What’s Been Going on at Gateway?

This year marks our 50th anniversary, and we are celebrating our accomplishments while working to improve and innovate. These past few weeks, we’ve looked back and forward:

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Gateway Aurora alumna Lucy Gabinski-Smith (left) and Lake Villa alumnus Nick Kanehl (center) visited our Gateway Chicago headquarters March 20 to inspire the board, including CEO Tom Britton (right), with their recovery stories*. They also shared how they have continued their connection to Gateway through our alumni programs.

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Chicago River North and Independence Clinical Director Gilbert Lichstein taught 36 participants about motivational interviewing at a Loyola University Medical Center Grand Rounds Training on March 22. Motivational interviewing helps clinicians to treat each patient as an individual.

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We’re over the Cupid Shuffle. A Gateway team ran with members of the recovery community for the annual Bank of America Shamrock Shuffle 8K March 25.

*If you or someone you know would like to tell your Gateway recovery story, please contact us. We’d love to interview you and inspire others. 

Bad Habits: Processing Addictions Beyond Alcohol and Drugs

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When people think of addiction, they think of substances like alcohol and drugs. They rarely think of addictive behaviors, but addiction goes well past substance use disorders.

In 2011, the American Society of Addiction Medicine included behavioral addiction in the broader definition of addiction. Behavioral, or process, addiction is the repeated compulsion to engage in a behavior, even when the behavior becomes harmful, because the individual cannot resist engaging in the behavior without intervention. Some of the most common behavioral addictions are eating, shopping, gambling, sex, and use of social media.

While process addictions have always been prevalent in the addiction community, they gained traction fairly recently in the larger medical community due to two big findings. First, people with substance use disorders tend to have more than one addiction. Second, the brain reacts to behaviors the same way it does to substances – this is why certain behaviors, like gambling, can be addictive.

Similar to substance addictions, there is no single cause of behavioral addictions. Addiction is complex, and so are the reasons why certain people develop them while others do not. However, research has indicated genetics play a major role in a person’s susceptibility to developing the disease. In addition, people who develop addictions often report high levels of impulsivity and sensation-seeking personality traits paired with low levels of harm avoidance traits.

Further, diminished control is common in individuals with substance use disorders and process addictions. Due to tolerance, people struggling with addiction experience less pleasure each time they engage in the behavior or consume the substance, so they become motivated by negative reinforcement (relief from withdrawals) as opposed to positive reinforcement.

Co-occurrence with substance use disorders is relatively common among individuals with behavioral addictions. People with a gambling addiction are 3.8 times more likely to struggle with an alcohol use disorder. (Correlation does not mean causation, however, and the relationship between the two is unclear.)

Oftentimes, process addictions are not regarded as dangerous or detrimental compared to substance use disorders. But job or financial loss and relationship issues with family and loved ones still accompany these disorders.

Process addictions can also be more difficult to diagnose, as the signs are usually not as clear as, say, a heroin addiction. Physical health does not immediately start deteriorating and individuals oftentimes hide and disguise their behaviors from people close to them.

One of the biggest challenges in identifying these disorders is the social acceptance and, in some cases, necessity – to a degree – of behaviors such as eating, shopping, and spending money. Others may not consider related addictions issues until it takes a tremendous toll on someone’s life, until it’s too late. Before addictions spiral, though, pay attention to the red flags.

Warning signs of a behavioral addiction:

Making lifestyle changes to accommodate the behavior
– Extreme mood fluctuations related to the activity
– Justifications or rationalizations for continuing to partake in the behavior
– Extreme excitement when discussing the behavior
– Debt and frequent money borrowing

Regardless of the type of addiction, societal stigma often casts addiction as a moral failing, a lack of willpower or motivation. Research shows sustained recovery is more successful when the addiction is treated professionally, so we must continue addressing the roadblocks preventing people with behavioral addictions from seeking and receiving professional treatment.

“It’s All in Your Head”

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For centuries, addiction was viewed as a psychological problem, all just in someone’s head. To be “cured” someone simply needed to want to quit. Addiction is, in fact, in a person’s head, but not in the way many believed. It is in people’s heads because addiction alters the brain.

