Addiction

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The Role of Addiction Psychology and Recovery

What to expect in this episode:

  1.  Traditional psychology has taken a central role in recovery and treating addiction, but it may not be ideal. 
  2.  Psychotherapists often recommend AA or treatment because no progress can be made while in active addiction.
  3.  Immersing in the recovery culture to help the psychology of recovery.

 

Psychology and Recovery

Its a newer phenomenon that psychotherapy and psychology has taken a central role in the world of recovery. Part of me is rubbed a little wrong by that. It’s not that I am anti-therapy, both my parents are psychologists I actually love psychology. I’m fascinated by it.

 

But traditionally, we have an understanding that individual Psychotherapy is not a very effective way to treat addiction.

 

Addiction Needs to Be Addressed for Better Mental Health

What you’ll find most commonly is somebody’s afraid to enter into the world of recovery for a variety of reasons, so they go see a therapist – maybe an addiction specialist or maybe just a therapist – and I think the most common story is somebody will see a therapist for months or even years while still continuing to engage in their addiction maybe with some improvement maybe with no improvement.

 

Eventually, that therapist will say – maybe in months maybe in years, “hey, I can’t continue in this therapeutic process until you do something about your addiction problem and I can’t help you with your addiction problem. You need to go to treatment or Alcoholics Anonymous.”

 

It’s kind of a shame to me that somebody might be in therapy for five, six, seven, eight years I would hope that therapists out there recommend that early, and I also understand that if the clients not willing to go into treatment or to seek out some recovery that the therapist is stuck.

 

Immersing in the Recovery Culture

In general, my belief (and this is complex in nuanced) is that people have to immerse themselves in a culture of recovery and integrate recovery as part of their identity as the primary task of recovery. And that’s up front.

 

Upfront I have to challenge myself to admit that I have an addiction problem that I’ve been unable to solve. Then I have to take on the task of saying, “Okay, I’m a person who suffers from addiction and in order to treat this condition, I need to be a person in recovery.”

 

I need to be a person who identifies myself as someone in recovery from this condition just like I would if I diabetes. If I had a horrible case of diabetes then my recovery from that, or even a cancer survivor, I would identify as a cancer survivor. It almost killed me!

 

I have to know that deeply about myself and it is the first and primary core task of recovery

 

Psychology in Later Recovery

Then therapy comes along in order to help me to better understand myself and treat the underlying emotional conditions that existed, maybe prior to my addiction. In all different dramas in different ways of being different blocks I had that caused me to suffer that I then use drugs and alcohol to treat. I think of therapy as by and large the later stages of recovery.

 

At first, I have to be a person in recovery then I can work on this other stuff because if I’m not a person to recover, continue to use I’m not going to get any therapeutic work done.

 

There are exceptions. The exceptions to that are if I have trauma and it’s so severe it’s getting in the way of me being able to identify as somebody in recovery. So if the psychological problem or even psychiatric problem is so severe that I can’t engage.

 

An easy example is if I have a really hard time regulating my emotions. Incredibly impulsive. It will be impossible for me to engage in recovery because I can’t sit still, I can’t stop talking, I can’t take it in, take information and reality in, so a specialist, a therapeutic specialist would have to come in and treat my Emotion Regulation Impulse Disorder in order for me to engage in recovery.

 

But in general, I think that’s the exception

 

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Addiction Hijacks: When I’m High, I Really Want to Be Sober

Understanding How Addiction Hijacks Rationality 

Addiction Hijacks our “semi-rational” thoughts to justify ego desires. 

 

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

 

Dealing with Cravings 

 

I remember working with a client. He was about a week sober, had gotten out of detox from opioids. He was a week sober and still somewhat obsessed about using heroin.

 

He very earnestly approached me as a counselor at the time.  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?” 

 

Semi-Rational Plan to Use

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 the 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, I’ll 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. 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. 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. And then what are you going to do?”

He said, “Then I’m going to get sober.”

 

Addiction Hijacks the Mind’s Rational Thought

 

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.”

Semi Rational Reasoning

 

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 and Justifications

The ego self can hijack the rationale 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 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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How Long Do I Need Addiction Treatment?

WHAT TO EXPECT:

 

 

One of the questions that people have when seeking treatment is: How long do I need to do it?

 

I’m always trying to empower people by thinking deeply about their questions.

 

If you put that question in perspective it’s more like: How long is it going to take for me to change? There isn’t an exact number of days that you can say.

Is 30 Days Enough for Addiction Treatment?

There’s a model out there for 30-day treatment. 

 

But what is that based on?

 

Is that based on some science that people break addictions in 30 days? Absolutely not. It’s based on the way that insurance billing works. The 30-day treatment model may not provide the kind of change that people need. 

 

The standard answer these days is recovery takes around 90 days. I think that has more to do with the amount of time that people can afford to spend away from the system of their lives. Most people can’t just drop out of their lives for six months or nine months unless they’re young and maybe have good insurance. Or have strong support from the family. Or possibly getting resources from the county or the city. 

 

Our treatment program is 90 days. Still, the 90-day program is sort of a compromise. It’s trying to get people as much treatment as they can get realistically.

