Leslie Glass's Blog, page 333

Three Keys To Avoiding Opioid Dependency

When I think about chronic pain, I think about my patient Margaret and her back pain. She wasn’t sure how it started — maybe she lifted her grandson wrong, or it was the extra hours on her feet at the shop.

Her doctors prescribed medications and physical therapy. She had X-rays and an MRI, which revealed arthritis in her spine. Then she developed intense sciatica — pain shooting down her leg. She received an injection and a prescription for an opioid medication to take when the pain was unbearable, which was often at night.

Other medications followed — for sleep, for the nerve pain, and finally to lift her mood. By the time she came to me, she was on five medications, including a daily opioid. She could no longer exercise and had gained 50 pounds in the past 10 years. She was miserable. When she didn’t take her opioid, she became agitated and irritable — classic signs of opioid dependence.

The Opioid Epidemic and Pain

There is limited evidence that these hard-hitting drugs are even effective for people with chronic pain like Margaret. They are also highly addictive, and over time, you need higher and higher doses just to get the same relief. They also have serious side effects, including depression, overdose, death, constipation, and withdrawal symptoms when you stop taking them, like the irritability Margaret experienced. Opioids also mask pain rather than address the underlying cause of the pain or enable you to live with the pain and still maintain a functional quality of life.

Given all this, in 2017 the Centers for Disease Control and Prevention (CDC) issued new pain management guidelines that specifically state: “In general, do not prescribe opioids as the first-line treatment for chronic pain.”

Attempts to reduce opioids, however, without treating the pain, don’t work. Instead, they lead to desperate people who may turn to alternative opioids like heroin or begin “doctor shopping” to find someone who will write the prescription. That’s why it’s critical to open up to other types of options for reducing pain rather than just reducing the number of opioids you’re taking.

Opioid Alternatives

My goal in providing you with this information is to help you avoid the 10 years of misery and pain Margaret experienced. People with chronic pain need three things:

1. A health care team that works together and shares information

If you’re like most people, the doctor you see most often is your primary care provider, likely a family physician or internist. And that’s certainly the place to start when you’re dealing with pain. Estimates are that primary care physicians treat about half of all people living with chronic pain. However, if your pain remains uncontrolled, it might be time to seek out other practitioners.

2. Non-drug approaches to help improve function, cope with the pain as well as reduce it

Non-drug approaches have been shown to have a positive and long-lasting impact. This includes guided imagery, in which people can listen to an audio recording that helps them envision pleasant experiences, meditation, and other relaxation techniques. Biofeedback, yoga, and cognitive behavioral therapy, in which they learn to change their thinking around their pain are also great non-drug approaches.

3. Help managing medications with a goal of getting off or reducing opioid use

Track your pain. For a week before your visit, keep a pain diary in which you rate your pain every couple of hours on a scale of 1 to 10 and what you were doing. Also, track all of the pain medications you take. Write down any non-medical approaches you use to cope with your pain.

For those looking to move away from opioids, remember that there are effective, accessible, non-drug options. With the right team supporting you, you can be in control of your own path to healing.

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Trauma Survivor: A 10 Year Recovery Journey

I am alive and thriving today because no matter what happened, I was determined to stay the course of my recovery journey and do more than just survive.

It wasn’t easy. I have now been in and out of recovery for half my life. If you want to get technical, I’ve been working on recovery my entire adult life. I entered an addiction recovery treatment program at the tender age of 21, but it didn’t stick the first time. Or the second. Or the third. I’m not a one-chip wonder, meaning I didn’t get sober once and stay clean the entire time. I did, however, make a serious decision to change my life ten years ago, and while it hasn’t been all smooth seas since, I have not strayed from that mindset. I am now 40 and healthy. It wasn’t easy.

The Recovery Journey Is More Challenging When Other Factors Are Involved

Recovery from addiction is a complicated process when there are no bumps in the road. When you’re dealing with more than one behavioral issue, or have trauma in your story, or a “generalized anxiety” diagnosis, or have ANY family dysfunction whatsoever, it becomes even more complex.

In my experience, I pull back one layer of the onion only to discover there are more underneath! I have a cellar in my basement where a vault lives, and locked in there hidden away were most of my feelings. This phenomenon has made my recovery journey a long process where sometimes I’ve taken a step forward only to take two steps back. The path to success is no straight line, especially when it comes to mental health and health and wellness.

Recovery Is Rewarding At Any Age

Life is bright and shiny at 40. It doesn’t look the way I expected it to, but it feels better than I ever imagined. Since we’re all still learning about what modern recovery looks like, and I’ve been writing about mine since I started, I compiled two lists that help consolidate the way I feel about all this. Here’s the first list of what I learned on this exciting and lasting recovery journey.

1. There Will Be Good Years And Bad Years On The Recovery Journey

That’s just life. I had this sense that if I made it five years, my life would be merry. It doesn’t work that way. Business is up and down, relationships come and go, and then as you get older, you start to lose people. However, if you’re prepared and armed with a toolbox full of tools, nothing takes you out.

