Methadone is a medication that can be used to help treat persons with an opiate use disorder maintain sobriety and not experience withdrawal symptoms by occupying areas of the brain that opiates target and make them less severe for those that have stopped using opiates. Methadone also helps with eliminating cravings for opiates.
Many people stay on methadone long-term and many gradually reduce their dose to completely stop taking methadone altogether. Methadone should not be taken with any other illicit substances and alcohol. The impact of mixing benzodiazepines (Xanax, Klonopin, Valium, etc.) and methadone can be deadly. There is an increased risk of overdose when benzodiazepines are taken with Methadone. Since Methadone is a depressant that slows the central nervous system, which includes heart rate and breathing, so does benzodiazepines. As a result, the combination of taking the two can slow the heart rate, risking the heart for cardiac arrest and stopping one from breathing.
Methadone can be prescribed and lasts longer in the body to help those with an opiate use disorder once someone stops using. Most persons are referred to a community treatment center for assessment. Most treatment facilities have a general practitioner on site that can complete the assessment. After the assessment, an initial low dose is prescribed. The low dose is prescribed out of safety and can be adjusted frequently. This stage is very important because this is the phase where a regular maintenance dose is identified over a few weeks time period. The maximum effect can vary person to person as it takes 2-4 hours for Methadone to reach its peak effect level.
Once the correct dose is identified, the person is now in what is called Methadone maintenance. Methadone is a once-daily liquid dose taken under supervision of a nurse or pharmacist who dispenses it. Methadone must be taken regularly and if three or more doses are missed, the body may lose its ability to break down the drug. If three or more doses are missed, persons can return to taking Methadone, but at a lower dose. Detoxing often takes years as it is safer to stay on Methadone than to detox before the person is ready.
People that use Methadone are more likely to stay off opioids if they are supported by friends and family. Too often, family and friends do not support persons with opiate use disorders because of their lack of knowledge regarding Methadone. Methadone is a medication used to help those persons with an opiate use disorder so they no longer use opiates. It can be viewed as taking medication for high blood pressure or insulin for type 2 diabetes. The way people can change their diet to reverse type 2 diabetes while taking medication is the same as those using Methadone to reverse their opiate use disorder. Support from loved ones goes a long way for a person using Methadone. Persons with opiate use disorders also do well when attending outpatient treatment coupled with group and individualized therapy. It is much harder to do it alone.
Please educate a friend, coworker and loved one on the benefits of supporting a person with opiate use disorder when they have made the choice to use Methadone in their recovery efforts. There are plenty of successful people around us, you may never know, that have or currently use Methadone. As America is going through the opioid epidemic, being educated on the various ways Methadone can help just might save your loved one’s life.
Abstaining from daily substance use can be very hard for persons in recovery. Every day without using can be uncomfortable especially when trying to practice and implement new recovery skills. This alone makes the first 90 days of recovery very critical. The first 90 days has been known as the time period where most relapses occur.
Those in active recovery give up substance(s) and behaviors. Recovery can be difficult to manage if there is no structure, a routine and consistency in place. Below are 12 critical tools for managing the first 90 days of recovery.
Graduating from high school is such an exciting time for many seniors! The pandemic made a lot of schools creative in how they could observe graduation in honor of its seniors. Unfortunately, millions were not able to attend prom while others were with mask and social distancing.
August means going back to school. Millions will be preparing to attend college out of state and going away to a new city or town can seem like an adventure for some, while for others it can be anxiety inducing due to leaving home and family. This is the perfect time for both parents and their college freshman to develop a schedule around how often they will be face-timing. Face-timing is key because it provides a visual parents' can use as a tool to notice if something is not right.
With no longer living at home and going away to college, new responsibilities are on the horizon between waking up on time and attending classes to managing your own schedule. Colleges and Universities market and promote the beauty of their campus, how well particular programs rank throughout the nation and state, their extra-curricular activities, etc! Although institutions do not promote the use of alcohol and/or drugs, it is expected by many to engage and is the misperceived campus norm when attending college.
There have been cases were college students develop an opioid dependence from obtaining them from friends on campus. What happens when your young adult suffers from substance misuse or worse, dies from an overdose? It can be very difficult to admit having a substance misuse problem when living in an environment that encourages using and partying. Educators are usually in a position where they have minimal leverage to help students with substance misuse problems. By the time the issue does come to surface, the student suffers because of the lack of support provided by their institution.
Young adults should be able to have a recovery system in place for when they are experiencing their life spiraling out of control due to misusing a substance. Some institutions have mental health counselors readily available, but not substance abuse counselors.
