Holiday Spirits: A look at Holiday Time drinking (and ways to cope)

The end of December brings America alive. Christmas is coming, a new year is next, and cheeriness is running on high. The holidays are a time for family and friends, for love and for togetherness, for giving (and for hopefully getting) some pretty cool stuff. For many, the holidays are also a time of indulgence – overspending, overeating, and overdrinking. When it’s just egg nog, no big deal… just make a resolution to work out more! It’s when the egg nog gets spiked, so to speak, that trouble can start.

Not to scare you, but starting Christmas Eve and ending on New Year’s Day, the number of DUIs increases by 33% on average. Furthermore, 41% of accidents on Christmas are alcohol-related, and 58% of them on New Year’s. This is much higher than average daily percentage of alcohol-related crashes, which is 28%. Now to scare you, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), nearly half of all car accident fatalities during that holiday week involve drunken drivers.

This is not an article on drunk driving. This is not just a regurgitation of statistics, although many will be cited. This article takes a look at holiday-time alcohol consumption, brings awareness to how dangerous Christmastime binge drinking can be, and offers a little background on Alcoholics Anonymous, the model example of the many free support groups that can further assist you in having a safe holiday.

The holidays bring a spike in problematic drinking.

Although this year’s Thanksgiving has come and gone at the time of this writing, the serious increase in national binge drinking actually starts the day before turkey day, which has come to be called ‘blackout Wednesday’. Many bars and alcohol-serving establishments say they receive more business the day before Thanksgiving than on St. Patrick’s Day, or even New Year’s Eve, according to PR Newswire. High school friends who have since moved on to live their lives are again reunited, possibly spurring on this day of binge drinking.

The Harris Interactive Survey recently took a poll regarding American holiday drinking. The results are eye-opening to say the least. Nearly one in six people admit to drinking more than they usually do during the holiday season. Nearly one in five say they’ve felt pressured to drink during the holidays. One in two people say their family’s holiday get-together involves alcohol directly. Most shocking of all, virtually everyone polled (96%) either admitted to being hungover for work after a holiday party the night before, or having known someone who was.

According to Scram Systems, makers of some of the top-of-the-line ignition interlock devices, half of those who already have a legal history of drunken driving consume more alcohol than normal during the holiday. (More than nine out of ten DUI offenders said having an ignition interlock device saved their lives). The holidays are meant to be fun, and there are ways to drink responsibly. We hope what we’ve discussed so far will give you reason to do so.

We drive (drunk) more during the holidays.

It’s an expensive time of year, what with dinners and gifts and travel expenses, and driving as opposed to any other form of transportation definitely saves some dollars. Driving sober saves lives. According to AAA (the Automobile Association of America), an astounding 48.7 million Americans drove at least fifty miles last year for Thanksgiving. (Over 89% considered the drive to be a road trip.) The number of those who drove such distances for Christmas surely is not far behind. Last year actually set a record for the number of individual holiday drivers on the road between the 23rd of December and the 3rd of January: 103 million. The highways are quite crammed, and in many areas of the country, snow is falling, making for even more hazardous conditions.

Also according to AAA, over the course of a year, one in eight drivers who are users of alcohol drive their vehicles with what they believe to be a blood alcohol content over 0.08, the legal limit. That means one in eight admitted to it in a survey. So, in reality, this writer bets everything in the bank that in reality, the number is more like 2 or 3. For the sake of the benefit of the doubt, even if the number is 2, this means of the 103 million drivers on the road during the holidays, well over three million of them are drunk.

Okay, there are just a few more stats courtesy of AAA, but stats paint a picture in a unique way, offering insight from a bird’s eye view. Between Thanksgiving and New Year’s Day, approximately 25,000 will be injured in an alcohol-related car crash, and another 1,200 will perish. This is about three times the average for this period of time, the highest spike all year.

Control your holiday drinking. Here’s one way how.

About 24 million Americans consume alcohol with some regularity. The number of Americans that consume alcohol during the holidays is probably somewhere in the range of 30 million. The NIAAA says just over 15 million Americans have AUD, or alcohol use disorder, commonly known as alcoholism. Half of those drinking during the holidays are alcoholics. If you find yourself among them and you want to be safe this year, or even if you’re not an alcoholic but you want to educate yourself on safe holiday drinking, an excellent place to start is Alcoholics Anonymous.

Disclaimer: Alcoholics Anonymous and similar self-help groups are not substitutes for alcohol abuse treatment in a professional facility. If you feel you have a drinking problem, absolutely check into a rehab as soon as possible.

Before the stock market crash of 1929, Bill Wilson made himself quite a wealthy man from Wall Street trading. By 1934, Wilson drank it all away. His severe alcoholism cost him his law school degree and his marriage, and then nearly his life. Hospitalized in New York City’s Towns Hospital, his doctor suggested to him that alcoholism was a disease, not a lack of willpower.

Through some now outdated therapies, Wilson stopped drinking successfully. Then he heard his calling. Wilson was a longtime member of the Oxford Group, a Christian missionary group, searching their philosophies for an answer to his drinking problem. At their meetings, still an active alcoholic but still seeking a cure, Wilson decided to make it his life’s goal to save as many other alcoholics from the disease that he could. In Akron, Ohio, on a business trip, Wilson found himself tempted to drink, and wanted to speak with a fellow alcoholic. Asking around, he was introduced to Dr. Bob Smith.

Henrietta Sieberling was also an Oxford Group member, and was the person who Bill Wilson asked about talking to an alcoholic. Sieberling was at the time attempting to help someone with severe alcoholism, a medical doctor named Bob Smith, who for seventeen years had been getting extremely drunk every single night. Sieberling arranged a meeting between Dr. Smith and Wilson, which reportedly lasted six hours.

Wilson actually moved into Dr. Smith’s home, living alongside the doctor and his wife. Wilson was able to cure Dr. Smith of his alcoholism, and the two men set out to develop one uniform program that could help people with any and all levels of alcoholism. It was 1935 when what would become Alcoholics Anonymous (AA) began. Since then, millions upon millions of people have attended and benefitted from the free service.

If you are an alcoholic, a problem drinker, or simply a concerned social drinker, call us today.

How do I know if I have an alcohol use disorder?

Alcoholism, AKA alcohol dependence, AKA alcohol use disorder, is a disease. However, the definition is not exactly clear cut. This is unique. Nobody can be on the fence with diabetes; you either have it or you don’t. Such is not the case with alcoholism. However, as a general rule of thumb, there are four components to the disease of alcoholism.

  1. Craving – Every drinker on every level experiences a craving for an adult beverage. If you experience this craving often, and the craving is strong, that is a sign of alcoholism. If you crave alcohol a few times a year, and even then could live without it, chances are you are not an alcoholic.
  2. Loss of Control – You may remember the longtime slogan for Pringles potato chips: “Once you pop, you can’t stop.” If this is how you feel about alcoholic beverages, there’s good chance alcoholism has crept in. Alcoholics are either literally unable to control, or have an extremely hard time controlling their consumption. Picture yourself at an open bar with no drink limits. Do you have a few and enjoy the rest of whatever the night has to offer, or do you find yourself drinking as many drinks as you can in order to achieve maximum drunkenness?
  3. Dependence – Being dependent on something is when the desire crosses over from a craving to a need. If someone exhibits withdrawal symptoms when sober from alcohol, it’s safe to say that someone is an alcoholic. Symptoms commonly associated with alcohol withdrawal include but are not limited to shaking, sweating, agitation, nervousness, nausea/vomiting, increased heart rate, and in rare cases delirium tremens which can be fatal.
  4. Tolerance – A tolerance to a substance is defined as the need for more and more quantity of that substance in order to achieve the desired effect. The first time someone gets drunk, it usually only takes one or two drinks. If you find yourself needing to drink six, twelve, maybe even more beers than that just to feel your desired level of intoxication, you, my friend, have an alcohol tolerance, and that is a surefire sign of alcoholism.

There is a commonly accepted AUD quiz. Here it is.

The National Council on Alcoholism and Drug Dependence (NCADD) offers a free online self-assessment as to whether or not you have alcohol use disorder. There are far too many questions to list here. All of the questions are important and play their own role, but we have determined there are nine pertinent questions. Reworded, they follow. The more answers of ‘yes’ you have to the following nine questions, the more likely you have alcoholism.

  1. Do you sometimes find yourself drinking more or for longer than originally desired?
  2. Do you sometimes want to cut back on alcohol intake but fail to?
  3. Do you need more time than average to recuperate from a night of drinking?
  4. Do you often feel a strong urge to drink?
  5. Does drinking ever interfere with your personal life, i.e. work or family?
  6. Do you sometimes find yourself giving up on or avoiding your hobbies in order to drink?
  7. Do you ever find yourself in dangerous or hostile situations due to drinking?
  8. Do you consistently need more alcohol to feel drunk?
  9. Do you ever experience any alcohol withdrawal symptoms when not drinking?

In Conclusion

Holidays are meant to be fun, family-filled, and ultimately safe. Contribute to safety this year and drink responsibly, if you drink at all. If you need help, then as stated, AA is not meant to be a substitute for rehab. If your drinking is excessive, and you question whether or not you’re an alcoholic, chances are you are. AA is, however, a wonderful place for recovering addicts to join and fight the good fight together. Good luck, and happy holidays.


