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Difficult, But Not Impossible: Medication Assisted Treatment for Substance Abuse

Difficult, But Not Impossible: Medication Assisted Treatment for Substance Abuse

There are a growing number of health professionals that believe medication-assisted treatment (or MAT) is an effective form of treatment as it uses FDA approved medications to help curb cravings and deal with the pain and other symptoms that can come from withdrawal.

The Growing Market for Substance Abuse Treatment

The Growing Market for Substance Abuse Treatment

According to the global substance abuse treatment market was valued at US$ 13.22 billion in 2016, and is expected to reach US$ 27.91 billion by 2025. The intent of this blog is to provide a snapshot of what’s covered in this study and at the very least pique the interest of the reader, perhaps to garner a discussion among the community about whether or not this magnanimous undertaking will be effective.

Depression, the silent killer.

Mental illness .jpg

As mental health disorders continue to be diagnosed at an alarming rate, it has become evident that those who suffer are often compelled to initiate self harm to relive them of the symptoms.  As it stands, mental illness is the only known disorder that carries a stigma of shame, guilt, and societal judgment so great that often the only recourse for relief is suicide.  Until we as a society can show the same compassion and empathy towards mental illness and addiction that we do towards other diseases, we will continue to lose our children, parents, friends, and idols to something that is more times than not, preventable. 

The following  remarks were penned by a powerful advocate and someone who truly cares,        Ms. Katy Peiters-Haslar. 

"There are a lot of great posts, articles, and other sentiments out there right now in the wake of the suicide-deaths of two very prominent public figures. The outpouring of support is great, but I wonder if those who have never experienced a clinical depression, the jail of addiction, or extreme anxiety understand WHY this tragedy happens, especially to people who seemingly "had it all." 

As I was watching CNN's special last night on the life and career of Anthony Bourdain, it occurred to me, as I listened to the myriad of friends and co-workers who spoke about Anthony, that the common threads in their sentiments regarding his suicide - we are baffled, we are shocked, we didn't see it, we didn't know he was hurting, it came out of nowhere - speak to the pervasive and hopeless truth of people's mental states: we never truly know what someone else is going through. And that's our fault as a society for perpetuating the stigma that mental illness is taboo, uncomfortable, or self-inflicted.

To those of us who have faced some of the same demons Bourdain had - clinical depression, extreme anxiety, feeling like your thoughts are tormenting you, and addiction - we know all too well that one minute we can be feeling just fine, and the next minute, our brain is hijacked by one of the many mind ruminations that get caught in horrible loops in our thoughts and derail our sanity and ability to think rationally. We lash out, or we crawl in our hole, or we do something to kill the pain. Sometimes, that thing ends our life. I would never say I wasn't devastated by the news of Bourdain's suicide, but I also will never say that I'm shocked or surprised - by ANYONE's suicide, quite frankly, sad as that is.

Our feelings that it will never get better, everyone would be better off, and we can't stand another minute in this human body, in this pain, are very real to us and virtually undetectable if we're among those who try to keep a "stiff upper lip." Maybe we aren't good at asking for help. Maybe we've been shamed before for our thoughts and feelings. Maybe we've done a lot of stupid shit while we were in pain and have isolated ourselves by our actions. Maybe that stupid shit has driven people away, making our case even stronger for our worthlessness. Or maybe we just don't possess the knowledge of how to reach beyond the mental anguish to someone who can help. And we're convinced we don't even want to. 

And maybe those who've tried to help us before got tired of getting nowhere, so they stop. And who can blame them? But we blame ourselves for yet another failed relationship, yet another person we've let down and sent away. One of Anthony's friends quoted him as saying something like - he has many friends, but really no friends. While those speaking on the subject couldn't seem to comprehend this thought, I know I can, and I know many of you can. We push people away, or our brain tells us we're unlovable as we are, so we put walls between who we really are and our friends so they don't see the real us. God forbid they see the crazy. 

Crazy. It's a word we throw around a lot in our culture to describe people. There are "people who do violent unspeakable things' crazy, (and I'm not talking about them), and then there are people who are clearly flailing in their brains and are desperately clinging to people while also vehemently pushing them away, saying and doing strange things crazy. And frankly it's sad to call those people crazy without realizing that label could be the thing that pushes them to an act of desperation. 

