COVID-19: How to Cope in Recovery

As the United States braces for an unprecedented time of ‘social distancing’ due to coronavirus disease 2019 or COVID-19, a few other countries, according to the United Nations (UN), are now seeing a decline in cases from this fast-spreading disease. And while the U.S. is just beginning to see the impact of this virus, it’s vital to remember that just as this is beginning to slow in China and South Korea, it will also pass for us.

As reported by the Centers for Disease Control and Prevention (CDC) on March 19, 2020, there were more than 10,000 confirmed cases of COVID-19 and 150 deaths with numbers projected to rise.

And while these numbers and projections can be alarming, it’s essential to remain calm, avoid feeding into fear, and act in the most effective manner to ensure not only your own health and well being but that of our nation. Solidarity is more important now than ever.

COVID-19 and Sobriety

During this time of uncertainty and stress, those in recovery will also face these same fears and stressors. However, for those in recovery they may also face the temptation to drink or use their substance of choice to help cope with the fear, anxiety, and constantly changing world. If you or someone you love is in recovery, it’s important to learn more about how you can stay sober (or help those you love find the resources) during these trying times.

One of the most important things to remember is that taking a drink or using another substance will never make things better but it will most definitely make things worse.

For most of us, daily life looks a lot different today than it did just weeks or months ago. From schools being closed and college students doing all classes online to working from home or being out of work altogether our landscape today has drastically changed in just a few short weeks.

And while these changes can be scary, particularly for those who are in recovery, it’s important to know that staying sober is always a choice. Life will always present challenges to sobriety and being able to adapt and find the support you need will make the difference.

Support is essential for almost anyone living in recovery from alcohol or another substance to continue to stay sober. Many find support groups both in and out of treatment very helpful in navigating the road of recovery.

If you are in recovery, have a loved one in recovery, or are considering getting help there are resources to help you on this journey even in the midst of this pandemic. At Futures Recovery Healthcare we continue to work daily to help those continue on their road to recovery as well as those who are ready to get started in sobriety.

What’s Changed in Recovery Support from COVID-19 Pandemic

While each day more states begin or expand mandatory ‘social distancing’ and the closing of non-essential businesses, the once so commonplace sobriety supports and resources are changing too. However, it’s important to understand the support groups for sobriety and treatment centers are still active and can provide the treatment, fellowship, and support needed for those in recovery.

For many, working is now all from home, for others work has halted altogether. Those with children are finding themselves at home with kids and often their significant others. Even college students are now back at home. These are all major changes from the norm to which we’ve become accustomed.

Churches, retail stores, movie theaters, entertainment venues have in most states ceased all activities. This can pose many challenges for not only those in recovery but everyone in general. As a nation, we are used to being on the move and rarely slowing down – particularly to this type of at-home 24/7 pace. For the time being, life as we know it has changed.

Support groups such as the Twelve-step programs, Celebrate Recovery, and Refuge Recovery are unable to hold in-person meetings as many churches and halls have closed. Some of these meetings are now being held online in virtual meeting spaces such as Zoom, Google Hangouts, or Skype.

If you are in recovery – especially early recovery – you may be struggling with all of these changes. Many treatment centers stress the importance of creating healthy, supportive routines in order to stay sober and enjoy life in long-term recovery. With all of the changes in the world as a result of the COVID-19 pandemic, most of our routines have changed rather drastically. This can put stress on everyone and it’s important to carve out new routines as soon as possible.

When there are additional stressors on people, those with addiction issues may first think to reach for a drink or substance to help them cope. This can increase relapses during this challenging time in our world.

It’s vital to remember that you can stay sober during this time. Successfully navigating this time of uncertainty and staying in recovery will make the challenges you face in the future that much easier to overcome in a healthy, positive – and sober – way.

The tools needed to stay in sobriety may look different, but it’s still very achievable. Here are some tips from experts in the field of addiction treatment you can immediately and easily adapt.

Staying Connected and Sober with COVID-19 Restrictions

Six Tips to Sobriety During a Pandemic

1. Connections
   One of the most fundamental pieces of staying sober at any time are the connections with other people in recovery. If you have been in a treatment center you most likely have phone numbers, social media connections, and emails of others you met there. Utilize these now. Pick up the phone, send a text, send a direct message (DM), or use Skype to get face to face contact. Talk to people not only about how you are feeling but see how others are doing, what tools they may be utilizing, and most importantly find out what you may be able to do to help others. Giving back is crucial at any time in recovery but particularly now.
2. Online Support Groups
   Many of the twelve-step programs already offered some online meeting options and today many more are now joining suit. Find the Twelve-step program that works for you and join. These meetings are being held in Zoom rooms and Google Hangouts. There are also twelve-step chat rooms that are open 24/7. Addiction treatment centers often have alumni groups that meet periodically during the year. If you were in a treatment center it is suggested you call them to see if they have set up online meetings for alumni during this challenging time.
   
3. Speaker Tapes and Sober Podcasts
   Utilize YouTube to listen to old school speaker ‘tapes’ from AA meetings. There is a wealth of AA and other twelve-step speaker tapes on YouTube which are proving to be very helpful to many in sobriety during this time. You can also search on YouTube or use the Podcasts app on your smartphone and find valuable talks on sobriety.
4. Gratitude Lists
   One of the most important ways to stay sober and positive in general is to make a habit of making a gratitude list every day. Try to write down three to ten things in your life to be grateful for today. It can be simple things like clean, fresh water to drink to bigger things like family and loved ones or your job. No matter what your circumstances are, there’s always something to be grateful for each day. Make it a habit to see the good in each day.
   
5. Prayer and Meditation
   Whether you are religious or spiritual or neither taking some time each day to quiet your mind and ask the universe, God, or your higher power to keep you sober and healthy can have immeasurable benefits. This time of being isolated at home is a great opportunity to start new healthy habits you can turn to anywhere. Prayer and meditation top that list.
6. Healthy Daily Habits
   When under stress it’s sometimes easy to let healthy habits go by the wayside. However, this is when it’s most important to engage in self-care and stay healthy in your body, mind, and spirit. Taking time to exercise; whether it is a walk outside, yoga, or hardcore cardio will help raise your endorphins (the feel-good hormones) and boost your mood.Look at what you’re eating and make an effort to incorporate more healthy fruits and veggies during this time of stress. When you put healthy food into your body your system is more able to deal with the chemicals being released from higher levels of stress.And while your mind may be racing and sleeping isn’t at it’s best, it’s vital to get at least seven to eight hours of sleep a night. If you are struggling to fall asleep or stay asleep try a guided bedtime meditation. These can be found on YouTube.There’s no doubt that today’s global situation can cause fear and concern. However, it doesn’t have to derail your sobriety or mental health. Use these tips to stay strong in recovery and come through this challenging period with renewed strength, hope, and sobriety.

If you have relapsed or are ready to get sober, Futures Recovery Healthcare is here to help. We are taking extra precautions during this pandemic to ensure the health and wellbeing of our current patients, our staff, and anyone new coming for treatment. Now is the perfect time to seek treatment for an alcohol or drug abuse concern. We can help. The most important step is the first step. Visit us online or call 561-440-6184 today.

Addressing First Responder Trauma

On Friday, January 24, 2020, Futures Recovery Healthcare sponsored a symposium to address trauma and the epidemic rates of mental health disorders and addiction experienced amongst first responders. This event was especially important given recent reports that at least 228 officers took their own lives last year. 

To hear our very own Cindy Goss discuss this topic more with Palm Beach i Heart Radio station WJNO, please listen here: https://wjno.iheart.com/featured/florida-news/content/2020-01-23-international-symposium-on-first-responder-trauma-amid-suicide-epidemic/

Providing Important Resources to Our Local Community

The above video is from local media coverage of our Community Resources event in partnership with the Tequesta Police Department.

Community Training: Proper Response to An Active Shooter Scenario

As part of our commitment to provide value and engage with the residents and families of Palm Beach and Martin Counties, we recently partnered with the Tequesta Police Department to host a valuable, free training on techniques to navigate active shooter scenarios. The training is referred to as ALICE (Alert, Lockdown, Inform, Counter, Evacuate) and our staff and concerned citizens were walked through each step of the acronym by experts.

Futures is proud to work alongside local organizations to promote any initiative aligned with growing awareness or knowledge of mental health issues. As a good neighbor, we continually seek ways to improve the lives and health of local residents.

To partner with Futures in the community, please contact Laura Kunz

The Ghosts of Christmas Past: Mindfulness and the Holidays

Written by Futures Community & Outreach Liaison Laura Kunz 

“The clock is running. Make the most of today. Time waits for no man. Yesterday is history. Tomorrow is a mystery. Today is a gift. That’s why it’s called the present.”
–Alice Morse Earle–

The sound of holiday tunes as you stroll through the mall, the twinkling lights as you drive through the neighborhood, the fresh smell of pine as you decorate this year’s Christmas tree. Perhaps these small joys were overlooked in life before sobriety or, as I jokingly say, in my past life. However, the world seen through clear and sober eyes looks very different and the holidays can look different too.

I remember my first Christmas without alcohol. I was only a few weeks sober and still a deer in headlights staring at my new life. “How can I not drink at Christmas?” I thought. Some of my best belligerent holiday blackouts were on Christmas Eve’s and Christmas Day Eve’s. Then, a week before I was supposed to fly home to Ohio, a college friend called from New York telling me one of our best friend’s mother passed away. The funeral was the week of Christmas. In recovery, opportunities to be of service and support others are essential. So much of a life consumed by addiction is self-centered. I changed my flight from Cincinnati to NYC, gently broke the news to my family in Ohio and I showed up physically and emotionally for my dear friend who had always shown up for me.

The next few holiday seasons didn’t grant me as much immunity from myself and from my past. It was difficult navigating through family dynamics, many of which were not changing as I changed. Running into old, high school friends in my hometown, finding recovery fellowship meetings and time to get to them, and experiencing a new romantic relationship with my now-husband and getting to know his family; All of this felt very overwhelming to me. Although I was sober and thoughts about alcohol were scarce and fleeting, I was still not fully present. I was allowing past memories and fear-based thought patterns and behaviors to control me. I was still missing the magic and joy of the holidays because my mind was either in the past or in the future. One of my former colleagues at Futures Recovery Healthcare used to refer thinking about the past or worrying about the future as “time traveling.” This is such a great description. It implies that I have a clear choice of where my mind is going to be. I have a clear choice of where I am going to be.

Five years ago, after I gave birth to my daughter, I really began embracing mindfulness, meditation and living in the “now.” As I searched to create moments of connection for my daughter, I began to connect more often too. Also, as a mom, my time for daily self-care and recovery maintenance became limited. Meditation was a perfect way to spend 10-20 minutes on myself each day. I remember the shift my mindfulness practice created was very evident during the holidays last year. Instead of fearing old family dynamics, hometown triggers, and the ghosts of my Christmas past’s, I began noticing and appreciating the small things. The smell of a holiday candle, the shot of cold air on my face on a Midwest December day, the sound of a cracking fire in the fireplace: I was aware of my surroundings and it gave me joy. I also had a heightened appreciation for family. I genuinely wanted to be there, sharing experiences, making memories and learning about each other in a deeper way.

If you are new to recovery, in long-term recovery or just open to giving the holidays a sober go, I have the following suggestions to help you stay present.

1. Look for the little things. Make a conscious decision to momentarily observe your surroundings. Even just a moment of awareness and connection can create a memory that you’ll cherish forever.

2. Try not to judge others or yourself. As you observe your surroundings and look for the little things, try to steer clear of making negative judgments. “She’s being rude to the waitress.” “He is drinking too much” or “I am underdressed.” “I am not interesting enough to talk to.” The most powerful mindfulness moments are those where are present and positive.

3. Just breathe. If family, friends or holiday traffic starts to irritate you, pause and take a deep, slow breath. Take another breath. Take a third breath. Let the moment pass.

4. Exercise or move your body. In recovery, there is a saying “move a muscle, change a thought.” If you’re stuck in the past or the future, obsessing over a person, place or thing or just bored, get moving. Stretch, your muscles, walk, run, lift weights; Choose a movement or exercise that you will enjoy.

5. Support others. Loving and supporting others feels good and who doesn’t like to feel good! Whether its twenty minutes listening to your elderly grandmother tell stories or helping your sister manage her four rowdy kids, look for ways to show love to the people you love.

6. HALT. If you’re in recovery, you are probably familiar with this acronym. If you’re not in recovery, this is helpful for you too- Hungry, Angry, Lonely, Tired. All four emotional or physical conditions can make a person very vulnerable and uncomfortable if not taken care of. Keep an eye on these four triggers as they make it difficult to stay positively connected to the present moment.

7. Hug. Hug people like you mean it! For many, the holidays are a time to see friends and family we may only see once each year. Furthermore, make the hugs count.

8. Laugh! Research has shown that laughter may reduce stress hormones and boost immune function. If nothing around you seems funny, remember this: Do not take life or yourself too seriously. If you look it loosely, you will feel it loosely and then the laughter will inevitably come.

9. Meditate. Take the breathing a step further and meditate. If you’re not in the mood to wrestle your squirrely mind, download an iPhone app to guide you through a meditation. I suggest the app Calm or Headspace. Even a 5-10 minute meditation will work wonders on your mood.

10. Stay sober. There is no easier way to remove yourself, and the joy, from the present moment than to take a drink or a drug. Whether you’re in recovery from a substance use disorder, wanting to abstain from alcohol, or work on your mindfulness practice, remember that a drink or a drug is a conscious choice to not be fully present. The holidays are packed with endless gifts of the moment. Don’t miss out!

The Dangers of Polysubstance Use

When addiction treatment professionals ask patients what substances they are using, they frequently get more than one answer. A considerable number of people who misuse substances typically consume more than one – taking them separately or combining them for a stronger high or a specific effect. Polydrug use often carries with it more risk than use of a single drug, due to an increase in side effects, and drug synergy. Futures Recovery Healthcare’s Medical Director, Dr. Gloria Dunkin, discusses her professional observations of polysubstance addiction in the below excerpt:

“In recent years the percentage of patients presenting with polysubstance addiction has increased dramatically.

Many patients augment their drug of choice with alcohol and/or a variety of prescription drugs, many of which were prescribed for legitimate reasons, the goal is to increase the intensity and duration of the primary drug’s effect. For example, patients might take an illegally obtained opioid in conjunction with muscle relaxers, benzodiazepines and gabapentin and top it off with alcohol.

Another dangerous practice is that of mixing cocaine with alcohol which initially enhances the euphoria derived from cocaine, this very dangerous practice leads to the production of cocaethelyne which builds up to toxic levels and can cause myocardial infarction, cerebral infarction or sudden death. Often a cocaine binge mixed with alcohol ends with the addition of heroin in attempts to balance off the negative effects from this dangerous combination.

The mixing of multiple substances means that on any given day a patient could inadvertently overdose, typically because their respiratory and or coughing reflexes are suppressed by a synergistic effect. Therefore the stakes are very high in these cases and intervention followed by proper treatment is truly a life saving process.

The complexity involved with both, the initial detoxification of patients who are withdrawing from multiple substances concomitantly and their initial road to recovery is such that intensive inpatient treatment is absolutely essential. People suffering from polysubstance addiction are not just addicted to a particular drug but rather to a lifestyle of being perpetually mentally and physically altered. It is a long road for them to attain a comfortable sobriety and they need expert guidance along the way.

Only after being free from the multiple substances for an extended period of time can these patients attain a baseline from which the reason behind their drive for polysubstance misuse is determinable. This should be the ultimate goal of treatment, for the patient to understand and accept who they are and take responsibility for choosing and living a drug free life.”

Increased Frequency

Polysubstance opioid overdose is increasingly common in the US, concluded a recent study led by Boston Medical Center’s Grayken Center for Addiction. It shows that opioid-related overdose deaths involving another substance are now the norm, not the exception.

Polydrug misuse has also had a significant impact on family life in America. Almost a fifth of respondents in a recent Gallup poll reported that both drinking alcohol and using drugs are a cause of trouble in the family. “Polysubstance use is common, particularly amongst some age groups and subcultures. It is also associated with an elevated risk of psychiatric and physical health problems,” reported Connor et al in a 2014 study. Using multiple addictive substances concurrently significantly increases the risk of overdose.

Common Combinations

Misusing alcoholic and opioid pain relievers (OPRs) concurrently is a risky endeavor. “When taken with OPRs or benzodiazepines, alcohol increases central nervous system depression and the risk for overdose,” warned the Centers for Disease Control and Prevention (CDC) in 2014.

The director of the National Institute on Drug Abuse, Nora Volkow, issued a similar warning. “Painkillers and booze are perhaps the worst to mix, because both slow breathing by different mechanisms and inhibit the coughing reflex, creating a ‘double-whammy’ effect, that can stop breathing altogether,” Dr. Volkow told Scientific American.

Alcohol also interacts with anti-anxiety drugs called benzodiazepines, antipsychotics, antidepressants, sleep medications, and muscle relaxants—intensifying the drugs’ sedative effects, causing drowsiness and dizziness, and making falls and accidents more likely.

The CDC also warns against using marijuana with other addictive substances. “Using alcohol and marijuana at the same time is likely to result in greater impairment than when using either one alone. Using marijuana and tobacco at the same time may also lead to increased exposure to harmful chemicals, causing greater risks to the lungs, and the cardiovascular system.”

Another popular concoction is the so-called “speedball,” a mixture of cocaine (or another stimulant) with an opioid such as heroin. Like other dangerous mixtures, speedballs are often more potent than just the sum of its parts due to drug synergy. Taking opioids and stimulants together is supposed to create a “push-pull” effect in the body and brain.

People with polydrug substance use disorder frequently combine cocaine and heroin to achieve an intense rush with a high that is supposed to combine the effects of both drugs while hoping to reduce the negative effects. Despite that intention, combining cocaine and heroin can have fatal consequences. Respiratory failure is particularly likely with speedballs because the effects of cocaine wear off far more quickly than the effects of heroin. Fatal slowing of the breathing can occur when the stimulating cocaine wears off and the full effects of the heroin are felt on their own.

As the preceding list of dangerous combinations shows, polysubstance abuse is especially life-threatening. Polydrug use makes increases the risks of overdose and death and makes addiction treatment more complicated. Detoxification is difficult when multiple drugs are present, and in most cases, polydrug use is an indication that addiction is more severe. Medication-assisted treatment with buprenorphine and naltrexone can help control cravings in the case of an opioid use disorder but the FDA-approved medications are contraindicated for addiction to stimulants such as cocaine or methamphetamine. The medications most often used to treat opioid use disorder do not work for stimulants, barbiturates, and other types of drugs.

Effectively treating people who use multiple substances requires expertise and a holistic approach. All substance use disorders pose challenges to clients and caregivers. Polysubstance addictions increase the importance of coordinated care that addresses underlying issues that contribute to the development of SUD and addiction.

Futures Recovery Healthcare offers coordinated medical detoxification, psychiatry, psychology, nutritional, and wellness services to address these complex conditions.

Jayson Williams Responds to NJ Reentry Report

In the above video, Jayson Williams responds to New Jersey Governor McGreevey’s recent New Jersey Reentry Corporation Report called “New Jersey Reentry Services Commission Barriers, Best Practices, and Action Items for Improving Reentry Services.”

An Open Letter to NJ Reentry Services

By Jayson Williams

On behalf of my colleagues at Futures Recovery Healthcare, I whole-heartedly commend the New Jersey Reentry Corporation and Governor McGreevey for recommending actions that will help people disenfranchised by incarceration to rejoin society as fully participating citizens. The Corporation’s report “New Jersey Reentry Services Commission Barriers, Best Practices, and Action Items for Improving Reentry Services” provides a crucial roadmap to restore the possibility of a productive life for America’s large population of formerly incarcerated people.

Supportive friends and access to financial, legal, and healthcare resources significantly helped my reentry. Most people who leave prison are not blessed with the same advantages and struggle with basic needs. If adopted, the policies recommended by NJRC will give formerly incarcerated people a fighting chance at restoring their quality of life and their ability to contribute to society. For too many people, being released from the physical constraints of prison does not relieve them from a lifetime of emotional, spiritual, and material imprisonment. Formerly incarcerated people face barriers to gaining the foundation of health, housing, documentation, and acceptance needed to thrive as full members of society — challenges that significantly increase the odds of recidivism.

The Corporation’s inclusion of addiction treatment as a principal recommendation is particularly encouraging. After my time in the criminal justice system and struggles with substance misuse, I dedicated my life to helping people with addiction. Today, I see striking similarities between the struggles of reentry from prison and recovery from addiction.

The issues of addiction and incarceration are highly linked. The NJRC report indicates that many people struggle with addiction before being imprisoned or develop addictions during or after incarceration. The report cites overdose as a leading cause of death in the days following release from prison. Addiction and incarceration share common contributors including, unaddressed trauma and negative life experiences, untreated mental health conditions, and environmental factors. The heavy stigma surrounding addiction and imprisonment exposes people in reentry and recovery to social isolation, unemployment, insecure housing, and other problems that perpetuate recidivism and relapse.

The recommendations of the NJRC, if implemented, can change the future of people affected by incarceration and addiction by restoring the rights, resources, and support that allow them to feel hope and to strive toward lives of purpose and meaning — keys to ending the damaging cycles of incarceration and addiction.

Click here to read the full report.

Humbly,
Jayson Williams

Efforts to Improve Mental Health Parity Compliance Continue

In the above video, Futures’ Utilization Director Kathy Piccirilli explains Parity Act and how it impact people’s mental health and substance use disorder insurance benefits.

Continued Improvements for Mental Health Parity Compliance 

More than ten years ago, President George W. Bush signed into law the Mental Health Parity and Addiction Equity Act, also known as MHPAEA. The legislation, commonly called “federal parity law,” requires most insurers to cover illnesses of the brain, such as depression or substance use disorder (SUD), just like other illnesses of the human body, such as heart disease or cancer.

A decade later, much remains to be done to fully realize parity. “Individuals still go years without care and often do not have access to the full range of effective treatment options,” wrote Caren Howard and Nathaniel Counts on MentalHealthAmerica.net on the tenth anniversary of MHPAEA in October. “Full realization of parity requires more work by informed policymakers, administrators, and consumers to challenge the existing discrimination.”

Not only do many patients with mental health issues not have access to the full range of treatment options, in some cases, insurance companies seem to have found fairly creative ways to negate the mental health parity mandates. In a recent article for Stat, Jack Turban explained how some insurance companies apparently employ “ghost networks” of psychiatrists to impede patients’ access to care by listing incorrect contact information for their in-network providers.

“Maybe insurance companies don’t know their lists are inaccurate. Maybe they do but choose not to do anything about it,” Turban wrote. “A more alarming possibility is that some companies intentionally keep the lists inaccurate to save money by preventing access to mental health care.”

It’s not just the insurance industry, either. Many states have failed to live up to the ambitious goals of MHPAEA as well. Analysis conducted by the Kennedy-Satcher Center for Mental Health Equity in 2018, gave 32 states a failing grade for their parity statutes—one of them was Florida. Only one state, Illinois, was awarded a grade better than C!

Florida’s legislature considered an important bill on parity earlier this year. However, Senate Bill 360, designed to help prevent health insurers that provide mental health and addiction coverage in the state from imposing less-favorable benefit limitations than those for other medical conditions, died in committee in May.

The efforts to make mental health parity a reality continue. On the federal level, Republican Congressman Gus Bilirakis, who represents Florida’s 12th district has introduced bipartisan legislation to improve health plans’ and insurers’ compliance with mental health parity laws. He was joined by Democrats Donald Norcross (D-NJ) and Katie Porter (D-CA) in introducing this bill.

“While mental health parity is rightfully the law of the land, our enforcement mechanisms are severely lacking and companies aren’t fully complying with the law,” said Norcross, who is vice-chair of the Bipartisan Addiction Task Force.

“As part of removing the stigma for treating mental illness, we must ensure that mental health needs are recognized as legitimate healthcare issues,” said Congressman Bilirakis. “One way to do that is to ensure parity between coverage for healthcare and mental healthcare services—which happens to be the law. For far too long, I have heard patient accounts of some bad insurance actors who are blatantly ignoring the Mental Health Parity law and provide inadequate mental health coverage.”

Hopefully, this initiative will go beyond the committee stage and lead to tangible improvements for patients with mental health issues.

Staff Perspective: Sober Curiosity

Futures’ Outreach and Community Liaison, Laura Kunz, describes sober curiosity and its benefits. Kunz suggests that one of the most positive aspects of the sober curious movement is that it encourages people to mindfully consider how alcohol affects their health, mood, and relationships. Mindfulness plays a significant part in lasting recovery. As behavioral healthcare practitioners, the Futures Recovery Healthcare team commends those who choose to pursue abstinence and make thoughtful choices about using substances.

Sober Curiosity, Mocktails, and Mindfulness – Is Sobriety Trending?

Written By: Laura Kunz

I made the decision to live sober in 2008. With the help of a community support group and a series of great outpatient therapists, I began changing myself and my lifestyle. I remember my last drink. I was at a PF Changs in Cincinnati a few days before Thanksgiving having dinner with my best friend since the third grade. We both ordered a glass of wine. After about halfway through the glass I started to feel what had once been the warm and fuzzy feeling of the beginning of a buzz. After years of highschool, college, and early 20-something alcohol misuse, that feeling was no longer a comfort. It was more like the doors of a jail cell being slammed shut and locked for an indefinite period of time. I pushed the half-full glass of wine away. I was done with alcohol.

I cannot say learning to live alcohol-free was easy. There were many times when I wanted to use alcohol to numb, celebrate, participate, or distract. At around three months sober, I was having a career and family-of-origin induced mini-meltdown at a gas station in Fort Lauderdale, where I was living at the time. As I pumped gas into my car, I remember thinking “I’ll just walk inside, buy a bottle of wine and a 12-pack of beer, go home and drink.” I immediately called a sober support and shared my plan. I screamed, “I just want to drink!” She calmly said “okay, then drink.” It was in that moment that I realized how committed I was to living this new way. Despite the way that I felt, alcohol would not improve my mood or circumstances. If I chose to walk through it all sober and feel and process my feelings, I had a chance to positively influence the outcome.

Ironically, when I pulled away from the gas station that night, I’d accidentally left the pump in my gas tank. As the gas sprayed everywhere and the attendant ran out to collect a hefty check, I laughed hysterically. I was living fully present in a moment of total chaos and surrender and I felt truly alive and grateful.

Fast forward eleven years. Mindfulness and living in the moment are household phrases and gluten-free, dairy-free, sugar-free, and now even alcohol-free are on-trend. If you’d told me back in 2008 that sober curious and abstinence would ever be a “thing,” I truly wouldn’t have believed you.

I believe sober curiosity, also known as mindful drinking, is an incredibly important and enlightened movement. It encourages awareness of the reasons why we drink as a society. “Am I trying to change a feeling or circumstance?” “Do I not want to feel or deal?” “Am I bored?” “Do I not think I can connect and build relationships without alcohol?” “Do I need to make changes in my life but don’t know how so I numb the feelings of doubt and fear?”

It also encourages awareness of the effect’s alcohol can have on the body and the mind. “I need to keep my gut and body healthy to achieve my fitness goals.” “When I drink, I focus less and I am less productive.” “I sleep better when I don’t drink” “I connect with the world and with people in a deeper way when I am sober.”

Sober curiosity increases self-awareness, self-control, and may help prevent the development of substance use disorders, which are rapidly on the rise in this country year after year.

Speaking of substance use disorders: Do I think sober curiosity or mindful drinking is enough for someone who is battling an active addiction? No, I believe abstinence is the best solution once a substance use disorder and problem drinking pattern has been developed. Due to the way addiction acts in the brain, the only way to change addictive patterns and behaviors is proper treatment, abstinence, and a consistent program of recovery.

Yet, the sober curious trend is certainly helping progress the recovery movement as a whole, which greatly benefits individuals who live abstinent or who will eventually live abstinent. It normalizes living alcohol-free and promotes conversation about health and wellness-centered lifestyles. Additionally, it has prompted many sober celebrities to speak out publicly about the benefits of recovery and popular national brands to launch products promoting sober curious and abstinent living. For example, Coca Cola’s new brand Bar None advertises “spirits without spirits” and many popular restaurants in major US markets are adding a variety of alcohol-free mocktails to their menus. Sober bars are also increasing in popularity such as the Sans Bar in Austin, Texas or Listen Bar in New York, New York.

Perhaps, a decade from now sober will not only be “sexy,” but it will be a fully integrated part of societal norms.

Laura Kunz
Outreach and Community Liaison

The Importance of Community In Recovery

In recovery from addiction, it is often necessary to give up old relationships and make major life changes, but going it alone is not a good idea. “Loneliness hangs over our culture today like a thick smog,” wrote Johan Hari in his 2018 book Lost Connections in which he sought to uncover “the real causes” of depression. Elsewhere the author of the bestseller Chasing The Scream, provocatively stated that “’the opposite of addiction is not sobriety. The opposite of addiction is connection.”

Recovery means connecting with your peers for mutual support and connecting with your local community. To that end, Futures Recovery Healthcare recently sponsored the inaugural Jupiter Recovery Day. The event brought members of the South Florida community together to honor and celebrate individuals in recovery from substance use or mental health disorders.

“Jupiter Recovery Day brought local businesses and community members together to highlight that recovery from substance use and mental health disorders is possible,” said Laura Kunz, Outreach and Community Liaison at Futures Recovery Healthcare. “There are many people living happy, healthy, and sober in this community. They are parents, employees, business owners, and students—people like you and me. It’s important that we all come together to spread a message of hope to the many in the Jupiter area who still need encouragement to recover.”

Fighting Stigma

An event like Jupiter Recovery Day connects people in recovery with the rest of the community. It helps raise awareness of the disease and overcome the stigma still attached to it. Community events like these may also encourage people with substance use disorder to feel more confident about seeking treatment and less afraid of being judged because of their disease.