Institutions can provide support with the expertise of substance abuse counselors as to how it can build a campus-based infrastructure that works with students to prevent substance misuse and relapse, while promoting academic performance. This effort should be community based for the entire student population and institution as a collegiate recovery community or community of recovery professionals on campus. This type of community will enable students to learn how to create a new circle of friends and not return to the same friends who sold and/or used drugs with them.
The institution can set up additional support for students, helping them navigate campus resources and maintain their recovery in the face of misperceived campus norms. Students can be treated on an outpatient basis to avoid having to withdraw from school and retake the classes upon their return. If a student does need inpatient care, institutions may consider implementing a drug return program. Not all college counseling centers provide opioid addiction treatment and are referred out to local doctors, but colleges can have Narcan (Naloxone) nasal spray on hand to reverse overdoses of opioids including prescription painkillers and heroin.
Students that are opioid-dependent can be safely and effectively treated with buprenorphine (Suboxone) in their institution's counseling center, but some students may perceive that their taking Suboxone has cured their addiction so they stop treatment (counseling, 12-step meetings, sponsorship, etc). Another option for students can be sustained-release Naltrexone (Vivitrol). Vivitrol is a pill or administered as a shot, once a month, which can help with the student not having to taper or stop treatment when they are ready. Vivitrol blocks opioid receptors in the brain and does not activate them, blocking the effects of opioids. Students cannot get high on Vivitrol, but they have to detox from opioids about a week before they can start it, which can be a disadvantage.
Substance misuse happens at college and although this is not new news, ignoring substance misuse at college does not make it go away. Collegiate recovery, having support for students in recovery attending college, should be the new norm across the nation and not an afterthought when institution's public relations department fail to revive the school's reputation from several tragic substance misuse incidents. Institutions have to consider their specific circumstances and student's needs when setting up its recovery efforts. Admitting substance misuse is becoming more prevalent and can be the first step. Early intervention matters as the use of drugs and alcohol has risen since the onset of the pandemic!
Depression can be defined as feeling sad for weeks or months and not just a day or two. It can be accompanied by a huge hole of emptiness inside, lack of energy and no pleasure in things once enjoyed.
Clinical depression is different from normal sadness. Clinical depression interferes with one’s work or school, relationships with others and ability to enjoy life. However, clinical depression is treatable with modern antidepressant medications and goal-orientated psychotherapy.
No two people experience depression the same. Some people may not seem sad while others can be unmotivated to do anything like eat or get dressed. These tasks can become large obstacles in their daily life. When friends and family notice these changes, it is alright to say something.
Since many people with depression have lost their ability to recognize their positive attributes, giving plenty of reassurance can also be very helpful. People with depression can spend a lot of time reflecting on their situation or ruminating.
Give understanding and empathy by:
Other things you can ask of your depressed loved one are:
The term drug is used to describe all mood-altering substances including alcohol and other sedative-hypnotics, opioids, stimulants and psychedelic drugs.
Thinking and talking about cravings for alcohol and other drugs can make some people crave them more. However, thinking and dreaming about alcohol and other drugs is a natural part of recovery. Learning how to stop these thoughts and turning them into cravings can help prevent a person from resuming use. Education about substance use is important. Learning how resume of use occurs, how to prevent it and identify signs that lead up to it, can prevent returning back to using.
People, places and things are connected to the use of alcohol or other drugs. These are known as triggers! Triggers are feelings and experiences tied to people, places and things that are associated with drinking or drug use.
To help identify your triggers, write a list of:
Internal, external and sensory triggers combined usually work together to create a drug craving. Internal triggers are feelings people have before or during drinking or using drugs (angry, lonely, depressed, sad, bored, etc.). External triggers are people, places and things associated with drinking or using drugs (old neighborhood, holidays or people one used to use with). Sensory triggers are related to sight, sound, taste and touch (certain songs, certain foods or drinks). Now, to help identify your internal, external and sensory triggers, name and describe them on paper or in a journal.
The steps in dealing with triggers start with identifying, avoiding, interrupting and talking about them. Once you identify what your triggers are, start avoiding them. For triggers that cannot be avoided, interrupt them by keeping yourself occupied, attending a self-help meeting, spending time with clean and sober friends or family, etc.
Planning ahead is the key to avoiding falling back into old habits and routines. Lastly, talk about it! Don't keep silent as this could allow your cravings time to build up and potentially lead to resume of use. Talking about triggers in a self-help meeting or therapy session can weaken the power of triggers.
