Answer Addiction

Tag: Tiffany Swedeen

  • Recovery of a Real-Life "Nurse Jackie"

    Recovery of a Real-Life "Nurse Jackie"

    Before I ever stole a pill from work, before I was ever a daily drinker and habitual pill-popper, I was just a burned-out nurse, exhausted and in pain.

    Nurses are often referred to as “angels in scrubs.” It certainly fits. 

    Who else but an angelic being can provide unconditional comfort in the throes of tragedy, hold your hands through unspeakable heartbreak, and save your loved one’s life all while cleaning up an array of bodily fluids?

    Nurses do it with a smile.

    Florence Nightingale left her predecessors with big shoes to fill. Nurses must function as caregivers under extraordinary pressure, possess superhuman resilience, scrupulous morals, exceptional coping skills and be immune to afflictions that trouble the general population. Nurses need to be available to care, comfort and to cure. There’s no time to be ill or emotionally fragile. 

    By striving to live up to Nightingale’s standards, we’ve earned the #1 spot on Forbes list of trusted professionals, but we’re also the most susceptible to job burnout. We’re brimming with intelligence and compassion, but far from celestial beings. Nurses are 100% human and just as likely, if not more so, to employ unhealthy coping mechanisms. 

    A Registered Nurse for over 14 years, I can attest to this. I mismanaged work stress and job burnout in the worst way possible: by turning to drugs and alcohol. 

    It’s estimated that around one in 10 nurses struggle with substance use disorder. That’s no small statistic, considering there are around 3 million nurses in the US.

    Alcohol, opiates and benzodiazepines are an all-too-accessible source of fuel to get through the work day. They’re also excellent numbing agents to sleep off the stress of a shift. It’s not uncommon to hear a nurse exclaim “This shift calls for wine!” or to joke about the necessity of drugs to wash away the day.

    Nurses readily encourage drinking as a coping skill, use of anti-anxiety medicine is socially approved of and sleeping pills are shared between friends. But admitting one has lost control of one or more of these highly addictive substances is absolutely taboo. 

    It was eight years into my career at the hospital that I became physically and psychologically dependent on Vicodin. Migraines interfered with my ability to work and be a mother. My doctor prescribed an opiate, and I experienced blissful relief as the migraine melted away and euphoric energy filled the void. 

    The progression of my addiction was insidious but certain. Since graduation from nursing school, I could count on one hand how many hangovers I’d woken up with. Recreational drugs, including smoking pot, was out of the question. Yet when all the factors fell into place – a legit prescription, disengaged from my work, overwhelmed at home and sleep deprived working nights – my fate seemed inevitable.

    Slowly and steadily I transformed from a Florence Nightingale prodigy – working overtime, volunteering, climbing the ladder to nursing success – into a real-life Nurse Jackie. 

    Eventually I became tolerant and my personal prescription wasn’t enough. I engaged in behavior I’d previously considered appalling and unthinkable. I stole from my employer. Compulsion to use and desperation to avoid withdrawal won over any rational thought process. Opiates had become a cure-all for the physical and emotional exhaustion that consumed me.

    Like so many other nurses, when I realized the line had been crossed from medical and occasional recreational use to abuse and dependence, I felt trapped. I couldn’t just tell my manager. I couldn’t even tell a friend. Too much was at stake. Drowning in opiate addiction, (and drinking heavily to boost the effects or stave off withdrawal) I saw no safe shore to swim to. 

    Washington State, along with most states in the US, offers an “alternative to discipline” program due to the high incidence of substance abuse in healthcare professionals. But since the problem isn’t talked about, the solution isn’t either. The organizations are spoken of in whispers, as are the nurses who “ended up in the program.”

    I wasn’t ignorant to the existence of these resources, but I was completely misguided as to their intention and function. 

    I’d heard rumors of nurses who were caught “diverting” – the fancy term we use for stealing the leftover or extra amounts of drugs that are supposed to be “wasted” at work in the proper receptacle.

    According to gossip, they were escorted off campus by security or police as the state program was notified. At worst they were forced to relinquish their license. At best, job opportunities were limited to grueling shifts at nursing homes earning half the pay they deserved. 

    It was a living nightmare. Imprisoned by addiction, paralyzed by fear. Terrified of being recognized, I refused to attend any type of peer-support group meeting. Finally, out of desperation I contacted a private counselor. She declined to treat me based on duty to report.

    “Oh, you’re a nurse? I can’t treat you. Too much liability. But good luck I’m sure you’ll find someone.” 

    Fortunately, I found rock bottom. Not in the form of an overdose, which I was dangerously close to many times, but in being caught by my employer. Someone had informed them of my suspicious behavior. I was required to give a urine sample, and when it came back glowing dirty with the truth of my drug use, I was given a choice according to my state’s department of health policy: Enter into treatment or face criminal charges and potential loss of my license.

    Both options felt like professional suicide. For the next two weeks as I contemplated the decision, I also contemplated actual suicide. With the support of one family member I felt I could confide in, I made my way to treatment; sick with shame and certain I’d destroyed my reputation, my dignity and life as I knew it. 

    Out of work as a nurse, but intentionally working on recovery, my outlook began to change. One month of sobriety turned into multiple, and the chemical fog began to clear. I made connections with nurses who had or were recovering. I began practicing mindfulness, cultivating resilience and digging deep to understand what had transpired. 

    As I researched, I discovered my story isn’t unique. Being an excellent nurse and having an addiction are not mutually exclusive. In fact, they often go hand-in-hand. The highest functioning, hardest working, most in-depth critical thinkers end up stealing and ingesting drugs from work. Numerous factors play into this, the most basic of which is drugs and alcohol offer instant relief from a mind that won’t shut off, and they are physically addictive. Nurses in particular feel invincible as the caregivers – “it’s others who are sick.”

    Our comprehensive knowledge of medications and how to ingest or inject “safely” gives us a false sense of security. And 75-80% of nurses are adult children of alcoholics, including me. We’re essentially predisposed and then enter into a pressure cooker of a career. 

    My research also uncovered that sober, recovering and/or “graduated” from an alternative to discipline program nurses still don’t disclose this part of their lives. This is a tragedy in itself. When nurses keep their recovery in their dark, still-suffering nurses keep their active addictions in the dark. 

    Healthcare as an occupation does a disservice to professionals who enter into it by neglecting to educate, advocate and adequately treat. 

    Nursing schools should provide courses in mindfulness and self-awareness, encouraging nurses to uncover the sometimes-hidden nature of addictive tendencies and teaching strategies to manage them. This should be done long before ever exposing them to the workforce and giving access to a plethora of pills and injectables. 

    Educational institutions and employers should offer free education, confidential counseling and allow time off work for treatment. Lunch breaks should be mandatory and enforced; employees should be trained in self-care. 

    Instead of shaming nurses who are under suspicion or undergoing treatment by posting names and license numbers on public lists, the department of health should be involved in the development of peer- support groups.

    Trauma-informed rehabilitation programs need to be implemented for nurses and first responders who have been repeatedly subject to high stress and high stakes patient care. 

    Asking for help shouldn’t be a trauma itself. We need to change the narrative from “being reported” to being “given an opportunity to receive treatment and protect your license.” Treatment providers need to change the verbiage from “You can’t tell me anything, I have a duty to report.” To “This is an opportunity for honesty, to find you the best treatment possible so you can achieve health and well-being again.”

    I never wanted to be known as a real-life Nurse Jackie. It would have been easier to quietly complete my time in treatment and live out my career with a well-kept secret. But I know that there are many more angels in scrubs still suffering. Neglecting themselves while striving to meet the needs of their patients, too afraid to ask for help and too sick to overcome addiction on their own. 

    Before I ever stole a pill from work, before I was ever a daily drinker and habitual pill-popper, I was just a burned-out nurse, exhausted and in pain. I needed a safe place to admit I was hurting and an outlet to vent the pressure. I needed somewhere to take off my scrubs, shed the angel wings, and become vulnerable without being made to feel inferior. I needed to know I wasn’t alone, and that treatment was not the end of my career; only the end of my addiction. My career would have a chance to flourish.

    Stigma must be eradicated for recovery to be possible. Prevention, early intervention, and treatment must be advocated for fiercely in order for nursing to be filled with thriving, healthy individuals. I live sober out loud because I believe this change is possible.

    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

  • 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

  • Sober Dating: Overcoming Triggers & Temptations

    Sober Dating: Overcoming Triggers & Temptations

    The date turned out to be a boobytrap of triggers that I wasn’t totally prepared for. But mindfulness, resilience, accountability – recovery – kicked in when I needed it most.

    I startled as my phone buzzed a text against my thigh. It was my date.

    “I’m late, but I’ve got tacos!”

    Relax, I urged myself, taking a breath and taking in the surroundings. It’s going to be fine. It’s just tacos.

    This was my first date in well over six months. Unless you include a Saturday night in late August while I vacationed in Iceland. We ran all over Reykjavik searching for traditional lamb meat soup, to no avail. It was whimsical, it was carefree, but it was all the way in Iceland. And it didn’t even end with a kiss. This taco rendezvous felt like a legitimate return from a dating hiatus. 

    Dating is challenging. Sober dating can be truly precarious. First of all, I have very little courtship experience. My M.O. has always been meet, mate, marry. Eventually, I learned not to wed every guy who showed interest. Twenty years of consecutive long-term relationships meant that at 36 years old I became sober and legitimately single, for the first time in decades. SCARY.

    At the very least, it’s uncomfortable. And why do so many of us drink? To treat discomfort! “Meeting for drinks” is both neutral ground, and grants permission for each party to self-medicate throughout the ordeal. 

    It’s natural to want a strong drink (or in my case a strong drink and maybe a powerful pill) to relax. When I’m home getting ready, agonizing over my hair, outfit, and what to say, “just one” would go a long way towards numbing my nerves. But “just one” steers me down a dangerous path. Before I know it, I’d be back on stage at POP-Solo karaoke, blackout wasted, singing “Sexy Back” off key. (ALLEGEDLY! There’s no evidence.) It’s just not worth the risk. 

    Deciding when, or whether to “out myself” as sober to a guy is always a gamble. He had mentioned “wine” more than once as a suggestion for our first activity. (An early red flag I adeptly ignored). Refusing a glass in the moment can be difficult and awkward, so I casually commented prior to the date, “I actually don’t drink…but if you want wine, it’s cool.” When he didn’t respond with the all-too-common: “Really?? You don’t drink ever??!!??” my optimism was buoyed.

    So I waited for Taco Guy with zero alcoholic pre-lubrication, counting breaths as a healthy coping mechanism instead of throwing back shots at the bar. He arrived, tall and attractive. He had a large bag of local Mexican food in one hand, a spirited canine attached to a leash in the other. He even brought me a Fresca, remembering my preference for sparkling water. Fresca is no La Croix, but he got points for thoughtfulness. 

    The date started out smoother than expected. As dinner wrapped up, he clumsily remarked he wasn’t sure what to do next. “Normally I’d take you to a bar, go wine tasting…something revolving around drinks.” My teetotaling ways left him at a loss. 

    I remember those days, pre-sobriety. Alcohol: a necessary ingredient for every situation. I once turned down an otherwise solid, yet sober guy over this. “Sorry, beer is seriously that important to me. I practically live at breweries. We’ll have nothing in common!” 

    Taco Guy was stressed about what we wouldn’t get to do together in future meetings. “Wine tasting? BBQs and Beer? How do you have fun without drinking?” 

    In nearly two years of sobriety, I’ve hardly been bored. I secretly questioned his capability for booze-free entertainment, but stayed aloof. “Anything you can do with alcohol, you can do without. I promise. I’m super fun.“

    “Do you do anything bad?” he asked skeptically. I laughed out loud, thinking how he’d probably never know the truth about my former IV drug use and three years left in probation. 

    “Trust me,” I assured him. “I’m not all good.”

    He had a teasing smile. “Oh yeah?” Sweetly persistent and skilled at flattery, he convinced me to bring our dogs to his place. They could play in the backyard and we could watch Netflix. 

    What the hell, I thought. Prove you can be fun!

    Within 15 minutes, I was standing in his small, tidy apartment. He’d called me beautiful and made his interest in me obvious. Did this mean we were going to make out? Was I ready? Do I make the first move? What are the rules?

    In the past, this was easy. Drink, flirt, and use alcohol as an excuse for whatever indiscretion occurred. Sober dating is not easy. Sober sex is on a whole other level. 

    He spoke, blessedly interrupting my thoughts. “I’m going to have a whiskey, do you mind? I’m really nervous.” 

    “Go ahead, of course!” I answered bravely, but thought REALLY?!?! Not fair!! I’m stone cold sober, trying to navigate first date rules, and you get to wash away your worries with hard liquor while I sip water to tame my cottonmouth. UGH!

