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Trauma Informed Treatment For Addiction

Trauma Informed Treatment For Addiction

Years of research and studies show an undeniable correlation between trauma and addiction. Many individuals who have been subjected to trauma or traumatic experiences in their childhood turn to substances as a coping mechanism when they become adults. Individuals who have been through physical, sexual or psychological abuse when they were children do not have the skills to process their experiences. Even events such as natural disasters, a difficult parental divorce, or becoming immigrants in another country which may not appear to be traumatic incidents, but because they can significantly impact their previous identities of self, they will need to integrate their traumatic past and rebuild a new self.

Trauma Informed Modalities for Addiction Treatment

With the recent attention on the connection between trauma and addiction, several trauma informed care (TIC) options are being developed in order to address the specific impacts of people showing PTSD or trauma related symptoms.

Some of the popular TIC treatments include :

  • EMDR
  • Brainspotting
  • Somatic Experiencing

Here at Buckeye Recovery Network, we have found EMDR to be extraordinarily effective on people who experience even significant traumatic injuries by helping them to free themselves of the association of those incidents, so the rest of this article focuses on how EMDR treatment can help provide trauma informed care.

EMDR 101

EMDR is short for Eye Movement Desensitization and Reprocessing which uses a simple process of bilateral stimulation. By using this body-based process, EMDR bypasses the part of the brain (the amygdala) where trauma gets stuck and allows the individual to activate the prefrontal cortex again so they can think properly and process what is going on around them in a calmer frame of mind. This allows the individual to reprocess their trauma but without experiencing the impacts of the trauma.

Therapists use bilateral stimulation in several ways, and EMDR is one of them. In the EMDR process, eye movements are made to follow a finger or a pointer back and forth in order to recreate the process that happens during REM sleep. Sleeping and dreaming allows reprocessing all the events that happened during the day, which is a similar process that happens during EMDR.

Another methodology of EMDR uses two tappers that clients hold and they buzz left and then buzz right, in a continuous process, which activates stimulation. So as the bilateral stimulation is going the client reprocesses the memory. Whether the clients have their eyes closed or open, whether they are talking or not talking, they are still reprocessing their traumatic memory during the entire time. Each time they reprocess their memory it loses some of its effect, so that their body no longer has the same reactions to the event even though they still remember the incident. One example is PTSD patients who have nightmares, flashbacks and dysregulated emotions arising from their past traumatic incidents slowly overcome them and may completely free themselves of them, after reprocessing the traumatic events through EMDR.

Who Can Benefit From EMDR Treatment?

Traumas can be broadly classified into Big Ts and Little Ts. Big Traumas are typically single-time occurrences of significantly traumatic events. Little Traumas are typically repeated occurrences of smaller traumatic incidents. Repeated exposure to Little Ts can have the same impact as a Big T. Therefore, there is an entire range of people who EMDR can be beneficial for. It includes people who have or have been:

  • Diagnosed with PTSD
  • Experienced or witnessed physical assault
  • Experienced or exposed to domestic violence, sexual abuse, or emotional abuse
  • Witnessed crimes or been a part of crimes, first responders
  • Exposed to death, loss, grief
  • Experienced Bullying at school or work

Essentially any time a person’s body enters an altered state of consciousness where things are not processed by their brain, EMDR can work to alleviate some of that pain.

When To Start EMDR Treatment in Recovery?

Although each individual responds differently to treatment, there are risks to starting EMDR treatment too soon in recovery. Here are some guidelines.

  • Someone who has just completed detox and does not yet have the skills to maintain sobriety may not be ready to address their trauma and its impact.
  • Trauma reprocessing can create intense pain in the short term, and the individual must have the ability to self-regulate when distressing memories arise.
  • Trust and rapport must be established between the therapist and the patient before addressing traumatic memories.
  • EMDR is not recommended for victims of crimes such as sexual abuse or physical assault who are in the midst of a court case because it may alter their perspective of the incident, and should wait until after the court case is completed.
  • EMDR is also not recommended for pregnant women because it can be distressing for the baby to experience its mother’s trauma, so it should be postponed until after the birth of the baby.

Get Help Now

If you are suffering from addiction as well as trauma, you know that unresolved and unprocessed trauma continues to make the future look like the past. If you want to free yourself from the chains of the past, then looking at the appropriate time with the appropriate provider and the appropriate clinician to address trauma is something that is necessary for long-term success in the recovery world.

When you’re ready to start your recovery reach out to us at https://buckeyerecoverynetwork.com/

Today is going to be the best day of your life.

Can Recovery Reverse Trauma?

Can Recovery Reverse Trauma?

There have been a lot of studies that show a scan of a traumatized brain versus a brain that has never experienced trauma and they look significantly different. An impala in Africa, when it is attacked by a lion, plays dead until the lion walks away. After the lion leaves, the impala lays there for a while and then starts viciously shaking. It violently shakes itself and then it gets up and walks away. Animals have learned how to deal with all of the energy that comes up when they go into survival mode, but humans haven’t. It is reasonable to think that this is because humans are frightened of the intensity of the survival energy, but because we don’t deal with it, it ends up getting stored in our body. Most other mental disorders such as depression and anxiety can go away on their own, but Trauma is one of the very few mental disorders that does not go away on its own, unless it is addressed, because it is stored in the body.

Neuroplasticity: the Ability to Adapt

Yes, the nervous system of a human being can reverse the effects of trauma internally through the process of recovery. Neuroplasticity is the brain’s ability to adapt and heal, which can be used in a safe, therapeutic environment to process traumatic events, as long as an individual is willing to address their trauma.

We have worked with countless numbers of human beings at Buckeye Recovery to help them recover from their traumatic experiences. In the field of addiction and mental health, it is rare to come across a human being who has not experienced some type of traumatic event, either first-hand or second-hand. Many people mistakenly think that trauma can only happen to those who experienced overtly obvious traumatic incidents. Just because someone did not get abused physically does not mean that they didn’t experience trauma. Trauma sometimes could be things that should have happened through the lifespan development of a person that never happened.

Types of Trauma

Trauma can be broadly classified into two types.

Single Incident Trauma : If a person has never experienced a traumatic event in their life and they get into a car accident and it’s very distressing for them, treating that trauma is generally going to be a little bit quicker than treating complex trauma for someone who has grown up in a home with abuse, such as substance abuse or sexual abuse.

Complex Trauma : For an individual who has experienced trauma throughout their lifespan development and demonstrates symptoms of complex trauma, they are typically diagnosed with Post-Traumatic Stress Disorder (PTSD).

Timeframe to Overcome Trauma Symptoms

In the case of complex post-traumatic disorder, it is very difficult to say that a person is going to heal in 30, 60, or 90 days. A person who is admitted into recovery does not necessarily overcome trauma just because they go through the recovery process. For someone who experienced a single incident trauma, they may be able to move through it in 3 – 5 sessions, however for someone with a complex PTSD, it can take several months, even a couple of years. Therefore, while there isn’t a specific timeframe for recovery, they can expect that their symptoms and risks would be diminished, or even removed, and after going through recovery.

If you are suffering from any kind of trauma, reach out for help: https://buckeyerecoverynetwork.com/

Today is going to be the best day of your life.

Can Trauma Lead To Addiction?

Can Trauma Lead To Addiction?

When an individual experiences trauma it impacts the prefrontal cortex of their brain, considered as the CEO of the brain. When this decision maker part of the brain is impacted, healthy decisions cannot be made. Typically, there is more impulsivity, risky behavior and addictive patterns. Trauma also impacts the brain in other ways, leading to increased anxiety, increased depression, increased PTSD symptoms, which then leads to having social impairments such as isolation. In order to deal with the mental and social discomfort, they instead seek out other behaviors or substances to help them regulate that discomfort.

For example, when someone has experienced a lot of trauma in their life, they can have significant amounts of anxiety. To calm their anxiety, they may consume alcohol or take a benzodiazepine or take some opiates and all of that anxiety all of a sudden magically disappears and goes away. Now they have learned how to cope and adapt with something that they did not know how to cope and adapt with, with a substance that’s highly addictive. When that individual is using a substance that is highly addictive for dealing with symptoms left over from trauma, it is easy to see how this perfect storm can create substance addiction or behavior addiction.

Trauma’s Impact on the Body

Trauma stored in the body and our bodies go with us everywhere that we go, therefore it severely impacts the life and functioning of an individual. Traumatic events can impact an individual psychologically, mentally, emotionally, and physically long after the trauma is over. Because a person re-experiencing trauma goes into fight-or-flight mode, the regular functioning systems such as the digestive system, or the sleep regulation cycle can be severely affected.

Some negative effects of Trauma :

  • Loss of appetite
  • Sleeplessness
  • Hypervigilance
  • Inability to stay calm

Trauma From Unremembered Events

Many individuals say they don’t remember any traumatic incidents in their life, however sometimes trauma is suppressed by the body and the brain that they simply don’t remember even as they are triggered by it.

One example is of a person going on a ski trip to Mammoth for the weekend and they had stopped at a gas station. When they stopped at a gas station, someone in a blue hoodie robbed them at gunpoint. They continued on with their ski trip, but when they came back and one day they were in college sitting in their lecture hall with 300 people, they had a serious panic attack and they didn’t know why. It wasn’t until about a month later when they were in therapy that they were able to make the connection that someone in their classroom was wearing a blue hoodie and that the person that had robbed them was wearing a blue hoodie.

Dissociative Amnesia

Our brains have neural networks that are able to link these experiences sometimes without us even consciously being aware of them. A lot of times when we are working with our clients in a group, they get activated and they cannot explain why because they don’t consciously remember the events that may be triggering their reaction.

The diagnosis called dissociative amnesia is when people don’t have memory from their childhood or from events in their life, usually because they had experienced traumatic incidents. It is a survival mechanism implemented by their bodies by suppressing the memories so far down so that they do not have access to those memories. In many such cases, suppressed memories come up during treatment or therapy.

Trauma Related Addiction Treatment

There are several ways to approach treating trauma, broadly classified as top down or bottom up.

The top down treatment is a cognitive approach which helps to shift the way that we think, the way that we look at things, our perspective. Top-down approaches work well to help deal with anxiety, provide coping mechanisms, and learn to become more confident. Top down approaches may not work in some cases of trauma because trying to shift their brain-based thoughts and perspective does not work on their body-based symptoms.

The bottom up approach focuses on the body, so any type of somatic approach can be effective. At Buckeye Recovery, we have found EMDR (Eye Movement Desensitization and Reprocessing) to be very effective in treating trauma. Other popular choices are somatic experiencing and brain spotting.

If you are suffering from addiction due to trauma, we can help! Take the first step and reach out: https://buckeyerecoverynetwork.com/

Today is going to be the best day of your life.

What is Trauma? And What Causes It?

What is Trauma? And What Causes It?

There is a movement that is long overdue, that is trauma-informed care and looking at every human being that goes into rehab or therapy through the lens of what they have experienced, what they’ve gone through, and the traumas they’ve endured.

The psychologist, Peter Levine, talks about how trauma is one of the most ignored and belittled and misunderstood causes of human suffering. For instance, when a kid in school calls their parents and says, “I have a stomachache or I’m throwing up,” the parent will immediately come and pick them up, but when it comes to mental health – anxiety, depression, and other mental health issues – it’s not treated the same. When we start looking at mental health the same way we do physical health, we’ll see a significant shift in human suffering and the treatment of it.

What is Trauma?

If you were to look at trauma and specifically the diagnostic criteria (the DSM of what therapists and psychologists use in order to diagnose someone trauma) is when someone directly experiences or witnesses a near-death experience or a serious injury or sexual violence, whether they directly experience it or sees someone, for example a first responder if they are in a car accident and sees someone else get hurt – that’s what the diagnostic criteria of what trauma entails.

How Trauma Impacts the Brain

Here at Buckeye Recovery, we look at trauma in a body based way. Anytime we go into an altered state of consciousness is when we experience trauma. When the prefrontal cortex of the brain is well functioning, we think clearly, and we have access to our emotions, so we are in a calm and collected state. However, when we experience a traumatic incident our amygdala, which is a different part of our brain, gets activated, sending us into fight-or-flight mode. The frontal lobe and the amygdala cannot both work at the same time so anytime we go into that altered state of consciousness that’s essentially when we’re experiencing a traumatic incident. When something traumatic happens to us, our bodies and brains naturally adopt this mechanism of going from the prefrontal cortex to the amygdala as a coping skill in order to survive.

It is important to note that the event itself is not what causes trauma, but it is our nervous system’s response to the event. Therefore two people experiencing the same event will probably respond differently.

Adverse Childhood Experiences

Vincent Fellitti, a world renowned expert on childhood trauma did a study on working with individuals that came through obesity clinics. He noticed that for some of them, no matter what he did, whether it was education, or medication, or a change in lifestyle, diet, or nutrition, these individuals were unable to, after a period of time, lose the weight, or maintain the weight loss. He recognized that there could be other factors and began to explore into the world of trauma to see what these individuals experienced in their life that they’re unable to adapt, or utilize these tools that are being given to them. He created a list called the Adverse Childhood Experiences of eight types of experiences.

