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Inspiring Success on the Road to Recovery

Thursday, October 4, 2018

Looking Back, Looking Ahead:

Reflecting on the Progress of Mental Health Treatment and Recovery, Along with New Hope Anchored in Science, Education and Integrated Care


By Terros health staff


Addiction — to tobacco, alcohol or prescription or illegal drugs — is a disease that contributes to 632,000 deaths in the United States every year, according to the Centers for Disease Control and Prevention. 

Yet most physicians don’t have adequate training to treat addictions comprehensively, and too few medical schools offer addiction education. According to the National Center on Addiction and Substance Abuse at Columbia University, the medical profession has failed — “in medical school, residency training, continuing education and in practice” — to address addiction.

There is a need: Statistics about substance abuse addictions, mental illness and suicide
  • An estimated 16 percent of Americans ages 12 and older — about 40 million people — have a substance abuse problem, an addiction to alcohol, illegal or prescription drugs or nicotine.
  • Only 11 percent of people in need receive treatment.
  • One-third of all inpatient hospital costs are linked to addiction and risky substance use.
  • Serious mental illness costs in the United States amount to more than $193 billion in lost earnings per year.
  • Drug overdoses took an estimated 72,000 
  • lives in the United States in 2017.
  • Suicide is the 10th leading cause of death in the nation and the second leading cause of death among people between the ages of 15 to 34.
(Sources: Center on Addiction, National Institute on Drug Abuse, Centers for Disease Control and Prevention) 

In Arizona, however, a stellar example of a behaviorally-led integrated approach to wellness, mind and body, is building healthy communities through exceptional patient experiences, quality outcomes and controlled health care costs. 

Terros Health, founded nearly 50 years ago, last year helped more than 53,000 Arizonans on the path to better health and an improved quality of life. It started by treating physical and behavioral health conditions as one, rather than in silos. As part of its integrated model of care, Terros Health provides primary medical, mental health, substance abuse and wellness care under one roof.

“We look at the whole person,” said Dr. Saul Perea, Terros Health’s Integrated Care medical director. “And we are educating people one by one, helping people one at a time, bringing them in for treatment and ultimately changing lives.”
Terros Health is working hard to change the stigma of mental illness, reduce barriers to treatment and achieve more effective treatment protocols. It’s part of a movement that began in 1909 when former psychiatric patient, Clifford W. Beers, witnessed and experienced horrible abuse while being institutionalized. Today, Mental Health America (MHA) is a leading community-based nonprofit that has made an indelible mark on tens of thousands of people. 

MHA also led advocacy efforts that have resulted in landmark legislation, including the signing of the National Mental Health Act by President Harry Truman in 1946, the creation of the National Institute of Mental Health and allocation of government funds for research into the causes of and treatments for mental illness.

Fast-forward nearly two decades to 1963: Congress passed the Mental Retardation Facilities and Community Health Centers Construction Act, providing federal funding for the development of community-based mental health services. 

Then in 1977, President Jimmy Carter established the President’s Commission on Mental Health, among the first comprehensive surveys of mental health care. Formation of The National Alliance for the Mentally Ill followed in 1979 and the Americans with Disabilities Act was adopted in 1990 to protect mentally and physically challenged Americans from discrimination in a variety of settings.

Progress continued in 1996, when the Mental Health Parity Act, the first federal legislation to bring more equity to health insurance coverage of mental health care, was adopted. The same year, President Bill Clinton moved to end discrimination in such coverage for 9 million federal workers by enacting mental health insurance parity for them. 

Mental health parity is important because it ensures equal treatment of mental health conditions and substance use disorders in insurance plans. Although Congress passed this legislation in 1996, the advent of the Affordable Care Act in 2010 delivered on this promise. 

As a result of the ACA, patients with physical and mental health conditions cannot be denied health care coverage. What’s more, behavioral health services are an “essential benefit” required by law.