To help manage your triggers, write and list:
This process can be occurring in your brain without realizing how powerful it is. Developing skills and tools in recovery is vital as sobriety. It's an ongoing process. Therapy and self-help meetings can help you develop a new set of important skills that will help with stopping triggers from leading to relapse.
Things are finally starting to open up again. Most people are getting vaccinated and the onset of the pandemic is growing faster behind us. So many of the face-to-face services that went virtual will remain. Therapy will be one of those of services. The pandemic showed us how much of our tasks can be done online without having to physically be in a building or office.
I always offered teletherapy, but as you can imagine with the pandemic, the amount of clients that chose teletherapy soared. I was very happy to see that my clients didn't allow the pandemic to stop them from taking care of their mental health needs. As you prepare for a post-covid world around you by getting back out there again, face-to-face, think about the things you can continue to do from the comfort of your own home. Therapy is definitely one of them!
If you've never experienced online therapy, here are 5 reasons why it's amazing!
There are a host of online therapy sites to help you choose the right therapist for you (Open Path Collective, Therapy for Black Girls, and My Tru Circle to name a few) taking away the stress of where to look for therapist that provide online sessions.
The one con to online therapy is that, if you're in a crisis situation, online therapy isn't the best option for you. Online therapists are at a distance making it difficult for them to respond fast enough. Call the National Suicide Prevention Lifeline 1-800-273-8255 or text "NAMI" to 741741. If it's an emergency, call 911 or going to your nearest crisis center is best.
Online therapy isn't for everyone. Some people prefer the face-to-face session and that's totally fine! As long as you are getting the help you need, the delivery method doesn't matter. Only you can decide if online therapy works best for you and your situation.
Seeing a therapist does not mean you are weak. Being vulnerable in front of a complete stranger can be uncomfortable although therapy is more than sitting in an office or from home and talking. Therapy includes building a professional, therapeutic relationship with boundaries and setting goals you want to achieve. The client-therapist relationship is a collaborative relationship. The therapist listens, ask questions and evaluates your needs, barriers and challenges. As well, you listen, ask questions and identify your needs, barriers and challenges. If you cannot identify your needs, barriers or challenges, that's okay! Your therapist has many years of experience and should be able to help you.
Unfortunately, therapeutic relationships can be unbalanced. Although finding a therapist that's a right fit for you can be hard, it can be done. Be encouraged! You don't want to stay in any client-therapist relationship that isn't serving you or its purpose. If you decide to leave your current therapist for a new one, be empowered by the fact that you can now use that past experience to your advantage by knowing what to look for in your new therapist. In addition, keep these 5 things in mind:
Do you find yourself physically living in the present, but your mind is in the past?
Are you sitting in resentment, guilt, or shame from the past?
Are your current circumstances causing you such displeasure that you think they'll continue in your future?
The voice of the ego-mind makes us believe we can only achieve internal peace based on external things. The philosopher, Ludwig Wittgenstein stated, “The eternal life belongs to those who live in the present.” When you don't allow yourself to experience any moment for itself, you stop time.
The past is said and done. What remains to be seen is what you can bring to your present and future. You always have the power to not repeat any poor decision you made in the past so it doesn't repeat in your present or future.
You owe it to yourself to treat yourself fairly! This includes not beating yourself up over your past, what someone did to you that wasn't in your control and anything you did without knowing how to respond better.
Today, tell yourself that you are important because you matter! Please know that no matter how others may have treated you or what they may have told you in the past is a reflection of them and not you.
Your past represents the things you've experienced. Your past does not make you a better or worse person nor is it your enemy. The enemy is your way of thinking about your past and if you allow it to ruin your present and future. Use your past to make you emotionally strong now for your future.
Let’s face it; the present can only get better for the future!
Happiness takes work. It's an inside job that can be easier said than done. Some of the basic ingredients to being happy includes safety, satiation, perception and quietude. These are things you can control. Depending on external things to be happy can make it hard to sustain happiness.
Feeling unsafe can bring about fear. This fear creates a fight or flight response on top of tension within your body. These things can make it hard for you to experience happiness. Ask yourself, “How safe and secure do I feel in my everyday life?” As you think about your answer, consider what you can adjust to feel safer.
No one has everything they want, but ask yourself, “At this moment, in what ways are my life full?” Only you can answer this question. Acknowledge in this present moment, without pointing out what you don't have, everything you do have that really makes your life full.
Right now, take the time to reflect on the bigger picture, your life! Getting caught up in the minuscule details of things you can't control can derail you from enjoying your life's journey, the positive impact you are having on others and within your own life. One’s quality of life can be enhanced by having a positive attitude and sense of general well-being. Improving your mind and memory through mentally stimulating exercises can also help.
