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Harm Reduction for the Clinical Setting12/2/2020H A R M R E D U C T I O N F O R T H EC L I N I C A L S E T T I N GP r e s e n t e db yK i mb e r l yM a y ,L PC-S,L M FT1Welcome, your facilitator will be:Samson Teklemariam, LPC, CPTM Director of Training and ProfessionalDevelopment for NAADAC NAADAC, the Association for AddictionProfessionals www.naadac.org Steklemariam@naadac.org2Halcyon Health provides high‐quality, evidence‐based, personalized care for our members –designed to increase Recovery Capital and improve outcomes.Certified Peer Recovery CoachingTech‐Enabled Whole‐Person CareIntegrated Care CoordinationHalcyon Healthhalcyonhealth.co33Presented by Kimberly May, LPC‐S, LMFT1

Harm Reduction for the Clinical Setting12/2/2020www.naadac.org/webinars4Using GoToWebinar(Live Participants Only) Control Panel02 Asking Questions Handouts Audio (phone preferred) Polling Questions5NAADAC Webinar PresenterKimberly May, LPC-S, LMFTFounder of Substance Use TherapyAustin, py.com6Presented by Kimberly May, LPC‐S, LMFT2

Harm Reduction for the Clinical SettingHARM REDUCTIONFOR THE CLINICALSETTING12/2/2020Kimberly May, LPC-S, LMFTSubstance Use TherapyAustin, TX7What isHarmReduction?Harm reduction is a set ofpractical strategies and ideasaimed at reducing negativeconsequences associated withdrug use.Harm Reduction is also amovement for social justicebuilt on a belief in, and respectfor, the rights of people whouse drugs.-Harm Reduction Coalition8Examples of HarmReduction Designated drivers Seat belts Moderation Nicotinereplacementtherapy Sunscreen Eat This, Not That Condoms9Presented by Kimberly May, LPC‐S, LMFT3

Harm Reduction for the Clinical Setting12/2/2020LET’STALKABOUTMEAT10 Meet people where they are. First reduce harm tothemselves or otherscaused by substance use. Crucial to get to know eachperson and theirrelationship with drugs andalcohol. View each person as anindividual who has complexneeds that may extendbeyond just addressingsubstance use.ApplyingHarmReduction totheClinicalSetting11Common ThemesLack of self-compassionLack of self-worthShameGuiltUnhealthy/non-existent boundaries12Presented by Kimberly May, LPC‐S, LMFT4

Harm Reduction for the Clinical Setting12/2/2020Types of Boundaries Emotional boundaries Physical boundaries Work boundaries Time boundaries Sexual boundaries13Beyond ToughLove Boundaries forcaregivers Rethink enabling &co-dependency What role are youtaking on? The problem withpromises What can yourealistically takeon?14C O N T I N U U M OF USE0. No use1. Experimentation2. Social/Recreational3. Habitual4. Abuse5. Dependence (addiction)6. Physiological dependence7. Persistent addiction15Presented by Kimberly May, LPC‐S, LMFT5

Harm Reduction for the Clinical Setting12/2/2020PROGRESSION FROM USE TODEPENDENCE IS NOT INEVITABLE16Addiction is abiopsychosocialphenomenon The full picture iscomplex Our strengths arealso GOAL and embracethe ambivalence18Presented by Kimberly May, LPC‐S, LMFT6

Harm Reduction for the Clinical 1Presented by Kimberly May, LPC‐S, LMFT7

Harm Reduction for the Clinical Setting12/2/202022ACTIVEUSERS CANAND DOPARTICIPATEIN TREATMENT23INCREASING MOTIVATIONFOR CHANGEIS THE THERAPEUTIC WORK,NOT A CONDITION FOR BEGINNINGTHE WORK24Presented by Kimberly May, LPC‐S, LMFT8

Harm Reduction for the Clinical Setting12/2/2020ANYREDUCTIONINHARM IS A STEPIN THE mbating ClinicianHopelessness andBurnout1. Redefine/reframesuccess2. Build trust throughlack of bias3. Create atmosphereof understanding4. Focus on process,let go of outcome27Presented by Kimberly May, LPC‐S, LMFT9

