Friday, February 24, 2017

Transcendental Meditation for PTSD

Tran·scen·den·tal Med·i·ta·tion ™
a technique for detaching oneself from anxiety and promoting harmony and self-realization by meditation, repetition of a mantra, and other yogic practices, promulgated by an international organization founded by the Indian guru Maharishi Mahesh Yogi ( c. 1911–2008). 

In circles of recovery around the globe, the practice of prayer and meditation is often a vital component of individuals’ programs. Such actions are tied to the spiritual component of addiction recovery, used as a conduit to one’s higher power. Sometimes both practices are employed on a daily basis. However, for some members of the recovery community, whose higher power is perhaps more nebulous than typical deities, forms of meditation are often the "go to" practice for “grounding” and “centering” oneself.

Meditation should never be brushed off or spurned; the practice has helped countless people (not just in the program) make important inner discoveries, and bring one out of a recovery tailspin that may have resulted in a relapse. People in recovery are often times anxious, especially in early recovery when just trying to figure out which way is up can be a challenge. Recovery is something foreign, counter to everything that active addiction encompassed; any action that can help bring you back to earth and focused on the greater goal of long-term sobriety should be welcomed.

Many individuals working a program are also contending with a co-occurring mental health disorders—on top of addiction. Anxiety, depression, bipolar and post traumatic-stress disorder (PTSD) are the most common. The symptoms of any one of the aforementioned disorders can be debilitating, and often times are the catalysts leading to relapse. It is vital that co-occurring disorders be addressed in recovery concurrently. Which can take the shape of going to a meeting and working the steps in conjunction with medication that helps keep mental illness symptoms at bay. However, there is new research which indicates that meditation may actually reduce one’s reliance on medication for treating mental health disorders like PTSD, according to the Medical College of Georgia at Augusta University.

Thousands of young Americans have returned from conflict(s) overseas with a number of scars, many of which are internal. The horrors of war can affect even the most stoic of soldiers. PTSD rates among servicemen and women are high, and much of the time the only treatment they receive are essentially medication band-aids. The symptoms of PTSD often include headaches, memory, sleep and mood issues which can severely impact quality of life. What’s more, PTSD afflicted individuals whose symptoms are not mitigated, will often resort to narcotics (prescribed or not) and alcohol to calm the internal storm. A practice which only provides temporary ease. Over time, one must use more and more to achieve the desired effect. Dependence and/or addiction is often a foregone conclusion in such cases.

PTSD symptoms are commonly treated with antidepressants and anti-anxiety drugs, such as Xanax or Ativan. The new study sought to determine the effect that Transcendental Meditation would have on active-duty service members with PTSD, the press release reports. The research involved 74 people receiving treatment at Dwight David Eisenhower Army Medical Center's Traumatic Brain Injury Clinic at Fort Gordon, Georgia.

For the study, half of the participants were asked to practice Transcendental Meditation regularly in addition to their other therapy. After just one month, 83.7 percent of the meditation group had stabilized, reduced or stopped their use of psychotropic drugs, compared to the 10.9 percent who had increased their medication dosage. In the non-meditation group only 59.4 percent had stabilized, reduced or stopped taking psychotropic drugs, according to the report. Of the non-meditators, 40.5 percent increased their medication intake. The trends held consistent months later.

"Regular practice of Transcendental Meditation provides a habit of calming down and healing the brain," said Dr. Vernon A. Barnes, physiologist at the Georgia Prevention Institute at the Medical College of Georgia at Augusta University. Barnes, the study's lead author. 

The findings were published in the journal Military Medicine. The Eisenhower TBI Clinic encourages patients to meditate twice daily, for 20 minutes.

Thursday, February 23, 2017

Suboxone and Our Fragmented Healthcare System

Suboxone is a drug that is used for treating addiction, specifically opioid use disorder. The drug is prescribed by doctors both inside addiction treatment facilities and outside at primary care offices. In recent years, in the wake of the American opioid addiction epidemic, there have been concerns about the number of doctors prescribing the drug. Given the scale of the epidemic, some two-million plus afflicted Americans, there simply are not enough doctors who are either licensed or willing to prescribe the potentially life-saving drug. Despite the fact that research shows  Suboxone, or buprenorphine, is effective when used in conjunction with cognitive behavioral therapy(CBT).

New research highlights why buprenorphine has been underutilized. Showing that even when it is prescribed to patients with an opioid use disorder, recovery success rates are fairly low. Of the 20,124 people studied who were prescribed Suboxone for addiction, the researchers found that 27 percent used another opioid during treatment and 54 percent received one after treatment was over, The Washington Post reports. The findings were published in the journal Addiction.

