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Tuesday, May 19, 2020

The Myth of 'Rock Bottom' in Addiction Recovery

Often in the world of addiction and recovery, it is said that “you cannot make people change”. While this is true, there is a corresponding belief that therefore people must hit “rock bottom” before being ready to change and commit to treatment. 

Often this refers to extreme hardships as a result of drug use including eviction, loss of a job, strained relationships, even an overdose. While some have shared that an experience like this has brought a moment of clarity to realize they need help, many do not get that opportunity. 

Even more so, many others can and will seek some level of treatment before hitting their relative rock bottom. It is important for help to be made available for individuals wherever they are on their journey, to avoid rock bottom and still promote health, wellness, and recovery.

Do you have to hit rock bottom before entering treatment?

If we are to consider the disease model of addiction, then we must view recovery from it also as such. For other medical diseases, it would be dangerous to wait until “rock bottom” to start treatment. Instead, the medical model seeks to identify and treat illnesses at first detection and recommends preventative practices to avoid the continuation of the disease process. 

Even with chronic illness where a quick cure is not viable, there are still treatments to alleviate symptoms and slow down the progression of the disease. Similarly, substance use disorders are diseases that can increase in severity and cause harm to the individual, families, and communities. Therefore prevention efforts, or interventions that reduce the negative effects, are ideal from both a medical and public health perspective. This is known as the harm-reduction model.

Types of harm reduction treatment

The philosophy of the harm reduction model is to meet people where they stand in the progression of their addiction. This means treating those who struggle with addiction with respect, compassion, and attempt to limit the health, social, interpersonal, and economic consequences associated with drug use. 

This philosophy understands that regardless of efforts, some will continue to use substances, and rather than ignore or neglect these individuals, there are still beneficial interventions that can be put in place. 

This can be a therapeutic approach adopted by clinicians and treatment programs, or be the guiding principle for organizations and agencies. Harm-reduction strategies are not actually a novel idea. Both putting on sunscreen to avoid sunburn and having a designated driver or driving service available when drinking are also good examples of this philosophy at work. 

What does this look like in the community?

Some examples of programs and resources that embody the harm-reduction model are:
  • Medication-Assisted Treatment (MAT) - Also known as an opioid treatment program, these programs provide prescription medications to lower overall opioid use, overdose, and reduce cravings. These programs usually have group and individual counseling as well.
  • Safe injection sites - Facilities that provide medical supervision to prevent overdoses and provide education on safe injection practices, medical treatment, and therapy.
  • Needle exchange programs (NEP) - Community-based programs that offer sterile needles and syringes, and safe disposal. This reduces the risk of blood-borne pathogens and infections.
  • Harm reduction Abstinence Moderation Support (HAMS) Groups - A free, peer-led support group to discuss drinking habits and personal goals for lessening drinking.
  • Managed Alcohol Programs (MAPs) - Treatment facilities for people with chronic alcoholism experiencing homelessness. MAPs will offer small, regular doses of alcohol to prevent withdrawal, as well as provides housing, and seeks to lessen emergency room visits, hospital admissions, and potential lethal withdrawals

Other harm reduction efforts include administering medication to reduce cravings, aid withdrawals, and limit the effects of drugs if one uses.  

Advocacy and awareness efforts are also important, as some can hesitate to support or adopt this model for fear of encouraging use. However, studies show the harm reduction model is effective, safe, and does reduce multiple harmful consequences for individuals, communities, and families.

How you can help

If you have a loved one suffering from an addiction, there are ways you can help. Primarily, let them know you are there for them and seek ways to do so in a nonjudgmental and compassionate way

In keeping an open dialogue, it will be more likely that they can ask for help in the future if they are currently unwilling. Providing local resources can allow them to understand their options for safe use if they are not ready for treatment. 

While each relationship is different and sometimes boundaries and limits must be set, adopting a harm-reduction model can prevent rock bottom and limit negative consequences. It is always good to seek the advice of trained professionals who can address questions and concerns about substance use and explain the treatment options available. By treating those with addiction with respect and compassion, recovery is possible without the looming danger of rock bottom.

Recovery at The Haven

At The Haven, we ascribe to a harm-reduction philosophy. While we work to help our guests understand the costs of addiction, we place equal emphasis on understanding how their use of substances or addictive behaviors makes sense to them. Our goal is to help them see if anything else could make more sense.
Whether it’s seeking the support of our trained staff or seeking more information about the treatment options for your loved ones, give us a call today to learn more!

