Posts Tagged ‘addiction’
Heroin Addiction: The Long Road Home
When you are in the grip of heroin, it seems like you’ll never be free of it. Heroin addiction is one of the most difficult drugs to overcome, it’s true, but that doesn’t mean it’s impossible. You do need to be prepared for a long haul. And you do need courage and conviction.
What Happens in the Body With Heroin Addiction
Just why it’s so hard to overcome heroin is easy to see when you look at what the drug does to your body. Over time, your nervous system has adapted to accommodate chronic use of the drug. When heroin first infiltrates your body, your brain’s natural chemistry reacts with heroin’s toxins to create the feeling of heroin euphoria. Other effects include a feeling of heaviness and inability to move, dizziness, nausea, change in skin temperature. You feel tired, and the world seems to no longer exist around you. In effect, you are incapable of functioning either mentally or physically.
Heroin also damages the central nervous system, and may also cause short- and long-term harm to the respiratory and cardiovascular systems. Many users overdose and die from the drug’s toxic effects, while others suffer severe and permanent damage.
A University of California study of 581 male heroin addicts monitored over 30 years (1964 to 1994) found alarming results. After 30 years, more than half (284) of the original participants, had died. Causes of the deaths: 22 percent died from overdose, 15 percent of chronic liver disease, and 20 percent from suicide or homicide. Of the remaining 43 percent of the deaths, the causes were AIDS, cancer or cardiovascular diseases. What about the 297 addicts still alive after 30 years? The sad truth is that 43 percent of them were still using heroin.
You’ve Made the Decision to Enter Detox – Now What?
Just by entering detox you’ve made a powerful first step. You may have finally hit bottom, due to a combination of physical and emotional consequences of the effects of heroin. Perhaps you had an intervention and that’s why you arrived at detox. The point is that you’re here. Now what?
Some of the immediate effects of detoxification from heroin are those you’re already quite familiar with. Every time your high wore off and you didn’t get your fix right away, your body started to feel some of the withdrawal symptoms. You may have even tried to quit cold turkey – not a good idea, as you well know if you’ve tried it.
Physical withdrawal symptoms include: a 3- to 5-day period of intense anxiety, insomnia, flu-like symptoms, cramps, chills, sweating, diarrhea and goose bumps. Muscles start to tighten and twitch, leading to involuntary spasms or kicking. Psychological cravings for the drug become almost unbearable, impossible to fight. Peak withdrawal symptom severity occurs about 24 hours after termination of the drug, and can last a week or more. Without medication to manage the withdrawal symptoms, the pain can be excruciating. But unless other medical problems exist, detox itself is not life-threatening.
Detoxification under medical supervision alleviates the discomfort of heroin withdrawal, managed by administration of medication – if the patient chooses this method. Using medication, the effects can be minimized or even prevented. Drugs used include methadone, clonidine and buprenorphine drugs like Subutex or Suboxone.
By Suzanne Kane
Substance Abuse & Mental Health
Co-occurring disorders, also referred to as dual diagnosis, is a term used when you have both a mental health disorder—such as depression, anxiety, or bipolar disorder—and a drug or alcohol problem. Both the mental health issue and the addiction have their own unique symptoms that may get in the way of your ability to function, handle life’s difficulties, and relate to others.
Complicating the situation, the two problems affect each other and interact. When a mental health problem goes untreated, the substance abuse problem usually gets worse as well. And when alcohol or drug abuse increases, mental health problems usually increase too.
Recovery depends on treating both the addiction and the mental health problem
Whether your mental health or substance abuse problem came first, recovery depends on treating both illnesses. The good news is that most people suffering from co-occurring addiction and mental health problems are able to recover, given proper treatment and support.
- There is hope. Recovering from co-occurring disorders takes time, commitment, and courage. It may take months or even years. But people with substance abuse and mental health problems can and do get better.
- Combined treatment is best. Your best chance of recovery is through integrated treatment for both the substance abuse problem and the mental health problem. This means getting combined mental health and addiction treatment from the same treatment provider or team.
- Relapses are part of the recovery process. Don’t get too discouraged if you relapse. Slips and setbacks happen, but, with hard work, most people can recover from their relapses and move on with recovery.
- Peer support can help. You may benefit from joining a self-help support group like Alcoholics Anonymous or Narcotics Anonymous. They give you a chance to lean on others who know what you’re going through and learn from their experiences.
What comes first: Substance abuse or the mental health problem?
Addiction is common in people with mental health problems. But although substance abuse and mental health disorders like depression and anxiety are closely linked, one does not directly cause the other.
The relationship between substance abuse and mental health problems
- Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety. Unfortunately, substance abuse causes side effects and in the long run worsens the very symptoms they initially numbed or relieved.
