CONSCIOUS CONNECTION

COMPASSION. CONNECTION. COMMUNITY

‘The greatest damage done by neglect, trauma or emotional loss is not the immediate pain they inflict but the long-term distortions they induce in the way a developing child will continue to interpret the world and her situation in it.


All too often these ill-conditioned implicit beliefs become self-fulfilling prophecies in our lives. We create meanings from our unconscious interpretation of early events, and then we forge our present experiences from the meaning we’ve created.

Unwittingly, we write the story of our future from narratives based on the past…

Mindful awareness can bring into consciousness those hidden, past-based perspectives so that they no longer frame our worldview.

Choice begins the moment you dis-identify from the mind and its conditioned patterns, the moment you become present…

Until you reach that point, you are unconscious.’ …In present awareness we are liberated from the past.”

― Gabor Maté

ADDICTION & MENTAL HEALTHCARE

I am a person in longterm recovery from addiction for over 31 years, my sobriety date 12th October, 1988 is one I intend to “one day at a time” maintain.

An integral aspect of recovery: service to at-risk people in the community is supported nationally within the UK.

The person best served to help another addict struggling with active addiction to engage them in a treatment programme are people like me who work in the voluntary sector.

Recently GOOGLE created “where to find” comprehensive addiction treatment services within the US – I have asked GOODLE to expand this service globally.

https://recovertogether.withgoogle.com

The #RecoveryMovement celebrates the 23 million Americans recovering from addiction, and paves the way for the 20 million still struggling to seek treatment. Our voices matter.

Connection. Community. Collaboration. At-risk people are not meant to be suffering in silence, alone.

Addiction is defined as repeating behaviours that have negative consequences, that reinforces disconnection from self, others, and the wider community. This felt sense of separation is experienced as abject loneliness, isolation and alienation.

When a person in an addiction and mental healthcare crisis is ready to seek help in stopping addictive behaviours…the benefits of engaging in a 24/7 recovery treatment programme that support all the stages of recovery from a psychosocial assessment that determines the entry point of a treatment plan, medically supervised detox, inpatient primary care, nutrition, and recovery counselling that is fully supported by a multidisciplinary addiction medicine team who work side by side with a lived experience volunteers.

My personal addiction recovery (31 years) and professional experience as a clinician remains focussed on effecting change, combatting stigma and promoting shared addiction and mental healthcare partnership and values.

Through the lens of recovery, different cultures and communities reveal the stages of recovery as a personal endeavour… the journey of lifetime… Though this lens there are many times of unprecedented challenges and polarisation.

CYCLE OF AWARENESS

Recovery community’s lived experience volunteers have the capability to deliver solutions that have the potency to build a better future for all who seek help in staying stopped, being authentic, autonomous, boundaries is actualising a continuum of self-care in the immediacy of daily life.

Implementing changes to healthcare policy through local and national community action, means progressive changes to healthcare policy can be achieved far quicker than ever before to respond to the addiction and mental healthcare crisis most pressing needs.

Upon reflection, having worked in the private sector for many years it is essential to recognise addiction and mental healthcare as a public health problem…ergo actively create something different – autonomous addiction and mental healthcare clinic that will not only help complement existing healthcare policy and efforts, but also advance the solutions addicts seeking help need most: 24/7 accessible addiction and mental healthcare.

30 years I had the privilege of volunteering at Marianne Willamson’s “MANHATTAN CENTRE FOR LIVING” founded upon the vision of creating a safe haven for people who were seeking help with living with a health crisis: AIDS and cancer.

In addition to helping people at MCL in need I helped coordinate an annual charity auction at Sothebys to raise funds and maintain Marianne’s high level of medical and therapeutic healthcare.

Marianne’s healthcare vision has evolved into one of universality. And champions the following policy changes:

1.Require our healthcare system to reimburse medical professionals for a broader array of lifestyle and nutrition support, focused on preventing disease and/or addressing root causes.
2.Longer visits with doctors and/or their support staff to better equip patients with skills necessary to make lifestyle changes.
3.Provide patients with more robust ongoing support from nutritionists, health coaches, therapists and mental health, exercise specialists, and other peripheral lifestyle treatment providers.
4.Integrate world-class technology and systems for better collaboration and cost-savings among healthcare providers.
5.Fund programs in all our educational systems, pre-k through college, designed to teach nutrition and lifestyle skills to help cultivate long-term health.
6. Restrict the marketing of overly-processed and sugary foods to our children.
7.Stop subsidies for agricultural production of unhealthy foods, like high-fructose corn syrup and hydrogenated fats, and incentivize and subsidize farmers, ranchers and food companies for more healthy food production, making it more affordable and available.
8. Shape food policies using cutting-edge public health science instead of following the lead of lobbyists for industries whose sole focus is profit.
9.Secure and expand the role of the EPA and the FDA to keep toxins out of our environment and food supplies.
10.Take a national look at stress levels, and develop ways to lower stress societally. That means adding vacation time, protecting a manageable work week, and taking a close look at how our electronic devices impact our lives. Just as the FDA is supposed to make recommendations about how we eat, the FDA should study, and make constructive recommendations, on how we consume data from our phones and devices.
11. We need to develop healthy habits at a community level. Towns and cities can, and should, look collectively at how active their populations are, and institute more ways to increase physical activity through walking paths, bike paths, and community events. The diet of entire cities should be reviewed, as well as ways that communities can contribute to one another’s daily health.
12. The Consumer Financial Protection Bureau should investigate how hospitals overcharge patients, and the Justice Department antitrust division should explore ways to remove as much of the profit motive out of medicine as we can.
13.The Center for Disease Control should invest more research into preventing disease, rather than treating symptoms and look broadly at vulnerabilities in the system (like avoiding pandemics by encouraging healthy disease avoidance behaviors).
14.We also need to find non-pharmacological ways to treat mental health issues, and to take all mental health issues as seriously as physical issues, and reduce the stigma of mental health illnesses, so that more will seek and receive treatment.
15.We need to treat drug addiction as a mental health issue, and not as illegal activity. Only by de-criminalizing drugs can we break the back of cartels and drug dealers, while getting addicts into recovery.

This is how a mature debate begins on the issue of health care. As with most issues, the underlying problem is the corporate dominance of American governmental policies. With Marianne Williamson in the White House, Americans would be well aware that on a daily basis, their president is working to realign governmental policies with the health and well-being of the American people.

Meanwhile in Westminster, UNIVERSAL HEALTHCARE strategies for changes in healthcare policy need to be actualised…”we are done talking” people like myself, clinicians in longterm recovery whose training treating addiction works…we know what to do…let us do what we do best..save lives…restore dignity, respect, purpose and most important of all wellbeing because it is basic human right to be able to access and receive healthcare.

Governments work for us, the people, not for health insurance companies or other corporate entities, whose short term profits may or may not align ultimately with the vision of community wellbeing.

We are experiencing a global health crisis, environmental crisis, that continues to impact the quality and length of our lives.

Healthcare policies changes that help prevent and reverse chronic illness, addiction and mental illness will cultivate optimal health, and engender people living healthier, longer and happier lives.

From drug policies, health policies, food policies, agricultural and environmental polices, to pharmaceutical policies the health and wellbeing of our humanity needs to be the greater concern of global governments, and not the profits ofcoprvate entities that are not held accountable for the toxicity their products produce.

