Response To Someone Saying Treatment Doesn’t Work IL

Response To Someone Saying Treatment Doesn’t Work

Totally understandable when someone comes in and says, “Treatment doesn’t work for me” given that the national recovery rates for patients are less than 15%. That’s characteristic of being treated with a 1930’s philosophy and what we believe has created the addiction. For sure our current approaches are evolving from a moralistic point of view where patients were seen as bad as a result of having an addiction which was an attribute of the climate surrounding the 1930s.

We know now that neurobiologically there have been structural and functional changes in the brain that are characterized by increasing compulsions and cravings to use substances that are beyond a patient’s control. So, if we use old-time treatment to treat basically a new time understanding of what’s going on with a patient, the outcomes are not going to be particularly good. In my opinion, the most effective treatment outcomes are going to be achieved by engaging the patient through an extended period of time.

What Would Be Some Ways To Fix This Issue?

    Obviously, 30 days of treatment does not do much other than isolate a patient from the use of a substance for the use of 30 days. Perhaps a more effective treatment strategy would be to have people engage in treatment over a two-year period of time because if we look at the definition of structural treatment in the brain, there aren’t many structural changes that we are going to remedy in 30 days. So you have to be in a position where, if you will, we have to reboot the brain such that people develop effective coping strategies, learn to handle stress, and engage in behavioral changes so that the neurobiology of the brain has subsequently changed where people regain some type of control.

    I think extended period of time in treatment is by far the most effective treatment strategy and that this should occur on an outpatient basis because the substance abuse occurs in the real-life setting where people live and you have to be able to treat and confront the issues on a daily basis in order to get better and learn to live with your addiction.

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4 Tactics to Combat Opioid Crisis

What are Some of the Recommended Tactics to Combat the Opioid Crisis?

That’s a very complicated question only because any agency that’s been in place in regards with treatment recovery, we’ve been doing it the same way since the 1930s and it hasn’t particularly worked. The only difference is the severity of the drugs that we have now and the multiple options that people have. The lethality of heroin is a big problem because we’re losing close to fifty-five to sixty-five thousand people on an annual basis, which is more than we lost in twenty years in Vietnam. Those numbers are directly related to or attributed to a drug overdose.

Our experience here at ATS is that every person we lose directly to substance abuse overdose there are five people that die that are correlated with that whether they died of heart attack, shot in a drug bust or something like that. The cause of death may not be an opioid overdose.

A Need for Legal Changes

Significant changes have to be made both in the legislation as well as the availability of treatment. I don’t think the correct procedure is residential treatment, that’s the most costly way to treat someone and it’s also the least effective way. Going away for 30 days doesn’t do anything but keep people from using for 30 days. I believe what we need to do is set up a large number of intensive outpatient programs, make medical assistance available and then put people in a position where in order to receive their treatment they must be in compliance for treatment programs. There’s a lot of compliance with medical programs that are essential to keep people alive.

Outpatient Programs Over Residential Treatment

A combination of working with both drug courts and individuals who are in the correctional facilities as a result of their substance abuse problem should be mandated to attend minimum time in an outpatient program should be two years. Legislation should be changed so we can hospitalize people or put people in treatment against their will on a legal basis so you can mandate treatment because it’s not unusual for a patient to come here for 12 to 13 months before they began to realize how big of a problem they had. The neurological process wants the patient to keep that addiction. That seems to be a paradoxical situation in that we would think people would want to eliminate their addiction. Because of the structural changes in the brain, the compulsions, and the cravings, they’re going to engage in behaviors that are reflexes of an action. They’re not a cognitive process so what we have to do is a counterbalance that reflex, that impulse control disorder that gets people to continue using which then reinforces and conditions the neurological structure of the brain to continue using.

You Have to Treat the Whole Patient

We have to change legally, in terms of how to mandate people get treatment, we have to change the treatment format from a residential treatment to an intensive outpatient, I think we have to people engaged in treatment programming for an extended time, and then you have to work with patients on a co-occurring disorder  where we can treat anxiety, depression, and their addiction, as well as the family dynamics to help them become stable and healthy. You also need to focus on vocational choices and getting people in a position where they can maintain some level of stability by living alone and having jobs. You have to treat the whole patient. That’s what appears to be a monumental shift in programming, but in reality what its doing is treating the patient with what the patient needs through an extended amount of time and getting the patient engaged on a legal basis so their options are limited so that you can treat them and that’s for about a two year period of time.