- Alcohol and drug abuse can increase underlying risk for mental disorders. Mental disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental disorder, drug or alcohol abuse may push you over the edge.
- Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or trigger new symptoms. Alcohol and drug abuse also interact with medications such as antidepressants, anti-anxiety pills, and mood stabilizers, making them less effective.
Addiction is common in people with mental health problems
According to reports published in the Journal of the American Medical Association:
- Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
- Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
- Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.
Recognizing and diagnosing co-occurring disorders
It can be difficult to diagnose a substance abuse problem and a co-occurring mental health disorder such as depression, anxiety, or bipolar disorder. It takes time to tease out what might be a mental disorder and what might be a drug or alcohol problem.
Complicating the issue is denial. Denial is common in substance abuse. It’s hard to admit how dependent you are on alcohol or drugs or how much they affect your life. Denial frequently occurs in mental disorders as well. The symptoms of depression or anxiety can be frightening, so you may ignore them and hope they go away. Or you may be ashamed or afraid of being viewed as weak if you admit the problem.
Admitting you have a problem is the first step on the road to recovery
Just remember: substance abuse problems and mental health issues don’t get better when they’re ignored. In fact, they are likely to get much worse. You don’t have to feel this way! Admitting you have a problem is the first step towards conquering your demons and enjoying life again.
- Consider family history. If people in your family have grappled with either a mental disorder such as depression or an alcohol or drug addiction, you have a higher risk of developing these problems yourself.
- Consider your sensitivity to alcohol or drugs. Are you highly sensitive to the effects of alcohol or drugs? Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink?
- Look at symptoms when you’re sober. While some depression or anxiety is normal after you’ve stopped drinking or doing drugs, if the symptoms persist after you’ve achieved sobriety, you may be dealing with a mental health problem.
- Review your treatment history. Have you been treated before for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?
Signs and symptoms of alcohol or drug addiction
If you’re wondering whether you have a substance abuse problem, the following questions may help. The more “yes” answers, the more likely your drinking or drug use is a problem.
- Have you ever felt you should cut down on your drinking or drug use?
- Have you tried to cut back, but couldn’t?
- Do you ever lie about how much or how often you drink or use drugs?
- Have your friends or family members expressed concern about your alcohol or drug use?
- Do you ever felt bad, guilty, or ashamed about your drinking or drug use?
- On more than one occasion, have you done or said something while drunk or high that you later regret?
- Have you ever blacked out from drinking or drug use?
- Has your alcohol or drug use caused problems in your relationships?
- Has you alcohol or drug use gotten you into trouble at work or with the law?
The mental health problems that most commonly co-occur with substance abuse are depression, anxiety disorders, and bipolar disorder.
Common signs and symptoms of depression
- Feelings of helplessness and hopelessness
- Loss of interest in daily activities
- Inability to experience pleasure
- Appetite or weight changes
- Sleep changes
- Loss of energy
- Strong feelings of worthlessness or guilt
- Concentration problems
Common signs and symptoms of mania
- Feelings of euphoria or extreme irritability
- Unrealistic, grandiose beliefs
- Decreased need for sleep
- Increased energy
- Rapid speech and racing thoughts
- Impaired judgment and impulsivity
- Hyperactivity
- Anger or rage
Common signs and symptoms of anxiety
- Excessive tension and worry
- Feeling restless or jumpy
- Irritability or feeling “on edge”
- Racing heart or shortness of breath
- Nausea, trembling, or dizziness
- Muscle tension, headaches
- Trouble concentrating
- Insomnia
Treatment for co-occurring substance abuse and mental health problems
The best treatment for co-occurring disorders is an integrated approach, where both the substance abuse problem and the mental disorder are treated simultaneously.
How do I find the right program for co-occurring disorders?
As with a substance abuse program, you want to make sure that the program is appropriately licensed and accredited, that the treatment methods are backed by research, and that there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.
There are a variety of approaches that treatment programs may take, but there are some basics of effective treatment that you should look for:
- Treatment addresses both the substance abuse problem and your mental health problem.
- You share in the decision-making process and are actively involved in setting goals and developing strategies for change.
- Treatment includes basic education about your disorder and related problems.
- You are taught healthy coping skills and strategies to minimize substance abuse, cope with upset, and strengthen your relationships.
You will know if you are receiving integrated treatment because your clinician or treatment team will do several things at the same time, including:
- Help you think about the role that alcohol and other drugs play in your life. This should be done confidentially, without any negative consequences. People feel free to discuss these issues when the discussion is confidential, nonjudgmental, and not tied to legal consequences.
