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COURTING RECOVERY DRUG COURTS OFFER A SENSIBLE ALTERNATIVE TO JAIL FUNDING TREATMENT IN THE AGE OF OBAMACARE PAYING THE BILL

HIGHER POWER IN RECOVERY

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“We sometimes have to educate clients on the meaning of the term 'higher power.'” – Noreen Ammons, New Life

When the subject of addiction recovery is discussed and debated, one topic that often comes up is spirituality, and what it means. How spirituality is dened is a very personal choice, and one each individual makes for him or herself. It has often been said that addiction is a disease that not only aects the mind and body, but also the spirit. So, it makes sense that recovery from addiction needs to include a spiritual component.

Not necessarily religion “Spirituality” doesn't necessarily mean “religion,” although some people may confuse the two terms. In the context of recovery from addiction or alcoholism, spirituality has many denitions based on the individual beliefs of those involved with recovery. “What many people think of when you say 'spirituality' is church, organized religion,” says Noreen Ammons, clinical director at New Life Addiction Counseling Services. “We sometimes have to educate clients on the meaning of the term 'higher power,' which is non-specic. It's some entity people feel connected with. It could be nature, a sunset, the ocean, mountains or some other entity or power greater than themselves. It's important for you to feel connected and not alone.” €e spiritual component which is necessary for sustained recovery can be maintained and strengthened in a number of ways, Ammons notes: through prayer, going to church, meditation, listening to music or enjoying other forms of art – “wherever people can nd peace of mind and connect to the idea that there’s more to life than material things.”€e New Life sta† encourages clients to attend 12-step meetings as another way of making a spiritual connection. “Without spirituality, recovery is a rough road, because you are in it by yourself, which is not necessarily a good place to be,” Ammons says. Jim Collins, a New Life group counselor, agrees that, for an addicted person seeking help, the higher power “can evidence itself

in lots of dierent ways. It could be a judge, a doctor, a family member... a power greater than you. At least initially, if they are telling you what to do, chances are they are a power greater than you.” Collins oers a way to clarify the distinction between religion and spirituality: “religion needs spirituality, but spirituality does not need religion.” “Every person who is addicted to a substance practices faith when they ingest whatever it is they are using,” Collins says. “ey have faith it is not going to kill them, and that (life) is going to continue. Sometimes, they can turn that faith around into a positive.” New Life Counselor Trish Earnest attends 12-step meetings as part of her own recovery, recommends them to recovering clients and believes in a higher power. But she is careful not to impose her own beliefs on clients. Earnest says it could be considered inappropriate for a counselor to introduce the topic of God or spirituality in a group therapy session, but it is appropriate for discussion if a client brings it up. “I have to be careful how I approach that topic at an early stage in recovery,” Earnest says. “I do have a dialogue with the clients about spirituality, but it needs to be kept very 'light'. Any time someone feels as though you are pushing something on them, there can be resistance. When it comes to something like God and religion there can be real resistance, and that's not what I want to create.”

Seeking a higher power in recovery

“Religion needs spirituality, but spirituality does not need religion.” – Jim Collins, counselor, New Life

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A SolutionThat Makes Sense Drug courts provide a new path

Since 2005, some defendants facing charges for drug possession in Anne Arundel County have been offered the option to choose addiction treatment rather than going to jail. Like other drug courts around the U.S., the Anne Arundel County Drug Court is designed to handle nonviolent criminal defendants and offenders, juvenile offenders, and parents with pending child welfare cases who have alcohol and other drug dependency problems. Drug courts have proven to be an effective form of intervention, and are widely recognized as such by the criminal justice system.The first drug court was implemented in Florida in 1989. As of June, 2014, there were more than 3,400 adult and juvenile drug courts active in the U.S. New Life Addiction Counseling and Mental Health Services frequently receives clients referred for treatment by the Anne Arundel County Drug Court, according to Clinical Director Noreen Ammons. Ammons says the drug court concept is valid and valuable as a “rehabilitation rather than punishment” approach to one of the major problems facing society. “Drug courts are great; we need more of them.”

