Mental Health Archives | Page 2 of 3

WIN Recovery: Regain Something Lost

Hamilton Center, Inc., based in Terre Haute, IN, and serving multiple counties throughout central and west central Indiana, is committed to supporting the State of Indiana in responding to the opioid crisis which has been growing in recent years. As a community mental health center, Hamilton Center, Inc. has been treating individuals with substance use disorders and a variety of other behavioral health issues for over 49 years.

WIN Recovery is the first Opioid Treatment Program (OTP) of its kind certified by the State of Indiana in Knox County. The clinic will provide daily Methadone administration and behavioral health counseling and case management to provide comprehensive medication assisted substance abuse treatment

I. The problem:

Substance abuse costs our nation over $740 billion annually
Opioid overdose continues to be a major public health problem in the United States. There were 67,367 lethal drug overdoses in 2018 – most were opioid related.
Drug overdose is the leading cause of accidental death in the United States. Over the past several years, Indiana has seen a record number of heroin overdose deaths.
The rate of opioid-related emergency department visits to Indiana hospitals increased 32% between 2009 – 2014
Indiana suffered 1,211 deaths from drug overdoses in 2019 (18.7 per 100,000)
In Vigo County, 10 deaths were attributed to opioid overdose in 2019.

II. Who is at risk?

Individuals using heroin are not the only individuals at risk. Anyone who uses opioids for long-term management of chronic cancer or non-cancer pain is at risk for opioid overdose, as are persons who use heroin. Those who use prescription pain killers are 40x more likely to develop an addiction to heroin. Nearly all addicted individuals believe at the outset that they can stop using drugs on their own and most try to stop without treatment. Because of the drug-induced changes in brain functioning, many individuals have behavioral consequences, even long after they may have stopped using drugs, including continued impulsiveness to use drugs despite consequences.

III. Medication Assisted Treatment (MAT):

Medication-Assisted Treatment (MAT) is opioid addiction treatment that includes medication administration such as Methadone coupled with other behavioral health services such as individual and group counseling, case management and other support services as appropriate.
Medication is prescribed and administered under monitored, controlled conditions and is safe and effective for treatment for opioid addictions when used as directed.
Methadone treatment provides patients with medication, health, social and rehabilitation services that relieve withdrawal symptoms, reduce cravings and allow normalization of the body’s function.
Methadone has been used for over 50 years world-wide and is the gold standard of opioid treatment as it is most effective and least expensive.
Methadone represents a community return on investment as the average cost of treatment is $5,500 annually compared to $25,000 annually for incarceration.
Methadone treatment programs are associated with a decrease in criminality, promotion of patient employability and education and connects patients with other medical and mental health care. In addition, the relationship between intravenous drug use, needle sharing, hepatitis and HIV/AIDS exposure is well documented. Methadone treatment is the most effective intervention for reducing the spread of HIV/AIDS and hepatitis – consistent with strong public health initiatives.

IV. WIN Recovery:

Hamilton Center, Inc., Vigo County, opened its first clinic in Terre Haute in May 2018. In November 2018 the organization received a second license from the State of Indiana to establish a clinic in Knox County.
WIN Recovery Knox County is currently open and accepting patients 18 years of age or older.
The program is certified by the State of Indiana, SAMHSA and accredited as appropriate.
In addition to medication assisted treatment, services will include individual and group counseling, case management and other behavioral support services as appropriate.
Hamilton Center, Inc. is partnering with Sagamore Medical Recovery Services, LLC which was formed in 2016 by Christian A. Shaw, MD, PhD and his partners. Dr. Shaw is a leader in the field and has worked to develop the most successful, innovative and respected methadone based opioid treatment program in New Mexico. Sagamore is providing the medical component of the clinic; Hamilton Center is providing the behavioral healthcare which will include individual therapy, group therapy and case management.
Hamilton Center is working with several community partners to integrate services within the Knox County community. This includes collaborating with the community mental health center, the hospital and physican practices, criminal justice, law enforcement amoung others.
The office is open from 6:00 am – 2:30 pm with new patients being seen from 6:00 am – 10:30 am. The clinic is open everyday including holidays and weekend.

For additional information call 833-232-0215 or 812-494-2215. Appointments can be made, however walk ins are welcome.

History and Effectiveness of Methadone Maintenance Treatment

Methadone treatment provides the patient who is opioid dependent with medication, health, social, and rehabilitation services that relieve withdrawal symptoms, reduce physiological cravings, and allow normalization of the body’s functions. Methadone treatment has been available for over 30 years and has been confirmed effective for opioid dependence in numerous scientific studies.

