Todays Date:
Inspiring Success on the Road to Recovery

Monday, October 31, 2016

An Ethical Compass

Navigating the Maze of Addiction Treatment

By Carey Davidson, MAC, CIP, ICADAC, CAI
At two years sober, I thought I had all the answers. I was heavily involved in my 12 step program and felt incredibly confident in my recovery. I started to gain notoriety in the recovery community, and when people were in crisis, they knew I was a solid resource to whom they could turn for help. I was, and still am— passionate about confronting the disease of addiction. 
“Why not?,” I thought. So, I did it. I printed up cards and called myself an “Interventionist.” It was easy. I recalled when applying for my real estate license, I was required to be finger printed and participate in a background check. However, all I needed to do to guide vulnerable patients and their often desperate families through this life-threatening disease was print up a card.
Without the proper training and certification, I had only one tool— my own recovery experience. I placed many people in treatment, but I’ll never know the extent of damage I may have caused families along the way.

Luckily, after a couple of tough cases in a row, I realized my approach, while legal and extremely common in the field, was not in the best interest of those I served.
Families depended on me to guide them and their loved ones into recovery. The course of their lives would be significantly impacted by my guidance, and the work I had done in my personal recovery program ‘could never substitute for the formal education and clinical training I knew I needed’. 

Consequently, I enrolled in the Hazelden Betty Ford Graduate School of Addiction Studies, where on the first day they inform you: “If you are looking to get your Masters in the 12 steps, you’re in the wrong place.”

To fulfill my passion to helping others I went back to school and earned a Masters Level degree in addiction studies and counseling, which included rigorous academics and more than 1,200 clinically supervised hours working with patients. I dedicated myself to education because, although my passion for this field hadn’t changed, my responsibilities to struggling families extended far beyond a simple desire to help people. If I was going to offer myself as a credible resource to the vulnerable, I had to become a trained professional with a solid clinical background.

One key difference between a trained professional and a layperson is that a layperson works solely from personal experience and a professional works from an empirically-evidenced theory. 

The Families of those in Need

While I can never “undo” what has been done, I have had to own some difficult truths as I’ve moved forward in the field. I now find myself hyperaware of the many untrained interventionists around me who, unfortunately, continue to do harm. 

Family can be the most powerful and motivating force in an individual’s life. Those traits, amplified in crisis, can be a family’s greatest asset or liability. There are those in this industry who capitalize on this vulnerability in an unethical manner. It is essential families are able to place their trust in capable, educated, and accountable specialists. 

However, because the behavioral health field is so vast, multi-faceted, and unregulated, it’s difficult to know where to begin. Let this article serve as an ethical compass for you to use when navigating the treatment world.

Questionable Treatment Placement Practices

The point at which your life, or life of someone close to you becomes too unmanageable to handle alone feels unprecedentedly vulnerable and frightening to most families. You want to trust anyone who promises a treatment or, in some cases, even a miracle cure. Because you want so desperately to believe what these self-proclaimed “professionals” say, your judgment can understandably become impaired.

A Surge of New Professions

It is crucial everyone be aware of the many questionable treatment placement practices that currently exist in the U.S. The 2008 Parity Act and Obamacare made treatment for mental health and substance use more accessible for millions of people.

Consultants, patient brokers, marketers, treatment placement specialists, and other creative professions surged, often, without formal training for those espousing these titles. While these workers are called different names, they serve the same function: to put “heads in beds.” They are people who, through one method or another, receive kickbacks for getting a patient into a particular facility. These so-called professionals make their money directly by placing someone into a specific treatment program who pays them a “bounty,” a “marketing fee,” or “reward” for “placing” the person with them. “Patient Brokers,” in effect, broker lives for cash.

Interventionists and Treatment Professionals 

My intent is not to discredit the challenging and indispensable work of interventionists (or anyone else working in the field). After all, I am one. I married one. However, it is crucial to know there are individuals without any formal behavioral health education, certification, license or clinical training who claim to be “interventionists” or “addiction specialists” that “work” in the addiction field. This is dangerous. Just because a person has been through recovery and/or has watched every season of Intervention on A&E, it does not follow they are qualified to be an Interventionist. While unfortunately legal, it is as reckless as watching Grey’s Anatomy, buying an ambulance, and calling oneself an EMT.

When considering employing the services of an interventionist, or ANY TREATMENT “PROFESSIONAL” involved in recommending a treatment program and involved with patient care, questions must be asked to ensure you find yourself in capable, educated, and ethical hands. 

What is the professional’s relevant education? What are their certifications? Does any board license them? How long have they been doing what they do? What qualifies them to make recommendations? 

For example, if an interventionist is not able to identify and specifically describe what they do or the intervention modalities they believe would be most effective and why, do not hire them. 

If a person who is recommending a treatment center can’t give clear criteria as to why they are recommending a particular center, find out more. Ask if anyone receives any kind of financial compensation or incentives for referrals and/or placement. 

Just because someone calls themselves a “professional addiction whatever,” does not mean their decisions are not financially incentivized. 

“Kickbacks” have become rampant in the intervention world and can prevent a person from being placed in a program that’s best fit for their needs. Kickbacks can be in the form of money, gifts, or anything that would encourage someone to recommend one program over another in exchange for compensation. 

A Parallel Situation

Your doctor tells you he has discovered a potentially life-threatening tumor in your brain and surgery is required. You panic. You don’t know anything about neurology, let alone a good neurologist or neurosurgeon with experience in tumor removal. You want the best option available, so you ask your doctor to recommend the best neurosurgeon in town. 

He or she knows of two neurosurgeons who specialize in the type of procedure that could save your life. One does a decent job, but has recently settled a malpractice suit. Due to the lawsuit, this surgeon’s referrals have decreased and he’s mentioned he would be willing to give your doctor a ‘cut of the profits’ for any surgery sent his way. The other neurosurgeon is highly respected — one of the best in the field. Her schedule is often full and services are in high demand, but your doctor has a good relationship with her and knows he can ask her to find time to perform the procedure. 

Your doctor writes down the name and office number of the first neurosurgeon and tells you, with a reassuring smile, he’s the better option. You walk out of his office unaware your wellbeing was just compromised for financial gain. 

This scenario seems almost too ridiculous to take seriously, but why is that? First, this is a violation of Stark Law (starklaw.org). Second, it’s difficult to fathom a medical professional would compromise the quality of a life-saving decision because of money. Why is mental health and substance abuse any different if we are, in fact, treating a disease? 

This happens to families every day. Most states do not have equivalent laws for non-professionals working in the behavioral health field, and those that do rarely enforce them. 

Who is paying the Addiction Treatment Professional?

If someone offers their services at no charge, more often than not, this is a red flag. 

If someone isn’t asking you to compensate them for their services, this often means someone else is. They are fully employed, contracted, or financially incentivized by a specific facility, and they have a professional and monetary obligation or “motivation” to recommend clients to a specific program(s). 

An independent professional depends upon being fairly compensated or will not mind telling you how they are compensated if it is other than by patients. A best practice would be to use independent professionals are compensated directly by the families they serve. 

Again, I implore you to do your homework. These questions may seem blunt, but a professional worth hiring will not get defensive, will answer directly, and will appreciate your asking.

Levels of Care

Addiction treatment has its own vocabulary, often difficult to decode and understand. There are so many acronyms it often sounds like you’re listening to a two-way radio in a police car: IOP, residential treatment, PHP, sober living, OP, extended care, transitional living, day treatment, peer driven care, half way house, gender specific, dual diagnosis, SA, NA, ACOA, trauma informed care, and the list goes on. 

Even if you are in a best-case scenario and are sitting across from an ethical professional who is giving you excellent treatment options, it can still feel impossible to make a decision when you don’t understand the language. Furthermore, how can you accurately assess the quality of services when you have no frame of reference for what the baseline should be?
The following is an overview of levels of treatment care. You can determine how they are differentiated in greater detail by researching the American Society of Addiction Medicine (www.asam.org) and identify the differences and approaches in each level of care. 

Medically-Managed Intensive Inpatient Services:

This most frequently takes place in the “psych ward” within a hospital setting. If a person has had a suicide attempt, is found to be of harm to themselves or others and placed on a mandatory hold, or has experienced a psychotic break, this is where they will be admitted, stabilized and then transported to another facility.

Medically-Monitored Intensive Inpatient Services

Takes place in a residential treatment setting, provides 24 hour care monitored by nurses, physicians, and credentialed clinicians. In layman’s terms, this is what allows some residential programs to be able to provide a safe medical detox program on the same campus where they provide a residential program. Once a person has been medically cleared and clinically stabilized, they are phased down to the next level of care. 

