Tag: evidence-based treatment

  • How to Find Butrans Addiction Treatment

    How to Find Butrans Addiction Treatment

    Trying to find a Butrans rehab? Look no further than our guide on finding the best options to recover in luxury.

    Table of Contents

    1. What is Butrans and How is it Used?
    2. How Buprenorphine Dependence Occurs
    3. How Buprenorphine Addiction Occurs
    4. Potential Abuse and Addiction Symptoms in Users of Butrans/Buprenorphine
    5. Detox and the Road to Recovery
    6. From Detox to Buprenorphine Rehab
    7. Inpatient and Outpatient Treatment
    8. Evidence-Based Treatment and Recovery Options
    9. Choosing the Best Rehab for You

    What is Butrans and How is it Used?

    Butrans is the brand name of an extended-release, transdermal medication made from the opioid prescription drug buprenorphine. Transdermal treatments deliver medication to your bloodstream through a patch applied to your skin. Once the patch is placed, you gradually receive your prescribed treatment over an extended period of time.

    Buprenorphine is not a full opioid like medications such as morphine, oxycodone or fentanyl. Instead, it belongs to a group of substances called partial opioids. Substances in this category are strong enough to produce a drug effect, but that effect is weaker than the one produced by a full opioid.

    When it enters your central nervous system (brain and spinal cord), buprenorphine does several things. First, it alters your nerve perceptions in a way that reduces pain. The medication also produces notable sensations of pleasure. In addition, like all other opioids, buprenorphine decreases the speed of cell-to-cell communication within your central nervous system. In turn, this drop in activity triggers a significant slowdown in your breathing rate and certain other involuntary nerve functions.

    Butrans is designed to treat pain in specific circumstances. First, to qualify for legitimate use of the medication, you must have long-lasting pain so severe that it can only be controlled with ongoing, 24/7 treatment. You must also be unsuited for the use of non-opioid medication or other, less risky treatment options. (Reasons you may not benefit from these safer alternatives include a lack of adequate pain relief and an inability to tolerate their side effects.) In addition, you cannot receive Butrans only on an occasional, as-needed basis.

    Butrans comes in several strengths. A low-dose version of this prescription drug is available for people who have never taken opioids before. There are also four higher dosages available for people with previous opioid exposure. Once applied, a patch of the medication stays in place for one week. Potential side effects of Butrans use include sleepiness, lightheadedness, headaches, nausea, vomiting, dry mouth and constipation. They also include itching, skin redness or rash at the site of the patch.

    When sold or used illicitly, buprenorphine-based medications are sometimes known by certain street names. These names include:

    • Stops
    • Strips
    • Buse
    • Sobos
    • Subs

    How Buprenorphine Dependence Occurs

    Butrans can form an important part of a plan to control serious, long-term pain. However, since it contains an opioid as its active ingredient, its use can trigger a state of substance dependence. In the case of Butrans, this state is defined by a reliance on the drug effects of buprenorphine. Since a transdermal patch delivers the medication to your system around the clock, dependence risks are relatively high.

    The most common sign of dependence is the appearance of opioid withdrawal symptoms if you stop taking Butrans or switch to a much weaker medication strength.When withdrawal first begins, you may experience symptoms such as a runny nose, increased sweating and mucus production, frequent yawning and disruption of your normal sleep patterns. If withdrawal progresses, you may also experience symptoms that include nausea, vomiting, loose bowels, cramps in your abdomen and abnormally widened pupils.

    Opioid dependence and opioid addiction do not have the same effects on your health and well-being. Dependence is a manageable reliance on opioids commonly found in long-term patients with legitimate prescriptions. You can work with your doctor to keep this condition in check while you lead a normal life. Crucially, the parts of the brain affected by opioid dependence differ from those affected by opioid addiction.

    How Buprenorphine Addiction Occurs

    Buprenorphine addiction marks a transition from a controlled, relatively safe pattern of medication use to an uncontrolled, dangerous pattern. Unlike dependence, it cannot be managed as a stable condition. Instead, it produces a serious, damaging impact on one or more areas of your daily life.

