A Safety Net of Recovery and Stability

Brandywine Counseling’s Safety Net Services program, now in its third year, is making a difference for Delawareans with high HIV risk and severe substance abuse and mental health issues. Safety Net is an umbrella program offering treatment and pre-treatment to people at various stages of readiness for help, who would otherwise be “lost in the cracks” of social services. The focus is specifically on reaching women and ex-offenders, two of Delaware's highest-risk populations.

In the past year, Safety Net has assisted with over 2500 outreach contacts and 248 HIV tests. Many of our referrals come from the BCI Outreach team, who upon identifying a contact from the target population, will introduce them to the Safety Net Intervention Specialist. The Intervention Specialist will then offer services, see the client through the admission process, and remain in contact throughout their treatment experience. Many referrals also come from the Emergency Room at the Wilmington Hospital, made possible by the unique partnership of BCI with Christiana Care. Both sources have proven to be very successful “front doors” to treatment admission. In the past year, we’ve seamlessly transitioned 74 clients to addiction and mental health treatment, with a total of 148 active clients in the Safety Net program.

Six months after admission, we measure several indicators of recovery and stability. Safety Net participants show good progress on all measures. 56% report no drug use, 80% report no alcohol use, and 52% report no alcohol or drug use. Many reporting HIV risk at admission report reduced risk, with 66% who reported high-risk sexual activity reducing or eliminating risk, and 66% of injection drug users ceasing use. Three-quarters of the clients not housed at admission are now housed. Of the clients reporting no income at admission, 39% now have income. Clients also improved their support system and social connectedness. Half of those without a support network at admission have developed one. 95% of clients have no new arrests. 90% of the clients on mental health medications are compliant with their medications.

Overall, Safety Net Services has enabled many Delawareans with severe addiction and mental health issues to achieve recovery and stability. Our approach is holistic, simultaneously addressing multiple critical issues. The result is a newly created network of services that effectively assists clients into substance abuse treatment and provides a safety net before, during, and after treatment engagement.

Safety Net Services is funded through a grant from the U.S. Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.

Advocating for Recovery at Legislative Hall

Delaware's Joint Finance Committee is holding its annual hearing this week on Substance Abuse and Mental Health Services, in preparation for making difficult decisions for this year's State budget. BCI Counselor Silver Debrick is testifying today to bring to their attention the needs of Delaware's citizens regarding treatment and recovery. Here is what she had to say.

Good afternoon and thank you for allowing me to speak on behalf of addiction services in Delaware. I am Silver Debrick, and I am a Dual Disorder Counselor of Brandywine Counseling, Inc., an addiction, mental health treatment and prevention agency celebrating 25 years of service to addicted persons and their families in the State of Delaware. I would like to thank you for your support in the past and to remind you why funding for these services remains essential.

Brandywine Counseling offers “Same Day Intake” for heroin addiction. We provide a patient their first dose of potentially life-saving methadone treatment the same day they walk in the door, with no wait time or waiting list. Many people have admitted that same day medication enabled them to stick with treatment rather than be back on the streets seeking heroin. Today, 40% of our methadone patients, nearly 450 people, have at least 90 days abstinence. We do not turn anyone away who needs our services.

Brandywine partners with other Delaware service providers, including Christiana Care, Detoxification, and community-based peer support. We strive for consistency, efficiency, and nonduplication of efforts to serve our common population. One successful collaboration is our on-site outreach at Wilmington Hospital, which has enabled us to reach a population that was previously “falling through the cracks.” In just over a year, 114 people have entered treatment thanks to this partnership. Drug use is known to increase one’s risk of chronic disease, including heart disease, cancer, or kidney damage. By helping these people enter treatment earlier, we help them avoid these health problems, while decreasing costs to hospitals and taxpayers.

Brandywine also continues to partner with the State of Delaware to better serve Delawareans with co-occurring substance abuse and mental illness. Co-occurring disorders are becoming more the rule than the exception for drug-dependent people. Nearly 4 in 10 people who come through our door have a Co-Occurring Disorder. Our team is prepared to provide them individualized, person-centered, culturally competent assessment and treatment, with minimal wait time. This includes our clinical staff, many of whom have obtained our Co-Occurring Professional Certification; as well as our physicians, psychologists, and psychiatrist Dr. Carol Tavani.

