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Opioid Alternatives for Chronic Pain Relief

As we all know, we are in an opioid epidemic in this country. But the good news is that the numbers are beginning to go down. Having said that, the job is still not done. The main reason we still high opioid use (and eventually abuse) is that we still have a very high prevalence of chronic pain (almost 1 in 10). And opioids are still being overprescribed. Hence, there is a pressing need to use opioid alternatives for chronic pain relief.

Not only that opioids have a very high addiction potential  (15-fold greater risk for those who have been taking opioids for three or more months), but also they are not very effective in the management of chronic pain. There are a number of alternative strategies that have been found to be effective against chronic pain, such as cognitive behavioral therapy, acupuncture, medical massage, physical therapy, etc.

Chronic pain is defined as a pain condition that lasts for more than six months. Studies have shown that chronic pain involves the same areas of the brain as the emotional disturbance. Emotional pain is treated with alternative methods, so it is worth exploring if chronic pain can be effectively managed that way as well.
Opioid use has yet to be seen whether these efforts made any difference in preventing addiction
Many healthcare providers have made initiatives to minimize the chance of opioid addiction. Pain clinics assess people for risk of addiction, have them sign a medication contract, educate and counsel them on the risks of addiction and other side effects, perform urine drug testing, undertake pill counts, etc. But it has yet to be seen whether these efforts made any difference in preventing addiction.

The opioid alternatives that are being used for chronic pain management include nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants and antiseizure medications. Nonpharmacologic options include cognitive behavioral therapy, exercise therapy, physical therapy, etc. There are also some interventional approaches such as nerve blocks, neuromodulation, etc. These methods have been found to be effective in chronic pain management.

There is now one-stop-shop type of pain clinics where the patient can see a physician, a physical therapist, a psychologist, a massage therapist, an acupuncturist, etc., for one’s pain complaint. However, these approaches can be expensive with limited or no insurance coverage.

 

It is being widely understood that opioids can only provide short term from severe acute pain and are ineffective for lasting relief from chronic pain. Instead, a better approach for the latter is to use a combination of alternative modalities mentioned above. But these methods take patience and effort because complying with them takes commitment and the results are not immediate. But when the patient sticks with them, the results are often very rewarding.

It is important to note that these alternative methods are much more effective once somebody is not on opioids. The reason may be psychological, at least in part, that the patients have gotten used to finding immediate relief that comes with taking opioids even if its temporary. But working closely with the therapists and with some encouragement and perseverance, patients are able to overcome chronic pain through these safe methods.

Methamphetamine Drug Rehabilitation

The abuse of illicit drugs is a serious health issue and it causes up to 200,000 lives every year. One of these dangerous drugs is Methamphetamine, which is a stimulant. It has several street names, such as speed, crank or meth. Other similar drugs in this class include levomethamphetamine and dextromethamphetamine (crystal meth).

This crystal meth is often made in illegal home-based labs. It is popular among partygoers and easily found on the streets and in the clubs. It is extremely addictive in nature and can cause dependency after just one use.

 

When a user takes crystal meth by way of snorting or swallowing, it causes a feeling of rush within 15 to 20 minutes. This effect is immediately following injection or smoking of the drug, causing extreme euphoria and a  sense of elation. This effect typically lasts for six to eight hours up to a full day. It may lead one to try more injectable drugs like heroin.

The most common cause of meth-related death is multiple organ failure
When a user is addicted to meth, it causes a withdrawal syndrome when you take away the drug. There is evidence of psychological addiction manifested by extreme shifts in mood, severe insomnia, intense paranoid and delusional behaviors. Physical symptoms include sickness, hunger, and even seizures. Addiction to meth also leads to anhedonia (inability to find joy in anything), which makes it extremely hard to stay abstinent as they seek that joy in abusing meth. It can take up to two years of abstinence to have restored mood and effect.

Prolonged use of crystal meth has devastating effects on one’s physical and mental health. It causes damage to the liver, kidneys, and lungs, leads to hypertension and vascular injury in the brain, increasing the likelihood of stroke and cardiac complications, which can be fatal.  The brain damage can be extensive and lead to stroke, epilepsy, and dementia. Smoking it can cause lung abscesses, snorting it damages nasal mucosa, and injecting it increases the risk of HIV, Hepatitis B and C, and infective endocarditis. Addicts of meth also suffer from tooth decay, psychosis, depressed mood, and weight loss as well.