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Methadone vs Suboxone

Methadone vs Suboxone as Treatment Drugs

Comparing & Contrasting Treatment Drugs: Methadone vs Suboxone

Methadone has been around for an extended period of time. I believe in the beginning the initial intent of using methadone was not for treatment but was to decriminalize the effects of those who have the addiction component in terms of they were needed to engage in criminal activity in order to get their drugs. Methadone was a legalized initial component of treatment.  So, methadone is a full agonist which means it activates mu receptors and there is no plateau in using methadone. Once an individual is on methadone, they are going to have to continue on methadone for an extended period of time.

Suboxone is a partial agonist, which means there is a plateau and once the secondary neurotransmitter capacity is full – it does not activate mu receptors any longer. Consequently, buprenorphine with a half-life of about 52-56 hours is an extremely effective drug in assisting people to overcome both the withdrawal and a maintenance dose of using a medication until such time that they get stable. Both of them can be components of medically assisted treatment. However, we believe that suboxone is far superior to methadone because it is a partial agonist and there is a ceiling effect with suboxone.

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Drug Addictions vs. Food Addictions

Are Food Addictions similar to Drug Addictions?

Both drug addictions vs. food addictions are very similar neurobiological processes. The brain reacts to stimulation which means in the case of an addiction to something, particular reward pathways evolved from nucleus accumbens to the ventral tegmental area which response normally to food, water, nurturing and sex. The first one being food. Food is also an extremely addictive substance to a lot of people only because it makes people feel good and they can also use it as a coping strategy. The downside of being addicted to food is it’s a slow and tedious process and there’s not much immediately validity to using that people find themselves having a difficult time stopping eating or controlling their ability to do that because of the neurological changes that have occurred in the motivations system to eat food.

In reality, the more food I eat not only is it more rewarding to me it’s also, I’m more motivated to eat food. A large component of an addiction to food is exactly like an addiction to any other substance other than the speed at which people can become addicted. Heroin addiction and food addiction are the same, other than some differences the neurobiological processes in terms of changes in the in the stomach and changes in the neurobiology of food. They both also hold lethal potential, just like any other substance addiction.

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ATS 12 Step Therapy Co-Occurring Disorders

Key differences of AA and ATS 12 Steps

Key Differences Between AA and ATS Addiction 12 Steps

In some of the previous posts we’ve been looking at the differences in a twelve-step approach to addiction intervention as well as a cognitive behavior therapy approach. We were comparing and contrasting the two approaches. There’s three more to do and we’ll pick up with the AA approach in terms of step ten.

Step Ten AA vs. ATS

AA step ten says basically, “I contend you to take a personal inventory and when we were wronged promptly admitted it.” That’s a very sophisticated process in terms of patients with an addiction have very limited insight or introspection of why they’re doing what they’re doing and that almost takes a professional person to point out some of the ways in which they can look at whats happening.

At ATS we start with, “I will endeavor to consistently inquire as to my behavior and demonstrate an addictive behavior being that I have a tendency to be deceitful, dishonest, and manipulative”. What we’re doing there is including some of the operational definitions that are associated with addictive behavior but even with that component of step ten, by the time our patients get to step ten they’ve already engaged in a consistent amount of behavioral change. Before we get the cognitive components back online you have to have behavior online. Our behavioral intervention has a lot with whether people have a capacity to look at what it is they’re doing and that’s the upper part of the prefrontal cortex. Even though both of them are somewhat similar to the moralistic approach, it is very complicated because it requires the person to look at themselves subjectively and that’s too complicated to do on your own. You almost need a guided intervention with that one.

Step Eleven AA vs. ATS

Step eleven for AA is, “Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out”. That once again has a moralistic tendency to that where the individual is pretty much on their own with regards of their thoughts and their ability to pray and receive some type of intervention from their perception of whatever their idea of God means.

ATS step eleven says, “I recognize I will be improved through structure organization and discipline. I will seek to achieve a balance in my life through awareness of sleep patterns, exercise, and diet”. What we’ve done is taketh moralistic approach out of it and looked at behavioral structuring of an individual. When we say structure organization and discipline, what we’re trying to do is put a position for a person to respond consistently to an organized approach with their life. Structure organization and discipline means basically have a daily plan, get that daily plan rank ordered in regards of what you need to get accomplished, and then implement it. That is the essence of the scientific approach to any problem is to have some type of dependent variable where were manipulating another variable to see how effective am I doing this? Step eleven is the scientific approach where were interested in looking at the impact that sleep patterns have on someone’s behavior, what exercise has on someone, both mental and physical exercise, and the other patterns we’re looking at is diet. The foods that influence how well people are doing and certainly if you have an addiction we have a diet program that assists people in there are twelve or thirteen different foods we recommend they eat that promotes brain growth. That’s step eleven.

