Author Archives: James Haggerty

About James Haggerty

Experienced Chief Executive Addiction Recovery and Mental Health Professional Business professional in the Addiction Recovery and Mental Health industry for the past 26 years. Caring, compassionate and strongly motivated to make a difference in the organizations I am affiliated with and welfare of the population we serve. Currently focused on advocating, educating and developing projects leveraging evidence based, real time technology to support individuals in recovery.

Teens Lack Future Planning

Disconnecting From Your Future Self: Why We Prolong Our Recovery

As a common practice, employers the world over ask their potential candidates a simple question: “Where do you see yourself in 5 years? 10 years?”

This line of questioning is meant to learn a candidate’s headspace, both in terms of their own plans for the future. and where they see themselves fitting within that framework. A candidate who has no clue where they will be in 5-10 years might seem, to an employer, to have no direction or purpose, especially when it comes to their goals within that company.

If a person cannot visualize themselves in a position within the company for which they’re applying, happy, successful, and possibly in a higher position than the job they’re applying for, how are employers to have faith in their prospective employee’s motivation for applying?

It’s similar for those in recovery from substance abuse disorder. The ability to visualize ourselves in a position of health, happiness, and continued recovery without relapse is paramount to recovery. As I explored the benefits of the visualization of success in recovery in part 1 of this blog series, I’ll likewise explore the detriments of not visualizing our future selves regarding our recovery—a roadblock many of us experience on our journeys of recovery.

Live Fast, Die Young, Leave a Good-Looking Corpse

James Dean once said, “Live fast, die young, and leave a good-looking corpse.” As morbid and disturbing as this quote is, I’ve found that it resonates with the youth of today in a big way. In fact, the sentiment has even evolved into a more modern iteration: “YOLO,” which is an acronym for “You Only Live Once”. The reasoning behind this phrase is that this is the only life you are given so you might as well live life right up to the hilt. You can find this phrase on t-shirts, mugs, water bottles, and even blankets, for some reason.

At first glance, this “YOLO” mentality might seem fun, clever, and certainly less morbid than Dean’s viewpoint. Unlike Dean’s reckoning, there is less emphasis on death in the future and more emphasis on our lives in the present, which serves to make it much more attractive to youth. Unfortunately, the phrase has also shifted in meaning as it’s become popular, as the most viral catchphrases often do. Instead of a “seize the day/carpe diem” sentiment, it’s become a rallying cry of unaccountability and encouragement to take unnecessary risks. The mindset is exceedingly harmful because it completely separates who we are today from our future selves, who will inevitably experience the fallout from today’s decisions.

Teens’ Future Planning (Or Lack Thereof)

Teens Lack Future Planning

It should come as no surprise that the younger subset of the populace has a tough time imagining their future selves as themselves, just “older”. So, it follows that making life-altering decisions that might affect a teen’s life later comes from this disconnection from their future selves. When teens make decisions like committing a crime or cheating on an important test, they often focus on the immediate consequences—punishment from parents and teachers versus the fact that a conviction will affect their permanent record and academic dishonesty will one day look unfavorable on a college application.

We are predisposed to miss the connections between our present and future selves. In social media, we see that adults today are being taken to task for problematic photos, comments, social media posts and other communiques of their youth, sometimes decades in the past. At the time, most of these individuals had no regard for what the behavior could mean for them in the future. While I can’t speak to the fairness of asking an adult to answer for the “crimes” of their younger, more frivolous selves, it is very much a reality today, especially with social media—and social evidence of the dangers of disconnection with your future self.

Inability to Visualize Future Self and Its Harm

Believe it or not, this mindset is not just employed by teenagers, as evidenced by the adults the world over who use this “YOLO” phrase unironically before they engage in risky or dangerous behavior. While a teenager’s lack of impulse control is backed by science because their prefrontal cortex is not fully developed, the science behind an adult’s risky behavior lies heavily in how we fail to visualize our future selves. Similarly, in teenagers, risk-taking and James Deansian “Rebel Without a Cause” behavior is also understandable and can serve a purpose. Some of the risks taken in youth will not result in positive future outcomes, but may provide life lessons. For adults, the consequences are much more dire.

For example, an adult who does not plan for their end-of-life expenses by way of life insurance could leave their family with hefty funeral expenses and a mountain of debt when they inevitably die. Yet, many of us do just that. While we’re living life, the concept of death is too scary and too troublesome to think about, so we procrastinate and “put off ‘til tomorrow what could be done today”.

Another instance of our need to visualize our future selves as they connect with our present decisions is when we make plans for retirement. By the time we reach federal retirement age at 65 years old, those of us who don’t have a retirement fund or pension must either ask for financial help from children or other family members or keep working to support our expenses. Where we fail, so to speak, is in visualizing ourselves as a retired person later in life when we’re younger. For a time, I, too, fell into the trap of this mindset, until my current path helped me see that the successful person I am today is connected to my past decisions as well as the self I will be in the future.

Why Do We Procrastinate on Important Decisions?

Why Do We Procrastinate on Important Decisions?According to fMRI scans run by Hal Hershfield of the Harvard Business Review with G. Elliot Wimmer and Brian Knutson of Stanford: “Many people feel disconnected from the individuals they’ll be in the future and, as a result, discount rewards that would later benefit them. But brief exposure to aged images of the self can change that behavior.” By being able to visualize themselves as physically older using a visual aid, subjects in the Hershfield study were able to shift their thinking in favor of striving for future rewards.

He further studied how people viewed themselves in the future as compared to how they viewed Hollywood celebrities like Matt Damon and Natalie Portman. Surprisingly, people tended to view themselves in the future and the actors in the same light – as strangers.

Hershfield found that, after reading about celebrities’ lives in gossip magazines, social media, and the like, we continue to regard them as strangers even with our “inside look” into their day-to-day lives. This is because they are strangers – we have never met these people in person, and we have not developed any kind of meaningful interpersonal relationship with them. Our inability to empathize with them, especially with the disparities in income and lifestyle, is normal and understandable.

However, the realization that we largely view our future selves the same as we view celebrities is somewhat alarming. This disconnect and the perception of our future selves as strangers is apparent when you consider alcohol, drug, and even tobacco use. Even with decades of scientific knowledge, readily available on the internet, of what happens to healthy lungs over years of smoking, people still choose to do so. They see their respiratory health as “future me’s” problem, unable to see the irony that “future me” and “current me” have the same set of lungs.

Future Visualization in Recovery

When we make decisions to use illicit drugs or develop a dependency on addictive substances, we are not visualizing our future selves at all. Much like the hypothetical smoker above, we are laying the burden of consequence on a future stranger, not connecting them with ourselves. Drinking to excess with friends seems like a fun time in the moment, especially with alcohol’s inhibiting effect. For many people experiencing addiction, the impact large amounts of alcohol or drugs have on the body, whether a hangover the next morning or liver failure from repeated excessive use years later, are still “future me’s” problem.

The disconnect can persist once recovery begins, delaying progress towards a future of sobriety and health. For this reason, during recovery from substance use disorder, future self-visualization is key. A therapist or mental health professional might implement the techniques employed by Hershfield and his colleagues mentioned above, such as displaying an age progressed photo to help lock in a person’s connection to their future self and what that might look like. Another way of doing this is to have a person close their eyes and really visualize, vividly, where they are in their recovery in a year’s time, 5 years’ time, and moving forward. By doing this, we are seeing ourselves as successful in recovery and truly identifying with our future selves. This further solidifies our motivation to achieve that goal of sobriety/successful recovery.

Conversely, by remaining disconnected from our future selves, we’re unable to see ourselves in sobriety—or even visualize what the alternative of remaining in addiction might truly mean for us. We remain blind to what sobriety might look like in terms of our relationships with our family and friends, our future work success, and how sobriety now affects our future selves. Without building these connections, that sober person in our future is a stranger, diminishing our personal investment in them, and making that goal much harder to achieve.