Many will argue that we “cannot afford” universal healthcare” – when in fact the burden upon the A&E -NHS would be be dramatically reduced if autonomous addiction and mental healthcare A&E clinics were established within A&E -NHS settings where clinicians and lived experience volunteers work together side by side to treat people in a mental and or addiction healthcare crisis. The clinics would be 24/7 treatment hubs.

Addiction is not a criminal justice issue but a public health issue which requires specialist training and insight into the medical and biopsychosocial nature of the illness.

Let’s transform the way in people seeking help in an addiction and mental healthcare crisis access addiction healthcare. People have a right to be treated, not dismissed, and discharged.

However, due to cutbacks, long waiting times and lack of experienced in addiction trainings first responders, doctors, nurses and associated healthcare workers, people are being turned away instead of receiving treatment.

It is not good enough to say implementing addiction healthcare will cost millions, addiction and mental healthcare are already costing billions globally:
loss of income, loss of family, loss of life.

I am committed to ending prejudice, stigma, isolation and shame by personally striving for 24/7 within established A&E NHS Hospital settings, accessible inpatient and outpatient addiction public healthcare programmes to combat the opioid crisis, treat addiction and COD: the coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorder.

ADDICTION HEALTHCARE RIGHTS & RECOVERY
Recovery-oriented care is prevention, intervention, medically assisted detox, inpatient and outpatient continuing support, and connecting with a recovery community. Recovery is a way of life, an attitude, and a way of approaching life’s challenges. The need is to meet the challenges of one’s life and find purpose within and beyond the limits of addiction while holding a positive sense of identity.

Since the inception of Alcoholics Anonymous in 1939, clinical and recovery evidence demonstrates that when people engage in primary care addiction treatment, they have better outcomes than those not retained in treatment. Providing a safe place in which at risk, vulnerable people can be given a choice to engage in treatment is addiction healthcare human right.

Addiction is characterized by an inability to consistently abstain or reduce substance use, impairment in behavioural control, craving, tolerance, and interference with interpersonal relationships, occupational responsibilities, recreational activities, and emotional response.

Like other chronic diseases, addiction often involves cycles of relapse and remission and recovery is about connection – lets engage vulnerable, isolated and disenfranchised, at risk people to a compassionate addiction healthcare care regimen.

Otherwise, without treatment or engagement in recovery activities, addiction is progressive and will often result in disability, or premature death.

And while the cost of addressing every facet of the addiction crisis is substantial, the cost of doing less than what is absolutely necessary is far more.

TOGETHER WE CAN: strengthen our nation’s addiction prevention and treatment infrastructure and expand access to evidence-based care is working in partnership with addiction trained clinicians to pursue bold, systemic solutions.

There is no time left for incremental policy changes – we need to come together as a UNITED KINGDOM to both implement and fund addiction healthcare programmes that will comprehensively combat untreated, complex, co-occurring chronic disease of addiction.

In January 2019 I initiated a partnership with the American Society Addiction Medicine to provide evidence based ASAM “Fundamentals in Addiction Trainings” and the ASAM Strategic Plan: a biopsychosocial evidence-based addiction healthcare treatment pathway that UK first responders, doctors, nurses need to be trained in to effectively treat addicted patients.

In addition to the ASAM “Fundamentals of Addiction Trainings” I am proposing implementing 24/7 Addiction Emergency Care Clinics within A&E-NHS settings an autonomous clinic and ward for primary care inpatient care facilitated by trained in the ASAM “Fundamentals of Addiction Medicine” clinicians, first responders, doctors, psychiatrists, nurses, pharmacists, and associated healthcare professionals to work alongside the Scottish Recovery Consortium lived experience – support volunteers, 24/7 in addiction and mental health primary care integrated treatment programmes.

In my 28-year, professional role, as an addiction clinician, and a person in long term recovery (31years) I continue to advance the recognition of mental health and freedom from addiction as being essential to overall health. Such recognition and focus will help to improve access to and integration of addiction healthcare services, to support and sustain positive outcomes, and address gaps and disparities in service delivery.

Addiction medicine is a medical subspecialty, formally recognized since 1990, concerned with the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction, of those with substance-related health conditions, and of people who show unhealthy use of substances, including nicotine, alcohol, prescription medications, and licit and illicit drugs.

The American Society of Addiction Medicine, founded in 1954, by Dr. Ruth Fox, a psychoanalyst who in 1959 became the first medical director of The National Council on Alcoholism, an agency devoted to alcoholism prevention is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine.

She was founder and first president of the American Medical Society on Alcoholism and Other Drug Dependencies in 1954 and wrote, lectured and taught extensively on the subject. She also maintained a private practice and was one of the first psychoanalysts willing to accept alcoholics as patients.

She was a fellow of several groups including the American Psychiatric Association, the New York Academy of Medicine, the American Academy of Psychoanalysis, the American Health Association and the American Society of Clinical Hypnosis.

The ASAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction.

The ASAM Patient Placement Criteria uses six dimensions to create a holistic biopsychosocial assessment of an individual to be used for treatment planning:

• Dimension one is acute intoxication or withdrawal potential.
• Dimension two is biomedical conditions and conditions.
• Dimension three is emotional, behavioural, or cognitive conditions or complications.
• Dimension four is readiness for change.
• Dimension five is continued use or continued problem potential.
• Dimension six is recovery/living environment.

The ASAM plan outlines ambitious research goals aimed at leading scientific and medical progression in the field with renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the organization’s mission.
In addition to the ASAM “Fundamentals of Addiction Trainings”

RIGHTS & RECOVERY
Recovery-oriented care is prevention, intervention, medically assisted detox, inpatient and outpatient continuing support, and connecting with a recovery community. Recovery is a way of life, an attitude, and a way of approaching life’s challenges. The need is to meet the challenges of one’s life and find purpose within and beyond the limits of addiction while holding a positive sense of identity.

In partnering with the ASAM the opportunity is in strengthening the focus on the full spectrum of addiction medicine, science, treatment and care:
prevention, treatment, remission, and recovery.

The continuing efficacy of the ASAM’s guiding principles will continue to set standards, pioneer research, educate professionals and the public, and challenge stigma. ASAM will always endeavour to enhance the goal of treating addiction and saving lives.

The American Society of Addiction Medicine’s evidence-based training and Strategic Plan:

The ASAM “Fundamentals of Addiction Training”
https://www.asam.org/education/live-online-cme/fundamentals-program

COMPASSIONATE ADDICTION & MENTAL HEALTHCARE

A VISION FOR THE FUTURE

A Public Health Approach to an Epidemic of Addiction

Addiction is not a criminal justice issue but a public health issue which requires specialist training and insight into the medical and biopsychosocial nature of the illness.

Let’s transform the way in which vulnerable, people at risk access addiction healthcare. People have a right to be treated, not dismissed, and discharged.

However, due to cutbacks, long waiting times and lack of experienced in addiction trainings first responders, doctors, nurses and associated healthcare workers, people are being turned away instead of receiving treatment.

It is not good enough to say implementing addiction healthcare will cost millions, addiction and mental healthcare are already costing billions globally:
loss of income, loss of family, loss of life.

I am committed to overcoming prejudice, stigma, isolation and shame by personally striving for 24/7 within established A&E NHS Hospital settings, accessible inpatient and outpatient addiction public healthcare programmes to combat the opioid crisis, treat addiction and COD: the coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorder.

