Addiction

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What does it mean to be vulnerable?

Being Vulnerable in Recovery

If you come to treatment or you are coming to recovery, one word you will definitely hear is vulnerability. The importance of being vulnerable in the therapeutic relationship–particularly in treatment–is something you might hear from a spouse as well. 

 

On the one hand, I think it is a word a lot of people have heard–definitely in California. On the other hand, it is a word that is often misunderstood. I think the way people automatically take the idea of being more vulnerable is allowing people to see and feel a certain domain of my emotional life, allowing people to see my sensitivity, allowing people to see my compassion, allowing people to see my sadness. It is what we think about when we hear the word vulnerability.

 

What is Vulnerability?

One definition I like that a friend of mine–Mordecai Finley–uses is: vulnerability actually is not about letting people see your softer emotions, it is allowing yourself to affect and be affected by other people. 

 

Vulnerability is on some level a certain amount of emotional openness that is not appropriate for every area of your life. For instance, when I am walking into Wells Fargo going cash a check, there is just no need for me to be vulnerable. 

 

Why is it Important to be Vulnerable?

 

In my home life with my wife, with my children, in a therapeutic process, in a transformational process, in an intimate moment with a friend or lover–in those moments being able to allow what is going on with that person to affect me. Often we will call that empathy, and also knowing that I am affecting another person.

 

That interpersonal exchange, that is the essence of what vulnerability is about. I think it is important–not just for a recovery process–but I do not think you can have a healthy life or healthy meaningful relationships without vulnerability. 

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Transparency in Treatment: What Does it Mean?

When you are entering into recovery there are a few terms or words, ideas that you will hear over and over again. And they are outlining the contours of the space we are inhabiting when we are working on ourselves to transform–when we are engaging in recovery, when we are looking at optimal well-being. 

 

Transparency in Treatment

In treatment in particular, one of the terms that they will use is “transparency”. And I will talk about the value of therapeutic transparency. What they mean when they say that is being able to talk about what is happening internally. 

 

First of all–this piece is really crucial–be clear. Understand what is happening inside of yourself. When you understand what is happening inside of yourself and being able to articulate it out loud so that you can be supportable or get the kind of support you need. 

 

Transparency as a Metaphor

They use transparency, obviously, as a metaphor. Meaning make yourself see through, so that I can understand what is going on, so I can come in and help you. 

 

I mean, on the one hand, that is an essential and completely valuable way of approaching transformation especially with outside support. On the other hand, you cannot take it completely literally, because we all actually have a right to privacy. 

 

What does Transparency Really Mean?

Really what we mean when we say “be transparent”, is share about the important therapeutic processes and things I need to know, the information that I need to help you. But those things that are private, that you are not comfortable sharing, or that maybe do not fit in this domain that you are working on, you can keep those to yourself.

 

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Medication Assisted Treatment

Medication assisted treatment (including Suboxone and vivitrol)

 

Medication-assisted treatment (MAT) is using pharmaceutical medications, prescribed medications to help treat active addiction. 

 

It’s different than just the psychiatric medication that you use to treat underlying conditions of depression and anxiety. MAT treatment is a specific classification of drugs that are used to affect the addiction directly. And so there are agonists and antagonists drugs that provide an effect similar to the drug you were using, but allow you to be more functional and reduce the harm around the habit. You don’t break the habit you use something that’s like a derivative of that substance that would be like subtext for opiates or methadone. 

 

It’s a similar molecular structure and has similar effects but you can manage it better and you don’t deal with all of the negative repercussions or most of the negative repercussions of using heroin. 

 

Then there are the blockers that stop the effect or deter people from using certain substances and abuse of a trial. That’s that classes of drugs. And basically, that’s it’s come into treatment in recovery very strong.

 

It started with methadone a few decades ago, and then Suboxone a couple decades ago has become very popular. 

 

And it’s understandable. Basically, we’ve been in the midst of a pretty serious opiate epidemic and people are dying. You have city officials, county officials, government officials, parents, loved ones and society as a whole having a conversation about what we do about this. 

 

There are lots of research studies that show that people have a better chance of achieving recovery if they use medication-assisted treatment. 

