Workplace injuries happen everyday, and more often than not, the injured worker will be prescribed an opioid as a way to help ease the pain and lasting issues associated with the immediate injury. Whether the ultimate treatment for the injury involves surgery, physical therapy, or another treatment, medical professionals often turn to opioids like Vicodin or Oxycodone to placate the injured worker’s reported pain.
Risk of Opioid Dependence
As well as they may work to reduce pain levels, the unfortunate truth about opioids is that they are highly addictive, and they have been shown to increase pain sensitivity, called Opioid-induced hyperalgesia (OIH), which creates a vicious cycle of increased pain, increased dosage, increased tolerance and increased risk of dependence and overdose. Several studies, including one in JAMA, show that as many as one-third of workers who begin using opioids for a workplace injury become addicted to them — which can hinder both the treatment and recovery for the injury, as well as their timetable to return to work and living a productive life.
One report from the CDC found that among adults (non-cancer patients) who received a prescription for opioids, the likelihood of chronic opioid use started after just three days of the medication, and increased with each additional day of medication supplied. The most dramatic increase among these patients was seen after the fifth day of taking opioids, and the highest probability of continued opioid use at 1 and 3 years was seen among patients who were prescribed long-acting opioids like Fentanyl or Morphine.
Increased Time Off Work
The research is strong enough that some medical groups have begun recommending against prescribing opioids for less severe injuries, as developing an addiction after a workplace injury has become a growing concern in industries around the world. Although some medical communities may see opioids as the best (or only) option for getting injured workers back to work — particularly for injuries that can’t be resolved with surgery and will likely linger for an extended period of time — opioid use triples a worker’s time spent on disability, on average.
Considering that the time spent on disability doesn’t even factor in other possible side effects of becoming dependent on opioids, the risks associated with the popular painkillers can make them a dangerous choice for anyone suffering from a workplace injury. Although they may seem necessary for a physician who has “tried everything”, finding an alternative source of pain relief could spare employees, employers, and workers compensation carriers all over the world from the weeks, months, or even years of suffering that opioids can lead to.
There are evidence-based alternative treatments for pain that focus on changing one’s beliefs and removing fear around pain – altering the pain experience. An effective and integrated pain recovery program, like Roots Chronic Pain Recovery, utilizes approaches including mindfulness, cognitive behavioral therapy, psychoeducation, EMDR, and art therapy, and integrates yoga, tai chi, physical therapy, family therapy, and other modalities.
“The goal is to get people moving again”, says Dr. Michael Aquino, PT, DPT, “The less people move out of fear of further injury, the more pain they will experience.”
Roots Chronic Pain Recovery has developed a mind-body approach to treat chronic pain and opioid dependency. With personalized treatment and an interdisciplinary team, we can help you regain control of your body – and your life.
Like any chronic health issue, the long-term aftercare that follows detox or inpatient treatment can be just as important as the initial treatment itself. If you look at recovering from addiction through the lens of a chronic condition, it is clear that long-term recovery requires similar steps to that of treating hypertension or diabetes: diagnosis, stabilization, continuing care, and of course, lifestyle changes.
Detox and Inpatient
The first step after seeking help might be to go into a medical detox or inpatient program for a period of time, where professionals can evaluate and observe you while withdrawing from a substance. During the inpatient portion of treatment, feelings, thoughts and behaviors will no doubt surface in the absence of the substances we use to escape these normally. This period of stabilization provides you with a solid foundation to begin addressing these issues as you develop your treatment plan for long-term aftercare.
After receiving comprehensive inpatient or residential treatment, and you’ve chipped away at the physiological and psychological hold that chemical dependency can have on you, it is critically important to find the proper outpatient aftercare program for the weeks, months, and years ahead. Considering that recovery from addiction is not a single episode, enrolling into aftercare for groups and individual therapy sessions at an intensive outpatient or day treatment program significantly lowers the risk of relapse.