ADDICTION HEALTHCARE RIGHTS & RECOVERY
Recovery-oriented care is prevention, intervention, medically assisted detox, inpatient and outpatient continuing support, and connecting with a recovery community. Recovery is a way of life, an attitude, and a way of approaching life’s challenges. The need is to meet the challenges of one’s life and find purpose within and beyond the limits of addiction while holding a positive sense of identity.

Since the inception of Alcoholics Anonymous in 1939, clinical and recovery evidence demonstrates that when people engage in primary care addiction treatment, they have better outcomes than those not retained in treatment. Providing a safe place in which at risk, vulnerable people can be given a choice to engage in treatment is addiction healthcare human right.

Addiction is characterized by an inability to consistently abstain or reduce substance use, impairment in behavioural control, craving, tolerance, and interference with interpersonal relationships, occupational responsibilities, recreational activities, and emotional response.

Like other chronic diseases, addiction often involves cycles of relapse and remission and recovery is about connection – lets engage vulnerable, isolated and disenfranchised, at risk people to a compassionate addiction healthcare care regimen.

Otherwise, without treatment or engagement in recovery activities, addiction is progressive and will often result in disability, or premature death.

And while the cost of addressing every facet of the addiction crisis is substantial, the cost of doing less than what is absolutely necessary is far more.

TOGETHER WE CAN: strengthen our nation’s addiction prevention and treatment infrastructure and expand access to evidence-based care is working in partnership with addiction trained clinicians to pursue bold, systemic solutions.

There is no time left for incremental policy changes – we need to come together as a UNITED KINGDOM to both implement and fund addiction healthcare programmes that will comprehensively combat untreated, complex, co-occurring chronic disease of addiction.

I will be updating on the 20th January, 2020 the compassionate care Addiction & Mental Healthcare initiative vision into four main parts:

Aims


Objectives: to actualise a addictions training network among a group of A&E- NHS- hospitals that will voluntarily commit to expanding their response to the opioid epidemic and sharing their experience with the network.

I have identified three overarching aims which I would like Addiction & Mental Healthcare initiatives to achieve:

CONNECTION. COLLABORATION. COMMUNITY

The Vision: Inspire change, educate, empower and clinicians, and healthcare professionals best practice in the treatment of vulnerable at-risk people who are seeking help.


I have identified conscious objectives which should enable the aims to be delivered. There are interdependencies between the objectives, the aims and the overall outcomes to be achieved.
The objective is to:
Ensure that at-risk people are supported at all stages
of addiction and mental healthcare programmes.
Address the incidence and impact of trauma in all its forms
End stigma
Support individual and family recovery

This plan will be accompanied by a primary compassionate care plan which will contain details of treatment which will be undertaken to achieve the objectives and identify who is responsible for delivering them.

A compassionate approach will aid the achievement of each of the aims, objectives and outcomes. These define key innovative ways this plan will work. The approaches are:

  • Implementing addiction medicine trainings for doctors, nurses, clinicians, first responders, and associated healthcare professionals.
  • Communicating and linking with peer-led recovery communities.
  • Collaborating with NHS partners.
  • Being innovative.
  • Delivering efficient services.
  • Operating strong governance and accountability arrangements.
  • Clinicians and lived experiences volunteers working side by side.
  • Communicating and linking with peer-led recovery communities.

POLICY AND INDUSTRY
For Hospitals, A Blueprint for Fighting the Opioid
Epidemic
A new report collects evidence-based strategies to help hospitals stem the tide of opioid use and overdose deaths.
Getty Images By Michael Botticelli, Donald M. Berwick, Maia Gottlieb, Mara
Lederman

December 20, 2019
Hospitals are on the front lines of the opioid epidemic. Nearly 500,000 people with an opioid use disorder (OUD) are discharged from the hospital each year. Rates of opioid-related emergency department visits and inpatient stays have risen dramatically, as have rates of serious infections such as endocarditis and hepatitis C stemming from opioid use. Total hospital costs related to opioid overdoses have been estimated at $2 billion annually.
These stark statistics show the mounting pressure on hospital capacity and resources. But the numbers also reveal the tremendous opportunity hospitals have to influence the opioid epidemic. No other setting provides as many touchpoints to engage people with OUD and connect them with effective treatment.

For any hospital, transforming OUD treatment is a challenge. Fortunately, hospitals have more access than ever before to a wide array of evidence-based tools and strategies, ranging from effective medications for opioid use disorder to detailed guidelines for opioid prescribing. As the evidence for these and other best practices increases by the day, the urgency increases as well. With so many best practices available to us, hospitals cannot delay in creating a systems-level approach for addressing the opioid epidemic.

To help hospitals meet the need and overcome challenges, the Institute for Healthcare Improvement (IHI) and the Grayken Center for Addiction at Boston Medical Center teamed up to document effective strategies that hospitals can put in place to respond to the opioid crisis and support their patients. The resulting report, a synthesis of evidence-based guidelines and lessons learned from around the country, serves as a blueprint for hospitals.

The blueprint: Key strategies
Many hospitals across the United States are already responding to the opioid epidemic in strategic and innovative ways. The full IHI/Grayken Center report contains dozens of these examples, along with specific actions hospitals can take. Below are three broad areas in which hospitals can have an immediate impact.
Identifying and treating individuals with OUD at key clinical touchpoints

The emergency department (ED) remains an underused touchpoint for treating acute withdrawal and initiating treatment. EDs everywhere should be equipped to provide this frontline care. (In some states, including Massachusetts, this standard of care is already required by law.) Medication initiation in the ED works. When patients are given buprenorphine in the ED and referred to ongoing treatment (versus screening or referrals alone), they are more likely to remain in treatment and reduce their use of illicit opioids after 30 days, research from the Yale School of Medicine has shown.
Given the rise of opioid-related inpatient stays, addiction consult services are another key opportunity to reach patients and connect them to ongoing care.

These services, which engage patients during acute hospitalizations and often provide key harm reduction, have the capacity to improve care quality and reduce readmissions.
Hospitals often cite the lack of community-based referral capacity as a barrier to implementing substance use disorder services.

However, successful models exist for growing ongoing care capacity internally. For instance, office-based addiction treatment, developed first at Boston Medical Center, centers around a nurse care manager model of primary care in which nurses oversee patient care and offer medications for OUD such as buprenorphine when appropriate.

This model keeps patients engaged, destigmatizes the experience, and minimizes disruption to patients’ employment and other responsibilities. Research from Marc Larochelle, MD, at Boston Medical Center and others found that medication for opioid use disorder (specifically, buprenorphine and methadone maintenance treatment) was associated with reduced opioid related mortality and all-cause mortality over several months.

The office-based addiction treatment model has already spread throughout the country, and the “Massachusetts Model” treats hundreds of patients, with dozens of community health centers adopting the model.

Changing the way that hospitals treat pain:
Many hospitals have already responded to the opioid epidemic by rethinking how they prescribe opioid medications—often reducing the number of pills prescribed—and the settings in which they’re prescribed. The Michigan Opioid Prescribing Engagement Network, affiliated with the University of Michigan, has been a leader in the field, bringing together hospital systems and clinicians to develop evidence-based prescribing guidelines, encourage safe opioid disposal, and develop patient education materials.

However, in some cases the increased attention has led providers to be overly wary of prescribing opioids, to the point that the Centers for Disease Control and Prevention (CDC) decided to clarify that there are many situations where opioids are indeed appropriate.

Providers are also learning to emphasize alternative medications and treatments for acute pain management and newly identified chronic pain.