Clinically-Managed, High Intensity Residential Services

A 24 hour, structured environment. Again, changing levels of care does not always mean changing a physical location. It is entirely possible to have three levels of care provided within the same campus. The distinctive element to this level of care is that it is non-medical and clinically managed. The programming provided is focused on maintaining abstinence from substances, delivering intensive therapy, and developing the skills necessary to accept responsibility and promote positive character change. 

Clinically-Managed, Medium-Intensity Residential Services

This is also known as extended care and is used to bridge the gap from an intensive therapy schedule in a residential setting to an intensive outpatient program (IOP). It maintains a level of care, but with a lesser amount of therapeutic programming. 

Partial Hospitalization (PHP)

If someone is enrolled in a Partial Hospitalization (PHP), they require daily monitoring. A person can participate in a PHP while also living in an extended care facility or sober living home. 

Intensive Outpatient Programs (IOP)

Intensive outpatient programs (IOP) requires nine or more hours of structured counseling and education services per week. Psychiatric and medical services can be scheduled in addition to programming but are used as needed. This level of care can be utilized at the same time a person is living in a sober living environment. It is best practice for this level of care to follow residential treatment. 

Outpatient Treatment Services

To be designated Outpatient Treatment Services, clinical interaction falls to a level of fewer than nine contact hours per week.

Low-Intensity Residential Services 

Low-Intensity Residential Services are better known as Sober Living Environments and were formally known as Halfway Houses. Clinical programming drops down to around five hours of professional addiction services per week. The main focus is reintegration back into work and society while maintaining a structured living environment.

“There are many levels of care available to individuals in need, and they all offer different services. While there are many treatment programs — not all hold themselves to the same ethical standards.”

As you can see, there are many levels of care available to individuals in need of treatment, and they all offer different services. While there are many treatment programs.... not all treatment programs hold themselves to the same ethical standards, nor do they offer the same clinical regime or enforcement of standards, and regulations of marketing strategies are lax at best.

Basic Questions to Providers

An example: What is the treatment setting? Describe your physical plant or campus. Is everything in one place in a “campus” setting 24/7?

If they are housing patients in one place and transporting them to a different location or “center,” the facility is likely getting combining IOP, or other levels of care, with an off-site sober living facility and marketing it as “residential treatment.” While many people get help this way, it is often not what a person expected when they agreed to seek treatment. 

While this is not a complete list of questions to ask a treatment provider, it’s a start:

  • How is your program licensed? (Residential, IOP/ PHP or ?)
  • What is the length of the program?
  • What do you do for detox if needed?
  • Where are your services provided?
  • What is a typical day in your program?
  • What is your relapse policy?
  • What is your maximum patient capacity?
  • How do you work with co-occurring issues?
  • How many on your treatment team have Masters Level or above educations?
  • Are there medical personnel on-site 24/7?
  • What does insurance cover?
  • What is your cash pay cost?
  • If a client leaves treatment early, is there a refund for unused amount
  • What age group/gender do you serve?
  • How many one-on-one sessions does a client have with Master’s Level or above clinician per week?
  • Is the client expected to prepare their own meals (sober living level) while in treatment?
  • How often do you drug test?
  • Are phones and computers allowed?
  • Is there a family program? If so, please explain.
  • Do you have an MFT on staff (Marriage and Family Therapist)
  • Is there an aftercare program?
  • How does the treatment provider measure “success”?

Insurance and Treatment

While treatment centers all have a cash price, some accept in-network insurance benefits while others either file out-of-network benefits on your behalf or provide you with a super bill (an itemized list of services provided and cost) at the end of your stay. Once a super bill is provided, the patient or policyholder can file for out-of-network reimbursement on their own behalf.

Each treatment center accepting in-network insurance has a usual and customary rate that determines part of your reimbursement. Usual and customary rates vary based on geographic region and are based on what providers in the area usually charge for the same or similar services. For example, if a treatment center offers in-network coverage and has a daily usual and customary rate of $375.00 - your reimbursement is calculated base on this rate. If your plan reimburses 80%, it will reimburse 80% of $375.00 per day. Out-of-network providers are not bound to usual and customary rates as defined by geographic region and can set their fee for services at whatever rate they like - although most (not all) stay close to the usual and customary rate for that reason. Let's say you are using an out-of-network treatment center and they have set the daily rate at $500.00 and your plan reimburses 20%. Your plan will reimburse for 20% of $500.00. 

Whether you are using in-network or out-of-network insurance, the patient or policyholder is responsible for the amount owed that is not covered by your insurance. 

In-network insurance can greatly reduce the cost of treatment. Most insurance policies require that a policyholder meet a deductible before the insurance benefits will take effect. Once the deductible is met and pre-authorization (if part of your plan) is obtained by the treatment center, in-network insurance can be used to cover up to 80% (in most cases) of the usual and customary rate. Once the deductible and out-of-pocket minimum is met, insurance can cover up to 100% of services at the usual and customary rate. 

Out-of-network insurance works in a similar way to in-network, although out-of-network providers can choose to not file on your behalf and simply provide you with a super bill that you can use to file at the end of treatment. Pre-authorization for services is still required for most plans and cannot be obtained until a person has entered a treatment program. Out-of-network insurance usually reimburses at a much lower rate than in-network insurance and often has higher deductibles and out-of-pocket minimums. 

Addiction and recovery impacts the life of an addict and everyone that is around them. 
Sadly, it can become Caveat Emptor, or “Let the Buyer Beware,” when it comes to navigating the world of addiction treatment. 

Find a qualified professional to help you. People do get better from addiction; the right treatment and treatment provider can make all the difference in the world. Do your homework, and ask the right questions. It can truly be a matter of life and death.

Carey Davidson is a Board Registered Intervention Specialist and Certified Intervention Professional. He holds a Master’s Degree from the esteemed Hazelden Graduate School of Addiction Studies. Carey is President of the Network of Independent Interventionists, sits on the Board of Certification of Addiction Counselors, and is a member of the Association of Intervention Specialists. Carey is trained in all models of intervention and practices only proven addiction intervention methods, implementing the best combination of techniques for each individual intervention. His focus is on helping people that care about someone struggling with substance abuse. Contact Cary Davidson at 800-219-0570 and visit www.hayes-davidson.com.

Curbing Opioid Addiction Through Executive Order

Curbing Opioid Addiction Through Executive Order
On October 24, 2016, Governor Doug Ducey marked the kickoff of Red Ribbon Week by signing an executive order that limits the first fill of addictive prescription opioids to 7 days in all cases where the state is the payer.
The measure limits all fills for children, except for those with cancer, chronic disease and traumatic injury.

“This action is essential to help prevent future drug addictions,” said Governor Ducey. “The numbers are staggering. In 2015, 401 people in Arizona – more than 1 a day – died from prescription opioid overdoses. In 2013 there were enough prescription pain medications dispensed to medicate every adult in Arizona around the clock for two weeks.

“These large prescriptions of highly addictive substances are incredibly dangerous, and we have to take action now. By limiting the fills of prescriptions for all state health plans, we hope to encourage private companies to consider similar action.”

Ducey also noted that children in particular are susceptible to addiction.

“We’ve got to do more to protect our kids from these addictive medications. I recently learned about a young boy who had his wisdom teeth removed and was sent home with a 30 day supply of opioids,” said Ducey. “This has to stop. These large prescriptions of highly addictive substances are terribly harmful for everyone, but especially for our young people.” (Source: http://azgovernor.gov

Hot Topics

Governor’s Office of Youth, Faith and Family Awarded $50,000 Grant to Help Address Opioid Epidemic

Governor Doug Ducey announced that the Governor’s Office of Youth, Faith and Family (GOYFF) has been awarded a $50,000 grant from the Corporation for National and Community Service (CNCS). The grant will be administered by the Governor’s Commission on Service and Volunteerism to help address Arizona’s opioid crisis.

The funding will enable the commission to assist eligible organizations in applying for future AmeriCorps grants focused on combating the opioid epidemic.
“This grant will go a long way in ensuring that good organizations have the resources they need to help those suffering from substance abuse,” said Governor Ducey. “There is a nationwide opioid epidemic occurring right now and Arizona is taking significant measures to stop it in its tracks. This is the latest win in an ongoing battle. This administration will continue to fight and work alongside community partners to curb opioid abuse in Arizona.”

“In 2015, Arizona experienced more than 1,100 acute drug overdoses,” said GOYFF Director Debbie Moak. “Our goal is to prevent as many overdose deaths as possible and to ensure that all Arizonans suffering from substance abuse have access to the treatment and support services they need.”
CNCS’s mission is to improve lives, strengthen communities, and foster civic participation through service and volunteering. Through AmeriCorps, Senior Corps, the Social Innovation Fund, and the Volunteer Generation Fund, CNCS has helped to engage millions of citizens in meeting community and national challenges through service and volunteer action.

Governor Ducey signed two bills last session aimed at preventing and treating opioid addiction in Arizona.

