Todays Date:
Inspiring Success on the Road to Recovery

Thursday, February 1, 2018

Interweaving Cycles of Addiction and Trauma

Adapted from newly released Unspoken Legacy
Claudia Black, Ph.D., Senior Fellow of The Meadows and Clinical Architect of the 
Claudia Black Young Adult Center at The Meadows

When most of us wake up in the morning, we can reasonably assume that our home, our family, our job or school, and our primary relationships will still be there when we go to bed that night. We can also expect that the way someone treats us that morning will be more or less how he or she treats us that evening. Our world is generally stable, and we expect it to stay that way. And, most of the time, it does.

This is not true in an addicted family, where nothing is ever stable or predictable. Everything is confusing and unknown; anything can happen at any time. No one knows who is responsible for what because the normal boundaries have been shattered. No one has any idea how to make anything better. And everyone is constantly anxious, frightened, worried, and confused. You never know when something small—a dirty plate in the sink, a bad haircut, a thermostat set a degree too high—might turn into a catastrophe. As a result, family members become apprehensive about the smallest decisions. Meanwhile, outrageous and hurtful things and major, deeply important life decisions may go ignored and unaddressed. There is no more perfect recipe than this for creating trauma.

A Steady Diet of Trauma

When a family is ill with the disease of addiction, its members are much more likely to experience trauma than non-addicted families. That trauma is also likely to be more serious and more painful, and it is likely to take longer to heal. In short, addiction worsens every dimension of trauma.
Addiction creates chronic losses for everyone in the family system: a loss of trust, connection, intimacy, stability, honesty, fun, clear communication, safety, and healthy boundaries. And that’s just in the earlier stages of addiction. As the disease progresses, family members also lose jobs, relationships, financial stability, health, and sanity. Children often lose their childhoods by being forced to take on adult family roles. Sometimes people lose their lives.
As one loss gets compounded upon another, the result is usually trauma. In addition to the many losses, chronic emotional abuse is especially prevalent in addictive family systems. It can take any or all of these forms:

  • Verbal abuse (ridicule, name calling, etc.)
  • Severe criticism and blaming
  • Lack of expressed love, care, and concern
  • Unrealistic expectations
  • Shaming and humiliation
  • Broken promises
  • Lying
  • Unpredictability
  • Sudden rages or ravings
  • Overly harsh (or outright cruel) punishment
  • Being forced into physically dangerous situations (such as being in a vehicle with an impaired driver)
  • Breakup or abandonment of the family

The Trauma of Physical and Sexual Abuse

In homes where there is substance abuse, kids are 2.7 times more likely to be physically and/or sexually abused. In a related study, in which I was one of the researchers, we found that in alcoholic families fathers were 10 times more likely, mothers four times more likely, and siblings twice as likely to be physically abusive to a child or sibling.
There’s more. In a family where there is substance abuse, daughters are twice as likely to be sexually abused than in other families; sons are four times as likely to be sexually abused — both by family members and by people outside of the immediate family. My clinical experience suggests that usually there is more than one abuser.
We don’t have good statistics on physical and sexual abuse in homes where there is a process addiction, but my forty-plus years of working with addicted families suggests that the numbers are similar.

Here is what else we know about abuse in addictive family systems:
The ultimate act of physical abuse is murder; however, far more common abuse involves being hit, slapped, shoved, kicked, pinched, or slammed against a wall.

In addicted families, discipline or punishment can often turn into abuse. This typically takes the form of extreme and inappropriate punishment. For example, forcing a child to stand on one foot for ten minutes, and then beating him when he falls over. In other cases, addiction can turn a somewhat less harsh punishment into abuse, such as when a child is sent outside to stand on a cold porch for a few minutes to “think things over,” and then left there all night because her parents have passed out. Often a punishment isn’t particularly severe, but it is inflicted capriciously on a child who has done nothing wrong; the addict in the family is simply scapegoating the child.

Sexual abuse is both overt and covert. Overt sexual abuse involves sexual touch. Covert sexual abuse of a child involves no touch, but can take many other forms, such as shaming them about their body or sexuality; sexual name calling (such as calling her a whore or a slut); graphic sexualized joking; exposing the child to pornography; or using sexual innuendo. For example, Dad tells his thirteen-year-old daughter, “You are so hot looking. I wish I were your age, so I could have a shot at you.”

The more frequent the abuse, the more likely the victim is to minimize and rationalize it. As sixteen-year-old Kailie told me, “No, I wasn’t abused. My mom didn’t mean to break my jaw when she hit me.”

When a child has two addicted parents, the likelihood of physical or sexual abuse is substantially greater than when only one parent is an addict.

In addicted families, abuse is especially hurtful on days of celebration, such as holidays, birthdays, anniversaries, and graduations. Often the celebration itself gets undermined, revoked, or denigrated.

When physical and/or sexual abuse occurs in an addictive family system, people usually assume the addict is the abuser. But this is not necessarily the case. Surprisingly often, a parent or sibling who does not suffer with addiction is the abuser.

It should come as no surprise that families impacted by addiction tend to experience higher-than-average rates of murder, suicide, premature death, accidental death, house fires, car accidents, gun accidents, other forms of serious injury, and serious illness. For the survivors in the family, any of these can create trauma.
It’s hard to find an emotional middle ground. People vacillate from one extreme to the other, often over-responding, withdrawing, or running away. People have trouble staying in the present and in their bodies. They either live mostly in their heads — reliving the painful past or imagining a horrible future — or entirely in their emotions, consumed with fear, anger, or dread.

Overlooked and Discounted Trauma

In addicted family systems, people don’t just act in ways that tend to evoke trauma responses. They also tend to respond with less love, caring, and support whenever a traumatic event occurs. In a moment of crisis, family members may be unable to solve problems, perceive options, seek resources, or even pay attention. This can be particularly damaging for children.

As fifteen-year-old Darlene walked home from school, a gang of boys approached her. They grabbed her and tried to drag her into the woods, but she managed to break free and run home. Gasping and in tears, she told her mother what happened. Her mom just lifted her martini and said, “Well, honey, you learned something important about boys today, didn’t you? Now leave me alone for a while. I’m watching my favorite TV show.” In the space of a few minutes, Darlene was traumatized twice—first by the boys, then by her mother.

Seven-year-old Jonathan was walking to school with his friend Abbie on an icy winter day. Suddenly a slow-moving car skidded off the road and struck Abbie. She fell in a heap by the roadside. People gathered around Abbie and did what they could to save her life, but she died an hour later in the emergency room. Throughout the event, everyone ignored Jonathan. This was partly understandable, because there was a dying girl a few feet away. But Jonathan’s experience of watching his friend die was traumatic for him nevertheless.

Jonathan’s trauma never got addressed. Everyone — his classmates, his teachers, his principal, his parents, and even the driver of the car, who was also traumatized by the event — focused on Abbie and her family. When Jonathan tried to tell his parents how hurt and confused he felt, they told him, “Do you realize how lucky you are? That could have been you who died. Count your blessings that you got to school without a scratch.” Then they lit up a joint.

It took Jonathan two more decades before he finally got treated for depression. Only then did he have a chance, for the first time, to talk about “little Jon,” who had watched his friend die.

Kevin was born with cerebral palsy. He was a bright and inquisitive child who was normal from the waist up, but needed many surgeries on his legs. As a result, he was in and out of hospitals until he was in eighth grade. While his mother was often with him in the hospital, what he remembers most was her incessant crying — not about him, but about his father, who was an alcoholic and a compulsive gambler.

Today, Kevin recalls the hospital nurses and orderlies fondly. But he doesn’t remember his father ever coming to the hospital. Nor does he remember his mother touching him much or doing anything to comfort him. He recently told his therapist, “I don’t know whether Mom came to the hospital to be with me or to escape Dad. I felt safe in the hospital, not because of Mom, but because of the nurses and because Dad wasn’t there.”

Painful and difficult things occur in every child’s life. Parents can’t protect their children from every painful event, but they can respond in a manner that lessens the negative impact. Unfortunately, in addicted families, children are often denied caring and empathy at vulnerable times. As a result, traumatic events usually affect them with full force.

It’s common for people with unhealed emotional trauma to turn to addictive substances or compulsive activities in an effort to medicate or numb their pain. Listen to some addicts describe the forces that first pulled them into addiction:

Jack: There was one reason I ever ingested alcohol, and that was to get blithering numb. Eventually, after deciding alcohol was uncool since that’s what our parents did, I started taking drugs. I would take anything to not feel.

Dana: When I did coke, I had no fear.
Hunter: I drank to relax. I was so uptight, always needing to be hypervigilant. I drank to relieve the pain. I drank to hide and to mask the way I felt. I was so anxious all of the time. I knew I was screwing up, but I didn’t know what else to do.

