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Addiction & Chronic Pain

What is the process for diagnosing addiction? Addiction Alternatives

Addiction & Chronic Pain?

A vast number of individuals who struggle with addiction often face other conditions that seem to complicate their substance abuse disorder. In some instance, chronic pain or other physical health problem have at time exposed these individuals to addictive prescription drugs to combat the pain. This exposure is often the root to the initial physical dependence linked to their addiction.

Individuals with chronic pain or other physical conditions may have initially began taking the prescriptions to relieve their pain, however, the highly addictive qualities of these drugs have in return forced individuals to take more than what was prescribed. These individuals may at some level continue taking the drug to deal with the pain, the excessive amount these individuals take is actually used to feed their addiction.

It is often difficult for individuals with chronic pain to come to grips with their addiction as the idea of being addicted to the substance that “helps” their pain is hard to fathom. While the substance has in some way reduced the pain, when these individuals attempt to discontinue use, their pain returns. Of course, for individuals with chronic pain, this is a true concern when entering addiction treatment as the use of these prescription drugs must be discontinued. It would defeat the purpose of addiction treatment to continue use and make recovery impossible.

What Types of Chronic Pain Can Rehab Help You Relieve Naturally?

Some conditions leave both patients and providers without a diagnosis for the pain and thus resort to treating the symptoms of pain with addictive prescription drugs. Typically, resorting to these methods are in an effort to improve the patient’s day to day life by reducing the pain.

There are several commonly known conditions that cause severe and chronic pain. These conditions may include:

  • Congenital malformations
  • Acute and chronic illness
  • Acute injuries
  • Conditions that affect eh nervous system’s ability to function properly

For Patients with The Above Chronic Conditions, Your Needs Will Be Assessed Prior to Intake

It has been our experience at Addiction Alternatives that many patients fear their medical conditions whether physical or mental illness will not be considered during their treatment plan. This is actually not true. At Addiction Alternatives, we understand the importance of determining causes and conditions linked to the addiction in order to better the chances of long term recovery.

It has been found that individuals with chronic pain and mental illness who are not treated for their other conditions often relapse after completing treatment as they have no defense against the pain or mental condition.

For this reason, Dr. Buscema and our nurse practitioner will evaluate your needs while also teaching you to cope with the symptoms. As you begin your treatment protocol with Addiction Alternatives we will help you either determine a much lower does to help you manage your pain or to find new ways to deal with the pain. Our goal is not to have your sober and in pain, our goal is to have you sober and in less to no pain.

How Will Your Addiction Treatment Program Help You Cope with Pain?

While it is our goal to help you wean off of your pain medication completely, there are rare circumstances where a recovering addict must remain on a small regulated dose of a pain management prescription. If possible, we attempt to find a non-narcotic version that is not addictive to help you manage your pain.

Certain types of cognitive behavioral therapy have shown benefits to reducing chronic pain in recovering addictions. Various types of counseling are specifically designed to address pain management while also assisting in the process of reducing drug cravings. 

There are also other physical activities that been known to help the body manage pain more efficiently. These physical activities work to strengthen your muscles, increase muscle endurance and increase mobility. These activities are linked to the reduction of inflammation that is usually the root cause of pain. While there are other causes of pain, the primary cause is usually linked to increased inflammation that if managed or treated, can reduce the pain for recovering addicts.

Examples of pain management physical therapies may include:

  • Yoga
  • High-intensity strength training
  • Meditation
  • Acupuncture
  • Chiropractic care
  • Massage therapy

At Addiction Alternatives we understand that the thought of dealing with your chronic pain while pursuing a sober life may be a scary thought. However, with our help, you can begin a positive road to recovery comfortably.

For more information about our out-patient program at Addiction Alternative, contact us at 772-618-0505.

How Can My Anxiety Affect My Recovery?

How Can My Anxiety Affect My Recovery?

What is the process for diagnosing addiction? Addiction Alternatives

How Can Anxiety Affect My Recovery?

