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Author Archive: aenriquez

Outpatient Rehab – Is it Right for Me?

For those whose lives still remain functional, outpatient rehab may be an option to consider. With this type of program, you see a counselor locally and work with therapy groups, attend AA/NA meetings, and complete assignments to help you with becoming drug- and/or alcohol-free. While you do have the freedom to live your life, random drug/alcohol tests are likely with this type of program, and you must be willing to submit to them, especially if it is court ordered outpatient care.

Addictive Medications and Minor AddictionsMinor Addictions

If you have trouble removing drugs and/or alcohol from your life, outpatient treatment may be right for you. This is especially the case if your life does not revolve solely around drinking and using drugs.  When you blow off friends, family, or general adult responsibilities to bar hop, consume an entire 12-pack of beer or bottle of alcohol, it’s time to get help. If you’d rather sit and completely lose your mind to get high instead of cleaning the house, grocery shopping, or spending time with your kids, it’s time to get help. This might be the right situation for you since you’re still able to function in daily life.

Remain in your Own Home

When attending outpatient rehab, you don’t have to deal with the stress of being in a strange place with conflicting personalities or those that are near death from their addictions. Being able to stay home with your family or in transitional housing while getting treatment has proven higher success rates. You have to take this program just as seriously as you would an inpatient center.

The transitional housing idea is to keep you in a dry household with others that are also in recovery. You still go to work, pay your bills, and have some freedom. There are curfews and some house rules to adhere to while seeing your counselor, participating in maintaining the home, and attending group sessions.

Live Normal Life without Drugs or Alcohol

In an outpatient program, you learn how to live life and make use of the extra time that you’d normally spend drinking or getting high. Some counselors suggest taking night college courses, painting, cooking, or taking up a hobby. It’s also an open invitation to get more involved with your spouse and children. Taking a more active role in your family is healing in itself and has plenty of benefits. You’re treating the addiction with your family, rather than being separated from them and feeling awkward returning home in a sober state.

Outpatient programs don’t work for everyone. This is the case with addicts where the only method of detection is by a blood sample or spinal tap. These expensive procedures have to be paid for by the patient and most cannot afford them. For those that recognize their problem and cannot afford inpatient care, this is a good place to start. It can be considered as temporary treatment while you look for financial aid or “scholarship” funds to get clean and live a healthy, substance-free lifestyle again.

Why Oxycodone is Being Used Recreationally

is oxycodone addictiveOxycodone is a synthetic opioid drug that is produced from thebaine which is found in the Persian poppy plant. The drug is used as a pain relieving medication and is found to be up to 1.5 times more potent than morphine.

Oxycodone is indicated for providing pain relief in patients with moderate to severe pain and is used in situations such as:

  • Post-surgical pain relief.
  • Severe spinal pathologies.
  • Pain caused by certain cancers.

Effects

Effects of oxycodone other than pain relief include:

  • Feelings of euphoria.
  • Reduced anxiety.

The reason why this happens is that the drug works on the opioid receptors in the brain that are involved with the reward system of the organ. Unfortunately, prolonged use of medications such as oxycodone can lead to other problematic behaviors such as:

  • Tolerance – where the user starts to use more of the medication because it doesn’t seem to provide the desired effect, be it pain relief or the mentioned euphoria associated with its use.
  • Recreational use – the pain may no longer be present but the individual may still be using the medication because of the mentioned effects it has on the body.
  • Dependence – this occurs when one stops using the drug and begins to experience withdrawal symptoms thereby causing the individual to continue using oxycodone to prevent these issues from occurring.
  • Addiction – is oxycodone addictive? Yes, it is because continued use of the medication may result in health-related problems, issues with school or work performance, and even getting into trouble with the law. Continued behaviors such as these without taking into consideration the negative consequences associated with it are regarded as addictive behaviors.

In one literature review, multiple studies demonstrated that oxycodone had an elevated abuse liability compared to other similar drugs such as morphine and hydrocodone-based on its high likability scores and relatively reduced amount of subjective effects.1

 

Adverse effects

Oxycodone use in high dosages can lead to problems such as:

  • Suppressed and shallow respiration.
  • Slowed heart rate.
  • Low blood pressure.
  • Circulatory collapse.
  • Respiratory arrest.
  • Spinal cord infarction, strokes, and heart attacks due to reduced blood flow and oxygen transport to the involved organs.
  • Liver and/or kidney damage if oxycodone combined with medications such as acetaminophen or ibuprofen are consumed.

