Methadone vs. Methadose
Abstinence-based programming is, by far, the most common approach for treating substance use disorders and addictions. While it is the most optimal outcome health-wise, chronic substance and alcohol use can have such sever effect on the brain that immediate abstinence is too difficult no matter the desire to stop. Drugs like opiates (e.g. heroin, morphine, fentanyl) have an intense influence on the release of dopamine in the brain. This alters the pleasure-reward systems so much that it begins to control the individual’s behaviours to ensure it is constantly activated (i.e. stimulated) and avoiding low levels of dopamine (withdrawals). For many people with this sort of experience, abstinence likely seems impossible. But living a normal life isn’t impossible. Opiate substitutes like Methadone and Suboxone allow individuals with opiate addictions to pursue a stable existence and life. Unlike other opiates, Methadone takes longer to metabolize in the body. This means users don’t experience withdrawal symptoms as fast. With longer periods between withdrawals and knowing that you’re receiving a constant dose, individuals can redirect their time towards more personally meaningful and beneficial activities rather than finding ways (sometimes criminal) to finance their drug use. The Methadone Maintenance Treatment (MMT) program has operated in BC since the 1990’s. Earlier this year, Methadone had some drastic changes. Previously, patients would attend a pharmacy daily to receive methadone – a powder solution mixed with a sweet drink (often Tang) by a pharmacist. The new medication (being offered in BC since February 2014) has be renamed Methadose – a cherry-flavoured premixed solution. Chemically, it is the same as its predecessor, but now is 10 times stronger than 1 mg/ml of Methadone. Methadose was developed to reduce the likelihood of abuse such as injecting it versus ingesting it orally. Methadose congeals underneath the skin or in the veins and can cause abscesses and discoloured, swollen arms. This change is similar to the transition from Oxycontin to OxyNEO. This new dosing system is also intended to prevent/reduce black market sales. According to a long-term user in Vancouver, pharmacists would dilute (add less methadone) in the old solutions they’d give to patients, then sell the rest. He, himself, admitted to buying methadone illegally from the back door of a pharmacy. One of the biggest concerns with this changeover to Methadose is the increased risk of overdose. For people who abuse methadone and don’t know about BC’s transition to a more potent solution may ingest a drug that is way stronger than they are aware of. People who have been regularly receiving diluted Methadone may also have an increased risk of overdose when they begin taking Methadose. Another major complaint that has arisen since Methadose’s arrival is it’s short life time. Long-time MMT participants have reported they felt withdrawal symptoms much faster than when they were on the original solution. Unable to get more Methadose in their prescription or return back to the original solution, many have reported to using heroin and other illegally purchased substances as a supplement between their Methadose times. This is the exact opposite of what the MMT’s original intention was when implemented (we hope anyways). Currently, BC’s Minister of Health said the province was looking into the effectiveness of Methadose after hearing the many concerns of long-term stable participants. Have you experienced a similar situation with the new Methadone? What have you done to address its shorter effects? We want to know. Alternatively, if this change has made you consider tapering off Methadone completely, contact us to discuss your options in BC, Alberta, Ontario, and the rest of Canada for Methadone detox and treatment. Resources Methadose and the Policy for Methadone Maintenance Treatment Methadose Drug Factsheet Changes...
