Appearances and Disorder

Reflecting on four years of being part of The ColemanInstitute team, I recognize that, more than a job, what we do here is a calling.

Dr. Martin Seligman says, “Sociologists distinguish among a job, a career, and a calling. You do a job for the money, and when the money stops, you stop working. You pursue a career for the promotions, and when the promotions stop, topped out, you quit or become a time-serving husk. A calling, in contrast, is done for its own sake. You would do it anyway, with no pay and no promotions. “Try to stop me!” is what your heart cries when you are thwarted.”

That being said, I do have bills to pay, so I’m not in the position to do this on a volunteer basis, but what I know is that the people we serve are more than numbers, more than another notch on a belt, and we are deeply committed to helping them achieve recovery.

That’s why this week has been particularly tough.  I received a laminated memorial card with the beautiful smiling face of one of our beloved young patients who ultimately succumbed to heroin overdose. It was accompanied by a note from his mother thanking us for all we had done for her son.

We had known him clean and free of drugs for almost a year. He had been a challenging rascal and we all adored his spirit and his spunk. When he was clean, his gifts and talents radiated to the world and lit up everything in its path.

I read this passage this morning: “Satan is no principle, no elementary power, but a rebellious, fallen creature who frantically attempts to set up a kingdom of appearances and disorder.”

Regardless of my religious perspective, I do know that dwelling in the world of drugs is truly about ‘appearances and disorder’.  Through my work, I have come to see that things are not always what they seem.  It's not always cut and dry, black and white...a gifted, talented young man isn't bad because he had a drug addiction.  He was a beautiful human being flawed and disordered like the rest of us (if we're honest, that is) often feeling like a kitten but sometimes roaring like a lion!   

As I remember this fallen patient slain by his addiction, I am reminded that we are devoted to helping people thrive in their own reality.  Please don’t wait to call us before it’s too late.

Joan R. Shepherd, NP

“An ounce of prevention is worth a pound of cure” – Benjamin Franklin

Chris Newcomb, M.Div.

Alcohol and Drugs are kind of like a playground…fun in the beginning but deadly if you don’t respect it; which brings us to our topic this month: Relapse Prevention.  The big obsession of every addict is trying to control his/her addiction.  Upon an admission of powerlessness, recovery begins and sobriety is achieved. 

                Then for many addicts, unfortunately, relapse occurs.  Dreams are shattered.  Guilt is piled high like a skyscraper.  Anxiety returns with a vengeance.  The playground is no longer any fun.  And before you know it, the relapse process starts and it begins with your imagination.  Common thoughts include:  I wonder what it would feel like if I took just one sip/one pill/one shot, etc.?, Why can’t I use like “normal” people?  Why do I have to be boring and sober when everyone else is having fun?  What’s wrong with doing something that feels good once in a while? 

                If you want to stay clean and sober, then you must wrestle with the issue of relapse prevention.  Without this column becoming a vocabulary test, let’s take a look at the key terms to gain an understanding and plan to stay clean.  First, let’s look at the word ‘relapse’ to understand what it really is: Relapse (verb): To fall or slide back into a former state; to slip back into bad ways.  Second, let’s take a look at the root word of ‘prevention’: Prevent (verb): To keep from happening; to anticipate or counter in advance.  The first word connotes a descent backwards into self-destructive behavior while the second word implies anticipation, planning, and action.  Put together, then relapse prevention is all about anticipating, planning, and acting when the urge to reenter the self-destructive zone arises, as we know it will.  How, is the question?

                First, understand your triggers (bad feelings, physical fatigue, relationship issues, work, stress, etc.).  Second, plan to do something about them when they arise.  For example, call someone you trust who is sober, can listen without judgment, and encourage you to continue walking in sobriety.  Consider doing a hobby, physical exercise or other stimulating, healthy behaviors.  Third, help another addict.  Helping someone else always gets you out of your own head and changes your perspective.  Fourth, read recovery literature that can challenge your thinking.  Fifth, journal your feelings on a daily basis.  It is crucial to understand your feelings because many times addicts use because they don’t want to feel a bad feeling.  Finally, have fun!  The A.A. Big Book says, “we are not a glum lot” for a reason.  And remember, you never regret being sober the night before!

