Gateway Nursing Manager Presents on Medication-Assisted Treatment

James Blasko, nursing manager at Gateway Foundation treatment centers in Pekin, Springfield and Jacksonville, will present on Medication-Assisted Treatment at the Tazewell County Justice Center in Pekin on Thursday, June 28 from 12 to 2 p.m. The first 30 minutes will begin with a lunch, followed by Blasko’s presentation and a question and answer session. In his presentation, Blasko will review the medications and methods used to assist patients suffering with substance use disorder and how these medications address withdrawal symptoms, cravings and detoxification and ultimately save lives.

What is Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) combines behavioral therapy and medications to treat substance use disorders. Gateway Foundation centers provide MAT as part of a comprehensive program that includes counseling and therapy to help individuals modify their behavior to make better lifestyle changes for long-term success.

MAT is an evidence-based treatment option proven to reduce or eliminate cravings, decrease withdrawal symptoms and reduce the risk of relapse.

Who is James Blasko?

After spending 16 years in the intensive care unit at a hospital, Blasko took a job with Gateway Foundation treatment center in Springfield and has been with Gateway ever since. He currently serves as the nursing manager for Gateway treatment centers in Springfield, Pekin and Jacksonville. He cites the patients, the family dynamic of the staff, the work he is doing and how many people it is helping as what he loves most about his job at Gateway.

Blasko is no stranger to MAT. He was one of the main forces behind Gateway’s initiative to offer Narcan to patients and their loved ones after treatment.

“I felt very strongly about helping our clients succeed and their families to feel a little more relief about taking them home and knowing if there was a relapse they could save their loved one’s life,” Blasko says.

Blasko’s commitment to patients goes beyond the sites’ walls. When Gateway patients cannot access the facilities in Springfield, he drives 45 minutes to Lincoln to provide it. He picks up medications from CVS and Walgreens for patients who are unable to pick them up. He also administers shots at area jails because MAT has been proven to reduce recidivism.

To learn more or attend the free event, click here.

John Oliver Brings Much Needed Attention to a Very Important Issue

On Sunday night, Last Week Tonight host John Oliver had a segment on the addiction treatment industry. During the segment, Oliver touched on many concerns that those within and outside of the industry have regarding addiction treatment providers.

At Gateway Foundation, we agree that there is not enough transparency or information available to the public about many of the treatment providers. People should be able to have access to the information they need to make a well-informed decision about where they or a loved one will receive treatment.

Oliver also made an assertion that there needs to be more expertise and oversight of the industry. At Gateway, we share his sentiment. There does need to be more oversight of the industry. This is why we are so pleased with all of the great work the National Association of Addiction Treatment Providers, NAATP, has done, including its Treatment Selection Guide and Code of Ethics 2.0. In addition, NAATP has also worked closely with Google and LegitScript to develop the qualification standards a treatment provider has to demonstrate in order to use Google AdWords.

In his segment, Oliver called for more treatment centers to provide evidence-based treatment options. We understand the importance of ensuring each one of our patients receives the treatment they need, which is why we utilize evidence-based practices, including medication-assisted treatment, motivational interviewing, cognitive behavioral therapy, and many more.

Starting Conversations about Mental Health

 

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May marks Mental Health Month, a time dedicated to raising awareness and reducing stigma. To start our month-long conversation about mental health, we started asking some questions:

Who is affected by mental health disorders?

Millions of people in the United States alone deal with mental health disorders. Yet less than half receive help. Chances are you know someone with a mental illness or someone who is affected by a person struggling with a mental illness.

According to recent studies, adults between the ages of 18 to 25 make up the highest percentage of people struggling with mental illness, but compared to other age groups, they also report the lowest rates of seeking treatment.

Why don’t more people seek treatment for mental health?

One of the main hurdles preventing people from seeking necessary treatment is the stigma surrounding mental health. Many people feel their mental health is not as important as their physical health or feel ashamed or embarrassed to admit they have a mental problem. As a result, some ignore their mental health concerns while others try to treat their symptoms by themselves.