“The program enables the criminal justice system to assist in a drug user’s recovery, as opposed to just picking them up, writing them up, and putting them in jail.” -Jennifer Wheeler, business development and outreach director, New Life

As of June, 2015, the Anne Arundel County Drug Court had served more than 435 participants and has had 164 graduates. In addition to saving lives and deterring victimization and recidivism, the drug court program saves money. According to data developed by the county, housing a jail inmate costs about $100 per day or $36,000 per year. During one typical week in 2015, there were 89 people participating in the Anne Arundel County program. Housing those 89 people in the county jail for one year would cost more than $3 million, according to the county. By contrast, the drug court program costs approximately $330,000 for one year, including addiction treatment costs.

“Victimless” defendants Ammons notes that most of the clients the court refers to New Life are first-time offenders and non-violent ones, and “haven’t put anyone’s life at-risk but themselves.” Once they are in the drug court program, defendants know they are being monitored and if they use drugs and have a positive urinalysis “they are going to have consequences.” New Life staff are in constant contact with the court and regularly provide reports on each client’s process, Ammons says. Drug defendants who are accepted into the drug court program, may or may not be sincere and “serious” about complying with the rules and completing the program successfully in order to have their criminal charges dropped.They show their intentions by their actions, Ammons points out. Those who do not follow the rules – including maintaining sobriety – and complete the process are returned to the criminal court. “So, it is not an easy path,” Ammons says. Ammons would like to see drug courts expanded to give more people the opportunity to access addiction treatment, and avoid having a criminal record caused by substance abuse. Jennifer Wheeler, business development and outreach director for New Life, also considers drug courts a “very positive” trend. Jails and other correctional facilities are not equipped to handle drug users who need detoxification and treatment, she points out.The drug court program enables the criminal justice system to “assist in a drug user’s recovery, as opposed to just picking them up, writing them up, and putting them in jail.” 

“It is not an easy path.” —Noreen Ammons, clinical director, New Life

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“When someone is ready for treatment, New Life will certainly look at all reasonable options to help their recovery.” -Jennifer Wheeler, business development and outreach director, New Life Addiction Counseling Services

insurance, he points out. Third party reimbursement is important because clients who can afford to pay the entire cost of treatment represent “a select few,” Collins says. They tend to be adults who are well-established in their careers, or younger adults whose parents are covering the cost. Those in their late teens to early 30s make up the demographic group that seems to be the most prone to substance abuse and addiction, and also “the largest population we serve,” Collins says. Jennifer Wheeler, business development and outreach director for New Life, says “we are very pleased” that the Affordable Care Act included a behavioral health option, since it has allowed some previously uninsured persons to have coverage for mental health and addiction treatment services. A signicant percentage of New Life clients use Medicaid to pay for their care because New Life is a participating provider in the state of Maryland's Medicaid program, according to Wheeler. A number of those are people in their 20s who were previously covered by their parents' insurance, but have reached the age of 26, and “aged out” of being covered as dependents. When an uninsured person who has decided they need treatment contacts New Life, “we encourage them to sign up for Medicaid,” Wheeler says. “The Medicaid enrollment process is quick, and coupled with our nance and billing department, we will get the client in as soon as they are approved.”The sta also works with each uninsured client to set up a viable payment plan. “When someone is ready for hen an uninsured person who has decided they ne d treatment contacts New Life, “we encourage the to sign up for Medicaid,” Whe ler says. “The Medicaid enrollment proces is quick, and coupled with our nance and billing department, we will get the client in as o n as they are ap roved.”The sta also works with each uninsured client o set up a viable pay ent plan. “When so eone is ready for treatment, New Life will certainly look at all reasonable options to help their recovery.” treatment, New Life will certainly lo k at all reasonable options to help their ecovery.”

