• Start by Doing What’s Necessary, Then Do What’s Possible

    “Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.” - St. Francis of Assisi

    As we begin the journey of recovery we are capable of doing only the necessary.  We don’t drink and we go to meetings and we live our lives in hourly increments.   Slowly, as hours turn into days and days into months, the fog lifts and we begin to recall our forsaken dreams and goals.   One day we realize it might be possible for us to achieve what we abandoned.  As our dreams are reclaimed we become the people we were intended to be and suddenly we realize we are doing the impossible.  That is the story of my recovery and as director of the Center for the Study of Addiction and Recovery at Texas Tech University it has been my honor to watch the miracle of recovery flourish in our students as they begin to achieve the possible and awaken to the fact they are accomplishing the impossible, living in community with sober peers, achieving an education and becoming the person they were meant to be.  Our Collegiate Recovery Community is founded upon values that nurture the qualities recovering students need for success such as civility, commitment, community and clean, sober and healthy environments.

     Kitty Harris, Ph.D., is Director of the Center for the Study of Addiction and Recovery at Texas Tech University

    This post is part of the ONDCP Stories of Hope blog series.

  • It Works for Me, My Life Has Turned Around Because of It

    Cross-posted from Faces and Voices of Recovery

    My addiction to opiate/opioid drugs began in 1974, back in New York City, where I was born and raised. Like most addicts, I first began getting high with beer and marijuana, then on to LSD, amphetamines, barbiturates, right up to that first shot of heroin. It was "love at first sight". I immediately fell in love with the high. Within a few months I was addicted. It became the focus of my daily routine. Before long, my paycheck couldn't cover the cost of what I was using and began a series of petty crimes to get the extra money. Nothing was sacred or taboo. Whatever I could do to get money, I did.

    I finally got arrested by Federal authorities for possession of stolen mail (tax return checks), forgery and bank fraud. I served 47 months. I wasn't yet 21 years old. My use would seem to pick up where it left off each time I was paroled. I'd eventually end up back in prison on a new charge. This pattern continued (addiction, crime, arrest, incarceration, parole) from 1974 until 1986, when I relocated to Minnesota to live with a woman I had been corresponding with for 24 months, while still incarcerated in a NY State prison. We both agreed that my relocation far away from NYC would help me start fresh. It did, for almost 9 years. But no matter where you go, there you are.

    My old self caught up to me in 1995. There was no heroin in St. Cloud (that I knew of, anyway) but I did know a guy who was getting morphine prescribed regularly for a severe knee injury, and each month I would buy a few from him, break them down in water as best I could, and inject them. Then I discovered OxyContin, which was far more potent than the morphine and it became my drug of choice.

    As in the past, I became addicted, but the addiction to OxyContin was worse than heroin ever was and before long, my habit was larger than what was available. I went back to pharmacy burglary, ended up serving 30 months in Moose Lake Correctional Facility in Minnesota. My addiction didn't stop there. It was only dormant while I was incarcerated.

    Not long after my release from Moose Lake, I started using again, violating the terms of my parole and did 30 day chunks of what time I had left until my time had expired. I got into shoplifting to make money to buy pain pills here and there, but most of them were not injectable, and that's what I craved, intravenous drugs.

    I went back to burglarizing pharmacies, a few times, and didn't get caught. But the "good stuff" like OxyContin, Morphine and Fentanyl was no longer easy to find. That still had to be purchased. To get the extra money, I was back to shoplifting.

    In and out of Benton County jail so many times for short stays (30, 60, 90, 120 days, etc) here and there. I finally got sick and tired of it all and enrolled in a methadone maintenance program. This past November 3rd was my 2 year anniversary of not using illicit street drugs or pharmaceuticals. I haven't been in jail in over 2 years, I also quit smoking. I attend outside support groups and relapse prevention groups at St. Cloud Metro (the methadone clinic). Some people will criticize methadone, saying it's only a substitutes for narcotics. In a way, it is. But it's administered under a doctor's orders, by a nurse and in a clinical setting. I give regular urine samples to monitor my progress. I do not get high on my dose (110 mg.) and I look at it as being similar to a diabetic who needs their insulin.