 

Those studies are complex and I want to get too into that. They’re complicated questions to ask about those studies and their different opinions. It’s not univocal, and everybody has the same opinion. But I want to look at it in general. So what’s going on here? How do we think about this? 

 

You deal with different perspectives on MAT.

 

So if I’m a government official, and there are thousands of people dying in my district, or in my state, or in my city. I’m thinking, “How do I stop people from dying?” I’m gonna take 100 million dollars, and I’m going to put it into what statistically is the most beneficial thing, medication-assisted treatment, people have to stop dying. And it’s really all the government can do.

 

The government can’t assign an individual therapist, a psychiatrist, long term treatment, isolate people on an island, the government doesn’t have the ability to do nuanced individualized care. 

 

For each and every person who suffers from addiction, the government can’t assign treatment to even 5% of the people who need it. 

 

So I think, how do we stop an epidemic?  On that level, it makes perfect sense and I get it. On the individual level, it’s much more complex. I’ll give an easy example. If somebody is a poly substance abuser, let’s say somebody is 23 years old, they use and this is not uncommon. opiates or methamphetamine or cocaine or alcohol or marijuana. 

 

That’s a lot of young people, they use all kinds of stuff, whatever they get their hands on. They also lack discipline, and they lack a lot of structure and maturity. So they actually don’t know how to do basic things like make their bed. That’s something like 60% of the population and people in treatment right now. They don’t know how to live well. 

One of the things I’ve concerned about with Suboxone is the difficulty in getting off of Suboxone.

 

If you go look up, get off of Suboxone and go read the personal forums. You will see how incredibly hard it is. It’s kind of scary. It takes about 45 days, let’s say you’ve been on Suboxone and you started at a 12-milligram dosage, which is normal. And you’ve gotten all the way down to one milligram after three years. 

 

Then you decide, this is getting in the way of my growth, my psychological well being, and I don’t want to be dependent on this anymore. It’s been years. I’ve seen people want to get off one milligram of Suboxone, that it was a 45-day taper meaning take a little tiny bit just less than one milligram, little less over 45 days, and then another month without the substance to get through we call the acute and then sub-acute detox phases. 

 

Then you’re no longer having the physiological symptoms, but you’ve got months and sometimes even a year to deal with the underlying issues and depression that comes up after having been on this substance for so long. 

 

I’m really concerned about putting thousands or hundreds of thousands or millions of people on Suboxone medication over long periods of time. 

 

What that looks like if there are negative psychological effects down the road. I don’t think we know. Some experts say to never take people off Suboxone. Once they’re on for two or three years. You leave them on it forever. But there’s nobody that’s been on Suboxone for 50 years. It hasn’t been around that long. We don’t know what that means and what that looks like. We still use Suboxone individually. 

 

It’s up to the treatment providers to figure out how to effectively administer Suboxone in smart ways.

 

Then to compile that data and share it with the rest of the community.  

 

Vivitrol is another option. 

 

I’m a huge fan of Vivitrol, Vivitrol is a blocker, and what Vivitrol does is two things, it stops you from being able to get high immediately from opiates. You can do it in an injectable form, which is a little frightening, but it lasts a month. 

 

On the one hand, it physically stops you from being able to do your substance of choice. On the other hand, it’s psychologically really helpful if I’m obsessive, but I know I can’t get high. And I’m willing to get into recovery, it’s a great message to send to myself. You could do Vivitrol with very little side effects for a year and a half, or six months.

 

Even with Vivitrol, we don’t know the long term psychological effects.

 

It’s been around 20 years, but they’re not great research and study on this stuff. And everybody’s very different with how they respond to the medication. I’m in favor, in general, of anything that helps people recover and get better, and of course, in favor of people not dying. But we also have to weigh these different claims. And figure out how we use medications in a way that’s effective for individual situations. That’s not an easy task. It’s going to be everybody working together and having conversations like this about medication-assisted treatment.