“It shows people that it is okay to be open about their recovery rather than hide such an important piece of themselves due to shame or fear of judgement.” said Kunz. “When people show up at these events, it shows others that they are not alone.”

Overcoming addiction is aided by connecting with supportive people, especially peers who have been going through similar experiences. Research shows that peer support and being part of a community significantly increase the chances of sustained recovery from addiction. The founders of Alcoholics Anonymous (AA) realized that early on. The fellowship of peers is one of the central tenets of Alcoholics Anonymous since the foundation of the mutual support group in the 1930s.

Helping Others Is A Primary Theme in Recovery

Alcoholics Anonymous made service a major component of its system. Members are expected to take on responsibilities and help newer members on their path to recovery. Helping other people tends to put your own problems into perspective, something that can be of enormous benefit for a recovering addict. Rather than continuing to focus on your own troubles and the physical aspects of recovery, your attention turns outward focusing on other people’s needs.

One way of helping each other recover from addiction is by joining community-based recovery housing. Staying sober and living in a recovery residence among peers can help stabilize people in their early recovery. Such housemates may also hold each other accountable, another benefit of recovery residences. Futures has established partnerships with certified recovery residences within our local community and across the country to assist clients who would benefit from safe, supervised sober living.

Another way for Futures clients to stay connected is to become part of our vibrant alumni community upon completing treatment. The role of alumni relations and program participation plays a significant role in our treatment approach. Alumni programming helps active patients plan for ongoing care, establishes a supportive network, facilitates additional treatment if needed, and collects data on outcomes to improve program performance. Futures holds frequent alumni meetings, sober activities, and volunteer opportunities attended by Futures alumni and others in the local recovery community.

Isolation and lack of genuine support can be dangerous, especially if you are recovering from the disease of addiction. When it comes to our social species, “every human instinct is honed not for life on your own, but for life … in a tribe,” Hari wrote. Belonging to a “tribe” is particularly important for people in recovery.

Chasin a Dream, a charitable organization with the mission of providing individualized, life-changing assistance to families with children battling cancer, heart disease, cystic fibrosis, and other life-threatening illnesses, was the primary beneficiary of Jupiter Recovery Day. Futures Recovery Healthcare would like to thank the partners who helped make the event successful, including Kula Yoga Shala, Blueline Surf and Paddle Co, F45 Training Jupiter, and The Woods Jupiter. We also thank our event sponsors Abaco Pools, The Snyder Group, Jupiter Island Estate Management, Eating Recovery Center, and Empower Therapy & Wellness. Stay tuned for announcements for next years’ Jupiter Recovery Day! #jupiterrecovers

Staff Perspective: Serving Others

Few people outside the field of behavioral healthcare grasp the importance of the therapeutic alliance. Facilitating a process of self-change through which patients become determined to pursue recovery requires the building of trust and the practices of empathy and deep listening. The art and skill of talented therapists are based mainly on an innate desire to serve, and an ability to practice their calling mindfully.

In the following article, Futures Outreach Professional and experienced interventionist, Stephen Watts, shares his thoughts about the importance of bringing a servant’s heart and the gift of presence to the practice of therapy. Informed by decades of work helping individuals and families find recovery and well-being, Stephen discusses the fundamental value of the authentic connection between patient and practitioner. The insights Stephen shares contribute to our ability to maintain an environment in which therapists feel safe, comfortable, and supported in their mission, and encouraged to do their best work for the individuals and families in our care.

Serving Others

Written by Stephen Watts

“We only have what we give” – Isabel Allende

I believe that when we are serving others, helping, counseling, volunteering, or whatever the circumstance, there are some basics that we need to possess. Growing up in the family of origin that I had, accidentally “falling into” a helping/counseling role for lots of years has taught me that our ability to serve others effectively is dependent upon our willingness and motivation. We need to have a servant’s heart, be present, and know how to engage the other individual successfully. I have facilitated a bunch of interventions and have counseled thousands of people and their families and I have learned from this, mistakes being one of my greatest teachers! I was academically trained in the liberal arts, not counseling but had many strong teachers and mentors along the way in my early years of working with suffering chemically dependent people and their families. Here is what I came to believe concerning the helping situation. We have to become “naturally therapeutic” as the author Jaquelyn Small put it.

John Holmes said, “There is no exercise better for the heart than reaching down and lifting people up.” Holding a servant’s heart has got to happen, I believe, before we can help others. There are degrees of servitude. There was only one Mother Theresa who possessed a tireless commitment to serving the abject poor of India. Not many of us can do this and I do not believe that level of service is necessary in most cases. Doing little unknown niceties to others daily is the character and behavior of many people who are never noticed. A heart of service comes from upbringing, is innate for some, and is learned through surviving some really difficult times and life events for others. The great twelve step movement of the twentieth century implores us to “clean house, trust God, and serve others.” There are countless occupations that require varying degrees of a dedication to service. The willingness, “the heart” for standing in the fire with others is not rare or uncommon. I see it regularly. It is a spiritual thing, a humanity thing, a paycheck thing, and a feel-good thing, though I seldom heard other counselors say “I feel good about doing ____________”.

Service is a great thing, but I believe that we have to practice being present when doing so, whether it’s a therapy session or serving a bowl of soup to the homeless. I found that when I showed up 100%, mentally and physically, things generally went well. The other person that we are helping knows if we are only partially present. They do. When we practice this presence, we can listen deeply, as Thich Nhat Hanh extols, empathize, and sit with the clients discomfort more easily. This IS a practice. The practice of truly being present in all ways while helping someone else improves our ability to serve. Many times, being present for the other person means listening with no response, judgement, counsel, or advice giving. People want to be heard. This is important and is a large part of being mindfully present. We sit, we breathe, and we listen deeply. We practice patience and acceptance when we hear stuff that is repetitive or makes us feel uncomfortable, or leads to wanting to fix the other person. We sit and keep ourselves in the present moment by noticing when we “drift off” and need to return to the room. Read “The Miracle of Mindfulness” by Thich Nhat Hanh, or “Start Where You Are” by Pema Chodron, and pretty much anything by Jack Kornfield, to help you improve being present for your clients. If you are successful with being present for the people that you assist, you cannot help but be more present in your day to day life which will lead to feelings of gratitude and appreciation. Be patient with yourself, again, being present is a practice.

Engaging others in a way that will lead them to talk to us honestly and openly is, what I believe, a major fundamental in the service of others. If we have the desire to help the person in front of us, are able to remain present with them most of the time, then we engage them in a conversational exchange that is coming from a place of sincerely wanting to help the other person move forward in positive direction and solutions. William Miller and Stephen Rollnick, the authors of “Motivational Interviewing” state in this important counseling text that if we have the intention of the other person, our client, improving then that intention translates as greater outcomes for the client. These two author-teachers set forth four basic tenets of motivational interviewing. These are; listen with empathy, develop discrepancy, roll with resistance, and support self-efficacy. Help the client by really listening, showing them that there is a difference in the life they are living and the life they want to have, do not argue or push back with resistance from the other, rather “roll” with it, and support the client when they make progress toward a goal. I mention these because they are great guidelines for daily interactions, because I have used them in interactions other than counseling ones. Engagement has to be non- threatening. Back in the early days of chemical dependency treatment, confrontation of the client was acceptable and the preferable mode of addiction counseling. I will say that some confrontation is effective if; you have the client’s trust, have a therapeutic alliance with the client, and do it professionally and non-judgmentally. There is a way to inform others that their reality is not reality without sounding harsh or judging. This is hard to pull off for rookies in service to others. Confrontation without the aforementioned components is not only ineffective, but can turn into a negative outcome for both client and server. Engagement with others who need our help also is much more successful when we set aside the results or outcome of our service to others. It is not up to us. If we engage others in conversations that offer sincere support, listening to their response, concerns, perspectives, without judgment, and have the intention of helping that person get better, solve their issue, assist them in some way that makes their life better, then we have successfully met them and helped them.

“When we give cheerfully and accept gratefully, everyone is blessed”
– Maya Angelou

Stephen Watts
Outreach Professional at Futures Recovery Healthcare

Sharing Thoughts on a Panel Discussion at MOC 2019

In my role as a Clinical Outreach Professional for Futures, I feel it’s vital and rewarding to remain current with the conversations our industry is promoting to the end goal of better treatment. As a professional resource to others, I know and appreciate the complexity of addiction, substance use disorders, and the variety of interventions and modalities that exist. In a recent presentation at Foundations’ Moments of Change this week, three overarching philosophies were the topic of healthy conversation amongst professionals in our field.

Abstinence

Dr. Brian Samford of The Arbor Behavioral Healthcare in Texas led the session through a description and preference for an abstinence based approach to treatment and spoke in detail of the internal motivators driving impulsive behaviors. One of the more provoking thoughts spoke to the challenges the abstinence philosophy faces and its perception as “outdated or antiquated” as more and more scientific study is conducted and evidence collected on alternative modalities, like Medication Assisted Treatment. On a professional note, he did openly state he would consider the use of Vivitrol and Campral as viable and complementary to a treatment plan for specific cases. In closing, he shared his overall belief that substance use disorders and their treatment will inevitably become a part of the mainstream medical and healthcare realms. Abstinence based approaches may need to adapt to remain viable for those individuals and families seeking programs with that philosophical preference.

Harm Reduction

Linda Lewaniak LCSW, CAADC of Sacramento, CA based Insight Behavioral Health Centers educated the audience on her perspectives of policies and programs that support harm reduction as an intervention and treatment philosophy. A public policy effort that has roots back to the 1980’s, the goal of harm reduction was to reduce the adverse consequences of substance abuse – death, crime, and resultant declining property values. The most common form is a needle exchange to reduce the rise of infectious diseases and the most controversial form would be any safe-injection site program established to curb fatal overdoses. Interestingly, Linda referenced motivational interviewing as a harm reduction intervention meeting patients where they are and creating internal desire to promote changed behavior. Further information and education was delivered on harm reduction’s careful incorporation of the stages of change – precontemplation, contemplation, preparation, action, and maintenance. Ideally, the harm reduction philosophy allows for an “open door” along any stage of change if present in someone’s lives. Simply stated, but I enjoyed her quote “harm reduction is a place to start, not a place to end treatment.” In fact, personally I don’t really consider any “end” to treatment. Importantly, Linda also highlighted the prior separation of addictions from mental health disorders in the 1980s as analogous to the current separation of abstinence and MAT programs and suggested the two schools of thought could benefit from a philosophical merger. She reassured the attendees that the increased focus on the epidemic and conversations will most likely emphasize the need for better and more elaborate collaboration and documentation of outcomes to push our industry forward.

Medication Assisted Treatment

Dr. Carlos Tirado, MD, MPH, Founder of CARMA Health in Austin, Texas rounded out the panel by covering Medication Assisted Treatment or MAT. Per his definition, “MAT is an incorporation of safe medication to ameliorate acute symptoms of substance use disorders and create more functional states for the patient”. He described three distinct branches of MAT: 

• Substitution: Methadone, Suboxone, Nicotine replacements
• Blocking: Vivitrol, Naltrexone
• Reward Modifier: Antabuse, Naltrexone, Campral, Chantix

From his perspective, MAT has gained significant acceptance amongst practicing medical professionals as a preferred protocol for the treatment of alcohol and opioid dependence. He relayed that appropriate patient profiles for MAT include the chronic relapser, those with prolonged history and severity of misuse, those with prior overdose or hospitalization episodes. He shared a quite personal perspective that he would first seek out an abstinence based treatment for one of his own family members, but that if they experienced a relapse episode he would likely suggest incorporating a MAT protocol. Like many of us, he shared the belief that medication alone will not provide the optimal outcomes our society desires. Dr. Tirado spoke of the innovations we’re likely to witness, including longer-term injectables and unobtrusive, wearable monitoring systems with increased public funding to curb the epidemic.

My Perspective

This panel was heavily weighted to discussion on the benefits of MAT, but never ultimately answered any questions related to substantiate what the goals for patients referred to MAT programs are. There was little discussion on what a detailed MAT protocol could or should look like, but there was a shared success story of an individual who has received consistent methadone treatment for 12 years. Residential treatment facilities, like Futures, typically administer medications to safely stabilize patients with the goal of tapering the patient to be free of any medications required to assist with physical cravings or withdrawal symptoms. I am extremely supportive of meeting individuals where they are along the change of stage lifecycle and certainly open to any intervention that may provide the impetus to a healthy lifestyle. As a person in long-term recovery, I also know individuals will most often seek the easiest way and fear that non-integrated MAT programs are delaying the inevitable hard work of what I consider true recovery. There was also no mention of the difficulty of withdrawal symptoms and detoxification process when an individual chooses to stop relying on substitution medications, such as methadone and suboxone. The term evidence-based is widely promoted, but believe we require more general education and consumption of that evidence to support better treatment and outcomes. I believe the government wants to reduce fatalities, increase property values, and reduce crime but think we should avoid any type band-aid or short-term solutions to the behavioral health crisis we face today.

Special thanks to Matt Feehery for moderating the panel discussion.

John Egan, Clinical Outreach Professional at Futures Recovery Healthcare

A&E Features Rebound Program

On September 14, 2019, A&E featured Jayson Williams and the Rebound Program as part of an Addiction Unplugged TV series. The series, described as “humanizing addiction and recovery, promoting solutions and raising awareness of the opioid epidemic,” showcased 10 episodes covering topics from personal stories of addiction to innovative treatment approaches. 

Click the below link to watch the episode featuring Jayson Williams and the Rebound Program at Futures Recovery Healthcare. Please note: you will need to sign in with your cable provider login information to view the episode.  

 
Watch The Episode Here

Jayson Williams appears on Today Show’s Lessons Learned

This morning Futures Recovery Healthcare’s Recovery Advocate, Jayson Williams, made a special appearance on NBC’s Today Show to share with the audience an update on how he’s focusing on helping others to help himself maintain his own sobriety. Leading the Rebound program at Futures provides him the perfect opportunity and platform to connect with and serve those who are seeking an alternative approach to treat the complex disease of addiction. An approach that has resonated deeply with Jayson and aligns well with Futures’ mission to provide an array of comprehensive services and reduce the barriers to seek treatment.

To watch the full segment, please go to the Today Show.

Jayson and the Rebound program at Futures will also be featured on Saturday’s (9/14) 1 PM EST airing of Addiction Unplugged

Florida’s Deadly Meth Resurgence

“Opioid death rate plunges 41 percent in Florida county at center of epidemic,” reported the Sun Sentinel in January about the efforts of Palm Beach County officials to combat the opioid epidemic. That’s good news for a county that recorded 558 opioid deaths in 2017.

Unfortunately, it doesn’t mean the addiction crisis is over. Blaming one particular substance for the continuous increase in drug overdose deaths in America and then focusing most of the effort on reducing access to that one type of addictive substance can only go so far.

While opioid misuse may have peaked in Florida and nationwide, users have been switching to other substances. Before the opioid crisis, methamphetamine—especially in the form of crystal meth—was “cooked” in homemade labs across America, particularly in economically deprived rural areas.

“The scourge of crystal meth, with its exploding labs and ruinous effect on teeth and skin, has been all but forgotten amid national concern over the opioid crisis,” the New York Times reported last year. “But 12 years after Congress took aggressive action to curtail it, meth has returned with a vengeance.” It certainly has in Florida.

“Just six years ago meth was discovered in the bodies of 146 people who died across the state. That number spiked four-fold in 2016 when, according to the Florida Department of Law Enforcement’s annual report, meth was found in 621 people who died,” the Tallahassee Democrat reported in October. In the first six months of 2017, “meth — which often mixed with other drugs like fentanyl, heroin, and cocaine — showed up in the bodies of 414 people who died in Florida, according to the report.”

And today’s meth has been upgraded: “Much of what’s being sold is no longer low-grade methamphetamine home-cooked in some ramshackle Florida trailer park,” the Miami Herald reported in December 2017. “Instead, the meth being seized in South Florida is high-grade crystal concocted in “super labs” south of the United States border, then smuggled in as part of Mexican cartels’ efforts to expand into East Coast markets, according to law enforcement authorities.”

Drug overdose deaths nationwide involving psychostimulants—including methamphetamine—have been increasing dramatically in the last few years:

As NPR noted in June, the federal government has given out at least $2.4 billion in state grants since 2017, “in hopes of stemming an opioid epidemic that killed 47,600 people” in that year alone. But state officials point out that drug addiction problems seldom involve only one substance. “According to the most recent data from the Centers for Disease Control and Prevention, 11 states—including California, Pennsylvania, and Texas—have reported that opioids were involved in fewer than half of their total drug overdose deaths in 2017.”

Addiction professionals have warned again and again that we need to pay more attention to the question why so many Americans struggle with substance use disorders instead of simply trying to reduce the availability of certain illicit drugs. Substance use disorder is a complex biopsychosocial disease, often driven by underlying mental health issues such as anxiety, depression, and unprocessed trauma. If these co-occurring conditions are not addressed as part of a comprehensive addiction treatment plan, the chances of a successful recovery are remote.

“The United States has a serious substance misuse problem,” was the opening statement of the groundbreaking 2016 report by former Surgeon General Vivek Murthy on alcohol, drugs, and health. The report was entitled “Facing Addiction in America,” not “Facing the Opioid Crisis.” Murthy suggested we need “a major cultural shift in the way we think about, talk about, look at, and act toward people with substance use disorders.”

Instead of starting yet another futile war on drugs, Murthy recommended “addressing substance use disorders with a public health model that focuses on reducing both health and social justice disparities”… “for the health and well-being of all Americans.”

Addressing polysubstance abuse and the underlying causes of mental health and substance use disorders are fundamental aspects of the Futures Behavioral Healthcare clinical approach. Futures emphasizes the importance of integrated treatment to address complex, individual experiences of addiction and dysfunction. Through holistic approaches to individualized treatment, the program works to establish a strong foothold in recovery, resilience, and a trajectory of continuing care and support.

Futures Previews Orenda with Open House Event

On Thursday, February 28, we were thrilled to host an incredible group of dedicated behavioral healthcare professionals from across the country to preview the Orenda program and accommodations.  Guests also had the opportunity to connect with the talented Orenda team and the diverse staff and leadership of Futures Recovery Healthcare.

Our sincere thanks to all who attended. Please check out the below gallery of photos captured at the event! 

For detailed information about Orenda, please go to: www.futuresrecoveryhealthcare.com/orenda 

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10 Signs Your Loved One Has a Drinking Problem

Because alcohol is such a large part of our culture, it’s not always easy to identify when drinking has become a serious problem for a loved one. Here are 10 signs that alcohol has become an intrusive part of your loved one’s life, and that it’s time to address the situation:

1. Lying about drinking or hiding alcohol: If you find bottles of gin tucked behind the wastebasket in the bathroom, it’s a problem. If there are bottles underneath the seats in the car or underneath towels in the laundry room, it’s clear that something is going on. When people have a normal relationship with alcohol, they store liquor in a liquor cabinet or put beer in the pantry. There’s no reason to hide bottles of alcohol unless you’re hiding a problem with alcohol.
2. Extreme mood swings based on drinking patterns: Alcohol is a depressant, and it can wreak havoc on a person’s mental and physical health. While under the influence, the drinker may be more likely to become angry, irritable, or even violent after the initial relaxation fades. When chronic drinking is an issue, it’s not uncommon for the drinker to develop depression, and if binge drinking is more often the problem, the days after a binge are often difficult emotionally and physically.
3. Health problems related to alcohol intake: Alcohol is a toxin. It is not easy for the liver to process alcohol without some damage. When a person drinks only occasionally, the liver has time to heal, but when someone binge drinks frequently (e.g. more than four drinks for women, more than five drinks for men) or regularly has more than seven drinks (for women) or 14 drinks (for men) each week, the constant onslaught of alcohol can cause significant wear and tear on the body. From the liver, to the cardiovascular system, to the immune system, it’s not uncommon for someone with a drinking problem to have a hard time avoiding colds and difficulty managing chronic medical disorders like diabetes. In addition, those with drinking problems may eventually develop deadly diseases like heart disease, liver failure, and certain cancers.
4. Problems at work or school: Showing up late, poor performance when in attendance, or problematic choices when at work or school due to drinking the night before, or even drinking during the day are some of the ways that alcohol can cause someone to be expelled or suspended from school or to suffer demotions or get fired from a job. Any of them is a clear sign that alcohol has too much power in your loved one’s life.
5. Legal issues related to behaviors while drinking: Driving under the influence, being drunk in public, or contributing to the delinquency of a minor are some of the ways that alcohol can get someone into trouble with the law. There are even a number of charges that could be related to alcohol, like assault, domestic violence, and theft. Anything that threatens someone’s freedom is clearly a problem.
6. Driving while under the influence: Getting behind the wheel after drinking is a very serious issue. One doesn’t have to be caught and arrested for it in order for it to be a sign that alcohol use has gone too far.
7. Inability to manage tasks at home: Paying bills on time, caring for children and pets, getting along with neighbors, and basic care and maintenance for the home are all hard to do during heavy drinking. Life tends to revolve around getting drunk or recovering after being drunk, and there is very little time to get to the details of day-to-day life. If these tasks are attempted, alcohol often blurs the specifics, and a lot of mistakes are made that can result in interpersonal problems with neighbors, financial problems due to mismanagement of the budget, negligence of dependents, and more.
8. Isolating from family members and friends: As alcohol becomes a larger part of the drinker’s life, they may retract from the people around them. No drinker wants to hear that others are concerned about their drinking, and the guilt, embarrassment, or irritation of dealing with others may lead to isolation.
9. Regularly promising to cut back on alcohol intake or quit: There’s a cycle that often defines alcohol use and abuse. Drinking tends to build and build until it culminates in disaster (e.g. arrest, a health problem, theft, a wrong done to someone in the family, etc.) that clearly identifies the alcohol use as a huge problem. The drinker is remorseful and promises to quit drinking, and may even manage to do so for a day or a week depending upon the specifics of his problem, but cannot maintain that sobriety for long. They may initially sneak a drink here and there, or may justify drinking for a certain reason and then never stop, building up in levels until there is again a climactic moment in which it is clear that they have a problem and again promises to stop.
10. Inability to stop drinking for any period of time, no matter what the consequences: Even when the drinker is genuinely interested in no longer drinking and despite how terrible things may have become or what they have lost due to alcohol, they may still be unable to stop drinking. If this is the case, this is a hallmark of an alcohol use disorder, and it is time for your loved one to enter an alcohol abuse and addiction treatment program now.

If you suspect your loved one has a drinking problem, call Futures today. We can give you and your loved one the help they need.

Adderall and Alcohol

Adderall and Adderall XR (amphetamine and dextroamphetamine) are commonly prescribed to treat narcolepsy and attention deficit and hyperactivity disorder (ADHD). As stimulant drugs, they can help people living with these disorders to focus and/or stay awake. Unfortunately, because it is a potent stimulant drug, Adderall is commonly abused. People often abuse Adderall to accomplish a great deal in their work or school life while also managing an active social life. When people abuse Adderall for those reasons, they often mix recreational substances – like alcohol – with their Adderall and inadvertently experience dangerous medical emergencies as a result.

Dangers of Adderall and Alcohol

Many people take Adderall so they can more easily manage a busy overall schedule – one that includes studying for tests or completing projects at work while also connecting with friends on the weekends. Though they may not intentionally take Adderall and chase it with a beer or a cocktail, they may have taken Adderall earlier in the day with the goal of working on a project and then hitting the bars or parties when they were done. With Adderall still in their system, they may have a drink, or multiple drinks, thus, inadvertently putting themselves in a situation where the two drugs are combined. Others purposefully take Adderall when they go out for the night with the intention to drink. This is because they are hoping that the stimulant effect of Adderall will allow them to stay out and drink longer without realizing that the combination of the two drugs can trigger adverse effects. These can include:

• Increasing the likelihood of accidents while under the influence
• Risky behaviors that can translate into life-changing issues (e.g. unprotected sex that leads to an unplanned pregnancy or an STD)
• Medical emergencies due to overdose

Getting Help for an Adderall Addiction

Mixing Adderall and alcohol can be a life-altering, if not deadly, choice. If you think your loved one is mixing Adderall and alcohol, don’t wait to intervene. Treatment can help them to find non-stimulant alternatives if there is an underlying medical diagnosis of ADHD and also assist them in learning how to live without abusing alcohol, Adderall, or any substance. 

Here at Futures Recovery Healthcare, we provide a comprehensive services that ensure that you receive the best chance of recovery. Addiction is a disease that is both physical and psychological, and both aspects need to be addressed in order to promote long-term success. Psychotherapy, evidence-based treatment models, support groups, healthy lifestyle choices, and a private, relaxing environment provide the necessary tools for a positive outcome. Call us today to learn about our addiction treatment programs.

Adderall Addiction & Risks

Adderall is a medication that is often prescribed for treating attention deficit hyperactivity disorder (ADHD) and narcolepsy. Nervous system stimulants, like Adderall, have a high potential for misuse due to the way they increase alertness, wakefulness, focus, and energy. An individual may form a dependence on Adderall in order to experience these stimulant effects.

Adderall is a Schedule II drug, meaning that it has medicinal purposes, but also a high potential for misuse and physical dependency. Long-term non-medical use of the drug can lead to addiction and substance use disorder. 

Dangers of Adderall Addiction

There is an alarming increase in the non-medical use of prescription drugs among young adults. College students are known to dabble in illicit drugs. However, long-term use could lead to physical and psychological dependence on the drug. The misuse of prescription stimulants without appropriate medical supervision could have devastating repercussions on college campuses or during parties where larger doses are misused. Data from the National Institute on Drug Abuse (NIDA) shows that at least 16 million Americans, on average, had engaged in the misuse of prescription stimulants. Depending on how often, how much, and by what method a person consumes, Adderall use disorder can develop as quickly as one week after the first exposure.

The physical dependence on Adderall can cause a range of harmful side effects and co-occurring medical conditions. In fact, addiction to any substance can cause physical and psychological changes in the body. As well as cause behavioral changes. From impulsive behavior in order to attain the drug to aggressive behaviors during withdrawal, dealing with addiction and its long-term side effects takes a toll on not just the person whose battling addiction but also their loved ones.

SIDE EFFECTS OF MISUSING ADDERALL

When Adderall is misused, it can cause a number of undesired effects. The most common side effects include: 

• Sleep disorders
• Anxiety
• Shortness of breath
• Headache
• Loss of appetite
• Mood swings
• Sexual dysfunction

Chronic or extreme use of Adderall can lead to physical dependence and cause more serious problems, such as:

• Breathing trouble
• Cold sweats
• Rapid or irregular heartbeat
• Fever
• Blurred vision
• Hallucinations

Suddenly stopping Adderall after prolonged misuse can cause withdrawal symptoms such as:

• Depression
• Nausea and vomiting
• Muscle cramps and pain
• Trembling
• Nightmares
• Suicidal thoughts

For this reason, people should seek medical help and guidance if they are struggling with Adderall misuse. Heavily misusing Adderall can have adverse effects and pose serious health risks. In high doses, Adderall can cause overdose and severe liver damage. Misuse of any prescription medication leads to toxic levels of the drug in the body. Stimulant drugs increase heart rate, blood pressure, and body temperature, and an overdose may cause cardiac arrest, coma, psychosis, rapid heart rate, sweating, and unusual mood swings. An overdose may be life-threatening, and if you suspect someone has overdosed on Adderall, seek immediate medical help.

TREATING ADDERALL MISUSE

Adderall addiction is typically treated with a combination of detoxification, behavioral therapies, medications, and support groups. Treatment begins with medically assisted detoxification, which involves weaning a person off of the substance they are dependent on and overcoming withdrawal symptoms comfortably and safely. Followed by behavioral therapies and support groups in an inpatient or outpatient setting.

At Futures Recovery Healthcare, we are dedicated to helping you or your loved one discover the best treatment options. Evidence-based treatment plans utilize scientific methods and research in a multidisciplinary approach. Compassionate staff members and mental health professionals work as a team to design specialized, individualized care plans. We believe in the importance of teaching coping mechanisms and life skills to help you or your loved one achieve a healthy physical and emotional balance. Call us today to learn about our treatment programs.

What Are the Side Effects of Percocet?

Percocet is an opioid-based drug that consists of of oxycodone and acetaminophen (Tylenol is a well known acetaminophen). According to the National Institute on Drug Abuse, the US consumes over 80% of the oxycodone-containing medications produced worldwide. When taken under a physician’s supervision, Percocet can provide effective and safe pain relief. Side effects are generally mild, but an overdose of the drug can produce severe, even fatal, health consequences.

Percocet’s Mild Side Effects

The most common side effects of Percocet can usually be managed by changing the dosage or by taking an over-the-counter medication to relieve symptoms. Mild side effects include:

• Nausea
• Vomiting
• Daytime drowsiness
• Dizziness
• Rashes or itching
• Constipation
• Diarrhea
• Dry mouth
• Sweating

If side effects are too unpleasant, your doctor may need to reduce the amount of Percocet you’re taking, or consider an alternative medication.

Percocet’s Severe Side Effects

The oxycodone in Percocet is a central nervous system depressant that can cause more severe side effects. Severe side effects of Percocet include:

• Lower heart rate
• Slow breathing
• Lower blood pressure
• Unconsciousness
• Overdose, and even death

These effects can be even more severe if Percocet is consumed with alcohol. The Drug Abuse Warning Network (DAWN) notes that in 2011, there were over 31,500 people treated in emergency rooms in the US because of taking oxycodone and alcohol. Because alcohol is also a central nervous system depressant, it intensifies the side effects of Percocet and increases the risk of a deadly overdose.

Another dangerous side effect of Percocet is the potential for misuse and abuse. Like other opiates, Percocet has a high potential for addiction, especially when the drug is taken incorrectly.

Additionally, the acetaminophen in Percocet can cause severe damage to the liver in high doses. People who take too much may be putting themselves at risk of liver failure.