For patients already on high-dose chronic opioids, providers should cautiously manage those prescriptions; abruptly tapering patients is not clinically advised. Prescription drug monitoring programs are now regularly required by state governments, and pharmacies have become crucial partners in using existing data to identify patients, providers, and prescribers who may need additional attention. While this requires oversight to be effective, it represents true progress.

Clinicians are being more thoughtful about how to prescribe opioids effectively and safely, and hospitals are beginning to incorporate this thinking across specialties—from primary care to dentistry to post-surgical care. In Massachusetts (as well as a few other states) there’s a phone line that clinicians can call with prescribing questions.

Training stakeholders on the risks of OUD and how to reduce stigma
The prevalence of substance use means that many more individuals than ever before need to learn about opioid use, opioid use disorder, and substance use disorder more generally.

This includes not only people working in addiction medicine, but health care professionals outside of the addiction sphere, patients, and the public at large. Widespread stigma around opioid use disorder and the medications to treat it persists, even among medical professionals.

A survey from RIZE Massachusetts found that only one in four providers had received training on addiction during medical education. Startlingly, less than half of providers in emergency medicine, family medicine, and internal medicine believed OUD is treatable.

The stigmatizing attitudes about patients with substance use disorder among medical providers are well documented, and the consequences are severe, leading to the undertreatment of patients with substance use disorders. This stigma leads them to hesitate before sharing important information about their substance use with providers for fear of judgment and retribution.

It may also cause patients to use drugs in secret, which could lead to a fatal overdose or cause people with an OUD to forgo potentially lifesaving drugs, such as methadone or buprenorphine, because of the negative stories they may have heard.

Hospitals, given their direct line to patients, families, and employees, can dismantle this stigma. One way to do this is to teach all faculty and staff the facts about substance use disorder.

Another is to encourage a hospitalwide commitment to using clinically appropriate terminology—for example, referring to “people with a substance use disorder” rather than “addicts.” Hospitals can also be incubators for positive community change.

As employees unlearn the stigma they’ve been taught, they’ll share this view with family and friends, helping the community at large to reframe the way they think about addiction.
Hospitals working together
Some hospitals—including those we highlight in the report—have done all this and more; others are just beginning to take a systematic approach to taking on the opioid epidemic. In either case, the efforts to date have largely been independent and disconnected.

To achieve the size, scale, and sense of urgency needed to turn the tide of the epidemic, hospitals must work together to accelerate learning and secure buy-in from their organizations.

To turn the tide of the epidemic, hospitals must work together to accelerate learning and secure buy-in from their organizations.


In the next phase of our partnership with the IHI, we will be using the IHI’s Leadership Alliance to formalize a learning network among a group of hospitals that will voluntarily commit to expanding their response to the opioid epidemic and sharing their experience with the network.
Invariably, as hospitals band together, we will encounter policy and payment barriers.

The learning networks we develop to scale effective strategies can also be used to advocate for policy and practice change. The willingness to work together collaboratively will continue to be essential as hospitals collectively heed the call and assume a leadership position in fighting the opioid epidemic.
Authors’ Note As noted in the piece, the Institute for Healthcare Improvement and the Grayken Center collaborated on a report outlining effective strategies for hospitals to address the opioid epidemic. Neither party received financial compensation for their input on this report.

This article originally appeared on the Health Affairs Blog (12/20/19), 10.1377/hblog20191217.727229. Copyright © 2019 Health Affairs by Project HOPE – The People- to-People Health Foundation, Inc.
Topics: Opioids |

ADDICTION & MENTAL HEALTHCARE EMERGENCY

ADDICTION & MENTAL HEALTHCARE.
Mobile: +447894084788
Email: ELIZABETHHEARN@ME.COM

A VISION FOR THE FUTURE

A Public Health Approach to an Epidemic of Addiction

“A CALL FOR NATIONAL DIALOGUE”

“To be a more successful country we need to see an overall improvement in our population health, and we need to close the gap between the health of our wealthiest communities and the health of our poorest.

Only through an effective partnership can we make the best use of our collective resources and work together to tackle our most difficult challenges – making a real difference to the prosperity and wellbeing of our communities.”
Rt Hon Nicola Sturgeon MSP
First Minister of Scotland

Addiction is not a criminal justice issue but a public health issue which requires specialist training and insight into the medical and biopsychosocial nature of the illness.

Let’s transform the way in which vulnerable, people at risk access addiction healthcare. People have a right to be treated, not dismissed, and discharged.

However, due to cutbacks, long waiting times and lack of experienced in addiction trainings first responders, doctors, nurses and associated healthcare workers, people are being turned away instead of receiving treatment.

It is not good enough to say implementing addiction healthcare will cost millions, addiction and mental healthcare are already costing billions globally:
loss of family, loss of life does…unlike loss of income… is why many addicts turn to crime, prostitution…. to survive…

I am committed to overcoming prejudice, stigma, isolation and shame by personally striving for 24/7 within established A&E NHS Hospital settings, accessible inpatient and outpatient addiction public healthcare programmes to combat the opioid crisis, treat addiction and COD: the coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorder.

I want people in an addiction healthcare crisis be given the same opportunity I was given after a failed suicide attempt, and desperate for help, because I wanted the pain and suffering to end.

Elizabeth Hearn
LONGTERM RECOVERY
12th October 1988 –

Rewind to:

I am a person in longterm recovery. April, 1988 my family and partner were worried about the progressiveness of my addiction to opioids, valium and vodka… and were terrified I was going to kill myself…

I was angry, and hurt at being “found out.” The time for excuses, promises to change etc had run out… no longer an option, they knew enough to know I could not recover alone…

I spent a month in treatment. Sadly my chaotic behaviour, mood swings kept me barricaded….incapable of fully engaging in the therapeutic process…I was trauma reactive, ergo incapable of feeling safe enough to engage in treatment…so I complied, lied and faked being “on the programme…” which the counsellors decided was good enough to remain in treatment….

Nothing prepared me for leaving…I relapsed within a few hours…at the airport…with no defence against that first drink, I headed straight for the duty-free shop…and somewhere to switch Vodka into an Evian bottle of water….and make it onto the plane.

…I came out of blackout several hours later having no recollection of how I got home from the airport..and back into my apartment.

The next few months blurred into cycles of craving, binge, purge. Obsession, compulsivity, depression and anxiety meant I hid in my apartment, and wold come out of a blackout not know if if it was 5am or 5pm…and worst of all, not caring….

Every morning, my mantra: today I will I stop using….would stick, sometimes but not for long enough to get me back to recovery meetings…just long enough to feel better… I would…eat, sleep, begin connect with friends..… eventually the pain of living became unbearable, despite a failed suicide attempt…I knew I needed to get help….

After a horrible night of freebasing in a a crack den…I staggered into Central Park…looking for someone to kill me…

It was the darkest early morning in my life.. I left the park and jumped in a cab to get help at Payne Whitney Psychiatric Hospital…

Waiting for the admissions office to open I sat in the garden, so confused and scared…I had a moment of clarity…everything stopped….I heard a voice say: “Addiction is not going to kill you…you will lose your mind”….I saw “my movie” ….me….alone and insane..

Just as quickly as “spiritual awakening” happened….life resumed…and ….I knew I could get sober…simply because I wanted to … I was called in to talk to one of psychiatrists, a woman… sitting opposite me in A&E Hospital in NYC saved my life.

