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person taking pillsWith the opioid epidemic making headlines every week, it’s understandable to be worried about the risk of addiction if you or someone you love has been prescribed opioids. However, you must remember that opioid medication does play a vital role in the management of chronic pain for certain individuals. It does these patients a disservice when a misunderstanding of addiction results in unnecessary withholding of opioid medications.

Chronic Opioid Use as a Last Resort

Although opioids are often used to control short term pain from surgery or injuries that are expected to fully heal within a specific period, this type of use is considered low risk. The primary concern in terms of addiction is the chronic use of opioids over an extended period of time.

According to the American Academy of Pain Medicine, chronic opioid therapy (COT) is only appropriate for use if the patient suffers from moderate to severe pain and more conservative measures have not been able to provide sufficient relief. This might include:

  • Non-opioid pain relievers
  • Physical therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Ultrasound
  • Therapeutic massage
  • Chiropractic care
  • Mind-body techniques such as mindfulness meditation

Although the perception of pain can be subjective, there is no doubt that living with chronic pain greatly affects one’s quality of life. Pain limits the ability to engage the activities of daily living and increases a person’s risk for developing anxiety and depression. For this reason, healthcare professionals must struggle to find a middle ground between limiting access to addictive opioids and providing relief to sufferers of chronic pain.

Dependence Isn’t Necessarily Addiction

The term dependence means that the body has physically adapted to having a steady supply of a substance in the system. When the substance is no longer being used, withdrawal symptoms such as headaches, nausea, vomiting, diarrhea, fatigue, and restlessness can occur.

Dependence and addiction are often used interchangeably in reference to opioid painkillers, but it’s important to note that the two are not always the same. Although someone with an addiction is likely to also be dependent upon the opioid medication, it’s possible to be dependent without being addicted.

Dependence can occur whenever a medication is being taken for a long period of time, even if it is used precisely as prescribed and isn’t considered addictive. For example, patients can develop a dependence when they take antidepressants to treat chronic depression even though these medications aren’t thought of as addictive. If they wish to stop or switch to a different drug, tapering the dose helps to minimize the severity of withdrawal symptoms.

Distinguishing Between Tolerance and Disease Progression

Tolerance refers to the need to increase a dosage of a substance to experience the same effects due to prolonged use. Tolerance is often thought to be a warning sign of a substance use disorder, but chronic pain patients may confuse tolerance with disease progression. For example, someone taking opioids to cope with cancer pain may require higher doses due to the progression of the cancer even if he or she takes the medication as prescribed. Osteoarthritis is another of a condition where pain levels can be expected to increase over time as the disease progresses.

It can be difficult for the layperson to determine the difference between a patient developing tolerance and someone who is experiencing more pain due to disease progression. This is why careful monitoring of opioid use is necessary.

Seeking a Substance Abuse Evaluation

The fact that someone has been using opioids for a long period of time doesn’t necessarily mean he or she has developed an addiction, but a substance abuse evaluation is in order if any of the following apply:

  • Lying about the severity of symptoms to obtain more medication
  • Seeing multiple doctors to increase availability of opioids
  • Borrowing, stealing, or illegally purchasing medication
  • Becoming defensive or angry when asked about opioid use
  • Mixing opioids with alcohol or other addictive drugs
  • Decreased performance at work or school due to opioid use
  • Withdrawing from family and friends to spend more time using opioids
  • Feeling powerless to control opioid use

It is important to remember that addiction can affect people of all ages, races, and socioeconomic backgrounds. It’s not a weakness or a character flaw. In fact, this form of a substance use disorder is considered unintended addiction because sufferers often originally took their medication exactly as prescribed.

If you or someone you love needs help treating opioid addiction, St. Joseph Institute for Addiction provides a peaceful and serene environment in which to take the first steps towards recovery. Detox, counseling, holistic treatments, and access to aftercare resources provides clients with the tools they need to set a foundation for lasting sobriety.  

By Dana Hinders

To learn more about our programs, please visit our website.

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Man using a cell phoneBeing in recovery means rethinking every aspect of your daily routine, including how you use social media. Your time online has the potential to either be a tool for sobriety or a threat to the recovery process.

Advantages of Social Media in Recovery

In some cases, social media can be an aid in the recovery process. Social media might be beneficial if:

  • You use social media to stay connected to family and friends who live far away but want to help support your recovery.
  • You use social media to get support when you’re struggling with specific issues related to your sobriety.
  • You participate in private accountability groups.
  • You read and share information about the nature of addiction.
  • Social media allows you to pursue specific hobbies that relieve stress, such as following craft sites to get ideas for new projects or swapping recipes with a cooking buddy.

Disadvantages of Social Media in Recovery

Social media may seem like an inescapable part of modern life, but unhealthy online behaviors can be a threat to your sobriety. It might be wise to limit your use of social media if:

  • Seeing pictures from parties or memes about drinking and drug use triggers cravings.
  • You’re being contacted by people who aren’t supportive of your recovery efforts.
  • You feel depressed and discouraged when you compare yourself to posts in your newsfeed.
  • You’ve become a victim of cyberbullying.

Substitute addictions or addiction replacements are a common problem in the early stages of recovery. This involves replacing alcohol or drugs with destructive behaviors such as binge eating, gambling, compulsive shopping, or Internet addiction.  If you haven’t addressed the unconscious emotional issues contributing to your addiction, you may be at risk for developing a substitute addiction to social media.

Not all Sites Are Created Equally

Not all social media sites are used in the same way. For example, LinkedIn is a valuable tool for a job search after leaving residential treatment and Pinterest can help inspire you to find new hobbies. However, one recent study found that cyberbullying is most common on Instagram, Facebook, and Snapchat.