The 8 Adverse Childhood Experiences:

  1. Did you ever experience any type of physical/sexual abuse?
  2. Did you ever experience any type of psychological abuse?
  3. Did you ever experience any type of neglect or abandonment?
  4. Did you ever watch physical abuse, like domestic violence in the home?
  5. Did one of your primary caregivers go to prison?
  6. Were they mentally ill?
  7. Were they addicted to substances?
  8. Was there divorce or separation in their life?

He tracked these experiences from the ages of zero to 18 and found, without any shadow of a doubt, that individuals who have been through adverse childhood experiences were impaired later on in various areas in life.

Addiction Related to ACE

Vincent Fellitti who studied the effects of Adverse Childhood Experiences noted that addiction is one of the most significant effects. He explains addiction as a ritualized compulsive comfort seeking, which is when the body does not feel calm or comfortable until it obtains the substance that brings it back to that place of comfort. It is really important to use a compassionate lens to look at substance abuse and addiction and then address it with trauma treatment.

Ready to get started with your recovery? Reach out to us: https://buckeyerecoverynetwork.com/

Today is going to be the best day of your life.

Trauma, Mental Health and Addictions

Parham : It says we’re live. I’m going to take its word for it Ms Sara, What’s up everyone? It is Saturday, February 12th of 2022. Like I say every week I’m getting used to saying that. It’s going to take another month or so to get familiar and comfortable with saying 2022. It still feels weird but long story short, it is here, it is family education and support group with myself, Parham and my wonderful guest today, Ms Sara Rotunno aka the Sarapist. What’s up Tony? Tony’s giving shout outs already, he’s ready to go at 9am! What’s up, Hi Tony! Really grateful to be here with a guest today because I like to provide education to all those who watch, that is not only relevant to where they are in their recovery journey but also can help them with gaining insight, understanding and awareness of how various things impact individuals throughout their lifespan development, one of those things being trauma. You got one of your friends (I think), gave you a shout out too, Sara already.

Sara : Hi Jori! You know it’s weird – I normally can see the comments but now being backstage I can’t see anything so I don’t know what’s going on.

Parham : I’ll make sure that you don’t feel left out. There’s a lot of people saying what’s up, there’s a lot of people saying hi and on the side over there where it says comments (By the way Sara, there is a little side thing that you can click on – you can probably see the comments)

Sara : Okay, okay.

Parham : Let me do a quick introduction of myself, then I’m going to introduce my guest and then from there we’ll get into the conversation today. So my name is Parham. I’m one of the people that helps manage the Buckeye Recovery Network and every single week, I’m here at 10 a.m Pacific Standard Time, providing some free family education and support to anyone who is interested and wants to hear and listen. All these talks are always shareable – you can share them with whoever you want. I try to do different things: educate on mental health addictions, substance abuse, anxiety, depression, communication, boundaries, a little bit of everything in between. One of the topics that I tend to talk about is the topic of trauma and by doing so one of the most important things that I wanted to do was to bring someone who is not only a trauma-informed clinician but also a licensed professional clinical counselor who is also trained in specialty with trauma and various modalities that comes with that. And that happens to be Ms Sara, so Sara go ahead do a little introduction of yourself and we’ll take it from there.

Sara : Thanks Parham. So I am a licensed professional clinical counselor which is just a fancy way of saying a licensed therapist. I have my master’s in clinical forensic psychology so essentially wherever law and psychology intersect is where my focus is and so trauma happens to fall very heavily in that space as well as substance abuse and addiction.

Parham : Right on, and I’ll give a little shameless plug. Sarapist has been working at Buckeye Recovery Network for her fifth year – she’s going into her fifth year now – I think October will be a full five going into six. So I’ve had the privilege of working side by side with Sara during all that time and been able to watch firsthand how she shows up for the profession, how she shows up for individuals that she gets to work with and how she shows up for the different staff members we have at Buckeye. And I could say Sara, from watching from a distance and close and far, whatever you want to call it, I could probably say that you suit up and show up at a very high level and you’re wonderful at what you do and you’re wonderful the way you impact others so I’m grateful personally that you took out some time on your Saturday morning to provide some education to those who are watching. And just so you know, the audience here – they’re committed, they’re faithful, they’ve been here for a couple years now watching this every Saturday. So I’m sure that they’re also grateful that you’re here. Yeah, Tony even said you’re one of the best in the business. I take the best to be me but yeah there you go. We got a lot of family members I think saying what’s up, you got some people saying hi, so let’s get into it. Are you ready Sara?

Sara : I’m ready.

Parham : So today we are talking about trauma – there is a movement that is long overdue, that being trauma-informed care and looking at every human being that comes and sits in front of us through the lens of what they have experienced, what they’ve gone through, the traumas they’ve endured, so I want you – from your perspective Sara – being someone that has a kind of a specialty in trauma, in your personal professional opinion what is considered trauma?

Sara : I’m glad that you talked about studying and looking at trauma being long overdue because there’s this well-known psychologist – his name was Peter Levine – and he talks about how trauma is one of the most ignored and belittled and misunderstood causes of human suffering. So if you think about a kid in school when they’re not feeling well and they call their parents, they say, “I have a stomachache or I’m throwing up,” the parent will come and immediately pick them up but when it comes to mental health – anxiety, depression, those things – it’s not treated the same – people take a different approach. When we start looking at mental health the same way we do physical health, we’ll see a significant shift in human suffering and the treatment of it. So if you were to look at trauma and specifically the diagnostic criteria (that would be the DSM of what therapists and psychologists use in order to diagnose someone trauma) is when someone directly experiences or they witness a near-death experience or a serious injury or sexual violence, whether I directly experience it or I see someone – if I’m a first responder if I am in a car accident and I see someone else get hurt – that’s what the diagnostic criteria of what trauma entails. But the way I look at trauma is very body based – so anytime we go into an altered state of consciousness is when we experience trauma. So a way that I can explain that is if I use my hands and this is our brain, we have two different parts of our brain – this is the frontal lobe and when our frontal lobe is working we’re well functioning, we’re thinking clearly, we have access to our emotions. Hopefully for everyone watching this right now their frontal lobe is working and they’re in a calm and collected state. When we experience a traumatic incident our lid flips and our amygdala which is a different part of our brain, which is the fight-or-flight part of our brain gets activated. Both of these can’t work at the same time so anytime we go into that altered state of consciousness that’s essentially when we’re experiencing a traumatic incident.

Parham : Absolutely, I mean wow, thank you for that true psycho education of trauma and how it actually impacts the brain of an individual. Let’s follow with what you just said right now when it comes to traumatic events – so let’s say something traumatic happens to someone how does that individual respond? At the level of the brain, why do they go from the prefrontal cortex to the midbrain (let’s call it) – is that a form of survival? Is that a form of adaptation? Is it a coping skill? Why do individuals do that and what’s the benefit of doing that for them when they leave the prefrontal cortex?

Sara : You said it perfectly – it is an adaptation and it’s a coping skill and it’s what our bodies naturally do to survive. So if a bear walked in the room right now you wouldn’t be like, “Okay, I need to do this and then I need to do this and I need to do this,” – your brain just takes over and it survives and it just does what it has to do to survive. And if anyone takes anything away from this talk, what I would hope they take away is that it’s not necessarily about the event itself that happens but it’s about the nervous system’s response to the event. Like you and I, Parham, could be in a gas station and someone walks in with a gun and my nervous system takes off and yours doesn’t – I could think about that event for the rest of my life and you would never think about it again. So we experienced the same exact event but our nervous systems responded differently.

Parham : Yeah absolutely, and I do like that individuality of it because I’ve always been on record saying two people can – if we have two identical plates that we bought from Ikea and we drop them from a distance they’re going to have completely different break patterns. Why does that happen? It’s one of those great mysteries. So two people can experience the same traumatic event that could lead to the same trauma and one of them responds differently than the other. Sometimes there’s no rhyme or reason for that – it’s just the individuality of human beings. The part that I really value and respect what you just said and just shared has to do with the fact that it’s a coping and an adaptation. So you named off a few traumatic events that could be considered trauma based on the literature and stuff like that. I want to go ahead and do a refresher for anyone watching – you know I’m a big passionate believer of adverse childhood experiences and how they impact an individual’s lifespan development at the level of the mind, body, spirit, soul and all that kind of stuff. So what are those adverse childhood experiences? I’m gonna share that real quick and then we’ll get on to the next thing because I want you to (after I’m done sharing these) to share how these events impact an individual and why do they impact an individual? The adverse childhood experiences (this was a study that came from a guy named Vincent Felitti) and the origin of his work actually came from working with individuals that came through obesity clinics. So there were these individuals that came through obesity clinics and no matter what he did, whether it was education, whether it was medication, whether it was change in lifestyle, diet, nutrition, whatever it was, these individuals were unable to, after a period of time, lose the weight, maintain the weight loss. So he knew there’s something else going on and he started to explore into the world of trauma to see what have these individuals experienced in their life that they’re unable to adapt, to just cope with or utilize these tools that are being given to them. He created this list called the adverse childhood experiences and there were eight of them and I’m going to go through some of them. Did you ever experience any type of physical/sexual abuse? Did you ever experience any type of psychological abuse? Did you ever experience any type of neglect or abandonment? Did you ever watch (this is really important because you were just talking about it – it doesn’t have to be firsthand it could be secondhand) – did you ever watch physical abuse, like domestic violence in the home? So mom and dad having physical altercations? Did one of your primary caregivers go to prison? Were they mentally ill? Were they addicted to substances? Was there divorce or separation in their life? He tracked these from the ages of zero to 18 and what he found without any shadow of a doubt was individuals who experience adverse childhood experiences were impaired later on in various areas in life. So tell us – at the level of the brain when someone experiences physical abuse (let’s just go with that one because that’s the most common one that people think of when they talk about trauma), how does that change the brain? Why does the brain change? And how does that change or impact the individual’s life?

Sara : There have been a lot of studies that show a scan of a traumatized brain versus a brain that’s never experienced trauma and they look significantly different. I can give an example – usually I show a video when I talk about trauma, of impalas in Africa. There’s an impala and this lion comes up and has the impala by the throat and the impala is about to die and it’s very traumatic to watch – it’s not fun. But you see that the impala plays dead and then the lion is essentially over the impala because it doesn’t want to eat something dead. So the impala lays there for a while and then as the lion walks away it starts viciously shaking. Anyone that’s watching this, if you’re interested you can pull up youtube and just put impala in. It shakes and shakes and violently shakes like you’ve never seen, and then it gets up and walks away. So what happens is that all of that energy that comes up when we’re in survival mode, animals have learned how to deal with that and get rid of that excess energy, but as humans we haven’t. We don’t know why but we think it’s because humans are frightened of the intensity of survival energy so they just don’t deal with it so it ends up getting stored in our body. So if you think about depression, anxiety, and other mental disorders, there are some mental disorders that (don’t always but can) go away on their own. Trauma is one of the very few that does not go away on its own unless it’s addressed because it’s stored in your body.

Parham : That’s a perfect example and I actually will check out that video. I have a feeling it’s going to be traumatic to watch but I do believe that we have a lot of similarities with mother nature and all the animals in the animal kingdom so it’d be kind of cool to watch that. So the question I have here is – I mean we work in the front lines – wait there’s a good question that popped up right here. Let’s see, I’m going to pull it up. Hossein says, “Can the nerve system of a human being reverse the events of trauma internally through the process of recovery?”

Sara : Do you want me to answer that? Okay. So our brains have something called neuroplasticity which is like the ability to adapt and heal, so as long as you are in a safe therapeutic environment and are willing to address those traumatic events you do have the ability to adapt back.

Parham : That’s perfect and thank you for giving the glimmer of hope because I do believe that also, Hossein. The brain is a beautiful thing and healing the brain and healing trauma is a beautiful thing, and not only have Sara and I seen this with countless human beings over the course of our careers, but I wouldn’t be having this talk on trauma and sharing later on we’re gonna talk about what treatment looks like in different modalities for it and stuff like that, if I didn’t believe that there is hope for individuals to experience trauma. Great question! If anybody else has questions feel free to ask – I’ll put them up and Sara does a wonderful job answering them. Working in the field of mental health and addictions is it safe to say Sara, that rarely do we come across those who have not experienced first-hand or second-hand, some type of trauma or traumatic event?

Sara : Yeah, “rarely” is absolutely the appropriate word to use for it.

Parham : Yeah, so I want everyone to hear that it’s “rarely.” So when someone says they didn’t experience anything in their life, sometimes individuals think that trauma is only the overt things, the obvious things. Just because I didn’t get abused physically by someone doesn’t mean I didn’t experience trauma. Trauma sometimes could be things that should have happened in life that never happened – there are things in life that should have happened through the lifespan development of a person that never ever happened. Jim has a question here – thank you for the question – so he said, “Is there a timeframe to overcoming trauma symptoms?”

