Warning: New Opioid Related Memory Loss Syndrome

Public health officials in Massachusetts recognize a new opioid related "reportable disease" called CHIAS (complete hippocampal ischemic amnestic syndrome). The CDC published a paper on 14 cases of memory loss from damage to the hippocampus. There are lots of theories on the relationship between opioids and the damaged brain. Listen in to this recovery support group as they discuss this topic. 

Discussion Guide:

Have you, as someone who has abused opiates, experienced any mysterious illnesses? 

Have you had experienced episodes of amnesia? 

What is your theory of why someone would develop this disease?

1. Opiates contaminated with a toxin?

2. Genetic predisposition that makes them sensitive to something in the drug?

3. Repeated use of fentanyl which causes respiratory depression, which could weaken the hippocampal neurons over time?

4. Loss of oxygen from overdose, which could damage the hippocampal cells, leaving the rest of the brain unscathed. 

5. The consequence of exposing the brain to opioids, again and again?

Supplemental Reading:

Azeen Ghorayshi, The Fourteen Who Forgot, https://www.buzzfeed.com/azeenghorayshi/the-addicts-who-forgot?utm_term=.ygEE4Mbny#.lgQKo0G6N

Should You Tell Your Doctor That You Are Taking Methadone or Suboxone?

Some people prefer not to tell their doctors that they are on medication, such as Methadone or Suboxone, because they fear discrimination. But they may also believe that coordinating Medication Assisted Treatment services with your physicians is important for adequate care. This is a difficult decision with possible negative repercussions. Listen in to this opiate support group discuss their opinions on this dilemma.

Discussion  Guide:

What are the pros and cons of informing your doctor about MAT (Medication Assisted Treatment)?

If you are taking a medication such as Methadone or Suboxone, have you informed your doctor?

Are you comfortable telling your physician your private matters?

Does your physician treat your addiction as a disease, or a moral condition?

Have you been discriminated against when professionals learned of your recovery treatment? What happened?

Supplemental Reading:

Karla Lopez, Deborah Reid, Discrimination Against Patients with Substance Use Disorders Remains Prevalent and Harmful, http://healthaffairs.org/blog/2017/04/13/discrimination-against-patients-with-substance-use-disorders-remains-prevalent-and-harmful-the-case-for-42-cfr-part-2/

Ask the Expert: Dr. Sarz Maxwell Talks about Addiction Treatment

Dr. Sarz Maxwell, psychiatrist, stopped by to talk to the support group. She addressed various types of treatment for opioid addiction. The most frequently recommended treatment for opioid dependence is detox. The problem is that detox is offered as if it were treatment. But detox is not treatment, it is a procedure. Listen in to hear what she has to say about the cause of opioid addiction, the course of its progression, and its treatment.

Discussion Guide:

Name all the different types of treatments for opioid addiction that you are familiar with. Which did you try?

How is detox different from treatment?

What do you believe causes opioid addiction? Brain chemistry, hereditary factors, trauma, stress, or other pre-existing conditions?

Which contributed to your personal addiction?

How long does current research recommend you stay in treatment?

Are there negative, long term consequences from Methadone and Suboxone?

If there is no magic cure for your disease, what is your long term plan to manage it?

 

 

 

 

In the News: Sober Dating Sites, Syringe Vending Machines, and the Link Between Unemployment and Opioids

What's in the news this week? 1. Vending machines now dispense more than candy and soda. New machines are coming to Las Vegas that dispense clean syringes, kits for safe sex, kits that clean wounds, and provide a means of safely disposing syringes. 2. Sober online dating sites. 3. A new study finds that as the jobless rate rises, so do drug overdoses. Listen in to this support group discuss these issues.

Discussion Guide:

What are the pros and cons of syringe vending machines?

Would you have utilized them?

How did you dispose of your used needles?

Have you used an online dating service?

What are the pros and cons of a recovery dating site?

12-Step conventional advise is to avoid dating in the first year of recovery. Do you agree or disagree? Why?

As the unemployment rate increases by one percentage point in a given county, the opioid-death-rate rises by 3.6%, and ER visits rise by 7%. What would you think causes this?

Supplemental Reading:

Victoria Kim, Country's First Syringe Vending Machines Are Coming to Vegas, https://www.thefix.com/country%E2%80%99s-first-syringe-vending-machines-are-coming-vegas

New Sober Dating Site, https://www.thefix.com/new-sober-dating-site

Olga Khazan, The Link Between Opioids and Unemployment, https://www.theatlantic.com/health/archive/2017/04/joblessness-and-opioids/523281/

 

 

Staying Clean Is Not Easy: Barriers to Long Term Abstinence

Getting clean may be easier than staying clean. Long-term recovery can be a challenge without the right support. There are many barriers that cause former drug abusers to become discouraged if they are not able to establish a stable life. Examples are lack of housing and employment. Listen to this recovery support group talk about external and internal barriers that might make them give up.

Discussion Guide:

What are the things you need to give up when you begin a recovery program?

What are you adding to your life when you are in recovery?

What are the barriers to maintaining drug abstinence?

Supplementary Reading:

J. Kelly, J. R. McKay, A Plante, The Fix, Remove the Barriers to Addiction Recovery, 

http://www.thefix.com/remove-barriers-addiction-recovery

As Drug Abuse Rises, the Number of Children in Foster Care Rises

Addiction is harmful to families. Children are often neglected and placed at risk of harm. We're all aware of the high number of deaths caused by the opioid overdose epidemic. What we don't think about is the number of children who are forced into the foster system. An already stressed foster care system is having difficulty accommodating these children. Listen to this recovery support group talk about this issue.

Discussion Guide:

Do you have an experience with the foster care system? Either yourself, or your own children?

If you have children, in what way did your addiction impact them?

Do you believe that you can be both an addict and a good parent?

Addiction causes harm to children to various degrees. What criteria would you use to determine if a child should be taken from the home?

If you lost your children, did it motivate you to stop drug use?

Supplemental Reading:

John DeGarmo, How the Heroin Crisis is Straining Foster Care, Huffington Post, http://www.huffingtonpost.com/entry/how-the-heroin-crisis-is-straining-foster-care_us_58ed0740e4b0ea028d568d3c

How to Take Narcotics Responsibly If You’re in Recovery From Opiate Addiction

If a Methadone or Suboxone patient suffers intense pain, such as being hit by a truck, will they need more, or less, analgesics to get relief from the pain? Pain management is a complicated issue for physicians in the best of circumstances, but it is further complicated for people who use the medications Methadone and Suboxone. Well meaning physicians may under-prescribe or withhold pain medications for fear of causing someone to relapse. Or they may fear inducing overdose in someone who is already prescribed a synthetic opiate. But in fact, these patients are likely to need more aggressive interventions such as larger doses of short-acting pain killers and more frequent intervals for severe pain. Listen in to this opioid recovery support group discuss their experiences with pain management while on these medications.

Discussion Guide:

Did your opioid dependence begin due to a medical condition in which you were prescribed pain killers?

Do you still have a medical condition that causes pain?

Do you believe that your MAT, Medication Assisted Treatment such as Methadone or Suboxone, prevents you from experiencing pain?

If you have an injury or medical condition in the future, that would require painful surgery or treatment, would you take narcotics?

If you choose to take pain medicine, what is your plan to minimize potential abuse?

Who is your accountability partner for the responsible use of a pain killer?

Supplemental Reading:

Olivia Pennelle, How I Took Narcotics Responsibly in Sobrietyhttp://www.thefix.com/how-i-took-narcotics-responsibly-sobriety

Addiction Treatment Forum, Dealing With Pain, http://www.atforum.com/documents/english/Dealing_with_Pain.pdf

Prater, Zylstra, Miller, Successful Pain Management for the Recovering Addicted Patient, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC315480/pdf/i1523-5998-004-04-0125.pdf

What Does Recovery Mean To You?

According to the Substance Abuse and Mental Health Administration (SAMHSA): “Recovery from alcohol and drug problems is a process of change through which an individual achieves abstinence and improved health, wellness and quality of life.  ”Listen in to this recovery support group discuss what recovery means to them personally.

Discussion Guide:

What does "working a program" mean to you?

What does "surrendering" mean?

What does "progress not prefection" mean to you?

What does "being in service to others" mean?

What do you appreciate about recovery?

Counterfeit Drugs and the Dangers of Mixing Benzo’s and Opioids

Did you know that 30% of opioid overdose deaths involve benzodiazepines? Benzo's such as Xanax and Valium increase the risk of overdose. If that wasn't bad enough, we're hearing of fake Xanax and other medications.  People have died of fentanyl laced Xanax. Gangs are moving away from selling cocaine and heroin to focus on health products. The risk is low and profits are high. Listen to this support group discuss the risks of benzodiazepines, and the new danger of counterfeit drugs.

Discussion Guide:

Benzodiazepines and opioids are not a good mix. If you take a medication such as Methadone or Suboxone, you put yourself at medical risk of harm if you combine it with a benzo.

Have you mixed the two classes of drugs?

Did you take both for legitimate reasons and use it as prescribed, or did you misuse them?

Have you known people who have overdosed from this mix?

Have you had experience with counterfeit pills?

How would you know whether you were given the real thing, or a dangerous mix?

Supplemental Reading:

Anna Almendrala, This Prescription Drug Is Implicated In Almost a Third of All Opioid Overdose Deaths, http://www.huffingtonpost.com/entry/opioid-overdoses-combination-benzodiazepine_us_58c83e16e4b01c029d76f5ad

Dennis Thompson, Fake Xanax Can Be A Killer, http://www.cbsnews.com/news/fake-xanax-can-be-a-killer/

Drug Treatment Center Finder, Fentanyl-Laced Xanax Deadly Street Drug, Authorities Warn, http://www.drugtreatmentcenterfinder.com/fentanyl-laced-xanax-deadly-street-drug/

Sara Ganim, CNN, Pill Presses for Counterfeit Drugs Seized in Record Numbers, http://www.cnn.com/2017/03/17/health/pill-presses-counterfeit-fentanyl/

Lizzie Parry, Fake Drugs Seized in Crackdown on Counterfeit Medicineshttp://www.capitalbay.news/world/842537-fake-drugs-seized-in-%C2%A351.6-million-interpol-crackdown-on-counterfeit-medicines.html

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