Tag Archives: opiate addiction

Group Member Talks About his Relapse

One of our group members is overwhelmed with depression following the loss of someone he loves. It was more than he could withstand, and he turned to substances to cope. Thankfully, he returned to recovery group for support. Listen in to the opiate recovery support group as he talks about what happened and what he needs now.

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 to 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.

 

Opioid Addiction Hotline – Would You Call It?

We live in a world where stigma prevents opiate addicts from asking for help. The state of Illinois launched a helpline to provide assistance to people who are dependent on opioids. 1-833-2FINDHELP is a confidential resource for people who want to locate a treatment facility. The aim of the hotline is to target opioid addicts for treatment and to curb overdose-related deaths. They want to make treatment easily accessible. Listen in to this opiate recovery support group as they discuss their experiences with hotlines.

Discussion Guide:

Have you called a hotline to ask for help? If so, was it helpful?

If it was not helpful, why not?

Have you resisted asking for help? Why?

What are the factors that would prevent you from utilizing the resources offered?

Are you familiar with the Safe Passage Initiative?

Would you present yourself to the police or sheriff's department and trust them not to charge you with a crime, and instead direct you to treatment?

Supplemental Reading:

Elizabeth Tomev, Gov. Rauner Launches 24/7 Helpline to Combat Opioid Epidemic, Help Illinoisans in Crisis, http://www.illinois.gov/ltg/news/PressReleases/HELPLINE.pdf

Samhsa Treatment Locator, http://findtreatment.samhsa.gov/

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?

 

 

 

Behavioral Addiction vs. Substance Addiction

When we think of addiction, we immediately think of alcohol, drugs and gambling.  Few of us think of sex, social media or spending as addictions. The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) does not recognize behavioral addictions, other than gambling. Behaviors such as sex, social media and spending are not included in the approved list of addictions. But should they be included? Listen in to this opiate recovery support group as they discuss the similarities and differences between behavioral addictions and substance addictions.

Discussion Guide:

Are you familiar with the terms behavioral addictions, or process addictions? What are they?

Name examples of behavioral addictions.

How are behavioral addictions different than substance addictions?

How are they similar?

Do these two types of addictions have similar or dissimilar outcomes?

Supplemental Reading:

Robert Weiss, Can You Really be Addicted to a Behavior? http://www.huffingtonpost.com/entry/can-you-really-be-addicted-to-a-behavior_us_59938c79e4b0a88ac1bc380e

Marc Lewis, Behavioral Addictions vs. Substance Addictions https://www.psychologytoday.com/blog/addicted-brains/201306/behavioral-addictions-vs-substance-addictions

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 https://www.opiatesupportgroup.com/ask-the-expert-dr-mary-wenzel-addiction-specialist/ 

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

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

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

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/

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

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’s With the High Cost of Narcan?

Narcan, also known as Naloxone, is a life saver for someone who has overdosed on opioids. The number of deaths has skyrocketed, but so has the cost of Narcan. What's up with that? Listen in to a group of people who are in recovery from opiate addiction discuss this issue.

Discussion Guide:

Have you overdosed? What were the costs associated with it?

Do you have a Narcan kit for emergency purposes?

Can you purchase Narcan from your local pharmacy? How much is it, do you need a prescription and does your insurance cover it?

What is the most expensive Narcan kit available on the market right now?

Why do you think the price of Narcan has increased over the years?

How does the manufacturer justify this cost increase?

Supplemental Reading:

Meg Tirrell, As Opioid Epidemic Worsens, the Cost of Waking Up From an Overdose Soars, http://www.cnbc.com/2017/01/04/as-opioid-epidemic-worsens-the-cost-of-waking-up-from-an-overdose-soars.html