Hannah: After being in so many foster homes, and after suffering sexual abuse at the hands of one of my foster parents, I wanted to die or, at the very least, disappear. The one source of power I was able to find was in my relationship to food. Restricting my calorie intake enabled me to wield power and control over food. At the same time, by losing weight, I was able to slowly disappear.

Lyle: My father raged and was abusive. By age eleven, I found what my father had — power in his raging. It protected me from my fears, my sense of unworthiness. Rage gave me the high, the power —and masturbation was my anesthetic. They worked in tandem for years.

Each manifestation of addiction offers its own unique way of hooking people. Food offers solace to a child who is hungry for love or attention or to anyone who feels isolated and alone. Starving can be a way to become less and less visible, in order to hide from deep inner pain or from a flesh-and-blood abuser. Cocaine can make someone who usually feels helpless, powerless, and talentless feel powerful and capable instead. Marijuana can help a chronically anxious person relax and feel comfortable.

The Trauma/Addiction Cycle

As mentioned previously, addiction often encourages trauma, and trauma can encourage addiction. This process can become what is often called a vicious circle or a negative feedback loop, with trauma contributing to addiction, which in turn fuels more trauma, which encourages still more addiction, and so on.
Here are some examples of how this process plays out in peoples’ lives:


Brent grows up with a father who is highly critical and nothing that Brent does is ever good enough for him. He routinely compares Brent to his two older brothers, who are both excellent athletes and who consistently get high grades. (TRAUMA)
In contrast, Brent struggles in school, and Brent’s father repeatedly accuses him of being stupid and lazy. (TRAUMA) (Later, in his twenties, Brent discovers he has a learning disability.) Brent’s mom — a professional singer who is on the road most of the time — is distant, busy, and preoccupied. (TRAUMA) She leaves most of the child rearing to her husband.
In high school, Brent becomes part of a group of close friends who spend much of their time partying together. Together, they find solace in drinking and smoking weed. (USING DRUGS TO SELF-MEDICATE) Brent especially likes that they don’t have to please their parents or, at least, don’t try to. By the time Brent is twenty-five, he is addicted to alcohol and pills. (ADDICTION)
One night, as he drives home from a party with his buddy Gary, his car hits a patch of ice and spins out. Brent does his best to regain control of the car, but he has had four beers and his reaction time is slow. The car tumbles into a deep culvert. Gary breaks both legs (TRAUMA); Brent suffers a serious brain injury. (TRAUMA) He is put on pain pills, which only further fuel his out-of-control drug use. (ADDICTION)


At age fourteen, Jenna is raped by three assailants. (TRAUMA) Her parents report the crime to the police, but Jenna is terrified, ashamed, and in shock, and refuses to talk about it with anyone.
Soon after that, her attendance at school becomes sporadic. At age fifteen, she begins periodically cutting her arms with razor blades. By age sixteen she is using pills and by age eighteen, meth. (ADDICTION) By the time Jenna is twenty, most of her friends are fellow addicts. On her twenty-first birthday, her boyfriend sells her for sex to their dealer in exchange for drugs. (TRAUMA)


Kim grows up with a severely alcoholic father and a hypercritical mother. (TRAUMA) From the time Kim is in kindergarten, her mother is preoccupied with Kim’s size and weight.
Soon after Kim turns nine, her dad goes into rehab and stops drinking. A month after that, her mom reveals that she has had a longtime boyfriend, and runs off with him. (THE TRAUMA OF ABANDONMENT)

For the next eight months, Kim’s parents fight over her in an angry and acrimonious divorce. (TRAUMA)

At age fourteen, Kim finds herself exercising excessively to keep herself thin. About once a month, she binges on tons of junk food, then sticks her finger down her throat and vomits it up (Bulimia Nervosa).

She also begins to party hard – drinking excessively and taking large amounts of opiates. One night, when she is drunk, she passes out and is raped by several of the guys at the party. (TRAUMA) One of them posts a brief video of the rape on social media. (TRAUMA)
Kim’s humiliation, shame, and inability to reach out to parents continue. So do her partying, her bulimia, and her drug use. And so do the sexual assaults. (TRAUMA)
By age twenty-four, Kim uses heroin and alcohol addictively. (ADDICTION) By age thirty-one, she has tried to kill herself three times.

Where and How Do I Begin?

Trauma and its many consequences do not need to be a life sentence. Healing is possible. The most common question people ask at the beginning of their journey is “Where and how do I begin?” The answer is to begin with where you are and what you are willing and able to do.
 If you feel you need to take immediate action, this might mean finding a therapist or a recovery group or going to a treatment center. It might mean talking to someone you trust, a spiritual leader, a friend, your neighbor who attends twelve-step meetings, or an addiction counselor. It might mean a process of self-reflection and journaling. Often it is a combination.

Jordan, who was sexually abused repeatedly by family members as a child, begins by reading about substance addiction in families. Before she begins any personal work, she wants to understand the family dynamics of drug abuse and addiction. She intuitively knows she will eventually need to look at and heal the wounds of her sexual abuse; but she’s not ready to do that.

Michael used cocaine addictively and is now a Narcotics Anonymous member with five years of abstinence and recovery. Although he’s done a good deal of work addressing his addiction, he is only now beginning to slowly and gently probe his unhealed trauma. He decides to put his toes in the water by going to a Co-Dependency Anonymous meeting and reading about codependency.

Cecily has been receiving both cognitive behavior therapy and anti-depressants for her depression and anxiety. She now seeks out a trauma therapist skilled in EMDR.
It’s important to understand that if you are in active addiction you won’t get very far in your healing until you are addressing the addiction too. Active addiction sabotages any chances to experience long term healing from trauma.

More than anything you need not do this alone. Addiction and trauma are both about disconnection. Healing is about reconnection to self and the ability to allow other people to be there to help shine the light and provide hope when it’s hard to do that for yourself.

(Note: Part 2 will be featured April 2018)

Unspoken Legacy is available on Amazon.com

Claudia Black Ph.D. is a renowned addiction author, speaker and trainer — internationally recognized for her pioneering and contemporary work with family systems and addictive disorders. In addition, her groundbreaking treatment program at the Claudia Black Young Adult Center is focused on treating complex addiction and mental health issues faced by youth, ages 18-26. These young adults struggle with unresolved emotional trauma, addictions, or have a dual diagnosis. Because Claudia is passionate about helping young adults overcome obstacles and strengthening families, she remains actively involved with the treatment team, the patients, and their families.
She is also a Senior Fellow at The Meadows Treatment Center, the nation’s premier program for treating trauma, alcohol, sex and drug addiction, as well as panic and anxiety disorders, post-traumatic stress disorder, codependency, depression, bipolar disorder and eating disorders. Visit https://www.claudiablack.com and https://www.themeadows.com. For immediate needs call 866-424-5476.

Update: AZ Advocacy

By Angie Geren

January 11th proved to be our most successful Addiction and Recovery Advocacy Day. Over 67 people met with their representatives and 35 confirmed meetings with individual legislators, Advocates, Senators, Representatives were scheduled. Discussions included Public Health Focused Addiction policy, what this would look like for Arizona and how it can help combat the opioid crisis in which we are currently entrenched.

Arizona is in a prime year for addiction and recovery advocacy as Governor Ducey declared a Public Health Emergency in June 2017 and his office and Department of Health Services have been working on recommendations that culminated into the Arizona Opioid Epidemic Act which was passed and signed into law, January 26, 2018. Arizona is the 41st state to have a Good Samaritan 911 law protecting people who call 911 for a drug overdose from being arrested, $10 million of that funding will be in the newly created Substance Use Disorder fund — used for those who are underinsured/uninsured, new prescribing guidelines, prevention education funds, and mandated medical professional education. Arizona seems poised to be on front lines of fighting this epidemic however there is so much more work to do. The provisions in the passed Act rely heavily on preventing on opioid addiction which is just a small piece of the puzzle.

What is Public Health Focused Addiction Policy?

  • Policy focusing on treating addiction instead of incarcerating;
  • Looks at the whole picture instead of individual symptoms;
  • Reduces stigma, thereby increasing the likelihood of people seeking treatment;
  • Protects the safety of people by seeing them as patients in need of assistance.
  • What can Arizona do if they truly wanted to have a robust policy that adequately treats addiction thru the health system instead of the criminal justice system? 
  • Pass HB2389 which would allow syringe access programs to operate;
  • Pass Sober Living Home Regulations and Pass a Ban on Patient Brokering;
  • Reject HB2241 which would create mandatory minimum prison sentences for heroin sales;
  • Continue to work with individuals and organizations focused on recovery to find innovative solutions and provide quality care;

We need your voice to join us. We are the ones who are most affected and have the story to help educate our legislators on what addiction really is and that recovery is possible. I encourage you to stay updated on the progress of these bills at www.addictionhaven.com/arizona-advocacy

LOVE IS. . .

