opioid-abuse

The Prevalence of Substance Misuse and Addiction in Sports

Posted on by Christy Weeks

Jessica Joiner, LCSW, LAC, has over a decade of experience working with those suffering from addiction, complex trauma, and co-occurring disorders. She uses her experience along with the extensive skills gained to address the many issues that arise for athletes.

In her workshop hosted by Harmony Foundation, Joiner discussed the prevalence of substance misuse among athletes, various ways of identifying “red flags,” and evidence-based interventions that can be helpful in combating the misuse of drugs and alcohol.

As Joiner explained, there are three main reasons athletes misuse substances: pain resulting from injuries, stress from incessant pressure to win, and the desire to enhance performance artificially. Over the years and decades, these reasons have stayed the same but the drugs involved are now more sophisticated than ever, with more options.

The statistics paint a grim picture. Substance misuse is prevalent in high school: approximately 19 percent of males and 14 percent of females binge drink in high school. 21 percent of teens use marijuana and up to 6.6 percent have used performance-enhancing drugs (PEDs).

It gets worse in college where 42 percent of students admit to binge drinking, 28 percent use cannabis, and around 11,000 NCAA athletes admit to taking PEDs. There is a strong correlation between concussions and alcohol use. “Having a concussion is actually predictive for alcohol use,” said Joiner. “If a high school student is entering college with a history of concussion, and we know about the correlation, we could put some measure in place to intervene before things get out of control. We don’t want them to get overwhelmed by the pressure of performing and the grades required to continue.” It’s much better to support them on the front end before things get out of hand.

Should players get drafted into the National Football League, the pain from injuries, the pressure to win, and the temptation to use PEDs get even worse. In the NFL, 51 percent of players use opioids and 71 percent of those athletes admit to misusing them. Many of the pills are not prescribed by medical doctors: 68 percent say they got them from other sources.

It takes only a few days to get addicted to opioids, Joiner warned, and professional athletes have easy access. Professional athletes tend to play through the pain and then “fix it” with opioids and other substances after the game, putting themselves at risk for greater injury and addiction.

Joiner then went over the possible consequences of such risky behavior, which include the impact on performance, health, relationships, and career—and in the worst-case scenario, death.

While substances were initially taken to enhance or maintain performance, escalating use will eventually compromise performance and wreak havoc with the athlete’s health. As is the case for all people with substance use disorder, addiction has “a definite negative impact on relationships.” If there is no intervention and treatment, players may end up with legal problems, a league suspension, or just get kicked off their team.

There are many examples of athletes falling into this trap. Former Boston Celtic Chris Herren struggled with substance misuse for much of his NBA career. While playing for the Celtics, Herren started to use opioid painkillers. In December 2007, he was charged with possession of heroin in Rhode Island and in the following June, Herren overdosed on heroin in Fall River, Massachusetts. According to the attending paramedics, he was clinically dead for 30 seconds.

Abby Wambach—widely considered the best female soccer player ever—was arrested for driving under the influence in 2016. Following the incident, Wambach published an autobiography revealing that she had misused prescription drugs and alcohol for many years.

After going into recovery, Herren started raising awareness of drug addiction and has now spoken to over one million students, athletes, and community members, promoting frank discussions about substance use disorder and wellness.

In the webinar, Joiner, too, stressed the importance of prevention and early intervention to attack this problem. Prevention should include educating everybody involved to raise awareness of mental health issues that often drive substance misuse, so parents, teachers, and coaches learn to recognize red flags. “From the outside, it often looks like they have everything”, explained Joiner. That’s why depression and anxiety disorders are often overlooked. Testing, screening and other interventions should be used in a supportive, not punitive way.

“We should stop just being reactive and be more proactive,” Joiner said. Coaches and trainers of athletes should not wait for a crisis to unfold and athletic programs should provide adequate mental health services for players (and other students). Treatment should not be perceived as punishment for bad behavior but as a concerted effort to heal psychological problems. “We need effective collaboration between therapists, doctors, school departments, and the community that facilitates integrated care,” Joiner said. Currently, too many people fall through the cracks because many athletic departments don’t provide nearly enough mental health professionals. Ultimately, a culture shift is required: our society’s approach to athletic injuries and mental illness needs to change significantly and we need more trauma-informed and stigma-free care—and not only for athletes.

