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Employee Assistance: EAPs and Unions

Employee Assistance: EAPs and Unions

Throughout time, employees struggling with addiction and other mental health issues have been unfairly targeted and mistreated by employers. But as the discussion around these issues becomes more informed and industries understand it is not a sign of weakness or a moral flaw, employers, unions, and other work-based resources like EAPs are becoming more commonly available both in the U.S. and around the world. Aside from creating a supportive and nurturing workplace that bodes well to productivity, employers have a responsibility to provide services to those who are struggling with these issues.

Employee Assistance Programs

The rise of Employee Assistance Programs, or EAPs for short, has spread across federal, state, and local government jobs and is now more commonly available in the private sector. Although they’re not new in concept, modern EAPs are now more focused on employees’ health and mental wellbeing than ever before, and they’ve come a long way from simply sending a worker to a quick psychological assessment before bringing them back into the field.

In addition to the family and workplace counseling they’re often known to provide, EAPs sometimes cover short-term and outpatient treatment for issues ranging from substance abuse and addiction to anxiety and trauma. Although their roles are still technically to assist in resolving issues that are affecting the employees’ ability to work, they’ve come a long way from the days in which employers believed that their workers would be able to leave their “personal issues” at home.

Many EAPs help organize health fairs, implement wellness programs to improve employee self-care, and educate their employees about their rights through the Americans with Disabilities Act (ADA) of 1990 and Family Medical Leave of Absence (FMLA). The management of EAPs varies from business to business, but many EAP professionals are Licensed Clinical Social Workers or have a background in counseling. Their experience and primary role make them a valuable resource for anyone struggling with substance abuse or mental health issues.

Unions

In addition to EAPs, some of the largest proponents of improved mental health and appropriate treatment for the workforce have been labor unions. Seeing as it is within their realm of responsibility to take care of their members, unions have started to make a shift from sweeping these issues under the rug to bringing them to the forefront. Like the EAPs, many unions now have drug and alcohol programs, and many even offer peer advocacy programs to educate their members about common addiction and mental health issues along with helping to identify and find appropriate treatment.

In the Long Beach area, for example, the ILWU-PMA offers the Alcohol and Drug Recovery Program, or ADRP. The ADRP provides its members with counseling and resources to help them find treatment and support them throughout the recovery process. ILWU members, many of whom find themselves injured in the workplace and develop a dependence on prescription pills, or are struggling with other issues, have found the ADRP program to be extremely supportive and beneficial for them as they go through treatment.

Outside Support

At Roots Through Recovery, we understand the challenges that addiction and mental health issues can create in one’s life, both personally and professionally. That’s why one of our goals is to help people get their lives back on track, regardless of what their journey has been thus far. We regularly work with EAPs and unions to help them provide better care for their employees, and we are encouraged by the current trend of incorporating more whole-person wellness programs in the workplace.

Although not every employer or industry is required to offer coverage for substance abuse and other mental health issues, it can certainly be worth investigating what options and benefits are available to you should you decide to explore support beyond what is offered by your employer.

 

 

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Medication-Assisted Treatment (MAT): Myths Debunked

Medication-Assisted Treatment (MAT): Myths Debunked

In 2015, Michael Botticelli, the director for the Office of National Drug Control Policy stated:

“Medication-assisted treatment saves lives while increasing the chances a person will remain in treatment and learn the skills and build the networks necessary for long-term recovery.”[1]

So why is it that the use of medication-assisted treatment remains staggering and access is limited for those who need it?

When it comes to medication-assisted treatment, there is a whole host of misinformation and confusion surrounding its use and purpose, which leaves it rejected or ignored by the vast majority of treatment centers. Medication-assisted treatment is the use of legal, FDA-approved medications in combination with counseling and behavioral services provided by treatment professionals and family and peer support (Source: SAMHSA).

But for those who don’t understand the benefits or its place in treatment, it can seem simply as replacing one drug with another. Of course, that’s not the case for any accredited medication-assisted treatment programs, which is often the best option for some people looking to achieve long-term sobriety.

 

Here are a few of the debunked myths surrounding medication-assisted treatment.

MYTH: If you take medications like Suboxone, you aren’t really sober.

TRUTH: While it’s true that opioid replacements, such as Suboxone which contains Buprenorphine and Naloxone, act on the same receptors as heroin or an opioid, the medication attaches to these receptors but does not activate them, and also blocks other opioids from these receptors[2]. The combination of these two mechanisms helps control cravings in a person who is physically dependent on opiates without getting the person high.

 

MYTH: Medication-assisted treatment is for people who aren’t serious about their recovery.

