Leslie Glass's Blog, page 355
June 23, 2018
Is it Difficult To Quit Marijuana? Is It Difficult to Quit Marijuana?
From Addiction Blog:
Physical Dependence
Marijuana is one of the most casually used drugs today. Repeated use can lead to physical and psychological dependence, which means your body and brain crave marijuana to be able to function normally. But what’s the difference between the two?
PHYSICAL DEPENDENCE is natural and expected outcome of regular use of a psychoactive drug like marijuana. It occurs in all individuals who use marijuana daily…but the time it takes to become drug dependent varies by individual.. Those who are physically dependent can become drug-free through a gradual decrease in dosage or by quitting marijuana cold turkey.
PSYCHOLOGICAL DEPENDENCE (a.k.a. ADDICTION) can be accompanied or precipitated by physical dependence, but not always. The main difference between physical dependence and psychological dependence are a mental obsession. Those who have become addicted to marijuana will experience an uncontrollable need (cravings) to feel the pleasurable and euphoric rush from another dose. This craving can lead to obsessive-compulsive drug seeking and drug use behavior and an inability to quit smoking weed, even if you want to, even if you are aware of the harm it’s causing.
How Addictive Is Marijuana?
The jury is still out on this one.
According to the Controlled Substance Act (CSA) marijuana is still a Schedule I drug. Federally, law enforcement officials view marijuana as having a high potential for abuse/addiction and no medical purpose. However, more and more states are challenging this view. According to Business Insider magazine, in 2018, over half of all U.S. states have legalized the use medical marijuana for therapeutic purposes. The medical use of marijuana is certainly under the microscope.
Still, scientific research supports the view that marijuana is an addictive drug due to the following facts:
Neuroscientific demonstrations have proved that marijuana affects the reward center in the brain in an exact same manner as all other addictive substances.
Animal studies where marijuana was given twice a day for one week showed an occurrence of addictive symptoms.
Clinical reports of humans reveal a similar pattern of withdrawal symptoms as in animal studies during the first weeks of abstinence.
The bottom line is that marijuana is a psychoactive drug. It affects the mind. When you use marijuana daily for a period of time, you become physically dependent on the THC found in marijuana. Take away the THC, and withdrawal symptoms occur.
Still, withdrawal alone does not characterize addiction. The cravings and obsessive thought patterns around use, followed by uncontrolled consumption are the hallmark signs of an addiction. Add to this continued use dspite negative consequences to home, health, or social life…and you’ve got a budding addiction on your hands.
Why Quitting Is Difficult?
Marijuana does not cause strong physical dependence when used for a short period, but when abused over a longer period it might cause tolerance (need for increasing doses to be able to reach the initial high). High-dose or long-term smokers can experience more severe withdrawal symptoms, making total cessation difficult. Furthermore, the need to use weed to fill an emotional gap can keep people from a life of abstinence.
Quitting can also be difficult if other people around you continue to use. For example, when surrounded by smokers while trying to give up, you’ll find yourself strongly influenced by them to smoke also. This is why experts advise major life changes when you want to quit for good.
Dangers
Marijuana is considered a fairly benign drug, although main dangers of use as reported by the NHTSA include the real threat of drugged driving incidents. Still, there haven’t been any consistent records of severe dangers during quitting. However, the following methods of discontinuation are not recommended due to the high chances of relapse that can lead you back to using again.
1. Relapse.
The main risk of quitting marijuana is starting back again. This is called “relapse”. Excessive cravings can make tapering a prolonged and unpleasant experience for you. In fact, if you find that can’t stop, then you can use cold-turkey as an alternative method. Be aware that going cold turkey can increase the severity of mood disorders and sleeping problems. See the list of side effects below for more.
2. Stopping marijuana without medical supervision.
Marijuana alters the brain chemistry and when used for a longer period causes physical and psychological changes. Doctors at detox clinics/ treatment centers can monitor your state and manage withdrawal symptoms to ensure that the process is safe…especially if co-occuring mental health disorders like depression or anxiety are just below the surface.
Side Effects
If you’ve been using marijuana for a longer period of time, physical dependence can cause you difficulties during quitting because of withdrawal symptoms. While many people report experiencing few or no withdrawal symptoms at all, others report extreme mood swings, dysphoria, and sleeping problems.
A list of common marijuana withdrawal symptoms includes:
Anxiety
Cravings
Depression
Distorted sense of time
Headache
Increased aggression
Loss of appetite
Paranoia
Sleep disturbances
The Safest Way To Quit
If you feel unable to stop using marijuana on your own it’s best to seek advice for the medical issue from a trained and educated medical professional. To make the process of quitting marijuana safer and less risky you can try any of the following methods:
1. Medical supervision and the use of medicines.
This method means that you’ll follow your doctor’s recommends on how to stop taking marijuana. Getting a medical clearance means that your condition will be evaluated by your doctor and you’ll be prescribed with medications to ease your withdrawal discomfort.
New medications prescribed during marijuana addiction treatment are:
Baclofen works by eliminating the reward effects or positive sensations associated with marijuana abuse.
Vistaril (Hydroxyzine) is prescribed to help you reduce anxiety during withdrawal.
The protocol is to test you before and after you quit smoking marijuana. Medical supervision also includes developing an individual plan for reduction of marijuana daily doses between you and your doctor, or a plan to go cold turkey.
