Communities—Know the Science of Addiction

 

RMPBS has aired the documentary, “Addiction” on the NOVA science series. NOVA, a production of WGBH Boston, takes an unflinching look at the science of addiction and how it works. It traveled across the country to hear firsthand from individuals and families struggling with addiction and meet with researchers on the front lines of the opioid crisis. While addiction has long been viewed as a moral failing, leading scientists will help viewers understand why addiction is a disorder that occurs as drugs profoundly alter the brain. An important and most informative part of the NOVA presentation, demonstrated that drug addiction is a disease of the human brain. Researchers pioneered the use of brain imaging to investigate the toxic effects and addictive properties of abusable drugs. Studies have documented changes in the dopamine system as the brain strives to find balance between pleasure, pain, and motivation. This research has produced irrefutable evidence of the value of medicine in addiction treatment and recovery. The documentary states that “addiction is a very treatable disease.” It is easier to forget all the brain parts names and focus on the brain receptors and their role in producing overwhelming craving and pain of withdrawal. To allow the brain to function, both must be reduced or eliminated and that is the role of medically assisted treatment recovery. We can identify elements of the documentary in non-scientific terms.

It Takes a Villain: We ignored known brain science that told us of the addictive nature of opiates. We have an opiate crisis. The “Addiction” documentary describes the devastating effect on communities, families, and individuals. It too briefly points out that there are other deadly and well-known villains—alcohol and nicotine. Misuse of alcohol is deadly and addictive. It causes 80,000 deaths a year and untold negative economic impact because of health care costs. My observation is that the introduction of vaping has eliminated some harmful effects of smoking tobacco. Vaping is a treacherous delivery system for nicotine and flavored nicotine is invading (invaping?) our youth culture. Unfortunately, vaping can include marijuana in the delivery system. It threatens young brain development and may lead to addiction. Colorado must focus on prevention through creative approaches.

A Spoonful of Wisdom Helps the Medicine Go Down: Fortunately, we have a new depth of focus on the science of addiction. From this has come medication-assisted treatment (MAT) recovery, and prevention of death from overdose. To better occupy our space on earth with hope and health we can also find a path to MARS— Medically Assisted Recovery Services. “Addiction” spends a great deal of time discussing the drugs that can overcome craving and the pain of withdrawal. For many, craving and fear of withdrawal may be more powerful than fear of death! Methadone, Suboxone, and a number of the newer drugs such as VIVITROL, can be effective. All medications will have a prescribed purpose. This treatment must be accompanied by appropriate therapy and recovery services support—MARS. A new Colorado Health Institute analysis examines the state of MAT in Colorado.

Addiction Recovery— A Family Affair: The process of a family’s recovery requires the hope of healing, healthy change, and regaining trust. “Addiction” told stories of families who had totally wiped out all financial assets in pursuit of solutions for their child or other family members. There were dramatic portrayals of family distress, A term to consider is one that somehow defines a family’s fate. The term is “chronic sorrow.” What a sad and apt descriptor of a paralyzing state of mind. There is little hope when the coper’s broke.

Infrastructure—Building Recovery after Addiction. Just as roads and bridges transport us from one location to another, a strong public health infrastructure serves as the framework to bring those suffering from active addiction to a place of safety and recovery. Infrastructure must include effective recovery support programs and be open to innovative but controversial approaches to harm reduction. Addiction provides insight to a Canadian program of safe and supervised injection sites. There are clean needles, drug testing for Fentanyl, and care and concern. It appears to overcome, outta site, outta mind. There are efforts in cities and states across the America to overcome legal issues and adopt similar programs. Immediate and serious consideration is being given by Denver and/or Boulder to approve what is termed supervised use sites. Critical, life-saving decisions are called for.

The Foundation of Fellowship and Friendship: The reduction or elimination of craving and the pain of withdrawal allow the individual to absorb and think about healthy solutions to living daily life. In “Addiction,” a group of individuals was shown, sharing their stories of feeling better and telling of their achievements, big and small. The power of stories shared could lead to long-term recovery. Connections allow elimination of isolation and the seeking of fellowship and friendship. Peer recovery support becomes invaluable and responsibility and accountability become realistic goals. The connections are made and kept between the heads and hearts of others with a positive common purpose and with mutual support. Recovery happens.