TRUTH: In certain cases, even the most intensive counseling and behavioral treatments just aren’t enough to achieve sobriety and prevent relapses in the future. For these situations—particularly when opioids or severe alcohol use is involved—using medication-assisted treatment to neutralize the physiological effects may help someone attain this critical first step of recovery, allowing them to focus on the underlying issues and move forward in their recovery.

 

MYTH: It’s always better to just get people off of all drugs.

TRUTH: Although going “cold turkey” and just outright stopping the use of any substances is the ideal scenario for many, using medication-assisted treatment to ease the body away from its previous addiction can be both easier and medically necessary in some situations. “Ripping the bandage off” may seem preferable at the time, but it can also lead to complications, permanent damage, and even death if a person’s health is too fragile to handle the severity of the physiological repercussions.

 

MYTH: Medication-assisted treatment is just taking the easy way out.

TRUTH: If one accepts that addiction is a chronic disease, like diabetes or hypertension, then the use of medication should be understood to be a critical component of treatment in some cases. Like hypertension, if someone is able to address their condition by changing their lifestyle, such as their diet and physical activity, that is ideal; however, for some, that isn’t enough[3]. We wouldn’t shame someone with hypertension for taking Beta-blockers or ACE inhibitors, and addiction should be treated with the same understanding and compassion.

 

MYTH: People using medication-assisted treatment are less likely to stay sober.

TRUTH: When utilized correctly, medication-assisted treatment carries with it lower risk, and higher probability of success than solely doing counseling and behavioral services[4] for many people looking to address their addiction, stay in treatment[5], and remain sober for the long-term. One study found that patients who were still on an opioid agonist 18 months post-treatment, were twice as likely to be sober from opioid pain killers than those who were not (80% versus 36.6%).[6]

Figure Below. Abstinence Rate Exceeds 60 Percent in Long-Term Follow-Up of Medication-Assisted Therapy for Dependence on Opioid Pain Relievers Dependence on pain relievers dropped below 20 percent at 18 months, and below 10 percent at 42 months, after patients were stabilized on, and then tapered off, Bp/Nx. At all three follow-up points, patients who were currently engaged in opioid agonist therapy had markedly higher odds of positive outcomes. (Source: National Institute of Drug Abuse)

 

Like any form of treatment, medication-assisted treatment isn’t for everyone, and the decision to start these medications is made after consultation with a treatment team, and a thorough assessment is completed. If you’ve struggled with relapse and traditional treatment hasn’t worked for you, contact Roots Through Recovery or another certified provider to consult on whether it would be an appropriate course of action.

 

References:

[1] https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2016/11/medication-assisted-treatment-improves-outcomes-for-patients-with-opioid-use-disorder

https://obamawhitehouse.archives.gov/the-press-office/2015/09/17/remarks-ondcp-director-michael-botticelli

[2] https://www.naabt.org/faq_answers.cfm?ID=5

[3] https://archives.drugabuse.gov/publications/drug-abuse-addiction-one-americas-most-challenging-public-health-problems/addiction-chronic-disease

[4] https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf?sfvrsn=24

[5] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/209312

[6] https://www.drugabuse.gov/news-events/nida-notes/2015/11/long-term-follow-up-medication-assisted-treatment-addiction-to-pain-relievers-yields-cause-optimism

 

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For more information or to start admissions – fill out the form below and we’ll reach out to you as soon as possible:

12 Step and Non-12 Step Support Groups

12 Step and Non-12 Step Support Groups

With nearly one in ten adults in the United States experiencing a substance use disorder, or an addiction to drugs or alcohol, in the past year, the need for substance abuse treatment is greater than ever. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline received 68,683 calls per month in the first quarter of 20181, up from last year. Only around 10% of Americans seek treatment for their substance use disorder, while others go untreated or seek the support from recovery support fellowships, such as a 12-step group like Alcoholics Anonymous, or a non-12 step group like SMART Recovery or Refuge Recovery.

Whether a person does get help at a treatment facility or not, research shows that participation in a recovery support community outside of treatment improves outcomes2. The key to achieving longterm recovery is for an individual to find a recovery support group that aligns with their core beliefs, which increases participation, and thereby, improving outcomes. While the membership of alternative, non-12 step recovery support groups are growing, the 12 Step community is by far the largest in the world with millions of members. There are basic tenants of the Twelve Steps that lead some to search for non-12 step communities. 

Alcoholics Anonymous and The 12 Steps

Developed in 1935 by New York stockbroker, Bill W., and surgeon Dr. Bob S.–both alcoholics–Alcoholics Anonymous is a fellowship of people struggling with alcohol use disorders. The foundation of Alcoholics Anonymous are the 12 Steps of recovery, as outlined in the Big Book, which was first published in 1939. The 12 steps are the philosophy and methods for achieving longterm sobriety, and have helped millions of people in the almost 80 years of existence.

