The document discusses the growing heroin addiction epidemic in the United States. It notes that prescription opioid misuse has led many Americans to turn to heroin and that overdose deaths have more than tripled since 2010. It provides information on prevention and treatment efforts, including expanding access to the overdose reversal drug naloxone and increasing medically-assisted treatment programs. The document also discusses Walgreens' efforts to install safe drug disposal kiosks and make naloxone available without a prescription to help address the crisis.

1. Heroin Addiction
JUNE 2016 | FUTUREOFPERSONALHEALTH.COM | An Independent Supplement by Mediaplanet to USA Today
Michael Botticelli,
our nation’s Drug
Czar, discusses the
measures being
taken by the Obama
administration to
combat a growing
public health crisis.
DISCOVER
how our kids went
from pills to heroin
EXPLORE
the epidemic known
as ‘Pharmageddon’

2. Containing Damage
Syringe exchange
programs—what are they,
and why is access to
sterile syringes an uphill
battle? Page 10
2 | FUTUREOFPERSONALHEALTH.COM | IN THIS ISSUE MEDIAPLANET
A Multi-Pronged Solution
to the Heroin Epidemic
As an emergency room doctor, I’ve seen the impact of opioid addiction firsthand. I also know
that the opioid overdose epidemic requires our urgent and continued action.
Shared Experience
A recovering addict lists
key lessons learned
about rehabilitation since
becoming a health care
professional. Page 20
The Whole Patient
Medically-assisted treat-
ment is key to compre-
hensive care. But, with
addiction, we must treat
the whole person. Online
I
t’s likely we all have a
friend,neighbor or family
memberwhoisstruggling
with addiction to pre-
scriptionopioidsorheroin
or who has overdosed on drugs.
Rising statistics
From 2000 to 2014, nearly half a
million Americans died from drug
overdoses. A significant portion
of those deaths involved heroin.
Heroin overdoses have more than
tripled since 2010, killing more
than 10,500 people in 2014.
Heroin use has increased signifi-
cantly across most demographic
groups. Some of the greatest
increases have occurred among
populations with historically
low rates of heroin use, including
women, the privately insured and
people with higher incomes.
Looking for underlying causes,
we’ve found that the wide avail-
ability, low price and increased
purity of heroin in the U.S. might
be contributing to the rising rates
of heroin use.Another known con-
tributing factor is the increased
prescribing of opioids, which has
quadrupled in the past 15 years.
Long-term opioid use has serious
risks including misuse and addic-
tionandamajorityofrecentheroin
users report non-medical use of
prescription opioids before starting
to use heroin.
A blueprint for progress
Improving prescribing practices is
one way to help reduce exposure
to opioids and prevent abuse. CDC
developed the Guideline for Pre-
scribingOpioidsforChronicPainto
help doctors make informed deci-
sions about prescribing opioids and
to work together with patients to
assessthebenefits,risksandpoten-
tialharmsofthesedrugs.We’vealso
developed educational materials to
helppatientsanddoctorstalkabout
the risks of opioids.
Reducing heroin-related addic-
tionandoverdosealsorequirespub-
lic health departments, emergency
medicalservices,lawenforcement,
the medical community and oth-
ers to work together. In addition
to changing opioid prescribing
behaviors,we must increase access
to medication-assisted treatment
(MAT) for people with opioid addic-
tion, combining the use of medica-
tions with counseling and behav-
ioraltherapies,tohelpturnthetide
on this crisis.
We also must expand the use of
naloxone, a life-saving drug that,
when given in time, can reverse
the effects of a prescription opioid
or heroin overdose. Improving
prescribing, helping to provide
access to evidence-based treat-
ment like MAT and reducing the
number of people who become
dependent on opioids are all
important steps we are taking to
combat the opioid epidemic. n
Publisher Lane Wollerton Business Developer Jourdan Snyder Managing Director Luciana Olson Content and Production Manager Chad Hensley Senior Designer Kathleen Edison Designer Marie Coons Copy Editor Sean Ryan
Production Coordinator Tiffany Kim Contributors Faye Brookman, Melinda Carstensen, Kristen Castillo, Jennifer DeMeritt, Deb Houry, Jake Nichols, Steven Stack, Sharon Stancliff, Tison Thomas, Megan Troise, Becky
Vaughn, Marvin Ventrell, Howard Wetsman Cover Photo Tom Fearney All photos are credited to Getty Images unless otherwise credited. This section was created by Mediaplanet and did not involve USA Today.
EMAIL CONTENT INQUIRES TO EDITORIAL@MEDIAPLANET.COM PLEASE RECYCLE AFTER READINGKEEP YOUR FEED FRESH. FOLLOW US @MEDIAPLANETUSA
• Find treatment
facilities and programs
for mental and
substance use disorders
at findtreatment.
samhsa.gov
• Find physicians
authorized to treat opioid
dependency at bit.ly/
bupe_treatment
• Find treatment programs
in your state for addiction
and dependence on
opioids at dpt2.samhsa.
gov/treatment
• Get free, confidential
treatment referrals and
other information by
calling 1-800-662-HELP
(4357)
• Learn how you can help
prevent opioid abuse
at ama-assn.org/go/
endopioidabuse
RESOURCES
Deb Houry
M.D., MPH,
National Center
for Injury
Prevention and
Control, CDC

3. • Addiction is a disease
• Treatment works
• Seek help today and reclaim your life
Patient and family information on substance use disorder at psychiatry.org/addiction
DON’T LET THESE...
...BE YOUR DYING WORDS.
“
”
My doctor prescribed it, so it must be safe.
I just use pills to ease my pain.
I can stop whenever I want to.
I won’t ever use ‘real’ drugs.
It’s just this one time.
Heroin won’t kill me.

4. 4 | FUTUREOFPERSONALHEALTH.COM | BY THE NUMBERS
Patientsdeserve effectivetreatment
for substanceusedisorders.
Pew works to reduce prescription drug misuse and expand access
to effective treatment services.
Learn more atpewtrusts.org/SubstanceMisuse
9 Things You Need
to Know About Opioid
Abuse Today
From the seeds of addiction to the
useful, preventative measures any-
one can take at home, the landscape
of America’s opioid crisis holds plen-
ty more than you might expect.
Here’s what you need to know about the
heroin crisis unfolding here at home.
1Hard numbers.Heroin is less prev-
alent. The number of heroin users
in the United States is still relatively
small: about 3 out of every 1,000 people,
or 900,000 people total.
2The bigger threat. Prescription
drug misuse is much more com-
mon. In 2014, 15 million Amer-
icans aged 12 or older reported using
prescription drugs non-medically in the
past year.This includes misuse of opioid
pain medication.
3More to misuse. The sale of opioid
pain medication nearly quadrupled
from 1999 to 2010,as did the number
of opioid overdose deaths.
4Collateral damage. Other nega-
tive outcomes that can result from
prescription drug misuse and abuse
include falls and fractures in older adults
and, for some, starting to use injection
drugs, with resulting risk for infections
such as hepatitis C and HIV.
5Tolerance yields higher risk.
While many people benefit from
using these medications to manage
pain, prescription drugs are frequently
diverted for improper use. As people
use opioids repeatedly, their tolerance
increases and they may not be able to
maintain the source for the drugs. This
can cause them to turn to the black mar-
ket for these drugs and even switch from
prescription drugs to cheaper and more risky
substitutes, like heroin.
6The slippery slope. According to a
2014 survey by the Substance Abuse
and Mental Health Services Adminis-
tration, 12.7 percent of new illicit drug users
beganwith prescription pain relievers.
7Rules of thumb. If you take prescrip-
tion medication, keep yourself safe:
• Alwaysfollowtheprescribeddirections.
• Be aware of potential interactions with
other drugs.
• Never stop or change a dosing regimen
without first discussing it with a health care
provider.
• Always tell your health care provider about
all the prescriptions, over-the-counter med-
icines and dietary and herbal supplements
you are taking.
• Never use another person’s prescription.
8Warning signs. Parents should discuss
the risks of misusing or abusing pre-
scription drugs with their children and
be familiar with the warning signs, such as
missingprescriptiondrugs,changesinfriends,
increased secrecy, changes in school perfor-
mance and frequent borrowing of money.
9Take-back time. Each year, the Drug
Enforcement Administration holds a
National Take-Back Day. During Take-
Back day, you can anonymously and safely
discardyourunusedandexpiredmedicationat
sites around the county at no cost. n
SOURCE: THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

