trends August, 2005	A publication of Treatment Trends, Inc 18-22 6th Street PO Box 685 Allentown, PA 18105 Publisher: Robert Csandl Managing Editor: Karen Tomlinson Production Staff: John Dillensnyder   Vol 4, Issue 4
Treatment Trends, Inc., 18-22 South 6th St., Box 685, Allentown, PA 18105
The advertiser assumes liability for all content (including text representations and illustrations) and agrees to indemnify Treatment Trends, Inc. against all claims. Upon acceptance, all articles submitted for publication become the property of Treatment Trends, Inc. No part of Trends may be reprinted without the express permission of the publisher.

MOVING TOWARD MINDFULNESS
By Robert Csandl, MHS, Executive Director

All around us there is talking, but is anyone listening? All around us people are looking but is anyone seeing, and even when we are eating, oftentimes we are not even tasting.

How often have you engaged a person in conversation and they are looking right at you but clearly, the mind is elsewhere? And how often is this us, with our mind off somewhere else, not able to give the person talking to us our full attention?

We live in a society in which employers want multi-tasking. Doing many things at the same time and usually none of them well. Present for the doing but unaware of what’s being done.

Imagine the impact of this on the individual. Is learning affected when it’s so difficult to focus long enough to actually hear? When you do hear, can you concentrate for longer than a moment, or does the mind quickly wander off again?

What is the effect of this when considering treating addiction or individuals with Mental Health problems or co-occurring disorders. Give thought to the person leaving prison after a few years of living in an environment where the only present moment you have seems to be in the future. And when the moment is now, the mind is so distracted that the present moment is here and gone without even being present to experience it.

It seems that this mindlessness is a common theme or practice in many parts of our society. Sadly, for its many practitioners, its impact is not even recognized.

Though mindfulness was a word heard years ago, it was only a little over a year ago that the possibilities of mindfulness became clearer to our agency. A therapist said that “mindfulness increased the effectiveness of cognitive–behavioral therapies” (CBT). Interested in increasing the effectiveness of our treatment efforts, opportunities were presented for us to further explore its possibilities.

During early spring, Thomas Jefferson Hospital in Philadelphia was running an eight week Mindfulness Based Stress Reduction Group. Each 2½ hour group easily brought the participants face to face with their own experience. In no time they had all the participants, mindfully meditating and aware of the unique qualities (body, mind, senses and emotions) of their own experience.

Participants learn to be with an experience for what it is. Experiencing what minds do, such as judgments, striving and expectations, jumping subject to subject, comparing, avoiding or thinking about the past or future; all are handy distractions from the present moment.

Since Mindfulness Based Stress Reduction is a part of Integrated, Mind and Body Medicine; several pathways were taught into the practice of Mindfulness. According to John Kabat-Zinn, PH.D, the founder of the MBSR program at the University of Massachusetts, Mindfulness simply means being awake in the present moment, paying attention on purpose and in a particular way. This involves the intention to pay attention, with curiosity and openness. There is no intention of fixing a problem but rather, making space to simply be with an experience without judgment.

The pathways into this practice are best learned experientially by doing and not through talking about it or through a book. During the 8 week MBSR program participants were taught to use sitting, breathing, walking, movement and body scans all as forms of mindfulness.

Science has found Mindfulness to have a myriad of applications with positive results. They include anxiety, depression, pain management and stress-related conditions such as high blood pressure and psoriasis.

Mindfulness is showing promising results in addiction treatment and is being used by the founder of Relapse Prevention, Alan Marlatt, Ph.D. He has developed the application of Mindfulness Based Relapse Prevention. Zindel Seigel, Ph.D., has developed Mindfulness-Based Cognitive Therapy, and there is also a Therapeutic Community in Texas utilizing Mindfulness, to name but a few.

It would make sense that the practice of Mindfulness will enable clients to have increased receptivity to not only Cognitive Behavioral Therapy but to all forms of therapy.

Treatment Trends has collaborated with Thomas Jefferson Hospital’s Department of Integrated Medicine to facilitate a 1-day training—Mindfulness in the Workplace this May. This was presented to a full house with no room to spare. People even came from Harrisburg. As a result of this training, enough additional interest was cultivated for the 8-week MBSR program to be run here in Allentown starting in September. This will be open to our staff and the professional community.

Two of our key staff members have attended the 7-day intensive professional MBSR training with John Kabat-Zinn and Saki Santorrelli; founder and director (respectively) of the U. Mass MBSR Clinic. We also have staff enrolled in the upcoming Zindel Seigel, 7-day Intensive Mindfulness Based Cognitive Therapy Training.