Education brings awareness, science gives answers 
Public policies have come a long way in helping the one in four Americans challenged by mental illness and addiction, yet more must be done. Society’s false beliefs about mental illnesses — that only weak people, poor people, damaged people have them — once were widespread. 
Fortunately, advancements in neuroscience, the advent of the Information Age, and focused public awareness campaigns are reversing that trend, said Dr. Randy Brazie, Terros Health’s chief medical officer. As Brazie explains, addiction isn’t selective. “It affects people of all socioeconomic levels, races, genders, ages and occupations,” he said. “A mental illness is no different, in terms of being ‘real,’ than a physical illness, such as cancer or heart disease.”
This realization is bringing mental illness out of the shadows, showing patients they aren’t alone, acknowledging they can’t just “snap out of it,” and expanding empathy and understanding, he said. 

Addictions have long been thought to be related to any number of things: psychological factors, stress and personality traits such as high impulsivity, environmental influences, including exposure to physical, sexual or emotional abuse or trauma, and using alcohol, nicotine or other drugs at an early age.

But just as the field of genetics is pinpointing the causes of cancer and Alzheimer’s disease so, too, is science revealing more about addiction and its associated risk factors. These include genetic predispositions and certain brain characteristics that may make a patient more vulnerable to addictive substances. 

Neuroscience also is producing a rapid evolution in our understanding of how pathways in the brain may be triggered by substance abuse. 
“Addictions are very much driven by how the brain responds to things,” Brazie said. “And when a pathway in the brain gets triggered, it can be very difficult to extinguish.”

“Dramatic revelations about the role of biology and genetics in mental illness make the hope for better diagnoses and treatments exciting,” Perea said. The Center on Addiction reports that genetics account for 50 to 75 percent of the risk for addiction. 

“Genetics are so impressive in other areas of medicine, in terms of prediction and treatment,” he said. “For example, in a cancer patient, what type of treatment will he or she respond to best, based on his genetic makeup? The same thing is happening in mental health, where we are identifying the gene that causes schizophrenia. The promise is huge.”

A new model of care

So is the promise of integrated care. 

Terros Health’s model of care hinges on many years of research at the AIMS Center – Advancing Integrated Mental Health Solutions, at the University of Washington. 
The Center’s evidence-based model, known as Collaborative Care, was used in a large randomized treatment trial for depressed adults who visited primary care clinics across the United States and abroad. Collaborative Care was shown to double the effectiveness of depression treatment while lowering long-term health care costs, according to study findings reported in the Journal of the American Medical Association. 

For example, at one year, about half of the patients receiving Collaborative Care reported at least a 50 percent reduction in depressive symptoms, compared with only 19 percent of those in primary care. They also experienced more than 100 additional depression-free days over a two-year period than those in primary care.

When a new patient with anxiety, depression or another mental health condition comes to Terros Health, he/she is seen by a primary care physician for a health screening, then meets with a behavioral therapist where medications, medical history and symptoms are chronicled. Throughout the process, Terros Health physicians, nurse practitioners and clinicians access the patient’s electronic health record and communicate about the course of treatment and progress. 

Such was the case with Shannon Ballejos. 

An unexpected job loss, a car accident, oxycodone for back pain, followed by heroin use, tore Ballejos’ family apart. Thanks to integrated care, she has been off drugs for nine months and is putting her family back together.

Ballejos was devastated when, after moving with her three younger children to a new city for her company, her new job fell through. She returned to Phoenix, was recovering from the disappointment and was planning to start over until the accident. 

“When I was no longer able to get the prescription for oxycodone, a friend introduced me to heroin. I was 39, and this was the first time I had used drugs. I changed so much. I was neglecting my children to the point that DCS (Arizona Department of Child Safety) had to step in and take them from me. They were 5, 7 and 11 at the time. It broke my heart, but contrary to every value I thought I had, I still wanted heroin.”

