In depth discussion of each disease starting with Hepatitis and HIV
Describe the history and epidemiology of Hepatitis A, B, and C
List available hepatitis vaccine options
Discuss treatment for HBV
List available HCV direct acting antivirals (DAAs) available for HCV regimens
Discuss factors that impact the selection of appropriate DAA regimens for patients with HCV
Describe the epidemiology of HIV
Discuss the history of HIV, including the impact of activism
List factors that put someone at high risk for contracting HIV
Describe how Antiretroviral Therapy (ART) has evolved since the 1980s
Outline current treatment regimens and trends in HIV
Define PrEP (pre-exposure prophylaxis)
To ensure you receive your continuing education credits for this training, sign-in begins at 12:45 PM and the training will begin promptly at 1:00PM.
Cumberland Heights is an approved provider for continuing education by the following authorities: NAADAC Approved Education Provider Program (No. 84491) and State of Tennessee Board of Alcohol and Drug Abuse Counselors (Endorsement#0813042).
Cumberland Heights is an NBCC-Approved Continuing Education Provider (ACEP) (No. 6127) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program. Cumberland Heights Foundation, Inc. maintains responsibility for this program. Daily participants’ hours reflect actual hours in attendance.
NBCC and NAADAC approval is limited to the sponsoring organization and does not necessarily reflect endorsements of individual offerings.
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.”
Dr. 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.”
“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.”
“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.”
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.
One woman’s journey from drunk driving to addictions professional
Louder than the sound of a 44 Magnum reverberating in the memories of my cousin’s failed suicide attempt. More deafening than the thunder in my scariest childhood storms. It was the sound of metal crunching against a concrete wall in the blackest of nights. It jolted me awake while drunk driving in a Xanax and wine induced blackout. I hit something with my car.
I remember thinking, ‘What was that?” but I didn’t see anything. Disoriented and barely conscious, I drove away in the dark.
The clasping of silver handcuffs on my wrists was a cold awakening the moment the police jimmied open my car door. I’d never seen so many blue lights. I had no idea what was going on, or how my life was about to change.
A failed field sobriety test, a police interview and an inadvertent spotlight on the TV news later; I found myself in the back of a patrol car on my way to Metro General Hospital for a blood-alcohol test to determine the level of my intoxication.
Still clueless, I asked a question of my own, “Am I being arrested for DUI?”
“No,” the officer said. “You’re being arrested for vehicular homicide.”
And from that moment forward, my life has never been the same.
In one night, I lost my children. I lost my home. I lost my award-winning career as a journalist, and I was labeled a killer who had just run over a father loading his daughter’s truck on top of his wrecker.
I never saw him. I was not able to avoid him. That has been a hard pill to swallow. Imagine how you would feel if you accidentally fell asleep at the wheel and killed someone? That’s exactly what happened to me.
I was drunk driving. I have no excuse. I take full responsibility for ingesting the substances that caused this accident. I’m horrified everyday with the knowledge of a wrong I can never fully make right for the family of the man I ran over that night.
However, this night was also a defining moment in the life of this alcoholic who was able to completely surrender to her Higher Power and allow him to rebuild her piece by piece.
In 2009, I sought addiction treatment at Cumberland Heights. This small step in faith toward a life of sobriety saved my life. In my first primary group, my counselor asked me to tell my story. With each sentence of truth, tears streamed down my face. I allowed myself to be vulnerable in public, and the healing began.
Women in my group said, “That could have been me.” Suddenly, I didn’t feel so alone anymore. I was able to identify. It was an important part of my journey, as was two years of individual and group therapy, regular AA attendance and working the steps after my discharge.
Eighteen months later, I accepted a plea deal for my crimes and was sentenced to 10 years of probation, including two weeks of incarceration at Christmas and at Father’s Day each year. As part of my sentence I was ordered to speak publicly twice a year, but I have done this as often as possible. I never turn down an invitation. I have spoken to more than 1,000 students in Metro Schools, master’s level counseling classes, youth outpatient programs, church groups and even basketball teams. I consider it my life’s mission to use my story to help others.
I have remained sober for the past seven years. The God of my understanding took something so tragic and used it for good. He did this by increasing my faith, teaching me humility by being willing to accept a job at Goodwill when no one else would hire me and by being willing to be of service to other sick and suffering alcoholics.
I have sponsored women, taken meetings to detox units and even taken over leadership for a 12-step book study that has been meeting every Thursday night for four years.
In 2015, I took the next step and made helping other alcoholics and addicts a vocation at Samaritan Recovery Community. During that time, I applied and was accepted into the master of arts of addiction studies: integrated recovery for co-occurring disorders at the Hazelden Betty Ford Graduate School of Addiction Studies.
Last year, I was hired to work at Still Waters for Women, a 12-step immersion program under the umbrella of Cumberland Heights, and was recently hired as a case manager.
Today, my life’s goal is to help the next alcoholic and addict at the treatment center that gave me life again.
Katrina Cornwell is a case manager at Cumberland Heights, a motivational speaker, blogger and three-time, first-place award winner in the annual Tennessee Press Association contest.
In her presentations, she speaks about her addiction to drugs and alcohol and how those habits led to a drunk driving accident which killed a man in October 2009.
Seven years ago, when I entered treatment, I was a mess. My focus was on getting through my withdrawals, and I wasn’t able to focus on anything else. After detox I began to feel human again until I realized I was going to be away from my children. My instinct was to run to them, beg their forgiveness and promise to never leave them again. However, I’d spent most my children’s lives begging forgiveness because of my addiction to methamphetamine and morphine. I was physically present for most of their milestones, but I wasn’t there emotionally. I was constantly thinking about how I was going to get high. My children were not my priority. So why was it so difficult to seek treatment as a mom? Here are 3 common fears of mothers seeking treatment:
“I can’t be away from my children for this long.“
In reality we’ve been absent from our children’s lives for the majority of our addiction. Some of us may have been physically present, but we weren’t there emotionally or spiritually. I wanted to explain to my children how my disease hindered my ability to show them love. Guilt consumed me. However, within the first week of treatment my counselors helped me realize it took time to get here, and it would take time to heal. From this point, I began to believe in a power greater than myself. I believed I could be restored to sanity and returned to the lives of my children.
“I’m afraid someone will take custody of my children.”
Custody is complicated, but when a mother is actively seeking treatment it strengthens her ability to parent. Historically judges rule favorably to parents who have completed treatment.
“I don’t want my children to be scared because I’m in a treatment facility.”
Cumberland Heights has a beautiful campus on the banks of the Cumberland River. There are relaxed areas to visit with children including a playground and gymnasium to allow for play. Although it was wonderful to see my children while I was in treatment it was also emotionally and physically exhausting. I hadn’t been fully present with them in such a long time it took a lot of effort to become an attentive parent again. At this point the treatment center began to represent a place of healing opposed to a place secluding me from my children.
After going through treatment and especially the family program, I was able to realize one day clean with my children was worth more than a year high. Today, I would say the time spent away from my children in treatment was actually the most present I’ve ever been with them. I’m grateful for the ability to be present with my children, which I’ve learned to do through a 12-Step program. Now I have an amazing relationship with both my son and daughter, and we’re all learning how to be in each others lives.
Yolanda Lancaster graduated from Lipscomb University with a Bachelors of Social Work in 2015 and received her LADAC II in December 2016. She is a primary counselor in the Women’s Program at Cumberland Heights and sits on the board of Mending Hearts, a nonprofit treatment center for women. She is actively working her own 12-Step program, as well as nurturing, repairing and re-building relationships with her children.
You can’t predict when you will “Hit bottom.” For some the mere threat of failing out of school, losing our spouse, family support or a job is motivation enough to begin the process of recovery. For others the bottom is a much messier, deeper, darker place. Those of us who experience increased physical tolerance for alcohol or drugs inevitably see an increase in our mental and emotional tolerance for pain, suffering and compromising our values. This desensitization is an integral part of the denial system a person needs to sustain their drinking or drug use. It sounds like, “Sure, my wife left me, I got a DUI and I was fired, but I don’t see why everyone else is so upset.” Similarly, a comment I’ve heard among younger, opiate addicted patients who relapse within a matter of weeks is, “Sure, I’ve overdosed a few times. I’ve had some friends die from overdose, but I don’t really need to do all this recovery stuff. I just need to quit using.”
Exactly what does it take to cause surrender? The unfortunate reality is past, present or future consequences, no matter how dire, are often not enough to cause a person to hit bottom and choose the path of recovery. That’s because hitting bottom, reaching the point when enough is enough, is an extremely personal thing. Some people in recovery describe having a moment when the pain and fear of staying in active addiction was greater than the pain and fear they felt about the recovery process. But the best definition I’ve heard recently was from a patient who defined hitting bottom by saying, “It’s when bad things are happening to me faster than I can lower my standards.”
Stan Bumgarner graduated from Vanderbilt Divinity School in 2006 and worked for the Tennessee Association of Alcohol and Drug Addiction Services teaching ministers across the state. This led him to become an alcohol and drug counselor. He is currently the Spiritual Director at Cumberland. Stan is a regular speaker at the Unitarian Universalist Church of Clarksville, the father of thirteen-year-old twins and active in his own 12-Step recovery.
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