 

In my mind, 30 days means maybe you’re starting to sleep good. Maybe you’re feeling safe. You’re beginning to approach recovery, but you’re nowhere near where you need to be to move on. By 90 days, you should have built a decent foundation…not a solid foundation, but a decent foundation. 

Effective Treatment: Engaging in Recovery

A lot of TV programs, they portray good treatment. But the goal of treatment is not to do treatment well. The goal of treatment is to engage people in recovery so they can do their lives well. That’s the real trick. 

 

The immersive experience is upfront: experience with the recovery culture, knowledge and tools, understanding therapy, psychiatry, all the things you need. And then you really want to kind of move that person into life to build those peer and family support structures outside that they have forever. So that they can keep recovery sustainable. 

 

Ninety days in relatively contained care, as I see it: first 30 days real contained, second 30 days less contained, and much more freedom in the third 30 days. Then you’re back in your life but with a lot of support and resources to help you along the way…

 

That’s really good treatment and it works phenomenally well when the circumstances lineup to be able to do that.

 

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The Power of Framing

In therapy, there’s a term we use…Framing. 

 

I actually believe that the term originated, and the way they use it in therapy, is from Neuro-Linguistic Programming (NLP). 

 

Even though a lot of therapists don’t respect NLP, a lot was stolen from it. And one of those notions, I could be wrong about this, is the notion of framing and reframing.

 

What is Framing and Reframing? 

 

Framing and reframing has to do with the interpretive structure of consciousness of what reality is or is not given. 

 

So I’m sitting in this room with the light and the microphone and the camera. Several people here…But that’s not given to me. 

 

That’s actually kind of a complex interpretation of what’s going on, you know. I mean, first of all, I’m inferring that there’s a thing called people, there’s a thing called light, there’s a thing called camera, and there’s a thing called room.

 

I mean, if we try to define all of these things–like what exactly is a room and what’s not a room– does it have to have four walls, only three? Does it have to have a ceiling, or no ceiling? Does it have to be built by man or can it be a natural room…or is it a cave?

 

It’s a lot to consider. 

 

Interpreting Our Reality

 

There’s a certain interpretive structure that goes into how we interface, understand, and cognize our reality, that’s called framing. We frame things in a certain way. The way that we generally think about that in therapeutic terms has to do with what we emphasize in any given experience. 

 

So I can have a very scary experience. What I’m thinking about that experience may be in order to communicate it to somebody else later. How I frame that experience is how I hold it. You know, that was very scary.

 

Let’s say I was on an airplane and there was terrible turbulence. That was very scary and I never want to do that again. You know, that plane could have crashed. 

 

I can frame that completely differently. It’s unbelievable that human beings were able to build these flying machines that take us from one island to another. You know, now and then, there’s turbulence. It’s very scary, but it’s much safer than even driving in a car or possibly riding a bicycle, right? It has to do with how I frame my reality.

 

So I think that the term and the deep understanding of the term is super important. 

 

Feelings Are Choices

 

Rabbi Mordecai Finley, who’s a great teacher of mine, says something very controversial. I don’t think it’s an original thought of his, but he says, “At a deep level, feelings are choices.” 

 

What does that mean? Feelings are the one thing we don’t have a choice over, right?

 

I don’t wake up and choose how I feel. And I think what he’s saying is that we have a deep pre-linguistic, emotional framing structure that we have a say in every day.

 

I’ll say that again because it’s a complicated notion. At a deep level, feelings are choices. We have a deep pre-linguistic–underneath language–framing mechanism that relates to our experiences

 

It’s so deep it relates to the part of us that we would call primitive and emotional. The deep brain. And I actually have a say in how that interpretation happens.

 

Posture and Your Reality

 

Jordan Peterson is a controversial figure. I should probably do a video about his journey with Xanax or, at least, what they’re reporting about it. It makes no sense to me as an expert in that field. 

 

He talks in his book,12 Rules for Life, about making your back straight. On one hand he has kind of a silly piece of advice: ”Okay Grandma, thank you for telling me to sit up straight.”

 

On the other hand, what he’s saying is, how you hold your body changes how you interpret and interface with your reality. It changes how you frame yourself. 

 

Do I think about myself as somebody who’s low confidence and has no backbone? Or is my pushing–my framing–who I am in such a way as to be assertive and to matter in the world? And my posture says a lot about that, right? About how I’m oriented…Framing orientation.

 

And so, that notion, however true it is, is a helpful notion. It’s empowering because it means I have the power in some ways–and at most moments–to frame what’s happening with me.

 

Framing and Grief

 

I’ll give one really deep story about this. I was having lunch with a friend of a friend. He’s an older gentleman and we were just kind of chit-chatting. 

 

As we were chit-chatting, it came up that he had a child that died when she was about 12 years old. He kept talking so I couldn’t say, “Oh, my condolences.” The normal decorum when somebody says that. 

 

He just kind of kept talking. 

 

So when he finally finished talking, I said, “By the way, you know, I wanted to offer, you know, my condolences. That’s just terrible and tragic.” 