Often times, people will complete a 28-30 day inpatient program with a renewed sense of self-efficacy, that “I got this” feeling, and will return home without seeking aftercare. As we touched on earlier, this period is intended to lay a foundation for treatment – it is not the end all, be all for recovery – and people are at the greatest risk for relapse and overdose following detox and inpatient programming. Research suggests that continuing care in an intensive outpatient program (IOP) produces the greatest outcomes for people following detox and inpatient treatment.
The statistics are widely known that approximately half of those who go through some type of addiction treatment will likely relapse at some point in their lives, but that number drops significantly among those who regularly attend aftercare treatment, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Benefits of Aftercare
Aftercare or continuing care in an IOP presents incredible benefits for someone in early recovery: addressing trauma, developing coping skills, finding balance, connecting with our bodies, mending broken family ties, improving communication, etc. And in addition to these revelations in personal development, maintaining regular contact with recovery and healthcare professionals as well as engaging with a recovery support community with peers who are faced with the same challenges, help to set you up for long term success and recovery.
At Roots Through Recovery, we understand the importance of finding a personalized aftercare plan that works for each person. We know that the inpatient treatment is a crucially important step, and it is the beginning of the long journey of recovery, along with aftercare or continuing care in an intensive outpatient program. Roots believes that no two individuals are the same, and neither are their journeys, so if we aren’t appropriate for you, we will ensure we find the right place to meet your individual needs.
From bike trails and yoga on the bluff to farmers markets and kayaking, Long Beach offers a uniquely diverse community where people can thrive while enjoying life to the fullest!
Roots Through Recovery, located in Long Beach, California, offers treatment for those coping with addiction and mental health issues. We embrace the culture of wellness that is at the heart of this city, and create a place for healing the mind, body and spirit.
See for yourself why Long Beach is the ideal place to start or continue your journey of recovery.
Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors National Recovery Month in an effort to increase awareness and understanding of substance use and mental health disorders, and to honor and celebrate the people who recover. The theme for 2017 is “Join the Voices for Recovery: Strengthen Families and Communities”.One of the most prevalent issues individuals and families face in their journey of recovery is trauma, or the way in which they perceive and experience major life events. As we’ve written in the past, trauma is completely subjective and, if untreated, can lead to the use of behaviors and substances to escape the effects of trauma.
This year, Roots Through Recovery is honored to celebrate Recovery Month with a special speaking event with Deborah Sweet, Psy.D.: “The Nuances of Trauma Treatment: What to use, how and when”. Treating trauma is it’s own specialized area of psychotherapy. Specific tools and modalities are needed to help people recover from the effects of trauma. Trauma is held in the subcortical region of the brain therefore traditional therapy, though wonderful, will not move traumatic incidents the way that EMDR, Brainspotting, Somatic or Havening therapies do. In this talk, Dr. Sweet will provide information on types of treatment and when and how to use them.
Title: “Nuances in Trauma Treatment: What to use, how and when” Date: Wednesday, September 27th Time: 11:00am to 1:00pm Location: 3939 Atlantic Avenue, Suite 102, Long Beach, CA 90807
Deborah Sweet, Psy.D. is a licensed psychologist, trauma expert and Founder of the Trauma Counseling Center of Los Angeles. Treatment at TCCLA focuses on helping people recover from the overwhelming effects of trauma using modalities that are specifically designed to help people recover from trauma. These cutting-edge modalities include the Somatic therapies of Somatic Experiencing, Sensorimotor Psychotherapy and the Trauma Resiliency Model; EMDR, Brainspotting and the Havening Technique. At the Trauma Counseling Center of Los Angeles, the team helps individuals clear traumas by engaging the subcortical regions of the brain to restore resiliency to the nervous system, enable clearer thinking and an ability to enjoy life more fully.
Lunch will be provided, thanks to our event sponsor WEconnect Recovery. The event is completely FREE, but you must RSVP, and seats are limited.
This is an officially-registered SAMHSA Recovery Month event. Find more Recovery Month events here.
