LETTER FROM THE DIRECTOR

The Elephant in the Room

Riddle:  How do you know the elephant was in the refrigerator?  Answer:  Because he left his footprints in the Jell-O.
Riddle:  How do you know the elephant is in the living room?  Answer:   Because family members keep secrets, blame each other for bad things that happen and are shame-based. 

For those in the recovering community, the elephant represents alcoholism and/or other drug dependency.  Before recovery occurs, the elephant is huge and takes up the entire living room.   Family members are pushed against the wall, struggling to survive in an environment that isolates them from each other and society.  The bottom line is that untreated alcoholism and/or other drug dependency ravishes families and kills the soul.  People in recovery know the story. 
The really sad part is that while the elephant is BIG, it is virtually ignored and denied.  People get divorced because of the elephant and do not recognize that their dependency on the bottle is the real cause for their relationship problems.  People get involved in the judicial system and do not realize that their legal problems can often be traced back to their relationship with alcohol and/or other drugs.  People have medical problems caused by the elephant and do not see the connection. Kids are in foster care because of their parents' addictions; emergency rooms are crowded with people who have had drug-related accidents; and court dockets are full with those facing alcohol or other drug-related crimes. 
People in recovery, who have faced the elephant, scratch their heads.  How can those who continue to ignore the elephant not see what is so clear to everyone else?  Yet, if they look back when they, too, ignored the elephant they understand how difficult those first steps are...admitting there is an addiction and recognizing the impact it has on their own health, the well being of their family members and society as a whole.
People in recovery and those who support them are signing petitions to inform their state representatives. It is important to keep public funding for prevention and treatment of substance use disorders.  Email Debbie Garrett, Greater Macomb Project Vox, at deborahg@comcast.net to secure an attachment of the petition.  Circulate and return it by September 20 to the address listed on the petition.   

The Death of Michael Jackson

The passing of a talent like Michael Jackson is always a shock but, not a surprise. Those of us that are older remember the loss of Elvis Presley.  Similar circumstances…..brilliant talent, consumed by those that depended on his talent for their livelihood, no privacy, and an indulgent lifestyle.  There have been others – Anna Nicole, Judy Garland, Marilyn Monroe and many, many more.  To say their lives were tragic is an understatement.
All of these talents became dependent on prescription drugs.  In some cases the prescription drugs were combined with alcohol and/or illicit drugs.   Prescription drug dependency is not only prevalent among the rich and famous but mainstream Americans.  The Legal Action Center, that monitors drug use, reports that non-medical use of narcotic pain relievers, tranquilizers, stimulants, and sedatives ranks second behind marijuana as a category of illicit drug abuse among both adults and youth.  Since 1995, emergency room visits, resulting from the abuse of narcotic pain relievers, has increased by 165 percent.  13.7 percent of youth between the ages of 12 and 17 have abused prescription drugs at least once during their lifetimes.
For many, prescription drug dependency starts innocently enough.  A doctor prescribes it for legitimate pain and the patient, over time, finds that he can not stop using them.  He may require more or stronger pain killers to satisfy the craving.  These people feel guilty and instead of seeking help, doctor shop, acquire pills from friends and family, or turn to alternative drugs such as alcohol to satisfy the craving.
For others, prescription drug dependency starts because people seek an altered state, to fit in with the crowd or to escape stressful situations.  Many of these people are under the age of 21. 
Once drug dependent, the addict faces upward challenges.  Private insurance and public funding for treatment is limited.  Often the addict is left to his own devices to “kick the habit.”  Obviously, if we can prevent dependency, we can alleviate a lot of suffering and loss.    

• Question your need for a pain reliever.  Television advertising for pain medications is at an all-time high.  Are we responding to flashy ads?
• Question your doctor about the medication that is being prescribed.  Is it addictive?  Are a large number of pills prescribed when, perhaps, a smaller number would be adequate?
• Lock up your prescriptions.  Young people can pilfer a small number of pills from each bottle and they will not be missed.
• Model appropriate use of medications.  If parents are seen as taking a pill for everything, kids will do the same.   

The death of Michael Jackson is a tragedy, however the same tragedy occurs daily in Detroit, Macomb County, Oakland County – any place people live. 

