PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

IT’S TIME FOR METHADONE TO BE PRESCRIBED AS PART OF PRIMARY CARE
BY JEFFREY SAMET, MICHAEL BOTTICELLI, AND MONICA BHAREL
This article was originally published by STAT: https://www.statnews.com/2018/07/05/methadone-prescribed-primary-care/ on July 5, 2018.

Opioid use disorder, which claims 115 lives a day by overdose in the United States, is a complex, chronic medical condition, but one that can be successfully treated with proven medications. And yet, one of the oldest and most effective medications to treat this disorder – methadone – is out of reach for many people, largely due to outdated federal laws.

Of the three medications approved by the Food and Drug Administration to treat opioid use disorder, federal law relegates only methadone to be dispensed in separate clinics apart from the general health care system. It’s not unusual for methadone clinics to be in out-of-the-way locations and often inaccessible by public transportation, especially in rural and suburban communities. When individuals trying to treat an opioid use disorder can’t get to a methadone clinic on a daily basis, they can’t get treatment.

The other two federally approved medications, buprenorphine and naltrexone, can be prescribed and administered in primary care settings, where treatment can take place as part of an overall clinical care plan.

Methadone is typically taken daily in a highly structured setting, an approach that benefits many patients. But methadone should be treated no differently than other FDA-approved medications for opioid use disorder. As we write in the New England Journal of Medicine, it’s time for Congress to remove this barrier to treatment and allow methadone to be prescribed in primary care settings, as well as in existing standalone clinics.

Only about 20 percent of Americans who have an opioid use disorder are being treated with buprenorphine, naltrexone, or methadone, a woefully small percentage that shows the extent of the barriers to treatment that we need to remove to stop this public health crisis. Restricting the availability of methadone to designated clinics has contributed to this treatment gap.

Methadone has been available by prescription in primary care clinics in Canada since 1963, in Great Britain since 1968, and in Australia since 1970. In these places, methadone is the most commonly prescribed treatment for opioid use disorder, and it isn’t controversial because it has been shown to benefit the patient, the care team, and the community.

Methadone works. In a 2017 review of all causes of death among people with opioid use disorder, those receiving this medication were one-third less likely to have died during the study period than those not treated with methadone.

Methadone is a synthetic opioid that reduces cravings and withdrawal symptoms for heroin and other opioids. Developed in 1937 as a pain medication, it was first studied as a treatment for heroin addiction in New York City in the 1960s.

By the 1970s, the system for delivering methadone that we know today had been fully developed. Patients visit a designated clinic, typically every day, take methadone under observation, and get specialized, highly structured care, including counseling and periodic drug tests.

The methadone clinic model was carved into law in the United States in 1974, when Congress passed the Narcotic Addiction Treatment Act. The regulations around methadone, driven by fears of accidental overdose and diversion, evolved in such a way that primary care physicians almost never delivered methadone treatment. Stigma and a not-in-my-backyard mentality resulted in the placement of a sizable number of methadone clinics in locations that were hard for many to reach.

The last time Congress expanded access to medication for opioid use disorder in primary care was when it passed the Drug Addiction Treatment Act of 2000. It allowed physicians to prescribe and administer buprenorphine in their offices, making this medication more available to thousands of patients. But the barriers to the delivery of methadone remain intact.

Methadone has saved many lives and could save many more. Several studies have shown that methadone treatment in a primary care setting is both feasible and successful. In rare cases, it has been allowed in primary care offices. Our experience in Boston over a 10-year period with a limited number of patients who received methadone treatment in a primary care setting after being stable in a methadone clinic was excellent, with no adverse incidents.

We call on Congress to allow methadone treatment to be delivered in primary care settings, as well as through special methadone clinics. That would be just the beginning. We also need to enhance physician training about opioid use disorder, create incentives for prescribing medications to treat it, and integrate treatment into existing models of care.

From the federal government down to community partners, we are all desperately searching for solutions to stem the opioid epidemic. Increasing the availability of medications that can effectively treat opioid use disorder – including methadone – will be essential if we are to succeed in saving lives.

Jeffrey Samet, M.D., is the chief of general internal medicine at Boston Medical Center and a professor of medicine at Boston University School of Medicine. Michael Botticelli is the executive director of the Grayken Center for Addiction at Boston Medical Center. Monica Bharel, M.D., is the commissioner of the Massachusetts Department of Public Health.

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

END STIGMA: Addiction healthcare is not a criminal justice issue…it is a human justice, public health and third sectors issue which requires holistic support, access to mental services, specialist trainings in addiction medicine, and public service education about the treatment of addiction.

The September 12th Scottish Parliament debate stresses an urgent health emergency is called for to action immediate changes.

https://www.scottishparliament.tv/meeting/members-business-scotlands-drug-death-public-health-emergency-september-12-2019

AREAS FOR IMMEDIATE URGENT CHANGE. Radical action.

STOP BUDGET CUTS: Driving forward investment in reform, policy changes, services and health services.

SHORT MEDIUM AND LONGTERM SOLUTIONS.

The right to health does not differentiate between mental and physical health. They are both central to human wellbeing. In reality, this is not often recognised.

Despite the significant social and economic burden of mental illness, provision for mental health often comes a very poor second to physical illness.

The need for specialised addiction medicine trainings and treatment directives in which addiction is treated concurrently with related physical health, mental health and social issues combines essential medical and psychopharmacology interventions uniquely tailored to each person’s needs.

New strategic opioid prescribing and tapering guidelines for specific pain needs can strengthen patient awareness of potential pain medication dependency/addiction in the longterm for short term pain medication.

Implementing Addiction Care Clinics within A&E-NHS settings where all healthcare professionals, doctors, nurses, first responders are trained in the fundamentals of addiction will saves lives.

It is time to include personal recovery into every aspect of the continuum including peer support, housing, and employment.

I am proposing a frontline lifesaving addiction healthcare services that tackle this health emergency crisis with the urgency and care it deserves.

