Posts Tagged ‘drug treatment’
After Treatment What if a Relapse Happens?
Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year.
It is critical that patients, their families and friends prepare for the possibility of lapse and relapse. The preparation should include early detection of a lapse and establishment of steps to keep that problem from becoming a full-blown relapse. Two sets of activities can reduce the likelihood of relapse and reduce the severity if it does occur.
Treatment-Related Preparation
A good addiction treatment program prepares patients to:
- recognize they have a problem that will require continued management and monitoring
- learn and practice some of the fundamental skills needed to recognize and overcome the urge to use or drink when these situations emerge
- be engaged in a continuing care program such as AA and receive regular monitoring of substance use through urine screening or breathalyzer
- receive periodic phone calls or in-home visits following care to monitor their recovery
These generic elements of effective planning during treatment are among the best clinical practices available to forestall lapse. This planning should involve families so they can better understand the treatment issues, be prepared to support the recovery plan and be aware of signs of lapse.
Post-Treatment Preparation
To prevent and contain relapse the family should agree to fully participate in planned continuing care activities. Families and all concerned others can take five helpful steps:
- Have copies of the continuing care plan prominently displayed to reduce ambiguity and promote full communication and response.
- Early in formal treatment, ask the family member in treatment to describe in writing some of the very early signs and behaviors that may lead to his/her lapse and relapse. For example, he/she might write something like “I will begin hanging out with my friend Jimmy,” “I will not do my homework” or “I will stop attending AA meetings.” As the family member undergoes continuing care, regularly refer to these written descriptions to monitor the recovery process.
- During formal treatment, as the individual thinks about relapse scenarios, ask what s/he thinks should be done when early relapse signs emerge. Use these words to develop a contract that includes an action plan the family will follow when any of these signs surface. For example, s/he might write “take my cash and credit cards,” or “increase the urine screens.” Be prepared – before the relapse happens – to take the type of actions contracted.
- Receive and display the results of post-treatment urine screens. Discuss any positive results openly and honestly.
- Monitor and support changes that are consistent with a drug-free lifestyle. In other words “catch him doing something good” and then support it appropriately.
Even effectively treated people with addictions will confront unexpected situations after they leave a treatment program and return to their home environment. These situations may produce intense periods of craving to re-use alcohol and other drugs. Lapse, defined as re-use of alcohol or drugs at least once following treatment, occurs in at least 50% of those who complete treatment. The most dangerous period for lapse is the first 3-6 months after completion of formal treatment. Relapse, defined as return to excessive or problematic use, is less common, occurring in approximately 20-30% of those who complete formal care in the prior year.
It is critical that patients, their families and friends prepare for the possibility of lapse and relapse. The preparation should include early detection of a lapse and establishment of steps to keep that problem from becoming a full-blown relapse. Two sets of activities can reduce the likelihood of relapse and reduce the severity if it does occur.
Treatment-Related Preparation
A good addiction treatment program prepares patients to:
- recognize they have a problem that will require continued management and monitoring
- learn and practice some of the fundamental skills needed to recognize and overcome the urge to use or drink when these situations emerge
- be engaged in a continuing care program such as AA and receive regular monitoring of substance use through urine screening or breathalyzer
- receive periodic phone calls or in-home visits following care to monitor their recovery
These generic elements of effective planning during treatment are among the best clinical practices available to forestall lapse. This planning should involve families so they can better understand the treatment issues, be prepared to support the recovery plan and be aware of signs of lapse.
Post-Treatment Preparation
To prevent and contain relapse the family should agree to fully participate in planned continuing care activities. Families and all concerned others can take five helpful steps:
- Have copies of the continuing care plan prominently displayed to reduce ambiguity and promote full communication and response.
- Early in formal treatment, ask the family member in treatment to describe in writing some of the very early signs and behaviors that may lead to his/her lapse and relapse. For example, he/she might write something like “I will begin hanging out with my friend Jimmy,” “I will not do my homework” or “I will stop attending AA meetings.” As the family member undergoes continuing care, regularly refer to these written descriptions to monitor the recovery process.
- During formal treatment, as the individual thinks about relapse scenarios, ask what s/he thinks should be done when early relapse signs emerge. Use these words to develop a contract that includes an action plan the family will follow when any of these signs surface. For example, s/he might write “take my cash and credit cards,” or “increase the urine screens.” Be prepared – before the relapse happens – to take the type of actions contracted.
- Receive and display the results of post-treatment urine screens. Discuss any positive results openly and honestly.
- Monitor and support changes that are consistent with a drug-free lifestyle. In other words “catch him doing something good” and then support it appropriately.
By: Thomas McLellan PHD
Walking Away Isn’t Quitting
Recovering addicts know that the days, weeks and months following treatment can be rough on the family. In many cases, familial relationships have already been so fractured they are almost beyond repair. For others in recovery, the very occurrence of a setback, however small, is enough to send the family into turmoil and threaten the sobriety of the newly-clean addict. So it is that recovery, which should be a joyous time, a time of hope and renewal, can just as quickly turn into a phase of desperation, failure and relapse. For the recovering addict and his or her spouse/significant other or family, sometimes the only option that makes sense is to walk away.
Walking Away Isn’t Quitting
When you walk away from your family, it should never be as a result of the desire to quit. Whether you are the recovering addict or the spouse of the newly-sober individual, your reasons for leaving must be based on the best interests of all concerned. The decision should come after all other options have been thoroughly explored, and/or you’ve come to the realization that by staying, you’re doing more harm than good – harm to you, your spouse and your family.
Let’s take an example. Jennifer, mid-30s, is the live-in partner of Woody, 40. They have no children but prior to Woody’s stay in rehab for cocaine and alcohol addiction, they’d talked about getting married and starting a family. Jennifer is an artist who works from home, an only child whose parents are deceased. Woody’s mother is an alcoholic and his father a compulsive gambler. His two younger brothers, Alex and Tim, early 30s, are heavily into street drugs. Money has always been an issue in Woody’s family and he witnessed many explosive arguments at home growing up. Jennifer worships Woody, but doesn’t know how to relate to him now that he’s home from addiction treatment. He’s often silent, not the talkative person she so enjoyed, and he doesn’t want to socialize anymore. Her own work is suffering, since she feels compelled to watch over Woody all the time, afraid that he might slip. They haven’t had sex since before he went into rehab and Woody says he no longer wants children. In fact, Woody’s so different now that Jennifer feels trapped in a relationship she doesn’t want.
Clearly these two individuals are experiencing a great deal of difficulty adjusting to Woody’s new sobriety. The couple isn’t married, so there would not be any legal issues to untangle should they decide to split. Woody and Jennifer may benefit from continued counseling, if they’d go. It appears, however, that their finances are constrained, so professional couple’s therapy probably isn’t in the cards. Woody needs to resume attendance at his 12-step meetings (Alcoholics Anonymous and Cocaine Anonymous) – even though he says he doesn’t like the people there and it’s not helping him. Jennifer could find help through Al-Anon or Nar-Anon, but she seems unlikely to go.
Perhaps in this instance, Jennifer and Woody should part ways – at least until Woody is more firmly rooted in his sobriety and has a solid game-plan for his future. Staying together now could mean the relationship continues to disintegrate to the point of irreconcilable differences. For his part, Woody should attempt to see things from Jennifer’s perspective. If she truly means anything to him, he will put aside his own concerns and resolve to set her free. He needs to heal himself before he can open up to Jennifer or any other woman. Jennifer, on the other hand, needs to let go of her guilt and have the courage to stand up to Woody. She needs to be free of Woody’s needfulness.
Display Respect and Love
It’s not as easy as that, however. Walking away involves striving to achieve a delicate balance of resolve and independence, and needs to be accomplished with a display of respect and love.
In other words, you don’t need to have a shouting match to get your point across. Two people should be able to sit down together, or with a counselor present, and discuss their wants and needs in a civil manner. No matter how rough things have been, or how many hopes and dreams have been shattered, the decision to split can be amicable. Sometimes, however, the hurt has been so profound that one partner is unable to see anything good in the other. In such instances, the split should occur as quickly and with as much dignity as possible.
Let’s take another example. Bradley, 58, is married to Lynnette, 43. The couple have three young children, two girls, ages 11 and 15, and one boy, 17. Bradley has been doing his best to take care of the children while his wife was in treatment for compulsive sexual behavior, alcoholism and prescription drug addiction. This was Lynnette’s third time at rehab. Bradley has a good job, is a loving father, but has been repeatedly hurt by Lynnette’s affairs and blatant refusal to be a mother. In fact, she’s often been verbally and physically abusive to the children while she’s drunk and high – most often when she returns from one of her sexual liaisons. Bradley’s at the end of his patience. Lynnette refuses to change, and has stated on more than one occasion that she wants out.
Bradley’s most important consideration is the welfare of his children. While he believes in marriage for life, in this case, he has come to realize that Lynnette is not the partner for him. He and Lynnette should work out the details for her departure, making sure that the children are not negatively affected by the discussions and arrangements. Bradley’s best bet is to remain as respectful of Lynnette as possible, and show her cordiality, if not love, as she leaves the family.
Source: Drug Addiction Treatment
Mom Hits Bottom After Years of Drinking
At the end of a country road, inside the walls of a quaint and calm Hattiesburg, Miss., home, a family was in crisis.
Lynn Wardlow, a 50-year-old wife and mother of three, had been a drinker for more than 20 years. All the while, though, she ran a family business and raised her children.
In January, “20/20? visited Wardlow. It was the day before she’d planned to give up alcohol for good.
“My hands are shaking,” said Wardlow as she packed her bags. “God, I hope I remembered to bring underwear.”
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In the morning, Wardlow would travel from the Gulf Coast to Palm Beach, Fla., check herself into a medical facility for detox and then enter a 30-day rehab program for her alcohol addiction.
Meanwhile, Wardlow planned one last hurrah. She took a bottle from a cabinet in her bedroom.
“Would this be my best choice for my last bottle of wine?” she asked.
The last year in the Wardlow home had been particularly difficult, especially for the children — Bo, 21; Jessy, 20; and Marina, 17.
“She’s been drinking every night for as far back as I don’t even know,” said Bo. “The last year there’s been a lot of drama, and it’d be nice if things were just normal for even just a little while.”
Wardlow poured herself some wine. “My kids want me to just stop, stop, stop, but I like, I don’t think I can just stop,” she said.
“And if I did, I don’t know if I would feel very good, or if we might have to go to the hospital, because I just stopped after I’ve been going, go, go, go for so long.”
Wardlow’s children have witnessed things no child should ever see: their mother passed out in her closet, in a drunken rage at a bookstore, in a car attempting to drive after an alcohol-infused fight.
“It’s hard to see someone you love have to be addicted to something in order to feel better,” said Marina.
“It makes you feel like you’ve done something wrong,” said Jessy.
Drunken Moms: ‘When She Gets Like That’
The kids say their mother’s drinking had reached a critical point. Last April, Wardlow was diagnosed with hepatitis C, unrelated to her alcoholism. Unless she quit drinking, she could die.
But even the threat of losing her life, the family said, hadn’t stopped Wardlow from consuming alcohol.
“I want my mom to get better and not just for our sake but for her sake for her health,” said Jessy.
Wardlow’s last night at home was tense. The alcohol fueled her anxiety of what was to come.
“I think after two drinks, I’m like, you know what, these people aggravate me,” said Wardlow, who ran the family’s ceiling construction business. “And they aggravate me during the course of the day, and at the end of the day, I have a couple of drinks.”
The kids knew better than to stick around once Lynn started drinking. Wardlow’s husband, Bob, soon became a target.
“If you want to spend more time with Bill O’Reilly and your computer then go ahead,” Wardlow cracked.
“When she gets like that, conversations can turn to arguments,” said Bob.
“Or being an a**hole can turn to arguments,” said Wardlow. “Maybe I’m just able to say, you know what, [I've] had it up to here!”
The next morning, her head a little clearer, Wardlow acknowledged that rehab may be her last chance.
“I’ve affected my children. … Our relationships would be different if alcohol wasn’t a part of my life,” she said.
But just before she walked out the door, the leftover wine from the night before called to her.
“I’m not going to drink that,” Wardlow said, wavering before she gave in and took a sip.
Wardlow’s family walked her down the steps. She gave them kisses. She grew emotional.
“I’m not the only person who needs to be healed,” said Wardlow. “I’m not the only person who has been affected by this.
“It’s gonna be good,” she assured her famliy. “I’m going to get better.”
Two planes, three bloody mary’s and two beers later, Wardlow landed in Florida.
She was greeted by Loren Seaman from the Orchid Recovery Center, where Wardlow would surrender herself for treatment.
“Did you drink?” Seaman asked.
“Well, hell yeah,” Wardlow said.
Wardlow and Seaman had been talking for weeks on the phone to prepare for her arrival.
But before her bags had even make it downstairs, a shoeless Wardlow headed off for one more drink.
“We’re going to make a new martini,” Wardlow said. “It’s called the Lynn’s-quitting-drinking-and-going-to-rehab martini. Ready?
Drunken Moms: Tough Recovery Odds
Finally, it was time for Seaman to sign Wardlow into the center.
“Have you ever been to detox?” Seaman asked. The answer was no.
“It’s OK, I’m good,” said Wardlow, laughing. “I’m drunk, so right now I ain’t scared. Give me a day or two, and I’m probably going to be frightened out of my wits.”
Over a million people submit to detox and rehab programs for alcohol addiction every year in this country. The odds going into rehab were against Wardlow. Studies show that 90 percent of people in recovery relapse.
Wardlow had a session with Linda Burns, head of nursing at Sunrise Detox.
“How much are you drinking a day, about?” Linda asked.