By Dina Evan, Ph.D

I have never really believed you fall in love instantly. You could conceivable fall into lust, or trip mindlessly into passion — but love, real love, takes time — like cooking the perfect soufflĂ©.

Love creeps gently into your insides when you glance her way and see the sun gently reflecting off locks of red hair cascading haphazardly over her shoulder.

Love is behind his eyes that seem to see forever.

Love wells up in your throat when you listen to your voicemail and hear his sultry voice telling you to “come straight home!”

Love smiles through lathered up faces, tucked in towels and hangs gently midair in tunes that are hummed early in the morning.

Love grabs you like gentle thunder in the middle of an orgasm, in the middle of laughter, in the middle of dinner.

Love walks into the room definitively beside you, not searching, roving or seeking something fantasized, but not yet found.

Love is being present, profoundly here, solid and alive.

Love is the connection, commitment, ecstasy and relief of right union.

Love creates a direct path to Spirit parts, head parts, heart parts and girl parts and boy parts.

When I was very young, I thought I’d fall into love repeatedly. Really, I was only practicing to be in love once.

When you are older you become the love, and then give that to each other.

When you become the love, there is no separation between who you are and what you feel and no way to give less than your best. If you still feel you are looking for the best, you have not yet found love.

Love is a surprise because it’s never what you thought it was and it never comes when you wish it would.

Love can take a break when the words seem hard to find, but love never goes very far away and always comes back to resolve the issue.

Love believes there will always be a resolve and love chooses not to sleep until we find it.

Love reaches across the distance either we create, when we feel a need to protect ourselves and persistently, ever so gently pulls us toward each other.

Real Love demands integrity. It tests each of our ability to stay present, aware and truthful. When we are both being love, we are able to cradle the child in each of us, respect the adult in each of us and encourage the Spirit in each of us.

Love is only able to flourish in truth. True love is about being really present, authentic and willing to risk honesty, solidity, sanctuary and grace.

Love is in anything real. You can hear love in Chopin, Beethoven, Puccini, Groban, Streisand or Brightman.

Love is about taking care of yourself and committing to your own growth so that your partner is not grieved, or required to spend time cleaning up the mess from your lack of awareness.

Love is about embracing weaknesses together, talking together; tearing up together and trying to do it better together.

Love is about believing not just enduring. It’s about devotion, not just affinity. It’s about passion, not just fondness. It’s about soul deep connecting, not just sex.

It’s about Beingness, not just bodies.

It’s about wanting those you love to be the best they can be for themselves, not just for you.

Mature love is a sacred thing. Some think it only comes once in one’s lifetime. I believe it can come to anyone who wants it badly enough, with anyone they choose.

Real love can be in the middle of every relationship we have, with everyone we know.

Real love never just happens. It is created, moment-by-moment, day-by-day, year-by-year.

Love is about your willingness to discover your own capacity for forgiveness, compassion and integrity.

It is created with respect for each other’s beliefs, support for each other’s goals and inspiration for each other’s dreams.

When you have love, there is nothing else you need.

When you are really in love, the grass is never greener and the questions disappear.

When you become love you have done what you came here to do.

Love is not an instantly falling into thing. Love is a feeling fully, failing and forgiving, filling up and flowing over, finding you and finding me — a slowly becoming a forever thing.

Pub Note

With the #metoo movement on our radar — it is perfect timing for our feature story.

I imagine some type of trauma is a part of every addict and alcoholics story. While it can be an uncomfortable topic to talk about openly, it is crucial for a healthy and strong recovery to do so.

When producing this issue, I read every word of our feature, Interweaving Cycles of Addiction and Trauma by Claudia Black. And — I read it again.

Both times, memories from my past surfaced. Some, I had done the work on — others had been locked away in the vault for years. What was interesting to me as memories came back, I no longer felt the rage, anger or shame. While I physically felt the ‘chills’ for a few seconds, there wasn’t any fear. Maybe that is forgiveness at work.

It is no surprise I sought out drugs and alcohol to soothe the pain. Growing up I had no way to process my feelings, let alone speak them out loud to my caregivers. I carried the emotional scars for a long time and used them as an excuse for bad behaviors. In recovery, I gained the willingness to share who I really am; with sponsors, therapists and people I trust.

These powerful relationships have given me the courage to share my story with others and continue to heal. We all deserve to heal.

Happy Valentines readers!

Together AZ Community Calendar

Professional Events

FEB. 20 —PCS Networking Luncheon, 12:15 -1:30 pm. 3302 N. Miller Road, Scottsdale. Register: Jacquee Nickerson, 480-947-5739, email: pcs@pcsearle.com

Feb. 23—11:00 to 12:45 p.m. Sierra Tucson Grand Rounds, Professionals are invited to attend at Sierra Tucson. 1.0 CE available. 11:30 a.m. - 12:45 p.m. Lunch and Program. Campus tour available . Immobility, Shame, and Healing the Roots of Trauma, by Sharon Stanley, PhD. No cost. Register by Feb. 19. Seating limited, Cathy.Kauffman@SierraTucson.com. (800) 624-9001, Ext. 600417

March 5— 8:15 a.m. – 4:15 p.m. 12th Annual DPG Symposium, The POWER to Address Problem Gambling and its Implications. Black Canyon Conference Center, 9440 N. 25th Ave. Phoenix. To register visit http://azgamblingsymposium.com/

Open Support Groups & Events

FEB.10—LOVE ADDICTION — Out of the Darkness presentation by Patricia L. Brooks. Edgy Gallery Alternative. 40 N. Robson, Mesa. 1:00 - 2:00 p.m. RSVP to Mike Edwards 480-646-7000. Book signing to follow, Three Husbands and a Thousand Boyfriends.

LGBTQ+ IOP Program. Dedicated specialty program designed to meet the mental health and substance abuse, treatment needs of the LGBTQ+ population. Mon., Tues., Thurs. 6:00-9:00 pm. Transportation available. Call 602-952-3939 or 602-952-3907 for information.Valley Hospital, 3550 East Pinchot Ave. Phoenix. www.valleyhospital-phoenix.com

SIERRA TUCSON— Alumni Groups. Scottsdale, Tues., 6:00- 7:00 p.m.Valley Presbyterian Church. 6947 E. McDonald Drive, Paradise Valley. 480-991-4267. Meet in Counseling Center (Parlor Room). Rob L. 602-339-4244 or stscottsdalealumni@gmail.com.

SIERRA TUCSON— Continuing Care Groups in Phoenix. Thursdays – Resident Alumni. Psychological Counseling Services, 3302 N. Miller Road, Scottsdale. 5:30 – 7:00 p.m.Group is facilitated by staff of PCS at no charge for Resident Alumni. Contact Courtney at 520-624-4000, Ext. 600205 or email: Courtney.Martinez@SierraTucson.com..

Sierra Tucson - Resident & Family Member Alumni. First/ third Thurs. of month – Blue Door Psychotherapy, 5929 E. Pima St. Tucson. 6:00 – 7:30 p.m. Bi-weekly group facilitated by clinical staff at Blue Door Psychotherapy. No charge for Resident and Family Member Alumni. Courtney at 520-624-4000, Ext. 600205 or e: Courtney.Martinez@SierraTucson.com.

Mondays– Scottsdale – FAMILY  RECOVERY GROUP—Facilitated by Brough Stewart, LPC. 5:30-7:30 p.m. Designed to help begin/continue family recovery. Meadows Outpatient Center, 19120 N. Pima Rd., Ste. 125, Scottsdale. Contact: Jim Corrington LCSW, 602-740-8403

Celebrate Recovery — Compass Christian Church. Fridays 7 p.m. Room B-200. For men and women dealing with chemical or sexual addictions, co-dependency and other hurts, Hang-ups and Habits. 1825 S. Alma School Rd. Chandler. 480-963-3997.

Valley Hospital—IOP Group for Chemical Dependency/Co-Occuring. Mon.,Tues., Thurs. 6:00-9:00 p.m. 602-952-3939. 3550 E. Pinchot Avenue, Phoenix. valleyhospital-phoenix.com

Open Hearts Counseling Services — Women’s Therapeutic Group for Partners of Sex Addicts. Comfort, strength and hope while exploring intimacy issues. Cynthia A. Criss, LPC, CSAT 602-677-3557.