Gender-Specific Treatment
Early Research Included Mostly Male Participants When research and studies on addiction began taking place, much of the research focused on male addiction. Men tended to have more substance dependency issues than women; a 5:1 ratio. That ratio then dropped down to 2.5:1. Addiction research on men, in the past, was often used to generalize female substance dependency problems. As a result, advocacy for female-specific treatment became prevalent in the 1990s and thereafter. Women & Men Experience Addiction Differently Women and men tend to experience addiction and recovery differently. Outside of biological sex, socioeconomic factors associated with male and female genders greatly influence addiction treatment. Both men and women face stigma for their addictions; women are particularly susceptible. Developing Addiction Research has shown drug and alcohol dependency is similar among both men and women: changes in brain chemicals and processes. In one study, both men and women with addictions showed reduced serotonin activity. Reduced Serotonin affects judgment, self-control, and emotional regulation. The development of men and women’s addiction is different. Women’s addictions are often associated with violence, sexual abuse, risky sexual behaviour, and unwanted pregnancies. Women tend to cite health and family problems as the reason for entering treatment, while men cite employment and legal concerns. Accessing Treatment Differences become even more apparent when men and women try to access treatment. Women commonly experience issues related to the caregiver role. They often delay treatment because of previous treatment failures, feelings of guilt and shame, fear of losing custody, feelings of helplessness, and the belief that change isn’t possible. Males often delay or avoid treatment based on masculine stigmas asserting men aren’t permitted to be weak or in need of help. In Treatment Because early research focused primarily on males, only minor changes were made to addiction treatment to include females. Because men tend to seek substance abuse treatment more than women, male cultural norms often dominated mixed gender programs. In group settings, male and female issues may conflict with one another. Women focus on issues such as unhealthy relationships, violence, sexual abuse, eating disorders, impaired sexual functioning and orientation, parenting, childcare and custody, physical health, appearance, and hygiene. Men usually discuss problems like father/son relationships, anger and aggression, emotional isolation, spiritual disconnection, and sexual issues. Why Mixed Gender Programs Then? You may be wondering why mixed gender addiction treatment programs continue to be provided if they continually lack effectiveness. Because early addictions research grouped men and women together, it became a longtime belief that they could be treated together. Some facilities do not have the resources to support separate male and female programs. With a desire to help both demographics, many facilities opt for mixed gendered programming. Catering to both men and women also provide facilities with a larger clientele pool than if they were to focus on just one sex. The Benefits of Gender-Specific Addiction Treatment Gender-specific addiction treatment has many benefits. For one, the separation allows individuals to address any issues specific to each gender. Males and females readily share more personal information in groups with peers of the same gender. Bonding behaviours are more noticeable, too. In mixed group settings, men and women may forego expressing issues in the presence of the opposite sex. Issues left unaddressed potentially magnify feelings of guilt, shame, and failure, which affect treatment outcomes. Single gender programs eliminate sexual distractions among clients. New relationships can be used to fill “voids” experienced during treatment and escape emotional distress. In gender-specific programs, safe and supportive environments provide ample time for individuals to focus on themselves and their recovery. Gender Affects Relapse Too The effect of gender on relapse also needs to be considered...
How Do I Choose The Best Treatment Facility
How do I Choose the Best Treatment Facility? Some Canadian treatment centers take part in a rigorous process of surveying, feedback, and quality improvement in order to maintain an accredited healthcare status. Accreditations and licensing can get confusing when you’re looking for addiction treatment, so we will try to make it easier to understand through this blog. There is a full spectrum of treatment options in Canada. They range from large-scale residential facilities with multiple locations to small sober living residences. Often, it is almost impossible to tell what kind of quality you’ll be receiving just through an online search. Government licensing used to be an accurate indicator of quality service, but is no longer dependable with financial cuts to many sectors such as healthcare. WHAT IS ACCREDITATION? Accreditation is a way of creating universal standards among businesses and sectors. Accreditation agencies demand best practices and standards for consistent, quality healthcare. There are several types of accrediting agencies as well. There are agencies that focus on certain sectors (such as healthcare for treatment centers) and then several agencies within each sector. Accreditation provides a framework for constant improvement. The good thing about the accrediting process is that it prevents organizations from just cleaning up every three years during inspection. A facility will only be successful if it’s constantly working towards better practices. In other words, facilities can’t put on a pretty face when accreditation time comes around. Accredited treatment facilities, because of the rigorous surveying process, will generally have high standards in medication, medical and nursing care, infection control, and staff credentials. While a non-accredited facility may not have a quality improvement program in place, accredited facilities are required to ask for, implement, and document feedback. A large healthcare facility treating substance use disorders that isn’t accredited should raise red flags. Even with the benefits of accreditation, there are some drawbacks and limitations. We note them below: PRICE DIFFERENCE Because accreditation isn’t free, accredited facilities will usuallyneed to charge more than equivalent non-accredited organizations. While there is a direct cost increase related to the cost of performing site surveys every three years, much of the higher costs comes from ensuring certain quality standards such as rigorous documentation and qualified staff credentials (e.g. more schooling and experience means more pay). BIAS & NO AUTHORITY While accrediting agencies require certain standards be adhered to, they don’t have the authority to shut down facilities with bad practices. In other words, they aren’t a healthcare licensor. In addition, because accreditation agencies are paid by the facility (as opposed to an outside governing body), it is in their best interest to keep working with organizations until they satisfy standards. Because there are so many agencies, accreditation is a competitive field that people can expect to find biases in. PROGRAM MODALITIES Accreditation will ensure that necessary credentials, proper medical care, and infection control are all in place in treatment facilities. It won’t, however, reflect certain programming and counselling/therapy approach used by a facility. So, if you think a program is good (or the right fit) just because it’s accredited, that may not be true. Regardless of the 12 steps or evidence-based models, accreditation simply means the best healthcare practices are being adhered to (or at least worked towards). SIZE Large accredited facilities will often only have 10% of its locations surveyed and choose which locations will be inspected. Thus, their “poorer quality” facilities receive better ratings even though no one has inspected them. EXCEPTIONS Not all non-accredited facilities indicate poor practices or quality. If an organization is too young (i.e. has only been open for...
