DSM-5 Draft: Call It "Addiction," Not "Dependence"

The guidebook doctors use to diagnose behavioral health problems is being revised to eliminate the term "dependence" and replace it with "addictions and related disorders." The change is one of many proposed in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the APA, the revision is intended to differentiate between normal withdrawal from a prescribed medication, and harmful behavior associated with non-prescribed substances.

You can read the full article from Join Together here. And here are some thoughts from the Discovering Alcoholic, who is skeptical the changes will benefit people seeking treatment.

What do you think about this proposed change in language? You can comment to the APA through April 20 through their Web site.

Marijuana No Big Deal? It Was For Him.

“It’s just weed!”

“It’s no big deal! It’s not like it’s crack or heroin.”

“It makes you all spacey, makes you laugh [cos it’s fun lol]! Go for it!”

Every day, thousands of teens pick up their first marijuana joint, because this is what they hear. They’re just looking for a good time. They’re curious. They think it won’t do any long term harm. Mike was one of those kids. He heard those things, too. But for him, marijuana became a very big deal. In fact, it became a trap that took ten years to get out of.

Mike started smoking weed at 16. For years, he used it just to relax, and no harm came of it. That soon changed. His grades started to suffer in college, and he dropped out. He drifted from job to job. He began selling drugs, was arrested for heroin possession, and did one year in jail. He continued to smoke pot with his friends and to deal with stress in his life. All the while, life’s opportunities were passing him by, but he was okay with that. He didn’t think much of it.

Things may have continued in a downward direction, had his probation officer not intervened in 2008. After a marijuana-positive drug screen, Mike was referred to treatment at Brandywine Counseling Alpha. His was one of 1613 admissions that year funded by the State of Delaware where marijuana was the primary drug of choice. He’d never tried to quit before, but he was open to the idea. It turned out to be much harder than he expected.

Mike’s counselor, Sara DeHoyos, worked with him to address his triggers for marijuana use. He tried other strategies to cope with stress. “I did other things like write music and play basketball,” he recalls. “I would let go of things I couldn’t control.” Sometimes, it worked, but sometimes it didn’t. He had to deal with the arrest and incarceration of his girlfriend, and a cutback in his hours at his job. When it became too much, it was just easier to pick up weed again. Marijuana was in his circle of friends, his mindset, and his thought processes.

Sara tried different exercises with Mike to increase his motivation to quit. They role-played, with him as the counselor and her as the client. He wrote a goodbye letter to marijuana. They talked about marijuana’s health effects: impairing the brain’s ability to form memories, exposing the lungs to more cancer-causing tar than a cigarette, and slowing coordination. Still, Mike struggled to stop using.

“Writing the goodbye letter would’ve helped if I was 100% sure about quitting,” Mike admits. “I did it to please my counselor instead of helping myself.” He wasn’t attending his required groups either. He had few options left: Transfer to a new counselor? Go to an inpatient program? Move to Florida to live with his father? None of those options was attractive.

One day, trying to make up his mind what to do, Mike asked his counselor a question. He asked her to make him a list. “Where will I end up if I keep using?” he asked. “What would happen?” Sara wrote down a long list and handed to him. Mike read it over. At the bottom, the last item caught his attention. It said, “Michael will be another statistic.”

That sentence hit him hard, and made him think. “Being ‘another statistic’ made me realize how serious addiction is, and that I’m not exempt from what it leads to. I didn’t want to be labeled in a negative way, and wanted people to remember me for something special before I’m gone.”

Around the same time, his probation officer violated him for continued drug use, and recommended a higher level of care. Mike’s mother suggested the same thing. Mike agreed with them. In May 2009, he agreed to enter inpatient treatment at Gateway Foundation for 4 ½ months. “I went to Gateway because I knew I couldn’t do this on my own, and I needed more intense treatment.”

He realized that drug use had caused him to settle for less in his life. He saw the opportunities he was missing out on. More intense and structured treatment was something he needed, and he even looked forward to it. “It was one of the best decisions of my life,” he says today. “I’m glad I went because I found out a lot about myself.”

Mike’s stay at Gateway was difficult, but it worked. He was finally able to quit marijuana. After his successful discharge from Gateway in October, he returned to Alpha for aftercare. He now has five months clean and continues to work with Sara on coping with anxiety and resisting peer pressure from friends to smoke weed. He knows staying clean will be a challenge, but he’s committed to his recovery, and also to sharing his story to help others.

“I wish people knew that marijuana can cause cancer and it ruins your brain cells,” he says. “It also takes away your determination to do more in life. Marijuana gets downplayed a lot because it’s not as harmful as other drugs, but it’s still a drug. People [who continue to use marijuana] will become content with life and may develop a non-caring attitude. They also are vulnerable to other drug use and severe health problems.”

The State of Delaware is working to reduce marijuana use from 16% to 12% among 8th graders, and from 28% to 21% among 11th graders, as part of the Healthy Delaware 2010 Plan. The goal is to prevent today’s kids from going down the road that Mike did. Because just like them, Mike never expected that picking up weed at 16 would someday land him in a drug treatment program.

He’s grateful to have found the help he needed at Brandywine and Gateway. It enabled him to avoid more jail time and is helping him rebuild his life. He looks forward to finishing his business degree, and continuing to pursue his music. “I feel motivated to do good things and take control of my life,” he says. “I think I can help a lot of people if I stay on the right track.”

BCI Alpha is funded by and is part of the system of public services offered by Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-472-0381.

The Magic Group

“Do Not Disturb. Magic Group in Session.”

There’s no such sign outside the door at the end of the second floor hallway, but if there were, that’s what it might say. It’s an exclusive club, invitation only. They meet here three days a week, from 9 AM to noon. And there’s a positive energy in the air; so much so, that walking in on a session feels like you’re interrupting something very important. Some have taken to calling it the Magic Group.

Whatever they call it, the group of 17 people at the Brandywine Counseling Lancaster Center is hard at work on their recovery. Sean, 28, who’s been attending for four weeks, describes what goes on. “It is at times really good, because we get a lot of people in here that are eager. We’ve got a good mix of people, different cultures, different people at different stages. [Some are just] starting to learn about their addiction; other people have been through programs like this before, and those people are willing to help other people.”

Sean is part of the IOP, or Intensive Outpatient Program. Run by counselor Janine Rinderle, the IOP consists of 3 hours of group counseling, 3 days a week, as well as individual counseling. It’s a higher level of care designed to help participants set and work toward their goals for recovery.

Brandywine introduced the service in 2009 at Lancaster and two other locations, realizing that traditional monthly counseling wasn’t enough for some patients. Unable to remain abstinent, they were at risk of discharge from the methadone program, which often leads to relapse. This was despite having consistent attendance and making a good effort in treatment. Patients who fit this profile and meet other medical criteria and agency requirements, are now recruited by staff for the IOP.

Sean was one of those on the verge of discharge. Traditional treatment had worked for him at first, but only for so long. “I just hit a crossroads after awhile, a couple months in. Once I got clean, I guess I needed something a little more than once a month. My counselor approached me to say they might recommend me for the IOP. I didn’t get too much information before I got in, because it was a new program.”

It was a similar situation for “Charles,” 38, who has been in the IOP for two months. “Recovery is hard for me. I was clean for five years straight. One day I relapsed, and since that time, I’ve been trying to pick myself up again. I thought I could do it by myself, but you can’t. When you’re an addict, you need help. You need the support.”

Joining the IOP is a big commitment. Participants not only have to be willing to do the work, they have to make time for the three hour sessions. “When I heard about the IOP, I was a little skeptical,” says Sean. “Coming here, it’s gonna cut into my time.” But his commitment brought unexpected benefits. “I’m a little more active. I wake up [and] get my day started a little earlier. And you meet more people here.” He’d never socialized much with other people on the clinic, but that has started to change.

Charles also came in with doubts. “In the beginning, I was a little nervous talking [in group], like everybody. But it’s coming along. I’m glad I’m in here. In group, we all get along. In the beginning, everybody was quiet, but we all give feedback now. I’ve got people to help me, and that’s what I like. Now I’ve got my support.”