Step Twelve AA vs. ATS

Step Twelve for AA is, “ Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs”. That’s for sure an important part of any religious experience. Taking the word out to the masses to get them in a position where they can also respond.

ATS step twelve is, “ I will share my knowledge of my addictive behavior with others in an appropriate format that leads to understanding a behavior change”. The operative word for us would be behavior change. You need to be able to change behavior regardless of how it is you feel or how it is you that you think. Behavior change is what makes people stable so that they can react in a predictable fashion and be considerably less compulsive.

So as a result of all of these twelve steps, what we’ve done is balanced a moralistic approach to a behavioral neurological or scientific approach. It has far better outcomes and that’s basically in a summary the differences between AA and the ATS approach of the twelve steps.

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ATS 12 Step Therapy Co-Occurring Disorders

What Are Co-occurring Disorders?

What Are Co-occurring Disorders?

Co-occurring disorders are relatively new with regards to the vernacular of treating people with an addiction. even though it is quite common for people who have studied human behavior. Most individuals do not have one particular component of a mental illness. Often time, people have components of anxiety and depressions, sometimes PTSD is a component of that. But we hath a co-occurring addiction is often times the addiction or the presenting problem of an addiction is masking an underlying condition. So what has to occur if you have to be able to treat the cause of the addiction which may be anxiety, depression, or whatever the mental illnesses are that is being medicated with the use of an addiction while at the same time treating the addiction. So both of them – the occurring and mental illness along with the substance abuse – must be treated simultaneously. While one decreases, the other may increase, If increase the dependence on a medication – the anxiety or depression may increase. So what you have to do is treat the co-occurring disorders so that both are decreasing simultaneously.

How Does ATS Treat Co-Occurring Disorders?

Our primary mission is to keep people alive. Drugs that people are using are extremely lethal. Obviously, heroin mixed with fentanyl or heroin mixed with lidocaine or heroin in doses that are not controlled by the person who is manufacturing the heroine is an extremely lethal drug. So, our primary mission is to keep people alive, first and foremost, while at the same time identifying some of those issues that may have caused the use of an addiction in the first place. We start looking at age of onset, when did someone start using something. In this particular case, our statistics indicate that our patients started using something around 12-14. Consequently, brain development at that time took on a totally different twist where a person develops a dependency on a substance or substances. At that time it is typically alcohol or marijuana. This then leads to something else. So we need to be able to treat both of them at the same time. Both substance abuse problems and something with regards to the mental health issue should be treated simultaneously.

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Addiction Recovery

How Long Will It Take To Recover From My Addiction?

First and foremost I would someone 30 days of a rehab program is not going to fix anything. Perhaps what it might be able to do is isolate you for a short period of time to decrease the probability that you might use a substance for 30 days. Given the definition of addiction is a chronic relapse disease in which the structure and function of the brain have changed, it also depends on the age of onset, when you used, what you were using, and how long you used it.

Neurological changes aren’t going to occur in thirty days. The part people need to understand is the model currently used does not have effective outcomes. It is an initiation of a 30-day program followed up by a short period of time of sobriety back in the real world and then going back to rehab again. Our number of rehabs for patients at ATS for people who are here is already 4. Most of our patients have been to 4 rehabs before they get here. They then find out as a result of teaching them to think differently, teaching them to have some sort of impulsive control, often times the average length of time that people spend at ATS in our programs is about 24 months.

At that time they are able to have a lot more positive control, they’re understanding the coping mechanism, they understand what stressors are for them, they are able to make healthier decisions, and they are least likely to go back to a pattern of using something that’s going to hurt them. Even after 24 months, it takes some extended period of time where people practice behaviors so it’s really important to change your behavior change your understanding and understand for the most part addiction is an impulse control disorder that reciprocated by stress. So if we teach people to think differently, how to handle stress and teach them coping strategies it decreases the probability they will rely on a substance to handle a new stressor in their life.

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Mental Illness and Addiction

Mental Illness and Addiction Relation

In Relation to Mental Illness and Addiction, How Do the Two Correlate?

With addiction and mental illness, the two particular conditions that were looking for are obviously anxiety and depression. Often times alcohol is used to assuage symptoms of a medical condition, for example, alcohol is used as a medication to decrease anxiety. Often times our patients use alcohol because they have rushing thoughts or anxiety or the inability to sleep at night so they will begin using alcohol in ever-increasing amounts so they can at least get some rest.

In reality what’s happening is they’re disrupting their sleep cycles because the use of alcohol prevents the brain from resting and prevents the brain from getting into a REM 4 sleep. What it’s actually doing is knocking the patient out so they believe they are resting, but what happens is you wake up even more fatigued and become more and more anxious and the only way to fix that is by consuming more alcohol. That then becomes a cycle of using medication to decrease the anxiety or depression and the increasing cycle then develops the dependency on the use of a substance to assist with their mental illness.