2. Getting Sober Was Only Step One

I needed enlightenment in many areas. Learning healthy boundaries was an unexpected adventure, as was sober dating. Both caused me as much discomfort as getting sober did. Seriously, detaching from enmeshed relationships felt physically painful to me at times. Learning to use food as fuel, not comfort, and becoming financially responsible was also difficult and stressful. There were years it felt like I was training for a recovery Olympics that I wanted no part in. But, somewhere along the way, I built a well-rounded recovery lifestyle. I’m almost to the point where I have every aspect of my life organized. Almost.

3. Relationships Are Still Hard

I thought I’d master and get relationships sorted out by now. Insert laughter here. While I find they are far less dramatic than they once were, I’m certainly no professional in this matter. I do believe I’ve become aware and considerate of other people’s feelings. It’s no longer all about me. I don’t believe I can change anyone and I would no longer dare to try. I also now know no one can change me. There is no magic pill, and there is no magic person. It’s all hard work. However, with age, I’ve come to enjoy the work and derive great satisfaction from my improvement.

4. Self Care Is Not All Baths and Mani-Pedis

I recently read an article about self-care being really hard. It said self-care is not all baths and mani-pedis. The article is correct. Real self-care is financial responsibility, emotional accountability, impulse control. Basically, adulting is really hard. It took a lot of practice for me to intuitively practice self-care and do things like grocery shop and plan out my whole week of meals, pay ALL my bills EVERY month, and try to stay gainfully employed.

Making sure all areas of your life are organized and well cared for is almost impossible for anyone coming out of addiction. I didn’t open my mail for years. I didn’t understand financial “stuff,” and I had the emotional capacity of a 12-year-old. Caring about those things did not come naturally to me. I had to learn how to do them years into my recovery; then I had to be disciplined in practicing them until they became habit. Trust me, it’s easier to get addicted to drugs than paying your taxes.

5. Patience and Gratitude Are Everything

What I was writing about above – The learning self-care? Sometimes I wonder what would have happened if I stopped trying years ago because it all seemed too hard and progress was slow. Trudging from program to program, painfully learning how to manage my emotions and relationships wasn’t fun. But, it was rewarding, and it worked. I can find gratitude daily. I try to live in gratitude most of the time, and it’s a beautiful thing. I’m also patient with myself, and other people. Man, do things go better when you can just calm down and wait.

The moral of the story is, while this may sound like it’s too much work, like it’ll take too long, and the pain along the way will make it impossible to get through—it wasn’t.  The markers along the way become too important, the progress becomes too gratifying, and then when you realize you’re no longer in pain or anxious anymore, it’s all worth it, and you never look back.

What a gift to go into the second half of my life organized, healthy and happy. Who’s really ahead of the game now?

We can’t do it alone, and thank God we don’t have to. Order your 

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Psychologists Define The ‘Dark Core Of Personality’

From Science Daily:

Egoism, Machiavellianism, narcissism, psychopathy, sadism, spitefulness, and others are among the traits that stand for the malevolent dark sides of human personality. As results from a recently published German-Danish research project show, these traits share a common ‘dark core’. So, if you have one of these tendencies, you are also likely to have one or more of the others.

Both world history and everyday life are full of examples of people acting ruthlessly, maliciously, or selfishly. In psychology as well as in everyday language, we have diverse names for the various dark tendencies human may have, most prominently psychopathy (lack of empathy), narcissism (excessive self-absorption), and Machiavellianism (the belief that the ends justify the means), the so-called ‘dark triad’, along with many others such as egoism, sadism, or spitefulness.

Although at first glance there appear to be noteworthy differences between these traits — and it may seem more ‘acceptable’ to be an egoist than a psychopath — new research shows that all dark aspects of human personality are very closely linked and are based on the same tendency. That is, most dark traits can be understood as flavoured manifestations of a single common underlying disposition: The dark core of personality. In practice, this implies that if you have a tendency to show one of these dark personality traits, you are also more likely to have a strong tendency to display one or more of the others.

As the new research reveals, the common denominator of all dark traits, the D-factor, can be defined as the general tendency to maximize one’s individual utility — disregarding, accepting, or malevolently provoking disutility for others — , accompanied by beliefs that serve as justifications.

In other words, all dark traits can be traced back to the general tendency of placing one’s own goals and interests over those of others even to the extent of taking pleasure in hurting other’s — along with a host of beliefs that serve as justifications and thus prevent feelings of guilt, shame, or the like. The research shows that dark traits in general can be understood as instances of this common core — although they may differ in which aspects are predominant (e.g., the justifications-aspect is very strong in narcissism whereas the aspect of malevolently provoking disutility is the main feature of sadism).