Legal status in the United States

Oxycodone is a Schedule II controlled substance under the Controlled Substance Act that was enacted in 1971. This includes formulations of the medication where other drugs are included with the oxycodone, such as those mentioned already.

Despite this legislation, oxycodone is still one of the most commonly abused pharmaceutical drugs in the United States and has given rise to the current opioid epidemic which has resulted in the death of over 180,000 people from 2009 to 2015 with nearly 35,000 of those fatalities coming from the latter mentioned the year.

Management

The primary focus of prevention is at the level of the physicians who prescribe these medications. Caution needs to be exercised when patients are prescribed oxycodone. Their needs and unique circumstances should be factors that must be considered when deciding who is prescribed these kinds of medications.

Where addictive behaviors are suspected in individuals using these medications, the services of local substance abuse rehabilitation facilities should be made use of.

Heroin – Dangers Associated with the Drug and its Addictive Factor

Heroin – Dangers Heroin is classified as an opioid drug because it acts on the opioid receptors in the brain. The drug is mostly used recreationally to produce euphoria in the user and also results in relaxation, drowsiness, and reduces any pain experienced by the individual.

In the United States, heroin is not accepted as medically useful whereas in countries such as the United Kingdom it may be prescribed as a strong pain reliever for the following situations:

  • Severe trauma.
  • Post-surgical pain control.
  • Myocardial infarction (heart attack)
  • Chronic pain caused by terminal illnesses and end-stage cancer.
  • Maintenance therapy for those who are addicted to heroin, even being considered more useful than methadone. This is somewhat of a controversial use of the drug though.

Does heroin cause have any adverse effects?    

 

The use of heroin as a recreational drug is extremely problematic and there are major adverse effects associated with its use such as:

  • Contracting blood-borne diseases such as hepatitis and HIV due to sharing infected needles and syringes to administer the drug intravenously (into the bloodstream through a vein).
  • Developing fungal or bacterial endocarditis (infection of the inner lining of the heart).
  • Formation of abscesses at the injection sites due to the introduction of harmful bacteria into the soft tissue when injecting the drug.
  • Accidentally becoming poisoned with products used to “cut” the drug.
  • Overdosing on the drug which can suppress the central nervous and respiratory systems enough to result in death.

How addictive is heroin?

Heroin is an extremely addictive drug because of the way it works on the brain. The mentioned opioid receptors are involved in the reward system of the brain and when they are stimulated, the result is a relaxed state, or a “high”, that makes the user feel pleasant.

The steps to full-on addiction to the drug are as follows:

  • Frequent and regular use of heroin leads to tolerance to the drug which means the individual needs to use more of the product to reach its desired effect.
  • Dependence develops when stopping the drug causes withdrawal symptoms such as restlessness, agitation, cold flashes, nausea and vomiting, diarrhea, muscles aches and pains, insomnia, and severe cravings for heroin. This results in the continued use of the drug to avoid these symptoms from occurring.
  • Continued use of heroin then leads to issues such as health-related problems, failure to meet responsibilities at school or work, and even getting into trouble with the law. This is termed as the user having a substance use disorder and the most severe form of it being referred to as an addiction to the drug.

Long-term effects

Individuals who use heroin over the long term may develop problems such as:

  • The collapse of veins that are used to inject the drug into.
  • Sleep disturbances that are difficult to manage.
  • Damage to the mucous membranes in the noses of those who snort the drug.
  • Damage to the valves of the heart due to endocarditis.
  • Liver and kidney disease usually caused by the additives in the drug.
  • Development or worsening of mental health disorders such as depression.
  • Irregular menstrual cycles in women.
  • Sexual dysfunction in men.

Why Getting a Dual Diagnosis in Important?

Dual diagnosis refers to a treatment facility for individuals who suffer from both mental illness and substance abuse. There are currently more than 50% of Americans suffering from psychological disorders, following substance abuse reports the Journal of the American Medical Association.

Many such individuals suffering from a mental condition rely on drugs and alcohol to relieve the symptoms. However, according to research, the unauthorized use of drugs worsens their mental illness.

