SUD Aftercare: An Indispensable Part of Successful Treatment

Why do patients receiving Inpatient medically supervised detoxification and rehabilitation levels of care for their substance use disorders (SUD’s) usually succeed in achieving their treatment goals? Our experience at Tully Hill Treatment and Recovery indicates that they succeed because their treatment and care occurs in a setting and environment that is highly structured. It also requires that patients make a sincere commitment to Tully Hill’s programming and services.
We know that SUD’s are a chronic illness requiring ongoing care and support after Inpatient treatment. Therefore, an essential component of effective Inpatient treatment and care is aftercare planning, which actually starts the day of admission at Tully Hill. Our treatment team knows that working with patients to formulate and execute an appropriate treatment and aftercare plan following discharge is critical to their continued sobriety and well-being.
What constitutes an effective aftercare plan for patients being discharged from an Inpatient setting? Aftercare planning needs to be individualized and tailored to meeting the needs of each patient. Our team at Tully Hill works to incorporate the following elements into aftercare…

Ensuring the continued wellbeing of discharged patients – once patients are stabilized medically and emotionally in Inpatient and begin achieving their treatment goals, it’s imperative to teach them how to manage their illness and make healthy decisions that support their emotional and physical welfare once they leave Inpatient treatment.
Discharging patients to safe, stable residences – an important part of effective aftercare is placing patients in a sober, safe, and secure living environment. This usually means a return to one’s home or another suitable environment, with appropriate treatment and care.
Active involvement in Outpatient Treatment—inpatient treatment is only the beginning of SUD treatment. All patients will be referred for ongoing Intensive Outpatient or Outpatient treatment following their discharge, as well as being referred for any ongoing outpatient mental health treatment.
Establishing with patients, sober living skills and support systems – teaching patients coping and sober living skills and helping patients establish and learn to keep sober support systems is an Inpatient treatment goal at Tully Hill. Effective aftercare includes establishing relationships and social and community networks that support a patient’s recovery.
Participation in a 12-Step recovery program – for most discharged patients, participating in a 12-Step recovery program has proven to be a significant factor in achieving and maintaining long-term recovery. Our aftercare planning includes impressing upon patients the value of fully utilizing this strongly recommended, and effective, aftercare plan piece.

It’s important to note that referring patients to longer-term residential care is an alternative to an Intensive Outpatient or Outpatient level of aftercare, when and where appropriate. Having a working relationship with agencies that provide either of these levels of care is important, to ensure that they will provide the treatment and care (including mental health care, if indicated) a discharged patient needs.

Continual growth, improvement in overall health and wellness, and resilience characterize effective aftercare plans. Following through with one’s aftercare plan is the key ingredient to experiencing the multiple benefits of successful recovery.

Ken Smith, LCSW
Clinical Director
Tully Hill treatment & Recovery

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The Vase, The Coin, and The Gift

How grief comes into our lives and making room for it.
By Gregg Snook M.A., NCC, LPC

So, recently I have had many conversations with people who have lost someone they loved. I find people rarely label the feelings that come from something changing or ending as “grief” unless it has something to do with someone’s death. It is reasonable to consider the connotation of grief as only applying to the death of someone who mattered to us, but I propose the following: grief is a feeling that occurs when our lives irreversibly change and we struggle to adjust to the cognitive, emotional, situational, and/or relational changes. I plan to write more about the different ways that grief enters our lives but today I wanted to focus primarily on how, when, and what we can do when grief comes to us.

Experience of grief.
Grief, as an emotion, can be one of the worst experiences of our lives. The turmoil, worry, confusion, sadness, anger, desperation, and hollow feeling that can result when someone we love passes away can be something that we fear with great trepidation. When it occurs, the overwhelming feeling often escapes the description of words. We express it in sleepless nights, tears, anxiety, fear, and sadness. First, I want to discuss why these feelings, intense and ominous, occur within us after we lose someone.
I like to ask people to reflect on this idea: grief exists on one side of a coin, on the other side is love. This idea is echoed in writers such as Kubler-Ross, Kessler, and Worden. The more intensely we love someone, the greater feeling of grief that results when they leave us. We live our lives with the experience of those we love and we feel it, in many ways, when they depart from our lives.

Grief as a gift we never wanted to receive.
I am sure the idea of grief as a gift is something that is contradictory and difficult. When we share our lives with people we love, they impact us. They change how we think, spend our time, and how we remember the time we spent with them. These impacts are kept by us in memories, idiosyncrasies, and many other ways. These impacts are part of what we miss when we lose them. The gift of grief is what we keep and how strongly we realize what we miss. Realizing that our lives have changed and the persistent experience of grief that occurs afterward is the reason why, once we receive the gift, we can never get rid of it.

Grief as a vase.
This is a metaphor I use with clients and support group members to explain how the feeling of grief never leaves us. I hear often that “time heals all wounds.” That one gets around more than requests for “Freebird.” Considering grief as wounds makes sense in how those affected are left with scars, but rather than the idea of “It goes away with time,” I like to remind people that in healing from grief, the feelings never go away; instead, they change.