EMDR has received some notable attention recently thanks to its effectiveness in treating trauma. There is a lot of information available online and in academic literature of the therapy, so we put together this article as an overview of EMDR to help you understand what it is and how it works.
So what exactly is EMDR and how does it work?
EMDR stands for Eye Movement Desensitization and Reprocessing, and it involves 8 phases including the use of eye movement, or bilateral stimulation, which appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. As we wrote about in past blogs, when a person experiences a traumatic event, their brain goes into defense mode and changes its function.
One of these functions includes the hippocampus, which usually works to store memories in a neat filing system that allows us to easily and accurately recall these memories. When faced with a threat, the hippocampus takes on the role of pumping cortisol throughout the body so that we don’t feel pain, and puts the memory storage on the back burner. So it’s no wonder it’s incredibly difficult to recall a traumatic event, or we recall it inaccurately by filling in the blanks later on.
EMDR allows us to go deep into the brain and file these memories with the appropriate meanings and emotions attached to them. According to the EMDR International Association, the goal of EMDR is to:
“Process completely the experiences that are causing problems, and to include new ones that are needed for full health… That means that what is useful to you from an experience will be learned, and stored with appropriate emotions in your brain, and be able to guide you in positive ways in the future. The inappropriate emotions, beliefs, and body sensations will be discarded… The goal of EMDR therapy is to leave you with the emotions, understanding, and perspectives that will lead to healthy and useful behaviors and interactions.”
One of the leading experts on developmental trauma and author of The Body Keeps the Score, Dr. Bessel van der Kolk recalls the experience he had using EMDR on a patient when he realized the power of the therapy. Watch below:
What are the 8 phases of EMDR?
Phase 1: The first phase is a history-taking session(s). The therapist assesses the client’s readiness and develops a treatment plan. Client and therapist identify possible targets for EMDR processing.
Phase 2: During the second phase of treatment, the therapist ensures that the client has several different ways of handling emotional distress. The therapist may teach the client a variety of imagery and stress reduction techniques the client can use during and between sessions. A goal of EMDR therapy is to produce rapid and effective change while the client maintains equilibrium during and between sessions.
Phases 3-6: In phases three to six, a target is identified and processed using EMDR therapy procedures. These involve the client identifying three things:
1. The vivid visual image related to the memory
2. A negative belief about self
3. Related emotions and body sensations.
In addition, the client identifies a positive belief. The therapist helps the client rate the positive belief as well as the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation. These sets may include eye movements, taps, or tones.
Phase 7: In phase seven, closure, the therapist asks the client to keep a log during the week. The log should document any related material that may arise. It serves to remind the client of the self-calming activities that were mastered in phase two.
Phase 8: The next session begins with phase eight. Phase eight consists of examining the progress made thus far. The EMDR treatment processes all related historical events, current incidents that elicit distress, and future events that will require different responses.
Does it actually work?
At least 20 positive controlled outcome studies have been done on EMDR therapy. According to the EMDR Institute, which hosts a comprehensive list of EMDR-related research, some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six, 50-minute sessions.
EMDR International Association reports on the same topic, “Clients often report improvement in other associated symptoms such as anxiety. The current treatment guidelines of the American Psychiatric Association and the International Society for Traumatic Stress Studies designate EMDR as an effective treatment for post traumatic stress. EMDR was also found effective by the U.S. Department of Veterans Affairs and Department of Defense, the United Kingdom Department of Health, the Israeli National Council for Mental Health, and many other international health and governmental agencies. Research has also shown that EMDR can be an efficient and rapid treatment” (www.emdria.org).
Who does EMDR?
Only Masters-level or Doctoral-level professionals–therapists, nurses and doctors–who have gone through approved EMDR training can provide EMDR to people. Roots Through Recovery is proud to have two clinicians on our team that are trained and certified to provide EMDR. Clients who have undergone EMDR therapy for trauma have seen great improvement in their management of traumatic experiences, and how that plays a role in their addictions and mental health.