Harm Reduction News - Latest developments in the world of Harm Reduction, Alcoholism & Drug Addiction - Provided to you by Dr. Andrew Tatarsky - Psychologist in New York City, Author and Addiction Specialist - Addiction Treatment, Substance Abuse Treatment, Harm Reduction Therapy, drug and alcohol rehabs, prescription drug addiction, heroin detox, addiction intervention, treatment clinics, treatment facilities, rehabs, dual diagnosis, recoveryconnection, recoveryconnection.com, addictiontreatment.net, addiction link, addictionlink.org, cliffsidemalibucom, cliff side malibu, sober recovery, soberrecovery.com, dual diagnosis, bi-polar, co-occuring disorders, opiate , teen drug rehabilitation, adolescent substance abuse, troubled teens, rapid opiate detox, young adult drug treatment, al-anon meetings

	The Center for the Integrative Psychotherapy of the Addictions Presents: Transformational Chairwork: A One-Day Training Group Drug Therapy Can Be Counterproductive for Teens Treatment Programs Report Surge in Prescription Drug Admissions MDMA (Ecstasy)-Assisted Psychotherapy Relieves Treatment-Resistant PTSD in First Completed Clinical Trial Integrative Harm Reduction Events in Appalachian Ohio An Open Letter Calling on International Agencies to Support Amnesty for Maksim Popov Harm Reduction Therapy Group - NYC area Integrative Harm Reduction Activities 2010 - NYC area The Center for Integrative Psychotherapy of the Addictions and PsychologicA present: Integrative Harm Reduction Psychotherapy and Transformational Chairwork 8th National Harm Reduction Conference: Harm Reduction Beyond Borders! The Women's Therapy Center Presents The Laurie Phillips Memorial Lecture US drug policy at the UN. Is the glass becoming more than half full? Integrative Harm Reduction Psychotherapy in Spanish and Chinese Moderate Drinking is a new, scientifically proven, program to help people learn how to change their drinking Upcoming Harm Reductions Trainings in the NYC area Guilt-Based Anti-Alcohol Ads Can Backfire, Study Finds Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers Howard Lotsof Dies at 66; Found Drug Treatment in an African Plant Study Links Alcoholic Energy Drinks to Intoxication, Drunk Driving Safe-Injection Program Survives Another Shutdown Attempt by Canadian Government Fast morphine treatment may prevent PTSD Join Harm Reduction Coalition for a FREE talk by Dr. David Marsh: "Supervised Injection and Prescribing Heroin in North America: Evidence and Politics" Word Choices Affect Attitudes Toward Addiction Recovery New Jersey Vote Backs Marijuana for Severely Ill Nicotine Replacement Therapy Before Quitting May Help Information, Not Scare Tactics, Helps Smokers Quit: Study Harm Reduction Psychotherapy on One Hour at a Time Radio - 12/28/09 New interactive web application for problem drinkers Congress Poised to Repeal Decades-Old National Syringe Funding Ban and Allow Washington, DC to Establish a Medical Marijuana Program Czech govt defines rules of hallucinogenic plants growing United States Changes Its Mind on Addiction - It's Not a Chronic Brain Disease After All The Needle Nexus An addict reaching out for help Moderate Drinking May Not Preserve Thinking Skills Abstinence Not the Only Path to Recovery Ketamine drug use 'harms memory' An Alternative to the Intervention: Seminar for Parents and Spouses Want to quit? Don't go to light smokes Drinking By Either Partner Cuts Odds of IVF Success Holotropic Breathwork All-day Workshop Supervision and Training Activities Fall 2009 Registration Now Open for Psychedelic Science in the 21st Century In My Backyard: Dispelling Myths About Methadone Study Counters Warnings on Quit-Smoking Drug Dr. Andrew Tatarsky on Voice America Radio Addicts get text overdose advice Drinking by Young Teens May Set Stage for Addiction The Women's Therapy Centre Institute - 6 Week Eating and Body Image Groups Starting soon Benefit for Howard Lotsof – Ibogaine Pioneer and Activist Any Drinking Raises Risk of Traffic Accidents, Researchers Say Impact of Supportive Housing for Chronically Homeless People with High Use of Alcohol-Related Crisis Services Do Racial and Ethnic Minority Drinkers Have More Alcohol Consequences than White Drinkers? Trauma-Focused Group Therapy Reduces HIV Sexual Risk Behaviors in Women with PTSD and Substance Use Disorders MDMA/PTSD Research Goes to Vancouver - MAPS News: September 2009 CLICK HERE TO VIEW OUR NEWS ARCHIVE WITH MORE ARTICLES



	The Center for the Integrative Psychotherapy of the Addictions Presents: Transformational Chairwork: A One-Day Training Drawing on the clinical wisdom and practice of a wide range of Gestalt and integrative psychotherapists, Transformational Chairwork Training is designed to introduce therapists to the art and science of chairwork or psychotherapeutic dialogues in an active, creative, and clinically-useful manner. Using didactic presentations, scripted and unscripted role-plays, and live demonstrations, participants will see how to use this technique to address several common clinical situations: Making Decisions; Resolving Loss, Grief, and “Unfinished Business”; Combating the Inner Critic; Healing from Abuse; and Working with Addictive Disorders. This training is focused on empowering both Mental Health Professionals and those who work with Addictions and Co-Occurring Disorders. The next Transformational Chairwork Training will take place: Date: Friday, August 6, 2010 Time: 9:30pm - 4:00pm Location: New York University, Deutsches Haus, 42 Washington Mews New York, NY 10003 New York, NY Fee: $60; $30 for Students For more information about chairwork, please go to: http://transformationalchairwork.com If you are interested in attending, please contact Scott Kellogg, PhD at scott.kellogg@nyu.edu (Please forward to interested colleagues and students. Thank you.) Scott Kellogg, PhD Department of Psychology Faculty of Arts and Sciences New York University 6 Washington Place, Room 403 New York, NY 10003 http://www.psych.nyu.edu/kellogg http://transformationalchairwork.com http://gradualismandaddiction.org http://therapists.psychologytoday.com/rms/67134 Transformational Chairwork Facebook Group: http://www.facebook.com/?sk=2361831622#!/group.php?gid=125616880793831




	Group Drug Therapy Can Be Counterproductive for Teens July 21, 2010 Group addiction treatment can actually lead to more drug use by teens if they are casual users placed in sessions with more experienced addicts, Time magazine reported July 16. "Just putting kids in group therapy actually promotes greater drug use," said Nora Volkow, director of the National Institute on Drug Abuse (NIDA). "I've known kids who have gone into inpatient treatment and met other users. After treatment, they meet up with them and explore new drugs and become more seriously involved in drug use," added Tom Dishion, director of research at the Child and Family Center at the University of Oregon. Some treatment programs also may weaken the bonds between adolescents and their families, which also can increase the risk of drug use. Plus, teens may view 12-step programs' emphasis on being powerless over drugs as defeatist rather than a call for abstinence and mutual support. On the other hand, research has shown that more troubled youth can benefit by associating with better-adjusted teens. Individual and family therapy have been shown to be effective with teens, but group therapy is more common because it is less expensive. NIDA is currently working to ensure that more teens receive such evidence-based treatment. http://www.jointogether.org/news/headlines/inthenews/2010/group-drug-therapy-can-be.html http://www.time.com/time/health/article/0,8599,2003160,00.html




	Treatment Programs Report Surge in Prescription Drug Admissions July 21, 2010 About one in 10 people admitted to addiction treatment programs in 2008 misused prescription drugs, quadruple the rate reported in 1998, ABC News reported July 16. "People are getting treatment, which is good news. But the bad news is the problem just keeps growing," said Peter Delaney, director of the Office of Applied Studies at the Substance Abuse and Mental Health Services Administration (SAMHSA). Researchers found that admissions for prescription-drug problems cut across age, gender, education, and employment status. The findings are drawn from the Treatment Episode Data Set (TEDS). Experts said that prescription drugs are widely available and that many people don't perceive their use as risky. "This has been a trend coming for 10 years," added Steve Pasierb, president and CEO of the Partnership for a Drug-Free America. "It should be no surprise that now it is showing up in ER visits and people checking into treatment centers." http://www.jointogether.org/news/research/summaries/2010/treatment-programs-report.html http://abcnews.go.com/Health/Drugs/pain-med-addicts-rehab-400-percent-10-years/story?id=11171686




	MDMA (Ecstasy)-Assisted Psychotherapy Relieves Treatment-Resistant PTSD in First Completed Clinical Trial Belmont, MA-based Rick Doblin, Ph.D., President of the Multidisciplinary Association for Psychedelic Studies (www.maps.org, a non-profit psychedelic and medical marijuana research and educational organization that sponsored the study), together with South Carolina-based psychiatrist Michael Mithoefer, MD and colleagues, conducted a pilot Phase II clinical trial with 20 patients with chronic PTSD persisting for an average of over 19 years. Prior to enrolling in the MDMA study, subjects were required to have received, and failed to obtain relief, from both psychotherapy and psychopharmacology. Participants treated with a combination of MDMA and psychotherapy saw clinically and statistically significant improvements in their PTSD – over 80% of the trial group no longer met the diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV-TR) following the trial, compared to only 25% of the placebo group. In addition, all three subjects who reported being unable to work due to PTSD were able to return to work following treatment with MDMA. The trial centred on two eight-hour psychotherapy sessions scheduled about 3-5 weeks apart, where 12 subjects received MDMA, and eight took a placebo. Subjects were also given psychotherapy on a weekly basis before and after each experimental session. A blinded, independent rater tested each subject using a PTSD scale at baseline, and at intervals four days after each session and two months after the second session. The clinical response was significant – 10 of the 12 in the treatment group responded to the treatment compared with just two of the eight in the placebo group. During the trial, the subjects did not experience any drug-related Serious Adverse Events (SAEs), nor any adverse neurocognitive effects or clinically significant blood pressure or temperature increases. After the two-month follow-up, subjects in the placebo group were offered the option to participate in the treatment process again, to receive MDMA on an open-label basis, acting as their own controls. Seven of the eight placebo subjects elected to receive MDMA-assisted psychotherapy, with successful treatment outcomes similar to the subjects initially randomized to MDMA. PTSD involves exaggerated and uncontrolled fear responses. To treat these, psychotherapists need to help sufferers revisit traumatic experiences. But patients often suffer intolerable feelings when they revisit the trauma, or numb themselves emotionally, resulting in the psychotherapy having little effect. The goal of using MDMA is to temporarily reduce fear and increase trust without inhibiting emotions, especially painful emotions, allowing these patients a window where psychotherapy for their PTSD is effective. MDMA’s pharmacological effects include serotonin release, 5HT2 receptor stimulation and increase in levels of the neurohormones oxytocin, prolactin and cortisol. Importantly, this trial involved concentrated periods of patient-therapist contact (31 hours over two months) including two all-day therapy sessions and overnight stays in the clinic. “These are not usual features of psychotherapy practice in the outpatient setting,” says Michael Mithoefer. MDMA-assisted psychotherapy would require special clinics equipped for longer treatment sessions and overnight stays if an MDMA-based treatment were approved. “This method also involves patient preparation and close follow-up to support further processing of emotions and integration of cognitive shifts that may occur,” Mithoefer adds, stressing that these are vital for safety and therapeutic effect. Measures like these may prove a price worth paying, however, to alleviate the debilitating effects of PTSD on sufferers in future. The authors caution that the study does have limitations – for example they did not look at gender and ethnic factors in their sample selection. Another important limitation was that most participants and trial investigators guessed accurately whether they were in the treatment or the placebo group. The placebo had no psychoactive effect and investigators could detect raised blood pressure and other symptoms in the MDMA group. A long-term follow-up to the study just published, evaluating subjects an average of about 40 months post-treatment, is underway. The investigators have now received the go ahead from the US Food and Drug Administration (FDA) for a protocol for a three-arm, dose-response design that they expect will result in successful blinding. This new study is for US veterans with war-related PTSD, most from Iraq and Afghanistan and a few from Vietnam. MAPS is currently sponsoring MDMA/PTSD Phase 2 pilot studies in Switzerland and Israel, and is working to start additional pilot studies in Canada, Jordan and Spain. # # # The safety and efficacy of ±3,4-methylenedioxymethamphetamine -assisted psychotherapy in subjects with chronic treatment-resistant posttraumatic stress disorder: the first randomised controlled pilot study by Michael C. Mithoefer, M.D., Mark T. Wagner, Ph.D., Ann T. Mithoefer, B.S.N., Lisa Jerome, Ph.D., and Rick Doblin, Ph.D. is published today (19th July 2010) in the Journal of Psychopharmacology. The Journal of Psychopharmacology is published by SAGE, on behalf of the British Association for Psychopharmacology. A treatment manual by the study’s sponsor, the Multidisciplinary Association for Psychedelic Studies on this topic can be found here: http://www.maps.org/mdma/. MAPS’ Investigator’s Brochure, reviewing and summarizing the entire published scientific literature on MDMA and Ecstasy, can be found here: http://www.maps.org/mdma/protocol/litreview.html SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars, practitioners, researchers, and students spanning a wide range of subject areas including business, humanities, social sciences, and science, technology, and medicine. An independent company, SAGE has principal offices in Los Angeles, London, New Delhi, Singapore and Washington DC. www.sagepublications.com Contact: Dr. Michael Mithoefer 1-843 566-4252 mmithoefer@mac.com Rick Doblin, Ph.D. 1-617 276-7806 rick@maps.org Mithu Lucraft, SAGE 44-(0)20-7324-2223 mithu.lucraft@sagepub.co.uk Article Source - Forbes.com




	Integrative Harm Reduction Events in Appalachian Ohio JULY 12TH, ATHENS COUNTY OHIO Dr. Tatarsky will conduct a forum for invited state, county & community leaders, Integrative Harm Reduction: A New Way to Think about Substance Use, Mental Health and Public Policy. Sponsored by Integrated Services of Appalachian Ohio. JULY 13TH, ATHENS COUNTY OHIO Dr. Tatarsky will conduct a one day training, Integrative Harm Reduction: A New Way to Think about Behavior Change. For Counselors, Social Workers and all helping professions. Sponsored by Integrated Services of Appalachian Ohio.




	An Open Letter Calling on International Agencies to Support Amnesty for Maksim Popov Dear colleague, I am forwarding the attached letter calling for the release of Maksim Popov, a psychologist and HIV educator in Uzbekistan who was convicted on false charges and sentenced to seven years imprisonment. Please read the letter for more details on his case. We have been advised by people familiar with the situation in Uzbekistan that the best first step is to publicly call on the organizations that funded his organization to work for his release. So we're asking for additional organizations to sign-on by May 10th, when we will send the letter to the addressees listed. Dr. Popov is a professional who, like many of us, has dedicated his career to bringing quality care to individuals struggling with HIV/AIDS, substance use problems and other related issues. Please help us right this horrible injustice! Sincerely, Andrew Tatarsky, PhD Harm Reduction Psychotherapy and Training Associates 303 Fifth Avenuem Suite 1403 New York, NY 10016 212-633-8157 www.andrewtatarsky in support of The International Committee for the Release of Maksim Popov ************************************************************************************************** AN OPEN LETTER CALLING ON INTERNATIONAL AGENCIES TO SUPPORT AMNESTY FOR MAKSIM POPOV April, 2010 Nemat Shafik, Director General Country Programmes, DFID Michel D. Kazatchkine, Executive Director, Global Fund to Fight AIDS, TB and Malaria Karl Hofmann, President and CEO, PSI Michel Sidibé, Executive Director, UNAIDS Helen Clark, Administrator, UNDP Anthony Lake, Executive Director, UNICEF Rajiv Shah, Administrator, USAID Robert B. Zoellick, President, World Bank Hillary Rodham Clinton, U.S. Secretary of State Robert Blake, Assistant U.S. Secretary of State for South and Central Asian Affairs Representative Howard Berman, U.S. House Committee on Foreign Affairs Dear colleagues: We, the undersigned, are writing to express our deep concern over the imprisonment of Maksim Popov, an HIV prevention educator, psychologist, and director of a small NGO in Uzbekistan who was falsely convicted in June 2009 of charges including “evasion of taxes and other compulsory payments” and “the involvement of minors in the use of narcotic drugs.” He was sentenced to seven years imprisonment as a result of his HIV prevention efforts. Mr. Popov was the director of the non-governmental organization IZIS, which was funded by the USAID, UNICEF, UNAIDS, the Global Fund, the U.N. Development Programme, and the Department for International Development (UK). IZIS conducted activities such as counseling services, provision of sterile injection equipment, training for an AIDS education hotline, and anti-drug education for youth. These services are desperately needed in Uzbekistan, which has the highest HIV prevalence in Central Asia, and where over half of those living with HIV are between the ages of 15 and 30. The court cited Healthy Lifestyles. Teacher’s Guide XXI, a booklet funded by UNDP, UNAIDS and USAID, and imported into Uzbekistan by Population Services International (PSI), stating it was used “with the aim of committing indecent acts against people he knew to be under age 16…bearing propaganda promoting homosexuality and prostitution, as well as pornographic images, among youth.” HIV and AIDS Today, a brochure written and funded by UNICEF and PSI that included a discussion of same-sex relations and the use of condoms, was also cited. All copies were seized by authorities and burned. The court’s verdict stated that HIV and Men who have Sex with Men in Asia and the Pacific – a publication of UNAIDS – was “categorically in contradiction with the mentality, the morality and moral foundations of society, religion, customs and traditions of the people of Uzbekistan.” We find it unconscionable that the bilateral donors who funded his work have abandoned him, and we are calling for concerted diplomatic efforts to secure his immediate release. The bilateral agencies, international donors, and NGOs that supported and encouraged Mr. Popov’s work must take steps to protect him and win his amnesty. The international fight against AIDS cannot succeed if local partners are forsaken when the political winds shift. We request a report on what steps your organization is taking to get Mr. Popov released as quickly as possible. Please contact us at releasepopov@gmail.com. We must all work together to right this horrible wrong! Sincerely, The International Committee for the Release of Maksim Popov: cc: Representative Gary Ackerman Representative Tammy Baldwin Senator Bob Casey Representative Joe Crowley Howard Diamond Christopher Bates, Office of AIDS Policy William Clinton, CHAI Representative Barney Frank Senator Karen Gillibrand Eric Goosby, U.S. Global AIDS Coordinator Paul Hunt, U. N. Special Rapporteur on Health Senator John Kerry Representative Nancy Pelosi Representative Jared Polis Senator Harry Reid Senator Charles Schumer Signers (list in formation): ACT UP/NY ACT UP/Philadelphia ACRIA – AIDS Community Research Initiative of America African Services Committee AREA – American Run for the End of AIDS Association for Human Rights in Central Asia, France ATAC – AIDS Treatment Activists Coalition AXIOS Eastern Orthodox Christian AIDS ministry CHAMP – Community HIV/AIDS Mobilization Project CitiWide Harm Reduction CIVICUS – World Alliance for Citizen Participation – Sonia Zilberman Comité IDAHO, Paris Committee for the Release of Prisoners of Conscience, Uzbekistan – Bahadir Namazov ECAB – European Community Advisory Board The Expert Working Group, Uzbekistan Fiery Hearts Club, London – Mutabar Tadjibaeva Global Network of PLWHA/North America Harm Reduction Psychotherapy and Training Associates Harm Reduction Coalition Health GAP (Global Access Project) Human Rights in Central Asia – Nadejda Atayeva International Crisis Group Mothers Against Death Penalty and Torture, Uzbekistan – Tamara Chikunova NAPWA – National Association of People with AIDS NYCAHN – NYC AIDS Housing Network Program for Wellness Restoration Topeka AIDS Project TAC – Treatment Action Campaign, South Africa TAG – Treatment Action Group Unitarian Universalist United Nations Office Uzbekistan Initiative, London "Veritas" Youth Human Rights Movement of Uzbekistan VOCAL – Voices of Community Advocates & Leaders




	Harm Reduction Psychotherapy Group This group is open to adults with a range of substance use issues who are in a variety of stages of change. The group will provide a safe, supportive space to explore the nature and meaning of members’ substance use and how it relates to the full range of other personal and life issues people face. The group also has a strategic focus on assessing harm, embracing ambivalence about change, setting harm reduction goals and developing individualized plans for positive change. A general goal might be for members to develop their healthiest relationship to substances whether that is safer use, reduced use, moderation or abstinence. The group enables open exploration, sharing of strategies and focus on interpersonal process in the group. A variety of techniques are taught including: “Urge Surfing”, awareness and relaxation training, self-monitoring, Decisional Balance, ”Microanalysis” of use patterns, the “Ideal Use Plan”, the “Game Plan” and “18 Alternatives”. We also explore how relational issues get enacted in the group and can get reworked in the group process. Tuesdays 6-7:30 PM Fee: $75.00




	Integrative Harm Reduction Psychotherapy Activities 2010 Harm Reduction Psychotherapy Group has openings This group is open to adults with a range of substance use issues who are in a variety of stages of change. The group will provide a safe, supportive space to explore the nature and meaning of members’ substance use and how it relates to the full range of other personal and life issues people face. The group also has a strategic focus on assessing harm, embracing ambivalence about change, setting harm reduction goals and developing individualized plans for positive change. A general goal might be for members to develop their healthiest relationship to substances whether that is safer use, reduced use, moderation or abstinence. The group enables open exploration, sharing of strategies and focus on interpersonal process in the group. A variety of techniques are taught including: “Urge Surfing”, awareness and relaxation training, self-monitoring, Decisional Balance, ”Microanalysis” of use patterns, the “Ideal Use Plan”, the “Game Plan” and “18 Alternatives”. We also explore how relational issues get enacted in the group and can get reworked in the group process. Tuesdays 6-7:30 PM Fee: $75.00 Supervision and Training Monthly Supervision Training Group on Integrative Harm Reduction Psychotherapy (IHRP) for Professionals has Openings This group provides training and case supervision in my approach to Integrative Harm Reduction Psychotherapy for people with drug and alcohol concerns. My approach understands substance use problems as being intertwined with the unique complexity of the person in context. IHRP is based on an integration of relational psychoanalytic and cognitive-behavioral theory and technique. IHRP blends a skills building focus on cognitive and behavioral change with an exploration of the multiple meanings and functions of substance use and other risk behaviors in the context of a therapeutic relationship that anchors the process and is also an agent of change. The approach reflects my 30 years of work in the area of substance use specializing over the last 15 years in applying harm reduction philosophy to psychotherapy. The harm reduction principles that inform this approach are: meeting the patient as a unique individual, the primacy of the therapeutic alliance, abandoning the abstinence requirement and any other preconceived agenda for the patient, special attention to social, personal and induced countertransference, working collaboratively to assess and identify problems, clarify goals and strategies that best suit the patient's needs, recognizing small incremental positive change as success and meeting the patient with empathy, respect, acceptance and flexibility. In this spirit the form, structure and timing of the therapy emerge out of the therapeutic process rather than being predetermined. The group combines case presentation with selected readings as appropriate to the members. Fee: $60.00 The group meets currently on a monthly basis on Mondays, 12-1:30 PM. ********************************************************************** The Center for Integrative Psychotherapy of the Addictions and PsychologicA present: Integrative Harm Reduction Psychotherapy and Transformational Chairwork** A one-day combined introductory training in these two approaches and how they complement each other by: Andrew Tatarsky, PhD and Scott Kellogg, PhD When: Friday, May 14th, 2010, from 10:00 AM to 4:00 PM Where: The Ellis Institute, 45 East 65th Street, NYC, NY 10065-6508 Fee: $80 Dr. Andrew Tatarsky is a leading developer of Harm Reduction Psychotherapy. His integrated approach to treatment utilizes the best of the psychodynamic, harm reduction, cognitive-behavioral, and experiential traditions in addiction treatment. This approach is very useful because it empowers the psychotherapist to simultaneously treat problems with substance use and the emotional difficulties that may underlie or drive it. His training will include a didactic overview and case consultation with material provided by attendees. More information about his work can be found at: http://www.andrewtatarsky.com Drawing on the clinical wisdom and practice of a wide range of Gestalt and integrative psychotherapists, Dr. Kellogg will introduce therapists to the art and science of chairwork, or psychotherapeutic dialogues, in an active, creative, and clinically-useful manner. Using didactic presentations, scripted and unscripted role-plays, and live demonstrations, participants will learn how to use this technique with addictive disorders and when treating problems related to loss and grief. More information about his work can be found at: http://transformationalchairwork.com If you are planning on attending, it would be helpful if you would let us know in advance. Please e-mail Dr. Tatarsky at: atatarsky@aol.com For more information, please call 212-633-8157. ******************************************************************* Integrative Harm Reduction Psychotherapy Workshops and Trainings Over the last several years I have been offering workshops and trainings in the U.S. and internationally for groups that wish to get a deeper immersion in harm reduction philosophy, it’s epidemiological and outcome research support, theoretical basis and applications to psychotherapy and counseling. This approach integrates a skills building focus to cognitive and behavioral change with an exploration of the multiple meanings and functions of substance use and other risk behaviors in the context of a therapeutic relationship the anchors the process and is also an agent of change. There is an emphasis on group participation and learning both theory and technique. Trainings are delivered in the collaborative spirit of harm reduction. These trainings can be delivered from half day to five full day formats depending on the needs of the group. Trainings can be tailored to the specific needs of the agency and client population. Modules include**: History and Evolution of Harm Reduction Philosophy and History Clinical Challenges and Limitations of Traditional Treatment Clinical and Epidemiological Rationales for Harm Reduction Psychotherapy Theoretical Basis of Harm Reduction Psychotherapy Biopsychosocial Process Model of Addiction Multiple Meanings of Drug Use Motivational Stages of Change Clinical Philosophy of Harm Reduction Psychotherapy Overview of Integrative Harm Reduction Psychotherapy Building Alliances with Drug Using Patients for Physicians Therapeutic Tasks Establishing and Maintaining the Therapeutic Alliance Therapeutic Relationship as Agent of Change Facilitating Self-management Skills: Curiosity,self-awareness and affect tolerance Assessment as Treatment Exploring and Embracing Ambivalence Harm Reduction Goal Setting Techniques for Facilitating Positive Change For more information call 212-633-8157. More information on my approach can be found on my website, www.andrewtatarsky.com




	The Center for Integrative Psychotherapy of the Addictions and PsychologicA present: Integrative Harm Reduction Psychotherapy and Transformational Chairwork A one-day combined introductory training in these two approaches and how they complement each other by: Andrew Tatarsky, PhD and Scott Kellogg, PhD When: Friday, May 14th, 2010, from 10:00 AM to 4:00 PM Where: The Ellis Institute, 45 East 65th Street, NYC, NY 10065-6508 Fee: $80 Dr. Andrew Tatarsky is a leading developer of Harm Reduction Psychotherapy. His integrated approach to treatment utilizes the best of the psychodynamic, harm reduction, cognitive-behavioral, and experiential traditions in addiction treatment. This approach is very useful because it empowers the psychotherapist to simultaneously treat problems with substance use and the emotional difficulties that may underlie or drive it. His training will include a didactic overview and case consultation with material provided by attendees. Drawing on the clinical wisdom and practice of a wide range of Gestalt and integrative psychotherapists, Dr. Kellogg will introduce therapists to the art and science of chairwork, or psychotherapeutic dialogues, in an active, creative, and clinically-useful manner. Using didactic presentations, scripted and unscripted role-plays, and live demonstrations, participants will learn how to use this technique with addictive disorders and when treating problems related to loss and grief. More information about his work can be found at: http://transformationalchairwork.com If you are planning on attending, it would be helpful if you would let us know in advance. Please e-mail Dr. Tatarsky at: atatarsky@aol.com For more information, please call 212-633-8157 DOWNLOAD INFORMATION AS ATTACHMENT: WORD DOC \| ADOBE PDF




	8th National Harm Reduction Conference: Harm Reduction Beyond Borders! November 18th--21st Austin, TX The 8th National Harm Reduction Conference will bring together approximately 2,000 drug users, ex-drug users, researchers, sex workers, social workers, doctors, politicians and community organizers from around the country and abroad to share perspectives on Harm Reduction. The National Harm Reduction Conference is the only multidisciplinary gathering in the United States focusing on the health of individuals and communities impacted by drug use. The purpose of the conference is to inspire and explore new perspectives on incorporating Harm Reduction into direct services, public policy and individual lives. This year's lifting of the ban on federal funding for syringe exchange promises for a renewed and dynamic collaboration between public health officials and grassroots organizations. This is an opportunity to uphold the right to health and dignity of this marginalized community. We hope you will join us in Austin, Texas in our efforts to combat these public health emergencies and implement real and lasting change. For more information on registration, scholarships, submitting abstracts, exhibitor/vendor applications, please visit: www.8thnationalharmreductionconference.com