What are some signs of a mental health disorder?

The signs of each mental health disorder are unique to that disorder, but here are a few to look out for:

  • Extreme changes in mood and behavior
  • Changes in work or school performance
  • Suicidal thoughts
  • Prolonged feelings of anger or sadness
  • Withdrawal from friends and family
  • Struggles with carrying out day-to-day tasks

What are some examples of mental health disorders?

Depression and anxiety are the two most prevalent mental health disorders in the United States; however, many Americans also live with obsessive compulsive disorder, bipolar disorder, schizophrenia, and post-traumatic stress disorders, among others. The severity of mental health disorders also varies by individual.

Co-Occurring Substance Use Disorders

Nearly 80 percent of people with mental health disorders have substance use disorders. In an effort to cope with the symptoms from their mental health disorder, many people turn to drugs and alcohol. The most common substance people turn to for help is alcohol. However, alcohol and many other drugs can exacerbate symptoms.

How can we reduce stigma?

In the past few years, there has been a change in the conversation around mental health. Mental illnesses, such as bipolar disorder, have garnered more attention due to more celebrities, such as Mariah Carey, sharing their battles. If we continue asking questions and normalizing conversations about mental illness, then we can continue investing in and improving treatment for mental health.

Where to Drop Off Unused Prescription Meds Near You

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Every year, the Drug Enforcement Administration (DEA) partners with local agencies throughout the country to administer safe and responsible drop-off sites for prescription medications. This year’s National Prescription Drug Take Back Day is this Saturday, April 28.

Easy access to prescription drugs has played a major role in the current opioid crisis. A significant portion of these drugs come from someone’s own home or the home of someone they know. In addition, other methods of disposal, such as flushing down the toilet, have been deemed unsafe and hazardous to public health and safety.  This makes responsible disposal of drugs all the more important.

To find a drop-off site near you, click here:

What Is Binge Drinking?

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What is binge drinking?
Binge drinking is the consumption of alcohol that raises a person’s blood alcohol concentration to 0.8 or above, according to the National Institute on Alcohol Abuse and Alcoholism. For men, this usually takes five or more drinks in two hours, and for women, it usually takes four or more drinks. In contrast, the recommended amount of alcohol consumption for women is no more than one drink a day and no more than two for men.

Why is binge drinking dangerous?
Most people who binge drink do not have a substance use disorder. However, the consequences of binge drinking are still severe, and extended periods of binge drinking can lead to alcohol dependence.

There are a lot of health risks associated with alcohol consumption, such as an increased likelihood of contracting certain cancers and difficulty with memory and learning. With excessive alcohol consumption, additional risks such as unintentional injury like blackouts, alcoholic coma, and alcohol poisoning are higher than with moderate use.

Rates of violence, including domestic and sexual abuse, also increase when drinking is involved. An estimated 50 percent of sexual assaults involve alcohol.

For women, binge drinking additionally increases the likelihood of an unplanned or a difficult pregnancy.

How common is it?
Binge drinking typically evokes images of college students in fraternity houses and, in fact, young drinkers consume more than 90 percent of their alcohol by binge drinking.
However, they are not the only ones. One in six adults in the United States engages in binge drinking four times a month. Over 50 percent of those who binge drink are between the ages of 18 to 34. It is also most prevalent among men, as men are twice as likely as women to binge. However, in the past couple of years, studies show women have begun to close the gap in alcohol consumption.

What should I do if I am or someone I know is struggling with binge drinking?
Attempts to quit without professional help are mostly unsuccessful, and they can also be fatal. Seeking professional help is the safest and most reliable way to stop drinking

Dr. Britton and Gateway Alum Broadcast Insights on Opioid Crisis

Gateway Foundation President and CEO Dr. Thomas Britton and Gateway alum Spencer spoke to Justin Kaufmann on WGN’s “The Download” about the opioid crisis, how we can combat it, and Spencer’s journey to recovery.

