methadone blunts mood swings

Methadone Blunts Mood Swings That Could Trigger Relapse

by recoveryhelpdesk on September 2, 2011 · 0 comments

Methadone moderates emotional responses including elation and depression says a new study reported in the science journal Addiction.

“Easy Does It” is a common recovery mantra.  Emotional stability is especially important for people in early recovery.  Both emotional highs and lows can contribute to relapse.

For people who are addicted to heroin or other opiates, methadone treatment may support recovery by taking the edge off of mood shifts.

Of course, methadone also supports recovery by limiting cravings, preventing withdrawal symptoms and blocking the effects of other opiates.

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Happiness 101: Random Acts of Kindness

by recoveryhelpdesk on July 1, 2011 · 1 comment

You may have heard about the benefits of committing random acts of kindness.  The benefits are very real and very concrete.

This works for people who are currently using, people who are in early recovery, people who are in long term recovery, and family members.  So try it yourself and suggest it to those who are close to you.

Helping others releases endorphins into the brain (a natural good feeling) and reduces stress.  Benefits include improvements in physical health and mental health.  And the benefits have been documented by scientific research.

But did you know that for best results you should commit these acts of kindness on a schedule?

You can get good results by commiting about 5 acts of kindness all during the same day about one day per week.

Acts of kindess can be just about any nice thing you can think of to do for another person.  The idea is to go beyond what is expected and reach out to another person in a way that demonstrates empathy for them by an actual act.  It’s not just about feeling empathy for another person, but going beyond feeling and actually acting on empathy so your empahty is made concrete and visible between you and the other person.

Watching for opportunities to be kind in and of itself can make a powerful change in the way we feel and look at the world.  Actually acting in kind ways has even greater power to change our emotional state and create conditions of happiness.

It’s ok to plan your act of kindness in advance (the idea of random acts of kindess was in response to the often heard phrase “random acts of violence”).

Acting out of the goodness within us benefits us and creates a ripple effect well beyond the person we reach out to with kindness.

I’m going to do 5 random acts of kindness on Mondays.  Pick a Random Act of Kindess Day for yourself and leave a comment on your experience.

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Mom Wonders: Is My Son’s Arrest A Good Thing?

by recoveryhelpdesk on May 1, 2011 · 6 comments

Will your son’s arrest ultimately turn out to be a good thing?  Not likely.

I certainly understand how a mother could feel a sense of relief when her son is arrested.  Even her son may feel a certain sense of relief.

Finally something might actually derail the runaway train.  But what about the train wreck that follows?

For the last 10 years, I’ve run an incarceration-prevention program for people living with opiate dependence.  Our goal is to help people find a path to recovery that does not pass through the jailhouse door.

Not only is it possible to find a path to recovery that does not pass through the jailhouse door, but passing through the jailhouse door reduces your chances of long term recovery success.

Sure, arrest and the threat of incarceration can result in a new focus on the need for change, and provide motivation for change.  But this particular path to focus and motivation risks some devastating side effects.

There are other ways to elicit focus on the need for change and build motivation for change.  Ways that are more effective over the long term and less harmful.

I fear that as a society we are too ready to use the cudgel of coerced treatment.  We’ve talked ourselves into believing that incarceration is a therapeutic response to addiction.  But the many-forked path through the criminal justice system often leads every which way but stable, long-term recovery.

I think we would be smart to be wary of a system of coerced treatment for addiction through the threat of incarceration –just as we would be wary of a system of coerced treatment for any other health issue with a behavioral component such as obesity, smoking, diabetes or heart disease.

I think we should recognize and be wary of the “enablers” of this system:

1.  Desperate parents, families and communities;

2.  Lazy and unskilled treatment providers who bottom feed on coerced treatment;

3.  Politicians who get more political mileage out of putting money into the criminal justice system instead of the drug treatment system; and

4.  Unjustified stigma against drug users that grants social permission to incarcerate rather than provide effective treatment.

I feel no sense of relief when a client is arrested.  I recognize that the job of helping that person build a safe and sustainable recovery just got a lot harder.

“I’m never coming back here again.”

“I’m never going to use again.”

“Getting arrested saved my life, if I wasn’t here I’d be dead by now.”

I hear these statements often from clients I visit in jail.  I recognize the sincerity behind the statements.  After many years of experience, I also recognize that these kinds of sincere statements are often not only not actually accurate, but almost the opposite of the reality of the situation.

Once in jail, more likely to be back in jail again.

Once in jail, less likely to be able to achieve the conditions of stability necessary to achieve long term recovery.

Incarceration is more likely to put a life at risk.  Getting effective treatment would have been more likely to save a life.

Getting sucked into the criminal justice system most often delays recovery, complicates recovery and destabilizes recovery.  Most people don’t get treatment in jail, and don’t get linked to treatment after release from jail.  Instead, statistics show that a large percentage of fatal overdoses happen right after release from incarceration.

There is a basic human impulse to try to make sense of bad experiences by finding the good that might give the experience a positive meaning.  We do this with war, serious illness, and even the tragic death of a loved one.  It’s a healthy coping mechanism.

It’s healthy to focus on the good.  It’s healthy to take the bad things that happen to us and weave them into our personal narratives in way that gives them positive and hopeful meaning.  But as a society, it’s more healthy to recognize that bad things are bad.

Incarceration as a solution to addiction is BAD.

