The Future of Addiction

The Potential Fallout of Suboxone Treatment

Recovery Blog, Rehabilitation Process, The Future of Addiction

What to Expect:

Medication-Assisted Treatment (MAT) uses prescribed drugs to help individuals struggling with opioid addiction manage their withdrawal symptoms and stay engaged in treatment.
Suboxone (or Subutex) is popularly prescribed to save lives and reduce the harm of opioid addiction.
What are the potential long-term effects of Suboxone in an individual’s overall quality of life?

Understanding Medication-Assisted Treatment (MAT)

Opiate use in the United States is at a crisis level–too many people are dying from abusing and overdosing on these powerful drugs. Opiates are highly addictive and a single overdose can prove fatal.

As a result of the opiate epidemic, lives are needlessly lost or destroyed, families devastated, and the socio-economic impacts widespread.

In an effort to save lives, medications have been developed as a means of harm reduction.

Medication-Assisted Treatment (MAT) gives an individual struggling with opiate addiction a fighting chance to recover and return to a normal life. That being said, a simple medication is not going to solve all of one’s problems–it is often a starting point where extensive counseling and therapy is necessary.

But is MAT just substituting one drug for another?

Not necessarily.

Drugs like heroin are unregulated and dangerous. Even prescription opiates are very dangerous when not taken as directed.

MAT offers those struggling with opiate addiction safer, FDA-approved medications. MAT medications–like Suboxone–help reduce or eliminate withdrawal symptoms without producing that euphoric high.

Using Suboxone to Treat Opiate Addiction

Suboxone is one commonly prescribed medication to treat opiate addiction. It is actually a combination of two different drugs–buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that blocks the brain’s opiate receptors to reduce urges. The effects are similar to an opioid, but weaker.

Naloxone is an opioid antagonist. It counters the effects of opioids in the system. In fact, Naloxone is a commonly used medication by first responders encountering an individual experiencing an opioid overdose.

Suboxone is usually self-administered once a day as a film or tablet placed under the tongue to dissolve.

Potential Future Challenges for Suboxone Users

As a result of the opiate crisis, we have a percentage of young people that are on some sort of opiate blocker or opiate substitute–the most common being Suboxone.

The first crisis we may face in the future of addiction is the vast number of individuals taking Suboxone or Subutex for up to 10 years. We don’t really understand the long-term effects of these drugs.

We don’t know how these medications affect people’s development. What happens when an 18-year-old is put on Suboxone. How will it affect their development as they reach the mid-20s? Maybe it’s hardly at all. Maybe it’s a big deal. BUT…we don’t know for sure.

Will it be a future challenge?

Will people start having mental health challenges as they reach their 30s, 40s, or beyond? Can it be related to Suboxone?

And then there is the issue of getting off Suboxone. It’s well known coming off Suboxone is harder than kicking heroin. So, Suboxone may be saving an individual’s life, but the detox and resulting depression can last months if not years.

So, in a nutshell, we are putting a band-aid on a gaping wound to help save a life. If we don’t tend to that “wound” with counseling, treatment, and teaching life skills, that “band-aid” may save lives, but not QUALITY of lives.

Will we have the capability to deal with these issues? If we think proactively, there certainly is a potential.

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Feb 26 2019

The Traditional Social Model of Recovery

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

The form of recovery nearest and dearest to my heart is the traditional social model of recovery
It’s profound, to watch a room full of people, who were previously in active addiction, coming together to talk and help each other
The future will see a mix, of the new, exciting, plnt medicine and medical techniques, with this old, traditional, beautiful social model

The Traditional Social Model of Recovery

I would say the 4th and final, and probably the form of recovery that’s nearest and dearest to my heart, is the Traditional Therapeutic Social Model of Recovery

That is really, for me, it reaches me in a deep place. Which is not about science, it’s not all that fascinating it’s about human beings coming together in a thoughtful way to help each other figure out their lives and how to do that together

So that includes therapy, that includes groups, that include social support like Alcoholics Anonymous.

