Answer Addiction

Tag: alternative treatments

  • The Role of Psychedelic Plant Medicines in Addiction Treatment

    Psychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. 

    Psychedelic plant medicines have the potential to help many people who are in recovery from substance use disorder dig deep into the roots of their addiction and come out of the other side. Plant medicines like psilocybin, ayahuasca, and particularly ibogaine, have demonstrated unprecedented results for those who use them as a tool on their recovery journey.

    While the legal status of many of these substances is still murky (depending on where you consume them), the ongoing research, decriminalization efforts, and shift in public narrative is promising. Hope lies on the horizon for wider access to these medicines, but right now, what’s needed is raising awareness and informed decision-making around their consumption.

    Here is how psychedelic plant medicines can help those that struggle with addiction and what people should consider before choosing this path.

    Ancient healing practices reconcile with modern science

    Psychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. 

    Research around the potential of ibogaine to treat opiate addiction is still in its infancy, but shows promising results. Ibogaine, which comes from the Iboga shrub, has been used historically in ceremonies in West Africa by practitioners of the Bwiti spiritual tradition since the late nineteenth century. The roots and bark of the tree are consumed ceremoniously in large doses to provoke a near-death experience, and in smaller doses during rituals and tribal dances. It is not considered a recreational substance by users, yet is classified as a Schedule 1 drug in the US.

    One 2017 study funded by the Multidisciplinary Association for Psychedelic Studies (MAPS) observed opiate addiction treatment delivered by two independent ibogaine clinics in Mexico. One month after the study, half of participants reported using no opiates in the month following the study. The researchers found that “ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful.” 

    Another study on the long-term efficacy of ibogaine-assisted therapy in New Zealand found that a single ibogaine treatment reduced opioid symptoms and resulted in no opioid use or reduced use in dependent individuals over 12 months. 

    Healing that gets to the root

    Ayahuasca is a psychoactive Amazonian brew traditionally used in the indigenous communities of South America. Research on the brew is grounded in its potential to support healing by allowing for a deeper connection to oneself and due to the spiritual context in which it is taken. 

    One 2017 study published in the International Journal on Drug Policy used qualitative analysis through long-term field work and participant observation in ayahuasca communities, as well as conducting interviews with participants with problems of substance abuse.

    The study found that “ayahuasca’s efficacy in the treatment of addiction blends somatic, symbolic, and collective dimensions. The layering of these effects, and the direction given to them through ritual, circumscribes the experience and provides tools to render it meaningful.”

    Researchers from a 2013 Canadian study, sponsored by MAPS, concluded that ayahuasca-assisted therapy for stress and addiction was correlated with improved mindfulness, empowerment, hopefulness, and quality of life-outlook and quality of life-meaning. The same study found that ayahuasca, when administered in a ceremonial setting, may have contributed to reduction in cocaine use in dependent participants.

    There have also been studies that show the benefit of psilocybin mushrooms in allowing people to overcome addictive or damaging behavior. A 2014 study from the Johns Hopkins Center for Psychedelic and Consciousness Research found that 80% of previously addicted smokers abstained from smoking six months after they were administered psilocybin. Remarkably, 60% continued to abstain two and a half years after the study.

    “Institutions like MAPS and the Imperial College London are pioneering the way forward with this evidence-based approach to psychedelic medicine—a necessary effort if these compounds are to be integrated into the mainstream,” said Gaurav Dubey, clinical biologist and content editor at Microdose Psychedelic Insights.

    “Though, we have a lot of catching up to do,” said Dubey. “We need to do better in understanding the psychotherapeutic mechanisms of these incredibly unique compounds and the only way to uncover that is through science and research.

    “The clinical data that strongly supports the therapeutic use of these compounds in addiction treatment will be fundamental in making them accessible to recovering addicts around the globe,” he added.

    Journeys to an addiction-free life, supported by plant medicines

    Kat Courtney is the founder of AfterLife Coaching, a trained ayahuasquera, and has been working with the plant medicine ayahuasca for over a decade. Courtney first began her journey with ayahuasca in Peru in 2006, while suffering with alcoholism and bulimia.

    “Not only did ayahuasca help me face and deal with the traumas and programming that created these destructive behaviors, she helped me access an authentic space of self love and gave me tools to work with in lieu of the addictions,” said Courtney.

    “They fast-track the healing and awakening process and ground us into our bodies so we can move past stages of self-destruction. They help us to move the trauma that is stored in the body through crying, purging, and all kinds of different forms of release.”

    But Courtney stresses that the act of taking these medicines is only part of the deal: “We absolutely have to be committed to integrating these experiences and making the life changes that support sobriety,” explained Courtney. “Otherwise, plant medicine ceremonies can become distant memories.”

