Psychiatry & Psychotherapy
Mental Health, Substance Abuse, and Eating Disorders
San Pedro and Long Beach California

Psychiatry & Psychotherapy
Mental Health, Substance Abuse, and Eating Disorders San Pedro and Long Beach California

(310) 957-2099
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sf.Pomona-Run-1_It is a transition most parents will experience at some point in time and one that many face with bittersweet sentiment. Anxiety, worry, sadness and loss are just some of the feelings that parents are confronted with when their children leave home for the first time. Though most parents hope their children will grow up to be strong, independent and successful individuals, the process of letting go can be quite painful. By learning healthy ways of coping with empty nest syndrome, parents can more easily navigate this challenging season and learn to better accept the process.

Tips for Coping with Empty Nest Syndrome

Recognize Your Relationship is Changing – Not Fading

Nothing will ever change the relationship and bond you have established over the two decades your child has spent in your home. Realize that while your role and responsibility as a parent may be evolving, it is not disappearing. Your children will always need you in some capacity, though it may look different than it did while they lived at home. In the same way a teenager does not need the constant supervision of a toddler or the diaper changes of a newborn, your adult child will have decreasing needs as well. However, your child will still look to you for guidance, love and support as he or she navigates the exciting, but sometimes scary changes that come with growing up.

Be Proud of How Far You have Come

Instead of viewing a child’s departure from home as a loss, recognize it as an accomplishment instead. Be proud that you have raised goal-oriented children who are making decisions and taking proactive steps toward the life they want. Moving away from home is a sign of healthy growth and an indication that you have done your job to prepare your child to begin standing on his or her own two feet.

Start a New Chapter in Life

Whether your children have already left home or will do so in the next few months or years, it is never too early to begin preparing for the transition. Take time to start talking with your spouse about the future and some of the goals you would like to achieve together and individually. Plan a weekend away to rekindle your romance and get to know each other all over again.

It may also help to begin making a list of interests and hobbies you would like to expand upon, as well as other roles you would like to take on or better develop. Perhaps this means spending more time growing your business, volunteering with a charity or joining a shared interest group. Try to think of activities and pastimes you enjoyed before having children or come up with new ones that spark your interest.

Just be sure to take the transition slowly, avoiding any major changes all at once. Adapting to an empty nest takes time. Jumping into other major life changes simultaneously, like down-sizing to a new home, might complicate the adjustment process. 

Process Your Emotions

Remember that it is completely normal to feel grief when a child leaves home. Allow yourself to feel emotion, crying when you need to cry and talking when you need to talk. It may help to find support with other empty-nesters by discussing their own experiences with empty nest syndrome and how they were able to cope. Simply talking about your feelings and allowing yourself to feel the pain of a child leaving home is often enough to help bring closure to the situation and relieve the pressure of suppressed emotions. However, it is important to also press forward by maintaining normal routines and keeping up self-care.

Empty Nest Syndrome Linked to Increased Risk of Substance Abuse

Unfortunately, empty nest syndrome can produce severe consequences – especially for those who have found their sense of identity or purpose in raising or spending time with their children. Stay-at-home-mothers are especially vulnerable to these types of feelings, as they may struggle to fill the large void left by the constant presence and companionship of their children. The mental and physical exertion is only compounded when women at this age are also facing other major stress factors, such as aging parents, a looming retirement and menopause.

Research has shown that people who experience empty nest syndrome are at an increased risk of becoming depressed and turning to substances like prescription drugs or alcohol as a means of coping. When a person becomes dependent on substances to feel better, professional intervention is necessary. Signs of a potential drug or alcohol problem include:

If you or someone you know has turned to substances as a means of coping with empty nest syndrome, help is available. Regardless of how strong an addiction may be or how empty you may feel, the journey to sobriety can start today. Do not wait to get the help you deserve. Contact RecoveryNow, Inc. today for more information and to find out how you can take the first step toward a fulfilling and meaningful future.

Thursday, September 10, 2015 is World Suicide Prevention Day – a day when people around the globe come together to raise awareness about suicide and how it can be prevented. This year’s theme is Preventing Suicide: Reaching Out and Saving Lives. The International Association for Suicide Prevention is responsible for organizing Suicide Prevention Day each year, but its effects reach around the world. Hundreds of organizations work to raise awareness in collaboration with the IASP, and we here at Recovery Now, Inc, are happy to join those efforts.

