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.

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.

Long-Term Risks Of Methadone Maintenance

Long-Term Risks Of Methadone Maintenance

Opioid addiction is an ongoing problem in the United States, and every state has been reporting record numbers of new opioid addiction cases and overdose deaths year after year, for more than a decade. One of the reasons behind this ongoing epidemic is the tremendous addictive power of opioids. While they are tremendously effective painkillers, they are also very easily habit-forming and addictive. Once addiction sets in, withdrawal symptoms are very uncomfortable and may even turn fatal.

What Is Methadone?

Methadone is a synthetic opioid painkiller first used by the United States during World War II when injured soldiers needed painkillers, but morphine supplies were low. In 1971 the Food and Drug Administration (FDA) officially approved the use of methadone as a viable treatment for opioid addiction and other forms of substance abuse.

Today, the FDA allows the prescription of methadone for addiction treatment purposes as well as chronic pain. However, methadone remains a Schedule II controlled substance at the federal level because of its powerful effects and potential for abuse.

Short-Term Uses For Methadone

Methadone can help during opioid addiction recovery by helping a recovery patient taper off of his or her typical regimen of opioids. Acute opioid withdrawal symptoms are incredibly uncomfortable and often life-threatening in advanced cases of addiction. Sudden cessation can not only lead to intense cravings for more opioids, but also potentially fatal medical conditions like abnormal heart rate, organ failure, or stroke.

When an individual enters opioid addiction treatment, the first phase of treatment is detox, during which the attending caregivers flush the last of the drugs out of a patient’s body. Medically assisted detox generally offers the best chances of a successful detox process, while mitigating the risk of life-threatening medical complications from withdrawal symptoms.

Some treatment centers prescribe detox patients methadone because it offers relief from the symptoms of opioid withdrawal without the dangerous side effects of opioids like morphine or hero in. Methadone maintenance therapy has proven to assist with withdrawal symptoms and reduce the likelihood of relapse. However, there are risks with any type of methadone use, even in the short term. Long-term use entails even greater risks.

Long-Term Methadone Maintenance

Methadone is a synthetic opioid and shares many painkilling properties with other opioids like heroin and morphine. However, the effects are generally less pronounced than natural opioids or other synthetic opioids like fentanyl. Some doctors prescribe methadone as a treatment for chronic pain. A drug maintenance prescription like this may help a patient manage his or her chronic pain symptoms, but since methadone activates the opioid receptors in the brain it inherently carries a risk of chemical dependency.

Risks Of Long-Term Methadone Use

Risks Of Long-Term Methadone UseMethadone maintenance therapy may entail slightly less of a risk than abusing stronger opioids, but it is crucial for anyone undergoing methadone maintenance therapy to understand the risk of addiction and the signs of a habit forming. If a patient starts to experience withdrawal symptoms, he or she should speak with the prescribing doctor immediately to discuss alternative medications or even substance abuse treatment.

Over time, the human body naturally builds a tolerance to opioids with consistent use. A prescribed dose may work for managing chronic pain for months or even years before a patient starts to notice that a single dose is no longer as effective. This, unfortunately, encourages some methadone maintenance patients to begin abusing methadone by taking too much at each dose or altering the pills for more concentrated effects. For example, crushing a methadone pill and snorting the powder causes intense feelings of euphoria similar to those caused by a dose of heroin. These powerful reactions can quickly cause a methadone abuser to build an even stronger tolerance, propelling him or her further into chemical dependency.

Side Effects Of Methadone

Methadone side effects vary greatly on an individual basis. Milder short-term side effects may include upset stomach, sexual dysfunction, dry mouth, lightheadedness, and drowsiness. More serious possible side effects include fainting, seizures, anaphylactic shock, and even death from overdose. So how long does methadone stay in your system? It usually lasts up to two weeks but may remain detectable for even longer. The initial effects typically wear off within a few hours, but individuals who use a methadone maintenance treatment for chronic pain generally report long-lasting relief from each dose.