    Alternative approaches offer a chance for healing

    Aeden Smith-Ahearn is the founder of Experience Ibogaine Clinic, based in Mexico. Aeden first tried ibogaine in an effort to overcome his dependency on multiple substances, including heroin. 

    “Ibogaine got me comfortably off opiates,” said Smith-Ahearn. “I had almost no withdrawal symptoms, and I had a very profound experience which helped give me a motivational boost in the right direction.

    “The medicine put me in my place, and that’s exactly where I needed to be. I got a fresh start, on top of a head start into my recovery,” he explained.

    Prior to his ibogaine experience, Smith-Ahearn had tried several programs in an attempt to break free from his addictions, which he describes as “cold turkey, three meals a day, and a therapist once a week.”

    “These programs work for many people, but they didn’t do the job for me. The problem was that I did not want to change, and was therefore unwilling to work towards something I didn’t want,” he said.

    Smith-Ahearn credits ibogaine with huge potential for recovering opiate addicts specifically because of how it interacts with the brain’s receptors. “The hardest part about breaking out of opiate addiction is getting over withdrawals,” he said. “The medicine alleviates withdrawal symptoms [for some patients], which is a godsend for someone who is in over their head with opiate addiction.”

    Like Courtney, Smith-Ahearn stresses that ibogaine is not a cure-all. “It’s crucial that patients of the treatment put their effort into a quality aftercare plan.”

    Charles Johnston, director of client success at Clear Sky Recovery, has also historically struggled with opiate addiction and subsequently used ibogaine as a tool to help him overcome his dependency.

    “Ibogaine was the medicine that interrupted my addiction, and for the first time let me fully witness the root cause of my addiction: self-hatred. It provided me with a path, purpose, and mission to support others and see that addiction is a blessing of self-discovery,” explained Johnston.

    “Ibogaine allows the individual to feel how they would after months of detox with conventional methods and if supported properly, encourages a whole new paradigm of accountability and acceptance,” he continued.

    With these and other accounts of personal transformation, it’s clear that ayahuasca and ibogaine have potential to assist people struggling with addiction on a path to recovery. However, these treatments should not be treated lightly and come with a number of risks to the patient if not administered responsibly.

    What you need to consider before trying psychedelic therapy

    Psychedelics generally have very little risk of abuse, but when taken in the wrong setting, or without proper guidance or structured preparation and integration, they can result in negative consequences.

    There are some short term health risks which are important to consider. “Using ibogaine comes with risks to your physical health, such as seizures, gastrointestinal issues, heart complications, and ataxia,” says board-certified psychiatrist and addiction specialist Dr. Zlatin Ivanov. “There have also been unexplained fatalities in people who have ingested ibogaine, which may be linked to the treatment.”

    Charles Johnston of Clear Sky Recovery explained that “if someone has heart issues, liver problems, other major health complications, serious psychological issues, or are expecting a quick fix, ibogaine may not be the right path.”

    The same largely goes for users of other plant medicines, including ayahuasca. Users of SSRI antidepressant medication have run into an adverse reaction while drinking the medicine with the drugs still in their system.

    “People need to do careful research and not fall foul of misleading things that they see on the internet. A lot of people have expectations that the medicine may not offer, like profound psychedelic experiences guaranteed to change them or no withdrawal whatsoever,” said Aeden Smith-Ahearn of Experience Ibogaine.

    Those seeking treatment with psychedelic plant medicines should make sure they go to a reliable and reputable center. In recent years, the number of tourists flocking to Peru to drink ayahuasca has boomed, resulting in illegitimate retreats run by people lacking in the experience required to administer the medicine.

    In many countries, including the US, these substances are illegal to consume. Many people do however seek out treatment in countries where the medicines are not outlawed, such as Mexico, Costa Rica, Peru, and Colombia. In the US, ayahuasca is legal within specific religious groups, such as the Santo Daime.

    A path to accessibility

    Looking ahead to the future of psychedelic treatment, progress is being made on the legalization front, with Oakland and Santa Cruz, California, and Denver, Colorado, voting for decriminalization of psilocybin-containing mushrooms in 2019 and 2020. Oregon and Washington D.C. also have votes ahead on the decriminalization of psychedelic-containing plants and fungi.

    Meanwhile, Canada is seeing a number of legal ayahuasca centers open up, on the part of religious groups who have special permission from the government to use the medicine. However, ultimately, it will be a continuation of the scientific research that paves the way for increased access to psychedelic therapy.

    “We need more large scale, gold-standard clinical trials examining these compounds in the context of addiction treatment, such that their impact can no longer be ignored—even by the most stubborn of policymakers and world leaders,” said Dubey.

