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Posted by on in Drug Addiction

 

Medication Assisted Treatment, or "MAT" for short, is the use of FDA approved medication for the treatment of opiate/opioid addiction and substance abuse.  It has never been quite as controversial a subject as it is today.  As more and more abstinence-based programs have become mainstream within inpatient treatment centers, the stigma being attached unnecessarily to MAT is discouraging to very high-risk drug addicts and those who have attempted treatment without medication several times and failed. 

When comunity-based groups such as AA began, there was no regulated MAT approved for widespread use in the US.  It was also back then in the 1930's that the medical community had not yet been able to establish that alcoholism or drug addiction was in fact a medical disease.  That fact came later and is now based in numerous evidence from research foundations & hospitals all over the country.

The fact that we all know addiction IS a disease now seems slightly hypocritical for those who still hold a strong personal bias against the use of MAT for addicts; instead refusing to acknowledge any route for treatment other than spirituality and willpower, solving the disease of addiction.  These efforts may help some people but the numbers clearly over time and especially now show that this is not the case for the majority. 

While ALL supporters and providers of MAT also encourge a multi-treatment approach, knowing medication alone is not the answer, there are those who ignore this and begin to spread a dangerous message to addicts who would benefit greatly from MAT methods, along with support groups, IOP's, individual therapy, group therapy, CBT, and other outpatient behavioral and support services.  The message being spread is almost always by those who have never used MAT or who have and did not follow proper protocol.  Very seldom do you hear positive aspects of MAT from people who were very successful using this method, as millions over several decades have. The danger is that someone who is bias against MAT, having been able to get clean and stay clean via abstinence is outspoken regarding the "negative" possibilities of MAT and almost never discuss or encourge the very positive aspects of MAT for the very severe addicts who need MAT to stabilize their physical dependance and then use that time on treatment to work on their behavioral addiction issues and dual diagnosis treatment such as depression or anxiety. 

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Posted by on in Drug Addiction

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Midwestern Mama continues observing the comings and goings of Methadone and Suboxone treatment participants.

Other than the first day my son started the HIOP (high-intensity, out -patient) treatment program, I haven’t returned to the waiting room – at nearly 22 years old, he’s a big boy and doesn’t need Mom to come in with him nor does he want me to.  Now, I wait in the parking lot and let me say it’s no less insightful.

Each morning, we arrive between 7:30 and 8:15 a.m.  There are taxi cabs, medical transportation vans and cars of all models – from luxury vehicles to ready-for-the-junkyard clunkers held together with duct tape (yes, I have actually seen this).  Some people walk from the nearby bus stop while others ride bikes.

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Posted by on in Drug Addiction

"Cognitive Dissonance" is defined as a great feeling of psychological discomfort produced by the presence of thoughts & behaviors that are conflicting in nature.  The theory suggests that if individuals act in ways that contradict their beliefs, then they typically will change their beliefs & thoughts to align with their actions.  In a nutshell, humans have a difficult time admitting to others but even more to themselves that they were wrong about something.  If you've ever told a lie and felt uncomfortable because you see yourself as scrupulously honest, then you've experienced cognitive dissonance.

 

It occurs whenever your view of yourself clashes with your performance in any area—you see yourself as smart but can't believe you made such poor decisions.  Cognitive dissonance often occurs because people fear appearing foolish or ignorant.  They are fully aware they have acted in a way that is either inappropriate or uncharacteristic with their belief system or morals, and so they use different strategies to protect their image to others, but even more so to protect their own self-image.  It is hypocrisy between what we believe in and what we engage in. 

 

When this internal conflict is present, people feel increasingly guilty or uneasy about holding these opposing cognitions – they don’t want to think of themselves as illogical or inconsistent. These internal conflicts are hard to live with, and if not dealt with the individual will feel bad about themselves and this can snowball into further and continuous illogical behaviors/actions and then cause very severe and damaging feelings towards one's self. 

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Posted by on in Drug Addiction

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Midwestern Mama discovers a community of opiate users in recovery -- just miles from her suburban home – as her son begins Suboxone treatment and counseling for Heroin addiction.

Less than five miles from my suburban home is an outpatient treatment center that offers Methodone and Suboxone dosing in addition to individual counseling, group sessions and training.  Although it’s close to where I live, it’s not on a road I ordinarily take and even though I’ve driven that road many times over the 20 plus-years that I’ve lived here, it’s not a structure that I ever noticed.

The past two days, however, changed that.  I have taken notice and I have spent several hours there.  It has been eye opening and I actually look forward to seeing and experiencing more in the days ahead.  As part of my son’s journey with addiction, I have yearned for an insider’s perspective to better understand the complexities of substance use disorder – if not his, that of others. 

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Posted by on in Drug Addiction

During one of my hospital stays at the renowned McLean Hospital, I became acquainted with an older Jamaican man who worked at the hospital in the unit where I stayed.  His name was Marvin & he was a mental health assistant.  His job was to have a "check-in" session every day with each of the patients he was assigned, which was always done privately.  He was extremely sincere and gentle, so when he would ask me "How are you feeling today?", I was convinced that he genuinely cared and wanted to know.  It seemed he had a commitment to his job that went far beyond the hospital walls, which is a very special quality in mental health & substance abuse treatment workers.

I was never someone to instantly have enough trust in someone that I would spill my true concerns, worries and mistakes, instead choosing to keep the proverbial wall up and not expose too much of my problems; this being in part, an issue of self-preservation as to not have others look down upon me, and part guilt and shame that I carried deeply over what I believed to be horrible mistakes that could only mean I was a terrible person.  A large part of this guilt and shame I carried inside, like a leaden weight, dragged me down further into my depression, my suicidal ideas and my relapses.  I was fully aware and conscious; I KNEW how detrimental this guilt & shame was to my health, my recovery and my very life, how it was holding me back by being unable to talk about it with anyone, but it was such a strong, all-consuming shame, that I didn't believe at the time, I could handle these thoughts being verbalized and thus open material to have a further conversation with.  I was terrified that if I said out loud all the things I had done, to anyone else, no matter if it was their job to help me or not, that they would use that information to think poorly of me and agree with my idea that I was simply a bad person.  I couldn't handle the thought of anyone looking at me as a flawed human being, that didn't already know my mistakes, only later to form the opinion that I was. 

Most people who know nothing about addiction as a disease or know someone close to them that has suffered with addiction, look at in the way that, if our actions directly cause harm or hurt to those we love (which they do), then it can't be a true disease; no matter how much modern medical research shows to the contrary, they believe we are choosing our actions and therefore are very flawed in a moral way.....not in a sick way.  This can explain why many addicts, even in recovery for years, even while in treatment facilities where their addiction is known about, they still keep up very high walls and let out very little information.  We already feel terrible about ourselves, whether we may show it or not, so it would obviously hurt our self-image, our self-esteem much more, to have other people added to that list of how morally corrupt we are. 

Although he already conducted his official "check-in" with me, Marvin approached me in the hallway and asked me if I would sit down.  He sensed something was wrong.  Marvin knew I was a mother.  He knew I was having difficulties at home with my marriage.  And from seeing me in tears walking in the hallways numerous times & bursting into tears after a telephone call, he knew that I felt guilty and ashamed that I was even in the hospital receiving the treatment I very much needed and that I did not feel I deserved it. 

His question was a very simple, "Why?"  

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