My name is Wendell Stone and my sobriety date is August 17, 2019.
I am always grateful for that day and always grateful to the New Leaf Clinic, 215 W. Breckinridge St., for providing me with the tools I need to stay sober after that day. I have tried almost every recovery program in Louisville and failed. It wasn’t until I found New Leaf that I was able to maintain my sobriety.
Once I managed to be sober for six months, I will never forget how I felt. He still had no purpose in life or any place to go. I had no goal or anyone I could lean on to get support. The only thing he had was that date, six months since he had last used a mind-altering substance.
The power to transform:1 day. 1 huge impact. How to Support Giving Good Louisville
Someone recommended me to look into an intensive outpatient program called New Leaf Clinic, and that was the best advice they could have given me. New Leaf not only gave me a place to put my head, but paid me rent during my stay at the clinic. When I didn’t have a trip, they picked me up and dropped me off. When I was hungry, they fed me. If a barrier got in the way, New Leaf not only told me how to break it, but helped me break it.
With all the excuses I could find to stay complacent with my situation, New Life presented a solution to encourage progress.
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New Leaf challenged me to reach my full potential. Coming from where I have been, it was not an easy task, but they were a definitive answer to all my prayers. Most of the IOP programs I’ve attended are basic education, but there was something about how the group leaders in New Leaf broke the substance use disorder that helped me understand what was going on with my addiction.
I felt like I had found a new family and was not ashamed to share things I once tried to hide in a closet. New Leaf taught me to take situations of remorse and look them in the eye. My past, which I once used as self-compassion to justify drinking or using drugs, became a learning experience.
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New Leaf loved me again when I was in a desperate mood, and even after completing the program, I was kept under the umbrella of the New Leaf Clinic.
After being in active addiction for over two decades, today I am over two years clean and sober, I work full time and return to giving support by sponsoring other people who suffer from addiction. On September 17, the annual delivery day of the Louisville Community Foundation, Give for Good Louisville, I want to ask for your support to continue our mission.
God is good and thank God for the New Leaf Clinic.
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Wendell Stone is a student in the New Leaf Clinic recovery program.
This comment is from Laura Chapman, a community organizer living in Putney.
“I don’t give them money, because they will only buy drugs with it. I don’t want to feed his addiction.”
Let’s unpack this statement that I just repeated to myself for what felt like the millionth time today. Maybe they are, maybe they aren’t.
But let’s say, for the sake of argument, that they are actively dependent on illicit substances, struggle and abuse to fuel a substance abuse disorder. Do you think not giving them money will starve the disorder and that will force them to stop?
Based on my years of embedded observations and experience, this will not be the case. Substance abuse disorder doesn’t work like that. If it were that simple, the so-called “war on drugs” would have worked. Instead, we have one of the highest rates of substance abuse disorders in the world.
Addiction of any kind is tenacious, but substance abuse disorder is downright herculean in the power it holds over those who struggle. One way or another, he will get what he needs. And it depends on us focusing on outcomes, not root causes, to continue to thrive and grow in our communities.
So what happens when someone struggling with a substance abuse disorder can’t meet the demands of addiction and manipulation doesn’t work?
What I have witnessed is that depending on the substance one is addicted to, some become incredibly sick and desperate. It really is a disease.
Some (not all, not even most) become so ill and desperate that they make an incredible effort, but in the illness they are not stable, their decision-making abilities are compromised, their inhibitions are lowered, and the ability to take care of themselves, others. , anything but what it will take to make this pain stop, goes out the window.
This may look like selling whatever they have, including themselves, to whoever will pay, no matter how horrible. It can mean allowing dealers to move into your home and take it over, turning it into a trap house, a place where they are literally trapped, fed a small supply to comply and often He subjects them to violence when they are not. . Or it can mean taking whatever they can find to sell, and sometimes that looks like breaking and taking from you, from me, from our community.
And after all that, when the disease is momentarily satiated, they know what they did to get there and often hate themselves more for it, so they medicate more, deepening the cycle and making it harder to break out.
That’s why I give money without a doubt.
Manipulation is a desperate enough act for my compassion and I don’t want anyone to feel driven to further despair. I give this because I hope that if they are being used, it will hurt them less to use in a compatible way than they would otherwise to have fed that need.
Because they are suffering, they deserve connection and support. I care that they stay alive and I hope that one day they find a way to live without the torment of substance abuse disorder.
The data shows again and again that the most successful outcomes are almost always rooted in harm-reduction approaches and not in making judgments or withholding aid.