Trump Anti-Opioid Commission Overlooks Prevention, Favors Supply Cuts

First and foremost, this article is politically neutral. We are not here to oppose President Donald Trump, and we are not here to support him. America has become quite a divided nation in this regard. We are simply here to report on the latest report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, and then to give some opinions from there. We will say that Trump’s commission has quite a long name, so from now on it will be referred to as the CCC, which we’ll say is short for ‘the commission combating the crisis.’

The CCC’s latest report was issued this October, and it heavily favors limiting and/or cutting-off opioid supply over reducing and/or eliminating demand for illegal opioid use. In other words, the CCC is extremely focused on both the criminal side of opioids and the way legal opioid prescriptions are handled. They are focused loosely at best on the prevention side of the fight against the opioid epidemic. This article explains why this is true, why this could be bad, and what could change if prevention were weighed evenly with cutting off supply.

Limiting Supply is a Good Thing, But…

Yes it is. Trump and his commission’s focus on criminal drug-dealing operations is extremely important business. There are plenty of high-scale dealers willing to do just about anything for another dollar. This includes violence, spiking drugs with deadly substances, and selling to anyone with cash – regardless of his or her condition. However, criminalizing regular people who happen to be opioid addicts has proven to be devastating. We all know how absurd some of the jail sentences are for non-violent drug offenders. So, does all of American law enforcement believe that addicts are diseased, not criminals? We think you know the answer here…

The CCC’s focus on prescriptions is also extremely important business, perhaps more so than the black market. After all, the vast majority of heroin addicts began with legal opioid pills such as Vicodin or OxyContin. It’s difficult to pinpoint who exactly is to blame for it, but this country is FLOODED with opioid pills. There are enough prescriptions for them written every year to give every single adult American his or her own bottle. Over-prescribing opioids is a terrible thing, and changes need to be made. However, just as with fighting the criminals, restructuring the legal side of opioids still doesn’t prevent people from abusing drugs.

The Commission’s Report

The full text of the report can be found here. The report in total makes 56 recommendations for how to combat the opioid crisis. Two of them are focused on prevention, and one of those two recommendations is for an ad campaign. Advertisements are old news. We live in a world now where we fast forward through them all, because we’ve recorded the program we actually want to see. Sorry, CCC, but ad campaigns simply don’t work. The commission’s other prevention-based recommendation is called SBIRT. It’s short for ‘screening, brief intervention, referral to treatment,’ and frankly it’s an awesome program. However, it does not prevent people from starting abuse – it (attempts to) identify people already abusing and prevent further abuse.

The commission did not invent SBIRT. It began with a theory presented by the Institute of Medicine, and is now endorsed by SAMHSA, the Substance Abuse and Mental Health Services Administration. SBIRT actually consists of three separate components: the screening, the intervention, and the referral to treatment. Here’s how it works.

Say you have a regular old doctor visit. You’re just getting a physical examination and hoping your cholesterol levels are normal. If the office you’re visiting participates in SBIRT, (which many do nowadays), part of your visit will include a screening for possible drug abuse. Your doctor will assess you and determine using standard screening methods if you are abusing substances. No, it’s not foolproof, but it is evidence-based.

Next comes the ‘BI’ part of SBIRT, the brief intervention. According to the SAMHSA website, during this part of the process, “a healthcare professional engages a patient showing risky substance use behaviors in a short conversation, providing feedback and advice.” If your screening shows you to be negative for substance abuse, there will not be an intervention. Finally comes, the ‘RT’ part, the referral to treatment. Again according to SAMHSA, “a healthcare professional provides a referral to brief therapy or additional treatment to patients who screen in need of additional services.”

Does it work?

Keith Humphreys is a government adviser in the field of drug prevention and treatment. He also happens to teach at the Stanford University School of Medicine. He also happens to think that SBIRT isn’t as effective as it should be. Humphreys was quoted as having said this recently to the New York Times: “The brief intervention part of S.B.I.R.T. has had success at changing problem drinking, but little with drug use. Referral to treatment has been a failure across the board. Almost no one follows up.”

Also, SBIRT does not prevent people from getting into drugs.

Preventive Methods to Combat the Epidemic

The remaining 54 recommendations made by the CCC involve in some way or another cutting off the supply of opioids to America. Obviously we are much more prepared to get rid of the drugs than we are to get rid of the addictions. This could be bad. It’s this writer’s humble opinion that we will never be able to fully get rid of drugs. They will always exist, no matter how many pounds of them are seized. It’s like that arcade game Whack-a-Mole; every time we knock one down, another will pop up.

If you prevent people from getting into drugs in the first place, it essentially doesn’t matter how many drugs are around. This is not to say we shouldn’t try and limit the supply of opioids. This is to say we should also be preventing the desire to abuse opioids altogether. Trump’s commission mentioned two methods of prevention in their report last month. However, there is an entire world of preventive methods out there to combat the opioid epidemic.

Let’s discuss a few of them. We think you, dear reader, will start to see just how important preventing drug abuse truly is.

The Nurse Family Partnership

Sometimes effective drug abuse prevention comes in a form you wouldn’t quite expect. The Nurse Family Partnership, or NFP, is a non-profit organization which places registered nurses in homes of first-time mothers who have low income. The nurses are there to educate the mothers about pregnancy and motherhood, help develop parenting skills, and promote infant health. It’s a beautiful program. What does it have to do with drug abuse prevention?

Well, in the results section of a fifteen-year long 1998 study published in the Journal of the American Medical Association all about the long-term effects of nurse home visitation, there is this sentence: “Parents of nurse-visited children reported that their children had fewer behavioral problems related to use of alcohol and other drugs.”

More up to date, a similar study, but twelve years long, was published in 2010 in Pediatrics and Adolescent Magazine that claimed, “By the time the firstborn child was 12 years of age, those visited by nurses, compared with those in the control group, reported fewer days of having used cigarettes, alcohol, and marijuana during the 30-day period before the 12-year interview…”

The Good Behavior Game

Back in 1967, Muriel Sanders just began her new job as a fourth grade schoolteacher. In order to maintain good behavior in her classroom, she developed a kind of game. Students were given a point for each occurrence of bad behavior, and then whoever had the fewest points would win a prize. Two years later, Sanders, Harriet Barrish, and Montrose Wolfe (who invented the ‘time-out’ for kids), officially created the Good Behavior Game.

The game is still being used in classrooms. In fact, in 2010, NIDA, (the National Institute on Drug Abuse), published a paper with the title Behavior Game Played in Primary Grades Reduces Later Drug-Related Problems. The opening line of the paper: “Awarding smiley-face stickers to teams of first-graders in Baltimore for the good behavior of the individual team members greatly increased the likelihood that the students would experience an adolescence free of substance abuse and dependence.”

The Good Behavior Game doesn’t just work – it works quite well. From the NIDA paper as well comes this eye-opening graphic:

trump anti opioid commission

Communities That Care

The final program we will mention began at the University of Washington and is now national. Communities That Care, or CTC, creates support groups within communities nationwide that foster good decision making and try to utilize evidence-based methods to stop and/or prevent drug abuse. It works well too. A trial involving 4,407 students was conducted, and followed them for three years starting in fifth grade. There was a control group not given the CTC program, and a group that was given the CTC program.

According to their website, “Panel students from CTC communities were 25% less likely to have initiated delinquent behavior, 32% less likely to have initiated the use of alcohol and 33% less likely to have initiated cigarette use than control community youths.” These numbers are staggering.

In Conclusion

It should be known that Trump’s CCC report from last month does mention these programs, and more, but it does not actually recommend implementing them. One can guess that means governmental funding for them will not be supplied. This doesn’t mean they’ll disappear, but they could be used on a much grander scale. This writer, for one, remembers the D.A.R.E. program and how inefficient it was. Perhaps things like the Good Behavior Game and Communities That Care should be implemented.

Strangely, no specific funding amounts were given in the report at all. For this reason, the report was met with some disdain. For example, Chuck Ingoglia, senior vice president of the National Council for Behavioral Health, said the CCC’s report “starves the country for the real resources it needs to save American lives.” On the bright side, the report recommends a one-application process for states to receive multiple federal grants, which is a world easier than the current process of applying for each and every grant individually.

New Jersey Governor Chris Christie is head of the commission. He knows personally how tragic drug abuse can be, having lost more than one person close to him to drugs. Although nobody knows how much money will actually be spent to implement some of the report’s suggestions, Gov. Christie did say in late October on cable news program This Week that Trump would soon be asking for an increase in funding for the good fight.

Richard Frank, former Obama administration member and Harvard Medical School professor, believes that it would cost approximately $10 billion annually “to provide medication and counseling to everyone with opioid use disorder who is not already in treatment.” Considering how many billions of dollars are tossed around daily, this seems well worth the cost.


Seven Myths about Going to Rehab

myths-about-going-to-rehabAddicts really have it bad when it comes to public perception. There is the stigma of addiction itself, whereby the public sees drug addicts or alcoholics as druggies or losers lower than the rest of us. Of course drugs themselves are horrible, but addiction is a disease. The average American does not tend to see it that way, or if he or she does, it doesn’t show on a grand scale. People with diabetes are treated much differently than heroin addicts.

Then there is the stigma surrounding seeking help as a drug addict or alcoholic. Entering a rehabilitation program tends to be seen as hitting rock bottom. The general public perception of an addict entering rehab is not that of someone making perhaps the most important decision of their lives. It is seen as a weakness, a form of being helpless – when it’s really quite the opposite.