I’m a huge fan of Alcoholics Anonymous, I think it’s one of the most miraculous things that the United States has produced that is a very American phenomenon. I find it incredible, I could talk about AA all day, I’ll give a little example:

Alcoholics Anonymous

If I go to a meeting on a Saturday night at 10 p.m. maybe somebody asked me to speak or something like that maybe I stumble into a young people’s meeting and the average age there is maybe 19 years old and there are a hundred people in the room in Los Angeles and they talking about their addictions, their problems, their relationships, their recovery in an honest way and they’re talking about their hope for the future may go outside and hang out together or something like that. 37 years old now so

I look at these young people on a Saturday night. These are the same people that weeks months or years ago were right the streets selling dope, using dump, doing Lord knows what kind of crime, Lord knows what to themselves, to other people, that are now sitting in a little room on chairs talking deeply and honestly about life

with no parents around no judges no counselors no therapist on their own and it sort of epitomizes the social model of recovery – how to become together solve our common problems. There’s something beautiful about that.

So, in the future of addiction, I see some mix of those different kinds of camps happening and I see them mixing in ways I couldn’t possibly predict or see. It’s exciting, it’s it’s scary.

What’s exciting about it for me is I think we need to find much more effective ways of dealing with the issues of addiction of the large-scale so it’s exciting as these new ways come in, and hopefully, for me, still at the core is that traditional recovery which is human beings coming together to solve their problems.

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Feb 20 2019

Plant Medicine, Ayahuasca, & the Right Relationship Model

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

Plant Medicine like psilocybin and ayahuasca are a burgeoning underground addiction solution
Much like diet, there is a sliding scale of harm – in food and drug – but most fall into a fuzzy middle
The future will see movement away from the abstinence-based model toward more individual recovery care

Plant Medicine, the spectrum of harm, and the Right Relationship Model

Looking at the future of recovery, another phenomenon that we’re experiencing now, it’s underground and it’s on the horizon, at least in the United States. Is using plant medicine to treat addiction.

So there are some great studies with nicotine and psilocybin which is the psychoactive component in magic mushrooms.

They’re also using psilocybin to treat depression, which of often is an underlying condition addiction, there has also been a lot of fanfare about Ayahuasca, which is a powerful psychedelic from South America that was used traditionally for either hundreds or thousands of years.

And the thought behind plant medicine is to invoke a spiritual experience and to disrupt the default network of the brain, meaning the patterns of our thinking and feeling, in such a way that people can get a boost in breaking free from addiction. Something gets rewired, you know, in the shorthand.

Plant medicine is becoming popular in the underground and so if you go online you’ll find it kind of buried there amongst different ways to deal with addiction, I’ve come across a lot of clients, both successful and unsuccessful, who have either tried or use plant medicine to treat addiction

it’s it’s a fascinating area, my own general philosophy on if I’m speaking to a parent or a potential client who’s looking for recovery and looking for help is I don’t have a philosophy it’s whatever works

The Future is a Multiplicity of Approaches

The way that I think the future of addiction is going to break down is there’s going to be a multiplicity of approaches and in the end, I think the best parallel when looking at the future of addiction is looking at how human beings approach diet. There have been all these diet fads that come and go – everybody is on keto now – where I think it’s going to go as modern science is getting there, is what specific diet is right for you.

so I think we’ll break away a little bit of overtime from an abstinence-base model meaning you can’t use any substances, to understanding your body and your neurochemistry better and specifically what substances in foods does your body and self react well to, and what substances and foods does is it not react well to

So I think about it on a spectrum write pretty much everybody knows that processed sugars and saturated fats really aren’t good for anybody hardly ever. You want to stay away from that stuff.

On the other side broccoli, celery. all these things we really don’t like, are pretty much healthy for everybody. So we have the stuff that’s pretty much healthy for everybody and pretty much bad for everybody then there’s a spectrum of the middle

That has to do with your own body. For some people red meat, the iron in red meat is good, and for some people, it’s not. Trying to figure that out, I think will happen with drugs eventually is the same kind of approach.

The Right Relationship Model

I call it the “right relationship model’.

Which is pretty much for everybody crack cocaine, methamphetamine, heroin… is not good for your life!

And I think we can all pretty much agree on that. But there are a group of substance is over here, in the proper set and setting, that can be good for huge groups of people.

The way that I think about that is: there are certain substances that narrow our consciousness, right, when you use methamphetamine – people use it to, like Adderall, it’s similar to methamphetamine, a stimulant, it helps you focus.

