Category Archives: Relapse Prevention

Achieving Stability in the Recovery Process

Opioid addiction is one of the more challenging substance use disorders to confront and manage because of its physical dependency characteristics. Once the process of physical addiction has taken hold, avoiding daily withdrawal becomes a high hurdle.

Because of this daily dilemma, it becomes difficult to remain focused on other aspects of recovery. It’s the law of “first things first” that applies when tackling any problem. There is a natural order and sequence which must be followed when trying to solve a complex task. Opioid addiction recovery is no exception.

Obtaining relief from opioid withdrawal symptoms is a very important first step in addressing opioid addiction. This is why medication-assisted treatment is specifically identified as a medical best practice. Science and years of exhaustive research have proven (not just suggested) that treatment coupled with medication-assistance offers the greatest probability of long-term success when trying to overcome moderate to severe opioid addiction.

Fortunately, more people are becoming aware of the need for buprenorphine, methadone, and other medications that can play a vital role in stabilizing an opioid addicted individual at the onset of their personal recovery.

Historically, efforts to come off of opioids in a detox setting have been often unsuccessful because many detoxes used insufficient medications to alleviate withdrawal symptoms. Consequently, patients would typically begin to get sick in 1-2 days with their withdrawal symptoms becoming intolerable. This can lead to patients abandoning the detox effort and a quick return to illicit opiates.

However, the tide is turning. As the American opioid crisis continues to impact families and U.S. society, many more physicians, lawmakers, and government representatives are gaining a quick education on the enormous value of medication-assisted treatment. Methadone is at the forefront of this new awareness as is buprenorphine-based products like Suboxone.

Appropriate medications used responsibly and under a doctor’s supervision provide stability, hope, and opportunity.

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. In the course of clinical trials of a new agent for the treatment of coronary heart disease, researchers at Pfizer Inc. found that while taking is not accompanied by a significant clinical improvement in angina, in many patients it leads to the development of a kind of “side effect”, which consists in improving erectile function. This observation has led to the study of the possibility of using this substance in the treatment of patients with erectile dysfunction.

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.

Using the data from the long-term and serious studies, we must admit that 60% of men using the drug on a daily basis normalized their erectile function; they had no symptoms of the diseases and felt healthy. It is interesting that after 2 years of use, this indicator remains almost unchanged. This suggests that there is no tachyphylaxis. The data of a large-scale study show that the patients taking PDE5 every day are less concerned with the time of action of the drug, the speed of the effect and spontaneity of sexual activity. The patient doesn’t think about whether the pill will work.

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: