Leslie Glass's Blog, page 267

What Is Passive Aggressive

One of my favorite stories about passive aggressive behavior in a marriage goes like this…“Cash, check or charge?” I asked, after folding the items the woman wished to purchase. As she fumbled for her wallet, I noticed a remote control for a television set in her purse. “So, do you always carry your TV remote?” I asked. “No,” she replied, “but my husband refused to go shopping with me and I figured this was the most evil thing I could do to him legally.”

In relationships, passive aggressive behaviors are often used to avoid the direct confrontation of short-term conflict, but in the long-term, these dynamics can be even more destructive to marriage than outright aggression. To keep assertive communication flowing in your relationship, here are four strategies to effectively confront passive aggressive behavior:

Recognize the Warning Signs of Passive Aggressive Behavior

Passive aggression is a deliberate and masked way of expressing covert feelings of anger. This “sugar coated hostility” involves a variety of behaviors designed to get back at another person without the other recognizing the underlying anger. When a person is able to quickly identify these behaviors for what they are—hidden expressions of anger—they take the first critical step in disengaging from the destructive dynamic. Some of the most common passive aggressive behaviors to be aware of include:

Procrastination
Behaving beneath customary standards
Pretending not to see, hear, remember, or understand requests
The silent treatment
Sulking & withdrawal
Gossiping
Refusing to Engage

Passive aggressive adults are experts at getting others to act out their hidden anger. The skill of recognizing passive aggressive behaviors at face value allows you to be forewarned and to make a choice not to become entangled in a no-win power struggle. When you sense these destructive dynamics coming in to play, manage your own emotions through self-talk statements such as:

“He is being passive aggressive and I will not participate in this routine.”

“I will not yell or become sarcastic because this behavior will only escalate the conflict.”

Point Out the Elephant in the Room

Passive aggressive people spend their lives avoiding direct emotional expression and guarding against open acknowledgement of their anger. One of the most powerful ways to confront passive aggressive dynamics and change the behavior in the long-term, then, is to be willing to point out anger directly when it is present in a situation. Anger should be affirmed in a factual, non-judgmental way, such as, “It seems to me that you are angry at me for making this request.” The impact of this seemingly simple exposure can be quite profound.

Expect & Accept Denial

Your goal is to make overt the anger that has been covert, stuffed inside, and kept secret for so long. Expect that once this has been done, the passive aggressive person will deny the existence of anger.

When he does, you should verbally accept the defenses for the time being, with a response such as, “Okay! It was just a thought I wanted to share with you.” Don’t argue or correct the person’s denial at this time, but rather quietly back away from further discussion, leaving your spouse with the thought that you are aware there are some feelings of anger behind his behavior.

The advantage of this approach is the comfort of not having to justify or defend your acknowledgement of the anger. By simply sharing your awareness of his covert anger, you have sent a bold and powerful message that the passive aggressive behavior cannot continue and the relationship needs to change.

From Signe Whitson, LSW @ GalTime.com

Passive aggressive behavior can wreak havoc on relationships, marriages and families. For more strategies and techniques to effectively confront passive aggressive behavior, check out The Angry Smile: The Psychology of Passive Aggressive Behavior in Families, Schools, and Workplaces, 2nd ed.,

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Legal Marijuana Increases Injuries And Car Accidents

From Science Daily

The legalization of recreational marijuana is associated with an increase in its abuse, injury due to overdoses, and car accidents, but does not significantly change health care use overall, according to a new study.

In a review of more than 28 million hospital records from the two years before and after cannabis was legalized in Colorado, UCSF researchers found that Colorado hospital admissions for cannabis abuse increased after legalization, in comparison to other states. But taking the totality of all hospital admissions and time spent in hospitals into account, there was not an appreciable increase after recreational cannabis was legalized.

The study, appearing online May 15, 2019, in BMJ Open, also found fewer diagnoses of chronic pain after legalization, consistent with a 2017 National Academy of Sciences report that concluded substantial evidence exists that cannabis can reduce chronic pain.

“We need to think carefully about the potential health effects of substantially enhancing the accessibility of cannabis, as has been done now in the majority of states,” said senior author Gregory Marcus, MD, MAS, a UCSF Health cardiologist and associate chief of cardiology for research in the UCSF Division of Cardiology.

“This unique transition to legalization provides an extraordinary opportunity to investigate hospitalizations among millions of individuals in the presence of enhanced access,” Marcus continued. “Our findings demonstrate several potential harmful effects that are relevant for physicians and policymakers, as well as for individuals considering cannabis use.”

According to the 2014 National Survey on Drug Use and Health, more than 117 million Americans, or 44.2 percent of all Americans, have used cannabis in their lifetime, and more than 22 million Americans report having used it within the past 30 days. While its use is a federal crime as a controlled substance, 28 states and the District of Columbia now allow it for treating medical conditions. Nine of those states have legalized it for recreational use.

To understand the potential shifts in health care use resulting from widespread policy changes, Marcus and his colleagues reviewed the records of more than 28 million individuals in Colorado, New York and Oklahoma from the 2010-2014 Healthcare Cost and Utilization Project, which included 16 million hospitalizations. They compared the rates of health care utilization and diagnoses in Colorado two years before and two years after recreational marijuana was legalized in December 2012 to New York, as a geographically distant and urban state, and to Oklahoma, as a geographically close and mainly rural state.

The researchers found that after legalization, Colorado experienced a 10 percent increase in motor vehicle accidents, as well as a 5 percent increase in alcohol abuse and overdoses that resulted in injury or death. At the same time, the state saw a 5 percent decrease in hospital admissions for chronic pain, Marcus said.

“There has been a dearth of rigorous research regarding the actual health effects of cannabis consumption, particularly on the level of public health,” said Marcus, holder of the Endowed Professorship of Atrial Fibrillation Research in the UCSF School of Medicine. “These data demonstrate the need to caution strongly against driving while under the influence of any mind-altering substance, such as cannabis, and may suggest that efforts to combat addiction and abuse of other recreational drugs become even more important once cannabis has been legalized.”

The study findings may be beneficial in guiding future decisions regarding cannabis policy, the researchers said.

“While it’s convenient and often most compelling to simplistically conclude a particular public policy is ‘good’ or ‘bad,’ an honest assessment of actual effects is much more complex,” Marcus said. “Those effects are very likely variable, depending on each individual’s idiosyncratic needs, propensities and circumstances. Using the revenues from recreational cannabis to support this sort of research likely would be a wise investment, both financially and for overall public health.”

The researchers could not explain why overall health care utilization remained essentially neutral, but said the harmful effects simply may have been diluted among the much larger number of total hospitalizations. They said it also may be that some beneficial effects, either at the individual or societal level, such as violent crime, counterbalanced the negatives.

Story Source:

Materials provided by University of California – San Francisco. Original written by Scott Maier. Note: Content may be edited for style and length.

 

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Habitual Coffee Drinkers Really Do Wake Up And Smell The Coffee

From Science Daily:

Regular coffee drinkers can sniff out even tiny amounts of coffee and are faster at recognising the aroma, compared to non-coffee drinkers, new research has found.

Habitual coffee drinkers are not just more sensitive to the odour of coffee and faster to identify it, but the more they craved coffee, the better their ability to smell it became.

It is the first time evidence has been found to prove coffee addicts are more sensitive to the smell of coffee.

The results could open the door to potential new ways of using aversion therapy to treat people addicted to substances with a distinct smell, such as tobacco and cannabis.

The research was led by Dr Lorenzo Stafford, an olfactory expert in the Department of Psychology at the University of Portsmouth.

He said: “We found the higher the caffeine use, the quicker a person recognised the odour of coffee.

“We also found that those higher caffeine users were able to detect the odour of a heavily diluted coffee chemical at much lower concentrations, and this ability increased with their level of craving. So, the more they desired caffeine, the better their sense of smell for coffee.

“We have known for sometime that drug cues (for example, the smell of alcohol) can trigger craving in users, but here we show with a mildly addictive drug, that craving might be linked to an increased ability to detect that substance.

“Caffeine is the most widely consumed psychoactive drug and these findings suggest that changes in the ability to detect smells could be a useful index of drug dependency.”

The team wanted to examine if there were any differences in the ability of people to smell and respond to the odour of coffee, depending on whether or not they were big coffee drinkers. The results point firmly to a link, with heavy coffee drinkers being more sensitive to the smell of coffee, and the smell being linked to their cravings.

The study is published in Experimental and Clinical Psychopharmacology.

The research was based on two experiments.

In the first experiment, 62 men and women were divided into those who never drank anything containing caffeine; those who consumed moderate amounts (70-250mg, equivalent to 1-3.5 cups of instant coffee a day); and those who consumed a high amount (300mg, equivalent to 4 or more cups of instant coffee a day).

Each person was blindfolded and, to test their sensitivity to the smell of coffee, they were asked to differentiate very small amounts of the coffee odour from odour blanks, which have no smell. For the odour recognition test, they were asked to identify as quickly as possible the scent of real coffee and, separately, the essential oil of lavender. Those who drank the most coffee were able to identify coffee at weaker concentrations and were faster to identify the odour.

Each person was also asked to complete a caffeine-craving questionnaire. Predictably, the results showed that the more caffeine a person usually consumed, the stronger their craving for caffeine.

“More interestingly, higher craving, specifically that which measured the ability of caffeine to reverse withdrawal symptoms such as fatigue, was related to greater sensitivity in the odour detection test,” Dr Stafford said.

In a second test, 32 people not involved in the first experiment were divided into those who drink coffee and those who do not and they were tested using the same odour detection test for coffee odour, and with a separate test for a control, using a non-food odour.

Again, the results showed the caffeine consumers were more sensitive to the coffee odour but crucially, did not differ in sensitivity to the non-food odour.

The findings suggest sensitivity to smell and its links to craving could be used to help break some drug use behaviours, including addiction to tobacco or reliance on cannabis, Dr Stafford said.

Previous research showed those who were trained to associate an odour with something unpleasant later showed greater discrimination to that odour, which provides evidence of a possible model for conditioned odour aversion.

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Legendary Quarterback Joe Namath Says Drinking Nearly Killed Him: ‘I’d Probably Be Dead By Now’

From People:

Former New York Jets star Joe Namath has come clean in a new book over his post-football career alcohol addiction, a habit that nearly cost him his life, according to ESPN.

The legendary quarterback says it got to a point to where a voice in his head told him to drink — a voice Namath named Slick, ESPN reported.

“Every now and then Slick whispers, but having a name for him makes me listen to him differently. And, health-wise, I’d probably be dead by now if I hadn’t stopped drinking,” Namath writes in All the Way: My Life in Four Quarters, his first autobiography in 50 years.

The notoriously private 1970s-era icon covers a wide range of personal and professional experiences in the book, according to ESPN — from football-induced brain trauma and his Super Bowl III victory to his path to sobriety after years of alcohol abuse.

Namath, now 75, admits his infamous 2003 sideline interview with Suzy Kolber — where he drunkenly told the reporter he wanted to kiss her — was a turning point in his life.

“I saw it as a blessing in disguise,” Namath writes, ESPN reported. “I had embarrassed my friends and family and could not escape that feeling. I haven’t had a drink since.”

“That shame is where I found my strength to deal with the addiction. With the help of my recovery, I learned that I had used my divorce as an excuse to go back to drinking. That knowledge made me a stronger individual.”

A 2000 divorce to his ex-wife Deborah made Namath even more of a problem-drinker, the Hall of Fame quarterback reportedly recounts.

“The drinking was what would kick my butt for a long time,” Namath writes, according to ESPN. “I believe any of us can be brought to our knees whether from physical or emotional pain. Over the years, I learned how fragile we humans can be. Emotionally, I used that as an excuse to start drinking again. … I would drink all day sometimes.”

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CVS Will Only Sell Supplements Tested for Safety

 

 

From Time

CVS Pharmacy announced May 15 that it will only sell vitamins and supplements that have been third-party-tested for safety and label accuracy, in an effort to bring order to the notoriously under-regulated world of health and dietary aids.

The U.S. Food and Drug Administration does not vet the contents of vitamins and supplements. The agency primarily intervenes when problems are reported and a product needs to be removed from the market, so supplements can hit stores bearing their manufacturer’s unchecked claims. Studies have shown that many supplements for sale—particularly those intended for weight-loss—may be dangerous to consume. Some have even been found to be tainted with substances similar to amphetamine.

 

CVS’ program is meant to help combat those issues. “We thought there was a real gap in making sure that people could trust that what’s on the label actually reflected what’s in the bottle,” says George Coleman, CVS’ senior vice president of merchandising.

As of May 15, all 1,400 vitamins and health supplements sold online and in CVS stores, including multivitamins, protein powders, pain relievers, digestive aids and more, were required to go through third-party testing. Some manufacturers already have their products certified by third-party groups like NSF International, an independent product testing and inspection firm, and U.S. Pharmacopeia, a nonprofit working to ensure the quality and safety of foods and medicines. While these seals do not guarantee efficacy, they do confirm that a product’s label is accurate and that it is not contaminated, according to the National Institutes of Health’s Office of Dietary Supplements. Both groups also inspect facilities to make sure they’re following good manufacturing practices.

To comply with CVS’ new rules, manufacturers had to pay for testing of any product not already validated by these groups, through either NSF or Eurofins, a laboratory that specializes in food, pharmaceutical and environmental testing. Each product was tested to ensure its ingredients matched those listed on its label, and was free of contaminants and unnecessary additives. Every supplement product CVS sells will undergo periodic testing moving forward, Coleman says.

About 7% of the products that went through testing failed, the company says. These were either removed from CVS’ shelves or their makers updated their labels or formulas, Coleman says.

Still, CVS’ program cannot guarantee the vitamins and supplements it sells are beneficial to consumers’ health. The testing is meant to confirm that “what’s on the label is what’s in the bottle, and it’s safe,” Coleman says. “We’re not making efficacy claims. That would be redefining the supplement category.”

The efficacy of vitamins and supplements, as a class, is dubious. One study published last month, for example, found that nutrients from dietary supplements are not as beneficial as those consumed through food, and that taking high doses of calcium and vitamin D supplements was associated with an increased risk of premature death. Other studies have also found efficacy issues with specific products, including calcium, omega-3 and vitamin D supplements.

The Academy of Nutrition and Dietetics, a professional group for nutrition experts, recommends supplement use for those who can’t meet their nutritional needs through diet alone, perhaps because of age, lifestyle habits, religious beliefs or dietary restrictions. But “the routine and indiscriminate use of micronutrient supplements for the prevention of chronic disease is not recommended,” the group says, “given the lack of available scientific evidence.”

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To Reduce Dementia Risk, Eating Well And Exercising Do More Than Puzzles And Pills

If you want to save your brain from the ravages of dementia, keep the rest of your body well with exercise and healthy habits rather than relying on vitamins or other pills, according to new guidelines from the World Health Organization.

About 50 million people around the world have Alzheimer’s disease or another type of dementia, and nearly 10 million new cases arise each year, the WHO said in a report issued Tuesday. The cost of caring for people with dementia is expected to reach $2 trillion per year by 2030.

Although age is the top risk factor, “dementia is not a natural or inevitable consequence of aging,” the report says. Many health conditions and behaviors affect the odds of developing it, and research suggests that one-third of dementia cases are preventable, said Maria Carrillo, chief science officer of the Alzheimer’s Assn., which has published similar advice.

Since dementia is currently incurable and so many experimental therapies have failed, focusing on prevention may “give us more benefit in the shorter term,” Carrillo said.

Much of the WHO’s advice is common sense, and echoes recommendations from the National Institute on Aging.

The new guidance includes getting enough exercise; treating health conditions such as diabetes, high blood pressure and high cholesterol; having an active social life; and avoiding or curbing harmful habits like smoking, overeating and drinking too much alcohol. Although there isn’t strong evidence that some of these actions will help preserve thinking skills, they’re known to aid general health, the WHO report says.

Eating well — such as by following a Mediterranean-style diet — may help prevent dementia, the guidelines say. But don’t expect vitamin B or E pills, fish oil or multi-complex supplements that are promoted for brain health to help. The guidelines emphasize that there’s strong research showing that these shortcuts don’t work.

“There is currently no evidence to show that taking these supplements actually reduces the risk of cognitive decline and dementia, and in fact, we know that in high doses these can be harmful,” said the WHO’s Dr. Neerja Chowdhary.

“People should be looking for these nutrients through food … not through supplements,” Carrillo agreed.

The WHO also declined to endorse puzzles, games and other activities aimed at boosting thinking skills. These can be considered for people with normal capacities or mild cognitive impairment, but there’s little evidence they provide any benefit.

Although antidepressants may be used to treat depression, there’s not enough evidence to recommend them for reducing dementia risk, the report says.

In addition, hearing aids may not reduce dementia risk, but older people should be screened for hearing loss and treated accordingly, the WHO says.

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Women, Alcohol And Perceived ‘Sexual Availability’

From The New York Times:

A new study finds that women who drink alcohol in social settings are seen as more “sexually available” and “less human.”

When Brock Turner, the former Stanford swimmer who was found guilty in 2016 of sexually assaulting an unconscious woman on campus, appealed his conviction, he and his lawyers devoted 60 pages to how intoxicated the victim seemed. He lost the appeal.

Last year, a Yale student, Saifullah Khan, was found not guilty of sexually assaulting a fellow student. His lawyers worked relentlessly to discredit the account of the woman, repeatedly asking how much she’d had to drink.

Using alcohol to cast doubt on women’s reputations, particularly in cases of sexual assault, in court and in life is not rare. Now a new studyfrom researchers at the Worcester Polytechnic Institute, the University of Nebraska and Iowa State University finds that women who drink are in fact judged more harshly than men who do the same.

The study, titled “She Looks Like She’d Be an Animal in Bed: Dehumanization of Drinking Women in Social Contexts,” explored the stereotypes applied to women who drink and how presumptions of alcohol and sexual promiscuity go hand-in-hand. It was published in a May issue of the journal Sex Roles.

Researchers found that both women and men believed that a woman drinking alcohol in a social setting was more intoxicated than a man having the same drink, and that she was more “sexually available” and “less human” than a woman drinking water or a man drinking alcohol.

“Sexual availability” was defined as whether study participants perceived the women to be single or open to having casual sex. “Less human” meant they were perceived to lack self-restraint and were described as mechanical and cold, unsophisticated, superficial, shallow, less intelligent and rational, as well as more immoral.

(The researchers came to these conclusions by asking study participants to respond to photos and fake social media posts of a woman and a man drinking.)

The findings, not surprisingly, have “troubling implications,” said Jeanine Skorinko, a psychology professor at the Worcester Polytechnic Institute and an author of the study.

Among them, the researchers found that people may be less likely to help a woman in a risky situation if she’s been drinking because they might think she’s interested in risky or casual sexual behaviors, and therefore not think the situation is a threat to her.

“This is especially shocking,” Skorinko said, “because just holding a beer bottle increased perceptions of intoxication and sexual availability for women, but not for men.”

