23Nov/14

Marijuana Like Starbucks

“My concern is the Marlboro-ization or Budweiser-ization of marijuana,” said Ethan Nadelmann, executive director of the Drug Policy Alliance. “That’s not what I’m fighting for.” This quote it taken from an article on NBCnew.com that discusses, among other things, how the alcohol and tobacco industries warily view marijuana as both a threat and an opportunity. One thing everyone agrees on is that Big Pot is here to stay.

Mr. Nadelmann has been a pawn for the wrong side and it seems like only now is he beginning to realize that the same marketing whizzes that got America hooked on Starbucks will churn out several new generations of ardent marijuana users. He should look up the term unintended consequences. The most irritating part about this is that multiple people told him this is exactly what would happen.

 

 

 

14Nov/14

Greek Life: “Rape Haven” and Other Campus Disasters

The stone walls at the Tiger Inn eating club at Princeton University were spray-painted with the words "Rape Haven" earlier this week (Photo courtesy of The Daily Princetonian)

The stone walls at the Tiger Inn eating club at Princeton University were spray-painted with the words “Rape Haven” earlier this week (Photo courtesy of The Daily Princetonian)

Back in late September, Caitlyn Kovacs, a Rutgers sophomore died after drinking at a Delta Kappa Epsilon party. I wrote a piece in the immediate aftermath calling for colleges and universities around the country to shut down fraternities and sororities. I wrote about the rampant alcohol and drug problems associated with Greek life, high rates of sexual assaults, racism, sexism, academic cheating and the overall negativity they bring to campus life (to date, it has been the most read piece I’ve written for this site). Members and alumni of the Greek system were outraged and responded in droves. Several stated that I had jumped to conclusions and that maybe she didn’t die because of alcohol or maybe she hadn’t been served alcohol at Delta Kappa Epsilon. Recently, the Middlesex County Prosecutor announced that the county coroner determined that she died from “acute ethanol toxicity.” Caitlyn was 19 years old. She died drinking at a fraternity. Those are indisputable facts.

In the last six weeks, there have been several more fraternity and sorority related disasters. I list several of them below. This piece concludes with a number of scholarly articles that provide data that backs up my assertions and adds weight to the problems I’ve enumerated.

The Tiger Inn Eating Club at Princeton University (Eating Clubs are the equivalent of Greek Life at a few Ivy League schools) is currently under investigation by local authorities because a photo of a sex act was electronically distributed (there is a wide range of possibilities of what happened, but clearly, someone’s privacy was violated). On Tuesday night, someone spray painted “Rape Haven” on the walls of their entrance. I’m not a supporter of the destruction of public or private property, but someone apparently feels very strongly that the Tiger Inn Eating Club is a Rape Haven.

Today, West Virginia University announced that is was suspending all frats and sororities after an 18 year old was found unconscious and not breathing in a WVU frat (he died a few days later). One week earlier, 19 pledges got involved in a street brawl. I know that I am going to seemingly malign a whole state here, but seriously, you know that an institution has gotten out of hand when it is banned in West Virginia.

In September, Clemson University suspended all frats after the death of a teenage pledge.

Last month, Phi Kappa Psi was suspended at Brown University (a great, world class school) after two students reported they were given date rape drugs and one of them claimed she was sexually assaulted later that evening.

In just a few paragraphs, I’ve detailed several anecdotal examples that include deaths, dangerous drinking, fighting, drugging and sexual assaults. Two weeks ago, the New York Times published an article about the high cost of Greek life. While it doesn’t cover the destruction of drinking, drugging, date rape and death, it does paint a further negative portrait of Greek life. Pledges and members of sororities are often asked to spend a lot of money on fees, parties, clothes and other events each semesters.

Here are a number of scholarly articles and/or studies about Fraternities and their relationship to binge drinking and sexual assaults (thanks to Tess Krakoff for conducting this research).

Fraternity membership and binge drinking by Jeff DeSimone
• Social fraternity and sorority membership relationship with binge drinking incidence and frequency among 18–24 year old full-time 4-year college students who participated in the 1995 National College Health Risk Behavior Survey.
• The main activity with which fraternities are associated is alcohol use.
• Data confirm that fraternity members drink more intensively than do non-members. In the NCHRBS, past month binge drinking, defined as consuming at least five alcoholic beverages within a few hours, was reported by 69% of fraternity members as compared with 42% of non-members.