I sensed I could trust her…and shows speaking the language of recovery…plus sash explained to me…her training in addiction medicine meant that I was understood…not dismissed.

Her compassionate approach, addiction recovery insights and personal disclosure of her recovery experience indicated there was another way …and I was not admitted and probably mis-prescribed antidepressants to treat my opioid addiction.

That person who helped me begin to recover from addiction health crisis impacted and interrupted by a failed suicide attempt was an addiction trained psychiatrist, in a NYC, A&E Hospital setting.

Her suggestion, based upon her assessment of series of relapses after rehab and was to re-engage with 12step meetings, and the recovery community.”

I followed all the suggestions in my early recovery to stay away from familiar people, places and things that would perhaps case me to relapse…fortunately the cravings stopped the day I committed to my recovery, 12th October, 1988 and have not returned.

Recovery is a process… my NYC therapist’s knowledge of the American Society of Addiction Medicine changed my thinking about “what is addiction?” from one of moral failing to medical disorder….

Beginning on a path to substance use recovery for many people may not begin the way mine did in an A&E setting with a choice: be admitted for a medically assisted detox, or return to 12step meetings and connecting with recovery community.

In my role as an additions clinician and recovery advocate I continue to seek out ways to reach people who aren’t likely to engage with traditional healthcare systems, and it is my wish to establish A&E Addiction Healthcare Clinics (more about in the attached document) when people are ready, that links them to many options for healthcare, mental health care, and substance use treatment.

I credit my ability to initiate an immersive process the day of the night of my begging into addiction recovery….I would experience a spontaneous remission from addiction, and I have not used a mood altering drug or drunk alcoholically since that day: October 12th, 1988.

ADDICTION HEALTHCARE RIGHTS & RECOVERY
Recovery-oriented care is prevention, intervention, medically assisted detox, inpatient and outpatient continuing support, and connecting with a recovery community. Recovery is a way of life, an attitude, and a way of approaching life’s challenges. The need is to meet the challenges of one’s life and find purpose within and beyond the limits of addiction while holding a positive sense of identity.

Since the inception of Alcoholics Anonymous in 1939, clinical and recovery evidence demonstrates that when people engage in primary care addiction treatment, they have better outcomes than those not retained in treatment. Providing a safe place in which at risk, vulnerable people can be given a choice to engage in treatment is addiction healthcare human right.

Addiction is characterized by an inability to consistently abstain or reduce substance use, impairment in behavioural control, craving, tolerance, and interference with interpersonal relationships, occupational responsibilities, recreational activities, and emotional response.

Like other chronic diseases, addiction often involves cycles of relapse and remission and recovery is about connection – lets engage vulnerable, isolated and disenfranchised, at risk people to a compassionate addiction healthcare care regimen.

Otherwise, without treatment or engagement in recovery activities, addiction is progressive and will often result in disability, or premature death.

And while the cost of addressing every facet of the addiction crisis is substantial, the cost of doing less than what is absolutely necessary is far more.

TOGETHER WE CAN: strengthen our nation’s addiction prevention and treatment infrastructure and expand access to evidence-based care is working in partnership with addiction trained clinicians to pursue bold, systemic solutions.

There is no time left for incremental policy changes – we need to come together as a UNITED KINGDOM to both implement and fund addiction healthcare programmes that will comprehensively combat untreated, complex, co-occurring chronic disease of addiction.

In January 2019 I initiated a partnership with the American Society Addiction Medicine to provide evidence based ASAM “Fundamentals in Addiction Trainings” and the ASAM Strategic Plan: a biopsychosocial evidence-based addiction healthcare treatment pathway that UK first responders, doctors, nurses need to be trained in to effectively treat addicted patients.

In addition to the ASAM “Fundamentals of Addiction Trainings” I am proposing implementing 24/7 Addiction Emergency Care Clinics within A&E-NHS settings an autonomous clinic and ward for primary care inpatient care facilitated by trained in the ASAM “Fundamentals of Addiction Medicine” clinicians, first responders, doctors, psychiatrists, nurses, pharmacists, and associated healthcare professionals to work alongside the Scottish Recovery Consortium lived experience – support volunteers, 24/7 in addiction and mental health primary care integrated treatment programmes.

In my 28-year, professional role, as an addiction clinician, and a person in long term recovery (31years) I continue to advance the recognition of mental health and freedom from addiction as being essential to overall health. Such recognition and focus will help to improve access to and integration of addiction healthcare services, to support and sustain positive outcomes, and address gaps and disparities in service delivery.

Addiction medicine is a medical subspecialty, formally recognized since 1990, concerned with the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction, of those with substance-related health conditions, and of people who show unhealthy use of substances, including nicotine, alcohol, prescription medications, and licit and illicit drugs.

The American Society of Addiction Medicine, founded in 1954, by Dr. Ruth Fox, a psychoanalyst who in 1959 became the first medical director of The National Council on Alcoholism, an agency devoted to alcoholism prevention is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine.

She was founder and first president of the American Medical Society on Alcoholism and Other Drug Dependencies in 1954 and wrote, lectured and taught extensively on the subject. She also maintained a private practice and was one of the first psychoanalysts willing to accept alcoholics as patients.

She was a fellow of several groups including the American Psychiatric Association, the New York Academy of Medicine, the American Academy of Psychoanalysis, the American Health Association and the American Society of Clinical Hypnosis.

The ASAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction.

The ASAM Patient Placement Criteria uses six dimensions to create a holistic biopsychosocial assessment of an individual to be used for treatment planning:

• Dimension one is acute intoxication or withdrawal potential.
• Dimension two is biomedical conditions and conditions.
• Dimension three is emotional, behavioural, or cognitive conditions or complications.
• Dimension four is readiness for change.
• Dimension five is continued use or continued problem potential.
• Dimension six is recovery/living environment.

The ASAM plan outlines ambitious research goals aimed at leading scientific and medical progression in the field with renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the organization’s mission.
In addition to the ASAM “Fundamentals of Addiction Trainings”

RIGHTS & RECOVERY
Recovery-oriented care is prevention, intervention, medically assisted detox, inpatient and outpatient continuing support, and connecting with a recovery community. Recovery is a way of life, an attitude, and a way of approaching life’s challenges. The need is to meet the challenges of one’s life and find purpose within and beyond the limits of addiction while holding a positive sense of identity.

In partnering with the ASAM the opportunity is in strengthening the focus on the full spectrum of addiction medicine, science, treatment and care:
prevention, treatment, remission, and recovery.

The continuing efficacy of the ASAM’s guiding principles will continue to set standards, pioneer research, educate professionals and the public, and challenge stigma. ASAM will always endeavour to enhance the goal of treating addiction and saving lives.

The American Society of Addiction Medicine’s evidence-based training and Strategic Plan:

The ASAM “Fundamentals of Addiction Training”
https://www.asam.org/education/live-online-cme/fundamentals-program

The ASAM Strategic Plan
https://www.asam.org/about-us/about-asam/theplan

MANY PATHS TO RECOVERY.

• The long overdue need for specialised addiction medicine training and treatment directives in which addiction/COD is treated concurrently with related physical health, and social issues.

• Addiction healthcare treatment that combines essential medical and psychopharmacology interventions uniquely tailored to each person’s needs.

