Tag Archives: Treatment

Tag Archives: Treatment

This presentation aims to help attendees better understand substance abuse diagnosis, co-occurring issues and addiction in our society, shift in treatment options and guide in the pain recovery processes. Attendees will be encouraged and learn ways to provide useful methods for facilitating improved understanding and multiple approaches to address these problems from a clinical standpoint.

Lunch is provided and no refunds are given.



Registration Opens (Coffee served)

Welcome to Attendees and CE announcements

Comprehensive Pain Recovery
J. Gregory Hobelmann, M.D., MPH

9:00-9:05 Break

A Paradigm Shift in Treatment: The Three Core Systems
Adrian Hickmon, PhD, LPC-S, LMFT-S, CSAT-S, CMAT-S, CTT, EMDR

Society, Addiction and Young Adults
Marsha Stone, JD, LCDC

11:35-12:05 Lunch is Served

Meaningful Engagement with the Substance Abusing Adolescent Male
Dean Porterfield, LPC, MHSP, NCC
Caleb Vogtner, LPC, MHSP, NCC

Causes and Conditions and Addiction
Dana Pollack, LCSW

2:35-2:40 Break

Family and Personal Recovery, A Parallel Process: The Case for Family Systems Treatment
Ryan Hanson, MA, CAP

Comprehensive Diagnostic Evaluations-Taking the Guess Work Out of Healthcare
James Flowers, LPC-S, PhD.

5:10-5:15 Break

The Blessings
Judith Crane, MA, LMHC, CAP, ICADC, CSAT






Pathways to Recovery: A Clinicians Toolkit to Achieving & Measuring Success

Event Details:

WHAT: Pathways to Recovery: A Clinicians Toolkit to Achieving & Measuring Success
WHEN: September 27, 2019 from 9:00AM – 2:00PM
WHERE: Powell Church – 323 East Emory Road Powell, TN 37849
COST: $15.00 — General Admission (includes lunch) | $30.00 — CE Admission (includes lunch)
3.5 CE credits available (approved by NAADAC & NBCC) — All proceeds will benefit the Metro Anti-Drug Coalition


Event Agenda:

9:30AM Opening Remarks: Karen Pershing-Metro Drug Coalition
9:30AM – 11:30AM Using Measurement Based Practices in Treating Psychological Disorders
Nick Hayes, PhD: Chief Science Officer, Cumberland Heights
11:30AM – 12:00PM Lunch
12:00PM – 1:30PM Etiology, Assessment, and a THird Wave Approach to Treating Substance Abuse and Co-Occurring Disorders
Amanda Lewis, LCSW: Primary Counselor, Cumberland Heights
1:30PM – 1:45PM Evaluations

Staying sober in college is about as foreign of an idea to some as going to a restaurant and not eating. You can watch just about any movie or tv show that takes place on a college campus and you’ll see keg stands, Jell-O shots and beer bongs galore. They even have a way of glamorizing the hangovers and next morning walks of shame. So, it really is no wonder some young adults in recovery wonder how they can possibly stay clean while still having a meaningful college experience.

College students: a culture of drinking and drug useGreg Snodgrass remembers that feeling. He is a Regional Outreach Coordinator at Cumberland Heights and spearheaded the design for Collegiate Recovery at the University of Alabama. But before all his success, he was lost.

“I lived my life in addiction for many years. I never thought that addiction would happen to me. I thought I could control it and that apparently was not the case. In my opinion drugs and alcohol were fun and that’s why I enjoyed them. However, at some point the drugs and alcohol stopped working and my life became miserable. I destroyed my college transcript and never thought I would return to college,” said Greg.

Greg Snodgrass, Regional Outreach Coordinator
Greg Snodgrass, Regional Outreach Coordinator

While in treatment in 2004, Greg was encouraged to apply to two Collegiate Recovery Schools. A Collegiate Recovery School is one with a supportive environment within the campus culture that reinforces engagement in activities free from drugs and alcohol. It is designed to provide an educational opportunity alongside recovery support to ensure students do not have to sacrifice one for the other. Despite Greg’s fears that he wasn’t smart enough to get into a program like this, he was accepted, went back to school and thrived in a way he never thought possible.

