Author: The Fix

Treatment Clinic Beat The Odds To Help Patients During Hurricane Florence

“Some of those nurses were without power, they sustained damage to their homes, but they showed up every day.”

When Hurricane Florence swept through the middle of the country, it left behind patients in treatment without access to their possibly life-saving medications.

The hurricane brought with it flooding and blocked roads and bridges—putting patients in addiction treatment who use methadone or buprenorphine at risk of withdrawal or worse, relapse.

One opioid addiction clinic, the Carolina Treatment Center, worked beyond its means to provide care for the stranded and desperate coming in from far and wide.

The clinic would have been in dire straits if the nurses working there—most of them severely and personally affected by the hurricane—had not been able to show up.

The clinic’s head nurse Kristen Morales worked 16 days in a row while living at a nearby hotel to ensure she could show up for her job. Huffington Post interviewed the treatment center director, Louis Leake, as he worked cases from as far off as Louisiana.

“We can do a lot of things, but we can’t do a lot of things without nurses,” Leake said. “Some of those nurses were without power, they sustained damage to their homes, but they showed up every day.”

Past studies have shown the toll that intense storms take on the community of addiction recovery. One study published in Substance Use Misuse, on Hurricane Sandy, concluded that among other troubling findings (such as the increase of shared use of needles) 70% of those in opioid maintenance therapy could not obtain sufficient doses to remain off of opioids.

The town of Fayetteville’s clinic was closed for a mandatory three-day evacuation. Patients were given between three and six days of treatment medication to take home, after which they had to be resupplied.

The Carolina Treatment Center was outside of the evacuation zone and took in all of Fayetteville’s addiction treatment patients, to treat a total of more than 900 patients.

Despite the four days of medication that patients could take home, between the three-day evacuation and road closures and flooding, many patients would have had to suffer through withdrawal or relapse if the Carolina Treatment Center had not gone above and beyond to provide a safety net for this vulnerable community.

Patient Teri Cooper told The Huffington Post, “It was busy, but thank God I could come here. I guess I would have got some damn drugs, to be honest. [if the clinic were closed] If I didn’t feel good. That’s the truth.”

View the original article at thefix.com

27 September 2018
SNL’s Pete Davidson Realized “It Wasn’t The Weed” In Rehab

“I was sober for 3 months at one point and I was like this f— sucks.”

In a recent interview, Saturday Night Live’s Pete Davidson expanded on his decision to return to smoking weed after a brief period of sobriety made him realize he was “never sadder.”

The 24-year-old Staten Island native told Howard Stern on Monday (Sept. 24) that he needed rehab to gain control of his marijuana use, but ultimately, could not live without it.

“There was no way I could stop. I was like somebody has to put me in a house where there is literally nothing. I had too much access,” Davidson said. The comedian entered a treatment program in December 2016.

He said in 2017: “I never really did any other drugs, so I was like, ‘I’m gonna try to go to rehab. Maybe that’ll be helpful.’”

But once he was in treatment, he said “it wasn’t the weed.”

“I was sober for 3 months at one point and I was like this f— sucks,” he told Stern. Davidson said in a past interview with Pete Rosenberg that he was “never sadder and everything was just way worse” during this period of abstinence.

But at first, he seemed to enjoy the immediate effects of quitting marijuana. In a since-deleted Instagram post from March 2017, he said, “I quit drugs and am happy and sober for the first time in 8 years. It wasn’t easy but I got a great girl, great friends and I consider myself a lucky man.”

But later he would be diagnosed with borderline personality disorder (BPD), an explanation for why he feels “depressed all the time.” “This whole year has been a f— nightmare,” he said in September of last year. “This has been the worst year of my life, getting diagnosed with [BPD] and trying to figure out how to learn with this and live with this.”

Davidson has been candid about his marijuana use and how it helps him cope with BPD as well as Crohn’s disease.

“I have Crohn’s disease, so it helps more than you can imagine,” he told Stern. “There was a point where I couldn’t get out of bed. I was 110 pounds.”

He told High Times in a past interview: “I found that the medicines that the doctors were prescribing me, and seeing all these doctors and trying new things, weed would be the only thing that would help me eat.”

View the original article at thefix.com

27 September 2018
God Hates Pikachu and He Also Killed My Daddy
My higher power doesn’t want me sticking a needle in my arm. For me today, it’s as simple as that.

I didn’t want to unpack this story so soon. My aim was to share my experience with getting and staying sober in a dry and witty way, do that for a while with you, maybe unpack the heavy stuff after we got to know each other a little more, and then go for the gusto. I didn’t want to bring up a subject that might rub you the wrong way but I recently finished a writing exercise that really got me thinking about my dad. He’s dead.

My father died when I was two years old. He was a heroin user who shared needles. Nobody was talking about harm reduction in the late 80’s nor were they concerned about the consequences of IV drug use. After he got sober, he found out that he had contracted HIV. It wasn’t long after that diagnosis that he lost his battle to AIDS.

I believe growing up without a father had an effect on the man I am today; but this isn’t a story about my dad. This isn’t a story about harm reduction or AIDS awareness. This is a story about God.

Wait! Stay with me, please. Don’t go.

I promise you this isn’t that kind of story. I’ve done right by you with the last two articles. I plan on doing the same with this one. I know the God word bothers some people. It bothers me sometimes. It’s okay, just keep scrolling. We’ll do this one together. Besides, you have to at least get to the part about Pikachu. I’m sure you’re wondering what the heck he’s got to do with all this. Stick around, I’ll tell you.

I grew up in an extremely charismatic religious household; the crazy dogmatic type. Let me tell you how crazy: Did you know that if you listen to any music that isn’t religious, demons will literally fly out of your headphones like a vapor of smoke and possess you? It’s true. My aunt told me that when I was only eight years old. Also, if you watch any movie that isn’t rated G or about the crucifixion of Christ, you run the chance of committing your soul into the fiery pits of hell. Here’s a good one: My younger brother and I were not allowed to watch Pokemon because our grandmother told us that those cute little Japanese cartoons were actually demons and it was Satan’s master plan to trick unassuming kids into falling in love with his minions.

Here’s a few more examples:
1. Don’t drink beer. You’re ingesting the semen of the devil.
2. True love waits. So if you have sex before marriage, you’re going to burn in hell.
3. Never smoke cigarettes, you’ll accidentally inhale a demon.
4. Don’t use profanity unless you want God to give your tongue cancer.
5. Hey boys, do you like your hands? Well, don’t play with your penis, that’s how you lose them.
Here’s my absolute favorite. When I was kid, my mom brought my younger brother and me to this old-time-holy-ghost Pentecostal church in the hood. The younger children had to go to Sunday school with some 16-year-old babysitter while the adults went to “big church” in the main auditorium. While we were waiting for our mom to pick us up, our babysitter kindly told me that God killed my dad because he was a junkie.

Yup, that’s right. This ignorant girl basically told me that God “gave” my dad AIDS because he was in love with heroin. And it was God’s perfect judgment to execute my powerless addict of a father. Cool, right? I’m going to grow up to be a perfectly normal man, unscathed by any of this tomfoolery.

When you grow up in an overbearing legalistic household and finally start doing some of the things that they told you not to and nothing bad happens, you end up slamming your foot on the gas, speeding straight into the freedom to do everything you’re not supposed to. The things you didn’t do growing up because you believed they would kill you turn into myths created to control you.

This isn’t going to end well for an addict like me. Once I started thinking for myself and realized that my dick wouldn’t fall off if I watch porn, I started watching all the porn. When I realized that I wasn’t possessed after smoking a cigarette, I started smoking all the cigarettes. Add sex to the mix, sprinkle a little drugs on top, and my newfound freedom as a junkie sinner is complete.

Let’s fast-forward a few years because I don’t want to get into other stories that deserve their own headline. Let’s land where I’m walking down the steps of the courthouse with a piece of paper that mandates that I start attending 12-step meetings. Meetings that I must go to or I’m going back to jail and possibly prison.

Imagine my delight, sitting in my first meeting while they’re doing the readings. I hear the 3rd step read aloud for the first time and everything within my gut cringes. I die on the inside. I’m powerless over drugs and alcohol. I can’t stop. I need to stop. And now I’m being told that the only way to do this is with God. I’m in big trouble.

I have a confession to make. Remember when I told you that this story was about God? It isn’t. I mean it is and it can be for you, too, but it really isn’t. It’s about a higher power; something greater than you. It’s crucial that you hear what I’m about to say.

If you’re a 12-stepper who’s all gung-ho about the 3rd step, that’s cool. If you’re not a 12-stepper who’s grasped the God concept, that’s cool too.

What I want to be explicitly clear about is just one thing. It’s my experience, being an addict in recovery— whether it’s the 12-step route or not—that at some point I have to accept the fact that I need saving. And it’s not going to be me that’s going to do the saving. It’s got to be something greater than me. What I’m good at is getting high. Getting sober is easy. Staying sober isn’t. That’s where the saving comes in for me.

In the beginning. G-O-D meant a lot of things.
- Group of Druggies
- Group of Drunks
- Grow or Die
- Guaranteed Overnight Delivery (kidding)
- Good Orderly Direction
A wise man once told me, “I don’t know what God’s will is for my life… but I know what it isn’t.” I know that my higher power doesn’t want me stealing in sobriety. I know I shouldn’t be smoking crack. I know that now that I’m attempting to live a new way, maybe I should concern myself with my physical health since I neglected it for so long. My higher power doesn’t want me sticking a needle in my arm. For me today, it’s as simple as that.

For people who don’t subscribe to an acronym but actually believe in a God, it can be slippery if it’s not kept simple. It’s common for people to get sober and say, “Okay, what do I do know? What is my life’s purpose and what is God’s will for me?” If they do that, they end up stressing themselves out and thinking themselves out of the game, thinking that they have to understand the meaning of life at 12 months sober; or that they should have a roadmap for their life drawn out, down to every little specific detail.

It’s not that serious. Instead of concerning yourself with some huge existential question mark, keep it simple. Get off the bench, get back on the field and play. Before you know it, you’ll find yourself sober years later with a beautiful life filled with purpose and meaning. I can promise you that only because I’ve seen it happen for many of my junkie friends around me.

My higher power doesn’t hate Pikachu. That’s just silly. If you believe in God, that’s cool. If you don’t, that’s cool too. Just find something greater than you when the days get dark in your life. Hey! Maybe it’s this story. Who knows.

If nobody told you that they love you today: I do. I love you.

View the original article at thefix.com
27 September 2018
New Opioid Laws Seek To Curb Overprescribing

Though there is no hard evidence of the effectiveness of the laws yet, some professionals see the numbers as heading in the right direction.

As the opioid epidemic has continued to claim lives, more than two dozen states have put laws in place in the hope of limiting the damage.

Of those two dozen, the most recent states to take action are Florida, Michigan and Tennessee, according to Harvard Health Publishing. The new rules put in place set limits for the amount of opioids medical professionals can prescribe for pain relief from surgery, injury or illness.

Opioid laws vary from state to state, according to Harvard Health. While most states limit first-time opioid prescriptions to seven days, some states, such as Florida, Kentucky and Minnesota, have shortened it to three days unless a medical professional can give reason for a week-long supply.

“For almost all acute pain problems, including after surgery, a week is usually sufficient,” Dr. Edgar Ross, senior clinician at the Pain Management Center at Harvard-affiliated Brigham and Women’s Hospital, told Harvard Health.

Additionally, some states have put procedures in place that require doctors to take more steps when prescribing. In Florida, both physicians and pharmacists are required to take courses about prescribing practices. They must also search a drug database to make sure doctors aren’t doubling up on prescriptions for patients.

Massachusetts has a similar procedure in place, but some medical professionals say it’s not as simple as it sounds.

“We have the ability to check the registry to see who else has prescribed it, but it’s not integrated with electronic records,” Dr. Dennis Orgill, a surgeon at Harvard-affiliated Brigham and Women’s Hospital, told Harvard Health. “If you have someone who needs opioids over the weekend, you can imagine the logistics of that.”

Another new law, this one in Ohio, allows doctors to override and refill acute pain prescriptions, but only after a patient has gone through the first prescription.

According to Harvard Health, patients will typically have to return to the doctor to get a prescription rather than getting a refill on the phone. If for some reason a refill is made over the phone, Harvard Health states patients will end up visiting the pharmacy more often and making more copays as a result.

If doctors do not follow the new laws, they may face consequences. As a result, Harvard Health states some patients that need prescriptions for chronic pain are not getting them.

“Many doctors now refuse to prescribe any opioids because of the fear of sanctions,” Ross told Harvard Health. “I have had several cancer patients whose pain was not well managed because of incorrect perceptions.”

Although there is no hard evidence of the effectiveness of the laws yet, some professionals see the numbers as heading in the right direction.

