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Saturday, December 3, 2016

The Naloxone Yo-Yo Effect

It could easily be argued that naloxone, the lifesaving overdose reversal drug sold under the brand name Narcan, is one of the most important drugs ever produced. If it's administered in a timely manner, the life of an opioid addict can be spared from what would have otherwise resulted in an overdose death.

In the United States, practically every first-responder has been trained to administer the drug, in response to the staggering overdose death rates linked to the epidemic plaguing America. Additionally, a number of states have taken certain actions, making it much easier for addicts and their families to acquire the ever important drug—in many cases a prescription is not required for obtaining the miracle drug.

While the United States has the highest overdose death rates in the world, after decades of over prescribing painkillers and a burgeoning heroin market, our neighbors from the North have hardly been spared. In fact, between November 17-23, there were nearly 500 overdoses that required paramedics in the greater British Columbia (B.C.) area, CTV reports. Situations that would usually be considered routine, involving naloxone treatment. However, it turns out that addicts have begun mixing naloxone with their heroin in an attempt to protect oneself from an overdose.

Obviously, the method is far from the right course of action. The act of using an opioid, followed by naloxone, is being called “yo-yoing” or the “yo-yo” effect, according to the article. Heroin causes feelings of euphoria; naloxone reverses those effects by essentially starting a process of drug withdrawal—a real up and down experience. One that is far from pain-free.

In B.C. paramedics are arriving at the scene of overdoses and seeing empty vials of the overdose reversal drug, the article reports. Addicts are getting a false sense of safety from yo-yoing, but Paramedic Sophia Parkinson says that a person who uses naloxone needs to be followed up with by medical personnel, as the effects of the antidote can be fleeting.

Please take a moment to watch a short video on the Yo-Yo Effect:

If you are having trouble watching, please click here.

Wednesday, November 23, 2016

Questions About Recovery This Thanksgiving

Thanksgiving is less than a day away and if you are in recovery then there is a good chance that you have some apprehensions about being surrounded by family, especially if you are new to the program. You may be concerned about how your relatives are going to respond to your new-found sobriety, and they may bombard you with questions about the program. Naturally, how you choose to handle the potential onslaught of questions will have an impact on your day.

Please keep in mind that your recovery is between you and your “higher power.” You are not required to share your story of recovery with people who are not in the program. If people ask about your recovery, you can simply answer them with a simple: “my life got out of hand because of drugs and alcohol, and I'm trying to live life in a different way.” There really shouldn’t be any need for follow up questions. People who have not had a problem with mind altering substances will never fully understand what you went through or what you are doing, today, in order to be free from such experiences in the future.

Another common scenario for people new to recovery who find themselves going home for the holidays is the someone asking you: “Why can’t just have a couple? I mean, it is Thanksgiving after all!” There are probably a million answers you could give to that question, all of which would be accurate. Nevertheless, you can answer that question with, “I have had enough, already.” If drinking and drugging brought you to the depths of despair, that answer would not be an untruth.

Those who love and support you will commend you for what you are working towards. If they saw you in active addiction, then they may be pleasantly surprised about the progress you have made. If your family is unwilling to get behind your recovery, it may be painful, but it is not that big of a deal; in time, it is likely that they will come to understand. If Thanksgiving becomes too much for you to handle, call your sponsor and find a meeting immediately. It is a lot easier to pick up the phone before a relapse, than it is after the fact.

Celebrate Hope at Hope by The Sea would like to wish everyone working a daily program of spiritual maintenance a safe and sober Thanksgiving 2016.

Saturday, November 19, 2016

Regulating Sober Living Homes

sober living homes
The American opioid epidemic has created a huge demand for addiction treatment services. With over 2.5 million Americans struggling with an opioid use disorder, providing adequate addiction programs across the country has proven to be a challenge.

Ideally, when an addict makes the choice to finally seek help and check into a program of recovery, there will be a treatment center close by with an open bed available. What’s more, such facilities should be both affordable and utilize evidence-based methods of treatment to ensure the best outcomes. Unfortunately, it can be difficult for addicts to access addiction treatment centers in rural America, such as inpatient and outpatient treatment or sober living homes.

Addiction treatment services are much more common in cities across the country. People with substance use disorders who reside in major cities often have a long list of choices when it comes recovery. Long-term, inpatient care is considered to be the best choice, usually resulting in ideal outcomes. The goal is being able to focus solely on one’s recovery, free from the distractions of family, friends and work.