“I sat in the front row when I used to sit in the back of the class. I raised my hand, turned in my homework, went to office hours with the professor, asked for help, and never missed class unless it was a legitimate excuse,” said Greg.

Greg graduated magna cum laude. He has since make it his mission to help other college students who are struggling.

“I pictured college through the eyes of John Belushi in ‘Animal House.’ In many aspects, the party scene has not changed since the movie was first released 40 years ago. Collegiate Recovery is like a sober fraternity/sorority. It is a fellowship that enables recovering students to create an environment on campus safe and fun. Collegiate Recovery is designed to empower those in recovery to strive for success. Collegiate Recovery helps to squash the fear of ‘I am less than’ or ‘I am not smart enough.’ The program turns our fear into confidence by building a fellowship of students that help one another achieve the unimaginable in academics and life,” said Greg.

Cumberland Heights and Still Waters was recognized for their support of Collegiate Recovery

The three longest standing Collegiate Recovery Programs are Rutgers University, Texas Tech and Augsburg University. One of the first replication model Collegiate Recoveries is here in Nashville, Tennessee at Vanderbilt University. Once accepted in the program, students have access to academic advisors, tutors, study rooms, printers, computer labs, meditation rooms, seminar courses, peer mentors, housing, scholarships, waived out of state tuition opportunities, recovering students and all other resources your higher education tuition has to offer. Essentially, it’s a fellowship. This is important because Academic Institutions can be a hostile environment for those in early recovery according to Greg.

“Collegiate Recovery helps you to change that lens and experience college as a recovering student. Students soon realize they can have more fun in their recovery than they did in their addiction. You can be successful in academics, friendships, relationships, life decisions, future careers and living life on life’s terms by being a part of a recovery fellowship on campus. I am living proof that it is possible to stay sober and enjoy life in college,” said Greg.

If you are your child is interested in learning more about Collegiate Recovery, contact Greg at greg_snodgrass@cumberlandheights.org or 615-879-7125.

We’re all guilty of it. Whether it’s jumping to conclusions, making generalizations or responding with emotion rather that sound evidence, unhealthy ways of thinking can creep up on us especially during stressful times. We’re not perfect so it’s okay as long as we can be mindful of when we’re doing this and take steps to change our thought process next time.

Below are the ten most common unhelpful thinking styles according to Adam Sicinski. Sicinski is an Australian life coach that uses mind maps and visual thinking principles. What are mind maps you ask? It’s an easy way to brainstorm thoughts organically without worrying about order and structure. It allows you to visually structure your ideas to help with analysis and recall. To the right you’ll see an example of a mind map.

Sicinski calls his unique mind maps IQMatrix. You can learn more by clicking here, but for the purpose of this article, we are just going to dive right into those 10 unhelpful thinking styles that when used too often can harm relationships and keep you from success.

Mental Filter

Here you tend to filter things in and out of your conscious awareness. This is a form of “tunnel vision” where you only tend to focus on a part of something and you ignore the rest. You might for instance only filter out all the negatives of a particular situation. You therefore only see the negatives and fail to recognize and acknowledge the positives. Your vision of reality is therefore based on your flawed perspective of the negativity you see in each particular situation.

Jumping to Conclusions

Here you tend to jump to unjustified conclusions. You make quick assumptions about how things are and what they’re going to be like in the future (predictive thinking), or you will assume that you know what someone else is thinking (mind reading). These conclusions and assumptions are not based on fact or evidence but rather based on your feelings and personal opinions. As such, they can often lead you astray down the wrong path.


Here you tend to blame yourself for your problems and for everything that goes wrong in your life. You might for instance continuously blame yourself for your misfortunes and bad luck. This will be true whether or not you are responsible or partly responsible for the problem or misfortune. Taking responsibility for things is admirable, however, it can end up being a very burdensome habit-of-mind that leads to very strong feelings of guilt and regret.

