Substance abuse affects people from all walks of life

Substance abuse affects people from all walks of life. It does not discriminate

It does not matter where you come from. The disease of addiction can invade your life. It can affect co-workers, bosses, family, and friends – actually anyone in your life.

Addiction is characterized in five ways:  compulsive use, loss of control, continued use despite consequences, tolerance, and withdrawal.

Addicted individuals display obsessive and compulsive behaviors.  They typically spend an inordinate amount of time thinking about using, planning to use, and obtaining their drug of choice.  These behaviors often become so much a part of the individual’s routine that they become automatic or compulsive.  The user may not even realize the behavior is taking place before it is too late.

Here are some signs that you or someone in your life may have a problem with alcohol or drugs:

-Repeated tardiness or no-shows for scheduled shifts or appointments

-Disappearing during scheduled shifts or activities

-Erratic behavior and/or moods

-Lack of focus while on the job

-Working in a position that is well below their qualifications

-Deterioration of physical appearance

-Coming to work smelling of alcohol or appearing hung over

-Positive drug screen

-Repeated use of the hospital and/or legal system

-Careless/risk-taking behaviors

-Disregard for consequences to self or others

-Documented family history of addiction

-Frequent financial problems

-Isolation

Treatment is often successful, especially when the need is identified early.  When addiction is treated as a chronic disease, better long-term outcomes result.  Treatment typically involves a continuum of care and may include:  detoxification, residential treatment, and/or outpatient treatment.  At each level, the emphasis is on initiating and maintaining a person’s recovery.

Regardless of the level of care, treatment that is holistic ensures that all needs contributing to a person’s substance abuse will be addressed.  For example, a well developed treatment plan will address the biological, psychological, and social needs in one comprehensive approach.  Engaging in the 12-Step self-help community is encouraged as well.

If you or someone you know wants help, please contact the Vince Carter Sanctuary. We are able to help the addict recover and find a new way to life. 

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High-Risk Situations in Recovery from Addiction

High-Risk Situations in Recovery from Addiction

High-risk situations are those times that involve the people, places, and things that trigger an individuals craving for alcohol or drugs.  The counselor discusses situational triggers with the person and helps the person to avoid these if possible or learn to cope by developing the alternative responses necessary to deal with these situations without “using”.  This is a review of what the person has learned about people, places, and things in general with an emphasis on the actual situations that occur in the person’s own life and trigger a craving for the drug.  Learning how to avoid these times or to develop alternative responses to whatever triggers the desire for the drug is central to recovery from addiction and bears regular repeating.

The counselor reviews with the person actual and potential “high-risk” situations that might occur and what can be done to avoid them.  Examples of high-risk situations are being offered drugs, being around a drug-using friend, or attending a social function where drugs are available.  The counselor will rehearse with the person alternative responses to exposure to these situations. Identifying such situations well in advance and rehearsing how one could deal with such exposure will provide a better chance of avoiding a relapse from such exposure.

After the person identifies his or her particular high-risk situations, the counselor will work together to develop strategies for avoiding these situations.  Other potential high-risk situations also will be considered.  The counselor will offer reasonable alternative responses to unavoidable high-risk situations, such as calling a friend or talking to a family member.  The person should be encouraged to use the support of drug-free or recovering friends, family members, and AA and NA acquaintances.

We at Vince Carter Sanctuary are strong advocates of this process in addiction recovery.  As an adjunct to this therapy, we utilize state of the art addiction treatment interventions such as Virtual Reality.  Give us a try…..we are able to help.

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Motivation to Change

Motivation to Change

Earlier I generally described an approach to the treatment of alcohol and drug addiction that includes generating the motivation to change and effecting that change through cognitive behavioral and community reinforcement therapies.  Let’s talk about motivation to change in addiction treatment.  What is motivation, how is it developed?  More importantly, how is it sustained?

First, what is motivation?  The dictionary defines it as “an inducement, incentive or reason to act in a specific way.”  More often we tend to think of motivation as a characteristic, something we either have or done have – “He just isn’t motivated to succeed in school” or “She is motivated to ensure that her kids have a better life.”  Typically motivation, or lack of motivation, is seen by others as key to recovery from alcohol and drug addiction or relapse back into the disease.

