#please learn how to use narcan it’s so important and the more you know about it the less afraid you’ll be to use it

[pussywiki]

Health clinic was handing out narcan at pride so here’s my reminder to y’all to please at the very least learn how to properly administer narcan!! Even if you think you’ll never need it, you don’t party, don’t do hard drugs, don’t hang out with people that do, you never know what information can be helpful in the future. Narcan saves lives

[adrie-75014]

YES YES ALL OF THIS!!

OMG SLIP JACKSON YES!! Subverting the moralizing drug dealer tropes!! Through my organizing work I know a decent amount of folks who sell/sold drugs, and most of them are folks either just surviving capitalism/surviving addiction the best they know how, folks who’ve been pushed out of traditional job markets, and even folks who have a passion for substances and want to provide people with a way to do them more safely. A good friend of mine sells, and tests his supply beforehand, distributes safer use supplies, narcan, and testing strips, and is a walking drug interaction encyclopedia.  SLIP JACKSON, a very imperfect but well-intentioned drug maker/seller just tryna provide people living in a dystopian hellscape with ways to safely escape or get a break from life. But Slip, BESTIE, when you’re trying out something new PLEASE MY FRIEND PRIORITIZE HAVING A TRIP SITTER!!!  

ALSO ALSO Ramses O’Flaherty - as someone who works adjacent to local politics, I find this whole storyline fascinating and also just, so SO relevant and important! A man who, by everything we know and everything he says, really truly wanted to do good, but causes immense, violent harm because - while he thinks of himself as a good person - he’s selfish, he doesn’t listen, he thinks *he* knows best and in fact thinks he knows *better* than the people he wants to help. A man who sees the effects of incredibly complex problems, but wants a simple solution, BELIEVES he can come up with a simple solution, and is so focused on that that he can’t see the trees for the forest. He misses the humanity, the complexity, and believed that an end can justify any means. But til his dying day, he genuinely seems like he always wanted to do good. (I see parallels of him in Sasha, in the end, though I’m not sure she genuinely believed or cared if she was doing good as time went on and she scrapped Sasha Wire for Director W...). What a fucking character.

I see Penumbra pod being a not-so-subtle gateway drug (pun intended, actually kinda forced) to conversations about restorative justice, abolition, and compassionate drug policy and i LOVE IT SO MUCH FOR THAT.

Thinking about author and abolitionist organizer Mariama Kaba saying “Everything worthwhile is done with other people”  Thinking about Juno Steel saying “If I learned anything during my time with the Aurinkos, it was this: there are very few battles in life that have to be one-on-one.” And a few episodes later, saying “if I'd learned one thing over and over again, it was this: if something's too scary to do alone, then guess what? You don't do it alone.”

Listening to the bonus commentary for ep 4.29 and crying about Director W because YES she was a terrible, cruel person and she tried to kill our favorite people but ALSO yes she was, at an earlier time, a good friend to our favorite people, and we know her backstory, and people are COMPLICATED and are sometimes someone different to different people and we can hate them and still be sad about losing them or we can love them but recognize that we aren’t sad about losing them, or any of a myriad of complicated and contradictory feelings because good vs evil is a false binary and very few things in life are black and white and sometimes when someone is gone or out of your life you can be both sad and glad ANYWAYSSSS I’M FINE HOW ABOUT YOU

[curryhealthcenter]

Harm Reduction: Speak Up, Speak Out 

HealthNut guest writer: Michael Layeux 

HealthNut photo: pexels.com 

Guest writer and advocate for drug policy and harm reduction, Michael Layeux, has joined as a guest to give a brief overview of what harm reduction is, what we as students can do to help reduce harm, and how to educate yourself on this topic. If you have any further questions or concerns about this topic, please reach out to Curry Health Center or someone you trust on campus to get help and information. Now without further ado here is what Michael had to say. 

What exactly is harm reduction? Why is it important? What does it have to do with me? Let’s start by exploring what it means for us in the context of substance use. 

Harm reduction is a philosophy of action that takes many diverse forms. That philosophy of action stems from the fundamental belief that all humanity is valuable and worthy of life. A major component of drug harm reduction is identifying what potential harms may exist for people who use substances; whether it be harmful policies surrounding substances and use, the stigma people who use substances suffer, the risks of an unregulated drug market, transmission of disease, or equitable access to safe supplies and lifesaving resources. Once these harms are identified, it is necessary to find ways to reduce or eliminate them. 

A key facet of harm reduction is reducing stigma for those who use substances. It is important to note that by recent estimates, only 11% of people who use some of the most stigmatized drugs develop dependence or a substance use disorder (Csete. J. et al, 2016). By cultivating an open and compassionate atmosphere around substance use, we can emotionally and physically be there for our friends and family, as well as ourselves. Practicing empathy and understanding is an important piece of harm reduction. If you use substances, or have loved ones who do, strive to create support networks and an honest, non-judgmental space about substance use. If we honestly learn to listen and care for one another, we can look out for our community and ensure people live safer and healthier lives. 

This critical philosophy can be practiced by every individual, as well as by groups. As individuals, the simplest form of harm reduction is practicing healthy habits: ensuring you have adequate sleep, proper hydration, exercise, etc. On the group scale, harm reduction organizations ensure equitable access of harm reduction materials to the most stigmatized and marginalized communities. They work tirelessly to provide lifesaving resources, education, and safe supplies to those that are most affected by the war on drugs, and the stigmatization of substance use. This can take forms such as: regularly testing people for HIV/Hep C., providing clean injection supplies, providing safer smoking and snorting supplies, providing narcan/naloxone (an opioid overdoes reversal agent), providing fentanyl testing strips, assisting with housing for HIV+ members of the community, and much more. 

“So, why is it important?” Well, for one we are in the midst of an overdose crisis that is directly caused by current drug laws and the unregulated drug market. Across the country overdoes deaths have risen dramatically in the past few years, even causing the CDC to release notice to all medical professionals and organizations to prioritize harm reduction efforts and tactics (Center for Disease Control, December 2020). Even here in Missoula fatal overdoses have increased 77% since 2019 (Missoula City/County Rx TaskForce). It is important to remember that each one of these deaths is a human life: a mother, a daughter, a son, a friend, or a partner. Each of these people are worthy and deserving of life, and it was taken from them by current attitudes and policies surrounding substance use. 

It is also incredibly important to note that non-fatal drug overdoses are increasing as well. You may wonder, “Why are overdoses increasing so dramatically?” The answer to that is a complex one. One of the largest factors is the fact that in the U.S. there is no safe and regulated supply to most substances, or free testing of these substances, as they are often criminalized unless prescribed. This causes unregulated drug markets to complete amongst each other to meet the demand in our country, which leads to cut/poisoned drug supplies. Another substantial factor is the prevalence of the drug Fentanyl and its many analogues in the unregulated drug market. 

Fentanyl is a synthetic opiate, like opium or morphine, but with a potency nearly 100x more than morphine, and 10x more than heroin. Some of the fentanyl analogues, such as carfentanil, are even 100x more potent that fentanyl. (National Center for Biotechnology Information, 2021). Fentanyl has been found in many drugs in the U.S. and here in Missoula. We know fentanyl to be in supplies of heroin, methamphetamine, cocaine, and even in pressed pills designed to replicate xanax or oxycodone, among other drugs. Due to the small amount of fentanyl required for a lethal dose (approximately 2 milligrams), many more people are overdosing. 

“How can we work to correct this issue?” “How do we know if the drugs we plan to take are adulterated?” The best thing we can do is to educate ourselves! Do personal research on the substances you would like to use, and take note of any interactions they might have with any prescriptions you may take or other substances you plan to use (Here are a few web resources: CAIRNmontana.org, Dancesafe.org, Erowid.org, combo.tripsit.me). Fentanyl testing strips are a cheap and effective way to check your drugs for fentanyl before ingesting them. Another incredibly valuable resource is narcan, an overdose reversal agent (in an easy to use nasal spray form). If you contact us at umontana@chapters.ssdp.org we will confidentially ship fentanyl testing strips to you at no cost, and can help you in accessing narcan. Also Open Aid Alliance (OAA) is a tremendously valuable resource in Missoula, and can offer fentanyl strips and narcan among many other harm reduction supplies and educational materials at no cost. 

