Early warning signs - Pain Med Addiction

Pain Med Addiction

Early Warning Signs

We here at Lasting Recovery  are receiving more and more inquiries for Chronic Pain and Addiction   Treatment . In all areas of San Diego  and elsewhere, there seems to be a lack of information about possible red flags that people could identify before pain meds turn from helping someone to becoming a problem for that same someone.

It would be great to be able to recognize the need to take action before we become dependent. So let’s take a look at some possible early signs – signs that could indicate that there might be a developing problem.

No one just wakes up one morning suddenly addicted to prescription opiates. Addiction  is a gradual, insidious process. The fact that it is a gradual process means that there are numerous opportunities for early intervention.

Below are five early warning signs that your use of pain medication is beginning to cross the line into addiction :

1. You start to use your medications to feel better, not just to ease pain.  

Most people who use prescription opiates have pain as a result of an accident, surgery, illness or other condition, and then take their medicine to relieve that pain. Those who become addicted have pain, take the medicine and find that they not only have less pain but they also feel better in other ways.

Initially, the meds may improve your sleep. You may feel energized, more confident. You may feel that they make you feel less stressed or anxious. You may find that the prescribed drug seems to numb emotional pain or even give you a sense of pleasure. A shift occurs where you’re no longer taking the medication because you’re in physical pain but because of the positive effects on your mood or outlook. You’re now taking the drug for its mood-altering effects.

For those who have struggled with alcohol or other drug dependency in the past, taking prescription opiate pain medication is putting themselves at high risk for this cross addiction and relapse.  Learning about non-addictive alternative options and holistic therapies can help to reduce the pain to a manageable level.

        

                 2. You’re thinking about increasing your dose without advice from your doctor.  

In most cases, physical dependence can be managed by a prescribing physician with appropriate identification. Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance  and where negative physical symptoms of  withdrawal  result from abrupt discontinuation or dosage reduction. The prescribing doctor may initiate a drug titration protocol. This is done by slowly decreasing the amount of the drug taken each day. Drug replacement therapy with buprenorphine (Suboxone) or methadone  is another way to do a prescription drug detox from an opiate-based drug.  Although drug replacement therapy is medically prescribed and often used, there is still a physical dependency on the drug and withdrawal symptoms will occur.

Physiological tolerance or drug tolerance is commonly encountered in pharmacology, when a patient’s reaction to a specific drug and concentration of the drug does not produce the same effect in reducing the symptoms of pain or anxiety related to the pain.

 For those who have predisposing factors (factors which can affect the likelihood of developing an addiction), tolerance can be a sign of addiction, as patients will increase the amount of drugs taken. If one tablet is prescribed, then a person who has an alcohol or drug history or the  genetic predisposition to be addicted,  begins taking two, three or more on their own, as “more will work even better.”

Other risk factors for addiction include: a family history of alcohol or drug dependency, a diagnosis of other psychological diagnosis, chronic pain and other disorders.

2. Even though your pain has subsided, you are taking the medication automatically.

If your pain has largely subsided or your doctor no longer recommends using pain medication and you continue to do so, you may be taking it habitually without recognizing that you are taking the drug for something other than pain.  Pain medication reduces sensations of physical pain and emotional pain and there are times when avoiding emotions of helplessness, anger, loss or depression.

You may be afraid of the pain coming back, but in actuality, long-term use of opiates can result in what is known as “backlash” pain where you feel increased pain and think you need more medications. You will be better off switching to a non-addictive anti-inflammatory pain reliever such as ibuprofen once the pain is not severe enough to warrant opiate medications.

4. You’re spending more and more time thinking about and getting medication.

How much time do you spend worrying about refills, keeping track of prescriptions, and traveling to new doctors’ offices or pharmacies? If you’d rather spend time getting and using medication than doing the things you typically enjoy, such as spending time with family or friends, your medication has become your number one priority. In addition to being hard on your loved ones, this imbalance may be a sign of prescription drug addiction .

5. You ignore other pain management  options.

Even if your doctor suggests non-drug alternatives, such as acupuncture, massage, yoga or physical therapy, you refuse, preferring instead to take more medication. Skipping doctor’s appointments unless you’re going to get a new prescription is another red flag.