Walking Barefoot Across Africa    

My 15 year old grandson, Sam, needed a new pair of shoes.  His mother had asked him to go shopping several times but he was always too busy.  Suddenly, one day, he decided that this was the day.  The shoes needed to be purchased immediately, if not sooner.  My daughter was busy and decided that the fair-haired child would need to wait.  Sam, while usually a very agreeable teen, was not always used to waiting to get his desires met.  He proceeded to share why it was important that he have the shoes that very day.
I had just completed reading, Long Way Gone, the story of the lost boys of Africa.  Boys who had been taught to kill in their war torn country and, when attempting to escape the ravegous of war, had to walk barefoot across Africa.  
I asked my grandson, “Have you ever had to walk barefooted across Africa?”  Sam looked blankly at me and, of course, had no idea what I was referring to.   My point was that while we are sometimes faced with disappointment and even hardship, others are facing situations that we in America can not even imagine. 
Through the work that we do (CARE’s Worklife Solutions Employee Assistance Programs, Student Assistance and access to treatment for mental health and substance use disorders) we have seen increases in the suicide rate and it is sometimes associated with the plummeting economy.  Hard times increase the pressures on theindividual and families.  Marriages dissolve, crimes increase, alcohol and other drug abuse spirals upward.  People become so discouraged that they are giving up.   I find this incredibly sad.  
How can we help?  We can learn to listen.  Discouraged people find it therapeutic to share their concerns with others.  When necessary, we can link people with services and attempt to help them find resources that are low cost or free.  We can also encourage services to waive fees or assist in finding ways to pay for them by contacting service organizations or faith-based communities. 
How can we help?  We can help give others hope by going the extra mile.  A police liaison in a public high school, Tom Pfeifer, heard of a teen that is living in a Detroit foster care facility and was unable to attend her home high school.  He approached a CARE staff member, Anna Marie Reisterer, who works with the Family to Family Foster Care project.  Anna Marie contacted the Department of Human Services case worker, Bobbi Mitchell. Together they worked thorough the red tape (a lot of red tape!) and were able to provide daily transportation so the girl could attend her home school. 
How can we help?  We can help give others hope in subtle yet tangible ways.  I observed a poorly dressed young woman grocery shopping with a baby and toddler.  She was choosing carefully.  Another well dressed women reached down beside her and fawned picking up a $20 bill.  The second women said to the first, “I think you dropped this,” and attempted to hand the bill over.  The first woman denied that she had dropped it saying that she did not have $20.  The second woman insisted, “It was by your feet so you must have dropped it.”  She forced the first astonished woman to take the money, turned and walked away.     
How can we help?  We can help others see that while things are bleak, we will never have to walk across Africa barefooted.

The Call for Action

Several recent events point to the increased need for services and diminishing funding opportunities.  In the 22 years that I have worked for CARE, I have never seen a time of such fear, sadness and confusion.  Of course, our economic insecurities play a key role in the way people are feeling.  But it goes beyond that.  CARE, through two divisions, Worklife Solutions and Student Assistance, provides support via critical incident debriefing and crisis support in instances where a traumatic event occurs.  We have been called out many times, this year, when a suicide, death to drunk driving, and other life altering events impacted the work place or school community.
     Most recently, we provided support in St. Clair Shores when four young people were killed by a drunk driver.  When the news media interviewed me, they voiced deep concern and shared that they were confident that this would change the perception of drunk driving.  Surely, people would stop drinking and driving after such a devastating event has impacted the community.   I was not convinced.  We have lost life before and under similar circumstances.  We all grieve for a few days and then life goes on for most of us.  It is only the friends and family of those we have lost that go on grieving. 
     Unfortunately, I seem to be right.  Recent news articles continue to tell stories of drunk drivers killing innocent bystanders.  Most recently, a Los Angeles Angel was killed at the age of 22.  Closer to home, at least two crashes due to drunk driving have taken lives.  Numerous tickets continued to be given for drunk driving, and in many cases they are given to otherwise upstanding citizens. 
     Often we hear, “change will not occur until someone dies.”  Not true.  People are dying and change is not occurring.  A well-known newscaster shared his sense of confusion and frustration.  “Nine people die from peanut contamination and the whole country mobilizes.  We lose hundreds of people yearly in crashes caused by drunk drivers and we wring our hands and go on."  Jon Stewart says that when Europe is frustrated with what they feel is an injustice, they march.  When American’s are frustrated, they email…..in all caps.

So, in efforts to make our voices heard, CARE and the Traffic Safety Association of Macomb County have joined forces to address underage drinking and drinking and driving crash fatalities caused by the inappropriate use of alcohol and other drugs. Project Remedy, funded through a Strategic Prevention Framework/State Incentive Grant, is working with local, community-based groups to bring change. Strategies used to address the problem include public awareness through town hall meetings, media blitzes, and calling those who have an immediate stake in the problem to the table. Law enforcement, including judges and magistrates, are being asked to formulate one voice and respond to the call for action.