Our aim is to provide comprehensive training for front-line medical staff, nurses, first responders and volunteers, in order that they can provide a compassionate and holistic response to drug or alcohol addicted adults who present themselves in crisis at Accident and Emergency Departments.

Mentally disordered individuals are often subject to multiple inequities, and to significant burdens of stigmatisation and marginalisation.

In the absence of resources, harsh restraint is used. Realising the right to health means refusing to discriminate against the mentally ill at all levels.

I believe in the efficacy of person-centred addiction healthcare and of a client’s right to safe prescribing, effective, inclusive and compassionate carewithout prejudice, fear of judgement or negative consequences.

Mental health issues and addiction are often inextricably intertwined. Some individuals begin their descent into addiction by trying to self-medicate untreated mental illness; others develop mental illness as a result of years of substance abuse. In either of these cases, successful long-term recovery hinges on addressing both of these issues in treatment.

Physical health can also be extremely damaged in multiple ways by long-term drug addiction. Effective drug addiction multidimensional assessment treatment programmes:

Addiction medicine trainings learning objectives offer interventions that are appropriate to specific substances and severity of usage pattern.

Respond to high risk alcoholic drinking with brief intervention strategies, appropriate to the patient’s willingness to engage in a medically assisted detox, inpatient continuum of care programme.

When appropriate conduct an assessment to provide a diagnosis and match the patient to an appropriate level of care.

The plan may include a variety of therapeutic modalities, lifestyle changes, health practices and medications depending on the client’s needs.

Recovery treatment plans are an affordable way to introduce this model through training experienced staff who are already working at the sharp end of the service with the support of peer-led trained volunteers who will also be based within these services.

I am a person in longterm recovery. I have 31 years of continuing abstinence from addictive substances and working in addiction and mental healthcare that began in in 1989 when I volunteered at the “Manhattan Centre For Living” co-founded by Marianne Williamson and Louise Hay. This experience of working side by side with holistic therapists prompted my trainings in addiction counselling and psychotherapy in America and England.

My work continues today in the capacity of Addiction recovery advocacy, educator, compassionate interventionist, counsellor, and clinician. I am an experienced group facilitator, former outpatient director, government advisor and broadcaster.

In addition to my role as the former Vice President to National Association Drug & Alcohol Counsellors (N.S.W) in Sydney, I advise the Australian Government advisory panel in harm reduction. .

I have worked in the private sector as the lead Primary Care Clinician in residential care settings in Melbourne, NYC, Pune, Delhi, Kent and London in England.

Prior to my recovery: former fashion magazine editor (Mode, Australia) art director, film and video producer (NYC, Tokyo, L.A. London, & Sydney.

I believe that by integrating the fundamentals of addiction training, providers as part of the dialogue with respect to the opioid epidemic can change the focus from a criminal justice perspective to a medical perspective.

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 other licit and illicit drugs.

I am dedicated to the universal recovery vison of overcoming prejudice, and stigma, (which stopped me initially from getting help when I most needed it) by making accessible inpatient and outpatient addiction medicine treatment programmes.

Motivating people to engage in the multiple programmes available, i.e. 12step fellowships, SMART Recovery, means addiction recovery continues to evolve into being better organised and supported.

I have worked successfully in treating addiction as a chronic primary disease of brain reward, motivation, memory, and related circuitry dysfunction, and how this leads to characteristic biological, psychological, social, and spiritual manifestations.

Many people/patients have gone onto train in the field, augmenting their recovery assets by maintaining the momentum/continuing self care that defines personal recovery.

Let’s change the way in which people in need access addiction healthcare.

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

At a record 867 drug deaths in 2016, and 247 deaths per million people, Scotland has the highest drug death rate in Europe: 12 times the EU average, 42 times Portugal’s rate, and 4 times the rate in England and Wales.

There is an HIV epidemic. Among Glasgow’s 500 street injecting population alone, there have been over 100 infections since 2015. In the 10 years prior to that, there were 10 infections per year in this group.
This is a financial time-bomb – lifetime treatment costs for someone with HIV are £360k.

Like many international cities, Glasgow has been ravaged by the opioid epidemic. Since 2000, annual overdose deaths involving opioids have increased tenfold, with a dramatic spike over the past few years driven by the spread of the highly lethal opioid fentanyl. In a recent survey, more than 1 in 4 Glaswegians reported knowing someone who had died from an opioid overdose.

The death toll is even more tragic in light of the many effective treatments for opioid use disorder that exist. Overdose-reversal drugs, naloxone and -approved medications for opioid use disorder — buprenorphine, methadone, and naltrexone — have all been shown to reduce overdose deaths.

Together we can actualise life saving services and dramatically reduce loss of life.


Posted on August 29, 2019 Edit

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

The opposite of addiction is connection, Johan Hari.

When there is an experienced person in recovery working alongside first responders, doctors nurses and healthcare practitioners the patient is able to be assessed for addiction recovery treatment.

Without training, the risk of being misdiagnosed, incorrectly prescribed medication, and discharged into the night without support. Relapse is inevitable when there is an absence of a continuing care programme.

It is time to change how vulnerable addicts in a health crisis receive healthcare.

Actualising acute care addiction clinics within A&E -NHS settings addresses the global health emergency.


Universal Addiction Healthcare was created in response to the consistently increasing number of drug and alcohol related deaths in the UK but particularly in Scotland.
The aim is to provide comprehensive training for front-line medical staff, nurses, first responders and lived experience volunteers, in order that they can provide a compassionate and holistic response to addicted individuals who present themselves in crisis at Accident and Emergency Departments.

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

I believe in the benefits of accessible and available addiction healthcare and of an individual’s right to expect effective, inclusive and compassionate treatment from NHS Services without fear of judgement or negative consequences

I am an addiction clinician and therapist, with 28 years of addiction healthcare treatment programmes experience, and 30 years lived experience to support fulfilling my professional and personal recovery obligation to provide addiction and mental healthcare to individuals and families in need of help.

In January 2019 I initiated a partnership with the American Society Addiction Medicine to provide evidence-based/fundamentals in addiction trainings and resources to augment healthcare providers in Scotland of the skills and knowledge they need to treat addicted patients.

