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Arizona Lawmakers Hope to Put Dent in Opioid Crisis

Gov. Doug Ducey greets Senate Minority Leader Katie Hobbs on Monday ahead of calling a special legislative session to enact what is billed as a bipartisan approach to dealing with the opioid crisis. (Capitol Media Services/Howard Fischer)

Lawmakers hope to put dent in opioid crisis

Originally Published: January 24, 2018 5:55 a.m.

By Howard Fischer, Capitol Media Services

PHOENIX — State lawmakers begin working today (eds: tuesday) on a bipartisan plan state officials hope will make a significant dent in opioid addiction, abuse and deaths in Arizona.

“In 2016, more than two Arizonans died each day due to an opioid overdose,’’ Dr. Cara Christ, the state’s health director, said at a ceremony where Gov. Doug Ducey signed a proclamation for a special legislative session to deal with the issue.

“Since 2012, we’ve seen an increase of 74 percent in opiod-related deaths,’’ she continued. “Drug overdoses kill more Arizonans than car accidents.’’

The proposal contains money designed to help provide treatment for those who are addicted. The state already does some of that through its Medicaid program. This package contains $10 million for those whose income leaves them unqualified for that.

But the governor said the measure also has a strong element designed to prevent addiction in the first place. That’s built around a five-day limit on how much opioids that doctors can prescribe to patients who have not been on the drug for at least 60 days.

“You’re talking about really taking advantage of the data and facts that we understand how someone gets addicted,’’ he said.

“When it goes past five days or six days, that’s when the incidence of addiction skyrocket,’’ Ducey continued. “So the objective here was not only to treat people that are suffering addiction so that they can get off it but to prevent future addictions and overdoses from happening.’’

But he said the legislation should not harm others.

“People that have chronic pain, people that are suffering from chronic pain and are already benefitting from these miracle drugs, there will be no change for them,’’ he said.

The governor called the measure “the most aggressive piece of public policy, the most thorough and thoughtful piece of public policy that’s been introduced in years.’’

Legislative Democrats are willing to go along, especially once they got that $10 million for addiction treatment. But they don’t see this as a cure all.

“It’s a thoughtful and thorough first step,’’ said Senate Minority Leader Katie Hobbs. “We won’t win this battle in one year.’’

State lawmakers actually already are in session. And there is no legal reason why the pieces of the proposal cannot be added to the regular legislative agenda.

But by calling a concurrent special session, Ducey sets the stage to go from proposal to finished law in three days.

“This is not being rushed through at all,’’ the governor told reporters after the ceremony. He said the measure has been in the works since September, with input from members of the medical community, law enforcement, addiction experts.

“And now it will be debated in the light of day in both of our chambers,’’ Ducey said.

“We needed urgency and focus on this issue, which is a crisis in our state,’’ he explained. “It called for a special session.’’

But what it also does is shorten the amount of time for people to read and scrutinize the final legislation — it was still not printed as of Monday afternoon — and be able to seek changes.

There are some potential flash points.

For example, the proclamation for the session says there will be new enforcement procedures to go after doctors who overprescribe not just opioids but other similar drugs. That could raise questions from doctors who specialize in pain management.

Ducey also wants to allow the state to charge companies that manufacture opioids as well as their executives with felonies for misrepresenting the effectiveness and addictive nature of their wares.

And the governor proposes to require insurance companies to expedite authorization for certain kinds of treatments. That is based on concerns that while patients are awaiting the go-ahead from insurers for surgery they end up being given opioids for the pain, increasing the possibility of addiction.

Other provisions include a “Good Samaritan’’ provision, allowing someone who is using drugs to call for help when a companion needs medical attention without putting himself or herself at risk of arrest.

The governor did part ways with his health director on one particular issue.

In briefing reporters last week, Christ said there is no simple answer to alternatives to highly addictive opioids when treating pain. But she said the list of options could include medical marijuana which is legal in Arizona.

Original Source: https://www.pvtrib.com/news/2018/jan/24/lawmakers-hope-put-dent-opioid-crisis/

 

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SMART Recovery ABC

SMART Recovery – Self Management for Addiction Recovery

“Discover the Power of Choice!”™

SMART Recovery is the leading self-empowering addiction recovery support group. Our participants learn tools for addiction recovery based on the latest scientific research and participate in a world-wide community which includes free, self-empowering, science-based mutual help groups.

The SMART Recovery 4-Point Program® helps people recover from all types of addiction and addictive behaviors, including: drug abuse, drug addiction, substance abuse, alcohol abuse, gambling addiction, cocaine addiction, prescription drug abuse, sexual addiction, and problem addiction to other substances and activities. SMART Recovery sponsors face-to-face meetings around the world, and daily online meetings. In addition, our online message board and 24/7 chat room are excellent forums to learn about SMART Recovery and obtain addiction recovery support.