Ingo Zettler, Professor of Psychology at the University of Copenhagen, and two German colleagues, Morten Moshagen from Ulm University and Benjamin E. Hilbig from the University of Koblenz-Landau, have demonstrated how this common denominator is present in nine of the most commonly studied dark personality traits:

Egoism: an excessive preoccupation with one’s own advantage at the expense of others and the community
Machiavellianism: a manipulative, callous attitude and a belief that the ends justify the means
Moral disengagement: cognitive processing style that allow behaving unethically without feeling distress
Narcissism: excessive self-absorption, a sense of superiority, and an extreme need for attention from others
Psychological entitlement: a recurring belief that one is better than others and deserves better treatment
Psychopathy: lack of empathy and self-control, combined with impulsive behaviour
Sadism: a desire to inflict mental or physical harm on others for one’s own pleasure or to benefit oneself
Self-interest: a desire to further and highlight one’s own social and financial status
Spitefulness: destructiveness and willingness to cause harm to others, even if one harms oneself in the process

In a series of studies with more than 2,500 people, the researchers asked to what extent people agreed or disagreed with statements such as “It is hard to get ahead without cutting corners here and there.,” “It is sometimes worth a little suffering on my part to see others receive the punishment they deserve.,” or “I know that I am special because everyone keeps telling me so.” In addition, they studied other self-reported tendencies and behaviors such as aggression or impulsivity and objective measures of selfish and unethical behaviour.

The researchers’ mapping of the common D-factor, which has just been published in the academic journal Psychological Review, can be compared to how Charles Spearman showed about 100 years ago that people who score highly in one type of intelligence test typically also score highly in other types of intelligence tests, because there is something like a general factor of intelligence.

“In the same way, the dark aspects of human personality also have a common denominator, which means that — similar to intelligence — one can say that they are all an expression of the same dispositional tendency,” Ingo Zettler explains.

‘For example, in a given person, the D-factor can mostly manifest itself as narcissism, psychopathy or one of the other dark traits, or a combination of these. But with our mapping of the common denominator of the various dark personality traits, one can simply ascertain that the person has a high D-factor. This is because the D-factor indicates how likely a person is to engage in behaviour associated with one or more of these dark traits’, he says. In practice, this means that an individual who exhibits a particular malevolent behaviour (such as likes to humiliate others) will have a higher likelihood to engage in other malevolent activities, too (such as cheating, lying, or stealing).

The nine dark traits are by no means the same, and each can result in specific kinds of behaviour. However, at their core, the dark traits typically have far more in common that actually sets them apart. And knowledge about this ‘dark core’ can play a crucial role for researchers or therapists who work with people with specific dark personality traits, as it is this D-factor that affects different types of reckless and malicious human behaviour and actions, often reported in the media.

‘We see it, for example, in cases of extreme violence, or rule-breaking, lying, and deception in the corporate or public sectors. Here, knowledge about a person’s D-factor may be a useful tool, for example to assess the likelihood that the person will reoffend or engage in more harmful behaviour’, he says.

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Supermodel Gisele On Panic Attacks And Suicidal Thoughts

From Charolette Triggs @ People: She’s one of the highest-paid supermodels in the world, married to one of the highest-paid athletes. She can breastfeed one-handed while getting ready for a lingerie photoshoot, she meditates every day at 5 a.m., and her family is so health-conscious that her children don’t even want Halloween candy.

But Gisele Bündchen is ready to blow up the perception that her life is as perfect as it looks.

In a new memoir, Lessons: My Path to a Meaningful Life, the famously private Bündchen, 38, reveals that she once battled panic attacks and suicidal thoughts.

“Things can be looking perfect on the outside, but you have no idea what’s really going on,” she says in a revealing interview in this week’s issue of PEOPLE, on stands Friday. “I felt like maybe it was time to share some of my vulnerabilities, and it made me realize, everything I’ve lived through, I would never change, because I think I am who I am because of those experiences.”

One of six girls raised in Horizontina, Brazil by Valdir, a teacher, and Vania, a bank teller, Bündchen, a twin and middle child, says she spent her childhood feeling “not very special” — until she was discovered by a modeling agent at a mall in São Paulo at 14.

After a rough start in the industry (“They told me, ‘Your nose is too big and your eyes are too small and you’re never going to be on the cover of a magazine,’ ” she recalls), Bündchen got her big break in 1997, when she walked topless in Alexander McQueen’s runway show and appeared on the cover of Vogue the next year as the exemplar of “the return of the curve.” Credited with ushering in a sexy, athletic look that replaced ’90s heroin chic, Bündchen became known in the fashion industry as “the boobs from Brazil.” In 2000, she landed a record $25 million contract with Victoria’s Secret and began dating Leonardo DiCaprio, making her a tabloid fixture.

But Bündchen — who is now married to quarterback Tom Brady — says her life in the fast lane came with a crushing sense of anxiety.

After having her first panic attack during a bumpy flight on a small plane in 2003, she developed a fear of tunnels, elevators and other enclosed spaces. “I had a wonderful position in my career, I was very close to my family, and I always considered myself a positive person, so I was really beating myself up. Like, ‘Why should I be feeling this?’ I felt like I wasn’t allowed to feel bad,” she says. “But I felt powerless. Your world becomes smaller and smaller, and you can’t breathe, which is the worst feeling I’ve ever had.”

When the panic attacks started ambushing her even in her own home, Bündchen says she contemplated suicide.

“I actually had the feeling of, ‘If I just jump off my balcony, this is going to end, and I never have to worry about this feeling of my world closing in.’ ”

After seeing a specialist, who prescribed Xanax, she decided she didn’t want to rely on medication. “The thought of being dependent on something felt, in my mind, even worse, because I was like, ‘What if I lose that [pill]? Then what? Am I going to die?’ The only thing I knew was, I needed help.”