The use of medications for the patient with addiction involving opioid use can be appropriate across all levels of care. Pharmacotherapy is not a “level of care” in addiction treatment but one component of multidisciplinary treatment. While medication as a stand-alone intervention has been utilized in North America and internationally, ASAM recommends that the use of medications in the treatment of addiction be part of a broad biopsychosocial intervention appropriate to the patient’s needs and to the resources available in the patient’s community.

Addiction should be considered a biopsychosocial co-occurring disorder, for which the use of medication(s) is but only one component of overall treatment.

A BIOPSYCHOSOCIAL ASSESSMENT TEMPLATE:
http://publichealth.lacounty.gov/sapc/NetworkProviders/ClinicalForms/TS/AssessmentToolAdultsPaperVersion.pdf

The following is an extract from the ASAM Strategic Plan and provides guiding principles:

• Positive changes are seen as starting points for the recovery process: reduced harm, safer use, reduced use, moderation and potential abstinence.

• A comprehensive initial assessment will determine an initial personalized treatment plan based on substance use severity, the psychobiosocial factors, multiple meanings and functions of the behaviour, motivation to change, and insight.

• Effective treatment has a primary focus on engagement and therapeutic alliance throughout the assessment process that “starts where the person is” with compassion, respect and acceptance, because creating safety and support are seen as essential to the therapeutic outcomes.

• Teaching self-management skills to address urges and difficult emotions is often essential. An ongoing assessment throughout treatment deepens both client and therapist awareness of the addiction severity and its meaning and functions.

• Exploring the client’s resistance to change reveals the issues that need new solutions. As these issues are clarified, positive change goals around the substance use and these issues can be established.

And, finally, a personalized plan for pursuing these positive changes can be developed collaboratively between client and therapist. The plan may include a variety of therapeutic modalities, lifestyle changes, health practices and medications depending on the client’s needs.

I believe that appropriately trained medical staff, supported by trained volunteers with lived experience in personal recovery, can save lives, stabilise chronic to acute stages of addiction and negative prejudices which are common when dealing with these patients.

These efforts, in turn, can save lives, reduce the financial burden of treating addiction to the health care system and support the interdisciplinary addiction medicine team.

RESEARCH AND EVALUATION
These specialised in addiction medicine clinics will conducts high quality research that can broadens and deepen the understanding of addiction treatment and care delivery.

Principles of Effective Treatment

  1. Addiction is a complex but treatable disease that affects brain function and behaviour. Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased.
  2. No single treatment is appropriate for everyone. Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.
  3. Treatment needs to be readily available. Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immediately available or readily accessible.
  4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture.
  5. Remaining in treatment for an adequate period of time is critical. The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs.
  6. Behavioural therapies—including individual, family, or group counselling—are the most commonly used forms of drug abuse treatment. Behavioural therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships.
  7. Medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies. For example, methadone, buprenorphine, and naltrexone (including a new long-acting formulation) are effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use.
  8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. A patient may require varying combinations of services and treatment components during the course of treatment and recovery.
  9. Many individuals have co-occurring disorders with other mental illnesses, treatment should address both (and all), including the use of medications as appropriate.
  10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse. Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence.
  11. Treatment does not need to be voluntary to be effective. Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.
  12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signalling a possible need to adjust an individual’s treatment plan to better meet his or her needs.
  13. Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counselling, linking patients to treatment if necessary. Typically, drug abuse treatment addresses some of the drug-related behaviours that put people at risk of infectious diseases. Targeted counselling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviours.
  14. Moreover, engaging in substance abuse treatment can facilitate adherence to other medical treatments. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results. Highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive.

If nothing changes, nothing changes

COURAGE

Courage is the measure of our heartfelt participation with life, with another, with a community, a work; a future. To be courageous is not necessarily to go anywhere or do anything, except to make conscious those things we already feel deeply and then to live through the unending vulnerabilities of those consequences.

To be courageous is to seat our feelings deeply in the body and in the world.to live up to and into the necessities of relationships that often already exist, with things we find we already care deeply about: with a person, a future, a possibility in society, or with an unknown that begs us on – and always has begged us on.

To be courageous is to stay close to the way we are made. The French philosopher Camus used to tell himself quietly to live to the point of tears, not as a call for maudlin sentimentality, but as an invitation to the deep privilege of belonging, and the way belonging affects us, shapes us and breaks our heart at a fundamental level. It is a fundamental dynamic of human incarnation to be moved by what we feel, as if surprised by the actuality and privilege of love and affection and its possible loss.

Courage is what love looks like when tested by the simple everyday necessities of being alive.

Whyte, David. Consolations (p. 32). Canongate Books. Kindle Edition.

YOU CAN HEAL YOUR LIFE AND RECOVER

I am alone…in my childhood….abandoned, boundary violated, anxious and afraid…

I am feeling stronger today, less coughing and more rest. I know from my ACE life story that this illness has it it’s roots in my childhood.’s “fertile soil” of an addicted family system.

31 years ago I initiated the first of a few immersive processes that manifested as spontaneous remission from addiction and breast cancer.

Last week I initiated a process to unpack why I am ill with this reoccurring chest infection…as is my way..a compassionate immersive revisit into exquisitely painful early childhood memories…this healing process has been ongoing for many years…this time has been a profound return to deepening love, self care, and forgiveness.

“One of my earliest memories is from around age three or four—sitting in a dress by myself playing with a doll. I was fine playing, but the sense was that there was no connection. There was nobody around; I was completely isolated. This was safe, but there wasn’t a sense of happiness, only that I had figured out how to protect myself.” “By being alone.”

Mate, Gabor Md. When the Body Says: The Cost of Hidden Stress No (p. 263). Knopf Canada. Kindle Edition.

Thank you Gabor Maté for writing about this radically healing topic at length.

You can recover. All for help. Don’t stop asking why…what to do and how you recover.

A VISION FOR THE FUTURE

A Public Health Approach: Addiction Recovery

I am a person in longterm recovery. April, 1988 I endured a family intervention that was exquisitely painful for all of us…my family and partner were worried about the progressiveness of my addiction to opioids and terrified I was going to kill myself…

I was angry, and hurt. I had been “found out.” The time for excuses, promises to change etc had run out… no longer an option, they knew enough to know I could not recover alone…

I spent a month in treatment. Sadly my denial and disconnecting from reality blocked me from fully engaging in the therapeutic process…eclipsed by shame, anger and fear – my critic grew louder day by day…telling me I pathetic, horrible, person…

With no defence against that first drink, by the time I arrived at the airport, I headed straight for the duty-free shop…and then the toilets to switch Vodka into an Evian bottle of water .to wash down the valium…

…I came out of blackout several hours later having no recollection of how I got home from the airport..and back into my apartment.

The next few months blurred into a cycle of craving, binge, purge, compulsivity, depression and anxiety. Every morning I would say, today I will I stop using….and for a few days, I would…eat, sleep, begin connecting with friends…but too ashamed to return to recovery meetings..I was disconnected from reality, family, friends, suicidal… eventually the pain of living became unbearable, despite a failed suicide attempt…I knew I needed to get help….

31 years ago the person sitting opposite me in A&E Hospital in NYC saved my life. Her training in addiction medicine meant that I was not dismissed.

Her compassionate approach, addiction recovery insights and personal disclosure of her recovery experience indicated there was another way …and I was not admitted and probably mis-prescribed antidepressants to treat my opioid addiction.

That person who helped me begin to recover from addiction health crisis impacted and interrupted by a failed suicide attempt was an addiction trained psychiatrist, in a NYC, A&E Hospital setting.