	THE WOMEN'S THERAPY CENTRE INSTITUTE Presents The Laurie Phillips Memorial Lecture Dr. Danielle Knafo By Herself: Women, Solitude and Creativity An examination of the lives and works of ten pioneering female artists over the last century whose self-representational art challenged the cultural presuppositions and gender stereotypes of their time, while opening up a vista on the feminine experience. Additionally, each of the artists - Käthe Kollwitz, Claude Cahun, Charlotte Salomon, Frida Kahlo, Carolee Schneemann, Hannah Wilke, Ana Mendieta, Adrian Piper, Cindy Sherman, and Orlan - used her art to overcome personal tragedy and trauma, so her work is in simultaneous and dramatic dialogue with both her social world and her personal history. Dr. Knafo, a psychoanalyst and art critic, analyzes the work and life of these artists and shows how their art illuminates and advances the way women relate to their bodies - to beauty, sexuality, motherhood, relationships, race, aging, sickness, loss and death. Their art reflects profound changes in woman's evolving self-awareness while it explores the transcendent possibilities of the female psyche and its creative potential for healing. Danielle Knafo, Ph.D. is a Professor in the Clinical Psychology Doctoral Program at Long Island University's C.W. Post Campus. She is Associate Clinical Professor and supervisor at New York University's Postdoctoral Program in Psychoanalysis. Dr. Knafo's books include: Egon Schiele: A Self in Creation, Unconscious Fantasies and the Relational World, Living with Terror, Working with Trauma: A Clinician's Handbook, and In Her Own Image: Women's Self-Representation in Twentieth-Century Art. Dr. Knafo is a clinical psychologist and psychoanalyst and she maintains a private practice in Great Neck, NY and NYC. Friday, April 9th, 7:00pm-9:00pm Mt. Sinai Medical Center, Hatch Auditorium 1468 Madison Avenue @ 100th Street, NYC Suggested Donation: $10 - $35 The Laurie Phillips Memorial Lecture is supported by the Phillips Family. It honors the memory of our colleague and friend and brings to the community leading contributors to the psychoanalytic field. Tickets available at the door or at www.wtci-nyc.org. Doors open 6:30pm




	US drug policy at the UN. Is the glass becoming more than half full? By Allan Clear Posted: March 12, 2010 11:33 AM Huffington post Here's the good news: From what I'm seeing here on the ground here at the 53rd annual UN global drug policy meeting in Vienna, the public face of US drug policy has changed overall under the new administration -- and for the better. There's a more humane, compassionate message, plus a greater understanding of both drugs and drug users. Only time will tell where this will lead, but it's a start. And a very welcome one, too. Because -- and not to mince words -- US drug policy has historically been punitive, impervious, murderous, and devastating. Not least because of the enormous power the US exercises publicly and behind the scenes. I've seen that power in action during previous CND meetings, watching as proxy states doing the bidding of the US raise objections to progressive developments in global drug policy. And I've spent my entire professional life (such as it is) criticizing it and being badgered by it. Still, even at its worst, I've always respected the way the US prepares for these meetings. They bring a large, smart, well-prepared team of career diplomats and policy analysts, plus some treatment/science-based folks. Not too dissimilar to the advocates that show up, really, except we don't have much money or much power beyond our passion and experience. But back to my original point -- that things appear to be changing over the last couple of years as far as the US message is concerned and there may be cause for hope. Exhibit A: Gil Kerlikowske, who just took over as US Drug Czar last May (official title: Director of the Office of National Drug Control Policy, or ONDCP). His smooth opening remarks for the US delegation this past Monday emphasized evidence-based interventions such as Screening, Brief Intervention, and Referral to Treatment, or SBIRT (a harm reduction intervention in many ways) and drug courts, but also advocated integrating addiction medicine into more mainstream medical settings. Kerlikowske also talked up a 17% increase in the federal budget for demand reduction enhancement. That means devoting more money to dealing with domestic drug problems. (Alas, apparently the written version of his remarks is explicit about the US not being comfortable with the term "harm reduction," so that battle that dominated last year's meeting, which I've documented in numerous posts, is far from over.) Exhibit B: Kerlikowske's second in command, ONDCP Deputy Director Tom McLellan, who has held his post since last August. As the meeting progressed to the more substantive "thematic" debate, his remarks during his presentation at the podium and from the floor were reasonable, pragmatic, and targeted. McLellan explicitly recognized that not all use is problematic and that there are degrees of drug use and drug problems. Chaotic drug problems lie in the top pinnacle of a pyramid of drug use, the larger portion of which is those Americans who do not use drugs. He also acknowledged later that problematic drug use is not necessarily a permanent condition and that he felt remiss in not saying so publicly. Oh brave new world! In welcome contrast to the bellicose rhetoric that the US delegation usually propagates, McLellan spoke of addiction as a disease. I would have liked to hear him add that not all drug use is an illness and that there is a genuine spectrum. But believe me, it's a great day when the ONDCP moves from the War on Drugs paradigm of criminalization and mass incarceration to the public health model. While McLellan didn't detail the ONDCP's new direction in great depth, he did talk about moving away from mass social marketing campaigns to a more nuanced approach targeting different communities and populations. Smart. Regarding young drug users and youth, he acknowledged that it's not about drugs in and of themselves but about the "other" issues in young people' lives as they grow and develop. (Not rocket science, I know, but still not the kind of thing we've been hearing from the ONDCP in the past.) McLellan offered genetics and brain disease as proof of the existence of the "disease" of addiction. But let's face it. Most drug users that use social services operating on a harm reduction model (such as syringe exchange programs) do not need to beaten over the head about the role drug use plays in their lives. They can be extremely articulate about the consequences of their own drug problems and what the solutions are but they're never asked, consulted or considered active participants in the solution. Is this kind of change in tune (and performer) that Kerlikowske and McLellan represent comprehensive from a progressive drug advocate's point of view? Absolutely not, especially given the US government's schizophrenic fear of harm reduction. Still, in the broader world of how problematic drug use is addressed in the US, it does signify a positive direction. It's obviously early days, so I'm reserving further judgment until I see change on the ground and the discarding of our old and imperfect ways. (In the ideal scenario, we start talking about releasing our drug users from prison and getting them back their freedom and families, too.) Again, it's a welcome start. http://www.huffingtonpost.com/allan-clear/us-drug-policy-at-the-un_b_496692.html




	Integrative Harm Reduction Psychotherapy in Spanish and Chinese March 6, 2010 Dear Friends, I am pleased to let you know that the following paper of mine is now available in Spanish and Chinese for free download on my website, www.andrewtatarsky.com, under Publications: Harm reduction psychotherapy: Extending the reach of traditional substance use treatment. (2003). Journal of Substance Abuse Treatment. Vol. 25, pp. 249-256. These translations were done for three-day trainings that I was invited to give in Santiago, Chile in 2008 and Kunming, China this past October. These invitation trainings, among others to Poland, Ukraine, North Carolina and Chicago in the past year, reflect a growing interest in integrative harm reduction psychotherapy in the international harm reduction and substance use treatment communities. Check back to my blog, http://harmreductionpsych.blogspot.com/, for reports on these very exciting trainings and the developments that they reflect in these communities. There is an international network of harm reduction therapists and substance use treatment practitioners that are working to adapt this therapeutic approach to their particular social and cultural contexts. Best, Andrew Tatarsky, PhD Harm Reduction Psychotherapy and Training Associates 303 Fifth Avenue, Suite 1403 New York, NY 10016 212-633-8157 www.andrewtatarsky.com




	ModerateDrinking.com is a new, scientifically proven, program to help people learn how to change their drinking "Our web site is for drinkers who want to change their drinking. If you are looking for answers about moderate drinking or abstaining, you may find our program useful. We can help you make responsible decisions about your drinking. We can also help you be successful in cutting back on your drinking. Before you register, consider our Guided Tour to see what we have to offer. Our protocol is evidence-based. This means we have evidence from a federally funded, randomized clinical trial of the program. What is moderate drinking? This page defines moderate drinking; what it is and what it isn't. Is moderate drinking for everyone? The short answer is NO. There are a many reasons to consider abstaining if you’re considering a change in your drinking. What might your chances of success be if you tried to moderate my drinking? Take a quick questionnaire and get feedback based on scientific research. If you decide to try moderate drinking how can you learn how to do it? Here is a description of our program on how to cut back and maintaining moderate drinking over time. There also is much here if you're considering abstaining. A picture is worth a thousand words. Here is a video demo of the program. It's large so please be patient while it loads. We also recommend that you consider joining Moderation Management, a unique support group for people wanting to moderate their drinking. Register to use our site." http://www.moderatedrinking.com/




	Upcoming Harm Reductions Trainings in the NYC area MARCH 18-21, 2010 - NEW YORK CITY Dr. Tatarsky will present a workshop, Integrative Harm Reduction Psychotherapy for the Treatment of Survivors of Trauma, as part of a pre-conference institute, Effective Approaches for Treating Traumatic Stress and Addiction, at MaleSurvivor : 2010 International Conference for Male Survivors, John Jay College of Criminal Justice. MARCH 24, 2010 - BRONX, NYC Dr. Tatarsky will present a Grand Rounds on Integrative Harm Reduction Psychotherapy for the Treatment Substance Using Patient, Department Of Psychiatry, North Central Bronx Hospital. MARCH 31, 2010 - NEW YORK CITY Dr. Tatarsky will present an in-service training on Integrative Harm Reduction Psychotherapy for the Treatment of Patients on Opiate Substitution Treatment, Opiate Treatment Program, Addiction Institute, New York.




	Guilt-Based Anti-Alcohol Ads Can Backfire, Study Finds March 1, 2010 Research Summary JoinTogether.org Using shame or guilt to try to prevent overconsumption of alcohol can actually cause people to drink more, researchers say. Researcher Adam Duhachek of the Indiana Kelley School of Business and colleagues said that ads that link alcohol abuse to negative consequences like blackouts and automobile crashes in order to elicit feelings of shame or guilt can trigger a defensive coping mechanism. This can lead viewers to believe that bad things related to drinking can only happen to others and can actually increase irresponsible drinking, researchers said. "The public health and marketing communities expend considerable effort and capital on these campaigns but have long suspected they were less effective than hoped," said Duhachek. "But the situation is worse than wasted money or effort. These ads ultimately may do more harm than good because they have the potential to spur more of the behavior they're trying to prevent." A better approach might be to educate the public about the negatives associated with drinking but link that message to one of empowerment, said Duhachek. "If you're going to communicate a frightening scenario, temper it with the idea that it's avoidable," he said. The study will be published in the Journal of Marketing Research. http://www.jointogether.org/news/research/summaries/2010/guilt-based-anti-alcohol-ads.html




	Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI). Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers. According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide suffer from infections acquired in hospitals. A Centers for Disease Control (CDC) report published in March-April 2007 estimated the number of U.S. deaths from healthcare associated infections in 2002 at 98,987. The risk of acquiring healthcare-associated infections in developing countries is 2-20 times higher than in developed countries. Afflicting thousands of patients every year, HAI often leads to lengthening hospitalization, increasing the likelihood of readmission, and adding sizably to the cost of care per patient. Financially, HAIs represent an estimated annual impact of $6.7 billion to healthcare facilities, but the human cost is even higher. Until recently, a lack of HAI reporting requirements for healthcare facilities has contributed to less-than-optimal emphasis being placed on eliminating the sources of healthcare associated infections. However, growing public anxiety regarding the issue and resulting legislation on state and local levels demanding accountability is serving to accelerate initiatives to combat HAIs. To learn more about the impact of healthcare-associated infections for both medical professionals and patients, please visit www.haiwatch.com. http://haiwatchnews.com/




	Howard Lotsof Dies at 66; Found Drug Treatment in an African Plant By DENNIS HEVESI Published: February 17, 2010 New York Times.com Howard Lotsof was 19, addicted to heroin and searching for a new high in 1962 when he swallowed a bitter-tasting white powder taken from an exotic West African shrub. “The next thing I knew,” he told The New York Times in 1994, “I was straight.” The substance was ibogaine, an extract of Tabernanthe iboga, a perennial rain-forest plant found primarily in Gabon. In the Bwiti religion it is used in puberty initiation rites, inducing a powerful altered state for at least 48 hours during which young people are said to come into contact with a universal ancestor. By Mr. Lotsof’s account, when he and six friends who were also addicted tried ibogaine, five of them immediately quit, saying their desire for heroin had been extinguished. It was the start of a lifelong campaign for Mr. Lotsof. And now thousands of former addicts around the world and some scientists contend that ibogaine should be scientifically tested for its ability to halt heroin and cocaine cravings and even end addiction. Ibogaine is used in drug treatment clinics in many countries, but is banned in the United States. Mr. Lotsof, who was 66, died on Jan. 31 at a hospital near his home on Staten Island. The cause was liver cancer, his wife, Norma said. Virtually from that day 48 years ago when he first tried ibogaine, Mr. Lotsof became perhaps its leading advocate, lobbying public officials, pharmaceutical companies and independent researchers to investigate its efficacy. In the mid-1980s, he persuaded a Belgian company to manufacture ibogaine in capsule form and begin offering it to addicts in the Netherlands. By then he had started the Dora Weiner Foundation, named for his grandmother, to develop ibogaine as a medication, to disseminate information about chemical dependence and to refer people to treatment. Mr. Lotsof ran the foundation. In 1986 he received a patent for the use of ibogaine as a remedy for heroin and cocaine addiction. Five years later, he began working with Jan Bastiaans, a Dutch psychiatrist who had gained renown by using LSD therapy for Holocaust survivors. They treated 30 addicts from around the world, two-thirds of whom stopped using drugs for periods ranging from four months to four years. With 75 percent of addicts typically relapsing within six months of conventional care, the results spurred scientific interest. “His great achievement,” said Kenneth Alper, an associate professor of psychiatry and neurology at the New York University School of Medicine, “was in inducing the National Institute on Drug Abuse to undertake a research project on ibogaine that produced scores of peer-reviewed publications and paved the way for F.D.A. approval of a clinical trial.” The Food and Drug Administration did approve the trial, Dr. Alper said, but it was never completed because of contractual disputes and lack of financing. Ibogaine remains banned by the federal government. “In the uncontrolled environments in which ibogaine is typically used, clinics or nonmedical settings,” Dr. Alper said, “the observations indicate that there is a resolution of withdrawal, meaning the addict is detoxified and no longer has withdrawal symptoms and is no longer physically dependent.” Scientifically controlled testing is needed, he said. Herbert D. Kleber, director of the division on substance abuse at the New York State Psychiatric Institute at Columbia University, said he was skeptical about the efficacy of ibogaine in treating substance abusers, including those addicted to opium-based drugs like heroin. “At various times ibogaine has been proposed to treat opioid withdrawal as a cure for opioid dependence and as a cure for cocaine dependence,” Dr. Kleber said. “But there is a lack of controlled scientific studies to back those beliefs. “A number of deaths have been associated with its use, especially to treat opioid withdrawal and dependence,” Dr. Kleber continued. “I therefore do not feel it is something that should be used in the absence of such evidence.” Howard Stephen Lotsof (pronounced LOTS-uv) was born in the Bronx on March 1, 1943, the only child of Abner and Lillian Weiner Lotsof. Besides his wife, the former Norma Alexander, he is survived by two daughters, Rosalie Falato and Holly Weiland. Mr. Lotsof, who dropped out of Fairleigh Dickinson University in the 1960s, graduated from N.Y.U. in 1976. Over the years he wrote or co-wrote scientific papers on ibogaine that were published in respected academic journals, including The Journal of Ethnopharmacology and The American Journal on Addictions. “These accomplishments are all the more extraordinary,” Dr. Alper said, “in view of the fact that Mr. Lotsof, a graduate of New York University who majored in film, was without a doctoral-level degree.” http://www.nytimes.com/2010/02/17/us/17lotsof.html