Suicide Rates and Risk Factors

The burden of suicide is tremendous – especially here in the U.S. According to the Centers for Disease Control, which tracks mortality rates and causes in the U.S., more than 41,000 people took their own lives in 2013. It was the 10th most frequent cause of death in America, claiming the life of 112 people every day.

Though not all people who commit suicide fit a particular risk profile, there are certain factors that are more common among victims. For example, four men take their lives in this country for every one woman. In fact, white men representing 70 percent of all the suicides that occurred in 2013. Of course, this does not take into account the much higher rates of unsuccessful suicide attempts, which are especially common among youth and women. Females attempt suicide three times as often as males, and approximately 25 teenagers attempt suicide for everyone successful attempt. Additionally, middle-aged individuals and elderly people over age 85 carry the highest age-related risk of suicidal tendencies, representing nearly 40 percent of all suicides in the U.S. 

Several lifestyle, relational and mental health factors also contribute to a person’s individual risk of committing suicide. Links between substance abuse and suicide are especially high, as is the association between depression and other mental health disorders. This is especially true when a person faces barriers to accessing professional treatment, whether due to physical, financial or emotional reasons. Other suicide risk factors include family history of suicide, impulsive tendencies and diagnosis of a fatal or long-term illness.

Recognizing the Signs of Suicidal Tendencies

In honor of Suicide Prevention Day, our goal is to shed light on the preventive nature of suicide – especially when friends and loved ones are aware of its signs. Unlike physical illnesses, which are prevented by healthcare providers, suicide prevention is a social issue that rests on the shoulders of friends and family. It is important to know the warning signs, which may include:

Withdrawal and isolation

Increased abuse of drugs or alcohol

Poor sleep habits

Talking about being a burden to others

Discussing feelings of rage or desiring revenge

Expressing feelings of hopelessness

If you feel that a loved one may be having suicidal thoughts or tendencies, do not wait to take action. The U.S. Department of Health and Human Services recommends addressing your concern directly, asking your loved one if he or she is considering suicide. A person who is having suicidal thoughts or tendencies should never be left alone or within easy access to lethal weapons or substances.

Anyone who is displaying signs of suicidal thoughts or tendencies should seek professional treatment immediately. For more information about suicide signs and prevention, contact us here at Recovery Now.

Join others in the Postpartum Group today.

Women are vulnerable to mood disorders – specifically depression – during the postpartum period. Also known as PPD, this disorder is often confused with the ‘baby blues’, which are a normal, but mild feeling of general weepiness and stress experienced in the first few days following delivery. However, postpartum depression is very different from the baby blues, though many women and their families are unsure how to differentiate the two.

For that reason, Postpartum Support International has declared May as Postpartum Depression Awareness Month. The proclamation is designed to raise awareness of postpartum depression as a serious mental health problem affecting an estimated 15 percent of all women in the weeks and months following the birth of a child. Understanding the difference between the baby blues and PPD can directly affect whether a woman seeks help for her illness or continues living with its symptoms.

What are the Baby Blues?

The baby blues affect approximately four in five women and are widely contributed to sudden postpartum hormonal changes, sleep deprivation, and the activity that surrounds the birth of a child. Most women with the baby blues feel happy most of the time, with only sporadic moments of sadness, crying, irritability or confusion. These symptoms are typically very mild, peaking approximately 5 days after delivery and disappearing within two weeks after birth. Women with baby blues often feel relief when they take time for themselves, leave their homes for a few minutes each day, and accept help from friends and family with the new baby.

PPD: When Baby Blues Don’t Stop

When a woman experiences symptoms that worsen and the amount of time depressed persists past two weeks anytime during the first year postpartum, she is likely to have postpartum depression. Women with PPD have strong feelings of sadness that are ongoing and can last for a long period of time. Though it often begins in the first few weeks after delivery, postpartum depression can affect a woman at any point up to a year after a child’s birth.

Women with postpartum depression often feel they are bad mothers or alone in their feelings. The truth is 1 in 7 women develops some form of PPD. Women with a history of depression or a family history of mood disorders are at a heightened risk for developing PPD, as are women experiencing stressful life events or who feel little support from friends or family after the birth of a child.

