Are you as smart as a substance abuse professional? #12

Q: A client presents with nonhealing ulcers, abscesses, brittle fingernails, and bruxism (teeth grinding). This client is probably abusing:

A: Amphetamines

B: Steroids

C: Inhalants

D: Narcotics

For the correct answer, click on comments. While you're there, leave a comment yourself.

Should breastfeeding mothers drink alcohol?

The Guardian reported on February 15, 2009, that a product would go on sale that week in Great Britain that would test the alcohol content in nursing mothers' breast milk. Here is a snippet from the article:

A product that tests for traces of alcohol in breast milk has triggered warnings that mothers who rely on its findings could damage the health of babies and encourage binge drinking.

Milkscreen, which goes on sale in Britain this week, contains test pads that change colour on contact with breast milk containing alcohol, warning women that it is unsafe to breastfeed.

Experts, however, say that there is no clear answer to how much a new mother can drink before the alcohol gets into her milk, nor how long she should wait after drinking the alcohol to ensure it is not passed on to her baby.

The British Medical Association advises breastfeeding women not to drink at all; the Royal College of Obstetricians and Gynaecologists says one or two units a couple of times a week is "probably" safe. Old wives' tales, however, advocate moderate drinking while breastfeeding, claiming porter can give new mothers extra energy, beer can increase milk production and alcohol in general helps infants sleep.

But, according to Milkscreen, infants can safely consume breast milk with an alcohol concentration of approximately 0.03%. The threshold is, admits Julie Jumonville, founder and chief product officer of the UpSpring baby care project company, based on a number of research papers published by the American Academy of Paediatrics that look only at the impact of alcohol in breast milk on babies' sleeping and feeding patterns.

To read the whole article, click here.

Would you want to be called a "drunk", a "crack head", a "doper"? Watch your language!

How important is language in the substance abuse field? Very important according to Dr. Norman Hoffman, Ph.D. His is part of what he writes in his editorial on BHC Journal.

Equally disturbing are the research reports on treatment outcomes for samples composed of a mixture of abuse and dependent cases. A variety of research studies have shown consistently that dependence is distinct from abuse.2,3 One would be horrified to find an oncologist reporting on the prognoses of patients with “lumps” without differentiating cysts or benign growths from malignancies. We should be equally horrified to find addiction researchers who fail to differentiate dependence from abuse. Failure to distinguish abuse and dependent cases is not just sloppy word usage; it is sloppy science.

Another way dependence is trivialized is by using abuse as the generic term to include both substance dependence and substance abuse. Abuse used as the generic term makes policy makers, elected officials and members of the general public think of all substance use disorders as willful behavior, minor conditions, or “habits” — not serious conditions requiring treatment services. Abuse implies that the person is in control and willfully abusing the substance. Perception becomes reality in the minds of the uninformed. The worst consequence would be to support the contention that public policies just need to make “those people” want to stop by criminalizing that behavior. As for prevention, all we have to do is promote “Just say no.” Remember how that slogan did nothing to cut drug use among the youth of our nation? “Just say no” did for the substance dependent youth what “Have a nice day” did for the clinically depressed.

If addictions and the treatment of substance use disorders are to be taken seriously, we need to call substance use disorders by their formal and technical names — all the time. Addiction to alcohol is alcohol dependence; not alcohol abuse; not problem drinking. Heroin dependence is heroin dependence; not a habit.

Discussions concerning substance use disorders require using the appropriate terms for the conditions in question. Those words need to be used when making the case for why adequate funding of treatment is important.

If professionals in the field do not take addictions seriously enough to use the correct and appropriate terms for substance use disorders, how can they expect the public to take addictions seriously enough to support funding for treatment and prevention?

At GCASA we strive to provide high quality, professional services. Using the professional terminology in appropriate ways is important in communicating with clients, colleagues, referral agents, families, and other community members.

I personally don't like to call people "alcoholics" any more than I would call someone a "diabetic", an "autistic", a "schizophrenic", and/or a "depressive". It is more correct to say that this is a person suffering from diabetes, or schizophrenia, or alcoholism. The disease is not the primary attribute of the person's identity. It is a disease that the person is suffering from. The problem is the problem, the person is not the problem. It is important for us to use appropriate language because it has implications for understandings and for functioning.

Many people in Genesee County receive assistance from DSS according to Jerry Moran

There was an interesting article in the February 20, 2009 issue of The Daily News written by Paul Mrozek describing Genesee County Interagency Council meeting which met on Wednesday, February 18, 2009.

Jerry Moran, the Director of Family Services at the Genesee County Department of Social Services reported that:

7,000 out of approximately 60,000 people or 12% in Genesee County are on Medicaid. Many of these folks are working.

In addition, GCDSS handles about 1,800 requests per year for food stamps and 3,000 requests for heating assistance.

Here is part of what is written in the article:

Moran said of the 7,000 Genesee County residents who received Medicaid benefits in 2009, many are from working families and many of their children received their medical care through a related program, Child Health Plus. The 7,000 number represents about 12 percent of the county's population of about 60,000.

Moran said DSS handles about 1,800 requests per month for food stamp eligibility. About 3,000 property owners or renters receive Home Energy Assistance Program funds to offset their heating bills.

"We expect those numbers to go up," Moran said.

GCASA staff participate in the Interagency Council and one of its staff, Neil Bedford is the Council's Vice-President.

Are you as smart as a substance abuse professional? #11

Q: The usual sequence of diagnostic activity is:



A: comprehensive assessment, evaluation, screening

B: screening, comprehensive assessment, evaluation

C: screening, evaluation, comprehensive assessment

D: evaluation, screening, comprehensive assessment


For the answer click on comments. while you're there, leave a comment of your own.

GCASA employee longevity contributes to great service!

I asked GCASA staff what they thought about working at GCASA? How are we doing from a human resources management perspective. I got some interesting feedback.

One employee said that she is amazed at the number of employees who came to GCASA right out of college and who have stayed here for a number of years because of the work opportunities to try new things, grow in their jobs, and professional develop in the agency.

