Category Archives: Research

The Recovery Support that is Available Following Overdose

What happens to people who experience a drug overdose and are successfully revived through emergency medical intervention?

What is their fate after they leave the hospital or other emergency care setting?

Missing in the media coverage of the unrelenting legions of drug overdose deaths in the United States is an equally important but less heralded story. What happens to people who experience a drug overdose and are successfully revived through emergency medical intervention? What is their fate after they leave the hospital or other emergency care setting? The Connecticut Community for Addiction Recovery (CCAR) and other grassroots recovery community organizations (RCOs) nationwide are influencing positive outcomes to overdose by placing recovery coaches with first responders and doctors in the emergency departments in hospitals to advance recovery options for the revived overdose patients.

The Connecticut Community for Addiction Recovery (CCAR) is one of several hundred recovery advocacy and recovery support organizations (RCOs) rising on the American landscape in the last two decades. One of the first RCOs, CCAR pioneered what have since become standard RCO service fare: recovery-focused professional and public education, legislative advocacy, recovery community centers, recovery celebration walks and conferences, recovery support groups, training for recovery home operators, face-to-face and telephone-based recovery support services, family-focused recovery education and support services, and collaboration with research scientists on the evaluation of the effects of peer support on long-term recovery outcomes. As an example of its reach, CCAR’s Recovery Coach Academy curriculum has been used in the training of more than 20,000 recovery coaches worldwide.

CCAR began piloting an Emergency Department Recovery Coach (EDRC) Program in March of 2017. Through this program, CCAR-trained recovery coaches are on-call for hospital emergency rooms to offer assistance to patients and their families during an emergency room visit resulting from an adverse drug reaction or other alcohol- or another drug-related medical crisis. An evaluation of EDRC services provided between March and November 2017 within four collaborating hospitals revealed the following. CCAR-trained recovery coaches provided recovery support services to 534 patients/families during the 8-month evaluation period with a relatively even distribution of services provided across the four hospitals. Of those served by the EDRC, the majority were in the ER due to an alcohol- or opioid-related condition; 70% were male; and 5% were seen more than once during the evaluation period. Most importantly, of the 534-people interviewed, 528 were assertively linked to a detoxification program, inpatient or outpatient treatment, or community-based recovery support resources.

A more formal and sustained evaluation of the EDRC program is underway in collaboration with Yale University, and the program is now being expanded to an additional four hospitals. Funding support for the EDRC comes from the Connecticut Department of Mental Health and Addiction Services through support of the federal block grant and a Targeted Response to the Opioid Crisis Grant from the Substance Abuse and Mental Health Services Administration.

CCAR’s EDRC program has many distinct features worthy of replication and local refinement. Among the more striking of such features are the following.

  • The EDRC program is governed by a formal agreement between CCAR and each participating hospital that delineates the roles and responsibilities of each party.
  • The EDRC program is currently staffed by one Recovery Coach Manager and 9 full-time Recovery Coaches (RCs).
  • Emergency Department Recovery Coaches (EDRCs) are recruited and screened (2 interviews with background and reference checks) based on desired experience, skills, and a good work history, but also for what our EDRC manager, Jennifer Chadukiewicz, calls “a servant’s heart.”
  • All EDRCs go through more than 60 hours of training and spend the first weeks shadowing tenured EDRCs. The training includes the CCAR Recovery Coach Academy© (30 hours) as well as topical trainings, e.g., Narcan (naloxone administration), medication-assisted recovery, ethical decision-making, crisis intervention, and conflict resolution. Hospital specific training includes such areas as fire/general safety, OSHA, blood borne pathogens, infection control, hazardous materials, and HIPPA regulations.
  • EDRC Recovery Coaches are employed by CCAR rather than the hospitals and enter the hospitals as service vendors and “guests” who defer to leadership of ER staff.
  • The RCs are paid a livable wage ($20-$25/hr. to start plus benefits, health insurance, etc.) that allows them to work full time and support themselves and their families while affording time away for rest and self-care.
  • EDRC coverage is provided from 8 am to 12 midnight, seven days a week, 365 days a year.
  • Patients have the option of enrollment in enhanced Telephone Recovery Support (TRS) program (i.e., patients receive daily support calls for the next 10 days and then weekly if desired).
  • EDRC’s provide assertive linkage and transportation (when needed) to treatment and recovery support resources.
  • The EDRCs spend considerable time with community providers and other stakeholders building collaborative relationships that facilitate this patient referral and service linkage process.
  • CCAR provides each hospital emergency department with “prescription pad” style resource handouts that can be attached to discharge paperwork and given to patient friend/family member.