Finally, there are a handful of myths about rehab itself, what it’s like and whether or not it works. This article is meant to debunk the seven most popular of those myths and not just tell you but prove to you that rehab as an addict seeking recovery is the strongest and single most empowering move you can make. It’s not scary and it’s not overwhelming. This isn’t the mid-1900s, when doctors wore white coats and experimented with your brain. Today’s rehabilitation facility, (at least the good ones), are designed to make you feel as comfortable as possible all the way through your recovery process.

Let’s begin the debunking.

Myth No. 1 – “Rehab is like jail.”

This is absolutely false. Jail is like jail. Rehabilitation facilities are extremely accommodating, sometimes even offering extracurricular activities such as hiking, swimming, basketball or tennis. Of course there is around the clock treatment, abstaining from all illicit substances, and multiple forms of therapy (depending on your addiction), but there are also books and movies and sometimes computers with internet and comfortable furniture and usually decent food to eat. If this is jail, then you are Martha Stewart.

The only goal of any rehab facility is to provide a safe and friendly environment for an addict seeking help to detoxify from his or her substance(s) of choice, and to make his or her stay at the facility as comfortable as possible. Jail-like surroundings are not conducive to healing. Also, in case you are wondering, you can leave rehab at any time! You are not a prisoner! Unless of course your stay at the rehab is mandated, you are free to check out whenever you want to.

Myth No. 2 – “I’m not bad enough of an addict to need rehab.”

If you think you are an addict, you’re probably an addict. If you have questioned yourself as to whether or not you’re an addict, even if you came up with an answer of no, you’re probably an addict. Drug addiction and alcoholism creep in slowly but take hold fast. If you truly believe that you are a recreational user, and not addicted, ask yourself the following questions:

  • Can you easily say no when it’s offered to you? If not, then you might be an addict because recreational users have no issue declining the substance.


  • Do you have healthy relationships with more users than non-users? If so, then you might be an addict because we as humans tend to hang around those who have similar interests and hobbies, and do the same things as us. If you are with your friends 3 or 4 times a week doing drugs or drinking, addiction has likely set in.


  • Do you depend on or rely on the drug to ‘get you through’ certain things? Do you find yourself using before events like movies or concerts? If this is the case, then you might be an addict because recreational users never feel the need to be high for personal strength or gain.


  • Do you crave the drug often, thinking about doing it again next? If so, then you might be an addict because cravings are one of the main signs of addiction.


  • Do you spend money on the drug even though you may not be able to afford it? If so, then you might be an addict because non-addicts would never spend money on getting high when other things need to be paid.


Let us clarify. Being a recreational user of illegal drugs, or abusing legal drugs, is NOT okay. We are merely attempting to point out the differences between a recreational user and an addict. Recreational use is literally the edge of the diving board into the pool of addiction. Consider this: every single addict essentially began as a recreational user.

Myth No. 3 – “Rehab is for the rich and I can’t afford it.”

It’s no lie that rehabilitation can be expensive, especially if planning an extended stay at a facility. Health insurance covers most if not all of this cost. However, let’s face it. Not the majority of drug addicts have top of the line health insurance, if any at all. Thankfully there are many ways to enter into rehab without health insurance. Of course you will need to prove why you cannot get health insurance. You can’t just quit your job, lose your benefits, and jump right in.

We feel the best place for anyone, health insurance carrier or not, to begin looking is with the Substance Abuse and Mental Health Services Administration’s locator tool, available here. This tool is designed to cater to your specific situation. Also, it might not be as expensive as you think. Find out what prices really are before you assume they’re all through the roof.

The average cost of a 90-day outpatient treatment program, with absolutely no insurance and no outside help, is around $5,000 which averages out to be about $55 a day. Now, subtract however much money you were spending on drugs and/or alcohol because you won’t be buying that in rehab! Say on average you spend $20 a day on your substance. Now, rehab costs $35 a day, well worth your health… and again that’s with NO insurance and NO outside help.

Of course, the glamorous and extremely lush rehabs you tend to see glorified in movies or online can be ridiculously priced, but these facilities are designed for the rich and famous and are priced accordingly.

Myth No. 4 – “I can quit on my own without the help of rehab.”

If you are an addict and you are thinking about quitting on your own, think twice.

There is a small chance you can. Then, on the other side of the coin, there is an overwhelming chance you will fail and relapse and then use even more than before. Quitting alone provides nothing but your sheer will to guard you against the widespread temptation of substance abuse. This is especially true for recovering alcoholics. Attempting to quit drinking on your own as an alcoholic is next to impossible. It’s literally everywhere.

The same goes for addicts of any other substance. If you abuse it, you know where to find it. Sure you can avoid those dark alleys, so to speak, but sometimes those dark alleys find you. Triggers of relapse can appear anywhere and in any form. Being in rehab eliminates the possibility of those triggers firing. Plus, scoring drugs in rehab is quite difficult… perhaps yet another difference between rehab and jail.

OK, so that was bathed in humor while also true. However, something very, very serious is how dangerous quitting alone can be. Most withdrawal symptoms from substances are intensely unpleasant when unassisted. In the cases of alcohol and opiates, unassisted withdrawal can be deadly.

Myth No. 5 – “You have to be at rock bottom to go to rehab and I am not.”

You yourself may not be at rock bottom, but that does not mean you don’t need help. You might even be what’s known as a functioning addict, meaning you can carry on a normal life, all except for the sober part. This is perhaps worse, since most functioning addicts do not believe they have a problem. Rehab is definitely the right place to go from rock bottom, but you do NOT have to be at rock bottom in order to enter rehabilitation.

Millions upon millions of Americans enter into treatment every year. It’s highly improbable that all of them felt they were at their absolute low point. Yet here’s something to consider. If you aren’t at rock bottom, but you’re continuing to abuse drugs or alcohol, where do you think you’re headed? Nobody ever abused their way to the top. Check into a rehab facility now before it’s too late and you do hit that personal rock bottom.

Myth No. 6 – “Rehab can be dangerous because it’s like quitting cold turkey.”

This is not true, and we’ll prove it with an age-old saying:  Fight fire with fire. Sometimes it takes one to know one, so to speak, and this is the same with the human body. Drugs like buprenorphine, methadone, and naltrexone are designed to aid in the process of recovery; tricking the body into thinking it’s receiving the substance of choice. However, these recovery drugs are infinitely safer than street drugs or being addicted to prescription pills.

Less severe opioid addicts and most alcoholics will generally be given either buprenorphine or naltrexone, respectively. In severe opioid addiction cases, methadone is often preferred. Antidepressants are also commonly used to ward off some of the negative mental effects of withdrawal, regardless of substance.

Myth No. 7 – “Rehab is for celebrities.”

While there are plenty of television shows that glorify rehab, they are shows, forms of entertainment. Entering into a rehab to help better your life is not a form of entertainment; it is a form of self-help. By making the choice to go to rehab you are allowing as much help in as you can. Rehab does not belong just to child actors and outdated musicians. Rehab is meant to be a haven of assistance for those who wish to abstain from illicit drug use.

If you see celebrities in rehab fail, do not let it discourage you. The majority of those who complete a treatment program remain sober. TV is not real life, and at this point in time, doesn’t even necessarily reflect it.

In Conclusion

Rehab is not an expensive jail meant for the privileged that can be dangerous and doesn’t even help. Rehab is the opposite of all of these things. It is a freeing place, meant for all who seek it, and is safe and comfortable and absolutely works. This writer once heard someone tell him that rehab is like working out because you’re only going to get from it what you put into it.

If you enter rehab with the mindset that it’s not going to work, then the chances are it’s not going to work. Yet if you give it your all and let it work for you, it will. Enter rehab if you are an addict seeking help.


Press Release

Help Reduce Suicide Rates

Coronado, California November 10, 2017:
The Coronado Bridge has been called the deadliest bridge in America. Nearly 400 people have committed suicide by jumping off this bridge. Unfortunately, this is the fate of many people who suffer with mental health and substance abuse issues.Coronado Bridge

Many of our Veterans have found the Coronado Bridge to be a convenient and easily accessible means to this end.   According to the U.S. Department of Veterans Affairs, the risk for suicide is 22 percent higher among Veterans when compared to U.S. non-Veteran adults. VA Secretary Dr. David J. Shulkin said “These findings are deeply concerning, which is why I made suicide prevention my top clinical priority.”

We must all do our part in helping to prevent suicides especially among our Veterans who have risked their lives in service to our country. On Wednesday, November 8, 2017, Dr. Matthew J. Bruhin, Ph.D., LMFT, the CEO of Apex Recovery Rebab was on his way home to Coronado. As he drove across the bridge, he noticed a man walking along the edge. He watched as the man then put one leg over the 3-foot-high wall of the bridge, prompting Dr. Bruhin to take immediate action. He pulled his car over and began speaking to him. Thankfully, the man was convinced not to jump. During their conversation, Dr. Bruhin learned that the man was a Veteran and had recently become homeless. He also had a history of substance abuse, like many of our country’s Veterans. Apex Recovery Rehab, one the country’s leading addiction treatment centers, as well as, the only residential treatment center offering all levels of care to hold a Joint Commission Certification offered aid to this individual. He is now in counseling and a GoFundMe page was set up for him by the community of Coronado earning $1,175 to date. You can contribute to this fund by going to He was also placed in one of Apex Recovery Rehab’s premier treatment facilities. It is everyday citizens, like us, who can help save and improve the lives of others.

