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.

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!

Let's talk about Opiate Use & Drug misuse

Takoda says, "Talk LOUD"

Takoda the rescue dog got a second chance at Life...someone you know might not if they misuse opiates, other drugs, or medications so....talk LOUD

Let's talk about
Opiate
Use &
Drug misuse

with your friends, with your kids, with your parents!

SAFE STATIONS

I am not sure about other parts of the US or world but here in the State of New Hampshire in USA, a trend started late 2016 where EVERY Fire Station in Manchester, NH and then in Nashua, NH was designated a SAFE STATION. What does that mean? It means that at ANYTIME day or night, if a person goes to the Fire Station they would be assessed by a fire fighter. If their condition warrants medical attention right away then an ambulance is called and that person is brought to the local Emergency Department for urgent medical treatment. If the person is medically stable but needs intervention for substance misuse treatment then the local treatment center on contract is called and that person is brought directly to the treatment center. NO ARRESTS. NO LEGAL IMPLICATIONS. Any drug paraphernalia, drugs or weapons are confiscated, obviously, and handed over to the local police for disposal. NO ARRESTS for amounts that do not implicate an intent to distribute. This was one way to help the opioid crisis since the Emergency Rooms were becoming overwhelmed and unable to handle the volume of people asking for help or needing intervention. Find out where the SAFE STATIONS are near you and take advantage! It is truly one of the best ways to get someone help.

WHAT IS BUPRENORPHINE? WHAT IS METHADONE?

Buprenorphine is an "analgesic", aka pain medication, aka narcotic. It is man made from something "natural" and altered chemically to become a semi-synthetic compound. Yes it is considered a narcotic and treated as such by the DEA. It is in the "Opioid" category. When taken, this medication will merge with opioid receptor sites just as morphine, heroin or methadone does. But this med has other slightly different properties. 

Buprenorphine is a partial agonist opioid. Heroin and methadone are full agonists. I mention this since you might hear those terms, not to conduct an opioid course. Because it is a "partial agonist" Buprenorphine can give pain relief same as the other opioids but it doesn't affect your breathing as much as methadone would. It is faster and easier to get stable with this medication and when you are ready, faster and easier to detox off.  It is considered to be less addicting and with fewer side effects. It is shorter acting compared to methadone. You can't be on any benzodiazepine prescriptions (or illicit) such as xanax since it is not medically safe. You must be illicit drug free after you are stabilized or usually you get terminated. Remain illicit drug free and you get "take home" doses for several days or a week so you don't have to go everyday. Some clinics have you go every other day. Of course there is a catch: buprenorphine has what is called a "ceiling" effect. Meaning, once you reach a certain dose, taking additional doses does not give you more pain relief and it is not suppose to get you euphoric or high. Once you reach a certain level, that is it. Okay if your drug use has been 5 years or less or your daily use is not real high. For some people with substance use disorder  this works very well!  If you are taking buprenorphine and still have cravings then you need methadone. With the carfentanil, it is hard to judge if this treatment would work well with heroin users until one tries it. Doesn't hurt to try. 

Heroin users usually need methadone; WHY? Because of the large amount of daily use and recently because of the carfentanil potency. Methadone is a full agonist. It has no ceiling effect. It gives full pain relief but take too much and you will stop breathing and die. Plainly put. It affects your breathing so anyone with a respiratory disease such as asthma or COPD must be monitored and must be very careful in taking this medication. Methadone can also affect your heart rhythm. A very high dose (> 200 mg) or a dose above 80 mg in combination with certain prescribed meds such as clonidine or seroquel can be deadly. That is why methadone clinic patients are monitored so closely. For medical safety. Methadone is dispensed by nurses only (not counselors) and you are assessed before you take that daily dose, for medical safety. Methadone has a very long half life....it lasts for days in your body until it is totally out of your system. When you take it at a methadone clinic daily, as you should, it builds up in your body to a therapeutic level and then it is maintained at that level. A therapeutic level is when you have no physical withdrawal symptoms at all AND no cravings. You almost forget that you take it because you feel "normal". Not high. Not sick. No cravings. Just live and enjoy life. When I say methadone clinic, I mean methadone for addiction NOT pain. Methadone for pain is a totally different program, different approach and different rules. 

What is Naloxone?

This is an excerpt from SAMHSA's Opioid Prevention Toolkit,

*I underlined and did bold on pertinent info. After the SAMHSA paragraphs I summarize it all...

