Date: Friday, June 14, 2013
Time: 8:30 am – 1:00 pm
Cost: $25 (breakfast and 3 CEU credits provided!)
Location: Nova Southeastern University: 3200 S. University Drive
Fort Lauderdale, FL 33328
Terry Building, 5th Floor, Chancellor’s Dining Room

Out of the Chair and Into the Wild… Treating Substance Abuse with Wilderness Therapy
Heather Schnoebelen, MA, LPC, LCAS, Clinical Director, Four Circles Recovery Center

Substance Use Disorders and the Law
Dr. Daniel Bober, DO, Medical Director, Lifeskills South Florida

Level of Care Determination & Intervention with Adolescents and Young Adults
Ana Moreno, LMHC, Co-Founder, Family Recovery Specialists

CEU’s for Florida Board of Clinical Work, Marriage and Family Therapy and Mental Health Counseling
provided by: Lifeskills South Florida CE Provider #50-14663
FREE PARKING in garage adjacent to Terry Building.
LIMITED RESERVED PARKING in the front lot adjacent to parking garage. If you would like to park in reserved parking, you must place the parking flier on the dashboard of your vehicle, which will be emailed to you before the event.

*** RESGISTER ONLINE AT: http://www.eventbrite.com/event/6216915963#

The study, based on an ongoing national survey of nearly 70,000 Americans aged 12 and over, offers a snapshot of a growing health and safety problem that is already responsible for more fatal overdoses than cocaine and heroin, combined, and has begun to spawn other crimes including gang violence.

“This is one of the greatest drug threats we have ever faced,” Michele Leonhart, who heads the U.S. Drug Enforcement Administration, told reporters as the study was released.

An estimated 7 million Americans abuse pharmaceutical drugs. Prescription drugs account for about 75 percent of all drug-related U.S. overdose deaths, according to the U.S. Centers for Disease Control and Prevention. And three of every four deaths from pills involve opioid pain relievers including oxycodone.

With data showing the home medicine cabinet to be a prime source, law authorities around the country face a daunting public education challenge to persuade legal drug users to dispose of medication properly before it can fall into the wrong hands.

But the epidemic has also begun to take on the characteristics of hard-core narcotics trafficking as prescription drug abusers become addicted and require a ready supply of pills.

U.S. agencies including the CDC, DEA and the Food and Drug Administration are working to educate the public, doctors and pharmacies about the epidemic.

The administration is also working on new regulations to make it easier for people and institutions to dispose of unused prescription drugs under legislation signed into law by President Barack Obama in October 2010.

Gil Kerlikowske, head of the White House campaign against drug abuse, said a national media campaign could convey the message that prescription drugs can be deadly when misused. But a program devoted to media outreach, which originated under President Bill Clinton, is no longer being funded by Congress.

“The president has requested $20 million for a media campaign that had been run successfully from this office,” Kerlikowske said. “Unfortunately, last year, Congress did not fund it.”

In the meantime, the criminal threat posed by illicit pill mills and dealers – who can include doctors and pharmacists – has begun to spread across the United States.

FLORIDA THE EPICENTER

Up to now, law enforcement officials have seen Florida as the epicenter for illicit activity. But Leonhart said that with a crackdown in that state, the problem has spread to Georgia, Ohio, Texas and California.

Violence has also begun to spread, including attacks on pharmacies and other healthcare organizations by criminals looking to steal pills that retail for as much as $80 apiece.

The crackdown in Florida has, in part, targeted distributors and pharmacies. The DEA is due to begin an administrative hearing on Wednesday in the case of two CVS Caremark Corp. stores suspected of selling the painkiller oxycodone outside legitimate channels.

The new study shows that 55 percent of prescription pain killer abusers got drugs from a family or friends for free, while 11 percent bought them from the same sources and 5 percent took them without asking. Reliance on friends and relatives is highest among new and occasional abusers.

About 25 percent of those who rank as chronic abusers of pain relievers get their drugs from doctors, while a slightly larger number buy them from dealers, over the Internet or from friends and relatives.

Among the chronic abusers, 41 percent still obtain pills for free or without asking from friends and relatives.

The data, based on the 2010 National Survey on Drug Use and Health, was released ahead of DEA-sponsored public education events scheduled for Saturday at more than 5,000 collection sites under the banner, “National Take Back Day.”

In a survey of young adults aged 18 to 25, more than half said they also use marijuana. Researchers from the University of California, San Francisco (UCSF), say that’s a big increase from the 35 percent of young adults that, in prior research, had admitted to using both marijuana and tobacco within the past month.

One expert said the new findings ring true.