Sara : I like that question. There’s different types of trauma we can experience. Single incident trauma: let’s say someone has never experienced a traumatic event in their life and they get into a car accident and it’s very distressing for them – treating that trauma is generally going to be a little bit quicker than treating complex trauma for someone who’s grown up in a home with abuse, with substance abuse, with sexual abuse, something like that. There’s not a specific timeframe. When I treat trauma some people will move through it in two to three to five sessions, but for some people it takes two to three to five months.

Parham : Perfect answer, and thank you for not giving a timeframe. I know Jim, why you’re asking, because there’s people that sit in groups like yours and Jim, as most of you know, is a certified counselor with many many years of experience, and a lot of times people say, “Well, how long do I have to work on myself? How long is this going to take for me to get better? How long is that going to take?” Well, for one person, like Sara said it might be a shorter period of time and for some people she said a couple of months. I would oppose that to say maybe sometimes even a couple years. When you’re dealing with complex post-traumatic disorder and you’re talking about complex trauma that happened throughout your lifespan development growing up, it is practically impossible to say that person is going to heal in 30-60-90 days. I want everyone to know that if you or your loved one is struggling from trauma when you come into the recovery process, just because you’re in a recovery program for 30-60-90 days, six months, nine months, that kind of stuff, does not mean that all of the symptomology – all of the signs and symptoms – of the trauma you’ve experienced is going to be diminished, reduced, gone during that recovery. Sometimes it’s long term, so we said it’s “rarely.” Oh, Tony asked a question here: “Is it possible to never remember the trauma or recognize that trauma ever happened, and if so how can that be overcome?” Good question – by the way Tony.

Sara : This is why I love our counselors at Buckeye – they ask really good questions. So absolutely, that’s very common – there’s actually a diagnosis called dissociative amnesia and a lot of the times that’s when people don’t have memory from their childhood or from events in their life and a lot of the time that’s because they’ve experienced traumatic incidents. I know later in the talk we’ll talk a little bit about treating trauma but when you’re doing EMDR or a different modality that looks at addressing it, a lot of the time suppressed memories come up. If I’m working with a client they’re like, “Oh my gosh, I did not remember this happened until this moment,” but that’s our body trying to survive, and our body trying to keep us safe is stuffing it so far down that we don’t have access to those memories.

Parham : There’s something you taught me I think a while ago Sara that you said – it’s the same question that Tony just asked – it kind of came up because I’ve had individuals say they don’t remember anything and you said sometimes trauma is so suppressed and it’s so unconscious. For example, if you experienced a traumatic event with somebody that was wearing yellow or something like that at the time it happened and then later on you’re just going through a grocery store you’re going through somewhere and you see someone that’s wearing yellow, without knowing why that’s causing a trigger or why it’s causing discomfort, any of that kind of stuff, it’s the association that all of a sudden hits. So can you talk about that a little bit from a more professional perspective than I did right there?

Sara : You did it really professionally. There’s something we have called neural networks. The example that you were using was: there was someone who was going on a ski trip to Mammoth for the weekend and they had stopped at a gas station. When they stopped at a gas station someone in (I think) a blue hoodie robbed them at gunpoint. And they went on with their trip, they went snowboarding and they came back and one day they were in college and they were sitting in their lecture hall with 300 people and out of nowhere they had a serious panic attack and they didn’t know why. It wasn’t until about a month later when they were doing EMDR that they were able to make the connection that someone in their classroom was wearing a blue hoodie and that the person that had robbed them was wearing a blue hoodie. Our brains have these neural networks that are able to link these experiences sometimes without us even consciously knowing. A lot of times when we have our clients, when we’re in a group, or when we’re around them, and they get activated and they can’t explain why, there’s sometimes a very very very legitimate reason for it – we just don’t know consciously why.

Parham : Oh thank you, that was a much more professional explanation than mine by the way, Sarapist! I’ve been on the record saying this one too before and I’ve learned this from somewhere but one of the possible outcomes of trauma is addictions and I’m going to share my perspective why that is and just add to it if you want. So when someone experiences trauma (Sara did a really good job talking about how that impacts the brain of an individual), it impacts the brain of an individual talking about the prefrontal cortex which is the CEO of the brain, which is the decision maker of the brain. When they experience trauma sometimes there’s no healthy decisions being made – there’s a lot of impulsivity, there’s a lot of risky behavior, all that kind of stuff, so it impacts the brain which leads to increased anxiety, increased depression, increased PTSD symptoms, all that kind of stuff which leads to having social impairments. So when a child is going through trauma they’re not rolling up to school saying, “Hey kids, I just want to go play.” They might be isolating, they might be not socializing, they might be pulling away from society, they might be stuck in their own head if you will. When all that’s happening to an individual what they do is they seek out either behaviors, or seek out substances, or seek out something to help them regulate that discomfort. So when someone’s experienced a lot of trauma and they have significant amounts of anxiety for example, and the first time that they consume alcohol or take a benzodiazepine or take some opiates and all of that anxiety all of a sudden magically disappears and goes away, they’ve learned how to cope and adapt with something that they did not know how to cope and adapt, with a substance that’s highly addictive. Now, when you’re consuming and using something that is highly addictive for dealing with symptoms left over from trauma it is easy to see how this perfect storm can get created and something like substance addiction or behavior addiction can exist. Based on that kind of platform or just the foundation that is laid is that what you see happens from your personal experience working with individuals? And how does addiction become a product of trauma from your perspective?

Sara : You explained it really well – it’s gonna be hard to piggy off that one. As we talked about trauma stored in the body and our bodies go with us everywhere that we go, how can it not impact an individual? There’s never really a time where it’s not impacting us in some way. When people talk about their inability to sleep when that’s supposed to be one of the most peaceful times of our lives but we experience trauma – we have difficulty sleeping if a bear walked into the room right? Now you wouldn’t be like, “Oh I’m really hungry” – that’s like the last thought that you would have because our body goes into fight or flight. And when we do that the first thing that really goes is our digestive system when we’re in fight or flight. A lot of the time after people experience trauma they remain in fight or flight for a while and they lose their appetite. So you’re losing your sleep, you’re losing your appetite, you’re impacting your hypervigilance, your ability to be calm in a restaurant isn’t really there, you’re always looking at the door, you’re always ready, so it kind of impacts us as a whole all the time.

Parham : Yeah 100%, that’s wonderful even if you are echoing what I said there. I just want individuals watching this to know that it’s not just my personal opinion. This is someone who works intimately with traumas, educated in trauma, uses trauma healing modalities in her personal practice that’s also saying what I’ve been saying here on a weekly basis. That’s what I want everyone to get educated on – to know that it’s real – these situations and circumstances she’s talking about are not just stuff that Sara’s read in textbooks or in classrooms or in trainings. These are human beings, maybe your sons, maybe your daughters, maybe your friends, maybe your neighbors, grandkids, that have sat down and shared how traumatic events have impacted them psychologically, mentally, emotionally, physically long after the trauma was over. And they’ve adapted any way they can to survive now, one of those outcomes potentially being addiction. So now that someone is at a place like Buckeye Recovery Network or any other facility that’s providing mental health and addiction treatment services to those they serve, in your perspective what are the best practices for the treatment of that trauma? It’s okay to talk in general terms, it’s okay to talk about aftercare, front-end care, whatever you want to talk about, there’s no right and wrong – I just want you to say when you assess somebody and you notice that they’ve experienced a lot of trauma what are the next steps from there?

Sara : I remembered what I wanted to say before so I want to answer that really quickly. In terms of how trauma impacts the body and abusing substances, one of the best things that I’ve read when I was reading about adverse childhood experiences (which is what you spoke on before) was when the guy said I no longer want it to be called addiction – I want it to be called ritualized compulsive comfort seeking. That’s what it is. Your body does not feel calm or comfortable until you use a substance and it brings you back to that place so I think that’s really important for people to hear because it’s a more compassionate lens to look at substance abuse and addiction and then in terms of what trauma treatment looks like. There are a lot of different ways to approach treating trauma and sometimes in the field they call it top down or bottom up. Top down would mean a very cognitive approach to it which is trying to shift the way that we think, the way that we look at things, our perspective. I really do like top-down approaches for some things but I personally don’t love it for trauma because how many times have people experienced a traumatic event and they think through and they think through and they try and shift their perspective and nothing really happens or those symptoms that they’re experiencing are still there. That’s because it’s a body-based experience. The bottom up approach is focusing on the body and so any type of somatic approach (there’s a lot of evidence-based research of how effective that is) – EMDR is a really popular one, somatic experiencing and brain spotting are the three that I’ve seen have been really really effective with treating trauma.

Parham : Yeah and also there’s a time component here that’s very important. So if you’re watching this and you are in the front stages, early stages of maybe getting off of a substance, or you’re a family member and your loved one has just got into treatment or just got into detoxing and that whole front end of treatment I want you to know that it is not always either recommended or even appropriate to dive into the trauma too soon. Can you just share real quick because I do want to establish some type of a timeline here even though timelines are subjective. In the early stages when someone’s getting off their drug of choice or behaviors, of addictive behaviors, why is going into the trauma too early kind of a high-risk intervention?

Sara : It can be pretty high risk because a lot of the times when someone’s in those stages they don’t have the skills and tools to be able to maintain their sobriety. When I talk about treating trauma the way that I talk about it is (I’m sure most of people on here, especially any of my friends that are watching, have watched Grey’s Anatomy or one of those medical shows) where someone comes in with an infection and they’re like, “We have to cut your arm to save the rest of your body,” that’s sort of what treating trauma looks like, where it’s a very very intense pain as you’re moving through it, but for a lifetime of relief hopefully. And so for someone to have the ability to be able to self-regulate when all of those distressing memories come back up is really really important. Sometimes that takes time. Another part to it is if you have a relationship and trust and rapport with your therapist, because some therapists will try and start doing some type of trauma work and they’ve known the person for an hour or two and they’re like, “Tell me about your deepest traumas,” and if you’ve experienced trauma you probably have some level of trust issues and you’re not going to open up to that person, so it ends up being not effective. And then there are actually a few other different criterias where sometimes it’s not appropriate for some people. If someone is a victim of some sort of crime – sexual abuse, sexual assault, and they’re in a court case, sometimes EMDR is not recommended because it says that it can alter your mind or your perspective. They don’t really recommend it until after the court case. Or if it is a woman that is pregnant or a soon-to-be mother they say that doing the EMDR work can be really distressing on the baby, so they recommend until after. If someone’s taking benzos it calms our nervous system so it’ll treat it while you’re on the benzos but as soon as you’re off it goes right back up. So there are like some factors that go into place to deem if someone’s appropriate for that type of treatment but if they are and it’s done correctly and there’s a lot of safety and rapport developed and coping skills it’s a very very effective treatment modality.

Parham : Yeah 100% – we are going to talk about EMDR – a little bit deeper dive right now – but I just want everyone to hear what you said there because there’s a lot of family members that might be watching this and they know their loved ones have gone through trauma so maybe there was a really traumatic divorce in their life or maybe there was psychological/physical/sexual abuse that they’ve become aware of in their loved one’s life or maybe they experienced a lot of catastrophes like people that go through natural disasters and all that kind of stuff and and lose previous identities of self and have to rebuild again, or maybe there was a lot of immigrant trauma, there’s a lot of different things that can happen in people’s lives that could be traumatic events. When the family member wants their loved one to deal with their trauma right off the bat – dealing with trauma is absolutely the right thing to do and it’s necessary for long-term abstinence and recovery – however it could be the right treatment at the wrong time. So it is important to work with a trained licensed clinician to identify when that individual has the coping skills, the ability to regulate their emotions without their drug or behavior of choice. Because as soon as someone gets dysregulated about talking about something that’s very traumatic to them their first move if they’re a substance user is not going to be, “Oh let me just go home and sit down and journal.” It’s going to be, “Let me go home and drink some alcohol and bring my emotions down.” It’s not going to be, “Let me go and talk to my sponsor or my support group about what I’m feeling right now.” It’s going to be, “Let me go hit up my previous drug dealer and see if I can get some Xanax. It’s not going to be, “Let me go breathe and meditate and do progressive muscle relaxation.” It’s gonna be, “Let me go eat a bunch of food that I know I shouldn’t be eating right now. Let me go act out impulsively potentially with dating partners, with meeting people” – codependency all that kind of stuff. So people act out in ways to soothe themselves if they don’t have coping skills. One of the components of proper treatment is to be able to first, before diving into the trauma, make sure the individual is learning how to regulate their emotions, self-regulate their emotions, learning coping skills, learning how to ask for help, working on their trust issues. Once all that has been in place it creates a perfect foundation and a beautiful platform in a healing environment for the trauma work to begin. That’s kind of what the beauty of aftercare is in my opinion. Because people that come to us, individuals who come to us, have hopefully already been stabilized, hopefully already learned some coping skills (and that’s not everybody that comes to us by the way), and then we can get to that work. Once we get into that EMDR work, which is something that I know you do at Buckeye Recovery Network for multiple individuals, I’ve seen firsthand (and I’m not just making this up – this isn’t a sales pitch my friends), I’ve seen firsthand, people who experience significant traumatic injuries, like accidents that have plagued them their entire life – 20 or 30 years – through the process of 10 – 12 weeks of EMDR the individual has freed themselves from the association of that car accident, in the way they perceive that trauma and it’s changed their entire freaking life. So can you give us an EMDR 101? Imagine you’re talking to people that have no idea what EMDR is. And when Sara’s talking everyone, I really want you to listen because if you know your loved one has experienced some type of trauma I strongly suggest you listen to what Sara has to say. If they’re not in treatment and they’re just doing therapy or you want them to go to therapy search on things like Psychology Today to find an EMDR specialist therapist because I know it works. I can’t say it works for everyone but I know it works for a significant number of people that go through the treatment. But Sara, tell us what the heck EMDR is, how does it benefit the individual, what does it look like, whatever you want – you’re the expert here – it’s your expertise – I’m gonna shut up. I know it’s a hard time for me to be quiet and listen but I love listening to you so I’m going to shut up and listen and take the stage.

