An inspirational article written by Foundry Steamboat Wellness and Recovery Coach is published in Steamboat Pilot & Today. This piece celebrates Mental Health Awareness Month, which is the month of May, and provides practical suggestions to support positive mental health.

Read the full article here: https://www.steamboatpilot.com/news/sarah-coleman-i-see-you-i-hear-you/

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Many people in rural America are on their own when it comes to mental healthcare. Nearly half a million, or 14 percent of, Coloradans are affected by mental health challenges, a 2016 report from the Colorado Health Foundation revealed, and many of them lack access to care. A 2020 report by the Colorado Rural Health Center (CRHC) found that of the state’s 64counties, 22 don’t have a psychologist or psychiatrist working there. 

According to the CRHC’s2022 Snapshot, “Nine rural counties in Colorado have no pharmacy, while eleven other rural counties have only one pharmacy.” Thirty-seven of Colorado’s64 counties (all rural or frontier) do not have any ICU beds.

The region around Durango in southwestern Colorado is a good example. Although many residents suffer from substance use disorder, treatment options are sparse. “The region has no recovery homes, no medical detox, and no inpatient substance use treatment facilities,” reported the Durango Herald in May. “While treatment resources do exist, those demanding inpatient care must usually travel to the Front Range.”

Many residents of rural America feel generally isolated and left behind by the modern world. In 2015, two Princeton economists argued that middle-aged white Americans without a college degree were now facing “deaths of despair”—suicide, overdoses from drugs and alcohol, and alcohol-related liver disease. They suggested that distress caused by globalization and rapid technological change probably drove those deadly outcomes. Middle-aged whites are now more likely than their predecessors to report pain and mental health problems and are experiencing symptoms of alcoholism at a younger age.

Middle-aged white males in rural areas are often also affected by so-called “man rules.” The rugged and self-reliant frontiersman is supposed to be able to “hold his liquor” and not “go on” about his feelings. Men, in general, face different expectations than women, which can impact their mental health and substance misuse. In the 2022 CRHC Snapshot, 21 percent of adult rural Coloradans reported drinking excessively.

Foundry Steamboat Rural Community Connection Effort

The Foundry Steamboat men's residential program treats adult men experiencing substance misuse, co-occurring mental health conditions, and trauma. The program offers comprehensive, coordinated treatment, including medical care, psychiatry, psychotherapy, fitness, and wellness coupled with gender-responsive and trauma-informed approaches. Its focus, milieu, and expertise make this program especially appropriate to men for whom previous treatment episodes have been successful. Foundry Steamboat also offers a virtual intensive outpatient program for men and women in Colorado and Wyoming and operates Chrysalis Continuing Care, an in-person IOP in Denver’s RiNo neighborhood. 

Foundry Steamboat team members are experienced with the challenges facing rural Coloradans, including steep rises in suicide and untreated mental health disorders. In 2022, Foundry Steamboat outreach representatives Amber King and Amanda Buckner, who hail from rural Colorado hometowns, established monthly virtual meetings to make connections between therapists and other behavioral health stakeholders in these rural communities. 

This rural community outreach and networking effort is beginning to yield results. Therapists, case managers, and peers are identifying new resources, and more people are being referred to treatment. The group’s recent discussions indicate that therapists are seeing positive changes that could make it easier for people in some communities to seek care. 

In Vail, for example, therapists have noticed that young people are becoming more vocal about experiencing mental health conditions, such as anxiety, depression, and suicidal ideation. Vail community members are also building a peer recovery system, which can help people seeking treatment and support those living in recovery.

Vail offers an important example of how problems facing rural Americans affect communities across the socioeconomic spectrum. Although Vail is a small community of 5,000 full-time residents, the town receives more than1.3million visitors per year who ski its slopes in winter and hike its mountains in summer. Tourism makes Vail a relatively affluent community and supports a range of businesses and healthcare facilities.

Despite its resources and infrastructure, Vail struggles from a lack of mental and behavioral healthcare and experiences stigmas affecting many rural communities, some of which are stubborn remnants of longstanding rural culture. And like many so-called mountain towns that attract a high population of visiting tourists, residents can struggle with forming lasting relationships or feel isolated despite being surrounded by people.

“While life in mountain towns and agricultural communities can differ greatly, rural communities can sometimes perpetuate unhealthy cultural cues by normalizing substance use as part of daily life. It can be easy for families to inadvertently keep cycles of substance misuse going by enabling or even encouraging substance use to overcome boredom, pain, or as a social lubricant. When communities are isolated from major population centers by hundreds of miles, it’s easier for ideas and behaviors — both good and bad — to remain unchanged while these thoughts and behaviors may be changing in the broader population,” says Foundry SteamboatCommunity Relations Manager Amanda Buckner.

"As a voice in rural recovery work, collaborating with community leaders throughout the state has transformed inspiration into action and helped build the recovery community organization in our mountain town,”says Rob Shearon, Founder of Reconnected, an app that helps people recovering from mental health and addiction to connect with others. Before foundingReconnected, Shearon was a program manager for the University of ColoradoCollegiate Recovery Center.

"At Reconnected, we're not just providing peer recovery coaches through our partnership with the local hospital, we're building a supportive community through a variety of social events, from non-alcoholic happy hours to mountain bike rides with the local rec district.We're creating a network of like-minded individuals who are there for each other every step of the way in their recovery journey," says Shearon.

“The fact that Vail is starting a peer recovery support network and getting community involvement happening represents major progress,”says Buckner. “When we started these Zoom meetings, we weren’t sure how responsive people would be or if it could help to make a change. It is still very early. But when we hear colleagues like Rob telling us about these successes, or that young people are feeling more comfortable talking about their problems, that’s a big deal. It shows that change is possible and that this effort can help to make change.”

Join the Connecting Rural Community monthly calls, which take place on the second Monday of each month by emailing amanda.buckner@foundrysteamboat.com.

The animal tranquilizer xylazine has become the latest scourge in the American addiction crisis. The substance often pushed under the names “Tranq” or “Tranq dope” is a non-opiate sedative, analgesic, and muscle relaxant only authorized in the United States for veterinary use, according to the federal Food and Drug Administration.

Xylazine—currently not a controlled substance—“was first noted as an adulterant in Puerto Rico in the early 2000s,” reported the Drug Enforcement Administration (DEA) in October. “Xylazine, reported as an adulterant in an increasing number of illicit drug mixtures, has also been detected in a growing number of overdose deaths. It is commonly encountered in combination with fentanyl but has also been detected in mixtures containing cocaine, heroin, and a variety of other drugs.”

