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Surgeon General Releases First Ever Comprehensive Report on Alcohol, Drugs and Health

The U.S. Department of Health and Human Services has released “Facing Addiction in America: Surgeon General’s Report on Alcohol, Drugs, and Health,” the first ever comprehensive report by the US government detailing substance addiction in the United States with the intent of raising the profile of the widespread epidemic and advocating proven treatment options.

Please click the links below to visit the Surgeon General website to learn more or to read the report in its entirety.

Click here to visit the Surgeon General website on Addiction

Click here for the PDF of the entire report.

naltrexone implant retention rates

Naltrexone implant for the Treatment of Polydrug Dependence: A randomized Controlled Trial

From  Am  J  Psychiatry  2012;  169:531–536
By: Jari Tiihonen, M.D., Ph.D. Evgeny Krupitsky, M.D., Ph.D. Elena, Verbitskaya, Ph.D. Elena Blokhina, M.D., Ph.D. Olga Mamontova, M.D., Jaana Föhr, M.D., Pekka Tuomola, M.D., Ph.D., Kimmo Kuoppasalmi, M.D., Ph.D., Vesa Kiviniemi, Ph.D. Edwin Zwartau, M.D., Ph.D

Objective: The majority of drug addicts are polydrug dependent, and no effective pharmacological treatment is currently available for them. The authors studied the overall real-world effectiveness of naltrexone implant in this patient population.

Method: The authors assessed the effectiveness of a naltrexone implant in the treatment of coexisting heroin and amphetamine polydrug dependence in 100 heroin- and amphetamine-dependent outpatients in a 10-week randomized, double-blind, placebo-controlled trial. The main outcome measures were retention in the study, proportion of drug-free urine samples, and improvement score on the Clinical Global Impressions Scale (CGI). Analyses were conducted in an in- tent-to-treat model.

Results: At week 10, the retention rate was 52% for patients who received a naltrexone implant and 28% for those who received a placebo implant; the proportions of drug-free urine samples were 38% and 16%, respectively, for the two groups. On the CGI improvement item, 56% of the patients in the naltrexone group showed much or very much improvement, com- pared with 14% of those in the placebo group (number needed to treat=3).

Conclusions: Naltrexone implants resulted in higher retention in the study, decreased heroin and amphetamine use, and improved clinical condition for patients, thus providing the first evidence of an effective pharmacological treatment for this type of polydrug dependence.

For more information on the benefits of naltrexone implant, read the original article here.



Individuals and their families suffering from addiction are in a time of crisis. In most instances, loved ones understandably don’t know what to do to help. This puts them at an information disadvantage and opens up an inevitable vulnerability to disreputable and predatory people. I believe many of those people work and make their living in the addiction recovery industry.

My name is Todd and this is my story…

For full disclosure, I was the recipient of a naltrexone implant in December of 2013.  I hope in sharing my story I can help prevent others from going through what I experienced.

As is the case with many people that suffer from addiction, I went through an extremely difficult period of my life in recent years experiencing several major life stresses. This included (but very much wasn’t limited to) a failed career, financial crisis, separation and divorce, and two major abdominal surgeries (one of which was emergency). This led me to start “roller coaster” drinking relatively later in life at the age of 40 (I’m 45 now).

After separating from my wife and while temporarily living with my parents waiting for things to settle, I awoke early one morning with severe abdominal pain—my large intestine had torn. I had diverticulitis…was born with it and never knew. After six/eight hours of emergency surgery I awoke in the ICU with a colostomy bag that I would have for five months. The reversal surgery was extremely difficult and after all of this I had lost 51 pounds. I wasn’t the same after that and started drinking again.

I would never claim any kind of excuse for my drinking. I’ll outline reasons, but never excuses. I’ve since examined all that happened and can see things such as postoperative depression, my fear and paralyzing sadness from such stressful life changing events, etc. All I knew then was that I had a long road ahead of me to get back to the outgoing, productive man I was. I had no idea of what was to come…I was about to be pulled into an abyss deeper than I thought possible…

My family was aware of my depression and drinking and tried to help. They were understandably in the dark as to what to do as we had never been exposed to anything like this. I have three other brothers and none of us had ever experienced anything regarding an addiction. This led to three horrific, heartbreaking experiences with recovery entities that unquestionably exacerbated my problems, were psychologically damaging, broke me financially and were even criminal.

