All posts by gailgabbert

What’s the Purpose of Support Groups?

Should you talk about your addiction war stories? Some people believe that telling your addiction history is not helpful. They fear that it could cause cravings and relapse to themselves and others. On the other hand, isn't your support group the appropriate place to talk out your trauma? It can be healing. Listen in to this opiate recovery support group as they discuss the rationale and goals of support groups.

Discussion Guide:

Have you felt that some of your group members have glorified their drug related behavior in the past?

If so, has that triggered a craving or relapse for you?

What are the pros and cons of telling your story to other group members?

What do you think the rationale and goals of support groups are?

What is the most helpful thing that you have experienced from your support group?

Supplemental Reading:

Group Interventions for Treatment of Psychological Trauma, http://www.agpa.org/docs/default-source/practice-resources/group-interventions-for-treatment-of-trauma-in-adults.pdf?sfvrsn=2, see page 32-33.

Is It OK to Stay on Maintenance Medication for Life?

A podcast listener asked the group a question. Do any of them want to stay on a maintenance medication indefinitely? He feels a subtle pressure to wean off his medication by his treatment clinic and wonders if this is true for others. Is it OK to stay on Medication Assisted Treatment forever? Listen in to this opiate support group talk about their progress, intentions and hopes for the future.

 

Discussion Guide:

If you are on a maintenance medication for opiate recovery, have you thought about whether you want to wean off your medication?

Have you experienced pressure from your clinic, or others, to either stay in Medication Assisted Treatment, or pressure to wean off?

What is your personal preference for how long you should stay on MAT?

How do you handle the stigma against MAT?

Do you believe there is any long term harm from staying on MAT indefinitely?

Are you familiar with the Tapering Inventory tool? If not, see Tapering From Methadone (below)

 

Supplemental OpiateSupportGroup.Com Podcast Listening on When or Whether You Should Stop MAT:

Ask The Expert: Dr. Mary Wenzel http://www.opiatesupportgroup.com/ask-the-expert-dr-mary-wenzel-addiction-specialist/ 

Should You Stop? Criteria for Ceasing Medication Assisted Treatment http://www.opiatesupportgroup.com/should-you-stop-criteria-for-ceasing-medication-assisted-treatment/

What You Should Know About Methadone http://www.opiatesupportgroup.com/what-you-should-know-about-methadone/

Tapering From Methadone http://www.opiatesupportgroup.com/tapering-from-methadone-2/

Trauma and Addiction are Connected

It is not surprising that people who have been traumatized are more likely to abuse substances. For example, those who have been sexually abused are more likely to use drugs than the general public. It is said that they are 3.4 times more likely to use marijuana, 6 times more likely to use cocaine, 10 times more likely to use other major drugs. This podcast explores the connection between trauma and addiction. Listen in to hear this opiate recovery group discuss their experiences and opinions.

Discussion Guide:

Have you experienced trauma?

Do you believe the trauma predisposed you to an addiction?

What would you say the root cause of your addiction is?

Some say that you are as sick as your secrets. Have you had counseling to address the trauma?

If you went to rehab, were you in a dual diagnosis program? Was it helpful?

What would you look for in a counselor?

Supplemental Reading:

Jennifer Storm, How Trauma, Victimization and Addiction Are All Connected, http://www.thefix.com/how-trauma-victimization-and-addiction-are-all-connected

Kaiser Permanente, Adverse Childhood Experience (ACE) Questionnaire http://www.ncjfcj.org/sites/default/files/Finding%20Your%20ACE%20Score.pdf

Opiatesupportgroup.com Podcast, Childhood Trauma Is Found to Underlie Most Addictions, May 21, 2017

Group Member Profiles: What’s Their Story?

Our group received an email this week from Dan. He wrote "I have listened to every one of your podcasts and I really enjoy them. The one thing I have noticed is that we never learn about the stories of how the people in the discussion got addicted in the first place. It would be nice if any of the members would be willing to talk about their histories. Keep up the good work and thank you for what you all do." Dan asked for it, and we delivered. Listen in to hear three group members share their stories.

Discussion Guide:

What is your addiction story?

Describe your life before addiction.

Describe your life during active addiction.

Describe your recovery process.

What is your biggest regret?

What advise would you give others?

What do you hope for in the future?

 

 

It Is Unethical and Inhumane To Withhold Narcan (Naloxone)

A stigma against people who abuse substances exists. Most often it is subtle, but now and then it is loud and ugly. Sheriff Richard Jones in Butler County, Ohio said that he will not equip his deputies with Narcan. "My officers don't carry Narcan, nor will they". He will change his position only if he is court ordered to begin carrying Narcan. Also in Ohio, Dan Picard, Councilman from Middletown, proposed a two strikes and you're out policy. He suggested that the council explore the possibility of denying emergency medical services to people who have sought overdose intervention twice before. Listen in to this group of addicts share their opinions on the matter.

Discussion Guide:

Have you overdosed? If so, were you revived with Narcan? How would you describe the benefits of Narcan to someone who is not familiar with it?

Have you experienced a stigma as a result of having a drug dependency? Please describe it.

If you, a close friend or a family member were denied Narcan and died as a consequence, what steps would you take to seek justice? And what steps would you take to ensure it doesn't happen again?

What are the underlying values of people who would withhold Narcan?

As the costs associated with overdoses increases, how do you think communities or the overdose patients should pay for it?

Some people think that withholding emergency medical response to overdose patients is manslaughter and premeditated murder. Do you agree or disagree?