 

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The Need to Control and Addiction

One of the common things that I come across with people that are trying to recover. So I sort of look at more universal elements that mean the thing about addiction, is it’s not really appropriate, it’s not accurate. To say… oh addicts do this, addicts do that. Because there’s a huge amount of personality, and… diversity, in the addicted population. Right? I mean, people– people are not the same, at all.

One of the things you want to understand is what are the characteristics, that you do seem to cross boundaries.

 

you can say, okay, those– these would definitely want to get to, and I’ve talked about in another piece, around people-pleasing which I see you know, something like 75%, of people over accommodated people-please. And they don’t have healthy boundaries and they don’t know how to assert themselves, to create a sense of self in their lives.

The other thing I see is issues around control.

 

 Human beings in general, addicts in particular, are people suffering from addiction, in particular, tend to be control freaks. And there are lots of ways that– that manifests.

Somebody who’s a control freak isn’t necessarily an overt control freak. 

 

Like if I look at myself, and I say, what are the ways that I defended against the world and attempted to predict and control outcomes so that I could feel safe? I was– I was never overtly controlling. As you can imagine, I did it with words… and rationale. Right, if you hear me speak… my biggest defense mechanism, the way to keep people away from me, was to understand what was happening around me, try to be predictive and to use a language, as a barrier.

I could hypnotize people with my speech, that was one of the ways that I maintain control. 

 

It’s why for me, it took me a long time to figure out how to do individual therapy, talk therapy because I’m good with words. And so I can… talk and talk and talk and talk and I’m not necess– you know, once I had worked on a lot of the shame, I can even talk about the issues but it wasn’t having a transformative impact.

The talk therapy, group therapy was really good for me. 

 

Group therapy I had so many eyes on me, that I couldn’t control… each person, because I got some you’re looking at me over here, and over here and this and it was too much. And so it made me more vulnerable, which is what I’m trying to do and try to let go of control.

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Boundaries, Assertiveness, and the Right to Say “NO”

 

In Recovery you need to have boundaries, assertiveness, and use your right to say “NO”

 

Usually, people don’t want to be in a relationship because they don’t want to be with that person anymore. The question that the party asks that is being broken up with is usually, Why? But they don’t mean it. Because nine times out of 10 there’s only one answer because I don’t want to be with you anymore. 

 

 

Human beings are naturally kind of narcissistic. 

 

So somebody breaks up with me, and I love them, and they don’t love me that I don’t understand. But I do understand because there are people who have loved me who I didn’t love in the same way. So I get that, right? We have all of these complicated interactions that require a lot of clarity, about what my rights are. And when I do that, it’s sort of like cleaning my room. 

 

 

People that can’t handle boundaries, are going to leave your life relatively quickly. 

 

You’re going to attract people that have good boundaries, and so, your whole life system changes real quickly when you begin to do that. It’s hard work and it’s uncomfortable.

I usually start back when people smoke before they vape I used to start with people with cigarettes because there’s a whole game of cigarettes and everybody smokes. And a lot of them don’t have any money. So ever got the cigarettes, it’s like, you know? if it’s not Newport’s. Now, they’ll come up to you and be like, “Oh man, can I bump a cigarette.” you know, and it’s like, eventually, like, Oh, my God, I’m giving away all my cigarettes, you know, what do I do? So you start making excuses. You know, so people come down and say, “Look, I get a cigarette.” and you say, “It was my last one.” And that’s the common responsible distributed rehab. 

 

 

If you don’t want to, you don’t want just say no, right? 

 

You say, “Oh, it’s my last one. I left the box in my room.” you know, I’m not going to go up to get it, right. One of the things that I have people practice with cigarettes and things like this are plenty of examples, is say no without qualification. And if they keep harassing you about it, ask them if, if you have round heel the right to say no. 

 

 

If you want to learn how to be a little more authentic and assertive, be honest with people.

 

If somebody wants something from you, and you don’t want to give it to them, and you can’t justify giving it to them, except for that you feel bad. That’s not a good reason to give somebody something most of the time, you know unless it’s saving their life or they’re hungry or something like this. 

