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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.

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


The Flight of Icarus

I knew all about my craft.  I am was in total control.  How was this any different from a dietitian modifying their intake or a trainer using his background to sculpt his body?  “I’m doing this under the safest of conditions”, was my maxim.  “If I just stick with clean supplies and remember to use sterile technique then I’ll be just fine.”  These were the thoughts echoing through my opiate addled mind as I propped myself up between the toilet and the sink in the single occupancy bathroom that I had turned into my own personal opium den.


I loved everything about it.  The ritual always culminated in a wave of feel-good euphoria as I drifted further into the warm embrace of my drugs.  And it was any drug.  Anything I could get my hands on was sufficient after my initial sample platter of experimentation.  I wasn’t picky.  I was an unlikely mix of anxious and groggy but I wasn’t picky.  I’d show up to any case any time and I’d definitely stay late!  As a matter of fact I’d dread vacations.  A time to enjoy my family and friends and to relax was spent withdrawing in misery.


I was always managing.  For a type A personality like me, whether I created the chaos or not, I got a kick out of solving things.  The craving and using cycle could be quite painful but at some level it was an end in and of itself.  To slyly divert a drug, steal off into the bowls of the hospital and untangle all the knots in my stomach was a thrilling ride.  It created a solvable problem that I could manage quite adeptly.  There was something sexy about anesthetizing a patient only minutes after tying off my foot with a tourniquet and injecting myself with drugs.  After the injection I would quickly remove the tourniquet and from my thrown on the bathroom floor raise my foot in the air as if to salute the drug as gravity hastened it’s journey to my heart. 


My heart often skipped a beat.  Whether it was when the warmth of the drug hit my chest or when I almost got caught injecting while crouching beneath the surgical table pretending I was checking my various monitoring equipment.  However, like Icarus, you can only fly that close to the sun for so long before you come crashing down. 


My run at juggling addiction and medicine didn’t last very long.  In fact, the last day that I worked I knew it was the day that I would get caught.  I had a very good idea of what was to come in the form of lost licenses, court dates, and unemployment but I couldn’t stop myself.  This is what addiction looks like but there is always hope.  The journey to put the pieces back together is far from over but it helps me to revisit these memories.  Not as a euphoric recall but as a warning of where I’ve been and where I can easily go again.........

BY:  Jason R.  


The Flight Of Icarus 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 


   By: Ethan Bickelhaupt


By: Ethan Bickelhaupt


For those of you familiar with the holiday classic, “It’s a Wonderful Life”, you may recall a very powerful moment in cinematic history when the film’s central character, George Bailey, (as played by the great Jimmy Stewart) suddenly stumbles upon the realization that the positive impact he’s made on a number of lives would not have happened had it not been for his very existence, an existence he was wishing never happened. When he sees how differently life would have been had he not been born, he becomes horrified at the idea and begs God to let him live again. Earlier, during his moment of realization, Clarence the angel says to George, "Each man's life touches so many other lives, and when he isn't around he leaves an awful hole, doesn't he?" What a powerful statement! Each person’s life can have a significant impact on so many other people’s lives.