“The drug causes dangerously low blood pressure, slow heart rates, blackouts, and skin wounds so severe they can lead to amputations,” reported Axios Denver on March 15. “The sedative, which makes the effects of fentanyl even deadlier, is also unresponsive to common overdose-reversal treatments, like naloxone.” The reason: naloxone (Narcan) only counteracts the effects of opioids and not of other psychoactive substances.

Tranq started to appear in Philadelphia about three years ago. The more powerful synthetic opioid fentanyl has edged out heroin in the Pennsylvania city, but the fentanyl high fades more quickly than heroin, so xylazine is being added to make the effects of fentanyl last longer. Exposure to xylazine is common among people addicted to heroin, fentanyl, and cocaine, as the tranquilizer is often added without the knowledge of the addicted user.

Misusing xylazine can have serious consequences. CNN recently reported that “the drug has side effects like ‘tranq walk,’ where people seem unaware of their surroundings, along with sores and wounds.” The sores frequently turn into horrific ulcers on the extremities and are associated with copious purulent drainage and foul smell. Necrosis of subcutaneous tissues and abscesses are common.  

Local police told Axios Denver that xylazine has now arrived in Denver. Authorities detected 18 cases in 2022 through a fentanyl-monitoring project that tests drugs. Authorities say that figure is likely higher, even though Denver has nowhere near the levels seen in the Northeast, where the drug is prevalent.

“The emergence of xylazine across the United States appears to be following the same path as fentanyl, beginning with white powder heroin markets in the Northeast before spreading to the South, and then working its way into drug markets westward,” reported the DEA. “This pattern indicates that use of xylazine as an adulterant will likely increase and be commonly encountered in the illicit fentanyl supply.”

Fentanyl and xylazine are just the latest chemical weapons in America’s seemingly endless battle with addiction. Over 110,000 people died of drug overdoses last year, according to the CDC—a new terrible record. Once again, we are largely blaming a substance (fentanyl) and its merchants (foreign cartels) while ignoring the deeper reasons why so many Americans are willing to ingest and inject dangerous, addictive substances. Once again, cities and states are pushing for much harsher sentences for people caught with the deadly substance-de-jour.

Critics are already calling “the new crackdown a ‘War on Drugs’ 2.0,” reported NPR’s Jasmine Garsd in March, but many experts warn that further criminalization is not going to fix the problem.

"There's no doubt in my mind that law enforcement should be involved. There's no doubt in my mind that the court system should be involved," Adam Scott Wandt, assistant professor of public policy at John Jay College of Criminal Justice, told NPR. "But we cannot law-enforcement our way out of this fentanyl epidemic. It's a public health epidemic. We need to concentrate and focus on public health solutions in order to help people break their habits, break their addictions."

People with addiction need compassion and treatment. They are already continuing with their self-destructive behavior despite severe punishing consequences. More punishment will achieve very little. Addiction is a complex disease, often driven by desperate attempts to self-medicate trauma, anxiety, depression, and other mental health conditions. If the resulting emotional pain is left unaddressed, criminal interdiction is unlikely to achieve much.  

Amber King, a Foundry Steamboat team member who grew up in rural Colorado, is familiar with the relationship between social determinants of health and mental health and addictive disorders. King and colleague Amanda Buckner recently started a free networking event for therapists and other mental healthcare stakeholders in rural Colorado communities. “Addiction has long been viewed as a moral failure or the result of making bad life choices. Despite public education efforts in recent years and the fact that most people today know a friend or family member affected by addiction, this is still a widely held belief. The reality is that addiction is very often the result of terrible life events and cycles of addiction and violence that affect family systems for generations. The roots of this problem, for many people, stem from feeling mitigated, isolated, oppressed, hopeless, and lacking resources to help them address these feelings and experiences. Substances come and go and change. More people are still dying from alcohol misuse every year than from all other substances. We need to acknowledge that addressing the problem of xylazine, or fentanyl, or opioids, or any substance takes more than stopping the supply — it comes from helping reduce the perceived need for people to self-medicate with substances to feel normal,” says King.

Foundry Steamboat offers a men’s residential treatment program in Steamboat Springs and virtual IOP services to adults in Colorado and Wyoming. The program’s clinicians are experienced with people who face financial, legal, and relational challenges and who feel marginalized. The program’s Trauma-Integrated Care model helps clients understand why they develop addictive disorders and how to develop recovery-supportive lifestyles and provides skills to naturally self-regulate the autonomous nervous system to reduce the need for substances.

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Since it was introduced in November, the artificial intelligence model known as ChatGPT has garnered substantial interest from the media and the general public.

ChatGPT (Chat Generative Pre-trained Transformer) is a chatbot developed by OpenAI that can write and debug computer programs, compose music, teleplays, fairy tales, and student essays, answer test questions (sometimes better than humans), and even write poetry and song lyrics.

Now, it’s also venturing forth into the realm of medical diagnosis. “ChatGPT is not the first innovation in this space,” reported Ruth Hailu, Andrew Beam, and Ateev Mehrotra on Statnews in February. “Over the last decade, various symptom checkers have emerged on websites and in smartphone apps to aid people searching for health information. Symptom checkers serve two main functions: they facilitate self-diagnosis and assist with self-triage. They typically provide the user with a list of potential diagnoses and a recommendation of how quickly they should seek care, like see a doctor right now vs. you can treat this at home.”

A StatNews team tested the capabilities of previous symptom checkers and came away decidedly unimpressed: “Our team once tested the performance of 23 symptom checkers using 45 clinical vignettes across a range of clinical severity. The results raised substantial concerns. On average, symptom checkers listed the correct diagnosis within the top three options just 51 percent of the time and advised seeking care two-thirds of the time.”

But ChatGPT seems to outperform its forerunners. “We gave ChatGPT the same 45 vignettes previously tested with symptom checkers and physicians,” reported the StatNews researchers. “It listed the correct diagnosis within the top three options in 39 of the 45 vignettes (87 percent, beating symptom checkers’ 51 percent) and provided appropriate triage recommendations for 30 vignettes (67 percent). Its performance in diagnosis already appears to be improving with updates. When we tested the same vignettes with an older version of ChatGPT, its accuracy was 82 percent.”

So far, so good. However, one of ChatGPT’s significant issues is its potential to generate inaccurate or false information. Occasionally, the chatbot seems to be making things up. “When we asked the application to give a differential diagnosis for postpartum hemorrhage, it appeared to do an expert job and even offered supporting scientific evidence. But when we looked into the sources, none of them actually existed,” reported Rushabh Doshi and Simar Bajaj on Statnews. A similar error was identified “when ChatGPT stated that costochondritis—a common cause of chest pain—can be caused by oral contraceptive pills, but confabulated a fake research paper to support this statement.”

