IÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢m a Recovering Addict, Child of an Addict and Psychology Major. I write this blog in the hopes that sharing my knowledge of addiction recovery can help people achieve a happy life in recovery. I want people to know they are not alone in this fight. This common struggle will hopefully bring us together so we can find support, in which we can gain the strength and the courage to keep fighting. I want this blog to help people understand addiction and inspire compassion within them for addicts. I hope to eliminate the discrimination and stigma of an already difficult struggle by raising awareness of the challenges addicts face, and hopefully increase peopleÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢s acceptance of them. As a society, I believe we need to stop punishing addicts and increase our harm reduction efforts.
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Is it possible to take drugs and get high while on Suboxone? If you are thinking about starting Suboxone, you might wonder what will happen if you take drugs while on Suboxone. Will the Suboxone block the drug high? Or, will Suboxone make you sick when you take drugs with it? First, Suboxone does not […] The post What happens if you take drugs while on Suboxone? appeared first on Recovering Addict...
If you are thinking about starting Suboxone, you might wonder what will happen if you take drugs while on Suboxone. Will the Suboxone block the drug high? Or, will Suboxone make you sick when you take drugs with it?
First, Suboxone does not have anything to do with non-opioid drugs. If you take Suboxone and then take cocaine, you will feel the effects of the cocaine. If you take methamphetamine, you will feel it. The high will be the same, and the crash afterwards will also be the same.
However, if you take an opioid while on Suboxone, the effects of the opioid will be blocked. Will it be completely blocked with no effect at all? No, most likely the Suboxone will not fully block the opioid and you may feel the effects of it.
One of the risks of prescribing an opioid receptor blocker to a patient is that they may try to overcome the blockade. Unfortunately, if they take enough opioid to feel the effects, they may overdose.
This is a concern of many patients who take Suboxone. What if they have emergency surgery? Will the opioids for pain given by the surgeon work at all?
Fortunately, it is possible for doctors, in emergency situations, to work around the blocking effects of Suboxone and provide adequate pain relief while under close supervision.
If I use a lot of different drugs, is there any point to getting Suboxone treatment?
This is an excellent question! If a person takes methamphetamine, cocaine, oxycodone, heroin, and alcohol, would it make sense to start Suboxone?
In many cases, the answer is yes, Suboxone should be started, even if it will only address the opioid addiction. The reason for this is the deadly nature of opioid misuse. The death rate from opioid overdose is much higher than other drugs, though alcohol is very close.
Providing Suboxone treatment to an opioid-using patient who is unable or unwilling to give up cocaine, for example, can still protect the patient and improve their quality of life. It might be considered a form of harm reduction. Even though the overall drug problem has not yet been solved, at least the patient will be safer with respect to opioid use.
Importantly, when a patient can not give up other drugs, a residential or outpatient program may be best with close supervision. Even though drugs such as cocaine are not as deadly as opioids, they still lead to serious consequences.
The main benefit of taking Suboxone is to help a patient stop ongoing opioid use and improve their quality of life. Yet, it may have some beneficial effect with respect to other drug addictions.
The drug naltrexone, an opioid blocker, has been studied for the treatment of alcohol addiction, binge eating, cocaine and meth addiction, and nicotine addiction. By blocking opioid receptors, the patient is conditioned to have a reduced response to the addiction through pharmacological extinction.
Suboxone contains the drug buprenorphine which is a mixed partial opioid agonist and opioid antagonist. This means that it works similarly to naltrexone in some ways.
While further studies should be done on this subject, it is reasonable to conclude that Suboxone may help patients to quit other drug addictions while they take it to treat opioid addiction.
It is important to be open and honest about drug use with your doctor. Do not be concerned about your doctor kicking you out of the program. Suboxone doctors understand the nature of addiction.
Your doctor will be able to help you and provide guidance. One thing that your doctor may explain is that the opioid receptor blockade of Suboxone can reduce your cravings for other drugs. You may continue other drug use out of habit.
If you are aware that your cravings are reduced, it may help to motivate you to alter your daily routines to avoid triggers. For example, if you drive by a drug dealer’s house on the way to work every day, you can change your travel route.
In changing your routines to avoid temptation, you may notice that the cravings for those other drugs are not as bad as they were before. You do not have to act on old habits that lead to self-harming actions.
Now that we have put one-fifth of the twenty-first century behind us, what does the future have in store for addiction treatment? While there have been many advances in the past 20-30 years in modern medical addiction treatment, many individuals and institutions are stuck nearly 100 years in the past. We have seen major pharmaceutical […] The post How Will The Future Of Addiction Treatment Look In The 21st Century? appeared first on Recovering Addict...
While there have been many advances in the past 20-30 years in modern medical addiction treatment, many individuals and institutions are stuck nearly 100 years in the past. We have seen major pharmaceutical breakthroughs, including the approval of naltrexone in the 90s, sublingual buprenorphine in the early 2000s, and even long-acting subcutaneous buprenorphine treatment.
Alcohol addiction and opioid addiction have benefited the most from these modern pharmaceutical advances. We have yet to see similar breakthroughs for the treatment of stimulant addiction, including addiction to cocaine and methamphetamine.
However, just recently, there is news that naltrexone, an opioid receptor blocker, may help to break these addictions as well. Naltrexone has already been proven to be useful in treating alcohol addiction, opioid addiction, and even food addiction.
One issue that we are confronted with is that we have a collection of effective tools, yet they are not being implemented in the best way to provide relief to the people who need it most. The problem is that there is still too much resistance, distrust, and lack of public support for medication-assisted treatments that have been around now for decades and are proven effective and relatively safe.
Suboxone, or to put in generic terms, buprenorphine/naloxone, is a miraculous response to the opioid epidemic. It works incredibly well when it is made available to people who are addicted to opioids. It is least effective when it is not available, or it is provided for too short a time in medical detox facilities.
Suboxone is also not effective when patients are pressured by society, friends, family, and even medical professionals, to stop taking it or not to start in the first place. The mixed messages put out that confuse the issue of medication-assisted treatment are life-threatening.
Even well-meaning doctors start to doubt if they are doing the right thing. However, a doctor who sees the response in many patients over time when they are provided Suboxone therapy will come to the conclusion that they are, without a doubt, helping their patients to achieve success in recovery.
In addition to MAT, including naltrexone for alcoholism and naltrexone or buprenorphine for opioid addiction, there are many other ways to help and save lives. Harm reduction is another revolutionary concept that is pushing away the old and dangerous idea of “tough love.”
Life-saving Narcan, or naloxone, is being made more and more available to the people who need it most, to ensure that more opioid overdoses can be reversed. In some parts of the world, monitored drug use is acceptable to provide a safe environment for people who are not ready yet to quit. Harm reduction is proven to prevent disease, injury, and death.
Interestingly, there are new and promising new therapeutic options for addiction treatment on the horizon. There are pharmaceuticals being developed that range from genetically targeted therapies to advanced psychedelic treatments.
Already available in many states, medical cannabis is proving to be helpful in some situations. While medical marijuana is not safe or effective for treating many conditions, it is helpful in some circumstances. Further study and clinical experience is needed to evaluate the usefulness of cannabis in helping to treat certain types of addiction.
For example, medical marijuana may be useful for some patients in the tapering process of discontinuing an opioid or opioid treatment, such as Suboxone. It may also help with chronic pain for patients who choose to discontinue opioids as part of their pain management regimen.
Ketamine is an anesthetic drug that is legal and is already being used to treat chronic pain, depression, and it may be useful in treating certain types of addiction. While ketamine does have some abuse potential, with proper medical supervision, it is a useful pharmaceutical that may be beneficial.
Psilocybin is a drug that has a long history in American and world culture. It is derived from a naturally occurring mushroom. Psilocybin is a psychedelic drug that causes hallucinations and provides a different perspective for a person to evaluate their life.
This hallucinogenic drug is not currently legal, but it has been decriminalized in some regions of the US. It is also being intensely studied for its use in treating multiple psychiatric conditions, including addiction.
Many experts are hopeful that this novel treatment for addiction may prove to be highly successful in difficult cases. It may reduce the need for treatments such as Suboxone, or it may be useful in the tapering process for patients who are completing a Suboxone regimen.
A current trend in treating addictions, from food addiction to drug addictions is to provide therapy, such as cognitive behavioral therapy, wrapped in a phone app or online service. There are even apps that have been authorized for medical use by the FDA.
Widespread effectiveness of these technological innovations has yet to be seen. However, the use of smart phones and connected wearables, such as smart watches, in treating addiction may have huge untapped potential.
There is also the use of sound and light devices and electrical stimulation treatments for psychiatric conditions, such as depression, anxiety, and addiction, and other conditions, including attention deficit disorder and ADHD.
