Marvin: I’m Marvin.

Burr Cook: And I’m Burr.

Marvin: And this is the Balboa Horizons podcast. Today our topic that we’re going to be talking about is getting help for drug and alcohol addiction for families. Burr, we’re talking about families, you know. There may be a lot of people out there that don’t necessarily know what addiction recovery entails. What would you say to someone who’s using Heroin, Xanax or even alcohol. What would be their first steps on seeking help?

Burr Cook: Well, the first step in the recovery process for many, especially for the drugs that you just named Heroin, Xanax and alcohol, a detox, a medically managed detox is going to be essential.

Marvin: Okay. And so the medically managed detox, let’s talk about that, for instance. So what would be the difference between like say, a hospital type situation or residential treatment setting? Do you know what those … Could you speak on those differences?

Burr Cook: Well, sure. The hospital is the highest level of care, and for a detox not always necessary. For somebody coming off extremely high amounts of alcohol or benzodiazepines where they have exhibited a past history of having seizures when they detoxed. There are times when we would want that person in the hospital.

Burr Cook: But for most people, a thorough assessment is done to see if they can be in a residential detox. At Balboa Horizons, we can take a fairly high level of acuity because, not only is our medical director of psychiatrists, Elizabeth Roberts managing each client’s care, we have 24-hour nursing to make sure the needs of the client are met and that they’re done in a safe way.

Burr Cook: So, safety and comfort are key. We’re most concerned with safety. Then addict alcoholic is concerned with comfort. It’s terrifying. And coming off these drugs, clients experience very high levels of anxiety and depression. And so we want to make sure they have some pharmacologic support to get them through the most severe of those withdrawal symptoms and to get them through it safely.

Marvin: Yeah. So talking about that anxiety involved and families often face these people in their worst moments. Their loved ones are in panic mode because whether or not they have drugs or not, they need help. But they want to get the right help. How do you talk them through that process as if you were a mom or a dad? How do you get your loved one to say, this is the place, this is where you need to go to get the help that you want and they’re going to help.

Burr Cook: Well reinforcing that their way isn’t working, and they’re going to need more help than they think they do. If you have to meet an alcoholic or an addict that didn’t underestimate the severity of their illness, and overestimate their ability to deal with it on their own, you’ve got to be able to acknowledge that you need help.

Burr Cook: And then for the family, I understand that this is a crisis situation, and this is why we want them to be working with professionals that can guide them through the process of getting their loved one into that first step, that safe detox where their illness is going to be managed and we’re also going to be preparing them for the next phase of their journey, which is generally it’s residential treatment.

Marvin: Got you. So the detox is just the beginning. If I was a family member and I didn’t know anything about treatment, detoxification is going to be the first step. So the next step would be residential treatment. What does that entail for the addict or the alcoholic that’s suffering?

Burr Cook: Well, for residential treatment, every client coming into about Balboa, I’ll just use Balboa as an example. Every client coming in, is going to get a thorough psychiatric evaluation. They’re going to meet with the therapist and counselor. After meeting with our doctor, they’re going to have a biopsychosocial assessment done and the counselor and the client are going to sit down using the information gathered in those two evaluation tools to map out a treatment plan for them.

Burr Cook: With drugs like Heroin where somebody could be experiencing post-acute withdrawal symptoms for quite a while. Four to six weeks sometimes it goes until months, a structured residential setting with lots of clinical support around them is going to be essential to carry this person through these beginning phases of treatment. We have an evaluation, we have a treatment plan, and the next step is for that client to engage in that process.

Burr Cook: While they’re doing that, this is an excellent time for families now that they have a break from the chaos, to get as much information as possible, and start to do their own work in learning about recovery, learning about what treatment is, what they can do to be supportive, and how they can start to deal with the issues that have been impacting them for a while. We take the team approach and the family is our team.

Burr Cook: And we’re encouraging families to buy in if you will, to parallel recovery. And by that I mean, while the addict’s getting better, the family is getting better. We’re going to see far better outcomes, when everybody’s involved. I like to say that I’d rather have a family in recovery than a family with someone in recovery. And again, it’s because we’re just going to see better outcomes.

Marvin: Okay. So in the admissions department, at Balboa Horizons, we get this question all the time from family members. They’ve been through the ringer, multiple times this has happened. Maybe even they have gone to treatment multiple times. Is this going to work and how do … you know what I mean? How does that change their … How do you change that perception?

