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What are Veteran Treatment Courts and how do they help?

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What are Veteran Treatment Courts and how do they help?

I host a radio weekly internet radio show on the VoiceAmerica Empowerment Channel called Life Altering Events (https://www.voiceamerica.com/show/3902/life-altering-events). People often ask me what exactly is a life altering event? I tell them this – It can be something we choose or something that is thrust upon us that dramatically alters the trajectory of our life.

On September 10, 2019 we will have a discussion about the Veterans Treatment Court program. My guests will be the Honorable David Abbott, presiding justice over the Sacramento, CA Veterans Treatment Court and Cindy Baldwin, a consultant with the California State Senate on Veterans Affairs Committee.

The choice to enter the military is a major life altering events. Most men and women enter the service between the ages of 18 to 22. At this young age, they have not had many life experiences. For many it is their first time away from home.  The military gives them a sense of purpose, a mission and provides self-esteem as they serve an important role within an organization. Some will stay and make the military their career. Most will not.

Given that the United States have been involved in war(s) or police actions or peace keeping missions, (call it whatever you like), for most of the 21st century these young service men and women have been exposed to many horrendous situations. They have seen and/or done things that no one should ever see let alone 18 to 22 year olds.

When their time of service is over, they go from being part of something bigger than themselves, something that give them a purpose as a warrior back  to civilian life as an unemployed and often hard to employ individual with no real purpose. The vast majority of our service men and women come home very different than when they joined. Many are physically disabled. A large number come home with some type of addiction. Almost all have suffered a major trauma such as Post Traumatic Stress Syndrome (PTSD) or Traumatic Brain Injury (TBI).

Sebastian Junger writes in his book “Tribe,” Humans don’t mind hardship, in fact they thrive on it; what they mind is not feeling necessary. Modern society has perfected the art of making people not feel necessary. This is particularly true for returning veterans. Their homecoming is better than it was for Vietnam veterans. Most people are quick to say “Thank you for your service,” which makes most veterans feel good for a moment, but what they really need is a job, a purpose, and to become part of a new community.

So our heroes try to assimilate back into a society where, at least initially, the cards are stacked against them. Many need help and treatment for their physical, mental, emotional, psychological, chemical and neurological disabilities/disorders. This further delays their successful re-entry process. They are told they must change, that the civilian world does not necessarily value their skills. Mark Balzer writes in his book “The People Principles,” Most people don’t hate change; however, people do hate being changed. What people want is to feel valued for who they are and what they do. Too many of our returning veterans do not feel valued.

As their frustration, anger and often depression increases some veterans become increasingly dependent on substances such drugs or alcohol to help them cope. Some are arrested for non-violent crimes such as DUI’s, or possession of a weapon or drug. They are not criminals they just need help. Treatment not punitive action is by far the best course of action. Fortunately Judge Robert Russell from my home town of Buffalo NY launched the first of the nation’s roughly 260 Veterans Treatments Courts in 2008.

What is a Veterans Treatment Court (VTC)?        With slight modifications, it follows the essential tenets of the 1997 U.S. Department of Justice publication, “Defining Drug Courts” a VTC is as follows:

  • The VTC model requires regular court appearances, as well as mandatory attendance at treatment sessions, and frequent and random testing for drug and alcohol use.
  • Veterans respond favorably to this structured environment, given their past experiences in the Armed Forces. However, a few will struggle, and it is exactly those veterans who need a VTC program the most. Without this structure, these veterans will reoffend and remain in the criminal justice system.
  • The VTC is able to ensure they meet their obligations to themselves, the court, and their community.

In short, the VTC says to our veterans, since you served our nation with honor and during your service you suffered a disorder or disability, you now have the ability to seek the treatment that will help you address the underlying reasons for many of your challenges. The VTC is a challenging program and the vast majority of veterans that have enrolled in the VTC successfully complete the intensive program and are able to take the next step toward a productive life.

