Saturday, October 17, 2009

Thoughts for the day....Intervention 911...Ken Seely's team...The Florida Marchman Act...A wonderful team...

First, I must apologize for not writing as of recent days. Addiction Recovery Legal Services has been active around the State of Florida working with families is desperate need of care for involuntary commitment services, and training health and services professionals on the minutia of the Florida Marchman Act procedure. We have made great progress. I would like to thank Broward Health (formerly the North Broward Hospital District) for having the vision to understand the need to educate their social workers, ER staff, and front line intake workers on the Florida Marchman Act for the benefit of the public. They serve our community well and have been both interested and pro-active.

I also want to thank Ken Seely and his intervention 911 team who took the afternoon to fly in from all around the country to meet and gain a better understanding about the Florida Marchman Act. I flew to Tampa with our Director of Outreach, Mellisa Morgan, and spent an afternoon that I can only describe as electric! Speaking to their team of interventionists made me feel as if I were speaking to a room full of old friends and kindred souls. Their work is so very important and I admire each and everyone of them for what they do - save lives every day. I am also excited because it was painfully clear of the synergy that existed between our teams; how we may assist them with families across the nation and how they may assist us with the very important work we are doing within the civil court system. Special thanks to Jerry and Evan who worked with our offices so closely last week, and the wonderful success on each case.

Finally, please keep coming back to this blog for updates. I am getting married in less than 8 days to my beautiful fiance, and then sailing her off to Istanbul for two weeks...but, I will keep checking in, posting when I can and feeling confident that no matter how difficult it may seem for those living with substance abuse and addiction, there are truly dedicated individuals committed to saving lives - one at a time.

Raymond G. Ferrero III, Esq.

Tuesday, October 13, 2009

NIDA Principles of Addiction Treatment and The Florida Marchman Act (See #10)

More than three decades of scientific research have yielded 13 fundamental principles that characterize effective drug abuse treatment. These principles are detailed in NIDA’s Principles of Drug Addiction Treatment: A Research-Based Guide.

1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each patient’s problems and needs is critical.

2. Treatment needs to be readily available. Treatment applicants can be lost if treatment is not immediately available or readily accessible.

3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. Treatment must address the individual’s drug use and associated medical, psychological, social, vocational, and legal problems.

4. At different times during treatment, a patient may develop a need for medical services, family therapy, vocational rehabilitation, and social and legal services.

5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The time depends on an individual’s needs. For most patients, the threshold of significant improvement is reached at about 3 months in treatment. Additional treatment can produce further progress. Programs should include strategies to prevent patients from leaving treatment prematurely.

6. Individual and/or group counseling and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients address motivation, build skills to resist drug use, replace drug-using activities with constructive and rewarding nondrug-using activities, and improve problem-solving abilities. Behavioral therapy also facilitates interpersonal relationships.

7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. Buprenorphine, can help persons addicted to opiates stabilize their lives and reduce their drug use. Naltrexone is effective for some opiate addicts and some patients with co-occurring alcohol dependence. Nicotine patches or gum, or an oral medication, such as buproprion, can help persons addicted to nicotine.

8. Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.

9. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification manages the acute physical symptoms of withdrawal. For some individuals it is a precursor to effective drug addiction treatment.

10. Treatment does not need to be voluntary to be effective. Sanctions or enticements in the family, employment setting, "CIVIL" or criminal justice system can significantly increase treatment entry, retention, and success.

11. Possible drug use during treatment must be monitored continuously. Monitoring a patient’s drug and alcohol use during treatment, such as through urinalysis, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that treatment can be adjusted.

12. Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place them or others at risk of infection. Counseling can help patients avoid high-risk behavior and help people who are already infected manage their illness.

13. Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Participation in self-help support programs during and following treatment often helps maintain abstinence.

Monday, October 12, 2009

California tests ignition devices for DUI drivers


SACRAMENTO, Calif. – California will test requiring that drivers convicted of drunken driving install devices that block vehicles from starting if alcohol is detected on the drivers' breath.

The bill by Assemblyman Mike Feuer, a Democrat from Los Angeles, is among those signed into law Sunday by Gov. Arnold Schwarzenegger.

It requires installing an ignition interlock device on every vehicle owned or operated by a first-time DUI offender in four counties: Alameda, Los Angeles, Sacramento and Tulare. The law expires in 2016.

Schwarzenegger also signed a bill by Sen. Bob Huff, a Republican from Diamond Bar, that lets repeat drunken drivers apply for restricted licenses if they install ignition interlock devices on their vehicles.

Hal S. Marchman

"I had a severe drinking problem…I'm allergic to two things. When I was 19 years old, the doctor gave me penicillin and I broke out and swelled up, and he said never to let anyone give you penicillin again...”

“When I was 26 years old, I found out I was allergic to alcohol...”

Friday, October 9, 2009

My thoughts for the day...Substance Abuse...Impairment...Addiction...

The term “substance abuse” has historically been a term associated with “addiction”. However, every substance abuser is not an addict (as addiction is an actual disease and abuse is behavioral). I have found that oftentimes this creates confusion, apprehension and ultimately has a negative impact on "how" society views the disease of addiction, or, is willing to engage in any productive dialogue on the topic. How many times have you heard someone say…”sure...I drink (or, recreationally use some substance), but I’m not an addict”.

It is estimated that between 13 and 15% of the U.S. population suffer from actual addiction. Generally, these stats are gathered from hospital admissions of individuals whose addiction has become physically disabling or life threatening. Substance abuse on the other hand is obviously far more prevalent and individuals may abuse substances for a life time, yet be fully functioning without any major dire consequence and invisible to statistical inquiry.

Accordingly, as a collective society - what is it that we are really speaking about?

My personal opinion is that the answer to this question is that we are speaking about “impairment”. The point when substance use and/or abuse leads to actual physical impairment and consequently progresses through the chronic (and, ultimately life-threatening) stages of addiction. Although this may be a minor point, I truly believe as a society, it is imperative to properly define and direct both dialogue and research on the national level. We need to lead in what it is that researchers are actually trying to discover. Is our inquiry looking at the effect that substance use and/or abuse has both physically and mentally upon an individual? Or, are we examining substance use and/or abuse whereby an individual begins to suffer from actual physical and mental impairment and subsequent addiction? I believe it to be both. However, there is an important need to re-examine and re-direct our discussions on substance abuse, impairment and addiction and clarify how our society understands this complex multi-factorial state of being.

Raymond G. Ferrero III, Esq. - Addiction Recovery Legal Services, LLC

Friday, October 2, 2009

Kabul Drug Treatment and Rehabilitation Center

(PAULA BRONSTEIN, GETTY IMAGES / September 29, 2009)
Drug addicts excercise during the Wadan rehabilitation program at the Kabul Drug Treatment and Rehabilitation Center Tuesday in Kabul, Afghanistan. Since the center opened in May 2009 it has rehabilitated over 400 addicts in it's 100 bed facility with temporary funding from International Organization of Migration (IOM) and help from the Ministry of Public Health (MoPH). The program lasts for 45 days combining both detox and rehabilitation. The center houses the 2 leading organizations that offer detox programs, Wadan and Nejat. A US Department of State report 2009 states that there are an estimated two million drug users in the country with atleast 50-60,000 drug addicts in Kabul alone.