Opiates

Strength? We don’t need no stinkin’ strength!

Nowadays I hear a lot of folks saying (to recovering people) things like “You’re so strong!” and “Be strong!”  I hear newcomers say “I pray for the strength to beat my addiction,” and other stuff like that.  While I understand the thinking behind such remarks (all too well), there are a few comments I’d like to make.

One of the first things we need to learn in recovery is our powerlessness.  We are powerless when it comes to our addictions as long as we are using our drugs of choice, and for some time afterward. If this were not true, we’d simply quit and no one would ever relapse.  The only strength we need is the strength to admit that unpleasant fact, accept it, and listen to people who know what they’re talking about — since we obviously don’t.

That does require a certain amount of guts.  We addicts and codependents hate to admit that we aren’t in control. In fact, though, weren’t most of our problems based on our illusions of control:  controlling our drinking or other drugging; controlling our addicts; controlling our kids; getting everything just right and then having it welded, as a friend of mine used to say?  (He was talking about tuning his 12-string, but the remark is so addict!)

When we have the strength to admit that we’ve lost control, that we’re whipped, that we can’t go on, then we have finally reached the point where recovery is possible. Without that realization of powerlessness, recovery is unlikely, if not impossible.  That’s why I worry when I hear folks speaking in terms of “strength.”  When we think that way, we are in danger of becoming convinced that we are no longer powerless, that we can control our using and keep it “social” this time, that he really isn’t a  rotten wife-beating s.o.b. when he’s drinking, that if we just took Muffy in off the street and give her a clean place to sleep, she’ll realize that she’s much better off and will quit using those nasty drugs.

In early recovery we don’t have much power, if any. We don’t need strength, we need the humility to learn from others the things that we were unable to learn on our own: how to handle our urges, our relationships, our jobs, our spiritual growth — in short, how to live lives of sobriety.  Then, after we’ve gone a good distance in that direction and our bodies and minds have begun to recover from the beating we gave them for all those months or years — at that point we begin having some power over our addictions.  As long as we don’t use.

Addiction is like a rattlesnake.  I can pick it up and haul it around wherever I please — all day long, if I like.  That’s strength.  But if I get careless, that’s when I find out what powerlessness is all about.

Prescription Drugs Abuse Taking Toll On Appalachia

No need for comment.  The article says it all.

About 10 years ago, when OxyContin first hurtled through the pretty hollow just north of town where the Mannering family lives, the two youngest children were still in high school. Their parents tried to protect them, pleading with neighbors who were selling the drug to stop. By mid-decade, they counted 11 houses on their country road that were dealing the drug (including a woman in her 70s called Granny), and their two youngest children, Nina and Chad, were addicted.

A vast majority of young people, officials said, get the drugs indirectly from dealers and other users who have access to prescriptions. Nina and Chad’s father, Ed Mannering, said he caught a 74-year-old friend selling the pills from his front door. The sales were a supplement, the man said sheepishly, to his Social Security check.

“You drive down the road here, and you think, ‘All these nice houses, no one’s doing any of that stuff,’ ” said Judy Mannering, Nina and Chad’s mother. “But they are. Oh, they are.”

http://www.nytimes.com/2011/04/20/us/20drugs.html?_r=1&hp

Authorities raid Florida pain clinics

FORT LAUDERDALE, Fla., Feb. 24 (UPI) — Authorities say they have raided 11 south Florida pain clinics, arrested 23 people and seized $2.5 million in cash and dozens of cars.

Among the four doctors arrested Wednesday for over-prescribing and illegally distributing pain medications was Zvi Harry Perper, the son of Broward Medical Examiner Joshua Perper, the South Florida Sun-Sentinel reported.

One of those arrested was Vincent Colangelo, 42, who allegedly earned $150,000 a day from the seven pain centers he owned. Officials were working to seize $22 million of his assets, including cash, homes and cars.  MORE…

Read more: http://www.upi.com/Top_News/US/2011/02/24/Authorities-raid-Florida-pain-clinics/UPI-79301298570250/#ixzz1EuJrZmxk

So, No One Understands Your Pain Pill Addiction?

How about the Deputy Commander of  United States Special Forces?

US Army Photo

In going public about his drug dependency during interviews with USA TODAY, [Lt. Gen.] Fridovich, 59, echoes the findings of an Army surgeon general task force last year that said doctors too often rely on handing out addictive narcotics to quell pain.

An internal Army investigation report released Tuesday revealed that 25% to 35% of about 10,000 soldiers assigned to special units for the wounded, ill or injured are addicted to or dependent on drugs, according to their nurses and case managers. Doctors in those care units told investigators they need training in other ways to manage pain besides only using narcotics.  READ MORE…USAToday.com
If a three-star general can admit a problem and get help, so can you!