We are hosting “Harm Reduction at the Oval” with OAA at UM on 3/31, 4/7, and 4/14 from 10am-3pm. Swing by for the free educational materials, free fentanyl testing strips and narcan as well as training, and other harm reduction materials!

Remember to practice love and compassion for yourself and your community. Be safe UM! 

[garbageshepherd]

I really recommend the comic version.

Moved to be above the CW cause its important/not any of the things im cw'ing for: If you're looking for non-stigma-based addiction-related help or information, you can try looking up "harm reduction" in your area. Lots of places have good, accurate info, needle exchanges, free narcan kits (oh my god please learn to use (its not hard) and cary narcan please please please), fentanyl testing strips, stuff like that.

(Cw for discussion of drugs, smoking, alcohol, addiction) I have been struggling a lot over the past couple months with ideation regarding heroin--something that, combined with starting smoking tobacco at 18 after a childhood of agreeing with Real Cost ads, and drinking knowing full well my family has an intense history of alcoholism/having told myself my entire life "I'll just never start", has made me realize on a deeply personal level how incredibly unhelpful almost all anti-addiction propaganda is.

Back in probably September, i read a piece of writing from an addict about what its like to be on heroin. The notes were full of people saying things like "wow, i really understand this now" and vowing to never start. It was a sincerely emotional piece, well written, about cognitive dissonance, degrading relationships, how the need for comfort will sink into you.

That is what triggered my craving and ideation around using opiates. The piece about how it ruined this person's life because they were desperate for comfort. The piece that had hundreds of people declaiming how much insight it had given them. Why?

See, anti-drug propaganda, both left and right, operates on the assumption that people start using drugs because they dont understand that it's bad, or in the "more progressive" form, that theres a culture of glamorization surrounding drugs, or, that people know its bad but they think their situation is worse. Perhaps this was true, that people just didnt know, in parts of the 20th century; i have no idea and welcome those that were alive at the time to chime in. From my experience, it is no longer true.

My desire to use drugs, my choice to start using tobacco and alcohol, are not because i think they're okay or won't help--theyre because I know theyre self destructive. My takeaway, and the perspective of the comic, from the rat park study, is that its not about the cage, it's about the social bonds you have. That piece that made me want to use heroin so bad did so because it described a relief from pain and a dissolving of social bonds that is expected, controlled, and most importantly contains a justification and a distraction.

I still struggle with ideation, but was helped significantly by a friend who used to use heroin and who sent me that comic, talked about all the mundane and frustrating/upsetting things about just the basic logistics of using heroin, nd encouraged/helped me to work on relationships. I am still intensely lonely but have been lucky enough to recently be able to have more concrete and helpful social bonds.

I don't really know how to end this, other than to try to say... The primary purpose of most anti-drug propaganda is to stigmatize addicts, and given that context even shit thats made with good intentions functions to stigmatize. If you see a piece of media that totally convinces you to not use x, or makes you feel frustrated thst people do use x, i think you should do some examining of the factors in your life, and your internal feelings, to see if you were ever at the same risk for x in the first place.

“Get a rat and put it in a cage and give it two water bottles. One is just water, and one is water laced with either heroin or cocaine. If you do that, the rat will almost always prefer the drugged water and almost always kill itself very quickly, right, within a couple of weeks. So there you go. It’s our theory of addiction. Bruce comes along in the ‘70s and said, “Well, hang on a minute. We’re putting the rat in an empty cage. It’s got nothing to do. Let’s try this a little bit differently.” So Bruce built Rat Park, and Rat Park is like heaven for rats. Everything your rat about town could want, it’s got in Rat Park. It’s got lovely food. It’s got sex. It’s got loads of other rats to be friends with. It’s got loads of colored balls. Everything your rat could want. And they’ve got both the water bottles. They’ve got the drugged water and the normal water. But here’s the fascinating thing. In Rat Park, they don’t like the drugged water. They hardly use any of it. None of them ever overdose. None of them ever use in a way that looks like compulsion or addiction. There’s a really interesting human example I’ll tell you about in a minute, but what Bruce says is that shows that both the right-wing and left-wing theories of addiction are wrong. So the right-wing theory is it’s a moral failing, you’re a hedonist, you party too hard. The left-wing theory is it takes you over, your brain is hijacked. Bruce says it’s not your morality, it’s not your brain; it’s your cage. Addiction is largely an adaptation to your environment. […] We’ve created a society where significant numbers of our fellow citizens cannot bear to be present in their lives without being drugged, right? We’ve created a hyperconsumerist, hyperindividualist, isolated world that is, for a lot of people, much more like that first cage than it is like the bonded, connected cages that we need. The opposite of addiction is not sobriety. The opposite of addiction is connection. And our whole society, the engine of our society, is geared towards making us connect with things. If you are not a good consumer capitalist citizen, if you’re spending your time bonding with the people around you and not buying stuff—in fact, we are trained from a very young age to focus our hopes and our dreams and our ambitions on things we can buy and consume. And drug addiction is really a subset of that.”

— Johann Hari, Does Capitalism Drive Drug Addiction?

[drugrehabtrends]

How Naloxone Can Help Save Lives: Meet Pat Aussem

Naloxone can be a life-saving drug for someone in an overdose situation from opiates.

Pat Aussem has helped families in New Jersey by creating a much-needed naloxone training. If your child is having a hard time with opioids, be sure to get trained and have a naloxone kit on hand. 

I’m delighted to share Pat’s interview! She provides information on naloxone as well as the CRAFT approach.

Please welcome Pat Aussem!

For people who don’t know you, could you briefly tell a little bit about yourself and how you became involved with families who have substance abuse issues?

Sure, about 15 years ago or so, my son was struggling with depression. He was diagnosed with ADHD and was having some difficulties with school. My husband and I realized that he was very depressed, so we started taking him to therapy.

It wasn’t long after that before I realized he was also smoking pot. His use escalated. So did our treatment protocol. We went from individual therapy to an outpatient program. He then attended a residential treatment program where he spent almost four months.

When he was discharged, we realized that we had to help him change so many aspects of his life to sustain his recovery. We worked hard at finding a different school, different friends for him to socialize with, and different activities. For a 16-year-old that is hard to do.

There was the prom, the weekend parties, the football games. They would have been toxic for him. I didn’t know anything about addiction at the time, or what recovery entails. I spent a lot of time getting educated about it.

As families learned about our experiences they began to call me, much like they call you Cathy, asking, “What did you do? How did you do it? Where did you go for treatment? How did you know what to look for in a treatment program?” and all those sorts of questions.

I started trying to answer them but felt like I didn’t have the training and the knowledge that I needed to do that effectively, or to the degree that I wanted to.

So in 2007, I went back to school and got a Masters in Counseling Psychology. After graduating, I spent the next four years or so working at a psychiatric hospital here in New Jersey. I worked in the detox, rehab, co-occurring disorders, and adolescent units.

My time was spent learning more about substance use and other mental health disorders. I had the intent of trying to help families in particular. That is my passion–helping families. There is so much stigma associated with substance use disorders. Families need support figuring out what to do to get the best treatment available.

I ran into families that could not afford treatment without taking out second mortgages on their homes. Or they were taking money from 401K plans to pay for treatment. If a child had cancer everybody would be doing bake sales. You say “substance abuse” and others give you the cold shoulder.

This has to be different. We have to reduce the stigma and get more funding for research and better treatment. That is why I got into the field.

It is amazing that you have put together a naloxone training for your county which has now spread to other counties in New Jersey. Can you explain what is involved with the training?

It started off as a county program. Now, the program has blossomed to five different counties at this point in the state of New Jersey.

I had been to a county-wide task force meeting dealing with the opiate epidemic. The meeting was all about the actions our county had taken to address the crisis. Our county is actually pretty progressive. They had passed the Good Samaritan Law and the Overdose Prevention Act. Our first responders, our police, and our EMTs would be able to carry naloxone.