5. NEWS | MEDIAPLANET | 5
A
s opioid abuse and
heroin use has
reached epidemic
heights in the
United States, local
treatment centers
and law enforcement agencies
have banded together to suppress
the outbreak of deaths, which,
according to government data,
now outnumber car accidents.
Putting up barriers
Deerfield,Illinois-basedWalgreens,
which has 8,200 stores nationwide,
is joining that fight by making it
easiertodisposeofunwantedmedi-
cationbyinstallingsafemedication
disposal kiosks in 500 of its stores
and working with state regulators
tomaketheanti-overdosedrugnal-
oxone available without requiring
a prescription.
“We want to fight the misuse of
drugswithatwo-prongapproach,”
says Walgreens President of Phar-
macy and Retail Operations Rich-
ard Ashworth. “Safe medication
disposal is something that’s for all
of us—whether you’re taking pen-
icillin or an allergy medication, all
the way up to opioids. Secondly,
naloxone gets to that population
that’s more at risk for overdose.”
The need for action
According to the Centers for Dis-
easeControlandPrevention(CDC),
opioid overdose deaths hit record
highs in 2014, increasing by 14 per-
cent in just one year.The epidemic
has hit rural and urban parts of
the U.S., and has become a driving
factor for lower life expectancies
among white men and women,
recent reports suggest.
As about half a million Ameri-
cans died of an overdose between
2000 and 2014, the White House
has taken notice. President Barack
Obama recently proposed $1.1
billion to help arm affected states
with more resources to increase
substance abuse counseling, train
doctors and expand access to
drugs like naloxone, which health
officials say can save lives.
“Naloxone is available in
emergency rooms and it’s in
first responders’ kits,” Ashworth
explains, “but these are situa-
tions where seconds count. If you
or a relative is going through an
overdose and you need naloxone,
you could potentially reverse the
effects of the overdose and give
that person a chance to live.”
Access to naloxone
In Walgreens stores, naloxone is
available either with a prescrip-
tion or, if allowed and in accor-
dance with state pharmacy regu-
lations,without a prescription. So
far, the drug is available without
a prescription at more than 1,500
Walgreens pharmacies through-
out the country.
“By the end of the year, we
expect to have naloxone available
without a prescription in about
5,800 of our 8,200 stores,” Ash-
worth says. “In states where cur-
rent regulations don’t allow us to
make it available without a pre-
scription, we want to work with
regulators to make that happen.”
Naloxone’s effectiveness, when
usedineitheritsinhaledorinjected
form,has been proven by data from
the National Institutes of Health,
which describes the anti-overdose
drug as “a potential lifesaver.”
Safe drug disposal
So far, Walgreens has rolled out
safe medication disposal kiosks in
50 California locations, as part of a
nationwide effort that’s expected
to be completed at more than 500
Walgreens locations later thisyear.
The kiosks at Walgreens phar-
macies will be available during
regular pharmacy hours (mostly
at 24-hour locations) and will of-
fer one of the best ways to ensure
medications are not accidentally
used or intentionally misused by
someone else.With this approach,
Walgreens hopes to further reduce
overdose deaths.
“Because of possible environ-
mental effects, discarding certain
medicationinthetrashorflushing
it down the toilet is not always the
right way to dispose of it,” Ash-
worth states. “We’re a pharmacy—
we’re here to help.”
Future of drug disposal
Chuck Rosenberg, administrator
of the Drug EnforcementAdminis-
tration, has supported Walgreens’
newdrug take-back kiosks.
“Take-back programs are an
important and easy way for the
public to anonymously dispose
of their unwanted, unused or
expired medications, and today’s
announcement is a step in the
right direction,” Rosenberg said
in a Feb. 9, 2016 statement follow-
ing an early announcement of
Walgreens’ initiative. “We look
forward to the day when safe drug
disposal options are commonplace
and I hope this action inspires
otherstocreate similar programs.”
For Ashworth, Walgreens’ deci-
sion to join this fight comes down
to one simple goal: saving lives.
He adds that the testimonials he
has received suggest the effort is
making a difference. “I get emails
and phone calls all the time from
patientsthankingus,”hesays.“Peo-
ple are really grateful for this.” n
SPONSORED
How Your Pharmacy Pushes Back
Against the Opioid Epidemic
With opioid addiction on a not-so-silent rise, there’s a new sense of urgency to launch efforts that can safely
manage prescription medication abuse across America’s pharmacies.
By Melinda Carstensen

6. 6 | FUTUREOFPERSONALHEALTH.COM | NEWS MEDIAPLANET
Recasting Public
Assumptions About
Medication Abuse
Life-Saving Treatment
for Opioid Addiction
Gains Bipartisan Support
By Megan Troise
how our country sees addiction—not as
a moral failing, but a chronic illness that
must be treated with skill, urgency and
compassion.”
The threat of opioids
Murthy has made it a priority to reach out
toeverymedicalprofessionaltoemphasize
theriskofopioids.“Someofusweretaught
incorrectly that opioidswere not addictive
whenprescribedforlegitimatepain,”Mur-
thy explains. “But we can transform pre-
scribingpracticestoensurewearetreating
pain effectively and safely.”
His efforts focus on bringing attention
to substance abuse as a whole.With hero-
in-relateddeathshavingmorethantripled
since 2010,Murthy is shining a light on an
epidemic that needs to be addressed.
Medication-assisted treatments
While traveling the country,he visited the
Man AliveTreatment Center in Baltimore,
which provides comprehensive, inno-
vative solutions through medication-as-
sisted treatments, art therapy, group and
individual counseling, and careful and
compassionate case management.
Murthydescribesthevisitasahumbling
experience. “One story I will never forget
came from a gentleman who has been
receiving treatment at the center for more
than40years,”Murthyshares.“Hesaidhad
it not been for the treatment he received
there, he would be another statistic.
“I was touched by the dedication of the
staff and patients,the inspirational stories
of healing through art therapy and the
strong sense of community.” n
Vivek Murthy is a prominent voice, amplifying the state of our drug dependency
crisis. But he’s also speaking up about what we can do about it.
FYI
Whether it’s heroin or
prescription pain meds, opioid
addiction is on the rise. Here’s
what the government is doing
to fight it.
IntheUnitedStates,heroin-related
deathsincreasedby39percentbetween
2012and2013,and37percentofoverdose
deathsin2013involvedprescription
opioids.HHSSecretarySylviaBurwell
states,“Approximately2.2millionpeople
needtreatmentforopioidaddiction,but
fewerthan1millionarereceivingit.”
What is the answer?
SecretaryBurwell(whogrewupinWest
Virginia,“wheretheepidemicisraging”)
isonamissiontoclosethistreatment
gap.Underherleadership,HHSis
requesting$1.1billiontotreatopioid
addiction—upfrom$100million.
Thevastmajorityofthisfundingwill
gotomedication-assistedtreatment
(MAT),whichtakesamulti-faceted
approach.Patientsreceivethedrug
buprenorphine,whichallowsthem
tostoptakingopioidswithoutthe
wrenchingphysicalsymptomsof“cold
turkey”withdrawal. Theyalsoreceive
supporttoaddressthebehavioral,
economicandmentalhealthissuesthat
canleadtoaddiction.
Funding access to tools
HHShasalreadygranted$94millionto
communityhealthcenterstoexpand
accesstoMAT;theagencyalsowants
toallowcertifieddoctorstoprescribe
Buprenorphinetomorepatients,and
toincreasetheuseofnaloxone,which
preventsdeathfromaccidentaloverdose.
Burwellbelievesthatnowistheright
timetodramaticallyincreasefunding
becauseMATisofferingnewhopeto
addictsandtheirfamilies.Shealsonotes
therecentsurgeinbipartisansupportfor
treatment:“Thereisaconsensusonthe
stepsweneedtotakeasanation,”says
Burwell.“That’swhyI’moptimisticwe
canmakeprogress.”
By Jennifer DeMeritt
S
urgeon General Vivek Mur-
thy is on a mission, one that
involves asking everyone in
this country to think differ-
ently about drug addiction.
How many are affected?
Today, at least half of overdose opioid
deaths involve a prescription, prompting
Murthy to spread the message that we
need to reexamine how painkillers are
being used as treatment.
“Everywhere I go, I find families and
communitiestouchedbytheopioidcrisis.
Like many clinicians, I’ve seen first-hand
the devastating impact that substance
use disorders and addiction have on our
patients, their families and our commu-
nities,” he states. “We have to change
PHOTO:ANNS.KIM/OFFICEOFTHESURGEONGENERAL,HHS