High-Risk Drinking Among College Fraternity Members: A National Perspective
• Extensive profile of drinking behaviors and predictors of drinking among 3406 members of one national college fraternity, distributed across 98 chapters in 32 states.
• Multiple indexes of alcohol consumption measured frequency, quantity, estimated blood alcohol concentration levels (BACs), and related problems.
• Among all members, 97% were drinkers, 86% binge drinkers, and 64% frequent binge drinkers.
• Drinkers had an average BAC of 0.10, reaching at least 0.08 on an average of 6 days.
• These fraternity members appear to be heavier drinkers than previously studied fraternity samples, perhaps because they were more representative and forthright.

‘Liquor before beer, you’re in the clear’: binge drinking and other risk behaviours among fraternity/sorority members and their non-Greek peers
• Respondents who binged were significantly more likely to be male and belong to a fraternity/sorority.
• Fraternity bingers were significantly more likely to engage in physical fights ( p < 0.05) than non-Greek male bingers.
• Sorority bingers were significantly more likely to be injured ( p < 0.01), drive under the influence of alcohol (DUI) ( p < 0.001), be sexually victimised ( p < 0.01) and engage in unwanted sex ( p < 0.05) than non-Greek female bingers.
• Fraternity members who binged frequently (≥3 times in 2 weeks) were significantly more likely to DUI ( p < 0.01) and engage in unprotected sex ( p < 0.05) than were those who binged intermittently.
• Sorority members who binged frequently were significantly more likely to DUI ( p < 0.05) than were those who binged intermittently.

Fraternity and Sorority Members and Alcohol and Other Drug Use
• A report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes the disturbing consequences of drinking on campus each year: 1,700 college student deaths from alcohol-related causes; more than 500,000 unintentional injuries; more than 600,000 assaults; and more than 70,000 cases of sexual assault and acquaintance rape.
• Fraternities and sororities are among the key groups that foster this culture of drinking on campus.
• Given the high rates of heavy drinking in fraternities and sororities and the role they take in promoting frequent and heavy alcohol consumption on campus, college and university prevention efforts should target these social societies.

Study Ties Binge Drinking To Fraternity House Life

• This 1995 study was written about in the New York Times. You can read it here (things haven’t changed in 19 years).

Living in a fraternity or sorority house is by far the strongest indicator of binge drinking in college, a new study by the Harvard School of Public Health reports.

• 86% of fraternity residents and 80% of sorority women are binge drinkers
This compares with 45 percent of men not affiliated with fraternities and 36 percent of women

 

 

 

11Nov/14

Our Friend Pat

Pat

Four members of the 2011 alumni softball team. Pat is the young blonde man.

Our friend Pat died last week. He was 30 years old. Yesterday, I went to Pat’s funeral in the suburbs of Philadelphia. There were at least 200 people there, most of them in their 20′s and 30′s. It was very somber, even by a funeral’s standard.

Pat got sober as a young man. He went to Rutgers and lived in Recovery Housing. I met him in 2005. I was finishing up my masters in social work and he was a rowdy undergraduate full of zest and life. He was close friends with a number of guys that I eventually became quite tight with. Pat was a strong member of the recovery community and he was extremely welcoming and supportive of newcomers. He was the RA of the Recovery House during the 2007-08 school year (which was the year before I was hired to oversee the program). Pat was never my student or my client. I was never responsible for him. We were both just members of the Rutgers Recovery Community who felt a strong sense of gratitude and dedication to the Recovery House. Eventually we became friends.

Pat shared his experience with me as a RA and made some suggestions for improving the program. He played in our Alumni-Student softball games, sang at Karaoke with his friends, and spoke with current students about the importance of academics and internships. He shared his time and experience.

In the past 18 months, I went to Costa Rica with Pat for a bachelor party, was in a wedding party with him and attended two other weddings together of mutual friends. He enjoyed smoking cigars on the beach, fine dinners, a good joke and dancing like a lunatic. I knew him. After 9+ years of sobriety, Pat relapsed. I’m not going to get into details, but I’ll say this:

1) He stopped doing what he used to do in order to stay sober

2) His close friends were upset and concerned

3) Pat made a series of poor choices and his life got increasingly worse

4) People talked to him and he wouldn’t hear it

5) He cut people off

6) He put together about two weeks of sobriety this fall. Our friends visited him and told me, “It was nice to have my friend back.”

7) A month later he was dead.

One of my closest friends called me on Tuesday night and told me the news. I felt sad because Pat was my friend. I felt bad because Pat was an alumnus of the Rutgers Recovery program. I felt frustrated because Pat had once turned his life around. I felt awful for his closest friends. I felt devastated for his family, especially his parents.

I lost my friend Fraser in September of 2002. I had tried for several years to get him sober. His death was the final event that put me on the path of my life’s work. Both Rutgers and myself have written about it. Pat’s death reminded me of Fraser again and all the feelings that I went through in the aftermath. I sent out an email to his closest friends:

I am so sorry for your loss. I know this pain all too well. I just wanted to share my experience with you all in the hope that it might be of some help.

(1) Write down everything you can about Pat. Things he said, things you did together, jokes played, things that pissed you off and little gestures. Your mind will be flooded with memories over the next two weeks, and then they will slowly fade. You will never remember him as well as you do right now. Write it down. Also…it will help you grieve.
(2) I was angry at Fraser for dying and then I would feel bad about being angry at my dead friend. It was confusing. It took me a while to reconcile all of those feelings. It is ok and natural for you to be angry at Pat.
(3) There was nothing you could do to help. Do not blame yourselves in any way or carry that burden. You were all good examples and good friends to him.
(4) Double up on your coping mechanisms, whether they be therapy, AA, exercise, yoga, meditation, hanging out with friends, hiking, etc….Do this for a number of weeks.
(5) You have the right to talk with who you want about this, and you can also tell people that you are sad and just need some space. I found that I talked about it a lot with a couple of close friends, shared about it at every meeting I went to and discussed it in therapy. But I didn’t have it in me to talk to everyone. Some people just pissed me off or didn’t “get it.”
(6) Remember that his family’s pain is worse than yours. Writing a letter to them about how much he meant to you, as well as some funny/good stories will be valued more than you can possibly know.

At the service, I told his parents about GRASP (Grief After Substance Passing). Since 2012, I either get a letter, email or phone call from at least one parent of a young person who died from substance abuse each week. The pain a parent experiences when their child dies is indescribable and immeasurable. There are no words or deeds of comfort.

I watched my friends at the service. I watched them look at pictures, talk to each other, cry in their spouses’ arms and try to make sense that this happened. “I keep waiting for him to pop out of the next room and say it was all a joke,” one friend told me. It happened so fast and seems so unreal. I wish I could take away their pain. All I can do is share my experience and be there for them.

___________________________________________________________________

We are going to create a scholarship for students in recovery in Pat’s memory. If you want to be a part of that scholarship, you can contact me. If you just want to donate in Pat’s memory, you can mail a check to Rutgers ADAP, c/o Lisa Laitman, 17 Senior Street, New Brunswick, NJ, 08901.

Pat 3

10Nov/14

Marijuana Effectively Decriminalized in NYC

I’m strongly against both marijuana criminalization and legalization. Criminalization is costly, leads to a crowded criminal justice system and mars the records of otherwise upstanding citizens. Legalization is costly, leads to more cops, more use, more hospitalizations and more treatment episodes.

Decriminalization does not encourage new users but also keeps the criminal justice system clear (so cops can do real police work and citizens don’t have to explain a marijuana arrest when they were 26).

It’s great news out of NYC: click here

07Nov/14

When Insurance Companies Engage in Medical Bad Practice

On Tuesday morning I received a call from a former colleague of mine that a young man was caught drinking on the job. My colleague knew that the young man, George*, was a former student of mine and that he had once been sober for about two years.

I was able to get in touch with George and explain to him that the jig was up. “Everyone at your job knows that you have a drinking problem,” I told him. I explained that he should go to treatment and that he could keep his job and that I would help him through this. He agreed to call several detoxes. Within 15 minutes, he had an appointment at a quality program in Central New Jersey for Wednesday morning.

The medical staff at the detox unit took his vital signs. His resting pulse was 101 and his blood pressure was 140/100 (he is 25 years old). He admitted to drinking for the last 72 hours and that he usually drinks 13 out of 14 days (his pattern for the last several months). The medical professionals and the substance abuse counselors all agreed that he needed to be admitted to the detox.

Here is a word by word copy of our text conversation from Wednesday morning (reprinted here with his permission):

George: I’ve been admitted.

