The Grieving Process and Its Importance to Addiction Recovery

This paper will address the importance of the grieving process to sustaining addiction recovery. In order to accomplish this I will utilize several sources which discuss the grieving process, including Elizabeth Kubler-Ross's stages of grieving, J. William Worden's book called "Grief Counseling and Grief Therapy", and Robert Helgoe's book "The Hierarchy of Recovery". Additionally, some personal and professional experience will also be included.

There are three reasons that the grieving process is important to sustained, rewarding recovery. The first is many addicts have unresolved grief issues from their pasts. Perhaps the death of a relative or the dissolution of a close personal relationship has occurred. The use of drugs and alcohol hamper the grieving process, resulting in a delayed grief reaction. The loss is not grieved until the addictive use of drugs and alcohol has ceased and the feelings surrounding the loss are felt and processed.

A second reason that grieving is important to recovery is the result of the losses that occur due to addictive use. Many recovering addicts grieve time they have lost with family, time lost in or starting their careers, and possibly potentials or opportunities that were lost. Recovering addicts compare their progress in their lives to that of non-addicted peers, and they appear to fall short. Their peers have moved on in their careers, have had and raised families, and have many amenities that a person new to recovery may lack.

In order to discuss the third reason that the grieving process is essential to rewarding recovery I must first introduce a theory from Helgoe's book, "Hierarchy of Recovery". Helgoe divides recovery into two phases. The push phase is defined by the focus of motivation, which in this case is toward the crisis or events which led to treatment. More concisely, the recovering addict is staying clean to avoid the consequences they experienced due to active addiction. Their motivation is largely to avoid the life they were living, being pushed from an old life to a new.

In the pull phase the recovering person is drawn toward a more spiritual and fulfilling life. The focus of recovery is no longer avoidance of an old way of living, but attraction to a new way of being, and enjoyment of the rewards of recovery in the present. Furthermore, focus on continued self-discovery, and eventually self-expression are the focus.

Helgoe believes that in order to move into the pull phase of recovery, in which the rewards of recovery are found, a person must complete the grieving process for their addiction. Facing the fact that the use of a substance such as alcohol or drugs can never be relied upon again is a painful experience for any addict. The reality of living the rest of your life without drugs and alcohol is sometimes nearly impossible to fathom to those dependent upon them. When an addict gives up substances they are giving up a friend, a lover, and possibly the only relief they know. True acceptance of powerlessness over substances is a true loss. And according to Kubler-Ross, an authority on grief and grieving, we experience grief whenever we lose anything of importance.

As identified by Kubler-Ross, there are six stages of grieving. They are:
Shock: the inability to grasp the situation as it is presented. The information is too overwhelming to process. Usually lasts only a few minutes.
Denial: a belief that the news can not be correct, due to the pain associated with the loss.
Anger: diminishes the experience of the pain that comes with the loss. Can occur at person or thing lost, at God, or at self.
Bargaining: hope leads to bargaining, a defense mechanism that delays the pain of the loss temporarily, until the hope is extinguished.
Depression: works to dull the pain of the loss because it dulls nearly all experience, internal and external. (Hierarchy of Recovery, pgs 56-59)

According to Helgoe, "at this point people go in one of two directions: they either continue defending against the pain or they drop their defenses and experience the pain." If they choose to continue to defend against the pain and not experience it, they "may resort to previously used (defenses, denial, anger, bargaining) and enter into what can be termed extended or chronic grief, a life debilitating situation often misdiagnosed". (pg59-60)
Acceptance: the acceptance of the pain associated with the loss.

In the book "Grief Counseling and Grief Therapy" by J. William Worden, the grief process is divided into four tasks, all of which relate to the stages of grief previously mentioned. They are described in the following:
Task I- Accept the reality of the loss.

During this phase the denial of the loss, including denial regarding the meaning of the loss and/or the irreversibility of the loss are resolved. Relates to shock, denial, and bargaining.
Task II- Working through the pain.

During this phase the grieving work in relation to the pain is processed and resolved. Avoiding the pain prolongs the process, as does avoiding the anger. People avoid anger due to feeling guilty, such as being angry at deceased or at God. In relation to addiction, the recovering addict may be angry with God for making them an addict, angry with the disease of addiction, angry at themselves for being an addict, and angry at those who can drink or use socially. They may have pain related to not being able to use again, and the acceptance of powerlessness may hurt their image of self worth. Relates to anger and depression.
Task III- Adjustment to the environment.

During this phase the individual may need to re-identify him or herself and take on new roles.
Relates to the beginning of acceptance.
Task IV- Emotional relocation of the loss.

