Answer Addiction

Tag: methadone

  • Addiction Is ‘A Disease Of Isolation’ — So Pandemic Puts Recovery At Risk

    Addiction Is ‘A Disease Of Isolation’ — So Pandemic Puts Recovery At Risk

    “We consider addiction a disease of isolation…Now we’re isolating all these people and expecting them to pick up the phone, get online, that sort of thing — and it may not work out as well.”

    Before the coronavirus became a pandemic, Emma went to an Alcoholics Anonymous meeting every week in the Boston area and to another support group at her methadone clinic. She said she felt safe, secure and never judged.

    “No one is thinking, ‘Oh, my God. She did that?’” said Emma, “’cause they’ve been there.”

    Now, with AA and other 12-step groups moving online, and the methadone clinic shifting to phone meetings and appointments, Emma said she is feeling more isolated. (KHN is not using her last name because she still uses illegal drugs sometimes.) Emma said the coronavirus may make it harder to stay in recovery.

    “Maybe I’m old fashioned,” said Emma, “but the whole point of going to a meeting is to be around people and be social and feel connected, and I’d be totally missing that if I did it online.”

    While it’s safer to stay home to avoid getting and spreading COVID-19, addiction specialists acknowledge Emma’s concern: Doing so may increase feelings of depression and anxiety among people in recovery — and those are underlying causes of drug and alcohol use and addiction.

    “We consider addiction a disease of isolation,” said Dr. Marvin Seppala, chief medical officer at the Hazelden Betty Ford Foundation. “Now we’re isolating all these people and expecting them to pick up the phone, get online, that sort of thing — and it may not work out as well.”

    Emma has another frustration: If the methadone clinic isn’t allowing gatherings, why is she still required to show up daily and wait in line for her dose of the pink liquid medication?

    The answer is in tangled rules for methadone dispensing. The federal government has loosened them during the pandemic — so that patients don’t all have to make a daily trip to the methadone clinic, even if they are sick. But patients say clinics have been slow to adopt the new rules.

    Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, said he issued guidelines to members late last week about how to operate during pandemics. He recommended that clinics stop collecting urine samples to test for drug use. Many patients can now get a 14- to 28-day supply of their addiction treatment medication so they can make fewer trips to methadone or buprenorphine clinics.

    “But there has to be caution about giving significant take-home medication to patients who are clinically unstable or actively still using other drugs,” Parrino said, “because that could lead to more problems.”

    The new rules have a downside for clinics: Programs will lose money during the pandemic as fewer patients make daily visits, although Medicare and some other providers are adjusting reimbursements based on the new stay-at-home guidelines.

    And for active drug users, being alone when taking high levels of opioids increases the risk of a fatal overdose.

    These are just some of the challenges that emerge as the public health crisis of addiction collides with the global pandemic of COVID-19. Doctors worry deaths will escalate unless people struggling with excessive drug and alcohol use and those in recovery — as well as addiction treatment programs — quickly change the way they do business.

    But treatment options are becoming even scarcer during the pandemic.

    “It’s shutting down everything,” said John, a homeless man who’s wandering the streets of Boston while he waits for a detox bed. (KHN is not including his last name because he still buys illegal drugs.) “Detoxes are closing their doors and halfway houses,” he said. “It’s really affecting people getting help.”

    Adding to the scarcity of treatment options: Some inpatient and outpatient programs are not accepting new patients because they aren’t yet prepared to operate under the physical distancing rules. In many residential treatment facilities, bedrooms and bathrooms for patients are shared, and most daily activities happen in groups — those are all settings that would increase the risk of transmitting the novel coronavirus.

    “If somebody were to become symptomatic or were to spread within a unit, it would have a significant impact,” said Lisa Blanchard, vice president of clinical services at Spectrum Health Systems. Spectrum runs two detox and residential treatment programs in Massachusetts. Its facilities and programs are all still accepting patients.

    Seppala said inpatient programs at Hazelden Betty Ford are open, but with new precautions. All patients, staff and visitors have their temperature checked daily and are monitored for other COVID-19 symptoms. Intensive outpatient programs will run on virtual platforms online for the immediate future. Some insurers cover online and telehealth addiction treatment, but not all do.

    Seppala worried that all the disruptions — canceled meetings, the search for new support networks and fear of the coronavirus — will be dangerous for people in recovery.

    “That can really drive people to an elevated level of anxiety,” he said, “and anxiety certainly can result in relapse.”

    Doctors say some people with a history of drug and alcohol use may be more susceptible to COVID-19 because they are more likely to have weak immune systems and have existing infections such as hepatitis C or HIV.

    “They also have very high rates of nicotine addiction and smoking, and high rates of chronic lung disease,” said Dr. Peter Friedmann, president of the Massachusetts Society of Addiction Medicine. “Those [are] things we’ve seen in the outbreak in China [that] put folks at higher risk for more severe respiratory complications of this virus.”

    Counselors and street outreach workers are redoubling their efforts to explain the pandemic and all the related dangers to people living on the streets. Kristin Doneski, who runs One Stop, a needle exchange and outreach program in Gloucester, Massachusetts, worried it won’t be clear when some drug users have COVID-19.

    “When folks are in withdrawal, a lot of those symptoms can kind of mask some of the COVID-19 stuff,” said Doneski. “So people might not be taking some of their [symptoms seriously], because they think it’s just withdrawal and they’ve experienced it before.”

    Doneski is concerned that doctors and nurses evaluating drug users will also mistake a case of COVID-19 for withdrawal.

    During the coronavirus pandemic, needle exchange programs are changing their procedures; some have stopped allowing people to gather inside for services, safety supplies, food and support.

    There’s also a lot of fear about how quickly the coronavirus could spread through communities of drug users who’ve lost their homes.

    “It’s scary to see how this will pan out,” said Meredith Cunniff, a nurse from Quincy, Massachusetts, who is in recovery for an opioid use disorder. “How do you wash your hands and practice social distancing if you’re living in a tent?”

    This story is part of a partnership that includes WBUR, NPR and Kaiser Health News.

    View the original article at thefix.com

  • My Methadone Pregnancy

    My Methadone Pregnancy

    I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

    The last time I stuck a needle in my arm was three whole months before I conceived my son, and I’m grateful that he’s never experienced me in active addiction. I say three whole months as if it were a lifetime, but it really is to anyone in early recovery. I was fortunate, I stopped using heroin before I found out that I was pregnant. I had just turned 29 and was in a stable relationship with my now-husband.

    For many women, getting on methadone doesn’t happen until they find out they’re pregnant. Their options are to either keep using or get into treatment. I started taking methadone five months before I stopped using and faced a bit of a learning curve. It was difficult to separate myself from the lifestyle and the people who I interacted with on a daily basis. I also had a needle addiction, and there’s no maintenance medication for that.

    When I decided to stop getting high, I immediately started trying to fix everything that I had destroyed. I was in a new relationship with someone who understood that I was broken and he took me to the methadone clinic every day. We met shortly after I got clean and he never once judged me for my past actions or made me feel bad for taking methadone during my pregnancy. Every expecting mom who takes opioids knows that if you just stop taking them, there is a high risk you will miscarry. Your baby experiences the withdrawal symptoms more strongly than you and in many cases they just aren’t strong enough to withstand it.