 

There is now a resurgence of meth-related emergency room visits related to overdose and withdrawals. The most common cause of meth-related death is multiple organ failure. An overwhelming percentage of these patients (86%) have co-occurring HIV infection due to associated risky behavior.

The treatment for meth addiction is extensive and rigorous rehabilitation. While brief stints at a rehabilitation facility can provide short-term benefits, fully recovery warrants a much longer commitment. A treatment period of at least 90 days is recommended to ensure efficacy. The detox process is highly involved and requires close monitoring of experienced staff. The withdrawal process can be challenging and the patients can become violent, which is why a skilled rehab facility should be carefully chosen. With proper professional help, the chances of a successful recovery are fairly high.

Drug Rehabilitation with Pain management

There are many causes of chronic pain – injury, accident or illness. One of the biggest healthcare crisis of our times is the opioid abuse crisis. Opioids are typically prescribed for severe and/or chronic pain, to which the patient ultimately develops tolerance and becomes addicted. However, an integrated approach that includes pharmacotherapy, physical therapy, individual counseling, and group support, can be the right choice for patients suffering from chronic pain. Drug rehab with pain management includes this approach for the effective treatment of chronic pain.

According to a recently published study, patients who suffer from drug addiction and chronic pain tend to receive inadequate pain control compared to non-addicted patients. Doctors in rehab facilities may be hesitant to provide opioid pain medications given their predisposition to addiction. However, these patients deserve adequate relief is the pain is severe, the same way as any other patient. Drug rehabilitation for chronic pain is an approach that treats the patient’s substance abuse without compromising pain control.
Drug rehab with pain management focuses on not only the substance abuse and pain control components but also other facets of health
Chronic pain can debilitating — physically, emotionally and socially. The end results of under-treated pain can be isolation, depression, substance abuse or worse, suicide.

Chronic pain is actually underreported. Many patients suffer from it and assume it as a part of growing old.  Adequate pain control can dramatically improve their quality of life and functionality.

It is true as well that prescription painkillers can be abused. These patients are vulnerable to getting addicted as they develop tolerance to them. This is why it is extremely important to provide them with pain in a controlled setting with careful monitoring. Patients undergoing drug rehab are in a structured program under careful supervision and it is important to provide them with adequate pain relief and monitor them for warning signs of abuse.

 

Having said that, giving alternatives to opioids for pain relief is advisable in patients with a past or current history of substance abuse. Some of the non-opioid options for pain relief, with varying degree of strength and efficacy, include buprenorphine, psychological counseling and behavioral modification, massage, acupuncture, hydrotherapy and herbal therapy, physical therapy, etc.

Psychotherapy can help identify negative behaviors and thought patterns that contribute to addiction, but it is not an actual pain relief method. Drug rehab with pain management focuses on not only substance abuse and pain control components but also other facets of health, such as nutrition, exercise, etc. As drug addicts tend to ignore these, addressing them is likely to help them regain physical and mental health. Pain should not be ignored. It should be addressed by the right clinicians and a personalized plan for pain relief should be sketched out keeping in view the unique history and health status of each patient. A comprehensive approach is likely to yield successful results in the recovery process of the patients and improve their overall quality of life.

6 Tips to make Recovery Easier

For many people with addiction issues, it is easy to feel overwhelmed with the daily triggers and pressures. These pressures can further trigger ineffective behaviors and responses, such as going back to the same substance and risking relapse.

Here are some simple yet highly effective tips to reduce the risk of relapse and make your recovery journey easier.

Have illnesses treated

Your physical health is as important as your mental and emotional health. Stay on top of your health and talk to your doctor whenever necessary. Take your medications as prescribed.

Eat healthy

Eat a balanced diet and maintain a healthy weight. Minimize the intake of junk and processed food. Add fresh fruits and vegetables to your diet and reduce intake of salt and sugar.

Avoid substances that affect your mood

Substances, legal or illegal, that can affect your mood or your ability to cope effectively should be avoided.

Balance sleep

Follow a routine of going to bed and waking up at regular times. This will help you feel rested and refreshed while maintaining your mood.

Stay active

Stay active and exercise daily for at least 20- 30 minutes. You do not need to go to a gym necessarily, to exercise. Any form of exercise, such as walking, jogging, running and yoga, is good.