Regarding Medicaid's reimbursement rates for addiction treatment services, Wheeler says New Life’s executive team considers them“reasonable.” But one problem in serving clients whose only coverage is provided by Medicaid, Wheeler says, is a shortage of inpatient treatment facilities to meet their needs – especially with opiate addiction rates continuing to increase. Medicaid rates are “reasonable” Regarding Medicaid's reimburse ent rates for ad iction treatment services, Whe ler says New Life’s executive tea considers the “reasonable.” But one proble in serving clients whose only coverage is provided by Medicaid, Whe ler says, is a shortage of inpatient reatment facil ties to me t their ne ds – especially with opiate ad iction rates continuing to increase. When the landmark Affordable Care Act became law in 2010, advocates for mental health and addiction treatment hailed it as the start of a new era of equality for those who need care. But addiction treatment professionals say that while the ACA represents a step forward, it is anything but a remedy for all difculties. Over the years, treatment providers have made great strides in developing care methods to yield positive outcomes. Today, the biggest challenge in providing addiction and mental health treatment may be guring out who will pay for that care. So, most of the questions involving the impact of the ACA, aka Obamacare, involve reimbursement, says Jim Collins, counselor and business development manager for New Life Addiction Counseling Services. One group the ACA does not cover is the voluntarily uninsured, those who “choose not to have the government involved in their nancial life – either because they work for cash or have an illicit means of income,” Collins says. There is also a lack of facilities to provide addiction treatment; just because someone has insurance doesn't mean a particular facility necessarily takes that

Regarding possible solutions to help make treatment aordable for more people, Collins would like to see changes in the procedural requirements insurance companies place on treatment providers like New Life. One of the major drivers of addiction treatment costs is patients who relapse, and – in some cases – cycle through treatment multiple times. Collins believes one way to reduce relapse rates would be to adopt more of a “top-down” approach: since insurers are focused on reducing costs, they typically favor starting with less-expensive outpatient care. They see inpatient care as a second option, for patients who have failed at outpatient treatment. Collins says it would make more sense to start with inpatient care, rather than “making clients fail at a lower level of care” before receiving inpatient treatment. In the latter case, patients who need inpatient treatment often have to be placed on waiting lists until a bed is available. “Any number of things” could happen to a client while they are waiting – a health crisis, incarceration or even death. So, “waiting is not the best option.” Regarding pos ible solutions to help make treatment aordable for more people, Collins would like to se changes in the procedural requirements insurance companies place on treatment providers like New Life. One of the major drivers of ad iction treatment costs is patients who relapse, and – in some cases – cycle through treatment multiple times. Collins believes one way to reduce relapse rates would be to adopt more of a “top-down” ap roach: since insurers are focused on reducing costs, they typically favor starting with les -expensive outpatient care. They se inpatient care as a second option, for patients who have failed at outpatient treatment. Collins ays it would make more sense to start with inpatient care, rather than “making clients fail at a lower level of care” before receiving inpatient reatment. In the lat er case, patients who ne d inpatient treatment often have to be placed on waiting lists until a bed is available. “Any number of things” could hap en to a client while they are waiting – a health crisis, incarceration or even death. So, “waiting is not he best option.”

“Waiting is not the best option.” -Jim Collins, counselor and business development manager, New Life Addiction Counseling Services.

Addiction treatment in the age of Obamacare i i e e i e e f b e

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“CLIENTS NEED TO KNOW YOU HAVE COMPASSION, EMPATHY AND A NON-JUDGEMENTAL ATTITUDE TOWARD THEM.” – TRISH EARNEST, COUNSELOR, NEW LIFE

Counselor believes in the power of the group

“I LOOK AT EACH CLIENT AS AN INDIVIDUAL, WITH THEIR OWN 'CHALLENGES’ THAT THEY BRING INTO TREATMENT.” – TRISH EARNEST, NEW LIFE

Non-judgement is “a big one,” Earnest says. Early in her counseling career, “heroin was a bit of a mystery to me, since I had never used it.” But, seeing the daily struggles of opiate users made her more empathetic toward those clients. “It's been eye-opening.” ‚e ˆrst step in providing help and support is ˆguring out what each client needs.‚at happens at intake. “We have a very extensive intake process. We screen clients on the phone, ˆrst, before they even walk in the door.” When she sits down with a new client, Earnest asks many questions – about their history of substance use, any past emotional or physical trauma, any previous attempts at treatment, family background and their present living situation. “I try to ˆnd out what is motivating them now. Do they go to 12-step meetings? Do they have a sponsor? It's a pretty lengthy and in-depth process, so I can get a picture of where they are in the (recovery) process.” One diŠerence among the clients she works with is that a certain percentage have been mandated by a court to undergo treatment. “‚ey