 




 







 

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Want To Stay Healthy As You Age? Let Go Of Anger

From Time:

Though emotions are often fleeting, they can have a lasting impact on your health. Stress, for example, may heighten the risk of both chronic and acute health conditions, while happiness can improve wellbeing.

Now, a small new study published in the journal Psychology and Aging suggests that anger, far more than sadness, is linked to negative health effects in older people, potentially by contributing to inflammation and chronic disease.

The new research was borne from a theory developed by two of the study’s co-authors, psychologists Carsten Wrosch and Ute Kunzmann. The theory posits that all emotions — even negative ones — play an important, evolving role throughout a person’s life. “All negative emotions may have a positive function if experienced in the right context,” says Wrosch, a psychology professor at Concordia University in Canada. Anger may motivate people to push through tough circumstances, for example, while sadness can kickstart the healing process after trauma.

But when people get older and face age-related problems, like the deaths of loved ones and the onset of physical and cognitive decline, some negative emotions may take a toll on physical health. Wrosch and Kunzmann analyzed data from the Montreal Aging and Health Study, which surveyed more than 200 adults ages 59 to 93 about their emotions three times over one week. People also reported their diagnosed health conditions and gave blood samples that researchers tested for markers of inflammation.

When people ages 80 and older regularly felt anger, researchers saw a link to elevated levels of the inflammatory marker IL-6 — perhaps because anger can throw off stress hormone levels. Inflammation is a normal process that the body uses to fight injury and infection, but chronic inflammation is associated with a range of health issues. Adults with elevated inflammatory markers were also more likely than their peers who didn’t feel as angry to have at least one chronic illness, such as cancer or cardiovascular problems. But researchers didn’t see the same link between sadness and health issues, Wrosch says, and anger wasn’t as strongly linked to inflammation and chronic disease among younger adults in their 60s and 70s.

Getting angry won’t fix the most serious problems that seniors face. Instead, Wrosch says, anger may only bring more stress and its attendant issues. “If people are angry and they try to resolve issues that they cannot resolve anymore, that prolongs problematic circumstances and may result in physiological dysregulation,” and, potentially, elevated inflammation levels, Wrosch says.

But even though being sad won’t stop the progression of Alzheimer’s or bring back a spouse, either, it can serve a purpose. While constant or inexplicable sadness can be the sign of a larger issue, like depression or loneliness, Wrosch says acute sadness is often a more appropriate reaction to late-in-life problems and may kickstart healthy grieving and healing. “Sadness may actually start the recovery process and help the person accept it,” he says. “It may also help recruit some social support from others to then help [them] cope with it.”

The study was small and preliminary, and it only showed associations between emotions and health. It also didn’t analyze the life circumstances that prompted their emotions, so it wasn’t possible to say whether each situation could or could not have been helped by anger. Still, Wrosch says it provides early evidence that people respond differently to varying emotions, even those that fall under the same general category of negative feelings. A separate new study, published in the American Journal of Geriatric Psychiatry, reached a related finding about the link between emotional and physical health. It found that optimism, resilience and self-compassion were associated with better health among seniors, while loneliness was associated with worse health.

While it may seem difficult to control emotional responses, research suggests that people can learn to regulate them. To reduce anger, the American Psychological Association suggests doing relaxation and stress-relief practices like breathing exercises and yoga; using more rational and measured speech; improving your communication skills; and keeping your environment as stress-free as possible. The Mayo Clinic also recommends getting plenty of exercise and relying on humor and forgiveness.

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How Does Suboxone Work?

Is Suboxone a helpful product to get off drugs like Heroin, or is it just another party favor? The truth is, it can be both.

What Is Suboxone And How Does It Work?

Suboxone actually can be two products. It is a detox medication used to treat opiate addiction and dependence. It is a combination product that has Buprenorphine and Naloxone (Narcan). Buprenorphine is an opioid that reportedly doesn’t provide the intense euphoria addicts love and want. Naloxone is also known as Narcan which is used to rapidly reverse an adverse drug reaction; it is used to instantly reverse a potential overdose. Narcan is used in the ER, but is now available to first responders, some police departments, and people who feel they might need it to save their loved ones from an overdose of drugs.