- Offer you a chance to learn more about alcohol and drugs, to learn about how they interact with mental illnesses and with medications, and to discuss your own use of alcohol and drugs.
- Help you become involved with supported employment and other services that may help your process of recovery.
- Help you identify and develop your own recovery goals. If you decide that your use of alcohol or drugs may be a problem, a counselor trained in integrated dual disorders treatment can help you identify and develop your own recovery goals. This process includes learning about steps toward recovery from both illnesses.
- Provide special counseling specifically designed for people with dual disorders. If you decide that your use of alcohol or drugs may be a problem, a trained counselor can provide special counseling specifically designed for people with dual disorders. This can be done individually, with a group of peers, with your family, or with a combination of these.
Source: SAMHSA’s National Mental Health Information Center
Group support for co-occurring substance abuse and mental health disorders
As with other addictions, groups are very helpful, not only in maintaining sobriety, but also as a safe place to get support and discuss challenges. Sometimes treatment programs for co-occurring disorders provide groups that continue to meet on an aftercare basis. Your doctor or treatment provider may also be able to refer you to a group for people with co-occurring disorders.
While it’s often best to join a group that addresses both substance abuse and your mental health disorder, twelve-step groups for substance abuse can also be helpful—plus they’re more common, so you’re likely to find one in your area. These free programs, facilitated by peers, use group support and a set of guided principles—the twelve steps—to obtain and maintain sobriety.
Just make sure your group is accepting of the idea of co-occurring disorders and psychiatric medication. Some people in these groups, although well meaning, may mistake taking psychiatric medication as another form of addiction. You want a place to feel safe, not pressured.
Locating a 12-step program in your area
Twelve-step programs, such as Alcoholics Anonymous or Narcotics Anonymous, can be a good source of support as you go through recovery. There are also specific 12-step groups that address co-occurring substance abuse and mental health disorders:
Supporting recovery from alcohol or drug addiction and mental health problems
Getting sober is only the beginning. Your continued recovery depends on continuing mental health treatment, learning healthier coping strategies, and making better decisions when dealing with life’s challenges.
- Get therapy or stay involved in a support group. Your chances of staying sober improve if you are participating in a social support group like Alcoholics Anonymous or Narcotics Anonymous or if you are getting therapy.
- Follow doctor’s orders. Once you are sober and you feel better, you might think you no longer need medication or treatment. But arbitrarily stopping medication or treatment is a common reason for relapse in people with co-occurring disorders. Always talk with your doctor before making any changes to your medication or treatment routine.
- Learn how to manage stress. Stress is inevitable, so it’s important to have healthy coping skills so you can deal with stress without turning to alcohol or drugs. Stress management skills go a long way towards preventing relapse and keeping your symptoms at bay.
- Know your triggers and have an action plan. If you’re coping with a mental disorder as well, it’s especially important to know signs that your illness is flaring up. Common causes include stressful events, big life changes, or unhealthy sleeping or eating. At these times, having a plan in place is essential to preventing drug relapse. Who will you talk to? What do you need to do?
- Adopt healthy habits to support your mental health. Basic self-care practices are essential to good mental and physical health. Eating right gives you plenty of energy and helps prevent mood swings. Sleep and exercise are also key to good mental health. Regular exercise is a powerful antidepressant and sticking to a sleep routine helps balance mood.
Helping a loved one with both a substance abuse and a mental health problem can be a roller coaster. Resistance to treatment is common and the road to recovery can be long. It’s common to feel isolated, overwhelmed, scared, and confused.
The best way to help someone is to accept what you can and cannot do. You cannot force someone to remain sober, nor can you make someone take their medication or keep appointments. What you can do is make positive choices for yourself, encourage your loved one to get help, and offer your support while making sure you don’t lose yourself in the process.
- Seek support. Dealing with a loved one’s mental illness and substance abuse problem can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through. It can also help to get your own therapy or join a support group.
- Set boundaries. Be realistic about the amount of care you’re able to provide without feeling overwhelmed and resentful. Set limits on disruptive behaviors, and stick to them. Letting the substance abuse problem or mental illness take over your life isn’t healthy for you or your loved one.
- Educate yourself. Learn all you can about your loved one’s mental health problem, as well as substance abuse treatment and recovery. The more you understand what you’re loved one is going through, the better able you’ll be to support recovery.
- Be patient. Recovering from addiction and mental health problems doesn’t happen overnight. Recovery is an ongoing process that can take months or years, and relapse is common. Ongoing support for both you and your loved one is crucial as you work toward recovery.