At Addiction Alternatives we have seen time and time again the difficulty to separate mental health and substance abuse disorder as they often go hand in hand. More often than not, the two seem to feed off of each other. More than 50% of addicts suffering from substance abuse have what we consider the dual diagnosis. We also refer to this as a co-occurring disorder where both disorders are present simultaneously.

There is no cut and dry single type of dual diagnosis. At Addiction Alternatives, Dr. Buscema often sees a variety of substance abuse disorders accompanied by a wide range of mental health disorders. Each case presents a unique set of side effects making this diagnosis difficult to treat and diagnose.

When addressing anxiety is important to understand exactly what it is. The term anxiety is referred to the normal stress reaction that can be beneficial in certain situations. Anxiety disorders, however, are completely different from the normal feelings of nervousness and stress. This response is often inappropriate and can be expressed as fear or anxiety. Normal anxiety goes away fairly quickly whereas anxiety disorders tend to not go away and can become worse over time.

Quick Facts:

This type of anxiety often interferes with activities of daily living such as work, school, and relationships. A few types of anxiety are as follows: generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder.

If you suffer from both anxiety disorder as well as substance abuse disorder, it is important to find a treatment center such as Addiction Alternatives that follows an integrated care model. With our hands-on program, you will finally have the opportunity to get to the root of your pain and find ways to cope. When both conditions are addressed simultaneously, it has been shown to have more promising outcomes.

If you are one of the many who suffers from anxiety and substance abuse disorder, you may not understand how the two interact, but we can guarantee you understand how it feels. The best way we can describe it is tension, stress, worries, and feelings of restlessness creeping into your day; sometimes this feeling may be present when you first wake up. You constantly try to go about your life but your anxiety continues to consume you. Frequently, this is where drugs and alcohol begin to take over as a means to self-medicate to get the thoughts to stop. Unfortunately, this is when you fall into the vicious cycle of dual-diagnosis once again.

Dual-diagnosed anxiety can completely destroy the best intentions for a sober life. Don’t let your untreated medical condition stand in your way of a sober life. Entering a recovery program that teaches you about what you suffer from as well as offering you support and motivation to make changes in your life is important. Reach out to Addiction Alternatives who treated both substance abuse disorder and co-occurring disorders, you owe it to not only yourself but your loved ones.

If you, or someone you know, needs help with their substance abuse disorder or dually diagnosed disorder, don’t hesitate to contact us. Addiction Alternatives is here for you. At Addiction Alternatives we use an integrated treatment approach to treat both substance abuse disorder and co-occurring disorders. Each disorder needs its own treatment plan and our one-on-one support and family sessions help identify and treat patients.

Life After Rehab

Life After Rehab

Completing a rehabilitation program is a major accomplishment, give yourself a pat on the back. Becoming sober is one of the toughest challenges someone can go through, however staying sober is not a walk in the park either. Staying sober is a lifelong process. You will have to make a combined effort at maintaining sobriety.

Assuming the 28- or 60-day treatment program that you attend will fix all your problems immensely underestimates the severity of what you have and will be going through. It takes a little time, patience, and hard work to get back to where you were before your addiction. Don’t be discouraged; there are so many people who want to help you make it through life after rehab.

Sustaining a Sober Life

Once you have completed detoxification and inpatient rehabilitation, you, a recovering addict, will return to normal life. This includes going back to work or finding work, seeing family and friends and starting new hobbies or picking up old ones that were forgotten. All of these daily stimuli might trigger cravings and cause relapses.

Research suggests most relapses occur in the first six months after treatment. When you understand your triggers, you can better guard yourself against them.  To overcome the triggers, you have to have a game plan for continuing care once you leave the treatment center. It will be easier to integrate back into regular life and the next phase of treatment if you already know where to start. Remember – you are starting a new life for yourself and Rome wasn’t built in a day!