Janine uses a wide variety of activities to help keep group members engaged, including psychoeducational components, art therapy, and goal setting. At times, she lets group members dictate where the topic goes. She has them practice relaxation techniques, and teaches skills to reduce anxiety. This is particularly useful in slowing down a craving when it occurs.

“Far too often, a craving occurs and is immediately acted upon,” she explains. “But if clients give themselves the chance to work through some of the thoughts associated with the craving, they may avoid following through with the urge to use.”

The most important technique she tries to use in group is a client-centered approach. “I want to create an environment where group members feel ownership of the group, where they feel safe and not judged. Giving members unconditional positive regard allows them to try new behaviors and ways of thinking within the context of the group. The group is a time where they can really work on things with the help and support of myself, but also the other group members who have been through similar trials and struggles.”

Charles has been able to take what he’s learned and make changes in his life. “The therapy she’s giving us, it’s good, believe me! I’m using the tools right now with this person in my life, a drug dealer. I’ve changed my ways with my behavior. All the feedback I’ve taken, it’s working for me.”

Sean has also gained insight from the group. “Being in a group helped a lot, seeing everyone else struggling, it wasn’t just me. I think it’s the more time in here, the more time we spend with the people, and the counselor. Three days a week and three hours long, that’s what’s really helping us.”

“The biggest progress I see in clients is a change in their motivation,” says Janine. “Many of them enter the IOP angry, frustrated, and hesitant; however, after a few weeks, I begin to see big changes in how they relate to one another, how much they open up in group, and the newfound motivation to become engaged and to take more of a proactive role in their recovery.

“I think the magic is that group members have become very close with one another. They meet three days a week and while some were hesitant at first to open up, it wasn't long before they were all sharing personal experiences. The closeness that has formed between them is, I think, what helps them feel supported and understood.”

The first seven members of IOP are about to successfully complete the program, many of them long-time drug users who have provided their first ever negative drug screen. There is a waiting list to get in. Many clients hear about the program by word of mouth, or when they see fellow clients like Sean sticking with treatment and doing better. “I think people are starting to hear more about it,” he says. “It’s starting to get a little buzz out there, as more people learn about it.”

Or they hear it from Charles, who would be back on the street right now if not for the program. They hear how the IOP turned his frustration into motivation. “I brought myself in here. If I’m doing it without missing days, that means I care. I want change. I take it one day at a time.

“The thing is good! I like it!”

Now that is magic.


Brandywine Counseling services are funded by and is part of the system of public services offered by Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-656-2348.

Recovery Month Contest: Make a Movie, Make a Difference!

Recovery Month is here, and BCI is celebrating with a contest! We want you to make a movie to spread the word that treatment works. What? You don’t have a video camera? No problem, you don’t need one, all you need is your keyboard. First, watch the clip below!



We made this movie about HIV prevention on Xtranormal.com. It’s a Web site where you type in whatever dialogue you want, and the cartoon characters say it. Then you add sound effects, actions, and expressions. When you’re done, publish it and share it with your friends. It’s fun, easy, and anyone can do it!

So our contest is called “Make a Movie, Make a Difference.” Here’s the rules:

1. Create a movie on the theme of recovery, treatment, HIV prevention, or any service BCI offers.
2. After you’ve published your movie, enter it in the contest by posting the link in a comment to this blog post. Email us your name and contact information to contactbci[at]bcidel[dot]org.
3. Entries are due by close of business October 29, 2009. Winners will be announced October 30, 2009. We will pick the best submission by a community member, and the best by a BCI staff member. Winners will get a prize to be announced, and your movie will be featured on BCI’s Web site.

We are looking for creativity as well as educational value. What would you say to support someone in their recovery? To tell someone where to go for treatment? To get someone to take an HIV test? Movie-making is a new and exciting way to get your message out. Maybe your movie will even “go viral” and be seen all over the net! What a difference that would make.

Those are the rules – everybody go to it!

Tobacco Addiction: Tolerable, or Treatable?

Should drug treatment programs be helping patients quit smoking? Historically, we look the other way. We see cigarette smoking as less of a health risk, and more difficult to quit, than illegal drugs and alcohol.

But some in the addictions field now say we should be doing more to help patients who want to quit. They point to the recent NIDA report, “Tobacco Addiction,” which summarizes the health risks and consequences of smoking, as well as medicinal and behavioral treatment options. Studies also show smoking can be a relapse trigger for drinking.

What do you think? Is a change in attitude needed? Is tobacco addiction tolerable, or is it treatable?

Should drug treatment programs address smoking?
	Yes, it’s a health risk, just like other drugs.
	No, let them smoke if they’re giving up other drugs.
Free polls from Pollhost.com

We Did It!

Delaware passed the FY10 budget early this morning with no cuts in program contracts to disability providers. We are so excited! It seemed inevitable there would be cuts this year that would force us to reduce services. But with your help, we wrote to the legislators and spoke with them directly about the value of addiction treatment. They heard us!

As we celebrate this victory, we want to say thanks to all of you who wrote letters and shared your stories. We want to thank DelARF for their work on our behalf. And we want to thank the officials and legislators, particularly the Joint Finance Committee, for their support.

Though we won this battle, we’ll continue to need your support in the future, so stay tuned to brandwinecounseling.org to see what you can do and when you can do it. Thank you again for making a difference!

A Dedication and Celebration, BCI Style (Complete with Water Guns)

BCI staff past and present, and our friends outside the organization, gathered June 24, 2008 for a twofold purpose. We dedicated our Outreach Center in honor of our first Outreach Director Linda DeShields, and we took time to pay tribute to our retiring Executive Director Sally Allshouse. In true BCI fashion, it was an afternoon of fellowship, recovery, and fun.

The afternoon began with a proclamation by Board President David Oppold dedicating the Linda DeShields Outreach Center. To the sounds of cheers, the ribbon was cut and a plaque was unveiled inside. Lunch was served, including dishes home cooked by staff, and tours were given of the renovated facility. Guest speakers then reminisced about Linda and honored her legacy.

James Harrison shared the story of how Linda recruited him as the first BCI employee to be previously a consumer on the methadone program. He also tells the story here. James recalled Linda’s work ethic, how she didn’t have a watch, or understand the concept of 8 hours and you were done. He recalled Linda sending him into a crack house to find a person. “I can’t go in there, I’m a recovering addict,” he said. Linda answered, “That’s why I hired you, go in there and get ‘em!” So James went in, because you don’t say no to Linda DeShields, and that person is doing well in treatment today.

Jack Booker, Linda’s oldest son, noted her unconditional love for her children. “When I think of my mom, I think about God, and to me, God is loving, caring, sharing, and helping.” In an emotional tribute, he thanked her for giving him the skills to be successful in life and for never giving up on her family. Her legacy includes daughter Rochelle who’s following in her footsteps as supervisor of the Needle Exchange.

Laurie Dyer, a past employee of BCI, recalled running a women’s group with Linda, and getting them makeovers at Wannamaker’s. Another time, they attended a workshop on African American heritage that ended with Linda initiating Laurie as an African American woman. “I was honored! I came back and told everyone, ‘I’m a black woman!’ and I am proud to say that today!” Finally, she recollected what it was like to take a trip with Linda as your backseat driver, pretending to be asleep, but somehow awakening at the moment you start to talk about her.

Shay Lipshitz said she is forever indebted to Linda, who hired her at BCI. Having been called away for a presentation and nearly missing today’s event, Shay recalled Linda’s words, “You always have to give something back to the house, and I hope I did that today.”

Sally Allshouse told of meeting Linda on her second day at work. “She looked at me, looked me up and down, and said, ‘Time will tell.’ She was the most amazing, strong, black woman. She loved her family, she loved God, and she loved working. She knew by giving back to her community, she would be rewarded. She adopted us. She would go eat anywhere. Every Thanksgiving, every Christmas, if she knew where you lived, she would show up. She was a Delawarean, she knew what it meant to live in Wilmington, to be raised in Wilmington, to have trouble in Wilmington, but she believed in Wilmington.”