Avoiding the Risks of Percocet

People who take Percocet for legitimate medical reasons and follow a doctor’s orders may never experience any serious side effects from this medication. To avoid serious health risks, do not take more of the medication than your physician has prescribed, or take the drug more frequently than your prescription indicates. Most importantly, avoid taking Percocet for non-medical reasons, accepting the drug from friends, or sharing your own pills with others.

If you or a loved one struggle with Percocet misuse, opiate addiction treatment programs are available that can help you overcome that dependency. Futures Recovery Healthcare provides individualized care for those who want to stop misusing prescription medications and lead healthy, drug-free lives. With a full array of evidence-based, therapeutic programs, our treatment team provides personalized care that is tailored to your needs. Call us today to see how we can help.

How Long Does It Take to Become Addicted to Percocet or OxyContin?

Percocet is a Schedule II prescription drug. It is an opioid-based cocktail consisting of oxycodone and acetaminophen (one widely recognized acetaminophen is Tylenol). It is a popular choice among physicians for treating moderate to severe pain, but unlike other prescription opioids, it is not a good candidate for post-surgical treatment due to clotting issues. The acetaminophen component isn’t added for pain relief, but rather as a booster for the effects of oxycodone. Percocet is intended to treat short-term pain, although many prescribing physicians refill patients’ supplies for long periods of time.

Addiction to prescription painkillers like Percocet and OxyContin is an exceedingly common problem in the United States. Despite increased awareness of the danger of over-prescription and overuse of these drugs, and legislation changes implemented with the goal of cutting back on painkiller misuse, thousands of Americans develop a painkiller addiction every year. There are a number of factors that can impact how long it will take before a person develops an addiction to prescription medications, including:

• Genetics: If someone in the family is currently struggling, or has ever struggled, with drug dependence or alcoholism, then the patient has an increased chance of the same.
• Misuse of the drug: If the person takes the prescription outside of the recommendations of the doctor, the chance of addiction increases.
• Misuse of other substances: Even if the patient takes the prescription exactly as prescribed, if they misuse other substances, addiction may be more likely to develop.
• Co-occurring mental health conditions: If the patient struggles with untreated mental health conditions, misuse of prescription painkillers may more quickly turn into addiction.

Chronic misuse of prescription painkillers will very often lead to an addiction. Whether it takes days, weeks, or months after the initial use, treatment can help.

Signs of Painkiller Addiction

It is not always readily identifiable when someone transitions from “normal” use of painkillers as prescribed by a doctor into addictive use of these pills. Some signs that addiction to prescription opiates has become a problem include:

• Any use of these medications without a prescription
• Fraudulent changes to a prescription in order to increase the number of pills received
• Going to multiple doctors to get similar prescriptions for addictive medications
• Filling a prescription at multiple pharmacies
• Frequently complaining about “lost” prescriptions and the need for emergency refills
• Altering pills before taking them
• Use of other illicit substances (e.g. alcohol, marijuana, or other prescription medications) in combination with prescription painkillers

Tolerance vs. Addiction

It’s important to note that there is a big difference between painkiller addiction and tolerance (physical dependence). Painkiller addiction is defined by psychological addiction (e.g. cravings) as well as a physical dependence characterized by withdrawal symptoms when the person stops taking the drug of choice. Physical tolerance is defined by withdrawal symptoms as well, but it can occur with drugs that do not create a high and therefore have a lower chance of being misused. Over time, patients can develop a tolerance – that is, they require higher and higher doses in order to continue experiencing therapeutic effects of the medication – but not an addiction. People with a physical tolerance can do a slow step-down process that is supervised by a doctor in order to be free of the drug, while people who are living with addiction require intensive and long-term treatment.

Treatment Options for Percocet Abuse

Professional help should always be sought in cases of Percocet misuse and addiction. Since every person is different, it is important to understand all of the options available for Percocet addiction treatment. 

Residential inpatient treatment: Residential inpatient is the best option for lasting recovery from Percocet addiction. At Futures, we treat Percocet addiction and co-occurring disorders through counseling or psychotherapy that treat the whole individual physically, mentally, and spiritually. We offer a wide-range of evidenced-based therapies, including:

• Individual Therapy
• Group Therapy
• Dialectical Behavior Therapy
• Cognitive Behavioral Therapy
• Holistic Care
• Alternative Therapies

Outpatient treatment: Following 30-day residential treatment, Intensive Outpatient (3 days per week) and Outpatient Programs (IOP and OP) are essential to reintegrating back into daily life while working on the skills to maintain recovery and lead a healthy, productive life.

At Futures Recovery Healthcare, we understand that every person is unique, so we work to treat the underlying causes of addiction to create a foundation for lasting recovery and well-being. Our accredited staff and mental health professionals are all experts in their fields and can provide the most cutting-edge and evidence-based treatments for addiction and co-occurring conditions. Call us today to get the help you need to break free from Percocet addiction.

Ativan Addiction & Risks

Ativan is a very powerful benzodiazepine and tolerance can build very quickly. Ativan is generally prescribed for short-term treatment of anxiety, manic bipolar disorder (as an adjunctive treatment), vomiting associated with cancer drugs and chemotherapy, chronic sleep problems, restlessness, muscle spasms, nausea symptoms associated with alcohol withdrawal, psychosis associated with abrupt withdrawal from alcohol. This class of drugs is also called sedatives or tranquilizers. Like other benzodiazepines, Ativan works by attaching to GABA (gamma-aminobutyric acid) receptors in the brain.

Signs of Ativan Misuse

The signs of Ativan misuse may not always be obvious. If you’re concerned a loved one is misusing Ativan, and not following their doctor’s orders, signs to be aware of include:

• Using more of their prescription than advised
• Taking Ativan with other substances
• Spending an increased amount of time, energy, and resources dedicated to getting and taking Ativan
• Negative impacts to their work, family, school, and/or personal obligations and relationships

Ativan Withdrawal Symptoms

Typically, Ativan withdrawal symptoms include:

• Insomnia
• Headache
• Confusion
• Anxiety
• Muscle aches and pains
• Nausea
• Tremors
• Weight loss
• Psychosis
• Sweating

If you or someone you love is engaging in Ativan misuse it is recommended that you seek professional assistance for medically assisted detox prior to involvement in a therapy-based treatment program.

Getting Help for Ativan Misuse

Attending a residential inpatient program can be very beneficial for treatment. Therapies will help you create new thought patterns and develop new ways to cope with anxiety and stress in a healthy environment that does not include Ativan dependency.

A few of the treatment methods used at residential facilities include:

• A thorough evaluation that will determine the presence of any untreated co-occurring conditions that may have contributed to, or stemmed from, the Ativan misuse
• Cognitive behavioral therapies that are designed to provide you with the tools and skills you need to overcome unhealthy thoughts and behaviors
• Alternative therapies, including yoga or meditation, that provide you with the skills you need to deal with anxiety or stress in a healthy manner
• Group therapy that can provide balanced relationships with others who have similar experiences
• Family therapy that can address not only your relationship with others in your family unit, but also address the needs of family members who may have been negatively affected by your Ativan misuse

Once the initial phases of treatment have been completed at an inpatient treatment center, it is highly recommended to continue treatment in an outpatient setting, as healthy habits are built over time. if you are, or someone you love is, suffering from addiction, please call Futures Recovery Healthcare today.

Futures Launches New Website

2018 has provided plenty of opportunity for substance use disorder treatment providers across the country to reflect on their missions. For Futures, we collectively reflected on our purpose and how we communicate that to our professional network, the general public, and industry oversight groups – specifically, the Joint Commission, LegitScript, and NAATP.

The output of our internal exercise is proudly on display today throughout our new website and in the purposeful shift of the brand from mentioning our location in Palm Beach County to better represent who we have always been:

• a compassionate, coordinated team of behavioral healthcare and support services professionals
• a clinically led system of care that embraces the complexity of substance use disorders
• driven by a patient-focused approach to help individuals and families regain their lives by learning to manage the chronic disease of addiction
• committed to reducing and reversing the negative perceptions that surround addiction and mental illness

Futures’ reputation is built upon the mutual trust clients and professionals have put in our team and approach. We look forward to extending that trust, continued collaboration with like-minded professionals, and the evolution of our programs and this industry to better meet the needs of our society.

Please find the full press release here: BusinessWire Press Release

Meth & Crystal Meth Addiction

Meth and crystal meth are man-made in clandestine laboratories. Crystal meth is short for crystal methamphetamine and is just one form of the drug methamphetamine. It is a dangerous and potent chemical and, as with all drugs, a poison that first acts as a stimulant but then begins to systematically destroy the body. It is associated with serious health conditions, including memory loss, aggression, psychotic behavior and potential heart and brain damage.

A Dangerous Mix

Meth is a powerful substance that attaches to specific receptors in the brain and triggers the release of very powerful chemicals associated with pleasure. People may also feel very alert and awake. Even a single dose can cause the desire to use repeatedly.

Deepening Problems

Brain receptors are turning off and chemical production decreases. Larger doses of the drug might be required to bring about the same effect.

The damage that meth can do isn’t limited to addiction either, as the National Institute on Drug Abuse (NIDA) reports that meth has also been associated with:

• Decreased verbal skills
• Reduced motor skills
• Memory problems
• Rotting teeth
• Lack of impulse control
• Weight loss

Some of this damage resolves when treatment is acquired and maintained for a year or longer, according to the NIDA. Other issues can be treated with the help of a medical or dental team. But some of the damage associated with meth use is so strong and so persistent that it lingers, even when the person is no longer misusing the substance.

Some of this damage concerns the heart. Meth can cause the heart to beat in a rapid and irregular manner, and the fragile muscle cells that line the heart can buckle and break under the strain. Meth also seems to have the ability to disrupt the electrical signals that power the heart, causing it to stop beating altogether. Some people have heart attacks while under the influence of meth.

Healing

People with a meth misuse disorder find it hard to simply stop their behaviors once they’ve started. Any underlying conditions like mental health conditions or eating disorders can also play a destructive role, keeping a person locked into their behavior. Therapy can help, however, as treatment allows people to develop a holistic view of their addictions and their habits.

At Futures Recovery Healthcare, we help people heal from meth addictions. Please call us to find out more about treatment programs and learn how we can help.

Dr. Dunkin on Pending FDA Approval of Dsuvia

Last week our Medical Director, Dr. Gloria Dunkin, was requested to comment on a Healthline news article by Brian Krans covering the potential FDA approval of a controversial new opioid, Dsuvia. This new entrant is produced by AcelRx Pharmaceuticals, Inc. and believes in the controlled administration of their new product as an alternative to intravenous delivery systems. For many in the medical field, it’s difficult but necessary to contemplate the downside potential of this innovation amidst a catastrophic overdose and addiction epidemic.

Gloria is clear on where she stands, “Dr. Brown is, rightly, focusing on the potential dangers and consequences of introducing this medication to the market,” she said. “We want to avoid more people dying from overdoses. Approving a sublingual tablet of sufentanil has a unique potential to only cause more.” She is backing the cautionary messaging efforts of Dr. Raeford Brown, the Chair of the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee.

To learn more or read the full text, please visit Healthline.

How Long to Wait Before Taking Suboxone to Avoid Precipitated Withdrawal

While opioid withdrawal is not typically life-threatening, it is not recommended to stop taking an opioid drug, such as heroin, methadone, and narcotic pain relievers, suddenly or “cold turkey.” Although not usually life-threatening, opioid withdrawal can still be very uncomfortable and may managed by certain medications, such as Suboxone. 

Suboxone is an Food and Drug Administration (FDA) approved opioid addiction medication. It contains four parts buprenorphine, a partial opioid agonist, and one part naloxone, which is an opioid antagonist. Typically, Suboxone is taken via a strip that dissolves under the tongue, usually once or twice per day, as part of a medication-assisted therapy regiment. While Suboxone does help with opioid addiction, since buprenorphine is an opioid narcotic, it can be abused. Abuse happens when higher-than-intended doses are taken.

What Is Precipitated Withdrawal?

Precipitated withdrawal is the rapid onset of opioid withdrawal symptoms brought on by taking a medication such as Suboxone before the last of the other opioids are completely out of your bloodstream. Withdrawal may be precipitated at different times, depending on when you took your last dose and your level of physical dependence as well as what type of other drug or drugs you may have taken. Each drug has a particular half-life that determines how long it remains in your bloodstream. Short-acting opioids, such as heroin, morphine, and most narcotic pain relievers, have shorter half-lives than longer-acting opioids like methadone, for example.

Some prescription narcotic opioids are designed to have an extended-release format as well, which extends the amount of time it will remain in your body. Precipitated withdrawal can start if you take Suboxone before the other opioid drug leaves your body. The timeline may differ from person to person depending on several factors, including personal physiology and genetics. Generally speaking, you should wait to take Suboxone the following amounts of time after your last dose of these specific drugs:

• Morphine: 8-12 hours
• Heroin: 12-24 hours
• Oxycodone and hydrocodone: 12-24 hours
• Oxymorphone: 24-30 hours
• Methadone: 36 hours to a week

A general rule of thumb to avoid precipitated withdrawal is to wait until opioid withdrawal symptoms start, as this typically means the drug has mostly left your bloodstream.

Precipitated Withdrawal and Suboxone

Most opioids are full agonists, meaning that they activate opioid receptors in the brain and body, blocking pain sensations, enhancing mood, and creating a euphoric rush when abused, often described as a “high.” Buprenorphine, the partial agonist in Suboxone, still activates opioid receptors, but not at the same level as full agonists. You may still feel some of the opioid effects, just not in the same intensity, and most of the time buprenorphine will not produce a “high” either.

Buprenorphine has a long half-life, generally staying in the system for at least 24 hours, as well as a ceiling effect, meaning that after a certain point you will cease to receive any benefit from taking it. Buprenorphine replaces the full opioid agonist with lesser effect, so if it is taken too soon, precipitated withdrawal can start as the full agonist is suddenly “kicked out” of your system. This can create quite a shock and may be very uncomfortable. The naloxone in Suboxone is a partial opioid antagonist as well, which is often used to reverse opioid overdose side effects and can also cause precipitate withdrawal. This part of Suboxone is more of an abuse deterrent, preventing potential diversion and abuse. Naloxone effectively blocks the opioid receptor sites, preventing other opioids from attaching, so even if you do take another opioid, you will not get “high.”

Mixing alcohol or other drugs with Suboxone may also cause precipitated withdrawal. It is important to be honest about your last dose of an opioid drug when seeking treatment for opioid abuse as well. Suboxone is effective for use starting in early withdrawal, during what is called the induction phase of medically assisted opioid addiction treatment. When used as directed, and at the right point during treatment, Suboxone can be a very effective tool for managing opioid withdrawal symptoms and cravings.

Opioid Withdrawal Symptoms

Generally speaking, the more physically dependent someone is on a drug, the longer it may take for the drug to leave their system, which means they might take Suboxone too soon and suffer from precipitated withdrawal. Precipitated withdrawal symptoms may be more intense and have a much faster onset than regular opioid withdrawal. Symptoms of both withdrawal and precipitated withdrawal may include:

• Nausea
• Vomiting
• Abdominal cramps
• Diarrhea
• Yawning for no apparent reason
• Dilated pupils
• Excessive tearing
• Runny nose
• Muscle aches
• Goose bumps or chills
• Sweating
• Agitation
• Anxiety
• Insomnia
• Drug cravings

Being aware of these symptoms is a good way to help your doctor, or the medical professional guiding you through addiction treatment, to identify the right time to start Suboxone. The timing of when to start, and take, Suboxone will vary greatly from person to person. Recognizing the psychological and flu-like physical symptoms that may indicate that withdrawal has started may be the best indicator that the opioid is leaving your bloodstream and that medication-assisted therapy can safely begin.

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

What It’s Like to Attend Your First AA Meeting (or Any Recovery Support Group)

Meetings are the foundation of recovery in 12-step programs like Alcoholics Anonymous or Narcotics Anonymous. It’s here that people learn more about how others cope with the challenges of addiction, and it’s here that they find out more about the skills they’ll need to develop in order to stay sober. Even though meetings can be remarkably helpful, the experience is a new one for people who have been steeped in substance abuse. We asked a few people to share their experiences about going to a meeting for the very first time, in the hopes that their words might inspire those new to recovery, and we paired their responses with those provided by Ryan Miller, Futures Alumni Coordinator. Here’s what they had to say.

5th Annual Alumni Holiday Giving Campaign

The “Friends of Futures” alumni program is participating in our 5th Annual Alumni Holiday Giving Campaign. This year, the alumni group has partnered with Friends of Foster Children. In Palm Beach County alone, there are over 1,600 children in foster care, and 45% are under 5.

With money raised by alumni worldwide, the Florida alumni group will purchase toys and household items as part of December’s sober outing. Futures and our parent company, GMH Associates, will match dollar for dollar ALL donations up to $5,000.

If you wish to donate, please send your donation by December 8, 2018 to:

Futures of Palm Beach
Attn: Ryan Miller
701 Old Dixie Highway
Tequesta, FL 33469

Donations are accepted via cash, check (please make check payable to “Friends of Foster Children”) or money order. Checks are tax-deductible.

If you have any questions, please contact Ryan Miller at rm*****@fu****************.com.

Withdrawal Symptoms & Managing Drug Withdrawal

Whether you are abusing drugs or alcohol, dealing with the unpleasant symptoms of withdrawal can be difficult, and when unsuccessful, can lead to relapse. Coping with cravings means instituting good habits that effectively circumnavigate your attention from the substance to the new, healthy practice. If you’ve tried to quit before, you know that this can be the worst part of beginning recovery. If you’ve relapsed in the past, you may not know that these unpleasant withdrawal symptoms do not last forever.

IDENTIFYING WITHDRAWAL SYMPTOMS

Drugs alter a person’s ability to think clearly and exercise good judgment. Especially when experiencing withdrawal, the brain will try to rationalize just about any reason to make taking drugs a good idea. Common symptoms of drug withdrawal may include:

• Increased sensitivity to pain
• Irritability
• Emotional instability, anxiety, and depression
• Restlessness or insomnia
• Increased heart rate and blood pressure
• Sweating, clammy skin, and hot flashes
• Stomach cramps
• Flu-like symptoms: weakness, muscle aches, and headaches
• Lack of or increased appetite

These symptoms alone don’t always lead to relapse. There are other emotional, social, or mental factors that can contribute to the risk of relapse as well. These symptoms include:

• A heightened negative or positive emotional state – turning to substance abuse because you feel bad or because you want to increase your good feelings
• Social situations – turning to substance abuse due to social pressure, because you’re in circumstances in which substance use is occurring, or because of conflict with another person
• Physical discomfort due to severe symptoms
• Intense cravings or temptation to use drugs
• Testing personal boundaries – many people use just “one more time” because they think they can stop at any point

The Severity of Withdrawal Symptoms

Several factors can define the severity of withdrawal symptoms. The first factor is the level of dependence on the drug. Individuals who are more dependent on a drug are likely to experience more severe withdrawals. The second factor is the duration and amount of drug use. Individuals who have used drugs for a longer period and in higher amounts are likely to experience more severe symptoms of withdrawal. The third factor is the presence of coexisting medical or psychiatric conditions. Individuals with other medical or mental health conditions may experience more severe withdrawal symptoms.

Healthcare providers can help determine the level of care required based on the severity of your withdrawal and physiological dependence.

COPING STRATEGIES

Not every treatment option or coping mechanism works for every person. Each person has a different addiction and reasons for abusing substances, so not every treatment will work for everyone. It’s important to remember that if something doesn’t work, you can try another method. Commitment to abstinence is key in achieving lifelong sobriety. Look at the reasons why you started taking drugs and why you kept doing it. It may help you identify which coping approaches will be best for you.

Physical Activities

Activities like exercising and yoga can be very helpful in keeping your mind off drugs. Yoga tends to help balance and center a person, much like meditation, and can prove very valuable in averting drug cravings. Many smokers for example don’t quit smoking for fear of gaining weight. Exercising just a few times a week can negate this result and make it easier for someone to quit.

Support Systems

Support of family and friends, and even counseling groups like Narcotics Anonymous or Alcoholics Anonymous, can be very encouraging for someone with an alcohol or drug addiction while quitting. Having someone to talk to and talk through your cravings can help quell the desire to use.

Preparation

Prepare for psychological symptoms like anxiety and depression, as well as physical symptoms like muscle cramps and rapid heart rate.  By knowing what to expect during the withdrawal period, you can make an action plan to help combat the cravings. If you’re prone to anxiety, identify ways you can work through the panic. Meditation, breathing exercises, and sensory strategies can help with this.

Medications

There are medications available to help with the withdrawal effects of addictive substances. Methadone and disulfram are two such medications that can treat withdrawal from heroin and alcohol, respectively.

Sometimes a person can cope with the withdrawal process on their own, but usually only if they are dealing with a mild or short-term drug or alcohol abuse issue. During severe physical dependence or severe withdrawal symptoms, however, a treatment facility like Futures Recovery Healthcare can help you achieve and maintain sobriety. We can work with you to implement a variety of strategies that can help you cope with cravings and effectively manage your abstinence. Call us today to learn more about the treatment options available.

Can I Get Fired for Going to Drug or Alcohol Rehab?

If you are struggling with substance use disorder, getting into an accredited, 30-day residential treatment program is your best option for recovery. You can get your life back, repair your relationships, find sobriety, and lead a healthy, productive life. Stepping away from your life, work, and responsibilities covered under FMLA to ensure that you will not be fired for getting treatment. In fact, many employees may encourage you to get the help you need. The Family and Medical Leave Act (FMLA) offers people with serious medical conditions (addiction included) up to 12 weeks of unpaid leave.

Get Support from your Employer

HR is there to help you – work with them to get support and info from the start. Getting treatment for yourself can have boundless benefits including better health, improved relationships, and you can learn the tools necessary to lead a happy, balanced, and fulfilling life. But it’s important to remember your employer has much to benefit from your well-being, as well, including:

• Increased Productivity: Employees who are healthy and not abusing substances are less likely to be frequently absent, experience improved job performance, and fewer accidents.
• Cost Savings: Healthier employees also result in lower healthcare costs over time and less corporate liability. Retaining employees is much more cost efficient, as well, since hiring an onboarding replacement talent can cost as much as 20-200% of annual compensation, according to SAMHSA.
• Better workplace for all: Employees who abuse drugs or alcohol off the job are more likely to come to work high or hungover, often irritable or fatigued, which can lead to poor interpersonal skills or even arguments with coworkers.

Common Concerns when talking to HR about Addiction

You may fear losing your job, losing out on a possible promotion, or dealing with the stigma of addiction mental health issues in your workplace. Remember, your employer and HR department are required to follow some key regulations when it comes to your health and safety, and may offer more help than you the think:

• Confidentiality: Your employer is required to maintain confidentiality regarding your medical issues, including addiction.
• Discrimination: For any government employer or private company with 15 or more employers, employees suffering from addiction are protected under the Americans with Disabilities Act (ADA) and cannot be fired for seeking or receiving treatment.
• Poor Performance: If HR comes to you first to address poor performance, you should be as honest as possible about your addiction and need for treatment. This will ensure that you are protected under ADA.
• Lost Pay: While on leave under FMLA, time off is unpaid, which can quite burdensome. Some employers provide their employees with short-term disability Insurance that provides a percentage of pay to compensate the lost wages during the leave.

Most employees of midsized to large companies are covered under FMLA, however, the best way to determine to if you are offered protection is to contact your HR department directly. If you are ready to take the time you need to get your life back, call Futures Recovery Healthcare today. We can help you understand your options. 

The Difference Between Helping and Enabling

We see this scenario time and time again. Families think they’re helping a loved one with a substance use disorder when they’re actually making things worse. A person constantly misusing substances will take your money, your charity, your time and your energy, and they’ll leave you completely drained. They’ll break your heart, and they’ll break their promises. How you respond to their behavior is crucial to veering them off the path they’re on.

The Many Ways of Enabling

Remind yourself that if things aren’t getting better, then you aren’t helping. There are many example of enabling, such as:

• Giving your loved one money that they may use to buy drugs
• Cutting them some slack and ignoring it when they use drugs after promising they’d quit
• Calling your loved one’s boss to say they’re ill when they’re really absent from work due to their substance use
• Taking care of responsibilities for your loved one: housekeeping, running errands, paying their bills, child rearing, etc.
• Bailing them out of jail
• Rationalizing or making excuses for their bad behavior

If you have to lie in order to assist someone else, you’re probably enabling, not helping.

Codependency

Often, the person with substance use disorder isn’t the only codependent in the family. When they claim they’re going to change, or quit using drugs or alcohol, but it’s on the contingency of you helping them with something else, you have to find the courage to say no. If you are fearful that your loved one will cut off contact with you or impose some other form of punishment if you don’t help them, you are becoming codependent and need to stop that behavior right away. It will only hinder them and hurt everyone involved if other family members become putty in their hands.

Codependent Behavior

Addictions train people well to be masters at manipulation. The kindest and sweetest of human beings can turn into the most destructive and hurtful people when addiction is in play. When you’re trying to support a person with substance use disorder, you’re inclined to want to help in ways that you would help others who are down on their luck. Many will offer money or a place to stay, some will simply be there as a friend, and others will go as far as taking in and caring for their children. These are all enabling behaviors, and they contribute to prolonging your loved one’s substance abuse.

For anyone who loves someone with substance use disorder, one of their biggest fears is what would happen to them if they turned their back on them. Families allow this fear to paralyze and trap them in a never-ending cycle of enabling. The trepidation you feel inside when thinking about removing yourself from your loved one’s life controls your behavior. Every time you catch them when they fall, they are reassured that you will next time. They are keenly aware of the control their emotional, psychological, and sometimes even physical threats have over you.

Take Action Now

Do not wait for your loved one to hit rock bottom. It’s a common misconception that those who are pushed into rehab against their will by their concerned families have no chance at success. This couldn’t be further from the truth. Sometimes it takes someone to realize that their family truly loves and supports them to get them to enter a treatment program.

Hitting rock bottom certainly does motivate some people to get help, but it isn’t an end-all-be-all requirement of addiction recovery. Likewise, rock bottom doesn’t have GPS coordinates – it isn’t the same place for everyone. Some people are motivated to quit for their families, whereas some stop when they realize they’re hurting themselves. Some take action at the first sign of trouble, and others still abuse substances after they’ve lost everything that ever mattered to them.

There are also people who are troubled by ramifications or shame they face because of their addiction, and this leads them to seek professional help. Others may be legally forced to.

Family members and loved ones of someone with substance use disorder often benefit from seeking help too. Support groups and family therapy play a hefty role in the rehabilitation of broken families, and serve to support family members and teach them ways to help instead of enable.

Ways to Help a Loved One

Stop hoping it will get better on its own. Do not turn the other cheek and allow someone with substance use disorder to wreak havoc on your life. This isn’t to say they can’t be in your life, but it needs to be on healthy terms. There are safe ways to protect yourself and other family members from a loved one without cutting ties.

Interventions

Interventions are a hot topic. There are entire television shows and documentaries based on this therapeutic concept, and for good reason — they’re successful in terms of getting people into rehab. Family involvement in substance abuse treatment programs, including interventions, often occurs before someone with substance use disorder enters rehab. This reinforces the idea that people with family support have a better chance at recovery. Likewise, it can hinder someone’s recovery if their family doesn’t follow through with their responsibilities and support them throughout their recovery journey.

The best thing you can do to show a loved one that you care is to educate yourself on what they’re going through. Learn what it feels like to be dependent on a drug or alcohol. Understand how desperate you become when under the influence of an addiction. Put yourself in the shoes of someone with substance use disorder and ask yourself what you’re feeling. Substance abuse and self-esteem often go hand-in-hand. It can be disheartening for your loved one to face the people who knew them before their addiction took over – they’ve lost people’s respect, and the substance abuse feels shameful and embarrassing.

Addiction Treatment Programs

Taking the step to accept help is a huge one, but it’s only the beginning of the long battle that lies ahead of your loved one. You must be prepared for what you will endure while holding their hand through this process.

It is a commendable trait to be compassionate enough to put your own feelings and judgments aside while helping a struggling loved one, especially one with substance use disorder. Your reward for such, if handled correctly, can mean getting the person you know and love back. Whether your loved one is participating in an outpatient or inpatient treatment program, you need to be equally as prepared to support them through it. When someone enrolls into inpatient treatment, it’s easy to feel like the problem has solved itself when it’s no longer in your home or impacting your daily life. Due to this, many people will get lax in their supportive roles.

Some stop visiting or even stop taking phone calls from their loved one. This can be very depressing for the person seeking treatment. Drug and alcohol addiction are scary things that no one wants to go through alone. Most people in a residential inpatient program worry about what will happen after they leave. As their family, it is your job to reassure them that they’re coming home to a loving and supportive environment.

Helping your loved one recover from substance abuse can ultimately make the difference between life and death. At Futures Recovery Healthcare, we understand that this can be a scary thought and you may feel as though you don’t know where to turn. Our compassionate team is here to help you and your loved one. Please do not hesitate to contact us as soon as you are ready.

Interventions and Family Mediation

An intervention is any process by which one individual or group of individuals intervene in the progress of a given situation. Interventions can take place in a variety of settings – they don’t always occur in living rooms. For instance, an intervention can occur in a doctor’s office when a doctor observes drug-seeking behavior and can make recommendations to their patient. Other types of interventions include school drug prevention programs designed to intercede in the normal progression of things like peer pressure or family history of abuse.

Perhaps the most popular form of intervention at the current time is the family intervention where a group of family members or friends of someone who is struggling with addiction confronts the individual to encourage them to get the help they need. Planning an effective intervention may not be as easy as it seems. During the intervention, the confronted individual may become resistant, angry, and might even try to leave the location where the intervention is taking place. In order to plan the most successful intervention possible, you may want to consider hiring a professional who is experienced in the planning and execution of drug abuse interventions.

What Are the Steps to Planning an Intervention?