By staying alert to these five indicators of dependency and talking to your doctor at the first warning signs, you increase the chances that you will benefit from the pain relief offered by prescription opiates without falling prey to addiction. Throughout someone’s life time, the chances are great that pain meds will be needed at various times due to surgery or other pain inducing issue, the key is to follow doctor’s instructions. When you find yourself veering away from your doctor’s prescriptions, you might be headed for trouble.

 If you have additional questions about prescription drug dependency or are feeling isolated and alone with the pain you are experiencing we can help!  We offer treatment for chronic pain and addiction individually designed for you.

For more information, call Lasting Recovery :  (858) 453-4315.

Judy Saalinger , Ph.D., MFT, CAS

Co-Founder & Executive Director

        

What is Pain Recovery?

Moving From Chronic Pain Into Chronic Pain Recovery

Because of the number of people coming to Lasting Recovery with chronic pain and addiction to pain meds, Lasting Recovery has developed a separate Pain Recovery track. We see people from Coronado, Poway, Carlsbad and as far away as the East Coast with chronic pain issues. Dr. Judy Saalinger , who is in Pain Recovery herself, is a respected advocate for individuals and families. She has helped those in pain heal and overcome the effects of emotional, physical pain and addiction for over 25 years. Dr. Saalinger’s book , revealing her own pain recovery journey, Fearless Change: Embrace the Choice to Reinvent Your Life is an integral part of Lasting Recovery’s programs .

This blog is the first in a series to address this health crisis and national epidemic. A separate page for Lasting Recovery’s Pain Recovery Program is still in the developmental stage but it should be published in the next several weeks.

Chronic Pain

Chronic pain can be defined as pain that has lasted 6 months or longer. It may no longer have a biological protective function that it is designed to provide. It is pain that persists even after healing of the initial injury. It impairs the function of the individual. An often ignored fact is that pain involves both psychological and physiological processes. If not treated, chronic pain can dominate a person's life.

Chronic pain is dehumanizing. It takes away many of the dimensions that make up our humanity. Some people have been injured and isolate due to not working, while others may not be able to do the physical activities that were once a source of stress release, social connection and sense of physical and emotional wellness.

Human beings are social creatures and with chronic pain, a natural response is to isolate . We don’t want to bother anydiv. We don’t want to be a burden. Most people interact with a large number of people on a daily basis. Our lives are somehow linked to the lives of others, and when we are in chronic pain it becomes extremely difficult to reach out. We often feel shame, broken and that we, ‘no longer belong in our workplace, school, or with our socially active friends.”

What is Chronic Pain Recovery?

The goal of Chronic Pain Recovery is to create wellness in replacement of hopelessness. Part of Chronic Pain Recovery is educating about pain which includes: understanding pain and accepting ownership of it. Recovery addresses sleep issues, depression, communication, exercise and nutrition.

Chronic Pain Recovery is an effective pain treatment program that reduces pain and increases function, thus improving the quality of life--all without opioid pain medications and other habit-forming medications.

Pain Recovery is a proven pain treatment alternative to pain management. It gives the individual the opportunity to detoxify their bodies from narcotics and develop a real-world plan to reduce and deal with chronic pain. This is accomplished by treating not just the identified physical pain, but uncovering and treating the associated emotional suffering. By treating the physical pain as well as the emotional aspect of pain, a person can develop a sustainable long-term solution to his or her chronic pain. Sustainable long-term solutions are critical to any kind of lasting recovery.

If you are tired of suffering and felt helpless and hopeless, know that it is possible for YOU to experience wellness and pain recovery. If we can help you or a family member, please contact us at (858) 453-4315.

Management of Opioid Dependence

The latest disturbing headline, “Number of Babies Born Suffering from Drug Withdrawal Triples” has compelled me to blog about the insidious effects of opioid dependence . I see it on daily basis from people who come in for treatment here at Lasting Recovery . Regardless if they come from Rancho Santa Fe, Carlsbad, Poway or Coronado, the need is the same—long lasting relief from opioid addiction.

Imagine how strong an addiction must be for a mother to risk the health of her baby?

