Chronic Pain and Chemical Dependency

Chronic Pain and Chemical Dependency

In the world of scientific journals and medical studies, there are dozens of reports about chronic pain all finding the same thing — that it often goes hand in hand with chemical dependency and substance abuse. Of course, each of the researchers, scientists, and doctors have their own thoughts on the matter, but they all pretty much come back to the point that chronic pain starts a vicious cycle that often leads to relying on some type of painkillers. It’s an issue that’s plagued mankind since the pain reducing properties of opium were discovered several millennia ago, and there’s no sign of it going away anytime soon.

Pain and Suffering

Regardless of what type of chronic pain a person may be dealing with, constantly being uncomfortable leads to a loss of both productivity during the day and sleep at night. Without the ability to function at a normal level, people are more likely to turn to controlled substances — whether they’re opioids, alcohol, or even cannabis-based — as a means to cut down on their discomfort and get back to a more regular lifestyle.

Unfortunately, what’s first used in moderation can quickly fall into a pattern of dependency and abuse. Even before true withdrawal symptoms would set in, just going back to the status quo of annoying (or possibly agonizing) pain can be bad enough to keep the painkiller usage going around the clock. The chronic pain sufferers end up having to increase the dosage to get the same result once they’ve become accustomed to the 24-hour usage, and things can quickly spiral out of control from there.

In addition to the physical discomfort, the mental and emotional strain of chronic pain can also play a major factor in developing a chemical dependency. The constant state of discomfort can lead to increased aggression, feelings of hopelessness, depression, and a wide variety of other unpleasant mental states — which are then often exacerbated by lack of sleep — leaving the person even more susceptible to substance abuse than ever before.

Factoring in how quickly chemical dependency can get out of hand for even the healthiest individual, the descent for someone suffering from chronic pain can take over before it is even noticed. The good news is that even the worst case scenarios can be turned around with some help and a push in the right direction from a treatment program that specializes in treating chronic pain without medication.

Treatment for Chronic Pain

Treatment for chronic pain in a comprehensive pain rehabilitation program can include a combination of medical and psychological care, cognitive behavioral therapy, psychoeducation and physical and occupational therapy. Although chronic pain may not go away entirely, its severity and the impact on our emotional well-being can be significantly lessened with a comprehensive pain rehabilitation program, coupled with a change in diet, light exercise, and a variety of other lifestyle switches.

Please contact us if you need additional support or professional help. Call us at (562) 473-0827 or complete the form below.

Sources:

https://europepmc.org/abstract/med/1633386
https://www.sciencedirect.com/science/article/pii/088539249390154N
https://journals.lww.com/pain/fulltext/2007/06000/Opioid_dependence_and_addiction_during_opioid.3.aspx
https://www.sciencedirect.com/science/article/pii/S0885392498001109

 

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Staff Spotlight: Meet Josh Pannell

Staff Spotlight: Meet Josh Pannell

Josh Pannell’s title might technically be “Executive Program and Clinical Assistant,” but he sees that as basically just a nice way of saying that he handles a little bit of everything. Whether it’s facilitating group activities or assisting the admissions team, directing the communication of doctors and pharmacies or helping clients take their first steps into their new lives, Pannell enjoys being a catch-all for Roots Through Recovery. After all, he was one of the facility’s very first employees and comes from a background that gave him plenty of knowledge on the other end of treatment.

Why were you initially interested in getting into this field?
Honestly, I had no clue what else I wanted to do with my life. I’m in recovery myself, and when I became sober I didn’t want to go back into sales. I didn’t know what I wanted to get into, so a counselor at the facility I was at recommended going into this field. They helped me go back to school to get everything I would need. Although I was originally scared to death of going back to school, once I started looking into it I got really excited about it. I dove in head first and started working in admissions and in a residential program while going to school full time. I pretty quickly realized that I wanted to keep going after I got my initial certification, so I’m now pursuing my bachelor’s degree with a plan to get my master’s degree after.