    Making The Best Painful Choice

    I was in a heartbreaking situation, but I needed to do what was best for the baby. I can see the comments already: How could you continue to take a medication like that while pregnant?! How could you do that to a tiny human, he’s going to withdraw! I heard this from my mother and a few other opinionated individuals who believed it was appropriate to weigh in on my treatment. I listened to what my doctor told me. I did my research and I am at peace with my decision: getting off methadone while I was pregnant just wasn’t an option.

    The doctor at the treatment facility gave me a ton of information as to what to expect with my continuing treatment. She told me that as the baby grew, I would most likely need to take more methadone to accommodate the increased blood volume. I needed to pay attention to my symptoms and try to tell the difference between normal pregnancy discomfort and methadone withdrawal. I was really grateful for her kindness and advice, especially in the beginning.

    After I had my baby, I found out that there are many online support groups for pregnant women on maintenance medication. These sites provide information on symptoms, what is normal, the rights you have as someone who has struggled with opioid addiction, and more. It’s especially important to know what your hospital’s protocols are for infants going through opioid withdrawal. I know a lot more after giving birth than I ever did in my pregnancy.

    I Would Judge Me, Too

    I was afraid that Child Protective Services would be getting involved during and after my pregnancy, but I was assured by my OB-GYN and the doctor at the methadone clinic that as long as I stayed clean, I would have nothing to worry about. Still, as someone who has worked in the medical field, I knew the stigma attached to my condition. I worried at every appointment that people would look down on me and talk negatively about me after I left. I mean, I was an ex-heroin addict who was pregnant and who was continuing to put something addictive into my body. I would judge me, too.

    My apprehension was unnecessary, my OB-GYN was very supportive. She referred me to a high risk maternal/fetal medicine doctor who I also saw regularly. I went to every appointment, took my methadone as prescribed, and continued to go to therapy.

    When I was about 10 weeks along, I told my parents I was pregnant. I wish I waited a little longer, but I was so excited to be a mom. Their reaction was concern that once my baby was born, he would go through withdrawal from the methadone. I tried not to take it as criticism and judgement, because their concerns were valid. I felt very guilty and scared that this little soul was going to suffer and it was all my fault.

    My stepmother threw me the biggest, most elaborate baby shower that I had ever been to. She invited all of her friends and they brought me nice gifts and things I didn’t know I needed. I remember eating the cherry cake she’d ordered especially for me and starting to cry. This party was thrown for me by a woman who I’d lied to and stolen from during my addiction but none of that seemed to matter to her. She invited her friends because I only had one or two left. I’d cut contact with everyone from my previous life when I stopped using.

    I chose to not go to meetings or participate in any 12-step activities because I did not want to be around other people who were struggling in the same way I was. I know that NA is a great support system and helps many people stay clean, but it wasn’t the right fit for me. Of all the resources available to me, I was the most successful with just the support of my husband, my parents, and our church.

    Induction

    At my 37-week appointment, the doctor found that I was low on amniotic fluid and decided I should be induced that day. I was ready, even though I was afraid of the pain and even more afraid that the painkillers wouldn’t work due to the methadone.

    My husband and I hustled over to the labor and delivery wing of the hospital, excited and nervous. As expected, when I got there, I was drug tested. It was mandatory since I had a recorded history of heroin use but it still made me sad.

    The induction process was incredibly painful. I remember not wanting to ask for anything to help with the pain because I didn’t want to be judged, but as soon as I felt my cervix start to stretch, I stopped caring what anyone thought. It was brutal. After 18 hours of agony, I received an epidural. I was exhausted and excited and running on encouragement from my husband.

    Before I knew it, I was 10 centimeters dilated and surrounded by doctors who were telling me to push with each contraction. A few minutes after they set up their delivery equipment, he was here! I have never cried harder than the moment they handed me this pink, messy, angry little person. He was gooey and gross and perfect. I felt so much at once; it’s hard to explain those first few moments. He was on my chest for about 45 minutes before they cleaned him up and took him to the NICU because his blood sugar was low.

    Because I had methadone in my system during my pregnancy, we had to stay for an extra five days so they could monitor my baby for withdrawal symptoms. I spent that time trying to breastfeed, learning to hold a baby properly, and getting sleep.

    My New Baby, in Opioid Withdrawal

    I would like to end this by saying that we went home after the five days and lived happily ever after, but that’s not the whole story. My husband and I went home but our little boy had to stay for an extra two weeks. He started to show signs of methadone withdrawal around day five.

    There are lots of myths about babies in withdrawal and what they look like. Yes, some are inconsolable and have tremors, but that isn’t always the case. I wasn’t able to recognize the symptoms in my baby because he didn’t match the picture in my head of a baby in withdrawal.

    He had a high-pitched cry; I held him against me and nursed him constantly. Sometimes it calmed him down, sometimes it wouldn’t.

    In the hospital, they use a chart called the Finnegan Scale to assess the severity of withdrawal and determine if the infant needs medication, and my son’s symptoms indicated that he needed to be medicated. The doctor in the NICU told us they were going to start my baby on a small amount of morphine to calm him down and make him more comfortable. I didn’t want them to give him morphine, but I felt more strongly that I didn’t want him to suffer.

    Seeing my baby for the first time after he was medicated gave me some peace. I knew that was best for him, just like taking my methadone was best for him during my pregnancy. It’s hard to convince someone unfamiliar to the world of maintenance medications and opioid addiction that I did what was right for my baby, but I know I did.

    He started getting better immediately and every day he received a little less morphine. My husband and I were lucky enough to have a private room in the NICU and be able to be with him 24-7. The most important things I did for his recovery were keeping him close to me (skin to skin contact), keeping the lights low, and the noises to a minimum. They recommended that I breastfeed as often as possible and my baby had an amazing nurse who taught me how to do this. She constantly encouraged me and kept me informed about his treatment.

    A Healthy, Happy Boy

    Per hospital protocol, my husband and I were interviewed by social services. I had to be completely transparent with them and give my doctor at the methadone clinic permission to speak with them. They even came to look at my home to make sure that it was a safe place for my baby to be. I went through a variety of emotions during this time. I felt violated, angry, insulted, and even confused. I had passed every drug test for the past year and my ability to be a good mom was being questioned. The whole process lasted about a week and then we never heard from them again. I was told that the only reason that social services (CPS or DYFS depending on your state) were contacted was because there were traces of methadone in his meconium.

    Our baby boy has been growing and thriving ever since we brought him home. I still have guilt about his first few weeks in the world, but that’s okay. I try to tell myself that he wouldn’t even be here if I didn’t get on methadone in the first place, but that might just be me justifying it. I now have a smart, healthy, beautiful two-year-old little boy who never stops smiling. When he gets older, I will have to explain to him why he got sick right after he was born. I hope he understands and forgives me.