ATS Demographics

It’s extremely common that patients at a very early age, also the patients here, began using something at an early age. Age of onset at Addiction Treatment Strategies is about year 14 where our patients are using alcohol or marijuana to decrease symptoms. What we have found here are the most commons symptoms for our patients are anxiety and attention deficit hyperactivity disorder for males. We then have a combination of anxiety, ADHD, and addiction and they all three seem to go with males.

Treat Co-Occurring Conditions

What we have to do is treat that co-occurring condition by addressing both the addiction issues, which is a neurobiological as well as a psychological issue, of anxiety and depression at the same time because as you decrease one, the other two may increase, hence co-occurring condition. What you have to be able to do is treat the whole patient for all of those symptoms at the same time so that the patient gets healthy and stable through an extended period of time and that takes a great deal of sophistication. Often times this extends twelve to eighteen months.

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Advice for Parents of Addicts Who Have Children

Advice for Parents of Addicts Who Have Children

This is a very complicated question. What we have is a large number of individuals that are in the retirement phase of their lives are now finding out that their children have an addiction to a substance and their child cannot handle the responsibility of child-rearing. Grandma and grandpa take on the role of not only parenting their child but also parenting their grandchildren. If the child’s mom and dad have an addiction to an opiate and they’re not able to function to parent adequately to a 3, 4, 5-year-old child, then grandma and grandpa take on the role of both taking care of their child as well as their grandchildren.

The most effective thing you can do is get professional help as quickly as you can so you can learn some coping strategies so that we can develop some behavioral changes so that the parent can get healthy. At the same time mom and dad, or in this case grandma and grandpa, need to be in a position where they can make decisions for the grandchild. Often times this will be a conflict between what mom or dad think they should be doing. However, the responsible party is not in a position where they can make responsible decisions as a result of their substance abuse.

Consequently, all three generations need to work collaboratively to bring about the most effective way to rear a young child in an environment that is going to be brought with difficulties of substance abuse that occurred prior to the time that the child was even born. So grandma and grandpa need to get a lot of support and get some professional intervention to show them how best to navigate these difficult times for them.

How Can Grandparents Help Play A Role In Addiction Treatment?

If an individual comes here requesting treatment, we try to involve as many people as we can. Often times that grandma and grandpa or mom and dad. Everyone has to be involved because the process of an addiction is an extremely deceitful process. The drug lies to the person who has the addiction, so we need a lot of monitoring, a lot of accountability and behavioral changes.

Collaboratively we will work with the grandparents or whoever the person is that’s supervising the person with the addiction. We will make sure we are all on the same page because it is common for the person who has the addiction to fragment the intervention strategy by telling grandparents one thing and telling us something different.

Once we have eliminated that ability to distract or separate the intervention strategies, the patient usually seems to respond a lot better to a consistent intervention position where knows what’s expected and we have outcomes we want the patience to achieve based on our mutual intervention strategy.

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How can a loved one help Opiate Addicts

How can a loved one help an Opiate Addict?

How can a loved one help an Opiate Addict?

That’s a very complicated question because addiction comes in varying degrees in terms that it occurs in a continuum. In the beginning, most people don’t know what it is or the severity of that addiction. Consequently, we don’t know how to treat it. As parents who are associated with someone, depending on the age, you’re a parent and that means you care deeply for the person in the situation. Usually, the parent keeps expanding their limit for what it is that they tolerate.

What is an opiate addict like?

Characteristic for a person who has an addiction, obviously a great deal of it is deceit because they have to be in a position where they continue to do or maintain the drug of choice that affects them neurologically. They understand they have to keep it from their parents because they know it’s illegal. The hard part is at what point does a parent step in, or in reality seek help?

Getting an Assessment is Critical

What I would say is, the sooner the better that you can get an assessment. When you have an addiction it’s not about whether you trust the person, it’s about what is the addiction? What is the neurobiology of the addiction doing to the person? The age of onset at which someone develops an addiction is anyone through the age of high school through the early twenties should be monitored carefully in terms of people having different options and in terms of how quickly someone becomes addicted.

Parents should be aware of that and if anything the most important thing parents can do is, even on your own, do some type of urine drug screen intermittently to see what types of substances that your child or loved one may be using. If there is an opioid for sure in their urine make sure you seek professional help as quickly as possible. Usually, that’s the beginning of a very complicated process that may take multiple years to remedy. So get professional help as quickly as you can.

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