DCS referred Ballejos to Terros Health for treatment
“My case manager believed in me when I didn’t. I kept relapsing, but she stuck with me and recommended that I enter residential treatment for 30 days at Maverick House. 
“Going there was the best decision I ever made. I not only learned the painful lessons of my addiction, but I also discovered what made me happy, little things like crocheting, reading and hiking.”
Ballejos’ recovery has been supported with Suboxone prescribed by Perea, whom she sees monthly. Another Terros Health physician manages her asthma and other general medical issues. 
Ballejos doesn't take her new life of recovery lightly. After Maverick House, she completed two sessions of outpatient treatment, has a recovery sponsor she speaks with every morning and participates weekly in Narcotics Anonymous and Heroin Anonymous.

Family life is becoming normal for Ballejos, who also has three adult children and has been reunited with her three younger children. 

Treatment works

The importance of treatment cannot be overstated, Brazie said. ”The reason is simple: treatment works.”

Christopher Gabriel Jojola had been using Percocet and heroin for six years, and when he tried to stop, he experienced excruciating withdrawal symptoms. “I felt sick and everything hurt. I didn’t crave the drug. In fact, I hated the drug. I needed help with my withdrawal.”
Jojola, 34, researched health care organizations and chose a Terros Health clinic about a year ago. 

“I had not used for 16 hours, which was a requirement before I could get treatment. I walked into the clinic fairly sick. They put me in a quiet room and made me comfortable. The doctor gave me Suboxone (an FDA-approved medication for testing opiate dependence) and monitored me to adjust the dosage. I felt better and came back the next two days for additional medication adjustment, and then they gave me a two-week prescription to continue helping me with the withdrawal.” 

When asked to begin intensive outpatient treatment, Jojola questioned whether he could get to the clinic three days a week for the three-hour group sessions. “Cathy, a primary care support specialist, asked me if I had been able to make it to my drug dealer every single day. Of course, I had. I realized I could make it to the counseling sessions.”

Jojola credits his successful recovery to his physicians and medication, plus seven months of intensive outpatient treatment, and individual counseling sessions when he needed it. He wondered if anyone at the clinic truly cared about him. “It turns out the staff does care. It is not just a job for them.”

Jojola is now working full-time as a commercial plumber and has joint custody of his two children, ages 7 and 9. “My future is looking bright.”
Prince Zombo is feeling equally hopeful about what lies ahead. 
Zombo is a permanent resident of the United States who was born in Liberia, Africa. When a civil war in his homeland broke out, Zombo and his family moved to New York City.

Soccer is Zombo’s passion. He played it in Africa and New York, where he graduated from high school, then coached soccer there. Since moving to Arizona in 2011, he has continued to coach, and enjoys involving children in healthy sports.

In August 2014, life became difficult for Zombo, 41, and his two sons, Prince Jr. and Promys, whom he was raising alone. Because of a medical emergency, Zombo was taken to the hospital, leaving his children with a neighbor. 

When DCS became involved in the matter, Zombo appeared in family court. He tested positive for marijuana, his two boys were placed in foster care and he was ordered to receive treatment.

“I didn’t think my marijuana use was at the level that needed treatment, but I wanted my boys back. I was willing to do anything for us to be a family again.” 

Zombo participated in two years of counseling and treatment services at Terros Health, and worked as a behavioral health technician in a group home.

He quit marijuana use and was reunited with his sons in June 2016. The most important lesson he learned in counseling was living a sober life.
Today, he says his life is great, “I have a roof over my head, a job as a manager of a group home and a beautiful family.” He has set a personal goal to become a peer recovery coach.

Knocking down insurance barriers

For some, it’s hard to imagine the thought of having mental health issues, particularly when there is no history of mental illness in the family. It’s how one confronts these challenges that is key to their recovery, Brazie said. “Shannon, Prince and Christopher are shining examples of what can happen when you are set on a path of recovery.”

Despite the roadblocks, mental health care in America and Arizona are evolving in a positive way, Brazie added. This includes stepped-up assistance by health insurance companies, which historically have been slow to reimburse providers for mental health services. A new program in Arizona, effective Oct. 1, will change that, when 1.5 million AHCCCS members will move to Complete Care integrated health care plan. It will provide both physical and behavioral health services. 