2. Tapering or slowly reducing doses.
This method can help ease your withdrawal symptoms and reduce cravings. Gradual tapering is recommended for those who have not succeeded coming off marijuana cold turkey. It is a longer lasting process than cold turkey but possibly more successful in the long-term. Tapering plans are unique for each individual, created along with a doctor, and tailored to a patient’s’ individual needs.
3. Go to a detox clinic, especially if you use other drugs.
Detox centers allow you to recover in a safe and drug-free environment. Detox programs usually begin with an assessment where you’ll be examined about your length and frequency of marijuana use, drinking, or other drugs. Addiction counselors at the detox clinic will compile a medical history file and develop a withdrawal symptom management course specifically designed to meet your needs.
Trained physicians and nurses at the detox clinic will help you minimize withdrawal symptoms while keeping you safe. Medical staff at the detox facility will always be available to help you handle any physical stress or emergencies and ensure that your marijuana detox is successfully done.
4. Consider rehab.
If you are a long time marijuana user and have developed an addiction, you will highly benefit from a structured and tailored to your needs treatment program. Inpatient treatment programs have an integrated approach which includes:
Introduction to the program and to life without marijuana.
Marijuana detox.
Pharmacological and psychological therapy to help you better cope with withdrawal.
Physical, emotional, and mental health support during the treatment process.
Aftercare programs that teach you about relapse coping techniques.
Tips For Tapering Marijuana
TIP #1 Avoid carrying big bag with you. Instead, make a gradual reduction plan
Decide how much you’ll smoke each day and how much you’ll reduce. Then reduce your marijuana into daily bags or daily joints. In order for this to work you need to stick to your daily dose and avoid taking joints from others.
TIP #2 Take longer breaks between each dose of marijuana
Find other things that will occupy your mind other than smoking. This way, you’ll prolong the hours between every next dose and you’ll have less difficulty reducing your daily intake. For example, you can start going home or going to bed earlier to shorten the hours during which you usually smoke.
TIP #3 Gradually cut the number of joints you smoke a day.
If you currently smoke 6 a day, smoke 6 for 3 days, then 5 for 3 days, then 4 for 3 days, and so on until you quit marijuana for good.
TIP #4 Stick to your plan!
The idea of tapering is to help you physically and psychologically accustomed to less marijuana, but this can only work if you have control over how much you consume and don’t give into pressure from your friends.
The post Is it Difficult To Quit Marijuana? Is It Difficult to Quit Marijuana? appeared first on Reach Out Recovery.
June 22, 2018
She Recovers: Why We’re Better Together
When I reached around two years sober, my recovery felt stagnant. The prospect of a life attending endless mutual-aid meetings and working menial jobs filled me with dread. I didn’t get sober to live in church basements telling my sad story over-and-over-again, or to do a meaningless job. But I didn’t know what else to do. I just knew in my heart that there had to be more.
This Was The Beginning Of A Journey To Self-Empowerment
Starting my website, Liv’s Recovery Kitchen, was a step towards leading a more fulfilling life. I began writing about my experience of living a holistic recovery. It was cathartic, but I knew that I wanted more for my recovery. As the months went on, I began interviewing others about how they recovered. That’s when I stumbled across mother-daughter team, She Recovers. I interviewed Dawn Nickel and Taryn Strong about their movement, what recovery looked like to them, and the importance of community.
What Is She Recovers?
She Recovers is a movement of all types of women, all around the world, who are all recovering from something:
Substance use disorders
Depression or anxiety
Codependency
Trauma
Sexual and physical abuse
Disordered eating
Love addiction, as well as chronic illnesses including cancer
What She Recovers provides is a sense of community and connection to other women like them. They also help women connect to their bodies and to their purpose. One of She Recovers guiding principles is that recovery is a journey to wholeness, taking care of our minds, bodies, and spirits. While many women connect online in their Facebook page and group, they also connect in-person at their retreats all around the world.
Learning what I did from She Recovers proved there was indeed more to recovery than I had been experiencing. That’s when I joined their online community. I dreamed of one day attending their events; I never thought for a minute that it would happen two years later. But it did.
A Bold Step
At four and a half years sober, I took the biggest leap of faith in my life: I quit my job, sold all of my belongings, and moved to America with just two suitcases and a dream. I think the faith I had—the knowing that there had to be more to life—is what propelled me forward, and, in part, is what I credit for my success.
From month one I began writing full-time. In month two, I booked my ticket to She Recovers first signature event, She Recovers NYC, where 500 women like me would meet in real life. I didn’t really know how it would work out—just like with my move—but it did. A lovely woman I’d never met, who was part of this community, offered me a bed in her home during the event. We quickly became friends and that friendship continues today.
I had no idea what to expect from the event. On the one hand I was excited to meet the community of women that I’d been talking to online, but on the other I was anxious. I need not have been anxious. I came away from that event like I’d been given fresh air to breathe. I met women like me, we connected, and we acknowledged each other. We celebrated who we were. I no longer considered myself to be broken, instead I saw what happened to me as a gift. I looked around at a room of 500 women just like me and saw their brilliance.
The level of empathy and connection I felt there was exactly what I was so hungry for; it fulfilled me in a way nothing else had.