Rochelle Booker, Linda’s daughter, thanked everyone for coming to celebrate her mom. She then introduced Sally and informed her this was a surprise going away party. (Actually it was not that surprising, as Sally found out a day before.) Rochelle noted that it was Sally who gave her her start. “I know when she saw my application, she probably said uh-uh. Another Booker? When you’re introducing someone this good, you can’t write nothin’ down. All I can say is thank you from my heart and I love you.”

Rochelle presented Sally with a baton to symbolically pass the torch to her successor, Lynn Fahey. Sally, in turn, brought some gifts for her staff. Explaining she was cleaning out her office and returning confiscated materials, she presented each manager with a toy water gun, to much laughter and applause. “If you know my staff, they can be a little raucous, and some of them have criminal histories!”

But this was only the beginning, as more toys were bestowed upon Lynn. Juggling balls, which every Executive Director needs. Punching bags for the days you get really angry. “Character In a Jar” for dealing with funding agencies who never play fair. “Whack a Mole” for dealing with all the BCI sites. “There's Alpha! There's Outreach! There's Lancaster! There's Newark! They keep poppin’ up!” “Grow a Therapist.” (Self-explanatory.) A foam sword to cut through the bull. Last but not least, the biggest water gun of all, because “When you have staff who are criminals, you need a really big gun. This thing will squirt, and Lynn, you’re gonna need to squirt!” All joking aside, Sally said she’s had the best 21 years at BCI, and 39 years in the addiction field, and it’s been a moment of joy every single day because she gets to see miracles.

Lynn Fahey thanked Sally for her caring over the years, for the opportunities and the life lessons, saying, “I will be doing everything in my power to continue what you’ve created and built.” She then presented gifts to Sally from the staff, reading a letter of gratitude for her leadership and dedication. Since Sally would not allow us to buy her anything, the staff made a donation of $600 to Brandywine Counseling in her name. Lynn also announced we will rededicate the Sara Allshouse Tree of Excellence, noting the tree trunk is a fitting symbol of her stable and strong leadership that enabled BCI to achieve such growth. Sally was also presented with a real, potted tree.

David Oppold read a letter from Senator Carper’s office thanking Sally for her dedication that has touched thousands of lives. The floor was then opened up to all the guests to share their stories, thoughts, and gratitude.

Steve Burns was given his start at BCI by both Linda and Sally. He recalled working as a counselor in Riverside, and one day Linda came and got everyone to go do outreach. Steve said, “I’m a counselor, not an outreach worker.” Linda replied, “Everybody’s an outreach worker today. Get your a** outside!” Steve thanked Sally for encouraging him to go back to school, and for her longtime support of the 1212 Club.

James Harrison described Sally as someone “to take a nobody and say you’re a somebody.” He also remembered spiritual experiences, like the time a Joint Commission challenge resolved itself not even an hour after Sally’s words, “Let’s pray!” Marge Flynn gave thanks for Sally’s support after her relapse after years of recovery, and eventually rehiring her. “That’s love! That’s recovery!” Laurie Dyer recalled how Sally made work pleasurable to come to every day, complete with pranks at the office and staff retreats.

Former staff member Joanne Coston noted Linda’s and Sally’s personal influence on her and on how she raised her kids. Consultant Dorothy Dillard presented Sally with the “Nth Chance Award,” after all those she gave a first, second, 50th, and 100th chance. Sally thanked us all and left us with these words: “If you don’t believe in recovery, and if you don’t believe people get better, then get out of the tent, because this tent is about recovery!”

What a day it was. Many more of us could have spoken yesterday if time permitted. Since I did not get my chance, I’ll do so now. It’s well known that Sally took a chance in hiring people new to recovery. But she also took a chance in hiring me to be her assistant. I came in with no non-profit experience, some grant writing ability, and a degree in chemical engineering, of all things. I knew nothing of addiction, and was dead set against working with “those addicts.” So much so, that I even turned down my second interview at first. But something stuck with me and eventually made me change my mind. I had interviewed at many non-profits, but this one was different. BCI was more rough around the edges, but behind that I saw passion, potential, and a refreshing frankness. Without meeting any other staff, I knew this attitude came from Sally, and I decided I wanted to work for her. And so it was that I got my big break in the non-profit sector, and also learned to open my mind to the unfamiliar and the exciting.

As yesterday’s celebration shows, that spirit is still here at Brandywine. It started with Linda DeShields and with Sally Allshouse, but will remain even after they’ve left. Thanks Linda, and thanks Sally.

Today is National Call-In Day to Include Addiction in Health Care Reform

National Addiction Health Care Reform Call-in Day: Make sure every health care reform bill includes addiction services. Take Action!

Call your members of Congress on TODAY, Wednesday, June 17, to tell them to make sure addiction prevention, treatment and recovery-support are included in Health Care Reform!

Today, June 17, the addiction prevention, treatment and recovery communities, along with allies from the mental health community, are hosting a Call-In Day to make sure that health care responses to addiction and mental health conditions are part of any national health care reform proposal considered by Congress. Call your members of Congress, and make sure our voice is heard loud and clear on Capitol Hill!

Background: Members of Congress and the Obama Administration are hard at work on proposals to reform the nation's health care system. Some drafts and proposals have already been released, and others will be released in the next few days. These bills will be reviewed, amended and (if all goes according to plan) voted on before Congress leaves Washington for its August recess. For more information about these health care reform proposals and NAADAC's responses to them, please visit www.naadac.org/advocacy.

So far, all of the draft healthcare bills or proposals include some mention of addiction and mental health. However, the serious discussions are just getting underway and strong advocacy will be needed to make sure that the full continuum of addiction and mental health services are included and will be available for people seeking recovery, just like any other health condition.

Click "Take Action" and then enter your zip code to get the names and phone numbers of your members of Congress.

Please join others from across the country to flood Capitol Hill with calls about the importance of including addiction and mental health services in health care reform!

This message was sent by the NAADAC-NAATP Government Relations Department, 1001 N. Fairfax St., Ste. 201, Alexandria, VA 22314 Ph: 800.548.0497 x129

The Real "War on Drugs": Treatment Vs. Your Brain?

Is "war on drugs" an outdated slogan? Gil Kerlikowske, White House drug czar, thinks so. He wants us to see addiction as a public health threat more than a criminal one. Courtland Milloy writes in the Washington Post that we could accomplish the same thing if we keep the slogan, but redefine what the "war on drugs" is.

It’s an interesting idea: Instead of casting the nation as the battleground, why not the brain of the individual drug user? Instead of the combatants as law enforcement vs. the criminal drug suppliers, why not the medication vs. the drug? Milloy’s analogy continues: Medication as a “rescue mission” inside an “occupied brain.” Drugs inside the body as a molecular “distribution network.” And drugs’ effects on the brain as “corrupt[ing] a ‘family of genes.’”

Gaining public support is important if we want to see more money spent on treatment and less on keeping drugs out of the country. For instance, researchers are developing the first medication for cocaine addiction which blocks the desire to use and the rewarding effects. Many would argue, we can’t stop drugs from coming here, and incarceration is of limited use, so why not shift these dollars toward promising research like this? But will the public support it? The old “war on drugs” lingo makes sense to people. Maybe they could come to understand treatment as a war, too.

What do you think?

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Should we keep the phrase "war on drugs?"

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Take a Video Tour of BCI Alpha

Are you thinking about getting help for drug or alcohol addiction, but aren't sure what to expect? Now you can take a "virtual tour" of the BCI Alpha Outpatient Program! Meet our staff, see each step of the process, and learn what you can do to be successful in treatment.



Thanks to Will Leitzinger who volunteered his time to film this video.

Write Your State Legislator: Maintain Funding to BCI

BCI clients, family members, and friends, you can help ensure that Delaware will continue to fund services for people served by behavioral health agencies. Here is a sample letter you can personalize and send to your State Representative or Senator.