Families Anonymous—12 step program for family members of addicts. Scottsdale Sun. 4:00 p.m., 10427 N. Scottsdale Rd., N. Scottsdale Fellowship 480-225-1555 or 602-647-5800

NICOTINE ANONYMOUS (NicA) Fellowship for those with a desire to stop using nicotine. Phoenix Sat., 5-6:00 p.m. at Our Saviour’s Lutheran Church, 1212 E. Glendale Ave., Glendale, Sun., 9:15-10:15 a.m. Fellowship Hall, 8910 N. 43rd Ave. 480-990-3860 or www.nicotine-anonymous.org

Chronic Pain Sufferers “Harvesting Support for Chronic Pain,” 3rd Saturday of month, 12-1:00 p.m. Harvest of Tempe, 710 W. Elliot Rd., Suite 103, Tempe. 480-246-7029.

Jewish Alcoholics, Addicts, Families and Friends (JACS) 1st / 3rd Wed., 7:30 p.m. Ina Levine Jewish Community Campus, 2nd floor. 12701 N. Scottsdale Rd. 602-971-1234 ext. 280 or at JACSarizona@gmail.com

COSA (12-step recovery program for thosewhose lives have been affected by another person’s compulsive sexual behavior) Thurs. 11:00 a.m.-Noon. 2210 W. Southern Ave. Mesa. 602-793-4120.

Women for Sobriety — www.womenforsobriety.org. Sat. 10-11:30 a.m. All Saints of the Desert Episcopal Church-9502 W. Hutton Drive. Sun City. Christy 602-316-5136.

Co-Anon Family Support— Message of hope and personal recovery to family and friends of someone who is addicted to cocaine or other substances. “Off the Roller Coaster” Thurs., 6:30-7:45 p.m., 2121 S. Rural Rd., Tempe. Our Lady of Mount Carmel Church. Donna 602-697-9550 /Maggie 480-567-8002.

Cottonwood Tucson  Alumni—First Wednesday of month 6:00-7:30 p.m. 4110 W. Sweetwater Drive. Tucson.800-877-4520 x2141. www.cottonwoodtucson.com

ACOA Thurs., 7:00 p.m., North Scottsdale United Methodist Church, 11735 N. Scottsdale Rd., Scottsdale.www.aca.arizona.org

ACA. Tucson. Wed. 5:30-7:00 p.m Streams In the Desert Church 5360 E. Pima Street. West of Craycroft, Tucson. Room A. Michael 520-419-6723.

OA—12 Step program for addictions to food, food behaviors. 520-733-0880 or www.oasouthernaz.org.

Pills Anonymous—Glendale, Tues. 7-8:00 pm. HealthSouth Rehab 13460 N. 67th Ave. Rosalie 602-540-2540. Mesa Tues. 7-8:00 pm, St. Matthew United Methodist Church. 2540 W. Baseline. B-14. Jim, 480-813-3406. Meggan 480-603-8892. Scottsdale, Wed. 5:30-6:30 pm, N. Scottsdale Fellowship, 10427 N. Scottsdale Rd., Rm 3. Tom N. 602-290-0998. Phoenix, Thurs. 7-8:00 pm. First Mennonite Church 1612 W. Northern. Marc 623-217-9495, Pam 602-944-0834, Janice 602-909-8937.

GA—Christ the Redeemer Lutheran Church, 8801 N. 43rd Ave. Sunday, Spanish 7:00-9:00 p.m. Good Shepherd Lutheran Church, 3040 N 7th Ave. Sunday, English 6:00-8:00 p.m. 5010 E. Shea Blvd., Ste. D-202, Contact Sue F. 602-349-0372

SAA — www.saa-phoenix.org 602-735-1681 or 520-745-0775.

Valley Hope Alumni Support. Thursdays 6-7:00 p.m., 2115 E. Southern Ave. Phoenix. Tues. 8-9:00 p.m., 3233 W. Peoria Ave. Ste. 203, Open.

Special Needs —AA Meetings. Cynthia SN/AC Coordinator 480-946-1384, email Mike at mphaes@mac.com

SLAA—Sex and Love Addict Anonymous 602-337-7117. slaa-arizona.org

GAM-ANON: Sun. 7:30 p.m. Desert Cross Lutheran Church, 8600 S. McClintock, Tempe. Mon. 7:30 p.m., Cross in the Desert Church, 12835 N. 32nd St., Phoenix, Tues. 7:00 p.m., First Christian Church, 6750 N. 7th Ave., Phoenix, Tues. 7:15 p.m. Desert Cross Lutheran Church, Education Building, 8600 S. McClintock, Tempe, Thurs. 7:30 p.m.

Debtors Anonymous—Mon., 7-8:00 p.m., St. Phillip’s Church, 4440 N. Campbell Ave., Palo Verde Room. Thurs. 6-7:00 p.m., University Medical Center, 1501 N. Campbell. 520-570-7990, www.arizonada.org.

Eating Disorder Support Groups— PHX— Monday  7:00 p.m. 2927 E. Campbell Dr. Ste. 104, (Mt. View Christian Church). Jen (602) 316-7799 or edaphoenix@gmail.com. Wed. 7:00 p.m.  Liberation Center, 650 N. 6th Ave, Phoenix. (cross street McKinley).  Jennifer (602) 316-7799. Tempe—Thursday6:30 p.m. Big Book/Step Study.  Rosewood Centers for Eating Disorders, 950 W. Elliot Road, Suite #201, Tempe. Contact info@eatingdisordersanonymous.com. Tucson— Tues.  5:30 - 6:30 p.m. Steps to the Solution . Mountain View Retirement Village, 7900 N. La Canada Drive, Tucson.  leeverholly@gmail.com. Thurs. 5:30 - 6:30 p.m. EDA Big Book Step Study. Mountain View Retirement Village, 7900 N. La Canada Drive, Tucson.  (203) 592-7742 / leeverholly@gmail.com.  Wickenburg—Wed. 7:15 p.m. and Sunday 7:45 p.m. (N,D/SP,O,) Capri PHP program. (928) 684-9594 or (800) 845-2211.Yuma —Wed. @ 5:00 - 6:00 p.m. 3970 W. 24th St. Ste. 206 Yuma. Alyssa (928) 920-0008 or email 2014yumae.d.a@gmail.com.

GODDESSESS & KACHINAS Philosophical, spiritual, religious 12 step, 12 Tradtition, 12 Promises support group. Details 480-203-6518.

Crystal Meth Anonymous www.cmaaz.org or 602-235-0955. Tues. and Thurs.Stepping Stone Place, 1311 N 14th St. Phoenix

A Mothers Worst Nightmare

By Dawn Cummings-Duchak

Four years ago, my life turned upside down. Thinking about what happened, I thought I would never survive the tragedy— but I have. Life is different in so many ways, I can smile, laugh and love.

At age 16, I had to place my son Zachary in rehab. Having been to court multiple times when he was younger, I was frustrated each time the judge would give him probation and nothing else. I didn’t want to lose my son to drugs. So I pleaded with the judge, begging for help, but nothing really happened. I was so happy when he decided to start fresh in Phoenix.

On Dec. 11 at 4:00 a.m. I received the call no parent ever wants. I was told my son Zachary was in the hospital and on life support in Flagstaff, at the time I was living in Houston. My parents happened to be visiting me, so my mom and I flew out to Phoenix. On the plane, I heard my son say “It’s all good Madre.” I should have known then.

When we landed and I called the hospital, I was told he didn’t make it. I remember dropping to my knees and screaming. I recall looking up and travelers was coming and going in the airport, smiling and laughing and thought, what’s wrong with these people, didn’t they know my world just stopped?”

My sweet Zachary had committed suicide. When I received the autopsy report, I had to Google the names of the drugs because I didn’t know what most of them were. Zachary had moved to Phoenix with what I hoped to be a new start.

My brother and Zachary had decided to buy a small cabin off the grid and decided to throw their cell phones away, keeping one in case of an emergency.

They lived so far out when my brother called 911 because Zachary had shot himself, an ambulance wasn’t able to get to him. So he was put in the back of a truck, driven down the mountain, put into an ambulance and airlifted to a Flagstaff hospital.

Somehow my mom in her own grief was able to drive us up north. When we arrived at the hospital, I was told I couldn’t see my son because he was taken for autopsy. That was devastating. I asked if they could take me to the room that he passed away in just so I could make sure he wasn’t really there.

I had the opportunity to hold Zachary’s hand one last time. I will never forget the peace on his face.

If you have lost a loved one to suicide, you are not alone. There are resources available to help survivors of suicide loss cope. Learn more at https://suicidepreventionlifeline.org/help-yourself/loss-survivors/. 800-273-8255


Tax news

Did you know?
The Tax Reform that passed in December 2017 will not affect most people’s 2017 tax return due in April. It will affect you for 2018.

If you are expecting a refund for any tax year, you must file a tax return within 3 years or the IRS will keep your refund.