Source: Helpguide.org
Addiction and the Brain
The truth about the cycle of addiction
The brain and addiction… what is the relationship? There has been an ongoing debate for years about where addiction actually originates from. You will find some drug addiction treatment professionals who claim addiction is a lack of willpower, while others insist that addiction is a disease of the brain, complete with signs and symptoms. The truth about addiction, as concluded by the American Medical Association with research-based criteria, is that addiction is most definitely a disease that is chronic in nature not unlike cancer, diabetes or bipolar disorder. Another critical outcome of the research-based study showed that the brain of the individual suffering from drug or alcohol addiction is both chemically and physiologically dissimilar from that of the normal brain. This particular finding supports the theory that the brain and addiction are interconnected. This is critical to understanding addiction, its development and an individual’s recovery process.
Addiction Definition
The word addiction is best defined as the obsessive thinking and compulsive need for and use of drugs, alcohol, food, sex or anything that is psychologically or physically addicting. Addiction can also be described by the development of tolerance with distinguishable withdrawal symptoms upon discontinuing the use of the particular drug or behavior. In addition to the development of tolerance with regards to addiction, the addict or alcoholic will experience intense physical cravings for the drug accompanied by an emotional obsession to take the drug regardless of the consequences. The process of addiction that leads the individual to experience the compulsive need for drugs regardless of the consequences is directly related to the change in brain chemistry affecting the process of thought.
The Science Behind the Brain and Addiction Relationship
Scientifically-based research on the brain and addiction relationship has demonstrated to us that drugs, alcohol and specific behaviors have a significant impact on the reward center located in the brain. Levels relating to certain neurotransmitters, send messages to the brain. These neurotransmitters include serotonin and dopamine. Chronic use of drugs and alcohol tends to over-stimulate the brain until it must depend upon substances and behaviors to produce the needed chemicals. This chemical dependency is what leads to tolerance and addiction.
Most people believe that drug addiction lies in the additional use of drugs or alcohol when it truly is related to chemical imbalances in the brain and the compulsion to use, regardless of the consequences. In light of all of this scientific research, we still find professionals who adopt the philosophy that addiction is due to a lack of willpower and/or moral imperfections.
Brain Chemistry and Addiction
Most individuals suffering from addiction use drugs or alcohol to feel “good” or to self-medicate physical or emotional pain. Substance use and addictive behaviors stimulate and increase the brain’s production and use of REWARD chemicals such as dopamine. Depending on the dose of the drug, the brain accepts neurotransmitters that are significantly more intense than they would experience during the “natural” highs produced by the brain normally. In basic terms, this is why addiction takes place physically and emotionally.
Addiction Alters the Brain
Over time, the continued use of a drug alters the way the brain functions. A person’s brain becomes dependent on receiving the substance. These changes in brain chemistry create the addiction and create the tolerance, withdrawal symptoms and cravings. The only “good” part regarding drug addiction is the disease is treatable and recovery is possible.
By Jonathan Huttner
What If Your Loved Ones Cannot Forgive Your Addiction
Coming back from the cycle of addiction is a long and tough road. Not only does it take a lot of courage and determination, but it’s physically and mentally taxing as well. When you’ve finished your treatment and are in recovery, you really need the love, support and encouragement of your loved ones to help you maintain your sobriety. So what happens if your loved ones cannot forgive your addiction? What if there’s so much weight in your baggage that they can’t look beyond the past?
Don’t worry. You can get past this. Here are some things to keep in mind.
First Things First
It’s important to recognize yourself first for the incredible achievement you’ve attained. At this stage of the game, you’ve completed your treatment – however personally challenging that may have been – and are now in recovery. This accomplishment alone is reason to celebrate. Sure, it would be great if your loved ones stood up and gave you credit for this, but it doesn’t detract from the fact that you did it. So, before you think about anything else, give yourself high marks for reaching this milestone.
Count Your Blessings
Now, while you are still giving yourself kudos for reaching the recovery stage, count your blessings for all the positive things that you have in your life. Loved ones notwithstanding, you do have them. Here are some that should rate high on your list. You now have a healthier physical condition, due to the fact that your body is no longer full of the harmful substances you previously ingested, or the addictive lifestyle you once maintained. You’ve made a lot of progress in understanding the roots and underlying causes for your addiction, learned how to identify triggers and how to avoid giving in to them. You worked hard on your self-esteem and self-confidence, learning that you have contributions that you can make to society. Even if you never felt that you made much of a difference before, you now know that each person can impact the lives of many around them, and that you have a tremendous opportunity to not only benefit your own future, but those of others as well.
These are all terrific blessings – and they don’t cost you a penny. While you’re at it, you can probably rattle off a few more. Include the fact that you now sleep better, are less depressed and anxious, look forward to each day rather than dreading what it will bring, and others.
How Bad is the Relationship?
Still, you need the love and support of those closest to you. Whether this is your spouse or partner, children, siblings or parents, the relationships mean a lot and are definitely worth preserving or repairing. Before you attempt to make any amends, however, you should first look at how bad the situation is with your loved ones. What do you see is the biggest obstacle to being whole again in their eyes? In other words, what will it take for them to forgive you – if you know? Maybe you think it is one thing, when, in fact, it may be something else altogether. Don’t just assume. Sit down and really try to figure it out.
Let’s say you’re the husband of a working wife who’s been struggling to keep the family together while you were in treatment. If there are children involved, magnify that struggle by increments depending on what shape (financially, emotionally, socially, etc.) the family was in prior to your entering treatment. Chances are, the inability of your loved ones to forgive you have a lot to do with heavy-duty emotional turmoil. Your spouse, for example, shouldered the burdens while you were away. She had to make many decisions on her own, not being able to get your input, or the situation demanded immediate attention. For a wife used to sharing decisions with her husband, this can take a tremendous toll.
Perhaps she had to scrimp to help pay for your treatment, since your insurance coverage either only covered part of it or you didn’t have any coverage. Having to sacrifice comforts the family has come to rely on or even pare necessities to the bone will build up resentment in the strongest and most caring person. Add that to the list of perceived grievances.
Being the sole parent also meant she shouldered dual roles in your absence. It’s tough to show love, dole out discipline when necessary, keep up appearances and try to ensure the children still have fun when you’ve got so much riding on the situation. She may have begun to wonder if the family would be better off without you. This thought, which is certainly understandable, would likely be instantly quashed as out of the question or a sign of betrayal (although it could still lurk beneath the surface). As you know from your own treatment, when you bury your emotions, they come back to haunt you or, at the very least, make growth more difficult.
While the above is just one example, the point is that you should make a list of the things that you believe stand in the way of your loved one forgiving you for your addiction. Once you have the list, you can go on to the next step.
Figure Out What to Do About It
Work down your list and try to come up with solutions to the problems. Again, this is something you do on your own even before having any conversation with your loved ones. Taking financial concerns into consideration, perhaps you can address how and when you will be able to alleviate this concern. Can you go back to your previous job? What are your employment prospects?
Did you get training in a new vocation or skill while you were in treatment? How willing are you to take any kind of job to
immediately start contributing to the family’s well being?
Recognize that you may have to start from scratch. You may have burned your job bridge behind you if you were fired for your addictive behavior. Or, your prospects upon your return may be limited for some time to come. In either case, start where you are and work your way back up. It’s really the only option you have, since you do have obligations and need to resume your role within society.
If you need training, look into how you can get it. Take any job and go to school at night, or learn a new trade or skill in an apprenticeship. Another advantage to tackling the financial concerns that may stand in the way of your loved ones’ forgiveness is that you will be doing something positive for yourself as well. Now could be the opportunity to ditch the old job you found boring or distasteful, or not reflective of your true talents or desires. Figure out what it will take for you to get where you really want to be – and then draft a plan to make it happen.
No, this goal won’t be realized overnight. It may take years for you to complete your degree, build up your own business, or become profitable, for example, but it is a positive first step toward eventually achieving the goal.
Speaking of time, it may be that you’ll need to prove yourself to your loved ones by being on your own for a while. It may be too painful for them to have you home on a full-time basis for now. You will need to accept that and really work at making the kinds of changes that can turn that around.
As for the emotional barrier that undoubtedly puts a strain on your relationship moving forward, this, too, requires time. Your loved ones may miss the financial security and feeling of self worth that came from having things in control – prior to your problems with addiction. A drastic drop in self confidence and self worth inevitably follows in the path of addiction, affecting everyone in the family. In fact, emotional turmoil is difficult for loved ones to overcome without some form of family treatment or counseling. They often are not able to see past barriers without professional help. Fortunately, such counseling is relatively easy to access – either as part of your aftercare treatment program, or through community services or self-help groups such as Al-Anon/Alateen, Nar-Anon, and others.
Remain Positive and Upbeat About the Future
Although it seems hard to look at a future without your loved ones in it, for now just keep as upbeat and positive as you can. Reach out to your support network of 12-step members and step up your meeting attendance. This is especially important at time in your life when your family environment may be severely constrained or restricted.
Your 12-step allies also include your sponsor. Don’t be afraid to ask for help from your sponsor, since he or she is ready, willing and able to give you the kind of encouragement and support you need, 24/7. You already have a pretty good familiarity with the 12-step process through contacts during your treatment program – if you went through a formal treatment program. If not, you do have a ready-made support network available to you through 12-step fellowships. There are 12-step groups for every kind of addiction. They are free to attend and have no memberships or dues. All they ask is for voluntary donations if you are able.
While the philosophies are similar and all are based on the 12-step principles, each has its own original focus and personality, if you will.
Here are some of the 12-step groups:
• Alcoholics Anonymous
• Cocaine Anonymous
• Crystal Meth Anonymous
• Debtors Anonymous
• Gamblers Anonymous
• Marijuana Anonymous
• Narcotics Anonymous
• Sexaholics Anonymous
• Sex and Love Addicts Anonymous
• Sex Addicts Anonymous
• Sexual Compulsives Anonymous
• Workaholics Anonymous
Besides in-person meetings, 12-step groups often offer online and phone meetings, blogs, and chats. Each group has its own website which provides access to articles, news, books, CDs, DVDs, and other resources, as well as helpful links for additional help. When you’re feeling down or lonely in the middle of the night, go online and check out some literature that may help – or get in touch with your sponsor or other 12-step group member with whom you have established a connection.
Make a Plan – and Stick To It
Besides continuing counseling, keeping an upbeat attitude and seeking the support and encouragement from your 12-step groups, what else can you do? The best advice is to make a plan, and stick to it. What do we mean by that? What kind of a plan are we talking about? It doesn’t matter what your plan is, or how simple or detailed. The point is that you will be doing yourself a great service by sitting down and designing a plan for your future.
Note the emphasis on your future. Here we are talking about what it is that you want for yourself one year, 5 to 10 years, or longer down the road. Make a list of your short-term (1 to 2 years), intermediate term (3 to 5 years), and long-term (5 to 10 years and beyond) goals. In the next column, jot down what you may need to do in order to reach the particular goal. This may include going to school, getting training, learning a new language, becoming proficient at a sport, joining a recreational or travel group, or something else. In the next column, write down everything you can think of in the way of resources available to help you get started. Include websites, organizations, advice or recommendations from friends, scholarships, grants, community, state or federal programs, etc.
Once you have your list, get started on the short-term goals, things you can tackle right away. Keep in mind that you should strive to make some progress each day or week toward your intermediate and long-term goals as well. This can take the form of gathering information, checking out websites, filling out applications, taking a class, and so on. Remember that your list of goals is only a guideline. Nothing is written in stone. Keep it flexible and always consider it a work in progress. Once you achieve a goal, take time to acknowledge your achievement. Give yourself the credit you deserve.
While you are pursuing your goals, and especially when you reach milestones in your sobriety (first year of sobriety, for example), take a moment to reflect how much differently you feel now than at the beginning of your recovery. Each small step you take toward the future means that much more progress that you have made. Your overall outlook will change as well. You will look forward to each day as a new opportunity to make a difference.
During this time, if not before, you may have been able to repair your relationship with your loved ones. If they have not forgiven you, they may have at least accepted your sincere expression of wanting to make amends. You will find that you will be able to move on. To do this most effectively, you need to be able to forgive yourself. Forgiveness from others, including your loved ones, has more of a chance.
There is an old expression, When one door closes, another opens. This is true in recovery from addiction as well. Open your heart to be able to receive love, as well as give it.
Source: www.drugaddictiontreatment.com
5 Myths about Drug Addiction and Substance Abuse
MYTH 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to. Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.
MYTH 2: Addiction is a disease; there’s nothing you can do about it. Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments.
MYTH 3: Addicts have to hit rock bottom before they can get better. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost it all.
MYTH 4: You can’t force someone into treatment. They have to want help. Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.
MYTH 5: Treatment didn’t work before, so there’s no point trying again. Some cases are hopeless. Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.
Buprenorphine & Opiate Addiction
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.
Abuses Are Found in Online Sales of Medication
A large majority of 365 Internet sites that advertise or sell controlled medications by mail are offering to supply the drugs without a proper prescription, according to a new study. The online trade is stoking the rising abuse of addictive and dangerous prescription drugs, the authors and federal officials say.
Drugs offered online include generic versions of opiates like OxyContin, methadone and Vicodin, which are legitimately prescribed as painkillers; benzodiazepines like Xanax and Valium, which are prescribed for anxiety; and stimulants like Ritalin.
Federal and state efforts to crack down on Internet sales appear to have reduced the number of sites offering such drugs, from 581 last year, said Joseph A. Califano Jr., director of the National Center on Addiction and Substance Abuse at Columbia University.
“Nevertheless, anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse,” Mr. Califano said. The center is issuing the study, the latest of five annual surveys, on Wednesday.
The Drug Enforcement Administration found that 85 percent of all Internet prescription sales involved controlled drugs, compared with just 11 percent of those filled through regular pharmacies, suggesting that online sales often are destined for misuse.