Supplemental Reading:

Nick Wing, Sheriff In Heart of Ohio's Opioid Epdemic Refuses to Carry Overdose Reversal Drug, http://www.huffingtonpost.com/entry/richard-jones-butler-county_us_595fb129e4b02e9bdb0c3b78

Corky Siemaszko, Ohio Councilman Sparks Fury After Asking If EMS Can Stop Responding to Overdoses, http://www.nbcnews.com/storyline/americas-heroin-epidemic/ohio-councilman-sparks-fury-after-asking-if-ems-can-stop-n778711

Do You Need a Dose Increase?

It is sometimes difficult to sort out symptoms – is it the influenza (flu), or is it opiate withdrawal? The Clinic Opiate Withdrawal Scale (COWS) is used as an assessment tool to distinguish true withdrawal symptoms. The outcome result will indicate whether you may need to increase your dose. Listen to this support group as they discuss their experiences.

Discussion Guide:

Are you familiar with The Clinic Opiate Withdrawal Scale (COWS)?

How can you tell the difference of opiate withdrawal and being medically ill with a flu?

Describe an example of being medically sick with a flu and the experience of withdrawal while in active addiction.

Has your dose of Methadone or Suboxone fluctuated up and down over time?

Have you been able to easily articulate the reasons why you might need to increase your dose?

Supplemental Reading:

Wesson and Ling, Clinical Opiate Withdrawal Scale, http://www.drugabuse.gov/sites/default/files/files/ClinicalOpiateWithdrawalScale.pdf

Am I An Addict? Coming to Terms with the Label

Rarely does one immediately identify themselves as having an addiction. The causes and progression of addiction are complex and unfold over time. Resistance to the label of addiction is common. Listen to this support group as they discuss their thinking as they came to accept the label of 'addict'.

Discussion Guide:

When was the point in your life that you accepted that you were addicted to a substance?

What was your thinking process as you came to accept that you were an addict?

What were the consequences of your drug use? Did the negative consequences present a red flag that you were addicted?

Did you compromise your values over time? Did this change of values present a red flag that you were addicted?

Did you lose control of your behavior? Was this a red flag that you were addicted?

What did your loved ones telling you? Was that a red flag?

What was your substance abuse trying to tell you? It could have been trying to tell you something about your life, something that needs to change, or a trauma that hasn't healed.

Have you participated in psychotherapy to address the underlying issues of addiction?

Supplemental Reading:

Sam Dylan Finch, 5 Better Questions to Ask Than 'Am I an Alcoholic?', http://www.thefix.com/5-better-questions-ask-am-i-alcoholic

Vivitrol Manufacturer Tries to Corner the Market on Opioid Medication Treatment

A drug manufacturer is at it again. Manufacturer, Alkermes, the maker of Vivitrol, is cashing in on the opioid epidemic. They are successfully lobbying legislation to pass bills in support of Vivitrol. Vivitrol is an opioid blocker which should prevent addicts from experiencing euphoria if they take heroin or pain killers. It also cuts cravings. These are also the properties of Methadone and Suboxone. Vivitrol is costly at $1000 for a shot that remains in the system for one month. Alkermes made $209 million in 2016 through their lobbying efforts coast to coast. They are alleged to be giving misinformation about Methadone and Suboxone and purposefully lobbying to restrict their use. Listen in to this opiate support group as they talk about this issue.

Discussion Guide:

Are you familiar with Vivitrol? What do you know about it, and have you been treated with it?

Do you believe that Vivitrol should be legislated for use, over Methadone and Suboxone?

What are the pros and cons of each of these medications in terms of cost, administration and adjunct treatment? (Vivitrol, Methadone and Suboxone)

What types of patients would do better on each?

Supplemental Reading:

Jake Harper, NPR, A Drugmaker Tries to Cash In On The Opioid Epidemic, One State Law At a Time, http://www.npr.org/sections/health-shots/2017/06/12/523774660/a-drugmaker-tries-to-cash-in-on-the-opioid-epidemic-one-state-law-at-a-time

Should We Relax HIPAA Regulations to Allow Release of Information to Family Members When Someone Overdoses?

Health Insurance Portability and Accountabiity Act (HIPAA) regulates the confidentiality of health records. Presently, healthcare records cannot be released without the informed consent of a patient. Governor Chris Christie, who is leading an opioid task force, was asked to consider relaxing HIPAA regulations in order to allow family members to be informed of a member's non-lethal overdose. This knowledge could open the door to treatment options. Listen in to this opiate support group discuss their opinions.

Discussion Guide:

If you were to overdose and received services from a healthcare provider, would you want that information released to your family?

Under what circumstances would you want your family to be informed of your overdose?

What are the pros and cons of relaxing HIPAA regulations in the case of overdose?

Narcan (also known as Naltrexone) is a life saving measure. Do you have Narcan available? Have you instructed your family and associates in how to use it?

Supplemental Reading:

Erin Mershon and Andrew Joseph, Do Family Members Have a Right to Know When a Loved one Overdoses on Opioids? https://www.statnews.com/2017/06/13/overdoses-family-notification/

Grounding Techniques To Stop Cravings and Manage Emotions

Many people who abuse substances struggle with emotions. They may have numbed themselves to pain with the use of substances, and then feel uncomfortable with emotions in recovery. Cravings are a common phenomena in recovery. Listen and learn practical skills for coping with emotions and stop cravings.

Discussion Guide:

When you have experienced drug cravings, what have you done to cope with them in a healthy manner?

What techniques do you utilize to deal with cravings?

There are three different types of grounding techniques: mental, physical and soothing techniques. Which types are most effective for you?

What if the techniques don't work immediately? What should you do?

Supplemental Reading:

Grounding Techniques