Binaural beats therapy, using simple stereo audio to induce relaxed and synchronized brain states, has been around since the 19th century. Only recently have scientific studies been performed to establish the effectiveness of this safe and affordable treatment that can be provided with a smart phone, earbuds, and an internet connection.
Biofeedback therapy, using computer-aided feedback to brainwave states to assist patients in altering their state of mind, has been studied for decades and is also effective. With improved brainwave monitoring devices, biofeedback may become widely available to the public via smart devices and wearables.
As stated earlier, the best bet for improving addiction treatment in the near future involves making what we already have more widely available. If you are currently struggling with alcohol or opioid addiction, the best next step is to see your doctor.
There are already effective treatments available for these conditions. The main limitations that we have to prevent more people from gaining access is the unfortunate social stigma associated with addiction and modern treatments for addiction.
Be assured that seeing a doctor for FDA approved medical therapy for addiction is the best way to go about starting off your plans for overcoming your addiction. By understanding that currently approved medication-assisted therapies are effective and available now will help you to make the best use of modern, 21st century advances in addiction treatment.
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Desperation can be a great motivator. It is easy to procrastinate and put off taking action. However, when you realize that you have been backed into a corner and there is no other way out, you may find the strength to take unprecedented action. The action that you take depends on your specific situation. If […] The post How Do You Get The Gift Of Desperation? appeared first on Recovering Addict...
It is easy to procrastinate and put off taking action. However, when you realize that you have been backed into a corner and there is no other way out, you may find the strength to take unprecedented action.
The action that you take depends on your specific situation. If you find yourself dealing with heroin addiction, or addiction to another opioid, you may finally commit to seeking medical treatment.
When confronting difficult challenges, we often want to solve our own problems. It can be hard to ask for help.
Yet, we should remember that asking for help is not a sign of weakness, it is a sign of great strength and courage. Some of the greatest success stories in history involve one person having the courage to ask others for help.
For example, if you look at old videos on YouTube of Steve Jobs speaking, there is a short video where he talks about how asking for help is the greatest secret to success.
He describes how, as a child, he dared to call the founder of HP and ask for help in obtaining some electronic components. With this early experience, he learned how to find success throughout life, reaching unparalleled heights of accomplishment.
With any good habit, practice is the best way to improve. The same goes for asking for help to overcome obstacles in life. But, how do we get the courage to ask for help?
Often, it is desperation that brings us to the place where we are ready to ask for help. Unfortunately, in many cases, tragedy can strike before the gift of desperation arrives.
I believe that it is possible with reflection and perspective of where we are in our lives. For example, you could take the time to reflect upon, in writing and on paper, your past accomplishments, and your unique talents and abilities.
This is a private and personal writing project that no one else will see, so don’t hold back. Be thorough in putting down everything on paper. Do not be humble in this exercise.
If you are struggling to overcome opioid addiction or alcohol addiction, you will likely have some fantastic and beautiful things to say about what you have accomplished before addiction took hold. While you, and the people around you, may have put you down for a long time, you will realize that you have the potential to accomplish great things in life.
Now, put that in perspective with where you are in life. While it is never too late to get to work to realize your full potential, you will see that you have wasted many years with drug use and earlier efforts to quit drugs and recover.
It takes time and persistence, just to get the drugs out of your system and give your body and mind a chance to heal. It is like climbing out of a deep hole that you have fallen into. After the hard work of climbing out, why would you allow yourself to fall back in?
Imagine the wasted time and effort of climbing out, over and over again. You can never get that time back. You can imagine the feeling of desperation that comes over you when you realize what you could do in life if you stopped falling back into the abyss of addiction.
In reflecting on your life, you may find that the regret and despair of realizing the waste of time and lost potential of growing physically, mentally, and spiritually is worse than the fear of injury and death from drug use.
What would you like to accomplish with the years you have left to live? If you could do anything, what would you do?
Please, do not have fear in reaching your potential and exposing your limitations. While we all have limits in what we can do, you may be surprised that you can push past boundaries and accomplish feats that you never imagined possible.
Many experts now recommend that the best path to success in personal development is to focus on furthering your strengths rather than spending too much time trying to smooth out your weaknesses. This is good advice to take into account. In your personal written reflections, you will see what you are good at and how you can use your abilities for success in many areas.
You may even find that your natural talents and abilities can be used for success in ways you never imagined. Why not take a chance and explore the possibilities of what you are capable of when the chains of addiction are removed?