7. INDICATION
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8. MEDICATION GUIDE
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9. MEDIAPLANET FACTS & FIGURES | FUTUREOFPERSONALHEALTH.COM | 9
1. Katie suffers an injury that
requires surgery.Throughout the
healing process,she is prescribed
painkillers.
2. After a few months of taking
the painkillers, Katie notices that
they don’t work as well or last as
long. She begins taking more pills
than prescribed.
3. Katie quickly runs out of her
Rx—and feels like she needs it. She
begins stealing pills from afriend’s
medicine cabinet. She learns that
crushing and snorting the pills
can help her feel better, faster.
4. Katie’s parents notice that
she is behaving strangely—and
that she has a new set of friends.
When they find a baggie of
loose pills in her room, they be-
come concerned and confront
her. Katie denies that she has
a problem.
5. Katie asks her doctor for more
painkillers, bur he refuses. She
can’t find enough pills and be-
gins to suffer from withdrawal.
Her friend Jacob says he has her-
oin (also an opioid), but no pain-
killers. Katie never thought she
The Road from Rx to HeroinAbout half of young users arrived at heroin as the result of an unsustainable addiction to prescription
(Rx) pain medicine. Katie’s journey doesn’t represent every person’s opioid addiction, but it does constitute
an all-too-common story.
would use heroin, but feels des-
perate to stop the horrible with-
drawal symptoms. She starts
snorting heroin.
6. Katie’s tolerance is very high
and she cannot afford the amount
she needs to keep away the pow-
erful cravings. Jacob says she can
use less heroin if she injects it.
She is afraid of needles, but Jacob
offers to inject the heroin for her.
She agrees. After a few hours Ja-
cob notices that Katie is breath-
ing very slowly and is turning
blue. He calls 911 and leaves her.
7. The paramedics find Katie
and administer naloxone, which
reverses the effects of the heroin
overdose. Katie is watched close-
ly at the hospital. Soon after, her
parents enroll her in an adoles-
cent recovery program, which in
this case, includes medication-as-
sisted treatment, counseling and
support.
8. Post-treatment, Katie’s family
is committed to continuing her
care to keep her healthy.
9. Katie is in recovery and work-
ing hard to stay sober. n
BY THE NUMBERS
Medication-assisted treatment is the use of medication, therapy and support to address
withdrawal, cravings and relapse prevention. Most people who get into and remain in
treatment stop using drugs. With ongoing recovery support, it is possible to lead a healthy,
productive life after addiction.
1 in 4 teens reports
having abused or
misused an Rx drug at
least once in their lifetime.
1IN 4 2 out of 3 teens who
abuse Rx pain relievers
say that they got them
from family or friends.
2/3Prescription drugs
are now the most
commonly-used drugs
among 12-13 year olds.
12-13
95% of parents believe
their child has never
taken a prescription drug
for a reason other than its
intended use.
95% Nearly half of young
people who inject
heroin start by
abusing Rx drugs.
1/24 out of 5 heroin
users began first with
recreational use of Rx
pain relievers.
4OUT OF 5
SOURCE: THE PARTNERSHIP FOR DRUG-FREE KIDS

10. 10 | FUTUREOFPERSONALHEALTH.COM | NEWS
DOCTOR’S ORDERS
How Physicians Can
Change America’s
Prescription Problem
I
n small towns and big cities
across America, thousands
of our friends, neighbors,
colleagues and children are
suffering and dying from
opioid misuse, overdose and the
consequences of opioid addiction.
Who can help?
America’s physicians are engaged
in solving the problem and commit-
ted to turning the tide. Physicians,
regulators, lawmakers, payors and
patient advocates all must work
toward a common goal of reducing
harm and improving care. Physicians
are recommitting to the highest level
of patient care that is compassionate
but mindful of the risks of prescrip-
tion opioids.
Responsibleprescribing
The AMA issued a direct call to action
to every physician to: learn more
about responsible prescribing prac-
tices and management options for
pain; register for and use their state’s
prescription drug monitoring pro-
gram; recognize and work to reduce
the stigma commonly experienced
by patients with chronic pain and
substance use disorders, and improve
access to treatment.
As physicians, we also need to
co-prescribe naloxone when it is nec-
essary for the safety of our patients to
prevent opioid overdoses.
Taking action
Your physician will provide an hon-
est and personalized assessment of
your condition and acknowledge
your pain. He or she will accept your
disclosure of pain as valid and ensure
your treatment plan balances the
benefits and risks of options, possi-
bly including prescription opioids, if
they are necessary.
America’s physicians also are advo-
cating for increased availability and
coverageofmedication-assistedtreat-
ments for addiction to treat those in
need. The promise of high-quality
health care calls physicians to treat
pain, protect health and save lives.
And we must lead that response. n
Manystudieshaveshownthatsyringeexchange
programsprovideapathtodrugtreatment,
healthcareandsocialservices.Nostudyhasever
foundthatsyringeexchangeincreasesdruguse.
In the early 1990’s I was a new physician trying to
treat patients dying of AIDS contracted through
shared syringes. But in those days there was no effec-
tive treatment.
A shelter for those in need
One Saturday Ivisited a then-illegal syringe exchange
program (SEP) and found that I might save more lives
volunteering on street corners than in my clinic.
Trust developed betweenvolunteers and syringe
exchange participants,many ofwhomwere homeless
and felt too stigmatized to go to standard facilities
alone,asked for more assistance.Sowe offered infor-
mation and referrals to agencies that might make
them feelwelcome,including my own clinic.
Charting progress
In 2014 NewYork State embarked on a campaign to
endAIDS.Thiswould be impossible if the state did not
support SEPs,beginning in 1992.At that time,over
50 percent of the new cases of HIV/AIDSwere among
peoplewho inject drugs.In 2010 itwas 3 percent.
Syringe exchange has been shown to be one of the
most cost effective means to prevent HIV.If the rest
of the country is to eliminate HIV,we must take these
lessons to heart.HIV can still sweep through a popu-
lation manyyears after syringe exchangeswere first
supported in some states.
A real need for help
Austin,Indiana bearswitness to this; in 2015 a town of
4,200 found that nearly 200 peoplewhowere injecting
opioidswere recently infected by HIV spread through
shared syringes.This tragedywas preventable.
Access to sterile syringes is vital; they should also
be easily available in pharmacies. However, SEPs
provide so much more.Well-funded programs are
able to provide health care and drug treatment on
site to individuals who feel stigmatized in other
facilities.The provision of naloxone to individuals at
risk of experiencing an overdose originated at syringe
exchange programs.
Access to this lifesaving medication,which prevents
opioid overdoses from becoming fatal,has swept the
nation.Provision of sterile syringes and other services
for peoplewho inject drugs must aswell.
What Our Response to HIV Can
Teach Us About Opioid Abuse
By Sharon Stancliff, Medical Director, Harm
Reduction Coalition, New York
We are in the midst of one of the most urgent yet complex public health issues
of our time. Addressing it requires an ambitious, comprehensive response.
Steven J. Stack
M.D., President, American
Medical Association

11. At Caron, we know you’re struggling with your loved one’s
addiction too. That’s why we treat the whole family. Our
comprehensive and innovative heroin and opioid treatment
programs address chronic pain, as well as co-occurring
disorders. So when you have given all you have to give, let
Caron take it from here. Reach out to us, and we’ll help you
take the next step. caron.org/letgo
COMPREHENSIVE
ADDICTION TREATMENT
First, heroin
affects the addict.
Then, it affects
the family.
What Treatment for Heroin
Addiction Really Looks Like
For most Americans with heroin addiction, the path to recovery doesn’t go through expensive
private rehab but through community-based facilities, at a much lower cost.
L
ike other chronic
diseases, enough
high-risk behaviors
and causes can lead
anyone to addiction.
Katilyn M. started using drugs as a
teen, to escape the trauma of rape.
Arthur A. began taking his wife’s
painkillers to help raise newborn
twins.BriannaW.pickeduphersis-
ter’s drug and alcohol use at age 13.
Finding a path to detox
They are different stories, and
yet similar. Use escalates to more
and different types of drugs. They
may or may not seek treatment.
Perhaps no one tries to inter-
vene. Once criminal justice gets
involved,they go to jail and maybe
get treatment or monitored
on probation.
Treatmentvariesfrompersonto
person,butoftenstartswithdetox
(possibly mandated by court) fol-
lowed by inpatient or outpatient
care that includes individual and
group counseling sessions. Most
programs will test individuals for
drugs in their system. Some peo-
ple use medication to assist with
their treatment. Over time, the
frequency of sessions lessens and
the person moves to an after care
plan that may include attending
support groups like narcotics
anonymous (NA).
Finding help is a challenge
Like other chronic diseases,heroin
addiction treatment isn’t easy and
recovery isn’t quick. Many people
refer to their treatment as a fight.
What makes the difference in
getting to recovery? For Vanessa
in Florida, it was feeling ready to
accept treatment. For Jessica C. in
New Hampshire, it is being able
to be honest with her counselor
and keep a daily routine. Shon T.
in Missouri credits a strong sup-
port network. Kaitlyn M. faced
her own mortality when her best
friend died of an overdose. Bri-
anna needed structure. Arthur A.
noted a strong desire to get better,
driven by his kids taking notice of
problems related to his addiction.
Many credit the option of hav-
ing medication as part of their
treatmenttohelpreducecravings.
The problem?Alimited number of
prescribers have been willing or
able to step up and help commu-
nity-based providers with this
important service. Medication
isn’t for everyone, but how many
morepeoplecouldbeinrecoveryif
they had access to this additional
treatment tool? n
INSIGHT | MEDIAPLANET | 11
By Becky Vaughn, Vice President,
Addictions, National Council for
Behavioral Health