While this is a perfect example of how one can positively impact another’s life, the reality is that sadly, one’s life also has the ability to impact others in a negative way as well.  The chain reaction of individual choice has the power to affect lives in such a way that can literally change the dynamic of a family, a community, a state, even the world. Whole wars have been started over poor judgment and the foolish acts of a few individuals, resulting in thousands of lives lost. It’s amazing what the power of one’s influence can wield and sadly, in many ways, it happens in our own backyard everyday. In fact, even the addict can have such power. Often times when the grip of addiction lays hold of someone, it has the ability to transform them into someone completely different. As the person changes, behaviors have the potential to become erratic, unreasonable, and unpredictable. Narcissistic, self serving behavior begins to cause strife within the familial structure. Theft can often times become an issue. Many times, alliances within the family start forming as manipulation on the part of the addict rears its ugly head. Questions begin rise as do tensions. Arguments break out. Blame games start being played. Self doubt and the question of “where did it all go wrong?” begin to surface. Everyone suddenly decides they have the answer for that individual and many times disagreements on how it should be handled causes more division. The struggle to decide what’s best for the addict and what’s best for the rest of the family starts taking precedence and all other priorities and responsibilities take a back seat. Things start to fall out of place due to neglect and the person to be blamed for it all continues his/her plight into an abyss of self destruction with seemingly no end in sight. Bickering and fighting among the family causes bitterness, other members of the household decide to leave for lack of strength and/or lack of attention. Each individual then takes with them this burden to their place of employment, education, worship, etc. and suddenly the impact is such that some members of the family feel the need to obtain their own treatment/and or counseling as much as the addict does, yet for a different battle, the battle of mental and physical survival.


But treatment for the family members of addicts isn’t available, is it? After all isn’t the addict the one who needs treatment? The answer to both questions is a resounding yes! Due the increasing issues that arise within families due to the behavior of an addicted loved one, much is being done to help those families get to a place where their family structure can be not only restored, but maintained and even thriving through the help and support of different programs and organizations nationwide! According to, there are a number of resources available along with tools you can use to help out in the meantime including tips on things you can do for the family, things you can do for the addict and things you cans do for yourself. The main thing you want to do is to take good care of yourself and don’t play the blame game. Don’t try to take this task on by yourself and reach out to professionals to get the right help for you and your loved one. Help is available for you just as much as it is for them. Make a positive choice to help yourself in this struggle, your strength is needed in helping your loved one get back to where they need to be and all the more thriving. You have the power to make a significant difference! Don’t hesitate another minute, much may be at stake!


For more information and tips on where to get help, please visit or please contact us at, we’d love to chat with you and help get you where you need to go!


Mythbuster Series: Insurance Won't Cover Treatment

By: Ethan Bickelhaupt

By: Ethan Bickelhaupt

For the addict looking to make some real changes in his or her life concerning their addiction, it goes without saying that there can be some really challenging steps that need to be taken on the part of the addict in order for real change to occur. A little bit of courage, a real desire to change and a willingness to get help are among the stepping stones of an addict’s journey that can lead to major milestones of recovery. This isn’t, by any means, something that is meant to be taken lightly and it also goes without saying that even these seemingly “small steps” can be difficult to even muster the strength to take. Many have had the courage to step out and take the path leading to the road of recovery, some falling short of their goal, but many pushing through, getting back up and continuing to move toward that goal of success. In spite of difficulties that arise including potential relapse, the constant temptation to use again, the shaming from outsiders and more, the addict/warrior presses on trying to remain strong, doing all they can to become the person they desire to be.

So imagine when to their horror, despite their efforts to take those initial first steps, they find out that their health insurance is very limited. In some cases, insurance companies may only make provisions for treatment up to 30 days or even worse, may not provide coverage for treatment at all. When it comes to small businesses, the latter is often the case, not being financially sound to take on such a health plan means often leaving their employees to fend for themselves in the struggle to obtain mental, behavioral, and substance abuse healthcare. For some, 30 days or less may be all that is required for them to recover from the horrors of addiction, but for so many others, 30 days may only be enough to scratch the surface of recovery. Not having the proper resources and/or the necessary recovery time could lead to disappointment and a push into the relapse the addict so vehemently fears and despises.