There are many things each of us can do to prevent the rate of suicide on the Coronado Bridge. We can contact our local government and insist that the bridge be modified by installing nets underneath it. Perhaps, the 3-foot-high guard rail is not enough of an impediment to prevent people from easily climbing over it. Finally, we should all get more involved in helping other people by speaking out about Mental Health, Drug Addiction and Veteran’s Suicide issues.


Apex Rehab: Only Facility in San Diego with Joint Commission Accreditation

apex rehab joint commission san diegoApex Rehab is located on Camino del Rio in gorgeous San Diego, California. Apex recently received accreditation for behavioral health from the Joint Commission, which is “America’s oldest and largest standards-setting and accrediting body in health care,” according to their website . This makes Apex Rehab the first and only current rehabilitation facility with accreditation from the Joint Commission.

This article will explain why this is so important.

Behavioral health is a complicated term. Preferred nowadays to the term ‘mental health,’ it’s the science of emotion, behavior and mental health all in one. According to Psychology Today, “Behavioral health includes not only ways of promoting well-being by preventing or intervening in mental illness such as depression or anxiety, but also has as an aim preventing or intervening in substance abuse or other addictions.”

In the world of substance addiction recovery, this is a goldmine, because literally about half of American drug addicts and/or alcoholics also suffer from some type of mental disorder. It’s become no secret to the healthcare industry that substance abuse and mental disorders are linked. So, in a way, a rehabilitation facility that offers behavioral health therapy is offering help for a dual diagnosis.

This is a critical component for a rehab facility to have during today’s times, when heroin and prescription pills and alcohol are ravaging our nation. The current drug epidemic knows no borders, and every state in the US is suffering horribly. It would make sense then that the state with the highest population, California, is suffering pretty particularly horribly.

Californian Addiction

Approximately 5 million residents of California are either drug addicts or alcoholics. That’s nearly 20% of the entire population of the golden state. According to California’s own Department of Public Health, about eleven people die every single day in the state due to fatal drug overdoses. We are talking over 4,000 people a year. Plus, literally tens of thousands of trips to the emergency room in California are drug-related every year, (40,000 in the last three years), and that does NOT include alcohol-related ER visits.

Ten years ago, only two of the 58 counties in California experienced an annual fatal overdose rate of 20 people per every 100,000 people. Today, nineteen of the counties qualify for this horrifying statistic.

California has a lot of guns. A lot of states do, but CA’s population is huge compared to most other states, so naturally there are lots of firearms. In fact, among premature deaths, guns cause the fifth most in the state. The following information pertains solely to premature deaths.

California has some seriously violent areas. There are maximum security prisons and gangs are very real. Every day you can read about someone killing someone else on the west coast. Homicide, in fact, is the fourth most prevalent cause of death in the state.

People don’t just kill other people, though. Very sadly, sometimes people end their own lives, and in California, suicide is actually third among leading causes of death. Perhaps this too is a statistic altered by the fact that so many people live in California. Also, so many people drive in California. This writer has a friend who works in L.A. who once said, “People get out of their cars on the highway and grill burgers sometimes when it’s real bad.” Unfortunately, car accidents cause the second most deaths in the state.

You may have guessed by now where this is going. Even if you have indeed figured it out, you cannot read the following sentence without feeling some sort of shock and awe. In a state known somewhat for its violence, and for its insane driving, the single most prevalent cause of death in California is drug abuse turned fatal. Perhaps even worse is how few Californians are seeking professional help.

Not Getting the Help they Need

For every one hundred Californian drug/alcohol addicts, only 15 of them will ever receive any kind of treatment. This means over 4 million of the state’s population are untreated addicts. At this point in time it’s well-known that addiction is a disease of the brain. This is not a good scenario.

Alarmingly, this trend is nationwide. Take a look at the graphic below. Believe it or not, California, at 15% as stated above, is actually ahead of the national average (11%) for percentage of addicts that have received or are receiving treatment.

people who have received treatment vs not receieve treatment

So, for every 100 Americans struggling with their addictions, barely ten will seek the help they need. Is this true for any other disease?!?!? Since it couldn’t be worded any better, bear in mind how few addicts in this country receive the help they need as you read this from the Substance Abuse and Mental Health Services Administration:

The substance use recovery process is highly personal and occurs via many pathways. For many Americans, this recovery process includes access to and use of substance use treatment at specialty facilities, such as a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or an outpatient), or a mental health center. Having access to substance use treatment and supportive services to address various needs associated with substance use disorders is critical for those who are in need of treatment.”

Now, let’s get real. The chances are that if you’re reading this, either you are an addict or someone you know and love is an addict. Also, there’s a decent chance you’re reading this from somewhere in California. The fact of the matter is that the services of a professional rehabilitation facility are definitely needed. Do not be like the majority and ignore the disease. Let’s talk about not only why rehab is a necessity for addicts, but which one is the best in California.

Note: Obviously, if you or someone you love is indeed an addict, reading this article should be low on your priority list. Seek help immediately, especially if any level of danger exists.

Why Behavioral Health Rehabilitation is a Must for Addicts

Addiction is not an easy thing to treat. It’s nothing that can be fixed with an antibiotic or some good exercise, (although the latter may help a little). According to CRC Health Group, “Because addiction has so many dimensions and disrupts so many aspects of an individual’s life, treatment for this illness is never simple. Drug rehabs must help the individual stop using drugs and maintain a drug-free lifestyle, while achieving productive functioning in the family, at work, and in society.”

So, obviously the main goal is to stop use of the drug or of alcohol altogether. However, rehab does much more than that. The quote from CRC Health goes on to say, “Effective drug abuse and drug rehab treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences.”

It’s not only about sobriety. Rehabilitation will also:

  • Remove you from the stresses of your everyday life
  • Provide therapy for all stressful aspects
  • Medicate you as necessary to ensure a safe process
  • Offer outdoor activities and extracurriculars
  • Improve living habits
  • Possibly create bonds that are lifelong

Behavioral health rehabilitation is the ultimate form of recovery for a substance addict. As discussed, this type of rehab focuses both of the substance addiction and any concurrent mental disorders. The location of the rehab you choose is important, and should be somewhere calm and with weather you enjoy. In the state of California, perhaps no better city for behavioral health rehab exists than San Diego.

And perhaps no better rehab exists in California than Apex Rehab.

Why Apex Rehab should be the Number One Choice

As mentioned, Apex is the only rehab accredited by the Joint Commission in all of San Diego. This is a huge deal. Since 1972, the Joint Commission has been issuing accreditation to behavior health rehabs, and approximately 2,500 organizations are accredited as of today. It’s the single most stringent accreditation organization in the country. You don’t just pay for it and get it.

Accreditation from the Joint Commission “concentrates on operational systems critical to the safety and quality of care, treatment or services provided to the individual,” as per their website. The requirements for qualification are developed by a team consisting of health care experts, health care providers, measurement experts, and also people who have been in rehabilitation. This ensures a well-rounded point of view.

Now, consider this. Apex Rehab not only met the stringent requirements for accreditation; it exceeded the requirements and was given behavioral health home certification. According to the Joint Commission:

“Behavioral Health Home Certification is an optional certification to recognize organizations that coordinate and integrate all health care needs of a population served. The optional certification goes above and beyond what is required for accreditation and provides additional recognition as a health home.”

Better than the Rest

There are two main reasons Joint Commission accreditation makes Apex Rehab the best in San Diego. One is obvious. The facility is so top-notch that it was accredited in the first place. Second is the benefit of having accreditation from the Joint Commission. Patient safety is strengthened, risk management is improved, surveyors are on-hand for expert advice and/or education, and much more. For a complete list of Joint Commission accreditation benefits, click here.

With a stay at Apex Rehab, you can expect:

  • Reduced Drug Use
  • Improved Mental Health
  • Improved Overall Health
  • Healthier Relationships
  • Better Employment Opportunities
  • A safe, secure, professional environment

Of course, there is never a guarantee that rehabilitation will work for every single person every single time. The fact is that when it comes to inpatient treatment, 73% of those who enter a program complete the program, and 21% of those who enter a program remain sober for at least the next five years. Before you go thinking that these numbers are not exactly favorable, consider this…

Among those who enter into a treatment program for Type I Diabetes, about 40% experience a relapse of symptoms. For asthma, the number is as high as 70%. Addiction, like diabetes or asthma, is a disease, so one can take comfort in knowing that the relapse rates for substance addicts are similar to those of other common diseases.

Again, to quote CRC Health, because they are the nation’s leading provider of treatment and educational programs: “Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data document that drug addiction treatment is as effective as are treatments for most other similarly chronic medical conditions.”

In Conclusion

So there you have it. Rehab works, it’s a necessity, not nearly enough who need it actually go, and Apex Rehab may just be one of if not the best one in California. Apex is at least the best in San Diego, which may indeed be the single best location for recovery in the entire nation.

Apex Rehab offers detoxification services, residential treatment, partial hospitalization, inpatient rehab & outpatient rehab – all of which are accredited by the Joint Commission. You’d be a fool to go anywhere else, really, so contact them today.


How to Prepare for Rehab | Getting Started

The first step in preparing yourself for recovery is to take a deep breath and recognize that you have made a healthy decision for your future.  Now that you’ve come this far, here are the next steps you should take before entering recovery.

The most important thing to remember when preparing for rehab is to keep it simple. It is important that you take care of any work, family or financial obligations.  Because while you are in treatment, your entire focus should ideally be on yourself and your recovery.

how to prepare for rehab

Spend positive time with loved ones.