Addiction counselors will typically recommend patients to aftercare programs, upon finishing the 90-day inpatient program. Aftercare options typically include outpatient treatment and living in what is known as “sober living” home. People in early recovery have a better shot at achieving significant recovery time, if they follow the recommendations of their counselors. The more time you spend in
safe environments, the better protected you are from relapse.

However, people who are new to recovery, should be careful when picking a sober living home. Not everyone who moves into a sober living home started their recovery in a treatment facility, so they may not have good sources for recommendations on which homes they should look at. There are some sober living homes that are not conducive to recovery.

The huge demand for addiction treatment services, led to a boom in sober living homes opening up across the country. When bad homes are operating, cities have struggled to determine which ones are taking advantage of the vulnerable to turn a quick profit. Addiction is a disability, which means that people living in sober living homes are protected by the Fair Housing Act, CBS12 reports. Unfortunately, medical privacy laws have actually ended up serving the interests of sober home owners, who are not subject to housing regulations. Meaning, people can get away with shady business practices, potentially affecting vulnerable newly sober people.

In an effort combat such behaviors, the Department of Justice and the U.S. Department of Housing and Urban Development announced the release of new guidelines for cities to use for the effective regulation of sober living homes, according to the article. A joint statement indicates that the agencies are giving cities:

"...the legal clarity they need to maintain the safety and character of their communities while protecting the rights and needs of people with disabilities, including those recovering from drug addiction.”

Thursday, November 10, 2016

Graphic Cigarette Warning Labels

Smoking cigarettes continues to be one of the number one killers in America. While products containing nicotine are legal for adult use, they are responsible for taking more lives than many Schedule I narcotics combined. With the nation focused on gaining the right to smoke marijuana, for better or worse, many have lost sight of cigarette smoking prevention efforts, despite the fact that experts overwhelmingly agree that cigarettes are one of the true “gateway drugs” along with alcohol, both of which are far more deadly.

Over the last decade, or so, there has been a push by tobacco opponents to include graphic warning labels on the packaging of cigarettes. Several Western countries have experimented with such labels, with beneficial results, yet “big tobacco” has fought graphic images tooth and nail. And for good reason. If people saw with their own eyes the havoc tobacco is wreaking on the inside, they would probably be less inclined to smoke.

Nevertheless, cigarettes continue to be sold in the manner that they have been for decades, despite the staggering death toll associated with the cancer sticks. There is more at stake than just the smoker, cigarettes have been linked to neonatal problems that could affect someone long after they are born. Secondhand smoke has also been linked to cancer with people who have never smoked.

We have come a long way in the U.S. with regard to tobacco legislation, none of which should be discounted. However, it is paramount that efforts to mitigate the harmful toll that tobacco takes on society continue. Graphic warning labels are the next logical step in the campaign to end tobacco use in America. New research suggests that labels depicting the harmful effects of tobacco could save more than 650,000 lives by 2065, HealthDay reports. The findings were published in the journal Tobacco Control.

"By any standard, this would be considered a very, very successful public health intervention," said study author David Levy. He is a professor of oncology at Georgetown University Medical Center in Washington, D.C. "The other countries have persisted and gotten the graphic warnings, so if they can do it, there's no reason that the United States shouldn't do it."

Friday, November 4, 2016

Teaching Teens the Science of Addiction

There is still much to learn about the disease of addiction, a complex mental illness that affects millions of Americans each year. Researchers continue to make breakthroughs regarding the complex nature of addiction, with the hope that it will lead to better, more effective methods of treatment. Addiction is a science, and failure to understand it or at least have a grasp on its nature, could lead to deadly outcomes for some.

Opioid addiction has been in the national spotlight for nearly two decades, with no real indication that the epidemic is diminishing. In the field of addiction medicine, it is well understood that addiction does not discriminate. While opioid use disorder affects primarily adults, teenagers are eligible too.

The “Just Say No” and subsequent D.A.R.E. campaigns over the years have shown that teenagers rarely respond to those types of adult directives. And, in fact, they may actually make teens more interested in trying drugs after learning about how they make you feel. It is no secret that adolescents hate being told what to do, even if such advice could save their life.