Specialists provide that mental illness and substance recovery are two different cultures, and developing an integration between both can be challenging.

Dual Diagnosis treatment

More than 7.9 million individuals in America experience a breakdown of substance and mental disorder simultaneously. Out of this population, 4.1 million are men according to the National Survey on Drug Use and Health.

Symptoms

The symptoms of dual diagnosis vary extensively given the combination of several factors. Mental health clinics have started to study both substance and psychological screening tools to identify individuals who suffer from both conditions together. Some symptoms that share common ground are:

  • Introvert behavior
  • Sudden changes in behavior
  • Suicidal attempts or engagement in risky behavior
  • Lack of resistance to the use of substance
  • Developing withdrawal symptoms
  • The need to rely on drugs to survive.

Treatment options

Different dual diagnosis treatment centers have different treatments options available, depending on the extent of the individual’s condition. Even though treatments are designed after screening each patient separately, some of the common treatments used in dual diagnosis include the following:

  • Detoxification

It is mostly the first treatment used in dual diagnosis. The detoxification process requires an individual to undergo cleansing for seven days. In this, the body is cleansed of the toxins stored in the body.

  • Inpatient rehabilitation

Individuals suffering from drug dependency and mental illnesses may need an inpatient rehabilitation. In such situations, they can receive both psychological and health care under the guidance of psychiatrists and health specialists. The administration tapers the substance amount with other effective medicines to reduce the withdrawal effects.

  • Psychotherapy

This part of the treatment plays a significant role in dual diagnosis. A cognitive behavioral therapy, it helps individuals cope with the stressful thoughts. The specialists help patients modify their thinking patterns

  • Medication

Medications are used to treat psychological disorders. Some of these medications also help individuals cope with the withdrawal symptoms during detoxification. These are mostly muscle relaxants that help ease the nerves.

  • Support housing

In dual diagnosis, motivation plays a significant role. It can be challenging to feel as if you are suffering alone. Support groups help individuals share their negative thoughts, their happy thought and find their motivation for survival.

Conclusion

In dual diagnosis, an integrated approach to mental illness and substance abuse is used to treat both problems simultaneously. The treatment features helping patients cope with stress by enhancing their motivation, reducing triggers that may force them to take drugs, increasing their social skills and detoxifying their body.

Dual diagnosis is a smart move that provides support to patients who suffer from mental illness followed by drug abuse.

We have a surprise!

Dr. Michael S. Duffy, Sr., DO, Medical Director of one of San Diego’s leading addiction treatment facilities is proud to announce a strategic change in its Senior Leadership. 

Opioid and illicit drug use in San Diego is at an all time high.  According to the CDC, one of every three patients who were prescribed a 30-day supply of Opioids for the first time were found to be addicted one year later.  Dr. Duffy calls this …“a crisis impacting our mothers, our fathers, our brothers, our sisters and our children.  It is an Urgent call to San Diegan’s to understand and recognize addiction and seek help”.

Pacific Bay Recovery strives to meet and exceed community’s needs for those affected by or afflicted by addiction.  In its response to this crisis and the immediate need to improve opportunities for access and admission to treatment programs, Pacific Bay Recovery has enriched its executive team.  Dr. Duffy is honored to announce the appointment of Bryan C. Sharp, to the position of Vice President of Admissions.

Mr. Sharp joined Pacific Bay Recovery in 2012 serving in various capacities throughout the organization, most recently as Director of Admissions. With respect to his new role, Mr. Sharp said, ‘This work is my passion, the people we help are people in dire need of a second chance at at living addiction free”.  Mr. Sharp thanks all the team members at Pacific Bay Recovery, and most importantly offers thanks and praise to his beautiful wife and son, without whom he could not achieve his passions and calling in life.

Please join us in congratulating Mr. Sharp on his new role within Pacific Bay Recovery.  You may reach Bryan at bryan@pacificmedicalcare.net, or call (858) 263-9700.

New Research on Treating Substance Abuse

Although widely opted for, detoxification may not be as effective to treat substance abuse as medication.

Treating Substance AbuseA new research suggests that substance-dependent individuals seeking assistance through an expensive medical detoxification can perhaps benefit better with a combination of opioid medications like buprenorphine and methadone. Such medication allows substance dependent patients to slowly modify their body pattern.