Please consider this before deciding that you will not support someone who is ill. Until we as a society can do better, as individuals we must act with more thought and compassion.
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Tags: an illness , casting judgments , effective treatment , harm reduction , laura chapman , substance abuse disorder
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UConn Today sat down with Dr. Lakshit Jain, clinical associate professor in the Department of Psychiatry at UConn Health, to learn more about what’s really involved in withdrawal from opiate addiction and what opioid use disorder sufferers and your loved ones stay safe and make sure they get the right care. Jain, along with UConn Health co-authors Dr. Vania Modesto-Lowe and former psychiatry resident Dr. Roberto León-Barriera, just published a letter to the editor in The Primary Care Companion for CNS Disorders titled “ Mindfulness Training in Opioid Withdrawal: Does it Help?”
Dr. Lakshit Jain is a Clinical Associate Professor in the Department of Psychiatry at the UConn School of Medicine. (Photo provided by Lakshit Jain)
Q: What is opioid use disorder? To: Opioid use disorder (OUD) is not just an individual who uses a lot of opioids to “get high”; refers to a problematic pattern of opiate use that leads to clinically significant impairment or distress, manifested by a persistent desire or unsuccessful efforts to reduce opiate use, making great efforts and spending a lot of time activities necessary to obtain the opioid. using the opioid or recovering from its effects; strong desires/desire/impulse to use; failure to fulfill the main vital obligations at work, at school or at home (losing a job, dropping out of school, etc.); continued use despite persistent or recurring social or interpersonal problems (divorce, separation, loss of child custody, etc.); using opioids in dangerous situations (drunk driving, etc.); and giving up important social, work, or recreational activities to use opioids.
Q: What is the prevalence of OUD in the US? To: Opioid use disorder in the United States has been a triple-wave phenomenon driven by the growing popularity of prescription opioids, heroin, and synthetic opioids, respectively. It is often interpreted as people developing an opioid use disorder when they were receiving opioid prescriptions from their health care provider or stealing opioid prescriptions from a family member who was receiving them from a provider; and then turned to heroin when prescriptions expired or stopped.
In the US, an estimated 5.7 million people (2.1% of people aged 12 and over) in 2019 had used heroin at some point in their lives, and 431,000 (0.2%) had report last month. Between 2002 and 2018, the prevalence of heroin use and heroin use disorder nearly doubled.
Q: How dangerous have illegal opioids become? To: Beginning in 2013, Illicitly Manufactured Fentanyl (IMF) began to gain popularity in the US, both in its pure form and mixed with heroin, as fentanyl is 30 to 40 times more potent by weight than heroin and it’s cheaper. Fentanyl has led to a significant decrease in the cost of opioids, and because the high potency of MFI can cause a rapid overdose, which is demonstrated by the fact that 56% of the dead do not have a pulse when first responders arrive.
This rise in opioid use disorder has led to a national pandemic of opioid overdose deaths, with more than 100,000 estimated drug overdose deaths in a 12-month period for the first time, with more than 64% of ‘these deaths with fentanyl. According to the CDC, the age-adjusted rate of overdose deaths nationwide increased significantly by 9.6% from 2016 (19.8 per 100,000) to 2017 (21.7 per 100,000). Opioids, primarily synthetic opioids other than methadone, are currently the leading cause of drug overdose deaths. Opioids were involved in 47,600 overdose deaths nationally in 2017. This number represents 67.8% of all drug overdose deaths in the United States.
Q: What do patient-reported as challenging withdrawal symptoms or opioid withdrawal feel like? To: Patients experiencing opioid withdrawal often experience extremely strong flu-like symptoms, and some refer to this as the “super flu” or “the flu on steroids.” These include severe muscle pain, tearing, runny nose, nausea, vomiting, abdominal cramps, diarrhea and restlessness. These make strong, constant cravings for an opioid worse.
Opioid withdrawal begins almost immediately if naloxone is used to revive someone on the street or in an emergency room, and signs and symptoms of withdrawal begin 4 to 12 hours after the last dose of an opioid short-acting and often delayed from 24 to 24 hours. 48 hours after stopping a long-acting opioid such as methadone. Withdrawal symptoms usually peak 24 to 48 hours after onset and persist for several days with short-acting agents and up to two weeks with methadone.
Severe withdrawal can cause an increase in heart rate, blood pressure, and respiratory rate. Severe vomiting and diarrhea can cause fluid loss and low blood pressure. Although they can be controlled, the cravings continue to worsen, forcing the patient to seek out more opioids and use them to lessen the cravings.