    I have proven time and time again, that I have a chemical imbalance in my brain and have a pre-disposition to opiate/opioid drugs, and methadone eliminates the cravings in addition to blocking the opioid receptor sites in my brain, so that even if I were to try and get high from any narcotics, the methadone blockades the effects. It works for me, and my life has turned around because of it.

    This post is part of the ONDCP Stories of Hope blog series. 

  • I Can't Believe a Woman Like Me Turned into a Woman Like Me

    Cross-posted from Faces and Voices of Recovery

    Hi, my name is Kelley. I can't remember my first drink or drug. They were always a part of my life. I was brought up around drugs and alcohol and they were intertwined with every feeling and nuance: love, hate, anger, fun, laughter, tears, and pain, both physical and mental. I started drinking young and then began getting high with my mother, once again learning that drugs and relationships went together. I learned to lie, cheat and steal and moved on to bigger and better things as I moved on to bigger arenas. In San Diego, I met a man and methamphetamine and fell in love with both, along with the needle. I lost a child and drug two more children through the dangers of ripping and running. We decided we were going to get clean and moved to Oregon, but wherever you go, there you are and there we were. After many showdowns and altercations, with various law enforcement agencies involved, it was time to call it a day.

    I have now been clean and sober for 21 years and am a member of mutual aid group. I had the opportunity to go to treatment. I have gone to school and now help people like myself. Those two children are now grown with children and I had another "clean and sober baby." I have loved and lost, experienced growth and death and made it through it all clean. I have some clear beliefs: 1. I believe the 12 steps taught me a way of living, not just a way to stay clean. 2. I believe that I never have to use again-no matter what and 3. From where I started to where I am - I can't believe a woman like me, turned into a woman like me.

    This post is part of the ONDCP Stories of Hope blog series

  • A Healthy Holiday Party Includes Non-alcoholic Drinks

    The holiday season provides a number of opportunities to celebrate with family and friends.  For individuals in recovery, it can also mean situations that challenge their recovery. That’s why, if you are hosting a gathering, be sure to provide non-alcoholic options for your guests.Thanks to our partner Epicurious.com,  here are some suggestions for your holiday get together:

    For many, a party isn't really a party without a good drink to enjoy. An alcoholic beverage often seems the obvious choice, but anyone looking for a non-alcoholic option is usually at a loss—and we're not just talking about pregnant women, kids and teens, or teetotalers. And by not providing non-alcoholic party drinks, a host may inadvertently create an unnecessary divide between guests who are partaking of beverages and those who are not. To foster a more inclusive atmosphere, below is some advice that allows everyone to share in celebratory beverages, with or without alcohol.

    Holiday Party Tips:

    • Prep Just in Time: For drinks that showcase fruit, such as the Strawberry-Kiwi Sangria, prep the day of the event so the fruit's vibrant colors and flavors will be at their best.
    • Substitute Freely: When you want a virgin version of an alcoholic cocktail, try the substitutions below. You can start with a 1:1 substitution ratio, but you should experiment and adjust to your personal taste.
      • Beer: white grape juice, ginger ale
      • Cognac: Peach, pear, or apricot nectar or juice
      • Sake: Rice vinegar
      • Tequila: Cactus juice or agave nectar
      • Vodka: White grape juice mixed with lime
    • Make Other Offers: Provide at least one special non-alcoholic drink that everyone can enjoy, or serve one fun beverage that can be "spiked," if desired. Another strategy is to set up the bar so that one drink can be made with or without alcohol—for example, the Mojito and Nojito. Another option to consider is serving non-alcoholic beer but keep in mind that by law, "non-alcoholic" beers can contain up to .5 percent alcohol by volume.
    • Dress It Up: Non-Alcoholic drinks need just as many accessories as alcoholic ones. Garnish drinks with sprigs of mint, slivers of zest, or any ingredient that ties into the drink itself—for example, fruit skewers-turned-stirrers that guests can assemble themselves.