The problem with methamphetamine is that it narrows your consciousness! So, you’re actually not that connected to the things around you or the people around you, more important, over time.

Heroin narrows our consciousness in a different way, If you’ve ever seen somebody do a large dose of heroin, they just pass out, so it’s not focusing your consciousness, it’s obliterating your consciousness, and you pass out into oblivion. But they have the same general narrowing effect.

Alcohol is another substance that is like that, you drink alcohol and it lowers your inhibitions and your consciousness – which is what we appreciate about it – we don’t have to think so much and deal with all those feelings of anxiety.

So there’s a group of substance over there that narrow and dim consciousness, that’s why we like them, there’s a group of substances in the middle – people respond differently to marijuana and even wine or something at a smaller dose,

Although it dims your consciousness, it maybe connects you a little more, so there’s a little bit of space there in the middle. Which is why I think we have some agreement that they are kind of, KIND OF okay.

Plant Medicine | Expanding your Consciousness & Empathy

Then you actually have this group of substances, largely in the plant medicine world, but also MDMA, that have the capacity to expand your consciousness and empathy, and it’s real it is very well documented that it actually kind of lets filters down and allows you to have a wider awareness and vision

and anybody who’s done MDMA knows you have an incredible amount of empathy on MDMA and you rarely see people fight, you don’t get in a fistfight on the street, on MDMA. They are dancing together with glow sticks, it’s incredible.

So I think where it’s going, is into that kind of model were people, meaning people in society as a whole, is figuring out what kind of substances are good for us as a whole, and in what setting, and how we deal with that legally,

And what substances are really killing us and separating us?

I’m kind of optimistic about that vision, but every vision of the future is problematic. They are huge problems with that vision, just like they’re huge problems with the way we approach drugs and alcohol the abstinence-based model now,

It’s more just looking at what’s probable… as to what’s good, I never know what’s good in a complex phenomenon.

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Feb 06 2019

Medical Approach to Addiction

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

The medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.
There are also non-harm-reduction, medical approaches to addiction.
Predicting more and more complex pharmaceutical approaches to addiction in the future.

The Medical Approach to Addiction

The future of recovery I see it in 4 strands, 4 different areas. We’ve covered traditional recovery.

One that we’ve been in, but I think will become more sophisticated, is the medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.

A great example is Methadone, for opiate addicts, methadone is a substance that is similar to opiates, but reduces a lot of the harm that comes along with an opiate addiction.

So if you are using heroin, you need a drug dealer, you have to break the law. You don’t know exactly what you’re getting when you are buying a bag of black tar or powder from somebody’s probably not that trustworthy and you’re putting it in a needle and shooting it in your arm – its and incredibly harmful or dangerous habit to have, often deadly

The thought was, “can we come up with something that is like heroin, but people can still function better, that we can distribute legally, to stop people from dying & falling apart?”

Methadone, in many ways, has been effective. There are huge downsides, whatever, it’s a medical harm reduction approach.

There are also non-harm-reduction, medical approaches to addiction.

Antabuse is an alcohol deterrent substance. If you’re taking Antabuse and you drink, you violently throw up. And it deters you from drinking – without getting you drunk.

Vivitrol is a blocker. Its been around a couple of decades, it’s not widely publicized enough.

But if you are an opiate addict and you are on Vivitrol, then even if you use opiates you can’t get high. It just blocks the effects of drug usage. It’s actually a great tool in the world of addiction.

I see more and more complex pharmaceutical approaches to addiction in the future.

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Jan 28 2019

Traditional 12-Step Treatment

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

Understanding the evolution of addiction rehab & recovery is important to understand where we are heading
The 12-Step program is a spiritual program that evolved after psychotherapy failed to help
This has become the foundation for most North American Treatment Programs, but the success rate could improve…

Traditional Addiction Rehab | The 12-Step Program

In terms of the future of recovery, I think we’re already in the midst of a rapid change in; let’s call it the recovery underground. To understand, first I think we need to understand traditional recovery and where that even comes from.

Traditional recovery is pretty much 12-step based in North America. Alcoholics Anonymous, Narcotics Anonymous everyone is familiar with that. The reason why traditional recovery developed in the first place is because the mental health and physical health systems that we’ve had historically weren’t helpful when it came to treating addiction.