Q: Where should patients seek help? To: Patients experiencing mild to moderate opioid withdrawal should contact their primary care providers, as there are ways to help patients participate in treatment with medications such as methadone and buprenorphine
If the withdrawal is severe (rapid heart rate, fainting, difficulty breathing, etc.) they should be presented to the nearest ER.
Q: What treatments have proven to be most effective? To: Treatment of opioid use disorder is multifocal, involving several treatment strategies that are often used together in a specialized treatment center. This includes:
Pharmacological management: These include opioid agonists (buprenorphine or methadone) and opioid antagonists (ie, naltrexone). Buprenorphine is preferred for mild to moderate opioid use disorders and methadone is preferred for people with high tolerance (people who use high doses of opioids to get the desired effect). In individuals unable or unwilling to take agonist treatment, naltrexone is a reasonable alternative; however, people who will be treated with naltrexone need medically supervised withdrawal before starting an antagonist.
Psychotherapy: includes the following interventions:
Counseling or cognitive behavioral therapy (CBT), including variants such as acceptance and commitment therapy and motivational interviewing.
Behavioral interventions such as contingency management that use incentives and other reinforcements to increase participation in treatment and decrease substance use. Contingency management is usually added to other interventions such as (CBT). It has generally been found to be effective in opioid use disorder.
Mutual aid groups such as Narcotics Anonymous or Methadone Anonymous.
Training or involvement in communities such as drug-assisted recovery services.
Q: Can mindfulness help patients fight opioid withdrawal? To: In some addiction settings (inpatient and outpatient), patients are exposed to mindfulness training (MT) in individual and group settings to decrease stress, cravings, and cue reactivity. MT also appears to have positive effects on various types of pain, including pain in patients with addiction. Anecdotal evidence suggests that MT may be particularly helpful during withdrawal states, despite scant empirical data to support this view.
Q: Along with prevention, what promising new treatments are on the horizon to help curb our nation’s opioid addiction epidemic? To: A new implant called Probuphine was approved by the US Food and Drug Administration (FDA) in 2016. It consists of a one-inch rod that a doctor inserts into the inside of the upper arm. This implant provides a constant dose of buprenorphine that can last up to six months with multiple rods.
Additionally, in 2017 the FDA approved Sublocade, which is a once-monthly injectable formulation of buprenorphine. Patients who have been on a stable dose of buprenorphine treatment for at least seven days can choose to receive this injection once a month. In 2018, the FDA approved Lucemyra (lofexidine hydrochloride) to reduce the severity of opioid withdrawal symptoms and to facilitate the abrupt discontinuation of opioids in adults. It works by a mechanism similar to clonidine.
In addition to the new treatments, the Department of Health and Human Services (HHS) is releasing new buprenorphine practice guidelines that lower barriers for providers to treat more people. Also, in 2018, the National Institutes of Health (NIH) launched the Long-Term Initiative to Help End Addiction (NIH HEAL Initiative). It’s an “aggressive, transagency effort to accelerate scientific solutions to curb the nation’s opioid public health crisis.” It aims to support multiple institutes to accelerate research to address this public health emergency from all angles.
Millions of people are affected by opioid addiction. Over 2.5 million people in the United States have an opioid use disorder, which resulted in over 28,000 overdose deaths in 2014. 1,2 Opioids, such as heroin and prescription pain medications, can cause neonatal abstinence syndrome and the spread of infectious illnesses such as HIV and Hepatitis.
Medications that work are available.
For the treatment of opioid use disorders, medications such as buprenorphine (Suboxone®, Subutex®), methadone, and extended release naltrexone (Vivitrol®) are helpful.
MAT Reduces opioid usage, overdose fatalities caused by opioids, criminal activities, and the spread of infectious diseases. 4,5,6 During the research period, which concluded in 2009, heroin overdose fatalities in Baltimore fell by 37% when buprenorphine became available. 6
MAT Improves social functioning and treatment adherence. 4,5 When compared to individuals who did not get medication, those who received medication were more likely to stay in therapy. 4
Methadone or buprenorphine treatment for opioid-dependent pregnant women improves their kids’ outcomes; MAT decreases symptoms of neonatal abstinence syndrome and length of hospital stay.
7
Improving Medications with Science-Based Solutions SublocadeTM, the first once-monthly buprenorphine injection, was authorised by the US Food and Drug Administration in November 2017 for moderate-to-severe opioid use disorder in adult patients who have started treatment with transmucosal buprenorphine-containing medications. Along with Probuphine®, an implanted buprenorphine formulation authorised in May 2016, this drug eliminates the need for daily dosage and improves treatment retention. Probuphine: A Game-Changer in the Fight Against Opioid Dependence is the Director’s blog.