Sara : So EMDR is Eye Movement Desensitization and Reprocessing which I know sounds like a lot and it also sounds very intimidating. But when you’re going through it it’s a very simple process. So what happens is EMDR uses something called bilateral stimulation – what it does is – you know how we talked about trauma with our amygdala gets stuck in your body and it gets stored in your body it bypasses the part of your brain where trauma gets stuck, allows you to activate your prefrontal cortex which is where we can think and we can feel and we can process things, so it accesses this part of your brain so that you can reprocess the trauma. What happens is – there’s different ways that different therapists use bilateral stimulation and it was originally called Eye Movement Desensitization and Reprocessing because the eye movements where they would start, where they would have your finger like this and you’d have to follow your finger back and forth. So if you think about REM sleep, when you’re sleeping your eyes are going like this and they essentially just recreated that. When you’re sleeping you’re dreaming and you’re reprocessing everything from the day before, so it’s kind of like revamping that when you’re awake. But it’s evolved since then and the way I do it personally is: I have these two tappers that clients hold and they buzz left and they buzz right and they buzz left and they buzz right and that activates stimulation. So as the bilateral stimulation is going the client reprocesses the memory. They could do it with their eyes closed or they can do it with their eyes open. They can talk or they cannot talk – it’s really whatever they prefer. But the cool part of it is, if you don’t feel comfortable you don’t have to say a word the entire time you reprocess the memory. Let’s say when you think of the distressing memory – let’s say mine was someone breaking into my house when I start the EMDR – if I’m at a 10 out of 10 I reprocess all parts of the memory that I need to until it gets to a zero out of ten. What happens is you don’t forget that the traumatic incident happened but you no longer have the same body reactions to it. So when you experience a trauma and when you have PTSD a lot of the times people have nightmares, they have flashbacks, they have negative beliefs about the world, and it works to clear all of those for you. It’s really really fascinating to see the toll that trauma takes on people and what their life can look like after it’s properly processed.

Parham : Yeah real quick, because I just want people to understand the gravity of what Sara just said right now – I remember vividly there was an individual who had a significant car accident and after the first or second session working with Sara this individual was really dysregulated, really emotional because they had just re-lived and walked through and reprocessed the trauma they’ve been suppressing and burying and drowning with alcohol and behaviors and all that stuff. Due to their trust in the system and the process, and their commitment to go through the entire treatment episode of 10 to 12 sessions, I’ll never forget this – the very last day they were done they sat in my office and they were smiling, they were laughing, they were joking. It wasn’t fake or insincere – it was the fact that they felt like they were free from that emotion, that psychological physical emotion, the physical experience that they had inside their body once and for all. My friends, it’s not like this gimmicky thing. Once you’re able to go through the process and really altering the brain and getting access to your prefrontal cortex, it’s a freeing feeling. So continue with what you’re saying right there, but I just wanted to share to say that – what she’s saying in practical application – I’ve seen the before and after, not just once or twice. Man, I’ve seen the before and after so many times and it’s a really beautiful experience to see. So continue on, sorry.

Sara : Yeah I know. I’m glad that you talked about how it changes someone’s not personality but how they show up, because something else that EMDR can do is help with cognitions. Cognitions are essentially beliefs that we have about ourselves or the world. So if you think about a lot of women, men, whoever, who have experienced sexual abuse or sexual assault a lot of the time they hold on to this belief of, “It was my fault. I could have done something differently. What did I do wrong?” And when you experience trauma because of the way that your brain processes it you’re very limited to other perspectives. So if anyone on this talk has ever been in New York or Pennsylvania or wherever, when it’s snowing and you have this really small hole you’re trying to look through as you’re driving – that’s kind of your perspective as you see trauma – it’s very limited. And the EMDR kind of works to clear the entire windshield and see the whole picture. I’ve seen people’s perspective on what they’ve been through completely shift. We’re in the middle of it – they open their eyes like, “Wait a minute, I didn’t deserve that, I didn’t do anything. That was not my fault,” and it really helps to alleviate some of the pain that we’re experiencing and the negative beliefs we have about ourselves or the world, that of course develop after we experience something really really painful.

Parham : I actually want you to take a minute or two to share about what kind of traumatic experiences, what type of symptoms have people come to you with that they wanted to use EMDR for? Let us know what EMDR is beneficial for. You talked a little bit about the single case trauma like the car accident for example, or the complex trauma for example, but what do you have in regards to who would benefit from EMDR treatment? Let’s call it that.

Sara : A lot of people with a diagnosis of PTSD would benefit from EMDR – people that have experienced physical abuse, sexual abuse, emotional abuse, who have witnessed crimes or been a part of crimes, first responders a lot of times. In the addiction space, a lot of people who are using are exposed to a lot of death and a lot of loss and a lot of grief – it’s very effective for that. I’m trying to think about what else – so there’s things called big T and little t, that I think is important for people to know. Big Ts are the big traumas that we’re talking about, like sexual assault, physical assault, but then there’s little ts which are the smaller things we experience in life that are like our dog dying, or being bullied in school. Repeated exposure to those little t’s have the same type of impact on your body that the big Ts do. So it’s essentially any time your body enters that altered state where it’s not processed and it just doesn’t feel good when you think about it, EMDR can work to alleviate some of that pain.

Parham : That’s awesome, thank you for sharing that. In closing, I guess the reason why I wanted Sara to come here and graciously give us her time on a Saturday was because I believe in the value and the importance of taking head-on, addressing trauma in order to help people free themselves of the constraints of the past. Because a lot of trauma happened then and there, meaning not in this present moment. However the then and there continues to impact the present moment and when the present moment is impacted, guess what it also does my friends? It alters the future. So the future begins to look like the past. When you deal with people that are coming through treatment programs they’ll tell you the past year of my life, the past five years of my life, the past 10 years of my life has been the same damn thing – it’s like Groundhog Day – same [ __ ], different day. And a lot of the reasons behind the same [ __ ] different day is unresolved and unprocessed trauma. Unresolved and unprocessed trauma continues to make the future look like the past and if that’s something that you don’t want anymore in life, if you want to free yourself from this, from the chains of the past, then looking at the appropriate time with the appropriate provider and the appropriate clinician to deal with and address trauma is something that I would say is necessary for long-term success in the recovery world. So Sara, I think what you brought here today was expertise at a level that I honestly don’t have. I know you keep saying I do have it but I’m not a trauma specialist kind of the way you are. I’m just a passionate guy that likes talking about recovery but you brought a different angle and I would love for you to be able to find time in your busy schedule once in a while on Saturdays to come in here. We don’t have to talk about trauma every time – you’re well versed in all things recovery, in health, in general overall health, so if you want you’re always welcome to come back here. Love to have you here. And if anybody has any questions right now while Sara’s here, we’re wrapping up, feel free to type your questions in the bottom before we get off. I’ll do my best to answer them, have Sara answer them. I do know there’s quite a few people watching – feel free to share what you want. Sara, what was this like for you to be able to have this platform, to be able to share what you know? There’s a couple people – just so you know Sara – like for example, Eileen here has been here for two years straight – I mean she’s a big advocate of us and in our program – just says, “This information is so powerful,” and it really is powerful because what’s common knowledge to you and me Sara, is not common knowledge to the general public, it really isn’t. Society doesn’t know the impact of trauma. They just think, “Oh it happens to everyone, it’s just a part of life, it is what it is, just deal with it and move on all,” that kind of stuff, when there are ways to treat it and to heal from it and to move forward. So any final words you got about this experience, about anything else you want to talk about feel free to.

Sara : Thank you for having me on, it was really enjoyable to talk. I think it’s important to spread awareness and education because like you talked about, people say it’s a part of life, we just move on from it, it’s not that big of a deal, but to bring awareness to the fact of how it can be incredibly debilitating to so many people and how it can shift and impact so many different aspects of their life. So I am grateful for the opportunity to bring awareness to that and to talk about the importance of treating it, looking at it, approaching it compassionately for family members, so thank you for this experience and this opportunity.

Parham : And the last thing I got here: the lens of trauma informed care – what the lens does is, it allows us to view people through the lens of compassion and allows us to view people as not who they are in the present moment but all of the life experiences that they’ve had, that’s shaped who they are in the present moment. I’ll tell you this – sometimes people that have experienced a lot of trauma make it really really difficult and a challenge to be able to connect with them and to be able to just wrap around them and give them the support they need because they’re so terrified of connection and they have so many trust issues. I will say this – those who are the hardest to love are the ones who need it the most, those who are the hardest to love are the ones who need it the most. I think my mom said something down here for you too, let’s see what you said: “Thank you, great professional information from the well knowledgeable, young and beautiful therapist.” Hey, I don’t think she’s talking about me – Mom, are you talking about me or are you talking about her? Okay, I think she’s talking about you because she said young in there. But long story short, appreciate you Sara, thank you so much. I hope you have a wonderful weekend and to everyone else, please, please, please, please, please share this video with anyone because I promise you there are individuals that will greatly benefit from this and need to hear this because it will give them hope that just because they experienced something in the past doesn’t mean they can’t heal from it in the future. And the final message is, “You are not your trauma.” Okay, I’ll see you Sara, take care.

How does addiction denial impact treatment?

In many cases, especially when a partner or parent wants their loved one to receive treatment, the individual themselves may be in denial that the problem exists, and therefore resistant to receiving treatment.

First, we have to always realize that people don’t see the world as it is; they see the world as they are. Just because something is a problem, like a glaring problem in the lives of others, it may not be one to that individual, and therefore there’s a disconnect that exists there. So the first step is to be able to have the individual identify and see that there is a problem.

Awareness of The Problem

One assignment that we use in treatment in Buckeye Recovery Network is what we call the 10 Consequences of Addiction Assignment. It helps an individual look at different areas in their life such as their relationships, their health, their finances, their overall mental health, and other factors, and see what kind of consequences their drinking or substances their using caused. If they are able to look at the consequences objectively and see that their substance use impaired and impacted all those different areas it’s one version of being able to break through that level of denial.

Sometimes people aren’t ready to let go. When someone resists something they’re not willing to let go. When they let go freedom happens but they’re not letting go, so the question becomes why? What is it that they’re continuing to receive from this drug and alcohol that other people might not be getting but they’re getting? And what is it going to take for them to be able to let go a little bit at a time?

When people are actively using or where there is a lot of resistance they don’t really recognize the chaos that they are bringing into their world, into family members’ world, into their lives. Bringing awareness to how substance use is impacting their mental well-being, their social life, their work or school allows them to take in that information.

Meet Them Where They Are

No one can force someone else to become ready, or to see the problems in their life. We have to meet them where they are and hopefully from there raise up together. The best thing a parent or partner can do in those moments is to take care of themselves first and be a really healthy role model for that person. It may allow their loved one to soak it all in and see and help them to recognize how unhealthy their behaviors are too.

How do you gently nudge someone into recognizing that they have an addiction problem, which I recognize, being one myself and in recovery, but gently open their eyes to take action? So pretty much what Katalin is saying here (I just want to open up the question) because of her personal experience in recovery, she’s able to observe someone else in their life and see that they got signs, they got symptoms, they potentially could have a problem with addiction, but the other individual doesn’t know yet, so what can that person do to nudge them or kind of gently expose them to the recovery world? You got anything for that?

Gentle Nudging

Communication is an important part of helping loved ones recognize and accept that they need help. We can say the same thing in two different ways and it will not land at all if we don’t say it correctly. There is a form of therapy called the Gottman therapy which focuses a lot on communication and relationships. According to Gottman therapy, the first three seconds of how a conversation starts generally indicates how a conversation will go. So if we start the conversation with a negative tone and really loud and aggressive body language the person we’re speaking to is going to immediately shut down, they’re going to get defensive and they’re not going to be able to hear us. That’s where gently nudging someone really comes into play.

Have a very soft startup when you speak to people and also speak from “I statements” like, “I notice,” “I feel,” “I have seen,” in whatever follows because if we start with “you’re doing this and you’re messing up your life and you’re ruining your life,” people get defensive and their brain turns off and they can no longer hear you.