Her suggestion, based upon her assessment of series of relapses after rehab and was to re-engage with 12step meetings, and the recovery community.”

I followed all the suggestions in my early recovery to stay away from familiar people, places and things that would perhaps case me to relapse…fortunately the cravings stopped the day I committed to my recovery, 12th October, 1988 and have not returned.

Recovery is a process… my NYC therapist’s knowledge of the American Society of Addiction Medicine changed my thinking about “what is addiction?” from one of moral failing to medical disorder….

Beginning on a path to substance use recovery for many people may not begin the way mine did in an A&E setting with a choice: be admitted for a medically assisted detox, or return to 12step meetings and connecting with recovery community.

In my role as an additions clinician and recovery advocate I continue to seek out ways to reach people who aren’t likely to engage with traditional healthcare systems, and it is my wish to establish A&E Addiction Healthcare Clinics (more about in the attached document) when people are ready, that links them to many options for healthcare, mental health care, and substance use treatment.

I credit my ability to initiate an immersive process the day of the night of my begging into addiction recovery….I would experience a spontaneous remission from addiction, and I have not used a mood altering drug or drunk alcoholically since that day: October 12th, 1988.

I initiated a series of immersive processes in my first recovery of recovery when I was diagnosed with breast cancer. I experience again the phenomena of spontaneous remission and thespians were clear of signs of malignancies when I went into for a biopsy two weeks later…

If I can heal my life from addiction and cancer so can you. I have decimated my life to helping others heal.

Which s why this proposed addiction healthcare innovative is so important to me… to help people with substance use disorders — from understanding the impact of social determinants of health, respecting an individual patient’s autonomy and empowering them to want to heal.

By creating an addiction healthcare environment that is, first and foremost, kind, the clici will provide an open gateway of support to a vulnerable population.

Under-resourced clients face challenges in accessing add-on healthcare and or linking together the different aspects of their healthcare.

They may have a GP appointment in one location and a hospital visit in another. For a person without reliable transportation, having to arrive to an appointment on time can be a hurdle. For someone involved in the criminal justice system, stigma and can be a deterrent for engaging in care.

Easy access: programmes and interventions can be established to help people feel safe, regarded and welcome, and this approach is more likely to produce positive future outcomes.

The American Society Addiction Medicine frame synced in with my recovery continuum of self-care….1-1 and group therapy, developing boundaries, ego strengths, resilience and recovery from trauma was held within the safety of therapy rooms, and small 12step meetings.

My home group was started by Betty Ford, the would visit regularly and share her experience, strength and hope..with us who remained in awe of her grace and effort with recovery…

My recovery tribe has grown throughout the years, I love the sharing of wisdom from peers, colleagues and people who inspire me to thrive…our collective primary purpose is to end the silence and stigma of addiction and mental health issues.

We are not silent. We are not alone. We are courageous, compassionate human beings.

Self -discovery sounds so much inviting than self-seeking, being of service is about connection, communication and collaboration: being available, present, and purposefully in the moment- becoming an asset within the community takes time to establish trust, and confidence in the recovery process.


My long term recovery experience continues to evolve, I love to raise awareness and inspire change in others… a continuing compassionate inquiry into understanding how our greatest challenges transform us by becoming valuable resources, assets, insights in the the human condition, and expressed compassion for the benefit of others.

I have helped hundreds of people recover. My commitment to addiction recovery extends to the wider community, I am proposing to UK Health ministers that we work together to implement addiction medicine trainings for all healthcare professionals and front-line first responders – with people in acute to crisis stages of addiction.

Addiction is complex to treat. Recovery is sustainable when the process is supported by holistic well being therapies: nutrition, EMDR, hypnotherapy, acupuncture, mindfulness meditation for stress management,and regular engagement with recovery communities via meetings and workshops.

Addiction impacts the immune system, the recommend establishing autonomous ADDICTION HEALTHCARE CLINICS in A&E-NHS Hospitals. Interdisciplinary teams with the additional benefit of lived experience volunteers work side by side with clinicians, and healthcare professionals.

I am an evidence and research based addiction clinician. Saving lives is what is needed. The quality of addiction treatment needs to accessible, 24/7. Lets make that happen.

ADDICTION HEALTHCARE
Mobile: +447894084788
Email: ELIZABETHHEARN.COM

ADDICTION & MENTAL HEALTHCARE

What is addiction:

Addictions—whether to drugs or to behaviours—share the same brain circuits and brain chemicals. On the biochemical level the purpose of all addictions is to create an altered physiological state in the brain. This can be achieved in many ways, drug taking being the most direct. So an addiction is never purely “psychological. All addictions have a biological dimension.

Addiction is any repeated behaviour, substance-related or not, which brings temporary relief or pleasure, and in which a person feels compelled to persist, regardless of its negative long-term impact on his life and the lives of others.

Addiction is not a criminal justice issue but a human justice, public health issue which requires specialist training in addiction medicine, and knowledge about the treatment of addiction.

The pillars of addiction person centred healthcare: prevention, intensive inpatient and outpatient treatment that support each stage of recovery from intervention through to continuing self-care supported by established recovery communities.

2% of US service providers are trained provide medications for addiction treatment. In the UK, 1%. There are abundant resources available to change how people engage in addiction treatment and recovery.

With over 30 years of personal addiction recovery and 27 years as a clinician specialising in addiction and mental healthcare inpatient and outpatient continuing recovery programmes in the UK, India and Australia I recommend implementing the American Society Addiction Medicine’s “Fundamental of Addiction Training” to educate, empower and support first responders, doctors, nurses, and associated health care professionals.

Training addresses the biggest problem: accessing 24/7 addiction healthcare clinics. A&E -NHS is the only available limited treatment option for people in active addiction seeking help in managing active addiction.

The global addiction recovery communities shared addiction healthcare vision is raise awareness of the need for autonomous addiction person-centred clinics to prevent, treat, and promote remission and recovery from the disease of addiction, and to provide resources for continuing research, education, trainings, innovation, advancement, and implementation of addiction science and care.

Given Glasgow’s opioid and heroin epidemic, the benefits of MAT: Medication-Assisted Treatment is an important tool in treating the chronic, progressive and potentially fatal disease.

Establishing autonomous 24/7 addiction healthcare clinics within A&E-NHS settings, a safe clinical setting where clinicians and lived experience volunteers can work, side by side to engage people, who want help, in accessing addiction healthcare.

Treatment programmes that implement Medication-Assisted Treatment in the form of Methadone, Buprenorphine (e.g., Suboxone), or injectable Naltrexone Extended Release (XR) (Vivitrol) to opioid use disorders are what is needed.Rigorous, evidence-based tapering guidance and best practices would help give both clinicians and patients confidence in the detox, treatment, recovery process.

Medication is meant to be used as a supportive tool and managed by qualified healthcare professionals in collaboration with addiction treatment trained specialists as part of a comprehensive therapeutic programme.

The fundamentals of addiction training ensure safety in the administration of Buprenorphine or Injectable Naltrexone XR used for MAT in the face of active heroin and or opioid use because this will precipitate withdrawal and the need for medical management.

Person-centred addiction healthcare programmes that utilise a multi-disciplinary approach to address the co-occurring disorders often found with the opioid epidemic is an extensive biospychosocial approach.

An expansion of the addiction healthcare clinical protocols is needed to ensure that MAT is only one facet of a comprehensive continuum of care: intensive inpatient and outpatient treatment and recovery programmes.