In many instances, inability to see ourselves as a sober person in the future, free of substance use disorder, can discourage us from continuing to receive help. Or, it can hinder and prolong our journey of recovery. Instead, work to develop a true connection with your future, sober, self, and continue your recovery in harmony with your goals for success.

Start Visualizing A Better Future Today

Visualizing A Better FutureAt ECHO Recovery, we are committed to educating the public about recovery and all the latest science behind it, including future-self visualization as a method of motivating a person to seek help with substance use disorder. We are also passionately fighting the stigma of substance use disorder and its negative effect on those in recovery.

The information on our site, our art classes and other resources are completely free to you. Please consider donating, volunteering, becoming a corporate sponsor or simply subscribing to our blog and following us on social media. Every effort helps us reach more people who need help with recovery. We do this because we care.

Post-Acute Withdrawal Syndrome and The Family

Post-Acute Withdrawal Syndrome and The Family

For many individuals recovering from a substance use disorder, as well as for their families and loved ones, the process can be long and arduous. For many, finally making the decision to stay away from drugs or alcohol can take years, and is sometimes the most difficult—and important—step towards recovery. However crucial this first step may be, it’s important for individuals and their families to understand what’s ahead, and to be patient and compassionate while seeking recovery.

Everyone knows that overcoming a drug or alcohol addiction is not an easy task, and is more complicated than waking up one morning and deciding to quit. Recovering from an addiction is a long and involved process, requiring near constant and ongoing diligence and understanding from both the individual and the people closest to them.

What Is Acute Withdrawal Syndrome?

Sometime during the initial few days or weeks after stopping use of an addictive substance, acute withdrawal symptoms usually set in. Acute withdrawal syndrome may include a variety of symptoms, including headache, nausea, muscle aches, and increased heart rate. For some, acute withdrawal can cause serious and even life-threatening physical reactions, which is why detox should always be done in a controlled and supervised environment.

In a supervised setting, doctors work with patients to help mitigate their withdrawal symptoms, while people choosing to detox on their own may struggle to manage their withdrawal symptoms and suffer a relapse, or could experience dangerous medical complications. For some, the physical withdrawal symptoms go away after a few days or weeks, depending on the type, quantity, and duration of drug use prior to detox. However, many people experience prolonged emotional and psychological symptoms long after the physical withdrawal symptoms have gone away. This type of prolonged withdrawal is called Post-Acute Withdrawal Syndrome, or PAWS, and can last for months or sometimes years.

What Is PAWS?

What Is PAWS?Recovering addicts experience acute withdrawal syndrome as their bodies try to adapt to the sudden absence of drugs. Withdrawal symptoms are caused by changes happening in your body as it tries to adjust. The symptoms caused by these physical changes are physical ones, often causing intense bodily discomfort, pain, and complications.

Post-Acute Withdrawal Syndrome (PAWS), on the other hand, is linked to the brain, rather than the body. After the body adjusts to not having drugs, it is the brain’s turn to adapt. As the brain attempts to recalibrate after detox, it undergoes some intense chemical fluctuation. These changes in chemical levels in the brain often lead to a period of psychological or emotional problems, known as PAWS. As the brain attempts to normalize, fluctuating chemical levels can cause individuals to experience a variety of symptoms associated with mood and psychological behavior, such as:

  • Depression and sadness
  • Anxiety
  • Aggressive or hostile behavior
  • Low energy
  • Severe mood swings
  • Physical or mental fatigue
  • Insomnia or vivid dreams
  • Thought fog or trouble remembering
  • Inability to focus
  • Lack of sex drive
  • Chronic pain

These symptoms can vary from person to person. The PAWS symptoms an individual experiences may vary depending on several factors.

For example:

  • Type of substance used
  • Duration and frequency of drug use
  • Physical size of the individual
  • Gender
  • Overall health
  • Pre-existing mental condition

What Substances Cause PAWS?

Most addictive substances can cause PAWS, including alcohol, and prescription and recreational drugs. Research shows PAWS most often occurs among people recovering from addictions to any of the following substances:

Alcohol

Alcohol was one of the first substances discovered to cause PAWS. Suddenly stopping alcohol consumption can be dangerous, as alcohol withdrawal can cause severe tremors, seizures, delirium, and psychosis. When alcohol use is stopped abruptly and without supervision, it can also lead to long-term PAWS.

Marijuana

Many individuals use marijuana to relax, relieve anxiety, and induce sleep. As a result, it is not uncommon to experience insomnia and an inability to relax after stopping use of marijuana. Prolonged insomnia can lead to PAWS.

Methamphetamine

For many people recovering from an active meth addiction, impulse control can be an issue for months or even years after detox.

Antidepressants

Few people abuse antidepressants, because they do not cause a rapid intoxication. However, abruptly stopping use of these drugs can greatly disrupt serotonin and other neurotransmitters in the brain, which could cause the individual to feel intensely depressed for weeks or months.

Antipsychotics

Antipsychotics bind to the dopamine receptors in the brain. When these drugs are discontinued, they could cause mood swings for months. PAWS symptoms may be more extreme if the antipsychotics are discontinued abruptly, without a taper.

Benzodiazepines

These drugs are usually prescribed to help people manage anxiety and panic disorders. Benzodiazepines are usually only prescribed for short periods at a time because it is very easy for the brain to develop a dependency on these drugs. Acute withdrawal symptoms from benzos will mimic panic attacks they are prescribed to treat, while long-term PAWS symptoms may include insomnia, cravings, and fatigue. These symptoms may last for months.

Opioids

Opioids, whether prescription versions or illegal recreational versions like heroin, can lead to intense acute withdrawal symptoms. Individuals who experienced the full intensity of physical opioid withdrawal symptoms are more likely to develop PAWS later on. PAWS may be especially strong in individuals who did not taper. PAWS symptoms after opioid use include cravings, cognitive impairment, fatigue, and exhaustion. These symptoms sometimes persist for a very long time after becoming sober.

How Long Does PAWS Last?

How Long Does PAWS Last?Unfortunately, there is no specific PAWS timeline. Just as there are many factors involved in determining who experiences PAWS, what symptoms they have, and how extreme the symptoms are, these same variables also affect how long PAWS will persist. When PAWS first sets in, it often feels like a roller coaster, with moods and feelings changing from minute to minute. Gradually, the time between changes gets longer. Later in the process, there may be weeks between symptoms. However, it’s important to be aware that even as the time between symptoms grows longer, bad episodes may still last for several days at a time.

In most cases, there is no obvious trigger for these episodes, so it can be impossible to predict when a post-acute withdrawal syndrome symptom may set in. For many people, this can be the most frustrating part. They can be having a great few days, feeling happy and healthy, and suddenly become irritable and depressed again for no seeable reason. It’s very important for individuals and families to know about PAWS, because these symptoms can be just as powerful as acute withdrawal symptoms and often cause people to relapse. Having the support and understanding of family and close friends while they experience PAWS is crucial.

How Is PAWS Treated?

The best way to manage and treat post-acute withdrawal syndrome is through continued support from counselors and therapists. Because PAWS encompasses a cluster of emotional and psychological symptoms, medical professionals help their clients by:

  • Educating clients and their families about the possible effects of PAWS and what to expect from recovery.
  • Encouraging patients during the process.
  • Celebrating every accomplished step towards recovery.
  • Helping the client find natural ways of promoting sleep.
  • Encouraging or prescribing regular physical exercise.
  • Encouraging clients to join emotional support groups.
  • Providing tools for impulse control.
  • Taking self-reported symptoms seriously and assessing potential co-occurring symptoms.