The gift of grief is a result of the deep feelings of connection and love we had with the person we’ve lost. But this is a gift we never want to receive. Now to the metaphor. You receive a gift of a vase in the mail one day. You are unsure from where it came or from whom. Also, the vase in question is UGLY. I mean made by a blind person in a horrible mood ugly. It is lop-sided, has the worst color combinations, is disproportional, and has parts that break off, but it can withstand a long drop so it can never be thrown away. Which brings me to why it is a gift that we can not throw away or re-gift. This gift came to us as a result of all of our experiences with those whom we love and have left us. The vase would never have been delivered to us, in all its hideous glory, without first having such love for another person. The gift of the vase is something that represents all of the memories, feelings, hopes, dreams, laughs, and most of all love, that we shared with the person who passed away.

So, what do I do with this vase?
Well, we can’t get rid of it, we can’t smash it, and if we do it’ll still stay with us. Instead, I offer another way to cohabitate with this ugly, disruptive thing. Find out where it belongs. Move it around. Put a hat on it. Put some flowers in it. Collect rain water (tears) in it. Fill it with candy. Do whatever you have to do but do not ignore it. Grief does change as time goes on. The pain never ends but it changes over time. We can take the grief vase and put it on a mantel to observe for months. Then we can take a break and keep it with the holiday decorations. We can keep it in the basement. We can use it as a paperweight, doorstop, a pitcher, anything. We have to get to know it, understand it, and see where it fits into our lives. We will place it in areas that are difficult for us to navigate with it there. Tripping over a vase on your way out of the house will teach us it doesn’t belong there, it will get in the way.

The point of all of these metaphors is that it is a struggle to get used to the feeling of grief when we experience it. The HBO series Six Feet Under described, pretty well, how the average Americans’ approach to grief is very sterile. The main character recounts to someone in the first episode about how in America we clean up the process of a loved one passing and then disassociate from it in order to “maintain our composure.” In many other cultures and countries, death is a very intimate and emotional process of preparing the dead, the funeral rights, and then the aftermath. I, personally, am very fascinated and impressed by the Jewish tradition of sitting shiva. Shiva is a process of grieving in Judaism of observing a person’s death with great attention for a period of about seven days. During this period, the tradition involves sitting on hard chairs and fully experiencing the emotions of the loss. This experience can be shared by others as a way of fully processing what it means to us to lose someone we loved so greatly and meant so much. A full range of emotion, however, can be incredibly difficult, overwhelming, and taxing.

T.E.A.R Model.
William Worden is a psychologist who worked to develop the T.E.A.R. model to address grieving as a process. This is a model I use often when addressing grief issues with clients and it is more dynamic than the precursor work of Kubler-Ross (which has become more nuanced with time and was a major part of developing all grief work by starting the conversation). The T.E.A.R model suggests that there are four tasks of grieving in order to complete and regain equilibrium after experiencing a loss. The first task is working To accept the reality of the loss. This can be difficult, as we often experience times where the loss feels so great that we can’t “accept that they are gone.” The second task is Experiencing/addressing and working with/through the pain of the loss. This is how we get used to our vase and try out the most appropriate place to have it in our lives. The third task is Adjusting to a new environment formed from the loss of our loved one. The fourth and final task is find a new and meaningful connection with the deceased and Reinvest in the new reality.

The way I explain this to people is that the process of the tasks is like accepting the delivery of the vase, really seeing how ugly it is, figuring out where to put it, and remembering why we received it in the first place. The ugliness of the feelings of grief can, again, be seen as how much the person meant to us. As Kessler says, grief is the other side of love.
Addressing our grief is WORK. There is a lot of relief in having time to ourselves when we are faced with grief but this can also be met with how lonely it can feel when others in our support system “move on” and we feel left alone with a menacing feeling: grief. When we love someone, they impact our life. We experience the side of the coin that holds love and connection. When they leave us (through death, separation, or other things), we experience the other side of the coin: grief. We grieve as strongly as we love. We cannot have one without the other or we would never feel the impact of the loss. When we are faced with the experience of that emptiness, we experience grief and can choose to do things that make it meaningful for us. I will write more about the tasks later. In this article, I wanted to talk about the feelings that occur and what we do with the change that comes with loss. The first part is the feeling.

If you are a person who is suffering with a loss and are ready to explore your feelings of grief and loss, please reach out for help. This can be in the form of a support group, a trusted friend, a member of your faith community, or other supports.

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Safe Injection Sites- Where’s the spot?