12. VIVITROL.COMALKERMES and VIVITROL are registered trademarks of Alkermes, Inc. ©2016 Alkermes, Inc. All rights reserved.
VIV-002428 Printed in U.S.A. | vivitrol.com
What is the most important information I should know about VIVITROL?
The most important risks of VIVITROL treatment are:
1. Risk of opioid overdose.
You can accidentally overdose in two ways.
• VIVITROL blocks the effects of opioids, such as heroin or opioid pain medicines.
Do not try to overcome this blocking effect by taking large amounts of opioids – this
can lead to serious injury, coma, or death.
• During treatment with VIVITROL and after you stop taking VIVITROL, you may be
more sensitive to the effects of lower amounts of opioids than you used to take:
• after you have gone through detoxification
• when your next VIVITROL dose is due
• if you miss a dose of VIVITROL
• after you stop VIVITROL treatment
Tell your family and the people closest to you of this increased sensitivity to opioids
and the risk of overdose.
2. Severe reactions at the site of injection. Some people on VIVITROL have
had severe injection site reactions, including tissue death. Some of these reactions
have required surgery. Call your healthcare provider right away if you notice any of
the following at any of your injection sites: intense pain, the area feels hard, large area
of swelling, lumps, blisters, an open wound, and or a dark scab. Tell your healthcare
provider about any reaction at an injection site that concerns you, gets worse over time,
or does not get better within two weeks.
3. Sudden opioid withdrawal. To avoid sudden opioid withdrawal, you must stop
taking any type of opioid, including street drugs; prescription pain medicines; cough,
cold, or diarrhea medicines that contain opioids; or opioid-dependence treatments,
including buprenorphine or methadone, for at least 7 to 14 days before starting
VIVITROL. If your doctor decides that you don’t need to complete detox first, he or she
may give you VIVITROL in a medical facility that can treat sudden opioid withdrawal.
Sudden opioid withdrawal can be severe and may require hospitalization.
4. Liver damage or hepatitis. Naltrexone, the active ingredient in VIVITROL, can
cause liver damage or hepatitis. Tell your healthcare provider if you have any of these
symptoms during treatment with VIVITROL:
• stomach area pain lasting more than a few days
• dark urine
• yellowing of the whites of your eyes
• tiredness
Your healthcare provider may need to stop treating you with VIVITROL if you get signs
or symptoms of a serious liver problem.
IMPORTANT FACTS
What is VIVITROL?
VIVITROL is a prescription injectable medicine used to:
• treat alcohol dependence. You should stop drinking before starting VIVITROL.
• prevent relapse to opioid dependence, after opioid detoxification. You must stop taking
opioids before you start receiving VIVITROL.
To be effective, VIVITROL must be used with other alcohol or drug recovery programs
such as counseling. VIVITROL may not work for everyone.
It is not known if VIVITROL is safe and effective in children.
Who should not receive VIVITROL?
Do not receive VIVITROL if you:
• are using or have a physical dependence on opioid-containing medicines or opioid street
drugs, such as heroin. To test for a physical dependence on opioid-containing medicines
or street drugs, your healthcare provider may give you a small injection of a medicine
called naloxone. This is called a naloxone challenge test. If you get symptoms of opioid
withdrawal after the naloxone challenge test, do not start treatment with VIVITROL
at that time. Your healthcare provider may repeat the test after you have stopped using
opioids to see whether it is safe to start VIVITROL.
• are having opioid withdrawal symptoms. Opioid withdrawal symptoms may happen
when you have been taking opioid-containing medicines or opioid street drugs
regularly and then stop.
This is only a summary of the most important information about VIVITROL.
Need more information?
• Ask your healthcare provider or pharmacist.
• Read the Medication Guide, which is available at vivitrol.com and by calling
1-800-848-4876, Option #1.
This brief summary is based on the VIVITROL Medication Guide (Version July 2013).
Symptoms of opioid withdrawal may include: anxiety, sleeplessness, yawning,
fever, sweating, teary eyes, runny nose, goose bumps, shakiness, hot or cold
flushes, muscle aches, muscle twitches, restlessness, nausea and vomiting,
diarrhea, or stomach cramps.
• are allergic to naltrexone or any of the ingredients in VIVITROL or the liquid used
to mix VIVITROL (diluent). See the medication guide for the full list of ingredients.
What should I tell my healthcare provider before receiving VIVITROL?
Before you receive VIVITROL, tell your healthcare providers if you:
• have liver problems, use or abuse street (illegal) drugs, have hemophilia or other
bleeding problems, have kidney problems, or have any other medical conditions.
• are pregnant or plan to become pregnant. It is not known if VIVITROL will harm
your unborn baby.
• are breastfeeding. It is not known if VIVITROL passes into your milk, andif it
can harm your baby. Naltrexone, the active ingredient in VIVITROL, is the same
active ingredient in tablets taken by mouth that contain naltrexone. Naltrexone
from tablets passes into breast milk. Talk to your healthcare provider about
whether you will breastfeed or take VIVITROL. You should not do both.
Tell your healthcare provider about all the medicines you take, including
prescription and non-prescription medicines, vitamins, and herbal supplements.
Especially tell your healthcare provider if you take any opioid-containing medicines
for pain, cough or colds, or diarrhea.
What are other possible serious side effects of VIVITROL?
VIVITROL can cause:
Depressed mood. Sometimes this leads to suicide, or suicidal thoughts, and
suicidal behavior. Tell your family members and people closest to you that you are
taking VIVITROL.
Pneumonia. Some people receiving VIVITROL treatment have had a type of
pneumonia that is caused by an allergic reaction. If this happens to you, you may
need to be treated in the hospital.
Serious allergic reactions. Serious allergic reactions can happen during or
soon after an injection of VIVITROL. Tell your healthcare provider or get medical
help right away if you have any of these symptoms:
• skin rash
• chest pain
• trouble breathing
or wheezing
• swelling of
your face, eyes,
mouth, or tongue
• feeling dizzy or
faint
Common side effects of VIVITROL may include:
• nausea
• sleepiness
• headache
• dizziness
• vomiting
• painful joints
• decreased
appetite
• muscle cramps
• cold symptoms
• trouble sleeping
• toothache
Tell your healthcare provider if you have any side effect that bothers you or that
does not go away. These are not all the side effects of VIVITROL. You may report
side effects to FDA at 1-800-FDA-1088.
DISCOVER A
NON-ADDICTIVE
TREATMENT OPTION.
VIVITROL®
is the first and only once-monthly non-addictive
treatment option proven to help prevent relapse to opioid
dependence when combined with counseling.
To be effective, VIVITROL must be used with other
drug recovery programs such as counseling.
Before starting VIVITROL, you must be opioid-free for a
minimum of 7-14 days to avoid sudden opioid withdrawal.
Ask your doctor and learn more at VIVITROL.com.
PLEASE SEE IMPORTANT FACTS ON FACING PAGE,
INCLUDING WHO SHOULD NOT TAKE VIVITROL.

