In Plain Sight? Tools for Recognition and Management of Substance Abuse in the Primary Care Setting

Dr. John Larson Corporate Medical Director Gateway Treatment Cetners

Dr. John Larson
Corporate Medical Director
Gateway Treatment Cetners

Gateway Partnered with the SIU School of Medicine and the Illinois State Medical Society to present “In Plain Sight? Tools for Recognition and Management of Substance Abuse in the Primary Care Setting” on Wednesday, June 3, 2015. The event was very well received by an audience of over 90 doctors, nurses and clinicians. Feedback was very supportive of the need for more education on the topic of substance abuse and substance abuse treatment.

In an effort to further educate medical professionals on recognizing the signs and symptoms of Substance Abuse, Gateway Alcohol & Drug Treatment’s  Corporate Medical Director, Dr. John Larson presented “”Identifying and Treating Substance Use Disorders” at the “In Plain Sight?” Conference.

Substance Abuse Screening toolsFor more information about the tools you can use to screening for substance abuse in a primary care setting, visit

The conference was held at the memorial center for Learning and Innovation in Springfield, Illinois.

Is That an Elephant in Your Exam Room?: How to Talk to Patients About Substance Abuse Treatment

As a health care professional, your role is to collaborate with patients in regards to their state of health and wellness. Together, you search for clues and evidence to either identify or rule out potential health risks and discuss strategies to enhance wellness. Understanding your patients’ lifestyles as well as details about how they manage stressors, such as career, home, family or personal set-backs, is customary during an annual health check-up. But are you adequately addressing the elephant in the exam room?

“Let’s face it talking to patients about substance abuse can be tricky. Whether real or perceived, there are disincentives for doctors to talk with their patients about substance abuse, including time constraints and our society’s aversion to awkward encounters,” says Dr. John Larson, Corporate Medical Director, Gateway Alcohol & Drug Treatment. “Yet, skipping the topic entirely is a huge disservice to your patients who depend on you to help keep them healthy.”

Bear in mind, there are plenty of myths about substance abuse and drug rehab that actually perpetuate avoidant behavior from patients who need help remaining sober, including:

  • A person can’t be forced into treatment, and has to have the desire to change for treatment to be work.
  • Addiction treatment didn’t work in the past, so there’s no point in trying again.
  • Overcoming addiction is merely a matter of willpower. People can choose to stop using drugs if they really want to change their lives for the better.

Help Inspire Self-Directed Change in Others

To overcome misperception as well as the societal stigma of substance abuse with your patients’, it’s important to motivational interviewing, substance abuse, gateway alcohol & Drug treatment centersset a positive tone from right off the bat. Simply advising patients to change if a problem is revealed often is unrewarding and ineffective. That’s why Gateway recommends using techniques of Motivational Interviewing (MI) to promote self-directed change. In fact, a recent meta-analysis* of 72 studies found that MI outperformed traditional medical advice-giving in 80% of the studies.

To clarify, Motivational Interviewing is an open-ended, non-confrontational approach for interacting with persons who are unsure, uncommitted or ambivalent about changing. The spirit of MI, which is prioritized over technique, includes partnership, acceptance, compassion and evocation…or P.A.C.E.:

  • Partnership refers to collaborating with patients on their journey of exploration and decision-making.
  • Acceptance involves acknowledging and respecting patients’ inherent worth or ability within and as ultimate decision makers.
  • Compassion involves demonstrating commitment and behavior supportive of patients’ best interests.
  • Evocation encompasses the use of reflections, open-ended questions and non-judgmental exploration to facilitate exchanges in which patients elicit their concerns and reasons for change.

Trying to impose motivation upon patients makes it less likely they will change. Rather, it’s the role of the patient to make needed changes in MI; and your responsibility as a physician is to educate and empower your patients to make well-informed decisions that satisfy their own personal health needs.

