Treatment

Nov 08 2022

The Role of Addiction Psychology and Recovery

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

What to expect in this episode:

Traditional psychology has taken a central role in recovery and treating addiction, but it may not be ideal.
Psychotherapists often recommend AA or treatment because no progress can be made while in active addiction.
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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Sep 19 2022

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

Yeshaia Blakeney

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

WHAT TO EXPECT

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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Aug 15 2022

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Common Outpatient Addiction Treatment Questions

Staff Writer

Men’s Addiction Treatment, Recovery Blog, Treatment

WHAT TO EXPECT:

Individuals who receive addiction treatment generally attend multiple levels of care during recovery.

Outpatient addiction treatment provides opportunities to develop skills necessary for a successful recovery. Outpatient treatment is less restrictive than detox and residential care. The individual has more personal freedom and can return home each evening.

What is Outpatient Addiction Treatment?

Outpatient addiction treatment addresses addiction with various evidence-based approaches. Some of the better outpatient rehabs in Santa Monica combine science with holistic health to address addiction and underlying issues in a comprehensive–but focused–manner.

For example, an outpatient program may use Brainwave Optimization neurofeedback techniques and cognitive testing to address changes that occurred in the brain due to drugs or alcohol usage. The objective findings of these scientific approaches combine well with individual, group, and family therapy which is often subjective.

Are There Different Levels of Outpatient Care?

Yes. Outpatient addiction treatment usually has two levels–outpatient and intensive outpatient treatment.

Here’s a quick look at each:

Outpatient Addiction Treatment (OP)

Outpatient addiction treatment (OP) is a lower level of care that works best for individuals without a severe drug or alcohol history. Individuals in OP care usually have more opportunities for structure in their lives (work, family, etc.) and a good support network.

Also, OP treatment may be used as a way of moving forward with addiction once an individual completes an intensive outpatient addiction program.

An individual usually spends less than 9 hours a week in OP treatment.

Intensive Outpatient (IOP)

Intensive outpatient (IOP) is a higher level of care for individuals who may require additional structure and support. IOP addiction programs require an individual to spend more time in groups, therapy sessions, skill-building classes, and sober activities.

Some individuals may spend the whole day in IOP programming before being able to return home or to a sober living home.

IOP programs are appropriate for individuals who completed a residential drug rehab program. Also, those struggling in an OP program can get moved to an IOP program for extra support.

An IOP program can last up to 6 hours a day.

How Will I Know Which Outpatient Addiction Treatment is Right for Me?

You don’t need to have all the answers. An intake professional helps determine which placement is most appropriate.

Placement depends on several factors. The intake coordinator listens to your or a loved one’s story, reviews any records, and provides guidance for the best addiction treatment options.

The intake coordinator will also explain what happens during outpatient or intensive outpatient treatment, available services, and how the admission process works.

If I Don’t Live in Los Angeles, Can I Still Attend Outpatient Addiction Treatment Here?

Coastal Los Angeles boasts beautiful scenery, comfortable weather, and is just a short trip to Los Angeles. Furthermore, our location, Santa Monica, is famous for its beaches, dining, and tourist attractions, hosting over 8 million visitors annually.

And yes, some of these visitors are individuals seeking substance abuse treatment. The fresh ocean air, change of environment, and opportunities to explore sober activities can be a source of inspiration for those ready to start or continue their recovery journey.

Can I Afford Long-Term Outpatient Addiction Treatment?

Some outpatient services get covered by insurance. Other outpatient addiction treatments are private pay. You will want to check with a facility that resonates with you and find out how they charge.

Some individuals may think addiction treatment is expensive–especially if they have to pay out of pocket. When considering the price, you also have to see this as an investment.

If you or a loved one continue to use and the addiction worsens, the consequences can be very expensive. Losing a job, getting arrested, or developing mental and physical health problems can cost much more than outpatient addiction treatment.

And yes, some luxury addiction treatment and sober living facilities in the Santa Monica area have a high ticket price. But the costs also include several luxury amenities for comfort and enjoyment. Those accustomed to a particular way of living appreciate the transition to luxury outpatient addiction treatment.

Starting Your Outpatient Journey

Recover Integrity provides values-based exclusive extended care treatment for men. Our boutique Brentwood IOP community offers high-quality group work, multiple individual sessions, and a theory-based approach to recovery. We maintain a private, supportive atmosphere so the men in our program can focus on clinical care, wisdom work, and recovering their lives.