Moreover, in 1997, the U.S. Department of Health and Human Services’ National Institutes of Health (NIH) Consensus Panel found the following concerning methadone treatment: “Of the various treatments available, methadone maintenance treatment, combined with attention to medical, psychiatric and socioeconomic issues, as well as drug counseling, has the highest probability of being effective.”

Methadone treatment programs are staffed by professionals with medical, clinical, and administrative expertise. Patients receive medication from a health professional. Patients routinely meet with a primary counselor (social worker, caseworker, or certified substance abuse counselor), attend clinic groups, and access medical and social services.

Methadone’s effectiveness, and the absence of any serious, long-term side effects from using it, have been demonstrated in numerous studies conducted over the past 30 years. Among the most commonly cited outcomes are:

Consumption of all illicit drugs declines to less than 40 percent of pretreatment levels during the first year and eventually reaches 15 percent of pre-treatment levels for patients who remain in treatment 2 years or more.
Crime is reduced substantially: For example, in the most detailed study of treatment outcomes to date, during the first 4 months of treatment, crime decreased from 237 crime days per year per 100 addicted persons during an average year of their addiction to 69 crime days per year per 100 patients, a reduction of more than 70 percent. This number declined further to only 14.5 crime days per year for patients in treatment 6 years or more.
Fewer individuals become infected with HIV: A study by Metzger, et al, 1993, showed that over a 3-year period, 5 percent of patients in methadone treatment became HIV positive (over and above those already positive at admission), while among a cohort of out-of-treatment addicts in the same neighborhood, 26 percent became HIV-positive (over and above those already positive at baseline).
Individual functioning improves, as evidenced in improved family and other social relation ships, increased employment, improved parenting, etc., according to the Substance Abuse and Mental Health Services Administrations Center for Substance Abuse Treatment, 1994, and Lowinson, et al, 1992.

Source: U.S. Department of Health and Human Services, Medication Assisted Treatment for the 21^st Century

Heroine vs. Methadone vs. Suboxone

TOPIC	HEROIN	METHADONE	BUPRENORPHINE (Suboxone)
Onset of action	A few seconds	30 minutes	30-40 minutes
Duration of action	4-6 hours	24-36 hours	About 24-48 hours
Route of administration	Injection, snorting, smoking	Oral	Sublingual
Frequency of administration	Several times a day	Daily or more frequently as needed	Every day or every other day
Effective dose	Ever increasing	Blocking dose usually 80-120mg	2-32mg
Tolerance	Increasing tolerance	Tolerance is stable	Tolerance is stable
Euphoric effects	Euphoria for up to 2 hours	No euphoria when stabilized	No euphoria when stabilized
Overdose potential	High and increasing	Rare (potential is mixed with other depressants)	Very rare
Overall safety	Potentially lethal	Very safe	Overall good. Suboxone injection will cause serious withdrawal symptoms in dependent person. Not recommended for pregnancy and caution with liver disease
Withdrawal	Within 3-4 hours after last dose	Within 24-36 hours after last dose	Within 36-48 hours after last dose
Craving	Recurring	Eliminated with adequate dose	Craving may not be totally eliminated due to ceiling effect
Pregnancy/Nursing	Grave risk for mother and fetus	Safe during pregnancy	Not indicated/study underway
Experience of pain and emotions	Blunted	Normal and full range of emotions	Normal pain but opioid analgesics may not be effective – may need to switch to methadone. Full range of emotions
Mood	Constant mood swings	Normal	Normal
Reaction time and intellectual functioning	Impaired	Reaction time normal. Intellectual functioning unimpaired on stable dose	Reaction time presumed to be normal like methadone. FDA cautions driving/operating machinery in the beginning of treatment
HIV & Hepatitis C transmission	High rate with needle use and unprotected sex	Reduced/eliminated	Reduced/eliminated
Immune system for HIV positive persons	Rapid progression to AIDS	Progression slowed	Progression presumed same as methadone – data not available
Immune/endocrine system functioning	Impaired	Normalized during treatment	Presumed normalized. Data not available
Stress Response	Suppressed	Normalized during treatment	Normalized during treatment
Criminal activity	High level	Reduced/eliminated	Reduced/eliminated
Community impact	Destructing impact. High crime, high death rate, transmission of disease	Contributed to public safety, low mortality, increased health	Contributed to public safety, low mortality, increased health

Reproduced from 2003 Medication Assisted Treatment for the 21^st Century: Community Education Kit, SAMHSA

Frequently Asked Questions

Does methadone treatment impair mental function?