Recognizing the need for further staff development, our plan is to continue the practice, dialogue and training. We are also researching methods for future implementation at all levels of our services and are developing the research design to evaluate the results and hopefully to make a contribution to the growing body of science about Mindfulness. Meantime, we will let the experience unfold, being Mindful, and open to the generating of ideas and methods that will best assist our clientele.

US TN: DRUG COURT GEARED TO IMPROVE LIFESTYLES
8/7/2005 —Johnson City Press (TN)
Dee Goodin
© 2005 Johnson City Press

The group gathered in a Downtown Centre courtroom is composed of the usual players—a judge, prosecutors, defense attorneys and probation officers—but it's not the usual courtroom scenario. Judge Robert Lincoln, Patrick Denton, assistant public defender, Robin Ray and Chris Ledford, assistant district attorneys general, and members of Comprehensive Community Services are gathered around the courtroom table normally used by prosecutors.

As they do each Thursday morning, sometimes with Lincoln, sometimes with Judge John L. Kiener, the group of county and state officials discusses the progress of individuals enrolled in "Drug Court." The first 30 minutes of the gathering is more casual than formal; however, the focus of drug court is never lost, although there is often light-hearted banter around the high-polished table. Individuals express concerns as well as high hopes for many of the program's participants.

"To be honest, I'm worried about ( one of the participants )." Lincoln says, as a recent weekly discussion about the participants begins. "I guess we'll just have to see if he's had a good week."

A handout provided to each official describes each participant's drug preferences, such as amphetamines, alcohol or THC, ( tetrahydrocannabinol ) the active ingredient in marijuana. The sheets also give a breakdown of each participant's weekly progress, as far as employment and alcohol and drug counseling.

Michael Moore, manager and chief probation officer with the Washington County division of CCS, addresses Lincoln with one of his major concerns. "Judge, one of my worries is some of these folks come in so concerned about points they don't understand this is about an attitude and lifestyle change. A lot of them are still wanting to dress like they really don't care."

Lincoln nodded positively and said, "While I appreciate your concerns, I know you come from a military background, dress is a personal preference. It's one of those things that is hard for us to say anything about. I don't like tongue piercings, especially when they stand at the podium flipping them at me. But we can't judge individuals by their dress, their tattoos or their piercings. I've got clerks that wear jeans in court, and while I don't think that's appropriate, they aren't my employees."

Moore said, "But a person gets one shot at a first impression, and some of these folks come dragging in, looking like crap."

Again Lincoln nodded. "I guess we just don't understand the perspective from the other side."

For people in the program, the judge, who has the option of either tossing an individual into a jail cell or dealing with them less severely, is the bottom line. Or using Lincoln's description, "The hammer behind it all is the courts, it's the only way to keep the sanctions in place."

Moore explained that individuals not in compliance with rules and/or requirements of drug court, either lose points, have to do an additional number of counseling meetings or sometimes additional jail time. He said people with alcohol problems who meet the 52-week program's qualifications can also be enrolled.

According to Moore, drug court is designed for individuals using drugs. "If an individual is a drug dealer, they're not going to be in the program. They need to go to the big house."

For more intensive treatment, Moore said CCS now has an adult in-patient treatment center in Kingsport. The 28-day program can increase an individual's chance of success in the drug court program.

"If we can get them into the in-patient treatment program before getting them into drug court, there is a much better benefit (for the participants), and the chances of successfully completing program are enhanced enormously."

While the drug court was originally implemented using federal funding, matched by CCS, the program is now 100 percent funded by the organization.

"I've got a sign I made in my office," Moore said. " 'Being on probation was your choice, you could have chosen jail. It's still available.' "

WHAT IS RECOVERY?...
From JoinTogether Online at www.JoinTogether.org

Being "in recovery" is the phrase used to signify that someone no longer has an addiction. For many people, recovery means abstaining from drugs and alcohol. Others characterize it more broadly as having achieved a renewed state of well-being and connection with family, loved ones, and the community.

One's recovery status used to be a taboo topic; for many, it still is. However, people nationwide have started to speak out for and about recovery. People in recovery are joining forces with friends and family, learning to talk about their experiences and successes in ways that do not compromise twelve-step traditions of anonymity.

For too long, those affected most by the disease of addiction have been silent, and therefore absent from the public policy debate. Silence perpetuates the ongoing stigma about addiction and reinforces its stereotypes. The more comfortable people can be with openly discussing recovery, the greater chance we have to overcome discrimination against people with active or past drug and alcohol problems.