How often do you go into a quiet place and reflect? If you can't do this every day, try to do this at least once a week. Find a quiet place where you can get in touch with feeling safe, seeing how satiated you are and self-reflect for 20 mins. Take a break from your day of being busy and implement rest. Identify a space where you can hear yourself think and have no responsibilities so you can focus on you, your peace.
As you reflect on some of these questions, focus on the ones you struggled with or couldn't answer. These are the ones that need your attention the most. As you begin to work on these, you are one more step closer to being a happier person.
You just landed your dream job earning more money making it easier to save more money; home-run!
Your daughter was accepted to her #1 college choice on a full scholarship; home-run!
Your brother just had his first baby and you're super excited to be an aunt; home-run!
After flying through green pastures, celebrating these homeruns, you grab a seat and close your eyes to relish on the beauty of it all. As soon as you open your eyes, the fastest curve ball you've ever witnessed is coming towards you. When life gives you lemons, they say to make lemonade. What do you make when life throws you fast curve balls?
The money in your savings account has dramatically decreased to repair your flooded basement because home insurance doesn't cover it; curve ball!
Your daughter received another letter from her college stating they made a typo on the letter and she will not be attending that college; curve ball!
Your brother calls to say his wife miscarried...you hang up the phone with the curve ball stuck in your throat; curve ball!
The phone rings again...your grandmother died' curve ball!
Now, you sit! The curve balls are sitting heavy on your chest. You can't seem to calm yourself and the curve balls are in various parts of your body. You feel the pressure. Your head is pounding.
The sound of mail being placed into your mailbox snaps you out of your head and for that split second, you are now focused on the task of reading the mail in hopes of a distraction.
The first piece of mail is $300 fine notification by the city for having too many times for false alarms. The second piece of mail is a notice stating your mortgage has increased by $400 because your mortgage company failed to take out enough money to cover last year’s escrow. Now, your once cushy savings is gone.
The room begins to spin because all those curve balls have knocked you on your ass. And it’s only Tuesday! How are you going to make it through today? The rest of the week?
Eat comfort food…or not eat at all.
Self-medicating discomfort isn't the way to handle discomfort. Allow yourself to sit with your uncomfortable feelings because you are human. Staying present is the only way to find a solution to current problems and fully go with the ebb of life’s curve balls as a means to adapt!
Life has a way of always testing you, for the good or bad! The reframe or new outlook is what will help you bounce back. A few reframing thoughts or new outlook could be:
More curve balls are sure to come. Remember, for every curve ball there's a homerun waiting to be hit out the park!
I might be aging myself here, but did you have a pen pal as a kid? I did! I remember how excited I was when my letter arrived in the mail. It was a wonderful experience to hold a letter that came from another state or country that someone else took the time and thought to write a letter back to me. I loved sitting down, writing and sharing something from my heart, funny or serious. The exchange was so fun as I was able to share my authentic self to someone else in a meaningful way without judgment.
My first pen pal was assigned to me in the 5th grade. She was another 5th grader from Alabama. In the 6th grade, I was assigned my second pen pal from Germany. Both pen pals added so much to my learning because of their cultures as they were different from mines growing up in Illinois.
The simplicity of writing a letter to a pen pal afforded me the experience to be myself, dream and listen while understanding others just the same. That experience alone taught me that I can embrace myself although it can be hard due wanting to fit in or change based on so-called norms in our society and/or culture.
Meaningful connections with others have been lost due to our overuse of social media and texting. I love technology and its benefits, but nothing will ever replace the human connection needed within ourselves or from others.
Here are some ways to embrace yourself and connect with others now:
Growing up, you may have discovered ways to make yourself feel better when you had been hurt or felt bad. Some examples of self-soothing include playing with your dog, favorite doll or toy truck.
As an adult, it's easy to forget how to self-soothe in a healthy way when feeling uncomfortable, upset, anxious or irritated. A lot of times, unhealthy self-soothing techniques are the quickest and easiest way to feel better, however it doesn't last long. Some examples of unhealthy self-soothing include:
There are healthy ways you can self-soothe as an adult. Try any of these 10 self-soothing techniques to feel better about yourself or any situation.
Each day you can help yourself feel better by doing many good things that don't involve self-harm, overeating or excessive use of alcohol or illicit substances. Do something fun, creative, uplifting, interesting and exciting to self-soothe.
People who are critical of others point out others perceived flaws. Many of us have grown up with painful criticism. Painful criticism can be toxic to anyone’s well-being. Being criticized as an adult can trigger suppressed pain and as a result, one either withdraw themselves or lashes out on others. Either action is counterproductive to one’s well-being.