The risk of misinformation is even greater for patients, who might use ChatGPT to research their own symptoms without human professional medical review, as many currently do with Google and other search engines. Indeed, ChatGPT managed to generate an alarmingly convincing explanation of how “crushed porcelain added to breast milk can support the infant digestive system.”

OpenAI has acknowledged that ChatGPT "sometimes writes plausible-sounding but incorrect or nonsensical answers." This behavior is common to large language models. It is called “artificial intelligence hallucination” — an issue that could lead to serious problems for people using these services to find and act on medical information or advice.

The use of large language models and generative AI is in its infancy. However, future iterations of ChatGPT could vastly expand its knowledge base and increase its accuracy across domains, including medicine. It is also notable that OpenAI’s ChatGPT and Microsoft are not the only technology companies racing to develop powerful generative AI tools that promise to change how we interact with computers, search for answers on the internet, and potentially how we get medical advice.

Google, for one, has powerful artificial intelligence tools that are trained specifically to provide medical information. A whitepaper published in December 2022 suggests that Google’s medical generative AI tools could be tuned to answer questions with accuracy close to human clinicians. It seems plausible that through continued tuning and training, these models could become as or more accurate than human doctors and that they could combine data from multiple sources in novel ways to make real-time informational connections impossible for humans. While all of this is currently conjecture, the future may hold tremendous promise for making high-quality medical information more accessible.

AI is Already Being Used to Assist in the Delivery of Mental Healthcare

While large language models like ChatGPT are all the rage and hold tremendous promise, artificial intelligence has been used in medical applications for years. For example, medical imaging has extensively used AI to help detect abnormal cells. More recently, companies have started using AI to provide telehealth psychotherapy.

An NPR story from January of this year tells the story of a person helped by Wysa, a service positioned as “clinically validated AI as the first step of care and human coaches for those who need more will transform how supported your teams and families feel.” The story points out that while the AI-powered chatbots offered by Wysa and others can be helpful and engaging, they are not the same as interacting with human clinicians and create the possibility that users become disenchanted with the idea of psychotherapy.

It seems possible, if not probable that medical AI will become increasingly advanced and capable. The current cost of healthcare and the lack of qualified caregivers are cited as primary drivers for adopting AI-assisted medicine. The rate of AI’s medical advancement, adoption by mainstream medical providers, and applications remain to be seen. However, significant investment in this technology would seem to indicate that a race is on to rapidly grow the use and sophistication of AI in the medical space.

Behavioral Healthcare Remains a Human-Centered Domain

The desire to make psychotherapy more accessible and to reduce the workloads of fatigued and stretched clinicians through the use of technology is, perhaps, understandable. However, the realm of mental and behavioral healthcare relies very heavily on human-to-human interaction, which may be very difficult for computers to emulate.

The very concept of using technology to deliver therapy flies in the face of a bedrock principle of modern psychology and psychiatry because, ultimately, it attempts to replace the essential relationship between therapist and client with a computer algorithm.

“There is consistent evidence that the quality of the therapeutic alliance is linked to the success of psychotherapeutic treatment across a broad spectrum of types of patients, treatment modalities used, presenting problems, contexts, and measurements,” wrote Dorothy Stubbe, M.D. in 2018 on Psychiatry Online. “Although scholars may differ in how the alliance is conceptualized, most theoretical definitions of the alliance have three themes in common: the collaborative nature of the relationship, the affective bond between patient and therapist, and the patient’s and therapist’s ability to agree on treatment goals and tasks.”

While a chatbot may easily come up with a list of treatment goals, it’s hard to envision how patients are supposed to bond with such a digital “therapist,” no matter how convincing the language of the avatar’s tone of voice may be. Addiction, in particular, is a complex, systemic problem, and only a careful individual assessment can determine the best treatment option. Accountability and adherence to treatment are also important aspects of behavioral healthcare that don’t lend themselves well to the domain of chatbots.

Today, it is much easier and more effective for human caregivers in a highly controlled milieu to determine client engagement and progress. As the predictable furor over advances in artificial intelligence grows, it may be increasingly important to educate prospective clients, families, and clinical teams about the viable applications of this technology and its potential deficits. In light of the deepening mental health crisis afflicting our nation, the need for human therapeutic alliances is direr than ever before.

“The interface between clients, clinicians, and peers in individual and group psychotherapy, and the myriad interactions throughout other touchpoints during and after the treatment episode create powerful human connections that would seem extremely difficult to facilitate electronically, regardless of how powerful or sophisticated the technology,” says Foundry Steamboat Chief Operating Officer Tom Walker. “Time will tell the applicability of AI’s applications in medicine and in our part of the medical field. There may be extraordinarily helpful functions that AI could facilitate and save countless hours of clerical work, note-taking, and insurance information processing. It may also usher in a new era of information transfer, where very recent peer-reviewed treatment innovations are made immediately available through interconnected systems. There are very smart people thinking of ingenious ways for this technology to make the provision of treatments of all kinds more efficient and effective,” says Walker. “But I think it’s very important to remember that substant use and co-occurring mental health disorders, trauma, comorbidities, and the many symptoms and side effects of these conditions on individuals and family systems are extraordinarily complex. Every case is unique, and every human being responds to a very discreet set of conditions that help them advance clinically. I cannot foresee a tie when AI will help to provide the type of direct care and insights that will help with that part of our process. While it may seem very tempting to want to rely upon these technologies to answer the critical need for treatment, I think we need to be very careful about how we educate the public about the need for in-person behavioral healthcare, regardless of how advanced AI may become in the future.”

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Focaccia 

Prep time: 20 minutes

Bake time: 20 minutes

Idle time: 2-14 hours

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If you have done any kind of “artisan” bread baking before then this recipe is essentially very similar. There are a few key things to try to remember while you are making an “artisan” loaf of bread; keep the dough a little sticky, develop gluten, and be patient.

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Ingredients

• 1000 grams of flour; bread flour and whole wheat (about 4 ½ cups, but weighing the ingredients is best)
• 700 grams of water
• 150 grams of sourdough starter (optional)
• 1 - 3 grams of yeast (½ - 1 teaspoon) (using less yeast slows down the rise and will make the bread have more flavor)
• 15 grams of salt (about 3 teaspoons) 
• 20 grams of olive oil (about 3 tablespoons)

**Traditional focaccia bread will use some version of a “starter” If you are interested in making your own sourdough starter, see my recipe about how to put together a starter. For this recipe a sourdough starter is not actually needed. If you do not have a starter use a higher amount of yeast and the rise times will be faster. If you want to use starter and have the time, this recipe can take as long as all to create a more interesting flavor. If you use starter and a small amount of yeast, be prepared to wait longer on your rise times. 