    Non-Alcoholic Drink Recipes:

    Visit Epicurious.com to get more information on their favorite non-alcoholic drinks.

  • New Data Show 1 in 9 High School Seniors are using Spice or K2 (Synthetic Marijuana)

    Today, the National Institute on Drug Abuse released the 2011 Monitoring the Future survey, which included some troubling new information on the prevalence of synthetic drug use among high school seniors.  The results indicate that one in nine high school seniors had used “Spice” or “K2” over the past year.  That means synthetic marijuana is now the second most frequently used illicit drug, after marijuana, among high school seniors. 

    So what do we know about these synthetic drugs? 

    First, they’re dangerous.  Poison Control Centers operating across the Nation have reported over 5,500 calls relating to synthetic marijuana as of October 31 of this year.  That’s almost double the number received in all of 2010. We also know that state and local public health departments note that these drugs cause serious adverse health effects, including agitation, anxiety, nausea, vomiting, tachycardia (fast, racing heartbeat), elevated blood pressure, tremor, seizures, hallucinations, and paranoid behavior. 

    Making matters worse, these drugs are often marketed as “legal” substances.  They are sometimes labeled as “herbal incense” and sold in small pouches or packets over the Internet, in tobacco and smoke shops, drug paraphernalia shops, gas stations, and convenience stores. 

    There’s still a lot we do not know about these drugs, but here’s what we do know:  We must all work together to respond to this emerging threat.  The good news is that over the past year, the Federal Government has taken comprehensive action to address this challenge:

    • ONDCP has convened several working group meetings to bring public health and safety agencies from across the Federal Government together to share data and coordinate the Federal response to reduce the threat these drugs pose.
    • In March, the Drug Enforcement Administration used its emergency scheduling authority to ban the sale of the chemicals used to manufacture K2 and Spice.  
    • We are also working with Congress to pass new laws aimed at reducing the availability of these drugs.  Just last week, the House of Representatives passed legislation that would ban synthetic drugs, including those marketed as “bath salts.”  (And at least 38 states have taken action to ban the chemicals found in K2 and Spice, as well.)
    • Over the next few weeks, ONDCP will reach out to a nationwide network of public health and safety organizations to provide them with the latest information we have on this public health problem, raise awareness, and spur action at the local level.

    We will continue to address this threat.  But parents, too, must take action.  Parents are the most powerful force in the lives of their teens.  That is why we ask that all of you take time today to talk to your teens about the serious consequences of using marijuana – in whatever form it may come, including synthetic forms like K2 and Spice. 

    Additional Resources:

    Rafael Lemaitre is Associate Director for Public Affairs

  • ONDCP and NIDA Voice Concerns over Vietnam's Approach to Drug Treatment

    A recent Human Rights Watch report asserts that there may be over one hundred facilities in Vietnam subjecting thousands of addicted individuals to inhumane labor conditions under the pretense of providing drug treatment.  Furthermore, there are indications that the Government of Vietnam may erroneously believe that these practices comply with NIDA’s Principles of Effective Treatment

    In a letter forwarded to Human Rights Watch earlier today, the Director of National Drug Control Policy and the Director of the National Institute on Drug Abuse (NIDA) reiterated the United States’ strong support for safe, effective, evidence-based, drug addiction treatment that is consistent with NIDA’s Principles of Effective Treatment and internationally recognized human rights.  This joint letter from NIDA and ONDCP sets the record straight.

    The United States does not in any way condone the forced labor or inhumane conditions described in Human Rights Watch’s report on drug rehabilitation facilities in Vietnam.  While NIDA’s Principles of Effective Treatment include a principle stating that “treatment does not have to be voluntary to be effective,” it is not intended to provide a justification for violent or punitive coercion without access to due process or internationally recognized human rights.  This principle is based on evidence that treatment entered as a result of a criminal justice mandate to avoid imprisonment, or even within a criminal justice setting, can be successful.  It also applies to other addicted individuals who would not have entered treatment were it not for a doctor, nurse, relative or friend who took the time to present to them the serious health consequences of avoiding needed drug treatment. 