      " Opioid overdose-related deaths can be prevented when naloxone is administered in a timely manner. As a narcotic antagonist, naloxone displaces opiates from receptor sites in the brain and reverses respiratory depression that usually is the cause of overdose deaths.7 On the other hand, naloxone is not effective in treating overdoses of benzodiazepines (such as Valium®, Xanax®, or Klonopin®), barbiturates (Seconal® or Fiorinal®), clonidine, Elavil®, GHB, ketamine, or synthetics. It is also not effective in overdoses with stimulants, such as cocaine and amphetamines (including methamphetamine and Ecstasy). However, if opioids are taken in combination with other sedatives or stimulants, naloxone may be helpful. Naloxone injection has been approved by the United States Food and Drug Administration (FDA) and used for more than 40 years by emergency medical services (EMS) personnel to reverse opioid overdose and resuscitate persons who otherwise might have died in the absence of treatment.8

FACTS FOR COMMUNITY MEMBERS
Naloxone does not have the potential for abuse. It reverses the effects of opioid overdose.9 Injectable naloxone is relatively inexpensive. It typically is supplied as a kit with two syringes10 These kits require training on how to administer naloxone using a syringe. The FDA has also approved an intranasal naloxone product, called Narcan® Nasal Spray, and a naloxone auto-injector, called Evzio®. The intranasal spray is a pre-filled, needle-free device that requires no assembly. The auto-injector can deliver a dose of naloxone through clothing, if necessary, when placed on the outer thigh.  Prior to 2012, just six states had any laws that expanded access to naloxone or limited criminal liability.11 Today, 42 states and the District of Columbia have statutes that provide criminal liability protections to laypersons or first responders who administer naloxone. Thirty-nine states and the District of Columbia have statutes that provide civil liability protections to laypersons or first responders who administer naloxone. Thirty-eight states have statutes that offer criminal liability protections for prescribing or distributing naloxone. Thirty-three states have statutes that offer civil liability protections for prescribing or distributing naloxone. And 42 states have statutes that allow naloxone distribution to third parties or first responders via direct prescription or standing order.

https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA16-4742

___________________

**What it means:  Naloxone is a medication that is prescribed by a doctor. This medication has been used for many years in hospitals when needed for patients post surgery if having an unfavorable reaction to anesthesia and pain medication. These medications slow down breathing. If your breathing is not providing enough oxygen to your brain and your heart, your brain will be damaged and your heart will stop. Naloxone is a special medication that can instantly reverse this situation! Miracle med!! Before the opioid crisis, this medication was given IV in hospitals. Now, you can get a prescription for naloxone that can be given by spraying in one nostril (close the other one) or by injection *thru the clothes* eliminating precious time unclothing the person (it will even tell you what to do). 42 states allow "third parties" (such as clinics) to give out naloxone by a "standing order", which means you don't need to personally see a doctor to get it. Just show up at the appropriate clinic and ask for it. No questions. 39 states have a law in effect that protects whoever calls 911...no arrests, no searches, if you call 911 to save a life. So please, call 911 for anyone in need. Don't drop someone off at an Emergency Room! Parents, friends, get a prescription for naloxone and carry it with you. No incrimination when asking for a prescription. You CANNOT harm someone if you give it and they don't need it. It just won't do anything. No side effects. But, if they need it...you saved a life and there is no better feeling than making a difference! One thing to remember, once given during an overdose, the person might need a second dose after a 30-60 seconds if no response. Why? It is because of the super duped drugs out there....carfentanil......making the drugs more potent and deadly. That is why naloxone always comes in packages of 2. Like  I said, it can't hurt and if needed will save a life. After receiving naloxone the person will start breathing and then will be in withdrawals. So, give the spray or injection then call 911 right away! Don't wait to see how it works. They will need intervention for their drug use and this is the perfect opportunity. Plus they need a medical evaluation to ensure they do not need any other medical care. 