I am proposing implementing 24/7 addiction emergency treatment clinics within A&E-NHS settings. facilitated by trained in the ASAM “Fundamentals of Addiction” medicine healthcare professionals, in addition to the Scottish Recovery Consortium lived experience – peer-led support volunteers for people in need to access available addiction and mental health primary care integrated treatment programmes to provide the most effective approach for supporting person-centred addiction and mental healthcare.

The following links reveal the backbone of the ASAM evidence-based research and teachings:

The ASAM definition of addiction:
http:// https://www.asam.org/resources/definition-of-addiction

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

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

Addiction and mental health disorders are medical conditions and their treatment has impacts on and is impacted by other mental and physical health conditions, integrated addiction and mental healthcare programmes can help address health disparities, reduce health care costs for both patients and family members, and improve general health outcomes.

Well-supported evidence shows that the current substance use disorder workforce does not have the capacity to meet the existing need for integrated health care, and the current general health care workforce is undertrained to deal with substance use-related problems.

Health care now requires a new, larger, more diverse workforce with the skills to prevent, identify, and treat addictive disorders, providing “personalized addictive care” through integrated care delivery.

A new strategic plan strengthens the focus on a full spectrum of addiction care: prevention, treatment, remission, and recovery.

• Biopsychosocial assessment
• Medically assisted detox
• Medically assisted treatment programmes
• Lived experience community support services

The New Model: Many Paths to Recovery.

• The understanding of addiction described above suggests the need for specialised addiction medicine training and treatment directives in which addiction is treated concurrently with related physical health, mental health and social issues.

• Universal addiction healthcare combines essential medical and psychopharmacology interventions uniquely tailored to each person’s needs.

It is time to put an end to v. long waiting times, overprescribing pain medication, and blocks to medication assisted inpatient treatment programmes. Let’s remove the barriers to accessing compassionate care.

We need clinics that support clinician and peers working side by side to educate, empower, inspire and help engage people in need in a recovery process.

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.”

– Desmond Tutu

The universal addiction and mental health care crisis has been building for decades—due to decades of neglect by political leaders.

Positive changes are seen as starting points for the recovery process: reduced harm, safer use, reduced use, moderation and potential abstinence.approach that tackles this crisis with the urgency and care it deserves.

Implementing Addiction Care Clinics within A&E-NHS settings where all healthcare professionals, doctors, nurses, first responders are trained in the fundamentals of addiction will saves lives.

It is time to include recovery into every aspect of the continuum including peer support, housing, and employment.

I am proposing a frontline lifesaving addiction healthcare services that tackle this health emergency crisis with the urgency and care it deserves.

Our aim is to provide comprehensive training for front-line medical staff, nurses, first responders and volunteers, in order that they can provide a compassionate and holistic response to drug or alcohol addicted adults who present themselves in crisis at Accident and Emergency Departments.

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 right to health does not differentiate between mental and physical health. They are both central to human wellbeing. In reality, this is not often recognised.

Despite the significant social and economic burden of mental illness, provision for mental health often comes a very poor second to physical illness.

Mentally disordered individuals are often subject to multiple inequities, and to significant burdens of stigmatisation and marginalisation.

In the absence of resources, harsh restraint is used. Realising the right to health means refusing to discriminate against the mentally ill at all levels.

I believe in the efficacy of holistic addiction healthcare and of a client’s right to safe prescribing, effective, inclusive and compassionate carewithout prejudice, fear of judgement or negative consequences.

Mental health issues and addiction are often inextricably intertwined. Some individuals begin their descent into addiction by trying to self-medicate untreated mental illness; others develop mental illness as a result of years of substance abuse. In either of these cases, successful long-term recovery hinges on addressing both of these issues in treatment.

Physical health can also be extremely damaged in multiple ways by long-term drug addiction. Effective drug addiction treatment must contain medical monitoring and interventions to ensure the individual’s health and safety during detox, treatment, and beyond.

Many individuals often fall prey to addiction in an effort to treat underlying chronic pain or other issues. Medical services can provide alternative, non-addictive ways of treating these triggering conditions.

Addiction doesn’t just destroy individual lives; it devastates families as well. By the time that drug abusers finally enter treatment, they have often caused considerable damage to their family relationships as well.

The guilt and shame over these damaged family bonds can often cause addicts to relapse even after treatment if they are not acknowledged and repaired, making family services an essential element in effective drug addiction treatment.

I envision implementing Addiction Emergency Care and Recovery Clinics within the A&E – NHS Hospitals for 24/7 people  in a health crisis  to be able to access to addiction primary care: 

  • Biopsychosocial assessment
  • Medically assisted  detox
  • Medically assisted treatment programmes
  • Long-term recovery community support services  

A biopsychosocial model treatment plan is a meaningful approach to trauma, pain and suffering. 

A proactive way forward would be to make addiction medicine directives including trauma recovery and, suicide prevention training mandatory for all NHS staff who receive mandatory physical health training: doctors, nurses, psychologists, allied health professionals and pharmacists will help children, young people and adults.

Addiction is a complex interaction of these vulnerabilities and is unique to each person giving rise to the reinforcing quality of the addictive personality. 

In this context, substance use intensity/risky behaviours take on complex personal and social meanings and functions that contribute to the addictive process. 

Common examples of addiction are in the self-medication of emotional pain.  People whose substance use serves important, often life-saving functions experience the substance as helpful; they are frequently in pre-action Motivational Stages of Change in which they are not ready or able to consider changing their behaviour. A

 The need for specialised addiction medicine training and treatment directives in which addiction is treated concurrently with related physical health, mental health and social issues combines essential medical and psychopharmacology interventions uniquely tailored to each person’s needs.

The treatment plan should begin “wherever the person is” in terms of a health crisis. There should be no “jumping through hoops” such as having to produce clean urine samples in order to access treatment services

A new strategic plan strengthens the focus on a full spectrum of addiction care: prevention, treatment, remission, and recovery. 