The IRS can collect on back taxes for 10 years from when a tax return is filed. If you don’t file a return, the 10-year statute of limitations never starts.

For more information visit www.tax-intervention.com Renee Sieradski, Tax Specialist, 602-687-9768.

A Different Kind of Valentine

By Alan Cohen

February is the month of Valentines, when our thoughts turn to love. Usually we give gifts and affection to romantic partners. This month I would like to shift our focus to expressions of love to our family, in particular our parents.

While reading Soul Friends by Stephen Cole, I came upon a quote by Buddha that caused me to put the book aside and think for a long time: “. . .the debt of gratitude we owe to our parents is so great that we could carry them on our backs for our entire lives and yet still never fully repay it.”


When I was growing up, I did not appreciate my parents. I was busy living out my own desires, figuring out who I was, and exploring the world. I took mom and dad for granted. I had judgments about them and wished they were otherwise. At times I was disrespectful. I was a self-involved teenager. 

My father passed away when I was 18, before I reached a stage of life when I became more conscious about my relationships, so I never got to express my appreciation to him. As I have matured, I have reconsidered the many kindnesses my folks showed me. They didn’t have much money. My father drove a bus at odd hours and my mother worked in a hat store during the day and a factory at night.

They did everything they could to keep me safe, comfortable, and happy. For most of my childhood we lived in an awful section of the city, where crime and depravity were rampant. Realizing the dangers of this environment, they worked harder to earn more money to move to a nicer part of town where the rent was quite high. They performed many other extraordinary generous acts. Despite their human frailties and habits I judged, their parenting was born of pure love. Looking back now, my heart is bursting with gratitude I wish I had shared with them when they walked the earth. My regret in not expressing this when I could have, is offset by the comfort that wherever they are now in God’s great kingdom, they receive my appreciation.

Perhaps your parents were not so loving and you were subject to mistreatment or abuse. Perhaps one or both of your parents were alcoholic or had some other dysfunctional habit. Perhaps they fought bitterly, or one was absent, or they divorced. Perhaps you harbor resentment, hatred, or guilt about your relationship with them. Perhaps you still have a hard time being with one or both of them. 

Perhaps you blame them for imprinting you with negative programming that created pain in your own relationships, and you feel thwarted from the reward you desire.
If so, there are three ways you can reframe your family experience to open you to more appreciation. 

The first is to reach for elements of their parenting that you genuinely value. Even if they were bad parents in many ways, they were probably good parents in some. What kindnesses did they show you? How did they encourage you? Who were they when they were at their best? They loved you somehow. Feel around for the gifts they did deliver to you. They are there. When you notice those blessings, they will expand. 

Next, gain compassion for your parents by recognizing that their acts that caused you pain issued from their own pain. “Hurt people hurt people.” I have coached many clients who are seeking to make sense of their relationship with a dysfunctional parent. I ask them, “What was your parent’s own pain? Who trained him or her to be fearful and mean?” In every instance my client traces their parent’s dysfunction back to some abuse that parent received from their own parent or another authority figure. The client’s parent did not have the skills or tools to achieve healing, so they passed their pain on to their children. 

A Course in Miracles tells us that every act is either a skillful expression of love or a call for love. When we reframe our parents’ negative behaviors as calls for love, we ease our own pain and clear the way for us to help them.

Finally, consider how you grew as a result of the challenges your parents posed to you. Did you learn to be more independent, or set boundaries, or dig in to find worth within yourself that they were denying you? Some teachers say that sometimes we choose our parents because they help us develop soul strength we would not have gained if our situation was easier. Thus they were our friends who helped us grow and step into our own power as adults. 

Most Asian families have altars in their homes honoring their ancestors — a practice we could well gain from doing ourselves. If you don’t wish to build an altar to your parents in your living room, you can create a sacred space for them in your heart. This year don’t reserve Valentine’s gifts for your honey only. Honor those who love you more than you know. 

Alan Cohen is the author of the bestselling A Course in Miracles Made Easy. For more information about books and videos, free daily inspirational quotes, online courses, and weekly radio show, visit www.alancohen.com.

Monday, January 8, 2018

An Integrated Approach to Tackling the Opioid Crisis

By CBI, Inc. staff

CBI knows we have an opioid crisis happening in the United States of America. If you work in the industry or have had a loved one affected by opioid addiction, then you get it. However, there are still many Americans who can’t explain opioids. They aren’t familiar with what they are, the side effects of use, and signs of abuse or withdrawal symptoms. They don’t know the opioid family expands from prescription painkillers (Percocet, Oxycodone, Vicodin, etc.) to the illicit drug of heroin and new forms of street fentanyl, an extremely potent narcotic that can be deadly from one use or exposure. Most people can’t explain the “crisis” component of opioids as many people are still unfamiliar with the addictive nature of all opioids. In community training, we often ask people what the number one cause of death is when abusing opioids and some typical answers are an overdose or heart attack. Yes, one c
an overdose, or take too many, but that doesn’t always mean death. We definitely need our hearts to function, but when it comes to opioids, they tend to act on our respiratory system, slowing our breathing, often resulting in respiratory failure, the number one cause of death. All this is just the start of the opioid epidemic in America.

Substance abuse is cyclical. 

It never ends. Patterns and trends change, but the abuse of drugs is constantly there. Over the years, Americans have seen an increase in drug overdose deaths. In the 1980s many will recall sayings like “the war on drugs” and “just say no” and we got the feeling that drugs were a problem in our communities. In 1980, there were 6,100 American lives lost to drug overdoses. As we approached the new millennium, we saw an increase to almost 17,000 deaths in 1999 and then we changed history when in 2008 there were more deaths from drugs than car crashes. Over 36,500 lives were lost. Sadly, the increase in drug deaths continues to rise. The Centers for Disease Control confirmed 52,404 drug deaths in 2015. Preliminary data suggests that the number of drug overdose deaths will reach over 64,000 for 2016! The deaths are from many substances; however, a majority of the deaths are from opioids. Early estimates claim 15,466 heroin deaths in 2016 and 20,145 deaths due to fentanyl. These numbers alone total 35,611, about 56% of all the deaths that year and we haven’t even factored in prescription pills.

You never know what you are taking. 

A substance that looks like a pill doesn’t mean it is a pharmaceutical grade drug. Anything can be pressed to look like a pill. There have been many cases of heroin and fentanyl showing up as counterfeit prescription meds. One should know that heroin is not only popular, but is the most potent it’s ever been. Today, heroin can be 90% pure, resulting in addiction or death with one time use. Fentanyl is 50 times stronger than heroin and the US has seen an influx of use and availability. Many of these fake pills are trafficked in from China and Mexico. Current trends reflect blue pills stamped to look like oxycodone. Fentanyl can be deadly in as little as 3 milligrams, which looks like 3 grains of salt… nearly undetectable to the human eye.

“The just say no” campaign failed. 

This is why being in the know or knowledgeable is so important. This is where it starts… education. We can’t be afraid to communicate with one another. Ask our doctors questions. Find out the facts. Inquire with loved ones about their habits, genetics, daily environments, etc. We need to prevent the problem before it occurs and start serious life skill conversations with our kids early and often. We can’t stop the efforts or give up hope. We just need to understand the potential for harm and reduce it.
Pain management is a real thing and necessary in some cases, but not all. It’s ok to feel pain and it’s ok to feel happiness. We learn from our life experiences and feelings. It’s all part of human nature to grow and develop. Perhaps we need reminders that drugs, legal and illegal, can hinder that progress. Maybe more importantly, we remember it’s possible to cope without the “pill for every ill” mentality.

Pain is part of life. We need to accept that pain is part of life. Yes, sometimes the pain becomes unmanageable. We may need medications, counseling or other means/skills to assist us in coping. However, it is when we do not accept the pain that we can create suffering for ourselves. When we burn our hand, we want to experience pain so we can treat that wound accordingly. When a loved one passes away, we may feel pain related to the grief of the loss. If we do not allow ourselves to feel the pain and/or process the experience, the pain can turn into suffering. We can store that pain or suffering in our bodies, which can impact our mind, behaviors, emotions and physical reactions.

There is treatment and support. 

Addiction and/or dependence not only impacts the individual who is addicted or dependent, it impacts families, friends and the community. Community Bridges, Inc. (CBI) provides services throughout the state of Arizona that assist individuals with getting on their own journey to recovery, and services that provide support and education to families, friends, and the community. At CBI, we know the journey to recovery is not always easy and it can look very different for each person. There's a stigma around addiction, which can include blaming the person who's addicted. Addiction does change the brain. As we treat other medical conditions, it's important that we're treating addiction the same way. When a loved one is going through cancer treatments, the family unit needs support as well. It's the same thing with addiction.

