Author Archives: Jason Schwartz

About Jason Schwartz

Jason Schwartz, LMSW, ACSW, CADC, CCS, is the Clinical Director of Dawn Farm, overseeing treatment services for its two residential treatment sites, sub-acute detox, outpatient treatment services & detention-based juvenile treatment program. Jason is also an adjunct faculty at Eastern Michigan University’s School of Social Work and School of Leadership and Counseling. Jason blogs at www.addictionrecoverynews.com and has been published in Addiction Professional magazine and in a monograph Recovery-oriented Supervision with the Addiction Technology Transfer Center. Jason serves on the advisory boards of Eastern Michigan University’s School of Social Work and School of Leadership and Counseling. Jason also serves as a board member for the Livonia Save Our Youth Task Force, a substance abuse prevention coalition in his home community.

Gratitude cultivates patience

daily-gratitude

A recent study suggests that gratitude fosters longer term thinking and patience. Traits that are undoubtedly helpful in recovery.

My colleagues Ye LiJennifer LernerLeah Dickens, and I decided to test how the experience of gratitude effects discounting and financial impatience. We designed an experiment (now in press at the journal Psychological Science) that presented participants with a set of 27 questions, which pit a desire for immediate cash against a willingness to wait for larger rewards at various times in the future. For example, one question required study subjects to choose between receiving $54 now or $80 in 30 days. To increase the stakes, participants knew they had a chance to obtain one of the financial rewards they had selected; it wasn’t purely hypothetical. If they chose the immediate cash, they’d be paid then and there; if they chose the delayed amount, we’d send them a check. However, before they made these decisions, we randomly assigned each one of them to recall and briefly write about an event from their past that made them feel (a) grateful, (b) happy, or (c) neutral.

As we expected, individuals who wrote about neutral or happy times had a strong preference for immediate payouts. But those who’d described feeling grateful showed significantly more patience. They required an immediate $63, on average, to forgo receiving $85 in three months, whereas the neutral and happy groups required only $55, on average, to forgo the same future gain. Even more telling was the fact that any given participant’s degree of patience was directly related to the amount of gratitude he or she reported feeling. It’s important to note that positive feelings alone were not enough to enhance patience: Happy participants were just as impatient as those in the neutral condition. The influence of gratitude was quite specific.

We see broad implications for these findings, since they suggest that gratitude can foster long-term thinking. We all recognize the fact that willpower can and does fail at times. Having an alternative source of patience – one that can come from something as simple as reflecting on an emotional memory – offers an important new tool for long-term success. And that itself is something to be grateful for.

Leave a comment

Filed under Uncategorized

Embrace harm reduction?

sndnhr-blue-feature

DJ Mac challenges recovery-oriented providers to embrace harm reduction:

Despite my focus on recovery I have a strong harm reduction ethos at my core. Sure, I challenge services to be recovery-orientated, but I firmly believe that the reverse needs to be true. Rehabs and other services with a recovery goal ought to have harm reduction practices woven into their fabric. If they don’t they could be short-changing clients.

Read the rest here.

Spend some time on his blog. His posts are consistently smart, challenging, concise and he avoids the simplistic and false binary arguments that plague writing on the topic.

3 Comments

Filed under Uncategorized

Collegiate Recovery – from the Dawn Farm Education Series

Collegiate Recovery Programs: Supporting Second Chances

GOAL: To provide an overview of the need, purpose, history and present development of collegiate recovery programs locally and nationally.

OBJECTIVES: Participants will:

  1. Get an overview of the challenges and obstacles students in recovery face on college campuses
  2. Learn about the theory and research that are at the foundation of the development of Collegiate Recovery Programs
  3. Learn about the development of Collegiate Recovery Programs at both the local and national level

Handouts and Related Reading

Collegiate Recovery Programs presentation

U-M Collegiate Recovery Plan

Substance Abuse Recovery in College” ; Community Supported Abstinence Series: Advancing Responsible Adolescent Development; Editors: H. Harrington Cleveland, Kitty S. Harris. Richard P. Wiebe; Springer Science and Business Media. 1st Edition., 2010

Audio

This audio is from the 2013/2014


Video

This is the presentation from the 2013/2014 education series

Collegiate Recovery Programs: Supporting Second Chances – February 2014 from Dawn Farm on Vimeo.

About the Presenters

Mary Jo Desprez
Mary Jo DezprezDirector, Wolverine Wellness, University Health Service, University of Michigan
University Health Service
University of Michigan

Mary Jo Desprez is a native of Ann Arbor, Michigan. She received her BA (1985) and MA (1987) from Michigan State University. She has worked in the field of college health/wellness for 20+ years.