 

 

So basically, it’s training people how to be authentic

 

I don’t want to do this. I don’t want to hang out with you. And training people how to say that. No, I’m not going to give you a cigarette. Why is your last one? No, it’s not my last one. So why aren’t you giving me a cigarette? Well, hang on before we go down this road of why I’m not giving you a cigarette. Can we agree, that I have the right to say no to you about it? If they say yes, that’s the end of the conversation, you say Oh, great, then we don’t need to discuss this other thing because you just get that I have the right to say no. If they say no, my direction will be just Walk away. If somebody doesn’t think you have the right to say no in a relationship, I would just walk away 

 

 

A great part of recovery is when you start drawing those boundaries and being respectfully assertive in your life, and seeing what it does for your life.

 

A little territorial about how much of yourself your going to give, you suddenly start to get clear about who you are when you stop and start then you begin to have a sense of self, then you begin to have a moral code you made to feel good about yourself and you attract people around kind of people you want to hang out with, that also know how to say yes or no and appropriate wise. Next thing you know you got a different life.

 

 

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The Role of People-Pleasing and Codependency in Addiction 

The Role of People-Pleasing and Codependency in Addiction 

 

When you’re working with people that are in early recovery, they suffer from the same kind of orientations and disorders that exist in the culture at large, just usually in a more extreme way. 

 

Over accommodation or people-pleasing

So one of the things that come across a lot is what we call over accommodation or people-pleasing, and it means sort of overextending the boundaries of myself in a way that causes me a deficit for the sake of the other, you know, psychologically call that kind of co-dependence, it’s on that spectrum. And it’s a really big deal.

 

 “A lot of people that you find coming into recovery have felt that they’ve been living for the world and they don’t really get theirs. And so there’s becomes using drug and alcohol.” 

 

Straightening out what your boundaries are 

You know, the metaphor for me is like, okay, I do everything I’m supposed to do. I mean, the world asks of me during the day and at night, I hide in the closet and drink vodka and smoke meth, you know, or whatever it is, that’s for me, the rest of its for the world because the world’s been demanding on me since I was born. You can think about that dynamic. And so one of the things that needs to happen in treatment is you have to straighten that out.  

 

You have to help people become more assertive. 

Assertive is a tricky word. I don’t mean asserting your will on others. But I mean, being clear about what your boundaries are, and being clear about how to draw those boundaries in a way that’s effective in your life. So if you’ve been people-pleasing for a long time, you have to get clear about how to assert boundaries. And you have to be clear about what your rights are and asserting those boundaries. So where people are confused, is they’re confused about where their rights stop and start in the interpersonal reactions. I’ll give interactions. 

 

When I was working in treatment

I remember I walked into a lobby, and there was a woman who I liked quite a bit, who was working there. And she said, “Hey, I sent you a Facebook friend request. Did you get it?” And I said, “Yeah, I got it. I saw that friend request.” And she said, “Well, are you going to friend me?” And I said, “No, I’m not going to accept your friend request.” And she gives me this look like you know, she’s offended. And she says, “Why not?” And I said, “Well, I don’t, you know, I don’t want to.” And she said, “Well, my roommate, who you know, she sent you a Facebook friend request, and you accepted that friend request.” And I said, “Yes, I did.” And what did she say? She said, “Why didn’t you accept my Facebook request?”

 

And you should know this a teaching from my mentor. When somebody says “why” to you and interpersonal reaction. They don’t really mean it. They don’t want to understand it. It’s really a complaint. Right? And so you go, is that a question or a complaint that “why”. I need to clarify that. But in that circumstance, I said, “Can I ask you a question?” She said, “Yeah.” And I said, “Do I have the right to decide who my Facebook friends are?” She said, “Yes.” I said, “Okay, good. We’re clear.” 

 

Let me ask you another question. “Were you ever married?” She said, “Yes”. I said “Did you have a wedding?” She said “Yes.” I said, “Did you invite some people to your wedding?” She said, “Yes.” I said, “Were there other people you didn’t invite?” “So the other people I didn’t invite?”. “And did you ever have somebody who didn’t invite to your wedding come up to you after the wedding?” And say, “Why didn’t you invite me to your wedding?” And she said, “In fact, I did.” And I said “What did that feel like?” She said, “It didn’t feel good.” I said, “Great. Now you understand this interaction. Right?”