What do you think it is about Roots Through Recovery that sets it apart from other treatment facilities that you’ve seen?
It’s the environment and team for sure. When I was in treatment, I never had the luxury or privilege of going to a facility like this. I always had the standard nonprofit one-size-fits-all mold. We have so many types of treatments, therapies, and experiences here for people to see what works best for them. Every facility says that they have “personalized” treatment, but I’ve never before seen such personalized treatment that really focuses on the individual. It’s also such a tight-knit team that helps everyone. I’ve never been a part of a team that works so closely and communicates so well.

What have you learned while working at Roots Through Recovery?
Kind of like how the treatment isn’t one-size-fits-all, sometimes success isn’t either. Success doesn’t necessarily mean that the client doesn’t relapse, but it might just be about an overall life change or giving them the tools they need to function in society whether sober or not. The goal is not just staying sober, but also about addressing the trauma that they’ve experienced. Identifying that trauma and learning how to address it has helped me recognize some of my own patterns as well.

What do you enjoy doing outside of work?
Well these days I’m mostly going to work, school, and also planning my wedding for May. In the little free time I have, I enjoy going to the gym — I’m trying get back into a shape that’s not round — and I like going new places, having new adventures, and eating new food. I’ve learned in the last year or so that i really enjoy going to amusement parks like Disneyland. My fiancée and I will go to Disneyland for a couple hours on a Friday evening, and we also love going up to Yosemite every year. I enjoy local things too as long as I’m doing something new and having fun.

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For immediate assistance, please call our Admissions Specialists at +1(562) 473-0827 or +1(866) 766-8776.

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Holiday Blues: 3 Ways to Find Joy This Holiday Season

Holiday Blues: 3 Ways to Find Joy This Holiday Season

From what we see on TV and in movies, the holiday season seems to be filled with the fun and excitement of family get-togethers, food, gifts and festivities; but for the more than 55 million Americans who are struggling with addiction and mental health issues, the holidays may be something else entirely. The holiday season may actually seem traumatic. Holidays serve as reminders of what we don’t have, what we’ve lost, and what we wish we had.

Many people who are facing the challenge of addiction or mental health issues find the holiday season to trigger them, reminding them of past trauma, creating new trauma as we approach a holiday season without friends or family, or in uncomfortable situations with loved ones. These triggers can lead to symptoms of anxiety, depression and increased substance use. Whether you’ve thought about getting help for these issues or not, here are a few things you can do to increase happiness and avoid using substances this holiday season.

1. Practice Gratitude

Practicing gratitude — being grateful for what you do have – brings your attention and focus to the positive things in your life. The practice of gratitude has been proven to increase happiness, joy and compassion, while reducing feelings of depression, isolation and loneliness. To practice gratitude, you pick up a gratitude journal or start and end your day by writing down the things in your life that you’re grateful for.

2. Be Mindful

Much like practicing gratitude, mindfulness has been proven to have numerous positive effects on our overall well-being and leads to better health outcomes. Mindfulness brings our attention to the present moment, and out of the past and future, where regret and anxiety live. Practicing mindfulness for just 5 minutes a day has tremendous impact on your mental health, and can help alleviate the stress that often leads to using substances. Read more about mindfulness here

3. Create New Traditions

If you find your current holiday traditions are triggering for you, or you dwell on past traditions that once were, create new holiday traditions. If the way you’ve been doing things in the past haven’t worked, try something else. You can go for a hike, visit that place you’ve been wanting to go, volunteer at a homeless shelter or soup kitchen, or any number of other activities that have a positive impact on your well-being and help you practice steps 1 and 2, gratitude and mindfulness.

Please contact us if you need additional support or professional help. Call us at (562) 473-0827 or complete the form below.

 

WE ARE HERE TO HELP YOU

For immediate assistance, please call our Admissions Specialists at +1(562) 473-0827 or +1(866) 766-8776.