As part of her current role as Director of Health Promotion and Community Relations she manages both the Alcohol and Other Drug Prevention Program and the Collegiate Recovery Program at the University of Michigan. Mary Jo is also an adjunct instructor at Eastern Michigan University (since 1997).

Mary Jo serves as the Co-Chair for both the Ann Arbor Campus and Community Coalition (A2C3), and the Michigan Campus Coalition (MC3). She is a Center Associate for the Higher Education Center for Alcohol and Other Drug Prevention (U.S Department of Education). In October 2010, she became a member of the Motivational Interviewing Network of Trainers (MINT). In May 2003 she was certified by the State of Michigan, Department of Community Health, as an HIV test counselor. In May 2002 Mary Jo successfully completed the curriculum for Critical Incident Stress Management certification.

 

Matt Statman
Matt_smallProgram Manager, Collegiate Recovery Program, University of Michigan

Matt manages the Collegiate Recovery Program at U-M. Prior to joining U-M, Matt worked at Dawn Farm from 2004 to 2012. He started as a House Manager and Resident Aid and later spent several years working as a Detox Counselor and Team Leader. He has also worked both as an Outpatient Therapist and an Administrator and Therapist in Dawn Farm’s Correctional Programs.

1 Comment

Filed under Uncategorized

Running over depression

Walking Feet

The Atlantic recently posted on the effectiveness of exercise to treat depression and the failure to integrate it into practice:

Percent of patients in each condition six months after treatment. (Psychosomatic Medicine)

Depression is the most common mental illness—affecting a staggering 25 percent of Americans—but a growing body of research suggests that one of its best cures is cheap and ubiquitous. In 1999, a randomized controlled trial showed that depressed adults who took part in aerobic exercise improved as much as those treated with Zoloft. A 2006 meta-analysis of 11 studies bolstered those findings and recommended that physicians counsel their depressed patients to try it. A 2011 study took this conclusion even further: It looked at 127 depressed people who hadn’t experienced relief from SSRIs, a common type of antidepressant, and found that exercise led 30 percent of them into remission—a result that was as good as, or better than, drugs alone.

Though we don’t know exactly how any antidepressant works, we think exercise combats depression by enhancing endorphins: natural chemicals that act like morphine and other painkillers. There’s also a theory that aerobic activity boosts norepinephrine, a neurotransmitter that plays a role in mood. And like antidepressants, exercisehelps the brain grow new neurons.

But this powerful, non-drug treatment hasn’t yet become a mainstream remedy. In a 2009 study, only 40 percent of patients reported being counseled to try exercise at their last physician visit.

Instead, Americans are awash in pills.

2 Comments

Filed under Uncategorized

The Big Book Turns 75

aa3PBS has a nice write up on the 75th anniversary of the publishing of  the AA’s basic text. the “big book”:

April 10, 1939, marks the publication date of “Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism.” One of the best-selling books of all time (it has sold more than 30 million copies), the volume is better known to millions of recovering alcoholics and addicts as “the Big Book.” Its influence on the world’s health and the treatment of alcoholism and other addictions is immeasurable. In 2011, Time magazine placed the Big Book on its 100 most influential books written in English since 1923 (not coincidentally the year the magazine was founded). In 2012, the Library of Congress designated it as one of the88 books that shaped America.

The book’s copyright application, filed April 19, 1939, lists William G. (“Bill”) Wilson, the co-founder of Alcoholics Anonymous, as the sole author. In reality, the book was very much a group effort. Dozens of recovering alcoholics, many who attended the earliest AA meetings and who had an average sobriety time of 1 to 1.5 years, helped Bill Wilson with the writing of the book in 1938. Their express purpose was to spread the life-saving premises of Alcoholics Anonymous.

Read the rest here.

1 Comment

Filed under Uncategorized

Putting Recovery on the Political Agenda

Photo source: Boston Globe

Boston’s new mayor is starting to make good on a campaign pledge:

Mayor Martin J. Walsh announced today that the City of Boston’s addiction and recovery services are about to get an upgrade, taking a major step towards one of the more personal platforms of his campaign for the mayor’s seat.

. . .

Through a collaboration with the Blue Cross Blue Shield of Massachusetts Foundation, a grant and research organization that works to expand access to health care services in Massachusetts, the city will create an expert advisory committee to evaluate the status of addiction and recovery services in Boston. Their work will culminate in a study that is expected in 2014, which will lay the foundation for a new Office of Recovery Services that will be run out of the Boston Public Health Commission, and will be funded by $300,000 of Mayor Walsh’s 2015 fiscal budget.