“This is good news for all Arizonans,” Perea said. “People should never suffer in silence. As a mental health community, we are here to help them get the services and treatment they expect and deserve.”

There is help: Mental health resources
Terros Health, terroshealth.org, 602-685-6000
National Institute of Mental Health, nimh.nih.gov, 866-615-6464
Substance Abuse and Mental Health Services Administration, samhsa.gov, 877-SAMSHA-7
National Alliance on Mental Illness, nami.org, 800-950-NAMI
Mental Health America of Arizona, mhaarizona.org, 480-982-5305
Veterans Crisis Line, veteranscrisisline.net, 800-273-8255

14th Annual NAMI Valley 5K Walk

Recovery is something that you have to work on every single day and it’s something that doesn’t get a day off.


14th Annual NAMI Valley 5K Walk on Saturday, October 20

Walk to increase awareness in Arizona about mental illness and its devastating effects. Help us bring Arizona’s mental illness community together, and raise dollars for NAMI’s outstanding and vital support and education programs!

Visit http://www.namiarizona.org to join and/or donate to the NAMI Valley of the Sun Stigma Stompers Walk Team. Help us exceed our goal of $5,000.

The community is coming together at the Arizona State Capitol grounds, 1700 W. Washington St. in downtown Phoenix.Registration starts at 8:30 a.m. The walk starts at 9:15 a.m. Sign up for either the 1.2K or 5K walk.

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI shapes national public policy for people with mental illness and their families and provides volunteer leaders with the tools, resources and skills necessary to save mental health in all states.

Suport and Events

Professional Events
OCT. 16—PCS Networking Luncheon,12:15 -1:30 pm. 3302 N. Miller
Road, Scottsdale. Jacquee Nickerson, 480-947-5739, E:pcs@pcsearle.com

Nov.4 —Arizona Psychodrama Institute Full Day of Basics — ($99 per session). API offers “Basics of Psychodrama” every two months and each one is uniquely different.

Nov. 30,— Sierra Tucson 11th Annual— “Gratitude for Giving” Celebration Sierra Tucson will recognize professionals in the Phoenix area for their years of giving to others. Join us in honoring your selected peers who have made a significant contribution to our community. 9:00 a.m.-Registration. 9:30 a.m. - 11:00 a.m. Breakfast, Presentation of Awards, Arizona Biltmore, 2400 E. Missouri Ave.

Support Groups & Events

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 602-952-3939/602-952-3907.Valley Hospital, 3550 E.Pinchot Ave. Phoenix. www.valleyhospital-phoenix.com

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

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

SIA (Survivors of Incest Anonymous) 12-step, self-help recovery program for men and women, 18 and older, who were sexually abused as children. The only requirement for membership is you were sexually abused as a child and want recovery.  Scottsdale, Saturday, 2:00pm - 3:00pm, Bethany Lutheran Church, 4300 N 82nd St. 480-370-3854. www.siawso.org

FAMILY RECOVERY GROUP—Facilitator, 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. Jim Corrington LCSW, 602-740-8403

HEALTHY INTIMACY GROUP— Tucson—Weekly women’s group.  Explore intimacy issues and help heal relationship and intimacy wounds. Desert Star Addiction Recovery Center. 520-638-6000.

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 /602-647-5800

NICOTINE ANONYMOUS (NicA) Fellowship for those with a desire to stop using nicotine. Phoenix Sat., 5-6:00 p.m. 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. 1st / 3rd Wed., 7:30 p.m. Ina Levine Jewish Community Campus, 2nd floor. 12701 N. Scottsdale Rd. 602-971-1234 ext. 280.

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

LIVING GRACE SUPPORT GROUP– A Christ centered approach for individuals and families affected by mental illness. Oasis Community church, 15014 N. 56th St. Scottsdale. 602-494-9557. 2nd & 4th Tuesday 6-8 p.m.

Women for Sobriety —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.

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, E: 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 Rd, Ste. #201, Tempe. E: 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.

