Answer Addiction

Tag: opioid addiction

  • Small Town Brings In Big-Thinking Addiction Specialist And Changes Everything

    Small Town Brings In Big-Thinking Addiction Specialist And Changes Everything

    Nearly 82% of rural Americans live in counties that do not have detoxification services and the town of Ashland, Wisconsin sought to change that reality.

    In a little town in Wisconsin, where the death rate from drug and alcohol abuse is almost twice as high as the state average, Dr. Mark Lim has changed the lives of those addicted and their families.

    A certified addiction specialist since 2016 (when it became a subspecialty of certification), Dr. Lim arrived in the town of Ashland as the newly hired recovery program medical director at NorthLakes Community Clinic.

    Rural communities typically lack basic resources to treat substance abuse.

    Nearly 82% of rural Americans live in counties that do not have detoxification services, a staggering number. This means anyone struggling with drug addiction has two choices – they can try to endure detox on their own (often medically unsafe), with the support of a local doctor (often hard to find in such areas) or they can relocate to begin treatment.

    A recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health named opioid and other drug abuse as the top health concern for rural Americans.

    The town of Ashland wanted to change this scenario. To fund an addiction treatment service program, NorthLakes applied for and won a grant from the state of Wisconsin, in addition to obtaining other federal grants intended for mental health and addiction.

    The next step was to hire a doctor to prescribe buprenorphine, known by the trade name Suboxone. Only doctors with special training are legally allowed to dole out Suboxone. Another staggering statistic on rural reality: a 2015 study found that more than 80% of US rural counties do not have even one physician able to prescribe it.

    Dr. Lim was hired and flew into Ashland with one request: He wanted to head a comprehensive program to treat addiction and not just treat it from one angle. Dr. Lim told NPR, “Opioids are big right now, but you have to work with alcohol too. You have to work with marijuana too. You have to work with methamphetamine, cocaine.”

    The addiction recovery program was built with community partners including educators, law enforcement and tribal leadership. The Ashland program includes a combination of counseling, group therapy for addiction and underlying mental health issues, as well as case management. Staff help patients with things like transportation to the clinic, daycare during therapy sessions and employment.

    John Gale of the Maine Rural Health Research Center supports this program structure, telling NPR, “That’s exactly the way it should be done. Because most people with a substance use disorder have co-occurring mental health and substance use problems. If we take care of [a patient’s] heroin problems and we don’t treat the underlying mental health and substance abuse problems, they’re going to go to go to [sic] alcohol, they’re going to do something else.”

    View the original article at thefix.com

  • Young Mayor’s Overdose Death Captures National Epidemic

    Young Mayor’s Overdose Death Captures National Epidemic

    “I never would’ve thought he had an issue. Brandon made a mistake and paid the ultimate price,” the former mayor’s mother said after his fatal overdose. 

    The story of a small-town Pennsylvania mayor and his friend who both fatally overdosed on opioids is highlighting the dangers of the national drug epidemic and the heartbreak of families left behind. 

    Brandon Wentz was 24 when he overdosed last year. He had recently resigned as mayor of Mount Carbon, population 87, because his family had moved to a nearby town. The resignation hit Wentz hard, said his mother, Janel Firestone.

    “You could just see the stress and sadness in him,” she told the Associated Press.

    After struggling to write his resignation letter, which ended up being just 180 words, Wentz’s friend Ryan Fessler came over. The pair had been spending more time together, according to Fessler’s childhood friend. 

    “They were the same person,” she said. “They both wrote, they both drew, they would make up funny raps together. They really did want the best for each other.”

    However, this worried some of Wentz’s friends, who knew that Fessler struggled with substance abuse. 

    “He wasn’t a bad person, he was nice, but he had his own demons, too, and demons will invite more demons,” said Brandon Radziewicz, Wentz’s longtime friend. “I think they were good at fueling each other’s habits.”

    The day of the resignation letter, the two men went to Wentz’s room until Fessler left. That afternoon, Firestone tried to wake her son for his overnight shift, but he wouldn’t rouse. She suspected he had a migraine, and since he had always been a heavy sleeper she wasn’t concerned. However, the next morning Wentz was dead of an overdose of heroin and fentanyl, something that shocked Firestone.

    “I never would’ve thought he had an issue,” she said. “Brandon made a mistake and paid the ultimate price.” 

    While Wentz’s family was blindsided, Fessler’s family knew of his addiction and did everything possible to protect him from overdose until he died just six months after Wentz, even sending him to treatment in Florida. However, Fessler’s grief over losing his best friend just made his addiction worse. A few weeks after Wentz died, Fessler’s girlfriend found him in bed crying, saying, “I killed my best friend. I gave it to him.” 

    Firestone, who was always skeptical of her son’s relationship with Fessler, blamed him for Wentz’s overdose. Fessler’s mother, Kim Kramer, said she understands completely.

    “I get it, I truly do,” she said. “You wake up, you think about it all day, it’s forever there. You want to find out who gave it to them. … You want to hate the one who handed your son the bag.”

    Firestone says she wishes Wentz’s friends had brought his drug abuse to her attention, something Radziewicz says he should have done, in hindsight. 

    “I was thinking, foolishly, that I would lose my best friend, and he wouldn’t talk to me again,” he said. “Guess what? I lost my best friend.”

    View the original article at thefix.com

  • Family Of Woman Whose Obituary Went Viral Sue For Info About Her Death

    Family Of Woman Whose Obituary Went Viral Sue For Info About Her Death

    According to the suit by the ACLU, police refused to provide Madelyn Lisenmeir with medical attention while being held in custody–neglect that may have led to her death.

    When Madelyn Linsenmeir died after a battle with opioid addiction on October 7, 2018, her family penned a heartfelt obituary for the 30-year-old single mother and earned sympathy and praise across the globe for turning their tragedy into a plea to help other opioid dependency sufferers.

