Have you heard of this term? I hope so. It is a policy that is being pushed through to all community agencies and professions in the field of community health, public health, mental health and substance misuse. It means that no matter what agency you call or go to, no matter what type of professional you see for an appointment of any kind, they are expected to hook you up with resources and help you even if it is not their specialty. So, if you go to your medical doctor for anything and you mention difficulty with mental health or substance use, they are bound to discuss options to help you and give you resources to call or go to in person....even make the call with you at that moment IF that is what you want. Yes, it is true. That is how bad this opioid crisis is and that is how tragic our numbers of suicides are; not accidental overdoses, I am talking actual suicides. This policy varies from state to state or region to region. If you bravely speak about your difficulty with mental health OR substance misuse OR are experiencing grief from losing someone from an overdose or suicide then whoever you confide in should offer to help you right then. What type of help and how you want to proceed is up to you. If you just want a phone number or website then that is it. Maybe ask for a brochure if available. If you want them to help you make the phone call, they should do that with you or hand you over to the RN nursing coordinator to help you right away. You must speak up and tell us your needs! We are eliminating the stigma to mental health, suicide, and substance use. We want to help but we need to know if you need help and what kind of help you want.
OPIATE ADDICTION: Let's talk about Opiate Use and Drug misuse
Spiritual Self Care
Spiritual self care is the feel good self care. It is NOT religious unless you want to make it that way. I am talking about doing what makes you feel good right down to your toes! It means different things to different people. Whatever it is...it must give you great joy and make you feel connected to yourself and others including feeling connected to something greater than yourself. This is the easiest self care because it makes you feel so good... who wouldn't want to practice it? So what makes people feel connected and full of joy? For some it is deep serious self reflection. Maybe reading a spiritual or prayer book and reflecting. For others it is meditation, Yoga, or practicing energy work by aligning their Chakras or receiving Reiki from a professional practitioner. Others go out in Nature such as sitting on the beach watching the waves, hearing the tides and smelling the salt air with the Sun shining on them. Adventurous people might climb a mountain then sit at the top and admire the view in wonder of the beauty. It doesn't have to be out in nature. Play with small children or a dog or cat. Sit at the local park and watch kids play. Volunteer your time and effort at a place where it makes you feel awesome! Go out in the community and see what is going on. Maybe join the festivities. Get up early to watch the sunrise or go somewhere special for a spectacular sunset. Go to a Church of your choice. Pass on your knowledge and talent by teaching someone something in your area of interest and watch the joy as they learn. Maybe you need to connect with others struggling with substance use disorder, so go to a Peer group to support and inspire others. If home alone, blast some music and sing your heart out! Dance! Whatever it is, feel the joy! Be grateful for the gift of life!
Mental & Emotional Self Care
I already talked about physical self care in a previous post. Mental and emotional health self care is even more important. Why? Because if you are a person with a substance use disorder then this part of you is very unbalanced and has contributed to your disorder. Sometimes it is the root cause of substance misuse. Since we are body, mind, spirit, all aspects of ourselves must be treated at the same time. This area might need a little more work to become balanced and whole.
Again, it starts with you...the real you. Not the person you pretend to be at school, work or even home. The real you without any masks. Some people don't really know who they are since they have pretended and used substances for so long. So, the first step is to acknowledge your feelings. This takes time. What you feel is NOT who you are. It is a temporary uncomfortable place. Maybe you are angry or bitter that life dealt you so many difficulties. Maybe you are scared to get help; fear of the unknown. Perhaps you think it means being judged. It could be that you don't like or love yourself. You have self blame and guilt for getting into this situation and having this disorder. Well all that can get better and those feelings can go away! How? First, make the phone call for help. Entire cities are getting together and each agency near you may have a common goal of supporting you, guiding you towards treatment and recovery, and being there for you every step of the way. Gone are the days of going at it alone! Even if your family and friends are not supportive, these agencies are being taught on how to manage your care according to all your specific needs and be your support system. If this is not the case, then find an area that is adopting this type of care. It will be well worth it.
After you start treatment and feel safe and supported, let all those negative feelings melt away. Cry if you need to....it is therapeutic. Then it is time to get to know yourself. Self reflection is needed. Counseling is recommended. In most treatment programs it is mandatory since it is so crucial to success. Also do things on your own such as taking a walk every day and think about yourself: your dislikes, what you like about yourself such as your positive qualities. Think about happy times in your past and what you can do to make happy memories in the future. Make an appointment for a Reiki session which is energy work that facilitates balancing and healing all aspects of you. Reflect while you paint or do color therapy. Besides walking, it is one of the best activities for self reflection and it can be fun! Work on a jigsaw puzzle. Go out and sit in nature without distractions. Listen to a guided meditation in a place where you won't be disturbed. Sit in the Sun. Do some gardening or get some houseplants and take care of them (yes talk to them!). Listen to meaningful music. Journal by writing or drawing every day. Join a peer support group. Recovery is successful when you have multiple support sources. Plus you might make a friend or two.