We know the State of Delaware is facing a huge budget deficit for next year. If we make our voices heard, we may prevent a possible reduction or elimination of services for addicted persons and their families. If BCI has saved your life or the life of a loved one, please tell your story!

If you don't know who your legislators are, you can call the numbers listed here.

Your voice matters. Write today and give people affected by addiction hope for the future. Thank you!

When You've Got a Coach, Recovery is 24/7

"You want to go to Baltimore?" asked the driver of the car, rolling his window down.

Kevin looked in and saw a familiar face. It was Brandywine Counseling's Steve Burns. "Well, I don't have any money..." he answered.

"I didn’t ask you that," said Steve. "Get in the car. You’re going to Baltimore today."

Kevin got in. What followed turned out to be a major milestone in his recovery from drug addiction.

“We went to a Baltimore NA [Narcotics Anonymous] convention. And that was through the recovery coach program. They took me and a couple other guys there. And man, that was the best thing! I met my sponsor that I have today, at that NA convention. So it was because of the coaching program, I got the network I have today.”

Recovery coaching is a new program at Brandywine under the supervision of Steve Burns. A recovery coach provides peer support to a client in treatment, through telephone conversations, meetings, and outings like the NA convention. He or she works with the client to set and achieve goals like remaining abstinent, finding housing, and avoiding criminal activity. As Kevin describes it, his time with his coach is part social, part therapeutic.

“My recovery coach is Chuck Harris. Most of our contact is in person, but we do talk on the phone during the day. He’ll come by and pick me up, take me for a ride. We shoot pool at the 1212 Club, we’ll go out to dinner, we’ll go out to lunch, we’ll go over some literature of the NA books. He’ll call me on a regular basis, just to check how I’m doing. He stops by the apartment. He constantly makes sure that I’m okay, up here in my head. Always checks my behaviors. If he hears something through another person, he immediately comes to me, because I represent him as well.”

Chuck doesn’t work for Brandywine, but is a recovering person and an active member of the 1212 Club, Wilmington’s “recovery clubhouse” and safe haven. A recovery coach is not a counselor and not a sponsor, and isn’t meant to replace either one. Like a sponsor, the coach is based in the client’s living environment and holds them accountable for their actions and goals. But the coach also keeps in touch with the treatment program and documents every contact with a client. When someone is new to recovery, they often need time to find the right sponsor, and this was the case for Kevin.

“The sponsor I had at that time, we weren’t very compatible, and we weren’t really clicking, so I was looking toward finding a new sponsor anyway. But the recovery coach program ended up doing way above and beyond the way they explained it. They said you were going to be assigned to a person, and they were just basically going to be there for you. You would be able to call on them when you were having thoughts of depression, using, bad feelings, anything.”

Likewise, a coach is different from a counselor. Recovery coaching is a new concept that is gaining popularity as treatment programs realize they aren’t meeting all the needs of people new to recovery. Professionally trained counselors are great at providing therapy and intervening in times of crisis, but are unable to offer ongoing recovery support. Clients who don’t connect with their community AA or NA meetings, or don’t want to take part in aftercare, often relapse once they leave the treatment program. But a coach who was once new to recovery himself understands that in the beginning, someone may feel unmotivated, need emotional support, or have unmet needs like transportation or housing. Thus, the coach becomes the link between the outside recovering community and the treatment program.

This link was what Kevin had been missing in the past and why he hadn’t found long-term recovery. By the time he was 24, he had a 10 year history of marijuana and cocaine use. He had spent time in numerous treatment programs and in prison. His addiction took a tremendous toll on his family and relationships. “I pushed people away. I ended up stealing from people that loved me. They just didn’t want to be around me. My father had to bail me out of jail - a few times it was around $20,000. I ended up coming right out of jail, and skipping bail and getting high again. I actively used, every day, while I was still going to treatment.”

But last year, things began to change for the better. Following his latest incarceration, Kevin entered Gateway Foundation’s inpatient program for 6 months. From there, his counselor referred him to outpatient treatment at Brandywine Counseling Alpha. Two months ago, he enrolled in the recovery coaching program at the suggestion of his counselor, Alesha Russell. Today he has 8 months clean.

When you have a recovery coach, your recovery is 24/7, and that’s something Kevin has learned well in the past two months. The urge to relapse can strike anytime, whether you’re walking down the street on your way home, or something happens that tests a close relationship. As it turned out, his coach helped Kevin through an especially difficult time, in a way a counselor couldn’t have done.

“I was going through a relationship with a woman, and she had relapsed, and went back out and started using. I was frustrated, overwhelmed, depressed, and mad and sad, all at once, and with those type of feelings, you could use again. I called Chuck up, and I said, ‘Listen, man, I need to explain something to you.’ And I talked to him over the phone, and he said, ‘Hold on, I’m on my way over now.’

“So he came over and we talked, and he gave me some positive feedback. He says, ‘Listen man, she’s not ready. You’re going on your 8 months clean. A year is right around the corner for you. You’re just about there. You’re on your way. And she decided to make the choice to go back out. Her motives and her mind is not going to be at same level with yours anymore, so you need to let her go.’

“And I didn’t want to hear that at first, because I was attached to her emotionally. But as more time and the weeks went by, I started to evaluate and process the information he gave me, because he went through that himself. And today I do let people speak into my life, and I listen to them. And I let her go. I look at it as, if I didn’t let her go, I’d have probably been back out there. I would’ve drug me down. Not saying it would have, but you don’t rule nothing out, not in this business.”

Since Brandywine introduced recovery coaching a year ago, 32 clients have taken part in the program. They’ve looked to their coaches as cheerleaders, confidants, role models, problem solvers, and friends. Many, like Kevin, are now looking ahead to their goals for the future. He plans to become a professional barber, attending classes through Vocational Rehab. “I want to be a barber, become a sponsor, remain abstinent from all drugs and alcohol, and someday have another relationship with a woman, and be getting married and have my own family.”

Kevin feels like a new person today. He no longer uses drugs and has made changes in his life. “I feel like a productive member of society today. I feel like a normal human being. I can go walk down the streets and look people in the eyes, and know that I haven’t done anything two or three days ago that would make them want to not even be around me. I can walk past police officers today, and not have my heart start racing, or get paranoia because I did some type of crime four or five days ago, and my name might be all out on the computers. I can go in a store today, knowing I’ve got the money in my pocket to pay for it, and I’m not going to steal something. And also, most of all, I have my family back today. They let me in their homes, they let me spend the night with them today. They come see me. We do things. And just 8 months ago, they wouldn’t even want me in their house.”

Kevin gives his recovery coach a lot of the credit for his success. When asked if he plans to keep in touch with Chuck after his treatment ends, he responds without hesitation. “Most definitely. The recovery coaching program is awesome. I can’t even explain the things that has done for me.”

Recovery coaching is funded by and is part of the system of public services offered by Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-472-0381.

Sally Allshouse's Testimony at State Budget Hearings

Good afternoon and thank you for allowing me to speak on behalf of addiction services in Delaware. I am Sally Allshouse, Executive Director of Brandywine Counseling, Inc., an addiction treatment and prevention agency. I would first like to thank you for your efforts in the past and want to remind us all about the facts of addiction:

• One in four people between the ages of 15-54 has an addiction problem.
• One in four children lives in a home where alcohol is abused.
• Addiction is hidden in the diseases and injuries it spawns, including: Cancer, heart attacks, diabetes, hypertension, strokes, pneumonia, kidney failure, asthma, bronchitis, hip fractures, HIV/AIDS, and Hepatitis C.
• $10 billion in acute care hospital charges result from addiction in women over the age of 59. 98% was spent to treat the illnesses and injuries that are the consequence of addiction. Only 2% is spent to treat addiction.
• School failure, infant mortality or low birth weight, and child abuse are consequences of not treating addiction.
• More than 50 epidemiological studies in the past decade have found small to modest increases in the risks of breast cancer associated with drinking alcoholic beverages.
• Between 80 and 95 percent of alcoholics smoke cigarettes, a rate that is three times higher than among the population as a whole. Approximately 70% of alcoholics are heavy smokers.
• Adolescents who begin smoking are more likely to begin using alcohol and smokers are 10 times more likely to develop alcoholism than nonsmokers.
• Considerable evidence suggests a connection between heavy alcohol consumption and increased risk of cancer, with an estimated 2 to 4% of all cancer cases thought to be caused either directly or indirectly by alcohol.
• Fetal Alcohol Syndrome is the leading known cause of mental retardation in western civilization.
• Most teenage pregnancy cases result from unprotected sex, which likely occurs between teens who are under the influence of alcohol. Only 75% of teens use protection when sober, and as teens consume more and more alcohol, that figure decreases. Just only a little over 10% of teens remember to use protection when intoxicated, and because of this, the number of teenage pregnancies have also risen.
• Addiction is the leading factor in: 40% of homelessness, 38% of child abuse and neglect, 50% of domestic violence disputes, 50% of auto accidents and 62% of aggravated assaults.
• Every person in the US pays approximately $1000 per year for unnecessary health care, extra law enforcement, auto crashes, crime and lost productivity resulting from untreated addiction.

