Author: Contributor

Many people suffer from chronic pain such as back pain or due to a remaining pain after recovering from traffic or sports accidents. Though there are several options to reduce pain, there is an increasing trend to resort to powerful drugs to control and relieve the constant discomfort. People who use strong pain medications such as opiates to treat chronic pain usually do so for a prolonged period of time. Because of the nature of the opioids, it creates the potential for drug dependency, drug abuse and addiction issues.  

This situation creates a vicious cycle with dangerous consequences. For example, patients trying to overcome their addiction problem can’t get treatment for their pain since most of the effective pain medications are prone to cause addiction. This in turn can jeopardise their addiction recovery since the patient tends to look for pain relief in the same addictive substances they need to get away from.

It is also difficult to quickly stop the drug usage because sudden discontinuation of opiate usage causes withdrawal symptoms to trigger. 

The good news is that under proper medical supervision, the symptoms associated with opiate withdrawal along with treating pain are manageable with proper professional support.

A new study based on the psychological theories of pain shows the potential for patients who have addiction issues along with chronic pain to get relief from a non-drug approach. This method uses a combination of behavioral therapy and social support. It helps the patients to manage their pain without painkillers thereby avoiding the addiction risk. 

Here are the details of the study: 

This study led by Mark Ilgin at the VA Center for Clinical Management Research, Veterans Health Administration, Ann Arbor, MI, USA tested the efficacy of a psychosocial pain management intervention. The intervention, called ImPAT (short for improving pain during addiction treatment), combines pain management with counseling and education to manage pain without substance use.

In the study, 55 veterans participated in 10 weekly sessions using ImPAT receiving pain-focused care along with addiction treatment. Researchers found differences in the treatment group and control group who only received addiction treatment. 

Even though both groups had similar use of medication for addiction treatment, veterans who received this pain-focused care through ImPAT found that the intensity of their pain decreased, their ability to function increased, and their alcohol use went down.

Results from this study are encouraging because the ImPAT approach has the potential to be easily and inexpensively adopted by addiction treatment centers and groups worldwide, through team members trained in standard psychological techniques. This could also be a break-through approach to help address the epidemic of addictions to opioids and other painkillers.

For more information about the study check out: A randomized trial of a pain management intervention for adults receiving substance use disorder treatment. https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.13349

Mindful Awareness in Body-oriented Therapy (MABT) is a method that combines mindfulness, manual and psycho-educational approaches. It is a type of awareness training that is anticipated to the capacity of the participants to understand and process the sensory information relayed by their bodies.

MABT was initially developed to help patients who feel disconnected from their bodies as a result of pain, traumatic experiences or chronic health issues. 

In the drug addiction treatment centers, the MABT approach has been tried as novel approach along with other substance abuse disorder treatments for better results. By combining mindfulness, manual, and psycho-educational approaches to teach introspection and self-care, MABT complements the traditional addiction treatment methods.

To understand the effectiveness of this new approach for the substance abuse treatment, researchers from the University of Washington studied in a large group of women in Seattle through a randomized trial using the mindfulness approach as an adjunct treatment.

In the study, while a group of 187 women participated in the standard treatment for addiction, another group received MABT also as a complementary treatment. Women in both groups were given general education and information sessions to ensure that MABT approach is the only difference between the two groups.  

To record the responses of the treatments, assessments were done at 3, 6, and 12 months from the beginning of the study. These included questions about substance use, distress, cravings, emotional regulation, mindfulness skills, and personal interoceptive awareness. 

The study led by Cynthia Price, Professor from the University of Washington School of Nursing concluded that women who received MABT training relapsed less to drug and alcohol use as a result of learning to attend to their bodies by applying the skills for better self-care.

The success of combining the MABT approach with the regular addiction treatment is attributed to the knowledge that often people suffering from addiction get trapped in the habit of numbing problematic emotions, rather than addressing them which in turn leads to reduced ability to process and work through challenges. The MABT method also takes into consideration one of the challenges of addiction where almost all systems in the body, including the brain’s emotional range, are disrupted. In this condition, the person lacks the ability to tune into their body’s needs to control them which makes cravings particularly dangerous and unpredictable. 

With the support of the mindfulness training, as shown in the study by Cynthia Price, patients  get the benefit of increased physical understanding and get in touch with their minds and bodies in new ways through identify feelings, urges, and points of tension. Essentially, listening to what their bodies are trying to tell them, they gain the power to regulate their own reaction to the cravings and urges that control the addiction.  

For more information about the study check out: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784109/ 

The first step in discussing alcohol detox is the understand the distinction between alcohol detox and alcohol rehab.  Alcohol detox is the process of managing the physical effects of withdrawing from the use of alcohol.  Alcohol rehab, on the other hand, helps the recovering alcoholic to live their life without the use of alcohol.

During detox, the body will experience a variety of symptoms as it rids itself of any alcohol that remains in the system.  This can take approximately 5-7 days, depending upon how serious the use of alcohol was.  The symptoms can be very severe and in 10-15% of cases will require medical supervision.  With this in mind, the safest route is to detox with medical supervision.  Among the more serious symptoms is delirium tremens, in which the body undergoes extreme shaking, along with fast heart rate and other symptoms.  Hallucinations can also be very severe and very dangers.

Why would somebody choose only detox and not rehab?  The answer is, actually very simple.  Detox may take a week or less, but rehab can take weeks or even months, depending upon the severity of the alcohol abuse and other factors, such as co-occurring mental health issues.  For a parent, to be gone for a week is something that can be explained, but being gone for months can be much more diffi

cult.  Further, the expense of a week in detox is much less than the expense of weeks or months in rehab.

It must be made clear, of course, that detox does not solve the entire problem.  If the victim of alcohol abuse participates in detox only, the likelihood of relapse is very strong.  Some kind of outpatient rehab is necessary if the person is to succeed in making the changes needed to maintain a sober lifestyle.  Whether it be professional therapy or a self-help group, the recovering alcoholic must learn the skills to manage their life without the use of alcohol.

Recovery from alcohol abuse can be very challenging.  Detox itself generally requires some kind of medical supervision and learning to live a sober life requires the support of counselors, therapists or others in recovery.  Nonetheless, recovery from alcohol abuse is vital.  The negative impact of alcohol abuse on the body is cumulative, getting worse as the disease progresses.  The sooner you quit, the better of you and those you love will be.  Don’t put it off for some nebulous day in the future.  Do it now, while you still can.

SAMHSA.gov has a very useful tool for finding treatment centers  You can find it here:  https://www.samhsa.gov/find-help

As noted in a previous blog, the Holiday Season can be a very difficult time for recovering addicts.  Guilt, shame and other challenges can have a powerful impact on the addict’s emotional state and weaken their commitment to recovery.  What is to be done?  There are some simple ways in which the addict can remain firm in the fact of great challenges.

First, the recovering addict must be especially vigilant during the holiday season.  Considering the many pressures the recovering addict is dealing with, they must be especially alert to the presence of triggers.  The addict must realize and be prepared for the reality that alcohol and other drugs can be even more prevalent during the holiday season.

Fourth, the support of others in recovery is vital.  It is too easy to let your mind wander down dangerous paths and begin to think that you can handle just one drink.  As many persons in recovery have learned the hard way, even one drink is far too much, because it’s never enough.  Keeping in contact with a sponsor and a recovery group can provide the individual with the support they need to resist their temptations.

It is also important that the addict make good decisions about how they spend their time during the Holiday Season.  An alcoholic, for example, may want to skip a gathering where most of those in attendance will likely be drinking to excess.  Visiting people with whom the addict previously used drugs is also probably a poor decision.  Overall, the recovering addict must be aware of their own limitations and weaknesses and not put themselves in situations where triggers and temptations will abound.  Telling yourself that you can handle the triggers may be the first step to a fall or relapse.

The holiday season should be a time of joy, companionship and family, and it can be.  The recovering addict who dwells on past failures and sufferings is starting down the path that leads to relapse.  Far better focus on the present.  Enjoy the companionship of family and friends.  Take a drive to see the lights and other decorations.  Savor the good things that the holiday season brings.  The past cannot be changed, so let it go.  Live in the now and focus on the positive.  Surrender the guilt and grief of the past and wallow in the love and joy of the present.

The holiday season is not a reason for sorrow, but for joy.  So, enjoy it!

For more information, please check out this website:  https://pubs.niaaa.nih.gov/publications/RethinkHoliday/NIAAA_Holiday_Fact_Sheet.pdf

Along with Thanksgiving Day, the winter celebration (Christmas, Hanukkah, Kwanzaa, etc.) and the New Year’s celebration are generally seen as times when families get together.  Usually, this is a good thing.  What happens, however, to a recovering addict who finds themselves surrounded by people they know they have hurt in the midst of their drug abuse?  Feelings of shame, guilt and grief can become very powerful.  In addition, drug abuse often begins because the user is dealing with mental or emotional pain from which they want to escape.  In simpler, terms, drug abuse is often an effort to escape the sufferings that are a part of daily life.  They drink to get away from the pain.

Family gatherings can bring this mental and emotional pain to the forefront.  The recovering addict may come to believe that his family and friends are being nice, but really resent having to spend time with a person who has caused them so much pain through their alcohol abuse or that they really don’t trust their recovery.  They’re just waiting for the recovering addict to go back to their old ways.

Another factor to consider is the simple reality that drinking addict beverages is a common part of the holiday season in most families.  A glass of champagne on New Year’s Eve, for example is almost a given in many families.  A glass of wine at dinner on Christmas is similarly common.  A glance through grocery store advertisements makes it very clear that these stores expect to sell a lot of alcohol during the holiday season.  What is the recovering addict to do when they find themselves in the midst of so much alcohol and surrounded by family friends who are all enjoying a drink of some kind?  Combined with the guilt, grief and sorrow that the individual is already coping with, it may become overwhelming.

Other factors can also lead the recovering addict to resume drinking.  Gathered with family and friends and witnessing the joy that they find in their children and grandchildren, may grieve the reality that they will likely never know those joys for themselves.  As the recovering addict reflects on past holiday seasons and remembering people who have since passed away may become overwhelmed by grief that these loved ones never had a chance to see them in their recovery.  They may even believe that these loved ones held them in contempt and dislike when they passed away.  Seeing no opportunity to apologize to these loved ones, the recovering addict is filled with guilt or even self-hatred.  They grieve over the harm they have caused and despair of redemption and forgiveness.

Here’s a website that can help family and friends support a recovering addict during the Holiday Season:  http://www.nj.gov/health/news/2017/approved/20171120a.shtml