Alumni, Residents and Staff Enjoy Picnic
By Bill Stauffer, Program Director, Halfway Home of the Lehigh Valley

On June 18th, 2005, the Halfway Home of the Lehigh Valley observed its 32nd year of continuous operation at the Annual Picnic which was held at the Pavilions behind the Rose Garden in Allentown. The Annual Picnic has been held for at least the last 15 years and the day could not have been a better one for the occasion. In addition to the current residents of the facility, about 125 Alumni, families and children joined us to enjoy the event with a day of clean fun and lots and lots of food.

Some of our current residents shared afterward about learning how much fun they could have when not using drugs—more than a few for the very first time in their lives.Alumni shared stories of when they were n the Home and offered support for those currently in the Home in making connections to the local recovery community. One of the Alumni talked about how she got the first job she ever had while a resident in the Home over four years ago and how she is now a supervisor for the very same employer. Stories were shared of how homelessness and despair have been replaced with productivity and self-respect. Some found that they could look at themselves in the mirror for the first time in years. Others stated that this was “the very first time that they had received the tools they needed to live clean and sober.”

The Annual Alumni Award was presented by our Alumni President, Ken M. to an alumni who has donated a professionally prepared meal on New Year’s Day every year for the last four years.

What makes the picnic special is seeing the miracles that people have experienced through their personal journeys of recovery. It is also good to hear that many of our Alumni see the Halfway Home of the Lehigh Valley as a place of safety and often the first true home that they have known. There is a bond that people feel with this—their first home in recovery—that draws them back to celebrate with us year after year. Some come from as far away as Colorado to see old friends and recall the struggles they experienced and to let our current residents know that the journey is well worth the effort.

MODIFICATION TO LAW HURTS ADDICTS
By Bruce Walters, TCAP, February 2, 2005, The Morning Call

On December 1, 2004 Governor Ed Rendell signed into law Senate Bill 959. Effective January 29, 2005, Act 2004–233, limits judicial discretion when sentencing addicts to intensive long term treatment programs, or what is otherwise known as Intermediate Punishment.

It used to be that candidates were deemed ineligible if they were facing charges or one of eighteen violent crimes. The list of crimes remain unchanged from the letter of the law prior to act 233. Most crimes on the list such as murder, kidnapping and any crime of a sexual nature are appropriate safeguards needed to prevent predatory or habitually violent criminals, who are not likely to change, from inflicting harm on innocent citizens.

However, there are three offenses that should not have been included in the first place: “Any crime related to escape, aggravated assault and robbery.” The sound of the words: escape, aggravated assault or robbery can conjure up visions of a hardened convict scaling a prison wall, a stabbing, or an armed robbery respectively. Therefore, it is important to know that under existing law, failure to return to work release on time is also considered an escape. Taking a swing at, or striking a police officer or an emergency medical technician with a fist constitutes aggravated assault. And anything related to robbery can mean taking valuables directly from a person, transporting the robber, or simply conspiring to commit the offense.

Granted, these are serious offenses but they are also a symptom of addiction. Here’s why: As drug tolerance rises, so too does the intensity of withdrawal symptoms. Since larger doses are needed to obtain relief, a gripping sense of urgency to feed a growing dependence ultimately leads to desperate acts that often result in criminal convictions. In time, the seriousness of the offenses escalate in proportion to the growing severity of the addiction.

Already out of step with the realities of addiction related crime and what to do about it, Pennsylvania law–makers have exposed yet another layer of their profound lack of knowledge on the subject, by effectively expanding their denial of Intermediate Punishment to addicts who have committed even one of the eighteen crimes mentioned above within a period of ten years, regardless of prior record.

Intermediate Punishment was designed to reintegrate back into society, those addicts whose crimes are addiction driven. Research has shown that the longer addicts are kept in treatment the greater the probability of a successful outcome.

In Lehigh County our Intermediate Punishment program is called Treatment Continuum Alternative Project, or TCAP. When a defendant is sentenced to TCAP, they are admitted to Keenan House where they must spend from four to six months in residential treatment, then two to four months in a half way house phase, followed by up to one year of outpatient treatment at Confront. The first half of the year is spent on house arrest and the second half of the year clients are under intensive supervision by Adult Probation.

Gradual re-entry design allows a recovering addict adaptation time for assuming the added responsibility that comes with each new phase, while maintaining access to needed supports.

Thanks to the joint efforts of Treatment Trends, the Lehigh County Judiciary, Adult Probation, Pretrial Services, the Public Defenders and County Administration, TCAP has helped an increasing number of addiction based criminals to get well. Addicts who were once a burden on their families and society have become contributing members of our community by playing an active role as fathers, mothers, and good neighbors. Punishment does not rehabilitate. If it did, the Pennsylvania Department of Corrections would be able to easily accommodate the low number of re-offenders that its successful rehabilitation efforts would have produced. Instead, it is forever expanding.