Personal Power

We all have personal power. Yes, we are made of energy particles therefore we are energy and energy is power. We all have the ability to use our power in amazing ways. We also have Free Will to do what we want with our energy. Have you ever "willed" yourself sick before an event you really did not want to go to...focused intensely on how happy you would feel after passing an exam...visualized yourself excelling in a sports game and actually have these happen, just as you expected? You used your personal power. What would happen if you focused on how to steal some money for the next fix....constantly lied to cover your habit...always thought about your "bad luck"? Your power would start becoming negative and sickly. Once you cross over that line and become addicted to some type of opioid, you give your personal power away to the drug 100%. The drug now controls you. You have allowed the drug to take your personal power. It starts affecting every aspect of your life because you are now the puppet. The drug has taken over your personality. You are negative, irritable and don't care about anything except your next drug use. It ruins your family life, social life, your school and/or your work. On the outside you are the same person, but on the inside you lack personal power because you gave it away. So, TAKE IT BACK! Step 1 in the 12 Steps talks about admitting you are powerless. Any disagreement there? If you are an addict then you are powerless at this time. But you CAN start heading the the direction of getting your power back 100%. It is never too late to begin this process. In order to do this you must begin at a basic level and admit that drugs have your personal power.... temporarily. At the very least, start Addiction Counseling. Maybe you need inpatient or maybe an outpatient clinic fits your needs. See an Addiction professional. They can get your input then tell you which one is best for you. Don't rely strictly on your friends and family unless they have experience and education in Addiction. There are too many myths out there. Family and friends however, can be a great support system if they are interested in becoming educated and involved with your recovery. With the right treatment, with the right professionals, with the right attitude, you CAN take back your personal power 100%. Read about "The Next Step: The Phone Call" and read about being "...nervous about going to a 12 Step Meeting" for more insight.

My Friends Keep Calling and Stopping By Even Though They Know I Started Recovery!

You will hear about how "friends don't tempt friends when they start a recovery program". Just think about it.....those friends are addicts too! Don't get angry. Addiction likes company. No matter how much a friend wishes you the best in recovery, the addict in them can't leave you alone. If you truly believe that your addiction is a disease then you must believe the friends knocking at your door have a disease also. But, the fact is, you must do what is best for YOURSELF, or recovery will not work for you. You can offer support while they seek treatment but don't put yourself in the position where they are using in your presence. Even if you don't participate in the drug use, the temptation will seep into your brain. You might start dreaming of using or have severe cravings when you are really stressed about something in your life. It will spiral down from there. So don't go there. If a friend is not ready to seek treatment then just let them know that you will be there when they decide to take that first step. Tell your friend that until that happens, they must stay away from you, out of respect of the friendship. No phone calls, no visits. This is the best approach with friends. Anyone else who is not a friend you can just say no and go away! If a person continues to bother you despite your request, say what you must to discourage them. This is your life and you want to live!

Can I die from withdrawal symptoms if they are bad enough? What can I do for withdrawals?

You will not die from the symptoms of opioid withdrawal, no matter how bad they are. You will feel like you are dying and others looking at you might agree. You will not die, but there is no doubt you are suffering :(     What can happen medically is severe dehydration from the sweating, vomiting and diarrhea. Being badly dehydrated is a feeling of extreme weakness, pale skin, sunken eyes, cracked dry lips, possibly even dizziness. If the person cannot drink a large amount of water and Gatorade or Powerade, then go to an Urgent Care for IV fluids to rehydrate. In a dehydrated state you are at risk for injury from a fall due to weakness. How many of us had a real bad flu and nearly fell in the bathroom from feeling weak and dizzy? Be safe.....getting hydrated is necessary whether it is from drinking lots of fluids or getting IV fluids. Always have some Gatorade or Powerade in addition to water and IV fluids to replenish your electrolytes. It will help bring back your strength. Over the counter products can help with other withdrawal symptoms such as Immodium for diarrhea, I would avoid Kaopectate and Pepto Bismol since it contains a substance similar to aspirin and anyone ages 12-18 should not take aspirin since there is a chance it can cause a disease called Reyes Syndrome (serious/ fatal disease) if conditions are right. Imodium takes a little time to work so take it at the first signs of diarrhea. If you are pregnant, go to the Emergency Room since you don't want to risk taking any medication, and dehydration when pregnant is much more serious! For muscle cramps take ibuprofen or naproxen but don't exceed the max dose recommended or you can damage your kidneys. I would avoid acetaminophen unless you are absolutely sure you do not have Hepatitis C Antibody; it might overload your liver. Over the counter magnesium supplements also may help muscle cramping if taken according to directions and you do not exceed the recommended dose. Need some sleep? Only at night, use generic benadryl (diphenhydramine) 2 caps and try some melantonin: anywhere from 3mg - 5 mg any brand, or a 10 mg time release tab by Natrol. Melantonin is a hormone your own body makes which regulates the wake-sleep cycle. Taking a supplement helps some people with sleep disturbances get a decent night's sleep. If you end up going to Urgent Care it is best to have someone with you who knows about why you are in this condition. If ER staff suspect you are in withdrawals then whoever is with you might find out. If the Emergency Room takes blood...if they draw any blood they might do some drug testing......if they get a urine sample they might do some drug testing.....that is all I will say on that. If you are drug tested in any way and you are on probation then your probation officer might find out and have concrete evidence against you. Be wise. Go for IV fluids and don't ask for any narcotics or benzodiazepines (like xanax or ativan) and you should be treated well, be rehydrated, & released. Simple as that.