13. I
n exclusive one-on-one, Bot-
ticelli shares his wealth of per-
spective on heroin and opioid
abuse, and answers how we’re
responding to addiction in
America at every level.
Discusstheoriginsofthisepidemic,and
howithasevolvedfromprescription
painmedicationtoheroinaddiction.
Since the late 1990s, we’ve seen a greater
emphasis on pain management in health
care. Prescription opioid pain medications
became an overused tool and as a result
the rates of overdose and opioid use disor-
ders increased. We know that the majority
of people who misuse prescription drugs
obtain them from family or friends. And
while most people who misuse opioid pain
medications don’t move on to use heroin,
4 out of 5 new, recent heroin users started
with prescription opioids before turning to
heroin.As a result,opioid-involved overdose
deaths tripled between 1999 and 2014.
This is a serious crisis touching every cor-
nerofthecountry,bothintermsofthenum-
ber of lives lost and the impact on our public
health and law enforcement resources.
Whyisitsoimportanttoensureeasy
accesstonaloxone?
Because overdose deaths are increasing
and we must save lives—naloxone can
reverse an overdose. In 2014, more than
28,000 people died from drug overdoses
that involved opioids. If they all had access
to naloxone, and their lives were saved
and they were referred to treatment, we’d
be talking about recovery success stories
instead of overdose deaths.
So our work becomes making sure
that naloxone is widely available. First
responders in many communities acrossPHOTO:TOMFEARNEY
Michael Botticelli holds a unique position. The director of the White House Office of National Drug Control Policy,
commonly called the drug czar, he is the first such official who also happens to himself be in long-term recovery
from a substance abuse disorder.
Tracking
Addiction and
Rehabilitation
in America
14 | FUTUREOFPERSONALHEALTH.COM | INSPIRATION MEDIAPLANET
CONTINUED ON PAGE 16

14. What is NARCAN®
Nasal Spray?
NARCAN®
Nasal Spray contains an ingredient, Naloxone Hydrochloride which is a prescription medicine used
for the treatment of an opioid emergency, or a possible opioid overdose with signs of breathing problems and
severe sleepiness or not being able to respond in adults and children.
• NARCAN®
Nasal Spray is to be given right away by a caregiver and does not take the place of emergency
medical care
• *HW HPHUJHQF PHGLFDO KHOS ULJKW DZD DIWHU WKH ÀUVW GRVH RI 1$5&$1®
Nasal Spray, even if the person
wakes up.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about NARCAN®
Nasal Spray?
NARCAN®
Nasal Spray is used to temporarily reverse the effects of opioid medicines.
The medicine in NARCAN®
Nasal Spray has no effect in people who are not taking opioid medicines.
Always carry NARCAN®
Nasal Spray with you in case of an opioid emergency.
1. Use NARCAN®
Nasal Spray right away if you or your caregiver think signs or symptoms of an opioid
emergency are present because an opioid emergency can cause severe injury or death.
Signs and symptoms of an opioid emergency may include:
• unusual sleepiness and you are not able to awaken
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• breathing problems including slow or shallow breathing
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2. Family members, caregivers, or other people who may have to use NARCAN®
Nasal Spray in an opioid
emergency should know where NARCAN®
Nasal Spray is stored and how to give NARCAN®
Nasal Spray
before an opioid emergency happens.
*HW HPHUJHQF PHGLFDO KHOS ULJKW DZD DIWHU XVLQJ WKH ÀUVW GRVH RI 1$5&$1®
Nasal Spray, because the effects
of NARCAN®
are temporary. The effects of the overdose can return in several minutes, after the NARCAN®
has
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medical help.
4. The signs and symptoms of an opioid emergency can return within several minutes after
NARCAN®
Nasal Spray is given. If this happens, give an additional dose using a new NARCAN®
Nasal
Spray every 2 to 3 minutes and continue to closely watch the person until emergency help is received.
Who should not use NARCAN®
Nasal Spray?
Do not use NARCAN®
Nasal Spray if you are allergic to naloxone hydrochloride or any of the ingredients
in NARCAN®
Nasal Spray.
What are the ingredients in NARCAN®
Nasal Spray?
Active ingredient: naloxone hydrochloride
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What should I tell my healthcare provider before using NARCAN®
Nasal Spray?
Before using NARCAN®
Nasal Spray, tell your healthcare provider about all of your medical conditions,
including if you:
• have heart problems
• are pregnant or plan to become pregnant. Use of NARCAN®
Nasal Spray may cause withdrawal
symptoms in your unborn baby. Your unborn baby should be examined by a healthcare provider right
away after you use NARCAN®
Nasal Spray.
• are breastfeeding or plan to breastfeed. It is not known if NARCAN®
Nasal Spray passes into your breast milk.
Tell your healthcare provider about the medicines you take, including prescription and over-the-counter
medicines, vitamins, and herbal supplements.
What are the possible side effects of NARCAN®
Nasal Spray?
NARCAN®
Nasal Spray may cause serious side
effects, including:
• Sudden opioid withdrawal symptoms. In someone who has been using opioids regularly, opioid
withdrawal symptoms can happen suddenly after receiving NARCAN®
Nasal Spray and may include:
body aches, fever, sweating, runny nose, sneezing, goose bumps, yawning, weakness, shivering
or trembling, nervousness, restlessness or irritability, diarrhea, nausea or vomiting, stomach cramping,
increased blood pressure, and increased heart rate.
• In infants under 4-weeks old who have been receiving opioids regularly, sudden opioid withdrawal may
be life-threatening if not treated the right way. Signs and symptoms include: seizures, crying more than
XVXDO DQG LQFUHDVHG UHÁH[HV
How should I use NARCAN®
Nasal Spray?
• Use NARCAN®
Nasal Spray exactly as prescribed by your healthcare provider.
• Each NARCAN®
Nasal Spray contains only 1 dose of medicine and cannot be reused.
• Lay the person on their back. Support their neck with your hand and allow the head to tilt back before
giving NARCAN®
Nasal Spray.
• NARCAN Nasal Spray should be given into one nostril. NARCAN®
Nasal Spray should only be used
in the nose, in accordance with the Patient Counseling Information included in the full Prescribing
Information for NARCAN®
Nasal Spray.
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again, use another NARCAN®
Nasal Spray in the other nostril.
How should I Store NARCAN®
Nasal Spray
• Store NARCAN®
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• Do not freeze NARCAN®
Nasal Spray
• Keep NARCAN®
Nasal Spray in its box until ready to use. Protect from light.
• Replace NARCAN®
Nasal Spray before the expiration date on the box.
Keep NARCAN®
Nasal Spray and all medicines out of the reach of children.
The risk information provided here is not comprehensive. To learn more, talk about NARCAN®
Nasal Spray
with your health care provider or pharmacists. The FDA-approved product labeling can be found at www.
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effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
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Adapt Pharma, Inc. Radnor, PA
Ask your pharmacist or doctor today about NARCAN®
Nasal Spray.
ONLY
THIS IS NARCAN
®
Visit NarcanNasalSpray.com
4mg