New Methadone Clinics Appearing Nationwide

In light of the ongoing opioid crisis in the U.S., new methadone clinics are appearing in metropolitan areas all over the country more frequently in recent years. A proposed methadone clinic in Baltimore met with protests from the local community, due to their concerns about the location of the clinic being too close to a local school, despite the fact that area crime statistics indicate that crime is less frequent around methadone clinics than liquor stores and corner shops.

Is Methadone Worth The Risk?

Despite the fact that methadone is a prescription medication that may aid in opioid addiction recovery, it may equate to trading one addiction for another in some patients. Everyone processes opioids differently, and depending on how long an addiction has lasted, and the severity of the addiction, an individual may find relief from opioid withdrawal symptoms with methadone treatment or the methadone may simply cause his or her addiction to last longer. However, some have made the argument that replacing one opioid for a less dangerous opioid is essentially the same as harm reduction.

Alternatives To Long-Term Methadone Use

Some chronic pain patients use methadone on a daily basis for several years without experiencing addiction or withdrawal symptoms, and the methadone manages their chronic pain well enough to carry on with daily activities. However, any long-term opioid use carries a risk of addiction. Any patient who relies on methadone maintenance therapy should closely follow his or her prescribing doctor’s directions for proper dosing and report any adverse symptoms immediately.

While methadone may help during opioid detox, this should only be a temporary measure that prepares the patient for rehab. Methadone can help reduce the appearance of withdrawal symptoms but may also inadvertently prolong an opioid addiction. Ultimately, methadone may offer relief from acute opioid withdrawal symptoms and chronic pain, unrelated to addiction, with appropriate use as directed by a physician, but it is essential to ensure responsible use or explore alternatives whenever possible to avoid the significant risk of methadone addiction.

Annapolis May Soon Offer Drug Test Kits That Detect Fentanyl In Drug Supplies

Annapolis May Soon Offer Drug Test Kits That Detect Fentanyl In Drug Supplies

In recent years, America has quietly been going through an opioid crisis that is only just now beginning to receive the attention it deserves. The most recent drug on the scene is fentanyl, a synthetic opioid that is now the main cause of overdose deaths in the country. Fentanyl is a white powder dealers and users can cut into cocaine without detection. This combination can easily lead to a fentanyl overdose.

New proposals would provide fentanyl test strips that would be available for anyone wanting to detect any traces of fentanyl in their cocaine. The idea has proven controversial, with some seeing it as a way to cut down on fentanyl deaths while others believe it avoids dealing with the real issue.

Cocaine And Fentanyl Overdose Deaths

In 2012, more than 4,400 people died from cocaine overdoses. Not counting methadone, only about 180 of those deaths involved a synthetic opioid like fentanyl. By 2016 – the last year for which we have complete data – cocaine deaths had risen to 10,400. Alarmingly, 4,200 of those involved a synthetic opioid other than methadone.

Cocaine overdose deaths are a problem that has traditionally hit the African-American community disproportionately hard. The use of heroin and fentanyl heroin, on the other hand, has arisen mainly in the white community. Some believe that the mixing of the two drugs could represent an opioid crisis spreading to a new demographic. But what is the reason for the link between the two?

Various Hypotheses

Though no one knows for sure why fentanyl is suddenly showing up in cocaine, there are a number of theories that experts find plausible.

  1. Users are mixing the two. They may be doing this unknowingly, because many dealers are selling fentanyl and calling it heroin. The problem is that fentanyl is far more potent, and if a user takes a heroin-sized dose of fentanyl, they could easily wind up taking too much. It is also possible that users are knowingly mixing the two together. A “speedball” is a mix of heroin and cocaine and has long been popular among drug abusers. As fentanyl increasingly replaces heroin, it is natural to find it as part of a speedball now.
  2. Dealers are mixing the two deliberately. There is some evidence to support this, as some batches of cocaine seized by police have tested positive for fentanyl. However, this occurrence is rare. It does not make much sense for dealers to mix the two, as one is an “upper” and the other a “downer”. Dealers don’t want to put their customers off any more than any other seller, and now that fentanyl is gaining notoriety as a dangerous drug, it makes less sense for dealers to risk the lives of people who are paying customers.
  3. Dealers are mixing the two accidentally. If a dealer uses the same table to cut their cocaine and fentanyl without cleaning it in between, this could lead to the two getting mixed together. This might explain why such a small proportion of seized cocaine batches actually have fentanyl in them.
  4. Better data. A final possibility is that the amount of fentanyl-linked cocaine deaths is not really changing, we are just getting better at detecting it as a cause of death. While it seems unlikely that this would explain the entirety of the apparent epidemic, some experts maintain it could be part of it.