 

And now I’m being a little bit you know, humorous or whatever. But it’s an example of how we get confused in our boundaries of what we’re obligated to do. Where do my obligations stop and start? If I’m in a relationship with somebody, and I don’t want to be with them anymore, which is usually why people break up out of relationships, right? 

 

Usually people don’t want to be in a relationship because they don’t want to be with that person anymore. 

The question that the party asks that is being broken up with is usually “why”, but they don’t mean it. Because nine times out of ten there’s only one answer, “Because I don’t want to be with you anymore.” Obviously, on the other end, that’s hard for you to understand because human beings are naturally kind of narcissistic. And so somebody breaks up with me and I love them and they don’t love me that I don’t understand. But I do understand because there are people who have loved me who I didn’t love in the same way.

 

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The Moral Aspects of Treatment

Remove the Moral Aspects of Addiction Treatment?

 

I talk a lot about the moral aspects of treatment and I am very resistant to removing morality from the conversation about addiction and recovery. I understand why people want to do that. It’s to bring down the stigma to address the confusion around the free will issues, for it to be covered by insurance, I agree with all that. I agree with the reasons. My hesitation is that there is a huge moral component to addiction and recovery, and let’s talk about what that looks like in recovery.

 

In recovery, the moments where we gain the most growth are the same moments where we gain the most growth in life.

 

One of the most pivotal moments of growth in my life, there are moments when I’m in a moral conflict and I’m not sure what to do. What is the right thing to do in this moment? If I’m in a marriage and I don’t know if this marriage is working and I have kids and I’m trying to figure out– I’m- some of them in this world conflict, what is the right thing for me to do? If I’m tempted to go into a career largely for money, but it’s not my passion, I’m in a moral conflict what is the right thing for me to do.

 

The most serious conflicts in our life are these moral conflicts with competing claims on each end.

 

The reason why I’m hesitant to remove that from the conversation is, it is the moral conflicts that induce inhuman beings the most important parts of ourselves. In order for me to wrestle with a moral conflict, I have to draw on all of these different parts of who I am and my personality. Right?

 

So a common conflict and treatment that happens is, my roommate snuck out and got drunk and I know. My roommate comes back and says, “Don’t tell anybody,” and suddenly there’s a couple of things happening.

 

One, I am asked to keep a secret. And in general, secrets, those kinds of secrets are not the healthiest things to keep inside of us.

 

Number two, I’m in this interesting quandary around loyalty to my friend, but on the other end I’m in an interesting quandary about being honest with the people that are helping me: counselors, therapists, the community at large and treatments. I have these competing claims. I also have me. I don’t want to be walking around with lies in myself. I don’t want my friend to get in trouble, which is a normal thing, but I don’t wanna be dishonest, and suddenly I’m in the midst of a moral conflict.

 

What somebody does in a predicament can be the make or break moment in somebody’s treatment experience.

 

When somebody can say, “Hey, you put me in a really bad position by asking me to keep your secret because you act it out and I’m not willing to co-sign that with you, and it wasn’t okay, and you need to go work this out because you’ve put me in a bad situation. You’ve put you in a bad situation. You’re an alcoholic who allegedly is here to get sober. I get that you don’t do this thing perfectly but you need to straighten this out,” right? That’s a high level response. That’s not the government’s fault, but imagine if somebody is used to cosigning everybody’s everything all the time in life, they’ve engaged in a program of recovery. They strike them, they built what we call a moral core, some center about what the right thing to do is. They’re challenged, they’re in the middle. They’re stuck there in the hallway. They don’t know whether to go left, whether to go right. Right? Suddenly it’s like, okay, and they have that conversation. You know what that does for me. That’s everything. That’s the turning point for people’s recovery.

 

The moment when you have the difficult conversation with your parents or your loved one that you’ve never had, we build that moral core.

 

Begin to put yourself in the equation. That’s where we get the most growth. Not only do we get that growth morally, we also get it psychologically. We are moral psychological beings that come hand-in-hand. Right? To be– if you meet somebody who’s evil, which is a moral term whether you believe in evil or not, but behaves in evil ways depending on their level of narcissism and the way in which they act out, you would have a difficult time saying, “Well, that person is mentally healthy. They’re just evil.” Right? In general, those things come together. Right?