It is important for any woman feeling strong feelings of sadness after delivery to speak with a doctor about PPD. Treatment is available, and many women feel better after seeking help. Left untreated, postpartum depression can worsen, resulting in physical, emotional and relational problems. The sooner a woman gets treatment for PPD, the faster she can begin feeling better for herself and her baby.

Resources:

American Psychological Association: Postpartum Depression

Postpartum Support International: Depression During Pregnancy and Postpartum

Join our Moderation Management Group or Recovery Choices Group!

A drink is defined as:
definition of a drink

Definitively, the U.S. Department of Health and Human Services considers moderate drinking to be no more than one drink per day in women and two drinks per day in men. This definition applies to day-to-day consumption – not an average of drinking overall. Therefore a man/woman who drinks a couple of six packs on the weekend and abstains the rest of the week is outside the boundaries of moderate consumption.

Since 1956, the American Medical Association has recognized alcoholism as a disease that progresses and may become terminal if left untreated over time. The AMA’s classification of alcohol dependence puts it in the same category as other diseases, such as diabetes, since alcoholism is associated with both lifestyle and genetic factors.  There is a wide gap between moderate drinking and alcohol dependence, although the lines are often blurred for people with a poor understanding of alcohol abuse and alcohol dependence. A person with alcohol dependence consumes alcohol despite negative consequences and at the more severe end of the alcohol dependence continuum experiences physiological withdrawal symptoms when not consuming alcohol.  These individuals are likely to experience strong cravings for alcohol.  Alcohol dependence may be causing problems physically, mentally, financially and with family, friends and work relationships.

It is important to recognize that people who exceed moderate drinking limits do not necessarily have alcoholism, but instead may be exhibiting patterns of alcohol abuse, which includes heavy drinking and binge drinking. This type of behavior can lead to dependence in some individuals who continue to abuse alcohol long-term.

Learning to Consume Moderately

know your drinkCountless resources are available to individuals with alcoholism. However, it is more difficult for a person to manage this disease once he or she has reached dependency. Instead, it is important to recognize the beginning stages of problem drinking and take steps to enforce moderation.

These programs tend to be more successful for problem drinkers, as they recognize binge drinking or excessive drinking to be a learned behavior, rather than a disease. They teach problem drinkers how to consume alcohol moderately and responsibly instead of requiring abstinence. People who participate in Moderation Management programs tend to feel empowered and personally responsible for their health and wellbeing, as well as that of others.One organization – Moderation Management – supports early intervention programs, which are generally shorter, more affordable, and less rigorous than rehabilitative programs for alcoholism. The program is comprised of several steps, much like an abstinence program. However, those steps involve education about moderate consumption, as well as goal-setting and self-management exercises.

Because some problem drinkers eventually develop alcohol dependency, approximately 1 in 3 people who attend moderation programs go on to participate in abstinence programs such as the 12-steps program of Alcoholics Anonymous or S.M.A.R.T. recovery.  However, people who are not affected by alcoholism can learn to drink responsibly before the problem becomes more severe.

 

Resources:

Moderation Management: What is Moderation Management?

Centers for Disease Control: Alcohol and Public Health

By Donna Balancia

Depression may not be genetic or a result of poor nutrition, obesity or other causes, a new study indicates. Rather, major depressive disorder may be caused by parasites and bacteria, and one psychology professor wants the disorder re-classified as an infectious disease and suggests research for a vaccination.

With an estimated 15 to 20 percent of the population that claims to be depressed at one time or another, a prominent psychology professor says major depressive disorder may be attributable to parasitic invasion and could possibly be cured by a vaccination.

Several examples are given by Turhan Canli, PhD, associate professor of Psychology and Radiology at Stony Brook University that back up his claim that depression may be caused by bacterial, parasitic or viral causes.

In his study, called “Biology of Mood and Anxiety Disorders,” Canli said that despite decades of research efforts, major depressive disorder still remains among the most prevalent of mental disorders. Canli says that pharmacological approaches have not changed and have brought only temporary relief to patients. The recurrence rate of depression is 50 to 80 percent in patients, indicating illness goes untreated, he wrote.

The study indicates that research shows markers present in patients, and in the postmortem brains of mood-disordered patients, are consistent with those that ward off pathogens produced by microorganisms.

Parasites, bacteria and viruses have been proven to impact brain function, as several previous studies point out.

A parasite that lives in cat excrement has been proven to change the brain functions of rats and mice so they lose their fear of the smell of cat urine. A study conducted by UCLA showed that women who consumed probiotics found in yogurt showed altered brain function while in a state of rest, Brain Balancers reported.