Appropriate Timing

An appropriate communication in terms of speaking to someone at the right timing is also important. If someone has not slept for three days because they’ve been using drugs, it’s generally not the time where they would be the most receptive towards any feedback about their life. Planning the time for conversations can help judge them and help them recognize some of their problems.

Attraction Rather Than Promotion

In the 12-step programs, they have a statement that works really well. It just says “attraction rather than promotion.” When a person is in recovery they become so attractive, meaning that the way they live their life without the use of alcohol, the way they engage, the way they interact, the way they behave, the way they think, the way they show up, the way they laugh, the way they smile, when all of those behaviors are seen by others it always piques the interest of the people that’s closest around them. And then they ask that million dollar question: “What are you doing to get to do that? How did you get to this place? How did you go from what you were to where you are?” When they ask the question then that’s the perfect opening to start talking about the recovery process. Continued work on self creates an attractiveness, like an attraction to others to inquire about what’s your secret sauce. That becomes attractive enough to whoever that is around to be gently nudged towards the recovery process.

Ready to Start your Recovery?

Reach out to us at Buckeye Recovery Network to see how we can help you or your loved one receive the treatment you deserve.

Why do family members need to do recovery?

Many family members get defensive and argumentative when we recommend that they go through recovery themselves. They think, “Why the heck do I gotta be here? I’m this successful human being, I’ve raised three good kids and this one happens to be the bad apple. How come the rest of their lives aren’t?” Parents and partners can be legitimately angry and upset: “How come they’re all fine and now that this one’s in recovery I have to come here and have to sit and learn these things? I don’t want to learn these things. Why do I have to?”

Imagine dropping four identical white plates from Ikea from the same height. They will have four different break patterns. Similarly, members in the same family, even if they are raised in the same environment, can react differently, because each person is a unique individual.

Addiction is a Family Disease

We always start by telling family members that addiction is a family disease and it is impossible to look at the strain that it takes on someone’s life and not acknowledge that it impacts the entire family, whether it’s parents, siblings, cousins, grandparents, whoever it is. There are a lot of benefits to family members needing some type of recovery because when family members do seek some type of recovery they learn things that they previously probably were not aware of, so it helps to overcome enabling behaviors which is really important.

Enabling can be extremely dangerous for someone in recovery or for an addict or alcoholic. Recovery helps with learning about financial support and the impact that has on someone and it also helps with learning to effectively establish boundaries. The best thing you could do for your loved one is to help yourself because then you’re modeling healthy behaviors, you’re a role model and you increase awareness and education which is really important.

Recovery = Regain What’s Lost

To anybody that’s resistant to the recovery process we always urge them to give it a try, be open-minded, and maybe they find something in there that they have always needed but never knew they needed. Many family members go in thinking they don’t need recovery but when they go in, all of a sudden they realize that the recovery process actually benefits them, helps them learn about themselves.

The working definition of Recovery means to regain something that’s been lost, stolen or destroyed – which is always our connection to ourselves. If you have a family where three of them are doing really well and one of them is really struggling, at some point we get disconnected to ourselves in this journey called life and recovery just allows us to stop, slow down, turn the mirror, look at ourselves and see who and what we are. It doesn’t have to be through traditional 12-step routes – it could be through individual therapy, it could be through support groups, could be through faith-based stuff, but we all need to recover. Life makes us lose ourselves at times – there’s nothing wrong or shameful about working on ourselves.

When Family Members Do Recovery:

  • It can help improve their loved one’s chances of recovery
  • It establishes (or re-establishes) connection
  • It creates a shared experience with other family members going through the same challenges
  • It provides support, motivation and information needed to understand their loved one’s recovery process
  • Improves communication with their loved ones

Internal vs. External Motivation

In recovery there is a phenomenon called internal versus external motivation. Internal motivation is when someone goes into recovery for themselves. External motivation is when they go into recovery because of external reasons, such as family members going into recovery to support their loved ones. However, once they go in and realize that the recovery is actually helping them, they become internally motivated themselves.

Develop a Common Language

One of the most important things that can come out of family members attending recovery is improved communication. When someone is going through addictions in their family it is safe to assume that miscommunication happens. They don’t understand their loved one, their loved one doesn’t understand them, there’s anger, there’s resentment, there’s frustration, it’s just a cluster of bad communication. When one person gets exposed to recovery and another person gets exposed to recovery what happens is that they start to gain a common language of recovery. They start to say the same things and act the same ways and look at themselves the same way. They stop externally blaming others and start looking at themselves. The common language of recovery allows for them to speak in a way they otherwise wouldn’t be able to speak so it helps them create a language that they both understand.

Here are some insights from some of Buckeye Recovery’s own community:

“Loved ones’ recovery is a gift that affects other relationships in your life. It makes all relationships more authentic.” – Eileen

“For families in recovery you can set a really good example for the loved ones in your life struggling with addiction.” -Jim

“I finally got sober once my family actually got involved in my recovery. Doing anything on your own can be very difficult.” -Michael


In fact, even if you or your loved one is not struggling with drugs, recovery work and 12-step programs can be an amazing process to go through. Recovery process challenges one to look at themselves and the part they play in any situation, understand how their behavior impacts others, and helps them make amends to people that they may have hurt. We think the world in general would benefit from doing recovery work.

If you or your loved one wants to get started on your road to recovery don’t hesitate to reach out to Buckeye Recovery Network to take that first step.

12 signs of addiction relapse

For parents, partners, and anyone who is looking for signs of addiction relapse in their loved one, there are some signs you can look for.

1. Significant Change in Behavior

Anytime someone has a drastic change in their norm or their behavior, it means that something happened. It may not always mean that there’s a relapse – it could be their depression getting worse, or maybe that person went through a life transition, but a lot of times, change in behavior is similar to reading a roadmap. Behaviors don’t change for no reason.

2. Mood Shifts

Another sign to look for is if someone is having shifts in mood, specifically rapid shifts in mood. If they’re really irritable one time and then you see them a few minutes in a really joyful mood within an hour or two hours, that’s usually a sign of addiction relapse.

3. Change in Physical Appearance

Another important sign to look for is changes in physical appearance. What a person looks like on the outside is a reflection of how they are feeling on the inside. Change in physical appearance may not necessarily be a sign of relapse, but if someone’s really depressed they may not be taking care of their wellbeing, they may not have showered in a long time, their hair might be really knotty, and other visible signs.

4. Weight Changes

Some signs of substance abuse show on their faces because many times people stop eating properly when they are using drugs, and therefore they are not getting the nutrients their bodies need. You may notice overall weight changes that happen suddenly and quickly.

5. Isolation

One of the biggest signs of relapse may be isolation. Addiction breeds in isolation so if we notice that there’s less connection with family or friends or their support network, if the person stops going to their 12-step meetings or engaging with their sponsor, or they are not showing up to work when they’re normally a reliable person, or not showing up to school, or getting the grades that they used to, those can be some indicators that there’s something going on with that person.

6. Changes in Sleep Patterns

Changes in sleep patterns is one of the common signs of relapse. People using substances aren’t sleeping at all because they’re up on stimulants, or they’re sleeping too much.

7. Signs of Prelapse

Prelapse is a phase where the signs and symptoms start showing before the physical relapse happens. When there are signs of prelapse, oftentimes a relapse is inevitable unless there is some type of awareness and intervention that happens at that moment. Family members have one unique advantage to people who don’t know the individual because they already saw their loved one in their addicted state for months or years. So when they notice their loved one starting to do things, say things, behave in ways, hang out with people, or have certain behaviors in the past that existed when they were using, it shows that they potentially are back closer to that realm than they are to the opposite realm.

8. Additional Signs of Relapse

  • Increased anxiety
  • Increased anger
  • Deflecting
  • Defensiveness
  • Argumentative

Relapse Happens

Seize the relapse as part of the recovery and growth process. It is natural for the family of substance users to be riddled with fear about every decision their loved one makes. Remembering that relapse does happen in the recovery process, it is important to simply go back to the basics. Whatever worked in their recovery before might work again. It is a difficult and challenging journey to go back to ground zero and start building forward from there again, but it is possible. If an individual does relapse, and if they’re able to survive it, it can actually help them get to a deeper level of recovery.

No one, not even the best clinicians and therapists, can predict the future of an individual’s relapse, because each person is on their own journey. Therefore there is always a risk of vulnerability of not knowing what may happen to their loved one. However, what one can do is to start taking care of themselves first. If their loved one is able to stay clean and sober, that’s wonderful. But even if they are not, it is important to not lose oneself in the process of looking out for their loved one.

What is fentanyl? Why is it in the news?

The New York Times has had several articles recently about fentanyl and all the people that are dying from it. Fentanyl might sound like it’s just some new drug that’s popped up and it’s killing people left and right, which it is killing people left and right. But it’s not a drug that’s just popped up. Fentanyl has been prescribed in the United States medicinal world for pain management to help with severe pain, chronic pain and in end of life stages is something for a long period of time. It’s a powerful painkiller – some say it could be up to 50 times or a 100 times stronger than heroin. It is used medicinally in the United States and there are controlled versions of it, where the dosage is controlled, including the duration and its release into the body.

Fentanyl on the Streets

We must separate the prescription fentanyl from the fentanyl that is being sold on the streets. Prescription fentanyl is manufactured by pharmaceutical companies under the guidelines of the FDA and is only available through a doctor’s prescription. Fentanyl sold on the streets is being made in illegal labs in Mexico and China and is being trafficked by multimillion dollar drug cartels.

Carfentanil which is even more powerful than fentanyl, a 100 times more potent by some accounts than fentanyl is cheap to make and easy to bring in because of the small size of the doses. Carfentanil has no legal human applications.

Fentanyl in Anti-anxiety Medications

Many people who have been prescribed opioid medications such as oxycodone, vicodin, percocet, xanax and others by their doctors have developed a dependence on them and when they can no longer get prescriptions from their doctors, they turn to the black market where they’re called press pills. As people use opioids over long periods of time, they get addicted to them and need larger and more frequent doses, and turn to the press pills to get a similar drug that they have been using.

Unfortunately, what most people don’t realize is that the drugs they’re buying illegally also contain fentanyl. Drug dealers and suppliers have noticed that by adding traces of fentanyl to a drug, it can produce significant addictive effects in the user which will ensure that the individuals keep coming back for the drug. The problem with this is that fentanyl is an immensely potent drug and people without any type of tolerance to that powerful drug are getting it in their regular drugs. So a majority of fentanyl deaths that we’re hearing about is not people who are chasing and pursuing fentanyl – it’s people that are trying to get a press oxycodone, or roxicodone pill. It’s people that are trying to get Xanax off the black market and somehow it’s found its way into stimulants such as methamphetamines and cocaine so people are looking for other drugs but fentanyl is being added to all of these drugs.

Why Fentanyl is a Killer

Fentanyl is a powerful painkiller which means it’s a powerful respiratory depressant, so it slows down an individual’s breathing. When a person takes fentanyl in combination with other substances such as alcohol or other medications or drugs that also slow down their breathing it’s a recipe for a person to stop breathing completely, killing them. This is what is happening in a majority of fentanyl overdose deaths.

There was a study that came out that said from April of 2020 to April of 2021, there were 100,000 deaths because of drugs. These numbers will probably increase to somewhere between 150 to 200,000 people in the following year because the 2020-21 statistics were completely suppressed when it started to get really bad.

Why is Fentanyl in the News? Imagine if there’s a mass murderer running around killing people left and right it’s going to be in the news. Fentanyl is the same way – it’s in the news because it’s killing people. We have program participants at Buckeye Recovery who have finished our program and they were positive for fentanyl in their urine analysis. They say they’ve never tried fentanyl, that they don’t like opiates, but somewhere they took another drug and because the other drug was laced with fentanyl that pulled up into their system.

There are individuals, usually opiate addicts whose drug of choice used to be heroin, who were intravenous users, but when they switch to fentanyl, they shift to smoking fentanyl pills because they get the same effects without having to use needles. This is a shift from where the smoking and snorting users would go to injecting, to now the other way around where the injecting users are going to smoking the substance because of its potency. One time use of fentanyl can kill a person. It has killed many people.

Lethal Doses of Heroin vs. Fentanyl

If you Google the lethal dose of heroin versus a lethal dose of fentanyl, it’s striking and overwhelming to see the amount of fentanyl it takes to cause an overdose. Fentanyl has been around for a very long time but it’s within the last few years getting more news coverage and bringing more awareness to it because of the deaths that people are experiencing and the overdoses.

People are more familiar with morphine, and fentanyl is 80 to 100 times stronger than morphine is. That’s the reason why there are a lot of overdoses happening and that’s why it’s so important to bring awareness and to talk about it so that people can really engage in harm reduction. Abstinence is great but if it’s not there then harm reduction is really important in order to save lives.

Testing for Fentanyl

There are many people who are testing individuals at home with the 10 panel cups to check for the presence of drugs. However, it’s important to know that the 10 panel cups don’t test for fentanyl. Therefore someone could be using fentanyl in your home, knowingly or unknowingly, and although they’re being tested they keep showing up negative even though they’re actually using fentanyl.

