A Sibling Says it Like No One Else Can: Doing Drugs is Helping No One

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A special, sincere and personal thanks to this week’s guest blogger and his mom, who granted me permission to share his recent Facebook post and her response with the OYA Community. Brandon’s older brother Devin overdosed and died earlier this year; he was a friend of my son’s and their family often provided refuge for him during addiction. Today, Brandon is sharing a heartfelt and courageous plea for siblings. Thank you, Brandon and Mom. You write the truth.

A Sibling’s Post & Plea

Me and Devin used to be best friends when I was young. He would take me everywhere and show me everything. He was there for me always.

Then the drugs took over and we distanced. He either got away from me so I wouldn’t have to see him like that. Or I distanced myself from him because I didn’t want to see him like that.

There were points where we didn’t talk to each other for months on end. Purely because I was mad at him for doing drugs. But you know through all of the drugs and everything else I still loved him as my brother and woulda done anything for him. I always borrowed him money and helped him. Like family is family.

And for those out there that are doing drugs. Think about your siblings …you have such a big impact on them. Like you could lose them at any moment or they could lose you. Please, please think about them.

They will never have another “you.”

So please if you get clean for anyone. Please get clean for them. They need you more than anyone else needs you and I can tell you that right now.

Even if you argue and are mad. Drop it. I can tell you from experience it’s not worth it. It really isn’t. Because you could wake up one day and not have them.

Losing a sibling is a terrible, terrible thing, and I wish that upon no one.

Please if you need anything to help you get clean let me know and I promise you I will do anything in my power to get you clean. Just remember you doing drugs is helping no one. Absolutely no one.

Mom’s Proud, Caring Response

Devin, we miss you so much. Your brother especially. 💔 We will never understand why you were taken from us so early in life. It’s not fair. Please watch over us and help us through these difficult days. Brandon, you are a wonderful young man I am proud to call my son. I know with this statement on here that you will be able to help others get help so they don’t have to go through the hell we are going through. Love you so.

©2016 Our Young Addicts            All Rights Reserved

Medication-Assisted Treatment: A Solution to the Statistics?

A three-part series by Guest Blogger Gloria Englund, MA. Suboxone, Naltrexone, Methadone

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Part I

I was very uneducated about medications that are affective for substance use disorder (SUD), especially opioid use disorder when my son, Aaron, was still alive. Although he was familiar with Suboxone and methadone, now I believe both of us could have been better informed about how to use methadone along with other support tools that were needed in order to make the treatment the more effective.

Prince’s death has brought the use of Suboxone, a medication that is used to treat opioid use disorder, and the idea of medication-assisted treatment (MAT) for substance use disorders to the forefront of the opioid overdose epidemic. The latest statistic from the National Institute on Drug Abuse (NIDA) is that 129 people are dying every day in the United States from drug overdose; 80 of those deaths involve the use of an opioid.

I believe the stigma and discrimination that accompany substance use disorders, also accompanies the medications that can be used to quell withdrawals symptoms and lesson cravings for those with substance use disorders as they seek recovery.

MAT can greatly reduce the possibility of relapse which often lead to drug overdose that can result in death.

Suboxone

Suboxone, the MAT treatment that didn’t get in Prince’s body soon enough, is one of these medications that is often used to quell withdrawal and cravings for opioids. What exactly is Suboxone? It’s referred to as 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 used to reverse an 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 of 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.

Methadone

Other readily used medications are methadone (mentioned above) and naltrexone. Methadone is a long-acting opioid agonist medication that is very effective in treating heroin and prescription pain medication addiction. It can only be distributed at specifically licensed clinics. Initially it needs to be dispensed every day requiring the user to make daily trips to the clinic. When the specific dose is determined that stabilizes the patient, then patients can begin to lessen their visits by receiving seven days of doses divided between two or three days a week and eventually, only coming in once a week to receive all seven days for the next week. This daily commitment combined with the difficulty many have in tapering off the medication (and its potential abuse as a full agonist that can be sedating) often outweighs, for some, the positives of its effectiveness in quelling withdrawal and cravings. Methadone is also much less costly than Suboxone if the user needs to pay out of pocket.

Naltrexone

Naltrexone is another MAT drug, but is an antagonist. This means it blocks any opioids from connecting to the receptor sites and can only be used after a patient has completed detoxification from all opioids and all opioid medications like Suboxone or methadone. If a patient uses it while any opioids are in the body, they will go in the immediate withdrawal. Naltrexone is not addictive or sedating and does not result in physical dependence as does Suboxone or methadone. However, poor patient compliance with the daily tablets has limited its effectiveness. A long-acting form of naltrexone called Vivitrol® is now available in a once per month injection eliminating the need for daily use which improves patient compliance. Unlike methadone or Suboxone, anyone licensed to dispense medications can prescribe naltrexone, but the cost may be prohibitive for many.

Note to readers: Part II will run on Thursday, June23, and 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.

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