The emotional energy once tied to the loss is relocated. This is the final task, and as it relates to recovery the individual has now accepted the loss. Relates to the acceptance stage. This would lend itself to entering the pull stage of recovery, as identified by Helgoe.

There are an array of feelings that are considered normal in the grieving process. These include but are not limited to: sadness, anger, guilt and self reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, and numbness.

There are several complications that can occur during the grieving process. These include:
Delayed grief -the immediate emotional response is insufficient to the loss. (Grief Counseling and Grief Therapy)
Extended grief -emotional flatness, feelings of guilt.
Chronic grief -the continued use of defenses and not dealing with the pain associated with grief results in this. (Hierarchy of Recovery, pg65).

Owner of Home Health Companies Sentenced for Role in $20 Million Health Care Fraud Scheme

WASHINGTON—The owner and operator of several Miami health care agencies was sentenced today to serve 120 months in prison for his role in a health care fraud scheme involving defunct home health care company Trust Care Health Services Inc.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office; and Acting Special Agent in Charge Michael J. DePalma of the Internal Revenue Service-Criminal Investigation’s (IRS-CI) Miami Field Office made the announcement.
Roberto Marrero, 60, of Miami, was sentenced by U.S. District Judge K. Michael Moore in the Southern District of Florida. In September 2013, Marrero pleaded guilty to conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks.
Marrero was an owner and operator of Trust Care, a Miami home health care agency that purported to provide home health and physical therapy services to Medicare beneficiaries.
Co-conspirators Sandra Fernandez Viera, 49; Patricia Morcate, 34; and Enrique Rodriguez, 59, all of Miami, have also pleaded guilty to related charges, including conspiracy to commit health care fraud and conspiracy to receive and pay health care kickbacks. On November 13, 2013, Fernandez Viera was sentenced to serve 120 months in prison; Morcate was sentenced to serve 60 months; and Rodriguez was sentenced to serve 57 months.
Together with Marrero, Fernandez Viera was an owner and operator of Trust Care. Morcate worked at and was an investor in Trust Care. Rodriguez served as a patient recruiter on behalf of Trust Care.
According to court documents, Marrero and his co-conspirators operated Trust Care for the purpose of billing the Medicare Program for, among other things, expensive physical therapy and home health care services that were not medically necessary and/or were not provided.
Marrero primarily controlled Trust Care and, in light of that role, oversaw the schemes operating out of the company. Marrero was also responsible for negotiating and paying kickbacks and bribes, interacting with patient recruiters, and coordinating and overseeing the submission of fraudulent claims to the Medicare program.
Marrero and his co-conspirators paid kickbacks and bribes to patient recruiters in return for the recruiters providing patients to Trust Care for home health and therapy services that were medically unnecessary and/or not provided. Marrero and his co-conspirators at Trust Care also paid kickbacks and bribes to co-conspirators in doctors’ offices and clinics in exchange for home health and therapy prescriptions, medical certifications and other documentation. Marrero and his co-conspirators used these prescriptions, medical certifications, and other documentation to fraudulently bill the Medicare program for home health care services, which Marrero knew was in violation of federal criminal laws.
From approximately March 2007 through at least October 2010, Trust Care submitted more than $20 million in claims for home health services. Medicare paid Trust Care more than $15 million for these fraudulent claims.
Marrero and his co-conspirators have also acknowledged their involvement in similar fraudulent schemes at several other Miami health care agencies in addition to Trust Care with estimated total losses of approximately $50 million. Those agencies include A&B Health Services Inc., Centrum Home Health Care Inc., Global Nursing Home Health Inc., Lovable Home Health Services Corp., New Concepts In Health Inc., Nursemed Home Care Corp., R&M Health Care Inc., Ubieta Health System Inc., and Vital Care Home Health Services Inc.
The case was investigated by the FBI and HHS-OIG, with the assistance of IRS-CI, and was brought as part of the Medicare Fraud Strike Force initiative, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorney A. Brendan Stewart of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Durable Medical Equipment Clinic Owner Pleads Guilty in Miami for Role in $11 Million Health Care Fraud Scheme