The first most important step to planning an intervention is determining whether or not your loved one is suffering from addiction or drug abuse issues. There are several indicators established by the Diagnostic and Statistical Manual that may indicate if you or someone you love has a problem with drugs or alcohol. This manual is used by professionals in the psychological field to ensure consistency in the diagnosis of mental illnesses and other conditions.

The criteria for drug abuse and addiction are as follows:

• An individual who is unable or unwilling to meet their obligations at home or work or school because of recurrent drug use may suffer from the condition of drug abuse.
• An individual who continually places themselves in danger, such as by driving a car while under the influence of drugs or alcohol may suffer from the condition of drug abuse.
• An individual who is repeatedly challenged by law enforcement due to behaviors associated with drug use may suffer from the condition of drug abuse.
• An individual who uses drugs despite constant social or family fighting about the issue may suffer from the condition of drug abuse.
• When an individual develops a tolerance, the need to use more of the same drugs to achieve the effects they are looking for, or suffers from withdrawal symptoms when they are unable to use their drugs of choice, they may suffer from the condition of substance dependence (also known as addiction).
• If an individual has no control over the amount of drugs they consume or for how long they expose themselves to drugs in a single event, they may suffer from addiction.
• When an individual continues to abuse drugs even though they know the drugs are hurting them physically or emotionally, they may simply be unable to stop using without help.

If someone you love has exhibited the types of behaviors described here, you may want to consider speaking with a professional intervention specialist to determine your best course of action. You can also discuss the matter with your primary care physician. Once you’ve established that an addiction or drug abuse situation is likely, your next step is to select your intervention team.

The intervention team should consist of people who have influence over or a great love and affection for the individual suffering from addiction. It is important to limit the participants in the intervention team to people the individual respects and admires. Perhaps a favorite teacher, employer, or family friend might be involved. Members of the clergy, if the individual is or has been a member of a local church, might also be a member of this team.

Family members are often members of the intervention team, and it is important to remember what constitutes family for many people. In a study conducted to show the effects of family therapy, the researchers established that there are several types families, and that family doesn’t just mean being blood related.

Once you’ve selected your intervention team, the benefits of a professional intervention specialist can be of great help. Addiction is a complex illness, so it is very difficult to understand if one has not experienced it. A professional interventionist or family mediator can take some time to educate everyone involved about what addiction is, how it develops, and how it is treated effectively. When all the members have a basic understanding of the disease they are about to fight, they can be can begin writing their intervention letters to their loved one.

Many times during an intervention, emotions run high. It is easy to become distracted, angry or frustrated with the individual who may make significant excuses for their behavior, continually deny that they have any issues, or – depending on the types of drugs being abused – become violent. This is why writing down thoughts can greatly help. While members of the intervention team may want to rehearse what they will say on the day of the intervention, it is important to have a letter right in front of them so they can read it word for word to their loved one. This letter may go through several drafts before the actual event, and that is to be expected. It is often difficult to find exactly what one wants to say and the appropriate manner in which to say it.

Do I Have to Ambush My Loved One?

Oftentimes in the media, an intervention is depicted as a surprise event, where family members ambush a member of their family who is abusing drugs. Depending on the individual, this may or may not be necessary. If you have a family member or loved one who has expressed a desire to break free of their drug addiction but have not followed through on it, you may schedule a time for a simple family meeting. Under these circumstances, a professional interventionist and family mediator may help keep everyone calm and on track for the purpose at hand.

Drug abuse is a sensitive topic for anyone, and the individual who is suffering from addiction may be defensive and angry even when they’ve agreed to engage in mediation. Addiction is a brain disease that changes how people behave, so having an individual who understands the issues without being directly affected by them, such as a professional interventionist or a mediator, can have often help keep the peace.

Getting Help for Your Family Member or Loved One

Regardless of whether you choose a surprise intervention or a scheduled mediation, finding out how to help your loved one recover from drug abuse or drug addiction can ultimately make the difference between life and death. We understand that this can be a scary proposition and you may feel as though you don’t know where to turn. Our staff of trained and compassionate professionals is here to help you find your way. Please do not hesitate to contact us as soon as you are ready.

DBT Decoded: Mindfulness “What Skills”

To begin exploring DBT Mindfulness skills, we start with the What Skills. Early in the process this may feel like, “What Skills?” – but with commitment to the practice, we can turn it into, “What Skills!” Taking a step back, let’s clarify that DBT Mindfulness Skills are broken into two categories, What Skills and How Skills. Dividing the whole into halves is very much in line with dialectical teachings – embracing two sides balancing each other out to achieve a middle ground practice. We can even view these two sides in terms of DBT’s central concepts of acceptance and change. From this perspective, we can see the What Skills (Observe, Describe, and Participate) as acceptance-based, and the How Skills (Non-judgmentally, One-Mindfully, and Effectively) as change-based.

Observe is an immensely important mindfulness skill. It is the skill that sets us up for success – granting us the power of being objective about our thoughts. When we observe our mind, from the perspective of an overseer, we are able to see that there is a difference between our thoughts and ourselves. In other words, we are not our thoughts, and we need not let our thoughts dictate our mindset. As an observer, we begin to understand that thoughts come and go. By doing this, we begin to have the power of choosing where to place our attention. Our thoughts become clouds that float by, waves that roll along the sea, or trains that enter and leave the station. Observation of mind in this way allows us to consider our mind between our thoughts – a quieter place in which we can acknowledge a newfound ability to be fully present in the moment, in the now! When we’re not observant, we tend to feel beholden to whatever thought pops up at any given moment. As an observer, we see the transient nature of thoughts and power of attention is rightfully ours once again. Observing thoughts without attachment teaches us powerful lessons about our ability to let go of that which does not serve us well. In addition to our thoughts, we can observe our physical presence, and by doing this we focus attention away from thoughts, toward the body. Mindfulness practice is anchored on observing our breathing – noticing the physical sensations of inhaling and exhaling. As we do this, we direct our minds away from unsolicited thoughts. Checking in with our breathing consciously connects mind and body, which is significantly different that merely relying on all that our body is programmed to do unconsciously.

Along with observing our thoughts and physical presence, it’s helpful to describe our mindful experiences – the second What Skill. If a recurring thought causes tension, stress, shortness of breath, or another sensation, we note it as such. Describing what we observe helps us to process and better understand the thoughts and feelings that are present. We have the ability to be mindful of how certain thoughts make us feel without clinging to those thoughts or giving them any particular value. Instead, we simply name the thoughts and our experiences – to know them better – as we watch them come and go. It’s akin to watching cars come and go on the highway versus watching black, red, and white Fords, Toyotas and Volkswagens passing. See the difference in level of attention and comprehension?

The third step in Mindful What Skills is to participate. Simply stated, participating is implementing the practice of these skills. It’s that act of choosing to observe your breathing and your thoughts, to name them and experience them fully, and to practice non-attachment. To participate in mindfulness is to engage in the act of refocusing the mind, gently, upon realizing that the mind has wandering off, clinging to thoughts or resisting. Participation includes granting oneself permission to give and receive the gifts of mindfulness – providing space (and time) for the practice in one’s life.

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

Signs of a High Functioning Alcoholic

Unlike most stereotypes that relate alcoholics with failure in their professional, financial, social, and emotional lives, the high functioning alcoholic does not portray any signs of failure. The high functioning alcoholic is an individual whose abuse of alcohol has not affected these important aspects of human life; they are able to maintain their jobs, social connections, business partnerships, and even emotional partners. High functioning alcoholics are individuals who are able to combine normal life events and responsibilities with alcohol abuse without it compromising their operations and existence. While they are notoriously stubborn about the need for intervention, these alcoholics require specialized treatment and counseling.

Why do HFAs drink in the first place?

High Functioning Alcoholics (HFAs) drink for many reasons, some of which may differ from the motivators of normal alcoholics:

• To enable social interaction with their friends, family, and colleagues. Although alcoholics usually drink in relative solitude or secrecy to mask their affliction, HFAs do not need to mask their consumption because of the fact that it does not incapacitate them professionally or otherwise.
• To mask mental illnesses that may be hindering their social, emotional, or professional lives. Although high-functioning alcoholics do not suffer the devastating effects normal alcoholics suffer after an indulgence, their professional and social performance suffer. Consequently, such HFAs resort to masking the resultant mental illnesses, such as depression and anxiety, using alcohol.
• To meet their body’s affinity for alcohol. Like all alcoholics, HFAs usually become addicted to alcohol making them dependent on the substance.

Common Characteristics of HFAs

High Functioning Alcoholics are often very capable of maintaining their personal and professional lives. To society, they appear to have everything in order and lead successful lives. Their lives are highly compartmentalized and they make concerted efforts to distance themselves from the common stereotypes that often accompany alcoholism.

Normally, alcoholism affects individuals adversely in their personal and professional lives, rendering them failures. However, HFAs avoid these failures altogether. They also tend to be in denial and are not able to admit to being alcoholics even when they clinically classify as such. Such alcoholics depend on the stereotypical assumption that normal alcoholics are failures to justify their claims of not needing an intervention. Some more specific characteristics of HFAs include:

• Alcohol-focused: dining, socializing, celebrating or grieving plans include alcohol consumption
• Change of demeanor: becoming unhappy or easily annoyed during extended periods of time without alcohol, and returning to “normal” after drinking resumes
• Blackouts: not remembering conversations or details surrounding activities in which the person participated
• Drinking to function: drinking in the morning, at lunch and/or prior to potentially stressful situations
• Coping mechanism: resorting to drinking as a way to deal with life’s difficulties

It’s easy to overlook these behaviors when someone is managing to take care of their responsibilities. However, these signs of a high functioning alcoholic signify a problem that needs to be addressed. If proper action is not taken, an alcoholic’s health can severely decline.

Signs and Symptoms of High Functioning Alcoholics

In order to intervene before someone’s health declines, one must be aware of the warning signs of a functioning alcoholic or HFA. The longer he or she denies treatment, the more he/she will display these signs and symptoms:

• HFAs prefer to drink rather than eat: When presented with the chance of feeding while indulging in alcohol, these individuals abstain from the food and stick to drinking. Such habits affect their metabolism and physique.
• Drastic changes in behavior and persona while drinking: HFAs may show a slow but distinct change in behavior and persona while drinking. Calm persons become outgoing and even impulsive and vice versa.
• Inability to have only small amounts of alcohol: HFAs drink too much when presented with the chance and have a hard time controlling when to stop.
• Chronic explanations for drinking: HFAs always have an explanation for their drinking habits and tend to add denial and aggression into the mix to cover up their afflictions.
• Concealment of alcohol: Sometimes HFAs conceal the substance on their bodies in the form of sachets and in hip flasks at home or at work. When unable to do so, these individuals sneak off to engage in fast drinking and return after masking the alcoholic breath.
• Surrounding themselves with those who like to drink: This helps to normalize the excessive behavior or the alcoholic.
• Obsessing over the next drink: They may be counting the hours until the next drink and calculating how much alcohol can be consumed without appearing drunk.
• Finishing others’ drinks: HFAs may get another drink from whoever is closest.

Long-term Effects of Alcohol Abuse

The importance of addiction treatment for high-functioning alcoholics cannot be understated. There are many long-term health effects of continued and excessive alcohol use:

• Brain damage – Excessive alcohol consumption leads to the death of brain cells causing cognitive defects, memory loss, and even mental incapacitation.
• Liver tissue destruction – As an individual abuses alcohol, the liver cell’s metabolic effectiveness is exceeded leading to the destruction of its tissue and a disease called liver cirrhosis. Eventually, the person abusing alcohol may require a liver transplant.
• Pancreatitis – This condition creates metabolic problems and damages surrounding tissue when the pancreas becomes swollen or excessively inflamed.
• Social and emotional problems – These can include social abandonment, injury from accidents and falls, marital and family-based separation, and financial issues.

Myths About the Functioning Alcoholic

There are plenty of myths which obscure a clear and accurate understanding of high-functioning alcoholics. Here are some of the biggest lies that people believe:

• Myth: They don’t have a problem. This myth is common because the person can’t see that their problem exists since all personal or professional obligations are met. However, attempting to manage responsibilities while heavily drinking is not sustainable and will catch up with the person.
• Myth: They cannot be successful. On the contrary, functioning alcoholics can have a family, a job, a large circle of friends, and can be very popular.
• Myth: They have control. Usually, they are well-educated, dedicated workers and highly intelligent. This can convince them that their drinking is under control while in reality, they’ve only been successful in keeping their drinking problem private.
• Myth: They do not show signs of alcoholism. They typically drink in order to become relaxed or confident and often prioritize drinking alone and often. Some functioning alcoholics experience problems with concentration or lapses in memory.
• Myth: No help is required. Some manage to live with their dependency without experiencing major losses. Because of this, they foster a deep denial of their problem, but still go to great lengths to feed and suppress evidence of their addiction. This makes functioning alcoholics often the last type of alcoholic to seek treatment.

How to Talk to and Help a Functioning Alcoholic

When talking to a functioning alcoholic, use of a non-judgmental tone is important because HFAs can be defensive and even aggressive. Talking an HFA down or talking over them only serves to exacerbate their alcoholic tendencies. Approach the individual strategically, especially when they themselves are trying to reduce their consumption in order to create the impression of a supportive party rather than a judge.

Never approach or talk to an HFA while they are drunk or consuming alcohol heavily because this may compromise the approach. Similarly, raising your voice or using aggressive gestures, such as pointing, may induce aggression or deflective behavior in the HFA. Avoid confronting the HFA when they are with drinking buddies or other enablers. Such communication dynamics compromise the process of getting through to the individual because they feel victimized and see a bias.

Avoiding Co-Dependency

Sometimes spouses, family members, friends, or colleagues fall into the trap of co-dependency by becoming alcoholics, or enablers, themselves. Avoiding co-dependency is crucial for a successful intervention, rehabilitation, recovery process of the HFA. It can be achieved through:

• Creating and maintaining boundaries: The people assisting the HFA must create and maintain boundaries with the recovering HFA. Such boundaries are an important part of the recovery process and reduce chances of being sucked into the problem.
• Mutual respect throughout the intervention process in order to avoid becoming: In order to avoid becoming someone upon which the HFA is codependent, the people assisting in the intervention process must practice mutual respect with the recovering HFA. Mutual respect enables the assisting parties to fight off the attempts by the recovering HFA to use condescending language on them or trickery using temptations.
• Self-respect and valuing your body: One ingredient of becoming an effective support system member is self-respect. This quality enables the individual to avoid indulging too much in alcohol and other substances, a trait that could potentially expose them to codependency. Additionally, such respect for one’s body encourages the recovering HFA to work harder at recovery.
• Knowing and respecting each other’s limits: An intimate knowledge of one’s limits is key to avoiding codependency because the individual cannot exceed these limits. Such discipline makes an individual integral to the process of rehabilitation and recovery of the HFA.

Conducting an Intervention

For HFAs, most processes of intervention are initiated when the patient suffers an occasional loss such as a DUI, an accident, mugging, or emotional separation. Early intervention is critical in avoiding these incidents and may be useful in avoiding more serious consequences related to their addiction.

Tips for conducting a successful intervention include:

• Use professional alcohol intervention professionals. While most people think of alcoholic intervention process from the perspective of friends, colleagues or family, these may not work for the functioning alcoholic. HFAs portray stronger attributes of denial and even aggression necessitating the use of professional therapist and alcoholic recovery professionals.
• Carry out progressive support processes during, and after, the first intervention. During and after the recovery process, the support system members must accompany the recovering HFA to counseling meetings and monitor their progress. Combined with encouragement and compassionate support, such intervention strategies usually succeed in helping even the worst HFA to recover.
• Encourage residential, inpatient treatment with full-time counselors and therapists. The support system members should accompany the recovering HFA on the first day but should also communicate firmly, and respectively, that the journey is the HFA’s. During the rehabilitation and recovery process, family, friends, and colleagues must liaise with the professional intervention personnel to ensure the recovering HFA succeeds in their rehabilitation.

Treatment for High Functioning Alcoholics

There are many options for treatment for an HFA that may aid in the recovery journey. For some, medication may be used to assist in the detox process, including:

• Naltrexone – this is an opioid receptor antagonist approved by a majority of the global medical boards for alcohol dependency treatment. It also intervenes in reversing the psychosocial complications associated with alcoholism. Scientists believe that this drug works by blocking certain opioid receptors associated with the reinforcement process of alcohol dependence and addiction. While it is a mild medication, its side effects include sedation, nausea, vomiting, and anxiety.
• Disulfiram – the second medication used in the treatment of alcohol abuse, dependence, and addiction. Essentially, it works by inhibiting acetaldehyde dehydrogenase which leads to a buildup of acetaldehyde in the blood causing unpleasant symptoms such as palpitations, nausea, chest pain, and low blood pressure. These side effects discourage recovering alcoholics from drinking. It is an effective medication in the management and treatment of alcohol dependence. Liver function tests must be conducted prior to use.
• Acamprosate – this is the third medication that alcohol dependence centers use in treating alcohol addiction. With heavy use of alcohol, brain neurotransmitters are affected and become accustomed to the chronic presence of alcohol. However, when you remove alcohol intake, the system becomes dysregulated and enters a pathologic hyper excitatory state. Acamprosate helps regulate and normalize this brain activity. The drug, also referred to as calcium homotaurinate, produces mild side effects that include sweating and anxiety.

Along with or in place of medication, there are a variety of therapies and treatments available to successfully treat an HFA.

The Need for Support during Detox, Rehabilitation, and Recovery

HFAs need support at all the stages of their intervention. They need support during detox which is one of the hardest parts of the process of intervention. Since HFAs are usually in a sound financial and mental condition, their relapses can go unnoticed causing them to revert back to addiction more easily. They must be watched more carefully and encouraged to participate in the intervention to minimize how much the HFA’s addiction affects his/her family and friends.

HFAs need support during rehabilitation because of the propensity for denial and even aggression. Unlike normal alcoholics who may be subdued from their losses and failures of their over-indulgence, HFAs function normally while in the society. Therefore, the support system participants must be compassionate and avoid judgmental attitudes that may cause a relapse through pride and denial.

Similarly, during recovery, HFAs must be monitored closely to avoid relapses and other negative outcomes such as depression. A support group may pre-occupy the recovering HFA with activities that exclude alcohol or social establishments. Additionally, the recovering HFA must be encouraged to adopt an alcoholic-free life.

How Does Heroin Kill You? The Facts About Heroin Overdose

Heroin overdose kills because it inhibits the body from breathing. Heroin overdose also causes your blood pressure to drop, with heart failure resulting. Other health problems heroin can cause include:

• Infectious endocarditis – an infection of the heart’s surface
• Arrhythmia – a condition in which the heart beats with an irregular or abnormal rhythm
• Pulmonary edema – a condition that causes blood to flow in the body in the wrong direction, backflowing into veins, through the lungs and into the left side of the heart
• Heart attack or kidney failure – these conditions are caused when excess fluid enters alveoli in the lungs and reduces oxygen

Common Characteristics of Heroin Overdose and Deaths

Heroin death is more likely when the following are true:

• The user is male
• Other drugs or alcohol were recently used
• At least one other person is present during the drug use
• The drug use is occurring in the user’s home
• The user is an experienced user

Heroin Death Does Not Have to Be the Result

Death happens more often to experienced users of heroin than to new users. This means that every time you or your loved one pick up the syringe to inject heroin, the risk of death grows. This also means that getting into a quality detox program and rehabilitative treatment grows more critical each day. Futures of Palm Beach in South Florida offers dual diagnosis residential inpatient adult addiction treatment programs that provide patients with a wide array of evidence-based therapies and relapse prevention techniques. Call Futures Recovery Healthcare before the chance to stop heroin addiction is lost to overdose.

Creating An Addiction Recovery Plan After Rehab

A well thought-out plan can be the difference between starting a new sober lifestyle and being set back by relapse. As soon as the elation of completing an addiction treatment program ends, you may find yourself asking, “What do I do next?” The responsibility of making major life changes while working to maintain sobriety can seem overwhelming; be prepared with a post-inpatient addiction recovery plan.

10 Tips for Creating a Sustainable Addiction Recovery Plan

1. Stay engaged with your recovery
   There are countless local informal and formal aftercare programs available. Do some research to find out which are the best fit for you and commit to a program that will provide the support and care you need. If you found particular therapy sessions or therapeutic treatment programs useful during your inpatient treatment, that can be a great place to start. Continuing to attend these appointments can provide vital ongoing structure and formalized support that will help you maintain your recovery. You can also seek out regular support groups or twelve-step meetings (Alcoholics Anonymous, for example), for support and camaraderie from those also on the journey to recovery. No matter what structure you choose, staying engaged is crucial to creating a reasonable and attainable addiction recovery plan. This step should be the theme of every single objective throughout a personal recovery plan.

2. Continue to pursue mental health treatment
   There is a proven link between substance abuse disorders and other mental health issues. The Substance Abuse and Mental Health Services Administration did a study in 2014 and estimated that around 8 million Americans are living with co-existing mental health and substance use disorders. The two disorders tend to feed off one another – mental health issues need to be managed in a healthy way to avoid exacerbating a substance use disorder. That is why, in recent years, physicians have made mental health treatment a standard part of the addiction recovery process. Make a point to explore mental health treatment and support options as part of your treatment and recovery process. If individual therapy was started prior to treatment, the continuation of those sessions is important. Personal therapy isn’t the only way to receive support for mental health. – twelve step meetings and support groups can also include a mental health element that works well for some individuals.

3. Attend to the basics
   Tackling some of the small, but necessary responsibilities you will be taking care of in the near future should be next on an action plan. Make a list of the basic responsibilities needed to feel more fully integrated in a healthy, sober, and productive life. Depending on individual situations, everyone’s list will look different, but here are some common first steps:
   • Apply for or renew an ID card or driver’s license.
   • Get a copy of your social security card or birth certificate.
   • Look into possibly relocating to a new or better living situation.
   • Begin searching for a job to pay for bills.
   • Open a new bank account.
   • Clear up any remaining legal matters.
   • Purchase new insurance (home and auto).

4. Have a relapse prevention plan
   Making the transition out of rehab can be intimidating, and many people find themselves afraid of facing some of their old triggers again. Remember that a relapse should be considered a setback, rather than a failure, and that it is something to plan for, rather than fear. A relapse plan should ideally be a running list that gets updated, along with your situation or status, for months or years after leaving treatment. Create your plan by focusing on your recovery goals and identifying anything that threatens your success in those areas.
   • Triggers to Address: First, you need to determine what some of your personal triggers are. These may include people, places or activities which increase the urge to use drugs and/or alcohol again. By figuring out what your most common triggers are, you can work to limit your exposure to them, making it easier to maintain your personal addiction recovery plan and sobriety. For the triggers that may be nearly impossible to avoid, take time to plan how you will manage those situations.
   • Helpful Tools: Assemble a “toolkit” of ways to keep yourself grounded in highly stressful or triggering environments. Meditation and relaxation techniques are fantastic resources for maintaining one’s composure and/or emotional stability. These practices can be paired with stress management techniques; when you maintain lower stress levels, you are less likely to be triggered when unexpected situations do arise. Finally, make sure that wellness, both physical and mental, is a part of your tool kit. A healthy body and mind is best equipped to resist triggers and temptations.
   • Support Network: – When you do find yourself in a situation that you cannot manage on your own, you will need a strong support network of friends, family members, and professionals to call on. Making a list of these contacts in advance can be instrumental for getting through tough cravings or stress when they do arrive.
   • Post-Rehab Recovery Programs: Stay actively involved in your own relapse prevention through proactive post-rehab recovery programs. These may come in many shapes and sizes, but starting with the twelve step format is still very common. If you haven’t been through such a program before, some of the steps may already be familiar, as many therapists and treatment centers use variations on these common steps in their everyday practices. For example, a moral inventory exercise may be suggested by a therapist to encourage self-awareness and to make amends with those you may have wronged.

5. Prioritize health and wellness
   After a course of treatment for substance use disorder, it is normal for the body to be weakened by the physical stress. The process of detoxing and enduring withdrawal from a dependance on drugs and/or alcohol is draining, making it important to begin focusing on rebuilding and then maintaining your strength and health after leaving treatment.Some of the most common health advice is often the easiest to overlook. Eating three healthy meals a day, getting a full night of sleep, and exercising regularly can do wonders towards improving your mood, health, and energy. Make sure to build these simple practices into your daily routine to ensure your health isn’t compromised by something well within your control. Although it may be tempting to go right back to tasty, unhealthy foods that you weren’t able to have during treatment, it is especially important to maintain a balanced diet. Indulging in a high-carb or sugary diet full of processed foods combined with a sedentary lifestyle can actually delay your physical recovery, as well as add to your stress! Instead, aim for meals that include fruits and vegetables, lean proteins, whole grains, and low-fat dairy products.

6. Make good friends
   Think of your exit from rehab and entrance back into the world as beginning a new chapter. Use this opportunity to cut ties with the things and people that contributed to or exacerbated your substance abuse. Though it is never easy, it is necessary to limit your time spent with anyone who is not supportive of your recovery. One of the best ways to navigate this transition is to find a new hobby or friend group to hang out with. Though it can be difficult to make friends as an adult, there are sure to be a variety of local meetup or hobbyist groups in your area. Many of these gatherings are now posted online; you can start by checking Facebook groups for your local town. By finding people you share a common interest with, it is easier to get acquainted and develop lasting, meaningful friendships. It may seem strange to be consciously aware of purposefully developing friendships, but you should keep some things in mind when choosing who you spend time with, and what activities you engage in. Some basic questions to ask yourself:
   • What do I want my life to look like now?
   • Who is around to help me achieve this goal?
   • Is this person allowing me to make sobriety an important part of my life?
   • Should I retain a friendship that in any way threatens my goals?

7. Cut out negativity
   Self-awareness is important, and you’ve probably already thought a lot about what has triggered your desire to drink or abuse drugs. Now it’s time to start purposefully changing paths and habits to avoid these negative triggers. For example, if the bar where you used to drink is on the way home from work, take a different route. Avoiding these locations can help to eliminate temptations associated with them. Also be on the lookout for things that offer comfort, but are in their own way vulnerable to abuse. For example, comfort eating is a habit that can be very easy to slip into, but very hard to quit, and can lead to avoiding feelings that should be processed. Likewise, getting lost in video games, television, or browsing the web can be a refreshing distraction from your day, but they need to be kept in moderation. Avoiding your feelings is unhealthy and will set your back in achieving your addiction recovery goals. Replacing drugs or alcohol with another crutch to support avoiding your real problems is not progress at all. Find ways to infuse positivity into your life every day. One of the best ways to do this is to surround yourself with overtly positive and supportive people. Use exercises, meditation, yoga or other practices to calm your mind and lift your mood. Make time each day to indulge in something healthy and positive to boost your mood and brush off any negativity.

8. Consider your career
   Many people need to find a new job once they leave treatment. Job markets can be difficult to deal with no matter what kind of work you are looking for, and sometimes even more so for someone with prior drug or alcohol offenses. Keep in mind while you are searching that your goal should be finding a position that does not hinder your recovery.Take time to plan out possible options for career directions. Ask for advice from friends, family members, counselors, former co-workers, and anyone who can give some insight on what kind of work suits your skill set. Many communities even host job fairs or other similar events to help promote local business in need of skilled workers. At the same time, keep in mind your own personal goals, and find where they cross with your available options. 
   • Compose a resume, and keep it up to date: If you have never created a resume before, there are many templates available on the web. Be detailed without being long winded, and don’t be afraid to be proud of what you have accomplished! Be sure to document your experience, training, skills, education, etc., as well as your professional goals.
   • Consciously network to make connections: This can be done in person or online, and there is now a large number of local sites or social networks that have a job listing section. You never know when an exciting opportunity may pop up, or from where, so keep a current resume on file so that you are not caught off guard. It is also okay to reach out to a specific company you would like to work for and ask if they have any positions available, you might be amazed where a personable conversation may lead.
   • Consider furthering your education as a way to advance your career: Research your local options and try to find students who have studied at those schools to find out about their experiences. Trade schools or other vocational training can be a great way to invest some time and give yourself a better chance at finding work. Whatever it is you choose, be sure it is something you are passionate about, and can imagine yourself doing as a long-term career.
   • Stay positive! It can be discouraging getting turned down from a position you really wanted, or never hearing back after an interview. Don’t take it personally, and always maintain the proper perspective. You have skills that make you a valuable asset, and you are interviewing employers as much as they are interviewing you. Even if it takes time to find the right fit, it will be worth the effort to be working towards a career that aligns with your long-term life goals.

9. Set personal goals
   No matter how small, accomplishing a goal you had set for yourself feels good! You can stay feeling positive about yourself and your recovery by setting personal goals and taking steps towards them every day. Try learning a new instrument, craft, language, or another hobby. Each small success adds up, and you may be amazed at how quickly complex or time-consuming things can be accomplished. When writing an individual addiction recovery plan, be sure to include some possible steps towards achieving personal goals. Do not try to take on the weight of the world, but instead include some external support for making your plans a reality. Turn to community support or the love of friends and family, and you will find that people are more eager to help you succeed then one may have imagined.

10. Check in with yourself regularly
    One step that cannot be overlooked is the importance of self-evaluation. You will need to often and honestly assess your progress and your emotional state. Don’t get caught in the habit of focusing on external circumstances and losing sight of your own feelings.
    Before anything else, ask yourself these questions:
    • Am I doing what I want to be doing?
    • Do I have a plan in place and the support to succeed in this new chapter of my life?

    If the answer to either of these is ‘no’ then there is still work to be done on shaping your addiction recovery plan. If you find yourself stuck, find time to reach out to your local addiction recovery centers and ask the staff for guidance. Even if you underwent rehabilitation at another location, support centers typically welcome clients at all stages of the recovery process.

Contact Futures Recovery Healthcare now to learn more about sober living options, aftercare programs, and other therapies available for people in need of some support while getting back on their feet and building a new sober lifestyle in recovery.