can still recover, even if some of those who have been mandated to treatment are a little more resistant.” At New Life, working individually with each client includes not only psychological counseling, but also addressing a wide range of other life issues, such as ˆnancial matters, coordinating medication, or helping clients ˆnd supportive housing and other needs.‚at often involves partnering with a variety of public agencies and private service providers, Earnest notes. “We've become a very multi-faceted treatment center in helping clients in all areas of their lives.” One of Earnest's primary roles is leading therapy groups, which provide an eŠective setting for recovery from addiction. “When I have a group that works well together – when they learn to trust each other, talk about issues and help each other move forward toward better lives – that is very gratifying. You don't get that all the time in group, but there is a tremendous amount of power in group work that can provide a lot of support for people.” 17

Bethesda, Md. Once in recovery, Earnest began to see addiction counseling as a good career ˆt and returned to school to earn the necessary certiˆcation. She completed her supervised clinical practice requirements, and joined the staŠ as a counselor about two years ago. Counseling professionals often say that the really important learning in their ˆeld takes place on the job, rather than in school. One key principle Earnest has learned and applied in her years of practice is the importance of treating each client as an individual. “I do group therapy, but I still look at each person as an individual, with their own 'challenges' that they bring into treatment. We can't treat everybody the same. Clients also need to know you have compassion, empathy and a non-judgmental attitude toward them.”

Trish Earnest, an intake clinician and group therapist at New Life Addiction Counseling Services, has spent her entire career in counseling and teaching roles. But, it wasn't until fairly recently that she found her true calling as an addiction counselor. After graduating from college with a psychology degree, Earnest began her career working with troubled youth in a state-run facility, and also worked as a special ed teacher in a private, religious school. In 1995, Earnest sought treatment and recovery after her long-term addiction to alcohol, marijuana and cocaine. ‚e addiction had led to the breakup of her marriage, a potential home foreclosure and the possibility of losing custody of her two young sons, then ages 1 ½ and 3 years old. To get her life back on track, Earnest completed six months of treatment and aftercare in a program in

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Dealing with the dysfunction

One of the most important facts about addiction is that it is a family disease, which affects not only the addict, but his or her entire family. Similarly, “recovery from addiction is a family affair,” according to Misshay White, a counselor who leads New Life's family support group. Education is the primary focus of the group, White says – giving family members the information they need to better understand what is going on with the addict or alcoholic, and nd out how they can help themselves. A mutual healing process

“They usually think addiction is just a matter of choice; they have to understand that addiction is a disease of choice.” – Misshay White, New Life

New Life's family support group gives family and friends an opportunity to look at their involvement in the cycle of enabling and codependency that accompanies addiction, learn how to take care of themselves, and also ways to support the client. Experts on addiction say the support that a family provides to a client recovering from addiction is crucial to that client's success.

further out, while at the same time learning how to say 'No' and developing coping skills.” She also helps family members understand the concept of codependency, and encourages them to seek out a 12-step support group like Al-Anon or Nar-Anon – programs developed to help the family members and friends of people who are battling addiction. Family members need to learn how to say “no.” They also need to learn how to communicate – “lack of communication is one of the reasons why addicts do what they do,” White explains. “They need to learn the best thing they can do for the addict or alcoholic is to be an example of balance and self-care. We are all still responsible for our own self-care.” When family members get involved in a healthy way, under counselor supervision, the addict or alcoholic has a better chance of achieving recovery, White says. Clients are encouraged to ask their family members to take advantage of the family group opportunity. In treatment, “we let the client know, 'It will work better for you and your family if you heal at the same time.'” Over time, White says she has seen more clients taking an active role by inviting their family members to participate in the group. And “once I share with a client that their family has attended, I can see them take on more responsibility and accountability for their own recovery.” Family members also need to learn that “after they do all that, the addict still has to make a choice: to choose life or death.”