SEND EVENT OR SUPPORT GROUP INFORMATION TO
aztogether@yahoo.com.

Statistics Show Arizona Is Making Progress in the Opioid Crisis



The latest information suggests the efforts by the State of Arizona is making progress against the war on opioids use.

The Arizona Opioid Emergency Response June 2017 to June 2018 report lists several significant factors that describe what Arizona is doing to eliminate the opioid epidemic crisis in the state. Some key indicators in the report are:

The percent of patients receiving referrals to behavioral health or substance abuse treatment services after an overdose increased from 45% in June 2017 to 73% in May 2018.

The number of naloxone prescriptions dispensed by pharmacists has more than tripled in recent months. July–September 2017, fewer than 900 naloxone kits were dispensed each month. In May 2018, 3,498 kits were dispensed to the public.

The number of opioid prescriptions filled declined 40% between June 2017 and June 2018.

The number of opioid pills dispensed decreased 43% between June 2017 and June 2018.
The 4 & 4 report is a list of patients who have obtained controlled medications from 4 different doctors and 4 different pharmacies in a given month.

The Arizona Board of Pharmacy sends any prescriber with a patient on the 4 & 4 list an unsolicited letter to alert the prescriber of the patient's possible doctor and pharmacy shopping. There has been a 62% decline in the number of patients on this report – from 99 in July 2017 to 38 in June 2018.

Further evidence that Arizona is aggressive in dealing with the opioid epidemic can be found in the Arizona Attorney General’s office issuing almost half a million dollars to fight the opioid abuse problem in the state.

These are just a few of the key indicators that let you State officials have plans to continue to address this epidemic for as long as necessary.

For more information visit azhealth.gov/opioid

SALLY'S PLACE

SALLY'S PLACE


In Phoenix, Sally’s Place is a supportive housing program for pregnant women struggling with addiction. The program provides a supportive environment in which women are given the opportunity to parent their newborn. The goal is to re-introduce the woman and her child into the community with safe housing, support, and continued resources.
Sally’s Place is a community with six two-bedroom apartments surrounding a communal courtyard. 24-hour on-site staff provides peace of mind and support for women during their pregnancy and new motherhood. The communal nature of the complex promotes a women-helping-women atmosphere where more experienced mothers can advise and support their peers. The women participate in the Women’s Outpatient Program and have access to all of NCADD’s services including Educational and Vocational training.

Sally’s Place opened in 2015 and was named to honor the work of former NCADD CEO Sally O’Malley Whitten Lara. Since its opening Sally’s Place provided shelter and support to many women and their babies.

Sally’s Place is open to women who: Are pregnant or have recently given birth, have a mental illness, and are actively working on recovery. For more information visit https://ncadd-phx.or call (602) 264-6214.  

Who’s Behind the Mask?

By Dr. Dina Evan

This is time of year when we wear masks and scare people. However, the scariest truth is we spend the majority of our lives behind a mask, not being who we really are and not knowing how to get there. Frequently, we are different people with different truths for different people, and we do it with such ease, we almost believe the lies ourselves. Pamela Meyer, author of Liespotting, claims in her TED Talk that we’re lied to from 10-200 times a day. We create a set of lies for this person or group and a different set of lies for another. It’s not that we are trying to be deliberately malicious, but boy, have we gotten creative with our lies.


One of the ways we lie, is we tell people what we think they want to hear. Like children, we even color our lies. For instance, lies of omission, or the ones we justify by not wanting to hurt someone’s feelings are considered white lies. Even these seemingly harmless, cute, little lies destroy our integrity and chip away at our self-esteem. They create guilt because we know, inside, we are hiding something about which we feel ashamed.

Frequently, we call in the troops and collude with others and we get them to shade the truth with us. When you create an alternate, agreed upon, reality between you and another person, this makes them complicit and especially if they are a young person — it teaches them that lying is okay. Another kind of lie is when we make ourselves look better by acting pridefully, as if we did something on our own, without acknowledging that we couldn’t have been successful without the help of others.