The critical part of your unlimited personal growth is that you must allow yourself the time to continue to compound improvement upon improvement. When you build something great, you will not be able to create something even greater if you tear it down right away. You create success upon success.
So, when the thoughts of desperation push you to the point of being ready to ask for help if you are experiencing opioid addiction and you are prepared to move forward, talk to your doctor. If your doctor does not have experience in this area, find one who does.
Keep in mind that experts in the field of medication-assisted treatment of opioid addiction recommend at least 1-2 years of medical treatment. When you allow medical therapy to work for an adequate period, your brain has a chance to heal, and you have an opportunity to clear the wreckage of the past and move forward in personal growth.
Many people describe the feeling of being on a medication-assisted program (MAT) to be as if they were never addicted in the first place. Their minds are clear, and they do not feel significant cravings or have thoughts of using drugs.
In this state of clarity of mind, you will be able to make the best use possible of your time. You can educate yourself, reading books, taking courses, meeting with experts in fields where you hope to improve yourself.
It is essential not to focus too much on completing medical therapy too soon. Give it time to work. Now is your time to make the best of your life.
I am reminded of an experience I had nearly twenty years ago when I climbed to a mountain top lookout in the Blue Ridge Mountains at a place called Chimney Rock Park. There was a set of rickety, wooden stairs that lead to the top.
It was a long and challenging climb. The stairs were old and damaged, and I felt as if I was risking serious injury or death with each step. What if a step broke and I fell to the bottom?
When I reached the top, the view was beautiful. I could see mountains, valleys, and rolling hills for miles and miles. While the view was exhilarating, the climb to get there was not easy and held significant risk.
At the top, there was a gift shop, serving hot chocolate, coffee, and snacks. I wondered how all of the other people had arrived at the top. Many people were enjoying the view, but I did not see many along the way as I climbed those old stairs.
In the gift shop at the top, I discovered that this mountain had a unique feature that I was completely unaware of. It turned out that there was an elevator at the center of the mountain. It carried visitors from the parking area to the lookout at the top. The elevator entrance was in a long tunnel at the bottom.
I had missed that tunnel as I went to climb the stairs. At the top, the elevator arrived inside the gift shop. I was relieved to be able to complete my trip by taking the elevator.
Did it feel as if I was cheating, using a short cut to get to my destination? No, it did not. My goal was to arrive safely at the lookout to see the beautiful view, not risk my safety in a dangerous climb. I took note to take the elevator next time if I ever returned to the park.
The point of telling you this story is to emphasize that the purpose of MAT for opioid addiction is to take you safely to your destination of enjoying your life, growing in all areas, and realizing your potential to do great things.
While there are people who find reward in the difficult climb upward to success, they also face considerable risk. If your goal is to get safely out of the hole you have fallen into and enjoy the light of day again, you do not have to take the dangerous and challenging path of climbing your way out.
Medical science has provided us with a better way to overcome opioid addiction. You may say that you prefer to take the spiritual path to recovery, but who is to say that the gift of medical science was not given to us ultimately through a spiritual source?
We often find that in times of need, we are given what we need to overcome obstacles. MAT is a safe and better way out of opioid addiction.
When you have found the gift of desperation, it is time to ask for help. Please, be open-minded about the possibilities of medical treatment and be honest with yourself about your goals and what you could do if the sickness and obsession of active addiction could be lifted right now.
What is an addiction coach? In recent years, professional recovery coaches have begun to appear online. An addiction coach does not provide formal therapy to a person recovering from addiction. Furthermore, an addiction coach can promote their services and work with clients without having credentials in counseling or treatment. A coach is, in a sense, […] The post Addiction Recovery Coaching VS. Addiction Counseling And Psychotherapy appeared first on Recovering Addict...
In recent years, professional recovery coaches have begun to appear online. An addiction coach does not provide formal therapy to a person recovering from addiction. Furthermore, an addiction coach can promote their services and work with clients without having credentials in counseling or treatment.
A coach is, in a sense, a personal cheerleader. When you meet with your coach for a session, you review your future goals and the progress that you have made so far. When you are accountable to another person for making progress, you will be more likely to stay on track.
An addiction coach specifically will help you to avoid alcohol and drugs as well as pointing out when you are exhibiting addictive behaviors. Recovery coaching can be a useful part of treatment and recovery.
When it comes to addiction coaching, your coach will likely have experience in working with people who have successfully overcome substance use disorders. Often, they will also either have personal experience in getting over an addiction or possibly experience in helping a close family member.