SB1283 targets “doctor shopping” by requiring physicians in Arizona to access and update the Controlled Substance Prescription Monitoring Program (CSPMP) database before prescribing a controlled substance to a patient.

HB 2355 allows a pharmacist to dispense Naloxone without a prescription to a person at risk of experiencing an opioid-related overdose, a family member or community member in a position to assist that person.

Meadows Out Patient Center in Network

The Meadows Outpatient Center is now an in-network provider with Blue Cross Blue Shield and Humana insurance carriers making The Meadows' cutting-edge services and resources accessible to more people than ever before.

"Many people in the community have wanted to be able to utilize The Meadows quality care, but before today, could not for various reasons. Now an in-network provider for BCBS and Humana, these people have access to the same state of the art quality of care available at a Meadows' facility" says Jim Corrington, Jr., MSW, LCSW, Director of Outpatient Serices.
"This is a huge development that will open the door for many people to admit directly to one of our comprehensive outpatient programs and receive high quality treatment for addiction and trauma."

Outpatient Program Services

Patients benefit from up to 20 hours of available services per week, which can include:
12 hours of group therapy weekly
1-2 hours of individual counseling weekly
Psychiatry consultations
BrainPaint Neurofeedback
CBT, Somatic Experiencing
EMDR and Acupuncture
Brain Spa open all day
Expressive art therapy
Trauma-sensitive yoga
Sexual Addiction/Intimacy Disorders
Claudia Black Young Adult IOP—18-26 years of age
Family Involvement and Family Recovery Group
Multifamily Group and Aftercare
Recovery Enhancement Group
Inspired Recovery Alumni Group
For information or an immediate need, 800-244-4949 or visit https://www.themeadowsiop.com.

Are Study Drugs Helpful or Harmful?

Teens’ lives today are jam-packed and many are stressed out and anxious. Instead of coping in healthy ways, some are abusing prescription stimulants not prescribed to them — also known as “study drugs.” These are medicines that are used to treat Attention-Deficit Hyperactivity Disorder (ADHD) such as Adderall, Concerta and Ritalin — but are abused to pull all-nighters and cram for exams. Most don’t see this behavior as risky. But stimulants that are not prescribed to them? Is this safe or are there real dangers?

The data is showing overall stimulant medications do not improve your cognitive performance. If you have someone that is performing optimally, and you give them a stimulant, the performance may deteriorate.

If you’re giving stimulant medications to a kid that doesn’t have ADHD, at the time in their life when their brain is developing very rapidly that may interfere with those developmental processes.

When someone is abusing stimulants, the effects can be not very dissimilar to those that you observe with cocaine or methamphetamine — all of these are stimulant drugs.

When you are dealing with adolescents, which is the period of higher risk, that’s why you have to be particularly careful, because even though they may not have the genetic vulnerability, they’re at a stage in their life where exposure to drugs can create changes in the brain that may result in addictive behaviors.

Stimulant abuse can produce full-blown psychosis. So you can end up in an emergency room because you are basically completely paranoid. It can be very severe, and devastating to the person. It does have deleterious effects.

New Program Fights Substance Use in GLBTQA Young Adults

By Wesley Perdue, MS, MAC
Building Blocks Counseling (BBC) has been awarded a contract with MMIC/AHCCCS to provide intensive outpatient substance abuse treatment services to young adults ages 18-25, who identify as LGBTQ or a supportive ally

This program is offered at no charge to those receiving MMIC/AHCCCS, and is also available to others with insurance, or those paying privately.

“It is estimated that between 20 percent to 30 percent of gay and transgendered people abuse substances, compared to about 9 percent of the general population,” (Hunt, J. Center for American Progress. 3/9/2012).

A combination of factors can impact this dynamic, and vary from study to study, but common factors often include: the influence of stress from stigma and discrimination, a lack of cultural competency among those in social services who are trying to assist, and the fact that a great deal of socialization among this community takes place in bars and nightclubs, due to the sense of belonging and safety people feel while in these environments.

At the heart of its mission, BBC strives to meet the needs of those who are often the invisible, feared, discriminated against or misunderstood members our society. Whether it be a member of a gender or sexual minority, a person who is homeless or struggles with unstable or insufficient housing, or someone who was formerly incarcerated and is now returning to the community, learning how to be a successful and integral part of society…BBC is that community partner, ready and willing to assist.

As part of its commitment to these young people, BBC has partnered with one-n-ten, a local organization focused on serving the needs of LGBTQ youth and young adults for more than 23 years.
Two former co-chairs of one-n-ten are part of BBC’s leadership, and share deep personal concern and commitment to serving the needs of these young people. one-n-ten staff will also be providing ongoing cultural sensitivity training to the BBC staff, and referring young people in-need to these services.

BBC is located at 4225 W Glendale Avenue, Ste. E-108, Phoenix, AZ 85051. 602-626-8112.

Get to know one·n·ten

one•n•ten envisions a world where all LGBTQ youth and young adults are embraced for who they are, actively engaged in their communities, and empowered to lead.

The mission is to serve LGBTQ youth and young adults ages 14-24, to enhance their lives by providing empowering social and service programs that promote self‐expression, self‐acceptance, leadership development and healthy life choices.

one•n•ten is a nonprofit organization dedicated to serving and assisting lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. We provide youth with tools to improve self-esteem and self-acceptance.

Youth range in age from 14 to 24. We create a safe space, mentally and physically, for youth of all socio-economic and cultural backgrounds. Our weekly discussion groups cover a wide range of social, educational, health and community issues.
For more details visit onenten.org

The Current State of R e c o v e r y A d v o c a c y

by Angie Geren

Our country is experiencing a climate where addiction is at pandemic proportions. 

It is said that 1 in 3 families are directly touched by addiction. The Office of National Drug Control Policy estimates the number of fatal drug overdoses are closer to 140 people daily. According to the National Institute on Drug Abuse, “there were just over 2.8 million new users of illicit drugs in 2013, or about 7,800 new users per day. Over half (54.1 percent) were under 18 years of age.” 
To say our society is in an addiction crisis is an understatement.
I often get asked who I believe is to blame for the rise in these figures — the doctors, parents, government, etc. My answer of “society in general is to blame” usually surprises them! Addiction doesn’t happen in a bubble, it takes many interwoven factors to create the current state of our nation. Our children are facing stressors like we’ve never seen before; more school pressure, less sleep, less community, broken families, and a culture that believes that there is a pill to fix anything that ails us. It is a “perfect storm” to, in essence, breed addiction in all forms.

How do WE Change this? 

It seems like a huge undertaking, how do we change something that is so pervasive, reaches so many people, and the backbone is a society in which effectively acts as the precursor to one of the largest health crisis ever? The answer — Advocacy, which is: the act or process of supporting a cause or proposal: the act or process of advocating something.
I’m sure everyone in recovery can remember the person or persons who were their biggest advocates during their journey. They played an integral part in supporting us, cheering us on, and were our motivation when recovery seemed so far out of our reach. They stood as our lighthouse, guiding us and being the ever present constant that we knew would help us find our way.
What society needs now is for all of us in recovery to be that advocate for those who may be first experimenting with drugs and alcohol, who may be getting their first prescription of opiates for a dental procedure, for those who are falling in love with the best friend they never dreamed was possible.

Advocacy is not just about lobbying for new laws, holding events, or speaking to a room full of people. Advocacy is as simple as standing up and being seen, highlighting that not only is recovery possible, but also we are normal, everyday people. As the crisis has grown there are many national groups who have risen up to help support these efforts; Facing Addiction, Shatterproof, Addiction Policy Forum, Faces and Voices of Recovery, Young People in Recovery, and many state specific groups. These organizations are all different, their own niche, however, they are all invested for the same reason: to educate society, to show what recovery really looks like, and to instill hope — we can change the conversation from addiction to recovery.
Remember when you first entered recovery, what changed? What was the conversation you heard over and over again? I bet it entailed possibilities, highlighting what recovery could do for you, magnifying hope and a new way to live. If we are ever to change the climate we are in, it will involve speaking a new language and changing our focus from addiction to recovery in society’s eyes.

WE are the change, WE are the only ones who can truly shift the paradigm. WE are the ones who give hope to the 16 year old who realized that what started out as partying has morphed into a beast that refuses to be caged. It is time for all of us to come together, one voice, to stand up and advocate for those who have no idea that recovery will bring them more joy and peace than the substances they are using.

If we continue to only speak about recovery in the rooms or with close friends and don’t come out of the shadows, we are then complicit to this pandemic growing and feeding into the perpetuating myths that addiction only happens to “other people.” It is OUR time, we need to be the voice for those with none, we need to be the lighthouse for those searching, we need to be the driving force to change the conversation, we need to stand up and say, “I’m in recovery and I refuse to stay silent anymore.”