Methadone treatment has no adverse effects on intelligence, mental capability or employability. Methadone treated patients are comparable to non-patients in reaction time, in ability to learn, focus and make complex judgements. Methadone treated patients do well in a wide array of vocational endeavors, including professional positions, service occupations and skilled, technical and support jobs.

How is success in methadone and other pharmacotherapy treatments defined?

The primary goals are to help addicts cease heroin use and lead more stable, productive lives. But, as knowledge about heroin addiction and effective treatment practices has grown, so too have the objectives of most methadone treatment programs, which also aim to:

Decrease criminality and reduce the numbers of substance abusers entering the criminal justice system.
Assist patients in addressing multiple substance abuse (including crack/cocaine addiction and alcoholism).
Assure treatment for general health matters, especially those related to drug use, such as HIV/ AIDS, tuberculosis and hepatitis
Promote patient employability and educational development.
Identify and treat mental health problems and alleviate homelessness, family substance abuse and child and family dysfunction.

Why do drug-addicted persons keep using drugs?

Nearly all addicted individuals believe at the outset that they can stop using drugs on their own and most try to stop without treatment. Although some people are successful, many attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences including an inability to exert control over the impulse to use drugs despite adverse consequences – the defining characteristic of addiction.

How effective is drug addiction treatment?

In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment, and related services used to address those problems and the quality of interaction between the patient and his or her treatment providers.

How long does drug addiction treatment usually last?

Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum and some opioid addicted individuals continue to benefit from methadone maintenance for many years.

How do other mental disorders coexisting with drug addiction affect drug addiction treatment?

Drug addiction is a disease of the brain that frequently occurs with other mental disorders. In fact, as many as 6 in 10 people with an illicit substance use disorder also suffer from another mental illness; and rates are similar for users of licit drugs-i.e., tobacco and alcohol. For these individuals, one condition becomes more difficult to treat successfully as an additional condition is intertwined.

Is the use of a medication like methadone simply replacing one drug addiction with another?

No – as used in maintenance treatment, methadone is not a heroin/opioid substitute. It is prescribed or administered under monitored, controlled conditions and is safe and effective for treating opioid addiction when used as directed.

Source: NIDA, “Principles of Drug Addiction Treatment”

WIN Recovery, Knox County Now Open

Hamilton Center Inc.’s Certified Opioid Treatment Program to serve adults with opioid use disorder

June 1, 2020 Vincennes IN- Hamilton Center, Inc., a certified Indiana community mental health center, announced the opening of its newest certified opioid treatment program, WIN Recovery at 1433 Willow St., Vincennes, IN. This clinic is one of two opioid treatment programs operated by Hamilton Center Inc. with a third scheduled to open in the fall in Hendricks county.

The office is open from 6:00 am – 2:30 pm. New patients are welcome to walk in without an appointment between 6:00 a.m. – 10:30 a.m. or can call toll free 833-232-0215 or 812-494-2215 to make an appointment. The clinic is open 7 days a week including weekend and holidays.

The facility, which is 5032 square feet, includes three medication dosing stations, separate drug screening rooms, physical examination room, and rooms for individual and group counseling. Black and white photography of local landmarks adorn the walls which were secured through assistance from the Knox County Public Library and Terre Haute photographer Wayne Jordan.

In November, 2018 Hamilton Center received a license to open the Knox county program. The clinic will provide comprehensive treatment for adults 18 years of age and older who are struggling with addiction to heroin or other opioids such as prescription pain medication. The program provides daily medication (Methadone) coupled with individual and group therapy and case management services to treat each individual’s unique needs.

Whether opioids are prescribed by a physician or acquired illegally, with continued use and misuse, they can cause serious changes to the brain and body. People often hesitate to begin the recovery process due to fear of the physical symptoms associated with withdrawal, or because they doubt recovery is even possible.

Methadone is a medication administered daily under monitored, controlled conditions. It has been utilized for years with a great deal of research determining its safety and effectiveness. Once patients begin taking methadone at appropriate levels, withdrawal is avoided, cravings are minimized and physical and mental stabilization occurs. “That is when the real recovery begins,” said Jessica Nevill, LMHC, WIN Recovery’s Clinical Director.

“The combination of medication and behavioral health interventions is the most effective in combating this disease,” said DJ Rhodes, Chief of Opioid Treatment at Hamilton Center Inc. “Opioid Use Disorder is a disease; treatment works and recovery is absolutely possible,” he added.

“We are so grateful to the Knox county community for welcoming this clinic to the area”, said Melvin L. Burks, CEO of Hamilton Center Inc. “There is a solid understanding of the benefits of medication assisted treatment and because of that many people in this community will benefit,” he added.