What we know, as of now, about injection sites.
I am sure you have heard in the news about the controversy regarding the possible Safe Injection Site that is being planned in the Kensington section of Philadelphia. Depending on who you speak with, it may be a hot topic. I assume there is a lot of opinion associated with a safe injection site and not a lot of policy or approaches. It makes sense. The idea of having a place where drug use is encouraged seems completely counterproductive to the mission of a safe injection site. I think the emotion behind these positions and arguments made for them comes down to the difference between abstinence and harm reduction. It is my hope in this editorial that I can provide information rather than address the merits of either position.
The safe or “supervised” injection site that is currently being discussed to open in Philadelphia, called Safehouse, aims to provide an environment that allows for safe oversight of substance use in order to prevent overdose deaths and possibly connect users to treatments. According to the Safehouse website, the facility hopes to: encourage treatment, reduce harm, provide a sterile means of consumption, reverse overdoses, provide wound care and basic medical services, provide onsite education, provide referrals to mental health/substance abuse services, offer safe disposal of supplies, and offer medication assisted treatment.
The site explains how interested individuals would use the safe injection site. First, users are registered at the site, almost as though it was a gym membership. Then, members are able to be provided with sterile equipment, test strips to examine if there is fentanyl (a strong analgesic that often contributes to overdose) in their substances, and they are given a space to use their substances with supervision. Members are NOT provided with any drugs at the site. Employees of the site will NOT aid in the administration of any substances. The substance user is observed by staff in order to identify and prevent overdose in the user. Then, substances and equipment used during the process are disposed of. Users are offered wraparound services and basic medical support. This last part can seemingly include things ranging from a bandage or referral to supports or treatment.
The site stresses that it does not provide, sell, or supply any substances to users (users presumably, provide them on their own). Nor do they assist with the administration of any substances (they’re not helping any one shoot up or consume other substances).
Philadelphia is not the first place to consider having a safe injection site to address the issue of opioid use in the community.
The idea of a safe injection site is not necessarily new. It is reported that there are approximately 120 safe injection sites in Europe. It is also reported that there has been a safe injection site in Vancouver, Canada for about 10 years now. It is reported that no deaths have occurred at any of these sites, and overdose fatalities decreased by 35% in Vancouver after the site opened.
These numbers can be seen as a success regarding mortality rate. It is not unreasonable to discuss how people using these sites would recover or stop using drugs. It was reported that participation in detox services increased by 30% after the site opened in Vancouver. Approximately 52% of IV drug users (injecting drugs) sought treatment. These numbers seem to provide information regarding those who may seek out treatment to work towards possibly not using drugs further.
According to a recent report on National Public Radio (NPR; heard by me on WHYY), an article titled Researchers Released New Data on Secret, Illegally Operating Supervised Injection Site in the U.S. discusses part of the plans and factors for the site. This article discusses how the Philadelphia Inquirer ran a poll and found that 67% of those whom responded were opposed to the site and 22% supported it. Another poll referenced in the article, conducted by the Pew Foundation, reported that 50% were in support and 44% were opposed. The article also reported that more than 1,100 individuals died of drug overdoses last year in Philadelphia.
The community is also important to consider when thinking about the Safehouse injection site. Another NPR article, entitled Kensington Neighbors Angered by Potential Location of Supervised Injection Site, discusses information gathered from residents of the Kensington section of Philadelphia, as well as legal challenges to the site. Brian Abernathy, the director of city management, is reported to not be in support of the location. He is reported in this article and others to be interested in the legality of the site and the benefits to the city. Former Governor of Pennsylvania, Ed Rendell, is a backer of the site and supporter. Another city organizer was reported to have visited an injection site in Toronto, Canada and voiced concerns about the difference between the settings in Canada and the presumed site in residential Kensington. The concerns were regarding how well concerns about use could be contained in a residential area. It was also reported in the article that Pennsylvania State Attorney General, Josh Shapiro, favored another strategy to remove drug dealers from the area via legal involvement.
There is a legal contest to the site by the Attorney General’s office to the site. The legal contest seems to be a result of a war-on-drugs legislation from the 1980’s that extends penalties to any place of business that may be used in or housing the sale of drugs. In some of the reading, the law was summarized as saying that law enforcement can target things like raves or business that engage in the sale of drugs “out the back door” or in addition to another business in a place that was established under legal pretenses. The position of Managing Director Abernathy (seems to be investigating if this law, or laws like it, can apply to the safe injection site (WHYY article Federal Prosecutors Sue to Stop Nation’s First Planned ‘Supervised Injection Site’ in Philly). On a larger scale, the community organizers and the Attorney General seem to feel that the site would increase risks to the residents in the Kensington section of Philadelphia already living in what is often referred to as “the largest open-air drug market in the United States.”
The concerns of those who oppose the site seem to focus on a purported impact. It is reasonable to consider the difficulty in instituting something that may not be new in other countries, but is new in the United States. Below is a pie chart from the website for crime in the time between April 12, 2019 and May 12, 2019. The section for “narcotic/drug law violations” was reported to number 140 offenses, accounting for 21.24% of crime in 30 days.