It is widely agreed upon that the longer one undergoes addiction treatment, the more equipped they will be for achieving long-term recovery. The longer the treatment, the stronger one's recovery will be. Yet, the research shows that the average length of stay on buprenorphine was 55 days, according to the article. More than a month shorter than 90-day treatment programs that have become commonplace across the country.

The study also brings to light how the health care system in America is not coordinating their efforts. Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at the Johns Hopkins Bloomberg School of Public Health, said that the research: "raises important questions about the quality of care these patients are receiving and the degree to which their care is coordinated across our fragmented health-care system."

Alexander pointed out that doctors are still not utilizing the prescription drug monitoring programs (PDMP), the article reports. He says that when patients continue to fill prescriptions for painkillers while also being prescribed Suboxone, it isn’t indicative of addicts gaming the system. It has more to do with “inefficiency and poor communication” throughout the healthcare system.

"Many doctors don’t use them [PDMPs]. Many doctors aren’t even registered. Many who are registered don’t use them regularly," says Alexander. "I don’t think we can put this entirely on patients or providers or any other single stakeholder."

Friday, February 17, 2017

Drugs, Alcohol and Athletics

If you were to look back on memories of high school and college, you can probably remember where you fit into the social order. Maybe you were in the glee or debate club, perhaps you hung with the intellectuals or played team sports. Or maybe you were not interested in any of that, choosing to stick to a small group of classmates who had had enough of social hierarchy, choosing to rebel by reading Kafka and smoking pot.

No matter which group(s) you associated with, it is likely that you saw a fair amount of drinking and drugging at one time or another. Let’s face it, sometimes partying is a part of one’s transition into adulthood. That being said, when mining your memory banks you may think of certain groups that took part in the culture of drugs and alcohol on a more regular basis. Naturally, we all have different memories about our younger days, but more times than not heavy drug and alcohol use is associated with art “heads” and social outcasts. While such associations may be spot on from time to time, there are other groups that engage in their fair share of harmful behaviors with regard to drugs and alcohol.

One such group may come as a surprise, those known by first name in the athletics department. Yes, that’s right, but let’s set aside the occasional post game partying for the time being. It turns out that athletes are often placed in environments which put them at a potentially greater risk of substance abuse issue problems down the road, especially those playing team sports from high school to the pro’s, according to a University of Alberta news release. A new study “Exploring the role of sport in the development of substance addiction” was published in the journal Psychology of Sport and Exercise.

Laurie de Grace, a master's graduate of the Faculty of Physical Education and Recreation and the study's lead author, interviewed a number of former athletes who are in recovery from addiction, the news release reports. Most of the study participants had a background playing team sports, predominately hockey. De Grace points out that conventional wisdom would associate athletics with good mental health, but she found something altogether different.

“Instead, what we found is with addiction, the more risks that are present, the greater likelihood it is going to develop,” said de Grace. “Sport, it appears, has the potential to increase the risk factors.” 

It is important to point out that the study doesn't suggest that all people who play team sports are at a risk of addiction, but rather that those who may have a family history of addiction or started drinking and drugging in high school are at greater risk later on. With problems beginning in college and in the environment of professional sports, where heavy drinking is often the norm even endorsed by certain coaches. Project supervisor Wendy Rodgers, a professor in the Faculty of Physical Education and Recreation, highlights the need for protecting the addiction susceptible athletes early on.

“There is a vulnerable period of life that seems to correspond with an elite performance level in high school when there are a bunch of things going on that can contribute to problems later in life,” she said, making clear that the researchers were surprised by the availability of drugs and alcohol to young athletes. “That is definitely a context where we can take more control of what is happening with teams and how they are behaving and engaging with the rest of the community.”

Thursday, February 16, 2017

Contingency Management Addiction Treatment

contingency management
When you were growing up, there is a good chance that your parents rewarded you for good behaviors. Such rewards would reinforce your desire to continue the same pattern in the future. Completed chores were probably rewarded with an allowance and following directions were likely rewarded with your parents exhibiting greater trust in your ability to make good decisions when they were not around. Whatever the reward for a specific action was is irrelevant, what’s important is that a foundation for exhibiting healthy behaviors was being laid.