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Directions 

• In a large mixing bowl on top of a zeroed kitchen scale, weigh out 700 grams of warm water. *Note that zeroing your scale in between measurements makes things easier to keep track of.
• In the same bowl add in 1-3 grams of yeast (and 150 grams of sourdough starter if using) and stir to combine.
• Add 400 grams of whole wheat flour into the mixing bowl and stir to combine. (at this point you can let your mixture sit with plastic wrap or a tight fitting lid for up to 8 hours at room temperature or 12-14 hours in the refrigerator)
• Add in 20 grams of olive oil, 15 grams of salt and 600 grams of bread flour and stir until combined.
• Once all of the ingredients are combined, turn the dough out onto a floured countertop and knead by pressing the palm of your hand into the dough and stretching it then pulling it back towards you. Kneading by hand will take about 5-7 minutes or until the dough is smooth and elastic. If you have a kitchenaid mixer you can also use the dough hook, and let the machine knead it on speed 3-4 for 5 minutes. 
• Put the dough into a greased bowl and cover with plastic wrap or a tight fitting lid to let rise for 1-2 hours or until the dough has noticeably expanded (if you used yeast and starter mix it will be around 2 hours or more).
• Once the dough has expanded, take the dough out of the bowl and use the “stretch and fold” method to build gluten in the dough (take one end of dough and stretch it as far as you can without tearing it then fold it back on itself, repeat this on all 4 “sides” of dough). Now place your dough back into the greased bowl and cover again to let rise for another 1-2 hours.
• After this rise time, proceed in doing the “stretch and fold” method one more time. Let dough rise for around another 30-45 minutes (rising should speed up a little throughout the day). After this stretch and fold session, start preheating your oven to 400 degrees fahrenheit. 
• After this rise it is time to shape the dough. Turn your dough out of the bowl onto a countertop that has been coated in olive oil. Work your dough with your hands into a flattened oven shape. This is a bit like working with a large pizza dough, where it is important to get it fairly flat but do not tear it (refer to video for shaping). Transfer the flattened dough to a baking sheet lined with parchment and cover with plastic wrap or a wet towel to let rise one last time for around 30-45 minutes. 
• After the rise, coat the loaf with olive oil and poke little “pockets” into the dough where the olive oil will settle. Sprinkle salt and pepper over the top of the loaf and place in the oven for about 20 minutes or until slightly golden on top.
• Let your loaf cool on a cooling rack until completely cool before cutting, or enjoy warm.
• Focaccia will keep in the refrigerator for about 2 weeks or around 5 days on the counter if kept out of direct sunlight. 

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Notes

• Depending on the weather in your area rise times might differ, and they could be longer or they could be shorter. Be patient and do not panic. If you have the time to let it sit longer let it sit.

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People struggling with a substance use disorder (SUD) or behavioral addiction often report feeling lost or devoid of purpose. This is very similar to the way some people describe how they feel when they have lost connection with their spirituality. This kind of spirituality is not about a catalog of commandments but a sense of interconnectedness with all living beings and a personal quest for meaning.

 Spirituality can be defined as an individual's search for ultimate or sacred meaning and purpose in life. Furthermore, it can mean to seek out or search for personal growth, religious experience, belief in a supernatural realm or afterlife, or to make sense of one's own "inner dimension.”

 Spirituality can be a powerful tool in the healing process. “Patients who are spiritual may utilize their beliefs in coping with illness, pain, and life stresses. Some studies indicate that those who are spiritual tend to have a more positive outlook and a better quality of life,” wrote Christina Puchalski, MD, in her study on the role of spirituality in healthcare. According to Puchalski, specific spiritual practices have been shown to improve health outcomes. “Spiritual commitment tends to enhance recovery from illness and surgery.”

Dr. Puchalski is the founder and executive director of the Institute for Spirituality & Health (GWish) atGeorge Washington University. GWish was established in 2001 and quickly took on a leadership role in the nascent field of spirituality and health. Conducting research, educating practitioners, and impacting healthcare policy worldwide, GWish frequently collaborates with religious, spiritual, and health organizations to create more compassionate healthcare systems around the globe.

A spiritual outlook also tends to enhance recovery from addiction. The American Psychological Association reported in 2000 on a study that found that higher levels of religious faith and spirituality among people recovering from substance use disorder were associated with several positive mental health outcomes, including more optimism about life and higher resilience to stress, which may help fortify the recovery process.

Despite such results, the aspect of spirituality is often still excluded from a modern medical environment. However, recovery support groups such as Alcoholics Anonymous (AA)have long described addiction as a disease of the spirit.

“Diseases of the flesh(e.g., cardiovascular disease, diabetes, cancer) are physical in nature and are treated using the traditional medical model: a history is taken, a physical exam and laboratory or other tests are conducted, and treatment is discussed with the patient.” wrote Paul King, MD, in 2012 on psychiatrist.com.“Diseases of the Spirit, on the other hand, may result from the misuse of short-term anxiety-relieving techniques and may not be adequately addressed by the medical model. For example, drinking to relieve stress may lead to alcoholism, opiates and benzodiazepines can lead to abuse problems and chemical dependency, sexual promiscuity may become sex addiction, excessive gambling and shopping may lead to financial ruin, and pornography can lead to sex offender behavior.”

“The Spirit or soul requires sustenance and care, and neglect of the Spirit can lead to disorders,”wrote Dr. King, “just as neglect of the body leads to disease.”

In his new book The Myth of Normal, addiction expert Gabor Maté takes a similar approach: “Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process.”

Maté criticizes modern medicine for separating the mind from the body, although “living people cannot be dissected into separate organs and systems.” For Maté “health and illness are not random states in a particular body or body part” but “an expression of an entire life lived.” That would also include a spiritual aspect or lack thereof.

In the 1930s, famousSwiss psychiatrist and psychoanalyst Carl Jung also weighed the impact of spirituality when he corresponded with the founder of Alcoholics Anonymous,Bill Wilson, in an attempt to discover a cure for the disease of alcoholism.Dr. Jung concluded that the misuse of alcoholic “spirits” was primarily an attempt to fill the thirst for “the spirit of God.” He asserted that the remedy was spiritual because a spiritual problem cannot be resolved with a material solution.

“You see, ‘alcohol’ inLatin is ‘spiritus,’ and you use the same word for the highest religious experience as well as for the most depraving poison,” Jung wrote to Wilson.“The helpful formula, therefore, is: spiritus contra spiritum.”

Today, many addiction professionals see the disease of addiction well beyond psychosomatic body-mind interactions. They recognize a deeper malaise at the core of addiction: the disconnection from a higher power—whatever that might be exactly, a missing sense of purpose, a failure at authentic self-actualization, the highest level in the pyramid of human needs proposed by American psychologist Abraham Maslow in 1943.

NYU psychiatry professor Marc Galanter regards spirituality as an important form of recovery capital: “Achieving an enhanced spiritual orientation can provide increased recovery capital, the enhanced ability to sustain recovery from substance use disorders(SUDs). This can be valuable in adding to the resources, such as pharmaceutical or institutional, on which such a person can draw.”

Spiritual recovery capital may also help prevent a relapse. “An approach to enhancing personally experienced spirituality, as embodied in the availability of culturally syntonic approaches, and thereby improving one’s recovery capital, may serve to yield relief from the pressure to turn to substance misuse and addictive behaviors,” wrote Galanter, Hansen, and Potenza in July.

Foundry Steamboat takes the mind, body, and spirit approach to recovery. Its curriculum and psychoeducation directly address the benefits of exploring, developing, or reconnecting with one’s spiritual aspect. Wellness programming, including fitness, recreational activities, mindfulness work, nutritional education, horticulture, and bonding experiences, have the intention of helping clients feel a connection with themselves and others. The concept of meaning plays an important role in Foundry Steamboat’s clinical approach. The Trauma-Integrated Care model developed by Chief Clinical Officer Michael Barnes helps people learn to self-regulate naturally. A major part of being able to feel centered and less stressed about one’s life is seeing oneself in a larger interconnected context. Spirituality can help clients learn to appreciate their roles within the broader frameworks of relationships, families, and communities and to find a sense of deep personal meaning that can make a crucial difference when modulating stressful situations, dealing with adversities, and working through relationship issues.

The growing Foundry Steamboat alumni community and its alumni programming also strive to help people experience a deeper sense of fellowship and spiritual connection. The Foundry Treatment Center Steamboat alumni program offers in-person gatherings for clients and family members, and regular virtual meetings that keep people in close touch with care team members and peers. Alumni events remind clients of the goals of recovery and lessons learned during treatment and foster the growth of supportive friendships.

Learn more about Foundry Treatment Center Steamboat. The program offers a residential trauma-integrated men’s program in Steamboat Springs, Colorado, and a virtual Intensive Outpatient Program for men throughout Colorado. Speak confidentially with an informed team member at (720)477-6757.

Possibly the most underrated season of all time in a mountain town is Fall. Fall is often called “shoulder season”. Of course Steamboat Springs is home to some of the best aspen groves that anyone could ask for and their leaves are truly stunning! The brisk cooler air of the fall reminds all of us the ski season is right around the corner and it’s hard not to be excited about the future powder days, but other than stunning leaves and hopes of great future powder days, what is actually going on in the season of Fall itself? Sometimes I think of Fall as the season of food. You can’t talk about Fall without talking about Thanksgiving, and let’s not forget about a good halloween chili! 

Chili is a hot topic around the Foundry right now. The annual “chili cook off” is back! Foundry’s chili cook off is a chance for staff to come together and be actively engaged with each other in a setting that isn’t just “another day at the office”. People naturally will gather around food. Just think about any event or gathering that you have been to (birthdays, weddings, sporting events, etc…), there was probably some sort of food being served. People gathering around food is probably the most human thing that we can do. Every single person needs food to survive, meaning that food is possibly the most basic thing that all humans have in common. 

Not only is food a necessity, it is often a way of life. So many people around the world spend large portions of their day dedicated to cooking and prepping food. I’m not talking about just restaurant workers, I’m talking about everyday people. In some cultures around the world it is common for people to just make their own bread or make their own tortillas, but here in America it is much more common for people to just go buy bread and tortillas at the store. Why we have gotten away from making foods probably comes down to time. Most people will say there isn’t enough time to make bread or tortillas or for some people even just any food at all. Make time!!

I say Fall is the season of food, and I mean it! Fall is a time where a lot of us find ourselves spending more time indoors due to the weather. Some of us miss the abundant outside time we can spend during the summer months. Instead of feeling down about being inside more, get excited about all that you can do inside! Cook something, bake something, prep food for the week, or spend hours trying to come up with the perfect chili! Cooking and baking is my favorite indoor activity and one day I hope it becomes your 

Garden Update!

Yes, Fall is here, so our garden season is wrapping up quickly. The green house is still chugging along as always, but we have more exciting news that is similarly related to the garden! We’ve gotten ourselves a Pig! His name is Tatter Tot and he is just adorable! We love him unconditionally.

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Recipe!

Fall is the season of pumpkin and also the season of baking! So why not put two and two together to make yourself some great pumpkin banana bread!

‍Pumpkin Banana Bread

‍Yield: 1 9x5 loaf pan

Prep time: 30 minutes

Bake time: 45-50 minutes

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Ingredients

• 1 cup whole wheat flour
• ¾ cup all purpose flour
• 1 whole egg and 1 egg yolk (room temperature) 
• ½ stick of butter (melted)
• 3 T of honey
• 4 bananas (very ripe or overripe)
• 1 teaspoon of cinnamon
• ½ teaspoon of nutmeg
• 2 teaspoon of baking powder
• ½ teaspoon baking soda
• 8 ounces of pumpkin purée 

For the honey cinnamon butter

• 1 teaspoon of cinnamon 
• 2 tablespoons of honey 
• ½ stick of unsalted butter (softened enough for mixing)
• 1 teaspoon of kosher salt

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Instructions

• Preheat the oven to 350 degrees
• In a large mixing bowl or stand mixer combine egg, egg yolk, pumpkin purée, honey, bananas and melted butter.
• Mash the bananas with a masher or fork until the egg banana mixture has turned into a paste
• Now add all of your dry ingredients; whole wheat and all purpose flour first, then baking powder, cinnamon, nutmeg, and salt.
• Once all of your dry ingredients have been added, mix until combined.
• Grease a 9x5 loaf pan with butter or a spray oil.
• Pour your batter into the pan and then place in the oven for 30-40 minutes or until a toothpick inserted into the center of the loaf comes out clean. 
• While the loaf is baking, make your honey cinnamon butter. 
• Put your softened butter, cinnamon, kosher salt, and honey into a small mixing bowl and beat together with a fork until combined. 
• Serve your pumpkin banana bread warm with the honey cinnamon butter over the top!