The proposed safe house site is reported to want to work in tandem with the community and local law enforcement, with the goal of decreasing drug-related crimes in the area. According to projections, the site is expected to save the city of Philadelphia approximately two million dollars, mostly in response costs to drug-related issues such as overdose and ambulance rides. Considering that reported crimes in Kensington also includes public intoxication, drug possession, drug paraphernalia charges, and the like, it would make sense that those crimes may decrease if they were contained in a safe house site (assuming the legal contest does not prevent it on the grounds of all use being illegal under federal law). Benefits could also manifest in other ways, such as lowering costs of responders to drug-related health issues (as Narcan is administered in the site), as well as preventing the sharing of needles with the safe observation and disposal that could occur at the site. When the needle exchanged opened in Philadelphia in the 1990’s, it was reported that the HIV rate of transmission via sharing of needles decreased by 95%.
It is also reported that there are conversations occurring in the state of New Jersey and the city of Pittsburgh regarding safe houses. It seem as though the discussion of safe injection sites may be occurring in different areas to address the problem of opiate use and resulting health issues.
As I stated above, I did not want to write this article with the goal of supporting either side of the safe injection site debate. Instead, I wanted to collect information from sources in order to more fully understand the intention of the site and understand the views of the opposition. It is reasonable to consider that the idea of an organized place that helped people get drugs and use them would be absurd. It is also understandable that individuals may feel differently regarding the intentions of the site based on their expectations of the problems it hopes to assess. This again brings us to the difference between abstinence and harm reduction. The position of abstinence based solutions attests to individuals ceasing their drug use entirely. The position of harm reduction asserts that addiction can be a complex issue that often results in relapse. Harm reduction asserts that having options for safety to be considered in someone’s addiction in order to prevent death. This in the hopes that their recovery (ceasing of using drugs in maladaptive and disruptive ways) can eventually be addressed through some kind of treatment. Some of the data from sites in other countries indicate that these sites can lead to individuals connecting with resources and support that would be easier to access due to them being at the site, being registered, and, therefore, available to those who can point them toward treatment options.
The issue seems to be in the planning stage for at least the past year. The legal contest occurred in February of 2019. There will be more to come as the community, site, and authorities consider the site moving forward. The desire of wanting to provide help for those who are using, as well as the concerns of those who are considering the ramifications of having a site in their community will also need to be addressed as time moves on.
To the readers, I would suggest, should you be interested, to continue to read about things that may come out regarding the Safehouse Injection site. This seems to be a complex issue with a lot of people concerned about the well-being of people in the community, as well as those who are struggling with the use of addictive substances. I hope this article was informative.

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What Are NA Meetings?

Opioid addiction is one of the nation’s most pressing public health issues. Clinical opiates either prescribed to patients or secured illegally are highly addictive, which can lead to drug dependency. Morphine, Oxycontin, fentanyl, and heroin create addiction levels that require intense clinical and behavioral rehab. However, once rehab is complete you’ll need to find support to curb your addiction. This is when you may ask, what is narcotics anonymous and how can NA meetings help?
Anyone addicted to opioids knows that the addiction can lead to problems. These include maintaining focus or a productive job, social and personal connections, and other critical components of a stable life. In addition, this means that families and caretakers should consider connecting their loved ones with a local narcotics anonymous (NA) chapter and attend their NA meetings in Levittown PA.
So what should you know about NA if you have a close friend or family member struggling with opioid addiction? Where can you connect to local Narcotics Anonymous meetings around Levittown, PA?
What is Narcotics Anonymous?
Narcotics Anonymous (NA) is an organization committed to ensuring that addicts have resources, support systems, and community members to help stabilize their life. NA operates the same way as alcoholics anonymous through a non-profit network of support groups, outreach, and education to help addicts take control of their life.
Created in 1953, the organization holds an international network of support centers and addict sponsors. Per the website: “Narcotics Anonymous is a global, community-based organization with a multilingual and multicultural membership.”
In the United States, NA holds thousands of meeting groups and is accessible to all addicts in all 50 states. Some states may have hundreds of meetings while some can even have over a thousand.
What Does Narcotics Anonymous Do for Patients Struggling with Addiction?
Also, just like other types of support groups, NA meetings help patients by hosting meetings and sponsor support for addicts across the country. In addition, a few types of lifestyle supports offered through NA include:
Accessibility to educational materials for addicts with certain disabilities including sign language resources
Free literature to help addicts understand where they can find help
Free support groups with sponsors available for individuals
Search tools online to help find a meeting nearby
Additionally, patients can find local regional chapters to learn more about lifestyle supports, job openings, and other organizations to help get your life back on track.
Find a Narcotics Anonymous Near You
In conclusion, if you or a loved one is struggling with opioid dependency and morphine dependency, then it may help to take them to find NA meetings in Levittown, Pennsylvania. Steps to Recovery can help patients connect with a local NA chapter to ensure that rehab and treatment are working to create a better lifestyle.
Do you want to know what is narcotics anonymous? Are you ready to take the first step? Patients that have any questions about our services should call us directly at 866.488.8684 to see what treatment and rehab options work for their needs. NA is a great tool to help you manage the daily struggle of opioid addiction.
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Can Depression Make You Angry?