    Now Linsenmeir’s family is suing the city of Springfield, Massachusetts and its police force to find out what happened to her in the days leading up to her death. According to the suit, filed by the American Civil Liberties Union (ACLU), Linsenmeir had requested and been refused medical attention while in police custody and remained in a woman’s correctional facility until October 4, when she was taken to intensive care. Linsenmeir died three days later, and her family is requesting that the Springfield police turn over any audiovisual recordings that would corroborate the allegations of neglect.

    According to the suit, Linsenmeir texted her family on September 28, 2018 with complaints that she was “really sick” and needed to be hospitalized. The following day, Springfield police arrested her for probation-related violations, including providing a false name, according to their arrest log. She was transferred to the Hampden County Sheriff’s Department and held at the Western Massachusetts Regional Women’s Correctional Center in Chicopee, Massachusetts.

    The ACLU suit then alleged that at the time of her arrest, Linsenmeir was allowed to call her mother, Maureen, with a Springfield police officer on the line. She reportedly informed her mother that she was not receiving medical attention, but as the suit alleged, “the police officer refused to provide medical attention and even made a sarcastic comment to Maureen after Maureen expressed concern that Madelyn was being denied care.”

    On October 4, Linsenmeir was transferred by ambulance to the Baystate Medical Center’s intensive care unit and died there on October 7, still in police custody but with her family in attendance.

    The ACLU alleged that the phone conversation with Linsenmeir’s mother confirms that the Springfield Police Department was aware she had been refused medical treatment and is “likely in possession of audiovisual recordings” that would corroborate their claim. In the suit, Linsenmeir’s family wrote, “release of the requested records would serve the public interest by supporting Madelyn’s family in their public advocacy for the humane treatment of opioid users and for increased access to medications and medical care for people suffering from opioid use disorder.”

    According to the suit, the police department and city of Springfield have not responded to the family’s request. Hampden County Sheriff Nicholas Cocchi, whose department was not named in the suit, expressed his sympathies to Linsenmeir’s family in an statement to CNN.

    The obituary that drew attention to Linsenmeir’s struggle, penned by her sister, Kate O’Neill, was brought to global attention through social media, where it was picked up by news media outlets. In the obit, O’Neill wrote, “If you are reading this with judgment, educate yourself about this disease, because that is what it is. It is not a choice or a weakness. And chances are very good that someone you know is struggling with it, and that person needs and deserves your empathy and support.”

    View the original article at thefix.com

  • How to Talk with Clients about Chronic Pain and Opioids

    How to Talk with Clients about Chronic Pain and Opioids

     

    ARTICLE SUMMARY: These guidelines will help you bring hope and healing to clients who may be in the midst of a battle with opioid addiction and dependency, stemming from chronic pain.

    ESTIMATED READING TIME: 7 Minutes.

    TABLE OF CONTENTS

    The Need to Talk

     Although I have written at length about The Opioid Crisis, it remains a long-term public health concern for Americans. In fact, the latest death toll estimates from the CDC put the number at 72,000 fatalities from overdose in the first half of this year.

    Chronic pain, which is one of the leading drivers of opioid overprescribing and subsequent addiction, affects 133 million Americans and 65% of them seek care for persistent pain at some point in their lives, reports the American Cancer Society. And the National Institutes of Health reports that an estimated $100 billion is spent annually to manage pain, including healthcare expenses, lost income, and lost productivity at work and home.

    Since this is an issue that impacts many families, friends colleagues, and loved ones in every stretch of the country, I’ve developed some tips for opening honest dialogue about this issue for healthcare professionals, clinicians and therapists to talk with their clients.

    Guidelines for Talking to Clients

    As a clinician and interventionist, I know first-hand how it can be difficult to broach this topic in an informed and compassionate manner. However, with these guidelines you’ll be able to bring hope and healing to clients who may be in the midst of a battle with opioid addiction and dependency, stemming from chronic pain.

    1. Meet Your Client Where They Are.

     I recently wrote The Definitive Guide to Addiction Intervention: Collective Strategies. In this textbook, I discuss the importance of starting where your client is. This means understanding who they are, where they come from, their family dynamics, experiences and their place in the world. The best theory in the world won’t take into account this human element. With unique people, a multitude of cultures, gender expressions and the changes in our genetic diversity, we must embrace difference as a teacher. That way you can help plan a strategy that meets their unique needs, not a preconceived cereal box of a model.

    This approach also leaves judgment at the door. Addiction – in all its forms – is a disease, not a moral failing, and should be discussed in terms of the best way to bring healing to the person experiencing the disease. When we do this, we see the person for who they are and that can open the door to recovery.

    2. Understand Your Client’s Trauma and Talk About It.

     Trauma is defined as an overwhelming experience that cannot be integrated and elicits animal defense mechanisms and dysregulated arousal. It can come from a host of experiences – a car accident, a dislocated knee or strained back, physical and sexual abuse, etc.

    Trauma can be both objective and subjective:

    • Objective trauma is the event that took place
    • Subjective trauma is how the person perceives what took place and the emotional aftershocks

    When we understand and discuss the trauma that took place, we then see how the door was opened to an opioid misuse problem. For example, a client may be a collegiate baseball player who tore his rotator cuff during a game. He undergoes two surgeries to fix the rotator cuff and is prescribed pain killers to aid in the healing process. But the player does not want to miss any more games, so he misuses the amount of painkillers he should take in order to “play through the pain” and stay in the game. As such, he develops an addiction and continues to take pills long after the rotator cuff healed. That you discuss the trauma in relation to the client’s pressure to succeed as a baseball player illuminates a detailed treatment plan for recovery.