While many individuals have good medical supervision and support during the physical stages of acute withdrawal syndrome, during the post-acute withdrawal syndrome stage, family and friends are often the first—and only—line of support.

Controversy of PAWS

Post-acute withdrawal syndrome is a controversial topic among medical professionals and individuals. Despite the thousands of people experiencing PAWS every year; it is not an official medical diagnosis. The nature of PAWS makes it difficult to define. The symptoms vary greatly between individuals, while many of the symptoms are self-reported by individuals experiencing them. Without a medical definition, PAWS cannot be officially recognized by the medical community, even though many medical professionals know PAWS to be a real and potentially dangerous part of the recovery process.

Another reason why PAWS sparks so much controversy is because there is no clear consensus about what the syndrome is or what to do about it. Some people believe PAWS symptoms are just an excuse to relapse. Others believe it was invented by doctors within the medical industry to make more money off of prolonged treatment. Some medical practitioners argue that it is just another form of acute withdrawal.

How Can Families Help During PAWS?

As a family member, it’s important to be informed about the recovery process and to know what to expect during the PAWS stage. After seeing your loved one through detox and acute withdrawal symptoms, it’s difficult not to feel like the challenges have all been faced already, or to expect your loved one to be completely recovered after detox.

Learning about PAWS will enable you to be more supportive, understanding, and helpful to your loved one rather than reacting to their PAWS-induced behavior with suspicion, fear, or anger. Behavior caused by PAWS can sometimes look like a person’s behavior while using drugs or alcohol—inability to sleep, irritability, or mood swings—and often arouse suspicion in family members, who may think their loved one has had a relapse. Accepting these symptoms as a normal part of the process can greatly reduce your own stress and anxiety, and help you be a more effective support for your loved one.

How Families Can Survive PAWS

How Families Can Survive PAWS

Be Patient

The most important thing to remember is to be patient. Recovery is a long, slow, and difficult process for all involved. The best thing you can do is to trust the process and take it one day at a time. Never try to hurry recovery.

Don’t Resent PAWS

It can be hard not to resent PAWS, especially when it causes your loved one to behave in ways you can’t understand. But if you react with frustration or resentment, both you and your loved one will start to feel exhausted, and the relationship strained.

Take Time for Yourself

While you may be tempted to devote all your time, efforts, and energy to supporting your loved one through their recovery, it’s important to take time for self-care so that you do not get burnt out. If you wear yourself down too far, you will no longer be able to provide the care and support your loved one needs. Part of this is learning to relax. Try to avoid dwelling incessantly on your loved one’s problems, and instead remind yourself often that what you are doing is enough.

Practice Meditation

Developing a consistent meditation practice can help you gain control over your thoughts and emotions and act more rationally in stressful situations. Sit comfortably with your eyes closed and begin to gently clear and empty your mind of all thoughts and distractions. It’s important—especially at first—that you don’t get frustrated when you feel your mind start to wander. This is a natural part of the process! When you notice your mind chasing after a certain thought or feeling, or getting swept up by distractions, gently call it back and resume your focus. You can start with five minutes a day, and gradually increase your time. Practicing meditation regularly for just a few minutes is more beneficial than attempting to sit in meditation for long periods, sporadically.

Get Regular Exercise

Getting regular exercise, whether it’s going for walks, taking a yoga class, doing some cycling—or whatever it is you enjoy—exercising for at least thirty minutes a day is another great way to gain mental clarity, sort through and control the thoughts, and manage stress.

Free Recovery Resources

Free Recovery ResourcesIt can be difficult to navigate PAWS, especially because it is impossible to predict exactly what symptoms will occur. Having strong family support can make the process more bearable, while seeking the help of counselors and therapists can help mitigate the symptoms and help reduce the chances of relapse.

ECHO Foundation provides support, tools, and resources for individuals seeking recovery, as well as information and answers for the families of people with mental health and substance use disorders. Visit our Free Treatment page for a list of resources you can use to find free and low-cost behavioral health services. There are also many resources available in the Harford County, Maryland community for those seeking addiction treatment and recovery support locally.

The Benefits of Connecting With Your Future Self

The Benefits of Connecting With Your Future Self

We Think of Our Future Selves as Strangers

Try to imagine your birthday next year. Now visualize yourself in 20 years, on your birthday. Did you see yourself through your own eyes blowing out the candles? What did you see in 20 years? Was it someone else, unfamiliar, who was blowing out the candles? For many people, it is extremely difficult to connect to a future version of themselves. I know that I never imagined the person I am today when I thought about my life 20 years down the road.

This disconnect between our current selves and that future version that is out there in the distance can make it difficult to make life choices that are beneficial to our future selves. Not having an emotional connection to our future selves makes it more difficult to make long-term plans, fulfill the goals we set for ourselves, and complete long-term projects. Given that our recovery journey is a long-term project, I’m sure you can see the importance of developing an emotional connection to our future selves.

The Science Behind Connecting to Our Future Self

The importance of connecting to our future selves is grounded in scientific evidence. Scientists from Stanford University used fMRI scans of research participant’s brains to compare neural patterns. Their research focused on the rostral anterior cingulate cortex and the medial prefrontal cortex, which experience more activity when a person thinks about himself. They found that when people were asked to describe their self ten years from now, their neurological patterns were similar to those patterns formed when thinking about another person such as a celebrity, instead of resembling the neurological patterns formed when thinking about their current self.

This same data was evidenced across the board of the research project. So, from the perspective of their brain, the future self was a completely different person. Those participants that had the widest variance between their view of their present and future self were also the least likely to defer immediate gratification for future rewards. These are the people for whom procrastination can be a serious problem.

If the part of your brain that lights up when you think of your current self is not the same as the part that is engaged when you think about your future self, it makes sense that it is difficult to take action today for some future version of yourself that you don’t feel connected to. For most of us, it’s the here and now that feels important. The “just for today” takes precedent over the “what about ten years from now.” Why not eat that extra piece of cake?

These same researchers found that by helping participants develop an emotional connection with their future selves, they were also more likely to participate in more future-oriented behavior. The correlation between a strong emotional connection to our future self and a willingness to put in the necessary work today to reap the benefits for our future self indicates how valuable and nurturing this relationship can be.

Impacts of Disconnection From Your Future Self

Impacts of Disconnection From Your Future Self When we are disconnected from our future selves, we are less likely to consider the impact that today’s actions have on our future. Our biases towards thinking in terms of the present make immediate gratification a more tempting option. We can see, feel, and taste the impact of our decisions in the present, but their effects on our future selves are a lot less tangible. For many of us who have struggled with addiction and substance abuse disorders, this is an all too familiar mindset.

Plus, we all tend to be overly positive about the expectations of our ability to make better decisions tomorrow. This disconnection impacts those who don’t struggle with substance abuse as well.

Here are a few areas of our lives that can be impacted by a disconnection with our future selves:

Financial

It can be much more difficult to save money for retirement when you can’t even begin to connect to the version of yourself that is 40 years in the future. So, instead of putting that tax refund into a retirement fund, you take a trip to Disney. But what if you had a picture of your 75-year-old self on your computer screen while you were making that decision? Would you still go to Disney? The research shows that simply having an avatar that resembles our aged self can cause us to deliberate a little longer and make a better choice for our future self.

Health

How many of us can relate to the “I’ll start my diet tomorrow” syndrome? And then tomorrow comes, but your brain is still not connected to that future version of yourself, and instead of starting that diet, you have that piece of cake or take a nap instead of a walk. Would you still participate in behavior that can put you at risk for chronic disease if you felt emotionally connected and responsible for that future version of yourself?

Ethics

Would you still cheat on a test or steal that purse if you knew what the impact would be on your future self? If you could see your future self, sitting in jail, would you be as likely to break into someone’s house to steal a TV? Research shows that those who have an emotional connection to their future self are less likely to behave in unethical ways.