Let’s start with the basics:

Opioids are the most powerful known pain relievers. Their use and abuse date back to antiquity. The pain relieving and euphoric effects of opioids are well known and have become both a societal blessing and a curse.

The terms opiate  and narcotic  are often used interchangeably with the term opioid  but for simplicity, here in this blog, I’ll use the term “opioid”

Opioids act by binding to opioid receptors on neurons distributed throughout the nervous system and immune system. These receptors are the binding sites where several important mind/div functions are regulated and modulated including the following:

• Pain 
• Stress 
• Temperature 
• Respiration 
• Endocrine activity 
• Gastrointestinal activity 
• Mood 
• Motivation

Opioid Addiction  is defined by the observation of maladaptive behaviors, such as adverse consequences due to drug use, loss of control over drug use, and preoccupation with obtaining opioids. This addiction is characterized as a psychological and behavioral syndrome in which the following features are observed:

• Drug craving 
• Compulsive use 
• Strong tendency to relapse after withdrawal

One of the most insidious features of opioid addiction is the tendency to relapse on the drug even weeks, months, or years after addicts stop using and withdrawal symptoms disappear. The mechanism for this type of relapse is being studied intensely. Animal studies suggest 3 distinct conditions that reliably induce relapse:

1. Stress 
2. Exposure to conditioned cues related to past drug use 
3. A dose of the previously administered drug or a drug with similar properties

Opioid use and dependence are associated with significant medical and psychiatric morbidities, as well as adverse social, familial, vocational, and legal consequences. The risk of criminal activity and legal consequences becomes greater as dependence becomes more severe.

Many of these morbidities are reduced by substitution therapies.

Although opioid addiction is generally regarded to be a chronic relapsing disease, the primary interest is still the cure of this disease (i.e. long-term stable abstinence from all opioids). Stable abstinence is achieved in two phases: a detoxification phase, in which the patient has to reduce and finally stop the consumption of all opioids; and a phase of relapse prevention, in which abstinence must be maintained.

Addiction treatment  helps those suffering from opiate dependence to identify internal and external warning signs and triggers, including mood, communication and relationship issues.

Much more research needs to be done regarding successful treatment methods to stop this national epidemic of opioid dependence and addiction if society is ever going to rid itself of this ongoing and increasingly difficult health crisis.

BLOG addiction and the family.docx

Does Your Family Member Have a 

Problem with Alcohol or Other Drugs?

76 Million People Have been exposed to Alcoholism in the Family

San Diego County families suffer from living with addictions, from Carlsbad, Rancho Bernardo, Poway, La Jolla,  to Del Mar and Scripps Ranch.

         The person who has someone close who drinks too much or who uses other drugs has plenty of company. People experiencing alcohol and other drug problems  not only hurt themselves but they also hurt their families, friends, coworkers, employers, and others.

Experience shows that for every person with an alcohol or other drug problem, at least five others are affected by their behavior. Therefore, millions of Americans have a personal stake in helping "someone close" find the way to overcome alcohol and other drug problems .

The person who sets out to help someone with an alcohol or other drug problem may at first feel quite alone, possibly embarrassed, not knowing where to turn for help. Many people have preserved so many wrong ideas and attitudes about problem drinking and other drug abuse, too often thinking of them as having merely a moral weakness or lack of willpower.

You may have learned to better understand alcohol and other drug problems  and already made contact with Alanon, Alateen, Naranon  or a local church, physician, therapist or treatment center. This does not mean that "someone close" will cooperate at once by going for treatment when you tell them how their behavior is affecting you. Those with alcohol and other drug problems may deny they have a problem. They may find it difficult to ask for or accept help.

If there is one thing true about alcohol and other drug abusers, it is that, as with all people, each one is different -- different in human needs and responses, as well as in their reasons for drinking and taking other drugs, their reactions to these drugs, and their readiness for treatment.

As a friend or relative, you  are in a good position to help because you know a good deal about their unique qualities and their way of life. And having made the effort to gain some understanding of the signs and effects of problem drinking or other drug abuse, you should be in a better position to consider a strategy for helping.

What does it take?

Be active, get involved. Don't be afraid to talk about the problem honestly and openly. It is easy to be too polite, or to duck the issue by saying, "After all, it's their private affair." But it isn't polite or considerate to let someone destroy their family and life. You may need to be persistent or break through any denial they have.