“Four, five, six …” replied Wardlow.
According to the National Institute on Alcohol Abuse, one third of alcoholics in the United States are women.
Staff at both the Orchid and Sunrise Detox Center told “20/20? that about 95 percent of the women they pick up at the airport are intoxicated upon arrival. Wardlow was no exception.
A Sunrise Detox tech measured Wardlow’s blood alcohol content upon admission.
“You’re not too bad — .106,” the tech said.
“What does that mean?” said Wardlow. “Would I be arrested?”
“Oh, definitely, yeah.”
“I would be arrested.”
“Yeah.”
“Point-zero-8 is the limit, and I’m at point 1-plus over. I’m over the limit to drive a vehicle.”
“Yes, you would be wearing nice bracelets.”
For the next five days — standard for alcohol addiction — Wardlow remained at Sunrise. She was medicated with a drug called librium to eliminate the side effects of withdrawal, which can range from tremors and insomnia to delirium or even seizures.
From day one, Wardlow was restless.
“If you reached in your pocket right now and pulled out a beer, it would be really hard for me not to drink it,” she told “20/20.” “Quite honestly, it would.”
By day four, her impatience and boredom reached all-time highs.
“I have not had a good morning,” she said, talking to a portable camera “20/20? gave her to document her journey. “I have cried on more than one occasion today. I have come to the realization that this is the closest thing to a jail that I have ever been in.”
But it was only the beginning of a long and difficult journey.
The next step for Wardlow was the Orchid Recovery Center, a drug and alcohol rehabilitation center designed specifically to treat women.
“We’re just glad you’re here, Lynn,” said an Orchid staff member who welcomed her.
“Thank you,” said Wardlow. “I’m glad I’m here too.”
Drunken Moms: From Detox to Rehab
Normally, TV cameras are not permitted to see inside the walls of a rehab facility. But with Wardlow’s permission, the Orchid Recovery Center allowed “20/20? unprecedented access to their treatment process.
“You don’t know Lynn clean and sober,” Mindy Appel, Wardlow’s therapist at the Orchid, told her. “You don’t know that woman.”
Unlike at detox, Wardlow’s days at rehab would be packed, from six in the morning until nine at night. She would have individual and group therapy sessions mixed with yoga, meditation, accupuncture and art.
An all-female facility, the Orchid is run almost exclusively by women, many of whom have been through some type of addiction recovery of their own.
The Orchid places enormous weight on the honing of life skills, encouraging women to shop and cook for themselves — all of the things they’ll have to do back home. But sometimes, even a simple trip to the grocery store can spell trouble. Once a woman from the center drank vanilla extract from the store. It’s 24 percent alcohol. The woman drank five or six big bottles, staff said — and came back reeking of alcohol and walking funny.
For recovering alcoholics, triggers to resume drinking can be anything from beer commercials on TV to the wine store they used to frequent — anything that reminds them of drinking, said Orchid staff.
Wardlow’s heavy lifting for the next 30 days would happen inside the office of Appel, her therapist.
“We want to stay really focused, and I’m going to keep you on task here,” Appel told her.
During her first session, Wardlow confessed her reasons for drinking went back to her relationship with her father.
“So what was growing up like for you?” asked Appel.
“I had times of sadness,” said Wardlow. “My father was an alcoholic… When I was 15 he decided it was time to go … so he died.”
Genetics may also have had a role in Wardlow’s addiction. Studies show that children of alcoholics are four times more likely to develop the problem.
A week into her treatment, “20/20? co-anchor Elizabeth Vargas paid a visit to Wardlow at Orchid. She appeared more calm and focused but still struggled with her addiction.
Vargas asked her if it was hard.
“It’s really hard,” she said. “It is hard and it’s, and it’s hurtful, and you realize how many people that you’ve hurt. And my children are amazing. I mean, I look at them, and I know I’ve not been a bad mother. I’m like, I know I’m a good mother. I’ve mothered them well — but how much better could it have been if these past 10 years, I hadn’t been living in the bottom, in the bottom of a bottle?”
Wardlow described the cycle of her drinking.
“I wake up the next morning, you feel horrible, and you say, ‘I’m gonna do better. I’m gonna do better. I’m gonna do better. So, but I don’t feel very good today. So this afternoon, I’m just gonna have a beer.’” Which turns into “three or four or five or six.”
Are Mothers Drinking More?
The team of therapists at the Orchid said regrets and expectations about being the perfect mother are often what push a woman deeper into her addiction.
“There’s so many women that are so sophisticated at covering up and being, you know, the PTA mom and being the soccer mom and doing all things for everyone,” said Appel.
But are women, particularly mothers, drinking more — or are we just finding out about it more?
“I think we’re finding out about it more,” said Mindy Agler, another therapist on the Orchid team. “[It's] just not something you talk about. … If a man walks away from a family because he needs to focus on his recovery, everybody says OK, so he needs to do that. But if a woman leaves her family to go get treatment and then decides ‘You know what, I’m not ready, I got to go to a halfway house before I go back to my kids,’ everybody goes, ‘Oh my God.’”
That double standard and the stigma of alcoholism can keep a woman’s disease under wraps. But past traumas, the therapists say, can also play a role.
In her short time at the Orchid, Wardlow opened up about not only her alcoholic father but other traumatic experiences: an abortion at 17, and a horrific gang-rape on her 18th birthday.
“She identifies, from 15 to 18, these were horrible years for her,” said Appel. “That she’s never, never dealt with.”
The entire time, a question hung in the background: Would Wardlow make it through treatment, and would she be able to stay away from alcohol once she was back home?
“I’ll be honest with you, I’m scared as hell,” she said. “I’m scared, I’m scared to go home.
Wardlow left the Orchid with 30 days clean and a lifetime of hurdles in front of her. We visited Wardlow in Hattiesburg after her release. She was ready to add another day to her sobriety.
“This is my little tablet,” she said, indicating a pad of paper. “And I wad up yesterday and I write today down, put my little tablet back up there, and if I drink, I have to put that tablet on zero — and I don’t want to have to do that.”
The time back home had not always been easy.
“We had to relearn how to live with one another,” said Wardlow. “The first week or two was pretty volatile. Not in a physical way, but there was lots of screaming and gnashing of teeth.”
But there are signs of healing.
“We’re all really proud of her,” said Marina. “I know if she sets her mind to anything, that’s what she’s going to do. I’m just glad that she finally set her mind to it.”
“I think she’s trying to be more aware, and I think she’s trying to make up for, in some aspects, everything that’s happened and stuff,” said Jessy. “But I think she’s working on it. … I think she’ll do it. I believe in her.”
Wardlow had followed her care plan closely. She had daily phone calls with her sponsor and attended support group meetings regularly.
To stay with the recovery program, Wardlow can never consume a drop of alcohol — or take any habit-forming medication — again.
“No mood-altering drugs, as far as any type of benzos or opiates or whatever,” she said. “I was on tremizal for joint pain. Also I was taking lunesta to sleep, and I’m not taking that any more either.”
Wardlow left one support meeting with a chip marking how long it had been since she’d stopped drinking.
“Ninety days! 90 Days,” she said. “Big three months. Three months sober.”
By SEAN DOOLEY and SHANA DRUCKERMAN
Pain Management & Chemical Dependency
Ideally, treatment should consist of chemical dependency and pain management. This could be accomplished at a treatment center equipped to handle both afflictions, or at a chemical dependency center that consults with a pain management program. The most effective treatment for chemical dependency and chronic pain is long-term, anywhere from three to six months. This time is needed for our bodies to fully adjust, once they are off mood-altering medications. As soon as we become abstinent, our brains begin to adjust the levels of neurotransmitters that were lacking during our usage, which will help the body fight chronic pain in a natural way. We also need to learn about pain management and building twelve-step support systems. Many of us live alone and tend to overexert ourselves just by doing daily chores or working. The treatment environment can keep us safe from worsening or reinjuring the affected pain area.
Managing the pain
There are many techniques for pain management that are very effective, both while we are in treatment and afterwards, if we just give them the chance to do so. Listed below are just some of the many useful and effective tools. A qualified physician should approve all techniques before you attempt them:
- Physical Therapy: This is the most effective treatment of all. Most of us have been through many forms of physical therapy before, but chances are good we were abusing chemicals at the same time, nullifying or weakening the therapy. The form of treatment can also strengthen other parts of our bodies that can be used to physically support the pain area, such as back, leg and stomach muscles. Posture exercises are essential in chronic pain therapy.
- Heat or Ice Therapy: I have two reusable ice packs in the freezer at all times. Ice is fast acting and very effective. Heat is very soothing to sore muscles. Always follow the suggestions of a physician, to be sure this type of therapy will help you and is safe.
- Relaxation Techniques: Stress causes pain and pain causes stress. Relaxation helps reduce stress while helping reduce muscle spasms. There are various methods of relaxation, and some are more effective than others, depending upon the source of the pain. Deep breathing exercises can work wonders, since deep breathing is the body’s natural way to relax.
- Biofeedback: This is a specialized form of relaxation that can help you relax the area that is the source of pain. This is taught by pain management programs or professionals in private practice.
- Massage Therapy: This works well when used alone or combined with other pain management techniques. The majority of us suffer from muscle pain even though our injury sites may be elsewhere. It is usually the responding muscles that hurt the most.