I left that meeting thinking “this is great news! The first responders are going to be equipped.” Later, I found out that half of the police departments weren’t carrying it. Of the 63 emergency rescue squads, six of them had it on board, and seven of them were planning on it. The rest weren’t going to for a variety of reasons.

They were concerned about keeping the medication temperature controlled. There was the worry that if someone had overdosed, and if they were revived with naloxone, they would be combative; just all different kinds of reasons. I didn’t think most of them were particularly great.

In any event, it occurred to me that this meant there were a lot of families who were going to be out of luck if their child overdosed.

The family is often the first one there anyway. A friend of mine, Denise Mariano and I set about to create an overdose prevention program with the funding we received from a woman who lost her child to an overdose and the support of the Partnership for Drug-Free Kids.

The program included many different elements. Included was an understanding of addiction, what happens in an overdose, how to recognize the signs, how to administer naloxone, what to do after someone is revived and how a family can help get their loved one into treatment. We also provided families with information on resources including treatment options, funding, and support groups.

How can people become more involved with naloxone training in their state? What are the benefits? Are there any negative outcomes to be aware of when administering naloxone?

There are a couple of different ways to get it. In many states where there is a CVS or Walgreens, you can actually go in and ask for naloxone and get a kit without a prescription. It is over the counter.

Some of them do training, yet it is kind of spotty. My recommendation for families is to go to a site called Get Naloxone Now. They have a wonderful animated training program on how to recognize the differences between an overdose and someone who is high. They explain all the steps that are involved in administering Narcan (the brand name) or naloxone.

It takes you through rescue breathing, what the rescue position is, when to call 911, how to put the nasal spray together, how to use the nasal spray, and the importance of getting emergency help. There is a possibility that the Narcan can wear off and the person can go back into an overdose state.

There is another website called Hope and Recovery. They have a zip code locator for finding naloxone training. Many organizations around the country have put their information into that website.�� You can search and find something close by.

Failing that, I would either call a substance abuse treatment center in the local area or the county mental health administration to ask them if they are aware of any training in the area. Often there are licensed addiction counselors as well who might be aware of training. The important thing is to get the training. It is very straightforward, and anybody can learn how to do it.

In fact, there are some newer products on the market. You don’t even have to put the nasal spray together; it comes in an all-in-one piece by Adapt Pharma.

There is also the auto-injector called Evzio. It is like an EpiPen version of naloxone. There are lots of advancements going on in this field on overdose reversals.  But again the most important part is having naloxone and making sure you know how to administer it. Checking the expiration date, as the medication expires after a period of time.

I want to underscore how important it is to get the training for anyone who is dealing with opiates. You will have accurate information about what naloxone can and cannot do. In some of the training sessions that I ran, there were people who thought that naloxone was only for heroin.

It is important to realize it can help in an overdose of OxyContin, Vicodin, Percocet – all opioids. It will not help if another drug causes the overdose.

Since naloxone brings people out of the overdose quickly, is there anything parents need to be aware of? 

The first thing I would say is if I gave you a dose of naloxone right now, all you would have is a wet runny nose, and need a tissue.  So even if you saw someone who was not doing well, and you gave them naloxone, but say they had passed out from alcohol, it is not going to hurt them. This is a very benign drug and there are no apparent side effects in that regard.

In determining that your loved one is overdosing, you want to look for blue lips and fingertips. You want to check for a really depressed breathing rate like less than one breath every five seconds, or a death gargle, and you can’t arouse them. 

If you try to give them a sternum rub with your knuckles on the breastbone or under the nose and they are not responding, you know you have a problem on your hands. An overdose can take a couple of hours to happen, so you may check on somebody and think they are fine, but as time goes by something more dangerous happens. 

The biggest issue in my mind is that naloxone only lasts for 30-90 minutes, so that is the reason a family has to call 911. There is the possibility the person could go back into respiratory arrest. They may need to be hospitalized and need more treatment, so that is something to think about. 

Another consideration is that sometimes a person may need more than one dose. With the naloxone nasal sprays that were provided in our community, families were instructed to give one dose and then wait two to four minutes. If the person was not revived, a second dose was given. 

My understanding is that with fentanyl that is hitting the market, there are instances where you need even more than two doses, so fentanyl can be kind of tricky in terms of how potent it is as a drug. 

Families should know that when a person is revived using Narcan or naloxone, he or she is immediately in withdrawal. They are going to cramp, feel like they’ve got the flu, or like someone hit them over the head with a hammer.  They are going to feel miserable, and sometimes say “I’ve got more heroin or pills over there, get them for me.” You don’t want to do that obviously. 

I would encourage every family to have Narcan on hand regardless of whether opiates are being used as prescribed or abused in their household. There are parts of the country where people get a naloxone kit even if their doctor just prescribed Percocet for back pain or something like that, just to make sure if there is a problem, overdose treatment is readily available.

Once someone has been revived, my concern shifts to thinking about how to help that person get into treatment, because we know if someone overdoses once, their risk level for a second overdose seems to go up tremendously. Getting them to treatment is really important.

That brings me to my next question. I know you are an advocate of the CRAFT approach. How does CRAFT benefit teens or young adults and their families in the short and long-term? How can it help them get their child into treatment?

Many families that I have come across sort of dismiss early substance use as typical teen experimentation, although what we are learning about the teenage brain is that it is so critical not to introduce toxic substances until the brain is fully developed, which really doesn’t happen until someone is in their mid-20s. 

I think parents often try to discipline their way out of the problem and when that doesn’t work, they get lots of advice. The advice goes along the lines of letting them hit bottom. “Why don’t you just detach from them and let them figure it out?” “They have to want it.” and “Why are you wasting your time?”

Even when I didn’t know much about this topic, “detach and let them hit bottom” did not resonate with me. I was watching my son struggle tremendously and I felt there had to be a better way. Through my work at The Partnership for Drug-Free Kids and The Center for Motivation and Change, I learned about CRAFT – Community Reinforcement and Family Training. 

Not only is it an evidence-based approach, it gives parents the sort of tools that they can use to influence their child in a positive way. It helps with engagement in positive behaviors, so instead of just letting your child fall apart in front of your eyes, and then try to pick up the pieces, it advocates intervening and using the influence that you do have in a strategic way.

Using positive reinforcement to try to engage your child in behaviors that you want to see more of is an example of one of the CRAFT tools. I know in so many households, parents that I talk to are focused on everything negative that the kid is doing. They didn’t show up and do their chores. He was late to work. She was smoking last night.  They were disrespectful.

They don’t focus in any way on what the child is doing right. 

It becomes this kind of nagging, pleading and lecturing situation, hoping you can give them one piece, or nugget of information, so they might stop using, and it doesn’t work. 

The beauty of CRAFT is that there are tools that can help you figure out how to get your child engaged in activities that compete with their drug use. It helps in ways to figure out how to collaborate with your partner if you are not on the same page. It allows other people to be the teacher of life lessons to your child instead of you, meaning letting natural consequences play out.  If they get a ticket from the police, you are not trying to minimize that ticket by saying, “Well, I’ll pay for it this time, but don’t do it again.” Instead, you let them learn that lesson. Let them feel the pain of paying the ticket.

All of it is surrounded by what I refer to as “background music,” which are the communication strategies that you can use. The first strategy is really being open to listening to what the benefits of drug use are, which probably sounds strange.

What is your child getting out of using? Is it helping with their boredom, anxiety, or desire to fit in socially? Maybe it gives them a thrill or some sort of excitement. 

It is trying to understand why a child is using drugs and alcohol, and the only way to get at that is to really listen to what your child has to say, instead of nagging and lecturing them. 

Just using different ways to present information, and to recognize and validate how they are feeling, can change the whole dynamic in the family. It increases family cohesion, and in most cases, there is either a reduction of drug use or the person gets into treatment.