Want To Join?
When I heard that She Recovers is hosting an event in Los Angeles in September, I knew I had to attend. I cannot wait to hear more powerful inspirational speakers, meet new women I’ve met online, meet friends I met last year, and share space with other women who truly understand me.
I encourage every woman to attend a She Recovers event. It will show you the true potential for your recovery, empower you to live a life that you love, and enable you to celebrate the incredible woman that you already are.
The post She Recovers: Why We’re Better Together appeared first on Reach Out Recovery.
Opioid Bills Won’t Help
If the opioid crisis could be solved by the sheer weight of proposed legislation, Congress would be able to pat itself on the back. Last week, the House began two weeks of voting on what will be more than 50 bills about the epidemic, and the Senate has its own stack of opioid bills wending through the chamber. Despite some good ideas, addiction researchers say, the legislative effort falls short of the coordinated response the epidemic demands.
From The NY Times By Margot Sanger-Katz and Thomas Kaplan
Some of the bills authorize actions that all involved agree would help ease the epidemic, such as increasing access to treatment or allowing doctors to more easily identify patients who are shopping for multiple prescriptions.
Then there are measures like the “Synthetic Drug Awareness Act,” the first bill that came to the House floor, which calls for a study of the effects of synthetic drugs like “spice” and “bath salts” on adolescents. Or the “Poison Center Network Enhancement Act,” meant to improve and build awareness of the national poison control call center.
Taken as a whole, addiction researchers say, the legislative effort has some valuable ideas but falls short of the coordinated response warranted by an epidemic that claimed at least 42,000 lives in 2016, more than guns or car crashes. Some of the measures would probably have little effect, they say, and many evidence-based strategies to expand treatment go unmentioned.
“I didn’t really see that many groundbreaking proposals,” said Joshua Sharfstein, a vice dean of public health at Johns Hopkins University and the former health and mental hygiene secretary in Maryland, who reviewed the dozens of bills.
The volume of legislation reflects the desire of lawmakers on both sides of the aisle to show that they can take action on a growing public health crisis that has touched Americans across the country and in every social class. Opioids legislation is a popular focus for lawmakers facing re-election this fall, and House Republican leaders have been eager to draw attention to their members’ work on the subject.
So have outside groups. The American Action Network, a nonprofit aligned with the House Republican leadership, is running digital ads around the country highlighting the anti-opioids work of vulnerable members. Senate Majority PAC, a group that supports Democrats, has created an ad about an opioid bill sponsored by Senator Joe Manchin III, of West Virginia, who is running for re-election.
In the House, the leadership is bringing many individual bills to the floor, allowing the maximum number of legislators to say they sponsored their own piece of legislation and won passage. At a news conference last week, 10 members each gave a short speech about the constituent story that inspired their bill. (During the Q. and A. portion of the conference, reporters asked about immigration policy.) The leadership has set up an opioids crisis website to highlight the bills. And there’s a social media hashtag: #opioidcrisis
The list of members sponsoring opioid bills is filled with Republicans facing tough re-election bids. As Politico recently noted, more than half of the Republicans in races considered to be “tossups” by the nonpartisan Cook Political Report are chief sponsors of a House opioids bill. Most of the bills are ultimately expected to be packaged into one piece of legislation this week.
The House’s effort has the patina of bipartisanship — most bills have sailed through their committees on broad bipartisan votes, and many of the bills in the first batch passed the full House on voice votes. After all, what legislator would want to be on the record opposing an opioids fix?
But Democrats have been privately grumbling about a rushed process that has ignored their favored ideas for battling the epidemic. “If the first principle of legislation is do no harm, we will have succeeded,” said Representative Peter Welch, a Democrat from Vermont who sits on the House Energy and Commerce Committee. “But if the goal of legislation is to solve a problem, we will have failed.”
Experts who reviewed the package of legislation said there were several bills that could make a difference in helping prevent people from becoming addicted to opioid medications, and a few that could help those already struggling with addiction to get treatment. There are also some long-term investments in pain research that could pay off, though not for the currently afflicted: Both the House and Senate legislation would direct the National Institutes of Health to invest more in studying pain treatments that are not addictive.
In February, The Upshot asked a broad panel of experts to recommend priorities for battling the opioid crisis. They overwhelmingly emphasized addiction treatment as most important, citing the expansion of Medicaid to cover more people and the broadening of medication-assisted treatment as particular priorities.
One of the most costly proposals up for a vote this week does not expand who is covered by Medicaid, but would allow Medicaid to pay for addiction treatment inside large residential hospitals, something currently permitted only on a state-by-state basis. Another bill would allow Medicare to cover certain forms of addiction treatment for the first time. Another would expand the types of health care providers who could prescribe medications that help treat people with opioid-use disorders.
But treatment is not the primary focus of this crop of bills. Instead, a large number address various matters related to the prescribing of drugs; the tracking of prescribing; and the packaging and disposal of medications. Many of these measures could be helpful in preventing new cases of addiction: A recent study cited by the Department of Health and Human Services suggests that over half of those in treatment for opioid-use disorders began by using prescription medications.
But the push comes as prescriber behavior is already changing, amid recent policy changes meant to deter the overuse of opioid medications in medical care. Prescriptions for opioids have been falling since 2012, according to a recent study, even as the overdose death toll has continued to rise.
There are also, of course, many bills calling for studies.
Another missed opportunity, addiction experts said, is the legislative strategy to encourage creation of more treatment options for patients who need them. Earlier legislation, including the recent big spending deal passed by Congress, created short-term state grants for local anti-opioid priorities. But what health care providers and other entrepreneurs really need is a more permanent source of funding, so that those setting up clinics or companies will know they can remain in business over the long term, said Caleb Alexander, a professor at the Johns Hopkins Bloomberg School of Public Health. The shorter-term grant programs may not provide the nudge, he said.
“States are getting $500 million here or $200 million there,” he said. “At any given moment, it’s unclear whether the rug is going to be pulled out from under them.”
President Trump has unveiled his own set of preferred opioids policies, many focusing on enhanced law enforcement approaches. The White House has signaled its approval of a number of the House bills under consideration, including the one that would expand coverage of hospital addiction treatment and two that seek to limit trafficking of synthetic opioid drugs, like fentanyl.
The Senate is moving ahead with its own legislative push on opioids, though the midterm politics differ in that chamber. Passing opioid bills in the coming months could benefit several Democratic incumbents who are up for re-election in states where the crisis is particularly severe, such as West Virginia, Ohio and Pennsylvania.
Nonetheless, an aide said Senator Lamar Alexander, Republican of Tennessee and the chairman of the Senate health committee, would lead an effort to bring a package of measures to the Senate floor.
More legislation may follow. Representative Greg Walden of Oregon, the Republican chairman of the House Energy and Commerce Committee and a leader in the current House opioid strategy, has said any holes in the current legislation can be patched in the future.
“While these bills are not our first efforts in this fight, you have my word they will not be our last either,” he said in the news conference. “We know there will be more work to do, even after these become law.”
Margot Sanger-Katz is a domestic correspondent and writes about health care for The Upshot. She was previously a reporter at National Journal and The Concord Monitor and an editor at Legal Affairs and the Yale Alumni Magazine. @sangerkatz • Facebook
Thomas Kaplan is a correspondent in the Washington bureau covering Congress. He previously covered the 2016 presidential campaign and New York state government. @thomaskaplan
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Codependent Cookbook Sale
Codependent much? Do you know how your behaviors in the kitchen are influenced by codependency? You may be spending way too much time and energy cooking to please others, and not yourself? Guess what, you matter. Have you given up foods you love? Cook your way free with the help of stories and recipes written by ROR’s own, Pam Carver. The codependent’s cookbook is a delicious blend of original recipes and sage recovery wisdom.
Codependent’s Cookbook For Sale
Pam tackles tough topics like people pleasing, boundaries, and enabling. Culinary adventures include:
Making an Angel food cake from scratch
Grilling the perfect steak
Putting a fresh spin on traditional pumpkin pie and many more
You Can Purchase The Codependent’s Cookbook Two Ways
This 57-page full color, 8.5″ by 8.5″ book is available in as a soft cover book or as a downloadable e-book. Order today and have a new recipe for dinner tonight! All proceeds go to Reach Out Recovery, a 501(c)3 non-profit who strives to break the stigma of addiction, recovery, and mental health.
Order your copy today!
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Cookbooks For Sale!
Reach Out Recovery is opening a bookstore, and we’re so pleased to introduce our inaugural book. Written by ROR’s own, Pam Carver, this cookbook is a delicious blend of original recipes and sage recovery wisdom.
Pam tackles tough topics like people pleasing, boundaries, and enabling. Culinary adventures include:
Making an Angel food cake from scratch
Grilling the perfect steak
Putting a fresh spin on traditional pumpkin pie and many more
Cookbooks Come In Two Versions
This 57-page full color, 8.5″ by 8.5″ book is available in as a soft cover book or as a downloadable e-book. Order today and have a new recipe for dinner tonight! All proceeds go to Reach Out Recovery, a 501(c)3 non-profit who strives to break the stigma of addiction, recovery, and mental health.
Order your copy today!
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June 21, 2018
Sober Homes Best Practices Legislation
A bill passed by the U.S. House and currently under consideration in the Senate would be the most significant effort to regulate sober living facilities at the federal level in recent memory.The Ensuring Access to Quality Sober Living Act, a bipartisan bill introduced by Rep. Judy Chu (D-CA), would require the Substance Abuse and Mental Health Services Administration to:
Publish best practices for operating sober living facilities
Distribute its publication to states
Provide technical assistance to states seeking to adopt the recommended practices
The proposed legislation has been referred to the Senate’s Committee on Health, Education, Labor and Pensions.
A spokesperson for SAMHSA declined an interview request with Behavioral Healthcare Executive, explaining that the administration prefers not to speculate on pending legislation, but noted that SAMHSA already works with groups to develop best practices for the operation of sober homes “and would continue to work with stakeholders to develop and publish best practices as called for in the bill if it were to become law.”
In a statement emailed to Behavioral Healthcare Executive, Dave Sheridan, president of the National Alliance for Recovery Residences, praised the bill as “a needed first step, in that it will lead to the promotion of best practices, and the development of implementation guidelines for state governments. It’s also an important step in protecting vulnerable individuals from predatory housing operators.”