Now that you know yourself a little it is time to love yourself and express who you are. Forgive yourself. No more self blame! Do one thing for yourself EVERY day. It is so important to love yourself and to show yourself that love. Practice positive affirmations every day and say them out loud. Learn a new hobby that always intrigued you. Dance while no on is looking! Hug a pet or a friend and share your love. Watch a comedy and engage in laughter which is very therapeutic. Read a self help or spiritual book. Go out and listen to live music. Join a social club of some sort. There is a social club for every type of interest such as sports, art & culture, photography, book club, dinner & movie, dog walkers, singles, chess, cribbage, billiards, gaming , arts and crafts, etc...
As I said before, it starts with balancing the physical, mental/emotional and spiritual aspects of yourself. All this is needed for a successful recovery.
Again, it starts with you...the real you. Not the person you pretend to be at school, work or even home. The real you without any masks. Some people don't really know who they are since they have pretended and used substances for so long. So, the first step is to acknowledge your feelings. This takes time. What you feel is NOT who you are. It is a temporary uncomfortable place. Maybe you are angry or bitter that life dealt you so many difficulties. Maybe you are scared to get help; fear of the unknown. Perhaps you think it means being judged. It could be that you don't like or love yourself. You have self blame and guilt for getting into this situation and having this disorder. Well all that can get better and those feelings can go away! How? First, make the phone call for help. Entire cities are getting together and each agency near you may have a common goal of supporting you, guiding you towards treatment and recovery, and being there for you every step of the way. Gone are the days of going at it alone! Even if your family and friends are not supportive, these agencies are being taught on how to manage your care according to all your specific needs and be your support system. If this is not the case, then find an area that is adopting this type of care. It will be well worth it.
After you start treatment and feel safe and supported, let all those negative feelings melt away. Cry if you need to....it is therapeutic. Then it is time to get to know yourself. Self reflection is needed. Counseling is recommended. In most treatment programs it is mandatory since it is so crucial to success. Also do things on your own such as taking a walk every day and think about yourself: your dislikes, what you like about yourself such as your positive qualities. Think about happy times in your past and what you can do to make happy memories in the future. Make an appointment for a Reiki session which is energy work that facilitates balancing and healing all aspects of you. Reflect while you paint or do color therapy. Besides walking, it is one of the best activities for self reflection and it can be fun! Work on a jigsaw puzzle. Go out and sit in nature without distractions. Listen to a guided meditation in a place where you won't be disturbed. Sit in the Sun. Do some gardening or get some houseplants and take care of them (yes talk to them!). Listen to meaningful music. Journal by writing or drawing every day. Join a peer support group. Recovery is successful when you have multiple support sources. Plus you might make a friend or two.
Now that you know yourself a little it is time to love yourself and express who you are. Forgive yourself. No more self blame! Do one thing for yourself EVERY day. It is so important to love yourself and to show yourself that love. Practice positive affirmations every day and say them out loud. Learn a new hobby that always intrigued you. Dance while no on is looking! Hug a pet or a friend and share your love. Watch a comedy and engage in laughter which is very therapeutic. Read a self help or spiritual book. Go out and listen to live music. Join a social club of some sort. There is a social club for every type of interest such as sports, art & culture, photography, book club, dinner & movie, dog walkers, singles, chess, cribbage, billiards, gaming , arts and crafts, etc...
As I said before, it starts with balancing the physical, mental/emotional and spiritual aspects of yourself. All this is needed for a successful recovery.
Physical Self Care
Self care is #1 priority for everyone! To be truly happy and feeling well, people must take care of themselves physically, mentally, emotionally and spiritually. A person can't be the best they can be if one of these areas is unbalanced. Dissatisfaction with life, unhappiness, and negativity can be the result from the lack of self care. Let's talk about physical self care.
Sleep. Without enough sleep a person can feel cranky and be irritable. This affects those around you and all your relationships with people at home, at work and when you are out with the public. It sets you up for a negative day. Also, it affects your coping skills. For example: dealing with traffic in a healthy manner is much more difficult when deprived of rest and sleep!
Sleep. Without enough sleep a person can feel cranky and be irritable. This affects those around you and all your relationships with people at home, at work and when you are out with the public. It sets you up for a negative day. Also, it affects your coping skills. For example: dealing with traffic in a healthy manner is much more difficult when deprived of rest and sleep!
Food. Not eating healthy can make you feel sluggish. Your brain might not be getting the protein and nutrients it needs to function at top level. Trouble concentrating at school or work can result. Long term results could be the development and susceptibility to disease.