    View the original article at thefix.com

  • Luxury Rehab Guide for Methadose Addiction

    Luxury Rehab Guide for Methadose Addiction

    Use this handy guide to find out everything you need to know about Methadose

    1. What is Methadose?
    2. What are the slang terms for Methadose?
    3. How do you use Methadose?
    4. What are the consequences of a Methadose overdose?
    5. What should you avoid when using Methadose?
    6. Methadose side effects
    7. What are the other drugs that can negatively interact Methadose?
    8. What is Methadose addiction?
    9. How long does Methadose stay in your system?
    10. What is Methadose withdrawal?
    11. What is Methadose rehab, and is it useful?
    12. How can you choose the right rehab center?

    What is Methadose?

    Methadose is an opioid that is used to treat moderate to severe pain. The synthetic painkiller can have several health risk factors that can lead to respiratory disorders when abused. Methadose reduces pain by directly acting on the brain stem and can suppress an individual’s autonomic respiratory drive. This medicine is strictly regulated, and is only available through a valid prescription provided by your doctor or pharmacist.

    What are the slang terms for Methadose?

    Many opioids have code names or slang terms. These code names are often used when painkillers are sold illegally. Medical professionals need to know about painkillers and their slang terms so that they can diagnose the symptoms of Methadose overdose before the situation gets worse. Here are some of the standard slang terms that are used for Methadose:

    >> Amidon

    >> Dollies

    >> Dolls

    >> Fizzies

    >> Mud

    >> Red Rock

    >> Tootsie Rolls

    How do you use Methadose?

    To get the most positive Methadose effects, you have to follow the dosage and instructions that are provided by yout doctor. Methadose usually comes in tablet form for oral consumption. One dose of Methadose is equivalent to 40 mg. As mentioned before, it’s prescribed for pain management that is caused from injuries and terminal diseases like cancer. Methadose is also used to help patients who suffer from opioid dependence to detox. Unlike other opioids which may have short half-lives and require frequent dosing, Methadose’s long duration and slow onset enable it to remain in a person’s system for up to thirty hours once ingested. This means that the patient will have to take a dose only once a day.

    Here are some crucial points you should know before you take Methadose:

    >> Avoid taking the medication if you have severe asthma or breathing problems

    >> Avoid taking the medication if you have any stomach or intestine problems

    Methadose side effects can result in a life-threatening heart rhythm disorder, and it’s necessary that you get your heart checked regularly during treatment.

    You must inform your doctor beforehand if you have any of the following conditions:

    • Heart problems
    • Lung disease
    • Head injury, seizures, or a brain tumor
    • Any mental illness or substance addiction
    • Liver or kidney problems
    • Urinary issues
    • Gallbladder or pancreatic diseases

    Avoid using this medicine during pregnancy because there are chances that your baby will become dependent on the drug as well. This will be dangerous for the baby once it’s born because it can experience life-threatening withdrawal symptoms, and may need medical treatment for many weeks. If you’re taking Methadose after giving birth, then you must avoid breastfeeding because the drug can pass into breast milk and cause drowsiness and breathing problems for the baby.

    When you receive your Methadose prescription, ensure that you follow the medication guide that comes with the drug. Avoid using Methadose for longer than necessary or taking a larger dose than prescribed. You should consult your doctor if your current dose is ineffective.

    Never share your painkillers with another person; your painkiller has a dosage that is specially formulated based on your current health and current condition. If you misuse Methadose, it can lead to addiction or overdose which, in extreme cases, can cause death. You should keep the medicine in a place where children cannot gain access to it easily. Selling the drug without a prescription is against the law. Ensure that you consult your doctor in case you have any questions about the medication or the dosage. 

    This medication is available in liquid form, and to consume it orally, you have to use a marked spoon or medicine cup that comes with the bottle. Do not use a household spoon for taking the medicine because the dosage will not be correct.

    Methadose can cause addiction when taken for a prolonged period.  Cessation can cause withdrawal as well. If you stop using the drug suddenly, then the withdrawal symptoms can be intense, so ask your doctor to taper the dosage. This way, the withdrawal won’t hit as hard.

    If, in any case, you miss a dose, then you will need to take it as soon as possible. Nevertheless, if you missed your dose and it’s almost time for your next dose, then you can skip the missed dose and go back to your regular dosage schedule. Avoid double doses. If you miss the treatment for three days in a row, then you should consult your doctor immediately because you may need to start with a low dose again.

    What are the consequences of a Methadose overdose?

    During a Methadose overdose, you should contact emergency services and poison control right away. An overdose, of any kind, can be fatal, especially if the patient is left unattended. The symptoms for overdose include the following:

    • Slow heart rate
    • Drowsiness
    • Muscle weakness
    • Clammy skin
    • Shallow breathing

    What should you avoid when using Methadose?

    Avoid Methadose abuse (using it for non-medical reasons), you should also avoid combining it with alcohol because this can cause dangerous side effects and can lead to death. Once the medicine begins to take effect, you should avoid operating any heavy machinery. The drug can make you tired, and operating any heavy machinery can cause accidents and serious injuries. Also, avoid consuming grapefruit or grapefruit products because they can cause adverse side effects.

    Methadose side effects

    If you begin to notice any side effects or allergic reactions when you take Methadose, like hives, difficulty in breathing, inflammation of your face, lips, throat or tongue, you should seek emergency help immediately.

    Side effects can include:

    • Shallow breathing
    • Constipation
    • Dizziness
    • Fainting
    • Heart palpitation
    • Nausea
    • Vomiting

    What are the other drugs that can negatively interact Methadose?

    Painkillers can react with many other drugs, and they can result in intense side effects. If these side effects are not resolved, then they can lead to death.

    >> Any other narcotic painkillers or cough suppressants

    >> Sedatives like Valium or Xanax

    >> Drugs that make you drowsy

    >> Drugs that affect the serotonin levels of your body

    You should also inform your doctor if you are currently taking any antibiotic, antifungal, heart, blood pressure, seizure, or hepatitis C medicines. Any over-the-counter drugs and vitamins should also be mentioned when consulting your doctor

    What is Methadose addiction?

    Addiction does not happen suddenly. Instead, it happens gradually over time. When you’re on a medication, it’s vital that you update your doctor on any issues that you’re facing. This way, your doctor can monitor your progress while on the dose he has given you. If you feel that your pain has not improved, then you will have to consult your doctor once again to adjust your dose. 

    It’s illegal to give your medicine to someone else. So, keep the unused medicine away from children and in a safe and secure location. If you show signs of overdose, get help as soon as possible.

    Patients who take Methadose have a high chance of getting addicted to the drug. The severity of the addiction depends on the dosage of the opioid. Methadose tends to create a mental and physical dependency on the drug.

    Because Methadose comes with a high risk of addiction, it’s classified as a schedule 2 substance in the United States. It’s categorized as a schedule 1 drug in Canada, and other countries as well. It’s illegal to use any methadone-based drugs in Russia.

    How long does Methadose stay in your system?

    Methadose takes a long time to clear your system. The way your body reacts to the drug, along with the duration of its stay in your system, depends, in part, on your physiology and medication history. It can take anywhere from 8 to 59 hours for the drug to metabolize. Urine tests can identify Methadose from 24 hours to 7 days after the last dose. Blood tests can detect Methadose for three days after the last dose.