Sheridan also cautioned that while publishing best practices is a positive start, funds are still needed for states to turn recommendations into realities, and currently, no new funds are being considered.
“We would like to see specific funding and programmatic descriptions for the support services needed to implement best practices by states, and ideally in the CARA 2.0 legislation currently under consideration by the House and Senate,” Sheridan said.
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Release Negative Emotions In 12 Minutes
Every emotion has a charge, and the positive or negative energy an emotion generates has a real and measurable impact on our bodies. The act of writing allows us to physically release some of that charge much in the same way we release tension during sex. Burning the page, which happens at the end of the exercise, allows us to purge even more of that charge and serves as a symbol of letting go. If you can release negative energy on a regular basis, it doesn’t accumulate. You could look at this exercise as an act of freedom. Whenever you release your emotions, you lighten your burden so you don’t have to carry it with you to your next experience.
Purge Emotional Writing (PEW 12)
This exercise works best if you just keep writing and don’t stop to think about what you’ll write next or self-edit. Forget about punctuation or making your handwriting pretty, even legible. In fact you may get to the point where your emotions are flowing so fast and furiously that you can’t even write real words. That’s great. Just keep the pen in contact with the paper and let the thoughts roll out of you. This isn’t a time to be polite or fair. This is your side of the story. Also, at the end of the exercise you’ll be destroying the pages you’ve written, so as you write there’s no reason to worry about anyone else reading them.
Directions
Before you begin, get a notebook and pen and find a quiet place where you won’t be disturbed. Sit down and set a timer for twelve minutes.
Open your notebook and simply start writing about whatever is disturbing your peace. It could be your health, job, finances, personal relationships, or anything else. Don’t think about it too much—just start.
At the end of twelve minutes, stop writing. Immediately take the pages to a secure, nonflammable area like a concrete patio, your driveway, fireplace, or barbecue and set them on fire. Don’t just tear them up. Fire is transformative and cleansing. Your goal is to neutralize the negative energy, and fire does that by changing the chemical composition of the paper to ash.
Things to remember
• As you finish each writing session, don’t read over what you’ve written! To do this is to reinfect yourself with the negative energy.
• Don’t do this on a computer or other electronic device. You want a physical energetic connection between you and the materials you’re using—the pen and the paper—so that you can expel as much of the emotional charge as possible. That’s why this exercise must be done in your own handwriting.
• You may use lots of powerful, negatively charged words during this process to discharge pain, but remember to never direct them toward yourself. Be kind to yourself and know that you have every right to feel what you feel.
Prescription
Do this every day for five days. Even after five days, it’s a great thing to work into your morning ritual as a way of regularly purging negative energy and maintaining clarity. Think of it as practicing good psycho-spiritual hygiene in the same way you practice good physical hygiene by bathing, grooming, and brushing your teeth.
What to expect
Not long ago my day started with a surprise. Intending to get to my office before anyone else, I was up and out the door early. But when I walked outside, I found something I wasn’t expecting. My car, which I’d parked on the street the evening before, was sitting there with the trunk and driver’s side door thrown wide open. I stopped dead in my tracks.
I remembered being in a hurry when I arrived home the previous evening, wanting to work on a birthday present I was making for my wife before she got home from her office. Could I have been in such a rush that I’d forgotten to close and lock the car? After a brief moment of confusion, I was certain I hadn’t left it that way. Then the obvious answer hit me. My car had been broken into.
I went to survey the damage and, sure enough, some personal items and documents I’d left in the car were missing. As I waited for the police to come so I could file a report, I discovered that my next-door neighbors had a security camera that happened to be pointed in the general direction of my car. I knocked on the door and asked if I could see the recording. While it didn’t show my car, it did show the space just behind it. That was where I saw a woman on a bicycle riding away with my belongings. She even dropped a few things as she pedaled away, leaving them on the ground like forgotten and unimportant breadcrumbs.
I couldn’t stop thinking about this woman. Her image stuck in my mind. I was angry that she had invaded my space and privacy in such a callous and careless way. I was worried about the personal information she had taken. I was annoyed that my day had been hijacked by an event that was beyond my control. All of these thoughts and feelings were swirling around in my head. In short, I started to stew.
After nearly a day of dwelling on what had happened, I turned to PEW 12. I wanted to stop fixating on my feelings of anger and violation, as well as on the woman who had done this to me. Aware that getting stuck can be a danger to clarity, I began to write. Moving my thoughts and feelings from my inner world to the outer one by putting them on the page helped me get past them and move on from the event. After all my years of practicing PEW 12, I find it still helps me through difficult situations of all kinds, big or small.
So that you aren’t left wondering whether PEW 12 is working or if you’ve somehow done it wrong, it’s important to understand the range of reactions you might experience after engaging in the exercise. As long as you follow the directions (i.e., remember to write by hand, don’t reread what you’ve written, etc.), it isn’t possible to make a mistake. There’s no wrong topic to write about, no wrong words to use, no wrong feelings that might come up as a result of what you’re writing.
Afterward you may immediately feel lightened and clearer, or you may feel exhausted and emotionally wrenched. It can be a bit like vomiting from food poisoning. At first you feel achy, tired, and awful, but once you’ve let it all out you start to feel better. If you keep up the exercise over time, you will eventually feel an emotional shift as your burden of negative energy becomes lighter and lighter with each written page. As with other disciplines such as exercise or meditation, the more you do it, the more benefits you’ll see.