Another vulnerable population Brandywine serves is women with children. Our residential program, the Lighthouse, is filled to its 10 bed capacity. We have 2 moms who have been awarded regular visitation with their children, and another mom who has regained custody of her children while at the Lighthouse. The Lighthouse is keeping these families together. It helps women find the courage to break the generational cycle of addiction and transform their lives to become productive citizens and good mothers. That is why we welcome them upon arrival with a big hug and a smile and say "Welcome to the Light!"

Treatment produces so many individual success stories. We help each person set goals, work toward them, and celebrate when they reach them. Here are just a few examples.

• One gentleman from Georgetown entered our vocational program. He just got employed with a cellphone company. When he came in to see his counselor, he was in a suit and tie and was beaming with pride!
  
  
• Another young lady named Dawn was living on the streets in Wilmington one year ago. She was addicted to heroin and was sleeping on a bus stop bench in the middle of winter. Today, she has one year clean, she has a place to live, and she is the mom of healthy 9 month old twins.
  
  
• A young man named Kevin took part in our recovery coaching program. He received peer support that helped him build a strong support network, stay clean, and reconnect with his family. He says, “I feel like a productive member of society today. I feel like a normal human being. Most of all, I have my family back today, and just 8 months ago, they wouldn’t even want me in their house.”

Lastly, I would like to remind you that when we treat and prevent addiction, we reduce the consequences of addiction, which often receive much more attention. 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. If we as a society recognize addiction as the underlying cause of these concerns, we will see how necessary treatment and prevention are. I ask that you continue to support addiction treatment and prevention services.

Thank you.

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.

Tom McLellan on Who's Winning the War on Drugs

Tom McLellan, Deputy Director of the White House drug czar's office, is interviewed in this article from The New Republic. He discusses a wide range of topics, including needle exchange, medical marijuana, and prescription drug abuse. We found it very interesting. It's long, so you might want to read it over coffee.

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.

Brandywine Counseling Awarded Federal Funds for Homeless Program

Brandywine Counseling Awarded $1.75 Million in Federal Funds
5 Year Project Will Expand Treatment for Delaware’s Homeless

WILMINGTON, DE – (September 18, 2009) – Brandywine Counseling, Inc. (BCI), a non-profit provider of addiction, mental health, and HIV/AIDS services, today announced they have been awarded a five-year grant from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA/CSAT) to serve homeless substance abusers in Sussex County, Delaware.

The program will be called STEP, Support, Treatment, Engagement, and Prevention. It will admit 200 homeless substance abusers and conduct 400 assessments annually in rural Sussex County. The target population has an average substance abuse history of over 8 years, with 3 or more treatment failures and dependence on more than one substance. The average client has co-occurring addiction and mental illness; primary health care needs; and is involved in the criminal justice and/or child welfare system. STEP will address the system and clinical barriers that currently hinder their long-term stability and health; specifically, uncoordinated services that frequently have incompatible service requirements, lack of affordable permanent housing, and no public transportation in an area where services are geographically dispersed.

STEP will provide evidence-based interventions through an integrated nested services approach, including substance abuse, mental health and primary healthcare treatment in conjunction with intensive case management and ancillary services. BCI will partner with a network of affiliated agencies, including La Red Health Center, Crisis House, and the Department of Veterans’ Affairs. The primary goal of STEP is to improve stability, health, and quality of life by facilitating sobriety, treating mental health symptoms, treating health issues, stabilizing and improving housing and employment, and reducing criminal activity.

Sen. Edward E. Kaufman (D-Del.) said of the award, “The grant that Brandywine Counseling was awarded will provide proven services to those most in need. Groups like La Red and Crisis House, along with the Department of Veterans Affairs, have turned around countless lives through the years, and this funding will allow them to expand their ability to help in Sussex County. My hope is that this opens hopeful and recuperative doors to the downtrodden who have nowhere left to turn.”