Hamilton Center, Inc. is a regional behavioral health system in Central and West Central Indiana. The organization provides service regionally to 13,000 clients annually. For additional information on Hamilton Center Inc., call 800-742-0787. For additional information on WIN Recovery call (833) 232-0215.

To learn more please visit www.winrecovery.org.

Hamilton Center Foundation distributes $600,000 to Hamilton Center, Inc.

Money to be used for start-up costs related to new Opioid Treatment Programs – WIN Recovery

Hamilton Center Foundation, Inc. is pleased to announce the distribution of $600,000 to Hamilton Center Inc. for the start-up of two new opioid treatment programs (OTPs) in Knox and Hendricks counties, both which are expected to open the first quarter of 2020.

In November of 2018, Hamilton Center secured two additional OTP licenses from the State of Indiana to expand the services of WIN Recovery, Hamilton Center’s certified OTP, to Knox and Hendricks counties. WIN Recovery, Vigo County opened May 2018. WIN Recovery is the first certified OTP of its kind for both counties, and will offer medication assisted treatment, in the form of the medication methadone, coupled with behavioral health services including individual and group therapy and case management services.

The Knox county clinic will be located at 1433 Willow St, Vincennes IN while the Hendricks county location has not been finalized.

Hamilton Center staff have been working closely with health and hospital organizations, social service organizations and others to collaborate on services once opened.

“Hamilton Center is committed to providing comprehensive substance abuse treatment to west central Indiana,” said Hamilton Center CEO Melvin L. Burks. “The opioid epidemic in our communities can only be fought successfully if we attack the issue head on and together” he said. “I would like to thank our community partners in Knox and Hendricks counties for supporting the development of WIN Recovery and for their work to assist us in combatting the impact of substance use disorder.”

WIN Recovery will be overseen by DJ Rhodes, PhD. Dr. Rhodes comes to Hamilton Center with a variety of healthcare experience including hospice, home health, hospital administration as well as OTPs and Federally Qualified Health Centers (FQHCs). Before making the career shift to healthcare, Dr. Rhodes spent over 15 years in military intelligence, including serving as the Technical Director of Air Force Space Command and Missile Defense System Command overseeing two weapon portfolios. In addition, he works as an adjunct professor at various universities teaching healthcare administration, leadership and critical thinking courses.

The mission of Hamilton Center Foundation is to strengthen the community by providing consistent and lasting support to Hamilton Center, as it provides the highest quality behavioral healthcare and wellness services in Indiana. People are encouraged to give to the Foundation to ensure a strong mental health system is available in central and west central Indiana in perpetuity. To give, go to www.hamiltoncenterfoundation.org or call (812) 231-8416.

“The Foundation is working to respond to community needs,” said Bob Rhodes, Hamilton Center Foundation’s Board Chair. “Assisting Hamilton Center in opening these opioid treatment programs will certainly help many people in central and west central Indiana,” he added.

“Hamilton Center is grateful to have the support of the Foundation,” said Burks. “The Foundation Board has a keen understanding of the priorities of Hamilton Center and the needs of the community,” he added.

Hamilton Center Announces New Team For Health Clinic

Grace Clinic Health Professional

Hamilton Center, Inc. would like to announce the additions of the following staff of Grace Clinic Health Professional, Hamilton Center Inc.’s new health clinic.

DJ Rhodes, PhD., Chief Officer of Health Clinics and Opioid Treatment Programs (OTPs), comes to Hamilton Center with a variety of healthcare experience including hospice, home health, hospital administration as well as OTPs and Federally Qualified Health Centers (FQHCs). Before making the career shift to healthcare, Dr. Rhodes spent over 15 years in military intelligence, including serving as the Technical Director of Air Force Space Command and Missile Defense System Command overseeing two weapon portfolios. In addition, he works as an adjunct professor at various universities teaching healthcare administration, leadership and critical thinking courses.

Nichelle Washington, B.S., Executive Director of Health Clinics, has been employed at Hamilton Center, Inc. for 12 years. Ms. Washington obtained her Bachelor of Science in Criminal Justice and Human Services in 2018. Previously, she has held management positions as a Program Manager of Employment Solutions and Project SEARCH. Through her work at Employment Solutions, she led a team of employment specialists who assisted individuals with barriers to employment seek and obtain jobs.