According to the Pennsylvania Department of Corrections Population report, as of January 31, 2004 the total prison population was 40,836, an increase of only 394 inmates from the previous year. On the surface these numbers may seem to indicate a fairly stable crime rate. However, the day to day operations within the Department of Corrections, is dependent upon an ability to maintain a state of relative homeostasis by controlling inmate population. Therefore, it is a revolving door. Inmates, many of whom are actually more violent than those now excluded from Intermediate Punishment by Act 2004-233, are granted early parole and released into the community to make room for the ever-growing number of the newly convicted.

Like many,“ get tough on crime,” laws before it, Act 2004-233 was designed to give our citizenry added protection from violent predators. Ironically, it will only compromise our safety rather than ensure it.

CREATIVE SOLUTION TO HELP OVERCOME STIGMA
Reprinted from www.Jointogether.org

5/14/2004
Overcoming the stigma associated with having a substance use disorder is a challenge that confronts almost everyone in recovery.

Last year, Parents for Addiction Treatment and Healing (PATH) in San Diego created a 2004 "Faces of Recovery" calendar featuring photos and stories of thirteen people.

The people featured in the calendar are very diverse, including an actress and an engineer, a rock star, treatment professionals, parents and grandparents, and wives and husbands. The collection shows that addiction can strike anyone at any time.

The calendar's introduction states its purpose best: "We know that treatment for drug addiction is as effective as treatment for other chronic illnesses, yet the perceived disgrace associated with it and the misunderstanding of the nature of the disease interfere with access to quality treatment services and effective solutions that could save lives, heal families and build healthier communities."

PATH used the calendars as a fund raiser. The group quickly sold out of its supply, and plans to do another for next year.

RISKY NEEDLE PRACTICES AMONG INJECTION DRUG USERS IN U.S.
From CESAR Fax, July 11, 2005; Vol 14, Issue 28

An estimated 354,000 U.S. residents aged 12 or older had used a needle to inject heroin, cocaine, methamphetamine, or other stimulants during the past year, according to data from the 2002 and 2003 National Survey on Drug Use and Health. Many of these injection drug users reported engaging in unsafe needle practices the last time they injected drugs. Nearly two-thirds (64%) reported that they did not clean their needle with bleach and one-half (51%) reused a needle they had used before. More than one in ten (13%) reported using a needle they know or suspected someone else had used before them and 18% reported that someone else used their needle after them. Research has shown a strong association between injection drug use and the transmission of blood-borne infections (e.g. HIV, hepatitis B, and hepatitis C), particularly when needles are reused or shared, and injection drug users have high rates of such infections (see CESAR FAX, Volume 8, Issue 24).

SOURCE: Adapted by CESAR from Substance Abuse and Mental Health Services Administration, Injecting Drug Use Update: 2002 and 2003,” The NSDUH Report, April 8, 2005. Available online at  http://oas.samhsa.gov/2k5/ivdrug.cfm
 

Drug War Clock excerpted from www.drugsense.org

As of Friday, August 12, 2005:

MONEY SPENT ON THE WAR ON DRUGS THIS YEAR:

The US Federal government spent over $19 billion dollars in 2003 on the War on Drugs, at a rate of about $600 per second. The budget has since been increased by over a billion dollars..

State and local governments will spend at least another $30 billion.
Source: Office of National Drug Control Policy

 PEOPLE ARRESTED FOR DRUG LAW OFFENSES THIS YEAR:

Arrests for drug law violations in 2005 are expected to exceed the 1,678,192 arrests of 2003. Someone is arrested every 20 seconds.

PEOPLE ARRESTED FOR CANNABIS OFFENSES THIS YEAR:

In 2002, 45.3 percent of the total 1,538,813 total arrests for drug abuse violations were for marijuana—a total of 697,082. Of those, 613,986 people were arrested for marijuana possession alone. This is a slight decrease from 2000, when a total of 734,497 Americans were arrested for marijuana offenses, of which 646,042 were for possession alone.

PEOPLE INCARCERATED FOR DRUG LAW OFFENSES THIS YEAR:

Since December 31, 1995, the US prison population has grown an average of 43, 266 inmates per year. About 25 per cent are sentenced for drug law violations.

PREVENTABLE HIV INFECTIONS THIS YEAR

Nearly 4,000 new HIV infections can be prevented before the year 2006 if the federal ban on needle exchange funding is lifted this year. About 10 new cases could be prevented every day.