Excerpted from the book THE CLARITY CLEANSE by Habib Sadeghi, DO. Copyright © 2017 by Habib Sadeghi, DO. Reprinted with permission of Grand Central Life & Style. All rights reserved.
Habib Sadeghi, DO, is co-founder of the Be Hive of Healing Integrative Medical Center in Los Angeles. In this excerpt from his book The Clarity Cleanse , he describes a simple writing exercise that can help you process anger and other toxic emotions that may be holding you back.
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Are You Oxycodone Dependent?
From Addiction Blog:
How can you know if you are dependent on oxycodone? See if the following statements are true for you:
Oxycodone at my current dosage seems to be losing its effectiveness.
My oxycodone dose has increased since I started therapy.
I feel sick when I attempt to decrease the amount of Oxy I use.
I experience withdrawal symptoms upon cessation which are resolved when I take oxycodone again.
If you recognize yourself or a loved one in these scenarios that indicate physical dependence…don’t worry!
In this article, we’ll cover more details about the nature and symptoms of oxycodone dependence. We’ll compare dependence with addiction, and share with you some effective methods on how to safely address dependence. Finally, we welcome your questions and feedback in the comments section at the end, In fact, we do our best to respond personally and promptly to all legitimate inquiries.
What Is Oxycodone Dependence?
Physical dependence on a psychoactive drug is a common and expected side effect. This is true of oxycodone, even when you completely adhere to treatment guidelines. But, every individual reacts differently to oxycodone. Some users may develop dependence within a few weeks of use, while others may take longer to become dependent.
Q: Why does dependence occur in the first place?
A: Mainly, it’s an adaptation required for survival.
In the brain, oxycodone binds to the mu, kappa and delta receptors and decreases their excitability. Over time and with continued oxycodone use, your body begins to adapt to the presence of the drug in order to continue to function. In this case, the body creates some stimulant effects to counteract the depressant effects of the opioid pain killer. Dependence usually gets to the point where the drug basically becomes a part of the normal body/brain functions and processing.
So, when you stop taking oxy, the body needs time to re-regulate its chemistry and return to homeostasis, which is why it triggers withdrawal symptoms. The set of predictable withdrawal symptoms are actually the “stimulant effects” that manifest when you take away the drug.
Make sense?
Does Oxy Dependence = Addiction?
NO. There is a difference between physical dependence on oxycodone and addiction to oxycodone.
DEPENDENCE is natural and expected outcome of regular use of oxycodone. It occurs in all individuals who use oxycodone, but is also easily treatable. Those who are physically dependent can become drug-free through a gradual decrease in dosage and may need some medical management of withdrawal symptoms. But most importantly, they will not experience a continued need to use oxycodone after quitting.
ADDICTION can be accompanied or precipitated by physical dependence, but it doesn’t always have to be. The main difference between physical dependence and addiction are cravings. Those who have become addicted to oxy will experience an uncontrollable need (cravings) to feel the pleasurable and euphoric rush from another dose. This craving can lead to obsessive-compulsive drug seeking and drug use behavior and an inability to stay off of oxycodone, even if you want to, even if you are aware of the harm it’s causing.
Symptoms
The two main symptoms that indicate drug dependence are: tolerance and withdrawal.
TOLERANCE causes the body to need a higher dosage to receive the same effect. It occurs with regular, chronic, and longer use of oxycodone. You may notice that your initial, lower doses of oxycodone have become less effective over time. As your tolerance grows, many feel compelled to use higher doses more frequently.
WITHDRAWAL occurs when your body develops physical dependence to oxycodone and you try to take less, skip a dose, or try to quit. Withdrawal symptoms usually occur about 4-6 hours after the last oxycodone intake, peak at around 72 hours later, and start to diminish anywhere from 7 to 10 days after cessation of use. In some cases symptoms may persist for several weeks, even months due to many factors.
Some of the most frequent oxycodone withdrawal symptoms include:
Anxiety
Breathing problems
Chills
Depression
Diarrhea
Nausea
Pain in the bones and muscles
Poor appetite
Sleeping problems
Vomiting
Signs
Experiencing an increase in tolerance and withdrawal symptoms are the two main symptoms of dependence. But there are a few more signs to be aware of when identifying dependence in yourself or a loved one. Below is a list of some of the more subjective, behavioral signs that can signal a problem.
Being defensive when inquired about your oxycodone use.
Buying oxycodone off illegal sources (off the street, internet pharmacies, off other people who are prescribed).
Going doctor shopping (visiting multiple doctors to obtain multiple prescriptions).
Losing the ability to control or stop use.
Running out of oxycodone before it’s time for a prescription refill.
Spending a lot of time and effort acquiring and using oxycodone.
Taking oxycodone to stop the effects of withdrawal.
Using oxycodone longer, more frequently, or in higher amounts than intended.
Using oxycodone secretively.
If you find 2 or more of these scenarios to be true for yourself or someone close to you, it might be a good idea to speak with your doctor about possible assessment of oxycodone dependence and even addiction.
