Tag Archives: drug addiction

Is Addiction a Choice, Disease, Both or Neither?

No one ever says they want to be an addict when they grow up. So how does it happen? Is it a choice or a disease? Listen in to this opiate recovery support group talk about whether addiction is a choice, disease, both or neither.

Discussion Guide:

Do you believe that addiction is a choice, a disease, both, or neither?

How would you characterize the beginning and progression of your addiction?

In what way was it a choice?

Would you say that addiction is an unintended consequence?

In what way is it a disease?

Supplemental Reading:

Derek Hobson, Is Addiction a Disease or a Choice? http://www.thefix.com/addiction-disease-or-choice

Key Principles of Addiction

Key principles about addictive disorders can help us understand the complexities of recovery. Listen in to the opiate recovery support group as they share their thoughts on these principles.

Discussion Guide:

What are your thoughts about these key principles?

  1. Don't expect a sick brain to make a healthy decision.
  2. Always a part of the problem, it is difficult for family members of people addictive disorders to become a part of the solution.
  3. In the treatment of patients with addictive disorders, any therapeutic compromise is destined to fail.
  4. Never, never underestimate the additive power of alcohol and opioids.
  5. Don't expect a broken brain to fix itself by itself.
  6. People who are addicted to alcohol and drugs alienate all friends who are not themselves chemically dependent.
  7. Combining other personality disorders with addictive disorders is like combining jet fuel with a match.
  8. It takes one physician to withdraw a person from alcohol and drugs. It takes a "therapeutic village" to prevent his or her return to alcohol and drugs.
  9. Although a person with addictive disorders cannot recover without total abstinence, total abstinence does not constitute recovery.
  10. When a person with addictive disorders begins to recover, the dynamics of all important relationship also change.
  11. The discontinuation of alcohol and drugs lifts the veil of denial covering over the tragic consequences of addiction-related misbehavior.
  12. Even though the reasons for depression are understandable, treat the person for depression. (Antidepressants may be required at any phase of the treatment of patients with addictive disorders.)
  13. Alcohol and drugs of abuse will poison a person's assets.

Adapted from Stuart C. Yudofsky, Fatal Flaws: Navigating Destructive Relationships with People with Disorders of Personality and Character

Stop Using the Word “Relapse” for the Chronic Disease of Addiction. Instead use the phrase “Recurrence of Symptoms.”

The language we use to talk about addiction and recovery can cause personal shame and perpetuate public stigma against people with substance dependence. It is time to stop using the shame based word "relapse" for the chronic disease of addiction. Instead, use the phrase "recurrence of symptoms." It is more accurate, reduces shame and encourages people to re-enter treatment for a flare up when symptoms of addiction return. Listen in to this opiate recovery support group as they discuss this topic.

Discussion Guide:

What's the difference between stigma and shame?

Do you feel shamed by other's perception of your disease?

No one ever says "I want to be a drug addict one day." Yet, many people believe that you chose the life, therefore an addiction is your own damn fault and you have a moral failing.  How do you explain the process in which you became dependent?

No one is exempt from bias and stigmas, even within the recovery community. How do we best correct ourselves in order to stop reinforcing the stigma?

It is time to stop using the shame based word "relapse" for the chronic disease of addiction. No other chronic diseases refer to symptoms of their disease as a relapse. Instead, use the phrase "recurrence of symptoms." Do you agree?

Supplemental Reading:

Michael Weiner, PhD, MCAP, Eliminate Stigma from the Inside Out, http://www.addictionpro.com/article/treatment/eliminate-stigma-inside-out

Snortable Chocolate is the Latest Craze

Perhaps it is a common human desire to alter our mood in any way possible. The latest craze is snortable chocolate. It comes by the name "Coco Loko" and "Infused Cacao Snuff" and some view it as "cocaine on training wheels" that will appeal to children. The FDA is is shutting down the company who markets it. Listen in to this opiate recovery support group as they discuss their opinions on the topic.

Discussion Guide:

Have you attempted to get high on novel substances? What were they?

Are you familiar with snortable chocolate? Have you done it?

What are possible negative consequences of snorting chocolate?

Do you agree with the FDA in attempting to shut down the manufacture and marketing of snortable chocolate? Why?

Supplemental Reading:

Keri Blakinger, FDA Moves to End the Sale of Snortable Chocolate, http://www.thefix.com/fda-moves-end-sale-snortable-chocolate

Recovery Can Be Difficult Over the Holidays

Recovery can be especially difficult over the holidays due to family gatherings and stigma against medication assisted treatment. Listen in to this opioid support group as they discuss their handling of holidays.

Discussion Guide:

Is your family or social network supportive of your medication assisted treatment?

If not, how do you handle negative attitudes against your choice of recovery?

Do you have a prepared statement which can defuse a difficult situation?

If you have a supportive and warm family how did they come to accept you and your medication?