WASHINGTON—The former owner of a defunct durable medical equipment (DME) clinic based in Miami pleaded guilty today for his role in an $11 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office, and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations’ Miami Office made the announcement.
Francisco Enrique Chavez, 36, of Miami, pleaded guilty before U.S. District Judge Patricia A. Seitz in the Southern District of Florida to one count of health care fraud. He faces a maximum penalty of 10 years in prison when he is sentenced on February 11, 2014.
According to court records, Chavez served as the president and sole corporate officer of World Class Medical Clinic Corp. (World Class). From March 27, 2006, through August 22, 2006, Chavez submitted or caused to be submitted approximately $11,303,494 in fraudulent claims to the Medicare program on behalf of World Class for DME that was neither prescribed by a physician nor medically necessary. Medicare paid more than $1,713,959 on these fraudulent claims. The proceeds of the World Class fraud scheme were deposited into corporate bank accounts that were controlled by Chavez, and he made numerous cash withdrawals and deposits into personal and shell entity bank accounts to conceal the nature of the scheme.
Chavez was a fugitive who was extradited from Spain to Miami on August 30, 2013.
This case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. This case was prosecuted by Trial Attorneys Allan J. Medina and Sarah M. Hall of the Fraud Section. The Criminal Division’s Office of International Affairs provided significant assistance in the extradition.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.

Effectiveness of Treatment in Alcohol Addiction

Effective treatment therapy can decrease high drinking limit - it's proven to ensure it that the alcohol rehabilitation center is perfect place.

Most of the rehab centers concentrates on, recovery of the addict. This recovery can classify under four categories. Those are: life style optimization, prevention of alcoholism and physical and spiritual growth of addict.

It is noticed that, the more complex lifestyle is more or less responsible for alcoholism. During this treatment session addict can enhance his power to overcome those complexity.

Prevention - is most important part of the holistic pattern treatment. Through this session addict can achieve how to overcome those triggers which will curve him towards alcohol. It's a very crucial stage of treatment where addict need a lots of specialist, who will cross verify the explanation of the addict and guide him to get the proper think ability.

Some of rehab centers focused on physical and spiritual growth of the addict through music and yoga. It is proven that, most of the cases relapse the alcohol abuse caused the improper prevention plan. Basically it's a problem solving technique. Through which addict can overcome the "Helplessness". So the addicts need a proper substance prevention plan by providing a continuous support. Generally the holistic approach takes 1 year for continuous support.

This is recommended that, the holistic intervention process is the beginning process of the treatment, so done it carefully with specialist supervision or by taking help of any rehab center. Sometimes detoxification is required; detoxification is a process - where using proper medicine alcohol and damaged cell can be removed from human body. Doctors will provide cross tolerance drugs into addict's body that will effect to prevent alcohol. Detoxification may or may not be required for all addicts. Perhaps it's a good therapy used by rehab centers.

Some of rehab centers develop their treatment in reverse way. First they start detoxification then they will provide holistic therapy. Although detoxification is difficult so do the detoxification with all medical facility.

Alcohol detoxification mainly classified under two categories. First approach is medicinal approach where doctor and other medical stuff will detoxify the addicts' body, and the second approach is after completion of medicinal approach - addict should make his body completely free from alcohol by taking proper healthy food and drink.

There will be little side effect of detoxification. After detoxification person can feel little nervous or feel little bit anxiety for a few days, little difficulties with sleep for few nights, but all this for a few days. Finally, to take a decision please consults with any rehab centers for proper guidance. Proper care and treatment can minimize the side effects of detoxification process.