There are critical windows of vulnerability and opportunity within addiction and recovery careers that serve to plunge one deeper into addiction or mark the catalytic beginning of a recovery process. The reversal of a drug overdose or treatment of other drug-related medical crises can constitute a recovery tipping point.

The emergency room is not the only critical point of potential intervention to reduce the risk of drug-related deaths and to promote addiction recovery. For persons with a history of addiction, the days and weeks immediately following release from a correctional facility, release from an inpatient or residential detoxification/treatment program without medication support, or cessation of medication-assisted treatment, and even transfer from one medication-assisted treatment provider to another all constitute a zone of heightened risk for re-initiation of risky drug use and death. Altering such risks and tipping the scales toward recovery stabilization, recovery maintenance, and enhanced quality of personal/family life in long-term recovery should be the goals of every community. Recovery community organizations like CCAR are showing us how this can be done.

This blog was written by William White, Rebecca Allen & Phil Valentine. It was originally posted on the William White web site: www.williamwhitepapers.com on January 18, 2018

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Posted in Addiction Recovery Posts, alcohol, Alcoholism, Coach Credentialing, Drug Abuse, Opioid addiction, Recovery Coaching, Relapse, Research | Tagged , , , , , | Leave a comment

Memoir of William L. White: Recovery Rising

Recovery Rising is the memoir of foremost recovery researcher and advocate, William L White. It has just been released on Amazon. White, for over five decades has had different roles in the addiction treatment field, beginning in Chicago’s inner city as a street worker working with addicts and the homeless, an addiction counselor, clinical supervisor, treatment administrator, educator, clinical and organizational consultant, and research scientist to being honored as the addiction field’s preeminent historian, one of the fields most visionary voices and a most prolific author.

In Recovery Rising, William White’s ideas, methods, and organizational studies emerge to give the reader an idea on how dynamic a leader White is in the modern addictions field. These stories, sometimes poignant, sometime humorous always are revealing and informative. Williams White’s life work has been affirmed by this memoir and(hopefully) a younger generation of addiction advocates and professionals will be inspired by his story  to continue his good work.

This link to his book on Amazon is:

https://www.amazon.com/Recovery-Rising-Retrospective-Addiction-Treatment-ebook/dp/B07526ZDVD/ref=sr_1_1?s=books&ie=UTF8&qid=1506351061&sr=1-1&keywords=recovery+rising

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Posted in Addiction, Addiction Recovery Posts, alcohol, Alcoholism, Drug Abuse, Health, Opioid addiction, Recovery Coaching, Research, Sponsor | Tagged , , , | Comments Off on Memoir of William L. White: Recovery Rising

Recovery Coaches working with sex offenders

Legal Consequences Crisis Management Team -Recovery coaches working with sex offenders

It is 5:30 am and a band of FBI and local sheriff authorities pull up to a New Jersey suburban house in a development not far from Philadelphia. Adorning Kevlar vests, and windbreakers with the yellow letters FBI on their backs, they storm past a toy doll stroller in the sidewalk. They bang on the door with their fist, demanding “Open up this is the FBI”. After a few more wraps, a bleary eyed woman about 40 years old opens the door a crack and peers out. With a burst of energy, five FBI agents and two local police enter her foyer, issue her a search warrant and spew out demands, only one she actually hears, “Your husband is under arrest for child pornography…where are the laptops, tablets, cell phones and computers?”

Emily, (all the real names in this story will be withheld for privacy purposes) is dazed. She is in her bathrobe, and slippers, her hair is mussed, her eyeglasses crooked. She is barely awake. She glances at the stairs. She sees her two children at the top of the stairs, as a troop of agents make their way up to them. The agents ascend, as her girls descend. They are squeezing towards the wall making way for the army of six foot tall, 250 pound men barreling past them. They are asking “Mommy, what is happening?” A sheriff from the local police department asks where her husband is. She says he is at work; he works the midnight shift at a local hospital. The Sheriff gets on his walkie-talkie and bursts out some demands, checking on a similar event at her husband’s workplace.

It is 6:00 am, and Tom is just wrapping up from his shift as a nurse. His supervisor walks up to him with a force of blue windbreakers flanking him on either side. “Tom,” his supervisor says, “these gentlemen want to see you in my office”. As they turn to go to the office to FBI agents take Tom at the elbows and nearly lift him off his feet. He is escorted to the supervisor’s office, is placed in an arm chair and the door slams. Tom hears the words he has feared for the past two decades. “You are under arrest for the possession of, and the suspected distribution, copying, or advertising of images containing sexual depictions of minors.” For some strange reason, Tom is relieved. He thinks “It’s over, it is finally over.”