With the advice of doctors, Bündchen began a total lifestyle overhaul.

“I had been smoking cigarettes, drinking a bottle of wine and three mocha Frappucinos every day, and I gave up everything in one day,” says Bündchen, who also cut out sugar and turned to yoga and meditation to combat her stress. “I thought, if this stuff is in any way the cause of this pain in my life, it’s gotta go.”

After that, she decided it was time to rethink her relationships as well. Realizing she was “alone” in her soul-searching, she split with DiCaprio in 2005. Looking back, she has no hard feelings.

“Everyone who crosses our path is a teacher, they come into our lives to show us something about ourselves,” she says. “And I think that’s what he was. What is good versus bad? I honor him for what he was.”

Did you know the 12 Steps, which have helped millions find recovery, can also help you find peace and serenity? Check out our latest book, Find Your True Colors In 12-Steps.

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More Bad News For Bosses: Overdosing At Work

From Jenny Gold @ The New York Times: Jimmy Sullivan prepared for his job as a bricklayer the same way every morning for years: injecting a shot of heroin before leaving his car.

The first time he overdosed on the job, in 2013 at a Virginia construction site, a co-worker who is his cousin stealthily injected a dose of Narcan, an opioid antidote, into Mr. Sullivan’s leg. He woke up and went straight back to work.

The second time, in 2014, his cousin revived him again, and after resting for an hour in his car, Mr. Sullivan was back on the job. His boss told him not to let it happen again. But within a month, Mr. Sullivan had again overdosed on the job site. This time, another worker called 911. After a few hours at the hospital, he went back to work.

As the opioid epidemic continues to rage across the country, with a record 72,000 drug overdose deaths estimated in 2017, the fallout is increasingly manifesting itself at construction sites, factories, warehouses, offices and other workplaces. A stunning 70 percent of employers reported that their businesses had been affected by prescription drug abuse, including absenteeism, positive drug tests, injuries, accidents and overdoses, according to a 2017 survey by the National Safety Council, a research and advocacy organization.

On-the-job injuries are common in that industry, and many workers begin their addiction with a prescription intended to help get them back to work. In 2016, two in five workers’ compensation claims for prescriptions included an opioid. Laborers tend to come and go on job sites, meaning employers often don’t know much about their workers.

Mr. Sullivan said he worked nonstop as a bricklayer in Portland during the 2000s, despite a serious drug habit — in those days, crystal meth. By 2011, he was a father of three girls and often so strung out that he didn’t recognize himself.

Alarmed by his descent, he moved across the country to Newport News, Va., where he would be far from his dealers and drug-using friends. Though he readily found a job in Virginia, he also quickly got hooked — this time to opioids. That part of the country was awash in cheap heroin, which he augmented with Dilaudid, a semi-synthetic opioid prescribed by a doctor for back pain.

He’s certain that several of his employers knew he was using, but they seemed not to care as long as he didn’t get caught. “I was so productive that a lot of crews just swept it under the rug,” he said. His employers did not respond to requests for comment.

At times he contemplated going into rehab at the suggestion of his family, but he did not seek treatment.

Employer Intervention

Mr. Sullivan said no employer asked him to take a drug test, even though he had a criminal history that included arrests for drug possession and distribution in Portland.

It is not that businesses are unaware of the toll the crisis is taking. Large employers spent $2.6 billion on treating opioid abuse and overdoses in 2016, up from $300 million 12 years earlier, according to the Peterson-Kaiser Health System Tracker. Those numbers do not include the cost of lost productivity. Workers who misuse pain medication miss an average of 29 days a year, compared with 10 and a half days for other employees.

Yet, many managers are unwilling to acknowledge drug use at their businesses.

“If you ask them if they believe they have an opioid problem within their population, a very high percentage of them would say, ‘No, we don’t,’” said Pat Sullivan, executive vice president of employee benefits at Hylant, a large insurance broker in Indiana that manages benefit plans for more than 19,000 businesses. “And yet we have access to prescription reports that are absolutely telling me there’s abuse happening” among their workers.

Pain Comes With The Job

Jimmy Sullivan, now 39, is slender and serious. He wears a heavy silver cross around his neck and has a half-finished tattoo of two barracudas, teeth gnashing, on his arm.

At least 217 workers died from an unintentional drug or alcohol overdose while at work in 2016, up 32 percent from 2015, according to the Bureau of Labor Statistics. Workplace overdose deaths have been increasing by 25 percent or more a year since 2010. Those numbers don’t include the many more overdoses that don’t end in death, like Mr. Sullivan’s, or accidents caused primarily or partly by drug impairment.

Incident reports from the Occupational Safety and Health Administration paint a grim national picture of workplace overdose deaths: a mechanic at a Fiat Chrysler Automobiles plant in Michigan, a construction worker on a barge in Rhode Island, a crawfish fisherman in Louisiana and a Sam’s Club worker who died while stocking shelves in a Texas warehouse.

But despite the growing problem, many employers have turned a blind eye to addiction within their work force, ill-equipped or unwilling to confront a complicated issue they do not know how to address, according to researchers and business executives.