While very helpful, VTC alone is not the end of the journey. Once the veteran has a better handle on the underlying issues, they still need to develop the transformational skills to secure a job, or career and a fulfilling life.

A new organization that helps our VTC graduates and other veterans develop transformational skills is Awakening Wholeness Inc., https://awakeningwholeness.org/ a charitable organization. Awakening Wholeness, Inc. (AWI), mission is to positively impact the lives of the people we serve by providing transformational educational programs that build character, instill life-enhancing values, and promote healthy choices. Our goal is to equip the people we serve with all the tools they need to become physically, mentally, and spiritually ready to live productive, fulfilling, and sustainable lives.

Why do we need Veterans Treatment Courts and organizations like Awakening Wholeness? Let me give you some facts:

Most veterans are strengthened by their military service, but the combat experience has unfortunately left a growing number of veterans with issue such as PTSD and traumatic brain injury.

  • One in five veterans has symptoms of a mental health disorder or cognitive impairment.
  • One in six veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom suffer from a substance use issue. Research continues to draw a link between substance use and combat-related mental illness.
  • Left untreated, mental health disorders common among veterans can directly lead to involvement in the criminal justice system.

Let me give you some frightening statistics:

Suicide – Between 20 and 22 veterans commit suicide daily.

Homeless

  • Over 630,000 homeless people in America. 67,495 are veterans.
  • Over 1 in 10 homeless people in America are veterans. Source Military Wallet April 10, 2019
  • Over 968,000 veterans lived in poverty in the last year.
  • 20,000 veterans with government sponsored mortgages lost their homes in 2010.
  • 76% of homeless veterans experience alcohol, drug, or mental health issues.
  • 2% of veterans ages 18-24 are unemployed.

It’s easy to jump to conclusions, but we shouldn’t. Here is some surprising information about homeless veterans:

  • 89% received an honorable discharge.
  • 67% served 3 years or more.
  • 47% are Vietnam veterans
  • 15% served before Vietnam
  • 5% are Iraq and Afghanistan veterans.

Incarcerations:

  • An estimated 181,500 veterans are incarcerated, including 131,500 in prison and 50,000 in jails
  • 8% percent of all federal and state inmates are veterans
  • 55 percent, of imprisoned veterans told department researchers they’d been told they had a mental health disorder

As Judge Russell stated when he formed the first Veterans Treatment Court, “Treatment not punitive action is by far the best course of action.” The VTC’s are good first step. Organizations like Awakening Wholeness provide that next critical step for successful re-entry.

Don’t miss this enlightening discussion on September 10 at 8:00 AM PST – https://www.voiceamerica.com/show/3902/life-altering-events

 

The Addicted Brain and How to Break Free BY LESLIE CAROL BOTHA

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The Addicted Brain and How to Break Free BY LESLIE CAROL BOTHA

brain2

Do you need caffeine or sugar to help you wake up and/or get through the day?  Do you turn to alcohol or other substances to help you relax and unwind?  Do you hide how much you eat, drink, or smoke? Are concerned about your current dependence on antidepressant or other mood-altering medications? Have you been in recovery, but still have cravings?

If you answered yes to any of the above, then listen to Dr. Hyla Cass share information from her e-book The Addicted Brain and How to Break Free. All too often people with addictive behaviors are subject to judgments from family and friends.  But no one judges them more than the negative messages they give themselves.

Dr. Cass will explain that your addiction is not because you are a “weak” or “bad” person – it is because your brain chemistry is out of balance. She will share how the correct combination of healthy diet and specific nutritional supplements can correct these problems so you can reclaim your happiness and well being.  Tune in September 26th, to Holy Hormones Honey! at 9 am PT for the show!

 

Guest Bio:

Hyla Cass M.D. Nationally acclaimed innovator and expert in the fields of integrative medicine, psychiatry, and addiction recovery, Dr. Cass helps individuals withdraw from psychiatric medication and substances of abuse with the aid of targeted nutritional supplements. She has appeared on Dr. Oz , E! Entertainment, and The View, and blogs for the Huffington Post. Dr. Cass is the author of: Natural Highs, 8 Weeks to Vibrant Health, Supplement your Prescription: What Your Doctor Doesn’t Know About Nutrition, and her eBook, The Addicted Brain and How to Break Free.

Dr. Cass graduated from the University of Toronto School of Medicine, interned at Los Angeles County-USC Medical Center, and completed a psychiatric residency at Cedars-Sinai Medical Center/UCLA. She is a Diplomate of the American Board of Psychiatry and Neurology (ABPN), and of the American Board of Integrative Holistic Medicine (ABIHM).  For more information, visit www.cassmd.com. 

 

Leslie Carol Botha

Leslie Carol Botha, host of Holy Hormones on the VoiceAmerica Health and Wellness Channel, is a Women’s Health Educator and Internationally Recognized Expert on Women’s Hormones and Behaviors. She is the co-author of the highly acclaimed Understanding Your Mind, Mood, and Hormone Cycle, the first in a menstrual health education series that provides women with the education they never received about how their hormone cycle affects not only their minds, and moods, but their personal and professional relationships and their overall health and happiness.

Botha is a member of the Society for Menstrual Cycle Research, and an advisory board member for the Cycles Research Institute. In 2006, Botha received the Edward R. Dewey Award for her pioneering research on how women’s hormonal fluctuations affect their behaviors. The award was bequeathed by the Foundation for the Study of Cycles.

Her research is also featured in The World According to Cycles- How Recurring Forces Can Predict the Future and Change Your Life by Samuel A. Schreiner, Jr., published by Skyhorse Publishing, New York City. Schreiner has noted that Botha is “one of the most prominent twenty-first century natural cycle thinkers.”

Botha has been a radio broadcast journalist for over 30 years. Her message is loud and clear: it is time for women to reclaim their health, and her passion and drive is to provide information to assist women in making informed choices about their health and well-being.

 

The genetic underpinnings of Alcoholism BY DR SURITA RAO

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Health & Wellness
The genetic underpinnings of Alcoholism BY DR SURITA RAO

 

alcoholism and genetics

 

Alcoholism is a complex disease with genetic factors intertwining with environmental influences to shape both the initial development of the disease and also its future course. Scientific evidence points to the strong genetic basis for alcoholism as a condition for many years. Many scientists in the field of research on alcoholism and alcohol use disorders believe that alcoholism may be a set of similar syndromes rather than a single discrete illness. The genetic factors are complex. There is no “single gene” that determines whether or not someone will go on to develop alcoholism. Rather it is a complex web of inheritance patterns. Certain ethnic groups are also more prone to develop alcohol use disorders and others are protected from it. 

Complex environmental influences play a part in how the genetic factors express themselves. No one inherits a certainty that they will develop alcoholism. It is more accurate to say that people inherit a strong vulnerability to the condition. If their brain never encounters alcohol or another addictive drug, then they cannot develop the disease. 

In our world today, the possibility of never being exposed to alcohol or the peer pressure to drink is fairly remote for most young people. In the United States, there is a lot of peer pressure both overt and more subtle and covert pressures, both in the high school and college years. Better education of our young people about the risks of developing addiction, a devastating , lifelong, chronic, relapsing illness if they experiment with drugs and alcohol, especially if they do have a family history of any addictive illness, would go a long way to reduce the numbers of young people developing an addiction of any type. Patterns of drinking among adults and subliminal and societal messages about alcohol also play a significant role in shaping the behaviors of the next generation and their relationship to alcohol. There are cultures such as France and Italy where wine is served at the table, wine at almost every meal, children may be allowed to taste a sip of wine on occasion, yet the rates of alcoholism are among the lowest in the world. There are also societies where religious or other taboos allow young people to grow up without ever tasting alcohol. However, alcoholism exists in almost every society across the globe. 

How can we best inoculate our children from never developing this devastating disease? There is no one answer. This week, Dr. Victor Hesselbrock, an internationally renowned research scientist in the field of the genetics of alcoholism will be discussing this complex interplay of genetics and environmental factors that lead to the development of alcoholism.

 

Surita Rao, M.D. is the physician leader of the Behavioral Health Services at Saint Francis Care and host of the show, Mental Health with Dr. Surita Rao on the VoiceAmerica Health and Wellness channel. She completed medical school at Bankura Sammilani Medical College in India and did her psychiatry residency training at St.Vincent’s Hospital in Staten Island, New York and the Yale University School of Medicine. She did her addiction psychiatry fellowship at the Yale University School of Medicine. She has been on the faculty at both Yale and Emory Universities. She is an Assistant Clinical Professor with the University of Connecticut School of Medicine. Her clinical work has focused on addiction psychiatry, including both substance use disorders and dual diagnosis issues. She has worked with impaired physicians and other health care professionals. Upon completing her fellowship training, she worked as the Medical Director of the methadone maintenance clinics at Yale University School of Medicine. She has been the Chair of Behavioral Health at Saint Francis since 2002 and is the President of the Saint Francis Behavioral Health Group. Dr. Rao is on the Board of Directors for the American Society of Addiction Medicine and is co-chair of their national membership committee. She is also on the Executive Committee of the Connecticut Chapter. Dr. Rao is chair of the physicians’ health committee at Saint Francis. She also serves on the Board of the Saint Francis Foundation and has been appointed as a Corporator for Saint Francis Care. – 

Addiction : Brain disease or a lack of willpower BY DR. SURITA RAO

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Addiction : Brain disease or a lack of willpower BY DR. SURITA RAO

Addiction-brain-disease

Addiction is one of the most hard wired brain diseases that exists , yet people routinely ascribe it to weakness or a lack of willpower. Complicating the issue is the fact that many of the consequences are social ones such as legal charges, financial problems or the impact of the addictive illness in a person’s relationships with friends and family. A patient suffering from alcohol or drug dependence may appear to be rational but when it comes to picking up whether to use or not or whether to tell the truth about what they are doing and how to go about it, they may not be using the rational part of their  brain at all.

 The Mesolimbic pathway of the brain is responsible for ” drive ” behaviors such as food and sex. The former is necessary to keep the organism alive and the latter to keep the species  alive. It is one of the most phylogenetically old pathways in our brain, one we share in common with animals who are far simpler than us such as lizards. In fact you can think of it as the ” lizard brain” , a part of the brain which is wired to work almost purely on instincts. The disease of addition ” hijacks” this pathway , tricking the brain into thinking that the drug , including alcohol is more important than food or anything else in life, maybe even more important than staying alive.

 In addiction treatment the person is taught to use their brain’s higher centers, those responsible for rational thoughts and inhibitions, such as the frontal  lobe or the cortex to override the ” lizard brain ” when a craving  occurs. The craving may be set off by external triggers or romanticized memories of drug or alcohol use. This is why in the therapies most often used to treat addiction such as relapse prevention therapy , there is emphasis on learning simple , easy to remember techniques and rules which are explained and practiced in a repetitive manner. One example is learning to avoid ” people  places and things” that are associated with the drug use. This may sound simple but can be a complex socially involved process that can eliminate a person’s entire social life and routines and replace them with new ones.

 Yes many people in society believe that addiction is a disease of choice rather than something that happens to us , like  clinical depression. While the patient does have to make a choice to get better or enter treatment or go to a 12- step meeting, these are not simple choices such as turning down an invitation to a party or choosing not to buy something or even have a second drink , may be for most of us. The closest those of us who do not suffer from addiction  can come to experiencing what it would  be like to give up  drugs and alcohol completely would be  for us to give up all sugar and refined carbohydrates. No one  can argue that sugar and refined carbohydrates are necessary foods. Yet we eat them everyday, even though we know they are not good for us. What if you could never eat them again ? No cake, cookies, donuts, bagels white rice, bread that is not one hundred percent whole grain,  and no pasta unless it is whole grain. How many of us could  really do that for the rest of our lives without slipping up , in a world whee these foods are everywhere?