    3. Teach Your Clients About Opioids and Chronic Pain.

    • The National Survey on Drug Use & Health found that 92 million US adults, or about 38 percent of the population, took a legitimately prescribed opioid like OxyContin or Percocet in 2015. Prescription opioids are easy to come by and are impacting people from all walks of life.
    • 11.5 million people, or nearly 5 percent of the population, misused prescription opioids they obtained through illicit means.
    • In 2015 more than one third of all adults were prescribed opioids.
    • Over 259 million prescriptions were written in 2012, which is enough to give nearly every person in the US regardless of their age their own prescription bottle
    • A study authored by Bradley Martin, a professor of pharmaceutical evaluation and policy at the University of Arkansas for Medical Science, found that with a one-day supply of prescription painkillers, there’s about a six percent chance “of being on opioids for a year or longer.” A five-day supply jumps to 10 percent. And a ten-day supply bumps the user to a 20 percent chance they’ll still be using a year later.
    • Pain has been considered the fifth vital sign. That being said, 90 percent of all pain is emotion.
    • The differences between acute & chronic pain. See chart below:

    4. Educate Your Clients on Alternative Pain Management Solutions.

     There are emerging evidenced based methods to help individuals, including:
    •  CBT
    • Breathing exercises
    • Qi chong
    • Physical therapy
    • Acupuncture
    • Mindfulness

    A study published in the journal Addiction in 2016 by a team from the Veterans Administration Ann Arbor Healthcare System’s Center for Clinical Management Research found a non-drug approach that combines psychological therapies with a social element. In the study, 55 veterans took part in therapy rooted in the psychological theories of pain and felt the effects last up to a year.

    The theory behind this approach is a self-management of pain. According to Medline Plus, the person experiencing the chronic pain needs help learning to think, feel, and do better, despite the persistence of pain. Self-management programs engage the individual in problem-solving, pacing, decision-making, and taking action to manage their pain. And they do it in a supportive environment where the social element plays a huge role because research shows that there is a link between pain and depression. Pain is responsive to mood and mood is responsive to social support, thus working through pain in a social environment posts strong results in healing.

    With research showing that the support of others aids in recovery, centers willing to address the issues of pain management and recovery, and the medical community rethinking how opioids are prescribed, there are new ways developing to more effectively deal with chronic pain and the mental health and lifestyle issues that arise from these conditions.

    Another alternative pain management solution that is gaining traction is meditation. Scott Weiss, clinical director at Bodhizone Physical Therapy and Wellness in New York City, who works with professional athletes, regularly prescribes meditation. “People often find meditation hard to swallow,” Weiss tells Outside Magazine, “but with the right instructor, they can start finding relief in just one session.” In fact, Weiss claims that half of the injured athletes he sees use meditation, and of those, 80% report reduced pain.

    A Call to Action

     I urge all of my colleagues in behavioral health care to rethink how we talk to our clients about opioids. We must educate them on the risks of taking prescription opioids, open up honest dialogue, and work with friends, families, coworkers and communities to promote lasting change. Lastly, since chronic pain is a leading driver of opioid use and opens the door to addiction, we must educate our clients in alternative pain management forms to promote healthier ways of living. These changes begin with open dialogue with our clients, so we can work through this crisis together.

    If you have a client that is experiencing difficulty with depression, anxiety ,chronic pain and/or opioid misuse, please give me a call. There is hope and solutions!

     

    View the original article at addictionblog.org

  • In-School Services Offered To Students Impacted By Opioid Addiction

    In-School Services Offered To Students Impacted By Opioid Addiction

    More than 50 schools in Massachusetts offer in-school counseling services to students with parents who are battling opioid addiction. 

    Maddy Nadeau’s childhood was less than ideal. Her mother often could not care for her, leaving her older sister to do the job when she came home from elementary school. 

    Maddy is one of many children affected by a parent’s substance use disorder, according to NPR. 

    Luckily, her school is taking steps to help her overcome the trauma of such a childhood. In October, Congress allowed for $50 million annually for five years to be allotted to mental health services in schools for children affected by the opioid epidemic.

    The girls eventually entered a foster home, which led to an adoption. Sarah Nadeau, their adoptive mother, told NPR both girls struggled with depression and anxiety, as well as performance in school. Maddy had a hard time especially, as she was exposed to opioids while in utero.

    “That makes it very difficult for her brain to settle down enough to do more than one task at a time,” Nadeau told NPR.

    Counselors at schools such as Maddy’s are employed by Gosnold, which is a substance use disorder treatment provider in Massachusetts. According to NPR, more and more schools are starting to screen and treat students who are considered at risk for opioid use disorder, as well as offer mental health services for those who have been affected by it.

    “Schools have more kids who cannot access the learning environment,” Sharon Hoover, co-director of The National Center for School Mental Health at the University of Maryland School of Medicine, told NPR.


    According to Hoover, having such services in schools is proving effective.
”This is considered a preferable model of care,” she said. “The kids show up for treatment services because they’re not relying on a family member to take them somewhere in the community.”

    Though the services are new, data demonstrates counseling for at-risk students leads to fewer absences and better academic performance. Massachusetts schools using Gosnold counselors say their students are performing better academically and emotionally. Sarah Nadeau says this is the case for her girls.

    “Their day runs smoother. They can get out their anxiety while they’re in school instead of bottling it up, and then go back to class and continue learning,” she told NPR.

    Each participating school pays Gosnold for the counselors, and students’ insurance covers the individual sessions. If a student does not have insurance or it will not cover the cost, Gosnold absorbs that cost. Currently, more than 50 schools in Massachusetts offer such services. 

    “I wish that more schools offered it because the epidemic is everywhere,” says Sarah Nadeau. “For a lot of these kids, school is the only place that is stable. They get their lunch here, they get their education here, so why not give them their support while they’re here at the school?”