You also may need to let them know how much courage it takes to ask for help, or to accept it.

You will find that most people with drinking or other drug-related troubles really want to talk it out if they find out you are concerned about them.

          What You Can Do

• Try to remain calm, unemotional, and factually honest in speaking about their behavior

and its day-to-day consequences.

• Let the person with the problem know that you are reading and learning about alcohol

and other drug abuse, attending Al-Anon, Nar-Anon, Alateen, and other support groups.

• Discuss the situation with someone you trust -- someone from the clergy, a social worker, a counselor, a friend, or some individual who has experienced alcohol or other drug abuse personally or as a family member.

• Establish and maintain a healthy atmosphere in the home, and try to include the

alcohol/drug abuser in family life.

• Explain the nature of alcoholism and other drug addiction as an illness to the children in

the family.

• Encourage new interests and participate in leisure time activities that the person enjoys.

Encourage them to see old friends.

• Be patient and live one day at a time. Alcoholism and other drug addiction generally

takes a long time to develop, and recovery does not occur overnight. Try to accept

setbacks and relapses with calmness and understanding.

• Refuse to ride with anyone who's been drinking heavily or using other drugs.

If you need support in helping your loved one to see what they are doing to themselves and to you, contact me at Lasting Recovery. We see the results of family members taking positive actions as stated above… getting treatment and  getting back in touch w/family and friends who learn more about the disease of addiction to create a lasting recovery. Call (858) 453-4315 if we can help!

In Gratitude for this Day,

Judy Saalinger, Ph.D., MFT, CAS

Co-Founder and Executive Director

The Complicated Relationship between Alcohol and Depression

                        

The Complicated Relationship between 

Alcohol and Depression

Lasting Recovery  sees this in clients from Carlsbad, 

La Jolla, Carmel Valley to La Mesa and Rancho Bernardo

Although popular wisdom has long held that those suffering from depression  have a tendency to self-medicate with alcohol , the reverse is also true--- drinking can lead to or exacerbate depression .

If you're drinking to combat the blues, you may also be increasing your risk of depression. This is particularly true if your drinking eventually rises to the level that can be characterized as alcohol abuse .
Due to the initial euphoric sensations that alcohol produces, those suffering from depression will often turn to it in an attempt to make themselves feel more in control. They are therefore far more likely to develop a dependency on alcohol than non-depressed individuals.

Often, people who are going through depression will turn to alcohol or drugs to deal with gloomy moods and negative thoughts. It may seem like a good idea at the time to have a drink to lift our mood.  But this mood elevation is only temporary.  The happiness and hopefulness that gives pleasure through self-medication only lasts for a short period.  When depression leads to self-medication, it can compound the difficulties that the person is already experiencing.

Problems associated with alcohol abuse  often compound depressive symptoms. These problems include:

Health Problems

If alcohol abuse is continued for an extended period of time, a person may suffer from chronic pancreatitis, alcoholic liver disease, cancer, cardiovascular disease, Wernicke-Korsakoff's syndrome and a host of other illnesses.

Social Consequences

Many people suffer a number of social consequences resulting from alcohol abuse. These can include unsafe sexual practices, a tendency toward violence, loss of inhibition, decreased performance at work and at school , and criminality.

Drunk Driving

Drunk driving accounts for nearly 16,000 deaths a year, according to AlcoholAlert.com. Alcohol's negative impact on decision making means it's more likely that you will choose to drink and drive despite the obvious and severe potential consequences.

Overall Effects

1. Studies show parallels between the effects of alcoholism and depression on brain function.
2. On the psychosocial front, stressful life events can serve as a trigger for both alcoholism and depression.
3.  Neglect and poor parenting during childhood are factors seen frequently in the backgrounds of both alcoholics and those with depression.  
4. Alcohol can also affect the brain in areas that promote depression, such as interfering with sleep and appetite.

The affects that alcohol has on the div are consistently predictable regardless of the use pattern. Alcohol is a mood altering depressant drug. For people who have been alcohol dependent for a long time, alcohol can  have a toxic effect on their serotonin neurotransmitters. Alcohol feeds depressive symptoms, increasing both their frequency and severity.