Federal Jury Convicts Brunswick Woman in $4 Million Medicaid Fraud Scheme

BRUNSWICK, GA—Schella Logan Hope, 47, of Brunswick, Georgia, was convicted earlier this month by a federal jury of various health care fraud, aggravated identity theft, and money laundering offenses for her role in a $4 million scheme upon the Georgia Medicaid program. Chief United States District Court Judge Lisa Godbey Wood presided over Hope’s five-day jury trial.
According to evidence presented during the trial, Hope was a licensed dietician who ran a business located in Brunswick, Georgia, known as Hope Nutritional Services. From 2005 through 2011, Hope stole the identities of thousands of needy children between the ages of zero and five that were enrolled in Head Start programs located throughout the state of Georgia. Once Hope obtained the identities of these children, Hope fabricated patient files, falsified prescriptions from doctors, and submitted $4 million worth of claims to Medicaid for nutritional services that were not provided. Hope then used the money she stole from Medicaid to pay for luxury automobiles, designer clothing, and vacations, among other things.
Co-conspirator Arlene Murrell pled guilty before Hope’s trial to her role in the scheme. Murrell testified against Hope at trial and detailed how she helped Hope commit the fraud.
Hope was convicted of 58 counts of conspiracy to commit health care fraud; health care fraud; aggravated identity theft; and money laundering. Upon her convictions for these offenses, Chief Judge Wood remanded Hope to the custody of the United States Marshals pending sentencing in the case.
United States Attorney Edward J. Tarver stated, “Defendant Hope preyed upon American taxpayers by stealing the identities of low-income Georgia families and then billing Medicaid for over $4 million in nutrition services that were never provided. This United States Attorney’s Office will continue its efforts to prosecute all who seek to defraud American taxpayers by scamming federal programs. Because of Ms. Hope’s criminal efforts to feed her extravagant lifestyle, she will have to rely upon the federal prison system for her own nutritional services.”
“The Head Start Program provides many of our nation’s children with invaluable services and opportunities,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office. “To use the Head Start Program as a vehicle to submit false and fraudulent claims to the Medicaid system is unacceptable, and the OIG will continue to pursue these kinds of egregious cases.“
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, “Those who defraud our publicly funded healthcare programs such as Medicaid and Medicare are taking valuable services and resources away from those in need. This guilty verdict reaffirms that the FBI will continue to provide significant investigative resources toward identifying, investigating, and presenting for prosecution such individuals that, by engaging in such criminal conduct, put themselves before others."
Georgia Attorney General Sam Olens said, “Fraud of taxpayer monies will not be tolerated in any form. Head Start is a program intended to offer assistance to children from low income families. The fact that this defendant used the Head Start Program and children in need to assist in her scam is especially appalling.”
“The Georgia Department of Community Health has made it a top priority to ferret out fraud, waste, and abuse in our Medicaid program. Our collaborative work with state and federal agencies enables us to ensure Medicaid program dollars are being used to provide health care services to Georgia’s most vulnerable populations,” said Clyde L. Reese, III, Esq., commissioner of the Georgia Department of Community Health.
At sentencing, Hope faces 10 years in prison for each of the 17 health care fraud offenses; 20 years in prison for the various money laundering offenses; and two years consecutive prison sentences for each of the various aggravated identity theft offenses. Hope also faces up to three years of supervised release and may be ordered to pay restitution to the victims in this case.
The convictions of Hope and Murrell resulted from a joint investigation by the United States Department of Health and Human Services, Office of Inspector General; the Federal Bureau of Investigation; Georgia’s Department of Community Health; and the Georgia Attorney General’s Medicaid Fraud Control Unit.
Assistant United States Attorneys Brian T. Rafferty and David Stewart, along with Assistant Attorney General Robin Daitch, prosecuted the case on behalf of the United States. For additional information, please contact First Assistant United States Attorney James D. Durham at (912) 201-2547.

Prominent Tri-State Cardiologist Sentenced to 78 Months in Prison in $19 Million Fraud Scheme and for Exposing Patients to Unncessary Medical Treatment