Patients in Need are Reached The emergency department (ED) is an excellent place to assess individuals for opioid use disorder and begin MAT treatment. When compared to patients who are referred for therapy, those who start MAT in the emergency room are more than twice as likely to stick with it. Read the JAMA article – Buprenorphine/Naloxone Treatment for Opioid Dependence Begun in the Emergency Department.
Treatment with extended-release naltrexone decreased relapse rates among criminal justice participants with a history of opioid addiction, according to a new study. Read the article Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders in the New England Journal of Medicine.
Medicine isn’t widely used. Only about half of privately financed drug abuse treatment facilities provide MAT, and only about a third of patients with opioid addiction in these programmes receive it. 8
From 35 percent in 2002 to 28 percent in2012, the proportion of opioid treatment admissions with treatment regimens that included getting medicines decreased.
9 Almost all states in the United States lack the treatment capacity to deliver MAT to all individuals with opioid use disorders. Medications Myths: 10 Facts to Know Methadone and buprenorphine DO NOT WORK AS A SUBSTITUTE FOR OTHER ADDICTIONS. When someone is being treated for opioid addiction, the medicine utilised does not get them euphoric; instead, it helps to lessen opioid cravings and withdrawal symptoms. These medicines help the patient’s brain repair while working toward recovery by restoring equilibrium to the brain circuits disrupted by addiction.
Buprenorphine diversion is infrequent, but when it does happen, it’s usually for the purpose of treating withdrawal symptoms.
Prescription pain medications, such as oxycodone and hydrocodone, are considerably more commonly diverted; buprenorphine accounted for fewer than 1% of all recorded medicines diverted in the United States in 2014.13
New Treatments Driven by Solutions Vaccines under development now target opioids in the circulation, preventing them from reaching the brain and causing euphoric effects.
Transcranial Direct Current Stimulation, a unique, non-invasive brain stimulation method, is being studied by researchers to see whether it may be used to treat opioid use disorder.
Improving Treatment Delivery – Researchers are looking into how the health-care system can reach more individuals who need aid, as well as assisting physicians in determining which therapies are most successful for specific patients.
Reaching Justice-Involved Youth – Through our Juvenile Justice Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) initiative, NIDA-funded research is aimed at identifying the most effective strategies for improving the delivery of evidence-based prevention and treatment services for youth. More information on Justice System Research Initiatives may be found here.
According to the World Health Organization, buprenorphine and methadone are “essential medications.”
3
According to an NIDA research, both a buprenorphine/naloxone combination and an extended release naltrexone formulation are equally effective in treating opioid use disorder after treatment is started. However, because naltrexone needs complete detoxification, it was more difficult to start therapy among active users. Both medicines were equally effective after detoxification was completed.
For a “whole patient” approach, medications should be coupled with behavioural therapy, which is known as Medication Assisted Treatment (MAT).
A large study of Medicaid patients found that the longer they take medication to treat their opioid use disorder, the less likely they are to overdose.
The study analyzed overdose and treatment data from Wisconsin and 10 other Midwestern and Eastern states that are among the highest in opioid overdose deaths. It analyzed the outcomes of 293,180 Medicaid beneficiaries with opioid use disorder who received treatment with drugs such as methadone, buprenorphine and naltrexone in 2016 or 2017. These drugs prevent withdrawal symptoms and cravings psychological problems of people living with an opioid use disorder, according to the US Dept. of Health and Human Services.
Andrew Hellpap ahellpap@uwhealth.org 608 225-5024
The study results are published today in the journal Addiction.
Marguerite Burns
“Longer is better, but even relatively short episodes of opioid use disorder medication treatment, as short as 60 days, are associated with significant reductions in overdose risk,” said Marguerite Burns. , associate professor of population health sciences at the University. of the Wisconsin School of Medicine and Public Health, who led the study. “We found that protection increases gradually as people take the drug over a 12-month period.”
Patients who took medication for the full 60 days had a 61% lower risk of overdose compared to those who stopped treatment before 60 days. The researchers then followed the patients at two-month intervals and found that for every additional 60 days the patients stayed on the medication, the risk of overdose dropped by 10 percent. The study ended with one year of treatment.
The findings suggest the importance of identifying strategies to keep Medicaid beneficiaries with opioid use disorder longer, Burns said.
“Performance metrics that encourage health systems to increase retention in treatment, rather than meeting a duration threshold, may serve patients better,” he said.