    View the original article at thefix.com

  • Rapper Lil Xan Checks into Rehab

    Rapper Lil Xan Checks into Rehab

    Lil Xan had announced in November that he intended to enter rehab but he had issues finding a bed in a treatment facility.

    Lil Xan has gone to rehab for the first time, according to an Instagram post penned by his girlfriend. Lil Xan, or Diego Leanos, is a 22-year-old rapper from the west coast with a big following. Since the recent overdose deaths of Mac Miller and Lil Peep – both idols of Lil Xan – those around Xan had heightened concerns about his safety.

    Lil Xan recently got tattoos memorializing Mac Miller, and CNN reported that Xan said in an interview that Miller’s death made him want to quit music.

    Lil Xan entered rehab hoping this would be a new start to his life; he declared his rap moniker would be changed from Xan, which is short for Xanax, to his actual name, Diego.

    Diego had announced in November that he intended to enter rehab, but had issues finding a bed in a treatment facility. On December 2, Diego’s girlfriend Annie wrote on his Instagram:

    “This sweet angel of mine officially entered rehab this morning. I’m sorry for all the confusion circulating about Diego leaving for rehab,” Smith wrote alongside a photo of Diego. “It’s a tricky thing since people are coming in and out of the facility so often that rooms end up getting switched around and dates can be pushed back. I’m so beyond proud of this precious boy for being the strongest person I know and for wanting to live a better life. Please keep him in your prayers, he is doing his best right now to find peace with himself. We love you all so much, and we appreciate all of the support. I love him beyond words and cannot wait to see what the future holds for our family. xanarchy family – love, Annie”

    A later Instagram post, also by Annie, read, “Diego was just admitted into his first treatment. He loves each and every one of you sending good wishes and prayers to him,” she captioned a selfie of the musician. “We thank you all so very much for all of the love and support you are sending his way. He will be back soon, with another top 10 album we love you all xanarchy family ! – love, Annie”

    Diego has been public about his ongoing struggle with opioid addiction. In November he told TMZ, “As far as my sobriety goes right now, there was a long period of time where I was clean. But I relapsed. . . . Any other addict would understand that that s—t just happens. You just relapse — you don’t want to — and then you get clean again. It’s like a process. You need treatment and help and sometimes that doesn’t even help. It has to come from within. That’s what I’ve learned.”

    View the original article at thefix.com

  • Dentist Wrote 200 Opioid Prescriptions For Five Patients In One Year

    Dentist Wrote 200 Opioid Prescriptions For Five Patients In One Year

    The dentist who wrote the opioid prescriptions claims state investigator were “telling lies” but he did not provide or clarify any additional details.

    A dentist in Tennessee has had his professional license revoked for reportedly writing approximately 200 prescriptions for opioid medications to just five patients, some of whom were never physically present in his office.

    A discipline report from the Tennessee Department of Health revealed that Michael R. Tittle, 64, who maintained a dental practice in the small town of Erwin, Tennessee, allegedly lacked the proper records to justify writing the prescriptions, which in one case totaled 71 prescriptions for 10 hydrocodone pills over the course of just six months.

    In a statement to the Tennessean, Tittle claimed that state investigators were “telling lies,” but he did not provide or clarify any additional details.

    In addition to the revocation of his license, Tittle was also assessed a civil penalty of $13,000, plus court costs not to exceed $3,000. These details, as well as the allegations against Dr. Tittle, were made public on November 15 as part of a monthly discipline report by the state Department of Health, which maintains public records on doctors and other health care professionals throughout the state. 

    According to the report, Tittle’s office came under investigation after the Department of Health received a complaint about his prescribing practices while on a five-year probation for multiple infection control violations. After reviewing his Controlled Substance Monitoring Database report, the Department requested 13 dental records; these were found to lack “a concise description and justification for the amount and frequency of controlled substances,” according to the report. 

    Prescription records for five patients were also highlighted in the report; in addition to the aforementioned patient, one patient is reported to have received 49 prescriptions for hydrocodone and 14 prescriptions for oxycodone, totaling 630 tablets, between October 2016 and September 2017.

    Another patient reportedly received 24 prescriptions, totaling 210 tablets, for more than a year after undergoing a root canal, while a third received two prescriptions for oxycodone and two for hydrocodone, all totaling 110 tablets, between August and November 2015, despite the fact that no documentation could confirm that the patient had ever set foot in Tittle’s office.

    The report also noted that Tittle admitted to having a pre-signed, blank prescription slip in his office that had been “copied onto security paper to generate additional pre-signed prescription slips.”

    To settle the case, Tittle agreed to the revocation of his Tennessee dental license as well as $1,000 in civil penalties for each of the 13 records reviewed by the Department of Health and the “actual and reasonable costs” of prosecuting the case. The findings were also reported to the National Practitioner Data Bank.

    View the original article at thefix.com

  • The Myths & Methods of Mindfulness Meditation

    The Myths & Methods of Mindfulness Meditation

    I kept cravings at bay with 12-step meetings and counseling but continued to seek meaning and purpose that would lead to lasting sobriety. Then I found mindfulness meditation.

    I was raised to believe meditation was wicked. Along with yoga, Buddha, incense, and anything symbolizing or hinting of Eastern religion or ritual. The rationale? Meditation clears our minds of all thought, therefore leaving us susceptible to other-worldly suggestion and worse: evil energy.

    The caution filled me with dread. If my mind was “cleared,” I would become vulnerable to Satan’s control, and then anything was possible. I pictured myself a savage, meditating zombie, turning violent or psychotic, doomed to Hades.