By Gregg Snook, M.A. NCC
Good morning all!
Recently I was listening to NPR and they did a small segment on anger and its relation to depression. You can listen to it here. It is an interesting look at depression being more than what we typically think; Sad.

The idea of depression can be recalled through figures like Eeyore, from Winnie the Pooh, or the little comma from the Zoloft commercials in the 90s. Rarely would we think of Frank Costanza as a depressed person when he is celebrating Festivus, or a stand-up routine by Lewis Black.

I first bring up Eeyore because, I find, the typical description of those whom may be addressing symptoms or Major Depressive Disorder expressing feeling low, sad, or unmotivated. Some people may even recognize at some point in their life hearing or saying “I feel depressed”. This is not to say all depressed people are angry but instead considering typical examples we see in entertainment or literature.

The Zoloft commercial from the 90s was, in my opinion, America’s first lesson on Neuroscience. That sad little comma hopped across the board with a solemn look on it’s face while the narrator described the feelings of depression. We later see how chemicals are exchanged in the brain through synapses to explain how the medication worked.

This article is more focused on what could be going on in Frank’s mind. Frank Costanza, another character George’s father on Seinfeld, is best known to me in the Festivus episode. Frank was often seen as “giving people the business” and could be described as a pragmatic grump. In the Festivus episode Frank famously said “I got a lot of problems with you people and you are going to hear about it”. I am not making attempts to diagnose a fictional character but instead chose him in order to show how some depressed individuals may manifest with anger.

I am sure some, if not all of us, have dealt with someone that is loveable at times but often critical, easily angered, or just grumpy. That ‘grumpy’ may be a byproduct of someone experiencing, and maybe being frustrated with, Major Depressive Disorder. That person whom could just want so badly for things to go their way. Or maybe who had “a lot of problems with you people…”.

The typical symptoms listed in the DSM-V for Major Depressive Disorder, or clinical depression, are: depressed mood, diminished interest in things or activities, weight loss or gain, sleeping too much or not enough, psychomotor agitation or retardation (fidgeting or sluggishness), fatigue, feelings of worthlessness or guilt, difficulty concentrating, and thoughts of death. For the sake of this piece, it is important to note that anger is not present among these symptoms.

So what do I do, Gregg? Do I go to my doctor and yell at them and tell them how angry I am? I wouldn’t advise it…depending on their reaction it may not end how you hoped, which is part of why I am writing this piece. How easy is it for all of us, including professionals, to overlook anger as a part of being depressed? Very difficult! So, when our friends, family, co-workers, paramours, or children are angry with us, it is very easy to become defensive, blaming, or dismissive when they may need us to be understanding. It is much more difficult to be curious and understanding in these times when others are angry.

Gregg, what can I do if I am angry and this is related to my Mood Disorder? Well, as always, be kind to yourself in these times. It can be really difficult to go through a cycle of emotions, which lead to anger, impulsive actions or miscommunications, and then regret and shame. Doing your best to communicate what you are feeling to those who can be patient and supportive may help. The old recovery adage of “mix it with air” has been around because, well, it seems to work. You don’t hear people saying “open those canned beans with a stapler,” because it does not work.

Gregg, that’s how others can treat me! What can I do for myself? Well, Anger Management techniques seem to focus on learning how to relax, and CBT techniques show us how to develop and use other Anger Management skills. You can learn more and find resources about Anger Management here.

There are a number of other things, all of which could be new experiences, that you can try in order to address your anger. I am writing another article in addressing mood disorders or feelings of malaise by walking in nature. There are also a number of meditation apps and videos on YouTube to address calming the self and releasing stress. This is also the part where I say to try to examine your diet, spend time with people that care about you, pet a doggo (preferably a puppy), or something else that may help you relax and take a step back from the feeling of being overwhelmed that anger can sometimes cause.

Remember, regardless of being in early recovery, or struggling another way, you are allowed to have emotions. You are also responsible for what you do with them. I always encourage others to seek support when they struggle in order to not be alone and have more heads, hands, and hearts on the project. When you feel angry thoughts or feelings, look around because anger is often traveling in tow of sad. People say anger is sad’s bodyguard.

Thank you for reading. If there is a comment section below, please feel free to leave a comment or question about what you may want to read about in the future. Share with us what works for you when you are angry. I look forward to reading the “Count to 10, punch a pillow” that everyone thinks of and no one does. I assume also there will be angry comments…because without those it’s just not the Internet.