Are You Self-Medicating?

Tough day at work? Head to the bar. Big fight with your boyfriend or girlfriend? Light up a joint. These may sound like “normal” reactions to a stressful or emotionally difficult situation, and perhaps they are “normal,” but they are not healthy. In some cases, when the behaviors are the natural response to any difficult situation, they may indicate an issue with self-medication. The act of self-medicating occurs when you turn to drugs or alcohol as a way to deal with tough issues. Unfortunately, this can lead to substance abuse and, in time, addiction and a host of new problems that are far more difficult to manage than the original difficulty that drove you to drink or get high. Do you self medicate? Here are four signs that you might be.

1. You drink or get high when you feel stressed, depressed, angry, or other uncomfortable emotions.

Though only on a rare occasion, many people may “drown their troubles” in a bottle of wine – or something harder. If this becomes a regular habit, it is a sign of self-medication. If every time you get mad at someone, feel depressed, attend a social event, or just feel bored, you turn to drugs or alcohol, you are using substances in an unhealthy way. Some people crave their drug of choice as soon as they enter a situation that is stressful. Others may begin to panic if they are unable to drink or get high when they feel social anxiety, depression, anger, and other uncomfortable emotions. If you find that you get irritable or restless when you are unable to drink, smoke, snort, or shoot away your difficult feelings, you are likely self medicating.

2. Your mood or mental health symptoms get worse the more you drink or get high.

Over time, substance abuse takes a toll on your physical and mental health. You may not sleep as well, your eating habits may change, and you may find that you more frequently struggle with illness. Additionally, you may find that the moods and emotions you were primarily trying to quell through substance abuse have become stronger, more frequent, or longer in duration since you began drinking or getting high to deal with them. Though initially you may have experienced some relief from these symptoms, over time, regular use of substances can worsen them.

3. You are experiencing more health, social, financial, and other problems.

Drug abuse brings with it a host of problems. Whether or not there are underlying difficulties in managing mental health symptoms or emotions, ongoing substance abuse creates too many issues to list. In general, people usually experience:

• Relationship problems
• Difficulties in maintaining commitments at school or work
• Low self-esteem and self-confidence
• Physical health issues
• Mental health symptoms related to drug and alcohol use
• Financial struggles
• Decreased ability to experience true joy and connection with others

4. You’ve been told by doctors, loved ones, and friends that you need treatment.

You may not take it seriously, but when the people who are closest to you tell you that they are concerned about the amount you are drinking or the drugs you are using, it’s worth your consideration. They know you better than anyone else, and they are more objective than you are and thus more capable of assessing the situation when you begin to shift from recreational use of substances to abuse or addiction. Similarly, when a doctor tells you that you are experiencing chronic health problems – or building toward chronic health problems – due to your use of alcohol or drugs, it’s time to listen.

What to Do if You Are Self-Medicating

Stop. There is nothing to be gained from using drugs and alcohol to manage difficult emotions. Instead, the practice will likely only worsen the underlying issue and then cause additional problems in your life. Don’t justify or accept the practice of self-medication as normal for any reason.
Learn new coping skills. Support groups for specific issues (e.g., social anxiety, anger, etc.) can assist you in learning how best to address your symptoms in a way that is healthy.
Moderate use or seek help. If possible, moderate your intake of alcohol and cut out the use of harmful substances altogether. If it’s not possible, seek substance abuse treatment.
Seek treatment for serious mental health symptoms (e.g., depression, anxiety, etc.). In some cases, comprehensive care that includes medication and therapy may be the best way to help you manage without self-medication.

What to Do if You Can’t Stop Drinking or Using Drugs

Unfortunately, self-medicating for months or years may add up to drug or alcohol dependence, and in this case, stopping on your own may not be possible. Addiction is a medical disorder, and medical treatment is available. Detox can help you address physical symptoms of dependence, and intensive therapy can help you to address the psychological cravings for your drug of choice, as well as the issues that initially drove you to self-medication and ultimately addiction. If you are living with a co-occurring mental health disorder in addition to addiction, this too should be treated. Dual diagnosis treatment will help you to learn how to live without drugs and alcohol while also managing the symptoms of the mental health disorder. Because the two issues are deeply entwined, it is not recommended that you attempt to get treatment for the mental health issue while continuing to drink or get high, or that you seek treatment for drug dependence without also getting treatment for the underlying mental health disorder. Call Futures Recovery Healthcare to learn how we can help you or a loved one stop self medicating.

3 Goals of Anorexia Treatment

The primary focus of any eating disorder treatment program aimed at helping those living with anorexia is to find balance and health in eating properly. But like any difficult undertaking, this is achieved by taking small steps that build upon each other – and lots of time and practice. Healing doesn’t happen overnight, but with perseverance, treatment of anorexia nervosa can save the life of any person who is dedicated to learning how to live healthfully.

TOP 3 GOALS OF ANOREXIA TREATMENT

• Addressing medical issues caused by long-term starvation. The body needs calories to perform basic body functions, and when it is deprived of this energy source, malnutrition can develop. As a result, major organs can cease to function properly, the whole body slows down in an effort to conserve calories, and in some cases, serious failure of major organ systems can occur. When entering anorexia treatment, the first order of business is to stabilize the patient medically and ensure that they slowly begin to rebuild their stores of vitamins and nutrients and mend the damage that occurred during active living with anorexia.
• Building toward a healthy weight. Because the gastrointestinal system and other organ systems in the body may be unable to handle large amounts of food or certain foods right away, another goal is to slowly move the patient toward a healthy body weight. This can be difficult physically and emotionally, and it is done as slowly and safely as possible. The goals of treatment are to help patients build a healthy relationship with food, change perceptions about health and body image, and address disorder behaviors exhibited toward food so they can maintain a healthy weight on their own when they return home.
• Providing psychotherapeutic treatment to deal with underlying issues. No one develops anorexia simply to lose weight. Low self-esteem, body issues, environmental triggers, social factors, emotional stress or trauma, need for control – any one of these can be a driving force behind anorexia. It is important to address these issues thoroughly, exploring the truth behind the myths that make these problems feel so overwhelming, and learn new, healthy coping skills that don’t include self-starvation and disordered eating.

Who Is Most at Risk of Developing Anorexia?

Anorexia is a serious mental illness that affects people of all ages, genders, sexual orientations, races, and ethnicities. It doesn’t care who you are or where you come from – it can strike anyone, anywhere, at any time. While anorexia is more commonly associated with girls and women, the truth is that boys and men are also at risk. In fact, eating disorders are on the rise among males, possibly due to the growing social pressures to conform to unrealistic body standards.

One group that is particularly vulnerable to anorexia is teenagers. Adolescence is a time of immense change and upheaval, both physically and emotionally. Teens may feel like they’re constantly under a microscope, facing peer pressure and scrutiny from every direction. Even innocent comments about weight or body shape can be enough to trigger a problem with distorted body image.

So, what causes anorexia? The truth is, no one really knows for sure. It’s likely a combination of biological, psychological, and environmental factors. However, we do know that anorexia is not a choice, and it’s not a lifestyle. It’s a serious mental disorder that requires professional help to overcome. Extreme weight loss related to anorexia nervosa is considered a medical emergency, and early treatment is important.

Who Typically Treats Eating Disorders?

When facing an eating disorder, such as anorexia or bulimia nervosa, it can be overwhelming to think about how to begin the journey toward recovery. But you don’t have to do it alone. In fact, having a treatment team of different healthcare providers can be a powerful tool in your recovery.

Your treatment team will be comprised of different professionals who will work together to provide you with the medical care and support you need to overcome your eating disorder. Here are some of the key players on your treatment team:

• Primary care provider: This is typically your first point of contact for any health concerns and can help you connect with other specialists if needed.
• Psychiatrist: A psychiatrist specializes in mental health and can provide medication management if needed.
• Psychologist or therapist: A therapist can help you work through any underlying emotional issues that may be contributing to your eating disorder.
• Nurse or nurse practitioner: Nurses can help with medication management and provide support throughout your recovery.
• Nutritionist or dietician: A nutritionist can help you develop a healthy relationship with food, create a balanced meal plan, and help you with your weight restoration.
• Social worker: A social worker can help you navigate any social or financial barriers that may be impacting your recovery.
• Case manager: A case manager can help coordinate your care and connect you with resources.
• Peer support mentor: A peer support mentor is someone who has gone through a similar experience and can provide guidance and encouragement.

Your treatment team may be located at a clinic or treatment facility, or you may visit them in different locations. Regardless of where you receive care, having a team of treatment providers working together to support you can make a tremendous difference in your recovery.

TREATING ANOREXIA AND CO-OCCURRING SUBSTANCE ABUSE

Anorexia and co-occurring substance abuse can be treated through a combination of therapies that address both disorders. Treatment plans may include different levels of care, including residential care, partial hospitalization programs, outpatient programs, and aftercare treatment.

The first goal of anorexia treatment is getting back to a healthy weight, which is essential for recovery. Depending on the individual and their symptoms, treatment options and types of therapy for individuals with anorexia can include:

• Medical care
• Nutritional counseling
• Interpersonal psychotherapy (IPT)
• Behavioral therapy, such as cognitive-behavioral therapy and dialectical behavior therapy 
• Family-based therapy 
• Acceptance and commitment therapy (ACT)
• Cognitive remediation therapy (CRT)

Substance abuse treatment typically involves detoxification, followed by behavioral therapies, medications, and support groups.

At Futures of Palm Beach, we help people and families struggling with the disease of drug or alcohol addiction, especially when complicated and accompanied by a co-occurring mental health condition like anorexia. Since substance abuse, drug or alcohol dependencies, can often co-occur with an eating disorder, our individualized treatment program is designed to explore and change the underlying core issues that drive each individual’s addiction and disorder. Our mental health professionals are here to help you gain control of your eating disorder and your addiction through our clinical, medical and wellness care programs. If you or a loved one is suffering from anorexia along with a comorbid medical or psychological condition such as addiction, call Futures today for the treatment outcomes you deserve. 

4 Factors That Contribute to the Development of Eating Disorders

How do eating disorders start? There is usually no one single cause, but rather a number of different issues that culminate in an eating disorder. These risk factors could be:

• Biological factors 
• Emotional factors 
• Interpersonal factors 
• Social factors
• Psychological factors

What do all these terms mean? How do you know if you may be dealing with something that could be a contributing cause when it comes to your issues with food?

BIOLOGICAL CAUSES

The subject of biological causes for eating disorders is continually being researched. Some propose that chemicals in the brain that control appetite and hunger may be a part of the story and that, when unbalanced due to genetics, accident or disease, can cause people to develop disordered eating habits. How to identify these issues and remedy them are still under investigation. What we do know for sure is that eating disorders – like other mental wellness issues – often run in families. But is it biologically passed from one member to another or an environmental issue that occurs when family members develop similar habits? Again, that is a question that is currently up for debate.

INTERPERSONAL CAUSES

Many use food to medicate emotional issues and there are few things more emotionally disturbing than interpersonal relationships. Problems that can trigger eating disorder issues range from moderate to severe, including:

• Breakups, divorce and on-again/ off-again romantic relationships
• Difficulty expressing emotions or emotional attachments to others
• Past issues with being victimized by bullies or teased, especially about body image
• Past or current issues of physical abuse, sexual abuse, and/or domestic violence

SOCIAL CAUSES

The importance that the media places on a particular beauty ideal varies from culture to culture, and in our country, tall and skinny is the media’s version of perfection. Actresses are airbrushed in magazines to look as close to the ideal body size as possible, models for almost every line of clothing are thin, and the cultural norm is to judge people based on their body shape. This distorted body image can make it difficult for those who are also dealing with other emotional or interpersonal issues to handle the pressure without developing disordered habits with eating. Although body dissatisfaction is one of the factors that can contribute to the development of eating disorders, it is not the main cause.

PSYCHOLOGICAL AND EMOTIONAL CAUSES

Psychological issues like low self-esteem, feeling a lack of control over stressful issues in your life, feeling inadequate, or struggling with mental disorders like depression, anxiety disorders, or obsessive-compulsive disorder can all trigger you to attempt to regain control through food or find comfort in eating. Obsessive-compulsive disorder is often connected with eating disorders since many behaviors may overlap, such as obsessive thoughts about food and food rituals, along with unhelpful beliefs. If you are using food to self-medicate feelings associated with the above problems, eating disorder treatment can help.

TYPES OF EATING DISORDERS 

Keep in mind that eating disorders, in general, are complex, and some eating issues will not meet the diagnostic criteria. But this shouldn’t make you take any eating issues lightly. Some of the common eating disorders include:

• Anorexia nervosa is probably the most well-known eating disorder. It usually develops during adolescence and early adulthood and affects more women than men. People with anorexia nervosa are extremely underweight but often view themselves as overweight. This distorted body image and body dissatisfaction are compounded by the fact that they have an intense fear of weight gain and take extreme measures to control weight. Studies indicate that anorexia nervosa had the highest mortality rate of all eating disorders, with a rate of 10.4%.
• Bulimia nervosa is yet another well-known eating disorder, which, like anorexia, develops during adolescence and early adulthood and is more common in women than in men. People with bulimia nervosa often eat unusually large amounts of food until they are painfully full. They then follow these episodes of binge eating with unhealthy compensatory behaviors such as purging to atone for the effects of binge eating. But it is worth noting that people with bulimia often maintain normal body weight, unlike people with anorexia. Studies indicate that bulimia nervosa had a mortality rate of 3.9%.
• Binge eating disorder is another eating disorder that develops during adolescence and early adulthood, but people can also develop it even later in life. Like bulimia nervosa, people with binge eating disorder eat relatively large amounts of food within a short period and sense a loss of control during such episodes. But they do not follow these episodes with compensatory behaviors such as purging. Binge eating disorder is one of the latest disorders formally recognized in the DSM-5. 
• Other Specified Feeding and Eating Disorders (OSFED)are a category of eating disorders that include individuals who do not meet the full criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder but still have significant eating issues. Studies indicate that OSFED had a mortality rate of 4%.
• Avoidant Restrictive Food Intake Disorder (ARFID), previously known as Selective Eating Disorder (SED), is a new diagnosis in the DSM-5. It is similar to anorexia nervosa in the sense they both include limitations in the amount or types of food consumed. But, unlike anorexia, those with AFRID are not preoccupied with body shape and body mass or have an intense fear of weight gain. Individuals with this disorder diagnosis have such disordered eating habits due to a general lack of interest in eating or repulsion for certain tastes, smells, textures, or temperatures.
• Rumination disorder is a disturbing eating disorder where an individual regurgitates food they have already chewed and swallowed, re-chews it, and then either swallows or spit it out. Generally, those with this disorder who regurgitate their food do not seem to make an effort or feel stressed, upset, or disgusted by this practice. Rumination disorder can develop during infancy, childhood, or adulthood. In infants, this can develop between three to 12 months and disappear on its own. But in children and adults, it requires therapy to prevent it from resulting in fatal malnutrition.

TREATMENT OPTIONS FOR EATING DISORDERS 

Eating disorders are complex mental health conditions that require specialized treatment. Treatment for eating disorders typically involves a combination of medical, nutritional, and psychological interventions. No matter the cause, if you are struggling with an eating disorder, help is available.

An eating disorder treatment program can vary depending on your particular disorder and disorder symptoms. But, it typically includes a combination of psychotherapy (psychological therapy), nutritional counseling, medical monitoring, and sometimes medications. 

Medical treatment may be necessary to address any physical complications resulting from the eating disorder, such as malnutrition or electrolyte imbalances. Nutritional treatment may involve working with a registered dietitian to develop a meal plan that meets the individual’s nutritional needs and supports recovery. Psychological treatment may include individual therapy, group therapy, or family-based therapy and may focus on addressing the underlying psychological factors contributing to the eating disorder.

Eating disorder treatment can also involve treatment approaches to address other psychiatric disorders caused by an eating disorder, such as substance abuse, which can turn serious or even life-threatening if they go untreated for a considerable period of time. If an eating disorder does not show improvement with standard treatment or causes other medical conditions, you may need hospitalization or another form of inpatient treatment. 

At Futures of Palm Beach we understand that the causes of an eating disorder are unique to each person’s situation. Our customized treatment programs are tailored to address the needs of each individual. If you or a loved one is struggling with an eating disorder, contact us today and talk to our mental health professionals and learn how you can start your eating disorder recovery journey. 

DBT Decoded: Walking the Middle Path

“You exaggerate more than anyone in the whole world!” If you have ever taken part in a disagreement that escalated into extreme statements such as this one, then you know how hard it is to come to an agreement once either or both parties become polarized in their thinking. One metaphor that helps to explain dialectical thinking, the foundation for DBT (Dialectical Behavioral Therapy), is Walking the Middle Path. If you walk away from DBT with one mindful tool for profoundly enhancing interpersonal relationships, this is as good as any!

To Walk the Middle Path means replacing “either-or” thinking with collaborative “both-and” thinking. Too often, we make up our minds about how we feel about something using a black and white, all or nothing, decision-making construct. When we do this, we run the risk of being out of balance – not giving deserved validation to another way of thinking. When we disagree with someone, it may be natural to believe that they are wrong and we are right. But is this necessarily how it is? Not if we take a dialectical approach to our thinking, appreciating that there’s always more than one way to view something. When we replace “either I’m right or they are right,” with “I’m right and they are right,” then we can see each perspective as an opinion rather than an absolute truth.

When we Walk the Middle Path, we make room for compromise. When that compromise validates our own feelings and those of another, we are on the path to a more harmonious outcome. Consider the results of extreme thinking. Often times, it leads to extreme feelings – either too emotionally invested or “checking out” completely, due to frustration. Sometimes extreme thinking causes us to become too rigid or too loose. In other words, we make too much of a situation or too little of it. Conversely, acceptance and change are most available when we choose to Walk the Middle Path. In doing so, we become unstuck. We gain flexibility, so that we can value our own perspective in proper balance to the opinions of others. Walking the Middle Path creates the type of open-mindedness that facilitates fairness and respect. Quite simply, it’s a powerful mindset for creating peace and contentment.

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

Breakups in Recovery: Top 10 Ways to Avoid Relapse Over a Broken Heart

Romantic relationships can start out great. They’re exciting and fun, give you something to look forward to, increase your self-confidence, and make you feel like anything is possible. But there’s a reason why newcomers to recovery are encouraged to avoid dating and getting involved in new romantic relationships despite all these positive effects: not all romantic relationships go well. Awkward early dates and abrupt endings are the norm, and these as well as heartbreak and explosive breakups can trigger a relapse. It’s not just newcomers who are at risk for relapse when a romantic encounter goes sideways. At any point in recovery, a breakup can cause a host of uncomfortable feelings, from insecurity and grief to depression, anger, and more – and any one of these can trigger the urge to drink or use drugs.

Tips to Fend Off Relapse

How do you fend off relapse when in the grips of a tough breakup? Here are some tips:

• Let yourself cry. Though you may feel better pretending that you are unmoved by the breakup, if you are feeling hurt, insecure, or betrayed, it’s okay to cry. Give yourself a couple days to do nothing but fully indulge your sadness. It’s okay to grieve the loss of the relationship or to fully feel the pain associated with the change in your life. The key is to only give yourself a couple of days to live in this space and then take steps to move forward.
• Reach out to others. Isolating when you’re feeling sad is not the best choice in recovery. Instead, reach out to supportive friends and change up your environment to help shake your mood. Positive people and good times can help you to feel better and realize that your life isn’t over without your ex. Additionally, speaking to your therapist about what you are feeling and really digging into what happened in the relationship and in the breakup will help you identify any patterns in the romance department, and help you to make sure that you pull out of your rut next time.
• Pamper yourself. Order a big pile of your favorite takeout. Get a massage. Spend the day watching a marathon of your favorite guilty pleasure TV show. Do your favorite things all day for a couple of days and don’t worry about anything else. It’s okay to take a break when you’re feeling bad – just no calling, emailing, or texting your ex. Take a break from the whole situation.
• Spend time with your dog. Or your cat. Or your fish. Spending time with a pet that adores you unconditionally can be extremely gratifying after a breakup. If you don’t have an animal of your own, go spend some time at the local animal shelter and bond with a nonjudgmental and cute little one.
• Volunteer. Getting out of your head and helping others for a little while may help you shake the blues and put things in perspective.
• Reconnect with your friends or family. During relationships, even healthy relationships, it’s easy to lose touch with friends and family. Take the days after a breakup to reach out and spend some quality time one on one with the people you’ve been missing in the past few months.
• Put more time in at work. Romantic relationships often cause you to lose focus at work and school, and there’s nothing easier than filling the open schedule left by a breakup with extra hours at work. If that’s not an option, you can get a second job, sign up for an internship, or enroll in classes that will help you to advance at work or make a move into a new job.
• Exercise. It’s not uncommon for people to respond to a breakup by taking better care of themselves. Establish a workout routine, take up a new sport, start running, make a conscious effort to eat right, and you’ll start looking better and feeling better in no time.
• Change your hair. Try a new style, change up the color, or cut it all off. Or if you like your hair the way it is, make another style change that you’ve been considering. Get your teeth whitened. Get your nails done. Buy a new jacket or pair of shoes. While appearances shouldn’t be the focus of your attempt to get over a breakup, and drastic changes that involve going under the knife are not warranted – this is not the time to get a tattoo, for example – there’s nothing wrong with updating your appearance and making a visible change to denote the fact that you are moving forward.
• Put the focus on you. In a relationship, you spend a great deal of time focusing on the other person – their needs and desires, what they would like to accomplish, and what they are going through in their lives. One of the nice things about being single is that you no longer have to consult with someone else before choosing what to eat for dinner, where to spend the weekend, what to watch on TV, and how late to sleep in on the weekend. You can do whatever feels right for you.

The Dangers of Domestic Violence and Substance Abuse

According to the late former US Surgeon General C. Everett Koop, domestic violence is the leading cause of injury to women ages 15 to 44. It is, in fact, more common than automobile accidents, muggings, and rapes combined.

Is All Domestic Violence Defined by Men as Perpetrators and Women as Victims?

No, although men – being more prone to violence by nature – predominate, and heterosexual couples more commonly experience domestic violence than homosexual couples. Some studies actually show, in fact, that women may be as prone to actually hitting their partners as men are. The difference lies primarily in the degree of the assault and of the resulting injury. Ordinarily, a woman will be smaller and therefore less able to bring harm to her victim if that victim is a man who is larger than she is, compared to the damage done by him to her with the same level of anger and force. A man’s blow to a woman’s body is likely to be much more injurious – unless she uses a weapon.

This is a very controversial issue, and some experts believe that the incidence of men being battered by their wives, girlfriends, or male partners may be underreported. The Bureau of Justice Statistics’ National Crime Victimization Survey, found that men were considerably more likely to follow through on a violent inclination as compared to women. The speculation is that the difference lies in the different methodologies employed by the different surveys.

Is There a Common Denominator Among Domestic Abuse Cases?

Yes, and it is the use of drugs or alcohol by one or both of the participants. In up to half of all cases, alcohol is involved. Even when the abuser is sober, if he (or she) is an alcoholic, the abuse is (1) much more likely to occur and (2) likely to be much more violent. Alcoholics, even when sober, are more likely to commit spousal or partner abuse. The Department of Justice states that about 61% of domestic violence offenders also have problems with alcohol or drug abuse.

Is It Always Only the Assailant Who Is a Drug or Alcohol Abuser?

No. Often, both parties are alcoholics or drug users. Sometimes, only the victim is a substance abuser. In such cases, the abuser may be likely to claim that violence is employed in an attempt to deal with the substance-abusing person. When a victim is abusing substances instead of or in addition to their partner, the situation becomes all the more dangerous. For example:

• The victim may be unable to resist the attacker or to accurately assess the level of danger and inadvertently remain in or exacerbate a dangerous or even deadly situation.
• The victim may be unwilling to report the attack, for fear the authorities may arrest him or her for criminal substance abuse.
• The victim may be driven by the violence to even more extreme drug or alcohol abuse in an effort to deal with the resulting feels of anger, depression, fear and shame.

Often, victims of domestic violence are substance abusers themselves. Additionally, a very common scenario is where both parties are high. In a North Carolina study, described in “Influence of Alcohol and Drugs on Women’s Utilization of the Police for Domestic Violence,” a total of 419 women were interviewed following calls placed to the police reporting domestic violence. More than half (52.8%) of the assailants were habitual users or bingers. One-third of the assailants habitually drank 10 or more drinks per day.

About 30% of the victims reported that their partners used cocaine habitually as well. As for the victims, about 20% of them were reported to be habitual drug users or binge drinkers, and about 30% were drinking on the day of the assault. About 25% admitted to drinking more than usual on that day, but less than 10% admitted to being drunk. It’s important to note that these accounts by the victims were self-reported and that many of them may not have been aware of how much they drank that day or were otherwise unable to correctly recall the event due to the trauma.

What Substances Other Than Alcohol Are Frequently Involved in Domestic Violence?

Perhaps surprisingly, prescription drugs – particularly antidepressants and anti-anxiety medications – are often involved in cases of domestic violence.

Experts often, for example, point to the so-called “Prozac defense,” a tactic used by attorneys to blame a defendant’s violence on his or her use of prescription drugs. The report of the UNC study mentions Prozac, Paxil, Lexapro, and Celexa as examples of antidepressants known to sometimes unleash violent behavior. Also discussed are the benzodiazepines, or “benzos,” a class of anti-anxiety drugs with a similar history of causing violent behavior. These include such drugs as Xanax, Klonopin, and Ativan.

Another type of drug known to accompany violent behavior is Chantix, a drug prescribed to help smokers stop smoking. All of these drugs, under the right circumstances, when used by the batterer or the victim, can exacerbate the violence and the resulting injuries.

TIME published a list of the prescription drugs most likely to inspire or induce violent behavior. It is led by Chantix, mentioned above, and includes various benzos and antidepressants, among others:

1. Varenicline (Chantix). While this drug does work to reduce the craving for nicotine, it is 18 times more likely to be linked to violent behavior than any ordinary drug.
2. Fluoxetine. This is the famous Prozac, which gave rise to the “Prozac defense” mentioned above. It is 10.9 times more likely to inspire violence.
3. Paroxetine. Known by its trade name Paxil, this drug is 10.3 times more likely to be linked with violent behavior.
4. Amphetamines. Amphetamines are legal drugs that are similar in effect to crystal meth or “speed.” They are often prescribed for the treatment of attention deficit and hyperactivity disorder (ADHD) and are 9.6 times more likely to be linked to violence.
5. Mefoquine. This one is a little different. Known by the trade name Lariam, it’s an anti-malaria drug. Its “violence index” is 9.5.
6. Atomoxetine (Strattera). This is a non-stimulant alternative treatment for ADHD. Nevertheless, its violence index is 9.
7. Triazolam. This is a benzodiazepine, known better as Halcion, used to treat insomnia. It is 8.7 times more likely to be linked with violence that ordinary drugs.
8. Fluvoxamine (Luvox) An antidepressant, this drug rates an 8.4 on the violence index.
9. Venlafaxine (Effexor). Another antidepressant, this drug comes in at 8.3 on the index.
10. Desvenlafaxine (Pristiq). Rounding out the top 10 with a violence index of 7.9 is this antidepressant.

Does Substance Abuse Cause Domestic Violence?

The statistical linkage between alcohol and drug use and domestic violence would strongly suggest that there must be a cause-and-effect relationship there somewhere. Yet, experts are reluctant to say so. For one thing, while heavy drinkers are often abusers, the heaviest drinkers aren’t. Furthermore, the majority of alcoholics overall are not abusers.

A book published by the Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Abuse Treatment and Domestic Violence, examines the issue, concludes that while substance abuse was a factor in domestic violence, it was not the only factor. Another important factor is having experienced or witnessing domestic violence as a child. In addition, the book points out that batterers will often blame their behavior on alcohol or drugs in an effort to explain away their violence and avoid responsibility. The book also discusses how non-substance abusers are sometimes batterers and that the worst substance abusers (in this case, the most severe alcoholics) do not batter.

Domestic Violence and Mental Health Disorders

Those who are the victims of domestic violence are more likely to struggle with a wide range of mental health disorders and require treatment in order to overcome the abuse. Two of the most common among both men and women are substance abuse and eating disorders. In an effort to regain control over their lives and to drown out the pain and fear that comes with chronic violence and attack, many attempt to micromanage their eating choices, binge eat, or overindulge in alcohol or other substances. In addition to substance abuse and eating disorders, other commonly diagnosed mental health disorders among domestic violence victims are depression, anxiety, and post-traumatic stress disorder (PTSD).

Treatment That Addresses Substance Abuse and Domestic Violence

Many perpetrators of violence quickly find themselves on the wrong side of the law, and as a result, are remanded to drug rehab and/or to anger management classes that focus on providing them with crucial information about the impact of domestic violence. The goal is to help these patients get both issues under control because if both are in evidence, both must be addressed in order to provide the person with better coping skills going forward.

Additionally, the trauma experienced by victims of domestic violence can lead to a wide range of mental illnesses that will require treatment.

It’s important that the trauma and any co-occurring disorders are addressed effectively through treatment. At Futures, we can help. We can help you or your loved one take the first step toward healing. Survival of abuse is possible, and it starts with an intensive treatment program that provides everyone involved with the coping mechanisms necessary to move forward in life. Contact us today to learn more about how we can help you or a loved one.

Health Consequences of Bulimia

Defined by eating excessive amounts of food and then purging that food from the body, there are a number of health problems that result from bulimia. The constant cycle of overeating and the various attempts to purge those calories before they are absorbed can damage the body’s digestive system – as well as cause a host of other problems.