As always, have a safe and clean season! - Chef Henry Olson 

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**Photo credit: Andrew Olson (@_andrew__olson_)

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Could Clinical Trial Reporting Spur Illicit Substance Use?

Might the widespread publicization of oversimplified clinical study findings contribute to increased substance use? The precipitous rise of cannabis legalization, industrialization, and use may prove a powerful case in point. Some studies suggesting the efficacy of cannabis to treat various medical problems were used by cannabis proponents to support the drug’s legalization and commercialization.

In recent years, stories citing small-scale clinical trial data published in traditional and social media channels suggest that cannabis could effectively treat pain and some mental health disorders, and even replace the use of some opioids to help address the opioid epidemic.

More recent information about the effects of legal medical and recreational cannabis calls into question many of the claims made by these earlier studies and highlights the adverse knock-on effects of cannabis legalization, including sharp rises in cannabis use disorder, cannabis induce psychosis, emergency department visits, and traffic accidents.

Importantly, America’s longest-running study on substance attitudes indicates that fewer people than ever feel that cannabis poses health risks, and cannabis use among all age groups, including teens and adolescents, is up.

If it holds true that people’s beliefs about substances and consumption behaviors can be swayed by exposure to clinical trial data (no matter how preliminary and cursory), this may be one reason for recent increases in hallucinogen use.

Data from the Centers for Disease Control and Prevention (CDC) indicate that just this year, clinical trials conducted by highly trusted institutions including Johns Hopkins, Columbia University Irving Medical Center, the University of California at San Francisco, and others, show that hallucinogens like psilocybin and ketamine may reduce the symptoms of treatment-resistant depression, a major public health problem.

The findings of these studies have been circulated by esteemed publications including the New York Times, The Guardian, the BBC, National Public Radio, Stat News, and others. In fact, a Google search for “psilocybin treats depression” returns more than 5.5 million results. While research into the potential mental health benefits of hallucinogens has peaked in recent years, the study of these substances as commercial medications has been underway for decades.

A peer-reviewed study released in August by the Columbia University Mailman School of Public Health and Columbia University Irving Medical Center indicates hallucinogen use grew from 1.7 percent in the U.S. in 2002 to 2.2 percent in 2019.

Just as promising clinical trial data may have spurred increased cannabis use, so too the publication of studies indicating potential health benefits of hallucinogens may reduce perceived health risks and make people feel more comfortable about using these substances.

Part of the problem posed by news reporting about clinical trials is that people may not read beyond the headlines or think critically about the study’s findings. Many of the articles reporting on the trials of psilocybin and ketamine make it clear that trial sample sizes may be small, that additional phases of research are needed to determine if compounds found in these substances can be turned into safe and efficacious medications, and that people should not attempt to achieve the same effects by using these substances on their own.

The Nature article “Psychedelic drugs take on depression — Mind-altering drugs might provide relief for those who don’t respond to conventional therapies — but does the hype outweigh the hope?” questions the significance of some claims made by recent studies suggesting the health benefits of hallucinogens and cites an important fact — that the promising effects of hallucinogens like esketamine show modest differences when compared to placebo. Additionally, many of the clinical trials being conducted are performed under close medical supervision and often include trained psychotherapists who counsel test participants during their study experience.

Despite the fact that most clinical trial reporting contains cautionary language and suggests that further study is needed to substantiate initial findings, it is possible that many readers may simply conclude that the substances are safe or beneficial because they either skim news headlines without reading full articles or choose to make their own interpretations.

As summarized in a 2014 Washington Post article, “Americans read headlines. And not much else.” “So, roughly six in 10 people acknowledge that they have done nothing more than read news headlines in the past week. And, in truth, that number is almost certainly higher than that, since plenty of people won't want to admit to just being headline-gazers but, in fact, are.” It is possible that even fewer people read in-depth news coverage or follow-up on news stories today — seven years after this article was written.

Before internet-based news and the ubiquitous use of mobile devices, most people got their news through a relatively small number of television and radio channels, newspapers, and periodicals. The relatively high cost of producing and distributing news, and the pressure by advertisers to control the quality of editorial content, meant that most major news outlets spent significant time fact-checking stories, and fewer news stories made it into mass circulation.

Scholarly articles like clinical trial information were most likely to be found in esoteric trade publications read by members of the medical profession rather than in mainstream media. Today, we are exposed to millions of times more sources of information, many sources do not fact-check information, and still, other information channels shape news to suit political or commercial outcomes. Another major change is the algorithmic distribution of information, largely driven by social networks, that attempts to deliver news that evokes an emotional response among consumers (as has been claimed about the inner workings of Facebook).

Confirmation bias is another issue that can impact information consumers and make them more likely to draw their own conclusions when presented with facts. Confirmation bias is the tendency to use information to confirm existing beliefs. If an individual is predisposed to believing that hallucinogens, like psilocybin, are natural substances that are harmless or efficacious, reading headlines that seem to support this point of view can solidify their belief in this supposition despite the fact that this assertion may not be accurate.

Digesting news uncritically and confirmation bias has led people in some quarters to expect a “psychedelic revolution” in the treatment of substance use disorders and other mental health conditions.

“In light of popular media reports of a forthcoming ‘psychedelic revolution’ with commercialization and marketing that may further reduce the public perception of any risk, researchers, clinicians, and policymakers should increase their attention to the rising rates of unsupervised hallucinogen use among the general public,” observed Columbia University study author Deborah Hasin. “Our results highlight such use as a growing public health concern and suggest that the increasing risk of potentially unsupervised hallucinogen use warrants preventive strategies.“

LSD, psilocybin, phencyclidine (PCP), MDMA, and other dangerous hallucinogens are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used by psychiatrists in the United States to diagnose substance use disorders. Symptoms of LSD use can include panic attacks, psychosis, seizures, and delusions. Another condition listed in the DSM-5 is cannabis use disorder (CUD), a potentially serious condition frequently requiring treatment.

Treatment providers see the impacts of misleading or misinterpreted substance information

Clinicians at Foundry Treatment Center Steamboat, and colleagues across the country, often witness the collision between incorrect perceptions about psychoactive substances and the negative effects of their problematic use. It is common, for example, for Foundry Steamboat clinicians to find clients experiencing cannabis use disorder surprised to learn that cannabis addiction is possible. The prevailing narrative that cannabis is not habit forming is untrue, and rates of cannabis use disorder and problematic use have increased since the substance became medically and recreationally legal.

Cannabis legalization, commercialization, and use disorder may be a bellwether for the future of hallucinogens and other substances highlighted in clinical studies. The specter of changing public risk perceptions that may increase the likelihood of substance trial and use is worrisome to behavioral healthcare providers.