	Study Links Alcoholic Energy Drinks to Intoxication, Drunk Driving February 11, 2010 Bar patrons who consumed energy drinks mixed with alcohol were three times more likely to leave drunk and four times more willing to drive drunk compared to patrons who drank alcohol alone, according to researchers who surveyed college-aged drinkers as they left bars. The University of Florida researchers surveyed more than 800 bar patrons at random between the hours of 10 p.m. and 3 a.m., and also collected breath samples to test blood-alcohol content (BAC). The average BAC for alcoholic energy drink consumers was 0.109 percent, well above the legal standard for intoxication. Patrons who consumed alcohol mixed with highly caffeinated energy drinks like Red Bull also were more likely to have consumed alcohol for longer periods of time, and left bars later than other drinkers. The study was led by Dennis Thombs of the school's College of Public Health and Health Professions. "His approach is unique because it was conducted in a natural drinking environment -- college bars," said Wake University's Mary Claire O'Brien, author of previous research on alcoholic energy drinks. "His results clearly support the serious concern raised by previous research, that subjective drunkenness may be reduced by the concurrent ingestion of caffeinated energy drinks, increasing both the likelihood of further alcohol consumption, and of driving when intoxicated." The study was published in the journal Addictive Behaviors. http://www.jointogether.org/news/research/summaries/2010/study-links-alcoholic-energy.html




	Safe-Injection Program Survives Another Shutdown Attempt by Canadian Government January 19, 2010 The British Columbia Court of Appeal has rejected a lawsuit from Canada's Conservative government that sought to shutter Vancouver's Insight safe-injection program for IV-drug users, theCanwest News Service reported Jan. 16. Insite was established as a three-year program in 2003 under the previous Liberal administration, but the B.C. Supreme Court later granted the program an extension of its exemption from Canada's drug laws. This week, the appeals court rejected the current government's challenge to that decision. Canada's federal government is expected to appeal the latest decision to the Supreme Court of Canada. http://www.jointogether.org/news/headlines/inthenews/2010/safe-injection-program.html




	Fast morphine treatment may prevent PTSD Speedy care slashes wounded troops’ chance of developing the disorder Associated Press Wed., Jan. 13, 2010 Quickly giving morphine to wounded troops cuts in half the chance they will develop post-traumatic stress disorder, according to a provocative study that suggests a new strategy for preventing the psychological fallout of war. Researchers at the U.S. Naval Health Research Center led the study of about 700 troops injured in Iraq from 2004 through 2006. “It was surprising how strong the effect of the morphine was,” said study leader Troy Lisa Holbrook, an epidemiologist at the naval center. The findings were published in Thursday’s New England Journal of Medicine. Whether the Pentagon will adopt the practice on the battlefield remains to be seen. Dr. Jack Smith, acting deputy assistant secretary of defense for clinical and program policy, said in an e-mail that the “very interesting findings” are “likely to stimulate further research.” About 53,000 troops returning from Iraq and Afghanistan have been treated for PTSD, a disorder in which someone who has endured a traumatic event keeps re-experiencing it and the fear it caused. Patients often have trouble with work, relationships, substance abuse and physical ailments. Researchers have been testing ways to treat it, and the new study looked at whether fast and strong pain relief can help prevent it. It was unclear whether it was the fast pain treatment or something specific to morphine that made the difference. But researchers theorize that simply easing pain might reduce the severity of the psychological trauma, or that prompt relief might alter the way the brain remembers the attack or injury — in essence, causing the mind to file away the episode as less traumatic. Troops in the study initially were treated at military medical facilities in Iraq, mainly for wounds caused by roadside bombs, bullets, grenades or mortar fire. A few dozen had burns or were hurt in crashes or falls. The decision on whether to give morphine was up to the individual doctor, based on the patient’s condition. Of the 696 troops in the study, 493 — about 70 percent — were given morphine, most within an hour of injury. Two years later, 147 of them had developed PTSD. Of the 203 not given morphine early on, 96 developed PTSD. That worked out to a 53 percent lower risk of developing PTSD for those treated early with morphine. No other factor, such as the nature or severity of injuries, had much effect on the chances of developing PTSD, Holbrook said. “These are provocative and thought-provoking findings that should lead scientists to investigate the underlying mechanisms” in future studies, said JoAnn Difede, a PTSD researcher at New York-Presbyterian/Weill Cornell Medical Center. Difede and Barbara Rothbaum, who heads the Trauma and Anxiety Recovery Program at Emory University School of Medicine, said that until more research backs up the findings, the study probably won’t lead to many more patients in civilian emergency rooms getting morphine. “At this point, I don’t see it having a huge impact” for civilians, Rothbaum said. A second study in the journal found that Army wives were more likely to develop depression or sleep problems the longer, or the more times, their spouses were sent to Iraq or Afghanistan. That study, by researchers at the University of North Carolina and elsewhere, examined medical records for outpatient care of about 250,000 wives of active-duty soldiers from 2003 through 2006. Compared with wives whose husbands stayed home, those whose husbands were deployed for up to 11 months were 18 percent more likely to be diagnosed with depression and at least 20 percent more likely to be diagnosed with sleep disorders, anxiety and acute stress. For wives whose husbands were deployed for more than 11 months, problems were even more common: They were at least 24 percent more likely to be diagnosed with depression or anxiety, and about 40 percent more likely to be diagnosed with acute stress or sleep problems. The researchers didn’t have data showing whether husbands were deployed or at home when the wives were being treated for mental health problems. That meant the scientists couldn’t conclude whether those problems were caused by worries about the spouse’s safety and the difficulties of being a single parent, or by stress caused by the returning spouse’s psychological problems or other behavior changes. “I suspect that if you look at the Reserve and National Guard wives, the toll might be even worse,” because they have less social support than families living in a military community, Rothbaum said. She said the effects of deployment on children also need to be studied so the military can figure out how to provide more help to families. http://www.msnbc.msn.com/id/34848093/ns/health-mental_health/




	Join Harm Reduction Coalition for a FREE talk by Dr. David Marsh: "Supervised Injection and Prescribing Heroin in North America: Evidence and Politics" Dr. David C. Marsh, MD, CCSAM Physician Leader, Addiction Medicine with Vancouver Coastal Health and Providence Health Care will be at HRC in New York at 3:00 pm Friday January 22, 2010. Learn what has been happening in Vancouver with these harm reduction interventions. All welcome! 22 West 27th Street, 5th floor New York, NY 10001 About Dr David C. Marsh, MD, CCSAM: Dr. Marsh graduated in Medicine from Memorial University of Newfoundland following prior training in neuroscience and pharmacology. In January 2004, Dr. Marsh began serving as the Physician Leader, Addiction Medicine with Vancouver Coastal Health and Providence Health Care. In this role he is also Medical Director for Addiction Services, HIV/AIDS Services and Aboriginal Health for Vancouver Community. Dr. Marsh is also Clinical Associate Professor in the Department of Health Care and Epidemiology, Faculty of Medicine at the University of British Columbia. Prior to relocating to Vancouver he was the Clinical Director, Addiction Medicine at the Centre for Addiction and Mental Health in Toronto. Dr. Marsh's research interests include the integration of pharmacotherapy and psychotherapy in the treatment of substance use disorders and focus primarily on novel interventions for opioid dependence. He is presently involved in several research projects including the North American Opiate Medication Initiative (NAOMI) trial of prescription heroin, an Interdisciplinary Health Research Team on Illicit Opiate Dependence in Canada funded by the Canadian Institutes of Health Research and an evaluation of the Supervised Injection Site in Vancouver. Harm Reduction Coalition 22 West 27th Street, 5th Floor New York, NY 10001 Tel: 212-213-6376 Fax: 212-213-6582 www.harmreduction.org




	Word Choices Affect Attitudes Toward Addiction Recovery A survey of health professionals found that referring to people with addictions as "substance abusers" was more likely to evoke punitive responses to drug use than those who referred to individuals with "substance-use disorders," according to researchers at Massachusetts General Hospital (MGH). John F. Kelly, Ph.D., associate director of MGH's Center for Addiction Medicine noted that the World Health Organization declared the term "abuser" as stigmatizing three decades ago, but the term is still commonly used to describe people with addictions to illicit drugs. Referring to recovery, Kelly said, "There's an old proverb that states, if you want something to survive and flourish, call it a flower; if you want to kill it, call it a weed." Kelly and colleagues surveyed more than 700 mental-health professionals attending a conference on addiction and mental illness. Half received a survey that referred to a hypothetical patient as a "substance abuser," while the rest got a survey referring to the patient as having a "substance use disorder." The surveys were otherwise identical. Respondents who received the "substance abuser" version were more likely to say that the patient should be punished for failing to follow a treatment plan and to agree that the patient shouldered blame for having trouble complying with court-ordered treatment requirements. "Our results imply that these punitive attitudes may be evoked by use of the 'abuser' term, whether individuals are conscious of it or not, and suggest that this term perpetuates that kind of thinking," Kelly said. "From the perspective of the individual sufferers, who often feel intense self-loathing and self-blame, such terminology may add to the feelings that prevent them from seeking help." The study was published in the International Journal of Drug Policy http://www.jointogether.org/news/research/summaries/2010/word-choices-affect-attitudes.html




	New Jersey Vote Backs Marijuana for Severely Ill The New York Times By DAVID KOCIENIEWSKI Published: January 11, 2010 TRENTON — The New Jersey Legislature approved a measure on Monday that would make the state the 14th in the nation, but one of the few on the East Coast, to legalize the use of marijuana to help patients with chronic illnesses. The measure — which would allow patients diagnosed with severe illnesses like cancer, AIDS, Lou Gehrig’s disease, muscular dystrophy and multiple sclerosis to have access to marijuana grown and distributed through state-monitored dispensaries — was passed by the General Assembly and State Senate on the final day of the legislative session. Gov. Jon S. Corzine has said he would sign it into law before leaving office next Tuesday. Supporters said that within nine months, patients with a prescription for marijuana from their doctors should be able to obtain it at one of six locations. “It’s nice to finally see a day when democracy helps heal people,” said Charles Kwiatkowski, 38, one of dozens of patients who rallied at the State House before the vote and broke into applause when the lawmakers approved the measure. Mr. Kwiatkowski, of Hazlet, N.J., who has multiple sclerosis, said his doctors have recommended marijuana to treat neuralgia, which causes him to lose the feeling and the use of his right arm and shoulders. “The M.S. Society has shown that this drug will help slow the progression of my disease. Why would I want to use anything else?” The bill’s approval, which comes after years of lobbying by patients’ rights groups and advocates of less restrictive drug laws, was nearly derailed at the 11th hour as some Democratic lawmakers wavered and Governor-elect Christopher J. Christie, a Republican, went to the State House and expressed reservations about it. In the end, however, it passed by comfortable margins in both houses: 48-14 in the General Assembly and 25-13 in the State Senate. Assemblyman Reed Gusciora, a Democrat from Princeton who sponsored the legislation, said New Jersey’s would be the most restrictive medical marijuana law in the nation because it would permit doctors to prescribe it for only a set list of serious, chronic illnesses. The law would also forbid patients from growing their own marijuana and from using it in public, and it would regulate the drug under the strict conditions used to track the distribution of medically prescribed opiates like Oxycontin and morphine. Patients would be limited to two ounces of marijuana per month. “I truly believe this will become a model for other states because it balances the compassionate use of medical marijuana while limiting the number of ailments that a physician can prescribe it for,” Mr. Gusciora said. Under the bill, the state would help set the cost of the marijuana. The measure does not require insurance companies to pay for it. Some educators and law enforcement advocates worked doggedly against the proposal, saying the law would make marijuana more readily available and more likely to be abused, and that it would lead to increased drug use by teenagers. Opponents often pointed to California’s experience as a cautionary tale, saying that medical marijuana is so loosely regulated there that its use has essentially been decriminalized. Under California law, residents can obtain legal marijuana for a list of maladies as common, and as vaguely defined, as anxiety or chronic pain. David G. Evans, executive director of the Drug-Free Schools Coalition, warned that the establishment of for-profit dispensaries would lead to abuses of the law. “There are going to be pot centers coming to neighborhoods where people live and are trying to raise their families,” Mr. Evans said. Keiko Warner, a school counselor in Millville, N. J., cautioned that students already faced intense peer pressure to experiment with marijuana, and that the use of medical marijuana would only increase the likelihood that teenagers would experiment with the drug. “There are children at age 15, 14 who are using drugs or thinking about using drugs,” she said. “And this is not going to help.” Legislators attempted to ease those fears in the past year by working with the Department of Health and Senior Services to add restrictions to the bill. But with Democrats in retreat after Mr. Corzine’s defeat by Mr. Christie, some supporters feared that the Democratic-controlled Legislature — which last week failed to muster the votes to pass a gay marriage bill — would balk at approving medical marijuana. Mr. Christie added to the suspense Monday, just hours before lawmakers were scheduled to vote, when he was asked about the bill during a press conference within shouting distance of the legislative chambers. He said he was concerned that the bill contained loopholes that might encourage recreational drug use. “I think we all see what’s happened in California,” Mr. Christie said. “It’s gotten completely out of control.” But the loophole Mr. Christie cited — a list of ailments so unrestricted that it might have allowed patients to seek marijuana to treat minor or nonexistent ailments — had already been closed by legislators. In the end, the bill received Republican as well as Democratic support. “This bill will help relieve people’s pain,” said Senator William Baroni, a Republican. Supporters celebrated with hugs and tears. Scott Ward, 26, who said he suffered from multiple sclerosis, said he had been prescribed marijuana to alleviate leg cramps so severe that they often felt “like my muscles are tearing apart.” “Now,” he said, “I can do normal things like take a walk and walk the dog.” http://www.nytimes.com/2010/01/12/nyregion/12marijuana.html?hp