“Massachusetts’ opioid legislation was signed into law in March of 2016. The overdose death rate then decreased by 8.3% in 2017, the first decrease since the beginning of the opioid epidemic,” Dr. Karsten Kueppenbender, an addiction psychiatrist at Harvard-affiliated Massachusetts General Hospital, told Harvard Health. “While it’s impossible to say the law caused the decrease, it’s certainly a welcome association.”

View the original article at thefix.com

27 September 2018
Bananas Donated To Prison Contained $18M Worth of Cocaine

The two unclaimed pallets of ripe bananas were filled with a lot more than potassium.

A Texas prison got much more than it bargained for, when a shipment of donated bananas bound for the penitentiary was found to contain nearly $18 million worth of cocaine.

“Sometimes, life gives you lemons. Sometimes, it gives you bananas. And sometimes, it gives you something you’d never expect!” the Texas Department of Criminal Justice wrote in a Facebook post.

According to NPR, representatives from the Ports of America in Freeport, Texas contacted the department when two pallets’ worth of ripe bananas were left unclaimed at the port. The port agreed to donate the fruit to the Wayne Scott Unit prison farm in Brazoria County so they could be consumed before they went bad.

“Two sergeants of the Scott Unit arrived to pick them up, and discovered something not quite right,” the department wrote.

When the correctional officers were loading the 45 boxes of bananas, one noticed that a particular box felt different.

“They snipped the straps, pulled free the box, and opened it up. Inside, under a bundle of bananas, he found another bundle! Inside that? What appeared to be a white powdery substance,” the department wrote.

That led to the whole shipment being searched and authorities found 540 packages of cocaine with a street value of $17.8 million.

“U.S. Customs arrived on the scene, and the substance tested positive for cocaine,” the department wrote. “Customs agents then searched each box on the two pallets, and they were all ripe and loaded. Once all 45 boxes had been emptied, what was left was quite the cache.”

The department praised the attentiveness of the corrections officers who followed his gut.

“With an instinct that something just wasn’t quite right, our guys uncovered 540 packages of cocaine within the shipment, with an estimated street value of $17,820,000!” the department wrote.

The Drug Enforcement Administration and U.S. Customs and Border Protection are investigating the cocaine shipment. They have not released where the shipment came from or who the intended recipient was.

Apparently, shipping cocaine in bananas is relatively common. In April, Spanish police seized nearly 9 tons of cocaine in a shipment of bananas from Colombia. Albanian, Romanian and German police have also uncovered cocaine in banana shipments shipped from Colombia, the largest producer of cocaine.

View the original article at thefix.com

26 September 2018
NYC Welcomes Public To Marijuana "Listening Sessions"

The public’s feedback will help state officials draft legislation to legalize marijuana in New York.

New York is hosting “listening sessions” across the state to gather the public’s input on marijuana legalization.

The Regulated Marijuana Listening Sessions will run from September to mid-October across New York state, as Governor Andrew Cuomo announced in August.

“Community input is critical as we work to draft balanced and comprehensive legislation on a regulated marijuana program in New York,” Cuomo said at the time.

A July report commissioned by Cuomo—the Assessment of the Potential Impact of Regulated Marijuana in New York State—concluded that the positive impacts of a regulated marijuana market outweigh the possible negative impacts, according to a press release issued in August by the governor’s office.

The feedback from the public will inform the Regulated Marijuana Workgroup, which will draft legislation to legalize marijuana in New York, that will be considered by the state legislature in the upcoming session.

“The multi-agency report identified the benefits of a regulated marijuana market, and with these listening sessions we are taking another important step to develop a model program for New York. We look forward to hearing what New Yorkers in every corner of the state have to say,” said Cuomo.

New York currently has a medical marijuana program in place, albeit with several limitations. Home cultivation, smokable medical marijuana, and edible products are not allowed under the program.

The report—which assessed the impact of a legal marijuana system in New York from a health, economic, public safety and criminal justice perspective—also stated that potential areas of concern can be mitigated through regulation and public education.

“Input from communities in every region of the state is an essential part of our approach to a regulated marijuana program,” said Lieutenant Governor Kathy Hochul in August. “With a thoughtful process, New York is moving forward to craft a policy that will ensure continued progress across our state.”

The remaining listening sessions are listed below:

Sept. 26 – Staten Island

Sept. 27 – Long Island

Oct. 1 – Newburgh

Oct. 2 – Binghamton

Oct. 3 – Buffalo

Oct. 4 – Rochester

Oct. 9 – Syracuse

Oct. 10 – Utica

Oct. 11 – Watertown

For more information on locations and pre-registration, visit the New York state website.