Angie Geren, Executive Director of Addiction Haven, empowers individuals and connects communities by giving a voice to the voiceless and providing hope to the hopeless. Angie knows first hand the heartache, shame, guilt, and judgment that addiction brings with it and this fuels her passion to bring love back into the equation. Angie’s own struggle with addiction, her daughter’s self harm, and brother’s death from overdose has inspired her to lead online family support groups, lobby for better laws, advocate for parents. She is committed to changing the conversation surrounding prevention, treatment, and creating recovery ready communities. Visit http://angiegeren.com/

Your Self or Selfie?

By Coach Cary Bayer www.carybayer.com

Recently I enjoyed a day of tennis matches at the U.S. Open with my cousin, when my body told me it was time to do my evening meditation. A match just ended, and there would be time before the players for the next contest would come on the court and warm up before launching 125-miles per hour bombs at each other.

Before I closed my eyes to meditate, I noticed quite a few of the fans in the stands lighting up with big smiles for their iPhones as they took a number of selfies with the tennis court in the background. It was their way, I suppose, to let the world know through Facebook they were in the same building as Roger Federer and Serena Williams. They were using this downtime for a selfie, while I was about to use the gap in the action to connect to my higher Self. That’s when the idea for this column dawned in my consciousness.

Clearly I was in the minority. as each of a dozen or more people wanted to photograph his self while I wanted to contact my Self. As my mantra brought me inward, it further dawned on me that a selfie should be renamed a “bodie,” because it only captures your body, not your Self. If you want to capture your Self, I thought as my consciousness got quieter, my mind both stiller and more expanded, then why not just meditate. I define meditation as a method for the busy mind to become the serene Self. Meditation is really the selfie. But let’s spell that Selfie with a capital S, because it captures a connection to your higher Self, not your lower self.

As a species, we seem to love the image, and crave it over that which is imageless, like the higher Self, which can be located at the depth of your mind. Hinduism, with its extremely colorful pantheon of gods, appeals to more than 1 billion people, while only 14 million people are Jewish, a religion that forbids the use of an image to depict the Higher Power. Those are interesting numbers, according to numbers presented by the Pew Research Center’s Global Religious Landscape in 2010.

It’s pretty much the same situation with regard to sound and silence. Music is among the most popular art forms in the our century. There are network reality shows like “American Idol” and “The Voice,” but there doesn’t seem to be a single program on network TV or elsewhere about the silence that underlies music. About 50 million people watch these shows. As a lover of music, I think this is great. But as a lover of meditation and the silence that is the foundation of all music, I await the day when equal numbers of people tune in to a TV show that shows them how to tune in to the delicious silence of their higher Self. There’s a lot of drama and competition in these shows, and anxiety for the contestants and the millions of people who vote for them. Silence is different from anxiety. Blaise Pascal, the French philosopher, put it brilliantly, “All of humanity’s problems stem from man’s inability to sit quietly in a room alone.”

Imagine a show called “American Idle,” which might feature a man and his ability to sit quietly in a room alone. This wouldn’t be the entire show, of course—too many people would liken it to watching paint dry. Such a program might show how people sitting quietly in a room get great insights, energy, creativity, and live dynamic lives that makes a difference for others, as well.  When “American Idle” becomes as popular as “American Idol,” an age of Enlightenment might dawn in our country. The U.S. might then become the united states of consciousness—higher states of consciousness, in which the selfie photograph is replaced by the Selfie contact and experience.

How to Get Paid Big Time for Your Creations

by Alan Cohen

Meryl Streep is considered by many to be the world’s greatest living actress. To date she has garnered 306 Best or Supporting Actress nominations and 158 wins, including three Academy Awards and eight Golden Globes. Her first Oscar came in 1979 for her Best Supporting Actress role in Kramer vs. Kramer. During the awards ceremony Streep went to the ladies’ room and forgetfully left the coveted gold statue on the toilet seat. For her, acting was the real gold. The trophy it led to was an afterthought.

Truly creative people are more interested in the process of creating than its side effects. They do not create in order to get something else. The joy of creating is reward enough in itself. Awards and accolades are not the goal; they are the by-products of the goal. To dwell in the sacred state of creation is heaven; trying to manage the results is hell. Never deny or withhold your creative gifts. They will pay off first in spirit, and then in the world.

When you know you deserve to be paid for your creative gifts and service, you will be.
Karen Drucker is a talented career musician who grew weary of playing for corporate conferences, weddings, and bar mitzvahs. After many years of performing pop tunes, she longed to launch out on her own, write original songs on uplifting themes, and perform for people who were actually listening. So Karen decided to take a leap of faith and establish a career as a recording and concert artist for audiences attracted to music that nourishes the spirit.
Initially Karen’s venture was shaky. It wasn’t easy to establish a new career in a field less popular than mass music. She got a few gigs, but there was more space between them than she had hoped, and the income was meager.

One day Karen found a musician’s magazine she wanted to subscribe to. On the subscription page she found two rates offered: (1) Regular, and; (2) a discounted rate called Starving Artist. Karen started to check the Starving Artist box, but then caught herself. Wait a minute, she thought. Do I really want to affirm that I am a starving artist?
Karen’s training in new thought had taught her that she would become whatever she thought about herself, and especially how she described herself. She did not want to identify herself as a starving artist who could not afford the regular subscription rate. So she took another leap of faith, checked the Regular box, and paid the higher fee.

Within a few days Karen received a wealth of invitations to perform, and checks in the mail. Her affirmation of herself as a successful artist became a reality. When she purposely checked the box that represented her ideal self rather than her feared self, that is the person she became. Karen went on to become an extremely successful performer for new thought audiences, traveling around the world, earning an excellent income, and receiving awards for her original music. Now she is a well-fed artist.

It is very common for artists of all kinds to think and speak of themselves as starving artists. They do not realize the great disservice they do to themselves and their peers by affirming this lackful condition. Belief systems are reinforced by the spoken word and by agreement. What you call yourself, you become. Take care—great care—to never define yourself or your condition as less than you would like it to be. Always speak of yourself and your work in terms of the ideal conditions you wish to create, and they will follow.

There are many ways you can and will be paid for your creativity, some that go far beyond money. At age 61, Andy Mackie had gone through nine heart surgeries and was taking 15 medications. He was tired of the surgeries, medications, and side effects. So he decided to just enjoy his life, even if his time was short. He quit taking the medications, took the $600 per month he was spending on the pills, bought 300 harmonicas, went into schools to teach children how to play them, and waited to die. When he didn’t die, he did the same thing the next month, and the next. He forgot about dying and started to live.

Andy went on like this for years, using his social security checks to purchase more and more musical instruments, including guitars and drumsticks. Ten years later Mackie was still alive and had used his money previously devoted to medicine to purchase over 20,000 harmonicas and 5,500 music sticks. When he finally left this world, even though his physical heart was worn out, his spiritual heart was fully alive.

Creativity brings life and rewards you on all levels. You can assess your mental and emotional health by the degree of creativity in which you are engaged. Are you expanding and growing? Are you launching into uncharted territory? Do you welcome challenge and change as opportunities to advance? Be true to your creativity, and life will take care of you in wondrous and miraculous ways.

Alan Cohen is the author the bestselling A Course in Miracles Made Easy: Mastering the Journey from Fear to Love. Become a certified professional life coach though Alan’s deeply transformational Life Coach Training beginning January 4. For more information about this program, his books and videos, free daily inspirational quotes, online courses, and weekly radio show, visit www.alancohen.com, on FB Alan H. Cohen (author), and Twitter @alanhcohen

Thanks Giving

What are you thankful for this year, and who are you thanking for it? 

In my world of metaphysics, where we teach that each of us creates our own reality, one could legitimately wonder, “Should I be thanking myself for all the good things and people in my life?”
Still, in the vast majority of homes and in most religions, and spiritual traditions, we thank an entity outside of ourselves, which implies we must have earned or qualified for the blessings in our lives in some odd way. So did those who were not so blessed, not qualify? Who should we be thanking for what?

A Thanksgiving State of Mind

Maybe Thanksgiving is really about something altogether different. It’s really just about a sense of gratitude that implies a connectedness linking us to all of creation. Albert Schweitzer says, “At times our own light goes out and is rekindled by a spark from another person. 
 Each of us has cause to think with deep gratitude of those who have lighted the flame within us. To educate yourself for the feeling of gratitude means to take nothing for granted.”

Author, Melody Beattie says, "Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion into clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow."

Being in thanksgiving and gratitude are acts of living appreciation.

Living in a sense of gratitude changes everything in your life. Notice I didn’t say “living with” a sense of gratitude because to be truly grateful one must embody the feeling, not just be with it. However, is being grateful utterly ridiculous given the circumstances that we are living with today? Not really. There are more consciousness teachers responding to today’s crisis than ever before. There are more books and movies, CD’s and DVD’s on the issues of compassion, integrity and honesty than ever before.