    ONDCP wholeheartedly supports all of NIDA’sresearch-based Principles of Effective Treatment, which also include:

    • Addiction is a complex but treatable disease that affects brain function and behavior;
    • No single treatment is appropriate for everyone;
    • Treatment needs to be readily available;
    • Effective treatment attends to multiple needs of the individual, not just his or her drug abuse;
    • Remaining in treatment for an adequate period of time is critical;
    • Counseling – individual and/or group – and other behavioral therapies are the most commonly used forms of drug abuse treatment;
    • Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies;
    • An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs;
    • Many drug-addicted individuals also have other mental disorders;
    • Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse;
    • Drug use during treatment must be monitored continuously, as lapses during treatment do occur; and
    • Treatment programs should assess patients for the presence of HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

    NIDA and ONDCP believe that regardless of the manner in which an intervention is initiated, effective drug addiction treatment ultimately must be:  a) evidence-based; b) take advantage of the various treatment modalities available; and, c) address the multiple needs of the individual. 

    The United States will continue to work to ensure that Vietnam and other countries worldwide receive this important drug treatment message loud and clear.  For more information, read the full letter.

  • Cocaine Seizures Outstripping Production? Not Exactly.

    An analysis released today by Narcoleaks makes the claim that cocaine seized worldwide in 2011 has surpassed our estimates of world production.  Their analysis is systematically flawed.  Here’s why:

    1 -  Seized cocaine is diluted, which means you can’t compare seizures to production estimates.

    Our estimates of production are expressed in terms of “pure” cocaine; this permits us to make comparisons over time.  Drug traffickers dilute cocaine by deliberately "cutting" the cocaine with other substances to increase its bulk at various stages of its distribution from South America to the United States.  What this means is that a kilogram of cocaine product seized in Los Angeles does not contain the same amount of actual pure cocaine hydrochloride as a kilogram of cocaine seized by the Coast Guard on the high seas.   Cocaine also continues to be diluted the further it goes in the supply chain (producer, exporter, wholesaler, retailer, etc.)

    Even cocaine seized in transit to the U.S. by the Coast Guard has been diluted.  Our forensic analysis shows that the average purity of cocaine seized on the high seas alone (before it even reaches U.S. streets) is 75 percent and dropping.  Moreover, our analysis of seized cocaine leaving South America in recent years show that approximately 85 percent of cocaine seizures are being cut with levamisole, a veterinary deworming medicine.

    As a result, it is comparing apples to oranges to compare potential production amounts with amounts seized.

    2 - Drug traffickers work in the shadows and make accounting very difficult. 

    Our estimates of cocaine produced in Colombia are just that – estimates.  Unlike producers of legitimate products, drug traffickers do not provide annual reports on production capacity and sales (although we wish they would!).  Most data--including potential cocaine production, seizures, availability, and consumption--have to be estimated.  The estimation procedures for each step are associated with varying degrees of uncertainty.  For example, our estimate of potential cocaine production of about 700 metric tons (of pure cocaine or about 850 metric tons of export quality cocaine) is actually the midpoint of a range--there may have been more or less actually produced.

    3 - Cocaine moving through the transit zone contains drugs from the previous year, so you can’t compare year to year. 

    The “cocaine pipleline” doesn't work on a simple annual basis.  Cocaine that is being consumed in the United States today may have been produced up to as much as two years ago in South America (the problem is compounded when it is understood that production in Colombia in previous years was greater than this year). So the estimate of cocaine moving to the U.S. at any given time is a mixture of the amount produced over two years; so attempting to do a precise year-on-year accounting is impossible.

    So what do we know?  Today, thanks to a variety of actions throughout the hemisphere, a wide array of data show that the U.S. cocaine market is under significant stress.       

  • The Health Care Innovation Challenge Wants Your Ideas

    As part of the Affordable Care Act, the Health Care Innovation Challenge will award up to $1 billion in grants to fund the best projects that doctors, hospitals, and other innovators propose to deliver high-quality medical care and save money.