Motivation is a lot more complicated than just a personal characteristic.  It’s clear that our ability to change is also shaped in part by those who are closest to us.  Enabling or co-dependence certainly have an impact on motivation to change.  Describing addiction as a “family disease”  reinforces the perception that family roles influence, even motivate, continued use of alcohol and drugs.  Conversely, the use of family interventions to change the family dynamic and increase motivation to change are often effective in leading people to begin the road to recovery toward treatment for addiction.

Ultimately, William Miller, one of the founding fathers of what is called a “motivational” style of client interviewing and counseling, concluded that “motivation can be understood not as something one has, but rather as something one does.  It involves recognizing a problem, searching for a way to change, and then beginning, continuing, and complying with that change strategy.”  (Miller, Increasing Motivation for Change, 1989).

Therefore an important role of a good counselor and counseling program is to assist a person in identifying, developing and nurturing the motivation to change.  Something important to consider when selecting a counselor or program such as the Vince Carter Sanctuary.   We will continue this discussion by talking about the “stages of change.”

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Painkillers!

Painkillers!

Painkillers that are prescribed by the doctor are done so to alleviate the pain or discomfort that comes along with a disease or post surgery. But little do we know that these medications stand the risk of being addictive because in many cases they become the first choice to manage and ease the pain. The dependency on the chemicals can come very easily.  Painkillers have the ability to block pains from all parts of the body - right from the nerve endings to the brain. They release the chemical Dopamine, which is responsible for the feeling of pleasure and well-being. Thus the brain gets used to this kind of a pain-free environment and demands it whenever it experiences feelings of pain.

The body shows withdrawal symptoms while trying to avoid painkillers. Some of these symptoms include extreme restlessness and anxiety, pain in both the muscles and bones, sleep disorders, vomiting and various stomach ailments including diarrhea.

You can study a person’s behavior to determine if that person is getting addicted to such prescribed medicines. If you notice that their intake and usage of these medicines has increased more than what is recommended or if it is observed that the person is going through mood swings and shifts in energy levels then these are signs of addiction. Also social isolation and a compulsive need to go to any extent to get these medicines are also signs to watch out for. Other signs include lowered levels of concentration, and memory loss or forgetfulness.

The treatment of this addiction has to be done under the guidance of a qualified physician. This helps in dealing with the withdrawal symptoms that come up during the process. The treatment involves both physical and psychological assistance – which includes counseling and drug treatment programs conducted in clinics or residential treatment programs.  Programs which are inpatient (where the patient has to stay in the medical facility) are seen to be more effective than outpatient treatment programs.   This also allows for a removal from the environment and access to the drugs of abuse.

You should remember that painkillers are meant to relieve pain but should only be used under the guidance of your physician.  This is the best way to avoid a dependency.  It is in fact better to avoid any addiction and minimize or eliminate the use of pain medication. Always ensure that the prescription is followed as it is and not exceed it without your physician’s approval. The damage caused is not worth the pain itself.  If you or someone you love is dependent on these medications, please know that inFloridathe Vince Carter Sanctuary can provide you with the tools you need to beat this addiction.

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Help for the Family of the Addict

Help for the Family of the Addict

It is accepted knowledge that addiction is a family disease.  This means that every person in the family is somehow affected by the disease.  Once the addicted person reaches out for help, it is important for those close to the individual to participate in the treatment process. 

Florida addiction family programs recognize the concept of a “family system” in offering help to those we serve.  The “family system” model means that the family consists of individuals whose life is affected by the behavior of the addicted family member. Better healing occurs if family members and significant others work together in treatment to form a healthier group.  It is quite common to find relationships where communication was difficult, or non-existent, improve once the drugs and alcohol are gone.

Family programs attempt to change the habit of blame into actions of healing. Treatment programs assess the current “climate” of the family unit and promote skill building that enhances communication, builds problem-solving behaviors, and strengthens trust and commitment.  Families in treatment work with other families to support, encourage, and share experiences in an air of acceptance.

To this end, the Vince Carter Sanctuary provides family counseling support through family treatment interventions where the family can work together toward a full recovery and return to a happy and drug free lifestyle.  Family treatment works!