“Abuse of prescription drugs has exploded among college students, and we think that one way they get these drugs is over the Internet,” Mr. Califano said. The use of prescription opioids and anxiety drugs, especially in combination, accounts for a growing share of deadly overdoses nationwide.
“The Internet made it easy for the drug dealers to sneak into your living room,” said Francine Haight of La Mesa, Calif, whose son Ryan died in 2001 at the age of 18 from an overdose of hydrocodone, generic Vicodin, which he had secretly ordered online with a debit card. An A-student and varsity tennis player, he had claimed in an online questionnaire to be a 25-year-old with back pain, got his prescription and was mailed the drug. Ms. Haight, a registered nurse, has since fought against online sales.
Federal law bars dispensing dangerous medications without a prescription from a doctor who has a bona fide relationship with the patient. But officials have had a hard time catching up to rogue Internet pharmacies that sometimes ship the drugs from foreign countries in disguised packages.
For the last several years, the Drug Enforcement Administration and others have worked to halt the illegal trade and prosecute involved doctors and suppliers, with limited success.
“One of the main problems is that the sites can literally open up for a week, close and open up under a different name,” said Michael Sanders, a spokesman for the Drug Enforcement Administration.
In a more recent practice, the new study found, some sites sell written prescriptions that can then be used at local pharmacies.
Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. Of these, 206 were advertising sites, directing consumers to a seller. Of the 159 sites that directly sold controlled drugs, 135, or 85 percent, did not require a prescription or provided them on the basis of online questionnaires.
In an effort to make their surveys consistent, in each of the last five years the researchers have spent the same amount of time searching, 210 hours, for the same list of drugs. The number of sites rose to 581 in 2007, then fell to 365 this year. The study will be available online on Wednesday at www.casacolumbia.org.
In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act, which would require certification of online pharmacies and that doctors see patients before prescribing controlled drugs. The bill is now in committee in the House.
At least eight states have passed laws barring electronic prescribing or sales without a legitimate prescription. Minnesota passed a law in 2007 requiring doctor-patient consultations but found that “the Web sites went around us, doing 30-second consultations on the phone,” said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug poisoning in 2006, aged 24, after obtaining large quantities of hydrocodone and Xanax from 17 online pharmacies. The law was strengthened this year to require face-to-face consultations.
“Anyone can have these drugs at their door within 48 hours,” usually using a credit or debit card to pay for an online prescription and then a money order to pay for express delivery, C.O.D., Mr. Pearson said.
Federal drug authorities have begun working with credit card companies and banks to try to prevent such transactions, while major Internet search engines have used a verification program called Pharmacy Checker to confirm that advertisers are legitimate. But the system appears to be full of holes, critics say.
Mr. Califano sent letters this week to senior officials of Google, Yahoo and MSN asserting that they were “profiting from advertisements for illegal sales of controlled prescription drugs online,” and calling for stronger action.
Diana Adair, a spokeswoman for Google, said the company took the problem seriously and in addition to using Pharmacy Checker, had consulted with federal agencies on ways to stem the trade. Kelley Benender, a spokeswoman for Yahoo, said the company was “working to identify the illegal sites and will take appropriate action.”
A spokesman from MSN said the company had no comment.
By ERIK ECKHOLM from The New York Times
Cancer Diagnosis can Threaten Sobriety
Recovery from alcoholism and other drug addiction often calls for breaking through layers of denial and shame. But people who face the task of recovery along with a diagnosis of cancer deal with an immediate threat to their sobriety.
“When people hear the word ‘cancer,’ there’s kind of an assumption that it’s a death sentence,” says Dr. Marvin Seppala, chief medical officer for the Hazelden Foundation. “That’s not the case, since so many cancers are treatable nowadays. Yet there’s still a chance that people in the midst of addiction treatment might say to themselves: ‘Why bother to get clean and sober? I’m not going to go through with it because I’ve got cancer.’ ”
Studies suggest that rates of substance abuse in people with cancer are lower than in the general population. However, these figures are difficult to interpret. They could simply mean that people in cancer treatment routinely hide their problems with alcohol and other drugs.
Secrecy is just one problem. “If you’re in the midst of an active addiction, you’ll also be undermining any kind of healing process related to cancer,” Seppala says. “And there’s always the question of whether some of the addictive drugs will interfere with medications used to treat cancer.”
In addition, a record of substance abuse can strain the human relationships that underlie cancer treatment. If doctors and nurses suspect that their cancer patients are lying about drug use, they may doubt anything that these patients say about their health.
People with cancer might sense this mistrust, doubt the goodwill of their health care team, and decide not to follow through with their cancer treatments. When this happens, prescriptions go unfilled, medical appointments are missed, and people with cancer can get sicker or die earlier.
