September is National Recovery Month during which new evidence-based treatment and recovery practices are highlighted. The strong and proud recovery community, including the dedicated service providers and community members across the nation who support the millions of individuals who are proudly living their lives in recovery, as well as their family members and loved ones, comes together to honor those working towards recovery for all.

The 2021 National Recovery Month theme “Recovery is for Everyone: Every Person, Every Family, Every Community” reminds people in recovery and those who support them, that recovery belongs to all of us. Everyone’s journey is different, but we are all in this together. This is true of everyone and, as in most cases, we cannot do it alone. Recovery Month will continue to educate others about substance use disorders and co-occurring disorders, the effectiveness of treatment and recovery services, and that recovery is possible.  All of us, from celebrities and sports figures to our co-workers, neighbors, friends, and family members, throughout our lives have experienced peaks and valleys, both big and small. But, with strength, support, and hope from the people we love, we are resilient.

National Addiction Professionals Day will be celebrated on September 20, 2021, as part of National Recovery Month. Started by NAADAC, the Association for Addiction Professionals in 1992, the day was established to commemorate the hard work that addiction professionals do on a daily basis. Addiction professionals provide people in need the support and tools necessary to address their addictions and move towards recovery. The need for addiction and mental health professionals has never been greater, and we can support their commitment to serving those in need by recognizing the vital role they play in the lives of our friends, our families and our community.

The Addiction professionals at Rimrock are committed to helping those struggling with addiction and meeting them where they are. This means meeting individuals where they are in their journey towards recovery and meeting where they can receive treatment. Rimrock has greatly expanded the treatment we are able to provide through telehealth with the introduction of Rimrock Connect, allowing us to connect those in need with addiction and mental health professionals online or by phone.

Faces & Voices of Recovery has created a new Recovery Month website that will host all Recovery Month events and assets that make this celebration possible. Faces & Voices of Recovery works to hard to support individuals in long-term recovery from drug and alcohol addiction and their family members, friends and allies in a variety of ways, including, capacity building in support of the national recovery movement, fighting the stigma of addiction, creating groundbreaking recovery messaging trainings and more. Faces & Voices of Recovery is dedicated to organizing and mobilizing the over 23 million Americans in recovery from addiction to alcohol and other drugs and families, friends and allies into recovery community organizations and networks. They work to promote the right and resources to recover through advocacy, education and demonstrate the power and proof of long-term recovery.

If your organization is interested in learning more about mental health and substance use issues facing our community, Rimrock staff provides education and outreach presentations at no charge. Please call us at 406-248-3175 to learn more.

And, if you need help  or know someone struggling with substance use or their mental health, we are here for you 24/7. Please call 800-227-3953 or complete our online request form to connect with our team of professionals. Rimrock Is Recovery.

Unfortunately, the chances that someone you know and love may experience a drug overdose are growing as the pandemic has made an already serious crisis even worse. The past several months have been an incredibly uncertain and stressful time for many people, and we are seeing an increase in drug consumption, difficulty in accessing life-saving treatments for substance use disorders, and a tragic rise in overdose deaths — both in the United States as a whole, and right here in Yellowstone County.

Drug overdose deaths rose by close to 30% in the United States in 2020, the highest number ever recorded according to the US Centers for Disease Control and Prevention. More than 93,000 people died from drug overdoses in 2020, according to provisional data released by the CDC’s National Center for Health Statistics. That’s a 29.4% increase from the 72,151 deaths projected for 2019. Overdose deaths from cocaine, synthetic opioids (primarily fentanyl), natural and semi-synthetic opioids (such as prescription pain medication), and psychostimulants all increased in 2020.

“This is the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999,” Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, said in a statement.

What does overdose look like?

People experiencing overdose will present with varying symptoms depending on the substance(s) they have overdosed on.

Opioid Overdose. Opioids attach to receptors in the central nervous system, reducing pain signals to the brain. Commonly used opioids include oxycodone, morphine, codeine, heroin, fentanyl, methadone and opium. A person who has overdosed from opioids may exhibit:

• No response to stimuli
• Shallow or stopped breathing
• Inability to be woken up
• Unusual snoring / gurgling sounds
• Blue or grey lips or fingertips
• Floppy arms and legs

Crystal Methamphetamine & Stimulant Overdose. Crystal methamphetamine is generally available as speed (powder), base (damp, oily substance), pills/tablets or ice, the purest form which has a white, crystalline appearance. Meth can be snorted, smoked or injected. Stimulants such as amphetamines, cocaine and Ecstasy increase alertness and heart rate, producing an effect of increased confidence and energy. A person who has overdosed from crystal methamphetamine or a stimulant may exhibit:

• Hot, flushed or sweaty skin
• Unsteadiness
• Uncontrolled movements
• Difficulty breathing
• Severe headache
• Chest pain
• Severe agitation or panic
• Confusion or disorientation

Alcohol and Depressants Overdose. Depressants such as alcohol, benzodiazepines and barbiturates slow the central nervous system to produce a calming effect. A person who has overdosed from depressants may exhibit:

• Confusion
• Loss of coordination
• Vomiting
• Seizures
• Irregular or slow breathing
• Unresponsive but awake
• Limp body
• Pale or clammy face
• Pale of blue fingernails, lips or skin
• Low body temperature
• Slow or erratic pulse
• Choking / gurgling sounds
• Loss of consciousness / passing out

New Psychoactive Substance (NPS) Overdose. NPSs’ are also known as ‘synthetic drugs’ or ‘legal highs’ – chemicals that are made to act in a similar way to drugs such as cannabis, ecstasy, cocaine or methamphetamine. A person who has overdosed from NPS may exhibit:

• Shaking / shivering
• Fever / overheating
• Nausea or vomiting
• Uncontrolled movements
• Difficulty or stopped breathing
• Inability to be woken up
• Seizures or rigid muscles / spasms
• Paranoia, fear and panic
• Confusion or distress
• Agitation and aggression

What should I do if I think someone has overdosed?

If you witness someone you think may have overdosed, first call 911 for help if possible. Provide rescue response with as much information as possible, including what and how much substance was taken, any pre-existing medical conditions, etc. While waiting for help you can take the following steps:

· Check for dangers, such as needles
· Try and get a response by calling their name
· Try and help them cool down or warm up as needed
· Provide a calm, reassuring presence if they seem panicked

· Remove items from their immediate environment that might cause injury if they are
having a seizure or spasms
· Ensure the person has adequate air and be prepared to give CPR if they stop breathing

If you cannot get a response or the person is unconscious, place them in the recovery position:

· Support their face by placing the person’s arm nearest you at a right angle to their body. Place their other hand against their cheek nearest you.
· Lift their far leg above the knee and pull it up, keeping the foot flat on the ground
· Keeping their hand pressed against their cheek, pull the bent leg towards you and roll them onto their side.

If your loved one is addicted to opioids, you may want to work with a treatment provider to receive a prescription and learn how to administer narcan/naloxone in case of overdose.

What should I avoid doing in case of an overdose?

In case of overdose, you can help keep the person as safe as possible by taking the following precautions:

· Do NOT leave the person alone
· Do NOT give the person anything to eat or drink
· Do NOT try to induce vomiting

How can I support family and friends affected by overdose?

You can support your family, friends and neighbors by learning more about the causes, signs & symptoms and effects of overdose on your community. More information and fact sheets can be found at www.overdoseday.com.

International Overdose Awareness Day has been held annually on August 31 since 2001, and this year Billings will host the city’s second annual event in coordination with the national effort. Kim Edinger and Carol Keenan have very personal reasons for bringing Overdose Awareness Day to Billings. Carol lost her 22-year-old daughter Mary Kate in November of 2016 and Kim lost her 20-year-old son Kaden in July of 2017; both died of an accidental Fentanyl overdose.

Please join us at Overdose Awareness MT to honor International Overdose Awareness Day Tuesday, August 31, at 6:30pm at the Rose Park Shelter (21st W & Ave C). The event will help bring awareness and end the stigma surrounding overdose while honoring those we have lost. Food trucks will be on site and t-shirts will be for sale. For more information, contact Carol Keenan at cjkeenan@bresnan.net. For more information on the event, please check-out their Facebook page.

If you or someone you love is struggling with substance use disorder, please reach out for help. At Rimrock, our staff is available 24/7 to talk with you by calling 800-227-3953 or by completing our online form.

“There’s something wrong with you.”

“Just snap out of it!”

“It’s your own fault.”

If you’ve had one or more of these connotations directed at you (or maybe you’ve even directed them at yourself), then you already know that the topic of mental health is one that’s surrounded by stigma. Seeking therapy is often viewed in a negative light by many people. They may interpret the need to speak with a professional as a sign of personal weakness, or that you should be able to control your thoughts, feelings, and emotions on your own. Think about it though— we have health professionals to help us care for our eyes, our teeth, our reproductive systems, etc. The list goes on. Why shouldn’t taking care of your brain be just as important?