Harmony Fights Opioid Epidemic with HOPE

Posted on by Christy Weeks

More than two-thirds of drug overdose deaths in the United States in 2017 involved opioids, according to the Centers for Disease Control and Prevention, escalating an epidemic the CDC says “continues to worsen and evolve.” From 2016 to 2017, opioid-related overdose deaths increased 12 percent overall, surging among all age groups 15 and older.

The CDC report’s recommendations for curbing opioid-related overdose deaths include “increasing naloxone availability, expanding access to medication-assisted treatment, enhancing public health and public safety partnerships, and maximizing the ability of health systems to link persons to treatment and harm-reduction services.”

Naloxone is a medication often used by first responders because it can rapidly reverse opioid overdose. It is an opioid antagonist—it binds to opioid receptors and can reverse and block the effects of other opioids. It can quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain relievers.

Medication-assisted treatment (MAT) is used to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. Medications used for the treatment of opioid use disorder are buprenorphine (Suboxone, Subutex), methadone, and extended release naltrexone (Vivitrol). Some of these drugs are controversial in the recovery community because they are themselves opioids.

The National Institute on Drug Abuse, a US government research institute, clarifies that contrary to what some critics say, “methadone and buprenorphine DO NOT substitute one addiction for another. When someone is treated for an opioid addiction, the dosage of medication used does not get them high–it helps reduce opioid cravings and withdrawal. These medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.”

The use of these medications should always be combined with behavioral counseling with the ultimate aim of ceasing all substance misuse.

HOPE – Harmony’s Opioid Programming Experience

Harmony has provided all clients with medication-assisted treatment for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce cravings, and give the patient time to heal from the psychological, social, and spiritual wounds of addiction.

“It’s important to remember that MAT is only a small part of the picture,” says Harmony’s medical director Christopher Reveley. “That is why we call it ‘medication-assisted’ treatment, because by itself it is not the treatment. Used alone it has a low probability of being successful.”

At Harmony, HOPE begins with thorough medical and psychological evaluations. Collaboration with the patient, members of the interdisciplinary team and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly support groups led by a professional addiction counselor. These groups address the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid relapse. In this setting, clients support each other and are educated about the process of recovery.

Medication-assisted therapy may help stabilize the patient for these challenges in early recovery. “It gives people an opportunity to step out of the chaos of addiction and consider other ways of being,” says Dr. Reveley. “I never felt that buprenorphine was meant as a lifelong or even long-term solution.” Although there may be exceptions. It all depends on the individual needs of the patient. Reveley remembers a patient who had been on methadone for 46 years. “He tried to taper off a dozen times and relapsed to heroin use every single time. His family was initially very opposed to him being on methadone but eventually they told him ‘this is working, your life depends on it.’ So there are people on either end of the bell curve but in most cases buprenorphine is only a small but important part of the solution.”

Buprenorphine can be an important tool, especially in early recovery from opioid use disorder. The medication offers patients the opportunity to start living a “normal” life, far removed from the drug culture lifestyle they may have been immersed in while using heroin and other opioids. People are dying every day from opioid overdoses, especially in the age of the fentanyl scourge. Buprenorphine may provide the buffer that enables them to launch into sustained recovery. It is a buffer that can save people with addiction from a potentially lethal overdose.

Harmony has been treating addiction for 49 years and HOPE is now offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.

The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.

If you or someone you know is struggling with opioid use disorder and needs help, call Harmony at 970-432-8075 and one of our admissions specialists can discuss next steps.

Harmony Foundation Responds to the Opioid Epidemic with HOPE

Posted on by Christy Weeks

by Christopher Reveley, MD, and Annie Peters, PhD, LP

The Opioid Epidemic

According to the National Institute on Drug Abuse (NIDA), nearly 100 people die from opioid overdose in the United States every day, and 2.6 million Americans struggle with opioid addiction. The prescribing of opioid pain relievers became much more common in the late 1990s, and it soon became evident that these medications were powerfully addictive. Opioid overdose deaths have increased significantly in the years since. Many of those addicted to heroin started with the abuse of prescription opioids.