I asked Kim Corcoran, GCASA's Director of Human Resources, to do a little research on the longevity and here is what she found out.

Out of 97 employees, 37% or 36 have been at GCASA 6 years or longer.

Out of 97 employees, 9% or 9 have been at GCASA 11 years or longer.

Out of 97 employees, 6% or 6 have been at GCASA 16 years or longer.

I don't know how this compares to other community based non-profit substance abuse agencies, but it strikes me as unusually good. Having long term dedicated employees enables GCASA to provide high quality, caring services to its clients and referral agents.

Recently, I have heard of a lot of other agencies which have had high turnovers of staff which is very disruptive to clients, agency operations, and collaborative relationships with other providers.

GCASA can be very proud of creating work environments and work teams where people are engaged, enthusiastic, and care about their work.

Are you as smart as a substance abuse professional? #10

Q: On survey what percentage of Americans report that there is or has been a substance abuse problem in their immediate family?

A: about half

B: about 3/4

C: about 2/3

D: about 1/3

To find the answer click on comments. While you're there leave a comment of you own.

Power of the peer group: need to fit in leads to trouble

When I was a kid my best friend was Jack Donahue. His mother and my mother were friends so when I wanted to do something and she wouldn't let me I would say, "Jack Donahue's mother is letting him do it", and she would say "you're not Jack Donahue." And then to cap off her point she would say, "If Jack Donahue was going to jump off a bridge, would you jump off a bridge???"

I usually had nothing to say to her. I was at a loss for words. But my mother taught me to be my own person and listen to my own inner voice. I have always been skepical of other's ideas. Being the oldest of 5 children, I am the leader, not the follower.

Watch this video. It only takes 0:31. You'll get the point.

Celebrity DWIs #3 - NFL Hall of Famer, Carl Eller

CBS News reported on 2/24/09 that NFL Hall of Famer, Carl Eller, was sentenced to 60 days for DWI. Here's the report:

A National Football League hall of famer is going to be spending time behind bars. Former Minnesota Vikings great Carl Eller Monday was sentenced to 60 days in the Hennepin County workhouse for driving while intoxicated and assault. That assault involved an altercation with a couple of police officers who followed Eller to his home last April after observing his erratic driving.After getting out of the workhouse, which is an adult corrections facility, Eller will be have 60 days of electronic home monitoring. He’ll also have to get chemical dependency treatment and pay a three-thousand dollar fine.In announcing the sentence Monday, Judge Dan Mable ordered Eller immediately taken into custody.

This is article #3 in a series on Celebrity DWI.

What is America's biggest date rape drug?

Alcohol!

The San Francisco Examiner had the following report on 02/19/09:

A University of San Francisco student called a “predator” by prosecutors pleaded not guilty Wednesday to charges of raping four unconscious classmates in the past year.
A San Francisco judge also increased the amount of Ryan Kenneth Caskey’s bail from $600,000 to $800,000, District Attorney’s Office spokeswoman Erika Derryk said.

Caskey, 21, of Bakersfield, allegedly supplied booze to the women at college parties, then waited until the victims passed out before sexually assaulting them in campus dormitories, authorities said.

You can access the whole article by clicking here.

Video lasts 1:00.

Death by snow mobile

I reported on this blog on February 22, 2009 that there have been 7 snow mobile fatalities in New York State this winter, several caused by alcohol intoxication. In Massachusetts there have been 3.

Now this comes from Massachusetts today, 02/25/09:

After two more DUI snowmobile accidents last weekend, one of them fatal, snowmobile enthusiasts are pushing for stricter drunken-driving laws for snowmobilers in the state.

“It’s outrageous that the penalty for driving drunk on a snowmobile is $75. That’s an insult to responsible snowmobilers, the public and law enforcement officers,” said Dan Gould, president of the Snowmobilers Association of Massachusetts.

From December 2008 through February 2009 there were 26 reported snowmobile accidents, with three of those accidents resulting in fatalities in Massachusetts.

To read the whole article click here.

Are you as smart as a substance abuse professional? #9

Q: In general the ratio of males to females in outpatient substance abuse treatment in New York State is:

A. 50% male and 50% female

B. 40% male and 60% female

C. 90% male and 10% female

D. 80% male and 20% female



For the answer click on comments. While you're there, leave a comment.

Drugs kill - Heath Ledger

Keith Ledger who died last year from a drug overdose received a posthmous Oscar on Sunday night, February 22, 2009, for Best Supporting Actor for his portrayal of the Joke in The Dark Knight a Batman movie.

Reuters published this article yesterday, February 23, 2009.

Heath Ledger won the best supporting actor Oscar on Sunday for his performance as The Joker in Batman movie "The Dark Knight," with the award hailed a fitting tribute for the Australian actor who died a year ago.

Ledger, 28, who was found dead in his New York apartment 13 months ago after an accidental prescription drug overdose, was the hot favourite to win the award which made him only the second actor to receive a posthumous Oscar.

This is article #6 in a series on Drugs Kill.

The alcohol olympics

Video lasts 2:57

Are you as smart as a substance abuse professional? #8

Q - The percentage of Americans on survey who say that substance abuse treatment should be covered by health insurance is :

A. 25%

B. 52%

C. 71%

D. 94%

Celebrity DWIs - Anne Adams former prosecutor in Buffalo

Anne Adams a former prosecutor and professor at University of Buffalo law school plead guilty of drunk driving, offering a false instrument, and tampering with evidence. She was fired from her job at UB law school.

This comes from an article in the Buffalo News on 02/22/09.

Adams, 46, a former prosecutor, pleaded guilty before Erie County Judge Sheila A. DiTullio to three misdemeanors: drunken driving, offering a false instrument for filing and attempted tampering with physical evidence.

Resigning from the bench the same day was Joseph G. Makowski, 55, who had been a State Supreme Court justice for 10 years and had nearly four years left in his term. The job paid $136,700 a year.