	Nicotine Replacement Therapy Before Quitting May Help (NRT) -- nicotine-infused gums, patches, etc. -- before quitting cigarettes may improve long-term cessation success, Reuters reported June 25. A study of 1,100 New Zealanders -- half of whom began NRT two weeks before they quit cigarettes, and another half that started NRT after -- found only a 2 percent difference in abstinence success after six months. When combined with previous pre-quitting NRT studies, however, success increased by approximately 25 percent overall. The findings suggest a "small-to-moderate" benefit to pre-quitting therapy, University of Auckland researchers wrote. Side effects from the pre-quitting and regular NRT groups were approximately the same. The study is published in the July 2010 issue of the journal Addiction. http://www.jointogether.org/news/research/summaries/2010/nicotine-replacement-therapy.html




	Information, Not Scare Tactics, Helps Smokers Quit: Study JoinTogether.org A new study finds that smokers who called a tobacco quitline were twice as likely to experience short-term success in quitting if they heard positive messages rather than negative ones, MedPage Today reported Jan. 8. Researcher Benjamin A. Toll, Pd.D., of the Yale University School of Medicine and colleagues found that the positive messages were more effective in the short run, although the effects were not sustained, with abstinence rates evening out among the two groups after three months. "Multiple messages may be necessary for longer-term impact," the study noted. The findings were published online in the Journal of the National Cancer Institute. http://www.jointogether.org/news/research/summaries/2010/information-not-scare.html




	Harm Reduction Psychotherapy on One Hour at a Time Radio - 12/28/09 One Hour At A Time with Mary Woods and Guest Host Dr. Mark Green will present Dr. Andrew Tatarsky on Monday December 28th 2009 at 3PM Eastern, Noon Pacific. Click here to listen to the show Monday 3pm (Noon PST) If you can't listen to the live show, you can click here and download the recording.




	New interactive web application for problem drinkers We are pleased to announce the availability of a new, evidence-based, web application, ModerateDrinking.com. ModerateDrinking.com is a comprehensive, interactive, and personalized program, designed to help heavy drinkers successfully change their drinking. The elements of the program are listed below. This is a subscription-based training program. Users can unsubscribe at any time. Dr. Reid Hester, Director of the Research Division of Behavior Therapy Associates (www.behaviortherapy.com) developed ModerateDrinking with funding from NIAAA. As part of this grant he conducted a randomized clinical trial of the effectiveness of the program (in combination with participation in Moderation Management). The study demonstrated that the program is effective in helping heavy drinkers change their drinking. An abstract of one of the papers reporting the results are available here. A video demo of the program is available at www.behaviortherapy.com The elements of the program include: Building motivation and self-confidence Setting drink goals/limits "Doing a 30" Self-monitoring drinking (with personalized feedback relative to each user's self-determined goals) Controling your drinking rate Personal drinking rules Self-monitoring urges to drink (w/ personalized feedback) Identifying and managing triggers Developing alternatives to drinking General problem solving Dealing with lapses and/or relapses Considering abstinence as an option Self-monitoring your mood (w/feedback relative to baseline) These elements are the components of the MM program, both as it was originally designed and as it has evolved in the years since. Our members have already enthusiastically used this software, as part of Reid Hester's original study. Perhaps others here will be interested in suggesting it to clients. Ana Kosok, Ed D Executive Director, Moderation Management




	Congress Poised to Repeal Decades-Old National Syringe Funding Ban and Allow Washington, DC to Establish a Medical Marijuana Program States Could be Using Federal Money to Distribute Sterile Syringes to Reduce HIV/AIDS and Hepatitis C by Next Year; Washington, DC Could Join 13 States in Allowing Patients to Grow and Use Marijuana for Medical Use Reforms Part of Growing Momentum in Support of Ending the Failed War on Drugs For Immediate Release: Wednesday, December 9, 2009. Contact: Bill Piper 202-669-6430 or Tony Newman 646-335-5384 As part of an end-of-year spending package widely expected to pass Congress, Democrats are making major changes to U.S. drug policy. The legislation will be voted on in the House of Representatives Thursday or Friday. Among other things, the omnibus bill would repeal the decades-old policy prohibiting cities and states from using their share of HIV/AIDS prevention money on syringe exchange programs which reduce the spread of HIV/AIDS, hepatitis C, and other infectious diseases. The lifting of the ban is because of strong leadership by Speaker of the House Nancy Pelosi, Congressman David Obey (D-WI), Congressman Jose Serrano (D-NY), Congresswoman Eleanor Holmes Norton (D-DC), and others. “Hundreds of thousands of Americans will get HIV/AIDS or hepatitis C if Congress does not repeal the federal syringe funding ban,” said Bill Piper, director of national affairs for the Drug Policy Alliance. “The science is overwhelming that syringe exchange programs reduce the spread of infectious diseases without increasing drug use. We will make sure the American people know which members of Congress stand in the way of repealing the ban and saving lives.” The legislation not only overturns the decades-old syringe funding ban but eliminates troubling provisions the House passed earlier this year. While some advocates remain concerned about some of the restrictions on syringe exchange funding in the bill, they are excited that federal money could soon start flowing to syringe exchange programs around the country. The lifting of the ban is a huge victory for HIV/AIDS prevention and drug policy reform. The omnibus bill would also repeal a provision that overturned a 1998 medical marijuana law approved by Washington, DC voters. The city would now be free to set its own medical marijuana policies. “Congress is close to making good on President Obama’s promise to stop the federal government from undermining local efforts to provide relief to cancer, HIV/AIDS and other patients who need medical marijuana,” said Naomi Long, the DC Metro director of the Drug Policy Alliance. “DC voters overwhelmingly voted to legalize marijuana for medical use and Congress should have never stood in the way of implementing the will of the people.” The reforms in the end-of-year spending bill are part of a national trend towards major drug policy reform. In April, New York State repealed the Rockefeller Drug Laws, thus eliminating mandatory minimum sentencing for low-level, nonviolent drug law offenses. In November, Maine citizens voted to establish compassion centers to distribute marijuana to patients. New Jersey stands poised this month to reform both its harsh mandatory minimum penalties for nonviolent drug law offenses and legalize marijuana for medical use. 13 states have already legalized marijuana for medical use; dozens have already overhauled their harsh sentencing laws to reduce incarceration and make treatment more available. On the campaign trail, President Obama called for treating drug use as a health issue instead of a criminal justice issue and advocates say he is beginning to follow through on his pledges. Administration officials have endorsed syringe exchange programs, called for federal sentencing reform, and taken steps towards reorienting U.S. drug policy towards a more demand-reduction approach. In March the Justice Department said it would no longer arrest and prosecute people using, growing or distributing marijuana as long as they are following their state’s medical marijuana law, ending a brutal Bush Administration policy. “It’s too soon to say that America’s long national nightmare – the war on drugs – is really over,” said Ethan Nadelmann, executive director of the Drug Policy Alliance. “But yesterday’s action on Capitol Hill provides unprecedented evidence that Congress is at last coming to its senses when it comes to national drug control policy.” http://www.drugpolicy.org/news/pressroom/pressrelease/pr120909.cfm




	Czech govt defines rules of hallucinogenic plants growing Prague - The Czech government today approved the list of hallucinogenic plants and mushrooms, including hemp, coca, mescaline cactus and magic mushrooms, and decided that people would be allowed to grow up to five pieces of such plants and keep 40 magic mushrooms at home, a CTK source said. The cabinet was today also expected to discuss artificial drugs and a permitted amount of these drugs in people's possession. However, it postponed the debate for two weeks, the source said. The new Penal Code, which will take effect on January 1, is designed to specify the government's directive. It contains a special provision on the growth of hemp and magic mushrooms. The government today also approved a directive on the use of anabolics and the list of diseases that will be considered congenial, according to the criminal law. The law distinguishes between the possession of marijuana and hashish for people's personal needs, for which they will face up to one year in prison, from the possession of other drugs for which they can receive up to two years in prison. According to the Justice Ministry's proposal that the government did not approve today, the possession of over 15 grammes of dried marijuana or over two grammes of methamphetamine (pervitine), cocaine and heroin will be punishable. The tolerated amount of drugs in people's possession is at present defined by police internal directives. No one thus knows precisely what amount is considered an amount "larger than a small amount of drug," the possession of which is punishable by the law. If the government approves the ministry's proposal without changes in two weeks, people will be able to have four pills of ecstasy in their possession and up to five grammes of hashish. Author: ČTK www.ctk.cz http://www.ceskenoviny.cz/news/zpravy/czech-govt-defines-rules-of-hallucinogenic-plants-growing/411010




	United States Changes Its Mind on Addiction - It's Not a Chronic Brain Disease After All Psychology Today.com Addiction in Society Blog by Stanton Peele November 20 2009 NIAAA says NIDA is mistaken about addiction as brain disease Nora Volkow and the National Institute on Drug Abuse (NIDA) insist, based on peering at MRIs, that addiction is a chronic brain disease. You know - you saw it on HBO, and your kids learn this in school. But, as I point out to Nora, she's looking in the wrong place. If you examine actual human lives, addiction is an interaction between people and their worlds that changes with time. Now the NIDA's sister organization - the NIAAA or National Institute on Alcohol Abuse and Alcoholism - agrees with me. According to Dr. Mark Willenbring, director of treatment and recovery research at NIAAA, "We're on the cusp of some major advances in how we conceptualize alcoholism." The NIAAA's summary of the situation is titled, "Alcoholism isn't what it used to be." This discovery, which I have described for decades , is based on the most sophisticated study yet conducted of Americans' drinking histories. Called NESARC (National Epidemiologic Survey on Alcohol and Related Conditions), the study questioned a random national sample of over 43,000 Americans about their lifetime and current drinking. Of this group, almost 4,500 had been alcohol dependent (read alcoholic) at one point in their lives. And, although 75% had never been treated or gone to Alcoholics Anonymous - and only half of the remainder (13%) received specific alcoholism treatment - three-quarters had ceased their alcoholism. Yet most had not stopped drinking! About 30% of Americans had experienced some kind of alcohol disorder, including abuse along with dependence, but about 70% of those quit drinking or cut back to safe consumption patterns without treatment after four years or less. Only a tiny minority (1%) fit the stereotypical image of someone with severe, recurring alcohol addiction that Alcoholics Anonymous, addiction disease proponents like Volkow, and American mythology consider typical. My Life Process Program addresses this 1% of the addicted and is exclusively abstinence based. Then there are the other 29% of Americans who abuse alcohol at some time. According to Willenbring, "It can be a chronic, relapsing disease. But it isn't usually that." We know that nonabstinent remission from alcoholism is real in NESARC. In a three-year follow-up of respondents, Dawson and her colleagues found that alcohol dependence causes significant decreases in mental health and coping, but social functioning and mental health underwent "significant increases among those who achieved full and partial remission from dependence" (including alcoholics who continued drinking with either no, or reduced, problems). The increases in social functioning and mental health "were equally great for abstinent and nonabstinent remission from dependence, butimprovements in bodily pain and general health were associated with nonabstinent remission only"(that means the alcoholics who reduced their drinking). What's stunning in these results is not any particular finding about controlled drinkers' health outcomes. The remarkable portrait NESARC produces is about how commonplace alcohol use disorders are, how frequently they are overcome by people on their own - including even those scored alcohol dependent - and how often people improve their drinking problems while continuing to drink. THIS is an entirely different alcoholism paradigm from the one we have been oversold. As Olivia Judson describes the impact of "On the Origin of Species": "Origin changed everything. Before the “Origin,” the diversity of life could only be catalogued and described; afterwards, it could be explained and understood. Before the “Origin,” species were generally seen as fixed entities, the special creations of a deity; afterwards, they became connected together on a great family tree that stretches back, across billions of years, to the dawn of life. Perhaps most importantly, the “Origin” changed our view of ourselves. It made us as much a part of nature as hummingbirds and bumblebees. . ." NESARC also changes everything. P.S. (November 27): I have just learned that, although the LA Times article quoting Dr. Willenbring appeared November 16, by that date he was no longer an NIAAA employee . Make of that what you will. http://www.psychologytoday.com/blog/addiction-in-society/200911/united-states-changes-its-mind-addiction-its-not-chronic-brain-dis-0





	The Needle Nexus By TINA ROSENBERG Published: November 17, 2009 NY Times Of all the mysteries posed by AIDS, perhaps the deepest and most damaging is a human one: why have we failed so utterly to stop its transmission? Most people with H.I.V. in the world, including a vast majority of the 22 million who are infected in sub-Saharan Africa, caught it from a sexual partner. Despite billions of dollars spent to slow this form of transmission, only a few countries have had significant success — among them Thailand, Uganda and Zimbabwe — and their achievements have been unreplicable, poorly understood and short-lived. We know that abstinence, sexual fidelity and consistent condom use all prevent the spread of H.I.V. But we do not yet know how to persuade people to act accordingly. Then there is another way that H.I.V. infects: by injection with a hypodermic needle previously used by an infected person. Outside Africa, a huge part of the AIDS epidemic involves people who were infected this way. In Russia, 83 percent of infections in which the origin is known come from needle sharing. In Ukraine, the figure is 64 percent; Kazakhstan, 74 percent; Malaysia, 72 percent; Vietnam, 52 percent; China, 44 percent. Shared needles are also the primary transmission route for H.I.V. in parts of Asia. In the United States, needle-sharing directly accounts for more than 25 percent of AIDS cases. Drug injectors don’t pass infection only among themselves. Through their sex partners, H.I.V. is spread into the general population. In many countries, the H.I.V. epidemic began among drug injectors. In Russia in 2000, for example, needle-sharing was directly responsible for more than 95 percent of all cases of H.I.V. infection. So virtually all those with H.I.V. in Russia can trace their infection to a shared needle not many generations back. Though it has been scorned as special treatment for a despised population, AIDS prevention for drug users is in fact crucial to preventing a wider epidemic. Unlike with sexual transmission, there is a proven solution here: needle-exchange programs, which provide drug injectors with clean needles, usually in return for their used ones. Needle exchange is the cornerstone of an approach known as harm reduction: making drug use less deadly. Clean needles are both tool and lure, a way to introduce drug users to counseling, H.I.V. tests, AIDS treatment and rehabilitation, including access to opioid-substitution therapies like methadone. Needle exchange is AIDS prevention that works. While no one wants to have to put on a condom, every drug user prefers injecting with a clean needle. In 2003, an academic review of 99 cities around the world found that cities with needle exchange saw their H.I.V. rates among injecting drug users drop 19 percent a year; cities without needle exchange had an 8 percent increase per year. Contrary to popular fears, needle exchange has not led to more drug use or higher crime rates. Studies have also found that drug addicts participating in needle exchanges are more likely to enter rehabilitation programs. Using needle exchange as part of a comprehensive attack on H.I.V. is endorsed by virtually every relevant United Nations and United States-government agency. All over the world, however, solid evidence in support of needle exchange is trumped by its risky politics. Harm reduction is thought by politicians to muddy the message that drug use is bad; to have authorities handing out needles puts an official stamp of approval on dangerous behavior. Consider the United States. In 1988, Congress passed a ban on the use of federal money for needle exchange; President Clinton said he supported needle exchange but never lifted the ban, and it remains in effect. It not only applies to programs inside the United States but also prohibits the U.S. Agency for International Developmentfrom financing needle-exchange programs in its AIDS prevention work anywhere in the world. The administration of George W. Bush made the policy more aggressive, pressuring United Nations agencies to retract their support for needle exchange and excise statements about its efficacy from their literature. (Today, U.N. agencies again recommend that needle exchange be part of H.I.V.-prevention services for drug users.) Despite Barack Obama’s campaign pledge to overturn the ban, his first budget retained it. The House of Representatives recently passed a bill that would lift the ban — but it includes a provision that would make using federal money for needle exchange virtually impossible in cities, where it is needed most. There are some parts of the world — Western Europe, Australia, New Zealand — that do widely use harm-reduction strategies, including needle exchange. And programs have begun even in Iran, of all places, which offers needle exchange and methadone; its program of giving prisoners methadone is now the world’s largest. China is now taking AIDS seriously, beginning to institute government-sponsored harm reduction nationwide. But the overwhelming majority of drug injectors around the world still have no such access. Because government financing is so politically unpopular, in most of the 77 countries that offer needle exchange, the programs are run by nongovernmental groups. As a result, these efforts are small, isolated and often undermined by uncooperative police and health departments. The world is casting aside the single most effective AIDS prevention strategy we know. Russia needs needle exchange more than any other country: its H.I.V. epidemic is large, one of the fastest-growing in the world, and perhaps the most dominated by injecting drug use. Yet the needle-exchange efforts that do exist are scarce, small and under siege. I traveled there recently to see what lessons they hold. At 9 p.m. on a May night, in a tough neighborhood in Moscow’s north, I joined two young men as they climbed the stairs from the Metro. Arseniy and David were in their late 20s, wearing jeans and baseball caps. They had arrived to give out clean needles and promote harm reduction — but theirs was a guerrilla effort. Click here to continue reading story at the NY Times.com http://www.nytimes.com/2009/11/22/magazine/22FOB-idealab-t.html



	An addict reaching out for help Dear Colleagues: I am copying below a correspondence I have had with an opiate addicted woman, "an addict since the age of 14", asking me for help. She asks if I can help her get into a heroin maintenance program overseas, a treatment that she sees as offering her "a small glimmer of hope" after years of failing to get free of her addiction or finding other treatments unhelpful. I offered to do an intensive, extensive evaluation and planning consultation if she is interested in that but also said I would find out what I can about these programs. I am sending this letter to my professional community for two reasons. Firstly I would greatly appreciate any information that may facilitate her getting in touch with one of the existing heroin maintenance programs. Secondly, and even more importantly, I would like to use this woman's heart breaking story of chronic addiction and failed treatments to open a discussion about the need to seriously examine the negative way we tend to view addicted people and the limitations of our existing treatment system here in the United States. Unfortunately, this woman's story is more likely the norm than the exception. Untreated or poorly treated substance abuse and addiction characterizes the experience of the majority of people who struggle with substance use problems. Addiction treatment in this country is in crisis. Our evidence-based practices are not being implemented. Addiction treatment is not viewed as desirable by most addicted people or else why would the majority of patients in treatment be mandated and not voluntary patients? Most addiction treatment is conducted by poorly trained, poorly paid counselors. Our understanding of addiction as a chronic disorder, our appreciation of the motivational stages of change and the fact that most addicted people struggle with serious co-occurring psychiatric and psychosocial issues all suggest the need for non-abstinence requiring treatments to attract the entire spectrum of substance misusers and enable them to stay in treatment despite their substance use status. Yet, our ideological, anti-scientific commitment to abstinence-only treatment is reflected in a treatment system that is irrelevant to most substance misusing people. This system, in effect, turns patients off from seeking treatment and sends the message that the patient is at fault. I still hear these practices being done at "the best" treatment programs! As a result, patients don't seek treatment because it is inadequate, substance use escalates as substance users' despair grows and overdose occurs at alarming rates. Rather than examining what we are doing wrong as a field and at the federal level to correct this tragic situation, we do business as usual and hold the drug user responsible for our failure to offer and make available appropriate treatments. Why not support a broad continuum of care that engages substance users wherever they are ready to begin the process of positive change? Why continue to licence and fund treatment programs that don't offer state of the art treatment, don't properly train and supervise their staff, have embarrassing low rates of retention and positive outcomes and seem to thrive on the failure to help people? Why does the federal government still not actively support and promote syringe exchange? Why not lead the world in innovation in addiction treatment and explore heroin maintenance, safe injection facilities, harm reduction psychotherapy and substance use treatments that engage patients at all stages of change and around all positive change goals? If the government acknowledges that substance misuse is one of the leading public health problems in our country, why do we spend so much more on incarcerating drug users than helping them? I would welcome dialogue on these questions. I also think it is time for us as a field to engage this crisis. Andrew Tatarsky, PhD Addiction Division, The New York State Psychological Association Harm Reduction Psychotherapy and Training Associates 303 Fifth Avenue, Suite 1403 New ork, NY 10016 www.andrewtatarsky.com ************************************************************************************************************* Subject: an addict reaching out for help hello, my name is R and i am a heroin/dilaudid addict from the united states and i have been researching the herion maintence programs in canada, switzerland and the uk. i have been an addict since the age of 14 and have been to over 20 treatment programs in the states and over christmas of 2008 went to mexico to do the ibogaine program at a clinic in cancun. i have been on suboxone and have been to pain management clinics and although i have learned a great deal about addiction i have had no long term success as a result of these treatments. My family life is in a shambles and i am filled with guilt and shame that are the consequences of my addiction. i come from a good family and even managed to attend university, although i wasn't able to graduate because the drugs became to important and my life has been a neverending cycle of chaos in which heroin is the central cause, the sheer amount of time spent finding, getting and using the drug is exausting. i am 32 years old now, a have hep C, and i am desperate for change. It seems i have looked everywhere for the cure, not realising the that has to come from within myself. I have come to the conclusion that abstince, at this time, is just too big a step for me to handle, let alone all the many times i have tried this method and failed. that is why a small glimmer of hope began to burn in my heart when i read of the maintence programs that are beginning to be offered. I can imagine finally living a life of success... finishing school, a job, perhaps a mending with my family, a future to speak of that i can finally be the woman of dignity who lives on in my soul despite my addiction. I am eager for any information or availability on the maintence programs that you could offer me. I have the time and the willingness to be a model patient, i have health insurance and i know that being from the united states might be a problem but i am willing to do whatever it takes, travel as far as needed to finally have the chance to live the life of my dreams, with help, of course. thank you so much for taking the time to read this letter and any response would be so gratefully received. Most sincerely, R *********************************************************************************************************** Dear R, I hope you are well. I would like to post the letter you sent asking for help on my website and send it out to various people to help raise some important questions that your situation highlights about the limitations of addiction treatment in this country. I would like your permission to re-print your letter as I have it below (without any identifying information) because I think your letter is very powerful and moving as you describe your personal struggle with addiction. I would absolutely respect your wishes if you are not comfortable with this or if you want to change the letter in any way....but I think your letter is really powerful as it is. I think we need real change in the way people who struggle with substance use problems are seen and treated, or mis-treated, in this country and I think sharing your letter may support that cause. I look forward to your response. Best, Dr. Andrew Tatarsky ************************************************************************************************************* hey doc, you absolutley have my permission to send any and all of our correspondence to whom you wish. Any voice in the dark that may help another addict make it one more day is the voice that speaks from my heart. Any help i might inadvertently provide would thrill me, people just dont care about the plight of addicts in this country and my wish is that one day that will change. The woman i told you about. trish walsh who is involved in the trials of the HAT program in canada asked me if i would be willing to speak publicly about these issues and of course i would be willing to speak to those who would listen. what really burns me is that the problem of addiction is a fixable one and with the right kind of tx options many could be helped, but most people just want to pretend addicts don't exist or should just be locked up, much like the homeless, people just want to look the other way rather than stop to help. just an update, i have entered the methadone program here in ft lauderdale and i'm 2 days without injecting a substance, im a little sick but i'm going to give this program a chance. the dope will always be there, heroin isnt going anywhere so why not try yet once again to get myself together. and the folks at the clinic really seem dedicated to the cause. it felt really nice to be complimented by you about the letter, ironically i have always been able to express my feelings through my writing but not so good at dealing with them in real life, hence one of the core issues surrounding my addiction. i enclose a piece of writing that best expresses my struggles with addiction, the utter helplessness i feel and deal with alot. This poem is called Run and hide, run and hide stay fast the demons i hold deep inside chaotic screams cut through my mind an eternal void sounds horrid cries and tread carefully upon my tracks its a maze that's confused the devils wrath you think you're safe, but you just can't see there are no windows here A mothers son has undone her soul with no repast lays to waste its toll upon a heart, forever broken shattered pieces all but lost save one solitary token its a hope that's dim, so far away chained up, guarded well, unspoken today yet somewhere deep, where demons reside burns a flame unseen to mortal eye i feel its heat but never for long its a gunners dream, a sorrow filled song and you think you're safe but you'll still be blind there are no windows here this poem is the way i feel when the chaos of my using threatens to consume my very existence, trapped and no way out of the cycle i create when i put i needle in my arm. You feel like the biggest loser on earth but you just do it over and over and over again. That is why i am so desperate for any kind of help and so grateful that there are people out there like you that are willing to help and understand that addicts are human beings who are sick and need treatment for their illness just the same as someone who has cancer needs and deserves to be treated as well. Thankyou again doc, for you interest and ongoing support. You've no idea how much it means most sincerely, Alissa




	Moderate Drinking May Not Preserve Thinking Skills By Joene Hendry November 16, 2009 ABC News Health NEW YORK (Reuters Health) - Think that a drink or two a day help keep your mind sharp into older age? Researchers from the United Kingdom may have poked a hole into that idea. Dr. Claudia Cooper, at University College London, and colleagues note in a study that moderate drinkers - generally that's two drinks a day for men and one for women - tend to have less forgetfulness and better mental skills as they age. However, moderate drinkers also tend to have social, economic, and educational advantages that help them amass greater thinking skills over time. A report by Cooper's team in the Journal of Neurology, Neurosurgery and Psychiatry, suggests that it's these advantages - and not moderate drinking itself - that are responsible for the benefits. Cooper's team evaluated social, economic, and physical factors, plus thinking skills, in 1735 men and women 60 to 74 years old. Most - about 87 percent - of the participants reported drinking moderately or abstaining. The rest had histories that suggested problem drinking, and were excluded from the study. They tested how well the participants could read words pronounced differently from how they are spelled, which indicates how much of their early-learned reading skills each retained into older age. It's also a skill that isn't lost until mental function declines a great deal, Cooper told Reuters Health by email, which makes it a good indicator of previously obtained thinking skills. When Cooper's team only took social and economic factors into account, they saw an association between moderate alcohol consumption and greater thinking abilities, similar to findings reported in earlier studies. But when they allowed for current thinking skills, and the fact that participants with greater physical health were also more likely to drink more, the association between moderate drinking and current thinking skills disappeared. The authors note that the American Heart Association recently warned against putting too much stock in the link between moderate drinking and better thinking skills, and that more than three drinks per day are linked to a variety of medical conditions such as heart disease and stroke. SOURCE: Journal of Neurology, Neurosurgery and Psychiatry, November 2009. http://abcnews.go.com/Health/wireStory?id=9099630




	Abstinence Not the Only Path to Recovery Research has shown that there are different degrees of drinking disorders, and many people can change habits on their own. By Shari Roan Los Angeles Times Health November 16, 2009 Seventy years ago, Bill Wilson -- the co-founder of Alcoholics Anonymous -- declared his powerlessness over alcohol in a book by the same name. The failed businessman contended that, as an alcoholic, he had to "hit bottom" before changing his life and that sobriety could only be achieved through complete abstention. For generations, Americans took these tenets to be true for everyone. Top addiction experts are no longer sure. They now say that many drinkers can evaluate their habits and -- using new knowledge about genetic and behavioral risks of addiction -- change those habits if necessary. Even some people who have what are now termed alcohol-use disorders, they add, can cut back on consumption before it disrupts education, ruins careers and damages health. In short, say some of the nation's leading scientists studying substance abuse, humans travel a long road before they become powerless over alcohol -- and most never reach that point. "We're on the cusp of some major advances in how we conceptualize alcoholism," says Dr. Mark Willenbring, director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism. The institute is the nation's leading authority on alcoholism and the major provider of funds for alcohol research. "The focus now is on the large group of people who are not yet dependent. But they are at risk for developing dependence." Many of these people need not give up alcohol altogether. The concept of so-called controlled drinking -- that people with alcohol-use disorders could simply curb, or control, their drinking -- has existed for many years. Evidence now exists that such an approach is possible for some people, although abstinence is still considered necessary for those with the most severe disease. The overall reassessment has been fueled by the groundbreaking National Epidemiologic Survey on Alcohol and Related Conditions, the largest and most comprehensive look at alcohol use in America. The project surveyed 43,000 people 18 and older in 2001 and 2002, and again in 2004 and 2005, with the results released in increments beginning in 2006. This survey alone has been enough to convince even national addiction experts that they've been too narrow in their approach to alcohol disorders. But the findings are being further bolstered by research in genetics and psychology. Perhaps the most remarkable finding of the epidemiologic study was how many Americans experienced an alcohol-use disorder (either abuse or the more severe dependence) at some point -- and how many recovered on their own. About 30% of Americans had experienced a disorder, the research showed, but about 70% of those quit drinking or cut back to safe consumption patterns without treatment after four years or less. Only 1% of those surveyed fit the stereotypical image of someone with severe, recurring alcohol addiction who has hit the skids. The data suggest that there are two forms of alcohol disorders: one that fits the traditional view of alcoholism, in which the need for a drink takes over a person's life, and a time-limited form in which people drink heavily for a period but then cut down and recover. "It can be a chronic, relapsing disease. But it isn't usually that," Willenbring says. Differentiating Alcohol abuse is defined as use that repeatedly contributes, within a 12-month period, to the risk of bodily harm, relationship troubles, problems in meeting obligations and run-ins with the law. Alcohol dependence includes the same symptoms, plus the inability to limit or stop drinking; the need for more alcohol to get the same effect; the presence of withdrawal symptoms; and a consumption level that takes increasing amounts of time. "For a long time there was an emphasis on alcoholism as if it were one thing," says Carol Prescott, a psychology professor at USC who has studied alcohol-use disorders. "I think that has been abandoned. People with alcohol-related problems don't all look the same at all. Some people only have problems for a short time. Others develop disorders that are ultimately fatal to them." The other key finding from the survey is that, at least once in the previous year, 28% of adults had exceeded the daily or weekly limits at which drinking is considered low-risk. For men, low-risk drinking is defined as no more than four drinks on any given day or no more than 14 drinks per week. For women, the limit is three drinks per day or seven drinks per week. (A standard drink is 12 ounces of beer, eight to nine ounces of malt liquor, five ounces of wine or 1.5 ounces of 80-proof spirits.) The majority of Americans who drink beyond these limits have mild to moderate disorders, meaning they occasionally have trouble controlling their intake, Willenbring says. That's where the overall risk assessment comes in. Willenbring compares it to treating high blood pressure or cholesterol before the condition develops into heart disease. "People with mild to moderate alcohol disorders can be treated with medications or behavioral therapy with a primary care doctor," he says. "But many people can do this on their own without having a professional. The idea is teaching people how to reevaluate their drinking." In the national survey, about half of the people who'd had an alcohol-use disorder recovered, enabling them to drink at low-risk levels without symptoms of dependence. "Some people are uncomfortable with that," Prescott says. "It's a safer prescription to tell someone to quit. But the studies suggest that a large proportion of people are able to cut down and aren't out-of-control." To continue reading the article click here http://www.latimes.com/features/health/la-he-alcohol16-2009nov16,0,474959.story?page=2




	Ketamine drug use 'harms memory' Frequent use of ketamine - a drug popular with clubbers - is being linked with memory problems, researchers say. Tuesday 17 November 2009 BBC Health News The University College London team carried out a range of memory and psychological tests on 120 people. They found frequent users performed poorly on skills such as recalling names, conversations and patterns. Previous studies said the drug might cause kidney and bladder damage. The London team and charity Drugscope said users should be aware of the risks. Ketamine - or Special K as it has been dubbed - acts as a stimulant and induces hallucinations. It has been increasing in popularity, particularly as an alternative to ecstasy among clubbers, as the price has fallen over recent years. A gram now costs about £20 - half the price of cocaine. In response, the drug was made illegal three years ago - it is currently graded class C - although it still remains legal for use as an anaesthetic and a horse tranquiliser. The study split the participants into five groups - those using the drug each day, recreational users who took the drug once or twice a month, former users, those who used other drugs and people who did not take any drugs. All of the people took part in a series of memory tests as well as completing questionnaires and were then followed up a year later, the Addiction journal reported. Researchers found the frequent users group performed significantly worse on the memory tests - in some they made twice as many errors. The study also showed performance worsened over the course of the year. There was no significant difference between the other groups. However, all groups of ketamine users showed evidence of unusual beliefs or mild delusions, such as conspiracy theories, the psychological questionnaires showed. Addiction The study also raised concerns about the addictiveness of the drug - hair sampling from the recreational group showed drug use had doubled over the year. Lead researcher Dr Celia Morgan said: "Ketamine use is increasing faster than any other drug in the UK, particularly among young people, and has now become a mainstream club drug. "However, many young people who use this drug may be largely unaware of its damaging properties and its potential for addiction. "We need to ensure that users are informed of the potentially negative consequences of heavy ketamine use." Martin Barnes, chief executive of Drugscope, said the charity had already raised concerns about the drug and the study provided "further evidence" of the risk of using it. "It is important that people are aware of the harms associated with the drug and that treatment services are equipped to provide necessary support." http://news.bbc.co.uk/2/hi/health/8362575.stm




	Center for Motivation and ChangE An Alternative to the Intervention: Seminar for Parents and Spouses Does your loved one have a drinking or substance use problem? You haven't heard the whole story. You may have been told to "detach with love," or to stage an intervention. Before you go down either of these painful paths, come to an introductory seminar on CRAFT, a New York Times-reported treatment that harnesses the powerful influence of family to safely help a loved one change. Hear about a non-confrontational option that works. WESTCHESTER Wednesday, December 2nd, 2009 6:00-7:30 pm 245 Main Street, White Plains New York City Monday December 7th 2009 6:00-7:30 pm 276 Fifth Avenue (30th St) Suite 605 Space is limited Advance registration required Attendance fee: $15 To reserve a spot, please e-mail events@motivationandchange.com or call (212) 683-3339 x38.




	Want to quit? Don't go to light smokes Tue Nov 3, 2009 6:45pm EST Rueters.com WASHINGTON (Reuters) - Smokers who switch to a low-tar, light or mild brand of cigarette will not find it easier to quit and in fact may find it harder, researchers reported on Tuesday. They found that smokers who traded to light cigarettes were 50 percent less likely to kick the habit. "It may be that smokers think that a lighter brand is better for their health and is therefore an acceptable alternative to giving up completely," Dr. Hilary Tindle of the University of Pittsburgh School of Medicine, who led the study, said in a statement. Her study of 31,000 smokers found that 12,000, or 38 percent, had switched to a lighter brand. A quarter said they switched because of flavor but nearly 20 percent said they had switched for a combination of better flavor, wanting to smoke a less harmful cigarette, and as part of an effort to give up smoking completely, Tindle's team reported in the journal Tobacco Control. Those who switched brands were 58 percent more likely to have tried to quit smoking between 2002 and 2003 than those who stuck with their brand. But they were 60 percent less likely to actually succeed in quitting, Tindle's team found. "Forty-three percent of smokers reported a desire to quit smoking as a reason for switching to lighter cigarettes. While these individuals were the most likely to make an attempt, ironically, they were the least likely to quit smoking," Tindle said. Other research has shown that so-called low-tar cigarettes have just as much tar, nicotine and other compounds as regular cigarettes, making their . The U.S. Food and Drug Administration was given the power to regulate cigarettes in June and was immediately sued by companies such as Reynolds American Inc and Lorillard Inc. Altria Group Inc's Philip Morris unit, the nation's largest tobacco company, supports FDA oversight. (Reporting by Maggie Fox; Editing by Cynthia Osterman) http://www.reuters.com/article/newsOne/idUSTRE5A263920091103




	Drinking By Either Partner Cuts Odds of IVF Success Posted by Maia Szalavitz Tuesday, October 27, 2009 at 9:52 am Time.com Couples having difficulty conceiving may want to skip one item that is ordinarily considered helpful to the process—alcohol—at least if they are using in-vitro fertilization (IVF). A new study of 2,574 couples undergoing 5,363 IVF cycles between 1994 and 2003 found that couples in which both partners drank four or more alcoholic beverages per week decreased their chances of having a live birth by 26%. If only the woman reported drinking that amount or greater, the odds of a successful pregnancy fell by 16%; if the man was the one imbibing at that level, the odds fell 14%. The researchers adjusted the data to account for other factors like age and obesity which can significantly affect fertility. The type of alcohol also seemed to matter: for women, white wine caused the most problems, cutting the live birth rate by 24%. For men, the culprit was beer, which reduced the chances of pregnancy success by 30%. Very few couples reported consuming hard liquor at these levels—so it's hard to know what effect that had. Given that the worst outcomes were for the type of alcohol most likely to be consumed by each gender, it's possible that the couples who were drinking most heavily under-reported their use, making the effects of lower levels of drinking look worse than they are. However, the study's lead author, Brooke Rossi, MD, a clinical fellow in reproductive endocrinology at Brigham and Women's Hospital in Boston notes that these effects were seen at a level below that considered as moderate drinking by national guidelines. “It comes down to this,” says Rossi, “There are many factors in an IVF cycle that contribute to success or failure. Most of these, patients have no control over, like age. But one thing you can control is alcohol intake. You can decrease or stop alcohol consumption, knowing that you are going to have to do it anyway if you do get pregnant and it may increase the chances of success in IVF cycle.” The research was presented at a meeting of the American Society of Reproductive Medicine, held last week in Atlanta. http://wellness.blogs.time.com/2009/10/27/drinking-by-either-partner-cuts-odds-of-ivf-success/




	HOLOTROPIC BREATHWORK ALL-DAY WORKSHOP Tim O'Connell, PhD, and Oliver Williams will offer Holotropic Breathwork on Saturday, November 21st, 2009 Time: 9.00am - 8.00pm. First time HB participants please arrive by 8.30am. Location: Trinity House, 1292 Long Hill Road, Stirling, NJ 07980 Holotropic Breathwork has demonstrated the ability to assist individuals in recovery from alcohol and chemical dependencies. Tim Brewerton, MD, following his presentation “Long-Term Abstinence Following Holotropic Breathwork as Adjunctive Treatment of Substance Abuse” to the International Society for Addiction Medicine (ISAM) 10th Annual Meeting in Cape Town, South Africa in November 2008, is currently preparing case reports documenting “…the successful use of Holotropic Breathwork in four cases in which complete abstinence was obtained for extended periods” into a case study for submission to a peer-reviewed journal. Cost: $150 ($135 with $50 deposit one week prior). Please send deposit to: Oliver Williams at 114 Horatio Street #809, New York, NY 10014-1574. Bring: blanket and pillow for your own use; food and beverage supplied. There is a full kitchen so please feel free to bring anything you wish to eat or drink. Contact: Oliver Williams; (917) 331-8971 http://www.rebecoming.org




	Supervision and Training Activities Fall 2009 *Monthly Supervision Group on Integrative Harm Reduction Psychotherapy (IHRP) for Professionals Starting November 16, 2009* This group provides training and case supervision in my approach to Integrative Harm Reduction Psychotherapy for people with drug and alcohol concerns. Substance use problems are understood as being intertwined with the unique complexity of the person in context. IHRP is based on an integration of relational psychoanalytic and cognitive-behavioral theory and technique. IHRP blends a skills building focus on cognitive and behavioral change with an exploration of the multiple meanings and functions of substance use and other risk behaviors in the context of a therapeutic relationship that anchors the process and is also an agent of change. The harm reduction principles that inform this approach are: meeting the patient as a unique individual, the primacy of the therapeutic alliance, abandoning the abstinence requirement and any other preconceived agenda for the patient, special attention to social, personal and induced countertransference, building self-management skills, working collaboratively to assess and identify problems, clarify goals and strategies that best suit the patient's needs and recognizing small incremental positive change as success. In this spirit the form, structure and timing of the therapy emerge out of the therapeutic process rather than being predetermined. The group will combine topical presentations and case presentation with selected readings as appropriate to the members. Fee: $60.00 The group will meet on a monthly basis on Mondays, 12-1:30 PM. It may meet more frequently if there is interest. November 21, 2009 Treating Drug and Alcohol Users in Your Practice: Rationale, Theory and Technique of Integrative Harm Reduction Psychotherapy A one-day introductory training at: The Training Institute for Mental Health 115 W. 27th Street New York, NY To Register: 212-627-8181 December 11, 2009 Effective Psychotherapy with Drug and Alcohol Users in Your Practice: Rationale, Theory and Technique of Integrative Harm Reduction Psychotherapy A one-day training at: The Albert Ellis Institute 45 East 65th Street New York, NY To register call: 212-535-0822 and tell them Andrew Tatarsky told you about the training… Integrative Harm Reduction Psychotherapy Workshops and Training Over the last several years I have been offering workshops and training in the U.S. and internationally for groups that wish to get a deeper immersion in harm reduction philosophy, epidemiological and outcome research support, theoretical basis and applications to psychotherapy and counseling. This approach integrates a skills building focus to cognitive and behavioral change with an exploration of the multiple meanings and functions of substance use and other risk behaviors in the context of a therapeutic relationship the anchors the process and is also an agent of change. There is an emphasis on group participation and learning both theory and technique. Trainings are delivered in the collaborative spirit of harm reduction. These trainings can be delivered from half day to five full day formats depending on the needs of the group. Trainings can be tailored to the specific needs of the agency and client population. Modules include: History and Evolution of Harm Reduction Philosophy and History Clinical Challenges and Limitations of Traditional Treatment Clinical and Epidemiological Rationales for Harm Reduction Psychotherapy Theoretical Basis of Harm Reduction Psychotherapy Biopsychosocial Process Model of Addiction Multiple Meanings of Drug Use Motivational Stages of Change Clinical Philosophy of Harm Reduction Psychotherapy: The New Paradigm Overview of Integrative Harm Reduction Psychotherapy Building Alliances with Drug Using Patients for Physicians Therapeutic Tasks Managing the Therapeutic Alliance Therapeutic Relationship as Agent of Change Facilitating Self-management Skills for Change: awareness and affect tolerance Assessment as Treatment Embracing Ambivalence Harm Reduction Goal Setting Active Strategies for Facilitating Positive Change All activities will be led by Andrew Tatarsky, PhD. and colleagues at 303 Fifth Avenue, Suite 1403, NE corner at 31st Street. For more information call 212-633-8157. More information can be found at: www.andrewtatarsky.com





	Registration Now Open for Psychedelic Science in the 21st Century Registration for Psychedelic Science in the 21st Century is now open. Psychedelic Science will be held in San Jose, California from April 15-18, 2010. This will be the largest conference in North America dedicated to psychedelic research in 17 years. The conference boasts an impressive list of presenters. http://www.maps.org/conference/




	In My Backyard: Dispelling Myths About Methadone ICAAT has produced a 15-minute video addressing the "not-in-my-backyard" (NIMBY) phenomenon - probably the greatest barrier to meaningful expansion of methadone treatment availability in America. Throughout the USA, and in many other nations as well, efforts to open new facilities are met with fierce opposition based on fear of resultant crime and a general deterioration of the neighborhood. This film highlights the patients, staff and services of a methadone maintenance treatment clinic operating since 1974 in a church building in the heart of residential and commercial Greenwich Village, NYC. We hope that the film promotes a greater understanding of methadone maintenance treatment, its patients and providers. http://www.icaatnimbyvideo.info/




	Study Counters Warnings on Quit-Smoking Drug FRIDAY, Oct. 2 (HealthDay News) -- The smoking cessation drug varenicline (Chantix) does not increase the risk for self-harm or depression, according to a new British study. In July, the U.S. Food and Drug Administration mandated that the drug carry a "black-box warning" on its packaging, indicating that people who use it face increased risk for "serious neuropsychiatric symptoms," including changes in behavior, hostility, agitation, depressed mood, suicidal thoughts and behavior and attempted suicide. In the new study, British researchers analyzed database information on 80,660 men and women, ages 18 to 95, who were prescribed a smoking cessation product between September 2006 and May 2008. Prescriptions were for varenicline, the antidepressant bupropion (Zyban) or nicotine replacement products, such as a patch, inhaler, gum, tablet or lozenge. People were followed through the period of the prescription and for three months after the date of their last prescription. No clear evidence emerged that varenicline or bupropion increased the risk for self-harm, suicidal thoughts or depression, the study reported. However, the researchers added that "the limited power of the study means we cannot rule out either a halving or a twofold increased risk." They recommended further study of varenicline's effect on suicide risk. They also said that any risks associated with varenicline must be balanced against the long-term health benefits of stopping smoking and the drug's effectiveness as a smoking cessation product. The study, which had no drug company funding, was published online Oct. 1 in BMJ. More information The Tobacco Control Research Branch of the U.S. National Cancer Institute has more on quitting smoking http://www.ajc.com/health/content/shared-auto/healthnews/drug/631560.html




	Dr. Andrew Tatarsky on voice America Radio Hear Dr. Tatarsky talk about integrative harm reduction psychotherapy and the current state of substance use treatment on Voice America Alternative content Download edited version from Dr. Tatarsky's site http://www.andrewtatarsky.com/harm_reduction.mp3 Listen at Voice America Talk Radio (includes commercials) http://www.modavox.com/VoiceAmerica/vepisode.aspx?aid=41530 Itunes Podcast - Subscribe & Download (includes commercials) http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?id=316281888




	Addicts get text overdose advice Drug users in Swansea are being asked to sign up to be sent mobile texts on what to do if they overdose and how to reduce their addiction risks. Messages such as "Overdose: Don't panic. Put them in the recovery position, dial 999" will be sent out. Project director Ifor Glyn said their ultimate goal for users was complete abstinence, but the texts were a way of keeping drug users engaged with them. But Tory AM Alun Cairns said any texts should try to get people off drugs. The Swansea Drugs Project is asking its 700 existing users to sign up to receive the texts. SDPFAST - the Swansea Drugs Project Free Advice Support Texts - will be free and confidential, and available to any of the users who sign up for it. http://news.bbc.co.uk/2/hi/uk_news/wales/8256406.stm




	Drinking by Young Teens May Set Stage for Addiction Brain changes caused by drinking before age 15 could predispose adolescents to a lifetime of alcohol dependency, HealthDay News reported Sept. 18. Researcher Arpana Agrawal of the Washington University School of Medicine, who studied alcohol use among twins, said that early drinking "may induce changes in the highly sensitive adolescent brain, which may also modify an individual's subsequent genetic vulnerability" to addiction. Agrawal found that age of first alcohol use corresponded with a greater number of alcohol dependency symptoms. Those who started drinking later in life were less likely to be dependent even if they were genetically predisposed to addiction, the study found. The research will be published in the December 2009 issue of the journal Alcoholism: Clinical & Experimental Research. http://www.jointogether.org/news/research/summaries/2009/drinking-by-young-teens-may.html




	The Women's Therapy Centre Institute - 6 Week Eating and Body Image Groups Starting soon Dear Colleague, I want to tell you about some wonderful groups that The Women's Therapy Centre Institute runs on eating and body image problems. In a therapist led supportive environment, participants are introduced to the process of relating more comfortably to food and their bodies. They look at the meanings of fat and thin, obsessive thinking, how to feed oneself when hungry and stop when full, as well as how to eliminate binge eating. Through our psychodynamic self attuned model, participants begin to identify the psychological issues that affect the woman's compulsive or restrictive eating and her troubled body image. These groups are a wonderful adjunct to ongoing therapy. All of the groups are led by experienced clinicians, run for 6 weeks and cost $200. Please call me if you have any questions or would like to refer someone to a group. We have a group starting soon. Sincerely, Wendy Miller PhD 212-475-3151 For more information about the groups and other activities please visit the Women's Therapy Centre Institute at www.wtci-nyc.org




	Benefit for Howard Lotsof – Ibogaine Pioneer and Activist Please join us Saturday evening, September 26th, for a very special evening in honor of Howard Lotsof, ibogaine pioneer and activist (to be held at the Judson Memorial Church during the Horizons: Perspectives on Psychedelics conference – www.horizonsnyc.org). Many of you are aware of the dedication and devotion Howard has brought to his work with ibogaine for over four decades. Working tirelessly in support of safe and effective treatment for those suffering under the yoke of opiate addiction, Howard has been a beacon of light and hope, and has had incalculable positive effect on innumerable lives. Known affectionately as “The Father of the Modern Ibogaine Movement,” Howard was the first to discover the addiction-interrupting effect of ibogaine. Since 1962, Howard's mission has been to make ibogaine legal, available, and safe - and to encourage further research into this remarkable substance. Howard and his muse, partner, and loving wife Norma have continued this important work for decades, making many personal sacrifices along the way. As many of his friends know, Howard is quite ill with advanced stage liver cancer and now we want to give something back. With his innate fighting spirit, Howard continues his work on behalf of a growing and grateful ibogaine community. Yet his medical expenses are mounting and we are now asking you to help. Our benefit event in celebration of Howard and his life's work will be held 7-9PM at Judson Memorial Church, 55 Washington Square South, New York, NY (A, C, E, B, D, F, V to W. 4th St); a light dinner will be provided, followed by a discussion of the current state of ibogaine research and Howard's work by Rick Doblin, President and Founder of MAPS, the Multidisciplinary Association for Psychedelic Studies (www.maps.org), psychologist Neal Goldsmith, and others sharing anecdotes supporting ibogaine and celebrating Howard’s life. We are asking for a one-hundred dollar donation, but please feel free to give whatever you can to help ease the financial burden on this great man and his family. Howard's noble work has allayed so much pain and saved so many lives, we are honored to have this opportunity to be of service to him now. Please RSVP to John Harrison at jakaileb@hotmail.com, as soon as possible, so we can gauge how much food to provide. Thank you for your support – we look forward to seeing you Saturday, September 26th!




	Any Drinking Raises Risk of Traffic Accidents, Researchers Say Even one or two alcoholic drinks can increase the risk of getting into an automobile accident, even if it's not technically drunk driving, according to Italian researchers. Reuters reported Sept. 10 that individuals who consumed one or two drinks within 2-6 hours of driving more than doubled their risk of getting into an accident. Having more than two drinks tripled the risk of a crash. Researcher Stefano Di Bartolomeo of the Università degli Studi di Udine and colleagues drew their conclusions from interviews of emergency-room patients who had been in car crashes; drivers were asked about their alcohol and food consumption prior to the crash, as well as how much sleep they had gotten. The study also found that drinking combined with sleep depravation greatly increased the risk of a crash. The study was published in the Sept. 1, 2009 issue of the journal BMC Public Health. http://www.jointogether.org/news/research/summaries/2009/any-drinking-raises-risk-of.html




	Impact of Supportive Housing for Chronically Homeless People with High Use of Alcohol-Related Crisis Services Housing First supportive housing programs do not make admission contingent on sobriety or treatment attendance and target chronically homeless people who are high users of publicly funded health and criminal-justice resources. The goal of these programs is to reduce safety-net system costs while improving quality of life for chronically homeless individuals by reducing acute care visits, hospital admissions, length of stay, incarceration, and shelter use and providing housing. Researchers studied the use and cost of services before and after program admission among 95 participants in a Housing First program in Seattle, Washington, and compared them with 39 wait-listed participants. All had severe alcohol problems. Monthly median costs among admitted participants decreased from $4066 in the year before admission to $1492 after 6 months in housing and $958 after 12 months in housing. Even after accounting for housing program costs, total mean monthly spending on housed participants compared with wait-listed participants was $2449 lower at 6 months. Both costs and crisis-services use decreased with longer time in housing. The number of drinks per day among housed participants decreased from 15.7 prior to housing to 14.0 at 6 months, 12.5 at 9 months, and 10.6 at 12 months. Comments by James Harrison, MHS, CADC This study provides compelling evidence that supportive housing for chronically homeless individuals can substantially reduce the cost of and burden on health and criminal justice services. It is important to note that both costs and alcohol consumption further decreased the longer participants were in supportive housing. Counselors, recognizing the high mortality rate among homeless individuals who drink heavily, should not make sobriety a prerequisite for supportive housing or other services. Reference: Larimer ME, Malone DK, Garner MD, et al. Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA. 2009;301(13):1349–1357. http://www.jointogether.org/news/research/tprb/sept09/harrison-larimer.html




	Do Racial and Ethnic Minority Drinkers Have More Alcohol Consequences than White Drinkers? Researchers analyzed National Alcohol Survey data from 4080 current drinkers (69% white, 19% black, and 12% Hispanic) to assess racial differences in alcohol dependence symptoms and social consequences and to determine whether self-reported social disadvantages (e.g., poverty, unfair treatment, and racial/ethnic stigma) explained any observed racial differences. Heavy drinking* was stratified into the following categories: none/low (69%), moderate (21%), and high (10%). More black (11%) and Hispanic (12%) than white (6%) participants had 2 or more alcohol dependence symptoms. More black (13%) and Hispanic (15%) than white (9%) participants had 1 or more alcohol-related social consequences (accidents; arguments/fights; or health, legal, and workplace problems). In separate adjusted analyses, black and Hispanic participants were significantly more likely than white participants to have 2 or more alcohol dependence symptoms (if they reported "none/low" or "moderate" heavy drinking), and to have 1 or more alcohol-related social consequences (the "none/low" category only). Adding social disadvantages to the models did not change the results. In this study, a composite variable was used to define past-year heavy drinking based on 3 indicators: frequency of 5+ drinks in a single day, frequency of subjective drunkenness, and maximum number of standard drinks in a single day. Comments by Tom Delaney, MSW, MPA* Those involved in program planning and clinical services for black and Hispanic populations will find this study a useful reference. The authors strongly suggest the need for additional investigations to support these results, but they are an important reminder of the need to factor in biological markers and sociologic and cultural factors in treatment. Reference: Mulia N, Ye Y, Greenfield TK, et al. Disparities in alcohol-related problems among white, black, and Hispanic Americans. Alcohol Clin Exp Res. 2009;33(4):654–662. http://www.jointogether.org/news/research/tprb/sept09/delaney.html




	Trauma-Focused Group Therapy Reduces HIV Sexual Risk Behaviors in Women with PTSD and Substance Use Disorders Studies indicate the frequent co-occurrence of trauma histories and substance use disorders in women, which may increase HIV sexual risk behaviors. Researchers studied the impact of 2 group therapy interventions to reduce unprotected sexual occasions (USO) among women with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders: Seeking Safety (SS), a cognitive behavioral intervention addressing substance use and PTSD symptoms, and Women's Health Education (WHE), a psycho-educational intervention focused on health, nutrition, and sexual behavior including sessions on HIV risk and transmission. A total of 346 women from 6 community-based drug treatment programs participating in the NIDA Clinical Trials Network were randomized to receive 1 of the 2 interventions. Forty-six percent of the total sample reported at least one USO in the 30 days prior to intake. Most had experienced physical or sexual violence in their lifetime (94% and 90%, respectively), and all met DSM-IV criteria for either full (80%) or subthreshold (20%) PTSD. Women in the SS group with the highest sexual risk at baseline (at least 12 USO per month) had significantly fewer USO at 12-month follow-up compared with women with the highest baseline sexual risk in the WHE group (4.97 versus 8.60 USO per month, respectively). There was no difference in USO between groups at 12 months among women with the lowest baseline sexual risk (≤2 USO per month). Comments by Norma Finkelstein, PhD Findings from this randomized controlled trial show that SS, which emphasizes coping skills and reducing unsafe behavior and treats PTSD and substance misuse concurrently, may be more effective than traditional sexual risk reduction interventions in high-risk women with co-occurring PTSD and addictive disorders. Addressing trauma and improving women's coping and behavior skills may also prove effective in HIV education services. It would be interesting to know whether SS combined with HIV-specific education would have further reduced USO among high-risk women in this study. Reference: Hien DA, Campbell AN, Killeen T, et al. The impact of trauma-focused group therapy upon HIV sexual risk behaviors in the NIDA Clinical Trials Network "Women and Trauma" multi-site study. AIDS Behav. May 19, 2009 (Epub ahead of print). http://www.jointogether.org/news/research/tprb/sept09/finkelstein.html




	MDMA/PTSD Research Goes to Vancouver - MAPS News: September 2009 Dear MAPS’ Supporters and Friends, We are gearing up for our newest study of MDMA-assisted psychotherapy for the treatment of posttraumatic stress disorder (PTSD) in Vancouver. On October 24, we will be hosting a benefit dinner in downtown Vancouver and we hope that if you are in the area you will join us and that you will encourage your friends to be there too. MAPS Executive Director Rick Doblin, Ph.D. and our Vancouver research team will give presentations about the project over a light tapas dinner. More information about the benefit dinner is below. We have more news below about Psychedelic Science in the 21st Century, the conference we are hosting in San Jose, California, from April 15-18, 2010. We have opened a call for proposals for presentations at the conference. In the coming weeks we will be sending you an email about ticket sales and hotel registration. This is a robust newsletter this month with an abundance of information about our research projects. You will also find lots of opportunities for you to get involved with MAPS and our sister organizations. Don’t forget, we rely on your support in order to conduct our research and to perform our educational objectives. Sincerely, Randolph Hencken, M.A. Director of Marketing and Communication CLICK HERE TO VIEW ENTIRE MAPS NEWSLETTER ONLINE



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