The benefit of Suboxone for recovery is that the components of Buprenorphine and Naloxone allow addicts to avoid the withdrawal pains but not experience the high of the opiate. It is taken as a slip of medication (think of those breath slips of Listerine) that you dissolve on the tongue. The Buprenorphine gets into the blood system immediately via the vascularity in the oral area while the Naloxone hangs around and dissolves in portions (and thus prevents the “high”). Suboxone is an effective maintenance for getting off heroin if the person is legitimate about getting off Heroin, and in this manner it works like Methadone does. Suboxone isn’t addictive (due to the Narcan component) and is difficult to abuse (also due to the Narcan component). But, of course, any drug can be abused and there are ways to abuse Suboxone.

The signs and symptoms of Heroin withdrawal are seen when it’s time for another dose of Suboxone and include:

Cold sweats
Body aches
Bone and muscle aches (flu-like symptoms)
Yawning
Sneezing
Gastrointestinal symptoms of nausea and vomiting and diarrhea
Anxiety and intense scratching.

However, the signs and symptoms associated with Suboxone include headaches, insomnia, abdominal pain, nausea and constipation, and some sweating.

So people who are misusing or addicted like to use Suboxone to get them through until they can get what they want. While Heroin has more withdrawal symptoms it supposedly is a “better” high and so worth it to the addict who wants the drug high.

Even more preferred is Subutex. This is a formulation of pure Buprenorphine, is more pure and doesn’t have the Narcan mixed in it, so they will get the high they want.

Methadone vs. Suboxone:

You have to go regularly to a Methadone Clinic with all that entails: inconvenience, cost, associated clientele, and potential not to get your drug if your drug screen is positive for drugs you shouldn’t be taking.
Any physician can work in and/or run a Methadone Clinic.
Methadone is a full agonist which means that its effects for that “buzz” and overdose potential are strong.
Methadone began in Belgium and the Netherlands.
You go to a physician who is able to prescribe Suboxone and get a prescription for the medication. But the Suboxone Clinics charge a fee (not cheap) for the first visit and each successive visit. There are drug screens and many physicians require the patient to also go through regular counseling and attend NA.
A physician who wants to prescribe Suboxone must go through an approved training process that used to involve several days of classroom time but now can be done online. Each prescribing physician can only treat 100 patients, so once they reach 100 they can’t take another patient until one drops off the panel.
Suboxone is a partial opioid agonist.
Buprenorphine began in Belgium in 1983 as a treatment for opioid addiction then moved to France and finally the USA in 2003.
While most people who want Suboxone genuinely want to get “sober” it can be expensive to go the legal route and many buy it on the street so they can afford it as the neighborhood drug dealer won’t charge for the office visits or require counseling or an NA membership.
Neither Methadone nor Suboxone is supposed to be a long term usage medication but both have ended up being just that.

So Where Does That Leave Us?

Those who want to do drugs will always find a way to get their drug of choice but sometimes they have to settle for plan B, and Suboxone has been that for many people addicted to whatever they can get. We all know that. Suboxone is no different and is bought, bartered, sold illegally and obtained legally from doctors who are able to prescribe it.

Where there’s a will, there’s a way is the moral of the story here. And while these products are used for “bridging” (getting the addict off their drug of choice slowly) it’s still a crutch. While you are learning to walk again and crutch or cane or walker can come in handy and may be helpful. However, at some point you have to take the training wheels off and ride off into the sunset on your own power. That said, there are some who take Suboxone for a long time and seem to do well on it. Everybody’s different.

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Confused About Methadone?

Lets first start with some medical information about methadone and methadone clinics and then discuss the possibilities/probabilities with this method of medically assisted recovery.

Methadone has been used for over 50 years here and in Europe for heroin addiction and also for opioid addiction. It is quite effective when used correctly in this way.