Russel Coutinho, MD, has served the Terre Haute community for nearly 15 years. Graduating from Pune University, in India, as a pediatrics physician, he has held several leadership positions across a variety of hospital settings. Prior to joining Hamilton Center, Dr. Coutinho was a neonatologist at Terre Haute Regional Hospital and Union Hospital, Terre Haute. He has worked as an educator at local colleges including Indiana State University and Indiana University – School of Medicine (Terre Haute), in the field of neonatology, nursing, and medicine. In addition, Dr. Coutinho is the Chairman of the Department of Obstetrics and Pediatrics at Regional Hospital, and in 2009 was locally honored as a March of Dimes Medical Honoree.

Robin Smiddy, NP, has 16 years of experience in acute care nursing and nursing leadership. She graduated in 2019 from Indiana State University with a master of science in Advanced Practice Nursing, and soon after became board certified. As a family nurse practitioner she focuses on preventative health, education, and women’s health.

Joy Whitt, NP, is a family nurse practitioner who has served Hamilton Center consumers’ primary healthcare needs since 2017. Her practice emphasis includes preventative health, education, and managing complications specific to behavioral health conditions.

Grace Clinic Health Professional, a primary and behavioral health clinic and community wellness provider, serves Vigo and Putnam Counties. Located at 620 8^th Ave. in Terre Haute, IN, the Vigo County clinic is open 8:00 a.m. to 4:30 p.m. Monday through Friday, while the Putnam County clinic, located at 239 Hillsdale Ave. in Greencastle, IN, is currently opened Thursdays, 9:00 a.m. to 1:00 p.m.

A focus of the clinic is to provide compressive health services to Hamilton Center consumers currently receiving behavioral health and addiction services. The clinic offers medical and dental care to all ages through a sliding fee scale based on federal poverty guidelines. No one will be turned away for inability to pay. Patients who do not have insurance can access a clinic navigator who are available on-sight to assist in finding a health plan that best meets the patients’ needs.

Hamilton Center, Inc. is a regional behavioral health system in Central and West Central Indiana with corporate offices located in Terre Haute, IN. Services are provided to children, youth and adults, with specialized programs for expectant mothers, infants, and people who may be struggling with stress, life changes, or relationship issues as well as more serious problems such as depression, anxiety disorders, and serious mental illnesses.

For information on Hamilton Center services call (800) 742-0787.

Hamilton Center, Inc. Expands Primary Care Services

Opens Grace Clinic Health Professional

Hamilton Center, Inc. – Hamilton Center is proud to announce the opening of Grace Clinic Health Professional, a primary and behavioral health clinic and community wellness provider serving Vigo and Putnam Counties. Located at 620 8^th Ave. in Terre Haute, IN, the Vigo County clinic is open 8:00 a.m. to 4:30 p.m. Monday through Friday, while the Putnam County clinic, located at 239 Hillsdale Ave. in Greencastle, IN, is currently opened Thursdays, 9:00 a.m. to 1:00 p.m.

A focus of the clinic is to provide comprehensive health services to Hamilton Center consumers currently receiving behavioral health and addiction services. The clinic offers medical and dental care to all ages through a sliding fee scale based on federal poverty guidelines. No one will be turned away for inability to pay. Patients who do not have insurance can access a clinic navigator who are available on-sight to assist in finding a health plan that best meets the patients’ needs.

Grace Clinic Health Professional will be overseen by DJ Rhodes, PhD., Chief of Opioid Treatment Programs and Health Clinics. In addition, the day to day operations will be managed by Hamilton Center’s Executive Director of Health Clinics, Nichelle Washington. A team of physicians, nurse practitioners and others will offer services that include health screenings, immunizations, treatment for minor illnesses, management of chronic conditions, laboratory and pharmacy services, and referrals to outside specialists including dental.

Hamilton Center has offered primary care services since 2017 through a grant through the Indiana Department of Mental Health and Addiction. The development of Grace Clinic Health Professional aligns with Hamilton Center’s strategic initiative to expand integrated health and wellness services.

“We often hear of the mind body connection and that one’s mental health can affect other parts of their body, and vice versa,” said Rhodes. “By offering a community wellness center focused on delivering primary care and behavioral health services all under the same roof, we simplify the process of seeking treatment for any condition, mental or physical,” he added.

“Those with serious mental illnesses die many years prior to those without these illnesses,” said Melvin L. Burks, Hamilton Center’s CEO. “It is our hope to address that statistic by helping make primary care easily accessible and integrated with behavioral health services,” he added.

For information on Hamilton Center Services call (800) 742-0787.