Overdose along with the spread of HIV, hepatitis C, and withdrawal syndromes in babies born to addicted mothers constitute a nationwide crisis that has overwhelmed the resources of state and local health care delivery services. Recently, the White House identified the opioid epidemic as a national public health emergency.

How is Harmony Responding to Opioid Epidemic?

Harmony Foundation in Estes Park, CO, has been treating addiction for 48 years and has fostered a generation of long-term recovery support for individuals and families. Harmony’s mission is to provide the foundation for sustained recovery from the diseases of drug and alcohol addiction. Harmony staff is committed to continuous improvement and closely monitors a client experience, treatment response, and the research literature on addiction treatment. In the field of opioid addiction research, advances in behavioral treatment, neurobiology, and brain imaging have given treatment programs guidance in developing better services. Harmony now offers HOPE – Harmony’s Opioid Programming Experience. HOPE is offered to all Harmony clients with opioid use disorders. The program involves enhanced medical, counseling, and case management services specifically tailored to meet these clients’ unique needs.

HOPE: Medical and Clinical Approaches

HOPE begins with thorough medical and psychological evaluations. Collaboration with the client, members of the interdisciplinary team and, when appropriate, family and referral sources, determine the most effective treatment plan. All HOPE clients are invited to participate in weekly Opiate Support Groups led by a professional addiction counselor. This group addresses the unique challenges of early opioid recovery, including uncomfortable physical and psychological symptoms, cravings, and strategies to avoid rapid relapse. In this setting, clients support each other and are educated about the process of recovery.

Harmony has provided all clients with medication-assisted treatment (MAT) for many years. This combination of education, counseling, and the use of medication in early recovery is part of the Harmony philosophy. HOPE expands MAT to include medications that alter the physical response to opioids, reduce craving, and give the individual time to heal from the psychological, social, and spiritual wounds of addiction.

HOPE clients may choose to avoid medications altogether or use only sleep and anxiety-reducing medications during the acute withdrawal period. For others, naltrexone, an opioid receptor blocker, can prevent the euphoria of opioid use and help control cravings, thereby changing the client’s drive to use illicit opioids after treatment.

Buprenorphine

This partial opioid agonist, administered in a tapering protocol, may be chosen by the treatment team and client to ease symptoms of severe opioid withdrawal during detoxification. On an individual basis, this medication may be continued during early recovery, most commonly for those with severe and persistent opioid addiction. Care following residential treatment may include ongoing buprenorphine to provide a craving-free foundation for the client as they rebuild damaged interpersonal and work relationships and regain physical and emotional health. The ultimate goal with all treatment approaches is complete abstinence from all opioids.

While some may question how an opioid medication (buprenorphine) can help someone recover from opioid addiction, this treatment approach is supported by organizations such as the World Health Organization, the American Society of Addiction Medicine, the Substance Abuse and Mental Health Services Administration, NIDA, the Veterans’ Administration, NAADAC – the Association for Addiction Professionals, and the National Association of Addiction Treatment Professionals. Due to the number and quality of research studies that have been completed on the use of buprenorphine in treating opioid use disorders, the level of evidence for the effectiveness of buprenorphine treatment is considered to be high (Thomas et al., 2014). Positive outcomes typically include improving retention in treatment and reducing illicit opioid use.

The Harmony care team works closely with clients who choose to include buprenorphine in their treatment strategy. This will typically involve full participation in HOPE and a recommendation for participation in Harmony’s Transitional Care Program (TCP), an intensive, 90 day intensive outpatient program coupled with monitored sober living and medication management by Harmony providers. When clinically indicated or to accommodate client preference, Harmony’s case managers may refer clients to other programs with similar services.

If you or someone you know is struggling with opiate addiction and needs help right away, Harmony is here to help. Call us at 866-686-7867 and one of our admissions specialists can discuss next steps.

References

https://www.drugabuse.gov/drugs-abuse/opioids/opioid-crisis

Center for Behavioral Health Statistics and Quality (CBHSQ), 2016. 2015 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Thomas, CP, Fullerton, CA, Montejano, L, Lyman, DR, Dougherty, RH, Daniels, HS, Ghose, SS, & Delphin-Rittmon, ME. Medication-assisted treatment with buprenorphine: Assessing the evidence. Psychiatric services, 65(2), 158-170.