So we knew very early on in 20s 30s 40s even before that, that Psychotherapy did not work with helping people to recover from addictions it’s a well-known historical fact. We’ve kind of forgotten that over time but it’s a well-known historical fact. Alcoholics Anonymous came along as an interesting spiritual program with elements of therapy and morality and eventually community and literature that people started to get sober and people start to recover. That worked and works!

So traditional recovery in North America is 12-step and it was it was the dominant form of recovery for the… last eighty years let’s call it. The success rates that we see now, I think they’re controversial, to be honest with you, I think it’s a difficult question to ask, to talk about that, but let’s say the success rates are 15%. That might be generous that might be stingy,

it just isn’t good enough.

What are the Alternatives that are on the horizon for people in recovery?

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Jan 22 2019

Marijuana Decriminalization | The Future of Addiction

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Addiction, Recovery Blog, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

Exploring how marijuana fits in society
Being Pro-decriminalization doesn’t mean there is no harm or side effects
We’re in an interesting experiment to see what happens when we decriminalize a substance, the stigma goes away, & how that affects our society in general over time.

Marijuana Decriminalization | The Future of Addiction

I don’t think we really know over the long-term what it’s like to regulate self-medicating marijuana over 5 years 10 years 15 years 20 years and the impact that has on individuals and the impact that has on groups or productivity or our society as a whole.

So we’re in the midst of an interesting experiment to see what happens when we decriminalize a substance and the stigma goes away, which I think is a good thing, how does that affect our society in general over time.

So part of what will be understanding is what does society look like in relationship to mass consumption of marijuana over a long period of time.

Probably chill.

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Jan 15 2019

Donald Trump & Addiction

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Addiction, Recovery Blog, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

Donald Trump appears to suffer from Attention Deficit Disorder
He has likely been prescribed methylphenidate, for decades
Irritability, lack of sleep are side effects, so he likely has been taking benzos like Xanax to sleep, effectively putting him on a pharmaceutical cocktail long-term, locking in aspects of his personality as an addict would.

Donald Trump & Addiction

I have an interesting and controversial theory, I have no facts, this is just, shooting the breeze – I’m sure I’ll hear about it…

I look at Donald Trump, I look at his character structure, the little bit that we know about his history, and it’s clear that he suffers from some kind of attention deficit disorder.

He seems impulsive, not always so contemplative and thoughtful, and I imagine as a kid he was a lot to handle.

He also comes from a wealthy background, I’m assuming his parents probably had access to private doctors, psychiatrist, etc.

At some point in his development, his parents or whoever was in charge went, “this kid is pretty wild” and they put him on some kind of methylphenidate.

Something like a Ritalin or Adderall or something like that, and they used that to help him narrow his focus and be able to accomplish the task in front of him, school, etc.

I imagine him on this methylphenidate for 10, 20, 30 years – what happens if you consume methylphenidate, which is related to the class of drug that’s methamphetamine or speed, a stimulant, is… you begin to have side effects.

The side effects are irritation, lack of sleep, it stops working, you start to feel your focus starts to slip…

Usually what people do at that point if you’ve been on a methylphenidate for a long time, is you’ll take a benzodiazepine or sleeping pills and then you’ll begin to balance it out with different kinds of medication,

So my guess, when you look at Donald Trump, is that he’s been on a pharmaceutical cocktail for 40 years.

The reason why I think that is, most human beings in an interaction with the world would grow past some of the immature characteristics that we see in him.

The only way that somebody gets locked in that kind of way is either through extreme avoidance of yourself, which is hard to do or through some kind of addiction.

He also doesn’t drink and doesn’t get high. His brother was an addict and so he doesn’t medicate with those things.

So my guess is he actually got hooked on stimulants and then other drugs like benzos like Xanax and things like that to calm his nerves from the stimulants and it’s been locked in place for decades.

I think one day we’ll find that out.

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Jan 07 2019

Suboxone Treatment | The Future of Addiction

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we're doing now with addiction. Click To Tweet

Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

The Immediate Future of Addiction | Suboxone and the Opiate Crisis

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we’re doing now with addiction.