What about Exaggeration?

Today, we’re experiencing a tremendous amount of exaggeration. When you exaggerate or lie about yourself or abilities, you are left feeling like a fraud, which further diminishes your self-esteem. When people realize you’re lying, not only have you lost credibility, but you have also lost trust.

You have taken a step back from being your true self, and into being more of a fraud. It’s especially difficult to watch those you love — lie. It makes us sad because we so want something real, especially with those closest to us.

The youngest among us lie the least, simply because they have not yet learned how. So what are we teaching them?

How do we Stop?
Perhaps, part of the issue is that we perceive telling the truth as hurtful. Actually, it’s a gift that says, “I respect and love you too much to lie to you.” People honestly feel safe and valued by you when they know you will always tell them the truth, even when it smarts a bit. Otherwise, when they know you are someone who lies, they never feel safe about anything you are telling them, even though you might think you are getting away with it.

So here is a real truth for you. Telling the truth is a gift you give to yourself and to those you love. It’s part of your soul work and a direct reflection of your integrity or lack of it. When you are truthful, those around you, see a role model for integrity and honesty and they too begin to feel safe about being authentic and coming out from behind the mask. Truth-telling is a part of our work and it’s solely about each of us, not about any other person.

We also want to remember that telling the truth doesn’t have to be delivered with a sledge hammer. For instance, When someone says, Do you think I look fat in this outfit?” A loving and truthful answer might be, “I like you in the blue one better.” Or, if someone congratulates you on a team accomplishment, rather than taking all the credit, you might say, “Thanks I appreciate the compliment, but I had a lot of help.”

So, given the level of consciousness, or lack of it, in the world right now, maybe you and I can make a commitment to take off our masks and even if we start with the little things. We can care about ourselves and those we love enough to simply tell the truth.

If you need some tools, go to DrDinaEvan.com and watch the videos. And here is one of our truths, writing these columns is an opportunity that requires us to take off our masks each month and I for one, am deeply grateful for that gift.

Community Bridges, HonorHealth Name Arizona’s First Addiction Medicine Fellow

Fellowship Begins in October; Applications Being Accepted for Second Fellow


Community Bridges, Inc. (CBI), the premiere provider of integrated behavioral health programs in Arizona, and the HonorHealth Family Medicine Residency Program proudly announce the first fellow in the only addiction medicine fellowship in Arizona accredited by the Addiction Medicine Foundation: Dr. Cooper Johnston. The fellowship, which begins in October, touches on a crucial community need, as the opioid epidemic reaches an all-time high. 

“Addiction has touched my extended family, and I understand the hardships it can cause,” explains Dr. Johnston of his decision to apply for the fellowship. “I have a passion for helping people overcome this debilitating problem, and plan on practicing addiction medicine after the fellowship.”

Spearheading this first-of-its-kind Arizona program are CBI Chief Medical Officer and addiction specialist Michel Sucher, M.D. and HonorHealth Program Director for the Family Medicine Residency Program Cynthia Kegowicz, M.D.

"This fellowship program is in line with CBI's role as the premiere provider of integrated care and specifically substance use disorder treatment,” explains Dr. Sucher. “By affiliating with HonorHealth, this puts CBI squarely in the forefront of academics and research in this vitally important specialty of addiction medicine." Hear what CBI’s Chief Medical Officer has to say about the Addiction Fellowship — https://vimeo.com/286393368

The misuse of opioids, including prescription drugs and heroin, is one of the most serious public health problems in the United States, according to the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. The organization says it now claims more lives than motor vehicle crashes. 
Apply here to be considered for an Addiction Medicine Fellowship this fall: https://www.honorhealth.com/academic-affairs/addiction-medicine-fellowship

Clinical training sites for the fellowship include CBI’s addiction and recovery, integrated care and psychiatric emergency centers, as well as HonorHealth’s Scottsdale Osborn, John C. Lincoln and Scottsdale Thompson Peak centers. 