Why do I quote these numbers? It is because of your concern about cancer rates, infant mortality rates, HIV/AIDS rates, and tobacco use. It is a hard fact for us as a society to admit and say that unless we treat addiction and offer addiction prevention efforts, some of our major health concerns will not be addressed. I ask that you continue to support addiction treatment and prevention services.

Thank you.

Making Our Case: Why Delaware's Disabled Should Be Spared In Budget Cuts

This week, Delaware's Joint Finance Committee is hearing testimony from health and social service organizations as it prepares for difficult budget cuts. Several of our BCI staff are in Dover to speak about the importance of maintaining funding for HIV prevention and addiction treatment.

Yesterday, Connie Hughes of the Delaware Association of Rehabilitation Facilities (DelARF) testified on behalf of their member agencies, including BCI, who provide 80% of all services to disabled Delawareans. Through our contracts with the state, DelARF members provide job training, residential care, counseling and support services to 50,000 individuals and untold numbers of guardians and family members. Here are some highlights of what Connie said:

“Our goal is to work with the state to find a way to provide quality programs to as many people with disabilities as we can. We have already taken a variety of steps to maintain existing levels of service: we have created greater efficiencies in our existing programs, have begun to consolidate services by working collaboratively with our colleagues, and have explored areas where the state can reduce costs. Here are two recommendations we have to reduce spending and decrease costs:

“First, continue to invest in the community-based care that our members provide. Services to people in their own homes and communities are better, cheaper, and allow us to give them the right service at the right cost. Funding cuts in our cost effective programs will have unintended consequences that will actually increase the state’s deficit.

“Second, the cost of services delivered by private organizations like our members is less than the cost of those same services provided directly by the state. To decrease costs, we recommend that the state consider privatizing some state run programs.

“We recommend and feel very strongly that funding to serve these very vulnerable individuals should be maintained. But, if you find that funding reductions must be made, we would ask you to first consider several points:

"First, bring us to the planning table before the cuts are made. Not only will this process be better for us but it will also be better for the state. We can tell you how to make these reductions in a way that limits the pain to those we are all serving.

"Second, we have a moral, legal and ethical obligation to our clients and their families to assure that we are meeting their health and safety needs. Because we have received no increases in our reimbursement rates from the state for the past 4-5 years, we can no longer do 'more with less.' We will need to 'do less with less' in order to provide our services in a safe and healthy environment. On that point, we cannot compromise.

“I would like to say a word about our 5,000 member workforce. While they are not technically 'state workers,' they are 'the state’s workers,' doing the work of the state to serve this population. Their average wages still hover at the $10.00 an hour level. They have been heroic in their dedication to this population, often working several jobs to support their families. Further cuts to us WILL increase the number of unemployed Delawareans.”

Well said, Connie. Thanks on behalf of BCI and the people we serve.

Hospital-Based Outreach Connects Patients with Drug Treatment

Brandywine Counseling and Christiana Care have found that placing an intervention specialist on site at the hospital helps get people into treatment who otherwise were not seeking help for their addiction.

Since September 2008, a BCI staff member has been working full time on site at Wilmington Hospital. His job is to be available “on demand” to patients who show signs of substance abuse. The hospital staff sends him referrals mostly from the emergency room, but also the inpatient, outpatient, and CAPES (Crisis and Psychiatric Emergency Assessment) departments. Intakes for treatment are available on site two days a week. If treatment or other services outside the hospital are needed, we make the linkages and assist the patient in following through.

We saw a need for this service, just by looking at drug abuse as a health issue. Drug use is known to increase your risk of chronic disease, including heart disease and cancer. A recent study showed that over an 8 year period, Johns Hopkins treated over 20,000 patients who abused two or more drugs. The average health care cost per patient was about $1300. If more patients got into treatment earlier, it may potentially improve their health and also avoid future health care costs.

Here are the results of our project: In a 4 month period, 122 patients at Wilmington Hospital agreed to speak with our BCI liaison. Their most common drug of choice was alcohol. Over half had at least one prior treatment episode, but 35% had never been in treatment before. 99 patients were referred to a treatment program and 59 were successfully admitted.

The fact that 35% of people never had treatment before shows we’re reaching a population we wouldn’t otherwise come in contact with. It was also surprising that only 21% were homeless; whereas we thought the majority would be. So we’re seeing people who have some level of stability in their life, but haven’t recognized on their own the problems their addiction creates.

Wilmington Hospital tells us the response and need for service have been exceptional. The numbers certainly back this up. We’ll continue to keep you updated as this effort moves forward.

Children of Alcoholics Week

National Children of Alcoholics Week is February 8-14, 2009. This annual, national observance recognizes the damaging effects of alcoholism on children. Often, the people hurt most by alcohol abuse don’t even drink. They are the children of alcoholics. The 2009 campaign theme is “A Celebration of Hope and Healing.”

The National Association for Children of Alcoholics (NACoA) mission is to educate the public and raise awareness about the hardships suffered by children living in households with one or more parents who drink. Children of alcoholics can be encouraged and supported to seek out help and that they can and should have access to caring adults who are able to provide that help. Children of alcoholics and other drug dependent parents need to understand that addiction is a disease and that it’s not their fault.

Here are some tips from NACoA on how you can make a difference during Children of Alcoholics Week 2009, including:

• Speak out as an organization and as an individual.
• Ask Churches and Other Faith-Based Organizations to join in Children of Alcoholics Week.
• Help your local schools, treatment programs and faith communities become acquainted with SAMHSA’s free Children’s Program Kit

SAMHSA also offers many related resources, including the brochures, “It’s Not Your Fault.” And “It Feels So Bad. It Doesn’t Have To.”

Must-Reads 1/23/09

It's time again for our occasional series where we share some of our favorite posts from around the blogosphere dealing with addiction, recovery, and related issues.

The Give and the Take
Jim Atkinson looks at what alcohol added to his life when he first started drinking, and what it took away that made him stop.

Please Don’t Forget
From L.A.’s Homeless Blog, a poem about the unsolved murder of a homeless man. Heart-wrenching.

What If There Were an Alcoholic Gene?
A question from Etta at The Second Road.

Report: Needle Exchange Program Finds Mixed Success in Atlantic City
The challenges of NEP startup in neighboring New Jersey.

On MLK, Jr. Day: I, Too, Have a Dream
From the World of Psychology blog, some timely thoughts on stigma and the mentally ill.

Thank You Friends, For All You Do

Season's Greetings and Happy Holidays!

This holiday season, Brandywine Counseling wants to say "Thank You" to all our friends. All year long, you've given us the gift of your time and talents as volunteers, and your contributions as donors. With your help, we are helping addicted Delawareans change behaviors and attitudes. You are making a difference in the lives of so many people.

And if you haven’t given before, now is a great time! With a holiday donation, you can help us save lives, and you’ll feel wonderful too. Make a secure online donation on brandywinecounseling.org. Or, to donate by check, please complete our printable donation form and mail to the address provided. All donations to Brandywine Counseling are tax deductible.