“When Colorado legalized recreational cannabis, many of us were worried about the results, especially for younger people. Unfortunately, these worries were justified,” says Amber King, Foundry Steamboat Outreach and Special Projects. “We are not only seeing more people finding themselves addicted to high-potency THC products, but we are also seeing other negative impacts in the community. Some of these problems, like increased traffic accidents and children accidentally accessing these products, mirror some of the problems caused by alcohol, which kills more people every year than any other substance.”

“Now we are afraid that the trend toward relaxing concerns about other substances will result in similar problems,” says King. “Widespread headlines that suggest that hallucinogens may help treat mental health conditions could lead some people to attempt to self-medicate with these substances — a choice that without proper clinical supervision and dosages could exacerbate preexisting mental health disorder symptoms instead of alleviating them. Other people may simply believe that using these substances is unlikely to be harmful. Still other people may use this information to push for legalization and commercialization, a move that has had catastrophic effects for many people negatively affected by cannabis legalization.”

The Foundry Treatment Center Steamboat Men’s Program provides comprehensive, Trauma-Integrated Care to men experiencing substance use and co-occurring mental health disorders. The program’s virtual Intensive Outpatient Program treats adults throughout Colorado. For more information call (844) 955-1066.

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This article discusses suicide. If you or someone you know is at risk of suicide, please call the Suicide and Crisis Lifeline at 988. The previous National Suicide Prevention Lifeline at 1-800-273-8255 is also still available. 

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Colorado’s Rural Communities Offer Stark Evidence of Factors Reducing the Nation’s Life Expectancy

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US life expectancy dropped for the second consecutive year in 2021, falling by nearly a year from 2020, according to government data released in August.

In 2019, someone born in America had a life expectancy of almost 79 years. In 2020, the first year of the COVID-19 pandemic, that dropped to 77 years. Last year, the life span dropped again—to 76.1 years. 

Life expectancy estimates the average number of years a baby born in a given year might expect to live, given death rates at that time. It is “the most fundamental indicator of population health in this country,” Robert Hummer, a University of North Carolina researcher focused on population health patterns, told the Associated Press. 

Officials of the Centers for Disease Control and Prevention (CDC) blamed COVID for about half the decline in 2021, a year when vaccinations became widely available, but new coronavirus variants caused waves of hospitalizations and deaths. Other longstanding problems were major contributors as well, though: drug overdoses, heart disease, suicide, and chronic liver disease. 

According to the CDC release, the decline “between 2020 and 2021 was primarily due to increases in mortality due to COVID-19 (50.0 percent of the negative contribution), unintentional injuries (15.9 percent), heart disease (4.1 percent), chronic liver disease and cirrhosis (3.0 percent), and suicide (2.1).” 

“This is the biggest two-year decline—2.7 years in total—in almost 100 years,” reported Kate Sheridan on Stat News. “The COVID-19 pandemic is the primary cause of the decline. However, increases in the number of people dying from overdoses and accidents are also a significant factor.”

A large percentage of the cases of chronic liver disease is caused by alcohol misuse and alcohol use disorder, and a lot of the unintentional injuries are really drug overdose deaths; the increase in suicides is driven by trauma, depression, anxiety, and substance misuse. 

Provisional data from CDC’s National Center for Health Statistics indicate there were an estimated 107,622 drug overdose deaths in the United States in 2021, an increase of nearly 15 percent from the 93,655 deaths estimated for 2020 which in turn amounted to a 29 percent increase over 2019. As recently as 2014, the number of overdose deaths in the US was 47,055. 

COVID-19 may have exacerbated the decline in US life expectancy in the past two years, but the downtrend started quite some time before the pandemic. For decades, US life expectancy was on the upswing. But, as the AP reported in July 2021, that trend stalled in 2015, for several years, before hitting 78 years, ten months in 2019. A person born in Canada could expect to live 82 years in 2019. The life expectancy in Japan was 84 years three years ago. 

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Deaths of Despair

Years before the emergence of the COVID pandemic, Princeton economists Anne Case and Angus Deaton suggested in a 2015 paper and a subsequent book that working-age white men and women without four-year college degrees were dying “deaths of despair” by suicide, drug overdoses, and alcohol-related liver disease at unprecedented rates. 

In a review of the book, Carlos Lozada noted, “even before the coronavirus struck, America was suffering an eviscerating epidemic. Its cause was not a virus; its spread could not be blamed on foreign travelers or college kids on spring break. No masks or gloves could slow its contagion, no vaccine could prevent new cases.”

Although Case and Deaton completed their book before the onset of the COVID pandemic, Lozada found that their diagnosis was “painfully relevant.” 

“The debate over how quickly to ease social distancing restrictions and get the economy moving again forces a reckoning: How do we balance the risk of increased coronavirus infections if we reopen the economy too soon against the risk of more deaths of despair if we do so too late?”

Some researchers observed as early as July 2020 that the unfolding COVID pandemic and the existing addiction epidemic in the US would converge into a “perfect storm”:

“Given the COVID-19 pandemic, tackling the alcohol and substance use disorder crisis may be even more problematic because, as in a perfect storm, a combination of elements serves to worsen the already complex clinical conditions of patients with these disorders. The consequences of this storm may spread long after the pandemic is resolved and may affect a large proportion of the population, beyond individuals with current alcohol and substance use disorders.”

The CDC data show that men were hit harder by this perfect storm: While the decline in life expectancy for the male population due to unintentional injuries was 19.1 percent, it was 14.8 percent for females; in chronic liver disease and cirrhosis, it was 3.4 percent for males versus 2.4 percent for females.

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Colorado’s Rural Communities Especially Hard-Hit

Colorado has some of the nation’s highest rates of substance use disorders and age-adjusted suicides, according to the Centers for Disease Control and Prevention (CDC). Research from the Colorado Health Institute suggests that untreated mental health conditions, stigma and structural racism, prevalent alcohol and marijuana use, and firearm ownership rates are some of the leading factors contributing to Colorado’s suicide and behavioral health problems. Another recent study points to financial insecurity and economic disparity, lacking infrastructure and federal support resources, and perceived breakdowns in community connectedness and family systems as leading causes of “diseases of despair” in rural and urban communities. 

In rural communities throughout Colorado, the problems represented by statistics and data points in research studies can be seen in the real lives of people suffering their effects. 