You may be familiar with the concept of a sponsor if you have been to Alcoholics Anonymous or similar 12-step recovery fellowships. The purpose of a sponsor is to help you work through the 12 steps. If you have read through or even worked through the 12 steps, you are aware that they dive deep into personal spiritual and psychological issues.
The only requirement to be a sponsor is to have worked through the 12 steps. In the program, they recommend that a sponsor should have a sponsor themselves. A sponsor does not have any particular protocol or curriculum to follow with their sponsees. Often, the way a sponsor approaches step work is dictated by how their sponsor worked through the steps with them.
The integrity of sponsorship exists at the group level. If your sponsor is not helping you, you can speak with other members of the group. You can also bring up sponsorship issues in meetings. You do not have to stay with a sponsor who is not helping you.
However, you may hear within the group that you cannot trust your thinking in these matters. What if it is your “addiction” trying to sabotage your recovery?
In nearly all situations, the accepted rule is that a sponsor should be of the same gender and have worked through the 12 steps with a sponsor. Also, a sponsor should be in recovery without relapse or slip for at least one year. Otherwise, you get to choose a sponsor, and your sponsor gets to choose to accept you or not.
Do addiction specialists recommend that you work with a sponsor? You might be surprised by the answer. They do support sponsorship in 12-step programs.
The 12-step philosophy, of which sponsorship is a cornerstone, is supported by the addiction treatment community. Significant institutions that credential doctors in addiction medicine support 12-step facilitation as an evidence-based therapy for addiction treatment.
While sponsors and coaches are both people who might help you with addiction and neither requires specialized training or certification, they are not the same. A coach is not limited to assisting you with the 12 steps.
While your coach might function somewhat like a sponsor and may even have experience in being a sponsor, the coach may also follow other paths to help you recover from addiction. Hence, in most cases, a coach works outside of the 12-step framework.
A psychologist or family therapist with a doctorate must go through years of rigorous schooling and training to work in the mental health field. They must also obtain a license from their state to work in the field of psychotherapy.
Addiction counselors may have certifications for completing programs in addiction counseling. While certified to work in recovery support services, they are not licensed or credentialed to treat mental illness.
Often, counselors who work in rehabs have personal experience in addiction recovery and consider this to be what qualifies them to work in the addiction field. As you can see, there is a wide gap in training and credentialing requirements for a psychologist and a counselor.
Surprisingly, many rehabs do not employ psychologists or family therapists with doctorates or even masters degrees. Counselors facilitate much of the group therapy in substance abuse treatment programs. These counselors often have, at best, a certificate from a training program. In some cases, this training may only take a month.
Coaches often go through specialized coaching programs to learn formal methods for working with a client. While not required, you may want to ensure that your coach is certified and may want to look into the certifying organization.
Some coaches have experience in psychology or medicine. There have been medical doctors, osteopathic physicians, and doctors of psychology, who have ventured into the addiction coaching business. While their training and licensing is not a requirement for coaching work, you may find this background experience reassuring.
A coach may function in a variety of ways. There are celebrities, such as actors or musicians, and business executives who may not be comfortable or have the time to sit in 12-step meetings. These individuals may seek out a celebrity addiction recovery coach.
These meetings are open to the public and may not be suitable in some situations for people who are concerned about being recognized or confronted by the public. A coach may function as a sponsor for an individual in this situation.
Whether in a tour bus, on a private plane, in the board room, or at home, a coach can be there to hold you accountable for your recovery. However, coaches can also be an affordable part of anyone’s long term recovery. You do not have to be a celebrity or powerful executive to get help from a coach in overcoming alcohol or drug addiction
They may even have experience in building successful businesses. If you are in recovery from addiction and interested in starting or growing a business, you may find it helpful to work with a coach who functions in both capacities.
There are also coaches with experience in motivating creative people to move forward in their work, such as art or music. Additionally, coaches can help with fitness and nutrition.
A life coach helps you improve in all areas of your life by keeping to your short term and long term goals.
Why would someone in addiction recovery want to work with a coach for business, health, or creative pursuits? As you may be aware, the people who are most susceptible to addiction are often the people with the most potential for success.
They are usually creative, intelligent, and hard-working. Unfortunately, the condition of addiction uses these strong traits against you. When you overcome addiction, you will find that you are capable of accomplishing anything.
A coach can help you to stay on track to reach positive goals. Keeping busy with activities, such as art, music, business, and fitness, can help you to avoid negative influences that lead back to active addiction and drug abuse.