NEWARK, NJ—A well-known cardiologist and the founder, CEO, and sole owner of two large medical services companies in New Jersey and New York was sentenced today to 78 months in prison and ordered to pay $19 million in restitution for conspiring in a multi-million-dollar health care fraud scheme that subjected thousands of patients to unnecessary tests and potentially life-threatening, unneeded treatment, as well as treatment by unlicensed or untrained personnel. The sentence was announced today by U.S. Attorney Paul J. Fishman of the District of New Jersey.
Jose Katz, 69, of Closter, New Jersey, previously pleaded guilty to an information charging him with one count of conspiracy to commit health care fraud and one count of Social Security fraud arising from a separate scheme to give his wife a “no show” job and make her eligible for Social Security benefits. Judge Linares imposed the sentence today in Newark federal court.
“Katz prized illegal profits over patients to a staggering degree, committing record-breaking fraud and compromising care,” said U.S. Attorney Fishman. “Prison is an appropriate consequence for ripping off the government and insurance companies through the shocking exposure of patients to unneeded or untrained treatment.”
As part of his plea agreement with the government, Katz agreed that the loss amount sustained by Medicare, Medicaid, and other insurers victimized by the fraudulent billings was $19 million. U.S. Department of Health and Human Services-Office of the Inspector General and FBI records indicate the loss amount suffered by the victims is the largest recorded in New Jersey, New York, and Connecticut for an individual practitioner convicted of health care fraud.
According to documents filed in this case and statements made in court:
Katz was the founder, CEO, and sole equity-holder of Cardio-Med Services LLC (Cardio-Med) and Comprehensive Healthcare & Medical Services LLC (Comprehensive Healthcare). From 2004 through 2012, Cardio-Med had offices in Union City, Paterson, and West New York, New Jersey, and Comprehensive Healthcare had offices in Manhattan and Queens, New York. Both Cardio-Med and Comprehensive Healthcare provided cardiology, internal medicine, and other medical services to individual patients. During that time period, Katz conspired to bill Medicare Part B, Medicaid, Empire BCBS, Aetna, and others for unnecessary tests and unnecessary procedures based on false diagnoses and for medical services rendered by unlicensed practitioners.
Between July, 2006 and February, 2009, Katz spent more than $6 million for advertising on Spanish-language television and radio stations. The ads attracted hundreds of patients to Cardio-Med and Comprehensive Healthcare every day. Overall, Katz was able to bill Medicare and Medicaid more than $75 million for his services from 2005 through 2012.
Over the course of the conspiracy, Katz ordered and performed essentially the same battery of diagnostic tests for nearly all the patients he treated, regardless of their symptoms. Katz also instructed his non-physician employees to order and perform diagnostic tests for patients of other doctors working at his offices, even though he had not examined those patients and the other physicians had not ordered the tests.
Most significantly, Katz admitted that he falsified patient charts with fictitious and boilerplate symptoms and falsely diagnosed a majority of his Medicare and Medicaid patients with coronary artery disease and debilitating and inoperable angina. He also admitted to making the diagnoses to justify prescribing and administering an unnecessary treatment for those patients called enhanced external counter pulsation, or EECP. Katz even prescribed EECP treatments for some patients with contraindications for the treatment, therefore subjecting those patients to a substantial risk of serious injury or death.
From 2005 through 2012, Medicare and Medicaid paid Katz more than $15.6 million just for his EECP treatments, most of which were fraudulent.
In addition, Katz ordered conspirator Mario Roncal, 62, of Woodland Park, New Jersey—who had a medical degree from San Juan Bautista School of Medicine in San Juan, Puerto Rico, but did not have a license to practice medicine in any of the 50 states—to treat patients, knowing he was not licensed. At Katz’s direction, Roncal held himself out to fellow employees and to patients as “Dr. Roncal,” examined new patients as well as Katz’s follow-up patients, ordered diagnostic tests, diagnosed patients with medical conditions and diseases, and recommended and prescribed courses of treatment and surgery—including falsely diagnosing patients with angina and prescribing EECP treatments for those patients.
To conceal this illegal and unlicensed practice of medicine, Roncal forged Katz’s signature on paperwork associated with Roncal’s unlawful medical services, including on patient charts. During the conspiracy, Katz used his own billing numbers to bill Medicare Part B and Medicaid for the illegal services Roncal provided as though they were provided by Katz.
Roncal was indicted on March 2, 2012, for conspiracy to commit health care fraud. He entered a guilty plea on January 4, 2013, and awaits sentencing.
Katz also admitted to a Social Security fraud scheme in which, from 2005 through 2012, he kept his wife on Cardio-Med’s payroll though she performed little or no work. During the course of the scheme, Katz sent false W-2 forms for calendar years 2005 through 2011 to the U.S. Social Security Administration purportedly reflecting $1,251,604 in earnings for his wife, making her eligible for an estimated $263,000 in Social Security benefits to which she was not entitled.
In addition to the prison term and restitution, Judge Linares sentenced Katz to serve three years of supervised release.
U.S. Attorney Fishman credited special agents of the FBI, under the direction of Special Agent in Charge Aaron T. Ford; the U.S. Department of Health and Human Services, Office of the Inspector General, under the direction of Special Agent in Charge Thomas O’Donnell; the U.S. Postal Inspection Service, under the direction of Inspector in Charge Maria Kelokates; the Social Security Administration, Office of the Inspector General, under the direction of Special Agent in Charge Edward J. Ryan; IRS-Criminal Investigation, under the direction of Special Agent in Charge Shantelle P. Kitchen; and criminal and civil investigators with the U.S. Attorney’s Office for the investigation leading to today’s sentence. He also thanked the Medicaid Fraud Division of the Office of the New Jersey State Comptroller for its assistance.
The government is represented by Assistant U.S. Attorney Scott B. McBride of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark.

A Teenager Needs Help For Drug And Alcohol Problems

There are times when the curve balls of life are a little more than we can handle on our own. The good news is, you are not alone and healing and treatment opportunities are readily at your disposal. Drug and alcohol addiction can creep up on the best of us, and the slavery that follows can be a period of time where darkness just seems to envelope everything around us. There is light at the end of the tunnel.

Addiction treatment can be successful when paired with love, education, diligence, community, motivation and recovery. There are a plethora of counseling agencies, therapeutic communities, specialized drug treatment programs and drug and alcohol rehabilitation centers available that offer hope, freedom and resurgence. Determination and support amongst family members is a vital component of helping addicted youths overcome dependence.

