Proud MAT Mom

wrestling

My youngest son is a wrestler – athletically and intellectually. Wrestling didn’t come easy to him, but he simply loved the sport and being part of the school team. At first I would watch his matches with my hands covering my eyes just peeking through my fingers and praying he wouldn’t get hurt. It was a foreign sport to me, but I made it to as many wrestling matches as possible and began tagging Facebook photos with the hashtag #ProudMatMom. He became a better wrestler and I became a more comfortable spectator and supporter of his choice to wrestle.

When he started wrestling in sixth grade in 2011-2012, his older brother (affectionately known in many of my blog posts as #SoberSon), was struggling with addiction and losing the battle. Little did I know that in July 2014 #SoberSon would eventually find his sobriety on a “mat” of his own: Medication Assisted Treatment (MAT)*.

Today, #ProudMATMom has double meaning and I am an avid proponent of MAT as a viable, preferred – and even necessary – treatment for opioid-use disorder.

 Finding a Solution

Not unlike his younger brother, #SoberSon got pinned and lost quite a few matches before experiencing a “win” and committing himself to ongoing training.  After trying several different treatment approaches, and experiencing relapse, #SoberSon through his own anecdotal research came to the conclusion that he wanted to try Suboxone, a form of Medication-Assisted Treatment. He had some other criteria, too: not 12 step and not in-patient.

That trifecta proved a difficult find. Ironically, the option that we found was one I’d never encountered in the years leading up to this and it was within a few miles of our home. Imagine that! Sometimes the solutions are so close, but we don’t even realize it.

Suboxone (Buprenorphine combined with Naloxone)

Gloria Englund, MA, a recovery coach and author of Living in the Wake of Addiction – Lessons for Courageous Caregiving, defines Suboxone as follows:

Suboxone is a partial agonist because it doesn’t bind to the opioid sites as does a full agonist so it produces much fewer endorphins. Because of its “partial” nature, it is much easier to withdraw from than a full agonist like methadone. Suboxone is the commercial name for buprenorphine (partial agonist) combined with naloxone, an opioid antagonist which is very effective at blocking euphoria when combined with the buprenorphine. Used alone, naloxone (Narcan®) is very effective in reversing opioid overdose if administered in a timely manner. Suboxone is also available as a film which is dissolved under the tongue thereby lessening the potential for abuse even more. In May 2016 the FDA approved a buprenorphine body implant that will dispense medication for up to 6 months but has not stated when in will be available for use.”

Note to readers: I’m excited to share an upcoming blog by Gloria on MAT and also an interview with her about her book, which is a must-read for parents.

Be Open-minded to Treatment Options

For my son, Suboxone has provided the stability he needed to focus on his recovery. He tried Naltrexone (also available as Vivitrol) during an in-patient treatment program but didn’t find relief; he was still craving opiates, which meant his head was anywhere but the treatment group. All he could think about was getting out so he could get his fix. He was just passing time, counting days, and was convinced he could moderate his use upon discharge.

Of course, he couldn’t and he returned to use within a few months of completing in-patient treatment. He was overwhelmed with freedom, a poor-fit after-care plan and insufficient means through employment, housing, and support. He wasn’t interested in coming home and we weren’t sure we were ready either. It was an awkward, difficult time of transition that went the wrong direction quickly.

From Relapse to Recovery

That relapse and its devastating demise unified our family and son’s friends. Together, we conveyed our concern for his well-being and voiced our very real fear that he was going to die soon.

He said, “Thanks but no thanks” to returning to treatment.

He wasn’t ready to stop using, but with hindsight, he was shifting from needing to stop to wanting to stop, and he learned that Suboxone might just be the best way for him to treat his opioid-use disorder.

Suboxone accomplishes three things for my son: 1) It takes away withdrawal symptoms; 2) It eliminates cravings; and 3) It makes it impossible to get high (for at least 48 hours) if he were to use an opiate. This combination provides incredible stability as he actively works an integrated treatment plan.

Right away, he enrolled in a high-intensity out-patient (HIOP) treatment program offered by the MAT clinic. In addition, he met one-on-one with a counselor. He has progressed from dosing daily at the clinic to picking up a week’s supply at a time. He passes all of the random, monthly UAs and sees his counselor regularly. More importantly, his self-confidence and self-esteem is returning: He got a job within a few months of starting Suboxone and has held it ever since, and he enrolled in college courses and has gotten straight A’s.

