By: MELANIE KILGORE-HILL
Published: September 14, 2017

Specialists Address Disturbing Trends, Skyrocketing Death Rates

The Opioid Crisis hits Nashville Tennessee - Cumberland Heights treats Addiction to Opioids and Heroin

More than 2.5 million Americans suffer from opioid use disorder, which contributed to more than 33,000 overdose deaths in 2015, according to figures from the Centers for Disease Control and Prevention. Fortunately, a growing number of treatment options are helping to break the addiction cycle and bring healing to families in Middle Tennessee and beyond.

The New Face of Addiction

“Once upon a time, opioid addiction was limited to healthcare professionals with access,” said Chapman Sledge, MD, FASAM, chief medical officer at Cumberland Heights.

 

An addiction specialist for more than 20 years, Sledge said programs like Cumberland’s primarily treated those suffering from alcoholism a decade ago. Fast-forward to 2017, and the 50-year-old program regularly sees housewives, teenagers and executives – all patients addicted to prescription opioids and, more recently, heroin.

 

“Eight years ago you rarely saw heroin in Nashville,” Sledge said. “When Tennessee became more aggressive with the Controlled Substance Monitoring Database Program, it cut down on multiple prescriptions from multiple prescribers, which tightened up the illegal supply and drove cost up.”

 

To help prevent abuse, pharmaceutical companies also made the drugs less dissolvable. That shift opened doors for mom-and-pop heroin dealers to set up shop, offering an alternative that’s cheaper, easier to get, and more potent than prescription opioids. Today, heroin is often the most popular opioid for first-time users, leading to more overdose-related deaths than ever.

 

Dr. Chapman Sledge, MD of Cumberland Heights Top Opioid Medical Doctor“The thing that’s a game-change is the rate at which people are dying and the desperation among families,” Sledge said. “It’s so incredibly dangerous because the potency has changed. With prescription opioids, we knew what to expect from a single dose … but with heroin, it’s difficult to judge potency.”

Evolving Therapies

Enter medication-assisted therapy (MAT) including fast-acting opioid antagonist drugs, now a standard in pharmacies and emergency departments nationwide. In fact, certain antagonist therapies are available without a prescription in many states, including Tennessee.

 

Also growing is the number of in- and out-patient treatment options now available. At Cumberland Heights, patients undergo an evidence-based, 12-step recovery process that focuses on spiritual healing, as well as physical. In 2016 the program treated more than 2,000 men, women and adolescents through their two main campuses and 10 outpatient offices.

Mental Health & Addiction

Fully addressing an addict’s mental health also is imperative. Kevin Lee, CEO of Nashville-based JourneyPure, said the majority of addicts struggle with mental illness related to anxiety, depression, OCD or bipolar disorder.

 

“Our approach to addiction treatment is to first get an examination done to identify possible mental illness,” said Lee. “That’s one reason we founded JourneyPure, because so many adults with chronic mental illness have spent time in psychiatric hospitals without addiction ever being addressed.”

 

Lee said 70 percent of addicts are between the ages of 20-35, many of whom developed mental illness after using drugs. While the company serves all demographics, JourneyPure also offers programs specifically for professionals struggling with addiction.

 

The company treats more than 3,000 new patients annually at facilities in Kentucky, Florida, Mississippi and Tennessee, including a Knoxville program specifically for expectant mothers. However, Lee said only 10 percent of addicts who would benefit from treatment receive it.

 

“They’re embarrassed because they think they can’t leave work or don’t have the money,” he said. “We want them to know it’s available and that it can be an enjoyable and rewarding process.”

A Lifelong Journey

While inpatient treatment programs traditionally last 30-60 days, those with substance abuse disorders typically face a lifetime struggle with addiction.

 

Maria Russo-Appel, MD, medical director for CleanSlate Addiction Treatment Centers Eastern Division, said patients who stop medications have an 80 percent chance of relapse. “Graduating from treatment is really an old concept in addiction medicine so we don’t frame our programs around that,” she said. “We understand that this is a potentially lifelong disease, and we provide medications for that.”

 

CleanSlate, which is relocating its Massachusetts headquarters to Nashville in 2017, currently treats more than 6,000 patients in eight states (and growing). Working closely with mental health providers, CleanSlate’s care coordinators ensure patients continue to receive medical and behavioral therapies as long as necessary.