Fellows will do clinical rotations with outpatient addiction medicine using the cutting-edge Medication Assisted Treatment, as well as inpatient medical detoxification, with elective rotations in women’s and children’s addiction treatment, addiction-free pain management and CBI’s Project for Assistance in Transition from Homelessness, known as PATH.

About Community Bridges, Inc. (CommunityBridgesAZ.org)

Community Bridges, Inc. (CBI) is the premiere provider of integrated behavioral health programs in Arizona, including prevention, education and treatments using cutting-edge, nationally recognized models. Programs include residential, inpatient, patient-centered medical homes, medication assisted treatment (MAT), crisis units, transition points and outpatient services to individuals who are experiencing crisis, opioid use disorder, homelessness and mental illness. CBI believes in maintaining the dignity of human life, and knows recovery is possible.

About Honor Health (honorhealth.com)

HonorHealth is a non-profit health system serving an area of 1.6 million people in the greater Phoenix area. The network encompasses five acute-care hospitals, an extensive medical group, outpatient surgery centers, a cancer care network, clinical research, medical education, a foundation and community services with approximately 11,500 employees, 3,700 affiliated physicians and 3,100 volunteers. HonorHealth was formed by a merger between Scottsdale Healthcare and John C. Lincoln Health Network. HonorHealth’s mission is to improve the health and well-being of those we serve. 

Drug Prevention Tips for Every Age

Conversations are one of the most powerful tools parents can use to connect with — and protect their kids. When tackling some of life’s tougher topics, especially about drugs and alcohol, just figuring out what to say can be a challenge. Here are some ideas:

Preschoolers 

Since the foundation for healthy habits — from nutrition to toothbrushing— is laid down during the preschool years, this is a great time to set the stage for a drug-free life.

Scenario: Giving your child a daily vitamin.

What to Say: Vitamins help you grow. You need to take them every day so you’ll grow up big and strong but yonly take what I give you. Too many vitamins can hurt you and make you sick.

Scenario: Your kids are curious about medicine bottles around the house.
What to Say: You should only take medicines that have your name on them or our doctor has chosen just for you. If you take medicine that belongs to somebody else, it could be dangerous.

Early Elementary (5-8 years old)

Five to eight year-olds are beginning to explore their individuality.

Scenario:  Your child has expressed curiosity about the pills they see you take every day — and the other bottles in the medicine cabinet
What to Say: Just because it’s in a family’s medicine cabinet doesn’t mean it’s safe for you to take.

Even if your friends say it’s okay, say, “No, my parents won’t let me take something that doesn’t have my name on the bottle.”

Talk about the drug-related messages they receive through advertisements, media and entertainment sources. Ask your kids how they feel about things they’ve heard — you’ll learn a great deal about what they’re thinking.

Keep your discussions about substances focused on the present — long-term consequences are too distant to have any meaning. Talk about the differences between the medicinal uses and illegal uses of drugs.

Set clear rules and explain the reasons for your rules. If you use tobacco or alcohol, be mindful of the message you are sending.

Work on problem solving: Help them find long-lasting solutions to homework trouble, a fight with a friend, or dealing with a bully.

Give your kids the power to escape from situations that make them feel bad. Make sure they know they shouldn’t stay in a place makes them feel uncomfortable or bad about themselves. Let them know they don’t need to stick with friends who don’t support them.

Preteen (9-12 year olds)

Preteens, on their quest to figure out their place in the world, tend to give their friends’ opinions a great deal of power, while at the same time starting to question their parents’ views and messages.

Scenario: Your child is starting middle school and you know that eventually, they might be offered drugs and alcohol.

What to Say: I know we talked about drinking and drugs when you were younger, but now is when they’re probably going to be an issue. I’m guessing you’ll at least hear about kids who are experimenting. I want you to remember the best thing you can do is just talk to me about the stuff you hear or see. Don’t think there’s anything I can’t handle or that you can’t talk about with me.”

Scenario: You find out kids are selling prescription drugs at your child’s school. Your child hasn’t mentioned it and you want to get the conversation about it started.