The decision to go into treatment has likely come with encouragement and motivation from close family and friends. Before treatment, spend time with loved ones — this will help keep you strong in your decision to get sober.

Get the proper rest.

Take care of yourself before you go to drug and alcohol rehab. Get some rest, and try to eat right. You’ll get more of this when you go to drug rehab, but the initial detox period can be physically taxing so it doesn’t hurt to start out with a full tank.

Be positive and patient.

Going into rehab with a positive attitude is essential to getting the most out of your detox experience and maintaining a healthy outlook on life. Don’t get discouraged if results aren’t seen right away.

Leaving Children for Treatment

If you have children, talk to them one-on-one. Kids do not need to know every detail of addiction, but they can understand being sick. Explain that just like they see a doctor when they are sick, you too are getting help for something that is making you sick. Allow your children to ask questions.

Prepare your home for your absence.

If you live alone, pay any bills you might have ahead of time, and have your mail and newspapers held.  If you have pets, ask a family member or friend to take care of them while you’re away or line up their stay at a kennel.  You might also want to have a neighbor, friend, or family member check on your home periodically while you’re away.

Tie up any Loose Ends Before Going into Treatment

Before entering rehab, there are several steps you may need to take to prepare. In general, it is important that you take care of any work, family or financial obligations.  Because while you are in treatment, your entire focus should ideally be on yourself and your recovery.  If you are stressing about your life outside of treatment it will be difficult to maintain that focus. Additionally, if you return to a chaotic situation upon completing treatment, you may be more prone to relapse. After all, stress is a major relapse trigger.

Keep an Open Mind.

Keeping an open mind is an essential part to getting the most out of recovery. It is not easy to go into treatment without expectations and preconceived ideas but the more you can be open to the process, the more you will be able to benefit from it. Notice when you have expectations about yourself or your treatment program, and try to surrender them.

If you have made the decision to enter a drug and alcohol rehabilitation program, then you have taken the first step towards a healthier, happier, more mindful life.  Sometimes, just making the decision to address your addiction is the most difficult part of the process.  For many people, it can take a series of hardships to arrive at this point, like the loss of relationships, deteriorating health, financial problems, and more.  Even if it might not seem like it right at this moment, your circumstances can only improve upon freeing yourself from addiction.  Yes, the process is challenging, but the rewards are more than worth it.


San Diego Scientist Receives Grant for Addiction Medicine

Heroin. Cocaine. Meth. Nicotine. These drugs have more in common than you may know. Yes, they’re all dangerous, all addictive, and all far too prevalent in American society. But did you know they all basically work the same way? Someone who did know that, and acted on it, is Nicholas Cosford, a professor with the Sanford Burnham Prebys Medical Discovery Institute in San Diego.

Cosford has come up with a compound that could possibly end addiction to all of the above-named substances. This makes sense, because in addition to being a professor, Cosford is the co-founder and head of Drug Discovery at Camino Pharma.

He recently received a $10.8 million grant from the National Institute on Drug Abuse, (NIDA), because it seems to be working. His idea is not original, just a tweak on a previously-established school of thought. Still, this brilliant professor from beautiful San Diego, California might have just cured drug addiction. We will explain how, but first let’s discuss how addiction workbiologically, and what the previous ideas for ending addiction were.

san diego scientist receives grant addiction medicine

Glutamate + Dopamine = Addiction

Put extremely basically, for this writer is no scientist, here is how shooting heroin, sniffing coke, smoking meth, and even smoking a cigarette, are all essentially doing the same thing to your brain. There are receptors all over the brain, which are tiny portals for neurotransmitters to go through. A neurotransmitter is what you may remember from high school as being called ‘a messenger.’ There are several different neurotransmitters, and they call carry different messages. The two most important in drug use are glutamate and dopamine.

Glutamate is known as an excitatory neurotransmitter because it stimulates the brain. At normal levels, it’s responsible for learning and memory in humans. It’s actually the most prevalent excitatory neurotransmitter in the whole nervous system.

Dopamine is the neurotransmitter responsible for the pleasure we feel when we engage in reward-motivated behavior. For example, it feels good to eat a candy bar, right? Have you ever wondered why? It’s because the sweetness of the candy is releasing dopamine into your brain’s receptors, causing you to feel joy from the behavior you engaged in – snacking on a Snickers.

Here’s where it gets tricky. When someone does a drug, say something strong like heroin, the brain gets absolutely flooded with dopamine and it feels good – it’s what we call a high or a buzz. At the same time, glutamate is also being produced at abnormally high levels. This causes the brain to basically remember how good the drug use felt, store that information, and then cause a desire for that drug again whenever a memory of using it is recalled.

OK that might be a lot of words. Here’s the true layman version: Doing drugs causes the brain to make the body feel really good, but it also causes the body to want to feel that same pleasure whenever drugs are around or thought of. This is why addicts have cravings, and this explains triggers, or things that cause cravings.

Here’s an example. Say Peter used heroin for years with his best friend Alice, but he quit last month. Chances are that every time he sees Alice, or even a picture of her, that his brain is going to associate her with the memory of feeling good (glutamate), and if he does use heroin again, the pleasure will return (dopamine) and again be remembered as a rewarding behavior (glutamate again).

It’s called addiction, and it’s a vicious cycle. The physical way to kill addiction is to simply not use the drug. This is nearly impossible for an addict. The physiological way to kill addiction is to enter into a treatment facility and take advantage of the medical professionalism. The psychological way to kill addiction is to attend therapy. Biology is concerned only with the actual body and brain.

Blocking Dopamine? Too dangerous.

In the past, the biological answer to addiction has been to block the dopamine receptors. The brain can release all the dopamine it wants, but if that dopamine is not received, no high, right? And if there’s no high, then why do the drug at all? Voila – addiction over.

That may seem good and dandy, but blocking dopamine receptors can cause some seriously horrible side effects. After all, it is a naturally occurring neurotransmitter that when at healthy levels is essential in our day-to-day function as people. Here are just some of the possible side effects of using a dopamine antagonist, a drug that blocks dopamine receptors:

  • Tardive dyskinesia (involuntary body movements)
  • Impotence and/or loss of libido in men
  • Menstrual dysfunction in women
  • Galactorrhea (spontaneous milk-flow from breasts) in both sexes
  • Parkinsonism
  • Irregular heartbeat

In the more recent past, it has been discussed to block glutamate receptors. This way, the learning and the memory associated with drug use is tampered down and possibly could prevent compulsive drug use and ultimately addiction. In fact, in 2015, a study was published in the journal Frontiers in Neuroscience that specifically dealt with glutamate and drug addiction. The findings serve as the perfect precursor to the current work of Nicholas Cosford.

Blocking Glutamate? A 2015 Study.

When it comes to the brain, there are two types of reward: natural and drug. A natural reward is critical to our lives, something such as how we feel when we drink water when thirsty. A drug reward is not critical, and is only “…consumed for [its] ability to produce pleasure and euphoria.”

The idea of the study was to explore three things in general: the effects that glutamate has on drug reward, the then-current status of using glutamate antagonists to combat drug addiction, and, in their words, to “…discuss future studies needed to address currently unanswered gaps in knowledge, which will further elucidate the role of glutamate in the rewarding effects of drugs of abuse.” In short, they reinforced the knowledge that glutamate plays a crucial role in drug addiction. They also warned of how dangerous blocking glutamate receptors can be.

“Significantly, blockade of glutamate transmission… attenuates the rewarding effects of drugs of abuse. Further, blocking glutamate transmission in brain regions associated with reward… likewise attenuates drug reward.”

Translation Into Layman’s Terms: The author of the study is saying that blocking glutamate receptors not only decreases the actual amount of pleasure (dopamine), but that it also reduces the tendency of the brain to remember and learn that drug abuse is rewarding. So, where dopamine blocking only reduces pleasure, glutamate blocking reduces both pleasure and desire. What could go wrong?

This next section, a bit of a longer quote directly from the study, explains what could go wrong. Don’t worry; there will be another translation!

“The ubiquitous distribution of glutamate makes targeting glutamate transmission to decrease the reinforcing effects of drug rewards very challenging. Further, it must be emphasized here that glutamate transmission is involved in many other physiological functions such as learning, memory, regulation of normal behavior and reinforcing effects of natural rewards. Hence, there is a need to develop medications that selectively attenuate the reinforcing effects of drugs of abuse without affecting other physiological functions.”

Translation Into Layman’s Terms: Because there is just so much glutamate produced by the body, and for so many different functions, simply blocking its receptors would cause some serious problems. These problems could include complications in essential functions such as learning and/or ‘regulation of normal behavior,’ which frankly is terrifying. Therefore, it’s a must that some kind of medication or compound be made that only blocks those glutamate receptors associated with ‘the reinforcing effects of drugs of abuse’.

These words were published only two years ago. Professor Nicholas Cosford may very well have found that compound – one that blocks all the right receptors, and doesn’t affect those that help us live normally.

Professor Cosford and the SBP Compound

“Our institute is very good at doing basic biology,” said Cosford to the San Diego Tribune, linked above. He was not lying. He and his partners recently developed a compound called SBP-0069330. According to the wordage of the SD Tribune, it “…regulates certain receptors on brain cells for the neurotransmitter glutamate.” What the compound actually scientifically does is “…target the metabotropic glutamate receptor 2 (mGlu2),” according to Cosford.

Again, using layman’s terms, the compound manages to focus on blocking those glutamate receptors most associated with addiction to heroin, cocaine, methamphetamines, and nicotine. SBP-0069330 has even been proven successful in rats, creatures which believe it or not are over 90% identical genetically to human beings. (This is why they’ve been used in such experiments for such a long time).