The Communities’ Role in the Opiate Crisis: Congress has taken action in the passage of the SUPPORT for Patients and Communities Act. It includes policies and resources that support people in recovery from addiction across the lifespan. The act provides for building communities of recovery. This provision reauthorizes and modifies the Building Communities of Recovery program to include peer support networks. This program provides funding for community organizations providing long-term recovery support services related to substance use disorder. It is hoped that agencies and entities will pursue the available funding for their communities. Beyond medications, there must also be attention to prevention as well as treatment and recovery support.

Merlyn Karst

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Opiate Crisis—Help and Hope in Communities

 

Nova, on PBS, featured a program on addiction pointing out through the study of the science of the brain, addiction is found to be a treatable mental health issue including substance use disorders.  It presented stories of crisis, stories of recovery, and potential medical solutions. The opiate crisis is a fact for all Colorado communities. Congress has taken action in the passage of the SUPPORT for Patients and Communities Act includes policies and resources that support people in recovery from addiction across the lifespan. The bill is over 600 pages long, but pay attention to the titles of some sections. Sec. 7151. Building communities of recovery. This provision reauthorizes and modifies the Building Communities of Recovery program to include peer support networks. This program provides funding for community organizations providing long-term recovery support services related to substance use disorder. During recovery month there were three notable events that were good news about resources available in Colorado and in many states across the country.

Advocates for Recovery—Colorado: This year Denver Colorado was the city that held Faces and Voices of Recovery’s national hub event. It was also the 15th annual Rally hosted by Advocates for Recovery-Colorado (AFR-C). In our present crisis, presentations featured words from those who understand the science of addiction and the value of medically assisted recovery (MAR) to save lives. It brings understanding and focus on Alcohol and Other Drugs (AOD) and use disorders. A remembrance wall and tree gave recognition to those who died from opiate overdose in the U.S. and Colorado. Visit website advocatesforrecovery.org —drop in at 6981 Federal Blvd, Denver. 

The Phoenix: A gala was held at the Colorado History Museum with hundreds in attendance, The Phoenix offers a free sober active community to individuals who have suffered from a substance use disorder and to those who choose a sober life. They state: “Using a peer support model, we help members heal and together we Rise & Recover & Live. To celebrate the triumphs of those in recovery and inspire the millions still suffering from substance use disorder, we’re sharing our stories to help shatter the stigmas around addiction and sobriety.” Are you ready to join The Phoenix community? Visit the Denver/Boulder facility at 2233 Champa St, Denver, CO 80205 and at 2204 Hagerman St. Colorado Springs, CO, 80904. Visit: thephoenix.org

Face it TOGETHER: FIT held a ribbon cutting ceremony and celebration at its new facility at 636 South Broadway in Denver. Denver’s Mayor Hancock attended and spoke. FIT is a nonprofit organization that provides effective, science-based peer coaching for people living with addiction, including loved ones of those with the disease.  Face It TOGETHER is headquartered in Denver and they state: “we believe people impacted by addiction, including their loved ones, deserve the same dignity and respect as anyone else affected by a serious illness. And it’s also why we focus on proven strategies, backed by science, and track our clients’ progress along the way. We do purposeful, mission-driven work as a business in the social sector. We see ourselves as change agents, using innovations in customer experience, technology and data science, to deliver personalized health coaching that transforms the lives of people impacted by addiction.”  Investigate their Workforce Initiative, denver@wefaceittogether.org

We long recognized that recovery Infrastructure must include effective recovery support programs. Critical is the use of recovery coaches, and reinforcing the value of services like peer-to-peer programs, skills training, and supportive housing. As stated above, congress is the prime mover in implementing and adequately funding these recommendations. Besides the organizations mentioned above there is also the Peer Coach Academy offering peer recovery coaching, and a multitude of agencies. Health and Human services provides funding support. Growing increasingly important is the science of medically assisted recovery—MARS. Certainly Young People in Recovery and the Betty Ford Children’s program serve the young and very young, and their families, Young adults are particularly vulnerable due to their still developing brains. The messages of prevention are very important and need special attention before any introduction to drug experimentation and use leading to addiction and even overdose. The informed and active communities have a critical role to play in overcoming the crisis. It may begin with knowing your neighbor.