    He poured a hefty amount of Jack Daniels over ice, and I took the opportunity to use the bathroom. 

    Shutting the door behind me, I leaned against it, worrying. Is he going to kiss me? Or more? Is my deodorant still working? Should I wash under my arms? I should use his mouthwash!

    The mirror reflected back glossy color on my freshly styled hair, nervous rosy cheeks, and a trace of pink lipstick that had mostly wiped off on the Fresca. I looked decent. I’m not a bad catch, for a sober chick. Wait, what if he tastes like liquor? Is it weird if I ask him to use mouthwash? No that’s crazy. Or is it? 

    Leaning into the sink to wash my hands, a familiar sight stood out on the countertop: the bright, cunning orange of a medicine vial. Right there, in plain sight. No cupboard snooping necessary. 

    My vision went fuzzy on the edges. Drying my hands on a towel, I waited for the buzzing feeling to dissipate. I’ve been sober awhile, but I’m not immune to triggers. Medication bottles are not just benign bathroom articles. 

    I chewed on my bottom lip and thought over my next move. One of the labels was readily visible: “Metoprolol.” Phew, I thought. Heart medicine. No big deal. Without warning, my hand took over and snatched up another bottle, turning it label side up. 

    Hydrocodone-acetaminophen. Otherwise known as Vicodin.

    Fuck.

    I set it back down, but picked up another. 

    Oxycodone hydrochloride. Percocet.

    Double fuck. 

    Opiates were my drug of choice, my former best friend and the most seductive, manipulative, toxic lover I’ve ever tangled with. 

    Setting the menacing vial down, I stepped away from the sink, clenching my hands at my sides. 

    I could take a couple. 

    It only took a second for the thought to formulate. I envisioned the euphoric, care-free feeling. Pictured worrisome “first date rules” slipping away, letting go and enjoying the moment.  

    Picking up the bottle once more, I shook it lightly.  

    How many are in here? I bet he wouldn’t notice any missing. 

    The thought was brief. But it was charged with deadly potential. Lucky for me, mindful recovery teaches me I don’t have to believe my thoughts. I have a choice.

    I don’t want this. It isn’t me anymore.

    I extricated myself from the bathroom, delivered from temptation. 

    Taco Guy was on his second tumbler and had stepped outside to smoke. Menthols. Of course! My brand. At least they were, once upon a time. This date presented landmines everywhere I turned. 

    Against my better judgment, I stayed long enough to play with fire. Taco Guy is pretty hot, kind and gainfully employed. I wasn’t planning a future together, but I hadn’t yet ruled out seeing where the night would go. Holding a menthol between my fingertips, I said flirtatiously “It’s been awhile.” I took a drag, hoping I looked dangerous and sexy. Coughing, I just ended up likely looking like a silly girl who hadn’t inhaled in awhile. 

    I stayed long enough to smoke the cigarette and regret it. Long enough to sulk and wish things were different. It’s not fair. I don’t want to be an addict. I want to be normal – I want to be able to get drunk and make out. I wished, for a moment, that Taco Guy and I weren’t so incompatible.

    While I pouted privately, I knew I was kidding myself. The truth is, we are incompatible and I was uncomfortable. I don’t really wish I could drink and have an excuse for my behavior. I definitely don’t wish I could take his pills or go back to using. What I guess I really wanted was just to be on a date where I could be my honest, open, sober-out-loud self. 

    I don’t want to date if I can’t be real. That probably means when I’m genuinely ready, I’ll date guys who are also in recovery. I’d questioned this when I first became single and sober. Who do I date? Can I date someone who drinks regularly? I got my answer this night.  

    Crushing the cigarette in a well-used ashtray, I reached for my keys. 

    He looked rejected. “You’re leaving? I promise to be a gentleman. We’ll just watch a movie.” 

    Within a couple hours in his presence, I’d given in to smoking. Next, I might ask for a sip of whiskey. Once the brown liquid passed my lips, burning the back of my throat, I’d slink into the bathroom. Tilting the bottle of Vicodin back and forth, contemplating the siren song as the pills clicked against one another. 

    Nope. Not gonna happen. I love myself too much to go back there. 

    Driving home, I felt a mix of relief, pride, and sorrow. And a touch of nausea from the cigarette. When was the last time I’d looked a bottle of pills in the face and walked away? 

