1. Patrick Roff MA, LCADC Addiction Recovery Advocate NJ Division of Mental and Addiction Services September 16, 2015

2.  “DO NO HARM” The Absolute Bottom Line as someone in the helping professions (Hippocratic Oath)  What does it mean in the context of addressing addiction?  In the USA– we treat individuals with addiction problems differently than individuals with other chronic diseases  When we discuss “getting help” for those afflicted with the disease of addiction – my message is – please, try not to do harm.

3.  Best approach is not an ultimatum or confrontation with addicted person:  Talk to your loved one --they are sick and need help.  Be compassionate, educated, non-judgmental, non-confrontational and non-adversarial;  Rigorous honesty – may require you to address your own substance abuse issues  CRAFT MODEL & Motivational Interviewing  “Meeting the person where they are at”.  EVEN when they have lied to you, cheated you and blamed you.  If you can only Reduce Harm – do it.  Get Help – 1. Peers in Recovery (Specialists/Coaches, 12 Step Fellowships, etc.) 2. Clinical Licensed Professionals

4.  AMA Definition : ◦ Addiction is a primary, chronic, progressive disease of brain reward, motivation, and memory. Primary – Not caused by something else. A health issue in and of itself. Chronic – It can be arrested and move in to remission but requires long-term maintenance (vs. only acute care. i.e. “treatment) – Progressive – gets worst over time if not treated and/or maintained

5.  Avoid the “WHY” Question – for now ◦ Very likely your loved one had no idea what they were getting into. ◦ Deeper “Why’s” connected to addiction can be addressed as treatment begins and during the life- long process of recovery.  Humble yourself -- This is not about you ◦ Counseling is not admitting failure  Talk with professionals - Be teachable  Follow professional advice  Doctor/ Treatment Professionals  12 step Recovery Fellowships – NA/AA  Recovery Center/Coach  SMART Recovery

6. Recovery Centers and Recovery Coaches Can HELP YOU specialize in referring individuals to treatment – informed, educated and passionate advocacy. Trained peer workers and volunteers – peer to peer contact is essential. Someone who has “been there”. For example, new DMHAS intitiative to have trained peers in the ER for individuals who are have had a “Narcan reversal”. 2 State Funded – 8 or so grassroots Recovery Community Organizations (RCO’s) Certified Peer Recovery Specialist (CPRS) - MCPIK

7.  Treatment of Any Disease – ◦ Care and management of a disease and its symptoms by trained, certified and licensed professionals  Addiction: Bio-Psycho-Social Approach 1. Biological – Abstinence (includes MAT– Medication Assisted Treatment and MAR – Medically Assisted Recovery). Also Includes overusing/abusing prescriptions and increasing includes information on smoking cessation.

8. 2. Psychological – Group and Individual Counseling:  Cognitive Behavioral Therapy  Motivational Interviewing  Anger Management  Psycho-Education on Addiction and Recovery  Emotional Maturity  Triggers to Use & Managing Cravings  Addiction and Relationships  Relapse Prevention Skills  12 Step and other Spiritual Approaches

9.  3. Social – Importance of Group Counseling  Accountability – attendance/on-time/to others (honesty)  Trust – share without judgment  “Peerness” – Mutual Identification – no one knows the experience of addiction like a fellow sufferer  Support – lean on each other  3.1 Spiritual – Identifying one’s own spiritual needs Individually and/or with a group

10.  Treatment Continuum ◦ Start at lower level of care and work your up and down  Outpatient -> Inpatient -> Outpatient ◦ Does not set client up for failure – Work your way up and down ◦ Individualized Care - Not everyone will need same treatment protocols ◦ Includes Prevention and Recovery Support

11.  Private Insurance & Self Pay  Medicaid – parity & expansion  NJ – DMHAS Funded Treatment  IME – Interim Management Entity 844-276-2777  County Grants – Each County has its own process  Agency Specific Scholarships/Assistance  Fee for Service Grants  DUII – IDRC  DCP&P (DYFS) – “Slots” for referrals, Mommy and Me  MAP - Parole  SJI – 18-25 yr. olds (southern counties only)  Drug Court

12.  A person suffering from addiction needs recovery – not just treatment. Treatment ends. Recovery does not. Find and/or create Recovery community for ongoing support.  And recovery from addiction is the hardest thing an addicted person will ever face.  What is Recovery? - Like Recovery from any disease it requires important changes in daily living  Recovery is a process much like addiction ◦ Bio-Psycho-Social : Change People, Places and Things

13.  Recovery ◦ A new way of being the world/A new way of living – ◦ HOWEVER – in early sobriety people are more can seem to “get worse” before they get better in terms of happiness, moods and feelings ◦ Involvement at Self Help Groups like AA and NA or involvement some “inner work” (counseling/therapy) ◦ Self –Respect/Self-Understanding/Self- Awareness/Self-Care –> WORKING WITH OTHERS ◦ Trained and Certified Peer Recovery Coaches and/or Specialists (CPRS) can help -- before, during and after treatment.

14.  Recovery Centers ◦ See next slide  Recovery Housing ◦ Oxford Houses ◦ Sober Living Situations ◦ Collegiate Recovery Housing ◦ MAT Housing  Recovery Coaching ◦ Peer to Peer Support. Available for free at Recovery Centers/private practitioners usually charge a free  12 step – AA/NA  SMART Recovery ◦ Cognitive Behavioral Techniques – Groups Facilitated by trained professional

15. 1. Eva’s Village Recovery Center – State Funded 16 Spring Street Paterson, NJ 07501 (973) 754-6784 evasrecoverycenter.tumblr.com 2. Living Proof Recovery Center -- State Funded 108 Somerdale Ave. Voorhees, NJ 08043 855- 967-3268 centerffs.org/recoverycenter/welcome 3. Hope All Day Recovery Center (609) 379-CLUB (2582) hopeallday.org

16. 4. City of Angels 609-910-4942 cityofangelsnj.org 5. C.A.R.E.S.caresnj.org Two Locations CARES - Center for Addiction Recovery, Education and Success 1 7 Star Plaza25 W. Main Street Washington, NJ 07882Rockaway, NJ 07866 908-835-1800973-625-1998

17.  Educate Yourself – Family Sessions  Respect Confidentiality of Counseling Process  Al- Anon/Nar-Anon  Counseling  Friends/Family you can be honest with 100%  Know who to leave out of it – toxic family/toxic friends and co-workers.  Know when and how to “detach with love”