In the early 2000s, I worked in community mental health in Portland, Oregon. I had the privilege of working with this amazing psychiatrist, Dr. Phil Shapiro, on an Assertive Community Treatment team. You can read an article about him here (on his website) or here (an article from the Oregonian, 2010).
At the time, he was working on this book called Healing Power: Ten Steps to Pain Management and Spiritual Evolution. He had groups that he did with clients in both community mental health and in the regular community (I attended!), all based on the program he outlined in his book.
He recently shared that his book and the subsequent workbook he published, are available for FREE from his new website. The books are available for download in text or audio format. What a gift! Please check out his new website to take a look and download these gems.
Thank you Dr. Shapiro, for your years of service and for making this work available to everyone!
Following up on my last post on harm reduction, I've been hearing a lot on the radio lately about harm reduction efforts happening in Seattle. In particular, stories about creating "Safe Consumption Sites" across King County. Here are a few links in case you have missed the discussion.
Research shows that these kinds of programs have worked in places such as Vancouver, BC, and several countries in Europe. The programs reduce harm by
* reducing the number of overdose deaths
* providing a safe, clean, and secure space for people to use, while reducing the visibility of use to the community
* reducing HIV and Hepatitis C transmission, thereby saving not only people's health but also taxpayer money
* providing an opportunity for people who are using drugs to have multiple contacts with health professionals, who can help users move towards treatment options, healthcare, housing, and other services
Opponents say that these programs encourage drug use and increase crime. The research does not support this. In fact, research indicates that those who use safe consumption sites actually get help and/or enter treatment sooner than those who do not use the sites.
For people who do not want a drug consumption site in their backyard, I wonder...Would you rather wake up to dirty needles outside of your doorstep? Would you rather have less people in your neighborhood contracting HIV and Hep C? Would you rather pay more or less in taxes for the costs associated with arresting and housing homeless people on drug charges, hospitalizing those who have overdoses, and paying for treatment for those who have contracted HIV and Hep C through dirty needles? Would you rather see people injecting drugs in your neighborhood, or have them do it indoors, out of sight?
What would you rather have?
I'd love to hear your thoughts!
For a long time, those who struggled with addictions had only one model of treatment and it centered around the idea of abstinence only. While 12 steps and abstinence only have certainly helped many people, they aren't for everyone.
What is harm reduction? In short, harm reduction refers to programs, policies, and practices that aim to the reduce the harms associated with substance use or other risky behaviors.
One of the first harm reduction ideas started with IV drug users and the concern of spreading HIV through dirty needles. At the time, it was controversial to be handing out clean needles to people who used IV drugs. Now needle exchange programs are commonplace, and the evidence supports that these programs reduce various harms (HIV, Hepatitis C, skin infections, etc.).
Some harm reduction ideas are so commonplace that many people don't realize they are participating in harm reduction--for example using condoms to prevent sexually transmitted infections, or using designated drivers while drinking.
Opioid Replacement Therapy, methadone maintenance programs, safe injection sites, and Naloxone distribution are among many other examples harm reduction.
Have you tried an abstinence only or 12 step approach and found difficulty with it? Don't give up hope--there are other options!
Harm reduction can be different for everyone. If you are using alcohol or other drugs, harm reduction may look like using less, using in different ways, using at different times, not driving while using, etc. Anything that reduces harm is part of harm reduction.
If you are interested in trying a harm reduction approach, whether it be with your alcohol use, gambling, or other drugs or risky behaviors, feel free to contact me. I'd love to help.
What have your experiences been with harm reduction and/or abstinence only approaches?
One of my goals at the beginning of this year was to read at least one book per week, or 52 books this year. I am well on my way to reaching that goal!
I was recently contact by a man from India who who asked me to read and review his book entitled Gulabi. The book was about a man who experiences psychosis. As I read the book, I couldn't help but wonder if the author himself had experienced psychosis. I reached out to him and he informed me that he was in fact diagnosed with schizophrenia and that Gulabi was one of his hallucinations during a psychotic episode. I was so impressed that this author, who has struggled with schizophrenia, was able to write this short book, and give readers a small glimpse of what it could be like to experience psychosis. He is now in graduate school and doing well!
It all got me thinking about mental health and recovery. When people hear the word recovery, they often think of addiction. But there is recovery in mental health as well. I thought I would share with you today some books written either about recovery or by those who are in recovery from mental health challenges.
Gulabi, written by Pankaj Suneja
Dante's Cure, written by Daniel Dorman
New Vision of Recovery: You Too Can Recover From Mental Illness, written by Daniel Fisher
Nobody's Child, written by Marie Balter and Richard Katz
There and Back Again: A Mental Health Recovery Book written by Someone Who Has Lived It, written by Emily Grossman
First Person Accounts of Mental Illness and Recovery, edited by Craig LeCroy and Jane Holschuh
My Schizophrenic Life: The Road to Recovery from Mental Illness, written by Sandra Yuen MacKay
If you find yourself struggling with a mental health challenge, know that you are not alone. And, know that there is hope. It is possible to get better! The people and books above not only give us a glimpse of mental illness but also give us a glimpse into the possibility of recovery.
As always, feel free to contact me if I can be of help!
Amber is a Licensed Independent Clinical Social Worker. She offers counseling for individual adults and clinical supervision for social workers. For fun, she enjoys spending time with her family, traveling, researching genealogy, reading, and dragon boating.
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