We know it's important to you to see how your donation supports our work. That’s why you can watch us in action on the BCI Blog. This year, you saw it here first when we exchanged our 10,000th syringe, when we built our playground, and reduced our wait time. So stay right here to read our success stories, join in the conversation, and see how you can help.

From all of us at BCI, and on behalf of everyone we serve, have a very joyous holiday season. Thank you for your generosity in the past, and thank you in advance for your support in the future.

Must-Reads 12/4/08

From time to time, we're going to share with you some "must-read" posts we found around the blogosphere dealing with addiction, recovery, and related issues.

Beyond Recovery? The Discovering Alcoholic looks at a prescription heroin program in Switzerland and asks, can one be so far into their addiction as to be beyond recovery?

Are You All In? As the holiday shopping season gets underway, Alix at The Second Road ponders whether consumerism is a form of addiction. Especially now that it can end in fatality.

Five Million Americans Attend Self-Help Groups, SAMHSA Estimates – And nearly half of those who did were abstinent from drugs and alcohol in the past month.

Ask a Homeless Person: What Does Poverty Mean? – The Center for Respite Care Blog puts this question to their clients.

Leaders and Role Models - Action Strategy – The Tutor/Mentor Connection looks at how athletes or local celebrities can mobilize public support for a community organization. Any famous Delawareans out there who want to help out BCI? Get in touch!

Oxford House to Expand Delaware's Recovery Housing

In case you missed it, the News Journal ran an article on the planned expansion of Oxford House from 3 to 14 recovery houses in Kent and Sussex County. Included were some impressive stats on how effective the houses’ approach is:

A 2005 study by DePaul University tracked nearly 900 people in more than 200 Oxford House programs for 27 months, and found that more than 80 percent had stayed clean and sober, Malloy said.

Also, resident Jim Martin shared his inspiring success story.

"It's just an amazing gift, to wake up in the morning and be sober, and know my guys are going to help me keep sober," he said.

Oxford House is clearly making a difference. It’s good to know they will be expanding so more Delawareans in recovery can take advantage of what they offer.

The Great American Smokeout 2008

Today, the third Thursday of November, is the Great American Smokeout. This annual, nationally recognized health observance day was founded by the American Cancer Society in 1976. An estimated 15 million smokers are taking part.

Here are the rules according to quitsmoking.com:

You just quit smoking for the 24 hours of the Smokeout. The wonderful thing is that you won't be alone; you can swap advice, jokes and groans with the other "quitters," nonsmokers and the American Cancer Society volunteers who will be cheering you on. Even if you don't go on to quit permanently, you will have learned that you can quit for a day and that many others around you are taking the step, too.

And from SAMHSA, here is some information and resources to help smokers:

• The Centers for Disease Control and Prevention (CDC)offers many resources and tools such as RSS feeds, podcasts, and a public health image library. If you’d like more information on smoking and health, contact CDC at 1-800-232-4636 or tobaccoinfo@cdc.gov.


• The National Cancer Institute (NCI has many online resources and information regarding tobacco and cancer, including clinical trials, prevention, statistics, research, literature, and more. If you have a question about cancer, call NCI at
  1-800-4-CANCER.


• Smokefree.gov offers online guides about quitting, expert help via phone or instant messenger, and print resources. Visitors can chat with an NCI smoking cessation counselor using the LiveHelp system. Call from anywhere by dialing 1-877-44U-QUIT, or dial 1-800-QUITNOW for in-state assistance.

BCI Gets Out the Vote

This year, Brandywine Counseling helped give people in recovery a voice in the election. 23 of our clients at BCI Alpha registered to vote after counselor Susan Anderson posted instructions and a sample ballot. Today is the day! Vote!

SAMHSA's Public Attitudes Survey: What Does It Mean?

This week I received in my email box the press release for a new survey on public attitudes about substance abuse, treatment, and recovery, by the Substance Abuse and Mental Health Services Administration (SAMHSA). At a glance, it seems that the findings are encouraging. More than half of American adults know someone in recovery. A large majority believe recovering persons can live productive lives. About two-thirds of us would be comfortable being friends or co-workers with a recovering person.

Over at the Addiction and Recovery News blog, Jason Schwartz has a different and interesting take on these stats. He poses some thought-provoking questions about recovery and stigma. I encourage you to check it out and share your thoughts. What do you think is the real meaning behind these survey findings?

The Saying Goodbye to Addiction Tour at BCI

Brandywine Counseling has received a copy of HBO's "Addiction" DVD set from our friends at The Discovering Alcoholic, as part of "The Saying Goodbye to Addiction Tour." The idea is to send this excellent, award-winning documentary from program to program so that a wide audience may benefit from the information and first-person experiences.

What better way to close out Recovery Month here at BCI than to send the DVD on a mini-tour to all our different sites, and show it on a loop in our waiting area? So that is what we are doing starting Monday September 29. The package will make its way from Lancaster to Alpha, to Edgemoor, to Newark, and then to our Sussex County sites.

So be on the lookout for the “Addiction” tour when you’re at BCI in the coming week. Watch the film, take a look through the companion book, and leave your message in the logbook. If you happen to miss it, you can always catch it online.

Then after we’ve enjoyed and learned from it, join us in “saying goodbye” as we send “Addiction” on to the next deserving recipient, H.E.R.O.I.N. Hurts. This Delaware organization provides parents, family members, and friends of persons with addictions; with educational, emotional, and social support, which will enable them to advocate for health, security, education, and rehabilitation of people with substance addictions.

As TDA says, “Wouldn't it be nice if we all could say goodbye to addiction…”

5 Questions for James Harrison, Site Director

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: James Harrison
Job: Site Director, Lancaster Avenue
Time with BCI: 20 years

1. How did you get started working in the addiction treatment field?
I think mine was a unique situation. I was actually finishing up a three [year] mandatory prison term, and Kay Malone and Linda DeShields came to the Plummer Center in 1988, and at the time, the American Red Cross was providing HIV education in the prison. They had a gentleman that came in, and none of the inmates would respond to him. They were rowdy, they were disruptive. And so, the warden asked me if I would co-facilitate the group. And I agreed to it. And after his first presentation, I actually took control of the presentation.

All the inmates were extremely receptive. It was like hearing it from one of their peers. And this was a time when HIV and AIDS was at truly epidemic proportion in our city, and folks were dying within five years. And so I hollered out, “Listen up, people! I have some life-saving information!” And people were quiet. People listened. And that kind of opened the door for me to start doing some prevention education, after I was released. Of course, Kay and Linda DeShields agreed to hire me after I was released, waited five months for my release, and I’ve been here ever since.

Many people would be surprised to know that I’ve actually had a 30 year history with Brandywine. So, many folks, especially newcomers, oftentimes will not realize that I’ve spent ten years on the other side of the fence. And so, I’ve seen the changes we’ve made as an agency, particularly around process improvement and access, and just being kinder and gentler to the addict. I think what folks will not realize is that ten years as a consumer embedded an advocacy in me that will never leave. And so I carry with me, day to day, having to straddle both fences. I’m still in recovery, I will say that. I can always see the client’s view clearer in my head as I’m also trying to move our agenda, and move the agency to the next level. So when you first look at me, you don’t see the old James, and so that’s the piece that I carry with my job that many folks don’t know about.

2. What changes have you seen in your 30 years with BCI?
Part of what I’ve seen is a growing trend, that we’re seeing a younger, sicker population. And I look at all of the old-timers, for loss of a better analogy. They are the dying breed. I recall one consumer I saw yesterday, who has been with Brandywine [for] a 30 year history, is actually wheelchair bound, and blind. And that same person, I used drugs with, I hustled with, I participated in drug addict behavior with. And now this person is barely struggling to survive.