Get Started on the Road to Recovery

The road to recovery is a long arduous journey. Setting up a plan for post-treatment and sticking to the plan will help with the road to recovery. There are many programs out there for recovering addicts. Some of the treatments are broad, others are specific, based on the type of addiction you had.

Types of continuing care:

  • Check-ups- To be successful you will have to have an accountability partner or team. It is important to have regular check-ups with a mental health professional. This ensures you are making progress and staying on course. You have the choice of how often you need to check in and check-ups can be as infrequent as four times a year.
  • Individual therapy- A good therapist will recognize that addiction is not just chemical dependence. It is often based on a lifestyle that included stress and other triggers which led to drug abuse. Therapies like cognitive behavioral therapy will help the recovering addict understand their underlying issues. Having the understanding will help address the addiction holistically.
  • 12-Step meetings: This has been the long the standard of addiction treatment support. 12-Step programs are available in both general and substance-specific formats. It originated with Alcoholics Anonymous but have grown to include many other drugs, from nicotine to crack cocaine as well as gambling and shopping/debt addictions. The 12-Step method relies on admitting powerlessness and relying on a higher power, often these are held in churches or in community centers.
  • Alternative support groups: It is important to find a support group of some kind, one that you feel comfortable going to, often. You will want to have the safety and security of the group so you can have somewhere to turn to when you start to have cravings. Whether it is based on the 12-Step model or not, finding a support group should be a priority. If the 12- Step model doesn’t seem to fit your personality there is Self-Management and Recovery Training (SMART). SMART is one of the most popular alternatives to 12-step groups. SMART is based on research-proven methodologies for recovery. It teaches people that they can take control of their addiction.

12-Step Program

The 12 Steps were created by Alcoholics Anonymous founder as a way to establish guidelines for overcoming an addiction to alcohol. Since the program gained enough success in its early years, other addiction support groups to adapt the steps to fit their own needs. Although the 12 Steps are heavy on spirituality, many have found the program immensely helpful, regardless of their spirituality. The language of the program emphasizes the presence of God as each participant understands him, allowing for people to have different interpretations and religious beliefs.

The 12 Steps of Alcoholics Anonymous:

  1. We admitted we were powerless over alcohol–that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character
  7. Humbly asked Him to remove our shortcomings
  8. Made a list of persons we had harmed and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

What is Self-Management and Recovery Training? (SMART)

Self-Management and Recovery Training (SMART) is a support program for people with addictions and behavioral disorders. It teaches addicts how to control their addictive behavior by focusing on underlying thoughts and feelings. Participants in SMART learn skills to manage their cravings and urges for long term success. SMART continuously updates its methodologies based on emerging scientific evidence in addiction recovery.

How Does SMART Work?

In contrast to the 12-step programs that require participants to admit powerlessness over their addiction, SMART is consider a self-empowering program. Volunteers are trained to help participants to examine specific behaviors. Participants will discover problems that need to be addressed and will decide what needs the most attention. Participants are then taught self-reliance, they are in control of their addictive behavior. SMART uses techniques from cognitive behavioral and motivational enhancement therapies to teach the skills to help recovering addicts. Participants will learn these skills by following the 4-point program.

The 4-Point Program

In the SMART Recovery Handbook, it details each point in the program. It also provides tips and exercises to maintain a sober life after treatment.

The 4-point program is not a step program, in the way the 12-Step program is. Participants can tackle a specific point in any order based on their needs and is decided through self-examination.

  • Building and maintaining motivation- Having the proper willingness to stay sober is an important part of reaching long-lasting recovery. Participants may make a list of priorities and weigh the costs and benefits of using versus being sober.
  • Coping with urges- Addicts will examine what triggers a craving. Participants learn how to suppress cravings through methods such as distraction techniques. They also identify and overcome irrational beliefs about urges to use.
  • Managing thoughts, feelings, and behaviors- Participants will learn how to prevent relapse by examining thoughts, feelings, and behaviors that lead to drug use. Participants learn self-acceptance and how to manage difficult feelings like depression.
  • Living a balanced life- Deciding to be sober is a drastic lifestyle change. Learning how to live a sober life is important for a successful recovery. Participants take an inventory of what’s important to them and are also taught realistic goal setting and planning for the future.