Me: Great. Keep me posted on your progress and let me know when they begin discharge planning.

George: Correction. I was denied. I’m under “doc” review from my insurance company.

Me: WHAT?!? If they don’t pay for it make sure that doctor gives you written reasons why and a referral/rec for other treatment.

George: Okay..like, I’ve drank for 72 hours straight, my pulse is 101, BP is 140/100 and they fuckin deny it. How is that possible? Alcohol is one of two detoxes that you can die from.

Me: Let’s try Sunrise detox or Bergen Pines.

George: It’s my insurance saying no.

Me: Ah…it’s the insurance. Right. Of course.

George: Yessir. The clinician is really pushing for me to be accepted.

Me: Who is your insurance company and what kind of insurance is it?

George: HBCBS and advantage EPO. I’m being referred to an ambulatory detox.

Me: Are you going to go there?

George: Probably not. I don’t see how I’m not going to drink at night. My pulse is 116 now. The doctor told me to go to a GP and have him prescribe me a benzo and detox at home.

Me: That is outrageous. Who is the doctor reviewing your file for the insurance company.

George: Dr. Pigvomit**.

Me: Ok. We are going after him and that company. Fill out this form when you get a chance – NJ State Insurance Complaint Form

George: Will do. This detox is admitting me.

Me: Ah, great news.

George: They said irrelevant to what the insurance doctor says, I’m in and not responsible for all payment if the insurance company says no.

Me: Wow. Great great news. I’ll have to contact them and thank them.

My student has been there for 36 hours now and is doing fine. We are going to file a complaint against the insurance company and I’ll take this story to the press. Sadly, this is all too common. If you have a story like this or know someone who does, please fill out this form: NJ Insurance Complaint Form and please tell your story to the press.

 

* George is not his real name. I’ve changed it for this article.

** Pigvomit is not the Dr.’s real name.

04Nov/14

Recent Articles That You Should Be Aware Of

Excellent article about addiction, overdose, treatment, medication assistance therapy, PMP’s and Narcan from the September 8, 2014 The New Yorker: click here

Halloween fell on a Friday night this year and college towns around the country were overrun with parties and alcohol-fueled hospitalizations. New Brunswick’s police force, EMT’s and hospitals were overwhelmed: click here.

A Natural Fix for ADHD from last Sunday’s New York Times.

I’m in favor of punishment and consequences, but after people have served their time, I think they should be allowed to move forward. Today Californians will vote on reclassifying some crimes from felonies to misdemeanors in an attempt to make it easier for ex-offenders to find jobs. This excellent piece appeared on 538.com: click here.

This guy is very sharp. He does an excellent job explaining why medication should be a part of some treatment and recovery regimens. My only disagreement is that I think needle exchange programs are a little better than he makes them out to be. Read the interview from The Fix.com here: one man’s war on treatment.

From Forbes: What 20 Years of Research Has Taught Us About the Chronic Effects of Marijuana.

For Addiction Treatment Professionals: sexual misconduct on the job.

More marijuana facts: What the Marijuana Industry Doesn’t Want You To Know

My favorite, current-sitting, NJ politician, Senator Joe Vitale, appeared at Rutgers in late October and spoke at an Overdose Vigil. His 21 bills that address education, prevention, treatment and recovery are a fantastic way to address the opiate epidemic. While Governor Christie gets headlines for saying things, Senator Vitale quietly works towards getting big things done. Read about it: Overdose Vigil at Rutgers.

* I post most of these on the Facebook page when they are published, as well as a number of other articles that I don’t discuss on this site.

31Oct/14

How do we know what humanity lies hidden underneath the rags and filth of a mangled life?

A recent article in The Nation described my well-discussed theme about how locking up people with alcohol and drug problems is a waste of money, poor public policy and inhumane. I’ve written about how we should educate prisoners and what books and articles people should read in order to learn more about criminal justice policy. One of my favorite facts is this: in NJ, it costs about $55,000 to incarcerate someone and about $12,000 to treat them in drug court (and drug court gets better results).

I am a fourth generation English teacher and a second generation college professor. For a time, I considered getting a PhD in English in order to pursue a career as a Professor of Shakespeare. Alas, my life took a different direction (that has worked out very well). I still read widely and go to the theater a few times a month. Last summer, I went to see Our Country’s Good at the Guthrie Theater in Minneapolis with my mother’s cousin Anne and her husband Phil.