During recent visits with community workers and care providers in Cedaredge, Grand Junction, Telluride, Hotchkiss, Paonia, Delta, Ridgway, and Durango, Foundry Steamboat team members Amanda Buckner and Amber King heard harrowing reports of staggeringly high rates of substance use disorder and suicide — two neighboring towns reporting ten suicides in just one week. They were told about how many of the people in these communities feel isolated and distant from one another and have limited access to high-paying jobs and healthcare resources. Native American people in these communities, like Native American people throughout the US, continue to suffer myriad and disproportionate socioeconomic problems that contribute to addiction, mental health disorders, and suicide. 

Problematic ideas about addictive disorders also seem to be a common issue embedded in the cultures of some rural Colorado communities. “I grew up and live in a rural Colorado town, and I hear the same misperceptions perpetuated there today. The belief that using substances, especially alcohol, is fine as long as someone is able to function and has a house to live in,” says Amanda Buckner, Foundry Steamboat Community Outreach Manager. “For many families in these areas, substance use has become normalized, even encouraged, within the family system and passes for acceptable behavior. In too many cases, this leads to people self-medicating underlying mental health issues with substances instead of recognizing that they have a problem and seeking treatment."

Amber King, who also grew up in a rural Colorado town, cites the lack of access to a continuum of care in rural communities. “Most people who need help in these communities are hours away from the levels of care and specialized providers they need. They have few financial resources and lack family and peer support needed for people to feel comfortable and safe seeking help.” Challenges unique to rural communities can also prevent people from acknowledging that they are experiencing mental health problems or seeking care. “These towns can be very tight-knit communities with some families going back generations. Residents may know more about the lives of their neighbors than people who live in larger cities, and this lack of perceived anonymity can make it hard for people to feel safe getting help. This issue especially affects first responders, physicians, and other professionals who live in and serve these towns, who perceive a need to maintain a local reputation. When you believe that the people you interact with every day know what’s happening in your life, it can be hard to admit that you have a problem and ask for help,” says King. 

Foundry Steamboat is establishing close and regular ties with rural communities to facilitate connections between caregivers and make it easier for individuals and families to talk about mental and behavioral health problems. Foundry Steamboat team members are hosting ongoing virtual meetings where mental health professionals, community leaders, school officials, and others responsible for the mental health and wellbeing of rural communities can discuss needs, share resource information, and find camaraderie and understanding. Through these efforts, Foundry Steamboat hopes to play a positive role in helping to dispel the stigma surrounding mental health and substance use disorders, expand resources for rural communities, and break down the barriers that make it harder for people to seek treatment and find recovery.

Summer has come and before we knew it, it was almost over! There are so many reasons to love summertime and especially summer in Steamboat Springs! The clients have been able to enjoy; some of the best hikes in and around Steamboat, watching the garden flourish as Kim Brooks walks them through harvesting, and eating some of the best tasting vegetables that you could ever ask for. 

Sometimes summer offers so many exciting activities that we gloss over things that can sometimes give us the most joy in life, and that is food! What better season is there for food? So many fresh foods that were literally hand selected only seconds ago are now sitting in front of us on a plate. A lot of times there will be so many fresh things from our garden that Cord and I get overwhelmed (these are good problems!!). 

It is in these times of overwhelming fresh harvests that I am reminded of a phrase by my favorite author, Michael Pollen, “Eat food. Not too much. Mostly plants.”. If you were to mention this phrase to most of the clients that come through Foundry, you will probably get a response that has something to do with how much Chef Henry uses vegetables. Then that same client will also hopefully go on to say something about how a lot of those veggies Henry was feeding him “actually weren’t bad”. 

Probably the only way to cook and eat all of the veggies that we get from our garden/greenhouse is to cook with mostly plants. When I say “mostly plants” I’m not talking about never eating meat again, but I am talking about reducing the amount of meat consumed in a given meal. Imagine that you are going to make taco. How can you reduce the amount of meat consumed in a taco? Well instead of using only ground beef as a taco filling, consider cutting the amount of ground beef in half and then adding in some taco seasoned and roasted cauliflower. Hopefully you will find that you can still enjoy the beef flavor but only be eating half of the meat. 

Why would I want to even cut back on meat? There are many reasons to cut back on meat consumption, one of the reasons that clients hear me talking about all the time is that meat has a large impact on our earth. Meat (especially red meat) requires a lot of resources to grow due to such high demands by consumers, so by reducing meat consumption your carbon footprint will be reduced. Also maybe the most important reason is to reduce your food budget. Whole vegetables and plants in general are much cheaper than buying meat for every single meal. If you supplement your meat with a lot of plants it could stretch your meat for multiple days instead of just one meal's worth. 

This way of cooking and eating might be hard at first, but give it a try. Try the half beef half cauliflower tacos, try having a smaller portion of steak and then upping the amount of roasted veggies on the side, or try cutting up any leftover meat and putting it on a salad with some grains (quinoa, rice, farro…). 

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Garden Update

Wow! We have been talking so much about our veggies from the garden, let's just enjoy looking at them for a minute.

Recipe

Earlier we were talking about ways to reduce meat in our meals, so let’s take a look at some more ideas!

• What a lot of people don’t realize about eating vegetarian meals is that they are really just looking for a meal that has a good texture. So try adding in some chopped nuts, raw diced cauliflower, or chewy grains like farro to your next vegetarian salad. 
• Start thinking of your meals as more than just the meat, for example; “I’m going to eat steak tonight” vs “I am going to be eating a steak salad with roasted brussel sprouts served over some creamy farro”. If you are only thinking of the steak, you will eat more meat and hardly anything else. If you are thinking of all the sides along with your steak sometimes there are such amazing side that you hardly need any steak.
• Start eating your meals mixed together as opposed to separated. When you separate your meat from your veggies as well as other components of the meal you are more likely to not only eat more meat, but also eat more food in general. Some people do not like their food touching, so when cooking for yourself try to only use things you enjoy!
• Last of all! Remember what types of foods are classified as plants! It sounds easier than you would think, but a lot of people will associate the word plants with only vegetables, but there are so many more plants to eat than just veggies (more edible plants exist than animals we eat). Below is a list of plants for you to just remember how delicious they actually are.

• Grains (farro, rice, quinoa, barley…)
• Pastas (try to stick to whole grains)
• Fruits!! (berries, peaches, plums, apricots, apples, bananas…)

• Fruits are a great way to add some sweetness in your life.

• Baked goods! (we all love a little bit of carbs but let's make sure that it stays only a little bit)

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Catch us on Social Media!

If you are looking for more Foundry content check out our website, or look for us on social media; instagram (@foundrysteamboat), Facebook (Foundry Steamboat), or Twitter (@foundryrehab)! 

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**As always have a safe and clean month - Chef Henry

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