One of the rst things White does during group is make sure family members understand that, as the client heals, there should also be healing taking place within themselves. “Usually, when family members come to me, they have a notepad and pen and a list of questions,” White says. “The rst question is often 'How can we x this person?' Family members often think there is a switch they can turn on or off to get them well; they think the problem is just with the person and not them.” Sometimes, family members don't understand the disease concept of addiction. “They usually think addiction is just a matter of choice; they have to understand that addiction is a disease of choice.” “Living with an addict is truly exhausting,” says White, who provides information on how addiction can destroy families and individuals within the family. She also suggests things the family members can do for the addict and themselves. One of the most important things family members can do for the addict is to take care of themselves, White says. Family members often blame themselves for the addict's behavior, and feel they haven't done enough to help them – or that they may have done too much, White says. An important principle she emphasizes is that “the family members should not work harder than the addict.” She helps family members learn what not to do to avoid “assisting the addict to move further into their addiction – they learn how to stop the name-calling and pushing the addict

“We let the client know, ‘It will work better for you and your family if you heal at the same time.’” – Misshay White, family group counselor, New Life

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“Once they accept and surrender to the fact that this is part of who they are, it becomes an easier process.” – Deb Murphy

Play with a Purpose Counselor uses varied tools to engage clients

Because each client is a unique individual, they pose different challenges for the counselors whose job it is to help them. Murphy says one of the most common is “getting clients to accept the fact that they have the disease of addiction.” Addicts’ and alcoholics’ denial systems are very strong and difficult to break through – along with the shame that accompanies addiction – “but once they accept and surrender to the fact that this is part of who they are, the recovery process becomes easier.” One factor that makes the counselor’s role interesting is the constant challenge to “come up with new ideas or new avenues in order to reach them; I’m always searching and trying to find new things for them to do in group,” says Murphy. As a staff member at New Life, Murphy says she’s come to appreciate the fact that “as counselors, we are given ample room to be able to use our personal talents, because every counselor is a little different in their approach. I feel I have free rein to do what I feel is appropriate.” Every client is different, and every group has a different dynamic, which requires a somewhat fluid, adaptable approach.The program at New Life which includes Intensive Outpatient and Continuing Care is 6 months (2 months IOP and 4 months COC).  55

Getting clients involved Murphy uses a number of techniques to involve clients in the group therapy process, such as role playing and art therapy. She might ask group members to draw Venn diagrams (simple charts consisting of two or more overlapping circles) comparing and contrasting thinking patterns in addiction versus recovery, to help them transition into healthier ways of thinking and acting. She might have them draw “recovery towns,” or more generally “draw what recovery means to them.” The goal is to help clients articulate their feelings, which have typically been numbed by long-term chemical use. “It’s difficult for them to be in touch with how they are feeling and thinking and articulate those feelings.The activity gives them an avenue to do that.” Role-playing is used as a way to help patients see themselves more realistically, particularly the defense mechanisms which often accompany addiction. Clients are asked to “act out” various scenarios where they would typically use defense mechanisms – denial, for example. Murphy begins with a lecture on defense mechanisms, and then clients pair up to create five-minute role plays.The exercise “makes a huge difference” in moving clients toward a mindset that will promote recovery, she says. Murphy even uses children’s stories in working with adult clients. She says classic stories, like “The Giving Tree” or “The Little Engine That Could” are other simple, but effective tools. In group sessions, she talks about “what is really going on in the story so the clients can see how it relates to where they are in recovery.” For example, “The Giving Tree” deals with selfishness and “taking from the people you love,” which is a typical part of addictive behavior, Murphy says.

“It’s difficult for them to be in touch with how they are feeling and thinking and articulate those feelings.”

– Deb Murphy, New Life group

Deb Murphy, a group counselor at New Life Addiction Counseling Services, began her professional career as a registered nurse and then spent seven years as a teacher. While working as a grade school teacher in north Baltimore, she became aware of the far-reaching problems caused by addiction to drugs and alcohol. The experience of “seeing a lot of kids who seemed to need help” motivated her to switch careers to the addiction counseling field.