Tuesday, May 12, 2020

What Medications Are Used In Addiction Detox?

When an individual uses a large amount of substances over a long period of time, the brain and body can become addicted. To function again normally requires a period of detoxification.

The necessity of detox for individuals seeking treatment for substance misuse boils down to the concepts of tolerance and withdrawal.

Tolerance: The need to increase the dose of a substance ingested in order to achieve the same effect as previous doses. 
Withdrawal: Adverse effects experienced when the substance is no longer present in the system. 

Each of these concepts points to the body’s dependence on the substance in order to function normally. 

How does withdrawal work?

For those seeking recovery, when they begin to halt the use of these substances, they enter a ‘withdrawal period’ as the body is adjusting to the lack of the preferred substance effects. The absence of the numbing effects of the drug can make individuals feel extremely sick and can even be life-threatening. That is why often a medically managed detoxification is considered to be the safest and most effective treatment during withdrawals. 

Withdrawals vary based on the type of substance, therefore medically managed withdrawal should be tailored to each individual’s medical needs. This detox period can last anywhere from a few days to a few weeks and is best managed under a physician’s care in a medically supervised and secure environment.

What medications are used?

In a medically managed detox, multiple medications are used to combat the symptoms of withdrawal, prevent life-threatening symptoms, and maintain safety and comfortability. Medications vary based upon what substances the individual has been taking, and what medical risks are associated. 

Some medications used in the detoxification process are:

Drug of Addiction
Common Medications Used in Detox
Naltrexone, while an opioid antagonist that prevents the effects of opioids, also reduces the urge to drink or use. Gabapentin is used for pain relief.  Studies show using these in combination has improved withdrawal and abstinence outcomes. 
Propranolol is a beta-blocker that can also help with alcohol withdrawal. For severe withdrawals, benzodiazepines may be used short-term.
Opioids (heroin, prescription opiate pills)
Opioid antagonists like naltrexone can be used in pill form, or as an injection called Vivitrol. Another option is opioid agonists like Methodone. Methadone will stay in one’s system longer and can help relieve withdrawals and cravings. Methadone and Suboxone (buprenorphine and naloxone) can be used as a part of Medication-Assisted Treatment (MAT) as a way to taper off of opioids slowly or remain on a small dosage to deter using heroin. This is often done as part of the harm reduction model, as explained below.
Often medial detox requires a safe and structured tapering using benzodiazepines themselves. In adjunct, Barbiturates can be used for insomnia, anxiety, and as a preventative measure for seizures, and antipsychotics may be used for delirium.
Stimulants (cocaine, methamphetamine, prescription amphetamines) 
While there is no official medication protocol for detox from stimulants, some medications can be used to treat psychological symptoms associated with withdrawal. This includes Gabapentin for pain relief, Trazodone for insomnia, and antidepressants for depression and fatigue.

What is the harm-reduction model?

The harm-reduction model is both a philosophy of treatment and public health approach towards those who misuse substances. Under this model, we are encouraged to treat those who utilize drugs with respect and compassion rather than judgment and shame, with the goal of reducing negative consequences associated with drug use. 

Rather than subscribing to an abstinence-only model, harm-reduction acknowledges that there are multiple paths to recovery and it is important to meet people where they are at. 

Principles of the harm-reduction coalition

While avoiding minimizing the dangerous and harmful effects of drug use on individuals and communities is the backbone of our work, however...
  • Drug use is a part of our world, and rather than ignore it or condemn it, communities can take steps towards limiting the negative consequences associated with it.
  • Drug use severity is on a spectrum and that various ways of using are safer than others.
  • Providing services and resources is essential for those engaging in substance use and that those who use/used to misuse substances have a voice in the creation and implementation of these programs.
  • Empowering those who use drugs themselves to share information, and support each other can be incredibly powerful.

Programs that incorporate harm reduction models can include advocacy and outreach programs, needle exchanges to prevent the spread of bloodborne pathogens, supervised injection sites to prevent overdose and accidental death, take-home Narcan (or naloxone) kits to prevent overdose, and peer support services.

How is the harm-reduction model incorporated in addiction treatment?