THE 12 STEPS OF ALCOHOLICS ANONYMOUS

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only or knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

In response to criticism and questions about religion, donations, purpose and public relations, the Twelve Traditions were developed and adopted a short time later.

THE 12 TRADITIONS OF ALCOHOLICS ANONYMOUS

  1. Our common welfare should come first; personal recovery depends upon AA unity.
  2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
  3. The only requirement for AA membership is a desire to stop drinking.
  4. Each group should be autonomous except in matters affecting other groups or AA as a whole.
  5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
  6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
  7. Every AA group ought to be fully self-supporting, declining outside contributions.
  8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
  9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
  10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
  11. Our public relations policy is based on attraction rather than promotion; we need always to maintain personal anonymity at the level of press, radio, and films.
  12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.3

With meetings taking place in bars, restaurants, churches and halls around the world, there are now over thirty different support groups based on the 12 steps, that vary from support for codependency (CoDA) and gambling (GA) to overeating (OA) and addictions to specific substances, including Heroin Anonymous (HA) and Cocaine Anonymous (CA). Some of the text is changed in the 12 Steps and 12 Traditions, depending on the group’s focus, for example Narcotics Anonymous uses the word ‘addict’ in place of the world ‘alcoholic’; but the steps that guide the philosophy and the traditions that provide guidelines for the fellowship remain the same.

You can find a listing of 12-step meetings at www.AA.org.

Effectiveness of the 12 Steps

The challenge in measuring the efficacy of a specific recovery support group is that there are too many variables that impact individual outcomes, including whether or not they have gone through treatment, live at home or at sober living, whether they have untreated mental health issues or trauma that contribute to their substance use or behavioral disorder, among countless others. As with any fellowship, studies have found that the outcomes for people in AA and other 12 Step groups are mixed, and vary greatly depending on the person’s commitment and participation level. We do know that millions of people have found help for their addictions, substance use disorders and other behavioral disorders through the 12 Steps.

Criticism of the 12 Steps

Even with this fellowship of millions of people around the world struggling with addictions and other challenges, the 12 Steps support groups have faced criticism due to the focus on God, religion, spirituality and prayer. “Working a program” requires one to subscribe to the doctrine of the steps and a belief in a higher power, though the definition of such has been broadened to mean whatever one believes it to mean. Another criticism of the 12 Step community is its admonishment of the use of psychotropic medications for those suffering from a mental health issue. Many consider the use of medications to mean that a person is not “clean and sober”. This alone leads some people to seek a more inclusive and progressive community of which to be a part.

Non-12 Step Recovery Support

In the past few decades, people recovering from drugs and alcohol, who found the 12 steps did not work for them, have developed alternative, non-12 step recovery support groups that provide the essential elements: fellowship, commitment, accountability and hope; while they differ in their approach.

SMART RECOVERY

SMART Recovery is a “science-based”, non-12 step self-help group that teaches, “common sense self-help procedures designed to empower you to abstain and to develop a more positive lifestyle”.4 The program is based on a form of Cognitive Behavioral Therapy called Rational Emotive Behavior Therapy, or REBT, which is founded on the belief that your thinking creates your feelings, and then leads you to act on those feelings.

SMART Recovery believes that drinking and using serve a purpose–to cope with emotions–and by managing the beliefs and emotions that lead you to drink or use, you can empower yourself to quit. SMART focuses on four key areas for its members:

  1. Enhancing motivation;
  2. Refusing to act on urges to use;
  3. Managing life’s problems in a sensible and effective way without substances; and
  4. Developing a positive, balanced, and healthy lifestyle.

Much like 12 step groups, SMART intends to provide widely-accessible meetings that a community member can find at locations around the world. SMART is an abstinence-based program that also embraces medical progress and does not preclude the use of medications among its members. Because the program does not reference a higher power or require its members to admit to being powerless over their alcoholism or addiction, people in recovery who are not religious or find it difficult to surrender their will over to another tend to prefer this philosophy. The community welcomes people who have a religious faith, however.

SMART Recovery also has an end point, which can be appealing to those who are more successful when they have a goal they are working toward. One can “graduate” from SMART Recovery, though they may continue to attend meetings and work on their abstinence. While the differences are clear, it’s important to note the similarities between SMART and other recovery support communities, which are the basic tenants: fellowship, commitment, accountability and hope. Many people who attend SMART meetings also attend 12 step meetings like AA or NA, as it is helpful to hear the words of others and the meetings are much more accessible.

For more information or to find meetings, visit www.SMARTrecovery.org. 

REFUGE RECOVERY

Another recovery support community that has grown in popularity in the last few years is Refuge Recovery. Refuge is a Buddhist-oriented approach to recovery, and like SMART, it is founded on the belief that, “All individuals have the power and potential to free themselves from the suffering that is caused by addiction.” This empowerment comes from practicing self-compassion, and opening one’s heart and mind to respond to events and moments in life without self-harm. Like other recovery support communities, Refuge Recovery has guiding principles, which are the Four Truths: ONE: Addiction Creates Suffering; TWO: The cause of addiction is repetitive craving; THREE: Recovery is possible; FOUR: The path to recovery is available.

In an article, The Early History of Refuge Recovery, spiritual director Joseph Rogers explains the background.

The beginnings of Refuge Recovery can be traced to the Buddhism & Recovery conference held in Los Angeles at the Against the Stream Buddhist Meditation Society (ATS). It was here that Alan Marlatt, a researcher from the University of Washington, presented his findings on the impact of mindful meditation for clients in outpatient addiction treatment. His pioneering study showed that while mindfulness meditation improved the chances of clients reaching the 90-day recovery mark, if these clients stopped meditating post-treatment, their recovery rates returned to baseline. However, those clients who continued to meditate in supportive communities saw a continued higher rate of recovery post-treatment.

Alan believed that there needed to be a national network of meditation groups that supported the wave of clients who would soon be using mindfulness as an integral part of their recovery, something like a Buddhist-based 12-step program but with mindfulness meditation. 5

The Refuge Recovery program incorporates meditation and mindfulness into its approach, and emphasizes kindness, compassion, appreciation and equanimity. Refuge community members follow the Eightfold Path to Recovery:

  1. Understanding
  2. Intention
  3. Communication/Community
  4. Action
  5. Livelihood/Service
  6. Effort
  7. Mindfulness/Meditations
  8. Concentration/Meditations

According to their website, the Eightfold Path “is an abstinence based path and philosophy. We believe that the recovery process begins when abstinence begins. The Eight factors of the path are to be developed, experienced and sustained. This is not a linear path, it does not have to be taken in order, rather all of the factors will need to be developed and applied simultaneously. This is a guide to having a life that is free from addiction. The eight-fold path of recovery will have to be maintained throughout ones lifetime.”6

As we wrote about in an earlier article, much research into the benefits of meditation and mindfulness have come out in support of its role in recovery. Recently, more treatment centers have begun incorporating this practice into their programming, increasing interest in Refuge Recovery, which is based on these principles and practices.

For more information or to find meetings, visit www.refugerecovery.org.

Other Non-12 Step Recovery Support Communities

WOMEN FOR SOBRIETY

LIFERING SECULAR RECOVERY 

SECULAR ORGANIZATIONS FOR SORIETY (SOS)

The Great Divide

A simple search of the internet will show you just how divided the recovery community is on the subject of recovery support groups. A large sector of the community believe the 12 steps are the answer for anyone struggling with drugs or alcohol, partly due to the fact that many people working in treatment centers are themselves recovering alcoholics or addicts who got sober using the 12 steps; while others believe non-12 step groups are more fitting due to their omission of religion or inclusiveness of other faiths. One will even find treatment centers whose curriculum is based on Twelve Step Facilitation (TCF), and others that denounce the steps and claim to be “Non-12 Step Rehab”.

Most of the literature that is available focuses on the differences between these two schools of thought, rather than the similarities in what they provide for people who are seeking help from their peers. The divide is harmful and the dangers of pitting fellowships against each other presents challenges to the recovery community, alienating individuals and groups, and suggesting that there is only one path to recovery. Creating the illusion that one community has better outcomes than the other, or that there exists only two clear options: 12-Step or Non-12 Step, forces people to place themselves in one of these two categories when, really, the recovery community as a whole should be unified and support one another regardless of the doctrine to which one subscribes.

Which Group is Best – 12 Step or Non-12 Step?

The answer to this question, as suggested earlier, depends on the individual and his or her belief system. Research has shown that people who are actively involved in a recovery support community achieve better outcomes and ‘success’, as they define it for themselves. One such study suggests that, “involvement in support groups significantly improves one’s chances of remaining clean and sober, regardless of the group in which one participates.” It goes on to say, “Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober.”

While the difference between communities, especially religion, may lead one to choose one over another, the reasons why active involvement in a recovery support community–regardless of the community–results in better outcomes, are the common themes among these groups, not the differences. Just as we urge clients in recovery to build empathy and compassion by finding the commonalities among them and their peers, rather than focusing on the differences, our approach to recovery support groups should be the same. What works for one, does not necessarily work for all.

Some treatment centers, like Roots Through Recovery, do not attach to any ideology or approach, and their philosophy is, “it doesn’t matter which community you join, but find one that speaks to you, and commit.” This approach embraces a belief in multiple paths to recovery, and encourages individuals to be both introspective and inclusive as they search for the community that they connect with most.