Tramadol (Ultram) – A New Safe Painkiller?

By 

Dr. Peter R. Coleman

When Tramadol was first approved a pain reliever, the drug company was happy to market it as a safe and non-addictive pain killer.  I was a little suspicious however, because the drug company reported that Tramadol worked on the same part of the brain (the mu opiate receptors) as Heroin and all of the other hard core, addictive narcotics.  And indeed, right from the early days, I started seeing patients who were prescribed this new “non-addictive” painkiller and they were becoming physically dependent on it.  It is still being prescribed by a lot of physicians, many of whom still think it is harmless and non-addictive.  Now we are seeing patients have a very difficult time coming off it – many patients have much worse detox symptoms than patients who are coming off of Heroin.

Last month, we had to detox a patient off very large doses of Tramadol.  He was taking about 40 pills per day – far more than the maximum of 8 pills per day, prescribed by most physicians.  It is quite surprising that he had not started having seizures, because many patients frequently have seizures if they take high doses of Tramadol.  I was very concerned about how difficult his detoxification would be coming off such high doses.  Over the years I have observed that most patients who are detoxing off Tramadol have a very difficult time.  I have seen many patients have such a difficult detoxification that they become confused, delirious, and even lose touch with all reality- they become psychotic.  I have been asked to consult on patients who have had this severe reaction.  One of the scariest things about these patients is that they can remain delirious for around 10 days.  Our patient did well.  We extended his detoxification to make it gentler on his body and we used high doses of medicines to calm his nervous system down.

The history of drug development and drug marketing has many examples of medicines, like Tramadol, that are introduced as safe and non-addictive drugs, only to find out later that they are very addictive and have serious side effects.  In the late 1800s, Sigmund Freud recommended using cocaine to help patients detoxify from Morphine - which had become quite a problem at that time.  Ironically, a short time later, physicians were recommending using Morphine to get off cocaine, which, by then, had also become a big problem!  Even Heroin was initially introduced as a safe cough medicine.  In the 1960s, Valium was introduced as a safe and non- addictive medicine for anxiety and insomnia, only to find out later that it was extremely addictive and withdrawal frequently included seizures and hallucinations.  A little later “non-addictive” Xanax (Alprazolam) was being recommended as a way to get people off Valium, and after that “non-addictive” Klonopin (Clonazepam) was being recommended as a way to get patients off Xanax!

In the world of opiates, there is a similar history of drugs being introduced as safer and non-addictive medicines, only to find out later that they are very addictive and sometimes even more difficult to detoxify off than the drug they are replacing. Darvocet was introduced and felt to be so safe that physicians were give large bottles of free samples to hand out to their patients.  Methadone was introduced as a safe alternative to heroin and other opiates.  Methadone is now used at clinics all over the country and is prescribed by many doctors as a chronic pain medicine.  I believe that Methadone has now become the number one cause of opiate overdoses in the country.  Recently Suboxone (Buprenorphine) was introduced and is being used as a substitute for other opiates.  When it was first released it was believed by many experts that Suboxone was not addictive and it would be easy for patients to stop taking.  As time has gone on, we are now aware that most patients have a very difficult time detoxifying off Suboxone.  Frequently, the withdrawal symptoms coming off Suboxone are more severe that withdrawal symptom coming off short acting opiates like OxyContin, Percocet and even Heroin.  The withdrawal symptoms coming off Suboxone go on and on, and unfortunately most patients revert back to taking their drug of choice.