    In a previous blog, the White House encouraged interested individuals to send innovative ideas and solutions, and submit a proposal for transforming the health care system.  This provides the substance abuse community the opportunity to join the conversation and create new innovations for the prevention, treatment and recovery fields.  In the application, proposals are encouraged to focus on high cost/high-risk groups including those populations with multiple chronic diseases and/or mental health or substance use issues, poor health status due to socio-economic and environmental factors, multiple medical conditions, high cost individuals, or the frail elderly.

    Visit the website for more information and to join one of the upcoming webinars.

  • President Obama Names December as National Impaired Driving Prevention Month

    “As we strive to reduce the damage drug use inflicts upon our communities, we must address the serious and growing threat drunk, drugged, and distracted driving poses to all Americans.” – President Obama, December 1st2011

    A new Presidential proclamation names December as National Impaired Driving Prevention Month, which is another important step in the Administration’s effort to raise awareness about drugged driving and ensure the safety our Nation’s highways.  It is well known that drugs, even those prescribed by a physician, can impair perception, judgment, motor skills, and memory.  ONDCP is proud to stand with our Federal, state, local and tribal partners to find innovative ways to address this alarming issue.  Each of us have a role to play in reducing the consequences of drug use and encouraging healthy lifestyles. As the President said in last week’s proclamation:

    While enforcement and legislation are critical elements of our strategy, we know that the parents, educators, and community leaders who work with young people every day are our Nation’s best advocates for responsible decisionmaking.”

    Additional resources:

  • Obama Drug Policy: Reforming the Criminal Justice System

    Ed. note: This was cross-posted from Huffington Post

    Recently we had the privilege of recognizing 10 community organizers at the White House as "Champions of Change." Each of these Champions represent innovative organizations and programs working across America to reform the way we approach our nation's drug problem. Among this group of educators, physicians, social workers and people in recovery from substance use disorders, was a 25-year veteran of the Providence, R.I. police department.

    As we sat in the Roosevelt Room just steps from the Oval Office, Lt. Daniel Gannon told us something many Americans might not expect from a law enforcement officer. Not every drug offender belongs in prison, he said. "Prisons are for the bad guys." For many of the others, he said, what's often needed is access to drug treatment, community services and a second chance. Lt. Gannon -- who advocates for an innovative community policing program called Drug Market Intervention -- is just one among thousands of community leaders around the country working to implement a variety of innovative, compassionate and evidenced-based drug policies at the local level.

    Progressive and effective reform efforts like these could not come at a better time. More than seven million people in the United States are under the supervision of the criminal justice system. Of these, more than two million are behind bars. Making matters worse, African Americans are disproportionately incarcerated for drug offenses. In fact, African Americans have higher proportions of inmates in state prison who are drug offenders compared to whites -- about 50 percent higher. For states and localities, the cost of managing the prison population has grown significantly. Between 1988 and 2009, annual state corrections spending jumped from $12 billion to more than $50 billion.

    Just as alarming is the strong connection between crime and substance use. Data shows that over half of state and federal inmates used drugs during the month preceding the offense corresponding to their sentence. And nearly a third of state prisoners and a quarter of Federal prisoners were using drugs at the time of the offense.

    The complexity and scale of our drug problem requires a nationwide effort to support smart drug policies that reduce drug use and its consequences. Since day one, the Obama Administration has been engaged in an unprecedented government-wide effort to reform our nation's drug policies and restore balance to the way we deal with the drug problem. We have pursued a variety of alternatives that abandon an unproductive enforcement-only "War on Drugs" approach to drug control and acknowledge we cannot arrest our way out of the drug problem and, further, that drug addiction is a disease of the brain, not some "moral failing."

    This strategy is vital because by recognizing drug addiction as a chronic and progressive disease, we can actually work to prevent and treat substance use disorders and break the cycle of drug-related crime. Simply put, it makes more sense to prevent and treat drug problems before they become chronic than simply to legalize drugs altogether or keep filling our prisons with drug offenders over and over again. Neither of these extremes are sound or humane drug policies.