The plan includes: the voice of patients and their families and will highlight the personal experience of addiction in much closer view. 

Grounded in integrity, the plan outlines ambitious research goals aimed at leading scientific and medical progression in the field. It also exemplifies a firm recommitment to providing continued education for all treatment providers.

Renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the Universal Addiction Healthcare’s mission. 

The opportunity to set addiction healthcare treatment standards, pioneer research, educate professionals and the public, and challenge stigma is in treating addiction and saving lives. 

The following strategic plan provides a road map to guide and prioritize that way forward. 

  • 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 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.

Recovery treatment plans are an affordable way to introduce this model through training experienced staff who are already working at the sharp end of the service with the support of peer-led trained volunteers who will also be based within these services.

I am a person longterm recovery. I have over 30 years of continuing abstinence from addictive substances. In 1989 I volunteered at the “Manhattan Centre For Living” co-founded by Marianne Williamson and Louise Hay that prompted my training in addiction counselling and psychotherapy in 1991.  

My work continues today in the capacity of Addiction recovery  advocacy as a compassionate interventionist, counsellor, clinician, group facilitator, outpatient director, government advisor, broadcaster in addition to my role as the former  Vice President to National Association Drug & Alcohol Counsellors (N.S.W) in Sydney. Primary Care Clinician in residential care settings in Melbourne, NYC, Pune, Delhi, London & Edinburgh. 

Author, former fashion magazine editor (Mode, Australia) art director, film and video producer (NYC, Tokyo, L.A. London, & Sydney.

I believe that by integrating the fundamentals of addiction training, providers as part of the dialogue with respect to the opioid epidemic can change the focus from a criminal justice perspective to a medical perspective.

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 other licit and illicit drugs. 

I am dedicated to the universal recovery vison of overcoming prejudice, and stigma, (which stopped me initially from getting help when I most needed it) by making accessible inpatient and outpatient addiction medicine treatment programmes.

Motivating people to engage in the multiple programmes available, i.e. 12step fellowships, SMART Recovery, means addiction recovery continues to evolve into being better organised and supported.   

We are still very behind in the UK in treating addiction as a chronic primary disease of brain reward, motivation, memory, and related circuitry dysfunction, and how this leads to characteristic biological, psychological, social, and spiritual manifestations. 

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

In addition, I want to highlight that Overdose Presentation Centres (Supervised Injection/Consumption Sites) need to be a part of the conversation and the strategy. Unfortunately, they remain illegal. 

This is in spite of their successful operation and multiple scientifically valid studies that provide clear and convincing evidence of their efficacy in the opioid crisis.

From the recently published Scottish Drug Policy Reform:

A deadly snapshot – change is needed 

  • At a record 867 drug deaths in 2016, and 247 deaths per million people, Scotland has the highest drug death rate in Europe: 12 times the EU average, 42 times Portugal’s rate, and 4 times the rate in England and Wales. 
  • There is an HIV epidemic. Among Glasgow’s 500 street injecting population alone, there have been over 100 infections since 2015. In the 10 years prior to that, there were 10 infections per year in this group. 
  • This is a financial time-bomb – lifetime treatment costs for someone with HIV are £360k. 

Like many international cities, Glasgow has been ravaged by the opioid epidemic. Since 2000, annual overdose deaths involving opioids have increased tenfold, with a dramatic spike over the past few years driven by the spread of the highly lethal opioid fentanyl. In a recent survey, more than 1 in 4 Glaswegians reported knowing someone who had died from an opioid overdose. 

The death toll is even more tragic in light of the many effective treatments for opioid use disorder that exist. Overdose-reversal drugs, naloxone and -approved medications for opioid use disorder — buprenorphine, methadone, and naltrexone — have all been shown to reduce overdose deaths.

Together we can actualise life saving services and dramatically reduce loss of life.

UNIVERSAL ADDICTION HEALTHCARE


Universal Addiction Healthcare is a global healthcare initiative that provides accessible treatment options for vulnerable drug users who are choosing to engage in recovery treatment programmes.

We are proposing opening Acute Care Clinics within UK A&E settings where clinicians and volunteers work side by side to treat drug users.

In March 2018, the Drug Policy Alliance led a delegation of 70 U.S. advocates to Portugal to learn from its health and human-centred approach to drug use.

The trip provided an opportunity for drug policy reform advocates to appreciate how effective a dramatically different approach to drugs can be.
Read the briefing paper about the Portugal visit and the link to:

Drug Decriminalization in Portugal: Learning from a Health and Human-Centered Approach

Universal Addiction Healthcare was created in response to the consistently increasing number of drug and alcohol related deaths in the UK but particularly in Scotland.
The aim is to provide comprehensive training for front-line medical staff, nurses, first responders and lived experience volunteers, in order that they can provide a compassionate and holistic response to addicted individuals who present themselves in crisis at Accident and Emergency Departments.

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

I believe in the benefits of accessible and available addiction healthcare and of an individual’s right to expect effective, inclusive and compassionate treatment from NHS Services without fear of judgement or negative consequences

I am an addiction clinician and therapist, with 27 years of addiction healthcare treatment programmes experience, and 30 years lived experience to support fulfilling my professional and personal recovery obligation to provide addiction and mental healthcare to individuals and families in need of help.

In January 2019 I initiated a partnership with the American Society Addiction Medicine to provide evidence-based/fundamentals in addiction trainings and resources to augment healthcare providers in Scotland of the skills and knowledge they need to treat addicted patients.

I am proposing implementing 24/7 addiction emergency treatment clinics within A&E-NHS settings. facilitated by trained in the ASAM “Fundamentals of Addiction” medicine healthcare professionals, in addition to the Scottish Recovery Consortium lived experience – peer-led support volunteers for people in need to access available addiction and mental health primary care integrated treatment programmes to provide the most effective approach for supporting person-centred addiction and mental healthcare.

Vulnerable, at risk drug users human right is to receive treatment, not be dismissed, and discharged. However, due to cutbacks, long waiting times and lack of experienced in the fundamentals of addiction trainings: first responders, doctors, nurses and associated healthcare workers will soon be able to sign up for the American Society of Addiction Medicine training, so that people will no longer be turned away away instead of receiving treatment.

