One Member Shares His Experience of a Near Relapse

One of our members faced a tough time in his recovery. His recovery was challenged by someone who came to his home with the intention of selling a substance to him. Listen in to this opiate recovery podcast as they give support to this member. They walk through a process to better understand the situation and develop a relapse prevention plan.

Discussion Guide:

Describe a situation that caused, or nearly caused, a relapse.

What was your intention at the time? What did you want to have happen?

What was your belief about the situation? What were the automatic thoughts that came to your mind? Can you identify faulty thinking?

What were your feelings? What emotions caused you be vulnerable at the time?

What was, or could have been, the negative effect of a relapse to yourself? To others?

What is your prevention plan? Identify the steps you will take to avoid a future relapse.

 

We Can Learn About Prevention From Iceland

20 years ago Icelandic teens were among the heaviest-drinking youths in Europe. Today, Iceland has one of the cleanest-living teens. The percentage of 15 and 16 year olds who had been drunk in the previous month dropped from 42 in 1998 down to 5 percent in 2016. The percentage who have ever used cannabis is down from 17 percent to 7 percent. Teens smoking cigarettes every day fell from 23 percent to 3 percent. This could serve as a model for other countries. The turnaround of teens in Iceland was radical and evidenced based. Listen in to this opiate recovery support group as they discuss the findings and whether they think this model would work in the US.

Discussion Guide:

How do you think Iceland brought down the substance use of teens?

As a teen, did you engage in a wide range of recreational activities?

If not, would you have turned to drugs if there were other means to enjoy yourself?

Can you think of other protective factors against substance use?

Would you recommend changing laws, curfews, parent-child interactions, etc?

Why would the protocol in Iceland not necessarily be effective in the US?

Supplemental Reading:

Emma Young, Iceland Know How to Stop Teen Substance Abuse – But the Rest of the World Isn't Listening, http://digg.com/2017/teen-substance-abuse-mosaic

Is It Hard for You To Ask for Help?

Many people have difficulty asking for help. Especially when it pertains to an embarrassing or shameful situation. People who realize they need help for an addiction can be reluctant to reach out. Listen in to hear our opiate support group talk about their experiences of asking for help.

Discussion Guide:

Is it easy for you to ask for help? If not, which of the following ways would make it easier? What are the pros and cons of each?

1. Write your request in a letter or email

2. Talk to someone you trust

3. Discuss your struggle with a stranger

4. Reach out to a medical professional

5. Search for online resources

6. Seek out someone who has been in your position

7. Call a helpline

Supplemental Reading:

Beth Leipholtz, 7 Ways to Ask for Help When You're Struggling with Addiction, https://www.thefix.com/7-ways-ask-help-when-you-re-struggling-addiction

What I Learned From a Police Officer Ride-a-long

Group facilitator, Gail, was given the opportunity to witness first-hand what it is like to be a police officer in Duluth, MN. It was an exciting ride as she witnessed a drug bust and got a glimpse of the opiate scene in that community. Listen in to this opiate recovery support group as they share their experiences with the law.

Discussion Guide:

Has your clinic been under scrutiny by the police and licensing bodies for poor behavior?

Are you aware of improper, unsafe, or illegal activity within your clinic that puts the clinic or other patients at risk? If so, have you intervened and informed the clinic staff?

If you saw such behavior, would you know who to report it to?

As a person who purchased illegal substances from drug dealers, do you have bad feelings toward them?

Did anyone suffer injury, overdose or death from a substance that you provided? Do you regret it?

If so, how do you cope with other's suffering because of something that you had a hand in?

Should the police set up stings to get drug dealers off the street?

What are your thoughts about the criminalization of drugs? What are the pros and cons for each class of drugs?

If you were aware of a drug dealer who mixed fentanyl and carfentanil with heroin to unsuspecting buyers, would you intervene?

 

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