Supplemental Reading:

Promises Treatment Center, Tips to Support Recovery During the Holidays, http://www.promises.com/articles/addiction-recovery/tips-to-support-recovery-during-the-holidays/

Do High Costs Prevent Poor People from Treatment?

According to the Centers for Disease Control, approximately 2 million people in the US are addicted to pain killers and half a million are addicted to heroin. However, there are only about 350,000 Americans utilizing methadone treatment, and 75,000 are getting treatment with Suboxone, according to Rockefeller University. Why don't more people access medication assisted treatment? Listen in to this opioid recovery support group as they discuss financial barriers to treatment.

Discussion Guide:

How much would you pay to be free of your opioid dependence?

How much are you able to pay?

Have you had difficulty accessing treatment due to lack of financial resources?

If you have health insurance, does it cover most or all of your treatment?

If your insurance no longer covered your treatment, what would you do?

Supplemental Reading:

Elizabeth Brico, The Cost of Addiction Treatment Keeps Poor People Addicted, http://talkpoverty.org/2017/11/01/cost-addiction-treatment-keeps-poor-people-addicted/


Rebuttal to an Abstinence Only Advocate

One of our group members wrote a rebuttal to a local newspaper column that had espoused an abstinence only view of opiate recovery. Our member wrote "It does no good to judge an addict on their form of treatment. What matters is if the treatment is successful or not." Listen in as the group discusses their views about medication assisted treatment and recovery.

Discussion Guide:

Have you utilized medicated assisted treatment for opiate addiction? If so, in your opinion, how does it compare to opiate abstinence without medication?

Have you been prevented from utilizing MAT (Medication Assisted Treatment) from someone in authority over you?

How do you combat negative and misinformed comments about MAT? What are the dangers of expounding a negative view?

How do you respond to the stigma against substance abusers as if it is a moral issue?

In what way is MAT similar and dissimilar to insulin for diabetes? Do you think it is a good analogy?

Have others implied that you should "man up" and stop using MAT? How has this effected you?



President Trump Declared Opioid Crisis a Public Health Emergency

President Trump declared the opioid crisis a public health emergency. More than 140 Americans die every day from an opioid overdose. The nation's Public Health Emergency Fund has a current balance of just $57,000. But the opioid crisis is a $14 billion problem, at minimum. Listen in to this opiate recovery support group as they discuss how they would approach the crisis, if they had the funds to do so.

Discussion Guide:

Are you familiar with the declaration of the opioid crisis as a public health emergency? How is a public health emergency different from a national emergency?

What are the pros and cons of this declaration?

If you were in a position to change policy and were given funds to address the crisis, what strategies would you recommend?

Supplemental Reading:

Claude Brodesser-Akner, 7 takeways from Trump's opioids public health emergency: What it really means, http://www.nj.com/politics/index.ssf/2017/10/5_takeaways_from_trumps_public_health_emergency_de.html

Should An Opioid Relapse Be a Punishable Crime?

Consider this scenario. You are on probation for a drug related crime, you quickly enter treatment and relapse early in your recovery. Should you immediately be subject to probation violation and sent to prison? Or, is the disease of addiction cause to deter criminal punishment? Listen in to this opiate recovery support group as they discuss their opinions on this topic.

Discussion Guide:

Is addiction a choice or a disease? 

Do you believe that opioid addiction causes you to be prone to relapses?

Does the threat of incarceration motivate substance dependent people toward recovery?

If  addiction is a medical condition and relapsing is a part of the disease, is it unconstitutional to punish the addict with incarceration?

Under what circumstances is incarceration a reasonable outcome for opioid addicts?  

What do you recommend as guidelines for the criminal justice system in making these decisions?

Supplemental Reading:

Deborah Becker, Court to Rule on Whether Relapse Be An Addicted Opioid User Should Be a Crime, http://www.npr.org/sections/health-shots/2017/10/26/559541332/court-to-rule-on-whether-relapse-by-an-addicted-opioid-user-should-be-a-crime

Attitudes and Stigma Drive Opioid Treatment and Policy, Not Research

Psychiatrist, Sarz Maxwell says that one of the greatest barriers to treatment and effective drug policy are attitudes towards drugs. Addiction is not seen as a disease, but as a moral failing. Methadone and Suboxone are not drugs of choice. They are medicines. Listen in to this opiate support group discuss stigma .

Discussion Guide:

It is said that this opioid epidemic is getting worse and the stigma against opioid abusers is worsening. Why would this be the case?

Dr. Maxwell said "It is not what the person does to the drug, it's what the drug does to the person." What does this mean?

Abstinence is one of the least effective methods of treatment for opioid addiction and has the lowest recovery rate. Have you been successful with long term abstinence without medication such as Methadone and Suboxone?

"Addiction is the only disease where we expect the patient to be immediately symptom and medication free."  Do people have this expectation of you?

In a genetically predisposed addict's brain, there are too many opioid receptors and too few endorphins. This can cause people to use substances in an effort to get normal. Did you feel abnormal without an opioid boost?