Addiction care is expensive, and you want the very best care at the best value for your loved one. You also want a good fit and the best possibility for a good outcome. Treatment centers are not all alike, nor do they have the same services or philosophy. Personality matters, too.
Rehab used to mean professional healthcare therapies to improve, maintain, or restore physical strength, cognition, and mobility. Usually after illness, injury or surgery.
Advice to the younger, more codependent me from the stronger, more independent me – thanks to nine months in the rooms of recovery. When your loved one is in Detox:
Treatment referrals can be problematic. If you have been referred to a substance abuse treatment center, there are things you need to do to ensure your safety or the safety of your loved one. First, consider any referrals from friends, your physician, an online website, or an ad as a starting point for research, only. It doesn’t matter who refers you to a center, you have to research the facility and make sure it’s a good fit for your needs.
Steps to Stay Safe Even if You Have a Referral
Before choosing a facility or giving any person or center your information be sure:
- The facility is upfront about costs (including urine screenings and other tests), insurance deductibles, copays, and other out-of-pocket expenses.
- The facility has a policy about patient referrals and does not engage in patient brokering by paying for patients.
- The facility is accredited. Most facilities want to brag about accreditation and will have a certification from the Commission on Accreditation of Rehab Facilities (CARF) or the Joint Commission Accreditation for Addiction Treatment Gold Seal for Behavioral Health on their website and marketing material.
- The facility has full time credentialed addiction counselors on staff, not just staff that is trained in recovery or related field. And the facility website has photographs of the staff with bios and contact information.
- The facility is equipped to handle any co-occurring disorders and treatment for these disorders are integrated into the program curriculum or tracks, and staff can assess, identify interventions, and prescribe medications.
- The facility practices evidence-based treatments and life-coping skills such as through:
- Acceptance-commitment therapy
- Cognitive behavior therapy
- Community Reinforcement and Family Training
- Community reinforcement approach
- Dialectical behavior therapy
- Medicated Assisted Treatment
- Multi-Dimensional Family Therapy
- The facility is proud of their daily schedule and is eager to share it with you. You should see structured and supervised activities such as weekday programs, weekend programs, group counseling, individual counseling, support group, chores, and recreational activities.
- The facility offers options for family involvement such as education abuse and support.
- The facility has dedicated discharge planners and continuing care programs or mentors.
- The facility is dedicated to patient safety and have programs in place to deal with patient relapses that includes support even if it means transferring them to a detox facility or another program.
When someone you love is using opioids, the constant fear of an overdose is debilitating. However, there is a way to keep a sliver of hope at home in your medicine cabinet and it’s called Narcan.
Our nation is drowning in opioids. According to the CDC 100 Americans are dying each day from an opioid overdose. As a result, more and more people are first responders to this type of health emergency. Because opioids slow your system down and affect the body in five key ways, bystanders must respond quickly. Even when taken as prescribed, opioids can be dangerous. If someone you care about is using an opioid, it’s important to know what an overdose looks like and what you can do.
This type of overdose requires action – not sleeping it off, hoping for the best, or giving it time.
Just remember: “S – B – S – B – S” spells overdose. Action is required.
- Severe sleepiness
- Breathing slowly
- Small pinpoint pupils
- Blue fingernails and lips
- Slow heartbeat
Too high an opioid dose causes respiratory arrest. In an opioid overdose, the body needs help breathing. This is markedly different from other emergencies where chest compressions are given to keep the blood flowing through the body. A person having an opioid overdose is unable to breathe for themselves and needs rescue breathing immediately.
Here are three tips to safeguard your loved one in an emergency.
1. If It’s An Opioid Overdose, Start Rescue Breathing
2. Keep A Dose Of Narcan On Hand
Narcan, also known by its generic name, naloxone, is an overdose reversing drug. Narcan can be given as a nasal spray or by an injector. If you are taking a prescribed opioid pain medicine, have Narcan on hand just in case. If you have a loved one who struggles with substance use disorder, Narcan should be part of your home first-aid kit. Even if your loved one is doing well, relapses are often a part of this disease process. (Click here to learn more about what Narcan is and how to get it.)
3. Trust Your Gut – Call 911
In a crisis, every second matters. A recent CDC study found 83% of overdose victims needed multiple doses of Narcan. Always have someone call 911 first then begin rescue breathing immediately.
Are you afraid you might be addicted to an opioid? Recovery Guidance can help you find choices for treatment. Click here to take our self-assessment.
Is Methadone Dangerous?
The FDA schedules drugs to classify their risks vs. benefits. Risky drugs without redeeming benefits are banned from medical practice; these are schedule one drugs. Methadone is a FDA schedule two drug, and it’s in the same class as:
Drugs like codeine cough syrup, a schedule five drug, are less risky.
What Does It Treat?
First, it’s a narcotic pain reliever that lasts longer than heroin and short-acting narcotics like Percocet and Oxycodone. Second, it’s also used in Medical Assisted Treatment (MAT) because it is an opioid replacement medication. In clinics, a person addicted to heroin or other narcotics takes methadone instead of the drug that gives them a “high.” Doctors then gradually lower dose the dose.
Why Is There So Much Controversy?
The Pros: Methadone reduces the drug cravings and harsh withdrawal symptoms. It helps lower the risk of relapse. About 4,000 inmates at Rikers Island in New York have taken it and shown promising results. Dr. Lipi Roy is the former chief of addiction medicine for New York City jails. He explains,
“People who are on this medication, when it is prescribed and used appropriately, and people are monitored, they not only live, they can thrive.”
The Cons: Federal laws dictate the med must be dispensed from a clinic. Some of these clinics are run as pill mills, and prescribing patterns vary from clinic to clinic. It’s a long-acting opioid, so patients who take too much risk an overdose. In fact, in 2014 Methadone was on the list of ten most deadliest drugs. Further, some traditional 12-step programs are critical of methadone use because they feel people are substituting one addiction for another.
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A Recovery Guidance Exclusive By: Dr. Gail Dudley
Gail Dudley, DO, MHA, FACOFP, is board certified in four areas of medicine. For more than twenty years Gail Dudley had a busy family practice with a hospital and nursing home component. Dr. Gail now works full time for a company that has contracts with Medicare and Medicaid to evaluate fraud, waste and abuse in the medical world.
Some people who become addicted to opioid pain relievers begin taking the drugs after painful surgeries. Which surgeries increase patients’ addiction risk?
In 2016, doctors handed out so many pain pills prescriptions that 3.3 billion pills went unused. Research firm, QuintilesIMS Institute for Healthcare Informatics, ties this factor to the current American opioid epidemic.
Some Surgeries Carry A Bigger Addiction Risk
Colectomy was the most dangerous risk with 18% of patients becoming long-term users, according to QuintilesIMS. Knee replacement patients came in second at 17% of patients who took the drugs. Hernia and hysterectomy surgeries showed to be lower-risk with about a 7% risk of misuse each. Women, overall, showed to be particularly vulnerable.
According to the report, almost three million Americans took opioids after surgery. Doctors prescribed pain meds to one in 10 post-operative patients for three to six months after their first dose post-surgery.
“The bigger the incision, the more painful something ought to be,” anesthesiologist Dr. Eric Sun told HuffPost. The colectomy is often an invasive surgery that removes part or all of the colon. He also said that “knee surgeries tend to be very painful,” and that “people complain about those.”
Refilling Script 10 Times Is A Warning Sign
A study published in Jama Internal Medicine defines chronic opioid users as:
Those who fill 10 or more prescriptions after a few months have passed since their surgeries.
Knee replacement and open gallbladder surgical patients had the highest risk for developing opioid addictions based on Jama’s research.
Who Is To Blame?
Some may blame doctors as the root cause of addiction through excessive prescription-writing, but post-op pain is real and doctors are required by law to compassionately treat their patients for their pain.
“There’s a lot of other things you can give that can help, but at the end of the day, if someone is in a lot of pain, opioids are part of the mainstay,” Sun said.
“That’s sort of the next phase in all this research,” he said. “We know there’s a problem. The question is: What do you do about it? How do you keep these people from transitioning to long-term use?”
Content Originally Published By: Ariel Scotti @ New York Daily News
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