Biggest takeaways:

“A criminal problem rather than a public health problem

Dr. Britton mentions how more government funding is being allocated to law enforcement compared to treatment options. He says of the estimated 30-60 million people who need treatment, only 3 million get it, and those who do often don’t get enough to be successful. He advocates for a multi-pronged policy approach.

“A bridge to recovery”

Dr. Britton speaks to the importance of medication assisted treatment (MAT) and how it saves lives every day. However, he warns MAT is not the cure for addiction, but one of the methods used to help people with substance use disorders. Other measures still need to be taken.

“All my morals out the window”

In an effort to support his habits, Spencer talks about stealing from his parents, relatives, neighbors, and even kids to pay for drugs and alcohol.

“Mentally in love with the drug”

While in treatment for the first time, Spencer counted down the days until he could use again. This happens again while he is in his hospital bed following his heart attack, counting down the days until he could have a drink.

“The flu on steroids”

Spencer describes the withdrawals every time he tried to quit by himself: the muscle aches, nausea, suicidal thoughts.

“Learn my parents’ names again”

Following his heart attack at age 25, Spencer fell into a coma. After waking up a couple months later, he had to relearn the basics, like how to say his parents’ names, how to use a fork, how to use the bathroom.

“Like trying to swim against the current”

Spencer relates his experiences of quitting by himself to a person drowning. He needed a lifeguard, which in this case was Gateway’s support system, to help him to recovery.

“A silent killer”

Due to the stigma surrounding addiction, many people feel ashamed to ask for help and spend their lives hiding their struggle from their loved ones. Addressing this stigma could change the conversation and increase the number of success stories.

“I wouldn’t say [addiction] defines me; I’d say it definitely has taken a lot out of me… It’s like a soldier that has gone to war. You have the stories but you just gotta keep going forward. Now, I love volleyball. I’d say that defines me. I love my sister, my parents. I love life.”

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. 

Drug & Alcohol Use in Adolescents

Nearly 70 percent of high school seniors have tried alcohol, 50 percent have taken an illegal drug, and more than 20 percent have used a prescription drug for a non-medical reason, studies show. Research has found the majority of people are most likely to misuse drugs and alcohol during this transformative time.

Why is this the trend?

  • Underdevelopment of the prefrontal cortex
    • The parts of the brain that process reward and pain first mature during childhood. However, the prefrontal cortex – responsible for controlling impulses, emotions, and decision-making – does not mature until people reach their mid-20s. Therefore, adolescents are motivated by the desire to feel pleasure and avoid pain, both of which are associated with drug and alcohol use.
  • Genetic factors
    • Certain genetic traits, for instance a low harm-avoidance personality trait, make individuals more susceptible to using drugs and alcohol.
    • Mental health concerns such as depression and anxiety also increase the likelihood an adolescent will turn to substances.
  • Social environment
    • Teens are more likely to try drugs and alcohol if their friends are also using.
  • Accessibility of drugs
    • Adolescents are at an increased risk of trying substances if they have easy access to them.
  • Family environment

Compared to adults, adolescents are much more likely to hide their substance use from loved ones. Adolescents are also less likely to show signs of a problem because they have a shorter history of use. However, there are still red flags.

What are the signs?

  • Loss of interest in school and hobbies
  • Sudden need for more money and unwillingness to explain spending habits
  • Withdrawal from family and friends, and an increased desire to be alone
  • Change in friends
  • Change in behavior or personality
  • Unresponsiveness to communication
  • Frequent rule-breaking, especially of curfew

While most adolescents who try drugs and alcohol do not have substance use disorders, the likelihood of developing a substance use disorder is greater for people who begin using in their early teens. According to a study, 15.2 percent of people who start drinking by age 14 develop substance use disorders, compared to 2.1 percent of those who wait until they are 21 or older.

What are the effects?