This research does not claim these medications to be a permanent alternative. But compared to the method of medical detoxification, this comes with a saving of approximately $78-257. Moreover, it is psychologically easier than facing the withdrawal symptoms during detoxification.

Today, more than 2.6 million residents of the USA suffer from opioid dependency. Claiming 91 lives each day, The US faces a tremendous challenge dealing with opiate addiction. And more than 80 percent of the drug addiction victims have been deprived of medication-based treatment.

California is currently the largest state found with opiate addiction crisis. The health regulations still favor detoxification by not prescribing opioid agonist medication till the patient is proven to have gone through detoxification. This implies that a patient would have to pay for the detox prior to being insured for buprenorphine or methadone.

New law:

The latest improvisation in the law has added a provision which organizes an emergency alcohol and drug detoxification program under the administration of the Health Department.

The purpose of this program is to encourage health services to develop new ways for detoxification of drug within a medical facility center after an overdose. Highlights of the bill include:

  • This bill is sponsored by State Rep. Aaron Kaufer.
  • It enables the Department of health to provide more proficient medical detox facilities, sharing the burden of Department of Drug & Alcohol that was previously responsible for dealing with a substance based emergency. Additionally, Department of Health has more resources, comparatively, says Kaufer.
  • It is important to note that this law does not impose upon hospitals to spare beds for drug addiction emergencies, but only to become more efficient in easing the risks involved with overdose.
  • This program will facilitate basic facilities required by an individual for detox.

Kaufer says:

“ There obviously is economies of scale at a place like a hospital. Whether it is space or access that is important, is the important question. People are treated and sent back, while this initiative proposes a stay in the hospital till a facility center is found for them where they can effectively get treated for addition”

It is still unclear how the law will come into practice. It is new and will require a complete design of how things would work before it is implemented as a must. “Much of the responsibility will fall on the Department of Health to determine how this program will work” provides Nate Wardle, a spokesman fforthe health department.

It is hoped that the research would help the health centers perceive a better and more effective combination of detox and medication to cater the needs of an opiate addict. In the current crisis, it is best if the state implies any law that promises better results.

 

How to Detox Your Liver From Alcohol Without 30 Day Rehab Programs

Detox Your Liver From AlcoholIn the past few years, more and more scrutiny has been placed on America’s addiction to short rehab programmes. Countless articles have why the current 30-day trend is outdated, expensive and has poor rates of return. Some estimate that only 10% of addicts going into a 30-day rehab programme will stay sober.  In an interview with Slate magazine, one Outpatient clinic owner noted: “You don’t treat a chronic illness with 30 days of intensive rehab – that’s absurd”. He’s got a point. The real question is what’s the solution? Luckily there are other options on how to detox your liver from alcohol.

 

Symptoms of Detox

Detox can be a painful process. Not only are symptoms of withdrawal severe and often very unpleasant, chronic alcohol abuse and addiction is a long built habit that takes time, effort and a certain amount of skill to break. The most obvious negative to alcohol detox is the withdrawal symptoms. Patients get a number of symptoms including:

  • Irritability
  • Anxiety
  • Nightmares
  • Fatigue
  • Sweating
  • Shaking
  • Hallucinations
  • Confusions
  • Seizures
  • Death

That final one is the biggest takeaway. Detox can be dangerous. In some ways, the 30-day alcohol detox rehab programme made sense when it was first invented. Get the addict safely off alcohol without some of the more severe side effects and back to their family sober. But the more we learn about addiction the more we learn this just doesn’t work. Here’s why:

  • Addiction isn’t just withdrawal. Whilst addicts don’t want to stop because they fear the withdrawal – this isn’t the only reason they are addicted.
  • Old habits die hard. How long does it take to make or break a habit? If you took up a new hobby would 30 days of doing that hobby count as a new habit? No. People take much longer, up to 90 days to make habits.
  • Addiction takes time to open up to. Often 30 days isn’t long enough to build trusting therapeutic relationships with the staff at these clinics
  • The addicts don’t want to be there. It’s no surprise that family members and loved ones want alcoholics to seek help. But often convincing them to go to a 30-day programme won’t be enough. They have to make a long-term commitment to change and signing up to 30 days isn’t a big enough commitment. Longer treatments take dedication and real willpower – the exact characteristics an alcoholic needs to overcome their addiction.

