10/1/2018 OUR CENTERS WHO IS GATEWAY FOUNDATION?

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1 R E D U C I N G C O M PA S S I O N FAT I G U E & I M P R O V I N G A C C E S S TO D R U G & A L C O H O L T R E AT M E N T P R E S E N T E D B Y J I M S C A R P A C E, L C P C E X E C U T I V E D I R E C T O R, G AT E W AY F O U N D AT I O N A U R O R A, J O L I E T 1 WHO IS GATEWAY FOUNDATION? Largest Provider of Substance Use Disorder Treatment in Illinois Locations throughout Illinois, St. Louis Metro East and Smyrna, Delaware Treatment for Adults and Adolescents 2 OUR CENTERS Outpatient services offered at 9 locations including: Joliet, Gurnee and Swansea (St. Louis Metro East). Residential services offered at 7 locations. 3 1

2 WHAT IS THE COMMUNITY PERCEPTION OF GATEWAY? Gateway has evolved over the years and will continue to evolve in order to be seen as a leader in the industry Field of addiction treatment is changing Many competitors and programs available to customers 4 WHY GATEWAY? H ow do w e r i s e ab ov e and b e s een as a c om p rehensiv e m edi c al and r esear c h s up p or t ed p r og ram t hat hel p s c l i ents achi ev e and sustai n r ecov ery? 5 TODAY S AGENDA W H AT I S S T I G M A A N D H O W D O W E O V E R C O M E I T? W H AT I S T H E R E L AT I O N S H I P B E T W E E N A D D I C T I O N A N D S T I G M A? O V E R V I E W O F T R E AT M E N T A N D T H E N E E D F O R C H A N G E I N L A N G U A G E 6 2

3 SUBSTANCE USE DISORDER IN AMERICA DID YOU K NOW? 1 in 10 American adults and teenagers have a diagnosable drug and/or alcohol disorder? Yet only 11% of those who need treatment received it at a specialty facility. 7 PERCEPTION IS REALITY REDUCING STIGMA BEGINS WITH YOU! 8 PERCEPTION IS REALITY; LANGUAGE IS POWER! 9 3

4 THE STIGMA OF ADDICTION CHARACTER FLAW There is something inherently wrong with me FEAR OF DISCRIMINATION I will never be accepted in society LASTING CHANGE IS HOPELESS Once an addict, always an addict SHAME IN LABELS Drunk, addict, loser, junkie, druggy, alcoholic 10 WHAT IS AN ADDICT? I a m n o t a n a d d i c t, I a r r e st a d d i cts T h at s b e c a use y o u r e a n a d d i c t W e ll w h a t d o y o u e x p e ct, h e i s a n a d d i ct? T y pic al b e h a vior The label can be misinterpreted by many, emphasizes choice, not the science The original intentions for the label were grounded in twelve step

5 COMMON MISCONCEPTIONS What is the difference between who someone is (identity) and what they struggle with? I am Cancer! What is the difference between treatment and twelve step groups? Why would I pay/exhaust my insurance if I can go to twelve step for free? Stigma associated with outdated concepts of rehab (TC model) Substance Abuse 13 DSM V DIAGNOSIS SUBSTANCE USE DISORDER A cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using despite significant substance related problems Underlying change in brain circuits that may persist beyond detoxification. These effects may be exhibited in the repeated relapses and intense drug cravings when the individual is exposed to drug related stimuli Overall substance use disorder is based on a pathological pattern of behaviors related to the use of the substance This can be grouped into impaired control, social impairment, risky use, and pharmacological criteria including tolerance and withdrawal Substance used disorder can range from mild to severe based on then number of symptom WHAT criteria DO YOU endorsed SEE? WHAT IS OMITTED? 14 CHANGING THE LANGUAGE WHITE HOUSE OFFICE OF NATIONAL DRUG CONTROL POLICY Addict Addicted To Alcoholic Clean/Clean Screen Dirty/Dirty Screen Drug Habit Reformed Addict or Alcoholic Opioid Replacement Substance Abuse/Dependence Person with substance use disorder Has a substance use disorder involving Person with Alcohol Use Disorder Abstinent Actively using/positive for a substance Substance Use Disorder Person in long term recovery Medication Assisted Treatment Mild, Moderate, or Severe Substance Use Disorder 15 5

6 WHAT ABOUT ADDICTION? The term Addiction is appropriate when Quoting findings of research of if it appears in the proper name of an organization Speaking of the disease process that lead someone to developing a substance use disorder Referring to scheduled drugs as addictive (Office of NDCP 2016) 16 How do we change the perception of addiction to support the science instead of reinforcing the public misconception? Addiction is a disease, It is a physiological disease, it is a psychological disease, -John Courshon GATEWAY AS A TREATMENT LEADER D i f f er en t i a t e ou r s e l v e s as pr ov i d e r of c h oic e U s e t r e a t m e n t t er m i n o l o g y an d app r o a c h e s t h at pos i t i o n u s pr of es s i o n a l l y an d ac ad e m i c a l l y U n der s t a n d t h e r es e a r c h an d wh er e t h e f i el d i s h ea d e d 18 6

7 TRAUMA STATISTICS 8 0 % o f c l i e nts w i t h a s u b s t ance u s e d i s ord er h a v e a n a d d iti onal t r i g ger 80% 19 B I O P S YC H O S O C I AL M O D E L Co- O c c urri ng D i s or der s E S P SOCIAL/ENVIRONMENT: ENVIRONMENT & OTHERS BIOLOGY: GENETICS PSYCHOLOGY: THOUGHTS & EMOTIONS 20 RISK FACTORS FOR PROBLEMATIC DRUG USE INDIVIDUAL Genetic predisposition, behavioral under-control Personality (lack social bonding, resistance to authority) Drug knowledge Academic problems Early age of first use FAMILY Ineffective parental techniques Negative communication Poor family relationships LOCAL ENVIRONMENT Traumatic experiences (child abuse, refugee status) SES (socioeconomic status) Support (peers, community) Labeling MACRO-ENVIRONMENT Legislation Law enforcement Drug availability Social message re. drug use and related problems 21 7

8 WHAT DO WE DO? T R (through) A U M A treating resistance acceptance understanding meaning & accuracy 22 EFFECTIVE INTERVENTION STRATEGIES Give the client the opportunity to fully share their story without interpretation or judgement Interventions should be focused on helping client understand the relationship between substance use disorder and other issues Expect the client to hold onto problematic behaviors for awhile, be patient, use Motivational Interviewing/Engagement Skills Remember the treatment process is a slow one sometimes Follow up with supports/systems that will reinforce the recovery process (i.e. family, assisted living, etc.) 23 RECOVERY VS. SOBRIETY Sobriety-defined as the discontinuation of drug or alcohol use. Common questions asked often is What is your sobriety date HOW IS SOBRIETY DIFFERENT THAN RECOVERY? 24 8

9 WHAT IS RECOVERY? Sustained abstinence from mood altering chemicals Removal of physical and psychological desire to use A removal of denial, rationalization, and justification Build-up of coping and living skills Improved functioning in primary life domains Development of healthy social networks The building of a life worth living 25 PRINCIPLES OF EFFECTIVE TREATMENT No single treatment is appropriate for all individuals Treatment needs to be readily available Effective treatment attends to multiple needs of the individual, not just drug use Evidence-based practices Remain in treatment for adequate period of time The treatment process must be a family experience Medications helpful/assess for co-occurring disorder 26 EVIDENCED-BASED PRACTICES & TREATMENT FAMILY INVOLVEMENT Huge impact in helping the individual overcome the substance use that has most likely affected every aspect of an individual s family life COGNITIVE BEHAVIOR THERAPY (CBT) Learning to be mindful, expanding perspectives, and improving coping skills in ways that help valueoriented living. Can be used in combination with DBT and Mindfulness based approaches CO-OCCURRING/DUAL-DIAGNOSIS DISORDERS PROGRAM (CDP) Co-occurring mental health disorders such as anxiety, depression, and bipolar disorder are common among those with substance use disorders. Effectively treating these disorders at the same time TRAUMA INFORMED CARE Helps individuals realize they may have abused substances to cope with overwhelming emotional pain Research shows many persons with substance use disorders have experienced a traumatic event (12-59% suffer from PTSD) MEDICATION-ASSISTED TREATMENT Medications that can treat cravings and other withdrawal symptoms, depression, anxiety, and sleeplessness Reduces risk of relapse Addresses both substance use 27 disorders and co-occurring issues 9

10 Hope does not take away your problems...it can lift you above them. M aya A ng el ou 28 EVIDENCE-BASED PRACTICES RESOURCES G AT E W AY F O U N D AT I O N t m e n t / e v i d e n c e - b a s e d S A M H S A G AT E W AY H O U R H E L P L I N E HO P E ( ) 29? QUESTIONS? T H A N K Y O U! 30 10