A virus, called ATCV-1, which was found in algae, has proven to slow brain functions, specifically in people who were taking tests that required visual processing, according to Science Mag.

“It would be worthwhile to conduct large-scale studies of carefully characterized depressed patients and healthy controls, using gold-standard clinical and infectious disease-related study protocols, as have already been developed for bacteria and viruses,” Canli wrote. “Such efforts, if successful, would represent the ‘end of the beginning,’ as any such discovery would represent the first step toward developing a vaccination for major depression.”

Headline and Global News

Buddha once said, “The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly.” Unfortunately, most people do not live in the moment – they live in their heads, directly affecting the way in which a person experiences life. Constant worry about the future or scrutiny over the past creates a never-ending personal dialogue that diverts healthy growth and distracts from what is happening now.

Few people live fully present in every moment of every day. As a result, several areas of life suffer, including emotional health, physical health, weight and productivity. Many people spend their lives chasing quantity – the next vacation, promotion or stage of life – rather than pursuing quality of time in the present. By instead living in the moment, each minute is fully appreciated, prolonging its value and making it more meaningful.

3 Tips for Living in the Moment

It isn’t easy for a person to be fully present. It requires a state of consciousness and awareness that a person must practice with intention. Living in the moment is about giving undivided attention to every person and complete focus to every task. Everything – including rest – should be fully embraced and savored.

Don’t dwell on the past.

Concentrating on the past can rob you of the moment at hand. Living in the past and its difficulties robs you of trusting the present and future. It is impossible to change any past event. The only way of coping with past hurts and experiences is by accepting them, learning from them, and moving on with life.

Avoid worrying about the future.

It is impossible to live in the moment if you are worrying about the outcome of that moment or of some future event. Fears about the future are common and often stem from wrong thinking or past experiences. It is difficult to be fully present if you are fearful of going broke, losing a loved one, experiencing failure or being rejected. While some fears are natural, allowing them to control life experiences, modulate behaviors or limit your dreams is a tragedy.

Slow down

One of the easiest ways to begin living in the moment is by slowing down and enjoying the process, rather than the destination. Learn relaxation techniques, such as meditation, to help focus your mind and quiet the ‘noise’ around you. Take time to notice your surroundings, and make it a point to listen attentively to conversation, the sounds of nature, or even silence.

Embrace Every Moment

Learning to live in the moment is a process worth undertaking. Over time, you’ll feel less as if though life is passing you by and much more connected with yourself and other people. You may also experience a greater appreciation for life and less fearful or anxious about the circumstances behind and ahead of you. It does not mean you fail to set goals for the future or reflect upon the past; but rather that you allow yourself to feel every moment as it unfolds.

New Year’s Day is a time to turn over a new leaf and resolve to do the things we wish we would have been doing all along. Americans love making New Year’s resolutions, perhaps because January 1st signifies the beginning of a clean slate. But after the ball drops and the confetti has fallen, the dust settles on an uphill climb toward personal ambitions and the desire for self-improvement.

Unfortunately, many of those goals are difficult to attain and sometimes completely unrealistic. It is not so much that the goals themselves are bad, but that the means by which a person plans to achieve them are impractical and unlikely to produce success. Many people hit the ground running day one, only to run out of steam within months, weeks or even days of the New Year. According to research from the University of Scranton, approximately half of Americans make resolutions each year, yet only 8 percent succeed in reaching their goals.

The list of specific resolutions varies from person to person, but there are some widespread commonalities between most Americans. Of the top 10 most common resolutions, the majority are related to improving personal health and relationships. Examples include:

Achieving New Year’s Resolution Success

Only you can determine whether you reach your New Year’s goals, though there are some steps you can take to increase your chances of success. If you are planning to make changes in the upcoming year, follow these tips to improve your chance of reaching your goals.

Set realistic goals. New Year’s resolution lists should not be a mile long or filled with over-the-top goals that that are impossible to achieve. The American Psychological Association recommends starting small. Perhaps this means smoking two less packs of cigarettes per week or going to the gym three days a week instead of seven. The APA also cautions against reassessing every area of life you desire change in. Instead, pick one thing to change, and focus all of your resolution efforts toward achieving that one, manageable goal.