WIN Recovery Offers Help, Hope, and Healing

Terre Haute – “One hundred and ninety; that’s the number of lives lost to overdose every day in the United States,” said Natasha Newcomb, Executive Director of Addictions Services, Hamilton Center, Inc. “WIN Recovery works every day to lower that number, and we are here to show our support to those families most affected by it,” she added.

On August 30th, 2019, WIN Recovery, Hamilton Center’s certified opioid treatment program, gave community members an opportunity to recognize struggles of addiction and the many lives lost to overdose in our community. The event featured the release of 190 butterflies, symbolic of the 190 lives lost, in recognition of International Overdose Awareness Day, set for August 31, 2019. The organization also celebrated the kickoff to September as Recovery Month with a testimony of recovery and a message of hope from community members who have previously struggled with addiction.

In 2017 it was reported the U.S. experiences one of every four overdose deaths in the world, with an estimated 20 million people, five percent of the global adult population, in need of some form or substance use treatment. With opioids playing a huge role accounting for 70 percent of all global drug use disorders, WIN Recovery is doing its part to serve the local needs of community members and their loved ones struggling with addiction.

If you or someone you care about is struggling with an opioid use disorder, contact WIN Recovery at (812)-231-8484. Regain Something Lost.

Hamilton Center, Inc. is a regional behavioral health system in Central and West Central Indiana. Services are provided to adolescents and adults, with specialized programs for expectant mothers, infants, and people with drug and alcohol problems. Counseling services are provided for people who may be struggling with stress, life changes, or relationship issues as well as more serious problems such as depression, anxiety disorders, and serious mental illnesses.

Opioid Addiction & Pregnancy

Contributed by: Jessica Nevil, LMHC, Clinical Director at WIN Recovery, and Zach Jenkins, Public Relations Specialist at Hamilton Center, Inc.

Here’s what you need to know.

Opioid addiction during pregnancy is treatable and here’s what you need to know.

First, addiction to opioids can happen to anyone at any point in life. The fact is addiction of any kind is a physical and behavioral disorder and should be recognized as such. The act of seeking help takes great courage, and is one that requires fostering support; without a strong system of support the likelihood of treatment and recovery dramatically decreases.

Opioid drug use, and certainly drug abuse, can cause significant health risks to an unborn child, however, abruptly stopping the use of opioids can also be dangerous, even life threatening.

When a pregnant women uses an opioid her baby is exposed to the drug as well as the “highs and lows” of chronic use, including dependency and withdrawal. There is a common misconception that babies are born addicted to a substance, which is incorrect and misleading. Addiction is a physical, mental, and emotional cycle of behaviors that effects an individual often times over the span of a lifetime. Babies born during addiction are not guaranteed to experience addiction later in life; other environmental variables lead to this.

When consuming high doses of opioids the risks of neonatal abstinence syndrome (NAS) greatly increases. NAS is a condition that requires medical attention for the symptoms of withdrawal and often appears as rapid shaking or sucking of the fists. These symptoms are managed through breast feeding, strengthening of the mother-child bond, and medical treatment.

With the opioid epidemic sweeping the country many federal, state, and local funds have been granted to community health centers across the state to develop opioid treatment programs (OTP). Indiana has opened nearly 20 opioid treatment programs in areas of the state hardest hit by the opioid issue. These programs offer medication assisted treatment (MAT) in several forms including buprenorphine, vivitrol, and methadone, some of which are coupled with comprehensive behavioral health services. Many programs are working closely with local hospitals to connect pregnant women to treatment. The collaboration of medical and behavioral health services found in opioid treatment programs is recognized as the most effective form of treatment when compared to abstinence or other programming options.

So what is the best drug option?

Today methadone is used as the gold standard for treatment of opioid use disorder (OUD) for most populations, including pregnant women. Used only for the treatment of opioid related addictions methadone is administered in daily dosing with mandatory addiction counseling. With the primary goal of harm reduction pregnant mothers will experience decreased risk of transmittable diseases including HIV, AIDS, and Hepatitis-C, decreased risk of overdose, and increased employability and social engagement.

If you are struggling with opioid use disorder during or after pregnancy it is important for you to seek medical help and have open and honest communication with your provider about past, current, and future drug use. Continued use will increase health risks for both you and your baby. WIN Recovery, the first OTP of its kind in the area, offers medication assisted treatment in the form of methadone, coupled with individual and group counseling, and case management. For more information about opioid use disorder, treatment, and recovery please contact 1-812-231-8484 or visit www.winrecovery.org.

www.drugabuse.gov
www.samhsa.org

“The opioid epidemic is impacting more than just the lives of those struggling with addiction”

Co-authored by: Anastasia Godsey, M.S. LMHC, Director of Child and Adolescent Services and HCI West at Hamilton Center, Inc. and Zach Jenkins, Public Relation Specialist, Hamilton Center, Inc.