Addiction is a chronic disease that afflicts millions of people across the country and millions more around the globe. It does not discriminate against an individual’s socioeconomic status, gender, sexual orientation, race, etc. It affects people of all backgrounds across all generations. It collaterally affects the families and loved ones of those battling this disease.

Addiction is an extremely complex disease that is misunderstood by many people to this day. Though much progress has been made regarding the stigma around addiction, many still view addiction as a moral failing. Unlike many other diseases, there is a sense of blame that is placed on those that have addictions.  As a whole, society has demonized addiction and made it so that those who are battling the disease have a hard time speaking out and seeking out the necessary treatment for the fear of being ashamed and judged.

Addiction, however, is not a moral failing. It is, instead, a chronic disease that often requires medical and professional help. Much like other diseases, addiction can destroy relationships with loved ones, it can cause many health and financial problems. Even with all of the negative consequences, addiction is hard to break because there is no simple solution or cure.

While no one decides or chooses to have a substance use disorder, some are more genetically predisposed to addiction than others. Through various research regarding addiction, genetics have been found to play a role in the disease. Studies conducted on twins and adopted children show that about 40 to 60 percent of susceptibility to addiction is hereditary. While it is not clear why some people become addicted and others do not, there are some factors such as genetics and environment that increase a person’s susceptibility to having an addiction.

But what is clear is the use of alcohol and drugs alters the brain and makes it harder for those with substance use disorders to quit. The brain starts to rely on the substance. Though the initial decision to try a substance may be voluntary, after a while it becomes compulsive – people begin to lose the ability to say no.

After continued substance use, the part of the brain that controls judgment becomes impaired. Once the brain becomes impaired, the person struggles to have the control he or she needs to say no. Addictive substances flood the brain’s reward circuit with dopamine. Dopamine is a chemical messenger that signals pleasure. Once dopamine is released, the brain begins to associate the substance with that feeling of pleasure, the “high.” This leads to the individual wanting to use that substance over and over again to chase that same feeling.

However, the feeling of pleasure diminishes as the brain adjusts to the excess dopamine; as a result, more of the substance is required in order for the individual to experience the same amount of pleasure. This leads to individuals developing a tolerance, needing more to feel the pleasure they once experienced. In many cases, individuals begin to take more of the substance in order to achieve that high and it becomes more difficult to break the addiction. Long-term use of drugs and/or alcohol leads to sometimes permanent changes in the brain, depending on the frequency and amount the individual used. The repeated use of drugs and/or alcohol begins to affect functions in the brain like learning, judgment, decision-making, and memory.

In addition, this excess dopamine can also lessen the pleasure an individual feels when they begin to do other things that once brought them pleasure, such as spending time with friend or eating their favorite dessert.

After someone stops using, they face withdrawals. Withdrawal symptoms include anxiety, shaking, fatigue, among many more effects. The only way to get immediate relief from the symptoms is to use the substance. Wanting a release from these unpleasant symptoms and to temporarily experience the “high” once again, the individual oftentimes turns to the substance. The brain has already associated said substance with pleasure and learned that this is the way to feel good. The brain is wired to seek pleasure, and once it has associated a certain action with pleasure, it is begins to seek out the source of the pleasure.

Since addiction affects learning and memory, people may be in danger of relapsing after seeing a beer bottle, for instance if they have alcohol use disorder. Because of conditioned learning, they will begin to crave the alcohol and feel compulsion try to take over – even if they haven’t had alcohol in a long time. The hippocampus and amygdala are the two parts of the brain that store environmental cues and even when an individual no longer wants to continue seeking out the source of their pleasure, the brain still associates the source with pleasure – they develop cravings when they are around the substance.

Many individuals battling addiction feel that they have to go through this fight by themselves, and to carry that burden solely on their shoulders. It is not an easy topic to discuss, but it is one that needs to be addressed differently. Instead of blame, empathy and acceptance needs to be shown towards those who are struggling. The stigma of addiction puts blame solely on those who have it. While breaking the vicious cycle of addiction does indeed take a lot of willpower and inner strength, it is not as easy as an individual deciding to quit.