ABCs- a crash course

The “ABC’s” are an exercise from SMART RECOVERY, which is a training program for recovery .  It is cognitive based (science based) from CBT.  SMART Recovery is simple enough and effective enough to be used by anybody and– it works.  Here is an example of how it works at changing thoughts about a behavior:

With the ABC’s we use this tool to examine the beliefs we have (or the thinking we are doing) as some of this may be causing us problems. The “ABC’s” are an exercise that helps us to stop being victims of our own thinking – by our (irrational beliefs) , with this tool you DISPUTE your irrational beliefs, and come up with EFFECTIVE New thinking.

 

It Works like this:

  1. (A) This is the Activator- the “thing” that happens
  2. (B)This is the Irrational Belief- the something that “should” be a certain way
  3. (C) This is the Consequence- of the irrational belief (anger, desire to use or unwanted behavior)
  4. Dispute- questioning the irrational belief, why ‘should’ a thing be a certain way?
  5. Effective new thinking  – changing a ‘demand’ to a ‘preference’

 

A common example of an irrational belief is- someone else’s behavior “MAKING”  us angry. This is a very common expression and we hear it often, but in fact it distorts the situation it attempts to describe.  NO ONE “MAKES” US ANYTHING… A more accurate description of “someone is making me angry” is to say that we feel angry about their behavior. They are simply behaving in a way that we are getting angry about.

 

I notice their behavior and then I become angry. The RESPONSIBILITY for the anger is mine, not theirs. This can sound strange at first, but dealing with anger and frustration in this way works.

 

SMART RECOVERY teaches that it is generally irrational and self-defeating to get all worked up about someone else’s behavior. The anger is based on a faulty assumption, which is that the other person SHOULD behave in the way we want them to. If you think about it, what the other person SHOULD do is not necessarily what they DO. This is a very important element of the equation- REALITY. They do what they do, and then you automatically get angry about it, and feel quite upset for a while- possibly very upset. It’s like walking around with a big push button on your forehead that says “Push here to aggravate”. Is this a useful response to others’ behavior? Probably not.

Since people are very likely going to do whatever angers us anyway, it seems, then it would make life a great deal easier if we didn’t get angry about it and lose our peace of mind.

 

For example, if I really believe that they MUST NOT do whatever they are doing, and then they still continue to do it, then the DEMAND that I have inside my head that says; “they MUST NOT do that”  …that demand will put considerable pressure on me from the inside to do something about it, which I am very often unable to do- or which may end up giving us an undesired result..

 

Often, it just isn’t possible to control other people’s behavior. So this will automatically make me feel bad; frustrated, ineffective, angry, desperate, hurt, enraged, and so on because we cannot translate the DEMAND “they MUST NOT do that” into reality. Most external things we simply cannot control. The problem is that we are DEMANDING something that we cannot get. It is better for our peace of mind if we simply PREFER to get what we want RATHER than DEMAND it.

How much easier it is if we can become aware of this and make a choice to change the DEMAND “they MUST NOT do that” into a more rational alternative, which actually means something; “I PREFER that they don’t do that”. Once I downgrade the DEMAND to a simple PREFERENCE, the heat is turned down and I can function again. After all, it’s now only a preference!

SMART RECOVERY has a simple exercise to help us make this adjustment, called “the ABCs”. It is used to analyze the situation and change our thinking about it so that without trying to change external reality, we can feel better about it. This doesn’t mean that we should never try to change external reality- sometimes it is appropriate- it’s when it isn’t an appropriate or an effective response,  that we can choose to have a different response instead in order to feel better.

 

To use this ABC exercise for yourself, just pick any situation where someone’s behavior is “making you angry” and take a look and see what it is you are thinking about it that is demanding and irrational, and change it into something more rational- a PREFERENCE. It is irrational to demand that people behave in the way we want them to!

Here is an example using drunken people making a lot of noise late at night as they pass by outside at night where we live when we are trying to sleep…

  1. A. (Activating situation)   Drunk people outside, making some noise.
  2. B. (Irrational Belief I have about A)   They MUSTN’T make any noise.
  3. C. (Consequences of having those beliefs about A)

When noisy drunken people pass in the street outside late at night and wake me up I feel angry.  It feels bad. I lie awake feeling angry and upset and don’t get back to sleep for a long time.

  1. D. (Dispute the irrational Beliefs in B by turning them into questions and answers)

WHY shouldn’t they make any noise- where is that commandment written in stone? Well, it isn’t.

  E. (Effective new thinking- substitute something rational instead of B)

A**holes and elephants are on the street, I choose not to let their behavior run me around or make me crazy!

Whatever happens – may be avoided. When it does happen the only thing you can control is your response to it.

Drunken people often tend to be noisy, but it’s no big deal. It is very common that they make  some noise on their way home. I will CHOOSE to not upset myself about this, and I will stop even noticing it because it is not a problem for me.