There is a product called a dipstick which you can put into the urine sample and that can separately test for the fentanyl. Some community colleges and local colleges give away free test dip strips because they assume that college students on some level will be dabbling in or using substances. It is a good step in harm reduction to test their drugs for presence of fentanyl.

Accidental Overdosing

Because fentanyl is illegally being added to other drugs, most cases of fentanyl overdosing and deaths are accidental. In one particular case in Fort Lauderdale, a group of people rented a house for spring break and had a cocaine party, but a large majority of them overdosed, some leading to deaths because they had no idea that their drugs were laced with fentanyl.

In cases like these where fentanyl is being added to drugs such as cocaine and methamphetamines, the risk of overdosing is even more severe because it is a combination of drugs that are meant to have opposite effects.

Reach out for Help

If you or your loved one is suffering from an addiction to opioids, seek help before it is too late. With commitment and perseverance, it is possible to recover from your addiction and create a life that is healthy and safe. At Buckeye Recovery Network, we provide customized treatment plans that are focused on outcomes. Don’t hesitate to reach out for help.

Addiction and Recovery Support – Questions and Answers

Parham : Alright, we are live! It is Saturday, May 14th of 2022. I am here this week on another family education and support group with a co-host that’s been here once before and by popular demand and by request is back again: Ms Sara Rotunno aka the Sarapist, who is one of our valued employees over at Buckeye Recovery Network and a very skilled and talented clinician that is really good at what she does. So I figured we have this platform, we have the opportunity to share and speak and we got Jim already popping up, look at that, Jim’s ready to go! Jim, we got to bring you back for one of these. You’re a good guy, you’re a good sidekick too. Jose and John, everyone’s coming in right now, good morning! So today’s topic I guess, if you will, is actually going to be questions and answers. So I posted this a few days ago and reached out to a few individuals that I know have been watching this and they kind of had some questions that they wanted us to address and answer and we have those questions ready for you and we’re going to gladly answer them. And on top of that if anybody watching this live, throughout this live stream or even afterwards, has certain questions that they want answered by myself or Sara or another treatment professional that watches this, feel free to ask those questions. We’ll gladly answer them and do our part to provide support to you.

Quick background about what this group is and what the purpose of it is: so my name is Parham. I’m here each and every single Saturday, 10 o’clock Pacific Standard Time live. Been doing this for over like two and a half years now on this platform and I personally have a (Sara’s gonna laugh but) master’s degree in marriage and family therapy. I’m a licensed addictions counselor. She’s laughing because I say this nonstop each and every single time I talk. And I’m also in recovery myself: June 13th, 2008 is my sobriety date and Sara, before we get into the questions and answers, if you want to give a quick background about yourself, your education your kind of your modalities that you practice, anything that you want to share feel free to.

Sara : Yeah, good morning and thank you for having me. I’m usually on the other side of this where I’m watching and leaving the comments so it’s interesting to be on the front end this time. I am a licensed professional clinical counselor which is just a fancy way of saying a therapist and I have my master’s degree in clinical forensic psychology, so essentially wherever the law and psychology intersect is where that degree falls. I’ve been working with Buckeye for about five years now as a therapist and they do a lot of individual work, a lot of trauma work, EMDR, brainspotting, CBT and DBT which are just different therapeutic modalities that I use and I’m happy to be here today.

Parham : And so we have a few other people that popped on – whoever just came on, hi, thank you for being here and we’ll just get into this. So the questions – I was able to kind of get them all ready for us – and the first one we have here Sara is: someone asked, can addiction lead to mental disorders? So kind of give us your take and I’m going to sit back and listen if that’s okay, and then see if I can add to that response.

Sara : Absolutely! So there are a few different parts to this. Addiction absolutely can lead to mental disorders – there’s no denying that – but there’s sometimes (or a lot of the time) the talk of, is it the chicken or the egg and which came first? So people begin to use substances and abuse substances for a specific reason which is generally comfort so sometimes there’s childhood trauma or sometimes there’s anxiety and we use the substance in order to help deal with those mental disorders so sometimes it can lead to those diagnoses but a lot of the times it just exacerbates mental disorders that were already there so if there’s some sort of paranoia using marijuana can make it a lot worse, or if there’s depression alcohol use can make the depression a lot worse. So it can lead to mental disorders and it can also exacerbate mental disorders that were already there.

Parham : Perfect, and really well said! I’ll kind of try to – I don’t want to have the same answers because that was a really well thought out answer and you nailed on everything that would need to be covered and for me I’ll try to just break it down a little bit more into layman’s terms if you will. What I mean by that is this: if there is a person in your life (and you’ll hear this a lot so everyone watching this I want you to catch this moment of education) a lot of times people who use substances and use drugs and alcohol or certain type of behaviors they don’t consider that the problem. They actually even say this was the solution to a problem that I was experiencing. So what does that mean? So if somebody’s like around 13, 14, 15 years old and there’s a lot of chaos, there’s a lot of disturbances, loudness, domestic stuff, mom and dad yelling and screaming and the kids starting to feel very, very, very dysregulated and starting to feel a lot of anxiety. So when a 14-15 year old starts to feel a lot of anxiety and they don’t know what to do with it. It’s an overwhelming feeling. It’s like this blanket that overtakes you – you don’t know what to do with that anxiety (which by the way anxiety disorders are mental disorders) and all of a sudden whether the parent says we don’t know what to do with our child, they take them to the doctor and they get some Xanax prescribed to them, or the kid just goes in the medicine or the alcohol cabinet and grabs some alcohol and drinks for that moment or smoke some marijuana for that moment what happens is that Xanax, that alcohol, that marijuana just all of a sudden alleviated all of the symptoms of the anxiety and for them it’s like they can finally breathe, they can finally feel okay. So the substance use was literally the solution to the anxiety and now you can see how this can become a perfect recipe for disaster. Because if the situation and the circumstances of the anxiety doesn’t go away, if there’s continued domestic craziness, if the kid continues to move around all the time, if there’s continued volatility at home and the anxiety doesn’t go away and now they found a way to deal with it with addictive substances that you can build tolerance and dependence on and become physically dependent to and that could seriously lead to addictions. And the part that Sara said (and I think it’s very important talking about) – if somebody has paranoia, delusions, smoking marijuana can exacerbate – to use her word – of those symptoms, if there’s underlying causes of mental illness in the family, if there’s genetic predisposition of certain diagnoses such as bipolar, if a person uses substances it could lead into those mental disorders, so the addiction can lead into those mental disorders. It’s kind of like a triggering event – that’s what we call it. There’s a question I think down here that got asked so that was wonderful to state that. And a lot of times, by the way, there are other disorders that aren’t really diagnosed, like the disorder of loneliness, the disorder of feeling disconnected, which shows up sometimes in things like depression. Oftentimes we hear opiate addicts say this (and to some family members you might not believe this but), opiate addicts might say that opiates are like the warmest hug I always wanted but never got. “The warmest hug I ever wanted but never got,” because that opiate all of a sudden provided a solution for that loneliness and that disconnection.

So let’s see what Jim has here – thank you for asking questions. How do you deal with resistance or a client not being able to identify that a problem exists in their lives? So pretty much he’s talking about resistance or denial – how do you deal with that?

Sara : Do you want to take this one away first and I’ll go after you?

Parham : 100% yeah! So first of all Jim, thank you for asking and I know you’re actually a very damn good clinician yourself so you do have the answer for this because you work with us all the time. I appreciate you asking this because I know you’re not asking for yourself – you’re asking for the many people who are going to be watching this later on. So first we have to always realize that people don’t see the world as it is; they see the world as they are. Just because something is a problem, like a glaring problem in the lives of others, to that individual it might not be, and there’s a disconnect that exists there. So the first step is to be able to have the individual identify and see that there is a problem. One assignment that we use in treatment in Buckeye (and I know Jim, you use) for example, we have the 10 Consequences of Addiction Assignment and what that does is to help you look at different areas in your life: you look at your relationships, you look at your health, you look at your finances, you look at your overall mental health, all that kind of stuff and you see what kind of consequences has drinking or substances you’re using caused? And if you look at that objectively and you see it’s impaired and impacted all those different areas it’s one version of being able to break through that level of denial. And also the other thing with resistance is, sometimes people aren’t ready to let go. When someone resists something they’re not willing to let go. I mean, when they let go freedom happens but they’re not letting go, so the question becomes why? What is it that they’re continuing to receive from this drug and alcohol that other people might not be getting but they’re getting? And what’s it going to take for them to be able to let go a little bit at a time? This is why it’s important, so that to answer your question you have to meet people where they’re at. You can’t force someone to become ready, you can’t force someone to exist, to see the problems in their life. You have to meet them where they’re at and hopefully from there raise up together. So Sara, add whatever you want to that.

Sara : I mean, you answered that question really well and I was also laughing when I saw Jim’s question because I know he knows the answer to this really well and deals with it on a daily basis but thank you for asking Jim. I agree with a lot of what you said, Parham. I think the first step is really to try to bring a lot of awareness to the behaviors because sometimes when people are actively using or where there’s a lot of resistance they don’t really recognize the chaos that they are bringing into their world, into family members’ world, into their lives, so to kind of bring awareness to how is this impacting your mental well-being, how is this impacting your social life, how is this impacting work, in school, and to kind of like have them take that information. But the most important thing to remember is that you can’t control someone else and you can’t get them to the place of wanting to be ready to stop using until they’re really ready. So I think the best thing you can do for yourself in those moments is to take care of yourself and to be a really healthy role model for that person, which they soak in and they see and it kind of in a way can really help them to recognize how unhealthy their behaviors are too.

Parham : 100%! Thank you for saying that, thank you for asking that Jim! Let’s get to the next one here. This is a question (believe it or not) that was asked: What is fentanyl and why is it in the news? I mean you could look at just yesterday or two days ago – The New York Times had an article about fentanyl and all the people that are dying from it. Fentanyl – let me just give a quick psych education on it for those who don’t know because it sounds like it’s just some drug that’s popped up and it’s killing people left and right, which it is killing people left and right. But it’s not a drug that’s just popped out. Fentanyl in the medicinal world, fentanyl in the pain management world, fentanyl in the severe pain in the hospital world, the chronic pain, the end of life stages is something that’s been prescribed in the United States for a long period of time. It’s a very, very powerful painkiller – some say it could be up to 50 times or a 100 times stronger than heroin, so it is used medicinally in the United States and there’s controlled versions of it, meaning that the dose is controlled, the duration of it, the release of it’s controlled, and all that kind of stuff. The fentanyl right now that’s in the streets – we have to separate those two things. One is being made by pharmaceutical companies and the second one is being made by mega super labs all over the world right now – China, Mexico, all that kind of stuff. It’s just as powerful if not more powerful. Carfentanil which is even more powerful and it is very, very cheap to make and easy to bring in because of the size of it – it’s so small. So what’s happening is now there’s a black market that exists that people might not know of. You think of people that are taking opioid medications – they’re using pills and all that kind of stuff – the oxycodones, those vicodins, percocets, narcos, xanaxes which are anti-anxiety medications. Those medications that we can all get from a doctor and use – there is a black market that they call press pills when you can’t go through legal channels to go get those medications because as you get addicted you can’t keep going back to doctors because the dose that you’re wanting, the amount of medication you want, or the drugs you want, becomes more and more. So you have to go to the black market and that’s where the press pills market exists. In the press pills market you might go in thinking that you’re getting some medication or some drug that does not have fentanyl in it however the people that are in charge of all the drugs and all that kind of stuff – the drug dealers and suppliers – they found out that by adding a little bit of fentanyl to a drug that you can produce significant effects in the user and the user is going to keep coming back to it. Now the problem with this is that fentanyl is very very very strong, fentanyl is very very very powerful and people without any type of tolerance to that powerful drug are getting it in their other drugs so majority of these fentanyl deaths that we’re hearing about is not people who are chasing and pursuing fentanyl – it’s people that are trying to get a press oxycodone, roxycodone pill. It’s people that are trying to get xanax off the black market and believe it or not, somehow it’s found its way into stimulants such as methamphetamines and cocaine so people are looking for other drugs but fentanyl is being added to all of these drugs. And while fentanyl is a very very powerful painkiller which means it’s a powerful respiratory depressant, it slows down your breathing, and when you take it with other things including alcohol by the way, if you take it with other drugs that also slow down your breathing it’s a recipe for a person to stop breathing which were all these overdoses are happening and people are dying. This is not like an exaggeration. There was a study that came out that said from April of 2020 to April of 2021, there were 100,000 deaths because of drugs. That stopped in April or May of 2021. I promise you this: when the statistics comes out for the following year (I know this is not going to age well in case it’s not right) but I promise you it’s going to be somewhere between 150 to 200,000 people in the following year because those statistics are completely chopped off when it started to get really really bad. Why is it in the news? Because imagine if there’s a mass murderer running around killing people left and right it’s going to be in the news. Fentanyl is the same way – it’s in the news because it’s killing people and I could tell you this that we have program participants that have finished our program and they were positive for fentanyl in their urine analysis and they swear up and down – they say they’ve never tried it, they don’t like opiates, they don’t do this, they don’t do that, but somewhere they took another drug and because the other drug was laced with fentanyl that pulled up into their system. So what do you want to say about it? Is there anything about fentanyl that I didn’t say, anything you see? And by the way last one, sorry, I just want to get this before – there are individuals, usually opiate addicts that their drug of choice is fentanyl so when they go looking for drugs they are looking for fentanyl pills and fentanyl is so powerful so a lot of people who are intravenous heroin users (they were using heroin in their veins) have shifted to smoking fentanyl pills because they’re able to get pretty much the same effect without having to to use needles and all that kind of stuff which is a complete shift. It’s always the smoking and the snorting crowd goes to injecting but now the injecting crowd is going to smoking fentanyl because of the power of it and it is true by the way – one time use can kill you. That’s one thing when back in the day when they would try to do these scared straight things with kids and say yeah one time smoking dope, marijuana can kill you, one time drinking is gonna kill you, which it can but it’s not as common. One time using fentanyl can kill you and it does kill and it has killed many people that people like me and Sara have been working with. So that’s my answer on fentanyl. Great question, by the way, thank you for asking that.