    The date turned out to be a boobytrap of triggers that I wasn’t totally prepared for. But mindfulness, resilience, accountability – recovery – kicked in when I needed it most. I was tempted, but not overwhelmed. I won that battle.  

    A few days later, Taco Guy texted. I had to be firm and honest. “I can’t date someone who drinks. That’s become very clear. Thanks, and good luck.”

    To my surprise, he replied with a compromise:

    “I shouldn’t drink either. I’ll try to stop. You could be a huge support and help to me with this.”

    As if the triple threat – alcohol, cigarettes and pills – wasn’t enough, co-dependency alarms rang in my ears. The final red flag was flown. 

    Firmly informing him that his request was wildly inappropriate, I blocked his number. 

    Over the last 20+ years, I’ve made really disappointing, damaging relationships decisions. Looking back, all I manage is, “What the fuck were you thinking?” 

    Just for once, I’d like to look at my life and think, “Well done, girl. You’re doing your best. It’s not easy, it’s not painless, but you’re making smart choices.“

    I think that time might be now. I could be doing it right for once. Saying “yes” to a drama free, recovery-centric era of radical self-love. Saying “no” to drugs, alcohol, and self-destructive behavior one nerve-wracking date at a time. 

    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

  • What Sets Suboxone Apart From Other Medication-Assisted Treatments?

    What Sets Suboxone Apart From Other Medication-Assisted Treatments?

    When taken as prescribed by an opiate addict, Suboxone doesn’t allow me to avoid or escape reality. This is one way it differs form other MATs.

    I’ve used the same pharmacy for over a decade. The tech filling my prescription this morning was the same one that had filled my Vicodin prescription for four years, on the first of the month every 30 days, like clockwork. 

    Today, I smiled at her as she stuffed a different prescription into a small white bag: 28 individually wrapped, “lime” flavored, orange-tinted filmstrips.

    “You’re still on Suboxone?” she questioned.

    “Yep.” I answered. “I don’t see weaning off anytime soon. My recovery is strong and life is good.”

    She raised a skeptical eyebrow.

    “Aren’t you just trading one for another? Wouldn’t it be better to never get on it? Nobody gets off of this stuff… It just seems like a waste…no different than any other drug addict.”

    My body deflated with a sigh, but I tried to give her the benefit of the doubt. I wasn’t expecting these questions from a woman whose career relies on understanding complicated medical pharmacokinetics, but I get it. She doesn’t grasp the complexities of addiction.

    I simply explained to her the differences in lifestyle, motivation and integrity between using illegal substances to get high, and using a medication as prescribed as one of many tools in a recovery program. 

    She’s not alone in her misunderstanding. Suboxone and other forms of medication-assisted treatment (MAT) are confusing and controversial, for addicts and “normies” alike. MAT isn’t the only thing that’s hotly debated. We argue whether addiction is a disease or a choice, what labels we should use, and how anonymous we should be. We quarrel about jargon, literature, sponsors and steps. 

    One thing most addicts and alcoholics can agree on is this: We don’t like to be uncomfortable. The inability to tolerate emotional or physical pain is often what sets us hurling down the spiral of addiction.

    An injury, illness, stress, loss, or combination of all of them (in my case migraines, divorce, job burnout) led us to drink or use to dull the pain. Whether its numbing out, sleeping it off, or chemically re-energizing, we’re professionals at self-medicating.

    Going to extreme measures to either chase pleasure or run from pain, we drink, use, pop, dose, snort, shoot and eat our way to an alternate reality.

    Could the pharmacy tech be right? Am I just trading one negative habit for another in an attempt to evade my problems? Like other opiates, Suboxone causes physical dependence and withdrawal if you stop taking it. How is taking it daily any better than taking Vicodin, Percocet, or heroin? I’ve often heard: “You might as well get in a managed cannabis program and smoke weed every day – isn’t that better than taking an opiate? “

    My answer?

    “No.”  

    But that answer hasn’t always come easily. Even as a grateful patient of this medication, I’ve grappled with the decision. Sobriety means getting honest with myself, taking into consideration anything that might be used as a “crutch” or negate recovery.

    I have to ask myself: Why am I OK with taking Suboxone? Why don’t I feel like a shady addict, living in the shadows and sneaking drugs, even though I am officially still taking an opiate? 

    The answer came to me during a particularly stressful day when all I wanted to do was get high, get wasted and go to sleep. That’s impossible to do in sobriety. I’ve had to learn to cope with emotions, to accept reality, and to tolerate discomfort. 