Similarities and Differences to 12-Step Programs

SMART has some similarities to the traditional 12-step programs. Both consists of recovering alcohol and drug users working through a series of endeavors to beat their addiction. Both programs are private, the identity of each participant is anonymous. People have successfully overcome their addiction when using both programs.

A few difference between 12-step programs and SMART is how each program defines addiction and handles the future of the participant. SMART does not label participants as “addicts” or as having a “disease.” They see these labels as discouraging and unproductive. Recovery is not a lifelong process in SMART; participants can “graduate” from recovery and begin a new, healthy life. Participants in the SMART approach view recovery as taking charge of their own lives instead.

Both 12-step programs and SMART provide helpful support for all people struggling to overcome addiction. It’s up to the individual to determine which is best for him or her. It best to view the journey of recovery as pointed out in the SMART Recovery Handbook, “What works for one person in one situation may not work for another in the same situation.”

Building a New Social Life

During rehab, new possibilities will open up and achievable goals that may have once seemed impossible are now attainable. As changes will start to shift in your life and lifestyle, recovering addicts have to prepare for it and how it will affect them. At first, entering a sober life often means coping with boredom, loneliness or helplessness, as the group of “friends” you once had won’t be an option to spend time with. Activities that once centered on using drugs or alcohol will no longer be available since you are trying to avoid triggers and temptation. There are many drug- and alcohol-free activities that can provide a mental and social outlet, some drug-free hobbies include:

  • Going to the movies – finding not just box office hits, but look for an indie film
  • Taking a class- completing your GED, learning new skills, or continuing education
  • Volunteering – helping others gives you a different outlook on your own life
  • Playing sports – allows focus to be on competition, but also search for sole sports which allows for inner reflection.
  • Playing video games – There are many places to get video games without breaking the bank, but you can also get group card and table games (Monopoly anyone??)
  • Learning how to play an instrument, speak another language or learn a new skill.

Building a daily routine will provides structure, which prevents boredom and thoughts about using. Going to bed at a regular time, attending support groups and making time for new hobbies creates stability and something to look forward to.

While the struggle of relapsing is something to be aware of, surrounding yourself with positive influential friends and family will help when old habits start to come back. It might be scary to start a new life or pick up where your old life ended prior to addiction, however, having a plan to help with continued recovery is going have helped you to be sober successfully.  No matter which method you prefer to use during your life after rehab, having support is important.

 

Kratom Use During Pregnancy

Kratom Use During Pregnancy & Withdrawal Symptoms in Newborns

Kratom, an herbal supplement with effects similar to opioids has caused a significant amount of withdrawal symptoms in two newborns in the United States. While currently legal and widely available in the U.S. these finding is beginning to raise red flags towards pregnant mothers using Kratom during pregnancy.

Kratom Use During Pregnancy Case

The first case involved a baby boy who was exposed to Kratom during pregnant. While this is only the second reported case of withdrawal symptoms for newborns exposed to Kratom, this signifies the growing use of pregnant women seeking alternatives to opioid painkillers, heroin, and oxycodone according to Dr. Whitney Eldridge.

Eldridge is a neonatologist at Morton Plant Hospital and St. Joseph Women’s Hospital located in Florida. According to Dr. Eldridge “I think mothers are becoming increasingly aware of the dangers of using prescription and non-prescription opioids during pregnancy”.

Eldridge added, “as opioid use among pregnant women has increased, I fear they may seek kratom as a potentially safe, legal, non-opioid alternative aid for opioid withdrawal, as its opioid-like properties are not well-advertised”.

Kratom Classification

The U.S Food and Drug Administration classified compounds in kratom as opioids in February 2018. Based on a computer analysis of kratom, receptors in the brain are activated in the same manner as opioids.