Much like many other diseases, addiction can be treated and managed. It is important to remember that relapses do occur, but it does not mean that the individual cannot successfully manage their addiction. Having specialized treatment programs and seeking out professional help is the best way to start towards a life of sobriety. Attempting to go “cold-turkey” without professional supervision can be dangerous. There are instances of death and other life-threatening occurrences. Which is why seeking out professional help is the safest and most reliable way to begin the journey to recovery.

The Relationship of Substance Use Disorder and Mental Illness

suicide and substance abuse, gateway treatment centersAt Gateway, we recognize that mental illness and Substance Use Disorder (SUD) often coincide. In fact, the presence of a co-occurring diagnosis is more the “rule” than the exception. The terms “dual diagnosis” or “co-occurring” refer to an individual that is affected by two or more disorders or illnesses.

The Journal of the American Medical Association (JAMA) reports that 37% of individuals with alcohol use disorder and 53% of those with a drug use disorder also have at least one serious mental illness.

It is difficult to diagnose which came first – the SUD or the mental health disorder. Drug use can cause one to experience symptoms of mental illness. However, mental illness can also lead to drug use as a form of self-medication to manage symptoms. There are many overlapping factors that can make it difficult to detect the initial issue.

“There is no question that no matter which came first; both issues need to be addressed in treatment,” said Katie Stout, Executive Director at Gateway. According to reports from the Substance Abuse and Mental Health Services Administration (SAMHSA), the most common reason for relapse is an untreated mental health problem.

“The best chance of recovery is through an integrated treatment program that includes treatment of the SUD and the mental health illness,” said Katie Stout.

Evidence-based treatment for co-occurring disorders includes: motivational interviewing, mindfulness based therapy, trauma informed therapy and 12 step facilitation.

Gateway is a recognized leader among behavioral health care providers in offering substance use disorder treatment, as well as treatment for individuals that are diagnosed with a co-occurring mental illness. To learn more about our treatment programs visit us at RecoverGateway.org.

Stress on the Road to Recovery

April is Natiroadonal Stress Awareness Month. According to the National Institute on Drug Abuse (NIDA), medical specialists believe that stress is the leading cause of relapse back into drug use. Research shows that the brain of those with substance use disorder is more hypersensitive to stress, which may provoke them to relieve their stress by returning to drugs.

 

 

For those in recovery, many stressors arise such as family/relationship conflicts, work, money and health concerns. It is important to pay attention to the signs your body is giving you to recognize stress.

  • Headaches
  • Neck or back pain
  • Stomach upset
  • Difficulty sleeping
  • Fatigue
  • Change in appetite
  • Irritability
  • Anxiety

Stress is often unavoidable. However, you can take a proactive role in acknowledging and calming the stress to avoid relapse. There are many healthy and practical ways to reduce stress and increase your chance of staying sober. Among these are: Exercise, talking it out (or write about it), breathing with purpose (yoga/meditation), and of course good old laughter.

Most important is to recognize when you are experiencing stress and find your most healthy way to cope with it.

What Is the Difference Between Alcoholics Anonymous and an Alcohol Use Disorder Treatment Program?

In Honor of Alcohol Awareness Month in April, Gateway highlights the differences between 12-Step Meetings (such as Alcoholics Anonymous) and an Alcohol Use Disorder Treatment Program.
What is Alcoholics Anonymous or 12-Step?

Alcoholics Anonymous (AA) is a 12-Step group for those struggling with alcohol use disorder. Led by peers, this group allows participants to follow a set of recovery steps to achieve and maintain abstinence from alcohol.

The only requirement for AA membership is a desire to stop drinking. AA works through members telling their stories of recovery from alcohol use disorder. AA is nonprofessional – it doesn’t have clinics, doctors, counselors or psychologists. All members are themselves recovering from alcoholism. There is no central authority controlling how AA groups operate. It is up to the members of each group to decide what they do. However, the AA program of recovery has proven to be very successful and almost every group follows it in very similar ways.

How is an Alcohol Use Disorder Treatment Program Different from AA?

Gateway Alcohol & Drug Treatment believes 12-step groups such as Alcoholics Anonymous and other kinds of recovery support groups play a valuable role in substance abuse treatment, but they only comprise part of the picture.