                                                                             Black and White Thinking

Woman working through trauma in addiction recovery

Here you tend to only see the extremes of a situation. You either see one extreme or another and this is why it’s called black and white thinking. You will for instance either see the good or bad, the right or wrong, the sad or happy, the left or right, etc. And because of your extreme way of viewing things, there is never a middle-ground. As such you are unlikely to view things in an unbiased and neutral way.


Here you tend to completely blow things out of proportion and make them out to be a lot worse than they should be. The reality of the situation might be quite insignificant and small. However, because you’re in the habit of catastrophizing, you always tend to make your problems larger than life — thereby making your problems even more difficult to overcome.


Here you tend to reference your past in order to make assumptions about the present. You might, for example, take one instance from the past and use that as a “predictor” or barometer for a current or future situation. Whenever you use the words “He always… She always… Everyone… You never… People never… I never…” you are at that moment overgeneralizing.

Shoulding and Musting

Here you tend to put unreasonable demands and pressure on yourself and on other people to do certain things. You tend to say, “I must… I should… You must… You should…”. These statements provide insight into the standards you tend to uphold and the things you expect of yourself and others. These standards can of course at times be helpful, however at other times “shoulding” and “musting” can create unrealistic expectations that you or others will struggle to live up to.


Here you tend to label yourself or other people in certain ways based on behavior in very specific situations. These labels you make form your belief systems. Therefore the more times you use these labels the stronger your beliefs become. This can be a good thing, however, it’s unhelpful when you tend to label things a certain way despite the facts and evidence that are inconsistent with the labels you are making.

Magnification and MinimizationHow you should respond to alcohol cues in addiction recovery

Here you tend to magnify the positives attributes of another person, while at the same time minimizing your own positive attributes. You are essentially devaluing yourself — bringing yourself down — while raising the stature of other people. In this scenario, you tend to explain-away everything you have going for yourself including your positive traits, characteristics, and achievements as though they don’t matter.

Emotional Reasoning

Here you tend to base your view of a particular situation in accordance with how you’re feeling. Therefore your feelings dictate how you perceive a situation despite evidence to the contrary. As such you might choose to feel bad about something that is going to happen just because you are feeling miserable in the moment. You are therefore using your current emotional state as a barometer that directs how you will view your life and circumstances.

Again, if you find yourself using these unhelpful thinking styles, it’s okay. The harm comes when we repeat this way of thinking and do nothing to try and change it. If we take note of, and work to change our thinking styles, we will find our work relationships, personal relationships and oveall happiness will improve greatly.

Tips on dating during addiction recovery

In 2017, U.S. News highlighted the fact that the first year of recovery is often the most challenging. Anne Lewis, a psychologist and clinical addiction counselor at Indiana University Health, stated,

“It will be easy for many to find replacement addictions, such as love addiction, to replace the high the drug or alcohol provided.”

There’s no doubt that love brings about feelings of euphoria similar to other addictions – and while it’s advised for those in recovery to refrain from maintaining romantic relationships while they recover, there will come a time when a person has reached mental, physical and spiritual stability – and that’s when there may be concerns about dating. In 2016, writer Emily Glover shared her personal lessons learned while dating in recovery. These were a few epiphanies she came to over time:

  1. Ensure you have a clearer understanding of who you are and where you’re at in life, as well as what you’d like from a relationship, before moving forward.
  2. Explore past trends you’ve had with relationships – do you have negative patterns that you want to be sure to avoid this time?
  3. Keep your eyes open for red flags in any potential relationship. If the other person is causing you to go back on your boundaries, they’re not a good option to pursue.
  4. Be upfront about your recovery and what your future plans are. They need to understand that your recovery goals, social support groups, 12-Step meeting and healthy rituals you’ve developed are all crucial to your mental, physical and spiritual wellbeing.
  5. Take the relationship slowly. It’s easy to completely immerse yourself into a relationship, but that can make it much more difficult to get to know a person for who they really are.

If you haven’t already, speak with your therapist about the decision to let a potential love interest in your life. Make sure you have clear boundaries and communication and approach each relationship cautiously – placing your recovery and yourself as top priorities.