Adam’s guilty pleas and Makowski’s resignation stem from her arrest on driving while intoxicated charges Sept. 2 after she had been at Shanghai Red’s restaurant on the Buffalo waterfront with Makowski. He said they were discussing her program at the law school.

Makowski did not mention why he resigned in his letter to Justice Sharon S. Townsend, administrative judge for the 8th Judicial District, but the district attorney who forced the resignation did not mince words.

“Because of his recantation and cooperation, I will not seek to brand Makowski a criminal,” District Attorney Frank A. Sedita III said. “However, I am deeply troubled by Makowski’s original affidavit and initial conduct. Accordingly, Makowski, in lieu of criminal prosecution, will also be required to resign from the bench.”

Makowski’s testimony in an affidavit he submitted after Adams’ arrest was at odds with what witnesses told investigators from the district attorney’s office.

“Neither party to this pathetic episode committed violent crimes, nor have criminal records,” Sedita said. “By the same token, one of my most important duties as district attorney is to restore public confidence in the justice system. Accordingly, this type of misconduct, particularly on behalf of lawyers, judges and public officials, will not be tolerated and will not be overlooked by this office.”

You can read the whole article by clicking here.

This is article #2 in a series on Celebrity DWIs.

Drugs kill - 24 year old 5 month pregnant mother and her husband killed in DUI crash in Illinois

The Associated Press reported on 02/23/09 that a 24 year old pregnant woman and her husband were killed in a DUI crash in Illinois.

Here is the article:

FAIRMONT CITY, Ill. (AP) -- Madison County authorities have charged two people with driving under the influence of alcohol in a three-vehicle collision that took the lives of a Granite City couple and their unborn child.

Illinois State Police say Lindsey Arnold-Zimmer, 24, who was 5-months pregnant, was driving southbound on Illinois Highway 111 near Fairmont City on Saturday afternoon, when her car was rear-ended by a Corvette driven by Donald Canterberry, 56, also of Granite City.

Officers say the impact drove Arnold-Zimmer's car into the path of a pickup driven by a third Granite City resident, Tiffany Orgara, 27.

Arnold-Zimmer and her husband, Adam Zimmer, 26, were killed in the crash.

Canterberry and Orgara, who suffered only minor injuries, were both charged Sunday with DUI.

Tonight GCASA's Victim Impact Panel meets at the City Centre in downtown Batavia, NY. I will speaking on the panel about the deaths of my two children. There will be other panelists as well. My kids were killed on March 10, 1993 in the Town Of Ogden between Brockport and Spencerport, NY.

Americans don't seem to understand that they don't need to worry about being killed by terrorists. It is much more likely they will be killed by one of their neighbors driving drunk. We can spend a trillion dollars on wars in Afghanistan and Iraq but can't clean up the carnage in our own country. As Pogo said years ago, "I have seen the enemy and it is us."

This is article #5 in a series on Drugs Kill.

Are You As Smart As A Substance Abuse Professional? #7

Q - Most Substance abuse professionals believe that

A. All drugs and alcohol should be prohibited

B. Abstinence is the only answer for treating addiction

C. Some people in substance abuse treatment may need to be on replacement therapies as long as they find them helpful.

D. People have to hit bottom before they want help.

Drugs kill - 760 pepple in Washington State died from drug overdoses in 2007

On February 19, 2009, NWCN.com news reported the following in part:

In 2007, more than 760 people died in Washington state from overdoses. That includes 16-year-old Danielle McCarthy from Puyallup, who died after taking Ecstacy. The other teens she was with claimed they were too scared to get her help until it was too late.

Stories like McCarthy’s have prompted lawmakers to push for the passage of a bill to give legal immunity to anyone who calls 911 when witnessing a drug overdose.

To read the rest of the story click here.



This is article #4 in a series on Drugs Kill.

Dangers of smokeless tobacco - Don't dip snuff

Video about Sean Marsee who died at age of 19 from tongue cancer after dipping.

Video lasts 4:32.

Drugs not only kill, they injure.

Scott DeSmit wrote an article about the aftermath of a DWI motorcycle accident in LeRoy back in July 2007 in the Saturday Daily News on 02/21/09. Barb Walters the victim is only 5% of what she used to be according to her brother. Here is part of what he wrote:

He didn't and no one will ever know if those lost minutes could have spared Barbara and her family from what they now face.

She spent four months at Strong Memorial Hospital and for the past year has been living at a long-care facility at Monroe Community Hospital.

"She still can't walk or talk or feed herself," Ron Walters told me. "She is 100 percent dependent on someone else's ability to care for her. She is 5 percent of what she used to be. She was very active, working two, three jobs, just crazy active."

And now the only activity she gets is when someone pushes her around in a wheelchair.

Her only daughter, Danielle, celebrated her 21st birthday in her mother's room, not at the party her mother had planned for her.

To read the whole article, click here.

Are You As Smart As A Substance Abuse Professional? #6

Q: Most underage drinkers do their drinking

A. In their own homes.

B. In a car

C. In someone else's home.

D. On the street

For the answer click on comments. While you're there, why don't you leave a comment of your own?

Snowmobiling while intoxicated, SWI, is deadly

There was an article in The Daily News on Tuesday, February 10, 2009 by Scott DeSmit entitled "Police cracking down on snowmobilers".

There have been seven deaths in New York State this winter and Troopers have investigated 4 serious snowmobile crashes including one fatality in 3 days in late January.

The cause of the crashes usually are excessive speed and intoxication.

Click on image to enlage article for easier reading.

Drugs kill - Drunk Driver kills 3 in St. Louis

The St. Louis Post Dispatch reported the following on February 6, 2009:

After six convictions for drunken-driving offenses, Newton M. Keene, left, wanted his license back.In a petition filed in August in St. Louis County Circuit Court, his lawyers argued that he hadn't had an alcohol conviction in several years.The state of Missouri had taken his license in 1997, and his driving privileges were revoked indefinitely in Illinois, too. But that didn't stop him from being behind the wheel Thursday morning.Keene, 46, was drunk, authorities said, when he drove the wrong way on Illinois 255 in Edwardsville, causing a crash that killed a woman, her friend and one of her two children and injured the second child.