- Alternative Medicine: Many of us receive relief from alternative sources such as chiropractic adjustments, acupuncture, reflexology and other forms of alternative medicine. This type of treatment is usually done when in-patient treatment is complete, however your particular program may make exceptions.
- Proper Diet: Depending upon the person, a nutritionist can be consulted for healthy eating habits. If we are overweight, chances are we are making the pain worse by putting extra strain on the body.
- Psychological and Psychiatric Support: Any program specializing in addiction and chronic pain will have appropriate counselors and psychiatrists to aid in pain management. Counselors and psychologists give emotional and spiritual guidance. They can also provide healthy support in therapeutic activities such as group therapy. Psychiatrists can prescribe antidepressants that can relieve depression and contribute to pain relief.
- Medications: All treatment programs of this nature have staff physicians than can provide pain relief by prescribing appropriate non-mood-altering medications that are just as good as, if not better than narcotics and benzodiazepines. It may take some trial and error before the best overall medication is found for each individual. Just remember, mood-altering medications are not effective once tolerance builds, and chances are the medications you abused stopped providing physical relief.
- Occupational Therapy and Vocational Guidance: Many of us are distressed because we can no longer function at work. Some of us must make occupational changes because of our chronic pain. Pain management treatment should include services that can help you return to work, or guide you toward new trades. Occupational therapy may be required if you intend to eventually return to your line of work. This involves training your muscles so they can cope with the stress of a particular job. Vocational counseling can help you change careers. These counselors specialize in this form of therapy, which includes a variety of testing and guidance.
- Setting Goals: Once we have arrived at a level of acceptance of our pain, it is imperative that we begin setting specific goals that, once we reach, gives us hope and raises our self-esteem. Setting specific goals is a major function of treatment planning. Your counselor will provide guidance and help you set these goals.
- Family Therapy: This is an essential part of treatment because the family plays such an important role in addiction and chronic pain. This form of therapy will help the family work through fears, and help them understand how they enable destructive behaviors in both areas.
Do Genetics Cause Addiction?
The role of genetics in addiction has been debated for decades. Scientists and other health experts have successfully identified various risk factors for the development of addiction, but concise and objective predictors of addiction have eluded discovery. This past year, however, science has made significant strides in discerning how genetics may affect addiction.
A landmark scientific paper published in the April 2009 issue of Nature Reviews Genetics presented some groundbreaking new insights into the role of genetics in addiction by honing in on specific genes that are tied to all types of addictions. The study, conducted by addiction experts at the University of Virginia Health System and the University of Michigan, even found that some genes that are associated with alcohol dependence are also linked to various other addictions. The gene was found to be a common factor in addictions to nicotine, cocaine, opioids and other substances.
Study co-author Ming Li, Ph.D., professor of psychiatry and neurobehavioral sciences at the UVA School of Medicine, commented on the study and its potential impact:
“Addiction researchers have found that several genes are linked with multiple addictions. … So, we’re narrowing the scope to specific genetic targets. Once researchers can pinpoint exact genetic variants and molecular mechanisms, then we can create much more effective, even personalized, treatments for individuals addicted to a variety of substances.”
Li also believes that further research is needed to understand the full impact of genetic variations on addiction. “The exact nature of the gene variants and how they function are still unknown, so functional studies as well as studies using additional ethnic population samples may be quite revealing,” Dr. Li said.
Another recent study, conducted by researchers at the University of Colorado in Denver, pinpointed genetic pathways and genes associated with alcohol consumption. The researchers were able to identify genetic factors that predisposed both rats and humans to drink more; however, they were unable to discover a similar link between the genes and actual alcohol addiction. Nonetheless, according to Boris Tabakoff, a lead researcher, the study’s results may help scientists to eventually connect the dots between genetic makeup and addiction.
Tabakoff said, “We know that high levels of alcohol consumption can increase the risk of becoming alcohol dependent in those who have a genetic makeup that predisposes to dependence. This is a case of interaction between genes and environment. Indeed, in our study we found that, higher alcohol consumption in humans was positively correlated with alcohol dependence. However, because different sets of genes seem to influence the level of alcohol consumption, as opposed to propensity for alcohol dependence, we are confronted with great variation in humans. Individuals with a set of genes that predisposes them to drink moderate amounts of alcohol may still have the genetic predisposition to lose control over their drinking behavior, and perhaps become alcohol dependent. Conversely, individuals with a genetic predisposition to drink high amounts of alcohol may not have the genes that predispose them to become dependent.”