Break big goals into smaller goals. When a big goal is broken up into smaller goals, it is much easier to measure success along the way. For example, if you have a goal of losing 50 pounds in the coming year, create 10-pound milestones, and celebrate those smaller achievements. The creation of small objectives within a larger goal provides a measure of success and forces you to evaluate your achievements according to the progress you are making throughout the year.

Make a plan. Planning is another important element of successfully holding to your New Year’s resolutions. A resolution almost always involves modifying behaviors that have become habitual. Changing bad habits takes time, and there are sure to be slip-ups along the way. Instead of holding yourself to impossible standards, anticipate the areas you are most likely to make mistakes, and take steps to avoid them. Perhaps that means packing a healthy snack to eat when hunger strikes at work. Maybe it means setting aside one or two specific nights every month to have dinner with family or friends. Whatever your goal, a plan should emphasize your strengths while limiting your exposure to moments of weakness.

Source

Forbes: Just 8% of People Achieve Their New Year’s Resolutions. Here’s How They Do It

American Psychological Association: Making Your New Year’s Resolutions Stick

CHADD

Educate Yourself. Teach Others. #ADHD

 

Spread the Word During ADHD Awareness Month

 

October 2014

October is ADHD Awareness Month! CHADD encourages you to educate yourself, teach others, and blanket the Internet with information about ADHD this month.

During October, CHADD will generate positive social media messages involving  ADHD Champions, teachers, facts about ADHD, resources, infographics, parents of children with ADHD, and adults with ADHD so that you can share them with your social media networks.

Led by actress Wendy Davis of Army Wives, this social media phenomenon will raise awareness of ADHD, share facts and resource information, and instill hope and pride in the ADHD community. Use your Twitter, Facebook, LinkedIn, and Pinterest accounts to share and retweet posts from CHADD and Join the Buzz. Select and share messages from our ADHD Champions including actress Wendy Davis, Auburn University football player Peyton Barber, triathlete Max Fennell, UPS sales executive Mike Merrilees, race car driver Luca Forgeois, entrepreneur Peter Shankman, make up business owner Marta Bota, best-selling author Dr. Dale Archer, and junior golf player Sean Murray. Or, post your own upbeat thoughts.

Read the inspiring stories about our ADHD Champions. Just like you, most of them struggled as youth in school, but found their gifts and creative ways to be successful. ADHD Champions are motivating role models that you and your family can refer to at any time.

Look for ADHD Awareness Month activities across the United States at the ADHD Awareness Month Coalition calendar. CHADD has planned activities in conjunction with the ADHD Awareness Month Coalition which includes CHADD, National Resource Center on ADHD, ADDitude Magazine, ADHD Coaches Organization (ACO), and Attention Deficit Disorder Association (ADDA).

Educate Yourself. Teach Others. #ADHD

 

As the media continues to sensationalize the tragic loss of Robin Williams, one realizes the realities of substance abuse and mental illness. All too often these 2 mental health problems collide and leave a path of destruction for not only the individual but also family and friends. It is interesting when people say such things as, “He seemed so happy. Why would he kill himself when he had everything?” Unfortunately having everything does not exclude one from experiencing mental illness and substance abuse problems. Major depression is an illness of the brain which creates a chemical imbalance with the neurotransmitters. This chemical imbalance often requires medication and psychotherapy to stabilize. With co-occurring disorders such as substance abuse and mental illness, it is hard to say which came first and this is why we must treat both at the same time.

“Depression and substance abuse can affect anyone”

It has been my experience while working with depressed patients who have also achieved a large degree of success; it is very confusing to have success and as a result of depression not able to enjoy this success. When there are no psychosocial stressors contributing to low mood and one is still depressed, life does not seem to have meaning or worth living. Death by suicide is often the result of at least 10 unsuccessful suicide attempts. When someone is successful, they are truly in a state of despair. Robin Williams was a wonderful Entertainer. He has left us all too soon as a result of the lethal combination of mental illness and substance abuse. If you are struggling with mental illness and substance abuse or someone you know is, please get help.  Treatment is necessary along with the love and support of family and friends.