Self-Improvement

Making sacrifices today for a better future in 20 years can be a tough sell when you have no real connection to that person. Sleeping in on the weekend is much easier than studying for a test, especially when you lack a connection to that future Fortune 500 version of yourself. Besides, you can get up early next weekend. Unfortunately, next weekend you will still have that present-day mindset that put you in this situation last weekend.

Substance Abuse

Would you choose to snort cocaine just for fun at that party you went to after work if you could see your future self dealing with withdrawal symptoms? Or would you still go to your daughter’s birthday party drunk out of your mind, if you could see your future self, living alone in an apartment because your wife divorced you and you no longer have custody of your children? The immediate gratification we derive from a substance can quickly turn into abuse and addiction for our future self that we never connect with our actions at the moment.

The thing is, until we change from a present-day bias in our thinking and connect more emotionally to our future selves, we will keep putting things off and making decisions that are based on immediate gratification.

Your Connection to Your Future Self Impacts Your Recovery Journey

Recovery Journey It isn’t that difficult to see how a disconnection to the future version of ourselves contributes to the choices that many of us made that lead us down the path of substance abuse. The immediate gratification of getting high or having that drink was much more tangible than the idea that our future self might end up in a rehab facility, especially when our mind thinks of our future self in the same way it views a stranger. Why would we prioritize the health and happiness of someone we aren’t connected to above the happiness and immediate gratification of this real-time version of ourselves?

If this disconnection to our future self contributed to the person we are today, then it is only logical that we can choose to connect to our future self in such a way as to make better decisions and to support our recovery process. Instead of only seeing ourselves as an alcoholic or an addict who is confined to that role, and all that comes with it, we can focus on our future selves and the goals we have for the future. If we can emotionally connect to a non-using version of ourselves, and make choices that will support that vision, then, based on science, we should find those positive choices are much easier to make.

Visualization is a powerful tool for bringing about change. The more vivid and realistic you can make that vision of a positive future self, and the more you can align it with your present self, the more likely you will be to act in a way that supports that vision. You will find that it is easier to sacrifice the immediate gratification of today to support that future self that you have grown to care about.

Imagine a future birthday party for your children where you are not only present physically but mentally and emotionally too. Imagine getting a promotion at your job or receiving a 5-year coin for your sobriety journey. The more real your goals are for your future self, the more you can connect that person to who you are today.

Another great tool for developing a closer connection to this vision is to write a letter from your future self, thanking your present-day self for having the courage to make the kinds of changes that allowed these positive milestones to happen. What actions did you take? How did you change your behavior? What sacrifices led to that future success?

Benefits of Connecting to Our Future Self

Taking the time to emotionally connect with our future selves can change the way we think and strengthen our ability to make positive choices in the present moment. Making simple changes such as playing out a decision before we act on it can connect us more deeply to our future self. Before deciding to put something off until tomorrow, play out the scenario.

If I don’t finish studying today and put it off till next week, then I’ll have to stay up late after I get off work to finish my studying. If I work late, I’ll be too tired to study and then fall asleep. Then when I have to take the test the next day, I’ll be tired and unprepared… may as well study now.  Taking the 20 seconds to walk yourself through the impact of your decision on your future self has now changed your brain’s neural process to think of your future self as being more directly connected to your present actions.

The more time we spend connecting to our future self, the more integrated that version of our self becomes with our present-day self. The most successful people have a strong connection to the future version of themselves and can act in such a way as to bring that vision to fruition. They can delay immediate gratification because they are deeply connected to the future vision of themselves.

Ways to Connect to Our Future Self

Taking the time to focus on better connections with your future self can provide the motivation you need to develop healthy habits in the here and now. Think about what you envision for your future self. What do your relationships look like? What does your recovery look like for your future self?

The following writing prompts can serve as a starting point to developing that connection:

  1. Try to envision your life five years from now. What does your path look like? What kind of work do you do? Where do you live? How do you spend your free time? How do you feel physically and emotionally? Try to visualize yourself in 10 years, and then farther down the path at 20 years from now. Have you chosen a different path for yourself? Are you doing the same work? Are you living in a different place?
  2. Write a letter to your “current self “from your “future self.” What type of advice do you think they might offer you? What kind of personal insight into your growth could they teach you? What have they learned in the future that can help you now?
  3. Take some time in the morning to consider how your present actions impact where you will be in the next 5,10, or 20 years. If that seems too far off, try the prompt using a year from now. Then make a list of actions you can take today that will have a positive impact on bringing you closer to your vision of your future self.

Prioritize a Relationship With Your Future Self

Prioritize a Relationship With Your Future SelfThe path of recovery requires that we not only take each 24-hour day, minute by minute but also that we envision a future for ourselves that is full of the things that we define as success and the love and joy of our friends and family. Our journey is a journey of discovering ourselves, and that includes connecting to the vision that we have for our future self. The more we can bring this vision to life and stay connected to this non-using version of ourselves, the more likely we are to make the positive choices that will make this future our reality.

Making a friend out of the stranger that our future self can be, is a beneficial step for anyone who wants to make more positive choices in the here and now. It can help you stop procrastination tendencies, delay immediate gratification, and improve your lifestyle to benefit your future. Take the next step on your journey of self-discovery today.

Sober Housing Funding for Substance Use Disorders

Housing Funding Can Better Help People With Substance Use Disorders

Housing issues tie in closely to substance use disorders in many ways, and stable housing is often essential to recovery. But for many people who experience substance use disorders, permanent housing can be incredibly difficult to achieve. Homelessness and other issues related to housing can lead to relapses, making recovery more difficult. State-funded sober living homes and grants for transitional housing, among other types of aid, help many individuals in recovery, but more funding is still needed.

How Housing Helps With Recovery

For many individuals with addiction, substance abuse habits are tied to “people, places, and things,” which means that familiar friends, locations, habits, and more can trigger substance use, which is why recovery housing is so important. Staying in the same home or returning to the same house after inpatient treatment can increase the chances of relapsing.

Recovery housing can come in several different forms, but will generally have some support staff on-site or nearby, as well as the support of peers going through the recovery experience together. These types of housing provide extra time and support for those in recovery in a safe, supportive, and drug-free environment.

Homelessness and Substance Use

Substance use disorders and the behaviors associated with addiction can be very destructive, often leading to homelessness. The use of drugs and alcohol is widespread among homeless individuals, and the lack of stable housing can become a barrier to achieving sobriety. Those experiencing homelessness likely have serious limitations in being able to afford any housing or treatment for their addictions. Grants for sober living homes help make it possible for many more individuals to find stable housing while in recovery.

How Housing Helps with Recovery

Does Medicaid Pay for Sober Living?

Medicaid and Medicare are two health insurance programs funded by state and federal governments and are available to certain age groups and income brackets. Medicaid and Medicare can provide low-cost or even free health care, including drug and alcohol recovery treatments; however, the details can vary between the different programs, as well as from state to state.

While these essential insurance programs can help with the initial recovery treatments, they usually do not cover the costs of halfway houses and other transitional or sober houses. Therefore, the need is great for additional funding for sober living situations. Grants for halfway houses and other transitional housing options are critical to providing the necessary financing to those in need.

Housing Approaches to Help Those in Recovery

There are two main approaches to addressing the issue of stable housing for people in recovery, especially those who are homeless. Both approaches are extremely helpful: Sober Living Houses (SLHs) and a program called Housing First (HF).

Sober Living Houses

Sober Living Houses Defined

Sober Living Houses provide a drug and alcohol-free housing environment for individuals who are attending a recovery program. This kind of recovery housing is generally found in residential, single-family neighborhoods. Support levels can easily be customized to match the level of need for the individuals staying at the residence. For example, many sober living homes are dedicated to one gender or offered during a specific level of care. Often times a long-term addiction treatment program offers lower levels of care. As an individual graduates from in-patient, residential care they may go into an outpatient program. If they do not live in the area, often times they need to find a sober living facility where they can stay while they continue their treatment program.