Merlyn Karst

Recovery from Addiction Happens See the Evidence

Every September, Substance Abuse and Mental Health Administration (SAMHSA) promotes Recovery Month to increase awareness and understanding of mental health and substance use issues and celebrate communities.During this month, many of the recovering millions will stand up, stand out, speak out, and be proud of their recovery. Faces and Voices of Recovery annually designates a city for a national hub event. This year it is in Denver, Colorado. Advocates for Recovery-Colorado will hold a Rally for RecoverWe in Civic Center Park on September 15. It begins with assembly and registration at union station at 10 a.m..  Beginning at 11, all will walk down the 16th Street Mall to the park. The music, faces and voices of recovery, food and fun fills the afternoon. On a solemn note: This year’s rally features a Remembrance Tree for those lost to the substance use disorder we know as addiction.  Our sponsors and resource providers are there to inform and encourage those who seek recovery for themselves, family members, and friends. The event concludes at five but the celebration of recovery continues and grows over time. Please visit advocates forrecovery.org for more information. Under the banner of Faces and Voices of Recovery, there will be many rallies and other events across the nation in September. They are worth time, attention, and support through presence and participation.  Those in the prevention, treatment, and recovery fields have constituencies of consequence. Those constituencies have faces and voices. The crisis needs informed and dedicated messengers and advocates to overcome the illicit drug crisis that creates economic, health, and family tragedies that plague our nation. The rallies and events are information resources for all. We have a national recovery movement. We could say that we need a WeToo movement that focuses on overcoming substance use disorders.

Carl Sagan was noted for his perspective on the universe and spoke of billions and billions of stars. He said, however, that extraordinary claims require extraordinary evidence. The Hubble telescope now provides evidence to support past extraordinary claims. Our small universe in the United States has been skeptical of what seemed to be an extraordinary claim: recovery from addiction is a reality. There is an old cliché that says, seeing is believing. We could expand that to say, Seeing and hearing is believing. Believe me, the stories of recovery are powerful. The recovery evidence lies with the lives of millions and millions of people—statistically reported to be twenty-three and one/half million. They are the evidence. The number could be a lot higher if there was more access to treatment and recovery and there weren’t stigma and discrimination preventing people from getting help. To assist in overcoming stigma and discrimination, Faces and Voices of Recovery has changed the language used to describe those who suffer from addiction.  Just as the Hubble opened the heavens, the studies and findings about the science of addiction, now identify addiction as a substance use disorder (SUD), a treatable mental health issue. As such, addiction can be treated with new discoveries in the medical field. Colorado’s Health and Human Services recently launched a campaign titled, Lift the Label.  For more information go to LiftTheLabel.org. The social media hashtag is #LiftTheLabel.
The Office of Behavioral Health is going after stigma as it relates to the opioid crisis. it states, Don’t let the label of addiction obscure the truth.  Though not the case for other addictive drugs, it must be realized that opioid addiction is not always readily apparent; many who abuse opioids conceal it and can remain highly functional in their work and home life.

In a previous blog I wrote: There are professionals with knowledge of the science of addiction who can prescribe appropriate drugs. Kaylin Klie, MD, says, There’s still an entrenched stigma against medication-assisted treatment (MAT) in the treatment community. Medication-assisted treatment includes the use of medications such as methadone, buprenorphine or naltrexone [Vivitrol]. However, the data clearly supports its use. It’s not debatable: we’ve seen significant decreases in overdose deaths, HIV and Hepatitis C transmission rates and other types of substance-use associated infections. People who are receiving MAT usually also have lower rates of incarceration and are more likely to retain custody of their children. These have coincided with increases in productivity and an uptake of medical and mental health treatment, meaning people are getting treatment for other health conditions while receiving medication-assisted treatment. I’m aware that there are many who believe a medication shouldn’t be used to treat addiction for another drug. However, these concerns simply do not stand up to any kind of examination. MAT boasts a significantly higher success rate (60-90%) than the non-medication treatments (5-15%). If we accept this data, the results should be evidence that great value can come from cost reduction and should be the goal of government and consumers. MAT can obviously be effective in stopping craving and allowing the brain to heal. Be not afraid, and be informed that medically-assisted recovery, coupled with therapy and peer support services, will promote long-term recovery and a life of hope, health, and happiness.