Parents and school personnel are being asked to explore their own behaviors regarding alcohol use, resist minimizing the problem and confront the reality - alcohol and other drug use is causing a life long health problem through addiction and, in some cases, is maiming and killing our children. Call Pam Werling or Jamie Siefert at 586.541.0033. Respond LOUDLY to the call for action.   

Opportunity and Change

The 2007-2008 fiscal year can best be described as one of anticipated change. Movement from an "assessment and referral system" to the "access management system" (AMS) caused fast and furious activity. The change, effective October 1, 2008, resulted in increased funding for treatment and a seamless access system. Qualifying adults seeking treatment for alcoholism and other drug dependency receive a telephone screen. A positive screen will result in the client being referred directly to a licensed treatment provider. Students and employees referred from contracted companies continue to receive a comprehensive, face-to-face, psychosocial assessment and referral to an appropriate treatment provider or ancillary service.

Change also offered opportunity. Four additional programs have been implemented.

• The United Way of Southeast Michigan awarded CARE funding to support activity for foster families, birth parents of children living in foster care and low income communities. Family to Family initiatives located in Roseville, Warren and Clinton Township benefit from increased case management services and support for birth parents through community support and wrap-around funds.
• South East Michigan Community Alliance (SEMCA) provides funding to expand alcohol and other drug prevention programs in the five Grosse Pointe Communities and Harper Woods.
• CARE will work closely with parents who have their children living in foster care and suffer from alcoholism and/or other drug dependency. Substance Abuse Support Services, funded from a contract with the Macomb County Department of Human Services, will focus on assisting these parents to overcome barriers to achieving and maintaining sobriety.
• Project Achieve, funded through a national contract with the Substance Abuse Mental Services Administration, provides education and early identification of children exhibiting characteristics of fetal alcohol spectrum disorders. Families are linked to diagnostic centers and supportive services.

Continued support from the Macomb County Community Mental Health Office of Substance Abuse has made it possible for CARE to provide services aimed at educating the community in substance abuse prevention strategies and providing access to treatment for substance abuse disorders. In addition, CARE has been able to link with other public agencies to support their target populations including Michigan Rehabilitation Services, Michigan Prison Re-Entry Initiative, Macomb Intermediate School Districts, Macomb County Department of Human Services and Macomb County Friend of the Court.

I, personally, continue to thank a talented and compassionate staff and dedicated Board of Directors.

Breaking the Anonymity

I must confess, I never heard of “anonymity” until a couple of years ago.  And then it took me a few tries to learn to pronounce it….and please do not ask me to spell it.    I now understand that it is a very important word in the recovering community. 

The principle of anonymity, according to the brochure Advocacy With Anonymity, means that those attending certain recovery groups are directed not to talk about their recovery as it relates to compromising the principles of the recovery program.  These principles are meant to protect the recovering person from stigma and discrimination as he/she begins the journey.  Anonymity plays a crucial role in establishing personal humility, which is a “cornerstone of the spiritual foundation of recovery.”  Further, it keeps groups from becoming enmeshed in any public controversy that would divert them from their primary purpose of helping alcoholics and other drug dependent persons to become drug free.

However, while attending the National Council on Alcoholism and Drug Dependence (NCADD) Dignity Dinner, Dwight Vaughter, CEO of Shar House, encouraged those in attendance to break their own anonymity and share their recovery with “dignity.”  Mr. Vaughter was at the dinner to receive the Joseph Dahmen Award for “Reducing Stigma in the Workplace.”  He eloquently said that, "Those who are in recovery need to be open about their own journey so that others may know that success is possible.”  He was clear.  There is no reason to break the anonymity of the group one may be affiliated with.  The power is in the individual stories. 

Advocacy With Anonymity explains that those in recovery need to speak out because we are losing the war in regards to adequate funding for treatment.  Michigan has not seen an increase in public funding of treatment for 17 years, therefore, those needing treatment are put on long waiting lists which decreases, in some cases, their opportunity to recover.  Until recently, the recovering population has been invisible.  It has only been, most recently, that those in recovery have started to speak out, allowing others to see their strengths and capabilities.  This reduces stigma and discrimination and, hopefully, encourages increased funding for treatment.

I was moved by Mr. Vaughter’s message.  Breaking one’s personal anonymity will allow the movement to grow, broadening opportunities and acceptance. 

During the Dignity Dinner, Debbie Garrett, Chairperson of Greater Macomb Project Vox and Stephanie Lang, Student Assistance Coordinator at ChippewaValley Schools, received the Honorable Myron H. Wahls “Recovery is Possible” Awards.  Congratulations to Dwight, Debbie and Stephanie.  You are the trendsetters.  Others will follow.        