The underpinning of all of it is the family’s own self-care and recognizing that if you don’t take care of yourself, it is really hard to engage in this. Sometimes this journey lasts decades, and you need those resiliency muscles to be really strong to do this and it helps to appreciate your own life and other people in your life instead of solely focusing on your child’s problems. 

CRAFT is a blessing. I’ve met Bob Myers who created it. I know you have too, and I think it’s just a remarkable way to approach someone you love and care about to address a disease, as opposed to thinking this is a moral failing on your loved one’s part. 

In many treatment centers, families are told that they are enabling, they are codependent, and they are contributing to their child’s problem. They are not really letting parents know what else they could be doing other than perhaps going to a support group. On the other hand, CRAFT is a very clear way to use the influence that you have as a parent to address your child’s substance use.

It is interesting because some parents think, “Well you know, now that they are a teenager, or especially if they are over the age of 18, I don’t have any influence.”

But they do.

It needs to be used in a strategic way so that you recognize and reinforce the things that the child is doing right, let natural consequences play out, use problem solving and collaboration, and make requests in a positive way — all of these tools and more are part of the CRAFT package.

CRAFT makes a tremendous difference. 

The changes in the family and in the individual parents are really quite remarkable. As you probably know or have encountered, there are so many parents who say, “I don’t see my friends anymore because I am sitting at home waiting for the next shoe to drop,” and that is just a horrible place to be.  You feel so isolated and you wonder what you could have done differently.  “I must be a terrible parent. I can’t figure this out.”

CRAFT is a great way to give parents something that is concrete and constructive and actually gets results instead of feeling shame and isolating. 

Finally, what advice do you have for parents who are struggling with their child’s substance abuse?

A couple of things. One is really doing your homework on what your child is using, what the signs of use are, what the side effects are, and things like that so you really know what this particular drug is doing to affect your child. That is really important. 

It is interesting to me that in many cases for parents if their child had a cancer diagnosis, they would be learning everything there is to know about cancer, but with substance misuse or abuse often there is a sort of apathy or a lack of really digging in and learning about what this does to the brain. What is it doing to their body on a physical level and on an emotional level?

Understand why your child is using and get a sense of why it is important to them. Intervene early and as often as you can because in many cases, it is so much easier for someone to build a life where they have friends, a job, they are in school, or they have their house rather than waiting for all of that to dissipate and then saying, “We are just going to start from scratch.”

Looking for ways to engage your child in activities that will compete with their drug use is important.

Also getting help from people with addiction credentials is important. I know in my early attempts at trying to help my son I didn’t realize that substance use was part of the picture so when we were turning to therapists and psychiatrists I wasn’t looking for someone that had an addictions background. I now know that this is critical. 

If they are using opiates, definitely get overdose prevention training. Also, I would suggest learning about medication-assisted treatment like the use of Vivitrol, which is a once-monthly injection; and Suboxone; which you can take on a daily basis to help with cravings and to help with preventing overdoses.

The last thing I would say is to really work on your own self-care and social supports as well as finding support groups like yours, because I think you learn so much from your peers who are struggling with this as well. You can get a lot of useful information and feel like you are not alone in this.

No parent should be left behind when it comes to a child struggling with drugs and alcohol because there is help out there if you just ask.

Patricia Aussem, LPC, MAC, provides counseling services to treat substance use and other mental health disorders based on the CRAFT model. As a consultant to the Partnership for Drug-Free Kids, she provides clinical oversight, workshops, and training materials for the Parent Support Network, a peer-to-peer coaching service for families negatively impacted by a loved one using substances. For more resources, contact the Partnership or the helpline: 1-855-DRUGFREE.

What are your thoughts about naloxone? How can we train more families to be the first responders? Would the CRAFT approach help your family? Let us know in comments.

If you liked this interview, please share on social media! Thanks.

If you have questions or want more information please reach out, I love to hear from my readers!

source https://cathytaughinbaugh.com/how-naloxone-can-help-save-lives-meet-pat-aussem/ from Addiction Treatment News https://addictiontreatmentnews1.blogspot.com/2018/05/how-naloxone-can-help-save-lives-meet.html

[darrellafrytx]

How Naloxone Can Help Save Lives: Meet Pat Aussem

Naloxone can be a life-saving drug for someone in an overdose situation from opiates.

Pat Aussem has helped families in New Jersey by creating a much-needed naloxone training. If your child is having a hard time with opioids, be sure to get trained and have a naloxone kit on hand. 

I’m delighted to share Pat’s interview! She provides information on naloxone as well as the CRAFT approach.

Please welcome Pat Aussem!

For people who don’t know you, could you briefly tell a little bit about yourself and how you became involved with families who have substance abuse issues?

Sure, about 15 years ago or so, my son was struggling with depression. He was diagnosed with ADHD and was having some difficulties with school. My husband and I realized that he was very depressed, so we started taking him to therapy.

It wasn’t long after that before I realized he was also smoking pot. His use escalated. So did our treatment protocol. We went from individual therapy to an outpatient program. He then attended a residential treatment program where he spent almost four months.

When he was discharged, we realized that we had to help him change so many aspects of his life to sustain his recovery. We worked hard at finding a different school, different friends for him to socialize with, and different activities. For a 16-year-old that is hard to do.

There was the prom, the weekend parties, the football games. They would have been toxic for him. I didn’t know anything about addiction at the time, or what recovery entails. I spent a lot of time getting educated about it.

As families learned about our experiences they began to call me, much like they call you Cathy, asking, “What did you do? How did you do it? Where did you go for treatment? How did you know what to look for in a treatment program?” and all those sorts of questions.

I started trying to answer them but felt like I didn’t have the training and the knowledge that I needed to do that effectively, or to the degree that I wanted to.

So in 2007, I went back to school and got a Masters in Counseling Psychology. After graduating, I spent the next four years or so working at a psychiatric hospital here in New Jersey. I worked in the detox, rehab, co-occurring disorders, and adolescent units.

My time was spent learning more about substance use and other mental health disorders. I had the intent of trying to help families in particular. That is my passion–helping families. There is so much stigma associated with substance use disorders. Families need support figuring out what to do to get the best treatment available.

I ran into families that could not afford treatment without taking out second mortgages on their homes. Or they were taking money from 401K plans to pay for treatment. If a child had cancer everybody would be doing bake sales. You say “substance abuse” and others give you the cold shoulder.

This has to be different. We have to reduce the stigma and get more funding for research and better treatment. That is why I got into the field.

It is amazing that you have put together a naloxone training for your county which has now spread to other counties in New Jersey. Can you explain what is involved with the training?

It started off as a county program. Now, the program has blossomed to five different counties at this point in the state of New Jersey.

I had been to a county-wide task force meeting dealing with the opiate epidemic. The meeting was all about the actions our county had taken to address the crisis. Our county is actually pretty progressive. They had passed the Good Samaritan Law and the Overdose Prevention Act. Our first responders, our police, and our EMTs would be able to carry naloxone.

I left that meeting thinking “this is great news! The first responders are going to be equipped.” Later, I found out that half of the police departments weren’t carrying it. Of the 63 emergency rescue squads, six of them had it on board, and seven of them were planning on it. The rest weren’t going to for a variety of reasons.

They were concerned about keeping the medication temperature controlled. There was the worry that if someone had overdosed, and if they were revived with naloxone, they would be combative; just all different kinds of reasons. I didn’t think most of them were particularly great.

In any event, it occurred to me that this meant there were a lot of families who were going to be out of luck if their child overdosed.

The family is often the first one there anyway. A friend of mine, Denise Mariano and I set about to create an overdose prevention program with the funding we received from a woman who lost her child to an overdose and the support of the Partnership for Drug-Free Kids.

The program included many different elements. Included was an understanding of addiction, what happens in an overdose, how to recognize the signs, how to administer naloxone, what to do after someone is revived and how a family can help get their loved one into treatment. We also provided families with information on resources including treatment options, funding, and support groups.

How can people become more involved with naloxone training in their state? What are the benefits? Are there any negative outcomes to be aware of when administering naloxone?

There are a couple of different ways to get it. In many states where there is a CVS or Walgreens, you can actually go in and ask for naloxone and get a kit without a prescription. It is over the counter.

