Category: Addiction News

How To Stop Taking Methadone?
READING SUMMARY: The best way to stop taking methadone is by consulting a medical professional. Methadone withdrawal can be painful and psychologically challenging. Whatever discontinuation method you decide to use make sure to discuss the risks and benefits with your doctor. S/He can help you decide whether a long-term taper or abrupt discontinuation is right for you.

TABLE OF CONTENTS
Why Quit Methadone?

There are a few reasons you may want to quit taking methadone.
1. Treatment completion. If you have achieved therapeutic stabilization and are ready to live without methadone, congratulations! According to this study published in 2009, methadone is the most successful treatment for stronger opiate addiction, although with fairly substantial financial and personal costs. If you’re ready for a change and have the support…go for it! See the chart below from the 1999 NIDA Notes on methadone treatment success.
2. Drug interactions. Other medications may interact with methadone and can cause heart conditions. Take a look at this WHO chart of methadone drug interactions for a full list of potential side effects.
3. You’re addicted to it. According to SAMHSA, methadone is addictive. After all, it’s still a psychoactive drug…and can cause euphoria especially when you’re not taking it a prescribed. If you get high on methadone, it may be time to look into treatment options for getting off methadone for good.
What Happens When You Quit?

Quitting methadone throws your body out of balance. Most users have developed physical dependence on the substitution drug. So, when you come off of methadone, the lack of it causes stress to the system.

According to the World Health Organization’s (WHO) Clinical Guidelines for Withdrawal Management, it can take between 3 and 10 days for the amount of methadone in in your system to stabilize. So, after taking methadone for a this period of time physical dependence on the medication is expected. This means that your brain and body begin to function normally in the presence of methadone.

When you remove methadone, it takes about 7-10 days to get back to normal. So, if you have developed dependence on methadone and you stop using it, you will experience typical methadone withdrawal symptoms.

Think of withdrawal like this: the body adapts to the depressant effects of methadone by “speeding up” some processes. Take away the methadone, and it takes time for these processes to slow down again.

Withdrawal

So, what is methadone withdrawal?

Withdrawal is a group of predictable symptoms that arise in the body when you lower or cut off your usual doses of methadone. Withdrawal symptoms occur as the effects of methadone wear off and the medication starts to leave the system. These unpleasant side effects are always accompanied by symptoms of discomfort which may increase your need for this drug.

The duration of these unpleasant withdrawal symptoms is around several days to one week. The withdrawal symptoms tend to manifest three days after dose reduction, and last 7-10 days. However, some protracted withdrawal symptoms such as depression, anxiety, or sleeping problems can last for several months after dose cessation.

Withdrawal Symptoms

When you stop taking methadone you can expect to experience some flu like symptoms. Muscle aches and pain occur as methadone is eliminated from your body. As withdrawal symptoms progress you will likely feel nausea, cramps, sweats, and you may experience vomiting and diarrhea. Click here for an Addiction Blog list of methadone symptoms and timeline.

You may also experience other uncomfortable symptoms during the withdrawal stage, such as:
- anxiety
- concentration problems
- confusion
- cravings
- diarrhea
- headaches
- insomnia
- mood swings
- shakes
- sweating
- tiredness
- vomiting
In order to overcome these difficulties it is best to stop using methadone under medical guidance.

Cold Turkey

Doctors never recommend quitting methadone cold turkey.

Going cold turkey off methadone can bring you serious difficulties and may have dangerous consequences. One of the biggest risks during the detoxification period is relapse. People who quit cold turkey usually start with high motivation and determination, but once withdrawal sets in, they’ll go to any length to get more of the drug…or will relapse to a stronger opiate, like heroin.

Tapering

“Tapering” is a procedure that involves a gradual reduction of methadone doses during an extended period of time. Methadone dose reduction schedules range from 2–3 weeks to as long as 180 days, with longer time periods generally associated with better outcomes. Studies have indicated that the more rapid the reduction, the more likely a drug relapse (especially to heroin). Still, this method of discontinuation is considered less aggressive and more safe than abrupt cessation.

Medical professionals recommend to gradually taper off methadone according to individualized tapering schedule created by your doctor. The main goal of tapering is to ensure that the withdrawal process is completed with safety and comfort. Methadone doses are usually reduced in the following rates:
- 20-50% from your current dose per day until you reach 30 mg/day.
- 5 mg per day every three to five days until you reach 10 mg/day.
- 2.5 mg per day every three to five days.
The Australian Department of Health states that the recommend methadone dose reduction should be from 10mg/week to a level of 40mg/day, then 5mg/week. Rates of reduction should be discussed with your doctor and dose changes should occur no more frequently than once a week.

Tapering won’t make withdrawal symptoms disappear. In fact, it can be unpleasant, but it can also lower the intensity and duration of symptoms. When tapering is used to manage withdrawals from heroin or methadone, withdrawal signs and symptoms will begin to manifest as you cut down your daily doses below 20mg. Symptoms reach their peak usually between the second and the third day after cessation According to The Department of Health methadone withdrawal symptoms subside after 10 to 20 days following cessation. Nevertheless, medical practice has confirmed that people tend to tolerate withdrawal symptoms better when they gradually reduce their dosage.

