Starving for Knowledge

When someone we love or we ourselves are caught up in addiction “starving” is an applicable word. We are starving for time, because we or someone we love is living a very risking and dangerous life. We are starving for money. Helping someone fighting addiction is costly, and the lifestyle brings a lot of financial stress. We are desperately starving for knowledge because the more aware and informed we are the more effectively we can make choices that could save our loved one’s life, or our own. Today I want to share a few ideas I wish someone told me the heartbreaking moment I discovered my daughter was addicted to heroin.

Since learning on July 17th 2016 that Lauren was fighting an addiction to heroin, there has been a notable shift in the approach to the recovery and treatment of addiction. This is a good thing and I hope change and progress continues.

A word you will hear mentioned a lot is “evidence” based treatments. It simply means that these treatments are ones that have properly conducted studies with supporting data that demonstrates they can work.

One such treatment that may be misunderstood today is MAT (Medically Assisted Treatment). Some of the better-known medications used in this form of care are: Methadone, Suboxone, Vivitrol. There are many variations of these brand names. The care plan is not fully “evidence” based unless it is combined with behavioral counseling for a “whole patient” approach. When this is happening, it is known as Medication Assisted Treatment and quite effective.

A common response to the idea of someone fighting an addiction using medicine to help them is “Isn’t this just trading one drug for another?” This must be a personal decision for each individual and family, but the reality is that this form of care can help a lot. The physical elements of addiction diminish relatively quickly, but the psychological effects can go on for many years. When administered properly these medications can help in reducing cravings and provide motivation to not use heroin or other drugs. These medicines give the individual time to learn and put in practice more effective coping skills for life. As I mentioned above these medications should always be administered with the support of good counseling to truly help and eventually stop.

So, what about the evidence? One study performed in Baltimore over a fifteen year period demonstrated a reduction of 37% in overdoses during the study period. You can read a summary of the study from 1995 to 2009 here . These medications are not substituting one drug for another since they do not provide a high but rather the medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery. That process often takes more than three years

While at an addiction symposium in our state last weekend, someone asked me what form of treatment was most effective for LaLa (Lauren). That is an excellent question and needs to be answered for each individual. We are all different, the reasons we end up addicted vary, greatly! Many believe that it is often an inappropriate response to pain in life, and even in that, we all have different tolerances to pain. The point is that different people respond to different types of treatment. For LaLa, the most effective means of care was with an individual addiction counselor in Shelton, CT . She made great strides in helping Lauren, but even with the counselor’s success, once she started to get to the issues driving Laurens addiction, Lauren pulled away. That’s natural, pain makes us flinch. The last few weeks of Laurens life Nereida and I spent a great deal of time encouraging her to go back to the counselor, sadly, my baby girl just ran out of time.

Another form of treatment is a residential program, usually 28 to 90 days. Many faith based residential plans are up to one year. If a loved one facing an addiction is lapsing often and been in and out of treatment the longer they are in a residential program the better.

Sometimes people cannot afford to leave their family or work for thirty or more days. A great alternative to residential treatment is Intense Outpatient Programs (IOP’s). These programs provide many of the same benefits as residential programs without having to live at the facility. Some of them may be five days or evenings a week, depending on the individual in treatment. For Lauren this was a good option. After Lauren passed away, several documents from her medical records revealed that she had a great fear of Nereida, her mom, or I dying while she was away from us. Although we wish someone had told us that, it is true that a fully monitored environment, like residential treatment may keep the addicted person alive. That was the main reason we encouraged Lauren to go to the last residential treatment she was in, to literally keep her alive. We had begged the last hospital LaLa was admitted to for an overdose not let her leave. You can read that story in the post “The Dangers of Being Alone” .

Another well-known treatment for families and individuals are groups, which are very effective for some people. When we think of this instantly Alcoholic’s Anonymous and Narcotics Anonymous come to mind, these do work well for some people, I have several friends who have been drug free for more than 20 years through this support system. AA and NA are not evidence based by the very nature of their structure, anonymity, but that does not mean they cannot work for your loved one. Generically this type of treatment is often referred to as twelve step programs. There are hybrids of twelve step programs that are evidence based because of the tools they use and teach. One of these is called Smart Recovery.  They offer group meetings that are led by licensed counselors using evidence-based treatments like Motivational Interviewing, CRAFT, Dialectical Behavior Theray (DBT), and Cognitive-Behavioral Therapy (CBT) Group. A great place to learn more about these treatments is The Center for Motivation and Change .

Another very common term you will hear in treatment is, “dual diagnosis” and “co-occurring” disorders. This means the person is facing not only an addiction, but the addiction may be driven by a mental health issue. Many experts say that over fifty percent of people battling addiction are also suffering from a mental health issue. Some cite even higher percentages but there comes a place where it is difficult to assess how much of the mental health disorder is resident or coming from the effects of long-term drug use. This is very important because many treatments may not be treating the mental health issue, they often are only medicating it. I am not a doctor or psychologist, but I feel there are few places that really treat co-occurring issues with counseling and medication. Thankfully great progress is happening regarding dual diagnose, one center in our area doing this well is the McCall Center in Torrington, CT. I had the chance to listen to and speak with the Executive Director, Maria Coutant Skinner, from McCall Center and was very impressed by her compassion and understanding of people facing addiction and mental health issues as well as her insight into the direction treatment needs to go moving forward. If your loved one is fighting an addiction co-occurring with a mental health disorder it is important to ask lots of questions about how that will be addressed.

Another resource for individuals fighting addiction, or significant others that love someone facing addiction are recovery coaches. This is a developing segment of treatment and recovery that is finding its place and showing itself to be extremely effective in saving time, money and quickly gaining the knowledge we need for informed decisions. I truly wish I had a recovery coach when we were trying to help LaLa. Recovery coaches do not provide treatment, they offer help to families based on the families current situation, then informing them of the array of options available to them in to get help for ourselves or someone we love. A big challenge families seeking help is a very confusing and complicated system. Recovery coaches can make it a lot easier to navigate.

This weeks featured image is by Brooke Shaden it is called “Starving for Knowledge”.

Several months ago I completed training with Dr. Michael Pantalon, Senior Research Scientist at the Yale School of Medicine and a clinical psychologist with his own practice in New Haven CT, called The Center for Progressive Recovery as a recovery coach. I have been working with families in the Connecticut area to help them make effective decisions in their own or a loved one’s care. Wherever you are, if I can be of any help to you or your family in person, skype, or phone please email me at v.provenzano@strategies4recovery.com