I've heard acquaintances who are trained therapists, who should know better, call a person in their social circle "crazy" because of addictive, depressive, or anxious behavior. A "crazy ex girlfriend" or "crazy ex husband" - - how many times have we heard that? Granted a lot of mental health professionals would never say something like this...but some of them would. If the very people we rely on to understand this plight and help us into the light could use such language to describe someone's obvious struggle with 'being ok' - what hope do ANY of us have for the greater population of untrained folks to understand?

This stuff is complicated, not easy to understand if you've never been there, but not at ALL surprising, if you understand that head space at all, when someone finally succumbs to those unrelenting, punishing thoughts. 

My heart goes out to Kate Spade's people, Anthony Bourdain's people, and to all of you who are in that head space right now but don't know what to do, and to your friends and family who truly care about you and worry about you. Shit, I don't know what to do to make it right for you either - but keep trying. Please keep trying. As trite as it sounds, we are all in this together. Much, much love to you all.- Katy" 

For more information on mental health or addiction please visit  or call 1-888-883-8433

If you or a loved one are struggling with suicidal ideations, please call the National Suicide Hotline today at 1-800-273-8255

My Beautiful Son, A Father's story

This past Thursday I buried my 24 year old son. He died March 25, 2017 after an overdose on what we suspect was tainted heroin. He had around a 9 year history of substance abuse. He started like so many kids with a little drinking and some pot. All of which were hidden. He was an extraordinarily talented musician, a world class Halo player, the most popular guy in school and made straight A's through middle school. As he grew there was increasing aggression, and a decreasing desire to do well in school or be anything BUT in control of every interaction. Like so many people with whom we may relate, he had the type of "A" personality that was sometimes a problem.


About 2 years ago his problems blossomed. He couldn't hold a job, my dad died and he used that as an excuse to hit the turbo on his drug use. He burned through relationships as fast as he could go. Eventually only close family had any significant interaction with him and unfortunately some of them were actively living the same cousin in particular.

About 7 months ago he went kicking and screaming into a residential rehab. Within 2 weeks a new man was writing letters and expressing feelings of long thought were beyond him. The next 4 months were almost heaven with him as new relationships were formed, old wounds were bound and new hope was on the horizon. But as a wise man once said, "Addiction is a 3 fold disease.... Thanksgiving, Christmas, and New Years". A few days into this year he left U-Turn and now within a few months he's gone.


(I) Cleaned out his car yesterday. The contrast was stark. Trash and open containers against suitcases of neatly folded clothes organized by season. Old candy wrappers and receipts contrasting little presents he had been collecting from the thrift store where he'd worked. He's gone and I'm still here. See, his story and mine aren't all that different.... for some reason he just couldn't stay in the solution and kept going back again and again to the problem.


A whole lot of you have already been expressing support for our family and for that we are grateful. is real, it is a disease, and it is survivable.


One last thought. As Andrew got closer and closer to leaving rehab he kept using the excuse of this (rehab) being a "waste of time now. I'm sober. If I get into school it'll help me stay focused and I can use the tools I've already learned." My response was "what is even a year's investment in this vs 50 years of life when if you leave you may only have a year?" He got into school...hated it and for whatever reason just kept on going.


Brad H.




 “We all want progress, but if you're on the wrong road, progress means doing an about-turn and walking back to the right road; in that case, the man who turns back soonest is the most progressive.”

― C. S. Lewis

Parkdale CEO to Present on National Stage




Parkdale CEO, Rodrigo Garcia will address attendees at the National Organization of Alternative Programs (NOAP) in San Antonio, Texas to discuss the addiction crisis amongst health care professionals.  During the April 28-April 30 National Symposium, Mr. Garcia will present his highly regarded “Catch Me If You Can” presentation which depicts the impaired professional managing the care of patients.  Drawing from his vast professional experience in the health care industry as a board certified nurse anesthetist, his formal didactic studies in addiction and health care, his role as CEO of Parkdale Recovery Center, and his personal experience, Mr. Garcia depicts the challenges, struggles, and societal implications of the impaired health care provider.  In experts from an interview with Mr. Garcia, he stated the following:


Interviewer:  We hardly ever hear about this so how big of a problem is this really?


Mr. Garcia:  That in it self is part of the problem.  The potential fallout and publicity hospitals will receive if the news of an impaired provider got out could be detrimental to their image.  This often encourages the facilities to act swiftly and quietly although not necessarily in the best interest of all involved.  According to the National Safety Council, 1:15 people currently suffer from some form of substance use disorder.  Those numbers are estimated to be closer to 1:10 for health care workers for a variety of reasons including increased stress, accessibility to controlled substances, and expert knowledge in how to use them. 