While coaching can be a rewarding process, it does not replace formal therapy with a licensed therapist. There may be significant issues in your life that have taken you down the path to active addiction.
A therapist can help you to work through childhood issues and events from your past. Additionally, they can help you to identify triggers that you should be aware of and avoid.
While you can work with a coach and a therapist, a coach does not replace a licensed therapist. When it comes to addiction treatment, there are roles for doctors, psychologists, family therapists, counselors, sponsors, and coaches.
You can start by searching online and also asking people close to you for recommendations. Once you have found some coaching candidates, you can narrow the field by looking at their experience.
Also, see if they have published articles, blogs, or if they host a podcast. Reading their work and listening to them may help you to decide if you have found the right person for your coaching experience.
When you have decided on working with a particular coach, you may try out a session to see how well you work together. You may find that working with a specific coach for the initial meeting reveals personality conflicts.
You and your coach must have compatible personalities and compatible working styles. For example, if you find that a coach has too much of an aggressive coaching style, you may want to look further for a more compatible coach.
When you have found the right coach and start working together, you will find that you can reach goals faster and more consistently. There is a reason why Olympic athletes work with coaches. A coach helps the athlete to upgrade their skills and move forward towards their goals of success.
The coach keeps them on track with their daily routine of training. If you want to be successful and work toward achieving the great things you can accomplish, you may want to consider working with a coach.
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Emerging from the dark ages of addiction medication dosing. Years ago, I walked into a music store, also known at the time as a “record store,” to look around at the albums of my favorite music. The time was probably in the 90s when vinyl records were on their way out, and CDs were popular. […] The post Alternate Day Dosing And Tapering Of Buprenorphine For Opioid Addiction appeared first on Recovering Addict...
Years ago, I walked into a music store, also known at the time as a “record store,” to look around at the albums of my favorite music. The time was probably in the 90s when vinyl records were on their way out, and CDs were popular. At that time, there was no iTunes online music store or music streaming services.
In the middle of this particular store was a machine that I had never seen before. It was a customized music machine. It was similar to an ATM, or the ticket machines that spit out your boarding pass at the airport. However, this machine was for creating custom music mix albums. You could pick from a list of available songs and have your custom mixtape created by the device.
The interface of the machine was clunky. The song selection was limited. And, the final product was overpriced. Yet, this machine was ahead of its time. In the following decade, Apple would release iTunes, allowing listeners to purchase individual songs and create their mix playlists. I remember reading a scene from the Steve Jobs biography where Dr. Dre gets excited, sitting in front of a screen, viewing iTunes for the first time before its release, exclaiming how they finally got it right.
Tapering off of buprenorphine means to reduce the dosage gradually over time with the intent of working towards taking a minimal amount of the drug or stopping it altogether. After a patient stops taking buprenorphine, they can continue with therapy. And, they have the option to continue with naltrexone, a non-opioid alternative for medication-assisted treatment of opioid use disorder. The problem with tapering is that the pharmaceutical industry resembles the pre-millennial state of the music industry, where there is no interest in providing a customized experience that might reduce their profits.
Suboxone, a brand of buprenorphine, comes in the form of rectangular films that dissolve under the tongue. It is available in 12mg, 8mg, 4mg, and 2mg. The 8mg and 2mg are the ones most readily available at pharmacies. I knew of a patient who drove all over South Florida, arguing with pharmacists because he had a prescription for the 4mg, and no place carried it, and they would not order it for him. Effectively, we have an 8mg and 2mg. Pharmacies typically price the 2mg film at more than half of the price of the 8mg strip, which you can verify for yourself at GoodRx. Cutting an 8mg film into pieces might seem like the right way to taper to lower dosages. However, the manufacturer recommends not cutting the strips. And, the drug may not be distributed equally throughout the film.
Think of an 8mg Suboxone film as an album and each milligram as an individual song. You can see what I am getting at with the comparison to the dark ages of music. Patients who take Suboxone and their doctors are severely limited when it comes to the tapering process. Every patient is different. Some patients will tolerate tapering down in daily dosage by 2mg at a time on a monthly or biweekly basis. Many more will find that this rate of tapering is too fast and uncomfortable. Their functioning in daily life is adversely affected by unreasonably rapid tapering. Going down 1mg or even 0.5mg at a time will work better for the majority of patients. This sort of customization is impossible with FDA-approved manufactured buprenorphine products. Patients may find themselves stuck at 8mg because there is no 7mg film. Or, they taper by cutting off a “1mg piece,” which is not likely to be accurate and not recommended.