The ultimate goal is obviously testing the compound on people. Before that happens, a lot of work needs to be done. Toxicity tests have to be performed. Much more volume has to be created. These are just two of many things that need to be accomplished before it’s tested on humans. That’s where a nice and handy $10.8 million from NIDA comes into play.

The Grant

Three more years of preclinical work: that is what the grant is funding. Toxicity tests and volume increases and all of the other extremely important work that needs to be done before this compound enters a human being will hopefully be paid for by this grant. Obviously multimillion dollar grants are not tossed around on a regular basis, so NIDA, one of if not the leading institute on substance abuse, truly believes in Cosford’s compound.

An ulterior motive of the grant being given was also to quicken the process of getting the compound from research-level to an actual product, able to marketed. Cosford said to the SD Tribune that they have “…the ability to do very early-stage drug discovery that gets to the in vivo proof of concept stage.” (This means the tests on rats were successful and proved that the compound works in live animals). “What we don’t have is the ability to move things from the in vivo concept into the clinic.”

Nearly eleven million big ones ought to be a great start, which is wonderful news. Consider the implications of a drug that actually cures heroin addiction, cocaine addiction, meth addiction, and even cigarette addiction, which is the single largest preventable killer worldwide. It’s almost a shame that three more years are needed, but it’s definitely better to be safe than sorry when it comes to medicine.

In Conclusion

The process is not over yet, and surely something could go wrong and compound SBP-0069330 might be canned for all time. Or, after three years, the compound might be perfected into a medicine and then made available to the public. Whichever drug company decides to endorse the end product will be delivering a significant punch in the battle against the drug epidemic that’s all but swept our nation.

It definitely helps that Professor Cosford is also the head of a pharmaceutical company. However, they are a start-up at this point, and they focus more on cancer therapies. It’s likely a different pharma company would have to endorse, but it seems rather likely one will.

In the conclusion of the Frontiers in Neuroscience study discussed earlier, it says that “…the FDA has approved several medications that attenuate glutamate transmission…” but that these medications are on route to become treatments for central nervous system disorders. While addiction may fall under that category, Cosford’s compound is apparently the first to be able to be able to target specific glutamate receptors associated with drug reward, and therefore with addiction. This is truly some exciting stuff.


Trump, the Opioid Crisis, and the Current Status of America

The opioid epidemic is far from over. The entire nation is being ravaged every single day by drug addiction, but especially by heroin and prescription pill addictions. The number of American deaths from drug overdoses continues to increase, and has been rising since 1999, back when Bill Clinton still had two years as our president.

Now, three presidents later, it’s a complete warzone out there, a full-blown opioid epidemic. In early August, Donald Trump, our current commander in chief, held another media briefing on the epidemic. The gist of what he said was that the problem is still out of control, and that the government is indeed working on slowing and stopping the epidemic. Unfortunately, one thing not mentioned was progress.

During his campaign for presidency, Trump acknowledged the depth of the American drug problem, and promised strongly that he and his administration would combat the opioid epidemic with an iron fist. Eight months into his presidency, during last month’s briefing, he basically said the same thing.

The Media Briefing

“Nobody is safe from this epidemic that threatens young and old, rich and poor, urban and rural communities… everybody is threatened,” said the president early in the discussion. He is absolutely correct. Unlike in the past, there is no demographic for today’s heroin or pill addict. The availability is widespread, and with the outrageous over-prescription issue in this country, more people than ever are becoming hooked on pills such as OxyContin or Vicodin. The problem is that once these pills run out, heroin becomes the easier-to-acquire replacement.

America hasn’t been throwing any white towels, either. Virtually every state in the country has implemented new programs and/or laws to help combat the epidemic over the past decade or so. Former president Barack Obama was responsible for enormous effort, especially with his 21st Century Cures Act, which garnered a billion dollars for the good fight. [In a dire attempt to remain apolitical, we still must share this with you: According to New York Magazine, in the beginning of Trump’s presidency he pledged an ‘additional’ $500 million to fight the opioid epidemic, but in reality that money was the second of two installments guaranteed by Obama’s 21st Century Cures Act].

However, it seems that the epidemic rages on regardless of how many dollars are spent, at least for now. During the recent briefing, Trump hinted at perhaps having new ways to combat the crisis:

“Today I’m pleased to receive a briefing from our team on ways we can help our communities fight this absolutely terrible epidemic, and keep youth from going down this deadly path.” No more was mentioned on the team’s briefing, and a full report is due to be published next month in October.  The president did speak at length on how we are fortifying the southern border of the US more than perhaps ever in history, and that part of why is to prevent illicit drugs from entering our country from Mexico, a country with many drug cartels that profit off of American addiction. He also mentioned that we are still negotiating with China regarding the shipment of illicit chemicals to the US.

Sadly, this is old news. We as a country have been aware of the Mexican-Chinese drug infiltration for over a year at least. It was last August when Vancouver police seized enough carfentanil to wipe out 50 million people. It was snail-mailed from China. Getting drug into America from Mexico is even easier.

The main focus of Trump’s recent briefing was that there has been a decline in federal drug prosecution. “At the end of 2016, there were 23 percent fewer federal prosecutions than in 2011…” said Trump, noting that the former administration “…looked at this scourge and they let it go by.” Whether that’s true or not, and whether you approve of Trump or not, there may be some credit in saying that we need to pump up law enforcement. It might be the only weapon left to try and use against the opioid crisis.

The War on Drugs

This writer is over thirty years old and has known about this term for at least twenty of them. By now it almost seems that America is in a perpetual war on drugs, and is perpetually losing. Sadly, the number goes up every so often, but currently 91 Americans die every day from either heroin or opioid prescription overdoses. Please let that soak in. Every single hour, nearly four people meet their end because of a drug. Six out of ten fatal overdoses are from opioids. Every three weeks, the same number of people die from opioids as died total in the tragedy of September 11th. Heroin officially has killed more people than AIDS. There are 100 ways to put it but one absolute truth: The opioid epidemic is in full effect.

We will have to wait another month to see what Trump and his administration have come up with as the next maneuver in the war, but so far here’s what’s going on right now. The Commission on Combating Drug Addiction and the Opioid Crisis, (CCDAOC), last month “…made a series of recommendations on the topic focused on treatment to combat addiction and regulating prescriptions to prevent abuse,” as reported by ABC News. The commission also recommended Trump declares a national emergency.

Around the same time, Attorney General Jeff Sessions issued a memorandum to all federal prosecutors in America. The first sentence of the second paragraph says it all: “First, it is a core principle that prosecutors should charge and pursue the most serious, readily provable offense.” The attorney general makes it clear that this includes mandatory minimum sentences, something Obama was starkly against.

Again, it is not our job to judge the politics of this country. Our job is to report on the status of the opioid epidemic, and ultimately to offer help to anyone who is struggling with any type of addiction. That being said, one can only hope that this boost in law enforcement will help. However, simply sending anyone who is in possession of any amount of an illicit substance to jail for as long as possible does not seem like the best way to combat what is essentially a personal problem that so happens to affect millions of persons. Thankfully, to this, Attorney General Sessions said:

“If you are a drug trafficker, we will not look the other way. We will not be willfully blind to your conduct. We are talking about a kilogram of heroin–that is 10,000 doses, five kilograms of cocaine and 1,000 kilograms of marijuana. These are not low-level offenders. These are drug dealers. And you’re going to prison.”

The CCDAOC (and Governor Christie)

There really isn’t a single state in America that hasn’t been hammered by the heavy hand of opioid addiction, but some states have it worse than others. One of the more affected states is New Jersey, home state to over 1,900 victims of opioid overdose last year. Remember how 91 US citizens die every day this way? In NJ, the number is 5.2 when rounded. If as many people died in every other state as in New Jersey, this country would see 260 people die from ODs every day – an increase of almost 300%.

NJ Governor Chris Christie has truly been one of the five-star generals in the war on the epidemic. He is, after all, head of the aforementioned CCDAOC, and actually has had two people close to him die from opioids. He has a dog in the fight, so to speak. Perhaps that’s why earlier this year in February he implemented perhaps the ‘harshest’ of all current drug laws: changing the supply of opioid prescriptions from thirty days’ worth to five days’ worth.  After all, it’s become apparent that the opioid epidemic began (and could end) at the doctor’s office.

This, recently, from the Centers for Disease Control and Prevention:

“The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010, yet there had not been an overall change in the amount of pain that Americans reported. Deaths from prescription opioids, drugs like oxycodone, hydrocodone, and methadone, have more than quadrupled since 1999.”

This writer, for one, does not find it coincidental that both the pill count and the death toll quadrupled over the same period of time. One hopes that other states will take influence from Christie’s law. One also hopes that the New Jersey governor’s newest move will have a positive impact.

On September 17th it was reported that Gov. Christie will soon pledge $200 million to help those who are ‘underserved’ during this time of crisis. This will include those without health insurance, those on Medicaid, and families with babies born into addiction. Also, about a sixth of the money will be spent to provide housing and treatment for current addicts. The governor hopes ultimately for sustained sobriety, not just a quick fix.