Merlyn Karst

A Simple Saying: Savvy Saves Us

Written by Merlyn Karst

Definition of Savvy:  Having shrewdness and practical knowledge and the ability to make good judgments. . Synonyms include common sense, discernment, and understanding.  Being savvy is incredibly important. in living our daily lives. However, Savvy can’t serve us if it is displaced by the craving and pursuit of mind-altering drugs.  Unfortunately, it often leads to the mental health disorder called addiction. Unusable, savvy can’t save anything or anyone.  The costs incurred with drug addiction in areas of financial, mental and physical health, and family distress, is life changing. Much attention is being given to opiates. Also deserving of attention is that deaths of young adults in their twenties and thirties are increasing alarmingly due to cirrhosis of the liver, a very preventable disease. Also know that one can overdose on alcohol. It’s called alcohol poisoning. This is the result of the excessive use of the drug alcohol, accelerated through binge drinking.  Data show s that 88,000 deaths are related to the use of the drug alcohol.  The economic costs are estimated at over $250 billion per year. As one who has had the experience, this conclusive data doesn’t mean much to a family who loses a loved one. Alcohol is cunning, baffling and powerful. It is out to kill but first wants to get you alone.  It is important to know that whether a drug that kills is legal or illegal—dead is dead.

 

FDA: “Too many kids” now experimenting with e-cigarettes. Vaping.  — the established new delivery system for drugs — is invading (invaping?) our youth culture. Primarily, the drug involved is nicotine but so is  marijuana. Nicotine is a highly addictive drug and millions are spent to overcome the “habit”. It’s called addiction.  Marketers of vaping promote the idea that it may help to stop smoking; however, a vaping starter kit is offered for $16 at the same time. Note: one must be of legal “vaping” age — 18 or 21 — depending on the state.  Since when have the young paid attention to the legal age for drinking and drug use?  Though denied by makers, vaping is appealing to kids Young minds have no savvy to measure for risk assessment and diminished brain development and are unaware that chance of addiction is real. Nicotine is a drug that our brain receptors love and want more of. The young person finds a new feeling and the brain likes repetition. When I first heard about kids describing flavors they liked, I thought they must be talking about Jelly Bellies.  Flavors like cookies & cream, cups o’ peanut butter, bubble gum, mango, and cool cucumber. These are vaping flavors with kid appeal, delivered through an easily concealed system and laced with nicotine. Kids, of course, suggest they only vape for the flavors. I suggest Jelly Bellies or better yet, Life-Saver candies.

 

Individuals and families are living in quiet desperation due to alcohol and other drug mis-use and addiction. Addiction not only haunts those caught in its trap but the family as well—especially when kids are involved.  I remember a poster made by a child showing mom on the couch, arm flung out with empty bottle on the floor. Caption:  Mom naps a lot. What isn’t said but thought —why do I make her so tired?

In Colorado’s Betty Ford Children’s Program, boys and girls, seven to twelve years old, learn about alcoholism and drug abuse and how to separate the person they love from the disorder that consumes them.

 

There is help for those seeking support in dealing with drug addiction and certainly, for a parent suffering from addiction, which is the mental health related substance use disorder. (SUD).  Your Hub is a community service that provides a diverse amount of information about events, recognition, profiles, and resource information. There are many faces and places providing healing and hope. —faces to provide experience and peer support and—places to provide safety and comfort.  A new and growing community and corporate resource, Face it TOGETHER  (FIT) has opened a new facility at 636 South Broadway in Denver.  Advocates for Recovery (AFR) at 6981 Federal Blvd, Denver, provides welcoming faces and a place along with many social events. These organizations, along with the Peer Coach Academy, offer peer coach support and training.  Colorado’s Health and Human Services provides grant support to many agencies to provide recovery support services. The web is a great source of information as is various hot lines. The Colorado Alcohol and Drug help hotline is 844-244-3171.  Please seek support in dealing with a crisis that affects individuals and their families.