Some people call the very last dose taken of Suboxone or buprenorphine, “The Drop Off.” Why do they call it that? Because, often, even when a person tapers to what seems to be a minimal dose of Suboxone, the ensuing physical withdrawal symptoms can be significant and prolonged. Some people have withdrawal symptoms for months after their last dose of Suboxone. One big problem with the drop-off is that the lowest available dosage of Suboxone is 2mg, and the manufacturer says you are not supposed to cut the film. 2mg may not sound like a lot, but when it comes to stopping Suboxone, it is quite high. Think of the drop off like an actual cliff. Ideally, you would want that cliff to be no more than a few feet off of the ground. Stopping Suboxone at 2mg is more like jumping off of a two-story building. You can survive the drop-off, but it will most likely be very uncomfortable.
So, if Suboxone films are like musical albums and each milligram is like a song, how can we customize individual dosages? We will probably not have much luck going to the big pharmaceutical corporations that make buprenorphine films and tablets. Asking a big drug company to change course is like steering the Titanic away from the iceberg. They move too slowly if they are willing to move at all. There is another solution that is already available.
Instead of thinking of the Suboxone film album broken up into 1mg songs, lets now imagine that even 0.25mg can be a song. What if patients could taper down to 0.75mg, 0.50mg, and even 0.25mg. Then, what if they could safely and evenly cut those dosages into halves or quarters. That would mean that a patient could taper to as low as 0.0625 mg. That would be a 1/32 of 2mg! Now, we can bring the discomfort of the drop off way down. And, as SAMHSA discusses on their website, alternate-day dosing can work for many patients. We can make the drop off even easier by getting to the lowest possible dosage and then going to 48-hour dosing.
There exists at least one compounding pharmacy that is making highly accurate compounded and customized patient medications that fit the description above. Where the pharmaceutical industry seems to have the goal to keep patients on their buprenorphine indefinitely, individual doctors and pharmacists can work with motivated patients to help them to reach their goal of reducing and discontinuing treatment medication when they are ready. For example, I have seen patients in the situation of being stable on Suboxone 8mg who would like to start tapering to a lower dose. Dropping to 6mg may seem like too big of a jump, and the solution would involve the more expensive and complicated solution of combining a 4mg with a 2mg or three 2mg films. What if we could go from 8mg one month to 7mg the next month? In my experience, patients who make this gradual reduction do not even notice the change.
Those patients who have switched to customized, compounded medication, where the dosage is adjusted precisely to their needs, and they can even pick flavors. Treatment progress can move forward. Also, if a patient is going to continue with buprenorphine for a long time, it is best to use the lowest effective dose to minimize possible side effects.
The pharmacy I am referring to that can make this customized medication is a little like that music machine I described at the beginning of this article. This pharmacy is ahead of its time, helping patients to follow through with their long-term addiction recovery goals. While this pharmacy can serve a limited number of patients in a single state, what about the many patients throughout the country would also benefit from a highly customized medication plan for tapering gradually? What is the next step? Possibly, the solution will involve a radical overhaul of the US pharmaceutical industry. Just like the music industry revolution and transformation to better serve the needs of the customers, we need a similar revolution in medical treatment. The precise solution may not be apparent right now because of the obstacles to overcome, but it is possible.
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MAT Stands For Medication-Assisted Treatment. Addiction treatment has been in the dark ages for a long time. When you are ready to stop drinking or using drugs, you might find yourself huddled in a group in a poorly-lit, dingy backroom of a church in a 12-step meeting. Or, you might find yourself sitting in a […] The post Let us change MAT To PAT And Revolutionize Addiction Treatment. appeared first on Recovering Addict...
Addiction treatment has been in the dark ages for a long time. When you are ready to stop drinking or using drugs, you might find yourself huddled in a group in a poorly-lit, dingy backroom of a church in a 12-step meeting. Or, you might find yourself sitting in a group circle in the well-lit meeting room of residential rehab. In either case, your chances of success in your recovery from addiction are in the 5-10% range.
Group support and talk therapy have a success rate in treating addiction that is a little better than the spontaneous recovery from addiction that can occur when an addicted person does nothing at all. Yes, you could spend hours and hours in meetings and spend 10s of thousands of dollars on rehab, and your outcome maybe just a little bit better than just trying to quit on your own.