    Methadose requires a prescription and you must only take the amount required. If you excede the prescribed dose, there can be big problems; people can get addicted to this drug easily, especially if there is no medical reason for them to use it anymore. An addict can experience increased dependency on the drug, and this means that their situation goes from bad to worse.

    What is Methadose withdrawal?

    Methadose is a type of methadone hydrochloride medication. When taken in moderate doses, it helps with pain and has a positive effect on the patient’s well-being. However, this does not negate the fact that the drug can be addictive and dangerous when taken more than prescribed. Methadose requires medical supervision and should not be taken without a doctor’s prescription.

    Once you know the severity of addiction and withdrawal symptoms, you will probably notice that any attempt at self-treatment is pointless. It’s hard to have a level of commitment to stop the addiction by yourself, without any help or support. Substance abuse can lead to addiction which is a behavioral disorder that often requires professional help, and it’s rarely something that can be cured immediately. Prescription drugs that are used for recreational purposes, more often than not, lead to addiction. When substance abuse takes over a major portion of your life, then it’s helpful to accept that you have a problem and that you need help.

    Common withdrawal symptoms are:

    >> Sedation

    >> Insomnia

    >> Vomiting

    >> Low blood pressure

    >> Swelling of the hands and feet

    >> Mood swings

    The symptoms of Methadose withdrawal can appear as flu-like symptoms. Withdrawal can cause emotional complications as well. During withdrawal, you will experience intense drug cravings, and this is where you will usually experience a relapse. The first step towards recovery is admitting you have a problem. From there, accepting professional therapy and medication often becomes easier, and the results can be positive as well.

    Many factors can lead a person into addiction. Here are some of the common risk factors for addiction:

    • Friends or family members who have struggled with addiction
    • Abusive or traumatizing domestic atmosphere
    • Mental health illnesses
    • Use of alcohol or drugs at an earlier stage in life

    Addiction is not a lost cause, and just like any behavioral disease, it can be treated with the right facilities, medication, and professionals. The journey of sobriety is not comfortable, and many obstacles may come your way. Your mind might rebel through most of the detox process, and your restraint and willpower will be tested to what may feel like a breaking point. Nevertheless, once you get through the dark and tedious phases, you will most likely feel that sobering up is the best decision you’ve made.

    What is Methadose rehab, and is it useful?

    Once a patient has accepted that they have a problem, it is easier for them to accept help. Rehabilitation centers benefit many patients who are addicted to drugs and are trying to overcome substance abuse. To begin an effective rehab treatment, you will probably have to detox. Detoxification causes withdrawal, and the process can be brutal. If you go through detox on your own, there is a high likelihood that you will cave and relapse into addiction once again. 

    Hence, having professional and medical help when going through detox can be important because the chances of relapse are lower.

    When you go for Methadose addiction treatment, the first step is creating a plan. The only way this plan can be effective is if you accept that you have a substance abuse problem. Once you do, you have to have the conviction to go through the withdrawal and recovery process. It’s never too late to get help; the earlier you accept that you have an addiction problem, the better it is for you. Rehabilitation centers are one of the many options that help with addiction and mental health recovery.

    Rehabilitation treatment will guide you through the recovery process with the help of detoxification and therapy. They will also assist when you’re going through the withdrawal process and help ensure that you don’t give in to your cravings. Self-treatment is not the best course of action, especially when you’re going through intense withdrawal symptoms.

    Listed below are three types of rehabilitation centers that are available for addiction and substance abuse treatment:

    Inpatient Rehab centers:

    Inpatient treatment involves a patient being admitted in a hospital-like scenario. Once admitted, they usually have to undergo intense therapy for a set period with 24/7 supervision. This includes medical counseling, medication, and medical assistance. This treatment will require the patient to be admitted into the center so that they can fully and safely recover.

    Outpatient facilities:

    In this treatment option, the patient can visit the center whenever they have an appointment. These facilities don’t require constant supervision or guidance. They are perfect for patients that don’t have a severe addiction and can survive through their daily routine without being triggered into a relapse. These sessions are done with the help of professionals, and they help ensure that you’re on the right path to recovery.

    Residential treatment centers:

    These are quite similar to inpatient treatment facilities, except that they are held in a residential complex. The environment and facilities of a residential center are really different from a hospital rehab center and more like a home. The approach of such rehab centers is all-inclusive, and the patient gets to live in a secure environment that takes them from the detoxification process which is carried out under supervision and on to treatment which includes therapy and, perhaps, medication. Staff and medical professionals help you get by and encourage you to complete your journey through sobriety. A residential program provides a solid foundation for recovery for the patient and is strongly recommended for Methadose treatment. Residential treatment is the most popular treatment plan, however, this plan can be expensive. 

    You can opt for rehab insurance policies, and they help with any expenses you may incur while receiving treatment. It’s important that you find out if your treatment plan is included in the policy and if you have to pay any additional costs.

    How can you choose the right rehab center?

    Every patient is different; this means there is no specific treatment plan for everyone. You need to find a rehabilitation center that will suit your needs and enable the recovery you require. It all begins with meeting your doctor and formulating a plan. Through a well-structured plan, you can make an informed decision about the rehab center you choose.

    Listed below is a typical rehabilitation process from start to finish; this process is what most centers tend to follow:

    >> Admission into the center:

    This is the starting point of your journey to sobriety, and here, you will have to contact the rehab center and enroll in the facility. Treatment facilities are aware of the overwhelming thought process that patients go through when they want to admit themselves. So, they make the enrollment process as quick and comforting as possible because the last thing they want to do is overwhelm or intimidate the patient. All you have to do is contact the admission center and book your treatment.

    >> Intake

    When you enter the facility for the first time, you have to go through an administrative process. Here, you will be asked basic questions about your lifestyle, and you will be searched for forbidden items like drugs, alcohol, or weapons. The intake process serves as an orientation for the new patients, and they are introduced to the facility and the staff. This process aims to make the experience as friendly and comfortable as possible.

    >> Assessing the patients:

    This is where the professionals begin interacting with the patients. Medical and clinical staff members will begin the process by interviewing you and determining if you have any specific needs during your stay at the center. During the assessment, the patient is asked about their addiction, the drug they are addicted to, the duration of the addiction, and if they suffered from any other mental health problems before and during their addiction. This step is quite important because it helps the staff to create a customized plan that is designed for you and will help you get better.

    >> Detox:

    The detoxification process enables your body to eliminate any toxins that are present because of your addiction. This process will lead to withdrawal, and as your body begins to adjust and balance itself chemically, you will feel a certain amount of discomfort and pain. The staff at the rehab center will make your detox process as comfortable as possible and help you through this tough time, the length of which will vary, but expect it to last a week or so. Once the detox is done, the patient feels better and calmer. You will be ready to heal yourself physically and mentally once your system is clean.

    >> Patient Care:

    Once the detox stage is complete, you’re now ready for inpatient care. During this stage, there will be many single and group therapy sessions and services that will help you in the short and long run. In this stage, you will identify your triggers, learn how to handle them, avoid relapsing, and work toward achieving long-term sobriety.