The play is set in Australia in the 1790′s. The English penal colony has just been set up and the Governor, Captain Phillips, has encouraged 2nd Lieutenant Ralph Clark to work with the prisoners and put on a play for the entertainment of the entire colony. A number of the officers are disgusted by this and have threatened to mutiny. The prisoners are looked on as less than human (some of them are serving seven year terms for stealing food because they were hungry). There is an incredible scene at the beginning of Act II in which Captain Phillips advises Lt. Clark to continue with the play, despite the protests of the other officers.

Phillips: If you break conventions, it’s inevitable you make enemies, Lieutenant. This play irritates them.
Ralph: Yes and I –
Phillips: Socrates irritated the state of Athens and was put to death for it.
Ralph: Sir –
Phillips: Would you want a world without Socrates?
Ralph: Sir –
Philips: In the Meno, one of Plato’s great dialogues, Socrates demonstrates that a slave boy can learn the principles of geometry as well as a gentleman.
Ralph: Ah –
Phillips: In other words, he shows that human beings have an intelligence which has nothing to do with the circumstances into which they are born.

Ralph: Sir –

Phillips: Sit down, Lieutenant. It is a matter of reminding the slave of what he knows, of his own intelligence. And by intelligence you may read goodness, talent, the innate qualities of human beings.

Ralph: I see — Sir

Phillips: When he treats the slave boy as a rational human being, the boy becomes one, he loses his fear, and he becomes a competent mathematician. A little more encouragement and he might become an extraordinary mathematician. Who knows? You must see your actors in that light…..How do we know what humanity lies hidden under the rags and filth of a mangled life?

How do we indeed? Americans love the story of a life redeemed. The bad boy (or girl) turned good. We are nation of second chances and third acts. We need to take this approach with those that have a substance abuse problem.

 

 

15Oct/14

Governor Christie sets aside .0037 of 1% of the State Budget for Prevention and Treatment in a BIG Announcement Today

Governor Christie announced that he is setting aside $12 million for prevention and treatment services in NJ. You can read about it here.

This is a good start. FAR more funding is needed, but again, he continues to say the right things and at least he has put some money up (before people get too excited, this is for 12 million dollars – the NJ State budget is 32.5 billion, so this is .00003692307 of our budget).

 

10Oct/14

Governor Christie’s Sound and Fury, Which Signifies Nothing

… a poor player that struts and frets his hour upon the stage And then is heard no more…

On September 17th, Senator Joe Vitale introduced 21 bills to combat the heroin and opiate painkiller epidemic and provide better prevention and treatment services. Governor Christie has not only failed to support those bills, he hasn’t even acknowledged their existence.

On September 30th, there was a celebration regarding the opening of the first recovery high school in NJ. Governor Christie was not there. Nor has he directed any state funding towards the school. That same day, the Governor held a summit at the New Hope Baptist Church in Newark about reducing the stigma associated with treatment and recovery from addiction. He said a lot of nice things, but didn’t talk at all about the new recovery high school opening up down the road nor offer up any substantive support on Vitale’s bills.

On October 7th, Governor Christie appeared at Robert Wood Johnson Hospital in New Brunswick to announce a partnership with neighboring states to share prescription drug monitoring program (PMP) information. This was a positive move, but it was also something that his Deputy Attorney General recommended in 2012. The Governor also continued to refuse to mandate NJ’s PMP, despite the fact that the GCADA’s Task Force report suggested it earlier this year (and also despite the fact that over 20% of other states have mandated PMP’s).

On October 9th, the Governor appeared in Trenton to announce the formation of yet another Task Force to fight drug addiction. He did not comment on any of Vitale’s 21 bills, the recovery high school or offer any funding for programs that he has claimed to support (drug courts, prisoner education, PMP’s).

And he won’t anytime in the future. He will now fall back on the fact that he has created a Task Force and that he needs to let them operate for awhile, hold hearings and gather information. They will need time to release a report, and he will say that this is a serious public concern that requires time, deliberation and careful consideration of the multifaceted issues and various stakeholders involved. He will delay legislation and the funding of any current or new programs. It’s all sound and fury, and it gets him a lot of positive press while he actually does very little to change things. The saddest and most frustrating aspect of this is that he already had a Task Force that did this, and we released a report too (you can read it here). Despite serving on the Governor’s Council, I have been highly critical of the Governor’s bluster on these issues. I understand that almost no one will win or lose an election based on how they handle drug policy. In Chapter 18 of The Prince, Machiavelli wrote:

Pope Alexander VI had no care or thought but how to deceive, and always found material to work on. No man ever had a more effective manner of asseverating, or made promises with more solemn protestations, or observed them less. And yet, because he understood this side of human nature, his frauds always succeeded.