Build mastery

Do at least one thing every day that makes you feel competent and have a great sense of self-worth. It could be as simple as baking a great cake.

Use these 6 tips maintain your physical, mental and emotional health. They help you reduce your vulnerability and be prepared to face more emotional situations better.

7 Signs of addiction in your loved one

Looking after a loved one who is struggling with addiction is a difficult task. T can leave you overwhelmed and frustrated. The road to recovery is long and full of challenges and helping someone get there requires awareness, patience and understanding.

Here is a quick look at the early warning signs of addiction in people around you, and what you can do to intervene.

The first thing, if you expect somebody is abusing drugs or alcohol, is to watch out for any significant changes in their life, such as

  • poor personal hygiene
  • strained relationships
  • financial problems
  • accidents
  • DUIs or legal problems
  • school or work problems
  • mood changes

Mood changes are more difficult to detect than a DUI or lost job but paying close attention can help you identify the issue. When it comes to illegal drug use, other signs to watch out for, include –

  • euphoria or frequent and sudden mood changes
  • nodding (chin on chest, sleepy, slow to respond) or eye rolling (the eyes start to roll back)
  • itching up and down arms
  • pinned pupils (you can see pinkish color on the bottom of the eye)
  • too many visits to the bathroom
  • flu-like symptoms, leg cramps, sweats, chills
  • irregular sleep habits
  • sudden loss of appetite and/or weight
  • dark circles under the eyes
  • empty small Ziploc bags or paper folded with waxy substance found lying around or hidden
  • straws cut in half, empty pens (for snorting), spoons missing
  • coins with traces of some powdery substance (looks like pills have been crushed with it)
  • dishonesty

If your loved one is displaying one or more of the above signs, here is what you can do. First, make it known to the person that substance abuse is unhealthy and unacceptable.

Find a rehab or recovery program where you can help your loved one seek treatment. It’s good to be open to various treatment programs, depending upon the needs of your loved one and the recommendations of the rehab. There are various treatment options available, such as inpatient and outpatient programs. Join a support group so that you understand you are not alone and you can discuss the situation with people who understand.

As much as possible, get involved in your loved one’s treatment and recovery plan, for instance, attending family counseling sessions. But remember that you cannot control their behavior, and it is not your fault. Recovery is always possible even if your loved one has suffered a relapse. Consult addiction professionals at a trusted rehab right away.

Substance Abuse Treatment Plan

Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior, rendering the addict feeling helpless in coping with it. It takes a highly specialized approach to treat someone’s addiction. Addiction is a chronic problem and fixing it requires a long-term plan to stop using completely and recover their lives.

The goals for addiction treatment include getting the patient to stop using drugs, stay drug-free, and be productive in the family, at work, and in society.

An effective treatment program should identify addiction as being a complex but treatable disease and that the treatments need to be personalized, as no single treatment works for everyone. It is important to account for the fact that people need to have quick access to treatment. It needs to be a holistic program that effectively addresses all of the patient’s needs, not just the drug use. The program needs to be comprehensive, with a focus on counseling and other behavioral therapies. Medications are also necessary, especially when combined with behavioral therapies. Patients’ needs change, so the treatment plans must be reviewed often and modified to fit the current status.

When patients don’t receive treatment following detox, they are very likely to resume their drug use

Treatment should also address other possible coexisting mental disorders. Treatment sometimes has to be involuntary to be effective. Of course, drug use during treatment must be monitored continuously. It is also necessary to screen these patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as educate them on ways to reduce their risk of contracting these illnesses. Following treatment, a long-term follow-up is necessary to prevent relapse. Follow-up care may include community- or family-based recovery support systems.

Medications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-existing conditions. Detoxification is the first step of the treatment. When patients don’t receive treatment following detox, they are very likely to resume their drug use. While medications are the mainstay option in detox, recently FDA granted the use of an electronic stimulation device, NSS-2 Bridge, for use in helping reduce opioid withdrawal symptoms.

Medications are also helpful in relapse prevention. They can help to re-establish normal brain function and decrease cravings. They are especially helpful in opioid, tobacco and alcohol addiction treatment.