A study just completed at Brown University (the results will be published in the January 2010 issue of Alcoholism: Clinical & Experimental Research) succeeded in identifying a link between a gene variation and teen alcohol misuse. For the study, researchers examined the genetic makeup of 187 adolescents (98 boys and 89 girls) around the age of 15 years. They were able to correlate a polymorphism (variation in the shape) of the OPRM1 opioid receptor gene called A118G with heightened risk for alcohol-related problems and likelihood to meet the clinical diagnostic criteria for Alcohol Use Disorder (AUD).
Robert Miranda, Jr., assistant professor in the department of psychiatry and human behavior at Brown University and corresponding author for the study, commented on the implications of the study’s findings:
“Our current knowledge about the genetics of alcohol misuse during adolescence comes almost exclusively from family and twin studies. … But the relative importance of environmental and genetic factors appears to shift considerably over the course of adolescence … with genetics playing an important role once teenagers begin to drink. … Our findings provide the first evidence to suggest that teenagers who carry a certain variant of the OPRM1 gene experience more alcohol-related problems.”
Notably, the Brown University team discovered that teens with this variant were more likely to report drinking alcohol because of the pleasurable effects than for other reasons. The fact that the genetic variation enhances the pleasure experienced by youth when consuming alcohol helps to explain why teens with this variation might be more likely to develop problem drinking behaviors.
Miranda, Jr., explains, “The G allele, or variant, of the OPRMI gene is associated with the function of the body’s own natural opiate system. Research suggests that the G allele is associated with experiencing more pleasure and greater intoxication after drinking.”
By Emily Battaglia
Benefits of Buprenorphine
Buprenorphine was initially introduced on the market in the 1980s as an analgesic. Now, its primary use is for the treatment of opioid addiction.
One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.
Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.
There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:
• Headache
• Drowsiness
• Dizziness
• Vomiting
• Decreased libido
• Constipation
• Respiratory depression
Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.
While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.
Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.
Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.
Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.
It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.
The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.
Source: Drug Addiction Treatment
Why medical detoxification alone isn’t enough
One of the first and most difficult steps that any person faces when entering a drug or alcohol rehabilitation center is detoxification – the medical process of riding the body of the toxins it has stored during years or decades of drug or alcohol abuse. This process can be devastating from both a psychological and physical standpoint, which is why people who enter an alcohol or drug rehab program often will need detox in order to get through the painful withdrawal symptoms that otherwise might lead them to give up on the idea of quitting.
Detox at an addiction center can take days or even weeks, depending on what the person was abusing, how much they were using and for how long. However, just because a person has completed medical detox doesn’t mean that they are through with their rehab program. In fact, detox is just one small step in the larger process of freedom from drug and alcohol dependency.
When a person becomes addicted to drugs or alcohol, they aren’t just addicted to the substance they are abusing – they become addicted to the flood of pleasurable stimuli that the substance provides to them. No drug rehab program can be successful without changing the mindset of a person and helping them to understand how their addiction has changed them and what they need to do to move forward.
In addition to the lessons about moving forward that are taught at a rehab center, addicts also must address the root causes of their addiction. The majority of addicts start abusing drugs or alcohol because of other factors such as genetics, unhappy childhoods or unstable current lives. Without addressing these underlying factors, most people will eventually fall right back into their patterns of addiction and dependence.
For all of these reasons, it’s important to do more than just “get dry” when trying to quit drinking. Long-term abstinence requires a total rehab program that addresses every aspect of the drug or alcohol addiction.
By Sarah Michaels
Treatment for Prescription Drugs in Florida
The main reason for the increasing number of addicts that need treatment for prescription drugs in Florida is the rampant abuse of  prescription drugs. The lack of a system to check who’s being prescribed what is making the problem worse. The patients who take certain drugs over a longer period of time also get addicted to them. Apart from these patients with long-term exposure to a drug, there are others who buy and consume prescription drugs illegally and suffer from drug addiction.
People looking for treatment for prescription drugs in Florida are basically addicted to three categories of drugs. The first types of drugs are opiates. They are taken to relieve pain. Codeine, Demerol, Dilaudid, Morphine and Vicodine are some of the commonly prescribed drugs under this category. Anyone taking these medicines over a longer period of time can easily get addicted and treatment for addiction is necessary, especially in the initial stage of withdrawal. The second category of drugs is CNS depressants. It can be divided into two sub-categories – barbiturates and benzodiazepines. Nembutal and Mebaral come under barbiturates and are given to people suffering from anxiety and sleep disorder. Halcion, Librium, Valium and Xanax come under benzodiazepines and are taken for panic attacks and anxiety. Stimulants belong to the third category. Ritalin and Dexedrine are examples of the Stimulants that are commonly used today. They are provided to stimulate the brain in order to make a person more agile and active. Treatment for prescription drugs should immediately the initiated once the addiction is detected.