    Under the Obama Administration, the shift has already begun toward programs that emphasize public health over incarceration. Over the past year, the federal government spent $10.4 billion on drug prevention and treatment programs. That is more than twice the amount -- $4.3 billion -- spent on drug-related incarceration operations. And it's just the beginning:

    • Last year, President Obama signed the Fair Sentencing Act into law. This important and long-overdue criminal justice reform dramatically reduced a 100-to-1 disparity between sentences for powder and crack cocaine that disproportionately affected minorities. More recently, we advocated for, and the U.S. Sentencing Commission approved, the retroactive application of these sentencing guidelines which became effective on Nov. 1.
    • The Administration ardently supports the expansion of drug courts, which place non-violent drug offenders into treatment instead of prison. Today, there are over 2,600 drug courts across the nation, diverting about 120,000 people a year into treatment instead of prison. Because of this expansion, someone in America is referred to drug treatment instead of jail through drug courts on average every four minutes.
    • The Administration is implementing the Second Chance Act, which passed Congress with overwhelming bipartisan support and provides resources for common sense, evidence-based approaches to reducing crime. Specifically, it provides funding for programs that improve coordination of reentry services and policies at the state, tribal, and local levels, including demonstration grants, reentry courts, family-centered programs, substance abuse treatment, employment, mentoring and other services needed to reduce recidivism and improve the transition from prison and jail to communities.
    • Last year, the Department of Justice awarded $100 million to support 178 state and local reentry grants to provide a wide range of services and, in late September, awarded another $83 million to 118 new grantees.
    • The Department of Justice has urged state attorney generals to review the legal collateral consequences of their state laws being placed upon ex-offenders that may burden their successful reentry into society. (State and local governments are also taking action. During their 2011 legislative sessions, more than a dozen states tackled sentencing and corrections issues.)
    • The Administration has worked to make certain that local public housing authorities understand Federal law regarding the discretion housing authorities have to allow ex-offenders access to public housing. Research shows that ex-offenders who do not find stable housing in the community are more likely to recidivate than those who do. Studies have also found that the majority of people released from prison intend to return to their families, many of whom live in public or other subsidized housing. Clarifying these rules allowing ex-offenders to rejoin their families is therefore an important part of our overall criminal justice reform efforts. There are only two explicit bans on occupancy: Individuals convicted of manufacturing methamphetamine in public housing and registered sex offenders.

    But more still must be done. That is why we are closely examining innovative new programs that show great promise in extending our approach to criminal justice reform and alternatives to incarceration. Here are two that are already showing solid results:

    • The Drug Market Intervention program.This community-based strategy has shown tremendous promise in disrupting open air drug markets by directly engaging drug dealers, their families, and communities by creating clear and predictable sanctions, offering a range of community services including drug treatment, and improving community-police relations. Jurisdictions that have implemented this strategy have experienced decreases in drug crime and other crimes without displacement of the drug market activity into other neighborhoods.
    • Hawaii's HOPE Probation program(Hawaii's Opportunity Probation with Enforcement).This program reduces probation violations by drug offenders and others at high risk of recidivism. Probationers in the program receive swift, predictable, and immediate sanctions - typically resulting in several days in jail - for each detected violation, such as detected drug use or missed appointments with a probation officer. So far, evaluation results indicate the program is highly successful at reducing drug use and crime, even among difficult populations such as meth users and domestic violence offenders.

    There is no simple, straightforward fix to America's drug problem. Successfully combating this social challenge and reducing the toll substance abuse takes on our nation requires a broad approach that blends drug treatment, smart law enforcement and effective alternatives to incarceration. With these proven public health and public safety strategies, we can break the vicious cycle of drug use and crime, thereby saving countless lives and taxpayer dollars and helping to make it possible for all Americans to achieve their full potential.

    Rafael Lemaitre is Associate Director for Public Affairs