15. WeHelpPeopleRecoverTheirLives
AN addiction professional
HAS THE specifictraining AND experience
NECESSARY TO PROVIDE
immediate and long term care
TO THOSE WITH
substance use disorders.
Doesn’t your loved one deserve to be treated by the best?
www.naadac.org/2016annualconference
REGISTER TODAY!
16 | FUTUREOFPERSONALHEALTH.COM | INSPIRATION
the country are now carrying naloxone and
are saving lives nearly every day. Pharma-
cies in many states are now making nalox-
one more available via a pharmacist, and
health care providers are also co-prescrib-
ing naloxone with opioids to help patients
at risk of overdose.
In this epidemic, we often focus on the
stories of overdoses and deaths, and that
needs to change. There are great recovery
stories to tell and we need to tell them,
because there’s life after addiction. But
for many people with an opioid use disor-
der, they’ll never get there unless they can
access naloxone.
Whatistheroleoflawenforcementin
thisissue?
Law enforcement, along with other mem-
bers of local communities, are on the front
lines of this issue.They see the human toll of
the opioid epidemic every day. Law enforce-
mentalsorecognizesthatwewillneverarrest
andincarcerateourwayoutofthisepidemic.
Certainly, police must hold drug dealers
accountable, however, they are also actively
seeking alternatives to incarcerating low-
level offenders with substance use disorders.
Public safety officials are creating partner-
ships with the public health community to
find ways to reduce this epidemic. One way
theyaredoingthisisbyadministeringnalox-
one,sincetheyareoftenthefirstonthescene
ofanoverdose.Andsomepolicedepartments
havebegunprogramstoconnectpeoplewith
substance use disorders to treatment.
In addition, law enforcement at the state,
local and federal levels work diligently to
disrupt drug trafficking networks and to
prevent diversion of prescription drugs. The
vast majority of prescription drugs that are
misused come from family or friends, often
in the home medicine cabinet. To curb the
number of prescription drugs that can be
misused, the Drug Enforcement Adminis-
tration(DEA)holdsregularTakeBackDaysat
which members of the community can drop
off unwanted prescription drugs.
The DEA just held just held its 11th
National Prescription Drug Take-Back Day,
and I was pleased to participate in an event
in Minneapolis on April 30. At this location,
the DEA collected more than 5,000 pounds
of unneeded prescription drugs.And similar
state- and local-level efforts occur around
the country and are organized by local police
departments.Law enforcement is an invalu-
able part of efforts to move our country from
crisis to recovery.
Whatisyourstanceonmedication-
assistedtreatment?
Medication-assisted treatment, when used
as part of a comprehensive approach that
includes other behavioral support services,
is a proven, evidence-based method to help
treat people with opioid use disorders and
help them sustain long-term recovery.
Aswithanyotherdisease,peoplewithsub-
stance use disorders should have access to
the full spectrum of services because every-
oneisdifferent—thetreatmentthatworksfor
one person may not work for the next.
HowshouldtheU.S.approachthe
implementationofsyringeexchange
programs?
In December, the President signed the Fed-
eral Budget into law, this budget includes
a provision to revise a longstanding ban
on using Federal funds to support syringe
service programs. Areas across the coun-
try, including rural areas, are at risk for
Hepatitis C and HIV outbreaks due to
intravenous drug use.
We saw this last year in Scott County,
Indiana. Syringe service programs provide
“...there’s life after
addiction. But for
many people with an
opioid use disorder,
they’ll never get there
unless they can
access naloxone.”
CONTINUED FROM PAGE 14

16. comprehensive services, to include clean
syringes but also treatment for infectious
diseases such as Hepatitis C and HIV and
for substance use disorders. Syringe ser-
vice programs can improve public health
because they reduce both the spread of
infections and the associated health care
costs of viral diseases contracted through
sharing syringes.
WhataresomerecentactionsPresident
Obamahastakentoengenderchange
andawarenesssurroundingthistopic?
President Obama has made ending this epi-
demic a priority for his Administration. Fed-
eralresourceshavebeenincreasedtoaddress
this epidemic—for example, the bipartisan
FY 2016 appropriations included more than
$100 million in new funding. And in Febru-
ary, the President announced his FY 2017
Budget request,which calls for an additional
$1.1 billion to, among other things, expand
access to treatment, including in under-
served areas.
In addition, the Obama Administration
has been focusing on lifting up local, com-
munity-based efforts on prevention, treat-
ment and recovery, working to end the
stigma attached to people with substance
use disorders, and making naloxone, the
lifesaving opioid overdose reversal drug,
more available.
The President also has made several
announcements that bring together private
and public sector leaders to address this epi-
demic.He proposed doubling the number of
patients doctors can treat with buprenor-
phine, a medication that is proven to help
peoplewith opioid use disorders.He’swork-
ing to make sure prescribers have the train-
ing and education they need to safely and
responsibly prescribe opioid pain medica-
tions and getting commitments from hun-
dreds of medical, osteopathic, nursing and
pharmacological schools to incorporate his
new CDC Guideline for Prescribing Opioids
for Chronic Pain into their curricula.
MEDIAPLANET | 17
PHOTO:TOMFEARNEY
A
ccording to the
National Insti-
tute on Drug
Abuse, addiction
affects 23.5 million
Americans every
year, but only 11 percent receive
treatment. This is an alarming
number of people who aren’t get-
ting care and, even worse, dying
because of it.
Thefirsthurdlestohelp
“More than 40 million Americans
die each day from prescription
opioidoverdoses,”sumsCDCdirec-
tor Dr. Tom Frieden. The new face
of addiction doesn’t discriminate
between rich or poor.
For those struggling with
addiction, it’s difficult to navigate
treatment options. Shame, guilt
and fear keep people searching
privately, often online, for help.
Combined with a growing digital
landscape and facility options, it
makes the process of obtaining
help difficult and overwhelming.
But deciding on the right treat-
ment is crucial. There has been a
clarion call for better consumer
information. “It’s essential for the
recovery-focused community to
provide clear, objective informa-
tion online to help educate indi-
vidualsontreatmentoptions,”says
Abhilash Patel, co-founder and
president of Recovery Brands. “We
need to better appreciate the vul-
nerable position people are in, the
dozens of questions and concerns
they have, and what information
they are actually looking for.Then,
it’s our job to give them that infor-
mation to make the best decisions
for their families.”
Matching the demand
To address the need, Patel and
his partner Jeff Smith formed
Rehabs.com, a site filled with
facility listings, 12,000-plus
facility reviews, vetted educa-
tional resources and insight from
professional in the field.
The most common concerns
prospective patients have are:
cost of treatment, availability of
financial support, staff experi-
ence and training requirements,
facility accreditation status and
privacy and confidentiality. When
information is put in the hands of
consumers right from the begin-
ning,expertssay,ownershipinthe
decision making process positively
impacts long-term recovery. n
Empowering Individuals to Break
the Silence of Opioid Addiction
The growing concern surrounding opioid addiction, including heroin, is simmering to the top of the
news recently. Despite this new focus, millions are still struggling to find proper treatment.
SPONSORED
By Faye Brookman
Shame, guilt
and fear keep
people searching
privately, often
online, for help.
CONTINUED ON PAGE 18

17. PHOTO:WHITEHOUSEOFFICEOFNATIONALDRUGCONTROLPOLICY
Shatterproof is a national nonprofit organization
committed to ending addiction and supporting
those affected by this disease. We’re working to
eliminate the stigma through scientific research,
evidence-based legislation, and national
awareness events. Collaborating with expert
advisors, we’re pursuing public policy initiatives
that will reduce the enormous human suffering—
and the exorbitant cost to society—of addiction.
LEGISLATIONHASBEENPASSED.
LIVESHAVEBEENSAVED.
ANDWE’REJUSTGETTINGSTARTED.
Together, we can change the conversation
about addiction and address this national
epidemic head-on. Visit shatterproof.org to
get involved today.
Whataresomestepsthoselivingwith
addictioncantaketoachievelong-term
recovery?
First, recognize that you have a disease, and
that this isn’t something to be ashamed of.
Contact the treatment locator at 1-800-662-
HELP (4357). There are millions of people
across this country in recovery, includ-
ing me. Get a support network. Life after
addiction is possible. n
18 | FUTUREOFPERSONALHEALTH.COM | INSPIRATION
“As with any other
disease, people
with substance use
disorders should
have access to the
full spectrum
of services...”Test your knowledge online.
futureofpersonalhealth.com
POP QUIZ
More than 40 people die every day from
overdoses involving prescription opioids.
TRUE FALSE
CONTINUED FROM PAGE 17

18. For more than 65 years, we’ve been at the
front lines helping people find freedom
from addiction. Today, we partner with
communities, educators, and leaders in
the treatment field to save lives through
innovation and expertise.
LEADING THE WAY OUT
OF THE OPIOID EPIDEMIC.
EVIDENCE-BASED TREATMENT | CLINICAL RESEARCH | PUBLIC ADVOCACY
MEDICAL AND GRADUATE EDUCATION | PREVENTION PROGRAMS
COMMUNITY MOBILIZATION | PROFESSIONAL TRAINING
Call 866-650-2084 to speak confidentially with a recovery
expert or visit HazeldenBettyFord.org/Opioids to learn more.
Get help. Become part of the solution.
People with both a mental
illness and a substance
abuse disorder can experi-
ence tremendously negative
consequences that impact
their health and well-being.
Despite a troubling increase, the
number of heroin users in the
United States is still relatively
small—900,000 out of a total
U.S population of 318.9 million
in 2014, or about 3 out of every
1,000 people. An even smaller
number who use heroin also
have a mental illness, but for
that population the repercus-
sions are severe.
Treating Both Substance
Abuse and Mental Illness
How risks add up
For example, people who use her-
oin are more likely to develop sig-
nificant medical conditions, such
as problems breathing, infections
of the heart and blood vessels and
sexual dysfunction.They also have
a higher risk of contracting dis-
eases like hepatitis and HIV from
sharing needles.
People with both a mental ill-
ness and addiction substance use
disorder have a greater risk of sui-
cide, are more likely to experience
side effects from medications and
may face an early death.They also
have the added challenge of nego-
tiating the health care system that
can be ill-equipped to handle two
very complex conditions at the
same time.
The right way to treat
Fortunately, thanks to the work
of people across the health care
professions, and the expansion of
health care through the Affordable
Care Act, there are many effective,
evidence-based treatments, ser-
vices and recovery support pro-
grams for individuals who have
co-occurring conditions, such as
heroin use and mental illness.
The Obama Administration and
the U.S. Department of Health and
HumanServicesareworkingevery
day to make affordable, quality
health care available to all Amer-
icans. However, we must never
stop in our efforts to ensure that
evidence-based treatments and
healthcareservicesareavailableto
those most in need. n
Tison Thomas
M.S.W., LMSW, Chief, State
Grants Eastern Branch,
Center for Mental Health
Services, Substance Abuse
and Mental Health
Services Association
People with both a
mental illness and
addiction substance
abuse disorder have
a greater risk of
suicide...
CHALLENGES | MEDIAPLANET | 19