Burr Cook: Well, it’s very common. Families have been defeated for a long time in their efforts to get somebody help. Addiction is one of the most treatable diseases out there. And I don’t want to sound simplistic but people that follow their treatment plans and then follow their aftercare plans while we have appropriate family support going on with that clinical support, peer support, the people that take direction and follow those plans do quite well.

Burr Cook: But like any illness, if you’re not going to follow your treatment plan. If you’re not going to take the doctor’s advice, you’re not going to get the results you’re seeking. So getting the family on board with us and following direction from us is going to be one of the most helpful things they can do.
Marvin: Okay. And as far as … so we’ve gone through detox, we’ve gone through the residential stage then what comes after that process?

Burr Cook: Well at Balboa we have what we call a continuum of care. And this is treatment in stages. We’ve got detox, we’ve got residential, the length of stay in residential is going to be determined by the individual we’re working with and their ability to progress through that residential treatment. Where we see the most relapse is at transition point. In other words, somebody leaving detox, but not going to treatment afterwards. Or leaving treatment and not having enough support after that phase.

Burr Cook: Entering into an intensive outpatient program, and then leaving that, not having enough support. So what we do is that every phase of treatment as we are helping this person increase their ability to take on life’s responsibilities, and to be accountable for those things, making sure they have clinical support around them, and also that they’re utilizing peer support that we recommend so that they can do this in a way that is not overly stressful.

Burr Cook: Relapse prevention is in many ways about stress reduction. And what we want to see people do is take on some challenges, set some difficult goals but achievable goals, and do it in a way where they’re maximizing their use of the support that’s offered. So having that clinical support at those transition points as a person moves back into being a productive citizen, a person that is starting to … their world starting to get bigger.

Burr Cook: Helping them manage that is going to be key. So through this continuum of care at every level, we’re just making sure the support that individual needs is there for them.

Marvin: So you get to see people in their worst possible moments and you get to see them go through this process. What’s that like for you?

Burr Cook: Well, that’s I guess one of the biggest payoffs of working in behavioral health. Sometimes I’ll say, “They’re crying when they come in, and they’re crying when they leave.” But they’re crying when they leave for a different reason. Because, they have made some crucial relationships with people. Not just the clinical staff but people in treatment. And it turns out that this was a crossroads in their life, and the door is opening to a transformation that they’ve been seeking for a long time.

Burr Cook: So it’s very gratifying to see someone who is just, as you said, in the worst moments of their life, and then a couple months down the road to see them laughing and smiling and be full of hope. They look healthier, they’re making healthier choices, it’s transformation and we get to witness that on a daily basis and it just doesn’t get better than that.

Marvin: I don’t think I could have said it better myself. That was amazing. So just yesterday marked the 78th birthday for AA, and speaking of AA and 12-step programs, how important do you think that would be continuing that after care that they’ve received during treatment that they continue on in that kind of fellowship of sobriety?

Burr Cook: Well, AA seems to work the best for the most. It’s not the only thing out there, but for many of our clients, they’re not going to live long enough to find something better, although we do offer other things. Recovery pathways for them besides AA. But following that continuing care plan, it’s everything. Treatment actually lays down a foundation for what the client’s going to be doing when they leave treatment, and this is not a disease that goes away.

Burr Cook: There’s a huge correlation between stress and relapse and life today in this country is very stressful. It’s very fast paced. There’s lots of pressures put on an individual and having the ongoing support of a 12-step fellowship, 12-step design for living as they say has made all the difference for our clients in what we’ve seen. So it’s going to be extremely important that they follow that care plan that is going to emphasize alliance on pure support.

Burr Cook: And our clients are doing that long before they leave treatment. We don’t ask them to do something they’ve never done when they’ve left treatment because many people won’t. But having that experience while they’re in treatment makes it a lot more accessible. It makes it a lot more comfortable for them, and it’s just part of their routine.

Burr Cook: So when they leave treatment, it’s not a big shock or a big change. Addicts don’t really like change but by the time they leave treatment, they’ve been coping with change quite well. And having that ongoing support because change is going to be an ever present part of our lives, that ongoing support is going to help them navigate those changes.

Marvin: Well, thank you for your time today. I surely appreciate you and all the work that you do for Balboa Horizons. That’s it. Thanks for joining us on this podcast. We’ll see you next week.

Burr Cook: Thanks Marvin. Let’s do this again soon.

Marvin: You got it.