    You can get addicted to Butrans even if you take the medication according to your doctor’s instructions. However, your addiction risks escalate when you take actions that qualify as prescription drug abuse. If you have a legitimate prescription, these actions include applying patches to your skin more often than directed. They also include using multiple patches at once or using a single patch with a higher dosage than prescribed. If you don’t have a Butrans prescription, drug abuse occurs when you use even a single patch of the medication.

    Buprenorphine/Butrans addiction is one specific example of a diagnosable illness called OUD or opioid use disorder. You can also receive a diagnosis for this condition if you’re not addicted, but still suffer significant harms as a result of your medication abuse.

    Potential Abuse and Addiction Symptoms in Users of Butrans/Buprenorphine

    • Inability to control how often you apply the medication to your skin
    • Inability to control how much of the medication you apply to your skin
    • Using Butrans abuse as a substitute for recreational or leisure-time activities
    • Establishment of a daily routine than centers on your medication abuse
    • Rising tolerance to the effects of accustomed buprenorphine intake
    • Continuation of a mentally or physically damaging pattern of patch use after you become aware of its impact
    • Continuation of a pattern of use that you know disrupts your ability to sustain personal, intimate or social connections
    • Strong desires for buprenorphine use while doing other things
    • A pattern of medication intake in situations that carry a risk for physical harm
    • Withdrawal symptoms that arise if your brain doesn’t get its expected medication intake

    All cases of OUD are graded as mild, moderate or severe. Milder cases are limited to just two or three symptoms that appear over the course of a single year. If you have four or five of the possible symptoms during that same timeframe, you fall into the category of moderate OUD. If you have at least six symptoms, you will qualify for a diagnosis of severe OUD.

    The most severely affected people have all 11 of the potential symptoms. The intensity of individual symptoms can vary between people, and may have a meaningful impact on your ultimate diagnosis.

    Detox and the Road to Recovery

    To begin your road to addiction recovery, you must break the cycle of uncontrolled substance use. This process begins during an initial step called detoxification or detox. The goal of detox is to halt (or, in some cases, significantly reduce) your medication intake while avoiding or limiting the worst effects of withdrawal. No one can tell in advance how long you will take to detox from Butrans addiction. While the average timeframe is a week to 10 days, factors specific to your situation may alter this estimate.

    The symptoms of opioid withdrawal can leave you feeling awful. However, on their own, they can usually be managed without endangering your life. This does not mean that detox is free from the potential for life-threatening complications. For instance, untreated diarrhea and vomiting during withdrawal can trigger medically serious dehydration. If you inhale particles of your vomit during detox, you can develop a serious lung infection.

    Despite the reality of these risks, the main dangers to your health during opioid detoxification are undoubtedly relapse and overdose. This is true because the process of detoxing lowers your tolerance to the drug effects of buprenorphine. As a result of this change, a dose of Butrans that was once safe for you to use may now stop your central nervous system from functioning normally. And without prompt medical attention, you may die as a result. Every day of the year, fatal opioid overdoses in the U.S. claim an average of more than 100 victims. The mixing of opioids with alcohol or benzodiazepines can significantly increase your overdose risks.

    As a rule, detox and addiction treatment are more difficult for people who have substance problems combined with mental illness. That’s true whether you abuse opioids, alcohol or any other addictive drug/medication. It’s also true whether you suffer from anxiety disorders, depression, a personality disorder (PD) or any other serious mental health condition. To provide adequate care, doctors must address both abuse/addiction and mental illness. Without treatment for both issues, your chances for a sustainable recovery will diminish.

    From Detox to Buprenorphine Rehab

    When your time in buprenorphine detox comes to end, addiction experts strongly recommend that you move on to a Butrans rehab program. This recommendation is based on a couple of critical points. First, after detoxing from the medication, you will have a much smaller tolerance to its effects. If you relapse back into a pattern of abuse for any reason, this susceptibility to the impact of buprenorphine can put your life in danger. Participation in a rehabilitation program is the best possible way to avoid a quick relapse and its unwanted consequences.

    But Butrans rehabilitation does more than help you decrease your short-term relapse risks. It’s also designed to give you the tools to learn how to stay sober long-term. Rehab programs achieve this goal in three ways. First, they help you clearly understand what addiction is and how it works. Rehabilitation also helps you recognize the behaviors, thought patterns and life attitudes that contribute to substance abuse. In addition, it helps you make new choices that keep your future abuse risks in check.

    Inpatient and Outpatient Treatment

    The vast majority of people with opioid use disorder receive addiction treatment in either an inpatient or outpatient facility. Inpatient rehab is a residential approach that requires you to live in a facility while you receive treatment. During your stay, you receive the benefit of constant support and staff availability. You also have the opportunity to put aside everyday responsibilities and focus on your efforts at recovery. And if any complications arise, immediate medical care will help keep you safe.

    Inpatient Butrans rehab is typically recommended for anyone with moderate or severe varieties of opioid use disorder. (In some situations, treatment for severe symptoms may begin in a hospital, instead.) Outpatient rehabilitation is the destination for many people with mild symptoms. This non-residential approach requires you to make periodic visits to a substance treatment facility while you continue to live at home. During your visits, you will do such things as participate in counseling sessions, undergo health assessments and receive any needed medication adjustments.

    Outpatient addiction treatment is an excellent way to make effective rehab part of your ordinary, daily routine. However, even people with mild symptoms of buprenorphine addiction sometimes seek inpatient care. The presence of serious mental illness is just one of the reasons for addressing mild addiction in a residential setting.

    Evidence-Based Treatment and Recovery Options

    The twin pillars of modern opioid addiction treatment are medications and behavioral therapies with demonstrated usefulness for your recovery. If you have Butrans-related problems, you may be surprised to learn that buprenorphine is also a frontline treatment option. It helps to understand that Butrans itself is not used for addiction rehabilitation. Instead, doctors use other medications that contain smaller amounts of buprenorphine. When given to you in the proper dosages, these medications help stabilize your condition, but they don’t get you “high.” Another opioid-based option, methadone, can also be used to achieve the same goals.

    When all opioids have left your system, your doctor may help you avoid a relapse by prescribing the anti-opioid medication naltrexone. When present in your bloodstream, this medication creates a chemical barrier that opioid substances can’t cross. By doing so, it prevents the reactions in your brain that make use of these substances feel pleasurable.

    Behavioral therapy for Butrans addiction can take several different forms. If you’re unsure of your reasons for seeking help, a technique called motivational interviewing can help you gain needed clarity. Two evidence-based therapies (contingency management and CRA, or community reinforcement approach, plus vouchers) produce results by offering rewards or incentives when you make progress in your program.

    A fourth well-known approach, cognitive behavioral therapy, helps you gain insight into how your habitual actions and attitudes support substance abuse. It also helps you establish alternative thoughts and behaviors that don’t provide such support.

    Choosing the Best Rehab for You

    When making your choices for Butrans rehab, your search should begin with reputable programs that meet modern standards for evidence-based therapy and medication. Your list of options should also be limited to programs that rely on expert caregivers with plenty of addiction-related experience. To make the most of your recovery efforts, look for programs that pair this level of expertise with secure and well-maintained treatment facilities.

    Today, most addiction centers have a hotline that you can call for advice and information. When you call a hotline, you should have access to someone who can answer all your questions and help you sort out your possible options. The person you speak to should be ready to address any of your concerns.

    At all professional, well-run programs, a doctor or addiction specialist will conduct an interview and assessment as the first steps in the intake process. One of the main purposes in these procedures is to determine the extent of your addiction and identify your specific symptoms. Your doctor or specialist will also take the opportunity to identify PD, anxiety disorders or other mental health conditions that must be addressed during treatment.

    Once you know that the facilities on your short list follow these accepted practices, you can look for the extra benefits provided by truly exceptional buprenorphine rehab programs. The best programs view their participants as individuals, not faceless victims of addiction. This holistic approach can be an essential factor in making you feel comfortable and welcome. It often includes personalized supporting treatments that focus on mind and body wellness. Top programs may also offer cutting-edge, supportive options not found in most facilities.

    Once you complete primary treatment, aftercare can also play an important role in your long-term recovery. Look for rehabilitation programs that allow you to check in periodically for follow-up assessment and assistance.

    No matter which program you choose, only you can take the gradual steps that lead to sobriety. However, by choosing your buprenorphine rehab options wisely, you increase your chances of making that journey a reality.

    View the original article at thefix.com

  • What Is Evidence-Based Addiction Treatment?

    What Is Evidence-Based Addiction Treatment?

    12-step programs are an incomplete approach and do not meet the requirements for evidence-based treatment because they lack biomedical and psychological components, and they use a one-size-fits-all approach.

    When looking for treatment for addiction, there is a lot of information out there and countless opinions. Friends, family, doctors, researchers, and people in recovery all have their own beliefs about what you need to do to get well. Unlike in other areas of healthcare, addiction treatment is often deemed “effective” based on anecdotal reports. In fact, most people who seek or are forced into treatment do not receive health care that is aligned with evidence-based practice.

    A frequently-cited definition comes from a 1996 article in the BMJ Medical Journal: evidence-based “means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” Other definitions also include the patient’s individual circumstances, preferences, expectations, and values.

    These variables are not necessarily constant, and there is no one-size-fits-all solution; any list of evidence-based treatments is going to include a wide variety of approaches.

    What is Addiction?

    In the United States, addiction is still treated more as a crime than as a chronic illness or disorder. Until that perspective changes, treatments will not meet their full potential and will not be as effective as they could be. Addiction, or substance use disorder (SUD), is a chronic medical condition that has remissions, relapses, and genetic components.

    Are Relapses Normal?

    A relapse is not a failure but a symptom. The brain of a person with SUD has gone through neurobiological changes that increase the risk of relapse because the damaged reward pathways stick around much longer than the substances stay in the body. Stressful events and other painful life experiences can trigger that maladaptive coping mechanism and cause a relapse.

    For other chronic illnesses we would consider a relapse to be an unfortunate symptom of the disease, and we might call it a recurrence instead of a relapse. When successfully managed, the condition is considered to be in remission. Remission is a term that is relatively new in addition treatment; substance use disorder was not always believed to be a disease but rather a moral failing and a problem of willpower. We now understand that addiction is a chronic medical condition and that remission is the goal of treatment. Remission, as defined by the American Society of Addiction Medicine, is “a state of wellness where there is an abatement of signs and symptoms that characterize active addiction.”

    What Is Successful Addiction Treatment?

    Let’s take a look at what it means to have an effective treatment outcome in terms of addiction. The primary goal is usually abstinence or at least a “clinically meaningful reduction in substance use.” To measure effectiveness, we must look at how and if treatment improves the quality of life for the patient. Improving quality of life is the aim when treating all chronic conditions that have no cure.

    Evidence-based therapies do not support the notion of “hitting bottom.” As with any chronic disease, early intervention is going to provide the best outcomes. Even more effective than early intervention is prevention because SUDs are both preventable and treatable.

    Pharmacotherapies to Treat Substance Use Disorders

    Addiction is an overstimulation of the brain’s reward pathways, and as the condition progresses, the brain becomes less sensitive to the rewarding effects of a drug and requires more of the substance to get the same effect. This overstimulation can play tricks on memory recall, turning experiences that were not good into ones that seem better than they actually were. It creates false memories to encourage re-indulging in the addictive substance or behavior.

    From a medical standpoint, this disparity needs to be interrupted and corrected. Akikur Mohammad, the author of The Anatomy of Addiction, argues that successful treatment of addiction “must first address the biological component and correct the brain’s chemical imbalance in the process.”

    Pharmacotherapy is used in medication-assisted treatment and recovery. Depending on the patient’s individual drug history, different medications may be used to mitigate the brain’s compulsive race to stimulate the reward loop.

    Therapy for Substance Use Disorders

    Most research on therapy for substance use disorders has been done on cognitive behavioral therapy (CBT)—a form of typically short-term psychotherapy that combines talk therapy with behavioral therapy. Patients are taught how to adjust their negative thought patterns into positive thoughts. There is clinical evidence that CBT can be as effective as medications for many types of depression and anxiety. For treating SUD, CBT has been shown to have a “small but statistically significant treatment effect” but doesn’t necessarily have a long-lasting effect. As it’s a chronic illness, it stands to reason that SUD requires further maintenance beyond any short-term treatment.

    Are 12-Step Programs Evidence Based?

    Alcoholics Anonymous and other 12-step programs use a social model of recovery. They are built on the basic notion of peer support in a safe environment. There is research on the efficacy of 12-step programs, which shows it works for some people and that there are benefits to this social model of recovery. The steps, or rather the principles of the steps, must be internalized into a person’s psyche in order for the person to achieve lasting abstinence. 12-step programs are an incomplete approach and do not meet the requirements for the classification of evidence-based treatment because they lack biomedical and psychological components, and they use a one-size-fits-all approach.

    One central tenet of the 12-step solution requires turning one’s will over to the care of a higher power. Certainly, letting go of the notion that force of will can change the trajectory of addiction is necessary for any treatment. It’s a disease, and willpower will no sooner cure addiction than it will cure diabetes or heart disease. An evidence-based approach could mean that a doctor recommends a patient attend a 12-step program, or other support group, as part of a maintenance regime.

    The addiction treatment world is overrun with rehabs that primarily utilize 12-step programs, which are touted as the only treatment for addiction. That simply isn’t true. Addiction researchers have found that individually, cognitive and behavioral therapies, including social supports like 12-step programs, are incomplete treatment for a chronic disease that is both physiological and genetic in origin. From a treatment perspective that is grounded in evidence-based practice, involvement in a support group would be merely one piece of the puzzle.

    Holistic Care

    In evidence-based practice, the treatment process individualizes care and uses a holistic perspective to see what combination of resources will work best for a particular patient. The combination of treatment tools depends on a clinician’s specialized knowledge, the patient’s values and preferences, and the best research evidence. We need more specially trained addiction clinicians who can help people with SUDs make informed treatment decisions.

    Are you in recovery from addiction? What worked for you? Tell us in the comments!

    View the original article at thefix.com

  • There's Nothing Wrong With You If AA Doesn’t Work

    There's Nothing Wrong With You If AA Doesn’t Work

    It isn’t that you’re incapable of being honest with yourself, or that you’re not working a “program” well enough. You are not too broken, or too far gone.

    I spoke to a friend, Damien, last week. He was devastated at losing someone close to him to alcohol use disorder. What is particularly harrowing about this person’s passing is that it might have been prevented. Damien’s friend was repeatedly pushed toward Alcoholics Anonymous (AA), even though it clearly wasn’t the right fit for him. Just like many others, instead of being supported by peers and professionals and given alternative options, this friend was left feeling that the problem was him.

    “It’s really frustrating to see friends die because the default treatment option doesn’t work for them,” Damien says. “We are losing far too many people with substance use disorder who find 12-step incompatible with their life experiences and belief systems.”

    He goes on to say, “It’s not because they aren’t willing. It’s not because they can’t ‘get it.’ It’s because, for many people, treating addiction requires more than hope, spirituality, and fellowship. And yet, the only option most are presented with is founded on those three pillars. If the recommended treatment for bacterial infections had the same success rate as the 12 steps, then antibiotics would not be our go-to treatment plan for staph infections.”

    My overarching message is: There is nothing wrong with you if AA doesn’t work. It isn’t that you’re incapable of being honest with yourself, or that you’re not working a “program” well enough. You are not too broken, or too far gone. You simply haven’t found the right pathway for you.

    These kinds of beliefs stem from the Big Book of Alcoholics Anonymous, which states: “Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.” [emphasis added]

    During my five years of attending countless AA and Narcotics Anonymous (NA) meetings, I have heard many members criticize those who come in and out of the rooms but return to using in between, categorizing them as unwilling, or incapable of being honest. “They just need to surrender to the program and work it like their life depends on it,” was the kind of statement I heard over and over again.

    I threw myself into the program because there were no other options for me in the northwest of England. I was so desperate to find something that would help me that I believed anything members said, even if there was no evidence to back it up. I did a fair amount of perpetuating these myths too. I was instructed to ignore my instincts and critical mind (because that was my “disease talking”), and do what I was told. Giving away my free will to a person in the sky or a church basement seemed weird, but I went with it for several years. After all, it had worked for many other members.

    With a period of sobriety under my belt, I couldn’t ignore my inner doubts any longer. They became louder. It was as though, even after years in recovery, I suddenly woke up. And I started to slowly unpack all the myths I’d been told.

    In particular, I tried to unpack “it works if you work it.” There is substantial evidence that shows there’s no one-size-fits-all method when it comes to recovery. If this program were suitable for everyone with substance use disorders, its success rate would be much higher. The fact is that success rates of 12-step programs vary wildly, from as low as 5 to 8 percent, with dropout rates from 69 to 86 percent, to as high as 42 percent after four years. I should point out that these dropout rates are a reflection of the attrition rates of addiction treatment generally. This underscores the point that the way we treat addiction isn’t appropriate for everyone and we need to get better at personalizing care based on individual circumstances.

    When I moved to the U.S., it was like my world opened up. I saw that despite what I’d been told in AA — that it was the only method for successful recovery — there was actually an open landscape of diverse recovery pathways.

    A leading study shows that tens of millions of Americans have successfully resolved an alcohol or drug problem through a variety of traditional and nontraditional methods. That means:

    • 9 percent recovered with “assisted pathway use” that consisted of mutual-aid groups (45.1 percent), treatment (27.6 percent), and emerging recovery support services (21.8 percent). 95.8 percent of those who used mutual-aid groups attended 12-step mutual aid meetings.
    • Just under half of those who did not report using an assisted pathway recovered without the use of formal treatment and recovery supports.

    I’m aware that an ideal model of treatment, individualized based on the person’s particular medical and psychological needs, is not always available to most people. Not all of us have the luxury of therapeutic treatment from a psychologist or psychiatrist. This is another reason mutual-aid groups are the most accessible form of recovery pathway — they’re free! We’re fortunate in the U.S. to have plenty of other support groups that are not all based on religion, and some have a solid evidence-based program. They include Refuge Recovery, LifeRing Secular Recovery, SMART Recovery, Moderation Management, Wellbriety — among many others listed here — and they have been shown to be equally as successful as 12-step groups.

    study comparing 12-step groups to alternative mutual aid groups found that LifeRing, SMART, and Women for Sobriety were just as effective as 12-step groups. Study author Dr. Sarah Zemore and her team reported that “findings for high levels of participation, satisfaction, and cohesion among members of the mutual help alternatives suggest promise for these groups in addressing addiction problems.”

    Despite my reporting about AA’s success rate and some of the myths perpetuated by the fellowship, I’m not here to bash AA. I’m here to shine a light on the false statement that it is the only successful way. There are many others. For those AA does work for, I respect your path. We just need to have a clearer picture of what recovery looks like so when someone is suffering, instead of saying they are the problem, we can be better informed to direct them to what may be a more suitable pathway. After all, we all have the same goal: recovery.

    View the original article at thefix.com