Inpatient Vs Outpatient Treatment
Inpatient vs outpatient treatment: Which is right for me? The day you or a loved one decide to enteraddiction treatment can be both an exhilarating and terrifying one. Everything after today will change. Now that you’ve decided to go to treatment, which one will you go to? This may be a question you never considered, because, really, how many kinds of treatment are there? You may be surprised to hear, then, that there are an overwhelming number of different treatment types based on modalities, services available, and how their programs are delivered. So now you’re probably even more overwhelmed at the prospect of entering treatment since there are so many options to choose from. Don’t give up hope! This blog will help you in your search for suitable addiction treatment. Outpatient Treatment Outpatient treatment (which can include services like counseling, group therapy, and aftercare) is a type of treatment considered more intensive than peer-support groups and self-help meetings, but has less resources than inpatient – or residential – treatment centers. This type of treatment is usually offered 1-2x/week for 3 hours each session. Depending on the clients needs, the amount of sessions per individuals will vary. Sessions can be provided through individual and group formats. The most common type of outpatient treatment is publicly funded (i.e. at no charge to the client) and is generally offered in community-based facilities. Who is Outpatient Treatment Suitable for? These clinics generally share many similarities with residential treatment programs. The most visible difference between these programs is the environment and level of “freedom” available. The most obvious difference is that clients go home at the end of the day in outpatient clinics. There are many benefits and disadvantages (dependent on the person) to this program type: BENEFITS Can maintain routines and obligations during treatment Don’t need to take a leave from work Can maintain work and family responsibilities Can practise and implement skills learned in treatment right away Can receive continually in-person support from friends, family, and other support networks Can maintain privacy and anonymity more than if he or she were to attend an inpatient facility Able to utilize other support resources while in treatment (e.g. life coaching and peer-support meetings) Avoid potential challenges of reintegrating into daily life after time away at treatment DISADVANTAGES Not as safe and secluded away from former negative influences like in residential treatment Many opportunities that tempt cravings and challenge willpower Individuals whom contribute to the struggle of addiction are still continuously interacted with Clients in outpatient treatment require more diligence during off hours Distractions arising in everyday life may inhibit progress in treatment What about Inpatient Treatment? Inpatient – also known as residential – treatment programs are generally the program people envision when they think “drug rehab”. These can be publicly funded or private facilities. Residential treatment generally has more resources and services than in public and nonprofit facilities. BENEFITS More resources to treat issues and conditions alongside addiction (e.g. mental health or trauma) Private, safe environment away from distractions, drama, and challenges of home Healthy barrier between family and friends (if necessary) Most inpatient treatment programs also offer family/couples programs and counseling Develop close knit peer group 24 hour care for medical needs Detox services often available Ability to focus on physical and psychological healing that is not always easily achievable in outpatient settings Structured program to help clients stay on track DISADVANTAGES Clients will require time off work which may mean less privacy in getting treatment Private facilities (which are easier to attend) can be costly Transition between inpatient treatment and home can...