NOTE HERE: You should not attempt to reduce methadone doses by yourself. Dose reductions should be made in consultation with a doctor. When you make an agreement on a tapering schedule, your doctor and addiction counselor or therapist. will be able to follow your progress.

Medications

Several medications are used during detox and addiction treatment programs for helping people who are addicted to methadone.
1. Buprenorphine may be prescribed to people because of its similar effects to methadone. Buprenorphine is effective in easing withdrawal symptoms.
2. Clonidine eases some of the physical withdrawal symptoms associated with methadone detox.
3. Naltrexone prevents methadone from binding to opioid receptors in the brain.
When medications are used as an integral part of a medically guided treatment program, mood-stabilizing medications, such as antidepressants or anti-anxiety medications can also help.

NOTE: Whether you decide to taper your methadone doses, or decide to go cold turkey, the most important point is that you first ask for support from medical professionals.

Stopping Safely

When you decide to stop taking methadone, a professional point of contact can be your doctor, addiction treatment program, or methadone clinic. Or, you can call us directly. Our hotline number on this page will direct you to an addiction recovery specialist. Here’s what you can expect when you seek help:

1. Assessment.

Medical professionals first determine whether you are physically dependent or addicted to methadone. They assess dependence levels, take your psychological profile, and interview you. You may be asked to submit a urine or blood sample for drug testing.

2. Medical detox.

After your methadone dependency level is determined, you are going to work out the safest alternative to quitting with methadone. One possibility is that you will need to visit a detox clinic. The medical detox clinic will provide you with round the clock care and a safe, drug free environment.

3. Rehab.

If necessary, you may be referred to longer term inpatient or outpatient rehab.

4. Therapy and counseling.

The goal of quitting methadone for good is learning to deal with psychological issues. Mental and behavioral therapies along with family support are usually combined to help you lead a sober life.

Your Questions Are Welcomed

Got a question?

If you or a loved one are considering quitting methadone, don’t hesitate to consult your doctor or treatment provider. Or, feel free to ask your questions in the comments section below. Additionally, if you have any tips or experiences you’d like to share, please do! We’ll do our best to answer all legitimate inquiries personally and promptly.

Reference sources: Medline Plus: Methadone
CSAT Tip 43: Medication Assisted Treatment for Opioid Addiction
DOJ: Methadone Fast Facts
NCBI: Methadone at tapered doses for the management of opioid withdrawal
The Department of Health: Cessation of methadone maintenance treatment

View the original article at addictionblog.org
2 May 2019
How long do benzos stay in your system?
ARTICLE OVERVIEW: Benzodiazepines can be detected up to 30 days in urine although chronic use (1+ years) can be detected 4–6 weeks after last dose in urine. Benzos can also be detected in serum and plasma for 12 hours to 2 days after last dose.

TABLE OF CONTENTS
Taking Benzos

Benzodiazepines, or “Benzos”, are one of the most powerful tranquilizer sedatives prescribed by doctors. As a central nervous system depressant, benzodiazepine can be highly effective. However, benzos vary in terms of uses, active times and addictive qualities. When taken recreationally, people use these meds for sedative effect, or to enhance the effects of alcohol or opioids…but also increase addictive potential.

Medically, benzodiazepines are prescribed to induce sleep, relieve anxiety, to sedate, treat muscle spasms and prevent seizures. Benzos can also be prescribed during alcohol withdrawal, or used to treat anxiety related disorders of the gastrointestinal tract. They should only be prescribed for short periods of time.

Benzodiazepines are usually prescribed and taken orally, but some people use benzos without a prescription from a doctor. This is illegal and can be very dangerous. Some use intravenous injection after preparing a solution from crushed tablets. Commercially available liquid forms can also be injected, and gel forms can be rectally administered.

The list below shows some of the different generic and brand names of benzodiazepines:
- Bromazepam: Lexotan.
- Clonazepam: Rivotril.
- Diazepam: Valium, Ducene, Antenex.
- Flunitrazepam: Rohypnol, Hypnodorm.
- Lorazepam: Ativan.
- Nitrazepam: Mogadon, Alodorm.
- Oxazepam: Serepax, Murelax, Alepam.
- Temazepam: Euhypnos, Normison, Temaze.
Some slang names for benzos are rowies, serries, moggies, vals, V, normies, downers, tranks and sleepers.

Main Effects

The effects of benzodiazepines can be divided into immediate and long-term effects and may last from a few hours to a few days, depending on the dose and type of benzo you take.

The immediate effects can include that you:
- Become confused or dizzy.
- Cannot judge distances or movement properly.
- Cannot remember things from just a short time ago.
- Feel drowsy, sleepy or tired.
- Feel really good.
- Feel relaxed.
- Have blurred or double vision.
- Have mood swings.
- Have no energy.
- Slur your words or stutter.
If you use benzodiazepines often for a long time, you may:
- Be cranky.
- Be depressed.
- Be hungrier and put on weight.
- Experience fatigue or drowsiness.
- Feel sick in the stomach.
- Get skin rashes.
- Have dreams that make you feel bad.
- Have headaches.
- Have menstrual problems if you are a woman.
- Have no energy or interest in doing normal things.
- Lose interest in sex, or your body will not work properly during sex.
Factors that Influence Metabolism

Not everyone reacts to benzos the same way. In fact, there are a number of factors that play into how these types of drugs effect you and how you metabolize them. For example, your current mood, past experience with benzodiazepines, and whether you use alone or with others, at home or at a party can also include outcomes.
Generally, benzodiazepine metabolism depends on:
- How many tablets and what dose you take.
- Route of administration.
- Whether you use benzos on their own or with other drugs.
- Your general health.
- Your height and weight.
Peak Levels And Half-Life

Peak levels and drug half life of benzos depend upon the particular drug prescribed, dosage, interval between doses, and route of administration. Longer half-life benzodiazepines have a more sustained effect, although some may accumulate. In general, benzos can be divided into these three categories:

Ultra short acting benzos: The half-life of ultra short acting benzodiazepines is less than 5 hours. These drugs are essentially non-accumulating.

Short acting and intermediate benzos: This class of benzodiazepines have half-life values from 5-24 hours and can be dosed more frequently. Accumulation during multiple dosage is less extensive than with the long-acting group, and diminishes as the half-life becomes shorter.

Long acting benzos: Long acting benzodiazepines have half-life values usually exceeding 24 hours. Drugs in this category have long acting pharmacologically active metabolites, which accumulate extensively during multiple dosage.

Blood, Hair, And Urine Sample Tests

Testing cutoff concentrations for benzodiazepine are at 200 ng/ml. So how long do benzos stay in the body?

Blood: Benzos can be detected in serum and plasma for 12 hours to 2 days after last dose.

Hair: Hair samples are usually not used to detect benzodiazepines. While some popular medicines like diazepam may regularly be detected via this method, false negative results and variability in performance make this test less standard.

Urine: Benzodiazepines can be detected up to 30 days in urine although chronic use (1+ years) can be detected 4–6 weeks after last dose in urine.

You can find a full list of Drug Tests approved by the FDA here. [1]

Benzodiazepines are now part of most routine drug screening procedures. Most standard drug screens are usually unable to distinguish between different benzodiazepines. Since a number of benzodiazepines share common pathways of metabolism, it is not possible to test for the abuse of specific benzodiazepines such as diazepam or temazepam. It is also difficult for drug tests to detect ‘low’ dose benzodiazepine use.

Tolerance and Dependence

Anyone can develop a ‘tolerance’ to benzodiazepines. Tolerance means that you must take more of the drug to feel the same effects you used to have with smaller amounts or lower doses. This may happen very quickly with benzodiazepines.

Physical dependence occurs when you regularly take benzos for period of a few weeks or longer. In fact, most of the drugs in this class of medications should be prescribed for 6 weeks or less, due to the phenomenon of dependence. According to this 2015 article published in the Australian Prescriber [2]:

Any patient who has taken a benzodiazepine for longer than 3–4 weeks is likely to have withdrawal symptoms if the drug is ceased abruptly. The risk of inducing dependence can be reduced by issuing prescriptions limited to 1–2 weeks supply.

When you become drug-dependent, your brain has adapted to the psychoactive chemicals found in the benzodiazepine by compensation, in this cases, “speeding up” certain processes or functions. It does this to balance out the sedative, depressant effects of the strong benzo drug in your system. When you significantly lower dosage or quit altogether, it takes time for the brain to find homeostasis again. So, withdrawal symptoms occur.

However, benzo dependence is not limited to physical dependence. ‘Psychological dependence’ on benzodiazepines is also possible. When a benzo takes up a lot of your thoughts, emotions, and activities…you might be hooked on it. People who are psychologically dependent spend a lot of time thinking about using benzodiazepines, looking for them, using them, and getting over the effects of using them. You may also find it difficult to stop using or control how much you use. This kind of dependence, also known as addiction, can lead to a variety of health, money, legal, work and relationship problems.

Not all people who ever use benzodiazepines become dependent. But it is very easy to become dependent on benzodiazepines and it can happen within four weeks.

Withdrawal

People who are dependent on benzodiazepines find it very hard to stop using them or cut down because of withdrawal symptoms. Withdrawal often involves “rebound” symptoms related to the original problem. So, if you were taking the meds to control anxiety, your anxiety can be amplified. Likewise for sleeping problems.
Still, suddenly stopping using benzodiazepines can be dangerous. You should get help and withdraw gradually if you have been using benzos regularly or using high doses of them. Tapering guidelines outlined by Dr. Heather Ashton are consider the go-to medical guidance for safely coming off these strong drugs. [3]

Symptoms of benzo withdrawal can include:
- Being confused or depressed.
- Convulsions.
- Disturbed sleep.
- Feeling nervous or tense.
- Feeling afraid or thinking other people want to hurt you.
- Feeling distant or not connected with other people or things.
- Flu-like symptoms.
- Heavier menstrual bleeding and breast pain in women.
- Pain, stiffness or muscle aches or spasms.
- Panicking and feeling anxious.
- Shaking.
- Sharpened or changed senses (e.g. Noises seem louder than usual).
Signs of a Problem

There is significant concern regarding overprescribing of benzodiazepines and the resultant harms. People who are benzodiazepine dependent or at risk because of misuse should be identified and appropriately assessed to determine their risk of harm.