Recovery Month

I recently had the opportunity to visit our legislatures in Lansing.  My message was, “treatment works” and the public system needs adequate funding to meet the needs of those who suffer from addiction.  One state representative responded, “It did not work for my family member and I don’t believe it works for others.  It is a waste of money.” 

I know the pain of watching loved ones die from alcoholism and other drug use.  Many of you know my story so I do not want to belabor it.  My brother died at the age of 38 after participating in treatment programs.  My sister died at the age of 50 after very limited treatment.  Intervention was not quick enough.    I could believe the same thing that the state representative believes: “treatment does not work.” 

I came to the following conclusion:  treatment for alcoholism and other drug addiction does not work for everyone suffering from the condition.*   It is true.  Treatment does not work for all people who suffer from cancer, heart disease or diabetes either.  Statistics show that treatment for those suffering from addiction must often experience multiple treatment episodes.  In some cases the recovery rate is low.  The jury is still out on why treatment, in some cases, is ineffective.  I have some thoughts.

• Intervention does not occur early enough in the disease process.  Denial (not a river in Egypt) of the reasons for the problems faced by those that are in the early stages of addiction, are often overlooked, minimized or rationalized by both the user and those who love him.   This allows the user to continue down the progressive path to full blown addiction. 

• There is little acceptance that addiction is a chronic condition that requires long term care.  Treatment episodes tend to be short and follow up is minimal.  Current attitudes continue to support the theory that treatment should work the first time.  While relapses occur, they are viewed as failures rather than conditions of the addiction that need further and ongoing attention.    

• One of the reasons treatment may appear ineffective is because there is not enough of it!  There has been an erosion of funding for public treatment.  Michigan has not received an increase in funding for the past 17 years!  This has resulted in longer waits for treatment, shorter stays and an increased number of addicts being “treated” through the penal system.

 All that being said, I know that alcoholism and other drug addictions are conditions that cause much pain for individuals and society as a whole.  I, also, know that treatment, as well as other forms of interventions, can and do work.  People are putting “faces and voices” to the recovery movement.  Two local events are being held in September where voices will be heard.

Celebrate Recovery! will be held on Belle Isle on Saturday, September 13 at 9:30 a.m.  Those in recovery and those who support them will gather to walk across the Belle Isle as a show of confidence….recovery works!

Macomb County’s Recovery Fest held at Huron Park, located on Frazho Road in Roseville, on Sunday, September 14, will provide an opportunity for the community to participate in a fun and informative day of celebrative activities.

I want to thank the family of Carl Lewis who died last winter.  His obituary reads, “Carl Lewis died suddenly at his home after losing his long struggle with alcoholism.”  Carl’s family gave us a gift.  They recognized alcoholism as the disease that it is.  They recognized that Carl struggled against the disease.  They recognized that alcoholism was the reason for the death; they didn’t hide behind a different diagnoses.  Their brave act validates for us what most want to deny:  alcoholism is real and kills.   Overcoming the addiction is a “struggle” and sometimes can not be achieved.      

When you read between the lines of Carl’s obituary, you can guess that he may have been a caring person.  He wanted memorial contributions to go to the local Humane Society.  He enjoyed the outdoors.  Both are characteristics that we identify with a sensitive sole.   

Carl’s family’s actions will go a long way in helping others understand the very terrible consequence of addiction.  For those that are drug dependent, the struggle is hard and often short lived. 

Do You Have a Back Door?
A counselor, treating those with alcoholism or other drug dependency, shared that she had recently been asked a question by a potential client.  “Do you have a back door?”  Its meaning was clear to the clinician and should be clear to everyone in long term recovery.  Stigma is alive and well in many of our communities.

In spite of the fact that research validates what has been known by most of us for years – drug addiction is a brain disease – many people still view it as a moral failure.

The failure to recognize addiction as a brain disorder impedes people from seeking treatment.  While progress has been made in understanding most mental illness, substance use disorders remain a condition that brings shame to those with the affliction, thus the need to use a back door when seeking treatment. 

We know this because

• Insurance companies refuse to offer treatment at the same level as other diseases
• Public funding for those with substance abuse disorders has not increased in 19 years! *
• Many of our laws and policies punish people with substance use disorders, including such practices as denying loans or voting rights, and welfare guidelines which require indiscriminant drug testing. 
• People ask, “Do you have a back door?”

*Send your letters of support for public funding to me at
Project Vox
31900 Utica Rd., Fraser, MI  48026