Dramatic as it may seem, the unfortunate reality is that many are faced with this issue and despite legislative measures being taken, Healthcare Reform continues to be the 500 pound elephant in the room. Thankfully, more measures are being taken to improve it. Here are some facts concerning the matter now. According to The Fix: “The Mental Health Parity and Addiction Equity Act mandated that health plans that cover substance abuse do so on equal footing with other types of diseases in terms of co-pays, deductibles, treatment limitations and other factors. But the act did not require coverage of substance abuse. The Affordable Care Act then mandated coverage of mental health and substance abuse for both Medicaid and private plans offered on the state and federal health care exchanges.” (

The good news is that things are on the upswing concerning these matters and much is being done to improve upon making coverage more readily available as needed for those struggling with addiction. Parkdale is happy to discuss financial options and will do all we can to help potential clients obtain the necessary treatment available to get them on the road to recovery. For more information on this topic and to find out alternatives in insurance options, visit: and for more information on Parkdale Center visit us at


By: Ethan Bickelhaupt

By: Ethan Bickelhaupt

The union of affluence and influence is a powerful one. Often times, where there is one, there you’ll find the other. Being a person of wealth, while perhaps challenging at times, brings a certain sense of comfort. It releases the burden of having to be a “slave to the lender”. Money talks, it’s what makes the world go round, in fact, there’s the old adage that suggests money answereth everything. When you’re rich, there isn’t much you can’t do and if you can’t do something, you pay someone who can. Most people strive to be wealthy for that purpose. The idea of having a carefree life full of luxury and financial freedom seems epic. No cares in the world, no one to answer to, no having to get up early to go to a job you don’t like, kissing up to people who don’t appreciate you and doing your best to earn your part of the “American Dream”. Most of us want that “pie in the sky”. It makes us feel as though we are safe, there’s the idea that wealth brings security. If you’re rich, you haven't a problem in the world. Right?

For most people who have a keen understanding about life in general and with social media giving us a closer look into the lives of the more fortunate, we all know that in reality, a lot of this isn’t true. In fact, when it comes to having money, there aren’t many people who can sum it up so eloquently as one iconic street poet did when he said that where there’s “Mo’ Money” there’s “Mo’ Problems.” People chase the green like a good golf swing, it’s natural to want, but at what cost? There have even been reported horror stories of lottery winners who have won mega jack pots, enough to last them generations, but because of a lack of understanding on how to maintain said wealth, have gone bankrupt within 5 years of becoming “newly rich”. It doesn’t take a Harvard study to figure out that having wealth doesn’t mean not having problems and it’s from this foundation where we address this myth.


While it is true that drug and alcohol addiction tends to be more prevalent among lower income households, some attribute it to the fact that lack of higher education and the lack of knowledge and understanding on how to deal with life’s problems can contribute to the overall addiction issue ( But does a lack of understanding discriminate between the rich and the poor? Do life’s problems affect one more than the other? Absolutely not. In fact, according to the Partnership for Drug-Free Kids

"The Contra Costa Times reported Feb. 19 that disposable income, disconnected families, and pressure to succeed all contribute to drug use among upscale youth, adding that parents in these communities add to the problem by denying that it occurs." -DrugFree.Org

The same can be true of adults. Being disconnected, overworked, feeling inadequate and not able to handle the pressure of keeping up with the Jones’ (or Kardashians as it were) can contribute to the rise in substance abuse and addiction within people of affluence. Add to that the access of disposable income and there you have the perfect storm. The impact can result not only in the loss of wealth, but families, friends and overall livelihood. The cycle then comes full circle when there’s the feeling that there is no one person or thing to turn to accept that which has caused the initial downfall. As it has been said before, addiction does not discriminate. It does not care who you are, what you do, what your social status is, what influence you hold on any particular person or parcel of prominence. Addiction is an equal opportunity destroyer and it has no qualms in taking out any and all who stand in its path. It’s what it was born to do. But is that the end of your story? 

It doesn’t have to be. While it may seem cliche, the reality is that hope, help and healing are just a phone call away. No pressure, no prejudice, just Parkdale. We’re available to help get you what you need so you can get where you’re going. Become the person you were meant to be. It all begins with giving us a call. 

For more information on Parkdale Center you can visit us at We look forward to hearing your story and hopefully adding a new chapter. 

What Hospitals Don’t Know May Hurt Them: Drug Diversion In Healthcare

By: Ethan Bickelhaupt

By: Ethan Bickelhaupt

The diversion of controlled substances from healthcare facilities is an elephant-in-the-room type of problem that no one likes to discuss.  The sad fact is that most hospitals and other facilities do not recognize that they have a diversion problem until something tragic happens.  A quick internet search will turn up dozens, if not hundreds, of articles picked up by the media regarding nurse, physician and pharmacist overdoses that were facilitated by medications stolen from the workplace.  These professionals were suffering from the disease of addiction and their disease continued to progress right under the nose of hospital administrators until it was too late. 

It is known that at least 10-15% of the general public has a problem with substance abuse.  Healthcare workers, especially pharmacists and anesthesia providers, are known to be at an even higher risk for several reasons.  Even using the lowest possible estimate, if 10% of a healthcare facility’s staff has an problem with addiction and controlled substances are readily available, it is an obvious statement of fact to conclude that diversion occurs at a significant rate.  In a recent study of over 9,000 heroin addicts, 75% admitted that their problem started after becoming addicted to legally prescribed pain medication.  They turned to heroin only after they were unable to continue using prescription drugs.  In a healthcare setting, controlled substances are readily available, diversion is *easy* without sufficient controls and accountability in place, and the result is that healthcare workers turn to diversion from the workplace.   But why would a healthcare professional resort to stealing medications from work? 

Healthcare professionals, like other Highly Accountable Professionals, have a significant amount of time, money, education and pride invested in their chosen profession.  They often are the primary source of income for their family and have jobs that are high-stress, high-responsibility and provide immediate access to highly addictive controlled substances.  Professionals with substance abuse problems are described as highly intelligent, typically graduate in the top 25% of their class, are highly respected by their peers and are often the last ones that would be suspected of having a problem.  This means that these individuals are often reluctant and unlikely to seek help for substance abuse until it is too late, for fear of significant consequences.  Job loss, legal and licensure issues, financial difficulties, loss of respect and a loss of identity are all factors cited by professionals as reasons to not seek treatment.  With so much riding on their career, professionals that become addicted to a legal prescription often feel they have nowhere to turn.  Rather than risk a loss of their livelihood by seeking professional help, they will attempt to quit on their own, only to find out it simply isn’t possible.  They become trapped, cut off from their legal prescriptions, fearful of seeking treatment with access to controlled substances taken from work.  As a result, the diversion and substance abuse often continues until ending in tragedy. 

One significant mistake made by healthcare administrators is to believe that just because a problem isn’t obvious or noticed must mean it doesn’t exist.  Administrators frequently overlook the signs, symptoms and evidence of drug diversion simply because they do not have the appropriate accountability and monitoring procedures in place.   70% of healthcare workers surveyed have stated that they believe the control systems at their facility are inadequate.  Professionals with a substance abuse problem report 75% of the time that they believe other co-workers knew of their problem but didn’t report them.  The simple fact is that this is a known problem occurring in nearly every healthcare facility across the country, but little is being done to systematically address the issue.  As a result, diversion will continue until something tragic occurs and the hospital ends up with a public relations and insurance nightmare and the addicted professional, if they survive, loses everything. 

So what can be done?

Parkdale Center can help healthcare facilities develop comprehensive policies and procedures to prevent diversion, investigate suspected diversion, satisfy legal and regulatory reporting requirements and compassionately treat the addicted professional.  Our all-star team has experience and credentials in anesthesia, pharmacy, healthcare administration, nursing, addiction medicine and diversion investigation.  We will work with your facility to comprehensively address the issue of diversion from the ground up to keep your facility, your patients and your staff safe.  No one in the industry has the ability or experience to address this significant issue on the same scope or scale as Parkdale’s staff.  Give us a call today to find out more about our Diversion Prevention Program.  Let us help your facility identify gaps in practice, perform risk management as it relates to diversion and implement changes to protect your facility as a whole.  We can help.