For more information or to start admissions – fill out the form below and we’ll reach out to you as soon as possible:

12 Step and Non-12 Step Support Groups

12 Step and Non-12 Step Support Groups

With nearly one in ten adults in the United States experiencing a substance use disorder, or an addiction to drugs or alcohol, in the past year, the need for substance abuse treatment is greater than ever. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline received 68,683 calls per month in the first quarter of 20181, up from last year. Only around 10% of Americans seek treatment for their substance use disorder, while others go untreated or seek the support from recovery support fellowships, such as a 12-step group like Alcoholics Anonymous, or a non-12 step group like SMART Recovery or Refuge Recovery.

Whether a person does get help at a treatment facility or not, research shows that participation in a recovery support community outside of treatment improves outcomes2. The key to achieving longterm recovery is for an individual to find a recovery support group that aligns with their core beliefs, which increases participation, and thereby, improving outcomes. While the membership of alternative, non-12 step recovery support groups are growing, the 12 Step community is by far the largest in the world with millions of members. There are basic tenants of the Twelve Steps that lead some to search for non-12 step communities. 

Alcoholics Anonymous and The 12 Steps

Developed in 1935 by New York stockbroker, Bill W., and surgeon Dr. Bob S.–both alcoholics–Alcoholics Anonymous is a fellowship of people struggling with alcohol use disorders. The foundation of Alcoholics Anonymous are the 12 Steps of recovery, as outlined in the Big Book, which was first published in 1939. The 12 steps are the philosophy and methods for achieving longterm sobriety, and have helped millions of people in the almost 80 years of existence.

THE 12 STEPS OF ALCOHOLICS ANONYMOUS

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only or knowledge of His will for us and the power to carry that out.
  12. 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.

In response to criticism and questions about religion, donations, purpose and public relations, the Twelve Traditions were developed and adopted a short time later.

THE 12 TRADITIONS OF ALCOHOLICS ANONYMOUS

  1. Our common welfare should come first; personal recovery depends upon AA unity.
  2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
  3. The only requirement for AA membership is a desire to stop drinking.
  4. Each group should be autonomous except in matters affecting other groups or AA as a whole.
  5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
  6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
  7. Every AA group ought to be fully self-supporting, declining outside contributions.
  8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
  9. AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
  10. Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
  11. Our public relations policy is based on attraction rather than promotion; we need always to maintain personal anonymity at the level of press, radio, and films.
  12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.3

With meetings taking place in bars, restaurants, churches and halls around the world, there are now over thirty different support groups based on the 12 steps, that vary from support for codependency (CoDA) and gambling (GA) to overeating (OA) and addictions to specific substances, including Heroin Anonymous (HA) and Cocaine Anonymous (CA). Some of the text is changed in the 12 Steps and 12 Traditions, depending on the group’s focus, for example Narcotics Anonymous uses the word ‘addict’ in place of the world ‘alcoholic’; but the steps that guide the philosophy and the traditions that provide guidelines for the fellowship remain the same.

You can find a listing of 12-step meetings at www.AA.org.

Effectiveness of the 12 Steps

The challenge in measuring the efficacy of a specific recovery support group is that there are too many variables that impact individual outcomes, including whether or not they have gone through treatment, live at home or at sober living, whether they have untreated mental health issues or trauma that contribute to their substance use or behavioral disorder, among countless others. As with any fellowship, studies have found that the outcomes for people in AA and other 12 Step groups are mixed, and vary greatly depending on the person’s commitment and participation level. We do know that millions of people have found help for their addictions, substance use disorders and other behavioral disorders through the 12 Steps.

Criticism of the 12 Steps

Even with this fellowship of millions of people around the world struggling with addictions and other challenges, the 12 Steps support groups have faced criticism due to the focus on God, religion, spirituality and prayer. “Working a program” requires one to subscribe to the doctrine of the steps and a belief in a higher power, though the definition of such has been broadened to mean whatever one believes it to mean. Another criticism of the 12 Step community is its admonishment of the use of psychotropic medications for those suffering from a mental health issue. Many consider the use of medications to mean that a person is not “clean and sober”. This alone leads some people to seek a more inclusive and progressive community of which to be a part.