Fortunately, for the deadliest of addictions, there are advanced medical therapies that work. MAT, or medication-assisted treatment, means using medication in conjunction with psychotherapy and group support to treat addiction. There is MAT for opioid use disorder. And, there is MAT for alcohol use disorder. Medications, such as methadone, buprenorphine, and naltrexone, are used to treat opioid addiction. Naltrexone works well for alcoholism.
While there is evidence that naltrexone may help to treat other forms of addiction, it may be of limited benefit. Addictions that involve drugs such as amphetamine, methamphetamine, and cocaine do not have medication-assisted treatment drugs approved by the FDA. Where opioid users can expect a 50-75% success rate with MAT and alcoholics can have up to a 78% success rate, people addicted to other drugs will have to settle for the lower success rates of group meetings and rehab. That is, until now.
There is a new technology that leverages the power of our smartphones and always-on internet connections. It is a proven, scientifically designed mobile software solution to help treat addiction. And, this new tech is FDA authorized and only available with a doctor’s prescription. The name of this new class of therapy, “Prescription Digital Therapeutics,” or PDT.
No, not at all. Medication-assisted treatment is still a vital part of treating opioid use disorder and alcohol use disorder. However, the long-term treatment plan for these conditions should include a standardized therapy overseen by a medical doctor or osteopathic physician. And, if the patient is addicted to a drug, such as methamphetamine, PDT can help, even though there is no MAT for meth addiction. With meth abuse on the rise, it is crucial to have additional proven tools such as PDT.
Again, therapy sessions with a licensed doctor of psychology with credentials in addiction treatment can make a big difference in long-term results. While prescription digital therapeutics does provide cognitive behavioral therapy or CBT, it does not replace your therapist or psychologist.
If you currently go to 12-step group meetings or a non-12-step group, if you are benefiting from it, don’t stop going. PDT cannot replace the value of building new friendships and connections to people who can support you throughout your recovery. Yet, PDT is entirely compatible with 12-step recovery.
Top psychologists have helped to design highly addicting video games that manipulate young children and adults by tapping into the reward region of the brain. More and more, we have witnessed this “gamification” of our society. Now, experts have put their knowledge of the neural pathways of the human brain and psychology to good use in designing PDT software. Addiction hijacks the reward system of the brain. PDT can stimulate these regions of the brain with electronic rewards to move the focus away from destructive drugs. Prescription digital therapeutics leverages cognitive-behavioral therapy in a unique delivery system to reshape the patient’s behavior over time. PDT helps patients to identify triggers and change the way they respond to them.
For decades, we have called addiction treatment that uses prescription drugs, MAT, or medication-assisted treatment. Now, doctors can prescribe more than medications for addiction. They can also prescribe FDA authorized prescription digital therapeutics. I propose that we change MAT to PAT or prescription-assisted treatment. PAT can include drugs, such as methadone, buprenorphine, and naltrexone, and PDT software as well. PAT indicates that the prescribed therapy is an evidence-based treatment that a doctor prescribes to treat the patient’s addiction.
For many drug addictions, doctors were only able to point the patient to therapy and group meetings or rehab. Now, doctors can prescribe PDT. Rehab doctors can prescribe PDT as well. So, when a patient presents with an addiction to a non-opioid, non-alcohol drug, doctors have something to prescribe that will help, even without MAT. When it comes to opioid or alcohol addiction, PDT and MAT go hand-in-hand. FDA authorized PDT is available now for doctors to prescribe to their patients to help them to overcome addiction.
The world is changing fast with the arrival of COVID-19, the novel coronavirus. We are adjusting to living and working differently, staying home, and using online video conferencing for school and work wherever possible. Many of these new practices will be with us for a long time to come and will become more refined as time goes on. Doctors are seeing patients using telemedicine, or telehealth, visits. Therapists are also using telemedicine technology to provide therapy to patients. Even rehabs and 12-step group meetings are going online. With the loss of in-person rehab and groups, we need all of the additional help we can get. PDT is an idea whose time has come at just the right time in history. Doctors can now see new patients with telemedicine for addiction and provide prescription therapy that does not even have to involve any medications at all. Most major health insurance companies have made arrangements for patients to have access to telemedicine doctors. If you are concerned about drug or alcohol addiction, make a telemedicine appointment today and talk to your online doctor about prescription digital therapeutics.
The post Let us change MAT To PAT And Revolutionize Addiction Treatment. appeared first on Recovering Addict Advice.
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