Seeking out educational, reliable information is a good first step. Gaining a better understanding of addiction and the symptoms it brings can help parents and other family members communicate more effectively and convey their love, concern and support. The first step is to get professional help; help that can offer trustworthy, unswerving guidance and therapy, both to teens and their families.

There are many options available for families who have a teen that is involved with substance and or alcohol abuse. Residential facility care is one such option which involves edification, medical care and localized treatment methods. Most programs are founded on the twelve step model, and group meetings are a central component of treatment. Many residential programs are substantially controlled in order to give residents the best possible opportunity for success and triumph over their specific addiction.

Infiltrating free time with structured events, activities, therapy sessions and group meetings allows little opportunity for addictive stumbling blocks. Teens can receive encouraging support and will have time to express themselves freely to trained, licensed professionals. In many cases, these sessions open doors of communication between youths and their family members bridging the painful gap that addiction can cause in meaningful, loving relationships.

Outpatient programs can offer success to those whose schedules and addiction may not require in-house rehabilitation, or who have already completed a more stringent residential program. Outpatient treatment offers a variety of key tools that can help families and those suffering from addiction find confidence, hope and autonomy through sober living. Outpatient services can include drug and alcohol assessments, both group and individual therapy sessions, and specialized counseling for family members. Enlightening and instructive courses on drug and alcohol addiction and methods are used to combat and treat addictions, including drug screening, and medical treatments, if necessary.

The ability to combat and find freedom against addiction and enjoy the wonder and beauty of a sober life is within reach for anyone who desires to make a change. Family members and their teens are not alone and there are facilities, professionals and treatment options that can and will bring additional support and encouragement and create a foundation of healing, not only for the addict, but to the relationships that have been damaged by the dependence. Liberty from addiction is one phone call away and the choice to restore sobriety and renew life is available to everyone. The choice and the opportunity are yours! Success awaits you!

Illinois Physician Indicted on Federal Charges for Allegedly Illegally Dispensing Prescription Medications

CHICAGO—A LaSalle County physician was taken into federal custody this morning after being indicted on federal charges alleging that he illegally dispensed prescription narcotics to three patients in 2012 and 2013. The defendant, Dr. Constantino Perales, was charged with 17 counts of illegally dispensing oxycodone and/or alprazolam in an indictment returned by a federal grand jury on Wednesday and made public today.
Perales, 62, of Peru, Illinois, was expected to appear at 2 p.m. today before U.S. Magistrate Judge Sidney I. Schenkier in federal court in Chicago. Perales has been in state custody on related charges, which were dismissed today by LaSalle County prosecutors. Perales’ Illinois medical license was suspended and he surrendered his DEA registration after federal and local authorities executed a search warrant at his office and he was arrested on state charges in August.
According to the indictment, Perales dispensed oxycodone and/or alprazolam outside the scope of professional practice and without a legitimate medical purpose to three different patients on 17 occasions between May 2012 and August 2013.
Each count carries a maximum penalty of 20 years in prison and a $1 million fine. If convicted, the court must impose a reasonable sentence under federal statutes and the advisory United States Sentencing Guidelines.
The arrest and charge were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Robert J. Shields, Jr., Acting Special Agent in Charge of the Chicago Office of the Federal Bureau of Investigation, Jack Riley, Special Agent in Charge of the Drug Enforcement Administration; Lamont Pugh, III, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General in Chicago; and the Peru Police Department.
The government is being represented by Assistant U.S. Attorney Lela Johnson.
An indictment contains merely charges and is not evidence of guilt. The defendant is presumed innocent and is entitled to a fair trial at which the government has the burden of proving guilt beyond a reasonable doubt.

Five Damaging Effects of Alcoholism on Your Body

Many studies have been done on the effects of consuming high amounts of alcohol over an extended period, and they have consistently shown that alcoholism has long-term and damaging effects on your body. Below, we've listed five major consequences and the most vital organs that alcohol attacks.