A report on substance abuse issues from the National Cancer Institute underscores these problems. It also suggests ways to help people face cancer and abstain from alcohol and illicit drugs at the same time:
Gather facts without judgment. When taking a health history, doctors and nurses sometimes avoid questions about alcohol and other drug use. They may feel awkward about raising the issue, or simply assume that they’ll never get honest answers. This assumption undermines cancer treatment. When health professionals ask about drug use with a non-judgmental attitude, people with cancer are more likely to speak candidly.
Involve a multidisciplinary health care team. Treatment for people with cancer and addiction should involve specialists in mental health and addiction medicine. Many people with a history of substance abuse–including those with cancer–also struggle with anxiety, depression, or personality disorders.
Treat pain with an accurate understanding of addiction. People can become physically dependent on opioid drugs such as codeine and oxycodone (OxyContin) that are used to treat cancer pain. This means that withdrawal symptoms will occur if the drugs are suddenly stopped. In this context, however, physical dependence and addiction are not the same. Addiction refers to the compulsive use of drugs for reasons other than pain control. Careful treatment planning can relieve withdrawal without triggering such use.
Current treatments also offer many options for treating cancer pain without drugs. Examples are acupuncture, acupressure, biofeedback, chiropractic treatment, osteopathic medicine, massage therapy, and meditation.
Set realistic treatment goals. There’s a saying among members of Alcoholics Anonymous: “Getting clean and sober is simple–just change everything about your life and do it now.” This slogan reminds us that recovery from addiction requires a transformation in thinking and behavior, which calls for decades of sustained effort. The risk of relapse is high, especially with the added stress of a cancer diagnosis.
Cancer specialists need to be realistic about this fact. Treatment planning for people in recovery should set up a structure for preventing relapse–and dealing with it openly if it does occur.
For more on this topic, visit the National Cancer Institute Web site at http://www.cancer.gov/ and click on “Cancer Topics” and “Coping with Cancer.”
Source: Hazelden
Dual Diagnosis What Is It & How It Affects Us
A dual diagnosis is when a person has been diagnosed with two or “dual” conditions: an alcohol, drug or other substance addiction coupled with a mental health disorder. Many patients that are in addiction treatment are found to have a dual diagnosis. Of the two million people in the United States that suffer from mental illness, about 50% of them also are an alcohol, drug or other type of substance abuser. For an alcoholic, whether they have a dual diagnosis or not, they need to enter an alcohol addiction treatment program. For others that have substance abuse and addiction, a dual diagnosis, addiction treatment is not only warranted but desperately needed. Not every addiction treatment center is equipped to help this illness. It’s vitally important that a center with professional staff prepared to work with patients with a dual diagnosis is chosen.
Probably the most challenging area for health care providers is diagnosing patients who truly have a dual diagnosis. The reason a dual diagnosis is so difficult to determine is because more cases than not, a mental illness is coupled with a substance abuse and addiction situation. It is for this reason that many of these patients are placed in addiction treatment homes or centers only to discover that they are in fact dealing with a dual diagnosis. The problem is that substance dependence can masquerade as a psychiatric disorder, so many times the mental illness is not discovered or revealed until much later than at the initial evaluation.
It can be a very difficult situation to identify a patient with dual diagnosis. Most times they are in denial about their substance abuse so when the addiction is discovered, they overlook the fact that the mental illness is still exacerbating the substance problem and vice-versa. Therefore only one of the two issues is identified. And with teens it is even more difficult. With kids going through puberty and all of the emotional fluctuations that accompany that, how can you be sure that this young man or woman are actually suffering from a bi-polar disorder or even depression? For that very reason it is imperative that when seeking an addiction treatment center you find one that has an acute awareness of this dual disease. It is only then that you can truly have hope for a full recovery.
by Groshan Fabiola
Drug Detox
If you are struggling with drug addiction at some point you will need to visit or check into a drug detox center. This time comes when you are ready to stop your drug use and/or your alcohol use. Detox treatment can be fairly expensive, therefore it makes sense to go through withdrawal only when you truly have a desire to stop using drugs.
Every addict hits rock bottom but at some point they realize that the addiction is causing the life problems. An addict will not want to give up their addictions so easily- but this is a classic point of surrender and this is your cue to step into recovery. Unfortunately the addict will always have a desire to use and this is the battle of recovery. As long as there is a want to be sober you are a candidate for sobriety.
The people in a drug detox facility are going to welcome you and treat you with respect. It is very rare for a staff person in a treatment center to treat a client with disrespect. Most staff members have been there in the same place you are at now, in fact, so they know what you are going through.
It is the first step to recovery