Breaking the Cycle

Like Sledge and Lee, Russo-Appel said the stigma around addiction is changing. “Many believe addiction is found in the lower socioeconomic class or the homeless, but it’s startling to see the number of high functioning, well educated people battling this,” she said. That’s because addiction so often starts with a valid prescription for chronic pain. “PCPs and other providers are all coming into an understanding that this has gotten out of control,” she said. “We now have task forces and doctors signing pledges on how to prescribe opioids moving forward.”

 

Russo-Appel said stopping the addiction cycle begins with prevention efforts as early as grammar school. “We need more awareness programs and access to care,” she said. “The heart of our mission is access. How do we get treatment to as many people as we can?”


Original Article By: MICHAEL CORKERY, NY Times
Date: SEPT. 15, 2017

As drug addiction soars in the United States, a booming business of rehab centers has sprung up to treat the problem. And when drug addicts and their families search for help, they often turn to Google.

Google Sets Limits on Addiction Treatment Ads, Citing Safety

But prosecutors and health advocates have warned that many online searches are leading addicts to click on ads for rehab centers that are unfit to help them or, in some cases, endangering their lives.

This week, Google acknowledged the problem — and started restricting ads that come up when someone searches for addiction treatment on its site. “We found a number of misleading experiences among rehabilitation treatment centers that led to our decision,” Google spokeswoman Elisa Greene said in a statement on Thursday.

Google has taken similar steps to restrict advertisements only a few times before. Last year it limited ads for payday lenders, and in the past it created a verification system for locksmiths to prevent fraud.

In this case, the restrictions will limit a popular marketing tool in the $35 billion addiction treatment business, affecting thousands of small-time operators.

Google Sets Limits on Addiction Treatment Ads, Citing Safety

“This is a bold move by one of the world’s biggest companies, saying people’s lives are more important than profit,” said Greg Williams, co-founder of Facing Addiction, a nonprofit group that is an advocate for people struggling with addiction.

Many rehab centers, a large number of which are clustered in warm climates like Florida, Arizona and California, rely on Google searches to attract patients from across the country. Their strategy often included buying an ad that would come up when someone searched for phrases like “drug rehab” or “alcohol treatment centers.”

Google Sets Limits on Addiction Treatment Ads

As of this week, Google has stopped selling ads related to those searches, although it may lift the restriction if it can find a way to weed out misleading advertisements.

Search ads for addiction treatment are lucrative. Treatment providers, in some cases, have been willing to pay $70 per ad click, according to an analysis that Mr. Williams’ group conducted and presented to Google executives.

But the payoff for those clicks can be significant. Addicts who sign up for 30 days of residential treatment can bring in tens of thousands of dollars from private insurance.

The crucial, if unwitting, role that Google has played in the treatment industry exposes the deep flaws in how drug addicts are cared for in America. Despite the rapid growth in the number of addiction cases — and the Trump Administration’s declaration that the opioid crisis is a national emergency — the treatment industry remains a hodgepodge of upstart businesses, with only a few well-known providers.

What constitutes treatment is also all over the map, from yoga and equine therapy to daily doses of medication. And unlike other serious illnesses, like cancer or heart disease, where a physician typically refers the patient for treatment, many addicts and their families look for help on the internet.

That has made Google one of the largest referral sources for treating a disease that affects millions of Americans. And the companies willing to the pay the most for ads are the one that addicts are most likely to see on their search.

But ad-driven searches, according to advocates and law enforcement officials, have not always led patients to the best care. In some cases, they have found that patients are being duped, a phenomenon Google on Thursday acknowledged.

Last December, a Florida grand jury released a report detailing abuses in the state’s addiction treatment industry, which is centered around Palm Beach County. Among the findings, the grand jury zeroed on the problems with how some of the shoddy programs were being marketed online.

One witness, according to the grand jury report, described how “online marketers use Google search terms to essentially hijack the good name and reputation of notable treatment providers only to route the caller to the highest bidder.”

Another common trap: Addicts search Google for a rehab program close to their home, but they will click on an ad for a referral service pitching treatment in another state. The referral service then collects a fee, if they signed up.