Non-12 Step Recovery Support

In the past few decades, people recovering from drugs and alcohol, who found the 12 steps did not work for them, have developed alternative, non-12 step recovery support groups that provide the essential elements: fellowship, commitment, accountability and hope; while they differ in their approach.

SMART RECOVERY

SMART Recovery is a “science-based”, non-12 step self-help group that teaches, “common sense self-help procedures designed to empower you to abstain and to develop a more positive lifestyle”.4 The program is based on a form of Cognitive Behavioral Therapy called Rational Emotive Behavior Therapy, or REBT, which is founded on the belief that your thinking creates your feelings, and then leads you to act on those feelings.

SMART Recovery believes that drinking and using serve a purpose–to cope with emotions–and by managing the beliefs and emotions that lead you to drink or use, you can empower yourself to quit. SMART focuses on four key areas for its members:

  1. Enhancing motivation;
  2. Refusing to act on urges to use;
  3. Managing life’s problems in a sensible and effective way without substances; and
  4. Developing a positive, balanced, and healthy lifestyle.

Much like 12 step groups, SMART intends to provide widely-accessible meetings that a community member can find at locations around the world. SMART is an abstinence-based program that also embraces medical progress and does not preclude the use of medications among its members. Because the program does not reference a higher power or require its members to admit to being powerless over their alcoholism or addiction, people in recovery who are not religious or find it difficult to surrender their will over to another tend to prefer this philosophy. The community welcomes people who have a religious faith, however.

SMART Recovery also has an end point, which can be appealing to those who are more successful when they have a goal they are working toward. One can “graduate” from SMART Recovery, though they may continue to attend meetings and work on their abstinence. While the differences are clear, it’s important to note the similarities between SMART and other recovery support communities, which are the basic tenants: fellowship, commitment, accountability and hope. Many people who attend SMART meetings also attend 12 step meetings like AA or NA, as it is helpful to hear the words of others and the meetings are much more accessible.

For more information or to find meetings, visit www.SMARTrecovery.org. 

REFUGE RECOVERY

Another recovery support community that has grown in popularity in the last few years is Refuge Recovery. Refuge is a Buddhist-oriented approach to recovery, and like SMART, it is founded on the belief that, “All individuals have the power and potential to free themselves from the suffering that is caused by addiction.” This empowerment comes from practicing self-compassion, and opening one’s heart and mind to respond to events and moments in life without self-harm. Like other recovery support communities, Refuge Recovery has guiding principles, which are the Four Truths: ONE: Addiction Creates Suffering; TWO: The cause of addiction is repetitive craving; THREE: Recovery is possible; FOUR: The path to recovery is available.

In an article, The Early History of Refuge Recovery, spiritual director Joseph Rogers explains the background.

The beginnings of Refuge Recovery can be traced to the Buddhism & Recovery conference held in Los Angeles at the Against the Stream Buddhist Meditation Society (ATS). It was here that Alan Marlatt, a researcher from the University of Washington, presented his findings on the impact of mindful meditation for clients in outpatient addiction treatment. His pioneering study showed that while mindfulness meditation improved the chances of clients reaching the 90-day recovery mark, if these clients stopped meditating post-treatment, their recovery rates returned to baseline. However, those clients who continued to meditate in supportive communities saw a continued higher rate of recovery post-treatment.

Alan believed that there needed to be a national network of meditation groups that supported the wave of clients who would soon be using mindfulness as an integral part of their recovery, something like a Buddhist-based 12-step program but with mindfulness meditation. 5

The Refuge Recovery program incorporates meditation and mindfulness into its approach, and emphasizes kindness, compassion, appreciation and equanimity. Refuge community members follow the Eightfold Path to Recovery:

  1. Understanding
  2. Intention
  3. Communication/Community
  4. Action
  5. Livelihood/Service
  6. Effort
  7. Mindfulness/Meditations
  8. Concentration/Meditations