Generally, in this scenario, an individual only needs to live in a SLH for a month or two while they complete the full continuum of care. A typical long-term program transitions a patient from detox to inpatient and finally outpatient care over the course of a 2-3-month period. Ideally someone recovering from a severe addiction will remain in professional care for 6 months or more. However, often times insurance carriers will not approve a patient for longer than 3-6 months and because of this, SLH often see a fairly high turnover.

Sober Living Homes are monitored by a house manager 24/7. There are normally strict house rules and individuals are free to stay as long as they follow the rules, including staying clean and sober and paying the rent.

Housing First Defined

Housing First Defined

In the Housing First approach, stable housing is placed as priority number one for individuals and their families who may be struggling with homelessness in addition to addiction. Often in this type of accommodation, there are no barriers or conditions to attain the housing. Many other types of recovery homes have conditions for complete sobriety to remain in the home, but the Housing First model ensures that permanent housing is available without restrictions. The thinking behind this approach is that those who have more stable housing and voluntarily accept treatments and services are more in control of their progress with addiction recovery and mental health.

Housing First really evolved during the 90’s when large numbers of people remained homeless despite being part of a recovery program. Low income individuals might find coverage for a state program, but still not have access to safe, sober living housing. Housing First doesn’t require the individual be part of an addiction recovery program, however, only that the individual is seeking help for a supportive living situation. Advocates argued that individuals suffering from a mental health or co-occurring disorders are more vulnerable without a stable living situation.

Different than Sober Living Houses, Housing First focuses on harm reduction rather than promoting a strictly abstinence-based recovery. The HF immediate focus is on helping the individual find a safe, stable environment to live in. Some of these arrangements go beyond a residence with 24/7 monitoring. HF provides individuals apartments within the general housing market and other times housing within a centralized setting where multiple homeless individuals are housed together. Programs vary and so do the supporting services. In programs without on-site staff, case managers will visit residents on a regular basis to monitor problems and provide referrals to off-site services as needed.

Sober Living Housing Versus Housing First

Each of these models addresses the problem in different ways, and both should be supported. Recovery from addiction is not a one-size-fits-all path, and each of these approaches can be successful for different individuals in recovery. Recovery housing is needed for those who need sober living with more structure and support, while in an addiction recovery program and sometimes also while they are transitioning back into “regular” life and not returning back home after their care program is over.

The Housing First model is intended to support individuals who have a mental health disorder or a dual diagnosis, that also need somewhere to live. Candidates for Housing First might have a co-occurring disorder, but do not necessarily have to be in treatment for a drug or alcohol addiction in order to get help from the Housing First program. HF is best for those who can be more independent but need a supportive housing environment due to their mental health issues.

It’s easy to see that both types of programs are essential and should be supported. For either approach, substance abuse prevention grants can be used to help fund these programs, and this outside funding is critical to keep these programs going.

The Echo Foundation Recovery Housing Initiative

At ECHO Recovery, we understand that not everyone can afford to find safe, stable housing while undergoing an outpatient addiction recovery treatment program. Housing for these types of situations is often not covered through the treatment plan or insurance programs. Usually, outside funding is used to fill in these gaps and ensure that even those who cannot afford it themselves can have access to safe housing while in treatment.

The ECHO Recovery Foundation provides housing scholarships to those in recovery and in financial need. These scholarships provide critical support to some of our most vulnerable individuals, but we need your help to keep these programs going. You can support our mission to provide housing and recovery treatment to these individuals with a donation in any amount.

The ECHO Foundation Recovery Housing Initiative

Contact us to learn more about how you can get involved or donate to the recovery movement today to help our important housing initiative. We appreciate your support.

The Link Between Addiction, Depression, And Suicide

The Link Between Addiction, Depression, And Suicide

Suicide is a major issue in the United States, and one of the leading causes of death among young adults. According to the National Institute of Mental Health, suicide was the tenth leading cause of death in the United States overall and the second leading cause of death among people between the ages of 10 and 34 in 2016. Approximately 45,000 people died from suicide in 2016 within the United States. Certain risk factors exacerbate suicidal thoughts and ideation among young people – and depression and addiction are at the top of the list.

Major Risk Factors For Suicidal Ideation

Major Risk Factors When someone makes the decision to commit suicide, they do not do so at random. Years of trauma can contribute to suicidal ideation, as well as abusing drugs and alcohol. Feelings of extreme sadness, pain, and trauma often push a person to take this action, much to the grief of their friends and family. While many people may think about suicide throughout their lives, certain risk factors and occurrences can increase someone’s chance of committing suicide.

Substance abuse is a major risk factor for suicide, especially if the person is also experiencing other mental disorders such as:

  • Major depressive disorder
  • Post-traumatic stress disorder
  • Anxiety disorders
  • Other personality disorders

In addition, stressful life events can push someone into committing suicide. Poor social support, loneliness, isolation, and feelings of hopelessness also increase a person’s risk of suicide. In addition, a history of childhood abuse, chronic pain, and prior suicidal behavior are risk factors for suicidal ideation. Feelings of aggression and impulsivity can lead others to act upon their suicidal thoughts.

Substance abuse can seriously impact a person’s life, leading to the stressful life events and feelings of isolation and loneliness that can exacerbate suicidal ideation. Relationships can crumble and people who suffer from addiction can isolate themselves from other people in order to use drugs and alcohol. Addiction can also increase instances of aggression, impulsive decisions, and chronic pain. Many people use drugs and alcohol to cope from traumatizing events in their past – making them susceptible to suicide.

How To Identify Suicide Warning Signs

Suicidal ideation does not exist in a bubble, especially if someone you know is suffering from drug and alcohol addiction. Each person who experiences suicidal ideation will express their feelings in a different way. Some people may exhibit no warning signs at all, while others will show some of the classic signs of suicide.

However, if you notice that someone you love is exhibiting any of the following warning signs of suicide, you should not ignore them.

  • Exhibiting extremely anxious or agitated behavior
  • Using heavy amounts of alcohol and drugs
  • Avoiding social situations
  • Isolating themselves from friends and family
  • Not participating in hobbies and other activities that they previously enjoyed
  • Expressing a desire to die or an interest in death
  • Engaging in reckless, dangerous behavior
  • Engaging in self-deprecating and self-critical talk
  • Suffering from insomnia
  • Exhibiting extreme irritability
  • A sudden, sharp decrease in their work and academic performance
  • Suddenly giving away personal and sentimental belongings
  • Evidence of self-harm on their body, such as cuts or burn marks

How To Help Someone Who Is Addicted And Suicidal

Helping someone who is struggling from addiction, depression, and suicidal ideation is not an easy task. Offering to help them seek treatment may feel like an attack or confrontation, while leaving them alone could increase their feelings of isolation. The best way to approach someone who is suffering from suicidal ideation and addiction is in a calm, measured, and prepared manner.

Pay attention to the warning signs that make you think they may be thinking about suicide. What is different about their behavior, actions, and overall persona? Has there been a sudden change after a traumatic event, or have you seen them gradually get worse over time? Knowing the reasons why you want to help them will aid you in your approach.

Approach your loved one calmly and with a great deal of care. Tell them that you are there for them, and they can tell you about whatever is on their mind. When someone is struggling with suicidal thoughts and addiction, they can feel trapped in their own thoughts and fall away from reality. By expressing their thoughts and feelings to you, they can bring themselves closer to reality. In addition, knowing exactly what is on their mind can help you make better decisions on how to help them. Remind your loved one that their life matters, that you care about them, and you want to help.