Google’s restrictions were cheered by health officials, who have called for more medically based treatment. “People don’t always know what good treatment is,” said Dr. Vivek Murthy, who was surgeon general in the Obama Administration and published a oft-cited report last year that warned of the nation’s addiction crisis. “I am glad Google took steps to prevent the spread of these false ads.”

In targeting the ads for addiction treatment, Google consulted with experts including Mr. Williams, who himself has been in recovery for many years. He said he began discussions with Google executives around the time that Dr. Murthy released his report.

Mr. Williams said that he had explained to Google that his own experience trying to buy ads from the company had illustrated how the process of finding information about addiction treatment online was providing people with unreliable information. Mr. Williams said he discovered this when his group received a grant from Google that would help him buy ads promoting a website providing information about community based treatment — and found he couldn’t compete.

Buying ads on Google involves bidding to place your ad at the top of the search results when a user types in words relevant to your product or service. But Mr. Williams found that the bid prices for words related to treatment had gotten so expensive that his group couldn’t pay as much as the for-profit treatment providers. Some of those treatment providers, Mr. Williams told Google, were not only misleading, they had been charged with crimes.

In a series of phone calls and a meeting in Washington, D.C., Mr. Williams presented the company his research. He highlighted that some of the biggest buyers of ad words related to treatment had been accused of misdeeds related to insurance fraud and sexual assault.

“We stumbled upon this issue organically,” said Mr. Williams. “And they heard us out.”


A version of this article appears in print on September 15, 2017, on Page B5 of the New York edition with the headline: In Rare Move, Google Imposes New Limits on Addiction Treatment Ads, Citing Saftey.

NASHVILLE, Tenn. (WKRN) – A hard hit can do more than just knock the wind out of a player on the field. It can leave them with an injury requiring medical attention and possibly pain medication.
“Sports are probably the leading cause of injury in kids but I think it is important to understand that sports in general are protective,” Dr. Alex Diamond said. “We know kids who play sports compared to kids who don’t are typically less likely to be involved in risky behaviors.”

 
High school sports injuries can lead to addiction depending on treatmentDr. Diamond is an assistant professor of Orthopedics and Pediatrics at Vanderbilt University Medical Center. He is also the team physician for Vanderbilt University, Nashville Predators and the Nashville sounds. He along with the other physicians at in his department treated 26,000 adult and children athletes in 2016.
“As physicians we need to be mindful when treating children with injuries what situation require pain medication and what situations can be handled without pain medication,” he said. “Most of them can be handled without pain medications.”

 
Pain medications like hydrocodone, oxycodone and other opioids can be very effective in treating chronic pain. But, they can also be addictive and lead to more illicit drugs like heroin.

 
At Cumberland Heights, a non-profit addiction treatment facility, the number of teens entering the facility’s Adolescent and Young Men’s Services department has grown so much in the past couple of months it is expanding to keep up with the need.

 
“We take kids from all over the country,” Director of Adolescent and Young Men’s Services Dean Porterfield said. “The primary diagnosis is substance abuse, but It is not uncommon though that the underlying issues once you take those substances away are anxiety, depression or trauma.”

 
According to Porter for the 18 year old to 25 year old age group that makes up the Young Men’s program a growing number are addicted to heroin.

 
“A notable factor with the young adult population that we serve is that several of them are athletes who have experienced high school or college sports injuries that have required surgery and have become addicted to painkillers.”

 
He continued, “When the painkillers run out or they become more expensive the more accessible affordable drug is the heroin. That replaces what used to be that passion for sports and athletics and now their primary goal is to drug seek.”

 
Porterfield said with heroin it is not uncommon for the treatment center to get a call from family or the patient themselves saying they are in route for immediate admission to the facility.

 
“They are also some of the most vulnerable patients and need a great deal of attention throughout the painful detox and early days of treatment to prevent them from leaving against medical advice,” he said. “One of the things Cumberland Heights clinicians have made a priority is educating these young men on the risks of relapse and the lethal dangers associated with resuming the volume of heroin use they came in handling with the assumption their tolerance level is the same.”

 
He continued, “This scenario increases the likely hood of a lethal overdose.”

 
At Cumberland Heights the process is based on the 12-Steps.

 
After detox the work begins to help the young men understand the underlying reasons they abused drugs. In many cases its tied to the emotion effect their injury had on them and their identities.