So, while I applaud drug manufacturers for developing new treatments and medicines for patients, we have to be careful.  We have to recognize that some new drugs appear safe but they are not safe.  Addictive drugs all work in the same part of the brain – the Nucleus Accumbens and Ventral Tegmental area.  Addictive drugs (and alcohol) all release Dopamine in this area and it is the Dopamine that feels good and makes people want to take more of it.  If new drugs work in this same part of the brain, then they will almost certainly be addictive.  Physicians and patients both need to be careful before trying something new.

Got Obstacles?

 

"Stand up to obstacles...you'll find they haven't half the strength you think they have"

- Norman Vincent Peale

Got obstacles?  If you're human, I imagine that you either have a few now or have experienced a few in your past.  It is common to the human condition.  I can prove it in 5 letters.  T-A-X-E-S.  I rest my case!

This, of course, is not a political column.  It is about recovery from substance abuse.  Alcohol and drugs are MAJOR obstacles to people's quality of life (see: death).  That is why The Coleman Institute exists: we want to help people get clean (read: remove obstacles) and stay clean (read: keep obstacles away) from alcohol and drugs.

The reality is sometimes we all need a little help.  Obstacles don't have half the strength you think they have most of the time.  Sometimes, though, you have to fight the obstacle in a different way.   You stand up by giving in and asking for help.  You stand up by conceding defeat in your own power and lean on the power of others to help you do for yourself what you can not do by yourself. 

The truth is, at The Coleman Institute, we have been helping people get over their obstacle of addiction for the past 10 years.  Alcohol?  Heroin?  "Benzos" such as xanax or klonapin?  Our innovative naltrexone implant therapy can help you remove these obstacles safely, conveniently, and for an affordable price lower than other detox facilities.

You know you have an obstacle.  We know you have an obstacle.  It's ok to ask for help.  Let us help you help yourself.  Pick up the phone and call us today.  Together we will defeat the obstacle of addiction in your life.
Stand up!  

- Chris Newcomb, M.Div
The Coleman Institute
1.877.773.3869

We Will Help!!!

Are you caught in the cycle?  You want to stop, you swear you will and this time you mean it.  But you can’t.  You try, but once again the desire washes over you like a tsunami and you are carried up into it, into the endless circling craving that is opiate addiction.  Everyone wants to stop, eventually.  Everyone knows they are not on the right road, they see the signposts, they try to stop and they cannot.   Not on their own.  It is simply too hard.

Folks who have never experienced the hot sliver of addiction have no idea.  They think you should just stop taking the pills, because that is what they would do.  Remember:  they have no idea.  There are two types of people who know, and that’s it: those who have experienced the spiraling, never-ending pull of opiate addiction themselves, and those in the trenches, those whose compassionate souls have compelled them to work with addicts who are trying desperately to get clean.

The Coleman Institute has changed how detox is done.  The addiction to opiates is so powerful that many times detoxification fails.  The addict gets the craving and cannot fight it off or the withdrawal symptoms—anxiety, agitation, insomnia, nausea and vomiting—are just too much.  To successfully detox from opiate addiction, the brain needs time to heal.  It can’t be an all or nothing approach, because most people cannot endure that.

Instead, The Coleman Institute will get you off opiates in three days!  We will monitor your entire progress so you are not left alone wondering, searching or crying out for help.  We will administer drugs to your system that will alleviate the cravings and that will allow your brain to slowly come back to normal.  You won’t be suffering during the three days your body detoxes.  And when the three days are up, you will be ready to begin learning how to live again.  That’s what The Coleman Institute, with our Accelerated Opiate Detox program, does every day for everyday people such as you.  Give us a call.  We’re waiting to help!

Opportunities for Growth

Happy New Year!  I hope this article finds you happy and healthy.  If not, I hope you are taking steps to improve your situation where you able to do so.  One day at a time, you can change your life in awesome ways!