Sliding Scale Arise Interventions

Limited Time Offer!! We are pleased to announce Alicia MacGowan, LCSW, LAADC completed Intervention training with ARISE July 9th to the 11th sponsored by Center for Dependency, Addiction and Rehabilitation (CEDAR) at the University of Colorado Hospital.  The training had additional sponsors which presented and are all reputable programs: Balboa Horizons Malibu Beach Sober Living Vista Taos A Mission for Michael Solid Landings Bridge to Recovery Elements Behavioral Health Foundations Recovery Network     Alicia has been doing Interventions since 2008 utilizing the Johnson Model and decided to receive this additional training since the research on this model of Intervention has a very high long-term success rate. “The Model seems to fit my style of practice very well.”   Alicia must in the next 6 months complete 2 interventions and receives weekly 1-hour Group Clinical Supervision via teleconferencing for 6 months in order to receive final certification.  She is now a Clinical Intern after completion of the 3 day Training.   The distinct differences between the Johnson Model and ARISE Model are:  

  1. The Intervention is not a surprise.  The Addicted Individual is invited and aware of the whole process.
  2. The Intervention process is over 3 to 6 months which includes continuing care group meetings for all individuals participating in the Intervention
  3. The focus is on the whole system, family, friends & co-workers and making sure that everyone in the system is getting whatever outside resources they need

  Alicia is offering a very special opportunity for those interested.  She will complete her first 4 ARISE Interventions on a sliding scale.     “I am not able to offer the same sliding-scale for my usual Interventions; this is only for ARISE Interventions.  On our current Interventions we refund ½ of the cost if the Intervention is not successful.    Since I am doing these Interventions on a sliding scale, I will not offer this same opportunity.  I am not qualified to do Interventions on adolescents therefore my Interventions are always limited to adults.”   Assisting all families, employers and addicted individuals has always been Alicia’s goal.  She has a special interest in helping Healthcare Professionals such as Mental Health Professionals, Substance Abuse Professionals, Nurses and Doctors.  These are individuals of special interest, since she herself understands how the demands of being a Helping Professional may increase the risk of substance abuse and/or mental illness.  A formal Intervention may be the only way to assist these individuals with recognizing their need for treatment.   Here is the link to ARISE for more information http://www.ariseinterventionnow.com/intervention.html and a brief summary of the Model from the ARISE website: The ARISE Intervention is directed towards getting the addicted loved one into treatment with the least possible effort through a loving, compassionate and non-blaming First Call and First Meeting. The support system is mobilized to form a committed Intervention Network to motivate the addicted individual into treatment. Phase A has three levels and the goal is to stop at the first level that works:

ARISE Continuing Care begins when the addicted individual enters treatment, and lasts for 6 months. The goals are individual and family healing and recovery. It includes, if possible, the family and individual becoming involved in 12-step program. The Certified ARISE Interventionist works collaboratively with the addicted individual, the treatment center, and the family to ensure treatment completion, relapse prevention, and the resolution of grief and other problems at the root of the pain and the addictive disease. ARISE Continuing Care focuses on the Certified ARISE Interventionist working with the Intervention Network and addicted individual to prevent relapse, initiate long-term recovery, and complete the work towards family healing and recovery. This includes ensuring that work, life style, social circle, family relationships and personal decisions made for personal growth in Continuing Care are happening for individual and family.   A special thanks to all of our trainers Dr. Landau, Sara Hills, LPC, CAC III, CAI and James Ott, LCSW, CAI, CIP.  I am looking forward to working with all the wonderful Professionals I trained with.     CEDAR Tour: While I was at CEDAR in Colorado I had the opportunity to receive a tour of the Treatment Center.  The grounds were spectacular and serene.  The facility was very clean and well maintained.  It was especially nice that they separated the Treatment Center from the Hospital and the facility had the appearance of a Wooded Lodge from the outside.  I found the CEDAR to be very inviting. Their program appears to be truly able to assist those dually diagnosed.  Many Treatment Centers make this promise, but do not have enough Licensed Staff, proper staff to patient ratio and knowledge to assist individuals with a mental illness and a substance abuse problem.  They also have the ability to assist with severe medical problems related to substance use, since they are on Hospital grounds. In addition CEDAR has a Physician Health Program (PHP) treatment track.  Unfortunately the state of California, unlike many other states, does not offer any sort of Diversion Program for Physicians.  Often this lack of Diversion Programs makes it difficult for our Doctors to receive necessary treatment due to fear of California Medical Board intervention and loss of License. The Staff appear to be very qualified.  Everyone I met was very genuine and helpful.  Overall I look forward to the possibility of coordinating Patient care with CEDAR in the near future.