Murphy, who joined the New Life staff in April, 2014, leads groups in New Life’s intensive outpatient program and the continuing care groups which last six months, including intensive outpatient treatment, followed by continuing care. In helping treatment clients face their addictions and move toward recovery, Murphy says she has learned the importance of engaging

the client. “It’s so important for them to actively be part of the treatment process.” Some clients who are dealing with the effects of their addiction may initially be unwilling, or unable to fully participate in program activities, at least in the early stage counseling, Murphy notes.

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“The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility.” – Dr. Nora Volkow, Dr. George Koob, Dr. AThomas McLellan

Setting the Record Straight Earlier this year, three of the nation’s leading drug experts wrote a paper seeking to explain, once and for all, how substance use affects the brain in the same way as similar diseases. In an article published in the New England Journal of Medicine, NIDA Director Dr. Nora Volkow, NIAAA Director Dr. George Koob, and Treatment Research Institute founder Dr. AThomas McLellan say they hope to reaffirm the brain disease model while simultaneously addressing common misconceptions about addiction. “The concept of addiction as a disease of the brain challenges deeply ingrained values about self-determination and personal responsibility that frame drug use as a voluntary, hedonistic act,” the authors write. The authors argue that public skepticism about the brain disease model comes from researchers’ inability to articulately describe the relationship between changes in neurobiology and the behaviors associated with addiction. Although countless scientific studies have proven the brain disease model to be accurate and effective, the authors admit more work may be needed to change public perception. “A more comprehensive understanding of the brain disease model of addiction may help to moderate some of the moral judgment attached to addictive behaviors and foster more scientific and public health–oriented approaches to prevention and treatment,” the authors write.

Fighting for the Brain Disease Model Model can complicate messaging in treatment plans

“You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” – Bob Rohret, MARRCH executive director

 Scientific studies attest that a person’s brain chemistry can be altered as a result of addiction.This fact can provide a needed explanation as to why continued use can still be a problem for people who clearly desire to get clean. “When you start to apply an explanation of why certain behaviors occur,” Rohret says, “it provides people some comfort in understanding why they’re doing what they’re doing.” Mixed Messages But as confident as many in the medical community are about the nature of substance abuse disorder, the idea that addiction is a disease presents something of a double-edged sword for treatment providers. “The messaging has to be sort of finessed,” says Bob Rohret, executive director of the Minnesota Association of Resources for Recovery and Chemical Health (MARRCH). “You have to emphasize the responsibility on the part of the person, but you also have to explain why the behaviors are happening.” Rohret says treatment providers have to inform those in recovery about the nature of their disease, while also making sure knowledge of that disease doesn’t become a crutch or an excuse for inaction. When presented correctly, Rohret says patients should understand their addiction and responsibility toward it in much the same way someone with heart disease may understand their affliction. Although they cannot change the biological makeup of their body immediately, they can make behavioral changes and take actionable steps that lead to more positive outcomes.

Fighting public opinion can be an uphill battle, sometimes even a futile one. Despite years of progress and scientific advancements, researchers and treatment providers still find themselves having to convince the general public that substance use disorder is a disease. But it’s a message that can often complicate treatment plans as much as it seeks to inform.

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We offer a safe, condential atmosphere that promotes the development and maintenance of a healthy, sober lifestyle abstinent of alcohol and drug abuse.

Offering a Fresh Start By Beverly Ervin

New Life Addiction Counseling Services recognizes the importance of focusing on recovery as we continue to battle the power of addiction. Recovery often means a fresh start for our clients as spotlighted in this issue. Also take a moment to read about the value of spirituality and the need to have faith in a “higher power” as an aid in recovery. New Life is actively involved in the first local conversation with “Recovery over Dinner” which brings together members of the political, faith and recovery community to continue the conversations and events supporting the many among us in recovery. Wherever you may be on September 25, 2016 show your support for those around you battling addiction and support your local Recovery Walk. Enjoy the Summer issue of New Life magazine. Beverly Ervin CEO

FOR MORE THAN 32 YEARS, WE’VE HELPED COUNTLESS PEOPLE MOVE PAST ADDICTION AND MENTAL HEALTH ISSUES TO EXPERIENCE HAPPY, PRODUCTIVE LIVES. WE CAN HELP YOU, TOO!