How To End Dependence
The best way to end physical dependence on any drug is by seeking help from a medical specialist such as your physician, psychiatrist, or in a specialized medical detox clinic. Then, once a treatment plan is set in place, here are some of your treatment options:
Tapered oxycodone withdrawal: Tapering includes 2-3 weeks of slow and gradual lowering of oxycodone doses. It is the most recommended and effective therapy for coming off of oxy. This therapy is specially designed and controlled by a medical professional because they can determine the tapering rate that is right just for you.
Medical detoxification: You may also be required to undergo oxycodone detox at a clinic to remove all traces of oxycodone from your system in a safe, supportive environment. If there is a possibility for any complications, your doctor may advise you to taper oxycodone while being monitored 24/7 by detox staff. This way withdrawal symptoms can be managed as they occur using medications.
Supportive withdrawal: Sharing your experiences through supportive family, individual, and/or group therapy is a great way to gain helpful advices and to navigate the period of stopping oxycodone and withdrawal.
Home treatment: Oxycodone withdrawal symptoms can be treated at home. Some over-the-counter medications are excellent for overcoming severe symptoms of withdrawal. However, this is not the safest way to end a case of dependence. You should always consult your doctor before attempting to quit or lower doses of oxycodone.
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Surviving Surgery Without Opioid Addiction
From Psychology Today:
Anyone can be one surgery away from developing an addiction to prescription pain medication. It’s estimated that 60% of the opioids that are abused are obtained directly or indirectly through a physician’s prescription. But when a recovering addict needs surgery, the stakes are even higher. Cellular changes in opioid receptors can occur faster. Addiction can be reactivated or a new one can be formed. So is there a way to manage pain without risking drug relapse for addiction?
Who Is At Risk?
Certain people are particularly vulnerable to addiction. You can assess if you are in a higher risk group if you check off one or more of the following:
Prior history of drug or alcohol addiction
Past problematic use of pain medicine
Parent or other family member with addiction
Unresolved childhood trauma
Co-occurring mental health disorders such as depression and anxiety
Long-term use of opioids for chronic pain is known to cause opioid use disorders. And there are risks around exposure to opiates after surgery for everyone. How much pain medicine does it take to form a painkiller addiction? The Centers for Disease Control and Prevention (CDC) has found that prescriptions for three days or less can help reduce opioid addiction or misuse. Research shows that for people predisposed to addiction, cellular changes in response to opioids can occur with as little as five days of exposure.
6 Ways to Avoid Addiction Post-Surgery
Doctors and hospitals have tended to give postoperative patients more opioids than needed and do not educate them about the potential dangers of opioid medication. Research shows that people who get addicted to pain medicine often move on to less expensive, more readily available heroin.
Painkillers can’t always be avoided entirely. But studies show that if people in recovery have the proper education and a limited amount of the medicine and are open to alternative forms of pain relief, they can heal without risking their sobriety. Here are a few tips for creating a recovery-friendly pain management plan.
Talk with your surgeon. Some hospitals are already making an effort to reduce the amount of opioids prescribed to postoperative patients in multiple surgical specialties. A recent study showed a drop in opioid prescriptions when surgeons offered education and options for pain relief. Encouraged by their doctors to use a nonsteroidal anti-inflammatory drug (NSAID) and acetaminophen before using opioids, 85% of patients went without opioids. Share your concerns with your surgeon.
Discuss pain medicine in advance. Tell your entire medical team, from surgeons and residents to attending physicians and nurses, that you are in recovery and ask for this to be taken into consideration while in the hospital and in prescribing medicine. Request the smallest amount for the shortest amount of time. Balance the need to control pain with non-narcotic pain relief.
Ask about regional analgesia. Pain after surgery is unavoidable and can be debilitating, but for some surgical procedures the need for pain medication can be delayed if the physician uses an analgesic techniqueduring the surgery. It is not something a doctor would automatically do so discuss the options.
Enlist your support system. Reach out and ask for support. If you are in a 12-step program or outpatient treatment, tell the people around you about your medical situation. Have friends visit you in the hospital and ask them to come to your home to help distract you from pain and to support you in maintaining your sobriety. If you are unable to attend meetings for a while due to surgery, ask friends to have them in your home.
Give the medication to a responsible party. Don’t tempt the hands of fate by thinking, “I can handle this on my own.” If you have to use opioid medication for a short amount of time, put the bottle of pills in the hands of someone who can keep them out of sight, give them to you as needed and will not let you take more than prescribed. They frequently do that in drug trials that involve either narcotics or treatment for narcotics, so that the drugs aren’t abused.
Plan for alternative pain relief. It takes time to heal from surgery and pain relief allows the body to heal faster, but people who have already experienced addiction should look into complementary pain management approaches, including:
Mindfulness meditation – Using brief meditations, patients can shift their moods and their response to pain. Mindfulness meditation is used to help self-regulate chronic pain as well as attenuate other forms of pain.
Hypnosis – This popular nonpharmacological means for managing surgical side effects has been used for pediatrics, post-surgical adults and cancer patients. Research has shown hypnotic analgesia may enhance nervous system inhibitory processes that attenuate pain.
Auricular acupuncture – Stimulation of acupuncture points in the external ear has been shown to help reduce pain after hip surgery and ambulatory knee surgery.
Relaxing music – Research has shown that sedative music has been effective in reducing pain and anxiety in open-heart surgery patients.