The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency of the U.S. Department of Health and Human Services (HHS). SAMHSA’s vision, “A Life in the Community for Everyone,” is based on the premise that people of all ages, with or at risk for mental or substance use disorders, should have the opportunity for a fulfilling life that includes a job/education, a home, and meaningful personal relationships with friends and family. SAMHSA works to achieve this vision through an action-oriented, measurable mission of “Building Resilience and Facilitating Recovery.”

Brandywine Counseling, Inc. is a community organization that provides holistic care to persons and their families living with addiction, mental health, and HIV-related challenges. BCI is Delaware’s largest provider of addiction services, serving over 2,000 clients age 18 and over at seven locations statewide. For more information, please visit brandywinecounseling.org.

For more information on STEP, please contact Sheera Lipshitz, Director of Sussex County Services at 302-856-4700.

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

Recovery is Vertical

This is a cool article about recovering addicts working on a farm as part of their treatment program. My favorite part was this quote:

“Regardless of the outcome... the idea that they’re doing something, and it’s self-supporting, keeping them clean longer, and being good for the community as a whole, and that they’re earning their keep as opposed to being treated as though they’re horizontal patients somewhere in a hospital. These are very good, exciting features.”

Good for them! Farming is certainly something you can't do as a "horizontal patient," and thanks to programs like this, people are able to pull themselves up from addiction and "get vertical" again. Would you like to see a program like this in Delaware? What other activities do you think would be a therapeutic addiction to traditional treatment?

BCI Reaches Reluctant Clients by Creating "Windows of Trust"

BCI’s Safety Net Services is featured in this month’s CSAT Grantee Spotlight. We’re pleased to reprint it for you here. Pictured from left: Case Manager Sharon Brown, Nurse Joyce Bunkley, Nurse Practioner Chris Zebley, and NSAFE Manager Rhonda Swanson.

Basha Silverman is the Director of HIV Prevention Services at Brandywine Counseling in Wilmington, Delaware, and is the Project Coordinator of its Safety Net Services project. Sharon Brown is the Case Manager for the Safety Net Services project. We spoke with Basha and Sharon about this TCE/HIV grant and discussed their challenges, solutions, and lessons learned.

Grantee Profile
Brandywine Counseling provides behavioral health services to individuals with substance abuse problems and their families. It is Delaware’s largest provider of outpatient addiction treatment services.

Brandywine provides opioid treatment, drug-free treatment, mental health treatment, and case management. It includes pregnant and parenting women’s services, a drug court program, an infectious diseases clinic, and an HIV prevention unit.

Safety Net Services is a multicomponent project offering integrated addiction pretreatment, treatment, and HIV/AIDS services. It incorporates outreach, HIV education and testing, medication management, and co-occurring disorders treatment. This grant targets women and ex-offenders and creates a safety net for at-risk and HIV-positive substance abusers at various stages of readiness to enter addiction treatment.

What are your unique challenges?
Clients have unique patterns of willingness, readiness, and commitment to treatment. They become interested, engaged, and disinterested, and leave, return, and cycle back and forth.

When engaged, clients visit us often, bring their babies, visit our clothes closet, and use our dropin services. We view these as special windows of opportunity to make use of clients’ motivation to change. But these windows can close quickly, challenging our ability to remain engaged.

Co-occurring mental health issues are notable challenges. When clients don’t have rapid access to mental health medications or professionals, their windows of opportunity can rapidly close and their treatment needs may be left unmet.

How do you address these challenges?
Since client willingness and readiness are dynamic processes, we make engagement methods flexible and dynamic. We meet clients where they are, not where we want them to be.

When clients stop coming to us, we reach out to them. But they shy away if outreach is coercive or pushy. Thus, we use gentle motivational interviewing techniques during outreach. We meet clients at times convenient to them. They are often on the street in the early mornings.

Our Case Manager will conduct outreach between 4:00 a.m. and 7:00 a.m. At such times, clients are often tired and willing to talk and join the Case Manager for coffee and donuts and discuss treatment. Many clients are willing to enter treatment on the spot. Since our program accepts intakes at 5:30 a.m., the Case Manager can take advantage of windows of opportunity and help admit clients immediately.