19. 20 | FUTUREOFPERSONALHEALTH.COM | ADVOCACY
By Marvin Ventrell, J.D., Executive Director,
National Association of Addiction Treatment
Providers
The Opioid Epidemic
Shines New Light on
How We Treat Addiction
Leaders in addiction treatment
for teens and young adults
ROSECRANCE
Introducing Rosecrance Lakeview,
our newest site in the heart of Chicago.
Help for young adults to rebuild a solid
path to the future.
AT A GLANCE
Ibegan speaking publically about
my 15-year struggle with addic-
tioninthefallof2010.Itledtofull-
time employment opportunities
that allowed me to support those working
inthefieldaswellasthosestrugglingwith
the disease.
The following highlights some of my
key opinions.
1. There are many incredible and
selfless individuals working in this
field. It is a well-known fact that many
working in this field have personal expe-
rienceswith addiction.I am not referring
to those individuals here; I am referring
to those clinicians that have gone into
this field simply to help those that are
sick. They acknowledged a public health
4 Realities of
Rehab, According
to an Addict-Turned
Caregiver
Asweworktogethertoimprove
lifesavingmodelsofcare,itis
imperativethatprofessionalsand
policymakersunderstandthe
needtosynthesize,ratherthan
isolatetreatmentmethods.
Neuro-scientific discoveries have
shown that the brain becomes damaged
through addiction, disrupting the choice
process that should enable a healthy
brain to signal the user to abstain rather
than call for more harmful substance.
This is scientific evidence that addiction
is a not a product of lack of willpower,
but a disease of the brain.
Revisingrehab
Thisledtopharmaceuticaladvances
thathelppatientsrecover,particularly
opiate-addictedpatients.Manyleading
treatmentcentersusesuchdrugsasacom-
ponentofholisticcare.And,fortunately,
muchofthemedicalcommunityand
lawmakersarefocusedonmedically-as-
sistedtreatment(MAT),oftenpresented
asapanaceaforopiateaddiction—itisnot.
WhileMATisanimportantcomponent
ofcomprehensivecare,wemusttreata
diseasethatimpactsthewholeperson.
By Jake Nichols, Pharm.D., MBA, Medication
Treatment of Opioid Dependence Specialist
Mypersonal experiencewith treatment led to myentrance into the field
of addiction medicine as a health care provider and resource.
crisis and felt it was their duty to help.
2. Therearesomeinthefieldthathave
motivations other than helping those
inneed.Unfortunately,therearealsothose
thatsawanopportunitytotakeadvantageof
those in avulnerable desperate state.I have
mixedopinionsaboutcash-onlyclinics,but
I do have a big issue with those charging
largemonthlyfees(ashighas$400)andpro-
viding nothing but a prescription.
3. Thereisnotonemethodthatismore
appropriate than another in addiction
treatment.Thereisalackofconsensusand
consistent data published in the medical
literature concerning what interventions
work best in specific individuals. In addi-
tion, there is so much inter-patient vari-
ability and multiple co-morbidities that
have to be dealt with. For this reason, it is
very hard to standardize care.
4.We don’t talk about the goal and con-
cept of recovery consistently. Believe it
or not, it is the rare clinician that breaches
the topic of recovery at a patient’s entry
into treatment. Some claim that it is too
daunting for a patient to think about
acutely.Idisagree;itneedstobemadeclear
that the end goal is truly recovery. Each
patient needs to identify what recovery
looks like to them personally and strive
towards achieving it. If that requires med-
ication for an extended period or even for
life, then so be it. n
Read the entire story online to see
how addiction therapy has evolved.

20. MEDIAPLANET | 21
T
he pill use, which
started out to ease
aches and pain from
a construction job,
ramped up into a bad
habit. “I was popping them like
candy,” he says. At the height of
his addiction, he took up to 30
hydrocodone pills a day.
Gorham, who spent $120,000
on his addiction, tried to quit cold
turkey three times, but it didn’t
work. “The withdrawals get so
bad that you just want it to stop
because it lasts for days and days,”
he says, describing the outlook as,
“‘I’ve just got to get some more
because I can’t handle this.’”
Getting clean
Quitting cold turkey can be tough.
That’s why patients are turning
to medication-assisted treatment
(MAT), which combines the use
of medicine, counseling and
behavioral therapies.
This “whole-patient approach”
to treating substance abuse is
effective, according to the Sub-
stance Abuse and Mental Health
Services Administration (SAM-
HSA), calling opioid addiction a
chronic disease like heart disease
or diabetes.
They say MAT can reduce prob-
lem addiction behavior, noting
certain medications “can reduce
the cravings and other symptoms
associated with withdrawal from
a substance, block the neurolog-
ical pathways that produce the
rewarding sensation caused by a
substance,or induce negative feel-
ings when a substance is taken.”
Typically those medicines
include opiate-based drugs like
methadone and buprenorphine,
also known as Suboxone or Subu-
tex.SAMHSAsaysthesetreatments
trickthebodyintothinkingit’sstill
getting the opioid. Another med-
icine, naltrexone, a non-opioid,
blocks the effect of opioid drugs,in
essence, preventing the high.
A new approach
WhileMATmedicinesaretypically
administered as pills, a new ther-
apy includes the use of a Naltrex-
one implant.
“I’m seeing things much clearer
now than I ever have before,” says
Gorham, who has been sober for a
year. He kicked his addiction with
the help of that implant, which
was placed in his abdomen and
time-released the medicine.
He says the implant makes the
cravings a lot easier to deal with
and puts the idea of drugs out of
his mind. “It put me in the mind-
set that I can get through this. I
don’t want the drug anymore. I’m
tired of it.”
Before getting the implant,
patients with opioid addictions
typically need to detox between 7
to 10 days and they must attend at
least once counseling session.
Rewired recovery
“Sustained naltrexone therapy
can allow the brain to rewire
itself over time,” says Brady
Granier, CEO of BioCorRx, an
addiction treatment company
that developed a MAT program
built specifically around long-
term naltrexone treatment and
offered to independent treatment
centers nationwide.
“This is an awesome tool to
take the cravings off the table so
we can do some serious work,”
says D. Dawn Maxwell M.A.,
CATC, MATC, Director of Coun-
seling for BioCorRx, explaining
the implantworks because it isn’t
reliant on a patient remembering
to take a dose.
“When someone has substance
abuse, they’re hijacked by crav-
ings. People who are addicts can’t
walk away,” she says. “It’s not
because they’re bad or weak. It’s
because the receptors in their
brain are stuck in an OCD-like
craving cycle.”
The recovery program com-
binestheimplantwith35modules
focused on solution oriented cog-
nitive behavior therapy. It typi-
cally takes 16 counseling sessions
over 4 to 6 months,giving patients
time to develop the tools for
long-term sobriety.
While MAT treatment can be
expensive, Gorham says it’s worth
it. “Once you get through the pro-
gram successfully,” he reflects,
“you can’t put a price on that.” n
SPONSORED
“Non-Addictive” Medication-Assisted
Treatment Helps Opioid Addicts Get Sober
Bradley Gorham was addicted to opioids for a decade. “It got me high,” says the married father
of two.“During the day, I took it to feel normal.”
By Kristen Castillo