Of the available choices for Naltrexone XR and Buprenorphine. These medications must be made available to all patients with an opioid use disorder. Buprenorphine is a detoxification medication/taper and, when clinically appropriate, is can be used as MAT maintenance. The decision between use of Naltrexone XR or Buprenorphine for maintenance is patient centered.

The ASAM is supporting National Addiction Treatment Week in the US. Each year, National Addiction Treatment Week (NATW) raises awareness that addiction is a disease, evidence-based treatments are available, and recovery is possible.

This year, October 21-October 27, the week will highlight the critical need for clinicians to enter the field of addiction medicine. Clinicians trained in addiction are essential to fill the treatment gap between patients who need evidence-based addiction treatment and the insufficient number of clinicians qualified to treat addiction.

Along with its supportive partners, the American Society of Addiction Medicine (ASAM) will be hosting the week with a dedicated twitter handle @TreatmentWeek and using #TreatmentWeek to build important conversations on social media.

More clinicians trained in addiction are needed to overcome the addiction epidemic overwhelming the United States today. In 2018, approximately 20.3 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year.

More people died from a drug overdose than from car accidents in 2017, and nearly 88,000 people die from alcohol-related causes each year.

Only about 17% of those diagnosed with substance use disorder received the treatment they need. In 2018, an estimated 2 million Americans were addicted to opioids, yet only about 400,000 people received treatment at a specialty facility.

“National Addiction Treatment Week amplifies the crucial message that when patients are treated appropriately by certified addiction medicine specialists, we can save lives and improve treatment outcomes.

The medical community must be at the forefront of communities proclaiming that addiction is a chronic brain disease, not a moral failure, and as such must be treated with evidence-based, research verified care.” said Paul H. Earley, MD, DFASAM, president of ASAM.

To overcome the health crisis, we need to expand the number of medical professionals who understand the complexities of the disease and are trained to treat addiction. Only then will we see real progress.

FORGIVENESS.

Judgement detox: Whenever we judge, make someone wrong, blame, project, repress anger, hold resentment, and the like, we create an energy blocks.

Inspiring change, raising awareness begins with me…

As you go about your day, you can try to look upon each person you encounter with tolerance and understanding. Even if someone does something to annoy you, you could think about what each person has experienced in their lives and how that has shaped them. You might then remind yourself of the fact that we are all bound by the love of the universe.

Imagining that all of us share the same spirit, are made from the same material, and have experienced struggle helps us hold others in compassion. Frustration with others usually comes from seeing ourselves as being separate.

When we think in this way, we have less patience with the problems and fears that other people experience. When we realize our interconnectedness and the fact that we are not so different from each other after all, however, our sense of understanding for others grows.

We see that by having compassion for others, we also care for ourselves. Holding others in compassion today will allow you to connect to and share the universal spirit that flows through everyone.

If we choose to believe that we are helpless victims and that all is hopeless, less, then the universe will support us in that belief.

Our worst opinions of ourselves will be confirmed. If we choose to believe that we are responsible for our experiences, the good and the so-called bad, then we have the opportunity to outgrow the effects of the past. We can change. We can be free.

We can are allow/accept a situation as it is, that’s all. This “allowing to be” takes you beyond the mind with its resistance patterns that create the positive-negative polarities. It is an essential aspect of forgiveness. Forgiveness of the present is even more important than forgiveness of the past.

Remember that we are not talking about happiness here. For example, when a loved one has just died, or you feel your own death approaching, you cannot be happy. It is impossible. But you can be at peace.


What if it is a situation that I can do something about?

How can I allow it to be and change it at the same time?

Whenever anything negative happens to you, there is a deep lesson concealed within it,although you may not see it at the time. Even a brief illness or an accident can show you what is s real and unreal in your life, what ultimately matters and what doesn’t.

Seen from a higher perspective, conditions are always positive. To be more precise: they are neither positive nor negative. They are as they are.

If you forgive every moment – allow it to be as it is – then there will be no accumulation of resentment that needs to be forgiven at some later time.

There may be sadness and tears, but provided that you have
relinquished resistance, underneath the sadness you will feel a deep serenity, a stillness, a sacred presence.

The road to freedom is through the doorway to forgiveness. We may not know how to forgive, and we may not want to forgive but if we are willing to forgive, we may begin the healing process. It is imperative for our own healing that we release the past and forgive everyone.

Forgiveness means surrendering. We understand our own pain so well. Yet, it is hard for most of us to understand someone s pain who treated us badly. That person we need to forgive was also in pain. And they were only mirroring what we believed about ourselves.

I find that when we really love, accept, and approve of ourselves exactly as we are, everything in life flows. Self-approval and self-acceptance here and now are the keys to positive changes in every area of our lives.

Emotional freedom is actualising self love. Surrendering into stillness. Loving the self, to me, means to never, ever criticising ourselves for anything.

Criticism locks us into the very pattern we are trying to change. Try approving of yourself and see what happens. You’ve been criticizing yourself for years. Has it worked?

“A Course In Miracles calls a miracle a “shift in perception.” When we feel the pain but do not connect with the origin of the pain, when something in our present triggers a past hurt or resentment, it feels as if it is entirely about the present, and the past gets projected onto the present.

Problems that are loaded with past issues make the present feel unmanageable. Energy patterns that store memories can rise to a conscious level, be looked at for what they are, felt and released in what Sigmund Freud called, “making the unconscious conscious.”

Dayton Ph.D., Tian. Daily Affirmations for Forgiving and Moving On (Powerful Inspiration for Personal Change) (p. 370). Health Communications. Kindle Edition.

Elizabeth Hearn, HP/NCH. SMAPPH
ELIZABETHHEARN.COM
+447894084788

EASING INTO STILLNESS

Meditation on Gratitude and Joy


Let yourself sit quietly and at ease.

Allow your body to be relaxed and open, your breath natural, your heart easy.

Begin the practice of gratitude by feeling how year after year you have cared for your own life.

Now let yourself begin to acknowledge all that has supported you in this care:

With gratitude I remember the people, animals, plants, insects, creatures of the sky and sea, air and water, fire and earth, all whose joyful exertion blesses my life every day.

With gratitude I remember the care and labor of a thousand generations of elders and ancestors who came before me.
I offer my gratitude for the safety and well-being I have been given.
I offer my gratitude for the blessing of this earth I have been given.
I offer my gratitude for the measure of health I have been given.
I offer my gratitude for the family and friends I have been given.
I offer my gratitude for the community I have been given.
I offer my gratitude for the teachings and lessons I have been given.
I offer my gratitude for the life I have been given.
Just as we are grateful for our blessings, so we can be grateful for the blessings of others.
Continue to breathe gently. Bring to mind someone you care about, someone it is easy to rejoice for. Picture them and feel the natural joy you have for their well-being, for their happiness and success. With each breath, offer them your grateful, heartfelt wishes:
May you be joyful.
May your happiness increase.
May you not be separated from great happiness.
May your good fortune and the causes for your joy and happiness increase.
Sense the sympathetic joy and caring in each phrase. When you feel some degree of natural gratitude for the happiness of this loved one, extend this practice to another person you care about. Recite the same simple phrases that express your heart’s intention.
Then gradually open the meditation to include neutral people, difficult people, and even enemies until you extend sympathetic joy to all beings everywhere, young and old, near and far.
Practice dwelling in joy until the deliberate effort of practice drops away and the intentions of joy blend into the natural joy of your own wise heart.