With 52 percent of children removed from a home due to parental substance abuse and 51 percent of displaced children living with a relative who may struggle to support them, issues, like the opioid epidemic, are impacting more than just the lives of those struggling with addiction.

For children and youth being separated from family and familiar surroundings can be traumatizing. Separations that are sudden, unexpected, or prolonged can interfere with a child’s ability to develop healthy coping strategies, putting them at increased risk of social and behavioral issues later in life. Unfortunately, children are impacted by both witnessing the parental substance use as well as their parent’s decreased ability to provide for their needs due to their altered state of being. Children who witness parental substance use are put at higher risk for future substance abuse which can lead to multigenerational cycles of addiction.

In the event of child displacement as a result of abuse or neglect, a child is placed with a family member, often referred to as kinship care. These types of displacements are typically categorized as informal, formal, and voluntary. Child welfare services are involved in both formal and voluntary kinship care. In these arrangements many cite more access to services but less overall flexibility. Informal kinship care is the most common form of child displacement, with grandparents most commonly receiving placement of the child without involvement of child welfare services.

Recent data suggests grandparents, as kinship care givers, may face additional emotional and financial challenges that other care givers involved with child welfare services do not. Of grandparents who are responsible for their grandchildren 41 percent are older than 60 years of age, 43 percent received Supplemental Security Income, public assistance income, or Food Stamps/SNAP Benefits, and 22 percent live in poverty. All of these factors contribute to financial burdens most commonly associated with receiving custody of a child. Furthermore, the majority of grandparents receiving placement of a child are not licensed in the foster care system and therefore may not be eligible for the same services and financial support as licensed foster parents, further complicating the issue.

The good news is that there are ways to break the cycles of multi-generational addiction. Kinship care promotes family bonds, stability, as well as a sense of belonging for children, all of which are considered risk factors when absent during a child’s earliest years of growth and development. Utilizing community resources for parental support and trauma related to parental substance use as well as seeking treatment for the child/children involved can minimize the risks associated with childhood displacement.
Hamilton Center, Inc. is a regional behavioral health system serving central and west central Indiana. The organization is “building hope and changing lives” through a broad array of behavioral health services for adults, children, adolescents, and families. Services are individualized, trauma informed, and evidence-based. Needs and strengths are assessed and utilized to develop a person-centered treatment plan.

Hamilton Center provides Infant and Toddler Services programs especially designed for children from birth until three years of age and their families. These services include: Healthy Families and Early Head Start. Admission criteria is different for each program, but all services are free of charge to families. Infant and Toddler Services’ programs are operated by Hamilton Center, Inc., a not-for-profit 501(c)(3) corporation. Both programs are offered in Vigo County; the Healthy Families program is also offered in Greene County, Sullivan County, and Vermillion County.

Hamilton Center also offers treatment services for adults and children who are impacted by trauma including: individual, crisis, family, school based therapy, and group therapy. Hamilton Center also offers skills training, case management, and wraparound services in the community and home as an opportunity to meet the needs of the consumers in multiple areas of their lives. Hamilton Center is currently a DMHA grantee for the Transition Aged Youth Grant which provides funding for ages 14-26. This grant focuses on helping individuals in being able to successfully navigate into early adulthood.

Dependency & Addiction

A thin but visible line.
As a society we know that medications are a necessity. Antibiotics fight infections; specialized medicines treat unique conditions; chemotherapy medication destroys malignant cancer cells; pain medications block acute and/or chronic pain. Of this list, pain medications are unique in that they carry a level of social stigma that is uncommon when compared to medications used to treat other health issues.

The fact is pain is one of the most powerful forces in human physiology. It can lead to depression, a loss of mobility, decreased cognitive function, and in some cases, thoughts of suicide. For many, this reality leads to a dependency on pain medications, which is often the only viable solution for the “pursuit of happiness”. It can however lead to health risks and even dangerous behaviors like addiction. This evolution of dependency and addiction is preventable with open and honest communication with your prescribing doctor.

Acknowledging the difference between dependence and addiction is an important component of this communication. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) views substance use disorder as a spectrum disorder in which there is a thin, yet visible, line between dependency and addiction; one that is easily misplaced in the absence of mindful consumption. Someone who is dependent on pain medication may actively follow dosing prescriptions, be more likely to have a moderate or low tolerance for the drug, and even seek to lower or stop dosing all together. Someone who is addicted to pain medication will exhibit compulsory behaviors, tendencies to hide consumption behaviors, a change in personality, and an especially high tolerance for the drug coupled with a desire for a higher dose. The DSM-5 also clarifies the point that to be addicted to something you must experience dependence. Dependence is, in fact, a symptom of addiction. Conversely, dependence does not equal addiction, which is a fundamental concept easily missed in our social discussions related to drug use and abuse.