    One too many chants of “om” and I’d transform into a freckle-faced, redhead Linda Blair. These fears were very real in the congregation of my childhood church. It would be decades before I’d be comfortable enough to engage in yoga for physical health, much less find spirituality and sobriety on a cushion, while flooding my nostrils with the heady smoke of palo santo. (A decadent alternative to smudging sage I highly recommend.)

    Despite the best intentions of my religiously conservative upbringing, by 30 I was tragically addicted to opiate painkillers and drinking IPA instead of orange juice alongside my oatmeal in the morning. I was in trouble. Desperate to quit.

    Limping along in 12-step meetings and counseling sessions, I kept cravings at bay but continued to seek meaning and purpose that would lead to lasting sobriety.

    Two events occurred that significantly impacted the direction of my recovery, leading to the life of sobriety and joy I’d been dreaming of. First, my counselor suggested I attend a course called “Mindfulness-Based Relapse Prevention.” (MBRP) Second, I heard Russell Brand in an interview share how he utilized transcendental meditation to help him kick heroin.

    “If Russell Brand can do it,” I thought, “surely I’m not hopeless!”

    I’d long since abandoned strict religion, expanded my worldview, and earned a Bachelor of Science. But I still had misconceptions to overcome. From a distance, meditation and mindfulness seemed foreign; a bit too “woo” for my nursing background in Western Medicine. But I wanted freedom from addiction more than anything. So I joined the eight-week course my counselor suggested and quickly learned mindfulness is backed by science, not voodoo.

    One session of MBRP and I was hooked in the best way. The gentle, individualized format reinforced compassion and welcomed curiosity. My heart felt as if it had come home.

    While presumably not as radical as my own youthful conditioning, limiting beliefs and inaccuracies are a common barrier to people trying out meditation. Whether you’re sober-curious, or the top coin-earning member of your local recovery program, meditation may boost your well-being to new heights. Don’t fall for the following myths.  

    Myth: Meditation means clearing the mind of thoughts.

    Method: Mindfulness Meditation consists of observing, training, and focusing thoughts; not eliminating them. The sign of a “good meditator” is not the capacity to make the mind go blank or think nothing. Many people fear they’re incapable of meditating because of incessant, restless, racing or overwhelmed thoughts.

    The truth is, all humans are continuously thinking; that’s just our minds doing what minds do best. Meditation improves our capacity to understand and even train the mind. No person’s brain is too chaotic to practice, it may just take some of us longer to discover successful techniques and cultivate these new skills.

    With time and perseverance, we can improve the quality of our thinking by bringing our awareness to the present moment. We detach from stressful, negative thought patterns, improving focus and concentration. Changing the relationship to our thoughts is an especially powerful tool in maintaining sobriety. And since cognitive function and personal control are fully intact, no need to panic; outside forces won’t hijack your brain for evil intent.

    Myth: Meditation is a religious ritual.

    Method: Meditation can be associated with religious ritual or tradition. So can most modern medicine, if you follow it back in time far enough. The history of medicine and healing intersects heavily with religion, and the earliest healers were shamans and apothecaries.

    Prior to scientific method and evidence-based practice, religion, magic and superstition formed the basis for treatments and remedies. With nearly 40 years of scientific research and present day MRI as a diagnostic tool, Western culture can appreciate what Yogis have known for centuries: Mindfulness works. And if mindfulness is the foundational concept, meditation is the practical tool. Meditation has roots in a multitude of religions, including Buddhism, Hinduism, Christianity, and Judaism. It’s prudent to understand and honor this, however, no doctrine or dogma is necessary.

    And one doesn’t need to feel they’ve betrayed their personal faith by practicing meditation; it’s a tool that spans the spectrum of spirituality from atheism to fundamentalism. Mindfulness-Based Stress Reduction is a secular mind-body intervention that has been shown to help relieve patient’s suffering and enhance coping skills for chronic pain, stress, and illness – including addiction and alcoholism.

    This program and others like it are becoming increasingly accessible and acceptable to the general population, as research enlightens us to the benefits. Mindful meditation is a powerful tool in sobriety, helping to manage cravings, foster resilience and better our relationship to ourselves and the world.

    Buddhist-inspired recovery like Refuge Recovery, while non-religious, explicitly promotes compassion, lovingkindness, generosity and forgiveness. And who doesn’t want a big heaping dose of that throughout their recovery journey?

    Myth: Meditation requires sitting in Lotus pose on a cushion.

    Method: There’s no perfect position to meditate. Formal practice is often accomplished while sitting upright, with eyes closed or a gentle gaze toward the floor. An upright posture keeps us relaxed but alert, diminishes distractions and prevents sleepiness. But the essence of mindfulness is compassionate awareness, not physical punishment.

    I’ve heard Dave Smith of Against The Stream, begin his meditation instructions with these words: “Find a posture that is good enough for you.” Personally, I can’t sit with my legs crossed – much less in proper Lotus Pose. My feet fall asleep, the pain disrupting my flow. Some may say that’s an aversion I need to work with….and maybe some day I will.

    For now, I find what’s good enough in the moment. If the physical position causes you to cringe, try sitting with your back supported in a chair and your feet flat on the floor. It may be comfortable to lie down with a small pillow under your head or knees. There are many different chairs, benches, seats and cushion choices these days, making meditation accessible and comfortable for nearly anyone, not just those who can achieve instagram worthy Lotus level. 

    Myth: Meditation is sitting in silence for hours.

    Method: Silence means being alone with our thoughts, a scary precedent for many of us, especially in early sobriety. With four years of consistent practice, I still feel anxious if the lesson calls for extended silence. If the quiet puts you off, experiment with guided meditations.