21. Cynthia Reilly
B.S. Pharm, Director, Substance
Use Prevention and Treatment
Initiative, The Pew Charitable Trusts
Over the past 20 years, opioid
prescriptions to treat acute and
chronic pain have nearly tripled,
and more potent, deadly forms of heroin
have flooded communities across the
country. Opioids of any kind can quickly
lead to dependence when misused.
Heroinismoreaccessibleandlessexpensive
thanprescriptionopioids,soindividuals
mayturntoitwhentheyareunableto
obtainprescriptions.However,prescription
opioidoverdoseskillapproximatelytwiceas
manypeopleasheroin.Studiesalsoindicate
thatroughly5percentofpatientsmisusing
prescriptionopioidsturntoheroin.
Medication-assistedtreatment,which
pairsFDA-approveddrugswithbehavioral
therapies,suchascounseling,has
beenshowntimeandagaintobemore
effectiveintreatingsubstanceuse
disordersthanotherinterventions.Yet
thistreatmentishighlyunderutilized,
oftenbecauseofstateandfederalpolicies
thatrestrictaccess.Thismustchange.
22 | FUTUREOFPERSONALHEALTH.COM | INDUSTRY PERSPECTIVE MEDIAPLANET
Finding Answers for Modern Addiction
Marvin D. Seppala
M.D., Chief Medical Officer,
Hazelden Betty Ford Foundation
Heroin use has increased over the
past 10 years, due to the exposure
of so many people to prescription
opioids since the mid-1990’s. The overuse of
these powerful pain medications resulted in
a tremendous increase in those addicted to
them, dying of overdose and using heroin.
Heroinisanopioid,justliketheprescription
painmedications.Theyallprovidepain
reliefandintoxication.Asprescription
opioidsbecamemorepopularandpeople
developedatolerancetothem,theysought
heroininsteadasitismorepowerful,less
expensiveandjustaseasytoobtain.
Treatmentforopioidaddictionisalong-term
affairusingacombinationofmedications
andpsychotherapies.Combiningevidence-
basedpracticesinthetreatmentofthis
chronicbraindiseaseisnecessarybecause
addictioncounselorsandphysiciansare
forcedtoworktogethertodetermineproper
treatmentpathwaysforallpatients.
Mendi Baron
Founder and CEO, Evolve
Treatment Centers
The heroin epidemic of late has really
increased drastically over the past
10 years. This is due to a variety
of factors including an increase in supply
to the U.S., as well as it functioning as a
cheaper alternative to the more accessi-
ble, but far more expensive painkillers.
Nearlyhalfofthoseaddictedtoheroinare
alsoaddictedtopainkillers.Painkiller
addictioniscloselylinkedtosubsequent
heroinaddiction.Becausepainkillers
areeasytoobtain,areheavilyprescribed
andareperceivedas“safer”thanstreet
drugs,theuseofheroininavarietyof
populationshasincreaseddrastically.
There is a strong push in treatment for
medically-assisted care. The goal is to be
able to address acuity faster and is spurred
by a need to address high volume, while
decreasing the amount of time spent in care.
Discuss the origins of the current heroin
addiction epidemic in the United States.
What is the link between prescription
pain medication and heroin?
What’s the most relevant trend
in treatment you see today?
Lack of education has consistently
been a large contributor to heroin
addiction. People weren’t aware
of heroin’s dangers until 1920, when
Congress made over-the-counter pur-
chases of the drug illegal. Even now, with
more understanding, consumers fail to
recognize, and act on, the severe risks
associated with prescription painkillers.
Sadly,alargepercentageofheroinusersbegan
withtheuseofprescriptionpainkillers.
Countlesspeoplebecomedependentonthe
highly-addictivenarcotics,however,heroin
isfarmoreaccessible,andoftentimesmore
affordable.Tocombatterrifyingwithdrawals,
peopleendupturningtoherointocurb
thosesymptomsandhelpthemmanage.
There’s a small movement toward outcomes-
based research that needs to be fostered.
Further, this work needs to be led by
impartial and independent third parties
who can create credible, objective outcomes
visibility. This type of standardized
information will help consumers determine
which facilities and programs they can trust.
Abhilash Patel
Co-Founder and President,
Recovery Brands
Saul Levin
M.D., M.P.A., CEO and Medical
Director, American Psychiatric
Association
Heroin use has increased among men
and women, most age groups and
all income levels, according to the
Centers for Disease Control and Prevention.
Heroin overdose death rates have more than
tripled since 2010, and research suggests the
rise in heroin use came on the coattails of
the epidemic of opioid painkillers misuse.
Medicationassistedtreatmentiseffectivefor
thesesubstanceusedisorders.Methadone,
Buprenorphineandextendedrelease
naltrexoneareFDA-approvedmedications.
There’salsonaloxone,afast-actingmedication
thatcanreverseanoverdose.Treatmentwith
anyofthosemedications,whencombined
withtalktherapy,canimprovelives,reduce
theriskofoverdoseanddecreasedruguse.
Recentdataindicatearelationship
betweenheroinandmisuseofopioidpain
relievers.Onestudy,forinstance,showed
thatmisuseordependenceonopioidpain
relieverswasthestrongestriskfactorfor
heroinuseordependence.Thereisno
denyingthefactthatweareinthemidst
ofamajorheroinandopioidepidemic.

22. AmericanAddictionCenters.org
How America’s Opioid Addiction
Reflects a Larger Issue
There’s no doubt America is in a crisis. But it’s not an opioid
crisis—we’re in a brain crisis.
T
rue,we are facing an
epidemic of opioid
overdose deaths,
and everyone from
the CDC to the Pres-
ident is focused on solving this
issue. But this isn’t the first time
this has happened. It’s actually
our nation’s third heroin and
opioid epidemic.
Shifting the mindset
Historically, we’ve seen one drug
crisis after another: cannabis,
stimulants, cocaine, opioids etc.
We’ve attacked and beat each
one,yetwe’re always left to tackle
the next. We’ve treated each epi-
demic with drug-specific solu-
tions, but for the past 100 years,
nothing has worked to prevent
the next crisis.
What we’ve missed is that
addiction is a brain illness not
limited to substances. We aren’t
facing an ‘opioid problem’ or
‘heroin problem.’ We’re facing a
biological brain illness. Addiction
as an illness involves dysfunction
in the brain’s reward center and
related circuitry, and drug use is
a symptom.
Seeing the entire illness
Most times, the illness is there
before the first drug, and it’s
still there after the drug use
stops. If we focus on ‘fixing’ the
substance use and not the brain
function, we’ve only partially
treated an individual suffering
from addiction and relapse is
highly likely. Just as we wouldn’t
treat the symptoms of cancer,
but rather treat the disease
itself, the same applies for addic-
tion. If we don’t treat the disease
of addiction, but rather its symp-
toms, we’ll get the same results:
the nation’s next drug problem.
Yes, people are dying of opioid
overdoses, and we should con-
tinue the great work to stop that.
For example, solutions such as
suboxone or naloxone are highly
importantanduseful.However,we
must simultaneously realize that
addiction won’t stop with opioids.
We must broaden our scope and
use medications and psychosocial
treatment to treat the whole ill-
ness. Otherwise, we can’t expect
our results to change. n
BIG IDEAS | MEDIAPLANET | 23
By Howard Wetsman, M.D.,
DFASAM, Clinical Associate
Professor, Louisiana State
University, School of Medicine
If we focus on ‘fixing’
the substance use
and not the brain
function, we’ve only
partially treated an
individual suffering
from addiction...

23. © 2016 Quest Diagnostics Incorporated. All rights reserved.
Understanding
prescription drug misuse
can make a difference.
More than one-half of patients misuse their prescription drugs.1
Get the knowledge you need to
combat prescription drug misuse with our free online Quest Diagnostics Health Trends™
Report.
The more you know, the more you can help your patients.
1. Quest Diagnostics Health Trends Report, “Prescription Drug Misuse in America:
Diagnostic Insights in the Continuing Drug Epidemic Battle”, 2016.
54% of patients tested
are not using their
medications appropriately,
according to the latest
Quest Diagnostics Health
Trends Report, Prescription
Drug Misuse in America:
Diagnostic Insights in
the Continuing Drug
Epidemic Battle.
Quest’s prescription drug monitoring test services help to
identify evidence of use of prescription and illicit drugs,
such as opioids and marijuana. In the right hands and in
the right context, Quest’s diagnostic insights can inspire
actions that transform lives.
Prescription Drug Behavior, 2015
Source: Quest Diagnostics, March–December 2015
46% Using appropriately
54% Using inappropriately
32% No drugs found
45% Additional drugs found
23% Different drugs found
Patients not following
prescribed therapy
23%
45%
32%
54%
46%
Arm yourself with valuable insights from our
latest Health Trends Report—download it at
QuestDiagnostics.com/Trends.