We are experiencing a health emergency. A radical restructuring of mental and addiction healthcare needs to actualise how people in need access and receive healthcare.

It is not good enough to say universal addiction will cost millions, actually addiction is costing people their lives…. addiction and mental healthcare is already costing billions globally: loss of income, loss of family, loss of life.

Changes in how vulnerable people access treatment is what I am suggesting for them to have a choice: a medically supervised impatient detox, impatient primary treatment plan with aftercare upon discharge to support the varying stages of addiction recovery or be discharged with appropriate medicine.

The NHS Health Scotland “Burden of Disease” study highlights that alcohol and drug dependence are major contributors to absolute inequalities and recommends that alongside other measures we must tackle conditions that are more prevalent within higher levels of deprivation.

Like many international cities, Glasgow has been ravaged by the opioid epidemic. Since 2000, annual overdose deaths involving opioids have increased tenfold, with a dramatic spike over the past few years driven by the spread of the highly lethal opioid fentanyl. In a recent survey, more than 1 in 4 Glaswegians reported knowing someone who had died from an opioid overdose.

The 2018-19 death toll 1,127, is even more tragic in light of the many effective treatments for opioid use disorder that exist. Overdose-reversal drugs, naloxone and -approved medications for opioid use disorder — buprenorphine, methadone, and naltrexone — have all been shown to reduce overdose deaths, but they aren’t consistently getting into the hands of the individuals or the communities that need them most.

What motivates me to continue to do service in the wider recovery community, to raise addiction awareness, and strive for essential changes in the dismissive, negative, judgemental language and perceptions that defines addiction? In my daily commitment to recovery I know I ned to reach out to my recovery tribe. It is my connecting with other recovering people that I feel “at home” accepted, seen and heard.

It is by overcoming prejudice, and stigma, (which stopped me initially from getting help when I most needed it) and making accessible inpatient and outpatient primary care, inpatient and outpatient addiction medicine treatment programmes that will save lives, NOW that is needed.

Let’s stop talking about what to do about addiction recovery ….we know what to do, and we know why people are dying from opioid overdoses…

I am currently engaged in forming strategic partnerships with Scottish recovery organisations to strengthen the focus on a full spectrum of addiction care: prevention, treatment, remission, aftercare, and re-generation of relationship with family, workplace and recovery communities.

The plan includes: patients and their families and will highlight the personal experience of addiction in much closer view aimed at leading scientific and medical progression in the field. It also exemplifies a firm recommitment to providing continued education for all treatment providers.

Renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the recovery from active addiction.

With a strategic plan in place, the opportunity to set standards, pioneer research, educate healthcare professionals and the public, challenge stigma, endeavours to enhance the goal of holistically treatments from medically supervised detoxes, to save lives, and reduce the financial burden upon the person in need of recovery, their family and community..
This strategic plan provides to guide and prioritize that way forward.

• 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 empathy, 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 about 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.

It is time for sustainable addiction healthcare programmes, that are accessible 24/7.


BE WELL

I love Mark Hyman’s “BE WELL” enriched, empowered person centered approach to healing: science, medicine, nutrition, and humanistic philosophy. Life at its best..

I am a person in longterm recovery who loves thriving all the while optimizing my health.

I am not alone…change is a constant and when my selfcare is compromised e.g traveling l long distances, be it by train boat or plane…time changes alone wreak havoc to my continuing care rituals: intermittent fasting, organic veg and fruit juicing, protein dense plant based nutrition…. in addition to socializing, eating out in restaurants that look fabulously inviting for my inner junk food addict but not to my recovering higher self…who would rather skip a meal than have to eat out…but that’s me being socially challenging person…who does not drink, eat crap or suffer fools…but I digress.. ….what to do?

Easy! I can go with the flow, and apply my rule: go late, leave early…and relax my nutritional guide-lines…as I plan the time for a detox…

Constant cravings can also define addiction. I no longer need or want to graze…ergo no more sugar/carb spikes. because I am disciplined to not eat between meals.

Intermittent fasting is fabulous at restoring hormonal balance, gut integrity and rehydration. From that 8am first rush of cortisol, throughout the day my hormones fluctuate… when I have meetings to go to in Central London I carry my water bottle and emergency remedy…

Trial and error would describe the plethora of ways to treat vertigo…my chiropractor is fabulous with the Epley manoeuvre and I will book in a session before getting on plane or boat.

From the very first vertigo attack a few years ago, I woke up at 5am…to a kaleidoscope of flashings lights, feeling nauseous, but cold not move out of the bed for fear of falling over….I woke my husband who calmed me down by helping me sit up while he called 911…They suggested going to A&E, we did and the first doctor who assessed me said it was Benign Positional Paroxysmal Vertigo and admitted me to continue investigating….I had a brain scan, lumbar puncture, blood tests etc… the results came back confirming it was indeed BPPV….

What to do…took a wide range of supplements and having regular Epley manoeuvre’s at the the Chiropractor…escalating anxiety came roaring back into life, and it was only when I was borderline agoraphobic I decided to detox and book in for s series of B12’s i.v treatments and then regular 3 times daily sublingual drops…

…I am symptom free now for the past two months…the spontaneous vertigo/panic attacks could pass…if I knew how to process the escalating anxiety…took a few times to master fear by recalibrating my thinking….from trauma-speak “I am going to die” to “I am safe, I am in control, I have everything I need right now…” plus a few inhales and exhales to oxygenate my mind and body, also carrying a bottle of filtered water, from home and a bespoke B12 sublingual supplement…and the feelings pass.