Offer to help your loved one contact a professional and seek psychiatric treatment. They may refuse to seek treatment for a number of reasons, including guilt, shame, and embarrassment. If you believe they need treatment, contact the professionals on their behalf. Accompany your loved one to the hospital and any treatment programs they may attend, and spend time with them. By establishing yourself as a consistent presence in their life, you can become a source of strength and someone to rely on – which a person who is struggling with addiction and suicidal thoughts needs to survive.

Seek Help For Addiction Today

Although addiction and depression can exacerbate suicidal thoughts and actions, help is available. Certain protective factors can reduce suicidal ideation in people struggling from addiction, and the first step is to seek professional help through a drug and alcohol treatment program. The following factors can reduce suicidal ideation in young adults struggling with addiction:

  • Being clean and sober from drugs and alcohol
  • Attending regular substance abuse support groups, such as Alcoholics Anonymous and other 12-step programs
  • Receiving mental health care from a trusted counselor, therapist, or psychiatrist
  • Identifying reasons for living
  • Believing in a higher power and adopting spiritual beliefs
  • Having stable relationships and responsibilities, such as employment and parenthood

You can achieve many of these protective factors by attending a drug and alcohol treatment program. If you are struggling with addiction anywhere in the United States, you are not alone. This issue impacts millions of people across the country. Help is available to aid you in reducing your dependency on the substance, manage withdrawal symptoms, and begin the path to recovery.

Seek treatment at a professional drug and alcohol rehabilitation facility as soon as possible. For additional resources on managing addiction and recovery, visit Echo Recovery today.

Addiction And Sleep Disorders: A Common Struggle

Addiction And Sleep Disorders: A Common Struggle

If you are recovering from an addiction to drugs and alcohol, you know that the road to recovery is full of challenges. You have to manage cravings, stave off relapses, handle withdrawal symptoms, and rebuild relationships, among many other tasks. However, one of the most common and most stressful issues that people in recovery face is sleep disorders. Not being able to sleep can heighten your chances of relapse and make recovery even more difficult – but there are strategies you can use to manage your sleep and get the rest you need.

What Happens To Your Sleep In Recovery?

According to the Journal of Addiction Medicine, people in recovery are 5 times more likely to suffer from insomnia than the general population. People in recovery are mainly at risk for these sleep disorders because of the complex psychological issues that occur when coming off of a substance, especially if you used this substance to help you fall asleep in the past. Sleep disorders can range during recovery – you may only deal with them during the withdrawal period, or you can keep experiencing them for weeks, months, or even years after recovery.

When it comes to addiction, you can experience long-lasting effects that impact your physical and mental health. Anxiety, depression, and other psychological conditions contribute to insomnia – and these issues are also common side effects during the recovery process. Unfortunately, sleep disorders can also feed into the risk of relapse, making recovery even more difficult.

First, you may have used the substance you are recovering from to help you sleep in the past. Now that you are clean from this substance, you cannot rely on it to fall asleep. In addition, you may be battling with very unpleasant side effects while in recovery – anxiety, depression, stress, and fear are some of the most common. As a result, it is more difficult for you to fall asleep at night.

Since it is more difficult to fall asleep, the sleep disorder exacerbates some of your recovery side effects. In particular, insomnia makes anxiety, depression, and stress even worse. You feel irritable, overtired, and like you cannot perform your daily functions – and your stress levels go through the roof.

You may think that old coping mechanisms, such as drug and alcohol use, are looking like a better decision. Since you are suffering from sleep deprivation, you could have more impulsive tendencies and want to end your discomfort as soon as possible. You could run the risk of relapsing at this point, or you could continue to suffer from sleep issues. However, a third option is available: using healthy methods to improve your sleep.

How Does Addiction Impact Your Sleep?

While sleep disorders in recovery are common, it is likely that you have experienced trouble sleeping before. Addiction itself can worsen your sleeping habits. Depending on the type of substance you used, you could impact your brain chemistry and sleep cycles. In addition, addiction withdrawal symptoms can also reduce your quality of sleep.

Because of the changes that drugs and alcohol make to your body, it can be very difficult to develop healthy sleeping habits while on these substances. Recovery and healthy sleep methods are the best options.

Addiction throws your natural body clock out of its rhythm – you often stay up very late in the night and wake up very late in the day. Drugs can also impact the time you spend in REM sleep, which reduces your feelings of restfulness in the morning. It takes longer to fall asleep when you are addicted to a substance, and you will reduce your overall sleep time because you often wake up during the night.

Tips For Improving Sleep While In Recovery From Addiction

While sleep disorders are often unavoidable in addiction recovery, it doesn’t mean that you cannot get a good night’s sleep. Follow these tips to enjoy a better night’s sleep and naturally improve your symptoms:

  • Exercise plays an important role in regulation your sleep cycles and increasing your relaxation during the day. In addition, exercise produces natural endorphins that can aid in your recovery journey. Performing 15 to 30 minutes of exercise about 3 to 4 hours before you go to bed can have a great impact on your ability to fall asleep.
  • Meditation can also aid in helping you fall asleep, especially if anxiety or intrusive thoughts play a role in your insomnia. With consistent practice, you can reduce your stress and help you focus on the present, both of which can help you fall asleep easier.
  • You can change your sleep environment to promote relaxation and aid you in falling asleep. If your mattress is uncomfortable, invest in a new one and supply it with supportive pillows, new blankets, and clean sheets. Keep your bedroom at a comfortable temperature, around 60 to 70 degrees Fahrenheit. Invest in a white noise machine to block out intrusive noises.
  • Using electronic devices right before bed can make it harder to fall asleep, since the blue light can block the release of your sleep hormones. Enable night mode to lower your exposure to this light before bed or avoid screens completely in the hours before you fall asleep.
  • A poor diet can also make it more difficult to get some rest, in addition to increasing stress and discomfort. Avoid foods that are high in sugar, fat, spice, and caffeine after midday. Incorporate foods that promote sleep, such as legumes, leafy green vegetables, dairy products, and meats, into your diet. Avoid eating large, heavy meals late at night.
  • Establishing a regular bedtime routine can also help you fall asleep easier. Having a regular schedule allows you to develop a ritual that can help you combat insomnia and promote relaxation. Avoid doing anything other than sleeping and relaxing in your bed. Go to bed and wake up around the same times every day, including weekends. Perform relaxation activities before bed, such as meditating, doing some light yoga, taking a warm bath, or reading a book.

If you are still struggling from a sleep disorder during recovery, visit a medical professional as soon as possible. If you find yourself struggling with a sleep disorder due to addiction, seek professional treatment from a drug and alcohol rehabilitation center. For more information on pursuing your recovery journey, visit Echo Recovery today to gain valuable resources from others like you.

Fentanyl Overdoses Are Rampant, But Where Is The Drug Coming From?

Fentanyl Overdoses Are Rampant, But Where Is The Drug Coming From?

By now, most of America is well aware of the ongoing opioid epidemic, or has at least heard about it on the news a time or two. However, while most of the country recognizes the names of the most common opioids – names like heroin and OxyContin – and may even have a little knowledge regarding their effects, the true danger of fentanyl remains a mystery to many. What is Fentanyl? Why is it so dangerous? Where does it come from?

What Is Fentanyl?

Fentanyl is an opioid, which means that it is a compound that resembles opium in the way it physically or psychologically affects the user. Originally developed in 1959, fentanyl is a synthetic opioid meant to provide anesthetic and pain relieving effects to those who had recently had major surgery. Like other opioids, such as morphine and codeine, fentanyl was first produced for medical purposes.

Fentanyl is over 100 times stronger than morphine, which made it extremely effective at addressing pain during and after surgery. In the 60’s, fentanyl was administered as an intravenous dose to provide anesthetics before surgery. Due to the drug’s usage primarily in the hospital setting, there were no cases of fentanyl abuse at that time.