Health Problems Caused by Bulimia

Common health consequences of bulimia include:

• Loss of electrolytes: This can result in arrhythmia (e.g., irregular heartbeats), heart failure and even death.
• Dehydration: Dehydration causes the loss of electrolytes and the consequent electrolyte imbalance can create the heart problems above – especially when it is combined with a loss of potassium and sodium due to purging by vomiting or using laxatives.
• Damage to major organs: The esophagus is one of the organs that can be damaged by bulimia. Inflammation and rupture can occur due to chronic vomiting. Gastric rupture is another possible effect of bulimia, caused by binge eating.
• Oral health problems: Vomiting brings stomach acids up into the mouth and when this happens repeatedly, it can cause rapid tooth decay and staining of the teeth.
• Bowel issues: If laxatives are used in an attempt to purge unwanted calories before they are absorbed, it can mean chronic constipation and difficulty maintaining regular bowel movements.

Bulimia Is Deadly

Though most who live with the disorder recognize that it’s not healthy, they have a hard time finding healthier ways to deal with body image. Many are of “normal” weight for their body size, so others may not realize that they struggle with the issue unless they catch them in the act of purging. Unfortunately, it’s a disorder that co-occurs with other life-threatening mental health disorders, like depression. Because it is not always easy to identify, too many patients go without the treatment they need and end up with lifelong health problems that can be deadly.

Treating Bulimia and Co-occurring Substance Abuse

At Futures Recovery Healthcare, we help people and families struggling with the disease of drug or alcohol addiction, especially when complicated and accompanied by a co-occurring issue like bulimia. Since substance abuse or drug or alcohol dependencies can often co-occur with an eating disorder, our individualized treatment program is designed to explore and change the underlying core issues that drive each individual’s addiction and disorder. We are here to help you gain control of your eating disorder and your addiction through our clinical, medical, and wellness care programs. If you or a loved one is suffering from bulimia along with addiction, call Futures today for the help you need.

DBT Decoded: Willingness vs. Willfulness

When examining the DBT concept of Willingness versus Willfulness, we see how Dialectical Behavior Therapy once again presents us with a pair of opposite forces at play within the mind. Remember that the central concept of dialectical thinking is that we often hold opposing viewpoints simultaneously – and the presence of these thoughts holds potential for conflict. The key to well-being is to acknowledge their presence and the potential for struggle – but to choose to “dance, not wrestle” with them. So, are you willing or willful? Willingness is our ability to go with the flow – to practice radical acceptance with our situation and what life hands us – and to be an active participant. Ask any behavioral health professional and they’ll tell you what a pleasure it is to work with a client who is willing. In fact, often times the first goal of treatment is to help someone see that there’s hope, because without hope, why try? Why would anyone be willing to do something if the result is certain to be failure? Of course, the reason to be willing is that we don’t know what the future holds, though we do know that success is only available for those who try.

The universe rewards willingness! Willfulness is the opposite. Acting willfully is trying to bend the universe to your wants and needs, regardless of what’s possible. In active substance abuse, the individual may practice willfulness by continuing to act irresponsibly and waiting for the world to change in order to meet his or her needs. Being willful is to thumb your nose at radical acceptance – taking a position that you need not accept what is – and thinking you can will your way through a universe that revolves around you. Acting willfully is something that we’ve all done at some time in our life. Young children act willfully when they disobey their parents’ instructions and do simply what they want to do – right or wrong. Parenting can be incredibly frustrating when one struggles to learn that there are times when you cannot change the will of a child; you can only change your method of interaction. When you ask someone who’s been successful in their recovery from alcohol and/or drug addiction about how they did it, you’ll often hear a response like, “I was ready.”

When you’re ready, you’re adopting a position of willingness. When you’re not, that’s your stubborn willfulness saying, “I’ll continue to act irresponsibly and it will turn out okay nonetheless.” The willing individual is an open-minded participant of life. The willful person is unreasonable and chooses to sit on the sidelines instead. As we consider the mindset of willingness versus willfulness, we can see how many good opportunities exist for those who are willing and how many opportunities are missed by those who act willfully.

What can we do to cultivate willingness, when our nature toward something makes us feel willful? We can follow the golden rule – to change something, we must first acknowledge it. Next time you feel stuck, ask yourself, “Am I acting willfully? Am I choosing to ignore the facts and staying attached to what I want?” Once we observe such a mindset, we can make the conscious choice to get unstuck, to do what we intuitively know to be a wiser choice, – and go for it! Sometimes it’s a matter of taking a chance, accepting that life is filled with the unknown, and that life requires risk in exchange for reward. For some people, the thought that gets them unstuck is becoming comfortable with discomfort (and doing it anyway). Others motivate themselves by physically taking an action that lines up with willingness, with the understanding that where the body leads, the mind will follow. Whatever it takes, choose willingness and enjoy being an active participant in this wonderful adventure known as life.

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

DBT Decoded: Build Mastery

The myth about DBT is that it’s complicated. The reality is that the word “dialectical” sounds complicated, but it really just means that there are oppositional forces at play. In the realm of psychology, it basically means that we have opposite sides of the brain delivering thoughts – one side delivers emotional thoughts and the other side sends us reasonable thoughts. The trick is to honor both sides and find balance, as opposed to feeling conflicted between the two, or consistently leaning to the side that comes easier to our habitual way of thinking.

Building mastery is about the empowerment that comes from achievement, and that in order to achieve something that we deem worthwhile, we need to set a goal and work toward mastering the skills needed to achieve it. The goal could be lofty, and even unattainable, but the act of improving our skills and getting closer to achieving a goal is, in itself, an empowering achievement. For example, think about mastering the guitar. If you play regularly, learn new techniques, and improve your chops, you’re mastering the instrument. If your goal is to become the world’s greatest guitar player, it may be unachievable only because it’s subjective – and even if others consider you to be best, you still may not. The point is that it’s not as much about achieving an ultimate goal as it is about achieving smaller, achievable goals – such as practicing five hours per week or learning a new song.

Building mastery is about committing to something and seeing it through. For the individual in recovery, it may mean reigniting a passion to do something that was abandoned when substance abuse took over. Getting back to a creative endeavor, such as painting, cooking, or writing can be therapeutic and fuel self-esteem. It also could be about trying something new. If you’ve always wanted to learn a new language, try yoga, or go hiking, just finding the courage to begin something new is a form of mastery. If you’ve contemplated doing it and never did, then the act of doing it once, for any length of time is an accomplishment.

What does mastery have to do with dialectical thinking? Consider which part of your brain is interested in trying something new or getting back to something you’ve abandoned earlier. If your passion to do something that excites you is interfered with by thoughts of how hard it will be, or the fact that you quit before and you’ll just quit again, then your reasonable mind may be dominating over your emotional mind. Conversely, if you know for certain that committing to a healthy activity is the right thing to do, but you’re concerned about the sadness you’ll experience if you fail, then your emotional mind is putting the kibosh on it!

What we must keep in mind is the fact that achievement breeds confidence, and confidence fuels achievement. Once we’ve experienced losing control of our lives due to substance abuse, the road to recovery is filled with self-doubt. The antidote to self-doubt is accomplishment, and mastering even small challenges creates positive momentum. Trying something new or retrying something at which we’ve failed takes courage. Find the courage, do it, and work toward your goal. You will not regret it!

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

DBT Decoded: Validation

“You really get me” is the type of phrase you might hear from your best friend. In fact, it’s indicative of the nature of best friends. You understand each other, confide in one another, and communicate in a way that puts you both at ease. You have history together, and that history helps you accurately interpret each other’s thoughts and feelings. Whether you recognize it or not, most of your favorable relationships are enhanced by acts of validation. Within the teaching of Dialectical Behavior Therapy (DBT), conscious validation is often called upon to help clients improve interpersonal effectiveness and mindfulness skills. Consistent with the power of dialectical thinking – how seemingly oppositional concepts actually work hand in hand – outward-facing validation of others is often balanced by the inward validation of one’s own thoughts, feelings, and motivations (self-validation).

Dr. Marsha Linehan, the creator of DBT, describes six levels of validation, with each “level” offering a different tactic for validating someone. With regard to interpersonal effectiveness, validation is useful whether we seek to better a relationship with a loved one, a friend, a coworker, or even someone we’ve just met. Validation is so powerful that it can be used to diffuse a hostile or escalating situation – since validating someone’s point of view helps to reduce frustration and stress. Let’s decode the six levels with regard to validating others.

1. Mindful engagement – Active listening is a good example of this first level of validation. Being present and showing interest nonverbally and/or verbally, such as communicating your understanding by way of nodding, making eye contact and asking appropriate questions. (“I hear you! What’d you do after she told you that?”)
2. Accurate reflection – Demonstrate to the person you’re listening to that their message is being received accurately. If you choose to disagree, at least the individual knows that you are listening with intention, and that helps. (“I just heard you say that your boss really likes you, but you don’t think you’re doing a good job. Are you being unjustly hard on yourself?”)
3. Reading cues – This involves some guesswork, and when you do this it’s best that you verbalize what you’re hearing, so that you can be corrected if you’ve misunderstood. You may think someone is upset with you, when they’re simply not feeling well, or vice versa. But the fact that you inquire and help someone communicate, when they may be having trouble doing so, enhances the relationship. (“You look unhappy. Is something bothering you?”)
4. Historical perspective – Drawing on your knowledge of someone’s prior experiences, you can lend perspective that helps the individual connect the dots about how they’re feeling or how they’re processing new information. (“Maybe you don’t trust your new girlfriend because your previous girlfriend cheated on you?”)
5. Assuring reasonableness – Letting someone know that their thoughts, feelings, or behaviors are normal and quite reasonable. This provides reassurance, comfort, and healthy perspective. (“I see your frustration. Most people would be annoyed at spending 30 minutes on hold with the cable company.”)
6. Respectful honesty – Providing feedback that lets a person know that you respect them enough to “keep it real.” This level of validation is best delivered with an accompaniment of radical acceptance, along with a nonjudgmental stance – taking into account that everyone has their strengths and limitations. Validating someone with honesty and respect means treating them as you’d want someone to treat you in a confidential relationship. (“I understand why you said that, but I think you could have had a better result if you used a softer tone?”)

Regardless of which techniques you use to validate someone, the results are bound to be beneficial. By the way, thank you for reading this. We realize that you’re busy and we’re grateful for your attention. Feels good, right?

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

4 Goals of Bulimia Treatment

Bulimia, or bulimia nervosa, is a serious and potentially life-threatening eating disorder characterized by the practice of eating large amounts of food in secretive binges followed by compensatory behaviors, such as purging that food via vomiting and/or laxative use to prevent weight gain. Unlike patients with anorexia nervosa, patients with bulimia nervosa rarely lose much weight or develop nutritional deficiencies.

Individuals who struggle with bulimia may feel a sense of lack of control over their binge eating episodes and an intense sense of guilt or shame afterward. Patients with bulimia nervosa can develop serious physical and mental health consequences if left untreated and typically requires professional treatment, such as therapy and/or medication, to overcome.

SIGNS AND SYMPTOMS OF BULIMIA NERVOSA

It can be hard to tell if a child, teen, or adult has bulimia, as people with this disorder are often at a healthy weight and only binge and purge when their family and friends are not around. So, recognizing the signs and symptoms of bulimia nervosa is important.

Symptoms of bulimia nervosa include:

• Being preoccupied with your body shape and size
• Having an intense fear of gaining weight
• Frequent episodes of binge eating large amounts of food in one sitting
• Feeling a loss of control while bingeing
• Forcing yourself to vomit or exercise rigorously to maintain the perceived goal weight
• Using dietary supplements or herbal products excessively to lose weight
• Abuse of laxatives, diuretics, or enemas after eating when they’re not needed

You may also notice physical symptoms such as:

• Fatigue
• A sore throat from being sick
• Abdominal pain
• Bloating
• Acid reflux
• A puffy face

According to a study published by the National Eating Disorders Association (NEDA), bulimia nervosa has a mortality rate of 3.9%.

The frequency of your binge eating and purging episodes determines the severity of your eating disorder. Consult with a healthcare provider if you suspect bulimia in you or a loved one.

What Are the Mental Health Disorders Associated With Bulimia?

Studies have shown that individuals with bulimia nervosa are more likely to experience one or more mental health disorders, including anxiety disorders (such as obsessive-compulsive disorder, generalized anxiety disorder, and social anxiety disorder), mood disorders (such as depression), and substance use disorders. In some cases, the eating disorder may develop as a way to cope with these other psychiatric disorders or as a result of the symptoms associated with them. It is not uncommon for individuals with bulimia to have a history of traumatic experiences, such as abuse or neglect, or to experience symptoms of post-traumatic stress disorder (PTSD). It’s important for individuals with bulimia nervosa to receive comprehensive treatment that addresses both the eating disorder and any co-occurring mental health conditions they may be experiencing.

TREATMENT OPTIONS FOR BULIMIA NERVOSA

It is important to seek treatment for bulimia nervosa because this eating disorder can have serious physical and mental health consequences if left untreated. Complications of bulimia can include electrolyte imbalances, dehydration, gastrointestinal problems, and damage to internal organs, among other health concerns. In addition to the physical health risks, bulimia can also have significant impacts on an individual’s mental health, including increased risk for major depression, anxiety disorders, and other mental health disorders.

Treatment of bulimia nervosa typically involves a combination of medical, nutritional, and psychological interventions. Medical treatment of bulimia may be necessary to address any physical complications resulting from the eating disorder, such as malnutrition or electrolyte imbalances. Nutritional treatment may involve working with a registered dietitian to develop a meal plan that meets the individual’s nutritional needs and supports recovery. Psychological treatment may include a combination of therapies, such as cognitive behavior therapy (CBT) and interpersonal therapy (IPT), or family-based treatment. This treatment approach may focus on addressing the underlying psychological factors contributing to the eating disorder, such as low self-esteem, anxiety, or depression.

Antidepressant medications may also be used to help reduce the symptoms of bulimia when used along with psychotherapy. The only antidepressant medication specifically approved by the Food and Drug Administration to treat bulimia is fluoxetine (Prozac), a type of selective serotonin reuptake inhibitor (SSRI), which may help even if the patients with bulimia nervosa don’t have symptoms of depression.

Your treatment team may include your primary care provider, a mental health professional, and a dietician with expertise in treating eating disorders. You may also be assigned a case manager to ensure that you receive the necessary treatments and services to address the condition effectively.

Here is a brief look at some of the psychotherapy options for bulimia:

Also known as talk therapy, psychotherapy is a treatment approach that involves discussing your eating disorder and related issues, such as distorted body image, with a mental health specialist. Evidence suggests that the below types of psychotherapy help improve physical and psychological symptoms of bulimia :

• Cognitive-behavioral therapy (CBT) – This helps you re-establish healthy eating patterns and identify and change maladaptive thought processes, beliefs, and behaviors. The goal is to help individuals learn to self-monitor, recognize distorted thought patterns, and reframe negative beliefs or attitudes.

• Enhanced Cognitive Behavioral Therapy (CBT-E) – This therapy evolved from traditional CBT 12, with the inclusion of several additional techniques. Specifically, it incorporates techniques designed to address problems with self-esteem, perfectionism, and interpersonal interactions.

• Family-based treatment or family therapy – This helps parents intervene and stop their children’s unhealthy eating behaviors, help them regain control over their eating, and resolve misunderstandings and issues that may have been caused due to the eating disorder.
• Interpersonal psychotherapy – This psychological treatment addresses issues in your relationships and helps you develop communication and problem-solving skills.

• Dialectical Behavior Therapy (DBT) – This is a form of therapy that combines elements of CBT with other techniques, including mindfulness and emotion regulation skills. In addition to addressing the eating disorder directly, it aims to help individuals improve their ability to tolerate distress and better regulate their emotions.

Will You Need to Be Hospitalized for Bulimia Treatment?

Treatment for patients with bulimia can be done outside of a hospital setting. However, hospitalization may be necessary for individuals with more severe or life-threatening symptoms, such as extremely low body weight or electrolyte imbalances. Hospitalization can help to stabilize the individual’s condition and provide medical care, nutritional support, and psychological treatment as needed. Additionally, some specialized residential or inpatient treatment programs may be available for individuals with bulimia who require intensive support and monitoring to manage their symptoms and achieve a sustained recovery. However, it’s important to note that hospitalization is typically reserved for individuals with the most severe symptoms, and most individuals with bulimia can be treated effectively on an outpatient basis.

GOALS OF BULIMIA TREATMENT

The goals for treatment will be tailored to meet the needs of the individual, but in general, the top four goals of treatment when bulimia nervosa is the primary disorder include:

1. Identifying distorted perceptions about food. Often, those struggling with eating disorders believe that whole food groups are fattening or unhealthy. They develop rituals in eating, grouping foods or eating large amounts of specific foods in the hopes of avoiding caloric absorption while still allowing them to binge. Recognizing which beliefs are false – and dangerous – is an important part of bulimia treatment.
2. Addressing issues of body image. Often people with bulimia nervosa are of average weight but perceive themselves as overweight. Learning how to more healthfully and accurately define “normal weight” can aid those in recovery in adjusting their self-perceptions.
3. Learning how to eat healthfully. Nutritional counseling that teaches patients how to plan meals, shop, cook, and order at restaurants can increase their ability to manage their eating habits and maintain healthy body weight without resorting to disordered eating habits.
4. Managing compulsive behaviors. Compulsive binge eating may be triggered by a number of different factors. Identifying the trigger issues in each patient and learning how to better handle those problems without resorting to episodes of binge eating is another main goal of treatment for bulimia.

PERSONALIZE CARE IN EATING DISORDER TREATMENT PROGRAMS

Everyone who lives with an eating disorder like bulimia develops these disordered eating behaviors for a number of different reasons, often including one or more of the following:

• Heredity
• Trauma
• Lack of control in life
• Body image issues and lack of self-esteem

If any of these issues are problematic for the patient, they should be addressed during the treatment program. Individual therapy, group therapy, and a wide range of holistic and alternative treatments can help patients with bulimia nervosa to progress as they process through the mental and emotional obstacles to developing positive eating habits.

It is not uncommon for those with an eating disorder to struggle with other mental disorders, such as major depression, obsessive-compulsive disorder, anxiety disorders, personality disorders, and substance use disorders. For such people, successful treatment entails a treatment plan that includes both the treatment of bulimia and other co-occurring psychiatric disorders.

If you would like to learn more about how we help patients heal through eating disorder treatment and improve mental and physical health here at Futures, contact us today.

Exercise and Addiction Recovery: 7 Benefits

The benefits of exercise on physical, mental, emotional, and spiritual health have been lauded for what seems like decades now. Whether reading peer-reviewed journals or scrolling through pictures on Facebook depicting the new CrossFit obsession, one thing becomes apparent, exercise has its benefits.

But what is the connection between exercise and addiction and recovery? After all, what does going on a brisk walk, lifting weights, or playing a pick-up game of basketball have anything to do with getting and staying clean and sober? More than you might think.

As the body is adjusting and recalibrating itself to a life without alcohol or drugs, it is undergoing numerous changes. These changes, while positive in the long term, may seem hellish and unbearable in the interim.

Increased feelings of stress, reduced energy, poor sleep, and depressed or anxious mood may follow individuals into recovery even after the detoxification period has ended. This is where exercise becomes beneficial. Individuals in recovery who engage in regular physical exercise can benefit from a reduction in stress, better sleep, increased energy, improved mood, and more.

7 Benefits of Exercise in Addiction Recovery

1. Stress Reduction: When individuals cross the line into alcohol or drug dependence, often the hoped-for release of stress once achieved by having a glass of wine or beer after work is but a distant memory. Ever increasing amounts of alcohol or drugs are consumed in a chase to alleviate stress. However, the relief from stress becomes more allusive and eventually disappears entirely. Often, the alcohol or drug use becomes a direct cause of stress. So what happens when an individual makes the decision to receive drug or alcohol treatment, does the aforementioned stress disappear, too? If only it were that simple. Fortunately, stress reduction can be achieved through almost any physical activity that raises the heart rate. Stress is something that recovering individuals will have to learn to navigate successfully if they hope to stay clean and sober. Regular exercise has been proven to alleviate stress both in the short and long terms. During exercise, chemicals are released in the brain serving to combat stress. Therefore, developing a healthy routine that can be utilized when stress related to life, work, or family shows up will go a long way to helping recovering individuals return to a place of balance.

2. Better Sleep: Issues related to problematic sleep are common, especially in early recovery. Regardless of the drug of choice, whether it be a stimulant such as cocaine or a depressant such as alcohol, the cessation of such substances (and numerous others) can greatly affect sleep. Difficulty in falling asleep, staying asleep, or wanting to sleep in the middle of the day may result, leaving recovering individuals feeling sluggish and tired. While over the counter, non-habit forming products may be of assistance, an even more natural remedy can be utilized. Regular exercise serves to improve sleep both in the amount of hours slept and quality of sleep, and can serve to counter the impulse to nap in the middle of the day. Consequently, as sleep improves, so does wakefulness. Individuals reporting sound sleep also report feeling more alert and able to tackle the demands of life. One way exercise serves to improve sleep is by altering the body’s temperature. Body temperature is highest during and following periods of exercise, and lowest during times of sleep. Hours after exercise, the body begins to cool at a faster than normal rate. Consequently, this accelerated cooling process allows a state of sleep to be reached more easily.Researchers warn that noticeable improvements in sleep, as it relates to exercise, may take weeks or occasionally months to become pronounced. Therefore, do not become discouraged. Remember, the body is adjusting to life without alcohol or drugs in every way imaginable and sleep patterns are not immune.

3. Increased Energy: There is a saying in many recovery circles that says, “You have to give it away to keep it.”. Expending energy in the form of exercise is no different. Therefore, to get energy, one must give it. During exercise, blood is pushed more aggressively through the heart, and oxygen levels within the body increase. With regular exercise, the boost in oxygen levels serves to improve overall energy. Furthermore, as the body becomes more cardiovascular and physically fit, activities of daily living become easier to perform. Tasks are completed more efficiently and with less energy. These are precisely the reasons many individuals choose to exercise early in the morning – the energy expended early in the morning returns as fuel for the remainder of the day. Individuals in early recovery may have forgotten how demanding life can be without the use of alcohol or drugs. Therefore, incorporating an exercise routine early in the recovery process can go a long way to helping newly clean and sober individuals as they begin to re-manage the demands of daily life.

4. Improved Mood: Mood changes can occur frequently during the detoxification process from alcohol or drugs. Even following detoxification, mood changes can fluctuate, especially in early recovery. One minute, the recovering individual feels on top of the world and the next minute, that same individual may feel disheartened and lost. Again, the body is adjusting to life without alcohol or drugs and these changes in feelings are normal. How can exercise serve to improve the mood of someone in recovery? Endorphins are one of the chemicals released by the body during exercise. Research shows that endorphins produce positive feelings such as happiness and euphoria. Happiness and euphoria were those same hoped for feelings that initiated and perpetuated continued drug or alcohol use. Like with stress reduction, research shows that regular exercise can improve mood both in the short and long terms. Exercise need not be long to achieve an improvement in mood. According to the Mayo Clinic, 30 minutes of exercise, per day is enough to see changes. A benefit of receiving professional alcohol or drug treatment is the ability to be guided down the sometimes uncertain and seemingly scary path of dealing with stress, fluctuating sleep patterns, decreases in energy, and changing moods by qualified medical professionals.Some medical professionals are eager to diagnose newly recovering individuals with depression or bipolar disorder. In their defense, prolonged drug or alcohol use can mimic behavior and symptoms similar to many diagnosable mental health conditions. However, fluctuations in affect and mood are normal early in recovery. As such, it is important to utilize professionals with addiction specific experience who realize a pronounced period of substance abstinence is needed before determining if any of these conditions are even remotely applicable. Furthermore, choosing a treatment center that promotes exercise as a healthy coping skill will serve as a building block for continued recovery, long after treatment ends.

5. Protects Against Disease: According to the Office of Disease Prevention and Health Promotion, exercise helps protect against many ailments, including: 
   • Heart disease
   • Stroke
   • Diabetes
   • Osteoporosis
   • Some cancers
   • Depression

6. Protects the Brain From Drugs: Long-term alcohol abuse gradually damages the white matter in the brain – the tracts of connections that link brain cells to one another. One study performed by the University of Colorado Boulder found that regular aerobic exercise, like running or cycling, helps protect the brain against this damage. Another study, from the University of Maine, found that mice were less likely to experience seizures while going through alcohol withdrawal if they chose to exercise regularly. Alcohol isn’t the only drug that exercise protects against. A study published in Synapse shows that exercise can partially protect rats against the neurotoxic effects of repeated methamphetamine binging. Methamphetamine use in high doses normally causes the brain’s nerve cells to lose dopamine transporters, which are involved in the brain’s ability to process motivation, attention, and reward. When the rats in the study had access to a running wheel, this damage was greatly reduced. This may be because exercise causes the body to create a compound called BDNF, which causes the growth of nerve cells and their connections.

7. Reduces Drug-Seeking Behavior: Exercise can also help reduce the drive to smoke and often reduces drug-seeking behavior. According to the National Institute on Drug Abuse (NIDA), a combination of cognitive behavioral therapy and exercise can help people quit smoking. When combined with nicotine replacement, exercise is more effective at helping smokers avoid weight gain than nicotine replacement alone. Since nicotine is an appetite suppressant, many people who try to quit smoking find that they gain weight when they stop, which drives them to resume smoking again. One study from Brown University published in Archives of Internal Medicine found that women who engaged in vigorous exercise three times a week for 12 weeks were twice as likely to succeed in quitting smoking as women who did not. Another study published in Psychopharmacology found that smokers who exercised intensely for 10 minutes felt their cravings to smoke diminished for a short time. Exercise can also help reduce cravings to smoke marijuana as well. The NIDA reports that teens who get regular exercise are not just less likely to smoke cigarettes, but are also less likely to abuse marijuana than their less-active peers. This is supported by a PLoS One study that found that exercise reduced marijuana usage and cravings in cannabis-dependent adults. Several studies have examined the effects of exercise on rats’ willingness to self-administer drugs.

Exercise can be a very effective tool during the recovery process and for life. Whether it’s yoga, team sports, running or aerobics, keep moving to increase the chances of continued recovery and a healthy life.

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

New Law in Florida Regulates Addiction Treatment Industry

In the current industry climate, it is challenging to vet addiction treatment providers for clients. With local and national facilities being sold, acquired or shut down weekly, it’s easy to become disoriented or disillusioned when making referrals to various programs. We’ve put together this quick guide with some key updates made in 2017 and 2018.

Florida Legislative & Accreditation Changes

The National Association of Addiction Treatment Providers (NAATP) has created a new Code of Ethics, and criteria for selecting an addiction treatment provider. NAATP identifies the need to label addiction treatment as ‘health care’ and outlines certain indices to look for when vetting a service provider.

In addition, a new criminal statute in Florida, Chapter 2017-173, has enacted new legislation that protects people in need of addiction treatment from bad actors within the space and nefarious treatment practices.

Key Elements of Chapter 2017-173

Licensing & Accreditation: Along with higher licensing fees, there are now new requirements necessary for certain licensure renewals. The Florida Department of Children and Families (DCF) now plays a more active role in licensure, and in specifying standards of care, procedures and staff requirements, and can make announced and unannounced inspections of any facility.

Background Screenings: Owners, directors, chief financial Officers, and clinical supervisors are all required to have background screenings done in order to obtain licensing.

Referrals & Patient Brokering: It unlawful to offer to pay, or solicit or receive, benefits for clients, and licensed service providers may not make a referral of a prospective, current, or discharged client to, or accept a referral of such a patient from, a recovery residence unless the recovery residence holds a valid certificate of compliance and is actively managed by a certified recovery residence administrator. In addition, service providers are required to maintain referral records. The new legislation specifically prohibits any health care provider or health care facility from giving or receiving any form of payment in exchange for referrals.

Marketing: Service Providers are not permitted to offer any enticements to bring a client to the facility. Further, service providers are prohibited from making false or misleading statements, or providing false or misleading information about their products, goods, services, or geographical locations in its marketing, advertising materials, or on its website. This includes websites that do not explicitly name the facility for which calls are being routed to or selling calls from call centers without disclosing this information clearly to the prospective client.

What This Means for Consumers

The changes outlined in Chapter 2017-173 were put in place to protect those suffering from addiction, and to provide them with a clear path to treatment, much like any other medical condition.

But like any other medical need, there are certain things to look for when looking for the right provider. When seeking treatment, clients should only consider facilities that:

• Ask for a full medical assessment before entering treatment
• Have a dedicated Medical Director on staff
• Offer a tour prior to committing to care
• Provide information regarding their staff accreditations, location, their assessment, treatment plan, clinical services, financing and billing practices.
• Have licensed staff available 24/7
• Offer a Family program and aftercare planning

At Futures, we are committed to upholding these new regulations, ensuring both the safety and health of our clients, as well as providing transparency and peace of mind for our referring professionals.

To read the bill, please visit click here. If you are looking for treatment for you or someone else, call Futures today for a free consultation.

2017 Overdose Deaths Increased by 10% According to the CDC

Drug overdose deaths increased in 2017, according to the study released by the Center for Disease Control and Prevention. In the US, over 72,000 people died of drug overdoses; 64,000 OD deaths occurred in 2016. Although the report features provisional estimates, it shows an increase in overdose deaths by almost 10 percent. In other words, there is a new OD death every 6 minutes in this country.

Causes of Overdose Deaths 

Among the major causes of overdose deaths is the continued abuse of synthetic opioids among them Fentanyl. Fentanyl is a fast-acting narcotic similar to morphine. It is 50-100 times more potent than morphine, and since users don’t often know that heroin is often laced with Fentanyl, fatal overdosing occurs.

Those drugs contributed solely to deaths of almost 30,000 people. According to the report, this is an increase by 9,000 as compared to the previous year.  Cocaine is another major causative of overdose deaths. According to the report, the number of deaths reported due to abuse of cocaine was significantly high going hand in hand with deaths caused by natural opiates such as oxycodone and hydrocodone, highly addictive and overprescribed painkillers. However, the number of deaths caused by oxycodone and hydrocodone stood at the same level as in the previous year.