Back in November, I posted about Walsh’s openness about his recovery and his army of volunteers from the recovering community.

Leave a comment

Filed under Uncategorized

Addiction and Willpower

Spinal_Tap_-_Up_to_Eleven

Peg O’Connor takes a look at our beliefs about addiction and willpower.

I believe there is an implicit formula undergirding this conception of willpower that “inability to resist temptation = addiction.” All parts of the formula—inability, resistance, temptation, and addiction—are worrisome.

Regarding inability: It would seem to follow that the further a person moves down the substance use disorder continuum (mild to severe), the less one is able to exert her self-control to resist the temptation of her drug of choice. A person either loses the ability she once had or develops the inability as she moves along the continuum. But what space is there to explore the conditions under which one loses the ability? This sort of question falls off the table and instead the focus remains on the individual and her failure to exert self-control in the right direction to the right degree.

. . .

Regarding addiction: The formula tends to reduce a very complex set of phenomena to one characteristic, namely the failure of an individual to exert the right amount of self-control. Addictions progress and manifest in many different ways. At the end of the day, I am not convinced that all addictions share one thing in common. More on this in an upcoming post.

It’s worth pointing out that there is considerable evidence that “temptation” in the brains of addicts is turned up to 11 out of 10, while there is also evidence that the regions responsible to saying “no” to drugs are impaired. And, as she points out:

Saying no to things is exhausting, as Baumeister and Tierney argue. We live in a world of unending temptations, and at times it seems as if we are constantly caught in a deluge of wants and desires. Having said no to 99 things makes it more likely that we cannot when the hundredth temptation crosses our path.

Leave a comment

Filed under Uncategorized

In defense of AA

Ideology-ideallery-cmJohn Kelly chimes in with a powerful and evidence-based defense of AA, that doesn’t just rebut Dodes’ arguments, he destroys them.

It’s too good to pull quotes from, take the time to read the whole thing.  Here’s a taste:

Dr. Dodes begins his criticism of AA and related treatment by citing a 1991 study published in the prestigious New England Journal of Medicine. This paper studied the treatment of a large number of individuals with alcohol problems. Dr. Dodes notes in his book that compulsory inpatient treatment had a better outcome than AA alone. But what he fails to mention is that the inpatient unit is a 12-step-based program with AA meetings during treatment, and requirements to attend AA meetings three times a week after discharge in the year following treatment.

Importantly, too, when you compare the alcohol outcomes (average number of daily drinks, number of drinks per month, number of binges, and serious symptoms of alcohol use), AA alone was just as good as the AA-based inpatient treatment. Yet Dr. Dodes uses this study to argue that AA is poor while inpatient treatment is good — a bizarrely distorted, misleading and incorrect interpretation of the study’s findings.

4 Comments

Filed under Uncategorized

Stuck on Methadone

billboard-stuck_1116867iDJ Mac reviews a recent German paper looking into why patients stay on methadone. His review is easily the best post I’ve read on the complicated relationship between methadone and recovery. Read the whole post.

The paper’s starting point:

The paper outlines that retention in ORT is not great, with just over half of patients sticking with methadone and fewer with Suboxone. Despite this, in Berlin, as we have said, there are growing numbers of people on ORT. These are people who are not moving on; I suppose the ones the press call ‘parked’ on methadone. Hence the question the authors pose: “Why is this?”

Their findings:

  1. Both patients and staff thought ORT helped physical and mental health. Beneficial effects of ORT on the ability to work and on crime were considered significantly higher by patients compared to staff.
  2. Staff and patients agreed that coming off ORT was hard. Patients thought it harder than coming off heroin.
  3. Patients wanted to eventually come off ORT at a significantly higher rate than staff estimated.

. . .

The thing that intrigues me the most is the “striking discrepancy between the patients’ and staff members’ assessment of the patients’ desire to end OMT on the long term. The large majority of patients report the desire to end OMT on the long term, whereas only a minority of staff members believe that their patients might really have such a desire.”

David Best found much the same thing (in aspirational terms) in a sample of drugs workers in the UK. They believed only 7% of their clients would eventually recover.

DJ Mac’s take:

It’s clear to me that where there is such a mismatch, when the bar is set so low and when there is little hope pervading treatment settings, then it’s no wonder that so few move on.

By the conclusion the authors find themselves at odds with the assertion at the start of the paper (that ORT has an aim of ‘abstinence from opioids’.) Here’s what they say (my emphasis):

“Finally, detoxification of OMT is not the prime objective of treatment. The prime objective of treatment is continued physiological and social stabilization. As yet, there is no validated medical cure for opioid addiction. Until a curative medication or a safe curative procedure is developed, many of the patients may have to remain in treatment for the duration of their lives to avoid relapses, increased criminality, subsequent overdoses, and death during the post treatment period.”