In many ways having an addictive illness is like having heart disease. It is a combination of genetics and lifestyle choices. Getting better from a heart attack involves medications, maybe surgery but also exercising, eating right and reducing stress.  One can go into remission but constant monitoring is needed to make sure that the person stays healthy.

Entering and staying in recovery from an addictive illness can be similar. The patient often enters treatment, either in ” rehab ”  ( residential level of care ) where they go away to a program  and immerse themselves in treatment and recovery or to an outpatient program where they attend group therapy while living at home , still working and doing other everyday activities. 

There are medications available for the treatment of substance uses disorders . They may be long acting opiates themselves ,such as methadone or suboxone

( buprenorhine) , ” anti  craving  and maintenance of recovery ” medications, like topiramate, acamprosate or naltrexone for alcohol or ” blockers” like naltrexone for opiates or antabuse  ( disulfiram ) for alcohol.  However they form only a small part of the treatment of the addictive illness. Psychosocial treatments are still the mainstay.  These should be done in a specialized treatment program or with a therapist who is experienced and trained in the treatment of addictive illnesses.

In either case, long term aftercare is often crucial to sustained recovery , as is active involvement in a 12-step program such as Alcoholics Anonymous and Narcotics Anonymous . It is not enough to just attend 12-step meetings. The person must also get a sponsor, a peer who has long term recovery and helps others and work through the twelve steps in a personalized manner. AA and NA are free, anonymous, available almost everywhere in the United States and provide a lot of support for the person with an addictive illness to enter recovery. 

Sometimes medical students or resident doctors will share that they are uncomfortable asking their patients to attend AA or NA if the patient feels it is too religious. Twelve step programs are spiritual programs at heart , but not religious . I have had patients who are atheists or agnostics who have actively participated and loved being in a 12-step program. I sometimes ask the medical student or resident that if there was a free , widely available way that someone with a different life threatening illness could go into remission for life, from cancer for example , would they be so conflicted .

Addiction is a life threatening illness. It is also a life long illness. However there is significant hope that if a person  has the discipline to do all the things needed to go into remission they can successfully go into recovery for  life. Making those healthy choices may not be as easy for a person with an addicted brain as it may seem to the rest of the world.

 

Surita Rao, M.D. is the physician leader of the Behavioral Health Services at Saint Francis Care and host of the show, Mental Health with Dr. Surita Rao on the VoiceAmerica Health and Wellness channel. She completed medical school at Bankura Sammilani Medical College in India and did her psychiatry residency training at St.Vincent’s Hospital in Staten Island, New York and the Yale University School of Medicine. She did her addiction psychiatry fellowship at the Yale University School of Medicine. She has been on the faculty at both Yale and Emory Universities. She is an Assistant Clinical Professor with the University of Connecticut School of Medicine.

Her clinical work has focused on addiction psychiatry, including both substance use disorders and dual diagnosis issues. She has worked with impaired physicians and other health care professionals.

Upon completing her fellowship training, she worked as the Medical Director of the methadone maintenance clinics at Yale University School of Medicine. She has been the Chair of Behavioral Health at Saint Francis since 2002 and is the President of the Saint Francis Behavioral Health Group.

Dr. Rao is on the Board of Directors for the American Society of Addiction Medicine and is co-chair of their national membership committee. She is also on the Executive Committee of the Connecticut Chapter.

Dr. Rao is chair of the physicians’ health committee at Saint Francis. She also serves on the Board of the Saint Francis Foundation and has been appointed as a Corporator for Saint Francis Care.

 

 

 

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