And I see on the other spectrum, young white females and young black males chronically addicted to opiates, but now struggling with HIV, mental illness, and addictions. And I think the most obvious change has been the severity of folks’ addictions and their problems, coupled with the social ills as well: increased gas prices, food, housing shortage. All those other issues, where I think years ago, folks could make it off of a year’s income of about $12,000, but now, that’s starving. And so, couple that with addiction that’s more severe in its nature, we’re seeing sicker and more violent individuals as well.

3. BCI was in the news last week because of the challenge of reaching black drug users with the needle exchange. What do you think it will take for this population to access these services?
There was a workshop I went to, years ago, that addressed this very issue. The name of it was, “Beyond Tuskegee.” And if you remember the Tuskegee experiments, blacks historically had a fear of public health systems, and the whole notion that, “This is suspect, in terms of, the government has its hands on it, and that law enforcement may use this as a vehicle to further disenfranchise us.” So getting beyond Tuskegee would say that, “No, this is not true. There’s not a great conspiracy theory around accessing needle exchange, or providing services in an outreach effort.”

I think we have to build a comfort zone for African Americans. It’s like, if they see me drink the water, then the water’s okay. But until they see it and watch me be okay, many times they won’t access. So I think the most valuable tool we’re going to have is our African American peers who currently work on the [needle exchange] van. For [drug users] to see, again for loss of a better analogy, that they too have drunk the water and the water’s okay. So there’s got to be a comfort level in saying, “You know what? Needle exchange is a good thing. It saves lives, it’s not connected to law enforcement, it’s not some sort of drug inside the syringes.” The belief that it is a good thing has to be kind of penetrated throughout the community.

And accessibility -- going into what we call the “red light district” of the city of Wilmington is challenging, especially with all the shootings. I don’t know if African Americans are truly the population who are now injecting at an alarming rate. Certainly we do have some folks injecting, but I also believe that this is a dying population as well. And more people, because of drugs being purer, are smoking and sniffing. And so, there may not be as great a need for syringes as we first thought. So I think a collective kind of effort with our Senator Margaret Rose Henry, who’s birthed this project, our community leaders, our naysayers, our people who advocate for this population, we all have to collectively come up with a strategy to keep pushing the message that the water’s okay.

4. You can tell a lot about a person from their office. Tell us what you have in your office.
My office is very eclectic. I sometimes am embarrassed about it! But I have jazz artwork here. I have New Orleans. The Nanticoke Indians, which never really got recognized during Mardi Gras, but they too decorated, and had the same kind of celebration, but never recognized. But then I also have one section that’s dedicated to family. I have pictures of my son who graduated from Villanova. I also have a collection of articles of the work we’ve done here at Brandywine, the projects where I grew up in as a kid, and articles saying, “A $10 bag of heroin approximate to the 95 exit [for] sale,” “Fewer resources spent on prevention,” and then one of Basha [Silverman] and a syringe-filled shooting gallery, which reminds me of the work that we do. And that’s in addition to the Comprehensive Accreditation Manual from Joint Commission, books around licensure, and policy and procedure manuals.

But I also have a snake to unclog many of the restrooms, and a quart of oil for some of our vehicles. And so, you can find anything from a light bulb to the 2007-2008 Delaware Psychiatric Residency program’s pictures, of which I’m also a part, doing some training with the residency. So I like to think of it as eclectic. I think there’s times when it’s more orderly than others, especially when visitors are around, but for the most part, it really depicts my work here at Brandywine. One minute I might be the janitor, one minute I am the clinical supervisor, the next minute I’m an administrative person, the next minute I am a client advocate. So it really depicts the changing roles I play.

I just recently described my job here at Brandywine to someone, and I said, “I can’t call it work, because it’s something I like to do.” Now, it just so happens I get paid for it, but even [in] absence of money, I would still be doing this type of work. So while the paycheck helps with the mortgage and the car payment and travel, absent of that I would still be doing the same thing I’m doing. So I’m fortunate and blessed that I can come and do something I was going to do anyway for the rest of my life, but get a paycheck for it.

5. If you had $30,000 to donate to BCI what would you do with it?
I think I would go to a learning institution and ask that we start a program specifically for addictions counselors to grow the work field. The major challenge is a workforce that’s declining. [BCI senior staff] will be leaving in a few years. We have a younger workforce, that I think for the most part, is not prepared for the challenges of a more sophisticated system, in terms of licensure, accreditation, and just maintaining a quality level of services.

So I would go to a Lincoln University, a Del State, or University of Delaware, and say, let’s have a name for a program specifically to grow the field. So I think that’s what I would do. While another clinic would be nice, a transitional house for recovering people would be nice, but I think if we don’t grow the field, we’re going to miss the opportunity to help people get better.

"Drugs Bring Death" - One Man's Sign Starts A Movement

In one Ohio city, a grass-roots movement against drugs has been started by one man with a handmade sign and a message that gets right to the point.

For about four hours, Jesse Lowe stood silently by himself holding a cardboard sign with three words scrawled in black marker: "Drugs Bring Death."

His message wasn't aimed just at the dealers or residents of the neighborhood scarred by shootings and fear. He wanted the city to hear him.
…

His wife, Cynthia, told him to take someone with him, but no one was willing to go along that first time. Neighborhood association leaders called his stand heroic while others said he was naive and putting his family at risk.
…

A week after that first protest, about 15 people stood with Lowe at another intersection in the same neighborhood.
…

"The courage of one man is spreading to everyone," said police Maj. Kevin Martin. "This is what the solution has to be. As police, we're limited in what we can do."

According to the article, there have been real results to come out of this campaign. Residents are more inclined to report suspicious activity; a coalition has formed among residents, police, and community leaders; and a website has been launched. You can’t help but admire the spirit of Mr. Lowe and those who later joined him to stand up to the drug dealers on their territory. The message certainly gets people’s attention as well. We wish them continued success in their efforts to clean up their city.

So is this the kind of “real solution” to drug-related crime that so many cities are looking for? And do you think it would work here?

An "Opioid Hit" From Your BlackBerry?

We in the addictions field like to say everyone is addicted to something, whether it be illegal drugs, alcohol, food, or caffeine. What about information? This article says that exposure to new and interesting information releases opioids in the brain, just as heroin does. We are biologically wired to seek out stimulating knowledge, news, or gossip because it gives us an “opioid hit.” But can this craving for information become harmful when done to excess, like compulsively checking your BlackBerry?

I am not a BlackBerry user myself, but I do have a habit of interrupting whatever I’m working on to open a new email. Even if I’m in the middle of something important, as soon as that email notification pops up, I need to find out what it is. Because you never know, it might be more something important than what I’m doing! Usually, it isn’t. But now I know why I do this. Darn you, opioids!

Friends & Families Picnic to Reunite Formerly Homeless Men with Their Families

You are invited to the Gateway House/Brandywine Counseling

Don Hofmann Memorial

FRIENDS AND FAMILY PICNIC

Saturday, July 19, from Noon until 5 pm

At Wilmington's Brandywine Park

(Next to the Wilmington Zoo)

BRING YOUR CHAIRS AND BLANKETS!!

If you would like to bring your favorite party dish

to share with the group that would be great!! (This is strictly optional)

The Friends and Family Picnic is a free, public event open to the community. The picnic gives Gateway House residents an opportunity to bring their families into their life in a non-threatening situation. Many residents need to mend relations with their families because of mistakes they made during their drug and alcohol addiction. The picnic is a welcome opportunity for friends and families to join in a resident’s new life.

Gateway House provides long-term, permanent housing for homeless men who are willing/ready to address the issues that caused or contributed to their being homeless. An estimated 29% of Delaware’s homeless report chronic substance abuse. With housing and treatment programs, many are able to overcome their addiction and become productive members of the workforce and society. Brandywine Counseling is proud to partner with Gateway House to put on this event.

Looking forward to seeing all our Friends and extended Family!!

5 Questions for Kim Ortiz, Nurse

5 Questions is our ongoing feature where we introduce you to the people who make Brandywine Counseling run, spotlighting a different staff member every two weeks.