The Intake Appointment Final Part 3

You did the business in Part 1. Saw the Addiction Counselor in Part 2. Now the last part is seeing the nurse. It is usually the Nurse Manager, Charge RN or seasoned staff RN who interviews you in this last stretch of the Intake appointment. All this is in preparation to see the doctor for your first medication dose. If you have any prescription medications that ARE PRESCRIBED TO YOU then bring them in for the nurse to log into your chart. Don't bring old bottles from last year and don't dump the new prescription pills into an old prescription bottle to condense it. The nurse needs current prescriptions in the current bottles, if possible. Please don't try to deceive the nurse and bring only some of your medications. Believe me, a nurse just knows! If you doctor shopped, say so. A history of doctor shopping or fraudulent prescription writing will NOT get you rejected from being admitted into the program. This is why you are here, right? Honesty is needed. By the way, programs do NOT report you to the police for such crimes. Consider it in the past. Just don't continue such behavior since it is counterproductive to your recovery and sets a bad example to other patients who are doing their best. Criminal behavior might get you kicked out if you choose to continue and get arrested. It is all about choices. Back to the nurse: the nurse will take a medical history such as diseases, injuries and surgeries. Please be sure to report any heart or respiratory issues, concerns or problems. Detox medications are serious business and the doctor needs to know of any heart or lung problems before prescribing your suboxone or methadone. It is his doctor's license on the line and he deserves to be informed. Methadone in combination with certain medical conditions and medications needs to be given with caution. Methadone and suboxone can affect your breathing and oxygen level in your blood, especially when combined with other prescription medications and medical conditions. If you have a medical history and are followed by a specialist then you will be asked to sign a "release" for that specialist. The same goes for your Primary Medical Doctor, your Psychiatrist and your Pharmacy. Why? It is coordination of medical care. Methadone and suboxone are actual prescriptions and all prescribing doctors need to know what the other doctors are prescribing, for medical safety. You might think it is overboard until something happens, some interaction of medications and medical conditions that go awry, and harms the patient in some way, including death. Most treatment centers also ask you to sign a form saying that you will tell any provider you are on methadone and you agree to use only one pharmacy. That is standard practice. After the medical history the nurse will ask about your mental health history, including asking if  you are suicidal or homicidal. Again, be honest. They are just getting the details to better serve you in your recovery process. Next step is actually seeing the doctor for admission into the recovery program of an outpatient clinic. It could be the same day or most likely it will be a few days later at the next available appointment. Again, do not come in impaired, sedated, drunk or high on anything in any way. **you must be in withdrawal when you see the doctor for admission. Enough withdrawal to make it safe to give you a low dose of methadone (or total withdrawal for suboxone). If it is methadone treatment then be in mild to moderate withdrawals and do not use after 8 pm the night before! Seriously, you might not be medicated if you use too late in the evening the night before. If it is suboxone treatement then you have to be in total withdrawals and not have any opiate of any kind for 2+ days. Sounds terrible, I know, but it is the nature of suboxone. If you do not follow the instructions that the clinic tells you, then you will be putting yourself in the worse withdrawals ever on admission day when you take your first dose of suboxone. You will do it to yourself! It is all about choices.

Recovery: The Intake Appointment Part 2

So you already gave you address, phone numbers, emergency contact, paid your fees and have been told countless of instructions and rules. Don't worry about remembering all that. You can always ask and most likely you will be reminded by both staff and other patients. The mindset of patients in recovery seems to vary according to what state or part of the USA you live. I have been told countless of times by "visiting" patients from other states how this is true. So this is straight from the patients themselves. (By the way, in NH, we are very friendly and helpful to all.)
So the Addiction Counselor is the next professional you will see after the business part. This is a long detailed meeting but it is very important! Please do NOT use right before this Intake appointment and do NOT use in the bathroom in between seeing professionals! You nod off, and you have to reschedule! You are cranked up and can't sit still, you have to reschedule! and that postpones your first medication appointment with the doctor so it is pointless. Now, we don't want you vomiting either so plan accordingly....you know what I mean. The appointment is at least 2 maybe 2 1/2 hours. When you see the Addiction Counselor you will be asked everything from the first day you ever used in your life until present day. Questions about every drug you tested including cigarettes and alcohol. Please be honest but don't embellish. No one will be impressed. They will ask about your childhood, your family, employment, legal stuff etc...all this plays a significant role in your recovery. If Uncle Brian beat you every Christmas morning, we aren't going to ask you how your Christmas was. If your friend overdosed in March, we will be on the alert for depressive behavior and possible alcohol/drug use near springtime. All the questions are for a reason. We don't like paperwork that much. A big thank you for being patient with all the questions! The last professional you will see is the nurse in The Intake appointment part 3.
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Recovery Program: The "Intake" Appointment part 1