This distinction is relevant because the transformation from dependency to addiction is preventable, and, most importantly, observable. We know that medications are useful, but they can also be dangerous when consumed outside of the parameters of a prescription. Whether you are the person prescribed the highly addictive medication for your now injured leg, the unfortunate product of an accident, or you are a witness to such, it is important to note that changes in behavior may be a distinct indicator of addiction and should be investigated. While it is the responsibility of the person prescribed the medication to monitor their own consumption, it is imperative that we, as a society, are aware that the evolution from dependency to addiction is not one that happens overnight, nor is it one that knocks at the door. As keepers of ourselves, our bodies, and that of our brothers and sisters we should all keep a watchful eye, with patience and vigilance, so as to prevent the unnecessary suffering of addiction.

If you believe that you, or a loved one, have transitioned from dependence to addiction there are resources available to you. WIN Recovery, formally known as Western Indiana Recovery Services, is an opioid treatment program (OTP) in West Central Indiana. The program is the first of its kind in the area and offers medication assisted treatment, in the form of methadone, to treat the disease process of opioid use disorder by offering daily medication, group and individual counseling, and case management services. For more information about services visit www.winrecovery.org. To set up an assessment, call 1-812-231-8484 or stop by the facility at 88 Wabash Court in Terre Haute, IN. Walk-ins are welcome.

Hamilton Center, Inc. also offers behavioral health services including addictions counseling and case management. For more information on services call 1-800-742-0787 or visit www.hamiltoncenter.org.

Peer Recovery

Lived Experience Informing Support

Peer Support Specialists (PSS) can be the keystone of an effective holistic treatment program for those struggling with a mental illness or addiction. Often acting as a navigator of community support systems and informed by lived experiences, someone struggling with a mental illness or addiction can be guided throughout the entire process of recovery increasing the likelihood of progressive treatment.

So how does the experience of a diagnosed mental illness or addiction help those who treat said illnesses? Working in conjunction with clinical staff, Peer Support Specialists fill a large gap in rapport that many clinical professionals of recovery programs cite as a barrier to progressive treatment. While mental health professionals are trained and certified in various forms of treatment, many lack the lived experiences that inform their empathy and sympathy, two of the most crucial characteristics in the health profession. Patients often cite feeling more confidence and comfort while pursuing treatment if they know recovery is truly possible, and if someone who has been in their shoes is willing to walk them down the all too scary, uncertain path of recovery.

One of the more valuable services a PSS can provide is daily communication and motivation, especially in times of relapse or crisis. PSS are often the first line of contact and support during the toughest of times and offer emotional and motivational backing for clients when they need it the most. They will coordinate transportation to and from treatment, help individuals through the process of reintegrating with friends and family, and help link them to a variety resources with a primary goal of increasing quality of life.

Perhaps the highlight of the Peer Support Specialist’s relationship with someone in recovery is the reciprocity of support and the role that the responsibility of mentorship can play in their own journey of recovery. In the case of mental illness and addiction, recovery is a lifelong process with highs and lows. While PSS can be an example of successful treatment and recovery, they too struggle with these highs and lows and can even find themselves in relapse or crisis, sometimes years after exiting treatment. Even so, many cite a greater sense of intrinsic motivation towards maintenance and recovery that can be directly attributed to the mentor/mentee relationship. One of the most profound forms of leadership a PSS can offer is to “walk the walk” they so zealously advocate to their clients.

Where can you find a Peer Support Specialists to support you through your journey of recovery? PSS can be found in hospitals, community mental health centers, as well as private health organizations. Some of their clinical responsibilities include working with other clinicians to coordinate care, creating and implementing social activities for consumers, and even assisting in securing housing and/or employment.

The fact is we need more Peer Support Specialists. With concerns for mental health becoming a staple in the public conversation on what it means to live a healthy and happy life, more and more demands will be placed on the already overburdened system of mental health services in our communities. For rural areas this will prove to be an even more challenging problem, not to mention the hold that taboo and stigma have on these isolated communities.

Peer Support Specialists can certainly play an important role in treatment and help to turn a good program into a great one. For additional information on Peer Support, go to: https://www.thenationalcouncil.org/integrated-health-coe/.