In a treatment program, the harm-reduction model means to understand that addiction is a disease and that addictive behavior, and “relapse” or “slips” are possible, even for those who are well-intentioned in their pursuit of treatment. Rather than this being an automatic termination from treatment, the harm-reduction model seeks to meet people where they are on their journey, and instead offer more support and treatment to help them maintain long term recovery. 

Another example is by offering Medication-Assisted Treatment (MAT) for those using opioids. This substitution program allows individuals to have fewer withdrawals, cravings, risk of relapse and ultimately leads to improved health and recovery outcomes. Individuals can utilize MAT to taper off of opioids or continue daily dosages for years. 

The harm reduction model is an evidence-based and holistic approach to improving substance misuse and related consequences for individuals, families, and communities.

Recovery Support at The Haven

At The Haven, we recognize that medically-assisted withdrawal management is only the first stage of addiction treatment and without effective treatment, does little to change long-term addictive drug use. After detoxification at The Pines, we strongly urge you to consider continuing your journey with us, through residential treatment and beyond. Call today to get started.

Tuesday, May 5, 2020

Does The Brain Have an Impact on Addiction?

There is a cultural myth that addiction is a choice. While it may be a choice to first use a substance, continuous use can have a dramatic impact on the brain and lead to a substance use disorder. 

According to Dr. George Koob, director of NIH’s National Institute on Alcohol Abuse and Alcoholism, “the brain actually changes with addiction, and it takes a good deal of work to get it back to its normal state. The more drugs or alcohol you’ve taken, the more disruptive it is to the brain.” 

A quick lesson in brain chemistry

The brain is made up of millions of cells called neurons. Neurons are responsible for sending signals throughout different parts of the brain, as well as to and from the body. When a neuron needs to send a signal, it releases a neurotransmitter to connect from one neuron to another. This process creates a neural network, where neurons can signal back and forth in a circuit. This can be a message from our brain to jump, smile, or curl our toes and the returning sensory information about the feel of the sand under our feet, or the breathtaking scenery we’re viewing. 

How do substances affect this process?

When drugs or alcohol are introduced, it interferes with neurotransmitters and therefore affects how the neurons send and receive signals. 

Different substances affect the brain in different ways. For example, depressants (like opioids or benzodiazepines) mimic neurotransmitters and activate neurons, causing abnormal signals to be sent throughout the brain. Stimulants (like cocaine or amphetamines) cause the brain to release abnormal amounts of neurotransmitters and can cause a euphoric high.

When someone uses substances and feels pleasurable effects, this is due specifically to the effects of a particularly reinforcing chemical called dopamine. Because dopamine allows the user to experience pleasure as they would after a really good meal, caring for loved ones, or having sex, they’re highly motivated to continue drug-seeking and using behavior. 

Not only does this exist on a somewhat-conscious level, this additionally changes the brain’s neural networks, creating physiological cravings, and making it easier for substance use to become a habit. 

How does this lead to addiction?

Over time and continued use, because you are providing an external source, the brain will severely decrease producing neurotransmitters on its own. This means that individuals now rely on ingesting substances to have normal levels of dopamine, or pleasure. Without them, they may feel unmotivated, helpless, and depressed. 

This rewiring of the brain causes drugs to become the priority for survival. The brain perceives drugs as more important than connection to others, success, money, even food, water, and shelter. The brain becomes physically, emotionally, and biologically dependent on the substance, and the individual becomes addicted.

What does recovery do to the brain?

While addiction can cause significant and sometimes long-term effects on the brain, it is possible to recover. 

Oftentimes when an individual stops taking a substance, they experience withdrawals as the body and brain detox from the substance. The withdrawal period depends on the substance, how long it was used for, and how often. Withdrawals can last days to sometimes months, and so it is often helpful to detox in a safe and structured environment

However, with continued abstinence and the right supports, the brain will remarkably heal itself. Not only will improvements in memory, executive functioning, and cognitive processes improve, but also the brain’s ability to find pleasure and enjoyment in activities and life again. 
Priorities are able to shift away from substances and align to the individual’s needs, wants, and values. Over time and with the right treatment, recovery from addiction is attainable and the brain’s ability to heal is possible.