These medications are used for the following addictions:

 

Opioids: Methadone (Dolophine®, Methadose®), buprenorphine (Suboxone®, Subutex®, Probuphine® , Sublocade™), and naltrexone (Vivitrol®).

 

Nicotine addiction: bupropion (Zyban®) and varenicline (Chantix®).

 

Alcohol: Disulfiram (Antabuse®), Acamprosate (Campral®), Naltrexone have been FDA-approved for treating alcohol addiction and a fourth, topiramate, has shown promise in clinical trials.

Behavioral therapies can greatly help these patients be aiming to modify their attitudes and behaviors related to drug use and by trying to increase healthy life skills.
Most of the programs involve individual or group drug counseling and include cognitive-behavioral therapy, multidimensional family therapy, motivational interviewing, etc.

Inpatient or residential treatment can be necessary in some cases, especially for those with more severe problems. Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention, and aimed at helping the patient live a drug-free, healthy and productive lifestyle after treatment.

Staying Sober During the Holidays

The holiday season can be challenging for a person who has only recently achieved sobriety. Even advertising includes alcohol with meals at family gatherings. Your own family could be serving alcohol at the feast. Here are a few highly effective tips to help you deal with the temptation and stay sober during Thanksgiving.

Decide to stay sober

Staying sober during the holidays begins with your decision to not drink, not even a little sip. You are in charge and you must stay so.

Whenever you realize that the temptation is too much, move away from the situation. Think of a polite excuse in advance and leave.

Ask your loved ones for help

Your loved ones have been part of your recovery journey. Ask them to help you stay away from alcohol and stock up on non-alcoholic beverages for family get togethers.

Coping with triggers

Despite your best intentions, you may be tempted to drink again, especially during the holidays. In rehab, you must have learnt to cope with triggers. Use those techniques now to prepare yourself.

Entering rehab before holidays

If you have been planning to go to a rehab and are worried about drinking too much, enter the rehab during the holidays and learn to overcome your dependence on alcohol.

 

How Long is Rehab?

There are several treatment options to choose from based on your specific abuse disorder and needs. The typical length of rehab programs are: 30, 60 and 90 days. There are extended programs as well, such as sober living facilities or halfway houses. The most important thing to consider while choosing a program is that what option has the highest likelihood of success. in that patient’s case. Most commonly availed option is that of months.

Research shows that the best outcomes occur with longer durations of treatment, but they can be costly. They may also seem intimidating at first, but do have the best chance of being successful. It should be reminded to the patient that the more patient they are with themselves and accepting of the treatment process, the more effective it is going to be.

The 30-Day Program
The patient or his/her caregivers don’t know how long the duration needs to be, so starting with this program will provide the insight into whether it is enough or a longer duration program is needed. This program offers enough time to get through any physical withdrawal symptoms and allows time to begin establishing relapse prevention techniques. A 30-day program is easier to commit to and feels less daunting. It is also the most affordable option, so many insurance companies are more likely to cover this type of program.
The first 1-2 weeks are mostly just about getting acclimated and going through the withdrawal process
The 60-Day Program
A 60-day program provides the added time that may be needed in more involved cases. In this program, there is enough time to detox from the substance and undergo therapy sessions to work through any familial, behavioral or situational circumstances at play. It also provides the opportunity to actively practice positive and healthy habits to help maintain sobriety. Insurance may not cover the full 60-day programs, however, many rehab facilities offer payment plans that make it easier to afford it.

The 90-Day Program
It is a significant time commitment to go for this program and it may seem intimidating. However, it is also most likely to be effective as it allows for the full gamut of intake and evaluation, detox, therapy, self-help groups and set up an aftercare plan. This program provides the best shot at becoming adjusted to life without drugs or alcohol. It allows for strengthening one’s skills in resisting any temptations and urges and identifying any potential triggers. This program is highly recommended for those with severe or long-term addictions.

 

Simply put,  the longer a person remains in treatment, the better the outcome. However, it is important to consider factors such as cost, fatigue and reintegrating back to daily life. The first 1-2 weeks are mostly just about getting acclimated and going through the withdrawal process. The real work begins after that – when the patient is feeling better enough to address deeper emotional issues and work on fixing them. One should plan on an extra week to ten days of detox before starting in-patient treatment if it’s under consideration.

