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Still Effective After All These Years

Fighting Fire With FIRE Researchers look to combat addiction through repurposed pharmaceuticals

Redefining Recovery One Day at a Time takes a hoistic approach to overcome addiction

Underserved &Undeterred Numbers Don’t Lie & Need For Understanding

Emotional Eating

Central Community Health Board CONTACT US TODAY! 513.559.2000 cchbinc.com 532 Maxwell Ave. Cincinnati, OH 45219

By Heather Hateld | WebMD Feature | Reviewed by Charlotte E. Grayson Mathis, MD EMOTIONAL EEAATTIINNGG EMOTIONAL AT

ere are several di erences between emotional hunger and physical hunger, according to the University of Texas Counseling and Mental Health Center web site: 1. Emotional hunger comes on suddenly; physical hunger occurs gradually. 2. When you are eating to ll a void that isn’t related to an empty stomach, you crave a specic food, such as pizza or ice cream, and only that food will meet your need. When you eat because you are actually hungry, you’re open to options. 3. Emotional hunger feels like it needs to be satised instantly with the food you crave; physical hunger can wait. 4. Even when you are full, if you’re eating to satisfy an emotional need, you’re more likely to keep eating. When you’re eating because you’re hungry, you’re more likely to stop when you’re full. r e

Are You an Emotional Eater?

You are an emotional eaters if you answer yes to any of the following questions: Do you ever eat without realizing you’re even doing it? Do you often feel guilty or ashamed after eating? Do you often eat alone or at odd locations, such as parked in your car outside your own house? After an unpleasant experience, such as an argument, do you eat even if you aren’t feeling hungry? Do you crave specic foods when you’re upset, such as always desiring chocolate when you feel depressed? Do you feel the urge to eat in response to outside cues like seeing food advertised on television? Do you eat because you feel there’s nothing else to do? Does eating make you feel better when you’re down or less focused on problems when you’re worried about something? If you eat unusually large quantities of food or you regularly eat until you feel uncomfortable to the point of nausea, you have a problem with binge eating. Please speak to your health care professional.

5. Emotional eating can leave behind feelings of guilt; eating when you are physically hungry does not. COMFORT FOODS When emotional hunger rumbles, one of its distinguishing characteristics is that you’re focused on a particular food, which is likely a comfort food. “Comfort foods are foods a person eats to obtain or maintain a feeling,” says Brian Wansink, PhD, director of the Food and Brand Lab at the University of Illinois. “Comfort foods are often wrongly associated with negative moods, and indeed, people often consume them when they’re down or depressed, but interestingly enough, comfort foods are also consumed to maintain good moods.” Ice cream is rst on the comfort food list. After ice cream, comfort foods break down by sex: For women it’s chocolate and cookies; for men it’s pizza, steak, and casserole, explains Wansink. And what you reach for when eating to satisfy an emotion depends on the emotion. According to an article by Wansink, published in the July 2000 American Demographics, “ e types of comfort foods a person is drawn toward varies depending on their mood. People in happy moods tended to prefer … foods such as pizza or steak (32%). Sad people reached for ice cream and cookies 39% of the time, and 36% of bored people opened up a bag of potato chips.”

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By Jennifer R. Scott | Updated February 15, 2014 Emotional eating can be a di£cult challenge when you are trying to lose weight. It’s a di£cult habit to break once it’s a part of your life, but by understanding what causes it and nding ways to cope that don’t involve food, you can overcome it. Read on to learn how to prevent and Prevent and Cope with Emotional Eating Before you can learn to cope with emotional eating, you must rst understand what it is. As the name implies, emotional eating is characterized by repeatedly eating in response to feelings rather in response to hunger to gain physical nourishment. Emotional eaters often consume large amounts of food at one sitting, which is sometimes referred to as a binge. Understand the Emotional Cues Many emotional eaters eat in response to ve common cues, which include boredom, loss of control and anger. Only you can know if these cues prompt you to eat emotionally: Eating a snack a few times a week because you are bored may not be a problem; eating a container of ice cream each time you’re angry probably is. Understanding these cues and learning how to choose another response — such as exercising to release pent-up anger —will help you end the cycle of eating in response to these feelings. Identify Your Triggers While many emotional eaters share cues in common, there may be certain feelings or situations that trigger you to eat that do not a ect someone else. One of the best ways to understand your own personal emotional eating triggers is to keep a “food and feelings” food diary. In it, you simply record what you eat and how you were feeling before, during and after your binge. Stress A ects Your Eating Habits Stress is one of the most common reasons that women in particular overeat. Stress is alleviated by eating certain foods and many women get in the habit of reducing tension by enjoying these foods rather than dealing with the source of their tension. By creating self-care skills that allow you to identify non-food solutions to tension-causing situations, you will be much less likely to cope with emotional eating. What is Emotional Eating?

(Please note: Extreme feelings of hopelessness are typical of chronic depression. Please talk to a mental health professional if you nd yourself feeling perpetually hopeless.) Lack of Control You think: My life is out of control. ere is nothing in it that I am in charge of. Everyone and everything around me rules my life. Except for eating…I can eat whatever I want, whenever I want it. So I will. Feeling Unappreciated Perhaps you’ve accomplished something exceptional at work and no one has noticed. Or maybe you’ve made a personal achievement you’d dreamed of for years. But no one at home shares your pride. You nd yourself tempted to congratulate yourself by “treating” yourself to a binge. Boredom ere’s nothing to do. Nowhere to go. Perhaps you feel lonely, too. ere’s nothing at home to occupy your mind or your hours. But there is a pantry full of comfort food that will kill some of that empty time. If you t into any one of these ve proles, try sitting down with a piece of paper and brainstorming to nd alternative behaviors to eating. You may be surprised at the solutions you come up with…and at just how well they work once you try them. en, write your ideas on notecards and post them where you will see them in your moment of need — how about on the refrigerator door or next to the pantry? Accepting why you eat the way you do can be a big step towards breaking the cycle of emotional eating.

eat emotionally after a stressful day. Let Go of All or Nothing inking

All or nothing thinking means you feel like you must do something perfectly or you should not do it at all. We often are either “on” our diets or “o ” of them. e sense of failure this brings can cause negative emotions that in turn trigger a binge. By allowing yourself the freedom to face every day as a fresh start and see every decision as independent of the one before it, you may nd emotional eating is much easier to avoid.

5 Common Emotional Eating Cues

By Jennifer R. Scott | Updated February 15, 2014

Emotional eating is the practice of consuming large quantities of food — usually “comfort” or junk foods — in response to feelings instead of hunger. Some of the common emotional eating cues are: Anger Whether you’re angry at yourself, another person or a situation, you stiªe your feelings using food rather than confronting them and releasing them. It’s easier to smother a problem than to

deal with it. Hopelessness

You think: Nothing really matters anyway. Nothings ever going to change or get better for me. So, why should I care about my health or weight? Besides, eating makes me feel better.

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Central Community Health Board 513.559.2000 cchbinc.com 532 Maxwell Ave. Cincinnati, OH 45219

Still Effective After All These Years After 80 years, AA still works

For those seeking to break free from addiction to drugs and alcohol, one of the most widely used -- and easily accessible -- tools has been the Twelve Steps, first published in 1939 in the book,”Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.” Not much has changed since 1939, in what the Twelve Steps require of individuals, in order to regain control of their lives.The process, known to its adherents as “working the steps,” involves taking individual responsibility for one’s actions, admitting that one is powerless to control the addiction, and seeking the help of a higher power in order to heal. The benefits of the Twelve Step method are widely known: acceptance into a fellowship of non-users who regularly attend meetings to discuss their addictions, face their actions, and atone for them through spiritual practice and forgiveness. Although Alcoholics Anonymous and its many offshoots do not conduct or allow others to conduct research into the effectiveness of the methods, the military has produced studies that show individuals who attend meetings are 60% more likely to achieve sobriety than those who do not.

Millions of men and women around the world have used the Twelve Steps to break free from a wide variety of addictions and compulsions. More than 200 self-help organizations around the world have adopted twelve-step principles for help with compulsion for, and/or addiction to, gambling, crime, food, sex, hoarding, debting and over-working, among others.

Where did the Twelve Steps come from? According to an article published by AA co-founder Bill W. in 1953, there were three primary sources of inspiration: the Oxford Groups, Dr. William D. Silkworth of Towns Hospital and the famed psychologist, William James, widely considered the father of modern psychology. The Oxford Groups, an evangelical movement which became popular in the 1920’s and early 30’s, preached concepts like absolute honesty, absolute purity, absolute unselfishness and absolute love. “The Twelve Steps could be considered a personal roadmap for achieving sobriety and serenity.”

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Combining science and spirituality William James’ major contribution to the philosophical underpinnings of AA was his book “Varieties of Religious Experience.” In his book, James provided scientific validation for the concept of spiritual experiences, which he said could transform people and enable them to overcome personal defeat and find recovery. The Twelve Steps could be considered a personal roadmap for achieving sobriety and serenity and living a life of freedom from addiction to alcohol and drugs. Each of the steps is only one sentence in length, but each one contains enough universally applicable wisdom and power to fill a book. While the 12 steps has provided a path to recovery for countless alcoholics, drug addicts and others seeking to break free from addictive or compulsive behavior, they have also sparked controversy and debate over the decades. The major source of controversy is AA’s longstanding emphasis on a belief in God. AA supporters point out that, in the AA context, that means belief in “a higher power,” a belief in something larger than the self.The phrase was coined in the early years of AA.

They also practiced a type of confession, which they called “sharing,” the making of amends for harms done they called “restitution.”They believed in the value of “quiet time,” a form of meditation and seeking of God’s guidance, practiced in both group and individual settings. Dr. Silkworth spent years helping alcoholics dry out at Towns Hospital in New York City. One of his core beliefs, which he often spoke on, was the disease concept of alcoholism -- defined as an obsession of the mind combined with an allergy of the body.

“’Higher power’ doesn’t necessarily mean a deity, and those who use the steps are free to interpret that phrase as they see fit.”

“Higher power” doesn’t necessarily have to mean a deity, and that those who use the steps are free to interpret that phrase as they see fit, based on their personal beliefs.The phrase could be applied to mean the power of the group, or nature. Some AA members around the world who don’t accept faith in a god as a necessary tenet have formed their own agnostic AA groups. More than 90 unofficial, self-described “agnostic AA” groups now meet regularly in the U.S., according to Patheos.com. The debate continues. Some think the 82-year old organization has drifted away from its core principles and become too lenient, Lee Ann Kaskutas, senior scientist at the Public Health Institute’s Alcohol Research Group in Emeryville, Calif., told CharismaNews.com. “Others think it’s too strict, so they want to change AA and make it get with the times.” Newcomers to AA are often advised to “take what you need and leave the rest,” Kaskutas points out.That flexibility allows participants to put together a recovery program that fits their needs. It’s one of the reason AA still works for people, eight decades after its founding. 15

Central Community Health Board CONTACT US TODAY! 513.559.2000 cchbinc.com 532 Maxwell Ave. Cincinnati, OH 45219

FIGHTING FIRE WITH FIRE

“I think this opens up a large world view with regards to this system in the brain.” - Dr. Heath Schmidt

“These results are very provocative and suggest these compounds could be repur- posed for drug addiction.” - Dr. Heath Schmidt,

University of Pennsylvania

D espite years of stigma, medication-assisted treatment (MAT) is steadily gaining in popularity among treatment providers. Government groups like the U.S. Department of Health and Human Services are actively campaigning to get more providers to offer MAT as a potentially vital resource for patients. While such groups often promote well-known medications such as methadone and buprenorphine, drug researchers are looking for new medications that could be a lifeline to patients in need. But new medications can cost millions to research and take years to get on the market. That’s why some researchers are taking a closer look, and finding success, with drugs already approved by the FDA. CURBING COCAINE USE Researchers at the University of Pennsylvania say a drug already on the market for diabetes may be able to curb cocaine use. The FDA-approved drug Byetta, used to regulate blood sugar in diabetic patients, is derived from a natural hormone known as GLP-1. The research team looked at how the hormone functioned in rats and found that the same hormone that regulates food intake could be used to suppress cocaine consump- tion. “These results are very provocative and suggest these compounds could be repurposed for drug addiction,” says Dr. Heath Schmidt, one of the lead researchers. “We have seen a reduction in cocaine consumption…but it doesn’t completely abolish it.” Currently, there is no FDA-approved drug for the treatment of cocaine abuse. But because Byetta and a similar drug have already gained federal approval, researchers say that leaves fewer hurdles before they could be used in treatment settings. Although still far from human trials, research- ers say they’re optimistic, especially because their research suggests the hormone is not specific to cocaine and could be used in treatment of other substance abuse disorders. “I think this opens up a large world view with regards to this system in the brain,” Dr. Schmidt says. “There’s really a lot to be explored here and I think it’s really an exciting time to be in the field and exploring the GLP- 1 system.”

ADJUSTING ALCOHOL CONSUMPTION Another team of researchers at the University of Queensland in Australia believe the FDA-approved drug pindolol could be used to stop alcohol abuse. Pindolol is an anti-hypertensive medication used to treat high blood pres- sure. But because of the way it interacts with neurotransmit- ters in the brain, they believe it could also be effective in treating alcohol use disorders (AUDs). To study the drug’s effect, the team used mice and exposed them to an alcohol consump- tion regimen similar to a binge drinking cycle common in humans. For mice also given pindolol, the team found they were able to reduce drinking in the long term (after at least 12 weeks). The team did not see as positive of results in the short term (only four weeks), but they say they’re still excited about its potential uses. “Although further mechanistic investigations are required, this study demonstrates the poten- tial of pindolol as a new treat- ment option for AUDs that can be fast-tracked into human clin- ical studies,” the authors wrote.

Central Community Health Board CONTACT US TODAY! 513.559.2000 cchbinc.com 532 Maxwell Ave. Cincinnati, OH 45219

Underserved And Undeterred Overcoming the unique challenges LGBTQ individuals face with addiction A s more and more addiction treatment centers are looking for ways to tailor programs to address the individual needs of clients, one section of the population is being largely overlooked. Advocates say treatment providers need to be more aware of the unique issues and barriers facing the LGBTQ community. Numbers don’t lie

For starters, statistics show substance abuse issues affect LGBTQ individuals at much higher rates than they do the heterosexual population. Some estimates show an addiction rate between 30 and 40 percent, compared to around 10 percent of the population in general. While statistics also show that LGBTQ individuals enter into treatment more readily than the rest of the country, they also face significantly higher animosity once in a program. Advocates say 46 percent of homosexual men and women have had a homophobic therapist, and 34 percent felt their sexuality was seen as irrelevant. While putting sexuality aside to address addiction directly may seem like a good thing at first glance, advocates say recognizing those differences is key to creating a lasting recovery. Need for understanding Understanding a person’s sexuality and gender identity can be as important as understanding their race or ethnic background in that it can uncover potentially hidden sources of stress or

trauma that may contribute to substance use. Just as counselors should consider the social experiences of African-Americans, so too should they consider the unique circumstances faced by members of the LGBTQ community. “In order to not continue to create trauma towards the LGBTQ community, the more culturally competent a person or work/recov- ery environment is, the better,” says Molly Gilbert, director of business development for the PRIDE Institute in Minnesota.

The PRIDE Institute specializes in addiction treatment for the LGBTQ community, and Gilbert says a lack of understanding or awareness by treatment providers can create barriers for people seeking treatment. Even for organizations that seek to become “inclusive” communities, they may not set up a program that accurately addresses LGBTQ concerns, or providers may not realize how they are doing harm to LGBTQ individuals, transgressions known as micro-aggressions. “Micro-aggressions occur daily towards the community and educating heterosexual colleagues, supporters and the rest of society is key in helping to diminish these daily slights and harm,” Gilbert says. Education first To improve treatment outcomes and the experi- ences of LGBTQ people in general, advocates say it’s vital that treatment pro-

viders, physicians, and social service employees educate themselves on

some of these unique challenges and barriers. But they also say LGBTQ people need to educate themselves as well. “Educating the LGBTQ community on the dangers of abuse of alcohol and drugs, and the fact that the community is actually being tar-

geted by institutions such as big tobacco, alcohol companies and drug manufacturers is key,” Gilbert says. With very few

LGBTQ-specific treatment centers across the country, advocates know many

LGBTQ individuals will end up in heteronormative treatment facilities. And while that can present prob-

lems, Gilbert says with the right education and the right system in place, recovery is attainable. “With the right therapy coexisting with a mainstream treatment center, we believe it is doable.”

513.559.2000 cchbinc.com

532 Maxwell Ave. Cincinnati, OH 45219

Redefining Recovery One Day at a Time takes a holistic approach to overcome addiction

Recovery can be a tricky word. For some it’s short- hand for overcoming chemical dependence, while others distinguish it from words like “abstinence” or “sobriety.”The word represents what an individ- ual does with a new life — how one uses past expe- riences to overcome hardship and thrive spiritually. One Day at a Time (ODAAT) recognizes that this distinction applies to populations beyond addicts and alcoholics, and aims to serve anyone in need of a fresh start. “When we say ‘recovery,’ we’re not just talking about drugs and alcohol,” says President Mel Wells. “We mean any challenges in life.”The support for addiction recovery is there, Wells says, but it rep- resents just one of ODAAT’s holistic services; they also address homelessness, HIV/ AIDS, poverty, and violence and gang prevention, to name a few. Historically speaking, ODAAT’s primary services give shelter and supportive housing to those in need. They have 60 beds for recovering addicts and alcoholics, a men’s and women’s house, each hold- ing 14 residents, and a 38-bed homeless shelter known as Safe Haven. The men’s and women’s homes work with clients to afford them low-cost, supportive housing; Safe Haven and the drug and alcohol facilities are state- and cityfunded, and do not charge rent.

“When we say ‘recovery,’ we’re not just talking about drugs and alcohol. We mean any challenges in life.” - Mel Wells president of One Day at a Time (ODAAT)

“In a lot of cases, the person who has been through those struggles is going to be more driven in life and more successful.” - Mel Wells president of One Day at a Time (ODAAT)

No one left behind Wells takes pride in ODAAT’s “no one turned away” ethos. He says instead of turning people away, the organization has always made room or given referrals to prospective cli- ents on the spot. ODAAT has reach spanning as far away as London and Cambodia, Wells says. In Philadel- phia, ODAAT reaches up to 56,000 people annually, a figure Wells hopes to increase to 70,000 in the coming years. The city of Philadelphia and state of Pennsylvania have picked up on ODAAT’s efficacy, Wells says, and approved increased funding, allowing ODAAT to reach more and more people every day. Not only does ODAAT welcome everyone, it does it fast. ODAAT has staff on hand at all hours to handle incoming clients who often have nowhere else to go. There’s a narrow time frame in which some- one is ready and willing to receive help, and Wells doesn’t want to miss it. “They might change their mind, or they might not even have the chance to. They might not make it another day,” Wells says, speaking to the fatality of life on the streets and in active addiction.

Learning from each other Clients at ODAAT benefit from its widespread acceptance, and Wells says they gain a rare opportunity to grow from others’ stories. With an open, empathetic ear, clients gain insight to struggles they might not know firsthand. For instance, Wells describes the scenario of a recovering addict getting to know an AIDS patient — the addict might have no idea what a person with AIDS goes through every day to stay well, and vice versa. A new perspective can change a client’s attitude toward recovery. And for someone to survive and prosper through any number of life’s challenges, Wells notes, there is no telling what they are capable of. “In a lot of cases, the person who has been through those struggles and comes out is going to be more driven in life and more successful,” he says.

513.559.2000

cchbinc.com 532 Maxwell Ave. Cincinnati, OH 45219

513.559.2000 cchbinc.com

Community leadership and comprehensive behavioral health programs that support a strong, well functioning community.

cchbinc.com 532 Maxwell Ave Cincinnati, OH 45219 (513) 559-2000