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Medical Detoxification – A must do!

In order to heal the body of substance abuse and overcome the associated problems, the most crucial step is to initiate medical detoxification. Your road to recovery begins with cleansing your body of the substance to which you were addicted.  This process has to be done under the supervision of a medically qualified doctor in a licensed treatment facility.

The first step of detox and rehabilitation starts with a medical evaluation from a qualified medical doctor.  Detox programs are not generic but vary from patient to patient and are individualized. The patient is stabilized under the supervision of the skilled medical practitioner.

LicensedFloridadrug treatment centers believe in providing the person with a safe, private and individualized detox program.  The number of days required for the detox program depends upon the level of addiction and the changes that it has brought about in the body.

A medical detox does not end until the doctor is convinced that the patient is stable and has been safely withdrawn from the drug of abuse and all detox medications.  The patient is then ready for the next phase of treatment.  It is very important that the patient, before initiating his treatment counseling sessions, be free from the drugs to which he was addicted.

InFlorida, one such program which can safely provide medical detoxification from drugs of abuse or alcohol, followed by rehabilitation counseling for the patient and family is the Vince Carter Sanctuary.  Give it a try; you will be glad you did!

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Keeping secrets continues family sickness

Keeping secrets continues family sickness

Substance abusers and those dependent on substances want to continue to use.  They will lie, manipulate, ask loved ones to hide their addictions saying it is no one else's business, and do many things to continue to use that they normally wouldn't do.  Their addiction and disease becomes more important than their children, loved ones, and even their own life.  Loved ones will often keep the addict's use a secret from others including family members and friends.  Family secrets are a part of the family sickness that perpetuates the problem and actually makes it worse.  Stop the sickness, get help for your loved ones, break the silence and do it now.  There are great, wonderful programs to help.  Save your loved one's life now -- don't wait or it may be too late!

Patrick Miley, Ed.S, CAP, LMHC

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Should I force my loved one into substance abuse treatment?

Should I force my loved one into substance abuse treatment?

If you are struggling with this question, please read this.  My brother-in-law is struggling with feelings of guilt after his wife (only 50 years old) passed away suddenly this past weekend.  She collapsed at home and died within 24 hours.  "I should have been more aggressive to get her into a program."  She lived in Virginia and we lived in Florida.  Although I'm in the field of addictions and knew there were issues, I never expected this.  What I also know from my training and experience in the field, coerced or forced treatment works.  Whether by civil, criminal, or personal persuasion, if you get them into treatment, a loved ones motivation can be influenced by treatment so they want the help.  But without being forced into it, they won't seek it out on their own.  Don't give in to keeping secrets, get help, and do it now before it is too late.

Patrick Miley, Ed.S, CAP, LMHC

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Is Marijuana Dangerous?

Is Marijuana Dangerous?

Marijuana swiftly moves to the brain from the bloodstream and to different parts of the body. It is generally smoked in a pipe or through a water pipe. The smoking effects are quickly felt; like dry mouth and throat, and rapid rise in the heart rate.  Marijuana also causes delayed reaction towards time, impaired coordination and people may also have problems with short term memory. Heavier use can cause severe paranoia.  It also makes it very difficult for the person to keep track of time or concentrate on what is happening around them.  Marijuana use can also cause lack of energy, inability to eat, nausea, increased heart rate, vomiting, dizziness, depression, and mood swings.  Some individuals have panic and anxiety attacks, loss of sleep, and hallucinations. Use also can lead to increased risk of cancer, impaired decision making ability and judgment, increased risk of accidents and failure of the respiratory, reproductive, and immune systems.   So, Is Marijuana Dangerous?  The answer is that it certainly is dangerous and this addiction requires help to get someone to stop.  This involves counseling and support.   You can get this help through a drug treatment and rehabilitation center.  The Vince Carter Sanctuary in Florida is the place to go for world class and compassionate help. 


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Understanding Addiction

Understanding Addiction

While many have tried to identify a singular reason for the people who are addicted to one substance or another, the reality is that there are many factors that underlie an individual's addiction to drugs, alcohol, and tobacco.  It is sometimes assumed that the addict has no willpower or lacks moral principles.  