Whether alcohol follows a change in mood or precedes it, the effects are similar.

1. Alcohol interferes with brain chemistry and leaves the individual feeling anxious, ill and solemn.
2. Depressed moods, arguments and poor performance at work start to become more common. This serves only to add to a cycle of stress and depression and may result in even more alcohol being consumed.
3. Alcohol has physical effects that can cause or deepen a state of depression. It inhibits people's motor skills, coordination and balance.
4. Alcohol also clouds rational thinking. This, in turn, can lead to frustration and low mood as a person struggles against its effects.
5.  After ingestion of large quantities of alcohol, people eventually pass out because of alcohol's depressive effects on their system.

If you or someone you care about is abusing alcohol and suffering from depression, treatment can help. We find a large percentage of people in treatment for alcohol are also suffering from depression. Seek help and begin healing the mind and div. Call Lasting Recovery, (858) 453-4315 for a confidential assessment. You and your family are worth it!  

Judy Saalinger, Ph.D., MFT, CAS

Co-Founder and Executive Director

Anxiety & Alcoholism

        

The Complicated Relationship between Anxiety and Alcoholism

Lasting Recovery serves clients from Carlsbad, La Jolla, Carmel Valley  and all of San Diego County

Like depression and alcoholism , anxiety and alcoholism are undoubtedly linked. Studies have shown that one-third of the people who have anxiety disorders struggle with substance abuse, and that one-third of substance abusers also have an anxiety disorder. The most common mental illness in the U.S., anxiety disorders afflict 40 million adults—twice as many women as men—and take a toll on the economy of more than $40 billion each year due to health-care costs and lost productivity. A recent New York Times article reports that, “the anti-anxiety drug alprazolam, — better known by its brand name, Xanax — was the top psychiatric drug on the list, clocking in at 46.3 million prescriptions in 2010.”

The tragic side of alprazalom and many other anti-anxiety drugs is that they are highly addicting, and contribute to a large percentage of people recovering from substance use disorder who want to quit or relapse back to alcohol or drug use after many years of recovery. A relapse can be devastating to a person’s mental and physical health. Some people lose their families and their jobs. Some even lose their lives. Benzodiazepines detoxification is dangerous, and can lead to a seizure and death, so do not try to do it alone. You need the help of a qualified doctor or detoxification center of a hospital or outpatient detoxification center to help you with the withdrawal side effects.

Anxiety is normal. Anxiety disorders are not normal. The challenge of diagnosing anxiety disorders is that everydiv has some degree of anxiety. Anxiety becomes a disorder when it interferes with life or causes a lot of distress.

Everyone has a different threshold level or limit as to how much of stress or stimulus coming to us from the world, that we can handle. As soon as that threshold is exceeded – we deal with that by engaging in a variety of coping mechanisms. Most ‘dysfunctional’ behavior stems from our ability to withstand this ‘stress.’

Anxiety sometimes drives people to do things to get rid of the discomfort. Many people who experience chronic feelings of anxiety about social situations, work and relationships, or other aspects of everyday life often reach for a beer or a glass of wine to quell their unease.

Alcohol may help anxious people cope in the short term, but over time this strategy can backfire. Self-medicating with alcohol or drugs can increase the risk of alcoholism and other substance-abuse problems , without addressing the underlying anxiety. And anxiety becomes the trigger for continued alcohol use and dependence.

People probably believe that self-medication works. What people do not realize is that this quick-fix method actually makes things worse in the long term.

On the flip side of the alcohol/anxiety relationship, alcohol consumption and hangovers can make many people anxious. It is a scientifically based understanding fact that alcohol can cause anxiety.

Scientists believe that alcohol causes or at least increases anxiety in 6 basic ways:

1. Mood

Alcohol can affect our mood because it can affect the level of serotonin in the brain. Serotonin is a feel good brain chemical that when in short supply can cause feelings of anxiety and depression.

2. Drop in blood sugar

A drop in blood sugar can cause dizziness, confusion, weakness, nervousness, shaking and numbness. These symptoms can most certainly trigger a bout of anxiety.