1. Your Liver

Over 2 million people in the United States suffer from a form of alcoholic liver disease. The liver detoxes the alcohol and removes it from your bloodstream, preventing it from accumulating and destroying other cells and organs. However, the act of metabolizing the alcohol actually creates substances that are harmful to the liver itself. This can lead to:

• Inflammation
• Liver scarring
• Liver failure
• Death

2. Your Brain

According to the National Institute of Alcohol Abuse and Alcoholism, studies have consistently shown that people with a history of alcoholism or repeated alcohol abuse have smaller, lighter and more shrunken brains than others of the same age and gender. This shrinkage in the brain has been shown to result in several damaging conditions, including:

• Memory loss
• Alcoholic blackouts
• Damage to brain cells
• Loss of cognitive thinking skills
• Strokes
• Dementia

3. Your Digestive System

Excessive drinking stemming from alcohol abuse or alcoholism has also been shown to damage all parts of the digestive system. If you consume several alcoholic beverages each day, you are at a higher risk for digestive system problems, such as:

• Chronic inflammation of the esophagus
• Pancreatitis
• Gastritis (inflammation of the stomach)
• Stomach ulcers
• Cancer (in esophagus, mouth, throat, colon and rectum)

4. Your Heart

Another damaging effect of alcoholism is heart problems and diseases. At high concentrations, alcohol has been shown to interfere with the pumping action of the heart. It has also been linked to a number of other cardiovascular problems, listed below.

• Loss of heart's ability to beat properly
• High blood pressure
• Coronary artery disease (the leading cause of death in Western society)
• Heart attacks
• Increased risk of stroke

5. Your Immune System

Alcoholics and people who drink heavily suffer from far more infectious diseases than people who drink moderately or not at all. One study found that alcohol abusers were 15 to 200 times more likely to get tuberculosis than nonusers. In extreme cases, the body can cease to accurately distinguish self from non-self, causing the immune system to actually attack your own body.

In addition to all of the health complications of high concentrations of alcohol, the University of Maryland Medical Center estimates that alcoholism can reduce your life expectancy by 10 to 12 years.

But there is hope. When alcoholics enter recovery, many of the affected vital organs begin to repair themselves and the overall health of the patient improves.

Entering into recovery can be a frightening, painful, even dangerous process. To guard the alcoholic's safety and increase the rate of long-term recovery, the first short-term goal is often a proven detoxification program to help alleviate withdrawal symptoms and ease the detox phase. Then the next phase of rehabilitation and recovery can proceed with a better prognosis for success.

Beaumont Orthodontist Sentenced for Health Care Fraud Violations

BEAUMONT, TX—A 70-year-old Beaumont orthodontist has been sentenced to federal prison for health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.
Terrence Ewing Syler pleaded guilty on June 18, 2013, to health care fraud and was sentenced to 22 months in federal prison today by U.S. District Judge Thad Heartfield. Syler was also ordered to submit to forfeiture of $829,000 and pay a $6,000 fine.
According to the information presented in court, Syler owned and operated Syler Orthodontics in Beaumont. From January 2007 to October 2012, Syler carried out a scheme to defraud Medicaid by submitting claims for palatal expanders that were never provided to his patients. As a result of the scheme, Syler received $829,333 to which he was not entitled. As part of his plea agreement, Syler has agreed to forfeiture of several bank accounts totaling just over $829,000.
The Texas Medical Assistance Program (Medicaid) is a health care benefit program, jointly funded by the state of Texas and the federal government, and helps pay for reasonable and necessary medical procedures and services provided to individuals who are deemed eligible under state low-income programs.
This case was investigated by Federal Bureau of Investigation, the U.S. Department of Health and Human Services-Office of the Inspector General (HHS-OIG), and the Texas Office of the Attorney General-Medicaid Fraud Control Unit (OAG-MFCU). Assistant U.S. Attorney Christopher T. Tortorice prosecuted this case.
Any individuals with knowledge of these or other health care fraud violations are encouraged to contact the Department of Health and Human Services’ fraud hotline at 1-800-HHS-TIPS (447-8477).

Patient Broker of South Florida Psychiatric Hospital Sentenced for Role in $67 Million Health Care Fraud Scheme