However, the controversy of kratom continues to remain in full swing. Kratom continues to be sold as a dietary supplement used to manage pain and boost energy. While also continuing to be sold as a non-opioid remedy for opioid withdrawal. Experts say, non-opioid alternatives to treat opioid dependence will continue to be researched and criticized.

Kratom Withdrawal Treatment

On November 7, 2018, the Pediatrics journal published another case involved another newborn boy whose mother had a seven-year history of oxycodone use. However, his mother had successfully completed a drug treatment program two years prior to the birth of her son. Her drug test came back negative in the hospital for drug use.

The mother denied the use of prescription medications, illegal drugs, and supplements during pregnancy. However, the child’s father reported daily use of kratom as an herbal tea throughout the duration of her pregnancy. It was reported the tea was purchased for help with sleep and opioid withdrawal symptoms.

For 8 days after the baby boy was born, he was treated with morphine and blood pressure medication to improve conditions and fortunately was released from the hospital.

Eldridge also added, “prior to this case, I was unfamiliar with kratom and unaware of its protentional to be a source of withdrawal for [newborn babies]. After caring for this infant, I started to pay attention to how heavily kratom is advertised and realized pediatricians and obstetricians need to be familiarized with its potential to affect our patients.”

Further research is needed to make the decision as to how to classify kratom.

Kratom’s Role in Opioid Dependence

While kratom may potentially have a role in opioid dependence, there is currently too little date to define that role. Pregnant women should disclose the use of kratom to their physician just as they would with alcohol and tobacco. It is the physician’s responsibility to educate women on the potential impacts of kratom for their newborn.

Many do not believe that herbal supplements will have impacts on the child as it is a “natural” remedy.

However, Dr. Buscema at Addiction Alternatives has many years of experience with treating opioid dependence in pregnant women. Do not take it upon yourself to detox and find alternatives to treat your dependence especially while pregnant. This process should be done under the care of a licensed psychiatrist specialized to treat opioid dependence to prevent complications.

If you or someone you know is pregnant and struggles with opioid dependence, please give us a call (772) 618-0505.

What Is The Process Of Diagnosing Addiction?

What is the process for diagnosing addiction? Addiction Alternatives

What Is the Process for Diagnosing Addiction?DSM-5 Diagnostic and Statistical Manual of Mental Disorders Book Cover

Addiction is a chronic condition that can be difficult to diagnose and treat properly. Addiction is not a disease that can be treated solely on the diagnosis from a doctor. While the signs may be glaring, diagnosing the disease requires the person struggling with addiction to acknowledge the problem and having the desire to address the disease. 

Initially, the diagnosis of addiction caused controversy in previous editions of the Diagnosis and Statistical Manual for Mental Disorders (DSM). However, the newest edition has combined substance abuse as well as dependence in a new category, substance abusedisorder.

The DSM-V was the first to include gambling addiction in the definition, as the behaviors associated triggers similar reward circuits as with other substance abuse disorders.

The Diagnostic Process

The first step in diagnosis requires acknowledgment from either the person with addiction themselves, a friend, or family member.

This is typically the most difficult step. Often times this step involves a personal or group intervention if an individual with substance use disorder is unable to see the extent of the problem.

Those with a suspected substance use disorder can begin their recovery process by visiting their primary care provider who can refer them to an addiction facility or rehabilitation specialist.

The suspected addict will go through a series of questions with their PCP about frequency of use, impairment of daily living, and whether the use of a substance is increasing. The primary care provider will also ask questions about how the pattern of use is impacting important social, occupational, education or other functional areas of the person’s life.

Questions regarding withdrawal symptoms that will have possibly occurred during times when the person has attempted to decrease or stop will narrow in on the severity of the disease progression.

The doctor will the complete a physical exam and run blood work to assess the overall health of the individual. This will help to determine
the type of facility that is appropriate for the individual.