Trump and the Future of the Epidemic

Governor Christie has been praised for his hard-nosed efforts in combating the opioid crisis. Trump, however, has not. In fact, add onto the pile of criticism the fact that Pres. Trump truly has been rather quiet about the epidemic. During his campaign, the opioid epidemic was a focal point. As of now, not much more than briefings and a continuation of Obama’s previous efforts has been done on a federal level. The increase of southern border security has an obvious ulterior motive, as does negotiating with China. (Again – not politicians – but a quick Google search ought to show you why this is true.)

Yet, whether or not Trump is sincere in fighting the crisis, two of his fellow Republicans definitely are sincere: Attorney General Sessions and NJ Governor Christie. One may be a little more old-school than the other, but at this point the general consensus has to be one of ‘whatever works’.

“The average sentence for a convicted federal drug offender decreased 20 percent from 2009 to 2016,” said Trump during last month’s briefing, adding that he promised indeed to fight this battle back during his campaign. Perhaps more law enforcement is what we need. Time will tell.

There is another thing Trump said at the briefing, something poignant and absolutely true. It may have been a line written for him, and he may not have fully embraced the meaning behind it, but the truth of the statement is inarguable, especially now. He said it about the war on the drug epidemic, and he said:

“We have to win. We have no alternative. We have to win for our youth.”

Yes, Mr. President, yes we do, especially since the largest increase in heroin use has been among those aged 18 to 25 – the future of this nation.

In Conclusion

Much evidence exists pointing toward the daily death toll being much larger than 91 per day. In fact, the same CCDAOC report that asked Trump to declare a national state of emergency also claimed 142 deaths a day due to opioids. Governor Christie it seems is a definite warrior of the drug war. His efforts lead the way in a country ravaged by drugs. As for Trump, let us have faith in the words Christie spoke about him:

“I’m convinced that the president is committed to this. I look forward to his and his administration’s reaction to the draft report [coming later this year], and I look forward to continuing to work with the members of the commission to make sure that we’re giving the president and his administration the very best information we can to deal with this crisis.”


Fentanyl: Not Worth the Risk

Have you ever heard someone say, “It’s almost a relief to find just heroin or just cocaine or just crack.”? Have you ever heard a police officer say how relieved they are they only found any of those three drugs during a drug bust? The above quote comes from East Liverpool, Ohio Police Officer, Chris Grant, who inadvertently overdosed on fentanyl by simply brushing it off the back of his shirt.

The report states that within two minutes Green crashed to the floor and woke up in the hospital to learn he had overdosed. No, he didn’t snort or ingest the drug in any way. He touched it with his hand. Some may say that’s impossible and the statistics of fentanyl overdoses don’t lie.

Fentanyl acts on the same receptors in the brain as opioids except it can be 50 to 100 times stronger than its predecessors: heroin, methadone, oxycodone and the like. Fentanyl is a synthetic drug that had found its way into the black market over the last four to five years. The drug has become an advantageous pursuit for drug dealers because of the strength of the drug, which mirrors the same pursuit of the user to find the next, more exhilarating high, often ignoring the potential pitfalls such as…death. The number of overdoses has been increasing at an alarming rate over the last four years.

  • The death rate of synthetic opioids other than methadone, which includes drugs such as tramadol and fentanyl, increased by 72.2% from 2014 to 2015
  • The number of states reporting large numbers of fentanyl encounters substantially increased from 2014 to 2015, with 8 states reporting more than 500 encounters in 2015 compared to 2 states in 2014 and zero states in 2013
  • The following states reported over 500 fentanyl encounters in 2015: Kentucky, Virginia, Ohio, Pennsylvania, New Hampshire, Massachusetts New Jersey and Florida

fentanyl outbreak

Regional Problem

As indicated in the aforementioned statistics, it appears fentanyl has become a regional problem, mainly concentrated in the Midwestern and Northeastern Regions of the United States, with one outlier being Florida. As we may be learning during our current President’s seemingly fruitless attempt to keep coal as a hot commodity, many of the aforementioned states have a large concentration of physically taxing occupations such as timbering, agriculture and, wait for it, coal mining!

The current prescription and illicit opioid epidemic originated from the prescription pain killer epidemic. Heavy prescription of painkillers such as oxycodone and hydrocodone began in the late 1990s and has become a public health epidemic, resulting in a quadrupling of prescription opioid overdoses between 1999 and 2015. Prescribing of opioid pain killers has increased at a similar rate over the same time period. Go figure.

So, how did we get here?

Like any business, a drug company will attempt to market their business in areas that will have the largest prediction for success. For example, if you go to Texas and California, you’re going to find that there are a lot more Hispanic food restaurants and food options per capita as compared to Oregon. The reason for this is the fact that Texas and California border Mexico and have the two highest Hispanic populations in the United States.

When prescription opioid pain killer companies were developing their marketing plans in the mid-to-late 1990s they compiled a list of physicians that treated people for chronic pain disorders. The database revealed that states such as Virginia had a higher rate of chronic pain patients and any dunce looking at the map of results would say, ‘why don’t we sell our drugs there’.  In addition to identifying where to send the pharmaceutical representatives, the company that sold OxyContin had lucrative sales bonuses for their employees, which only increased their reps’ desire to sell more drugs.

It’s possible that liking money is not exclusive to Dax Shepard’s character, Frito, of the movie Idiocracy.

All jokes aside, it’s pretty scary that drug companies used such deceptive marketing tactics as they have been will be gummed up in several lawsuits for several years for their marketing of “non-addictive” pain killers. Most recently, the state of Ohio decided to sue 6 pharmaceutical companies, most notably Purdue Pharma. Not so ironically, Purdue Pharma was on the forefront of marketing of OxyContin to vulnerable areas in the mid-1990s. Ohio’s lawsuit alleges that Purdue Pharma:

  • Overstated the benefits of chronic opioid pain therapy
  • Targeted susceptible prescribers and vulnerable patient populations such as veterans and elderly patients
  • Violated state anti-fraud and consumer protection laws

Can Chronic Pain be Managed?

What’s wrong with a physician wanting to assist a patient with managing his or her chronic pain? There is a consensus that using opioids for acute or severe cancer related pain can be useful and improve physical functioning and quality of life for over short periods of time. That’s something that cannot be denied. However, the use of opioid pain killers for non-cancer related pain for long-term relief has not proven to be efficacious in improving the patient’s overall functioning beyond short-term relief.  To extend the point, long-term use of opioid pain killers can result in the following:

  • Respiratory depression
  • Sedation
  • Constipation
  • Nausea
  • Inconsistent improvement in functioning
  • Opioid-induced hyperalgesia
  • Adverse hormonal and immune effects of long-term opioid treatment
  • A high incidence of prescription opioid abuse behaviors
  • An ill-defined and unclarified risk of iatrogenic addiction

On May 10, 2007, Purdue Frederick Company Inc., an affiliate of Purdue Pharma, along with 3 company executives, pled guilty to criminal charges of misbranding OxyContin by claiming that it was less addictive and less subject to abuse and diversion than other opioids, and will pay $634 million in fines. It’s interesting to see Purdue Pharma named in the Ohio lawsuit ten years later for similar allegations.

Can Fentanyl Be Useful?

Fentanyl was originally meant for cancer patients that were experiencing significant chronic pain that affected their lives enough to make it seem unlivable. The introduction of the fentanyl patch at least made their days more bearable and they were able to eat more regularly and have a higher quality of life. For cancer patients that are experiencing chronic pain, fentanyl patches have proven to be effective in certain case studies, suggesting controlled administration of the patch could be beneficial to a patient even if it is only for the last few weeks of his or her life. The introduction of the patch has eliminated the need to take several doses of opioids orally on a daily basis, which can have undesirable side effects.

Back to the Bad Side of Fentanyl

On June 1st, 2017 New York City issued an advisory for recreational drug users to be leery of purchasing cocaine. The advisory has been issued for good reason as New York City statistics show that 37% of overdose deaths in 2016 involved cocaine and fentanyl without heroin, which is up from 11% in 2015. That’s a sharp increase and it’s not just the addicts that are at risk anymore due to the strength of fentanyl. Don’t forget a police officer, who’s presumably drug tested on a regular basis, nearly died just from touching fentanyl let alone ingesting the drug. In cases where fentanyl labs have been busted the criminals have warned law enforcement of touching the powder without gloves due to the high potency of fentanyl. The occasional cocaine users, who won’t have a high tolerance for fentanyl, can die from one dose.

Buyer Beware

Fentanyl has become a hot alternative to heroin and other opioids because of the increased restrictions around opioid prescriptions therefore limiting its availability and creating a balloon effect.  A balloon effect often happens when enforcement agencies begin cracking down on one drug epidemic only to see a new one rise from the ashes just when they think they’re winning the war on drugs.

Just like drug companies saw an opportunity in states with chronic pain patients, drug dealers are constantly looking for new opportunities to market and sell their drugs, especially if they can make more money in the process and even make the drug themselves. The Drug Enforcement Agency reports that one kilogram of fentanyl can be purchased from China for $3,000 to $5,000 and sold on the black market for a profit of approximately $1.5 million dollars. The acting US attorney for the northern district of Ohio Cleveland, Carole Rendon, is quoted saying “we have seen an influx of fentanyl directly from China” and that “it’s being shipped by carrier. It’s hugely concerning because fentanyl is so incredibly deadly”.

As most of us know, the famous singer Prince died from a fentanyl overdose which was masked as counterfeit hydrocodone. That’s exactly what the state of Ohio and other states near Ohio are seeing. They are finding fentanyl in counterfeit pain killers and benzodiazepines (i.e. Xanax). There have been strings of reports over the last couple of years across the country that entail busting drug dealers selling counterfeit pain killers and benzodiazepines and home-based labs producing counterfeit drugs that contain fentanyl.