Interviewer:  That number seems very high.  I would expect to see impaired health care providers falling over themselves in the hospitals.  How does the impaired provider typically present?


Mr. Garcia:  That is a great question.  In fact, it can be very difficult to detect unless you are looking for it specifically.  The impaired provider can present in many ways that, on the surface, may not appear significant until a sentinel event occurs.  An impaired provider can be:  A surgeon who is hung over from the night before, A radiologist suffering from withdraw symptoms and unable to concentrate, a pharmacist that is diverting pills from patients leaving them in pain, a nurse that is actively under the influences of drugs or alcohol and forgets to administer a medication, a technician who is switching out medications and infecting unsuspecting patients, or the anesthesiologist that just overdosed in the bathroom.  As you can see, the implications on the patients can be quite profound.


Interviewer:   I am still surprised as to nearly 10% of providers being “sub-optimal” due to some form of substance use.  These providers have spent years of their life and significant financial sacrifices to be accomplished professionally.  The burning questions is “WHY?” would they do this?


Mr. Garcia:  Although there are some factors that may predispose people to addiction or alcoholism, there is usually a precipitating event.  Sometimes it is increased personal stress, a prescription for pain after surgery, a chronic medical condition, or a significant life event.  The event coupled with maladaptive coping skills and a genetic predisposition creates a perfect environment for the addiction to seed it self and take root.  In other words, the addiction and subsequent addictive behaviors usually have a benign onset.  In fact, at some point most of our patients say a variation of “ I once said I would NEVER do those things yet here I am”. 


Interviewer:  If that is the case, why don’t they ask for help before they get caught or hurt someone else? 


Mr. Garcia:  Unfortunately, society does not allow that to happen so easily.  The stigma associated with the word ADDICTION or ADDICT and the common punitive response to it often dissuades people from asking for help.   It is easy to track the “scarlet letter” of addiction through work history, insurance submissions, legal fall out, and general town hall gossip.  Once the stigma is placed, it and all its’ prejudices are hard to shake.  As a result, the addict will try to stop on their own repeatedly, until the subsequently get caught.  Ill ask you a similar question, and be honest, what is the first thing you think about when you hear that your nurse is a recovering drug addict?  Furthermore, does the word “recovering” bear any weight? 


Interviewer:  Point taken, I can see how that could be a problem.  I am sure there is no simple solution but what is one thing you would suggest that we could all do about this apparent epidemic?


Mr. Garcia:  You are right; solving this problem will require the dedicated concerted efforts of many.  However, we can all start by learning more about this disease and realize that not talking about it is making it worse.  The facts are that nearly everyone is affected by addiction or alcoholism.  One in ten people live with addict or alcoholic and one in three know an addict first hand.  The only way this gets better if we all commit to talking about it with an open mind and more importantly, an open heart.


Mr. Garcia continued the interview by discussing proposed solutions for health care facilities, suggesting ways the general public could help safeguard their care, and provided resources / advice for the impaired professional. 


Rodrigo Garcia possesses an MBA with a focus in Health Care Administration; he is a Board Certified Nurse Anesthetist, Advanced Practice Nurse, and Critical Care Registered Nurse with over 20 years of patient care experience.  He is also the current CEO of Parkdale Center, a treatment center specializing in the holistic management of the impaired professional.  To contact Mr. Garcia directly or to request a speaking engagement with your facility, please email

Opening the Gates

“Just Stop!”   That phrase had replaced more common conversational dialogue between people like “Good morning”,  “ What’s for lunch?” or the one I missed most, “I love you”.   I had become a numb to the repeated cries to “Just Stop!”  I knew I was getting worse; I didn’t need to hear about my progress regarding my self-destructive behaviors.  I knew I was a piece of shit, I didn’t need to be reminded every time I talked to my loved ones of how much potential I once had.  I knew that people had grown tired of me and had accepted the fact that I would soon be dead.  In fact, I believed that more times than not and even wished that on some occasions.  What I expected was to be treated like this from people who didn’t know me, but what I was surprised at was that those closest to me often judged me the harshest.  I get it, I really do.  I knew my friends and family were driven by fear of the worst possible outcome and stood to loose the most.  Call it the “tough love” approach if you must.  Regardless, my addiction had consumed not only me but also all the people around me.  Those that were lucky to be on the outer most concentric circle of my life were able to disappear into the unknown never to be seen or heard of again.  Those that remained close to me suffered the consequences by proxy and were anchored into a deep, dark, and helpless abyss filled with sadness and despair.  They, however, knew the way back to sanity for the never left it.  I was completely trapped and did not know if I would survive my addiction, or if I even wanted to. 