If you’re looking a positive social media environment, you may find it more useful to gravitate towards specialized networks for people in recovery. For example, Sober Grid is a social networking app for people in recovery that uses your smartphone’s GPS capabilities to let you connect with people near you who are also in recovery from drug or alcohol addiction. You can use the site to find a ride to a 12-Step meeting, get help dealing with cravings, or find people with similar interests.

If you’re struggling to figure out how to socialize with drugs or alcohol, Meetup.com may be able to help. This site lets you search for local book clubs, workout buddies, cooking groups, and any other special interest meeting you can imagine. If you’re not sure what type of sober socializing you’d be interested in, the “Popular Meetups Nearby” feature lets you browse through what’s going on in your area.

Dating in the early stages of recovery is typically discouraged. However, if you’re feeling confident in your sobriety and ready to start searching for someone special, Sober can help. This dating site caters to sober singles, so you can connect with people who share your commitment to recovery.

Saying Safe on Social Media

When you’re using social media as a recovery tool, consider the following safety tips:

  • Popular social media sites are often targets for fake news, financial scams, and/or identity theft schemes. Review USA.gov’s online safety tips to learn the best ways to protect yourself.
  • Employers often check social media for information about prospective candidates. If you’d prefer to keep your recovery private, consider using an alias and avoiding posting photos or personal details that may confirm your identity.
  • If you’re arranging to meet a person you’ve connected with online, always plan to meet in a public location. Bringing a trusted friend along or informing someone of where you’re going and who you plan to meet are also good safety precautions.

Making the Decision that’s Right for You

Deciding what role social media should play in your recovery takes a great deal of self-reflection. You need to be honest with yourself about your online habits and how you feel after using social media. If you’re undecided, consider doing a “digital detox” where you abstain from social media for one week, one month, or another predetermined time period. Take notes on your thoughts and recovery progress during this time, then use these insights to figure out the approach that’s right for you.

By Dana Hinders

To learn more about our programs, please visit our website.

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Two men talking“Continuum of care” is a phrase that’s commonly used in addiction treatment, but many people seeking help for a substance use disorder find themselves wondering exactly what this means.

Essentially, continuum of care refers to having a detailed plan for what services a person needs to help him or her stay sober after seeking residential treatment. This is a system where clients are guided and monitored over time as they progress through all levels and intensities of care. In some cases, this approach may be referred to as a “Recovery-Oriented System of Care” (ROSC).

There’s No Quick Fix

The most common misconception about addiction treatment is that detox and a quick inpatient stay are all that is needed to ensure lasting sobriety. Unfortunately, treating addiction is much more complex.

Addiction is widely recognized as an illness, but it’s not like getting strep throat and having your doctor write a prescription for an antibiotic. It’s more like being diagnosed with diabetes and having your doctor recommend diet changes, exercise, and blood sugar monitoring in addition to your medication.

You can live a full and productive life after being diagnosed with a substance use disorder, but you need to stay on top of your recovery. If you become complacent, you put your sobriety at risk.

Personalized Care Is Essential

No two people with a substance use disorder are exactly alike. Someone who has been abusing drugs or alcohol for many years has very different needs than someone who has only recently developed an addiction. Exposure to trauma, the availability of family support systems, and the presence of a co-occurring mental health disorder are also examples of factors that can widely influence what services are necessary after residential treatment.

Depending upon the client’s specific needs, some services that may be recommended as part of the continuum of care include:

  • Ongoing outpatient counseling
  • Intensive outpatient treatment that offers a more intensive counseling experience but still allows the client to return home each night
  • Sober living homes that serve as an interim step between residential treatment and living independently
  • Participating in 12-Step groups
  • Participating in alumni events sponsored by the residential treatment center
  • Online recovery education programs

Steps in the Continuum of Care

Every case is a little different, but the general steps in the continuum of care are as follows:

  1. Assessment: Determine the nature and extent of the substance use disorder, as well as any chronic illnesses or co-occurring mental health conditions that would complicate care.
  2. Treatment Plan: Develop an evidence-based plan for addiction treatment.
  3. Treatment: Use detox, counseling, and holistic treatment to build the skills necessary for long-term sobriety.
  4. Evaluation: Determine how successful treatment has been in helping to break old behavior patterns.
  5. Case Management: Develop a plan for ongoing care, such as intensive outpatient treatment or sober living.
  6. Extended Care: Provide the services necessary to ease the transition into independent living while addressing physiological, psychological, and spiritual concerns.
  7. Monitoring: Periodically check in with the individual to make sure there are no areas of concern.


Notice that the level of support gradually decreases as the client becomes more adept at practicing the skills necessary to manage the chronic nature of a substance use disorder.

Easing the Transition to Independent Living

Although the specifics are different for each individual, the goal of continuum care planning is to ease your transition from the structured environment of residential treatment to an independent sober life.

Your care team will help you determine what support you need to practice applying the skills you’ve learned to everyday situations. This includes:

Your continuum of care plan can help address specific goals you may have for yourself as you embrace the possibilities of a life without drugs or alcohol. For example:

Providing a Roadmap to Recovery

It may be helpful for you to think of the continuum of care in addiction treatment as a roadmap to recovery. You still need to do the work of building the skills necessary for sober living, but this approach provides you with a detailed plan and actionable steps to guide the process.

However, this does not mean that your continuum of care plan is set in stone. If you suffer an unexpected setback, the plan can be adjusted as needed. There’s no criticism or judgement, only a sincere desire to help you find the best way to move forward with your recovery journey.

By Dana Hinders

 

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