Recovery at The Haven at Pismo

As a fully-equipped treatment center, we are capable of meeting you where you’re at on your journey towards recovery and provide you with the right support all along the way. As a part of our “phase program”, we can lead you right from our beautiful detox residence, The Pines, into residential care and follow that with our Partial Hospitalization or Outpatient programs. 

At The Haven, we understand how addiction has impacted, and in many ways “hijacked”, the brains of the guests who come to us to heal. Not only can we offer a plan to help the brain detox and heal from harmful substances; we also understand that through holistic healing in mind, body, and soul, you’ll have your best chance to truly experience long term recovery. 

Contact us today, no matter where you fall in the journey to recovery to experience real and lasting life change!

Tuesday, April 28, 2020

Combatting the “I Deserve This” Mentality

The year is 2020, and not much has changed in that we are still constantly bombarded with messages about health, lifestyle, self-care, how to create deep and meaningful friendships and relationships, and how, “with these three simple tips”, we can make parenting look easy. It can feel overwhelming to consider all of the supposedly “simple” aspects of our existence that we are expected to pay attention to in order to create a meaningful life. 

It can feel exhausting to be alive these days, no matter what stage of life you are in. For those who struggle with addictive patterns especially, extinguishing the pull towards drinking or eating or shopping as a means to celebrate our abstinence from that very same behavior is a large focus of treatment. It is not long before this mentality becomes a problematic cycle.

So how do we cultivate motivation, set goals, and reward ourselves in ways that are beneficial to our health, rather than furthering problematic patterns?

Isn’t it a good thing to be proud of yourself?

To some, claiming “I deserve this” Megan Rapinoe style is a battle cry and message of female empowerment to take pride in your hard-won accomplishments. For many, she serves as a model for acknowledging that you can be proud of yourself without feeling ashamed or egotistical. It is entirely inspiring to see a woman confident enough to unapologetically take up space in this world. 

This mentality, however, does not tend to be the end result of someone claiming “I deserve this” in the face of another slice of chocolate cake, or when staring down the untouched drink in their hand. This is simply rationalization and justification at it’s best, and it is important to realize that this constant internal battle will not ultimately lead you down a path of meaning or fulfillment.  

The road towards such entitlement that led someone to that point was likely one littered with deprivation and self-judgment. In this case, the self-judgment may have been thought to be either negative or positive with equally disastrous results, as believing that one’s value grows with each positive step further imbeds the ideology that self-worth is earned rather than innate. 

In addition, a lifestyle focused on deprivation is at the core fixated on harmful rather than helpful beliefs. It is a classic glass half-full or half-empty metaphor in the making. For example, if I am angry because of all the food that is off-limits to me as a result of my health goals, I am going to have a much more miserable time than if I dedicate myself to finding healthy foods that fit the goals and that I actually like eating. 

But shouldn’t we celebrate our accomplishments?

To resist the temptation to indulge in one’s vice after a hard day’s work, and to decide not to stop at the liquor store on your way home from work takes a great deal of willpower. Developing some amount of dedication and determination towards meeting the goals we set for ourselves is no small feat, and of course, it is an enticing idea to celebrate our achievement by making other allowances throughout the day. 

Again, the key to correcting this problematic phrasing is in switching the direction of our attention. Take the following scenarios:
Thought: I deserve this drink because I have been working hard all week long and deserve a break. 
Reframe: I deserve a break and am excited to provide my body with something that will actually refresh me.
Thought: I deserve to drink tonight because I feel lousy, and this wine is going to make me feel better.
Reframe: I deserve to indulge in a mug of tea tonight before bed, to give my body its best chance at a good night’s sleep, and my mind an opportunity to avoid future guilt.

Thought: I deserve this drink because I’ve already ruined what matters in my life and I might as well keep going. 
Reframe: I deserve a fresh start because, despite my past regrets, I have faith that my future will be of my own creation. 

It is not hard to see how easily these thoughts may arise and take over without our attention to capturing and correcting them. Thoughts like these often pave the way for relapse and make the commitment to sobriety a daily test. Of course, paying attention to thoughts like these is a focus of Cognitive Behavioral Therapy, as is learning to challenge and reframe them. 

Transitional Living at The Haven

Whether you’re concerned about addictive patterns in your life or have recently completed treatment, it may be important for you to seek the structure that a transitional living community can provide. Contact us today at Info@thehaven.com or call us at 1-805-202-3440 to learn more about our program and how we can be a support to you!