Harm Reduction for the Clinical Setting12/2/2020IT WASN’T THE WORSTDAY OF MY LIFE28Drug, Set, andSettingDRUG Potency Route ofadministration Adulterants Pharmacologyand actions ofeach drug Amount29Drug, Set, andSettingSET Personality traitsMood when usingExpectationMotivationEmotional issuesCoping deficitsHealth30Presented by Kimberly May, LPC‐S, LMFT10

Harm Reduction for the Clinical Setting12/2/2020SETTINGDrug, Set, andSetting EnvironmentLife stressorsAlone or with others?How at ease or rushed they feelTime of dayCulture31Myth: Harmreduction isagainst abstinenceTRUTH Harm reduction therapistssimply accept that peopleuse both licit and illicitsubstances. Use is not condoned, butpersonal choice isrespected, and goals comefrom the client. At the forefront will behonest discussions of riskwith continued use.32Change my drinking/drug useProsSave moneyLook betterNot be hungoverNot worry about getting a DUIConsLike going to barsTrouble sleepingKnee would hurtFear of unknownContinue using the way I am nowProsNo withdrawalI wouldn’t feel overwhelmedI could keep going to barsConsMight lose my relationshipMight get arrestedDecisionalBalanceExercise33Presented by Kimberly May, LPC‐S, LMFT11

Harm Reduction for the Clinical Setting12/2/2020SUBSTANCESPECIFICHarm reduction strategies34Alcohol & harm reduction Transportation planBlack out preventionModeration strategiesAbstinence daysNaltrexoneSinclair MethodChanging locationMeasuringAvoid mixing with other drugsLess is more35Opioids & harmreduction Medication AssistedTreatment Needle exchange Safe shoot practices Fentanyl testing kits Naloxone (Narcan) Use less after periodsof abstinence Use less in strangeenvironments36Presented by Kimberly May, LPC‐S, LMFT12

Harm Reduction for the Clinical Setting12/2/2020“THE OPPOSITE OFADDICTION IS NOTSOBRIETY,IT’S CONNECTION.”-Johann Hari37HarmReductionResources Harm ReductionCoalition The Naloxone Finder Harm ReductionInternational Dance Safe Tweaker38References Cocaine Rat—Drug Free America (2011, Aug 21). YouTube:https://www.youtube.com/watch?v 7kS72J5Nlm8&index 93&t 0s&list PL4B2ED816CB9CA428 Denning, P. (2000). Practicing Harm Reduction Psychotherapy: An AlternativeApproach to Addictions. The Guilford Press. Denning, P., & Little, J. (2017). Over the Influence: The Harm Reduction Guide toControlling Your Drug and Alcohol Use. The Guilford Press. Hari, Johann. (2015). Chasing the Scream: The First and Last Days of the War onDrugs. Bloomsbury Publishing. Kuhn, C., Swartzwelder, S., & Wilson, W. (2019). Buzzed: The Straight Facts aboutthe Most Used and Abused Drugs from Alcohol to Ecstasy. W.W. Norton & Company.39Presented by Kimberly May, LPC‐S, LMFT13

Harm Reduction for the Clinical Setting12/2/2020ReferencesImages Retrieved from: 0-c85.jpg c9a50cd15dfcc/1548858898378/Screen Shot 2019-01-22 at 3.40.28 PM.png?format 1500w https://static.gosquared.com/images/liquidicity/18 10 25 proactivechat/crosssellingarrows.png om/2010/04/slide11.gif feel-so-good nsulting-2204253 1280.png reduction.png https://miro.medium.com/max/596/0*xm7KCqyN j5I0IZf.jpeg differences-drug-and-alcohol-abuse.jpg https://i.redd.it/o3m03gxd7nb21.jpg /2019/12/alcohol-and-depression.jpeg /5582dd0d-c75d-4852-9902-1aa9f838d860-Social Happy Hour.jpg?crop 938,704,x212,y0&quality 50&width 640 -harm-reduction-international-png-clip-art.png https://encrypted-tbn0.gstatic.com/images?q sqp CAU https://sadkhin.com/gallery/blogs/85 451.jpg 9/IMG 7806-688x688.jpg gs-Drinking-Alcohol-Does-to-Your-Body.jpg 8-dangerous-painkillers-super-tease.jpg far post headers/images/1YsKTV9Ksc/original lantern-festival-floating.jpg?auto compress,format&fit crop&crop top&lossless true&w 1600&h 700 https://cdn-b.william-reed.com/var/wrbm gb .jpg oin-006.jpg?width 700&quality 85&auto format&fit max&s b4a85a6a6d07f14b33f1653b4ad3c4a0 500x340-Forest-Fire-Shot.jpg rCIK2hNcKU.jpg 0/04/7-types-of-boundaries-you-may-need.jpg cyon Health provides high‐quality, evidence‐based, personalized care for our members –designed to increase Recovery Capital and improve outcomes.Certified Peer Recovery CoachingTech‐Enabled Whole‐Person CareIntegrated Care CoordinationHalcyon Healthhalcyonhealth.co41Halcyon Healthhalcyonhealth.co4241OverviewHalcyon Health specializes in substance use disorder (SUD) andaddiction treatment solutions. By combining a proprietary,software‐driven integrated care platform, Certified PeerRecovery Coaching (CPRC), and Care Coordination; Halcyon fillsin the gaps in care at a highly targeted level — enhancing well‐being and improving patient outcomes.42Presented by Kimberly May, LPC‐S, LMFT14

Harm Reduction for the Clinical Setting12/2/2020HOW IT WORKSMember JourneyProvider talks to prospectiveMember enrolls with Halcyon Health,With member input, Halcyon care teammember about Halcyon andmakes referral.completes intake with dedicated CareCoordinator and is matched with their CPRC.designs a personalized recovery planand handles all referrals coordination.Member works with CPRC to buildrecovery capital and improveoverall well‐being.Care team works with the member to assessprogress using ongoing surveys and membercommunication — further refining plan as needed.Halcyon Healthhalcyonhealth.co4343acting as an extension of their team to eliminate any barriers totreatmentPARTNERSHIPSWe Partner with Best‐In‐Class Providers We help decrease patient/client hospitalizations and improvelong‐term outcomes We help increase patient/client satisfaction, resulting incontinued engagement in care You will be are added to our “Preferred Provider Database,”which Halcyon utilizes when seeking referral options that fitmembers’ needsHalcyon Healthhalcyonhealth.co4444Have questions?Need more resources?Reach rapy.com45Presented by Kimberly May, LPC‐S, LMFT15

Harm Reduction for the Clinical ction-webinarCost toWatch:FreeCE HoursAvailable:2 CEsCE Certificatefor NAADACMembers:FreeCE Certificatefor Nonmembers: 2546UPCOMING WEBINARSDecember 11th, 2020December 4th, 2020Engaging Learners in Online SupervisionBy: Eileen McCabe O’Mara, EdD, LADC, NCCSocial Media andEthical Dilemmas forOpioid UseDisorderin theBlack Community:SocialMedia andEthicalExpertDilemmasfor Panel DiscussionBy: Sherrá Watkins, PhD, LCMHC-S, LCAS,CRC, CCS, BC-TMH, Andrew Kolodny, MDand Lamiaa Tolba, PA-C, DMSc, MPASDecember 9th, 2020December 16th, 2020SubstanceUseDisordersSocial MediaandEthical and Suicide:Addressinga Co-occurringEpidemicDilemmasforBy: Geoff Wilson, LCSW, LCADCNonopiate Therapy for Chronic PainBy: Tammy Flemming, DNP, ACNP-BCwww.naadac.org/webinars47Cultural Humility Webinar Series NAADAC’s 8-Part Cultural Humility Webinar SeriesSocial Media and Ethical NAADAC’s On-Demand FREE WebinarsDilemmas forSubstance Use Disorder in the African American Community and Virtual Town HallSocial Media andpresented by:Ethical Dilemmasfor Sherrá Watkins, PhD, LCMHC-S, LCAS, CRC, CCS, BC-TMHwww.naadac.org/culturaSocial Media and Ethicall-humility-resourcesDilemmas for Anthony Andrews, PhD, CRC, LCMHC, TF-CBT Cynthia Moreno Tuohy, BSW, NCAC II, CDC III, SAP Samson Teklemariam, MA, LPC, CPTM Highest viewed 2020 webinarSocial Media and EthicalDilemmasfor Materials Addiction Technology Transfer (ATTC)Network Print Resources Webinars Podcosts48Presented by Kimberly May, LPC‐S, LMFT16