It’s nearly impossible to sit with anyone and not eventually get to the issues of the major changes happening today that ask us to reexamine what we use to think was important. The challenges we are dealing with have created an opportunity for quantum leaping into higher states of consciousness. We are no longer able to ignore the vicious cycle of violence in the world and thousands have joined in the fight against unconscious acts of inhumanity. We are making changes, good ones. An active practice of gratitude can quite literally change the world.

Gratitude and thanks giving are deeply personal. They are centered on our own heart condition and state of awareness. It’s not about being egotistical—but rather humble. It’s about embracing the hard lessons and small joys. It’s about being thankful for a level of awareness that knows how important the people in our lives can be and treating them and yourself with a sense of reverence. It’s about taking care of our planet, homes, and four-legged creatures. It’s about having a sense of the sacred in our personal lives and not waiting too long to express it. For some things, we simply don’t want to wait too long. This is one of them. Gratitude increases a sense of health, expansiveness and wonder.

It pushes at the outer limits of your heart and asks you to change. It’s a journey toward enlightenment.

What and who is it that you love in your life right now? What is it that you could not, would not want to live without? What great lessons have changed the very fiber of your being and pushed your soul forward. What people have stood their ground and stayed through everything? These are the gifts for which me must feel great thanks giving. As John Kennedy said, “As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.”
We are grateful that each of you has given us a way to fulfill our purpose.

Happy thanksgiving and love to all of you from all of us.

Dr. Evan specializes in relationships, personal and professional empowerment, compassion and consciousness. 602-997-1200, e: DrDinaEvan@cox.net, www.DrDinaEvan.com.

To Be or Not to Be.... Grateful

We have a choice on where to focus our attention, even with all the digital distractions bombarding us daily. As I continue to grow in my recovery, I still need reminders to view all that life throws at me— with gratitude, and some days are easier than others.

When I was actively consumed in addiction, being grateful never entered my thoughts — not unless it was to get me out of a jam, away with another lie, you know the story. 

I wasn’t a bad person, yet my behavior would always prove otherwise. That’s where addiction took me. It robbed me of my conscience, integrity and morality. Even though I was taught right from wrong; wrong was the fork in the road I took.

Now, and for the last 26 years, with a rigorous commitment to my recovery — being in gratitude is the safest place for me to be; not in my head, not regretting past mistakes or projecting future outcomes. I have a choice to focus on what I have; and not what I want. 

I need gratitude and thanksgiving as part of my daily routine more than I need to know who has texted, emailed or friended me, because the most important entity I must connect with — is always with me.

Have a blessed Thanksgiving.

Sunday, October 2, 2016

Stopping Expanded Addiction Problems

By Seth Leibsohn

I’m a radio host and also privileged to chair an organization dedicated to prevention. In my individual capacity, I was asked to address the connection between prevention and recovery and a very serious ballot measure facing all of us this November — a measure that, if passed, will radically change both prevention and recovery efforts in Arizona.

The Miracle of Recovery

Whenever I meet someone in recovery, I am always reminded of how much of a miracle that person is. Those that don’t know about this magical thing called recovery just don’t get it. People in recovery quietly and nobly fight—daily. And the fight is against physiological inclinations, nature, and the environment we all live in. I’ve heard it put this way: Shopaholics shop. Chocoholics eat chocolate. Workaholics work. Alcoholics drink. Substance abusers use substances—that’s how they often get to, or change, their “normal.”

So, as I’ve learned it and seen it with family and friends: Every day of sobriety for someone in recovery, every week, every month, every year is a successful fight against physiology, inclination, and nature. It’s a miracle. It really is. And it’s a hell of an achievement.

And it’s also so, so rare. In an ironic sense, we all want to see more people in recovery who don’t get it, who don’t have it—addicts in the grips or throes of their addictions. Yet on the other hand, we also wish there were not so many—or any—with these problems. But there are, and those in recovery always have their hands and arms open to others. There are no greater helpers among us than those in recovery. And I’m going to ask for your help in a moment.

The Side of Prevention

But first, I want to explain why I work the other side of the street: prevention. I work in the prevention field precisely because I know how hard recovery is. I know how rare a miracle is. I know that for each and every person in sobriety who gets it, who keeps it, there are millions who will never find it, or, if they do, simply will not be able to join you and hold on to it. You are the minority of the minority. You are the miracles.

So I push prevention—better not to start, better not to initiate, better not to play Russian roulette because who knows which chamber will have the fatal bullet. So while those in recovery open their hands and arms and hearts, we in prevention do our best to limit how many will ever need it.

We Have a Choice in November

This is why I have been such a strong advocate against a choice before all of us this November, a choice that will make all of our work harder if we get it wrong. We actually have a real choice, in the form of a ballot vote, on whether we want to create more addicts or not, more drug problems or not, more alcohol problems or not. We will not have a choice on whether we can give more people more recovery, but we do have the choice about whether we can make the problems we all know worse.

Irony. It’s an important word in our movement. I was thinking about a book on it, by the philosopher Reinhold Niebuhr. The book is the Irony of American History. If Niebuhr’s name is at all familiar, perhaps it is because he wrote the Serenity Prayer. I love that prayer:
God, grant me the serenity to accept the things
I cannot change, the courage to change the things I can, and the wisdom to know the difference.

Lately I’ve been focused on the second part: Courage. The courage to change the things we can. One thing that is of no irony to me is that Aristotle taught that courage is the most important of virtues, because without it nothing else is possible. My plea here to you is to embrace the courage to help our community—and in this case, to help our community not make things worse.

Prop 205

So, for those that want less addiction temptations and opportunities for our families, our friends, our children, our co-workers, our neighbors, think about what is before us this November. There will be a ballot initiative known as Proposition 205. It will make marijuana legal for recreational purposes. But I want you each to actually read the initiative—it is 20 pages long. Once you read it, you will see it does far more than just make marijuana legal. And as too many know, this is not the marijuana of yesterday, we are talking about high potency THC marijuana and child-attractive edibles like gummy bears, lollipops, and candy bars. Proposition 205 will, among other things:

Allow households to grow indoors and out, 6 to 12 marijuana plants that can yield pounds of marijuana.

It will ban every city or HOA from preventing that home growth.

  • It defines a place of residence for such growth so that you could have entire apartment buildings or condominium buildings or frat houses with each unit number being a high-yield marijuana grow house. Or you could be the one unit that is not, as you are surrounded by it.
  • It will set up marijuana stores and facilities throughout the state—all selling high potency THC edibles and smoked marijuana.
  • It will allow for marijuana delivery, just like pizza. It will allow advertisements in newspapers, on billboards, and sign spinners promoting commercialized marijuana on our streets.
  • While Proposition 205 states marijuana stores have to be 500 feet from a school, it allows them to be built or operate with no distance limits from a church or synagogue, a rehab facility, a half-way house, or a homeless shelter—you very easily could have one of these right next to where your 12- step meetings take place; right next to the most vulnerable of populations, at an after school club or rehab or homeless shelter. When we think of the way those who seek addicts to make profits off their intoxicants, we simply cannot assume this is an accident or oversight. 
  • Proposition 205 will change family law. Judges will no longer be able to use marijuana consumption or growth as a determinant in awarding custody or parenting time. Why does this bother me so much? How many of you have seen or worked to keep your children away from those who use substances and do not get recovery? We all know one big thing in prevention, too: Children get a lot of their substances from their homes, be it a parent’s medicine or liquor cabinet. Now they will be able to get them from their parent’s gardens and kitchens. 

Lollipops, Gummy Bears, Cookies and Candies and. . . .

And please understand, the marketing of edibles is highly child-attractive. Marijuana gummy bears, lollipops, candies. All will be legal. Now look to Colorado—since legalization, youth use of marijuana has increased to 74% higher than the national average. And accidental youth ingestions have risen 150%.
Perhaps the most important thing to know about those numbers: Colorado’s legislature just banned certain forms of those child-attractive candies. Arizona is unique in that it has a Voter Protection Act, barring our legislature from making that kind of adjustment or change. What we decide at the ballot box with propositions in Arizona is essentially permanent. Do not think that is an accident either.

To repeat: When an initiative is passed here, the Governor cannot veto it and the legislature cannot amend it against the purpose of the language. In other words, if this thing passes, we will have radically changed 80 years of good, hard, substance abuse prevention work overnight—with consequences that will be permanent.

Now consider: almost every person with a use disorder, started using in their teens. And in Colorado, the plurality of youth who use marijuana will tell you they got it from a friend who obtained it legally. 25% got it from their parents’ homes.