Prescription Pills Addiction Diagnosis

Criteria

The DSM-V separated substance abuse disorder into nine individual categories.

  • Alcohol-related disorders
  • Caffeine-related disorders
  • Cannabis-related disorders
  • Hallucinogen-related disorders
  • Inhalant-related disorders
  • Opioid-related disorders
  • Sedative-, hypnotic-, or anxiolytic-related disorders
  • Stimulant-related disorders
  • Tobacco-related disorders
  • Other, or unknown, substance-related disorders
  • Non-substance-related disorders

DSM-V lists varying criteria for the above categories and many dependencies are accompanied with different withdrawal symptoms that occur when an individual does not have the ability to obtain the substance.

To receive a diagnosis of substance use disorder, an individual must demonstrate two of the following criteria within a 12-month period:

  • Regularly consuming larger amounts of a substance than initially intended or for a longer amount of time than anticipated
  • Often attempting to moderate the intake of a substance without actually reducing consumption or at least wishing to moderate the intake
  • Spending long periods trying to obtain or recover from use of the substance
  • Expressing a strong desire or craving the substance
  • Failing to fulfill professional, educational, and family obligations
  • Regularly using a substance in spite of social, emotional or personal issues it may be causing
  • Giving up pastimes, passions or social activities as a result of substance use
  • Consuming the substance in places or situations that could cause physical injury
  • Continuing to consume a substance despite being aware of physical or psychological harm it is likely to have caused
  • Increased tolerance, meaning that the person must consumer more of the substance to achieve intoxication
  • Withdrawal symptoms, or a physical response to not consuming the substance that is different for varying substances but may include sweating, shaking and nausea.

The number of qualifying criteria a person demonstrates helps define the severity of the dependence. If a personal regularly demonstrates two of three of these criteria, the DSM advises that that have a mild substance use disorder.

A person with four to five of these criteria would have a moderate substance use disorder. Six or more continuous prevalence in criteria would denote a severe addiction.

As new evidence emerges regarding addictive disorders, researchers attempt to determine whether or not they can develop reliable diagnostic criteria.

Some addictive disorders appear in the International Classification of Disease, Tenth Edition such as sex addiction, which the ICD-10 classes under the category of “other sexual dysfunction not due to a substance or know physiological condition”.

Whereas the DSM-V does not acknowledge sex addiction as a diagnosis.

A study from 2016, suggests that smartphone addiction is a developing condition and fits within the criteria of addiction.

Take Away

The DSM-V uses a category called “substance use disorder” to group addictive disorders.

Diagnosing the substance use disorder is a vital first step from either the person with the condition or someone close to the individual. Acknowledging and accepting the fact that a health problem exists must also be accompanied with wanting help, otherwise treatment is unlikely to be a success.

A doctor will ask about the patterns of use to determine the fit within the criteria in the DSM-V. Primary Care Providers will also assess the impact of physical damage already prevalent as a result of the substance use disorder.Addiction Diagnosis

To match the criteria, an individual must present two or more signs of addiction over the previous 12 months, including consuming more and more quantities, continued use despite severe consequences, and a reducing interest in activities and socializing.

A person who fits a large number of criteria is diagnosed with a severe substance use disorder.

The doctor will then refer the individual for specialized care.

Opioids: The Crisis Next Door

The Crisis Next Door: Stories of the opioid epidemic

THE CRISIS NEXT DOOR

The US government has created a website to inspire hope for people suffering from opioid addiction.  On the website, Crisis Next Doorthere is a list of different people and their stories.  Some are famous, such as Darryl Strawberry, and others are just your everyday, average American. To hear some of their stories about overcoming addiction click the button below:

In 2018, more than 2 million Americans will suffer from addiction to prescription or illicit opioids. Opioids killer more people last year than either car accidents or gun violence. The crisis of addiction can affect any Amercian, from all-state football captains to stay-at-home mothers.  As a result, Americans across the country are feeling the weight of the crisis next door.