So, we have a gigantic opiate crisis in the United States, unprecedented really. One of the things that we’ve done to save people’s lives, understandably, is we’ve approached it from a governmental level and an Institutional level, and our approach has been harm reduction. Which means finding medications that reduce the amount of harm caused by heroin and oxy and these drugs and so the consequence of that is we are going to have a generation of young people or some percentage of this next generation that is on some sort of opiate blocker or opiate substitute the most common is called Suboxone most common is called a Suboxone or Subutex and the first crisis we’re going to deal with in terms of the future of addiction as we’re going to have hundreds of thousands or even millions of people who have been on Suboxone or Subutex for 3, 4, 5,10 years and we don’t really understand on that scale the effects of those drugs long-term on the individual.

We don’t know how that affects people’s development over the long-term you know, what happens when you put it on 18-year-old on Suboxone how does it affect the development when they are 24. Maybe it’s hardly at all, maybe it’s a really big deal, we don’t really know. But my guess is it’s something we’re going to have to deal with. As people start to have mental health problems years out of their development may be in relation to the Suboxone the questions going to be how do we get these people off of this drug? And, what I found in my own experience in treatment, is it’s actually harder to come off of suboxone than it is to come off of heroin – it’s actually well known. If you’ve been on Suboxone for a long time, you know, two, three, four, five years the detox is horrendous and often the depression is really heavy and lasts months if not years and so…

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn't die but they didn't completely heal Click To Tweet

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn’t die but they didn’t completely heal and they’re on this medication, maybe for life or maybe they want to get off and what do we do so that’s a new media crisis that we will be in the headlines in a couple of years.

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Jan 02 2019

The Future of Addiction

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Addiction, Recovery Blog, Rehabilitation Process, The Field of Treatment, The Future of Addiction, Video, Yeshaia Blakeney

What to expect in this episode:

The drug and alcohol treatment industry tends to be very reactive
How addiction works in relation to social phenomenon and social systems; increased anxiety and depression
Prediction: Vaping, vaporizers & increasingly complex designer drugs.

The Future of Addiction

The question of what drug addiction looks like in the future is massively important. What I am experiencing working in drug and alcohol treatment is that we are very reactive. We’re in the midst of an opiate epidemic, methamphetamine use is also on the rise, and we’re so busy dealing with that we’re not looking at what’s coming down the pipeline, which I think is an important conversation to have.

I see addiction working in relation to social phenomenon and social systems, things that are happening in the world around us. I think the biggest thing that’s happening in the world around us, the biggest event of our time, is the rise of technology and the complexity of human urban life; and we don’t know how to deal with it. So we know how to engineer complex systems but we don’t know how to deal with our feelings. We’re not necessarily training our children to make their bed and do the laundry, even though they can be top scorer on Fortnite or whatever.

And so what I see is (this is already happening) I see massive growth in anxiety and depression which are internal disorders that come from coping with the difficulties of life. And so when I think about what’s happening in the future of addiction, I think of what’s happening in the future of mental health. My prediction is that there’s going to be more and more complex designer drugs.

Designer drugs are drugs where the molecular structure is modified usually from an existing drug for a specific application like Pharmaceuticals are designer drugs and what I see is a massive growth in designer drugs and their distribution online and so if you go online right now and you look up how many different kinds of drugs there are that list is growing more rapidly or drugs are coming out in the recipes are available and I think they’re going to be used for people to self medicate to treat feeling that they don’t know how to deal with a don’t know how to live into.

The other thing that’s happening is the way that drugs are being ingested is changing. There’s been maybe seven different routes of ingesting drugs for the last hundred years and when the vaporizer came on the scene I took notice. It was a new way to ingest a substance rapidly right that you can inhale and it’s also concealed you can flavor it however you want so the odor changes. We know that with marijuana THC and nicotine that you could… we have high schoolers that are running around vaping weed and nobody knows, nobody smells it so you can completely conceal it.

Now you can also Vape methamphetamine, you can also Vape dimethyltryptamine, in fact you can be anything that’s water soluble. So you can imagine the mix that you can see on the horizon as clever human beings all of these designer drugs all of these mental health problems and having a way to ingest them that’s hidden difficult for police officers and authorities to detect, parents, Etc.

So, I see a lot of complexity on the horizon and I see nobody talking about it. Interestingly I am not anti-drug. I think human beings have had relationships with two substances for all of history and it’s not a bad thing. The question is how we collectively deal with our relationship to drugs and alcohol, which is a really deep question.

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