All of this is one grand recipe for a lot more substance abuse. We know this, don’t we? You make an attractive and intoxicating and addictive substance more available, it will be used more. Now make it child friendly. We’ve seen this with alcohol, we’ve seen this with tobacco, and Colorado and Washington State are seeing it with marijuana. And if alcohol is your most important concern, just think about the new studies showing marijuana users are five times more likely to have alcohol problems. We are talking about multi-substance abuse problems with this one initiative.

We don’t need this in our state, and we cannot afford it. I love hanging out with people who get recovery. In this movement, I have found the actual proof of the theoretical notion that it is the weak who are cruel and that gentleness can only be expected from the strong. I ask you to summon your strength, to summon the courage to change the things you can, and help in stopping this public health disaster in the making, a disaster that comes in the form of a ballot, a disaster that will be nearly impossible to reverse.

It would seem the ultimate irony to me that as we all celebrate and work for more recovery we would—at the same time—make more available an increasingly potent, child-attractive, and addictive drug. We’ve come too far, all of us, for that.

As the Greek poets put it:
Let’s do our best to help make gentle the life of this world—that can only come from the strong.
Right now, it must come from you, your experience, your strength, and all of our hope. I thank you for your help.

Seth Leibsohn is the host of the Seth Leibsohn Show, heard nightly on KKNT/960am, and the
Chairman of NotMYKid.

It’s Up to You

Legalizing recreation marijuana will lead to more addiction.

by Lisa James

I am the sister of a long term addict. My brother started down the path of addiction over 30 years ago with a little pot. No harm there right?

He has spent half his adult life in prison. He has no job. He is the father of three wonderful children, two of them now live with their grandmother.

At 46 years of age the future is not bright. Short periods of sobriety are followed by long periods of life threatening addiction.

There is hardly a family in the world not touched by this scourge. If you have not been touched in your family, odds are that your co-worker, your neighbor, a church member, or club member has not been as fortunate. It knows no economic boundary. Rich or poor. Famous or anonymous. A recent survey showed that of the 310 million US citizens some 20 million have a serious untreated addiction problem. This is an epidemic.

Addiction isn’t the disease we talk about. There is a stigma attached that doesn’t exist for heart disease, cancer, diabetes, and more. But it is a disease and it is far reaching. We to come together not only for a cure, but to prevent legalizing more substances that lead to addiction.

Economic Boom or Doom?

Proponents of legalizing marijuana point to the economic boom in the industry along with huge tax revenues generated by the sales.

What they don’t take into account is the economic toll this will take on individuals, families, and our state and local economy. Broken families, homeless, lost productivity, and state and local funded recovery resources all have a financial cost.

Even by just talking about legalizing marijuana they are fueling the fire. Our young citizens must be thinking “what’s the harm? They are going to legalize it anyway. It must be government approved just like alcohol and cigarettes.”

Nothing could be further from the truth. I am not saying that some people can’t smoke and never get lung disease. I am not saying some people can’t have an occasional glass of wine and never have a problem. I am saying that legalizing marijuana will not solve a problem, it will only make a problem worse.

When my children would ask to do something I wouldn’t allow, they would always ask why. And they always had a response for each reason I gave them. Eventually it would lead to, “but my friend, Sam or Sarah, gets to go/do. Their parents don’t care.” And my response would be, “Well, I love you more.” I’m asking you today to love Arizona’s kids more. To love Arizona more. To love Arizona’s future more. Please love our kids more.

I want to remind you the same people who are asking you to make marijuana legal for recreational use are the very same people who, just a few short years ago, told you it was a powerful medicine. What other medicine do we encourage people to use recreationally? None. Zero. Why start now?
We already have a law on the books legalizing medical marijuana. While this law is easily abused, it is allowing those with a legitimate medical reason for using marijuana to get it from a licensed facility. Why not wait a while and see how this works out?

Make no mistake, these are dealers who want to market to your children and try to buy your support with promise of money for education. Tell them you can’t be bought. Your children aren’t for sale. You love your children more.

Please, for the sake of our children, let us not encourage those who already have problem to use something that can only make it worse. 

It is up to you!
Just Vote No Arizona

Addiction Treatment and Insurance: A Troubled Relationship!

By Jim Kreitler, CEO, Calvary Addiction Recovery Center

Addiction Treatment and Insurance: A Troubled Relationship!

They don’t trust us and we don’t trust them! And yet the vast majority of people seeking help at private addiction treatment centers use their insurance to access care. Insurance companies are dealing with an avalanche of abuse and fraud. Treatment centers and patients are feeling the restriction of approvals of benefits people have paid for and deserve.
Something has to give, but if the addiction treatment community is not careful, that change will be thrust upon us in ways we will not like. Imagine plans with no out-of-network addiction benefits at all, and the power that gives insurance companies to force low rates for contracted providers. This could lead t
o many programs shutting down, reducing the availability of care in the midst of the opiate epidemic!

First let’s discuss the types of insurance and the issues that are becoming problematic.

In-Network vs Out-of-Network

Most, but not all, plans have both in-network and out-of-network benefits. There are important differences the public and referring entities must understand. It is possible to operate legally and appropriately as in or out-of-network, but the differences must be explained and understood by the patient to make an informed decision.

In-network providers have discounted their rates in return for being contracted as in-network to plan members. The advantage for plan members is significantly reduced patient out-of-pocket cost and confidence that the insurance company has qualified the program as properly licensed, accredited and free of claims of malfeasance.

In-network plans may have a co-pay of $20 for an office visit or $150 to $500 admission fee for a stay in inpatient. PPO plans have a split, with 80/20 being the most common. Insurance pays 80% and the patient pays 20% until a maximum out-of-pocket is reached. If a plan has a $5000 max, care is covered at 100% after the patient pays that amount.

Out-of-network providers are not limited in what they can charge, provided they attempt to collect the difference between what is paid by insurance and what is billed. Most plans pay at a much lower percent; typically 50%, and have a higher out-of-pocket limit. Obviously insurance payers prefer the discounted rates of in network providers. They complain about fraudulently inflated billing with no serious attempt to collect from patients. Their audits have led to large dollar recoveries backed by the threat of legal action for insurance fraud.

How it Should Work

In-network cost control is achieved through contracting of discounted rates. Out-of-network control of unnecessary care and overbilling is dependent on collection of patient responsibility. If I want to continue to see my long term primary care physician I should have that right. Because I am paying 50% I won’t go more than necessary and if he charges an outrageous amount, I will switch to an in-network doctor.

Many self-pay programs now accept out-of-network insurance. A program that costs $50k self-pay may now collect $25k from insurance and $25k from the patient. A high level of care and amenities is provided and well to-do persons have an increased choice of treatment programs. The system works in this situation or wherever the patient responsibility is considered and collected.

When it Becomes Troublesome

Certain programs have determined that they can overcharge for services provided and not collect anything from patients in violation of insurance fraud statutes. Thomas Force, a licensed attorney and ERISA litigator, says in his seminar The Balance Billing Requirement - Why Out-of- Network Providers Must Balance Bill Their Patients, “If you're waiving fees, if you're waiving co-insurances or agreeing to accept the insurance as payment in full . . . you're committing insurance fraud in most state jurisdictions.”

In some cases the overbilling is so high it can also pay for the sober living and the program is unethically marketed as “residential treatment.” Insurance may audit for this also. Certain insurance companies are refusing to verify out-of-network benefits unless they speak to the member and he agrees he has been notified that it will cost more and the provider is required to balance bill the charges.

Urine Screens becomes Liquid Gold

Testing patients with urine drug screens to determine compliance and sobriety is clinically indicated and ensures safety for the group and program. But in an extreme and distorted example of unethical ingenuity, treatment providers or sober living operators have determined that overcharging for frequent testing of a person’s urine can create, excuse the pun, an income stream second to none!
The system was perfected in Florida but has migrated to Arizona. This is how it works: A program does urine testing and for what may be worth $50 — charges insurance $1,500. And they may test 3 times a week or in the worst cases 7 days a week. My Palm Beach Post reports about addiction treatment providers and sober living operators

 “Owners scraped by. It was, said one person close to the industry, doing “God’s work.”
That began changing when some realized insurance companies would pay big bucks for urine testing. At first, money from urine testing was just a means to make ends meet. But as time went on, and the cash started rolling in, it became a financial linchpin — and now, a gold mine.
Urine testing is a staple of rehab, a fast way to both track relapse and gauge use of prescribed drugs.

It’s also cheap. Corner drug stores sell $25 tests that will immediately indicate the presence of a wide array of drugs.
Over the past few years, though, some treatment centers, sober homes and their affiliated labs have charged hundreds of dollars for a similar test. One routinely charged a reported $1,500.”