“The data presented are far more consistent with what I hear simply by speaking with thousands of students of middle and high school age,” noted Stephen Dewey, an addiction researcher and director of the Laboratory for Behavioral and Molecular Neuroimaging at the Feinstein Institute for Medical Research in Manhasset, N.Y. “The importance of getting accurate data like these cannot be stressed enough, as treatment programs and the financial support required for them are often guided by studies that demonstrate both prevalence and risk.”

According to the researchers, the fact that their study was conducted online, primarily through Facebook, and participants could remain anonymous, may have resulted in a more accurate picture of tobacco and marijuana use.

“We were curious whether rates would be different in our study where we reached out through social media and the Web,” study author Danielle Ramo, a postdoctoral scholar in the UCSF Department of Psychiatry, said in a university news release. “And rates were much higher, which shows the problem might be larger than we realize.”

The study, published April 18 in Addiction Science and Clinical Practice, was conducted in two phases. First, researchers questioned participants on their smoking habit. In the second stage, 3,500 participants were asked to anonymously reveal if they had used marijuana in the past 30 days.

The study found that of the 68 percent of respondents who smoked cigarettes every day, 53 percent said they had also used marijuana within the past month. Both tobacco and marijuana use was highest among whites, those from the Northeast, those living in rural areas and young adults who were not students, the researchers noted.

“Residence in a medical marijuana state was unrelated to the prevalence of marijuana use as well as the co-use of marijuana and tobacco in this young adult sample,” study senior author Judith Prochaska, an associate professor of psychiatry at UCSF, said in the news release. “The prevalence of marijuana use also did not differ by respondents’ age, income or gender.”

Another expert said he wasn’t surprised by the findings.

“Those who suffer from mental health and substance abuse problems have an extremely high rate of nicotine dependence,” said Bruce Goldman, director of Substance Abuse Services at The Zucker Hillside Hospital in Glen Oaks, NY. “It stands to reason that those seeking help to quit smoking also would have high rates of substance abuse including cannabis.”

He added that, “given the high rates of concurrence, it is a good idea to briefly screen all those seeking smoking cessation services for alcohol and drug abuse problems as well.”

The study’s authors argued that programs to help young adults quit smoking should also take into account the effects of marijuana use. They said the next step in their research is to bring counseling and other therapies to help people quit to Facebook.

“Adapting the social media aspect into intervention and incorporating the social environment are new ways to approach finding the most effective means for treatment,” Prochaska concluded.

“This format allows them to remain anonymous as much as they want, but have ease to access interventions when they are at the age when they are less likely to enter a treatment center, research lab or clinic,” added Ramo.

Goldman agreed. “Individuals might be more comfortable seeking assistance via the web than presenting in person to a local treatment center,” he reasoned.

More information

The U.S. National Institute on Drug Abuse provides more information on marijuana.

SOURCES: Stephen L. Dewey, Ph.D., director and investigator, Laboratory for Behavioral and Molecular Neuroimaging, Feinstein Institute for Medical Research, Manhasset, N.Y.; Bruce Goldman, LCSW, CASAC, director, Substance Abuse Services, The Zucker Hillside Hospital, Glen Oaks, N.Y.; University of California, San Francisco, news release, April 18, 2012.

A new report shows that adults (aged 18 and older) who had a mental illness in the past year have higher rates of certain physical illnesses than those not experiencing mental illness. According to the report by the Substance Abuse and Mental Health Services Administration (SAMHSA), adults aged 18 and older who had any mental illness, serious mental illness, or major depressive episodes in the past year had increased rates of high blood pressure, asthma, diabetes, heart disease, and stroke.

For example, 21.9 percent of adults experiencing any mental illness (based on the diagnostic criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)) in the past year had high blood pressure. In contrast, 18.3 percent of those not experiencing any mental illness had high blood pressure. Similarly, 15.7 percent of adults who had any mental illness in the past year also had asthma, while only 10.6 percent of those without mental illness had this condition.

Adults who had a serious mental illness (i.e., a mental illness causing serious functional impairment substantially interfering with one or more major life activities) in the past year also evidenced higher rates of high blood pressure, asthma, diabetes, heart disease and stroke than people who did not experience serious mental illnesses.

Adults experiencing major depressive episodes (periods of depression lasting two weeks or more in which there were significant problems with everyday aspects of life such as sleep, eating, feelings of self-worth, etc.) had higher rates of the following physical illnesses than those without past-year major depressive episodes: high blood pressure (24.1 percent vs. 19.8 percent), asthma (17.0 percent vs. 11.4 percent), diabetes (8.9 percent vs. 7.1 percent), heart disease (6.5 percent vs. 4.6 percent), and stroke (2.5 percent vs. 1.1 percent).

The report also shows significant differences in emergency department use and hospitalization rates in the past year between adults with past-year mental illness and those without. For example, 47.6 percent of adults with serious mental illness in the past year used emergency departments as opposed to only 30.5 percent of those without past-year serious mental illness. Adults with past-year serious mental illness were more likely to have been hospitalized than those without past-year serious mental illness (20.4 percent versus 11.6 percent respectively).

“Behavioral Health is essential to health. This is a key SAMHSA message and is underscored by this data,” said SAMHSA Administrator Pamela S. Hyde. “Promoting health and wellness for individuals, families and communities means treating behavioral health needs with the same commitment and vigor as any other physical health condition. Communities, families, and individuals cannot achieve health without addressing behavioral health.”

To that end, since 2009 SAMHSA has funded the Primary and Behavioral Health Care Integration (PBHCI) program, which works to improve the physical health status of people with serious mental illness and those with co-occurring substance use disorders by supporting community efforts to coordinate and integrate primary care services into publicly funded community-based behavioral health settings. Currently 64 community behavioral health providers receive the PBHCI grant, with the expected outcome of entering into partnerships to develop or expand their offering of primary healthcare services, resulting in improved health status for their clients. As of March 2012, over 17,500 adults with serious mental illness and/or co-occurring substance use disorders have been served via the PBHCI program. More information about the PBHCI program is available at http://www.integration.samhsa.gov/about-us/pbhci .

Another SAMHSA effort — its Wellness Initiative – builds on the HHS Million Hearts campaign and promotes wellness for people with mental and substance use disorders by motivating individuals, organizations, and communities to take action and work toward improved quality of life, cardiovascular health, and decreased early mortality rates. To learn more, please visit http://www.samhsa.gov/wellness and http://millionhearts.hhs.gov/index.html .

The report entitled, Physical Health Conditions among Adults with Mental Illnesses is based on SAMHSA’s 2008-2009 National Survey on Drug Use and Health (NSDUH) data. NSDUH is an annual nationally representative survey of the U.S. civilian, non-institutionalized population aged 12 or older. The report is available at:
http://www.samhsa.gov/data/2k12/NSDUH103/SR103AdultsAMI2012.htm or
http://www.samhsa.gov/data/2k12/NSDUH103/SR103AdultsAMI2012.pdf .

Candidates for this position will have at least 2 years experience working with patients in a mental health setting, working knowledge of psychiatric disorders and 12 step philosophy, computer literacy, a clean driving record, and excellent supervisor references.  Candidates in recovery must have at least three years clean and sober.

To apply, attach a resume.

Salary: $12.00 an hour

See full posting in Psychiatric News Alert of the APA.

Resources:  www.aaap.org

Petros Levounis, MD of The Addiction Institute of New York and Michael Gillis, MSW of Lifeskills South Florida	Nancy Nitenson, MD of Boston, MA
Roger Weiss, MD Chief, Alcohol and Drug Abuse Treatment Program of McLean Hospital and Grace Hennessey, MD of VA NY Harbor Healthcare System	John Mariani, MD AAAP Program Chair and Director of Columbia University’s Substance Treatment and Research Service (STARS)
Jaime Grodzicki, MD Silverhill Hospital and Marc Galanter, MD of New York University	Sherry Nykiel, MD Director, McLean Center at Fernside
Eric Collins, MD New York Presbyterian Hospital and Columbia University Medical School	Ed Khantzian, MD of Harvard University Medical School, Cambridge, MA

Resources for Education, Training and Treatment:

www.iaedp.com

www.timberlineknolls.com

www.sierratucson.com

Henah Gupta, PhD and Nicolle Arbelarz-Lopez, PsyD of South Florida IAEDP

Rachael Soliman of Timberline Knolls, Miss America 2008, Kirsten Haglund and Jason Ross, PhD, LMHC of Lifeskills South Florida

Lisa Delaney, RD, MS, LD/N of Lifeskills South Florida

Resources for Awareness and Treatment of Borderline Personality Disorder:

www.borderlinepersonalitydisorder.com

www.fbpda.org

www.lifeskillssouthflorida.com

www.mclean.org

www.southfloridadbt.com

www.dbtassociatesofsouthflorida.com

Michael Gillis, MSW and Brandon Marshall

Anna Traylor, PsyD, Perry Hoffman, PhD and Jason Ross, PhD

Amanda Smith and Laura Durant, LMHC

Susan Geraci, LCSW, Brandon Marshall, Rachel Whipple, LCSW and Laura Durant, LMHC

Maureen Smith, LICSW, George Smith, LICSW, Anna Traylor, PsyD and Michi Nogami-Marshall