However, CDC has put caution that the figures in this report are an early estimate arrived at by looking at all monthly records kept by the agency. The CDC may, however, adjust the figures in the report once some recorded deaths are fully investigated. Clear figures can only be arrived at usually at the end of the following calendar year when the full report is released. These provisional numbers are updated by CDC every month and can be found on the CDC’s website.

Overdose Death Distribution Trend 

Although there are some changes in figures involving overdose deaths, there is no change in how those deaths are distributed geographically. Those places are known for high mortality rates such as parts of Appalachia and also New England continued with the trend. The highest overdose death rates were clearly seen in West Virginia where there were 58.7 deaths reported for every 100,000 residents. In with previous years, states in Great Plains recorded the lowest number of deaths.  An increase in deaths was witnessed nationwide.

However, some parts or the country recorded a higher number of deaths related to overdose. This was witnessed in a number of states including North Dakota and Wyoming. Some states such as Vermont actually saw a decrease in OD deaths. The same trend was witnessed in Massachusetts which has historically had a high OD death rate.

Changing the Trend

It is unclear what next steps will be necessary to curb this alarming trend. While the Trump administration has declared this epidemic a public health emergency, real progress is only visible in part of the country that is aggressively acting and putting dollars behind proven strategies to help individuals overcome addiction, such as the Vermont Hub and Spoke model.

Though Fentanyl fueled the OD deaths in 2017, many people become addicted through the use of prescribed opioids, moving to illicit drugs because they are often cheaper and more easily accessible. Due to this, many states counties and towns have brought lawsuits against drug manufacturers, and doctors may be more limited in the amount they can prescribe.

If you or someone you love is struggling with addiction, it is imperative to get help immediately. Call Futures Recovery Healthcare to discuss your options.

Hypnotherapy Treatment

Similar to meditation, hypnotherapy goes a step further into the subconscious mind and is used as a technique in alcoholism and addiction treatment.

Medical Excellence

Director of Nursing Linda Spencer talks about the high level of medical and clinical care found at Futures Recovery Healthcare.

Committed Employees

Program Director at Futures Recovery Healthcare, Omar Kamal, discusses the culture, dedication and superior level of care and service our staff provides for our clients everyday.

Emotional Regulation

Outreach Director Laura Kunz discusses the importance of learning emotional regulation during treatment.

The “Wise Mind” ACCEPTS

Much of Dialectical Behavioral Therapy’s effectiveness for impulse control and relapse prevention can be attributed to the mnemonic devices employed in its teachings. Some DBT concepts provide rich visual associations, such as Walking the Middle Path and Turning the Mind. Others, such as ACCEPTS, make use of acronyms that are easy to recall and help to group a set of tactics for accomplishing a common goal. In the case of ACCEPTS, a DBT distress tolerance skillset, the immediate goal is to distract the mind just long enough to intervene in an emotional response to a stressful situation. Like all skills, the more we practice, the more efficient we become with our ability to call upon it when needed. So, let’s do a little DBT decoding and explore how our Wise Mind ACCEPTS.

A – Activities. Sometimes the best way to give the mind a break from stress-inducing stimuli is to get physically busy. Here, we can call upon hobbies, chores, or other activities that serve to gain attention. Playing guitar, going for walk, organizing a closet, food shopping, or playing Frisbee are all good examples. If you choose to accomplish a chore, then you’re killing two birds with one stone – you’re effectively distracting yourself and completing a necessary task at the same time.

C – Contributing. Whether you choose to volunteer time for a community cause, help a friend who’s shorthanded at work, or babysit your nephew, you’re doing something productive that requires focus. Contributing to the needs of someone else can help us to feel good about ourselves too, and building self-esteem is always a good thing. Meanwhile, we’re accomplishing the goal of distraction, allowing us to calm down and make a higher quality decision.

C – Comparisons. As human beings, we can’t help but compare ourselves to others. The point of this distraction technique is to gain perspective by making such comparisons. Sometimes all we need to do is compare our own situation now versus a previous time when we were considerably worse off in order to regain a healthy sense of gratitude. It may be enlightening to consider people who live in impoverished circumstances, or those who have limited access to friends and loved ones, to remember just how fortunate we are compared to those who have less.

E – Opposite Emotions. Such is the nature of DBT that we frequently use opposites to help us get back to, or maintain, middle ground. For example, we can listen to music that makes us happy to counterbalance feelings of sadness. Anger may be alleviated by watching a comedy routine that never fails to produce giddiness. Anxiousness may be relieved by finding calm in the practice of meditation or simply reading a spiritual book.

P – Pushing Away. While the aforementioned techniques give us a visualization of heading toward something, pushing away is about maintaining our ground and sending stressful thoughts away. Because our mind may want to hold on to stress, believing that we need it, we may employ tactics that help us to compartmentalize our thoughts, even if we place them aside to be addressed later. We also may take total control of these thoughts; write them down on a piece of paper and burn it. In doing so, we demonstrate our power to push away what doesn’t serve us, perhaps banishing such thoughts permanently (if not, there’s always more paper and matches!).

T – Thoughts. Distracting with thoughts is a bag of tricks that we keep nearby for emergency use. These are our “go to” thoughts that simply and quickly distract our mind – providing valuable time to process whatever is causing newfound stress. This may include counting to ten or reciting the Serenity Prayer.

S – Sensations. Sometimes stress overcomes us so quickly that we need to call on a tried and true physical sensation to snap us out of it and provide momentary distraction. Cold water splashed on the face may do it. For some, it’s the calming sound of a bell, or a hard rock song that gets the heart racing. It’s worth experimenting with a physical sensation that’s easy to call upon and acts as a trigger to bring you back to your senses – and remind you not to sweat the small stuff (and that it’s all small stuff).

As you can see, this DBT acronym is effective for helping us remember this important set of distraction techniques. The DBT skills we practice enable us to better tolerate stress, act mindfully, and regulate our emotions. In doing so, we remain in control, make good decisions and maintain healthy interpersonal relationships. How fortunate we are to possess a Wise Mind!

The compassionate and highly trained, Futures Recovery Healthcare team strives to provide education, support, and behavioral therapies in conjunction with medications at the proper times in order to promote a successful recovery from a substance abuse disorder. Call today to learn about our specialized and effective treatment programs.

Professional Referrals

Futures of Recovery Healthcare Outreach Director, Laura Kunz, talks about her role in the professional referral process.

Stigma of Addiction

Primary Therapist Julia Valente discusses the Stigma of Addiction, and how the Futures Recovery Healthcare staff prepares clients to cope with this challenging topic.

Coining In

Alumni Director Ryan Miller discusses the Futures Recovery Healthcare Coining In process, which sets the foundation for our clients on their journey to a life of recovery.

5 Best Books on Addiction and Recovery

Sometimes we are asked what are the best books on drug/alcohol addiction we recommend to clients? Can these books be separated into categories for recovering addicts and family members? Our short answer is, yes! For our long answer, keep reading… Books, movies, music and various art forms can do wonders to inform what we know about addiction and recovery. When counseling clients, we will frequently cite excerpts and recommend reading from books that present a particularly insightful or influential point of view. In recent years, a growing number of famous figures have authored books about their battles with addiction – seeking to help others who struggle to learn from their experience. Authors who successfully transition from addiction to long-term recovery often serve to inspire readers who identify with them. The best books on addiction teach us about the commonalities of the disease and the fact that a great number of people ultimately do recover. Here are list of five addiction and recovery books we’ve been referencing and recommending lately.

1. Rewired: A Bold New Approach To Addiction and Recovery by Erica Spiegelman
   Considered to be one of the best addiction recovery books in recent history, author Erica Spiegelman’s lays out a path to recovery that is empowering and easy to follow. As the title infers, Rewired is about thinking differently about living clean and embracing recovery. The book presents healthy recovery as the result of living in accordance to twelve time-honored powerful principles, including honesty, evolution, solitude, love, compassion and hope. Erica Spiegelman is a well-respected addiction counselor, author and speaker who has had her own struggles with alcoholism and addiction. She promotes a holistic approach to healthy recovery that goes well beyond abstaining from drugs and alcohol. The smart reality of her book is that the attitudes and beliefs that accompany addiction are what fuels the disease. Change your focus and healthy choices that rejuvenate body, mind and spirit are bound to follow. The book includes action-oriented, positive affirmations and intentions to help you do so.
2. Scar Tissue by Anthony Kiedis & Larry Sloman
   Of books about heroin use, none is rawer than this bravely told memoir about the life of Red Hot Chili Peppers frontman Anthony Kiedis. Published in 2004, Scar Tissue holds immense value for as a cautionary tale for anyone prone to glamourizing drug use, especially heroin use. The book does a terrific job at taking the reader through the depths of sadness and despair that accompany heroin addiction. With the book, the reader sees not only how much one can lose to drugs – such as Anthony Kiedis’s loss of best friend and bandmate Hillel Slovak to overdose – but also how intense the hold of addiction can remain after the loss of a loved one. While the book may prove insightful about addiction, the authenticity of the addictive drug experience makes this a book that we would not recommend to someone in treatment or early recovery, as the content could be triggering, as well as depressing.
3. The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are by Brene Brown
   According to Futures Case Manager Katie Dalo, this is a book every person on the planet should read a minimum of 10 times. As Katie describes the book, “it’s about radical acceptance, that you are perfectly imperfect and it’s o-freakin-k!” Researcher Brene Brown has become immensely popular over the past handful of years, due in large part to her excellent TED Talks about vulnerability and shame. The Gifts of Imperfection is about evaluating ourselves and seeing that we are bombarded with “messages from society and the media telling us who, what, and how we should be.” These messages help to inform how we perceive ourselves, and feed the feelings of inadequacy that live beneath the surface for a great number of people who struggle with substance use disorder. Just as so many of the best books on alcoholism and drug addiction teach us about living well in general, this book is so profound in its universal message of recovery that it translates beautifully for people recovering from the disease of addiction.
4. Codependent No More: How to Stop Controlling Others and Start Caring for Yourself by Melody Beattie
   For the past three decades, Codependent No More has been one of the best books for families of recovering alcoholics and drug addicts. This book is a helpful guide for everyone whose life has been strongly affected by the disease of addiction. Filled with exercises and self-tests, the book is immensely helpful for the individual who has lost himself or herself in the continuous story of a loved one’s addictive behavior. Codependent No More offers practical advice for regaining one’s individuality. So often in drawn out battles of substance abuse, family members fall into familiar rhythms of place an imbalance of energy – for better or worse – into the addicted loved one. Codependency is dangerous for healthy treatment and addiction recovery practices, so we’re grateful for this liberating book.
5. Spirit Junkie by Gabrielle Bernstein
   The most prominent message of Spirit Junkie is that of self-love, though it is delivered in a way that makes it both accessible and non-corny. This book echoes much of what we teach about mindfulness, asking the reader to observe thoughts and distinguish between positive and negative messages. Gabrielle Bernstein conveys the life-altering power that comes from gaining a better understanding of the mind and being able to choose a healthy response. Spirit Junkie can benefit the individual recovering from addiction to reconnect with a sense of hopefulness, gratitude and compassion – tools for productive recovery practice. As demonstrated by Gabrielle Bernstein’s explanation of “love,” recovery should come from a place of peace and joy. She is adept at making the intangible just a bit easier to grasp. In doing so, transformative practices appear as simple, logical steps.

These are but five of hundreds of good books about drugs, alcoholism, and recovery that are available to help people heal at their own pace. However, for those still at the beginning stages of recovery, sometimes books aren’t enough. If you or someone you know someone is struggling with addiction and ready for help, contact Futures Recovery Healthcare today.

DBT Decoded: DEAR MAN

The beauty of DBT (Dialectical Behavioral Therapy) is that regardless of whether you’re recovering from the disease of addiction or you’re simply someone looking to improve your relationship with yourself and others, – DBT skills are a perfect fit. The Interpersonal Effectiveness acronym DEAR MAN, is an excellent example. DEAR MAN can be thought of as a strategy for effective communication that helps you achieve positive outcomes, whether you’re negotiating a promotion at work or saying no to a persuasive salesperson (who just may be your best friend).

D is for describe, and it’s a great place to start. Describe the situation and include details that clarify and demonstrate your understanding. It may look or sound something like this: “I’ve told you that I don’t want to go to a bar, but you’re trying to convince me that I should go anyway.” “I’ve proven that I’m an expert at my job and I’d like to be promoted to a management position.”

E is for express, and it’s a logical next step in building your position. Express your opinion, your perspective, and how this situation affects you. “When you ask me to do something that jeopardizes my sobriety, it makes me think that you don’t realize the importance of my choice to avoid bars at this time.” “I feel that I’m ready to take on the responsibility of moving into a management position, and I believe that I’m an excellent candidate for the spot that is opening up with Jeff’s decision to retire.”

A is for assert, and now that you’ve clarified your position, it’s time to ask for what you want. You understand the opportunity or the challenge, — now honor yourself and present your solution. “I’m not going to the bar and I’d greatly appreciate it if you would stop asking me to go to this or any bar right now.” “I’d like to be promoted and take over the management role that Jeff will be vacating.”

R is for reinforce, meaning to provide context regarding the benefits associated with the solution you’ve proposed. It may sound like this: “Thanks for understanding how important this is to me. I know that my real friends, like you, are supportive of the decisions I’m making to protect my sobriety.” “As a manager, I’ll be able to have a bigger impact on the success of this company.”

M is for the mindful focus that keeps you on point and not distracted. Stay the course with your objective and don’t deviate by getting involved in other discussions right now, even if it makes you sound like a broken record. If the other person takes the discussion in a new direction it’s your job to bring it back to working toward resolution. “I realize that the restaurant we went to yesterday served alcohol, but that’s a different environment and I will not be going to a bar, where I don’t feel comfortable right now.” “Yes, the new cafeteria is really nice, but I’d like to know if I can be promoted to Jeff’s management position when he leaves next month.”

A is for appear confident. Even if you feel nervous or unsure of yourself, make your case with a confident tone of voice, maintain eye contact, and use positive body language. This may be something you need to practice, so that you’re prepared for situations that call for DEAR MAN. In preparation, try a Superman pose, with elbows bent, hands resting on hips, and head held high.

N is for negotiate. When you’re unable to get what you want, the tactic of negotiation may help you improve the situation. Sometimes, you need to give to get, – and meet someone in the middle with a compromise. In the case of saying no to a request that asks you to go beyond your boundaries or against your values, negotiating doesn’t mean giving in – it means offering consolation with something that you are willing to give. Negotiation may sound like this: “I won’t go to a bar, but if you want to catch a movie or play golf this weekend, I’m in.” “I understand that someone with more seniority is in line for the management position, but perhaps there’s an alternative solution the company can consider to expand my role. Surely I’d be an excellent fit for assistant manager.”

Remember, you cannot get everything you want from others all the time. Certain environments are immune to even the most skilled of individuals. Even though great interpersonal skills can increase your chances of getting your objectives met, it is not a guarantee. In such difficult situations where it is impossible to get what you want, stay calm and ensure to practice distress tolerance skills and radical acceptance. 

At Futures DEAR MAN is a favorite among clients. Sometimes, days after our DEAR MAN session, a client will say “I had a conflict yesterday and DEAR MAN-ed my way to an excellent resolution!” This DBT acronym offers a healthy dose of self-validation, which can be a powerful tool for someone in early recovery who’s working to overcome feelings of shame and doubt. And not to forget, it also helps develop effective interpersonal communication skills that are sure to get you what you want and develop healthy relationships with others. 

DBT Decoded: Mindfulness “How Skills” in Action

The How Skills: Non-Judgmentally, One-Mindfully, and Effectively are actions that contribute to a healthy mindfulness practice.

Non-Judgmentally – the act of taking a non-judgmental stance. In order to begin observing our thoughts and emotions objectively, we must commit to being non-judgmental about them. Within our mindful practice, there are no good thoughts, bad thoughts, unwanted thoughts, or welcomed thoughts. They are all equal because we don’t judge. Part of the relief we experience in mindfulness is the letting go of our opinions. By doing so we’re able to let go of the stress that comes from trying to resist that which causes us pain. Such resistance can become a contributing factor, or even the source, of suffering. Because we’re human and judgment is within our nature, we’re likely to be challenged by this part of mindful practice. That’s okay. When we notice ourselves judging, we know that we’ve wandered from mindfulness, and we begin again. Mindfulness is a vacation from judgement, so we don’t judge ourselves for noncompliance. We simply notice, treat ourselves with understanding and compassion – and begin again. Like the basketball player who endeavors to make a shot, the nonjudgmental approach of mindfulness is akin to the good technique of having a balanced stance. With legs shoulder-width, and the body squared up to the basket, we are setting up for a successful shot.

One-Mindfully – the act of focusing on one thing at a time. This is the opposite of multitasking; a common habit associated with our modern, overstimulated environment. By engaging in tasks with one-mindfulness, we strengthen our ability to engage in one practice at a time. Meditation is a one-mindfully practice that allows us to focus our mind and let go of distractions. Within our everyday lives, we can act one-mindfully by simply completing a task without pausing to check email, answer the phone, or concern ourselves with another pending task. We can choose to cook, eat, play music, listen, swim, or do anything one-mindfully. With our mind focused on the basket — thinking only of the strength and projection needed to complete the shot — One-Mindfulness gives us the best chance for flawless execution.

Effectively – the act of applying mindful concepts, learning, and honing our practice. To be effective means that we progress and strengthen our mindful muscles as we move along. As we practice mindfulness, we become more aware of the spaces between our thoughts and our actions – giving ourselves a newfound ability to reduce impulsivity – an especially valuable tool for people recovering from the disease of addiction. Becoming more skillful at the practice of mindfulness enhances our ability to effectively reduce judgment (of ourselves and others), let go of emotions that hinder us and to nurture our sense of compassion. The act of beginning again when we notice our mind wandering is an effective act that strengthens our resilience. Simply stated, when we practice mindfulness effectively, the positive takeaways are unlimited. With a nonjudgmental stance forming the base of sound technique and our ability to focus one-mindfully, all that’s left is to effectively take the shot. Hit or miss, it’s a thing of beauty.

Mindfulness in Addiction Treatment

Mindfulness-based stress management techniques have been proven effective in the treatment of stress- and anxiety-based disorders. When incorporated into a well-rounded mental health or addiction treatment program, the practice of mindfulness through mindfulness-based stress reduction (MSBR) can provide patients with a useful tool to control the effects of anxiety, fear, agitation, phobias, panic, and other stress-related mental health issues.

How Do I Practice Mindfulness?

“Mindfulness” is another way of saying “noticing the small things in the moment.” Actively being in your present moment can help you to avoid obsessing over the past, worrying about the future, or otherwise drowning in emotional responses to stressful issues. To some, it may be easier said than done. Shutting off the mind can be difficult. So how do you do it? There are a number of different techniques. Paying attention to your breath and breathing is a great place to start. Focusing on nothing but the breath coming and going from the body, feeling it enter the nose, fill the lungs, and leave the body can be a positive initial practice in mindfulness. During this period, there should be no active thoughts in your head. You are to do nothing but notice your breath. Another way to describe the practice is to define it as a form of meditation in which you quiet your inner dialogue and focus solely on the sensations of the body.

What Disorders Benefit From the Use of Mindfulness?

Any mental health disorder that is characterized by insomnia, a decreased ability to manage stress, increased anxiety, or depression would benefit from a treatment plan that includes the practice of mindfulness for stress management. This includes:

• Eating disorders. Self-awareness, acceptance and self-criticism all decrease for people struggling with bulimia, anorexia or eating disorders after MSBR treatment.
• Anxiety disorders. Generalized anxiety disorder has been shown to improve with mindfulness treatment.
• Panic attacks. Panic attacks can be mitigated when MSBR techniques are used.
• Phobias. The overwhelming nature of phobias can be reduced when mindfulness is practiced during the stress period.
• Depression. Improved mood has been associated with MSBR techniques as well.
• Substance abuse. A number of issues related to substance recovery – insomnia, emotional outbursts, depression, anxiety, etc. – can be improved by the practice of mindfulness.

How Quickly Does the Practice of Mindfulness Produce Results?

The peaceful and calming effects of mindfulness and meditation increase over time. The more you practice, the more lasting the positive effects in your life, and the more quickly you will begin to see a lessening of the impact of stress.

Is Mindfulness About Sitting Still?

Though the goal is to still the mind, it is not necessary to still the body. Many people find that they best benefit from mindfulness techniques learned in stress management when they do something to occupy their hands. Focusing on the breath while practicing a passive activity can increase the calming effects and decrease the chances that your inner dialogue will drown out your peace. While practicing mindfulness, some people enjoy:

• Gardening
• Walking or jogging
• Knitting
• Cleaning the house
• Listening to soft music (usually without lyrics) or playing music

Is Mindfulness-Based Stress Reduction Right for You?

Almost everyone can benefit from incorporating the techniques and philosophies of mindfulness into their lives, but most who are struggling with issues like an eating disorder or substance abuse will almost always find that their experience in treatment improves when they practice mindfulness. If you would like more information, contact us at Futures today.

Harmful Effects of Diet Pills and Supplements

For individuals with a strong desire to lose or maintain their weight, diet supplements may seem like a magical solution. The manufacturers of these products make extravagant promises about the properties of their drugs, but most of these claims are not backed up by clinical research. In fact, the drugs that promise to help you shed pounds or burn fat may hold hidden dangers to your health. In spite of the risks of using diet supplements, the demand for these products continues to rise, especially among individuals with eating disorders.

Up to 50% of those who meet the criteria for an eating disorder use over-the-counter diet pills, herbal supplements, or prescription drugs to lose weight, according to Eating Behaviors. Unless you’re using weight-loss drugs for legitimate medical reasons under a doctor’s supervision, you may be putting yourself in harm’s way by using these products.

What Exactly Are Diet Supplements?

A diet supplement is any product that you take orally that adds to the content of your ordinary diet. Not all supplements are intended to promote weight loss; a supplement may provide valuable nutritional replacement for consumers who don’t get enough of a specific ingredient in their daily meals. A dietary supplement may contain:

• Vitamins
• Minerals
• Amino acids (Building blocks of protein)
• Enzymes
• Botanical products/herbs
• Glandular extracts
• Organ products

People take diet supplements for many different reasons: to lose or gain weight, to restore lost nutrients, to build muscle tissue, to support physical functions like eyesight, to improve sleep, or to boost energy.

Just because a diet pill or supplement is sold in attractive packaging at a local drugstore or through an online vendor doesn’t mean that it’s safe. Many consumers aren’t aware that products marketed as diet supplements aren’t subject to regulation by the U.S. Food and Drug Administration (FDA) unless the product contains a new ingredient. According to the Dietary Supplement and Health Education Act (DSHEA) of 1994, it’s the manufacturer’s responsibility to prove that a supplement is safe, and not all manufacturers comply with this requirement. Many manufacturers have been accused of making false claims about their products, adding pharmaceutical ingredients to their supplements or producing their supplements under unsafe circumstances.

How Do Weight Loss Supplements Work?

If you’re searching for dietary supplements that will help you lose weight, you’ll have no shortage of choices. The companies that distribute these products claim that the ingredients in their supplements can help you achieve results like these:

• Curb your cravings for food (chickweed, bee pollen, fennel)
• Make you feel full before you’ve had too much to eat (guar gum, psyllium)
• Speed up your metabolism (caffeine, guarana, synephrine, B-complex vitamins)
• Slow down your body’s fat production (green tea, hydrocitric acid, flax seed)
• Keep your body from absorbing the fat in the foods you eat (chondritin)

Diet supplements are available in just about any form that you can take by mouth – from pills and capsules to powders, liquids, and teas. Some products are taken with a meal, while others are taken instead of a meal. Over-the-counter diet pills supposedly help you lose weight by stimulating your metabolism, your body’s system for utilizing energy. The primary ingredient in products like Dexatrim with Metabolic Support is caffeine, a central nervous stimulant that may help you burn fat through a process called thermogenesis. But the risks of taking these stimulants may outweigh the benefits.

Why Are Weight Loss Pills Dangerous?

Many diet supplements are harmless, and some may even be effective at creating a sense of fullness, burning fat, or boosting your metabolism. But some of the popular ingredients in weight loss products have been banned by the FDA because of harmful side effects like these:

• Increased heart rate
• High blood pressure
• Agitation
• Diarrhea
• Sleeplessness
• Kidney problems
• Liver damage
• Rectal bleeding

Ephedra – Banned

Once widely sold as an ingredient in diet supplements, the Chinese herbal stimulant ephedra was banned in 2004 because of evidence that its use could increase the risk of a heart attack or stroke. In 2005, a lower court ruled that ephedra could be used in small doses. In 2006, a federal appeals court reinstated the FDA’s original ban, ruling that ephedra was too dangerous to be used as a supplement at any dose.

Hydroxycut – Recalled and Banned

Some weight loss products can cause severe damage to your kidneys, liver, and other vital organs. Hydroxycut products were banned and recalled in 2009 because of reports of serious adverse reactions, including hepatitis and jaundice. One person who took these fat-burning supplements died; another required a liver transplant.

Fen-Phen – Recalled

Fenfluramine, one of the two active ingredients in the off-label diet drug Fen-Phen, was recalled in the late 1990s after the drug was linked to cases of heart damage and lung disease. Phentermine, the other primary ingredient in Fen-Phen, is still prescribed in certain cases for weight loss, but should be used only with a doctor’s prescription.

Meridia – Withdrawn from the Market

Sibutramine, a prescription drug sold as Meridia, was withdrawn from the market in 2010 after a clinical study indicated that the drug could increase the risk of heart attack or stroke. According to the National Institutes of Health, sibutramine was originally prescribed as a long-term appetite suppressant and weight management solution. The manufacturer voluntarily stopped production after Meridia was associated with evidence of cardiovascular damage.

How Do You Know What You’re Taking?

One of the biggest risks of taking over-the-counter diet supplements is that you can’t always be certain about the ingredients that a product contains. Because the FDA does not test all weight loss products for safety, there’s no guarantee that each ingredient in every supplement is safe. The FDA maintains a list of tainted weight-loss products so consumers can be aware of ones they should stay away from. Because the manufacturers did not list these ingredients on their product labels, consumers would have no way of knowing that they were ingesting products like these:

• Sibutramine: a weight-loss drug withdrawn because of its association with an increased risk of high blood pressure, heart attack and stroke
• Rimonabant: an appetite suppressant not approved for use in the US
• Phenytoin: an anti-seizure drug
• Phenolphthalein: an experimental drug that may cause cancer

The FDA issued a warning to consumers not to purchase supplements in its list of tainted products; however, this agency can’t test every new product on the market. The best way to ensure your safety is to consult a healthcare professional before you take any weight loss supplement.

How Are Diet Pills Abused?

Someone with an eating disorder may not be concerned about the dangers of dietary supplements. They may be so preoccupied with losing weight that they don’t care about the risks to their health. In an obsessive drive to lose weight, an individual with anorexia or bulimia is likely to abuse diet supplements in the following ways:

• Taking more than the recommended dose of a dietary supplement
• Taking diet products that aren’t recommended for individuals who are at a normal weight or underweight
• Taking prescription weight loss medication without a doctor’s supervision
• Combining multiple weight loss stimulants
• Combining diet pills with laxatives or diuretics
• Combining diet supplements with illegal stimulants like meth or cocaine

Taking an excessive dose of a diet supplement or combining supplements can be extremely hazardous. An overdose of stimulant products could raise your blood pressure to dangerously high levels, putting you at risk of a heart attack or stroke. Taking fat-blocking supplements along with laxatives or diuretics could cause diarrhea, fluid loss, and an electrolyte imbalance. Abusing products that hold a risk for liver or kidney damage only increases the possibility of life-threatening organ failure.

Are There Any Safe Weight Loss Drugs?

The FDA recently approved the prescription medications Belviq (lorcarserin hydrochloride) and Qsymia (a combination of the previously approved drugs phentirmine and topiramate extended release) for weight control. Both drugs are approved for adults with a body mass index (BMI) of 30 or greater. Adults with a chronic, weight-related health condition such as high cholesterol or hypertension and a BMI of 27 or above may also qualify.

Many of the diet supplements you see in your local stores are generally recognized as safe for human consumption. But just because these drugs can be purchased without a prescription doesn’t mean that you can use more than the recommended dosage safely, or combine them with other drugs without experiencing serious side effects. Because diet supplements are widely available at commercial outlets or online, people with eating disorders have easy access to these products and are likely to misuse them.

In some cases, a weight loss drug or diet supplement may be a useful part of an eating disorders rehab program. Binge eating disorder, for instance, can leave patients overweight or morbidly obese. But in many cases, these products are being abused by teens or adults who have no medical need to lose weight. In such cases, the use of a diet pill is dangerous, even life-threatening. The focus of an eating disorders rehabilitation program is on supporting each client individually in his or her recovery goals. Whether that means gaining or losing weight is up to the treatment team, which may include a doctor, therapist, counselor and nutritionist. Unless diet pills are recommended by a medical professional, they are generally not part of a healthy recovery plan for eating disorders.

If you are struggling with substance abuse and an eating disorder, contact Futures Recovery Healthcare for help today.

Common Eating Disorders

Eating disorders are characterized by preoccupations with weight, body image issues, and a lack of control over the food that leads to restrictive eating patterns, binging, and excessive exercise. Individuals struggling with long-term eating disorders often suffer from physical symptoms and related medical conditions due to nutritional deficiencies from the lack of a balanced diet. Eating disorders are often a mental cage for sufferers and exist in conjunction with other mental health issues such as anxiety disorder.

Though there are a number of different kinds of eating disorders, there are a few common types. Most people who have a dysfunctional relationship with eating and their bodies have a disorder that falls into one of the following categories: anorexia, binge eating, bulimia and other eating disorders.