    A light bulb came on: Suboxone is different because it doesn’t change me or my circumstances. It doesn’t get me high.

    Suboxone doesn’t do what other opiates did for me; I can’t numb physical or emotional pain. On Vicodin and alcohol, I was irritable, suffered memory loss, was incapable of personal growth and spirituality. I spent my time and energy chasing drugs, chasing a high, running from withdrawal. I cannot avoid or escape reality by taking Suboxone. At all.

    When taken as prescribed by an opiate addict, it differs from other harm reduction and medication-assisted treatment such as methadone or marijuana by that fact.

    The form of Suboxone I currently use can’t do anything to enhance my mood even if I take it other than prescribed. I can’t dissolve it in liquid and shoot it, because the Narcan in it (the ingredient that prevents overdose) will put me into immediate withdrawal.

    I can attempt to get high by taking more than prescribed, but once my brain’s receptors are filled, Suboxone ceases to give any more effect. That undeniably sets it apart from other drugs — over-the-counter and otherwise.

    Methadone, on the other hand, can easily be abused. I’ve done it myself. Taking three times the amount of methadone I should have, I went to a meeting to “work on recovery.” I couldn’t tell you what happened at that meeting, or how I got home.

    If I take three times my Suboxone dose, I’ll likely not notice much enhanced effect, and I’ll screw myself over, since I’ll be short three doses and will somehow have to explain to my doctor why I ran out early. I’ll potentially be kicked out of the program as well, without ever even getting high! For an addict like myself, it’s not worth it. 

    Marijuana as harm reduction has become popular, and is considered safe because there’s no lethal dose. However, for daily users and first-time experimenters alike, marijuana impairs judgment, driving, and learning. Smoking weed and then showing up to meditate or work on the 12 steps is counterproductive.

    Treatment centers that prescribe cannabis generally give participants their dose at night, to make sure that they’re not high during meetings and counseling sessions in the daytime. This isn’t necessary with Suboxone – there’s no roller coaster effect of “high” vs “sober.” I feel no different after taking my daily dose than I do when I wake up in the morning prior to taking it.

    I experience every range of emotion, the same as I would without medication. If life is hard and painful and sad, I can’t go to my Suboxone box and take a big dose to make it all go away. But methadone, marijuana, Vicodin, heroin?…..Escaping life and avoiding pain is exactly what they’re good for.

    Suboxone isn’t a perfect fix by any stretch. Prescriptions can be diverted and sold on the street. Active heroin addicts will sometimes buy it to avoid withdrawal, if they can’t get their drug of choice. That’s an unfortunate fact. But is it the worst- case scenario? Every time a person injects heroin, they’re risking death by overdose or a systemic infection. There’s no guarantee that the substance is what the dealer says it is.

    When an addict buys street Suboxone, they’re taking a safer opiate. They’re protected against agonizing, incapacitating withdrawal, which leaves them helpless for their family or employer. They could even have a few days feeling like their “normal” self; maybe even well enough to join a meeting and consider recovery. I don’t condone or encourage the sale of Suboxone on the street.

    There are increasing safeguards set up by prescribing clinics and pharmacies that make it really difficult for someone to get their hands on another person’s medications. I’m just suggesting that Suboxone on the street isn’t the most dangerous or dreadful thing that can happen. 

    Suboxone does have side effects, and it’s important to mention that not all Suboxone is created equally. Addicts are the ultimate manipulators. Certain pill forms can be crushed and used inappropriately (the safest from is widely considered the film strip which is part buprenorphine/part narcan).

    If an opiate-naïve person (one who has not been abusing either heroin or prescription meds) takes Suboxone, s/he will very likely experience an initial sense of euphoria or sleepiness.  But the same can be said for Benadryl, Nyquil, or prescription nerve pain meds such as Gabapentin. The list of drugs that have potential for abuse is extensive. Recreational use is a separate situation altogether; misusing any medication is completely out of line with recovery.

    Abuse is dependent on motives and intention, not the side effects themselves. Nicotine and caffeine are two highly addictive substances that can be mood altering and cause withdrawal if stopped cold turkey. They’re not only acceptable in recovery, they’re plentiful; Coffee is supplied at meetings in unlimited doses. The use of these doesn’t negate one’s sobriety. 