However, in the 1990s, manufacturers developed a fentanyl patch that could be applied to the skin for long-term pain relief, as well as a lollipop that could be consumed to provide pain-relieving benefits. Cancer patients enjoyed the pain relieving benefits of fentanyl, as well as the reduction in the emotional responses to pain. Unfortunately, recreational users did, as well.

Why Is Fentanyl So Dangerous?

As mentioned, fentanyl is extremely potent – 100 times stronger than morphine and 50 times stronger than heroin. In fact, even two milligrams is strong enough to cause death in adults. So, why do users risk death with such a strong substance? Sometimes, those using fentanyl are unaware.

In the early 2000’s, drug cartels began cutting fentanyl with a number of other illicit drugs, including cocaine, methamphetamines, and especially heroin. Sometimes, the cut drugs are diluted and sold in bricks; other times, the product is pressed into pills and sold as Xanax, OxyContin, or other prescription medications. Either way, a poorly mixed batch can feature areas rich in fentanyl, which is much stronger than the drugs it imitates. An unsuspecting user can consume high amounts of fentanyl without even knowing they’re using the drug.

What’s the motivation behind cutting fentanyl into other drugs? First, fentanyl’s ready availability from foreign laboratories makes it hard for dealers to pass up the ease of mass production. Compared to heroin, which takes months of growing and cultivating – not to mention land – accessing synthetic fentanyl is simply easier. In addition, the high potency of fentanyl means manufacturers must only include a little in each pill on order to give the user the effects of using another prescription opioid.

Diluting and cutting fentanyl can result in a great deal of money to be made. In fact, street values of a kilogram of diluted fentanyl can reach upwards of $350,000, all for a product that cost only $3,000 in its purest form. In pill form, that same kilogram can result in a million pills worth as much as $20 apiece – up to $20 million in profits for the seller.

Where Does Fentanyl Come From?

One source of fentanyl in the US is legal prescription medications. Some users improperly obtain and consume fentanyl lollipops for recreational purposes. Others remove fentanyl gel from the fentanyl patches and concentrate and inject or smoke it. Still, legal prescriptions are only one source of fentanyl.

Primarily, fentanyl in the United States comes from China, through multiple channels. One way Chinese manufacturers send fentanyl to the US is via direct mail. Consumers purchase fentanyl and other drugs over the dark web; the drugs are then packaged and arrive directly at the consumer’s mailbox, ready for consumption. Since fentanyl is so potent, the product arrives in tiny envelopes, packed in small packages that are easy to overlook with the large volume of international mail that passes through the US Postal System every day.

In many cases, fentanyl via mail is intentionally mislabeled so that it passes through other countries that proved less conspicuous than China. Often, packages travel through countries like Tonga and Canada before finding their way to the United States. Hundreds of shipments are seized each year, but hundreds more arrive at their destinations. When you consider just how potent a small envelope of fentanyl is, hundreds of shipments takes on a scary, new meaning.

However, in other cases the fentanyl pipeline is much more complicated than a direct route from China to US shores. First, much of the bulk fentanyl produced in China gets funneled through Mexico, where it is accessed and distributed by the same drug cartels that push other drugs across the US border. It is diluted, cut with other drugs, and distributed – usually through San Diego – to dealers across the county.

How does the fentanyl cross the border? The bulk of the US fentanyl trade comes from the Sinaloa and Cártel Jalisco Nueva Generación cartels. Like many other drugs, fentanyl reaches the US via the cartel’s smuggling routes on foot, via car, semi-truck, or boat. To that end, seizures of fentanyl have occurred in produce trucks, shoes, buses, and in airport passenger terminals.

What Can We Do About It?

Investigators in the United States and Mexico are working together to try and halt shipments of fentanyl from coming into the United States, which includes efforts to cease manufacturing, cutting, and transport operations in Mexico. Border security, mail inspections, and other efforts continue on both sides of the US borders with Canada and Mexico. China, as well, has begun efforts to curb fentanyl production with a series of regulations on the chemicals involved.

Still, officials are fighting a tough battle. Fentanyl has maintained its position as the most commonly overdosed drug in the United States since 2016, when it first surpassed other opioids in that respect. Similarly, between 2014 and 2015, officials saw a 2,400% increase in the seizure of fentanyl at the border. Cooperation among all countries and agencies is necessary to limit the amount of this truly dangerous drug that crosses our borders.

Could You Lose Your Job For Going To Rehab?

Could You Lose Your Job For Going To Rehab?

The decision to seek treatment can be lifesaving for many individuals experiencing addiction. Unfortunately, attending treatment takes time – often as many as 90 days, and sometimes more. The length of treatment can cause some individuals to assess the benefits of rehab against the potential risks taking time away from work and the rest of their lives.

Why Do Some People Fear Attending Rehab?

Although addiction can be a full-time job in itself, most people experiencing addiction hold steady jobs in order to support themselves, their families, and even the potential costs of addiction. When a physician, interventionist, counselor, or someone else suggests attending rehab, the prospect of leaving that job for the length of time necessary to complete rehab can seem daunting. Not only must the addicted individual face leaving the addictive substance behind, but friends and family as well.

When you add in the prospect of leaving a job for as many as 90 days, the idea of nearly three months without pay can compound already-present anxiety surrounding how you are going to pay for treatment in the first place. Then, the ultimate fear – what if there is no job waiting upon your return? Can your employer fire you for attending rehab?

Laws Exist To Protect You

Depending on the circumstances of your employment, laws are in place that may protect your ability to keep your job while you are in rehab. However, these laws only apply to companies of certain sizes. It is important to learn your rights before approaching the topic of rehab with your employer.

Once you enter rehab, the Americans With Disabilities Act (ADA) states that you are protected and cannot be terminated for reasons associated with your addiction. For example, missing work due to the treatment process – whether it is to participate in a weekly drug test or attend treatment – is a protected action under the ADA as long as you are using your vacation time or sick leave. If your employer fires you for seeking treatment, you may file discrimination charges against your employer. ADA regulations only apply to government agencies and companies with fifteen employees or more.

Similarly, the Family Leave and Medical Act (FMLA) states that employees may take as many as 12 weeks off to pursue medical treatment for a condition. This includes addiction disorders, allowing you to pursue treatment for up to 12 weeks without fear of reprisal. However, FMLA leave is generally leave without pay, unless your employer agrees to pay you anyway. FMLA regulations only apply to full-time employees of companies with over 50 employees. In addition, you must have worked at your company for at least 12 months.

What Are Your Options?

People Fear Attending Rehab

If FMLA or ADA does not apply to you due to the circumstances of your job, or if you cannot afford to miss work for a long period, attending a full, inpatient treatment program lasting 90 days or more may not be your best option. Instead, you may want to consider whether an outpatient treatment center is a better option. Although you may need to leave work for drug testing or sessions outside of the norm, it is possible to schedule outpatient treatment around a full-time work schedule.

Similar to inpatient rehab, however, those instances in which you must leave work early for sessions related to your treatment may occur, and similar questions may arise regarding missed work. You are still protected under FMLA and ADA if your company meets all size requirements. You are continuously protected from reprisal and discrimination resulting from your addiction.

Additionally, you may want to consider disability. If you are unable to work during treatment and earn less than $1,000 per month, you may qualify for disability payments. However, you must prove that your medical condition renders you unable to work, or that it has affected your work to the point where you cannot maintain employment. Ask a medical professional for more information.

What Should You Do Before Attending Treatment?