The FDA oversees drugs in the USA and in 1970 released the following schedules under the Controlled Substance Act (CSA) which organizes drugs (prescription) into five groups based on risk or harm. The drugs with highest risk and no counterbalancing benefit are banned from medical practice; these are schedule one drugs. These have no currently accepted medical use and include drugs such as heroin, LSD, marijuana, ecstasy and Quaaludes (the drug Bill Cosby is currently in the news for giving to women and then having sex with them). Schedule two drugs include narcotics like Dilaudid, Percocet, Oxycontin, oxycodone, opium, morphine, codeine and Methadone. Schedule five at the bottom of the list includes codeine cough syrup.

When used correctly, methadone, which is longer acting then heroin and short-acting narcotics (like Percocet, Oxycodone) can help someone not crave the high of heroin and can help them regain a life of sorts. It can also relieve pain as the other narcotics can.

Methadone is also used for those addicted to other opioids. There are many Methadone Clinics all over the place and some are run better than others. There are some clinics that are run as pill mills though, and you already are aware that many pain clinics are not run legitimately. The practicing and prescribing patterns of physicians and the midlevel providers (physician assistants and advanced registered nurse practitioners) who work for them varies.

While addiction is a disease it, unfortunately due to the issues involved, is not viewed as other medical diseases because of the problems that can be caused by illegitimate use of these medications. Methadone supposedly reduces the drug cravings and harsh withdrawal symptoms that are often associated with a patient’s relapse, without creating the sense of euphoria associated with the abuse of heroin and the other opiates.

When a narcotic is used correctly for someone with pain and at the correct dosing they rarely have the side effects that drug abuser look for; the euphoria, high feeling. It is a complicated chemical pathway of receptors in the brain. Therefore, in the Methadone clinics the person addicted to heroin or other narcotics is switched from the drug that gives them a “high” to an opioid (methadone) that does not. They then can be titrated to gradually lower does over time with the goal of getting off the drug. So for the abuser who takes Methadone instead of their drug of choice the risk involves taking  too much or too high a dose in an effort to get the high that they want.

Because Methadone is a long acting drug when they take too much they are at real risk of overdose.

Now Let’s Look At Three Terms You Need To Understand: Addiction, Dependence And Tolerance.

Addiction: characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, and continued use despite harm and craving. The user has developed physical as well as psychological dependence. They crave it and need it and do whatever they have to so the can get the drug.

Dependence: is the state of adaptation that is manifested by withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. You have to have the drug or have problems when it is taken away.

Tolerance: is the state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time. Over time taking the medication you need more to achieve the same effect.

The Negatives Of Methadone

So now lets look at concerns about this type medically assisted recovery. You probably won’t want to hear what I am saying but it’s important for you to understand for your sake if not theirs. If this person is getting methadone pills from more than one source, not all that are “legal” sources (doctor’s offices), it’s likely an addiction. Persons who are addicted do what they must to get what they want. At a minimum that involves lying.

How To Know The Truth?

A person can get Methadone from a clinic (pill mill or supposed legitimate office). If he really is going to a Methadone Clinic daily then a physician writes the order. Unless you have power of attorney over him, you will not be able to get medical records. I have often seen patients getting narcotics and going to a Methadone Clinic as well. This is particularly dangerous. The legitimate Methadone Clinics will test patients and look for issues but the “pill mill” Methadone clinics might not. Methadone will not show up in a drug screen unless specifically ordered.

Get Educated

I recommend educating yourself in all aspects of these drugs and their abuse potential; particularly learn about the side effects, withdrawal symptoms and how they appear when they are high. This education is too involved for this article as there are too many possible drugs and scenarios to describe. Learn more about Methadone clinics and about where you can obtain Narcan injectable which is becoming available in some areas. If you suspect he is overdosing this drug might help. Pay attention to where he is getting money from as street drugs are expensive and many user become dealers to obtain their supply “for free”.

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