Sometimes, painful criticism can trigger shame causing one to revert back to the hurt child who could never do anything right. Shame can also be an extremely painful emotion. When shame is triggered, some people find ways to not feel such as cutting, overeating, or using illicit substances. Shame can feel very threatening as it dysregulates the nervous system. Practice mindfulness by noticing it, allowing it some space and realizing when it has arisen. Understand that you are not the shame.
You have no control over how others perceive you. You do have control over how you react and view yourself. Find your inner strength and accept your lovely, unique human flaws. Here are 9 key ways to building mental strength in the face of criticism:
People are going to have their own opinions no matter what. In the end, yours is the only one that matters!
There are many things in life we try to control like what other people do, say and feel about us. Sometimes, we internalize these things.
There are also times where we can't control the things we can because we struggle when it appears as though everything is falling apart in the middle of a life-storm. We then find ourselves in a flight or flee response. But, even in difficult times, we can get through life-changing events.
As life happens, try to be honest for what’s true for you. Remind yourself, you have power no matter the circumstances that comes your way and you're not alone. With the help of a therapist, you can cultivate a meaningful, fulfilling and compassionate life for yourself.
Here are 12 ways therapy can be helpful in navigating life. Therapy can teach you how to:
I encourage you to think of ways therapy can be helpful for you.
We all have experienced stress, anxiety, depression, grief or relationship problems at some point in our lives, right? Many of us have friends or loved ones who are suffering right now and could benefit from therapy. Suggesting to a loved one or friend they need therapy can sound offensive and make them feel as if they are being criticized.
Do you know how to recommend therapy to your loved one? Here are 6 ways to recommend therapy to your loved one:
Don’t let your loved one or friend suffer in silence. Express to them that therapy is not replacing your relationship with them. If they decide to not go to therapy, it's their choice and you did your part. If the relationship is becoming harmful to you, reevaluate your boundaries with them. You might want to examine if the relationship is worth continuing. Remember, we all can benefit from therapy!
Help.org is an organization that provides people with trusted, real-world, evidence-based health and wellness information from healthcare providers and professionals. Help.org delivers relevant and digestible information that puts health and wellness into context in peoples’ lives.
Right now people are more isolated than normal, which adds another layer of complexity for those struggling with addiction. Social frameworks that usually exist to provide a supportive presence or accountability are crippled. Meanwhile, COVID-19 related life changes and stresses are compounding, likely leading to or furthering substance abuse and addiction.
In order to provide support during these challenging times, please check out the following resources! The resources provide comprehensive information on the various faces of addiction and how to get help. It is written for both individuals who are struggling with addiction at any phase, as well as concerned friends or family members that are looking for information to educate themselves or to share.
It’s completely normal to be experiencing a wide range of emotions like:
Provided by the Wellness Society thewellnesssociety.org/
Holly Sawyer, PhD, MS, LPC, CAADC, NCC
As a therapist, I am constantly finding ways to evolve not only professionally, but as a human being. My evolving process is holistic – physical, mental, emotional, social, and spiritual. Being mindful requires being present, living in the now and sitting with whatever emotion you’re experiencing. It can be based on something you perceive as negative or positive at that moment.
Not practicing mindfulness can push your mind to wander between the past and future instead of focusing on what is happening right in front of you; the present. This can trigger unproductive, negative thoughts and possibly negative behaviors.
For example, went on a job interview and left feeling like you aced it. Your mind begins to think about the future and all the good benefits the new job can bring. A couple of days goes by and you hear nothing from the hiring manager or HR. Your mind now goes to the past, replaying the interview and asking yourself “what did I do wrong?” because you really wanted “this” job, and your emotions are running high from not knowing if you got the job or not. Now, you start to retreat, ruminate over the interview, and isolate with your negative thinking without having all the facts. When you’re in a negative thinking pattern, it can be hard to be present in your life, flexible in your thinking or not controlled by your emotions.
When you find yourself in this or any related situation…
These things are definitely easier said than done because the mind can wander! What you may find helpful is venting to a nonjudgmental friend &/or instantly write your thoughts down. Every day, 3 things you are grateful for. This can also help you stay present.
For every negative, find a positive. Focusing too much on the future causes worry and staying in the past creates guilt and/or regret. None of these emotions add to your well-being although pain is a part of life. However, mental, and emotional pain can be reshaped by practicing mindfulness.
No one can change what happened yesterday, and tomorrow is not promised. Constantly going between the past and future can be draining and daunting. You deserve peace within your body, mind, and spirit.
How mindful are you? How will you practice mindfulness?