 
“Just being an adolescent adult in general is full of ups and downs,” Porterfield said. “When they realize this substance can help alleviate that, they get hooked pretty quick.”
The same progression from painkillers to heroin and stronger opioids is much the same in adult users.

 
According to the CDC Tennessee is one of the most overprescribed states for painkillers.

 
At one point doctor’s wrote more prescriptions for painkillers than there were people in the state.

 
“As physicians we need to be mindful when treating children with injuries about which situations require pain medication and what situations can be handled without pain medication,” he said.

 
“We have a lot of other options that don’t have the same complications and risk involved with addiction.”

 
Dr. Diamond said things like physical therapy, proper braces or casts and anti-inflammatory medications can be very effective.

 
“As a parent you need to be diligent on what pain medication your kids are getting,” he said. “For the most part the narcotic pain medication is not needed for what we are seeing in our children. It is very rare.”

 
Porterfield said parents should be involved in their teens lives take note if you start to notice missing money, missing prescription medication, if your child is hanging out with friends or in places you do not know, and if your child attends unsupervised parties.

 


Original Article: Green Hills News, Staff Writer, David Smith – February 22, 2017

Beloved Long-Haul Driver Bequeaths Home to Cumberland Heights Addiction Treatment Center
Beloved Long-Haul Driver Bequeaths Home to Cumberland Heights Addiction Treatment Center
A retired bus operator let it be know that upon his death he wanted to donate his home.

But Timothy Cotton, a retired bus operator who drove for major country music stars Tim McGraw, Conway Twitty, Alan Jackson, Kathy Mattea and the country music group Lonestar, also had a more pointed message: he wanted the success he achieved in life to be a tool for people needing help.

The home at Setliff Place in East Nashville sold this January generating $285,000, all of which was donated to Cumberland Heights, an addiction treatment center.

“This home holds a special place in our heart,” said Mallory Gibson, who, along with her husband, purchased the home. “Our family also lives on Setliff Place and we will now be able to raise our children within walking distance of each other. Tim was deeply committed to his family and his community, and we look forward to honoring that legacy in this beautiful home.”

Following the transaction, Cumberland Heights announced the creation of the Timothy Cotton Fund for Patient Assistance. The fund is part of Cumberland Heights’ endowment and will provide financial assistance to patients who cannot afford treatment or do not have insurance to cover costs.

Cotton was himself a patient on a MusiCares scholarship.

“Tim Cotton was a generous soul who loved caring for others,” said Jay Crosson, chief executive officer at Cumberland Heights. “His incredible donation and the Timothy Cotton Fund for Patient Assistance will help many, many people recover their life from drug and alcohol addiction. Tim’s memory will live on at Cumberland Heights in perpetuity.”

Cotton was renowned for his ability to make friends. He touched so many people in the Nashville recovery community that they organized aftercare meetings in his hospital room so he did not have to miss meetings.

After his death, Cotton’s sister Cathy Reisch, received numerous calls from former Cumberland Heights’ patients who had met Tim Cotton during treatment and were touched enough to call with condolences.

“The Cotton family is grateful to Bill Branch and Life Style Real Estate Advisors. Bill did more than donate his commission – he put his heart into this task, was very supportive to our entire family and dedicated a lot of time to make this sale happen for all the parties involved,” said Reisch.

Bill Branch of Life Style Real Estate Advisors served as broker and donated his commission because proceeds were being donated to Cumberland Heights.

Branch describes the experience as follows: “Tim Cotton loved his family, his home, and his neighborhood.”

Having worked with Cumberland Heights on several other real estate transactions to support their mission, it was immediately apparent to me that this was a very special situation. After meeting Tim’s sister Cathy Reisch for the first time, I wanted to be a part of helping to make Tim’s dreams and wishes for his home come true. We had two goals from the start: to raise as much money for Tim’s endowment to Cumberland Heights as possible through the sale of his home, and do as much as possible to find new stewards for the property that would love the home and the neighborhood as much as Tim did. On both counts, we succeeded beyond our hopes, and there will be many people benefiting from Tim’s beautiful heart and enormous generosity for years to come.”

Cotton was the 1991 Honoree for the Mary Catherine Strobel Award as Volunteer of the Year from Nashville CARES and trained HIV/AIDS volunteer.

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