferrero III, Esq. I am I am an educator, family advocate, and former partner with the Florida based law firm: Addiction Recovery Legal Services, LLC. During that time, I also served as the Executive Director of Heath Affairs for Nova Southeastern University’s Health Professions Division, Chair of NSU's Institute for Behavioral Health and Wellness, as well as a former Gubernatorial Appointee to Florida's Statewide Drug Policy Advisory Committee.

It is my great pleasure to be writing this brief overview of the Florida Marchman Act for your family. Let me begin by saying that this is an often misunderstood law, which is often (unfortunately) mishandled by well meaning family members or treatment providers, as they attempt to advocate within the legal system without license to do so, or ability. For over a decade, I have been actively involved in Florida’s mental health community and Marchman Act Courts.  I have witnessed the Florida Marchman Act develop from what was once a little known (and, little understood) law into what is now recognized throughout Florida and nationally as one of a family’s most powerful intervention tools to assist someone in substance use crisis within any family unit. Professionally, I take great pride in my work, and find great satisfaction counseling / advising families about how the Florida Marchman Act is able to assist them to address the trauma associated with having to save a loved one in crisis. Personally, I take even greater pleasure when I witness the often surprised reaction a family experiences when they realize that this law actually empowers them to deal with a problem once considered hopeless - head on and without unnecessary delay.

The Florida Marchman Act, when properly litigated by an experienced attorney with a full understanding of the nuances and powers of this law, becomes a legal process that will: (1) establish consequences and hold an impaired individual legally accountable for their continued substance abuse; and (2) empower families with a legal mechanism to interrupt the stranglehold the individuals addiction has on the people around them; and (3) become an invaluable clinical support tool for the recovery team. 

Let’s begin our overview of the Florida Marchman Act…

What is the Florida Marchman Act?

Most simply put, the Florida Marchman Act is an “involuntary commitment statute”. However, I believe it should more aptly be called a "crisis intervention statute." Specifically, the Florida Marchman Act is a legal process and procedure that allows the family OR friends (at least three) of someone in crisis to confidentially petition a civil court judge to help them address their loved one's substance use crisis. So, how does the court help? If the evidence exists, a civil court judge can order the individual in crisis to mandatory drug and/or alcohol “assessment & stabilization” (in layman's terms - a detox) and then into subsequent treatment (that the court will then overseen for up to (60) sixty days. An order that can be extended in 90 day increments with credible evidence demonstrating such a need. 

The key to a Florida Marchman Act "orders for assessment and treatment" are that the period of detox and the subsequent treatment become “involuntary”. Put another way, the impaired individual, or, Respondent, must comply with any and all treatment recommendations made by the licensed substance abuse professional, and/or licensed treatment provider - or, face legal consequences by the court for their non-compliance.  I refer to this as “compulsive care” or “leveraged care”. Accordingly, once the court order has been entered, the person in crisis must complete assessment, stabilization and/or treatment. The person in crisis no longer has a choice in the matter. In fact, even if the individual in crisis has an extensive medical history of relapse, repeatedly refusing voluntary detox and/or treatment, or, has a history of leaving detox and/or treatment against medical advice; once the Florida Marchman Act order is in place, the impaired individual will likely attempt to again refuse care and repeat prior behavior patterns. However, now, in order to do so, they must also deal with the consequences of their actions.

Under the Florida Marchman Act, if an individual refuses to comply with treatment once ordered, they subject themselves to contempt of court and possibly jail time for up to (6) six months (per the Florida Rules of Civil Procedure for civil contempt violations). This may seem harsh, but recognize foremost that the intention of the Florida Marchman Act statute is to provide treatment - not punishment.  The intent of the court is only to see that their order is followed - again, not punish. Accordingly, any person sentenced to jail under the Florida Marchman Act for contempt will always be given a "purge provision". A purge provision means that they can “purge” their jail sentence for contempt at any time by doing one simple thing: re-entering and re-engaging treatment. At all times the person in crisis holds the keys to the jail. This is why I call it leveraged care versus involuntary 
commitment. At no time is the individual allowed to be physically held or restrained - the choice is always their own as to how they wish to proceed.

What is the history of the Florida Marchman Act?

The Marchman Act was passed in 1993 by the Florida Legislature and is officially entitled the Hal S. Marchman Alcohol and Other Drug Abuse Services Act of Florida.  The Marchman Act was named after Hal S. Marchman, a pastor and lifelong advocate for the rights of alcoholics and drug addicts throughout Florida.  Ironically, Hal S. Marchman held worldwide recognition, not for his service to addicts, but as the Chaplain of the Daytona International Speedway, who gave the invocation at the beginning of every race for 42 years before retiring at the age of 85.  Hal S. Marchman passed in October of 2009 in Daytona, Florida.

Why did Florida enact the Florida Marchman Act?

In many ways, Florida is an extremely progressive state in its recognition of the growing trend of substance use across the nation and the need of the state and community to play a role in addressing the consequences that addiction has upon society as a whole.  Especially, when an individual in crisis reaches the progressive stage of addiction whereby their substance use escalates to the point that it poses a danger not only to themselves, but also the public at large. Science has conclusively demonstrated that chronic substance use and abuse of substances can impaired an individual to such a degree that they lose the ability to make rational decisions regarding their own care. More so, that the person in crisis actually loses the ability to even appreciate their own need for care despite the devastatingly negative consequences associated with the substance use. Left unchecked this will progress along the typical stages of clinical addiction toward death. The Florida legislature recognized that an avenue for intervention (without criminal penalty) was necessary for the protection of society and the impaired individual. Thus, the Hal S. Marchman Alcohol and Other Drug Abuse Services Act of Florida was adopted and entered into law in 1993.