Sara : I mean you covered the topic really really well Parham. Are you able to pull up a picture in the thing or you’re not able to pull up photos?

Parham : Of what? What are we trying to see?

Sara : If you Google it, if you can pull it up that would be great but if people can’t pull it up, if you google the lethal dose of heroin versus a lethal dose of fentanyl it’s striking and overwhelming to see the amount of fentanyl it takes to cause an overdose. Are you able to pull that up?

Parham : Oh yeah, for sure, so let me see – we’re going to do some really cool technical stuff right now. I don’t know if it’s going to work. Let’s see – share screen – if it asks me to restart the thing I’m probably not gonna do it.

Sara : I mean anyone interested can Google and it’s one of the first photos that pops up and I think that’s really important to share to bring awareness to how strong the drug is. I know that fentanyl, like Parham mentioned, has been around for a very long time but it’s within the last few years getting more news coverage and bringing more awareness to it because of the deaths that people are experiencing and the overdoses. People are more familiar with morphine – I would say historically, and fentanyl is 80 to 100 times stronger than morphine is. That’s about how strong fentanyl is so there’s a reason why it’s ending up in the news. There’s a reason why there’s a lot of overdoses happening and that’s why it’s so important to bring awareness and to talk about it so that people can really engage in harm reduction. Abstinence is great but if it’s not there then harm reduction is really important in order to save lives.

Parham : Yeah, and I saw something actually when I was doing my research to answer this question. Just so family members know and those who are testing individuals at home with those cups – those 10 panel cups – even if you get the cup that can test for the most amount of substances out there – you know they call them these 10 panel cups – it doesn’t test for fentanyl. This is really huge! Someone could be using fentanyl in your home and you’re testing for them, they keep showing up negative but they’re actually using fentanyl. You have to get this thing called a dipstick which you can put into the urine sample and that can separately test for the fentanyl. In the research that I saw there were some community colleges and local colleges that were giving out free test dip strips because they assumed that college students on some level will be dabbling in, using substances, whether you believe it or not, that’s what people do at that age, and it was just good to see them offering that type of a harm reduction thing, to be able to test their drugs to see if fentanyl is in it or not. You think that something that’s so deadly is a deterrent but if that was the case then all these people wouldn’t be dying from fentanyl. And again, remember a lot of these overdose deaths are not on purpose – they’re completely accidental. They’re not trying to die – it’s just that fentanyl is that powerful.

Sara : Yeah, and I’m from South Florida – Fort Lauderdale – and it happened a few months ago where a bunch of people rented a house in Fort Lauderdale and they had gotten some cocaine. It was spring break and they just wanted a party and a large majority of the people there overdosed and passed away because it was laced with fentanyl and they had no idea. They thought they were just using a little cocaine, we’re gonna party, stay up late and that’s what ended up happening. It’s laced in a lot of different drugs currently and unfortunately.

Parham : Yeah, the New York Times article, if anybody ever looks it up, is specifically to do with fentanyl and methamphetamines. I mean those are two completely opposite drugs, kind of like what Sara said with the cocaine the party drug, and somehow they’re making it – they’re intertwining them so I’m super sad to see that happening.

So the next one here (this is for sure, I know parents sent this one): What are the signs to look out for that my loved one is using again or has relapsed? You could go ahead and take this one Sara.

Sara : Okay, so I think for parents, for partners, for anyone to look out for any significant change in behavior, anytime someone has a drastic change in their norm or their behavior, it means that something happened. And it doesn’t always mean that there’s a relapse – maybe it’s that depression is getting a little bit worse or maybe that person went through a life transition, but a lot of the times it’s kind of like (I think Parham, you’ve said this before) a road map. Behaviors don’t change for no reason. Some of the things that you can look for is if someone is having shifts in mood and a lot of time rapid shifts in mood, if they’re really really irritable one time and then you see them and a few minutes later they’re really joyful within the hour or two hours. Something else to look for that’s really important is changes in physical appearance. I’m personally a big believer in what you look like on the outside is a huge reflection of how you’re feeling or how you’re doing on the inside. So again, like I said, not a sign of relapse but if someone’s really depressed you’re going to see them not taking care of their wellbeing, they’re not going to have showered in a long time, their hair might be really knotty, their face, but then some of those signs of substance abuse like you’ll see changes in their face a lot of times, if you’re not getting the nutrients that you need because a lot of the times people stop eating when they’re using drugs, so just overall weight changes, just changes in physical appearance in general that happen suddenly and quickly. And I think one of the biggest ones is isolation. Addiction breeds in isolation so if we notice that there’s less connection with family or friends or their support network, like if the person stops going to their 12-step meetings or engaging with their sponsor, and then also isolation in terms of not showing up to work when they’re a reliable person, or not showing up to school, or getting the grades that they used to, those are some indicators that there’s something going on with that person.

Parham : 100%! Those are all, I think you nailed pretty much all of them. Changes in sleep pattern too I’d probably say is one of the ones that’s very common. People aren’t sleeping at all because they’re up on stimulants or they’re sleeping too much. Also the thing is, there’s signs and symptoms of relapse. I have this talk I’ve done here so I just want to kind of connect this talk to a previous talk we talked about. I talked about relapse in them so if you go look at one of these previous talks about relapse one of those things in the relapse process I actually talk about this thing called the prelapse, which is the signs and symptoms before the physical relapse happens. And that’s the road map she’s talking about. Once you’re on that road relapse is oftentimes inevitable unless there’s some type of awareness and intervention that happens at that moment. For family members (because I think the family member asked this question, I know there’s a question up there I’ll pull it up in a second), you have one unique advantage to people who don’t know the individual. Okay, so what I mean by that is this: you know your loved one, so whether this is your child, your grandkid or your spouse or your friend you’ve seen them in their addicted state for days, weeks, months and years. Most people in their new environment have never seen that version of them so when you start to see and feel that your spidey senses start going off, that something is starting to feel like the past again, this is like really good insight because you have that insight. They’re starting to do things, say things, behave in ways, hang out with people, or have certain behaviors in the past that existed when they were using, it’s not always the fact that they’re 100% using, but it shows you that they potentially are back closer to that realm than they are to the opposite realm. It’s a unique advantage and then as soon as you start to see that and feel that and hear that and observe that, like Sara said in one of the first questions was, that’s when you got to double down on yourself because myself, Sara, the greatest clinicians and therapists in the world, counselors in the world, we can’t predict the future. Neither can you. We do not know what happens to people in their journey but because of that risk of that vulnerability of not knowing what’s going to happen the only thing that’s certain is taking care of yourself in those moments, literally taking care of yourself. Because if they’re able to get through that and stay clean and sober, wonderful, cool. If they’re not, at least you don’t lose yourself in the process. Because relapse does happen in the recovery process, oftentimes if not more than frequently, with individuals. Once it happens you just go back to the basics. So if it happens once it happens you go back to the basics – what did you do the last time around that you were able to provide help? Do you just say, oh this never works and I’m over it and all that kind of stuff, or you say go back to ground zero and start building forward from there again? Sometimes that journey is very very difficult and challenging and it’s kind of hard to go through it again but it might happen. I’m just giving you some reality that it might happen.

So there’s some good questions over here. This one’s about neuroplasticity, probably of the brain. Could the brain cells damage recover themselves during the recovery from addiction and to what extent? You want to take that one? You want me to go?

Sara : I can take it. I’m sure you’ll be able to expand a little bit better than I can. Our brains have something that we call neuroplasticity and so our brains and our body want to heal and they want to be healthy. So over time it will, but it really just depends on the person – how long they were using the substance, the amount of substance they were using, and also the substances that they were using do impact the brain as well. So it is a time thing a lot of the time and every day that we are sober is a step in the right direction of our brains healing.

Parham : 100% on that neuroplasticity. So Jose, this question that you’re talking about here – I do want to also double down on what Sara said and it’s not just me and her doubling down – there’s other people’s research that doubles down on what we’re saying that the brain does recover. It can recover. Now to what extent is based on the frequency and the duration and the length of time that people are using and if it’s a significant amount of time and a significant amount of duration in an amount that leads to those parts that the brain has a hard time recovering from there. But for the most part let’s say if we have a bell-shaped curve of addiction, most people that fall in the addicted world that stop using their brains do recover in a very powerful way with certain drugs. For example, the highly dopamine related drugs like methamphetamines which is the most powerful drug on the brain, they say it takes up to 18 months for the brain to resolve, to reset to normal functioning with dopamine receptors to be able to function the way that they need to function. So this isn’t like a 30-60-90 day thing, up to 18 months. And also all the other organs and tissues of the body they actually do regenerate. People sometimes don’t know this, that the hair, skin, nails, the internal organs, the surfaces, every seven years or so they also regenerate themselves internally when there’s a healthy conducive environment to it which is a powerful fact. So hopefully that answers that.

There’s questions here from Katalin: How do you gently nudge someone into recognizing that they have an addiction problem, which I recognize, being one myself and in recovery, but gently open their eyes to take action? So pretty much what Katalin is saying here (I just want to open up the question) because of her personal experience in recovery, she’s able to observe someone else in their life and see that they got signs, they got symptoms, they potentially could have a problem with addiction, but the other individual doesn’t know yet, so what can that person do to nudge them or kind of gently expose them to the recovery world? You got anything for that?

Sara : I really like that you said “gently.” I think that’s really important. We talked earlier about bringing awareness to that person and I’m going to go on a little bit of a side tangent with this but I’m really big on communication and the importance of communication and how we can say the same thing in two different ways and it will not land at all if we don’t say it correctly. There’s been a lot of research, there’s a form of therapy that they call the Gottman therapy and it focuses a lot on communication and relationships, and it says the first three seconds of how a conversation starts generally indicates how a conversation will go. So if we start the conversation with a negative tone and really loud and aggressive body language the person we’re speaking to is going to immediately shut down, they’re going to get defensive and they’re not going to be able to hear us, and that’s where that “gently nudge someone” really comes into play. To have a very soft startup when you speak to people and to also speak from “I statements” like, “I notice,” “I feel,” “I have seen,” in whatever follows because if we start with “you’re doing this and you’re messing up your life and you’re ruining your life,” people get defensive and their brain turns off and they can no longer hear you. So I think the gentle approach is really really important. An appropriate communication in terms of speaking to someone at the right timing as well, so if someone has not slept for three days because they’ve been using drugs, it’s generally not the time where they’d be the most receptive towards any feedback about their life. So kind of plan the time where you talk to them and judge them and help them recognize some of their problems.

Parham : That’s perfect and I’m all about the compassionate approach to everything and the other one too Katalin, in the program, now you know the 12-step programs for example, they have a statement that works really well. It just says “attraction rather than promotion.” So what does that really mean is when you are in your recovery (and I know that’s what you’re doing right now) you become so attractive, meaning that the way you live your life without the use of alcohol, the way you engage, the way you interact, the way you behave, the way you think, the way you show up, the way you laugh, the way you smile, when all of that stuff starts to be seen by others it always piques the interest of the person that’s closest around you. They say, Wow, something’s different about them, something’s changed about them. And then they ask that million dollar question: What are you doing to get to do that? How did you get to this place? How did you go from what you were to where you are? Because when they ask the question then that’s like the perfect opening: “Oh let me tell you,” and that’s when you can actually start talking about all this stuff so the continued work on self creates an attractiveness, kind of like an attraction to others to inquire about what’s your secret sauce – that’s what I call it. So continue doing you and hopefully that becomes attractive enough to whoever that is around you that you’re trying to gently nudge towards the recovery process.