    YouTube has an array of 60-second mindful exercises. Free Apps such as Aura and Insight Timer offer a seemingly endless assortment, with many in as little as three minutes. In just this brief amount of time, you can reset your daily intentions and regain mental clarity. Don’t beat yourself up if you plateau at the 10-minute mark or flee from the room when silence becomes unbearable.

    Mindful recovery teaches us to tolerate the discomforts in life – perhaps that starts with the silence on the cushion. Or perhaps for you, guided is the way to go. Either way, it takes gentle patience and persistence. This is personal training for the brain, not a quick fix for enlightenment. 

    Myth: Meditation happens on a cushion in a monastery.

    Method: Mindfulness meditation can happen anytime, anywhere, and isn’t practiced with a goal of perfect meditation under perfect conditions. It’s meant to help us get better at life. To help us develop compassionate, wise responses to external and internal stimuli. Some mindfulness can and should be done in ordinary spaces.

    For example, you can try an everyday task such as hand-washing or brushing your teeth mindfully. Similarly, eating meditations (like this raisin meditation) are a great method for concentrating the mind, expanding perspective, and cultivating awareness of the present moment.

    Integrating mindfulness into your lifestyle is the ultimate desired outcome. Just don’t attempt meditation while driving your car or operating heavy machinery!

    Mindfulness meditation can be a vital tool for successful sobriety. It improves our ability to live in the present moment, nurture ourselves and others with compassion and tolerate discomfort without reaching for substances to numb the pain. Let go of myths and misconceptions and begin practice today to start experiencing the rewards of living mindfully.  

    There are many types of meditation. This article discusses Mindfulness Meditation specifically, which is just one form of the practice. Resources for mindful/meditation recovery programs include but are not limited to: Refuge Recovery (Buddhist inspired, non-religious), Eight Step Recovery (Buddhist Path) and Mindfulness Based Relapse Prevention (science-based). Go here for other types of meetings in your area.

    Tiffany Swedeen, RN, BSN, CPC/CPRC is a certified life and recovery coach, She Recovers Designated Coach, and a registered nurse in recovery herself from opioids and alcohol. Tiffany lives “sober out loud,” proudly sharing her story through advocacy and blogging and is passionate about helping others do the same. Her goal is to eradicate shame and empower all to live a life of radical self-love. You can contact Tiffany through her website Recover and Rise, read her blog www.scrubbedcleanrn.com and follow her @scrubbedcleanrn. 

    View the original article at thefix.com

  • Florida Sues CVS, Walgreens For Their Alleged Roles In Opioid Crisis

    Florida Sues CVS, Walgreens For Their Alleged Roles In Opioid Crisis

    The suit claims that the companies failed to stop “suspicious orders of opioids,” and dispensed “unreasonable quantities” of such drugs.

    The state of Florida has named two of the largest drugstore chains in the United States—Walgreens and CVS—as well as Insys Therapeutics, in a lawsuit that alleged that they “played a role in creating the opioid crisis.”

    Florida Attorney General Pam Bondi issued a press release stating that the pharmacy giants and Insys, which manufactured the fentanyl-based medication Subsys had been added to a state-court lawsuit filed on May 15, 2016 against Purdue Pharma, L.P.—the manufacturer of OxyContin—and other pharmaceutical manufacturers for allegedly contributing to the opioid epidemic with their opioid-based products.

    The suit against CVS and Walgreens alleges that the companies failed to stop “suspicious orders of opioids,” and dispensed “unreasonable quantities” of such drugs from their locations.

    In the complaint, the Attorney General’s Office alleged that Walgreens Co.—the largest drugstore chain in the nation—has distributed vast amounts of opioids throughout the state of Florida, and in some cases, reportedly distributed millions of pills that far outnumbered town populations.

    The suit cites an unidentified Florida town where the Walgreens location is alleged to have sold 285,000 pills in a single month to a town with just 3,000 people.

    According to the suit, some stores reportedly experienced six-fold sales growth for pills in just two years time. Walgreens previously paid a record settlement of $80 million in 2013 for violations of record-keeping and dispensing regulations that allowed oxycodone and other pain medications to be diverted for black market sales.

    The accusations against CVS Healthcare Corp. and CVS Pharmacy, Inc.—the second largest U.S. drugstore chain—claim that the company sold more than 700 million opioid products between 2006 and 2014, including three towns that received and dispensed “huge quantities” of opioids during that time frame.

    CVS also paid $22 million to resolve allegations by the Drug Enforcement Administration (DEA) that retail stores in the town of Sanford, Florida sold painkillers that were not prescribed for “legitimate medical purposes.”

    The suit’s allegations against Insys Therapeutics echo similar charges levied against the troubled pharmaceutical firm, which has been accused of paying doctors to prescribe Subsys, a medication for patients with breakthrough cancer pain, to patients without cancer or similar diagnoses.

    The suit cites public records that showed that Insys paid $18.7 million to doctors between August 2013 and December 2016, including one Florida physician who received $270,000 from the company.

    According to data from the Center for Medicaid and Medicare Services, more prescriptions for Subsys were written in Florida than in any other state.

    A spokesperson for CVS labeled the lawsuit “without merit” and said that in recent years, the company “has taken numerous actions to strengthen our existing safeguards to help address the nation’s opioid epidemic.”

    View the original article at thefix.com

  • Did You Know Carfentanil Is 5000 Times Stronger Than Heroin?

    Did You Know Carfentanil Is 5000 Times Stronger Than Heroin?

    ARTICLE OVERVIEW: Recently, drug dealers have been cutting heroin with carfentanil to increase profit. However, this medicine is not meant for human use. In fact, carfentanil was originally designed to tranquilize large mammals. This article reviews what you need to know about carfentanil, the dangers associated with it, and tips for finding treatment if you’re struggling with an addiction. At the end, we invite you to ask questions. We try to respond personally and promptly to all real-life questions.