Exercise. Not exercising can also make you feel sluggish, easily fatigued with loss of muscle tone and strength. All your tissues are getting the minimum amount of oxygen needed. Your heart needs to be exercised. Studies show that cardiac problems such as high blood pressure can be improved by exercising. If you are not active physically, stress builds up within you since there is no energy release from daily stress and negative emotions. As stress levels increase, anxiety can result. Blood pressure and blood sugar go up. All of that contributes to the development of diseases.
What can you do for physical self care?
Stick to a bedtime routine. Relax for an hour before trying to sleep. Don't eat too late in the evening since that can contribute to insomnia. Read a book. Take a hot bath and unwind. Shut off your cell phone early or program it to ring for certain numbers only after a certain time of night.
Eat healthy. I am not talking about being a fanatic unless that is what you want. Logically, choose foods with less salt and sodium and don't use the salt shaker. Choose foods lower in sugar and limit sweets to fresh fruit. Use fresh or frozen vegetables instead of canned. Have fun with new recipes! Choose heart healthy options on the restaurant menu.
Take a daily walk for 30 minutes. Not motivated to do that? Then adopt a dog from the Humane Society and that will force you to take that walk every day. Take the stairs instead of elevator. Park your car further away from the store entrance. Get a neat bicycle and ride the local trails. Join fundraiser walks for your favorite cause. Be creative and have fun with your partner!
Other ideas: make an appointment for your annual physical or wellness visit.
Monitor your blood pressure and blood sugar if applicable.
Try something different for your health such as acupuncture, chiropractor, or treat yourself and get a massage monthly. Join the local Y and use their pool. Try something you always thought about, like Tai Chi, gentle Yoga, kickboxing, Judo or Karate. Take a self defense course. Go hiking. Make it fun and challenge someone to do a specific number of trails to try to beat you. Join a local club that does activities together such as dancing of any kind, hiking, nature walks, rollerblading, volleyball, biking, swim racing.
It all starts with taking care of yourself. Start doing this and getting help and staying in recovery will become easier.
Here is how we can make a difference!
I went to a conference where virtually every public and community health agency in the area where I live was represented. There is a change in the wording of the common language being used when speaking about "addiction". I want to talk about this and explain some of the reasons why this is being changed.
When you hear the words "addict", "addiction", "drug abuse", it brings a mental image to whoever hears or reads these terms.....for example, the word abuse brings on the image of someone hurting another person. These words, which depict images when heard, influence a person towards being judgmental of that person or group of people. This could affect the quality of healthcare for that judged person. Maybe that person feels judged and won't go for help. That is a terrible thought! We need to stop judging by changing our language when speaking about or with "people with substance use disorder". Doesn't that sound like we are talking about an everyday person with a diagnosis that needs to be treated? Yes! Let's start using these terms:
substance use disorder, person in recovery, drug misuse, actively using, abstinent, not using.
NO more addiction, addict, drug abuse, former addict, clean, dirty. Let's talk about people as if they ARE people, like you, like me. When people who have a substance use disorder talk about themselves, they also should not use the old terms. Why? Because talking about themselves in a negative way presents a negative self image in their own mind. When they say it over and over again, that negative self image is reinforced over and over. That is enough to make anyone depressed, want to hide and numb those negative feelings! So let's help others talk and feel more positive about themselves. It starts with me and you. Together we can make a difference!
When you hear the words "addict", "addiction", "drug abuse", it brings a mental image to whoever hears or reads these terms.....for example, the word abuse brings on the image of someone hurting another person. These words, which depict images when heard, influence a person towards being judgmental of that person or group of people. This could affect the quality of healthcare for that judged person. Maybe that person feels judged and won't go for help. That is a terrible thought! We need to stop judging by changing our language when speaking about or with "people with substance use disorder". Doesn't that sound like we are talking about an everyday person with a diagnosis that needs to be treated? Yes! Let's start using these terms:
substance use disorder, person in recovery, drug misuse, actively using, abstinent, not using.
NO more addiction, addict, drug abuse, former addict, clean, dirty. Let's talk about people as if they ARE people, like you, like me. When people who have a substance use disorder talk about themselves, they also should not use the old terms. Why? Because talking about themselves in a negative way presents a negative self image in their own mind. When they say it over and over again, that negative self image is reinforced over and over. That is enough to make anyone depressed, want to hide and numb those negative feelings! So let's help others talk and feel more positive about themselves. It starts with me and you. Together we can make a difference!
Let's talk about Opiate Use & Drug misuse
 |
| Takoda says, "Talk LOUD" |
Let's talk about
Opiate
Use &
Drug misuse
with your friends, with your kids, with your parents!
FEAR OF WITHDRAWAL & TREATMENT OPTIONS
Statement from ariticle
https://www.ndtv.com/health/bidding-goodbye-to-addiction-1662311
"The patient’s fear of withdrawal perpetuates dependency or makes it more permanent. For the late stage opiate addicted individual, fear of the pain from withdrawal can be the single factor that continues their dependency"
This is so TRUE! That is the biggest excuse of why a person with substance use disorder did not start treatment earlier. The fear of being in withdrawal. Most people with substance use disorder hear horror stories of others who started treatment and were so sick they couldn't work. Well, that is in the "old days" or maybe at a different type of program where they only detox you, roughly. It is different now. There are new medications and different modes of delivery being used. Plus, with the Opioid Crisis, programs are being scrutinized and held to certain standards. Programs are changing according to the needs of the crisis. Treatment plans are individualized according to the patients needs and the patients goals! Counties and other communities are being given grants to hire more professionals to meet the needs of society and this crisis. So if the program you are looking into is short staffed or is not being somewhat flexible to your needs (within reason) then move on to one who received a grant and is hiring and training more professionals. Not every clinic received a grant. But all must follow the DEA, Federal, State Pharmacy and State rules and regulations according to the type of license they hold. Private companies that did not receive a grant will become more competitive, hire and train staff and find ways to attract and retain their patients; to better meet the patient's needs.
Of course the biggest attraction to a treatment program is the ease of transition due to the fear of withdrawal. Treatment varies according to the treatment program in which you enroll, and that depends on the insurance, funds you have or money you can borrow. There is, Ultra Rapid Opiate Detoxification without Anesthesia where a patient is place under light sedation and rapidly detoxed. Nothing is felt. Naltrexone, (which is similar to naloxone) is then implanted. Once fully awake, the withdrawal symptoms are gone! Similar to naloxone, Naltrexone blocks any opiates and the implant lasts anywhere from 3-12 months. I am not sure if it takes care of cravings but that is another reason why addiction counseling is so important. It is not offered everywhere and I am not sure of the cost or insurance coverage.
There is Suboxone treatment which can be administered at a clinic or a certified physician's office along with mandatory addiction counseling or groups. With suboxone, a person MUST have very small to no opioids in their system in order to begin (NO use in 24+ hours). You must be in moderate withdrawals before you take your first suboxone dose. It is the nature of the medication. Suboxone's properties are strong, meaning that once taken, it kicks out any opioid you previously took; it kicks it out from the opioid receptor site and takes its place. The first dose of suboxone is not enough to fully fill the receptor site as much as the opioid you had in your system, therefore you are in withdrawals quite quickly. So, it is better to be in withdrawals before your first dose, and within 1-2 hours after a couple small doses of suboxone, you feel fine....normal. That "normal" state will last for 24 hours! But. if you use 24 hours or less before your first dose of suboxone, then you will make yourself sick and won't feel better until the next day's dose of suboxone. It would work on that second day, since this second day of suboxone would be 24+ hours after your drug use and the opioids would be out of your system. It would be successful and you would feel better within minutes to an hour of that dose and remain symptom free by taking that therapeutic suboxone dose every day to every other day depending on the program. Stay off of any opioids, marijuana, benzodiazepine and alcohol and you could get take home doses and go only once a week for your addiction group and medication and live a normal life!
Methadone treatment can be started right away at a small dose and that dose is slowly increased until you feel normal. This takes some time. I discussed how methadone programs work in previous blogs. Don't expect to suddenly stop opioids with your first methadone dose. How do you start methadone and not be in withdrawals or sedated? By being honest about your use and listening to the doctor and nurses treating you. Don't go to your admitting appointment sedated or tired looking or you might be denied or started on a smaller than normal dose, for medical safety. The unspoken rule is: Do not use after 8 pm the night before. Go to your admitting appointment in mild to moderate withdrawals. The doctor will do a physical and order your first dose of methadone which is anywhere from 20 mg to 30 mg. Will that be enough? No. But it is the only way to begin. Too large a dose at the beginning could make you sedated. It has to be done slowly. The day before your assessment and increase day (they will remind you), decrease your drug use to prepare for that increase. If you do it that way: slowly cut down your opioid use as your methadone increases, you will slowly transition to only methadone. You will have periods of withdrawal that will lessen and improve as you learn how to cut down your use and time it wisely. Listen to the nurses dispensing your dose. Talk to one with experience, then ask questions! An experienced methadone nurse can tell you exactly how to transition smoothly and can even estimate what dose will have you feeling "normal". Unfortunately, due to the long action of the medication and the potential for overdose with this medication, the rules for methadone take homes are very strict and it takes longer to earn take home medication doses.
There are other medications being trialed for alcohol and cocaine use. So far, for opioid misuse, the Naltrexone implant sounds like the smoothest transition. Hopefully they will make it affordable and more accessible in the near future.
Subscribe to:
Posts (Atom)