ANOREXIA

Severely cutting calories by eating very, very little defines the disorder anorexia nervosa. Anorexia Nervosa is often characterized by an intense fear of weight gain that leads to restrictive food intake and often presents as dramatic weight loss in the sufferer. The goal is always extreme weight loss or maintenance of a dangerously low weight, and the repercussions can be deadly. Those who live with anorexia for a long period of time will:

• Have a body mass index that is unhealthy for their body type, height or activity level
• Fear “getting fat” or being viewed as overweight
• Have a distorted body image where they still see themselves as fat even if they are underweight
• Not have their menstrual cycle (e.g. no monthly period or irregular periods)
• Suffer from hair loss, brittle hair, or damaged and dry skin
• Be intensely focused on caloric intake, quantities of food intake,  body shape, and weight

BULIMIA

Bulimia, or bulimia nervosa, is defined by eating large amounts of food, often in secret, and then purging. Purging may happen through vomiting, laxative use, or extreme exercise. Those who are living with bulimia may:

• Recurrent episodes of bingeing and purging
• Eat compulsively when they binge and eat well beyond the point of comfort
• Live in a cycle of bingeing followed by fasting
• Diet constantly
• Obsess over their body weight, how they look, and suffer from poor body image
• Be of average body weight (normal weight) or overweight
• People with bulimia nervosa may also suffer from tooth decay, erosion of tooth enamel, and acid reflux as a consequence of throwing up. 

BINGE EATING

Compulsive overeating or binge eating disorder is the habit of eating well beyond the point of fullness compulsively. If a person regularly binges at least once a week for three months, they may have a binge eating disorder. Those who struggle with binge eating disorder:

• May be overweight or obese
• Feel a loss of control when they binge
• Attempt to diet frequently
• Attempt to fast after bingeing
• Often struggle with depression, anxiety and feelings of isolation

OTHER EATING DISORDERS

All other types of eating disorders fall into the last category. Every year, medical professionals identify new versions of eating disorders that have the goal of losing weight but often just result in serious malnutrition and medical complications. Some include:

• Extreme or excessive exercise
• Restrictive diets used solely to lose weight (e.g. veganism, raw foods, etc.)
• Late night binge eating
• Diet pill or stimulant addiction with the purpose of speeding up metabolism in order to lose weight

What Causes Eating Disorders?

Experts have long been studying the complex nature of eating disorders and have identified several contributing risk factors that increase the likelihood of developing one. One such factor is genetics. It appears that individuals with a family history of eating disorders are more susceptible to developing one themselves.

Personality traits also play a role. Neuroticism, perfectionism, and impulsivity are three traits that have been linked to a higher risk of developing an eating disorder. These traits can create a sense of pressure and an unhealthy level of self-criticism that can lead to disordered eating habits.

In addition, societal pressures cannot be ignored. Perceived pressures to conform to unrealistic beauty standards and cultural preferences for thinness can fuel the development of eating disorders. The constant exposure to media promoting these ideals only exacerbates the problem.

Recently, experts have also been investigating the role of brain structure and biology in the development of eating disorders. Chemical imbalances in the brain, particularly in the levels of serotonin and dopamine, may be contributing factors. However, further studies are necessary to draw conclusive evidence.

It is clear that eating disorders are complex issues with multiple contributing factors. Understanding these factors is crucial in developing effective treatments and prevention methods.

Eating disorders of any kind cause extreme mental and physical health problems that can last a lifetime. If you are living with issues that you believe may be caused by an eating disorder, contact us at Futures of Palm Beach today to discuss how we can help you change the outlook for your life.

Can You Die From Withdrawal?

Generally, for most people struggling with a substance abuse, withdrawal symptoms start out mild and heighten around 2 to 3 days after last use of the substance in question. Many people admit themselves to detox programs every year to help deal with the discomfort felt during withdrawal. The symptoms a person can experience during withdrawal vary depending on the substance being abused, and how much of and how often the substance is used. That being said, typical symptoms that stem from withdrawing from just about any substance include:

• Diarrhea
• Agitation
• Anxiety
• Depression
• Nausea
• Vomiting
• Cramps
• Hallucinations
• Mood swings
• Fatigue and/or insomnia
• Coma
• Respiratory depression
• Seizures
• Trembling

Some withdrawal symptoms are fairly mild, while others can get quite intense. Withdrawal from certain substances even poses the risk of death, such as alcohol and benzodiazepines.

Alcohol Withdrawal

Withdrawing from alcohol dependence is more dangerous than most are aware of. In a professional treatment setting, side effects can possibly be prevented, or at least managed, with medications like benzodiazepines. Any complications can also be addressed quickly if they arise.

Some patients who detox from alcohol dependence will incur a serious side effect known as delirium tremens (DTs). DTs usually occurs two to four days after the last drink, but it can happen up to even 10 days later. DTs causes the person withdrawing from alcohol to become disoriented and experience confusion and hallucinations. Of those who experience DTs, 5-25% will die.

Benzodiazepine Withdrawal

The easiest and safest way to withdraw from benzodiazepines is gradually tapering off them, sometimes while taking another type of benzo under medical supervision. Typically, people addicted to benzos start feeling withdrawal symptoms within 6-12 hours of their last dose, at which point symptoms such as mood swings, fatigue, and insomnia may set in. Professional detox is recommended so that the tapering schedule is supervised, and side effects can be controlled.

Without medical intervention, risks to the withdrawing patient can include experiencing depersonalization, hallucinations, panic, and even death. Most often, patients who die during benzo withdrawal have attempted to quit abruptly by going cold turkey.

Opioid Withdrawal

Withdrawal from opiates, either prescription painkillers or heroin, carries significant risks and should not be entered into without professional help. About 12 hours after the last dose, people abusing opiates can expect to begin experiencing mild symptoms, such as insomnia, diarrhea, agitation, and muscle aches.

As withdrawal progresses though, generally 5 or 6 days into it, more intense symptoms, like anxiety, panic attacks, and vomiting, can show up. For people who decide to break their habit at home, the risk of death is much higher. The biggest risk of death during opiate detox comes from the chance of relapse.

As the body begins to withdraw from the substance, tolerance lowers and as such, the required dose needed to get high does, too. Most people going through withdrawal fail to account for this, and when they relapse, they overdose. According to the Washington Post, 16,235 people died from prescription opioid painkiller overdoses in 2013 and 8,257 from heroin overdoses.

Additional Complications

Sometimes, death during withdrawal can stem from emotional instability. This is because individuals afflicted with depression, anxiety, rage, or paranoia during withdrawal may act out with self-destructive behavior.

Suicide is a real risk among people who abuse drugs and/or alcohol. According to Psychology Today, the rate of suicide among people who and struggling with substance abuse and fail to seek treatment being as high as 45%. Often, matters are far more complex than the mood swings that come alongside withdrawal. In many cases, mental health is a larger concern.

Depression and anxiety are often at an all-time high during withdrawal from a substance. On top of that, many people who are severely mentally ill are also struggle with substance abuse. Letting a mental health disorder grow makes it harder to treat in the long-term, and it may very well lead right back to substance abuse.

Post-Acute Withdrawal Syndrome

Some people struggling with addiction develop post-acute withdrawal syndrome (PAWS), which can make withdrawal symptoms persist for a few years after detox. These patients are at increased risk of relapse, which can be deadly if they decide to use again and don’t account for their newly lowered tolerance.

It’s Time to Get Help

If you or a loved one is struggling with substance abuse and are ready to accept help, call Futures Recovery Healthcare today. We can answer your questions about the detox process and help you get started on the road to recovery.

How Long Does Suboxone Withdrawal Last? Timeline, Tips, and Symptoms

Opioid misuse and dependency treatment may start with a medical detox protocol since withdrawal symptoms are often uncomfortable and drug cravings can get intense.

What to Expect During Withdrawal

Even when taking medications as directed, changes can occur in the brain disrupting the natural chemistry and interfering with the chemical messengers that run the body. When you take anything for a prolonged period of time, these changes grow more pronounced. The chronic or long-term misuse of opioids can lead to a physical dependence, wherein the brain is used to the chemical stimulation and begins to rely on it. Psychologically, the person can become dependent as well, since opioids generally make the individual feel good and therefore encourage him or her to keep taking them.

One of the symptoms of addiction is the onset of withdrawal symptoms when the substance is removed or leaves the bloodstream. This is the brain’s attempt to restore balance now that chemical interference is no longer present. The severity and duration of withdrawal will depend on several factors, such as:

• Dosage or amount taken
• Duration of abuse
• Level of dependency
• Genetic or physiological factors

Generally, the method of ingestion also affects the withdrawal timeline.
Suboxone is thought to have a long half-life of around 36 hours. Withdrawal symptoms typically don’t start until after the drug leaves the bloodstream, and in the case of Suboxone, this may mean that the user won’t experience withdrawal until after the first day or two of taking the last dose. Early withdrawal symptoms are very similar to a bad case of the flu, and include:

• Muscle aches
• Dizziness
• Tremors
• Excessive tearing
• Runny nose
• Abdominal cramps
• Diarrhea
• Nausea
• Vomiting
• Chills
• Loss of appetite
• Fatigue
• Sweats
• Trouble regulating temperature.

Acute withdrawal usually peaks within a few days, and the individual may experience all of the physical symptoms plus psychological ones such as,:

• Agitation
• Irritability
• Anxiety
• Feelings of being on edge
• Drug cravings
• Insomnia

Protracted withdrawal, sometimes called post-acute withdrawal syndrome, or PAWS, may continue for as long as few weeks or a few months, and the person may feel depressed and angry, have mood swings and drug cravings, and experience some or all of the physical symptoms intermittently.

Managing Withdrawal

Suboxone withdrawal is not life-threatening or generally dangerous, although it can feel like it may go on endlessly while going through it. Individuals should not attempt to stop taking opioids suddenly, as these withdrawal symptoms may be difficult to manage without professional help. Instead of stopping suddenly, a medical professional may help you set up a tapering-off schedule. This method weans Suboxone slowly and safely out of your system in a controlled manner, helping to keep withdrawal symptoms and cravings at bay. Just removing Suboxone from the brain and body is not enough, however. Relapse after detox is common, and it can be dangerous since the body is no longer used to the same amount of drugs taken previously.

Detox alone is not an effective opioid misuse or dependency treatment, although it can be a very useful first step. Drug misuse and dependency are generally at least partially rooted in psychology, either stemming from a childhood trauma, low self-esteem, or mental health conditions.

Behavioral therapies and counseling sessions are important as they can teach life skills and coping mechanisms to assist with social and emotional triggers or stressors that may typically cause the turn to self-destructive behaviors, such as drug misuse. These therapies can help to rewire the brain to seek positive outlets and behaviors instead. Support groups are also important during substance misuse treatment and recovery, as they provide a positive network and social outlet where people in recovery can feel safe and connected. There are some general tips that can help during recovery and Suboxone withdrawal, as well:

• Eat a balanced and nutritious diet
• Keep a structured sleep schedule
• Exercise regularly
• Maintain positive connections with peers and family
• Educate yourself on the process
• Stay busy in a productive manner
• Be patient and stay the course
• Ask for help when you need it
• Try yoga or meditation

By taking care of yourself both emotionally and physically, you can help to ease the symptoms and shorten the withdrawal timeline.

At Futures, we can provide a peaceful respite where you can recover from substance misuse and dependency in privacy and comfort, surrounded by professional medical staff and compassionate counselors trained in both traditional and holistic recovery methods. Call Futures to learn more.

How Long Does Precipitated Withdrawal Last

Patients who are ready to put opiate dependence behind them have the option of utilizing medication designed to help them break free from addiction in a slow and controlled manner. Unfortunately, though, certain medications (especially buprenorphine) can help to mitigate withdrawal symptoms and the harsh nature of “cold turkey” opiate detox in patients, but in some cases can cause precipitated withdrawal.

What Is Precipitated Withdrawal?

Precipitated withdrawal can happen when a patient takes an antagonist (e.g. naloxone) or partial agonist (e.g. buprenorphine) when he or she is still dependent upon full agonist opiates (e.g. heroin, or prescription painkillers like OxyContin or Percocet). Defined by many of the same withdrawal symptoms that characterize an opiate detox, many patients fear precipitated withdrawal, and therefore, do not view medication-assisted treatment using Suboxone to be a viable option for their recovery.

How Long Does Precipitated Withdrawal Last?

The length of precipitated withdrawal varies greatly from patient to patient. In fact, some patients will not experience the phenomenon at all, reports the National Alliance of Advocates for Buprenorphine Treatment (NAABT). According to NAABT, patients can, and should, work with their doctors to avoid this experience altogether or minimize it as much as possible.

Is It Possible to Avoid Precipitated Withdrawal?

The more that patients understand how buprenorphine treatment works, the better they will be at advocating for themselves and minimize their experience with precipitated withdrawal. Doctors who prescribe buprenorphine are certified in its prescription and understand how to help patients avoid precipitated withdrawal, and should always be consulted if you have any questions. One major way that patients can help themselves is to accurately report the last use of their opiate drug of choice. Too often, patients under-report their last use – that is, they say that their last use was longer ago than it actually was – and this puts them at risk for a quick and severe withdrawal experience. In fact, patients should already be exhibiting some of the first withdrawal symptoms when they take their first dose of buprenorphine.

Should You Try to Avoid Precipitated Withdrawal?

Absolutely. Experiencing a severe withdrawal syndrome quickly after taking the first dose of the treatment medication can be disconcerting to the patient and make him or her worry that detox was a mistake or that the doctor won’t be able to help. If it’s possible to minimize or avoid precipitated withdrawal, it makes sense to take steps to make detox easier.

What if Precipitated Withdrawal Occurs?

Medically supervised detox using medication assistance means that a doctor is available to assist with any issues as they arise. There may be non-addictive medication that will be useful in treating the specific symptom and/or an adjustment to the dosing schedule that will help to address the issue.

Find Out What You Need to Know

Before beginning any treatment program, it is advisable for patients to learn everything they can about their options, what to expect, and how their personal circumstance may modify the detox options that will be viable for them. The more the patient knows before they begin, the more likely it is that he will make the best possible choice for their needs and avoid unexpected surprises. Contact us today to learn more about how to successfully detox off heroin and other opiates.

Dangers of Mixing Suboxone With Benzos, Alcohol, and Other Depressants

If Suboxone is taken in conjunction with other drugs or alcohol, it will amplify all of the potential medical related risk factors, including increasing the likelihood of a life-threatening interaction or overdose. In 2010, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 30,135 Americans sought emergency medical treatment for buprenorphine-related causes, with 52% of these visits for the non-medical use, or abuse, of buprenorphine products, and 59% of these visits involved other drugs.

How Suboxone Works and Its Risk Factors

Opioids drugs attach to opioid receptors throughout the brain and body, blocking pain signals and stimulating the production of neurotransmitters that are responsible for regulating moods and emotions – essentially the brain’s reward circuitry. Buprenorphine is an opioid drug. The National Institute on Drug Abuse (NIDA) reports that between 26.4 million and 36 million people are believed to misuse opioids worldwide, while the World Health Organization (WHO) further estimates that around 15 million opioid misusers suffer from an opioid dependency. Regular use or abuse of an opioid drug can create a psychological and physical dependence. The brain begins to depend on the drug in order to feel “normal” or balanced, and it ceases to function exactly as it did before the drugs. Brain chemistry is altered, and the brain relies on the opioid in order to provide certain chemicals that produce feelings of happiness, for instance. In addition to being habit-forming, Suboxone also can suppress breathing, or respiration, to dangerous levels when abused, as well as potentially induce drowsiness, lethargy, and vomiting.

Side Effects of Mixing Suboxone With Depressants

The manufacturers of Suboxone state that the drug can have dangerous, and even life-threatening, interactions when mixed with central nervous system depressants, such as benzodiazepines (benzos), alcohol, sedatives, muscle relaxers, or tranquilizers. Adverse reactions mostly include potentially fatal breathing problems, as central nervous system depressants also suppress respiration.

Motor control and functions may be impaired, which can lead to accidents or impaired driving. Suboxone and central nervous system depressants when used together also alter cognition levels as well as the ability to make rational decisions. They may affect impulse control and willpower, causing the individual to engage in potentially risky behavior. Opioids, as well as alcohol and benzodiazepines, stimulate the production of the brain’s chemical messenger gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter. GABA is a sort of natural tranquilizer that acts on the nervous system, calming things down and suppressing stress, anxiety, and panic as well as lowering heart rate, respiration, blood pressure, and body temperature. When overstimulated, the overproduction of GABA can slow things down too much.

Similarly, alcohol inhibits the production of the excitatory neurotransmitter glutamate, which is partially responsible for energy levels and increased brain activity. While Suboxone and opioid drugs are not technically considered central nervous system depressants, they do have many of the same effects as true depressants, and combining them can result in disastrous consequences. In addition to fostering addiction, higher doses also increase the likelihood of a potentially fatal overdose.

Since it’s primarily used to treat addiction, when Suboxone is coupled with other drugs or alcohol, it may actually increase addictive behaviors. Increasing dosage regularly greatly enhances the odds of becoming physically and psychologically dependent on each substance.

Signs of an Overdose

Suboxone is sometimes prescribed as a moderate pain reliever as it functions in much the same way as other opioid analgesics, just to a lesser extent. When surveying opioid pain reliever overdose fatalities, alcohol was involved 22.1% of the time, as published by the CDC. If you recognize any of the following symptoms, seek immediate medical attention as an overdose from mixing Suboxone and other central nervous system depressants can be fatal without proper treatment:

• Slurred speech
• Vomiting
• Blurred vision
• Confusion
• Loss of coordination
• Severe drowsiness
• Weak muscles or limp appendages
• Irregular heart rate
• Shallow or slowed breathing
• Loss of consciousness

Get Help Today

Brain chemistry altered through addiction and dependency can be reversed over time, and with the proper treatment. Physical stabilization is the first goal of addiction treatment and may require detox in a safe and secure facility that provides 24-hour medical care and supervision. Recovery, in order to be successful long-term, should also include psychotherapy, such as behavioral therapies and counseling sessions. In addition, support groups may be invaluable at preventing the severity, duration, and frequency of relapse.

At Futures, we offer a state-of-the-art treatment facility, providing evidence-based and comprehensive recovery plans in order to promote healing and long-term success. Contact Futures today to speak with a compassionate and highly trained admissions counselor for more detailed information on the specialized and unique treatment plans we have to offer.

Signs and Symptoms of Suboxone Abuse

Suboxone is a synthetic opioid made by combining two different drugs – buprenorphine and naloxone. Like methadone, Suboxone is a medication-assisted treatment that’s prescribed to help people overcome addiction to other opioid drugs, such as heroin and morphine. The drug works by preventing withdrawal symptoms and by lessening the euphoric effects of opioids, making it easier for people who are addicted to get clean.

Although Suboxone is very effective therapeutically, the drug is still dependent-forming and addictive, so there is a potential for abuse, especially among people who don’t currently have an opioid addiction.

In 2012, doctors in America wrote 3 million prescriptions for drugs that contain buprenorphine, like Suboxone, and in the previous year, there were more than 21,000 visits to emergency rooms around the country because of nonmedical buprenorphine use.

Physical Signs & Symptoms of Suboxone Abuse

There are many physical symptoms of Suboxone abuse that people can watch for to determine if there’s an issue:

• Track marks on the arms
• Infections or bruising around injection sites
• Sudden weight gain or loss
• Other drug paraphernalia around the house
• Getting sick more frequently
• Contracting a bloodborne (such as HIV or hepatitis) illness from needle-sharing
• Constricted or pinpoint pupils

Psychological and Behavioral Signs & Symptoms of Suboxone Abuse

Beyond the physical signs of Suboxone abuse, there are also behavioral changes that are very noticeable in people who are misusing or addicted. There are also many behavioral and psychological Suboxone misuse signs and symptoms, including:

• Missing work or school, or being late frequently
• Spending a lot of money on drugs or getting into financial trouble
• Stealing or borrowing money or valuables
• Neglecting hygiene, personal appearance, and health
• Visiting multiple doctors to obtain more Suboxone prescriptions
• Getting in trouble with the law
• Social isolation or changing friend circles
• No longer caring about hobbies and passions
• Stealing drugs from medicine cabinets
• Lying, keeping secrets, and being defensive about behavior and actions

Side Effects of Suboxone Abuse

Suboxone is a combination of two different drugs, and each of these drugs has its own list of potential side effects. The first component of Suboxone is buprenorphine, which is a synthetic drug that produces effects similar to other opioids, such as euphoria, and this helps to mitigate the symptoms of withdrawal. The other component is naloxone, and this drug blocks the effects of opioid drugs, which is why Suboxone can be effective at reducing opioid use. Together, these drugs have a number of side effects, including:

• Muscle aches
• Fever
• Cramps
• Nausea and vomiting
• Constipation
• Insomnia
• Irritability
• Sweating
• Drowsiness
• Slurred speech
• Lack of coordination
• Depression
• Respiratory depression
• Mood swings

Short-Term and Long-Term Effects of Suboxone Abuse

As with all drugs, Suboxone has a number of both short-term and long-term effects that can impact a person’s life, body, and brain. The most common short-term effects that people experience include:

• Mild euphoria that lasts for about eight hours
• Relaxation
• Decreased stress levels
• Sense of ease and calm

The long-term effects associated with Suboxone abuse, and these are very similar to the effects a person will experience during a Suboxone withdrawal. After prolonged use, some of the most common long-term Suboxone abuse signs include:

• Anxiety and depression
• Confusion
• Disorientation
• Chronic constipation
• Gastrointestinal problems
• Nausea
• Vomiting
• Low tolerance for pain
• Heart palpitations
• Increased risk of dependence and addiction
• Increased risk of overdose

If you or a loved one is struggling with a Suboxone addiction, call Futures today to get the help you need.

Suboxone Abuse

Widely popular for its use in treating heroin and other opioid addictions, Suboxone has taken on a life of its own, with many patients developing a dependency on the more controlled – and supposedly safer – high offered by Suboxone. The reality is that using Suboxone as a crutch brings with it a number of health problems, and the risks of Suboxone addiction are very real.

What Is Suboxone?

Suboxone is a mixture of buprenorphine and naloxone. It is prescribed for people who are addicted to legal opioids (in the form of prescription medication, like morphine and OxyContin) and illegal opioids (like heroin). Suboxone leapt into prominence as patients and doctors around the country looked for a way to deal with the epidemic of opioid abuse. According to the New York Times, at one point, Suboxone was even more popular than Viagra and Adderall, generating sales of $1.55 billion in the United States.

Recreational Suboxone Misuse

The fact that buprenorphine can result in the same effects as opioids makes it one of the most abused pharmaceuticals in the world. According to a Substance Abuse and Mental Health Services Administration (SAMHSA) report, in 2010 buprenorphine was responsible for 30,135 emergency room visits, and over half of those visits were because of nonmedical (recreational) use.

Addiction has many risks beyond behavioral effects. Spending money to procure multiple prescriptions or illicitly purchase Suboxone may cut into other financial responsibilities and lower the patient’s quality of life. However, if they persist with getting more Suboxone despite this, then their Suboxone addiction will run them (and potentially their family) into the ground. Taking more Suboxone than is medically recommended still carries a number of risks to the patient’s body, such as:

• Sleep disorders
• Depression
• Fatigue
• Memory problems
• Headaches
• Slurred speech

Furthermore, once a patient starts taking Suboxone beyond their prescription levels, they build up a tolerance to the drug.

Suboxone Withdrawal Symptoms

Another risk of addiction is that it causes withdrawal symptoms. If a patient experiences withdrawal symptoms after they don’t use Suboxone for a short period of time, it is a clear sign that their use has gone too far. They may feel withdrawal symptoms similar to those associated with other opioids, such as:

• Completely drained of energy and motivation
• Muscle cramps and pain
• Fever
• Nausea and vomiting
• Diarrhea
• Anxiety and agitation

Suboxone Overdose

In a worst-case scenario of addiction, a patient can overdose on Suboxone, which happens when the brain is no longer able to process the buprenorphine and naloxone. If this occurs, the user will experience:

• Low blood pressure and heart rate
• Circulatory problems
• Blurry vision
• Respiratory failure
• Coma
• Cardiac arrest

If the Suboxone is being used in conjunction with other drugs, or alcohol, death is a possibility.

Treating a Suboxone Addiction

There are two components to treating a Suboxone addiction. The first is detoxification. To be done right, the patient should be checked into a rehab center, where detox can be overseen by doctors and clinic staff. As part of the intake and assessment process of checking in, clinic staff should be made aware of the patient’s drug history. This information will determine what medications, if any, the patient should receive to ease the stress of detoxification.

The second component of treatment can make all the difference in terms of long-term recovery. No drug treatment program is complete without psychotherapy, which educates patients on the reasons and thought processes behind the cycles of addiction. In many instances, patients who leave a treatment program after detox, without going through psychotherapy sessions, invariably relapse.

Therapy following detox will help a patient learn how to act and think in ways that give them more control and clarity in everyday life. After psychotherapy and discharge from a treatment facility, a patient should start an outpatient program, and remain connected to aftercare support programs, like NA groups. Such outlets provide constant support and solidarity, further distancing the patient from the temptation to take Suboxone again.

At Futures, we have trained medical and mental health professionals on our team who are here for you. Please call us today and take the first step in overcoming a Suboxone addiction.

Symptoms and Causes of Precipitated Withdrawal With Suboxone

Opioid addiction is considered a chronic and progressive brain disease that is highly treatable. One of the methods used during opioid addiction treatment is medication-assisted therapy. It is never recommended to stop taking, or abusing, an opioid “cold turkey,” or suddenly, as this can lead to the onset of difficult withdrawal symptoms. Medications may be used to help curb cravings and manage these withdrawal symptoms.

Suboxone is an FDA approved sublingual filmstrip that treats opioid addiction. It is dissolved in the mouth, usually once or twice a day. Suboxone contains both buprenorphine, a partial opioid agonist, and naloxone, a partial opioid antagonist. The partial opioid agonist works by displacing full opioid agonists from the brain, and the antagonist then blocks the opioid receptors from receiving any more drugs. Partial agonists, like buprenorphine, are less likely to create a “high” or have other mind-altering effects. They may make you feel more energized and generally pleasant. Buprenorphine’s effects also plateau after a certain amount is ingested, so even if you take higher doses to try and increase the “happy” feelings, after a set amount you will not be able to. Suboxone also contains the antagonist naloxone, which serves to block opioid receptors from receiving more opioids, so even if you take another opioid while on Suboxone, you won’t get “high.” Naloxone is relatively dormant when Suboxone is taken as directed and only serves to precipitate withdrawal if abused and injected.

The use of Suboxone during medication-assisted therapy can speed up detox and promote long-term success with fewer instances of relapse. Precipitated withdrawal occurs when Suboxone replaces a full opioid agonist in the brain before the other opioid is out of your system.

Precipitated Withdrawal Symptoms

Precipitated withdrawal is similar to opioid withdrawal, although it can be more intense and start suddenly. Symptoms of opioid withdrawal and precipitated withdrawal include:

• Agitation
• Anxiety
• Insomnia
• Excessive yawning
• Muscle aches
• Runny nose
• Watery eyes
• Abdominal cramping
• Nausea
• Vomiting
• Diarrhea
• Dilated pupils
• Sweating
• Chills

The severity of these symptoms may depend on how long you abused opioids, which drug you abused and your method of abuse, the level of physical dependency, and certain genetic factors. Drug cravings may also occur during withdrawal, as withdrawal symptoms can be uncomfortable, and it may seem easier to relapse, or return to abusing opioids to stop those withdrawal symptoms.

Avoiding Precipitated Withdrawal

When starting medication-assisted therapy, it is vital that you are honest about what drugs you took and when the last time you took them was. Different drugs stay in your system for varying amounts of time depending on your metabolism, physiology, tolerance levels, and the half-life of the particular drug taken. Some drugs have short half-lives, for example, meaning that they may leave your bloodstream more quickly than others. Morphine, oxycodone, and hydrocodone immediate-release products such as OxyContin, Vicodin, and Percocet, are generally out of the bloodstream within 8-12 hours, for instance. Oxymorphone drugs like Opana and extended-release formats may stay in your bloodstream for up to 24-30 hours.

Methadone is a long-acting opioid with a long half-life, and it can take 36 hours to a few days to be fully flushed from your body. In order to avoid precipitated withdrawal, you should wait to begin taking Suboxone until all other opioids are completely out of your bloodstream. This may be indicated by the onset of early withdrawal symptoms, which include psychological side effects as well as some of the physical ones, such as the muscle aches, sweating, yawning, tearing, runny nose, sweating, and insomnia. Once these symptoms begin, it is likely safe to initiate medication-assisted therapy.

Physical dependence plays a role in the onset of precipitated withdrawal, and often, in order to safely detox from opioid drugs, a tapering schedule is implemented first. Someone who is heavily dependent on an opioid may need to gradually taper their dosage slowly, in a controlled manner and over a period of time, gradually reducing the dosage down to zero. This should be closely monitored by medical professionals in order to maintain safe levels of the drug and to ensure that the dosage continues to decrease. Once the drug is tapered off completely, Suboxone can be introduced to continue to keep withdrawal symptoms and cravings to a minimum.

Suboxone is generally started within 12-24 hours of your last dose of an opioid and during the induction phase of opioid addiction treatment. The amount of time you take Suboxone for will depend largely on your level of dependency and addiction, and medical professionals should determine its use. In order to avoid precipitated withdrawal when taking Suboxone, you also need to take the medication exactly as directed. Taking higher doses, abusing, or diverting Suboxone may lead to precipitated withdrawal. In addition, mixing other drugs or alcohol with Suboxone can be dangerous and also precipitate withdrawal symptoms.

Get Help Today

In addition to a Suboxone regiment, psychotherapy, including behavioral therapies to address psychological dependence, is an important part of opioid addiction treatment. Support groups and therapy sessions are tools used in conjunction with medications for successful treatment and recovery.

At Futures, we employ the latest evidence-based treatment methods to assist with your recovery. Contact us today for a free and confidential assessment.