Cumberland Heights is a nonprofit alcohol and drug addiction treatment center located on the banks of the Cumberland River in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of two 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first. For more information, call 1-800-646-9998 today.

Opioid Overdose Response-Naloxone Administration TrainingDrug overdose is the leading cause of death in Americans under 50. In many cases lives could be saved if someone nearby had the education and ability to administer Naloxone. Naloxone is designed to rapidly reverse opioid overdose. It can quickly restore normal respiration to a person whose breathing has slowed or even stopped due to the overuse of heroin or prescription opioid pain medications.

Event Details:

WHAT: Opioid Overdose Response-Naloxone Administration Training
WHEN: Saturday May 4th 10:00AM – 11:00AM
WHERE: River Road Main Campus – Ishee Chapel

In 2018, over 1,500 Tenesseans were administered Narcan to reverse a potential drug overdose. Narcan can be a life saving medication for an addict in distress. The more public knowledge and accessibility the more lives can be saved.

Kaitlynn Jackson is a Regional Overdose Prevention Specialist with STARS. She will be facilitating an hour long training and providing free Narcan kits to attendees.
Kits include: 2 doses of Narcan, a pair of gloves, an instruction sheet, a card with a list of substance use treatment resources, and a reporting form for the state if the Narcan is used.

This event is FREE but RSVP is required to receive a Narcan kit. Please RSVP to Jaime Gibbons. Thank you, see you soon!.

Who should attend?

  • Employees of Heathcare or Mental Health facilities
  • Community members who come into contact with people at risk of overdose
  • Family & friends of people with Substance Use Disorder
  • Caregivers of the Elderly/Disabled
  • Anyone interested in saving a life

Below is the current Surgeon General’s Advisory regarding Naloxone and Opioid Overdose

“I, Surgeon General of the United States Public Health Service, VADM Jerome Adams, am emphasizing the importance of the overdose-reversing drug naloxone. For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life.”

Training Objectives:

  1. Understand administration of naloxone products, including “Good Samaritan” protection law
  2. Recognize the signs of an opioid overdose and identify its causes and risks
  3. Describe what NOT to do during an opioid overdose
  4. Know the steps to follow when encountering an opioid overdose
  5. Earn a certificate of completion of naloxone administration training

The stigma surrounding addiction recovery makes it hard for people to get treatment.Addiction is often accompanied by shame in the public eye, as depictions shown in the media portray a less-than-optimal view of someone who is going through more than what is seen on the surface. For those who don’t understand, it’s easy to judge – to assume that people choose addiction. The reality is that addiction isn’t the problem in someone’s life, it’s the solution to other problems they face – and without the right tools, resources and support, many people just don’t know where to turn. A 2017 study published in the Journal of Bioethical Inquiry noted that stereotypes about who people with addiction “really are” makes it only harder to move on, to recover, and to be part of society. The study’s participants provided several examples of this in their statements, such as:

  • Not wanting to be alone with someone’s possessions in fear that someone might think they stole something
  • Feeling as though they’ll never be able to get out of addiction because nobody else believes they will
  • Worried that what they say will be twisted into words that only serve stigmatization
  • And more

What happens for many people with addiction is that the stigmatization they experience becomes pointed inward, and they self-stigmatize; when this happens, they begin to dismiss themselves as valuable people who deserve to be a part of society – and so they withdraw and the continue to abuse substances in order to forget or set aside the negative feelings that come from society’s shame. As The Fix explains it, society tends to view addiction as a moral failure – they stated,

“When people obtain a stable recovery they are always presumed to be on the verge of relapse. The label, shame and stigma of problems with substances is always around – once an addict, always an addict.”

