Monday, November 30, 2009

BAC of .477

Reas Kroicowl is a Psychiatric Social Worker who works in an unnamed city and writes a blog entitled "Trench Warfare".

She tells the story of a patient brought into the ED (Emergency Department) with a BAC of .477.

I worked as a Psychiatric Social Worker in three large urban hospitals for over 18 years and I remember seeing a few patients with BAC's in this range as well. Most people couldn't survive with a BAC this high which indicates a very high tolerance.

To read her quick report, click here.

The CAGE music video

The CAGE music video comes from the Calgary Addiction Program.

It's cute, short, and worth watching. To watch it click here.

The CAGE is an easily administered four question screen for problems with alcohol.

1. Have you ever thought you should CUT down on your drinking?

2. Have people ANNOYED you by criticizing your drinking?

3. Have you ever felt bad or GUILTY about your drinking?

4. Have you ever had a drink first think in the morning to steady your nerves or get rid of a hangover? ( An EYE-OPENER)

Sunday, November 29, 2009

Make-up or beer?

Saturday, November 28, 2009

Recovery doesn't have to be done alone

Most people make changes on their own. About 80%. But the other 20% have a much tougher time. Their biochemistry has been altered and recovery is no longer just a choice, but a biological craving like being extremely thirty for water when one is parched.

To deal with these cravings people need understanding, support, and tools to manage these cravings and triggers. That's where treatment helps. There are people who know what it takes, how it might be accomplished, and can teach and assist in taking life changing action.

If you have promised yourself that you can stop your use or behavior, that you will quit tomorrow, but tomorrow never comes or doesn't last, you are not alone. Treatment is available which is life transforming for you and your relationships.

Friday, November 27, 2009

Thursday, November 26, 2009

Is addiction a choice?

Research Psychologist Gene Heyman says that addiction is a choice and he has written a book about it. Tom Ashbrook interviews Heyman and others about this idea on his show "On Point" on August 11, 2009.

I think the argument is kind of silly because addiction is BOTH a choice and a disease not one or the other.

It is worth listening to. Show lasts about 50 minutes and you can access it by clicking here.

Wednesday, November 25, 2009

Break your shopping addiction - Buy nothing day is 11/27/09

Click on image to enlarge it for easier reading.

Social Work is the most stressful and badly paid job in the CNN poll.

Ladies and Gentleman I am a Social Worker, proud to be a Social Worker, and have been for 41 years.

I feel very validated to see a CNN poll on jobs that pay badly and are very stressful and find that Social Work is #1 not #5 or #10 but #1.

In light of what has been going on recently at GCASA with its financial difficulties and it high demands for service with clients who have multiple and at times overwhelming problems, and being snipped at by people who seem to believe that we are overpaid and a drain on the taxpayers, it was very vaidating to find out that there is some objective evidence that my thoughts and feelings are correct.

Substance abuse counselor is #13 on the list out of 50. You can check it out by clicking here.

I recommend this brief article to you.

Tuesday, November 24, 2009

What can health care providers do about prescription drug abuse?

SAMHSA pamphlet for health care providers on talking to patients about prescription drug abuse. Click here.

Monday, November 23, 2009

Millions of Americans Go Without Substance Abuse Treatment

Millions of Americans go without substance abuse treatment reads a headline in the October 16, 2009 issue of the Psychiatric News. To read the article click here.

Click on image to enlarge for easier reading.

Poverty and addiction - cutting services to those least able to pay for them

According to the U.S. Census bureau 5,451 people or 13.9 percent of the population in Orleans County lives in poverty. The median income is $46,220.00.

In Genesee County 5,992 people live in poverty or 10.6 percent of the population. The median income is $49,133.00

In Monroe County 92,057 people live in poverty or 13.1 percent of the population and the median income is $51,799.00

In Erie County 118,825 people live in poverty or 13.5 percent of the population. The median income is $48,427.00.

In Niagara County 25,504 people live in poverty or 12.1 percent. The median income is $45,545.00

In Wyoming County 4,252 people live in poverty or 11.4 percent of the population. The median income is $48,472.00.

From the data, it is clear that GCASA serves the poorest county in the region where people have the least ability to pay for services. It seems unfortunate that GCASA has had to curtail services to people in this county because of a lack of deficit financing from County and State government where people need the help the most because of their inability to pay for the services that they often desperately need.

It is interesting to note that Orleans County has higher poverty rates that the larger counties like Erie and Monroe even with their large populations of urban poor in their large cities.

GCASA for the last several years has been able to subsidize its service delivery in deficit plagued Orleans Counties with the surpluses it generated from its operations in Genesee County, but with the advent of another provider in Genesee County skimming off clients who can pay and leaving people needing a sliding fee scale with GCASA, the surpluses in Genesee have been eliminated and now both county treatment service programs are running deficits requiring the agency to cut services.

And so it goes...................

Friday, November 20, 2009

Idea of the day

Thursday, November 19, 2009

Thoughts as I struggle to go to work.

There was an article in the Batavia Daily News last Friday, 11/13/09 which describes the deficits which GCASA is facing in 2010 and the curtailment in staffing and services which will occur to balance the budget.

GCASA is a private nonprofit agency which has contracts with State and County governments and since State and County governments are going through their own financial difficulties there is no ability to provide additional resources to provide services to help people struggling with substance abuse problems.

We live in a society where alcohol, tobacco, gambling, street drugs, and prescription drugs are glamorized and sold as the means to experience the good life. These advertisements and marketing strategies are, of course, lies because while these substances and activities can provide temporary enjoyment, their consistent use and abuse leads to disease and death.