Motivational Interviewing Combats Opioid Abuse

Posted on by Christy Weeks
motivational-interviewing

It is safe to say that prescription opioid addiction, like any substance with the potential for addiction, does not discriminate. The nation has seen opioids take the lives of thousands of people for over a decade, yet patients continue to be prescribed the drugs at unprecedented levels. Part of the problem is that pain needs to be managed, and the drugs that work best happen to be highly addictive. If misused, opioids like oxycodone or hydrocodone can be life threatening.

Unlike the typical stereotypes that often accompany heroin addiction, prescription opioid addicts are often: professionals, mothers, students, productive members of society. Addiction typically stems from an injury that required the use of painkillers. While most people can use a prescription opioid until the pain goes away, there is a large number people who become dependent on such drugs and what was once a method of pain management can quickly become an addiction.

Faced with a prescription opioid addiction epidemic, federal agencies and lawmakers have made it more difficult for prescription opioids to be acquired and abused. In turn, people dependent on the drugs have been forced to look to the street, many of which opt for heroin as a cheaper and stronger opioid.

The American Society of Addiction Medicine (ASAM) reports that prescription opioids:

  • Are abused by 1.9 million Americans.
  • Cause nearly two deaths every hour from overdose or respiratory depression.
  • Almost 75 percent of opioid addiction patients switch to heroin.

The nation’s opioid epidemic happens to coincide with the “Baby Boomers” meeting old age or on the cusp. Naturally, the generation is requiring more frequent medical attention, many of which require pain management. It is believed that more than half of patients being treated for chronic pain misuse their medication at some time, ScienceDaily reports. Fortunately, new research suggests that motivational interviewing (MI), a form of behavioral counseling developed to treat alcohol abuse, may be effective in fighting prescription opioid abuse among aging adults.

“Older adults are at high risk for complications resulting from prescription opioid misuse,” says Chang, PhD, RN, associate professor and interim associate dean for research and scholarship in the University of Buffalo School of Nursing. “As the baby boomer generation ages and more patients are prescribed opioids, abuse is likely to become an even greater problem.”

MI promotes a patient’s desire to change behaviors that may be problematic by:

  • Expressing empathy for what they are going through.
  • Using non-confrontational dialogue
  • Creating a divergence between actual and desired behavior.

Patients 50 years of age and older who had chronic pain and were rated at risk for opioid misuse were examined by researchers, according to the article. The participants underwent MI for one month with counselors, and later received a one month follow-up test. Participants reported an increase in confidence, self-efficacy and motivation to change behavior, and a decline in depression, anxiety and the intensity of chronic pain.

“The Effect of Motivational Interviewing on Prescription Opioid Adherence Among Older Adults With Chronic Pain,” was published in a recent issue of Perspectives in Psychiatric Care.

Doctors and Pharmacists Fight Against Addiction

Posted on by Christy Weeks
opioid-addiction

It’s no secret that doctors and pharmacists played a large role in the prescription opioid crisis that has been raging in the United States for over a decade. So it stands to reason that the doctors and pharmacists have a responsibility to help correct the problem.

In Massachusetts, a state which has witnessed firsthand the effects of the opioid crisis in America, U.S. Attorney General Loretta Lynch told a group of physicians and pharmacists that their assistance to law enforcement is crucial for curbing prescription opioid and heroin abuse, the Associated Press reports. U.S. Attorney Carmen Ortiz and Massachusetts Attorney General Maura Healey were also in attendance.

On Friday, at the Massachusetts Medical Society, Lynch credited the state’s medical community and commended the efforts of the Department of Justice in the fight against opioid abuse, according to the article. Lynch stated:

“I applaud you for leading a truly comprehensive campaign to reduce prescription drug abuse in the Commonwealth – and I want you to know that the Department of Justice and the entire Obama Administration, is standing with you in this fight. Through the tireless efforts of our Drug Enforcement Administration (DEA) – under the leadership of Acting Administrator [Chuck] Rosenberg – we are making major strides on all four of the action areas identified in the White House Prescription Drug Abuse Prevention Plan, which President Obama discussed in his weekly address just a few days ago: enforcement, disposal, monitoring and education.”

Lynch also spoke on the value of safely disposing of unused or unwanted prescription narcotics. She points out that opioid addiction often originated inside the family medicine cabinet.