Recovery is possible. 

Community Bridges, Inc. (CBI) understands the support that is needed when you or a loved one are going through recovery. Many CBI employees have been through recovery, and are now working to help others realize the light at the end of the tunnel. Over the past 35 years, CBI has helped thousands of men, women, and families from all walks of life, including Veterans, homeless, and those suffering from mental illness and substance use. They offer a variety of programs that are catered towards very specific needs, such as opioid dependency.

CBI’s programs can help. 

UnScript is a program of Community Bridges, Inc.(CBI) which was developed to treat individuals who have become dependent on prescription pain medications due to having a legitimate pain condition and being prescribed medication by a doctor. The program uses medical interventions, along with an addiction-free pain management model to assist individuals in decreasing their dependence on opioid-based interventions and increase their ability to manage their pain in a manner that is less disruptive to their life. The programs assist the individual in making a long-term gain in their ability to manage their pain.

Don’t always believe your doctor. 

People go to the doctor and get a legitimate prescription for pain medication and feel as though they are doing the right thing. Over time, that dependence can build to where we see the need for the Unscript Program because it is that unintentional dependence that was developed due to being prescribed medication that was needed. We have become so used to prescribing these medications, even in large quantities for minor injuries or minor procedures. One may become physically dependent or addicted to these medications in as little as five days.

The original opioids are unheard of. 

The original opioids are naturally occurring substances and come from the opium poppy. Rather than converted into morphine and heroin, they are made into all these synthetic analogs that are meant to be more effective, more powerful pain relief. Then there's the street world of heroin. Physicians and the public have become more aware of the epidemic and physicians are starting to be wary of prescribing. We also have pharmaceutical databases to look at what somebody is being prescribed, and that's driving the move to street drugs.

The face of addiction has changed. 

Addiction no longer looks like the stereotypical homeless person on the side of the street. Most individuals who are dependent on drugs are like most of us, with families, jobs, and children. Substance use is becoming common in the workplace. The philosophy behind chronic pain management is that you'll be able to function until it starts getting out of control and addiction takes over.

Adolescents are becoming addicted to opioids. 

It is not just adults in the workplace becoming addicted to opioids, but it is also our youth. CBI is introducing their new Unscript Adolescent Program in 2018. The program will provide comprehensive, medically integrated behavioral health services that support members in achieving their recovery goals, enhancing health and wellness, and improving the quality of their lives.

Teenage deaths continue to grow due to heroin and other opioids. 

CBI developed an Adolescent Opioid Use Disorder Treatment Program model for those 16 to 18. The program will focus on brief intervention techniques and taper adolescents off opioids by using Medication Assisted Treatment (MAT), individual counseling, and expanded family support. By using a holistic approach and age-specific interventions, CBI will guide and support adolescents in their journey through addiction recovery.

Medically treating opioid dependencies. 

Medication Assisted Treatment (MAT) helps treat opioid dependency by using suboxone. According to studies, suboxone is a medication often prescribed to teens and is used to treat opioid dependence. “One of the advantages to using suboxone is that it can’t be taken to achieve a full opioid effect, making it more difficult to abuse than other forms of medication-assisted treatment, such as methadone. It is designed to assist the youth in slowly coming off opioids by introducing the suboxone and then to taper off suboxone. This transition process is done under the care of both a psychiatric and family practitioner to monitor mental health and physical health issues. CBI currently offers Medication Assisted Treatment services at five of their facilities in Arizona.

Treating more than just your addiction 

CBI’s specialized programs work through a multidisciplinary team approach to assess biological, medical, psychological, social, and spiritual domains of life to design the most effective treatment modality for each individual and/or family. The model addresses these domains to achieve true wellness and recovery. Family Support Services are used throughout the treatment to engage the family in discussion regarding education, crisis intervention, skills training, management of mental illness, problem-solving, and social and emotional support. CBI believes it is important to not only treat the patient, but their families too.

Your path to recovery. 

Everybody has their own journey through recovery. Every person has their own unique story and path. Community Bridges, Inc. (CBI) acknowledges that and takes every facet of your life into consideration when helping you through your path of recovery. CBI remarkable and talented staff loves people. CBI offers inpatient and outpatient programs that fit all individual needs.

For more information and to learn about our services please visit:

Sierra Tucson celebrates 10 years - Gratitude for Giving

December 1, 2017, marked the 10th annual Sierra Tucson Gratitude for Giving Recognition Award Breakfast. Each year colleagues in the addiction recovery and behavioral health industry vote for their peers for their outstanding work in the community.

This years winners include (from left) Humility Award: Nancy Barto (AZ State Senator), Compassion Award: Valita Warner (Terros Health), Gratitude Award for Lifetime Achievement: Dr. Michael Sucher,  Hope Award: Stephanie Siete (CBI, Inc., Community Bridges), Spirit Award: Terra Schaad (Hunkapi Programs).  Congratulations to all!

AZ Advocacy Day — January 11

By Angie Geren

In the November 2016 edition of Together AZ I wrote, “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.” 

January begins our legislative season, and it’s imperative we come together and advocate for change. Historically, those affected by addiction have not been represented in the legislative process. We were a demographic easily ignored and dismissed. As the opiate crisis continues to expand and overdose deaths continue to rise, we can no longer sit idle. Last year 35 people represented all of us by meeting with legislators and advocating for key legislation at our Addiction and Recovery Advocacy Day. I know we can easily double our attendance this year on January 11, 2018! It was clear we are being heard and have support from many legislators, however, we cannot rest on our laurels. The legislative process is long, arduous and requires diligence and support through the process.

Quick breakdown of bill process: first read, second read, committees, Committee of the Whole, Caucus, third read, vote and on to either Senate or House to repeat the process before being sent to the Governor’s desk for signature and then the law won’t go into effect for another 6-8 months. This allows for bad legislation to get changed and stopped along the way, it requires us to follow the bills and make sure good legislation has support through the entire process.

Many new bills are being introduced that could have a profound impact changing the conversation around recovery and addiction. Some bills directly affect the way addiction treatment works, ie., banning patient brokering, sober living regulations, and a Good Samaritan Bill that would not punish those who call emergency responders in a case of overdose with drug violations. These big changes need our support and voice. Legislators need to see people in recovery, they need our stories to shift their perceptions that we are “junkies” who will never amount to anything.

Advocating takes on many forms, from meeting one on one with your legislators to calling or emailing. The process can seem daunting and for those of us who have been let down by the “system” it can be very scary, however we are here to help shift your perception also! 

We need YOU, please join us at www.addictionhaven.com/arizona-advocacy  to find out how to become involved, read the bills that we are advocating for, and create change in our communities.

Can We Prevent a Suicide?

By Renee Sieradski, EA

Last month, a colleague told me she had lost her son to suicide a few years back, and then another friends daughter had a failed suicide attempt.

If I were to count how many personal friends and family I’ve lost to suicide, it’s 10 people. If I expand to colleagues, acquaintances, and their families, that’s another 10. I don’t know if this is an average statistic or if my count is higher.

As a person who has struggled with suicidal thoughts since pre-teen years, I know the feeling of the deep relentless pain and wanting it to stop. Thankfully I’ve always found the right people and medications to help with those feelings.

My cousin Becky who took her life at age 18. She had the biggest, most beautiful smile and was always so kind to me.

My husband and I are approaching our 20-year wedding anniversary. As I’ve mentioned in previous articles, he has bipolar disorder. According to the textbooks, he is at a higher risk for suicide than I am because most medications are ineffective for him.

We’ve figured out the secret to him staying stable is a combination of several factors including an obscure medication called Clozaril, not traveling long distances, avoiding crowds if he is in an irritable mood, and going to sleep at the same time every night.

I realize there may come a day when he gives up the fight against bipolar disorder. I, of course, would be devastated. He’s the love of my life. He was my first kiss, taught me how to drive a stick-shift and how to have humor in life. And he makes me laugh so hard my stomach hurts. We’ve been together longer than we’ve been apart and he is an amazing person. I don’t know how I would live without him.

When he first became ill, I used to leave work, run home and check on him almost daily out of the fear of losing him to suicide. I’ve since learned that if he was going to take his life, he would find a way no matter what magical, perfect words I came up with. I’ve learned to let go of the terror of losing him. I would like to think somehow me letting go of controlling whether or not he would take his life has empowered him to think it through for himself.
I have to take life one day at a time
I heard the most beautiful quote and wanted to share: “Your heart is full of a new storehouse of love every day that you wake up and if you don't give it away, it's gone forever.”

On to Finances:

On July 1, Arizona instituted a new law requiring employers to give their employees paid sick time. The only exceptions to this law being government employers and sole proprietor employers. It used to be only full-time employees received paid sick time but it now includes part-time, and seasonal or temporary workers. It, however, does not include contract workers.