    >> Aftercare services:

    When you leave the rehab center, you’re encouraged to join the aftercare program. This is done because stepping back into the real world after an intensive rehabilitation can be quite overwhelming, and it can trigger a relapse. Aftercare services will teach you how to handle your daily routine without giving in to substance abuse.

    If you or anyone you know is suffering from Methadose addiction, ensure that you get help from trusted sources as soon as possible.

    When you spot the addiction symptoms in the early stages, you can stop it from getting worse by getting admitted to an established rehabilitation center. All centers don’t charge the same rate, and some can be more expensive than others. Some of the best rehab centers may be out of the budget for most people. Not to worry; you may be able to take out short-term loans or insurance policies that will last you through the treatment period. You should ensure that the insurance policy you choose covers the treatment plan you want.

    If you or anyone you know is suffering from Methadose addiction, you can always reach out for help from capable rehab centers and their teams of professionals. Family and friend support is always welcome, but professional help can aid in getting you through the problem.

    View the original article at thefix.com

  • 7 Things I Wish I Could Tell My Parents About My Addiction

    7 Things I Wish I Could Tell My Parents About My Addiction

    Here, on this motel floor, I need to know that you still love me. If it isn’t too painful for you, please visit me in rehab. When I tell you that I’m finally ready to get clean, please believe me even if it’s the 100th time.

    I constantly find myself in conversations with both of my parents about that dark time in my life. In the beginning of my sobriety, I tried to explain to them about opioid receptors and dopamine levels but it never seemed to make a difference. Many parents have a “You did this because you are weak!” mindset. They think that you can just quit. Well, Mom…

    1. I Can’t Just Quit

    I’ve been tired of this life for a long time and I have the desire to be the person you once trusted. But every time I quit, I get sick and believe that life just isn’t worth living. I’ve tried to get clean but once the fog clears I realize how much I’ve damaged my life and I go back. I wish I could snap my fingers and be normal with a job and home, but my brain has changed. I want to be the child who you loved unconditionally but I’m not, I’m sick. I don’t like sleeping outside and going to rehab every few months, but that’s what this drug has done to me. It’s a part of me now and unless I have it I can’t even get out of bed. I hate myself and what I’m putting you through, but my mind and body are broken right now.

    2. This Isn’t Your Fault

    This didn’t happen because you left me to cry it out in the crib for too long or because you weren’t strict enough. There isn’t a recipe that you followed to make me a drug addict. This happened because I tried something out of curiosity and my brain and body responded in a way that made it impossible to stop. Ever since that first time, my brain hasn’t worked the same. I am not lazy, stupid, or weak. I wish that I could sleep this off with a hot shower and an iron-rich diet but it doesn’t work like that. It started off as fun, but now I’m trapped.

    3. My Addiction Shouldn’t Be the Topic of Gossip

    I wish you could tell all your coworkers that I graduated from that expensive university we planned on me attending. I know you aren’t proud of me right now, but I’m still a person. I want you to heal and be able to talk about how much I’ve hurt you, but please don’t use me and my addiction as entertainment. I am still your child.

    You might not know much about how addiction works but I need for you to keep my most embarrassing secret close to you. Your coworkers and distant relatives don’t need to know that I’m in jail yet again. My great grandmother that lives a thousand miles away doesn’t want to hear about how I am living in a dirty motel. Unless I’m a threat to them or their belongings, I ask that you protect my dignity. People assume the absolute worst about people like me and I’m not proud of anything I’ve done to feed my addiction. Along with getting high, I have engaged in degrading behaviors and even exposed myself to disease and violence.

    When people hear, “My child is a drug addict,” they think about every negative thing they’ve ever seen in a movie or heard on the news and they will apply it to me. Why would you even want to share these awful things? Talk about the president or what movie you just saw instead. When I get better, I will have to face what I have done and accept the mistakes that I have made. I will have to face the people that you shared my humiliation with. Please don’t think that I am asking you to suffer in silence. There are support groups and therapists who have the knowledge and skills to help you get through this, too.

    4. Try to Learn About My Addiction

    Did you know that the American Medical Association classifies my addiction as a disease? I didn’t make this up to make you feel sorry for me, it really is. I made the initial choice to start using drugs but when I wanted to stop, my brain said no. It made everything else in the world unenjoyable. Could you imagine not being able to enjoy your favorite piece of cake from the best bakery in town? This is my life right now. The chemicals in my brain have been reprogrammed to want one thing only.

    If you don’t believe me, and you probably won’t, take ten minutes and do a little research on addiction. While you are clicking on different links and learning about what I’m going through, please look at all of the different treatment options too. Did you know that there is a medication you can give me in an emergency that will reverse an opioid overdose at home? It’s called naloxone and you can get it from the pharmacy and it could possibly save my life.

    I know that you want me to get better. I do, too, but it’s much harder than just saying no. It’s important that you know that there are some medications available that can help my cravings and others that will completely block the effects of opioids. Whether or not these are what’s best for me is something I will have to decide on my own but you should know about them. As long as I am seeking treatment or have even talked about how I want to get better, I am still here fighting.

    5. I Have Suffered Through Incredible Trauma

    I have seen death and loss. I have lost my dignity and self-respect. Some of my friends have died because of these drugs and I have been close to death myself.

    I don’t know if I’ll ever be able to talk about the terrible things that have happened in my addiction because I know how much it will hurt you. You might say that this is my fault and that I’m weak, but I’m not. I’m in here fighting with these memories and still waking up in the morning. When I get clean, I will need time to heal. I will need counseling and even a little bit of space.

    6. I’m Sorry

    I’m sorry I stole from you and constantly lied to you. I’m sorry I didn’t make it to Thanksgiving last year, and I’m sorry you found me unconscious. I’m sorry that I made you cry. If I had a penny for every regret, I could pay you back for everything you’ve done for me. Right now, however, I would probably spend that money on drugs because I’m sick. One day I hope that you will forgive me. I don’t expect you to forgive me soon, but hopefully you realize that your child is still in here.

    7. Please Don’t Give Up on Me

    I’m not asking you to give me money, that ship has long sailed. I’m not asking you to let me come home or even to trust me right now. Here, on this motel floor, I need to know that you still love me. I need you to call me and tell me how you are. Please be a constant in my life, even if it’s just through text messages. If it isn’t too painful for you, please visit me in rehab. When I tell you that I’m finally ready to get clean, please believe me even if it’s the 100th time. If I tell you that I’m going to start taking medication to help with my sobriety, be proud of me! Don’t tell me that I’m trading one drug for another, because I’m trying.

    Just please, don’t give up on me.

    View the original article at thefix.com

  • How methadone affects sex and pregnancy (INFOGRAPHIC)

    How methadone affects sex and pregnancy (INFOGRAPHIC)

    How does methadone affect sexual health? We review here. Then, we invite your questions about long term use of methadone as an opiate/opioid substitute at the end.

    Methadone affects libido and fertility

    Don’t have the urge to have sex? While you’re on methadone, this is normal.