An unlikely band of brothers

It is Monday night, a steady stream of middle aged men drift into a hospital conference room, and take a seat. One of them opens a gym bag and starts to place books, pamphlets and tri-fold fliers on the table. A clear plastic envelope stuffed with one dollar bills is placed next to a thin loose-leaf binder. He sits down, opens the binder, checks the time on his cell phone and says, “Welcome to the Monday night meeting of Sex and Love Addicts Anonymous, my name is Ken, and I am a sex and love addict.” The seemingly normal cohort of men reply, “Hi Ken”.

The Monday night meeting of Sex and Love Addicts Anonymous begins. The reading is on Step Three; made a decision to turn our will and our lives over to the care of God, as we understood God. During the share a newcomer, Tom, tells his story about what brought him into the rooms tonight. He is not sure he can be helped. He knows he has been a porn addict for all of his adult life. He says he has just been found out and he has no idea what will happen next, to his life, to his marriage, to his kids. He was advised to go to a 12-step meeting for sex addiction and luckily, he saw this meeting listed when he searched online.

The members of this unlikely band of brothers looks at Tom. His head is down. His focus is on the ravaged cuticles of his right thumb. As he raises his thumb to his mouth, a tear rolls down his cheek. They know how he feels. Each one of them have felt this same despair. Joe raises his hand to share. Joe is almost 45, yet one would think he is no older than 35. His Goorin Brothers Slayer cap is on backwards, his flannel plaid shirt is unbuttoned revealing an LA Dodgers vintage t-shirt. Appropriately ripped skinny jeans end in a pair of Vans slip-ons. He gets current, talking about his therapist, his groups and what the third step means to him. Then he looks directly at Tom. “I know there is no cross talk in this meeting, so let me just say this, Tom, can we talk after the meeting?”

Joe knows what has happened to Tom. Tom need not even say the word ‘legal’ for the subliminal message to be delivered. Joe knows because it happened to him, less than two years ago. The Cop Knock. The end of life as he knew it. The opening up of a new world. A new life without any more hiding. Relief.

The start of a new life

Joe and Tom walk to the hospital café and Joe buys Tom a soda and a sandwich. It is the first thing Tom has eaten in two days. The café is empty, they find a corner table and sit down. After just a few minutes, Tom’s experience from the last week is told. Joe’s head was nodding the whole time, but he lets Tom talk.

Before an hour was up, Joe had given Tom the names of three men, Michael, Steve and Jay. Also, the phone number of an attorney and of a therapist that specialized in treating sex offenders. As they walked out of the hospital, Joe said the first call should be to Michael. Michael will coordinate everything. And Joe was right, Michael coordinated everything.

Michael answers the phone at 9:30pm, and Tom was on the other line. Michael was already informed by Joe, just minutes before. By 10:00, Michael had assembled the Legal Consequences Crisis Management Team on a conference call and briefed us all. The attorney appointment will be made by the client, Tom. The therapist introduction will be on the phone, and the first group therapy meeting is tomorrow and Joe will bring Tom. Michael will coordinate the lawyer and therapist calls and speak to his parents. Jay and Steve will call Tom daily, for support. I am assigned to work with the wife. All of these recovery coaching services will be free to Tom.

Doing service to give back what we have freely received

Every one of us responds to this call. It initiates a recruitment effort that rivals the Avenger’s response to Ultron’s threat to eradicate humanity. This Legal Consequences Crisis Management Team is committed to respond to any sexual addiction crisis- the family affected by a patriarch’s incest, the individual devastated by sexual trauma, or the man that has heard the “Cop Knock”. We know they feel alone, whether they have been abandoned by their family, abused by loved ones or in this case, arrested for an illegal act. Tom needs this “Avengers” team to help him, because this is territory he is not familiar with. However, this team is very familiar with it; the family dynamics, the law, the courtroom, treatment and therapy, prison and the re-entry process. They have walked this path, and emerged on the other side, as healthier and better people for the experience. So, we are there for Tom, in order to keep our own sobriety, we are doing service to give back what we have freely received.

This band of Recovery Coaches comes to the aid of individuals dealing with the crisis of legal consequences of their sex addiction in the New Jersey, Delaware and Southeastern Pennsylvania region.

 

 

 

 

 

 

 

 

 

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Posted in Addiction, Addiction Recovery Posts, alcohol, Alcoholism, body image, Drug Abuse, Family Dynamics, Gambling, internet addiction disorder, love addiction, mental health, Opioid addiction, Parents, Pornography, pornography addiction, Recovery Coaching, Relapse, relationships, Research, Sex Addiction, Sleep Deprivation, Sleep Loss, Sponsor | Tagged , | Comments Off on Recovery Coaches working with sex offenders