So the solution to the mismatch between the low expectation of staff and the higher expectation of patients is to lower the expectation of patients to that of staff?

It’s clear that issues identified in this paper are not isolated. They report on the patient experience in Germany. It resonates with DJ Mac in the Scotland. And, it resonates with me, here in the states. (Methadone’s problems in the US are often attributed to a system that’s dominated by abstinence-oriented providers who stigmatize ORT. That can’t be said of the other countries.)

The post, to my mind, ended up being a great informed consent document on one of the more concerning hazards of ORT.

Read the whole thing here.

1 Comment

Filed under Uncategorized

Eating Disorders – from the Dawn Farm Education Series

This program will examine the evidence that eating disorders are true biopsychosocial diseases, similar to chemical dependency. The program will define various eating disorders and their consequences, explore neurobiological and behavioral theories of addiction, describe physiological consequences of eating disorders, discuss screening tools, and provide information on treatment options and resources for people with eating disorders.

Handouts and other goodies:

Handouts:

Related reading suggestion:

Video:


Slidecast:

Audio only


About the presenters:

Carl Christensen, MD, PhD, MRO

Carl Christensen

Dr. Christensen is an Associate Professor in the Departments of OB Gyn and Psychiatry at WSU School of Medicine. He obtained his MD and PhD in Biochemistry at Wayne State University School of Medicine and did his residency in OB Gyn at Hutzel Hospital. He then completed a Fellowship in Gyn Oncology at Duke University Medical Center. He later became certified in Addiction Medicine and is also certified as a Medical Review Officer.

He is currently the Medical Director for the Student Health Monitoring Program at the WSU School of Medicine, which is designed after the Michigan Health Professional Recovery Program (HPRP). He is also currently the Vice Chairman of the Michigan Health Professional Recovery Committee, which oversees the HPRP.

In addition to treating pain and chemical dependency in his private practice at Pain Recovery Solutions in Ann Arbor, Dr Christensen specializes in treatment of chronic pain, especially pelvic pain, and the treatment of addiction in pregnant patients.
He is the current Medical Director of the James Wardell Women’s Recovery Center, an outpatient program dedicated to caring for pregnant, chemically dependent women, as well as the Medical Director at the Substance Abuse Research Division in the Department of Psychiatry at WSU. He is the current President of the Michigan Society of Addiction Medicine. He is the Associate Residency Program Director for the OB Gyn residency at Wayne State University/Detroit Medical Center and has received numerous teaching awards.
He has been named one of the “Top Docs” in Addiction Medicine in Hour Magazine for 2006, 2007 and 2008. He has also served as a past Medical Director for Dawn Farm.

He lives in Superior Township with his wife Cathy, a Nurse Practitioner, and their 3 dogs and multiple rescue cats.

Lori Perpich, MS, LLP
EDEN Program Facilitator, ED League of Michigan Member

Lori started working directly with women recovering from eating disorders in 2000 through an organization called EDEN (The Eating Disorders and Education Network). She became a facilitator in both Washtenaw and Livingston County. For 8 years she led groups through the EDEN Process. The EDEN Process is a 17- week course of one hour meetings. Each meeting covers a specific topic related to recovery and or the acquisition of behavioral skills to break disordered eating habits. Lori facilitated 2 groups per year for women recovering (ages 18-55), and a separate group in each county for families and supporters. In 2004 she began working on her Masters in Clinical Behavioral Psychology at Eastern Michigan University with a clinical interest in behavioral approaches to eating disorders. Lori became involved with Dawn Farm through EDEN, and later conducted her Psychology internship at Dawn Farm. This opened a door for Lori to work with clients experiencing co-addiction of eating disorders and chemicals. Since graduation in 2008 she has been working individually with eating disorder clients in Ann Arbor many of which are dually diagnosed with chemical addiction. Lori continues to lead an ongoing EDEN group in Ann Arbor.

Lori’s personal approach to eating disorder treatment is both whole and behavioral. She approaches eating disorders as an addiction with physiological and classically conditioned or escape maintained behaviors. She examines with her clients both their skills for intervening in habit breaking and their overall balance in emotional, social, physical, and spiritual health. She works with her clients to find their most powerful self- worth, accountability and motivations which will give them the strength to intervene in their disorder. She herself is a recovered bulimic and draws on her experience to aid clients through recovery and seeking balance.

Lori has two sons and lives in the Livingston County Area.

1 Comment

Filed under Uncategorized