 

Unrealistic Expectations – Outpatient or Longer Stays are the Only Way

As we’ve seen – 30-day alcohol detox programs aren’t working. The success rates are low, sometimes lower than 10% completing and continuing the programme. There are, however, a number of solutions. One alternative is longer residential programmes. Those deeply ingrained habits, that have years and years of history are far more likely to be broken by much longer stays, perhaps 3 or more months. Many recovery practices do offer this service and it typically has a much higher rate of success (up to 2 or 3X higher than the best 30-day programmes). Another option is outpatient recovery, with skilled doctors prescribing the best medications to guide a person through the process and stop dangerous withdrawal. In fact, studies have shown for all substance abuse, including alcohol, that longer stays in rehab simply work better.

 

 

Can You Get Alcohol Withdrawal Treatment At Home?

alcohol abuse treatmentA recent article on Foxnews.com explored just how dangerous attempting to deal with alcohol withdrawal at home without treatment can be. Alcohol addiction is a difficult illness to overcome, especially in people who can’t afford expensive long-term residential programmes. However, going cold turkey without the proper medication can be deadly. Luckily there are alternatives but currently, there is a lack of understanding about the options for alcohol withdrawal treatment at home.

Alcohol Withdrawal

If you don’t remember your biology classes from high school take a minute to remind yourself about homeostasis. Homeostasis explains how the body keeps itself in sync. Homeostasis explains why you are able to maintain a body temperature of 37 degrees Celsius (by sweating if you become too hot or shivering if you are too cold). The same principle applies to alcohol. When you consistently consume alcohol, your brain adapts to its new normal. The neurons (the signaling cells in the brain) adapt and get used to the alcohol. Of course, the alcohol is having detrimental effects on the body – particularly the liver – whilst a person drinks. When you take the alcohol away you put the body out of sync. The brain is no longer in homeostasis. Without the depressant effect of the alcohol, the brain goes into overdrive causing a number of distressing symptoms:

  • Tremors – your hands may shake as the brain wrestles to control the body
  • Nausea
  • Vomiting
  • Headache
  • Sweating
  • Irritability
  • Hallucinations – This occurs in the brain cannot process what is a genuine stimuli (aka what the brain is seeing) and what is part of the imagination. This can be particularly distressing.
  • Death

Alcohol Withdrawal medication

A much safer way to detox from alcohol is with a certified recovery practice. This can either be as an inpatient, but can also be managed at home. You may have heard of many of the alcohol withdrawal medications which include:

  • Benzodiazepines: these drugs have been used for years to treat symptoms of alcohol withdrawal. They work by decreasing brain activity (which you need during the withdrawal period). They have a sedative effect, relaxing the patient and putting them to sleep.
  • Anticonvulsants: You might have heard of these drugs being used for epilepsy. That’s because they were originally designed to treat epilepsy. However, addicts undergoing withdrawal can often have seizures (much like an epileptic would) and these drugs can help prevent that.
  • Vitamins: In very severe instances, vitamin deficiencies in alcoholics can lead to dementia. As such vitamins are needed to supplement addicts who are usually extremely low in vitamins.

As we have seen – alcohol withdrawal is dangerous but there are options for addicts looking for alcohol withdrawal treatment at home. A number of alcohol withdrawal medications are available to avoid some of the distressing and occasionally deadly side effects of withdrawal. If you do try to detox at home, make sure you seek help from an experienced recovery clinic that can prescribe withdrawal medications and guide you through the process with experienced practitioners.

Men’s Rehab – Teaching Men to Deal with their Demons Head-On

Men’s Rehab - San DiegoCo-ed rehabilitation (rehab) facilities make it hard for each gender to concentrate on healing and starting the recovery process. When you remove the distraction of the opposite sex, the focus goes back to the individual and full concentration on the addiction is in place. This might seem harsh, but men are more distracted by women than women are by men.

Male Counselors

It is often difficult for a man to open up and discuss their troubles with a female. Men know how to relate to each other. This type of approach helps men to figure out exactly what led them to addiction. Perhaps social drinking while watching sports turned into dependency in everyday life. That is common for men. Male counselors use male-driven approaches to counseling sessions by relating items to their specific interests. This aids the patients in recognizing triggers and trouble areas. For instance, while watching a football game, instead of grabbing a beer, get some apple juice instead. It’s the same color as beer but is minus the alcohol.