Test Strips May Arrive Soon

Annapolis May Soon Offer Test Strips To Detect Fentanyl In CocaineAmidst the growing opioid crisis, Annapolis may soon offer test strips for fentanyl detection. A test kit could be as inexpensive as $1 per unit. The test itself is as easy as sprinkling a little bit of the drug into a cup of water and then putting the strip in the water. One line on the strip means there is fentanyl, two lines means there is none.

The effectiveness of such a plan depends on why fentanyl and cocaine are suddenly linked. If dealers are mixing fentanyl into their cocaine, whether by accident or on purpose, there may be a demand for the test strips if word about them spreads. However, as we have seen, there is scant evidence of widespread cocaine batches laced with fentanyl.

If it is principally users who are mixing the two, then there is no reason to believe there will be demand for a product that tells them what they already know, and cannot tell them how much fentanyl they have mixed in. We should also note that toxicology tests only determine the presence of cocaine and fentanyl in the body of the deceased. It is possible that the addict took the two drugs separately, which would further obviate the use of test strips.

We Should Have Seen This Coming

Test strips for fentanyl may do some good, but the drug problem is much bigger than that, and there are reasons to wonder just how much good it can do. Is someone who tests their drug supply and finds that it contains fentanyl going to get rid of it? It is likely that he or she may find it difficult to resist taking the drug if it means waiting several more hours until they can purchase more. Additionally, they may not have the money on hand to buy another dose. Although using the test strips suggests a level of self-care, those struggling with addiction also tend to lean towards high-risk behaviors.

Another issue is that the strips reveal the presence of fentanyl, but not the concentration. A person who decides to test their drugs has no way of knowing how much fentanyl the dealer mixed with the cocaine and may decide to risk taking the dose anyway.

Lastly, the mere availability of test strips does not guarantee that anyone will want to use them, or even see the need. If a user has already been taking fentanyl, even unknowingly, they may have developed a chemical dependency on the drug. If avoiding fentanyl means going through fentanyl withdrawal, they may see no reason to use the strips.

Treatment Is The Only True Solution

Ultimately, strips that test for fentanyl can have only limited usefulness at best. Even if someone struggling with addiction can use them to avoid taking fentanyl, they still are taking a harmful drug that can do damage on its own.  Any type of drug addiction makes it impossible to lead a normal, healthy life. The only way to make drug use safe, is to not take drugs at all, and that means a long-term addiction treatment plan.

Treatment centers, such as Echo Recovery in Maryland, give people the best hope to beat their addiction and start on the road to recovery. A good rehab center offers treatment, counseling, group therapy and a sponsor or mentor to support a person going through the recovery process. This is the best addiction relapse prevention. Those in Annapolis who require drug detox can contact Echo Recovery for help.

Every individual’s life experience, outlook and future goals are different. A treatment center will adapt their treatment plans to suit the individual. This offers the best chance at recovery, and recovery is the true goal for anyone with addiction problems. A fentanyl test strip is a band aid for a problem far worse than a cut to the skin.

First Responders Are In U.S. Classrooms Helping The Silent Victims Of Drug Abuse

First Responders Are in U.S. Classrooms, Helping the Silent Victims of Drug Abuse

The opioid crisis is causing far more damage beyond overdose deaths and increasing addiction rates. Drug addiction has had a profound effect on American families in every state. Every community has unique concerns when it comes to the opioid crisis, and American teachers are quickly becoming one of the most important forces of positive support in the country.