If you’re struggling with addiction, know that you’re not alone – and you deserve a safe, respectful environment where you can thrive.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Experiencing relapse dreamsSleep is an important topic of discussion for those in addiction recovery, both in terms of the quality and quantity of sleep. Since substances can have such a major impact on the mind and body, it’s not uncommon for those in recovery to have difficulty sleeping at night, and this could be for several reasons: 1) for many people, nighttime is when they use substances the most, which means their body is going to be more awake the later it gets, 2) withdrawal symptoms can peak around this time, making it hard to sleep, 3) relapse dreams can cause a lot of tossing and turning at night. According to Tonic in 2017, about 85% of people who’ve been addicted to alcohol or other substances will have a “using” dream – otherwise known as a relapse dream – within the first 2 months of their sobriety.

It can be terrifying for someone to be in the middle of treatment yet have a dream that they’re back where they were when actively using; One woman shared her nerve-wracking relapse dream that had her fearful that she was back to using again. She told Tonic,

“They were never fun. They were always similar: I pick up a drink or serve myself punch that I don’t realize includes alcohol, drink it, and am terrified that I will restart my primal obsession…I would wake up feeling scared, disgusted, and then so, so grateful.”

A 2019 study published in Science Daily found that these types of relapse dreams are most likely to happen in those with more severe addiction histories, but thankfully the frequency of these dreams is likely to decrease the more a person spends in recovery. Dr. John F. Kelly, author and expert on addiction recovery, told The Fix earlier this year that as the mind and body gradually adapt to life in recovery, the psychological “angst” that they experience over relapse will diminish.

When these instances occur, you have to ground yourself and remember that you’re fully in control. At Cumberland Heights, you have the comfort and support system of knowing that you’re where you need to be – in recovery, with minimal to zero triggers. Dreams can feel incredibly real, but in your waking life, you are taking steps towards sobriety. These beginning stages are going to be the most challenging – but once you get through them, you’ll become stronger.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

Boy adolescent struggling with addictionDespite the fact that we’ve all been adolescents at one point or another, it becomes harder and harder as we get older to reel into the mindset that we held at that age. Even now, adolescents face unique pressures than adolescents 10 years ago; how can we tell what they’re really thinking? When substance abuse is involved, the quest to fulfill our youth’s needs becomes evermore challenging. We’re left in disarray as we scramble to find the answers – but without having a deep remembrance of what it’s like be an adolescent, we rely on punishments, strict curfews and serious talks – hoping that will solve our problems. Thankfully, researchers have explored the very responses that adolescents need during times of trial and tribulation – and this type of research can be used to benefit us in our own family experiences.

If you have an adolescent who’s been acting out, getting into trouble at school, home, or with the law and abusing substances, there is a path of healing for them. It will take time, effort and additional resources – but recovery is certainly possible and could even save their life. Three particular studies – one published in the International Journal of Criminology and Sociology, another published in the Journal of Adolescent Research and yet another published in the journal Spirituality in Clinical Practice assessed adolescent addiction recovery from diverse perspectives. Of all three studies, these were the most effective response methods shown to help adolescents recover from substance abuse disorders (SUDs):

  • Service to others – by helping others through volunteerism, adolescents are likely to be reminded of the many ways they can make a difference in this world. It promotes community, acceptance and overall purpose.
  • Love – many adolescents experience bullying or problems at home; love and kindness in recovery can promote their mind – and their heart – to remain open.
  • Social activities – as human beings, we’re social creatures. We thrive on being around other people and feeling a sense of inclusion. Adolescents have been shown to thrive when engaged in social activities as part of recovery – because it gives them a chance to reconnect with others in fun, meaningful ways.
  • Spirituality – 12-Step programs, in addition to learning the importance of love, kindness, respect, gratitude and community, can all have significant positive influences on adolescents’ addiction recovery.

Don’t wait any longer to speak with a professional from Cumberland Heights regarding you or your child’s struggle with addiction. Healing and restoration is right around the corner – it’s up to you to take the first step.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

The harms and consequences of intravenous drug use Those with addiction are already placed at high risk for health conditions, but the method they use to take their drug of choice can also have a huge impact on their health. Illicit drugs – such as heroin, cocaine, methamphetamine, ecstasy, ketamine, PCP and more – can be injected different ways, including through the veins. Intravenous drug use tends to give people a “high” much quicker because the drugs are injected directly into the bloodstream; although it appears to a fast-acting method for consuming drugs, there are major risks involved – and it can be fatal.