The first was Recovery Facility #1 (RF-1), a treatment facility that claimed detoxification and recovery services and was accredited by The Joint Commission (JCAHO – Joint Commission on Accreditation of Healthcare Organizations). I have no idea how such an accreditation could have been granted. I absolutely had my reservations about the facility, but I was very upset at having disappointed my family and desperately wanted to prove myself to them. I was brought there by my mother, father, and my two younger brothers. The facility is owned by “John Doe” & “Jane Doe” (husband and wife respectively…both former addicts) and run by general manager “Mike” (former addict with time spent in prison). All three (along with my family members) were present during admittance. It was then that I adamantly stated based on extreme personal importance with my recovery that I couldn’t lose my job and that I had to have a chance to see my son. I was told several times in front of all that I would not lose my job and that I would be able to see my son. I also presented my Ativan medication…prescribed to me by my general physician at that time (a very good man) that of course advocated for me to stop drinking completely, but that if I did go through a bender and stopped abruptly, I should take it to prevent a seizure. The bottle was several months old and almost completely full.

I saw a breakdown that showed the structure of everything that was “supposed” to be happening at the facility. This entailed counseling sessions, daily meetings, medical exams, etc. Approximately one fifth of all that was outlined on that sheet actually happened there. I believe (and I think it’s very important to always point out anything on speculation as opposed to very objective events) that this sheet was presented to the Joint Commission for their accreditation. I was not scheduled to see anyone from a medical standpoint until the fourth day. How can any entity claim detoxification services without starting anything until that long after admittance? I didn’t even have my blood pressure taken during that period—never even saw a cuff for measurement…let alone ever saw anyone there that was qualified to do so. I even brought in high blood pressure medication that I was allowed to take—one would think that would cause concern while going through horrific detoxification. Outrageously unacceptable…

Unbeknownst to me at that time, my mother signed the contract that was $4,000 for 90 days of treatment. They also collected my insurance information. Approximately three weeks later my parents were approached very aggressively by Jane Doe (Owner/Director of RF-1) stating that $12,000 was due immediately. My mother wasn’t sure if it was meant that in their scam they were claiming it was $4,000 per month or the original amount was just a down payment and it was $12,000 per month. Regardless, it was absolutely against the contract she held in her hand and the amounts were unacceptable.

I had read online that this exact scenario happened to someone else a short time later. It was posted on a formal review site and the details were frighteningly similar. Apparently that was the sales tactic by Jane (owner/director) to get patients in the door where they were vulnerable and possibly had no other choice but to stay and pay the additional funds demanded. When it comes to safety & health care, to call something like this “unprofessional” is way too vast an understatement…

They brought me into the main living area to get me situated and I knew that they were escorting my family out of the facility. I would have liked to have said goodbye and I love them. I was incredibly scared and uncomfortable…especially since I started experiencing a bad detox right away. I started vomiting and couldn’t stop for over 24 hours. I asked for my Ativan (directly prescribed to me by my own physician) and was told by Jane that “you can’t have that—it’s a benzo” (as in benzodiazepine).”

It’s here that I should point out that outside of getting high maybe 5 times in my life (last time being roughly 25 years ago in college—absolutely wasn’t for me) I have never been on drugs. I do not take drugs. I have never abused pharmaceutical medications. In fact, I philosophically don’t like taking medication—I would rather do everything I can to fix an ailment as opposed to mask any symptoms.

I was brought there early on a Monday afternoon and vomited all night. I did not sleep at all the first night or the second night. I was very frightened and did not doze off one single time. I strongly requested/demanded my Ativan at least 20—25 times throughout those first few days. I had detoxed before on my own and this was by far the worst I had experienced. I was petrified at how wrong I felt in my head and kept telling the staff this (absolutely including Jane, John & Mike) many times…always asking for my Ativan. I was simply told that I couldn’t have it and to “focus on my recovery” (a line told to me dozens of times by Jane). I was instructed that I was going to see the doctor on Thursday morning (because that’s when another patient was scheduled thus it was convenient for them).