Comfortable Male-Friendly Setting

Centers that are decorated for men, with themes and accessories or even building projects to complete, are more successful. A male-friendly setting includes a lounge area with big couches, bulky tables, stuffed wildlife, and sometimes, sports themes. This helps men to feel more comfortable and less out of their element. It is still unfamiliar and uncomfortable but being able to recognize things that interest them is a step in the right direction. Men have a variety of interests from cooking to sports and using their hands to build things. Rehab facilities that focus on what they enjoy while treating their disease are found to be the most beneficial.

Activities Geared toward Men’s Interests

While television is unavailable in rehab centers, there are activities to keep men busy. Men need something constructive to do when they’re not in a therapy session.  Working rehab centers help channel frustrations, pent-up stress, and hidden emotions into completing projects. Working with your hands is very therapeutic and rewarding at the same time. Think of the piece of wood or project, you’re working on as your addiction. Take that negative energy and achieve the finished product, which in this case would be sobriety. Some other activities may include a golf outing, flag football, or learning to cook.

Re-Introduction to Society and Family Life

Some men take a back seat to raising children, paying the bills, and helping around the house. As part of their re-introduction to a normal lifestyle, parenting classes and family counseling are often suggested. When family members join therapy sessions, it becomes intense, but this is near the end of the program so that dealing with the pain and anguish felt by family members is easier to cope with. This helps men to want to be part of their children’s lives and help with the household. Essentially, it rounds them out as an adult and teaches them what living responsibility is really all about. The end result is a happier male that is more involved with life in general.

Holistic Rehab – It Isn’t just Crazy Talk

What is Holistic RehabA holistic approach to rehabilitation (rehab) for addictions might seem crazy, but the truth is, it works. These programs are based upon the premise that natural elements remove negative energies and toxins from the body to reduce the “need” for drugs and/or alcohol. Consider it as being a realist’s way of healing. Look into these programs and view the success rates–you may be shocked.

Natural Cleansing Remedies

Connecting with nature and natural elements help to detoxify the body naturally, removing toxins that aid in your dependency on drugs and/or alcohol. What this does is create natural endorphins, which are what creates happiness and energy.  When your body rids itself of negative feelings from positive reinforcements, such as a happy life, a tranquil environment, and a great support group, you can be on your way to embracing a natural lifestyle. This holistic approach may seem absolutely nuts to some, but it isn’t harsh on the body at all. It’s actually quite refreshing.

Aromatherapy for Trigger Reduction

Triggers and temptation cause a general unsettled feeling in the body. Aromatherapy counteracts it. There are different scents that every person finds relaxing. It is important to work with your counselor to find the perfect combination for your unique situation. For instance, someone who becomes angry when their drug of choice is not available may enjoy warm scents such as cinnamon, chocolate, or fresh baked goods. Those that get anxious when they need a fix typically enjoy eucalyptus or fruit scents.

What this type of therapy does is teach you how to take those feelings of anger, depression, and anxiety in combination with a relaxing scent and allow the negative energy to leave the body. The counselor will instruct you to use these scents, and fresh air to calm these unwanted feelings.

Creating Positives Out of Negatives

For every negative in life, there are several positives that will follow. It is important to learn how to take bad feelings, cravings, and triggers and turn them into something constructive. This can mean building something, painting, a new hobby or even going for an evening walk. It’s very cleansing to concentrate these feelings into something constructive to create feelings of accomplishment and happiness. Yoga is peaceful and helps to relax both the mind and body at the same time. Other ideas to consider are learning to cook, taking classes to learn a new trade, joining a walking club, or even just taking walks in nature on your own.

Holistic approaches aren’t for the birds. The body reacts to natural stimulation in a positive manner. Negative energy by allowing life’s stresses and tragedies to take over is what often leads society to dangerous addictions. Those with serious addictions may take longer to benefit from this approach and it may be very hard on the body in the beginning. Once you go through the program and see just how fresh and happy you feel, you’ll see that the tough road was all worth it and you’ll be more motivated to maintain the lifestyle.