Jim opened up our pre-lapse discussion. Here’s some good ones. So if there’s increased anxiety, if there’s increased anger, sleeplessness, over-sleeping, bad diet habits, isolation, deflecting (we didn’t talk about that) – if someone asks are you doing okay and you just deflect and talk about something else it’s not a good sign. It’s like they don’t want to get the root of stuff. And defensiveness as well. We could probably come up with a nice list here – defensiveness is a very good one. Argumentative. Debbie said this really resonates when we were talking about the relapse. This question is a little bit older but she said “I no longer do, knowing it seems to lead too deep.” So she used to freak the heck out about pre-lapse and relapse but no longer she does because she realized that if the individual does relapse, which it happens, and they’re able to survive it, which talking about stuff like fentanyl out there it’s a very high risk these days, if they’re able to survive it, it actually helps them get to a deeper level of recovery. So seize the relapse as part of the recovery and growth process. I’ve known Debbie here for a couple years now – Debbie would have never been able to if she would have seen herself write this two years later she would have thought that that’s not her. It’s kind of cool to see how far we can come in recovery. She was just riddled with fear, so much fear, I mean about every decision of their loved one. Jose wanted to thank us. Katalin, this one Jim said is for you because you’re asking how do you approach someone gently? Timing is really important. So as Sara said those first three seconds of not what you say but how you say. Also when you say it and I think Sara you said if someone’s been up for three days they might not be receptive to take it so timing’s really important with everything in life. We have some more questions: Why do family members need to (I probably misspelled that so let me just fix that because my perfectionism right now is going to flare up and I’m going to have a hard time) also do some type of recovery? This was actually a real question – it was a family member that was resistant. I kind of invited them to watch this. I don’t think they’re here so maybe if they come later but I invited them to watch this and they were kind of a little bit defensive and argumentative and all those things that lead to relapse of an individual, they deflected, they said “Why the heck do I gotta be here? I’m this successful human being, I’ve raised three good kids and this one happens to be the bad apple. How come the rest of their lives aren’t?” This person was legitimately angry and upset: “How come they’re all fine and now that this one’s in recovery I have to come here and have to sit and learn these things? I don’t want to learn these things. Why do I have to?” You got anything for that Sara? Because I got way too many things to say.

Sara : I know this is kind of like your forte. I always start by telling family members that addiction is a family disease and it is impossible to look at the strain that it takes on someone’s life and not acknowledge that it impacts the entire family, whether it’s parents, whether it’s siblings, cousins, grandparents, whoever it is. So there’s a lot of benefits to family members needing some type of recovery because when family members do seek some type of recovery they learn things that they previously probably were not aware of, so it helps to overcome enabling behaviors which is really important. Because enabling it can be extremely dangerous for someone in recovery or for an addict or alcoholic. It helps with learning about financial support and the impact that has on someone and it also helps with learning to effectively establish boundaries so there’s a lot of benefits to family members getting some type of recovery. And like we’ve mentioned before the best thing you could do for your loved one is to help yourself because then you’re modeling healthy behaviors, you’re a role model and you increase awareness and education which is really important.

Parham : Yeah, that’s a perfect answer. To anybody that’s resistant to the recovery process I always urge them to do this. We say this: individuals are recovering from substances so family members give it a try, be open-minded, and maybe you find something in there that you’ve always needed but never knew you needed. How about that? Actually I have to put something up here – this is legit – you said something my son actually asked me to join Al-anon and I’m grateful to him. You know what I mean? I’m not going to get too much into it but let’s say the son’s going through the recovery process and the son says, “Mom, go to Al-anon, I’ll help you,” and the mom’s like, “Hey, why do I got to go to something?” My mom said the same thing by the way – if she’s watching this – my mom was like, “Why the hell do I have to go to these groups and meet with these people and do all that kind of stuff? I don’t need to do that,” but she went there and all of a sudden she found out she’s like, “Oh my gosh this is all for me, I’m doing this for me, I’m getting to know who I am, what I’m all about, all that kind of stuff.” Because recovery just means (by the way I’ve used this working definition). So why do family members need to also do some type of recovery? Recovery means to regain something that’s been lost, stolen or destroyed – that’s all it means – to regain something that’s been lost, stolen or destroyed and what is that? It’s always our connection to ourselves. If you have a family, a wonderful family, and three of them are doing really well and one of them is really really struggling at some point we get disconnected to ourselves in this journey called life and recovery just allows us to stop, slow down, turn the mirror, look at ourselves and see who and what we are. It doesn’t have to be through traditional 12-step routes – it could be through individual therapy, it could be through support groups, could be through faith-based stuff, but we all need to recover, including myself, including Sara. It’s like life makes us lose ourselves at times – there’s nothing wrong or shameful about working on ourselves. Here’s the thing – I’ll say this because I talk about this every single week literally – there’s some really nice comments I’m going to put up – instead of hearing it from me you can hear from families – but even if you say “I don’t want recovery, I don’t care to go to these programs, I don’t care to learn about addiction, I’ve raised three good kids and this one’s the only bad apple” you want to frame or whatever this family member was telling me and I do a really good job of not talking about people because I just need to but what if I told you as a licensed professional and Sara’s a licensed professional, that your loved one, your child that you say you love so dearly, your adult child that you say you love so dearly, what if for their recovery and for their chance to survive and their chance to heal they need you? How about have you ever thought about what if they need that connection with you to be able to work on themselves and you deprive them of that connection by saying I don’t want to engage with this recovery stuff? They can figure out on their own because like I said even if you have three wonderful kids and one of them struggles that’s saying that if you have two identical plates from Ikea, those white ones that look identical and drop them from the same distance (or in this case have four identical plates and drop them from the same distance) they’re going to have four different break patterns – they’re all going to look different. And guess what? Even if you think you know why, you actually don’t, because people are unique and individual and different and that kid, that loved one, that child, that partner, that friend, might need you in recovery and maybe that’s enough to get you in and you realize you’re there for yourself. So we have this thing in recovery called internal versus external motivation. It’s like I get sober for my mom and then I realize after getting sober I did it for myself. Sometimes as family members you go into recovery for your loved one and then after a while you realize, “Oh [ __ ] this is actually for me,” so you go from being externally motivated to internally motivated. Every single person that watches this – I know there’s not that many of them – but let’s just call 15 or 20 people watch this live every week and I’m cool with that – those 15-20 people all were externally motivated and they finally became internally motivated and they stay here and come back because they’re internally motivated.

Sara : I really like to tell family members too that watching your child or your loved one struggle with addiction is challenging and it’s heartbreaking and it’s sad and it’s anxiety producing and we watch families lose sleep for so many nights in a row that it can just be helpful to be in a room with people going through similar experiences and have that safe place to talk about what you’re going through and to not hold on to it all on your own. So there’s a lot of benefits for someone having recovery themselves and going to the Al-anons and the Nar-anons and the different meetings like that to get some support to navigate a really challenging experience.

Parham : I’m gonna piggyback on you now if that’s cool. When someone’s going through addictions in their family it’s safe to say that miscommunication happens. They don’t understand their loved one, their loved one doesn’t understand them, there’s anger, there’s resentment, there’s frustration, it’s just a cluster of just really really horrible communication. When one person gets exposed to recovery and another person gets exposed to recovery what happens is they start to gain this common language of recovery – they start to say the same things and act the same ways and look at themselves the same way and stop externally blaming others and start looking at themselves. That common language of recovery allows for them to speak in a way they otherwise wouldn’t be able to speak so it helps them create a language that they both understand. There’s a bunch of good stuff here coming in. Tony said hi, John Donahue said hi guys, What is up? The Ohio house manager that’s been there for a long time and he’s a fan favorite. Debbie said “it is absolutely a family disease. I can’t imagine any good changes could happen without the family members going through recovery.” See, this is a family member talking, my friends, it’s not just me. Eileen said, “Loved ones’ recovery is a gift that affects other relationships in your life. It makes all relationships more authentic.” It just makes the relationship with your loved one more authentic – all relationships – this is talking about personal and professional, by the way. We just level up when we go into recovery. And Jim: “For families in recovery you can set a really good example for the loved ones in your life struggling with addiction.” Absolutely! It’s the same thing – model what you want to see. Michael, let’s give him a shout out – he is the gentleman with four years of continuous sobriety that’s doing his internship for drug and alcohol counseling at Buckeye Recovery Network. He wrote, “I finally got sober once my family actually got involved in my recovery. Doing anything on your own can be very difficult.” Well said! It’s kind of like trying to create and assemble an Ikea piece of furniture without the Ikea book – very very hard to do. John just said “what’s up,” so let’s see we have another one – Hossein said, “Being a part of a big family of Al-anon is by itself a blessing and a great help in what is the right way to deal with the disease, thanks for your great knowledge and guidance.” You’re very welcome, thank you for being here. Like I say, if you’re not here then we’re just random people talking in computer screens.

Sara : I was going to say something really quickly – so you know it’s really cool that kind of like piggybacks on what all the comments are saying here talking about recovery and working a program, whether your loved one is or not is that I myself am not in a 12-step program, I haven’t struggled with drugs or alcohol but I work with Jim who’s on here every single morning and he took me through the 12 steps when I started working at Buckeye to get a deeper understanding of it and when I went through it I was like, “Holy crap, the world would be such a better place if everyone went through this process, whether you struggled with substances or not,” because to be able to have a situation and it really challenges you to look at your part in situations so moving forward from doing that with Jim every day moving forward I started trying to look at my part in different scenarios and how my behavior impacts others or to make amends to people that you’ve hurt. The world in general would benefit from doing this so I think there’s a lot of benefits to working 12-step programs.

Parham : They really are, and I knew that you and Jim did that – I actually remember in real time when you guys were doing that and that’s a shout out to Jim obviously for making himself available for that but also for you Sara. A good clinician has to know the population they work with, they have to be able to relate with the population they work with, and for you to say you don’t have that much personal experience here but you’re trying to get a lot of professional experience and you want to go through the experience, you want to walk the walk so you can talk the talk so you can connect with people. And that’s what’s made you – I mean you did that about four or five years ago – that’s what made you the clinician you are right now, that even though you never put a needle in your arm or even though you never start snorting a bunch of things not all these consequences, because of it when someone sits down and talks to you you’re able to talk to them human to human and you’re able to go back to the recovery principles even without going through it firsthand. Sometimes for some people with education it helps to have personal experience. But don’t always believe someone says if someone wasn’t an addict I can’t work with them because here’s the thing – when you go get a knee surgery, well the knee surgeon if he’s never had knee surgery himself I’m not going to let him do surgery on me it doesn’t make sense. If the knee surgeon has the ability to effectively help reconstruct and heal your knee without going through knee surgery you allow him or her to do so and recovery is the same way. I’m not saying everybody that has that personal experience can help out those with addictions because if they didn’t do the work like Sara they might just miss the boat – they might just be completely overwhelmed, but if they’ve done the work to really understand that population it doesn’t matter if they use or not themselves, I promise you it does and I know this for a fact. All that matters is, can you connect to people? Can you have compassion? Can you hold space? Can you model what it’s like to be a healthy human being? Can you have unconditional positive regard? Can you give a [ __ ] about the life of another human being? If you can do all those things it doesn’t matter if you were addicted to heroin or jelly beans – you know you could help anybody else out.

This is all the time we have. I know we had about three or four more questions so in the feedbacks what I would encourage you to do is if you can go ahead and let us know if you like the question and answer format If you do we will try to bring this back not every week but maybe a couple times, once a month, something like that. A couple times a month to do the questions and answers thing is a really nice way to kind of broaden the platform a little bit. If you know somebody struggling out there or you know a family member struggling, tell them to come here and post their question for us and we’ll do a great job responding to them and helping them in their recovery and guiding them in the right direction. It’s just such a privilege to do this every week and Sara what are your closing thoughts? How was this for you this time?

Sara : Thank you for having me. It was a lot of fun and I appreciate all the comments and everyone’s engagement in being able to sit up here and talk about some of the stuff that we’re both so passionate about so I really enjoyed it, thank you for having me.

Parham : You did great and thank you everyone for your participation and this whole format was good so we got we got a couple of shout outs and I think those are kind of like air hugs or whatever they are – those emojis – but right back at you Katalin, everyone else, “Great format, love seeing Sara participate,” we got some thank yous, we got great education. Jim, you’re going to come up here too for questions and answers. I know you’re here Tony if you’re around there too it’ll pop you up maybe we’ll do all of us. I could probably pull up four screens and just let questions go wild and out with a bunch of counselors and therapists that’d be wonderful. Love and appreciate all of you. We’ll be back same time, same place next week for another family education support group. Have a wonderful weekend and stay safe out there. Bye everyone!

Kelsey Gearhart

Director of Business Development

Kelsey carries multiple years of experience working in the substance abuse and mental health treatment field. Her passion for this field comes from her personally knowing recovery from addiction.

Prior to Buckeye she held titles of Recovery Coach, Operations Director, and Admissions Director. Kelsey was brought on at Buckeye Recovery as the Director of Business Development. She has a passion for ensuring every individual gets the help that they need, and does so by developing relationships with other providers.

Kelsey also oversees our women’s sober living environments – The Chadwick House for Women. She is committed to creating a safe, nurturing, and conducive environment for all women that walk through the doors of Chadwick.