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Tough Love Addict

Tough Love Delays Recovery For Heroin Addicts

by recoveryhelpdesk on April 1, 2011 · 6 comments

Tough love delays recovery for people living with addiction to heroin or prescription pain killers like Vicodin or OxyContin.

Tough Love Defined

Tough love is a term used to describe dysfunctional behaviors by parents that are intended to help the addicted son or daughter, but instead cause harm by perpetuating the addiction.

I realize that this is not the standard definition of tough love.  In fact, it is the standard definition of enabling.

The term enabling is often used to describe dysfunctional behaviors by parents that are intended to help the addicted son or daughter, but instead cause harm by perpetuating the addiction.

The Problem

Tough love is sold to parents as the antidote to enabling.  But all too often, tough love behaviors are more destructive than the behaviors they replaced.  They increase the risk of harm to the addicted love one, delay recovery and perpetuate the addiction.

Parents are often torn in two directions between the polar extremes of “enabling” and “tough love.”  They cycle between the two extremes in an agony of confusion, painful emotions and good intentions gone awry.

More Problems

  • Tough love is not effective
  • Tough love is often adopted in the context of feelings of anger, frustration, confusion and desperation
  • Tough love is often applied in a rigid, black and white manner that negates the need to recognize and accept responsibility for the consequences of our own actions, or even exercise basic common sense
  • Tough love behaviors are often inconsistently applied
  • Tough love behaviors are often motivated by the parent’s own legitimate personal need to set appropriate boundaries, but mis-labeled as tough love for the addict
  • Tough love behaviors deprive the struggling addict of an important source of appropriate support
  • Tough love behaviors fail to address real barriers to recovery (and call it a virtue) and instead impose new barriers to recovery
  • Tough love “theory” implies that parents have caused or perpetuated their child’s addiction by “enabling” and so must remedy the harm they have caused through tough love

Even More Problems

  • Tough love is not necessary to create the conditions needed for recovery
  • Tough love is not enough to create the conditions needed for recovery
  • Tough love makes it harder to create the conditions necessary for recovery
  • Tough love perpetuates barriers to recovery (and often even creates new barriers to recovery), and then blames the addict for not changing
  • Tough love shames and blames parents who take reasonable steps to keep their loved one safe and promote the stability necessary for recovery
  • Tough love is a blunt instrument used to try to club an addict into change–and it is handed to parents in place of more sophisticated recovery tools that are more effective, less risky and less harmful
  • Tough love counsels parents to withhold conditions of safety and promote (or at least permit) conditions of unnecessary risk
  • Tough love doesn’t work!  Tough love does not result in recovery
  • Tough love delays recovery

My Suggestion

My suggestion is that parents move away from the black and white thinking that much of recovery folklore seeks to impose on them.

My suggestion is that parents avoid the polar extremes of both enabling and tough love, and instead adopt moderate behaviors based on both reasonable personal boundaries and common sense recovery supports for their addicted love one.

p.s.

I’ve outlined the problem and suggested a solution.  But we can explore some concrete examples in the comments, if you like.

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suboxone treatment

Suboxone Treatment Cuts Crime, Incarceration

by recoveryhelpdesk on March 16, 2011 · 2 comments

Suboxone is incarceration prevention in a bottle.

A wonderful “side effect” of Suboxone treatment is that it helps keep people out of trouble and out of jail.

Suboxone treatment is associated with big drops in criminal activity and incarceration, a recent study shows.

Only 2 percent of opiate-dependent people treated with Suboxone reported committing crimes as compared to 19 percent of those who are untreated.

Only 1 percent of opiate-dependent people treated with Suboxone reported having contact with the criminal justice system as compared to 16 percent of those who are not in treatment.

The study analyzed data from a randomized clinical trial of 166 opiate-dependent people, and was conducted in a primary care clinic.  Opiates include heroin and prescription pain killers like Oxycontin.  The study was reported at the Annual Meeting of the Society of Internal Medicine.

These results don’t surprise me.  They are very much in line with what I observe working as a counselor with opiate-dependent clients.

People who are addicted to opiates often feel driven to commit crimes that they do not want to commit.  And the consequences are devastating.

Years of youth, young adulthood and adulthood are often lost to incarceration.  Marriages end and families are broken apart.  Inmates often experience violence.  Incarcerated people in need of mental health and drug treatment rarely get the care they need.  And medical care is often of poor quality.

I don’t share the cavalier attitude of many in the tough love crowd who view incarceration as a good thing.

After working with hundreds of opiate-dependent inmates and former inmates, I have concluded that:

  • Incarceration can result in serious and permanent harm
  • Incarceration is not necessary to recovery, and other options are both more effective and less risky
  • Incarceration is not treatment and is not effective in building long term recovery
  • Incarceration delays recovery
  • Cycling in and out of jail is destabilizing and makes achieving the stability necessary for long term recovery more difficult
  • Incarcerating people living with addiction instead of offering them a realistic path to recovery including effective treatment is immoral

I have seen how Suboxone treatment drastically reduces criminal activity and incarceration.  This is of great benefit to our communities both because there are fewer victims of crime, and because incarcerating people is very expensive (in my state it costs about $50,000 per person per year).  But also important is the benefit to those who are living with opiate addiction, their children and other family members.

Since Suboxone treatment helps cut crime and risk of incarceration, Suboxone treatment may be especially useful for those who are:

  • committing crimes
  • on probation or parole
  • in drug court

It often makes sense for Suboxone patients who are on probation/parole or enrolled in drug court to continue with medication-assisted treatment at least until they are no longer under the supervision of the criminal justice system.

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