If you plan to attend inpatient treatment that will require you to miss work, or if you intend to schedule outpatient treatment that may interfere with your work schedule, you will need to discuss your upcoming absences with your employer. However, even if you believe outpatient rehab will not impact your work schedule, consider the fact that your treatment or the resulting withdrawal symptoms may affect your work performance. Usually, it is in your best interest to discuss these issues with your employer before they occur.

Before the conversation:

  • Know your rights. It is essential to take the time to learn about your rights to privacy and continued employment before entering into a discussion with your employer. To achieve this, you may want to speak with an insurance provider or medical professional with knowledge in these areas.
  • Familiarize yourself with your workplace’s drug policy. If you are well informed about your company’s drug policy, you are better able to reassure your employer that you do not intend to violate the policy. In addition, you can reassure your employer that your treatment plan is, in part, an effort to adhere to company policy.
  • Find your company’s HR representative. In most cases, HR is the appropriate place to have a discussion regarding your drug treatment plans. Reiterate that your treatment is an effort to improve your health as well as to improve your performance at work.
  • Have the conversation as soon as possible. Adequate notice that you are spending time away from work is a consideration to your employer, who can adequately plan for your absence. In addition, you will have sufficient time before beginning treatment to ensure your employer is respecting your rights.
  • Take care of responsibilities. Ensure that you leave your employer in a good position. Do your best to complete any projects that are your responsibility, and tie up any loose ends.

After You Return

Once you’ve completed rehab and return to work, the FMLA stipulates that you return to a similar position and work schedule as before so long as you continue to perform your job as expected. Your employer must keep the details of your addiction and treatment confidential, as well as the terms of your return. In some cases, you may have agreed to a return to work agreement. This document is an agreement between you, your employer, and the treatment center, and stipulates your continued sobriety, possible drug testing, and job performance as a condition of your continued employment.

Maryland Attorney General Unable To Stem Drug Price Gouging With Legislation

Maryland Attorney General Unable To Stem Drug Price Gouging With Legislation

Drug manufacturers in the United States have recently faced mounting public scrutiny and outrage over consistently escalating drug prices. Manufacturers have raised prices of vital medications by more than 6000% in some cases*, outraging Americans who rely on these medications to survive. Price gouging, or the practice of driving up the price of goods in the face of high demand when a product manufacturer has effectively “cornered the market,” is a major issue in the pharmaceutical industry with very real effects on American lives. Some state lawmakers have attempting to enact new laws and regulations to curb this worrisome trend, but so far, these efforts have largely failed.

Understanding Price Gouging With Pharmaceuticals

Most Americans witnessed one of the most recent developments in the fight against drug price gouging with the downfall of Martin Shkreli, the former CEO of Turing Pharmaceuticals who increased the price of a drug intended to treat a rare disease by nearly 5,000%, outraging patients and the general public and earning him the title of the “most hated man in America.” Shkreli is currently in prison for unrelated securities fraud charges and other crimes, but the impact of Turing Pharmaceuticals’ price gouging started an important conversation in the American public sphere about the justifiability of astronomical price increases on important drugs.

Maryland Steps Up To Fight Drug Price Gouging With New Laws

Maryland Attorney General Scott Frosh has been fighting pharmaceutical price gouging since 2017, championing a new bill intended to function as an anti-price gouging law that eventually passed on October 1, 2017. The new law allows the state Attorney General to take legal action against any pharmaceutical manufacturer that enacts an exorbitant or “unconscionable” price hike without justification.

Difficulties With Appeals

Many pharmaceutical manufacturers argue that the cost of developing complex medications justifies these price increases, and the Association for Available Medicines (AAM) fought Frosh’s new bill vehemently. The AAM argued the term “price gouging” was too vague to be included in official legislation and that such a law violates the Commerce Clause of the U.S. Constitution. This clause prohibits state governments from enacting laws and regulations that interfere with interstate commerce.

Unfortunately, these arguments held up in appellate courts, and although U.S. District Judge Marvin Garbis denied the AAM’s request for an injunction, he allowed their lawsuit to continue. A three-judge panel ruled that the lawsuit was justifiable and Frosh’s new law violated the U.S. Constitution’s Commerce Clause. Frosh responded to this decision by petitioning the U.S. Court of Appeals to reverse the decision, but they ruled against him and rejected this appeal on July 24, 2018. Their justification for this decision was that states should not have the right to impose regulations or consumer protection requirements on out-of-state manufacturers, even if those manufacturers intended to sell their products in those states.

Frosh Fights Back

Despite the U.S. Court of Appeals ruling that upheld the AAM’s lawsuit’s claims, Frosh and his team decided to reorganize their efforts and broach the issue with the United States Supreme Court. As of October of 2018, Frosh has helped spearhead the effort to convince the U.S. Supreme Court to reverse the U.S. Court of Appeals’ decision, citing the fact that any 1,000% increase in the price of a drug “defies common sense.”**

In his petition to the U.S. Supreme Court, Frosh argues that his anti-price gouging act contained objective examples of predatory practices among pharmaceutical manufacturers, but the Supreme Court has yet to hear the case.

Setting Precedent

Although Frosh’s anti-price-gouging law encountered hold-ups in the appellate court system, it served as an important catalyst that encouraged other states to start developing legislation to counteract price-gouging practices in the pharmaceutical industry.

On February 8, 2019, U.S. Senators Kirsten Gillebrand and Sherrod Brown co-sponsored new legislation aimed at fighting pharmaceutical price gouging***. Their new law would penalize any pharmaceutical company that engaged in any unjustifiable price gouging to exploit patients who depend on their products. Some of those patients suffer from cancer, diabetes, drug addiction, and other complex medical conditions requiring specialized medications.

This new law requires all pharmaceutical companies to report all price increases and include clear justification for such increases, such as objective manufacturing cost increases or increasing prices of necessary ingredients and raw materials. The law imposes heavy fines for companies that engage in any type of exploitative price gouging. Congressional representatives Mark Pocan and Marcy Kaptur have also co-sponsored similar legislation in the U.S. House of Representatives.

Pharmaceutical Manufacturers Respond

Many pharmaceutical companies have fought against these new legislative maneuvers, citing the rulings from the U.S. Court of Appeals against Frosh’s new law in Maryland and continuing to cite the U.S. Constitution’s Commerce Clause and protections for interstate commerce.

These companies have also attempted to justify their seemingly absurd price increases. In a recent interview with Financial Times****, Nostrum Laboratories representative Nirmal Mulye defended the company’s decision to increase the price of their drug nitrofurantoin from $474.75 to $2,392. Nitrofurantoin is a common antibiotic treatment for bladder infections and holds a spot on the World Health Organization’s list of essential medicines.

Mulye brazenly argued that selling a product at the highest possible price was a “moral requirement” of doing business, stirring up further outrage concerning predatory practices of American pharmaceutical manufacturers. He went on to further clarify these statements in other interviews, explaining that seeking profitability was an essential part of doing business and keeping a company alive.

Doctors Share Patient Stories To Draw Attention To Drug Price Gouging

Understanding Price Gouging With PharmaceuticalsThe Baltimore Sun***** recently published the story of a patient forced to choose between her life-saving heart medication and providing for her family. The grandmother of eight required a specific type of heart medication to support optimal heart function after overcoming a potentially fatal heart condition in the hospital. When she visited the pharmacy to fill her prescription and saw the $200 price tag, she decided to choose providing for her family over filling this expensive pharmacy order.

The woman’s doctor, Nicky J. Mehtani, reported the woman died of a heart attack shortly thereafter, after missing her required medication. Mehtani argued that neither negligent medical care nor ineffective treatment caused this woman’s death, but rather the predatory practices of pharmaceutical manufacturers pursuing profits at the expense of those who need their products to survive.

The Supreme Court has yet to rule on Frosh’s petition concerning his anti-price gouging law, and the viability of other new legislation aimed at curbing drug price gouging remains uncertain as well.