 

We were having a deep spiritual conversation, so he kind of pulled me aside and said, “You know, I wouldn’t say this to most people, but I think you’d understand the fact that she passed is not a bad thing. Well, most people, if I say that, they’d think I’m crazy, but I think you get it.” 

 

And he walked me through the experience of her sickness and how she held it and how he held it. He shared what the experience of her actually passing was like. He didn’t see it as bad…he didn’t frame it as bad. 

 

And I don’t know that I could do that. I definitely wouldn’t want to find out. 

 

It struck me at a deep level. For this man, it was kind of like, at some soul level, this man is in touch with something where he’s able to frame a tragedy and hold it in such a powerful and good way that if we all could do…Well, the whole world would be in a better place.

 

So that’s the power of framing…it reaches down in the past turns the therapeutic into the spiritual.

 

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Psilocybin: Magic Mushrooms and Perspective

In the plant medicine world, there are currently a lot of studies and a lot of work happening– also politically to make it legal– about psilocybin. This chemical occurs in what we tend to call magic mushrooms

 

Magic Mushrooms and Religion?

People have been eating magic mushrooms maybe since before religion. Some people even theorize that religion comes out of psychedelic experiences that people had including experiences on mushrooms. Potentially, people ate mushrooms and had spiritual experiences which later were the foundation for religion. 

 

Which, for me, is quite credible because everything is built on people’s experiences, just what kind of experiences were they? Probably vast and varied. 

 

Deeper Spiritual and Reality Experiences

What kind of experiences are people having on magic mushrooms? How can they create something like religion as a possibility or theorize about such a thing? 

 

Well, I’d say people are probably having pretty deep spiritual experiences where they are getting access to parts of themself, reality, or maybe other people’s psyches that they normally don’t have access to. That creates a somewhat reverential stance. 

 

What’s interesting about psilocybin, ayahuasca, or any of these more traditional plant medicines, is that the experience is organized enough that it produces some of what you see in the shamanic cultures. These rituals, ways of being, and sacred parts of a tribal community using psilocybin and psychedelics as possibly a fundamental experience that creates religion. It means that those experiences are organized enough that they produce something like a religion. 

 

Tapping into Transcendence

I don’t just mean people are worshipping “the mushroom”. I mean that they tap into something like the transcendent moral good. 

 

Wow. Could you imagine that you could be walking through the forest, you see this ugly, slimy mushroom, fungus, you eat it and suddenly you have an understanding of the moral good in a way that you didn’t before? 

 

That’s very weird. That’s very strange. How does that occur nowadays? 

 

Psilocybin and Revelations in Our Lives

I don’t think it’s uncommon that somebody might eat psilocybin mushrooms and realize that they’ve been a total schmuck in their relationship for a very long time. They’ve been a total asshole and they’ve been unaware of it. 

 

Why would it be that you would eat a fungus growing out of the ground and then that fungus, when you ingest it, looks at you and tells you, you know, you’ve been a real asshole…and you go, “You know what? It’s the truth.” 

 

I hadn’t really seen it that way for the last 10 years. That’s kind of unbelievable. You have these really mysterious and powerful living plants that when you ingest them give you access to things you just don’t have access to in your everyday life most of the time.

 

I think of the potential in the future of addiction and mental health recovery, because plant medicine gives you access definitely to parts of yourself–possibly to parts of the universe–that we don’t know about. 

 

There’s so much potential and so much power in learning how to navigate those spaces, but then it’s only going to work out if we do it with proper set and setting…And if we’re patient about it. If we have a reverential attitude towards something that may be sacred.

 

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Adapting Treatment During A Pandemic…What’s Next?

It’s been a little over a year since COVID-19 has become a harsh reality changing the course of all our lives.

The pandemic presented inconceivable challenges and altered the way we reach those struggling with substance abuse and addiction.

During this uncertain time, Recovery Integrity adapted and created protocols to ensure the safety of our clients and staff.

We’re entering a time where there is a light at the end of the long, dark tunnel. Restrictions are cautiously being lifted. Vaccines are becoming more widely available. Life as normal may not be within reach…but we are getting closer.

Of course, we can’t let our guard down. And we have to address the concerns, anxieties, and trauma caused by COVID-19.

Let’s face it: Some that had a solid footing in recovery at the beginning of last year may have regressed or suffered emotionally during this difficult time.

Social isolation, loss, lack of support, fear that any interaction may lead to a life-threatening infection…these are very real issues that affect recovery.

What’s the best way to move forward?

Recover Integrity believes this is a two-fold approach: addressing addiction and the trauma caused by COVID-19.

Prior to the pandemic, Recover Integrity offered trauma-focused care. After all, many individuals struggling with addiction also experienced trauma at some point in their lives.

Our knowledge of the effects of trauma on a person’s overall well-being allows us to address the emotional struggles many faced as COVID-19 disrupted our lives.

It’s time to process, regroup, and make efforts to move forward…while cautiously acknowledging the pandemic is still a reality.

We are all still learning to adapt. Recover Integrity is constantly evaluating our treatment model to be a beacon for those suffering from addiction during a pandemic.

Feel free to reach out to discover how we are helping those suffering with addiction during the pandemic.

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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. [/vc_column_text]

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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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