3. Dehydration

This has been known to cause nausea, dizziness, fatigue, light-headedness and muscle weakness. These symptoms wouldn’t cause anxiety per say but they add to a sense of illness which fosters anxiety.

4. Nervous System

The nervous system is affected because in order for the div to fight off the sedative effects of alcohol it puts the div into a state of hyperactivity in order to counteract this effect. This hyperactivity can lead to shaking, light/sound sensitivity and sleep deprivation.

5. Heart Rate

Your heart rate can become elevated as a result of consuming alcohol which can cause a palpitation false alarm and put you into a state of anxious anticipation. Is it a heart attack or isn’t it you might ask. This “what if” questioning can increase your general state of anxiety.

6. Concentration

A hard night of drinking can also make you hazy, bring on headaches and create a sense of disorientation.

Treatment for many anxiety disorders most often includes a combination of non addicting medication and cognitive-behavioral therapy. Research suggests that a combination of cognitive-behavioral therapy and medication can help control symptoms and lead to complete remission in some people.

For those people who have suffered an alcohol and drug relapse, or who have not been able to maintain sobriety due to anxiety, Lasting Recovery offers a cognitive behavioral program. We support people to people make changes in their thinking and in their lives and to understand the causes of anxiety and basic fears. We offer the Fearless Change Process that helps you to see that a lot of anxiety comes from unmet needs or fear that one’s needs will not be met in the future.

If you are suffering from dependence on anti-anxiety medications, alcohol or drugs, call us at (858) 453-
4315. We can help you to reduce your anxiety and get back the quality of life you deserve.

Judy Saalinger, Ph.D., MFT, CAS 

Co-Founder and Executive Director

Holistic Approach to Addiction Recovery

Holistic Treatments Improve Recovery

Recent scientific studies have demonstrated dramatically improved success rates of recovery from substance abuse with the addition of holistic treatment approaches.   A Holistic approach looks at the whole picture. By definition, the totality of a person is much greater than the sum of its individual actions and they cannot be understood by the isolated examination of their of their lives w/out examining the other surrounding aspects.

 
Addiction affects every aspect of a person's life: the physical body, which includes our brain that directs our thoughts and emotions which then effect decisions and communication. Addiction directly affects our relationships with friends and family, work, and one’s core values. Therefore, it makes sense that the whole body (both physical, emotional and mental) should be cared for when treating someone with a substance abuse problem. In addition, the family and close friends need to be treated as they have become angry, fearful and hurt as a result of the behavioral and emotional changes created by the progressive dependence on substances.  

Family education in rehab provides an understanding of what has happened to the person with the addiction and how this progression has impacted the family and friends. Meeting together helps restore the positive emotions of the family and relationships, and what the family can expect during the first 6-12 months of recovery, brings can help bring the peace of acceptance.  

Medical professionals now agree that addiction is a chronic disease of the brain, leading to emotional problems, and a physical dependence.  Because addiction to drugs, alcohol, sex, gambling, or any other destructive behavior are a result of brain and relational changes,  holistic addiction treatment takes a comprehensive look at the entire human being rather than treating only the symptom or behavior. From yoga to qigong, nutritional therapies to acupuncture, holistic techniques have proven highly beneficial to people in recovery from all types of addictive and compulsive behaviors.

Holistic treatment forms of care can help reduce tension, anxiety, depression, and insomnia, and can increase personal awareness, improving overall mental, physical, and spiritual health. By offering a broad selection of traditional and alternative therapies, those suffering from addiction receive the most progressive form of therapy designed to suit their particular needs. This gives recovering addicts every opportunity for a successful and insightful long-term recovery.

After years of abusing the body, waging war against the mind, and disregarding the spirit, patients respond well to gentle holistic therapies. These techniques use natural avenues to help ease the discomfort of withdrawal, avoid relapse, and reconnect addicts with themselves, with others, and with a higher power. As patients begin to become aware of their thoughts, feelings, and behaviors, they take responsibility for themselves and their ongoing recovery.

If we can be of help to you in choosing a program that meets your needs, contact us at (858) 453-4315.  The goal is for the entire family system to continue to develop a life of wellness.

In Gratitude,

Judy Saalinger, Ph.D., MFT, CAS
Co-Founder and Executive Director