The National Safety Council survey, which was based on interviews with 501 managers at businesses with 50 or more employees, found that fewer than one in five companies felt extremely well-prepared to combat the opioid crisis. Just 13 percent were very confident they could identify risky use. And a little more than half said they screened all employees for drugs, but 40 percent of those had failed to screen for synthetic opioids like oxycodone and fentanyl.

“Employers have been asleep at the wheel,” said Dave Chase, co-founder of Health Rosetta, a company that certifies employer health benefits, and author of “The Opioid Crisis Wake-Up Call.” Some companies are “key, unwitting enablers,” he added.

A bricklayer for more than two decades, he is proud of his skills. “I love my job. All over the city I drive around and say, ‘Hey, I built that,’” he said over lunch in Portland, Ore., where he grew up and now lives. “It’s really tough work and not too many people can do it.”

The construction industry has the second-highest rate of pain medication and opioid misuse after the entertainment, recreation and food business. About 1.3 percent of construction workers are thought to be addicted to opioids, or nearly twice the addiction rate for all working adults, according to data from the 2012-14 National Survey on Drug Use and Health

Construction workers had the highest proportion of heroin- and methadone-related overdose deaths from 2007 to 2012, according to the Centers for Disease Control and Prevention. In Massachusetts, a recent report found that one in four opioid deaths involved construction workers.

It was an open secret on job sites that many workers were using drugs, he said. They were the ones who disappeared for long lunches, isolated themselves and occasionally nodded off. “If you drug-tested everyone, you wouldn’t find many people to work with you,” Mr. Sullivan said.

This summer, Mr. Hart fired 12 of his 50 employees for suspected drug abuse. It pained him to do it, he said, and it was difficult to lose so many workers in his busiest season. But he said the risk of keeping someone on who was using drugs was too high.

The Association of Union Constructors recently devoted the spring issue of its magazine to the opioid epidemic. The group says an increasing number of union contractors provide naloxone, the opioid antidote, on job sites.

A Lifesaving Union Benefit

After his third overdose on the job for the same contractor in Virginia, Mr. Sullivan was fired. In 2015, he returned to Portland, which was in the throes of its own heroin crisis. Amid clusters of homeless encampments that dot downtown Portland, users can be spotted leaning against buildings, heads nodding back, needles in arms.

Back in his hometown, enticed by union retirement benefits, Mr. Sullivan joined the Bricklayers and Allied Craftworkers Local 1, Oregon in 2016, which turned out to be a turning point for him.

Shortly after he joined the union, Mr. Sullivan was laid off for erratic behavior and his local learned he was abusing drugs. But unlike his previous employers, the union had a plan to get him back to work.

In theory, employers are in a unique position to confront opioid misuse, through random testing and spotting erratic behavior or absenteeism, said Mr. Chase, the author of “The Opioid Crisis Wake-Up Call.” They could change their health insurance policies to limit opioid prescriptions to five days and waive deductibles for addiction treatment — an option that is often not available to construction firms because they typically do not provide health insurance.

But many employers have been slow to act.

The Nord Family Foundation, a charity in northern Ohio, hosted an event in May in Elyria, near Cleveland, that was designed to teach employers how to identify and treat employees with substance use problems. Dr. Donald S. Sheldon, a trustee at the foundation and a former hospital president, advertised in local newspapers and reserved a room at the local community college that would seat 200.

Just 30 people showed up, he said.

Of the 10 companies whose employees’ suspected opioid overdose deaths were detailed in O.S.H.A. reports since 2014, most did not respond or refused to address specific incidents.

Sam’s Club, a division of Walmart, said in a statement that it provided mental health and substance abuse coverage to employees and offered an employee assistance program. Fiat Chrysler said in an email that it had adopted more stringent opioid prescribing guidelines in its health plan and supported the use of medication-assisted addiction treatment.

Just one employer, Giovanna Painting in Spencerport, N.Y., agreed to an interview. Alan Hart, the company’s president, said he was shocked when one of his employees was discovered dead from a heroin overdose in a port-a-potty on a job site in 2017.

A recovered addict himself, Mr. Hart said he tries to be sympathetic and help workers get into rehab, though he does not provide health insurance.

“We’re much, much stricter now,” since the 2017 overdose death, he said. “We’re doing a lot more drug testing. I’m on the sites a great deal more. I’m walking and talking, and I pull the guys aside and look in their eyes.”

Having seen many of its members struggle with addiction, officials at the International Union of Bricklayers and Allied Craftworkers had over several years come up with a suite of programs to prevent substance abuse, to identify affected workers and to steer them into treatment.

Matthew Eleazer, the president of Mr. Sullivan’s local, said at least 10 of his approximately 650 members had recently struggled with opioid use disorders, some with lethal outcomes. One was a single father prescribed opioids for a back injury who accidentally took too many pills. Another was a promising young apprentice found by the side of the road with a needle in his arm on his way to a wedding.

Mr. Eleazer said the union tests all members when they join and randomly after that; he often gets reports from employers when a member doesn’t show up for work or is repeatedly tardy.

The union told Mr. Sullivan he could return to work if he went into rehab, but there was a problem: He had an arrest warrant out for violating parole from a prior arrest, and the treatment centers would not accept him until he served his jail term.

Mr. Sullivan was unwilling to go to jail and disappeared. Union officials tracked him down and called the police to arrest him when he was passed out in his car. The union persuaded a parole officer who helped convince a judge to let him serve his time at a drug treatment facility instead of jail, and union representatives called him several times a week.

As promised, they found him a job when he was released in 2017, but this year he was laid off at the end of a construction project and relapsed again. Weeks later, Mr. Sullivan called to say he was living in his two-door Honda, claiming to have been clean for a couple of weeks.

“Do you remember what I told you to do when you were in that situation? That I was your first phone call?” Mike Titus, a union official, said to him when they met up at a bar. “Could you pass a drug test right now?”

If so, the union had a job for him and he could shower at the union hall until he found a place to live. “Matt and Mike were the first ones who cared enough,” Mr. Sullivan said. “None of my employers gave a [expletive] enough to even ask.”

A month later, Mr. Sullivan was back to work on a union job, living in a new home and clean once again.

Hanging this easy to follow poster in your break-room is one of the easiest things you can do to introduce workplace safety and recovery to your employees. Your small investment can save you thousands and who knows how many lives. Order yours today.

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SUDs Cost US Businesses $81 Billion In One Year

From The National Safety Council: In 2016, substance use cost US businesses $81 BILLION, according to the National Council on Alcoholism and Drug Dependence Inc. (NCADD).

Nearly 21 million Americans are living with substance use disorder, according to the U.S. Surgeon General. That’s more than the total number of people living with of cancer and more than the population of the state of New York.

Three-quarters of those struggling with addiction to alcohol, pain medication, marijuana and other substances are employed. Workers with substance use disorders miss nearly 50% more work days than their peers – up to six weeks annually – and absenteeism leads to losses in productivity.

While the Surgeon General reports substance use disorders cost the U.S. economy more than $400 billion a year, employers don’t seem to recognize the scope of the problem. In a National Safety Council survey, 39% of employers viewed prescription drug use as a threat to safety and just 24% said it is a problem, even though seven in 10 companies reported issues ranging from absenteeism to overdose.

What Employers Told Us

Construction, entertainment, recreation and food service sectors have twice the national average of employees with substance use disorders. NSC also found:

Industries dominated by women or older adults had a two-thirds lower rate of substance abuse.
Industries that have higher numbers of workers with alcohol use disorders also had more illicit drug, pain medication and marijuana use disorders.
Employers were most concerned about the costs of benefits (95%), the ability to hire qualified workers (93%) and the costs of workers’ compensation (84%) – but less concerned over drug misuse (67%) and illegal drug sale or use (61%).
Workers in recovery have lower turnover rates and are less likely to miss work days, less likely to be hospitalized and have fewer doctor visits.

How Employers Can Make a Difference

NSC found healthcare costs for employees who misuse or abuse prescription drugs are three times higher than for an average employee.

Employers can take simple steps to protect themselves and their employees:

Recognize prescription drugs impact the bottom line
Enact strong company drug policies
Expand drug panel testing to include opioids
Train supervisors and employees to spot the first signs of drug misuse
Treat substance abuse as a disease
Leverage employee assistance programs to help employees return to work

The annual cost of untreated substance use disorder ranges from $2,600 per employee in agriculture to more than $13,000 per employee in information and communications.

You can actually calculate the average cost to your business with this calculator.

Hanging this easy to follow poster in your break-room is one of the easiest things you can do to introduce workplace safety and recovery to your employees. Your small investment can save you thousands and who knows how many lives. Order yours today.

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Kristen Bell Has A Self Confidence Assignment For You

From Julie Mazziotta @ People: Kristen Bell wants to empower her fans.

The Good Place star, 38, shared an inspiring, body positive message for one woman who wrote on Bell’s Instagram page that she wished she were as pretty as the actress.

“So mother f—— beautiful,” the fan wrote on Bell’s photo of her look for the 2018 Emmy Awards. “U are stunning unlike me.”

Bell, in between Emmys appearances, noticed the woman’s comment and responded with a message of encouragement, which was spotted by the popular Instagram account Comments By Celebs.

“Gurl don’t u dare,” she wrote. “You got one time on this planet — don’t waste time being negative. You deserve all the love in the world. And I think your face is beautiful AF. Don’t u dare tell me I’m wrong.”

Bell also gave the woman some tasks to help her build up her body confidence.

“Here’s your homework,” Bell told her. “Follow @glennondoyle and watch all her stories. Read her book, Love Warrior. Smile more, because u are alive and wonderful. And loved. Xo.”

Bell is all about encouraging positive self-esteem. She works on building that up in her two daughters, Lincoln, 5, and Delta, 3.

“It’s important to me to show my children that I care about my health and fitness enough to stay committed,” she previously told SHAPE. “So when I’m in their room with them, I’ll do squats. When they ask what I’m doing, I’ll say I’m getting my physical fitness in. And because they copy everything I do, the next time they pick up a heavy bag they’ll say, ‘I’m getting my workout in.’”

But Bell isn’t working out for aesthetic reasons — for her, it’s about her overall health.

“To me, being healthy means feeling good about the choices I’m making, and most important, it’s about keeping fit mentally and physically,” she said. “I’m constantly reminding myself it’s not about my thighs: It’s about my commitment and my happiness level.”

