Addiction2Recovery

It is not un-common for individuals who are in recovery to struggle going to  weddings, graduations, holidays or other events where there will be a lot of people and/or a lot of celebrating. It is a societal norm to have alcohol at these events and this can place the person in recovery into a very difficult situation.  In this episode, we will discuss what this may look and feel like to a person in recovery. We will also discuss tips and tricks for that individual to think about and plan for prior to the event in order to help mitigate triggers, cravings and/or lapses/relapses. This is also very important for close family and friends to be aware of as well so they can help support the person in recovery. 

[This also applies even if the person in recovery does not have an alcohol use disorder.]

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Kristi shares her story. What does addiction look like when you are a person who doesn't use drugs or alcohol but are married to someone who does?  Kristi has been with her husband for 19 years, married almost 16, and nearly all of it has been shadowed by his substance use disorders. She has supported him, loved him and has endured a lot of emotional pain because of him, but she has also stayed with him. In this episode, she will tell us how she coped, how she helped their daughter, what she would do differently now, and what her current life looks like with her husband in recovery! 

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In the last episode we discussed what an ACE score was and the correlation between ACE scores and the lasting effects on health, life potential and behaviors. As elevated ACE scores are a risk for substance use disorders, it is extremely important for all care team members to be aware of how best to care for patients with a trauma history. Trauma Informed Care (TIC) is a care-delivery model aimed at creating a safe, person-centered approach to caring for individuals with trauma. We will discuss the basic principles and tenets of TIC and how best to insititute them. 

Derefinko K, Addictive Behaviors. 2019. 96: 171-174 
Fineber S. Biol Psychiatry. 2017. 81(3): e19-e21, Machin A. Behaviour. 148(9/10). 2011: 985-1025 Thomas J. Dev Psychopathol. 2018 Aug;30(3):921-939. 

SAMHSA TIP Series 57. HHS Publication No. (SMA). 2014: 13-4801 

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Adverse Childhood Experiences (ACE) Scores highlight and 'score' the traumatic events people experience prior to turning 18. These traumatic events can have lasting impacts and lead to a multitude of adverse outcomes later in life. In this episode, we will discuss the origin of the ACE score, the questions that make up one's ACE score, as well as how one's ACE score can be a factor in the development of substance use disorder(s). Disclaimer: one's ACE score does not define you! 

Sources: Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey ACE Data. Atlanta, Georgia: US Department of Health and Human Services. 

Delisi, Stephen. Greater Risk: The Intersection of ACEs/Trauma and Substance Use Disorders. 

Felitti, VJ, et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American journal of preventive medicine, 14(4), 245–258. 

Herzog JI, Schmahl C. Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial, and Somatic Conditions Across the Lifespan. Front Psychiatry. 2018;9:420. Published 2018 Sep 4. doi:10.3389/fpsyt.2018.00420 

Merrick MT, Ports KA, Ford DC, Afifi TO, Gershoff ET, Grogan-Kaylor A. Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse Negl. 2017;69:10–19. doi:10.1016/j.chiabu.2017.03.016 

National Center for Injury Prevention and Control, Division of Violence Prevention, April 2, 2019 

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We are joined by Mike, a person in recovery from drug and alcohol abuse. Mike will discuss with us the different types of inpatient and outpatient treatments he has attended as well as the positives and negatives of the different types. We will discuss the things that made certain aspects of the treatments more helpful and impactful than others and what made his most recent treatment successful. We will end with a pilot program he is part of ATI (alternative to incarceration) and how this has been such a blessing. 

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We are joined, in this episode, by our first guests- Certified Peer Recovery Support Specialists (CPRS) Ryan and April. Not only will they share their personal recovery journeys, but they will also share how they got to the point of giving back and finding their career paths in supporting others in their own journeys. They will explain what a CPRS does as well as how they are different than an LADC, a social worker or even a sponsor.  Hopefully, after this episode, you will understand the [crucial] role of a CPRS in the care team for addiction treatment! 

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All family units become affected when one of its members develops a substance use disorder. Family dynamics, the type of family structure, if a family is 'open' or 'closed' more in nature, all factor in to how the family functions during active addiction as well as during early recovery. This family-based episode, the first of several, will explain different types of family dynamics as well as the different roles that family members may assume while one member is affected by the disease of addiction.

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People often ask why people with active substance use disorders ("addicts" to use inappropriate language) don't just stop using drugs- Afterall  ... you destroyed your marriage... you are in jail... you lost your job.., you have kids... you have nothing... 

If it was as easy and as simple as "just stop" we would not be in the middle of this epidemic. The War on Drugs tried this too and it resulted in jail populations that went up and drug use that, well, we are currently living in the time after the War on Drugs so that obviously didn't work. The "choice" (we will discuss 'choice' in this episode) to 'just be done' is far more complex as the pain of recovery itself is much more complex than one would assume. 

This episode, we hope, will at least broaden the listeners thoughts on this topic so as to better understand other perspectives. We are not defending addiction, we are simply reframing the ways in which one looks at the situation of "just stop."

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So what happened after 2009 with Josh and his opioid use? We will discuss the next several years and the progression of not only his opioid story but also the next decade and more of the greater opioid epidemic. The data, the trends and the manipulation used by many are all talked about on this episode. 

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Starting with a... (need to listen to hear this interesting tidbit)... Josh describes how he got his first opioid prescription, what it felt like, and how he managed to stay on them for 2 years. Unfortunately, his story is just one of thousands, he is just one of thousands, who was a direct victim of Purdue Pharma and the infamous "pain as the 5th vital sign". Dr. Heather will then explain the data and facts behind how this all 'happened' - ie. the story of the first wave of the opioid epidemic.

- Dr Portenoy: Pain, 1986 May 25 (2) 171-86
- Porter and Jick. New England Journal of Medicine 1980; 302:123
- Perry and Heidrich. Pain 1982; 13: 267-280
- Minnesota Board of Medical Practice controlled substance work group, November 10, 2007
- CDC. National Center for Health Statistics, Provisional 2017.

For questions, comments, episode recommendations or requests or to learn more, email us at: [email protected] 
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