Gateway believes that a substance use disorder treatment program should include the use of evidence-based practices – drug and alcohol disorder treatments that integrate professional research and clinical expertise to achieve the best outcome for an individual.  The clinical professionals at Gateway Alcohol & Drug Treatment Centers employ evidenced-based practices to create meaningful, individualized treatment programs. We believe there is more than one pathway to recovery so we expose clients to a wide array of treatment methodologies. The greatest benefit can be derived from experiencing 12-step programs in conjunction with evidenced-based treatment.

Gateway engages both adults and teens through a variety of highly effective clinical approaches and therapies to help them get life back on track. On average, Gateway’s drug rehab programs have a 10% higher successful treatment completion rate when compared to other Treatment Providers.

12-Step as Part of Gateway’s Integrated Treatment Programs

“It’s a Personal Choice – Some individuals come to Gateway convinced that a 12-step program is the only thing that will work for them, while others have equally strong reservations about them. We make it a priority to accommodate the needs of clients who are of either mindset and implement the 12-steps accordingly,” said Gilbert Lichstein, LCPC, MS Clinical Psychology, Program Manager at Gateway Chicago.

Gradual Exposure- Our experienced staff utilizes a targeted approach that provides clients with an in-depth understanding of 12-step principles. Our curriculum is designed to break down barriers to participation and “kick start” the process of attending meetings and finding a sponsor.

12-step meetings can not only be challenging for some, they also vary from group to group and meeting to meeting. In order to give clients a good idea of what to expect out of support groups like these after leaving treatment, Gateway provides exposure to 12-steps in multiple settings. To offer our full support, we accompany individuals in our treatment programs to both on-site and off-site 12-step meetings.

For those who prefer not to use 12-step techniques, many Gateway treatment locations offer on-site SMART recovery groups and linkage to other peer support options such as Dual Recovery Anonymous.

To learn more about Gateway’s alcohol and drug treatment programs, visit RecoverGateway.org

The Role of Nutrition in Recovery

Substance Use Dnutrients and substance abuse recoveryisorder (SUD) and poor nutrition often go hand-in-hand. Nutrient imbalances can intensify the cravings for alcohol and drugs. Poor nutrition can also have an effect on co-occurring disorders such as depression and anxiety. According to an article in Today’s Dietitian SUD is known to lead to vitamin and mineral deficiencies that threaten physical and mental health, damage vital organs and the nervous system, and decrease immunity.

“A well balanced diet rich in nutrients is needed for cognitive repair, processing and critical thinking; which are all compounding factors to a healthful and lasting recovery,” said Jayne Chatzidakis, Gateway’s dietitian consultant with Cynthia Chow & Associates.

The recovery process at Gateway Foundation includes encouragement for proper nutrition through collaboration with the dietitians from Cynthia Chow & Associates. The dietitians provide the highest standard of dietary consultation for the specialized needs of Gateway clients.

Proper nutrition aids in ridding the body of toxins and restores the nutrients that have been lost as a result of substance use. What does proper nutrition look like? “Eat more nutrient rich foods such as fruits, vegetables, whole grains and fish,” encourages Jayne Chatzidakis. “Stay away from overly prep
ared, frozen, processed, or prepackaged foods. Also, drinking plenty of water throughout the day is vital to hydrate the body and assist in the detoxification process.”

“Overall, it’s about achieving a healthy lifestyle that is drug free, nutritious and active,” said Jayne Chatzidakis.

Meet Gaia McVey, MS, LCPC Adolescent Clinical Supervisor

“Watching an individual change, succeed and grow through treatment is very motivating,” says Gaia McVey, Adolescent Program Clinical Supervisor at Gateway CarbondaleGaia McVey. With a wealth of experience in substance use disorder treatment, she works closely with her team at the Adolescent Male Residential Program.

“We are flexible in our individualized treatment planning and approach for adolescents. We use a great deal of interactive activities in our group counseling sessions to help teens learn new skills in a variety of ways,” explains Gaia. Gaia has been a member of the Gateway’s clinical team since 2000.

She obtained her Master of Science degree in Rehabilitation Counseling from the Rehabilitation Institute at Southern Illinois University in Carbondale, IL.