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Medical science has signicantly increased its knowledge of basic pharmacology and the receptor sites involved in addiction and the management of patients, Dr. Forrester points out. “As usual in medicine, there is much more to be learned and, as time goes on, I'm sure there will be newer compounds that will become available for treatment of these patients.” Another positive development is that “the government is nally taking a more critical look at the fact that there is a major need to help fund programs to assist these patients,”Dr. Forrester says. He also points out that more assistance is needed not just for those patients who are covered by Medical Assistance or other public plans, but also for patients who are covered by private insurance plans. While advances in medication-assisted treatment have helped make it possible to treat more people for opiate addiction, the treatment eld still faces a shortage of psychiatrists and addiction medicine specialists. Dr. Forrester says he receives two to three dozen telephone and e-mail requests weekly

from search rms seeking physicians for temporary or permanent employment. “In psychiatry and addiction medicine we are sorely understaed. Congress has been considering legislation to make more funds available for addiction treatment. I don't know if – in the long run – that will lead to the creation of more comprehensive care systems, or to oering additional funding for private clinics like ours.” To better respond to the current epidemic of opiate addiction, Dr. Forrester would like to see the government do more to one, acknowledge the problem; two, destigmatize addiction and treatment; and, three, provide additional funding for treatment. Going forward, Dr. Forrester believes that health systems, government and society in general are “going to be much more attentive to the needs of this population.”

New Life Addiction Counseling Services recently announced the appointment of a new medical director: Dr. Alfred Forrester, a psychiatrist with extensive experience in addiction medicine. Dr. Forrester's primary roles at New Life are to assess and manage clients for psychiatric and substance use disorders, conduct patient chart reviews and provide medical leadership for the New Life Executive Committee. At New Life, Dr. Forrester spends most of his clinical time assessing patients, making pharmacologic

New Life announces new medical director

PLAYS A PIVOTAL ROLE

In the addiction treatment setting, Dr. Forrester says he sees the psychiatrist's role as “pivotal” in providing patient care which complements the care provided by other caregivers. “He or she is the one who integrates information from a variety of sources; the one to whom the other caregivers turn to address the interface of emotional and medical issues,” he says. The pharmacologic treatment of addiction has been advanced by several recent developments, including the introduction of buprenorphine, a prescription medication for those addicted to heroin or other opiates. Buprenorphine acts by relieving the symptoms of opiate withdrawal such as agitation, nausea and insomnia. Buprenorphine is less addictive and has a lower risk of overdose than methadone. “It's been an advance over what we had, which was methadone,”Dr. Forrester says. Using the drug to alleviate the symptoms of opiate withdrawal makes it easier to get the patient to address some of the issues in his or her recovery, while being gradually weaned from buprenorphine, he explains. “Some programs believe in buprenorphine maintenance (for indenite periods) as opposed to our approach, which involves starting the patient on buprenorphine and gradually tapering it over the ensuing months.”

recommendations in the management of major psychiatric disorders, and

providing follow-up medication management. He also provides ongoing psychotherapy to patients, either as an adjunct to or in the absence of pharmacologic management.

HIGHLY QUALIFIED

residents in the training programs at Johns Hopkins, University of Maryland and the Sheppard and Enoch Pratt Hospitals; he has served as a consultant for community mental health clinics and been a member of the Towson University Counseling Center; along with maintaining an active private practice for the past 19 years. Earlier in his career, Dr. Forrester collaborated with investigators and coauthored numerous articles examining the relationship between the diagnosis of major depression and traumatic brain injury, spinal cord injury or myocardial infarctions. 47

New Life Executive Director Beverly Ervin says Dr. Forrester brings “impressive credentials” to New Life. Dr. Forrester received his undergraduate degree fromYale University and his medical degree from The Johns Hopkins University School of Medicine. He is board-certied by the American Board of Psychiatry & Neurology and is a diplomate of the National Board of Medical Examiners; he is a member of the American Medical Association and the Maryland Psychiatric Society, and a Fellow of the American Psychiatric Association. Dr. Forrester has had privileges at several hospitals in the Baltimore area; he has supervised psychiatric

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