My recovery toolkit: is a series of small actions…breathwork is perfect for reducing stress, regular yoga, walking, running etc…and are consciously gut cleansing e.g. reducing a lifetime of addiction to sugar, fat and salt…in addition to restorative afternoon naps (often) and sleeping in, again often… eating nutrient-dense foods, and taking time out every day to be ease in the stillness… just “be” is nectar for my soul…

I love silence…and fortunately for us I have the space at home to retreat to …

I inhabit a crazy, chaotic world…nothing is easy and nothing is as it seems… I have no control over what happens to anyone except myself…..ergo it is a relief at night to drift off with more than modicum of peace of mind…. just as intermittent fasting is fabulous for engendering a good night sleep, so too is turning of all devices off by a set time each night….until the next morning…

Our bodies love routine, and can recover from stress faster when we stop bingeing on fast food, munchies, or Netflix or social media….

Be well.

BE WELL: RECOVERY IS A LIFE SAVER….

Mindfulness & Recovery

I love my recovery life. 12step recovery community and mindfulness meditation saved my life. One is my lifeline, the other my anchor…

In treatment for addiction I learned of the 12steps, and the importance of engaging in the recovery community to stay supported, connected and sober.

Unfortunately I was not ready to let go, surrender and commit to a daily abstinence based programme. My time in rehab was one of resistance to change. I held onto anger, shame and feeling like a victim which was a setup to relapse art the first hurdle of sober living…

The anxiety became overwhelming and I felt pressure from my family to have solved my problem with using illicit drugs, and drinking alcoholically…I simply had not had my last drink or drunk… and I relapsed upon leaving treatment for the next seven months…everyday was the same, I would wake up, and not know for a few minutes whether it was 8am or 8pm…that is if I made it home….

The physical damage of using ever day was primarily to my mind…I had panic attacks crossing the streets of New York…and because increasingly isolated from family and friends and ended up with no-one except my drug dealer to call…

Because I could not surrender, life did for me what I cold not do for myself… Often all it takes is moment of clarity, you may know from experience a similar moment, where suddenly everything stops, you are present, you are aware that there is another way out of the madness of addictive addiction’s constant cravings, obsession, pain and suffering…and in that moment all you have to do is take a leap fo faith, trust the process and connect with a recovery community to learn from them how to change your thinking, feeling, behaviours…stop the madness of using even when you don’t to use…and that moment of clarity came at a time of desperation…

It was the hardest challenge I had ever faced in my life…when I had my moment of clarity… it was similar to when I had nearly downed surfing many yeas ago and my life flashed into my consciousness then I was rescued and dragged from under a massive wave and brought breathless back to the safety of the shore……or when I was held up at knife point, when someone had followed me home to my front door in NYC, and again my life flashed in an instant.. and I knew in that moment that this was not my time to die….and spontaneously hard-high-kicked the assailant who doubled over, and ran way….so too was that momentary realisation that addiction was not going to kill me …but I was losing my mind” …boom! I stopped. And have not used since October 12th, 1988. ….I call it my higher self…the voice of my soul…

That I was sitting in the garden of Payne Whitney Psychiatric Hospital, desperately seeking help, because I wanted to kill myself, and had taken myself to to the hospital to get help is a significant part of story …fortunately for me the admitting psychiatrist intervened in my life in a way that only a person in recovery can…they sat with me, and something happens that can only be described in that unique that two people in recovery connect, share our lives for a few minutes, without judgement, and with compassion, that profoundly helps one another….

I had relapsed upon leaving rehab that April and for seven months been on a slow suicide mission….we talked about this, what it felt like to spiral into thinking about dying as constant….and we talked abut recovery, connections, and community…they recommended I return to meetings, or be admitted, prescribed medication and left alone in a room, isolated and alone and if I did this my addiction would not be treated but exacerbated with a toxic medication regime….I chose recovery…left the hospital and returned to meetings, asked for help, and did 90 meet in 90 days…and with the help of my recovery tribe, I seized a second chance at being in recovery….

My higher self is my real-time guide to mind/ body balance, inner healing and self-discovery. And has help me create a life of inner peace, balance and clarity.

The aim of recovery is to build awareness and inspire change. The intention is to develop our capacity to learn how to live life with greater resilience, compassion and happiness. It is possible live a life without stress, anxiety, worry and fear. Mindfulness educates us in how to master our emotions to create a more fulfilling life.

Recovery cultivates the ways of maintaining a balanced attitude in day-to-day living. This ancient but perfect science, deals with the evolution of the mind. It includes all aspects of one’s being, from bodily health to self-realization. The term mindful is to be intentional in what we think and feel. Spontaneously open. Creative to unfolding opportunities possibilities.

Recovery is being authentic. Conditioned mind tells us untruths. Peeling away the layers of conditioned thinking is mindfully to engage in life with authenticity and autonomy. Insights gained are restorative and affirming.

MEDITATION: Be still my beating heart….A typical introduction to the art of meditation practice begins with awareness of the breath/breathing. This can be done standing, sitting or lying down. The intention is to interrupt our mental disconnection from reality when we are projecting into the future or ruminating on the past.

As thoughts continue to come and go the intention is to raise awareness of the physical sensations taking place during the process and not attaching any meaning to passing thoughts. Meditation practice evolves over time into including a body-scan, mantra, a mudra and restorative yoga postures.

Meditation taps into the constant dynamic interplay between our interior and exterior worlds. A cause and effect relationship that ripples through our essential being.

Addiction influences the brain’s complex reward circuitry systems. Mindfulness holistic therapies have a unique role to play in addressing addiction and mental health challenges when there is a greater focus on early interventions and relapse prevention.

Integrating stress-management is proving to be one of the most promising wellbeing/mental health strategies, and is non-stigmatizing.

Awareness of self is paying attention, on purpose, in the present moment. Cultivating a mindfulness meditation practice provides a “safe place’ and a personal sense of fulfilment when challenges arise.

Managing time is a benefit of mindfulness training. Learning the value in being able to “switch-off” slows down the brain’s autopilot set point. Just as we neuro-biologically hard-wired to connect, conditioned mind becomes “stuck” in reactionary life position.

“Although the practice of meditation is associated with a sense of peacefulness and physical relaxation, practitioners have long claimed that meditation also provides cognitive and psychological benefits that persist throughout the day,” says study senior author Sara Lazar of the MGH Psychiatric Neuroimaging Research Program and a Harvard Medical School instructor in psychology.