Why can't they JUST SAY NO?  It is helpful to understand the difference between a habit of using, and addiction to substances.  A drug habit is repeated substance use through choice, while addiction is use that is not only compulsive, but physically necessary just to achieve a normal level of functioning. 

If the addicted could simply choose to change their using behavior and stop indulging their compulsion to use mood altering substances, they would.  The reality is that the path to sustained recovery is a complex process that far exceeds good intentions. 

Addiction can be described as a constant need to compulsorily seek any substance, whether a mood-altering drug, alcohol, or tobacco (and quite often a combination thereof), fully knowing the destructive consequences of use to himself and to those around him.    Addiction and chronic substance use adversely impact employment, school performance, family stability, and social connectivity. 

Addiction depends upon a combination of various factors associated to the individual. Biological (such as genetic structure and gender) and environmental  (culture, peer pressure, family traditions) factors couple to create a unique and individual perspective, laying the foundation for a pattern of decision-making that is not only the beginning point of a life of addiction, but is also the necessary beginning point for recovery from addiction.

Addiction, like any other chronic disease, can be successfully managed.  After an initial detoxification treatment episode, cognitive behavioral treatments can help the individual sustain sobriety through the development of conscious decision-making skills.  It is not just possible, it is a fact-the addict can live a healthy, addiction-free life!

Florida's drug treatment system includes a strong prevention component, and targets youth and families that are at the highest risk for substance abuse and addiction.  The comprehensive system of care throughout the state has demonstrated a positive impact upon the trends of use among youth, a factor that has encouraged investment in more and better ways to address the issue for people seeking drug rehab in Florida.  

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E=MC2

E=MC2 – It’s not Rocket Science, but it is the formula for an Evidence Based Recovery

Addiction is such a complex disease – physically addiction primarily affects the brain, but also is toxic to the rest of the body and to the human spirit.  It’s also complex because of human desire for new experience and the desire to escape from the pressure and stress associated with daily life.  However we have learned over time that there are treatment approaches that are capable of bring addiction into remission and keeping it there.  We now know the basic combination of interventions that show real evidence of treating alcoholism and/or addictions to Cannabis, Crack, Cocaine, Heroin, Xanax, Lortab, Oxycontin, Methamphetamine and Synthetic drugs like K2 and Bath Salts.  

Motivation Enhancement is a treatment approach that “tips the decisional balance” in favor of abstinence over continuing to engage in the addictive behavior.  Coping Skills Training describes a variety of approaches designed to improve interpersonal skills, better regulate mood, improve the ability to cope with daily living and stressful life events and cope when confronted with substance use cues. The Community Reinforcement Approach is a treatment based in the belief that each person’s environment – family, friends, work, school, neighborhood, church and social activities - plays a key role in recovery.  12 Step Programs like AA, NA and Alanon are wonderful examples of the Community Reinforcement Approach.

Provided in combination at Vince Carter Sanctuary these three approaches mimic Einstein’s famous equation: E=MC2.  In our model E is Effectiveness and MC2 is Motivation Enhancement, Community Reinforcement and Coping Skills Training

William Miller and Reid Hester identified the superiority of these three treatment approaches in their seminal article “What works:  A summary of alcohol treatment outcome research” (2003).  Their analysis of 381 addiction treatment clinical trials ultimately ranked the effectiveness of 48 different treatment modalities. Motivational Enhancement and Community Reinforcement ranked 2 and 4 in their rankings.  Coping Skills Training approaches including a Self-Change Manual, Behavioral Self-Control Training, Behavior Contracting and Social Skills Training ranked 5,7,8 and 9. 

In contrast some of the most often used treatment approaches were ranked the lowest – Educational tapes, lectures and films 48, Psychotherapy 46, Confrontational Counseling 45, Relaxation Training 44 and Milieu Therapy 40.

At Vince Carter Sanctuary we have organized our Medical Detoxification and Intervention programs around Motivation Enhancement, Community Reinforcement and Coping Skills Training.  My blogs in the upcoming weeks will further describe the Motivational, Community Reinforcement and Coping Skills Training approaches we use at Vince Carter Sanctuary.

E=MC2.  In this case it’s not rocket science, but is the formula for an Evidence Based Recovery.