With that in mind, the acting administrator of the Drug Enforcement Administration (DEA), Chuck Rosenburg launched a new drug-education program that goes about teaching teens with science rather than scare tactics, The Washington Post reports. The DEA funded Discovery Education, a subsidiary of Discovery Communications, to develop a “virtual field trip,” which included a panel made up of a:
  • Scientist
  • Recovering Addict
  • Assistant Principal
  • DEA Agent
The group discussed addiction with high school biology students, according to the article. It was then broadcast to 200,000 students nationwide. The program also includes:
  • Free Videos
  • Classroom Materials
  • A Student Video Contest
“We’re focusing on the science behind addiction and what it can do to your brain and your behavior,” said Bill Goodwyn, president and chief executive of Discovery Education. “It’s not a one-off assembly where you’ll have a speaker come in once a quarter or once a semester. It’s actually part of the core curriculum.”

Friday, October 28, 2016

Opioid Addiction Medication Preauthorizations

The American opioid epidemic highlights the need for greater access to addiction treatment services throughout the country. While over 70 people die from an opioid related overdose every day, there are effective addiction treatments that are being underutilized. In recent years, there has been a huge push from both Federal and local government agencies to ensure that everyone who wants or needs treatment—gets it. Whether it be through residential treatment or intensive outpatient, millions of Americans desperately need care.

At reputable residential treatment centers around the country, the drug buprenorphine is widely used for detoxification purposes. The drug can ease the painful and uncomfortable symptoms of opioid withdrawal. Most people with an opioid use disorder would struggle making it through detox without buprenorphine, sold under the brand name Suboxone. However, buprenorphine is a semisynthetic opioid derivative, that can cause euphoria and lead to dependence if taken for extended periods of time.

Most treatment centers will wean patients off of Suboxone after their withdrawal symptoms subside and before they are discharged from the facility. On the other hand, primary care physicians around the country have begun prescribing Suboxone in an effort to stem the tide of opioid addiction epidemic, it is a program referred to commonly as medication-assisted treatment (MAT). There are conflicting opinions about MAT. On the one hand it is considered to be the lesser of two evils when compared to heroin abuse, yet the drug is addictive and withdrawing from Suboxone can be more painful than that of heroin.

As was mentioned earlier, people are dying so there is a real need to combat this epidemic where and when we can. If the recommendation from the Substance Abuse and Mental Health Administration (SAMHSA) is MAT, then it is likely that more and more doctors will be prescribing Suboxone in the coming years. Last week, the insurer Cigna announced that it will no longer require pre-authorization for prescriptions to treat opioid addiction, USA Today reports. The news comes in the wake a national settlement announced by New York Attorney General Eric Schneiderman.

"Getting people into treatment faster, and when the window of opportunity is open, is vital to stemming the opioid addiction crisis,” Schneiderman said in a statement. “Other health insurers should take notice of Cigna’s actions to remove access barriers to treat opioid dependency and I encourage those insurers to follow suit.”

Friday, October 21, 2016

National Prescription Drug Take-Back Day

prescription opioids
Even if you are not in recovery, or work in the field of addiction medicine, you can play a role in helping to end the American opioid epidemic. Every year, millions of prescription opioids are handed out by doctors to American patients. The United States accounts for about 5 percent of the planet’s population, yet we prescribe and consume the vast majority of all opioid narcotics.

Naturally, not everyone who is prescribed a painkiller is going to abuse them, or become dependent on the drugs. In many cases, people prescribed opioids for pain will only use the drug until the pain eases up. They often have leftover drugs that will just sit in the medicine cabinet collecting dust. While it may not seem like a big deal to just forget about one’s unwanted or unneeded medications, in actuality, many peoples' initiation into the world of prescription opioids is made possible by a friend or family member's prescription.

In fact, many Americans have no problem diverting some of their Vicodin or OxyContin to someone in need, even though the act is illegal. They will often do this despite having the knowledge that we are in the grips of an epidemic, believed to be caused by prescription opioids. It is crucial that unwanted medications are disposed of safely, so they do not end up in the wrong hands or lead to another person developing an opioid use disorder.

On October 22nd, Americans across the country can take part in National Prescription Drug Take-Back Day. The event, which is organized by the Drug Enforcement Administration (DEA), could help keep millions of unwanted opioids out of the wrong hands. With more than 5,000 collection sites nationwide, there will be ample opportunity to dispose of your drugs. You can find a location close to you by clicking here.

Additionally, the White House points out that major pharmacies are doing their part to help with the cause:
  • Walgreens Pharmacy has installed more than 500 drug disposal kiosks at pharmacies in 35 states and Washington, D.C.
  • CVS Pharmacy has donated more than 600 disposal units to law enforcement and is holding more than 125 events across the country for Take-Back Day.
If you have unwanted medication, please keep in mind that safely disposing of those drugs could save lives.
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