To enhance outreach effectiveness, our Case Manager has multiple roles. All of our clients are assigned a counselor and a Case Manager. Our Case Manager is an active part of the counseling team and conducts follow-up locating and outreach. Thus, clients already have a relationship with her. She is a friendly face.

We promote treatment-on-demand to address mental health challenges. CSAT funding helped us expand the roles and hours for our nurse and nurse practitioners. They previously worked only with HIV clients but now work with HIV clients and those with co-occurring disorders. We were also able to increase physician and psychiatrist time. These changes increased access to psychiatric evaluations and medication management. Having our Case Manager coordinate appointments further increased access and reduced waiting lists.

What lessons would you like to share?
Program and client goals can be at odds. A program may seek to achieve 80 percent abstinence, which is commendable. But clients may have such goals as getting a home or a job, leaving an abusing spouse, or reuniting with their children. They may want to be better spouses or parents.

We can improve the lives of our clients best if we use goals and milestones that are client-centered, realistic to each client, and take into consideration the resources in the community and clients’ lives.

We implemented several process improvements that resulted in reduced waiting time and increased admissions. To do so, we had someone anonymously walk through the admission process and experience it from a client’s perspective. This revealed delays to make appointments, complete the intake and assessment paperwork, enter treatment, and receive lab tests.

We convened a committee to analyze the processes. We took steps to reduce appointment times, shortened the admission process by eliminating duplicate admission and assessment paperwork, and reduced lab delays from weeks to hours by using same-day lab tests.

How has GPRA data collection helped you?
Asking the GPRA tool questions fosters thoughtful and probing discussions with clients. It helps to create relationships with clients and opens up windows of trust and intimacy. Asking the GPRA questions helps us to better understand clients’ lives, experiences, treatment needs, and resources.

This article is reprinted with permission from CSAT Discretionary Grantee News, July 2009.

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.

It's Not Too Late to Write Your Legislator

We're still awaiting the 2010 budget for the State of Delaware, and what it will mean for BCI's services. Cuts will be coming, how much is still yet to be determined. Many of our staff are taking time out of our schedule to meet with legislators and advocate as much as we can. We need your help!

If you believe addiction services are important, there's still time to make your voice heard. Use our sample letter to send to your State Representative or Senator. It takes hardly any time at all. When I sent mine, I even got a response back. If you don't know who your legislators are, you can call the numbers listed here. Thank you for your support!

A Life Saved By Inches

A few inches made all the difference for James. The difference between life and death. Between hope and despair. Between a life he's now living to the fullest, and one he wanted to end.

Seven months ago, James was admitted to Wilmington Hospital with a self-inflicted stab wound to the chest. It was his fourth suicide attempt. By inches, he survived. And by inches, he gained the chance to get help, become sober, and make a remarkable transformation in a very short time.

For 49 years, James had been living a life he thought was normal. He drank heavily from an early age, but all his family and friends did. His diabetes and other health issues just kind of happened. When he lost his job, it was natural to feel depressed and not want to leave the house. Even his attempts on his own life made sense. “My suicide attempts, I didn’t think was a big deal,” he recalls. “Sometimes, I just felt I needed to take myself out.” In his eyes, it was all normal.

But that began to change last November. Thanks to a new partnership between a hospital and a drug treatment program, James faced the underlying issues behind his suicidal thoughts. “A gentleman came into the hospital from Brandywine Counseling and gave me some information. I had never done anything as far as addressing my addictions at all in my life, and I did have a serious, serious problem. I realized that I had to do something. I was ready to turn my life around.”

The gentleman was BCI outreach worker Bobbie Dillard, who works full time at Wilmington Hospital. He meets with patients who show signs of substance abuse, and links them to services when they’re ready. BCI and Wilmington Hospital started this partnership last fall after seeing more and more people showing up at the hospital with injuries sustained while intoxicated. It’s here that many, like James, first discover they have a drug problem, and often, mental illness as well. Right from the start, the service proved successful. In four months, Bobbie met with 122 patients and referred 99 to drug treatment. Like James, 35% had never had treatment before.

Shaken, but ready for change, James walked in the door to BCI Alpha. The staff quickly put his fears to rest. “Ms. Evelyn, [the receptionist,] was very nice. I felt comfortable with her. And the young lady who did my intake, [Maria Cruz], she was very nice. I felt I had made a big first step. It was the first day of my new life.” Like 45% of Alpha’s admissions, James had co-occurring drug abuse and mental illness. Because of his severe depression and past suicide attempts, he was assigned to counselor Keith Kaut, a co-occurring disorders specialist. He attended weekly individual sessions and a Co-Occurring Disorders Group. But it was the individual counseling that helped the most.

“My one-on-ones with Keith, they’ve been terrific. We’ve gone deep with a shovel on a lot of things. Things that were haunting me, and I didn’t realize it. We’ve brought them up, brought them to the forefront, and reburied them, and I don’t have to worry about them anymore."

Keith had James write letters to people he was angry with, not to send, but to unfreeze his own anger he was turning inward, causing his depression. James also learned to address his suicidal thoughts, which would return from time to time, and to reach out instead of isolating himself. With Keith’s guidance, his hopelessness began to turn into self-confidence.

“The main subject in how he’s helped me, is me. I’ve never really liked myself. I never really had much confidence in myself. He’s allowed me to take a step back, and look at myself, and be able to have more confidence in myself.”

James began attending AA regularly. He found a primary care doctor and began to deal with long-standing medical issues. He reconnected with his brother after 13 years and began weekly visits. Slowly, he began to feel a change take place. But just how much of a change, was a huge surprise. Keith had him take a self-test, the Beck Depression Inventory, on a regular basis. It’s one of the most widely used measures of depression. His first score, just after admission, was a 52 out of 63, severe depression. A month later, he scored a 30, more moderate, but still severe. Three months later, he scored a 2, which is minimal depression, nearly the lowest possible score. James was stunned at the result.

“It’s kind of amazing. Some of the questions, the lowest you can answer is a zero. I was actually looking for a minus one on some of them, because they just didn’t seem relevant, or they didn’t show the happiness that I would like to answer.”

Keith Kaut was equally shocked. In 23 years as a therapist, he’d never seen this before. “It almost knocked me out of my chair. You just don’t see a 50 to a 2 in five, six months. It just kind of doesn’t happen.”

But both client and counselor knew that behind that score was real-life change. “It shows me all the work that I’ve put in, and what Brandywine Counseling has done for me,” James says. “A lot of people say, ‘You’re gonna hear people say you look like you’ve changed, as you go through recovery, but you’re not really gonna see that in yourself.’ But I actually see it in myself. In my personality, my behavior, my knowledge, how I treat other people, my belief in myself. It’s amazing.”

“My body feels clean. My mind feels clean. My memory’s starting to come back. I’ve had two doctor’s appointments this week, and I’ve walked back from Wilmington Hospital through Brandywine Park, and just the smell of the outdoors. I just appreciate things that I really didn’t appreciate before. I appreciate my husband more than I used to, even though he still has the same faults he did before. I appreciate my newfound family. [My brother and I] hadn’t spoke for 13 years, and we’re now reunited.”

Today, James has seven months clean and will soon graduate from treatment. He sees it as just the start of the next phase. “Getting a paper certificate is really no big deal. I’d like to still participate in the groups, because I’ve learned an awful lot here. I see the people that come in and out of my groups, and I know where I was when I first came here, and what I’ve learned, and things I’ve been able to share with my friends. I want to do that for other people that need it. Seeing what I can do for other people will help me continue to do the great things I’m doing for myself.”

It’s hard to believe James is the same person who tried to take his own life just seven months ago. Appreciative, empathetic, motivated, he has challenges ahead, but he’s ready to take them on. He’s still out of work, but diligently job-hunting. “The market’s not too good, but I’m out there every day passing out my resume like it’s the newspaper, and I’m on the computer every day, so something’s got to come up.” He’s also lost 40 pounds in six months. And, he’s looking forward to some long-needed dental work, knowing it will do wonders for his self-esteem. “That’s going to be wonderful for me, like getting a paint job on the car. The car’s been in the shop for six months, now it’s time to get a paint job.”