Did you know the 12 Steps, which have helped millions find recovery, can also help you find peace and serenity? Check out our latest book, Find Your True Colors In 12-Steps.

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6 Expert Ways To Manage Stress

By Audrey Noble @ Time: Let’s face it – we’re all stressed. In fact, a 2017 Gallup poll found that eight out of 10 Americans are afflicted by stress. The top three stressors for Americans today are the uncertainty of the nation’s future, money and work, according to the American Psychology Association, with workplace stress accounting for nearly $200 billion in healthcare costs, as reported by Forbes.

“Stress is a direct result of negative emotions that are out of control,” says stress consultant and life coach Elaine Sanders. “It doesn’t matter what triggers those emotions—whether it be pressure from a superior, a difficult colleague or time pressure.” Sanders lists factors like a low level of resilience and a lack of emotional regulation as possible contributors to stress.

“Stress is a physical, mental, or emotional response to change,” says Kathleen Hall, founder and CEO of Mindful Living and The Stress Institute.

But there’s a difference between acute stress and chronic stress. Hall says that while dealing with some acute stress is normal—think being called to the principal’s office or getting into a fender bender—chronic stress, which is a day after day, week after week, month after month phenomenon—is not something we as humans are equipped to handle.

Still, stress is inevitable and there are healthy ways of dealing with it. Here, experts share tips on how to manage stress better in the workplace—and in your daily life.

1. Focus On Intention

When you direct your emotions toward positive feelings instead of focusing on the negative, it can change your attitude, according to Sanders.

“Start your day with intention—start every new task with intention, start every interaction with intention,” says Sanders. “Don’t let a negative emotion run off with you blindly.”

Honing in on your intention—whether it be for a meeting, or any task you are setting out to accomplish—requires some discipline and imagination. Sanders suggests envisioning how you would go about accomplishing the task at hand and focusing on a specific positive emotion you would want to feel in that scenario. When you pick that emotion, practice feeling it repeatedly so that you can carry that mindset whenever stress starts to arise. “Your day will go so much smoother and you will naturally be less stressed,” she says.

2. Set Realistic Expectations

We live in the era of the upgrade—we’re constantly looking for something bigger and better in every aspect of our lives—and that automatically sets us up for failure, according to Hall.

“People think that they’ll be less stressed if they get a better job or better romantic partner,” she says. “I tell clients to stop [thinking that].” Rather, she suggests finding gratitude for the things that we already have in our lives and fulfill us. Focusing on what you do now, Sanders says, can help mitigate the stress about what is next.

3. Find A Confidante

Sometimes it takes an outside perspective to bring to our attention that we’re not handling stress well. That’s why experts suggest that having someone to confide in can be a key component to reducing your stress.

Hall suggests finding someone at work or in your life to lean on. “They’ll be the one to know when you’ve gone AWOL, when you’re about to flip a switch, or when your productivity has gone down,” she says.

4. Write It Down

Putting pen to paper can be a therapeutic mode of expression. “Write somewhere—whether it be in a journal or on your computer—the persons, places and tasks that have been triggers of stress,” Hall says.

She suggests journaling regularly for at least a month and then reading it back to analyze your level of happiness. “Once you’ve identified those triggers, go talk to your manager or supervisor about these things,” she says.

5. Practice S.E.L.F. Care

Hall created an acronym to help keep her clients on track when life gets overwhelming. “S.E.L.F. care” stands for serenity, exercise, love and food—all necessities to ease the common stressors in our lives, according to Hall.

Meditation can reduce feelings of anxiety and stress, according to a 2006 study published in the American Journal of Psychiatry. Hall suggests taking five minutes a day to find something that will bring you serenity—whether it’s listening to music or finding quiet time to take deep breaths. This, she says, will reboot your mind and body.

Studies continue to show that exercise is also a major stress-reliever. Hall says adding some physical activity to your life—whether as intense as a spin class, or as simple as a 10-minute walk—can make a world of difference on your mental and emotional state.

Hall says love is also a key component to our overall well-being. “What we know is isolation kills and community heals,” she says. This can include surrounding yourself with caring friends and family, or having a loving pet. She also recommends decorating your workspace with plants and colors to elevate your mood and make you feel less alone.

Finally, food can have a notable effect on our state of mind. According to a 2016 study published in the American Journal of Public Health, happiness increases when people consume healthy food. “It is medicine and changes your mood,” Hall says. She suggests incorporating antioxidant-rich foods like berries into your diet to keep you feeling healthy and energized.

6. Change Your Mindset

According to both Hall and Sanders, the biggest misconception about stress is that we have to beat it; when we make stress the enemy, we actually create more stress for ourselves, they note.

“While stress arises from unregulated negative emotions, intentionally activating positive heart emotions such as care, appreciation, compassion and ease, decreases your stress by creating physiological harmony,” says Sanders. “Positive thinking isn’t enough here; it must be positive feelings from the heart to affect your body and brain.”

What it all comes down to is learning to react positively—from a mental and emotional standpoint—to negative stressors in our lives.