You can read more by clicking here.

This is article #3 in a series on Drugs kill.

Overlap of Recovery volunteers and substance abuse professionals - What's the story?

In early February, 2009, Social Work Student, Deirdre Drohan Forbes went to the board meeting of Friends Of Recovery - NY in Albany, NY and she writes of her experience on her blog Midlife Musings and My Second Career. It is interesting reading that raises many interesting questions about the relationship between the growing recovery movement and the professional substance abuse field.

I recommend her article to you and you can access it by clicking here.

Drugs kill - DWI

Video lasts 3:56.



This is article #3 in a series on Drugs Kill.

Are You As Smart As A Substance Abuse Professional? #5

The number of drunk driving deaths in the United States each year is about

A. 1,000.

B. 16,000

C. 8,000

D. 40,000

For the answer click on the comments. While you're there, leave a comment of your own.

Drugs kill - two 17 year old girls die in Dallas on January 14, 2009

Cheese Heroin kills two teenage 17 year old girls in Dallas on January 14, 2009.

"My daughter was a good person who never hurt anyone," says Maria Prado, the 44-year-old mother of the young girl found dead Jan. 14 in a house down the street. Authorities suspect that she died from a "cheese" heroin overdose.

For more on this story, click here.

This is article #2 in a series on Drugs Kill.

Celebrity DWIs - Charles Barkley

Video lasts 1:53.



This is article #1 in a series on celebrity DWIs.

Are You As Smart As A Substance Abuse Professional? #4

Q: In the United States, the definition of binge drinking is

A. 3 or more drinks a week

B. 10 or more drinks a week

C. 8 or more drinks a day

D. 5 or more drinks on a singe occasion

For the answer click on comments. While you are there, please leave a comment of your own.

Drugs kill - 17 year old Chicago youth dies from heroin

There is a lot of stigma attached to people who work in the substance abuse field with "those people". "Those people" are, of course, us. People forget that chemical dependency is a deadly disease and people die.

This fact, that people die from the diseases that GCASA attempts to alleviate, reminds me again of the importance of our work and the serious responsibility that we, as professionals have for our clients, their families, and our communities.

Therefore, today I am starting a new series on this blog entitled "Drugs kill". I post these articles not to sensationalize, but to remind GCASA Cares readers of the seriousness of chemical dependence and the life saving work that our substance abuse professionals perform every day.

From the Chicago Tribune, January 26,2009:

"One of the group, Jordan D. Billek, 18, later told police that he and a man named Nathan L. Green "are heroin users and they had purchased a quantity of heroin in the Chicago area, along with a quantity of cocaine," authorities said

The group spent the night using the drugs, and, reports said, Green injected York with heroin "because York had not injected heroin in a while and he was having trouble doing so."

After he was injected, York began to show signs of an overdose, officials said. He stopped breathing and lost consciousness, according to the report. Green and Billek resuscitated him twice, and they took steps to lower York's body temperature to avoid seizures, the documents say. The five then spent the night at the house, with York in an upstairs guest bedroom, authorities said.

The following morning, as Billek, Green and the third man headed to a gas station, Parker called, according to authorities. York was dead, she said. Billek and Green returned and found York "cool to the touch," reports said."

For more information, click here.

This is article #1 in a series on Drugs kill.

Has Lady Luck got you under her spell?

Video lasts 0:32.

New York State should fund problem gambling services with revenues from its state sponsored gambling activities

Micelle Hadden, LMSW, CPP, a Prevention Specialist with the NYS Council on Problem Gambling has developed four talking points in advocating for funding for dedicated problem gamblng treatment services in New York State.

o Approximately 1 million New Yorkers have a gambling problem.

o The Governor’s proposed 2009-2010 budget calls for deregulation and expansion of gambling in New York.

o In 2009 it is estimated that state sponsored gambling will generate approximately $3 billion in revenues for New York.

o New York is the only state without dedicated funding from gambling revenues for problem gambling services.

Please join us in asking the legislature to dedicate ½ of 1% of gambling revenue in NYS or approximately $15 million to problem gambling services for New Yorkers.

Are You As Smart As A Substance Abuse Professional? #3

Are you as smart as a substance abuse professional?

Q - The lifetime prevalence rate of problem gambling (the percentage of the population which will develop gambling problems sometime in his/her life) is

A. About 10% of the population

B. About 15% of the population

C. About 1% of the population

D. About 3% of the population

For the answer click on comments. While you are there, leave a comment of your own.

I love Jesus, but I drink a little

Video lasts 6:52.

Ellen Degeneres talks with Gladys Hardy in Austin, TX. Gladys Hardy says "I love Jesus, but I drink a little." A little later on she says she doesn't like to travel because people make a big deal out of "listerine".

What do you think?

Delerium Tremens, DTs

Yesterday on Are You As Smart As A Substance Abuse Professional #2 we asked what drug can it be deadly to withdraw from? The answer was alcohol which can cause delerium tremens.

Hre is a video which lasts 3:56 of man going through delerium tremens. He is very agitated and has a seizure which then leads to a coma.

Are You As Smart As A Substance Abuse Professional #2

Q - The withdrawal from addiction to which drug can be life threatening?

A. Marijuana

B. Heroin

C. Alcohol

D. Cocaine

For the answer click on comments. While you're there leave a comment yourself.

What enables effective team performance in the human services?

Erica G. Foldy, NYU Assistant Professor of Public and Nonprofit Management, discusses how to enable teams of social workers to be more effective.

Video lasts 4:03.



I wonder if this information is applicable to Substance abuse treatment teams and Substance abuse prevention teams.

What made a difference for effective team functioning?

1. Clear direction, purpose, and mission.
2. Clear membership of the team - Who's in and who's out.
3. Effective team leader
4. Support for team activities from superiors
5. Team's capacity for reflection on their own experience.

I wonder if we could do a better job at GCASA on the development and management of work teams?