    Long-term use of methadone can cause a loss of libido and significantly lower the desire for intercourse in both, men and women. In medical studies, menstrual cycle irregularities, erectile dysfunction and sperm damage have been noted. So, methadone abuse can not only lower your interest in sexual activities, but can also harm your fertility.

    Pregnancy complications with methadone use

    At the beginning of the pregnancy, women should be given solid medical advice by their prescribing doctor and gynecologist. Basically, your dosing is best when it stays in the same. Most pregnancy complications are observed when methadone users try to reduce doses during pregnancy. In fact, medical professionals advise that methadone use throughout pregnancy should be continued (unless the risk is greater than the benefit and a doctor recommends).

    Still, methadone is listed in the Pregnancy Category C and prolonged use of the medication can result in side-effects, including:

    • physical dependence in the neonate
    • neonatal abstinence syndrome
    • decreased fetal growth in infants
    • deficit in performance on psychometric and behavioral tests
    • methadone withdrawal symptoms

    Effects of methadone on breastfed babies

    In the mother’s body, peak methadone levels will occur within 4-5 hours after taking an oral dose. If a baby is breastfed during this time it will receive 2%-3% of the oral maternal dose through the milk.  As a result of ingesting methadone through mother’s breast milk, effects such as sedation and respiratory depression in babies have been observed.

    Mothers should be informed and instructed by doctors on how to identify side effects in their baby that have occurred as a result of having too large dose of methadone in the milk. More importantly, mothers should be informed about the choice not to breast feed their babies, but to use a formula instead, or about when is the safest period of time for breastfeeding.

    Methadone’s effects on sexuality and fertility questions

    It is a fact that methadone helps addicts stay clean and live a drug-free life. But, when it comes to libido, fertility, conception, pregnancy and breastfeeding, it’s best to listen to the doctor’s guidelines, thus risks will be minimized. If you have any further questions or concerns feel free to ask us by posting your questions in the comments section below.

    If you found our infographic useful, send us your feedback and SHARE it with others.

    View the original article at addictionblog.org

  • How To Stop Taking Methadone?

    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

  • Why Aren't More Doctors Embracing Medication-Assisted Treatment?

    Why Aren't More Doctors Embracing Medication-Assisted Treatment?

    A new op-ed suggests that concerns about “branding” may deter many doctors from offering medication-assisted treatment (MAT) for opioid use disorder.

    A new op-ed on STAT News highlights a troubling concern in regard to medication-assisted treatment (MAT).

    Author David A. Patterson Silver Wolf, PhD, opined that the reason why methadone, buprenorphine and naltrexone aren’t more widely used to treat opioid use disorders (OUDs) may be due to “branding”—specifically, concern on the part of primary care physicians about the stigma associated with OUDs and its effect on their practice.

    But as Silver Wolf noted, the toll taken by the opioid epidemic on individuals and families all but required physicians to undertake the necessary steps to prescribe MAT, despite any qualms they may have.

    In the article, Silver Wolf, an associate professor at Washington University in St. Louis, Missouri and faculty member for training programs funded by the National Institute on Drug Abuse (NIDA), wrote that he came to his opinion after participating in a national panel of addiction experts that produced “Medications for Opioid Use Disorder Save Lives,” a report from the National Academies of Sciences, Engineering and Medicine.

    In the report, he and his fellow experts noted that while the need for medication-assisted treatment is sizable, and drugs like methadone and Suboxone have been approved as safe and effective treatments for OUD by the Food and Drug Administration (FDA), only a small number of physicians have signed up for the necessary training by the Drug Enforcement Administration (DEA) to be able to prescribe it.

    Silver Wolf also cited another STAT opinion piece, which speculated on some of the reasons why more physicians haven’t been lining up to prescribe MAT. One deterrent may be the process for receiving a federal waiver and the specialized training required to administer this treatment.

    But he also suggested that concern over the perception of those with substance use disorders by other patients may also color certain medical professionals’ opinions, who fear that the inclusion of such individuals to a patient base may negatively impact business.

    “Physicians whose practices focus on patients with opioid use disorder don’t have to worry about their ‘brand’ being harmed because it is tied to this treatment and this patient population,” Silver Wolf wrote. “But a typical primary care physician in Manhattan or suburban Atlanta or rural Nevada might worry about the potential trouble that patients with addictions might cause in their waiting rooms.” 

    The answer, according to Silver Wolf, is for more physicians to look past financial concerns and stigma, and take the steps to make medication-assisted treatment a part of their practice—even though, he adds, that many will not.

    But if individuals and families impacted by the addiction crisis—what the National Academies committee has come to view as an “all-hands-on-deck” situation—then Silver Wolf believes that physicians need to do the same.

    View the original article at thefix.com

  • How Suboxone Helped Me Until I Could Help Myself

    How Suboxone Helped Me Until I Could Help Myself

    I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed.

    Suboxone, while often controversial among addiction treatment professionals and people in recovery, has moved to the forefront in discussions about opioid treatment. The recovery community has no shortage of naysayers insisting that medication-assisted treatment (with drugs such as Suboxone, buprenorphine, and methadone) is simply trading one addiction for another, characterizing it as heroin in legal form and just another way for the big pharma companies – who are already blamed for the initiation of the opioid epidemic – to pull in profits. But Suboxone is not an illicit street narcotic with fatal overdose rates surpassing even automobile accidents, it’s a life-saving tool that many experts insist is our best hope for the current public health emergency.

    Medication-Assisted Treatment Is Effective, But Stigmatized

    According to Dr. Gavin Bart, Director of the Division of Addiction Medicine at Hennepin County Medical Center and Associate Professor of Medicine at the University of Minnesota, opioid addiction requires long-term management; behavioral interventions alone have extremely poor outcomes with more than 80% of patients returning to drug use.

    “Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function,” Bart writes. “Extensive research shows that each of the three available medications used to treat opiate addiction have superior treatment outcomes to non medication based therapies. Increased retention reduces mortality, improves social function, and is associated with decreased drug use and improved quality of life.”

    Abstinence proponents may be skeptical about Bart’s research, but for me, it rings true. Reduction in illicit opiate use? Check. Decreased craving? Check. Improved social function and improved quality of life? Check, check. Abstinence-based treatment did not save my life. Medication-assisted treatment paired with specialized addiction therapy helped me save my own life.

    As an active member of the recovery community, I am mostly outspoken and typically very candid, even when it comes to mortifying revelations. And even for me, Suboxone is a touchy subject. I am more comfortable discussing random substances I’ve injected than I am discussing how Suboxone was a key player in my opioid addiction treatment. I think my discomfort is a result of the negative rhetoric that surrounds the medication, and ironically enough its harshest critics are often other people in recovery. The prejudice against medication-assisted treatment is harmful, and even deadly when the negative discussion derails someone from seeking the help that, according to the evidence base, may give them the best chance of staying alive.

    Is medication-based treatment the perfect fix to a horrific and increasingly deadly addiction? No. Suboxone has its burdens. I grappled with those too. When I first started taking Suboxone, I’d take it for a week and then relapse on heroin. I did that a handful of times before I was finally serious about getting clean.