This led to the FBI getting involved in some high profile raids in Florida and some major lawsuits by insurance companies. One way programs tried to hide the scheme was to buy “shares” in test labs and then collect dividends on the volume of urine they sent for testing. United Health Care has filed a $50 million lawsuit against Skye Toxicology for this practice, named 20 major defendants and lists 150 unnamed co-conspirators. I cannot speak to the merits of the lawsuit, but it is likely some of the unnamed programs are operating in AZ. Julie Miller Editor in Chief of Behavioral Healthcare Magazine 2  writes “Elements Behavioral Health is claimed to have the largest stake of the investments among those named, holding 20 limited partnership shares, resulting in $600,000 in payments per month, according to the language in the lawsuit.”

Insurance Companies are not Angels

On the other side of the coin are  insurers who deny care for persons who clearly meet medical necessity, or retroactively terminate plans or agreements to pay after authorization has been given and expensive care provided. The recent freezing of payments in Arizona by Healthnet affected good and bad programs. Insurance companies are massive for-profit companies publicly traded on Wall Street. Do they sometimes place profit before patient care? You’re darn tootin! Do they dance around the requirements of the Federal Parity Act which requires addiction and mental health benefits are provided on par with medical benefits? Why hell yes!

In a recent court case, Cigna vs Humble, a Texas court awarded $13M to the provider in a suit over balance billing. The case is expected to reset the expectations of balance billing and charity qualification but mainly served to chastise the insurance company for overplaying their hand when withholding claim payments. This is good news for out-of-network providers.


Insurance coverage with substance use disorder benefits is an important factor in addicted people getting the help they need. There is a place for both in-network and out-of-network treatment providers. The relationship needs improvement from both sides or change will come in ways that could be painful — including lawsuits and law enforcement.
When referring clients the difference must be understood and explained to them. Out-of-network treatment when it provides amenities or services not available in-network is appropriate. The patient just needs to understand that as a rule it should cost them more or something is amiss.
I suggest we first look at our own practices. If we are operating in a way that is unethical and puts us at risk of reprisal we must stop it. Join those of us forming coalitions to unite treatment centers as forces of ethical patient care and advocacy for accessible treatment. Once our side of the street is cleaner, our collective voice will carry more validity as we push to hold insurance companies responsible for their behavior!

1 Beall, Pat and Stapleton, Christine. "Addiction treatment bonanza: How urine tests rake in millions” MyPalmBeachPost.com., 14 Aug. 2015.
2 Miller, Julie “UnitedHealth names labs, treatment centers in federal fraud case.” Behavioral Healthcare, 2 May. 2016.

Providing Answers to the Opioid Epidemic

By Jennifer Stolpe MS, LASAC

With heroin and opiate abuse aggressively sweeping the nation the effects are devastating. Eighty-one people die each day in the US from an opioid overdose and 2.2 million Americans struggle with an addiction to opioids —  such as heroin or pain pills. With drug overdoses now leading the cause of accidental deaths, it is clear this epidemic does not discriminate.

What are Opioids/Opiates?

Opiates cover a large variety of substances, some legal like pain pills and others illegal — opium and heroin. Vicodin, OxyContin and Percocet to name a few are often referred to as “opioids.” When referring to drugs naturally derived from active narcotic components of the opium poppy like heroin and opium they are referred to as “opiates.” These terms have become interchangeable.
Opiates are medications prescribed to relieve pain; they reduce the pain signals reaching the brain.

They target the brain’s reward system and floods the brain with dopamine. Dopamine a neurotransmitter is present in sectors of the brain that regulate movement, cognition, emotion, motivation and feelings of pleasure. There are certain life-sustaining activities the brain wants to make sure people repeat in life, in order to do so, when a person performs one of those activities the brain associates those activities with pleasure or a reward like the release of dopamine. Since drugs of abuse stimulate these same areas it teaches the person to abuse drugs

Heroin is an opioid drug synthesized from morphine, it usually appears as a white or brown powder. It can be inhaled by sniffing or snorting, smoked or injected. All three ways of consumption deliver the drug to the brain rapidly. Upon entering the brain it is converted back to morphine and binds to molecules on cells known as opioid receptors. These receptors are throughout the brain and body and are involved in the perception of pain and in reward.With continued use tolerance is built and dependence occurs.

What can be done?

 At this time, MAT is the industry standard for treating opioid addiction, as recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA). It offers the best possible outcome for people struggling to stop illicit opioid use. Medication assisted treatment (MAT) is the use of medications combined with counseling and behavioral therapies, to provide a ‘whole patient' approach to the treatment of substance use disorders. Research indicates that a combination of medication and behavioral therapies can successfully treat substance use disorders, and for some people struggling with addiction, MAT can help sustain recovery.

Intensive Treatment Systems

Intensive Treatment Systems (I.T.S) is a CARF accredited, outpatient substance abuse treatment program providing Medication Assisted Treatment (MAT) to patients who are affected by Opioid Use Disorder, or Opioid Addiction. The primary treatment objective of I.T.S is to help patients free themselves from the dysfunctional pattern of opioid abuse through the use of medications such as methadone as well as counseling and case management services.
Ultimately through the use of medication, counseling, and case management services, the goal is to guide patients toward a drug-free lifestyle with improved personal and vocational functioning. Medication services are provided and closely monitored by qualified medical staff, who emphasize safety and a comprehensive approach to the patient’s treatment. Counseling, case management services and groups are provided by addictions professionals who utilize Motivational Interviewing and other evidenced based practices to ensure exceptional recovery-oriented and patient centered treatment.

I.T.S has been serving patients in the Phoenix area for more than 20 years and has developed a program that is dedicated to high quality patient care and is focused on comprehensive recovery. I.T.S has three clinics in the Phoenix area, offering methadone and counseling services at all locations. Each patient’s care is also closely monitored by a Physician Assistant to ensure therapeutic dosing and to prevent overmedication. Our Medical Director is Board Certified in Addiction Medicine and directs the program to abide by all federal and state guidelines and to ensure safety for all patients served.

I.T.S looks forward to serving any patients in need of MAT. Currently we accept AHCCCS and private pay as forms of payment. In addition, we utilize the Substance Abuse Block Grant to provide treatment to patients who are unable to pay and who do not have AHCCCS. We provide priority treatment to pregnant women and work closely with OBGYN doctors to ensure the most effective care for pregnant women addicted to opioids.

I.T.S is dedicated to providing quality care to all patients. To ensure the best care for every patient,

I.T.S believes in the importance of strong community ties and the power of the community working together to provide as many services and resources to each and every patient. ITS is aware that together is the only way to find a solution to this devastating epidemic.

For more information on Intensive Treatment Systems, visit www.itsofaz.com.

12th Annual NAMI Valley Walk

12th Annual NAMI Valley Walk

By Rebecca Duke

On Saturday, October 15, NAMI Valley of the Sun, an affiliate of the National Alliance on Mental Illness (NAMI) will hold its 12th Annual 5k Walk on the streets in front of the State Capitol Grounds.  Registration begins at 8:00 am and the walk begins at 9:15— 17th Ave. and Jefferson is the starting point.  In addition to people and pets (dogs are welcome to register and walk right along with their owners!) there will be exhibitors, entertainment, food and plenty of bottled water.
NAMI, is the nation's largest grassroots organization dedicated to improving the lives of individuals and families affected by mental illness.  Locally, NAMI Valley of the Sun enriches our community by raising awareness, tackling stigma, educating, and offering support groups.

Last year alone, NAMI Valley of the Sun touched the lives of close to 22,000 people in Maricopa County through a variety of presentations, public speaking events, community forums, educational classes and support groups.

Because of the time, talents and fund raising efforts of devoted volunteers and donations from the public and our community partners, all of NAMI's programs were and are offered at no cost.

1 in 5
One in five people are affected by mental illness, be it the individual living with mental illness, or a close friend or family member. With a high rate of teen suicide, an increase in depression among the elderly, an ever growing homeless population, and our vets returning home, NAMI's services and invaluable support and education to those who are suffering are vital.
The Walk is NAMI Valley of the Sun's main fundraiser and it's through generous donations from partners, sponsors, walkers, and individuals, that NAMI will continue to be able to offer these life changing programs at no cost.  Every year, tens of thousands of concerned citizens in more than 84 communities across the nation will join NAMI and walk together to raise money and awareness about our country's need for a treatment and recovery system for people living with mental illness.
To register, donate or volunteer visit  www.namiwalks.org/valleywalk  or email our Volunteer Walk Manager, Gloria, at  info@namivalleywalk.org

If you're unable to join the event, consider making a donation and spreading the word about the Valley Walk.  Donations can be made online at www.namiwalks.org/valleywalk, or by mail... send a check or money order to: NAMI Valley Walk, 5025 E. Washington Street, Suite 112, Phoenix, AZ 85034.  Please make checks payable to NAMI Valley Walk.

Who Taught You to Doubt Yourself?

By Alan Cohen

A young entrepreneur came to me complaining that she was having trouble completing the text for her website. “Where is the roadblock you are hitting?” I asked Barbara.

“It’s the About Me page,” she answered with a contorted face that told me how painful this process was for her. This is the page that most entrepreneurs get hung up on, the very one I have had countless coaching sessions to help clients get posted.
“Do you have any doubts about presenting yourself to the world?”
“Well, yes. . .” she answered sheepishly. “I question if I am really qualified and if I am worth people paying me for my services.”

“Got it. . . Now let’s put the web page aside for the moment, and look deeper,” I suggested, knowing precisely where we were headed. “Who taught you to doubt yourself?”
“My father was a newspaper editor and highly critical of me, especially when it came to English.

Even beyond that subject, there was nothing I could ever do that was good enough. If I did a project with 99% excellence, he wouldn’t compliment me on my achievement. Instead, he would criticize me for the deficient one percent.”

“And even though you have grown up and moved out of your father’s home, his voice still lives in your head, constantly banging at you for never being perfect.”
“That’s right.”

Nearly every person I have ever coached has voiced some variation on this theme.
“So your current challenge with your About Me page is just one more instance of a theme that has been going on for your entire life.”
“It is so.”
“Then let’s reframe this: You are now being presented with an opportunity to finally break free from this lifelong oppressive voice within you, implanted long ago by your father, that has debilitated your progress in ways far more serious than the website.”

“If I could do that, it would be tremendous!” she answered, her face lighting up for the first time since we met.

“Then let’s do a role play,” I suggested. “I will represent your father. I won’t say anything, but I will give you a chance to say to him what you wished you could have said when he criticized you as a child, or when his judgmental voice chides you as an adult.”
Barbara sat up straight, looked me in the eye, and spoke firmly. “Dad, I know you love me and you want the best for me. But I can no longer live under the whip of your criticism. Every time I did something as a child, or an adult, you found something wrong with my action and with me. Your judgments have kept me small for my entire life. I am not willing to live with them and allow them to impede me anymore.”

Then came the tears.

“I am a bright woman with a good heart, strong skills, and a significant contribution to make. I want to do that through my new business and other avenues down the road. I know I can do this, and I do not need your permission to live the life I choose and to create a successful career. So I now release all the dark criticisms I have borne for so long, and I step with confidence into a richer life.”
Barbara’s tears had cleared and her eyes shone. She looked like an entirely different person than the one who had complained about her inability to complete her web page.

“How do you feel now?” I asked her.
“Freer than I have felt in a long, long time.”
“And how do you feel about setting up your About Me page?”
“Ready,” she answered with a smile. “Totally ready.”

A long silence ensued. Barbara’s eyes lit up as she said, quietly stunned, “It wasn’t about the website, was it?”

No, it wasn’t about the website. The website was directing Barbara to look inward for her answer. Her block was about self-image, self-esteem, self-confidence, attitude, beliefs, and expectations—the factors that make or break any endeavor. The business and relationship situations in your life do not have a life or reality of their own. They are reflections of your psyche, the images you hold about yourself projected onto the screen of the world. As James Allen brilliantly stated, “We think in secret and it comes to pass. Environment is our looking glass.”

Situations that bother us are not curses. They are arrows pointing us to places in our mind where we are holding illusions. When we can identify the illusion that is causing us pain, we are ready to discover the truth the illusion was covering. When we do, we are free.
It’s not about the website. Or the relationship, the job, the money, Or the world. It’s about waking up.
When we do, everything changes!

Alan Cohen is the author the bestselling A Course in Miracles Made Easy: Mastering the Journey from Fear to Love. Become a certified professional life coach though Alan’s deeply transformational Life Coach Training beginning January 4. For more information about this program, his books and videos, free daily inspirational quotes, online courses, and weekly radio show, visit www.alancohen.com, on FB Alan H. Cohen (author), and Twitter @alanhcohen

A Value Driven Life

By Dr. Dina Evan

One of the new thought phrases we often hear, is that we should be living a purpose driven life, but what does that mean? 

How does one decide on a purpose, fulfill a purpose and create a purpose driven life? I think it might be simpler than we think. What’s under a purpose driven life? It has to start somewhere. It starts with values...yours. 

A way of living your values is to be sure that both what you say and what you do are fully aligned with what truly believe. Then you are living your values. Think of the last time you did something courageous just because you knew with every part of you it was the right thing to do. Now imagine living your life that way.     

Seeking Fulfillment

Most of us are focused outside of ourselves for finding happiness and fulfillment. A value driven life starts with you being willing to look inward to examine what you believe are your values. Start to explore whether or not they are still viable and working for you in your current life. We grew up being taught that some things and some people are good, and others are bad. What if it’s all good and all there in service — to your life and your growth. How else can we learn if we don’t bring ourselves to our knees occasionally with a bad choice? Maybe bad choices aren’t bad choices, and bad people aren’t really bad people, maybe they are simply lessons we have created so that we can wake up!

On that note what about the other people in a value driven life? What if each of these people, whether stranger or beloved, family or friend is simply a master teacher in our life teaching us something about our self. We might be able to see each person with greater compassion if we knew that on a spiritual level we invited them in so that we could find out who we are as spiritual beings. For instance, when your child is acting out in the restaurant, and you feel horrified watching the reaction of the couple two tables away, are you horrified because of what they might be thinking about you as a parent or are you horrified because your child is acting like a child? In that moment, your child is being your master teacher, as is the couple.     

To fine tune your values, begin to ask the deeper questions... When I hold back my truth, is it because I am afraid I’ll be abandoned or judged if I speak the truth? When I’m afraid to stand up for what I believe, is it because, I am afraid I’ll look foolish if I stand up or — because I haven’t committed to what I believe. When I lack compassion when delivering a criticism, is it because I have the same fault that I have not yet owned, or because the other person’s error reflects poorly on me? Asking these kinds of questions opens the door to deeper soul work and a refining of your values. The more we embrace our values, the more we courageously stand in them.    

In essence that is what mindfulness is; being so present in your own life that you can notice your actions and reactions objectively, without judgment, in order to make new decisions about who you want to be and how you want to respond from your best self. You start to act like you own your life and you came here for a reason. You did and that reason is only to wake up to your potential as a compassionate, conscious human being. This planet is the best school for that and it means you take ownership of everything that you have created in your life! The gift when you do own your life and choices, is that you will also understand you are able to change anything that no longer serves you.   

Living a mindful, values driven life is exciting. It brings clarity, compassion for yourself and others and a commitment to waking up. The greatest thing about that is you know for a certainty that waking up ever ends and nothing else is ever as exciting.

What Are We In For?

Together AZ has always been on the side of prevention, hope and recovery. While this publication has never taken a political stance and has remained neutral — times are changing.
The more I’ve learned about the recreational marijuana issue on our ballot this November, the more I cringe and become frightened of what passing this will do — not only our State, but our children, teens, and community at large.

The pot of today is not the pot of yesteryear. It is a chemical nightmare. 

Yes, back in 70’s and 80’s I used it—why? Because I wanted to be part of the in group, the rebels, the anti-crowd, the defiant ones. I am not saying my indulgence in marijuana took me to the depths of addiction, or was the cause.

Once alcohol was in my system, and my defenses were low, I was willing to try the next drug available, and many times it was marijuana, which led to_______, which led to_______, and the list could go on.

These destructive behaviors were ongoing and extremely detrimental to my emotional and academic growth. Getting high was all that mattered, really. I am one of the lucky ones who escaped a deeper plunge — the abyss where there is no turning back. What I am asking you is:  please do your homework on Proposition 205 before making a decision. Otherwise, what are we in for?

Prop 205 Endangers Arizona Kids

45% of the marijuana products sold in Colorado are edibles – accessible and attractive to kids.
Accidental ingestion by youth has increased by 600% in marijuana-friendly states.
Colorado’s teen marijuana use is now 74% higher than the national average.

Prop 205 Causes Major Public Safety Risks

Under Prop 205, Arizona’s authorities are prohibited from ever imposing a THC limit for impaired drivers.
Prop 205 prohibits almost all cities and towns in Arizona from banning marijuana operations in our communities.
Prop 205 allows HOME GROWS which authorities in CO found virtually impossible to regulate. Citizens are using the law as a way to break the law.

Prop 205 Protects Marijuana Special Interests

Prop 205 creates a monopoly - a select few will get rich while taxpayers pick up cost of prevention, treatment, accidents and lost potential in our youth.

The Colorado Experiment is a Disaster

Colorado YOUTH now rank #1 in the nation for marijuana use.
Colorado marijuana-related traffic deaths increased 62% since legalization.
Crime, homelessness, and drug cartel activity have all increased in CO since legalization.

Voter Protection Act:

Arizona’s Voter Protection Act means if Prop 205 passes, there is virtually NO TURNING BACK. The Governor cannot veto it and the legislature cannot repeal it.

Visit Arizonans for Responsible Drug Policy in Opposition to Prop 205 https://noprop205.com/