Medication-Assisted Treatment: A Solution to the Statistics?

A three-part series by Guest Blogger Gloria Englund, MA. New Protocols, Addiction as a Progressive Brain Disease.

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Part II

Old-school Perception & Protocol – the 1990s

My history with MAT goes back to the 1990s when most people considered substance use disorders a character flaw, and/or lack of will power and motivation. Although the American Medical Association (AMA) recognized alcoholism as disease in 1956 which allowed it to be viewed as a diagnosable condition for which insurance reimbursement was possible, most treatment focused on it being a psychological/behavior disorder. This was the treatment protocol I learned in graduate school in the early ‘90s.

Addiction Recognized as a Progressive Brain Disease

Aaron died in 2007.  It wasn’t until 2011 that The American Society of Addiction Medicine (ASAM) first stated that addiction is a progressive brain disease that is fatal without intervention.

This meant both of us went through our 20-year struggle with his SUD without knowledge of addiction being a brain disease – as I suspect many have. It was a wake-up call for me to learn that this illness is about underlying neurology, not outward actions.

The NIDA soon after stated that addiction is “a chronic relapsing …brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”  It was so hard for me to grasp that my son’s was ill not only with a physical dependence – but also a psychological compulsion that would create drug seeking behavior no matter what the consequences.

Abraham Maslow’s Hierarchy of Needs is a theory of psychological health predicated on fulfilling innate human needs in a specific priority. Physiological needs such breathing, food and water are at the bottom the hierarchy. In other words – a human’s first priority is sustaining life. The hierarchy culminates in self-actualization at the top. The compulsion that is characteristic of SUD precludes those basic physiological needs.

This is why many need MAT to get their cravings quelled. If the cravings aren’t under control, they can’t even think about meeting those basic needs of life – so they can go on to recovering their life.

Tapering Off or Long-term Maintenance?

In 2007, most people on MAT methadone programs were encouraged to start tapering off the medication once they had been stabilized for weeks or a few months. The yo-yo effect of trying to taper and failing to find the correct dosage created constant turmoil for Aaron as well as frequent relapses. At that time, both of us attended recovery support groups which promoted that if you were on medication-assisted treatment you weren’t really in recovery because you were still using an opioid medication. And this continues to happen today.

Very few supportive services were offered along with Aaron’s MAT program – which I now know is very important to recovery. You can’t just take a pill or get an injection and recover from this illness. Although behavior and psychological issues may not be a CAUSE of this illness, they do result as we try to SURVIVE the illness.

That’s why MAT needs to be offered along with individual or group therapy, peer recovery support groups, classes on exercise, nutrition – basic life skills – keeping a budget and learning how to seek employment.

Minnesota Recovery Connection, like many other recovery community organizations (RCO) in other states – offer many of these resources on their website and support all pathways to recovery.

Note to readers: Part III will run on Thursday, June 30. We will post the full three-part series in our Resource section.

About our Guest Blogger: Gloria Englund, founder of Recovering u breaks new ground in the field of addiction recovery and support. As an ally of the recovery community, she honors all pathways of recovery. She is a psychotherapist, who holds a Master of Arts degree in Human Development. As a certified Recovery Coach, she works with individuals and families dealing with an addiction to alcohol, drugs, food, and relationships. Gloria has personal as well as professional knowledge of addiction and recovery; her oldest son, Aaron, died of a heroin overdose in 2007. As an accomplished public speaker, advocate and published author, Gloria brings a message of hope and recovery to others.

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

When You’re Concerned About Your Kid’s Drug And Alcohol Use

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Guest blogger Rose Lockinger gets right to the heart of things with her take on what parents can do when they become concerned about a kid’s substance use. Thanks for sharing your insights. MWM

There are so many things we worry about as parents. We worry about them getting hurt or sick. We worry about accidents, we worry about their future, about their choices and we worry about them when they are sad and scared. As they get older we worry more, not less. They grow up a little and our hold on them has to loosen as they rely more on their friends for company and start to spread their wings.

One of the top concerns for parents of teens today is substance use and abuse. There are other things, of course. Bullying, gun violence, car accidents. But drugs and alcohol are a pervasive issue that teens face every single day, and often times, many of the other concerns parents have seems to go along with drug and alcohol use.

Do All Kids Experiment?

Not all do, but it’s common enough. While it doesn’t always result in negative consequences, it does warrant close scrutiny. Kids are impulsive and tend to think they are invincible. This creates problems when they get caught up in substance abuse. Most people who become addicted start using in their teens. The earlier drug or alcohol use starts, the greater the chances that the problem will turn into addiction.

What Are Signs That Your Child Has a Problem?

So as a parent what do you need to look for when you suspect that your child is using.  Sometimes it’s hard to tell the difference between just being a teenager and possible substance use.

Here’s a list of 6 main things to look for:

  • Changes in physical appearance
  • Extreme changes in emotions
  • Changes in academic performance and attendance
  • Always in search of money and not able to explain where it’s going
  • Significant changes in mood and personality
  • Missing prescription drugs and alcohol around the house
  • A lack of concern in their appearance and personal care.

These are some common ones to start with, although you may run into others that are specific to your individual situation.

What Do You When It’s A Problem?

If you suspect that your teen is struggling with substance abuse, it’s important to address the matter right away.

Things can escalate quickly, and it’s important that you let your teen know you are aware of the behavior.

Because the situation is scary, it’s easy to come from a place of fear and even anger. It’s important to encourage honest and open communication.

 

One of your first steps may be to bring your child to your family doctor so that he or she can be screened for substance abuse disorder and any other issues that may be present.

Substance abuse often goes hand in hand with things like depression, anxiety or trauma, so it’s important that they be screened for these things as well.

It’s Never Too Early For Professional Help

If you’ve addressed the issue through communication, education, a professional evaluation and firm boundaries and consequences and the problem is persisting, it’s time to take the next step. It may be that your teen needs to get help via an adolescent rehab.

 

Teen rehab programs can provide a safe place to recover from substance abuse disorder. Getting away from using friends is helpful, and while they are in rehab they will learn more about addiction and the dangers of substance abuse, they will receive individual counseling to help identify and deal with any underlying issues and they will learn new coping skills that will help them deal with difficult emotions without turning to drugs or alcohol to cope. This is important, because the adolescent years are full of challenges and powerful feelings. Learning how to deal with them in a healthy way can help them make better decisions when things come up.

 

It may feel like you are jumping the gun a bit to put your teen in rehab, but the earlier they get help, the better. Teens and drugs and alcohol are a dangerous mix. Substance use disorder progresses and will only get worse if left unchecked.

 

This is never an easy situation. You’ll feel like it is an uphill battle, and your teen will fight you at every turn. It’s important that the family present a united front and a consistent message for your child so they know that everyone is on the same page.

Remember, your teen is frightened. For the person with substance abuse disorder, the idea of losing their drugs or alcohol is scary. They feel like they have to have it in order to live on a daily basis. Anyone who stands in their way is a threat and possibly an enemy, no matter how much they love them.

 

While some level of confrontation is necessary in order to bring the problem into the open and start the process of getting help, over-the-top, harsh interventions are not only ineffective but can do more damage.

Supporting Your Teen Through Recovery

If you have decided to take the next step in helping your child recover, the most important thing you can do is to continue loving and supporting them. Teens are often consumed with feelings of guilt and shame as a result of using drugs and alcohol as well as their behaviors. It may not look like it from the outside, but on the inside they are hurting. Reassuring them that you aren’t judging them and that you are only getting them the help that they need is crucial.

About Our Guest Blogger:

unnamedRose Lockinger is passionate member of the recovery community. A rebel who found her cause, she uses blogging and social media to raise the awareness about the disease of addiction. She has visited all over North and South America. Single mom to two beautiful children she has learned parenting is without a doubt the most rewarding job in the world. Currently the Outreach Director at Stodzy Internet Marketing.

Find our guest blogger, Rose Lockinger, on LinkedIn, Facebook, & Instagram

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

 

 

Holiday Treatment

If your loved one is in treatment this season, read about some of the ways we found joy and check out some of our archived blog posts. December 2013, my son decided to go to treatment. Although he was bummed about “missing the holidays,” it was the best decision he could have made and it turned out to be one of our best-ever Christmases. Perhaps, this will help you have a happier experience as well. MWM

Our drive to treatment took place during a blizzard. My son slept and I white-knuckled the slippery roadways. Although he’d been to other treatment programs, this was the first time he made most of the arrangements. He wasn’t excited about it, but he accepted that it was what he needed to do.

That alone was a present, a holiday miracle. I encourage you to recognize the generosity of your loved one’s decision to go to treatment.

In our initial phone calls and contact with our son, he said things were OK but that he was bored and that time passed very slowly. He complained that the group had to put up Christmas decorations, and that it was a stupid, pointless way to spend time.

Although I could understand his frustration and although I felt he was being unfair with his attitude, I just let it go. Instead, I looked forward to our upcoming visit and seeing the decorations.

Just the other day, I had a meeting at a local treatment program (not the one my son attended), and program participants were in the process of putting up Christmas decorations. They were jovial and seeming to enjoy the experience. It made me think of my son’s experience, and my hunch is that he enjoyed it more than he let on.

That brings me to my next piece of wisdom. Don’t let your loved one make you think it’s so miserable. It just takes time for them to get in the swing of treatment and to find hope (if not immediate happiness) in the positive changes underway. That’s not to say it’s all fun and games; treatment is hard work and emotionally draining. Know in your heart that they are in the right place, doing exactly what they need to be doing. That is a true gift.

During our weekly family visits, I brought commercially prepared treats (homemade wasn’t allowed) and lots of games – board games, cards, dominoes, etc. My son wasn’t ready to be conversational, so playing games was an easier way to connect and share our support. Other residents joined in, too.

My son truly likes our holiday treats – fudge, peanut butter balls, frosted sugar cookies – so I made extra and put these in a decorated tin in the freezer so that he could enjoy these when he completed treatment. He very much appreciated that!

Christmas Eve and Christmas Day fell outside of normal family visiting days, so the treatment center designated a special time. It was on Christmas Day from  1 to 3 p.m., if I remember. I had hoped to bring a deep-dish pizza, but our son’s favorite place was closed on Christmas Day. Instead, I brought a variety of snack items (chips, pretzels, crackers) and individual containers of ice cream – a treat he was really missing.

Keep in mind that treatment food gets boring and is very basic. Working within the Center’s guidelines, we were able to bring special treats.

Again, on Christmas Day, we brought games and had family rounds of all sorts of favorites including the card game UNO. None of us missed the “usual” gathering at Grandma’s that year because we were so glad to be with our son who was sober and starting recovery. (Now, the next year … and this year … well, we are blessed to return to our favorite traditions at home. )

We will never forget the year my son spent Christmas at treatment!

Midwestern Mama

©2015 Our Young Addicts            All Rights Reserved.

 

 

 

 

 

 

 

 

 

Guest Blog: Impact of Exercise in Addiction Recovery for Youth

This week’s guest blogger is Fiona Parascandalo of DUO, an Ontario addiction-recovery program focused on youth and the healing value of exercise. For young adults,  in particular, exercise is a key component to recovery. Learn why and how. MWM. #OYACommunity

Exercise is something that is often touted as making people happier and reducing stress, but less commonly discussed is the how the benefits of exercise can be used in the addiction recovery process. Youth especially have a lot to gain by incorporating exercise into their treatment or counseling. Exercise allows youth to take control of their journey towards to recovery, exercise also has significant impacts on the brain in there critical stage of development, and exercise is an easy practice to build into a daily routine.

  1. Exercise promotes active engagement with recovery: It is important for youth to feel in control of their recovery process and be given the opportunity to see the outcomes of their daily choices. In many treatment programs, youth are treated as passive participants and removed from making choices about their recovery or long term treatment plans. This can be damaging to the development of self-identity in a crucial stage of transitioning into adulthood. When youth engage in an exercise program as a focal point of recovery, they are the centre of the recovery process and their physical effort has direct ties to their recovery.

The purpose of exercise is to revitalize and develop the body, mind, and spirit. Initiating a fitness regime at any stage of recovery involves making a change to addiction driven behaviours and engaging in new, mindful behaviors. Exercise is an opportunity to tune out stimulus and cravings, and focus on natural sensations in the body.

As youth are developing into themselves and defining who they are as individuals, exercise provides a means to discover the underlying catalysts of addictive behaviors so that addiction does not become a lifelong issue.

  1.  Exercise stimulates the same areas of the brain as addictive substances: Addiction is created in the brain by the addictive substance (i.e. cocaine, methamphetamines) or behaviour (i.e. sex, video games) continuously stimulating the brain’s reward centre. New pathways are created and the user begins to crave the substance that caused the over stimulation of their reward centre. For youth, this is an especially dangerous neurological dependence as their brains are at an important stage of development.

In terms of brain development, late teen and early adult years mark the time when the prefrontal cortex, involved in the control of impulses and decision-making, is maturing. Involvement in substance abuse can delay or damage this development causing lifelong struggles with reckless and irrational behaviour.

In addition to creating new pathways in the brain, establishing a regular exercise regime as part of a stringent recovery process has been shown to reduce cravings and build resistance to triggers.

This allows the youth to take control of their reliance on a substance or addictive behaviour and engage in an activity that will positively affect their future neurological development as well as overall health.

  1. Exercise can be incorporated into a daily routine: For treatment to have a lasting effect it should be easily integrated into daily life and the practices learned should be simple to recall when facing a trigger. Establishing a daily routine will allow for a disciplined approach to facing triggers that can be utilized anywhere and at any time.

For example, if first thing in the morning is when you typically have your first cigarette, switch this behaviour with a morning run or simple body-weight workout; if after school you typically use with your friends, switch this with an after school team practice or start a regular football game with your friends. While this is a simplified explanation of how exercise can be leaned on when facing triggers or cravings, it does highlight the fact that exercise is a tool that can be used by anyone to assist in the recovery process. As part of a controlled and monitored recovery process small behavioural changes can have lasting impacts.

For teens and young adults the ease of integrating exercise into their daily routines is essential to its impact on their addiction. Between the ages of 15-24 daily activities and commitments are continuously changing, and addiction can be used as a coping mechanism to deal with these changes or as a way to escape the burden of increasing stressors.

Exercise is an affordable and customizable tool that has the capability to replace the feelings of relief and escape caused by substances. Chemicals released in the brain while exercising, endorphins and serotonin, reduce stress and increase happiness.

When facing stressful or overwhelming situations, individuals in recovery can learn to rely on exercise rather than abusing a substance to improve their mood and cope with the situation. Youth have the most to gain from engaging in an exercise focused recovery program as they will learn lifelong skills that can be easily integrated into their busy schedules.

Fiona Parascandelo

DUOaddictionfj@outlook.com

www.duoaddictionsupport.ca

©2015 Our Young Addicts            All Rights Reserved.