    ESTIMATED READING TIME: Less than 10 minutes.

    Table of Contents:

    What is Carfentanil?

    Carfentanil is very similar to the synthetic opioid analgesic, fentanyl. To date, it’s not only one of the most potent opioids available, it’s the most potent opioid on the streets. In fact, it’s estimated to be 100 times stronger than fentanyl. And fentanyl is already 50 times stronger than heroin!

    Carfentanil is estimated to be 10,000 times stronger than morphine.

    However, carfentanil wasn’t created for people to use. Back in 1986, the chemical was labeled under the brand name “Wildnil”. It was used in tranquilizer darts designed for large mammals such as elephants. Carfentanil was the perfect drug for this task, as the overdose risk is similar to that of its cousin, fentanyl, but still contains much higher opioid activity.

    The risks involved with human consumption of carfentanil are HUGE. Overdose risk is extremely high. All it takes is 1 microgram to provoke psychoactive effects. With that in mind, it’s understandable why drug dealers are cutting it with heroin. Even the smallest amounts of the opioid cause dosing reaction, and in this way, a small supply of the drug can cause heroin profits to soar.

    But how does such a powerful drug affect the brain?

    How Does it Affect the Brain?

    Effects of carfentanil are similar to other opioids. The chemical components of these drugs attach themselves to opioid receptors within the brain which are responsible for:
    • Dopamine
    • Norepinephrine
    • Serotonin

    These receptors are attached to neurotransmitters which then carry chemical signals throughout the rest of the body. This can be highly effective if you’re experiencing severe pain in a particular area, as these neurotransmitters travel to where a pain is most intense and change the way that we perceive pain. Opioids can also case euphoric effect, the feeling of being high.

    The effects of opioids are strong and very addictive. Short-term effects from taking an opioid drug like carfentanil include:

    • Drowsiness
    • Feelings of euphoria
    • Pain relief
    • Sedation

    People develop an addiction to opioids through a chemical change in the brain and body. Over time, the body becomes drug-dependent; we chemically develop a necessity for the drug as a means of feeling normal. Without the drug, the body goes through withdrawal.

    Though this happens over a period of time, it should be noted that it doesn’t take long to develop dependence on opioids: usually, drug dependence can occur with about 3 weeks of regular use. When use persists, a person is unable to stop despite the negative effects the drug has on her/his life. In these cases, an addiction can begin.

    Why Overdose Happens

    Opioids are already dangerous in and of themselves. A synthetic opioid like carfentanil that is thousands of times stronger is even more dangerous. As mentioned above, it only takes 1 microgram of carfentanil to trigger activity within a human brain. However, at 20 micrograms, the dose becomes lethal.

    In fact, it’s been determined that of all the dangers of carfentanil, overdose is most likely. Cincinnati, Ohio experienced these consequences in just one weekend where 30 people overdosed because the drug was added to heroin. In the same area, the following weekend, another 78 overdosed.

    An overdose occurs when you take too much of a drug. It literally overwhelms the body. In particular, opioids affect the regulation of breathing and heart rate. When you take too much of an opioid drug, your respiratory and cardiovascular systems slow until they stop. How can you prevent an overdose?

    There are signs to be aware of when someone is experiencing an overdose:

    • Body goes limp.
    • Breathing or heartbeat slows or stops.
    • Face grows very pale and/or seems clammy upon touch.
    • Lips or fingernails turn a purple or blue color.
    • Seizure.
    • Unable to be awakened or cannot speak.
    • Vomiting or making gurgling sounds.

    Overdose Precautions

    So, what should you do if someone overdoses?

    IT’S VITAL YOU CALL 911 IMMEDIATELY!

    A fatal overdose can be prevented under the right medical attention. Calling emergency services needs to be your first priority. However, there are a few steps you can take in order to administer immediate action:

    • If naloxone is available, administrate it. Most likely, the medical professionals who arrive will use it as a means of stopping the overdose. Naloxone quickly blocks the effects of opioids within the body. You can either inject it into the muscle or spray it into the nose.
    • Attempt to keep the person awake by talking to him/her and try to keep them breathing, through CPR if necessary.
    • Make sure the person is placed on their side. This prevents them from choking on bodily fluids.
    • Stay by the person’s side until emergency services arrive. When it comes to an overdose, there’s no telling what can happen within just seconds.

    When it comes to opioid overdoses, most can be prevented through careful steps. When it comes to carfentanil, the story is a little different as it’s so powerful of a drug. Since so little can cause an overdose – and most don’t know whether or not or how much of their drugs are cut with carfentanil – there are GREAT risks involved.

    And these risks go beyond an overdose.

    Carfentanil Health Risks

    Synthetic opioids cause rapid depression within your central nervous system as well as immediate effects including:
    • Drowsiness
    • Increase in blood pressure (particularly, in the brain)
    • Lethargy
    • Muscle spasms
    • Nausea
    • Paranoia
    • Postponed or decreased respiratory function
    • Respiratory arrest
    • Tightening of chest muscles

    However, just as with other opioids, there are also long-term problems which can occur from a prolonged period of use. These include:

    • Abdominal distention and bloating
    • Addiction
    • Brain damage
    • Constipation
    • Development of mental health issues, such as depression or anxiety
    • Development of tolerance
    • Heart complications
    • Liver damage
    • Nausea and vomiting

    Furthermore, since carfentanil can be laced with heroin, there are health risks involved for people who inject as a means to get high including:

    • Gangrene
    • Hepatitis B (HBV)
    • Hepatitis C (HCV)
    • Human Immunodeficiency Virus (HIV)

    According to medical examiners and coroners, the number of deaths due to carfentanil increased by 94% from the second half of 2016 (421 deaths) to the first half of 2017 (815 deaths).

    Carfentanil Trends and Statistics

    The Center for Disease Control and Prevention analyzes opioid death through death certificates from 32 states and the District of Colombia. Of their analysis of fatal opioid doses between July 2016 and June 2017, it was discovered that – of 11,045 opioid overdose deaths – 1,236 (11.2%) had positive test results for carfentanil.

    Furthermore, the trends of overdose have been found to be area specific.

    • Within 2016 and 2017, Ohio had the largest number of carfentanil laced opioid deaths with September of 2016 being the peak month at 86 deaths.
    • Opioid overdose deaths where Carfentanil was present increased across the world in the second half of 2016, from 54 countries affected to 77.

    These trends are able to give us insight into how Carfentanil has only recently made its way into the illicit market. For the most current drug-related trends, including where synthetic opioids are making an appearance, you can follow the National Institute on Drug Abuse’s Emerging Trends and Alerts for all the latest information.

    Basic to Treatment

    If you or someone you love is currently struggling with an opioid addiction, it’s vital to seek help. The risks are too great. You are literally playing with your life. From experience, we promise you:

    You or your loved one has the ability to stop and start a new life!

    Addiction treatment typically works like this:

    1. First, a Medical Assessment

    Medical assessment forms the basis of any treatment plan. When you’re ready to get help, a team of doctors, nurses, and therapists will perform physical and mental exams. You can expect to go through a full medical exam, provide blood and/or urine samples, and go through interviews. This first assessment is crucial to your treatment plan. A good medical assessment should take from 1-2 hours to complete.

    2. Then, Medical Detox

    In order to get past physical dependence, your body must undergo withdrawal. This is the process of removing an opioid from your system and getting back to your natural body chemistry – a state known as “homeostasis”.

    Since opioid withdrawal has some risks such as dehydration and relapse, it’s important you find a detox facility. This will allow you to be in a controlled and safe environment while medical treatment to ease withdrawal symptoms. You can expect to be in detox for about a week, with symptoms peaking 72 hours after your last dose of opium. These symptoms include:

    ◦ Abdominal cramping
    ◦ Agitation
    ◦ Anxiety
    ◦ Diarrhea
    ◦ Dilated pupils
    ◦ Goosebumps
    ◦ Increased tearing
    ◦ Insomnia
    ◦ Muscle aches
    ◦ Nausea
    ◦ Runny nose
    ◦ Sweating
    ◦ Vomiting
    ◦ Yawning

    3. Psychotherapies

    Once an opioid is out of your system, you’re going to experience strong. This is due to the fact that your brain has been dependent on opiates and must readjust back into day-to-day life without it.

    Typically, psychotherapies are designed to teach you how to handle everyday emotions and life stressors. They are highly effective not only in showing you how to live a sober life but also in helping with any mental health conditions which may have arisen due to your opiate use. Furthermore, psychotherapies will reduce cravings. Typical therapies include:

    ◦ Behavioral Therapy
    ◦ Cognitive-Behavioral Therapy (CBT)
    ◦ Community Reinforcement and Family Training (CRAFT)
    ◦ Contingency Management
    ◦ Dialectical Behavior Therapy
    ◦ Group Therapy
    ◦ Family Therapy
    ◦ Individual Counseling
    ◦ Integrative Approach
    ◦ Motivational Interviewing
    ◦ Multidimensional Family Therapy
    ◦ Narcotics Anonymous (NAA)

    4. Pharmacotherapy (Medication)

    Medications can help to reduce withdrawal symptoms and cravings. When it comes to opioid withdrawal or longer term maintenance, typical medications prescribed are:

    ◦ Buprenorphine
    ◦ Loxifidine
    ◦ Methadone
    ◦ Naltrexone

    5. Education and Aftercare Services

    Once you begin to learn enough to get back into your day-to-day routine, you’ll have the option learn more. Addiction treatment programs should educate you about how drugs affect your brain … and how to cope without them. You may also be invited to go to meetings to connect with others who are going through the same thing. A support system helps maintain sobriety and stops you from isolating. Other aftercare services include ongoing counseling, sober living houses, and alumni programs.

    Where to Find Help

    When trying to find treatment, it can be difficult to know where to turn. Luckily, addiction treatment is more understood and accepted as a medical condition within the healthcare system. Medicare and Medicaid are being updated to include reiumbursements for addiction treatment. Likewise, state and federal grants aim to increase your access to needed medications and treatment.

    So, where do you go first? The first point of contact can be your general doctor or family physician. S/He can perform a brief assessment and then refer you to treatment centers within your area. From there, you can begin researching different types of treatment programs and their requirements. You can also find help through specialists like:

    Furthermore, keep an eye out for support groups either outside or within your treatment program.
    The people involved in these will help you along the recovery process. If you need to reach out to someone immediately, here are some hotline numbers to contact:

    • Drug Hotline: 877-736-9802
    • National Clearinghouse for Alcohol and Drug Information (NCADI): 800-729-6686
    • National Council on Alcoholism and Drug Dependence Hope Line: 800-475-HOPE (4673)
    • National Drug and Alcohol Treatment Referral Service 800-622-4357
    • National Suicide Prevention Helpline: 800-273-TALK (8255) or 800-SUICIDE (784-2433)
    • Substance Abuse Helpline (available 24/7): 800-923-4327
    • Relapse Prevention Hotline: 800-RELAPSE (735-2773)

    When you’re ready to look for treatment, we’re always glad to help! Feel free to give us a call. Or, you can leave us a personal question in the comment section below.

    Your Questions

    Still have a question about carfentanil? If you have any questions, we invite you to ask them below. If you’d like to share information about carfentanil or offer some advice about opioid addiction, we’d also love to hear from you.

    We try to reply to each comment in a prompt and personal manner.

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