The new law requires 24 hours of paid sick time per year, per employee for businesses with 14 or fewer workers and 40 hours for businesses with 15 or more people.

Another facet of this law is employees may request to use their sick time for other issues. Sick leave may be taken if an employee is dealing with domestic violence, sexual abuse, stalking issues, or the closing of a child’s school. The time may also be used for meeting with lawyers, arranging housing, or problems within the family.

An employer may only request proof of sick time when an employee has been absent for three consecutive days. Proof may be provided by way of a letter from an attorney, a doctor’s note, a police report, or a statement written by the employee. In the case of a written statement from the employee, he is not required to state why he needed the time off, but the time off was necessary. Employers are generally required to grant requests for sick leave. They are also required to keep records of accrued time off for each employee. These records of paid sick time, whether accrued or used, must be retained for four years. Employee paystubs should show the amount of sick time used and the amount available for use. This new law must also be posted in a conspicuous area where all employees can see it such as the breakroom. Employers should also have a company policy in place that clearly states, in writing, what happens to unused sick time if an employee is fired or quits.

Opioids After Surgery Left Her Addicted. A Medical Error?

By By Martha Bebinger, WBUR

In April 2017, Katie Herzog checked into a Boston teaching hospital for what turned out to be a nine-hour-long back surgery.

The 68-year-old consulting firm president left the hospital with a prescription for Dilaudid, an opioid used to treat severe pain, and instructions to take two pills every four hours as needed. Herzog took close to the full dose for about two weeks.

Then, worried about addiction, she began asking questions. “I said, ‘How do I taper off this? I don’t want to stay on this drug forever, you know? What do I do?'” Herzog said, recalling conversations with her various providers.

She never got a clear answer.

So she turned to Google to try to figure out how to wean herself off the Dilaudid. She eventually found a Canadian Medical Association guide to tapering opioids.

“So I started tapering from 28 [milligrams], to 24 to 16,” Herzog said, scrolling through a pocket diary that she used to keep track.

About a month after surgery, she had a follow-up visit with her surgeon. She had reached the end of her self-imposed tapering path the day before and at the doctor’s, she recalls feeling quite sick.
“I was teary, I had diarrhea, I was vomiting a lot, I had muscle pains, headache, I had a low-grade fever,” Herzog recalled.

The surgeon thought she had a virus and told her to see her internist. Her internist came to the same conclusion.

She went home and suffered through five days of what she came to realize was acute withdrawal, and two more weeks of fatigue, nausea and diarrhea.

“I had every single symptom in the book,” Herzog said. “And there was no recognition by these really professional, senior, seasoned doctors at Boston’s finest hospitals that I was going through withdrawal.”

Herzog did not name any of the providers who had something to do with her pain management or missed signs of withdrawal. She said she sees this as a system-wide problem. Herzog did share medical records that support her story. After the withdrawal, she did not crave Dilaudid and she manages any lingering pain with Tylenol. She has since returned to her providers, who’ve acknowledged that she was in withdrawal.

Not An Isolated Incident

Herzog’s story is one doctors are hearing more and more. “We have many clinicians prescribing opioids without any understanding of opioid withdrawal symptoms,” said Dr. Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing and co-director of the Opioid Policy Research Collaborative at Brandeis University’s Heller School. One reason, Kolodny said, is that doctors don’t realize how quickly a patient can become dependent on drugs like Dilaudid.

Sometimes that dependence leads to full-blown addiction. About half of street drug users say they switched to heroin after prescribed painkillers became too expensive.

Now, a handful of doctors and hospital administrators are asking, if an opioid addiction starts with a prescription after surgery or some other hospital-based care, should the hospital be penalized? As in: Is addiction a medical error along the lines of some hospital-acquired infections?
Writing for the blog and journal Health Affairs, three physician-executives with the Hospital Corporation of America argue for calling it just that.

“It arises during a hospitalization, is a high-cost and high-volume condition, and could reasonably have been prevented through the application of evidence-based guidelines,” write Drs. Michael Schlosser, Ravi Chari and Jonathan Perlin.

The authors admit it would be hard for hospitals to monitor all patients given an opioid prescription in the weeks and months after surgery, but they say hospitals need to try.

“Addressing long-term opioid use as a hospital-acquired condition will draw a clear line between appropriate and inappropriate use, and will empower hospitals to develop evidenced-based standards of care for managing post-operative pain adequately while also helping protect the patient from future harm,” said Schlosser in an emailed response to questions.
Kolodny said it’s an idea worth considering.

“We’re in the midst of a severe opioid epidemic, caused by the over-prescribing of opioids,” Kolodny said. “Putting hospitals on the hook for the consequences of aggressive opioid prescribing makes sense to me.”

Potential Addiction vs. Pain Management Awareness

Penalizing hospitals for patients who become addicted to opioids conflicts with payments tied to patient satisfaction surveys. Hospitals that do not adequately address patients’ pain may lose money for low patient satisfaction scores. In response to the opioid epidemic, patient surveys are shifting from questions like, “Did the hospital staff do everything they could to help you with your pain?” to questions that emphasize talking to patients about their pain. But physicians may still prescribe more, rather than fewer, opioids to avoid complaints from dissatisfied patients.
“This is a real concern that patients who may feel that their pain is under-managed may take that out in these patient report cards,” said Dr. Gabriel Brat, a trauma surgeon at Beth Israel Deaconess Medical Center who studies the use of opioids after surgery at Harvard Medical School.
Most patients leave the hospital with more pain meds than they need. Studies show that between 67 and 92 percent of patients have opioid pills left over after common surgical procedures.

One reason that may contribute to over-prescribing is that patients vary a lot. Brat said about 10 percent of patients need intense pain management, but it’s difficult to identify who will be that 10 percent.

“Many surgeons are still prescribing opioids for the subset of patients that have higher requirements, as opposed to for the majority of patients who are taking a very small percentage of the pills that they are prescribed,” Brat explained.

There are no firm guidelines for which opioids to prescribe after surgery, at what dose or for how long. The CDC released opioid prescribing guidelines for chronic pain in 2016, but it included only brief references to acute pain.

Some opioid prescribing guidance for surgeons is emerging. A study published in September reviewed surgical records for 215,140 patients. It found that the optimal opioid prescription following general surgery is between four to nine days.

This story is part of a reporting partnership with NPR, WBUR and Kaiser Health News.

Finding Joy

The dictionary defines joy as a deep feeling or condition of happiness or contentment, a source of happiness, an outward show of pleasure or delight; rejoicing.

Sometimes feeling a sense of joy can come from having a few moments of serenity or during a quiet meditation or reflection. It isn’t always an outward experience; it is also internal and quite personal.

I’ve sensed joy taking my seat in a 12 step meeting,  reaching my hand out to another, smiling at stranger in the grocery store for no reason, and when my cat sits on my lap and snuggles.
I’ve felt sadness, pain and grief through the years, and coupled with fear it can be debilitating. I have learned sometimes you have to dig deep and dive down to find the light and the way up.

A few months back I was exhausted, physically, mentally and spiritually. The first thought that came to mind was, “Well, you’re not 35 anymore.” I realized I couldn’t keep running and doing, it was time to be a human “being.” Just being.

So I took some time off, a few long needed naps on the weekends and asked my Higher Power for guidance. Along with His guidance —  I prayed for patience. Patience with myself, the people and world around me.

Everything really does happen in God’s time.

I wish for you this coming New Year to enjoy all the joy that is around you.

It’s Your Year

By Dr. Dina Evan

No doubt about it, 2017 was a tough year for most. However, the energy of the New Year brings a fresh start, and new hope. One of the greatest gifts we have as human beings, is we get to begin again in each moment, in each day and on each New Year. We get to do that by making a new choice. Nothing you have done in the past can hurt you, the moment you make a new choice. None of the headlines, news reports or the scare tactics can have any effect at all, unless you begin to believe them. The past has no power over you unless you drag it kicking and screaming into this new year.