    Self-improvement, spirituality, and community connection are now my daily foundation. Suboxone doesn’t impede this. It doesn’t change my perception of reality or my ability to be mindfully present. I no longer look for any means to avoid discomfort (ok sometimes I eat brownies or surf social media– we’re all a work in progress!!)

    Using tools I’ve gained from mindfulness and my recovery community, and maintained on a low dose of Suboxone to help keep cravings at bay, I work though challenges with balance and compassion. If I were still getting high, this wouldn’t be possible. 

    Suboxone’s not a magical cure. But it is a safe alternative to other opiates. It’s a solid tool that helps many of us maintain sobriety and the presence of mind to progress in recovery and personal growth. 

    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

  • Clean, Sober And Using Suboxone

    Clean, Sober And Using Suboxone

    Suboxone users deserve a safe space, in and out of the rooms. And we deserve to proudly call ourselves clean and sober.   

    It was pretty apparent when I began taking Vicodin for migraines that I was going to have a problem, but I was too ashamed and afraid to ask for help.

    On the outside, I was a working professional, undergrad student and hands-on mom.

    Beneath the surface I was deteriorating. 

    It wasn’t until my career was in jeopardy and many relationships broken that I finally admitted I was out of control and needed treatment. I learned the hard way: Secrets keep you sick. Addiction grows in the dark. 

    Today, as a nurse in long-term recovery from opiate and alcohol addiction, I’ve made an intentional choice to forgo anonymity and live “Sober Out Loud.” I advocate for everyone in recovery, especially healthcare professionals, using blogging, public speaking, and coaching to do my part to end the stigma.

    My hope is that talking openly will give others the courage to speak up early. That they’ll notice their decline and get help long before their careers and lives are in danger. Choosing to be open about my addiction also supports my healing. I find accountability, connection, and purpose in sharing my experience.

    It wasn’t easy in the beginning – I was terrified of being judged. The opposite has been true – even in the hospital I worked for. Even with colleagues who may have reason to look down on me. I’ve been met with abundant compassion and acceptance. 

    Except I still have one secret. There’s one disquieting fact I haven’t told many people. I’m flooded with fear that I’ll be exiled from the recovery community and excluded from meetings. Petrified that my integrity as a coach and writer will be questioned. And if that’s the case, then what’s my value as a sober advocate?

    There are others who have the same fears, and my silence validates the stigma. Recently, I heard on the radio about a young man who committed suicide. He was tortured by internal conflict; he questioned his sobriety. We share the same secret.

    For that struggling human being, and for everyone else struggling – It’s time for me to be completely open.

    “Hello, my name is Tiffany; I’m an addict and an alcoholic. AND I use Suboxone.”

    This isn’t my opening line when I introduce myself at meetings – nobody has to divulge their prescribed medications to the group, right? The answer’s not so clear if you use Medication Assisted Treatment (MAT).

    On one hand, I feel I shouldn’t have to add a qualifier to the already awkward label I use when attending certain groups. (In the program I regularly go to, we don’t use labels at all, but that’s a subject for another time). On the other hand, it feels like I must add the qualifier, otherwise I’m a fraud. I start spiraling: “Am I allowed to share? What’s my ‘real’ clean date? Can I pick up a chip on my birthday month?”

    In my first month of sobriety, newly on Suboxone, I readily shared at meetings and with a few sober friends. Completely unaware of my disgrace, and totally unprepared for the reactions, I wanted to swallow my words as I was assaulted by:

    “Do you think you’ll be on it long?”

    “You’re going to get off of it soon right?”

    ‘You’re still on an opiate.”

    “You’re still getting high though.”

    “You’re not actually clean yet.”

    “Well you’re definitely not sober. Don’t call yourself sober.”

    “Do what you’re gonna do but don’t talk about it here.”

    “You can’t have a sponsor until you’re done with that.”

    “We all did it without. We didn’t need medication to get clean. You’re obviously not serious – not strong – not determined enough. You haven’t done enough steps. You haven’t gone to enough Meetings.”

    “You’re not sober. Come back when you are.”

    I thought I was sharing success and hope. They asserted I was “cheating the system” and “staying in the game.”

    This inhospitable reception is the reason I’ve stayed silent, the reason I haven’t written about it in my own blog. I found myself avoiding meetings altogether, second-guessing my sobriety; debasing my worth and value in the recovery community. 