 

9 Tips to Encourage Your Valentine to “Lean In” to Addiction Recovery

iStock_000008811652MediumIn honor of Valentine’s Day, Gateway Alcohol & Drug Treatment reminds couples that selfless act of love can rekindle a sense of purpose in their Valentines. Without a doubt, the power of love can help people take the first step in overcoming alcoholism and/or drug addiction.

“An act of concern and support may arouse a renewed sense of personal power in others, which changes their perspective from ‘feeling forced’ or powerless to change to ‘feeling confident’ or capable of change,” explains John Larson M.D., Corporate Medical Director, Gateway Treatment Centers.

Building self-confidence and sense of purpose in your Valentine requires genuine respect and judgment-free affection from reliable “agents of change.” To help encourage an open approach versus a confrontation about substance abuse concerns, Gateway offers nine tips:

  1. Get smart about effects of alcoholism and drug abuse as well as potential treatment options to help facilitate a productive discussion.

  2. Timing is extremely important. Choose a time when your Valentine is sober and the mood is calm.

  3.  Set a caring and supportive tone for the conversation–anything less may backfire.
    – “You haven’t seemed to be yourself lately. Is everything okay?”
    – “What can I do to help the situation?”
  4. Use open-ended questions to draw out underlying feelings.
    – “It’s not uncommon for people to drink alcohol to try to appease their tough thoughts and feelings. What are some memories and feelings that trigger drinking?”
  5.  Talk less, listen more. Listen and respect everything your Valentine has to say, and resist interrupting.
    – “What are some of the things that make you happy when you’re not drinking?”
    – “What are some of the not-so-good things about drinking?”
  6. Use affirming statements to demonstrate understanding and to validate a loved one’s feelings. Validating a person’s feelings—no matter what he or she has to say—can help encourage self-guided change.
    – “You are under a tremendous amount of pressure so it’s no wonder you feel so overwhelmed.”
    – “That must have been devastating. I’m sorry you had to go through that.”
  7. Take with a grain of salt any accusations of blame or verbal abuse, and refrain from engaging in arguments.
    – “I understand this isn’t easy to talk about so I’m going to let that one go.”
  8. Substance abuse rattles one’s self esteem so be sure to express he or she deserves better, and is capable of achieving whatever change is desired.
    – “I’m not giving up on you. You are the most amazing person I know.”
  9.  If shut down, don’t take it personal. Rather, just listen and try to withhold frustration or it may be more difficult for him or her to open up later.

“Planting the seeds of recovery from addiction is a delicate balancing act requiring patience and unconditional love but it’s not impossible,” says Larson.

For more insights and tips about helping a person take on addiction issues, download Gateway’s Roadmap to Understanding Substance Abuse at RecoveryGateway.org/Roadmap.

Another Helpful Article: “What To Do When a Loved One Has a Substance Abuse Problem?”

Editors Note: This post was originally published in February 2015 and has been revamped and updated for accuracy and comprehensiveness February 2016.

In Honor of National Recovery Month, Gateway Alumnus Shares the Story of his Road to Recovery

In Honor of National Recovery Month in September, John Fields, Gateway Alumnus Shares His Recovery Story:

National Recovery Month, Gateway Alcohol and Drug Treatment CentersBy the time John Fields turned to Gateway, he was having a drink as soon as he woke up in the morning. He had become aware his drinking was out of control and that he needed help. “I knew I couldn’t quit on my own. I needed a safe place where I didn’t have access to drugs or alcohol,” John said.

John wanted to get his mind clear so he could begin to think rationally again. He also wanted to learn how to live on the outside without using alcohol

“Gateway gave me what I needed most, a safe place and the tools and knowledge I needed to live a sober life outside of treatment,” John explained.

John had been sent to drug treatment centers in the past by family members or managers at a job but he’d never gone to treatment for himself. Each time, he’d end up returning to his same routines. He never followed up with meetings or became involved in an alumni program, and he thought he could resume his old lifestyle with friends.

This time around, he was highly motivated and he also did his homework. John said, “Gateway is a much nicer facility than the others I looked at and the staff is great. These people know what they’re doing.”

Read John’s full story at RecoverGateway.org/AlumniSuccess>

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