 

 

Focus and Follow the Road to Recovery

Written by Merlyn Karst..

Solutions to opiate addiction and addiction to alcohol, nicotine, marijuana and other drugs are diligently being sought. Help is available, but the individual must seek or be persuaded to find solutions. William White is a noted author of books and papers on the subject of addiction and these roads and paths to recovery. Before a recent blog, mentioned below, he has a picture of a butterfly with one wing in black and white and one in color.  In the past, I have written about the power of stories of recovery. Many stories are openly and fearlessly shared in the rooms of the alphabet soup of support groups. The rooms are essentially cocoons and metamorphous is gloriously happening. I contend that outside the rooms, too few get to see the butterflies.  As I thought about the picture of the butterfly with one wing black and the other in color, I had an inspiration about the journey from addiction to recovery. I was reminded of a classic movie. The Wizard of Oz. The movie opens in black and white. Chaos, concern, worries, and stormy weather begin the story. The family doesn’t know what is troubling Dorothy and she runs away with her little dog and a few belongings.  When she returns in the face of more a major storm, she finds no family and the door to safety closed to her. Then comes the tornado and the spiral to who knows where. Finally the turmoil abates.  In my movie, a new wonderful world appears in living color and the wicked witch, addiction, has been crunched. Remember, the community of Oz was plagued with a battle between good and evil.  More is revealed and there is encouragement to follow the road to recovery. It looks very inviting considering the paths of the past.

We do have to realize that like the yellow brick road in the Oz movie, the road to long-term recovery has some perils and is rather rocky and winding.  The flying monkeys are out there. They snatch you up and fly off to relapse land. There are temptations from different kinds of witch’s brew and other bewitching stuff.  A touch of irony here— the characters in the movie were delayed in their progress when they lay down in a poppy field. In the real world, it may not be a layover but the end of the journey. So we say, fear not, it is a journey worth taking and there can be some lion-hearted, courageous professionals and peers to show the way. Persevere and you get your brain back, your courage back, and your heart back.  To help on the journey, the faces and voices of recovery have pulled back the curtain of shame and stigma and exposed the reality of recovery. There is no wizard with a magic wand.  The magic is in the stories of millions of persons who have trudged the happy road of destiny.  On the way, share their stories with young people. Our “munchkins” are our future and we need to prepare them for the storms, but also help them see the natural rainbows without any mind-altering chemicals.

In Bill White’s recent blog titled Quality of Life in Early Recovery and Beyond (check the butterfly) he includes some survey information that describes what one might expect on the road to recovery. “These surveys provide retrospective confirmation of the improvements in physical/emotional/relational health and quality of life that accrue with duration of addiction recovery. They confirm that increased time in recovery is linked to enhancement of housing stability, improvements in family engagement and support, educational/occupational achievement, debt resolution, and increased community participation and contribution, as well as reductions in domestic disturbance, arrests/imprisonment, and health care costs.” He further notes that recent studies indicate that quality of life (e.g., happiness, self-esteem, and recovery capital) increases exponentially over the first five years of recovery and continues to increase in smaller increments in subsequent years.

In the past I have written about all of the elements that guide communities to be “recovery ready.” Borrowing more wisdom from Bill White, I learned that sustained Recovery Management (RM) coupled with recovery-oriented systems of care (ROSC) would provide the road map that assures the appropriate support along the journey. In a previous blog I mentioned progress along the road to recovery could be supported by G.P.S.—Guided by Peer Support.  I also wrote that traveling the recovery road requires stops for fellowship fill-ups and spiritual refreshment. It’s a good idea to pull into an overlook for a new vista.  For those who are want to begin the journey to recovery—close your eyes, click your heels together and repeat. I’m ready—Take me to hope, health, and happiness. Take me to hope, health and happiness.  Take me…—and hold on tight.