The Newest War on Drugs

Who do we target to stop the newest drug epidemic? China, Mexico, pharmaceutical companies, dealers, labs, users, politicians, employers of physically taxing jobs or physicians? There’s no clear answer of who or what the drug enforcement agencies, local law enforcement agencies, lawyers, substance abuse clinics, centers for disease control and prevention and food and drug administration officials should put in their crosshairs. What’s becoming clearer is that it actually isn’t crazy to say that it’s relieving when a drug bust only involves crack, cocaine or heroin.

With fentanyl essentially becoming an invisible killer due to its presence in recreational drugs that formerly didn’t have such a high death rates, the path to extinguishing or at least mitigating the epidemic remains unclear. Sure, some users knowingly purchase fentanyl because it possesses the most bang for the buck, being 50 to 100 times stronger than opioids. The irony of it all is that the chronic fentanyl and opioid users are actually at lower risk of death because of the tolerance they’ve created over time. At the end of the day, we know it’s an addiction problem that afflicts millions of Americans that should be addressed with comprehensive and longer-term treatment programs that involve behavioral and pharmacological interventions.

A researcher for Centers for Disease Control and Prevention sums up the current progress in stating, “We’re trying to get a better handle on how widespread it is and where it is”. We clearly have a long way to go and we should not let it overtake this country much like the opioid epidemic has for the last 20 years.


Addiction, The Threat That Needs to be Taken More Seriously

As a country we have seen a long period of growth and prosperity. The advances we have made in both technology and medicine have helped not only increase longevity of life, but also quality. As a result, we saw a decrease in deaths around the United States for many years; but as of late, the death toll has been rising dramatically each year.

It seems as though we are taking steps backwards instead of forwards. What is the cause of this sudden increase in death frequency? The answer is simpler than it seems: drugs. Opioids have started to tear through the country and are taking lives left and right; but are people taking this threat serious enough?


Addiction is a Disease

The first issue with our society is the fact that addicts are continuously looked at in a bad light. Addiction is “a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences”. The first step in acknowledging that there is a problem is to understand the problem itself. When you hear that someone is struggling with a disease the first thing you want to do is get them the help they need. Addicts need help. It is not a choice to suffer from addiction and it is very difficult to overcome.

People become addicted to drugs for many different reasons. There are those that never will; but because there are so many outside factors that influence addiction and dependency, it is important to understand what triggers them.


One of the most influential factors in addiction is genetics. Biological makeup can hold a great deal of influence over someone’s tendency towards addiction and recovery. Genes are passed down from our parents. We see this happen a lot with alcohol dependency. Children who have an alcoholic in their immediate family are 4 to 10 times more likely to become alcoholics than children who do not. The same idea applies to those with family members who have suffered from any type of addiction. It tends to be passed down, and the vulnerability to addiction becomes greater. Withdrawal symptoms and relapse probability can also increase due to genetic factors.


When a person suffers from addiction, so does their health. Those who start early in life can be greatly affected by this. When you think of puberty and growing up, physical growth is the first thing that pops into your head. Growing taller and developing according to your gender are typical facets of growing up. The ones that lies underneath the surface, however, are just as important; if not more so. The development of our brain can affect us the rest of our lives, which is why those who start drinking or doing drugs at a young age, even recreationally, are more likely to develop a dependency later in life. Also the prospect of messing with one’s brain development can be a very scary prospect. Your brain helps in your decision-making, judgment, and self-control.


The age old argument of nature verses nurture. People are starting to realize that it is a bit of both. Environment and our surroundings can influence our decision making. The “Just say no” to drugs campaign is a good example. As easy as that sounds, peer pressure makes it very difficult. I’m sure you have heard your mother say “if your friends jumped off a bridge, would you do it too?” This may seem simple enough but when you have all of your friends doing something and you don’t want to disappoint them it becomes very difficult to say no.

Stress can also have a great impact on your tendency to develop a drug dependency. School, economic factors, and quality of life can drive a person to use. Being a part of a generation that almost always needs a college degree to get a good job can be very stressful. Not only trying to keep a good grade point average, but also participating in extracurricular activities to get accepted into college. Once you have been accepted, the stress doesn’t end there. You need to do well in order to get a good job to pay off the debt from college if you didn’t receive a scholarship. It is an endless cycle that could get to anyone.

The Epidemic

The understanding of addiction can aid in acknowledgement that there is a problem. People are suffering from this disease which has led to epidemic proportions throughout the United States. Drug overdoses are now the leading cause of death for people under the age of 50. In 2016 alone, at least 59,000 people died from drug overdose; 33,000 of these due to opioid overdose. Deaths rose 19 percent from the previous year. Experts fully expect the problem to only get worse over the next year. With more and more data being compiled, we should find out for sure how many deaths occurred from overdose in 2016.

One of the main issues is that opioids are being overprescribed. In 2016 there were more than 236 million prescriptions written for opioids in the United States. That would supply every American adult with one bottle of opioids. The Center for Disease Control recommends that there be a 3 day limit for opioids if it can be helped. This is in order to avoid addiction. A study done by the National Safety Council found out that 99 percent of doctors surveyed were prescribing highly addictive opioids for longer than the recommended 3 days. Prescriptions for opioids have quadrupled since 1999. They are being prescribed at a higher rate than ever.

But why are doctors giving them out so lightly? There are those being handed out after surgery, for back pain, dental pain, and for helping patients through cancer treatment. The CDC recommends opioids be handed out for short periods of time, unless they are being prescribed for cancer, palliative and end-of-life care. This is not what is happening around the United States and it is part of a bigger issue. The National Safety Council survey found that 1 in 5 doctors prescribed opioids for 30 day periods on a regular basis. These are drugs that the American Academy of Neurology finds inappropriate.

Once doctors have given opioids to patients, they fail to recognize the signs that their patients need help. Only 38 percent of doctors surveyed said that they refer their patients to drug treatment. The doctors need to learn to recognize the signs of addiction and treat them if they are going to supply unnecessary opioids. Doctors need to be asking themselves if the benefits outweigh the risks. The longer you prescribe opioids, the higher the risk of addiction is.

We are using far more opioids than necessary. The United States accounts for only 5 percent of the world’s population. We are consuming at least 80 percent of opioids across the globe. The U.N. reported specifically that Americans consume more than 99 percent of the world’s supply of hydrocodone. If other countries are able to live without overprescribing opioids, the United States can make that adjustment as well.

Who is Helping?

While doctors need to adjust the way that they go about treating pain, there are other people who can make just as much of an impact. There are a lot of feelings circulating around the United States right now dealing with politics and how best to help our people. We need to figure out the best approach to curb this opioid epidemic.

One important step that has been taken was the creation of a commission.  The President’s Commission on Combating Drug Addiction and the Opioid Crisis was created to find some answers. Made up of people of different backgrounds and political beliefs, the commission was made to approach a problem that all Americans can agree on: the opioid crisis. The commission itself will not create measures or take action, but provide advice for a logical and effective approach to handle this crisis. They are set to publish their findings by October 1st, 2017. With their help we may be able to come up with a plan of action.

While the commission is a step in the right direction, there are many backwards steps being taken. The proposed health care bill would cut Medicare and Medicaid funding dramatically. These are programs that help provide healthcare to millions of Americans. By defunding these programs the government will be denying treatment to Americans struggling with addiction. The new health care bill is said to put up to 24 million Americans without health insurance. This is not the right way to fix our health care system and those who need help the most will not be able to get it.

The Best Approach

So how can we handle something that seems so great and so intimidating? There are several approaches to handling this enormous problem that plagues our country. Several people lean toward harsher punishments and more boarder security, while others want to focus on treatment and preventative measures. What is the right answer? There is none. Maybe the answer is everything. This issue has not been taken seriously enough.

A combination effort is the key. The first step should be to cut off the supply. By tightening boarder security we can insure that drugs aren’t crossing our boarders; especially from Mexico and other cartels down south. In addition to boarder security we need to make sure that punishments are being administered correctly and fairly. We need to strike a balance with being merciful and showing leniency to give people second chances. If people have nothing to look forward to in the future and their records are ruined than they will continue to make the same mistakes with nothing left to lose. By saving someone’s record and reputation, you may deter them from committing another crime.

The other element includes preventative measures. This starts with education. By educating adults and youth we can see a change. Youth should be learning about the side effects and longevity of issues that result from using drugs, especially opioids which are a large portion of deaths that occur each year for those under the age of 50. Adults may not think they need to learn about addiction and recovery but it is just as important for them as it is for the younger generation. By learning themselves, they can in turn educate their children and recognize signs of substance abuse.

Treatment and recovery are the most important steps in combatting drug abuse. Instead of sending someone to jail if the offense was not violent, we should look toward treatment; so that people can re-enter the world and contribute to society. Recovery is a long process and may be a continuous part of your life but it is of the utmost importance that we focus on rehabilitating our community and country.

Time to take it Seriously

As a whole, our country needs to realize just how big the problem is. The issue may seem like it has been addressed, but not enough of an effort is being made. Even if you think you are not in a community plagued with drug abuse, do everything you can to help make the country and your community a better place so that it does not spread further. More and more deaths are occurring each year from something that is very preventable. It is time we take a genuine stand against this epidemic.

If your or a loved one is struggling with addiction, don’t hesitate to call us. We are available 24/7 to take your call.