Some of them do training, yet it is kind of spotty. My recommendation for families is to go to a site called Get Naloxone Now. They have a wonderful animated training program on how to recognize the differences between an overdose and someone who is high. They explain all the steps that are involved in administering Narcan (the brand name) or naloxone.

It takes you through rescue breathing, what the rescue position is, when to call 911, how to put the nasal spray together, how to use the nasal spray, and the importance of getting emergency help. There is a possibility that the Narcan can wear off and the person can go back into an overdose state.

There is another website called Hope and Recovery. They have a zip code locator for finding naloxone training. Many organizations around the country have put their information into that website.  You can search and find something close by.

Failing that, I would either call a substance abuse treatment center in the local area or the county mental health administration to ask them if they are aware of any training in the area. Often there are licensed addiction counselors as well who might be aware of training. The important thing is to get the training. It is very straightforward, and anybody can learn how to do it.

In fact, there are some newer products on the market. You don’t even have to put the nasal spray together; it comes in an all-in-one piece by Adapt Pharma.

There is also the auto-injector called Evzio. It is like an EpiPen version of naloxone. There are lots of advancements going on in this field on overdose reversals.  But again the most important part is having naloxone and making sure you know how to administer it. Checking the expiration date, as the medication expires after a period of time.

I want to underscore how important it is to get the training for anyone who is dealing with opiates. You will have accurate information about what naloxone can and cannot do. In some of the training sessions that I ran, there were people who thought that naloxone was only for heroin.

It is important to realize it can help in an overdose of OxyContin, Vicodin, Percocet – all opioids. It will not help if another drug causes the overdose.

Since naloxone brings people out of the overdose quickly, is there anything parents need to be aware of? 

The first thing I would say is if I gave you a dose of naloxone right now, all you would have is a wet runny nose, and need a tissue.  So even if you saw someone who was not doing well, and you gave them naloxone, but say they had passed out from alcohol, it is not going to hurt them. This is a very benign drug and there are no apparent side effects in that regard.

In determining that your loved one is overdosing, you want to look for blue lips and fingertips. You want to check for a really depressed breathing rate like less than one breath every five seconds, or a death gargle, and you can’t arouse them. 

If you try to give them a sternum rub with your knuckles on the breastbone or under the nose and they are not responding, you know you have a problem on your hands. An overdose can take a couple of hours to happen, so you may check on somebody and think they are fine, but as time goes by something more dangerous happens. 

The biggest issue in my mind is that naloxone only lasts for 30-90 minutes, so that is the reason a family has to call 911. There is the possibility the person could go back into respiratory arrest. They may need to be hospitalized and need more treatment, so that is something to think about. 

Another consideration is that sometimes a person may need more than one dose. With the naloxone nasal sprays that were provided in our community, families were instructed to give one dose and then wait two to four minutes. If the person was not revived, a second dose was given. 

My understanding is that with fentanyl that is hitting the market, there are instances where you need even more than two doses, so fentanyl can be kind of tricky in terms of how potent it is as a drug. 

Families should know that when a person is revived using Narcan or naloxone, he or she is immediately in withdrawal. They are going to cramp, feel like they’ve got the flu, or like someone hit them over the head with a hammer.  They are going to feel miserable, and sometimes say “I’ve got more heroin or pills over there, get them for me.” You don’t want to do that obviously. 

I would encourage every family to have Narcan on hand regardless of whether opiates are being used as prescribed or abused in their household. There are parts of the country where people get a naloxone kit even if their doctor just prescribed Percocet for back pain or something like that, just to make sure if there is a problem, overdose treatment is readily available.

Once someone has been revived, my concern shifts to thinking about how to help that person get into treatment, because we know if someone overdoses once, their risk level for a second overdose seems to go up tremendously. Getting them to treatment is really important.

That brings me to my next question. I know you are an advocate of the CRAFT approach. How does CRAFT benefit teens or young adults and their families in the short and long-term? How can it help them get their child into treatment?

Many families that I have come across sort of dismiss early substance use as typical teen experimentation, although what we are learning about the teenage brain is that it is so critical not to introduce toxic substances until the brain is fully developed, which really doesn’t happen until someone is in their mid-20s. 

I think parents often try to discipline their way out of the problem and when that doesn’t work, they get lots of advice. The advice goes along the lines of letting them hit bottom. “Why don’t you just detach from them and let them figure it out?” “They have to want it.” and “Why are you wasting your time?”

Even when I didn’t know much about this topic, “detach and let them hit bottom” did not resonate with me. I was watching my son struggle tremendously and I felt there had to be a better way. Through my work at The Partnership for Drug-Free Kids and The Center for Motivation and Change, I learned about CRAFT – Community Reinforcement and Family Training. 

Not only is it an evidence-based approach, it gives parents the sort of tools that they can use to influence their child in a positive way. It helps with engagement in positive behaviors, so instead of just letting your child fall apart in front of your eyes, and then try to pick up the pieces, it advocates intervening and using the influence that you do have in a strategic way.

Using positive reinforcement to try to engage your child in behaviors that you want to see more of is an example of one of the CRAFT tools. I know in so many households, parents that I talk to are focused on everything negative that the kid is doing. They didn’t show up and do their chores. He was late to work. She was smoking last night.  They were disrespectful.

They don’t focus in any way on what the child is doing right. 

It becomes this kind of nagging, pleading and lecturing situation, hoping you can give them one piece, or nugget of information, so they might stop using, and it doesn’t work. 

The beauty of CRAFT is that there are tools that can help you figure out how to get your child engaged in activities that compete with their drug use. It helps in ways to figure out how to collaborate with your partner if you are not on the same page. It allows other people to be the teacher of life lessons to your child instead of you, meaning letting natural consequences play out.  If they get a ticket from the police, you are not trying to minimize that ticket by saying, “Well, I’ll pay for it this time, but don’t do it again.” Instead, you let them learn that lesson. Let them feel the pain of paying the ticket.

All of it is surrounded by what I refer to as “background music,” which are the communication strategies that you can use. The first strategy is really being open to listening to what the benefits of drug use are, which probably sounds strange.

What is your child getting out of using? Is it helping with their boredom, anxiety, or desire to fit in socially? Maybe it gives them a thrill or some sort of excitement. 

It is trying to understand why a child is using drugs and alcohol, and the only way to get at that is to really listen to what your child has to say, instead of nagging and lecturing them. 

Just using different ways to present information, and to recognize and validate how they are feeling, can change the whole dynamic in the family. It increases family cohesion, and in most cases, there is either a reduction of drug use or the person gets into treatment.

The underpinning of all of it is the family’s own self-care and recognizing that if you don’t take care of yourself, it is really hard to engage in this. Sometimes this journey lasts decades, and you need those resiliency muscles to be really strong to do this and it helps to appreciate your own life and other people in your life instead of solely focusing on your child’s problems. 

CRAFT is a blessing. I’ve met Bob Myers who created it. I know you have too, and I think it’s just a remarkable way to approach someone you love and care about to address a disease, as opposed to thinking this is a moral failing on your loved one’s part. 

In many treatment centers, families are told that they are enabling, they are codependent, and they are contributing to their child’s problem. They are not really letting parents know what else they could be doing other than perhaps going to a support group. On the other hand, CRAFT is a very clear way to use the influence that you have as a parent to address your child’s substance use.

It is interesting because some parents think, “Well you know, now that they are a teenager, or especially if they are over the age of 18, I don’t have any influence.”

But they do.

It needs to be used in a strategic way so that you recognize and reinforce the things that the child is doing right, let natural consequences play out, use problem solving and collaboration, and make requests in a positive way — all of these tools and more are part of the CRAFT package.

CRAFT makes a tremendous difference. 

The changes in the family and in the individual parents are really quite remarkable. As you probably know or have encountered, there are so many parents who say, “I don’t see my friends anymore because I am sitting at home waiting for the next shoe to drop,” and that is just a horrible place to be.  You feel so isolated and you wonder what you could have done differently.  “I must be a terrible parent. I can’t figure this out.”

CRAFT is a great way to give parents something that is concrete and constructive and actually gets results instead of feeling shame and isolating. 

Finally, what advice do you have for parents who are struggling with their child’s substance abuse?

A couple of things. One is really doing your homework on what your child is using, what the signs of use are, what the side effects are, and things like that so you really know what this particular drug is doing to affect your child. That is really important. 

It is interesting to me that in many cases for parents if their child had a cancer diagnosis, they would be learning everything there is to know about cancer, but with substance misuse or abuse often there is a sort of apathy or a lack of really digging in and learning about what this does to the brain. What is it doing to their body on a physical level and on an emotional level?

Understand why your child is using and get a sense of why it is important to them. Intervene early and as often as you can because in many cases, it is so much easier for someone to build a life where they have friends, a job, they are in school, or they have their house rather than waiting for all of that to dissipate and then saying, “We are just going to start from scratch.”

Looking for ways to engage your child in activities that will compete with their drug use is important.

Also getting help from people with addiction credentials is important. I know in my early attempts at trying to help my son I didn’t realize that substance use was part of the picture so when we were turning to therapists and psychiatrists I wasn’t looking for someone that had an addictions background. I now know that this is critical. 

If they are using opiates, definitely get overdose prevention training. Also, I would suggest learning about medication-assisted treatment like the use of Vivitrol, which is a once-monthly injection; and Suboxone; which you can take on a daily basis to help with cravings and to help with preventing overdoses.

The last thing I would say is to really work on your own self-care and social supports as well as finding support groups like yours, because I think you learn so much from your peers who are struggling with this as well. You can get a lot of useful information and feel like you are not alone in this.

No parent should be left behind when it comes to a child struggling with drugs and alcohol because there is help out there if you just ask.

Patricia Aussem, LPC, MAC, provides counseling services to treat substance use and other mental health disorders based on the CRAFT model. As a consultant to the Partnership for Drug-Free Kids, she provides clinical oversight, workshops, and training materials for the Parent Support Network, a peer-to-peer coaching service for families negatively impacted by a loved one using substances. For more resources, contact the Partnership or the helpline: 1-855-DRUGFREE.

What are your thoughts about naloxone? How can we train more families to be the first responders? Would the CRAFT approach help your family? Let us know in comments.

If you liked this interview, please share on social media! Thanks.

If you have questions or want more information please reach out, I love to hear from my readers!

from Drug Rehab Treatment Near Me https://cathytaughinbaugh.com/how-naloxone-can-help-save-lives-meet-pat-aussem/ from Addiction Treatment News https://addictiontreatmentnews.tumblr.com/post/174091545387

[addictiontreatmentnews]

How Naloxone Can Help Save Lives: Meet Pat Aussem

Naloxone can be a life-saving drug for someone in an overdose situation from opiates.

Pat Aussem has helped families in New Jersey by creating a much-needed naloxone training. If your child is having a hard time with opioids, be sure to get trained and have a naloxone kit on hand. 

I’m delighted to share Pat’s interview! She provides information on naloxone as well as the CRAFT approach.

Please welcome Pat Aussem!

For people who don’t know you, could you briefly tell a little bit about yourself and how you became involved with families who have substance abuse issues?

Sure, about 15 years ago or so, my son was struggling with depression. He was diagnosed with ADHD and was having some difficulties with school. My husband and I realized that he was very depressed, so we started taking him to therapy.

It wasn’t long after that before I realized he was also smoking pot. His use escalated. So did our treatment protocol. We went from individual therapy to an outpatient program. He then attended a residential treatment program where he spent almost four months.

When he was discharged, we realized that we had to help him change so many aspects of his life to sustain his recovery. We worked hard at finding a different school, different friends for him to socialize with, and different activities. For a 16-year-old that is hard to do.

There was the prom, the weekend parties, the football games. They would have been toxic for him. I didn’t know anything about addiction at the time, or what recovery entails. I spent a lot of time getting educated about it.

As families learned about our experiences they began to call me, much like they call you Cathy, asking, “What did you do? How did you do it? Where did you go for treatment? How did you know what to look for in a treatment program?” and all those sorts of questions.

I started trying to answer them but felt like I didn’t have the training and the knowledge that I needed to do that effectively, or to the degree that I wanted to.

So in 2007, I went back to school and got a Masters in Counseling Psychology. After graduating, I spent the next four years or so working at a psychiatric hospital here in New Jersey. I worked in the detox, rehab, co-occurring disorders, and adolescent units.

My time was spent learning more about substance use and other mental health disorders. I had the intent of trying to help families in particular. That is my passion–helping families. There is so much stigma associated with substance use disorders. Families need support figuring out what to do to get the best treatment available.

I ran into families that could not afford treatment without taking out second mortgages on their homes. Or they were taking money from 401K plans to pay for treatment. If a child had cancer everybody would be doing bake sales. You say “substance abuse” and others give you the cold shoulder.

This has to be different. We have to reduce the stigma and get more funding for research and better treatment. That is why I got into the field.

It is amazing that you have put together a naloxone training for your county which has now spread to other counties in New Jersey. Can you explain what is involved with the training?

It started off as a county program. Now, the program has blossomed to five different counties at this point in the state of New Jersey.

I had been to a county-wide task force meeting dealing with the opiate epidemic. The meeting was all about the actions our county had taken to address the crisis. Our county is actually pretty progressive. They had passed the Good Samaritan Law and the Overdose Prevention Act. Our first responders, our police, and our EMTs would be able to carry naloxone.

I left that meeting thinking “this is great news! The first responders are going to be equipped.” Later, I found out that half of the police departments weren’t carrying it. Of the 63 emergency rescue squads, six of them had it on board, and seven of them were planning on it. The rest weren’t going to for a variety of reasons.

They were concerned about keeping the medication temperature controlled. There was the worry that if someone had overdosed, and if they were revived with naloxone, they would be combative; just all different kinds of reasons. I didn’t think most of them were particularly great.

In any event, it occurred to me that this meant there were a lot of families who were going to be out of luck if their child overdosed.

The family is often the first one there anyway. A friend of mine, Denise Mariano and I set about to create an overdose prevention program with the funding we received from a woman who lost her child to an overdose and the support of the Partnership for Drug-Free Kids.

The program included many different elements. Included was an understanding of addiction, what happens in an overdose, how to recognize the signs, how to administer naloxone, what to do after someone is revived and how a family can help get their loved one into treatment. We also provided families with information on resources including treatment options, funding, and support groups.

How can people become more involved with naloxone training in their state? What are the benefits? Are there any negative outcomes to be aware of when administering naloxone?

There are a couple of different ways to get it. In many states where there is a CVS or Walgreens, you can actually go in and ask for naloxone and get a kit without a prescription. It is over the counter.

Some of them do training, yet it is kind of spotty. My recommendation for families is to go to a site called Get Naloxone Now. They have a wonderful animated training program on how to recognize the differences between an overdose and someone who is high. They explain all the steps that are involved in administering Narcan (the brand name) or naloxone.

It takes you through rescue breathing, what the rescue position is, when to call 911, how to put the nasal spray together, how to use the nasal spray, and the importance of getting emergency help. There is a possibility that the Narcan can wear off and the person can go back into an overdose state.

There is another website called Hope and Recovery. They have a zip code locator for finding naloxone training. Many organizations around the country have put their information into that website.  You can search and find something close by.

Failing that, I would either call a substance abuse treatment center in the local area or the county mental health administration to ask them if they are aware of any training in the area. Often there are licensed addiction counselors as well who might be aware of training. The important thing is to get the training. It is very straightforward, and anybody can learn how to do it.

In fact, there are some newer products on the market. You don’t even have to put the nasal spray together; it comes in an all-in-one piece by Adapt Pharma.

There is also the auto-injector called Evzio. It is like an EpiPen version of naloxone. There are lots of advancements going on in this field on overdose reversals.  But again the most important part is having naloxone and making sure you know how to administer it. Checking the expiration date, as the medication expires after a period of time.