It is critical to realize that taking the time one needs to get a solid foundation for your recovery is critical. Leaving treatment prematurely involves the risk of relapsing, and failed therapies make it less likely for future rehab treatment to work. So give the time that is needed to properly heal and succeed in the recovery process.

How long does heroin detox take?

One of the toughest addictions to overcome is heroin addiction. Heroin is a powerful opioid that rapidly enters the brain upon consumption. It creates a pleasurable “rush” that the individual become dependent upon. Eventually, the user’s body starts needing larger amounts to feel good. This increases the risk of using too much or overdosing.

Heroin users are also highly likely to abuse painkillers. This is why it is critical that heroin addicts into a good rehab as soon as possible. The treatment to overcome heroin addiction begins with medical detox to rid the body of the drugs.

Heroin Detox

The body and brain become used to heroin pretty quickly. This is why withdrawal symptoms appear when you stop taking the drug. Withdrawal symptoms can range from mild to severe and it is not recommended that detox at home.

At a medical detox facility, you detox under the supervision of addiction specialists who can make it easier to go through withdrawal. They may prescribe safe medications to treat withdrawal symptoms. Symptoms often begins in 6 to 12 hours after the last dose.

Heroin withdrawal symptoms include –

  • flu-like symptoms, such as an upset stomach, aching, and runny nose
  • fast pulse
  • fever
  • tremors
  • violent urges

How long does Heroin Detox take?

The time taken to detox from heroin is different for everyone, based on the person’s history and overall health. However, the first 48 hours are typically the worst for everyone due to the most severe withdrawal symptoms. The symptoms start subsiding third day onwards and will fade within a week. Detox often ends in 7 to 10 days and is followed by inpatient and/or outpatient treatment programs.

Is Alcohol a Drug? Why is it so Addictive?

Alcohol is classified as a depressant – it slows down vital functions causing slurred speech, unsteady movement, inebriation, etc. It decreases one’s ability to think rationally and distorts his or her judgment.

After you drink alcohol, it absorbs into the bloodstream through the stomach and small intestine.  From there it readily gets into the brain where it interrupts the parts that control consciousness, heart rate, and our breathing patterns. This can cause slower reaction times and loss of coordination. The effect alcohol has on you is determined by the amount consumed and how quickly. At low doses, it has a mild stimulant effect, improving the mood and helping to socialize. The user feels subjectively relaxed and may feel euphoric. They may turn to alcohol as it allows them to pay less attention to feelings of self-consciousness or awkwardness in social situations, like if they want to “drown their sorrows” or forget about someone or something. Inhibitions also get lowered, which can lead to an increased risk of poor decision-making and potentially dangerous or harmful outcomes. Alcohol can have a sedative effect, and people may turn to it thinking that it helps them sleep. helps them sleep. This may get to a point where they are unable to fall asleep without a drink or two.

Physical addiction is when a person is unable to stop drinking without experiencing withdrawal symptoms

Our society is accepting towards alcohol consumption and that leads to uninhibited behavior, such as short-term binges our long-term heavy drinking. People drink socially but it produces a sort of “high” that they begin to crave. What may start as a social exercise to fit or giving in to peer pressure can lead to becoming addictive. The more you drink, the higher your tolerance for alcohol get. This begins a vicious cycle of needing more and more alcohol to reach the desired effect. This gets to a point where they feel they want to consume most if not all the time. This is known as a psychological addiction because this means that the act of drinking alcohol is now a habit.  Physical addiction is when a person is unable to stop drinking without experiencing withdrawal symptoms, which is the cause of alcohol include anxiety, shakiness, and on the more extreme end, seizures severe shaking, confusion, and hallucinations.

 

All of the above factors make alcohol a highly addictive drug. And that is an extremely dangerous thing. Because at a higher dose, it works as a depressant of the nervous system. And when it’s overdosed, it causes even more severe depressant effects – respiratory depression, coma, even death.  Short-term effects of alcohol include:

  • Impaired judgment
  • Loss of inhibition
  • Slurring speech
  • Loss of balance
  • Blackout
  • Nausea/Vomiting
  • Delirium Tremens (DTs)

Long-term effects of alcohol include:

  • Depression
  • Brain damage
  • Stroke
  • High Blood Pressure
  • Liver Disease
  • Cancer

It is critical to monitor and be watchful of early signs of alcoholism and to realize its seriousness as a health concern, as mentioned above.