Tuesday, April 21, 2020

Supporting a Loved One in Addiction Treatment

The idea of addiction and everything it represents is a weighty topic in our society today. For some, “addiction” wears the face of their best friend, son, or primary caretaker. For others, it is the shapeless, anonymous face that represents ‘all that is wrong in society’. For others still, it is their best-kept secret or the master puppeteer that keeps them silenced and isolated. 

Those who have been caught up in addictive patterns who have chosen to seek recovery often rely on the support of their family and loved ones in order to persevere through the recovery process, and every day thereafter.  It can be challenging, however, to know how to support a loved one in any stage of the treatment process.  

For many of us, it may inspire frustration, or may even spark the idea that those trapped in its cycle need to “get their act together”. Or it may even bring us back to a time when we were young, feeling small and stuck believing that we have no power. 

Remember: Addiction is a Disease

Since 1956, the American Medical Association has adopted a “disease model” as the best way to understand addiction. This arose in reaction to some believing it to be a “weakness of character”. 

Due to this widespread intolerance for individuals who struggle with addiction, so often, the idea that YOU might have an addiction holds such a negative connotation that can inherently make someone want to cower in shame when they recognize themselves within its insidious grip. By its very design, it keeps individuals isolated from those who could offer their help, and stuck instead in a cycle of shame.

However, in the same way in which we would not place blame on our loved ones for their cancer diagnosis, it does not do much good to place blame on those struggling with addiction. 

We can, however, hold them accountable for their actions and set boundaries as it relates to patterns of enabling and codependence. We also must be willing to understand that recovery from addiction can be a lengthy process and in order for it to be successful, it requires participation from both the individual seeking the change and their supporters. 

From the Support Team Perspective

We must ask ourselves as the family or friends of someone struggling with addiction, how can we help and show our support? 

Many times this looks like first becoming educated on the typical methods of treatment for addiction, involving yourself in the process, and seeking your own support system that can help you to also seek new patterns of relating to your loved ones. 

Becoming educated on the different rehabilitation centers (both inpatient and outpatient) in your area or in key locations across the country and the services they offer is important because it allows a realistic picture of what your loved one may require and experience while in treatment. 

Whether this means gathering more information on family therapy, group counseling, twelve-step integration, and any other holistic or experiential elements, this is helpful to know what sort of supports are required in order to help your loved one recover. More importantly, this also helps you to know how, once they’ve returned home, you can help them establish a similar system of supports.  

How to Best Communicate with a Loved One in Recovery

When talking and when listening to your loved one who is struggling with addictive patterns, it is important to approach the situation with the mindset that this person is not acting entirely of their own accord. Their brain’s reward system has been hijacked by the substance or behavior and has reorganized their ability to effectively prioritize the health of their bodies, finances, relationships or desire for a better future.

These are not actions that this person necessarily wants to be taking, and it does not mean that because they make bad choices, that they are a bad person, or deserving of a bad outcome. Those who suffer from an addiction to alcohol or drugs are no longer in control, even if they can see the damage that their actions are having, or have had.

As a supporter of this person, it is your job to provide encouragement. This can be related to their willingness to seek treatment or to participate in a therapy session while informing them that these actions are important, noticed, and appreciated.

Family Integration at The Haven at Pismo

A central goal of The Haven at Pismo is to train family members on how to interact more positively regarding their loved one’s substance abuse, and open the door to having constructive and even healing discussions. The approach we believe is most helpful calls for expressing concern for the person in an empathetic and caring way while avoiding blaming or shaming them. We also recommend working to remain centered with a calm demeanor, even though responses from the person may be unpredictable or hurtful. 
The goal of the most effective approaches in these types of conversations is to create a dialogue. This is not the opportunity to berate the person or to tell them about all of the struggles that their addiction is causing you, however tempting that may be. Rather, time is used most beneficially when we allow them to share their perception of the changes they are seeking and the new life they are creating with the support of The Haven community. Using open-ended questions shows that you are interested in their point-of-view and want to be involved in their recovery process. 

We need to remember that the main thread here in supporting someone in treatment is entering each encounter with an open mind. It is seeing the addiction from a place of concern, but also a place free of judgment. It is holding our family member or friend accountable and placing boundaries when necessary. But, mainly it is being a part of their treatment process and whatever else may arise while on their recovery journey. 