According to their website, the Eightfold Path “is an abstinence based path and philosophy. We believe that the recovery process begins when abstinence begins. The Eight factors of the path are to be developed, experienced and sustained. This is not a linear path, it does not have to be taken in order, rather all of the factors will need to be developed and applied simultaneously. This is a guide to having a life that is free from addiction. The eight-fold path of recovery will have to be maintained throughout ones lifetime.”6

As we wrote about in an earlier article, much research into the benefits of meditation and mindfulness have come out in support of its role in recovery. Recently, more treatment centers have begun incorporating this practice into their programming, increasing interest in Refuge Recovery, which is based on these principles and practices.

For more information or to find meetings, visit www.refugerecovery.org.

Other Non-12 Step Recovery Support Communities

WOMEN FOR SOBRIETY

LIFERING SECULAR RECOVERY 

SECULAR ORGANIZATIONS FOR SORIETY (SOS)

The Great Divide

A simple search of the internet will show you just how divided the recovery community is on the subject of recovery support groups. A large sector of the community believe the 12 steps are the answer for anyone struggling with drugs or alcohol, partly due to the fact that many people working in treatment centers are themselves recovering alcoholics or addicts who got sober using the 12 steps; while others believe non-12 step groups are more fitting due to their omission of religion or inclusiveness of other faiths. One will even find treatment centers whose curriculum is based on Twelve Step Facilitation (TCF), and others that denounce the steps and claim to be “Non-12 Step Rehab”.

Most of the literature that is available focuses on the differences between these two schools of thought, rather than the similarities in what they provide for people who are seeking help from their peers. The divide is harmful and the dangers of pitting fellowships against each other presents challenges to the recovery community, alienating individuals and groups, and suggesting that there is only one path to recovery. Creating the illusion that one community has better outcomes than the other, or that there exists only two clear options: 12-Step or Non-12 Step, forces people to place themselves in one of these two categories when, really, the recovery community as a whole should be unified and support one another regardless of the doctrine to which one subscribes.

Which Group is Best – 12 Step or Non-12 Step?

The answer to this question, as suggested earlier, depends on the individual and his or her belief system. Research has shown that people who are actively involved in a recovery support community achieve better outcomes and ‘success’, as they define it for themselves. One such study suggests that, “involvement in support groups significantly improves one’s chances of remaining clean and sober, regardless of the group in which one participates.” It goes on to say, “Respondents whose individual beliefs better matched those of their primary support groups showed greater levels of group participation, resulting in better outcomes as measured by increased number of days clean and sober.”

While the difference between communities, especially religion, may lead one to choose one over another, the reasons why active involvement in a recovery support community–regardless of the community–results in better outcomes, are the common themes among these groups, not the differences. Just as we urge clients in recovery to build empathy and compassion by finding the commonalities among them and their peers, rather than focusing on the differences, our approach to recovery support groups should be the same. What works for one, does not necessarily work for all.

Some treatment centers, like Roots Through Recovery, do not attach to any ideology or approach, and their philosophy is, “it doesn’t matter which community you join, but find one that speaks to you, and commit.” This approach embraces a belief in multiple paths to recovery, and encourages individuals to be both introspective and inclusive as they search for the community that they connect with most.

 

Xanax Withdrawal Symptoms: List of Symptoms

Xanax Withdrawal Symptoms: List of Symptoms

This is the second article of the five-part series Benzodiazepines: What You Don’t Know Can Hurt You. Read part one, Benzodiazepine Addiction: Causes and Treatment.

Xanax is a benzodiazepine with high potency, and it’s one of the most commonly prescribed and abused benzodiazepines. While all benzos generally produce the same effects and have the same withdrawal symptoms, different types have different potencies that can affect the intensity of symptoms and how long Xanax withdrawal symptoms last.

Xanax is a short-acting benzodiazepine, so when you stop taking it, Xanax withdrawal symptoms set in within one or two days after the last dose. Xanax withdrawal symptoms can last for as few as two weeks or as many as four weeks. In some cases, symptoms can persist even longer.