You made the phone call and have your first appointment. It is commonly called the "Intake" appointment. This appointment is the most important! From my experiences, this appointment is where all info on you is gathered by MULTIPLE healthcare/addiction professionals. These professionals have heard every story so don't leave out any details and please BE HONEST & precise. After all, this is YOUR life! First piece of business is getting your address and a reachable phone number such as your cell number. If you give a second phone number, please specify if it is OK to leave a message. Don't worry, no one will call you mindlessly or call to check on you. It is needed in case your counselor has the flu and has to cancel counseling, in case of fire and the place of business is in a temporary location etc....in other words, for something very important. You will also be asked for at least one emergency contact name and phone number. This is in case you have a medical emergency or injury, so someone close to you can be told. Otherwise, an emergency contact is NEVER called. Confidentiality is taken seriously. The other piece of business is the payment. Programs can't run on love and good intentions. There should be an "intake" fee or it could be called an administrative fee for the admission process. You will also be asked for the first week's payment up front. Yes, that is a big blow to someone who spends all their money, and other people's money on drugs. But it is necessary for two reasons: 1) It is common for addicts to act on impulse by being admitted to a program then not showing up or paying. It is a lot of work to admit someone into a program. It is considered a waste of time and money when this happens. Someone else who is ready for recovery could have come to that appointment. and 2) If you pay a week in advance with your money or borrowed money, you will be sure to show up that first week to get your money's worth, right? Commitment it what it is. That commitment of one week in treatment opens the door to maybe another week, maybe even another month and bingo! You are on your way to a BETTER life and loving it!

Myth: Methadone rots your teeth

FALSE. Teeth do not rot within months of starting a methadone program. It takes time, lots of time to have more than one tooth rot enough to be pulled. It is the amount of time you spent using that is the culprit. Years of not eating properly (and not taking vitamins), years of not brushing, years of not seeing a dentist for preventative cleanings will lead to tooth decay. A poor diet for an extended period of time will leave your body deficient in nutrients. Then your body start taking nutrients where it can, at the least vital place...your teeth. Once you are in recovery, you start noticing what you couldn't see or feel while you were using all those years. Your gums are sore, they might bleed easy, you have uncontrolled bad breath. You start taking care of your health and think you escaped any health issues. Then one day you bite into something and start chewing and....snafoo! A broken tooth. It is easy to blame methadone and since there is some amount of sugar in the liquid form. It might sound like a very logical blame to you. But know it takes years to do that kind of damage. Nothing you can do about it now except take care of what is, and do what you can to prevent any further damage. At the first sign (or before) of trouble with teeth or gums, make an appointment with a dentist. Don't wait until you are in pain, have an infection or break a tooth since there will be a period of waiting until an appointment is available. Worst case scenario:  having a legitimate infection with pain and going to the Emergency Room as an addict asking for an antibiotic and pain med. If they don't want to give you pain med, you suffer. If they give you pain med, you should give the med to a family member who can dispense the correct amount of tablets to you during the prescribed time frame. Until you are further along in recovery it is way too tempting to abuse the prescription. You don't want to make your situation worse, make yourself feel worse or lose any ground you gained while in recovery. If you made progress in recovery, be proud and ask someone to help you with your prescribed med!