You are very powerful 

Since you are creating your reality with each new choice, you have an immense impact on creating the life, the body, the joy you want to have, the moment you make that decision. That choice is your first step. It ignites the fire. Believing a new choice is available and claiming it as yours is not always easy. Sometimes what seems to be...can feel overwhelming. Your choices direct the energy in your life to whatever you choose to focus on and we can be inadvertently focused on the strife in life before we realize we are drowning in that energy.
A master is careful about who he or she invites into his or her mind and life. A master knows that choices must be in alignment with integrity, spirit and values because if it is not, the creative force is lessened. For instance, think about the last time you made a half-hearted decision you really didn’t believe in or knew was wrong. What happened? No doubt you spent some time cleaning up the mess because that decision or action wasn’t aligned with your heart and soul. It wasn’t part of your purpose. It’ a little like a sour note in a symphony.
On the other hand, think about the times your made a decision or took an action that your heart and soul just knew was right for you, even if it didn’t seem possible. No doubt it worked for you in some form. If you still have doubt, you have clearly not heard of Ho’oponopono, the Hawaiian healing process used by Dr. Stanley Hew Len. Take a moment to find his story online and read about he healed a ward of mentally ill, criminal patients with Ho’oponopono. Yep, he actually healed a hospital full of murderers and insane patients that were criminals, simply by using directed energy and love. He never even spoke with them personally. The staff thought he was nuts, but after a year, there was no longer any turnover in staff, no need for strait jackets and the place was flourishing with love and healing. The energy there became joyful for both staff and patients.

We have a choice this year. 

We can listen to the rhetoric of division, separation and fear, or we can create life as WE want it to be. We can stop and help another with love, we can encourage someone even if it is just a sweet hello. We can decide what energy we will empower in our lives. I know many people feel this is a bunch of woo-woo nonsense. These are the same people who have never tried it. Sometimes the simplest things in life are also the most effective. So, here is the secret. Think of something you want this year. Every morning when you get up and you are getting ready for your day, look in the mirror and say, “Today I have (you fill in the blank). Don’t say it in a wimpy way. Own it. It’s that simple. The hard part is not allowing doubt and negative energy to seep in and diffuse your directed energy. So, when that happens, and it might because this is a new thought process, just say cancel — cancel and reaffirm your first thought. For some reason, the mind hears a cancel, cancel or erase-erase or delete-delete as an instruction not to retain the last negative thought in mind. What have you got to lose?   

Reaffirming you new thought each day may change your year in wonderful new way. And, it also changes the energy for the rest of us in a positive way. It’s a team effort. We wish you every blessing in 2018.

The Teen Vaping Trend What Parents Need to Know

With the recent Monitoring the Future Study release indicating that nearly one in three 12th graders reported using a vaping device in the past year, it’s imperative that parents are informed of the potential dangers that can result from vaping.

What is Vaping?

Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapor, produced by an e-cigarette or similar device. It’s become more popular among teens than regular cigarettes, especially given that vaping devices can be used for anything from flavors like mango, mint or tutti frutti, to flavorings containing nicotine or THC, the chemical compound in marijuana that produces the high.

What are the Risks?

There are several risks to vaping for teens. Below are three major ones for parents to be concerned about:

Vaping is often marketed to kids, downplaying the dangers.
With lots of flavors available for vaping liquids, as well as the variety of colors and devices available that charge just like cell phones, it’s clear that vaping products are often marketed to teens. One of the slang terms for vaping, known as JUULing (“jeweling”), comes from the JUUL brand device that looks more like a flash drive as opposed to an e-cigarette. Vaping is also often sold as a “safer” alternative to cigarettes, and some teens are under the false assumption that because e-cigarettes don’t contain tobacco they’re safe.

Vaping chemicals used in the liquids can be more concentrated and dangerous.

Inhaling from a vape pen or e-cigarette, especially in the case of one containing nicotine or THC, can enhance a drug user’s high and can amplify a drug’s side effects. Vaping is also very new and there are literally hundreds of brands, so there’s not a lot of firm information about what chemicals might be in what vape liquids. But even beyond nicotine and THC, synthetic chemicals that make up these liquids – including “herbal incense” like spice and synthetic marijuana – expose the lungs to a variety of chemicals, which could include carcinogens and toxic metal nanoparticles from the device itself. Not only could these chemicals make their way into young lungs, causing irritation and potentially “smoker’s cough,” but they could also damage the inside of the mouth and create sores.

Vaping may make the transition to cigarette smoking easier in adolescence.

In a meta analysis of six studies, the findings concluded that the risk of smoking increases four times if a teen vapes versus a teen that does not. In another study of more than 2,000 10th graders, researchers found that one in five teens who reported a regular vaping habit at the start of the study smoked traditional cigarettes at least three times a month by the end of the study period. Another 12% of routine vapers smoked at least one day a month. By comparison, less than 1% of students who didn’t try vaping reported smoking even one day a month at the end of the study.

What Can Parents Do?

Make it clear to your son or daughter that you don’t approve of them vaping or using e-cigarettes, no matter what.
If you think your son or daughter is vaping, take a deep breath and set yourself up for success by creating a safe, open and comfortable space to start talking with your son or daughter. As angry or frustrated as you feel, keep reminding yourself to speak and listen from a place of love, support and concern. Explain to them that young people who use THC or nicotine products in any form, including e-cigarettes or vaporizers, are uniquely at risk for long-lasting effects. Because these substances affect the development of the brain’s reward system, continued use can lead to addiction (the likelihood of addiction increases considerably for those who start young), as well as other health problems.

You want your child to be as healthy as possible. Find out why vaping might be attractive to your son or daughter, and work with him or her to replace it with a healthier behavior.  (Source: drugfree.org/parent-blog/the-teen-vaping-trend-what-parents-need-to-know/)

BOOK REVIEW: You Can’t Make Me Angry

By Dr. Paul O

Reviewed by Kyle Rhodes

“By the time you put this book down, you will be convinced that people and circumstances don’t make us angry; we make ourselves angry. People can’t make us angry—unless we let them. We alone are responsible for our feelings.

A measure of the effectiveness of communication is the result it produces. If you don’t like the results you are getting when communication with another person, there’s a great deal you can do about it. I’m not willing to let any thing or any person put my physical sobriety at risk; why should I put less value on my emotional sobriety?

For physical sobriety, we had to give up drinking, and for emotional sobriety, we have to give up blaming others. No longer can we say, “You made me angry!” Instead, we must accept personal responsibility for our emotional state.

This much responsibility may seem extreme, yet in fact it is a great freedom. Henceforth, no person or situation can upset us if we don’t give them or it permission to do so. What could be a greater freedom than that?

Emotional maturity is like serenity. 

The first time I felt serene, I wondered what was happening, but I liked the feeling and wanted more. The more I got, the more I wanted. Serenity is addictive,” passage from the back cover.
“And acceptance is the answer to all my problems today.” Alcoholics everywhere know of Dr. Paul’s wisdom through the often-quoted passages from his story, “Acceptance was the Answer”, in the big book of Alcoholics Anonymous. Dr. Paul continues sharing his astute insight and gentle humor with discussions of the physical, mental, emotional, interpersonal and spiritual aspects of sobriety in his book, You Can’t Make Me Angry.

He begins by discussing “the problem.” With an extremely interactive use of language targeted directly at the reader, he points out the importance of both physical and emotional sobriety by explaining what he believes is a contributor to becoming a “dry drunk” or experiencing alcoholic “slips”. As an alcoholic, Dr. Paul says his emotional sobriety must be maintained in order to remain physically sober. A key aspect to this “emotional sobriety”, he suggests, is accepting responsibility for his own emotional state and his emotional reactions to someone else’s behavior.

Dr. Paul uses examples from his own experience in Al-Anon to show living examples of how people are able to make incredible changes along the lines of emotional sobriety. Al-Anon members are particularly suited as examples because many of them are able to maintain emotionally sobriety whether or not their alcoholic is drinking, dry or sober. Dr. Paul’s simple wisdom complements his tall order for action by acknowledging that human beings, alcoholic or not, are simply not going to be able to “maintain complete control of our emotional state at all times”.

Interpersonal relationships depend on communication in order to thrive. Dr. Paul suggests that emotional independence is a way to clear communication with others. When we allow others to control our emotions and actions with their behaviors we are not always able to clearly communicate what must be said or done. He tells us that if we aren’t happy with the results our communication skills are producing, then we must have “the courage to change our thinking, our attitudes and our behavior in many small ways.”

One of the most effective and interesting styles I have experienced, Dr. Paul doesn’t only put forth suggestions and solutions. He points out several behaviors and tendencies many people struggle to let go of. He adds the resulting chaos as part of his explanation of what can get in the way of effective communication and emotional independence. He borrows theories from psychologists and counselors to drive home several of his main concerns.

Dr. Paul borrows valuable advice from other books and authors as well as drawing from his own experience in Alcoholics Anonymous, Al-Anon, and his marriage to Max O. in order to put some perspective behind the suggestions he has put forth. As a reader, we are able to see practical application of some of the things we have read up to this point and the results that came to fruition for Dr. Paul. He continues to offer up techniques and practices that he has had success with in maintaining his own emotional sobriety. His experiences are easily relatable for anyone who is a member of Alcoholics Anonymous or Al-Anon, and for those who are in a committed relationship or marriage.