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A Guide on Rebuilding Relationships in Recovery

Addiction can damage many facets of your life, including your relationships. Rebuilding relationships in recovery and family therapy needs to be done with care. Your friends and loved ones do not enjoy watching you spiral down into the throes of addiction. Before you approach people about your sincere apologies, make sure that you take a hard look at yourself and know exactly what you are sorry for.
Rebuilding relationships in recovery simply cannot be on your terms. You are going to have to allow the people that you want to reconnect with to make up the terms themselves. People will probably want evidence that you are better, they will need to watch you do well for an amount of time before trusting you enough to be forgiving.
Start By Forgiving Yourself
If you hold resentments and anger toward yourself, you will need to work through them in order, to be honest in your apologies to others. It’s like they say, you can’t love someone if you don’t love yourself. You can’t ask someone for forgiveness if you can’t forgive yourself. This part is about taking a good look at things and taking responsibility for the things you have done in your mind. Once this step is completed, you can move on.
Don’t Expect Too Much
Just because you finally figured it out and got sober, does not mean that your family and friends should be celebrating you. They are more likely to be like, wow finally. Don’t be hurt when your sobriety does not garner positive attention, stay focused on being sober, do not get upset with your friends and family for holding a grudge for longer than you see fit, be patient with them when rebuilding relationships in recovery.
The Ones You Owe The Biggest Apology To
For people that you have hurt over and over don’t keep saying you are sorry over and over again. Make sure that they know that you are healthy and functioning and that they are at the forefront of your mind at all times. Actions speak louder than words:
Help with things even when not specifically asked to
Lend an ear when it is needed
Be there for them
Continue acting this way to show them consistently that they do matter to you
This is a big one. When you go to apologize to someone, don’t make up excuses about why you did something, or how you are so different now. Just tell them that you are sorry and allow them to talk. Also, this is their time to get things off their chest about you. If you let them do this; things are likely to smooth over. It may not be easy to hear what this person has to say, but you owe them that much at the least.
Be Tolerant
In essence, tolerance is a learned skill. Addicts can have a tough time with tolerance. Be tolerant with the ones you love, especially while you are in early sobriety. During the early stages, you can be quite irritable and anxious. Dial it back a bit and allow people to be who they are character defects and all.
Be Realistic
When rebuilding relationships, you need to consider the amount of damage that has been done. You may never be able to reform some of your old relationships due to your addiction. Be realistic about it and know that it is OK.
Believe That Everything Will Work Out
As long as you are working on yourself and staying positive things will work out while rebuilding relationships in recovery.
For example, here are a few things you will want to do:
Approach people with care
Be sincere in your apology
Accept their reaction
And make a note to not do these things:
Make excuses for your actions
Tell people that they need to be better
Be impatient
Know That You Deserve To Be Loved And Will Be
It’s important to remember, no matter how your loved ones and friends take your amends, even if they all leave. You will find love and acceptance elsewhere. People need you, people love you, and people are out there all over the place waiting to meet you!
Start Rebuilding Relationships in Recovery
One final thought. Family therapy is one of the ways clients begin rebuilding relationships in recovery. Steps to Recovery in Pennsylvania offers family therapy programs along with inpatient and outpatient rehab programs Give us a call today at 866.488.8684 to find out more.
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What Causes Addiction

Many people wonder what causes addiction. Initially, people believed that addiction was simply a black and white choice. And that people that fell prey to it did so because of moral shortcomings. This is no longer the case. As science has progressed, we have learned that addiction can stem from many things.
Currently, people see addiction as a disease. This point of view is controversial, but it is more important to not see addiction as a judgment of character. It is treatable. The underlying theme behind what causes addiction is that a person finds relief of some sort from using substances and over time, their brain physically changes, and they become addicted.
What Causes Addiction?
As mentioned above, a person uses substances to achieve relief from symptoms of other underlying problems the structure of their brain changes, and they become addicted. Substance abuse affects three main areas of the brain; they are the prefrontal cortex, the basal ganglia, and the extended amygdala.
Here is the role that each plays in your brain:
Prefrontal Cortex
This area is where your conscious decision making takes place. You can gauge need from other parts of the brain and control your impulses accordingly. When you change your brain to think that you need substances, your prefrontal cortex will prioritize obtaining substances over other actives like working, and that can become a problem.
Basal Ganglia
Known as your reward center, when this area of the brain is on you feel good or motivated to do things like socializing or eating. Ingesting a lot of substances over time will overstimulate this area of the brain, and when you are out of substances, it will send signals to the rest of your brain to get more.
Extended Amygdala
This area of the brain is responsible for making you feel irritable and anxious. If suffering from addiction, when you stop using this area of your brain becomes overstimulated and sends signals to the rest of your brain to obtain more substances.
Through the changes made in all three part of the brain, a negative feedback loop is created, and the more you use, the harder it is to stop because your brain is working against you. If you have ever been to an AA, NA or other 12-step meetings you may know that the first step is to admit that you are powerless over alcohol, which is shown to be true through science.
The Inability to Control Consumption
The inability to control consumption due to the structural changes that have taken place in your brain renders you an addict and powerless over your drug of choice. This is why it is so hard for chronic users to stop use; they no longer have the ability to make rational decisions around using. It is important for people to seek help of some sort to put an end to the damage.
People with an addictive personality are likely to have brains that are more easily reshaped than others or underlying issues that lead to chronic use. People with the following underlying conditions often have addictive personalities. These conditions can also lead to drug use as a form of self-medication which is possibly what causes addiction in some.
Obsessive-Compulsive Disorder
Anxiety Disorder
And More
Taking the First Step
The trick to finding help with addiction is to be sure that you are getting help from people that can assist with all of your problems. If you have underlying OCD that makes you compulsive, tell your caretakers. In order for you to get sober and stay sober, you need to work on all of your problems. Steps to Recovery is a holistic rehab center that employs licensed professional that can help you heal on all levels, and learn what causes addiction. Give us a call today at [Direct] to find out more.
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Steps to Recovery Incorporates Innovative Technology into Their Treatment Paradigm Target Market

Press Release – Steps to Recovery Incorporates Innovative Technology into Their Treatment Paradigm
Target Market – PA
Steps to Recovery is announcing the addition of an innovative technology that will be used in their treatment approach for all addictive behavior treatments known as the GARS® test. GARS® by MyGenx® is the first and only patented genetic test that identifies a person’s risk to substance and non-substance behaviors. Through a non-invasive cheek swab, the GARS® test stratifies a person’s risk to many different substance and non-substance behaviors including alcohol, opioids, stimulants, online gaming, gambling, and more. Steps to Recovery will be incorporating this new science to personalize their treatment approach. “As we continue to expand our understanding of addiction and learn about new, innovative practices, we are constantly looking for ways to enhance the care that we provide to our patients. Incorporating GARS® into our protocols will allow us to personalize our treatment plan one step further” says Ryan McCarthy, CEO at Steps to Recovery.
Steps to Recovery isn’t just going to offer GARS® in their addiction treatment center, but STR is looking at ways that this could serve as an opportunity to provide early intervention within our community.
The greatest value of the GARS® test, is that when it comes to genetics and addictive behaviors, genetics only make up 50% of the equation, a person’s environment or exposure to risks make up the other half. All of us go through life without knowing what different substance or non-substance behaviors we could be at risk to. Imagine now knowing this information. A person would have the ability to make lifestyle changes to combat and reduce triggers for these addictive behaviors. “Steps to Recovery does not just want to be known for helping treat addiction, but we want to do our part by helping challenge stigma regarding addiction and helping provide interventions as early as possible. We want to work with our community partners, school districts, local PTOs, local townships, county municipalities, church groups, and really anyone with a larger reach to get the word out about early steps that we can take!” states Manuel Rivera, MA, LPC, NCC, Clinical Director at Steps to Recovery.
MyGenx® by Geneus Health, the company that created the GARS® test, has recently launched their national awareness campaign. “As we continue to expand the utilization of GARS® we are extremely humbled by this partnership and look forward to working with Steps to Recovery to bring this new genetic technology to Philadelphia and the state of Pennsylvania. What they (Steps to Recovery) are doing is truly remarkable…it is not every day you hear about an addiction treatment center putting such a genuine effort in early intervention” says Justin Jones, Geneus Health CEO.
Kristina Kipp, PharmD at Penn Med is a big supporter of this new technology. “Addiction is a complex disorder, and the more information we can obtain, the better decisions healthcare providers can make, to offer the most optimal treatment. Just like with any disease state out there, the best way to tackle it, is through prevention. I think it is outstanding what Steps to Recovery is doing on the preventative side. Think alone how this could impact the opioid addiction crisis, by better informing providers of a patient’s potential risk for addiction.”
Steps to Recovery will be offering this new genetic test starting at the end of this month. For more information, visit their website at
About Steps to Recovery
Steps to Recovery is a program owned, operated, and driven by compassion. Our mission goes beyond treating the addiction, STR’s goal is to engage each individual in realizing their full potential. It is our fundamental belief that when people are cared for through empathy and innovative practices, the stage is set for meaningful reflection, expression, and ultimately, growth. The intimacy developed between the team and client acts as the foundation for individualized care.
Our staff embraces the idea that we can help clients by supporting them to understand themselves better and seeing recovery as a new way of life instead of a barrier to the way they want to live. We do this by offering our core values through every encounter; Authenticity, Connection, Integrity. We want each client experience with us to be so special that it is carried throughout their recovery journey. To learn more, visit
About MyGenx®
MyGenX® is a division of Geneus Health, a genetic testing company based in San Antonio, Texas. We focus on proactively providing our customers with scientific genetic information and neuro-nutrient supplements, through DNA testing, to help them live their best possible life. To learn more, visit
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What to Bring to Rehab