WASHINGTON—A patient broker of a South Florida psychiatric hospital was sentenced today to serve 24 months in prison, followed by three years of supervised release, for her participation in a $67 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; and Special Agent in Charge Christopher Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations’ Miami Office made the announcement.
Gloria Himmons, 54, of Union Springs, Alabama, was sentenced by U.S. District Judge Jose E. Martinez in the Southern District of Florida. In March 2013, Himmons pleaded guilty to one count of conspiracy to receive health care kickbacks and one count of receiving a health care kickback. In addition to her prison term, Himmons was ordered to pay $14 million in restitution, jointly and severally with her co-defendants.
According to court documents, Himmons was a patient broker at Hollywood Pavilion LLC (HP), a state-licensed psychiatric hospital in South Florida that purported to offer both inpatient and outpatient mental health services. Himmons would provide Medicare beneficiaries to HP in exchange for bribes and kickbacks, and she knew that the patients she provided to HP were not appropriate for inpatient psychiatric hospitalization or for outpatient mental health treatment. The patients she provided to HP included those who were not severely mentally ill, as well as substance abusers looking for rehabilitation programs. The patients did not have legitimate referrals from hospitals or doctors who had been treating acute-phase, severe mental illness.
From at least 2005 through September 2012, in exchange for bribes and kickbacks, Himmons knowingly and willfully provided to HP Medicare beneficiaries who did not need inpatient or outpatient psychiatric treatment. As a result of Himmons’s participation in this scheme, HP was improperly paid more than $7 million by Medicare. From at least 2003 through at least August 2012, HP billed Medicare approximately $67 million for services that were not properly rendered, for patients that did not qualify for the services being billed, and for claims for patients who were procured through bribes and kickbacks. Medicare reimbursed HP on approximately $40 million of those claims.
On September 10, 2013, co-defendants Karen Kallen-Zury, Daisy Miller, and Christian Coloma were sentenced on their June 2013 jury convictions. Kallen-Zury, the chief executive officer of HP, and Miller and Coloma were convicted on all counts at trial and sentenced to 300 months, 180 months, and 144 months, respectively. Kallen-Zury and Miller were ordered to pay, jointly and severally with their co-defendants, nearly $40 million in restitution. Coloma was ordered to pay, jointly and severally, more than $20 million in restitution.
This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Miami. This case is being prosecuted by Assistant Chief Robert A. Zink and Trial Attorneys Andrew H. Warren and Anne McNamara of the Fraud Section.
Since their inception in March 2007, Medicare Fraud Strike Force operations in nine locations have charged more than 1,500 defendants who collectively have falsely billed the Medicare program for more than $5 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov.

Drug and Alcohol Denial and Intervention

Denial and Intervention

Denial and family intervention is often an essential part of the recovery process. Denial plays a common role with drug addiction and what's called tough love can be very persuasive. because an individual's life has become unmanageable as a result of drug addiction and/or alcoholism, no matter what the drug being abused, along with the abuse comes a lack of willingness and/or ability to confront the true nature of one's own problem with drugs and alcohol and to take any kind of action to better their lives. This is called denial, and it comes in many forms - blaming, playing the victim, anger, fear etc. Along with denial, an addict must deal with pride and ego, two of the worst enemies of addiction, as they will in no doubt keep an addict or alcoholic using until one of three inevitable ends - jails, institutions, or death. This is where a type of addiction professional called an interventionist becomes important. Interventionists play an essential role in the treatment process.

A family Intervention or Interventionist's job is to break down denial. Denial is a very strong defense mechanism used by addicts that enables them to justify continuing their destructive behavior. Often they blame their usage on family members, jobs, and stress, anything that allows them not to accept responsibility for their addictive actions and continue the substance abuse. Breaking through these barriers and gaining commitment to receive care is essential to begin the healing process.

The purpose of an interventionist is to coordinate with the family and/or other professionals in selecting a proper detoxification and treatment facility to suit the need. Advanced arrangements must be made as the expectation is immediate admittance upon the completion of the intervention. Experienced interventionists will counsel the family with understanding an answer any questions they may have and to resolve any bad feelings to ease the situation keeping in mind the goal of getting the addict to drug or alcohol detox treatment program immediately. The intention is clear, the tone is hopeful and the resolve is unwavering. This process is born out of love and concern interventions and interventionists are successful in 90%-95%+ of all cases.

In the event that the drug addict or alcoholic chooses not to agree to treatment, the family, friends, and employers must be prepared for the next step. This involves of all enabling behaviors by the parties involved needs to cease.

Typically the only reason this process may not be effective is that in the past, consequences of the drug addicts have been so minimal that the addict doesn't think that anything will change. The family must be prepared to set strong boundaries and not waver at the time of intervention. The addict is once again told he/she is loved and that the family and interventionist are willing to get them effective drug or alcohol treatment. It must be made clear, however, that the family (with the guidance of the interventionist as a mediator) will no longer accept this behavior and watch the addict slowly kill themselves. The drug addict or alcoholic is expected to accept the gift that is being offered and get help at a drug or alcohol detox and treatment program. Intervention can be a very painful process, because it is a time during which a family often gets to see the true strength of the addictive minds. Intervention is a serious undertaking and it is imperative that it be done effectively, safely and with confidentiality. No intervention should be done without at least being researched and discussed with a knowledgeable counselor or interventionist.