Did you know the 12 Steps, which have helped millions find recovery, can also help you find peace and serenity? Check out our latest book, Find Your True Colors In 12-Steps.

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Q: How Much Does Substance Use Cost US Businesses?

From The National Safety Council: A: In 2016, substance use cost US businesses $81 BILLION, according to the National Council on Alcoholism and Drug Dependence Inc. (NCADD).

Nearly 21 million Americans are living with substance use disorder, according to the U.S. Surgeon General. That’s more than the total number of people living with of cancer and more than the population of the state of New York.

Three-quarters of those struggling with addiction to alcohol, pain medication, marijuana and other substances are employed. Workers with substance use disorders miss nearly 50% more work days than their peers – up to six weeks annually – and absenteeism leads to losses in productivity.

While the Surgeon General reports substance use disorders cost the U.S. economy more than $400 billion a year, employers don’t seem to recognize the scope of the problem. In a National Safety Council survey, 39% of employers viewed prescription drug use as a threat to safety and just 24% said it is a problem, even though seven in 10 companies reported issues ranging from absenteeism to overdose.

What Employers Told Us

Construction, entertainment, recreation and food service sectors have twice the national average of employees with substance use disorders. NSC also found:

Industries dominated by women or older adults had a two-thirds lower rate of substance abuse.
Industries that have higher numbers of workers with alcohol use disorders also had more illicit drug, pain medication and marijuana use disorders.
Employers were most concerned about the costs of benefits (95%), the ability to hire qualified workers (93%) and the costs of workers’ compensation (84%) – but less concerned over drug misuse (67%) and illegal drug sale or use (61%).
Workers in recovery have lower turnover rates and are less likely to miss work days, less likely to be hospitalized and have fewer doctor visits.

How Employers Can Make a Difference

NSC found healthcare costs for employees who misuse or abuse prescription drugs are three times higher than for an average employee.

Employers can take simple steps to protect themselves and their employees:

Recognize prescription drugs impact the bottom line
Enact strong company drug policies
Expand drug panel testing to include opioids
Train supervisors and employees to spot the first signs of drug misuse
Treat substance abuse as a disease
Leverage employee assistance programs to help employees return to work

The annual cost of untreated substance use disorder ranges from $2,600 per employee in agriculture to more than $13,000 per employee in information and communications.

You can actually calculate the average cost to your business with this calculator.

Hanging this easy to follow poster in your break-room is one of the easiest things you can do to introduce workplace safety and recovery to your employees. Your small investment can save you thousands and who knows how many lives. Order yours today.

The post Q: How Much Does Substance Use Cost US Businesses? appeared first on Reach Out Recovery.

The Toxic Past: A Survival Guide

I started crying the other day while I was hiking. It just happened, and before I knew it, tears were rolling down my face. I finally stopped and took off my glasses to wipe my face just as this nice-looking guy passed me. Both of us with our dogs, dressed all sporty, in shape and on top of a mountain on a brilliant morning in Southern California. But there I stood, with the pain in my heart written all over my face. He looked at me with concern but also curiosity, and I felt caught, exposed, and embarrassed, so I knelt down next to my dog and pretended to do something. He passed, and I stood up and pulled myself together. Sort of.

“What happened to her?” he must have thought. “Did someone die? Is she sick? What could have caused her to crumble like that in such a beautiful setting on such a beautiful day?”

How could I have possibly explained that it wasn’t anything, in particular, that day that made my soul ache? It was just my toxic past.

It was the decades of stuff that occasionally surfaces, particularly at this time of year. I never talk about the specifics of my story anymore because it doesn’t matter and continuing to retell those stories only gives them power when they don’t have any hold over me anymore. But, I did have a therapist at one particularly dark time in my life who told me, “There will be some days you will cry for the rest of your life. That’s just how it’s going to be, and you’ll have to learn how to take care of yourself when those moments come up.”

So, there I am on top of the mountain sobbing. Why?

Because I’m a survivor of trauma, addiction, deaths of beloved friends and boyfriends and sometimes it still hurts.

Some days there are people I miss and relationships I mourn. Rage and sadness spills out, but I don’t need to use over it anymore. That’s the good news. It passes pretty quickly. That’s the other good news, but I do need an action plan.

In moments of despair I:

Talk about my feelings with someone. Anyone I feel safe with will do, but I don’t keep it locked inside.
I keep active. There’s a reason I’m on top of that mountain, or in boot camp, as many times a week as my schedule and body permits.
Eat well. My brain needs it to function correctly. This is not a joke. I used to get so annoyed when people would bitch at me to eat regularly and nutritionally and now I know I feel awful when I don’t. Anxious, hangry, stressed are not good for me.
Take a break. If I feel overwhelmed I turn everything off for an hour, a day, a week, as long I can/need.
Care for others, animals, be of service, whatever I can do to get out of myself and my head for an hour a day.

For me, the recovery plan has to account for the fact that there will be bad days.

It’s not enough to have smart feet that take me to the right places. I need to know how to mend my heart and nourish my soul at a moments notice. These are just some of the tools I use. Find the ones that work for you—nature, animals, cooking, meditation—all of these things make me happy. Start by using the ones above and making a list of the things you like to do. With practice, it becomes second nature