How American Teachers Are Stepping Up To Face The Effects Of The Opioid Crisis

The effects of drug addiction on a family may go unnoticed by outsiders. It’s difficult to tell the difference between a child suffering from the effects of addiction at home and the typical growing pains of the school-age years. However, American teachers are witnessing the effects of addiction on American children firsthand. More students are living in poverty and broken families than ever before, largely due to the ongoing opioid crisis. This makes teachers an important source of support for many American youths.

Families Fractured By Drug Abuse

Addiction takes a toll on a family. A parent with a substance abuse disorder will eventually deteriorate without intervention, and his or her children are likely to suffer the most when this happens. There are countless ways that drug abuse can harm a family, but children bear the brunt of this damage and often carry the scars for the rest of their lives. Addiction can also separate a child from his or her parents during the time parents are needed most; during the early years and school-age years.

Children In Foster Care And Poverty

Many areas across the country have been reporting higher entrance rates into the foster care system since the opioid epidemic started picking up steam. When a parent neglects financial responsibilities or endangers a child, the state intervenes and will typically place the child with a foster family or relative if possible. Ultimately, the state has a legal duty to rule in favor of the best interests of any children involved in any case.

Many parents have lost homes, custody, and even visitation rights due to substance abuse. Some go years without any contact. While there are plenty of avenues the government may take to separate a child from a potentially harmful parent, there are very few channels for reuniting families once a parent overcomes addiction.

Abuse And Neglect From Addiction

Drug abuse can lead to seriously damaging effects for any family. Some children have suffered physical and sexual abuse at the hands of addicted parents and relatives. Others have been trafficked to pay for a parent’s addiction. Many face neglect, homelessness, and poverty due to their parents’ habits and may come to school tired, hungry, and wearing filthy clothes.

Children who experience poverty, abuse, and/or neglect at young ages typically display significant behavioral and psychological distress for years to come. Seeing drug abuse firsthand at home can be traumatic and drastically impact a child’s outlook on the world. Children from fractured homes and those who go through the foster care system generally face a higher risk of developing substance abuse disorders themselves as well.

West Virginia Teacher Addresses Student Poverty

A recent Huffington Post report* covered the story of Gary Cruey, a middle school teacher in War, West Virginia, one of the areas of the country most acutely affected by the opioid epidemic. While the rate of foster care admissions in 2016 was 369 per 100,000 children, the rate in West Virginia skyrocketed to 1,221 per 100,000 children. Cruey reports that as many as half of the students he teaches live in foster care, with one parent, or another relative.

In 2014, McDowell County had the highest opioid-related hospitalization rate in the state, and West Virginia already reported significantly higher opioid abuse statistics than most other states. Cruey also reported that about 40% of middle school students in his district have individualized lesson plans or participate in special education. He attributes this spike in special education needs to the number of pregnant mothers abusing drugs in the area.

Long-Term Damage For Children Of Addicted Parents

The children who witness drug abuse at home often experience severe trauma. Even the children lucky enough to avoid physical and sexual abuse may still come home to find a parent dead from an overdose, eviction from unpaid rent, or a sudden removal from his or her home and foster care placement. The efficacy and safety of the U.S. foster care system has also been a hot topic of debate in recent years due to the increasing number of reports of abuse at the hands of foster parents and poor vetting practices in foster care services. Essentially, there is no guarantee that a child removed from his or her family home due to substance abuse will benefit in any way from foster care placement.

Overcoming trauma is difficult for anyone, but children lack the self-awareness of adults and may not be able to make sense of their environments. This leads to trouble learning, problems socializing, and an increased risk of drug abuse and criminal activity later in life. Teachers can play an important role in helping children in need by stepping outside their role as educators and offering support however they can. While this is an undue burden on American teachers whose job it is to simply teach, many undertake this burden because they want the best for their students and feel compelled to help however possible.

Finding Hope In Recovery

The resources available for fighting the ongoing opioid crisis are very limited, and while state and federal policymakers have made significant strides toward improving access to treatment and boosting the effectiveness of available treatments, there has been little progress in the way of improving the lives of children affected by substance abuse.

Echo Recovery offers a full range of substance abuse treatment services, including support for families struggling with homelessness. Learn more about the housing services we can provide and consider how you can start rebuilding in recovery.