The aforementioned practice is known as contingency management, the use of incentives or rewards to encourage good behavior in the future. It is a strategy that a number of researchers have considered when trying to develop more effective forms of addiction treatment. If you have a history with addiction, you may be thinking that contingency management won’t work. Considering the countless people who have failed to achieve sustained abstinence, even when they have the expectation of something good coming their way for doing so. You cannot bribe people into sobriety and the addict-mind only knows one reward—euphoria.

At a number of extended-care residential addiction treatment facilities across the country, following directions and adhering to the principles of the program will often be rewarded with weekend passes or certain perks (i.e. going on fun excursions). They not only honor those new to recovery for their good work, the rewards in themselves actually can test the strength of one’s recovery at a given juncture. If a patient goes on pass from the center and relapses, it is indicative that an overhaul of their program is needed.

There will always be a contingent in the field of recovery who believe that one’s own recovery is the reward. The idea that people should be rewarded for their abstinence just doesn’t sit well with their ideas. It could even be broken down as such: the behaviors associated with active addiction are abnormal, leading to all kind of life problems; whereas, the behaviors tied to recovery are normal which are not accompanied by hardships. Recovery is its own reward.

That being said, it is generally agreed upon that there isn’t just one way to treat or recover from addiction. So, it is important that researchers continue to probe novel methods of helping people achieve sustained abstinence from mind altering substances. Researchers from Washington State University (WSU) studied the efficacy of contingency management when it came to treating co-occurring disorder (aka dual-diagnosis) cases, a WSU news release reports. The findings were published in The American Journal of Psychiatry.

A group of 79 outpatients at a mental health center in Seattle were followed by researchers for 12 weeks, according to the report. The researchers divided the participants into two groups, one of which would be rewarded after 12 weeks of negative results on drugs tests. The other group (control) would be rewarded regardless of drug test results. The rewards were nothing major, anything from soap to a gift card.

The findings showed that the reward-group was found to be three times less likely to test positive for alcohol use during the 12-week study period, compared to the control group. They were also five times less likely to test positive for tobacco use, and three times less likely to test positive for cocaine. An abstinence trend among the reward group continued during a three-month follow-up period.

“Our findings suggest that contingency management is a feasible approach for people with alcohol problems,” said lead investigator Michael McDonell, an associate professor in WSU’s Elson S. Floyd College of Medicine. “And it may be particularly effective in those with serious mental illness – such as schizophrenia and bipolar disorder – a high-cost and difficult-to-engage population.”

Friday, February 10, 2017

Marijuana Puts Baby At Risk

Abstaining from all mind-altering substances during pregnancy is generally considered to be the safest course of action for any expectant mother. The warnings are pasted on bottles of alcohol and printed on cigarette packs. Taverns typically post disclaimers about the potential harmful effects that alcohol can have on a fetus. And now, in the wake of the an opioid epidemic which has led to a spike in neonatal abstinence syndrome (NAS) cases, pregnant women are advised to be leery of opioids. However, when it comes to marijuana, there has not been a lot of talk about the potential effects the drug can have on a developing baby.

In the United States, individual states have taken a softer stance on cannabis of late. It is now legal to use medical marijuana in 28 states. What’s more, adults can engage in recreational marijuana use Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington as of November 9, 2016. While legalization is generally considered to be a step in the right direction when it comes to criminal justice, there is still a serious debate about the harms of cannabis use. Partly the result of a lack of research.

Many Americans have opinions about cannabis that are not based on science. They believe that because marijuana is now legal in their home state, that the risks of use are minimal. Although, with that line of logic, both alcohol and cigarettes would be considered to be safe. Which, they most certainly are not.

More than one study has shown that marijuana can have a detrimental impact on the developing brains of adolescents. So, if that is possible, then it is not that big of a stretch to think that “pot” may have a harmful effect on a developing fetus, right? Research indicates that tetrahydrocannabinol (THC) can pass through the placenta to the fetus, The New York Times reports. THC (the main psychoactive ingredient found in cannabis) experts point out, can potentially impact brain development, cognition and birth weight.

“Even early in development, marijuana is changing critical circuits and neurotransmitting receptors,” said Dr. Yasmin Hurd, a neuroscientist and the director of the addiction center at Icahn School of Medicine at Mount Sinai in Manhattan. “Those are important for regulation of emotions and reward, even motor function and cognition.” 

If you are using marijuana on a daily basis and thinking of making a family, then it is vital that you abstain from drugs and alcohol, regardless of one’s own perceptions of potential harm. If you find that you are unable to quit on your own, you should consider addiction treatment. It will not only help your baby, it will help you.
CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC