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FRONT COVER Summer 2017 Issue UMADAOP Urban Minority Alcoholism & Drug Abuse Outreach Program Cincinnati

meet our CEO

and the scoop on her success!

A BLEND OF EDUCATION & PLAY AMBITION GIRLS WITH

CLIENT DWAYNE BALLOU ON HIS RECOVERY PEOPLE THAT CARE THE PRODIGAL’S RETURN HOW RAYMOND JONES GOT HIS LIFE BACK

YOUTH LED HOW STUDENTS ARE MAKING A DIFFERENCE COALITION

We can

HELPYOU BUILD FORYOUR F U T

3021 Vernon Pl Sui te 2 Cincinnat i , OH 45219 w w w . c i n c y u m a d a o p . o r g U R E 513.541.7099

CONTENTS INTERESTED IN MORE FROM UMADAOP? To learn more about our resources for living a healthy lifestyle, contact us!

Cincinnati UMADAOP 3021 Vernon Pl Suite 2 Cincinnati, OH 45219 www.cincyumadaop.org (513)541-7099

UMADAOP Magazine is published by CRG Media.

Copyright 2017 by CRG Media . No part of this publication may be reproduced in any form or by any means without the prior written permission of the publisher, excepting brief quotations in connection with reviews written specifically for inclusions in magazines or newspapers, or limited excerpts strictly for personal use. Printed in the United States of America. All rights reserved.

18 DR. KAMARIA TYEHIMBA Meet our President CEO 12 YOUTH LED COALITION How students are making a difference 16 RAYMOND JONES Th prodigals return 18 DEASA NICHOLS The business side of help 24 EMORY LIVERS A lifetime of service 28 PROLONGINGTHE PAIN Study suggests painkillers may be having the opposite effect in the long run 30 GROWING CONCERNOVER HEROIN USE The dangers that heroin use poses to the country

32 BOOM, BUST, AND DRUGS Study says economic downturn leads to increase in substance use disorders 36 MORETHAN SKIN DEEP Implant represents revolutionary approach to treating opioid addiction 38 COPINGWITH DISCRIMINATION Discrimination remains largely ignored as a cause of substance abuse 46 DWAYNE BALLOU How one man overcame his addiction 50 GIRLSWITH AMBITION A blend of education & play

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Dr. Kamaria Tyehimba

Dr. Kamaria Tyehimba is the President CEO at UMADAOP in Cincinnati. Her office has spearheaded addiction recovery operations to a higher recovery rate for admitted residents than the national average. “We are about 80% sobriety rate after one year,” Dr. Tyehimba reported. Her UMADAOP office is at the heart of one of the most severe states in the U.S. for opioid addiction overdoses, but rather than speaking about the broader existence of the epidemic, Dr. Tyehimba narrowed the conversation to what she considers a hidden crisis: “There is a culture for African Americans to not seek treatment. [And] when they seek treatment it is only in the most chronic stage of their addiction.”

“There is a culture for African Americans to not seek treatment. [And] when they seek treatment it is only in the most chronic stage of their addiction.” -Dr. Kamaria Tyehimba, CEO UMADAOP Cincinnati

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“We are transparent and open and a loving organization…The people we serve like being here because we know their names and their stories.”

-Dr. Kamaria Tyehimba, CEO UMADAOP Cincinnati

Dr. Tyehimba explained that many families consider heroin addiction to be a white person disease, and therefore feel disinclined to pursue help. She believes that raising awareness that “addiction does not discriminate,” is one of the strongest practices for extending help to those in need. She encourages, “Share the message: church, community, home, workplace.This is a disease; not just a white person’s disease.” Before occupying her role at the facility, Dr. Tyehimba was a volunteer at UMADAOP for 28 years. She received her Doctorate in Social Psychology fromThe University of Cincinnati, staffed for years at multiple mental health and addiction recovery facilities, and finally became President CEO at UMADAOP in 2014. Dr. Tyehimba spoke proudly of the deep care the organization consistently conveys to its clients,

“The presentation and culture is compassionate but also very serious. Our clinic demands a lot from people. We are transparent and open and a loving organization… The people we serve like being here because we know their names and their stories.” Dr. Tyehimba says that her team has a “tradition of giving 110%.” With the commitment and quality of UMADAOP, and the incredible help the organization receives from local funders like the Ohio Department of Mental Health and Addiction Services and The Hamilton County Mental Health and Recovery Services Board, she anticipates their Cincinnati office to become a household name.

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AGENCY AD 2 Cincinnati UMADAOP now offering Medication Assisted Treatment

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Youth Led Coalition How Students Are Making aDifference In Cincinnati, 8th through 12th grade students come to UMADAOP to participate in a community-action based program, Youth Led Coalition. The program is year-round and involves students strategizing, organizing, and executing plans that improve their communities, and occasionally communities far away. Since it is the students choosing how and where to lend aid, one Youth Led Coalition initiative was goaled with serving families harmed by the Flint water crisis.The team created their own gofundme.com page, which they used to raise 2,500 dollars in support! This student-raised funding purchased bottled water, water filters, and baby wipes for those afflicted by the cause. The program provokes students to ask what differences they would like to participate in fulfilling. It allows decisions to be made, initiatives to be tackled, and tangible differences to be seen. The program also teaches about the dangers of drug usage. While teams serve their neighborhoods, they also learn how to avoid falling into harmful traps caused by substance abuse.

The team created their own gofundme.com page, which they used to raise 2,500 dollars in support!

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The program provokes students to ask what differences they would like to participate in fulfilling.

Bruce Gay is a student who has been greatly influenced by Student Let Coalition. He first heard of UMADAOP after being referred there for a drug and alcohol course. Bruce says that the programs and people have, “Helped with not only my growth, but the growth of my community.” Bruce spoke about what the program taught him. He said, “I’ve learned a lot of things while working with UMADAOP, but some of the most important things… include [maintaining] a strong network; the importance of community.” Students like Bruce have been influenced and have made their own impacts by participating in the Youth Led Coalition. He says that in the next chapter of his life, Bruce will be attending college, where he plans to be intentional about plugging into another healthy community.

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Our Youth are the Future URS Intensive Outpatient AOD treatment for adolescent is an alternative option for young people male and female needing a more intensive service. Intensive outpatient services are a minimum of three days a week. It is co-ed and is available Mondays – Thursday. Group sessions are held for three hours. Family, Individual sessions and urine screens are built into the program. INTENSIVE OUTPATIENT AOD TREATMENT FOR ADOLESCENTS

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Faith Keep the Our programming expands access to an array of treatment and support, to include recovery coaching, FAITH-BASED and non-traditional programs.

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EDITORIA Raymond Jones is from a family of five. His mother, as he describes, raised Raymond and his brothers to be gallant men. She is strong, supportive, and at 84, still believes unvaryingly in her children. But even with a positive upbringing, Raymond found his way off the beaten path at an early age, “I am the only one who went astray.” The Prodigal’s Return Raymond Jones

Raymond was addicted to drugs from age 16 to 61. In and out of rehab centers, and even finding means of using narcotics while in prison, his ability to return to sobriety might have seemed from the outside like a hopeless cause. “Ain’t no reason you can’t recover if you want it – and I wanted it!” A friend knew of Raymond’s yearning to become clean, and recommended that he try UMADAOP. “The first conversation I had, I knew I was in the right place,” Raymond described the love and knowledge that seemed to exude from each staff member at the facility in Cincinnati.The staff joined in Raymond’s belief that he could be clean, and worked with him patiently until now he celebrates full sobriety since August 2016.

“The first conversation I had, I knew I was in the right place.” -Raymond Jones, Client UMADAOP in Cincinnati

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“I walked in here with better than 45 years of using narcotics. Without UMADAOP this never would have happened. I tried other programs and none of them worked until I got here.” Raymond’s recovery even caught the notice of one of his doctors, who offered him a job as custodian. He has since been promoted to security. “I’ve got my life back again,” Raymond says, “This is my safe haven. I come here even when I don’t have to be here.” Raymond explained his conviction for giving to others what he has learned, “I want to give to somebody what God has given me. You can’t just hold onto this – you gotta help somebody else get to where you are today.” “This is my safe haven. I come here even when I don’t have to be here.” -Raymond Jones, Client UMADAOP in Cincinnati

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We’re Here FOR YOU

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We provide students with opportunities to develop and practice leadership in real world environments, equipping them to become change agent amongst their peers in school and in their communities at large.

ACTIVITIES INCLUDE:

• Youth Led Prevention • YCCYouth Summit Planning Committee • Summer Apprentice Program • State of OhioYouth Led Prevention Network • Youth Civic Engagement Academy • GirlsWith Ambition

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DeAsa Nichols: The Business Side of Help

“Cincinnati is like the ground zero for opioid addiction,” DeAsa Nichols, the Board Chair at UMADAOP in Cincinnati, explained. Her interest in UMADAOP was first piqued by the substantial help she’d heard the organization continuously brought to her city, but DeAsa’s career did not begin in the field of addiction recovery and rehabilitation. She became involved only three years ago; before this, DeAsa came from a career in business. DeAsa earned her Business and Marketing undergraduate degree as well as her MBA from Xavier University in Cincinnati. Even now, as she serves as Board Chair for UMADAOP, she is also the Supplier Diversity Manager for Cincinnati Children’s Hospital. Her role is to oversee, receive, and maintain the hospital’s contracts. Prior to this, she was the CEO at the Chamber of Commerce in Cincinnati, where she was involved for years in the respective operations of hundreds of diverse corporations. UMADAOP was soon to open a new world for DeAsa. Experiences began to raise DeAsa’s awareness for the overwhelming drug threats that took place in her community.These conglomerated through what DeAsa remembers as three distinct events: The first and most crucial of these came in the form of struggles she witnessed some of her family members endure which involved both legal and illegal drug abuses.

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“Cincinnati is like the ground zero for opioid addiction.” -DeAsa Nichols, Board & Chair UMADAOP in Cincinnati

Proximity to these types of conflict can quickly immerse anyone into the realities of the crisis, as DeAsa quickly discovered. The second experience roused as DeAsa began to witness UMADAOP at work in her home town, “Every week there is another story about someone experiencing an addictive episode related to opioids addiction,” and she noticed the investment Umadaop played in the rehabilitation, counseling, and care of those suffering from opioids, as well as other harmful substances. And thirdly, DeAsa was introduced to Dr. Kamaria Tyehimba. Dr. Tyehimba, the CEO at Umadaop, had deep roots in the substance community for knowing how to fight the dangerous epidemic.The two met and quickly bonded both as friends and ambitious professionals. DeAsa soon became a member of the UMADAOP board, and after only two years, took over as Board Chair. For a business-driven person like DeAsa, she might appear misplaced among the counselors, caregivers, and other addiction recovery specialist who typically walk the halls at Umadaop. But DeAsa is right at home. She has already made positive strides for the improvement of operations at the facility. “We’ve been able to take a look at what were the skills and resources of those on the board, and if we had gaps then we made sure to fill those gaps to advance the organization. We are on the third phase of our three-year strategic plan. We will soon be finalizing our next three years so that we can continue to provide the services at a higher level.” DeAsa spoke about some of the steps the organization is taking to pursue more corporate funding. State, local, and federal grants already help organizations like UMADAOP, but reaching out to local businesses is an avenue that could sponsor programs that enable greater relief and prevention education.

As the board comes up with new possibilities for funding, UMADAOP utilizes community teamwork to see greater aid extended to the Cincinnati community. Some of these steps involve forming strong partnerships with nonprofits and social-businesses who, as DeAsa says, “offer similar services to UMADAOP so that we treat people as a whole person.”

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Some of these steps involve forming strong partnerships with nonprofits and social-businesses who, as DeAsa says, “offer similar services to UMADAOP so that we treat people as a whole person.” 21

She explained, calling this partnership approach Capacity Building, “Looking at the whole person: Because of addiction people spend their money [on drugs] and can’t make it to work. We not only help them with their addiction, but also to stabilize their life. We help them be gainfully employed and [to receive] adequate housing.” The team has learned that some of the most comprehensive aids come through these partnerships. DeAsa’s focus for growing relationships was voiced in another way that seemed to pique her enthusiasm. She explained her infatuation for participating in Umadaop conferences, “It is a family reunion… to celebrate the successes of those who have come out of these addictions to say that this is something people can beat!” She recounted examples of teenagers and young adults who were for years under the hold of drugs until, now that they are free, have become teachers who spread awareness and practical, testimony-driven advice to young people still under some form of addiction. “Those conventions are very educational and as long as I am associated with UMADAOP I will try to not miss any.” At the UMADAOP in Cincinnati, there are testimonies equally inspiring. Because DeAsa is a member of the board, she is kept at a slight distance from those receiving treatment in the programs, but she still hears word of successes that go on within the organization. “One young lady who was pregnant and had an addiction was helped through her addiction so that it would minimize the impact of her unborn child. We have people who were on the verge of losing their jobs because they spent all of their money on drugs and couldn’t afford transportation to their jobs. [UMADAOP helped these people to] retain their jobs. We help those who are in prison and we’ve worked with them upon getting out… so that they can come back into society.” UMADAOP offers many strong programs. Among them, DeAsa noted intensive outpatient operations and services through which women can receive special help and forms of protection from a drug-using spouse. Early intervention services, aftercare, and various youth prevention education also help to alleviate drug usage by providing information on substance abuse, community drug awareness, and warnings about drug-related diseases such as aids. DeAsa’s pride in UMADAOP’s work is impossible to miss, and her ambition for helping others is evidenced by her actions. Beyond all that she performs at UMADAOP, she is also a board member at the local WYCA branch in Cincinnati. She is the founder of Life Launch 101, a business focused on helping high school juniors and seniors effectively prepare for their next step in life: Employment, college, enlistment, or otherwise. Among the many goals that forge the direction of DeAsa’s professional life, she is also soon to fulfill a dream that has been on her mind since her early twenties. As a young adult, she made a goal to one day set foot on every continent, and DeAsa now says that before the end of 2017 she will have accomplished her seventh and final region. Antarctica awaits.

“We have people who were on the verge of losing their jobs because they spent all of their money on drugs and couldn’t afford transportation to their jobs. [UMADAOP helped these people to] retain their jobs. We help those who are in prison and we’ve worked with them upon getting out… so that they can come back into society.” -DeAsa Nichols, Board & Chair UMADAOP in Cincinnati 22

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INSERT 1 Emory Livers A Lifetime of Service Emory Livers has served an impactful career within the field of addiction recovery and rehabilitation. His lifelong work includes over 25 years with UMADAOP in Cincinnati, as well as time working with facilities and programs of similar focus. Through decades of compassionate involvement with prison inmates and people struggling with various forms of addiction, Emory has worked closely with countless families to bring wholeness and safety back into many of their lives. To describe his work humbly, he is a man of insatiable commitment to the cause of helping others. Many still remember the Attica Riots that took place in the early 70’s in the state of New York.The prison uprising was among the worst riots to ever take place in any U.S. correctional facility.The event saw thousands of prisoners take employees and volunteers hostage, only for the event to end in bloodshed from both sides of the conflict, with no short amount of political controversy to heighten the stakes and outcome.The riot took place shortly after Emory began his internship with NYS Narcotic Control Commission in Rehabilitation Counseling. And before long, Emory’s study turned to practice as he counseled and gave treatment to inmates at Attica Prison, playing his role in an event that would eventually make history books.

And before long, Emory’s study turned to practice as he counseled and gave treatment to inmates at Attica Prison, playing his role in an event that would eventually make history books. 24

After his time helping those at Attica Prison, Emory continued his work in counseling and involved himself in programs that educated young people about the dangers of addiction and violence. One of these programs, Too Young To Be High, became Emory’s introduction to UMADAOP. It turned out that UMADAOP’s facility manager at the time needed someone with Emory’s background, and this became his entrance into the team that he’d eventually serve for what is now two and a half decades. Throughout his career at UMADAOP, Emory has played many roles for the organization, including that of a board member, Board Chair, the director of UMADAOP’s B.E.S.T. program, among others. Emory took the time to explain his interest in B.E.S.T. The acronym broke down to Building Effective Solutions Together, and the program functioned by eliciting the time of counselors who were sent to regularly visit juvenile correctional institutes in Ohio.Their goal was to form relationships with those soon to be released.The visits were an opportunity for inmates with less than 3 months’ remaining detention to have a strong, reliable resource upon returning to their home and previous way of life.

B.E.S.T. sought to avoid leaving these young men and women without guidance and help upon their reentrance into society. Emory and the B.E.S.T team knew that many of those soon to be released would return to the same struggles and scarce resources that might have paved their way to imprisonment in the first place.The counselors established strong relationships with prisoners so that, once released, each person could have someone to turn to for advice, relief, and genuine care. “The program did a lot of good work,” Emory noted. While B.E.S.T. did not last long because of low funding, he believes that the initiative made consequential strides in the lives of those the program served. Emory recounted some of the history that he’d both studied and lived. He reminisced some of the changes that have happened over the course of his time in this field; spoke of the crack epidemic that took place from the 70’s-90’s, as well as how those times have influenced those who are using the same or similar substances today.

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“The problem… affected many families of the people put into jail. Families were left without fathers, which only reinforced the drug problem at play.” But back then, Emory notes, addiction was attacked at the root by focusing almost exclusively on putting a halt to usage altogether. Emory spoke about some of the problems facing addiction recovery methodologies that are often implemented today, “Instead of encouraging abstinence, new drug-stopping processes encourage control [of substances] instead of stopping drug usage.” And he summed up how this challenge is equally strengthened when he remarked, “doctors prescribe drugs that are addictive, so when someone no longer has access to those prescriptions they turn back to illegal, cheap drugs like heroin.” But Emory remained optimistic. “There is a lot that works,” he said, and “A person that’s addicted and wants to get clean will get [clean] any way they can.” He continued, “Young kids come through the doors at UMADAOP. Many are from diverse families and backgrounds [coming] to learn about addiction and about themselves… [It’s UMADAOP’s job to] grow, change, and adapt

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As Emory retires from the board at UMADAOP, the stories and impact that have followed his compassion-driven career enlist every reason for UMADAOP, and many of those he has helped, to celebrate his lifelong commitment to this cause. In closing remarks for this interview, Emory contributed one more source for inspiration: This year he celebrates 5 years’ cancer free.

to the culture. Some of the ways we did things in the past don’t work today, and UMADAOP has been able to make some of those transitions.” His pride in the work that UMADAOP provides and their ability to overcome shifting challenges was contagious.

As Emory retires from the board at UMADAOP, the stories and impact that have followed his compassion-driven career enlist every reason for UMADAOP, and many of those he has helped, to celebrate his lifelong commitment to this cause. 26

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theinfluence.org is an online platform to have a voice in the national discussion on addiction and recovery.

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ain relievers are supposed to relieve pain. It sounds simple enough, but new research suggests a common pain medication may actually be prolonging chronic pain. Morphine is an opioid painkiller commonly prescribed in hospitals and clinics, and while it is e ective in the short term, doctors don’t always consider the potential consequences for pain down the road. at’s why a team of researchers based out of the University of Colorado - Boulder set out to study how morphine treatment a ects chronic pain, and found some troubling results. e team, which used mice with spinal cord injuries, found that in mice not given morphine, their pain thresholds went back to normal about four to ve weeks after the injury. But mice who were given morphine didn’t see their pain levels return to normal until around 10 to 11 weeks, meaning the use of morphine e ectively doubled the length of their chronic pain. P Prolonging the Study suggests painkillers may be having the opposite e ect in the long run Pain

“We were surprised that morphine was able to induce these really long-lasting changes,” says Dr. Peter Grace, the study’s lead author. Dr. Grace says the cause of the chronic pain increase has to do with cells that form part of the immune system. He says if those areas could be isolated or their e ects reduced, the resulting pain may not be as great. “If it does turn out to be a relevant issue to patients, then what our study suggests is that targeting the immune system may be the key to avoiding these kinds of e ects,” Dr. Grace says. “Opioids could essentially work better if we could shut down the immune system in the spinal cord.” e team’s research only looked at spinal cord injuries and morphine, and did not study other opioids that are commonly prescribed to patients experiencing pain. But he said it’s likely drugs like Vicodin or OxyContin could a ect other parts of the body in a similar way. “While we haven't actually tested other opioids in this particular paradigm, we predict that we would see similar e ects,” Dr. Grace says.

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Chronic problem Chronic pain can be debilitating for many people facing serious health problems, and it can also be a key factor in substance abuse. Many people report developing a dependence on opioids after having them prescribed for an injury. But new research suggests the number of people who develop dependency issues because of chronic pain may be far higher than people realize. A study from researchers at Boston University looked at a group of nearly 600 people who had either used illicit substances or misused prescription drugs.

ey found that 87 percent reported su ering from chronic

pain, with 50 percent of those people rating their pain as severe. ey also found that 51 percent of people who had used illicit drugs like marijuana, cocaine and heroin had done so to treat their pain. While many prevention e orts focus on recreational users, the numbers suggest that chronic pain plays just as prominent a role in substance abuse. “Many patients using illicit drugs, misusing prescription drugs and using alcohol reported doing so in order to self-medicate their pain,” the authors of the study wrote. “Pain needs to be addressed when patients are counseled about their substance use.”

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CONCERN OVER HEROIN USE GROWING

New Poll Shows Americans Are Increasingly ConcernedWith

45 percent of Americans think heroin use is a bigger problem in their communities than shows they’re not wrong. According to the Centers for Disease Control, heroin-related overdose deaths nearly quadrupled from 2002 to 2013. Experts fear the numbers will continue to rise, with recent data showing roughly 156,000 Americans began using heroin in 2012 alone. Political Discourse a time when lawmakers and treatment providers are struggling to combat the rise in heroin overdoses. Several states have passed legislation making it legal to purchase Naloxone, a drug that works as an antidote for opiates, and Congress is considering several bills that would change the way federal authorities handle drug issues.

ore and more Americans are feeling the dangers of heroin, with nearly half of adults describing heroin abuse as a very serious problem,

according to a recent poll.

1,000 U.S. adults about heroin abuse, with 49 percent saying they thought it was a very serious problem, and another 38 percent saying they thought it was somewhat serious. heroin epidemic is hitting, with one-third of respondents saying they personally know someone who has become addicted to heroin or another opiate. Numbers Don’t Lie Public perception of heroin use has changed quickly over the last few years. A Rasmussen Reports survey in November of 2015 found

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groups to increase understanding of addiction as a disease, 28 percent said those who use heroin are most to blame. Still, the poll showed public opinion remains somewhat balanced, with 48 percent of people saying all groups are equally to blame. A Universal Issue races. Although black and Hispanic Americans were more likely than white respondents to cite heroin as a very serious problem, all three groups had similar views on nearly every other question. across almost every demographic over the past decade, and poll numbers show perception and reality are more in line than most would like to admit.

commander-in-chief have also paid closer attention to the heroin epidemic, with the issue playing a more prominent role in this year’s presidential campaign than it has in

past election cycles. Who’s To Blame?

voters are paying close attention to the problem may come as no surprise considering how much blame the public puts on them. Of those surveyed, 5 percent said the U.S. government and those who decide how heroin users are treated are most to blame for the current heroin problems. In comparison, drug dealers themselves were singled out by only 11 percent of “49 percent of U.S. adults think heroin abuse is a very serious problem, and 38 percent say it’s somewhat serious.” -

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Boom, Bust, and Drugs Study says economic downturn leads to increase in substance use disorders When the economy tanks, drug abuse goes up.That’s the finding of a new study which shows the state of the economy is closely linked with substance abuse disorder rates for a variety of substances. The study, conducted by researchers from Vanderbilt University, the University of Colorado and the Substance Abuse and Mental Health Services Administration (SAMHSA), found the use of substances like ecstasy becomes more prevalent during economic downturns. Researchers also found that other drugs like LSD and PCP see increased use only when the economy is strong. But for overall substance use disorders, the findings were clear.

“Problematic use (i.e., substance use disorder) goes up significantly when the economy weakens,” says Christopher Carpenter, one of the lead researchers. “Our results are more limited in telling us why this happens.” Researchers say it’s possible that people turn to substance use as a means of coping with a job loss or other major life changes caused by economic pressures, but their particular study did not pinpoint an exact cause and effect. Not all drugs are equal The study showed that a downward shift in the economy has the biggest impact on painkillers and hallucinogens. Rates of substance abuse disorders were significantly higher for those two categories than any other class of drug.

Researchers also found the change in disorder rates was highest for white adult males, a group which was one of the hardest hit during the Great Recession.They say more research is needed to determine exactly how the economy and drug use are related, but they say the study highlighted some key groups for prevention and treatment workers to target during future economic downturns.

“Problematic use (i.e., substance use disorder) goes up significantly when the economy weakens.” - Christopher Carpenter, Vanderbilt University

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Slippery slope Despite some lingering questions, researchers were able to show the significance of the economy’s role in problematic substance use.The study showed that even a small change in the unemployment rate can have a tremendous impact on the risks for substance abuse disorders. “For each percentage point increase in the state unemployment rate, these estimates represent about a 6 percent increase in the likelihood of having a disorder involving analgesics and an 11 percent increase in the likelihood of having a disorder involving hallucinogens,” the authors write. Previous studies have focused on the economy’s link to marijuana and alcohol, with many looking at young people in particular.This study is one of the first to highlight illicit drugs, which given the current opioid epidemic, holds important lessons for those working to curb problematic drug use.

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When it’s needed most The study bears significant weight for treatment facilities and public policy makers in particular. During economic downturns, government agencies typically look to cut spending on treatment programs as a way to save money, something researchers say may be more costly in the end. “Our results suggest that this is unwise,” Carpenter says. “Such spending would likely be particularly effective during downturns since rates of substance use disorders are increasing when unemployment rates rise, at least for disorders involving prescription painkillers and hallucinogens.”

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“Spending would likely be particularly effective during downturns since rates of substance use disorders are increasing when unemployment rates rise.” - Christopher Carpenter, Vanderbilt University

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More Than Skin Deep Implant represents revolutionary approach to treating opioid addiction

Sign of the times Experts say the newly approved implant also provides a big boost to the concept of medication-assisted treatment (MAT) in general. For years, the idea that someone could achieve recovery through the use of drugs like methadone and buprenorphine was rejected by many professionals in the eld who saw complete abstinence as the only true sobriety. Many still hold that belief, but attitudes appear to be changing. Top government oŽcials say they want to increase the amount of MAT taking place at the country’s treatment centers. Several states as well as the federal government have enacted laws making it easier for physicians to prescribe medications like buprenorphine, but they say too few patients receive the medication they need. National Institute on Drug Abuse, in a statement. “ is product will expand the treatment alternatives available to people su ering from an opioid use disorder.” ] [ "Opioid abuse and addiction have taken a devastating toll on American families.” - Dr. Robert M. Cali , FDA Commissioner “Scientic evidence suggests that maintenance treatment with these medications in the context of behavioral treatment and recovery support are more e ective in the treatment of opioid use disorder than short-term detoxication programs aimed at abstinence,” said Dr. Nora Volkow, director of the

M edication-assisted treatment is growing in popularity and acceptance among addiction recovery professionals. And now it’s taken a revolutionary step forward that could o er renewed hope to thousands of people struggling with an addiction to opioids. is summer, the U.S. Food and Drug Administration approved a new buprenorphine implant to treat opioid dependence. Buprenorphine had previously been available only as a pill or a dissolvable lm placed under the tongue. But the new implant, known as Probuphine, can administer a six-month dose of the drug to keep those dependent on opioids from using by reducing cravings and withdrawal symptoms. "Opioid abuse and addiction have taken a devastating toll on American families,” FDA Commissioner Dr. Robert M. Cali said in a statement. “We must do everything we can to make new, innovative treatment options available that can help patients regain control over their lives.” e implant comes in the form of four one-inch rods that are placed under the skin on the upper arm. e implant must be administered surgically and comes with the possibility of certain side e ects, but experts say it could be more convenient and more e ective for patients. ey say by eliminating the need to take pills, ll prescriptions and generally manage their medication, it makes it easier for people to focus on the other areas of their recovery while making it less likely someone will lapse in their treatment plan.

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“We must do everything we can to make new, innovative treatment options available that can help patients regain

control over their lives.” - Dr. Robert M. Califf

Although the implant is certainly a new alternative, it has yet to show any increased success in keeping people from relapsing compared to the pill or lm tablet. In a study of the implant’s e ectiveness, they found that 63 percent of people given the implant were free of illicit drugs at six months, compared to 64 percent of people who took buprenorphine by pill. Still, those rates are much higher than the success rates of people who follow abstinence-only treatment plans. And oŽcials hope the new implant will lead more people to get MAT, increasing the number of successful recoveries across the country.

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INTERVIEW 4

Discrimination, whether based on race, gender, or sexual orientation, has long been thought to be a contributor to substance abuse. Now a new study has confirmed the relationship between discrimination and addiction, but it’s also brought up many more questions that still need to be answered in order to improve treatment outcomes. Researchers at the University of Iowa recently completed a peer review study in which they looked at 97 previous studies on discrimination and alcohol use. Their goal was to summarize the collective knowledge researchers have uncovered throughout the years, and what they found confirmed in more detail what many had previously suspected.

“Generally there is good scientific support, but the evidence is mixed for different groups

and for types of discrimination.” - Dr.Paul Gilbert, University of Iowa

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overtly racist or sexist to another person. But less research has been done on what are known as micro-aggressions, small everyday occurrences that can rub a person the wrong way. That research is improving, but there are other factors that need to be more fully explored. While studies have looked at historical trauma in the African-American population, the concept has not been fully investigated with regards to Hispanic and Asian populations. “This notion of historic trauma could be really relevant to other groups, but it hasn't received much attention at all,” Dr. Gilbert says. “This is something we should pay attention to.” All of this adds up to the fact that treatment providers may be missing a key piece of the substance abuse puzzle.

The team found that discrimination did indeed lead to an increase in drinking frequency, quantity of alcohol consumed, and in the risk for alcohol use disorders. Researchers say drinking can represent a coping mechanism in response to the stress caused by discrimination, and several studies showed clients acknowledging this direct link themselves. But when looking at specific populations and types of discrimination, the picture becomes less clear. “The story is that generally there is good scientific support, but the evidence is mixed for different groups and for types of discrimination,” says Dr. Paul Gilbert, the study’s lead author. “We don’t really know comparing one type or one level to another.” For example, much research has been done on interpersonal discrimination where someone is

INTERVIEW 4

But just because the intricacies of how discrimination affects drinking aren’t yet fully understood, that doesn’t mean our current knowledge base can’t be helpful. Dr. Gilbert says simply knowing that experiences with discrimination can drive drinking could inform the way treatment providers interact with clients, opening new areas of their lives to explore during treatment. “It can serve as sort of an early warning or indicator,” Dr. Gilbert says. “For treatment providers, it’s worth looking at: is there something that may be keeping folks from accessing services or affecting outcomes?”

Dr. Gilbert says treatment providers should continue to address discrimination as part of a holistic approach to recovery. He says it will be up to researchers to fill

in the gaps to find the precise ways that discrimination affects drinking behavior. “We’ve got good evidence on this level of interpersonal discrimination,” Dr. Gilbert says. “We’ve gotten the low-hanging fruit, now it’s time to start working on the stuff that’s a little further up the tree.”

“It can serve as sort of an early warning or indicator.”

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Bend But Don’t Break Yoga is being used to help people maintain recovery and avoid relapse

Yoga is no longer exercise your annoying, health-conscious friend won’t stop talking about.The ancient practice is now being used to help people recover from addiction. While scholars estimate yoga was developed sometime around 300 to 400 B.C., the practice hasn’t stopped changing over the last 2,000 years. A new wave of yogis are now helping people in recovery connect their spiritual and physical sides through yoga by combining the practice with more traditional 12-step elements. “It’s just a way of coming back to a sense of wholeness,” says Nikki Myers, a yoga therapist who helped develop the 12-step yoga system. “We use yoga as a process in order to bring that reintegration.”

Myers says she developed the system primarily as a means of relapse prevention. She says a typical 12-step yoga session would begin the same way most 12 step meetings do, with a focus on sharing and discussion of important recovery topics. Once the “meeting” portion of the session is over, the group will then move into a series of yoga poses designed to help participants focus on their physical recovery. “A focus needs to be on the body based piece as well as the cognitive piece in order for wholeness to really be manifested,”Myers says. “Once you include those things, the whole idea is that these will begin to offer us a set of tools that we can use both on the mat in the yoga practice and off the mat when the triggers of life show up.”

“It’s just a way of coming back to a sense of wholeness.” - Nikki Myers, yoga therapist

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The right tools Myers says the idea that yoga can provide a set of tools is critical as the practice of yoga is much more than the poses themselves. She says there’s also a focus on breathing techniques, a meditation of sorts, and a connection to one’s physical reactions that can prove vital when faced with difficult circumstances. Myers recalls how one woman who participated in 12-step yoga later found herself in a very stressful situation at home with her kids misbehaving and everything going wrong. She said she could feel the negativity boiling up inside her. It was the kind of stress that had triggered her to drink in the past, but the woman said in that moment she was able to relax and calm herself by focusing on her breathing and remembering the feeling of tranquility she had experienced in class. “It had a way of creating a space, giving her tools to create a space between her reactions and instead take a different neural pathway,”Myers says. “These are the kind of tools that we’re looking to have people use.” “A focus needs to be on the body-based piece as well as the cognitive piece in order for wholeness to really be manifested.” - Nikki Myers

Not a replacement Myers is quick to point out that yoga is not a substitute for traditional 12-step support, but rather an additional measure that some people may find helpful. She says some people have pushed back against the practice, but others have been enthusiastic about its power, with classes spreading across the country and even internationally. Myers says she hopes that one day 12-step yoga will be as common as other treatment programs. But she says as long as people are maintaining sobriety and finding wholeness within themselves, she’ll be proud of the difference her system has made. “We’ll tell people, ‘Notice this in your body, what it really feels like,’” Myers says. “Healing only happens in safe space.”

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Dwayne Ballou

“When you walk into the doors at UMADAOP, you feel something. You can feel that people care.” Dwayne Ballou is a man who has traveled extensively, lived a happy life, and by 56 already enjoyed retirement for several years. However, Dwayne’s life flipped upside down when his daughter began using heroin. Dwayne’s career as a union boiler maker required some intense labor, a detail that Dwayne remembers as a positive aspect of the job. But even in retirement the life of labor still weighs heavy on Dwayne’s body, and so as Dwayne’s daughter began using heroin, her father’s curiosity for how the drug might alleviate his pain provoked him to try. Dwayne, like his daughter, became addicted.

“When you walk into the doors at UMADAOP, you feel something. You can feel that people care.” -Dwayne Ballou, UMADAOP client

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He overdosed once and immediately sought help. A year later, Dwayne overdosed for his second time. “The devil still had his claws in me,” he described.This time Dwayne was introduced to Umadaop, the team that became a saving grace. Dwayne was counseled by Mr. Carter. “This man, next to my father, has given me the most insight on life and myself…He is someone steadfast and compassionate and considerate.”Mr. Carter meets with Dwayne three hours a day, three days a week to empower him concerning many of Dwayne’s continued struggles and concerns, especially regarding his daughter. With the generous help of Mr. Carter, Dwayne says that he has never felt more sober. And now the two strategize how to support Dwayne’s daughter back to sobriety.The conversation has inspired Dwayne to begin an organization that educates parents about how to help a child struggling with addiction.The plans are conceptual for now, but Dwayne looks forward to the day when he can pass on to others the same care Mr. Carter and UMADAOP have extended to him.

With the generous help of Mr. Carter, Dwayne says that he has never felt more sober.

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Girls With Ambition A Blend of Education & Play

Girls With Ambition, a program at UMADAOP in Cincinnati, is an instrument for empowering young girls to make positive decisions that add security, community, and pragmatic education to their lives. To stumble into one of their meetings, you’d find 7th and 8th grade girls meeting up in a relaxed setting where open dialogue is encouraged, and pizza is free and plenty. The young girls learn about the dangers of drugs, how to protect themselves from and during harmful situations, and how to respond when put in uncomfortable settings where they feel unsafe.The girls are taught to be R.E.A.L; which is an acronym most of them could probably break down for you: Refuse, Explain, Avoid, Leave.

The girls are taught to be R.E.A.L; which is an acronym most of them could probably break down for you: Refuse, Explain, Avoid, Leave.

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As they enter high school, these girls graduate into Youth Led Coalition, where they can holdconsequential decision-making roles that enable each to make substantial impacts within their community.

UMADAOP has established Girls With Ambition as an environment of safety, learning, and determined growth for these young girls.The program goes on throughout their’ school year to empower the students and include them in activities with their friends.These activities often double as both educational and fun, like movie nights with popcorn and treats where the students watch films that teach about some of the dangers of harmful drugs. Participants also have opportunities to help in events held by Youth Led Initiative, another UMADAOP program that equips teenagers to make positive differences in their community. Alexis Jackson, from UMADAOP, spoke about the relationship between these two programs. She said, “Think of [Girls With Ambition] as a stepping stone.” In this she meant that Girls With Ambition is a place for young girls to begin conversations about substance abuse, community outreach, and their safety. As they enter high school, these girls graduate into Youth Led Coalition, where they can hold consequential decision-making roles that enable each to make substantial impacts within their community.

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OPIATE + OPIOID ADDICITON What is the difference between Opiates and Opioids?

OPIATES

OPIOIDS SYNTHETIC PAIN MEDICATIONS

Opium Natural Pain RemedIES

VS.

Oxycodone

Thebaine

Hydrocodone

Morphine

Oxymorphone

Codeine

Hydromorphone

Heroin

What Medications Treat Opiate & Opioid Addiction?

Naltrexone

These medications act directly upon the opioid receptors; more speci cally the mu receptors. Because the effects of these medications vary at the receptor level, there can be different clinical effects during treatment.

ReVia | Depade | Vivitrol

Methadone Dolophine

Buprenorphine

Suboxone | Subutex

A FULL AGONIST binds to the receptor and activates it by changing its shape, inducing a full receptor response.

A PARTIAL AGONIST binds to the receptor and activates it with a smaller shape change in the receptor that induces a partial receptor response.