Comorbidty: Addiction and Other Mental Illnesses, an overview of the topic from NIDA

NIDA, The National Institute On Drug Abuse, has released a report entitled, "Comorbidity: Addiction and Other Mental Illnesses." It is available in a PDF file and 12 pages long and is stocked with good information if you don't know much about the topic.

You can access the report by clicking here.

Are You As Smart As A Substance Abuse Professional? #1

A popular TV show is named, "Are You Smarter Than A Fifth Grader." This gave me the idea of starting a new feature on this blog entitled, "Are You Smarter Than A Substance Abuse Professional?"

I am looking for good questions, so if you have some, send them my way to david@davidgmarkham.com.

Here is the first question -

Q: The most deadly drug in America is

A: Heroin

B: Methamphetamine

C: Alcohol

D: Tobacco




The answer is D, tobacco

Tobacco kills about 410,000 Americans a year while Alcohol kills about 100,000 and street drugs about 30,000.

71% of Americans say that health insurance should cover substance abuse treatment according to survey done by the Hazelton Foundation

On February 3, 2009 the Hazelton Foundation reported on a survey they did of 1,000 families and found that 71% agree that health insurance should cover the cost of treatment but most did not know if their own insurance would cover it.

Even more interesting is that 56% stated that their employer did not offer Employee Assistance Services for employees suffering from substance abuse, mental health, or personal problems.

About 1/3 or the respondents reported that someone in their immediate family has had a problem with substance abuse.

Here is a snippet from the Hazelton Foundation web site report:

Nearly three out of four Americans (71 percent) agree that health insurance should cover the cost of addiction treatment - yet most consumers have no idea if their own health insurance would pay for substance abuse treatment, according to the first-ever "Public Attitudes Toward Addiction Survey" from Hazelden, the national nonprofit organization that helps people reclaim their lives from drug addiction.

With the passage of the U.S. Mental Health Parity Law last October and the Obama administration now designing its agenda on healthcare issues, it's striking that most Americans (77 percent) agree that addiction treatment should be part of healthcare reform. Hazelden's new survey also found that: most Americans (78 percent ) understand that drug addiction is a chronic disease rather than a personal failing; and more than half (56 percent) say their company doesn't have an Employee Assistance Program to help employees deal with problems involving alcohol or other drugs.

Addiction Still Widespread in American Families
Among the most dramatic of Hazelden's survey findings was the prevalence of addiction within American families:

Nearly one-third of Americans responding reported past abuse of alcohol or drugs in their immediate family - and of those households with an immediate family member who had an addiction problem, nearly half (44 percent) reported more than one family member with a drug problem.
A third of the families which reported a drug problem in their immediate family say that a majority of their family members have problems with drugs. With one in six of the respondents dealing with substance abuse in their family, every member of the family has a problem with drugs or alcohol.
When you expand the questions to include both immediate and extended family, virtually half of Americans surveyed reported three or more family members have experienced a problem with drugs during their lives.

OASAS has new toll free Hope Line for people looking for substance abuse help

As of February 1, 2009, the New York State Office of Alcoholism and Substance Abuse Services (OASAS) has sponsored a new help line which people can call for referrals for help with drug, alcohol, and gambling problems.

GCASA provides treatment services for drugs, alcohol, gambling, and tobacco. You can reach GCASA directly in Genesee County at 585-343-1124, and in Orleans County at 585-589-0055.

Click on image to enlarge for easier reading.

Josh Hamilton, Texas Ranger outfielder, describes his recovery from Cocaine addiction

Josh Hamilton, a former No. 1 overall draft pick, descended into a cocaine addiction that nearly destroyed his career. In his book "Beyond Belief" Hamilton discusses his dozens of indelible tattoos, and his comeback with the Texas Rangers.

Video lasts 3:52

29% of GCASA's 2008 admissions are female - Women's issues in substance abuse treatment

In 2008, out of GCASA's 1094 admissions,71% of admissions or 778/1094 were male, and29% of admissions or 316/1094 were female.

These percentages have stayed pretty much the same since 1996 when the Welfare To Work reform act went into effect and screening for substance abuse problems became required for welfare applications. Prior to that time female admissions were under 20%.

There is a great deal of practice wisdom and some research literature which shows that women need specialized services to be successful in substance abuse treatment. GCASA provides specialized treatment for women. For more information contact Norma Miller, LMHC, CASAC, GCASA's Batavia clinic women's specialist at 585-815-1846, and Kathy Hodgins, BSW, CASAC in the Albion Clinic at 585-589-0055 and Bev Maniace, CASAC, Director of Residential Services at 585-815-1886.

To read more about women's issues in substance abuse treatment click here.

This is article #6 in series on 2008 GCASA admission data.

The less teens go out, the less they abused cannibis in 31 developed countries

According to a study reported in the February, 2009 issue of the Journal, Archives of Pediatrics and Adolescent Medicine, the less 15 years old go out at night the less likely they will use cannibis. Here is a snippet from the abstact of the article:

A decrease in the prevalence of cannabis use was found in most of the 31 participating countries and regions. The most marked decreases were found in England, Portugal, Switzerland, Slovenia, and Canada. Increases occurred only in Estonia, Lithuania, Malta, and among Russian girls. The more frequently adolescents reported going out with their friends in the evenings, the more likely they were to report using cannabis. This link was consistent for boys and girls and across survey years. Across countries, changes in the mean frequency of evenings spent out were strongly linked to changes in cannabis use.

My wife and I had nine children. We had a rule that when you are going out we need to know where you are going, who you will be with, what you will be doing, and when you will be home. If we didn't have the answers to these questions or didn't like the answers to these questions, our son or daughter would not be going out. I would add, "And make sure you're straight with me because I might check.", and randomly I did.

You can read the study abstract by clicking here.

Underage drinking party broken up in LeRoy due to good work by citizen and LeRoy police

Underage drinking party broken up in LeRoy due to good work by citizen and LeRoy police.

Here is the article from The Daily News published on 02/09/09.

Click on image to enlarge for easier reading.