Chet Bell, MPA, CCJAP

CEO, SMA Behavioral Healthcare

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12 Step Program

12 Step Program

Drugs and Alcohol abuse as we all know have never done well to anyone; they are simply known to cause more malice in the society today. And it just doesn’t end here, they get you addicted with time, sooner than you thought thereby destroying every iota of ability that lets you think and act rationally. It’s nothing but simply a lonely illness. It isolates you from practically everything, even yourself. People have ended up destroying their lives, families, careers, friends and peers, if they have not stopped themselves well in time. So many such drug abuse cases are reported in the western countries and more so, shockingly, amongst our younger generation. Addiction help for this becomes pivotal.  

There are quite a few people who get reported for alcohol and drug abuse in Florida, what works is that the state does have many alcohol rehab centers and detox centers to check on the same. The authorities are taking steps to combat this crisis and facilitate easy and timely addiction treatment in Florida.

Various drug rehab centers and treatment programs in Florida thoroughly encourage those addicts to openly participate and co-operate in the therapy of the 12 Step Program. These treatment centers in Florida also help during and after the course of the treatment. Addiction help is their main focus and Florida drug treatment centers also offer a great deal of community level social support to these victims and patients by counseling them in order to accomplish a speedy recovery with educating them on lifestyle goals or abstinence or helping them with the 12 Step Program.

The 12 Step program, for a lot of recovery programs, has undoubtedly been a very integral process with many Florida alcohol rehabilitation centers which led them to the road of taking an initiative with acceptance along with being the prime stepping stone for a lot of recovery programs. A not so large group of alcoholics (Alcoholics Anonymous), over 60 odd years ago, thought of The 12 Step program. This group later realized that this was now not just merely a method of not drinking but a road to a newer way of life!

The 12 Step program in Florida is for strength, sobriety and stability for most rehab centers and is now adapted for the treatment of many other addictions treatments too:

1. Admit the fact; by being honest at least to yourself so that you can identify you have a problem.

2. Have full faith in the powers to bring back your sanity, have faith in yourself first.

3. Just surrender yourself and turn your addiction problem over to that spiritual power.

4. Probably the toughest, understand and look out for what is bad for you. Talk it out with your counselor - most rehab centers in Florida and across take this step seriously

5. Admit your (addict) faults; speak about them to your super power.

6. Look out for the addicts preparedness and integrity, don’t break here!

7. The addict surrenders themselves to that power and let it take over your vices.

8 and 9, Speaks of those that were hurt by you during your stint with abuse, for restitution and seeking forgiveness for your state of mental affairs.

10. This is where the addict looks for amendments and serious life changes and holds on to them.

11. Here the addict only seeks out for wellbeing and maintenance of all that he's learnt so far.

12. Finally the last stage of The 12 Step program - the addict (now not an addict) seeks for service to others and helps them in a similar situation.

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Finding an Alcohol rehabilitation program