The First Step: The Phone Call

So you don't want to tell your family or friends you have a problem with misusing substances or medication...OK. It's your life, but if you want to take that next step towards a BETTER life, then you need to talk to professionals who can help you with tackling this disease and head towards recovery. So it is a matter of making that first phone call. NOT always a  simple task!  You might feel a rush of all kinds of feelings that are very uncomfortable. Feelings you have numbed and shoved back inside of you all this time. One way to help minimize this experience is to have someone with you when you make that first call. It can be someone from a recovery group or local community service. Heck it can be a firefighter or a social worker or nurse in the local Emergency Room. All public service professionals will be willing to sit with you for a few minutes as support while you make your first phone call for help with your disease. If you have someone in your personal life with you at the time of the phone call, make sure they are stable, sober, not impaired and have your best interest at heart. FYI:  The first phone call will 1) give you basic info on the service,  2) info on insurances accepted or cash payment and either 3). make your first appointment for an Intake or put your name on a wait list. ***This phone call, entire conversation and any info given is completely confidential.  NO ONE can call and see if you called, NO ONE can check to see if you have appt or are on the wait list. NO ONE, period. Not even your mom! This is the law! A violation of this law can get a person jail time. So congratulations if you made your first phone call :)  I will talk about the first Intake appointment in another section with the word Intake in the title.

Do I have to tell anyone?

Have you ever tried to explain the mechanics of what is wrong with a car and how to fix it to someone who doesn't have a clue?  That is what you will get trying to talk addiction to friends and family who are not educated on the subject. It is a foreign language and a foreign land. Not their fault and not their problem. It's your problem and your recovery. Some family are open to the subject and if they are ....well, you are very lucky!  Not everyone is open to the subject when it comes to family. Could be pride, or maybe they are addicts/alcoholics themselves! Who wants to look in the mirror? If you don't have the support of family and/or friends then there are plenty of support groups and others in recovery you can turn to. If it's one thing I know to be true:  addicts will always accept other addicts and be there for that 2 am phone call when you really want to use. You don't have to be BFF, but some type of support is needed in recovery. Someone who understands exactly what you are going through and can listen without judging. With the opioid crisis going on there are many new hotlines, support groups, treatment centers and professionals in this field. If one doesn't suit you, there are plenty more to try.

"I'm getting clean...now what....I still have problems!"

Problems, problems, problems! You had a problem and turned to drugs/alcohol to fix it, then got addicted. You had a problem and did drugs to distract you or numb you, then got addicted. You did drugs/alcohol, you got addicted, and it caused problems in your life. Addiction ruins every aspect of your life: personal, family, social, employment, legal. It is a vicious cycle: problem....drugs, drugs....problems...back to drugs etc...Your mind makes up excuses and reasons to continue using drugs. In the old day it was called, "Stinkin Thinkin". Your mind wants to win, and your mind is strong! That's where Addiction Counseling comes in with Addiction Focused Problem Solving to break the cycle. It is a specialized approach to .....everyday shit.  You need Addiction Counselor to show you how it works. With focus and 100% effort it can be done!

HOPE

Like the Phoenix, the addict can rise from the ashes of  the old self into the new self!

Misconceptions

"I can detox myself"
If you take another person's methadone or suboxone, you buy it off the street (it is probably diluted or altered somehow). You try detox yourself slowly so you don't go into withdrawals. So, intentions are there...but....can you really do this and wean yourself completely off, and stay off ... off ANY narcotic or alcohol? NO. I know because addiction is an official disease. and even if you don't believe that, think about it: How many addicts have tried but couldn't stop on their own? or if they did, how long could they maintain that? When an addict sees how it destroys their life, they don't WANT to do it but they MUST so they don't get physically ill and can function normally at work, at home etc... and even when an addict physically weans off the drug, there is a psychological component that is not addressed. Therefore the cycle eventually starts over and continues until addressed. That is where outpatient treatment centers come in. Could be methadone or suboxone. The "medication" is an actual prescription by a certified psychiatrist. It is dispensed by Registered Nurses who are trained in Addiction. Yes, you are usually routinely drug tested to check your progress and there is Addiction Counseling. The physical addiction part is easy. It is the psychological component that a person normally cannot do on their own without guidance, monitoring and support. It is the only way to change your thoughts and behaviors long term. Remember, Addiction is a disease and needs to be treated seriously as a disease or it will come back as that awful problem and cause problems.

Recovery CAN be successful!

YES it can work!
But I have often heard these statements:
"i can't"
"I've been doing this for x years, I can't stop...recovery won't work for someone like me...it's my life".
Yes you can!
But don't expect it to happen in 1 day or 5 days. Patience is NOT a virtue of any type of addict!

**So you must PUT IT INTO PERSPECTIVE:
It took ____yrs to become addicted to opiates. It didn't happen overnight. So it will take a little time for recovery. Like something that has been out in the rain for years and has lots of rust....it takes more time to get all that rust off. But if you don't START cleaning it, it will never get clean! So, think about it, and decide what it is you want to do. Everything is a choice that YOU make. Start cleaning or let it rust some more