The severity of Xanax withdrawal symptoms and the duration of withdrawal typically depend on the dosage you’ve been taking, how long you’ve been dependent and other factors like your age and your general state of health.

Xanax withdrawal symptoms include:

  • Intense cravings
  • Anxiety or panic attacks
  • Tremors
  • Headache
  • Nausea
  • Insomnia
  • Restlessness
  • Agitation or irritability
  • Poor concentration
  • Memory problems
  • Muscle aches

During detox, dangerous Xanax withdrawal symptoms may occur, including seizures and dangerous shifts in heart rate and blood pressure, according to an article published in the journal American Family Physician. For this reason, the safest way to manage Xanax withdrawal symptoms is to gradually decrease the dosage.

The best way to do this is to base the length of time between each dose reduction on the presence and severity of Xanax withdrawal symptoms. The longer the interval between dose reductions, the safer and more comfortable withdrawal will be. In general, there should be at least a week between reductions. Benzo withdrawal symptoms can fluctuate, but if symptoms worsen, a higher dose probably won’t be given in order to relieve them. Rather, you’ll likely be kept on the current dose until the symptoms subside and then continue with the reduction schedule.


Read part three of this five-part series, Professional Help for Benzo Withdrawal is Essential for Success, or download the entire series as a fully illustrated eBook, Benzodiazepines: What You Don’t Know Can Hurt You.


Benzodiazepines: What You Don't Know Can Hurt You

Benzodiazepine Addiction: Causes and Treatment

Benzodiazepine Addiction: Causes and Treatment

Benzodiazepines are a class of drugs that slow the central nervous system to produce a sense of calm and well-being. Often used to treat anxiety and panic disorders, benzodiazepines include drugs like Xanax, Klonopin, Valium and Librium. Benzos work by increasing levels of the brain chemical GABA, which inhibits nerve transmissions in the brain to produce feelings of relaxation. Benzos also increase the activity of the dopamine system, which leads to feelings of happiness and euphoria.

When used as directed for the short-term, benzodiazepines are safe and effective. But when they’re taken for non-medical purposes or in higher doses than prescribed, benzos can cause addiction and dependence.

Benzodiazepine Addiction

Addiction is characterized by the inability to stop using a drug even though it’s causing problems in your life. A variety of issues underlie most addictions and require therapy to work through and resolve.

Dependence is different from addiction and is characterized by withdrawal symptoms that set in when you stop using a drug.

How Dependence Develops

When you abuse benzodiazepines, your brain changes the way it functions in order to compensate for the presence of the drug. For example, since benzos increase dopamine and GABA activity, the brain will reduce the activity of these neurotransmitters in an attempt to normalize brain function.

This leads to tolerance, which means that you need increasingly larger doses to get the desired effects. But as you increase your benzo intake, the brain continues to change its function to compensate.

At some point, brain function may shift so that the brain now operates more comfortably when benzos are present than when they’re not. Then, when you stop using the drug, normal brain function rebounds, causing withdrawal symptoms. Benzo withdrawal is uncomfortable, and it can be dangerous.

According to the Center for Substance Abuse Research at the University of Maryland, dependence most often develops in those who have used benzodiazepines for six months or more.

Treating Benzo Dependence

Medical detox helps individuals end a dependence. During detox, the drug is withheld so that traces can leave the body and brain function can begin to return to normal. Medical detox is supervised by medical and mental health professionals who administer medications to reduce the intensity of withdrawal symptoms.

However, due to the potentially dangerous side effects of benzo withdrawal and the fact that no medications have been approved by the FDA to treat them, withdrawing from benzodiazepines should be a matter of decreasing the dosage over time to prevent the onset of dangerous symptoms.


Read part two of this five-part series, Xanax Withdrawal Symptoms: List of Symptoms, or download the entire series as a fully illustrated eBook, Benzodiazepines: What You Don’t Know Can Hurt You.


Benzodiazepines: What You Don't Know Can Hurt You