Stigma from Unexpected Sources

Unfortunately, like many aspects of addiction, Suboxone users, proponents and supporters encounter stigma. Interestingly, the stigma – from my perspective – comes from the broader recovery community and not from the general public.

These folks (certainly not everyone) seem to feel that recovery must not include medication assistance – they say it’s trading one drug for another, that it’s just another form of addiction.

This simply isn’t true as my son and many others will attest.

More encouraging, however, is the open-mindedness that friends, family and the general public seems to take regarding Suboxone, and perhaps more so with the news that Prince was about to start using Suboxone. They are amazed to learn that such an option exists. They see it as comparable to taking an anti-depressant or anti-anxiety medication to treat those brain disorders. They see it as taking insulin for diabetes, as taking cholesterol-lowering medication … they see medication as a form of treatment for a chronic disease. In this case, the chronic disease is a brain disorder known clinically as substance-use disorder or opiate-use disorder, or more familiarly as addiction (which takes us down a whole other rabbit hole of lexicon vs stigma).

Like any medication – prescribed, over the counter, or illegal street drug – Suboxone can be abused, it can be used to get high, and it can be sold on the street. UNLESS, it’s being used with integrity as prescribed and under the care and guidance of a physician who specializes in opiate addiction. AND, when it’s used in conjunction with other treatment protocols – group, individualized therapy, mental health, support, etc.

Future Plans

We’re fairly new to Suboxone – just two years in July 2016 – but the benefits are amazing. I understand that some physicians and people believe in life-long maintenance; others believe it’s possible to taper off Suboxone, slowly and with full support.

My son’s clinic believes in an individualized approach to MAT offering a general guideline that it takes 18 to 24 months for a person to stabilize (their life) using Suboxone in conjunction with ongoing counseling services. My son would like to taper off, very slowly, at some point. Our family will support him in that decision and remain open minded to the possibilities that it brings.

But, as he says, “Why mess with what’s working?” I wholeheartedly agree.

With MAT, Suboxone in particular, our family is no longer wrestling with opioid addiction and that makes me a very, very #ProudMATMom.

*Medication-Assisted Treatment (MAT): This is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating substance-use disorders, a combination of medication and behavioral therapies is most successful

Midwestern Mama

©2016 Our Young Addicts            All Rights Reserved

Guest Blog: A Foundation for the Future by Bill Rummler

This week’s guest blogger is Bill Rummler from the Steve Rummler Hope Foundation. In this poignant blog post, he share’s his son’s story of pain, addiction and death, and the efforts of the Foundation to prevent future opioid-overdose deaths.

Lexi Reed Holtum, vice president of the Steve Rummler Hope Foundation, with high school sweetheart and fiance Steve Rummer, September 2010
Lexi Reed Holtum, vice president of the Steve Rummler Hope Foundation, with high school sweetheart and fiance Steve Rummer, September 2010

Our son Steve Rummler was one of the more than 16,000 people who died from prescription drug overdoses in 2011. He died on July 1 of that year at the age of 43 and we miss him more than you can ever know.

Steve was a very intelligent and highly talented person. He was a deans list college student. He was a competitive athlete, an all-conference soccer player and division-one college prospect. He was a gifted piano, guitar and drum player who wrote many beautiful songs. He was an astute businessman and a top financial advisor in the Twin Cities.

All who knew Steve respected and loved him. He was very caring, loved being with people and was engaged to be married to Lexi, his high school sweetheart. He was in many ways the all around success story that every parent hopes their child will become. He was living the American dream and we were very proud of him.

In 1996, at the age of 28, Steve suffered a severe injury to his spine, which began his tragic story. He sought medical advice from the top doctors in Minnesota and they were never able to find what caused the shock like symptoms that surged up and down his spine every single day. The pain was especially severe at night and he suffered from lack of sleep for the rest of his life. Steve continued to work hard and play music and sports. He even ran a marathon in under four hours. He was able to be quite active during the day, but the nights were intolerable.

The pain and lack of a medical diagnosis caused Steve to become depressed. So, he was prescribed anti-depressants, which were supposed to help his depression and his pain.

He soon began to like the idea of getting help from a pill. This was a major fork in the road of his life. He had chosen pills, rather than other healthier alternatives.

The pain continued and he was then prescribed anti-anxiety medications known as benzodiazepines.

Finally, in 2005, when Steve was 37 years old, he was prescribed opioids by our family doctor. This doctor was well intentioned, but unaware of the potential side effects of these highly addictive pills.

The FDA was calling them safe and effective for treatment of long-term pain. And the pill manufacturers were making huge profits as a result.

This was the beginning of Steve’s end of life struggle. He soon began to show many of the signs of addiction, which included taking more pills than were prescribed to him in order to maintain his high and seemingly “treat” his pain. He had become totally convinced that these heroin-like pills were the only way to solve his pain problem. After he died we found a note in his handwriting: “at first it was a lifeline, now it is a noose around my neck”.

Addiction is a disease of the brain, the most valuable asset we have for dealing with life’s challenges. But, when something adversely affects our brain, it can severely limit our ability to make good choices. Taking a narcotic did not eliminate the cause of Steve’s pain; it simply made him less aware of it. His brain became numb to the pain just as it became numb to most things that matter in life.

We sadly saw this begin to unfold with Steve. Not long after he began taking opioids, we began to notice serious side effects. He lost his enthusiasm for most things in life. He often seemed out of it and would sometimes slur his words. He became less sharp in business and began losing clients. He became more irritable and blamed others for his problems. He stopped paying his taxes on time and was less punctual. He spent most his waking hours sedentary on the couch, stayed up late, slept in late and rarely exercised. He was often sick and would go for days without returning our phone calls. Always honest, he began to lie.  And the pain was still there and likely even worse. So he wanted more opioids. Steve was very sick with an addiction to the very pills that were supposed to help him.

We could see this tragic scenario unfolding, but were powerless to help. Steve had to help himself.

But the drugs numbed his brain and made him unable to do so. We begged and pleaded with him to try any alternative for help with his pain. It was heart wrenching for us.

We thought we had been good parents and now all was unraveling before our very eyes.

It is difficult for anyone to take a single opioid pill without it having some effect on that person’s mind. These drugs are basically a form of heroin that can produce a high that is very difficult to resist. Steve used prescription opioids for over five years, in ever increasing amounts.  In reality, he likely became addicted to them within the first few months.

While opioids are very risky and can lead to death when used to treat chronic pain, they do have a benefit for acute and end of life pain.

In 1995 my sister Peggy was dying from pancreatic cancer and in great pain. Her morphine pump worked wonders for her. She was in a constant state of euphoria from the drugs, but her pain was tolerable until the end. Sadly, Steve became addicted to those very drugs that were so helpful to his Aunt Peggy. For him, with chronic pain, it was a death sentence.

The tragedy of Steve’s untimely death and our resulting grief, have motivated us to work very hard to prevent others from suffering as he did.

The Steve Rummler Hope Foundation (SRHF) was born out of Steve’s death. Its mission is “to heighten awareness of the dilemma of chronic pain and the disease of addiction and to improve the associated care process”. Through its Overdose Prevention and Prescriber Education programs, and through its Advocacy efforts, SRHF saves lives, educates healthcare professionals, and engages the public as well as public-policy-makers in addressing the epidemic of opioid addiction and overdose deaths. (Opioids include narcotic painkillers and heroin). This public health crisis has been labeled an “epidemic” by the Centers for Disease Control and Prevention (CDC).

There is much that needs to be done to help pain patients avoid the risks of addiction and bring this epidemic under control. Our emphasis has been to focus first on the areas in which we can have the greatest immediate impact: stopping overdose deaths and educating physicians about the responsible prescribing of opioids.

At its inception in 2011, SRHF founders explored the nonprofit environment for organizations focused on providing hope for those with chronic pain and addiction. They found that there was a need for this focus and were encouraged to fill the gap. To date, this uniqueness has led to many opportunities for success and many demands from the community for us to do more.

We encourage you to get to know more about the SRHF. Please visit our website at:

http://www.steverummlerhopefoundation.org/

Here you can learn about Steve’s Law, a Minnesota good-Samaritan and Naloxone law, named for our son Steve. The implementation of this law (similar laws are in effect in many other states) has already saved, and will continue to save, many lives. Our website has a wealth of other information, too.

Please consider making a donation to help us continue our life saving work. Anything you can give will be very much appreciated.

Finally, we encourage you to tell others about us and join us in our effort to change and save lives.

Thank you for your interest.

Thank you, Bill, for sharing your story with the #OYACommunity. We are grateful for your efforts and accomplishment on behalf of families and friends who are concerned about substance use and addiction.

©2015 Our Young Addicts            All Rights Reserved