I want to underscore how important it is to get the training for anyone who is dealing with opiates. You will have accurate information about what naloxone can and cannot do. In some of the training sessions that I ran, there were people who thought that naloxone was only for heroin.

It is important to realize it can help in an overdose of OxyContin, Vicodin, Percocet – all opioids. It will not help if another drug causes the overdose.

Since naloxone brings people out of the overdose quickly, is there anything parents need to be aware of? 

The first thing I would say is if I gave you a dose of naloxone right now, all you would have is a wet runny nose, and need a tissue.  So even if you saw someone who was not doing well, and you gave them naloxone, but say they had passed out from alcohol, it is not going to hurt them. This is a very benign drug and there are no apparent side effects in that regard.

In determining that your loved one is overdosing, you want to look for blue lips and fingertips. You want to check for a really depressed breathing rate like less than one breath every five seconds, or a death gargle, and you can’t arouse them. 

If you try to give them a sternum rub with your knuckles on the breastbone or under the nose and they are not responding, you know you have a problem on your hands. An overdose can take a couple of hours to happen, so you may check on somebody and think they are fine, but as time goes by something more dangerous happens. 

The biggest issue in my mind is that naloxone only lasts for 30-90 minutes, so that is the reason a family has to call 911. There is the possibility the person could go back into respiratory arrest. They may need to be hospitalized and need more treatment, so that is something to think about. 

Another consideration is that sometimes a person may need more than one dose. With the naloxone nasal sprays that were provided in our community, families were instructed to give one dose and then wait two to four minutes. If the person was not revived, a second dose was given. 

My understanding is that with fentanyl that is hitting the market, there are instances where you need even more than two doses, so fentanyl can be kind of tricky in terms of how potent it is as a drug. 

Families should know that when a person is revived using Narcan or naloxone, he or she is immediately in withdrawal. They are going to cramp, feel like they’ve got the flu, or like someone hit them over the head with a hammer.  They are going to feel miserable, and sometimes say “I’ve got more heroin or pills over there, get them for me.” You don’t want to do that obviously. 

I would encourage every family to have Narcan on hand regardless of whether opiates are being used as prescribed or abused in their household. There are parts of the country where people get a naloxone kit even if their doctor just prescribed Percocet for back pain or something like that, just to make sure if there is a problem, overdose treatment is readily available.

Once someone has been revived, my concern shifts to thinking about how to help that person get into treatment, because we know if someone overdoses once, their risk level for a second overdose seems to go up tremendously. Getting them to treatment is really important.

That brings me to my next question. I know you are an advocate of the CRAFT approach. How does CRAFT benefit teens or young adults and their families in the short and long-term? How can it help them get their child into treatment?

Many families that I have come across sort of dismiss early substance use as typical teen experimentation, although what we are learning about the teenage brain is that it is so critical not to introduce toxic substances until the brain is fully developed, which really doesn’t happen until someone is in their mid-20s. 

I think parents often try to discipline their way out of the problem and when that doesn’t work, they get lots of advice. The advice goes along the lines of letting them hit bottom. “Why don’t you just detach from them and let them figure it out?” “They have to want it.” and “Why are you wasting your time?”

Even when I didn’t know much about this topic, “detach and let them hit bottom” did not resonate with me. I was watching my son struggle tremendously and I felt there had to be a better way. Through my work at The Partnership for Drug-Free Kids and The Center for Motivation and Change, I learned about CRAFT – Community Reinforcement and Family Training. 

Not only is it an evidence-based approach, it gives parents the sort of tools that they can use to influence their child in a positive way. It helps with engagement in positive behaviors, so instead of just letting your child fall apart in front of your eyes, and then try to pick up the pieces, it advocates intervening and using the influence that you do have in a strategic way.

Using positive reinforcement to try to engage your child in behaviors that you want to see more of is an example of one of the CRAFT tools. I know in so many households, parents that I talk to are focused on everything negative that the kid is doing. They didn’t show up and do their chores. He was late to work. She was smoking last night.  They were disrespectful.

They don’t focus in any way on what the child is doing right. 

It becomes this kind of nagging, pleading and lecturing situation, hoping you can give them one piece, or nugget of information, so they might stop using, and it doesn’t work. 

The beauty of CRAFT is that there are tools that can help you figure out how to get your child engaged in activities that compete with their drug use. It helps in ways to figure out how to collaborate with your partner if you are not on the same page. It allows other people to be the teacher of life lessons to your child instead of you, meaning letting natural consequences play out.  If they get a ticket from the police, you are not trying to minimize that ticket by saying, “Well, I’ll pay for it this time, but don’t do it again.” Instead, you let them learn that lesson. Let them feel the pain of paying the ticket.

All of it is surrounded by what I refer to as “background music,” which are the communication strategies that you can use. The first strategy is really being open to listening to what the benefits of drug use are, which probably sounds strange.

What is your child getting out of using? Is it helping with their boredom, anxiety, or desire to fit in socially? Maybe it gives them a thrill or some sort of excitement. 

It is trying to understand why a child is using drugs and alcohol, and the only way to get at that is to really listen to what your child has to say, instead of nagging and lecturing them. 

Just using different ways to present information, and to recognize and validate how they are feeling, can change the whole dynamic in the family. It increases family cohesion, and in most cases, there is either a reduction of drug use or the person gets into treatment.

The underpinning of all of it is the family’s own self-care and recognizing that if you don’t take care of yourself, it is really hard to engage in this. Sometimes this journey lasts decades, and you need those resiliency muscles to be really strong to do this and it helps to appreciate your own life and other people in your life instead of solely focusing on your child’s problems. 

CRAFT is a blessing. I’ve met Bob Myers who created it. I know you have too, and I think it’s just a remarkable way to approach someone you love and care about to address a disease, as opposed to thinking this is a moral failing on your loved one’s part. 

In many treatment centers, families are told that they are enabling, they are codependent, and they are contributing to their child’s problem. They are not really letting parents know what else they could be doing other than perhaps going to a support group. On the other hand, CRAFT is a very clear way to use the influence that you have as a parent to address your child’s substance use.

It is interesting because some parents think, “Well you know, now that they are a teenager, or especially if they are over the age of 18, I don’t have any influence.”

But they do.

It needs to be used in a strategic way so that you recognize and reinforce the things that the child is doing right, let natural consequences play out, use problem solving and collaboration, and make requests in a positive way — all of these tools and more are part of the CRAFT package.

CRAFT makes a tremendous difference. 

The changes in the family and in the individual parents are really quite remarkable. As you probably know or have encountered, there are so many parents who say, “I don’t see my friends anymore because I am sitting at home waiting for the next shoe to drop,” and that is just a horrible place to be.  You feel so isolated and you wonder what you could have done differently.  “I must be a terrible parent. I can’t figure this out.”

CRAFT is a great way to give parents something that is concrete and constructive and actually gets results instead of feeling shame and isolating. 

Finally, what advice do you have for parents who are struggling with their child’s substance abuse?

A couple of things. One is really doing your homework on what your child is using, what the signs of use are, what the side effects are, and things like that so you really know what this particular drug is doing to affect your child. That is really important. 

It is interesting to me that in many cases for parents if their child had a cancer diagnosis, they would be learning everything there is to know about cancer, but with substance misuse or abuse often there is a sort of apathy or a lack of really digging in and learning about what this does to the brain. What is it doing to their body on a physical level and on an emotional level?

Understand why your child is using and get a sense of why it is important to them. Intervene early and as often as you can because in many cases, it is so much easier for someone to build a life where they have friends, a job, they are in school, or they have their house rather than waiting for all of that to dissipate and then saying, “We are just going to start from scratch.”

Looking for ways to engage your child in activities that will compete with their drug use is important.

Also getting help from people with addiction credentials is important. I know in my early attempts at trying to help my son I didn’t realize that substance use was part of the picture so when we were turning to therapists and psychiatrists I wasn’t looking for someone that had an addictions background. I now know that this is critical. 

If they are using opiates, definitely get overdose prevention training. Also, I would suggest learning about medication-assisted treatment like the use of Vivitrol, which is a once-monthly injection; and Suboxone; which you can take on a daily basis to help with cravings and to help with preventing overdoses.

The last thing I would say is to really work on your own self-care and social supports as well as finding support groups like yours, because I think you learn so much from your peers who are struggling with this as well. You can get a lot of useful information and feel like you are not alone in this.

No parent should be left behind when it comes to a child struggling with drugs and alcohol because there is help out there if you just ask.

Patricia Aussem, LPC, MAC, provides counseling services to treat substance use and other mental health disorders based on the CRAFT model. As a consultant to the Partnership for Drug-Free Kids, she provides clinical oversight, workshops, and training materials for the Parent Support Network, a peer-to-peer coaching service for families negatively impacted by a loved one using substances. For more resources, contact the Partnership or the helpline: 1-855-DRUGFREE.

What are your thoughts about naloxone? How can we train more families to be the first responders? Would the CRAFT approach help your family? Let us know in comments.

If you liked this interview, please share on social media! Thanks.

If you have questions or want more information please reach out, I love to hear from my readers!

from Drug Rehab Treatment Near Me https://cathytaughinbaugh.com/how-naloxone-can-help-save-lives-meet-pat-aussem/

[wavelengthintl]

Catching Up With Karmik: Harm Reduction Amidst The Fentanyl Crisis

Last spring I talked to Munroe Craig, the co-founder of Vancouver-based harm reduction group Karmik, about the basics of harm reduction philosophy.

The discussion centred around the idea that harm reduction is more than the sum of individual acts like pill checking, or creating a safe tent at festivals. At its core, it’s about affecting change at both the cultural and individual levels to empower safe choices.

This also means that harm reduction initiatives have to be dynamic, as substance use and the attitudes surrounding them are constantly changing.

Before Craig and her team head to Costa Rica to work harm reduction at the second Bamboo Bass Festival, I decided to connect with her again to find out what’s changed over the previous year, both with drug discourses and their approach to harm reduction.

This time around Craig is joined on the phone by Alex Betsos, one of Karmik’s co-founders and their volunteer coordinator. Betsos also currently sits on the national board for Canadian Students for Sensible Drug Policy (CSSDP).

“When we last chatted it was a really great chance for us to be at the beginning of what was seeming to be a changing time,” says Craig.

During the previous interview Craig described the then-current drug discourse as a “paradigm shift” that saw substance use becoming part of popular culture and even gaining acceptability in the media.

Now, she says, this is provoking a change within governing bodies and a new wave of activism.  

“I think that some of the things that have changed is actually the talk about drug policy. Some of the progressive pieces that we’ve seen are focused around political officials and health officials; we have more people standing up and taking notice, even if that stepping up is starting with asserting ourselves and identifying that proactive, progressive drug policies are needed,” she says.

Nowhere is the dynamic nature of harm reduction more apparent than the fentanyl crisis, an issue that’s risen to the forefront of public discussion over the past year and left some officials scrambling to develop a response.

“A couple major things have happened since March,” says Betsos.

“One, Health Canada sought consultation to make naloxone more easily accessible, and that was responded to with an overwhelming, ‘Yes, please do that.’ ”

Naloxone is a medication used to treat opiate overdoses, currently sold under the brand name “Narcan.”

“I think that was a very good first step because it means that people have easier access to Narcan kits, which they didn’t necessarily have before,” says Betsos.

“One of the issues that’s coming up is so many people want Narcan kits because they’ve either known someone who’s had an overdose, or they’ve heard about fentanyl being cut into other substances and they want to make sure they’re safe.

“It’s created this new level of awareness which has been pretty fantastic.”

This new demand led Karmik to recently begin training sessions for the administering and usage of the kits.

Another major event occurred in June, when Betsos and Craig were invited to participate in a panel on overdose prevention held by the B.C. Centre for Disease Control.

“There’s definitely this change in awareness; both with the individual substance use level, but also we see public health is really trying to deal with this and catch up to the problem,” says Betsos.

Both Betsos and Craig agree that public health being put in the position of having to “catch up” signals one of the biggest flaws in how policies deal with substance use.

“We need proactive policies and support, not primarily reactive,” says Craig.

“When somebody has an overdose, responding with naloxone can be considered proactive; we educate individuals prior to situations occurring with an overdose, providing them with the tools to support. However it is also considered primarily reactive.

“Naloxone is what we respond with to an overdose situation, but it is not addressing the root cause which is why someone is overdosing to begin with.

“So I think that naloxone is really great, and it’s a step in the right direction, but we need to have more broader harm reduction policies as a whole.

“People have naloxone support and training, but we still have friends, loved ones and family passing away, often with naloxone in their hands.”

Some proactive initiatives that harm reduction activists have long been campaigning for include lobbying for substance decriminalization, launching public awareness initiatives, and working to reduce the stigma that users often face when dealing with public health officials.

These initiatives are favoured over prohibition because, as Betsos points out, prohibition can maintain the same situation currently being seen with fentanyl.

“It’s not like fentanyl came out of nowhere and hit the scene because Oxys [Oxycodone] became Neo [controlled release] Oxys,” says Betsos.

“It already happened before. It’s part of this constant process of drug-prohibition where, because we have all of these drugs prohibited, the cheapest substances that are the easiest to cut into other substances are always going to try to make their way onto the market.”

Similarly, Craig believes that without fundamental shifts in drug discourse, substance-related epidemics will continue happening.

“This substance could be anything,” says Craig.

“Fentanyl is absolutely a cause for concern. The amount of fentanyl that we need to take in order to overdose is much smaller and the substance increasingly potent, especially with synthetic analogues of fentanyl being created at an alarming rate.

At the same time let’s remember that illicit substances being adulterated is not a new thing, this happens all the time.”

The current climate has created a sentiment of fear, with some media outlets either declaring this as the most dangerous time to do drugs, or urging people to avoid drugs entirely. Betsos refers to this as fear mongering, and it creates the illusion that drugs will be safe again once fentanyl leaves.

“It’s actually recreational users that we’ve been seeing the most overdoses with, and we’ve seen an increase in that, so if that’s your metric for the most dangerous time to try substances then maybe it is there,” says Betsos.

“But, I think that’s kind of a sticky way of thinking about it, because it implies that there was a time when there weren’t overdoses, which is not true, and it also implies that there aren’t risks associated with taking substances.”

Rather than join this rhetoric of drug avoidance, Karmik is dealing with the issue by using their training sessions to engage the community.

“I know that what we’re talking about with naloxone, it can seem like a big, deep dark thought,” says Craig.

“You can kind of wormhole all the way down there to where you might feel really scared, afraid, anxious and concerned.

But really, let’s also understand that what we’re doing is actually proactive as well.

We’re empowering and engaging people and their communities to accurately respond and take care of one another.

“We’re increasing the capacities for communities to become more self sufficient as individuals, and lets face it, individuals who are healthy create healthy communities, and that’s also what we’re trying to do.”

The people who attend these workshops then return to their own networks and relay what they’ve learned.

“They’re so happy to put a picture on Facebook and say guess what everybody, I have that kit and I’m here for you. If you need something let me know, and when I go out to an event you’re going to know that I have this kit,” says Craig.

Our interview last March ended with an optimism that harm reduction policies were gaining more traction in both the public and political spheres.

This optimism is still there, but Craig points out the irony of requiring a grave catalyst like fentanyl to initiate discussions, something she hopes will change in the future.

“Why do people need to die or be severely threatened for us to want to change harm reduction policies, support, funding, and possibly start to look at stigmas around substance use,” says Craig.

“Why do we need to have such a very aggressive result happen, or such a very final result happen for us to even look at changing any of these policies, or for them to even garner any attention?

“Karmik has been doing harm reduction work not because people are dying all the time, but because we know it’s an important and significant piece of public health.”

Learn more about Karmik and donate to them at http://www.karmik.ca/

Words by Jonathan Crane Follow Wavelength on Facebook at https://www.facebook.com/WavelengthINTL/