Specifically, The Florida Marchman Act – F.S. §397.305 recognize(s):

“Substance abuse is a major health problem and leads to such profoundly disturbing consequences as serious impairment, chronic addiction, criminal behavior, vehicular casualties, spiraling health care costs, AIDS, and business losses, and profoundly affects the learning ability of children within our schools and educational systems. Substance abuse impairment is a disease which affects the whole family and the whole society and requires specialized prevention, intervention, and treatment services that support and strengthen the family unit.”

When should you actually consider using the Florida Marchman Act?

That is actually a simple decision. The friends or family of an individual in crisis should consider pursuing Florida Marchman Act intervention, if the individual in crisis simply refuses  any offer of assistance despite the clear substance use concern. This includes individuals who continuously promise to get help but never take any steps to do so. Remember, addiction is well established as a progressive disease. Addiction is disease that simply does not get better on its own over time, if left untreated. In fact, the opposite is true. Addiction is a chronic medical condition that is progressive in nature (having well-defined stages) that can only be first treated by abstinence. Without intervention and immediate abstinence, addiction is not only a chronic disease; addiction is a fatal disease. Those are the facts. Accordingly, the sooner one intervenes in the progression of an individual’s chronic substance use the better.

Just to be clear, although I said above that the decision seek Marchman Act assistance is a simple one, please do not get the impression that I fail to recognize the difficult decision a family faces, when deciding to seek court assistance for a loved one in crisis. It is a terrible thing to have to do in the grand scheme, but in most cases the only thing that can be done. There are also many factors that a family must consider. When counseling a family, I typically ask them to consider the following: (1) the behavior of the person in crisis, and their substance use will continue until some overriding, significant uniquely personal consequence interrupts their use cycle; (2) most often, the person in crisis does not get better alone, or without great (unnecessary) hardship without something being done to assist them; and (3) there are ultimately only two possible outcomes for an individual who progresses through the stages of chronic substance use and addiction: jail or the morgue. 

Is this a big decision? Yes, this is a big decision.  However, I cannot stress enough, Florida Marchman Act courts are truly nothing to be intimidated by or feared. The Florida Marchman Act courts exist to help families and individuals in crisis. Even in a scenario, where a family only has a mere suspicion that a person is substance abuse impaired (instances often experienced by the parents of juveniles or young adults), filing a Florida Marchman Act can be an incredibly effective tool to simply uncover what (if anything) is actually going on. Also, there is absolutely nothing harmful that will result from initiating this process for anyone involved - if, properly addressed by legal counsel. The person filing a Florida Marchman Act and the person on the receiving end of a Florida Marchman Act have nothing to lose and everything to gain. Remember: The Florida Marchman Act is a civil process, not criminal.  All hearings are held in closed courtrooms and the process is strictly confidential in nature.  Filing a Florida Marchman Act will never impose a criminal court ramification upon a person's legal record. The intent of the Florida Marchman Act is treatment, not punishment.  More so, because addiction is a medical condition, the Florida Marchman Act process as mentioned previously is strictly confidential. Any and all assessment and/or treatment records; including the Florida Marchman Act petitions, are protected by Federal HIPPA law (the Health Insurance Portability and Accountability Act of 1996).  Accordingly, being proactive versus reactive in these situations is incredibly helpful.  Don't simply wait and hope that things will somehow get better.

What are the criteria required to prove a Florida Marchman Act case?

Before I discuss the criteria of the Florida Marchman Act, let me first thank you for taking the time to read this brief overview. I hope that this information was helpful.  Everyone knows someone who may be in need of substance abuse services, so feel free to pass this information on to another.  This information can save families years of frustration and thousands of dollars in treatment costs.

In conclusion, I leave you with the following criteria established by the Florida Marchman Act statute that I review with every family I counsel.  More often than not, simply hearing the following criteria becomes their “Ah-ha” moment for recognizing that a loved one truly needs help and recognizing that The Florida Marchman Act is the next step they need to take:

"A court may grant a Petition for Involuntary Assessment, Stabilization and/or Treatment, if there is a reasonable belief that the individual is substance abuse impaired and the individual: 

(a)   has lost the power of self-control with respect to substance use;

and, either

(b)   has inflicted or is likely to inflict physical harm on him/herself or others unless admitted;

 or 
(c) the person's judgment is so impaired they are incapable ofappreciating the need for care and making a rational decisionregarding such care;

or

(d)   the person has refused to seek voluntary care.

Raymond G. Ferrero III, Esq., A Family Guide to the Florida Marchman Act © 2008

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How do I file a Marchman Act Petition?

Call 1-877-35-ABUSE for a $75.00 detailed consultation by attorney Alan S. Levine, Esq. The above overview has been offered as a general overview of the Florida Marchman Act process. Litigating the Florida Marchman Act statute should be done by an attorney well versed and experienced in Florida Marchman Act law. As in any legal procedure, you should always seek the advice of an experience legal professional to ensure the best possible approach for success.



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