Although I had a great childhood and upbringing, my parents blamed themselves for something they did or did not do.  There was never a specific point of accountability but rather a pessimistic and looming thought they must have done something wrong.  I was able to pick up on their empathetic parental instincts and early on used that to my advantage.  It would always get me bailed out of a tough spot; provide me with an alibi, or the financial means to quench my ever-needy opiate receptors.   I soon realized the trend that the people closest to me would often enable me to keep getting away with things that I wanted to do, despite the caustic effects it was creating in my life.  Despite that, I used everyone around me to meet my addiction latent agenda because of no other reason than I could….. and it was easy. 


The thing about addicts is that we know we are addicted.   It usually starts off simple enough like social drinking or recreational drug use.  Sometimes it’s just a little pot on the weekends, sometimes its one of these to sleep better, one of those for this unrelenting back pain, and another prescription from my doctor because I really need it.  I was a little mix of all the above.  Through the cacophony of my all-consuming “extracurricular activities”, I graduated top ten in high school, 4 years of the college dean’s list, and successfully defended my dissertation to cap off graduate school.  While I would like to accept full credit for my academic accomplishments, it was really due to a well orchestrated and self-administered pharmacologic balancing act that would even make the best alchemist envious.   Sleep, wake, energy, relaxation, recreation, anxiety, confidence, depression, and self-esteem all controlled by exogenous chemicals.  What I failed to realize was that I had physically and mentally deteriorated to a state were acquaintances were leaving, friends were worried, and my family was crying.  By social standards, I was a success therefore believed I had things under control. 


To prove my family wrong, I would stop immediately and without trouble.  After years of using pills, I stopped completely.  That lasted no more than 8 hours.   I was immediately flooded with nausea, anxiety, fear, restlessness, and general discomfort.   I would sneak off to “pop a few pills” to stop the symptoms while simultaneously proclaiming to my family “See, I told you so”.  Their response was “Just Stop!”   I was out of control and now preferred to be alone.  When my family saw me, all they could say was “Please, Just Stop”.  I was working just to support my habit and gladly bartered suitable living conditions for my next fix.  When my dad found me sleeping in my car he looked at me with tear filled eyes and said, “ Just stop”. This went on for months and months.  After I was let go from my job, I quickly turned to the streets for a quicker and more affordable alternative.  I lost it all, my health, my friends, my financial security, all meaningful relationships, time, and most importantly, my will to survive.  I was incredibly shame filled.  You know the difference between shame and guilt?  Guilt means you feel bad because you did something bad and shame means you are a bad person because you did something bad.   In my mind, I was a bad person, a very, very bad person and didn’t deserve to be treated otherwise.  I was being told how bad I was for years and I found out that there was a pill for that too. 


I found my way into a treatment center because I literally had no other option.  I was living in my personal hell every day and everything I touched burned to the ground.  I needed to get help.  Ill never forget when the treatment center asked why I was there.  I said, “I have hit rock bottom”.  Without missing a beat, my counselor said, “While you are face first at your rock bottom, look around for the trap door, you can still go lower”.  That made all the difference to me at the time. 


I was asked to write this and share my experience and any advice I have.  I want to tell everyone that being an addict or an alcoholic is not fun.  It is a living hell.  We know we need help but if “Just Stop” was the answer, we would all do it.  It just doesn’t work like that.  I would encourage you to get help for yourselves before you try to help your loved one.  Make sure that YOU understand addiction and what to do to take care of yourself first and the addict only after that.  If you are struggling now, just know that you are not a bad person, you just got off track somewhere and need a hand up.  On March 23, 2017 I will celebrate 8 years of sobriety.  I am grateful, healthy, back on track, and did I say grateful?  Ill leave you with this final thought, being in recovery and living a healthy life does NOT open the gates of heaven to let you in, it opens the gates of HELL and let’s you out.  


Curtis L.

D.O.S. March 23, 2009


Opening the Gates is a story in the Perspective Series, presented by Parkdale Center.  Every story is a self-told personal account of someone struggling with, recovering from, or affected by addiction/alcoholism.  For more information on how to receive help or assist someone currently struggling, please visit  or call 1-888-883-8433