What to Say: You probably know parents talk to each other and find things out. I heard some kids are selling pills – prescriptions that either they are taking or someone in their family takes. Have you heard anything?”

Scenario: Your child’s favorite celebrity—the one they really look up to has been named in a drug scandal

What to Say: Being in the public eye puts pressure on people, and many turn to drugs because they think drugs will relieve stress. The thing is, when a person uses drugs and alcohol—especially a young person it changes how his brain works. Most people who use drugs and alcohol need help to get better.

Tips for Conversations with Your Preteen

Make sure your child knows your rules — and you’ll enforce the consequences if broken. Research shows kids are less likely to use tobacco, alcohol, and other drugs if their parents have established a pattern of setting clear consequences.

Kids who don’t know what to say when someone offers them drugs are more likely to give in to peer pressure.

Feelings of insecurity, doubt and pressure may creep in during puberty. Offset those feelings with a lot of positive comments about who he is as an individual — and not just when he brings home an A.

Preteens aren’t concerned with future problems that might result from experimentation with tobacco, alcohol or other drugs, but they are concerned about their appearance — sometimes to the point of obsession. Tell them about the smelly hair and ashtray breath caused by cigarettes.

Get to know your child’s friends and their parents. Check in by phone or a visit once in awhile to make sure they are on the same page with prohibiting drug or

Make sure your teen knows your rules and the consequences for breaking them — and, most importantly, that you really will enforce those consequences if the rules are broken. Research shows kids are less likely to use tobacco, alcohol and other drugs if their parents have established a pattern of setting clear rules and consequences for breaking those rules. Kids who are not regularly monitored by their parents are four times more likely to use drugs.

Make it clear you disapprove of all alcohol, tobacco and drug use. As teens are extremely concerned with their physical appearance, remind your teen about the negative effects alcohol, tobacco and other drugs have on appearance.

Let your teen in on all the things you find wonderful about them. Positive reinforcement can go a long way in preventing drug use among teens.

Show interest in and discuss your child’s daily ups and downs. Learn how to talk to each other, and don’t take your child by surprise when you voice a strong point of view about drugs.

Don’t just leave your child’s anti-drug education up to their school. Ask what they have learned about drugs in school and build on that with topics, such as how and why chemical dependence occurs; the unpredictable nature of dependency and how it varies from person to person; the impact of drug use on maintaining a healthy lifestyle; or positive approaches to stress reduction.

Encourage your teen to volunteer somewhere that he can see the impact of drugs on your community. Teenagers tend to be idealistic and enjoy hearing about ways they can help make an impact.

(Source: DrugFree.org)

When “me” became “We”

This edition is dedicated to the memory of 
Christopher Kennedy Lawford. 
Thank you for your service and dedication to the Recovery Community.



The longer I’m clean and sober, the more I feel a sense of obligation to help others.

Like many addicts and alcoholics in the throes of this disease, my world revolved around me; and the deeper I dove in to it— the more vacant my spirit became. People who cared about me did their best to encourage me to seek help, and the more I heard I had a problem — the farther away I ran. The shame I felt was overwhelming and frightening. “They just don’t understand,” is what I kept telling myself. “I can stop whenever I want to!” A lie most addicts tell themselves.

When I tried to block out the truth, the closer it got. So I moved, changed jobs, friends, sought out lower and lower companions who let me get drunk and high with them and I never felt safe. Those were very dark years and there were many of them. Thinking about that time in my life still gives me chills. Fear and anger ran through my veins, and gratitude was a word I never used.
I came across this quote that sums it up:

“Recovery is not simple abstinence. It’s about healing the brain, remembering how to feel, learning how to make good decisions, becoming the kind of person who can engage in healthy relationships, cultivating the willingness to accept help from others, daring to be honest, and opening up to doing.” ~ Debra Jay

When “me” became “We” and I became willing to change -- is when this magnificent journey of recovery began. I am honored to be on this path with you.

Barbara