This study and many others from Harvard Medical School demonstrates that changes in brain structure may underlie some of these reported improvements and that people are not just feeling better because they are spending time relaxing.

There are many ways to cultivate the efficacy of mindfulness through repetition and regular practice until it becomes a natural everyday occurrence. Perfectionistic, fear-based thinking drives overthinking.

Maladaptive coping skills:

Internet addiction is endemic. The digital addict’s brain complex circuitry systems are impacted in the same way as illicit drugs, sugar and salt.

In a cause and effect world, everything is connected…so it no wonder young people are highly stressed, reactive, demotivated, anxious, discontented and depressed.

Mindfulness is not the silver bullet when addiction is active in a person. However, in my experience of working with addictive personality types of diverse cultures, ages and gender there is hope for change when the person is treated holistically – with a strong emphasis upon engaging in a medicially assisted inpatient detox & primary care treatment programme. Upon discharge, people are at their ost vulnerable, self needs to be factored into daily life…

Self care is an effective relapse prevention methodology….as is the importance of connecting with a recovery community support network. Physical wellbeing is vital. Enough sleep. Planning ahead to ensure there is always easily prepared food in the refrigerator needs to become a habit….


As simple as it sounds restorative mindfulness disciplines bring our focus back to the breath. Most people are surprised by their habit of shallow breathing. Learning how to breathe, deeply, longer and stronger is immediately energises the body. Getting comfortable in the stillness and silence of your thoughts is where people discover inner peace and clarity.

Mindfulness meditation invites the process of healing from within… Basically, mindfulness recognizes the Self and empowers individuals to act as a purposeful agent in their own lives and in the lives of others.

In its purest form Mindful Awareness has the potential to add value and freedom to every day living. To experience being here now in the present moment is recognising a powerful shift in energy and intention.

Learning how to manage mental stress reduces the volume of the “inner critic” relentless only negative self-talk. Teaching people to retrain their brain to interrupt the habit of overthinking is both empowering and esteem building for them and to observe the changes created by successfully incorporating mindfulness techniques is also rewarding for the practitioner.

Stress negatively impacts optimal wellbeing: adrenal fatigue is caused too much cortisol and not enough exercise, poor nutrition, sleep deprivation, and the absence of stress management

The issues are in the tissues. Mind body soul total health is mindfulness in action. Mindfulness helps us thrive, overcome addictions, be in community and connected to others and ourselves.

With over five decades of experience, I expertly guide people through a transformational journey of meditation with the practical application of breath work.

Clients learn breathing techniques and exercises that can make them happier, be more reflective rather than reflexive, gain focus, and make better decisions.

The power of meditation changes lives forever.
Elizabeth Hearn, Hypno-psychotherapist CHP/NC. Founder of the London-based UNIVERSAL RECOVERY MOVMENT http://addictionawareness.co.uk

Elizabeth works as a psychotherapist, consultant, educator, advisor, and broadcaster in London, Glasgow and Edinburgh. and is the founder of:

BE WELL
96 HARLEY STREET
LONDON W1G 7HY
+447894084788


BE WELL

My health improved and I began to thrive when I stopped using vodka, valium, nicotine and cocaine. A moment of clarity changed forever the illusion that escaping from reality was the solution to my pain, angst and unhappiness.

I am person in long term recovery. The foundation of my 30 plus years, lived experience began with an intervention by another person in longterm recovery. The admitting psychiatrist at a well known NYC mental health hospital whose assessment began with a leading question: “what are you willing to do to stop using addictively?”

The question shattered layers of denial….defence mechanisms built up to avoid reality, responsibility and recovery. I said I was willing to go to any lengths to be in recovery, stop the pain and start living.

Instead of being admitted, medicated and left alone….the psychiatrist spoke for a few minutes about what they had done to stop…I was relieved to hear that recovery works if you work it…and they recommended I return to the 12step fellowship, ask for help, get a sponsor and doing 90 meetings in 90 days.

I did. I surrendered to the illusion of being in control, stoped abandoning myself, took a leap of faith and began the journey of healing my soul from the hell on earth that is addiction…

….I began to trust myself, and allow others to help me…thus my humility kickstarted my recovery by letting go the illusion that I was alone, helpless and hopeless….

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY



“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


In order to positively impact the financial and emotional burden upon the A&E-NHS of vulnerable people seeking help with mental and addiction healthcare issues it is time to actualise expanded acute care clinics that can be implemented into the public health sectors.

I am a person in longterm recovery – 30 years of lived experience that begin with an encounter A&E following a failed suicide attempt. I failed not because I am alive today, I was fortunate to not have the courage to kill myself… flipping this into having the courage to live, is primarily because of an intervention by a psychiatrist in recovery who offered me choice: return to 12step meetings. OR be admitted, and medicated but not be treated for substance mis-use (cocaine) alcohol dependency (straight vodka), and prescription pill abuse (valium).

I returned to 12step meetings, which takes courage to admit defeat, and humility to ask for help…which I did as I spoke about the past 24 hours, walking through Central Park looking for someone to murder me…and that familiar feeling of desperation….something shifted… and I knew I needed to get help…I left Central Park and caught a cab to Payne Whitney, a psychiatric hospital where the intervention took place…

From that moment on I have never been alone in my recovery. I ask for help. I worked though the 12steps, and I took meetings to prisons, hospitals and homeless shelters.

In my lived experience, and my training in addiction counselling, psychotherapy, and as a clinician that people suffering who are within the spectrum of addiction: sex addiction, sugar, fat salt addiction, illicit drugs, prescription drugs, alcohol, and or workaholism…. whatever their drug of choice is, they cn recover…there is hope…to break the cycles of deep suffering.

Addiction is complex…and can be exacerbated by trauma from the past being triggered in the present…creating a cascade of obsessive thinking, (cravings) irrational behaviours (compulsivity) anxiety, depression and suicidal ideation.