Tuesday, April 14, 2020

Most Important Addiction Recovery Apps

In a new comedy Netflix special, Taylor Tomlinson delights us with her depiction of technology that “the internet is the most beautiful, amazing, disgusting, horrifying thing in the Universe”. Of course, it can give way to mind-numbing isolation and a perfect distraction from life’s difficulties that we’d usually rather avoid, but it can also provide us with innumerable supportive resources to pursue recovery and maintain our health and wellbeing. 
It also exists as a way to take what is learned in session, and transfer it to everyday “real” life. True, meaningful recovery takes place when individuals are able to harness the tools learned in therapy and actively apply them to their mental, emotional, and physical selves. 
The following is a summary of five types of recovery apps that, in addition to seeking treatment in a supportive environment, are important resources for your recovery.

Time Management

The first tool that comes to mind when considering the usefulness of technology are apps that allow us to actually track our time spent online. It is important to check out how we spend our digital lives, and this will likely give insights into areas of concern for you. 

This might be as simple as checking your phone’s built-in screen time tracker (called ‘Digital Wellbeing’ on Android phones) or downloading software that helps you prioritize and keep track of time. 

On both built-in versions of the apps, you are able to set time limits for specific categories or the apps themselves, and once time has run out, they will block further use. For apps that are known distractions, this can be entirely helpful in increasing focus and eliminating distractions.

Additional functions of time-management apps allow you to have a central place to organize and track important events and tasks, and schedule out time for self-care as well. Whether you’re using a task management platform, or simply using the Notes or Reminder apps built-in on your smartphone to take those thoughts from buzzing around and swarming in your brain to a system that makes sense to you. 

Meditation and Relaxation

Meditation is the active pursuit of mindful awareness that seeks to connect the brain and body to bring one to a state of calming peace and awareness of self and one’s surroundings. Meditation and its sister, Yoga, are often recommended or included in holistic treatment programs to help clients access inner strength and a sense of peace. 
However, much like attempting to solve math equations without the teacher present, trying meditation on your own can at first be confusing and frustrating. Meditation apps provide structured suggestions and guided activities to provide support. 
Many different apps have been developed in this space to help those new to the practice:

Books and Podcasts

It’s possible that you still have not jumped on the podcast train, or taken the time to explore what information is available to you online. However, this is one of the best ways to make use of your time, whether you’re on the bus, driving to an appointment, or getting ready in the morning. It may take some time to discover a podcast that you love, but it can be a truly influential experience to sit back and listen to others’ perspectives as they chat on various topics, or to get caught up in the plot of a suspense-filled drama. 
Individuals in treatment who invest in their mental well-being by reading on subjects related to their recovery often find healing in their selections, whether they’re reading for enjoyment, as a means to learn more about a particular topic, or as a supplement to therapy sessions. 


Research on sleep hygiene and its connection to mental health and wellness place it high on the priority list as an area of concern for those in recovery. While the recommended 8-10 hours of sleep is ideal, research indicates that we are rarely truly resting for that time regardless of how long we sleep. Sleep studies suggest that lack of sleep contributes to symptoms such as fatigue, headaches, migraines, and difficulty concentrating (just to name very few). 
Using apps like Calm, or others that allow you to tailor your sleeping environment can be helpful in initially falling asleep, where apps like Sleep Cycle will take over and track your REM cycles and wake you in the morning during the ideal time, at your lightest sleep. Other apps built into your phones such as Do Not Disturb and the android equivalent are also important to help build healthy routines around sleep. 

Addiction Recovery Apps

Recovery from addiction requires a great deal of support outside of the time allotted for individual and group meetings. As people and the behaviors leading to addiction change and adapt, so too have the resources that are available to those in recovery. 
Apps for recovery include those mentioned above, as well as tools for peer support, clinical support, educational materials, and interactive check-in and support features to foster healthy personal and peer accountability. Some of these addiction recovery apps may be helpful tools in the journey of recovery.

Recovery at The Haven

Today’s technology has evolved to provide viable resources for those in recovery, although it’s possible that you will need more support than just what these apps can provide. Recovery is a journey best traveled with both internal and external resources, including access to qualified treatment professionals that are able to expertly tailor treatment to meet your needs. If you or someone you know is ready to begin the journey of recovery, contact us today!