It applies perfectly to Governor Christie, at least when it comes to his drug and alcohol policies. I’ve quoted Shakespeare a few times in this piece, and I’ll provide the full quote from Macbeth from whence I grabbed the title. Interestingly enough, it both describes and quotes Christie:

it is a tale told by an idiot, full of sound and fury, which signifies nothing

 

 

08Oct/14

What You Can Do To Help

We need YOU to help foster recovery.

Every week, at least a half dozen people approach me, email me or call me asking for advice about what they can do to help address drug and alcohol problems in their town, county, state or country. I’m always happy to answer those questions, but I decided that it was time for me to write out a list of options and directions for people to look at and work off of. Here are 12 suggestions:

(1) Every town that has over 10,000 people should have a prescription drug drop box (Usually they are at police stations. To learn more about them, click here. For help getting one put in your town or county, click here).

(2) We need advocates to tell their stories to politicians, government officials, school administrators, parent groups, students and a host of professionals. In NJ, there is an Advocacy Leadership Program that takes a new class every year. You don’t have to be a person in recovery to have a story worth telling – you can be the parent or spouse or child or friend of someone who found the joys of recovery or died from this public health problem.

(3) We don’t really need new organizations. Join an existing one. Many municipalities and most counties have anti-drug coalitions that engage in a lot of prevention work. This is a great point of entry into the field, an easy way to make a difference and a fantastic way to build your network if you want to eventually do more.

(4) Let’s say you have a lot of money and want to make your own organization. Talk to your lawyer and accountant. Then find some influential people in your county and state to talk to. They should be able to give you some good advice about existing programs. I strongly urge you to join an already established group. There are plenty of 501C3 organizations that have some good people working there but they need better organization skills, publicity and/or more funding.

(5) You still want to create your own organization. You better find a really great person with a lot of experience to run it. And you need to be prepared for the fact that you are probably going to lose money.

(6) There are a lot of great programs that need fundraising help. I can steer you towards them in NJ or wherever you live. Of course, one of my favorites is the Rutgers ADAP and Recovery House program. If you want to raise money or donate to them, I’ll be happy to put you in touch with the right people.

(7) If you have been clean and sober for two years and have decided that you want to work in this field, I suggest that you get an entry level job (part time or full time) at a halfway house or in-patient program. Work several months on nights and weekends. Interact with clients. Drive them to appointments and meetings. Sit in on groups and watch great and lousy counselors. Accept the fact that the hours are long and the pay is bad (and will be for a long time if you decide to continue this work). For those of you that don’t have an addiction disorder but want to do this work, you can still follow this advice step by step.

(8) Take a couple of professional courses (in NJ, they are called CADC courses; in NY they are CADAC courses). The Rutgers Center of Alcohol Studies offers courses year round on Thursdays and has a one week summer school. You will be exposed to new ideas and meet a number of other people like you (some of whom will be further along and can offer you their experience in this process).

(9) Middle school and high school curricula do a poor job at addressing the prescription drug problem. You can urge your local school board to bring in some programming (for students, for faculty and staff, and for parents) that educates people on these issues. This is an area where you can EASILY make a big impact.

(10) Contact your town council, county executive (or freeholder) and state legislator and let them know that you care about these issues. If you are wondering what issues are out there, keep reading my website (and look for extra articles that I link to on the Facebook version of my site) and read the health section of the New York Times each day.

(11) If you really want to engage in direct service work, you need to get your Bachelors and Masters degrees and then get a license. Consider getting a Masters in Social Work (the quickest way to a powerful license) or getting a Masters in Addiction Counseling from Hazelden. You will be a much better candidate for these programs, a better student and a better prospective employee if you followed my advice in point (7). Once you have a Masters level license, you can teach, train workers, take on interns, run programs and cast a much wider influence. It’s a long road, but worth it.

(12) If you need additional help or guidance, feel free to contact me.