Incredibly, none of this would have been possible had he not lived to take a chance at recovery. By inches, he gained that chance. But he was equally lucky that his hospital partnered with a drug treatment center. After his prior suicide attempts, he “fell through the cracks,” discharged with no connection to treatment, not realizing he even had a problem. This time, he got the information that started him on his successful path. What if circumstances had been different?

“I would’ve tried to take my life again, I’m sure. I would’ve been still drinking, doing drugs, living the same lifestyle, thinking it was normal. Looking back on it now, it’s not normal, and I’m going to do everything in my power and with the help of the Lord to not be that way again.”

Real normalcy was within James’ reach. A difference of inches actually made a difference immeasurable. “To have drugs and alcohol out of my life, it’s just been great, and the future’s only gonna get better. Once you clear your mind of all that junk, and you finally get a chance to do baby steps, it just starts rolling, and more things just happen more and more quickly, more great things in your life.”


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.

A Client's Review of BCI: Turn Your Life Around and Get Your Freedom Back

We had to share this with you. One of our clients wrote a heartfelt and honest review of BCI on GreatNonprofits.org. "Ronzo" has been in and out of treatment for close to 9 years. They received "life changing services that turned my life around in the right direction." Here are some excerpts from their review:

On gratitude to BCI:

They really take it upon themselves to provide you with the up most care and affection they possibly can. If there wasn't places like brandywine counseling than I might not be here today.

On how treatment reduces crime:

It keeps the crime down, "in there part of town anyway". You might say how? If a drug addict needs drugs every day to keep from getting sick. When he or she run's out of money look out, because someone is getting robbed so thats how. If we don't have to worry about getting sick thanks to brandywine counseling then everyone on drugs gets the medication and mental stability to keep off of drugs then everyone is happy and there car radio's are snug and secure in there dash boards.

On what they enjoyed the most:

Learning to love my self and to respect others that have the same or similar problems as myself.

On the biggest challenges facing the organization:

Keeping the place up and running because I can say that they try and help every one that comes in there door but that comes with a cost of course nothing is free and asking a drug addict at rock bottom to pay for it some times is asking a lot.

On why to come in for help:

So if there is anyone out there that wants to come clean I would really recommend BCI. It's a great place to turn your life around and get your freedom back from addiction, and make amends with family and friends not to mention your higher power.

Ronzo, thanks so much for your review. It means a lot to us as staff, and it can really help others who are looking for help. We wish you well in your recovery.

Do you want to share your experience as a client? Want to tell us what’s good and what needs improvement? Write your review today.

Suboxone in Sussex County

Suboxone treatment is now available in Sussex County, Delaware.

Are you addicted to opiates, heroin, percocets, or oxycodone,
and not using cocaine, marijuana, benzodiazepines, or alcohol?

Want help?

Call:
J.A. Glick, M.D., 302-540-5437
For phone assessment and treatment recommendation

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?

Free polls from Pollhost.com

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.

Mark Lanyon Discusses Binge Drinking on "Delaware Tonight"

Mark Lanyon, Program Manager of BCI Alpha, appeared on WHYY's "Delaware Tonight" St. Patrick's Day evening as part of a report on the dangers of binge drinking.

Mark discussed how excessive drinking lowers one’s social inhibitions and may lead to high risk behaviors, including unintended sex, violence, and drunk driving. He also said if you feel you need treatment for alcoholism, “You have to do it on your own, but you can’t do it alone,” meaning family or friends can’t make you decide to stop, but you will need their help once you’ve made that choice.

The report also included what the University of Delaware is doing to make students aware of their drinking habits in terms of how they compare to their peers, how many calories they take in, and how much they spend. Finally, there was discussion of how families are impacted when one member has a drinking problem, how to set boundaries, and how to encourage that person to seek help.

You can watch the video here. It will be available through March 24. If that link doesn’t work, click here, then click Tues. Mar. 17, 2009, and the report begins about 12 minutes in. (To watch the video, you need to have Real Player installed or download it for free.)

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.”

How Much Would You Pay to Save a Life?

What can you do with a $1.00 donation to Brandywine Counseling? You might think, "not a whole lot," but you'd be wrong.

We know in these economic times, it's more and more difficult to support your favorite charitable causes. "Microdonations" of 1, 5, or 10 dollars are becoming a popular option. So with that in mind, I asked some of our BCI program directors what we could do with one dollar, five dollars, or ten dollars. This is what they came up with:

$1.00 will buy 14 condoms to protect someone from HIV.
$1.00 will also buy:
… 4 First Aid Kits
… 1 Wound Care Kit
… 1.3 Dignity (Hygiene) Kits (contraception, instructions, and resource guide)
… 10 Sterile Water Vials for use with bleach to clean syringes
… 12 Sterile Syringes

$5.00 will provide a hot meal for someone who comes to us hungry.
$5.00 will also provide:
… one group counseling session
… a gift card incentive for someone doing “well” in treatment for continued motivation.
… 70 condoms
… 21 First Aid Kits
… 5 Wound Care Kits
… 6.5 Dignity (Hygiene) Kits
… 50 Sterile Water Vials
… 60 Sterile Syringes

$10.00 will buy a DART bus pass for someone without a car to get to treatment and search for a job.
$10.00 will also:
… assist someone in obtaining an evaluation for addiction treatment.
… pay for 2.5 days worth of daily medication for a methadone patient.
… pay for 1 day of daily medication for a Suboxone patient.
… provide someone with 10 minutes of face to face contact with a counselor. Dollars buy minutes, and time saves lives.

So you can believe me when I say, one dollar can indeed save a life. As one of my co-workers put it, “Treatment works!! Not all clients can get treatment paid by Dr. Phil. How much would you pay to save a life?”

Brandywine Counseling offers convenient, secure online donations, including one time or recurring donations with your American Express card. Microdonations welcome. Thank you so much!

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.

A Network of Partnerships and Technology Makes "Safety Net" Work for Delaware's Severely Ill

One year ago, Brandywine Counseling began an ambitious, multifaceted project targeting Delawareans with some of the most severe needs for substance abuse, mental health, and HIV risk reduction services. Never before in the state had all of these services been connected under one umbrella. Safety Net Services has changed that, and the results so far indicate this approach is working.

We started this program last October with a 5 year grant from CSAT, and admitted our first clients in January. Many of them enter the program through Christiana Care’s Wilmington Hospital. They come to the hospital for emergency care, OB/GYN care, or other services, but also have substance abuse and/or mental health needs which the hospital system is not equipped to treat. Through Safety Net Services, we’ve established a partnership with Christiana Care and other agencies so we can link these patients to appropriate care, whether it’s medication management; HIV outreach, education and risk reduction counseling; or substance abuse treatment.

We are reaching people who could otherwise get “lost in the cracks.” On one occasion, a woman we encountered during street outreach tested positive for HIV on our mobile van. She was ready to be linked to medical care and other services, and also was ready to enter substance abuse treatment. We got her admitted to our program that day, enrolled her in our on-site HIV medical clinic so her health could be monitored, and also connected her with our HIV case management program (NSAFE). She now has easy access to all these services under one roof, increasing the likelihood that she can adhere to medical care and be successful in treatment.

Safety Net Services owes much of its success to technology. Staff have the ability to do “mobile intakes” out in the community, which creates a path of least resistance for clients to enter treatment. We use laptops with wireless air-cards for Internet access to remotely dial into the Brandywine Counseling servers. We also depend on cell phones to keep our team in constant communication with one another, whether it be for a new referral or to contact a client who has been absent for treatment. Constant communication among our staff from various programs lets us assist each client with managing their time and responsibilities, such as keeping appointments.

In the past year, we’ve seamlessly transitioned 75 clients to co-occurring treatment, in which substance abuse and mental health disorders are treated simultaneously. Our average client is 40 years old and female. About half the population is minority. Of the 75, 42 clients had medical problems in addition to HIV that required medication management at our “one stop shop” clinic, with an average of four medical problems per participant. Most (83%) of the clients also have a mental health diagnosis, most commonly major depression. They are also seeking greater stability in regards to living situation, employment and income.

Six months after admission, we measure several indicators of recovery and stability. Our clients show good progress on all measures. None had dropped out of treatment after six months. Two-thirds reported no drug use, half reported no alcohol use, and 40% reported no alcohol or drug use.