If you know someone that could benefit from a free, confidential substance abuse consultation, encourage them to call 800-971-HOPE, or visit

*US National Library of Medicine National Institutes of Health

Insight from Gateway Expert: How to Break a Habit

John Larson Gateway Treatment Centers

Dr. John Larson
Corporate Medical Director
Gateway Treatment Centers

A large portion of our waking lives is filled with habits of behaving that seem almost automatic. For instance, we may walk into the bathroom first thing in the morning and immediately reach for a toothbrush and toothpaste. The fresh taste and sweetness of the toothpaste triggers a small response in the reward center of the brain, and the behavior is reinforced.

In fact, habitual behaviors like brushing one’s teeth create pathways in the brain that actually change its chemical activity in a way that is similar to the change produced by addictive substances. The stronger and faster the behavior affects that reward center, the quicker a habit is formed.

So, what’s the best way to break a bad habit?

Form a good habit that is incompatible with the behavior we are trying to change, and “stick with it!” The reward of that new behavior may not be apparent at first. Research suggests it takes an average of several months to form a new habit through repetition so we have to be mindful and make a concerted effort to “stick with it” until new connections to the brain’s reward center are formed. When that happens, the new behavior becomes easier and easier, and as a result we have a new healthier habit to replace a less desirable one. If we “stick with it,” together we can reap the benefits of enhanced wellness in 2015 and beyond!


Addiction Treatment Expert Presents at 15th Annual Interdisciplinary Nephrology Conference

dr john larson, gateway alcohol and drug treatment, medication assisted treatmentOn Friday, October 24, 2014, addiction treatment expert, Dr. Larson (Medical Director, Gateway Alcohol & Drug Treatment Centers) presented, “Recent Advances in Medication Assisted Treatment of Addiction” at the 15th Annual Interdisciplinary Nephrology Conference. The conference was hosted by the National Kidney Foundation of Illinois in partnership with the Illinois Council of Nephrology Nurses and Technicians (ICNNT), the Illinois Council on Renal Nutrition (ICRN) and the Illinois Council of Nephrology Social Workers (ICNSW).

Mara Lidacis, Director of Community Health Education of National Kidney Foundation of Illinois, stated “We thank Dr. Larson for presenting to the social workers. From what I heard, the presentation was very well received. I know they appreciated having him share his expertise.”

Learn More:

A Doctor’s Note: How Self-Medicating Spirals into Addiction

By Dr. John Larson Corporate Medical Director Gateway Treatment Centers

By Dr. John Larson
Corporate Medical Director
Gateway Treatment Centers

Many individuals stumble into addiction unwittingly by trying to self-medicating, or using a substance to manage the symptoms of an underlying medical or psychiatric problem such as pain, anxiety, or depression.  The substance may be alcohol, an illicit drug, or a prescription medication.  In the beginning there may be short-term relief but as tolerance develops the medication or drug becomes less and less effective.

A common example is social anxiety, or fear of being in large groups, especially when there are lots of strangers.  Alcohol is commonly available and in modest doses it may initially reduce the anxiety providing a sense of relief and even a pleasurable sensation because of the effect it has on brain chemistry.  However, the body metabolizes the alcohol very quickly and it soon loses its effect.  With continued use the chemistry of the brain gradually changes and the feeling of anxiety or nervousness gets worse when alcohol is not present, even when the individual is not in a stressful social situation.  The amount and frequency of use increases and physical dependence develops.  When an individual tries to cut back, the rebound of the original symptoms only intensifies the discomfort experienced during withdrawal, making it very difficult to stop using. A person becomes more and more preoccupied with obtaining and using alcohol or their drug of choice.  This also often occurs with drugs such as Valium and Xanax, sleeping medications, and drugs used to treat acute and chronic pain.

This is often called “self medication.”  Unfortunately many people and even health care professionals are under the mistaken impression that the addiction issues will disappear if the underlying problem is treated: “If I can find some other way of treating my social anxiety my alcohol problem will simply go away.”  This is seldom the case.  When it reaches this point the drug or alcohol use has a life of its own and the individual needs to be specifically evaluated and professionally treated for addiction as well as for the underlying psychiatric or medical problem.  Failure to treat both inevitably results in continued suffering and worsening health complications.