Communities usually don't get up in arms about underage drinking until one of their children die or is severely injured as happened in Elba a couple of years ago.

It is good to see LeRoy take a pro-active approach to dealing with underage drinking before serious injury or death occurs.

Thanks to the good work of a citizen in LeRoy for tipping off the police and for the police for taking action.

If you would like to know more about GCASA's underage drinking prevention programs call Shannon Ford at 585-815-1876, and to know about GCASA's adolescent treatment programs call Lynette Lex at 585-343-1124.

In 2008, 23 of GCASA's admissions came from Monroe County.

In 2008, GCASA admitted 23 patients from Monroe County in its outpatient services. GCASA operates satellites in Holley, NY and in LeRoy, NY which may be attractive to Monroe County residents.

GCASA's Orleans clinic admitted 16 patients in 2008: 10 from Brockport, 5 from Hamlin, and 1 from Adams Basin.

GCASA's Genesee Clinic admitted 7 patients in 2008: 4 from Rochester, 1 from Scottsdale, 1 from Hamlin, and 1 from Churchville.

There are many reasons why patients might want to seek treatment out of county: geographical proximity, anonimity, good reputation, etc.

Counties increasingly have rules about not wanting their Medicaid recipients to go out of county for services. In some instances this enhances the quality of care by increasing coordination and continuity of care, and in some instances it works against good care. Unfortunately, these policies and procedures are implemented in bureaucratic ways to save money and at times these policies and procedures are not in the best interests of the patient.

This is article #5 in a series on 2008 GCASA admissions data.

GCASA's payroll tops 2 million dollars

GCASA employs about 100 people in Genesee and Orleans counties.

It's payroll is over 2 million dollars pumping a lot of money into the local economies.

As a nonprofit GCASA is tax exempt and does not pay real estate taxes on the 3 properties it owns in Batavia, but its employees and clients keep the economy going with their financial expenditures in our local area.

On top of the social and health benefit which GCASA's services provide, its economic contribution to the local economy is very significant. Citizens should be very proud of having such a high quality substance abuse service area in its community.

47% of GCASA's admissions are Adult Children of Substance Abusers

In 2008, 47%, or 518 out of 1,094 GCASA admissions are Adult Children of substance abusers.

GCASA's admission data certainly validates the idea that substance abuse is a family disease and that children of substance abusers are at high risk for contracting the disease themselves.

GCASA's prevention program enages in many activities to decrease the risk factors influencing the precipitation of this disease in this high risk population. In other words, we do a lot of work with children of alcoholics and substance abusers, but not enough because of our limited resources. In our treatment programs, we are increasingly including family members of the identified patient in treatment but few counselors feel confident in their family therapy skills and the reimbursement mechanisms work against including families in treatment on a regular basis.

For more information check out the World Service for Adult Children of Alcoholics by clicking here, and the National Association of Children of Alcoholics by clicking here.

This is article # 4 in a series on 2008 GCASA admissions data.

Royal Employer Services, GCASA's EAP, meets real needs of employees in Western New York

GCASA's Employee Assistance Program provides counseling and training services for employers in Western New York.

It is well documented that employee personal problems due to family problems, depression, substance abuse, contribute to an increase in absentism, accidents, spoilage, tardiness, and poor performance. An employer having a readily available service available to employees can help them address their problems with support in a more effective way so that they concentrate again on their jobs.

In 2008, GCASA's Employer Services had contracts to provide EAP services to over 26 different employers including some of the biggest employers in Genesee and Orleans Counties as such government employees of the Counties of Genesee, Orleans, and Wyoming, as well as employees of Genesee Community College, Medina Memorial Hospital, and the ARCs of both Genesee and Orleans Counties.

You can find out more about Royal Employer Services by clicking here.

22% of GCASA's 2008 admissions are 21 and younger

In 2008, 22% of GCASA's admissions, or 241 out of 1,094, were 21 years of age or younger.

Also, 3% of GCASA's admissions, or 31 out of 1,094, were 56 or older.

Clearly, GCASA is serving many more adolescents than older people. Lynette Lex, M.S., ATR, and Holly Main, L.C.S.W. do a great job serving adolescents in the Batavia Clinic, and Sarah Edwards, CASAC is the adolescent counselor in Albion.

You can reach Lynette and Holly at 585-343-1124 and Sarah Edwards at 585-589-0055.

GCASA has been assessing the need for specialized services for seniors. In our prevention program we have developed a "Senior Spice" program which offers services on Caregiver Support and other chemcial free recreational activities. Also, a group of seniors is very active as volunteers. For more information on Senior Spice contact Mike Laycock at 585-815-1874.

This is article #3 in a series on 2008 GCASA admission statistics.

GCASA staff will be attending national CADCA conference in Washington, DC, Feb. 9 -12

GCASA will be represented at the 19th annual CADCA National Leadership Forum in Washington, DC from February 9 -12, 2009.

GCASA staff attending will be Maryann Bowman, Tom Talbot, Danielle Brinkman, Jennifer Zambito, Pat Crowley, and Carol Nicometo.

Maryann Bowman will be making a presentation.

GCASA was the CADCA Got Outcomes National Award Winner in 2006.

Here is a snippet from the CADCA web site:

Join us on February 9-12, 2009 for CADCA’s National Leadership Forum XIX, the nation’s largest training event for community prevention leaders, treatment professionals and researchers! We’ve designed an exciting program for 2009, with more than 100 results-driven workshops, plenary sessions and special events. This year, we’re at a new location, Gaylord National Resort and Convention Center, right on the banks of the Potomac River and just 15 minutes from downtown Washington, DC.

It is interesting how GCASA has become known at the National level of it high quality prevention work.

In 2008, 6% of GCASA's admissions involved in Child Protective Services.

In 2008 GCASA had 1,094 admissions to its treatment programs. Of these 1,094 admissions, 66, or 6% were involved in Child Protective Services at the time of the admission.

According to the NIDA, the National Institute on Drug Abuse, about 2/3rds of patients in drug abuse treatment say that they were abused as children.