LGBTQ Addiction Treatment
In several studies ranging from 2000 to 2011, many LGBTQ individuals reported negative treatment experiences. Reports noted unsupportive staff, heterosexual attitudes, discomfort around peers, and anxiety when sharing personal details. As a result, many researchers have suggested gay and lesbian specific rehab programming. Such programs include typical addiction therapy for alcohol, drugs, and processes (gambling, sex, and food), but also address homosexual-specific issues like internal homophobia, sexual anxiety, self-acceptance, and rebuilding spirituality (shi h often involves counteracting past damage caused by organized religion). Bars and clubs are popular hangout spots for the LGBTQ community. While not a concern for everyone, individuals with substance use issues may begin to develop such problems in these places. Because of this, learning alternate ways to socialize during treatment will help individuals in social situations after treatment. There are only a handful of addiction treatment programs specifically for lesbian and gay individuals. Specialized programs like this can also be costly. As a result, the likelihood of attending gay or lesbian specific programming is low. Here’s the catch: manycan get the same benefits in the right ‘non-homosexual’ addiction treatment center. Why it’s Important to not Differentiate Because addiction and treatment is not black and white, it is important tonot classify and treat those with addictions all in the same way. Everyone has “baggage” and it’s all different. Some have severe mental health disorders, some have trauma and PTSD, some are gay and struggle with internalized homophobia, and some heterosexual individuals have sexual problems. Addiction treatment providers shouldfocus most of their attention towards addiction and related issues. Many gay individuals looking for treatment have no concerns regarding their sexuality; they need help with other issues like addiction and mental health. Sometimes, though, a person’s anxiety about their sexuality will be so prominent that they will feel more comfortable dealing with their issues in an environment with similar peers. This is when specialized treatment for LGBTQ communities is most beneficial. These types of programs definitely have their place in the addiction treatment field. The post LGBTQ Addiction Treatment appeared first on Canada Drug...
OxyNEO Drug Abuse
Prescription drug abuse is being seen more and more among all ages and demographics. Painkillers, or Opioids, like Oxycodone and Methadone are some of the most commonly misused prescriptions. These medications can become very addictive if not effectively monitored by both patient and physician. In the last few years, Canada has seen many changes to the popular painkiller, Oxycontin. Manufacturers changed Oxycontin’s formula shortly before their patent on the painkiller expired (which would allow generic copies to be produced). While Oxycontin was originally developed as a slow-release painkiller, it was quickly learned that snorting or injected it allowed users to experience the drug’s entire effect all at once. Oxycontin’s New Identity This change in formula made Oxycontin (renamed OxyNEO) harder to abuse. When a person tries to alter OxyNEO for snorting or injection, it forms into a gel and becomes too gummy for such purposes. This change has garnered both support and criticism. Advocates believe OxyNEO lowers levels of abuse and addiction in addition to reducing the risk of fatal respiratory relapse. Others believed it only translates into different problems elsewhere. Outcomes of OxyNEO One of the problems noticed shortly after OxyNEO’s debut was a spike in heroin use. With the inability to use OxyNEO in the same ways as its predecessor, many people turned to the next closest substance – heroin. Heroin is much cheaper and easier to access than prescription opioids. But because illicit substances like heroin are not regulated, users do not know how much heroin they’re ingested or if there are other substances cut in. The risk of overdose, serious health complications, and death are much higher among heroin users. People have also found ways to abuse OxyNEO. A quick search on google will show you how to remove the plastic coating responsible for creating its gummy consistency. Approaching Substance Use Differently Simply removing or changing a substance does not counteract substance abuse or addiction issues within a community. People struggling with substance dependency will find other ways to stimulate their experiences while using substances. Not only is the adoption of substances like Heroin more dangerous, but heroin’s withdrawal symptoms can also be life-threatening. It’s difficult to know what stance you should take on issues like this, especially when authorities are so divided on solutions for people with mental health and addictions. Who do you believe? How do you know who is right and wrong? The truth is you can’t be black-and-white about it. There were likely some people who went into recovery after Oxycontin was taken off the market, meaning that the change worked for some. Additionally, not everyone prescribed Oxycontin in the past developed a dependency to it or the other painkillers than have been around for years. For this reason, unique, individualized approaches to opioid addictions are more effective than simply wiping something off the shelf (alcohol prohibition in the United States is a good example of this). The post OxyNEO Drug Abuse appeared first on Canada Drug...