You can call (310) 294-9030 if you have any questions about our Brentwood IOP program.

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Aug 05 2022

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Learning to Feel Your Thoughts and Emotions

Yeshaia Blakeney

Recovery Blog, Therapy, Treatment, Yeshaia Blakeney

WHAT TO EXPECT:

In general, one of the things that happen in modern times–as people become a lot more conscious of their physicality, nutrition, exercise, and of the importance in taking care of it–is being conscious of your body in the healing process. In other words, being able to check in and be present.

So with that, therapeutically, one of the things that have become very popular is somatic work. It is the work in the body.

Here is a somatic work example: You and I are doing a therapy session or counseling session. I can tell based on your breathing, how you are holding your shoulders and jaw, and your speech patterns that you are upset or frustrated.

But maybe I go, “Hey, you know, you are a little upset or frustrated.”

I am trying to process with you emotionally what is going on.

And you say, “You know, I am a little frustrated.”

Processing Emotions

Does that mean you just sort of allow somebody to say that they are frustrated sometimes?

Sometimes somebody just identifying that they are frustrated helps them go:

“Oh, that is what is going on. Do I want to be frustrated? Okay, let me kind of calm myself down.” Or: “Why am I frustrated? Oh, you know, I let this thing slide.”

What is Somatic Experiencing?

There is a way to process that frustration cognitively by identification. But there is also a way to process that frustration somatically. How frustration shows up sensationally in the body.

Meaning…

“Uh-oh, seems like you are frustrated.”

“Yeah.”

I would ask you a question like, “Where?”

If you have never done somatic therapy, you will go, “What do you mean?”

“Well, where in your body do you feel that tension, frustration, or whatever it is that you are feeling?”

“Oh, you know, actually in the back of my shoulders right here. I feel really tight.”

“Okay. I want you to close your eyes, and lean into that tightness. I want you to describe a little bit of it and tell me what is happening with it.”

And really, what you are trying to do is connect your thinking mind to your emotions and your body.

If you think about mind, body, and spirit, you think about the connection of all three of those.

And so, “Oh, I see that sensation. And then what I want to do is…I want to metabolize that emotion.”

Allow Yourself to Feel

But what happens is, you stop yourself from allowing to be frustrated. You know, the whole point of feelings is to feel them.

What fucks us all up is that we have a feeling and we want to think them away…or we want to figure them out.

But the whole thing about feelings is to experience them. And how do we experience them?

One way to experience them is somatically…to actually allow yourself to focus your consciousness on the points of your body that are responding to that emotional need. And then allow it to kind of work its way through you. See what comes up from there.

That is somatic work. It is really popular right now because I think everybody is a little suspicious of our minds these days. And so we are sort of looking for something to trust. And maybe it is our body.

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Jun 30 2022

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Understanding Outpatient Addiction Treatment

Staff Writer

Recovery Blog, Treatment

WHAT TO EXPECT:

Outpatient addiction treatment allows an individual in recovery to attend therapy sessions and then return to their daily lives. This level of care requires a certain level of commitment and, ideally, a supportive home environment.

To better understand outpatient addiction therapy, it’s important to be aware of all levels of care.

Continuum of Care for Addiction Treatment

Recovering from addiction is a process. An individual struggling with addiction gets placed in the least restrictive environment based on the type and history of substance abuse.

The levels of care include:

Detox/Intensive Inpatient: Medically managed care for those with chemical dependency and intense withdrawal symptoms. Individuals in this setting receive 24-hour medical care, medications, and extensive counseling.
Residential Treatment: After detox, individuals live on-site with 24-hour supervision in a residential facility. Their withdrawal symptoms are monitored, and they have a highly structured environment with scheduled therapy, activities, and medical care.
Intensive Outpatient (IOP): Addiction treatment that takes place in non-residential settings like hospitals, day treatment programs, or behavioral health treatment centers during the day. Depending on an individual’s circumstances, an IOP program can be a step up or step down in their recovery process. Then, an individual goes home–or to sober living–when it’s complete.
Outpatient (OP): Outpatient addiction rehab is also held in hospitals and behavioral health treatment centers. OP care is similar to IOP but not as extensive. This level of care may be for someone finishing IOP. OP is also for someone with less severe substance use disorder symptoms.
Sober Living: Individuals in sober living environments often do not have a stable support network at home. They choose to enter a sober living home to gradually develop the skills to support their recovery in a safe, nurturing environment.
Aftercare & Alumni: Those successfully progressing through the addiction treatment continuum of care find aftercare programs an opportunity to reinforce what they’ve experienced on their recovery journey.
Early Intervention: Services that focus on education and resources for those at risk for substance use disorder.

What Happens During Outpatient Treatment?

An intake coordinator determines if outpatient treatment is the best option for an individual struggling with addiction. Then the treatment team creates a customized care plan and outpatient schedule.

Outpatient treatment offers services including:

Individual psychotherapy
Group therapy sessions
Medication-assisted treatment (MAT)
Family therapy
Life skills training
Vocational training
Psychiatric care
Case management
Restorative justice
Drug testing and monitoring
Anger management and other social skills classes.
Reviewing and revising the treatment plan based on progress

As you can see, this is a very carefully-planned process that involves the coordination of many skilled addiction treatment professionals. To succeed in the program, an individual must follow the prescribed schedule outlined.

Outpatient programs also offer new opportunities to enjoy recovery by exposing an individual to sober leisure activities, holistic health experiences like yoga and meditation, and team-building challenges.

Outpatient (OP) vs. Intensive Outpatient (IOP)

The main difference between outpatient and intensive outpatient addiction treatment is the amount of time spent in the program. Outpatient treatment is less than 9 hours per week for adults. An individual in the intensive outpatient level may attend treatment programming for up to 6 hours daily.

Intensive outpatient rehab requires an individual to spend more time in structured therapy, groups, and activities. Successful intensive outpatient programs require near full-time treatment using a variety of evidence-based approaches.

IOP signifies a critical transition period. Those successfully completing residential care graduate to an IOP program. Conversely, those struggling in regular outpatient care may find a more structured IOP environment helpful for their recovery.

Some individuals in intensive outpatient programs also choose to spend their free time in sober living homes for extra recovery support.

Finding Outpatient Addiction Treatment in Santa Monica

What Happens During Outpatient Treatment_

Outpatient (OP) vs. Intensive Outpatient (IOP)

Benefits of Outpatient Addiction Treatment

When deemed an appropriate care level, outpatient addiction drug rehab can be a valuable experience for those struggling with substance abuse. The benefits of outpatient addiction treatment can include:

Flexibility to Tend to Personal & Family Obligations

In IOP or OP programs, you can go home once the day’s treatment is complete. This flexibility allows you to be with your family, work, and take care of errands and other obligations.

More Privacy

Entering residential treatment could mean people like coworkers, colleagues, and acquaintances discovering you are in drug rehab. It may not be something you want to share with those you casually encounter.

Since outpatient programs have more flexibility in scheduling and don’t require you to stay at a facility for 24 hours, you can continue more of your everyday activities while receiving treatment.

Learn Skills & Practice Them In Real Life Settings

Outpatient treatment allows you to practice the skills you learn during groups, therapy, and education sessions in real life. After your treatment is over for the day, you get to practice communication, anger management, social, and sober living skills with friends and family.

Build on Skills Developed in Higher Levels of Care

If you’ve completed residential treatment, outpatient programs are an extension of what you already learned. You get the opportunity to continue your personal development and focus on being in recovery.

Get Extra Support From Loved Ones

Being away from a loving, supportive family could be very difficult. Individuals in residential treatment struggle with this often. Outpatient care allows you to be with and supported by your family while still attending treatment.

Finding Outpatient Addiction Treatment in Santa Monica

In all honesty, the Santa Monica area has a lot of outpatient programs available. Finding the one to suit you or a loved one’s needs may seem overwhelming.

Finding an outpatient treatment that will make a difference requires you to feel comfortable, supported, and motivated during therapy. You have to resonate with the program and believe it will help you make the desired changes.

Addiction treatment isn’t a one-size-fits-all approach. It’s a good idea to find outpatient treatment with various opportunities and services. The more services you have available, the more likely you’ll find what resonates and encourages you to stay with treatment.

Recover Integrity is a men’s only luxury intensive outpatient program in Santa Monica. In addition to the services mentioned previously in this article, we also provide cognitive testing for more effective assessments and treatment planning. Also, our exclusive person-centered V.E.G.A. program is designed to help individuals stay motivated through unique assessment, action, and achievement phases.

Recover Integrity is a boutique, luxury men’s intensive outpatient program in West Los Angeles. You could get in touch with us by calling 310.294.9030.

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Dec 29 2020

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Medication Assisted Treatment

Yeshaia Blakeney

Addiction, Rehabilitation Process, Treatment, Yeshaia Blakeney

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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