A report on the Connect For Kids web site says the following:

Studies by the Child Welfare League of America and other organizations have found that substance abuse is a factor in at least 75% of all placements in out-of-home care. Eighty percent of states now report that parental abuse of alcohol or drugs is one of the two most common problems in families reported for child maltreatment.

GCASA collaborates in a unique program with Genesee and Livingston Counties teaming substance abuse professionals with Child Protective Workers. Jim Morasco is the laison with Genesee County, 585-344-2589, x6731, and Kathy Cecere in Livingston County at 585-243-7300, x7429.

This is article #2 in a series on 2008 GCASA Admissions Data.

Biggest barrier to treating co-occurring disorders - money

ASAP, the Alcholism and Substance Abuse Providers of New York State sponsored a study to review the practice of 153 providers in New York State who provide services to people experiencing substance abuse and psychiatric disorders. People who struggle with both substance abuse and psychiatric disorders are referred to as MICA, Mentally Ill Chemical Abusers, or people experiencing "co-occuring disorders".

Of the 153 ASAP providers providing services for people with co-occurring disorders, 103 returned surveys with a return rate of 76%.

The biggest barrier to agencies providing co-occurring services is reimbursement policies. Simply put, there is no money in it.

The second biggest barrier was lack of trained staff. Trained staff who can competently deal with substance abuse and psychiatric disorders tend to be more highly trained and experience. They command and deserve higher salaries something which most substance abuse agencies are not able to pay.

Improving services to people struggling with co-occurring disorders is not rocket science even though the bureaucrats dither endlessly. It will reguire some regulatory changes allowing agencies to become dually licensed to provide both substance abuse and psychiatric services so they can become reimbursed for these services. Hopefull the higher reimbursement will provide resources to hire competent staff. Until these changes occur not much is likely to happen that will significantly change the quality and effectiveness of services.

At GCASA we struggle to provide services to people with co-occurring disorders. We have what the jargon of the study calls, DCC, Dual Diagnosis Capable, as distinguished from AOS, Addiction Only Services, and DCE, Dual Diagnosis Enhanced. GCASA has made investigatory efforts to develop Dual Diagnosis Enhanced Services but having the psyciatrist on staff was too expensive and GCASA's inablility to bill for his services since we are not Mental Health Licensed made it financially necessary to reduce our services to DCC. However, our medical director, a family medicine physician does provide a great deal of psychotropic medications until we are able to get patients seen in the County run mental health clinics. We also have L.C.S.W.s, Licensed Clinical Social Workers who provide a great deal of mental health services in our specially designed MICA program.

The Co-Occurring Committee Survey Report dated January, 2009 is available and I am happy to send you a copy if you email me at dmarkham@gcasa.org.

Success in quitting smoking during pregnancy influenced by psychosocial stressors

There is an interesting study which will appear in the April, 2009 issue of the journal, Addictive Behaviors, which studies pregnant women in Holland to see who stopped smoking during pregnancy and who didn't. Not suprisingly, the women who did not stop smoking had signicantly more psychosocial stressors. Here is a snippet from the abstract of the article:

After adjustment for sociodemographic and smoking-related covariates, low and high levels of pregnancy-related anxiety, exposure to physical/sexual violence, and high job strain were significantly associated with continued smoking during pregnancy. Intensive and comprehensive smoking cessation programs are required for pregnant women, which includes the management of psychosocial problems.

The last sentence has import for us in the substance abuse field in that quitting smoking is not just a matter of nicotine replacement therapy or the desire to quit but also attention to the triggers (stressors) and alternative ways of managing distressful emotions. At GCASA, we offer such treatment in our counseling services.

You can read the abstract of the article from Addictive Behaviors by clicking here.

GCASA had 1094 admissions to its programs in 2008.

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GCASA had 138 more admissions in 2006 than it did in 2005 which is an increase of 12%.

GCASA had 589 more admissions in 2006 than it did in 1999 which is an increase of 107% in the last 7 years.

GCASA had 18 more admissions in 2007 than it did in 2006 with the biggest increase in the Orleans County clinic. Overall, it appears that the number of admissions is stabilizing around 1,150 per year after significant increases since 1999.

GCASA had 65 fewer admissions in 2008 than it did in 2007. The system is stabilizing around 1,100 admissions per year. Without additional resources or expanded service areas or new service products, it is expected that admissions will continue around this 1,100 level.

This is article #1 in a series on 2008 GCASA Admission data.

Genesee County Drug Treatment Court graduation is on February 19

The Genesee County Drug Treatment Court graduation will be in Thursday evening, February 19, 2009 at 5:30 PM at the Generations Center on 15 Center St. in Batavia, NY. The ceremony will include a pot luck dinner and the public is invited.

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Charles Evans, CASAC-T described his role as GCASA's Drug Court Coordinator last October, 2008. You can access that article and video by clicking here.

Sparks - What recovery is really about

Recently, I have noticed in my psychotherapy practice, how many people started using substances to manage their moods. Substance use and abuse is mood altering. They often started this method of managing their moods at an early age, usually in their early teens.

Recovery is not so much about abstinence or harm reduction as it is about how to managy dysphoric moods without chemicals. This is a psychological problem, a social problem, and a spiritual problem.

Can I be happy and enjoy life without chemicals? Yes.

How can I be happy and enjoy life without chemicals? Everyone has to work this out for themselves. It can be done, but it has to do with learning how to live life and this takes months and years, not days and weeks.

According to a study published in the February, 2009 issue of the journal, Pediatrics, it appears that binge drinking, defined as four or more drinks on a single occasion, by pregnant women in their second and third trimesters increased the liklihood that their children would manifest symptoms of hyperactivity disorder by age 4. Here is a snippet from the article:

After controlling for a range of prenatal and postnatal factors, any episodes of consuming 4 drinks in a day were independently associated with higher risks for mental health problems (especially hyperactivity/inattention) in girls at the age of 47 months and in both genders at 81 months. There was no association with IQ scores at 49 months after adjustment for confounders. The consumption of 4 drinks in a day continued to carry risk for mental health problems (especially hyperactivity/inattention) in the absence of regular daily drinking.