 

So, you know, to use the extreme example. Adolf Hitler was not only evil. There’s such a thing exists. He was also mentally ill and a methamphetamine addict. Those things come together. So our moral behavior in our psychological wellness, they’re integrated with each other. We have to understand that. So we cannot remove morality from the equation of recovery addiction. We have to figure out how we incorporate that in the conversation about well-being, psychological well-being, spiritual well-being, etc.

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Medication Assisted Treatment for Substance Abuse

Overcoming addiction isn’t easy. Those struggling with addiction often require a comprehensive approach addressing substance abuse and underlying causes.  Addiction professionals use a variety of tools and evidence-based treatments to guide an individual towards a successful recovery.

 

Counseling and behavioral therapy can be effective for addressing underlying issues and triggers. Also, developing a strong support network is crucial for helping an individual through hard times and preventing relapse.

 

Can medications help with addiction? 

 

Evidence says medications can be extremely helpful for some types of substance use disorders.

 

Medication assisted treatment (MAT) is one of the many tools addiction professionals may use to help those with chronic and/or severe addiction. MAT can save lives and help get individuals focused on their recovery.

 

Addiction is a disease affecting the brain and body. Without proper treatment, it only gets worse–destroying relationships, families, careers, physical & mental health, and life itself.  Those diagnosed with cancer or diabetes wouldn’t think twice about taking medications to treat their conditions. Why should treating addiction be any different?   

 

It shouldn’t. In fact, agencies like the American Academy of Addiction Psychiatry, The National Institute on Drug Abuse, and the Centers for Disease Control all recommend MAT as a first line treatment for opioid and other substance use disorders. 

 

What is Medication Assisted Treatment?

 

Medication assisted treatment (MAT) uses a combination of behavioral therapy and FDA-approved medications in the treatment process. Studies have shown MAT is effective in helping those struggling with opioid, alcohol, and other addictions.

 

MAT helps to relieve withdrawal symptoms and psychological cravings. These medications also help to safely restore chemical imbalances caused by substance abuse. 

 

But isn’t that just substituting one drug for another?

 

This is a common misconception of medication assisted treatment. As you probably know, substance abuse can destroy your physical, mental, and emotional health. The medications used to treat opioid and other addictions are provided at safe doses that do not affect a person’s mental, physical, and daily functioning. 

 

In short: MAT replaces drugs that can destroy your life–and kill you–with safer medications that ultimately help you.  

 

MAT gives those struggling with opioid or alcohol addiction a chance to release the suffocating hold these substances create. Combining MAT with behavioral therapy allows a person to refocus on a life that is free from the dangerous substances taking control of the body and mind.  

 

Doctors prescribing these medications closely monitor individuals to ensure they are given safe, therapeutic doses.

 

What Medications are Used for MAT?

 

For those struggling with addiction to opioids like heroin, oxycodone, codeine, morphine and hydrocodone, the following drugs may be used in different situations:

  • Methadone
  • Buprenorphine
  • Naltrexone
  • Naloxone 

 

Drugs like methadone and buprenorphine activate opioid receptors to help suppress cravings. Naltrexone, on the other hand, blocks the sedative and euphoric effects of opioids. In fact, naltrexone prevents a person from getting that “high” feeling from opioids or even alcohol.

 

Naloxone (Narcon) serves a different purpose. It rapidly reverses the effects of an opioid overdose. It’s been used by first responders, police, and addiction professionals to save lives of those overdosing on opioids. 

 

MAT may also help those with alcohol addiction by using:

 

  • Acamprosate
  • Naltrexone
  • Disulfiram

 

Acamprosate, for example, helps to restore the disrupted changes in the brain caused by chronic alcohol abuse. This safe, well-tolerated drug has been used to treat over 1.5 million patients throughout the world. In fact, acamprosate is safe even when a person suffers a brief relapse. 

 

As with any drug, you want to make sure the doctor reviews your complete medical history and current medications. Discuss any potential side effects and risks of using MAT drugs. Also, be sure to consult with your doctor or treatment team before stopping any medications.

 

Medications used to treat addiction are not “magic bullets” that quickly make your addiction go away. You still have to do the personal work to address causes, triggers, and moving forward. MAT does, however, provide an opportunity to counteract some of the physical and neurobiological effects of abstaining from your drug of choice.

 

What are the Benefits of Medication Assisted Treatment?

 

As a part of a holistic drug treatment program, MAT medications are safe, cost effective ways to help manage addiction. They can also:

  • Reduce the risk of potentially fatal overdoses
  • Keep you engaged in treatment
  • Reduce cravings
  • Help stabilize your mood and emotions
  • Prevent engaging in dangerous or criminal behavior
  • Help with your social and occupational functioning
  • Reduce risk of contracting HIV or hepatitis C due to unsafe needle use
  • Improve birth outcomes among pregnant women with substance use disorders

 

Common Medication Assisted Treatment Myths

 

MAT research and data proves better outcomes and significant reductions in relapse. Still, some individuals–and even practitioners–are reluctant to embrace MAT.

 

But why?

 

For some, they may not have the correct information. Others may feel completely abstaining from any drugs is the best method of recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) states that MAT is “greatly undersused.”

 

We already talked about why medication assisted treatment is more than replacing one drug for another. Here are a few other MAT myths that need to be debunked:

  • MAT only provides short term results. Individuals using MAT for up to 2 years have the greatest rates of long-term success.
  • MAT is only for those with a chronic, severe substance use disorder. MAT uses a variety of medications that can be modified to fit the unique needs of most patients–especially those struggling with opioids.
  • MAT makes overdose more likely. MAT helps to prevent overdoses. Once someone detoxes from opioids, even one brief relapse can cause a fatal overdose. MAT helps reduce cravings and gives those struggling with opioids a safer alternative.
  • MAT keeps a person from experiencing a full recovery. MAT allows a person to function better and enjoy a better quality of life so they can focus on the personal issues contributing to their addictive behaviors.

 

Is Medication Assisted Treatment Right for You?   

 

Looking for addiction treatment in a values-based program that emphasizes dignity, respect, and compassion? Recover Integrity gives men dealing with life-threatening addiction a chance to refocus and recenter their lives on what is truly important.

 

When appropriate, Recover Integrity uses the latest, evidence-based medication assisted treatment as part of their holistic recovery program

 

Tried 30-day programs with little or no success? Our exclusive, extended care addiction treatment for men offers an opportunity to comfortably address your issues and move past the dark tunnel of addiction.

 

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Do You Need to Dumb it Down in Treatment?

Do You Need to Dumb it Down in Treatment? 

 

One of the things that’s common in some therapeutic communities, when it comes to recovery is telling people to dump it down. And I understand what they mean, but I don’t like it. Because I like to think.

If you learn to reason well, which is not about coming to the conclusion that I had before I started reasoning, that you’re actually trying to figure out the truth of the situation. That has been an incredible asset.

 

 

Recovery is cognitive

 

In my recovery, in many ways, a lot of my recovery was cognitive. It was an intellectual endeavor. I was trying to reason whether or not this made sense to do. Now reason alone won’t do it. 

I have to have some foundation, some axiom there. And my axioms are to live is better than to die and to be healthy is better than to be sick. I don’t know why that is. I can’t tell you why that is. It’s a choice that I make. It’s the foundation for the rest of my reasoning. 

Once I start there I could build up reasons to get clean, that makes sense to me, reasons to do things I don’t want to do, reasons that I can transcend my ego desires. 

A part of what I do when I work with people, is I try to harness that.

 

If you ask questions, and you’d like to learn, instead of telling people like, “Hey, dump it down. Don’t think. Just show up.” 

 

You can actually harness that asset that people have and use it.

Now, the reason why people don’t like it is because people have the capacity to reason their way into what they want. But just means you’re not reasoning, good enough, well enough. It doesn’t mean don’t use your reason. It means use your reason better. Right? And that’s a huge part of recovery.