“We also know, as you do, that opioid addiction often begins not with a law-breaking doctor, but with a family medicine cabinet. That’s why we are working to ensure that unused, unwanted and expired medications are responsibly discarded and taken out of circulation. In the last five years, the DEA has held ten National Take Back Days – most recently this past Saturday – when the public is encouraged to bring excess prescription drugs to thousands of designated sites across the country for safe and secure disposal.”

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If you are or a loved one is abusing opioids, please contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.

Addiction and recovery news provided by Harmony Foundation.

Prescription Drug Overdose Deaths Rise in 26 States

Posted on by Christy Weeks

In a number of states, especially the ones hardest hit by prescription opioid abuse, drastic measure have been taken to curb the problem. While such efforts have shown promise, such as prescription drug monitoring programs and greater access to naloxone, many states are still seeing a rise in overdose deaths. New research suggests that the number of drug overdose deaths rose in 26 states between 2009 and 2013, Reuters reports. Only six states saw a decrease in overdose deaths during the same time period.

The study was conducted by the nonprofit group Trust for America’s Health and the Robert Wood Johnson Foundation. Their findings indicated that an estimated 44,000 Americans died from drug overdoses in 2013, a figure which is more than double the number found in 1999. Drug overdoses were responsible for more deaths in 36 states than motor vehicle-related deaths, according to the article.

In 2013, almost 52 percent of overdose deaths were related to prescription drugs. The two types of prescription drugs that were linked to the majority of overdoses were opioid painkillers and benzodiazepine anti-anxiety medications, such as OxyContin ® (oxycodone) and Xanax ® (alprazolam). The study found that more than 16,000 deaths were related to opioids and almost 7,000 were tied to benzodiazepines and sleep medications.

The report clearly shows the need for more access and training to the life saving overdose reversal drug naloxone, sold under the brand name Narcan ®. There are 34 states and D.C. which have laws in place to expand access to, and use of, naloxone, according to the study. 

Prescription Drug Abuse Treatment 

If you are currently struggling with prescription drugs, and are need of help, please do not hesitate to contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.
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Addiction and recovery news provided by Harmony Foundation

Opioid Abuse on the Rise in Colorado

Posted on by Christy Weeks

A recent survey from SAMHSA suggests that opioid abuse is on the rise in Western states including Colorado.

About 5 years ago, painkiller addiction reigned in Southern and Appalachian states. The abuse of opiates like OxyContin was well known as “hillbilly heroin” from the high percentage of southerners abusing it. But today states like Colorado, Oregon, Washington and Idaho have among the highest rates of opioid abuse.

For example, according to SAMHSA, as many as 6.5% of Oregon residents abuse opioids and deaths from overdoses climbed 172% between 2004 and 2011. Southern states like Kentucky have seen a reduction in painkiller abuse at 4.5% ranking it at 31 in 2011 compared to 6 in 2009. Many attribute this to policies that were enacted following statistics of opioid abuse. When the statistics were high in the South, there were several efforts made to curb abuse such as creating state task forces to crack down on prescribing privileges of physicians and the enforcement of harsher penalties for illegal possession and using false prescriptions.

The growing rate of opiate abuse in the West is attributed to a greater supply of prescription painkillers from drug trafficking rings and lenient prescribing rights for doctors who operate “pill mills” with limited restrictions. Recent articles have covered incidences of doctors in Nevada and Southern California who are recklessly prescribing large quantities of oxycodone.

The drugs are then transported to neighboring states like Colorado – a state that has seen its fair share of prescription drug overdoses and is working to curb them. For example, Colorado addiction treatment centers have stepped up their specialized programs for those addicted to opioids and the Colorado School of Public Health has created an online course to train prescribers statewide. The course gives healthcare providers guidelines on pain management. According to Alfred Gilchrist, the CEO of the Colorado Medical Society, “The goal of this private-public initiative is to help improve practice, address the epidemic of opioid prescription-associated health problems and improve care.” The course includes training on assessing risk for addiction, using the Prescription Drug Monitoring Program (PDMP) to stop those who engage in “doctor shopping” and other risk reduction practices.

If you or a loved one is struggling with opioid addiction and are seeking addiction treatment for painkillers, Harmony Colorado has affordable addiction treatment programs for men and women suffering from prescription addiction.