  A Spoonful of Wisdom Helps the Medicine Go Down

Community alert: Where is Mary Poppins when we need her? Mary, grab your umbrella, duty calls. Our children are in danger of impaired mental and physical development from improper and inappropriate use of drugs by themselves and their parents. The reported number of babies being born addicted is growing. The unreported number of opiate-addicted babies may be partly due to the fear that women who give birth to them are in danger of having their children seized by child protection agencies. I hear that ”vaping”—a new delivery system for flavored nicotine—is invading (invaping?) our youth culture. The first line of defense is prevention. There needs to be a massive educational effort dealing with the dangers in using many deadly drugs—beginning in middle school and including whole families. This is a multi-generational and multi-cultural threat to be ignored at our peril. Another community alert: Funds are becoming available for this important effort from the federal government though state and local agencies and entities. Don’t miss opportunities to use financial and social resources to maximize efforts in community communications.

As a nation, we are involved in an opiate epidemic. Fortunately, we have a new depth of focus on the science of addiction. From this has come medication-assisted recovery. These medications are primarily directed at reducing constant craving and the pain of withdrawal. There is now a medication that prevents death from overdose, but we need to get ahead of that ultimate intervention. The first medically-assisted response came from facing the heroin menace many years ago. Methadone was introduced as a treatment for heroin addiction. The Substance Use and Mental Health Services Administration (SAMSHA) provides the following: Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. Controversy over methadone maintenance has plagued the progress in providing service to recovering heroin addicts. The patients are best served by accessible and convenient clinics to obtain their daily dose. The process of obtaining permits is stalled or stopped because of unfounded fears so NIMBY (not in my backyard) prevails. In today’s environment, it is important to have recovery-ready communities with attitudes and actions to benefit the health and well being of all of its residents. Live informed instead of in fear.

Dip your spoon in the alphabet soup of knowledge about medication-assisted recovery.  In a previous blog I wrote: There are professionals with knowledge of the science of addiction who can prescribe appropriate drugs. Methadone, buprenorphine, naloxone, and naltrexone can all be effective in treating opioid addiction. Nalaxone HCI (NARCAN) can prevent overdose deaths. Medications are often an important part of treatment, more so when combined with behavioral therapies. All lead to the essential ability to think clearly and responsibly. Recovery from addiction leads to physical and mental well-being and alternatives to prolonged medicinal drug use.

Bill White, author and provider of education and motivation to those seeking recovery from addiction writes in a blog titled: The Role of Medicine in Addiction Treatment, “Imagine that the vast majority of organizations specializing in treatment of your condition have no affiliation with a hospital or other primary healthcare facility. Imagine the existence of FDA-approved medications specifically for treatment of your condition, but that you will not be informed about nor have access to these medications as part of your prescribed treatment. These are precisely the circumstances encountered today by the majority of people entering addiction treatment in the U.S.”

The opiate epidemic presents opportunity to educate about prevention, treatment, and recovery. Publications and dialogue must continue to inform and encourage understanding of the science of addiction and that a substance use disorder (SUD) is a treatable mental health issue with recovery possible.  The brain says we are doing fine on drugs—until the body betrays us. Our recovery-ready communities have an important role to play in providing reason and resources to support hope, health and healing. All are within our grasp—if we extend our reach.     Merlyn Karst

House-Help-Home

hope

Driven by the opiate crisis, there has been a lot of talk and some beginning action on funding and outlining needs to help communities to become Recovery Ready. This includes housing and alternatives to incarceration. Overcoming stigma and the overreaching attitudes related to NIMBY are constant barriers to sensible, social, and economical, solutions. I offer several examples beginning with a recognized example of successful sober/recovery living program Oxford House™ was born in 1975 when thirteen men living in a county-run halfway house that was closing needed a safe living place to continue their recovery. It has continually focused on providing opportunity for long-term recovery. From it’s beginning, Oxford House™ has drawn on three legacies inherent in American history: individual liberty, participatory democracy, and entrepreneurial freedom. This focus has paid off. Today, there is a national network of 2,200 Oxford Houses (17,490 beds) with continued expansion and recovery outcomes second to none.  Sober living is essential but recovery living for the long term is the goal. We are pleased to have several Oxford Houses on the front range of the Rockies.  Available are housing, help, hope—and healing.

I discovered an article in the Washington Post Magazine, dated November 1989. It was titled: The Oxford House Experience and the opening paragraph reads: Roommates Wanted: To live in a group house in a good neighborhood. Must be recovering addicts or alcoholics wiling to work hard, pay their own way—and help each other stay clean. It tells the story of the beginning of Oxford House and the struggle to establish group homes in “good” neighborhoods—or any neighborhoods for that matter. The attitude about NIMBY (not in my backyard) was dramatically apparent.  Even Mr Rogers may have hesitated. Finally, help was on the way. The 1995 Supreme Court case, City of Edmonds, WA v. Oxford House, Inc. established that Oxford House residents are a protected class under the Federal Fair Housing Act and entitled to accommodation with respect to locating Oxford Houses in areas zoned for single families. This Act has and can have broad implications in dealing with NIMBY activity.

In the early 90’s, after retiring from corporate life, I became acquainted with Nancy Clark’s Alternative Sentencing Program (ASP) in Orange County, California. I bought into the program and the promise of wellbeing for others and myself, and became administrator for a number of years. Our Recovery Centers housed dozens of residents in shared apartments with limited freedom. They could to work, go to school or enjoy fun, fellowship, wit, and wisdom in mandatory meetings. Subject to testing, no alcohol or other drug use was permitted.  Outside smoking was allowed. Docile about no drinking, they would commit mayhem for a cigarette. Residents paid fees, learned responsibility, accountability, and the worth of freedom.  Though NIMBY attitudes existed, these residents were part of a quiet, civil, community. Many were involved in community service. Our role in the justice system was to provide a safe environment, education, supervision, and reporting. The social and economic value to the County was significant in face of the costs of incarceration.  We provided reason and resource to reduce recidivism.  Counties and communities along the front range are providing alternative sentencing programs. It allows work and pursuit of education and skills training. Programs may involve house arrest, electronic or GPS monitoring, and court supervision.  Drug offenses may require recovery support services.
Fee Schedules and information about application and access to alternative sentencing programs are available on the internet.

During this time, drug courts were beginning to be established. Our drug court was a mutual resource and benefit to our program and several of our residents. I appreciated drug court graduations. There were no caps and gowns just claps and grins. Today drug courts are made up of judges, prosecutors, defense attorneys, community corrections, social workers, and treatment service professionals. There is focus on the family and their health and welfare.  As of June 2015, the estimated number of drug courts operating in the U.S. was over 3,000. That number is substantially larger today. Many counties in Colorado are being well served by our drug courts .

The history I have related is relevant today as we build recovery ready communities. As we work to provide housing and recovery support services for recovering persons, we need to change language and attitudes. A section of the Comprehensive Addiction and Recovery Act, (CARA2.0) indicates funds may be used on to conduct public education and outreach on issues related to substance use disorders (SUD) and recovery and reduce the stigma associated with SUD. Funds may be used to build connections between recovery support services and networks, including treatment programs, mental health providers, treatment systems, and other recovery supports. Grants to recovery community organizations to enable such organizations to develop, expand, and enhance recovery services are available.  Recovery community organizations can mobilize resources within and outside the recovery community to increase long-term recovery. They should be wholly or principally governed by people in recovery who reflect the community served.” Under the Act there is a National Youth Recovery Initiative: Funds may be used to develop, support, and maintain youth recovery support services, including maintaining a physical space for activities, staff, social activities—and to establish recovery high schools. Initiatives should be coordinated with other social service providers (mental health, primary care, criminal justice, substance use disorder treatment programs, housing, child welfare, and more. It will support development of peer support programs, and other activities that help youth and young adults achieve recovery from substance use disorders.

The recognition of the need for funding is evident but the stated recognition of the comprehensive needs out lined in CARA 2.0 is also very important. Recovery community organizations have opportunities along with the need to be aware, wary, and wise in determining means and motivation of those who will serve. Politics and recovery are local.

Merlyn Karst