Foot and hand massage – Massage can take the focus off of pain and promotes relaxation.
Although there is greater awareness of the opioid crisis and how addiction can begin with pain medicine prescribed after surgery, there is still more education needed on best prescribing practices and also catching drug addiction before it begins. The CDC has suggested physicians prescribe less and refuse unnecessary prescriptions. But people in recovery from addiction have to take the extra step of informing their physicians of their special vulnerabilities and asking for help so they can have the healthiest, least painful surgical recovery.
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Overcoming Obstacles To Change
From Psychology Today:
Peter wants to stop his back pain. He’s paid for expensive physiotherapy, but somehow never finds the time to do his exercises.
Suzie is constantly frustrated by her inability to quit smoking. She joins the other smokers outside on every lunch break.
Sanjiv wants to address his tendency to ruminate, as he knows it contributes to his depression. He knows that he feels better when he sees his friends, and yet he ignores their calls.
If these scenarios sound familiar, you are not alone: At times we all behave in ways we’d like to change. Even when we know what we should do instead, most of us struggle to make and sustain positive changes.
Change is really really hard. Were it easy, there would be no demand for the $10 billion self-help industry offering quick fixes.
But why on earth is it so difficult? Just what is going on? Typically, we procrastinate or start but fail to sustain change after a couple of days, and then berate ourselves for not sticking to our resolutions.
A crucial, but usually overlooked, factor is that all behavior — even when apparently undesirable on the surface — makes sense and performs some useful function given our current view of the world. Our ‘bad’ behavior is good for us in some way. Attempts to change a behavior, without an awareness of its real role in our lives, leave us with a gap in our tool set for coping with the world. Thus we tend to revert to the status quo.
Let’s look at what Peter, Suzie and Sanjiv might be getting from their unwanted behaviors.
Peter’s back pain may get him attention and care. It might make him feel special or give him something to talk about. It might give him excuses to avoid work or certain activities and responsibilities.
Suzie’s smoking may give her a sense of community with other smokers, or support her identity as a rebel. It may also be the only way to get a break from work.
Sanjiv’s depression may protect his self-esteem by giving him an ‘excuse’ for not achieving, or it may have become central to his identity. He may feel that ruminating is helpful and ‘doing something useful’, or it may protect him from really facing his role in his problems.
Looked at in this way, it’s easy to see that changing behavior ‘for the better’ – through improved health, stopping smoking, or reducing rumination – could in fact open Peter, Suzie and Sanjiv up to the expectation of ‘personal threats’ such as the loss of attention, or community or identity. No wonder we resist change…
How then can we move forward?
Understanding why we function the way we do is a start.
As children we develop our own individual idiosyncratic ways of understanding the world, and what is required of us. One key idea from psychologist Albert Adler was that whilst children are excellent observers, they are poor interpreters, and make mistakes in understanding how best to get what we want. However, these mistaken beliefs and goals come to form the basis for our actions, just as our more reasonable conclusions do.
Peter may have concluded he needs to be ill to be valued, or that he must be perfect – and thus needs an excuse to explain why he isn’t. For Suzie, smoking may been how she showed she was ‘cool’ or different to others in her strict family, whilst Sanjiv may have learnt to use rumination to block more difficult feelings.
Such beliefs led to behavior that served them well at some point, but now creates resistance to moving to more objectively positive and constructive behaviors. If we want real behavioral change, we need to modify underlying beliefs, and find better ways to satisfy our needs.
It’s not always easy to do this psychological work alone, as what seems reasonable to us depends on our existing beliefs, so can be self-justifying. Therefore a therapist may be needed to help unpick deep-seated beliefs.
However, the following sort of questions may get us started:
-Do I really want to make the change I say I want to? I.e. what am I attached to in my current behavior.
What are my fears if I make this change? What will I lose or open myself up to?
Do I (honestly) want to make the effort required to make this change?
Sometimes, with a little introspection we realize that the goal of a behavior is completely misguided making it easier to drop, and psychologically more difficult to maintain. For example, Peter might realize ‘it’s ridiculous to think I need to be ill to be valued’. Or we might realize that although we’ve paid lip-service to wanting to change, it’s actually not the priority right now.
At other times, by focusing on barriers to change, or fears if we do change, we reveal something about the motivations and role of the behavior we wish to change. We can then begin to identify better ways of achieving goals such as getting attention or being accepted or building self esteem.
Focusing on adding more constructive ‘replacement’ behaviors, is often the key to reducing an unwanted behavior. In general, moving towards an outcome is a much more successful strategy for change than moving away from something unwanted. I explore reasonable goals further in Part 2 of this three-part blog series on making change happen.
It should be clear that changing ourselves is a complicated business, which often demands we challenge our deeply buried beliefs and reward systems. We should be kinder to ourselves when we find it so very hard: there is rarely a quick fix. Unfortunately, we tend to beat ourselves up instead.
To change, we have to learn how to be our own cheerleaders rather than our own bullies, which will be the focus of Part 3. We need to learn to say to ourselves: ‘come out for a lovely walk!’, not ‘get off the couch you lazy slob!’ … Being bullied (by anyone) is a recipe for reduced energy, low mood, and failure, and will not help anyone change for the better.
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