While the breweries and distilleries and casinos and state lottery commission spend billions of dollars per year to convince Americans to use their products, there is very little spent to warn people of the dangers and to help them when their use turns to abuse and addiction.

Substance abuse kills hundreds of thousands Americans a year. Two of my own children were killed by a three time drunk driver and so I personally know the pain and tragedy that substances cause our society. The man who killed my children was known as the "town drunk" and he had never had any treatment for his alcoholism.

The comments to the Daily News article are very disturbing for me and the GCASA staff. They indicate a contempt and disdain for the services that GCASA provides and for the patients that we serve. As a Psychiatric Social Worker I am well aware of the shame and humiliation which mental illness and addiction bring to patients and their families. Throughout history people suffering from these disorders have been ridiculed, vilified, stigmatized and humiliated. These reactions are what in psychology we label "projections" because we tend to attack others when we see what is most shameful in ourselves.

Any one who is willing to sit quietly for 10 minutes and just watch one's own thoughts and feelings will quickly observe how we each are full of lust, greed, hate, envy, fear, arrogance, and shame. We all have our weaknesses and what Carl Jung called our "shadow side". We hide it not only from others but most of all from ourselves but it is there and not repressed very deeply either if we are only willing to watch.

We live in an addictive society. We are addicted to our substances, consumerism, militarism, sex, eating, anything which will alter our mood and help us feel less scared, less depressed, less frustrated with the chaos and darkness we see around us. It is always a delight to find people who are willing to look into the darkness, call a spade a spade, take the ugly bull by the horns and with the help of others move toward the light.

What we do at GCASA at the superficial level is provide medical services to help people with their addictions and to help our society become aware of and deal with the shadow side of the culture, but at the deeper level we attend to people's spirit and help them become all that they were created to become so that they can realize their potential, create healthy more satisfying lives for themselves, and to help others.

It seems strange to be criticized and hated for this but even the existence of agencies like GCASA reminds us as Americans of our weaker natures, of our vulnerabilities, of more shameful problems, and it is understandable how those who would step forward to call attention to this and try to help would be feared and subject to the expressions of contempt and disdain.

The work we do at GCASA is honorable and noble work in spite of the lack of support and outright contempt it engenders. We will continue on as best we can trying to help and serve those who are in need. If the man who killed my children had had the help he needed with his alcoholism, my children today would be 22 and 25 instead of killed at 5 and 8.

What we do at GCASA among other things is turn pain and sorrow into understanding and hope, anger and shame into compassion and self respect, confusion and loathing into clarity and admiration.

I will go to work today because I believe in the work, to honor the memories of my dead children, because I know that there are people suffering who need a place to turn, and because there are many colleagues and volunteers who understand. They are silent in the comment section of the Daily News article for various reasons, but I know they are there and so it keeps me going.

Having worked in the field of mental health and substance abuse for over 41 years, I am in the last stretch of my career and life. I have seen many ups and downs and the support for mental health services and substance abuse services wax and wane on the political tides of our society. Overall, though, the treatment for people with mental health and substance abuse disorders is much better now than it was when I started at Kings Park State Hospital on Long Island back on 10/31/68. I think and I hope that I have helped.


Wednesday, November 18, 2009

Significant progress in tobacco free initiative says OASAS commissioner

The following letter was sent by OASAS Commissioner, Karen Carpenter-Palumbo, yesterday, 11/17/09 concerning New York's leadership in treating tobacco addiction.

At GCASA our staff as not been able to be nicotine dependent since 1999 and our grounds became smoke free in 2003.

Here is the letter:


I want to congratulate you on the significant progress occurring throughout New York with the tobacco-free initiative. We are continuing to capture the program compliance rate during recertification and are encouraged to report that we now have over 80 percent compliance – showing a steady increase since July, 2008.

As New York leads the nation with addressing tobacco in the same context as treating all other substance abuse disorders, we are demonstrating to the country the ability to change the cultural acceptance of tobacco use and treat the deadliest addiction of all. Substance abuse counselors have the knowledge and skills to help individuals working toward recovery deal with their use of addictive substances. These skills are the backbone of the OASAS system of care and directly apply to the treatment of tobacco. The most commonly used models for tobacco treatment combine cognitive behavioral therapy such as motivational enhancement with nicotine replacement therapy (NRT).

Tobacco kills over 430,000 Americans every year. While New York smoking rates have dropped below 17 percent, the addicted population is more than four times that rate, ranging from 80-92 percent. We should remind ourselves that it was not that long ago that another legal substance was allowed during breaks and reward ceremonies. That substance was alcohol. Today, we understand the connection between alcohol and substance use and the studies are becoming more pervasive regarding the strong correlation of tobacco use and the development of other substance use disorders and with more severity such as:

• Early onset of smoking and heavy smoking are highly correlated with the subsequent development of other substances use. (Degenhardt, Hall and Lynskey, 2001)
• Heavy smokers have more severe substance use disorders than do non-smokers and more moderate smokers. (Marks et al., 1997; Krejci, Steinberg and Ziedonis, 2003)
• Tobacco use impedes recovery of brain function among clients whose brains have been damaged by chronic alcohol use. (Durazzo et al., 2007; Durazzo et al., 2006)

Programs are adopting a variety of policies that lead to improved health and long-term recovery. Keeping people engaged in treatment to address their addiction, including tobacco, is the best place for progress. Your policies, commitment and leadership will prevail as we continue to treat tobacco in the same context as treating all other substance abuse disorders. Together we are helping New Yorkers reach their goal of recovery and enhanced health.

Thank you for the work you do each and everyday to prevent, treat and help individuals recover from addiction - saving lives one day at a time.

Karen M. Carpenter-Palumbo