Medicaid insures nearly a quarter of Americans, about 80 million people, covers four out of 10 people with opioid use disorder in the country, and is the largest payer of drug treatment for opioid use disorder. use of opioids. Medicaid recipients have low incomes. Private insurers often adopt policy changes about medical treatment made by Medicaid.
Medicaid data analyzed for the research came from Delaware, Kentucky, Maryland, Maine, Michigan, North Carolina, Ohio, Pennsylvania, Virginia, West Virginia and Wisconsin. States pool their results using meta-analytic statistical methods to obtain a multi-state pooled estimate as part of the Medicaid Distributed Outcomes Research Network (MODRN).
“After a year in which opioid-related deaths have increased dramatically, there is an even greater urgency to identify and implement effective overdose prevention strategies,” said Julie Donohue, lead author of the study. and director of MODRN. Donohue is a professor and professor at the University of Pittsburgh School of Public Health Department of Health Policy and Management.
More than 107,000 Americans lost their lives to drug overdoses in 2021, leaving behind countless family and friends who still feel their absence. Those lives, which have been cut short, no longer have the potential for joy, change or gratitude. However, those who are struggling with substance use have a good chance of recovery. Research indicates that one in 10 Americans has experienced drug and alcohol problems and gotten better.
Addiction recovery is as common as being left-handed. But stigma and pessimism about addiction persist and contribute to painful, and often tragic, outcomes.
“Stigma hides the success stories that happen every day in our backyard. Your neighbor may be in recovery, but you’re unlikely to know,” said Jess Williams, a recovering Pittsburg resident who advocates against the ‘stigma of addiction.
Experts point to stigma as a major barrier to help-seeking of any kind, including professional treatment, community services such as needle exchanges, or social support in general. Reluctance to seek help means someone is less likely to receive naloxone, which reverses the overdose. They are less likely to find a supportive therapist. In short, they are more likely to suffer and die.
Stigma doesn’t just affect one person. It leaves families with condemnation rather than support. It has been said that “no one brings you a pan when your child has an addiction.” Ohio Township resident John Watts lost his son, Carter, to an overdose at age 20. During the years he dealt with addiction, Carter also struggled with mental health issues, homelessness and growing physical health problems. Like his father, Watts struggled to provide help that respected Carter’s autonomy.
John Watts (left) and his son Carter while fishing. (Photo courtesy of Tony Lolli)
After many efforts to help lead Carter on the path to healing, Watts realized that “we would continue to fail if we tried to help him choose … ultimately it should be his discovery and choice.” But for Carter, Watts observed, any path to recovery was clouded by danger and inadequate support. “As a teenager and then a young adult find some kind of recovery, even if they want to, while they’re homeless, out of work, out of education, struggling with triggers and mental health, while they’re looking for food and a bathroom and a place to sleep ?while many demons of different forms pursue them?
State Rep. Jim Struzzi, R-Indiana, lost his brother, Michael, to an overdose in 2014. Since then, Struzzi has been passionate about spreading a message of hope to Pennsylvanians affected by addiction.
“I understand the devastating impact drug addiction can have on people’s lives and their families,” Struzzi said. “Everyone in our society is affected, but there is hope. This is why supporting recovery is so important. People struggling with addiction need to know that others care and there is a path back to a positive and rewarding quality of life.”
Participants in the Pittsburgh Walk for Recovery. (Photo courtesy of Kyle Harder)
Struzzi is co-sponsoring a bill to legalize fentanyl test strips, which would help identify the presence of highly potent opioids in the drug supply and prevent future overdose deaths. He will speak at this year’s Pittsburgh Walk for Recovery, which will be held on September 17.
More than a year after Carter’s death in 2021, Watts described participating in the Pittsburgh Recovery Walk as a way to experience the kind of supportive, non-judgmental world she wishes Carter had lived in.
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“I am volunteering and supporting the Pittsburgh Recovery Walk so that I can help, but not allow, others like my son, as I would have wanted the same support from others for Carter when there was still time for us,” she said Watts.
Several thousand participants are expected in this year’s Pittsburgh Recovery Walk, which is free and includes a large resource fair, children’s activities, speakers sharing personal stories and a 1-mile parade through downtown.
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Dr. Lakshit Jain is a Clinical Associate Professor in the Department of Psychiatry at the UConn School of Medicine. (Photo provided by Lakshit Jain)
Marguerite Burns
John Watts (left) and his son Carter while fishing. (Photo courtesy of Tony Lolli)
Participants in the Pittsburgh Walk for Recovery. (Photo courtesy of Kyle Harder)