View the original article at thefix.com

26 September 2018
Could "Magic Mushrooms" Help You Stop Smoking?

A new study examined whether psilocybin could help long-time smokers put down their butts for good.

Once dismissed as a remnant of ’60s counterculture, and eventually banned as a Schedule I drug, psilocybin—the naturally-occurring psychedelic compound found in certain species of mushrooms, thus earning them the sobriquet “magic mushrooms”—has in recent years been ushered to the forefront of medical and psychological research for its reported efficacy in treating any number of health conditions, including depression and alcoholism.

Now, a new study suggests that psilocybin may also help to curb smoking, as evidenced by the results of six years of research involving smokers who had tried and failed to quit smoking on multiple occasions.

The study found that through controlled psilocybin use and cognitive behavioral therapy (CBT), more than half of the participants had successfully quit smoking after a six-month period—a higher rate of abstinence than with CBT alone, according to researchers.

The study, conducted by researchers from Johns Hopkins University, involved 15 study participants—10 men and 5 women, all at an average age of 51, and who smoked, on average, slightly less than a full pack (19 cigarettes) daily for 31 years. All had attempted to stop smoking on previous occasions, but had failed.

The study authors administered treatment to the participants and then followed up with them over a period of six years, between 2009 and 2015.

The treatment consisted of carefully controlled and monitored psilocybin use in conjunction with CBT. After a period of more than two years, the researchers invited the participants to take part in a follow-up interview to determine if and how the treatment affected their smoking. Twelve of the original 15 participants took part in the interview.

What researchers found was that the 12 participants had not only succeeded in complete smoking cessation after six months, but also experienced a host of additional emotional and psychological responses to the treatment.

Participants said that through a combination of the treatment, counseling, a “strong rapport” with the study team, and a sense of momentum after taking part in the study all contributed to their achieving abstinence.

They also reported “gaining vivid insights into self-identity and reasons for smoking” from the psilocybin treatment, and the sense of “interconnectedness, curiosity and awe” continued after the treatment had ended. Participants also said that they felt an array of “persistent” positive feelings, including “increased aesthetic appreciation, altruism, and pro-social behavior” as a result of their participation.

The researchers concluded that the results of their study underscored the value in continuing research into what some have labeled “psychedelic therapy,” and recommended future research trials.

Their findings also supported previous study findings by Johns Hopkins researchers, which suggested that lifetime smokers treated with psilocybin experienced twice the rate of abstinence than those who used the FDA-approved drug Chantix.

View the original article at thefix.com

26 September 2018
Jenna Jameson Celebrates Three Years of Sobriety

“Today is an important day for me in my recovery. 3 years. I can’t begin to explain what sobriety has brought to my life. But I will try.”

Former adult film star Jenna Jameson took to Instagram this week to celebrate three years of living sober.

“Today is an important day for me in my recovery. 3 years. I can’t begin to explain what sobriety has brought to my life. But I will try,” Jameson wrote in an Instagram post. “Yes, I’m not the intensely self centered ‘the world owes me something’ woman anymore. I am now the ‘What can I do for the world’ woman.”

Jameson hasn’t spoken extensively about her addiction, but there are reports that she was abusing alcohol and prescription pills. Her post was tagged #aa and #na, and she has suggested that she used 12-step fellowships to help her stay sober. Along the way, the 44-year-old said that she discovered new things about herself.

“Sobriety has taught me a lot about myself, my coping mechanisms that I ignored came bubbling to the surface quickly after getting sober,” she wrote. “That scared me. Everything I knew was wrong. Everything I believed in was hurting me, not helping. Meetings and leaning on my Sober friends… made things bearable the first year. I was surviving. Sober. It was shocking at first, but now it’s my new normal.”

Now, she recognizes that her substance abuse was an attempt to fill a void. “I think back to the way I used to run… run as far and as fast as I could, and I pray to God I never feel that emptiness again,” she wrote.

In April 2017, Jameson gave birth to a daughter and struggled afterward with her weight. Now, she has dropped from 187 pounds to 130, a journey she has celebrated on social media.

“My weightloss has solidified my toughness and strength,” she wrote. “I know I am capable of beautiful things and these are the qualities I want to teach my daughter. No matter what life throws at you, you can overcome and flourish. 3 years. 3 whole years. I am grateful. Just for today.”

Previously, Jameson worried that she couldn’t maintain weight loss while sober.

“I was worried I couldn’t lose the weight sober,” she wrote earlier this year. “I’m being real with you. When I was in my addiction it was easy to stay thin. Sobriety and being overweight was new to me. I kept telling myself if I could beat addiction and stay sober, I can easily lose the weight… and I did. The healthy way.”

Both weight loss and recovery have shown her how to tap into her inner strength, she said.

“And as of today I can say my mental game is STRONG,” she wrote on Instagram. “I feel I can do anything, I conquered abuse, addiction, PTSD and depression.”

View the original article at thefix.com

26 September 2018
Taraji P Henson Talks Breaking Mental Health Stigma, Therapy

“I go home to problems just like everybody else. I’m here to tell you, I have a therapist. I probably need to see her more often.”

Actress Taraji P. Henson is continuing her campaign to create dialogue about mental health in the black community.

In a recent appearance on GMA Day, Henson got personal with some strong words about mental health. “When I go to set and you see me as Cookie and they yell ‘Cut,’ I go home to problems just like everybody else. I’m here to tell you, I have a therapist. I probably need to see her more often,” she said on the morning show.

In August, the Empire actress launched the Boris Lawrence Henson Foundation (BLHF) in honor of her late father. “My dad fought in the Vietnam War for our country, returned broken, and received little to no physical and emotional support,” Henson said at the time. “”I stand now in his absence, committed to offering support to African Americans who face trauma daily, simply because they are black.”

Through her foundation, the actress is targeting the African American community specifically to eradicate the stigma around mental health issues, hoping to break the silence and encourage the community to be open about their struggles.

“Why aren’t we embarrassed to talk about our thyroid problem but we’re embarrassed to talk about our mental [health]? As far as African Americans, we don’t include that in total health care and that’s a problem,” said Henson.

The three main goals of the BLHF are to provide mental health support in urban schools, increase the number of African American mental health professionals, and reduce the prison recidivism rate.

“We need psychologists in urban schools. These kids are coming to school every day trying to learn and they’re coming from really traumatic situations at home,” Henson said on GMA Day.

By increasing the number of black mental health professionals in the US, and having a presence in schools, BLHF is hoping to build trust between the black community and mental health professionals.

“You have to understand the culture,” said Henson. “If you go into a therapist session and you’re looking at the person and you feel like, ‘I can’t say this. What would they think about me if I say this?’ Then we’re not getting any work done.”

Another barrier to mental health support in the black community is the perception of weakness. “We’re told to pray [mental illness] away. We’re told that it’s a weakness or we’re demonized because we express these feelings that have been bottled up for so long,” said Henson.

By attacking the stigma with a multi-faceted approach, Henson is hoping to break the silence, and the cycle, of mental illness.

View the original article at thefix.com

26 September 2018
An Open Letter to Addiction Treatment Providers
There’s something wrong with addiction patients feeling the need to ask for medical advice from their communities because they don’t trust their providers.

Maybe you’re a psychiatrist. Maybe you’re a dosing nurse at a methadone clinic. Maybe you’re an inpatient counselor. Maybe you work in an emergency department, or you’re an OBGYN; maybe you don’t specialize in addiction at all, but you regularly come into contact with people who are struggling with the condition. If you’re a medical professional, and all or some of your clients have a substance use disorder (SUD) diagnosis, this letter is for you.

I am a person in remission from a substance use disorder. I’m here to tell you that addiction patients need you to understand our condition. That sounds basic, I know. It is basic. But here’s the thing: too many of you don’t understand. I’m not trying to attack you. I’m not saying you’re all misinformed. There are unquestionably many caring and well-informed providers doing excellent work in this arena. But it’s also true that enough of you are misinformed to be causing major problems for SUD patients. And that needs to change. Like yesterday.

Right now my husband is white-knuckling his way through methadone withdrawal while his clinic works on getting him safely back on his therapeutic dose after one of you, a behavioral health doctor, rapidly dropped him 100 milligrams without consent, for no medical reason, while he was in the hospital for mental health reasons. And in 2014, my newborn daughter went through over a month of neonatal withdrawal from my prescribed methadone, which could have been prevented or lessened if my pre- and postnatal providers had made a few small changes to their protocols; sadly, this kind of medical treatment is still provided to mothers and infants across the country.

Every damn day SUD patients crowdsource medical information from social media communities and online forums, often due to mistrust in the medical community when it comes to addiction care.

Sara E. Gefvert, a certified recovery specialist who runs the Methadone Information Patient and Support Advocacy (MIPSA) Facebook group, says that she created MIPSA because she saw members of other communities receiving unreliable responses to medical questions. “Many MAT sites and groups I saw were not monitored frequently for correct and accurate content or were only adding to the misinformation and stigma that persons in recovery face, especially being on medication-assisted treatment.”

In just one day, questions asked in five separate addiction treatment-focused Facebook groups included:

What kind of pain relief options are available during labor while I’m on buprenorphine?
Should I raise my methadone dose if I have psychological but not physical cravings?
Is it normal to lose my sex drive while on methadone?
Am I still in recovery if I drink alcohol occasionally?
Can cold-turkey opioid withdrawal kill you?
Is it safe to detox while pregnant?
Can you combine buprenorphine and methadone?
Should my methadone be making me nod out?

And others along those lines.

These are all medical questions with real world consequences—some dire. The answers to these questions should be coming from trusted providers with medical expertise. Sure, people crowdsource medical information from the internet all the time, but it’s usually about pretty mild concerns, or trying to squirrel out whether they should go to a doctor. On the other hand, these addiction specific questions are often accompanied by complaints that the patient couldn’t get a straight answer from her treatment provider, or that the information she received was the opposite of what she read in a research study or an online article. There’s nothing wrong with people seeking community input on issues they’re facing, especially when the answers are reviewed by knowledgeable and professionally trained administrators like in the MIPSA group.

There is, however, something wrong with addiction patients feeling the need to ask for medical advice from their communities because they don’t trust their providers.

This seems to be an especially prevalent issue for medication-assisted treatment (MAT) patients. I was on methadone for about a year in 2013 and 2014, and on buprenorphine from 2014 to June of 2018 (with a short break of about five months in 2016). Before starting methadone, I was actively addicted to heroin for close to five years. In all of that time, I heard a lot of different things from a lot of different doctors, nurses, counselors and detox staff in virtually every region of the country. For example:

Buprenorphine is only good as a detox aid.
Buprenorphine works best as a long-term treatment.

Methadone is more addictive than heroin.
Methadone creates a dependency but effectively treats addiction.

Breastfeeding while on methadone is unsafe.
Breastfeeding while on methadone can help ease neonatal withdrawal.

I can’t count myself sober if I take medication
I’m at an increased risk of relapsing and overdosing if I detox.

Addiction is a disease.
Addiction is a spiritual malady.

How was I supposed to tease out the truth from all that?

With all the confusing and contradictory information that patients receive about addiction, it would be easy for someone to assume that the medical science is still out. In reality, there’s quite a lot of straightforward, peer-reviewed data about substance use disorders. Frankly, there is no excuse for a medical provider to ignore these facts. For example, decades of research have shown that methadone (a long-acting opioid agonist) and buprenorphine (a partial opioid agonist), help deter opioid misuse, decrease the risk of fatal overdose, and may help to correct neurochemical changes that took place during active addiction.

To quickly address some of the other misinformation I’ve encountered:
- Both methadone and buprenorphine treatment are appropriate, and in fact designed, for long-term use. Patients who choose to taper from these medicines can do so safely, but there is no generalized medical reason why someone with an opioid use disorder should be forced off either medication.
- Breastfeeding while on methadone or buprenorphine is considered safe as long as the mother is not using other substances.
- If a patient is using these medicines as prescribed and is not using other substances in a compulsive manner, they are in remission from their substance use disorder. In other words, they’re sober (though defining oneself with the term “sober” is a personal choice).
- Addiction is medically defined as a disease. Which means that the onus is on our medical providers to stay informed about the science of this disease.
Ultimately, you can’t be held responsible for everything your patient does. But you do have a responsibility as a treatment provider to give your patients accurate and informed medical advice.

According to the Substance Abuse and Mental Health Administration (SAMHSA), about 20 million adults in the United States have a substance use disorder. So we’re not talking about some rare condition that only a handful of specialists can be reasonably expected to understand. This is a common, treatable disorder with a robust body of solid research behind it. You need to read that research. You need to stay informed. If you don’t have an answer to a patient’s question, you need to refer them to an accessible colleague who will. You took an oath to do no harm. Staying informed about addiction medicine is part of keeping that oath.

Sincerely,

Elizabeth Brico

View the original article at thefix.com
26 September 2018