    My Suboxone Journey: From Relief to Frustration

    My initial Suboxone dose was 8 mg buprenorphine with 2 mg naloxone. It was an orange strip with a tangy taste that I’d place under my tongue and wait while it dissolved into my bloodstream. Because I essentially switched directly from heroin to Suboxone (taking the first dose when I began experiencing opioid withdrawal symptoms), I didn’t have to suffer the weeks-long detox that frequently triggered my repeated relapses.

    Taking my daily dose of Suboxone was like a sigh of relief at the beginning: one more day that I didn’t have to suffer through withdrawal. But after a few years, the sighs of relief eventually turned into sighs of disdain. My once-considered reprieve from the consequences of my addiction was starting to feel like a rusty pair of shackles. I was sick of going to the doctor and refilling my prescription, I was sick of keeping this secret from everyone in my life, I was sick of being terrified to travel. This thing that had once made me feel normal now had me feeling like I was still, after so much time, tied to my painful past of addiction.

    Nothing else in my life reminded me of my past. There were no remnants of my previous addict self. I didn’t associate with any of my old using friends, I hadn’t seen or spoken with any dealers in ages, I never even got pulled over for traffic stops. I didn’t look like a junkie anymore and I didn’t act like one either. I had nurtured and repaired the ties with my family, I had a loving, healthy relationship, and I was well on my way to getting a college degree. I had successfully restored myself to sanity, as good ol’ Bill would say.

    Fear kept me stagnant, which didn’t feel fair. I had come so far and was nothing like the junkie I once was, but I still had this inevitable withdrawal from Suboxone hanging over my head. My one final detox. The big whopper. How would I go through with it? I was in school so I couldn’t miss two to four weeks of classes, and anytime a summer or winter break neared, I’d chicken out, despite telling myself it was time and trying to prepare for it. In the meantime, I’d slowly been cutting down. I went from the initial dose of 8 mg buprenorphine/2 mg naloxone strips to 4 mg/1 mg, and then even further to 2 mg/.5 mg.

    Suboxone Withdrawal

    I had no idea what to expect. Like many of us, I have some form of post-traumatic stress disorder from my time in active addiction, and a major part of that was the horrendous withdrawals. I was completely fixated on these impending withdrawal symptoms, and there was nothing I could do — I had to pay the debt.

    I finally made the decision to go through with it. I made the appropriate arrangements and was prepared to suffer for a couple weeks minimum, several weeks or maybe even months maximum. I watched YouTube to try to ease my frazzled nerves, but the videos pacified my anxiety like a game of Russian Roulette. Do not watch YouTube. Some videos had people detoxing, drenched in sweat and sobbing into the camera and others had people after just a week saying, “Not so bad guys!”

    The night before I took my final dose, which was a teeny tiny square cut from a buprenorphine 2 mg/naloxone .5 mg strip, I curled up into the fetal position, buried myself under my duvet and cried myself to sleep. I couldn’t believe I was about to enter junkie limbo after living as a functioning member of society for so long.

    The first few days weren’t pleasant, but it was nothing like I’d experienced in the past. I couldn’t sleep, I tossed and turned, I had tingling chills and clammy sweats, general anxiety and a sense of unease. I once detoxed from a $100 a day heroin habit and it was like I was the star of an exorcism horror film; compared to withdrawals like that, this one wasn’t nearly as bad as I’d anticipated. I think spending so much time tapering down to as small a dose of suboxone as I could handle really paid off when it came time to detox.

    Another big fear I had, mostly thanks to Google and YouTube, was post-acute withdrawal syndrome (PAWS). After the initial detox, the last time I felt any symptoms I knew were directly related to my withdrawal was about a month and a half after day one. I had a mini-panic attack when Target was too crowded. I started pouring sweat, rushed to my car, and burst into tears. And after that, I’ve simply felt normal. That thing we all desperately want to feel: “normal.”

    What If?

    The detox was tough, it was emotionally taxing and physically draining. But I realized that it was the fear of the withdrawal that had me suffering the way I was. It was a fear of the symptoms and a fear of the unknown. I felt confident that I had no desire to use opioids again, not because the Suboxone had eliminated my cravings, but because I had changed my life. The pain I worked so hard to anesthetize with heroin had been addressed. I did deeply introspective work in therapy and I changed my social environment, all while using Suboxone. I built up my self-worth by investing in myself and investing in healthier relationships, things I never could have done while still using heroin. I fixed my broken coping mechanism, I knew how to handle stress and sadness. Yet, there was still this tiny sliver of me that wondered, “what if?”

    What if it was all some magical mask that Suboxone created and none of this was reality and as soon as I stopped taking it I would revert to my old tormented life?

    That is what prompted me to finally write this piece — realizing that regardless of the discomfort I feel discussing Suboxone, there are other people in recovery using medication-assisted treatment right now, scared to talk about it and scared to get off, experiencing the exact same fears that plagued me. Once I made the leap and decided to go ahead with my final detox, and then when it was complete, I felt free. Finally free. Not because Suboxone had me stuck, but because Suboxone helped me move past the hardest time of my life. This withdrawal was the final chapter to that saga and it was finally over — and I survived.

    I closed the book, I’d won the war.

    View the original article at thefix.com

  • Florida Versus Evidence: How I Lost My Children Because of Past Drug Use

    Florida Versus Evidence: How I Lost My Children Because of Past Drug Use

    When my first slew of drug tests returned negative, the opposition began slinging whatever they could think of in my direction, hoping something would stick.

    I am living in two worlds. One is a world populated by doctors and advocates, run on the tenets of research and science and reason. It is a world in which addiction is treated with medicine, and where there’s no question that people who use drugs deserve to be safe and free of avoidable infections and diseases. In this world, nobody hesitates to administer naloxone if the occasion calls for it. In this world, people are not afraid to touch the bodies of drug users, and we all understand that if you can self-administer naloxone, you don’t need naloxone. I experience this world through phone lines, e-mails, and social media. I write about this world; this world is my template for how all worlds should be.

    Addiction as Moral Failure

    Then there is the world where my life takes place. In this world, having an addiction is a moral failure. Drug use is met with punishment. Judges replace doctors and toxicologists, making medical decisions and determining the results of drug tests with reckless abandon. In this world, abstinence is the only route to health. In this world, a hit of pot is just as chaotic as compulsive, daily injections of heroin. In this world, there is no sterile equipment; in this world, everyone is sick. Here, you can be sentenced to death just for being the friend of someone who overdoses. This is the world I touch with my fingers and teeth—the world where I walk, and eat, and breathe. This is the world where I live.

    I became involved with the Florida Department of Children and Families in April 2018. I was never charged with a crime or afforded the presumption of innocence, evidentiary standards, or jury decision that would have accompanied a criminal charge. Instead, one judge—virtually accountable to no one and equipped with full immunity—deemed my husband and me guilty of some nebulous pre-crime like the woeful characters in Philip K. Dick’s short-story-turned-film “Minority Report.” Apparently, I am guilty of the possibility of neglecting or otherwise harming my children in the future because I have a diagnosed substance use disorder.

    Since that decision, I have been forced to obey the mandates set forth by my county’s child welfare authorities in an attempt to win back custody of my girls. So far, not a single mandate has been evidence-based.

    I love writing about harm reduction, evidence-based addiction care, and trauma-informed mental health practices. I enjoy staying informed about best practices in addiction medicine. I am proud that I get to help demystify and destigmatize addiction and mental illness, and I am honored to have the opportunity to speak with the researchers who have dedicated themselves to driving us out of the dark ages of addiction medicine. But now that I am living in those dark ages myself, I can’t shake a sense of bitterness: I write about a better world, but it’s one that I only get to view from afar.

    Substance Use Disorder Treatment and Geography

    In 2017, I wrote an article for OZY about the general disparities between addiction care in red states and blue states. I was living in Seattle, Washington, at the time but I’d had some experience trying to get help for addiction in Florida—so I knew how backward providers could be. For example, when I gave birth to my daughter in Palm Beach while on prescribed methadone, hospital staff refused to let me breastfeed her. She was treated for Neonatal Abstinence Syndrome (NAS) and pediatric staff claimed that enough methadone would be passed through my breast milk to potentially harm her. In reality, numerous studies have found the exact opposite to be true and breastfeeding is now recognized as one of the most effective balms for NAS, due to the maternal contact and general health benefits of breast milk. The amount of methadone passed through breast milk is too negligible to help or harm.

    As I wrote in the OZY article, Democratic-ruled states are more likely to offer Medicaid coverage for methadone and buprenorphine, while Republican states are less likely to even offer the medications themselves, much less cover them. People in red states also face harsher penalties for drug crimes and are less likely to be allowed to continue a methadone or buprenorphine prescription while incarcerated. (Though this is a nationwide issue, blue states are leading the reform.) But writing the story from Seattle meant writing from a place of comfort: I was living among the reformers—walking within the pages of history that will be attributed to the good guys. I was able to take my buprenorphine every day because my state insurance covered it. I was surrounded by intelligent, informed people with whom I could speak honestly about my decision to engage in non-abstinence-based recovery. When I wrote about the issues in the system, I wrote from a place of distance. Of privilege.

    I did not appreciate how lucky I was until I dove headlong into the true trenches of the Drug War. 

    In Recovery and Losing Custody

    In Broward County, Florida, my children were removed from me because of unsubstantiated accusations of drug use. When my first slew of drug tests returned negative, the opposition began slinging whatever they could think of in my direction, hoping something would stick. Most of it revolved around the fact that I was poor—but ignorance about mental illness and addiction reared its ugly face yet again. The opposition cited my prior child welfare investigation in Florida—the one that was triggered by my daughter’s NAS. It was a routine investigation that had been deemed unsubstantiated. These types of investigations are typically labeled “harmless.” I had been in compliance with my methadone program, and my daughter’s doctors had no concerns—but five years later, the opposition used that prior methadone prescription as a basis for deeming me an unreliable witness: the dirty, lying junkie. 

    When I was asked under oath whether I had spoken with one of my husband’s siblings about possibly purchasing marijuana, I admitted that I had. Clinicians in addiction treatment recognize that drug cravings are normal and applaud us when we admit that we think about buying drugs but then decide against it. But the guardian ad litem attorney—the counsel whose job it is to protect my daughters’ interests—argued that by considering using marijuana, I placed my sobriety and therefore my children at risk. It didn’t matter that I canceled the purchase and honestly acknowledged that I’d thought about it. The judge called my process of considering marijuana but then deciding against it “drug-seeking behavior.” She gave custody of my daughters to my husband’s parents.

    The terribly irony underscoring the entire proceeding is that if I were still living in a state that embraced the most current research on addiction, I would never even have been in a courtroom. The accusation against me stated that I left my daughters in the care of their grandparents for three days while I used drugs outside of the home. According to the U.S. Department of Health and Human Services, “drug tests do not provide sufficient information for substantiating allegations of child abuse or neglect or for making decisions about the disposition of a case.” Drug use on its own, away from any children, is not child abuse. A parent who leaves their child with a family member to go to a bar for an evening is generally considered to be engaging in responsible substance use.

    The federal government recognizes that child abuse cannot reasonably be defined as placing a child with a trusted caregiver, leaving the home for a couple days, and returning sober. It doesn’t much matter what went on during those two days. True or false—the accusation against me never described child abuse. A more enlightened jurisdiction would have recognized that. The separation trauma that my children and I have endured over the past nine months is completely attributable to our location.

    I used to write about addiction and drug policy from a place of privilege. Now I am writing from the deep trenches. I feel as though I am performing a kind of literary necromancy whenever I publish—except that instead of communing with the dead or demonic, I am writing from within that unillumined place, hoping that, by disseminating research, facts, and the words of distant experts, I can summon reason back into my life.

    View the original article at thefix.com

  • West African Clinic Offers Free Methadone, Clean Needles & More

    West African Clinic Offers Free Methadone, Clean Needles & More

    The goal of Senegal’s free program is not only to rehabilitate, but also to reduce the spread of HIV and AIDS among drug users.

    A clinic in West Africa is doing its part to mitigate the region’s opioid crisis.

    People line up at the Center for the Integrated Management of Addictions (known locally as CEPIAD) in Senegal to receive a daily dose of methadone and counseling. Some travel hours for treatment.

    “You get here, you have your methadone and you are not thinking about taking drugs. You are thinking about moving your life forwards,” says Moustapha Mbodj, who is in recovery from more than 30 years of heroin use.

    A new CNN report highlights CEPIAD’s efforts. Established by the Senegalese government in 2014, the clinic is the first in West Africa to provide free opioid substitution treatment. CEPIAD offers methadone, clean syringes and condoms, as well as skills workshops and help with reintegrating into family networks, according to CNN. It has helped more than 700 people since it opened.

    The goal of the free program is not only to rehabilitate drug users, but to reduce the spread of HIV and AIDS among drug users. Over 10% of injecting drug users in Senegal live with HIV, according to United Nations estimates. Among the general population, this number is less than 1%.

    An estimated 1,300 injecting drug users were counted in Dakar (Senegal’s capital) in 2011, according to a voluntary survey by the French National Agency for Research on AIDS.

    In response to the survey, Senegal’s government turned to a harm reduction approach. In a two-year period, public health workers distributed 18,614 clean syringes and 17,564 condoms to the public at no cost.

    The need for such services is rising.

    Senegal is among a handful of African nations that offer this type of free service. According to a 2017 report, out of 37 African nations reporting drug use data to the UN, just eight offer harm reduction approaches, including Senegal, Tanzania, Kenya and Mauritius.

    Pierre Lapaque, a representative with the UN Office on Drugs and Crime (UNODC) for West and Central Africa, explained that the market for drugs is growing in a region that previously served only as a transit point for drug traffickers.

    Lapaque says traffickers used a “smart approach” to introduce drugs to a “region where there was absolutely no market ten years ago.”

    “Often what the traffickers are doing is they are paying their support staff not only in cash but in drugs,” said Lapaque.

    View the original article at thefix.com