I completely realize that addicts can be demanding based on all they are encountering during treatment. I also believe that during the intake process, common sense needs to be applied. Recovery is NOT one size fits all…for the love of God I’m a good guy with a tight family and needed help. I did not need condescending discipline and criminal treatment. When I continually informed all applicable people that something was wrong, it’s pure evil for them not to have addressed it in any way whatsoever. I had detoxed before on my own and this time was different. I was experiencing very scary feelings in my head and sternly expressed this. “Just keep focusing on your recovery”…insane words that ended up psychologically damaging to me…

On Wednesday afternoon at approximately 4:00pm I had a grand mal seizure.

I awoke in an ambulance en route to the hospital approximately 40 minutes later (from what was told to me). I was asked my name and didn’t know it, asked my birthday and didn’t know it, asked what city I lived in and didn’t know it. I was in a neck brace (the kind football players are placed in from possible spinal cord injuries). My head was stuck to the gauze behind it…apparently I fell on the back of it and after seizing for a minute I was lying in a pool of blood.

The next day when speaking with other patients as to what actually happened during that long period I can’t remember, the general consensus by all was that I screamed loudly and groaned from the air being forced past my vocal cords while dropping backwards on my head. We were all on the patio near a very large built-in barbeque with jagged, sharp stones on the walls. I just missed hitting the corner of it and the patients were quite certain if I had in fact hit that corner I would have died. I convulsed for at least a full minute with some saying it was much longer…

John and Jane arrived at the hospital at 9:15pm. I was still in the ER, still in the neck brace and awaiting results from X-rays and scans to determine possibilities of a cracked skull, broken neck, spinal cord damage or brain damage. I asked where my family was…I had thought that this event would have brought an end to the nightmare and I would head home to recover. Jane enthusiastically claimed “I spoke with your mother and told her you were fine” several times. At that point, I really don’t think my state (especially awaiting said results) could have been defined as “fine” in any way. I came to find out later that they phoned my mother at 8:30 that night, told her I was fine and sternly demanded that nobody came to the hospital to see me. The cover up had started.

My mother wasn’t even informed that I had a seizure…she was told that I simply fainted. My family would have rushed to the hospital but that wasn’t the case. They were explicitly told not to go to the hospital in an almost threatening manner. Throughout all of the uncomfortable and frightening feelings of waiting to find out if I had any extensive or long-term damage, the only comfort I could remotely try to think about was that I would be discharged with my family and I would be away from these people because of what happened. Not the case—that of course wasn’t in the plans for John & Jane…

Interestingly enough…the first medication I received at the hospital was Ativan.

All tests came back negative and I received 8—10 staples in the back of my head. I made it back to RF-1 at approximately 11:30 that evening. I slept in small increments that night and my entire body ached from the convulsing during my seizure. The next morning I was taken to the “facility physician” (30 minutes away), apparently to BEGIN my detox. This is purely based on assumption, but I imagine this involved referral exchanges monetarily. I have heard how widespread and lucrative it is in the recovery business but can’t understand how it can be legal based on medical treatment.

It was discussed enough throughout the facility that the reasoning for seeing a physician so far away was purely because of referral revenue. I know that this is illegal with medical treatment so I don’t understand how this can be acceptable in the treatment industry. I saw the physician for approximately 90 seconds and left with a prescription. When it came time for my follow up appointment at the hospital for the staples to be removed from my head, sure enough Jane canceled it. She instead waited an extra few days until it was time for my follow up appointment with their physician…she had his assistant remove the staples. I was billed for the ambulance ride to the hospital and my insurance was billed for the emergency visit…

Sure enough, the first prescription the physician presented to me was for Ativan.

The next morning, Jane told me I needed to sign a power of attorney agreement with a notary so that they could “go after” my insurance company. I said absolutely not and that my family would absolutely have to be involved. Jane was adamant while flashing me the agreement and said it only involved my insurance. She said she would drive the agreement right over to my family immediately afterwards. I of course still said no. A short time later, Mike approached me and instructed me that they would “make my life hell” if I didn’t sign it. I was scared enough, still shook up from the seizure with staples in the back of my head, and not knowing what to do signed it under duress.

It was very difficult for me to see things transpire around me with such clarity and have nobody to tell. Their devious tactics were audaciously transparent. I knew what they were doing, didn’t like it, was incredibly uncomfortable with everything and yet couldn’t reach out to anyone. I should point out here that it was during that time I discovered that I was one of only a few patients that weren’t there via court order. The owners were part of a program that received government funds to house recently released/paroled convicts. I overheard that the program was “going away”…thus such aggressive measures taken for me, my family and my insurance to augment that lack of income…

It’s important to point out that I was absolutely forbidden to contact anyone outside the facility. They of course confiscated my cell phone and wallet upon admittance. I couldn’t contact anyone…

That same day, I continued inquiring about my employer and what the status was regarding my job. It was a good career position with a global company that valued my contributions. Jane finally brought me into her office and flashed me a letter, addressed to me, on my company letterhead, and said “you’re fine—just focus on your recovery.” I demanded to read the letter and she wouldn’t let me and locked it in her desk. For the next two days I kept demanding to see the letter. Finally a night manager went in to get it for me and it was then that I saw my company supplied me with as many days possible through human resources and stated that I only had to be back online with correspondence by the date of June 14th. That day was just under two weeks away.

This was a big turning point for me…being scared turned to petrified. I realized the depth of their depravity as I knew they were going to do whatever it takes to prevent me from holding onto my career position. Their plan being that losing my job would entail a helplessness in which I would be forced to stay at their facility longer. ANYTHING to keep the revenue coming…NOTHING whatsoever in terms of treatment or, God forbid, actual help…

I approached Jane and told her about the deadline of the 14th and she said she’d drive over to my folks to pick up my laptop. This conversation went on until two days before the 14th when I expressed serious concern about losing my position. Jane stated the same line each time, again and again…”I’ll get you your laptop—just focus on your recovery.” I didn’t trust her so I snuck out and used the phone at night to call my mother and ask for her to bring me my laptop. My mother informed me that they were under explicit instructions that if I ever called them they were to hang up on me immediately. She said she was afraid to do anything based on any repercussions. Mike saw me use the phone on a security camera and immediately came to tell me again that “they would make my life hell” if I should ever do that again.

My parents were AFRAID of John & Jane. They were threateningly told to never accept a call from me. My mother informed me later that she was so scared when I called because she was concerned about the ramifications of what would happen if they did in fact speak with me. All of this brings together the devious planning from day one by the owners of a facility that was supposed to help me…

The 14th came and went with no laptop. I lost my job because of this. All I simply had to do was spend a few hours each day corresponding via email. It’s more than obvious it was their plan all along to deviously cause me to lose my job as it could amount to a longer stay at their facility. I still haven’t been able to bounce back from what I held at that career position.

When looking at monies spent at treatment facilities that generally provide dismal success rates and don’t work, I believe that many do in fact have good intentions at assisting patients striving for recovery. To spend a formidable amount and have nothing to show for it is one thing…to spend money and be victimized by predatory people that cause major problems and make everything worse with intent—that’s on criminal level…

A few days later they allowed me to be taken to lunch with my parents so I could see my son. It was then that they had outlined the scam by RF-1 along with the plan to sneak me out of the house. It was there I signed the retainer for an attorney. We eventually filed suit and won a settlement…alas, it was a loss for us with all of the costs involved. My attorney can corroborate the audacity of the behavior of the defendants (RF-1). He said it should have gone to trial where they would have committed perjury and there most likely would have been punitive damages awarded. It was hard on my family though and they wanted to settle as soon as possible, putting this darkness behind us. During that time, I received in the mail an EOB (explanation of benefits) that showed RF-1 collected over $28,000 from my Blue Cross insurance.

Part Two Coming Soon…

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