Overall, Safety Net Services is making recovery and stability possible for many Delawareans with severe substance abuse and mental health issues. This program has allowed us to focus on some of the most needy individuals in this community, simultaneously addressing multiple critical issues. The interagency partnerships with organizations like Christiana Care, and the new technology available to us, make it possible to reach people who would otherwise have no contact with treatment providers.

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?

Linda DeShields, A Pioneer of Addiction Treatment in Delaware, Dies at 63

Linda DeShields, a steadfast advocate for Delaware's most disadvantaged citizens who helped build programs for treatment, prevention, and rehabilitation, died on Tuesday in Wilmington, Delaware. She was 63.

Linda was one of the pioneering black females in Delaware’s treatment services. She opened the doors for people of color to enter this field, and is thought of as “the Harriet Tubman of treatment” for the state’s African American women and men. This legacy continues today, as many of the outreach workers she hired have ascended to supervisory positions. Her daughter, Rochelle Booker, is the supervisor of Delaware’s first needle exchange program.

In the late 1980’s, Linda started her career at Brandywine Counseling, Inc. (BCI) as Delaware's first HIV/AIDS outreach worker. Later, as Director of Outreach Services, she hired a team of indigenous outreach workers who were in recovery themselves, and often recently released ex-offenders. She had a strong work ethic, often working 10-12 hours a day when it was necessary to get the job done. She passed on these values to her team, many of whom had never held a job. Throughout her career, she became the voice for her clients in the community and diligently worked on behalf of them to ensure better access to the services they needed.

Linda recognized that addicted persons face interrelated challenges such as housing, crime, and domestic violence. In addition to her full-time job, she worked with numerous community organizations that dealt with these social ills. She was a liaison with the Wilmington Housing Authority for drug and alcohol services, a position that was the impetus for the creation of the NSAFE HIV case management program at BCI. She also worked with Mayor Sills’ administration as a community liaison focusing on substance abuse and related problems. Linda also appeared on the cable TV show “Women 2 Women” on channel 28 to interview women on women’s issues. She highlighted successful business owners, struggling domestic violence victims, as well as those addicted to drugs, and offenders.

One of the populations Linda was most passionate about was inmates, particularly women. For nearly 20 years, she volunteered at the Women’s Correctional Institution. She would go to WCI on a daily basis, meet with inmates about to be released, and prepare them for what to expect and to meet important goals like rejoining the workforce. She was also a very dear friend to the staff and often called to just check in on them. The staff remembers her as “an inspiration [who] always had a listening ear, and never turned away.” The way she touched the lives of the offenders and so many officers was like “being touched by an angel.”

Linda also volunteered at the Plummer Center, coming to the dining hall to have lunch with ladies who did not get family visits or any money. Her heart was in this work and she genuinely cared for the inmates. She continued her visits even after suffering a stroke that left her in a wheelchair.

Linda was also a member of the Police Advisory Board, and went to many parole board hearings to advocate for ex-offenders. She did substance abuse evaluations on offenders who had been referred to the Public Defenders office, and made recommendations for treatment as well as for pre-sentencing investigation.

Another passion of Linda’s was children in at-risk situations. She did weekly prevention and education interventions with arrested youth at Bridge House and Ferris School. She also worked with organizations seeking mentors, such as Eighth Street Baptist Church’s "Magic and Minds Together," which developed therapeutic drama skits for kids. The program was the result of a faith-based partnership with Brandywine Counseling, a connection Linda initiated before such partnerships were mainstream.

Rev. Ty Johnson recalls that Linda “was way before her time. She made the connection between the power of spirituality and power of recovery and knew it was vital to success and healing.” She knew that once she connected Eighth Street Baptist, whose board members were ex-offenders in recovery, to the recovery community that had resources, that things could change.

Linda DeShields was an inspirational and influential figure at BCI. She laid the groundwork for many of the services we provide today, and positively affected the lives of countless Delawareans. She will be greatly missed.

Funeral services will be held Monday July 14 at 12 Noon at Ebenezer Baptist Church, 2300 N. Claymont Street, Wilmington, 19802, with viewing from 10 am - 12 pm only.