The truth is, we all need someone to talk to. Someone to share our feelings with, someone to vent to when we’re upset, and someone who is able to listen to us and help us through whatever challenges we may be facing. Whether this is your spouse, a trusted friend, or another family member, it’s important to have a reliable person in your corner. So, how do you know when to seek therapy or find a counselor? If you find yourself excessively worrying, struggling with feelings of depression or loneliness, or you begin skipping work, losing sleep, or avoiding plans with friends, it may be time to reach out for help.

In addition to offering an unbiased view on your thoughts and feelings, counselors are responsible for making you feel comfortable and safe while sharing those feelings. It’s also important to know that everyone’s mental health journey is different— while some find that weekly sessions are important for them to feel in control of their thoughts, others may only need to schedule sessions on an as-needed basis. Speaking with a counselor can help you resolve any current challenges you’re facing, learn different coping methods, and allow you to make any necessary personal changes that help you return to a healthier version of yourself.

On that note though, keep in mind that counselors specialize in different areas of mental health and have different personalities. Think of them as pairs of pants— not all pants fit you the same way, but that doesn’t mean that they’re “bad” pairs of pants. It just means you haven’t found your perfect pair yet. Similarly, it’s important to “try on” on different counselors until you find one that’s a great fit for you and your mental health needs.

Rimrock’s Mental Health Services team is comprised of dually-licensed counselors that hold a LAC (License in Addiction Counseling) as well as a mental health license (LCSW or LCPC). If you are interested in learning more about Rimrock’s mental health services or would like to schedule a session with one of our counselors, please call us at (406) 248-3175.

From shopping to baking to decorating, most people gladly welcome a little extra help during the holiday season. For those in recovery from Substance Use Disorder and Co-Occurring Mental Illness, that extra help may look a little different, and may come from those you wouldn’t expect. Our Peer Support Specialists are an integral part of our treatment team. They share lived experience and recovery-based lifestyles, and are trained to assist others in initiating recovery, maintaining recovery, and enhancing the quality of personal and family life in long-term recovery.

Our gift to the community for a healthy and happy holiday season is to share our Peer Support Specialists top tips for navigating the holidays while in recovery. We hope that in these tips, you find the inspiration and the support you need to enjoy the holidays with friends and family this year.

1. Honesty

While in recovery, it’s important to be honest with yourself, as honesty is the foundation to a healthy recovery. Infusing the truth into every aspect of your recovery can help you hold yourself accountable.

2. Hope

When many people begin their recovery journey, they may feel hopeless at the start. At Rimrock, we provide you with the support and the resources you need to feel hopeful about kickstarting your recovery journey.

3. Faith

Having faith in a higher power, whether it’s God, the universe, or some other force, allows us to experience stability in the middle of instability. If you need to find your faith, start by identifying what feels righteous to you.

4. Courage

Taking the first step to recovery is accepting that you are, in fact, ready to recover. Acknowledging that you need help (and that you want help) takes a great deal of courage.

5. Integrity

Define what your own personal values are, and why standing by them during recovery is important to you. In order to have integrity, you must uphold your values, even if others don’t support them or tempt you to abandon them.

6. Willingness

Admitting that you’re ready for help, while also being willing to accept the help that’s offered, can be difficult. Willingness to trust in the process while recognizing there will be barriers along the way that may make you feel discouraged is important for a successful recovery journey.

7. Humility

It’s common to feel a sense of pride and to battle your ego when entering recovery. Humility can help you take a step back and see the situation through a new lens.

8. Self-Discipline

Self-discipline is something everyone struggles with from time to time. Learning to control your emotions and desires is critical, not only during every step of the recovery journey, but during long-term recovery as well.

9. Love

“In the end, all that remains is love.” Love and kindness both go a long way in helping to transform lives. What you give in love ultimately comes back to you and multiplies.

10. Perseverance/Patience

Patience really is a virtue. It takes time to heal your mind and body, and patience can help you repair any tense or damaged relationships with loved ones. It also helps us to appreciate the present moment and to manage our stress.

11. Awareness

Being fully aware of your current situation and accepting the reality of it, rather than wishing your reality were something different, is crucial to a successful recovery. Mindfulness will help you focus on difficult thoughts and feelings, while addiction pushes these feelings aside.

12. Service

When you focus on others, you focus less on yourself. Actively serving another person lets them know that they matter to you and that you are willing to put their needs above your own.