By now, about 40% of people who made New Year’s resolutions have already failed (read: the author)!  So many of them will give up and try again next year.  It is sad because many have great resolutions and lots of resolve and desire to succeed.  It is very frustrating now to have even made it out of January of the new year before failing to meet your goal for the year!

I have already failed at keeping my resolutions.  On the outside, it can look pretty sad as I write write this on January 5^th…not even a week into the year. So, in light of such disheartening news, I have two choices .  First, I can quit and give up since I demanded perfection and have failed miserably.  Thankfully, that is not the way I roll!

I believe that I have one choice and one choice only, namely, to get back on the horse.  Defeat is common when striving for a noble goal.  An ancient Chinese proverb says, “Fall down seven times, get up eight”.  How profound!   Falling down (i.e. failing)  is not  the issue; it’s whether we choose to get up again or stay prone in our self-pity.  What will you choose?

At The Coleman Institute, we believe that our innovative Naltrexone Therapy using Naltrexone Implants combined with our commitment to quality aftercare is just the solution for you or someone you know who is struggling with alcohol, opiate, or benzo  (i.e. Xanax, klonipin, etc.) addiction.  In addition, those who struggle with ‘maintenance’ drugs like suboxone and/or methadone can finally be free through our services.  Do you or someone you know need freedom this year?  

We are here to help provide you with an ‘opportunity for growth’  by helping you get clean through our convenient and comfortable detox so that you can stay clean and get back to living the life you want to live.  Please don’t let the negative voices of fear and failure convince you otherwise.  Hope whispers…one more try!   We are here for you…why don’t you seize the opportunity to grow and give us a call at 1.877.77.DETOX? 

Best Wishes in the New Year,

Chris Newcomb, M.Div.

Thoughts?

I had a rather desperate call from a patient who had recently completed an Accelerated Opiate Detox with us at The Coleman Institute.  Jean* works in the dental field. She is the mother of three young children.  Prior to completing her detox, she had been using opiates for several years; originally starting when her employer at the time prescribed hydrocodone for tooth pain.

As we hear frequently from our detox clients, her use went from being somewhat sporadic to more frequent, until one day she realized her low energy, sweats, irritability and upset stomach had everything to do with the fact she was out of the drug.

She called me over the long holiday weekend.  Although her naltrexone implant was only a week old, she said she was still having cravings when confronted by her ‘major trigger’. Her ‘major trigger’, it turns out, is being with her children and the chaos that is part of the package in normal, every-day, family life.

She wondered, “Isn’t there another kind of pill, or maybe a stronger version of naltrexone?”  It’s a great question, but the answer is pretty simply no.

I happened to be reading The Tao of Sobriety by David Gregson and Jay Efran, and was struck by this line:

        “Part of the ecstasy of detachment comes from being relieved of the burden of believing that you must always do something special or immediate about upsets, losses, or cravings. Let them be, and they just might let you be.”

The authors describe the progress of one of their clients who had stopped using heroin a few months earlier.  After doing pretty well for a few months, she found herself in a funk, with negative thoughts and strong emotions taking up residence in her brain with gusto.  She had been practicing diligently the lesson: “This Too, Shall Pass”.  The assignment consists mainly in noticing her responses to uncomfortable thoughts and emotions, and choosing not to act on them.  

At first, this was difficult.  Like most people, she was used to responding to every strong emotion or thought that entered her mind.  But persistent awareness allowed her to know with startling clarity—she was NOT compelled to react.

I think that is one of the greatest values for a person in early recovery is going to 90 meetings in 90 days, or to some kind of intensive therapy.  The message is reinforced over and over again: “you are a person who has thoughts; you are NOT your thoughts”.

Jean had not started therapy of any kind, so it’s easy to understand that all the demons she’d been running from by using opiates had grown to immense proportions.  After we talked, she intellectually understood what I was saying.  Her ecstasy will come when she puts it into practice!

*(Details are always changed enough to protect our patient’s privacy, unless they specifically ask for their story to be told.)

- Joan Shepherd , NP