Treatment for prescription drugs in Florida involves inpatient therapy, outpatient therapy and group therapy. The inpatient treatment requires patient to be admitted to a detox treatment facility. The patients are carefully examined by physicians and taken off of their particular drugs safely and securely. The whole procedure may take 7 to 10 days. After the detox treatment is complete patients are referred to counselor who then makes further arrangements for individual and group therapy. They are subjected to number of educational lectures and group discussions in order to make them understand the drug addiction and its consequences. This helps them to rehabilitate successfully. In the outpatient program patients are treated through various interventions that include detox treatment, massage therapy, acupuncture sessions and hydro-therapy. Patients are required to visit the treatment facility from time to time in order to be examined and to determine the extent of their addiction and the progress of their individual treatment plan. Patients are also encouraged to take part in various recreational activities like swimming, running, exercising, playing outdoor games and others that are provided at the treatment facility. In group therapy patients are encouraged to participate in meetings that are designed to educate them about Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) programs. Emphasis is laid on social interaction as most take to drug addiction because of the feeling of loneliness.
Treatment for prescription drugs in Florida is based upon the philosophy that every individual is important and unique and should be treated with distinction and respect. The main purpose of the treatment is to help the individual to become healthier and lead a drug free life.
By Gen Wright
Signs of Hydrocodone Addiction
 Signs of hydrocodone addiction are no different than most other painkiller addictions, or any addiction for that matter. Here is just a short list of some of the things I have experienced in my own life. If any of these things sound familiar whether it’s in your life or the life of someone close to you, it could be the beginning of a hydrocodone addiction.
Not taking the drug as prescribed by your doctor. There are a specific ways to take hydrocodone for it to be effective to treat pain, taking it for any other reason could be a sign of addiction. Taking hydrocodone for sleep, to get high, to relax, to calm the nerves, mixing it with alcohol or other drugs, and taking them more frequently than your doctor recommends. If you are running out of pills long before your next prescription, than you may want to tell your doctor so he can monitor your use better. Doctor shopping is a definite no no when it comes to having pain medication prescribed. Not only is it a sign of drug abuse, it is also against the law. Â If you are caught doctor shopping then you may never be able to get pain medication prescribed again. This can be a big problem if you are taking them for legitimate pain.
If you feel ill a lot for long periods of time then you may be going through hydrocodone addiction withdrawal. This can make someone very irritable and lash out to the ones close to them. Withdrawal can make you sick for days on end and if you must come off the pain medication, then it is best to do so under the care of a doctor and enter a detox center. Hydrocodone addiction is a serious issue. If you feel you may be addicted please consult a doctor. Hydrocodone contains acetaminophen, and if over exposed can lead to liver damage in the future. A doctor can best advise proper hydrocodone addiction detox treatment. Then later after the drug is removed from the system, then you can think about drug addiction recovery. There are many great treatment centers available that can be visited around your schedule. A 28 in patient treatment may be the best route, but outpatient treatment is also available. 12 step recovery is also a great way to deal with addiction once released from treatment. This way you can have a form of personal treatment when released into the real world.
By Gordon Thomas
Post-Acute Withdrawal Syndrome
After I went to detox and rehab I was ready for a greeting card life full of rainbows. Of course that is not how it worked out, I still had to deal with life on life’s terms. When I was using drugs I was in a constant state of euphoria and rarely, if ever thought about reality. When I got clean and sober I was forced to see and feel everything set before me and it wasn’t always easy. The first few days out of rehab were especially difficult because I was so fragile and used to living in a controlled environment. In the treatment center mealtime was set by a schedule as was wakeup time and bedtime but in the real world I was responsible for setting these limits for myself. When I was using drugs I would just do whatever I wanted when I felt like it and I certainly didn’t adhere to any type of schedule. There were many things I had to relearn about life when I got off drugs. One of the hardest lessons I had to learn in recovery was that I was not in control of anything or anyone else besides myself- and half of the time I didn’t even feel in control of that either.Â
Being newly detoxed from drugs my body was still going through PAWS (Post Acute Withdrawal Syndrome). PAWS tends to create in individuals an excess of emotion including hyper activity. Even small events of little consequence may loom large in someone’s mind and create strong (not being able to bond thoughts together) reactions. This may lead others to suspect a relapse or create social withdrawal. Shame emotions may be noted. Conversely, they may notice a numbing of emotions. The inability to feel impairs proper emotional bonding with friends and family during the early recovery process. It also impairs the recovery process itself as the individual struggles with trying to feel the resentments, anger, guilt, shame and other emotions common in recovery.