Name: Kim Ortiz
Job: Nurse, Lancaster Center
Time with BCI: 2 years

1. What led you to work in addiction treatment rather than a doctor’s office or hospital?
Three experiences have prompted me to go into an addiction treatment center:

In addition to being a nurse, I am a musician also. I became acquainted with a fellow musician who started playing for one of my choirs years ago. I found out that he was an addict and learned about his cruel childhood and what triggered his drug use. We still managed to become the best of friends. On one occasion, I didn't hear from him for two days, which confirmed my suspicions that he must be using. By Monday, he came to my door, asking to take a shower. I refused to let him in my home. In fact, I packed his clothes, gave him $5 for gas, kissed him farewell, closed my door, and then slid to the floor in tears. He was as close to me as any brother could ever have been. It hurt to have to practice "tough love." But I did. The story goes on, [and] through his recovery process, we stayed in touch. It was this friend that taught me to have an open mind about people and not to be so judgmental.

Before I came to Brandywine, I worked at the Veterans’ Hospital. Many of the patients were current drug users. They were introduced to drugs while in the military, serving in various wars. While assessing some of my patients, I got to know many of them. I loved working there. To see the things they were having to struggle and deal with, it’s become a desire of mine to help people.

[Also,] I love psychiatry, getting to know people and what makes them tick. One of my dreams is to further my study so that I will better equip myself to counsel those that are in need. I play a major role in scheduling Dr. Tavani's appointments (the Psychiatrist here at Brandywine.) It's interesting to hear the experiences and challenges that our clientele have endured. The past-to-present stories of some of our clients would make the top best book seller's list and it wouldn't even be fiction! What better place to work than Brandywine, to touch these areas of interest for me?

2. The nursing staff sees our clients every day, when they come to your dispensing window. What’s your relationship like with your clients?
They feel like family to us. We get to know what's happening in their lives on a regular basis. They bring their children in, bring us pictures of their families. When a client comes to my window, if they’re having a problem with anything, I can talk to them. I think they feel comfortable at confiding in us about their lives, things that they might not tell other people here. I love talking with people and I love helping people, so I really count that as a privilege.

The thing that I value most in working here as a nurse is, that I am working with people that are the same as you and I. I believe most people have some type of addiction, whether it be food, sex, drugs, or working too much. It's what we do to try to make up for the off-balance that is reflected in our lives. I hate the stigma that's placed on [addiction]. We sometimes put people in this little box, and think that they all should be labeled as such, as an "addict." But the fact is, that these are real people, with real issues, real problems, and real concerns. If we treat them as such, I think we get back the same respect that we would expect. I wish our society would get out of the mindset that, "They are just addicts." Yuck!! No!!! A lot of them didn't ask to be in this position. If we could just be understanding about that, the world would be a much nicer place, as far as I'm concerned.

3. The BCI medical staff has been very involved in our P2R efforts to improve access to treatment. We’ve become less like a doctors’ office and more like an emergency room, with all walk-in intakes, no appointments. Do you think those changes have helped the clients?
I do. I think that it makes it easy. I can get a call on the phone today from someone asking, “How do I get into this program?" And I can say, "We're open every day of the week. Be here by 5:00 in the morning, Monday through Friday, first come, first served." If they want treatment right away, they know that we're available, we're flexible, and all they have to do is get here. Once they get in here, we take their names, and, 1-2-3-4-5-6! We take six people, Monday through Wednesdays, and two clients on Thursdays and Fridays. As long as they're willing to get here by 5:00 A.M., their chances of being seen are really good.

4. What advice do you have for someone who would like to do the job you do?
My advice would be to go in with an open mind, and to not have that judgmental stigma of people that are addicted to a substance. If they can block that out of their mind and realize with every client, there is a story. There's background history. And God knows, that if we read all of the background history that Dr. Tavani compiles on each client that she sees, some of our stigmas would definitely change. In many instances, it may not have been that client's fault that propelled them into substance abuse. What caused that client to use? Were they born addicted with an addicted parent to govern them?

If we could just get that stigma out, I mean, throw it out the window, and realize, these are people, just like those coming out of the hospital with physical ailments. Our clients have major physical impairments going on, maybe stemming from the experiences that have happened in their lives. Whether it was just choosing the wrong friends and someone starting them on the drug-use trail, as innocent as that may sound, now they're stuck with a habit that they wish they had never started. In all of this, remember that, many of our clients are here because they want help desperately. Do everything that you can to give them that help without enabling them.

5. What is the most rewarding part of your job?
There are several rewarding aspects of my job.

[First,] being able to run to emergencies. Just recently, we had somebody who had a seizure, and he fell out in the waiting room, and hit his head, and we had to call 911. I like trauma type settings, so when that kind of thing happens, it’s an adrenaline rusher for me. Being able to get that person revived, and get them back conscious. That’s firsthand nursing experience right there.

When a client comes to my window and tells me that they're going to a job interview, and they're afraid to reveal to the employer that they are on methadone, I feel their fear. I enjoy encouraging them, “Think positive! Hold your head up, and smile, smile, smile!” Reminding them that they are doing this for themselves, and they are doing all within their power to heal themselves, so they can do better in their lives. This is all that any of us want in our lives ... to do better. “So, go get that job! You're gonna do this for you!" Then, it really makes my day when they come back to report that they did indeed get the job, and thank me for being so supportive. Hallelujah!!!

Lastly, when a client finally gets to zero milligrams of methadone. It's a day of rejoicing!!! They've done their part in their treatment, and are finally able to walk away from here without any withdrawal symptoms. To God be the Glory!!!!

Alpha Program Shortens Wait Time, Reduces No-Shows

The BCI Alpha Drug Free Program is seeing our clients engage in treatment more quickly after admission. At the same time, we see the fewest no-shows we've ever had for appointments. These are our latest successes in Paths to Recovery, patient-focused process improvement without additional costs or staff.

In the month of April, our clients progressed from admission to their first unit of service (individual or group) in an average of 9 days, which is the fastest in two years. Our average had been 12 days.

These results came after we introduced a new service called the Meet & Greet. This is the first time the client returns after admission. On average, it's 4 days afterward. They meet their assigned counselor, review the program rules, view a ten-minute orientation video, and schedule their first individual appointment. It’s a much more streamlined version of how we used to do orientation. Previously, clients would not meet their counselor until the first individual, nearly a week later. Knowing how important it is to establish the therapeutic alliance, we made it a priority to push this meeting up as early as possible.

Also in the month of April, our no-show rate dropped to 19%, which is our lowest in two years. This is for individual appointments for all active clients. Our average had been 26%. Client retention is also better, with more people staying in the program past the 45 day benchmark.

This came about because of our new, retooled motivational incentives. Since February 2008, each client draws from the fishbowl once at every individual and every group. They can win credits of $1, $5, $10, or $50 which they can bank and redeem for prizes including gift cards, bus passes, and 12 Step items.

This is a real turnaround after we had used motivational incentives for a year without seeing improved no-shows. Before, there were fewer chances to win since draws were not done in groups. There were also “Good Job” certificates mixed in with the prizes which had no value in dollars, only as motivation. Turns out, they weren’t very motivational! So the “Good Jobs” are now gone, and every draw wins something. And the best part is, the cost to the program is about the same. Banking of credits is also new, giving clients a choice to cash in right away or save up for something they really need.

Both of these projects took a long time to fine tune and perfect. The Alpha change team worked at this week after week at our lunchtime meetings. Our ideas made sense, and we expected them to work, but if the numbers didn’t show it, it was back to the drawing board. In terms of the PDSA cycle, it seemed like we were stuck on "A" for “adapt.” It just shows that process improvement in addiction treatment is hard work. It doesn’t get any easier just because you’ve been working at it for nearly5 years.

So it is all the more rewarding when we do get the great stats we’ve been waiting for. Good Job! I mean, Good Work, team!

Video: The Joy of Being Normal

AATOD has produced a video on the benefits of methadone treatment called "The Joy of Being Normal." They hope to get the message out to a large audience that methadone helps people lead normal lives, and dispel the myths that persist. 3 patients and family members tell how their lives were saved. Nice work, AATOD, and hopefully this video will help change minds.