Suboxone and Opiate Detox

Suboxone (buprenorphine & naloxone)

Some detox centers do not medicate their patients during withdrawal. This is known as “cold turkey” and Sunrise Detox doesn’t believe in it. Opiate withdrawal symptoms can produce potentially dangerous health situations, including high blood pressure and dehydration. Left untreated, the pain of the withdrawal symptoms can make it psychologically difficult to stay in the detoxification facility, and makes the client more likely to leave prematurely.

At Sunrise Detox we use Suboxone®, buprenorphine-based medication that effectively manages opiate withdrawal symptoms. Read More…

Pride: An Excuse To Avoid Detox And Treatment

Pride is one of many obstacles that can get in the way of our decisions regarding detox and treatment. Drug addicts and alcoholics are loaded with it.  We don’t want to admit that we couldn’t handle our own problems our own way.

But that’s usually false pride.  As is the case with so many forms of denial, the real issue is fear: fear of being labeled an alcoholic or addict; fear of losing the prestige that we may have accumulated; fear of the process of detox, treatment and recovery itself — but, most of all — fear of having to live without the crutch of alcohol or other drugs to get us through life.  Let’s look at those one at a time.

Fear of being labeled an alcoholic or addict; fear of being “found out.”

For some reason, many of us imagine that no one outside our immediate circle of family and friends has noticed our addiction.  Think about it.  How likely is it that we wouldn’t notice someone we worked or socialized with if they had a problem with drinking or drugging? We  might make excuses for them to protect our own behavior, but the fact is that we’d know long before they did.

There is no reason to think that other folks don’t know about our problems.  Bosses notice work quality, absences, long lunches, coming in late and the other ways that we accomodate our using.  Later on they may notice other things like discrepancies in expense accounts, clients not seen, and so forth.  Bosses are in the business of evaluating employees.  Of course they notice that stuff!

Our kids notice our failure to participate in their lives; our spouses the disintegration of a partnership into much less than it could be.  Other family members notice the decline of our participation in family events, changes in our personalities, booze on our breath.  They may remark on our tendency to hang with the drinkers in the family and avoid the social or non-drinkers. Same with our friends. Bottom line: we’re not very good at fooling folks.  Not good at all.

Loss of prestige

We really have a choice here: we can either go to detox and treatment, attend a 12-step group, get our act together and regain our ability to function at a high level, or we can continue to allow things to deteriorate to the point where we blow our standing in the community ourselves.

Fear of the process

Detox and treatment were a walk in the park 21 years ago when I did my stint, and things have gotten better since.  A medically-monitored inpatient detox is as close to pain-free as it’s possible to make a process like that.  For me, treatment was like a vacation from troubles and care, with the additional benefit of being among people — staff and other clients — who understand where we’re coming from, won’t judge us, and will help us on the road to recovery and getting our lives back.  I didn’t want to leave.

That leaves us with our biggest fear of all, giving up our best friends.

If we don’t think alcohol and other drugs were our best friends, we need to think again.  ”Who” did we go to when we were feeling down?  What was our refuge from problems?  What was the one thing that we made sure we always had nearby?  What did we choose, while forsaking most of the people in our lives?

Right.

Giving up the drugs is scary.  There is no question about it.  But continuing the life we have while using is scary too.  There is one big difference between our friend and recovery.

Recovery will let us live a life that may be better than we even hoped. Our friend will take everything from us, and then kill us slowly and painfully.

Your choice.

Study Shows Buprenorphine Beats Methadone For Pregnancy Maintenance Treatment

An article in the December 9th issue of the New England Journal of Medicine (not available online) refers to a Johns Hopkins study regarding maintenance treatment for opiate addiction in pregnant women.

photo: Martin LaBar/Flickr

First, we need to mention that, when a woman who is currently addicted to opiates gives birth, the baby is addicted as well. The child’s detox symptoms are known as neonatal abstinence syndrome (NAS).

The Johns Hopkins study revealed that babies born to women who were maintained on buprenorphine (Subutex) during pregnancy, rather than methadone, required 89% less morphine to relieve the symptoms of NAS than those whose mothers had methadone. Furthermore, hospital stays for the babies were reduced by an average of 43% (10 days versus 17.5 days).  The reason for this is not clear, but it is likely related to the long life of methadone metabolites, some of which are also opioids.

The study’s authors reported that “Although there were no significant differences in overall rates [of NAS] … the benefits of buprenorphine in reducing the severity of neonatal abstinence syndrome … suggest that it should be considered a first-line treatment option in pregnancy.”

It is important to note that the study involved buprenorphine in the form of Subutex rather than Suboxone which, in addition to buprenophine, contains the narcotic antagonist naloxone.  Unborn babies should not be exposed to naloxone. Any mothers or doctors considering this form of maintenance should be very clear on this point.