You can access the whole article by clicking here.

Parental smoking enhances the liklihood of their teens smoking

Both my parents smoked when I was growing up and neither I nor any of my other 4 siblings became smokers. However, a study published in the February, 2009 issue of the journal Pediatrics found that kids 12 - 17 are more likely to smoke if their parents smoke and the tendency is increased if both parents smoke as compared to just one. Here is a brief snippet from the article:

Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relationship between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of fathers' smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterward), and residence of parents (with effects of fathers' smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use.

You can read the whole article by clicking here.

An additional concern about smoking is that it is also predictive of other substance abuse, so cigarettes are considered a gateway drug in our current society.

At GCASA we offer smoking cessation services to our clients who would like to stop smoking and we work hard to prevent smoking to begin with with programs such as Smoke Free NOW.

RAP does a great job and in need of financial support

The Daily News had a great article in Saturday, January 31, 2009 paper on RAP, the Regional Action Phone. GCASA depends on RAP for its after hours service and for its Tip Line.

RAP is having financial difficulties and they are looking for donations. I encourage you to think about making a donation to RAP which does a great job serving our community, 24/7/365.

You can access the article the Daily News by clicking here.

Nothing like a good night's sleep

As a psychotherapist I have often found that clients with mood disorders and substance abuse disorders have significant problems with their sleep patterns. This then leads to a viscious cycle in the sense that it is hard to know whether the mood disorders and substance abuse problems are contributing to the sleep disturbance or whether it is the sleep disturbance which is contributing to the mood disorder and substance abuse problems. Whichever way it is, the two are closely linked.

I have found that when clients start sleeping well again the mood disorders and substance abuse disorders improve. So the clinical question becomes, "How do you help clients sleep better?" There is too quick a move to pharmacological treatments with sleeping aids. I think antidepressants can help but the benefit on sleep usually is not immediate and it takes a few weeks. However, counseling around good sleep practices known as "sleep hygiene" can be very helpful to people.

To read more about the study reported in the Psychiatric News on January 16, 2009, click here.

Superbowl Sunday is for gamblers what New Year's Eve is for alcoholics

From the Sacramento Bee on February 1, 2009:

--Super Bowl Sunday, it has been said, is to gambling addicts what New Year's Eve is to alcoholics. That is, an occasion to go off on a dangerous bender.

An estimated $90 million will be bet at Nevada casinos on today's game between the Arizona Cardinals and Pittsburgh Steelers. And that's not counting the illegal gambling taking place in living rooms and sports bars, via the Web with offshore bookies, as well as the friendly wager at the office.

Just how much does gambling permeate the Super Sunday gestalt? You can bet on everything from which team wins the coin toss to the duration of the national anthem to how long it takes for the first penalty to be called. "The Super Bowl," says Mike Osborne, executive director of Harbour Pointe, a compulsive gambling treatment center in Maryland, "is a gateway to a long road of self-destruction for many people."

Osborne should know. He is a recovering gambling addict, starting as a teenager betting on football and other sports, and watching it take over his life as an adult.

His self-destruction was nearly total: He lost his job and served jail time for embezzlement; he lost his family after pawning his wife's wedding ring and returning his kids' Christmas presents unopened; he lost his sense of self as he wandered the streets homeless and suicidal.

Those days are behind Osborne now. But he knows that gambling addiction, like alcoholism and substance abuse, never really goes away. It's a constant battle to stay vigilant in a society where gambling is not only tolerated more than other addictions but actually is state-sanctioned in the form of lotteries and tribal casinos.

"The largest enemy we face is public ignorance," Osborne says. "It may seem like it's harmless fun. It is not."

Indeed, pathological gambling has been classified since 1980 as an impulsive control disorder in the Diagnostic and Statistical Manual of Mental Disorders.

According to a 2007 study in the journal Analysis of Gambling Behavior, 6.2 percent of visits to a general practitioner involved problem gambling. A 2006 report by the California attorney general's office found that gaming addicts cost the state an estimated $1 billion annually in lost work time and crime.

And although it's been estimated in several studies that as much as 3 percent of the population has a gambling problem, awareness and treatment lag behind that of alcohol and drug abuse.

Clients with co-occuring disorders much more likely to be psychiatrically hospitalized than clients with mental illness or substance abuse disorders.

According to a study in Psychiatric Services in January, 2008, clients with co-occuring disorders were 3 - 4 times more likely to be hospitalized than clients with mental illness only, and 10 -20 times more likely to be hospitalized than clients with a substance abuse disorder only. Here is a snippet from the article:

Clients with co-occurring disorders were three to four times more likely to be hospitalized than clients with mental illness only and ten to 20 times more likely to be admitted than clients with a substance use disorder only. The average number of inpatient days per admitted client differed across states by more than 100% for each diagnostic group (Figure 1). Despite the divergence in absolute values across states, in each state the length of inpatient stays were longest for admitted clients with mental illness only, followed by those with co-occurring disorders and those with a substance use disorder only. Yet across all clients, not just those admitted, the annual average number of hospital days per group was highest for the group with co-occurring disorders



GCASA treats many patients with co-morbid psychiatric and substance abuse disorders. We have MICA (Mentally Ill Chemical Abuser) specialists who work in both our clinics in Batavia and Albion and we collaborate closely with the Mental Health Clinics in both counties.

High cormobidity between intimate partner violence and behavioral health problems

Behavioral health clinicians have known for years that there is a high association between intimate partner violence and mental health and substance abuse disorders in men. Now a study in the Jan/Feb, 2009 has found data to support the relationship. You can access the article by clicking here.

It has bothered me for years that these men are referred for "anger management" classes as if this is merely a matter of learning how to control one's temper. This is part of the picture but unless the underlying disorders are dealt with, anger management alone won't do much good.

Here at GCASA, we attempt to help the whole person with their problems which often include relationship problems and anger management problems which are symptoms of their mental health and substance abuse disorders.