My therapeutic biopsychosocial approach is compassionate, mindful and is about empowering people, meeting them where they are….when they in need of help with addiction.

Vulnerable, at risk 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 away instead of receiving treatment.

We are experiencing a health emergency. A radical restructuring of mental and addiction healthcare needs to actualise how people in need access and receive healthcare.

It is not good enough to say universal addiction will cost millions, actually addiction is costing people their lives…. addiction and mental healthcare is already costing billions globally: loss of income, loss of family, loss of life….

Changes in how vulnerable people access treatment is what I am suggesting for them to have a choice: a medically supervised impatient detox, impatient primary treatment plan with aftercare upon discharge to support the varying stages of addiction recovery or be discharged with appropriate medicine.

The NHS Health Scotland “Burden of Disease” study highlights that alcohol and drug dependence are major contributors to absolute inequalities and recommends that alongside other measures we must tackle conditions that are more prevalent within higher levels of deprivation.

Like many international cities, Glasgow has been ravaged by the opioid epidemic. Since 2000, annual overdose deaths involving opioids have increased tenfold, with a dramatic spike over the past few years driven by the spread of the highly lethal opioid fentanyl. In a recent survey, more than 1 in 4 Glaswegians reported knowing someone who had died from an opioid overdose.

The 2018-19 death toll 1,127, is even more tragic in light of the many effective treatments for opioid use disorder that exist. Overdose-reversal drugs, naloxone and -approved medications for opioid use disorder — buprenorphine, methadone, and naltrexone — have all been shown to reduce overdose deaths, but they aren’t consistently getting into the hands of the individuals or the communities that need them most.

What motivates me to continue to do service in the wider recovery community, to raise addiction awareness, and strive for essential changes in the dismissive, negative, judgemental language and perceptions that defines addiction? In my daily commitment to recovery I know I ned to reach out to my recovery tribe. It is my connecting with other recovering people that I feel “at home” accepted, seen and heard.

It is by overcoming prejudice, and stigma, (which stopped me initially from getting help when I most needed it) and making accessible inpatient and outpatient primary care, inpatient and outpatient addiction medicine treatment programmes that will save lives, NOW that is needed.

Let’s stop talking about what to do about addiction recovery ….we know what to do, and we know why people are dying from opioid overdoses…

I am currently engaged in forming strategic partnerships with Scottish recovery organisations to strengthen the focus on a full spectrum of addiction care: prevention, treatment, remission, aftercare, and re-generation of relationship with family, workplace and recovery communities.

The plan includes: patients and their families and will highlight the personal experience of addiction in much closer view aimed at leading scientific and medical progression in the field. It also exemplifies a firm recommitment to providing continued education for all treatment providers.

Renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the recovery from active addiction.

With a strategic plan in place, the opportunity to set standards, pioneer research, educate healthcare professionals and the public, challenge stigma, endeavours to enhance the goal of holistically treatments from medically supervised detoxes, to save lives, and reduce the financial burden upon the person in need of recovery, their family and community..
This strategic plan provides to guide and prioritize that way forward.

• 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 empathy, 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 about 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.

It is time for sustainable addiction healthcare programmes, that are accessible 24/7.

UNIVERSAL ADDICTION HEALTHCARE

A biopsychosocial approach to addiction medicine and primary care treatment is essential in treating addiction. Medically supervised and assisted detoxing will give a person the best chance at recovery from addiction.

It is a process, one that requires commitment and courage to change.

Addiction creates complex health issues: Disorganised obsessive thinking. Constant mental and physical cravings. Compromised nutrition – sugar, fat and salt fast-food addiction, can left untreated be the cause of metabolic syndrome.

The lack of love, meaning and purpose in the immediacy of daily life causes isolation and great suffering in the human condition. It is the pain of existence that cause many people to use additively something to fix them…

People who are not addicts, ( I am married to one) understand the gravitas of addiction by this simple statement “one is too many and a thousand not enough) and he observes and maybe triggered into wanting to control me…however we both know that isa ike bring to catch the wind…

I am person longterm. My recovery tribe – the global recovery community, is in multiple of millions, however it is an individual/person-centred recovery process….moreover the language of recovery is universal – I have sat in meetings India, Paris, Rome, Istanbul, and felt deeply connected to every single person in the recovery meeting room despite our language, cultural, class, gender and age differences.

…the connection we share is of of compassion, courage and kindness… inequality does not divide us..it is without a doubt the most humbling of life experiences to be in recovery..to be of service, to compassionately helps others in need of sharing their problems in staying and or live a sober life…one day at a time…

I can often get caught up in the madness that is 21st centre urban living, however I am mindful of the constant need to unplug my “wanting machine” pause, return to NOW…and detach from this insta-world of want….

When a person is given the all clear after undergoing rigours treatments for cancer the doctor will state that their metabolic syndrome is cancer free…( vital organs) and their body is self-regulating to a higher level of optimal health.

ACCESSIBILITY: Everyone has the right to the highest attainable standard of physical and mental health is a fundamental human right, protected by international law.

Although the right to health is legally grounded, universal healthcare is not about law, policy or prohibitions.

Universal Healthcare is the right to health in the day-to-day work of health care professionals within a universally accepted framework of values.

The right to universal health does not ask governments to commit resources they do not possess to the provision of health care. It asks those who make decisions that affect people’s health – be they health professionals, private corporations or public bodies – to promote and protect health, and to understand and to justify the effects of their decisions.

ACCOUNTABILITY
By signing international human rights treaties that affirm the right to health, a state agrees to be accountable to the international community, as well as its citizens, for the fulfilment of its obligations.

PARTICIPATION
The right to participate in decision-making is a guiding principle of all human rights. A human rights approach to health emphasizes that good health services can only be achieved if people participate in their design and delivery.

The involvement of peer-led lived experiences within recovery communities has been shown to increase the likelihood that the needs of the community will be met more effectively and thus contribute to achieving better health. Participation helps ensure that the health system is responsive to the particular health needs of disenfranchised addiction and mental heath groups.

You are not alone. May you find the help you need.

Posted on July 11, 2019