If you need support this holiday season, we are here to help! Our Peer Support Specialists and entire Rimrock team are available if you need support for yourself, or a friend or loved one. Please complete our online request form or call us for help at (406) 248-3175 or (800) 227-3953. Normal admission hours are between 8:00 am and 5:00 pm Mountain Time, Monday through Friday. However, we are available to take your call 24/7.

Behavioral Health Alliance of Montana’s (BHAM) vision is to ensure that quality, community-based services are available and accessible to people, families, and communities in need. BHAM’s mission is to achieve their vision with effective advocacy and support of service providers. As Chairperson of the Board of Directors of BHAM, Rimrock’s CEO Lenette Kosovich helps lead and coordinate public policy direction related to behavioral health services, as well as helps coordinate with other stakeholders in healthcare on advocacy and service delivery (primary care, criminal justice, law enforcement, child welfare, prevention). Through her work with BHAM, Lenette is working with others to build a voice for mental health and addiction services in Montana.

BHAM has created the “Already Gave” campaign directed at lawmakers to create awareness of the importance of mental health and addiction services in Montana. Through this campaign, BHAM hopes to create conversations between lawmakers and behavioral health and addiction services providers and work together to help our neighbors in need and establish the funding necessary for this important work.

Behavioral health providers have always competed for scarce resources and have often not been aware of key policy and regulatory opportunities. These providers have faced economic, regulatory, and workforce challenges in a rapidly evolving health care environment, and they have and continue to struggle to provide services to a group of people who are among the most vulnerable. At the same time, they have had few opportunities to meet, learn from each other, and collaborate on programs, health system reforms, strategic planning, or policy and advocacy.

Historical fragmentation of the behavioral health system has resulted in a fragmented delivery system in communities across Montana for adult mental health, youth mental health, and substance use disorders in the adult, youth, and American Indian populations.

“Pulling all sectors of the behavioral health provider community together allows us to provide expert solutions to the serious behavioral health problems facing Montana: high suicide rates and an epidemic of mental illness and substance use disorders.”

– Mary Windecker, BHAM Executive Director

In the past, Montana has had formal and informal state associations that reflect regulatory and oversight divisions (children, adults, substance use, mental health, and tribal) of the Montana Department of Public Health and Human Services. But these organizations had never had consistent staffing and despite dedication and passion, there were few resources with which to engage effectively. In 2016, many were beginning to recognize that a strong state behavioral health association was needed to provide a powerful tool for strengthening behavioral health services. A behavioral health association that includes substance use disorders (SUD), would inherently elevate this part of the behavioral health spectrum as a valued and important health issue as well.

In June 2016, the Montana Health Care Foundation (MHCF) brought together executives from addiction, mental health, and tribal behavioral health organizations to discuss the idea of forming a strong state association representing all behavioral health services. Meeting participants observed that this was the first time the diverse group of behavioral health leaders had met! The leaders realized that to meaningfully embrace behavioral health in the greater health system, the behavioral health leaders themselves must be aligned and united—no small task for behavioral health providers that had functioned separately for decades. Over several meetings, this group decided to pursue creation of a state behavioral health association and solidify its commitment to unite as behavioral health providers and reinforce behavioral health as a foundational component in the state’s health care system.

MHCF provided convening resources, strategic leadership, and facilitation for this group. The group developed a vision, mission, and value statements, and committed to developing a business plan and achieving sustainability within three years. After a year of work, this group formed BHAM with a Founding Board consisting of two representatives each from the children’s, adult, substance use, and Native American groups.

Even as such a new organization, BHAM has already made critically important contributions to strengthening behavioral health in the state by:

• Bringing behavioral health providers together to identify and address common issues. For example, BHAM is currently working on an initiative to develop a standard set of patient experience and service quality measures. With these measures in place, providers can better understand if their treatment is effective.
• Advancing the use of peer support by behavioral health providers. BHAM contracted with the Montana Department of Public Health and Human Services (DPHHS) to support the early implementation of peer support by behavioral health providers by providing clinical supervision, training, and measuring outcomes.
• Developing a single voice to speak for behavioral health providers. The ability to speak with a unified voice has allowed for a more constructive partnership and effective communication with DPHHS.
• Offering behavioral health training opportunities.

More information on upcoming quality improvement and new skills training and other BHAM events can be found here.

BHAM has been successful in a task that had never been done before – pulling all the separate behavioral health providers together to work as a collaborative. By creating a unified purpose and voice, behavioral health disciplines across the state can collaborate, advocate for themselves effectively, and provide the best care possible for their patients. Rimrock is proud to be working with this amazing team of behavioral health and substance use professionals to improve the services available in Montana.

More information about BHAM can be found at montanabehavioralhealth.org.