Finding an Alcohol rehabilitation program can be relatively simple with the advances in technology in the last decade. There are plenty of alcohol rehabs in Florida; the important issue is to find an alcohol rehab that is the right fit for you or your loved one.
The internet is an excellent source to do research on finding an alcohol treatment center. Almost everyone today owns a computer and if you don’t, the public library has computers for your use. There are many different web browsers, I suggest you use http://www.google.com/ to get the most updated information on alcohol treatment centers. You will want to search “alcohol rehabilitation program or center” or “alcohol rehabilitation center in Florida”. Research the alcohol rehabs thoroughly and make contact with those centers you find appealing and visit them if possible to see the center and get an understanding of the people, philosophy, recovery community, and the treatment offered. Make sure the program is a 12- step abstinence based program and has support from the local AA community.
There are many alcohol rehabilitation centers that take a holistic and modern medical approach to the disease of alcoholism. The disease of alcoholism has been misunderstood for many years as a lack of morals or will power, and this simply is not true. Alcohol rehabilitation centers are aware of this fact and will provide a safe, understanding and effective way to treat you or a loved ones disease.
Be sure to be specific in your search, such as residential, dual diagnosis or long- term treatment.  The majority of alcohol rehabs offer a medical/holistic approach to the disease because it affects the physical, mental and spiritual aspects of an individual. If you are searching for an alcohol rehab that offers dual diagnosis, make sure there is an addictionolgist or psychiatrist on staff. The medical professionals should be qualified to treat the mental illness associated with their alcohol addiction. Also, ask about the medical overlay of the facility and make sure they have a medical detoxification program. Finally, make sure to inquire about the length of stay they offer and if they truly are a residential treatment program. Many alcohol rehab centers utilize apartments, whereas, the true residential alcohol treatment center has the individual reside on the recovery campus.
You or your loved one should not be afraid to go to an alcohol rehab. Alcoholism destroys lives, families and even communities. Alcohol rehabilitation centers gives people the tools they need to stop drinking and remain sober. They will teach you new ways of thinking, behaving and coping with life. It is a positive step for anyone to make in their lives. Alcohol rehab provides the foundation someone needs on which to build a healthy and positive future.
If you or someone you know is struggling with a substance abuse problem. We, Vince Carter Sanctuary, offer Medically Supervised Detoxification, Residential Alcohol/Drug Treatment, Partial/Day Treatment for alcohol and drugs and Intensive Outpatient Treatment. You can contact us at http://www.vincecartersanctuary.org/ or 800 478 0331.


 

Problem Drinking

 Courtesy of  http://www.militarymentalhealth.org/

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Prescription Drug Abuse and Addiction

Signs, Symptoms and Treatment

Brief Description:
     Prescription drug abuse consists of taking a prescription medication that is not prescribed for you, or taking it for reasons or in dosages other than as prescribed. Abuse of prescription drugs can produce serious health effects, including addiction. Opiate addiction can hinder the physical, emotional and financial aspects of their lives. Commonly abused classes of prescription medications include opioids, central nervous system depressants, and stimulants. According to several national surveys, prescription medications are being abused at a rate second only to marijuana among illicit drug users. The consequences of this abuse have been steadily worsening, reflected in increased treatment admissions, emergency room visits and overdose deaths.

Warning Signs of opiate addiction and dependency:
The addiction or dependency is usually defined as a central nervous system disorder which results from continual use of the drug. In order for an individual to be diagnosed with opiate addiction, two or more of the following must be present in a 12 month period according to the Diagnostic and Statistical Manual of Mental Disorders V.

1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)
2. recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use
3. continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
4. tolerance, as defined by either of the following:

a.   a need for markedly increased amounts of the substance to achieve intoxication or desired effect
b.   markedly diminished effect with continued use of the same amount of the substance
(Note: Tolerance is not counted for those taking medications under medical supervision such as analgesics, antidepressants, ant-anxiety medications or beta-blockers.)

5. withdrawal, as manifested by either of the following:

a.   the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
b.   the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
(Note: Withdrawal is not counted for those taking medications under medical supervision such as analgesics, antidepressants, anti-anxiety medications or beta-blockers.)

6. the substance is often taken in larger amounts or over a longer period than was intended
7. there is a persistent desire or unsuccessful efforts to cut down or control substance use
8. a great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects
9. important social, occupational, or recreational activities are given up or reduced because of substance use
10. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
11. Craving or a strong desire or urge to use a specific substance.

Opiate Withdrawal:
Detoxing from opiates is not a pleasant experience. When detoxing from these drugs it is necessary to obtain medical supervision, because abruptly ceasing to use the drug without medical supervision and treatment can lead to death. Depending on the length of use, the dose and frequency of use, quitting “cold turkey” can cause seizure, heart failure, permanent damage to the cardiopulmonary and nervous system and result in death. Symptoms include:

• Nausea and vomiting
• Diarrhea
• Chills and Sweating
• Irritability and panic attacks
• Intense muscle and bone pain

If you or someone you know is displaying these warning signs please reach out for HELP. We here at the Vince Carter Sanctuary offer Medically Supervised Detoxification, Residential Alcohol/Drug Treatment, Partial/Day Treatment for alcohol and drugs and Intensive Outpatient Treatment. You can contact us at http://www.vincecartersanctuary.org/ or 800 478 0331.


Resources
www.dsm5.org
www.drugabuse.gov