You may have a problem if you present any of these characteristics:
- Amnesia.
- Appearance of dementia.
- Benzodiazepine overdose.
- Blurry vision.
- Confusion.
- Disturbing dreams.
- Drowsiness.
- Hostility.
- Instability when walking or moving.
- Irritability.
- Judgment alteration.
- Lack of coordination.
- Reduced inhibition.
Furthermore, these medicines can be addictive. Since many benzodiazepine addictions start out as prescriptions, it can be challenging to notice when a person becomes addicted. Once a person has become addicted to benzodiazepines, they may appear detached and apathetic. They may begin removing themselves from normal family and social activities and lose interest in hobbies and maintaining relationships.

The main signs of benzodiazepine addiction include:
1. Continued use, despite harm to health, work, or relationships.
2. Feeling that you cannot function without the medicine.
3. Trying to quit but being unable to stop.
4. Using benzos to get high.
Prescribing interventions, substitution, psychotherapies and pharmacotherapies all contribute to the management of benzodiazepine dependence.

Risks of Misuse

The way a person uses benzodiazepines can also cause some problems. If you take a very high dose of benzodiazepines alone or with other drugs, you can depress the respiratory system, go into a coma or die. Injecting benzodiazepines that are intended to be swallowed in tablet/capsule form can also cause severe damage to veins, leading to loss of limbs from poor circulation, organ damage or stroke. Injecting benzodiazepines with used or dirty injecting equipment makes you more likely to get infected with HIV, hepatitis B or C, get blood poisoning and skin abscesses.

NOTE HERE: To minimize possible harm, avoid injecting benzos. If you do, DO NOT SHARE fits (needles and syringes), spoons, water, filters, alcohol swabs, or tourniquets.

Benzos and Addiction

Do you have problems with Benzodiazepines? If you think that you have a problem (with any chemical or drug), you probably do. Ask yourself, why you are taking it? And you will have an answer. We understand some benzodiazepines are more addictive than others and the problems they can cause.

You are not alone. In fact, once you are ready to face potential addiction to drugs, help is available. If you think that you are addicted to benzos, please email us or write us a comment below. We would love to hear from you and are here to help you get treatment.

Reference Sources: [1] FDA: Drugs Of Abuse Test
[2] NCBI: Management Of Benzodiazepine Misuse And Dependence
[3] New Castle University: Benzodiazepines: How They Work And How To Withdraw
FDA: Drug Safety
NIDA: Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties
NIH: Detection OF Benzodiazepines AND Z-Drugs IN Hair Using AN Uhplc-Ms/Ms Validated Method: Application TO Workplace Drug Testing
SAMHSA: FDA Regulation Of Drugs Of Abuse Tests
STATE OF NJ: Benzodiazepine Addiction Help And Treatment In New Jersey

View the original article at addictionblog.org
2 May 2019
Virgin Islands Struggle With Mental Health Crisis After 2017 Hurricanes

The children of the U.S. Virgin Islands were deeply affected by the trauma of surviving two massive hurricanes.

The U.S. Virgin Islands are still struggling to recover from the two devastating hurricanes that hit them along with Puerto Rico and the Southeastern continental U.S. in 2017, according to a report by NPR.

While they slowly rebuild their island’s infrastructure, schools, homes and businesses, the population is also dealing with a mental health crisis fueled by the stress of disrupted government services, lost jobs and severely damaged homes.

Children appear to be having a particularly difficult time. The hurricanes damaged many of the island’s school buildings, forcing them to resort to two four-hour school sessions each school day in order to house and continue education for the kids with half the classrooms.

This change appears to have severely disrupted the typical education process for the children of the Virgin Islands, resulting in behavioral problems and widespread mental health issues. The educational disruption comes on top of the initial trauma of surviving two Category 5 hurricanes.

“We see… regression in behaviors, especially with our little ones who had been potty-trained, reverted to using diapers,” says mental health counselor Vincentia Paul-Constantin. “We see a lot of frustration, cognitive impairment, hopelessness and despair” among older children, she added.

Researchers have found that 60 percent of adults on the island now suffer from depressive symptoms and/or PTSD, as well as 40 percent of children. According to the report, over 20 percent of students in grades 7-12 reported suicidal thoughts and 1 in 12 had attempted suicide.

According to Virgin Islands educators, the past two years have seen a large spike in children acting up in the classroom and an increase in defiant behavior. This has continued even after the schools finally returned to their normal schedule in October 2018.

“They show up in defiance, actual defiance to authority. We have children who are sleeping in the middle of the day,” said Cancryn Junior High School Principal Lisa Ford. “You try to wake them up, they become angry. And maybe that’s what we’re seeing — a lot of anger and defiance.”

The culture on the U.S. Virgin Islands places a lot of shame on mental illness, making people reluctant to seek help. At the same time, there were already very few mental health professionals available. The local government only employed one full-time and one part-time psychiatrist for the entire island, and they and private mental health professionals have reportedly been overwhelmed by a new demand for care.

To help combat this problem, Governor Albert Bryan recently declared a mental health state of emergency in order to expedite the recruitment of psychological experts.

“This is a kind of ‘cry in the dark’ kind of community,” Bryan told NPR. “A lot of that is driven by the stigma. You wouldn’t ostracize somebody who had high blood pressure. Why would you ostracize somebody who has some kind of personality disorder?”

View the original article at thefix.com

2 May 2019
Workers Challenge Japanese Tradition of Drinking With Bosses

One Mitsubishi executive says that “nominication”—drinking with bosses after work—is unproductive and excludes parents of young children.

Younger generation shaking up tradition in the Japanese workplace.

These days, “millennials” in the US are drinking less and more venues are catering to sober patrons, according to recent headlines. Apparently, this younger generation―those between the ages 22-37―is generally more mindful of drinking habits than their parents’ generation.

There seems to be a similar trend happening in Japan as well. According to a recent Bloomberg report, young people in Japan are shaking things up in the workplace, in particular by skipping out on drinks with the boss and co-workers―a practice called “nominication” that is ingrained in Japanese culture. (Nomu, the Japanese word for drink, plus communication.)

Some say that getting after-work drinks with the boss is a great way to de-stress and break the ice between managers and employees. But to others, nominication is unproductive and excludes parents of young children, especially mothers.

As Bloomberg reports, “Some women in particular often resent having to entertain their superiors after a long working day.”

Saiko Nanri, a banking unit executive at Mitsubishi UFJ Financial Group Inc. and mother of two teenage daughters, decided to ditch the tradition altogether. She notified her team that she will not participate in nominication. So far, she says, she’s gotten positive feedback from her employees. Parents in particular expressed their appreciation. “It’s not as if I have any special knowledge to share with my staff by drinking with them every day,” she told Bloomberg.

Bloomberg observed that “bonenkai”―office parties at the end of the year that are often many employers’ “biggest and booziest” events―is also falling out of favor among millennial workers. A survey from last November showed that more than half of 20-somethings have little interest in these parties.

Here at The Fix, we’ve also observed the growing popularity of mindful drinking. It’s easier than ever to live a sober lifestyle. Alcohol-free “mocktails” are becoming more sophisticated, “sober bars” offer a place to socialize, and the market for low- or no-alcohol beverages is growing.

It will be interesting to see how this trend progresses and how drinking culture―abroad and stateside―will evolve over time.

View the original article at thefix.com

1 May 2019
Mexico May Legalize Marijuana by Fall of 2019

Polls currently show that 80% of the public in Mexico support legalization efforts.

Mexico may join a growing list of countries with full legalized access to marijuana when lawmakers convene in May to draft a regulation bill that may take effect in late 2019.

A key committee member of the country’s Senate Justice Committee, which has been tasked with reworking existing marijuana laws in the wake of the 2018 Supreme Court decision to strike down a ban on cannabis consumption, was quoted in a newsletter posted by the Senate that the committee will use an upcoming recess in May to finalize the bill prior to the Supreme Court’s deadline of October 2019.

Polls currently show that 80% of the public in Mexico support legalization efforts.

Senate Justice Committee chairman Ramon Menchaca Salazar said that his group will “take advantage of the recess period,” which takes place May 1 to May 30, to finalize legislation, and has already met with Mexico’s attorney general to discuss the proposed bill.

“Canada already decriminalized, and marijuana is decriminalized in several states of the United States,” said former senator Olga Sanchez Cordero, who now serves as Mexico’s interior minister. “What are we thinking? We are going to try to move forward.”

Mexico legalized medical marijuana in 2017, but broad legalization efforts were stymied until the Supreme Court decision, which was the fifth such ruling against the recreational pot ban since 2015. Five amparos, or federal injunctions, must be successfully filed before national law can be changed in Mexico, and the Supreme Court ruled on the fifth and final such effort on October 31, 2018, which declared the ban unconstitutional.

Marijuana Moment stated that the Senate Health Commission held a hearing on marijuana law reform earlier this month, where lawmakers testified about the realities of regulating such a market. Among the benefits cited were improvements to public health through improvements to production and distribution of cannabis. Regulation could also help curb the violence which, according to legalization supporters, claimed more than 230,000 lives in the country’s fight against drug cartels.

Maria McFarland Sanchez-Moreno, who serves as executive director of the Drug Policy Alliance, issued a press release which stated that “Mexico will demonstrate regional leadership and take an important step towards reforming the misguided policies that have caused such devastating harm in recent decades.”

As the Motley Fool noted, legalization in Mexico could make the country the largest marijuana market in the world. Population numbers currently hover around 132 million – more than triple that of Canada, which in 2018, reported that one in six adults used marijuana.

The Motley Fool also noted that if a similar number of adults in Mexico bought legal cannabis, the country could not only pass sales figures in Canada but also California, the fifth largest economy in the world.

View the original article at thefix.com

1 May 2019
Programs Aim to Bridge Addiction Treatment Gap After Jail

Treatment programs both public and private are working to keep newly-released inmates on the right track.

Programs are popping up around the country aiming to help people with substance use disorder stay sober after they are released from jail—a time that can be especially dangerous for those who have been in forced sobriety while behind bars but were not given the necessary treatment to stay sober on the outside.

“A lot of people come out of prison, and they don’t have anything, and it’s really hard to be successful,” Judge Linda Bell, who presides over an opioid court in Las Vegas, Nevada, told News3 Las Vegas.

The program that Bell oversees helps people released on parole stay sober by connecting them with medication-assisted treatment, housing, counseling and other supports.

“If it’s still available, I’d like to stay an extra month and continue to stay in sober living,” parolee Clayton Dempster told Bell during a recent court hearing.

Bell does her best to help people like Dempster stay sober, but also imposes consequences if they’re not adhering to the terms of their release by staying in recovery.

“I have frequent status checks to make sure all of that is going well. If it’s not, I might impose community service or even a short jail sanction,” she said.

While programs like the one Bell runs, which is grant funded, are part of the criminal justice system, other programs outside the system are also trying to help newly-released inmates stay sober.

In Baltimore, a privately-funded van parked outside the city jail helps people connect with many of the same services provided in Bell’s courtroom, like medication-assisted treatment—bridging the gap that opens when people are released from jail but not put in touch with ongoing services.

“This program works,” Michael Rice, a client of the van, told Vox.

Without a functioning government system to help people, especially in cities like Baltimore, private organizations and foundations are left providing lifesaving treatment to people at risk.

“There are plenty of high-threshold options, but not enough low-threshold options,” said Natanya Robinowitz, executive director of Charm City Care Connection, which provides treatment services in Baltimore. “If you had a functioning system, it would be very low-threshold.”

Because access to treatment can be prohibitively expensive, especially for people who don’t have insurance, jails have become the default detox and treatment facilities for people with substance use disorder.

Because of that, there has been more recent support for evidence-driven treatment options like medication-assisted treatment, but still only about 12 percent of jails provide it. Fewer still provide services after a client leaves. However, even in the law enforcement community people are beginning to realize that treatment provided in jails and after release can be lifesaving.

“We know if you are an opiate user you come in here, you detox, and you go out—it’s a 40% chance of OD-ing,” said Carlos Morales, the director of correctional health services for California’s San Mateo County. “And we have the potential to do something about it.”

View the original article at thefix.com

1 May 2019
U.S. Reps Say Stop Classifying Marijuana as a Dangerous Drug

The federal government currently classifies marijuana as a Schedule I drug, impeding important research and new medical treatments.

U.S. Representatives Earl L. Carter and Earl Blumenauer published a call for the government to remove marijuana from the list of Schedule I drugs in NBC News’ opinion section Monday. They argue that marijuana’s current classification, which labels cannabis as dangerous and without any medical benefits, has prevented researchers from studying a substance that is being legalized on a medical and recreational basis across the country.

Carter, a Georgia Republican, and Blumenauer, an Oregon Democrat, believe that it’s past time to remove many of the hoops researchers must go through to even begin to study the effects and medical benefits of cannabis.

“[R]esearchers seeking to conduct clinical research must jump through several hoops to submit an application to the FDA and get approval from the DEA before starting their work,” they wrote. “Furthermore, all research efforts must go through the National Institute on Drug Abuse and the cannabis used must be sourced from their authorized facility. In 2016, the DEA announced that it would create a process to license additional manufacturers for research, but it has yet to approve a single application despite bipartisan congressional pressure.”

The representatives support their argument by pointing out that over 90 percent of U.S. residents approve of legalizing cannabis for medical purposes and the FDA approved oral cannabidiol (CBD) solution for the treatment of two forms of epilepsy in 2018. They also express concern that not only could the current red tape prevent people from getting treatment that could help them, it could be preventing some from realizing that they “need to pursue a different treatment.”

An increasing number of federal U.S. legislators have been getting on board in terms of cannabis decriminalization or full legalization. Recent business deals between large cannabis companies have caused speculation that legalization could be right around the corner in spite of the DEA’s continued refusal to take the drug off of the list of the most tightly-controlled substances.

As more states legalize cannabis and more people try it for treatment of physical and psychological illnesses, there has been increasing concern that research has fallen too far behind. As the opioid epidemic has raised questions about what to do about the millions of people who need regular pain relief, U.S. researchers have been unable to quickly and effectively research how well cannabis could act as a full or partial replacement for drugs that are physically addictive and carry the risk of overdose.

“The chemistry found only in cannabis plants can provide relief across an incredible array of adverse health states. It does this with minimal side effects and with the prospect of being eminently cost-effective in its use,” said ANANDA Scientific CEO Dr. Mark Rosenfeld.

“The medicinal use of cannabis today has its roots in the 1960s, when Israeli scientists began studies on its unique chemistry. A government program for administering medical cannabis has been in place there for 12 years, and doctors do not hesitate to encourage its use as an effective pharmaceutical alternative. Meanwhile, the United States remains regrettably behind because of its draconian and antiquated anti-cannabis laws.”

View the original article at thefix.com

1 May 2019
Parkland Students Find Ways to Cope with Trauma of School Shooting

The survivors of last year’s horrific school shooting are creating their own channels of healing.

In the aftermath of the Parkland school shooting, some survivors have created unique outlets to channel their pain.

Many are still haunted by what happened on February 14, 2018 at Marjory Stoneman Douglas High School in Parkland, Florida.

The impact of the horrific event lives in each survivor, many of whom are struggling to cope with the trauma of what they witnessed. This year, two Parkland survivors died by suicide—16-year-old Calvin Desir and 19-year-old Sydney Aiello, who graduated last year.

To bring awareness to the mental health challenges of trauma survivors, People magazine recently caught up with six Parkland students. While they are each battling the trauma within, some have transformed their pain to help others.

Carlos Rodriguez, 18, created Stories Untold, a Twitter-based platform for victims of gun violence to share their stories. The platform has created a community of support and activism for not only Parkland survivors, but anyone affected by gun violence.

Eden Hebron, 16, is processing the trauma with a therapist. It has helped her, but unfortunately, she says, not everyone is open to therapy. “Some families still consider it, like, ‘Oh, it’s a shrink. Are you going to talk your feelings out?’”

Hebron has created a mobile app to help people find ways to cope with stress, anxiety and depression. With her app, people can learn ways to address these symptoms.

“So many kids have anxiety,” Hebron told People. “This shooting impacted people all over the country. This app is a way to give them the tools to help themselves.”

Kai Koerber, 18, launched Societal Reform Corp, a non-profit organization working to establish mental health programs in schools. “We need to put mental health on equal standing with gun control,” said Koerber.

Today, the need for mental, emotional, and trauma support is greater than ever. These young people are leading the charge and doing the work to provide themselves and others with effective coping strategies.

“I don’t think I’ll ever be able to forget what I saw in that classroom,” said Hebron. “You can try to imagine, you can try to sympathize… but nobody understands how it feels to be in a room and literally feel, ‘These are the last moments of life.’”

View the original article at thefix.com

1 May 2019
How to Manage Depression: 6 Simple Reminders

Treat yourself with gentleness and forgiveness. With every negative thought about yourself, throw in a dose of self-love. Self-compassion can reduce the severity of depression and anxiety.

Depression is not easy.

If depression is new to you, or coming back after a long absence, you need to give yourself time and patience to adjust to new ways of being. I’ve had depression most of my life, but I am learning to live differently than I once expected myself to. Even though it may feel strange and uncomfortable, try to be kind to yourself and give yourself space to take things slowly.

1. Dealing with Fatigue

I can see it begin to creep up on me. Depression, self-consciousness, low self-esteem, loneliness, tiptoeing towards me. I’m cornered and I don’t see an exit plan. At the moment, I’m still using fancy footwork to confuse and tire out those demons. Behind me, on the other side of the wall, is joy. I want to turn to that entirely, but a wall separates us. It’s exhausting.

A feeling of deep tiring sorrow is just one possible symptom you may experience with depression. For me, fatigue is a debilitating part of my daily life. It’s constant and powerful. Even when everything else is good on a particular day and my symptoms are minimal and I feel joyful, I will still be tired. My heavy fatigue makes everything more difficult to do.

Part of practicing self-care is that I don’t fight the fatigue; I accept it and adapt. Instead of trying to force myself to do what my body cannot, I adjust my tasks and expectations of myself to better suit my abilities.

2. Occupy Your Time

And now I’m stuck here, me and depression. I can’t look directly at it. But it senses my weakness and fear. My defenses are down. I want to go on the attack and Charlie’s Angels my way out of here. But fear keeps that thought bubbling just below the surface, it remains ideation and not action. I turn every which way, eyes darting here and there. Nothing stays in focus longer than a few seconds.

To deal with the short attention span, I find it helpful to occupy myself with a variety of distractions. Find things to do that can take up your time, whether that’s sleeping a bit more or watching television or playing a game on your phone. Maybe pick up a book, or work on something with your hands. Music can be very soothing. There are times when I’m experiencing sensory overload and have to stop completely, but usually even then if it has the right tempo and volume and no words, music can help.

3. Breathe

Depression is growing bigger, having eaten Alice’s fantasies. It’s the demon in Spirited Away, gluttonous for pain. Now my head hurts and I can’t remember what I did in the past to get out of this corner. I sink to the floor, close my eyes and take several deliberate breaths. In and out, focusing only on that breath. When I open my eyes, I can see a sinister troll cackling behind Depression.

Depression’s troll tells me that I don’t know who the girl smiling in my photos is. That the joyful image I sometimes portray isn’t me. Depression tells me, “You don’t know where that joy is, what a facade. What a phony getup.”

When the anxiety that often accompanies depression rushes in, what helps me (even when it helps only a little) is to take a few seconds to just remember how to breathe. In and out, deep and slow. If I can close my eyes for those few seconds, even better; thinking just about the breath. Sometimes it helps a lot, sometimes it provides only those few seconds of relief; either way, it presses pause on everything else and lets my body relax for a moment.

4. Accept Yourself

When I get closer, not to examine but because I am no longer running away from it, I can see my depression for what it really is. It looks ridiculous, rubbing its hands together like a cartoon villain. I push myself up off the ground and walk up to Depression. I want to make it cower in terror, but when I stand up it shrinks down and the costume falls to the floor in a heap. I can see the air pump in the back that was blowing it up to such a size. Then I notice the heart of the facade is not a demon or a monster. It’s a sad little girl who looks just like me, maybe she is me. Her armor has been taken away and she is vulnerable. She looks at me with fear.

I swear one of the most common inspirational phrases in a Pinterest black hole is “Let it go.” When it comes to depression, I don’t know if letting go is as useful of a strategy as acceptance. They’re distinct routes to finding contentment. Moving on from a painful feeling or experience requires the ability to process memories and have healthy emotional control. Letting go implies that you can “get over it” and move forward. Someone who has depression cannot just “let it go.” Depression is a diagnosable medical condition. It affects many more aspects of life than just emotional. Some symptoms can severely impact quality of life.

Acceptance, on the other hand, is a powerful tool that people with depression can actually use. My negative feelings are recognized and the sad thoughts that come in are not to be trusted as the whole truth, they’re just there because I have this condition. Acceptance takes away some of depression’s power. Resisting depression is exhausting and doesn’t make it disappear. But practicing acceptance changes the lens through which we see our depression, making it more manageable.

5. Practice Self-Compassion

Should I destroy her, now that I’ve emerged the victor? No, I won’t do that. She needs love. I don’t embrace her in a hug, not yet, but I do walk up to her and bend down to her height. I want to tell her something, but no words come, so I just give her a small kind smile. We will get to know each other. She will see that everything will be okay, and I will see pain at its correct size, not in its monstrous manifestations.

Be compassionate with yourself. Without self-compassion we can spiral so quickly and we only prolong our own suffering. Self-compassion is a continual process that can be started over at any moment. It simply means being nice to yourself. Treat yourself with gentleness and forgiveness. With every negative thought about yourself, throw in a dose of self-love (even when you don’t believe it). Dis-identify from your thoughts.

Self-compassion can reduce the severity of anxiety disorders, depression, and improve success rates of sobriety. Researchers have found that self-compassion lowers how harshly we judge and criticize ourselves. Mindfulness inspired the notion that self-compassion may be an effective therapeutic tool and self-compassion is like a stepping stone for practicing mindfulness. This is critical for people who blame themselves for their own suffering, since a lack of self-compassion perpetuates an unhealthy cycle of self-hate and aversion to treatment (i.e.; why get treatment when you don’t think you deserve it?).

6. Love Yourself and Your Depression

This isn’t some emo quote on MySpace, it’s a simple piece of advice that can bring around positive results. Loving your depression doesn’t mean you love feeling this way, but it means you accept your current reality and are willing to feel it. Feel what you feel. Accept what you feel. Love yourself and your feelings. I know firsthand the changes that can come when you stop fighting yourself and start loving yourself, in all your manifestations.

Please share your tips for dealing with depression in the comments.

View the original article at thefix.com

1 May 2019
Fewer Employers Screening For Marijuana Use

Employers are less willing to limit their pool of qualified applicants by screening for personal marijuana use.

As marijuana becomes legal in more places, fewer employers are screening potential applicants for cannabis use.

“We’ve seen that companies have to adapt with what happens with legislation within the country,” Lauren Lewis, a recruiter in Buffalo, New York, told WKBW News.

According to WKBW’s report, about 21 percent of the U.S. workforce uses cannabis regularly, defined as once or twice per month. That means that employers who disqualify people who use the drug can really reduce their pool of applicants.

“You can limit yourself from a lot of potential employees by not allowing it,” Lewis said.

While employers are more likely to disregard cannabis use outside of work hours, being intoxicated on the job is still unacceptable. However, certain industries take a harder line toward any cannabis use. Federal contractors and the federal government, for example, are required to maintain a cannabis-free workplace.

Certain jobs, like those in which people are operating heavy machinery, may be more likely to care about cannabis use, Lewis said. “Because they have really need their cognitive function to perform the position,” she added.

“Really a lot of companies are really walking a thin line. There is still a lot of gray area regarding marijuana use in the workplace and drug testing for it,” Lewis said.

This is especially complicated when a person is using medical marijuana. People who use medical cannabis have argued that denying them for a job or firing them over use violates the Americans With Disabilities Act.

In New Jersey a judge recently ruled that employers cannot fire people who test positive for medical marijuana. “The sweeping effect is you can no longer say, ‘You (tested) positive — you are outta here,’” Maxine Neuhauser, an employment expert, told NJ.com.

The ruling shows that the issue of cannabis use is not black and white, even though marijuana remains entirely illegal at the federal level.

“There had been a general belief that since marijuana is illegal under federal law, employers would not have to accommodate its use by employees, even if they had a prescription for it and using it legally under state law,” Neuhauser said. “This appellate case very strongly came down in the opposite direction following the lead of other states confronted with the same issue.”

Lewis said that employers are realizing they need to have a more in-depth conversation about cannabis.

“We have to make sure they are aware and start thinking about thinking a little more open mindedly,” she said.

View the original article at thefix.com

1 May 2019