The good news is that through integrated substance abuse treatment, a person can begin to understand how their underlying mental health concerns and substance abuse issues are related, to get them the help they need. To learn more about treatment options for substance abuse issues, or our free, confidential consultation, call Gateway today at 877-505-HOPE (4673).



May 2014: Gateway Treatment Centers Offers Two Free CEU Webinars

Gateway Alcohol & Drug Treatment Centers will offer a Lunchtime Learning Series in May featuring two complimentary webinars:

  • Altered States: Marijuana, the Brain and Legalization
    May 15, 2014
  • Understanding Mindfulness-Based Sobriety *New! CEUs available: IAODAPCA & Psychology
    May 21, 2014

MAY 15, 2014: 12:30 – 1:30 p.m. (Plus Additional time for Q&A)

1 CEU – NAADAC, Illinois: LCSW, LSW, LCPC, LPC, Nursing

About the Training
From board rooms to family rooms, marijuana legalization continues to be a hot topic. This is largely due to rapidly changing attitudes toward marijuana in the United States. In fact, the majority of American adults (55%) now support legalization of marijuana.*

As the taboo surrounding marijuana appears to dissipate, the webinar will serve as an important reminder regarding the health repercussions and legal implications associated with marijuana.

What You Will Learn

  • Short-term effects marijuana abuse has on the body and brain.
  • Long-term physical and social implications of abuse.
  • Why long-term users find it hard to quit.
  • Legal changes concerning medical and recreational marijuana.

Training provides: 1 CEU NAADAC, Illinois: LCSW, LSW, LCPC,
LPC, Nursing

Cost: FREE with Registration

free ceu webinar gateway treatment centers

Meet the Trainers

gateway treatment centersDr. John Larson
Corporate Medical Director
Gateway Treatment Centers

With more than 40 years of professional experience in the addiction and behavioral health fields, Dr. John Larson oversees medical practices at Gateway’s network of treatment centers.

KAren WEbinar imageKaren Wolownik Albert, LCSW
Program Director
Gateway Lake Villa

Karen has been a member of the clinical team at the Gateway Treatment Center in Lake Villa since 2010. She leads efforts related to the quality of care and program development for the Adult Men’s and Women’s Residential Programs and the Young Men’s Residential Bridge Program.


MAY 21, 2014: 12:30 – 1:30 p.m. (Plus Additional time for Q&A)

About the Training
The goal of this webinar is to increase understanding of mindfulness and its use in substance abuse treatment programs.

Mindfulness is a state of active, open attention on the present. The practice is highly effective in treating emotion dysregulation, stress, depression, grief and impulsivity—all of which are at risk of fueling addiction .

What You Will Learn

  • The basics of mindfulness practice.
  • The history and development of the Mindfulness-Based Therapy model.
  • How Gateway’s unique approach to mindful sobriety integrates Acceptance and Commitment Therapy, Motivational Interviewing and Relapse Prevention Therapy.

Training provides: 1 CEU IAODAPCA, NAADAC, Illinois: Psychology, LCSW, LSW, LCPC, LPC, Nursing

Cost: FREE with Registration

webinar 2 registration





Meet The Trainers

phil welches gateway treatment centersDr. Phil Welches
Clinical Director
Gateway Treatment Centers

A licensed clinical psychologist, Gateway Clinical Director Dr. Phil Welches joined Gateway Foundation in 2003 and directs clinical services at all 10 Gateway Treatment Centers.

nick turner gateway treatment centersNick Turner, MSW, LCSW, CADC
Clinical Supervisor
Gateway Foundation Chicago River North

Nick Turner is a Clinical Supervisor that specializes in providing individual and group counseling for those with substance abuse and mental health needs.

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