Category Archives: Relapse Prevention

Expanding Access to Medication-Assisted Treatment

opioid-treatment-in-mediaAn article in the Huffington Post recently addressed President Obama’s public comments on expanding access to opioid treatment, particularly medication-assisted treatment (MAT) like methadone or buprenorphine (suboxone).

Many members of the treatment industry and recovery community do not have a realistic grasp on the role that medication-assisted treatment can play in recovery from severe opioid addiction. Historically, the recovery community has not regarded those utilizing methadone or suboxone as truly in recovery. They emphasize total abstinence, even from methadone, despite the fact that methadone and buprenorphine have restored individuals to normal functioning and even saved lives in many cases.

There was a time some years ago, in the 12 step community, when individuals were chastised for taking psychotropic medication for depression or other mental health disorders. This criticism came from a fundamental lack of knowledge about the biological basis for many mental health disorders. Similarly, medication-assisted treatment interventions have been the subject of misunderstanding and unwarranted rejection by those with limited education on varied treatment approaches.

As America’s opioid problem continues to grow, we need real solutions rooted in medical science and research. At this point in time, medication-assisted treatment has been in use long enough to clearly demonstrate its usefulness in facilitating personal recovery from addiction.

In 2015, we saw numerous local and national political figures rally around families that have been impacted by heroin overdoses and the heartbreaking loss of loved ones. Opioid addiction has finally come into focus within the mainstream media, and even current Presidential candidates have begun to address this as an important issue which commands attention and a solution.

More: Question and Answers on how methadone works


Stepping Onto The Path of Recovery

the-pathAn important consideration in examining the disease of addiction is the recognition that “recovery” is an incremental process. Many people facing their addiction will experience brief setbacks, and some will struggle for years before they are able to remain on the path of positive change.

As a counselor, I have listened to many recovering individuals talk about their resistance to change. Addiction is a persistent disease of disruptive thinking and behavior highly subject to repetition. Addicts will repeat the same bad “choices” as a result of many factors. Scientific research has shown that habitual patterns of behavior are neurochemically driven deep within the brain. These patterns can be reinforced by one’s social connections, immediate environment, and underlying belief system.

With severe levels of addiction sustained over years, it can become difficult for people to shift their lifestyle, thinking, and decision-making toward a healthy, recovery-oriented mindset. In 12 Step recovery, there is the popular expression called “hitting bottom”. This expression is typically used to describe a specific time in which a person has lost so much, or suffered such a painful crisis, that their readiness for change finally emerges. This window of opportunity is often times short-lived. Hitting bottom will compel some people to finally take the right action – to seek help – to admit they have a problem. If this happens, then a decision to step onto the path of recovery may actually occur.

Active addition is often characterized by a short range view in which consequences are not thoroughly considered. Focusing on consequences interferes with the compulsive desire to use. And even then, a recognition of consequences to oneself and family is often not enough to change the decision to get high. With opiate addiction, the decision to use is overwhelmingly controlled by opiate withdrawal sickness. This never-ending physical sickness takes people away from recovery and keeps them trapped in a desperate existence centered around doing whatever is necessary to avoid being “dope sick”.

Fortunately, this dilemma can be addressed through medication-assisted treatments (methadone, suboxone, naltrexone). These do not replace the need for a recovery program, but they become an important part of one’s overall personal recovery program. Staying on the path of recovery is the next critical phase after stepping onto the path. Medication-assisted treatment greatly aids recovering addicts in staying on the proper path. Science has proven that those with the greatest chance of long-term, successful sobriety are those that remain in treatment and recovery. Said differently, a person’s chance of recovery success is statistically improved the longer they remain in treatment.

When a person no longer has to face the crippling weight of daily withdrawal sickness, they have a chance to re-approach their overall recovery and the opportunities that lie ahead of them.

Reducing Risk of IV-Related Infections

drug-safetyOne of the risks associated with the progression of opioid addiction is the increased probability of an addicted person moving to injectable heroin as a last resort in dealing with opioid withdrawal. In the early years of methadone’s adoption in treatment centers, it was used primarily to help heroin addicted individuals detox from heroin and eventually remain heroin free.

While heroin is definitely resurfacing, the opioid epidemic of recent years has primarily been about prescription opioids taken orally. Following this pattern of use, users eventually discover that crushing and snorting pills is a more efficient means of getting an opioid into their system. Injecting is typically the last step in this progression of the disease of addiction.

But with injection comes a variety of new risks and health problems such as skin abscesses, localized infection at the site of injection, as well as hepatitis C (a viral infection of the liver) and HIV infection acquired through needle sharing with infected persons. A recent story in the news highlighted a sudden increase in HIV infections in Scott County (Indiana) in conjunction with the rise of opioid addiction there and injectable drug use.

Indiana’s governor has temporarily approved the use of needle exchange programs to help reduce the risk of virus transmission resulting from the use of dirty needles. The story indicated that the number of documented HIV infections had risen month over month. The county is presently trying to locate over 100 people who may have been exposed to the HIV virus in connection with injecting opiates.

Methadone and other medication-assisted treatments have been conclusively proven to reduce heroin/opiate relapse and injection drug use. For many individuals trapped in a daily cycle of perpetual drug abuse, the risk of acquiring a deadly infection increases with every day that they are not in treatment receiving help.

Treatment leads to recovery, and recovery leads to dramatic lifestyle change. Many patients who choose methadone as a tool in their personal recovery never go back to injecting drugs. This obviously is a life saving choice.

Someone recently stated “If you’re dead, you can’t recovery.” This is a rather blunt way of expressing a profound and meaningful truth. Addiction does rob loved ones, friends, family, and neighbors of life, health, and happiness. Recovery has the ability to restore all of these. Let us keep our minds and hearts open about the value of medication-assisted treatment. It is making a real difference for numerous people around the world.

Right Path Clinics Offer Suboxone and Addiction Counseling

right-path-clinics-2Right Path is an opioid treatment provider operating in the greater Hampton Roads area of eastern Virginia. The organization specializes in the use of burprenorphine (the critical ingredient in Suboxone that alleviates opioid withdrawal symptoms).

Right Path currently have outpatient services in Virginia Beach, Newport News, and Suffolk, but plan to soon offer a location convenient for residents and visitors along the Outer Banks.

Recognizing the importance of individualized treatment plans, Right Path tailor their services to the needs of the individual patient. While suboxone is beneficial in eliminating the pain of opioid withdrawal, addiction counseling is essential in helping patients to understand the addiction and recovery process. Right Path provide addiction counseling as a component of their overall treatment program.

Evening and weekend hours are offered, and most insurance is accepted. The Right Path website has a helpful page that outlines various questions and issues that you might cover with your Suboxone Doctor in your first appointment. Their website provides another highly informative page on Suboxone which answers many common questions about this increasingly popular medication. More information on Right Path’s locations and contact information can be obtained here:

When Emotional Pain Fuels Relapse

grief-and-lossPeople in recovery from addiction face very substantial stresses. The stress of trying to cope with cravings & urges, the stress of facing life and trying to resolve problems, and the common pressure of trying to make ends meet when finances are not in good shape.

While many addicted individuals find that they are more resilient than perhaps they ever believed, loss can sometimes be a particularly crippling experience. People from all walks of life suffer and struggle with losses – divorce, the death of a loved one, the loss of a job, income, security, or health.

A recent New York Times article briefly profiled a young woman released from prison who was trying to stay clean from heroin. She really missed her child who had been removed from her custody. While she loved her baby, she also recognized she was not yet ready to resume the pressures and responsibilities of parenting until she got herself on more solid, sober ground.

With the death of a loved one, the feelings run so deep that coping is sometimes beyond one’s inner resources. Grief has a way of overwhelming the senses and the heart such that making rational choices is much harder than would normally be the case. In extreme emotional situations, thoughts can become paralyzed and feelings intensified. Such a combination can make sobriety incredibly challenging.

Emotional pain is part of life. We have all felt it. Recovery teaches many principles that help to make life more manageable and which can help a person to hold on, to survive the lows of life. And for those that slip, life must go on. All is not lost. In 12 step meetings, they say “keep coming back”. In treatment, they say, “don’t give up”. While these may sound like annoying platitudes, they are generally true and correct sentiments that are there to remind us that pain subsides, and the human heart can find a way to survive and to be happy again.

How this happens varies greatly from one person to another. Support from others can make a huge difference. Prayer and connection with the proverbial higher power can make a difference. We are connected (or can be connected) to good people and good things if we try to open ourselves to them. It is not always easy when we are hurting. Therapy and counseling sometimes point us to answers that we didn’t know even existed. Spiritual support can achieve this as well. Whatever life brings us, good or bad, happy or sad, hopefully we can pause for a few moments to reflect on the small blessings that so often go overlooked and underappreciated.

The message for today is to remember that you are worth it! It can get better. Recovery is always here for you.