Monthly Archives: March 2017

Addiction, Medical Ethics and Involuntary Commitment

Opioid abuse, involving both prescription pain relievers and heroin, is having a major impact on the US healthcare sector. Expensive treatments, such as replacement of heart valves from endocarditis, are a burden upon medical facilities and insurance systems. How many times should a substance abuser receive these surgeries, assuming that they will continue to abuse drugs? And under what circumstances should a substance abuser be involuntarily committed to treatment if they are a risk to themselves? Listen in to this recovery support group as they discuss this complicated issue.

Discussion Guide:

Have you put yourself at risk of medical problems by misusing needles, or doing other dangerous drug related behaviors?

Have you had expensive medical treatment due to this unsafe drug related behavior?

If so, how much did it cost to you personally, to your insurer and medical facility?

How many times should a medical facility, or insurer, provide expensive treatment to a substance abuser who is not in recovery?

What ethical guidelines do you suggest to make a decision on how many times, and under what conditions, a substance abuser receives expensive treatment?

37 states allow people who are addicted to be involuntarily committed to treatment if they are a danger to themselves or others. In what way are substance abusers a threat to themselves or others? Examples?

What are the benefits of involuntary commitment?

Supplemental Reading:

Jack Rodolica, Doctors Consider Ethics of Costly Heart Surgery for People Addicted to Opioids, http://www.npr.org/sections/health-shots/2017/03/21/520830183/doctors-consider-ethics-of-costly-heart-surgery-for-people-addicted-to-opioids

Kelly Burch, Involuntary Commitments for Addicts Being Considered By More States, http://www.thefix.com/involuntary-commitments-addicts-being-considered-more-states

What Do Drug Addicts Look Like?

We've all seen the before and after photos of the Faces of Meth campaign. The general public believes that drug addicts are poor, homeless, have poor hygiene, are skinny, have scabs on their face, dark circles under their eyes, bad teeth, and are males. There are negative consequences to this stigma. Listen to these opiate support group members talk about whether the perception is valid, why it might be true in late stage opiate addiction, and address the consequences of this stigma.

Discussion Guide:

What was your perception of what drug users look like before you developed an addiction?

What is your current perception of what an addict looks like?

Why would an addict look this way?

What are the negative consequences of this stigma?

Supplemental Reading:

Allison Tierney, Why We Need to Destroy the Concept of What a Drug User Looks Like, http://www.vice.com/en_ca/article/why-we-need-to-destroy-the-concept-of-what-a-drug-user-looks-like?utm_source=vicetwitterca

Public Policy: Which Approach Is Most Effective To Stop the Opioid Epidemic?

It is clear that the US is facing an opiate epidemic in which an average of 91 opioid-related deaths occur each day. It is not clear how to best stop the epidemic. In this podcast, we discuss three different approaches to this problem. Listen to this group of people who have been addicted to opiates give their opinions of which approach works, and which cause more harm.  

Discussion Guide:

Are you familiar with Gloucester's Angel Program in Massachusetts? Instead of being arrested, drug dependent people can present themselves to the police and get help. Do you think this is a good idea? What are the pros and cons?

There is a town in Fayetteville County, Ohio who charge overdose survivors with a misdemeanor after they have saved their lives with naloxone. Do you think this is an effective strategy to decrease deaths? What are the pros and cons?

US Attorney General Jeff Sessions spoke at an opioid awareness summit in New Hampshire. He said that the "Just Say No" campaign and D.A.R.E. curriculum were effective. However, this is not supported by research. Sessions thinks drug prevention and education is an effective way to stem the opioid epidemic.  Do you believe education alone is effective?

Which approach do you think is the most effective? What do you recommend?

Supplemental Reading:

Terry Weber, Gloucester's Angel Program Helps 260 in Four Months, http://gloucester.wickedlocal.com/article/20151030/NEWS/151039478

Philip Marcelo, Researchers: Gloucester's Angel Program Helped Nearly 400 Drug Addicts, http://bigstory.ap.org/article/731169b9ace54d808b53df2acc160b86/researchers-nearly-400-drug-addicts-helped-police-effort

Kelly Burch, Ohio Town To Criminally Charge Overdose Survivors, http://www.thefix.com/ohio-town-criminally-charge-overdose-survivors

Britni de la Cretaz, AG Jeff Sessions Talks Addiction Crisis At Awareness Summit, http://www.thefix.com/ag-jeff-sessions-talks-addiction-crisis-awareness-summit

Anyone Addicted to Sugar?

Who doesn't love sweets? It turns out that sugar hits the same part of the brain's reward system as substances. Sugar has the same effect as drugs to a milder degree and some people find it addicting. They can experience dependency, cravings and unpleasant withdrawal symptoms if abruptly cut off from sugar. Listen in to this recovery support group as they talk about their experiences with sugar.

Discussion Guide:

Can someone be addicted to sugar?

Do you crave sugar and consume large amounts of it?

Have you experienced difficulty cutting back on sugar?

Do you consume food as a means of coping with stress?

Is sugar especially dangerous to people in recovery?

Do you believe that Methadone and Suboxone cause people to gain weight?

Good nutrition is an antidote to an addict's body that has been depleted. Do you eat nutritionally balanced meals?

Supplemental Reading:

Pennelle, Olivia, Everything You Need to Know About Sugar and Early Recovery

Gallagher, James, Fruit and Veg: For a Longer Life Eat 10-a-day,

Who Are These Group Members?

Who are these support group members? Listen in to this group of six people who are in recovery from an opiate addiction, as they introduce themselves to a new counselor.

Discussion Guide:

What brings you to this podcast?

What is your addiction story?

How many times have you been in a substance abuse treatment program?

Are you currently in treatment?

How long have you been drug free?

 

 

What Do You Want In a Counselor?

Alcohol and drug addiction counseling is an important part of many treatment programs. There are many different counseling approaches and frameworks. Listen in to a group of recovery group members discuss what they want in a counselor.

Discussion Guide:

As you reflect on your experiences with a counselor, what was especially helpful?

What was unhelpful?

What skill base do you think they should have?

Do you think they should share your experience as a recovering addict? What are the pros and cons of this?