    “There needs to be a shift in global drug policy so these powerful medicines can be reclassified and reintegrated into our society in an effort to heal the masses.”

    In essence, psychedelics need to go mainstream and lose the stigma that they have held for decades so that the public appetite can develop and further drive policy changes. In addition to research, diverse voices and experiences, along with mainstream support, will be key in the psychedelic renaissance maintaining its momentum.

    The value of psychedelic plant medicines for addiction recovery is difficult to overstate, but is a path that should be explored carefully, mindfully, and while armed with the right information and support. And there’s hope that a future where accessibility isn’t an issue is on the horizon: The ongoing research and changing societal attitudes towards psychedelic plant medicines demonstrate promise. Education around these medicines and their proper use is vital for this renaissance to continue.

    By shining a light on the potential of psychedelic plant medicines to help and heal, we can contribute to forming more pathways to change and legitimate channels for people to benefit from their treatment.

    View the original article at thefix.com

  • The Opioid Crisis Is Our Greatest Opportunity

    The Opioid Crisis Is Our Greatest Opportunity

    Overdose survivors need more than a second (or third) chance: they need a parachute. When you’re in free fall, a little more time isn’t much help.

    Perhaps everything that is terrible is,
    in the deepest sense, something
    that wants our love.

    Rilke

    The overdose epidemic in the U.S. has been called “the greatest public health crisis of our time.” It’s also our greatest opportunity.

    The opioid crisis is an identity crisis: it’s a challenge to how we see ourselves. Do we truly believe that we are all in this together? One answer leads us deeper into despair. The other, into a hopeful future.

    It’s been said that “doing more things faster is no substitute for doing the right things.” What are the “right things,” the measures that can resolve the crisis, not just postpone it? The right actions come from the right thoughts. Those thoughts come from feelings, and feelings are never right or wrong. But there are some feelings we are born with. They are our birthright. And one of them is love.

    The Kindness of Strangers

    Hatred never ceases by hatred, but by love alone is healed.

    The Buddha

    Behind the opioid epidemic is a prevailing lack of compassion, of caring about everyone equally. At the heart (or lack of it) of this societal disease is rampant inequality. The social determinants of health: stress, unemployment, lack of support, poor health care, etc. are major drivers of addiction. Many authors promote this view, including Gabor Mate, Bruce Alexander, Sam Quinones, Robert Putnam, and Harry Nelson.

    Our increasing fragmentation affects everyone, poor or rich.

    Drug overdose is the leading cause of death for Americans under the age of fifty…

    Our material lives may be outwardly prosperous, but our psychological and spiritual lives are in freefall. What is driving us to self-destruction? There are many factors, all with one unifying theme: we are no longer living in community with one another and, consequently, we are lonely.

    Francie Hart Broghammer

    We all hunger for the same thing. The question is this: do we love our neighbor as ourselves? That’s not just a commandment; it’s a requirement. How do we rebuild community? First, by taking full responsibility for the fallout of not being one.

    For Whom the Boom Tolls

    Compassion is not a relationship between the healer and the wounded. It’s a relationship between equals. Compassion becomes real when we recognize our shared humanity.

    Pema Chodron

    I live in Asheville, a city that has recently, like the opioid crisis, exploded. Tourism is at an all-time high, and Asheville has appeared in dozens of destination top ten lists. It has also been ranked second in the country in gentrification.

    Asheville sits in the heart of Appalachia, where the opioid crisis is at its worst. In 2017, North Carolina had the second highest increase in opioid deaths in the country. The Blue Ridge Parkway runs through town and I spend a lot of time there, mostly foraging. That’s where last summer, for the first time, I found not mushrooms, but needles.

    Despite the crisis, the city just spent six months trying to shut down the local syringe exchange. The same thing is happening in other cities. In Asheville, the exchange had been operating without incident for over two years — until the houseless (a.k.a., homeless) in adjacent areas were kicked out to make way for new development.

    Addiction depends on denial. What if development is the real addiction? Will we face up to the dark side of gentrification or just try to make it “go away?”

    If a canary dies in a coal mine, you don’t blame the canary. Yet blaming the victim is exactly what we’ve been doing.


    Blue Ridge Parkway, 8/20/18 

    License to Ill

    A man came to the Rabbi and said, “Rebbe, my son has turned against me. What should I do?” The rabbi said, “love him even more.”

    Hasidic story

    Most people by now have heard that naloxone (Narcan) can prevent a deadly overdose. So many Americans are dying — often from a mix of drugs, but mainly due to opioids — that naloxone should be as ubiquitous as aspirin. Everyone using a drug that may contain opioids should carry it like an EPI pen. And with the increasing prevalence of fentanyl, a single dose may not be enough. Everyone should know how to tell how much naloxone to give someone in the midst of an overdose. This should be basic, universal knowledge.

    But keeping someone alive is just the beginning. In fact, while naloxone may be physically safe, it does have one significant side effect: precipitated withdrawal. And not helping someone through it is like catching them from falling only to drop them from higher up.

    A Devil’s Bargain

    Be kind, for everyone you meet is fighting a hard battle.

    Ian Maclaren

    As one response coordinator describes it, precipitated withdrawal is like “the worst flu you’ve had… times 100.” For some, the feeling is so bad that they find themselves dying, so to speak, to use again.

    To the uninformed, it is inconceivable that someone who nearly died from a drug would run out that very same day and buy more of it. Narcan works by binding to opioid receptors, blocking the effect of narcotics like heroin. In drug users with a physical dependency, it also has the effect of causing severe withdrawal symptoms. This all but guarantees that the first thing a user will think of after their overdose is reversed is getting another fix…

    Christopher Moraff

    Naloxone is not just a “bandaid on a bullet hole.” It can feel like ripping open a wound. For “withdrawal is the very situation that [users] are seeking to avoid in the first place.”

    “A dose of naloxone,” according to the Chief Medical Officer for a Connecticut health agency, “is a chance. But if it’s not coupled with immediate offers of treatment, it may be a slim chance that leaves the revived individual running back to the same dealer who sold them their last lethal dose.”

    Overdose survivors need more than a second (or third) chance: they need a parachute. When you’re in free fall, a little more time isn’t much help.

    Back on the Chain Gang

    Without forgiveness, our lives are chained, forced to carry the sufferings of the past and repeat them with no release.

    Jack Kornfield

    “They’re usually very angry when we bring them around,” says one responder. “One kid yelled at me, ‘You think this will make me stop doing drugs?’” Indeed, one substance abuse specialist in Ohio says that 67% of people revived with naloxone in her area use again within 24 hours. NPR reports that “about 30 percent of those revived with Narcan at Boston Medical Center have been revived there more than once… and about 10 percent of patients more than three times. Those statistics are in line with what’s seen in ERs elsewhere, public health officials say.”

    According to a former agent for the DEA, one woman in Ohio, within 24 hours of being revived for the the sixth time, was using again. In the first half of 2017, one man in North Carolina was revived fourteen times.

    To be clear, I am not saying naloxone provides a safety net that encourages people to take bigger chances. Studies have shown that naloxone does not increase drug use any more than free condoms increase sex. Nor am I saying we should place limits on the number of times we revive people.

    What I am saying is that naloxone is no miracle drug. When you “come to,” the problem remains. Overdose survivors are 24 times more likely than the general population to die in the following year. One study found that for those revived with naloxone, nearly one in ten are dead within a year, the majority within the first month. Follow up is critical. But even that is not enough.

    Not by Locks Alone

    Few things can help an individual more than to place responsibility on him, and to let him know that you trust him.

    Booker T. Washington

    In June of 2019, New Jersey became the first state to allow paramedics to administer buprenorphine along with naloxone to ease the pain of withdrawal. Buprenorphine is the drug that, like methadone, is used in opioid replacement therapy. But this measure will, according to one expert, “make a meaningful difference only if rescued individuals are linked immediately to ongoing treatment and agree to participate in that treatment.”

    “Immediate” is key. And at least one hospital in New Jersey has been making that link, through state-paid recovery coaches, since 2017. A coach might work with someone “for weeks or months.” And the cost to taxpayers of helping people in this way is surely far less than the cost of leaving them on their own.

    Unfortunately, however, getting people into treatment is not enough. Not all treatment is good treatment. In fact, much of it is worse than doing nothing at all.

    Under the Rug

    Beware of all enterprises that require new clothes, and not rather a new wearer of clothes.

    Thoreau

    People usually go to rehab for 28 days, maybe a month and a half. In most cases, the treatment fails, if you regard failure as return to use. A study reported in the Irish Medical Journal found that 91% of people who go through rehab are using again within a year; 80% in the first month.

    “Most honest program directors,” says veteran addiction expert Julia Ross, “will admit to 90% relapse rates, and I assume that if they admit to 90%, it’s probably worse.” Drug courts are no better. A national study of seventy-six drug courts found a reduction in the rate of rearrest of only 10 percent.

    Moreover, when people come out of abstinence-based rehab, their tolerance has gone way down, so they are more likely to overdose. This is a common reason why fentanyl is killing people: it’s much stronger than they are expecting, especially in an opioid-naïve state. Making fentanyl test strips available can help prevent overdose, but that still doesn’t deal with the basic issue of why they’re using in the first place. What pain are they killing?

    Zero Tolerance

    Winning isn’t everything; it’s the only thing.

    Henry “Red” Sanders

    I watched my grandmother die a very slow death. At 90 years old, after three cancers, open heart surgery, and several strokes, she still fought tooth and nail. Christopher Ryan, author of Civilized to Death, compares our approach to death to the final minutes of an NBA basketball game. We drag it out. We go for quantity instead of quality. Is that also our approach to addiction? As long as they don’t die, we’re OK. This is similar to abstinence-based approaches to addiction treatment: As long as you don’t use, you’re OK. This amounts to saying, “it’s more important to look good than to feel good.”

    To be clear: I’m not saying we should just let our neighbors die. I’m saying we need to do more than just keep people alive; not less. We need to treat the cause, not just the symptom.

    Spare the Prod

    If you want to be heard, whisper.

    Author Unknown

    The overdose crisis is part of a larger epidemic of despair. The facade of America as the “land of opportunity” is failing. Asheville today is “booming.” For whom? Are we saving lives or just saving face?

    Fortunately, Asheville has begun to address its weak spots, and we now have three needle exchanges. We all need to look in the mirror and face where we — as a community, as a country — are really at. Because not doing so is killing us. Whether we die quickly from overdose or slowly from alcoholism, cancer, or depression, we are ALL canaries in a coal mine. And you can’t just rake the canary over the coals.

    It’s one thing to save lives. But throwing someone into withdrawal without providing detox support or throwing them out of treatment because they’ve relapsed is like hitting a child to make them stop hitting other children. Such heavy-handed measures only perpetuate a cycle of abuse. Even a magic bullet leaves a wound.

    Sticks and Phones

    Can you love people and lead them
    without imposing your will?

    …leading and not trying to control:
    this is the supreme virtue.

    The Tao Te Ching

    There’s a reason our greatest leaders practice nonviolence. If all we do is arm people with naloxone, if we fight firearms with firearms, the conflict will only escalate. Stronger opioids are already requiring stronger antidotes.

    With this approach, we may win a few battles, but we will lose the war. You can’t win when you see this as a war to begin with. Because you can’t force someone out of addiction any more than you can force them to stay alive. Force is what causes addiction.

    In 2015, Victoria Siegel, 18, died of a methadone overdose precipitated by cyberbullying. We worry about bullying in schools. What about parental bullying — or governmental? Some of us are aware of the alarming incidence of domestic violence. How many of us recognize how our culture is inherently abusive, our very way of life?

    Sometimes we forget that we are treating people, not diseases. We are bio-psycho-social beings. We have feelings. If addiction comes from pain, and pain comes from hurt, then we need to reduce hurt, not just harm.

    A Dying Shame

    You cannot be lonely if you like the person you’re alone with.

    Wayne Dyer

    We will not end drug abuse until we end human abuse. We will not end human abuse until we end abusive thinking, because violence starts with what you think. A saying often attributed to Martin Luther King Jr. is that “you can have no influence over those for whom you have underlying contempt.” As long as I think, “you’re not good enough; this is all your fault,” or I say that to myself, addiction has a foothold.

    The blame game has no winners. “We’ve lost what it means to just be ourselves and for that to be ok and for that to be enough. So we find ways to self-medicate,” says Rev. Shannon Spencer. People will use painkillers as long as the pain is killing them, for there are few emotions more agonizing than shame.

    We Are Faminy

    I don’t remember now how many days we stayed—long enough to hear David sing often and tease us about white people’s music, which, according to him, is only about “love.” He observed that the Hopi have many songs about water, which they consider the rarest and most precious of resources, and then asked, with feigned innocence, if white people sang so often about love because it was equally rare in our world.

    Peter Coyote

    To many, opioids feel like the opposite of shame. One user describes the feeling as “like being hugged by Jesus.” Indeed, “the very essence of the opiate high,” according to Gabor Mate, is that it feels “like a warm soft hug.” This is the feeling of unconditional acceptance and support, or love.

    We live in a culture where love is the one thing we sorely lack. Millions of people are starving for just a few drops of it. If only for a few moments, we desperately need to feel like we’re OK, that someone wants us to be here, as we truly are. Like they say, it is rain that grows flowers, not thunder.

    Inside, we know we’re not just here to feed The System. We know it should be feeding us. We should not be starving. We should not have to be forced, or force ourselves, to do anything. People need to be supported to decide for themselves what healing looks like for them and to approach it in their own time.

    The Emperor in the Room

    Opioids are like guns handed out in a suicide ward; they have certainly made the total epidemic much worse, but they are not the cause of the underlying depression.

    Anne Case and Angus Deaton

    To solve the drug problem, we need to focus on more than drugs. Otherwise, we are shooting the messenger. Drugs are like the emperor’s clothes; it’s time to look at who’s wearing them.

    Like Dr. Jekyll and Mr. Hyde, opioids and their antagonists are two sides of the same coin. Focusing on either is like looking for your keys under the streetlamp when you know you dropped them further up the street. There is an “upstream” issue here. That issue is our domination-based, “have to” culture. If we stick to our guns, if we continue to be violent, inside and out, we will continue to die.

    Whether we kill another person, the planet, or ourselves, we are a culture committing suicide. We are overdosing on “progress.” We are addicted to things far more insidious than opioids; you’re looking at one.

    Progress isn’t progress when it’s in the wrong direction. The direction we’re going is apart. The direction we need to go is back together.

    Only the Lonely

    Humanity’s current crisis may not, at its root, be an economic crisis or an environmental crisis. It may well be a crisis of consciousness, a crisis in how see ourselves and the world around.

    Peter Russell

    If you’re in the right place at the right time, armed with enough naloxone, you can save a life. But what about an hour later, or the next day? You might get someone into treatment, but what about after that? A person that susceptible to overdose can scarcely be left alone. And that aloneness is the real problem. In fact, it’s how addiction starts.

    The connection between social isolation and addiction shows up on many levels, from treatment to prevention. The most obvious is that you can get naloxone into the hands of every drug user, but it will do them no good if they overdose alone.

    Human beings may be the most social animals on earth. Social isolation can drive us to despair, addiction, and even suicide. Loneliness is self-reinforcing and can lead to shame, for it can mean “I don’t deserve to be loved.” This can be the underlying emotional pain that comes back during withdrawal, whether from an opioid or from someone withholding their affection. And that lack of affection could be the primary cause of addiction.

    Fatal Attraction

    If one has a friend, what need has one of medicines?

    Bhartrihari

    There can be no healing without community. “This unique American moment asks not for a call to arms, but for a call to neighborliness.” (Francie Hart Broghammer)

    No amount of “care” can substitute for the watchful eye of loving family, friends, or neighbors. No amount of “treatment” can make up for how we treat each other. It truly takes a village.

    Ultimately, it’s not drugs that are killing us; they are just finishing us off. Whether or not we beat the horse, we’re already practically dead. Something has weakened us enough to succumb to drugs. It’s the same thing that allows dealers to intentionally make some of their merchandise deadly, or if it’s naloxone, to jack up their prices.

    What our culture is most addicted to is exploitation. It’s what the system is set up for. It compels us not to care. As Ken Eisold says, “The loss of community is not a problem that can be dealt with through psychotherapy,” for what needs rehabilitation is our society. There’s something wrong “with the village.”

    The greatest tool I know for rebuilding community is Nonviolent Communication (NVC). The best approach I’ve encountered for addressing the disconnection inherent in addiction is SeekHealing.

    We are the Medicine

    At the root of the opioid epidemic are deeper questions that we have to ask about society. What kind of society do we want to live in? Do we want to live in a society where we believe every life truly matters? Do we want to live in a society where we all chip in, recognizing that we are vulnerable in some way, whether it’s to addiction or loneliness or other conditions, and that we are stronger when we come together, when we recognize our interdependence, and when we help each other?

    As tragic as the opioid epidemic is, if it can move us in a direction of shared understanding about our interdependence, if it can help us address these deeper social roots of disease, then I believe that we will have used it ultimately to improve ourselves to become stronger as a country.

    Vivek Murthy

    To make it out of this crisis, we need to look at the big picture. As writer David Dobbs puts it, “trying to understand mental illness without accounting for the power of social connection is like studying planetary motion without accounting for gravity.” If we only look at addiction on an individual level, we are missing the forest for the trees. If you don’t heal the forest, it gets harder and harder to heal each tree.

    It’s especially hard to heal when you’re continually cut down. In this culture of mutual exploitation, we treat each other like truffula trees. We factory-farm humans and clear-cut them for fuel. We do it to each other and we do it to ourselves. All to feed the machine, the matrix. To race into space, we’re melting our wings.

    Saving lives, then, is only the beginning. It’s the tip of the iceberg. Because it is we, not “they,” who have an addiction. This isn’t about how we use drugs; it’s about how we use each other. Because ultimately, there are no others. We are not just a bunch of individuals. We are one, interdependent whole. Our greatest public health crisis is that we’ve forgotten who we are.

    The Opposite of Addiction

    Sometimes out of really horrible things come really beautiful things.

    Anthony Kiedis

    This crisis is an opportunity, a wake-up call. If we take responsibility for it, there’s no limit to what we can do. It’s said that anything is possible if it doesn’t matter who gets credit for it. The same is true of blame.

    We are all in this together. That’s the bottom line. There is but one answer to this crisis, and we each carry it at the bottom of our heart.

    View the original article at thefix.com

  • Ibogaine: Promising Addiction Treatment or Snake Oil?

    Ibogaine: Promising Addiction Treatment or Snake Oil?

    The induced vivid hallucinations and memories of childhood and formative experiences seem to be the key to ibogaine’s effectiveness in treating addiction, but experts don’t fully understand its mechanisms.

    With the rise in interest of various psychedelic drugs for a range of conditions (MDMA for PTSD, and ketamine and psilocybin mushrooms for treatment-resistant depression, to name a few), it seems only fair that we should pay serious attention to other substances in this family that might treat other conditions.

    Introducing ibogaine. Well, not quite introducing. The fairly-obscure African plant, used traditionally in Gabon, was first patented in the United States for use in treating opioid addiction in 1985. Unlike common street drugs such as MDMA (“ecstasy,” “molly”), ibogaine does not have the reputation of being known as a club drug.

    Like Years of Therapy in One Day

    But Ibogaine is still relatively unknown, despite a guest appearance in an early episode of Homeland. When I have advocated for its use in combating our nation’s opioid crisis, most of the responses range from a confused “What?” to an inquisitive “Oh, yeah. I’ve heard of that.” It isn’t a cheap thrill, something folks are clamoring to ingest. People who have found relief with the African root-bark have compared it to receiving years of therapy in the course of one day. The induced vivid hallucinations and memories of childhood and formative experiences seem to facilitate the process of overcoming addictions, even if it isn’t an automatic or guaranteed cure.

    However, that doesn’t mean it’s free of stigma. The federal government classifies it as schedule one – right up there with heroin, the addiction it is most well-known for treating, despite having “no medical use” according to the law. Statistics vary, with some rates as low as 20 percent. Other data shows  61% abstinence, eight months after treatment.

    So, what’s the issue? If this plant boasts a higher success rate than Suboxone (8.6%, once Suboxone use is discontinued), why is it only available outside the U.S.? Why are we not allowing a treatment method that people with opioid use disorder have touted as the thing that saved their lives?

    Why Is Ibogaine Illegal in the U.S.?

    Some of the fault lies with the media. Much like with LSD, clinical studies are slow and evolution of public consciousness is slower. Most of what we see in the news is negative and exaggerated. As with anything, there are risks. Up to 30 deaths have been documented. When people with other health problems related to addiction are treated by those without medical training, death rates can be as high as three percent. In healthy folks, that same rate is around .3%. 

    But when much of what you see in the news and on television is people panicking, convulsing, or dying, it’s tough to form a well-rounded opinion. We are emotional creatures, and even with positive perspectives from people who swear by their experiences, we can’t get the negative images out of our minds for long enough to consider the benefits of ibogaine treatment. 

    Many of the risks involve heart issues. Most psychedelics function as stimulants, raising the heart rate, but ibogaine can be especially cardiotoxic. Ibogaine affects electricity in the heart and could potentially result in dangerous arrhythmias or bradycardia (low heart rate). Because of this and any other possible risks, legitimate clinics pre-screen patients and offer a small test dose to evaluate the effects. Based on the results, they decide if a full dose will be safely tolerated. 

    Like Other Hallucinogenics, Proven Benefits but Not a Panacea

    The substance seems to work due to the uniqueness of the experience. I’ve read multiple accounts of people having vivid visions of the choices they made, and how they’ve arrived at this particular point in their life. This type of experience seems to be the key to its effectiveness in treating severe opioid and alcohol addictions, but experts don’t fully understand its mechanisms.

    And yet, even with its proven benefits, it’s not a panacea. The person with the addiction cannot just visit a clinic, have an ibogaine experience, and expect to return home without changing anything. There is still a rate of relapse, because they haven’t worked on the external triggers. They must still tackle their disease in a proactive way, which may include altering their life and addressing what led to using in the first place.

    Unlike commonly-used routes of getting off opioids – substitution medications such as methadone and Suboxone – ibogaine doesn’t require a patient to remain on another drug, taking it day in and day out to avoid experiencing cravings or going into withdrawal. Ibogaine seems to work by disrupting the receptors associated with addictive behaviors, as was witnessed in one 2015 study on its efficacy in opioid addiction.

    Scientists found that the substance (which, I learned, doesn’t always produce the talked-about hallucinogenic effects that led to its illegal status) acts on receptors such as dopamine and serotonin, which are linked to addiction and the brain’s reward system. Other psychedelics that are currently being studied for their effects on mental illness and addiction – such as MDMA and psilocybin mushrooms – make use of these same receptors. What makes ibogaine unique is that, rather than attaching to receptors on the outside of a cell membrane, it attaches to the inside. This mechanism seems to be unique to ibogaine; it has not been observed in any other naturally occurring molecule.

    Legal Status of Treatment Creates Financial Barrier and Increased Risk

    A major barrier to receiving an ibogaine treatment is the prohibitive cost. A single week of treatment in Mexico costs $5,000, and that’s after the price of a plane ticket. In Canada, the price for a ten-day round is $8,000. As a result, it’s not an option that’s available to most people in need of addiction treatment.

    We must legalize it here. International travel, necessary funds, time off from your job to recover – all these restrictions make it virtually impossible for the average person with treatment-resistant addiction to crack the barriers of that final, desperate chance at a life beyond drugs or alcohol.

    There is a strong, tight-knit movement of psychedelic therapists, but due to the criminalized status of what should be viewed as medicine, those involved with administering these substances remain underground, increasing risks. Even though many of these practitioners are medical doctors, they work without the support of a hospital or facility. While their willingness to practice this medicine outside of the law is a testament to their belief in its efficacy, it also means they are less able to quickly and safely address problems that may come up.

    Who knows what the genuine death toll of ibogaine is in the U.S.? It’s not likely that underground doctors are reporting these deaths to nurses and other hospital staff. If so, they’d be discovered, in turn ruining their careers and possibly derailing the entire growing movement. At least, that’s what instinct tells me. If nothing else, with the substance legalized, fewer deaths and injuries would occur due to more rigorous testing and administering – and consequently fewer accidents would happen as well.

    Ibogaine has shown lasting benefits in treating addiction, as many people attest. One patient was quoted as saying: “It’s not just [that] it gets you off the heroin, it’s like, it hits the reset button — that’s the only way to really explain it. It’s like a new brain.” Shouldn’t we be listening to the voices of people who have actually been there, rather than tossing their words to the wind and sticking with what hasn’t worked?

    View the original article at thefix.com

  • Doctors Prescribe More Opioids Late In The Day, When Running Late

    Doctors Prescribe More Opioids Late In The Day, When Running Late

    Time constraints and “chaotic practice environments” may be to blame for the troubling reliance on prescriptions.

    Doctors are significantly more likely to prescribe opioid pain pills later in the day or when their appointments are running behind schedule, according to a new study. 

    The study, published in JAMA Network Open, looked at records from nearly 700,000 primary care appointments. The study authors found that doctors were 33% more likely to prescribe opioids late in their day than they were during their earlier appointments. In addition, appointments running behind schedule increased the likelihood of an opioid being prescribed by 17%. 

    It’s often mentioned that time constraints on patient appointments cause doctors to turn to prescriptions, rather than engaging to find alternative treatments, a process that can take much longer. The researchers wanted to use measurements and data to see if that is truly the case. 

    A Long-Suspected Factor in Overprescription

    “Many observers have blamed chaotic practice environments (ie, increasing financial pressure, productivity expectations, and the cognitive effort of caring for complex patient populations) for high rates of opioid prescribing because opioids can be a quick fix for a visit where pain is a symptom,” study authors write. “The concept that time pressure can drive physician decision-making is long-standing, but little empirical literature has examined the existence of this phenomenon or its magnitude.”

    They found that the theory did hold up, across all providers. 

    “Physicians were significantly more likely to prescribe opioids as the workday progressed and as appointments started later than scheduled,” they wrote. 

    Awareness of Bias May Help Reduce Opioid Dependence

    The researchers said that there are vast difference in prescription rates between individual doctors and hospitals that can’t be explained just looking at the the time of day of appointments. However, they point out that the difference in prescribing at different times of the day can also help explain some of the difference in prescribing between different providers.

    “Full-time clinicians may have higher opioid prescribing rates simply because of the effort involved in long clinical days,” they wrote. “Sharing individual data on these patterns with physicians could raise awareness of this bias and help them develop approaches such as schedule modifications to lower the burden of taxing or time-consuming decisions late in the day.”

    On a national level, addressing this difference could help reduce opioid prescriptions and ultimately lead to fewer people becoming dependent on opioids. 

    “If similar patterns exist in other clinical scenarios, such as managing challenging chronic illness, this phenomenon could have relevance for public health and quality improvement efforts,” the study authors write. 

    View the original article at thefix.com