  • Difficulties with schoolwork
  • Relationship problems
  • Loss of interest in normal healthy activities
  • Impaired memory and thinking ability
  • Increased risk of contracting an infectious disease
  • Mental health problems—including substance use disorders
  • Increased possibility of partaking in unsafe sexual activities
  • Overdose
  • Death

The key in the battle against adolescent addiction is time: We need to involve adolescents in professional treatment programs as soon as possible. Adolescents are less likely to seek out help on their own, so it is crucial loved ones help them into treatment.

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.

The Trump Administration’s Opioid Action Plan

valentino-funghi-276005-unsplashDuring the 2016 presidential election, then Republican nominee Donald Trump took a tough stance on the opioid crisis, declaring he would help solve the crisis if he were elected. President Trump often cited his personal connection to addiction as a major motivator, as his oldest brother passed away after a battle with alcohol use disorder.

The first step the Trump administration took was to declare the opioid crisis a national public health emergency last October. In 2017, Trump also donated his third quarter salary to the Department of Health and Human Services in an effort to combat the opioid crisis.

During a speech on Monday in New Hampshire, President Trump released his plan to combat the opioid crisis, which he called “The Crisis Next Door.” The plan is broken into the following three sections: enforcement and interdiction, education and prevention through a federal advertising campaign, and employment assistance for those battling addiction:

Enforcement & Interdiction

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President Trump has mentioned numerous times a desire to implement the death penalty for drug traffickers when the Department of Justice (DOJ) deems it appropriate, which has stirred controversy. During today’s speech, Trump officially called for the use of the death penalty for high-level drug traffickers.

The DOJ is now leading a task force on major litigation against drug companies at the federal level. Trump called for these companies to be held responsible for their actions. The administration plans to cut the nationwide opioid prescriptions by one-third. Trump also stated federal funding will be invested in the development of non-addictive painkillers. In addition, within two years at least half of all federally employed healthcare providers will adopt best practices for opioid prescribing, and within five years all federally employed healthcare providers will do so in order to prevent over prescribing.

Trump also emphasized supplying emergency responders and law enforcement with the overdose-reversing medication Narcan. Some cities, including Chicago, have already put forth this policy.

Education & Prevention

children-403582_1280A major initiative will be a federal advertising campaign targeting young adults and children. The administration plans to spend money on commercials that depict the devastating effects of drugs to scare children away from ever using them.

During his speech, Trump highlighted Adapt Pharma and its work with colleges and high schools. Adapt provided colleges and universities across the country with four boxes and high schools with two boxes of Narcan in an effort to reduce student overdose deaths. Adapt has also provided education on Narcan to school staff.

Employment

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Another focal point is helping inmates with substance use disorders get the treatment they need and, further, helping them secure employment after they are released. Trump referenced the country’s low unemployment rate and strong economy as being beneficial to helping inmates get hired.

Additional Takeaways:

Although no financial plans were discussed during the speech, in his latest budget proposal released in February, Trump called for an allocation of nearly $17 billion in 2019 to fight the opioid epidemic. The money from the budget will mainly go to expanding coverage of Medication Assisted Treatment (MAT) and helping states monitor and track clinics that prescribe a large amount of opioids, which many public health officials deem necessary to resolving the crisis. Trump reiterated in his speech that the administration will dedicate resources to ensure the accessibility and affordability of medication-assisted treatments.

The administration will also waive a Medicaid rule that prevents treatment facilities with more than 16 beds from receiving reimbursements for addiction services. This initiative could prove instrumental for low-income individuals seeking treatment.

Shortly after the president’s speech, Congress released plans to introduce multiple bills to help end the opioid crisis. One of the bills is the Preventing Overdoses While in Emergency Rooms (POWER) act. This bipartisan bill aims to set up protocols for emergency rooms across the United States on best practices for discharging overdose patients, to ensure patients have the resources they need to succeed post-hospitalization. Measures of this act would ensure patients’ access to overdose-reversal medication and other medication-assisted treatments, as well as peer-support specialists and other types of treatment programs.

“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.

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