The Rise of Drug Injection

Intravenous drug use has become an increasing concern as the heroin epidemic has grown. In 2017, researchers from the University of Southern California collected data from 776 active drug users; on average, the researchers found that it took around 6 years for these individuals to escalate from first using illicit drugs to injecting drugs for the first time. Adolescents are likely to try intravenous drug use if they’ve smoked crack cocaine for a short period of time, according to a study published in Public Health Reports. The World Health Organization (WHO) estimates that globally, around 13 million people inject drugs; Ricky Bluthenthal, a research from the Keck School of Medicine at the University of Southern California, stated in 2017,

“The prescription opioid epidemic is creating a heroin epidemic, which will create an injection drug use epidemic. We’ve seen the first two. Now we’re waiting to see the last emerge on the national level. I predict we’ll see an uptick in injection-related diseases over the next couple of years.”

With so many lives at stake, it’s important that we explore the health risks associated with intravenous drug use – and provide more support for our loved ones to seek help sooner rather than later.

Intravenous Drug Use

A 2016 article written by a researcher from the University of Rochester highlighted that alongside drug injection comes subcutaneous injection, also known as “skin popping”. With this, an individual may inject drugs directly into the skin. Furthermore, drug injection can also be done in a muscle tissue. Heroin is the most commonly used drug for this method, but practically any drug can be injected intravenously if broken down.  Intravenous drug use involves needles and syringes, and many people with active addictions find themselves sharing these tools. Unfortunately, this is where a lot of seriously complex health conditions can arise.

Serious Health Issues at Risk

The sharing of needles from intravenous drug use can cause serious health conditions to arise, such as HIV. Human immunodeficiency virus (HIV) is a virus spread through certain body fluids which attacks the body’s immune system. Over time, HIV destroys so many cells – CD4, or T cells – that the body can no longer fight infections and disease. If this virus becomes its most severe state, AIDS can develop. With AIDS, a person’s immune system is so significantly damaged that they get an increasing number of infections; As the government has noted, there are currently no cure for HIV –  a person can only pursue proper caretaking and by undergoing a form of treatment called antiretroviral therapy, or ART.

The National Institute on Drug Abuse (NIDA) argues that in addition to HIV, two other serious health issues can arise, such as:

  • Infection of the heart and its valves (a condition known as endocarditis)
  • Skin infections (a condition known as cellulitis)

Hepatitis C is another deadly disease that can occur from sharing needles and from misguided judgment of sexual activity from abusing drugs. A serious liver disease, the Centers for Disease Control and Prevention (CDC) notes that around 75%-85% of those with this disease will go on to develop a chronic infection, and 10%-20% will develop cirrhosis over the next 20 to 30 years. If a person develops Hepatitis C from needle sharing, there are a variety of symptoms that can take place short term:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Joint pain
  • And more

The sooner a person can seek treatment, the greater their likelihood of protecting themselves from further development of any of these life-threatening health conditions.


Intravenous drug use is increasingly common, but the health risks can be mitigated if a person seeks help as soon as possible. For those struggling with addiction, Cumberland Heights offers residential treatment programs to provide the intensive support that those recovering need. Treatment will most often begin with detoxification, in which a person’s body naturally cleanses itself of the toxins acquired from drug use. Medication-assisted treatment (MAT) is also an option, which can help ameliorate some of the pain and discomfort associated with withdrawal effects.

Speak with a professional from Cumberland Heights to learn more about the various treatment programs your loved one may benefit from.

Cumberland Heights is a nonprofit alcohol and drug-addiction treatment center located on the banks of the Cumberland river in Nashville, Tennessee. On a sprawling 177-acre campus, we are made up of 2 12-Step immersion campuses, 12 outpatient recovery centers and 4 sober living homes. We believe that each person has a unique story to tell – and that’s why we always put the patient first.

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Your gift to Cumberland Heights through our annual and capital initiates gives immediate support to patients and their families. To make a longer term impact a gift to the endowment fund will provide patient assistance funding for years to come.