Gooden Center
A residential drug treatment center for men located in Pasadena, CA. The Gooden Center is a proud member of the National Association of Addiction Treatment Providers (NAATP).

(626) 356-0078
191 North El Molino Avenue Pasadena, CA 91101 US

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Archive for the ‘Treatment’ Category

Holiday Relapse and Why You Should Be Thinking About it Now

Posted on: October 24th, 2017 by The Gooden Center No Comments

Holiday Relapse and Why You Should Be Thinking About it Now

Recovering from an addiction comes with many complications and struggles throughout the year but one of the toughest times for most sober people is the holidays. The few months between November and January can be some of the most difficult to get through because of the many parties, celebrations and gatherings that tend to involve alcohol. People who have quit drinking may feel especially tempted during this period of time because they have certain associations with the holidays and having drinks.

Another reason the holidays can cause people to be more vulnerable to relapse is that it can also be a stressful time of year. Worrying about shopping for gifts and spending time with family can be difficult especially if you have any dysfunctional family members who create more stress. Although the holidays are meant to produce feelings of togetherness, the reality is that many people actually feel more lonely and depressed.

Because of these factors, it is essential to prepare for the holidays in advance and have a plan in place to prevent holiday relapse. Even though you might be optimistic about how your recovery is going you may never know for sure how you will react during the holidays. You need to think about what the holidays will bring and create your own relapse prevention plan so that you are fully prepared for any difficult situations.

Prevention is Key During the Holidays

When you have a plan in place before the holidays you will feel more confident and prepared for any issue that might come up. Instead of feeling nervous and scared about how you will react at a holiday party or gathering, you will know what to do in any situation. Relapse will be much less of a possibility when you have a plan ready in advance.

The first step in creating a relapse prevention plan is thinking about how you will react and handle it when someone offers you a drink or asks why you don’t drink. It is inevitable that this situation will come up so you can rehearse and think about some answers beforehand that you will feel comfortable with.

There are different ways that people choose to handle being offered a drink but you can simply say “no thank you, I don’t drink”. This may be enough to shut down any other offers the rest of the night if people know that it is a deliberate choice. Be firm and avoid opening any doors that might make people want to convince you to have a beer with them later on.

If someone asks you why you are choosing not to drink, you don’t necessarily have to tell them you are in recovery if you don’t feel comfortable enough to share. You can prepare some answers that you think will make you feel okay with the conversation and will prevent any further prying. You can say for example that you quit for health reasons which is reasonable and in most cases is probably the truth on some level.

Create a Support System

Most people in recovery know how important it is to have a support system in place when you are struggling with temptation. This is especially the case during the holidays when many people feel isolated and under more stress than usual. It might be a good time to talk to your sober friends more often and ask for extra support.

If you are going to a party that you are particularly nervous about you always have the option of bringing a sober buddy with you. Being the only sober person at a party can feel very alienating and can drive you to want a drink again. Take a friend from your AA group so that you can support each other and get through the night safely.

It is always a good idea not to spend too much time alone when you are in recovery and particularly during the holidays. As part of your prevention plan, try to organize some activities and outings with friends that don’t involve alcohol. Activities with friends from your AA group will not only help you but also everyone else in your meetings that is having a hard time.

As part of your prevention plan make sure that you have the option to leave when you are in any situation that may endanger your sobriety. If you are at a party that feels overwhelming, then make sure you have your own car or arrange a ride home so that you don’t have to stay.

You don’t want to be in any situation that will trigger a relapse. As important as it is to challenge yourself, your highest priority should be staying sober. Practice self-care and focus on your goals so that you can stay on track throughout the holidays.

The Past, Present and Future of the Opioid Crisis

Posted on: September 26th, 2017 by The Gooden Center No Comments

The Past, Present and Future of the Opioid Crisis

Opioid overdose has recently become the leading cause of fatal injuries in the U.S. as rates of abuse have been steadily increasing over the past decade. Rising statistics of emergency room visits, deaths and dependency related to opioids results in an alarming trend which has the government seeking solutions. The opioid crisis is a national problem that is now on every politician and lawmaker’s mind in order to reduce the impact that this drug has had on our country.

Abuse of opioids has not always been such a tremendous problem and it is only recently that numbers have reached epidemic levels. When opioids were first introduced in the form of morphine and opium, the drug became rampant until a law regulating its production and sale in 1914 worked to dramatically decrease opioid use. Opioid use was minimized by government laws for years studies were published in the 1980s claiming that opioids were not as addictive as previously believed.

These papers actually encouraged the long-term use of opioid for pain management and noted a low risk of addiction in patients with chronic pain. The study was cited in many cases in support of opioid use in spite of its limitations in using a small sample size and very low doses of opioids. When Oxycontin was introduced in 1995, aggressive marketing tactics were used that often cited this flawed study as evidence that opioids were not addictive.

Throughout the mid-90s the pharmaceutical industry heavily advertised opioids like Oxycontin to both providers and patients. Pharmaceutical companies also provided contributions to regulatory organizations such as the Federation of State Medical Boards and a number of others so that they would encourage opioid use to reduce pain. Physicians were urged to treat pain aggressively with opioids while organizations helped to spread the belief that opioid use would not result in dependence.

An Increase in Prescriptions

All of these tactics employed by the pharmaceutical industry resulted in physicians becoming more lenient about prescribing opioids to patients. Doctors were more permissive in allowing people to use medications such as Oxycontin without much regard to possible consequences. This trend continued into the early 2000s as more studies suggesting a low risk of addiction continued to mislead physicians and patients alike.

Rates of chronic pain began to rise and boundaries to treat these disorders also expanded. Pain advocacy groups promoted aggressive diagnosis and management for pain. The FDA was also passive in developing risk evaluation and mitigation strategies for opioid addiction.

All of these issues combined led to a dramatic increase in the number of people being prescribed opioids for pain and subsequently an increase in opioid dependency. Opioid use became normalized over time but ultimately use of the drug progressed very quickly.

Reaching the Point of Crisis

Opioid addiction rates continued to grow throughout the 2000s until in 2007 drug overdose deaths surpassed car collisions as the number one cause of death by injury. The Centers for Disease Control documented how prescription opioids were to blame for these deaths more than any other drug.

Addiction to opioids is particularly an American problem. The U.S. is responsible for more than three quarters of the world’s opioid use in spite of representing only 5% of the global population. In 2014, overdose deaths in the U.S. were more than 2.5 times the rates in 1999 and were the highest they had been in over 15 years.

Dependency on opioids can occur in different ways but research indicates that 50.5% of individuals engaging in non-medical use of these drugs obtain them from an acquaintance while 22.1% obtain them directly from a physician.

In spite of the early studies that helped to drive the increase in opioid use, the reality is that nearly all individuals using prescription opioids will develop a dependence. This means that they experience withdrawal symptoms at the cessation while many others also struggle with impaired control over their drug use. It is also common for opioid users to switch to heroin once they become addicted.

The Future of Opioid Use

Now that opioid use has reached epidemic rates, efforts are being made to attempt to reduce the problem. Responses from local, state and federal levels have led to an increase in prevention, education and enforcement to combat high mortality rates. Prescription drug monitoring programs are being put into place to prevent over-prescribing by physicians and “doctor-shopping” by people abusing opioids.

Education programs for prescribers now help promote safe prescribing and and prevention of adverse outcomes. First responders are now more often equipped with naloxone, a medication that helps prevent death from overdose. The Affordable Care Act also expanded treatment for opioid addiction, although under the new administration it is unclear whether this access will continue.

State of Emergency Called for Opioid Crisis

Posted on: August 25th, 2017 by The Gooden Center No Comments

State of Emergency Called For Opioid Crisis

Cases of opioid abuse and overdose have been rising drastically in recent years, causing widespread concern for the health of the country. Recently a white house panel created by Trump recommended that the president to declare the opioid crisis a national emergency.

His commission on the opioid crisis was created in March with Governor of New Jersey, Chris Christie appointed to lead it. The panel held its first public meeting last month and just recently issued an interim report about the state of opioid addiction and abuse in the U.S.

The commission members wrote that the death toll for opioid abuse has reached an unprecedented level of 142 Americans dying every day. They believe that if the president declared the crisis a state of emergency that it would force Congress to focus on providing funding for treatment and prevention and empower the executive branch to take steps to reduce this loss of life.

Treating and Preventing Opioid Abuse

Within the report, the commission also proposed waiving a federal rule that places a strict limit on the number of people who can receive addiction treatment through Medicaid. They called for greater access to medications used to treat opioid addiction as well as legislation to allow states to use naloxone which is employed by first responders to reverse the effects of an overdose. They also emphasized prevention methods such as requiring “prescriber education initiatives”.

The main goal of declaring a state of emergency would be to allow Americans to take the crisis more seriously as an urgent matter affecting the country. A state of emergency would also mean that federal agencies would focus more attention and coordination toward the issue to save as many lives as possible.

Certain states have already taken the step to declare a state of emergency for the opioid crisis including Arizona, Florida, Maryland, Massachusetts and Virginia with Alaskan governor Bill Walker issuing a disaster declaration. Alaska’s health department found that the emergency declaration helped improve coordination between agencies and worked to expand access to naloxone.

Implications of an Emergency Declaration

The director of the Centers for Disease Control and Prevention, Dr. Tom Frieden believes a state of emergency may not be the right solution as it is usually reserved for national disasters and infectious diseases such as the H1N1 virus. He thinks the focus should be placed on improving prescribing methods and cutting down the flow of illegal opioids into the country.

However, those involved in anti-addiction groups across the country assert that a state of emergency could be a significant step in acknowledging how severe the crisis is currently and how much effort is needed to curb abuse and overdose deaths. They believe the opioid crisis needs national emergency funding and changes to regulations which could potentially save lives.

According to the commission’s report, an emergency declaration could give the government the power necessary to quickly expand access to inpatient treatment services and even lower prices for naloxone so that more people recover from overdoses. People are concerned about how the Trump administration might respond to the report because of their past record regarding policies to limit healthcare access for drug users. The administration had proposed in their health care bill (which recently failed to pass the senate) to cut funding for agencies addressing the opioid crisis.

The Opioid Crisis and Healthcare

The opioid crisis commission has been plagued by contradictions between the Trump administration’s policies and proposed solutions which emphasize expanded healthcare access rather than stricter Medicaid regulations. Their main concern is that the administration’s efforts to repeal and replace the Affordable Care Act could be detrimental to dealing with the current level of opioid addiction. Members of the commission asserted that the crisis could become worse if the government makes it harder and more expensive to receive healthcare coverage for addiction treatment.

Threats to cut funding have made the situation difficult for key agencies who are tasked with responding to the crisis. The white house had initially proposed cutting 95% of funding to the Office of National Drug Control Policy as part of its new budget but eventually restored funding in a revised version due to backlash from both Republicans and Democrats.

Dealing with the crisis has also been hampered by leadership vacancies such as Trump’s decision to fire the US surgeon general in April. This position has not yet been filled and the CDC only recently appointed a new director after Frieden resigned in January.

If President Trump agrees with the commission and declares a state of emergency it will remain to be seen how his administration chooses to handle the crisis. Expanding access to treatment and prevention will be a key element in stemming the tide of overdose deaths in the country if the government decides to become more active in handling the emergency.

The Trump Administration and Mental Health

Posted on: July 24th, 2017 by The Gooden Center No Comments

The Trump Administration and Mental Health

President Trump and his administration have made it a mission to overhaul our current healthcare system and eradicate “Obamacare” which they believe was inefficient and problematic. Their new healthcare plan has passed the house but is still being considered by the senate and has not yet been voted into effect.

Trump is optimistic that his Senate healthcare bill to repeal and replace Obamacare will eventually be voted through when Republicans can agree on supporting its terms.

Many Americans are concerned about what the new healthcare plan will mean for the country’s public health in general but some are also particularly worried about mental health coverage. The expectation of Trump’s healthcare plan is that many Americans will lose their healthcare coverage through federal programs like Medicaid which will be dramatically reduced under the new bill.

Unfortunately for many people in need, the new healthcare plan will slash much of the resources that the Affordable Care Act had made more available for mental health, behavioral health and substance abuse.

Medicaid and Mental Health

Trump’s decision to reduce Medicaid will have a devastating effect on those who rely on it to provide treatment for mental illness or addiction. People are particularly concerned about the new healthcare bill and what it would mean amidst the opioid addiction epidemic that has taken over the country in recent years.

Medicaid is currently the single largest source of funding for mental health and substance abuse treatments. Much of the funding has been provided by Obamacare especially through its expansion to include low-income adults.

A significant portion of people with substance abuse and/or mental health issues have low incomes or are even homeless. Prior to the Affordable Care Act, most people with little income were ineligible for public insurance through Medicaid. Even those with lower middle class incomes who simply had inadequate insurance were unable to receive coverage for mental health until the ACA made significant expansions.

The Cost of Repealing Obamacare

The ACA made it possible for people with low incomes to have access to preventative and rehabilitative services for mental health or substance abuse issues. Previously, Medicaid would only cover issues severe enough to merit admission into an emergency room or institution. With better coverage, people were able to get help before their situation became a mental health emergency.

Previously, most insurance companies would provide more coverage for physical health problems and very little for mental health or substance abuse issues. The Mental Health Parity and Addiction Equity Act passed in 2008 mandated that employer plans would cover medical and mental health or substance abuse services equally. The ACA also expanded that law to many people on Medicaid, ultimately covering mental health services for more than 30 million people.

Unfortunately, Trump’s new American Health Care Act would take away most of this coverage by cutting Medicaid expansion and reducing funding for low income adults. It would also allow states more flexibility to avoid parity rules and reinstate many of the old barriers for mental health care.

Who Will Lose Coverage?

While the current trend under the Obama administration has been to reduce the number of uninsured Americans to the lowest rates in over 50 years, Trump’s plan would reverse this trend and likely increase the rate of uninsured by 7.4%. The area of the country that would be hit the hardest by this new healthcare plan would be rural America which benefitted greatly from ACA’s expansion of Medicaid.

The new healthcare plan would also negatively affect senior citizens who will have to pay higher premiums, deductibles and co-pays if the bill passes. Lower income individuals will receive thousands of dollars less in tax credits which allowed them to afford healthcare under the ACA. Repealing Obamacare for many demographics will mean that they can no longer afford healthcare and will not be covered for medical or mental health services.

Those with mental health issues will be among those who are most affected by the change, especially the many Americans who received care through Medicaid. Although the American Health Care Act will not repeal the Mental Health Parity Act it will remove a mandate that required Medicaid to cover basic mental health and substance abuse services. As a result of this, 1.28 million people currently receiving mental health care through Medicaid will be threatened with losing these services.

The new healthcare plan proposed by the Trump Administration could cause problems for those in need of treatment for substance abuse problems including the millions of Americans addicted to opiates. Although Trump promised to fight the painkiller epidemic, his plans to end Medicaid coverage for substance abuse services will make it more difficult for people to receive addiction treatment.

Although many republicans support the bill, it remains to be seen how the new healthcare plan will affect Americans including many of Trump’s supporters.

Attending An AA Meeting On Vacation

Posted on: July 20th, 2017 by The Gooden Center No Comments

Attending an AA Meeting on Vacation

While you are planning a long vacation it can be stressful to worry about how you will cope with the experience and still stay sober. Vacations are meant to be relaxing and a way to get away from your problems but unfortunately you are also away from the comforts of home and your usual routine. This can be difficult for people in recovery who are used to having certain resources available and a structure to their life that helps keep them sober.

The great thing about 12 step meetings though is that they really are available everywhere. You may have already had people in your local meetings who were visiting on vacation from different parts of the country. It is pretty common for people to find an AA meeting wherever they are so that they can keep in touch with their sobriety goals even while traveling.

Anytime you are going on a significant trip, or even a short getaway, you might consider looking into what types of AA meetings are available in the area. Being prepared and knowing you can go to a meeting beforehand can ease some of the stress of traveling.

Connecting with New People

The more you travel and find different AA groups the more connected you will feel with the sober community all around the country and even around the world. AA is even available on many cruise ships, so really almost any vacation can include a meeting or two if you really need it.

It may feel intimidating to have to start over with a group of people you have never met. You might have a special bond and rapport with the people in your local AA group and feel hesitant to try something new. But as you have probably experienced in your own AA group, twelve step meetings are always welcoming and offer support to anyone new to the group.

It can be very rewarding to open up to a new group of people in an entirely new city. It can even help you realize just how universal addiction and the process of quitting really is for everyone. No matter where you go, every AA group will understand what you each person is experiencing and be able to provide empathy.

Triggers During a Vacation

Almost every occasion for traveling can include some type of trigger that will make it hard to stay committed to your goals. Your resort might offer free drinks or classes like wine tasting. They might even unknowingly hand you a glass of champagne when you arrive to check in. These types of situations come up all the time and it is important to be prepared for them.

Being away from home can make it harder to handle the obstacles that come up during vacation. Going to at least one meeting or even attending them every day might be the best way to get through your vacation without struggling too much.

It is important to communicate about your sobriety to whomever you are traveling with. If you are on a trip with a big group of friends or more distant family members they may not be familiar with your situation.

To avoid any confusion or pressure tell them about your recovery and your need to attend meetings. Let them know that you might have to miss out on certain excursions or activities so that you can spend time at a meeting. You might feel bad about being on a different schedule but your sobriety should be the highest priority throughout your vacation.

How to Find Meetings

As soon as you know where your hotel is located you should start looking into meetings that are close by. You can search the AA directory on www.aa.org and type in the name of the city or zip code which will direct you to the websites of local AA resources. There are also several apps you can download to your smartphone such as the Twelve Steps companion app that includes a directory and a map function to help you get directions to a meeting.

You should try to find a meeting as close as possible to your hotel so that there will not be too many issues as far as transportation. Something within walking distance, a bus ride or quick taxi ride is the best option. Make sure that you are completely prepared by finding exactly where the meeting is and knowing how you will get there before you even leave for your vacation.

Even though looking for a meeting and talking to a new group of people may seem like it’s out of your comfort zone, most people find it extremely helpful while traveling. Discussing your vacation stresses and fears with the group will help you stay strong no matter what type of triggers you experience on your trip.