When people go to rehab for the first time, they often wonder what they should take. Every rehab center is different with regard to what they allow inside of their facilities. When you decide what to bring to rehab, there are a few necessities that you should pack. While most rehab centers allow these necessities, it’s still good to contact your facility beforehand to learn about specific rules.
What to Bring to Rehab
If you enroll in an outpatient program, you won’t have to take much with you. The reason is that you won’t live at the rehab center. Instead, you’ll return home every day after you receive treatment at the facility. However, residential rehab requires you to take certain items because you’ll live there.
First, remember to pack clothing. In most cases, it’s a good idea to take about seven days of clothes. Then, you won’t have to do laundry too often. When you pack, don’t forget pajamas for the evenings. You may even want to pack a light jacket depending on the time of year and your rehab center’s location.
Also, you should take your own personal hygiene products, including razors, shampoo, and toothpaste. During rehab, you’ll get to go to the store. However, you need to make sure that you have products to get you by until then.
It’s a good idea to take a small amount of cash with you as well. You can use this cash for shopping trips or to buy items from vending machines. Many rehab centers have on-site vending machines with snacks and drinks.
Can You Take Medication?
Pennsylvania addiction recovery services allow patients to bring certain medications. For example, you can typically take over-the-counter drugs such as ibuprofen or Imodium. However, you can’t take any medication bottles or containers that are open. The purpose is to ensure that you don’t try to sneak other drugs into the facility.
Another thing to consider for what to bring to rehab is prescription medications that you might need. Keep in mind, however, that you can’t take prescription painkillers. In many cases, rehab centers are helping people stop using narcotic pain relievers.
What Not to Bring to Rehab
While there are many things that you should or can bring, there are some things that you shouldn’t. Obviously, you shouldn’t take illegal drugs or alcohol with you. You also shouldn’t take weapons or pornographic materials.
When you inquire about what to bring to rehab, electronic devices typically aren’t on that list either. Laptops, iPads, and cellphones are items that you should leave at home. These belongings will distract you from focusing on treatment.
Reach Out to Us to Learn the Truth About Rehab
Do you need to know more about what to bring to rehab? Maybe you want to know more about the programs in which you can enroll. In either case, reach out to Steps to Recovery. Some of the programs that we offer include:
Individual and group therapy
Partial hospitalization program
Intensive outpatient program
Standard outpatient program
Trauma therapy
Don’t let drug addiction ruin your life or the life of someone you care about. Get the help that you need to kick the bad habit. Contact us at 8664888684 to learn more about what to bring to rehab.
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OCD and Addiction — Is There a Connection?

It’s not always easy for people to understand obsessive-compulsive disorder (OCD). Only a select few people can wrap their heads around this mental illness. One element that most people don’t know is the strong connection between OCD and addiction. Why is there a link between these disorders, and how do people with OCD get help for addiction.
Understanding OCD
Before people can seek treatment for OCD and addiction, they have to know that they have OCD. Unfortunately, a majority of people who have it never seek treatment.
Characterizing OCD is hard because everyone experiences it to a different degree. In general, it occurs when compulsions and obsessions have traits such as:
Consuming a large amount of time (more than an hour each day)
Causing a lot of distress
Interfering with daily life, including social activities, family, relationships, work, and school
Making it nearly impossible to concentrate
Engaging in compulsive behavior
Not everyone who experiences fear, worry or doubt needs an OCD treatment program. In fact, it’s normal for people to have these issues from time to time. Once these worries interfere with daily life, it’s time to get help.
OCD and Addiction
Understanding the link between OCD and addiction isn’t very hard when people learn that both are mental disorders. Those who have one disorder are susceptible to others. However, OCD is a bit more common in people with addiction. What comes first, though — OCD or addiction?
In most cases, OCD comes first. Then, people use drugs and alcohol to mask the anxiety and depression that they experience. Some people have these symptoms on a daily basis and don’t express that it bothers them. Instead, they turn to drugs.
How Can Rehab Help?
Now that people know the link between OCD and addiction, it’s important to know that rehab can help. Some rehab centers offer a service that addresses both addiction and underlying mental disorders, such as OCD. This service is a dual diagnosis or co-occurring disorder treatment.
This treatment is helpful because it helps people overcome both issues. Failure to address OCD often results in relapse. After all, it’s a common cause of addiction.
Without professional help, people can’t learn to manage either problem properly. In many cases, they refuse to seek professional help on their own. At this point, it’s up to family members to get them the help that they need.
Turn to Us to Get Help
Are you looking for Pennsylvania addiction recovery services? If so, consider getting help at Steps to Recovery. We’re a Pennsylvania rehab center that takes great pride in offering co-occurring disorder treatment. However, we offer a lot more than that, including:
Intensive outpatient program
Outpatient rehab
Partial hospitalization program
Group and individual therapy
Gender-specific treatment
Don’t give up on addiction treatment just because you have OCD. Find a treatment program that can help you with both OCD and addiction. Start by giving us a call at 8664888684.
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