    Despite the booming increase in patients using Suboxone, popular opinion – especially in traditional 12-step programs – is that Suboxone treatment and “clean and sober” are mutually exclusive. Regardless of research showing decreased morbidity and mortality of medication-supported patients, and the success addicts are seeing as they put their lives back together, the underlying criticism persists:

    “You’re not CLEAN.” 

    If I’m not “clean” I’m still dirty. If I’m dirty, I must be worthless. And if that’s the case, what’s the point of trying to recover?

    It’s abhorrent that leaders in the recovery community perpetuate the degradation. At a local level, meeting facilitators model this disparaging behavior, despite literature clearly stating that a person’s medication is no one else’s business. (Read The A.A. Member – Medications & Other Drugs).

    Even trusted chemical dependency physicians tout their opinions, adding to the universal disapproval. Dr. Drew Pinsky stated on the podcast “Dopey” episode #124  “I’d rather have them on cannabis.” And though he concedes he’d be open to discussing short-term use with patients to “get them in the door”, he says that Suboxone patients  “replace” other opiates and are merely surviving; that they are “not fully recovered” and “still chronically ill.”

    Still chronically ill? Not fully recovered? In the 3 years since I initiated a Suboxone regimen, I’ve worked tirelessly at making amends. I’ve regained my job as an acute care nurse and clinical instructor in a nursing program. I facilitate Recovery Meetings, and I’ve transformed into a certified Life and Recovery Coach. I’ve repaired relationships with family and friends.  I’m traveling, writing, and above all – finding JOY in living. I’m not an outlier. There’s thousands of us. We’re just not  allowed the safe space to share. 

    MAT is NOT perfect. I’m aware of it’s flaws and have experienced some of them myself. Anyone considering it should carefully review all potential side effects with their physician and trusted, non-biased recovery support. Suboxone causes physical dependence, and there’s severe withdrawal if one quits cold turkey. It is, chemically speaking, an “opiate.”

    Some prescriptions are diverted; I’ve personally cared for patients who admit getting the drug on the street. And with full transparency, I sometimes feel conflicted about using pharmaceuticals to overcome an addiction to pharmaceuticals. I’m not oblivious to the irony. And I strongly assert that any MAT is only truly successful if taken while simultaneously working on recovery of the mind and spirit. 

    But people are dying. We don’t have time to argue over which is the most righteous recovery path.

    After weighing all the pros and cons, searching my soul, and utilizing critical thinking skills I’ve honed in 17 years of working in healthcare, here’s what I’m absolutely sure of:

    Suboxone is right for ME.  I am Clean and Sober. 

    Four years ago I was resigned to being found dead in a bathroom with a needle in my arm. Today, I prove that recovery is possible. I am on a journey toward physical, emotional and mental wellness, and have a quality of life I couldn’t have dreamed up. Suboxone, for now, is a part of my story. As it is for many, in increasing numbers every day.

    Whether I wean off in a month or stay on it forever has no bearing on my credibility.

    It’s likely that someone sitting next to you today in a meeting is on Suboxone. It’s also likely they’re petrified to talk about it, like I was, and might leave the meeting fighting the humiliation of being “unclean.”  

    They might decide that it’s better to go back out and use, since they don’t belong in recovery; or to wean off without a doctor’s supervision, undergoing agonizing withdrawal and back at risk of using street drugs- which is part of my story as well. They might even decide that they don’t belong here – at all. That the only choice is to end their life. 

    What is your role in this? Are you hurting or helping? Consider the language you’re using. Is it pejorative and shame-inducing? Or do you cultivate love and belonging? 

    Those of us in recovery have a responsibility to welcome everyone who is making positive progress towards a sober lifestyle. It’s not our business to take the inventory of someone else’s medication list – it IS our business to eradicate stigma. Offer compassionate acceptance. Keep an open mind. Suboxone users deserve a safe space, in and out of the rooms. And we deserve to proudly call ourselves clean and sober.   

    Next time someone shares with you that they choose to use Suboxone – or any MAT – as part of their journey, don’t criticize. Don’t interrogate or give them a timeline to stop it. Ask how it’s working, and If they’re happy. Ask if they’ve been successful staying off street drugs; if they’ve made strides towards repairing the damage of their past. And when they share with you their clean date, congratulate them on being SOBER. 

    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 reach Tiffany through her blog www.scrubbedcleanrn.com and follow her @scrubbedcleanrn. 

    View the original article at thefix.com