 

If you know, I need to make reasonable decisions to have a healthy life and if I don’t know how to think well, I can’t do it and there are techniques and ways to think well. 

They don’t teach you that in school. You memorize a lot of facts in order to figure out how am I supposed to be in my relationship with this person when I’m in a moral conflict between using drugs and my parents, you know, coming into town next weekend. How do I weigh those competing claims and come to a decision, you know. We don’t teach people how to do that, but we can. 

 

 

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“When I’m High, I Really Want to Be Sober”

Addiction hijacks- let’s call it semi-rational thought, as a way to justify ego desires. 

 

The simplest way to put this is to tell a story. 

 

I remember working with a client, and he was about a week sober, had gotten out of detox from opioids. He was a week sober and he was still in some obsession to use heroin. And he very earnestly approached me as a counselor at the time. That’s probably 10 years ago.

 

He said, “Can I talk to you for a little bit?” I said, “Sure.” We went back in my office, and he said, “I’m craving. I really want to use heroin, you know, will you help me?” 

I said, “Well, tell me what your plan is. How are you– let’s lay it out. How are you going to go use heroin?” 

He said, “Well, I go to Inglewood. I’m going to get some heroin.” I said, “Slow down. Do you have any money on you right now?” He said, “Yeah, I got 10 bucks.” “Well, first of all, give me that 10 bucks.” I took that 10 bucks. 

Then I said, “So, how are you going to get ahold of your dealer?” And he said, “I’m going to call him.” I said, “Do you have a cell phone?” He said, “No. You like picked up on my game, right?” And I said, “Okay, well now, if you don’t have a cell phone, how are you going to call dealer?” 

He said, “We go to the gas station, and I’m going to call him.” I said, “But you don’t have any money.” He said, “Well, panhandle and then I’ll call my drug dealer.” 

I said, “Okay. So, we’re going to walk to the gas station on the corner over there. You’re going to call your drug dealer. He’s going to come drop it off.”

He said, “No. My dealer doesn’t deliver. I got to go to Inglewood. I got to get there. So, I’m going to take the bus.” 

I said, “Okay. So, you’re going to take the bus to Inglewood and you’re going to meet your dealer. Where?” “There’s Burger King in Inglewood.” I said, “Okay. And then what?” “So, I’m going to use.” “So, where are young going to use?” 

He said, “I’m going to use in the Burger King bathroom.” I said, “With what?” He said, “With foil and a straw.” 

I said, “Okay. So, using in a Burger King bathroom.” I said, “And then what are you going to do.” He said, “I’m going to be high.” I said, “Okay. And then what?” And then he said, “I’m going to come home.” 

I said, “Yeah. You’re going to go back to your mom and dad’s?” And he said, “No. They kicked me out and I’m going to come back here.” “Okay, so you’re going to go use at the Burger King. You’re going to get high in the bathroom. You are going to catch the bus back after you’re high. You’re going to come back to this treatment program.” So, yeah. I said, “And then what are you going to do?”He said, “Then I’m going to get sober.”

 And I, of course, you know, I said, “But you’re sober now. You’re already there. You don’t have to do the loop de loop.” 

And he looked at me and he said, “Yeah, but when I’m high, I really want to be sober.” 

And I said, “Okay, so what I hear you saying is that in order for you to get and stay sober, you have to get high again.” He said, “Yeah.”

 

The ego self had basically taken the rational ability and created a little narrative and story, that makes semi sense.

 

But obviously, if you use that rationale in your life, you’d never get sober, right? Because every time I try to get sober, I have to get high and be motivated to get sober again. You just do that rinse and repeat, over and over. It’s actually what a lot of people do. 

 

The ego self can hijack the rationale in order to create justifications

 

It’s a reality. And with this particular person, he actually did it. He didn’t do it that night. But a couple of days later, he left and incredibly he was right. He got high at the Burger King. We ended up referring him to a program out of town. And he’s, I think, sober eight, nine years now. So, he happened to be right. But it’s not a good equation as to how to get clean. As an example of how the ego self can hijack the rationale in order to create justifications to continue to enable addiction.

 

 

 

 

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We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

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